POUDRE VALLEY HEALTH CARE INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: POUDRE VALLEY HEALTH CARE INC (EIN 84-1262971)
Tax period: 2011-01-01 to 2011-12-31
Filed: 2012-11-13
IRS object ID: 201223189349302662
Schema version: 2011v1.3
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 M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-11-13T12:59:50-06:00	Timestamp
Tax Period End Date	2011-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	111 South Tejon Suite 800	AddressLine1
City	Colorado Springs	City
State	CO	State
ZIP Code	809039848	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-01-01	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)
In Care Of Name	% THE ORGANIZATION	InCareOfName
Name Control	POUD	NameControl
Phone	9702377000	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2315 E Harmony Road	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
Date Signed	2012-10-30	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	David S Mason CPA	Name
Phone	7194714290	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Rulon Stacey	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

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

Field	Value	IRS element (for citing)
Gross Receipts	673678789	GrossReceipts
Group Return For Affiliates	false	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	POUDRE VALLEY HEALTH SYSTEM IS AN INTEGRATED, INDEPENDENT, NON-PROFIT ORGANIZATION, PROVIDING INNOVATIVE, COMPREHENSIVE CARE OF HIGHEST QUALITY & EXCEEDING EXPECTATIONS OF THE COMMUNITIES WE SERVE.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	11	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	8	NbrIndependentVotingMembers
Total Nbr Employees	6072	TotalNbrEmployees
Total Nbr Volunteers	693	TotalNbrVolunteers
Total Gross UBI	11265922	TotalGrossUBI
Net Unrelated Business Txbl Income	1668043	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	8098366	ContributionsGrantsPriorYear
Contributions Grants Current Year	19676937	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	423726041	ProgramServiceRevenuePriorYear
Program Service Revenue CY	500594992	ProgramServiceRevenueCY
Investment Income Prior Year	8470934	InvestmentIncomePriorYear
Investment Income Current Year	6512780	InvestmentIncomeCurrentYear
Other Revenue Prior Year	8904167	OtherRevenuePriorYear
Other Revenue Current Year	7855207	OtherRevenueCurrentYear
Total Revenue Prior Year	449199508	TotalRevenuePriorYear
Total Revenue Current Year	534639916	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	1482109	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	1373901	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	218684389	SalariesEtcPriorYear
Salaries Etc Current Year	262591241	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	190771747	OtherExpensePriorYear
Other Expenses Current Year	230150743	OtherExpensesCurrentYear
Total Expenses Prior Year	410938245	TotalExpensesPriorYear
Total Expenses Current Year	494115885	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	38261263	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	40524031	RevenuesLessExpensesCY
Total Assets BOY	727783197	TotalAssetsBOY
Total Assets EOY	771988968	TotalAssetsEOY
Total Liabilities BOY	235600988	TotalLiabilitiesBOY
Total Liabilities EOY	240523827	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	492182209	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	531465141	NetAssetsOrFundBalancesEOY
Mission Description	THE MISSION OF POUDRE VALLEY HEALTH SYSTEM IS TO BE AN INTEGRATED, INDEPENDENT, NON-PROFIT ORGANIZATION PROVIDING INNOVATIVE, COMPREHENSIVE CARE OF THE HIGHEST QUALITY AND EXCEEDING EXPECTATIONS OF THE COMMUNITIES WE SERVE.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	343913328	Expense
Grants	1373901	Grants
Revenue	421894133	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 2011, PVHC recorded 58,779 patient days; 15,175 discharges; 494,889 outpatient visits; 44,728 emergency visits; 3,250 births; 5,703 inpatient surgeries; and 3,717 outpatient surgeries.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	101084842	Expense
Grants	0	Grants
Revenue	73407686	Revenue
Description	The physician network of Poudre Valley Health System encompasses Timberline Medical LLC, Heron Lake LLC, and Poudre Valley Medical Group LLC. During 2011, the physician network had 415,294 outpatient visits. At year end, the physician network was comprised of 133 employed physicians, representing 21 specialties at 24 medical clinics in Colorado, Nebraska, and Wyoming.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	444998170	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	true	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	true	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	true	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	true	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	true	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	true	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	true	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	true	RelatedOrgControlledEntity
Transaction Related Entity	true	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	558	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	6072	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	true	UnrelatedBusinessIncome
Form990-T Filed	true	Form990-TFiled
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	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	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	true	InvestmentInJointVenture
Written Policy Or Procedure	true	WrittenPolicyOrProcedure
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	THE ORGANIZATION	NamePerson
Telephone Number	9702377000	TelephoneNumber

Address US AddressUS

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

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

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	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
Stu VanMeveren
Board Chair	2.0	X	X	879	0	0
Chris Osborn
Vice Board Chair	2.0	X	X	1188	0	0
Christine Chin
Board Member	2.0	X		879	0	0
Mike Dellenbach
Board Member	2.0	X		2239	0	0
Gary Ludwin MD
Board Member	2.0	X		879	0	0
Thaine Michie
Board Member	2.0	X		3102	0	0
Todd Sorensen MD
Board Member	2.0	X		2827	0	0
Laurie Steele
Board Member	2.0	X		2639	0	0
Dan Stroh
Board Member	2.0	X		3206	0	0
Joe Hendrickson
Board Member	2.0	X		879	0	0
Rulon Stacey
Chief Executive Officer	40.0	X	X	1528683	0	184217
Stephanie Doughty
Chief Financial Officer	40.0		X	486338	0	158443
Russ Branzell
Chief Information Officer	40.0			436824	0	96554	X
Grace Kowalyshyn-Taylor
VP of Strategy	40.0			197008	0	62906	X
Craig Luzinski
PVH Chief Nursing Officer	40.0			109565	0	2590	X
William Neff MD
Chief Medical Officer	40.0			434879	0	111126	X
Patti Oakes
VP-Human Resources	40.0			226244	0	59990	X
Donna Poduska
PVH Chief Nursing Officer	40.0			173164	0	24701	X
Dan Robinson
PVH VP of Operations	40.0			261209	0	73471	X
Carl Smith
VP of Payor Relations	40.0			195000	0	36782	X
Kevin Unger
PVH President	40.0			444902	0	123182	X
Barb Yosses
VP Ambulatory Services	10.0			453196	0	7369	X
Mary Blattner MD
Physician	40.0			648758	0	26966		X
Hans Coester MD
Physician	40.0			1456466	0	22473		X
Mark Grossnickle MD
Physician	40.0			558010	0	56142		X
Mark Guadagnoli MD
Physician	40.0			760716	0	45071		X
Joshua Petit
Physician	40.0			1242166	0	35135		X
Diane Gross
Former VP-General Council	0.0			193852	0	0			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	9825697	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	1127118	TotalOtherCompensation
Number Individuals GT100 K	268	NumberIndividualsGT100K
Formers Listed	true	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
NORTHERN COLORADO PULMONARY CONSULT
2121 E HARMONY RD SUITE 300	FT COLLINS	CO	80528	MEDICAL	2193871
Fort Collins Women's Clinic
1107 S Lemay Ave Ste 300	FORT COLLINS	CO	80524	MEDICAL	1654512
Harmony Addiction Health
2121 East Harmony Rd Ste 310	FORT COLLINS	CO	80528	MEDICAL	1504955
Mayo Collaborative Services INC
PO Box 9146	MINNEAPOLIS	MN	554809146	MEDICAL	1474964
NORTHERN COLORADO HOSPITALISTS
2121 EAST HARMONY ROAD STE 300	FORT COLLINS	CO	80528	MEDICAL	1365807

