TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) JOHN HICKS...................................................................... CEO/PRESIDENT	50.0 ................. 1.0	X	X	738,730	0	38,908
(2) BOB FEIS...................................................................... DIRECTOR/VICE-CHAIR	3.0 ................. 0.0	X	X	175	0	0
(3) FAYE HUMMEL PHD...................................................................... DIRECTOR/CHAIR	3.0 ................. 0.0	X	X	175	0	0
(4) GERRY LEWIS-JENKINS...................................................................... DIRECTOR	3.0 ................. 0.0	X		175	0	0
(5) HEIDI STORZ...................................................................... DIRECTOR	3.0 ................. 0.0	X		175	0	0
(6) JEFF SIPPEL MD...................................................................... DIRECTOR	3.0 ................. 0.0	X		175	0	0
(7) JOHN RHOADES...................................................................... DIRECTOR	3.0 ................. 1.0	X		175	100	0
(8) LOWELL PALMQUIST...................................................................... DIRECTOR (part-year)	3.0 ................. 0.0	X		0	0	0
(9) MATT FLAHERTY MD...................................................................... DIRECTOR (part-year)	3.0 ................. 0.25	X		0	0	0
(10) MICHAEL DOLAN...................................................................... DIRECTOR/FOUNDATION CHAIR	3.0 ................. 1.0	X		175	100	0
(11) MICHAEL TAYLOR...................................................................... DIRECTOR	3.0 ................. 40.0	X		125	862,381	133,729
(12) MICHELLE LEBLANC-GROSS...................................................................... DIRECTOR	3.0 ................. 0.0	X		175	0	0
(13) RIC ROBBINS MD...................................................................... DIRECTOR/CHIEF OF STAFF	3.0 ................. 0.0	X		175	0	0
(14) RICHARD GONZALES...................................................................... DIRECTOR	3.0 ................. 0.0	X		175	0	0
(15) ROD BLUNCK...................................................................... DIRECTOR	3.0 ................. 0.0	X		175	0	0
(16) SHAWN DUFFORD MD...................................................................... DIRECTOR	3.0 ................. 40.0	X		125	529,543	99,381
(17) SONYA NORMAN MD...................................................................... DIRECTOR	3.0 ................. 40.0	X		175	172,890	19,896

(A) Name and business address	(B) Description of services	(C) Compensation
CERNER HEALTH SERVICES, 51 VALLEY STREAM PARKWAY MALVERN,PA19355	SOFTWARE SUPPORT	1,262,388
SOUND PHYSICIANS, 1498 PACIFIC AVENUE SUITE 400 TACOMA,WA98402	Hospitalist services	1,098,684
ANESTHESIA SERVICES INC, 14835 SILVER FEATHER CIRCLE BROOMFIELD,CO80023	ANESTHESIA SERVICES	1,094,513
INTEGRAL HEALTHCARE SERVICES, 750 W HAMPDEN AVE 501 ENGLEWOOD,CO80110	COLLECTION SERVICES	767,479
CHILDREN'S HOSPITAL, 12123 E 16TH AVE AURORA,CO80045	SPECIAL CARE NURSERY	739,476
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 26

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

Brighton Community Hospital Association

Employer identification number

84-0482695

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513...
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Name of the organization

Brighton Community Hospital Association

Employer identification number

84-0482695

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization Brighton Community Hospital Association

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization Brighton Community Hospital Association		Employer identification number 84-0482695

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization Brighton Community Hospital Association			Employer identification number 84-0482695
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Brighton Community Hospital Association

Employer identification number

84-0482695

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures ...................................................................................................................... SchCMd Bullet

Volunteer hours .............................................................................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ...............................................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...........................................
c	Total lobbying expenditures (add lines 1a and 1b) .......................................................................
d	Other exempt purpose expenditures .........................................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ....................................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) ..........................................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ..........................................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ...........................................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ..............................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2012	(b) 2013	(c) 2014	(d) 2015	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2015

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Yes

6,147

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Total. Add lines 1c through 1i ....................................................................................................

6,147

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1g	Lobbying: BRIGHTON COMMUNITY HOSPITAL ASSOCIATION D/B/A PLATTE VALLEY MEDICAL CENTER RECEIVED CORRESPONDENCE FROM THE AMERICAN HOSPITAL ASSOCIATION AND COLORADO HEALTH AND HOSPITAL ASSOCIATION REGARDING THEIR MEMBERSHIP DUES. A PORTION OF THEIR DUES WAS ATTRIBUTABLE TO LOBBYING.

Schedule C (Form 990 or 990EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Brighton Community Hospital Association

Employer identification number

84-0482695

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	1,989,750	1,935,964	1,823,296	1,483,995	1,387,279
b	Contributions ...
c	Net investment earnings, gains, and losses	258,849	374,478	628,337	487,280	186,906
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	322,578	320,692	515,669	147,979	90,190
f	Administrative expenses ....
g	End of year balance ......	1,926,021	1,989,750	1,935,964	1,823,296	1,483,995

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

0 %

Temporarily restricted endowment SchDMd Bullet

100.000 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	13,703,100		13,703,100
b	Buildings	75,565,516	33,156,815	108,722,331
c	Leasehold improvements	255,631	255,631
d	Equipment ...	45,447,785	31,501,906	13,945,879
e	Other ...	23,997,441	3,787,782	20,209,659
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				156,580,969

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
RELATED PARTY PAYABLE	318,461
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	318,461
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
Schedule D, Part V, Line 4	Describe the intended uses of the organization's endowment funds: THE TEMPORARILY RESTRICTED NET ASSETS ARE THOSE WHOSE USE BY THE MEDICAL CENTER HAS BEEN LIMITED BY DONORS TO A SPECIFIC TIME PERIOD OR PURPOSE.
Schedule D, Part X, Line 2	UNCERTAIN TAX POSITIONS: 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.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Brighton Community Hospital Association

Employer identification number

84-0482695

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 125 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .		240	2,491,522	0	2,491,522	2.370 %
b	Medicaid (from Worksheet 3, column a) . . . . .		17,259	27,852,971	20,148,329	7,704,642	7.340 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		17,499	30,344,493	20,148,329	10,196,164	9.710 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	13	38,399	123,156	9,764	113,392	0.110 %
f	Health professions education (from Worksheet 5) . . .	6	163	232,363		232,363	0.220 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	3	58,573	163,060		163,060	0.160 %
j	Total. Other Benefits . .	22	97,135	518,579	9,764	508,815	0.490 %
k	Total. Add lines 7d and 7j .	22	114,634	30,863,072	20,158,093	10,704,979	10.200 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	1	53	1,052	0	1,052
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	1	53	1,052	0	1,052

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

4,559,778

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

19,783,428

Enter Medicare allowable costs of care relating to payments on line 5.....

18,666,684

Subtract line 6 from line 5. This is the surplus (or shortfall)........

