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Home My WebLink About20163922.tiffNCMC BOARD OF TRUSTEES Regular Session Meeting Monday, March 28, 2016 Attachment 1 Minutes of Regular Session of February 29, 2016 * * - Action Required NCMC Board of Trustees Regular Session Minutes Monday, February 29, 2016 12:00 Noon The Board of Trustees of North Colorado Medical Center met in Regular Session on Monday, February 29, 2016, in the Richard Stenner Boardroom located at North Colorado Medical Center. Dr. Carter declared a quorum and called the meeting to order at 12:05 p.m. ATTENDANCE REPORT: NCMC Board of Trustees: Dr. Susan Carter, Larry Cozad, Catherine Davis, Mark Lawley, Michael Simone, Brian Underwood, Jason Yeater, and Sean Conway (Commissioner, non -voting member) Banner Health: Rick Sutton (NCMC CEO) - Excused; and Wendy Sparks (NCMC COO) Staff: Ken Schultz (Board Executive) Recording Clerk: Esther Gesick (Weld County Clerk to the Board) PUBLIC COMMENT: There was no public comment. APPROVAL OF MINUTES: It was moved and seconded (Davis/Yeater) to approve the minutes from both the Annual and Regular Session meetings conducted on January 18, 2016. The motion carried unanimously. OLD BUSINESS: In response to Dr. Carter, Ms. Gesick confirmed all of the Conflict of Interest Questionnaires were submitted and a Summary has been provided to all of the Trustees, a copy of which is attached to these Minutes. NEW BUSINESS: There was no New Business to consider. CEO REPORT or COO REPORT: NCMC COO, Wendy Sparks, gave the following report: • Employees - Performance reviews will be completed by managers and directors for all Banner employees between now and March 15th. • Patient Satisfaction - In 2015, there were eight (8) dimensions; however, for 2016 they are striving to meet ten (10), with the two new system categories being: RN Courtesy and Respect, and Understanding of Managing Health. They are hitting target or stretch on five of the ten, so there is still work to be done and the survey results are reviewed on a weekly basis. • Quality - It is too early in the year, so there are no results yet for the Quality Strategic Initiatives related to the hospital; however, they will be reviewed on the following: a) Improve the quality of care and utilization of resources - reduce the length of stay (for observation patients the target for discharge from NCMC is 20 hours); b) Improve care reliability by reducing the inappropriate use of red blood cells and platelet transfusions; Page 1 of 3 February 29, 2016 NCMC Board of Trustees c) Reconciliation of medication orders for patients (verified on charts during admittance and discharge to increase patient safety); and d) Advanced Directives (the goal is to have 10% of NCMC employees with their own personal advanced directives to set a good example for patients.) • Physicians - Recruiting is ongoing. Dr, Michael Kim will start the end of March and is an Interventional Cardiologist, experience with procedures which are less invasive for heart valve replacements. Dr. Robert Kinzer will start in July and specializes in Infectious Diseases. • Financials -The Greeley Community had an operating loss of $3.3 million due to admissions which were under budget by 13.1%. Additionally, she explained the Colorado Health Op Plan was the least expensive plan on the Health Exchange and it went out of business in the fourth quarter of 2015. Therefore, 75% of the accounts receivable were booked as a $1.5 million loss. In response to Ms. Davis, she explained the pharmacy techs do assist with verifying the patient medications during admittance. Responding to Commissioner Conway, she confirmed the $1.5 million loss was 75% of the annual projected loss. In response to Mr. Simone, she stated the quality initiatives are specific to Banner; they are not federally or state mandated. Lastly, Ms. Sparks reported that last Tuesday HealthGrades officially announced NCMC as one of the Top 50 Hospitals (NCMC is the only hospital to receive this recognition in the Banner system, and only one of two facilities in the entire state of Colorado). Commissioner Conway commented the Board of Commissioners also intends to formally recognize NCMC during the March 23, 2016, Board meeting. COMMISSIONER'S REPORT: Commissioner Conway stated the U.S. Highway 34 Coalition met with CDOT representatives and presented a plan for a PEL (Planning and Environmental Linkages) Study. Next, the North Front Range Metropolitan Planning Organization (NFRMPO) and the Upper FRMPO will hear a presentation from CDOT, and if one or both decide to proceed, the funds will become available as early as July and the study would be started this year. He explained this is significant because Highway 34 is not currently eligible for any funds, since there is not an identified project; however, the Study would allow CDOT to compete for future project funding, He also reported that the County Road (CR) 49 project is on schedule and construction will begin as early as May on a design/build basis and as right-of-way is acquired. He confirmed the County is still very strong economically, it remains within Budget, and they are prepared to deal with issues due to decreased oil and gas valuations. The housing and auto sales still remain strong, job/wage growth remains strong, and oil and gas global operations indicate production will continue in Weld County due to the infrastructure that is in place. In response to Mr. Lawley, he stated he serves on the STAC (State Transportation Advisory Committee) which advises the Transportation Commissioner and Transportation Board, and he is not aware of an impact or shifting of funds designated for 1-25 projects. He discussed the funding issues faced by CDOT which does not receive budgeted funds at the State level, VISITATION REPORTS FOR FEBRUARY: SECURITY DEPARTMENT Catherine Davis shared her report from the visit conducted on January 18, 2016, which was held over from December due to a scheduling conflict. A written copy of her visitation report is attached as a part of these minutes. Page 2 of 3 February 29, 2016 NCMC Board of Trustees VISITATION REPORTS FOR FEBRUARY (can't): SERVICE EXCELLENCE DEPARTMENT Mark Lawley shared his report, dated February 15, 2016. A written copy of his visitation report is attached as a part of these minutes. Dr. Carter noted the BMG (Banner Medical Group) has a separate Service Excellence department. CANCER REGISTRY DEPARTMENT Dr. Susan Carter shared her report, dated February 29, 2016. A written copy of her visitation report is attached as a part of these minutes. She addressed general questions. VISITATIONS FOR MARCH: Larry Cozad Brian Underwood NCMC, INC. REPORT: Dr. Carter reported they attended a conference on Leadership, Management and Administration in Hospitals, which was a very positive experience and she gained an added awareness of what is happening nationally. Ken Schultz informed the Trustees that NCMC, Inc. is considering a $106 million bond issue to refinance the Series 2003 Bonds at a lower rate and to replenish cash reserves. Two conditions make it very timely to do so: 1) the low interest rate environment, and 2) the premiums that are being paid by municipal bond buyers. Due to the high premiums being paid, INC should be able to lower the dollar amount that needs to be issued and achieve higher savings on future P&I payments. He explained that the Series 2003 A & B Bonds mature between 2019 and 2030 with interest rates ranging between 5-6% fixed. He projects