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	84	NumberOfContractorsGT100K
Related Organizations	19210763	RelatedOrganizations
Government Grants	405858	GovernmentGrants
All Other Contributions	60316	AllOtherContributions
Noncash Contributions	351602	NoncashContributions
Total Contributions	19676937	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	ExclusionExclusionAmount	Unrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT SERVICE REVENUE	900099	460312541	460312541
PROVIDER FEE INCOME	621400	28253835	28253835
DIETARY SERVICES INCOME	900099	2025934		$2,025,934
LAB UBI	621500	2634602			2634602
JOINT VENTURE	621400	3528615	3308337		220278

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	3839465	TotalRevenueColumn
Related Or Exempt Function Income	3427106	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	412359	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Program Service Revenue	500594992	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	6375165	TotalRevenueColumn
Exclusion	$6,375,165	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	462922	TotalRevenueColumn
Exclusion	$462,922	ExclusionAmount

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	6034672	Real
Personal	396644	Personal

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	3395230	Real
Personal	396644	Personal

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	2639442	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	2639442	TotalRevenueColumn
Unrelated Business Revenue	2982673	UnrelatedBusinessRevenue
Exclusion	-$343,231	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	131876996	Securities
Other	2491499	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	131866292	Securities
Other	2827510	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	10704	Securities
Other	-336011	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-325307	TotalRevenueColumn
Exclusion	-$325,307	ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	770922	GrossSalesOfInventory
Cost Of Goods Sold	553197	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	217725	TotalRevenueColumn
Unrelated Business Revenue	30340	UnrelatedBusinessRevenue
Exclusion	$187,385	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
REIMBURSEMENT - NON OPERATING DEPTS	621400	4891555	4891555
SERVICES PROVIDED TO OUTSIDE ENTITIES	621400	63320	63320
INCOME TAX REFUND	621400	12370		$12,370

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	30795	TotalRevenueColumn
Unrelated Business Revenue	30795	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Other Revenue	4998040	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	534639916	TotalRevenueColumn
Related Or Exempt Function Income	495301819	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	11265922	UnrelatedBusinessRevenue
Exclusion	$8,395,238	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	1373901	Total
Program Services	1373901	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	5888345	Total
Program Services	644702	ProgramServices
Management And General	5243643	ManagementAndGeneral
Fundraising	0	Fundraising

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	666115	Total
Program Services	666115	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	203428337	Total
Program Services	193121177	ProgramServices
Management And General	10307160	ManagementAndGeneral
Fundraising	0	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	8749544	Total
Program Services	7498228	ProgramServices
Management And General	1251316	ManagementAndGeneral
Fundraising	0	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	29657345	Total
Program Services	25856772	ProgramServices
Management And General	3800573	ManagementAndGeneral
Fundraising	0	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	14201555	Total
Program Services	12094965	ProgramServices
Management And General	2106590	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	1278601	Total
Program Services	56562	ProgramServices
Management And General	1222039	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	249134	Total
Program Services	84	ProgramServices
Management And General	249050	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	19147	Total
Program Services	0	ProgramServices
Management And General	19147	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	589799	Total
Program Services	0	ProgramServices
Management And General	589799	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	29560789	Total
Program Services	21478351	ProgramServices
Management And General	8082438	ManagementAndGeneral
Fundraising	0	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	2150963	Total
Program Services	34284	ProgramServices
Management And General	2116679	ManagementAndGeneral
Fundraising	0	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	4598750	Total
Program Services	2708756	ProgramServices
Management And General	1889994	ManagementAndGeneral
Fundraising	0	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	10903049	Total
Program Services	9689779	ProgramServices
Management And General	1213270	ManagementAndGeneral
Fundraising	0	Fundraising

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	13750532	Total
Program Services	10291326	ProgramServices
Management And General	3459206	ManagementAndGeneral
Fundraising	0	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	1178626	Total
Program Services	835494	ProgramServices
Management And General	343132	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	912118	Total
Program Services	633888	ProgramServices
Management And General	278230	ManagementAndGeneral
Fundraising	0	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	9482838	Total
Program Services	9482838	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	27951004	Total
Program Services	26146713	ProgramServices
Management And General	1804291	ManagementAndGeneral
Fundraising	0	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	2045787	Total
Program Services	1600858	ProgramServices
Management And General	444929	ManagementAndGeneral
Fundraising	0	Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES	76333825	76288099	45726
PROVIDER FEE EXPENSE	19565332	19565332	0
BAD DEBT	13772423	13772423	0
UBI ESTIMATES PAID	1310000	0	1310000

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	14498026	Total
Program Services	11157523	ProgramServices
Management And General	3340503	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	494115885	Total
Program Services	444998170	ProgramServices
Management And General	49117715	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	3595327	BOY
EOY	3613668	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	48816414	BOY
EOY	43194507	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

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

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	78566431	BOY
EOY	68134094	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	2302454	BOY
EOY	1949687	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

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

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	1743834	BOY
EOY	1924628	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	6175678	BOY
EOY	5708412	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	2931636	BOY
EOY	4042593	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	499679446	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	267127672	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	234209442	BOY
EOY	232551774	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	272009524	BOY
EOY	343669732	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	3011040	BOY
EOY	3011209	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	46464951	BOY
EOY	39320959	EOY

Intangible Assets IntangibleAssets

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

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	27956466	BOY
EOY	24867705	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	727783197	BOY
EOY	771988968	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	59860633	BOY
EOY	62329882	EOY

Grants Payable GrantsPayable

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

Deferred Revenue DeferredRevenue

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	131351513	BOY
EOY	131343037	EOY

Escrow Account Liability EscrowAccountLiability

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

Loans From Officers Directors LoansFromOfficersDirectors

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

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	25144046	BOY
EOY	24822477	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	5244455	BOY
EOY	5824089	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	14000341	BOY
EOY	16204342	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	235600988	BOY
EOY	240523827	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	492182209	BOY
EOY	531465141	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

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

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

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

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	492182209	BOY
EOY	531465141	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	727783197	BOY
EOY	771988968	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	40524031	ReconcilationRevenueExpenses
Reconcilation Other Changes	-1241099	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	false	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)
Total Grassroots Lobbying		TotalGrassrootsLobbying
Total Direct Lobbying		TotalDirectLobbying
Total Lobbying Expenditures		TotalLobbyingExpenditures
Other Exempt Purpose Expenditures		OtherExemptPurposeExpenditures
Total Exempt Purpose Expenditures		TotalExemptPurposeExpenditures
Lobbying Nontaxable		LobbyingNontaxableAmount
Grassroots Nontaxable		GrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non Tx		TotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying Nontx		TotLobbyExpendMnsLobbyingNontx
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	false	GrantsOtherOrganizations
Direct Contact Legislators	true	DirectContactLegislators
Direct Contact Legislators	$19,147	DirectContactLegislatorsAmount
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	false	OtherActivities
Total Lobbying Expenditures IIB	19147	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	Direct Contact with Legislators, staff, Gov't officials	Identifier
Return Reference	Form 990, Sch. C, Part II-B, Line 1g	ReturnReference
Explanation	Poudre Valley Hospital pays annual membership dues to CHA and AHA. A percentage of the annual dues are attributable to lobbying. The amount shown on this line is that percentage.	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts
Agent Trustee Etc	false	AgentTrusteeEtc
Included On FS	false	IncludedOnFS
Current Year Minus3 Years		CurrentYearMinus3Years