1,116,744

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2015

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)						Facility reporting group
1	BRIGHTON COMMUNITY HOSPITAL ASSOC 1600 Prairie Center Parkway BRIGHTON,CO80601 www.pvmc.org 010311	X	X	X	X	1

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	BRIGHTON COMMUNITY HOSPITAL ASSOC
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): PVMC.ORG/ABOUT-US/COMMUNITY-BENEFITS/

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): PVMC.ORG/ABOUT-US/COMMUNITY-BENEFITS/

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	BRIGHTON COMMUNITY HOSPITAL ASSOC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 125.% and FPG family income limit for eligibility for discounted care of 250.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V, SECTION C

The FAP application form was widely available on a website (list url):

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, SECTION C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	BRIGHTON COMMUNITY HOSPITAL ASSOC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that
can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
SCHEDULE H, PART V, SECTION B, LINE 5	Targeted interviews were used to gather information and opinions from persons who represent the broad interests of the community served by pvmc. Sixteen interviews were completed during september and october, 2012. For the interviews, community stakeholders identified by pvmc were contacted and asked to participate in the needs assessment. Interviewees included individuals who are leaders and representatives of medically underserved, low-income, minority and chronic disease populations, or regional, state or local health or other departments or agencies that have "current data or other information relevant to the health needs of the community served by the hospital facility". A list of the stakeholder interview respondents, their titles, organizations and leadership roles can be found in attachment 2 of the community health needs assessment.
SCHEDULE H, PART V, SECTION B, LINE 11	The needs that were identified as priorities by the 2013 CHNA included: Access to Care, Cancer and Cardiovascular Disease. To address the identified health need of access to care, PVMC is: - Offering financial assistance to individuals who do not qualify for the State Safety-net Healthcare Programs, Colorado Indigent Care Program (CICP) or Medicaid and who do not have the resources to pay for their care. - Offering assistance with financial counseling, education on insurance programs, screening for Medicaid, and assistance with Medicaid application process to our inpatient, outpatient and Emergency department clients. Financial counseling is available if the patient does not qualify for Medicaid. - Providing infrastructure in two communities (Ft. Lupton and Commerce City) that currently have very limited access to medical providers by building medical office buildings. - Subsidizing primary care and specialty medical providers in communities where access to these services is limited. - Subsidizing an ambulance service for our service area. - Providing resources for recruitment of local primary care physicians (PCP). We provide staff for the recruitment process and financial guarantees when necessary. - Providing a hospitalist program for management of inpatient care to the patients of community primary care providers, allowing community providers to remain full-time at their clinics for primary care visits. - Offering health education, preventive services and free and low-cost screenings to the community including: * An annual health fair, offering low-cost blood tests as well as free screenings, exams and consultation with a medical professional. Calls are made to participants with critically abnormal lab values. Assistance is provided to people who do not have access to health care services. * Girl's Night Out, which is an annual event that offers education, screening exams, consultations with medical professionals, and easy access to making mammogram appointments. - Subsidizing the cost of a health coach for the employee wellness program for the local municipality of Brighton. To address the identified health need of cancer, PVMC offers: - A monthly Cancer Support Group, which is open to the public. - Low-cost mammograms for uninsured women. - Free cancer screenings: skin cancer checks, pap smears, breast exams at an annual health fair. - Educational seminars on cancer topics which are open to the public and presented at the hospital and the local senior center. To address the identified health need of cardiovascular disease, PVMC offers: - A stroke support group, which is open to the community. - Cardiac Rehab and Cardiac Support Group which are open to the community. - Educational seminars related to cardiac care are open to the community. - An Annual Health Fair offering blood pressure checks and Cardiac Risk Assessment. - A Stroke Fair to provide stroke education to the community. Other Health Needs not addressed: Platte Valley Medical Center has chosen not to actively address the remaining health needs identified in the CHNA as they were not selected as priority health needs: birth indicators (prenatal care, low birth weight), housing / homelessness, mental health, overweight and obesity, preventive care, smoking, transportation, and unintentional injuries. Taking existing community resources into consideration, Platte Valley Medical Center has selected to concentrate on those health needs that we can most effectively address given our areas of focus and expertise. Therefore, the hospital's charitable resources will be placed on the selected priority health needs.
SCHEDULE H, PART V, SECTION B, LINE 13b	EXPLAIN INCOME LEVEL OTHER THAN FPG: PLATTE VALLEY MEDICAL CENTER LOOKS AT OTHER FACTORS IN ADDITION TO FAMILY INCOME LIMITS AS A PERCENTAGE OF FEDERAL POVERTY GUIDELINES, SUCH AS MONTHLY EXPENSES AND INDIVIDUAL FINANCIAL SITUATIONS.
SCHEDULE H, PART V, SECTION B, LINE 16a, 16b & 16C	WEBSITE URL FOR FAP, FAP APPLICATION FORM, AND PLAIN LANGUAGE FAP SUMMARY: https://www.pvmc.org/charitycare/
SCHEDULE H, PART V, SECTION B, LINE 22d	Following a determination of financial-assistance eligibility, an individual will not be charged more than the amounts generally billed (AGB) for emergency or other medical care provided to individuals with insurance covering that care. Platte Valley Medical center has adopted the look-back method of calculating AGB which means the AGB is calculated by reviewing all past claims that have been paid in full to the hospital for medically necessary care by Medicare fee-for-service together with all private health insurers paying claims to the hospital in a prior 12-month period. In most cases the previous calendar year is used. This amount can include co-insurance; copayments and deductibles.

