POUDRE VALLEY HEALTH CARE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: POUDRE VALLEY HEALTH CARE INC (EIN 84-1262971)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2014-05-15
IRS object ID: 201431359349302603
Schema version: 2012v2.1
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 L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-05-15T09:12:39-05:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	461497033	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	EKS&H LLLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	7979 E TUFTS AVENUE SUITE 400	AddressLine1
City	DENVER	City
State	CO	State
ZIP Code	802372521	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	841262971	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	POUDRE VALLEY HEALTH CARE INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	POUD	NameControl
Phone	9702377000	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2315 E HARMONY ROAD NO 200	AddressLine1
City	FORT COLLINS	City
State	CO	State
ZIP Code	80528	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	STEPHANIE DOUGHTY	Name
Title	CHIEF FINANCIAL OFFICER	Title
Phone	9702377000	Phone
Date Signed	2014-05-14	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	CRAIG R CHOUN	Name
PTIN	P00173718	PTIN
Phone	3037409400	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	KEVIN UNGER	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	2315 E HARMONY RD 200	AddressLine1
City	FT COLLINS	City
State	CO	State
ZIP Code	80528	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	833047994	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.PVHS.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1994	YearFormation
State Legal Domicile	CO	StateLegalDomicile
Activity Or Mission Description	WE IMPROVE LIVES.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	11	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	8	NbrIndependentVotingMembers
Total Nbr Employees	4869	TotalNbrEmployees
Total Nbr Volunteers	831	TotalNbrVolunteers
Total Gross UBI	11906421	TotalGrossUBI
Net Unrelated Business Txbl Income	2554320	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	15778292	ContributionsGrantsPriorYear
Contributions Grants Current Year	25492114	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	245202095	ProgramServiceRevenuePriorYear
Program Service Revenue CY	545139001	ProgramServiceRevenueCY
Investment Income Prior Year	2640701	InvestmentIncomePriorYear
Investment Income Current Year	7452561	InvestmentIncomeCurrentYear
Other Revenue Prior Year	4157339	OtherRevenuePriorYear
Other Revenue Current Year	9500694	OtherRevenueCurrentYear
Total Revenue Prior Year	267778427	TotalRevenuePriorYear
Total Revenue Current Year	587584370	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	690886	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	1864214	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	137371005	SalariesEtcPriorYear
Salaries Etc Current Year	319437809	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	110742702	OtherExpensePriorYear
Other Expenses Current Year	242119517	OtherExpensesCurrentYear
Total Expenses Prior Year	248804593	TotalExpensesPriorYear
Total Expenses Current Year	563421540	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	18973834	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	24162830	RevenuesLessExpensesCY
Total Assets BOY	795561995	TotalAssetsBOY
Total Assets EOY	1036706894	TotalAssetsEOY
Total Liabilities BOY	246640221	TotalLiabilitiesBOY
Total Liabilities EOY	446760442	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	548921774	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	589946452	NetAssetsOrFundBalancesEOY
Mission Description	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.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	379586920	Expense
Grants	1864214	Grants
Revenue	437975871	Revenue
Description	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 2013, PVHC RECORDED 58,844 PATIENT DAYS, 14,411 ADMISSIONS, 166,812 OUTPATIENT VISITS, 53,545 EMERGENCY VISITS, 2,394 DELIVERIES, 5,774 INPATIENT SURGERIES, AND 3,489 OUTPATIENT SURGERIES.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	124363696	Expense
Revenue	102483048	Revenue
Description	THE PHYSICIAN NETWORK OF POUDRE VALLEY HEALTH SYSTEM ENCOMPASSES TIMBERLINE MEDICAL LLC, HERON LAKE LLC, AND POUDRE VALLEY MEDICAL GROUP LLC. DURING FISCAL YEAR 2013, THE PHYSICIAN NETWORK HAD 676,253 OUTPATIENT VISITS. AT YEAR END, THE PHYSICIAN NETWORK WAS COMPRISED OF 207 EMPLOYED PHYSICIANS, REPRESENTING 27 SPECIALITIES AT 60 MEDICAL CLINICS IN COLORADO, NEBRASKA, AND WYOMING.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	503950616	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	1	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	0	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	1	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	655	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	4869	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	11	NbrVotingGoverningBodyMembers
Number Independent Voting Members	8	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	1	WrittenPolicyOrProcedure
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

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

Field	Value	IRS element (for citing)
Telephone Number	9702377000	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2315 E HARMONY ROAD SUITE 200	AddressLine1
City	FORT COLLINS	City
State	CO	State
ZIP Code	80528	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
DANIEL G STROH
BOARD CHAIR	2.00	X	X	0	0	0
CHRISTINE CHIN
VICE BOARD CHAIR	2.00	X	X	0	0	0
RICHARD M DELLENBACH
BOARD MEMBER	2.00	X		0	0	0
JOE D HENDRICKSON
BOARD MEMBER	2.00	X		0	0	0
DENNIS JOHN HOUSKA
BOARD MEMBER	2.00	X		0	0	0
THAINE J MICHIE
BOARD MEMBER	2.00	X		0	0	0
DAVID C OSBORN
BOARD MEMBER	2.00	X		0	0	0
TODD S SORENSEN
BOARD MEMBER	2.00	X		0	0	0
JAMES ALAN SPROWELL
BOARD MEMBER	2.00	X		0	0	0
LAURIE S STEELE
BOARD MEMBER	2.00	X		0	0	0
RULON STACEY
PRESIDENT/CEO	26.00	X	X	1132627	624092	151027	14.00
STEPHANIE DOUGHTY
CFO	26.00		X	1179557	649954	68362	14.00
RUSS BRANZELL
CEO, CHMG	40.00			953713	0	75468		X
DOUG FAUS
VP OPERATIONS	40.00			396542	0	31341		X
DR WILLIAM NEFF
CMO	40.00			919197	0	80023		X
DONNA PODUSKA
CNO	40.00			328439	0	43702		X
DR MICHAEL RANDLE
CMO, CHMG	40.00			304749	0	17475		X
DAN ROBINSON
CEO, CHMG	40.00			638738	0	50440		X
STEVEN SCHWARTZ
CFO, CHMG	40.00			166746	0	15299		X
KEVIN UNGER
CEO, PVH	40.00			840875	0	131090		X
DR HANS COESTER
PHYSICIAN	40.00			1620785	0	51540			X
DR MARK GUADAGNOLI
PHYSICIAN	40.00			804016	0	45385			X
DR WILLIAM MILLER
PHYSICIAN	40.00			740745	0	22184			X
DR JOSH PETIT
PHYSICIAN	40.00			1271922	0	56767			X
DR LARS WIDDEL
PHYSICIAN	40.00			708783	0	14553			X
GRACE KOWALYSHYN-TAYLOR
DIR PHY RELATIONS	40.00			261118	0	69679				X
PATTI OAKES
VP HUMAN RESOURCES	40.00			500448	0	33028				X
CARL SMITH
VP PAYOR RELATIONS	40.00			539439	0	62702				X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	13308439	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	1274046	TotalReportableCompFrmRltdOrgs
Total Other Compensation	1020065	TotalOtherCompensation
Number Individuals GT100 K	165	NumberIndividualsGT100K
Formers Listed	1	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
N COLORADO PULMONARY CONSULTANTS
2121 E HARMONY RD 300	FT COLLINS	CO	80528	MEDICAL	2753659
FORT COLLINS WOMEN'S CLINIC
1107 S LEMAY AVE STE 300	FT COLLINS	CO	80524	MEDICAL	1668913
MAYO COLLABORATIVE SERVICES INC
PO BOX 9146	MINNEAPOLIS	MN	55480	MEDICAL	1377679
HARMONY VALLEY CONDO ASSOC
375 E HORSETOOTH RD 3-100	FT COLLINS	CO	80525	PROPERTY MANAGEMENT	1374203
FORT COLLINS YOUTH CLINIC
1200 E ELIZABETH ST	FT COLLINS	CO	80524	MEDICAL	1319549