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	38415988	OtherCostOrOtherBasis
Book Value	38415988	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	182359581	OtherCostOrOtherBasis
Depreciation	90731649	Depreciation
Book Value	91627932	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	96710904	OtherCostOrOtherBasis
Depreciation	50164910	Depreciation
Book Value	46545994	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	179815541	OtherCostOrOtherBasis
Depreciation	124342498	Depreciation
Book Value	55473043	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2377431	OtherCostOrOtherBasis
Depreciation	1888614	Depreciation
Book Value	488817	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	232551774	TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
Description	JOINT VENTURES	Description
Book Value	39320959	BookValue
Method Of Valuation	C	MethodOfValuation

Field	Value	IRS element (for citing)
Total Of Book Value Program Related	39320959	TotalOfBookValueProgramRelated
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
OTHER ACCRUED LIABILITIES	$10,330,535
CASH OVERDRAFTS	$5,873,807

Field	Value	IRS element (for citing)
Total Of Amounts	16204342	TotalOfAmounts
Total Revenue	534639916	TotalRevenue
Total Expenses	494115885	TotalExpenses
Excess Or Deficit For Year	40524031	ExcessOrDeficitForYear
Net Unrealized GL On Investments	-1160783	NetUnrealizedGLOnInvestments
Other	-$80,316	OtherAmount
Total Adjustments	-1241099	TotalAdjustments
Excess Or Deficit Per FS	39282932	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	500758414	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	-1160783	NetUnrealizedGainsInvestments
Other Revenues	678839	OtherRevenues
Revenue Not Rptd F990	-481944	RevenueNotRptdF990
Revenue Subtotal	501240358	RevenueSubtotal
Other Revenues Not Included	33399558	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	33399558	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	534639916	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	461475482	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	4859018	OtherExpensesIncluded
Expenses Not Rptd F990	4859018	ExpensesNotRptdF990
Expenses Subtotal	456616464	ExpensesSubtotal
Other Expenses Not Included	37499421	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	37499421	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	494115885	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
FIN 48 DISCLOSURE	Part X, Line 2	At December 31, 2011, all entities included in PVHCs consolidation are exempt from taxation under Section 501(c)(3) of the Internal Revenue Code except for Lakota Lake, LLC, PVHS/Timberline, LLC, Heron Lake, LLC, Poudre Valley Medical Group, LLC, and Innovation Enterprises, Inc., including wholly-owned subsidiary. Lakota Lake, LLC, PVHS/Timberline, LLC, Heron Lake, LLC and Poudre Valley Medical Group, LLC act as tax flow-through entities to PVHC, which, as noted, is tax-exempt under Section 501(c)(3) of the Internal Revenue Code. Innovation Enterprises, Inc. is taxed on its net profit under Subchapter C of the Internal Revenue Code and includes their wholly-owned LLC as a tax flow-through entity. The Foundation has also been classified as an entity that is not a private foundation within the meaning of Section 509(a) and qualifies for deductible contributions as provided in Section 170(b)(1)(A)(vi) of the Internal Revenue Code. Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.
OTHER RECONCILING DIFFERENCE	PART XI, LINE 8, OTHER DESCRIPTION	IMPAIRMENT OF EQUITY INVESTMENTS ON AFS (477,737) CONTRIBUTION FROM PV FOUNDATION NOT ON AFS (133,880) EXCESS AUXILLARY INCOME NOT ON AFS (148,160) AUXILLARY COGS ON AFS (176,575) EXCESS AUXILLARY GRANTS PAID NOT ON AFS 175,000 TIMING DIFFERENCE ON FDN/PVH CONTRIBUTIONS 2,193 OTHER CHANGES ON AFS 3,911 BOOK/TAX TIMING DIFFERENCES ON JOINT VENTURES 674,932 TOTAL PART XI LINE 8 AMOUNT: (80,316)
OTHER RECONCILING DIFFERENCE	PART XII, LINE 2D, OTHER DESCRIPTION	OTHER CHANGES IN NET ASSETS 3,907 BOOK/TAX TIMING DIFFERENCES ON JOINT VENTURES 674,932 TOTAL PART XII LINE 2D AMOUNT: 678,839
OTHER RECONCILING DIFFERENCE	PART XII, LINE 4B, OTHER DESCRIPTION	PROVISION FOR BAD DEBT IN AFS INCOME 13,772,423 NET RENTAL LOSS IN EXPENSE ON AFS (3,492,073) TTT, ONCOLOGY SHOP COGS IN AFS EXPENSE (376,622) LOSS ON SALE OF ASSETS IN EXPENSE ON AFS (336,011) MCR PHYSICIAN NETWORK CONTRIBUTION IN AFS EXPENSE 18,551,761 NON-OPER REIMBURSEMENTS IN EXPENSE ON AFS 4,891,555 INCOME TAX REFUND IN EXPENSE ON AFS 12,370 CONTRIBUTION FROM PV FDN. NOT IN AFS REV 133,880 AUXILLARY INCOME NOT INCLUDED IN AFS INCOME 148,160 SVCS PROVIDED TO O/S ENTITIES IN EXP ON AFS 63,320 VARIOUS UBI INCOME NOT IN AFS INCOME 30,795 TOTAL PART XII LINE 4B AMOUNT: 33,399,558
OTHER RECONCILING DIFFERENCE	PART XIII, LINE 2D, OTHER DESCRIPTION	NET RENTAL INCOME IN EXPENSE ON AFS 3,492,073 COST OF GOODS SOLD IN EXPENSE ON AFS 553,197 IMPAIRMENT OF EQUITY INVESTMENTS ON AFS 477,737 LOSS ON SALE OF ASSETS IN EXPENSE ON AFS 336,011 TOTAL PART XIII LINE 2D AMOUNT: 4,859,018
OTHER RECONCILING DIFFERENCE	PART XIII, LINE 4B, OTHER DESCRIPTION	PROVISION FOR BAD DEBT IN AFS INCOME 13,772,423 MCR PHYSICIAN NETWORK ALLOCATION ON AFS 18,551,761 NON-OPERATING REIMBURSEMENTS ON AFS 4,891,555 INCOME TAX REFUND REDUCING EXPENSE ON AFS 12,370 SERVICES PROVIDED TO O/S ENTITIES ON AFS 63,320 VARIOUS UBI INCOME IN EXPENSE ON AFS 30,795 AUXILIARY GRANTS NOT ON AFS 175,000 TIMING DIFFERENCE ON FDN/PVH CONTRIBUTIONS 2,193 OTHER CHANGES IN NET ASSETS 4 TOTAL PART XIII LINE 4B AMOUNT: 37,499,421

