2025-05-13T10:26:45-05:00 2024-06-30 331498605 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2023-07-01 840398876 YAMPA VALLEY MEDICAL CENTER YAMP 9708791322 1024 CENTRAL PARK DRIVE STEAMBOAT SPRINGS CO 80487 DAVID THOMPSON CFO 9708791322 2025-05-12 1 1 AMY CIMINELLO P00796388 6148493000 2025-05-12 2023 2025-03-06 01:10:19Z UCHEALTH YAMPA VALLEY MEDICAL CENTER SONIYA FIDLER 1024 CENTRAL PARK DRIVE STEAMBOAT SPRINGS CO 80487 147384159 0 X WWW.UCHEALTH.ORG X 1946 CO WE IMPROVE LIVES THROUGH LEARNING, HEALING, DISCOVERY, AND THROUGH HUMAN CONNECTION. 12 11 775 35 0 0 621853 811041 132582212 142266080 1030343 3093597 2141386 1118162 136375794 147288880 941044 1329332 0 0 61509628 62303502 0 0 0 69555999 72536865 132006671 136169699 4369123 11119181 174699596 192552193 20821997 24313736 153877599 168238457 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 107368819 1329332 142266080 YVMC IS A 39-BED ACUTE CARE HOSPITAL PROVIDING SOPHISTICATED MEDICAL SERVICES TO MORE THAN 142,797 OUTPATIENTS ANNUALLY. FROM FAMILY MEDICINE AND OBSTETRICS TO EMERGENCY MEDICINE OR CHRONIC DISEASE CARE, YVMC PROVIDES HIGH-QUALITY CARE TO RESIDENTS AND VISITORS ALIKE. IT ALSO SERVES AS THE LEADING CENTER FOR ORTHOPEDIC CARE IN NORTHWEST COLORADO; OFFERING COMPREHENSIVE SERVICES SUCH AS ORTHOPEDIC TRAUMA CARE, JOINT REPLACEMENT, SPORTS MEDICINE AND GENERAL ORTHOPEDICS. 107368819 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 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 0 0 0 1 131 0 1 775 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X YAMPA VALLEY MEDICAL CENTER 9708791322 1024 CENTRAL PARK DR STEAMBOAT SPRINGS CO 80487 KEVIN UNGER CEO 50.00 0.00 X X 1021506 0 170133 SCOTT MARR BOARD TRUSTEE 1.00 0.00 X 0 0 0 DR JIM COTTER BOARD TRUSTEE 1.00 0.00 X 0 0 0 KATHY CONNELL BOARD TRUSTEE 1.00 0.00 X 0 0 0 DR NATHAN ANDERSON BOARD TRUSTEE 1.00 0.00 X 0 0 0 MIKE STOLTZ BOARD TRUSTEE 1.00 0.00 X 0 0 0 KELLY LATTERMAN BOARD TRUSTEE 1.00 0.00 X 0 0 0 NELLY NAVARRO BOARD TRUSTEE 1.00 0.00 X 0 0 0 DR LISA KETTERING BOARD TRUSTEE 1.00 0.00 X 0 0 0 LAURIE STEELE BOARD TRUSTEE 1.00 0.00 X 0 0 0 KARA STOLLER BOARD TRUSTEE 1.00 0.00 X 0 0 0 KATHLEEN WASSERMAN BOARD TRUSTEE 1.00 0.00 X 0 0 0 SONIYA FIDLER PRESIDENT 40.00 0.00 X 418666 0 60260 DAVID THOMPSON CFO 40.00 0.00 X 551430 0 72049 LAURA SEHNERT CMO 40.00 0.00 X 355932 0 57630 KELLY GALLEGOS CNO 40.00 0.00 X 278120 0 54171 RYAN LARSON DIRECTOR OF CLINICAL OPERATIONS 40.00 0.00 X 217684 0 29526 WESLEY HUNTER PHARMACY DIRECTOR 40.00 0.00 X 216845 0 34857 ELI NYKAMP DIRECTOR OF OPERATIONS 40.00 0.00 X 162239 0 43776 JEFFREY CHAMBERLAIN PHYSICIAN 40.00 0.00 X 388008 0 56517 ELAINE STRICKRATH PHYSICIAN 40.00 0.00 X 389614 0 56422 LAURIE LEBLEU VASZILY PHYSICIAN 40.00 0.00 X 395781 0 46488 GARY BREEN PHYSICIAN 40.00 0.00 X 518675 0 55972 MALAIKA THOMPSON PHYSICIAN 40.00 0.00 X 428935 0 56644 5343435 0 794445 90 0 1 0 STEAMBOAT EMERGENCY ASSOCIATES PO BOX 770636 STEAMBOAT SPRINGS CO 80477 MEDICAL 2920125 VAYA WORKFORCE SOLUTIONS LLC 5930 CORNERSTONE CT W STE 300 SAN DIEGO CA 