that the resolutions to approve the bond issue will be presented to the Board of Commissioners, Trustee Board and the INC Board at the end of March. He reiterated that this action will refinance expensive debt, as well as add $40 million in new debt to replenish cash reserves that were depleted by capital spending in 2015. A key goal is to maintain INC's A+ credit rating as the bonds are being issued. It was agreed to set up a trunk line for Trustees to call in if they are unable to attend to ensure full participation at the March meeting. ADJOURN: There being no further business to come before the Board, it was moved and seconded [Lawley/Davis] to adjourn the meeting at 1:20 p.m. Respectfully submitted, Esther Gesick Page 3 of 3 February 29, 2016 NCMC Board of Trustees NCMC BOARD OF TRUSTEES 2016 SUMMARY OF CONFLICT OF INTEREST QUESTIONNAIRE Pursuant to the NCMC Board of Trustees Bylaws, the Trustees are required to disclose potential conflicts of interest (both personal and immediate family which refers to parent, spouse, child, or sibling, either by birth or marriage). The summary results for 2016 are as follows: 1. Investments: Do you or your immediate family have any material investments in any firm that does business with NCMC Board of Trustees and/or BHS? Carter Yes Cozad _ Yes Davis Yes Lawley _ Yes Simone _ Yes Underwood Yes Yeater Yes X No X No X No X No X No X No X No 2. Management and Consulting Services: Do you or your immediate family provide directive, managerial or consulting services to any outside concern that does business with or that competes with NCMC Board of Trustees and/or BHS? Carter --Yes X No Cozad Yes X No Davis — Yes X No Lawley ` Yes X No Simone _ Yes X No Underwood Yes X No Yeater X Yes No Explain: Owner of local home health company named Touchstone Home Health. 3. Other Financial Interests: Other than investments, do you or your immediate family hold a position or a material financial interest in any outside concern from which NCMC Board of Trustees and/or BHS secures goods or services or that competes with NCMC Board of Trustees directly or indirectly? Carter _ Yes X No Cozad Yes X No Davis Yes X No Lawley — Yes X No Simone Yes X No Underwood _ Yes X No Yeater _ Yes X No Board of Trustees - 2016 Summary of Conflict of Interest Questionnaire Page 1 4. Acceptance of Gifts or Hospitality: Have you or your immediate family accepted gifts, gratuities, hospitality, or excessive or unusual entertainment that might appear to influence your judgment or actions concerning business of NCMC Board of Trustees and/or BHS? Carter Yes Cozad _ Yes Davis — Yes Lawley _ Yes Simone Yes Underwood Yes Yeater _ Yes X No X No X No X No X No X No X No 5. Employment of Immediate Family: Do you have an immediate family member currently employed or employed during the prior 12 months at NCMC Board of Trustees and/or BHS? Carter _ Yes Cozad Yes Davis _ Yes Lawley _ Yes Simone _ Yes Underwood Yes Yeater Yes X No X No X No X No X No X No X No Board of Trustees - 2016 Summary of Conflict of Interest Questionnaire Page 2 NCMC Trustee Report Department History Dylan Hockett is the Security Director of the department and reports to the Banner Director in Phoenix and has developed a program of safety and security with an outstanding and loyal team who are dedicated to serving and protecting the NCMC facility, employees and cyber data, patients and visitors. Name of contact: Dylan Hockett, Security Director History of contact: Dylan has been with NCMC for 17 years. He received his undergraduate degree from UNCO and his MBA from Colorado State University Services Provided. Security of people (employees, patients, visitors) and cyber security of hospital's electronic information. HUGS system for newborns on Birthing Center. Employee security badges. Monitor in and around hospital grounds. Number of Staff: full-time and Part time and what fieds: ' Liar 1 See•: rir r nu 1'. System Toei1 Sr.I;,:r••l'i 'r ? S. -•c Tech-nithan • N oCO Safety/ Security Director Dylan Hackett PitictrP vcr{ S. i;l'rf'r53r Officers WR Safety/ Security ' Officer • Ifu.l Revenues/Budgets if Relevant Has expenses and salary of 1.184 Million annually Dito.l{[i-I 1 A 2 Securety Operators, Successes. The department focuses on the concept of PROTECTION for both the employees and the patients and visitors to NCMC The department views security as a barrier between good and bad and strives to develop therapeutic relationships with patients. Both approaches keep people from doing horrendous things. K-9 (Ares) and his handler are great successes for the hospital. Challenges/Obstacles: Keep communication open with local law enforcement that bring in suspects and convicted criminals under their purview for medical care whether through the ER and/or medical care. Security does not use metal detectors in ER and is not armed with lethal weapons. Departmental Needs/Reguests: Continue to support enhanced — non -lethal protection measures (e.g. K- 9 and handler, pepper spray and taser). Suggestions For improvement: Another K-9 and handler would be great. Good ambassador for the hospital and non -lethal approach for protection and compassion of patients, visitors, and employees. What Would The Department Manager/Director Like NCMC Trustees To Know: Thank the directors for their support especially for the K-9 support of Ares and his handler. The dog senses the need for serving as an ambassador as well as calming situations that may require his presence to avert Visit conducted by: Mark Lawley On. Date 2/15/2016 Department History Department Service Excellence Patricia McNulty -Collins, MSM, CTAA Program Director Service Excellence Patricia indicated the department began in 2008. It has changed some over time, for the most part they have had the same core team since 2008. The philosophy has remained constant. Build a service excellence culture through leadership alignment, strategy development, staff education and coaching, reward and recognition and accountability. Service(s) Provided The "service excellence goal at Banner Health is to provide an excellent patient experience which is coordinated, convenient, compassionate and consistent. The Hospital is required by The Centers for Medicare and Medicaid. Service (CMS) to survey a random selection of inpatients. HCAHPS survey evaluates patients' perception of care. The. identities c•iaht dimensions:" • Doctor communication • Nurse communication • Responsive to needs Pain management Communication about medications • Clean • Quiet at night • Discharge instructions HCAHPS (also known as Hospital CARPS) stands for Hospital Consumer Assessment of Healthcare Providers and Systems. HCAHPS consists c}l-a standardized survey ittstrutncut and a set or (kiln collection and rcportiui4 procxxlures- -1 ltese arc used by hospitals (or their survey vendors) to gather information about patients' perxpectka:s On care in the organization. !WAIF I'S is part of -o pt1Ulic/private partnership dedicated to publicly reporting valid and comparable information on Hospital cart' grainy, This inrorniatiui1 serves the goal of increasing eOnstirucrs' knc wiedec of hospital care. It also provides hospitals with dent and benchmarks uw gouge [heir pert.oTimmee relatiee to others. CMS reports the results cc the hospital compare wcbsilc: www.hospitalcompare.hlis.gov \vita( is ircAllp5 protocol? The HCAI II'S Survey is designed to be completed by adult patients who had a recent medical, surgical or obstetrical visit to an acute care