A Year In Review 2009

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On March 21, 1959, Longmont Community Hospital officially opened as a 50-bed hospital serving the community of 11,000 residents. Owned and operated by the people of the community, the non-profit hospital employed 87 full time equivalent employees and had a medical staff of 13 physicians.

In 1971, Longmont Community Hospital merged with Longs Peak Osteopathic Hospital and became Longmont United Hospital. Hank Amicarella, retired hospital administrator of Longmont Community Hospital/Longmont United Hospital (1959-1977), remarked at his retirement, “Our hospital could not have been a reality without the dedication and commitment, interest and efforts of countless volunteers, community citizens and leaders…All exemplified the value and importance of community involvement and support, making it a truly hospital-community partnership.”

This hospital-community partnership is evident today. Currently, the hospital is licensed for 201 beds, and provides a broad range of comprehensive services such as Women’s and Children’s, Cardiac, Surgical, Cancer, Emergency, Trauma, and other Medical Specialties.

Longmont United Hospital Celebrates 50 Years of Healthcare Service

“We are thankful for the commitment of the communities we serve, which continue to provide excellent support for the hospital. We are dedicated to building better communities and providing patient centered high-quality care locally.” Mitchell C. Carson, President and CEO commented. “Looking ahead, the hospital will continue to make patient safety a priority, focusing on incorporat-ing technological advancements that are less invasive and safer for patients.”

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Message From Chair and President/CEOProviding safe, excellent care continues to be forefront of our mission, core values, and strategic plan. We expect the best of ourselves in order to provide the very best and safest care to our patients.The plethora of organizations analyzing data on hospital performance has increased dramatically in the last 10 years. Tracking Core Quality Measures allows Longmont United Hospital to evaluate hospital performance in regards to improvement plans. We are proud to announce in 2009 all of our Core Quality Measures improved. We acknowledge and appreciate the outstanding efforts made by our employees and physicians. Excellent employees and physicians provide excellent patient care. We continue to offer opportunities, such as the Embrace Wellness program, to help each employee have a well-rounded life while being mentally, socially, and physically healthy. We understand each employee needs to take care of him or her self in order to provide compassionate care.

We expanded the medial care available to the people we serve. In 2009, we completed the construction of the new Interventional Radiology suite. Interventional Radiology, a 21st century technology, can diagnose and treat medical procedures through guided 3D images. The changes in economy required leadership to reduce expenses to be aligned with the strategic plan and prepare for health care reform. The year ended with record high patient revenues but also very high charity care costs. We continue to be dedicated to providing excellent care to any person from our service area entering the hospital. This year we celebrated 50 years of service. We are very appreciative of our staff, physicians, and volunteers for their continued dedication to our mission, core values, and patients over the years. Each person makes a difference in providing excellent care. Each person helps in “Change The Caring Experience...” every day.

Martin Plaster, Chairperson, Board of Directors Mitchell C. Carson, President and CEO

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Dr. Eva Patricia Gill has been an active member of Longmont United Hospital’s medical staff since June 1995. She is board certified in Infectious disease and Imternal Medicine. Dr. Gill has been Chair of the Department of Medicine, Chief of Staff, and a member of the Pharmacy and Therapeutics and Infection Control Committees. She continues to Chair the Infection Control Committee. Dr. Gill practices at the Longmont Clinic. She is also an active member of the Boulder County Disaster Preparedness Team and a Medical Advisor of the Immunization Program for Boulder County Health Department.

The Board of Directors establishes and maintains Longmont United Hospital for the care of all persons suffering from any illness or disability requiring hospital care. The term length for directorship is three years, effective January 1. All directors should be a representative of the Longmont United Hospital service area.

Longmont United Hospital Welcomes New Board Director

2009 Board of Directors

Martin PlasterChairpersonJohn Shetter,Vice-ChairpersonLeona Stoecker,SecretaryJohn Caldwell,TreasurerDan GustAsst. Sec-TreasurerJames Britton, M.D.Mitchell CarsonE. Patricia Gill, M.D.Richard LyonsEdwina SalazarClair Volk

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Longmont United Hospital opened a new Interventional Radiology Suite with service beginning March 16, 2009. The Interventional Radiology Suite is an important technology in diagnostic imaging because it provides minimally invasive procedures that diagnose and treat medical conditions. The suite is a warm, comfortable setting that has a Reading Room for the radiologist to educate the patient regarding the procedure and to interpret images. The Interventional Radiology Suite also has Pre- and Post-Procedure Rooms, a Nursing Station to support the patient, and a Technologist Control Room for additional monitoring of the patient.