92121 MEDICAL/CONTRACT LABOR 2710967 FORT COLLINS RADIOLOGY ASSOCIATES 2008 CARIBOU DRIVE FORT COLLINS CO 80525 MEDICAL 1205665 CHILDRENS HOSPITAL COLORADO 13123 E 16TH AVE AURORA CO 80045 MEDICAL 695084 COLORADO PATHOLOGY CONSULTANTS 4567 E 9TH AVE DENVER CO 80220 MEDICAL 676457 18 630010 181031 571488 811041 NET OUTPATIENT SERVICE 900099 108235695 108235695 NET INPATIENT SERVICE 900099 33001861 33001861 MISC OPERATING REVENUE 900099 1028524 1028524 142266080 1735002 1735002 29731 0 29731 29731 29731 1453874 0 95279 1453874 -95279 1358595 1358595 CHILDCARE 624410 563356 563356 MEALS/FOOD SALES 900099 525075 525075 1088431 147288880 142266080 0 4211759 1329332 1329332 1646889 1272983 373906 47828100 36969318 10858782 3630795 2832020 798775 8619142 6671638 1947504 578576 451289 127287 2500 2500 83010 83010 11439254 8424045 3015209 17146 17146 1049736 1025967 23769 44046 43132 914 776174 776174 208189 192191 15998 325497 90399 235098 130337 130337 11598154 3569524 8028630 468324 122246 346078 MEDICAL SUPPLIES/FOOD 27696988 27696988 MEDICAL PROVIDER FEES 6345329 6345329 BAD DEBT EXPENSE 4185833 4185833 PROVIDER FEE EXPENSE 3351422 3351422 4814926 2018989 2795937 136169699 107368819 28800880 0 4088014 5532339 17523108 19089312 4151828 4016329 1141564 1837161 187393437 101264742 65895431 86128695 54444046 52906018 3711067 2757971 2854299 2624222 20890239 17660146 174699596 192552193 10236306 14898911 33619 702415 620168 9883276 8761038 20821997 24313736 X 153877599 168238457 153877599 168238457 174699596 192552193 11119181 3317002 -75325 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7746 7746 0 PART II-B, LINE 1: YVMC PAYS ANNUAL DUES TO STATE AND NATIONAL HEALTH CARE ORGANIZATIONS THAT CONDUCT LOBBYING ACTIVITIES. THE AMOUNT SHOWN IS THE ALLOCATION OF THOSE ANNUAL DUES THAT ARE ATTRIBUTABLE TO LOBBYING. 26000 26000 26000 26000 26000 26000 26000 71 71 26000 26000 212 212 26000 0.00000 1.00000 0.00000 0 1 1 4650750 4650750 85409728 46455846 38953882 455526 361245 94281 65562103 53936555 11625548 31315330 511096 30804234 86128695 WORKER'S COMP RECEIVABLE 238031 RELATED PARTY RECEIVABLE 11317657 DEFERRED OUTFLOW OF ASSETS 3453326 OTHER ASSETS 2651132 17660146 THIRD PARTY SETTLEMENTS 4487019 DEFERRED COMPENSATION 1901735 LEASE LIABILITY LT 2062000 OTHER LIABILITIES 310284 8761038 SCH D, PART V, LINE 4 DESCRIBE THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS: COMMUNITY RESOURCE CENTER ENDOWMENT FUND HAS BEEN PERMANENTLY RESTRICTED BY DONORS. THE COMMUNITY RESOURCE CENTER ENDOWMENT FUND HELPS SUPPORT THE ALL VOLUNTEER COMMUNITY RESOURCE CENTER LOCATED IN YAMPA VALLEY MEDICAL CENTER. 