2026-05-13T15:39:08-05:00 2025-06-30 331498605 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2024-07-01 841262971 POUDRE VALLEY HEALTH CARE INC POUD 9702377000 2315 E HARMONY ROAD 200 FORT COLLINS CO 80528 DAVID THOMPSON CHIEF FINANCIAL OFFICER 9702377000 2026-05-12 1 1 AMY CIMINELLO P00796388 6148493000 2026-05-12 2024 2025-03-06 01:10:19Z KEVIN UNGER 2315 E HARMONY ROAD 200 FORT COLLINS CO 80528 3595158033 0 X WWW.UCHEALTH.ORG X 1994 CO WE IMPROVE LIVES THROUGH LEARNING, HEALING, DISCOVERY, AND THROUGH HUMAN CONNECTION. 11 11 5063 352 472812 417154 6137110 3203216 836102962 880899164 123022761 145117185 4907734 3113500 970170567 1032333065 61570859 77214958 0 0 329695326 343633821 0 0 0 362623392 390093785 753889577 810942564 216280990 221390501 11988728381 11660581007 8680387388 8011617535 3308340993 3648963472 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 723882348 77214958 880466145 POUDRE VALLEY HEALTH CARE INC. (PVHC) PROVIDES TERTIARY, ACUTE, INPATIENT, OUTPATIENT AS WELL AS EMERGENCY CARE. PVHC SERVICES COMMUNITIES IN NORTHERN COLORADO, SOUTHWESTERN NEBRASKA, AND SOUTHEASTERN WYOMING. DURING FISCAL YEAR 2025, PVHC RECORDED 65,407 PATIENT DAYS, 13,318 INPATIENT ADMISSIONS, 5,360 OBSERVATION PATIENTS ADMISSIONS, 711,219 OUTPATIENT VISITS, 77,088 EMERGENCY VISITS, 2,074 DELIVERIES, 1,881 INPATIENT SURGERIES, AND 7,559 OUTPATIENT SURGERIES. 723882348 1 1 0 1 0 0 0 0 0 1 1 0 0 1 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 1 0 0 0 1 1 1 1 0 0 1 268 0 1 5063 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X DAVID THOMPSON 9702377000 2315 E HARMONY ROAD SUITE 200 FORT COLLINS CO 80528 BRAD OLDEMEYER DIRECTOR 1.00 2.00 X 0 0 0 CHRIS OSBORN DIRECTOR 1.00 2.00 X 0 0 0 CHRISTINE CHIN DIRECTOR 1.00 2.00 X 0 0 0 DAN STROH DIRECTOR 1.00 2.00 X 0 0 0 DENNIS HOUSKA DIRECTOR 1.00 2.00 X 0 0 0 DOUG ERION DIRECTOR 1.00 2.00 X 0 0 0 FARAZ NAQVI VICE BOARD CHAIR 1.00 2.00 X 0 0 0 JIM PARKE BOARD CHAIR 1.00 2.00 X X 0 0 0 JOHN MCKAY DIRECTOR 1.00 2.00 X 0 0 0 LISA CLAY DIRECTOR 1.00 2.00 X 0 0 0 MIKE DELLENBACH DIRECTOR 1.00 2.00 X 0 0 0 DAVID THOMPSON CHIEF FINANCIAL OFFICER 22.00 24.00 X 259797 202086 60746 DENISE JOHNSON SECRETARY 8.00 6.00 X 10119 10945 7486 KEVIN UNGER CHIEF EXECUTIVE OFFICER 20.00 27.00 X 736701 796846 147453 MICHELLE ALBRIGHT SECRETARY (TERMED 7/2024) 20.00 27.00 X 24035 25998 9172 ANDREW HARMON DIRECTOR OF PHARMACY 22.00 24.00 X 111323 86593 42574 ANNETTE VIZENA CHIEF QUALITY OFFICER VP 24.00 26.00 X 222094 172758 46202 ASHLEY BRUNING CHIEF NURSING OFFICER, PVH 50.00 0.00 X 325406 0 61666 BRIAN ALLEN CHIEF OPERATING OFFICER 20.00 27.00 X 227849 246453 42740 CHRISTINE JOHNSTON ASSOCIATE CHIEF MEDICAL OFFICER 24.00 26.00 X 115259 