Form990
Click to see attachment
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Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 01-01-2021 , and ending 12-31-2021
BCheck if applicable:
CName of organization
SCL HEALTH - FRONT RANGE INC
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
500 ELDORADO BLVD SUITE 4300
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
BROOMFIELD, CO80021
D Employer identification number

84-1103606
E Telephone number

G Gross receipts $ 1,038,553,159
F Name and address of principal officer:
MARK KORTH
500 ELDORADO BLVD SUITE 4300
BROOMFIELD,CO80021
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.SCLHEALTH.ORG/LOCATIONS
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1988
M State of legal domicile: CO
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: 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.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 12
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 2021 (Part V, line 2a) ...... 5 9,057
6 Total number of volunteers (estimate if necessary) ............. 6 160
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 598,640
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 51,333,271 27,227,246
9 Program service revenue (Part VIII, line 2g) ......... 869,107,438 994,170,182
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 7,493,453 9,089,876
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,851,290 2,002,274
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 929,785,452 1,032,489,578
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 2,084,512 2,063,730
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) 414,681,790 452,017,681
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 484,636,066 665,571,353
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 901,402,368 1,119,652,764
19 Revenue less expenses. Subtract line 18 from line 12....... 28,383,084 -87,163,186
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 769,910,245 715,905,008
21 Total liabilities (Part X, line 26)............. 228,965,884 262,264,737
22 Net assets or fund balances. Subtract line 21 from line 20..... 540,944,361 453,640,271
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
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Signature of officer Date
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Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OFTHE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POORAND VULNERABLE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 976,192,546 including grants of $ 2,063,730 ) (Revenue $ 995,823,004 )
SEE SCHEDULE O
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet976,192,546
Form 990 (2021)
Form 990 (2021)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
15
Yes
 
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
0
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
9,057
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
Yes
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
12
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
11
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletKYLE ENGMAN500 ELDORADO BLVD SUITE 4200   BROOMFIELD,CO80021 (303) 813-5543
Form 990 (2021)
Form 990 (2021)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) LYDIA JUMONVILLE......................................................................
FORMER OFFICER
0.00
.................
50.00
          X 0 2,132,408 470,113
(2) MARK KORTH......................................................................
MEMBER
1.00
.................
50.00
X           0 1,191,313 182,370
(3) JANIE WADE......................................................................
TREASURER
2.00
.................
50.00
    X       0 1,095,286 162,697
(4) ADAM SMITH MD......................................................................
PHYSICIAN
50.00
.................
0.00
        X   1,207,760 0 47,722
(5) JAMES TREADWELL MD......................................................................
PHYSICIAN
50.00
.................
0.00
        X   1,176,485 0 51,627
(6) JOHN WICKLUND......................................................................
PRESIDENT REGIONAL WESTERN CO & LMC
50.00
.................
0.00
    X       0 1,056,624 33,767
(7) JASON SHOFNOS MD......................................................................
PHYSICIAN
50.00
.................
0.00
        X   1,021,902 0 46,731
(8) JAKE CHANIN MD......................................................................
PHYSICIAN
50.00
.................
0.00
        X   969,039 0 31,482
(9) BASHEAL AGRAWAL MD......................................................................
PHYSICIAN
50.00
.................
0.00
        X   912,000 0 49,959
(10) JENNIFER ALDERFER......................................................................
PRESIDENT GSMC & SYSTEM TRANSFORM OFCR 1/1-11/29
50.00
.................
0.00
    X       0 787,946 96,153
(11) THOMAS MYDLER MD......................................................................
VP CHIEF MEDICAL OFFICER 1/1-4/1
50.00
.................
0.00
      X     0 603,552 76,295
(12) THOMAS DONOHOE......................................................................
SECRETARY
2.00
.................
50.00
    X       0 502,346 93,350
(13) JAMES DOYLE......................................................................
FORMER OFFICER
0.00
.................
50.00
          X 0 546,676 29,585
(14) KAREN SCREMIN......................................................................
FORMER OFFICER
0.00
.................
0.00
          X 0 517,877 55,943
(15) STEVEN BROWN MD......................................................................
VP CHIEF MEDICAL OFFICER
50.00
.................
0.00
      X     0 493,392 38,207
(16) ANDREA BURCH......................................................................
VP CHIEF OPERATING/NURSING OFFICER LMC
50.00
.................
0.00
      X     0 396,619 79,201
(17) SCOTT DAY......................................................................
VP HUMAN RESOURCE OPERATIONS LMC
50.00
.................
0.00
      X     0 339,498 58,955
Form 990 (2021)
Form 990 (2021)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) SEAN FADDEN........................................................................
FORMER OFFICER
0.00
.......................50.00
          X 0 310,310 64,557
(19) PETER BENKOWSKI........................................................................
VP STRATEGY & BUS DEVELOPMENT GSMC
50.00
.......................0.00
      X     0 278,852 63,990
(20) JUSTIN SCHMIEDEL........................................................................
VP CHIEF OPERATING OFFICER GSMC
50.00
.......................0.00
      X     0 271,697 64,683
(21) MEGAN DURNING........................................................................
VP STRATEGY & BUS DEVELOPMENT LMC
50.00
.......................0.00
      X     0 301,637 34,603
(22) HILDA DALFONSO........................................................................
VP FINANCE GSMC
50.00
.......................0.00
    X       0 237,784 32,787
(23) MARY DEINES........................................................................
VP CHIEF NURSING OFFICER GSMC
50.00
.......................0.00
      X     0 247,871 20,581
(24) PATRICE FARRELL-DELINE........................................................................
FORMER KEY EMPLOYEE
50.00
.......................0.00
          X 0 198,241 45,733
(25) CALVIN BEASLEY........................................................................
VP INTEGRATIVE SVCS LMC
50.00
.......................0.00
      X     194,197 0 48,353
(26) TONI GREEN-CHEATWOOD........................................................................
VP CHIEF MEDICAL OFFICER
50.00
.......................0.00
      X     0 182,963 8,575
(27) ASHLEY DENTON........................................................................
VP FINANCE LMC
50.00
.......................0.00
    X       0 146,890 21,719
(28) KATHY BOELTER........................................................................
MEMBER
1.00
.......................0.00
X           0 0 0
(29) CHRISTINE FORKNER........................................................................
MEMBER
1.00
.......................0.00
X           0 0 0
(30) STEVEN FRANKEL MD........................................................................
MEMBER
1.00
.......................0.00
X           0 0 0
(31) FAYE HUMMEL RN........................................................................
MEMBER
1.00
.......................0.00
X           0 0 0
(32) MARK ISAKSON........................................................................
VICE CHAIR
2.00
.......................0.00
X   X       0 0 0
(33) DAVID KINNARD MD........................................................................
MEMBER
1.00
.......................0.00
X           0 0 0
(34) GILLIAN MCNIGHT-TUTEIN........................................................................
MEMBER
1.00
.......................0.00
X           0 0 0
(35) BERRY MORTON MD........................................................................
CHAIR
2.00
.......................0.00
X   X       0 0 0
(36) KELLY SNOW-DUNKIN........................................................................
MEMBER
1.00
.......................0.00
X           0 0 0
(37) BRUCE WARING MD........................................................................
MEMBER
1.00
.......................0.00
X           0 0 0
(38) BARTH WHITHAM........................................................................
PAST CHAIR
2.00
.......................0.00
X   X       0 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 5,481,383 11,839,782 2,009,738
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet750
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet0
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 21,022,614
e Government grants (contributions)1e 6,204,046
f All other contributions, gifts, grants, and similar amounts not included above1f 586
g Noncash contributions included in lines 1a - 1f:$ 1g 22,921
h Total. Add lines 1a-1f.......MediumBullet 27,227,246
 Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUE 622110 992,565,183 992,190,209 374,974  
b MEDICAL DIRECTOR FEES 621110 1,604,999 1,604,999    
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 994,170,182
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 9,022,381     9,022,381
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   1,459,981 6a
b Less: rental expenses   1,439,525 6b
c Rental income or (loss)   20,456 6c
d Net rental income or (loss).......MediumBullet 20,456   -106,332 126,788
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 4,689,962   7a
b Less: cost or other basis and sales expenses 4,622,467   7b
c Gain or (loss) 67,495   7c
d Net gain or (loss).........MediumBullet 67,495     67,495
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a 587
b Less: cost of goods sold .. 10b 1,589
c Net income or (loss) from sales of inventory..MediumBullet -1,002     -1,002
Business Code Miscellaneous Revenue
11a CAFETERIA 722514 1,652,822 1,652,822    
b MED. DIRECTORS' FEES - DAVITA 621110 329,998   329,998  
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 1,982,820
12 Total revenue. See instructions.....MediumBullet 1,032,489,578 995,448,030 598,640 9,215,662
Form 990 (2021)
Form 990 (2021)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 2,023,730 2,023,730
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 40,000 40,000
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 6,143,713 5,949,568 194,145  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........ 370,577,194 358,866,727 11,710,467  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 13,789,442 13,730,634 58,808  
9 Other employee benefits ....... 39,436,781 37,808,090 1,628,691  
10 Payroll taxes ........... 22,070,551 21,679,749 390,802  
11 Fees for services (non-employees):        
a Management ...... 155,026   155,026  
b Legal ......... 99,660   99,660  
c Accounting ...........        
d Lobbying ........... 7,000   7,000  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 119,625,046 110,923,056 8,701,990  
12 Advertising and promotion .... 5,694,071   5,694,071  
13 Office expenses ....... 1,978,810 1,891,191 87,619  
14 Information technology ...... 63,947,709 5,503,893 58,443,816  
15 Royalties ..        
16 Occupancy ........... 20,295,418 20,051,139 244,279  
17 Travel ............ 575,333 524,807 50,526  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 970,074 821,923 148,151  
20 Interest ........... 6,209,942 6,209,942    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 157,870,828 157,870,828    
23 Insurance ... 5,996,326 5,996,326    
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 128,216,691 128,216,691    
b MEDICAL PROVIDER TAXES 53,335,093 53,070,486 264,607  
c BILLING & COLLECTION - 20,154,230   20,154,230  
d BAD DEBT EXPENSE 19,744,503 19,744,503    
e All other expenses 60,695,593 25,269,263 35,426,330  
25 Total functional expenses. Add lines 1 through 24e 1,119,652,764 976,192,546 143,460,218 0
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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 25,110 1 24,821
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 75,284,302 4 108,725,431
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ........... 701,676 7 1,134,004
8 Inventories for sale or use ............ 16,970,497 8 16,605,463
9 Prepaid expenses and deferred charges ...... 7,540,954 9 6,094,284
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 923,348,628
b Less: accumulated depreciation 10b 493,946,736 454,327,741 10c 429,401,892
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 215,059,965 15 153,919,113
16 Total assets. Add lines 1 through 15 (must equal line 33)... 769,910,245 16 715,905,008
Liabilities 17 Accounts payable and accrued expenses ..... 87,569,321 17 104,147,839
18 Grants payable ...   18  
19 Deferred revenue ......... 74,096 19 160,093
20 Tax-exempt bond liabilities .........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties .. 795,185 23 0
24 Unsecured notes and loans payable to unrelated third parties ..   24  
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 140,527,282 25 157,956,805
26 Total liabilities. Add lines 17 through 25.. 228,965,884 26 262,264,737
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 540,944,361 27 453,640,271
28 Net assets with donor restrictions ...........   28  
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 540,944,361 32 453,640,271
33 Total liabilities and net assets/fund balances ........ 769,910,245 33 715,905,008
Form 990 (2021)
Form 990 (2021)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,032,489,578
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,119,652,764
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-87,163,186
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
540,944,361
5
Net unrealized gains (losses) on investments ...............
5
819
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-141,723
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
453,640,271
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2021)
Form 990 (2021)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
SCL HEALTH - FRONT RANGE INC
 
Employer identification number

84-1103606
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 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
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 failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
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) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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  
12
12
 
13
First 5 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
14
14
 
15
15
 
16a
b
17a
b
18
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) 2021

Schedule A (Form 990) 2021
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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 on 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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c 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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
 
7
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) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
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.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on 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.
9c
 
 
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
 
 
b
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) 2021

Schedule A (Form 990) 2021
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, 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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
 
2
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).
2
 
 
3
By reason of the relationship described in line 2 above, 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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
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.
2a
 
 
b
Did the activities described on line 2a, above 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.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
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?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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 0.015 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 0.035 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  
7
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
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 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI
). See instructions
8  
9 Distributable amount for 2021 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2021
(iii)
Distributable
Amount for 2021
1 Distributable amount for 2021 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2021:
a From 2016.......  
b From 2017.......  
c From 2018.......  
d From 2019.......  
e From 2020.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2021 distributable amount  
i Carryover from 2016 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2021 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2021 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2021, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.
 
6 Remaining underdistributions for 2021. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.
 
7 Excess distributions carryover to 2022. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2017.....  
b Excess from 2018.....  
c Excess from 2019.....  
d Excess from 2020.....  
e Excess from 2021.....  
Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021
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) 2021


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Name of the organization
SCL HEALTH - FRONT RANGE INC
 
Employer identification number

84-1103606
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




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
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2021)
Schedule B (Form 990) (2021) Page 2
Name of organization
SCL HEALTH - FRONT RANGE INC
 
Employer identification number
84-1103606
Part I
Contributors
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


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)
Schedule B (Form 990) (2021)
Page 3
Name of organization
SCL HEALTH - FRONT RANGE INC
 
Employer identification number

84-1103606
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) (2021)
Schedule B (Form 990) (2021)
Page 4
Name of organization
SCL HEALTH - FRONT RANGE INC
 
Employer identification number

84-1103606
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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2021)
Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990)

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 BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
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
SCL HEALTH - FRONT RANGE INC
 
Employer identification number

84-1103606
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
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.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
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 Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(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? ...................................................................................................................

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) 2018 (b) 2019 (c) 2020 (d) 2021 (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) 2021


Schedule C (Form 990) 2021
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|No
(b)
Amount
1
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:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
7,000
j
Total. Add lines 1c through 1i ....................................................................................................
7,000
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
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
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
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."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
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? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures. See Instructions .........................................
5
 
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
PART II-B, LINE 1: SCHEDULE C, PART II-B, QUESTION 1I LOBBYING EXPENDITURES LOBBYING EXPENDITURES INCLUDES THE PORTIONS OF VARIOUS MEMBERSHIP DUES THAT ARE DESIGNATED AS LOBBYING EXPENSE BY THOSE ORGANIZATIONS IN WHICH SCL HEALTH - FRONT RANGE, INC. OR ITS ENTITIES ARE MEMBERS.
Schedule C (Form 990) 2021


Additional Data


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SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
SCL HEALTH - FRONT RANGE INC
 
Employer identification number

84-1103606
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .............................
9
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.
1a
If the organization elected, as permitted under FASB 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.
b
If the organization elected, as permitted under FASB 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 $  
2
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 FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2021

Schedule D (Form 990) 2021
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?...
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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 .... 8,381,778 7,715,903 6,636,208 7,059,069 6,248,061
b Contributions ... 700 14,703 173,500 189,134  
c Net investment earnings, gains, and losses 1,014,239 919,333 934,761 -191,643 905,286
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
296,017 268,161 28,566 420,352 94,278
f Administrative expenses ....          
g End of year balance ...... 9,100,700 8,381,778 7,715,903 6,636,208 7,059,069
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet100.000 %
c
Term endowment SchDMd Bullet0 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
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 .....   23,929,573 23,929,573
b Buildings ....   611,428,194 295,311,271 316,116,923
c Leasehold improvements   6,455,545 32,611,040 -26,155,495
d Equipment ....   278,729,632 164,931,542 113,798,090
e Other .....   2,805,684 1,092,883 1,712,801
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 429,401,892
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 3
Part VII
Investments - Other 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.)Small Bullet  
Part VIII
Investments - Program 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.)Small Bullet  
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)INTERCOMPANY RECEIVABLES 99,473,348
(2)OTHER RECEIVABLES 5,250,749
(3)LT ASSETS - ROU ASSETS 49,195,016
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 153,919,113
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  
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 157,956,805
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) 2021

Schedule D (Form 990) 2021
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
PART V, LINE 4: THE SCL HEALTH - FRONT RANGE, INC., ENDOWMENT FUNDS ARE HELD AND ADMINISTERED BY THE RELATED ORGANIZATION'S LUTHERAN MEDICAL CENTER FOUNDATION AND GOOD SAMARITAN MEDICAL CENTER FOUNDATION. THE ENDOWMENT FUNDS CONSIST OF: 1) THE HEALTH EDUCATION ENDOWMENT FUND. THE PURPOSE IS TO SUPPORT HEALTH EDUCATION IN THE COMMUNITY. DISTRIBUTIONS ARE LIMITED BY BOARD ACTION TO THREE PERCENT OF ANNUAL VALUE. 2) THE FRIENDS OF HOSPICE ENDOWMENT FUND. THE PURPOSE IS LIMITED TO PROGRAMS AT LUTHERAN HOSPICE. DISTRIBUTIONS ARE LIMITED TO THREE PERCENT OF ANNUAL VALUE. 3) THE VOLUNTEER ENDOWMENT FUND. THE PURPOSE IS TO SUPPORT PROGRAMS AND ACTIVITIES OF THE VOLUNTEERS AT LUTHERAN MEDICAL CENTER. DISTRIBUTIONS FROM THE FUND CAN ONLY BE MADE IF THE FUND BALANCE IS GREATER THAN $1 MILLION AND IS DISTRIBUTED TWICE ANNUALLY - BASED ON THE BALANCE AS OF MARCH 31 AND SEPTEMBER 30. 4) THE SENIOR CARE ENDOWMENT FUND. THE PURPOSE IS TO SUPPORT THE HEALTH AND HEALING OF ELDERS IN OUR COMMUNITY BY PROVIDING A WELLNESS WAY OF LIFE WITH QUALITY, EFFICIENCY AND EMPATHY TO THOSE ENTRUSTED IN OUR CARE TO INCLUDE BUT NOT LIMITED TO HOSPICE CARE, SENIOR EMERGENCY CARE AND SENIOR CHARITY CARE. DISTRIBUTIONS FROM THE FUND CAN ONLY BE MADE IF THE FUND BALANCE IS GREATER THAN $1 MILLION. 5) HOSPICE ENDOWMENT FUND. THE PURPOSE IS LIMITED TO PROGRAMS AT LUTHERAN HOSPICE. DISTRIBUTIONS ARE DETERMINED UNDER THE SCL HEALTH ENDOWMENT SPENDING POLICY AND AMOUNT OF DISTRIBUTION DETERMINED BY THE SCL HEALTH PHILANTHROPIC IMPACT COMMITTEE. 6) COCHRAN FAMILY ONCOLOGY ENDOWMENT. THE PURPOSE IS TO PROVIDE CONTINUING EDUCATION SUPPORT TO ASSOCIATES EMPLOYED BY LUTHERAN MEDICAL CENTER. DISTRIBUTIONS ARE DETERMINED UNDER THE SCL HEALTH ENDOWMENT SPENDING POLICY AND AMOUNT OF DISTRIBUTION DETERMINED BY THE SCL HEALTH PHILANTHROPIC IMPACT COMMITTEE. 7) LILES FAMILY ENDOWED FUND. THE PURPOSE IS TO PROVIDE HOSPICE CARE SUPPORT AT COLLIER HOSPICE. 8) MATSUO FAMILY ENDOWED FUND. THE PURPOSE IS TO PROVIDE HOSPICE CARE SUPPORT AT COLLIER HOSPICE. 9) VILLANO FAMILY ENDOWED FUND. THE PURPOSE IS TO PROVIDE HOSPICE CARE SUPPORT THROUGH LUTHERAN MEDICAL CENTER. 10) HENDERSON FAMILY ENDOWMENT FUND. THE PURPOSE IS TO PROVIDE HOSPICE CARE SUPPORT AT COLLIER HOSPICE. 11) JOHN & ROBERTA NYBERG JUNIOR VOLUNTEER ENDOWMENT. THE PURPOSE IS TO PROVIDE SCHOLARSHIP SUPPORT TO JUNIOR VOLUNTEERS AT LUTHERAN MEDICAL CENTER. 12) EDWARD PYUN, JR, MD ENDOWMENT FUND - THE PURPOSE OF THE FUND IS TO PROVIDE SUPPORT FOR EDUCATION AND PATIENT ASSISTANCE IN THE TRAUMA DEPARTMENT AT GOOD SAMARITAN MEDICAL CENTER. ACCOUNTS FOR ENDOWMENT FUNDS WERE INVESTED, ALLOWING INCOME AND PRINCIPAL TO GROW OVER TIME.
Schedule D (Form 990) 2021


Additional Data


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Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
SCL HEALTH - FRONT RANGE INC
 
Employer identification number

84-1103606
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in the region (d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in the region
(f) Total expenditures
for and investments
in the region
SUB-SAHARAN AFRICA 0 0 GRANT HOSPITAL & MEDICAL CENTER 40,000
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .... 0 0 40,000
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 0 40,000
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2021
Schedule F (Form 990) 2021
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(c) Region (d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of noncash
assistance
(h) Description
of noncash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
SUB-SAHARAN AFRICA SUPPORT SELIAN LUTHERAN HOSPITAL AND ITS SISTER HOSPITAL ARUSHA LUTHERAN MEDICAL CENTER IN TANZANIA. 40,000 WIRE TRANSFER 0    
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
0
3 Enter total number of other organizations or entities .......................MediumBullet
1
Schedule F (Form 990) 2021
Schedule F (Form 990) 2021Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant
(e) Manner of cash
disbursement
(f) Amount of
noncash
assistance
(g) Description
of noncash
assistance
(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2021
Schedule F (Form 990) 2021
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2021
Schedule F (Form 990) 2021
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
ReturnReference Explanation
PART I, LINE 2: SCL HEALTH - FRONT RANGE, INC.(SCLHFR) PROVIDES ASSISTANCE TO ONLY ONE ORGANIZATION OUTSIDE THE U.S. SCLHFR OBTAINED AN INITIAL NEEDS ASSESSMENT REPORT FROM THE ORGANIZATION, WHICH ALSO OUTLINED THE COMMITMENT OF SCLHFR TO PROVIDE SUPPORT TO THE ORGANIZATION BASED ON AN INITIAL SITE VISIT. SCLHFR MAINTAINS REGULAR CONTACT WITH THE ORGANIZATION, SENDS A TEAM OF CLINICIANS FOR SITE VISITS TO THE ORGANIZATION EVERY YEAR AND REVIEWS THE ORGANIZATION'S ANNUAL REPORT.
PART III ACCOUNTING METHOD:  
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2021
Additional Data


Software ID:  
Software Version:  



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
SCL HEALTH - FRONT RANGE INC
 
Employer identification number

84-1103606
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: . . . . . . . .
3b
Yes
 
%
c
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.
4
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"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
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? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
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) . . .
    8,244,309 1,965,579 6,278,730 0.570 %
b Medicaid (from Worksheet 3, column a) . . . . .     196,557,532 148,856,596 47,700,936 4.340 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     1,632,176 1,208,101 424,075 0.040 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     206,434,017 152,030,276 54,403,741 4.950 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     1,497,337 12,000 1,485,337 0.140 %
f Health professions education (from Worksheet 5) . . .     2,041,076 0 2,041,076 0.190 %
g Subsidized health services (from Worksheet 6) . . . .     50,846,212 42,884,541 7,961,671 0.720 %
h Research (from Worksheet 7) .     0 0    
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     1,006,655 0 1,006,655 0.090 %
j Total. Other Benefits . .     55,391,280 42,896,541 12,494,739 1.140 %
k Total. Add lines 7d and 7j .     261,825,297 194,926,817 66,898,480 6.090 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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 (f) Percent of total 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            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
19,744,503
3
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. ......
3
0
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
289,265,159
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
401,521,523
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-112,256,364
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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 .........................