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	66	NumberOfContractorsGT100K
Related Organizations	24903465	RelatedOrganizations
Government Grants	390267	GovernmentGrants
All Other Contributions	198382	AllOtherContributions
Total Contributions	25492114	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
NET PATIENT SVC REV	900099	503872542	503872542
PROVIDER FEE INCOME	621400	29650967	29650967
JOINT VENTURE	621400	3973161	3099263	873898
LAB UBI	621500	3146999		3146999
DIETARY SVC INCOME	900099	2031979			$2,031,979

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	2463353	TotalRevenueColumn
Related Or Exempt Function Income	2160270	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	303083	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Program Service Revenue	545139001	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	4167956	TotalRevenueColumn
Exclusion	$4,167,956	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	197665	TotalRevenueColumn
Exclusion	$197,665	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	5154075	Real
Personal	457336	Personal

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	1943857	Real
Personal	457336	Personal

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	3210218	Real
Personal	0	Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	3210218	TotalRevenueColumn
Unrelated Business Revenue	3126322	UnrelatedBusinessRevenue
Exclusion	$83,896	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	245185375	Securities
Other	501080	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	242594857	Securities
Other	4658	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	2590518	Securities
Other	496422	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	3086940	TotalRevenueColumn
Exclusion	$3,086,940	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	791279	GrossSalesOfInventory
Cost Of Goods Sold	462916	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	328363	TotalRevenueColumn
Unrelated Business Revenue	169883	UnrelatedBusinessRevenue
Exclusion	$158,480	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Unrelated Business RevenueUnrelatedBusinessRevenue	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
REIMBURSE- NON-OP DEPT	621400	4260114	4260114
MISCELLANEOUS REVENUE	621400	1678532	2655	1675877
SVCS TO OUTSIDE ENTITY	621400	23467	23467

Field	Value	IRS element (for citing)
Total Other Revenue	5962113	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	587584370	TotalRevenueColumn
Related Or Exempt Function Income	540458919	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	11906421	UnrelatedBusinessRevenue
Exclusion	$9,726,916	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	1864214	Total
Program Services	1864214	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	8799457	Total
Program Services	800024	ProgramServices
Management And General	7999433	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	512051	Total
Program Services	512051	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	250003143	Total
Program Services	226851598	ProgramServices
Management And General	23151545	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	29221499	Total
Program Services	25762974	ProgramServices
Management And General	3458525	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	21855411	Total
Program Services	19779271	ProgramServices
Management And General	2076140	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	9046248	Total
Program Services	7236623	ProgramServices
Management And General	1809625	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	779402	Total
Program Services	36132	ProgramServices
Management And General	743270	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	174277	Total
Management And General	174277	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	21037	Total
Management And General	21037	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	266573	Total
Management And General	266573	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	19844589	Total
Program Services	19186499	ProgramServices
Management And General	658090	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	3247850	Total
Program Services	156666	ProgramServices
Management And General	3091184	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	10107958	Total
Program Services	4699625	ProgramServices
Management And General	5408333	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	9341026	Total
Program Services	7453448	ProgramServices
Management And General	1887578	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	12873041	Total
Program Services	12318214	ProgramServices
Management And General	554827	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	2752814	Total
Program Services	1394781	ProgramServices
Management And General	1358033	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	1312803	Total
Program Services	1252960	ProgramServices
Management And General	59843	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	9795134	Total
Program Services	9795134	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	28932230	Total
Program Services	26435563	ProgramServices
Management And General	2496667	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	6311944	Total
Program Services	5860649	ProgramServices
Management And General	451295	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES	79193498	78703408	490090
PROVIDER FEE EXPENSE	23069759	23069759
BAD DEBT	18195632	18195632
UBI TAXES	1190000		1190000

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	14709950	Total
Program Services	12585391	ProgramServices
Management And General	2124559	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	563421540	Total
Program Services	503950616	ProgramServices
Management And General	59470924	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	4407271	BOY
EOY	16706035	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	84924888	BOY
EOY	299523	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	67221191	BOY
EOY	73303366	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	2164004	BOY
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	2280316	BOY
EOY	2483125	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	5604216	BOY
EOY	6266869	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	6463649	BOY
EOY	6517958	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	525970338	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	258156414	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	233606743	BOY
EOY	267813924	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	323200575	BOY
EOY	5485130	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	3011076	BOY
EOY	2997063	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	40365606	BOY
EOY	29654266	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	22312460	BOY
EOY	625179635	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	795561995	BOY
EOY	1036706894	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	52764430	BOY
EOY	60962420	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	672177	BOY
EOY	65775	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	131338799	BOY
EOY	131119658	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	24870254	BOY
EOY	136284565	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	6925070	BOY
EOY	5116039	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	30069491	BOY
EOY	113211985	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	246640221	BOY
EOY	446760442	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	548921774	BOY
EOY	589946452	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	548921774	BOY
EOY	589946452	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	795561995	BOY
EOY	1036706894	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	24162830	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	17721199	ReconciliationUnrealizedInvest
Reconcilation Other Changes	-859351	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

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)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	1	DirectContactLegislators
Direct Contact Legislators	$21,037	DirectContactLegislatorsAmount
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	0	OtherActivities
Total Lobbying Expenditures IIB	21037	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	PORTION OF DUES FROM MEMBERSHIP IN CHA AND AHA THAT ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES.	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	8938992	BeginningOfYearBalance
Contributions	2680308	Contributions
Investment Earnings Or Losses	53692	InvestmentEarningsOrLosses
Grants Or Scholarships	334527	GrantsOrScholarships
Other Expenditures	1090451	OtherExpenditures
End Of Year Balance	10248014	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	8589487	BeginningOfYearBalance
Contributions	1202986	Contributions
Investment Earnings Or Losses	379517	InvestmentEarningsOrLosses
Grants Or Scholarships	448977	GrantsOrScholarships
Other Expenditures	784021	OtherExpenditures
End Of Year Balance	8938992	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	8012240	BeginningOfYearBalance
Contributions	3552647	Contributions
Investment Earnings Or Losses	-345716	InvestmentEarningsOrLosses
Grants Or Scholarships	1678528	GrantsOrScholarships
Other Expenditures	712777	OtherExpenditures
Administrative Expenses	238379	AdministrativeExpenses
End Of Year Balance	8589487	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	7405708	BeginningOfYearBalance
Contributions	2585645	Contributions
Investment Earnings Or Losses	656963	InvestmentEarningsOrLosses
Grants Or Scholarships	910474	GrantsOrScholarships
Other Expenditures	1725602	OtherExpenditures
End Of Year Balance	8012240	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	6106859	BeginningOfYearBalance
Contributions	3452441	Contributions
Investment Earnings Or Losses	527257	InvestmentEarningsOrLosses
Grants Or Scholarships	393016	GrantsOrScholarships
Other Expenditures	2287833	OtherExpenditures
End Of Year Balance	7405708	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.00000	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.45610	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.54390	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	1	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	1	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	1	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	62136902	OtherCostOrOtherBasis
Book Value	62136902	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	184330606	OtherCostOrOtherBasis
Depreciation	91448917	Depreciation
Book Value	92881689	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	94754319	OtherCostOrOtherBasis
Depreciation	54628434	Depreciation
Book Value	40125885	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	161435896	OtherCostOrOtherBasis
Depreciation	97823338	Depreciation
Book Value	63612558	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	23312615	OtherCostOrOtherBasis
Depreciation	14255725	Depreciation
Book Value	9056890	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	267813924	TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescription	Book ValueBookValue
INTERCOMPANY RECEIVABLE	620393339
DEFERRED DEBT ISSUANCE COSTS	3411432
OTHER RECEIVABLES	1365619
OTHER ASSETS	9245