89655 15558 DIANA BREYER CHIEF MEDICAL OFFICER 23.00 21.00 X 295932 274018 72231 GRACE KOWALYSHYN-TAYLOR VP OF OPERATIONS 20.00 27.00 X 148998 161162 53500 KRYSTLE BELL SR DIRECTOR PERIOP 22.00 24.00 X 90739 70583 35258 JANELL WOZNIAK FAMILY MEDICINE CENTER DIRECTOR 40.00 0.00 X 401944 0 59803 JASON COLLISON PSYCHIATRIST 40.00 0.00 X 438348 0 60130 JILLIAN BUSCH PSYCHIATRIST 40.00 0.00 X 552378 0 59135 KARL JOHNSON PSYCHIATRIST 40.00 0.00 X 402949 0 63436 SPENCER HARRISON PSYCHIATRIST 40.00 0.00 X 388223 0 67476 4752094 2137097 904566 554 0 1 0 THE BECK GROUP 1601 ELM STREET SUITE 2800 DALLAS TX 75201 CONSTRUCTION 14016902 HSS SECURITY 990 S BROADWAY 420 DENVER CO 80209 SECURITY 7197797 NORTHERN COLORADO ANESTHESIA 1236 E ELIZABETH ST STE 1 FORT COLLINS CO 80524 MEDICAL 4943297 NORTHERN COLORADO HOSPITALISTS 2121 E HARMONY RD STE 300 FORT COLLINS CO 80528 MEDICAL 4604975 LAB LOGISTICS PO BOX 84938 CHICAGO IL 60689 COURIER 2407562 54 3078092 118658 6466 2507367 3203216 NET PATIENT SVC REV 900099 837304108 837304108 PROVIDER FEE INCOME 621400 25482112 25482112 JOINT VENTURE 621400 12387584 11922079 465505 OTHER PROGRAM REVENUE 900099 3070727 3070727 RENT INCOME - AFFILIAT 532000 2654633 2654633 880899164 72959311 72959311 47534 47534 2021575 6675 1784430 6675 237145 0 237145 237145 2632616852 433792 2560717947 222357 71898905 211435 72110340 72110340 172073 93559 78514 78514 DIETARY SVC INCOME 900099 2298048 2298048 INCOME TAX REFUND 621400 460000 460000 PHARMACY SALES 456110 7307 7307 32486 32486 2797841 1032333065 880466145 472812 148190892 77214958 77214958 2904890 632912 2271978 269579212 229839985 39739227 20997620 17860648 3136972 44474557 37830211 6644346 5677542 4829337 848205 657806 657806 66242 66242 55488 55488 3905569 3905569 40676401 34865219 5811182 2926771 2802963 123808 5906029 5398864 507165 17657456 15613841 2043615 6054503 5149981 904522 1347723 1167120 180603 795704 172614 623090 3537574 3264421 273153 35110545 24816458 10294087 1358240 155327 1202913 MEDICAL SUPPLIES 188735655 188735655 PROVIDER FEE EXPENSE 43619613 43619613 0 REPAIRS & MAINTENANCE 17393553 12990184 4403369 BAD DEBT 11609229 11609229 8679684 5312808 3366876 810942564 723882348 87060216 0 158629651 54205908 2505140 2616988 74267314 80241501 14252099 14489107 10539711 13502049 917324174 512208242 394002288 405115932 2274179070 2609796260 89923206 89222882 8970429902 8391390380 11988728381 11660581007 110383397 95037522 893607 893607 127705525 119379771 69569947 67889766 50019 75257 8371784893 7728341612 8680387388 8011617535 X 3308340993 3648963472 3308340993 3648963472 11988728381 11660581007 X 221390501 121290986 -2059008 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 36136 0 1 19352 55488 0 PART II-B, LINE 1: PORTION OF DUES FROM MEMBERSHIP IN CHA AND AHA THAT ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES - $19,352. INTERNAL STAFF TIME AND EXPENSE SPENT ON DIRECT LOBBYING ACTIVITIES - $36,136. 