9b

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 %
11 E PLUS PET IMAGING X LP
 
RADIOLOGY SERVICES 42.860 % 0 % 57.140 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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?2Name, 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)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 LUTHERAN MEDICAL CENTER
8300 W 38TH AVENUE
WHEAT RIDGE,CO80211
WWW.SCLHEALTH.ORG/LOCATIONS/
010440
X X         X      
2 GOOD SAMARITAN MEDICAL CENTER
200 EXEMPLA CIRCLE
LAFAYETTE,CO80026
WWW.SCLHEALTH.ORG/LOCATIONS/
01I529
X X         X      
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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)
LUTHERAN MEDICAL CENTER
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):
1
Yes No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 21
5 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 ................. 5 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.................................. 6a Yes  
b 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. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
LUTHERAN MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
LUTHERAN MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
17 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 nonpayment?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
LUTHERAN MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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)
GOOD SAMARITAN MEDICAL CENTER
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):
2
Yes No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 21
5 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 ................. 5 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.................................. 6a   No
b 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. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
GOOD SAMARITAN MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
GOOD SAMARITAN MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
17 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 nonpayment?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
GOOD SAMARITAN MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 8
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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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
LUTHERAN MEDICAL CENTER PART V, SECTION B, LINE 5: LUTHERAN MEDICAL CENTER PARTICIPATED IN A COLLABORATIVE PROCESS TO CONDUCT THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), ALONG WITH JEFFERSON COUNTY PUBLIC HEALTH AND ST. ANTHONY HOSPITAL (CENTURA). A NUMBER OF COMMUNITY BASED ORGANIZATIONS WERE INVOLVED IN THE PROCESS AS WELL.COMMUNITY SURVEYTHE 2021 PUBLIC HEALTH PARTNERSHIP COMMUNITY HEALTH AND WELLBEING SURVEY GATHERED THE OPINIONS OF RESIDENTS IN JEFFERSON, CLEAR CREEK AND GILPIN COUNTIES. DEVELOPING THE QUESTIONNAIRE WAS A COLLABORATIVE EFFORT BETWEEN POLCO STAFF AND STAKEHOLDERS FROM JEFFERSON COUNTY PUBLIC HEALTH (JCPH), WITH INPUT FROM MOUNTAIN YOUTH NETWORK, CLEAR CREEK COUNTY PUBLIC AND ENVIRONMENTAL HEALTH, GILPIN COUNTY PUBLIC HEALTH, AND OTHER HEALTH STAKEHOLDERS WITHIN JEFFERSON COUNTY. THIS SURVEY WAS IMPLEMENTED IN MAY THROUGH JULY 2021. A TOTAL OF 8,400 HOUSEHOLDS WERE RANDOMLY SELECTED TO RECEIVE MAILED INVITATIONS TO COMPLETE AN ONLINE SURVEY AND/OR TO COMPLETE AND MAIL BACK A PAPER SURVEY. HOUSEHOLDS WERE SELECTED RANDOMLY FROM A USPS LIST OF HOUSEHOLDS IN THE THREE COUNTIES AND STRATIFIED BY MAJOR CITIES WITHIN THE COUNTIES. USPS LISTS ARE BEST FOR ENSURING ALL HOUSEHOLDS IN A GIVEN AREA ARE INCLUDED IN THE SAMPLING FRAME AND THEREFORE HAVE AN EQUAL CHANCE OF BEING SELECTED TO PARTICIPATE. THE SURVEYS AND MAILED INVITATIONS WERE ALSO TRANSLATED INTO SPANISH. THE JCPH AND PARTNERS WERE PROVIDED A SEPARATE URL TO SHARE AN INVITATION TO AN "OPEN PARTICIPATION" SURVEY, WHERE ALL RESIDENTS WHO RECEIVED NOTICE THROUGH SOCIAL MEDIA OR OTHER COMMUNICATION CHANNELS COULD COMPLETE THE SURVEY. A TOTAL OF 486 COMPLETED THE RANDOM SAMPLE SURVEY (1 IN SPANISH) FOR A RESPONSE RATE OF 7% AND AN OVERALL MARGIN OF ERROR OF 5%. ADDITIONALLY, 503 COMPLETED THE OPEN PARTICIPATION SURVEY (3 IN SPANISH). THE RESULTS FROM THESE TWO EFFORTS WERE STATISTICALLY COMPARED AND THE TWO DATA SETS WERE COMBINED FOR ANALYSIS. THE RESULTS OF EACH EFFORT WERE WEIGHTED TO REFLECT THE DEMOGRAPHIC PROFILE OF EACH OF THE SUB-GEOGRAPHIES WITHIN EACH COUNTY THAT WERE INCLUDED IN THE STUDY, AND THEN WEIGHTED TO REFLECT THEIR PROPORTION OF THE POPULATION IN THE COUNTY AND THE REGION OVERALL.
GOOD SAMARITAN MEDICAL CENTER PART V, SECTION B, LINE 5: GOOD SAMARITAN MEDICAL CENTER (GSMC) IS AN ACUTE-CARE HOSPITAL LOCATED IN THE CITY OF LAFAYETTE, COLORADO AND WHILE LAFAYETTE IS SITUATED IN BOULDER COUNTY, THE HOSPITAL SERVICE AREA INCLUDES COMMUNITIES IN BOULDER, BROOMFIELD, ADAMS, JEFFERSON, GILPIN AND WELD COUNTIES. WE ARE COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITY. IN SO DOING, GSMC WORKED CLOSELY WITH COMMUNITY PARTNERS TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2021. THE GOAL FOR THE CHNA WAS TO DETERMINE CURRENT AND PROJECTED FUTURE HEALTH CARE NEEDS IN THE GSMC PRIMARY COMMITMENT AREA AND TO IDENTIFY GAPS IN SERVICES TO IMPROVE THE HEALTH OF OUR COMMUNITY. WE UTILIZED FOUR METHODS OF COLLECTING PRIMARY DATA: COMMUNITY LEADER PRIORITIZATION MEETINGS; PUBLIC INPUT AT COMMUNITY EVENTS; ONLINE COMMUNITY SURVEYS; AND KEY INFORMANT PHONE SURVEYS.COMMUNITY LEADER PRIORITIZATION MEETINGSHOSPITAL LEADERS, DEPARTMENTAL REPRESENTATIVES, AND LEADERS FROM THE COMMUNITY MET ON JULY 6, 2021, TO DISCUSS AND PRIORITIZE THE SIGNIFICANT NEEDS. THE MEETING WAS A HYBRID OF IN-PERSON AND VIRTUAL PARTICIPATION USING GOOGLE MEET. THE GROUP RECEIVED A SUMMARY OF THE SECONDARY DATA RESULTS. FOLLOWING THE PRESENTATION, ATTENDEES MET IN SMALL GROUPS TO DISCUSS THE 13 COMMUNITY NEEDS. AFTER THE SMALL GROUP DISCUSSIONS, THEY WERE ASKED TO INDIVIDUALLY PRIORITIZE THE TOP SIX ISSUES IN THE GOOD SAMARITAN MEDICAL CENTER SERVICE AREA. THE PARTICIPANTS IN THE ROOM WERE GIVEN FIVE VOTING DOTS AND ASKED TO PLACE A DOT NEXT TO FIVE ISSUES OF GREATEST IMPORTANCE. EACH DOT REPRESENTED ONE POINT. PARTICIPANTS WHO JOINED VIRTUALLY SUBMITTED THEIR TOP FIVE ISSUES IN THE GOOGLE MEET CHAT. AFTER EVERYONE VOTED, THE VOTES WERE TALLIED UP. THE SIX ISSUES WITH THE MOST POINTS BECAME THE TOP SIX PRIORITY NEEDS.A SECOND ROUND OF PRIORITIZATION TO INCORPORATE PRIMARY DATA COLLECTED, CONSISTED OF HOSPITAL LEADERS, DEPARTMENTAL REPRESENTATIVES, AND LEADERS FROM THE COMMUNITY. THE MEETING OCCURRED ON SEPTEMBER 13, 2021 TO DETERMINE THE PRIORITY NEEDS TO ADDRESS FOR THE NEXT THREE YEARS. THE MEETING WAS A HYBRID OF IN-PERSON AND VIRTUAL PARTICIPANTS USING GOOGLE MEET. THE GROUP RECEIVED A SUMMARY OF THE PRIMARY DATA COLLECTED FROM KEY INFORMANT PHONE INTERVIEWS, PUBLIC INPUT FROM COMMUNITY EVENTS, AND OPINIONS COLLECTED FROM A COMMUNITY ONLINE SURVEY. FOLLOWING THE PRESENTATION, THE ATTENDEES WERE GIVEN TIME TO DISCUSS THE SIX ISSUES AND WERE ASKED TO INDIVIDUALLY PRIORITIZE THE TOP TWO ISSUES IN THE GOOD SAMARITAN MEDICAL CENTER SURROUNDING AREA. THE PARTICIPANTS THAT WERE IN THE ROOM WERE ASKED TO RANK THEIR NUMBER ONE AND NUMBER TWO ISSUES FOR THE COMMUNITY. THE NUMBER ONE ISSUE WAS GIVEN TWO POINTS AND THE NUMBER TWO ISSUE WAS GIVEN ONE POINT. PEOPLE WHO JOINED VIRTUALLY SUBMITTED THEIR TOP TWO ISSUES, IN ORDER, IN THE GOOGLE MEET CHAT.ORGANIZATIONS THAT TOOK PART IN THESE MEETINGS INCLUDED: LAFAYETTE AND BROOMFIELD SENIOR CENTER, BROOMFIELD FISH, BOULDER VALLEY SCHOOL DISTRICT, VIA MOBILITY, BOULDER COUNTY PUBLIC HEALTH, TRU COMMUNITY CARE, MENTAL HEALTH PARTNERS, BROOMFIELD COUNTY PUBLIC HEALTH, CLINICA FAMILY HEALTH CENTER, SISTER CARMEN COMMUNITY CENTER, AND BOULDER COUNTY AREA AGENCY ON AGING.PUBLIC INPUT AT COMMUNITY EVENTS GOOD SAMARITAN MEDICAL CENTER ENGAGED COMMUNITY MEMBERS AT TWO EVENTS TO FURTHER DISCUSS AND PRIORITIZE THE NEEDS. THE FIRST COMMUNITY EVENT WAS HELD ON AUGUST 5, 2021, AT THE ADAMS COUNTY SENIOR RESOURCE FAIR AND ENGAGED 45 PEOPLE. THE SECOND EVENT WAS AUGUST 21, 2021, AT THE LAFAYETTE PEACH FESTIVAL AND ENGAGED 230 PEOPLE. A POSTER WITH THE TOP IDENTIFIED ISSUES WAS USED TO SOLICIT COMMUNITY INPUT. COMMUNITY MEMBERS WERE ASKED TO THINK ABOUT THE BIGGEST PROBLEMS IN THE COMMUNITY. THEY WERE THEN GIVEN TWO VOTES. THE PROBLEM THAT THEY FELT WAS THE WORST IN THE COMMUNITY RECEIVED A NUMBER ONE VOTE AND WAS WORTH TWO POINTS. THEIR CHOICES FOR THE SECOND BIGGEST PROBLEM RECEIVED A NUMBER TWO VOTE AND WAS WORTH ONE POINT. ONLINE COMMUNITY SURVEYSTHE COLORADO HEALTH INSTITUTE (CHI), A DENVER-BASED RESEARCH AND DATA ANALYSIS FIRM THAT WORKS TO PROVIDE HEALTH DECISION SUPPORT AND INSIGHTS, DEVELOPED AND CONDUCTED A COMMUNITY SURVEY ON BEHALF OF SCL HEALTH. THE SURVEY WAS ADMINISTERED TO MORE THAN 300 PEOPLE IN SCL HEALTH'S FRONT RANGE SERVICE REGION, INCLUDING DENVER, JEFFERSON, ADAMS, BROOMFIELD AND BOULDER COUNTIES, FROM AUGUST 10 TO AUGUST 23, 2021. THE SURVEY WAS PROVIDED IN ENGLISH AND SPANISH. CHI SENT THE ELECTRONIC SURVEY LINK TO POTENTIAL PARTICIPANTS BY EMAIL USING CONSTANT CONTACT, WITH LIMITED ADDITIONAL OUTREACH THROUGH PERSONAL EMAILS AND SOCIAL MEDIA POSTS. SCL HEALTH'S INTERNAL COMMUNICATIONS TEAM ASSISTED WITH SURVEY DISSEMINATION BY SENDING TARGETED EMAILS TO LOCAL CONTACTS. THROUGH THE USE OF ZIP CODE IDENTIFICATION, SURVEY RESULTS WERE SEGMENTED BY EACH HOSPITAL'S SERVICE AREA. OF THE RESPONDENTS, 75 WERE RESIDENTS OF GSMC'S SERVICE AREA COUNTIES. KEY INFORMANT PHONE SURVEYSTWELVE (12) PHONE INTERVIEWS WERE CONDUCTED FOR THE CHNA FROM JULY 26 TO SEPTEMBER 9, 2021. INTERVIEW PARTICIPANTS INCLUDED A BROAD RANGE OF STAKEHOLDERS CONCERNED WITH HEALTH AND WELLBEING IN ADAMS AND WELD COUNTIES WHO SPOKE TO ISSUES AND NEEDS IN THE COMMUNITIES SERVED BY THE MEDICAL CENTER. THE IDENTIFIED STAKEHOLDERS WERE INVITED BY EMAIL TO PARTICIPATE IN A PHONE INTERVIEW. THE STAKEHOLDER INTERVIEWS WERE STRUCTURED TO OBTAIN GREATER DEPTH AND RICHNESS OF INFORMATION ON COMMUNITY NEEDS IDENTIFIED AS PRIORITIES THROUGH A DISCUSSION CONDUCTED WITH COMMUNITY REPRESENTATIVES PRIOR TO THE INTERVIEWS. FIRST, INTERVIEW PARTICIPANTS WERE ASKED TO DESCRIBE, FROM THEIR PERSPECTIVES, SOME OF THE MAJOR ISSUES IMPACTING THE COMMUNITY AS WELL AS THE SOCIAL DETERMINANTS OF HEALTH CONTRIBUTING TO POOR HEALTH IN THE COMMUNITY. INTERVIEW PARTICIPANTS WERE ALSO ASKED TO RATE THE IMPACT AND IMPORTANCE OF EACH NEED PRIOR TO PARTICIPATING IN THE TELEPHONE INTERVIEWS THROUGH A BRIEF SURVEY. DURING THE INTERVIEWS, PARTICIPANTS WERE ASKED TO SHARE THEIR PERSPECTIVES ON THE ISSUES, CHALLENGES AND BARRIERS RELATIVE TO THE IDENTIFIED HEALTH NEEDS (I.E.; WHAT MAKES EACH HEALTH NEED A SIGNIFICANT ISSUE IN THE COMMUNITY? WHAT ARE THE CHALLENGES PEOPLE FACE IN ADDRESSING THESE NEEDS?), ALONG WITH IDENTIFYING KNOWN RESOURCES TO ADDRESS THESE HEALTH NEEDS, SUCH AS SERVICES, PROGRAMS AND/OR COMMUNITY EFFORTS.ORGANIZATIONS THAT PARTICIPATED INCLUDED: COLORADO COMMUNITY HEALTH ALLIANCE, CENTURA HEALTH, CITY AND COUNTY OF BROOMFIELD, THE REFUGE, BOULDER COUNTY PUBLIC HEALTH, OUT BOULDER COUNTY, COAL CREEK MEALS ON WHEELS, BEHAVIORAL HEALTH GROUP, AND THE UNIVERSITY OF COLORADO, BOULDER.
LUTHERAN MEDICAL CENTER PART V, SECTION B, LINE 6A: SAINT ANTHONY HOSPITAL
LUTHERAN MEDICAL CENTER PART V, SECTION B, LINE 6B: JEFFERSON COUNTY DEPARTMENT OF PUBLIC HEALTH, ARVADA CHAMBER, ARVADA FIRE, BRIGHT BY THREE, CITY OF EDGEWATER, CITY OF LAKEWOOD, CITY OF LAKEWOOD RECREATION, CITY OF WESTMINISTER, CITY OF WHEAT RIDGE, COLORADO COMMUNITY HEALTH ALLIANCE, COMMUNITY FIRST FOUNDATION, CONSORTIUM OF OLDER ADULTS, CREA RESULTS, EVERGREEN FIRE, FAMILY TREE, JEFFCO VETERANS SERVICES, JEFFERSON CENTER FOR MENTAL HEALTH, CONSERVATION COLORADO, JEFFERSON COUNTY HOUSING AUTHORITY, JEFFERSON COUNTY PUBLIC LIBRARIES, METRO COMMUNITY PROVIDER NETWORK, REGIS UNIVERSITY, SENIOR RESOURCES CENTER, SCL LUTHERAN MEDICAL CENTER, STATE SENATOR DISTRICT 20, THE ACTION CENTER, WEST CHAMBER, WEST METRO FIRE, TRI COUNTY PUBLIC HEALTH, WEST PINES.
GOOD SAMARITAN MEDICAL CENTER PART V, SECTION B, LINE 6B: THE FOLLOWING ORGANIZATIONS LISTED PARTICIPATED THE CHNA PROCESS:BEHAVIORAL HEALTH GROUPBOULDER AREA AGENCY ON AGINGBOULDER COUNTY PUBLIC HEALTHBOULDER VALLEY SCHOOL DISTRICTBROOMFIELD FISHBROOMFIELD COUNTY PUBLIC HEALTHCENTURA HEALTHCITY AND COUNTY OF BROOMFIELDCLINICA FAMILY HEALTH SERVICES, COAL CREEK MEALS ON WHEELSCOLORADO COMMUNITY HEALTH ALLIANCELAFAYETTE AND BROOMFIELD SENIOR CENTERMENTAL HEALTH PARTNERSOUT BOULDER COUNTYTHE REFUGESISTER CARMEN COMMUNITY CENTERTRU COMMUNITY CAREUNIVERSITY OF COLORADO, BOULDERVIA MOBILITYLUTHERAN MEDICAL CENTER:PART V, SECTION B, LINE 7A, HOSPITAL FACILITY'S WEBSITE:HTTPS://WWW.SCLHEALTH.ORG/LOCATIONS/LUTHERAN-MEDICAL-CENTER/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/GOOD SAMARITAN MEDICAL CENTER:PART V, SECTION B, LINE 7A, HOSPITAL FACILITY'S WEBSITE: HTTPS://WWW.SCLHEALTH.ORG/LOCATIONS/GOOD-SAMARITAN-MEDICAL-CENTER/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ LUTHERAN MEDICAL CENTER:PART V, SECTION B, LINE 10A, HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY POSTED ON WEBSITE:HTTPS://WWW.SCLHEALTH.ORG/LOCATIONS/LUTHERAN-MEDICAL-CENTER/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-IMPROVEMENT-PLAN/GOOD SAMARITAN MEDICAL CENTER:PART V, SECTION B, LINE 10A, HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY POSTED ON WEBSITE:HTTPS://WWW.SCLHEALTH.ORG/LOCATIONS/GOOD-SAMARITAN-MEDICAL-CENTER/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-IMPROVEMENT-PLAN/
GOOD SAMARITAN MEDICAL CENTER PART V, SECTION B, LINE 7D: COPIES OF THE CHNA WERE DISTRIBUTED AT VARIOUS COMMUNITY COALITIONS AND RESOURCE MEETINGS BY THE REGIONAL DIRECTOR OF COMMUNITY HEALTH IMPROVEMENT AND TO COMMUNITY ORGANIZATIONS UPON REQUEST.
LUTHERAN MEDICAL CENTER PART V, SECTION B, LINE 11: THROUGH THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS IN COLLABORATION WITH SAINT ANTHONY HOSPITAL AND JEFFERSON COUNTY DEPARTMENT OF PUBLIC HEALTH, THREE NEEDS SURFACED AS THE MOST PRESSING FOR JEFFERSON COUNTY: 1. MENTAL HEALTH AND SUBSTANCE USE 2. FOOD INSECURITY 3. HOUSING.MENTAL HEALTH AND SUBSTANCE USEOFFER MENTAL HEALTH FIRST AID TRAINING IN COMMUNITY: ELEVEN COMMUNITY-BASED TRAININGS WERE OFFERED WITHIN COMMUNITY-BASED ORGANIZATIONS, WHICH REACHED 111 COMMUNITY MEMBERS.GROW PARTICIPATION IN THE ROCKY MOUNTAIN CRISIS PARTNERS SUICIDAL IDEATION/ATTEMPT FOLLOW-UP PROGRAM: PROGRAM EXPANDED TO INCLUDE REFERRAL FROM WEST PINES AND THE LMC EMERGENCY DEPARTMENT. 208 INDIVIDUALS WERE REFERRED OVER THE PERIOD TO RECEIVE 90 DAYS OF FOLLOW-UP SUPPORT. TRACKING INDICATED THAT NO PARTICIPANTS READMITTED IN THE LMC SYSTEM FOR A SUICIDE ATTEMPT.INCREASE PARTICIPATION IN THE RECOVERY NURSE ADVOCATE PROGRAM FOR NEW AND EXPECTANT MOTHERS: BEGINNING WITH A BASELINE OF EIGHT PARTICIPANTS (2018) IN THE LONG-TERM, SUBSTANCE USE RECOVERY GROUP, THE GROUP EXPANDED TO 16 IN THE-2019. 2020 SAW A DECLINE IN IN-PERSON ATTENDANCE AS THE PANDEMIC TOOK HOLD. 2021 EXPERIENCED AN UPWARD TRAJECTORY WITH 11 NEW OR EXPECTANT MOTHERS RECEIVING PROGRAM SERVICES.FOOD INSECURITYINCREASE PROCUREMENT OF LOCALLY PRODUCED FOOD TO SUPPORT HEALTHY FOOD SYSTEMS: LMC HAS PARTNERED WITH HEALTHCARE WITHOUT HARM TO BUILD A SYSTEM FOR PURCHASING LOCALLY PRODUCED BEANS FOR USE IN THE HOSPITAL PATIENT FOOD PREPARATION AND CAFETERIA MEALS. PURCHASING LOCALLY GROWN FOOD SUPPORTS A HEALTHY FOOD DELIVERY SYSTEM THAT MAKES HEALTHY FOOD MORE AVAILABLE TO THOSE WHO NEED IT. EXPAND FOOD FARMACY TO SERVE DURING COVID: OUR ABILITY TO ENGAGE COMMUNITY MEMBERS AROUND NUTRITION EDUCATION AND TO OFFER FOOD ACCESS WAS IMPACTED BY COVID RESTRICTIONS. IN RESPONSE, LMC DEVELOPED A VIRTUAL PROGRAM CALLED HEALTHY U. TO DATE 23 FOOD INSECURE COMMUNITY MEMBERS HAVE PARTICIPATED IN THE 12-WEEK PROGRAM WHICH PAIRS ONLINE EDUCATION ABOUT NUTRITION AND IN-PERSON HEALTH VISITS.HOUSINGINVEST IN EVICTION MITIGATION FUND AT THE ACTION CENTER JEFFERSON COUNTY: A $30,000 DONATION WAS MADE TO THE EVICTION MITIGATION FUND WITH THE SPECIFIC INTENT THAT IT BE USED TO SUPPORT INDIVIDUALS AND FAMILIES WHO MAY NARROWLY MISS CERTAIN STANDARDS FOR FEDERAL ASSISTANCE. TO DATE, 54 FAMILIES HAVE BEEN ABLE TO STAY IN THEIR HOMES.SUPPORT MEDICAL RESPITE FOR UNHOUSED INDIVIDUALS WHO NEED TO QUARANTINE BASED ON A POSITIVE COVID TEST: MOTEL VOUCHERS WERE PURCHASED BY LMC FOR USE BY HOMELESS NAVIGATORS WHEN FACED WITH NEEDING TO HOUSE COVID POSITIVE INDIVIDUALS. ADDITIONAL PRIORITIES NOT ADDRESSED LUTHERAN MEDICAL CENTER (LMC) RECOGNIZES THAT THE OTHER HEALTH NEEDS AND INDICATORS IDENTIFIED IN THE 2021 LMC COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS ARE IMPORTANT FOR THE HOSPITAL AND THE COMMUNITIES IT SERVES. NUMEROUS OTHER ORGANIZATIONS ARE CONCURRENTLY ADDRESSING MANY OF THESE REMAINING NEEDS. THEREFORE, DUE TO LIMITED EXPERTISE AND RESOURCES AT THE INDIVIDUAL HOSPITAL LEVEL LMC HAS NARROWED ITS TOP PRIORITIES TO THE FOCUS AREAS LISTED ABOVE. LMC WILL, HOWEVER, CONTINUE TO BUILD PARTNERSHIPS WITH OTHER COMMUNITY AGENCIES IN OUR PRIMARY SERVICE AREA IN ORDER TO EXPAND OUR FOOTPRINT AS FAR AS POSSIBLE INTO ALL RELEVANT HEALTH PRIORITY AREAS WITHOUT OVERTAXING AVAILABLE RESOURCES IN OUR IDENTIFIED PRIORITY AREAS. COMMUNITY-BUILDING ACTIVITIES ARE THOSE THAT IMPROVE THE HEALTH AND SAFETY OF COMMUNITY MEMBERS BY ADDRESSING THE ROOT CAUSES OF PROBLEMS (E.G. POVERTY, HOMELESSNESS, AND ENVIRONMENTAL HAZARDS). IN 2021, LMC CONTINUED TO EXPAND SEVERAL PARTNERSHIPS INTENDED TO DIRECTLY ADDRESS THE HEALTH AND SAFETY NEEDS OF RESIDENTS OF JEFFERSON COUNTY. ONE EXAMPLE IS A STRENGTHENED COLLABORATION WITH COMMUNITY TABLE, RED ROCKS COMMUNITY COLLEGE, AND STRIDE. THROUGH THIS MULTISECTORIAL PARTNERSHIP WE HAVE BEEN ABLE TO IDENTIFY AND OFFER PROGRAMMING TO FOOD INSECURE JEFFERSON COUNTY RESIDENTS WHO HAVE A CHRONIC HEALTH CONDITION THAT IS MANAGEABLE THROUGH DIET. THROUGH EDUCATION, FREQUENT BIOMETRIC SCREENING, COOKING CLASSES, AND BUILDING TRUSTED RELATIONSHIPS COMMUNITY MEMBERS HAVE BEEN ABLE TO SEE CHANGES IN THEIR HEALTH RELATED TO CHANGES IN DIETARY HABITS AND FOOD ACCESS.2021 ALSO SAW DEVELOPMENT OF A NEW PARTNERSHIP WITH THE JEFFERSON COUNTY PUBLIC LIBRARY. LMC IS FINANCIALLY SUPPORTING THE DEVELOPMENT OF NEW PROGRAMMING TARGETING THE MENTAL HEALTH NEEDS OF COMMUNITY MEMBERS EXPERIENCING UNSTABLE HOUSING AND SUBSTANCE USE ISSUES. WEEKLY PROGRAM MEETINGS WILL PROVIDE AN OPPORTUNITY FOR COMMUNITY MEMBERS TO MEET ONE-ON-ONE WITH A MENTAL HEALTH PROFESSIONAL.
GOOD SAMARITAN MEDICAL CENTER PART V, SECTION B, LINE 11: UNINTENTIONAL INJURIES-IN 2021, SEVEN "STOP THE BLEED" TRAININGS WERE OFFERED REACHING 211 COMMUNITY MEMBERS. THIS TRAINING INSTRUCTED PARTICIPANTS ABOUT THE THREE QUICK ACTIONS THAT CAN BE USED TO STOP LIFE-THREATENING BLEEDING IN A SEVERELY INJURED PERSON. PARTICIPANTS IN THE TRAINING RECEIVED EDUCATION AND WERE ABLE TO PRACTICE WHAT THEY HAD LEARNED.-THE INJURY PREVENTION DEPARTMENT HAS ALWAYS PROVIDED SEVERAL CLASSES AND EVENTS TO ADDRESS INJURIES DUE TO FALLS. THE POPULAR "MATTER OF BALANCE" CLASS WHICH IS OFFERED THROUGH THE NATIONAL COUNCIL ON AGING AND SPONSORED LOCALLY BY THE BOULDER AREA AGING ON AGING (BCAAA), WAS NOT ABLE TO BE OFFERED IN PERSON IN 2021 AND WAS NOT DELIVERED ONLINE. FALL PREVENTION EDUCATION WAS OFFERED AT FESTIVALS AND FAIRS IN COLLABORATION WITH NORTH METRO FIRE AND REACHED 270 INDIVIDUALS.-GSMC WAS ABLE TO OFFER SOME CLASSES IN 2021 TO ADDRESS FALL PREVENTION. (AMP) IS A 10-CLASS COURSE CREATED BY THE NATIONAL COUNCIL ON AGING TO HELP OLDER ADULTS MAKE THE MOST OF THEIR LIVES AS THEY AGE. FALL PREVENTION IS ONE OF THE CLASSES IN AMP AND IT OUTLINES WAYS TO PREVENT FALLS AND HOW TO REDUCE THE RISK OF FALLING.-DUE TO COVID RESTRICTIONS, THE ANNUAL FALL PREVENTION WEEK ACTIVITIES HAD TO BE MODIFIED. THE INJURY PREVENTION COORDINATOR WORKED WITH A VIDEOGRAPHER TO PRODUCE THREE FALL PREVENTION VIDEOS. THE VIDEOS FEATURED A PHYSICAL THERAPIST INSTRUCTING THE VIEWER ON THE FOLLOWING TOPICS: TIPS ON HOW TO AVOID FALLS, HOW TO USE ASSISTIVE DEVICES, AND TIPS FOR GOING UPSTAIRS. A LINK WAS SENT OUT IN A NEWSLETTER THAT WENT OUT TO ALL OF THE BCAAA CLIENTS. SINCE SEPTEMBER OF 2021, THE VIDEOS HAVE RECEIVED 31,400 VIEWS ON GSMC'S FACEBOOK PAGE, 98 VIEWS ON VIMEO AND 21 VIEWS ON YOUTUBE. -BICYCLE SAFETY AND HELMET DISTRIBUTION - 121 ATTENDED THE TRAINING AND 57 HELMETS WERE DISTRIBUTED. CHILDREN RECEIVED A PROFESSIONAL FITTING FOR THE HELMETS IN ADDITION TO RECEIVING THE FREE HELMET. -GSMC OPERATED A CHILD CAR SEAT CHECK FOR THE COMMUNITY TO PREVENT CHILDHOOD INJURIES FROM AUTO ACCIDENTS. THE SEATS WERE CHECKED TO MAKE SURE THAT THEY WERE INSTALLED CORRECTLY AND THAT THEY WERE NOT DAMAGED OR ON A RECALL LIST. ANY SEAT THAT WAS FOUND TO BE DEFECTIVE, RECALLED OR OTHERWISE A DANGER TO THE CHILD WAS REPLACED AT NO COST TO THE FAMILY. THE PROGRAM WAS USUALLY DONE IN-PERSON BUT DUE TO COVID, THE PROGRAM WAS PROVIDED VIRTUALLY FOR PART OF THE YEAR. 1,061 CAR SEATS WERE EXAMINED IN 2021. NONE NEEDED TO BE REPLACED. CARDIOVASCULAR DISEASE-THE GSMC EMS OUTREACH COORDINATOR PROVIDED TRAINING AND RECERTIFICATION CLASSES (CPR, PALS AND ACLS) AT NO COST TO LOCAL EMS PROFESSIONALS. CONTINUING EDUCATION OCCURRED THROUGHOUT THE YEAR AT THREE LOCAL FIRE STATIONS SERVING 624 PERSONS. HE ALSO PROVIDED RECERTIFICATION CLASSES TO 64 LOCAL FIRST RESPONDERS THROUGHOUT THE YEAR.-GSMC HOSTED A BOOTH AT THE LAFAYETTE PEACH FESTIVAL WHICH SAW AN ATTENDANCE OF CLOSE TO 20,000 PEOPLE. IT IS ESTIMATED THAT AT LEAST 2,000 STOPPED AT THE BOOTH AND SPOKE WITH OUR STAFF WHO ARE KNOWLEDGEABLE ABOUT CARDIOVASCULAR HEALTH. -GSMC WAS ABLE TO OFFER SOME CLASSES IN 2021 TO ADDRESS TOPICS RELATED TO CARDIOVASCULAR HEALTH WITHIN THE AGING MASTERY PROGRAM (AMP). AMP IS A 10-CLASS COURSE CREATED BY THE NATIONAL COUNCIL ON AGING TO HELP OLDER ADULTS MAKE THE MOST OF THEIR LIVES AS THEY AGE. TWO CLASSES RELATED TO CARDIOVASCULAR HEALTH ARE HEALTHY EATING AND EXERCISE.-IN ORDER TO PREVENT DEATH FROM CARDIAC EVENTS IN THE COMMUNITY, GOOD SAMARITAN PURCHASED AN AED TO DONATE TO BIG ELK VOLUNTEER FIRE DEPARTMENT AND PROVIDED TRAINING ON THE EQUIPMENT. -GSMC IN 2021 HOSTED A BI-MONTHLY STROKE SUPPORT GROUP IN COORDINATION WITH THE ROCKY MOUNTAIN STROKE CENTER (ATTENDANCE IN 2021: 250). ROCKY MOUNTAIN STROKE CENTER ALSO PROVIDED 83 INDIVIDUAL COUNSELING SESSIONS THROUGHOUT THE YEAR.HEALTH PRIORITIES NOT ADDRESSEDTHE REMAINDER OF NEEDS IDENTIFIED IN THE CHNA ARE IMPORTANT TO GSMC, BUT DUE TO LIMITED RESOURCES AT THE HOSPITAL LEVEL, AND THE AVAILABILITY OF COMMUNITY ORGANIZATIONS WHO ARE ALREADY ADDRESSING THESE NEEDS, GSMC WILL FOCUS PRIMARILY ON ITS SELECTED PRIORITIES. GSMC WILL CONTINUE TO COLLABORATE WITH COMMUNITY ORGANIZATIONS TO ENSURE OTHER NEEDS AND HEALTH INDICATORS ARE SUPPORTED. SOME OF THE ORGANIZATIONS ACTIVELY ADDRESSING OTHER HEALTH PRIORITIES INCLUDE: BOULDER COUNTY PUBLIC HEALTH, BROOMFIELD PUBLIC HEALTH DEPARTMENT, CATHOLIC CHARITIES, UNITED WAY, AMERICAN CANCER SOCIETY, MENTAL HEALTH PARTNERS, WOMEN'S HEALTH.
SCHEDULE H, PART V, SECTION B, LINE 16 LUTHERAN MEDICAL CENTER:PART V, SECTION B, LINE 16A, FINANCIAL ASSISTANCE POLICY WEBSITE:WWW.SCLHEALTH.ORG/LOCATIONS/LUTHERAN-MEDICAL-CENTER/PATIENTS-VISITORS/BILLING-PRICING/FINANCIAL-ASSISTANCE/GOOD SAMARITAN MEDICAL CENTER:PART V, SECTION B, LINE 16A, FINANCIAL ASSISTANCE POLICY WEBSITE:WWW.SCLHEALTH.ORG/LOCATIONS/GOOD-SAMARITAN-MEDICAL-CENTER/PATIENTS-VISITORS/BILLING-PRICING/FINANCIAL-ASSISTANCE/LUTHERAN MEDICAL CENTER:PART V, SECTION B, LINE 16B, FINANCIAL ASSISTANCE APPLICATION WEBSITE:WWW.SCLHEALTH.ORG/LOCATIONS/LUTHERAN-MEDICAL-CENTER/PATIENTS-VISITORS/BILLING-PRICING/FINANCIAL-ASSISTANCE/GOOD SAMARITAN MEDICAL CENTER:PART V, SECTION B, LINE 16B, FINANCIAL ASSISTANCE APPLICATION WEBSITE:WWW.SCLHEALTH.ORG/LOCATIONS/GOOD-SAMARITAN-MEDICAL-CENTER/PATIENTS-VISITORS/BILLING-PRICING/FINANCIAL-ASSISTANCE/LUTHERAN MEDICAL CENTER:PART V, SECTION B, LINE 16C, FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY:WWW.SCLHEALTH.ORG/LOCATIONS/LUTHERAN-MEDICAL-CENTER/PATIENTS-VISITORS/BILLING-PRICING/FINANCIAL-ASSISTANCE/GOOD SAMARITAN MEDICAL CENTER:PART V, SECTION B, LINE 16C, FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY:WWW.SCLHEALTH.ORG/LOCATIONS/GOOD-SAMARITAN-MEDICAL-CENTER/PATIENTS-VISITORS/BILLING-PRICING/FINANCIAL-ASSISTANCE/
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 9
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?114
Name and address Type of Facility (describe)
1 1 - SCL HEALTH MEDICAL GROUP - ROCKY MOUNTAI
627 25 1/2 ROAD
GRAND JUNCTION,CO81505
OUTPATIENT PHYSICIAN CLINIC
2 2 - SCL HEALTH HEART & VASCULAR INSTITUTE -
3655 LUTHERAN PKWY
WHEAT RIDGE,CO800336010
OUTPATIENT PHYSICIAN CLINIC
3 3 - SCL HEALTH MEDICAL GROUP - NEUROLOGY
750 WELLINGTON AVE
GRAND JUNCTION,CO815016124
OUTPATIENT PHYSICIAN CLINIC
4 4 - SCL HEALTH ST MARY'S HOSPITALISTS
2635 N 7TH ST
GRAND JUNCTION,CO815068209
OUTPATIENT PHYSICIAN CLINIC
5 5 - SCL HEALTH MEDICAL GROUP - LUTHERAN
8550 W 38TH AVE
WHEAT RIDGE,CO800336016
OUTPATIENT PHYSICIAN CLINIC
6 6 - SCL HEALTH MEDICAL GROUP - CENTER FOR BR
750 WELLINGTON AVE
GRAND JUNCTION,CO815016124
OUTPATIENT PHYSICIAN CLINIC
7 7 - SCL HEALTH - ST MARY'S HOSPITAL AND MED
2698 PATTERSON RD
GRAND JUNCTION,CO81506
OUTPATIENT PHYSICIAN CLINIC
8 8 - SCL HEALTH MEDICAL GROUP - MIDTOWN
1960 N OGDEN ST
DENVER,CO802183667
OUTPATIENT PHYSICIAN CLINIC
9 9 - SCL HEALTH HEART & VASCULAR INSTITUTE -
360 WEST PARK DR
GRAND JUNCTION,CO815068817
OUTPATIENT PHYSICIAN CLINIC
10 10 - SCL HEALTH MEDICAL GROUP - BROOMFIELD
12169 SHERIDAN BLVD
BROOMFIELD,CO800202459
OUTPATIENT PHYSICIAN CLINIC
11 11 - SCL HEALTH MEDICAL GROUP - THORNTON
1181 E 120TH AVE
THORNTON,CO802335729
OUTPATIENT PHYSICIAN CLINIC
12 12 - SCL HEALTH HEART & VASCULAR INSTITUTE -
300 EXEMPLA CIR
LAFAYETTE,CO800263394
OUTPATIENT PHYSICIAN CLINIC
13 13 - SCL HEALTH HEART & VASCULAR INSTITUTE -
1818 N OGDEN ST
DENVER,CO802183667
OUTPATIENT PHYSICIAN CLINIC
14 14 - SCL HEALTH MEDICAL GROUP - PATTERSON
2570 PATTERSON RD
GRAND JUNCTION,CO81505
OUTPATIENT PHYSICIAN CLINIC
15 15 - SCL HEALTH MEDICAL GROUP - DENVER WEST
1726 COLE BLVD
LAKEWOOD,CO80401
OUTPATIENT PHYSICIAN CLINIC
16 16 - SCL HEALTH MEDICAL GROUP - LAFAYETTE
2600 CAMPUS DR
LAFAYETTE,CO800263358
OUTPATIENT PHYSICIAN CLINIC
17 17 - SCL HEALTH MEDICAL GROUP - OB-GYN SERVIC
610 25 ROAD
GRAND JUNCTION,CO81505
OUTPATIENT PHYSICIAN CLINIC
18 18 - SCL HEALTH HEART & VASCULAR INSTITUTE -
1818 N OGDEN ST
DENVER,CO802183671
OUTPATIENT PHYSICIAN CLINIC
19 19 - SCL HEALTH HEART & VASCULAR INSTITUTE -
2643 PATTERSON RD
GRAND JUNCTION,CO815061937
OUTPATIENT PHYSICIAN CLINIC
20 20 - CANCER CENTERS OF COLORADO - LUTHERAN ME
400 INDIANA ST
GOLDEN,CO80401
OUTPATIENT PHYSICIAN CLINIC
21 21 - SCL HEALTH MEDICAL GROUP - GREEN MOUNTAI
12790-A W ALAMEDA PKWY
LAKEWOOD,CO802282850
OUTPATIENT PHYSICIAN CLINIC