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent100	X	Pcent100
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	true	ExpensesExceededBudget
Unable To Provide Care	false	UnableToProvideCare
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3927433	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	3927433	NetCommunityBenefitExpense
Percent Of Total Expense	0.00790	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	43346399	TotalCommunityBenefitExpense
Direct Offsetting Revenue	19232588	DirectOffsettingRevenue
Net Community Benefit Expense	24113811	NetCommunityBenefitExpense
Percent Of Total Expense	0.04830	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	46659965	TotalCommunityBenefitExpense
Direct Offsetting Revenue	34211483	DirectOffsettingRevenue
Net Community Benefit Expense	12448482	NetCommunityBenefitExpense
Percent Of Total Expense	0.02490	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	93933797	TotalCommunityBenefitExpense
Direct Offsetting Revenue	53444071	DirectOffsettingRevenue
Net Community Benefit Expense	40489726	NetCommunityBenefitExpense
Percent Of Total Expense	0.08110	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4644156	TotalCommunityBenefitExpense
Direct Offsetting Revenue	45124	DirectOffsettingRevenue
Net Community Benefit Expense	4599032	NetCommunityBenefitExpense
Percent Of Total Expense	0.00920	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4462955	TotalCommunityBenefitExpense
Direct Offsetting Revenue	828375	DirectOffsettingRevenue
Net Community Benefit Expense	3634580	NetCommunityBenefitExpense
Percent Of Total Expense	0.00730	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	15951908	TotalCommunityBenefitExpense
Direct Offsetting Revenue	10082836	DirectOffsettingRevenue
Net Community Benefit Expense	5869072	NetCommunityBenefitExpense
Percent Of Total Expense	0.01180	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	657176	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9101	DirectOffsettingRevenue
Net Community Benefit Expense	648075	NetCommunityBenefitExpense
Percent Of Total Expense	0.00130	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1168401	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	1168401	NetCommunityBenefitExpense
Percent Of Total Expense	0.00230	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	26884596	TotalCommunityBenefitExpense
Direct Offsetting Revenue	10965436	DirectOffsettingRevenue
Net Community Benefit Expense	15919160	NetCommunityBenefitExpense
Percent Of Total Expense	0.03190	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	120818393	TotalCommunityBenefitExpense
Direct Offsetting Revenue	64409507	DirectOffsettingRevenue
Net Community Benefit Expense	56408886	NetCommunityBenefitExpense
Percent Of Total Expense	0.11300	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Total Community Building Expense	14040	TotalCommunityBuildingExpense
Net Community Building Expense	14040	NetCommunityBuildingExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	3400	TotalCommunityBuildingExpense
Net Community Building Expense	3400	NetCommunityBuildingExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	276170	TotalCommunityBuildingExpense
Net Community Building Expense	276170	NetCommunityBuildingExpense
Percent Of Total Expense	0.00060	PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	35246	TotalCommunityBuildingExpense
Net Community Building Expense	35246	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Total Community Building Expense	104962	TotalCommunityBuildingExpense
Net Community Building Expense	104962	NetCommunityBuildingExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Total Community Building Expense	161628	TotalCommunityBuildingExpense
Net Community Building Expense	161628	NetCommunityBuildingExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	595446	TotalCommunityBuildingExpense
Net Community Building Expense	595446	NetCommunityBuildingExpense
Percent Of Total Expense	0.00120	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$14,052,108	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	90154091	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	138414694	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-48260603	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost Accounting System	X	CostAccountingSystem

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

Form990 Schedule H Part IV Form990ScheduleHPartIV (7 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivity	Organization Profit Or OwnershipOrganizationProfitOrOwnership	Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership	Physicans Profit Or OwnershipPhysicansProfitOrOwnership
Harmony Surgery Ctr
Ambulatory Surgery	0.50000	0.00000	0.50000
Peak Surgical Mngt
Management Services	0.14000	0.00000	0.14000
Harmony Image Ctr
Medical Imaging	0.46000	0.00000	0.46000
Srg Ctr Fort Collins
Ambulatory Surgery	0.26000	0.00000	0.26000
Gateway Medical Svcs
Real Estate/Medical Equipment	0.50000	0.00000	0.50000
Eye Laser Ctr NO CO
Laser Surgery	0.50000	0.00000	0.50000
VEIN & LASER CTR NC
LASER SURGERY	0.33000	0.00000	0.33000

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	Ft 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 Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	100	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	300.	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	true	ActionsOnNonpayment
Collection Activities	false	CollectionActivities
Notified All Patients	X	NotifiedAllPatients
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	46	NumberOfOtherFacilities