Schedule H (Form 990) 2015

Page 8

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2015

Page 9

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
SCHEDULE H, PART I, LINE 3C	PLATTE VALLEY MEDICAL CENTER LOOKS AT OTHER FACTORS IN ADDITION TO FAMILY INCOME LIMITS AS A PERCENTAGE OF FEDERAL POVERTY GUIDELINES, SUCH AS MONTHLY EXPENSES AND INDIVIDUAL FINANCIAL SITUATIONS.
SCHEDULE H, PART I, LINE 7, COLUMN F	BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 BUT EXCLUDED FOR PURPOSES OF CALCULATING PERCENTAGES IN THIS COLUMN EQUAL $4,559,778.
SCHEDULE H, PART I, LINE 7	The organization used a cost-to charge ratio for lines 7a and 7b. The cost-to-charge ratio was derived from Form 990, Schedule H instructions, 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.
SCHEDULE H, PART II, Coalition Building	DESCRIBE HOW THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES PROMOTED THE HEALTH OF THE COMMUNITY IT SERVES: PVMC sponsors a quarterly meeting of agencies in our service area known as the Brighton Service Agency Coalition. This meeting is a networking meeting for community service organizations to hear about resources for their clients. Some of the members of the coalition include people from: local health clinics, mental health counseling centers, school district, home health care agencies, transportation providers, homeless shelter, Adams County Human Services Agency, and Adams County Work Force Center. The PVMC staff also forwards any emails generated by the members to the full coalition to help promote upcoming events or educational offerings.
SCHEDULE H, PART III, SECTION A, LINES 2 & 4	Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Medical Center 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 bad debts. 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, the Medical Center analyzes contractually due amounts and provides an allowance for the difference between contract rates for services and the amounts charged for services 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 unlikely the realization of amounts due). For receivables associated with patients with self-pay account balances (including both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Medical Center 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. The Medical Centers allowance for doubtful accounts for self-pay patients was 66% and 74% of self-pay accounts receivable at December 31, 2015 and 2014, respectively. The Medical Center identified and wrote off bad debt accounts of approximately $1,632,000 and $2,615,000 for the three month period ended December 31, 2015 and the nine month period ended September 30, 2015 compared to approximately $4,316,000 for the year ended December 31, 2014. Due to financial class changes as a result of the Affordable Care Act and Medicaid expansion, much of the decrease was the result of the dynamics associated with increased Medicaid eligibility and a reduction in self-pay, although higher out-of-pocket responsibilities of consumer-driven health care plans continue to impact doubtful account write-offs. Bad debt expense is determined using the methodology as described in the note to the financial statements as shown above.
SCHEDULE H, PART III, SECTION B, LINE 8	The Medicare allowable costs were determined from the Medicare cost report. IRS Revenue Ruling 69-545, which established the community benefit standard for nonprofit hospitals, states that if a hospital serves patients with government health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community. This implies that treating Medicare patients is a community benefit.
SCHEDULE H, PART III, SECTION C, LINE 9B	The hospital charity care policy outlines steps for financial counselors to follow to identify and qualify patients eligible for charity care and steps to collect information. The policy also describes the application form to be completed by the patient, the review process by a financial counselor, patient follow up, and the write off of patient charges to charity care.
SCHEDULE H, PART VI, LINE 2	NEEDS ASSESSMENT: Programs and services provided by the hospital to the community are based upon strategic assessment of community need conducted by hospital administration and the hospital board of directors. Information considered in the assessment include Platte Valley Medical Center historic and projected inpatient admissions, historic and projected outpatient and emergency room visit data, County and State demographics, Colorado Department of Public Health and Environment health statistics, and community requests.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: Platte Valley Medical Center makes available to patients a Frequently Asked Questions (FAQ's) hand-out, which includes information about financial assistance, and whom to call. The same FAQ is located on Platte Valley Medical Center's website. Financial counselors are located in the emergency department during peak days and hours to screen for, identify, and advise patients who need financial assistance. In addition, financials counselors are staffed monday through friday to work with patients who need financial assistance to settle their accounts or schedule hospital services.
SCHEDULE H, PART VI, LINE 4	COMMUNITY INFORMATION: Our primary service area includes the communities of Brighton (zip codes 80601,80602, and 80603), Ft. Lupton (80621), and Commerce City (80022). Specifically the following : Carrier Routes: RR1, RR3, RR4, RR5, RR6, RR7 & Census Tracts: 008512 and 00870. Our secondary service area includes: Thornton (80241), Henderson (80640), Hudson (80642), & Keenesberg (80643).
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH: PVMC utilizes a tithing program to fund the "Community Health Improvement Program." Through a granting process, this program provides funding to local non-profit organizations whose programs have a link to health promotion. The hospital provides a site for clinical education for local Community colleges and Universities. Student programs include nursing, pharmacist, phlebotomy, medical imaging, EMT, dietitian, physical therapist, surgical and nursing assistant. The hospital provides educational support programs through the cancer and stroke support groups and educational seminars which are offered monthly. Through the annual flu clinics, members of the community have access to low cost or no copay influenza and pneumonia immunizations. Due to the hospital's dedication to an annual health fair and to an annual stroke fair and women's health fair, members of the community have access to low or no cost health screenings and blood tests. The ambulance service provides first aid stand by to the majority of community sponsored events (city celebrations, school sponsored athletic events, county events) throughout the year at no cost to the organizations that are sponsoring the event. The emergency department sponsors an educational event for high school students during the prom season. Students are videotaped during the simulation of a fatal drunk driving accident, trip to the emergency department and notification to the parents of the death of the child. There is an entire day centered around this event for the students involved in the simulation as well as all the students at the school. At the end of the school day, the video is shown to the entire student body to show the devastating consequences of drunk driving.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM: Platte valley medical center is a controlled entity of the sisters of charity of leavenworth health system, inc. (sclhs). Sclhs and its affiliated entities have a common calling and mission: "we reveal and foster god's healing love by improving the health of the people and communities we serve, especially those who are poor and vulnerable." We strive to provide high-quality, compassionate and affordable healthcare in each of our hospital sites and their respective community, as well as in a variety of outpatient settings and in the home. Sclhs is a faith-based, nonprofit healthcare organization that operates nine hospitals, two safety net clinics, one childrens mental health center and more than 190 ambulatory service centers in three states colorado, kansas and montana. The health system includes more than 15,000 full-time associates and more than 500 employed providers. As our health system grows, were leveraging that growth to achieve benefits of scale, identifying cost and other advantages that we gain due to our size. Were also working to streamline and unify our system wide processes to eliminate costly duplication of effort. We actively encourage our people to pursue creative ideas that improve efficiency, service and the overall care experience. When our associates or leadership teams identify best practices in any area of care, we rapidly replicate those across all care sites. Platte valley medical center promotes the health of the community by delivering direct high quality healthcare services that are responsive to the needs of its patients and their families. This includes coordinating community benefit processes, providing guidance with community needs assessments, and establishing consistent financial assistance and charity care policies and procedures. Additionally, sclhs benefits affiliates through quality improvement and performance excellence initiatives; system-wide information technology implementation and infrastructure; strategic and operations direction and oversight; supply chain management and purchasing; finance administration and revenue cycle support, benefits administration, risk management; disaster planning and crisis assistance, central cash management and investment, internal audit, legal services, tax services and mission integration.

Schedule H (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
Brighton Community Hospital Association

Employer identification number
84-0482695

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

(1) PENNOCK CENTER FOR COUNSELING 211 S 21ST AVE BRIGHTON,CO80601	20-0986823	501(C)(3)	15,000	operating funds
(2) ALMOST HOME INC 231 NORTH MAIN STREET BRIGHTON,CO80601	84-1220644	501(C)(3)	16,840	operating funds
(3) THE SENIOR HUB 2360 WEST 90TH AVENUE FEDERAL HEIGHTS,CO80260	74-2412032	501(C)(3)	8,000
(4) WELD COUNTY FOOD BANK 1108 H STREET GREELEY,CO80631	74-2244826	501(C)(3)	10,000
(5) CASA 1100 JUDICIAL CENTER DR BRIGHTON,CO80601	31-1657019	501(C)(3)	10,000	operating funds
(6) VIA MOBILITY SERVICES 2855 N 63RD STREET BOULDER,CO80301	84-0777296	501(C)(3)	10,000
(7) THE BOYS & GIRLS CLUBS OF WELD PO BOX 812 GREELEY,CO80632	84-0529902	501(C)(3)	25,000	program funding
(8) BRIGHTON SDA 567 E BROMLEY LN BRIGHTON,CO80601	84-1210598	501(C)(3)	8,000	support operations
(9) WELD CENTRAL HIGH SCHOOL 99 WEST BROADWAY AVE KEENSBURG,CO80643	84-6013310	government	18,500
(10) BRIGHTON CHAMBER OF COMMERCE PO Box 605 Hudson,CO80642	27-5348251	501(c)(6)	11,250	SUPPORT OPERATIONS
(11) SOUTH EAST WELD COUNTY PO BOX 456 KEENESBURG,CO80643	23-7306107	501(c)(5)	6,215	SUPPORT OPERATIONS

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of non-cash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of non-cash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference	Explanation
Schedule I, Part I, Question 2	Organization's procedures for monitoring the use of grant funds: All grant recipients are first required to submit applications which detail the intended uses of grant funds. After grants have been awarded, recipients are required to complete a final report indicating how grant funds were actually spent.

