2024-12-23T09:46:25-06:00 2024-06-30 381357951 PLANTE & MORAN PLLC 8181 E TUFTS AVE SUITE 600 DENVER CO 80237 990 2023-07-01 821613059 LONGS PEAK HOSPITAL FOUNDATION LONG 7208488778 1750 E KEN PRATT BOULEVARD LONGMONT CO 80504 DAVID THOMPSON CFO 7208488778 2024-12-18 1 1 RYAN C HARRIS P00614618 3037409400 2024-12-18 2023 2024-10-15 13:58:12Z DAVID THOMPSON 1750 E KEN PRATT BOULEVARD LONGMONT CO 80504 401472 0 X HTTPS://WWW.LONGSPEAKHOSPITALFOUNDATION.ORG/ X 2016 CO SUPPORT & PROMOTE ACTIVITIES THAT BEST SERVE THE HEALTH INTERESTS OF THE HOSPITALS. 7 7 3 10 0 0 463267 381960 0 0 12633 16322 -8744 -13671 467156 384611 180782 151883 0 0 189175 134190 0 0 78850 49643 31041 419600 317114 47556 67497 549003 646181 37857 36183 511146 609998 THE MISSION OF THE LONGS PEAK HOSPITAL FOUNDATION IS TO ADVANCE PHILANTHROPIC INNOVATION FOR HEALTHY, EXTRAORDINARY LIVES. 0 0 139770 121483 RESTRICTED FUND - PROVIDES FUNDING TO SUPPORT HOSPITAL PATIENT FINANCIAL ASSISTANCE, COMMUNITY EDUCATION, HOSPITAL CAPITAL EQUIPMENT, AND SCHOLARSHIPS. 56683 30400 UNRESTRICTED FUND - PROVIDES FUNDING FOR HOSPITAL CAPITAL EQUIPMENT AND PROGRAM SERVICES. 196453 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 7 0 1 3 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 7 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X DAVID THOMPSON 7208488778 2315 E HARMONY ROAD SUITE 200 FORT COLLINS CO 80528 GREG LUDLOW BOARD CHAIR 1.00 2.00 X X 0 0 0 KAREN STUART BOARD VICE CHAIR 1.00 2.00 X X 0 0 0 DAN STROH DIRECTOR 1.00 2.00 X 0 0 0 STEVE HESS DIRECTOR 1.00 2.00 X 0 0 0 DR JOHN STATHIS DIRECTOR 1.00 2.00 X 0 0 0 COLLEEN SIMPSON DIRECTOR (STARTED FEB 2024) 1.00 2.00 X 0 0 0 TIM WATERS DIRECTOR (STARTED FEB 2024) 1.00 2.00 X 0 0 0 RYAN ROHMAN PRESIDENT, LPH & BH 1.00 50.00 X 0 376431 8173 MATT YEHL BOARD TREASURER LPH/BH DIRECTOR OF FINANCE 1.00 50.00 X 0 176308 39607 CHAR CORTEZ BOARD SECRETARY EXECUTIVE ASSISTANT 1.00 40.00 X 0 94490 33231 DAVID THOMPSON CFO, UCHEALTH NORTH 1.00 1.00 X 0 0 0 JON ALFORD CFO, METRO DENVER (RESIGNED 3/24 1.00 1.00 X 0 0 0 JULIE NICKELL CFO, METRO DENVER (STARTED 4/24) 1.00 1.00 X 0 0 0 0 647229 81011 1 0 1 0 0 35891 207436 138633 7600 381960 12960 12960 3362 0 3362 3362 3362 3190 35891 16861 -13671 -13671 384611 0 0 2651 62424 62424 89459 89459 102562 28287 21953 52322 3089 867 618 1604 26844 7384 5802 13658 1695 476 339 880 3750 3750 5510 5510 513 513 9696 9696 2349 1659 690 370 370 253 253 HOSPITAL INITIATIVES 7556 7556 MISCELLANEOUS EXPENSES 953 953 CORPORATION ALLOCATION 91 91 317114 196453 41811 78850 97163 190597 10000 0 405095 454241 36745 1343 549003 646181 31210 10628 6647 25555 37857 36183 X 101851 190886 409295 419112 511146 609998 549003 646181 67497 31355 0 X 0 1 X 1 0 X 420021 556619 544485 463267 381960 2366352 420021 556619 544485 463267 381960 2366352 1298431 1067921 853 1634 6345 12960 21792 2388144 0.44720 0.43610 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 126824 5339 8869 141032 104882 14447 7495 126824 71341 37201 -3660 104882 40413 29710 1219 71341 16502 23911 40413 0.90130 0.09870 0 0 0 432827 31355 31355 401472 -16861 -16861 384611 333975 16861 16861 317114 0 317114 PART V, LINE 4: ENDOWMENT FUNDS ARE USED FOR THE INTENDED PURPOSE TO FUND SCHOLARSHIPS. PART XI, LINE 4B - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES -16,861. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES 16,861. CORN HOLE OCT 2023 38201 35011 3190 250 410 4001 250 6750 38201 35011 3190 250 410 4001 250 6750 11661 -8471 1 LONGS PEAK HOSPITAL 1750 E KEN PRATT BLVD LONGMONT CO 80504 611786722 501(C)(3) 13017 49407 BOOK MEDICAL EQUIPMENT TO SERVE PATIENTS 1 HEALTHY HEARTS 4303 30185 CANCER PATIENT ASSISTANCE 84 26418 EMPLOYEE SCHOLARSHIPS 12 21500 PATIENT ASSISTANCE 285 6356 NEW PARENTING CLASSES 46 5000 PART I, LINE 2: THE FOUNDATION REQUESTS GRANT RECIPIENTS TO REPORT BACK TO THE FOUNDATION ON USE AND OUTCOME OF FUNDING. 0 0 0 0 0 0 0 0 0 RYAN ROHMAN PRESIDENT, LPH & BH 0 267431 0 108110 0 890 0 5451 0 2722 0 384604 0 0 MATT YEHL BOARD TREASURER LPH/BH DIRECTOR OF F 0 160167 0 15780 0 361 0 16723 0 22884 0 215915 0 0 FORM 990, PART VI, SECTION A, LINE 6 LONGS PEAK HOSPITAL IS THE SOLE VOTING MEMBER OF LONGS PEAK HOSPITAL FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE MEMBER OF LONGS PEAK HOSPITAL FOUNDATION, LONGS PEAK HOSPITAL APPOINTS ALL BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B LONGS PEAK HOSPITAL HAS SOLE DETERMINATION OVER: A) AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE FOUNDATION; B) DISSOLUTION, MERGER, OR CONSOLIDATION OF THE FOUNDATION; C) SALE, LEASE, MORTGAGE, OR OTHER TRANSFER OF ALL OF OR SUBSTANTIALLY ALL OF THE FOUNDATION'S ASSETS; AND D) ADMISSION OF ANY NEW MEMBERS TO THE FOUNDATION OR APPROVAL OF ANY TRANSFER OF A MEMBERSHIP INTEREST. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY A THIRD PARTY. 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 DIRECTOR MEMBERS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS ARE COVERED UNDER THIS POLICY. CONFLICTS ARE REVIEWED AT MANAGEMENT LEVEL. BOARD MEMBERS RESCIND ON VOTING IF A CONFLICT EXISTS. FORM 990, PART VI, SECTION B, LINE 15 LONGS PEAK HOSPITAL FOUNDATION DOES NOT HAVE EMPLOYEES FOR FORM 990 REPORTING PURPOSES. ALL EMPLOYEES OF LONGS PEAK HOSPITAL FOUNDATION ARE REPORTED ON THE PAYROLL OF UNIVERSITY OF COLORADO HOSPITAL AUTHORITY THROUGH 6/30/2024. EMPLOYEES ARE LEASED TO LONGS PEAK HOSPITAL FOUNDATION. THE EXPENSES THAT ARE REPORTED FOR SALARIES AND BENEFITS ON THE STATEMENT OF FUNCTIONAL EXPENSES REPRESENT THE EMPLOYEE LEASE EXPENSE FOR THE YEAR ENDED 6/30/2024. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND THE CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST WITH A LEGITIMATE BUSINESS PURPOSE. LONGS PEAK HOSPITAL 1850 MOUNTAIN VIEW AVENUE LONGMONT CO 80501 611786722 HOSPITAL CO 501(C)(3) LINE 3 0 0 1 1 0 0 0 0 0 0 0 1 0 1 1 1 1 1 0 0