Other Facilities OtherFacilities (46 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
Greeley Medical Clinic
1900 16th Street	Greeley	CO	80631	Physician Offices
Westbridge
1107 S Lemay	Fort Collins	CO	80524	Physician offices, medical spa
Mountain Crest Behavioral Health
4601 Corbett Dr	Fort Collins	CO	80528	Behavorial Health blood draw
Peakview Medical Center
5881 W 16th Street	Greeley	CO	80634	Physician offices
MCR North MOB
2500 Rocky Mtn Ave	Loveland	CO	80538	Physician offices
Redstone
2315 E Harmony Rd	Fort Collins	CO	80528	Outpatient Lab, Physician Office, SSOR
MCR South MOB
2500 Rocky Mtn Ave	Loveland	CO	80538	Physician offices, HCOR, Physician Office, SSOR
Greeley OncologyRheumatology
1800 15th Street	Greeley	CO	80631	Physician Office SSOR
Centre Ave Health and Rehab-JV
915 Centre Ave	Fort Collins	CO	80526	Rehab
Surgery Center of Ft Collins-JV
1100 E Prospect Rd	Fort Collins	CO	80524	Surgery Center BLOOD DRAW
Pennock Place
1025 Pennock Place	Fort Collins	CO	80524	Physician offices, blood bank
Prospect Medical Plaza
1106 E Prospect Suite 100	Fort Collins	CO	80524	Physician offices,
Loveland OncologyHematology
2975 Ginnala Drive Suite 120	Loveland	CO	80538	Oncology outpatient rehab, neurology, int medicine
Snow Mesa
4674 Snow Mesa Drive	Fort Collins	CO	80528	Physician Offices
Windsor Medical Center
1455 Main Street	Windsor	CO	80550	Physician Offices
Express Lab
1020 Doctors Lane	Fort Collins	CO	80524	Lab
Timerline Medical
131 Stanley Dr	Estes Park	CO	80517	Physician Offices
PVMG OBGYN
1136 E Stuart St 2100	Fort Collins	CO	80525	Physician Offices
Children's Therapy
1500 S Lemay	Fort Collins	CO	80526	Therapy
Family Healthcare of the Rockies
3000 S College Ave St 210	Fort Collins	CO	80525	Physician Offices
Columbine Poudre Homecare-JV
915 Centre Ave	Fort Collins	CO	80526	Home healthcare
Poudre Infusion Therapy-JV
915 Centre Ave	Fort Collins	CO	80526	Infusion
HCORScottsbluff
2 W 42nd St 2200	Scottsbluff	NE	69361	Physician Offices
Primary Care-Sterling
620 Iris Drive	Sterling	CO	80751	Physician Offices
Foxtrail Family Medicine
1625 Foxtrail Dr	Loveland	CO	80538	Physician Offices
Endocrinolgy
1040 E Elizabeth Street	Fort Collins	CO	80524	Physician Offices
HCORSteamboat
940 Central Park Dr 290	Steamboat Springs	CO	80487	Physician Offices
West Loveland
3850 N Grant Ave	Loveland	CO	80538	Urgent Care, Physician Offices
HCOREstes Park
555 Prospect Ave	Estes Park	CO	80517	Physician Offices
HCORFort Morgan
1000 Lincoln Street 207	Fort Morgan	CO	80701	Physician Offices
Thompson Valley Towne Center
1327 Eagle Drive	Loveland	CO	80537	Physician Offices
HCORCraig
595 Russell Street	Craig	CO	81625	Physician Offices
HCORLaramie
3116 Willet Drive	Laramie	WY	82070	Physician Offices
HCORSidney
1625 Dorwart Drive	Sidney	NE	69162	Physician Offices
HCORAlliance
2101 Box Butte Ave	Alliance	NE	69301	Physician Offices
HCORYuma
910 S Main Street	Yuma	CO	80759	Physician Offices
HCORKremmling
214 S 4th Street	Kremmling	CO	80459	Physician Offices
HCORWalden
350 McKingley St	Walden	CO	80480	Physician Offices
Lab Draws
708 22nd Street	Greeley	CO	80631	Lab
GMCBrush
2400 Edison Street	Brush	CO	80723	Physician Offices
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 (10 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
SCHEDULE H, PART I, LINE 7, COLUMN F	TOTAL BAD DEBT EXPENSE REMOVED FROM THE DENOMINATOR PRIOR TO THE PERCENTAGE CALCULATION = 14,052,108 (13,722,423 REPORTED ON PART IX, AND 279,685 FROM JOINT VENTURES)
SCHEDULE H, PART I, LINE 7	The organization used a cost-to charge ratio for lines 7a, 7b, and 7c. The cost-to-charge ratio was derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. 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. The information for line 7g includes some computations based upon the cost-to-charge ratio mentioned above. SCHEDULE H, PART I, LINE 7g The organization included as subsidized health services costs that were attributable to physician clinics. The total costs were $7,859,206.
SCHEDULE H, PART II	As mentioned under promotion of community health we have a multitude 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 comunity which is an important part of overall community health and therefore a benefit to the community.	COMMUNITY BUILDING ACTIVITIES
SCHEDULE H, PART III, LINE 4	Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, PVHC analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for uncollectible accounts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, PVHC analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), PVHC records a significant provision for uncollectible accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or provided by policy) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. PVHCs allowance for doubtful accounts for self-pay patients increased from 62% of self-pay accounts receivable at December 31, 2010, to 63% of self-pay accounts receivable at December 31, 2011. Changes in allowances for self-pay accounts were the result of negative trends experienced in the collection of amounts from self-pay patients in fiscal year 2011. Bad debt expense is determined using the methodology as described in the note to financial statements as shown above. The Patient Business Service team assists all potentially eligible patients with the application process for financial assistance programs (government and internally sponsored). If the application is completed and the patient is eligible, the account balance is not written off to bad debt, instead it is recorded as a charity care adjustment. If the application is not completed, we have no way to determine patient eligibility for charity care classification, and the account is written off as bad debt. At this time community benefit does not include any bad debt amounts.	BAD DEBT EXPENSE
SCHEDULE H, PART III, LINE 5	Poudre Valley Health Care Cost Report 61,546,870 Poudre Valley Health Care GME Payment (632,755) Centre Ave Health & Rehab Cost Report 3,405,218 Columbine Poudre Homecare Cost Report 1,070,984 PVHC Inc. Medicare disallowed programs 728,488 Disregarded Entities 21,270,768 Joint Ventures 2,764,518 Total to Line 5 90,154,091	MEDICARE REVENUE WAS COMPUTED AS FOLLOWS:
SCHEDULE H, PART III, LINE 6	MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENTS WERE COMPUTED AS FOLLOWS: Poudre Valley Health Care Cost Report 90,179,009 Centre Ave Health & Rehab Cost Report 3,407,828 Columbine Poudre Homecare Cost Report 1,070,362 PVHC Inc. Medicare disallowed programs 1,033,714 Disregarded Entities 40,068,706 Joint Ventures 2,655,075 Total to Line 6 138,414,694
SCHEDULE H, PART III, LINE 8	Approximately 22% 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. The amount on line 6 was determined by allowable costs as reported on the Poudre Valley Hospital 2011 Cost Report aggregated with disregarded entities and ownership portions of joint ventures.
SCHEDULE H, 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.
SCHEDULE H, PART V, LINE 19D	ALL PATIENTS ARE BILLED AT FULL CHARGES
SCHEDULE H, PART VI	Needs Assessment: We assess the health care needs of the communities we serve in several ways. First, we complete our own Community Health Survey once every three years. This is a blinded survey sent out to 5,000 residents of the communities we serve. This survey is meant to assess the needs of our community and priorities for health prevention, intervention, and treatment for the people we serve. Alongside of this is an extensive review and assessment of other health data to examine the trends and impact and burden of disease. We partner with the Health District of Northern Larimer County and the Larimer Department of Health and Environment to examine the data and develop action plans to address the needs with high morbidity and mortality rates. We utilize hospital data, state and local health department data, the health district survey, and BRFSS data to examine the health issues that affect the people we serve. We utilize the assistance of Epidemiologist to ensure correct assumptions based upon the data we review. Our marketing department will also administer specific surveys related to services we offer in the community to see if needs are being addressed. We also administer focus groups for specific areas of focus to ensure we are meeting health needs. Patient Education of Eligibility for Assistance: There is documentation in a billing brochure given to patient/families, self-pay inpatients are screened by the Financial Assistance teams, the monthly statements mention a contact if assistance is needed, and if a patient/family call Patient Billing and inform us they need assistance they are put through the screening process. Community Information: Poudre Valley Health System (PVHS) is a locally owned, private, non-profit organization with a strong Vision: to provide world class healthcare. Based in Northern Colorado, PVHS 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. PVHS is a regional medical hub that includes Poudre Valley Hospital, Medical Center of the Rockies, Mountain Crest Behavioral Health Center, Poudre Valley Medical Group, and dozens of associated clinics and outpatient services. The organization's Mission is to be an integrated, independent, non-profit organization providing innovative, comprehensive care of the highest quality while exceeding expectations of the communities we serve. Promotion of Community health: We have implemented a multitude of programs that address the health of our community involving all age groups and focus on what an individual can do to improve his/her health. We also give dollars to other entities that work to improve the health of our community. Examples are: primary care for children, activity programs for developmentally disabled adults, obesity prevention, feeding programs for low income, and mental health services for the underserved. Affiliated Health Care System: 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. State filing of community benefit report: We only submit community benefit data in the state of Colorado.	SUPPLEMENTAL INFORMATION