Schedule I (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Brighton Community Hospital Association

Employer identification number

84-0482695

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

Any related organization? .........................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2015

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1JOHN HICKSCEO/PRESIDENT	(i) (ii)	489,906 ------------- 0	131,431 ------------- 0	117,393 ------------- 0	21,200 ------------- 0	17,708 ------------- 0	777,638 ------------- 0	0 ------------- 0
2MICHAEL TAYLORDIRECTOR	(i) (ii)	0 ------------- 666,411	0 ------------- 0	125 ------------- 195,970	0 ------------- 113,501	0 ------------- 20,228	125 ------------- 996,110	0 ------------- 0
3SHAWN DUFFORD MDDIRECTOR	(i) (ii)	0 ------------- 450,362	0 ------------- 69,601	125 ------------- 9,580	0 ------------- 77,580	0 ------------- 21,801	125 ------------- 628,924	0 ------------- 0
4SONYA NORMAN MDDIRECTOR	(i) (ii)	0 ------------- 152,933	0 ------------- 19,719	175 ------------- 238	0 ------------- 19,830	0 ------------- 66	175 ------------- 192,786	0 ------------- 0
5HAROLD DUPPERCFO/CORPORATE SECRETARY	(i) (ii)	267,376 ------------- 0	72,198 ------------- 0	45,336 ------------- 0	21,200 ------------- 0	13,191 ------------- 0	419,301 ------------- 0	0 ------------- 0
6KURT GENSERTVICE PRESIDENT OF OPERATIONS	(i) (ii)	250,557 ------------- 0	67,778 ------------- 0	36,232 ------------- 0	21,200 ------------- 0	27,560 ------------- 0	403,327 ------------- 0	0 ------------- 0
7DUANE LIVADNEYMEDICAL IMAGING SUPERVISOR	(i) (ii)	152,102 ------------- 0	0 ------------- 0	4,159 ------------- 0	9,748 ------------- 0	15,427 ------------- 0	181,436 ------------- 0	0 ------------- 0
8ERIC STIRMPHARMACY DIRECTOR	(i) (ii)	168,584 ------------- 0	20,819 ------------- 0	270 ------------- 0	26,213 ------------- 0	29,787 ------------- 0	245,673 ------------- 0	0 ------------- 0
9JACKIE DUNKINHUMAN RESOURCES DIRECTOR	(i) (ii)	124,206 ------------- 0	15,343 ------------- 0	5,187 ------------- 0	16,491 ------------- 0	20,797 ------------- 0	182,024 ------------- 0	0 ------------- 0
10KAREN WELZOR DIRECTOR	(i) (ii)	136,850 ------------- 0	16,897 ------------- 0	6,421 ------------- 0	19,166 ------------- 0	14,786 ------------- 0	194,120 ------------- 0	0 ------------- 0
11MARK BAKERCATH LAB MANAGER	(i) (ii)	128,261 ------------- 0	11,244 ------------- 0	3,753 ------------- 0	12,861 ------------- 0	21,938 ------------- 0	178,057 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Schedule J, Part I, line 1a	Information Regarding Benefits Provided: CHRISTMAS GIFTS ARE GROSSED UP FOR HOSPITAL EMPLOYEES AND TAXED: JOHN HICKS, HAROLD DUPPER, KURT GENSERT, ERIC STIRM, KAREN WELZ, DUANE LIVADNEY, JACKIE DUNKIN AND MARK BAKER RECEIVED CHRISTMAS GIFTS DURING 2015. Platte Valley Medical Center (PVMC) provides travel for companions. The benefit includes any amount for flights plus 50% of meals (unless otherwise specifically allocated on the reimbursement request). The amount is grossed up and is a taxable benefit for the individual receiving the benefit. There were no spousal travel benefits used in 2015 for any of the officers, directors, and highest compensated employees of PVMC.
Schedule J, Part I, line 7	Explanation of non-fixed payments: The organization has an incentive bonus policy that is determined and adopted by the board and administration of the organization. The policy has multi-tiered financial, operational/strategic, quality performance, and community integration objectives.
SCHEDULE J, PART II	INFORMATION REGARDING COMPENSATION REPORTING: BONUSES EARNED FOR THE 2015 CALENDAR YEAR WERE PAID OUT WITHIN 2.5 MONTHS AFTER YEAR END FOR ALL EXECUTIVES. THE FOLLOWING INDIVIDUALS DID NOT RECEIVE 2015 BONUS PAYOUTS WITHIN THAT TIME FRAME, THEREFORE THE W-2 WAGE AMOUNT ON PART II INCLUDES THE 2015 BONUS (EARNED IN 2014, PAID OUT IN 2015), AND THE OTHER DEFERRED COMPENSATION COLUMN WILL INCLUDE THE ACCRUAL OF THE 2015 BONUS (EARNED IN 2015, PAID IN 2016). - ERIC STIRM - KAREN WELZ - DUANE LIVADNEY - JACKIE DUNKIN - MARK BAKER
Schedule J, Part I Line 4b	PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN A RELATED ORGANIZATION PROVIDES NONQUALIFIED DEFERRED COMPENSATION PLANS (NQDC) KNOWN AS SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) FOR EXECUTIVES (SENIOR MANAGEMENT) TO COMPENSATE FOR REGULATORY IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. IN 2014, IN AN EFFORT TO REDUCE LONG-TERM COST AND HAVE GREATER CONTROL OVER FINANCIAL RISK, THE SERP WAS CONVERTED FROM A DEFINED BENEFIT (DB) TO A DEFINED CONTRIBUTION (DC) DESIGN. CERTAIN MEMBERS OF SENIOR MANAGEMENT WHOSE BENEFITS WERE CONVERTED FROM DB TO DC WOULD HAVE BEEN DISPROPORTIONATELY AND NEGATIVELY AFFECTED BY THE CHANGE, SO THE COMMITTEE DETERMINED IT WOULD BE APPROPRIATE