22 22 - SCL HEALTH MEDICAL GROUP - CHERRY CREEK
400 S COLORADO BLVD
DENVER,CO80246
OUTPATIENT PHYSICIAN CLINIC
23 23 - SCL HEALTH MEDICAL GROUP - CENTRAL PARK
2803 ROSLYN ST
DENVER,CO802382624
OUTPATIENT PHYSICIAN CLINIC
24 24 - SCL HEALTH MEDICAL GROUP - CENTRAL PARK
2823 ROSLYN ST
DENVER,CO802382624
OUTPATIENT PHYSICIAN CLINIC
25 25 - SCL HEALTH MEDICAL GROUP - GOOD SAMARITA
300 EXEMPLA CIR
LAFAYETTE,CO800263396
OUTPATIENT PHYSICIAN CLINIC
26 26 - SCL HEALTH MEDICAL GROUP - COMMUNITY FOO
11900 GRANT ST
NORTHGLENN,CO80233
OUTPATIENT PHYSICIAN CLINIC
27 27 - SCL HEALTH MEDICAL GROUP - LUTHERAN NEUR
3455 N LUTHERAN PKWY
WHEAT RIDGE,CO80033
OUTPATIENT PHYSICIAN CLINIC
28 28 - ST MARY'S MEDICAL CENTER - CANCER CENTER
750 WELLINGTON AVE
GRAND JUNCTION,CO81501
OUTPATIENT PHYSICIAN CLINIC
29 29 - MATERNAL FETAL MEDICINE CENTER SJ
1960 OGDEN ST
DENVER,CO802183669
OUTPATIENT PHYSICIAN CLINIC
30 30 - SCL HEALTH MEDICAL GROUP - DENVER OB-GYN
1960 N OGDEN ST
DENVER,CO802183668
OUTPATIENT PHYSICIAN CLINIC
31 31 - LMG SPINE CARE LUTHERAN SPINE CENTER AT
1687 COLE BLVD
LAKEWOOD,CO804013322
OUTPATIENT PHYSICIAN CLINIC
32 32 - SCL HEALTH MEDICAL GROUP - PHYSICAL MEDI
2686 PATTERSON ROAD
GRAND JUNCTION,CO81506
OUTPATIENT PHYSICIAN CLINIC
33 33 - SCL HEALTH MEDICAL GROUP - WESTMINSTER
8758 WOLFF CT
WESTMINSTER,CO800316904
OUTPATIENT PHYSICIAN CLINIC
34 34 - SCL HEALTH ST MARY'S NEPHROLOGY
2635 N 7TH ST 4TH FLOOR
GRAND JUNCTION,CO815016100
OUTPATIENT PHYSICIAN CLINIC
35 35 - WEST PINES
3400 LUTHERAN PKWY
WHEAT RIDGE,CO800336035
OUTPATIENT PHYSICIAN CLINIC
36 36 - SCL HEALTH HEART & VASCULAR INSTITUTE -
11900 GRANT ST
NORTHGLENN,CO80233
OUTPATIENT PHYSICIAN CLINIC
37 37 - ST MARY'S MEDICAL CENTER - CANCER CENTER
750 WELLINGTON AVE
GRAND JUNCTION,CO81501
OUTPATIENT PHYSICIAN CLINIC
38 38 - SCL HEALTH MEDICAL GROUP - WHEAT RIDGE
8550 W 38TH AVE
WHEAT RIDGE,CO800331724
OUTPATIENT PHYSICIAN CLINIC
39 39 - SCL HEALTH ST MARY'S NEONATAL INTENSI
2635 N 7TH ST
GRAND JUNCTION,CO815068209
OUTPATIENT PHYSICIAN CLINIC
40 40 - SCL HEALTH HEART & VASCULAR INSTITUTE -
2643 PATTERSON RD
GRAND JUNCTION,CO815061937
OUTPATIENT PHYSICIAN CLINIC
41 41 - SJH RADIATION ONCOLOGY
1375 EAST 19TH AVE
DENVER,CO80218
OUTPATIENT PHYSICIAN CLINIC
42 42 - SCL HEALTH MEDICAL GROUP - SUPERIOR
3 SUPERIOR DRIVE
SUPERIOR,CO800278656
OUTPATIENT PHYSICIAN CLINIC
43 43 - SCL HEALTH MEDICAL GROUP - SUPERIOR
3 SUPERIOR DRIVE
SUPERIOR,CO800278656
OUTPATIENT PHYSICIAN CLINIC
44 44 - SCL HEALTH MEDICAL GROUP - WHEAT RIDGE
8550 W 38TH AVE
WHEAT RIDGE,CO800331724
OUTPATIENT PHYSICIAN CLINIC
45 45 - SCL HEALTH MEDICAL GROUP - LUNG & SLEEP
1050 WELLINGTON AVE
GRAND JUNCTION,CO815018121
OUTPATIENT PHYSICIAN CLINIC
46 46 - SCL HEALTH MEDICAL GROUP - OCCUPATIONAL
2686 PATTERSON RD
GRAND JUNCTION,CO815068817
OUTPATIENT PHYSICIAN CLINIC
47 47 - CERTIFIED NURSE MIDWIVES
1960 N OGDEN ST
DENVER,CO802183669
OUTPATIENT PHYSICIAN CLINIC
48 48 - SCL HEALTH - ST MARY'S HOSPITAL AND ME
2698 PATTERSON RD
GRAND JUNCTION,CO81506
OUTPATIENT PHYSICIAN CLINIC
49 49 - SCL HEALTH MEDICAL GROUP - ROCKY MOUNTAI
627 25 1/2 ROAD
GRAND JUNCTION,CO81505
OUTPATIENT PHYSICIAN CLINIC
50 50 - SCL HEALTH MEDICAL GROUP - WHEAT RIDGE D
3555 LUTHERAN PKWY
WHEAT RIDGE,CO800336000
OUTPATIENT PHYSICIAN CLINIC
51 51 - SCL HEALTH MEDICAL GROUP - LARKRIDGE
16570 WASHINGTON ST
THORNTON,CO800238964
OUTPATIENT PHYSICIAN CLINIC
52 52 - SCL HEALTH MEDICAL GROUP - MATERNAL FETA
710 WELLINGTON AVE
GRAND JUNCTION,CO81501
OUTPATIENT PHYSICIAN CLINIC
53 53 - SCL HEALTH MEDICAL GROUP - BELMAR
325 S TELLER ST
LAKEWOOD,CO802267429
OUTPATIENT PHYSICIAN CLINIC
54 54 - SCL HEALTH MEDICAL GROUP - DENVER UROGYN
1960 N OGDEN ST
DENVER,CO802183671
OUTPATIENT PHYSICIAN CLINIC
55 55 - SCL HEALTH MEDICAL GROUP - AURORA
23770 E SMOKEY HILL RD
AURORA,CO80016
OUTPATIENT PHYSICIAN CLINIC
56 56 - SCL HEALTH MEDICAL GROUP - DENVER SPORTS
1830 FRANKLIN ST
DENVER,CO802183667
OUTPATIENT PHYSICIAN CLINIC
57 57 - SCL HEALTH MEDICAL GROUP - QUAIL CREEK
2055 WEST 136TH AVE
BROOMFIELD,CO800239308
OUTPATIENT PHYSICIAN CLINIC
58 58 - SAINT JOSEPH HOSPITAL - CANCER CENTERS O
1825 MARION ST
DENVER,CO80218
OUTPATIENT PHYSICIAN CLINIC
59 59 - SCL HEALTH MEDICAL GROUP - FIRESTONE
8350 COLORADO BLVD
FIRESTONE,CO805046803
OUTPATIENT PHYSICIAN CLINIC
60 60 - SCL HEALTH MEDICAL GROUP - HIGHLANDS RAN
8671 S QUEBEC ST
HIGHLANDS RANCH,CO80130
OUTPATIENT PHYSICIAN CLINIC
61 61 - SCL HEALTH HEART & VASCULAR INSTITUTE -
1818 N OGDEN ST
DENVER,CO80218
OUTPATIENT PHYSICIAN CLINIC
62 62 - LUTHERAN MEDICAL CENTER - CANCER CENTERS
3550 LUTHERAN PKWY
WHEAT RIDGE,CO80033
OUTPATIENT PHYSICIAN CLINIC
63 63 - LUTHERAN MATERNAL FETAL MEDICINE
3455 LUTHERAN PARKWAY
WHEAT RIDGE,CO800336012
OUTPATIENT PHYSICIAN CLINIC
64 64 - SCL HEALTH MEDICAL GROUP - DENVER DIABET
1960 N OGDEN ST
DENVER,CO802183667
OUTPATIENT PHYSICIAN CLINIC
65 65 - SCL HEALTH MEDICAL GROUP - DENVER SURGE
1960 N OGDEN ST
DENVER,CO802183671
OUTPATIENT PHYSICIAN CLINIC
66 66 - SCL HEALTH MEDICAL GROUP - GREEN VALLEY
4859 N YAMPA ST
DENVER,CO80249
OUTPATIENT PHYSICIAN CLINIC
67 67 - SCL HEALTH MEDICAL GROUP - LOWRY
63 N QUEBEC ST
DENVER,CO80230
OUTPATIENT PHYSICIAN CLINIC
68 68 - SCL HEALTH HEART & VASCULAR INSTITUTE -
3555 LUTHERAN PARKWAY
WHEAT RIDGE,CO800336023
OUTPATIENT PHYSICIAN CLINIC
69 69 - LUTHERAN PALLIATIVE CARE
3210 LUTHERAN PKWY
WHEAT RIDGE,CO800336019
OUTPATIENT PHYSICIAN CLINIC
70 70 - SCL HEALTH MEDICAL GROUP - PEDIATRIC SPE
2643 PATTERSON RD
GRAND JUNCTION,CO815061937
OUTPATIENT PHYSICIAN CLINIC
71 71 - SCL HEALTH MEDICAL GROUP - BROOMFIELD
12169 SHERIDAN BLVD
BROOMFIELD,CO800202459
OUTPATIENT PHYSICIAN CLINIC
72 72 - GOOD SAMARITAN MEDICAL CENTER - CANCER C
340 EXEMPLA CIR
LAFAYETTE,CO80026
OUTPATIENT PHYSICIAN CLINIC
73 73 - SCL HEALTH ST MARY'S PALLIATIVE CARE
2635 N 7TH ST
GRAND JUNCTION,CO81506
OUTPATIENT PHYSICIAN CLINIC
74 74 - SCL HEALTH MEDICAL GROUP - DENVER COMPRE
1960 N OGDEN ST
DENVER,CO802183671
OUTPATIENT PHYSICIAN CLINIC
75 75 - SCL HEALTH MEDICAL GROUP - LAFAYETTE DIA
300 EXEMPLA CIR
LAFAYETTE,CO800263395
OUTPATIENT PHYSICIAN CLINIC
76 76 - ST MARY'S METABOLIC AND BARIATRIC SURGER
2440 N 11TH STREET
GRAND JUNCTION,CO815018102
OUTPATIENT PHYSICIAN CLINIC
77 77 - SCL HEALTH MEDICAL GROUP - INFECTIOUS DI
2643 PATTERSON RD
GRAND JUNCTION,CO815061937
OUTPATIENT PHYSICIAN CLINIC
78 78 - GOOD SAMARITAN MEDICAL CENTER - CANCER C
340 EXEMPLA CIR
LAFAYETTE,CO80026
OUTPATIENT PHYSICIAN CLINIC
79 79 - SCL HEALTH MEDICAL GROUP - LARKRIDGE
16570 WASHINGTON ST
THORNTON,CO800238964
OUTPATIENT PHYSICIAN CLINIC
80 80 - LUTHERAN MEDICAL CENTER - CANCER CENTERS
8300 W 38TH AVE
WHEAT RIDGE,CO80033
OUTPATIENT PHYSICIAN CLINIC
81 81 - SCL HEALTH MEDICAL GROUP - CENTRAL PARK
2807 ROSLYN ST
DENVER,CO802382624
OUTPATIENT PHYSICIAN CLINIC
82 82 - SCLHFR LM SPINE CARE SCL HEALTH MEDICAL
1687 COLE BLVD
LAKEWOOD,CO80401
OUTPATIENT PHYSICIAN CLINIC
83 83 - SCL HEALTH MEDICAL GROUP - VIRTUAL CARE
8550 W 38TH AVE
WHEAT RIDGE,CO80033
OUTPATIENT PHYSICIAN CLINIC
84 84 - SCL HEALTH MEDICAL GROUP - BRIGHTON DIAB
1606 PRAIRIE CENTER PARKWAY
BRIGHTON,CO80601
OUTPATIENT PHYSICIAN CLINIC
85 85 - SCL HEALTH MEDICAL GROUP - LAFAYETTE URO
300 EXEMPLA CIR
LAFAYETTE,CO800263392
OUTPATIENT PHYSICIAN CLINIC
86 86 - SCL HEALTH MEDICAL GROUP - ENDOCRINOLOGY
2686 PATTERSON RD
GRAND JUNCTION,CO81506
OUTPATIENT PHYSICIAN CLINIC
87 87 - SCL HEALTH MEDICAL GROUP - GREEN MOUNTAI
12792 C-1 W ALAMEDA PKWY
LAKEWOOD,CO802282850
OUTPATIENT PHYSICIAN CLINIC
88 88 - SCL HEALTH MEDICAL GROUP - LOWRY
63 N QUEBEC ST
DENVER,CO80230
OUTPATIENT PHYSICIAN CLINIC
89 89 - SCL HEALTH MEDICAL GROUP - CONGRESS PARK
1400 JACKSON ST
DENVER,CO802062761
OUTPATIENT PHYSICIAN CLINIC
90 90 - SCL HEALTH HEART AND VASCULAR INSTITUTE
1536 COLE BLVD STE 110
LAKEWOOD,CO804013426
OUTPATIENT PHYSICIAN CLINIC
91 91 - SCL HEALTH MEDICAL GROUP - LUTHERAN WEIG
3455 LUTHERAN PKWY
WHEAT RIDGE,CO80033
OUTPATIENT PHYSICIAN CLINIC
92 92 - SCL HEALTH MEDICAL GROUP - LAFAYETTE OB-
300 EXEMPLA CIRCLE
LAFAYETTE,CO800263395
OUTPATIENT PHYSICIAN CLINIC
93 93 - SCL HEALTH MEDICAL GROUP INPATIENT CON
2635 N 7TH ST
GRAND JUNCTION,CO815068209
OUTPATIENT PHYSICIAN CLINIC
94 94 - SCL HEALTH MEDICAL GROUP - NEUROLOGY
750 HOSPITAL LOOP
CRAIG,CO81625
OUTPATIENT PHYSICIAN CLINIC
95 95 - SCL HEALTH MEDICAL GROUP - LUTHERAN WEIG
3455 LUTHERAN PKWY
WHEAT RIDGE,CO80033
OUTPATIENT PHYSICIAN CLINIC
96 96 - SCL HEALTH HEART & VASCULAR INSTITUTE
296 STAFFORD LN
DELTA,CO814162243
OUTPATIENT PHYSICIAN CLINIC
97 97 - SCL HEALTH MEDICAL GROUP - NEUROLOGY
1280 N MILDRED RD
CORTEZ,CO81321
OUTPATIENT PHYSICIAN CLINIC
98 98 - SCL HEALTH ST MARY'S WOUND & HYPERBAR
2635 N 7TH ST
GRAND JUNCTION,CO815018209
OUTPATIENT PHYSICIAN CLINIC
99 99 - SCL HEALTH MEDICAL GROUP - WHEAT RIDGE D
3555 LUTHERAN PKWY
WHEAT RIDGE,CO800336000
OUTPATIENT PHYSICIAN CLINIC
100 100 - SCL HEALTH MEDICAL GROUP - NEUROLOGY
350 MARKET AVE
BASALT,CO816217405
OUTPATIENT PHYSICIAN CLINIC
101 101 - SCL HEALTH MEDICAL GROUP - NEUROLOGY
711 N TAYLOR ST
GUNNISON,CO812302243
OUTPATIENT PHYSICIAN CLINIC
102 102 - SCL HEALTH HEART & VASCULAR INSTITUTE -
23770 E SMOKY HILL RD
AURORA,CO80016
OUTPATIENT PHYSICIAN CLINIC
103 103 - SCL HEALTH MEDICAL GROUP- WHEATRIDGE URO
1960 N OGDEN ST
DENVER,CO80218
OUTPATIENT PHYSICIAN CLINIC
104 104 - SCL HEALTH MEDICAL GROUP PODIATRY
627 25 1/2 ROAD
GRAND JUNCTION,CO81505
OUTPATIENT PHYSICIAN CLINIC
105 105 - ST MARY'S MEDICAL CENTER - CANCER CENTER
750 HOSPITAL LOOP
CRAIG,CO816258750
OUTPATIENT PHYSICIAN CLINIC
106 106 - SCL HEALTH MEDICAL GROUP - NEUROLOGY
476 WEST WILLIAM WAY
MOAB,UT84532
OUTPATIENT PHYSICIAN CLINIC
107 107 - ST MARY'S MEDICAL CENTER - CANCER CENTER
450 WEST WILLIAMS WAY
MOAB,UT845322185
OUTPATIENT PHYSICIAN CLINIC
108 108 - SCL HEALTH MEDICAL GROUP - MATERNAL FETA
711 N TAYLOR ST
GUNNISON,CO812302243
OUTPATIENT PHYSICIAN CLINIC
109 109 - ST MARY'S MEDICAL CENTER - CANCER CENTER
501 AIRPORT ROAD
RIFLE,CO816508510
OUTPATIENT PHYSICIAN CLINIC
110 110 - SCL HEALTH MEDICAL GROUP - LUNG NODULE C
1960 N OGDEN ST
DENVER,CO802183673
OUTPATIENT PHYSICIAN CLINIC
111 111 - SCL HEALTH MEDICAL GROUP - CENTER FOR BR
575 RIVERGATE LN
DURANGO,CO813017488
OUTPATIENT PHYSICIAN CLINIC
112 112 - LUTHERAN SPINE CENTER AT PVB
1606 PRARIE CENTER PARKWAY
BRIGHTON,CO80601
OUTPATIENT PHYSICIAN CLINIC
113 113 - SCL HEALTH MEDICAL GROUP LUNG & SLEEP
0401 CASTLE CREEK ROAD
ASPEN,CO81611
OUTPATIENT PHYSICIAN CLINIC
114 114 - SCL HEALTH MEDICAL GROUP - NEUROSURGERY-
1960 OGDEN STREET
DENVER,CO802183671
OUTPATIENT PHYSICIAN CLINIC
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 10
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
PART I, LINE 6A: THIS ORGANIZATION IS PART OF SCL HEALTH SYSTEM WHICH PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT ON A CONSOLIDATED BASIS. THE REPORT IS PREPARED BY THE PARENT COMPANY, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC.
PART I, LINE 7: THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H AND 7I ARE REPORTED AT COST AS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS.
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 19,744,503.
PART II, COMMUNITY BUILDING ACTIVITIES: LUTHERAN MEDICAL CENTER:COMMUNITY-BUILDING ACTIVITIES ARE THOSE THAT IMPROVE THE HEALTH AND SAFETY OF COMMUNITY MEMBERS BY ADDRESSING THE ROOT CAUSES OF PROBLEMS (E.G. POVERTY, HOMELESSNESS, AND ENVIRONMENTAL HAZARDS). IN 2021, LMC CONTINUED TO EXPAND SEVERAL PARTNERSHIPS INTENDED TO DIRECTLY ADDRESS THE HEALTH AND SAFETY NEEDS OF RESIDENTS OF JEFFERSON COUNTY. ONE EXAMPLE IS A STRENGTHENED COLLABORATION WITH COMMUNITY TABLE, RED ROCKS COMMUNITY COLLEGE, AND STRIDE. THROUGH THIS MULTISECTORIAL PARTNERSHIP WE HAVE BEEN ABLE TO IDENTIFY AND OFFER PROGRAMMING TO FOOD INSECURE JEFFERSON COUNTY RESIDENTS WHO HAVE A CHRONIC HEALTH CONDITION THAT IS MANAGEABLE THROUGH DIET. THROUGH EDUCATION, FREQUENT BIOMETRIC SCREENING, COOKING CLASSES, AND BUILDING TRUSTED RELATIONSHIPS COMMUNITY MEMBERS HAVE BEEN ABLE TO SEE CHANGES IN THEIR HEALTH RELATED TO CHANGES IN DIETARY HABITS AND FOOD ACCESS.2021 ALSO SAW DEVELOPMENT OF A NEW PARTNERSHIP WITH THE JEFFERSON COUNTY PUBLIC LIBRARY. LMC IS FINANCIALLY SUPPORTING THE DEVELOPMENT OF NEW PROGRAMMING TARGETING THE MENTAL HEALTH NEEDS OF COMMUNITY MEMBERS EXPERIENCING UNSTABLE HOUSING AND SUBSTANCE USE ISSUES. WEEKLY PROGRAM MEETINGS WILL PROVIDE AN OPPORTUNITY FOR COMMUNITY MEMBERS TO MEET ONE-ON-ONE WITH A MENTAL HEALTH PROFESSIONAL.GOOD SAMARITAN MEDICAL CENTER:COMMUNITY-BUILDING ACTIVITIES ARE THOSE THAT IMPROVE THE HEALTH AND SAFETY OF COMMUNITY MEMBERS BY ADDRESSING THE ROOT CAUSES OF PROBLEMS (E.G. POVERTY, HOMELESSNESS, AND ENVIRONMENTAL HAZARDS). GOOD SAMARITAN MEDICAL CENTER (GSMC) CONTINUES TO BE INTENTIONAL IN BUILDING COMMUNITY RELATIONSHIPS WITH LOCAL ORGANIZATIONS TO ADDRESS THE HEALTH OF OUR COMMUNITY. THIS IS ADDRESSED THROUGH STAFF PARTICIPATION ON SEVERAL COMMUNITY BOARDS, INVESTMENT IN COMMUNITY WORK GROUPS AND COALITIONS, SUCH AS THE BOULDER COUNTY PUBLIC HEALTH IMPROVEMENT PROCESS (PHIP) STEERING COMMITTEE. PROVIDED SUPPORT FOR EMERGENCY PREPAREDNESS AND DISASTER READINESS. ACTIVELY WORK WITH LOCAL STAKEHOLDERS TO ENSURE SOCIAL DETERMINANTS OF HEALTH ARE INCLUDED IN COMMUNITY IMPROVEMENT PROJECTS - HEALTH PROFESSIONS EDUCATION, HOUSING, AND SAFETY.PART III, LINE 1THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) STATEMENT NO. 15 TO THE EXTENT THAT HFMA STATEMENT NO. 15 FOLLOWS THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) FOR THE REPORTING OF BAD DEBT.
PART III, LINE 2: THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS AT CHARGES AS RECORDED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS.
PART III, LINE 4: THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS.THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE AND/OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN AND PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS.CERTAIN PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT BECAUSE THE ORGANIZATION DOES NOT HAVE SUFFICIENT INFORMATION TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR FREE CARE OR FINANCIAL AID. THEREFORE, IT IS POSSIBLE THAT SOME BAD DEBT IS ACTUALLY CHARITY CARE. HOWEVER, IF A PATIENT ACCOUNT IS WRITTEN OFF TO BAD DEBT AND THE COLLECTION AGENCY LATER DETERMINES THAT THE PATIENT WOULD HAVE QUALIFIED FOR FREE CARE OR FINANCIAL AID, THEN THE BAD DEBT EXPENSE IS RECLASSIFIED TO CHARITY CARE. THE FOLLOWING IS THE TEXT OF THE FOOTNOTE IN THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES THE BAD DEBT ALLOWANCE AND BAD DEBT EXPENSE: NET PATIENT SERVICE REVENUE GENERALLY RELATES TO CONTRACTS WITH PATIENTS IN WHICH THE PERFORMANCE OBLIGATIONS ARE TO PROVIDE HEALTH CARE SERVICES TO PATIENTS OVER A PERIOD OF TIME. REVENUE IS ESTIMATED FOR PATIENTS WHO HAVE NOT BEEN DISCHARGED AS OF THE REPORTING PERIOD BASED ON ACTUAL CHARGES INCURRED TO DATE IN RELATION TO TOTAL EXPECTED CHARGES. SCL HEALTH BELIEVES THIS METHOD PROVIDES A FAITHFUL DEPICTION OF THE TRANSFER OF SERVICES OVER THE TERM OF THE PERFORMANCE OBLIGATION BASED ON THE INPUTS NEEDED TO SATISFY THE OBLIGATION. THE CONTRACTUAL RELATIONSHIP WITH PATIENTS ALSO TYPICALLY INVOLVES A THIRD-PARTY PAYOR (MEDICARE, MEDICAID, MANAGED CARE PLANS, AND COMMERCIAL INSURANCE COMPANIES), AND THE TRANSACTION PRICES FOR THE SERVICES PROVIDED ARE DEPENDENT UPON THE TERMS PROVIDED BY OR NEGOTIATED WITH THE THIRD-PARTY PAYORS. THE PAYMENT ARRANGEMENTS WITH THIRD-PARTY PAYORS FOR THE SERVICES PROVIDED TO THE RELATED PATIENTS TYPICALLY SPECIFY PAYMENT OR REIMBURSEMENT TO SCL HEALTH AT OTHER-THAN-STANDARD CHARGES. BECAUSE ALL OF ITS PERFORMANCE OBLIGATIONS RELATE TO CONTRACTS WITH A DURATION OF LESS THAN ONE YEAR, SCL HEALTH HAS ELECTED TO APPLY THE OPTIONAL EXEMPTION NOT TO DISCLOSE THE AGGREGATE AMOUNT OF THE TRANSACTION PRICE ALLOCATED TO PERFORMANCE OBLIGATIONS THAT ARE UNSATISFIED OR PARTIALLY SATISFIED AT THE END OF THE REPORTING PERIOD. THE UNSATISFIED OR PARTIALLY SATISFIED PERFORMANCE OBLIGATIONS REFERRED TO ABOVE ARE PRIMARILY RELATED TO INPATIENT SERVICES AT THE END OF THE REPORTING PERIOD. THE PERFORMANCE OBLIGATIONS FOR THESE CONTRACTS ARE GENERALLY COMPLETED WHEN PATIENTS ARE DISCHARGED, WHICH GENERALLY OCCURS WITHIN DAYS OR WEEKS OF THE END OF THE REPORTING PERIOD. NET PATIENT SERVICE REVENUE IS REPORTED AT ESTIMATED AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED AND INCLUDES ESTIMATES OF IMPLICIT PRICE CONCESSIONS AND RETROACTIVE REVENUE ADJUSTMENTS DUE TO AUDITS, REVIEWS, AND INVESTIGATIONS. IMPLICIT PRICE CONCESSIONS RELATE PRIMARILY TO UNINSURED PATIENTS AND PATIENTS WITH CO-PAYS, CO-INSURANCE, AND DEDUCTIBLES AND ARE ESTIMATED BASED ON HISTORICAL COLLECTION DATA. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, OR INVESTIGATIONS.
PART III, LINE 8: THE ORGANIZATION BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS WE INCUR IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. PROVIDING THESE SERVICES CLEARLY LESSENS THE BURDENS OF THE GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINES 5, 6 AND 7, OUR MEDICARE "ALLOWABLE COSTS" CLEARLY EXCEED THE PAYMENTS WE RECEIVE FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. BY ABSORBING THE MEDICARE SHORTFALL COSTS WE ARE PROVIDING A COMMUNITY BENEFIT AS WELL AS EASING THE BURDEN OF THE FEDERAL GOVERNMENT HAVING TO COVER THESE COSTS.TO ARRIVE AT THE FORM 990, SCHEDULE H, PART III, LINE 6 AMOUNT, WE USED ACTUAL MEDICARE CHARGES FROM INTERNAL RECORDS AND APPLIED AN ESTIMATED COST TO CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS. THE ESTIMATED MEDICARE COST TO CHARGE RATIO IS THE PRIOR PERIOD MEDICARE COST REPORT COST TO CHARGE RATIO.
PART III, LINE 9B: AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WEMAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TOTHOSE WHO NEED IT MOST AND ENSURE THAT WE MANAGE OUR RESOURCES SOWE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. THE ORGANIZATION NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND DISCHARGE. IN ADDITION, THE PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED.
PART VI, LINE 2: LUTHERAN MEDICAL CENTER:AS PART OF LUTHERAN MEDICAL CENTER'S CORE VALUE OF SERVICE TO THE POOR AND VULNERABLE, THE HOSPITAL TAKES STEPS TO DETERMINE WHERE THERE IS THE MOST NEED IN ORDER TO PROVIDE THE GREATEST GOOD THROUGH INCREMENTAL REVIEW OF CURRENT NEEDS ACROSS THE COMMUNITIES SERVED. AS AN ACTIVE MEMBER AND LEADER OF THE NEWLY FORMED JEFFERSON COUNTY HEALTH ALLIANCE, THE HOSPITAL IS IN TOUCH WITH CURRENT NEEDS AND POISED TO RESPOND WHEN NEW NEEDS ARE IDENTIFIED. AN EXAMPLE OF THIS RESPONSIVE APPROACH CAN BE FOUND IN THE LMC PIVOT RELATED TO ITS VACCINE RESPONSE WHEN LAGS IN UPTAKE WERE IDENTIFIED. AS DATA REVEALED A DISPROPORTIONATELY LOW PARTICIPATION IN COVID VACCINATION AMONG COMMUNITY MEMBERS IDENTIFYING AS HISPANIC, LMC INITIATED A COMMUNICATION EFFORT. WIDE DISSEMINATION OF SPANISH LANGUAGE FLYERS, SPANISH SPEAKING COMMUNITY NAVIGATORS, AND CHANGES TO THE ID AND INSURANCE PREFERENCES ALL LEAD TO A 112% INCREASE IN UPTAKE IN THE POPULATION OF FOCUS.GOOD SAMARITAN MEDICAL CENTER:IN ADDITION TO THE CHNA PROCESS, GSMC ACTIVELY PARTICIPATES WITH COMMUNITY COALITIONS AND WORK GROUPS WHO WORK ON SPECIFIC HEALTH ISSUES WITHIN THE COMMUNITY. THESE PARTNERSHIPS ENABLE AN ABILITY TO REVIEW OUTCOME METRICS ON HEALTH ISSUES IN A MORE DYNAMIC FASHION, EITHER THROUGH PROGRAM DELIVERY RESULTS, SERVICES TO VULNERABLE POPULATIONS AND/OR ANNUAL MEETINGS. INTERNAL TRACKING AND REVIEWS ARE COMPLETED IN ORDER TO CONFIRM THAT GSMC PROGRAMS ARE MEETING THEIR GOALS TO ADDRESS THE NEEDS OF THE COMMUNITY.
PART VI, LINE 3: THE ORGANIZATION NOTIFIES PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND PRIOR TO DISCHARGE. NOTICES ABOUT THE FINANCIAL ASSISTANCE POLICY ARE DISPLAYED THROUGHOUT THE HOSPITAL. IN ADDITION, PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS AND THROUGH THE PATIENT PORTAL, MYCHART. THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE POSTED ON THE HOSPITAL'S WEBSITE. THE POLICY AND APPLICATION ARE ALSO AVAILABLE UPON REQUEST. THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE AND/OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN, PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS.
PART VI, LINE 4: LUTHERAN MEDICAL CENTER:LUTHERAN MEDICAL CENTER (LMC) IS SITUATED IN THE WESTERN PORTION OF THE DENVER METROPOLITAN AREA IN THE CITY OF WHEAT RIDGE, COLORADO. THIS ACUTE CARE FACILITY HAS A SERVICE AREA THAT SERVES SEVERAL COMMUNITIES IN THE WESTERN METROPOLITAN AREA INCLUDING WHEAT RIDGE, ARVADA, GOLDEN, LAKEWOOD, WESTMINSTER AS WELL AS COMMUNITIES IN THE FOOTHILLS OF THE FRONT RANGE. LMC'S PRIMARY SERVICE AREA CONSISTS OF 18 STANDARD ZIP CODES, MAINLY LOCATED IN JEFFERSON COUNTY (13 ZIP CODES), BUT ALSO REPRESENTED BY ZIP CODES IN THE COUNTIES OF DENVER (3 ZIP CODES), ADAMS (1 ZIP CODE) AND GILPIN (1 ZIP CODE). THE SECONDARY SERVICE AREA INCLUDES 20 ZIP CODES AND EXTENDS THROUGH ADAMS COUNTY, BROOMFIELD COUNTY, CLEAR CREEK COUNTY, DENVER COUNTY AND JEFFERSON COUNTY. THE PRIMARY SERVICE AREA IS DEFINED AS THE GEOGRAPHIC AREA OF CONTIGUOUS ZIP CODES FROM WHICH THE HOSPITAL DRAWS APPROXIMATELY 75% OF ITS INPATIENT DISCHARGES AND THE COMBINED PRIMARY AND SECONDARY SERVICE AREA IS BASED ON APPROXIMATELY 90% OF DISCHARGES. LMC'S MAIN CONCENTRATION OF CARE IS PROVIDED TO THE COMMUNITIES OF WHEAT RIDGE, ARVADA AND GOLDEN. 50% OF THE CARE SITE'S DISCHARGES COME FROM EIGHT ZIP CODES WITHIN THOSE CITIES. ADDITIONALLY, LMC SERVICES THE MOST PATIENTS WITHIN ITS PRIMARY SERVICE AREA WHEN COMPARED TO OTHER HOSPITALS FURNISHING CLOSE TO 30% OF THE INPATIENT CARE. LMC AND SAINT ANTHONY HOSPITAL ARE THE ACUTE CARE PROVIDERS IN ALL OF JEFFERSON COUNTY WITH LMC BEING THE ONLY TO OFFER MATERNITY SERVICES. THERE ARE TWO ACUTE CARE HOSPITALS LOCATED IN THE SECONDARY SERVICE AREA, NORTH SUBURBAN MEDICAL CENTER (AN AFFILIATE OF THE FOR-PROFIT HEALTHONE SYSTEM) AND DENVER HEALTH (GOVERNMENT OWNED). BESIDES LMC AND GOOD SAMARITAN MEDICAL CENTER, THERE ARE FIVE OTHER NOT-FOR-PROFIT HOSPITALS IN THE COMMUNITY:- ST. ANTHONY NORTH HOSPITAL-CENTURA HEALTH, WESTMINSTER- ST. ANTHONY WEST HOSPITAL-CENTURA HEALTH, LAKEWOOD- AVISTA ADVENTIST HOSPITAL-CENTURA HEALTH, LOUISVILLE- LONGMONT UNITED HOSPITAL, LONGMONT- BOULDER COMMUNITY HOSPITAL, BOULDERTHERE IS ALSO ONE FOR-PROFIT HOSPITAL, NORTH SUBURBAN MEDICAL CENTER-HEALTHONE,THORNTON.THE COMMUNITY SERVED BY LMC CONTAINS THE FOLLOWING DEMOGRAPHIC INFORMATION, UPDATED FOR 2021, USING THE RESOURCES OF COUNTY HEALTH RANKINGS, US CENSUS DATA, STATE HEALTH DEPARTMENT DATA AND THE EXISTING CHNA.POPULATIONFROM 2015 - 2019, THE AVERAGE POPULATION OF THE LUTHERAN MEDICAL CENTER (LMC) SERVICE AREA WAS 595,832. JEFFERSON COUNTY'S POPULATION WAS 574,798. COLORADO'S TOTAL POPULATION WAS 5,610,349.YOUTH, AGES 0 - 19 MAKE UP 20% OF THE POPULATION IN THE SERVICE AREA. 63.5% OF THE POPULATION WAS 20 TO 64 YEARS OLD AND 16.4% WERE 65 YEARS AND OLDER. THE SERVICE AREA HAD A LOWER PERCENTAGE OF YOUTH, AGES 0-19, AND A HIGHER PERCENTAGE OF ADULTS, AGES 45 AND OLDER, THAN IN THE STATE.IN THE SERVICE AREA, LITTLETON (80127) HAD THE LARGEST PERCENTAGE OF YOUTH, AGES 5-17, (23.7%) AND KITTREDGE HAD THE SMALLEST PERCENTAGE OF YOUTH (4.2%). BUFFALO CREEK HAD THE HIGHEST PERCENTAGE OF SENIORS (26.8%) AND KITTREDGE HAD THE LOWEST PERCENT OF SENIORS IN THE SERVICE AREA (9.4%). THE MEDIAN AGE IN JEFFERSON COUNTY WAS 40.3 YEARS.RACE AND ETHNICITYIN THE SERVICE AREA, 80.2% OF THE POPULATION IS WHITE, 12.9% ARE HISPANIC/LATINX, 3.0% ARE ASIAN, AND 1.1% ARE BLACK/AFRICAN AMERICAN. THE LMC SERVICE AREA HAD MORE WHITE AND ASIAN RESIDENTS THAN JEFFERSON COUNTY.IN THE SERVICE AREA, BUFFALO CREEK HAS THE HIGHEST PERCENTAGE OF WHITE RESIDENTS (98.7%). DENVER 80226 HAS THE HIGHEST PERCENTAGE OF HISPANIC OR LATINX RESIDENTS (31.6%). IDLEDALE 80453 HAS THE HIGHEST PERCENTAGE OF ASIANS (17.3%) AND DENVER 80235 HAS THE HIGHEST PERCENTAGE OF BLACKS (5.8%) IN THE SERVICE AREA.LANGUAGEOVER THREE-QUARTERS OF THE SERVICE AREA POPULATION, AGES 5 YEARS AND OLDER, SPEAK ONLY ENGLISH IN THE HOME (90.2%). 9.8% SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME, AND 5.2% OF THE POPULATION SPEAKS SPANISH IN THE HOME. COLORADO'S RATES OF SPANISH SPEAKING AT THE HOME AND SPEAKING A LANGUAGE OTHER THAN ENGLISH AT HOME WERE HIGHER THAN THE SERVICE AREA.GOOD SAMARITAN MEDICAL CENTER:GOOD SAMARITAN MEDICAL CENTER (GSMC) IS LOCATED IN THE CITY OF LAFAYETTE, COLORADO. WHILE LAFAYETTE IS SITUATED IN BOULDER COUNTY, THE HOSPITAL SERVICE AREA INCLUDES COMMUNITIES IN ADAMS, BOULDER, BROOMFIELD, GILPIN, JEFFERSON, AND WELD COUNTIES. TOTAL POPULATION: ON AVERAGE, FROM 2015 TO 2019, THE POPULATION OF THE GSMC SERVICE AREA WAS 1,111,074. ADAMS COUNTY HAD A POPULATION OF 504,108, BOULDER COUNTY'S POPULATION WAS 322,510, AND BROOMFIELD COUNTY'S POPULATION WAS 67,886.POPULATION BY GENDER: IN THE GSMC SERVICE AREA, 50.3% WERE MALE AND 49.7% WERE FEMALE.POPULATION BY AGE: YOUTH AGES 0 TO 19 COMPRISE 26.5% OF THE POPULATION IN THE SERVICE AREA. JUST OVER 61% OF THE POPULATION WAS 20 TO 64 YEARS OLD, AND 12.6% WERE AGES 65 YEARS AND OLDER. ADAMS AND WELD COUNTIES HAD THE HIGHEST PERCENTAGE OF YOUTH, AGES 0-19, (29.3%). GILPIN COUNTY HAD THE HIGHEST PERCENTAGE OF SENIORS (17.9%) AS A PROPORTION OF THE TOTAL POPULATION. POPULATION BY YOUTH, AGES 0-17 AND SENIORS, AGES 65+, AND MEDIAN AGE: COMMERCE CITY HAD THE LARGEST PERCENTAGE OF YOUTH, AGES 5-17 (32.8%) AND BOULDER (80310- UNIVERSITY OF COLORADO) HAD THE SMALLEST PERCENTAGE OF YOUTH (0.3%) IN THE SERVICE AREA. BOULDER (80310-UNIVERSITY OF COLORADO) ALSO HAD THE SMALLEST PERCENTAGE OF SENIORS (0.0%). WHEAT RIDGE (80033) HAD THE HIGHEST PERCENTAGE OF SENIORS (19.8%) IN THE SERVICE AREA. THE SERVICE AREA HAD A MEDIAN AGE OF 36.4 YEARS. MEDIAN AGE IN ADAMS COUNTY WAS 33.8 YEARS AND IN 34.4 YEARS IN WELD COUNTY WHICH WERE LOWER THAN THE STATE MEDIAN OF 36.7 YEARS. ALL OTHER COUNTIES HAD MEDIAN AGES THAT WERE HIGHER THAN THE STATE MEDIAN WHICH INCLUDE BOULDER COUNTY 36.6, BROOMFIELD COUNTY 37.8, JEFFERSON COUNTY 40.3, AND GILPIN COUNTY 49.0.RACE/ ETHNICITY: IN THE SERVICE AREA, 69.3% OF THE POPULATION IS WHITE, 22.7% ARE HISPANIC/LATINX, 3.9% ARE ASIAN, AND 1.2% ARE BLACK/AFRICAN AMERICAN. THE SERVICE AREA HAD A GREATER PERCENTAGE OF WHITE, LATINX, AND ASIAN-AMERICAN INDIVIDUALS THAN COLORADO OVERALL. RACE/ ETHNICITY BY PLACE: OVER HALF OF THE POPULATION IN COMMERCE CITY (53.4%) IS HISPANIC OR LATINX. BROOMFIELD 80023 HAD THE HIGHEST PERCENTAGE OF ASIANS (7.4%) IN THE SERVICE AREA. GOLDEN (80403) HAD THE HIGHEST PERCENTAGE OF WHITES (90.9%) AND COMMERCE CITY (80022) HAD THE LARGEST PERCENTAGE OF AFRICAN AMERICANS (4.7%) IN THE SERVICE AREA. CITIZENSHIP, 2019: AMONG AREA COUNTIES, 15.3% OF ADAMS COUNTY, 10.7% OF BOULDER COUNTY, 8.9% OF BROOMFIELD COUNTY, 8.7% OF WELD COUNTY, 6.4% OF JEFFERSON COUNTY, AND 4.6% GILPIN COUNTY RESIDENTS WERE FOREIGN BORN. THIS WAS HIGHER THAN THE 9.7% OF THE STATE POPULATION WHO WERE FOREIGN BORN. OF THE FOREIGN BORN IN WELD COUNTY, 64.3% WERE NOT U.S. CITIZENS, FOLLOWED BY ADAMS COUNTY 63.1%, BOULDER COUNTY 57.4%, GILPIN COUNTY 54.3%, JEFFERSON COUNTY 45.7% AND BROOMFIELD HAD THE LOWEST PERCENTAGE, 41%, OF FOREIGN BORN RESIDENTS THAT WERE NOT U.S. CITIZENS. LANGUAGE SPOKEN AT HOME FOR THE POPULATION 5 YEARS AND OVER: IN THE SERVICE AREA, 87.9% OF THE POPULATION, AGES 5 YEARS AND OLDER, SPEAK ONLY ENGLISH IN THE HOME. JUST UNDER 18% SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME, AND 12.1% OF THE POPULATION SPEAKS SPANISH AT HOME. ADAMS COUNTY HAD THE HIGHEST RATE OF RESIDENTS SPEAKING A LANGUAGE OTHER THAN ENGLISH AT HOME (29.0%) AND GILPIN COUNTY HAD THE LOWEST (6.7%). ADAMS COUNTY HAD THE HIGHEST RATE OF RESIDENTS WHO SPEAK SPANISH AT HOME (23.6%) AND GILPIN COUNTY HAD THE LOWEST RATE OF RESIDENTS WHO SPEAK SPANISH AT HOME (2.7%).SOCIAL AND ECONOMIC FACTORS RANKINGS: THE COUNTY HEALTH RANKINGS RANKS COUNTIES ACCORDING TO HEALTH FACTORS DATA. SOCIAL AND ECONOMIC INDICATORS ARE EXAMINED AS A CONTRIBUTOR TO THE HEALTH OF A COUNTY'S RESIDENTS. COLORADO'S 64 COUNTIES ARE RANKED ACCORDING TO SOCIAL AND ECONOMIC FACTORS WITH 1 BEING THE COUNTY WITH THE BEST FACTORS TO 64 FOR THAT COUNTY WITH THE POOREST FACTORS. THIS RANKING EXAMINES: HIGH SCHOOL GRADUATION RATES; UNEMPLOYMENT; CHILDREN IN POVERTY; SOCIAL SUPPORT; AND OTHERS. ADAMS COUNTY IS RANKED 38TH, WELD COUNTY CAME IN 28TH, FOLLOWED BY GILPIN COUNTY AT 6TH, JEFFERSON COUNTY AT 15TH, BOULDER COUNTY 13TH, AND BROOMFIELD COUNTY RANKED 2ND. ECONOMICS, 2020: THE MEDIAN HOUSEHOLD INCOME IN THE STATE WAS $77,104. THE COUNTY INCOMES WERE (FROM HIGHEST TO LOWEST) BROOMFIELD ($106,892), JEFFERSON ($89,696), BOULDER ($88,341), WELD ($78,160), ADAMS ($75,341), AND GILPIN ($74,806). SEE CONTINUATION BELOW