Interventional Radiology is considered one of the most advanced technologies available because it can diagnose and treat medical procedures without surgery. It is a minimally invasive procedure guided by 3D images. It can provide safe alternatives to surgery for complex medical conditions.The interventional radiologist is a medical doctor specialized in radiology.

New Interventional Radiology Suite Opens

“We expect the patients will have a tranquil experience from the minute they first meet the radiolo-gist to their departure for home,” said Lois Heater, Director of Diagnostic Imaging. “The minimally invasive procedures offered will also reduce stress for patients, families and doctors. For we now offer this advanced technology close to home, close to their doctor.”

Procedures/Diagnoses Available

Chemoembolization Chemo treatment delivered directly to tumor

Angioplasty Opening of narrow or blocked vessels

Biopsy Taking a tissue sample

Embolization Blocking abnormal blood ves-sels to stop internal bleeding

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“Longmont United Hospital has state-of-the-art facilities with people who are very experienced at every level of care - from cardiology to cardiovascular surgery.”

Thomas Matthew, MDCardiovascular Surgeon

Procedures, Interventions

Angioplasty

Cardiac Catheterization

Coronary Artery Bypass Surgery

Interventional Radiology

Minimally Invasive Cardiac Surgeries

Open Heart and Thoracic Surgeries

Pacemakers and Defibrillators Implants

Cardiology Services - ready for any heart emergency.

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Aneurysm Deformity Degenerative Disc Disease Degenerative Spinal Conditions Disc Herniation Glioblastoma Multiforme Failed Back Surgery Syndrome Herniated Disc Lower Back Pain

Meningioma Myelopathy Neck Pain Neuropathic Pain Osteoporosis Sciatica Scoliosis Spinal Stenosis Spondylolisthesis Trigeminal Neuralgia Tumors

Surgical TreaTmenTS

Minimally Invasive Spine Surgery

Artificial Disc Replacement

Laser in Neurosurgery

Spinal Fusion

Neurosurgery Services - treating the central nervous system, the peripheral nervous systems, and spinal column diseases

Conditions Treated

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Surgical Treatments

Achilles Tendon Injuries ACL Reconstruction Ankle Arthroscopy Ankle Joint Replacement & Total Ankle Reconstruction Bunion Repair & Heel Pain Cartilage & Meniscus Transplantation Foot Trauma Hammertoe Correction Hand, Wrist Arthroscopy, Replacement Hip Replacement - Partial, Total, Minimally-Invasive, Computer-Assisted Knee Replacement - Partial, Total, Minimally-Invasive, Computer-Assisted Knee Resurfacing Rotator Cuff Repair Shoulder and Elbow Replacement- Total

Access to minimally invasive and computer-assisted surgical treatments - from head to toe.

“There are always new ways to fix fones - metal, titanium plates - we try to match it to what the patient has fractured. So there are lots of choices. That helps us. That helps the patient. IT makes surgery easier and the recovery easier. Ideally what want is for someone to have full motion, no pain, and full funcition.”

Peter Wood, MD, Orthopedic Surgeon

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Community Service is important. We helped over 50 non-profit organizations provide services to communities in need of food, healthcare, wellness, education & special needs transportation.Charity Care Costs $8,143,000Community Building and Benefit Activities 34,500Community Health Services 495,000Community Support Donations 365,000Health Professions Education 1,651,600Unreimbursed Cost of Medicaid and Medicare 6,465,000Subsidized Health Services 5,789,000Community Benefit provided by Longmont United Hospital $22,448,100