8639363 9674 1032173 53777 237119 85032 9305282 7951438 115564 788252 15783 162891 37217 8639363 7505139 15248 739495 51797 256647 7951438 8519574 80607 -772629 45447 242696 34270 7505139 7696043 67691 1053774 36975 222882 38077 8519574 0.04910 0.74320 0.20770 0 1 1 39776726 39776726 376978163 179944652 197033511 89463614 84296267 5167347 236400643 187284319 49116324 174705028 60683004 114022024 405115932 INTERCOMPANY RECEIVABLE 8318306160 DEFERRED PENSION OUTFLOW COSTS 7366338 OTHER RECEIVABLES 4561518 LEASE RECEVIABLE LT 10033303 DEFERRED OUTFLOW PUBLIC PRIVATE PARTNERSHIP 51123061 8391390380 INTERCOMPANY PAYABLES 7642640470 ACCRUED INTEREST PAYABLE 1833162 OTHER DEFERRED EXPENSES 2285834 PENSION LIABILITIES 17567442 DEFERRED INFLOW OF LEASES 8909190 PUBLIC PRIVATE PARTNERSHIP LIABILITY TRANSFER 55105514 7728341612 1134811700 121290986 1884664 123175650 1011636050 3905569 16791446 20697015 1032333065 794189221 1884664 1884664 792304557 3905569 14732438 18638007 810942564 PART V, LINE 4: ENDOWMENT FUNDS ARE USED FOR THE INTENDED PURPOSE TO FUND SCHOLARSHIPS, EDUCATION, PROGRAMS, AND COMMUNITY BENEFIT. TEMPORARILY RESTRICTED NET ASSETS ARE THOSE WHOSE USE BY THE FOUNDATION HAVE BEEN LIMITED BY THE DONOR TO A SPECIFIC TIME PERIOD OR PURPOSE. THESE NET ASSETS ARE AVAILABLE FOR VARIOUS HEALTH CARE PURPOSES AS DEFINED BY DONORS. THE ENDOWMENT FUND IS OWNED BY UCHEALTH NORTHERN COLORADO FOUNDATION. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE INCLUDED IN EXPENSE ON AFS 1,791,105. COGS REPORTED AS EXPENSE ON AFS 93,559. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS 11,609,229. RENTAL EXPENSE AS INCOME ON 990 6,675. PHARMACY SALES INCLUDED IN EXPENSE ON AFS 7,307. INTERCO EXPENSE ALLOCATIONS RECLASS 2,078,501. CASH CONTRIBUTIONS FROM FDN NOT IN AFS REVENUE 570,725. BOOK VS. TAX ADJUSTMENT IN EQUITY EARNINGS 2,059,009. INCOME TAX REFUND 460,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE INCLUDED IN EXPENSE ON AFS 1,791,105. COGS REPORTED AS EXPENSE ON AFS 93,559. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT IN AFS INCOME 11,609,229. RENTAL EXPENSE AS INCOME ON 990 6,675. PHARMACY SALES INCLUDED IN EXPENSE ON AFS 7,307. CASH CONTRIBUTIONS FROM FOUNDATION NOT IN AFS REVENUE 570,725. INTERCO EXPENSE ALLOCATIONS RECLASS 2,078,502. INCOME TAX REFUND 460,000. 