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (26 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
AMERICAN CANCER SOCIETY
8221 W 20th A	Greeley	CO	80634	841316555	501(c)(3)	19400	SEE SCH I, PART IV
BOYS & GIRLS CLUB OF WELD COUNTY
PO BOX 812	Greeley	CO	80632	840529902	501(c)(3)	6125	SEE SCH I, PART IV
CROSSROADS SAFEHOUSE INC
PO BOX 993	Fort Collins	CO	80522	840786145	501(c)(3)	5900	SEE SCH I, PART IV
Colorado State University
601 South Howes St	Fort Collins	CO	80523	846000545	501(c)(3)	57900	SEE SCH I, PART IV
ENGAGING LOVELAND INC
231 W 4th St	Loveland	CO	80537	205257077	501(c)(6)	15000	SEE SCH I, PART IV
FORT COLLINS MUSEUM FOUNDATION
200 Matthews Street	Fort Collins	CO	80524	742541265	501(c)(3)	41000	SEE SCH I, PART IV
FOUNDATION FOR MALCOM BALDRIGE
165 Summit Ridge	Maryville	IL	62062	592891492	501(c)(3)	25000	SEE SCH I, PART IV
Front Range Community College
3645 West 112th Ave	Westminster	CO	80031	841311148	501(c)(3)	108995	SEE SCH I, PART IV
FT COLLINS CHAMBER OF COMMERCE
225 S Meldrum St	Fort Collins	CO	80521	840201983	501(c)(6)	11450	SEE SCH I, PART IV
GREELEY INDEPENDENCE STAMPEDE INC
600 N 14th Ave	Greeley	CO	80631	840722231	501(c)(4)	7500	SEE SCH I, PART IV
HEALTH DISTRICT OF NORTHERN
120 Bristlecone Dr	Fort Collins	CO	80524	840515919	GOVERNMENT	23781	SEE SCH I, PART IV
IVINSON MEMORIAL HOSPITAL
255 N 30th Street	Laramie	WY	82072	836000188	501(c)(3)	13500	SEE SCH I, PART IV
LOVELAND CHAMBER OF COMMERCE
5400 Stone Creek Cr 200	Loveland	CO	80538	840254565	501(c)(6)	18830	SEE SCH I, PART IV
MARCH OF DIMES FOUNDATION
1325 S Colo Blvd B508	Denver	CO	80222	131846366	501(c)(3)	5500	SEE SCH I, PART IV
METRO DENVER SPORTS COMMISSION
444 ShermanSt 300	Denver	CO	80203	202052624	501(c)(3)	25000	SEE SCH I, PART IV
MOUNTAIN STATES BETTER BUSINESS
8020 S Cty Rd 5	Fort Collins	CO	80528	742525298	501(c)(3)	6500	SEE SCH I, PART IV
NATIONAL MULTIPLE SCLEROSIS SOC
900 S Broadway St 250	Denver	CO	80209	135661935	501(c)(3)	5400	SEE SCH I, PART IV
NINE HEALTH SERVICES INC
1139 Delaware Street	Denver	CO	80204	742452969	501(c)(3)	20000	SEE SCH I, PART IV
OPERA FORT COLLINS INC
PO Box 503	Fort Collins	CO	80522	841183179	501(c)(3)	6575	SEE SCH I, PART IV
Poudre Valley Health System Foundation
2315 E Harmony Rd	Fort Collins	CO	80528	741894581	501(c)(3)	423847	SEE SCH I, PART IV
THE COMMUNITY FOUNDATION SERVING GREELEY
711 8th Ave	Greeley	CO	80631	841315296	501(c)(3)	5510	SEE SCH I, PART IV
THOMPSON SCHOOL DISTRIC R2-J
535 N Douglas Ave	Loveland	CO	80537	846013346	501(c)(3)	24250	SEE SCH I, PART IV
TOUCHSTONE HEALTH PARTNERS
125 Crestridge	Fort Collins	CO	80525	841512383	501(c)(3)	7500	SEE SCH I, PART IV
UNITED WAY OF LARIMER COUNTY
424 Pine St 102	Fort Collins	CO	80524	846031503	501(c)(3)	15266	SEE SCH I, PART IV
University of Northern Colorado
UNC Campus/Carter Hall	Greeley	CO	80639	846044833	501(c)(3)	170640	SEE SCH I, PART IV
WELD FOOD BANK INC
1108 H Street	Greeley	CO	80631	742244826	501(c)(3)	41720	SEE SCH I, PART IV

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	26	TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Purpose of Grant or Assistance	Question 1, Part II, Col. H	FOR RELATED ENTITIES, THE GRANTS ARE RELATED TO SPECIFIC REQUESTS. THE FUNDS 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.
Procedures for monitoring grants	Part I Question 2	The organization awards grants based on benefit to the community. The organization requests information from the grantees to ensure that the funds will be used for the specified purpose.

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	false	WrittenPolicyReTAndEExpenses
Substantiation Required	true	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	true	SeverancePayment
Supplemental Nonqual Retire Plan	true	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (17 entries)

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
1045640	0	1316	0	481727	0	157079	0	27138	0	1712900	0	351913	0
Stephanie Doughty
467980	0	1316	0	17042	0	150183	0	8260	0	644781	0	9903	0
Mary Blattner MD
645720	0	0	0	3038	0	4900	0	22066	0	675724	0	0	0
Russ Branzell
390389	0	2041	0	44394	0	71357	0	25197	0	533378	0	30622	0
Hans Coester MD
1454833	0	0	0	1633	0	0	0	22473	0	1478939	0	0	0
Diane Gross
0	0	0	0	193852	0	0	0	0	0	193852	0	0	0
Mark Grossnickle MD
548226	0	0	0	9784	0	27819	0	28323	0	614152	0	0	0
Mark Guadagnoli MD
755400	0	0	0	5316	0	28750	0	16321	0	805787	0	0	0
Grace Kowalyshyn-Taylor
195267	0	1581	0	160	0	36020	0	26886	0	259914	0	0	0
William Neff MD
407960	0	1616	0	25303	0	83876	0	27250	0	546005	0	21744	0
Patti Oakes
223449	0	1766	0	1029	0	50905	0	9085	0	286234	0	0	0
Joshua Petit
1202274	0	0	0	39892	0	7956	0	27179	0	1277301	0	0	0
Donna Poduska
169750	0	2192	0	1222	0	17126	0	7575	0	197865	0	0	0
Dan Robinson
232917	0	1591	0	26701	0	46214	0	27257	0	334680	0	23610	0
Carl Smith
188062	0	1316	0	5622	0	19817	0	16965	0	231782	0	0	0
Kevin Unger
359853	0	1316	0	83733	0	101203	0	21979	0	568084	0	0	0
Barb Yosses
56333	0	1243	0	395620	0	1758	0	5611	0	460565	0	11554	0

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Reimbursement or provison of expenses	Part I, Line 1b	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 W-2. Gross-Up Payments: Gross Up Payroll is calculated at year end for special checks created to add specific items to employee's W-s 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 pay social club dues for specific members of the senior management group. The club dues are added to the senior management's W-2 on an annual basis.
PERSONS WHO RECEIVED A SEVERANCE PAYMENT OR CHANGE OF CONTROL	Part I, Line 4a	BARB YOSSES: $330,079 THIS AMOUNT REPRESENTS SEVERANCE PAY AS PART OF THE EMPLOYMENT TERMINATION AGREEMENT.
Nonqualified retirement plan	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 AMOUNTS LISTED INCLUDE AMOUNTS IN W-2 BOX 5 WAGES AND AMOUNTS INCLUDED IN DEFERRED COMP. W-2 BOX 5 UNFUNDED DEFERRED COMP RULON STACEY 393,088.60 - STEPHANIE DOUGHTY 9,903.78 93,637.36 RUSS BRANZELL 30,621.88 - DIANE GROSS 193,923.34 - CRAIG LUZINSKI 12,629.25 - WILLIAM NEFF 21,745.37 - DAN ROBINSON 23,623.59 - KEVIN UNGER 41,252.87 72,821.04 BARB YOSSES 37,177.06 -
SPLIT DOLLAR LIFE INSURANCE PLAN	PART I, LINE 4B	OFFICERS AND KEY EMPLOYEES PARTICIPATE IN A SPLIT-DOLLAR LIFE INSURANCE PLAN. NORTHWESTERN MUTUAL COMPUTES THE IMPUTED INCOME RELATED TO THE PLANS AND THE AMOUNT IS INCLUDED ON W-2 BOX 5. THE AMOUNT REFLECTED AS DEFERRED INCOME IS THE PREMIUMS PAID, NET OF THE AMOUNT ON THE W-2, AND THE INCREASE IN THE NOTES RECEIVABLE DISCLOSED ON SCHEDULE L. DEFERRED INCOME IMPUTED INCOME ON W-2 RULON STACEY 210,886.15 16,367.92 STEPHANIE DOUGHTY 23,904.16 7,036.90 RUSS BRANZELL 28,508.49 1,734.93 WILLIAM NEFF 35,030.91 1,435.50 PATTI OAKES 14,770.30 209.49 DAN ROBINSON 27,508.26 1,197.62 KEVIN UNGER 19,916.67 2,399.27