Over 50 Community Service Organizations

9HealthFairAmerican Cancer SocietyBoulder County Civic ForumCareer Development CenterColorado Cancer Research ProgramEd & Ruth Lehman YMCAEducation Foundation for the St. Vrain ValleyFront Range Community CollegeHospiceCare of Boulder and Broomfield CountiesLongmont Entrepreneurial NetworkOUR CenterSafe Shelter of St. Vrain ValleySalud Family Health CenterSpecial TransitWoman’s WorkWorkforce Development

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Financial Highlights for 2009

In 2009, Longmont United Hospital continued to maintain and improve the level of services and to sustain its value as a significant community resource by providing over $46 million of benefits to the community. This result is $9.03 of benefit for each dollar of tax relief granted from being a tax-exempt non-profit 501c3 hospital. Longmont United Hospital provided $8 million in charity care, $8 million in subsidized health care services and over $30 million in unreimbursed costs to care for the low income or elderly members of our community. As a significant community asset, we were successful in meeting our goal for providing and enhancing our sophisticated services to keep health care local and to optimize the healing experience of our patients.

For the year December 31, 2009, your community hospital had a margin of 2.0% or $3.3 million. Net revenue increased over the prior year approximately 7.3% due to higher outpatient volumes and a 4.3% increase in the intensity of inpatient care provided which were partially offset by fewer inpatient admissions. Inpatient days at 38,108 were 4,633 days or 11% less than the prior year. Outpatient visits were higher than prior year by 8.8%. Expenses increased by 1.8% as a result of increasing labor, employee benefits, supply, interest, and depreciation on our facilities and equipment. Over $284 million of uncompensated care was provided for charity, bad debts, and contractual discounts, up 10.4% from the previous year due to the increase in the uninsured and/or underinsured.

As a nonprofit community hospital, we are continually challenged to manage rising health care costs and declining reimbursement. We also seek to achieve and maintain a profit margin, of which 100% is utilized for reinvestment in our services, equipment, and facilities to ensure we meet the needs of our communities for today and the future. We are proud of our caring staff and physicians who continually meet these challenges while providing extraordinary care and optimum patient satisfaction.

Neil Bertrand, Chief Financial Officer

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2009 2008Assets Cash 11,921 13,694Net Patients Accounts Receivable 23,363 23,421Inventories 4,364 3,303Other Current Assets 6,197 3,423 Total Current Assets 45,845 43,841Board Designated Funded Depreciation 51,882 48,551Bond Indenture Funds 5,765 6,800 Total Assets Limited To Use 57,647 55,352Net Property, Plant, Equipment 120,929 117,606Other Assets 5,625 5,907 Total Assets 230,046 222,706Liabilities and Net Assets Current Liabilities 26,597 25,547Long Term Debt 99,922 96,803Unrestricted Net Assets 103,410 100,192Restricted Net Assets 117 164 Total Net Assets 103,527 100,356 Total Liabilities and Net Assets 230,046 222,706

Longmont United Hospital Condensed Balance Sheet December 31, 2009 & 2008 (in thousands)

2009 2008Revenue Gross Patient Revenue 431,325 402,055Less Contractual Allowances (246,571) (218,235)Charity (23,391) (23,996) Net Patient Revenue 161,361 159,823Other Operating Revenue 3,192 3,287 Total Operating Revenue 164,553 163,110Expenses Salaries and Benefits 77,245 76,666 Supplies and Other Expenses 52,845 51,186Professional Fees 4,808 4,208Depreciation 10,415 9,752Interest Expense 4,838 4,402Provision for Uncollected Patient Accounts 13,664 14,695 Total Operating Expenses 163,815 160,909 Income from Operations 738 2,202 Interest and Other Non-operating Income 2,612 2,555 Excess of Unrestricted Revenue Over Expenses 3,350 4,757Assets Released from Restriction 109 216 Net Change to Total Assets 3,459 4,973

Longmont United HospitalStatement of Operations For the Year Ended December 31 (in thousands)

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OutpatientInpatient

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Total Patient Revenues (In millions)

213 223 256 280 284

85 93

122 148

106

Five Year Trends - Revenue & Uncompensated Care

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Uncompensated Care (Bad Debt, Charity, and Contractuals)

178 190 226 257 284

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ER Visits (IP and OP)