Field	Value	IRS element (for citing)
Total Book Value Other Assets	625179635	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescription	AmountAmount
INTERCOMPANY PAYABLES	$108,418,007
ACCRUED INTEREST PAYABLE	$2,243,500
OTHER DEFERRED EXPENSES	$2,550,478

Field	Value	IRS element (for citing)
Total Of Amounts	113211985	TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt	560324927	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	17721199	NetUnrealizedGainsInvestments
Other Revenues	2689153	OtherRevenues
Revenue Not Rptd F990	20410352	RevenueNotRptdF990
Revenue Subtotal	539914575	RevenueSubtotal
Investment Expenses Not Included	99656	InvestmentExpensesNotIncluded
Other Revenues Not Included	47570139	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	47669795	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	587584370	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	518454163	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	2420828	OtherExpensesIncluded
Expenses Not Rptd F990	2420828	ExpensesNotRptdF990
Expenses Subtotal	516033335	ExpensesSubtotal
Investment Expenses Not Included2	99656	InvestmentExpensesNotIncluded2
Other Expenses Not Included	47288549	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	47388205	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	563421540	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	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:		BOOK VERSUS TAX ADJUSTMENT IN EQUITY EARNINGS 327,014. RENTAL EXPENSE INCLUDED IN EXPENSE ON AFS 2,089,522. COST OF GOODS SOLD INCLUDED IN EXPENSE ON AFS 272,617.
PART XI, LINE 4B - OTHER ADJUSTMENTS:		PROVISION FOR BAD DEBT IN AFS INCOME 18,195,632. NON-OPERATING REIMBURSEMENTS INCLUDED IN EXPENSE ON AFS 4,260,114. AUXILIARY INCOME NOT INCLUDED IN AFS INCOME 149,769. CONTRIBUTIONS FROM PV FOUNDATION NOT IN AFS INCOME 299,322. MCR PHYSICIAN NETWORK ALLOCATION IN AFS EXPENSE 24,604,144. SERVICES PROVIDED TO OUTSIDE ENTITIES IN EXPENSE ON AFS 23,467. VARIOUS UBI INCOME NOT INCLUDED IN AFS INCOME 2,655. PHARMACY SALES INCLUDED IN EXPENSE ON AFS 35,036.
PART XII, LINE 2D - OTHER ADJUSTMENTS:		RENTAL EXPENSE INCLUDED IN EXPENSE ON AFS 2,089,522. COST OF GOODS SOLD INCLUDED IN EXPENSE ON AFS 272,617. TIMING DIFFERENCE ON FDN/PVH CONTRIBUTIONS 58,689.
PART XII, LINE 4B - OTHER ADJUSTMENTS:		PROVISION FOR BAD DEBT IN AFS INCOME 18,195,632. NON-OPERATING REIMBURSEMENTS INCLUDED IN EXPENSE ON AFS 4,260,114. AUXILIARY GRANTS NOT ON AFS 167,501. MCR PHYSICIAN NETWORK ALLOCATION IN AFS EXPENSE 24,604,144. SERVICES PROVIDED TO OUTSIDE ENTITIES IN EXPENSE ON AFS 23,467. VARIOUS UBI INCOME NOT INCLUDED IN AFS INCOME 2,655. PHARMACY SALES INCLUDED IN EXPENSE ON AFS 35,036.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare

Other Percentage OtherPercentage

Field	Value	IRS element (for citing)
Other	X	Other
Free Other Percentage	250.000000000000	FreeOtherPercentage

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3642977	TotalCommunityBenefitExpense
Net Community Benefit Expense	3642977	NetCommunityBenefitExpense
Percent Of Total Expense	0.00640	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	46970769	TotalCommunityBenefitExpense
Direct Offsetting Revenue	20536773	DirectOffsettingRevenue
Net Community Benefit Expense	26433996	NetCommunityBenefitExpense
Percent Of Total Expense	0.04680	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	43021302	TotalCommunityBenefitExpense
Direct Offsetting Revenue	34330436	DirectOffsettingRevenue
Net Community Benefit Expense	8690866	NetCommunityBenefitExpense
Percent Of Total Expense	0.01540	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	93635048	TotalCommunityBenefitExpense
Direct Offsetting Revenue	54867209	DirectOffsettingRevenue
Net Community Benefit Expense	38767839	NetCommunityBenefitExpense
Percent Of Total Expense	0.06860	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2404323	TotalCommunityBenefitExpense
Direct Offsetting Revenue	439153	DirectOffsettingRevenue
Net Community Benefit Expense	1965170	NetCommunityBenefitExpense
Percent Of Total Expense	0.00350	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3675053	TotalCommunityBenefitExpense
Net Community Benefit Expense	3675053	NetCommunityBenefitExpense
Percent Of Total Expense	0.00650	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	90111463	TotalCommunityBenefitExpense
Direct Offsetting Revenue	65441994	DirectOffsettingRevenue
Net Community Benefit Expense	24669469	NetCommunityBenefitExpense
Percent Of Total Expense	0.04360	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2264625	TotalCommunityBenefitExpense
Net Community Benefit Expense	2264625	NetCommunityBenefitExpense
Percent Of Total Expense	0.00400	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	98455464	TotalCommunityBenefitExpense
Direct Offsetting Revenue	65881147	DirectOffsettingRevenue
Net Community Benefit Expense	32574317	NetCommunityBenefitExpense
Percent Of Total Expense	0.05760	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	192090512	TotalCommunityBenefitExpense
Direct Offsetting Revenue	120748356	DirectOffsettingRevenue
Net Community Benefit Expense	71342156	NetCommunityBenefitExpense
Percent Of Total Expense	0.12620	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Total Community Building Expense	2600	TotalCommunityBuildingExpense
Net Community Building Expense	2600	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	23050	TotalCommunityBuildingExpense
Net Community Building Expense	23050	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	152240	TotalCommunityBuildingExpense
Net Community Building Expense	152240	NetCommunityBuildingExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Total Community Building Expense	8080	TotalCommunityBuildingExpense
Net Community Building Expense	8080	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	11630	TotalCommunityBuildingExpense
Net Community Building Expense	11630	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Total Community Building Expense	49840	TotalCommunityBuildingExpense
Net Community Building Expense	49840	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	247440	TotalCommunityBuildingExpense
Net Community Building Expense	247440	NetCommunityBuildingExpense
Percent Of Total Expense	0.00040	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$18,552,643	BadDebtExpenseAmount
Amount Reimbursed By Medicare	108469025	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	155438465	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-46969440	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (7 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivity	Organization Profit Or OwnershipOrganizationProfitOrOwnership	Physicans Profit Or OwnershipPhysicansProfitOrOwnership
1 HARMONY SURGERY CENTER LLC
AMBULATORY SURGERY	0.51000	0.49000
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	0.00000

Field	Value	IRS element (for citing)
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	POUDRE VALLEY HOSPITAL	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	1024 S LEMAY	AddressLine1
City	FORT COLLINS	City
State	CO	State
ZIP Code	80524	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Teaching Hospital	X	TeachingHospital
Research Facility	X	ResearchFacility
Er24 Hours	X	Er24Hours
Other	PHARMACY, LAB, CARDIOVASCULAR	Other

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	POUDRE VALLEY HEALTH CARE	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	1	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Information Gaps	X	InformationGaps
Other	X	Other
Needs Assessment Conducted	12	NeedsAssessmentConducted
Take Into Account	1	TakeIntoAccount
Other Facilities	1	OtherFacilities
CHNA Widely Available	1	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Other Method	X	OtherMethod
Adopt Implement Strategy	X	AdoptImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Adopt Budget	X	AdoptBudget
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	0	AllNeedsAddressed
Organization Incur Excise Tax	0	OrganizationIncurExciseTax
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	250.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	400.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	1	ActionsOnNonpayment
Permit Lien On Residence	X	PermitLienOnResidence
Collection Activities	1	CollectionActivities
Report To Credit Agency	X	ReportToCreditAgency
Lawsuit	X	Lawsuit
Lien On Residence	X	LienOnResidence
Notify Upon Admission	X	NotifyUponAdmission
Notify Before Discharge	X	NotifyBeforeDischarge
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Lowest Negotiated Rates	X	LowestNegotiatedRates
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	62	NumberOfOtherFacilities

