As noted in the accompanying chart, more than half of the hospitals in the region reported net-income losses in 2024. Those with positive net income were AdventHealth Avista in Louisville, Banner Fort Collins Hospital, Boulder Community Health’s Foothills Hospital in Boulder, UCHealth Poudre Valley in Fort Collins, UCHealth Medical Center of the Rockies in Loveland and UCHealth Longs Peak Hospital in Longmont.
Hospitals across the nation have ridden a roller coaster since the days of the COVID-19 pandemic, which began in 2020. Patient counts, according to the Colorado Hospital Association Hospital Utilization Summary for the years 2020-24, peaked in 2021 and then, with some exceptions, fell to pre-pandemic levels. The exceptions, according to the report, were CommonSpirit Longmont United, where patient counts fell significantly, and also Banner North Colorado Medical Center in Greeley.
The hospitals of Northern Colorado and the Boulder Valley face pressures not unlike those of hospitals anywhere, and may actually be in a better position because of population growth that has spurred expansion in numerous locations. Rural hospitals — those outside of the metropolitan Denver area and urban counties such as Weld, Larimer, Boulder and Broomfield — are in far worse shape, according to the Colorado Hospital Association. Eighty-three percent of rural hospitals are operating with “unsustainable margins,” it said.
The Medicaid Hospital Provider Fee reimbursed hospitals $3 billion in 2023 for treatment of low-income Coloradans, the CHA said. It also paid $476 million for uninsured patient care and $148 million for Medicaid administration expenses.
Regional performance
Expenses grew 18.8% more than patient revenues during 2024, CHA reported. Charity care is up 123% since 2021. Nearly 70% of hospitals are operating “with margins deemed unsustainable,” the organization reported.
Some factors for performance are the result of local decisions.
When UCHealth opened its Foothills Hospital in Longmont in 2017, metrics at CommonSpirit Longmont United Hospital, an institution created in 1959, plummeted to half of what they had been.
The McKee decision
Its listing with the state identified 82 registered nurses and six physicians among the 351, some of whom — maybe half, a spokesperson said — might find jobs elsewhere in the Banner organization.
That layoff notice resulted in a notice of an investigation by a law firm that specializes in class-action lawsuits. The law firm, Strauss Borrelli PLLC, was attempting to determine whether Banner met the requirements of the WARN Act, which requires 60-days notice before layoffs such as those anticipated by Banner can occur. Banner’s WARN Act notice was filed Sept. 4 with the stated intent of layoffs occurring “by Nov. 5,” which would be 62 calendar days.
The McKee facility includes the Houston-headquartered MD Anderson Cancer Center, which opened in 2016. Banner and Anderson extended their agreement in June 2024 until 2032. Banner also renamed the transformed facility to Banner North Colorado Medical Center — Loveland campus. Temporary signs immediately went up to cover the McKee name.
The McKee campus, now Banner North Colorado Medical Center – Loveland Campus, is quiet with its parking lot, and patient rooms, largely empty since the decision to close its emergency department and end acute care in that location. (Ken Amundson/BizWest)When it opened in 1976, the hospital was said to be the first facility between Omaha and the West Coast to have single-patient rooms.
The former McKee campus “will offer inpatient and outpatient medical and surgical services, outpatient rehabilitation, a cardiac catheterization lab, cardiac rehabilitation and interventional radiology,” Banner said. Mammography and specialty-care clinics also will be there.
“Over time, the space there will find a use. We’ve looked at a couple of different options but haven’t settled on anything. The space is complicated because it’s configured a certain way, and it’s expensive to change it,” Qualls said.
The numbers Banner reported to the American Hospital Association bear that out. The 8,318 inpatient days for 2024, when spread over the year, amounts to about 23 patients per day, well under the capacity of the hospital.
He said that MCR’s Trauma 1 emergency care designation, earned July 18, 2022, had an impact, too. McKee’s designation was Trauma 3.
“Our strengths were in specialized care and surgical services,” Qualls said.
“We’re watching closely Medicaid reimbursements and what the statehouse might do” as the state figures out how to balance its budget going into 2026, Qualls said. Qualls was on a legislative strategy conference call just prior to speaking with BizWest. “That’s (Medicaid) of most concern to all hospital systems. What has happened is that we struggle with inflation, workforce and now negative impacts to reimbursement.”
It was just four years ago, Sept. 1, 2021, that Banner consolidated its birth operations from McKee to Banner Fort Collins.
In addition to the McKee decision, Banner also closed a stand-alone emergency department and an urgent-care clinic in Greeley.
“We are extremely busy. Yesterday (Nov. 17) was the busiest through our emergency rooms in Greeley, Loveland and at Poudre,” said Kevin Unger, president and CEO of UCHealth’s Northern Colorado facilities.
He said a combination of increased population growth and Banner’s decisions have an impact.
UCHealth is also expanding cancer care from its Harmony campus, and this month will open additional behavioral health beds at Poudre Valley.
UCHealth will open expanded emergency operations at the Greeley Hospital by mid-summer.
The changes for UCHealth mean that additional employees are needed, something not unnoticed by the 351 people laid off at McKee.
Elsewhere
Among the hospitals with the most-striking downturns in utilization, as recorded by the Colorado Hospital Association, was CommonSpirit Longmont United. Between 2020 and 2024, the hospital saw inpatient days decline by more than half, from 15,893 to 7,731. Births declined by half, as did inpatient surgeries. Emergency room visits for the hospital, a Level 3 Trauma Center like its cross-town competitor UCHealth Longs Peak, declined by 3,000 while outpatient visits increased markedly.
Recognizing the issue with Longmont United, CommonSpirit brought in a new president, Deb Mohesky, two years ago. Mohesky, who previously served at other CommonSpirit facilities including in Bismarck, North Dakota, embarked on a new strategic plan for the hospital.
The emergency department has been redesigned, surgical and obstetrics have been improved, and the oncology speciality has been rebuilt. Four additional primary care doctors and a surgeon have been hired, and two orthopedic doctors and a spine surgeon will start in January, she said.
The future still unclear
What the future holds for Colorado’s hospitals will become more clear after the legislative session starting in January 2026, when the state grapples with how to balance its budget. Thirty-one percent of the state’s general fund pays for Medicaid. Medicaid spending has grown faster than revenue, cutting into all other state spending.
A chart shows hospital performance at Northern Colorado hospitals. (BizWest research)
A chart shows hospital utilization for Northern Colorado hospitals. (BizWest research)
This article was first published by BizWest, an independent news organization, and is published under a license agreement. © 2025 BizWest Media LLC.
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