POUDRE VALLEY HEALTH CARE INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: POUDRE VALLEY HEALTH CARE INC (EIN 84-1262971)
Tax period: 2016-07-01 to 2017-06-30
Filed: 2018-05-14
IRS object ID: 201801349349310035
Schema version: 2016v3.0
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule K
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-05-14T18:03:18-05:00	ReturnTs
Tax Period End	2017-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	461497033	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	EKS&H LLLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	8181 E TUFTS AVENUE SUITE 600	AddressLine1Txt
City	DENVER	CityNm
State Abbreviation	CO	StateAbbreviationCd
ZIP	802372579	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	841262971	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	POUDRE VALLEY HEALTH CARE INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	POUD	BusinessNameControlTxt
Phone	9702377000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2315 E HARMONY ROAD NO 200	AddressLine1Txt
City	FORT COLLINS	CityNm
State Abbreviation	CO	StateAbbreviationCd
ZIP	80528	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	STEPHANIE DOUGHTY	PersonNm
Person Title	CHIEF FINANCIAL OFFICER	PersonTitleTxt
Phone	9702377000	PhoneNum
Signature	2018-05-11	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	DORI J EGGETT	PreparerPersonNm
PTIN	P00645252	PTIN
Phone	3037409400	PhoneNum

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	KEVIN UNGER	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2315 E HARMONY RD 200	AddressLine1Txt
City	FT COLLINS	CityNm
State Abbreviation	CO	StateAbbreviationCd
ZIP	80528	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$1,201,899,581	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.UCHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1994	FormationYr
Legal Domicile State	CO	LegalDomicileStateCd
Activity Or Mission	WE IMPROVE LIVES THROUGH LEARNING, HEALING, DISCOVERY, AND THROUGH HUMAN CONNECTION.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	4544	TotalEmployeeCnt
Total Volunteers	540	TotalVolunteersCnt
Total Gross UBI	$7,136,847	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$6,141,000	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,749,929	PYContributionsGrantsAmt
CY Contributions Grants	$2,840,052	CYContributionsGrantsAmt
PY Program Service Revenue	$497,070,556	PYProgramServiceRevenueAmt
CY Program Service Revenue	$577,191,100	CYProgramServiceRevenueAmt
PY Investment Income	$34,325,141	PYInvestmentIncomeAmt
CY Investment Income	$22,577,481	CYInvestmentIncomeAmt
PY Other Revenue	$12,353,000	PYOtherRevenueAmt
CY Other Revenue	$12,670,163	CYOtherRevenueAmt
PY Total Revenue	$545,498,626	PYTotalRevenueAmt
CY Total Revenue	$615,278,796	CYTotalRevenueAmt
PY Grants And Similar Paid	$33,530,461	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$41,334,657	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$204,165,832	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$216,412,492	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$232,570,715	PYOtherExpensesAmt
CY Other Expenses	$259,555,547	CYOtherExpensesAmt
PY Total Expenses	$470,267,008	PYTotalExpensesAmt
CY Total Expenses	$517,302,696	CYTotalExpensesAmt
PY Revenues Less Expenses	$75,231,618	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$97,976,100	CYRevenuesLessExpensesAmt
Total Assets BOY	$3,847,835,066	TotalAssetsBOYAmt
Total Assets EOY	$4,835,353,781	TotalAssetsEOYAmt
Total Liabilities BOY	$2,784,126,390	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$3,498,192,542	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$1,063,708,676	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,337,161,239	NetAssetsOrFundBalancesEOYAmt
Mission	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.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$471,507,387	ExpenseAmt
Grant	$41,334,657	GrantAmt
Revenue	$577,191,100	RevenueAmt
Desc	POUDRE VALLEY HEALTH CARE INC. (PVHC) PROVIDES TERTIARY, ACUTE, INPATIENT, OUTPATIENT AS WELL AS EMERGENCY CARE. PVHC SERVICES COMMUNITIES IN NORTHERN COLORADO, SOUTHWESTERN NEBRASKA, AND SOUTHEASTERN WYOMING. DURING FISCAL YEAR 2017, PVHC RECORDED 57,037 PATIENT DAYS, 15,744 ADMISSIONS, 282,182 OUTPATIENT VISITS, 64,736 EMERGENCY VISITS, 2,098 DELIVERIES, 4,129 INPATIENT SURGERIES, AND 5,707 OUTPATIENT SURGERIES.	Desc
Total Program Service Expenses	$471,507,387	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	Yes (1)	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	212	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	4544	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	STEPHANIE DOUGHTY	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	9702377000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2315 E HARMONY ROAD SUITE 200	AddressLine1Txt
City	FORT COLLINS	CityNm
State Abbreviation	CO	StateAbbreviationCd
ZIP	80528	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
MIKE DELLENBACH
BOARD CHAIR	1.00	2.00	Yes (X)	Yes (X)	$0	$0	$0
CHRIS OSBORN
VICE BOARD CHAIR	1.00	2.00	Yes (X)	Yes (X)	$0	$0	$0
CHRISTINE CHIN
PAST BOARD CHAIR	1.00	2.00	Yes (X)		$0	$0	$0
LISA CLAY
BOARD MEMBER	1.00	2.00	Yes (X)		$0	$0	$0
DOUG ERION
BOARD MEMBER	1.00	2.00	Yes (X)		$0	$0	$0
TESS HEFFERNAN
BOARD MEMBER	1.00	2.00	Yes (X)		$0	$0	$0
DENNIS HOUSKA
BOARD MEMBER	1.00	2.00	Yes (X)		$0	$0	$0
JIM PARKE
BOARD MEMBER	1.00	2.00	Yes (X)		$0	$0	$0
JAMES SPROWELL MD
BOARD MEMBER	1.00	2.00	Yes (X)		$0	$0	$0
DAN STROH
BOARD MEMBER	1.00	2.00	Yes (X)		$0	$0	$0
KEVIN UNGER
PRESIDENT/CEO	25.00	26.00	Yes (X)	Yes (X)	$626,478	$626,478	$115,260
STEPHANIE DOUGHTY
CFO	25.00	26.00		Yes (X)	$305,967	$305,967	$62,905
DR STANLEY GUNSTREAM
VP CHIEF QUALITY OFFICER	25.00	25.00			$228,092	$228,092	$54,497	Yes (X)
DONNA PODUSKA
CNO	50.00				$263,226	$0	$36,903	Yes (X)
MARILYN SCHOCK
COO	25.00	25.00			$192,754	$192,754	$44,581	Yes (X)
DR JOSEPH GOTTFRIED
PSYCHIATRIST	50.00				$256,422	$0	$48,653		Yes (X)
DR HERMANN MORENO
PSYCHIATRIST	50.00				$263,898	$0	$47,365		Yes (X)
DR DAVID SEHR
PSYCHIATRIST	50.00				$260,523	$0	$49,005		Yes (X)
KENNETH WATANABE
PSYCHIATRIST	50.00				$296,809	$0	$49,500		Yes (X)
DR JANELL WOZNIAK
CLINICAL DIRECTOR	50.00				$291,661	$0	$41,896		Yes (X)
RUSSELL WOOLEY
VP OPERATIONS, FORMER	0.00				$97,265	$97,265	$27,347			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$3,083,095	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,450,556	TotReportableCompRltdOrgAmt
Total Other Compensation	$577,912	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	158	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
UNIVERSAL PROTECTION SERVICE
PO BOX 31001-2374	PASADENA	CA	91110	SECURITY	$3,035,330
NORTHERN COLORADO HOSPITALISTS
2121 E HARMONY RD 300	FT COLLINS	CO	80528	MEDICAL	$2,237,528
FORT COLLINS WOMEN'S CLINIC
1107 S LEMAY AVE 300	FT COLLINS	CO	80524	MEDICAL	$1,955,965
SUMMIT PATHOLOGY
5802 WRIGHT DR	LOVELAND	CO	80538	MEDICAL	$1,851,456
ARUP LABRORATORIES
PO BOX 27964	SALT LAKE CITY	UT	84127	MEDICAL	$1,465,912