Other Facilities OtherFacilities (62 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
HARMONY CAMPUS MOB
2121 E HARMONY RD	FORT COLLINS	CO	80528	PHYSICIAN OFFICES, ONCOLOGY, HCOR
HARMONY CAMPUS AMBLUATORY CARE CENTER
2127 E HARMONY RD	FORT COLLINS	CO	80528	SURGERY CENTER, DIAGNOSTIC CENTER, IMAGING, URGENT CARE
REDSTONE
2315 E HARMONY RD	FORT COLLINS	CO	80528	OUTPATIENT LAB, PHYSICIAN OFFICE, SSOR, UROLOGY
PEAKVIEW MEDICAL CENTER
5881 W 16TH STREET	GREELEY	CO	80634	PHYSICIAN OFFICES
MCR NORTH MOB
2500 ROCKY MTN AVE	LOVELAND	CO	80538	PHYSICIAN OFFICES
MOUNTAIN CREST BEHAVIORAL HEALTH
4601 CORBETT DR	FORT COLLINS	CO	80528	BEHAVIORAL HEALTH
GREELEY MEDICAL CLINIC
1900 16TH STREET	GREELEY	CO	80631	PHYSICIAN OFFICES
CHMG MEMORIAL GENERAL & VASCULAR SURGERY
1400 E BOULDER STREET	COLORADO SPRINGS	CO	80909	PHYSICIAN OFFICES
CHMG CARDIOLOGY
1400 E BOULDER STREET	COLORADO SPRINGS	CO	80909	PHYSICIAN OFFICES
MCR SOUTH MOB
2500 ROCKY MTN AVE	LOVELAND	CO	80538	PHYSICIAN OFFICES, HCOR, SSOR
CHMG CHEYENNE MEDICAL SPECIALISTS
5050 POWDERHOUSE RD	CHEYENNE	WY	82009	PHYSICIAN OFFICES
CHMG MATERNAL-FETAL MEDICINE
1400 E BOULDER STREET	COLORADO SPRINGS	CO	80909	PHYSICIAN OFFICES
CHMG INPATIENT MEDICINE
1400 E BOULDER STREET	COLORADO SPRINGS	CO	80909	PHYSICIAN OFFICES
SURGERY CENTER OF FT COLLINS-JV
1100 E PROSPECT RD	FORT COLLINS	CO	80524	SURGERY CENTER
PROSPECT MEDICAL PLAZA
1106 E PROSPECT SUITE 100	FORT COLLINS	CO	80524	PHYSICIAN OFFICES, OUTPATIENT REHAB, NEUROLOGY, INT MEDICINE
CENTRE AVE HEALTH AND REHAB-JV
915 CENTRE AVE	FORT COLLINS	CO	80526	REHAB
PENNOCK PLACE
1025 PENNOCK PLACE	FORT COLLINS	CO	80524	PHYSICIAN OFFICES, BLOOD BANK
WESTBRIDGE
1107 S LEMAY	FORT COLLINS	CO	80524	PHYSICIAN OFFICES, MEDICAL SPA, BLOOD DRAW
UROLOGY CENTER OF THE ROCKIES
3520 E 15TH STREET	LOVELAND	CO	80538	PHYSICIAN OFFICES
CARDIOTHORACIC SURGERY
525 N FOOTE AVE SUITE 302	COLORADO SPRINGS	CO	80910	PHYSICIAN OFFICES
WINDSOR MEDICAL CENTER
1455 MAIN STREET	WINDSOR	CO	80550	PHYSICIAN OFFICES
MEMORIAL NEUROSCIENCES
1725 BOULDER STREET SUITE 101	COLORADO SPRINGS	CO	80909	PHYSICIAN OFFICES
SNOW MESA
4674 SNOW MESA DRIVE	FORT COLLINS	CO	80528	PHYSICIAN OFFICES
BREAST SURGERY
4110 BRIARGATE PARKWAY SUITE 465	COLORADO SPRINGS	CO	80920	PHYSICIAN OFFICES
EXPRESS LAB
1020 DOCTORS LANE	FORT COLLINS	CO	80524	LAB
MEMORIAL VEIN CENTER
4110 BRIARGATE PARKWAY SUITE 140	COLORADO SPRINGS	CO	80920	PHYSICIAN OFFICES
GREELEY ONCOLOGYRHEUMATOLOGY
1800 15TH STREET	GREELEY	CO	80631	PHYSICIAN OFFICE
HEMATOLOGYONCOLOGY
525 N FOOTE AVE SUITE 202	COLORADO SPRINGS	CO	80910	PHYSICIAN OFFICES
TIMERLINE MEDICAL
131 STANLEY DR	ESTES PARK	CO	80517	PHYSICIAN OFFICES
WEST LOVELAND
3850 N GRANT AVE	LOVELAND	CO	80538	URGENT CARE, PHYSICIAN OFFICES
CHILDREN'S THERAPY
1500 S LEMAY	FORT COLLINS	CO	80526	THERAPY
COLUMBINE POUDRE HOMECARE-JV
915 CENTRE AVE	FORT COLLINS	CO	80526	HOME HEALTHCARE
MEMORIAL SUNFLOWER FAMILY MEDICINE
1730 N CORONA STREET	COLORADO SPRINGS	CO	80907	PHYSICIAN OFFICES
PRIMARY CARE-STERLING
620 IRIS DRIVE	STERLING	CO	80751	PHYSICIAN OFFICES
FOXTRAIL FAMILY MEDICINE
1625 FOXTRAIL DR	LOVELAND	CO	80538	PHYSICIAN OFFICES
SENIOR CLINIC
175 S UNION BLVD SUITE 300	COLORADO SPRINGS	CO	80910	PHYSICIAN OFFICES
POUDRE INFUSION THERAPY-JV
915 CENTRE AVE	FORT COLLINS	CO	80526	INFUSION
HCORSCOTTSBLUFF
2 W 42ND ST 2200	SCOTTSBLUFF	NE	69361	PHYSICIAN OFFICES
THE VEIN AND LASER CENTER-JV
2008 CARIBOU DRIVE	FORT COLLINS	CO	80525	PHYSICIAN OFFICES
YAMPA VALLEY STEAMBOAT
940 CENTRAL PARK DR 290	STEAMBOAT SPRINGS	CO	80487	PHYSICIAN OFFICES
THOMPSON VALLEY TOWNE CENTER
1327 EAGLE DRIVE	LOVELAND	CO	80537	PHYSICIAN OFFICES
CHMG OB-GYN CLINIC
1715 61ST AVENUE	GREELEY	CO	80631	PHYSICIAN OFFICES
ESTES PARK
555 PROSPECT AVE	ESTES PARK	CO	80517	PHYSICIAN OFFICES
EYE LASER CENTER OF N COLORADO-JV
1725 EAST PROSPECT RD	FORT COLLINS	CO	80525	PHYSICIAN OFFICES
CRAIG
595 RUSSELL STREET	CRAIG	CO	81625	PHYSICIAN OFFICES
WATER VALLEY
1870 MARINA PLAZA DRIVE	WINDSOR	CO	80550	OUTPATIENT REHAB
FORT MORGAN
1000 LINCOLN STREET 207	FORT MORGAN	CO	80701	PHYSICIAN OFFICES
SIDNEY
1625 DORWART DRIVE	SIDNEY	NE	69162	PHYSICIAN OFFICES
CHMG SLEEP MEDICINE CLINIC
4110 BRIARGATE PARKWAY SUITE 445	COLORADO SPRINGS	CO	80920	PHYSICIAN OFFICES
GMCBRUSH
2400 EDISON STREET	BRUSH	CO	80723	PHYSICIAN OFFICES
LARAMIE
3116 WILLET DRIVE	LARAMIE	WY	82070	PHYSICIAN OFFICES
YUMA
910 S MAIN STREET	YUMA	CO	80759	PHYSICIAN OFFICES
KREMMLING
214 S 4TH STREET	KREMMLING	CO	80459	PHYSICIAN OFFICES
WALDEN
350 MCKINGLEY ST	WALDEN	CO	80480	PHYSICIAN OFFICES
CHMG HCOR CV SURGEON
7960 NIWOT ROAD	NIWOT	CO	80503	PHYSICIAN OFFICES
ALLIANCE
2101 BOX BUTTE AVE	ALLIANCE	NE	69301	PHYSICIAN OFFICES
HAYTHORN BROTHERS
7251 W 20TH ST	GREELEY	CO	80631	SLEEP LAB
LAB DRAWS
708 22ND STREET	GREELEY	CO	80631	LAB
PHLEBOTOMY STATION
1113 OAKRIDGE DRIVE	FORT COLLINS	CO	80525	LAB DRAWS
PHLEBOTOMY STATION
2001 S SHIELDS	FORT COLLINS	CO	80526	LAB DRAWS
PHLEBOTOMY STATION
2025 BIG HORN DRIVE	FORT COLLINS	CO	80525	LAB DRAWS
PHLEBOTOMY STATION
3519 RICHMOND DRIVE	FORT COLLINS	CO	80526	LAB DRAWS

Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 7: THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINE 7B AND 7C. THE COST-TO-CHARGE RATION WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE TO COST-TO-CHARGES.LINE 7A WAS DERIVED USING A COST-TO-CHARGE RATIO FROM THE COST REPORT.THE INFORMATION FOR LINES 7E THROUGH 7I WAS DERIVED FROM INFORMATION IN THE GENERAL LEDGER AND OTHER FINANCIAL DATA RELATED SPECIFICALLY TO THE VARIOUS TYPES OF COMMUNITY BENEFITS.
PART I, LINE 7G: INCLUDES PHYSICIAN GROUPS AS A SUBSIDIZED SERVICE. THESE CLINICS PROVIDE SERVICES IN UNDERSERVED AREAS IN COLORADO, NEBRASKA AND WYOMING.
PART I, L7 COL(F): TOTAL BAD DEBT EXPENSE REMOVED FROM THE DENOMINATOR PRIOR TO THE PERCENTAGE CALCULATION = $18,552,643.
PART II: 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:POUDRE VALLEY HEALTH CARE COST REPORT 70,774,223POUDRE VALLEY HEALTH CARE GME PAYMENT (648,327)CENTRE AVE HEALTH & REHAB COST REPORT 3,958,909COLUMBINE POUDRE HOMECARE COST REPORT 1,165,018PVHC INC. MEDICARE DISALLOWED PROGRAMS 717,662DISREGARDED ENTITIES 29,410,992JOINT VENTURES 3,090,548TOTAL TO LINE 5 108,469,025PART III, LINE 6: ALLOWABLE COSTS AS REPORTED ON THE POUDRE VALLEY HEALTH CARE INC. 2013 COST REPORT.PART III, LINE 6: MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENTS WAS COMPUTED AS FOLLOWS:POUDRE VALLEY HEALTH CARE COST REPORT 104,661,256CENTRE AVE HEALTH & REHAB COST REPORT 3,443,138COLUMBINE POUDRE HOMECARE COST REPORT 1,165,018PVHC INC. MEDICARE DISALLOWED PROGRAMS 937,769DISREGARDED ENTITIES 41,827,682JOINT VENTURES 3,403,602TOTAL TO LINE 6 155,438,465
PART III, LINE 8: APPROXIMATELY 22.2% OF NET PATIENT SERVICE REVENUES 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 COLORADO INDIGENT CARE GUIDELINES, REVIEWED BY FINANCIAL ASSISTANCE COMMITTEE (FAC), CROSS FUNCTIONAL TEAM CHAIRED BY DIRECTOR PATIENT FINANCIAL SERVICES. UPON APPROVAL OR DENIAL OF THE REQUEST FOR CHARITABLE AID FROM THE FAC, THE PATIENT WILL BE ADVISED OF THE DECISION. THE BILL IS PARTIALLY OR TOTALLY ADJUSTED AS APPROVED BY THE FAC, 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 V, SECTION B, LINE 1J: THE CHNA REPORT ALSO DESCRIBES CLINICAL SERVICES PROVIDED BY HOSPITAL FACILITY ADDRESSING THE FOUR LEADING CAUSES OF MORTALITY IN THE COUNTY.	POUDRE VALLEY HEALTH CARE
PART V, SECTION B, LINE 3: TWO COMMUNITY MEETINGS WERE HELD DURING FEBRUARY 2013 WHERE FINDINGS FROM THE CHNA WERE PRESENTED, QUESTIONS AND COMMENTS WERE RECEIVED AND RESPONSES PROVIDED. THE FOLLOWING INDIVIDUALS WERE CONSULTED:ANNETTE ALFANO, UNIVERSITY OF COLORADO HEALTHMARY ATCHISON, KAISER PERMANENTEKRISTIN BIERI, FOOD BANK FOR LARIMER COUNTYDEBORAH CAMPBELL, LARIMER COUNTY COMPASSJENNIFER CHASE, NORTHERN COLORADO AIDS PROJECTANDREA CLEMENT-JOHNSON, LARIMER COUNTY DEPARTMENT OF HEALTH & ENVIRONMENTBRUCE COOPER, HEALTH DISTRICT OF NORTHERN LARIMER COUNTYLORI DAIGLE, NORTHERN COLORADO AIDS PROJECTALISON DAWSON, DISABLED RESOURCE SERVICESEMILY DAWSON PETERSEN, TOUCHSTONE HEALTH PARTNERSTOM DONNELLY, LARIMER COUNTY COMMISSIONERSMICHELE DOYLE, COLUMBINE HEALTH CARE SYSTEMSLINDA FELLION, EARLY CHILDHOOD COUNCIL OF LARIMER COUNTYLEW GAITER, LARIMER COUNTY COMMISSIONERSCHAZZ GLAZE, SALUD FAMILY HEALTH CENTERNEIL GLUCKMAN, LARIMER COUNTY, ASSISTANT COUNTY MANAGERMARTHA HARGRAVES, COMMUNITY MEMBERBARBARA HARTMAN, THOMPSON SCHOOL DISTRICTSUE HEWITT, HEALTH DISTRICT OF NORTHERN LARIMER COUNTYJESSICA HINTERBERG, CANDO WITH UNIVERSITY OF COLORADO HEALTHERICA IVERSON, FOOD BANK FOR LARIMER COUNTYSTEVE JOHNSON, LARIMER COUNTY COMMISSIONERSASHLEY KASPRZAK, TEAM FORT COLLINSKATY KOHNEN, LEAGUE OF WOMEN VOTERSJENNY LANGNESS, ALPHA CENTERJENNIFER LEE, LARIMER COUNTY BOARD OF HEALTHDIANA LINDEN, PLANNED PARENTHOOD OF THE ROCKY MOUNTAIN'S RESPONSIBLE SEX EDUCATION INSTITUTEMARIE MACPHERSON, LARIMER COUNTY DEPT OF HEALTH AND ENVIRONMENTJOHN MCGEE, CROSSROADS SAFEHOUSEDAWN NANNINI, TEAM FORT COLLINSKAREN NICHOLSON, ESTES PARK MEDICAL CENTERTRACI ODDY, BANNER MCKEE MEDICAL CENTERCAROL PLOCK, HEALTH DISTRICT OF NORTHERN LARIMER COUNTYMARK RICHARDS, LARIMER COUNTY BOARD OF HEALTHDOUG RYAN, LARIMER COUNTY DEPARTMENT OF HEALTH & ENVIRONMENTKIM SHARPE, HEALTHIER COMMUNITIES COALITION OF LARIMER COUNTYBILL STOUT, WOMEN'S RESOURCE CENTERAVERIL STRAND, LARIMER COUNTY DEPARTMENT OF HEALTH AND ENVIRONMENTDEIRDRE SULLIVAN, CANDO WITH UNIVERSITY OF COLORADO HEALTHJILL TAYLOR, UNIVERSITY OF COLORADO HEALTHGRACE TAYLOR, UNIVERSITY OF COLORADO HEALTHMARILYN THAYER, COMMUNITY ORGANIZING TO REACH EMPOWERMENT (CORE) CENTERLEE THIELEN, THIELEN CONSULTINGCOLETTE THOMPSON, UNIVERSITY OF COLORADO HEALTHJANE VISTE, LARIMER COUNTY DEPARTMENT OF HEALTH AND ENVIRONMENTSCOTT VON BARGEN, TURNING POINT CENTER FOR YOUTH & FAMILY DEVELOPMENTMARGARET WATSON, UNITED WAY 2-1-1 OF LARIMER COUNTYNANCY WEBER, POUDRE SCHOOL DISTRICTVALERIE WENDELL, BOHEMIAN FOUNDATIONLISE YOUNGBLADE, HUMAN DEVELOPMENT AND FAMILY STUDIES/COLORADO STATE UNIVERSITYSTEVE YURASH, LARIMER COUNTY BOARD OF HEALTH	POUDRE VALLEY HEALTH CARE
PART V, SECTION B, LINE 4: MEDICAL CENTER OF THE ROCKIES ALSO PARTICIPATED IN THE 2013 CHNA.	POUDRE VALLEY HEALTH CARE
PART V, SECTION B, LINE 5C: E-MAIL DISTRIBUTION OF LINK TO CHNA REPORT ON HOSPITAL WEBSITE TO MEMBERS OF THE COUNTY HEALTH ASSESSMENT PLANNING & PARTNERSHIP TEAM.HTTP://WWW.PVHS.ORG/DOCUMENTS/CHGENERAL/CHNA_WEB201213.PDF	POUDRE VALLEY HEALTH CARE
PART V, SECTION B, LINE 7: AN IDENTIFIED HEALTH ISSUE RELATED TO A HIGH RATE OF UNINTENDED TEEN PREGNANCY IN WELD COUNTY IS NOT BEING ADDRESSED WITH DIRECT RESOURCES ALLOCATED FROM POUDRE VALLEY HOSPITAL OR THE MEDICAL CENTER OF THE ROCKIES. THE WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT PROVIDES REPRODUCTIVE HEALTH SERVICES FOR TEENS THROUGH A TITLE X CLINIC. ADDITIONAL EDUCATION AND OUTREACH TO WELD COUNTY TEENS IS PROVIDED BY A COMMUNITY ORGANIZATION; LUTHERAN FAMILY SERVICES. POUDRE VALLEY HOSPITAL AND MEDICAL CENTER OF THE ROCKIES PROVIDED SUPPORT TO THIS ORGANIZATION THROUGH CASH DONATIONS TOTALING $2,460.00 DURING THE 2012/13 FISCAL YEAR. ANOTHER IDENTIFIED HEALTH ISSUE - MOTOR VEHICLE SAFETY FOR TEENS IN WELD COUNTY - IS ALSO NOT BEING DIRECTLY ADDRESSED DUE TO LACK OF RESOURCES. THE ISSUE IS BEING ADDRESSED BY A NON-PROFIT COMMUNITY COALITION - DRIVE SMART WELD COUNTY - WHICH HAS DEDICATED RESOURCES AND ACTION PLANS TO ADDRESS THIS ISSUE.	POUDRE VALLEY HEALTH CARE
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 EMERGENCY DEPARTMENT, 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 HEALTH CARE INC. IS A LOCALLY OWNED, PRIVATE, NON-PROFIT ORGANIZATION WITH A STRONG VISION: FROM HEALTH CARE TO HEALTH. BASED IN NORTHERN COLORADO, PVHC 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.PVHC IS A PART OF THE UNIVERSITY OF COLORADO HEALTH 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, COLORADO HEALTH 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 AS FOLLOWS: 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.
CO	REPORTS FILED WITH STATES	PART VI, LINE 7