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
COLORADO HEALTH FACILITIES AUTHORITY SERIES A
840752932	196474W48	2005-03-31	50000000	REFUNDING 1999A BONDS	false	false	false
COLORADO HEALTH FACILITIES AUTHORITY SERIES B
840752932	196474W48	2005-03-31	26294807	PAYMENT OF COMMERCIAL PAPER DEBT	false	false	false
COLORADO HEALTH FACILITIES AUTHORITY SERIES F
840752932	196474W48	2005-03-31	55343750	REFUNDING 1999A BONDS	false	false	false

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Total ProceedsTotalProceeds	Amount In Reserve FundAmountInReserveFund	Refunding EscrowRefundingEscrow	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Credit EnhancementCreditEnhancement	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
50000000	3187873	46468713	433893	3097393	false	true	true	true
26294807	1673498	25000000	397052	897754	true	false	true	true
55000000	3534732	54542446	795916	0	false	true	true	true

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI	Total Private Business UseTotalPrivateBusinessUse	Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
false	true	false	false	0.00460	0.00460	true
false	true	false	false	0.00460	0.00460	true
false	true	false	false	0.00460	0.00460	true

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiled	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Term Of HedgeTermOfHedge	Superintegrated HedgeSuperintegratedHedge	Hedge TerminatedHedgeTerminated	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Business Name Line1NameOfGICProvider/BusinessNameLine1	Gross Proceeds InvestedGrossProceedsInvested	Exception To RebateExceptionToRebate
JP MORGAN CHASE
true	false	true	25.67	true	false	false	0	false	false
JP MORGAN CHASE
true	false	true	30.83	true	false	false	0	false	false
0
true	false	false				false	0	false	false

Field	Value	IRS element (for citing)
Fed Tax Requirements Compliance	X	FedTaxRequirementsCompliance

Form990 Schedule K Part VI Form990ScheduleKPartVI

Field	Value	IRS element (for citing)
Identifier	BOND ISSUE PRICE - SCHEDULE K, PART I, COLUMN E	Identifier
Return Reference	0	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

Loan Table LoanTable (9 entries)

Purpose Of LoanPurposeOfLoan	Loan From OrganizationLoanFromOrganization	Original PrincipalOriginalPrincipalAmount	Balance DueBalanceDue	DefaultDefault	Approved By BoardApprovedByBoard	Written AgreementWrittenAgreement
STEPHANIE DOUGHTY
Split-$ Life Ins Prm	X	$753,315	649479	false	true	true
KEVIN UNGER
Split-$ Life Ins Prm	X	$306,862	269285	false	true	true
RUSS BRANZELL
Split-$ Life Ins Prm	X	$430,876	353640	false	true	true
BILL NEFF
Split-$ Life Ins Prm	X	$295,528	247018	false	true	true
DAN ROBINSON
Split-$ Life Ins Prm	X	$288,284	228996	false	true	true
BARB YOSSES
Split-$ Life Ins Prm	X	$95,743	69761	false	true	true
PATTI OAKES
Split-$ Life Ins Prm	X	$91,653	73761	false	true	true
GRACE TAYLOR
Split-$ Life Ins Prm	X	$20,247	20247	false	true	true
JOSHUA PETIT
Recruitment loan	X	$75,000	37500	false	true	true

Field	Value	IRS element (for citing)
Total Balance Due	1949687	TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (6 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
Cindy Luzinski
SEE PART V	31816	EMPLOYMENT WAGES	false
Jenna Bernklau
SEE PART V	17413	EMPLOYMENT WAGES	false
KATHLEEN MICHIE
SEE PART V	64155	EMPLOYMENT WAGES	false
SCOTT OVERLY
SEE PART V	52036	EMPLOYMENT WAGES	false
STAMPEDE PROPERTIES
SEE PART V	411840	1099 INCOME PAID TO ENTITY	false
Paul Poduska
SEE PART V	88856	EMPLOYMENT WAGES	false

Form990 Schedule L Part V Form990ScheduleLPartV

Field	Value	IRS element (for citing)
Identifier	BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS	Identifier
Return Reference	SCHEDULE L, PART IV, COLUMN B, RELATIONSHIPS	ReturnReference
Explanation	CINDY LUZINSKI IS A FAMILY MEMBER OF CRAIG LUZINSKI, KEY EMPLOYEE OF THE ORGANIZATION JENNA BERNKLAU IS A FAMILY MEMBER OF CRAIG LUZINSKI, KEY EMPLOYEE OF THE ORGANIZATION KATHLEEN MICHIE IS A FAMILY MEMBER OF THAINE MICHIE, DIRECTOR OF THE ORGANIZATION SCOTT OVERLY IS A FAMILY MEMBER OF PATTI OAKES, KEY EMPLOYEE OF THE ORGANIZATION DAN STROH, A DIRECTOR OF THE ORGANIZATION, HAS OWNERSHIP IN STAMPEDE PROPERTIES, AN ENITY TO WHICH 1099 INCOME WAS PAID. PAUL PODUSKA IS A FAMILY MEMBER OF DONNA PODUSKA, KEY EMPLOYEE OF THE ORGANIZATION	Explanation

Schedule M IRS990ScheduleM

Field	Value	IRS element (for citing)
Works Of Art		WorksOfArt
Art Historical Treasures		ArtHistoricalTreasures
Art Fractional Interest		ArtFractionalInterest
Books And Publications		BooksAndPublications
Clothing And Household Goods		ClothingAndHouseholdGoods
Cars And Other Vehicles		CarsAndOtherVehicles
Boats And Planes		BoatsAndPlanes
Intellectual Property		IntellectualProperty
Securities Publicly Traded		SecuritiesPubliclyTraded
Securities Closely Held Stock		SecuritiesCloselyHeldStock
Securities Prtnrshp Trust Intrsts		SecuritiesPrtnrshpTrustIntrsts
Securities Miscellaneous		SecuritiesMiscellaneous
Qualified Contrib Hist Struct		QualifiedContribHistStruct
Qualified Contrib Other		QualifiedContribOther
Real Estate Residential		RealEstateResidential
Real Estate Commercial		RealEstateCommercial
Real Estate Other		RealEstateOther
Collectibles		Collectibles
Food Inventory		FoodInventory
Drugs And Medical Supplies		DrugsAndMedicalSupplies
Taxidermy		Taxidermy
Historical Artifacts		HistoricalArtifacts
Scientific Specimens		ScientificSpecimens
Archaeological Artifacts		ArchaeologicalArtifacts

Other Non Cash Contributions Table OtherNonCashContributionsTable (2 entries)

Non Cash CheckboxNonCashCheckbox	DescriptionDescription	Number Of ContributionsNumberOfContributions	Noncash Contribs Rptd F990NoncashContribsRptdF990	Method Of Determining RevenuesMethodOfDeterminingRevenues
X	LEASEHOLD IMPROVEMENTS	2	32695	COST
X	MAJOR MOVEABLE EQUIPMENT	18	318907	COST