hospital, There are certain exclusions For patients who should not receive the survey. For example, patients with certain illnesses or diseases are excluded, as well as patients who are not alive at discharge. a All payer types are included in HCAI-IPS. Even though this is a CMS initiative, it is not focused on Medicare beneficiaries. o Patients under age 18 are not included in HCAHPS. o Spec ia Ity hospitals are not included in HCALIPS. Only general acute care hospitals are covered by the protocol. o Some patient exclusions are required. These include expired patients, most psychiatric cases, and patients who are discharged to hospice, etc Exclusions are based on DRG and admit or discharge status. AboElt the Sursv v The HCAHPS survey contains 21 patient perspectives on care and patient rating items that encompass nine key topics: communication with doctors, communication with nurses, responsiveness of hospital staff, pain management, communication about medicines, discharge information, cleanliness of the hospital environment, quietness of the hospital environment, and transition of care. The survey also includes four screener questions and seven demographic items, which are used for adjusting the mix of patients across hospitals and for analytical purposes. The survey is 32 questions in length. 11.O tILe mirri,ttlr� fl:' In July 2012 Banner chose to engage NRC Picker as the survey administrator. CMS approves several modalities to survey patients; phone and mail are the most popular. Banner chose a phone modality to administer the survey. According to CMS protocol, a random selection of patients is selected to receive a phone call. The survey administrator must make 5 attempts to contact the selected patient. ''Attached are the patient survey questions. Number of staff: 2 FTE and 1 PT responsible for all three of Banners Facilities Successes: Revenues/Budgets if relevant N/A NCMC has received a 4 out of 5 Star rating from the Hospital Consumer Assessment of Healthcare Providers and Systems "HCAHPS" star ratings enable consumers to more quickly and easily assess the patient experience of care information that is provided on the Hospital Compare website. HCAHPS star ratings allow consumers to more easily compare hospitals using a 5 -star scale, with more stars indicating better quality care. To calculate the HCAHPS star ratings, HCAHPS Survey information from one hospital is compared to that from others. More stars indicate better quality care than fewer stars. The stars are one way of comparing hospitals. HCAHPS star ratings, like the HCAHPS measures on which they are based, are updated quarterly. Hospitals differ in the quality of care and services they provide to patients. HCAHPS star ratings provide a snapshot of the 11 measures of patient experience of care on Hospital Compare. In addition, the HCAHPS summary star rating combines all 11 HCAHPS star ratings into a single, comprehensive metric. It is important that you consider multiple factors when making decisions about your health care and comparing hospitals. The HCAHPS star ratings summarize patient experience, which is one aspect of hospital quality. The patient experience star ratings are based on the information on quality of care that is reported on Hospital Compare. • Hospital Compare displays hospital performance on certain important measures of quality care. ■ Positive results on patient experience of care measures may mean that a hospital is delivering good care. However, other information may be important to you, like timely and efficient care and results or outcomes of care measures, that isn't included in HCAHPS star ratings. Challenges/Obstacles None noted Departmental Needs/Requests None noted Manager's suggestions for improvement None noted What would the department manage/director like NCMC, Inc. to know, if anything? Patricia believes the services provided are excellent. She wanted everyone to know that patients were in good hands and the patient's emotional, spiritual and educational needs were being met. Patricia also wanted to make sure that the focus wasn't singularly directed on HCAHPS. Pat believes her team as well as the majority of hospital employees truly live a culture of caring and believe they should do the right thing for the right reasons. Notes/Miscellaneous None Comment Question: if you could change one thing about your recent visit, what would it be? Question During this hospital stay, how often did nurses treat you with courtesy and respect? During this hospital stay, how often did nurses listen carefully to you? During this hospital stay, how often did nurses explain things in a way you could understand? During this hospital stay. after you pressed the call button, how often did you get help as soon as you wanted it? During ibis hospital stay, how ofai did doctors trout you wily courtesy and respect? During li,is hospital stay, how ()lien did doctors listen carefully to you'? During this hospital stay, how often did doctors explain things in a way you could understand? During this hospital stay, how often were your room and bathroom kept clean? During this hospital stay, how often was the area around your room quiet at night? During this hospital stay, did you need help from nurses or other hospital staff in getting to the bathroom or in using a bedpan? How often did you get help in 'Dotting to the bathroom or in using a bedpan as soon as you wanted? During this hospital stay, did you need medicine far pain? During this hospital stay, how often was your pain well controlled? During this hospital stay, how often did the hospital staff do everything they could to help you with your pain? During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? Before giving you any new medicine, how often did hospital staff describe possible side effects in a way you could understand? After you left the hospital, did you go riirertly to your own home, to someone else's home, or to another health tactility? During this hospital stay, did doctors, nurses or other hospital staff talk with you about whether you would have the helo you neeaeo when you lett the hospital? Dining this hospital stay, did you get information in writing about what symptoms or health problems to look out for after you left the hospital? Using any number from 0 to 10, where 0 is the worst hospital possible and 10 is the best hospital possible, what number would you use to rate this hospital during your stay? Would you recommend this hospital to your friends and ramify? During this hospital stay, staff took my preferences and those of my family or caregiver into account in deciding what my health care needs would be when I left. When I left the hospital, I had a good understanding of the things I was responsible for in managing my health. When I left the hospital, I clearly understood the purpose for taking each of my medications While in the hospital, did staff check on you regularly and ensure your comfort needs were met? Once you were home, did you receive a phone call from someone at the hospital asking how you were doing? During this hospital stay, were you admitted to this hospital through the Emergency Room? In general, how would you rate your overall health? In general, how would you rate your overall mental or emotional health? What is the highest grade or level of school that you have completed? Are you of Spanish, Hispanic or Latino origin or descent? What is your race? Please choose one or more. What language do you mainly speak at home? rD2015 