TO GRANT "TRANSITION" CREDITS IN ORDER TO MITIGATE THE NEGATIVE IMPACT OF THE CHANGE ON THEIR RETIREMENT BENEFITS. THIS IS A COMMON APPROACH EMPLOYED BY OTHER ORGANIZATIONS UNDERGOING A SIMILAR TRANSITION. THE TRANSITION CREDITS VEST IN ACCORDANCE WITH THE TERMS OF THE DC SERP (I.E., AFTER THREE YEARS) AND ARE PAID TO THE EXECUTIVE UPON VESTING. NQDC SERP PLANS PRIOR TO 2014 PRIOR TO 2014, THE RELATED ORGANIZATIONS NQDC SERP PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS 5 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN AFTER DECEMBER 31, 2013. THE RELATED ORGANIZATION HAS DETERMINED THAT THESE BENEFITS SHOULD BE SUBJECT TO TAXATION AS THE AMOUNTS ARE VESTED RATHER THAN WHEN THEY ARE RECEIVED. AS A RESULT, THE TOTAL NONQUALIFIED RETIREMENT PLAN BENEFITS, WHICH WERE VESTED IN THE CURRENT YEAR, ARE CONSIDERED TAXABLE AND THUS WERE TAXED TO THE PARTICIPANTS. FOR SOME OF THE PARTICIPANTS, AN AMOUNT EQUAL TO THE PARTICIPANTS EXPECTED INCOME TAX LIABILITY WAS WITHDRAWN FROM THE PARTICIPANTS ACCOUNT AND REMITTED TO THE FEDERAL AND STATE GOVERNMENTS AS WITHHOLDING ON THE TAXABLE BENEFIT. NO CASH PAYMENT IS MADE DIRECTLY TO THE PARTICIPANT AND THE REMAINING BENFIT AMOUNT STAYS IN THE RETIREMENT PLAN. FOR THE PERSONS LISTED ON 990 PART VII AND SCHEDULE J PART II, THERE WERE NO AMOUNTS WITHDRAWN FROM THE PLAN FOR TAXES IN 2015. FOR AMOUNTS CONTRIBUTED TO THE NQDC SERP PLAN PRIOR TO 2014, VESTED AMOUNTS ARE PAYABLE UPON THE END OF EMPLOYMENT. THE VESTED AMOUNTS WITHDRAWN INCLUDE AMOUNTS PREVIOUSLY TAXED TO THE RECIPIENT AND AMOUNTS TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENTS W-2. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. NQDC SERP PLANS STARTING IN 2014 STARTING IN 2014, THE RELATED ORGANIZATIONS NQDC SERP PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS ROLLING 3 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN BEFORE JANUARY 1, 2014. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. STARTING IN 2014, FOR CONTRIBUTIONS TO THE NQDC SERP PLAN, CERTAIN PARTICIPANTS ARE VESTED OR BECAME VESTED IN THE PLAN DURING 2015. VESTED AMOUNTS ARE PAYABLE TO THE RECIPIENT. THE VESTED AMOUNTS ARE TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENTS W-2. FOR THE PERSONS LISTED ON 990 PART VII AND SCHEDULE J PART II, THERE WERE NO AMOUNTS WITHDRAWN FROM THE NQDC SERP PLANS IN 2015. IN ACCORDANCE WITH THE REQUIREMENTS OF SCHEDULE J, DEFERRED COMPENSATION EARNED OVER THE VESTING PERIOD IS REPORTED IN COLUMN C AND ANY AMOUNTS VESTED/PAID FROM A DEFERRED COMPENSATION PLAN ARE REPORTED IN COLUMN B(iii). THUS, THE SAME AMOUNT WOULD BE REPORTED TWICE (FIRST WHEN IT ACCRUED DURING THE VESTING PERIOD AND AGAIN WHEN IT IS VESTED/PAID). THIS RESULTS IN THE APPEARANCE OF CERTAIN EXECUTIVES RECEIVING MORE THAN THEY ARE ACTUALLY PAID FROM THE DEFERRED COMPENSATION PLANS. COLUMN F IS INTENDED TO RECONCILE THIS DUPLICATION (BY REPORTING AMOUNTS INCLUDED IN COLUMN B(iii) THAT HAD BEEN REPORTED AS DEFERRED COMPENSATION ON A SCHEDULE J FOR A PREVIOUS YEAR). HOWEVER, THE SIGNIFICANCE OF THE AMOUNTS LISTED IN COLUMN F IS OFTEN OVERLOOKED AND GIVEN THE COMPLEXITY OF THE SCHEDULE J REPORTING REQUIREMENTS, THE AMOUNTS SHOWN ARE EASILY MISUNDERSTOOD. TO DETERMINE TOTAL AMOUNT EARNED (RATHER THAN THE AMOUNT VESTED/PAID OUT) DURING THE YEAR, SUBTRACT THE AMOUNT IN COLUMN F FROM COLUMN E.
Schedule J, Part I, Line 7	OTHER NON-FIXED PAYMENTS THE AT RISK COMPENSATION PLAN WAS ESTABLISHED TO ENABLE THE HEALTH CARE SYSTEM AND ITS CARE SITES TO ATTRACT AND ENGAGE QUALIFIED LEADERS AND TO PROVIDE SUCH LEADERS WITH AN ADDITIONAL PERFORMANCE COMPENSATION OPPORTUNITY TO PROMOTE AND FURTHER ITS CHARITABLE MISSION, VISION, STRATEGIC PRIORITIES AND KEY INITIATIVES. THE PLAN OPERATES ON A CALENDAR-YEAR BASIS AND IS FUNDED EACH YEAR BY MEETING THRESHOLD LEVELS OF OPERATING INCOME. TARGET AWARD AMOUNTS ARE A PERCENTAGE OF LEADERS BASE PAY AS DETERMINED BY THEIR SPECIFIC ROLE AT THE HEALTH CARE SYSTEM. ACTUAL AWARDS ARE PAID OUT BASED ON ATTAINMENT OF BOARD APPROVED GOALS, INCLUDING OPERATING INCOME, STEWARDSHIP, PATIENT EXPERIENCE, EMPLOYEE SAFETY AND COMMUNITY BENEFIT/MISSION TARGETS. AWARDS ARE BASED ON THE BOARDS DETERMINATION ON HOW WELL THE HEALTH CARE SYSTEM PERFORMS RELATIVE TO THE PLANS STATED PERFORMANCE STANDARDS AND THE WEIGHT GIVEN TO EACH OF THE PERFORMANCE MEASURES AS DEFINED FOR THAT PLAN YEAR. THE AT RISK COMPENSATION PLANS ARE BASED ON A COMBINATION OF PERFORMANCE MEASURES. PERFORMANCE MEASURES INCLUDE OPERATING INCOME, STEWARDSHIP, PATIENT EXPERIENCE, EMPLOYEE SAFETY AND COMMUNITY BENEFIT/MISSION TARGETS. THE AT RISK COMPENSATION PLAN SHALL BE INTERPRETED, APPLIED AND ADMINISTERED AT ALL TIMES IN ACCORDANCE WITH CODE SECTION 409A AND GUIDANCE ISSUED THEREUNDER. THE HEALTH CARE SYSTEM RESERVES THE RIGHT TO AMEND OR TERMINATE THIS PLAN AT ANY TIME FOR ANY REASON.