PART VI, LINE 5: LUTHERAN MEDICAL CENTER:LMC HAS A MULTITUDE OF PROGRAMS IN PLACE THROUGH ITS CANCER CENTER, NEUROVASCULAR CENTER, TRAUMA CENTER AND THROUGH COMMUNITY OUTREACH. A VARIETY OF CLASSES ARE OFFERED ON WEIGHT MANAGEMENT AND MAINTAINING A HEALTHY LIFESTYLE. SUPPORT GROUPS FOR CANCER PATIENTS ARE ALSO OFFERED. ADDITIONALLY, LMC ROUTINELY OFFERS COMMUNITY HEALTH EDUCATION, SKIN CANCER SCREENINGS, BREAST CANCER SURVIVORSHIP PROGRAMS, CLASSES FOR PROSPECTIVE PARENTS AND DIABETES MANAGEMENT CLASSES, TO NAME A FEW. LMC PARTNERS WITH SAFETY NET CLINICS SUCH AS STRIDE. LMC ALSO RECOGNIZES THE ESSENTIAL NEED TO ENHANCE AND IMPROVE MEDICAL OUTCOMES, QUALITY, AND SERVICES. THE OBJECTIVES OF THESE PROGRAMS ARE TO BE A HIGHLY RELIABLE ORGANIZATION, OFFER HIGH QUALITY CARE, PROVIDE SAFETY FOR PATIENTS AND STAFF, AND BE COST EFFECTIVE. THE QUALITY INDICATORS ARE IN ALIGNMENT WITH MAJOR PUBLICLY COMPARABLE DATABASES INCLUDING THE COLORADO HEALTH AND HOSPITAL ASSOCIATION AND CENTERS FOR MEDICARE AND MEDICAID SERVICES. GOOD SAMARITAN MEDICAL CENTER:COLLECTIVELY WITH ITS 234 LICENSED BEDS, GOOD SAMARITAN MEDICAL CENTER (GSMC) HAS SERVED ITS COMMUNITY BY PROVIDING COMPREHENSIVE MEDICAL SERVICES INCLUDING CARDIOLOGY, ONCOLOGY, ORTHOPEDIC, WOMEN AND FAMILY, EMERGENCY AND TRAUMA, NEONATAL INTENSIVE CARE, NEUROLOGY, NEUROSURGERY, OB/GYN, GENERAL SURGICAL AND MEDICAL, PRIMARY CARE, INTERNAL MEDICINE, BEHAVIORAL HEALTH, SENIOR EMERGENCY DEPARTMENT CARE, PALLIATIVE & HOSPICE CARE AND INTEGRATIVE HEALTH SERVICES.COMMUNITY OUTREACH PROGRAMS: OUTREACH PROGRAMS WERE STILL IMPACTED IN 2021 BY COVID RESTRICTIONS AND NOT ALL CLASSES AND OUTREACH EFFORTS HAVE RETURNED TO THE NORMAL. -GSMC PROVIDED FREE COVID VACCINATION CLINICS TO THE PUBLIC ADMINISTERING OVER 28,000 VACCINES.-BABY'S FIRST RIDE- PROVIDED 1061 CAR SEAT CHECKS-AGING MASTERY PROGRAM- THIS IS A COURSE TO HELP OLDER ADULTS IMPROVE HEALTHY BEHAVIORS AND TO LEARN BEHAVIORS THAT WILL INCREASE WELL-BEING AS THEY AGE. THE CLASS CONSISTS OF TEN 1.5 HOUR CLASSES AND COVER TOPICS SUCH AS: FALL PREVENTION; MEDICATION MANAGEMENT; HEALTHY EATING AND HYDRATION; FINANCIAL FITNESS; COMMUNITY ENGAGEMENT AND ADVANCE PLANNING. TWELVE PEOPLE ATTENDED THIS CLASS.-CANCER SUPPORT GROUP: TWO GROUPS- ONE SPECIFICALLY FOR YOUNG ADULTS WITH CANCER. OFFERED BY THE CANCER CENTERS OF COLORADO AT GSMC-STROKE SUPPORT GROUP- VIRTUAL GROUP DONE IN COLLABORATION WITH THE ROCKY MOUNTAIN STROKE CENTER.-"DOING GOOD" GRANT - EIGHT GRANTS DISTRIBUTED IN 2021 WORTH NEARLY $114,000. 1) VIA MOBILITY, 2) SISTER CARMEN COMMUNITY CENTER, 3) BROOMFIELD FISH, 4) BROOMFIELD PARKS AND RECREATION, 5) BICYCLE COLORADO, 6) CLINICA FAMILY HEALTH, 7) WOW! CHILDREN'S MUSEUM, 8) MENTAL HEALTH PARTNERS. LOCAL NON-PROFITS WROTE A 4 PAGE APPLICATION TO APPLY FOR THE FUNDS.-EMS PROGRAM TO PROVIDE CONTINUING EDUCATION TO LOCAL EMS PROVIDERS- 624 ENCOUNTERS (FREDERICK-FIRESTONE FIRE DEPARTMENT, LAFAYETTE FIRE DEPARTMENT, PLEASANT VIEW FIRE DEPARTMENT)-EMS PROGRAM TO PROVIDE EDUCATIONAL FOLLOW UP TO EMS PROVIDERS WHO DROPPED OFF PATIENTS AT GSMC- 782 ENCOUNTERS ANNUAL TRAUMA CONFERENCE FOR GSMC AND EMS PROVIDERS (VIRTUAL IN 2021) 282 ATTENDEES-RECERTIFICATION FOR EMS PROVIDERS (39 ENCOUNTERS) PROVIDES PARAMEDIC REFRESHER COURSE, CPR AND AED TRAINING, BASIC EKG TRAINING-IN KIND DONATIONS TO PROJECT CURE IN EXCESS OF $90,000.-QPR SUICIDE PREVENTION TRAINING- 70 STAFF AND COMMUNITY MEMBERS PARTICIPATED IN THIS 1 HOUR COURSE-STUDENT CLINICALS- 212 STUDENTS COMPLETED THEIR CLINICAL ROTATIONS IN NURSING, PHARMACY, RADIOLOGY, LABORATORY, PHYSICAL MEDICINE, SURGERY AT GSMC-WHAT DO YOU CONSIDER LETHAL- TEEN DRIVER TRAINING WHICH ADDRESSES DISTRACTED AND RECKLESS DRIVING. 28 PEOPLE ATTENDED THE CLASS IN 2021.-FRIENDS DON'T LET FRIENDS FALL OBSTACLE COURSE- FALL PREVENTION TRAINING FOR OLDER ADULTS- 27 PEOPLE ATTENDED THE CLASS IN 2021.-BICYCLE SAFETY AND HELMET DISTRIBUTION- 121 ATTENDED THE TRAINING AND 57 HELMETS WERE DISTRIBUTED-FALL PREVENTION EDUCATION AT FESTIVALS AND FAIRS IN COLLABORATION WITH NORTH METRO FIRE- 270 ENCOUNTERS-PROVIDED $500 TO COMMUNITY REACH CENTER TO COVER COST FOR MENTAL HEALTH FIRST AID TRAINING.WE ARE AN IMPORTANT PART OF OUR COMMUNITY AND SERVE IN MANY WAYS, IN RESPONSE TO DIRECT REQUESTS FROM COMMUNITY ORGANIZATIONS AND RESIDENTS. FROM DELIVERING CORE HEALTH CARE TO PREVENTIVE CARE TO SUPPORT OF OTHER CIVIC GROUPS, OUR COMMUNITY INVOLVEMENT TAKES MANY FORMS. OUR BOARD OF DIRECTORS REPRESENTS MEDICAL AND BUSINESS PROFESSIONALS, AND ALL PROVIDE HOURS OF SERVICE IN SUPPORT OF OUR HOSPITAL. THEY ARE DEEPLY INVOLVED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, BUILDING PROGRAMS AND SERVICES, AND COMMUNITY OUTREACH TO ENSURE THAT RESIDENTS ARE INFORMED ABOUT AVAILABLE SERVICES. WHEN GSMC HAS EXCESS REVENUE OVER OPERATING EXPENSES, WE USE THOSE FUNDS TO OBTAIN CURRENT HEALTH CARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CARE, PROVIDE MEDICAL TRAINING EDUCATION AND RESEARCH, AND TO EXPAND ACCESS TO CARE FOR UNMET NEED AREAS.
PART VI, LINE 6: THE ORGANIZATION 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 COMMUNITIES, AS WELL AS IN A VARIETY OF OUTPATIENT SETTINGS AND IN THE HOME. SCLHS IS A FAITH-BASED, NONPROFIT HEALTHCARE ORGANIZATION THAT OPERATES EIGHT HOSPITALS, TWO SAFETY NET CLINICS, ONE CHILDREN'S MENTAL HEALTH CENTER, HOME HEALTH AND MORE THAN 200 PHYSICIAN CLINICS IN THREE STATES - COLORADO, KANSAS AND MONTANA. THE HEALTH SYSTEM INCLUDES MORE THAN 15,700 EMPLOYEES AND MORE THAN 500 EMPLOYED PHYSICIANS.AS OUR HEALTH SYSTEM GROWS, WE'RE LEVERAGING THAT GROWTH TO ACHIEVE BENEFITS OF SCALE - IDENTIFYING COST AND OTHER ADVANTAGES THAT WE GAIN DUE TO OUR SIZE. WE'RE 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.THE ORGANIZATION 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, 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, PART VI, LINE 4 CONTINUED NARRATIVEGOOD SAMARITAN MEDICAL CENTER:HEALTH FACTORS RANKINGS: THE OVERALL RANKINGS IN HEALTH FACTORS REPRESENT WHAT INFLUENCES THE HEALTH OF A COUNTY. THEY ARE AN ESTIMATE OF THE FUTURE HEALTH OF COUNTIES AS COMPARED TO OTHER COUNTIES WITHIN A STATE. THE RANKS ARE BASED ON FOUR TYPES OF MEASURES: HEALTH BEHAVIORS, CLINICAL CARE, SOCIAL AND ECONOMIC, AND PHYSICAL ENVIRONMENT FACTORS. ADAMS COUNTY RANKED 41ST, FOLLOWED BY WELD COUNTY 27TH, JEFFERSON COUNTY 13TH, GILPIN COUNTY 8TH, BOULDER COUNTY 4TH AND BROOMFIELD COUNTY 2ND.HEALTH OUTCOMES RANKINGS: COUNTY HEALTH RANKINGS EXAMINES HEALTHY BEHAVIORS AND RANKS COUNTIES ACCORDING TO HEALTH BEHAVIOR DATA. COLORADO'S 64 COUNTIES ARE RANKED FROM 1 (HEALTHIEST) TO 64 (LEAST HEALTHY) BASED ON A NUMBER OF INDICATORS THAT INCLUDE: ADULT SMOKING, OBESITY, PHYSICAL INACTIVITY, EXCESSIVE DRINKING, SEXUALLY TRANSMITTED INFECTIONS, AND OTHERS. ALL COUNTIES WERE IN THE TOP HALF FOR HEALTH OUTCOMES. ADAMS WAS THE LOWEST AT 30, FOLLOWED BY GILPIN COUNTY AT 28, WELD COUNTY AT 19, JEFFERSON COUNTY AT 12, BOULDER COUNTY AT NUMBER 5 AND BROOMFIELD COUNTY AT 4 FOR COLORADO. EMPLOYMENT STATUS FOR THE POPULATION 16 AND OVER (2019): WITHIN THE SERVICE AREA, BOULDER (UNIVERSITY OF COLORADO) 80310 (11.9%) AND WESTMINSTER 80030 (6.7%) HAD THE HIGHEST UNEMPLOYMENT RATES AND BLACK HAWK HAD THE LOWEST UNEMPLOYMENT RATE (1.2%). AMONG THE COUNTIES IN THE SERVICE REGION, GILPIN COUNTY HAD THE LOWEST UNEMPLOYMENT RATE (1.5%) AND BOULDER COUNTY HAD THE HIGHEST (4.2%). THE UNEMPLOYMENT RATE FOR THE HOSPITAL SERVICE AREA WAS 4.0%. COLORADO HAD A HIGHER UNEMPLOYMENT RATE (4.3%) THAN THE SERVICE AREA.POVERTY LEVELS, 2019: POVERTY THRESHOLDS ARE USED FOR CALCULATING OFFICIAL POVERTY POPULATION STATISTICS AND ARE UPDATED EACH YEAR BY THE CENSUS BUREAU. FOR 2021, THE FEDERAL POVERTY THRESHOLD FOR ONE PERSON WAS $12,880, AND FOR A FAMILY OF FOUR IT IS $26,500.2 IN THE SERVICE AREA, 9.2% OF THE POPULATION WAS LIVING AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL), AND 22.1% WERE CONSIDERED LOW-INCOME (LIVING AT OR BELOW 200% FPL). THESE POVERTY RATES WERE LOWER THAN THE COUNTY RATES. OF THE COUNTIES IN THE SERVICE AREA, ADAMS COUNTY HAD THE HIGHEST RATE OF RESIDENTS LIVING BELOW 200% OF THE FEDERAL POVERTY LEVEL (29.0%) AND BROOMFIELD COUNTY HAD THE LOWEST RATE (13.6%). BOULDER COUNTY HAD THE HIGHEST RATE OF RESIDENTS LIVING BELOW 100% OF THE FEDERAL POVERTY LEVEL (11.7%) AND GILPIN COUNTY HAD THE LOWEST (4.9%).FREE AND REDUCED-PRICE MEALS ELIGIBILITY, 2017 - 2018: THE NUMBER OF STUDENTS ELIGIBLE FOR THE FREE AND REDUCED-PRICE MEAL (FRPM) PROGRAM IS ONE INDICATOR OF THE SOCIOECONOMIC STATUS OF A SCHOOL DISTRICT'S STUDENT POPULATION. THE PERCENT OF STUDENTS IN ADAMS COUNTY ELIGIBLE FOR THE FRPM PROGRAM WAS 54.3%. IN WELD COUNTY, 42.8% OF STUDENTS WERE ELIGIBLE FOR THE PROGRAM. ADAMS COUNTY HAD THE HIGHEST RATE OF STUDENTS ELIGIBLE FOR FREE AND REDUCED- PRICE MEALS (54.3%) AND BROOMFIELD COUNTY HAD THE LOWEST (18.1%). JUST UNDER 42% OF COLORADO STUDENTS WERE ELIGIBLE FOR THE FRPM PROGRAM.EDUCATIONAL ATTAINMENT (25+): AMONG THE SERVICE AREA POPULATION, AGES 25 AND OLDER, 8.4% HAD NOT ATTAINED A HIGH SCHOOL DIPLOMA. 91.6% OF ADULTS WERE HIGH SCHOOL GRADUATES. 19.3% OF THE POPULATION IN THE SERVICE AREA HAD SOME COLLEGE WITH NO DEGREE, AND 43.9% HAD A BACHELOR'S DEGREE OR HIGHER. BOULDER COUNTY HAD THE HIGHEST RATE OF BACHELOR DEGREE ATTAINMENT AMONG ITS RESIDENTS (62.1%), AND ADAMS COUNTY HAD THE LOWEST (24.3%). ADAMS COUNTY HAD THE HIGHEST RATE OF ADULTS WITHOUT A HIGH SCHOOL DIPLOMA (16.2%) AND GILPIN COUNTY HAD THE LOWEST RATE (1.5%). GILPIN COUNTY HAD THE HIGHEST HIGH SCHOOL GRADUATION RATE (98.5%) AND ADAMS COUNTY HAD THE LOWEST (83.8%). HIGH SCHOOL GRADUATES, 2015 - 2019: HIGH SCHOOL GRADUATION RATES ARE THE PERCENTAGE OF HIGH SCHOOL GRADUATES THAT GRADUATED FOUR YEARS AFTER STARTING NINTH GRADE. GILPIN COUNTY HAD THE HIGHEST HIGH SCHOOL GRADUATION RATE (98.5%) AND ADAMS COUNTY HAD THE LOWEST (83.3%). THE STATE RATE WAS AT 91.7%. THE HEALTHY PEOPLE 2030 OBJECTIVE FOR HIGH SCHOOL GRADUATION IS 90.7%. ONLY ADAMS AND WELD COUNTIES WERE BELOW THE STATE AND HEALTHY PEOPLE 2030 RATES.HOMELESS POINT-IN-TIME COUNT, JANUARY 2020: A HOMELESS POINT IN TIME (PIT) COUNT IS A FEDERALLY MANDATED COUNT OF PERSONS EXPERIENCING HOMELESSNESS AT ANY GIVEN NIGHT IN A COMMUNITY. IN 2020, THE WELD COUNTY PIT COUNT WAS JANUARY 28, AND, GIVEN THE NEWNESS OF THE NORTHERN COLORADO CONTINUUM OF CARE, ONLY A SHELTERED COUNT WAS COMPLETED. THE TOTAL NUMBER OF SHELTERED HOMELESS IN WELD COUNTY AT THE PIT COUNT IN 2020 WAS 240 PERSONS. ABOUT 73% OF THE SHELTERED HOMELESS WERE HOUSED IN EMERGENCY SHELTERS, 15% WERE CHRONICALLY HOMELESS AND 34% HAD A DISABLING CONDITION.FERTILITY RATE, PER 1,000 WOMEN AGES 15-44: IN 2019, THE GENERAL FERTILITY RATE PER 1,000 WOMEN, AGES 15 TO 44, IN ADAMS COUNTY WAS 59.5. IN THE SERVICE AREA, GILPIN COUNTY HAD THE LOWEST GENERAL FERTILITY RATE IN THE SERVICE AREA (29.8 PER 1,000 WOMEN), AND WELD COUNTY HAD THE HIGHEST FERTILITY RATE (61.5 PER 1,000 WOMEN). COLORADO'S FERTILITY RATE WAS 53.7 PER 1,000 WOMEN.LATE ENTRY INTO PRENATAL CARE (AFTER FIRST TRIMESTER) / NO CARE, 2017-2019: ADEQUATE PRENATAL CARE CAN PREVENT HEALTH RISKS IN WOMEN AND PREVENT HEALTH PROBLEMS FOR THE MOTHER AND CHILD. THE HEALTHY PEOPLE 2030 OBJECTIVE IS FOR 80.5% OF WOMEN TO RECEIVE EARLY AND ADEQUATE PRENATAL CARE. 90.1% OF WOMEN IN HSR 16 (BOULDER AND BROOMFIELD COUNTIES) RECEIVED CARE IN THE FIRST TRIMESTER (8.9% DID NOT). HSR 17, GILPIN COUNTY, HAD THE LOWEST RATE OF PRENATAL CARE AMONG PREGNANT WOMEN IN THE SERVICE AREA (88.3%) AND HSR 21, JEFFERSON COUNTY HAD THE HIGHEST RATE (94.7%). 89.9% OF PREGNANT WOMEN IN COLORADO RECEIVED PRENATAL CARE (10.1% DID NOT).LOW BIRTH WEIGHT (UNDER 2,500 G), 2018: LOW BIRTH WEIGHT IS A NEGATIVE BIRTH INDICATOR. BABIES BORN AT A LOW BIRTH WEIGHT ARE AT HIGHER RISK FOR DISEASE, DISABILITY AND POSSIBLY DEATH. FOR THIS MEASUREMENT, A LOWER RATE IS A BETTER INDICATOR. BOULDER COUNTY HAD A 7.8% RATE AND BROOMFIELD COUNTY HAD A 9.3% RATE OF LOW-BIRTH WEIGHT AMONG SINGLE BABY BIRTHS. GILPIN COUNTY HAD THE HIGHEST RATE OF LOW-BIRTH-WEIGHT SINGLE BIRTHS (14.3%), AND BOULDER COUNTY HAD THE LOWEST RATE (7.8%). 9.4% OF COLORADO BIRTHS WERE LOW WEIGHT.INFANT MORTALITY RATE, 2018: THE INFANT MORTALITY RATE IS THE NUMBER OF DEATHS OF INFANTS (LESS THAN ONE YEAR OLD) PER 1,000 LIVE BIRTHS. THE HEALTHY PEOPLE 2030 OBJECTIVE HAS AN INFANT MORTALITY RATE GOAL OF 5.0 PER 1,000 LIVE BIRTHS. THE INFANT MORTALITY RATE IN BOULDER COUNTY WAS 3.7 PER 1,000 LIVE BIRTHS AND IN WELD COUNTY IT WAS 4.8 PER 1,000 LIVE BIRTHS. THE RATES IN ALL COUNTIES EXCEPT ADAMS COUNTY ARE LOWER THAN THE HEALTHY PEOPLE 2030 OBJECTIVE. JEFFERSON COUNTY HAD THE LOWEST INFANT MORTALITY RATE (3.6), AND ADAMS COUNTY HAD THE HIGHEST INFANT MORTALITY RATE (5.2). COLORADO HAD AN INFANT MORTALITY RATE OF 4.6.AGE-ADJUSTED DEATH RATE, ALL CAUSES, 2020: WHEN ADJUSTED FOR AGE, THE DEATH RATE FOR ADAMS COUNTY WAS 925.4 PER 100,000 PERSONS, JEFFERSON COUNTY WAS 712.3, WELD COUNTY 697.1, GILPIN COUNTY 628.9, BOULDER COUNTY WAS 600.3 PER 100,000 PERSONS AND IN BROOMFIELD COUNTY THE DEATH RATE WAS 581.2 PER 100,000 PERSONS. ALL COUNTIES EXCEPT ADAMS COUNTY WERE BELOW THE STATE RATE OF 738.7.PREMATURE DEATH RATE 2018: A PREMATURE DEATH RATE IS A DEATH RATE FOR A PERSON UNDER THE AGE OF 75. THE PREMATURE DEATH RATE IN BOULDER COUNTY WAS 205.4 PER 100,000 PERSONS AND IN BROOMFIELD COUNTY, THE PREMATURE DEATH RATE WAS 209.6 PER 100,000 PERSONS. ADAMS COUNTY HAD THE HIGHEST PREMATURE AGE-ADJUSTED DEATH RATE AMONG THE COUNTIES IN THE SERVICE REGION (318.8 PER 100,000 PERSONS), AND BOULDER COUNTY HAD THE LOWEST (205.4 PER 100,000 PERSONS). CANCER DEATH RATE, AGE-ADJUSTED DEATH RATES PER 100,000 PERSONS, 2020: ADAMS COUNTY HAD THE HIGHEST AGE-ADJUSTED RATE OF DEATH FOR ALL CANCERS AT 140.3 AND GILPIN COUNTY WAS THE LOWEST AT 105.4 PER 100,000 PERSONS. ADAMS COUNTY AND WELD COUNTY (133.2 PER 100,000) WERE HIGHER THAN THE STATE RATE OF DEATH BY CANCER (125.1) AND HIGHER THAN THE HEALTHY PEOPLE 2030 OBJECTIVE OF 122.7 PER 100,000 PERSONS FOR ALL CANCERS. ALL OTHER COUNTIES WERE BELOW THE STATE AND HEALTHY PEOPLE 2030 RATES.HEART DISEASE DEATH RATE, AGE - ADJUSTED DEATH RATE PER 100,000 PERSONS, 2020: ADAMS COUNTY HAS AN AGE- ADJUSTED RATE OF DEATH DUE TO HEART DISEASE OF 149.7 FOLLOWED BY JEFFERSON COUNTY OF 127.2, GILPIN COUNTY 107.0, WELD COUNTY 115.8, BROOMFIELD COUNTY 91.5, AND BOULDER COUNTY OF 106.8 PER 100,000 PERSONS. THE RATE FOR THE STATE OF COLORADO WAS 124.7.STROKE DEATH RATE, AGE - ADJUSTED PER 100,000 PERSONS, 2020: THE RATE OF DEATH FOR CEREBROVASCULAR DISEASE IN ADAMS COUNTY WAS 43.8, BOULDER COUNTY 37.2, JEFFERSON COUNTY 31.1, BROOMFIELD COUNTY 23.3 AND WELD COUNTY 27.5 PER 100,000 PERSONS. THE RATE FOR THE STATE OF COLORADO WAS 34.9.
SCHEDULE H, PART VI, LINE 4 UNINTENTIONAL INJURY DEATH RATE, AGE - ADJUSTED PER 100,000 PERSONS, 2020: ADAMS COUNTY HAD THE HIGHEST RATE AT 65.6 FOLLOWED BY GILPIN COUNTY AT 61.6, JEFFERSON COUNTY 60.8, WELD COUNTY 54.7, BOULDER COUNTY 42.4, AND BROOMFIELD COUNTY 39.6 PER 100,000 PERSONS. THESE ALL EXCEED THE HEALTHY PEOPLE 2030 OBJECTIVE FOR UNINTENTIONAL INJURY DEATHS OF 43.2 PER 100,000 PERSONS.DIABETES DEATH RATE, AGE ADJUSTED PER 100,000 PERSONS, 2020: THE AGE - ADJUSTED DEATH RATE FOR DIABETES WAS HIGHEST IN ADAMS COUNTY AT 24.3 FOLLOWED BY WELD COUNTY 20.9, BROOMFIELD COUNTY 12.1, JEFFERSON COUNTY 12.0, AND BOULDER COUNTY 10.6 PER 100,000 PERSONS.PNEUMONIA DEATH RATE, AGE- ADJUSTED PER 100,000 PERSONS, 2020: THE DEATH RATE FROM PNEUMONIA HIGHEST IN ADAMS COUNTY WAS 6.7, FOLLOWED BY BROOMFIELD COUNTY AT 5.9, WELD COUNTY 5.8, BOULDER COUNTY 5.6, AND JEFFERSON COUNTY AT 5.3 PER 100,000 PERSONS. THE RATE FOR THE STATE OF COLORADO WAS 5.8 PER 100,000 PERSONS.SUICIDE DEATH RATE, AGE-ADJUSTED PER 100,000 PERSONS, 2020: THE COUNTY WITH THE HIGHEST RATE OF DEATH BY SUICIDE WAS ADAMS COUNTY AT 22.0 PER 100,000, FOLLOWED BY WELD COUNTY 17.0, JEFFERSON COUNTY 19.3, BOULDER COUNTY 17.7, AND BROOMFIELD COUNTY 8.6 PER 100,000 PERSONS. ALL COUNTIES EXCEPT BROOMFIELD AND THE STATE RATE OF 21.4 EXCEED THE HEALTHY PEOPLE OBJECTIVE OF 12.8 DEATHS PER 100,000 PERSONS.DRUG-INDUCED DEATH RATE, AGE - ADJUSTED PER 100,000 PERSONS. 2020: THE HIGHEST RATE OF DRUG- INDUCED DEATHS IS SEEN IN GILPIN COUNTY AT 57.8, FOLLOWED BY JEFFERSON COUNTY 29.2, ADAMS COUNTY 26.7, WELD COUNTY 16.2, BOULDER COUNTY 15.7 AND BROOMFIELD COUNTY 13.9 PER 100,000 PERSONS.THE AGE-ADJUSTED DRUG-INDUCED DEATH RATE FOR THE STATE IS 25.5. ALCOHOL LIVER DISEASE, AGE- ADJUSTED PER 100,000 PERSONS, 2016: THE RATE OF DEATH DUE TO ALCOHOL LIVER DISEASE WAS HIGHEST IN ADAMS COUNTY AT 19.9 FOLLOWED BY JEFFERSON COUNTY 12.4, BOULDER COUNTY 9.9, WELD COUNTY 9.3, AND BROOMFIELD COUNTY 6.1 PER 100,000 PERSONS. THE RATE FOR THE STATE WAS 13.5. HIV/ AIDS MORTALITY, AGE- ADJUSTED PER 100,000 PERSONS, 2020: THE RATE OF DEATH DUE TO HIV/AIDS WAS 1.0 IN ADAMS COUNTY AND 0.9 IN JEFFERSON COUNTY. THE RATES FOR THE OTHER COUNTIES WERE TOO LOW TO BE RECORDED. THE STATE RATE WAS 0.7.HEALTH INSURANCE COVERAGE, CIVILIAN NONINSTITUTIONALIZED POPULATION, AGES 18-64: HEALTH INSURANCE COVERAGE IS CONSIDERED A KEY COMPONENT TO ACCESS HEALTH CARE. THE HEALTHY PEOPLE 2030 OBJECTIVE IS FOR 92.1% OF THE POPULATION TO HAVE HEALTH INSURANCE COVERAGE. IN THE SERVICE AREA, 93.8% OF THE POPULATION WAS INSURED. INSURANCE COVERAGE IN HSR 16 (BOULDER AND BROOMFIELD COUNTIES) WAS 94.7%. INSURANCE COVERAGE WAS HIGHER IN HSR 18, WELD COUNTY (95.9%) THAN IN HSR 14, ADAMS COUNTY (90.9%). INSURANCE COVERAGE WAS HIGHEST IN HSR 21, JEFFERSON COUNTY (97.4%), AND LOWEST IN HSR 17, GILPIN COUNTY (88.2%). HEALTH INSURANCE COVERAGE RANGED FROM 85.3% IN DENVER 80260 TO 99.4% IN BOULDER 80310. COLORADO HAD 93.5% INSURANCE COVERAGE ACROSS THE STATE. UNINSURED CHILDREN, AGE 0-18 2019: THE PERCENTAGE OF UNINSURED CHILDREN UNDER THE AGE OF 18 WAS HIGHEST ADAMS AND WELD COUNTIES (4.6%) FOLLOWED BY JEFFERSON COUNTY (3.5%), BOULDER COUNTY (2.1%). BROOMFIELD COUNTY (2.0%) HAD THE LOWEST RATE OF UNINSURED CHILDREN IN THE SERVICE AREA. EXCEPT FOR ADAMS AND WELD COUNTIES, ALL COUNTIES HAD LOWER RATES THAN THE STATE RATE OF 4.5%.ADULTS WITH UNMET MEDICAL NEED DUE TO COST: NEARLY 15% OF ADULTS IN HSR 17 (GILPIN, CLEAR CREEK, PARK AND TELLER COUNTIES) AND 12% OF ADULTS IN HRS 18, WELD COUNTY HAD AN UNMET MEDICAL NEED AND WERE NOT ABLE TO AFFORD CARE. HSR 16 (BOULDER AND BROOMFIELD COUNTIES) HAD THE LOWEST RATES OF FOREGONE MEDICAL CARE DUE TO COST AMONG COUNTIES IN THE SERVICE AREA (8.1%), AND HSR 14, ADAMS COUNTY HAD THE HIGHEST RATE (16.9%). JUST UNDER 13% OF COLORADO RESIDENTS DID NOT GET NEEDED CARE. PRIMARY CARE PHYSICIANS, NUMBER AND RATIO, 2019: THE PRIMARY CARE PHYSICIAN RATIO REPRESENTS THE NUMBER OF LICENSED PHYSICIANS PER 1,000 PERSONS. WELD COUNTY HAD THE LOWEST RATE OF PRIMARY CARE PHYSICIANS IN THE SERVICE AT 0.9 PER 1,000 PERSONS AND GILPIN AND BOULDER COUNTIES HAD THE HIGHEST RATE OF PHYSICIANS AT 2.5 PER 1,000 PERSONS. THERE WERE 3.1 LICENSED PHYSICIANS PER 1,000 PERSONS IN COLORADO. ADULTS WITH UNMET DENTAL CARE DUE TO COST, 2019: MORE THAN 18% OF ADULTS DID NOT GET THE DENTAL CARE THEY NEEDED IN HSR 16, (BOULDER AND BROOMFIELD COUNTIES) BECAUSE OF COST. HSR 17, GILPIN COUNTY, HAD THE HIGHEST RATE OF FOREGONE DENTAL CARE DUE TO COST (26.4%), AND HSR 18, WELD COUNTY, HAD THE LOWEST RATE (16.8%). HSR 16, (BOULDER AND BROOMFIELD COUNTIES) HAD THE HIGHEST RATES OF ADULT DENTAL VISITS (82.1%), AND HSR 14, ADAMS COUNTY HAD THE LOWEST (69.1%). NEARLY 74% OF COLORADO RESIDENTS HAD A DENTAL VISIT LAST YEAR AND 20.6% NEEDED DENTAL CARE BUT DID NOT GET IT DUE TO COST. MENTAL HEALTH PROVIDERS, NUMBER AND RATIO, 2020: MENTAL HEALTH PROVIDERS INCLUDE PSYCHIATRISTS, CLINICAL PSYCHOLOGISTS, CLINICAL SOCIAL WORKERS, PSYCHIATRIC NURSE SPECIALISTS, AND MARRIAGE AND FAMILY THERAPISTS WHO MEET CERTAIN QUALIFICATIONS AND CERTIFICATIONS. BOULDER COUNTY HAD THE MOST MENTAL HEALTH PROVIDERS (6.3 PER 1,000 PERSONS) IN THE SERVICE AREA AND WELD HAD THE FEWEST (1.7 PER 1,000 PERSONS). GILPIN COUNTY HAD THE MOST MENTAL HEALTH TREATMENT FACILITIES AT 1.66 PER 10,000 PERSONS AND BOULDER COUNTY HAD THE LEAST (0.12 PER 10,000 PERSONS). COLORADO HAD 2.7 MENTAL HEALTH PROVIDERS PER 1,000 PERSONS AND 0.28 MENTAL HEALTH TREATMENT FACILITIES PER 10,000 PERSONS. FAIR OR POOR HEALTH, ADULTS, 2018: WHEN ASKED TO SELF-REPORT ON HEALTH STATUS WITHIN THE PAST MONTH. ADAMS COUNTY HAD THE HIGHEST RATE OF SELF-REPORTED POOR PHYSICAL HEALTH (11.8%), AND BROOMFIELD COUNTY HAD THE LOWEST RATE (8.2%). 9.1% OF ADULTS IN COLORADO REPORTED POOR PHYSICAL HEALTH FOR 14 OR MORE DAYS WITHIN THE LAST MONTH. ASTHMA PREVALENCE, PERCENT OF ADULT POPULATION (18 AND OLDER), 2018: THE PREVALENCE OF ASTHMA IS 11.3% IN ADAMS COUNTY, BEING THE HIGHEST, 9.7% IN JEFFERSON COUNTY, 8.7% IN WELD COUNTY, 8.0% IN BROOMFIELD COUNTY, 6.9% IN GILPIN COUNTY AND 6.7% IN BOULDER COUNTY, BEING THE LOWEST PERCENTAGE. ONLY ADAMS AND JEFFERSON COUNTY RATES WERE HIGHER THAN THE STATE RATE OF 8.9%.ADULT DIABETES PREVALENCE, 2018: THE PERCENTAGE OF ADULT DIABETES IS THE HIGHEST IN WELD COUNTY 8.6%,FOLLOWED BY ADAMS COUNTY WITH 8.4%, JEFFERSON COUNTY 6.3%, BROOMFIELD AND BOULDER COUNTY 5.9%, AND GILPIN COUNTY 4.0%, BEING THE LOWEST. ONLY ADAMS AND WELD COUNTY RATES WERE HIGHER THAN THE STATE RATE OF 6.8%.HIGH BLOOD PRESSURE, 2018: THE PERCENTAGE OF HIGH BLOOD PRESSURE IS THE HIGHEST IN GILPIN COUNTY 33.7%, FOLLOWED BY ADAMS COUNTY WITH 26.3%, WELD COUNTY 25.1%, JEFFERSON COUNTY 24.6%, BROOMFIELD COUNTY 23.9%, AND BEING THE LOWEST, BOULDER COUNTY OF 22.6%. ONLY GILPIN AND ADAMS COUNTY RATES WERE HIGHER THAN THE STATE RATE OF 25.8%.SEXUALLY TRANSMITTED INFECTIONS, PER 100,000 PERSONS, 2018: RATES OF HIV, CHLAMYDIA AND GONORRHEA WERE HIGHEST IN ADAMS COUNTY COMPARED TO OTHER SERVICE AREA COUNTIES. CHLAMYDIA HAD THE HIGHEST INCIDENCE RATES OF A SEXUALLY TRANSMITTED INFECTION: 571.2 PER 100,000 PERSONS IN ADAMS COUNTY AND 458.2 PER 100,000 PERSONS IN WELD COUNTY. GILPIN COUNTY HAD THE LOWEST RATES OF GONORRHEA (49.2 PER 100,000 PERSONS), AND CHLAMYDIA (65.6 PER 100,000 PERSONS) AMONG THE COUNTIES IN THE SERVICE AREA. ADULT OVERWEIGHT (BMI 25.5 TO 29.9) AND ADULT OBESE (BMI > 30), 2018: IN THE SERVICE AREA, ADAMS COUNTY HAD THE HIGHEST RATE OF OVERWEIGHT OR OBESE ADULTS AS A PERCENTAGE OF THE POPULATION (67.6%), AND WELD COUNTY HAD THE HIGHEST RATE OF ADULT OBESITY (29.3%). JUST MORE THAN 58% OF COLORADO IS OVERWEIGHT OR OBESE AND 22.6% OF THE POPULATION IS OBESE.PHYSICAL ACTIVITY, 2018: IN THE SERVICE AREA, BOULDER COUNTY HAD THE LOWEST RATE OF PHYSICAL INACTIVITY (9.8%), AND BROOMFIELD COUNTY HAD THE HIGHEST LEVEL OF ACCESSIBILITY TO LOCATIONS FOR PHYSICAL ACTIVITY (99.5%). SLIGHTLY MORE THAN 90% OF COLORADO RESIDENTS HAD ACCESS TO LOCATIONS FOR PHYSICAL ACTIVITY AND 16.1% OF COLORADO RESIDENTS REPORTED NO LEISURE TIME PHYSICAL ACTIVITY.
SCHEDULE H, PART VI, LINE 4 CIGARETTE/E-CIGARETTE SMOKING, 2016-2018: THE HEALTHY PEOPLE 2030 OBJECTIVE IS 5% OF THE POPULATION WHO SMOKE CIGARETTES. ALL SERVICE AREA COUNTIES EXCEED THIS RATE. 8% OF PREGNANT MOTHERS IN JEFFERSON COUNTY AND 7.8% IN GILPIN COUNTY SMOKED DURING THEIR PREGNANCY. AMONG STUDENTS WHO REPORTED USING AN E-CIGARETTE IN THE PAST 30 DAYS, RATES RANGED FROM 23.4% IN HSR 14, ADAMS COUNTY, TO 29.3% IN HSR 18, WELD COUNTY. HSR 17, GILPIN COUNTY, HAD THE HIGHEST RATES OF STUDENTS REPORTING SMOKING CIGARETTES IN THE LAST 30 DAYS (8.7%). ABOUT 15% OF COLORADO ADULTS SMOKE CIGARETTES AND 5.7% OF COLORADO HIGH SCHOOL STUDENTS REPORTED SMOKING CIGARETTES ONE OR MORE TIMES IN THE PAST 30 DAYS. 26.1% OF STUDENTS REPORTED USING AN ELECTRONIC VAPOR PRODUCT ONE OR MORE TIMES WITHIN THE PAST 30 DAYS, AND 6.1% OF PREGNANT WOMEN IN COLORADO REPORTED SMOKING CIGARETTES. FREQUENT MENTAL DISTRESS, ADULT, 2018: THE PERCENTAGE OF THE ADULT POPULATION REPORTING MORE THAN 14 DAYS OF POOR MENTAL HEALTH PER MONTH WAS 10.0% IN BOULDER COUNTY AND 11.8% IN ADAMS COUNTY. BROOMFIELD COUNTY HAD THE HIGHEST LEVEL OF FREQUENT MENTAL DISTRESS AMONG ADULTS (15.4%) IN THE SERVICE AREA, AND JEFFERSON COUNTY HAD THE LOWEST LEVEL OF FREQUENT MENTAL DISTRESS AMONG ADULTS (9.8%). JUST UNDER 11% OF COLORADO ADULTS REPORTED FREQUENT MENTAL DISTRESS. BINGE DRINKING, ADULTS, 2016- 2018: BINGE DRINKING IS DEFINED AS FIVE OR MORE DRINKS ON ONE OCCASION FOR MEN AND FOUR OR MORE DRINKS FOR WOMEN. THE HEALTHY PEOPLE 2030 OBJECTIVE IS THAT ONLY 25.4% OF ADULTS ENGAGE IN BINGE DRINKING IN THE PAST MONTH. HEAVY DRINKING IS DEFINED AS MORE THAN TWO DRINKS PER DAY FOR MEN AND MORE THAN ONE DRINK A DAY FOR WOMEN. IN THE SERVICE AREA, HSR 16 (BOULDER AND BROOMFIELD COUNTIES) HAD THE HIGHEST RATES OF DRINKING AMONG STUDENTS WITH 36.6% OF STUDENTS REPORTING HAVING HAD AT LEAST 1 DRINK IN THE PAST 30 DAYS. HSR 21, JEFFERSON COUNTY, HAD THE HIGHEST LEVEL OF BINGE DRINKING (21.4%) IN THE SERVICE AREA. SEVEN PERCENT OF COLORADO RESIDENTS REPORTED HEAVY DRINKING WITHIN THE PAST MONTH AND 19.1% REPORTED BINGE DRINKING WITHIN THE PAST MONTH. JUST UNDER 30% OF HIGH SCHOOL STUDENTS REPORTED HAVING AT LEAST 1 DRINK IN THE PAST 30 DAYS IN COLORADO.
Schedule H (Form 990) 2021
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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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
SCL HEALTH - FRONT RANGE INC
 