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 2971499 2971499 0.02250 2548886 2548886 0.01930 5520385 5520385 0.04180 2785489 65953 2719536 0.02060 198258 198258 0.00150 1596694 1004158 592536 0.00450 1308851 1308851 0.00990 5889292 1070111 4819181 0.03650 11409677 1070111 10339566 0.07830 104450 104450 0.00080 77442 77442 0.00060 181892 181892 0.00140 1 4185833 21516385 27308035 -5791650 X 1 1 1 STEAMBOAT SURGERY CENTER LLC AMBULATORY SURGERY CENTER 0.50000 0.50000 1 1 YAMPA VALLEY MEDICAL CENTER 1024 CENTRAL PARK DRIVE STEAMBOAT SPRINGS CO 80487 WWW.UCHEALTH.ORG 010860 X X X YAMPA VALLEY MEDICAL CENTER 1 0 0 1 X X X X X X X X X 22 1 0 1 1 X SEE PART V, SECTION C FOR DIRECT URL 1 22 1 SEE PART V, SECTION C FOR DIRECT URL 0 1 X 250.000000000000 400.000000000000 X X X 1 1 X X X 1 X WWW.UCHEALTH. ORG/BILLING-AND-PRICING/FINANCIAL-ASSISTANCE/ X WWW.UCHEALTH. ORG/BILLING-AND-PRICING/FINANCIAL-ASSISTANCE/ X 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 YAMPA VALLEY MEDICAL CENTER PART V, SECTION B, LINE 5: BETWEEN NOVEMBER 2021 AND MAY 2022, YVMC CONDUCTED A CHNA IN COLLABORATION WITH THE HEALTH PARTNERSHIP, WHICH CONSISTS OF COMMUNITY AND SAFETY NET ORGANIZATIONS, MEDICAL AND BEHAVIORAL HEALTH CARE PROVIDERS AND GOVERNMENT AGENCIES COVERING GRAND, JACKSON, MOFFAT, RIO BLANC, AND ROUTT COUNTIES. A MULTIPHASED APPROACH WAS USED TO IDENTIFY TOP HEALTH PRIORITIES FOR ACTION PLANNING AND IMPACT DURING 2022-2024. A COMPREHENSIVE ANALYSIS OF CURRENT, LOCAL POPULATION HEALTH INDICATORS WAS INITIALLY PERFORMED. USING A SUBSET OF THESE INDICATORS, A WEB-BASED SURVEY WAS ADMINISTERED TO SOLICIT LOCAL HEALTH CARE PROVIDERS' RANKING OF SIGNIFICANT HEALTH ISSUES AFFECTING THEIR PATIENTS. COMMUNITY INPUT WAS GAINED THROUGH A COLLABORATIVE OUTREACH EFFORT WITH MEMBER AGENCIES OF THE HEALTH PARTNERSHIP. THE NEXT PHASE CONSISTED OF CONVENING A SUBSET OF YVMC'S SENIOR MANAGEMENT GROUP TO REVIEW ALL INFORMATION OBTAINED FROM THE ACTIVITIES DESCRIBED ABOVE. PARTICIPANTS OF THIS INTERNAL ADVISORY GROUP (IAG) COMPLETED A HEALTHISSUE PRIORITIZATION IDENTIFICATION USING AN EVIDENCE-BASED, STRUCTURED PROCESS. DURING THEIR MAY 2002 MEETING, THE YVMC BOARD OF TRUESTEES, WHICH INCLUDES REPRESENTATIVES FROM THE SURROUNDING COMMUNITIES, REVIEWED, DISCUSSED, AND APPROVED THE INFORMATION CONTAINED WITH THIS REPORT. YAMPA VALLEY MEDICAL CENTER PART V, SECTION B, LINE 6B: LIST OF OTHER ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES INCLUDED IN THE CHNA: YVMC CONDUCTED THE CHNA IN COLLABORATION WITH THE HEALTH PARTNERSHIP, WHICH FACILITATED THE WORK THROUGH THE YAMPA VALLEY WELL-BEING CONSORTIUM AND INCLUDES COMMUNITY AND SAFETY NET ORGANIZATIONS, MEDICAL AND BEHAVIORAL HEALTH CARE PROVIDERS AND GOVERNMENT AGENCIES COVERING ROUTT AND MOFFAT COUNTIES. QUANTITATIVE DATA FROM REGION 11 WAS ALSO USED AND REFLECTS DATA FROM JACKSON, MOFFAT, RIO BLANCO, AND ROUTT COUNTIES. SCHEDULE H, PART V, SECTION B, LINE 7A:DIRECT URL FOR CHNA:HTTPS://UCHEALTH-WP-UPLOADS.S3.AMAZONAWS.COM/WP-CONTENT/UPLOADS/2019/10/24083924/ABOUT-YVMC-CHNA-2019-IMPLEMENTATION-STRATEGY-REPORT.PDFSCHEDULE H, PART V, SECTION B, LINE 10ADIRECT URL FOR IMPLENTATION PLAN:HTTPS://UCHEALTH-WP-UPLOADS.S3.AMAZONAWS.COM/WP-CONTENT/UPLOADS/2019/10/24083924/ABOUT-YVMC-CHNA-2019-IMPLEMENTATION-STRATEGY-REPORT.PDF YAMPA VALLEY MEDICAL CENTER PART V, SECTION B, LINE 11: YVMC IS TAKING SEVERAL STEPS IN ORDER TO ADDRESS THE NEEDS IDENTIFIED IN THE FY 2022 CHNA. THE THREE PRIMARY HEALTH ISSUES FOUND WERE ACCESS