Hospitals in Northern Colorado and the Boulder Valley sometimes take in billions of dollars of revenue as they treat patients. Yet not all are profitable. And in one case, the ownership organization for Banner McKee Medical Center in Loveland pivoted away from acute care, shut down its emergency room and changed its name.
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.
In communities with competing hospitals, both Fort Collins hospitals reported positive income, both Greeley hospitals reported losses, and just one of the two hospitals in Longmont and Loveland reported positive net income.
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.
UCHealth Greeley saw large increases in patient counts, even higher than the peak of the pandemic. So did UCHealth Longs Peak in Longmont and UCHealth Medical Center of the Rockies in Loveland. UCHealth Poudre Valley Hospital also saw increased patient counts over the five-year period of the utilization summary.
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 association, the organization that tracks hospital performance and spotlights barriers to performance, has noted since the passage of H.R. 1, aka The One Big Beautiful Bill, that Colorado can expect a $10.4 billion negative impact over the next five years. The change in eligibility for Medicaid, the primary means by which hospitals are reimbursed for services for people without insurance, will mean that 150,000 more state residents will be without insurance, according to the Kaiser Family Foundation. More uninsured will mean more serious medical cases and more uncompensated care.
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.
The CHA noted that when 575,000 Coloradans lost Medicaid coverage as the COVID-19 pandemic wound down, uninsured visits to hospitals increased 40%.
Regional performance
Numerous factors are likely involved for the financial performance of regional hospitals. Some are universal issues. Labor expenses, for example, are up 39% since 2019, and supply expenses are up 50% in that time period, according to the CHA.
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.
“The financial condition of our hospitals is at a critical juncture,” Tom Rennel, CHA senior vice president for financial policy and data analysis, said in a written statement. With so many hospitals operating on negative margins, “the ripple effects for patient access, quality of care and community health are profound.”
Some factors for performance are the result of local decisions.
When UCHealth Medical Center of the Rockies, for example, earned its Level 1 Trauma designation in July 2022, emergency-room visits at cross-town hospital McKee declined and they exploded at MCR.
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
First public word of changes at Banner’s McKee facility, a community hospital named after Thomas McKee, the donor of the farm land on which it sits, came Sept. 4 when Banner filed a WARN notice with the Colorado Department of Labor and Employment. In that notice, it said it would lay off 351 workers as a result of a shift in focus of McKee. It would cease emergency-room operations and redirect its acute-care activities from the Loveland facility to its Banner Fort Collins and Banner North Colorado Medical Center in Greeley.
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.
“We are hopeful that many of them will stay within the Banner system,” the spokesperson said. “We are also providing staff with comprehensive resources and assistance including first choice for open positions throughout the organization, career counseling, mental health resources, financial planning resources, extended benefits coverage and more.”
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 same day of the layoff notice, Banner told the public that it was transforming McKee from acute-care to specialty health, with a focus on cancer and cardiac care.
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.
Alan Qualls, Northern Colorado CEO for Banner, told BizWest that the name change was “driven by the regulatory environment” because of the change in how the facility is now licensed. “It’s a federal thing through CMS,” he said, referring to Centers for Medicare and Medicaid Services.
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.
Whether the new direction for the facility will fill the space remains to be seen. Qualls said the company has not determined other options for it.
“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 decision to shift focus was “multi-factorial,” including health care trends and reimbursements, he said. “I’ve been here four years, and the number of patients we were serving through the emergency department and traditional acute care had declined,” he 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.
By comparison, the 54,706 inpatient days recorded for UCHealth Medical Center of the Rockies averages out to 150 patients per day.
He said that MCR’s Trauma 1 emergency care designation, earned July 18, 2022, had an impact, too. McKee’s designation was Trauma 3.
The trauma designation doesn’t necessarily mean that first responders automatically transport to the emergency room with the highest level of care, but it could be a factor.
“Our strengths were in specialized care and surgical services,” Qualls said.
Northern Colorado remains one of the fastest-growing regions of the state, and that causes all the health systems to consider their options.
“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.”
Change isn’t new to Banner, or any of the other providers in the region.
It was just four years ago, Sept. 1, 2021, that Banner consolidated its birth operations from McKee to Banner Fort Collins.
Banner has continued to look for expansion opportunities. In April this year, Banner acquired seven Village Medical clinics after numerous health care providers left to join UCHealth clinics. The seven clinics are in Fort Collins, Loveland, Longmont and Windsor.
In addition to the McKee decision, Banner also closed a stand-alone emergency department and an urgent-care clinic in Greeley.
UCHealth was caught somewhat unaware by Banner’s McKee decision, and that of the closure of the stand-alone emergency department 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.
“We’re short of beds and are trying to keep up,” he said. Expansions at UCHealth Poudre Valley, UCHealth Medical Center of the Rockies in Loveland and UCHealth Greeley are not yet open.
He said a combination of increased population growth and Banner’s decisions have an impact.
Unger said that MCR’s expanded emergency department will open in January, and the expansion of MCR will open in June 2026. UCHealth is adding 270,950 square feet and renovating another 20,371 square feet at MCR. The expanded campus will be 988,450 square feet when complete.
UCHealth is also expanding cancer care from its Harmony campus, and this month will open additional behavioral health beds at Poudre Valley.
Estes Park Health affiliated with UCHealth on Dec. 1, which means that UCHealth will likely move some Estes Park patients back to the facility in their home community, thus freeing up space along the Front Range.
UCHealth will open expanded emergency operations at the Greeley Hospital by mid-summer.
All these changes will help with the demand for services in the region, he said, but they won’t be the last expansions.
The changes for UCHealth mean that additional employees are needed, something not unnoticed by the 351 people laid off at McKee.
“We’re getting applicants from Banner, and we’re hiring a number of Banner employees for all three hospitals” that UCHealth operates in Northern Colorado, Unger said.
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.
CommonSpirit, which operates numerous hospitals in Denver and Colorado Springs in addition to Longmont United in Colorado, split off from the Centura Health collaboration in 2023. The prior affiliation also included Avista Adventist Hospital in Louisville, which is now part of AdventHealth.
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.
“We planned to grow 10 service lines,” she said, and in those areas through the end of the hospital’s fiscal year June 30, 2025, “growth has been tremendous.” Gross revenue increased by $90 million last year, she said.
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.
A dispute with the nursing staff, which affiliated with the National Nurses United in 2022, has been resolved with a new contract signed in April 2025. “We made the nurses whole, including those no longer with the facility,” she said. Salary ranges are the same as those in the Denver market. “We’re hiring nurses,” 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.
Health care, and hospitals in particular, are huge drivers of local and state economies. About 100,000 people work in Colorado hospitals. And even though hospitals bring in billions of patient dollars, per patient costs remain below national averages. The Colorado Hospital Association said hospital costs per patient are $692 less than what patients pay on average elsewhere in the country.
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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