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 10434161 10434161 0.01310 132800949 77807263 54993686 0.06880 10320963 6347455 3973508 0.00500 153556073 84154718 69401355 0.08690 15657550 5075302 10582248 0.01320 8421012 1016276 7404736 0.00930 6880514 6162050 718464 0.00090 46002 6463 39539 0.00000 77135573 77135573 0.09650 108140651 12260091 95880560 0.11990 261696724 96414809 165281915 0.20680 61178 61178 0.00010 394102 394102 0.00050 455280 455280 0.00060 0 11609229 155438750 171739267 -16300517 1 1 1 HARMONY SURGERY CENTER LLC AMBULATORY SURG 0.50000 0.50000 2 PEAK SURGICAL MANAGEMENT MANAGEMENT SERVICES 0.07000 0.81000 3 HARMONY IMAGING CENTER LLC MEDICAL IMAGING 0.60000 0.40000 4 GATEWAY MEDICAL SERVICES REAL ESTATE/MEDICAL EQUIPMENT 0.50000 0.50000 5 OCR OF LOVELAND LLC AMBULATORY SURG 0.50000 0.50000 6 OCR OF FORT COLLINS LLC AMBULATORY SURG 0.50000 0.50000 1 1 POUDRE VALLEY HOSPITAL 1024 S LEMAY FORT COLLINS CO 80524 010305 X X X X X PHARMACY, LAB, IMAGING, BIRTH CENTER, HEART AND VASCULAR POUDRE VALLEY HEALTH CARE 1 0 0 1 X X X X X X X X X 24 1 1 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 POUDRE VALLEY HEALTH CARE 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 PVH AND MCR TO GATHER INPUT ON COMMUNITY HEALTH NEEDS.REVIEW OF THE MOST RECENT COMMUNITY HEALTH IMPROVEMENT PLAN FOR LARIMER COUNTY AS PRODUCED BY LARIMER COUNTY DEPARTMENT OF HEALTH AND ENVIRONMENT.PARTICIPATION IN MEETINGS WITH LARIMER COUNTY DEPARTMENT OF HEALTH AND ENVIRONMENT AND OTHER LOCAL ORGANIZATIONS TO GAIN INSIGHT INTO COMMUNITY NEEDS POUDRE VALLEY HEALTH CARE PART V, SECTION B, LINE 6A: POUDRE VALLEY HOSPITAL (PVH) AND MEDICAL CENTER OF THE ROCKIES (MCR) PREPARED A JOINT CHNA AS BOTH HOSPITALS SERVE RESIDENTS FROM THE SAME GEOGRAPHIC LOCATIONS. POUDRE VALLEY HEALTH CARE PART V, SECTION B, LINE 6B: IN 2025, THE CHNA PROCESS FOR MEDICAL CENTER OF THE ROCKIES (MCR) AND POUDRE VALLEY HOSPITAL (PVH), 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 PVH AND MCR TO GATHER INPUT ON COMMUNITY HEALTH NEEDS. AN INCLUSIVE LIST OF OVER 175 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/. POUDRE VALLEY HEALTH CARE PART V, SECTION B, LINE 11: EXAMPLES OF HOW PVH/MCR IS ADDRESSING ISSUES RELATED TO ACCESS TO CARE FOR VULNERABLE INDIVIDUALS INCLUDES STAFFING A RN HOME VISIT PROGRAM FOR POSTPARTUM WOMEN WHO ARE ELIGIBLE FOR OR ENROLLED IN MEDICAID. NURSES ASSESS THE NEWBORN, PROVIDE THE MOTHER WITH LACTATION COUNSELING, SELF-CARE GUIDELINES AND ACHIEVE AN INCREASE IN THE MOTHER'S CONFIDENCE TO CARE FOR HER NEWBORN. ADDITIONALLY, COMPREHENSIVE CARE COORDINATION SERVICES ASSIST FAMILIES OF CHILDREN WITH SPECIAL HEALTH CARE NEEDS AS WELL AS VULNERABLE ADULTS WITH MEDICALLY COMPLEX, CHRONIC CONDITIONS. TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES, PVH/MCR 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, PVH/MCR DIRECTS RESOURCES TO PROVIDING MEDICALLY ASSISTED ADDICTION TREATMENT AS WELL AS 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. 