2026-05-14T16:30:11-05:00 2025-06-30 331498605 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2024-07-01 822666059 UCHEALTH GREELEY HOSPITAL UCHE 9706522000 2315 E HARMONY ROAD SUITE 200 FORT COLLINS CO 80528 DAVID THOMPSON CFO 9702377000 2026-05-14 1 1 AMY CIMINELLO P00796388 6148493000 2026-05-14 2024 2025-03-06 01:10:19Z MARILYN SCHOCK 2315 E HARMONY ROAD SUITE 200 FORT COLLINS CO 80528 260846231 0 X WWW.UCHEALTH.ORG X 2017 CO WE IMPROVE LIVES THROUGH LEARNING, HEALING, DISCOVERY, AND THROUGH HUMAN CONNECTION. 4 3 1974 135 5221 0 17549 0 237264622 259499174 -36987 168968 1059219 1122255 238304403 260790397 20253824 19843780 0 0 93520950 102588261 0 0 0 128500365 130497939 242275139 252929980 -3970736 7860417 222528248 216211278 322223530 308046143 -99695282 -91834865 WE IMPROVE LIVES. IN BIG WAYS THROUGH LEARNING, HEALING AND DISCOVERY. IN SMALL, PERSONAL WAYS THROUGH HUMAN CONNECTION. BUT IN ALL WAYS, WE IMPROVE LIVES. 0 0 214242808 19843780 259515494 UCHEALTH GREELEY HOSPITAL (GH) PROVIDES TERTIARY, ACUTE, INPATIENT, OUTPATIENT, AS WELL AS EMERGENCY CARE. GH SERVICES COMMUNITIES IN NORTH AND EASTERN COLORADO, SOUTHWESTERN NEBRASKA, AND SOUTHEASTERN WYOMING. DURING FISCAL YEAR 2025, GH RECORDED 20,410 PATIENT DAYS; 5,335 INPATIENT ADMISSIONS; 3,471 OBSERVATION PATIENTS ADMISSIONS; 191,570 OUTPATIENT VISITS; 41,928 EMERGENCY VISITS; 764 BIRTHS; 702 INPATIENT SURGERIES; AND 3,799 OUTPATIENT SURGERIES. 214242808 1 0 0 1 0 0 0 0 0 0 1 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 84 0 1 1974 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 4 3 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X DAVID THOMPSON 9702377000 2315 E HARMONY ROAD FORT COLLINS CO 80528 KEVIN UNGER CEO 5.00 3.00 X X 221048 131812 33929 PATTY GATES CHAIR OF THE BOARD 1.00 X X 0 0 0 TOBIAS GUZMAN BOARD MEMBER (TERM ENDED 10/2024) 1.00 X 0 0 0 STEVE MORENO BOARD MEMBER 1.00 X 0 0 0 DANIEL ZENK BOARD MEMBER 1.00 X 0 0 0 MARILYN SCHOCK PRESIDENT 50.00 X 530189 0 57082 SUEANN SWETZIG SECRETARY 40.00 X 76495 0 17191 DAVID THOMPSON CHIEF FINANCIAL OFFICER 5.00 3.00 X 77952 46483 16365 MICHELLE KERR PATIENT SERVICES DIRECTOR 50.00 X 160164 0 40778 TAMMY PICCONE CHIEF NURSING OFFICER 50.00 X 260746 0 52329 JEFFREY BOWMAN PHARMACIST 40.00 X 146703 0 39668 LISA CHAN PHARMACIST 40.00 X 180521 0 47014 WILLIAM CLARK PHARMACIST 40.00 X 157455 0 40399 CHRISTINE FAIRS PHARMACIST 40.00 X 155486 0 30748 MATTHEW FOX RESPIRATORY THERAPIST 40.00 X 158951 0 15063 2125710 178295 390566 126 0 1 0 NORTHERN COLORADO ANESTHESIA 1236 E ELIZABETH ST STE 1 FORT COLLINS CO 80524 MEDICAL 2461205 NORTHERN COLORADO HOSPITALISTS 2121 E HARMONY RD STE 300 FORT COLLINS CO 80528 MEDICAL 2406038 HSS SECURITY 990 S BROADWAY 420 DENVER CO 80209 SECURITY 1720331 SUMMIT PATHOLOGY PLLP 5802 WRIGHT DRIVE LOVELAND CO 80538 MEDICAL 930644 CHILDREN'S HOSPITAL COLORADO 13123 