National Research Corporation Page 1 of 1 Report to North Colorado Medical Center Board of Trustees Trustee -Susan Carter, M.D. February 29, 2016 Cancer Registry Department at North Colorado Medical Center Department History: This department was known as Tumor Registry, but is now known as Cancer Data Registry. It has been functioning at North Colorado Medical Center for over 30 years. Recent transition includes regionalization with 4 facilities- McKee Hospital, Sterling and Fort Collins Hospital in the Banner system. Name of contact: Julianne Fritz- NOCO Regional Director of Oncology Services History of contact: Julianne has been the oncology service director for 20 years. Patsy White was the previous oncology data manager, but recently retired after over 25 years of service. Julianne Fritz is the head of the Northern Colorado region oncology services. Services Provided: Website: "The Cancer Registry bridges the information gap by capturing the whole picture of the disease from diagnosis to end of life as each patient is followed for the rest of his or her life. The Registry contains complete information including all treatment received, both within and outside of the hospital setting. It provides integrated data to form a complete cancer record of care provided. The Registry also reminds physicians and patients of the need for continued follow-up examinations. The Cancer Registry helps our Cancer Committee evaluate and improve the care and services we provide. All information is confidential. Statistics are sent to the Colorado Central Cancer Registry, which in turn offers information to the National Institute of Health". Cancer Committee is an interdisciplinary group that helps provide direction and cohesion of all cancer services, including social services, American Cancer Society, Palliative care/hospice, physical therapy, surgical and adjuvant therapy management, statistics, reporting to the American College of Surgeons. We have a designated ACS liaison, who is Dr. Gene Tullis at present. We convene on a quarterly basis. Tumor Board conference meets weekly Wednesday morning at 7 a.m., and reviews all cancer cases diagnosed over the previous week. The entire cancer team reviews the diagnosis and assures appropriate treatments and options and support services are available. This includes surgeons, medical and radiation oncologists, radiologists, pathologists, genetic counselors, oncology nurses, clinical research specialists, care coordinators, social workers, pharmacists and a program administrator. All are charged with discussing each case and making a recommendation together for the best treatment of each cancer patient. Occasionally, Tumor Board meeting is dedicated to a breast conference. Breast cases diagnosed or treated at NCMC are reviewed at this time. This segment is as above, with the addition of professionals specializing in breast diagnostics and treatment. Number of Staff full-time aneL Dart -time and what fields 6 FTE, 2 per diem- total 8 ( 3.6 FTE's NCMC) Teri Waters, Kate Barnes (soon CTR exam), Tina Prato (new), Tammi Becker, CTR X 2 years Oncology Data Coordinator Oncology Data Management Certified Tumor Registrar Revenues/Budgets If Relevant: n/a Indirect- Hospital operating license dependent Successes: Accreditation, designation- Colorado Central Cancer Registry, National Institute of Health, American College of Surgeons. Recent American College of Surgeons Commission On Cancer Accreditation Survey, Nov 4, 2015. Dr. Eric Ohlsen, surveyor. The evaluation process also done by JCAHO, last year in the spring. They were impressed with our handling of data. We are part of the Colorado Medical Society Oncology care model; M.D. Anderson Cancer Center corroboration 8 site visits with them, they were also impressed and further negotiations re official affiliation Challencies/Obstacles' All of our data abstractors are required to have Certified Tumor Registrar (CTR) certification. Nota hugo f Zvi o o; ll[Idato3. aivveiy� ii ILiIIUG S Vil111 LILIUII �1}i..l uoI)IperisaiIorl. Regionalization requires organization, more staff would make things easier Tins, the new hire, has just begun as part of the team, which should help significantly. Departmental Needs/Requests' EMR interface. Transition to Cerner Ambulatory is occurring in AZ. NCMC oncology physicians utilize Mosaic software Suggestions for improvement: What Would The Department Manager/Director Like NCMC Ti .I ,,Gs To Know How important the tumor registry is! The tumor registrars endure constant pressure to report correct data on a continual basis. They are very proud of our cancer commitment to the community, and the ability to maintain quality care and recognized statistic management. Cancer population is increasing, and services will be needed long term. NCMC BOARD OF TRUSTEES Regular Session Meeting Monday, March 28, 2016 Attachment 2 NCMC Series 2016 A&B Bond Issue * * - Action Required RESOLUTION OF THE BOARD OF TRUSTEES FOR NORTH COLORADO MEDICAL CENTER WHEREAS, the Board of Trustees for North Colorado Medical Center (the "Hospital") is a body corporate duly organized, existing and created by Weld County, Colorado (the "County") pursuant to Title 25, Article 3, Part 3 of the Colorado Revised Statutes, as amended, with requisite corporate power to lease and operate hospital facilities and to carry on its business as presently being conducted; and WHEREAS, in connection with the previous issuance by the Colorado Health Facilities Authority (the "Authority") of certain of its bonds, of which its Hospital Revenue Bonds (NCMC Inc. Project) Series 2003A and Series 2003B (together, the "Series 2003 Bonds"), its Hospital Revenue Bonds (NCMC, Inc. Project) Series 2012 (the "Series 2012 Bonds") and its Hospital Revenue Refunding Bonds (NCMC, Inc. Project) Series 2013 (the "Series 2013 Bonds") (collectively, but not including the Series 2003 Bonds which are being refunded by the hereinafter defined Series 2016 Bonds, the "Prior Bonds") are currently outstanding under the Restated Indenture, as defined herein, the Hospital has previously entered into a First Restated Lease, dated as of May 1, 2013 (the "Restated Lease"), with the Authority, whereby the Hospital leases those certain hospital facilities in the City of Greeley, Colorado, known as North Colorado Medical Center (the "Hospital Facilities") currently being operated by NCMC, Inc., a nonprofit corporation duly organized and existing under the laws of the State of Colorado (the "Corporation") or its designee pursuant to a Restated Operating Sublease, dated as of July 1, 2012, between the Hospital and the Corporation (the "Restated Sublease"); and WHEREAS, the Hospital Facilities are situated on land currently owned by the County and leased to the Authority pursuant to a Restated Ground Lease, dated as of July 1, 2012 (the "Restated Ground Lease"), between the County and the Authority; and WHEREAS, the Hospital and the Corporation propose to have the Authority issue its Series 2016 Bonds (i) to refinance and refund the Series 2003 Bonds, (ii) to finance the cost of acquiring, constructing, renovating, improving and equipping certain real property and hospital and healthcare related facilities for the Corporation, including reimbursing the Corporation for certain of such capital expenditures already made and (iii) to pay certain costs associated with the issuance of the Series 2016 Bonds (the "Series 2016 Project"); and WHEREAS, the First Restated Trust Indenture, dated as of May 1, 2013 (the "Restated Indenture"), between the Authority and Wells Fargo Bank, National Association, as trustee (the "Trustee"), executed in connection with the issuance of the Prior Bonds, provides that, upon the Hospital meeting certain conditions contained therein, the Authority may issue additional bonds for the purposes set forth in the Restated Indenture; and WHEREAS, the Hospital has complied with the necessary requirements contained in the Restated Indenture with respect to the issuance of additional bonds; and WHEREAS, it is anticipated that the Authority will agree to issue its Hospital Revenue Bonds (NCMC, Inc. Project) Series 2016 (the "Series 2016 Bonds") and to use the proceeds thereof for the purposes set forth above; and 4848-4804-3567 WHEREAS, in connection with the issuance of the Series 2016 Bonds, the parties to the Restated Indenture desire to further restate the Restated Indenture pursuant to the Second Restated Trust Indenture, between the Authority and the Trustee (the "Second Restated Indenture"); and WHEREAS, the Series 2016 Bonds will be issued pursuant to the Second Restated Indenture; and WHEREAS, in connection with the issuance of the Series 2016 Bonds, the parties to the Restated Lease desire to further restate the Restated Lease pursuant to the Second Restated Lease, between the Authority and the Hospital, which also provides for the payment of the Series 2016 Bonds through additional lease payments to be made by the Hospital; and WHEREAS, in connection with the issuance of the Series 2016 Bonds, the parties to the Restated Sublease desire to further restate the Restated Sublease pursuant to the First Restated Operating Sublease (the "First Restated Sublease"), between the Hospital and the Corporation, which also provides for the payment of the Series 2016 Bonds through sublease payments to be made by the Corporation; and WHEREAS, in connection with the issuance of the Series 2016 Bonds, the parties to the Restated Ground Lease desire to further restate the Restated Ground Lease pursuant to the First Restated Ground Lease, between the County and the Authority (the "First Restated Ground Lease"); and WHEREAS, it is deemed to be in the best interests of the Hospital and the Corporation to have the Authority issue the Series 2016 Bonds for the purposes set forth above; and WHEREAS, the Series 2016 Bonds will be secured by payments to be made by the Corporation, on behalf of the Hospital, to the Authority pursuant to the First Restated Sublease and the Second Restated Lease, which amounts will be pledged by the Authority to the Trustee pursuant to the terms of the Second Restated Indenture; and WHEREAS, Wells Fargo Bank, National Association (the "Underwriter") is expected to agree to purchase the Series 2016 Bonds pursuant to a Bond Purchase Agreement (the "Bond Purchase Agreement") among the Authority, the Hospital, the Corporation, Banner Health ("Banner") and the Underwriter; and WHEREAS, the Series 2016 Bonds will be offered to investors by the Underwriter by a preliminary official statement (the "Preliminary Official Statement") and a final official statement (the "Official Statement") containing information with respect to the Series 2016 Bonds and the security therefor, including information with respect to the Hospital, the Corporation, the Hospital Facilities and others; and WHEREAS, the Corporation will guarantee the payment of the principal of, premium, if any, and interest on the Prior Bonds, the Series 2016 Bonds and any Additional Bonds (as defined in the Second Restated Indenture) pursuant to the terms and conditions of a Second Restated Guaranty Agreement, between the Corporation and the Trustee; and 2 4848-4804-3567 4 WHEREAS, Banner has guaranteed the payment of the principal of, premium, if any, and interest on the Prior Bonds and will guarantee the payment of the principal of, premium, if any, and interest on the Series 2016 Bonds pursuant to the terms and conditions of various limited guaranty agreements between Banner and the Trustee; and WHEREAS, there have been presented to this meeting proposed forms of: (a) the Second Restated Indenture, (b) the Second Restated Lease, (c) the First Restated Sublease, (d) the Preliminary Official Statement, (e) the Bond Purchase Agreement, and (f) the First Restated Ground Lease. NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF TRUSTEES FOR NORTH COLORADO MEDICAL CENTER, AS FOLLOWS: 1. The issuance of the Series 2016 Bonds by the Authority in the principal amount of not to exceed $115,000,000 and the financing of the Series 2016 Project, to be implemented in accordance with the various documents described in the preambles hereto, are hereby approved. Upon the Board of County Commissioners of Weld County, Colorado indicating no objection to the issuance of the Series 2016 Bonds, the First Restated Ground Lease and the Second Restated Lease (whether by letter, resolution or ordinance of the Board of County Commissioners), all of the officers of the Board of Trustees are hereby authorized, empowered and directed to execute any instruments and take any actions required to cause the issuance of the Series 2016 Bonds by the Authority and the financing of the Series 2016 Project. The Series 2016 Bonds shall be issued as fixed rate bonds on a tax-exempt basis. The maximum yield on the entire issue of the Series 2016 Bonds as a whole (giving effect to any original issue discount and original issue premium) shall not exceed 3.60% per annum. The Series 2016 Bonds shall mature no later than May 15, 2034. 2. The forms of the Second Restated Indenture, the Second Restated Lease, the First Restated Ground Lease, the First Restated Sublease, the Preliminary Official Statement and the Bond Purchase Agreement submitted to this meeting, forms of which shall be reviewed and approved by the County's Attorney's Office, as counsel to the Hospital, be and they hereby are approved, and, upon receiving the aforementioned evidence of no objection from the Board of County Commissioners, the President, the Vice President, the Chair, the Vice Chair or any other member of the Board of Trustees are hereby authorized, empowered and directed to execute, acknowledge and deliver the Second Restated Lease, the First Restated Sublease and the Bond Purchase Agreement in the name and on behalf of the Hospital and, thereupon, cause the same to be attested by the Secretary or any Assistant Secretary of the Board of Trustees or any other member of the Board of Trustees not executing the documents, with such changes therein as shall be approved by the officers of the Hospital or other representative of its Board of Trustees executing the same (the final forms of which shall be reviewed and approved by counsel to the Hospital), their execution thereof to constitute conclusive evidence of the Hospital's approval of such documents and any and all changes or revisions therein from the forms now before or described at this meeting; and that from and after the execution and delivery of such documents, the officers; and such agents and employees designated by such officers, of the Hospital or its Board of Trustees are hereby authorized, empowered and directed to do all such acts and things and to execute, attest, acknowledge and deliver all such documents as may be necessary to carry 3 4848-4804-3567 4 out and comply with the provisions of such documents as executed, including but not limited to any and all other documents necessary or desirable in connection therewith. 