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	42	CntrctRcvdGreaterThan100KCnt
Related Organizations	$1,344,348	RelatedOrganizationsAmt
Government Grants	$1,177,462	GovernmentGrantsAmt
All Other Contributions	$318,242	AllOtherContributionsAmt
Noncash Contributions	$1,060,184	NoncashContributionsAmt
Total Contributions	$2,840,052	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SVC REV	900099	$584,462,621	$584,462,621
PROVIDER FEE INCOME	621400	$22,991,257	$22,991,257
DIETARY SVC INCOME	900099	$2,161,245		$2,161,245
JOINT VENTURE	621400	-$32,547,012	-$32,859,744		$312,732

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$122,989	TotalRevenueColumnAmt
Related Or Exempt Func Income	$107,936	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$15,053	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$577,191,100	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$15,288,622	TotalRevenueColumnAmt
Exclusion	$15,288,622	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$945,951	TotalRevenueColumnAmt
Exclusion	$945,951	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$10,797,733	RealAmt
Personal	$1,603,452	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$2,198,835	RealAmt
Personal	$1,603,452	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$8,598,898	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,598,898	TotalRevenueColumnAmt
Unrelated Business Revenue	$6,809,062	UnrelatedBusinessRevenueAmt
Exclusion	$1,789,836	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$588,962,280	SecuritiesAmt
Other	$72,733	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$582,244,792	SecuritiesAmt
Other	$447,313	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$6,717,488	SecuritiesAmt
Other	-$374,580	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,342,908	TotalRevenueColumnAmt
Exclusion	$6,342,908	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$389,195	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$126,393	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$262,802	TotalRevenueColumnAmt
Exclusion	$262,802	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
MISCELLANEOUS REVENUE	621400	$2,478,566	$2,478,566	$0
EHR REVENUE	624100	$933,401	$933,401
INCOME TAX REFUND	624100	$396,496		$396,496

Field	Value	IRS element (for citing)
Other Revenue Total	$3,808,463	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$615,278,796	TotalRevenueColumnAmt
Related Or Exempt Func Income	$578,114,037	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$7,136,847	UnrelatedBusinessRevenueAmt
Exclusion	$27,187,860	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$41,334,657	TotalAmt
Program Services	$41,334,657	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,746,148	TotalAmt
Program Services	$721,777	ProgramServicesAmt
Management And General	$1,024,371	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$165,695,661	TotalAmt
Program Services	$152,990,631	ProgramServicesAmt
Management And General	$12,705,030	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$27,649,967	TotalAmt
Program Services	$25,382,806	ProgramServicesAmt
Management And General	$2,267,161	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$19,157,448	TotalAmt
Program Services	$17,586,632	ProgramServicesAmt
Management And General	$1,570,816	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,163,268	TotalAmt
Program Services	$1,985,891	ProgramServicesAmt
Management And General	$177,377	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$41,805	TotalAmt
Management And General	$41,805	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$72,156	TotalAmt
Program Services	$1,305	ProgramServicesAmt
Management And General	$70,851	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$41,744	TotalAmt
Management And General	$41,744	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$2,181,150	TotalAmt
Management And General	$2,181,150	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$26,516,593	TotalAmt
Program Services	$10,859,416	ProgramServicesAmt
Management And General	$15,657,177	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$3,209,178	TotalAmt
Program Services	$3,132,272	ProgramServicesAmt
Management And General	$76,906	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,889,479	TotalAmt
Program Services	$4,514,442	ProgramServicesAmt
Management And General	$375,037	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$9,164,638	TotalAmt
Program Services	$8,229,907	ProgramServicesAmt
Management And General	$934,731	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$3,198,644	TotalAmt
Program Services	$2,583,912	ProgramServicesAmt
Management And General	$614,732	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,024,082	TotalAmt
Program Services	$786,420	ProgramServicesAmt
Management And General	$237,662	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$712,805	TotalAmt
Program Services	$640,456	ProgramServicesAmt
Management And General	$72,349	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$7,465,458	TotalAmt
Program Services	$7,465,458	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$23,522,024	TotalAmt
Program Services	$22,336,307	ProgramServicesAmt
Management And General	$1,185,717	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$2,285,392	TotalAmt
Program Services	$138,171	ProgramServicesAmt
Management And General	$2,147,221	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$118,591,931	$118,235,207	$356,724
UBI TAXES	$2,155,911		$2,155,911
PROVIDER FEE EXPENSE	$23,301,078	$23,301,078
BAD DEBT	$18,171,497	$18,171,497

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$13,009,982	TotalAmt
Program Services	$11,109,145	ProgramServicesAmt
Management And General	$1,900,837	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$517,302,696	TotalAmt
Program Services	$471,507,387	ProgramServicesAmt
Management And General	$45,795,309	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$25,306,411	BOYAmt
EOY	$101,680,312	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,729,412	BOYAmt
EOY	$1,910,410	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$54,166,356	BOYAmt
EOY	$59,387,946	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$44,554	BOYAmt
EOY	$44,807	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$8,574,425	BOYAmt
EOY	$9,500,542	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$5,914,506	BOYAmt
EOY	$7,126,559	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$669,913,042	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$360,277,831	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$295,390,465	BOYAmt
EOY	$309,635,211	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$909,389,700	BOYAmt
EOY	$1,039,103,384	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$26,544,710	BOYAmt
EOY	$26,424,622	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$2,520,774,527	BOYAmt
EOY	$3,280,539,988	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,847,835,066	BOYAmt
EOY	$4,835,353,781	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$84,155,664	BOYAmt
EOY	$85,287,624	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$615,274	BOYAmt
EOY	$1,494,757	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$204,394,246	BOYAmt
EOY	$196,985,054	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$21,127,201	BOYAmt
EOY	$19,705,807	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$78,767	BOYAmt
EOY	$85,807	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,473,755,238	BOYAmt
EOY	$3,194,633,493	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,784,126,390	BOYAmt
EOY	$3,498,192,542	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,063,708,676	BOYAmt
EOY	$1,337,161,239	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,063,708,676	BOYAmt
EOY	$1,337,161,239	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,847,835,066	BOYAmt
EOY	$4,835,353,781	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$97,976,100	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$86,282,154	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$89,194,309	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	Yes (1)	DirectContactLegislatorsInd
Direct Contact Legislators	$41,744	DirectContactLegislatorsAmt
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	0	OtherActivitiesInd
Total Lobbying Expenditures	$41,744	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	PORTION OF DUES FROM MEMBERSHIP IN CHA AND AHA THAT ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$11,854,028	BeginningYearBalanceAmt
Contributions	$3,821,556	ContributionsAmt
Investment Earnings Or Losses	$845,737	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$1,407,171	GrantsOrScholarshipsAmt
Other Expenditures	$1,817,159	OtherExpendituresAmt
End Year Balance	$13,296,991	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$11,242,112	BeginningYearBalanceAmt
Contributions	$3,051,448	ContributionsAmt
Investment Earnings Or Losses	$73,951	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$720,479	GrantsOrScholarshipsAmt
Other Expenditures	$1,793,004	OtherExpendituresAmt
End Year Balance	$11,854,028	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$11,287,236	BeginningYearBalanceAmt
Contributions	$2,977,196	ContributionsAmt
Investment Earnings Or Losses	$98,459	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$1,595,156	GrantsOrScholarshipsAmt
Other Expenditures	$1,525,623	OtherExpendituresAmt
End Year Balance	$11,242,112	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$10,692,037	BeginningYearBalanceAmt
Contributions	$4,841,525	ContributionsAmt
Investment Earnings Or Losses	$985,793	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$3,756,845	GrantsOrScholarshipsAmt
Other Expenditures	$1,455,274	OtherExpendituresAmt
End Year Balance	$11,287,236	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$8,938,992	BeginningYearBalanceAmt
Contributions	$2,680,308	ContributionsAmt
Investment Earnings Or Losses	$520,466	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$565,964	GrantsOrScholarshipsAmt
Other Expenditures	$881,765	OtherExpendituresAmt
End Year Balance	$10,692,037	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.48540	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.51460	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	Yes (1)	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$58,703,442	OtherCostOrOtherBasisAmt
Book Value	$58,703,442	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$281,390,646	OtherCostOrOtherBasisAmt
Depreciation	$119,396,566	DepreciationAmt
Book Value	$161,994,080	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$97,481,548	OtherCostOrOtherBasisAmt
Depreciation	$71,528,107	DepreciationAmt
Book Value	$25,953,441	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$179,683,699	OtherCostOrOtherBasisAmt
Depreciation	$126,180,852	DepreciationAmt
Book Value	$53,502,847	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$52,653,707	OtherCostOrOtherBasisAmt
Depreciation	$43,172,306	DepreciationAmt
Book Value	$9,481,401	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$309,635,211	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
INTERCOMPANY RECEIVABLE	$3,265,071,272
DEFERRED DEBT ISSUANCE COSTS	$2,704,534
OTHER RECEIVABLES	$5,035,104
DEFERRED PENSION OUTFLOW COSTS	$7,729,078