E 16TH AVE AURORA CO 80045 MEDICAL 896597 9 NET PATIENT REVENUE 900099 243447291 243447291 PROVIDER FEE INCOME 900099 13248303 13248303 RENT INCOME - AFFILIAT 900099 2166564 2166564 JOINT VENTURE 900099 637016 637016 259499174 126645 126645 6001 837 5164 5164 5164 42323 0 42323 42323 42323 98119 54997 43122 43122 DIETARY SERVICES INCOM 900099 1052428 1052428 PHARMACY SALES 456110 5221 5221 16320 16320 1073969 260790397 259515494 5221 1269682 19843780 19843780 1699879 514017 1185862 79907519 61144808 18762711 5115195 3904220 1210975 14203355 10840843 3362512 1662313 1268776 393537 191230 191230 19684 19684 21345 21345 22250807 14180656 8070151 775576 775086 490 672192 643400 28792 5158855 4454962 703893 1049568 1049568 53881 41480 12401 25334 18028 7306 5774659 5601322 173337 17239331 15677836 1561495 588441 588441 MEDICAL SUPPLIES 52474546 52474546 PROVIDER FEE EXPENSE 11427833 11427833 0 BAD DEBT EXPENSE 6852599 6852599 REPAIRS & MAINTENANCE 2985161 2040982 944179 2936897 1488066 1448831 252929980 214242808 38687172 0 5051 5050 24164412 26993640 6456007 6183357 2853694 3278082 272194984 106886655 174103471 165308329 14682748 14218689 262865 224131 222528248 216211278 21784882 18320555 121335211 121068866 179103437 168656722 322223530 308046143 X -99695282 -91834865 -99695282 -91834865 222528248 216211278 7860417 0 X X 0 1 X 1 0 X 0 0 0 0 0 0 1 10738 0 1 10607 21345 0 PART II-B, LINE 1: PORTION OF DUES FROM MEMBERSHIP IN AHA THAT ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES - $10,607. INTERNAL STAFF TIME AND EXPENSE SPENT ON DIRECT LOBBYING ACTIVITIES - $10,738. 17055433 17055433 184749610 3285483 181464127 66598231 101161529 -34563298 3791710 2439643 1352067 165308329 INVEST IN OCR GREELEY REAL EST 14218689 C 14218689 INTERCOMPANY PAYABLE 166247973 ACCRUED INTEREST PAYABLE 259536 OTHER DEFERRED EXPENSES 711196 LEASE LIABILITY 1438017 168656722 253988411 55834 55834 253932577 6857820 6857820 260790397 246127994 55834 55834 246072160 6857820 6857820 252929980 PART XI, LINE 2D - OTHER ADJUSTMENTS: COGS ADJUSTMENT 54,997. RENTAL EXPENSE 837. PART XI, LINE 4B - OTHER ADJUSTMENTS: UBI PHARMACY 5,221. PROVISION FOR UNCOLLECTIBLE ACCOUNTS 6,852,599. PART XII, LINE 2D - OTHER ADJUSTMENTS: COGS ADJUSTMENT 54,997. RENTAL EXPENSE 837. PART XII, LINE 4B - OTHER ADJUSTMENTS: UBI PHARMACY 5,221. PROVISION FOR UNCOLLECTIBLE ACCOUNTS 6,852,599. 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 7192551 7192551 0.02920 48962446 27446415 21516031 0.08740 3072351 3020935 51416 0.00020 59227348 30467350 28759998 0.11680 1101895 114609 987286 0.00400 57398 57398 0.00020 249972 205928 44044 0.00020 13803 1939 11864 0.00000 19826785 19826785 0.08060 21249853 322476 20927377 0.08500 80477201 30789826 49687375 0.20180 16496 16496 0.00010 117111 117111 0.00050 133607 133607 0.00060 1 6852599 33568990 37378921 -3809931 X 1 1 1 1 UCHEALTH