Employer identification number
84-1103606
Part I
General Information on Grants and Assistance
1
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? ........................
2
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
noncash assistance
(h) Purpose of grant
or assistance
(1) LUTHERAN MEDICAL CENTER FOUNDATION
8300 WEST 38TH AVENUE
WHEAT RIDGE,CO80033
20-8846152 501 ( C) (3) 655,782 0     PROGRAM SUPPORT
(2) GOOD SAMARITAN MEDICAL CENTER FOUNDATION
200 EXEMPLA CIRCLE
LAFAYETTE,CO80026
84-1649162 501 ( C) (3) 636,868 0     PROGRAM SUPPORT
(3) PROJECT CURE INTERNATIONAL HEADQUARTERS
10377 E GEDDES AVENUE
CENTENNIAL,CO80112
84-1568566 501 ( C) (3) 0 486,206 BOOK SURGICAL SUPPLIES PROGRAM SUPPORT
(4) METRO COMMUNITY PROVIDER NETWORK
2255 S ONEIDA STREET
DENVER,CO80224
74-2477108 501 ( C) (3) 31,500 0     PROGRAM SUPPORT
(5) JEFFERSON COUNTY LIBRARY FOUNDATION INC
10790 W 50TH AVE SUITE 200
WHEAT RIDGE,CO80033
23-7029313 501 ( C) (3) 30,000 0     PROGRAM SUPPORT
(6) COLLEGE TRACK COLORADO
1391 SPEER BLVD SUITE 405
DENVER,CO80204
94-3279613 501 ( C) (3) 20,000 0     PROGRAM SUPPORT
(7) MENTAL HEALTH PARTNERS
1455 DIXON AVE
LAFAYETTE,CO80026
84-0520493 501 ( C) (3) 15,225 0     PROGRAM SUPPORT
(8) SISTER CARMEN COMMUNITY CENTER
655 ASPEN RIDGE DR
LAFAYETTE,CO80026
84-0820308 501 ( C) (3) 15,000 0     PROGRAM SUPPORT
(9) CLINICA FAMILY HEALTH SERVICES
1345 PLAZA COURT N
LAFAYETTE,CO80026
84-0743432 501 ( C) (3) 15,000 0     PROGRAM SUPPORT
(10) CITY AND COUNTY OF BROOMFIELD
13201 LOWELL BLVD
BROOMFIELD,CO80020
84-6014589 BROOMFIELD COUNTY 15,000 0     PROGRAM SUPPORT
(11) BROOMFIELD FISH
6 GARDEN CENTER
BROOMFIELD,CO80020
84-1591870 501 ( C) (3) 15,000 0     PROGRAM SUPPORT
(12) BICYCLE COLORADO
1525 MARKET STREET SUITE 100
DENVER,CO80202
84-1201078 501 ( C) (3) 15,000 0     PROGRAM SUPPORT
(13) WOW CHILDRENS MUSEUM
110 N HARRISON AVE
LAFAYETTE,CO80026
84-1421537 501 ( C) (3) 15,000 0     PROGRAM SUPPORT
(14) YOUNG AMERICANS CENTER FOR FINANCIAL EDUCATION
3550 EAST FIRST AVE
DENVER,CO80206
84-1564926 501 ( C) (3) 10,000 0     PROGRAM SUPPORT
(15) VIA MOBILITY SERVICES
2855 63RD ST
BOULDER,CO80301
84-0777296 501 ( C) (3) 8,775 0     PROGRAM SUPPORT
(16) COLORADO RAILROAD MUSEUM
17155 W 44TH AVE
GOLDEN,CO80403
84-6037753 501 ( C) (3) 7,500 0     PROGRAM SUPPORT
(17) COLORADO HEALTH INSTITUTE
1999 BROADWAY STE 600
DENVER,CO80202
74-3082235 501 ( C) (3) 7,150 0     PROGRAM SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
17
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2021