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$3,280,539,988	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
INTERCOMPANY PAYABLES	$3,179,131,660
ACCRUED INTEREST PAYABLE	$1,840,529
OTHER DEFERRED EXPENSES	$2,401,503
PENSION LIABILITIES	$11,259,801

Field	Value	IRS element (for citing)
Total Liability	$3,194,633,493	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$720,937,395	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$86,282,154	NetUnrealizedGainsInvstAmt
Other Revenue	$3,928,680	OtherRevenueAmt
Revenue Not Reported	$90,210,834	RevenueNotReportedAmt
Revenue Subtotal	$630,726,561	RevenueSubtotalAmt
Investment Expenses Not Incld	$2,181,150	InvestmentExpensesNotIncldAmt
Other Revenues Not Included	-$17,628,915	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	-$15,447,765	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$615,278,796	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$500,170,395	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$3,928,680	OtherExpensesIncludedAmt
Expenses Not Reported	$3,928,680	ExpensesNotReportedAmt
Expenses Subtotal	$496,241,715	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$2,181,150	InvestmentExpensesNotIncld2Amt
Other Expenses Not Included	$18,879,831	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$21,060,981	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$517,302,696	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 POUDRE VALLEY HEALTH SYSTEM FOUNDATION.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	RENTAL EXPENSE INCLUDED IN EXPENSE ON AFS 3,802,287. COGS REPORTED AS EXPENSE ON AFS 126,393.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	PROVISION FOR BAD DEBT IN AFS INCOME 18,171,497. CONTRIBUTIONS FROM PV FOUNDATION NOT IN AFS INCOME 284,164. RENTAL EXP AS INCOME ON 990 12,621. PHARMACY SALES INCLUDED IN EXPENSE ON AFS 15,053. INCOME TAX REFUND REDUCED EXPENSES ON AFS 396,496. BOOK VS. TAX ADJUSTMENT IN EQUITY EARNINGS -36,508,746.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	RENTAL EXPENSE INCLUDED IN EXPENSE ON AFS 3,802,287. COGS REPORTED AS EXPENSE ON AFS 126,393.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	PROVISION FOR BAD DEBT IN AFS INCOME 18,171,497. RENTAL EXP AS INCOME ON 990 12,621. PHARMACY SALES INCLUDED IN EXPENSE ON AFS 15,053. CASH CONTRIBUTIONS FROM FOUNDATION NOT IN AFS REVENUE 284,164. INCOME TAX REFUND REDUCED EXPENSES ON AFS 396,496.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	250.000000000000	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	0	FinancialAssistanceBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$306,024	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$306,024	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$72,824,993	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$62,900,187	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,924,806	NetCommunityBenefitExpnsAmt
Total Expense	0.02000	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,332,007	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$18,436,727	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,895,280	NetCommunityBenefitExpnsAmt
Total Expense	0.00580	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$94,463,024	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$81,336,914	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$13,126,110	NetCommunityBenefitExpnsAmt
Total Expense	0.02640	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,135,424	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$224,321	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,911,103	NetCommunityBenefitExpnsAmt
Total Expense	0.00590	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,907,150	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$784,502	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,122,648	NetCommunityBenefitExpnsAmt
Total Expense	0.01030	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,508,294	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,819,870	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,688,424	NetCommunityBenefitExpnsAmt
Total Expense	0.00540	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$158,200	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$111,966	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$46,234	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$40,784,787	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$40,784,787	NetCommunityBenefitExpnsAmt
Total Expense	0.08210	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$58,493,855	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,940,659	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$51,553,196	NetCommunityBenefitExpnsAmt
Total Expense	0.10380	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$152,956,879	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$88,277,573	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$64,679,306	NetCommunityBenefitExpnsAmt
Total Expense	0.13020	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$147,113	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$147,113	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$820	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$820	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$210,342	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$210,342	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$358,275	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$358,275	NetCommunityBenefitExpnsAmt
Total Expense	0.00070	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$20,768,786	BadDebtExpenseAmt
Reimbursed By Medicare	$162,736,134	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$236,645,729	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$73,909,595	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (8 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 HARMONY SURGERY CENTER LLC
AMBULATORY SURGERY	0.50000	0.50000
2 PEAK SURGICAL MANAGEMENT
MANAGEMENT SERVICES	0.14000	0.86000
3 HARMONY IMAGING CENTER LLC
MEDICAL IMAGING	0.46000	0.54000
4 SURGERY CENTER OF FORT COLLINS
AMBULATORY SURGERY	0.26000	0.49000
5 GATEWAY MEDICAL SERVICES
REAL ESTATE/MEDICAL EQUIPMENT	0.50000	0.50000
6 EYE AND LASER CENTER OF NORTHERN COLO LLC
LASER SURGERY	0.50000	0.50000
7 VEIN AND LASER CENTER OF N COLO
LASER SURGERY	0.33000	0.67000
8 PVHS-ICM EHW LLC
MEDICAL CLINIC	0.50000	0.50000

Field	Value	IRS element (for citing)
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	POUDRE VALLEY HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1024 S LEMAY	AddressLine1Txt
City	FORT COLLINS	CityNm
State Abbreviation	CO	StateAbbreviationCd
ZIP	80524	ZIPCd