GREELEY HOSPITAL 6767 W 29TH ST GREELEY CO 80634 01F112 X X X LAB, PHARMACY, IMAGING, BIRTH CENTER, HEART AND VASCULAR UCHEALTH GREELEY HOSPITAL 0 0 1 X X X X X X X X X 24 1 0 1 1 X HTTPS://WWW.UCHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ X 1 22 1 HTTPS://WWW.UCHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 0 1 X 250.000000000000 400.000000000000 X X X 1 1 X X X 1 X HTTPS://WWW.UCHEALTH.ORG/BILLING-AND-PRICING/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.UCHEALTH.ORG/BILLING-AND-PRICING/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.UCHEALTH.ORG/BILLING-AND-PRICING/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 UCHEALTH GREELEY HOSPITAL PART V, SECTION B, LINE 5: A MULTI-PHASED APPROACH WAS USED TO IDENTIFY THE TOP HEALTH PRIORITIES FOR FUTURE IMPACT. THE PROCESS INCLUDED: A COMPREHENSIVE ANALYSIS OF LOCAL POPULATION HEALTH INDICATORS. SOLICITATION OF COMMUNITY INPUT ON LOCAL HEALTH ISSUES THROUGH: DISTRIBUTION OF A WEB-BASED SURVEY TO LOCAL COMMUNITY-SERVING ORGANIZATIONS, SCHOOL DISTRICTS AND GOVERNMENT AGENCIES. A WEB-BASED SURVEY DISTRIBUTED TO HEALTH CARE PROVIDERS AT GH TO GATHER INPUT ON COMMUNITY HEALTH NEEDS. A REVIEW OF THE MOST RECENT COMMUNITY HEALTH IMPROVEMENT PLAN CONDUCTED BY WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT. PARTICIPATION IN MEETINGS WITH WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT AND OTHER LOCAL ORGANIZATIONS TO GAIN INSIGHTS INTO COMMUNITY NEEDS UCHEALTH GREELEY HOSPITAL PART V, SECTION B, LINE 6B: IN 2025, THE CHNA PROCESS FOR GREELEY HOSPITAL (GH), INCLUDED A MULTI-PHASED APPROACH TO IDENTIFY THE TOP HEALTH PRIORITIES AND A COMPREHENSIVE ANALYSIS OF LOCAL POPULATION HEALTH INDICATORS, SOLICITATION OF COMMUNITY INPUT ON LOCAL HEALTH ISSUES THROUGH A WEB-BASED SURVEY AND A WEB-BASED SURVEY DISTRIBUTED TO HEALTH CARE PROVIDERS AT GH TO GATHER INPUT ON COMMUNITY HEALTH NEEDS. AN INCLUSIVE LIST OF OVER 80 COMMUNITY ORGANIZATIONS INVITED TO PARTICIPATE IN THE COMMUNITY SURVEY IS INLCUDED IN APPENDIX 2 OF THE CHNA DOCUMENT ON THE WEBSITE HTTPS://WWW.UCHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/. UCHEALTH GREELEY HOSPITAL PART V, SECTION B, LINE 11: EXAMPLES OF HOW GH IS ADDRESSING ISSUES RELATED TO ACCESS TO CARE FOR VULNERABLE INDIVIDUALS INCLUDES OUR ASPEN CLUB/SENIOR SERVICES PROGRAM THAT PROVIDES COMMUNITY-BASED HEALTH PROMOTION, DISEASE PREVENTION AND SELF-MANAGEMENT EDUCATION AND PROGRAMS. THEY ALSO PROVIDE NON-BIASED MEDICARE BENEFITS COUNSELING, EDUCATION AND ENROLLMENT ASSISTANCE. TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES, GH IS EXPANDING THE USE OF TECHNOLOGY TO PROVIDE TELE-PSYCH SERVICES TO RESIDENTS WHO ARE NOT ABLE TO ACCESS A LOCAL MENTAL HEALTH PROVIDER OR TO BRIDGE GAPS IN PROVIDER AVAILABILITY. WE ARE ALSO EMBEDDING TEAMS OF LICENSED CLINICAL SOCIAL WORKERS AND PSYCHOLOGISTS INTO PRIMARY