25,860 26,422 28,259 29,819 30,996

Five Year Trends - Admissions & Emergency Room Visits

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Admissions

10,060 9,869 10,221 9,934 9,062

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In 2009, Longmont United Hospital’s performance improvement initiatives were selected to the support the mission and vision of the hospital and to support strategic initiatives outlined in the hospital’s strategic plan.The goal for quality improvement was to facilitate data collection, analysis and presentation through the development of a series of scorecards.The scorecards are used to measure overall operational and clinical performance. The scorecards provide consistent com-munication about performance, focus on the strategic initiatives, keep all “eyes” on the same goals and allowed Longmont United Hospital to align internal and external initiatives. The graph represents four inpatient clinical core measures that were a priority focus in 2009: •HeartAttack-AcuteMyocardialInfarction(AMI) •HeartFailure-HeartFailure(HF) •Pneumonia-Community–AcquiredPneumonia(PNE) •SurgicalCare-SurgicalCareImprovement(SCIP)These areas were chosen due to the high risk, high volume and problem prone processes involved in caring for these patient types. The Core Measures have been shown to reduce the risk of complications, prevent recurrences and treat the majority of the patients who come to a hospital for treatment of one of the conditions listed above.

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100 Top 10% in Country

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Surgical

Pneumonia

Pneumonia AMI

AMI

Heart Failure

Heart Failure

200920082007

Core Measures December 31

Three Year Trends - Core Measures

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Foundation Awards Scholarships For Healthcare Careers

John C. Flanders ChairpersonDouglas J. Staver Vice-Chairperson

Mitchell C. Carson Secretary Carol Oswald Yoakum Treasurer

Martin Plaster Frank BigelowEric E. DoeringEd Kanemoto

Herbert Ogden, M.D.C. L. Rowley, D.D.S Virginia ShawBrent Wahl, M.D.

The Longmont United Hospital Foundation is devoted exclusively to supporting Longmont United Hospital through philanthropy. The Foundation pursues its mis-sion through: 1) Fundraising for Longmont United Hospital to enhance its services and programs offered to the community, and 2) Healthcare Career Scholarships to encourage individuals interested in the healthcare field and service to others to follow their dream.We gratefully acknowledge your gifts which enable the Longmont United Hospital Foundation to realize its important mission of helping Longmont United Hospital continue its proud tradition of healthcare excellence and service.

Capital Campaigns Hope Cancer Care Center $1.65 millionPatient Bed Tower $2.6 millionEmergency Department $1.8 million as of December 31, 2009 General Fund $2.9 million as of December 31, 2009

The Foundation is a 501(c) (3), not-for-profit, charitable

organization.

2009 Board of Trustees

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Medical Staff Officers Mary Faini, M.D., Chief of StaffTodd DeBoom, M.D., COS-ElectPatti Rosquist, M.D., TreasurerMark Schane, M.D., Immediate Past COSDepartment ChairsSachinTalusani,M.D–DiagnosticImagingHerbertOgden,M.D.–EmergencyHansElzinga,M.D.–FamilyPracticeBryanReynolds,M.D.,–MedicineJohannaFigge,M.D.–OB/GYN/PEDSCarlyneCool,M.D.–PathologyGreggKoldenhoven,M.D.–SurgeryCommittee ChairsMary Faini, M.D., Medical ExecutiveFabio Pivetta, D.O., Continuing Medical EducationDenise Miller, M.D., Cancer ServicesMark Schane, M.D., CredentialsDouglas Tangel, M.D., Pharmacy & TherapeuticsDavid Burnham, M.D., Quality ReviewKevin Berg, M.D., Trauma Services

Leadership Council, Medical Staff Officers and Committee Chairs Leadership CouncilMitchell C. Carson, MHA, FACHE President and CEONeil Bertrand Chief Financial OfficerSharon Rominger, RN, BS, MS Chief Nursing OfficerNancy Driscoll, RN, MHA, FACHE Vice-President, Patient Care ServicesRebecca Herman, PT , FACHE Vice-President, Clinical & Support ServicesWarren Laughlin Vice-President, Human ResourcesJohn Peterson, Vice-President, Information SystemsCarol E. Smith, JD, BSN, CPHRM Vice-President of Legal & Regulatory Affairs

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