Schedule I (Form 990) 2021
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
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash 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
PART I, LINE 2: THE ORGANIZATION KEEPS RECORDS TO SUPPORT THE AMOUNTS PROVIDED OR REASON FOR SUCH SUPPORT. ELIGIBILITY FOR FUNDING IS DETERMINED ON AN INDIVIDUAL BASIS, CONSIDERING THE USE OF THE FUNDS AND HOW THE USE RELATES TO THE ORGANIZATION'S MISSION.
Schedule I (Form 990) 2021



Additional Data


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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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
SCL HEALTH - FRONT RANGE INC
 
Employer identification number

84-1103606
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
If any of the boxes on 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 .....
1b
 
 
2
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 on Line 1a? ....
2
 
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
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, 1099-MISC compensation, and/or 1099-NEC (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
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1LYDIA JUMONVILLE
FORMER OFFICER
(i)

(ii)
0
-------------
1,302,227
0
-------------
439,629
0
-------------
390,552
0
-------------
448,852
0
-------------
21,261
0
-------------
2,602,521
0
-------------
378,434
2MARK KORTH
MEMBER
(i)

(ii)
0
-------------
934,809
0
-------------
251,834
0
-------------
4,670
0
-------------
156,290
0
-------------
26,080
0
-------------
1,373,683
0
-------------
0
3JANIE WADE
TREASURER
(i)