CARE PRACTICES. FOR PERSONS WITH SUBSTANCE USE DISORDERS, GH IS PARTICIPATING IN THE COLORADO ALTERNATIVES TO OPIOIDS TREATMENT PROTOCOLS. INCREASED SCREENING AND REFERRAL TO TREATMENT FOR PERSONS USING ALCOHOL HAS ALSO BEEN IMPLEMENTED. THE IDENTIFIED HEALTH ISSUES ARE DESCRIBED IN THE 2022-24 COMMUNITY HEALTH NEEDS ASSESSMENT AND THE FULL SPECTRUM OF SERVICES AND PROGRAMS ARE NOTED IN THE 2023-25 IMPLEMENTATION STRATEGY REPORT POSTED TO THE UCHEALTH WEBSITE: HTTPS://WWW.UCHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ PREVIOUS ASSESSMENTS AND IMPLEMENTATION STRATEGIES CAN BE FOUND THERE AS WELL. PART I, LINE 7: LINE 7A WAS DERIVED USING A COST-TO-CHARGE RATIO FROM THE COST REPORT. THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINE 7B AND 7C. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE TO COST-TO-CHARGES. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24E - BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE SCHEDULE H, PART I, COLUMN F PERCENTAGE EQUALS $6,852,599. PART III, LINE 2: ACCOUNTS WITH UNRESOLVED PATIENT LIABILITY AFTER REASONABLE COLLECTION EFFORTS, SET BY POLICY AND IN CONJUNCTION WITH FEDERAL, STATE AND PAYOR SPECIFIC REGULATIONS WILL BE ASSIGNED TO BAD DEBT. THESE ACCOUNTS SHALL BE REFERRED TO AN OUTSIDE COLLECTION AGENCY OR IN CERTAIN INSTANCES, ATTORNEYS FOR ADDITIONAL COLLECTIONS ACTIVITIES. PART III, LINE 3: THE ORGANIZATION DOES NOT CONSIDER ANY OF ITS BAD DEBT EXPENSE TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: THE PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF ALLOWANCES FOR DOUBTFUL ACCOUNTS, CONTRACTUAL ADJUSTMENTS, AND MEDICALLY INDIGENT ALLOWANCES. SEE PAGE 26 IN THE ATTACHED FINANCIALS FOR RELATED FOOTNOTE. PART III, LINE 8: APPROXIMATELY 31.12% OF NET PATIENT SERVICE REVENUE IS FROM PARTICIPATION IN THE MEDICARE PROGRAM, THUS PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES TO A SIGNIFICANT PORTION OF THE COMMUNITY POPULATION. PART III, LINE 9B: IF UCHEALTH DETERMINES THAT AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE FOLLOWING UCHEALTH'S REVIEW OF A COMPLETE APPLICATION, UCHEALTH WILL REVERSE ECAS (IF ANY) AND WILL REFUND AMOUNTS PREVIOUSLY PAID FOR CARE COVERED BY THIS POLICY IN EXCESS OF THE AMOUNT OWED, EXCEPT OVERPAYMENTS THAT ARE $5 OR LESS. IF THE GUARANTOR STILL OWES ANY AMOUNT, UCHEALTH WILL PROVIDE AN UPDATED BILLING STATEMENT SHOWING HOW THE ADJUSTED AMOUNT WAS DETERMINED. PART VI, LINE 2: SEE NARRATIVES FOR PART V, SECTION B, LINES 5 AND 6B. PART VI, LINE 3: THERE ARE SEVERAL WAYS WE NOTIFY THE PATIENT AND ATTEMPT TO ASSIST THEM. FOR SURGERIES AND HIGH DOLLAR SCHEDULED PROCEDURES, WE PROVIDE THEM WITH AN ESTIMATE AT REGISTRATION AND GO OVER ALL FINANCIAL ASSISTANCE OPTIONS AVAILABLE IF THEY ARE INTERESTED. WE ALSO HAVE FINANCIAL COUNSELORS AVAILABLE EACH DAY THAT CAN ANSWER QUESTIONS AND HELP THEM FILL OUT