3. The Preliminary Official Statement relating to the Series 2016 Bonds submitted to this meeting be and it hereby is approved and its distribution is approved subject to final review by counsel to the Hospital, and the officers of the Hospital or other representative of its Board of Trustees or any of them be and they hereby are authorized, empowered and directed to execute and deliver the final Official Statement, and the distribution of the Preliminary Official Statement and final Official Statement is hereby approved; each of the Preliminary Official Statement and final Official Statement is to be in the form of the Preliminary Official Statement now before this meeting and as hereby approved and with such changes therein and completions thereto as shall be approved by the officer of the Hospital or other representative of its Board of Trustees executing the same, the execution thereof to constitute conclusive evidence of the Hospital's approval of any and all changes or revisions therein and completions thereto from the form of Preliminary Official Statement now before this meeting. 4. The officers of the Hospital or other representative of its Board of Trustees or any of them are hereby appointed and authorized to execute all certificates and other documents, including tax documents, which may be necessary in connection with the issuance of the series 7016; Bonds and to rho all things necessary to nrnvirde for the aale and icsnanre of the Series 2016 Bonds, including, but not limited to, any agreements or certifications necessary to comply with any applicable tax and securities law requirements, requirements of the Authority, requirements of the rating agencies and the Bond Purchase Agreement and the other documents described above, and all such actions and doings of said persons which are in conformity with the purposes and intent of this resolution hereby are in all respects ratified, approved and confirmed, 5, Since the adoption of Section 20 of Article X of the Colorado Constitution, the Board of Trustees of the Hospital has operated the Hospital as an "enterprise" for purposes of Section 20 of Article X of the Colorado Constitution, as the Hospital has been operated as a government owned business, has retained authority to issue revenue bonds, and receives less than ten percent of its total annual revenues in state and local grants, and the Board of Trustees hereby ratifies the designation of the Hospital as an enterprise for purposes of Section 20 of Article X of the Colorado Constitution. 6. A form of this Resolution has been given to the Board of County Commissioners and shall constitute the notice to incur revenue debt required by Section 25-3-304(4)(b), C.R.S. 7. All other acts and doings of the officers, agents and employees of the Hospital or of its Board of Trustees, including but not limited to the execution of other agreements, certificates and documents, which are in conformity with the purposes and intent of this resolution and in furtherance of the issuance and sale of the Series 2016 Bonds and the financing of the Series 2016 Project shall be and the same hereby are in all respects ratified, approved and confirmed. 8. All prior acts and doings of the officers, agents and employees or the Board of Trustees of the Hospital which are in conformity with the purposes and intent of this resolution 4 4848-4804-3567.4 and in furtherance of the execution and performance of the documents described herein and the issuance and sale of the Series 2016 Bonds, and in furtherance of the financing of the Series 2016 Project shall be and the same hereby are in all respects ratified, approved and confirmed. 9. The passage and approval of this resolution and the execution by the Hospital of the documentation described herein shall not create any third -party beneficiary rights in any person or entity not a party to such documents, unless specifically provided therein. 10. If any section, paragraph, clause or provision of this resolution shall for any reason be held to be invalid or unenforceable, the invalidity or unenforceability of such section, paragraph, clause or provision shall not affect any of the remaining provisions of this resolution. 11. All bylaws, orders and resolutions, or parts thereof, inconsistent herewith are hereby repealed to the extent only of such inconsistency. This repealer shall not be construed as reviving any bylaw, order or resolution or part thereof. 12. This resolution shall be in full force and effect upon its passage and approval. Adopted this 28th day of March, 2016. By Dr. Susan Carter, President [SEAL] Attest: By Larry Cozad, Trustee/Secretary 5 4848-4804-3567 4 Esther Gesick From: Sent: To: Cc: Subject: Attachments: Schultz, Ken <Ken.Schultz@bannerhealth.corn> Friday, March 18, 2016 11:44 AM Ellen E. Stewart; Steve CI ik, wrll.douglas c wellsfargo.com; Al Dominguez (amdcla@comcastret), Bob Murphy (brnarphy@floodpeterson.com); Brandon Routchens {brandonbh4 ri gmaJi corn); Or. Susan Carter, Jeffrey Carlson ()scarlson@turningpnt.org); Kay Kosmicki; Mark Lawley: Mike Simone; Tom Grant (tgrant ct greeleyattorneys.com); Vicki Wilson tvict<i wilso#1 c[i?- unca erlu} Brian Underwood; Catherine Davis Ph. D. (catherne,davis1225@gmailcoirr): Esther Gesick; Jason Yeater; Larry Cozad (larry Cozad c©autornatiori-x.com); Sean Conway Bruce Barker; Don Warden, Esther Gesick, Gibson, Patricia; Ashford, Anna L NlCMC Series 2016 MB Bond Issue - Rationale NCMC SERIES 2016 A&B BOND ISSUE - Rationale,docx Attached is a merno that will hopefully give everyone a bolter undcrstan.diirig of why NCMC., Inc, is moving forward with at bond issue to `advance refund' {l.e. refinance) the Series 2003 ,'1&B Bonds and arise an additional $40 million anew money. I t'ealixe that within this explanation there are some rather esoteric ctineepts and that I may not have covered every base, .So you may not fell comfortable with all the nuances, Since the only objective here is to provide you 4 itll greater clarity, if i its doesn L quite. get It done, please don't hesitate to contact me iii advance of the tipcL'm iii2. riledlin s for Further ckirii3crltion. Best reprds, Kew 1 SERIES 2016 BOND ISSUE Rationale March 18, 2016 Arguments supporting the issuance of $110,000,000 in Series 2016 A&B Bonds include' 1. NEED: In 2015, $40 million was transferred from INC's investment accounts to fund capital outlays related to the MCP Infrastructure Project. The drawdown came at a time when the stock market was experiencing a correction. As a result of these two factors, days cash on -hand, a key liquidity metric, decreased 52 days from 299 to 247 on a year -over -year basis. Thus, INC needs to replenish its cash position. In anticipation of this need, on 4/28/15, the INC Board adopted a "reimbursement resolution" reserving the right to reimburse itself for $35 million of capital expenditures by issuing that amount of future debt. 2. MARKET CONDITIONS: Current market conditions - in particular, significant inflows of cash to municipal bond funds and the willingness of muni buyers to pay healthy premiums for new bond issues to replace retiring bond issues — have made it possible to advance refund INC's outstanding $78.9 million Series 2003 A&B Bonds. These bonds mature at various dates between 2020 and 2030, carry an average fixed rate of 5.65%, and are callable in 2019. Normally, it would be inadvisable to "advance refund" three years prior to the call date on a bond because it would be too expensive. However, at