(ii)
0
-------------
867,860
0
-------------
222,790
0
-------------
4,636
0
-------------
136,927
0
-------------
25,770
0
-------------
1,257,983
0
-------------
0
4ADAM SMITH MD
PHYSICIAN
(i)

(ii)
895,637
-------------
0
310,349
-------------
0
1,774
-------------
0
14,915
-------------
0
32,807
-------------
0
1,255,482
-------------
0
0
-------------
0
5JAMES TREADWELL MD
PHYSICIAN
(i)

(ii)
646,544
-------------
0
514,751
-------------
0
15,190
-------------
0
17,400
-------------
0
34,227
-------------
0
1,228,112
-------------
0
0
-------------
0
6JOHN WICKLUND
PRESIDENT REGIONAL WESTERN CO & LMC
(i)

(ii)
0
-------------
588,508
0
-------------
172,200
0
-------------
295,916
0
-------------
14,500
0
-------------
19,267
0
-------------
1,090,391
0
-------------
0
7JASON SHOFNOS MD
PHYSICIAN
(i)

(ii)
843,709
-------------
0
175,849
-------------
0
2,344
-------------
0
15,271
-------------
0
31,460
-------------
0
1,068,633
-------------
0
0
-------------
0
8JAKE CHANIN MD
PHYSICIAN
(i)

(ii)
564,939
-------------
0
403,142
-------------
0
958
-------------
0
17,400
-------------
0
14,082
-------------
0
1,000,521
-------------
0
0
-------------
0
9BASHEAL AGRAWAL MD
PHYSICIAN
(i)

(ii)
854,692
-------------
0
56,438
-------------
0
870
-------------
0
17,400
-------------
0
32,559
-------------
0
961,959
-------------
0
0
-------------
0
10JENNIFER ALDERFER
PRESIDENT GSMC & SYSTEM TRANSFORM OF
(i)

(ii)
0
-------------
530,437
0
-------------
151,178
0
-------------
106,331
0
-------------
82,438
0
-------------
13,715
0
-------------
884,099
0
-------------
67,888
11THOMAS MYDLER MD
VP CHIEF MEDICAL OFFICER 1/1-4/1
(i)

(ii)
0
-------------
195,753
0
-------------
74,838
0
-------------
332,961
0
-------------
51,882
0
-------------
24,413
0
-------------
679,847
0
-------------
44,881
12THOMAS DONOHOE
SECRETARY
(i)

(ii)
0
-------------
424,612
0
-------------
76,120
0
-------------
1,614
0
-------------
64,520
0
-------------
28,830
0
-------------
595,696
0
-------------
0
13JAMES DOYLE
FORMER OFFICER
(i)

(ii)
0
-------------
320,899
0
-------------
93,174
0
-------------
132,603
0
-------------
9,524
0
-------------
20,061
0
-------------
576,261
0
-------------
0
14KAREN SCREMIN
FORMER OFFICER
(i)

(ii)
0
-------------
0
0
-------------
78,404
0
-------------
439,473
0
-------------
49,404
0
-------------
6,539
0
-------------
573,820
0
-------------
48,455
15STEVEN BROWN MD
VP CHIEF MEDICAL OFFICER
(i)

(ii)
0
-------------
366,304
0
-------------
74,160
0
-------------
52,928
0
-------------
17,400
0
-------------
20,807
0
-------------
531,599
0
-------------
0
16ANDREA BURCH
VP CHIEF OPERATING/NURSING OFFICER L
(i)

(ii)
0
-------------
312,221
0
-------------
60,771
0
-------------
23,627
0
-------------
49,171
0
-------------
30,030
0
-------------
475,820
0
-------------
22,896
17SCOTT DAY
VP HUMAN RESOURCE OPERATIONS LMC
(i)

(ii)
0
-------------
253,092
0
-------------
50,401
0
-------------
36,005
0
-------------
40,634
0
-------------
18,321
0
-------------
398,453
0
-------------
25,253
18SEAN FADDEN
FORMER OFFICER
(i)

(ii)
0
-------------
243,550
0
-------------
44,987
0
-------------
21,773
0
-------------
37,506
0
-------------
27,051
0
-------------
374,867
0
-------------
21,233
19PETER BENKOWSKI
VP STRATEGY & BUS DEVELOPMENT GSMC
(i)

(ii)
0
-------------
213,725
0
-------------
43,672
0
-------------
21,455
0
-------------
35,210
0
-------------
28,780
0
-------------
342,842
0
-------------
19,642
20JUSTIN SCHMIEDEL
VP CHIEF OPERATING OFFICER GSMC
(i)

(ii)
0
-------------
219,619
0
-------------
51,512
0
-------------
566
0
-------------
39,132
0
-------------
25,551
0
-------------
336,380
0
-------------
0
21MEGAN DURNING
VP STRATEGY & BUS DEVELOPMENT LMC
(i)

(ii)
0
-------------
229,780
0
-------------
45,021
0
-------------
26,836
0
-------------
34,603
0
-------------
0
0
-------------
336,240
0
-------------
26,315
22HILDA DALFONSO
VP FINANCE GSMC
(i)

(ii)
0
-------------
198,104
0
-------------
38,936
0
-------------
744
0
-------------
31,392
0
-------------
1,395
0
-------------
270,571
0
-------------
0
23MARY DEINES
VP CHIEF NURSING OFFICER GSMC
(i)

(ii)
0
-------------
244,246
0
-------------
0
0
-------------
3,625
0
-------------
0
0
-------------
20,581
0
-------------
268,452
0
-------------
0
24PATRICE FARRELL-DELINE
FORMER KEY EMPLOYEE
(i)

(ii)
0
-------------
164,268
0
-------------
32,136
0
-------------
1,837
0
-------------
23,917
0
-------------
21,816
0
-------------
243,974
0
-------------
0
25CALVIN BEASLEY
VP INTEGRATIVE SVCS LMC
(i)

(ii)
160,405
-------------
0
32,963
-------------
0
829
-------------
0
26,344
-------------
0
22,009
-------------
0
242,550
-------------
0
0
-------------
0
26TONI GREEN-CHEATWOOD
VP CHIEF MEDICAL OFFICER
(i)

(ii)
0
-------------
144,228
0
-------------
0
0
-------------
38,735
0
-------------
0
0
-------------
8,575
0
-------------
191,538
0
-------------
0
27ASHLEY DENTON
VP FINANCE LMC
(i)

(ii)
0
-------------
142,275
0
-------------
4,233
0
-------------
382
0
-------------
5,490
0
-------------
16,229
0
-------------
168,609
0
-------------
0
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
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
PART I, LINE 3 COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH). COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE SCL HEALTH BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SCL HEALTH AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO SCL HEALTH'S BOARD FOR APPROVAL OF ANY CHANGES TO COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY SCL HEALTH AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. CONSISTENT WITH THE PAY PHILOSOPHY SET BY SCL HEALTH'S BOARD, THE COMMITTEE EMPHASIZES THE IMPORTANCE OF ENSURING TOTAL REMUNERATION IS REASONABLE AND APPROPRIATE WHEN REVIEWING AND MAKING RECOMMENDATIONS WITH RESPECT TO COMPENSATION PACKAGES FOR THE OFFICERS AND SENIOR MANAGEMENT. AS PART OF THE REVIEW PROCESS, SCL HEALTH USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1)COMPENSATION COMMITTEE 2)INDEPENDENT COMPENSATION CONSULTANT 3)FORM 990 OF OTHER ORGANIZATIONS 4)WRITTEN EMPLOYMENT CONTRACTS 5)COMPENSATION SURVEYS AND STUDIES 6)APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD.
PART I, LINES 4A-B SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS THE ORGANIZATION AND RELATED ORGANIZATIONS PERIODICALLY INCUR SEVERANCE PAYMENTS TO FORMER EMPLOYEES. THE INDIVIDUALS AND THE AMOUNTS PAID FOR SEVERANCE IN 2021 WERE: THOMAS MYDLER - $273,446, KAREN SCREMIN - $384,479. SCHEDULE J, PART I, LINE 4B PAYMENTS FROM 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 ORGANIZATION'S 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. 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 RECIPIENT'S W-2. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. IN 2019, THE RELATED ORGANIZATION CONSOLIDATED FOUR NON QUALIFED DEFERRED COMPENSATION PLANS INTO ONE PLAN. AS PART OF THIS EFFORT, ALL VESTED BALANCES FROM THE SERP PLANS PRIOR TO 2014 WERE PAID TO THE PARTICIPANTS IN 2020. THERE ARE NO REMAINING PARTICIPANTS IN THE LEGACY PLANS. NQDC SERP PLANS STARTING IN 2014 STARTING IN 2014, THE RELATED ORGANIZATION'S 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 2021. 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 RECIPIENT'S W-2. THE AMOUNTS WITHDRAWN FROM THE NQDC SERP PLANS IN 2021 WERE: JENNIFER ALDERFER - $67,888, J. GRANT WICKLUND - $281,185, PETER BENKOWSKI - $19,642, STEVEN BROWN, MD - $45,160, ANDREA BURCH - $22,896, SCOTT DAY - $25,253, MEGAN DURNING - $26,315, THOMAS MYDLER, MD - $44,881, JAMES DOYLE - $123,276, SEAN FADDEN - $21,233, LYDIA JUMONVILLE - $378,434, KAREN SCREMIN - $48,455. 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.
PART I, LINE 7 THE AT-RISK COMPENSATION (ARC) PLAN WAS ESTABLISHED TO ENABLE SCL HEALTH TO ATTRACT AND ENGAGE QUALIFIED LEADERS AND TO PROVIDE SUCH LEADERS WITH AN ADDITIONAL PERFORMANCE COMPENSATION OPPORTUNITY TO PROMOTE AND FURTHER ITS CHARITABLE MISSION AND STRATEGIC IMPERATIVES. THE PLAN OPERATES ON A CALENDAR-YEAR BASIS AND AWARD OPPORTUNITIES ARE A PERCENTAGE OF LEADERS' BASE PAY AS DETERMINED BY THEIR MANAGEMENT LEVEL AT SCL HEALTH. ACTUAL AWARDS WILL BE PAID OUT BASED ON ATTAINMENT OF SELECTED SCL HEALTH BOARD-APPROVED GOALS, INCLUDING OPERATING INCOME, STEWARDSHIP, QUALITY, PATIENT AND ASSOCIATE SAFETY AND PATIENT EXPERIENCE AND FULFILLMENT OF OUR MISSION. AWARDS ARE BASED ON THE BOARD'S DETERMINATION ON HOW WELL THE HEALTH CARE SYSTEM PERFORMS RELATIVE TO THE PLAN'S STATED PERFORMANCE STANDARDS AND THE WEIGHT GIVEN TO EACH OF THE PERFORMANCE MEASURES AS DEFINED FOR THAT PLAN YEAR. 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 - ADDITIONAL OFFICER AND BOARD DISCLOSURES THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH) AND RELATED TAX EXEMPT ORGANIZATIONS CONSISTS OF EIGHT HOSPITALS, NINE FOUNDATIONS, TWO SAFETY-NET CLINICS, ONE CHILDREN'S MENTAL HEALTH CENTER, HOME HEALTH AND MORE THAN 200 PHYSICIAN CLINICS IN THREE STATES - COLORADO, KANSAS AND MONTANA. THE HEALTH SYSTEM INCLUDES MORE THAN 15,700 FULL-TIME ASSOCIATES AND MORE THAN 500 EMPLOYED PHYSICIANS. SCL HEALTH AND RELATED TAX EXEMPT ORGANIZATIONS ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. IN KEEPING WITH SCL HEALTH'S CORE VALUE OF STEWARDSHIP, SCL HEALTH'S BOARD COMPENSATION COMMITTEE (COMMITTEE) HAS RETAINED THE SERVICES OF AN INDEPENDENT COMPENSATION ADVISOR. THE COMPENSATION ADVISOR IS RESPONSIBLE FOR ADVISING THE COMMITTEE ON ALL MATTERS RELATING TO EXECUTIVE COMPENSATION INCLUDING SUPPORTING THE COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. THE SISTERS WHO SERVE AS OFFICERS AND/OR BOARD MEMBERS ARE MEMBERS OF THE SISTERS OF CHARITY OF LEAVENWORTH (A RELIGIOUS ORDER OF WOMEN). THE SISTERS HAVE TAKEN VOWS OF POVERTY AND RECEIVE NO COMPENSATION, EXPENSE ACCOUNT ALLOWANCE, OR CONTRIBUTIONS TO BENEFIT PLANS FOR THEIR SERVICES TO THE HEALTH CARE SYSTEM. HOWEVER, A PAYMENT IS MADE DIRECTLY TO THE SISTERS OF CHARITY OF LEAVENWORTH FOR THE SERVICES OF THOSE WHO PERFORM PROFESSIONAL, ADMINISTRATIVE, AND OTHER SUCH SERVICES.
Schedule J (Form 990) 2021

Additional Data


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Schedule L
(Form 990)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
SCL HEALTH - FRONT RANGE INC
 
Employer identification number

84-1103606
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990) 2021
Schedule L (Form 990) 2021
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) AMELIA BROWN SEE PART V 165,841 EMPLOYMENT - KEY EMPLOYEE JUSTIN SCHMIEDEL IS THE SPOUSE OF AN EMPLOYEE OF SCL HEALTH - FRONT RANGE, INC.   No
(2) BRIAN BURCH SEE PART V 10,646 EMPLOYMENT - KEY EMPLOYEE ANDREA BURCH IS THE PARENT OF AN EMPLOYEE OF SCL HEALTH - FRONT RANGE, INC.   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990) 2021


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SCHEDULE O
(Form 990)

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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
SCL HEALTH - FRONT RANGE INC
 