3 1 - UCHEALTH HARMONY CAMPUS AMBULATORY CARE 2127 E HARMONY RD FORT COLLINS CO 80528 SURGERY CENTER, IMAGING 2 - OCR LOVELAND 3470 E 15TH STREET LOVELAND CO 80538 SURGERY CENTER 3 - OCR FORT COLLINS 2500 E PROSPECT FORT COLLINS CO 80525 SURGERY CENTER PART I, LINE 7: LINE 7A 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, LINE 7G: INCLUDES PHYSICIAN GROUPS AS A SUBSIDIZED SERVICE. THESE CLINICS PROVIDE SERVICES IN UNDERSERVED AREAS IN COLORADO, NEBRASKA AND WYOMING. PART I, LN 7 COL(F): TOTAL BAD DEBT EXPENSE REMOVED FROM THE DENOMINATOR PRIOR TO THE PERCENTAGE CALCULATION = $11,609,229 PART III, LINE 2: ACCOUNTS WITH UNRESOLVED PATIENT LIABILITY AFTER REASONABLE COLLECTION EFFORTS, SET BY POLICY AND IN CONJUNCTION WITH FEDERAL, STATE, AND PAYOR SPECIFIC REGULATIONS, WILL BE ASSIGNED TO BAD DEBT. THESE ACCOUNTS SHALL BE REFERRED TO AN OUTSIDE COLLECTION AGENCY, OR IN SELECTED INSTANCES, ATTORNEYS, FOR ADDITIONAL COLLECTION ACTIVITIES. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF ALLOWANCES FOR DOUBTFUL ACCOUNTS, CONTRACTUAL ADJUSTMENTS, AND MEDICALLY INDIGENT ALLOWANCES.PART III, LINE 5: MEDICARE REVENUE WAS COMPUTED AS FOLLOWS:PVHC COST REPORT: $137,992,654PVHC DISALLOWED PROGRAMS: $2,686,210JOINT VENTURES: $14,759,886TOTAL TO LINE 5: $155,438,750PART III, LINE 6: ALLOWABLE COSTS AS REPORTED ON THE POUDRE VALLEY HEALTH CARE INC. FY25 COST REPORT AGGREGATED WITH DISREGARDED ENTITIES AND OWNERSHIP PORTIONS OF JOINT VENTURES. PART III, LINE 6: MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENTS WAS COMPUTED AS FOLLOWS:PVHC COST REPORT: $151,113,352PVHC DISALLOWED PROGRAMS: $3,625,656JOINT VENTURES: $17,000,259TOTAL TO LINE 6: $171,739,267 PART III, LINE 8: APPROXIMATELY 32.92% 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: POUDRE VALLEY HEALTH CARE INC. IS A LOCALLY OWNED, PRIVATE, NON-PROFIT ORGANIZATION WITH A STRONG VISION: FROM HEALTHCARE TO HEALTH.BASED IN NORTHERN COLORADO, PVH PROVIDES EVIDENCE-BASED HEALTHCARE AND WELLNESS SERVICES AND PRODUCTS IN COLORADO, NEBRASKA AND WYOMING, ACROSS A SERVICE AREA COVERING MORE THAN 50,000 SQUARE MILES.PVH IS A PART OF THE UCHEALTH WHICH AIMS TO DELIVER THE HIGHEST QUALITY PATIENT CARE WITH THE HIGHEST QUALITY PATIENT EXPERIENCE. THE PARTNERSHIP COMBINES POUDRE VALLEY HOSPITAL, MEDICAL CENTER OF THE ROCKIES, UCHEALTH 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: WE HAVE IMPLEMENTED A MULTITUDE OF PROGRAMS AND SERVICES THAT ADDRESS THE HEALTH NEEDS OF OUR BROADER COMMUNITY TARGETING ALL AGE GROUPS WHILE MAINTAINING A SPECIAL FOCUS ON SERVING