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (13 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
PVHMCR HOSPITAL FOUNDATION
2315 E HARMONY RD 200	FORT COLLINS	CO	80528	741894581	501(C )(3)	1332421	SEE SCH I, PART IV
UNIVERSITY OF N COLORADO
501 20TH STREET	GREELEY	CO	80639	846000546	GOVERNMENT	170640	SEE SCH I, PART IV
WELD COUNTY FOOD BANK
1108 H STREET	GREELEY	CO	80631	742244826	501(C )(3)	75100	SEE SCH I, PART IV
HEALTH DISTRICT OF N LARMIER COUNTY
120 BRISTLECONE DR	FORT COLLINS	CO	80524	840515919	GOVERNMENT	41000	SEE SCH I, PART IV
NORTHERN COLORADO ECONOMIC DEVELOPMENT CORPORATION
3553 CLYDESDALE PARKWAY 230	LOVELAND	CO	80538	841012341	501(C )(3)	20000	SEE SCH I, PART IV
UNIVERSITY OF N COLORADO FOUNDATION
501 20TH STREET	GREELEY	CO	80639	846044833	501(C )(3)	17610	SEE SCH I, PART IV
PARTNERS MENTORING YOUTH
530 S COLLEGE AVE UNIT 1	FORT COLLINS	CO	80524	742486211	501(C )(3)	11000	SEE SCH I, PART IV
UNITED WAY OF WELD COUNTY
814 9TH STREET	GREELEY	CO	80632	846011918	501(C )(3)	10000	SEE SCH I, PART IV
IVINSON MEMORIAL HOSPITAL FOUNDATION
255 N 30TH STREET	LARAMIE	CO	82072	836000188	501(C )(3)	9268	SEE SCH I, PART IV
AMERICAN CANCER SOCIETY
8221 W 20TH STREET	GREELEY	CO	80634	841316555	501(C )(3)	9200	SEE SCH I, PART IV
GREELEY CENTENNIAL ROTARY
1035 37TH AVE CT	GREELEY	CO	80634	840714073	501(C )(3)	7500	SEE SCH I, PART IV
ARTHRITIS FOUNDATION
2280 S ALBION STREET	DENVER	CO	80222	383826066	501(C )(3)	6000	SEE SCH I, PART IV
ALTERNATIVES TO VIOLENCE
313 E 4TH STREET	LOVELAND	CO	80537	840886127	501(C )(3)	5080	SEE SCH I, PART IV