this juncture, due to a market tailwind and the recent increase in Treasury rates, the refunding cost can be mitigated and INC could potentially realize gross cash flow savings of $9.9 million ($8.2 million on a net present value basis) on future 2003A&B P&I payments, although these estimates are dependent on market conditions the day the issue is priced. Given these factors, it appears to be a good time to proceed with refunding the 2003A&B Bonds and rebuilding INC's liquidity position by borrowing an additional $40 million at the same time. 3. LOWER COST OF CAPITAL & OTHER OBJECTIVES: INC's current cost of capital is approximately 3.9%; one of the key objectives of the proposed offering is to lower it to approximately 2.9%. Other goals include: 1) maintaining the company's A+ credit rating; 2) increasing days -cash on - hand; and 3) maintaining maximum annual debt service (MADS) at or below $19 million annually (so the debt coverage ratio is not negatively impacted by the new debt). This last objective will require the maturity dates on the new issue to extend beyond the expiration of the Banner operating agreement in December 2027 and beyond the final maturities on the Series 2003 Bonds (2030). The intent is to limit this extension on the final maturities on the new issue to no more than four years (2034). 4. DISADVANTAGES/RISKS: The most obvious disadvantage of issuing $40 million in new debt is that it will increase INC's leverage; debt -to -total capitalization will increase from 38% to 44%. However, based on S&P's new credit analysis system, the increase of INC's debt burden is more than offset by the replenished liquidity from the reimbursement of the $40 million. Another disadvantage of refinancing the Series 2003 A&B Bonds is that it will require INC to write-off in 2016 approximately $3 million in unamortized deferred financing costs (primarily prepaid insurance premiums) related to that issue, although this will be recorded as a "non -cash" expense. Ken Schultz, Board Executive, NCMC, Inc. Esther Gesick Subject: Attachments; FW: Series 2016 Bond - Estimated Issuance Costs Series 2016 Cost of Issuance Estimate.xlsx From: Schultz, Ken[mailto:Ken.Schultz@bannerhealth.com] Sent: Tuesday, March 15, 2016 11:39 AM To: Al Dominguez (amdda@comcast,net) <amdda@comcast.net>; Bob Murphy (bmurphy@floodpeterson,com) <bmurphy@floodpeterson.com>; Brandon Houtchens (brandonbh4@gmail.com) <brandonbh4@gmaiLcom>; Dr. Susan !r Carter esdcarter7@att.net>; Jeffrey Carlson (jscarlson@turningpnt.org) <jscarlson@turningpnt.org>; Kay Kosmicki <4kaykoz@comcast.net>; Mark Lawley <mlawleyl@msn,com>; Mike Simone <mikeslmone@yahoo.com>; Tom Grant (tgrant@greeleyattorneys.com) <tgrant@greeleyattorneys.com>; Vicki Wilson (vicki.wilson@unco.edu) <vicki.wilson@unco.edu>; Brian Underwood <briansunderwood@comcast.net>; Catherine Davis Ph. D. (catherine.davis1225@gmaiLcom) <catherine.davis1225@gmaiLcom>; Esther Gesick <egesick@co.weld.co.us>; Jason Yeoter eJason.yeater@touchstonehomehealth.corn>; Larry Cozad (larry.cozad@automation-x.com) <larry.cozad@automation-x.com>; Sean Conway <sconway@co.weld.co,us> Cc: Ellen E. Stewart <EStewart@bw-legal.com>; Stephen B. Clark <steve@sbclarkinc.com>; Bruce Barker <bbarker@co.weld.co.us>; Don Warden <dwarden@co.weld,co.us>; Esther Gesick <egesick@co.weld.co.us> Subject: Series 2016 Bond - Estimated Issuance Costs I just wanted to give all of you some advanced warning on the estimated cost (attached) of riving the nropo ed $1 10 million bond issue for NCMC, Inc. Although at first glance most of these fees appear to be high, I am assured that they —II- !'"- t,v�iill i. _-�.ki5' �letllt clltl ��,I-It, -9.71/4211S originaiiy quoted $5.33/i 1.000 0;586,300), but with the help of Steve Clark we negotiated down to .l.;:-..5.0.3/$1.000 t$555.500). By. comparison, the underwriter's discount (or "spread") on the fixed portion of rialanor•`, rTa,.as! recent issue v,as :I { 51$ I.t)00 Kutak Rock initially quoted $151,000 all in and, again thanks to Steve C'latrl<. tianaa down Lo .` 130,000, So we negotiated a total savings of $51,800: nothing sensational, but we're prulaahh. paying less than top dollar at sub -1% ol'tile total issuance. In and of themselves, these costs will not im ae1 [NC's bottom line as they will be added to the debt and amortized over the life of rlw honck. However, we will need to write-off the unamortized issuance costs, premiums and discounts generated bt' (he Series 2[103 Bor:d issue, As of 2/-29( that write-off would have resulted in a noneaash expense of S3 6 million. ('I'lrese costs arc 5€ill so because they include the uaamortited insurance premium paid to I:SA/A sured C;araranty uac the date the bonds were issued, j Since non -crash tx[,crlses are cackled back for the purpose of calculating the coverage ratios oil 11 t''s outstanding dell, the only detrimental impact the `b3.6 nil Lion write-ol'[ will have is Lo decrease net equity by a like amount. Any negative perception that the adjustment may have caused will be completely swamped by the addition jai"I [0 ini[lion in debt tc1 the ha[anee sheet. Please contact me if you have any quest ions rc.ga rditrg this inat l4r, I will try to give you some on -going insight into the genesis of the bond issue as we approach the upcoming meeting dates so everything isn't dumped on you in one fell swoop. Right now, we have a work session scheduled with the County Cowin issioners on March 21ST (11:00 AM) in anticipation of their resolution on March 28th (9.1711 AM): the I bard at..[-ru;t,2es will take action at their regularly scheduled meeting on March 28t' (noon); and the INC Board will hold a Finance Committee meeting on March 29t" (11:30 AM) followed directly thereafter by a special Board of Directors meeting (I:00 PM) to approve the issue as well as the 12/31/15 audited financial information to be included in the Official Statement, Meetings with the ratings agencies are scheduled for April 14ti' (Fitch) and April 15th (S&P). The bonds should be priced shortly thereafter and close approximately two weeks later (early May?). Best regards, Ken Schultz i CO • N O O CV N o 8.0 (O ri 0 0 0 0 o ri O a O O O O o O o 0 O o o o O O d O O O O O O o O O O O O Q O O ro o m 0 O O O a a a O 0 O O o a o vDo o n1O OO o o o 0 o O o un N o 0 00 O Lrl a O o O VI u'1 O o ry cn O o oco O 00 m N n [UD 0 0 m m'N u1 o v,. ri 0 ,i r♦ in Estimated Issue = a a (a 3 ma 0 C CO • O u LI ri Z 4-I w E Ca Z Va)1 W 5. O U 0) 3 u� U rl Y C as L > C C Y C 'q� C s--, }MI L } CG tn t0 0 O 04 (0 U b4 (Q = _C r0 X Y Y a) C 00 CO 4- °Ill r9 ro • v w U U a) �C SC ]C ❑ m W co V +T Li 5 Bond Counsel 0a C C N U Tu C C CO 3 > O aaJ t' tn O O U w o Underwriter Counsel Borrower Counsel Wells Fargo Bank O 0. 3 D C C [n r Li (0 O O O CCLuU 3 3 - CO CV in s- C 0) 1O m u chi }' Q O C C C C cc C' p 0.0 a t�0 OO O 1OO a1 ui .S° Q Q < c can ro O c- d0 oa a U C m } _C C - O '+. } C n U J C 'N .