Field	Value	IRS element (for citing)
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Research Facility	Yes (X)	ResearchFacilityInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Other	PHARMACY, LAB, CARDIOVASCULAR	OtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	POUDRE VALLEY HEALTH CARE	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	250.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare	Yes (X)	LookBackMedicareInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
POUDRE VALLEY HEALTH CARE	PART V, SECTION B, LINE 5: TWO COMMUNITY MEETINGS WERE HELD DURING NOVEMBER 2015 WHERE FINDINGS FROM THE CHNA WERE PRESENTED, QUESTIONS AND COMMENTS WERE RECEIVED AND RESPONSES PROVIDED. PARTICIPANTS IDENTIFIED ADDITIONAL HEALTH ISSUES AND PROVIDED FEEDBACK AS TO HOW THE HOSPITALS MIGHT ADDRESS THEM. ATTENDEES REPRESENTED ORGANIZATIONS SERVING LOW-INCOME, UNINSURED AND MINORITY POPULATIONS. A LIST OF THE ORGANIZATIONS REPRESENTED IS INCLUDED AS AN APPENDIX TO THE CHNA REPORT. THE SECOND MEETING INCLUDED MEMBERS OF A COALITION SERVING LOW-INCOME, HISPANIC INDIVIDUALS. THE SYNOPSIS OF INFORMATION GATHERED DURING THESE MEETINGS IS INCLUDED IN AN APPENDIX OF THE 2016 CHNA REPORT.
POUDRE VALLEY HEALTH CARE	PART V, SECTION B, LINE 6A: MEDICAL CENTER OF THE ROCKIES ALSO PARTICIPATED IN THE 2016 CHNA. THE GEOGRAPHIC SERVICE AREA FOR BOTH POUDRE VALLEY HOSPITAL & MEDICAL CENTER OF THE ROCKIES IS THE SAME.
POUDRE VALLEY HEALTH CARE	PART V, SECTION B, LINE 6B: CENTENNIAL HIGH SCHOOL HEALTH CENTER POUDRE SCHOOL DISTRICT - WELLNESS TEAM THOMPSON SCHOOL DISTRICT TEAM WELLNESS & PREVENTION LUTHERAN FAMILY SERVICES THE MATTHEWS HOUSE CITY OF FORT COLLINS - HOUSING AUTHORITY FAMILY CENTER/LA FAMILIA HEALTH DISTRICT OF NORTHERN LARIMER COUNTY HOUSE OF NEIGHBORLY SERVICES LARIMER COUNTY FOOD BANK LARIMER COUNTY DEPARTMENT OF HEALTH AND ENVIRONMENT SALUD FAMILY HEALTH CENTER-FORT COLLINS SUMMITSTONE BEHAVIORAL HEALTH THE CENTER FOR FAMILY OUTREACH VIDA SANA COALITION COLUMBINE HEALTH SYSTEM DEMENTIA FRIENDLY COMMUNITY PARTNERSHIP FOR AGE-FRIENDLY COMMUNITIES SHARING THE CARE CAMPAIGN UCHEALTH - COMMUNITY HEALTH IMPROVEMENT UNITED WAY OF LARIMER COUNTY WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT PART V, SECTION B, LINE 7A:HTTPS://WWW.UCHEALTH.ORG/PAGES/ABOUT-UCHEALTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.ASPXPART V, SECTION B, LINE 10A:HTTPS://WWW.UCHEALTH.ORG/WP-CONTENT/UPLOADS/2016/11/COMHEA-COMMUNITYHEALTHNEEDSASSESSMENT-NORTH-INTERACTIVE.PDF
POUDRE VALLEY HEALTH CARE	PART V, SECTION B, LINE 11: HEALTH NEED - ACCESS TO CARE FOR OLDER ADULTS, MINORITY AND LOW-INCOME INDIVIDUALS: BOTH POUDRE VALLEY HOSPITAL AND MEDICAL CENTER OF THE ROCKIES PROVIDE A NO-COST COMMUNITY PARAMEDIC HOME BASED SERVICE WHICH PROVIDES CLINICAL REVIEW OF CHRONIC CONDITIONS TO HOME-BOUND OR FRAIL INDIVIDUALS. BOTH HOSPITALS ALSO PROVIDE AN RN HOME VISIT PROGRAM, SERVING MEDICAID-ELIGIBLE WOMEN WITH POST-PARTUM NEWBORN ASSESSMENTS AND LIMITED CASE MANAGEMENT SERVICES. COMMUNITY CASE MANAGEMENT NURSES PROVIDE NO-COST IN-HOME SERVICES TO PERSONS NEEDING ASSISTANCE IN MANAGING CHRONIC DISEASE. HEALTH NEED - CARDIOVASCULAR DISEASE PREVENTION AND CONTROL: BOTH HOSPITALS SUPPORT A SCHOOL-BASED HEART DISEASE SCREENING AND EDUCATION PROGRAM FOR ELEMENTARY, MIDDLE AND HIGH SCHOOL-AGED YOUTH; CHRONIC DISEASE SELF-MANAGEMENT PROGRAMS PROVIDE COUNSELING AND ACHIEVE INCREASED SELF-EFFICACY BY PARTICIPANTS TO MANAGE THEIR CONDITION; COMMUNITY HEALTH WORKER MODEL PROVIDES NO-COST, COMMUNITY-BASED HEART DISEASE ASSESSMENT AND REFERRAL TO SCREENING SERVICES TO LOW-INCOME, OLDER ADULT AND/OR MINORITY POPULATIONS. HEALTH NEED - SUICIDE PREVENTION / SUBSTANCE ABUSE PREVENTION & TREATMENT: PLANNING TEAM FORMED TO DEVELOP METHODS TO IMPLEMENT EVIDENCE-BASED ZERO SUICIDE INITIATIVE AT BOTH HOSPITALS RESULTING IN ADDITIONAL STAFF RECRUITED TO TRAIN NON-BEHAVIORAL STAFF ON SUICIDE PREVENTION AND ALSO FOR BEHAVIORAL HEALTH PREVENTIVE SERVICES; SEVERAL NO-COST CARE COORDINATION INITIATIVES WORK TO REMOVE BARRIERS TO BEHAVIORAL HEALTH CARE FOR VULNERABLE POPULATIONS (E.G. CHILDREN IN FOSTER CARE OR AT RISK FOR REMOVAL FROM BIOLOGICAL HOME / LOW-INCOME, MEDICAID-ELIGIBLE COMMUNITY MEMBERS) BY ENROLLING INDIVIDUALS INTO A PATIENT-CENTERED MEDICAL HOME, ENSURING TIMELY ACCESS TO BEHAVIORAL HEALTH SERVICES, REMOVING TRANSPORTATION OR CHILD-CARE BARRIERS, ETC. FULL DESCRIPTION OF ALL INITIATIVES IS INCUDED IN THE IMPLEMENTATION STRATEGY REPORT ATTACHED. 2017 PROGRESS REPORT ALSO ATTACHED.PART V, LINE 16A, FAP WEBSITE:HTTPS://WWW.UCHEALTHBILLPAY.ORG/PAYMENTOPTIONS.ASPX?TABID=4PART V, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.UCHEALTHBILLPAY.ORG/PAYMENTOPTIONS.ASPX?TABID=4PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.UCHEALTHBILLPAY.ORG/PAYMENTOPTIONS.ASPX?TABID=4