VULNERABLE POPULATIONS. WE ALSO GIVE DOLLARS TO OTHER ENTITIES THAT WORK TO IMPROVE THE HEALTH OF OUR COMMUNITY. EXAMPLES ARE: TEEN PREGNANCY PREVENTION EDUCATION; SUBSTANCE ABUSE PREVENTION EDUCATION FOR YOUTH AND YOUNG ADULTS; OBESITY PREVENTION; IMPROVED FOOD SECURITY FOR LOW INCOME RESIDENTS; AND MENTAL HEALTH SERVICES FOR THE UNDERSERVED. PART VI, LINE 6: ALL THE SERVICES WE OFFER ARE AVAILABLE TO ANYONE THAT USES ANY OF OUR FACILITIES IN THE HEALTH SYSTEM. OUR GEOGRAPHY IS NOT THAT LARGE SO WE ARE ABLE TO ACCOMMODATE THE DIFFERENT COMMUNITIES THAT UTILIZE OUR SERVICES WITH THE SAME LEVEL OF COMMUNITY HEALTH PROGRAMMING. PART VI, LINE 7, REPORTS FILED WITH STATES CO 1 UCHEALTH MEDICAL GROUP 2315 E HARMONY RD 200 FORT COLLINS CO 80528 800348943 501(C)(3) 73106283 0 SEE SCH I, PART IV UNIVERSITY SCHOOL OF MEDICINE 13001 17TH PLACE AURORA CO 80045 846000555 501(C)(3) 3825892 0 SEE SCH I, PART IV FREEDOM SERVICE DOGS 7193 S DILLON CT ENGLEWOOD CO 80112 841068936 501(C)(3) 22464 0 SEE SCH I, PART IV COLORADO STATE UNIVERSITY 120 CAMPUS DELIVERY FORT COLLINS CO 805230120 846000545 GOVERNMENT 20000 0 SEE SCH I, PART IV UNITED WAY OF LARIMER COUNTY 424 PINE ST 102 FORT COLLINS CO 80524 846031503 501(C)(3) 14062 0 SEE SCH I, PART IV OUTREACH FORT COLLINS 19 OLD TOWN SQUARE FORT COLLINS CO 80524 131837418 501(C)(3) 10000 0 SEE SCH I, PART IV THE CENTER FOR FAMILY OUTREACH 212 W MOUNTAIN AVE FORT COLLINS CO 80521 841515937 501(C)(3) 10000 0 SEE SCH I, PART IV SUMMITSTONE HEALTHCARE PARTNERS 4856 INNOVATION DR STE B FORT COLLINS CO 80525 841512383 501(C)(3) 10000 0 SEE SCH I, PART IV FORT COLLINS AREA CHAMBER OF COMMERCE 225 S MELDRUM ST FORT COLLINS CO 80521 840201983 501(C)(6) 10000 0 SEE SCH I, PART IV AMERICAN CANCER SOCIETY 3380 CHASTAIN MEADOWS PKY 200 KENNESAW GA 30144 131788491 501(C)(3) 8495 0 SEE SCH I, PART IV PARTNERSHIP FOR AGE-FRIENDLY COMMUNITIES IN LARIMER COUNTY 525 WEST OAK B3 FORT COLLINS CO 80521 841030514 501(C)(3) 8477 0 SEE SCH I, PART IV CHRIST CLINIC 3920 S SHIELDS ST FORT COLLINS CO 80527 455300042 501(C)(3) 7500 0 SEE SCH I, PART IV ELDERHAUS ADULT DAY PROGRAM 6813 S COLLEGE AGE FORT COLLINS CO 80525 840833808 501(C)(3) 7500 0 SEE SCH I, PART IV FAMILY HOUSING NETWORK 1606 S LEMAY AVE 103/105 FORT COLLINS CO 80525 463225758 501(C)(3) 7500 0 SEE SCH I, PART IV HOMEWARD ALLIANCE PO BOX 873 FORT COLLINS CO 80522 274641606 501(C)(3) 7500 0 SEE SCH I, PART IV RESPITE CARE 6203 S LEMAY AVE FORT COLLINS CO 80525 840840653 501(C)(3) 7500 0 SEE SCH I, PART IV BOYS & GIRLS CLUB OF LARIMER COUNTY 103 SMOKEY STREET FORT COLLINS CO 80525 742425914 501(C)(3) 5651 0 SEE SCH I, PART IV IVINSON MEMORIAL HOSPITAL FOUNDATION 225 N 30TH ST LARAMIE WY 82072 830259429 