TO CARE, MENTAL AND BEHAVIOR HEALTH, AND SUBSTANCE US DISORDERS WITH THE GOALS OF IMPROVING ACCESS TO PRIMARY AND BEHAVIOR HEALTH CARE SERVICES FOR VULNERABLE POPULATIONS, IMPROVING IDENTIFICATION AND TREATMENT OF MENTAL HEALTH ISSUES AMONG HIGH-RISK INDIVIDUALS, AND EXPANDING AND STRENGTHENING SUBSTANCE USE DISORDER PREVENTION AND TREATMENT SERVICES BEING THE GOALS OF THE IMPLEMENTATION STRATEGIES, RESPECTIVELY. CARDIOVASVULAR HEALTH, OBESITY, AND CANCER WAS ANOTHER IDENTIFIED HEALTH ISSUE FOUND IN THE CHNA WITH AN IMPLEMENTATION YAMPA VALLEY MEDICAL CENTER 84-0398876 STRATEGY TO PROVIDE LOW TO NO COST HEALTH SCREENINGS, HEALTH PROMOTION EDUCATION AS WELL AS COMMUNITY-BASED WELLNESS PROGRAMS. SCHEDULE H, PART V, LINE 11 YVMC IS TAKING SEVERAL STEPS IN ORDER TO ADDRESS THE NEEDS IDENTIFIED IN THE 2022 CHNA. THE THREE PRIMARY HEALTH ISSUES FOUND WERE ACCESS TO CARE, MENTAL AND BEHAVIOR HEALTH, AND SUBSTANCE US DISORDERS WITH THE GOALS OF IMPROVING ACCESS TO PRIMARY AND BEHAVIOR HEALTH CARE SERVICES FOR VULNERABLE POPULATIONS, IMPROVING IDENTIFICATION AND TREATMENT OF MENTAL HEALTH ISSUES AMONG HIGH-RISK INDIVIDUALS, AND EXPANDING AND STRENGTHENING SUBSTANCE USE DISORDER PREVENTION AND TREATMENT SERVICES BEING THE GOALS OF THE IMPLEMENTATION STRATEGIES, RESPECTIVELY. CARDIOVASVULAR HEALTH, OBESITY, AND CANCER WAS ANOTHER IDENTIFIED HEALTH ISSUE FOUND IN THE CHNA WITH AN IMPLEMENTATION YAMPA VALLEY MEDICAL CENTER 84-0398876 STRATEGY TO PROVIDE LOW TO NO COST HEALTH SCREENINGS, HEALTH PROMOTION EDUCATION AS WELL AS COMMUNITY-BASED WELLNESS PROGRAMS. SCHEDULE H, PART V, LINE 22B MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS. THE AMOUNTS BILLED FOR EMERGENCY AND MEDICALLY NECESSARY MEDICAL SERVICES TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE CALCULATED BASED ON THE LOOK-BACK METHOD AND WILL NOT BE MORE THAN AGB TO INDIVIDUALS WITH INSURANCE COVERING SUCH CARE. YVMC IS USING THE LOOK-BACK METHOD BASED ON ACTUAL PAST CLAIMS PAID TO THE HOSPITAL FACILITY BY MEDICARE FEE-FOR-SERVICE TOGETHER WITH ALL PRIVATE HEALTH INSURERS PAYING CLAIMS TO THE HOSPITAL FACILITY (INCLUDING, IN EACH CASE, ANY ASSOCIATED YAMPA VALLEY MEDICAL CENTER 84-0398876 PORTIONS OF THESE CLAIMS PAID BY MEDICARE BENEFICIARIES OR INSURED INDIVIDUALS). YVMC CALCULATES AN AGB PERCENTAGE FOR EACH FACILITY AND USES THE LOWEST PERCENTAGE FOR ALL FACILITIES, WHICH IS 71.8%. 10 1 - UCHEALTH WOMEN'S CARE CLINIC 1100 CENTRAL PARK DR SUITE 1000 STEAMBOAT SPRINGS CO 80487 PHYSICIAN CLINIC SERVICES 2 - UCHEALTH HEART AND VASCULAR CLINIC 940 CENTRAL PARK DR SUITE 202 STEAMBOAT SPRINGS CO 80487 PHYSICIAN CLINIC SERVICES 3 - UCHEALTH PRIMARY CARE CLINIC - CRAIG 595 RUSSELL STREET CRIAG CO 81625 OUTREACH PHYSICIAN CLINIC 4 - UCHEALTH SPORTSMED CLINIC - HAYDEN 300 SOUTH SHELTON LANE HAYDEN CO 81639 PHYSICAL THERAPY CLINIC 5 - LITTLE SNAKE RIVER CLINIC 305 WHIPOORWILL STREET BAGGS WY 82321 OUTPATIENT CLINIC 6 - UCHEALTH SPORTSMED CLINIC - OAK CREEK 300 MAIN STREET OAK CREEK CO 80467 PHYCIAL THERAPY CLINIC 7 - UCHEALTH SPORTSMED PEDIATRIC CLINIC 1920 