Field	Value	IRS element (for citing)
Facility	70	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (70 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt	Address Line2USAddress/AddressLine2Txt
1 - HARMONY CAMPUS MOB
2121 E HARMONY RD	FORT COLLINS	CO	80528	PHYSICIAN OFFICES, ONCOLOGY, HCOR, CANCER CENTER,NCPC, SSOR, RHEUMATOLOGY
2 - HARMONY CAMPUS AMBULATORY CARE CENTER
2127 E HARMONY RD	FORT COLLINS	CO	80528	SURGERY CENTER, DIAGNOSTIC CENTER, IMAGING, URGENT CARE
3 - UCHEALTH HARMONY EMERGENCY
4630 SNOW MESA DRIVE	FORT COLLINS	CO	80528	HARMONY ED
4 - UCHEALTH-LONGMONT
1925 MOUNTAIN VIEW AVE	LONGMONT	CO	80501	PHYSICIAN OFFICES
5 - UCHEALTH PHYSICIAN CLINICS
1400 E BOULDER STREET	COLORADO SPRINGS	CO	80909	PHYSICIAN OFFICES
6 - MCR NORTH MOB
2500 ROCKY MTN AVE	LOVELAND	CO	80538	PHYSICIAN OFFICES, ONCOLOGY, SSOR, OHS
7 - UCHEALTH GREELEY MEDICAL CLINIC
1900 16TH STREET	GREELEY	CO	80631	PHYSICIAN OFFICES, LAB, RADIOLOGY & ONCOLOGY, URGENT CARE
8 - UCHEALTH BRIARGATE
4110 BRIARGATE PARKWAY	COLORADO SPRINGS	CO	80920	PHYSICIAN OFFICES
9 - UCHEALTH PEAKVIEW MEDICAL CENTER
5881 W 16TH STREET	GREELEY	CO	80634	PHYSICIAN OFFICES, LAB & RADIOLOGY
10 - MCR SOUTH MOB
2500 ROCKY MTN AVE	LOVELAND	CO	80538	PHYSICIAN OFFICES, HCOR, CARDIAC REHAB, SLEEP LAB, BRAIN & SPINE
11 - UCHEALTH PENNOCK PLACE
1025 PENNOCK PLACE	FORT COLLINS	CO	80524	PHYSICIAN OFFICES (FMC), BLOOD BANK
12 - UCHEALTH CHEYENNE MEDICAL SPECIALISTS
5050 POWDERHOUSE RD	CHEYENNE	WY	82009	PHYSICIAN OFFICES, NEUROLOGY, OHS, GI
13 - UCHEALTH REDSTONE
2315 E HARMONY RD	FORT COLLINS	CO	80528	PHYSICIAN OFFICE, UROLOGY, NEUROLOGY
14 - UCHEALTH PRINTERS PARK
175 S UNION BLVD	COLORADO SPRINGS	CO	80910	PHYSICIAN OFFICES
15 - UCHEALTH SNOW MESA
4674 SNOW MESA DRIVE	FORT COLLINS	CO	80528	PHYSICIAN OFFICES, OHS
16 - UCHEALTH WESTBRIDGE
1107 S LEMAY	FORT COLLINS	CO	80524	PHYSICIAN OFFICES, SLEEP LAB, WEE STEPS
17 - UCHEALTH MEMORIAL NEUROSCIENCES
1725 BOULDER STREET SUITE 101	COLORADO SPRINGS	CO	80909	PHYSICIAN OFFICES
18 - UCHEALTH-FIRESTONE
660 FIRESTONE BLVD	FIRESTONE	CO	80504	PHYSICIAN OFFICES NEW BUILDING
19 - UCHEALTH PROSPECT MEDICAL PLAZA
1106 E PROSPECT SUITE 100	FORT COLLINS	CO	80524	PHYSICIAN OFFICES, OUTPATIENT REHAB, INT MEDICINE, ENDOCRINOLOGY
20 - CENTRE AVE HEALTH AND REHAB-JV
915 CENTRE AVE	FORT COLLINS	CO	80526	REHAB
21 - UCHEALTH URGENT CARE CIRCLE SQUARE
2767 JANITELL ROAD	COLORADO SPRINGS	CO	80906	PHYSICIAN OFFICES
22 - MOUNTAIN CREST BEHAVIORAL HEALTH
4601 CORBETT DR	FORT COLLINS	CO	80528	BEHAVIORAL HEALTH
23 - UCHEALTH URGENT CARE POWERS
4323 INTEGRITY CENTER POINT	COLORADO SPRINGS	CO	80917	PHYSICIAN OFFICES
24 - UCHEALTH WINDSOR MEDICAL CENTER
1455 MAIN STREET	WINDSOR	CO	80550	PHYSICIAN OFFICES, RADIOLOGY, LAB
25 - UCHEALTH OB-GYN CLINIC
1715 61ST AVENUE	GREELEY	CO	80631	PHYSICIAN OFFICES, OB-GYN
26 - SURGERY CENTER OF FT COLLINS-JV
1100 E PROSPECT RD	FORT COLLINS	CO	80524	SURGERY CENTER
27 - UCHEALTH PHYSICIAN CLINICS
525 N FOOTE AVE SUITE 302	COLORADO SPRINGS	CO	80910	PHYSICIAN OFFICES
28 - UROLOGY CENTER OF THE ROCKIES
3520 E 15TH STREET	LOVELAND	CO	80538	PHYSICIAN OFFICES, UROLOGY
29 - UCHEALTH PRIMARY AND URGENT CARE
131 STANLEY DR	ESTES PARK	CO	80517	PHYSICIAN OFFICES
30 - UCHEALTH EXPRESS LAB
1025 GARFIELD ST SUITE C	FORT COLLINS	CO	80524	EXPRESS LAB, THERAPEUTIC ENDOSCOP
31 - UCHEALTH CHILDREN'S THERAPY
1500 S LEMAY	FORT COLLINS	CO	80526	THERAPY
32 - UCHEALTH NORTH SPRINGS FAMILY MEDICINE &
8540 SCARBOROUGH DRIVE	COLORADO SPRINGS	CO	80920	PHYSICIAN OFFICES
33 - UCHEALTH PRIMARY CARE AT BRIARGATE
8890 N UNION BLVD SUITE 100B	COLORADO SPRINGS	CO	80920	PHYSICIAN OFFICES
34 - UCHEALTH RANGEVIEW
2695 ROCKY MOUNTAIN AVE 200	LOVELAND	CO	80538	NEUROLOGY
35 - UCHEALTH PRIMARY CARE
2975 GINNALA DRIVE	LOVELAND	CO	80538	PHYSICIAN OFFICES
36 - UCHEALTH OCCUPATIONAL MEDICINE CLINIC- G
1035 GARDEN OF THE GODS 120	COLORADO SPRINGS	CO	80907	OCC HEALTH
37 - UCHEALTH PRIMARY CARE - FRONT RANGE
5265 N ACADEMY BLVD SUITE 1800	COLORADO SPRINGS	CO	80918	PHYSICIAN OFFICES
38 - UCHEALTH PRIMARY CARE - ROCKRIMMON
6615 DELMONICO DRIVE	COLORADO SPRINGS	CO	80919	PHYSICIAN OFFICES
39 - UCHEALTH URGENT CARE VOYAGER PARKWAY
13445 VOYAGER PARKWAY	COLORADO SPRINGS	CO	80921	PHYSICIAN OFFICES
40 - UCHEALTH SCOTTSBLUFF
2 W 42ND ST 2200	SCOTTSBLUFF	NE	69361	PHYSICIAN OFFICES
41 - UCHEALTH PRIMARY CARE-STERLING
620 IRIS DRIVE	STERLING	CO	80751	PHYSICIAN OFFICES
42 - UCHEALTH NORTH LOVELAND
3830 N GRANT AVE	LOVELAND	CO	80538	PHYSICIAN OFFICES
43 - COLUMBINE POUDRE HOMECARE-JV
915 CENTRE AVE	FORT COLLINS	CO	80526	HOME HEALTHCARE
44 - UCHEALTH WEST LOVELAND
3850 N GRANT AVE	LOVELAND	CO	80538	URGENT CARE
45 - WALK IN CLINIC
2211 S COLLEGE AVE	FORT COLLINS	CO	80525	WALK IN CLINIC
46 - UCHEALTH SUNFLOWER FAMILY MEDICINE
1730 N CORONA STREET	COLORADO SPRINGS	CO	80907	PHYSICIAN OFFICES
47 - UCHEALTH WATER VALLEY
1870 MARINA PLAZA DRIVE	WINDSOR	CO	80550	OUTPATIENT REHAB, CLINICAL EDUCATION, MED FITNESS CENTER
48 - THE VEIN AND LASER CENTER-JV
2008 CARIBOU DRIVE	FORT COLLINS	CO	80525	PHYSICIAN OFFICES
49 - UCHEALTH PRIMARY CARE-MONUMENT
15854 JACKSON CREEK PARKWAY SUITE	MONUMENT	CO	80132	PHYSICIAN OFFICES	120
50 - UCHEALTH FORT MORGAN
1000 LINCOLN STREET 207	FORT MORGAN	CO	80701	PHYSICIAN OFFICES
51 - EYE LASER CENTER OF N COLORADO-JV
1725 EAST PROSPECT RD	FORT COLLINS	CO	80525	PHYSICIAN OFFICES
52 - UCHEALTH URGENT CARE THORNTON
13631 COLORADO BLVD	THORNTON	CO	80602	PHYSICIAN OFFICES
53 - UCHEALTH FALCON MEDICAL CENTER
11605 MERIDIAN MARKET VIEW 184	FALCON	CO	80831	PHYSICIAN OFFICES, OCC HEALTH, PRIMARY CARE
54 - UCHEALTH STEELE STREET
311 STEELE STREET	DENVER	CO	80206	PHYSICIAN OFFICES
55 - UCHEALTH - LARAIME
3116 WILLET DRIVE	LARAMIE	WY	82070	PHYSICIAN OFFICES
56 - UCHEALTH STEAMBOAT
940 CENTRAL PARK DR 290	STEAMBOAT SPRINGS	CO	80487	PHYSICIAN OFFICES
57 - UCHEALTH ESTES PARK
555 PROSPECT AVE	ESTES PARK	CO	80517	PHYSICIAN OFFICES
58 - UCHEALTH SIDNEY
1625 DORWART DRIVE	SIDNEY	NE	69162	PHYSICIAN OFFICES
59 - UCHEALTH HEART AND VASCULAR CRAIG
595 RUSSELL STREET	CRAIG	CO	81625	PHYSICIAN OFFICES
60 - UCHEALTH CASTLE ROCK
4404 BARRANCA LANE 101	CASTLE ROCK	CO	80104	PHYSICIAN OFFICES
61 - UCHEALTH CANCER CARE AND HEMATOLOGY CLIN
910 S MAIN ST	YUMA	CO	80759	PHYSICIAN OFFICES
62 - UCHEALTH CARDIOLOGY BRIDGEPORT
1313 S STREET	BRIDGEPORT	NE	69336	PHYSICIAN OFFICES
63 - UCHEALTH CV SURGERY
2030 MOUNTAIN VIEW AVE 540	LONGMONT	CO	80501	PHYSICIAN OFFICES
64 - UCHEALTH CANCER CARE AND HEMATOLOGY CLIN
1017 W 7TH STREET	WRAY	CO	80758	PHYSICIAN OFFICES
65 - UCHEALTH CANCER CARE AND HEMATOLOGY CLIN
1101 E JOHNSON ST	HOLYOKE	CO	80734	PHYSICIAN OFFICES
66 - PHLEBOTOMY STATION
1107 SOUTH LEMAY AVE	FORT COLLINS	CO	80526	LAB DRAWS
67 - PHLEBOTOMY STATION
1113 OAKRIDGE DRIVE	FORT COLLINS	CO	80525	LAB DRAWS
68 - PHLEBOTOMY STATION
2001 S SHIELDS	FORT COLLINS	CO	80526	LAB DRAWS
69 - PHLEBOTOMY STATION
2025 BIG HORN DRIVE	FORT COLLINS	CO	80525	LAB DRAWS
70 - PHLEBOTOMY STATION
3519 RICHMOND DRIVE	FORT COLLINS	CO	80526	LAB DRAWS