Schedule J (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

Brighton Community Hospital Association

Employer identification number

84-0482695

Return Reference	Explanation
Form 990, Part VI, Section A, Question 1a	Material Differences in Voting Rights: The CEO serves on the Board and is paid by Platte Valley Medical Center as an employee. Therefore, he does not vote on his own compensation but is permitted to vote on all other matters.
Form 990, Part VI, Section A, Line 2	Family/Business Relationship: John Hicks and Harold Dupper have a business relationship because they are directors of the wholly owned subsidiaries disclosed on Schedule R, Part IV.
Form 990, Part VI, Section A, Line 4	Changes to Organizational Documents since Prior 990: THE BYLAWS ARTICLES OF INCORPORATION WERE AMENDED TO REFLECT INTEGRITY HEALTH AS THE SOLE MEMBER OF PLATTE VALLEY MEDICAL CENTER.
Form 990, Part VI, Section A, Line 6	Classes of Members or Stockholders: THE SOLE MEMBER OF THIS CORPORATION SHALL BE INTEGRITY HEALTH, A COLORADO NOT-FOR-PROFIT CORPORATION (THE "CORPORATE MEMBER").
Form 990, Part VI, Section A, Line 7a	Members who can elect members of the governing body: THE ORGANIZATION'S SOLE CORPORATE MEMBER HAS RESERVED POWERS TO APPOINT MEMBERS OF THE ORGANIZATIONS BOARD.
Form 990, Part VI, Section A, Line 7b	Decisions of governing body subject to approval by members: The following matters with respect to pvmc are reserved solely to the corporate member: (a) To change the Mission and Philosophy; (b) To adopt, amend or repeal the Articles of Incorporation or these Bylaws; (c) To appoint/remove Directors, and exercise the authority of pvmc to appoint the members of the board of directors; (d) To implement corporate goals, policies and procedures; (e) To establish parameters and authority to approve: acquiring assets, incurring indebtedness, or lease, sell, transfer, assume, encumber or any other disposition of assets; (f) To cause the merger, dissolution, conversion into another form of entity, or corporate restructuring; (g) To approve the annual strategic plans and operating and capital budgets and deviations; (h) To appoint the auditors of PVMC; (i) To have full oversight and approval authority over the PVMC's executive compensation and benefits paid to any director, trustee, officer, employee or other person.
Form 990, Part VI, Section B, line 11b	Process to Review the Form 990: THE FORM 990 IS PREPARED BY A THIRD PARTY. THE 990 GOES THROUGH A DETAILED REVIEW BY THE ACCOUNTING MANAGER AND CHIEF FINANCIAL OFFICER. ONCE THIS REVIEW IS COMPLETE, THE 990 IS PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL. ONCE APPROVED, A COPY OF THE 990 IS MADE AVAILABLE TO EACH BOARD MEMBER BEFORE FILING WITH THE IRS.
Form 990, Part VI, Section B, line 12c	Process for Monitoring Compliance with Conflict of Interest Policy: The organization has a compliance officer who monitors the organization's conflict of interest policy. The board of directors, officers and key employees are required annually to complete and review the conflict of interest policy and disclose any potential conflicts. Directors are not permitted to vote on issues where they have a conflict of interest.
Form 990, Part VI, Section B, line 15a & 15b	Describe process for determining compensation: Platte Valley Medical Center uses the services of an independent compensation consultant, Yaffee & Company, to establish compensation for the CEO, other officers and Key Employees. A review was done in 2015. Upon completion of the compensation analysis, the compensation package is recommended to the compensation committee of the board for approval. Officers have written employment contracts which are signed and maintained by the human resource department.
Form 990, Part VI, Section C, line 19	Governing Documents Available to the Public: The governing documents, conflict of interest policy, and financial statements are made available to the public upon request.
Form 990, Part XI, Line 9	Other Changes in net assets: CHANGE IN INTEREST IN NET ASSETS OF PLATTE VALLEY MEDICAL CENTER FOUNDATION (63,724) NET REVENUE PASSED THRU THE COLORADO HOSPITAL ASSN TRUST FOR WORKER'S COMPENSATION (80,409) IMPUTED INTEREST - CLINICS (149,986) NET ASSET ADJUSTMENT FOR CHANGE IN CONTROL 64,166,351 TOTAL 63,872,232
Form 990, Part XII, Line 2C	Change in Oversight or Selection Process during the Tax Year: Integrity Health Board assumed the oversight role replacing oversight role of The Platte Valley Medical Center Board Investment/Audit Committee.
FORM 990 PART IX LINE 11G	DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:4360228
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACTED STAFF LABOR TOTAL FEES:929860
FORM 990 PART IX LINE 11G	DESCRIPTION:LAB SERVICES TOTAL FEES:978383
FORM 990 PART IX LINE 11G	DESCRIPTION:COLLECTION SERVICES TOTAL FEES:1104536
FORM 990 PART IX LINE 11G	DESCRIPTION:CONSULTING TOTAL FEES:3719999
FORM 990 PART IX LINE 11G	DESCRIPTION:SURGICAL ASSISTANT TOTAL FEES:20461
FORM 990 PART IX LINE 11G	DESCRIPTION:NURSERY SPECIALIST TOTAL FEES:812499
FORM 990 PART IX LINE 11G	DESCRIPTION:PHARMACY SERVICES TOTAL FEES:126894
FORM 990 PART IX LINE 11G	DESCRIPTION:MAINTENANCE TOTAL FEES:764974
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER HEALTH SERVICES TOTAL FEES:433277
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER MISC SERVICES TOTAL FEES:1053315
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER PROFESSIONAL FEES TOTAL FEES:137127
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER CONTRACT LABOR TOTAL FEES:18240

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Brighton Community Hospital Association

Employer identification number

84-0482695

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) CLINIC SUPPORT SERVICES LLC 1600 PRAIRIE CENTER PARKWAY BRIGHTON,CO80601 45-3962647	CLINICAL SVCs	CO	4,016,641	633,488	PVMC
(2) PLATTE VALLEY MEDICAL IMAGING LLC 1606 PRAIRIE CENTER PARKWAY BRIGHTON,CO80601 32-0402320	IMAGING SVCS	CO	187,387	239,320	PVMC
(3) WorkWellness LLC 1450 DEXTER AVENUE FORT LUPTON,CO80621 47-4891329	Medical svcs	CO	12,933	28,631	PVMC
(4) SPECTRUM MEDICAL IMAGING LLC 1600 PRAIRIE CENTER PARKWAY BRIGHTON,CO80601 47-5236844	IMAGING SVCS	CO	0	0	PVMC