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	13	TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	PART I, LINE 2:	SCHEDULE I, PART I, LINE 2: THE ORGANIZATION AWARDS GRANTS BASED ON THE BENEFIT TO THE COMMUNITY. THE ORGANIZATION REQUESTS INFORMATION FROM THE GRANTEES TO ENSURE THAT THE FUNDS WILL BE USED FOR THE SPECIFIED PURPOSE.
QUESTION 1, 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.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	X	TravelForCompanions
Idemnification Gross Up Payments	X	IdemnificationGrossUpPayments
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	1	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (18 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
RULON STACEY
PRESIDENT/CEO	632826	348694	93872	51725	405929	223673	79798	43970	17575	9684	1230000	677746	357520	196999
STEPHANIE DOUGHTY
CFO	301861	166331	35702	19672	841994	463951	39361	21689	4714	2598	1223632	674241	770858	424755
RUSS BRANZELL
CEO, CHMG	393041	0	47739	0	512933	0	49274	0	26194	0	1029181	0	503279	0
DOUG FAUS
VP OPERATIONS	181285	0	22945	0	192312	0	6715	0	24626	0	427883	0	182795	0
DR WILLIAM NEFF
CMO	429856	0	51666	0	437675	0	54977	0	25046	0	999220	0	418354	0
DONNA PODUSKA
CNO	179855	0	21881	0	126703	0	37398	0	6304	0	372141	0	74193	0
DR MICHAEL RANDLE
CMO, CHMG	49981	0	0	0	254768	0	12500	0	4975	0	322224	0	0	0
DAN ROBINSON
CEO, CHMG	232269	0	29125	0	377344	0	24859	0	25581	0	689178	0	363972	0
STEVEN SCHWARTZ
CFO, CHMG	151051	0	646	0	15049	0	8298	0	7001	0	182045	0	0	0
KEVIN UNGER
CEO, PVH	379697	0	45741	0	415437	0	109132	0	21958	0	971965	0	374565	0
DR HANS COESTER
PHYSICIAN	674681	0	0	0	946104	0	29500	0	22040	0	1672325	0	0	0
DR MARK GUADAGNOLI
PHYSICIAN	283329	0	0	0	520687	0	29500	0	15885	0	849401	0	0	0
DR WILLIAM MILLER
PHYSICIAN	359641	0	0	0	381104	0	12500	0	9684	0	762929	0	0	0
DR JOSH PETIT
PHYSICIAN	1230818	0	0	0	41104	0	29500	0	27267	0	1328689	0	0	0
DR LARS WIDDEL
PHYSICIAN	107136	0	0	0	601647	0	11001	0	3552	0	723336	0	0	0
GRACE KOWALYSHYN-TAYLOR
DIR PHY RELATIONS	210694	0	28801	0	21623	0	43765	0	25914	0	330797	0	20247	0
PATTI OAKES
VP HUMAN RESOURCES	255151	0	30803	0	214494	0	24889	0	8139	0	533476	0	172530	0
CARL SMITH
VP PAYOR RELATIONS	138323	0	686	0	400430	0	45902	0	16800	0	602141	0	108763	0

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
PART I, LINE 1A	TRAVEL FOR COMPANIONS: PER SYSTEM POLICY, TRAVEL FOR COMPANIONS IS NOT REIMBURSABLE. FOR CONVENIENCE OF TRAVEL ARRANGEMENTS FOR THE ANNUAL BOARD MEMBER RETREAT AND SELECT CONFERENCES, PVHC PAYS FOR ONE COMPANION PER BOARD MEMBER AND EMPLOYEE ATTENDING THE CONFERENCE. EACH BOARD MEMBER RECEIVES A 1099 FOR THIS INCOME. EACH EMPLOYEE HAS THIS ADDED TO THEIR FORM W-2 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, PERSONAL USE OF LAPTOP COMPUTERS AND IPADS, 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 III	PART I, LINE 4A: CARL SMITH RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $216,919. PART I, LINE 4B: THE FOLLOWING EXECUTIVES PARTICIPATED IN AN EXECUTIVE RETENTION PLAN DURING THE YEAR. THE PLAN PROVIDES THE PARTICIPANT WITH SUPPLEMENTAL DEFERRED COMPENSATION, SUBJECT TO SUBSTANTIAL RISKS OF FORFEITURE, TO ENCOURAGE CONTINUED EMPLOYMENT WITH THE ORGANIZATION FOR A SIGNIFICANT PERIOD OF TIME. THE AMOUNT LISTED IS INCLUDED IN FORM W-2 BOX 5 WAGES AND AMOUNTS INCLUDED IN DEFERRED COMP. W-2 BOX 5 UNFUNDED DEFERRED COMP. RUSS BRANZELL 503,279 - STEPHANIE DOUGHTY 833,556 106,130 DOUG FAUS 182,795 - GRACE KOWALYSHYN-TAYLOR 20,247 - WILLIAM NEFF 418,354 - PATTI OAKES 172,530 - DONNA PODUSKA 74,193 - DAN ROBINSON 363,972 - CARL SMITH 108,763 - RULON STACEY 472,582 - KEVIN UNGER 374,565 77,002	SUPPLEMENTAL INFORMATION

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Bond ReferenceBondReferenceCd	Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
COLORADO HEALTH FACILITIES AUTHORITY SERIES A
A	840752932	196474W48	2005-03-31	50000000	REFUNDING 1999A BONDS	0	0	0
COLORADO HEALTH FACILITIES AUTHORITY SERIES B
B	840752932	196474W48	2005-03-31	26294807	PAYMENT OF COMMERCIAL PAPER DEBT	0	0	0
COLORADO HEALTH FACILITIES AUTHORITY SERIES F
C	840752932	196474W48	2005-03-31	55000000	REFUNDING 1999A BONDS	0	0	0

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Bond ReferenceBondReferenceCd	Total ProceedsTotalProceeds	Amount In Reserve FundAmountInReserveFund	Refunding EscrowRefundingEscrow	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Credit EnhancementCreditEnhancement	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A	50000000	3133031	46468713	433893	3097393	2005	0	1	1	1
B	26294807	1644630	25000000	397052	897754	2005	1	0	1	1
C	55000000	3474651	54542446	795916		2005	0	1	1	1

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Bond ReferenceBondReferenceCd	Any Lease ArrangementsAnyLeaseArrangements	Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI	Total Private Business UseTotalPrivateBusinessUse	Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A	1	0.00610	0.00610	1
B	1	0.00350	0.00350	1
C	1	0.00610	0.00610	1

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiled	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Term Of HedgeTermOfHedge	Superintegrated HedgeSuperintegratedHedge	Hedge TerminatedHedgeTerminated	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Written Proc To Monitor ReqsWrittenProcToMonitorReqs
JP MORGAN CHASE
A	1	0	1	25.670000000000	1	0	0	0	1
JP MORGAN CHASE
B	1	0	1	30.830000000000	1	0	0	0	1
(no name)
C	1	0	0				0	0	1

Form990 Schedule K Part V Form990ScheduleKPartV (3 entries)

Bond ReferenceBondReferenceCd	Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A	1
B	1
C	1

Form990 Schedule K Part VI Form990ScheduleKPartVI

Field	Value	IRS element (for citing)
Identifier	SCHEDULE K, PART I, COLUMN E	Identifier
Return Reference	BOND ISSUE PRICE	ReturnReference
Explanation	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 8038: $83,000,000.	Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
STAMPEDE PROPERTIES
SEE PART V	430092	SEE PART V	0
KATHLEEN MICHIE
SEE PART V	81959	SEE PART V	0