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 7:	THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINE 7B AND 7C. THE COST-TO-CHARGE RATIO 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, LINE 7G:	INCLUDES PHYSICIAN GROUPS AS A SUBSIDIZED SERVICE. THESE CLINICS PROVIDE SERVICES IN UNDERSERVED AREAS IN COLORADO, NEBRASKA AND WYOMING.
PART I, LN 7 COL(F):	TOTAL BAD DEBT EXPENSE REMOVED FROM THE DENOMINATOR PRIOR TO THE PERCENTAGE CALCULATION = $20,768,786
PART II, COMMUNITY BUILDING ACTIVITIES:	AS MENTIONED UNDER PROMOTION OF COMMUNITY HEALTH WE HAVE A MULTITUDE OF PROGRAMS DESIGNED TO ADDRESS THE HEALTH OF OUR COMMUNITY INVOLVING ALL AGE GROUPS AND FOCUS ON WHAT AN INDIVIDUAL CAN DO TO IMPROVE HIS/HER HEALTH. MANY OF THE PROGRAMS REFLECTED IN PART II ARE DESIGNED TO PROMOTE HEALTHY OPTIONS AND CHOICES FOR OUR COMMUNITY WHICH IS AN IMPORTANT PART OF OVERALL COMMUNITY HEALTH AND THEREFORE A BENEFIT TO THE COMMUNITY.PART III, LINE 2: ACCOUNTS WITH UNRESOLVED PATIENT LIABILITY AFTER REASONABLE COLLECTION EFFORTS, SET BY POLICY AND IN CONJUNCTION 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 COLLECTION ACTIVITIES.
PART III, LINE 4:	PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF ALLOWANCES FOR DOUBTFUL ACCOUNTS, CONTRACTUAL ADJUSTMENTS, AND MEDICALLY INDIGENT ALLOWANCES.PART III, LINE 5: MEDICARE REVENUE WAS COMPUTED AS FOLLOWS:PVHC COST REPORT: 113,642,637CENTER AVE COST REPORT: 2,994,041COLUMBINE HOMECARE COST REPORT: 1,230,507PVHC DISALLOWED PROGRAMS: 976,909JOINT VENTURES: 43,892,040TOTAL TO LINE 5: 162,736,134PART III, LINE 6: ALLOWABLE COSTS AS REPORTED ON THE POUDRE VALLEY HEALTH CARE INC. 2016 COST REPORT AGGREGATED WITH DISREGARDED ENTITIES AND OWNERSHIP PORTIONS OF JOINT VENTURES. PART III, LINE 6: MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENTS WAS COMPUTED AS FOLLOWS:PVHC COST REPORT: 152,864,931CENTRE AVE COST REPORT: 5,655,301COLUMBINE HOMECARE COST REPORT: 1,593,970PVHC DISALLOWED PROGRAMS: 1,390,516JOINT VENTURES: 75,141,011TOTAL TO LINE 6: 236,645,729
PART III, LINE 8:	APPROXIMATELY 26.4% 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:	PATIENT PROVIDES DOCUMENTATION BASED ON FINANCIAL ASSISTANCE POLICY GUIDELINES, REVIEWED BY FINANCIAL COUNSELING TEAM. UPON APPROVAL OR DENIAL OF THE REQUEST FOR CHARITABLE AID FROM THE FAC TEAM, THE PATIENT WILL BE ADVISED OF THE DECISION. THE BILL IS PARTIALLY OR TOTALLY ADJUSTED AS APPROVED BY THE FAC TEAM, NO FURTHER COLLECTION PROCESS WITH THE PATIENT. FOR ANY PORTION NOT ADJUSTED OFF, THE PROPER SEQUENCE OF ATTEMPTS TO COLLECT ARE FOLLOWED. FINAL ASSIGNMENT OF THE BILL IS TO A COLLECTION AGENCY.
PART VI, LINE 2:	HEALTH CARE NEEDS ARE ADDITIONALLY IDENTIFIED THROUGH COLLABORATIVE RELATIONSHIPS WITH HEALTHCARE PROVIDERS IN THE COMMUNITIES WE SERVE. AN EXAMPLE IS OUR CARE COORDINATION INITIATIVE TARGETED TO AT-RISK CHILDREN WITH SPECIAL HEALTHCARE NEEDS . PHYSICIANS IDENTIFIED THE NEED TO IMPROVE THE COORDINATION AND TIMELINESS OF CARE FOR THIS POPULATION; WE RESPONDED BY DEVELOPING AND STAFFING A CARE COORDINATION / PATIENT NAVIGATION SERVICE MODEL (HEALTHY HARBORS).
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. FOR THOSE THAT ARE UNINSURED, OUR CONDITIONS OF SERVICE FORM HAS A SPOT THEY INITIAL STATING THAT WE HAVE OFFERED ASSISTANCE AND MADE THEM AWARE OF PROGRAMS AVAILABLE TO THEM. 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.
PART VI, LINE 4:	POUDRE VALLEY HOSPITAL IS A LOCALLY OWNED, PRIVATE, NON-PROFIT ORGANIZATION WITH A STRONG VISION: FROM HEALTHCARE TO HEALTH.BASED IN NORTHERN COLORADO, PVH 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.PVH 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 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 DOLLARS TO OTHER ENTITIES THAT WORK TO IMPROVE THE HEALTH OF OUR COMMUNITY. EXAMPLES ARE: TEEN PREGNANCY PREVENTION EDUCATION; SUBSTANCE ABUSE PREVENTION EDUCATION FOR YOUTH AND YOUNG ADULTS; OBESITY PREVENTION; IMPROVED FOOD SECURITY FOR LOW INCOME RESIDENTS; 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