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)PLATTE VALLEY MEDICAL CENTER FOUNDATION 1600 PRAIRIE CENTER PARKWAY BRIGHTON,CO80601 74-2255936	Fundraising	CO	501(C)(3)	11A TYPE I	PVMC	Yes
(2)SIS OF CHARITY LEAVENWORTH HEALTH (SCLH) 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021 23-7379161	MGMT ORG	KS	501(C)(3)	11C TYPE 3	NA		No
(3)INTEGRITY HEALTH 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021 47-4520350	SUPPORT ORG	CO	501(C)(3)	11C TYPE 3	SCLH		No
(4)MOUNT ST VINCENT HOME INC 4159 LOWELL BOULEVARD DENVER,CO80211 84-0405260	RESIDENT CARE	CO	501(C)(3)	Line 9	SCLH		No
(5)NJH-SJH INC 500 ELDORADO BLVD SUITE 4300 DENVER,CO80211 47-1194849	MGMT ORG	CO	501(C)(3)	11A TYPE I	SCLH		No
(6)SAINT JOSEPH HOSPITAL INC (SJH) 1375 E 19TH AVENUE DENVER,CO80218 84-0417134	HOSPITAL SVCS	CO	501(C)(3)	Line 3	SCLH		No
(7)SAINT JOSEPH HOSPITAL FOUNDATION 1375 E 19TH AVENUE DENVER,CO80218 84-0735096	SUPPORT ORG	CO	501(C)(3)	11A TYPE I	SJH		No
(8)SCL HEALTH - FRONT RANGE INC (SCFR) 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021 84-1103606	HOSPITAL SVCS	CO	501(C)(3)	Line 3	SCLH		No
(9)GOOD SAMARITAN MEDICAL CENTER FDN 200 EXEMPLA CIRCLE LAFAYETTE,CO80026 84-1649162	SUPPORT ORGS	CO	501(C)(3)	Line 7	SCFR		No
(10)LUTHERAN MEDICAL CENTER FOUNDATION 8300 WEST 38TH AVENUE WHEAT RIDGE,CO80033 20-8846152	SUPPORT ORGS	CO	501(C)(3)	Line 7	SCFR		No
(11)ST MARYS HOSPITAL & MEDICAL CTR (SMHMC) 2635 N 7TH STREET GRAND JUNCTION,CO81501 84-0425720	HOSPITAL SVCS	CO	501(C)(3)	Line 3	SCLH		No
(12)ST MARYS HOSPITAL FOUNDATION 2635 N 7TH STREET GRAND JUNCTION,CO81501 23-7001007	SUPPORT ORG	CO	501(C)(3)	11A TYPE I	SMHMC		No
(13)CARITAS CLINICS INC 818 NORTH 7TH STREET LEAVENWORTH,KS66048 48-1009910	CLINIC SVCS	KS	501(C)(3)	LINE 3	SCLH		No
(14)MARIAN CLINIC INC 3164 EAST SIXTH AVENUE TOPEKA,KS66607 48-1046905	CLINIC SVCS	KS	501(C)(3)	LINE 3	SCLH		No
(15)ST FRANCIS HEALTH CENTER INC (SFHC) 1700 SW 7TH STREET TOPEKA,KS66606 48-0547719	HOSPITAL SVCS	KS	501(C)(3)	LINE 3	SCLH		No
(16)ST FRANCIS HEALTH CENTER FOUNDATION 1700 SW 7TH STREET TOPEKA,KS66606 48-1092520	SUPPORT ORG	KS	501(C)(3)	11A TYPE I	SFHC		No
(17)HOLY ROSARY HEALTHCARE (HRH) 2600 WILSON STREET MILES CITY,MT59301 81-0231792	HOSPITAL SVCS	MT	501(C)(3)	Line 3	SCLH		No
(18)HOLY ROSARY HEALTHCARE FOUNDATION INC 2600 WILSON STREET MILES CITY,MT59301 20-2270238	SUPPORT ORG	MT	501(C)(3)	11A TYPE I	HRH		No
(19)ST JAMES HEALTHCARE (SJHC) 400 SOUTH CLARK STREET BUTTE,MT59701 81-0231785	HOSPITAL SVCS	MT	501(C)(3)	Line 3	SCLH		No
(20)ST JAMES HEALTHCARE FOUNDATION INC 400 SOUTH CLARK STREET BUTTE,MT59701 65-1202190	SUPPORT ORG	MT	501(C)(3)	11A TYPE I	SJHC		No
(21)ST VINCENT HEALTHCARE (SVH) 1233 NORTH 30TH STREET BILLINGS,MT59101 81-0232124	HOSPITAL SVCS	MT	501(C)(3)	Line 3	SCLH		No
(22)ST VINCENT HEALTHCARE FOUNDATION INC 1106 NORTH 30TH STREET BILLINGS,MT59101 81-0468034	SUPPORT ORGS	MT	501(C)(3)	Line 7	SVH		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) DENVER WEST ENDOSCOPY CENTER LLC 382 S ARTHUR AVENUE LOUISVILLE,CO80027 46-0788218	OP ENDOSCOPY	CO
(2) EKG INTERPRETATION SERVICE 3464 S WILLOW STREET SUITE 111 DENVER,CO80231 84-0927945	EKG INTERPRET	CO
(3) GRAND VALLEY SURGICAL CENTER LLC 710 WELLINGTON GRAND JUNCTION,CO81501 84-1505075	OP SURGERY	CO
(4) HEALTHCARE MANAGEMENT LLC PO BOX 1929 GRAND JUNCTION,CO81502 84-1238904	MANAGEMENT SVCS	CO
(5) LUTHERAN CAMPUS ASC LLC 3455 LUTHERAN PKWY STE 150 WHEAT RIDGE,CO80033 02-0749532	OP SURGERY	CO
(6) PAVILION IMAGING LLC 750 WELLINGTON GRAND JUNCTION,CO81501 03-0516198	RADIOLOGY	CO
(7) SAN JUAN CANCER CENTER LLC 600 SOUTH 5TH STREET MONTROSE,CO81401 20-2856331	OP CANCER	CO
(8) SMHMMH AIR MEDICAL TRANSPORT LLC 500 ELDORADO BLVD SUITE4300 BROOMFIELD,CO80021 47-3525381	MED AIR TRANSPORT	CO
(9) SCL HOME HEALTH SOLUTIONS LLC 500 ELDORADO BLVD SUITE 4200 BROOMFIELD,CO80021 46-2418729	HOME CARE	DE
(10) SCLTDI JV LLC 5214 MARYLAND WAY SUITE 200 BRENTWOOD,TN37027 47-2294770	RADIOLOGY	DE
(11) ATHLETIC MEDICINE & PERFORMANCE LLC 1144 NORTH 28TH STREET BILLINGS,MT59101 27-2270640	PHYSICAL THERAPY	MT
(12) MED-MAP LLC PO BOX 1295 BILLINGS,MT59103 81-0491356	RENTAL REAL ESTAT	MT
(13) NORTHERN ROCKIES HEALTHCARE ALLIANCE 2475 VILLAGE LANE SUITE 302 BILLINGS,MT59102 38-3978770	PROVIDER NETWORK	MT
(14) YELLOWSTONE SURGERY CENTER LLC 1144 NORTH 28TH STREET BILLINGS,MT59101 72-1519467	OP SURGERY	MT
(15) CODY MEDICAL ARTS COMPLEX LLC 720 LINDSAY LANE CODY,WY82414 33-1031839	RENTAL REAL ESTAT	WY

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) PVMC PHYSICIAN SERVICES INC 1606 PRAIRIE CENTER PARKWAY SUITE BRIGHTON,CO80601 94-3458548	MEDICAL SERVICES	CO	PVMC	C-Corporation	0	0	100.000 %	Yes
(2) HIGH PLAINS HEART & VASCULAR CENTER INC 1606 PRAIRIE CENTER PARKWAY SUITE BRIGHTON,CO80601 27-2038197	MEDICAL SERVICES	CO	PVMC	C-Corporation	1,993,296	417,780	100.000 %	Yes
(3) INTEGRATIVE INTERNAL MED & ACUPUNCTURE 1606 PRAIRIE CENTER PARKWAY SUITE BRIGHTON,CO80601 27-4433325	MEDICAL SERVICES	CO	PVMC	C-Corporation	1,062,728	225,054	100.000 %	Yes
(4) MOUNTAIN VIEW ORTHOPEDICS INC 1606 PRAIRIE CENTER PARKWAY SUITE BRIGHTON,CO80601 27-5382523	MEDICAL SERVICES	CO	PVMC	C-Corporation	2,866,759	409,282	100.000 %	Yes
(5) EAGLE RIDGE MEDICAL INC 1606 PRAIRIE CENTER PKWY SUITE 240 BRIGHTON,CO80601 46-2387681	MEDICAL SERVICES	CO	PVMC	C-Corporation	1,291,775	693,730	100.000 %	Yes
(6) Apex Surgical Partners Inc 1606 PRAIRIE CENTER PKWY SUITE 240 Brighton,CO80601 47-3268324	MEDICAL SERVICES	CO	PVMC	C-corporation	525,791	447,138	100.000 %	Yes
(7) CARITAS INC AND SUBSIDIARIES 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021 48-0941069	HEALTHCARE	KS	NA	C-CORPORATION					No
(8) PROVIDENCE MEDICAL CENTER INC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021 48-0784446	HOSPITAL SERVICES	KS	NA	C-CORPORATION					No
(9) SAINT JOHN HOSPITAL INC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021 48-0543768	HOSPITAL SERVICES	KS	NA	C-CORPORATION					No
(10) ST FRANCIS ACCOUNTABLE HEALTH NETWORK 1700 SW 7TH STREET TOPEKA,KS66606 46-2874128	HEALTHCARE	KS	NA	C-CORPORATION					No
(11) LEAVEN INSURANCE COMPANY LTD 23 LIME TREE BAY AVENUE WEST BAY ROAD KY1-1102 CJ 98-0370522	INSURANCE	CJ	NA	C-CORPORATION					No
(12) PVMC MEDICAL TEAM 1606 PRAIRIE CENTER PARKWAY SUITE 2 BRIGHTON,CO80601 47-3988808	MED SOFTWARE	CO	PVMC	C-CORPORATION	294,750	360,515	100.000 %	Yes