PINE GROVE ROAD STEAMBOAT SPRINGS CO 80487 PEDIATRIC THERAPY SERVICES 8 - UCHEALTH CRAIG MEDICAL CLINIC 651 YAMPA AVE CRAIG CO 81625 OUTREACH PHYSICIAN CLINIC PROVIDING LAB SERVICES 9 - UCHEALTH OCCUPATIONAL MEDICINE CLINIC 3001 SOUTH LINCOLN AVE SUITE A STEAMBOAT SPRINGS CO 80487 OCCUPATIONAL HEALTH CLINIC 10 - UCHEALTH PAIN MANAGEMENT CLINIC 3001 SOUTH LINCOLN AVE SUITE A STEAMBOOAT SPRINGS CO 80487 PAIN MANAGEMENT CLINIC PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 4,111,996. PART III, LINE 8: APPROXIMATELY 23.82% 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. SCHEDULE H, PART III, SECTION A, LINE 2 THE ORGANIZATION 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. 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 8 THE ORGANIZATION IS A SOLE COMMUNITY HOSPITAL THAT PROVIDES HEALTHCARE SERVICES TO COMMUNITY RESIDENTS AND VISITORS. ACCESSIBLE, HIGH-QUALITY HEALTHCARE SERVICE IS IMPORTANT FOR THE OVERALL HEALTH OF ALL RESIDENTS, EVEN THOUGH THE MEDICARE PAYMENTS DO NOT MEET THE COSTS OF PROVIDING CARE. THE MEDICARE SHORTFALL REFLECTS THE EXCESS OF COSTS OVER PAYMENTS RECEIVED FOR PARTICIPANTS IN THE MEDICARE PROGRAM. COSTS ARE BASED ON MEDICARE COST REPORT ALLOCATIONS. THE COST REPORT WAS USED TO DETERMINE THE ALLOWABLE COSTS REPORTED ON LINE 6. PART III, LINE 9B STATEMENTS AND LETTERS ARE SENT AND PHONE CALLS ARE PLACED TO ATTEMPT TO COLLECT THE REMAINING BALANCE. CO-PAY OR SLIDING FEE BALANCES MAY BE REFERRED FOR FURTHER COLLECTION ACTIVITY 120 DAYS FROM FIRST POST-DISCHARGE BILLING STATEMENT FOR THE CARE IS PROVIDED IF THE BALANCE IS NOT PAID IN FULL OR IF A MUTUALLY AGREED-UPON PAYMENT PLAN IS NOT PUT IN PLACE. PART VI, LINE 5: BETWEEN NOVEMBER 2021 AND MAY 2022, YVMC CONDUCTED A CHNA IN COLLABORATION WITH THE HEALTH PARTNERSHIP, WHICH CONSISTS OF COMMUNITY AND SAFETY NET ORGANIZATIONS, MEDICAL AND BEHAVIORAL HEALTH CARE PROVIDERS AND GOVERNMENT AGENCIES COVERING GRAND, JACKSON, MOFFAT, RIO BLANC, AND ROUTT COUNTIES. A MULTIPHASED APPROACH WAS USED TO IDENTIFY TOP HEALTH PRIORITIES FOR ACTION PLANNING AND IMPACT DURING 2022-2024. A COMPREHENSIVE ANALYSIS OF CURRENT, LOCAL POPULATION HEALTH INDICATORS WAS INITIALLY PERFORMED. USING A SUBSET OF THESE INDICATORS, A WEB-BASED SURVEY WAS ADMINISTERED TO SOLICIT LOCAL HEALTH CARE PROVIDERS' RANKING OF SIGNIFICANT HEALTH ISSUES AFFECTING THEIR PATIENTS. COMMUNITY INPUT WAS GAINED THROUGH A COLLABORATIVE OUTREACH EFFORT WITH MEMBER AGENCIES OF THE HEALTH PARTNERSHIP. THE NEXT PHASE CONSISTED OF CONVENING A SUBSET OF YVMC'S SENIOR MANAGEMENT GROUP TO REVIEW ALL INFORMATION OBTAINED FROM THE ACTIVITIES DESCRIBED ABOVE. PARTICIPANTS OF THIS INTERNAL ADVISORY GROUP (IAG) COMPLETED A HEALTHISSUE PRIORITIZATION IDENTIFICATION USING AN EVIDENCE-BASED, STRUCTURED PROCESS. DURING THEIR MAY 2002 MEETING, THE YVMC BOARD OF TRUESTEES, WHICH INCLUDES REPRESENTATIVES FROM THE SURROUNDING COMMUNITIES, REVIEWED, DISCUSSED, AND APPROVED THE INFORMATION CONTAINED WITH THIS REPORT. PART VI, LINE 6: LIST OF OTHER ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES INCLUDED IN THE CHNA: YVMC CONDUCTED THE CHNA IN COLLABORATION WITH THE HEALTH PARTNERSHIP, WHICH FACILITATED THE WORK THROUGH THE YAMPA VALLEY WELL-BEING CONSORTIUM AND INCLUDES COMMUNITY AND SAFETY NET ORGANIZATIONS, MEDICAL AND BEHAVIORAL HEALTH CARE PROVIDERS AND GOVERNMENT AGENCIES COVERING ROUTT AND MOFFAT COUNTIES. QUANTITATIVE DATA FROM REGION 11 WAS ALSO USED AND REFLECTS DATA FROM JACKSON, MOFFAT, RIO BLANCO, AND ROUTT COUNTIES. SCHEDULE H, PART VI, LINE 2 THE ORGANIZATION USES FEEDBACK FROM SEVERAL SOURCES TO DETERMINE COMMUNITY NEEDS. SOURCES INCLUDE FEEDBACK FROM PHYSICIANS, HOSPITAL AND YAMPA VALLEY MEDICAL CENTER 84-0398876 FOUNDATION BOARD MEMBERS, AND COMMUNITY LEADERS. INFORMATION RECEIVED FROM PATIENT AND RESIDENT INQUIRIES AND SUGGESTIONS AND VARIOUS NON-PROFIT COMMUNITY ORGANIZATIONS IS ALSO USED TO ASSESS COMMUNITY HEALTH CARE NEEDS. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:THE ORGANIZATION EMPLOYS FINANCIAL COUNSELORS ON A FULL-TIME BASIS TO ASSIST PATIENTS IN COMPLETING APPLICATIONS THAT DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. INFORMATION IS ALSO IN PRINTED FORM ON PATIENT CORRESPONDENCE SUCH AS LETTERS AND STATEMENTS, AS WELL AS AVAILABLE ONLINE ON THE ORGANIZATIONAL WEBSITE. PATIENTS ARE ALSO REFERRED TO THE DEPARTMENT OFSOCIAL SERVICES FOR MEDICAID ELIGIBILITY. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION:YVMC IS GEOGRAPHICALLY LOCATED IN A LARGELY RURAL AND REMOTE AREA IN THE NORTHWEST COLORADO REGION, SERVING ROUTT COUNTY AND THE SURROUNDING COUNTIES OF GRAND, MOFFAT, JACKSON, AND RIO BLANCO. YVMC IS LOCATED IN STEAMBOAT SPRINGS WITH A LARGE SKI RESORT WITHIN THE CITY LIMITS. SEASONAL POPULATIONS PLACE INTERMITTENT DEMANDS ON LOCAL HEALTH CARE RESOURCES DUE TO RESORT TRAVELERS AND SECOND HOMEOWNERS IN BOTH WINTER AND SUMMER SEASONS. IN WINTER, PATIENT TRAVEL TO LARGER METROPOLITAN HOSPITALS CAN BE DIFFICULT DUE TO SEVERE WINTER WEATHER. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH:YAMPA VALLEY MEDICAL CENTER 84-0398876 YVMC SPONSORS COMMUNITY HEALTH EDUCATION THROUGH NEWSPAPER ARTICLES, FACE-TO-FACE EDUCATION COURSES AT ITS FACILITIES, CORPORATE AND COMMUNITY WELLNESS PROGRAMS, AND A COMMUNITY HEALTH FAIR. IN ADDITION TO PROGRAMS WITHIN THE FACILITY, YVMC OFFERS THE COMMUNITY HEALTH RESOURCE CENTER (CHRC) WHERE THE COMMUNITY CAN ACCESS BOTH HARD COPY AND ELECTRONIC MEDICAL PUBLICATIONS AND MULTIMEDIA MATERIALS. THE CHRC IS STAFFED WITH VOLUNTEERS TO ASSIST COMMUNITY MEMBERS WITH QUESTIONS ON MEDICAL TOPICS. THE ORGANIZATION MAKES FINANCIAL CONTRIBUTIONS TO COMMUNITY NON-PROFIT ORGANIZATIONS FOR PRENATAL CARE FOR UNINSURED PATIENTS, SCHOOL-BASED MENTAL HEALTH PROGRAMS, AND OTHER PROGRAMS THAT BENEFIT VARIOUS MEMBERS OF THE COMMUNITY. YVMC ENJOYS A HIGHLY ENGAGEDVOLUNTEER COMMUNITY BOARD OF TRUSTEES. USE OF NET OPERATING REVENUE IS RESERVED FOR INVESTMENT IN CAPITAL AND EXPANSION OF THE CHARITY CARE PROGRAM, HOSPITAL PROGRAMS AND SERVICES TO THE COMMUNITY. THERE IS OPEN MEDICAL STAFF EXCEPT FOR HOSPITAL-BASED SPECIALTIES. SEVERAL