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (23 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
ALLIANCE FOR SUICIDE PREVENTION
1100 POUDRE RIVER DRIVE SUITE B	FORT COLLINS	CO	80525	841194619	501(C )(3)	$5,200	SEE SCH I, PART IV
AMERICAN CANCER SOCIETY
8221 W 20TH STREET	GREELEY	CO	80634	131788491	501(C )(3)	$33,000	SEE SCH I, PART IV
BOOK TRUST
789 SHERMAN STREET SUITE 300A	DENVER	CO	80203	204124164	501(C )(3)	$9,050	SEE SCH I, PART IV
BOY SCOUTS OF AMERICA - LONGS PEAK COUNCIL
1900 16TH STREET	GREELEY	CO	80631	840253710	501(C )(3)	$7,000	SEE SCH I, PART IV
CITY OF FORT COLLINS
PO BOX 580	FORT COLLINS	CO	80522	846000587	GOVERNMENT	$12,000	SEE SCH I, PART IV
COLO NONPROFIT DEVELOPMENT CENTER
789 SHERMAN STREET SUITE 250	DENVER	CO	80203	841493585	501(C )(3)	$20,000	SEE SCH I, PART IV
DOWNTOWN BUSINESS ASSOCIATION
19 OLD TOWN SQUARE 230	FORT COLLINS	CO	80524	840535419	501(C )(3)	$10,000	SEE SCH I, PART IV
FOOD BANK OF LARIMER COUNTY
1301 BLUE SPRUCE DRIVE	FORT COLLINS	CO	80524	742336171	501(C )(3)	$9,000	SEE SCH I, PART IV
GREELEY PHILHARMONIC ORCHESTRA
PO BOX 1535	GREELEY	CO	80632	846031376	501(C )(3)	$82,900	SEE SCH I, PART IV
HEALTH CENTER FOUNDATION
645 OSAGE STREET	SIDNEY	NE	69162	470686476	501(C )(3)	$6,000	SEE SCH I, PART IV
HOPE LIVES
2629 REDWING ROAD 260	FORT COLLINS	CO	80526	841595472	501(C )(3)	$5,400	SEE SCH I, PART IV
IVINSON MEMORIAL HOSPITAL FOUNDATION
255 NORTH 30TH STREET	LARAMIE	WY	82072	836000188	501(C )(3)	$9,500	SEE SCH I, PART IV
LARIMER COUNTY PARTNERS
530 S COLLEGE AVENUE 1	FORT COLLINS	CO	80524	742486211	501(C )(3)	$24,000	SEE SCH I, PART IV
LOVELAND CHAMBER OF COMMERCE
5400 STONE CREEK CIRCLE	LOVELAND	CO	80538	840254565	501(C )(6)	$5,700	SEE SCH I, PART IV
NOCO UNIFY
4627 W 20TH STREET B	GREELEY	CO	80634	208575428	501(C )(3)	$13,400	SEE SCH I, PART IV
PROJECT SELF SUFFICIENCY
375 W 37TH STREET	LOVELAND	CO	80538	841206341	501(C )(3)	$5,500	SEE SCH I, PART IV
UNITED WAY OF LARIMER COUNTY
424 PINE ST 102	FORT COLLINS	CO	80524	846031503	501(C )(3)	$35,562	SEE SCH I, PART IV
UNITED WAY OF WELD COUNTY
PO BOX 1944	GREELEY	CO	80632	846011918	501(C )(3)	$36,553	SEE SCH I, PART IV
VOICES CARRY CHILD ADVOCACY CENTER
5529 S TIMBERLINE ROAD	FORT COLLINS	CO	80528	841324009	501(C )(3)	$8,600	SEE SCH I, PART IV
YAMPA VALLEY MEDICAL CENTER FOUNDATION
1024 CENTRAL PARK DRIVE	STEAMBOAT SPRINGS	CO	80487	311806773	501(C )(3)	$18,000	SEE SCH I, PART IV
PVH FOUNDATION
2315 E HARMONY ROAD 200	FORT COLLINS	CO	80528	741894581	501(C )(3)	$1,335,816	SEE SCH I, PART IV
UNIVERSITY OF COLORADO SCHOOL OF MEDICINE
13001 E 17TH PL	AURORA	CO	80045	846000555	GOVERNMENT	$3,762,149	SEE SCH I, PART IV
UCHEALTH MEDICAL GROUP
2315 E HARMONY ROAD 200	FORT COLLINS	CO	80528	800348943	501(C )(3)	$35,413,154	SEE SCH I, PART IV

Field	Value	IRS element (for citing)
Total501c3 Org	21	Total501c3OrgCnt
Total Other Org	2	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KEVIN UNGER
PRESIDENT/CEO	$251,527	$251,527	$368,078	$368,078	$6,873	$6,873	$47,953	$47,952	$9,678	$9,677	$684,109	$684,107	$0	$0
STEPHANIE DOUGHTY
CFO	$239,840	$239,840	$63,771	$63,771	$2,356	$2,356	$25,451	$25,451	$6,002	$6,001	$337,420	$337,419	$0	$0
DR STANLEY GUNSTREAM
VP CHIEF QUALITY OFFICER	$177,662	$177,662	$44,840	$44,840	$5,590	$5,590	$19,982	$19,981	$7,267	$7,267	$255,341	$255,340	$0	$0
DONNA PODUSKA
CNO	$205,550	$0	$52,159	$0	$5,517	$0	$26,194	$0	$10,709	$0	$300,129	$0	$0	$0
MARILYN SCHOCK
COO	$153,343	$153,343	$38,626	$38,626	$785	$785	$17,506	$17,505	$4,785	$4,785	$215,045	$215,044	$0	$0
DR JOSEPH GOTTFRIED
PSYCHIATRIST	$249,682	$0	$6,193	$0	$547	$0	$25,922	$0	$22,731	$0	$305,075	$0	$0	$0
DR HERMANN MORENO
PSYCHIATRIST	$256,787	$0	$6,564	$0	$547	$0	$26,475	$0	$20,890	$0	$311,263	$0	$0	$0
DR DAVID SEHR
PSYCHIATRIST	$253,731	$0	$6,554	$0	$238	$0	$26,230	$0	$22,775	$0	$309,528	$0	$0	$0
KENNETH WATANABE
PSYCHIATRIST	$266,481	$0	$29,921	$0	$407	$0	$28,785	$0	$20,715	$0	$346,309	$0	$0	$0
DR JANELL WOZNIAK
CLINICAL DIRECTOR	$264,438	$0	$26,834	$0	$389	$0	$25,979	$0	$15,917	$0	$333,557	$0	$0	$0
RUSSELL WOOLEY
VP OPERATIONS, FORMER	$36,118	$36,118	$61,147	$61,147	$0	$0	$8,442	$8,441	$5,232	$5,232	$110,939	$110,938	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

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 4A

RUSSELL WOOLEY RECEIVED A SEVERANCE PAYMENT OF $84,802.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
COLORADO HEALTH FACILITIES AUTHORITY SERIES A
A	840752932	196474W48	2005-03-31	$50,000,000	REFUNDING 1999A BONDS	0	0	0
COLORADO HEALTH FACILITIES AUTHORITY SERIES B
B	840752932	196474W48	2005-03-31	$26,560,000	PAYMENT OF COMMERCIAL PAPER DEBT	0	0	0
UNIVERSITY OF COLORADO HOSPITAL AUTHORITY 2017 SERIES A
C	841179794	914183BB3	2017-02-16	$43,493,450	REFUNDING 2015A BONDS	0	0	0
UNIVERISTY OF COLORADO HOSPITAL AUTHORITY 2017 SERIES B1B2
D	841179794	914183BD9	2017-02-16	$57,125,000	REFUNDING 2015BC BONDS	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$50,000,000	$4,091,637	$653,467	$1,459,346	$43,795,550	2005	0	Yes (1)	Yes (1)	Yes (1)
B	$26,560,000	$2,173,477	$347,122	$2,204,559	$21,834,842	2005	Yes (1)	0	Yes (1)	Yes (1)
C	$43,493,450				$43,493,450	2017	Yes (1)	0	Yes (1)	Yes (1)
D	$57,125,000		$97,273		$57,027,727	2017	Yes (1)	0	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Any Lease ArrangementsAnyLeaseArrangementsInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)
D	Yes (1)	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd	Term Of HedgeTermOfHedgePct	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd
(no name)
A	0	0	0	Yes (1)	0	0	0	0	Yes (1)
(no name)
B	0	0	0	Yes (1)	0	0	0	0	Yes (1)
CITI
C	0	Yes (1)	0	0	0	Yes (1)	0	0	Yes (1)	10.000000000000	0	0
(no name)
D	0	Yes (1)	0	0	Yes (1)	0	0	0	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)
D	Yes (1)

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE K, PART I, COLUMN E	BOND ISSUE PRICE THE BOND ISSUE PRICE FOR THE SERIES B BOND DOES NOT EQUAL THE ISSUE PRICE LISTED ON THE FILED FORM 8038 AS THIS BOND WAS SPLIT WITH A RELATED ENTITY. ISSUE PRICE AS REPORTED ON FORM 80389: $83,000,000.
SCHEDULE K, PART IV, LINE 2C	THE REBATE CALCULATION WAS PERFORMED IN APRIL 2015 FOR BOND ISSUANCES A AND B.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	UNIVERISTY OF COLORADO HOSPITAL AUTHORITY 2017 SERIES C1C2	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	841179794	BondIssuerEIN
CUSIP	914183BA5	CUSIPNum
Bond Issued	2017-02-16	BondIssuedDt
Issue Price	$18,406,000	IssuePriceAmt
Purpose	NEW CONSTRUCTION	PurposeDesc
Defeased	0	DefeasedInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Pool Financing	0	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Total Proceeds	$18,406,000	TotalProceedsAmt
In Reserve Fund	$7,095,250	InReserveFundAmt
Issuance Costs From Proceeds	$55,315	IssuanceCostsFromProceedsAmt
Capital Expenditures	$11,255,436	CapitalExpendituresAmt
Substantial Completion	2017	SubstantialCompletionYr
Current Refunding	0	CurrentRefundingInd
Advance Refunding	0	AdvanceRefundingInd
Final Allocation Made	0	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (1)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedPropertyInd
Any Lease Arrangements	Yes (1)	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	0	MgmtContractBondFincdPropInd
Any Research Agreements	0	AnyResearchAgreementsInd
Private Bus Concerning UBI	0.00000	PrivateBusConcerningUBIPct
Total Private Business Use	0.00000	TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test	0	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	Yes (1)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiledInd
Rebate Not Due Yet	Yes (1)	RebateNotDueYetInd
Exception To Rebate	0	ExceptionToRebateInd
No Rebate Due	0	NoRebateDueInd
Variable Rate Issue	0	VariableRateIssueInd
Hedge Identified In Bks And Rec	0	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	0	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (1)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (1)	ProceduresCorrectiveActionInd