Form990 Schedule L Part V Form990ScheduleLPartV

Field	Value	IRS element (for citing)
Explanation	SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:(A) NAME OF PERSON: STAMPEDE PROPERTIES(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DAN STROH, DIRECTOR, HAS AN OWNERSIP INTEREST IN STAMPEDE PROPERTIES(D) DESCRIPTION OF TRANSACTION: 1099 INCOME PAID TO ENTITY(A) NAME OF PERSON: KATHLEEN MICHIE(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: KATHLEEN MICHIE IS A FAMILY MEMBER OF THAINE MICHIE, DIRECTOR(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT WAGES	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
VOLUNTEERS	FORM 990, PART I, LINE 6	PVH HAS 831 ACTIVE VOLUNTEERS IN FISCAL YEAR 2013. 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 11	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	POUDRE VALLEY HEALTHCARE, INC DETERMINES CEO, EXECUTIVE DIRECTOR, TOP MANAGEMENT OFFICIALS AND OTHER OFFICERS AND KEY EMPLOYEES COMPENSATION ANNUALLY. THIS DETERMINATION IS ACCOMPLISHED THROUGH THE USE OF THE HAY GROUP. THESE SERVICES ANNUALLY COLLECT LIKE DATA ON LIKE JOBS FROM LIKE ORGANIZATIONS. THE DATA IS SUBMITTED TO THE VP OF HUMAN RESOURCES WHO TAKES THE INFORMATION TO THE COMPENSATION COMMITTEE OF THE GOVERNING BOARD OF DIRECTORS WHERE ANY NEW COMPENSATION IS THEN ADOPTED AND RECORDED APPROPRIATELY IN THE MINUTES. EMPLOYMENT AGREEMENTS ARE KEPT ON FILE FOR THE CEO AND AN ADDITIONAL DOCUMENT THAT OUTLINES THE SENIOR MANAGEMENT ANNUAL INCENTIVE PLAN IS MADE AVAILABLE.
	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.
POLICIES	FORM 990, PART VI, SECTION B	ALL ANSWERS MARKED "YES" UNDER PART VI, SECTION B - POLICIES APPLY TO POUDRE VALLEY HEALTH CARE INC AND LAKOTA LAKE LLC. QUESTIONS 15A AND 15B APPLY TO TIMBERLINE MEDICAL LLC AS WELL AS POUDRE VALLEY HEALTH CARE INC, LAKOTA LAKE LLC, AND POUDRE VALLEY MEDICAL GROUP, LLC.
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 9:	GASB PRIOR YEAR ADJUSTMENT 67,093. REMOVE HSS INVESTMENT BEGINNING BALANCE -913,179. AUXILIARY INCOME NOT INCLUDED IN AFS -149,769. AUXILIARY GRANTS NOT INCLUDED IN AFS 167,501. CONTRIBUTIONS FROM PV FOUNDATION NOT IN AFS INCOME -299,322. TIMING DIFFERENCE ON FDN/PVH CONTRIBUTION -58,689. BOOK VERSUS TAX ADJUSTMENT IN EQUITY EARNINGS 327,014.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (4 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Total IncomeTotalIncome	EOY AssetsEOYAssets	Business Name Line1DirectControllingEntityName/BusinessNameLine1
TIMBERLINE MEDICAL CLINIC
131 STANLEY AVE	ESTES PARK	CO	80517	043772090	OUTPATIENT	CO	1419613	370651	PVHC INC
LAKOTA LAKE LLC
2315 E HARMONY RD STE 200	FORT COLLINS	CO	80528	841447761	OUTPATIENT	CO	3922874	8013822	PVHC INC
HERON LAKE LLC
2315 E HARMONY RD STE 200	FORT COLLINS	CO	80528	264189163	OUTPATIENT	CO	651660	721901	PVHC INC
POUDRE VALLEY MEDICAL GROUP LLC
2315 E HARMONY RD STE 200	FORT COLLINS	CO	80528	800348943	OUTPATIENT	CO	74372801	20415666	PVHC INC

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
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	1
PVHS FOUNDATION
2315 E HARMONY RD STE 200	FORT COLLINS	CO	80528	741894581	BENEFIT HEALTH	CO	501(C)(3)	LINE 7	PVHC INC	1
CARBON VALLEY HEALTHCARE HOLDINGS
1950 MOUNTAIN VIEW AVE	LONGMONT	CO	80501	273769602	LAND HOLDINGS	CO	501(C)(3)	LINE 3		0	N/A

Form990 Schedule R Part III Form990ScheduleRPartIII (12 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership
HARMONY SURGERY CENTER
2127 E HARMONY RD 200	FT COLLINS	CO	80528	841479751	AMBULATORY SURG	CO	N/A	RELATED	2102135	2695569	0	0	0.51100
UNITED MEDICAL ALLIANCE
2021 BATTLECREEK DRIVE STE A	FT COLLINS	CO	80528	820572743	HEALTH CLAIMS	CO	N/A	RELATED	182308	516094	0	1	0.50000
CENTRE AVENUE HEALTH & REHAB FACILITY
947 WORTHINGTON CIRCLE	FT COLLINS	CO	80526	841560494	NURSING FACILITY	CO	N/A	RELATED	232710	821023	0	0	0.50000
COLUMBINE POUDRE HOME CARE
947 WORTHINGTON CIRCLE	FT COLLINS	CO	80526	841529817	NURSING CARE	CO	N/A	RELATED	69546	329535	0	0	0.50000
EYE LASER CENTER OF NO COLORADO
1725 E PROSPECT RD	FT COLLINS	CO	80525	841518334	LASER SURGERY	CO	N/A	UNRELATED	36722	11806	0	0	0.50000
GATEWAY MEDICAL SERVICES
2500 E PROSPECT RD	FT COLLINS	CO	80525	841427970	REAL EST/MED	CO	N/A	UNRELATED	3302028	7596926	0	0	0.50000
POUDRE INFUSION THERAPY
947 WORTHINGTON CIRCLE	FT COLLINS	CO	80526	841530973	MEDICAL SERVICES	CO	N/A	RELATED	40648	189639	0	0	0.50000
PVHS HOME MEDICAL SUPPLY
6820 N COUNTY RD 13	LOVELAND	CO	80538	202034599	MEDICAL SUPPLY	CO	N/A	UNRELATED	245504	664429	0	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	34208	41440	0	0	0.33330
HARMONY IMAGING CENTER
1951 WILMINGTON DRIVE	FORT COLLINS	CO	80528	582479187	MEDICAL IMAGING	CO	N/A	RELATED	902350	1551838	0	0	0.46000
PEAK SURGICAL MANAGEMENT
2127 E HARMONY RD STE 200	FORT COLLINS	CO	80528	260899618	SURGICAL MGMT	CO	N/A	RELATED	65209	48241	0	0	0.14290
SURGERY CENTER OF FORT COLLINS
1100 E PROSPECT ROAD	FORT COLLINS	CO	80525	841541559	SURGICAL PROC	CO	N/A	UNRELATED	839292	1151171	0	0	0.26000

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

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

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2315 E HARMONY RD STE 200	AddressLine1
City	FORT COLLINS	City
State	CO	State
ZIP Code	80528	ZIPCode

Field	Value	IRS element (for citing)
EIN	202036774	EIN
Primary Activity	IT CONSULTING	PrimaryActivity
Legal Domicile State	CO	LegalDomicileState
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Type Of Entity	C	TypeOfEntity
Share Of Total Income	1176693	ShareOfTotalIncome
Share Of EOY Assets	3374372	ShareOfEOYAssets
Percentage Ownership	1.00000	PercentageOwnership
Controlled Org	1	ControlledOrg

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	1	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	1	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	1	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	1	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	1	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	1	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	1	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (20 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
HARMONY SURGERY CENTER
A	699243	TRANSACTION TOTAL
HARMONY SURGERY CENTER
O	3171876	TRANSACTION TOTAL
HARMONY SURGERY CENTER
Q	434456	TRANSACTION TOTAL
HARMONY SURGERY CENTER
S	2338285	TRANSACTION TOTAL
UNITED MEDICAL ALLIANCE
M	1425395	TRANSACTION TOTAL
CENTRE AVENUE HEALTH & REHAB FACILITY
S	150000	TRANSACTION TOTAL
COLUMBINE POUDRE HOME CARE
S	50000	TRANSACTION TOTAL
EYE LASER CENTER OF NO COLORADO
M	137037	TRANSACTION TOTAL
GATEWAY MEDICAL SERVICES
S	3240000	TRANSACTION TOTAL
MEDICAL CENTER OF THE ROCKIES
L	3953227	TRANSACTION TOTAL
MEDICAL CENTER OF THE ROCKIES
N	3605069	TRANSACTION TOTAL
MEDICAL CENTER OF THE ROCKIES
O	46499678	TRANSACTION TOTAL
MEDICAL CENTER OF THE ROCKIES
R	81975350	TRANSACTION TOTAL
PVHS FOUNDATION
B	1332421	TRANSACTION TOTAL
PVHS FOUNDATION
C	299322	TRANSACTION TOTAL
PVHS FOUNDATION
O	241621	TRANSACTION TOTAL
INNOVATION ENTERPRISES
A	123690	TRANSACTION TOTAL
INNOVATION ENTERPRISES
A	437013	TRANSACTION TOTAL
INNOVATION ENTERPRISES
O	232090	TRANSACTION TOTAL
INNOVATION ENTERPRISES
S	238648	TRANSACTION TOTAL