MEMBERS OF THE YVMC MANAGEMENT STAFF ARE ENGAGED IN BOARDS OF LOCAL AND REGIONAL NON-PROFIT COMMUNITY SERVICE ORGANIZATIONS. COMMUNITY BENEFIT INFORMATION IS INCLUDED ON THE YVMC ANNUAL REPORT. SCHEDULE H, PART VI, LINE 6 YAMPA VALLEY MEDICAL CENTER IS PART OF UCHEALTH, A COLORADO-BASED HEALTH SYSTEM THAT OFFERS THE MOST ADVANCED CARE THROUGHOUT THE ROCKY MOUNTAIN REGION, EXTENDING FROM COLORADO TO WYOMING AND WESTERN NEBRASKA. AS COLORADO'S ONLY INTEGRATED COMMUNITY AND ACADEMIC HEALTH SYSTEM, WE ARE DEDICATED TO IMPROVING LIVES AND PROVIDING THE HIGHEST QUALITY MEDICAL CARE WITH AN EXCEPTIONAL PATIENT EXPERIENCE. WITH MORE THAN 150 LOCATIONS THROUGHOUT THE REGION, UCHEALTH PUSHES THE BOUNDARIES OF MEDICINE, PROVIDING ADVANCED TREATMENTS AND CLINICAL TRIALS TO ENSURE EXCELLENT CARE AND OUTCOMES FOR 2.3 MILLION PATIENTS EACH AND EVERY YEAR. UCHEALTH IS ALSO THE LARGEST PROVIDER OF MEDICAID SERVICES IN COLORADO, WITH NEARLY 836,000 INPATIENT ADMISSIONS AND OUTPATIENT VISITS FOR MEDICAID PATIENTS DURING FISCAL YEAR 2021, AN INCREASE OF 310% SINCE FISCAL YEAR 2013. SCHEDULE H, PART VI, LINE 6 COLORADO 1 YAMPA VALLEY MEDICAL CENTER FOUNDATION 1100 CENTRAL PARK DRIVE STEAMBOAT SPRINGS CO 80487 311806773 501(C)(3) 353498 0 PROGRAM SUPPORT 1 0 PART I, LINE 2: ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS: YAMPA VALLEY MEDICAL CENTER (YVMC) PROVIDES GRANTS TO MANY LOCAL COMMUNITY ORGANIZATIONS. MANY OF THE ORGANIZATIONS ARE SMALL AND DO NOT NEED ADDITIONAL MONITORING AS THE FUNDS PROVIDED ARE USED FOR THEIR INTENDED PURPOSES. IN ADDITION, YVMC REQUIRES ALL GRANT REQUESTS TO BE SUBMITTED TO THE ORGANIZATION FOR CONSIDERATION AND APPROVAL. EXECUTIVE MANAGEMENT APPROVES REQUESTS THAT PROMOTE HEALTH AND WELLNESS WITHIN THE COMMUNITY AND THAT SUPPORT GENERAL COMMUNITY HEALTH IMPROVEMENT. X X X X X 0 0 0 0 0 0 0 1 0 KEVIN UNGER CEO 721335 0 277224 0 22947 0 144065 0 26068 0 1191639 0 0 0 DAVID THOMPSON CFO 451048 0 95917 0 4465 0 46621 0 25428 0 623479 0 0 0 GARY BREEN PHYSICIAN 512094 0 4167 0 2414 0 30822 0 25150 0 574647 0 0 0 MALAIKA THOMPSON PHYSICIAN 428251 0 0 0 684 0 30822 0 25822 0 485579 0 0 0 SONIYA FIDLER PRESIDENT 331368 0 86179 0 1119 0 34964 0 25296 0 478926 0 0 0 ELAINE STRICKRATH PHYSICIAN 380441 0 8750 0 423 0 30822 0 25600 0 446036 0 0 0 JEFFREY CHAMBERLAIN PHYSICIAN 378231 0 9375 0 402 0 30822 0 25695 0 444525 0 0 0 LAURIE LEBLEU VASZILY PHYSICIAN 386426 0 8750 0 605 0 20922 0 25566 0 442269 0 0 0 LAURA SEHNERT CMO 296158 0 58829 0 945 0 33243 0 24387 0 413562 0 0 0 KELLY GALLEGOS CNO 228152 0 48808 0 1160 0 23860 0 30311 0 332291 0 0 0 WESLEY HUNTER PHARMACY DIRECTOR 194619 0 20365 0 1861 0 18929 0 15928 0 251702 0 0 0 RYAN LARSON DIRECTOR OF CLINICAL OPERATIONS 195958 0 21098 0 628 0 20432 0 9094 0 247210 0 0 0 ELI NYKAMP DIRECTOR OF OPERATIONS 146302 0 15634 0 303 0 14786 0 28990 0 206015 0 0 0 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. DR NICOLE COTTER WIFE OF BOARD MEMBER DR. JIM COTTER 155860 EMPLOYED PHARMACIST 0 STEAMBOAT ORTHOPAEDIC AND SPINE INSTITUTE DR. SIELATYCKI RECRUITMENT