CHARITY APPLICATIONS. ONCE A PERSON HAS RECEIVED CARE IN THE ED, WE ALSO HAVE EDUCATED STAFF THAT ASSISTS THEM AND EDUCATES THEM OF WHAT IS AVAILABLE FOR FINANCIAL ASSISTANCE. IN ADDITION, ONCE A PATIENT DOES RECEIVE A STATEMENT OR BILL, THERE IS INFORMATION ON THE BILL OF WHO THEY CAN CALL TO GET INFORMATION ON FINANCIAL ASSISTANCE. ADDITIONALLY, WE WIDELY PUBLICIZE OUR FINANCIAL ASSISTANCE POLICY AS REQUIRED BY LAW, INCLUDING A PLAIN LANGUAGE SUMMARY. PART VI, LINE 4: UCHEALTH GREELEY HOSPITAL IS A LOCALLY OWNED, PRIVATE, NON-PROFIT ORGANIZATION WITH A STRONG VISION: FROM HEALTHCARE TO HEALTH.BASED IN NORTHERN COLORADO, UCHEALTH GREELEY HOSPITAL 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.UCHEALTH GREELEY HOSPITAL IS A PART OF THE UCHEALTH WHICH AIMS TO DELIVER THE HIGHEST QUALITY PATIENT CARE WITH THE HIGHEST QUALITY PATIENT EXPERIENCE. THE PARTNERSHIP COMBINES POUDRE VALLEY HOSPITAL, MEDICAL CENTER OF THE ROCKIES, UCHEALTH GREELEY HOSPITAL, UCHEALTH MEDICAL GROUP, UNIVERSITY OF COLORADO HOSPITAL AND MEMORIAL HEALTH SYSTEM INTO AN ORGANIZATION DEDICATED TO BUILDING HEALTHIER COMMUNITIES AND PROVIDING UNMATCHED PATIENT CARE IN THE ROCKY MOUNTAIN WEST. THE ORGANIZATION'S MISSION IS WE IMPROVE LIVES. IN BIG WAYS THROUGH LEARNING, HEALING AND DISCOVERY. IN SMALL, PERSONAL WAYS THROUGH HUMAN CONNECTION. BUT IN ALL WAYS WE IMPROVE LIVES PART VI, LINE 5: GH HAS IMPLEMENTED PROGRAMS AND SERVICES THAT ADDRESS THE HEALTH NEEDS OF OUR BROADER COMMUNITY TARGETING ALL AGE GROUPS WHILE MAINTAINING A SPECIAL FOCUS ON SERVING VULNERABLE POPULATIONS. WE ALSO GIVE FUNDING TO OTHER ENTITIES THAT WORK TO IMPROVE THE HEALTH OF OUR COMMUNITY. EXAMPLES INCLUDE: MENTAL HEALTH SERVICES FOR THE UNDERSERVED; PROGRAMS FOR CHILDREN WHO HAVE BEEN ABUSED AND NEGLECTED; HEART HEALTH, HEALTHY EATING AND SUBSTANCE ABUSE PREVENTION EDUCATION FOR YOUTH AND YOUNG ADULTS; AMERICAN CANCER SOCIETY (FUNDING COLORADO PROGRAMS THROUGH A WELD COUNTY EVENT); AN ORGANIZATION DEDICATED TO PROVIDING TRANSPORTATION ASSISTANCE; THE LOCAL FOOD BANK; A COMMUNITY ORGANIZATION THAT FILLS FUNDING GAPS THAT FEDERAL, STATE, AND OTHER SUPPORT PROGRAMS CANNOT SUPPLY OR CANNOT PROCESS FAST ENOUGH FOR WOMEN IN NEED; AND UNITED WAY OF WELD COUNTY. PART VI, LINE 6: ALL THE SERVICES WE OFFER ARE AVAILABLE TO ANYONE THAT USES ANY OF OUR FACILITIES IN THE HEALTH SYSTEM. OUR GEOGRAPHY IS NOT THAT LARGE SO WE ARE ABLE TO ACCOMMODATE THE DIFFERENT COMMUNITIES THAT UTILIZE OUR SERVICES WITH THE SAME LEVEL OF COMMUNITY HEALTH PROGRAMMING. PART VI, LINE 7, REPORTS FILED WITH STATES CO 1 UCHEALTH MEDICAL GROUP 2315 E HARMONY RD 200 FT COLLINS CO 80528 800348943 501C(3) 18738249 0 COMMUNITY HEALTHCARE UNIVERSITY SCHOOL OF MEDICINE 13001 17TH PLACE AURORA CO 80045 846000555 501C(3) 1040465 0 COMMUNITY HEALTHCARE GREELEY-WELD HABITAT FOR HUMANITY 2080 GREELEY MALL ST UNIT D05 GREELEY