—' 7 U .C C 3 4a Vf Q ii cc cc H w> a 2 22 lD O 0 Lc, 00 O Lr) Wells Fargo Bank Underwriter Discount (Le. "SPREAD") n C1 0 an O O TOTAL COST OF ISSUANCE U' 1O C O v O rO Q C 110 C 3' a} L Lel J. a1 L U' E E a) i o_ aJ L C a ut C a) c. as a) VI VI a s 4.4 • N col H Esther Gesick From: Schultz, Ken <Ken.Schultz@bannerhealth corn> Sent: Thursday, March 17, 2016 2:14 PM To: Al Dominguez (amIda@corncast.net); Bob Murphy (bmurphycDfloodpeterson com); Brandon Houtchens (brandonhh4@grnail cam}, Dr Susan Carter; Jeffrey Carlson (1scarIson caturningpnt.cry), Kay Kosrnicki; Mark Lawley; Mike Simone; Tom Grant (tgrant@greeleyattorneys,com): Vicki Wilson (vicki.wilson@unco.edu); Brian Underwood; Catherine Davis Ph. ID (catherine davis1225 @gmail.conn); Esther Gesick; Jason Yeater; Larry Cozad (tarry Cozad €@autorrration-x.com); Sean Conway Cc: Ashford, Anna I.., Esther Gesick (Bruce Barker; Don Warden Subject: Revised Timetable & Distrii}ution List Attachments: NCMC - Timetable 03-17-16.pdf; NCMC - Distribution List 03-17-16.pdf Attached are the revised timetable and distribution list for the Series 2016 A&B Bond issue. Hopefully, these documents will give you better insight into the scope of the process and how it is proceeding. At this juncture, things are going according to plan, especially since we received this afternoon a draft of Banner's audited Lin racial statements from Ernst & Young. New Fide l.iailly can begin preparation of the Recombined Entity audit. Completing the audit in a lime ly fashion is s[i 11 ort• of the more crucial elements in the plan, but my hope is that it will not be by this time next week. NCMC, Inc. Tentative Timetable As of March 17, 2016 Colorado Health Facilities Authority NCMC, Inc. Project Hospital Revenue Bonds, Series 2016 1 2 3 4 5 B I 1 2 3 4 3 2 1 1 2 3 4 5 6 7 7 8 9 10 11 12 Ole 7 8 9 10 11 11 3 4 5 8 7 8 Y 4 9 10 11 12 13 p 1 ti 1116 17 18 19 20 i Q 14 b 18 Tr 18 1111 i 8 11 12 13 14 15 18 t 18 17 18 14 20 2' 21 22 23 24 25 26 27 ' 20 21 22 23 24 ® Ib . 12 18 19 20 21 22 23 ,22 23 24 25 26 27 36 20 29 27 28 29 30 31 24 25 26 27 28 29 70 1213 El 31 Holidays Week Of March 14 3/15 First draft of bond documents circulated 3/17 Begin Weekly Group Call (10:30 AM MDT) NCMC, Inc. and Medical Center Audit drafts circulated First draft of Rating Presentation circulated March 21 March 28 April 4 3/21 Working Session with County Commissioners 3/22 Second draft of Appendix A circulated 3/24 Weekly Group Call (10:30 AM MDT) 3/28 County Commissioners meeting to approve parameters resolution H, FA 3/29 NCMC, inc. and Medical Center Board Meetings H 3/31 Provide comments on Appendix A and bond documents to counsel(s) All 3/31 Weekly Group Call (10:30 AM MDT) All Second draft of Rating Presentation circulated U, FA 4/4 TEFRA Hearing BC, I 4/5 Finalize & submit Rating Agency Presentations U, FA 4/7 Weekly Group Call (10:30 AM MDT) All Perlin BC All A U H DC All April 11 4/12 Colorado Health Facilities Authority Board Meeting — Approvals 4/13 Second draft of all bond and disclosure documents circulated BC, DC 4/14 Fitch Rating Call (11:00 AM MDT) H, U, FA, RA 4/15 S&P Rating Call (10:00 AM MDT) H, U, FA, RA Weekly Group Call (TBD) All April 18 4/19 Finalize Preliminary Official Statement 4/20 Receive Ratings 4/20 Post Preliminary Official Statement 4/21 Weekly Group Call (10:30 AM MDT) April 25 4/25 Investor Call 4/27 Pricing May 9 5/11 Pre -Closing at Kutak Rock (2:00 PM MDT) 5/12 Closing at Kutak Rock (9:00 AM MDT) DC, H, U, FA RA, H, U, FA DC, U All H, U, FA H, I, U, FA All All Responsible Parties H: Borrower BC: Bond Counsel DC. Disclosure Counsel I: Issuer IC: Issuer's Counsel FA: Financial Advisor to COHFA HC: Hospital Counsel U: Underwriter UC: Underwriter's Counsel T; Trustee RA: Rating Agencies FA: Financial Advisor to NCMC, inc. A: Auditor NCMC, Inc. Kutak Rock Kutak Rock Colorado Health Facilities Authority Ballard Spahr Ponder & Co. Berenbaum Weinshienk PC Wells Fargo Securities Dorsey & Whitney Wells Fargo Standard & Poor's, Fitch S.B. Clark Eide Bailly ►i NCMC, Inc. $110,000,000 Colorado Health Facilities Authority NCMC, Inc. Project Hospital Revenue Bonds, Series 2016 ISSUER: Colorado Health Facilities Authority 3033 East First Avenue, Suite 301 Denver, CO 80206 Corinne M. Johnson Phone: 303.321.2112 Email: 1D_Lur,cv.3r_ ISSUER'S COUNSEL: Ballard Spahr LLP 1225 17th St. #2300 Denver, CO 80202 Anastasia G. Khokhryakova, Esq. Phone: 303.299.7310 Email: IC_Iioithrya kovaAc bA:Ir'.,Isp,lnr_c«rn Brittany Barrient Phone: 303.299.7394 Email: bar:_ienr.b@bJltriI' i j] l -h -:CIF, ISSUER'S FINANCIAL ADVISOR: Ponder & Co. 141 Guilford Road Valparaiso, IN 45385 Mike Tym Phone: 219.531.2369 Email: mtvm@poi-lerco.com BORROWER: NCINIC, Inc. 1801 Sixteenth Street Greeley, CO 80531-5199 Ken Schultz, Board Executive Phone: 970.350.6052 Email: Distribution List As of March 17, 2016 1 Anna Ashford, Admin Assistant Phone: 970.810.1574 Email: anna,ashford@bannerh..al_h.com BORROWER'S COUNSEL: 8erenbaum Weinshienk PC 4800 Republic Plaza 370 Seventeenth Street Denver, CO 80202 Ellen Stewart, Esq. Phone: 303.592.8310 Email: .2,;tD,Va: _ bi lea7i � 'Ir. BORROWER'S AUDITOR: Eide Bailly 4310 17th Ave. S. Fargo, ND 58103 Bradley W DeJong Phone: 701.239.8630 Email: hcir,Ionts'a iclebaiu' 5601 Green Vally Dr., Suite 700 Minneapolis, MN 55437 Tyler Bernier Phone: 952.918.3568 Email: erriar{EThi{1ebaillMl BORROWER'S FINANCIAL ADVISOR: S.B. Clark Companies 999 18`h Street, Suite 1440-S Denver, CO 80202 Steve Clark Phone: 303.794.3956 Email: At.v�{r.?_;:cl•Jrlcinr...�,.. COUNSEL TO BOARD OF TRUSTEES AND BOARD OF COUNTY COMMISSIONERS; Weld County Colorado 915 10th Street P,0 Box 758 Greeley, CO 80632 Bruce Barker, Weld County Attorney Phone: 970,336.7235 Email: '+�6�rlgerrerl,u.5w�I-! cti.�_,s BOND COUNSEL: Kutak Rock 1801 California Street, Suite 3100 Denver, CO 80202-3329 Robert Irvin, Esq. Phone: 303.292.7811 Email: r._)130[-[.rivirr [1!Cu1(aurk.4ur� Kristin Caid, Esq. Phone: 303.292.7858 Email: KAmiIIo I r i+rvl„ Cr,. Phone: 312.602,4129 Email: !c l :yi e urvlor~ kutdi<i i-1Cft coil! UNDERWRITER'S COUNSEL: Dorsey & Whitney LIP 125 Bank St, Suite 600 Missoula, MT 59802-4407 Erin McCrady Phone: 406.329.5585 Email: :1i raElyvrinL+Jci!'s�-L'�nm OPERATING SUBLESSEE: Banner Health Northern Colorado Medical Center 1801 Sixteenth Street Greeley, CO 80631-5199 Patricia Gibson, CFO Phone: 970.810.6024 Email: tri,-iLgibsun Banner Health 2901 N. Central Ave, Suite 160 Phoenix, AZ 85012 David Bixby, Senior VP & General President Phone: 602,495.4130 Email: 2 Brenda Schaefer Phone: 602.747.2274 Email: Brenda s, haefer@banneil,e.ilth.com OPERATING SUBLESSEE'S AUDITOR: Ernst & Young 2 North Central Phoenix, AZ 85004 Laurie Taylor Phone: 602.322.3983 Email: laure. _ayiszrta!?,{ com UNDERWRITER: Wells Fargo Securities 1700 Lincoln, 21`h Floor MAC C7300-215 Denver, CO 80203-4500 Will Douglas Director Phone: 303. 863.6339 Email: will ,is.r.al;l:s,,t),Ne.ilsl.ar o.�urn Sheldon Pope Phone: 303 863.4752 Email: sh izIon.oi3aeraweik.t,n-pc,;,7: 333 Market St, 15th Floor MAC A0109-154 San Francisco, CA 94105-2102 Francis Adarkwa Phone: 415.537.7389 Email: lr, cl;, �4.l;.lc'Icw-r r� trellsl`r_I +,•�.� an+ TRUSTEE: Wells Fargo Bank N.A 1740 Broadway, MAC C7300-107 Denver, CO 80274 Ms. Ethel M. Vick Phone: 303.863.4884 Email: vi=ktQ7vrN1!,f irnu.;...}lr: Marybeth Jones Phone: 303.863.6450 Small: i i,n �1_•Li'1. +.N1N��: 6JiiU li�i-Jr f?i i,COm EMAIL ADDRESSES: cj@cohfa.org; KhokhryakovaA@ballardspahr.com; barrientb@ ballardspahr,com; mtym @ponderco.com; ken.schultz@bannerhealth.com; anna.ashford@bannerhealth.com; estewa rt @ bw-legal . co m; bdejong@eidebailly.com; tbernier@eidebailly.com; steve@sbclarkinc.com; bbarker@co.weld.co.us; robert. irvin@kutakrock.com; kristi n.ca id@kutakrock.com; kamille.curylo@kutakrack,com; mccrady,erin @dorsey.com; patricia.gibson@bannerhealth,com; david.bixby@bannerhealth.com; brenda,schaefer@bannerhealth.com; laurie.taylor@ey.com; will.douglas@wellsfargo.com; sheldon.pope@wellsfargo.com; francis.adarkwa@wellsfargo.com; ethel.m.vick@wellsfargo.com; marybeth.jones2@wellsfargo.com 3 Hello