AGREEMENT 316000 LOAN FORGIVENESS 0 X MEDICAL EQUIPMENT 3 571488 FMV 0 1 0 FORM 990, PART VI, SECTION A, LINE 6 UCHEALTH IS THE MEMBER OF YAMPA VALLEY MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7A UCHEALTH HAS THE AUTHORITY TO APPOINT THE MEMBERS OF THE BOARD. TWO MEMBERS ARE NOMINATED AND APPOINTED BY UCHEALTH. THE REMAINING 11 ARE NOMINATED BY YVMC AND APPOINTED BY UCHEALTH. FORM 990, PART VI, SECTION A, LINE 7B APPROVAL FROM UCHEALTH IS REQUIRED BUT NOT LIMITED TO THE FOLLOWING AREAS: - APPROVAL FOR CHANGE IN MISSION, PROGRAMS, SERVICE, FACILITIES OFFERED BY YVMC, CORPORATE STRUCTURE OR TERMINATION OF EXEMPT STATUS - SALE, TRANSFER, PLEDGE OR GRANTING OF SECURITY INTEREST OF ANY MATERIAL YVMC OR AFFILIATE ASSETS - AMENDMENT OF ARTICLES OF INCORPORATION OR BYLAWS - ENTRY BY YVMC OR ITS AFFILIATES INTO INSOLVENCY, BANKRUPTCY, REORGANIZATION, OR RECEIVERSHIP - APPROVAL OF THE APPOINTMENT OR REMOVAL OF YVMC'S CEO - APPROVAL OF YVMC'S AND ITS AFFILIATES ANNUAL BUDGETS - APPROVAL OF ENTRY INTO OR CHANGE IN ANY MATERIAL CONTRACT FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN AN INDEPENDENT ACCOUNTING FIRM, WITH THE ASSISTANCE OF THE ORGANIZATION'S ACCOUNTING DEPARTMENT AND FORM 990 COMMITTEE OF THE ORGANIZATION. THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES REVIEWS THE DRAFT OF THE FORM 990. PRIOR TO COMPLETION, THE FINAL DRAFT IS APPROVED BY THE BOARD OF TRUSTEES BEFORE FILING THE FORM 990 WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY REQUIRES COMPLETION OF THE COI DISCLOSURE FORM FOR ALL UCHEALTH TEAM MEMBERS WHO BELIEVE THAT THEY OR AN IMMEDIATE FAMILY MEMBER HAVE A PERSONAL, FINANCIAL OR OWNERSHIP INTEREST WITH AN ENTITY OR ORGANIZATION WHO COMPETES WITH UCHEALTH, DOES BUSINESS WITH UCHEALTH, OR REGULATES UCHEALTH MUST SUBMIT A COI DISCLOSURE. UCHEALTH DIRECTORS AND ABOVE, INCLUDING TEAM MEMBERS AUTHORIZED TO CONDUCT BUSINESS TRANSACTIONS WITH 3RD PARTIES ON BEHALF OF UCHEALTH MUST DISCLOSE ON AN ANNUAL BASIS TO 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, SULLIVAN COTTER COLLECTS AND REVIEWS COMPENSATION LEVELS FROM LIKE ORGANIZATION FOR LIKE JOBS AND PROVIDES UCHEALTH WITH THE COMPARATIVE MARKET DATA. THE DATA IS SUBMITTED TO THE CHIEF HUMAN RESOURCES OFFICER WHO ADVICES THE SYSTEM PRESIDENT AND CEO ON COMPENSATION DECISIONS FOR SENIOR EXECUTIVES. BASED ON THE MARKET DATA, THE SYSTEM PRESIDENT AND CEO DETERMINES THE SALARY OF THE ENTITY CEO'S COMPENSATION ANNUALLY. 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. YAMPA VALLEY MEDICAL CENTER FOUNDATION PO BOX 883451 STEAMBOAT SPRINGS CO 80488 311806773 FUNDRAISING CO 501(C)(3) LINE 10 YAMPA VALLEY MEDICAL CENTER 1 UNIVERSITY OF COLORADO HEALTH 7901 E LOWRY BLVD SUITE 350 DENVER CO 80230 454552631 HEALTHCARE MANAGEMENT CO 501(C)(3) LINE 7 N/A 0 STEAMBOAT SURGERY CENTER LLC 705 MARKETPLACE PLAZA SUITE 200 STEAMBOAT SPRINGS CO 80487 840398876 SURGERY CO 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 YAMPA VALLEY MEDICAL CENTER FOUNDATION B 354974 FMV YAMPA VALLEY MEDICAL CENTER FOUNDATION C 630010 FMV