Employer identification number

84-1103606
Return Reference Explanation
FORM 990, PART III, LINES 4A - 4D DESCRIPTION OF PROGRAM SERVICE ACHIEVEMENTS SCL HEALTH - FRONT RANGE, INC. (SCLHFR) OPERATES LUTHERAN MEDICAL CENTER (LMC) SERVING PRIMARILY WESTERN AND SOUTHERN SUBURBAN AREAS OF METRO DENVER AND GOOD SAMARITAN MEDICAL CENTER (GSMC), SERVING PRIMARILY BOULDER AND NORTHWEST COUNTIES OF METRO DENVER, AND OTHER AFFILIATED MEDICAL OPERATIONS. THE SYSTEM'S COLLECTIVE PROGRAM SERVICES ACCOMPLISHMENTS INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING: MEDICAL SERVICES ARE PROVIDED TO ALL WHO SEEK SERVICE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES IS CRITICAL FOR THE OPERATION AND STABILITY OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THE MISSION OF SCL HEALTH IS "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". THEREFORE, IN KEEPING WITH SCLHFR'S COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE WILL BE CONSIDERED AND PROVIDED WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY EXIST. IN ADDITION, SCLHFR RECOGNIZES THE ESSENTIAL NEED TO BE EXCEPTIONAL STEWARDS OF MEDICARE, MEDICAID AND COMMUNITY/PRIVATE FUNDING DOLLARS. DURING THE YEAR, SCL HEALTH - FRONT RANGE, INC. PROVIDED BENEFITS TO THE COMMUNITY WHICH WENT TO CARING FOR THOSE WHO ARE POOR AND VULNERABLE THROUGH CHARITY CARE, UNREIMBURSED MEDICAID AND OTHER MEANS - TESTED GOVERNMENT PROGRAMS. SCLHFR PROVIDED ADDITIONAL BENEFITS TO THE COMMUNITY WHICH WENT TO IMPROVING THE HEALTH OF THE HOSPITAL'S COMMUNITY THROUGH HEALTH EDUCATION, COMMUNITY PROGRAMS, SUBSIDIZED HEALTH SERVICES AND ENVIRONMENTAL IMPROVEMENTS. SCLHFR ALSO RECOGNIZES THE ESSENTIAL NEED TO ENHANCE AND IMPROVE MEDICAL OUTCOMES, QUALITY AND SERVICES. IN RESPONSE, A BEST IN THE NATION STRATEGY AND PROGRAM WAS IMPLEMENTED. THE OBJECTIVES OF THE PROGRAM ARE TO BE THE BEST IN THE NATION IN PREDEFINED QUALITY, SERVICE AND COST INDICATORS. THE QUALITY INDICATORS ARE IN ALIGNMENT WITH MAJOR PUBLICLY COMPARABLE DATABASES, INCLUDING THE COLORADO HEALTH AND HOSPITAL ASSOCIATION AND CENTERS FOR MEDICARE AND MEDICAID SERVICES. COLLECTIVELY WITH ITS 572 LICENSED BEDS AT LMC AND GSMC, SCLHFR SERVED THE COMMUNITY WITH 27,461 INPATIENT ADMISSIONS AND 257,739 TOTAL OUTPATIENT VISITS WHILE PROVIDING SURGICAL SERVICES TO 13,193 RECIPIENTS. TOTAL BIRTHS AT SCLHFR WERE 3,686. TOTAL ER VISITS WERE 95,517. TOTAL LAB TESTS PERFORMED WERE 1,433,267. -COMPREHENSIVE MEDICAL SERVICES INCLUDE, BUT ARE NOT LIMITED TO, CARDIOLOGY, ONCOLOGY, ORTHOPEDIC, WOMEN AND FAMILY, PEDIATRICS, EMERGENCY AND TRAUMA, NEONATAL INTENSIVE CARE,NEUROLOGY, NEUROSURGERY, OB/GYN, GENERAL SURGICAL AND MEDICAL, PRIMARY CARE, INTERNAL MEDICINE, BEHAVIORAL HEALTH, HOSPICE CARE AND INTEGRATIVE HEALTH SERVICES. A STRONG COMMITMENT TO THE HEALTH OF THE COMMUNITY IS FURTHER EXEMPLIFIED BY, BUT NOT LIMITED TO, THE FOLLOWING PROGRAMS; -THE CANCER CENTER AT LMC INCLUDES ALL STAGES OF CARE INCLUDING INITIAL DIAGNOSIS; PROVIDING MONITORING, AND MANAGING MEDICATIONS. THE CENTER INCLUDES STATE-OF-THE-ART-RADIATION ONCOLOGY CENTER, INFUSION CENTER, ONCOLOGY UNIT, CLINICAL TRIALS, NUTRITION COUNSELING, SOCIAL WORK SERVICES, SITE SPECIFIC CARE TEAM, EDUCATION AND SUPPORT SERVICES. -AT THE HEART AND NEUROVASCULAR CENTER, PATIENTS ARE TREATED BY AN INTERDISCIPLINARY TEAM FOR CARDIAC AND NEUROLOGICAL CARE. PATIENTS DO NOT NEED TO BE TRANSFERRED TO ANOTHER FACILITY. THE CENTER FEATURES ADVANCED IMAGING EQUIPMENT AND NEUROLOGICAL SUITES TO SPEED PATIENTS' CARE. -THE BREAST CARE CENTER, ACCREDITED BY THE AMERICAN COLLEGE OF RADIOLOGY AND THE NATIONAL ACCREDITATION BREAST CARE CENTER, PROVIDES A FULL RANGE OF HIGH-TECH SERVICES IN ITS SCREENING AND DIAGNOSTIC SUITES INCLUDING DIGITAL MAMMOGRAPHY SCREENINGS AND DIAGNOSTIC SERVICES, ULTRASOUND, STEREOTACTIC BIOPSIES, MEDICAL CONSULTATION, EDUCATION, AS WELL AS AN ALTERNATIVE HEALTH CENTER AND EMOTIONAL SUPPORT. -THE WOMEN AND FAMILY CENTER INCLUDES A LEVEL III NEONATAL INTENSIVE CARE UNIT AND COMPREHENSIVE PRENATAL AND PARENTING EDUCATION. THE ANTEPARTUM FAMILY UNIT HELPS PREGNANT WOMEN WHO NEED SPECIALIZED CARE FOR THEMSELVES AND/OR THEIR UNBORN BABIES. SUPPORT FOR THE NEW UNIT HELPS US REACH OUR GOAL TO HELP WOMEN HAVE HEALTHY PREGNANCIES, BIRTHS AND BABIES. -THE DIAGNOSTIC IMAGING CENTER IS ONE OF DENVER'S MOST ADVANCED IMAGING CENTERS FEATURING COMPREHENSIVE STATE-OF-THE-ART DIAGNOSTIC IMAGING SERVICES INCLUDING 40 SLICE CT SCANNER, 3.0 TESLA MRI SYSTEM, 3D MAMMO EQUIPMENT ULTRASOUND ROOMS WITH ADJOINED CHANGING ROOMS AND RESTROOMS AND DIAGNOSTIC TECHNOLOGY IN ALL-DIGITAL ENVIRONMENT. -THE HUMAN MOTION INSTITUTE (HMI) OFFERS STATE-OF-THE-ART MUSCULOSKELETAL CARE. HMI COMBINES THE MOST ADVANCED MEDICAL TECHNOLOGY WITH A DEDICATED TEAM OF PHYSICIANS AND MEDICAL PROFESSIONALS. THE FOCUS IS ON PREVENTION, ASSESSMENT, TREATMENT AND REHABILITATION OF MUSCULOSKELETAL INJURIES. -COLLIER HOSPICE CENTER PROVIDES COMPASSIONATE, COMPREHENSIVE, INTERDISCIPLINARY END-OF-LIFE CARE FOR TERMINALLY ILL PATIENTS AND SUPPORT FOR THEIR FAMILIES. PATIENTS ARE SERVED IN THEIR HOMES, IN NURSING HOMES AND IN THE HOSPICE INPATIENT UNIT LOCATED ON LMC'S CAMPUS. THERE ARE FREE COMMUNITY SERVICES INCLUDING VOLUNTEER-BASED PRE-HOSPICE SUPPORT, GRIEF SUPPORT GROUPS, GRIEF EDUCATION WORKSHOPS, CAREGIVER SUPPORT GROUPS AND GRIEF SUPPORT FOR YOUNG PEOPLE. -WEST PINES IS A BEHAVIORAL HEALTH FACILITY THAT PROVIDES INPATIENT AND OUTPATIENT PSYCHIATRIC AND ADDICTION SERVICES TO ADULTS. THE WEST PINES RECOVERY CENTER OFFERS AN INNOVATIVE TWO-WEEK ADDICTION RECOVERY PROGRAM TO CLIENTS AND THEIR FAMILIES WHO STRUGGLE WITH ADDICTION, OR ADDICTION PLUS MENTAL ILLNESS. AFTER THE TWO-WEEK STAY, CLIENTS RECEIVE INTENSIVE OUTPATIENT ASSISTANCE AND OPTIONAL MEDICATION MANAGEMENT. THE PROGRAM PROVIDES SHORTER STAYS AND LOWER COSTS. THE SENIOR BEHAVIORAL HEALTH IS A 20 BED UNIT LOCATED AT LMC TO TREAT SENIORS WITH PSYCHIATRIC ILLNESSES. -BRIDGES INTEGRATIVE HEALTH AND WELLNESS OFFERS INTEGRATIVE CARE ACUPUNCTURE, MASSAGE, HEALING TOUCH, PULMONARY REHABILITATION, PHYSICAL THERAPY AND CARDIAC REHABILITATION. -ESTES STREET COMMUNITY CLINIC IS A PARTNERSHIP BETWEEN LMC, THE JEFFCO ACTION CENTER AND METRO COMMUNITY PROVIDER NETWORK. THE CLINIC SERVES HOMELESS AND LOW-INCOME CHILDREN AND ADULTS WITHOUT INSURANCE. IT PROVIDES ACUTE AND PREVENTIVE CARE, IMMUNIZATIONS, WELL-CHILD AND WELL-WOMEN CHECKUPS. -LMC PROVIDES COMPREHENSIVE EDUCATION PROGRAMS WITH OPPORTUNITIES FOR ALL AGES. THROUGH EDUCATION, RELIABLE HEALTH INFORMATION AND SUPPORT, THE PROGRAM PARTNERS WITH DOCTORS AND OTHER HEALTH CARE EXPERTS TO IMPROVE COMMUNITY HEALTH. -CARDIAC AND VASCULAR SERVICES INCLUDES THE CARDIAC CALCIUM SCORE FOR DETECTING HEART DISEASE RISK. -EMERGENCY AND TRAUMA SERVICES INCLUDES A LEVEL III TRAUMA CENTER. -BONE AND JOINT INSTITUTE INCLUDES A COMPREHENSIVE TREATMENT OF ALL JOINT INJURIES AND REPLACEMENT. FULL SERVICE PHYSICAL THERAPY IS ALSO AVAILABLE. -NEUROSCIENCES: THE GOOD SAMARITAN MEDICAL CENTER ADDED TWO BREAKTHROUGH NEUROSCIENCE TECHNOLOGIES - THE INFRARED 800TM AND THE OPMI PENTERO - FOR TREATMENT OF STROKES, ANEURYSMS, BRAIN TUMORS AND OTHER CONDITIONS. THE HOSPITAL EMPLOYS A STROKE FELLOWSHIP-TRAINED PHYSICIAN AND HAS CREATED A STROKE CENTER. -OTOLARYNGOLOGY INCLUDES BALLOON SINUPLASTY. -WOMEN AND FAMILY CENTER INCLUDES A LEVEL II NEONATAL INTENSIVE CARE AND COMPREHENSIVE PRENATAL AND PARENTING EDUCATION. SUPPORT FOR THE UNIT HELPS US REACH OUR GOAL TO HELP WOMEN HAVE HEALTHY PREGNANCIES, BIRTHS AND BABIES. GSMC ALSO IS THE FIRST HOSPITAL TO RECEIVE THE BABY-FRIENDLY DESIGNATION IN COLORADO. INPATIENT AND OUTPATIENT SURGICAL SERVICES INCLUDES A BONE & JOINT INSTITUTE.
FORM 990, PART III, LINES 4A - 4D (CONT'D) -NEUROSURGERY, INCLUDING O-ARM TECHNOLOGY FOR COMPLEX NEUROSURGICAL CASES AND THE OPMI PENTERO MICROSCOPE, A STATE OF THE ART IMPROVEMENT IN INTRA-OPERATIVE VISUALIZATION FOR BRAIN TUMORS AND ANEURYSMS, THE ONLY ONE OF ITS KIND IN THE REGION. GSMC ALSO BEGAN A DEEP BRAIN STIMULATION SERVICE FOR TREATMENT OF SEVERE MOVEMENT DISORDER LIKE ADVANCED PARKINSON'S DISEASE. -INTERVENTIONAL AND DIAGNOSTIC RADIOLOGY INCLUDING A 64-SLICE CT SCANNER. OTHER SERVICES INCLUDE MRI, ULTRASOUND AND DIAGNOSTIC IMAGING. -GSMC'S HEALTH & HEALING CENTER OFFERS INPATIENT AND OUTPATIENT INTEGRATIVE CARE (ACUPUNCTURE, MASSAGE, HEALING TOUCH, PULMONARY REHABILITATION, PHYSICAL THERAPY AND CARDIAC REHABILITATION). -GSMC PROVIDES WELLNESS QUEST, A COMPREHENSIVE EDUCATION PROGRAM WITH OPPORTUNITIES FOR ALL AGES. THROUGH EDUCATION, RELIABLE HEALTH INFORMATION AND SUPPORT, THE PROGRAM PARTNERS WITH DOCTORS, OTHER HEALTH CARE EXPERTS AND SCHOOLS TO IMPROVE COMMUNITY HEALTH. -GSMC WORKS CLOSELY WITH CLINICA CAMPESINA, A LAFAYETTE-BASED, FEDERALLY-QUALIFIED CLINIC FOR INDIGENT AND LOW INCOME INDIVIDUALS IN BOULDER COUNTY, PROVIDING ASSISTANCE TO FAMILIES IN NEED. LMC WORKS CLOSELY WITH METRO COMMUNITY PROVIDER NETWORK, A FEDERALLY QUALIFIED HEALTH CENTER ALSO SERVING INDIGENT AND LOW INCOME INDIVIDUALS AND FAMILIES IN JEFFERSON COUNTY. -GSMC AND LMC ARE DESIGNATED "BABY-FRIENDLY HOSPITALS" THAT SUPPORT BREASTFEEDING ON NEWBORNS AND PROMOTES THE INITIATION OF BREASTFEEDING WITHIN 1 HOUR OF BIRTH AND ALLOWS MOTHERS AND INFANTS TO REMAIN TOGETHER 24 HOURS A DAY. -GSMC AND LMC OFFER THE "BABY'S FIRST RIDE PROGRAM" AS A SERVICE TO ALL FAMILIES DELIVERING AT OUR HOSPITAL. PARENTS ARE TAUGHT THE PROPER WAY TO INSTALL AND USE A CAR SEAT TO ENSURE THEIR BABY'S FIRST RIDE IS A SAFE ONE.
FORM 990, PART V, LINE 1A EXPLANATION FOR NUMBER REPORTED IN BOX 3 OF FORM 1096 THE ORGANIZATION'S EXPENSES ARE PAID BY A RELATED 501(C)(3) TAX-EXEMPT ORGANIZATION. THE RELATED ORGANIZATION FILES THE REQUIRED FORM 1096 AND RELATED 1099 TAX FORMS FOR ANY EXPENDITURE THAT REQUIRES A FORM 1099 TO BE FILED.
FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) IS THE SOLE MEMBER OF SCL HEALTH-FRONT RANGE, INC.
FORM 990, PART VI, SECTION A, LINE 7A POWER TO ELECT OR APPOINT MEMBERS SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC., THE SOLE MEMBER OF SCL HEALTH - FRONT RANGE, INC., APPROVES MEMBERS OF SCL HEALTH - FRONT RANGE, INC. BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS; SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) HAS CERTAIN RESERVE POWERS TO APPROVE CHANGES TO THE ARTICLES OF INCORPORATION AND THE BYLAWS INCLUDING THE APPOINTMENT OR REMOVAL OF BOARD MEMBERS AND THE PRESIDENT/CEO. SCLHS ALSO HAS CERTAIN RESERVE POWERS OVER ANY CHANGE IN OWNERSHIP OF THE CORPORATION, CHANGE IN MISSION, ACQUISITION OF ASSETS, DISPOSAL OF ASSETS, LEASING OF ASSETS, INCURRENCE OF DEBT, MERGER OR DISSOLUTION, APPROVAL OF STRATEGIC PLANS AND BUDGETS, APPOINTMENT OF AUDITORS AND OVERSIGHT AND APPROVAL OF COMPENSATION AND BENEFITS FOR DIRECTORS, OFFICERS, KEY EMPLOYEES AND PHYSICIANS.
FORM 990, PART VI, SECTION B, LINE 11B PROCESS USED TO REVIEW THE FORM 990; THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT OF THE PARENT ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). THE FORM 990 IS REVIEWED BY CERTAIN MEMBERS OF SENIOR MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE FILING OF THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. ANY QUESTIONS ARE ADDRESSED TO THE TAX DIRECTOR OF SCLHS PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY: SCL HEALTH - FRONT RANGE, INC., AND THE PARENT ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (COLLECTIVELY REFERRED TO AS SCL HEALTH), REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY PROVIDING EDUCATION AND TRAINING FOR ITS EMPLOYEES, STAFF, OFFICERS AND DIRECTORS. PERSONS CONSIDERED TO BE IN AN INFLUENTIAL POSITION, SUCH AS BOARD MEMBERS, OFFICERS, PHYSICIANS, EXECUTIVES AND DIRECTOR LEVEL MANAGERS ARE ALL REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT UPON HIRE/APPOINTMENT AND ON AN ANNUAL BASIS TO DISCLOSE ANY POTENTIAL CONFLICT ISSUES. THESE STATEMENTS ARE CAREFULLY REVIEWED BY THE SCL HEALTH INTEGRITY AND COMPLIANCE DEPARTMENT AND APPROPRIATE LEADERSHIP. A REPORT IS PROVIDED TO SCL HEALTH'S PRESIDENT/CEO AND THE BOARD OF DIRECTORS. THE BUSINESS AND AFFAIRS OF SCL HEALTH WILL AT ALL TIMES BE CONDUCTED IN A MANNER THAT IS SOLELY IN THE BEST INTERESTS OF SCL HEALTH AND NOT BE INFLUENCED BY CONFLICTING INTERESTS OF PERSONS RESPONSIBLE FOR ADMINISTERING THOSE AFFAIRS. THE EXISTENCE OF ANY CONFLICTS OF INTEREST WILL BE DISCLOSED AND THE PROCEDURES SET FORTH HEREIN WILL BE FOLLOWED. CERTAIN TRANSACTIONS DETERMINED TO CONSTITUTE A CONFLICT OF INTEREST ARE PROHIBITED. ANY PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER SCL HEALTH IS CONSIDERED AN INTERESTED PERSON. THIS TERM INCLUDES, BUT IS NOT LIMITED TO THE FOLLOWING: - BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS AND DIRECTORS; - SENIOR LEADERS AND EXECUTIVES (CEO, PRESIDENT, SVP, VP, EXECUTIVE DIRECTORS); - EMPLOYED PHYSICIANS AND PHYSICIANS IN MEDICAL STAFF LEADERSHIP ROLES (E.G., DEPARTMENT CHAIRS, MEMBERS OF MEDICAL STAFF COMMITTEES); - MEDICAL DIRECTORS OF CLINICAL PROGRAMS THAT ASSESS, REVIEW, RECOMMEND OR REQUEST PURCHASE OF ANY SPECIFIC PHARMACEUTICAL PRODUCTS, MEDICAL DEVICES, SUPPLIES AND/OR EQUIPMENT; - DEPARTMENT DIRECTORS; AND - OTHER SELECT INDIVIDUALS IDENTIFIED BY LEADERSHIP WHICH MAY INCLUDE, BUT IS NOT LIMITED TO, SUPPLY CHAIN AND FINANCE. UPON BECOMING AN INTERESTED PERSON AND ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO DISCLOSE ANY RELATIONSHIPS THAT CONSTITUTE OR MIGHT LEAD TO A CONFLICT OF INTEREST BY COMPLETING THE CURRENT CONFLICT OF INTEREST AND GIFT DISCLOSURE STATEMENT ("STATEMENT") AS APPROVED BY THE CHIEF INTEGRITY AND COMPLIANCE OFFICER. THE CHIEF INTEGRITY AND COMPLIANCE OFFICER WILL OVERSEE THE REVIEW OF THE STATEMENTS AND THE RESOLUTION OF ANY IDENTIFIED CONFLICTS OF INTEREST AND ALERT THE SCL HEALTH CEO AND/OR THE CHAIR OF THE SCL HEALTH BOARD OF DIRECTORS TO ANY ITEMS OF CONCERN. WHEN AN INTERESTED PERSON BECOMES AWARE OF A CONFLICT OF INTEREST WHICH HAS NOT BEEN DISCLOSED ON A STATEMENT, HE OR SHE SHALL CONTACT THE LOCAL COMPLIANCE AND PRIVACY OFFICER OR THE CHIEF INTEGRITY AND COMPLIANCE OFFICER, OBTAIN A STATEMENT FORM, COMPLETE AND RETURN IT TO THE SCL HEALTH INTEGRITY AND COMPLIANCE DEPARTMENT. WHENEVER AN INTERESTED PERSON BECOMES AWARE THAT AN ARRANGEMENT WITH RESPECT TO WHICH HE OR SHE HAS A CONFLICT OF INTEREST IS BEING CONSIDERED, THE INTERESTED PERSON MUST DISCLOSE ALL MATERIAL FACTS CONCERNING THE EXISTENCE AND NATURE OF THE CONFLICT OF INTEREST TO HIS OR HER SUPERVISOR (IF AN EMPLOYEE OTHER THAN THE ORGANIZATIONS SCL HEALTH CEO) OR TO THE APPLICABLE BOARD OR COMMITTEE CHAIR (IF THE SCL HEALTH CEO OR A BOARD OR COMMITTEE MEMBER), EVEN IF THE CONFLICT OF INTEREST HAS BEEN PREVIOUSLY DISCLOSED. WITH REGARD TO EMPLOYEES OTHER THAN THE SCL HEALTH CEO, THE INTERESTED PERSON'S SUPERVISOR WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. WITH REGARD TO THE SCL HEALTH CEO AND BOARD OR COMMITTEE MEMBERS, THE REMAINING MEMBERS OF THE BOARD OR COMMITTEE WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. PERSON(S) RESPONSIBLE FOR THE DETERMINATION SHOULD OBTAIN FURTHER GUIDANCE FROM THE SCL HEALTH INTEGRITY AND COMPLIANCE OR LEGAL DEPARTMENTS. UPON MAKING HIS OR HER DISCLOSURE, THE INTERESTED PERSON WILL LEAVE THE MEETING OR OTHERWISE REMOVE HIM OR HERSELF FROM THE DELIBERATIONS OR OTHER DECISION-MAKING PROCESS UNTIL SUCH TIME AS A DETERMINATION IS REACHED. IF A DETERMINATION HAS BEEN MADE THAT NO CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON MAY BE PRESENT AND PARTICIPATE IN THE DELIBERATION REGARDING THE TRANSACTION OR ARRANGEMENT. HOWEVER, IF AN INTERESTED PERSON HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST, HE OR SHE MAY NOT PARTICIPATE IN THE DELIBERATION OR DECISION REGARDING THE TRANSACTION OR ARRANGEMENT; BE PRESENT DURING THE DELIBERATION OR DECISION-MAKING; OR BE ALLOWED TO MAKE A PRESENTATION PRIOR TO THE DELIBERATION AND DECISION-MAKING ACTIVITIES. WHEN AN INTERESTED PERSON HAS A CONFLICT OF INTEREST, THE DECISION-MAKER/DECISION-MAKING BODY CONSIDERING THE TRANSACTION OR ARRANGEMENT WILL TAKE REASONABLE MEASURES, PRIOR TO APPROVING OR ENTERING INTO THE TRANSACTION OR ARRANGEMENT, TO ENSURE THAT THE PROPOSAL IS IN SCL HEALTH'S BEST INTERESTS. THE PROPOSED TRANSACTION OR ARRANGEMENT MAY PROCEED IF THE DECISION-MAKER/DECISION-MAKING BODY, AFTER HAVING BEEN FULLY INFORMED OF THE MATERIAL FACTS ESTABLISHING THE CONFLICT OF INTEREST, DETERMINES THAT THE TRANSACTION OR ARRANGEMENT IS IN SCL HEALTH'S BEST INTERESTS AND IS FAIR AND REASONABLE. A MAJORITY VOTE OF THE DISINTERESTED DECISION-MAKERS IS REQUIRED WHEN A DETERMINATION IS MADE BY A BOARD, COMMITTEE OR OTHER DECISION-MAKING BODY. MANAGEMENT OF POTENTIAL CONFLICTS IS DONE BY THE CHIEF INTEGRITY AND COMPLIANCE OFFICER AND/OR CARE SITE COMPLIANCE AND PRIVACY OFFICERS AND REPORTED ANNUALLY TO THE CARE SITE LEADERSHIP COMMITTEES AND/OR MINISTRY INTEGRITY AND COMPLIANCE COMMITTEE AND TO THE AUDIT COMMITTEE, ORGANIZATIONAL INTEGRITY AND COMPLIANCE COMMITTEE OF THE SCL HEALTH BOARD OF DIRECTORS. ANY REPORTED CONFLICTS OR POTENTIAL CONFLICTS WILL ALSO BE REPORTED TO AND REVIEWED BY THE SCL HEALTH TAX DIRECTOR FOR COMPLIANCE WITH THE FORM 990 TAX RETURN.
FORM 990, PART VI, SECTION B, LINE 15B FORM 990, PART VI, SECTION B (POLICIES) LINES 15(A) & 15(B) THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCL HEALTH). COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE SCL HEALTH BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SCL HEALTH AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO SCL HEALTH'S BOARD FOR APPROVAL OF ANY CHANGES TO COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY SCL HEALTH AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. CONSISTENT WITH THE PAY PHILOSOPHY SET BY SCL HEALTH'S BOARD, THE COMMITTEE EMPHASIZES THE IMPORTANCE OF ENSURING TOTAL REMUNERATION IS REASONABLE AND APPROPRIATE WHEN REVIEWING AND MAKING RECOMMENDATIONS WITH RESPECT TO COMPENSATION PACKAGES FOR THE OFFICERS AND SENIOR MANAGEMENT. AS PART OF THE REVIEW PROCESS, SCL HEALTH USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACTS 5) COMPENSATION SURVEYS AND STUDIES 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD.
FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND GOVERNING DOCUMENTS AVAILABLE UPON REQUEST.
FORM 990, PART VII, SECTION B, LINE 2 INDEPENDENT CONTRACTORS THE ORGANIZATION'S EXPENSES ARE PAID BY A RELATED 501(C)(3) TAX-EXEMPT ORGANIZATION. THE RELATED ORGANIZATION FILES THE REQUIRED FORM 1096 AND RELATED 1099 TAX FORMS FOR ANY EXPENDITURE THAT REQUIRES A FORM 1099 TO BE FILED.
FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 51,672,229. MANAGEMENT AND GENERAL EXPENSES 4,053,722. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 55,725,951. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 19,779,342. MANAGEMENT AND GENERAL EXPENSES 1,551,703. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,331,045. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 39,471,485. MANAGEMENT AND GENERAL EXPENSES 3,096,565. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,568,050.
FORM 990, PART XI, LINE 9: TRANSFER FROM FOUNDATION FOR REIMBURSEMENT OF CAPITAL ACQUISITIONS 108,143. BOOK VS. TAX DEPRECIATION -249,866.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
SCL HEALTH - FRONT RANGE INC
 
Employer identification number

84-1103606
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) GOOD SAMARITAN MEDICAL CENTER LLC
200 EXEMPLA CIRCLE
LAFAYETTE,CO80026
43-1982139
HOSPITAL SERVICES CO 352,362,803 613,910,067 SCL HEALTH - FRONT RANGE INC
 
(2) SCL HEALTH MEDICAL GROUP - DENVER LLC
500 ELDORADO BLVD SUITE 4300
BROOMFIELD,CO80021
46-3778226
PHYSICIAN SERVICES CO 165,600,026 214,848,964 SCL HEALTH - FRONT RANGE INC
 
(3) SCL PHYSICIANS - RMPC LLC
500 ELDORADO BLVD SUITE 4300
BROOMFIELD,CO80021
35-2563201
PHYSICIAN SERVICES CO 0 0 SCL HEALTH MEDICAL GROUP - DENVER LLC
 
(4) SCL HEALTH MEDICAL GROUP - GRAND JUNCTION LLC
2635 NORTH 7TH STREET
GRAND JUNCTION,CO81502
46-3778277
PHYSICIAN SERVICES CO 100,062,556 123,667,273 SCL HEALTH - FRONT RANGE INC
 
(5) SCL HEALTH - FRONT RANGE NETWORK LLC
500 ELDORADO BLVD SUITE 4300
BROOMFIELD,CO80021
85-1517471
CLINICALLY INTEGRATED NETWORK CO 0 0 SCL HEALTH - FRONT RANGE INC
 


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?
Yes No
(1)SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC
500 ELDORADO BLVD SUITE 4300

BROOMFIELD,CO80021
23-7379161
MANAGEMENT OF RELATED TAX EXEMPT HOSPITALS AND HEALTHCARE SERVICES KS 501(C)(3) LINE 12C, III-FI N/A
 
No
(2)SCL HEALTH FOUNDATION
500 ELDORADO BLVD SUITE 4300

BROOMFIELD,CO80021
82-3290526
SUPPORT RELATED TAX EXEMPT ORGANIZATIONS CO 501(C)(3) LINE 7 SCLHS
 
 
No
(3)SCL HEALTH RESEARCH INSTITUTE INC
500 ELDORADO BLVD SUITE 4300

BROOMFIELD,CO80021
85-2014794
MEDICAL RESEARCH CO 501(C)(3) LINE 4 SCLHS
 
 
No
(4)INTEGRITY HEALTH
500 ELDORADO BLVD SUITE 4300

BROOMFIELD,CO80021
47-4520350
SUPPORTING ORGANIZATION CO 501(C)(3) LINE 12C, III-FI SCLHS
 
 
No
(5)BRIGHTON COMMUNITY HOSPITAL ASSOCIATION
1600 PRAIRIE CENTER PARKWAY

BRIGHTON,CO80601
84-0482695
HOSPITAL SERVICES CO 501(C)(3) LINE 3 INTEGRITY HEALTH
 
 
No
(6)PLATTE VALLEY MEDICAL CENTER FOUNDATION
1600 PRAIRIE CENTER PARKWAY

BRIGHTON,CO80601
74-2255936
SUPPORTING ORGANIZATION CO 501(C)(3) LINE 12A, I BRIGHTON COMMUNITY HOSPITAL ASSOCIATION
 
 
No
(7)MOUNT ST VINCENT HOME INC
4159 LOWELL BOULEVARD

DENVER,CO80211
84-0405260
RESIDENT CARE CO 501(C)(3) LINE 10 SCLHS
 
 
No
(8)NJH-SJH INC
500 ELDORADO BLVD SUITE 4300

DENVER,CO80211
47-1194849
MANAGEMENT OF RELATED TAX EXEMPT HOSPITALS AND HEALTHCARE SERVICES CO 501(C)(3) LINE 12A, I SCLHS
 
 
No
(9)SAINT JOSEPH HOSPITAL INC
1375 EAST 19TH AVENUE

DENVER,CO80218
84-0417134
HOSPITAL SERVICES CO 501(C)(3) LINE 3 SCLHS
 
 
No
(10)SAINT JOSEPH HOSPITAL FOUNDATION
1375 EAST 19TH AVENUE

DENVER,CO80218
84-0735096
SUPPORT RELATED TAX EXEMPT ORGANIZATIONS CO 501(C)(3) LINE 7 SAINT JOSEPH HOSPITAL INC
 
 
No
(11)GOOD SAMARITAN MEDICAL CENTER FOUNDATION
200 EXEMPLA CIRCLE

LAFAYETTE,CO80026
84-1649162
SUPPORT RELATED TAX EXEMPT ORGANIZATIONS CO 501(C)(3) LINE 7 SCL HEALTH-FRONT RANGE INC
 
Yes
 
(12)LUTHERAN MEDICAL CENTER FOUNDATION
8300 WEST 38TH AVENUE

WHEAT RIDGE,CO80033
20-8846152
SUPPORT RELATED TAX EXEMPT ORGANIZATIONS CO 501(C)(3) LINE 7 SCL HEALTH-FRONT RANGE INC
 
Yes
 
(13)ST MARYS HOSPITAL & MEDICAL CENTER INC
2635 NORTH 7TH STREET

GRAND JUNCTION,CO81501
84-0425720
HOSPITAL SERVICES CO 501(C)(3) LINE 3 SCLHS
 
 
No
(14)ST MARYS HOSPITAL FOUNDATION
2635 NORTH 7TH STREET

GRAND JUNCTION,CO81501
23-7001007
SUPPORTING ORGANIZATION CO 501(C)(3) LINE 12A, I ST MARYS HOSPITAL & MEDICAL CENTER INC
 
 
No
(15)CARITAS CLINICS INC
818 NORTH 7TH STREET

LEAVENWORTH,KS66048
48-1009910
CLINIC SERVICES KS 501(C)(3) LINE 3 SCLHS
 
 
No
(16)MARIAN CLINIC INC
3164 SE 6TH AVENUE

TOPEKA,KS66607
48-1046905
CLINIC SERVICES KS 501(C)(3) LINE 3 SCLHS
 
 
No
(17)HOLY ROSARY HEALTHCARE
2600 WILSON STREET

MILES CITY,MT59301
81-0231792
HOSPITAL SERVICES MT 501(C)(3) LINE 3 SCLHS
 
 
No
(18)HOLY ROSARY HEALTHCARE FOUNDATION INC
2600 WILSON STREET

MILES CITY,MT59301
20-2270238
SUPPORTING ORGANIZATION MT 501(C)(3) LINE 12A, I HOLY ROSARY HEALTHCARE
 
 
No
(19)ST JAMES HEALTHCARE
400 SOUTH CLARK STREET

BUTTE,MT59701
81-0231785
HOSPITAL SERVICES MT 501(C)(3) LINE 3 SCLHS
 
 
No
(20)ST JAMES HEALTHCARE FOUNDATION INC
400 SOUTH CLARK STREET

BUTTE,MT59701
65-1202190
SUPPORTING ORGANIZATION MT 501(C)(3) LINE 12A, I ST JAMES HEALTHCARE
 
 
No
(21)SCL HEALTH - MONTANA
1233 NORTH 30TH STREET

BILLINGS,MT59101
81-0232124
HOSPITAL SERVICES MT 501(C)(3) LINE 3 SCLHS
 
 
No
(22)ST VINCENT HEALTHCARE FOUNDATION INC
1106 NORTH 30TH STREET

BILLINGS,MT59101
81-0468034
SUPPORT RELATED TAX EXEMPT ORGANIZATIONS MT 501(C)(3) LINE 7 SCL HEALTH - MONTANA
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(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?



(k)
Percentage
ownership


Yes No Yes No
(1) SCLH-GI ENDOSCOPY HOLDINGS LLC

382 S ARTHUR AVENUE
LOUISVILLE,CO80027
81-2979243
OP ENDOSCOPY CO N/A
        No     No  
(2) SCLTDI JV LLC

4200 SIX FORKS ROAD SUITE 1000
RALEIGH,NC27609
47-2294770
RADIOLOGY DE N/A
        No     No  
(3) ATHLETIC MEDICINE & PERFORMANCE LLC

1144 NORTH 28TH STREET
BILLINGS,MT59101
27-2270640
PHYSICAL THERAPY MT N/A
        No     No  
(4) SUMMIT SURGERY CENTER LLC

434 SOUTH CLARK STREET
BUTTE,MT59701
81-0536068
OP SURGERY MT N/A
        No     No  
(5) GRAND VALLEY SURGICAL CENTER LLC

710 WELLINGTON AVENUE SUITE 21
GRAND JUNCTION,CO81501
84-1505075
OP SURGERY CO N/A
        No     No  
(6) HEALTHCARE MANAGEMENT LLC

PO BOX 1929
GRAND JUNCTION,CO81502
84-1238904
MANAGEMENT SERVICES CO N/A
        No     No  
(7) PAVILION IMAGING LLC

750 WELLINGTON AVENUE
GRAND JUNCTION,CO81501
03-0516198
RADIOLOGY CO N/A
        No     No  
(8) SAN JUAN CANCER CENTER LLC

600 SOUTH 5TH STREET
MONTROSE,CO81401
20-2856331
OP CANCER CO N/A
        No     No  
(9) CAREFLIGHT OF THE ROCKIES LLC

500 ELDORADO BLVD SUITE 4300
BROOMFIELD,CO80021
47-3525381
MEDICAL AIR TRANSPORT CO N/A
        No     No  
(10) MED-MAP LLC

PO BOX 1295
BILLINGS,MT59103
81-0491356
RENTAL REAL ESTATE MT N/A
        No     No  
(11) YELLOWSTONE SURGERY CENTER LLC

1144 NORTH 28TH STREET
BILLINGS,MT59101
72-1519467
OP SURGERY MT N/A
        No     No  
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?
Yes No
(1) CARITAS INC AND SUBSIDIARIES

500 ELDORADO BLVD SUITE 4300
BROOMFIELD,CO80021
48-0941069
HEALTHCARE KS N/A
C         No
(2) WEST END ASSOCIATION INC

500 ELDORADO BLVD SUITE 4300
BROOMFIELD,CO80021
85-4261243
REAL ESTATE MANAGEMENT MT N/A
C         No
(3) LEAVEN INSURANCE COMPANY LTD

23 LIME TREE BAY AVENUE WEST BAY R
GRAND CAYMAN   KY1-1102
CJ
98-0370522
INSURANCE CJ N/A
C         No








Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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
No
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 .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
Yes
 
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
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) GOOD SAMARITAN MEDICAL CENTER FOUNDATION

B 636,868 CASH
(2) GOOD SAMARITAN MEDICAL CENTER FOUNDATION

C 325,071 CASH
(3) LUTHERAN MEDICAL CENTER FOUNDATION

B 655,782 CASH
(4) LUTHERAN MEDICAL CENTER FOUNDATION

C 1,600,159 CASH


Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) 2021

Additional Data


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