CO 80631 841091487 501C(3) 10000 0 COMMUNITY HEALTHCARE FREEDOM SERVICE DOGS 7193 S DILLON ST ENGLEWOOD CO 80112 841068936 501C(3) 6675 0 COMMUNITY HEALTHCARE 4 0 PART I, LINE 2: THE ORGANIZATION AWARDS GRANTS BASED ON THE BENEFIT TO THE COMMUNITY. THE ORGANIZATION REQUESTS INFORMATION FROM THE GRANTEES TO ENSURE THAT THE FUNDS WILL BE USED FOR THE SPECIFIED PURPOSE. X X 1 1 X X X X 0 0 0 0 0 0 0 1 0 MARILYN SCHOCK PRESIDENT 412270 0 109644 0 8275 0 45386 0 11696 0 587271 0 0 0 KEVIN UNGER CEO 87133 51958 130487 77810 3428 2044 17711 10561 3544 2113 242303 144486 0 0 TAMMY PICCONE CHIEF NURSING OFFICER 212353 0 47895 0 498 0 25522 0 26807 0 313075 0 0 0 LISA CHAN PHARMACIST 176799 0 3487 0 235 0 16791 0 30223 0 227535 0 0 0 MICHELLE KERR PATIENT SERVICES DIRECTOR 142754 0 16932 0 478 0 14944 0 25834 0 200942 0 0 0 WILLIAM CLARK PHARMACIST 153766 0 3538 0 151 0 14667 0 25732 0 197854 0 0 0 JEFFREY BOWMAN PHARMACIST 143441 0 3129 0 133 0 13878 0 25790 0 186371 0 0 0 CHRISTINE FAIRS PHARMACIST 151902 0 3408 0 176 0 14249 0 16499 0 186234 0 0 0 MATTHEW FOX RESPIRATORY THERAPIST 154517 0 4389 0 45 0 14565 0 498 0 174014 0 0 0 PART I, LINE 1A GROSS-UP PAYMENTS: GROSS UP PAYROLL IS CALCULATED AT YEAR END FOR SPECIAL CHECKS CREATED TO ADD SPECIFIC ITEMS TO EMPLOYEE'S FORM W-2 WAGES INCLUDING COUNTRY CLUB DUES, SPOUSE TRAVEL FOR ANNUAL BOARD RETREAT AND SELECT CONFERENCES, AND IMPUTED INCOME ON LIFE INSURANCE POLICIES. PART I, LINE 7 THE ORGANIZATION OFFERS A BONUS PLAN THAT PAYS A PERCENTAGE OF AN EMPLOYEE'S BASE PAY. THE INTENT OF THE PLAN IS TO REWARD AN EMPLOYEE'S PERFORMANCE TOWARDS ACHIEVEMENT OF STRATEGIC GOALS DURING THE FISCAL YEAR. SUCCESSFUL ACCOMPLISHMENT OF GOALS THAT CONTRIBUTE TO THE ORGANIZATION'S OVERALL STRATEGIC DIRECTION RESULT IN VARIABLE PAYMENTS ALIGNED WITH THE ORGANIZATION'S TOTAL COMPENSATION STRATEGY. THIS PROGRAM REWARDS EMPLOYEES BASED ON ORGANIZATIONAL PERFORMANCE MEASURES AND INDIVIDUAL EMPLOYEE GOAL PERFORMANCE. ALL PAYOUTS ARE CONTINGENT BASED ON THE UCHEALTH BOARD OF DIRECTORS APPROVAL EACH FISCAL YEAR. A UNIVERSITY OF COLORADO HOSPITAL AUTHORITY 2019 SERIES B 841179794 2019-10-28 50000000 NEW CONSTRUCTION FOR GRH 0 0 0 B UNIVERSITY OF COLORADO HOSPITAL AUTHORITY 2019 SERIES D 841179794 2019-10-28 50000000 NEW CONSTRUCTION FOR GRH 0 0 0 C UNIVERSITY OF COLORADO HOSPITAL AUTHORITY 2024 SERIES A 841179794 914183CD8 2024-08-21 21322744 REFUNDING 2019C BONDS 0 0 0 A 50000000 67500 49932500 2019 0 0 1 1 B 50000000 67500 49932500 2019 0 0 1 1 C 248469 21074275 203247 21119497 2024 1 0 1 1 A 0 1 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE MEMBER, WHICH IS UCHEALTH. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER HAS THE AUTHORITY TO APPOINT INDIVIDUALS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER MUST APPROVE ANY AMENDMENTS OR MODIFICATIONS TO THE ORGANIZATION'S ARTICLES OF INCORPORATION OR BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT CPA. A PRELIMINARY DRAFT IS REVIEWED BY THE INTERNAL FINANCE DEPARTMENT. THE FINAL COPY OF THE FORM 990 IS PROVIDED IN AN ELECTRONIC FORMAT TO ALL BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY REQUIRES COMPLETION OF THE FORM ON AN ANNUAL BASIS BY THE BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. COMPLETED FORMS ARE SUBMITTED AND REVIEWED BY THE INTERNAL COMPLIANCE DEPARTMENT TO ENSURE COMPLIANCE WITH THE WRITTEN POLICY. ANY QUESTIONS OR ULTIMATE ENFORCEMENT WOULD BE HANDLED BY THE COMPLIANCE DEPARTMENT. FORM 990, PART VI, SECTION B, LINE 15 UCHEALTH CONTRACTS WITH SULLIVAN COTTER FOR EXECUTIVE COMPENSATION CONSULTING SERVICES. ON OUR BEHALF, THE SULLIVAN COTTER COLLECTS AND REVIEWS COMPENSATION LEVELS FROM LIKE ORGANIZATIONS FOR LIKE JOBS AND PROVIDES UCHEALTH WITH THE COMPARATIVE MARKET DATA. THE DATA IS SUBMITTED TO THE CHIEF HUMAN RESOURCES OFFICER WHO ADVISES THE SYSTEM PRESIDENT AND CEO ON COMPENSATION DECISIONS FOR SENIOR EXECUTIVES. BASED ON THE MARKET DATA, THE SYSTEM PRESIDENT AND CEO DETERMINE THE SALARY OF THE ENTITY CEO'S COMPENSATION ANNUALLY. OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE REVIEWED ANNUALLY BY AN INTERNAL HUMAN RESOURCES COMPENSATION TEAM. PUBLISHED COMPENSATION REPORTS ARE UTILIZED TO COMPARE INCUMBENT PAY TO COMPARABLE ROLES IN LIKE-SIZED ORGANIZATIONS. THE DATA IS REVIEWED WITH THE CHIEF HUMAN RESOURCES OFFICER EACH YEAR AND RECOMMENDATIONS FOR CHANGES ARE INCLUDED IN THE FOLLOWING YEARS' BUDGET PLANNING PROCESS. UCHEALTH GREELEY HOSPITAL DOES NOT HAVE EMPLOYEES FOR FORM 990 REPORTING PURPOSES, AS ALL EMPLOYEES OF GH ARE REPORTED ON THE PAYROLL OF UNIVERSITY OF COLORADO HOSPITAL AUTHORITY OR UNIVERSITY OF COLORADO HEALTH. EMPLOYEES ARE LEASED TO GH. THE EXPENSES THAT ARE REPORTED FOR SALARIES AND BENEFITS ON THE STATEMENT OF FUNCTIONAL EXPENSE REPRESENT THE EMPLOYEE LEASE EXPENSE FOR THE CURRENT FISCAL YEAR. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC BASED ON THE BUSINESS PURPOSE FOR THE REQUEST. THESE REQUESTS ARE ADDRESSED BY THE SENIOR MANAGEMENT TEAM ON A CASE BY CASE BASIS. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS DURING THE TAX YEAR. FORM 990, PART I, LINE 6 GREELEY HOSPITAL (GH) HAD 135 ACTIVE VOLUNTEERS IN FISCAL YEAR 2025. THESE VOLUNTEERS SERVED MORE THAN 7,900 HOURS. AT GH, VOLUNTEERS PLAY AN INTEGRAL ROLE IN PROVIDING MUCH NEEDED SUPPORT FOR PATIENTS, VISITORS, PHYSICIANS, AND STAFF. FROM ASSISTING IN SURGERY AND CARDIAC WAITING ROOMS, INFORMATION DESK, GIFT SHOP, VOLUNTEER PATIENT LIAISONS, BABY KNITTERS, VOLUNTEENS, AND PET THERAPY TO NAME JUST A FEW OF THE MANY PROGRAMS. EVERY VOLUNTEER CONTRIBUTES TO THE SUCCESS OF THE UCHEALTH NORTH TO ENHANCE THE COMFORT AND CARE OF THE PATIENTS AND THEIR FAMILIES. 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