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Desc	MEDICAL EQUIPMENT	Desc
Contribution	61	ContributionCnt
Noncash Contributions Rpt F990	$1,060,184	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FMV	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	0	ReviewProcessUnusualNCGiftsInd
Third Parties Used	0	ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART I, LINE 6	PVH HAS 540 ACTIVE VOLUNTEERS IN FISCAL YEAR 2017. AT POUDRE VALLEY HOSPITAL, MEDICAL CENTER OF THE ROCKIES, AND OFF-SITE LOCATIONS, 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, VOLUNTEER PATIENT LIASONS, BABY KNITTERS, VOLUNTEENS, AND PET THERAPY TO NAME JUST A FEW OF THE MANY PROGRAMS, EVERY VOLUNTEER CONTRIBUTES TO THE SUCCESS OF POUDRE VALLEY HEALTH SYSTEM TO ENHANCE THE COMFORT AND CARE OF THE PATIENTS AND THEIR FAMILIES.
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 HAYGROUP FOR EXECUTIVE COMPENSATION CONSULTING SERVICES. ON OUR BEHALF THE HAYGROUP 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 XI, LINE 9:	MCR DISTRIBUTIONS TO PVH 52,685,563. BOOK VS. TAX ADJUSTMENT IN EQUITY EARNINGS 36,508,746.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Total IncomeTotalIncomeAmt
TIMBERLINE MEDICAL CLINIC
131 STANLEY AVE	ESTES PARK	CO	80517	043772090	OUTPATIENT	CO	-$16,785	PVHC INC
LAKOTA LAKE LLC
2315 E HARMONY RD STE 200	FORT COLLINS	CO	80528	841447761	OUTPATIENT	CO	$30,893,301	PVHC INC	$7,868,622
HERON LAKE LLC
2315 E HARMONY RD STE 200	FORT COLLINS	CO	80528	264189163	OUTPATIENT	CO	$657,338	PVHC INC

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
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	Yes (1)
PVHS FOUNDATION
2315 E HARMONY RD STE 200	FORT COLLINS	CO	80528	741894581	BENEFIT HEALTH	CO	501(C)(3)	LINE 7	PVHC INC	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (12 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
HARMONY SURGERY CENTER
2127 E HARMONY RD 200	FT COLLINS	CO	80528	841479751	AMBULATORY SURG	CO	N/A	RELATED	$2,176,867	$3,159,602	0	0	0.50000
CENTRE AVENUE HEALTH & REHAB FACILITY
947 WORTHINGTON CIRCLE	FT COLLINS	CO	80526	841560494	NURSING FACILITY	CO	N/A	RELATED	-$327,154	$449,736	0	0	0.50000
COLUMBINE POUDRE HOME CARE
947 WORTHINGTON CIRCLE	FT COLLINS	CO	80526	841529817	NURSING CARE	CO	N/A	RELATED	$275,512	$712,708	0	0	0.50000
EYE LASER CENTER OF NO COLORADO
1725 E PROSPECT RD	FORT COLLINS	CO	80525	841518334	LASER SURGERY	CO	N/A	UNRELATED	$31,765	$45,963	0	0	0.50000
GATEWAY MEDICAL SERVICES
2500 E PROSPECT RD	FORT COLLINS	CO	80525	841427970	REAL EST/MED	CO	N/A	UNRELATED	$7,343,494	$12,660,041	0	0	0.50000
PVHS HOME MEDICAL SUPPLY
6820 N COUNTY RD 13	LOVELAND	CO	80538	202034599	MEDICAL SUPPLY	CO	N/A	UNRELATED	-$75,674	$674,921	0	Yes (1)	0.50000
THE VEIN AND LASER CENTER OF NO COLORADO
2008 CARIBOU DRIVE	FORT COLLINS	CO	80525	204943970	MEDICAL SERVICES	CO	N/A	UNRELATED	$3,529	$33,713	0	0	0.33330
HARMONY IMAGING CENTER
1951 WILMINGTON DRIVE	FORT COLLINS	CO	80528	582479187	MEDICAL IMAGING	CO	N/A	RELATED	$539,026	$1,837,281	0	0	0.46000
SURGERY CENTER OF FORT COLLINS
1100 E PROSPECT ROAD	FORT COLLINS	CO	80525	841541559	SURGICAL PROC	CO	N/A	UNRELATED	$485,367	$1,031,722	0	0	0.26000
POUDRE VALLEY MEDICAL GROUP LLC
2315 E HARMONY RD STE 200	FORT COLLINS	CO	80528	800348943	MEDICAL SERVICES	CO	N/A	RELATED	-$35,797,120	$37,707,192	0	Yes (1)	0.99000
PVHS-ICM EHW
2315 E HARMONY RD STE 200	FORT COLLINS	CO	80528	463311308	MEDICAL SERVICES	CO	N/A	RELATED	$3,486	$191,157	0	0	0.50000
PEAK SURGICAL MANAGEMENT
2127 E HARMONY RD 200	FORT COLLINS	CO	80528	260899618	SURGICAL MGMT	CO	N/A	UNRELATED	$154,991	$84,380	0	0	0.14300

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	INNOVATION ENTERPRISES	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2315 E HARMONY RD STE 200	AddressLine1Txt
City	FORT COLLINS	CityNm
State Abbreviation	CO	StateAbbreviationCd
ZIP	80528	ZIPCd

Field	Value	IRS element (for citing)
EIN	202036774	EIN
Primary Activities	IT CONSULTING	PrimaryActivitiesTxt
Legal Domicile State	CO	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	PVHC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Entity Type	C	EntityTypeTxt
Share Of Total Income	$824,747	ShareOfTotalIncomeAmt
Share Of EOY Assets	$1,443,564	ShareOfEOYAssetsAmt
Ownership	1.00000	OwnershipPct
Controlled Organization	Yes (1)	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (1)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (1)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	Yes (1)	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	Yes (1)	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (19 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
HARMONY SURGERY CENTER
A	$953,198	TRANSACTION TOTAL
HARMONY SURGERY CENTER
Q	$625,341	TRANSACTION TOTAL
HARMONY SURGERY CENTER
S	$1,925,000	TRANSACTION TOTAL
EYE LASER CENTER OF NO COLORADO
M	$145,700	TRANSACTION TOTAL
GATEWAY MEDICAL SERVICES
S	$7,588,549	TRANSACTION TOTAL
MEDICAL CENTER OF THE ROCKIES
L	$8,979,597	TRANSACTION TOTAL
MEDICAL CENTER OF THE ROCKIES
N	$4,496,038	TRANSACTION TOTAL
MEDICAL CENTER OF THE ROCKIES
S	$52,685,563	TRANSACTION TOTAL
PVHMCR FOUNDATION
B	$1,335,816	TRANSACTION TOTAL
PVHMCR FOUNDATION
C	$1,344,346	TRANSACTION TOTAL
PVHMCR FOUNDATION
L	$58,871	TRANSACTION TOTAL
PVHMCR FOUNDATION
N	$52,080	TRANSACTION TOTAL
INNOVATION ENTERPRISES
A	$119,169	TRANSACTION TOTAL
INNOVATION ENTERPRISES
A	$255,599	TRANSACTION TOTAL
POUDRE VALLEY MEDICAL GROUP LLC
B	$35,413,154	TRANSACTION TOTAL
POUDRE VALLEY MEDICAL GROUP LLC
J	$2,077,768	TRANSACTION TOTAL
POUDRE VALLEY MEDICAL GROUP LLC
M	$4,751,153	TRANSACTION TOTAL
POUDRE VALLEY MEDICAL GROUP LLC
L	$5,133,691	TRANSACTION TOTAL
POUDRE VALLEY MEDICAL GROUP LLC
N	$2,967,482	TRANSACTION TOTAL