501(C)(3) 5569 0 SEE SCH I, PART IV CHEYENNE REGIONAL MEDICAL CENTER FOUNDATION 214 E 23RD ST CHEYENNE WY 82001 830236858 501(C)(3) 5062 0 SEE SCH I, PART IV 18 1 PART I, LINE 2: THE ORGANIZATION AWARDS GRANTS BASED ON THE BENEFIT TO THE COMMUNITY. THE ORGANIZATION REQUESTS INFORMATION FROM THE GRANTEES TO ENSURE THAT THE FUNDS WILL BE USED FOR THE SPECIFIED PURPOSE. QUESTION I, PART II, COLUMN H PURPOSE OF GRANT OR ASSISTANCE FOR RELATED ENTITIES, THE GRANTS ARE RELATED TO SPECIFIC REQUESTS. THE FUNDS ARE TO BE USED TO BENEFIT THE HEALTHCARE COMMUNITY OF NORTHERN COLORADO. EACH REQUEST IS EVALUATED ON AN INDIVIDUAL BASIS. FOR NON-RELATED COMMUNITY AND GOVERNMENTAL ORGANIZATIONS, THE GRANTS ARE MADE AT THE DISCRETION OF THE ORGANIZATION. THESE DISCRETIONARY GRANTS ARE TO BE USED TO BENEFIT THE HEALTHCARE COMMUNITY OF NORTHERN COLORADO. X X X 1 1 X X X X 0 0 0 0 0 0 0 1 0 KEVIN UNGER CHIEF EXECUTIVE OFFICER 290396 314104 434882 470386 11423 12356 59025 63844 11810 12774 807536 873464 0 0 DIANA BREYER CHIEF MEDICAL OFFICER 236197 227553 57214 44504 2521 1961 22489 20823 14728 14191 333149 309032 0 0 JILLIAN BUSCH PSYCHIATRIST 549298 0 2700 0 380 0 31602 0 27533 0 611513 0 0 0 DAVID THOMPSON CHIEF FINANCIAL OFFICER 205787 160073 51951 40411 2059 1602 21721 16896 12447 9682 293965 228664 0 0 BRIAN ALLEN CHIEF OPERATING OFFICER 187500 202808 35841 38768 4508 4877 18907 20451 1625 1757 248381 268661 0 0 JASON COLLISON PSYCHIATRIST 437860 0 0 0 488 0 31602 0 28528 0 498478 0 0 0 KARL JOHNSON PSYCHIATRIST 396687 0 6000 0 262 0 31602 0 31834 0 466385 0 0 0 JANELL WOZNIAK FAMILY MEDICINE CENTER DIRECTOR 359696 0 40440 0 1808 0 32502 0 27301 0 461747 0 0 0 SPENCER HARRISON PSYCHIATRIST 383428 0 4500 0 295 0 34780 0 32696 0 455699 0 0 0 ANNETTE VIZENA CHIEF QUALITY OFFICER VP 178367 138744 42806 33297 921 717 19846 15438 6142 4776 248082 192972 0 0 ASHLEY BRUNING CHIEF NURSING OFFICER, PVH 259944 0 64100 0 1362 0 29994 0 31672 0 387072 0 0 0 GRACE KOWALYSHYN-TAYLOR VP OF OPERATIONS 118384 128048 30201 32667 413 447 14898 16115 10803 11684 174699 188961 0 0 ANDREW HARMON DIRECTOR OF PHARMACY 98788 76843 12199 9489 336 261 10288 8002 13659 10625 135270 105220 0 0 CHRISTINE JOHNSTON ASSOCIATE CHIEF MEDICAL OFFICER 92666 72080 21762 16928 831 647 7842 6100 909 707 124010 96462 0 0 KRYSTLE BELL SR DIRECTOR PERIOP 80560 62664 9996 7776 183 143 6315 4912 13517 10514 110571 86009 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. CLUB DUES: THE HEALTH SYSTEM EXPECTS THE HOSPITAL MANAGEMENT TO PARTICIPATE IN COMMUNITY LIFE AND THEREFORE THE SYSTEM PAYS SOCIAL CLUB DUES FOR SPECIFIC MEMBERS OF THE SENIOR MANAGEMENT GROUP. THE CLUB DUES ARE ADDED TO THE SENIOR MANAGEMENT'S FORM W-2 ON