Field	Value	IRS element (for citing)
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts	true	ReviewProcessUnusualNCGifts
Third Parties Used	true	ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SCHEDULE M, PART I, LINE 32A	USE OF RELATED ORGANIZATIONS TO SOLICIT NON-CASH CONTRIBUTIONS	Poudre Valley Health System Foundation, a related organization, receives, administers and distributes cash and non-cash contributions to Poudre Valley Healthcare Inc., other related organizations, and the surrounding communities.
SCHEDULE M, PART I, COLUMN B	CONTRIBUTIONS	THE NUMBER IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (27 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
990 Review Process	Form 990, Part VI, Section B, Line 11B	The Form 990 is prepared by independent CPAs. A preliminary draft is presented by the organization's CFO to the finance committee of the board of directors for the detailed review. The final copy of the 990 is provided in an electronic format to all board of directors prior to filing with the IRS.
How conflict of interest policy is monitored & enforced	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.
Compensation Determination	Form 990, Part VI, Section B, Line 15a &15b	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.
Governing Documents	Form 990, Part VI, Section X, 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.
Volunteers	Form 990, Part I, Line 6	PVH had 693 active volunteers in 2011. 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 Liaisons, 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.
POLICIES	FORM 990, PART VI, Section B	All answers marked "yes" on under policies section B part VI 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.
OTHER CHANGES IN NET ASSETS OR FUND BALANCES	FORM 990, PART XI, LINE 5	SEE SCHEDULE D PART XI FOR RECONCILIATION OF NET ASSETS
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Stu VanMeveren TITLE:Board Chair HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Chris Osborn TITLE:Vice Board Chair HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Christine Chin TITLE:Board Member HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Mike Dellenbach TITLE:Board Member HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Gary Ludwin MD TITLE:Board Member HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Thaine Michie TITLE:Board Member HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Todd Sorensen, MD TITLE:Board Member HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Laurie Steele TITLE:Board Member HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Dan Stroh TITLE:Board Member HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Joe Hendrickson TITLE:Board Member HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Rulon Stacey TITLE:Chief Executive Officer HOURS:8
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Stephanie Doughty TITLE:Chief Financial Officer HOURS:8
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Craig Luzinski TITLE:PVH Chief Nursing Officer HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Patti Oakes TITLE:VP-Human Resources HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Dan Robinson TITLE:PVH VP of Operations HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Carl Smith TITLE:VP of Payor Relations HOURS:4
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Kevin Unger TITLE:PVH President HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Barb Yosses TITLE:VP Ambulatory Services HOURS:4
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Hans Coester, MD TITLE:Physician HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:Joshua Petit TITLE:Physician HOURS:6

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	1347531	328446	NA
Lakota Lake LLC
2315 E Harmony Rd Ste 200	Fort Collins	CO	80528	841447761	Outpatient	CO	3640108	7076855	NA
Heron Lake LLC
2315 E Harmony Rd Ste 200	Fort Collins	CO	80528	264189163	Outpatient	CO	483065	657292	NA
Poudre Valley Medical Group LLC
2315 E Harmony Rd Ste 200	Fort Collins	CO	80528	800348943	Outpatient	CO	74220253	23921043	NA

Form990 Schedule R Part II Form990ScheduleRPartII (4 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
Medical Center of the Rockies
2315 E Harmony Rd Ste 200	Ft Collins	CO	80528	043730045	Tertiary Care	CO	501(c)(3)	line 3	NA	true
PVHS Foundation
2315 E Harmony Rd Ste 200	Ft Collins	CO	80528	741894581	Bene. health	CO	501(c)(3)	line 7	NA	true
Healthy Start
2315 E Harmony Rd Ste 200	Fort Collins	CO	80528	742523091	Inactive Corp	CO	501(c)(3)	LINE 7	NA	false
CARBON VALLEY HEALTHCARE HOLDINGS
1950 MOUNTAIN VIEW AVE	LONGMONT	CO	80501	273769602	MEDICAL	CO	501(c)(3)	Line 3	NA	false

Form990 Schedule R Part III Form990ScheduleRPartIII (12 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership
Harmony Surg Ctr
2127 E Harmony Rd 200	Ft Collins	CO	80528	841479751	Ambulatory Surg	CO	NA	RELATED	1788325	2600343	false	false	0.51100
United Med Alliance
2021 Battlecreek Drive Ste A	Ft Collins	CO	80528	820572743	Health Claims	CO	NA	RELATED	119012	440547	false	false	0.50000
Ctr Ave Hlthrehab
947 Worthington Circle	Ft Collins	CO	80526	841560494	Nursing Facility	CO	NA	RELATED	279054	778816	false	false	0.50000
Columbine Poudre HC
947 Worthington Circle	Ft Collins	CO	80526	841529817	Nursing Care	CO	na	RELATED	98114	332953	false	false	0.50000
Eye Lsr Ctr of N co
1725 E Prospect Rd	Ft Collins	CO	80525	841518334	Laser Surgery	CO	NA	RELATED	-71020	-12728	false	false	0.50000
Gateway Med Svcs
2500 E Prospect Rd	Ft Collins	CO	80525	841427970	Real Est/Med	CO	NA	RELATED	3158379	6090984	false	false	0.50000
Poudre Infs Therapy
947 Worthington Circle	Ft Collins	CO	80526	841530973	Medical Services	CO	NA	RELATED	76460	137695	false	false	0.50000
PVHS Home Med Sply
6820 N County Rd 13	Loveland	CO	80538	202034599	Medical Supply	CO	NA	RELATED	-106709	383369	false	false	0.50000
Vein & Laser Ctr
2008 Caribou Drive	Fort Collins	CO	80525	204943970	Medical ServiCES	CO	na	RELATED	36340	45352	false	false	0.33330
Harmony Imaging Ctr
1951 Wilmington Drive	Fort Collins	CO	80528	582479187	Medical Imaging	CO	NA	RELATED	867759	1344666	false	false	0.46000
Peak Surg Mgmt
2127 e Harmony RD Ste 200	Fort Collins	CO	80528	260899618	Surgical Mgmt	CO	NA	RELATED	71161	79368	false	false	0.14290
Surgery Ctr of FC
1100 E Prospect Road	Fort Collins	CO	80525	841541559	Surgical Proc	CO	NA	RELATED	640900	965221	false	false	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 Name DirectControllingEntityName

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

Field	Value	IRS element (for citing)
Type Of Entity	C Corp	TypeOfEntity
Share Of Total Income	1580019	ShareOfTotalIncome
Share Of EOY Assets	1646543	ShareOfEOYAssets
Percentage Ownership	1.00000	PercentageOwnership

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

Transactions Related Orgs Table TransactionsRelatedOrgsTable (23 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
Centre Ave Health and Rehab
R	350000	Transac. Total
Columbine Poudre Homecare
R	175000	Transac. Total
Gateway Medical Services
R	2990000	Transac. Total
Harmony Surgery Center
A	664416	Transac. Total
Harmony Surgery Center
N	2999971	Transac. Total
Harmony Surgery Center
P	423025	Transac. Total
Harmony Surgery Center
R	1659976	Transac. Total
Innovation Enterprises Inc
A	173045	Transac. Total
Innovation Enterprises Inc
D	2080611	Transac. Total
Innovation Enterprises Inc
A	393892	Transac. Total
Innovation Enterprises Inc
N	1393566	Transac. Total
Medical Center of the Rockies
K	9644380	Transac. Total
Medical Center of the Rockies
M	3668869	Transac. Total
Medical Center of the Rockies
N	86326315	Transac. Total
Medical Center of the Rockies
Q	101661606	Transac. Total
Medical Center of the Rockies
R	6907714	Transac. Total
PVHS Foundation
B	423847	Transac. Total
PVHS Foundation
C	659002	Transac. Total
PVHS Foundation
K	169532	Transac. Total
PVHS Foundation
N	1387236	Transac. Total
Poudre Infusion Therapy Inc
L	58713	Transac. Total
United Medical Alliance LLC
L	1268984	Transac. Total
United Medical Alliance LLC
R	137961	Transac. Total