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

Yes

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) PVMC Physician Services Inc	A	291	financials
(2) High Plains Heart & Vascular Center Inc	A	230,267	financials
(3) INTEGRATIVE INTERNAL MED & ACUPUNCTURE	A	174,955	financials
(4) Mountain View Orthopedics Inc	A	220,671	financials
(5) EAGLE RIDGE MEDICAL INC	A	204,040	financials
(6) Apex Surgical Partners Inc	A	8,176	financials
(7) Platte Valley Medical Center Foundation	C	322,573	CASH TRANSFER
(8) High Plains Heart & Vascular Center Inc	D & R	3,956,373	a/r balance
(9) INTEGRATIVE INTERNAL MED & ACUPUNCTURE	D & R	1,457,095	a/r balance
(10) Mountain View Orthopedics Inc	D & R	3,879,331	a/r balance
(11) eagle ridge medical inc	D & R	1,700,246	a/r balance
(12) Apex Surgical Partners Inc	D & R	840,945	a/r balance
(13) High Plains Heart & Vascular Center Inc	Q	1,201,160	billed amount
(14) INTEGRATIVE INTERNAL MED & ACUPUNCTURE	Q	518,688	billed amount
(15) Mountain View Orthopedics Inc	Q	1,254,160	billed amount
(16) eagle ridge medical inc	Q	672,903	billed amount
(17) Apex Surgical Partners Inc	Q	232,139	billed amount

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	320,692	322,573
9	Program service revenue (Part VIII, line 2g) .........	107,565,152	111,572,134
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	3,626,303	3,236,098
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,151,917	491,552
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	112,664,064	115,622,357
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	136,476	162,847
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	42,585,168	44,297,073
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 206,606
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	58,089,071	65,111,101
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	100,810,715	109,571,021
19	Revenue less expenses. Subtract line 18 from line 12.......	11,853,349	6,051,336
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	230,554,929	301,340,786
21	Total liabilities (Part X, line 26).............	98,663,341	101,580,994
22	Net assets or fund balances. Subtract line 21 from line 20.....	131,891,588	199,759,792

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 17,199,743 including grants of $ 0 ) (Revenue $ 14,842,070 )
	INPATIENT ROUTINE CARE, TOTAL PATIENT DAYS: 8,605

4b	(Code: ) (Expenses $ 58,116,864 including grants of $ 162,847 ) (Revenue $ 69,230,193 )
	INPATIENT/OUTPATIENT ANCILLIARY SERVICES, WEIGHTED PATIENT DAYS: 24,015

4c	(Code: ) (Expenses $ 17,743,995 including grants of $ 0 ) (Revenue $ 27,499,871 )
	TOTAL EMERGENCY ROOM VISITS AND AMBULANCE CALLS: 26,419

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses93,060,602

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) KIRK QUACKENBUSH MD - CMO as of........................................................................ 4/15, director thru 4/15	15.0 .......................0.0	X	X		91,617	0	0
(19) HAROLD DUPPER........................................................................ CFO/CORPORATE SECRETARY	50.0 .......................0.0		X		384,910	0	34,391
(20) KURT GENSERT........................................................................ VICE PRESIDENT OF OPERATIONS	50.0 .......................1.0		X		354,567	0	48,760
(21) DUANE LIVADNEY........................................................................ MEDICAL IMAGING SUPERVISOR	50.0 .......................0.0			X	156,261	0	25,175
(22) ERIC STIRM........................................................................ PHARMACY DIRECTOR	40.0 .......................0.0			X	189,673	0	56,000
(23) JACKIE DUNKIN........................................................................ HUMAN RESOURCES DIRECTOR	40.0 .......................0.0			X	144,736	0	37,288
(24) KAREN WELZ........................................................................ OR DIRECTOR	40.0 .......................0.0			X	160,168	0	33,952
(25) MARK BAKER........................................................................ CATH LAB MANAGER	45.0 .......................0.0			X	143,258	0	34,799

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,366,270	1,565,014	562,279

1	Briefly describe the organization’s mission or most significant activities: The mission of Platte Valley Medical Center is to provide excellent quality comprehensive health services, which are affordable, convenient, and responsive to community needs.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	786
6	Total number of volunteers (estimate if necessary) .............	6	240
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	149,986
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	101,456

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	322,573
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		322,573

		Business Code
2a	PATIENT SERVICES REV, NET OF ALLOWANCE	900099	82,871,641	82,871,641
b	MEDICARE/MEDICAID	900099	22,792,667	22,792,667
c	CLINIC SUPPORT SERVICES REVENUE	900099	3,928,299	3,928,299
d	340B PHARMACY REVENUE	900099	1,192,370	1,192,370
e	CLINIC PROGAM SERVICE RENT REVENUE	900099	359,699	359,699
f	All other program service revenue.			427,458	410,703	16,755
g Total.Add lines 2a–2f.....			111,572,134

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			2,697,706		149,986	2,547,720
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		773,163
b	Less: rental expenses		798,732
c	Rental income or (loss)	0	-25,569
d	Net rental income or (loss)......			-25,569			-25,569
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	184,473	54,449,238
b	Less: cost or other basis and sales expenses	142,956	53,952,363
c	Gain or (loss)	41,517	496,875
d	Net gain or (loss).....			538,392			538,392
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	CAFETERIA SALES		900099	517,121			517,121
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			517,121
12	Total revenue. See Instructions......			115,622,357	111,555,379	149,986	3,594,419

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	162,847	162,847
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	1,694,235	1,380,971	313,264	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	32,256,451	28,345,880	3,817,084	93,487
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	913,108	792,471	113,922	6,715
9	Other employee benefits .......	6,825,363	5,750,677	1,041,712	32,974
10	Payroll taxes ...........	2,607,916	2,313,528	282,251	12,137
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	650,326		650,326
c	Accounting ...........	378,308	12,295	366,013
d	Lobbying ...........	6,147		6,147
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	224,072		224,072
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	14,459,793	12,097,938	2,344,605	17,250
12	Advertising and promotion ....	287,426	1,250	286,176
13	Office expenses .......	4,685,154	4,098,014	550,499	36,641
14	Information technology ......	5,076,931	1,737,468	3,334,262	5,201
15	Royalties ..	0
16	Occupancy ...........	882,077	715,658	166,419
17	Travel ............	87,746	54,261	32,493	992
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	113,517	83,749	29,668	100
20	Interest ...........	2,828,492	2,305,504	522,988
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	10,694,185	8,802,073	1,891,558	554
23	Insurance ...	727,918	581,348	146,570
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	13,757,760	13,757,760
b	BAD DEBT EXPENSE	4,559,778	4,559,778
c	PROVIDER FEE	5,048,682	5,048,682
d	OTHER DIRECT EXPENSES	642,789	458,450	183,784	555
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	109,571,021	93,060,602	16,303,813	206,606
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			8,065,330	1	9,820,460
2	Savings and temporary cash investments .........			20,857,021	2	13,889,898
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			13,974,564	4	14,652,471
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net ....			31,820	7	18,956
8	Inventories for sale or use ........			694,460	8	836,706
9	Prepaid expenses and deferred charges ......			1,931,469	9	2,201,344
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	158,969,473
b	Less: accumulated depreciation	10b	2,388,504	82,676,816	10c	156,580,969
11	Investments—publicly traded securities .			75,894,482	11	69,356,260
12	Investments—other securities. See Part IV, line 11 .....			9,091,548	12	9,469,875
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			0	14	10,000,000
15	Other assets. See Part IV, line 11 ...........			17,337,419	15	14,513,847
16	Total assets. Add lines 1 through 15 (must equal line 34)...			230,554,929	16	301,340,786

17	Accounts payable and accrued expenses .....	11,609,736	17	18,056,862
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	87,053,605	23	83,205,671
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	0	25	318,461
26	Total liabilities. Add lines 17 through 25..	98,663,341	26	101,580,994

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	129,901,843	27	197,833,771
28	Temporarily restricted net assets ...........	1,989,745	28	1,926,021
29	Permanently restricted net assets	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	131,891,588	33	199,759,792
34	Total liabilities and net assets/fund balances ........	230,554,929	34	301,340,786