AN ANNUAL BASIS. PART I, LINE 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 2018 SERIES A 841179794 914183BH0 2018-07-26 45915000 REFUNDING 2005A BONDS 0 0 0 B UNIVERSITY OF COLORADO HOSPITAL AUTHORITY 2018 SERIES B 841179794 914183BJ6 2018-07-26 24374400 REFUNDING 2005B BONDS 0 0 0 C UNIVERSITY OF COLORADO HOSPITAL AUTHORITY 2017 SERIES A 841179794 914183BB3 2017-02-16 43493450 REFUNDING 2015A BONDS 0 0 0 D UNIVERSITY OF COLORADO HOSPITAL AUTHORITY 2024 SERIES A 841179794 914183CD8 2024-08-24 5665403 REFUNDING 2019C BONDS 0 0 0 A 45915000 318692 45596308 2018 1 0 1 1 B 24374400 169360 24205040 2018 1 0 1 1 C 43493450 213070 43280380 2017 1 0 1 1 D 66018 5599386 54002 5611401 2024 1 0 1 1 A 0 1 1 0 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 0 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 1 1 0 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 1 1 0 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 1 CITI 21.500000000000 0 0 0 0 1 B 0 0 0 1 1 1 CITI 21.500000000000 0 0 0 0 1 C 0 0 0 1 0 1 CITI 10.000000000000 0 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 X MEDICAL EQUIPMENT & FACILITY UPGRADES 16 2507367 FMV 0 1 0 FORM 990, PART I, LINE 6 POUDRE VALLEY HOSPITAL (PVH) HAD 352 ACTIVE VOLUNTEERS IN FISCAL YEAR 2025. THESE VOLUNTEERS PROVIDED OVER 100,000 HOURS OF SERVICE DURING THE YEAR. AT PVH, 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. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY INDEPENDENT CPAS. A PRELIMINARY DRAFT IS REVIEWED BY THE INTERNAL FINANCE DEPARTMENT. THE FINAL COPY OF THE FORM 990 IS PROVIDED IN AN ELECTRONIC FORMAT TO ALL BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY REQUIRES COMPLETION OF THE FORM ON AN ANNUAL BASIS BY THE BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. COMPLETED FORMS ARE SUBMITTED AND REVIEWED BY THE INTERNAL COMPLIANCE DEPARTMENT TO ENSURE COMPLIANCE WITH THE WRITTEN POLICY. ANY QUESTIONS OR ULTIMATE ENFORCEMENT WOULD BE HANDLED BY THE COMPLIANCE DEPARTMENT. FORM 990, PART VI, SECTION B, LINE 15 UCHEALTH CONTRACTS WITH SULLIVAN COTTER FOR EXECUTIVE COMPENSATION CONSULTING SERVICES. ON OUR BEHALF, 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. THE ORGANIZATION DOES NOT HAVE EMPLOYEES FOR FORM 990 REPORTING PURPOSES, AS ALL EMPLOYEES OF THE ORGANIZATION ARE REPORTED ON THE PAYROLL OF UNIVERSITY OF COLORADO HOSPITAL AUTHORITY OR UNIVERSITY OF COLORADO HEALTH. EMPLOYEES ARE LEASED TO THE ORGANIZATION. 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 XI, LINE 9: BOOK VS. TAX ADJUSTMENT IN EQUITY EARNINGS -2,059,008. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS DURING THE TAX YEAR. 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