FURP.ORG / PUBLIC DATA EXPLORER

COLUMBUS MEDICAL ASSOCIATION FOUNDATION: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
COLUMBUS MEDICAL ASSOCIATION FOUNDATION (EIN 31-0679012)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-11-11
IRS object ID
202113159349301786
Schema version
2020v4.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-11-11T09:00:17-06:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN381357951PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1250 S HIGH ST SUITE 100AddressLine1Txt
CityCOLUMBUSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43215ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN310679012EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COLUMBUS MEDICAL ASSOCIATION FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOLUBusinessNameControlTxt
Phone6142407410PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11390 DUBLIN ROADAddressLine1Txt
CityCOLUMBUSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43215ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonROBERT E FALCONEPersonNm
Person TitleCEOPersonTitleTxt
Phone6142407410PhoneNum
Signature2021-11-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstROBERTPersonFirstNm
Person LastFALCONEPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAMY CIMINELLOPreparerPersonNm
PTINP00796388PTIN
Phone6148493000PhoneNum
Preparation2021-11-09PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerROBERT E FALCONEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11390 DUBLIN ROADAddressLine1Txt
CityCOLUMBUSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43215ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,053,187GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CMAFOHIO.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1958FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionTHROUGH GRANT-MAKING, CMAF IMPROVES THE HEALTH OF RESIDENTS IN CENTRAL OHIO.ActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent19VotingMembersIndependentCnt
Total Employee18TotalEmployeeCnt
Total Volunteers40TotalVolunteersCnt
Total Gross UBI$50,381TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$49,381NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$105,257PYContributionsGrantsAmt
CY Contributions Grants$41,677CYContributionsGrantsAmt
PY Program Service Revenue$208,640PYProgramServiceRevenueAmt
CY Program Service Revenue$222,824CYProgramServiceRevenueAmt
PY Investment Income$680,265PYInvestmentIncomeAmt
CY Investment Income$704,229CYInvestmentIncomeAmt
PY Other Revenue$59,359PYOtherRevenueAmt
CY Other Revenue$58,338CYOtherRevenueAmt
PY Total Revenue$1,053,521PYTotalRevenueAmt
CY Total Revenue$1,027,068CYTotalRevenueAmt
PY Grants And Similar Paid$1,671,422PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,507,150CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$791,111PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$531,967CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$174,681CYTotalFundraisingExpenseAmt
PY Other Expenses$1,157,060PYOtherExpensesAmt
CY Other Expenses$1,111,365CYOtherExpensesAmt
PY Total Expenses$3,619,593PYTotalExpensesAmt
CY Total Expenses$3,150,482CYTotalExpensesAmt
PY Revenues Less Expenses-$2,566,072PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$2,123,414CYRevenuesLessExpensesAmt
Total Assets BOY$88,162,725TotalAssetsBOYAmt
Total Assets EOY$98,257,781TotalAssetsEOYAmt
Total Liabilities BOY$3,143,842TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,602,545TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$85,018,883NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$95,655,236NetAssetsOrFundBalancesEOYAmt
MissionTHE COLUMBUS MEDICAL ASSOCIATION FOUNDATION, THROUGH THE GOVERNANCE AND OVERSIGHT OF ITS BOARD OF PHYSICIANS AND OTHER EXPERTS, EFFECTS CHANGE WITHIN SPECIFIC PRIORITY AREAS TO IMPROVE THE HEALTH OF THE RESIDENTS OF CENTRAL OHIO.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,726,544ExpenseAmt
Grant$1,507,150GrantAmt
Revenue$222,824RevenueAmt
DescTHE COLUMBUS MEDICAL ASSOCIATION FOUNDATION EXISTS TO EFFECT CHANGE WITHIN SPECIFIC PRIORITY AREAS TO IMPROVE THE HEALTH OF ALL CENTRAL OHIO RESIDENTS.PRIORITIES:-TRANSFORMING CLINICAL HEALTHCARE DELIVERY-SUPPORTING AND IMPROVING HEALTHCARE SAFETY NET CLINICAL SERVICES TO UNINSURED AND UNDERINSURED POPULATIONS-SAVING AND IMPROVING LIVES THROUGH THE COORDINATION OF TRAUMA AND EMERGENCY HEALTHCARE RESOURCES-PROVIDING PHYSICIANS THE LEADERSHIP SKILLS TO FURTHER ENHANCE THE PATIENT/DOCTOR RELATIONSHIPDesc
Total Program Service Expenses$1,726,544TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised FundYes (1)DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign ActivitiesYes (1)ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document14IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee18EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member19IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LAURIE HAWKINSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6142407410PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11390 DUBLIN ROADAddressLine1Txt
CityCOLUMBUSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43215ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JAMES L NICHOLS
SECRETARY/TREASURER5.001.00Yes (X)Yes (X)$0$0$0
LINDA SIEFKAS
VICE PRESIDENT1.001.00Yes (X)Yes (X)$0$0$0
MARC L PARNES MD
PRESIDENT2.003.00Yes (X)Yes (X)$0$8,000$0
NEDRA HADLEY
TRUSTEE1.001.00Yes (X)$0$0$0
ALVIN RODACK
TRUSTEE1.001.00Yes (X)$0$0$0
EDWARD T BOPE MD
TRUSTEE1.001.00Yes (X)$0$0$0
JASMINE GREEN
TRUSTEE1.001.00Yes (X)$0$0$0
MARK STAMM
TRUSTEE1.001.00Yes (X)$0$0$0
BRET KOCKENTIET MD
TRUSTEE1.001.00Yes (X)$0$0$0
GREG SAWCHYN MD
TRUSTEE1.001.00Yes (X)$0$0$0
KAREN KING MD
TRUSTEE1.001.00Yes (X)$0$0$0
BARBARA LACH
TRUSTEE1.001.00Yes (X)$0$0$0
MYSHEIKA WILLIAMS ROBERTS MD
TRUSTEE1.001.00Yes (X)$0$0$0
JEFF HALL MD
TRUSTEE1.001.00Yes (X)$0$0$0
DON BROWN
TRUSTEE1.001.00Yes (X)$0$0$0
ANITA SOMANI MD
TRUSTEE1.002.00Yes (X)$0$0$0
JEFFERY JANIS MD
TRUSTEE1.001.00Yes (X)$0$0$0
BETH LISTON MD
TRUSTEE1.001.00Yes (X)$0$0$0
SUGAT PATEL MD
TRUSTEE1.001.00Yes (X)$0$0$0
ROBERT E FALCONE MD
CEO25.0015.00Yes (X)$260,169$0$3,233
LAURIE HAWKINS
CFO24.0016.00Yes (X)$146,886$0$29,182
FieldValueIRS element (for citing)
Total Reportable Comp From Org$407,055TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$8,000TotReportableCompRltdOrgAmt
Total Other Compensation$32,415TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$41,677AllOtherContributionsAmt
Total Contributions$41,677TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
RENTAL FROM AFFILIATES900099$141,860$141,860
CAM900099$50,911$50,911
PROGRAMS900099$30,053$30,053
FieldValueIRS element (for citing)
Total Program Service Revenue$222,824TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$704,229TotalRevenueColumnAmt
Exclusion$704,229ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$76,500RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$26,119RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$50,381RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$50,381TotalRevenueColumnAmt
Unrelated Business Revenue$50,381UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
INSURANCE PROCEEDS900099$6,980$6,980
VENDING MACHINE900099$977$977
FieldValueIRS element (for citing)
Other Revenue Total$7,957OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,027,068TotalRevenueColumnAmt
Related Or Exempt Func Income$222,824RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$50,381UnrelatedBusinessRevenueAmt
Exclusion$712,186ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,507,150TotalAmt
Program Services$1,507,150ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$439,472TotalAmt
Program Services$139,929ProgramServicesAmt
Management And General$201,892ManagementAndGeneralAmt
Fundraising$97,651FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$11,127TotalAmt
Program Services$3,543ProgramServicesAmt
Management And General$5,112ManagementAndGeneralAmt
Fundraising$2,472FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$15,820TotalAmt
Program Services$5,037ProgramServicesAmt
Management And General$7,268ManagementAndGeneralAmt
Fundraising$3,515FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$57,246TotalAmt
Program Services$18,227ProgramServicesAmt
Management And General$26,299ManagementAndGeneralAmt
Fundraising$12,720FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$8,302TotalAmt
Program Services$2,643ProgramServicesAmt
Management And General$3,814ManagementAndGeneralAmt
Fundraising$1,845FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$10,374TotalAmt
Management And General$10,374ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$46,411TotalAmt
Management And General$46,411ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$387,516TotalAmt
Management And General$387,516ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$71,430TotalAmt
Program Services$38,521ProgramServicesAmt
Management And General$12,611ManagementAndGeneralAmt
Fundraising$20,298FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$65,746TotalAmt
Program Services$9,493ProgramServicesAmt
Management And General$20,676ManagementAndGeneralAmt
Fundraising$35,577FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$253,228TotalAmt
Program Services$1,085ProgramServicesAmt
Management And General$251,540ManagementAndGeneralAmt
Fundraising$603FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,780TotalAmt
Management And General$3,780ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$4,077TotalAmt
Program Services$916ProgramServicesAmt
Management And General$3,161ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$77,120TotalAmt
Management And General$77,120ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$191,228TotalAmt
Management And General$191,228ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescTAXES & LICENSESDesc
Total$455TotalAmt
Management And General$455ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,150,482TotalAmt
Program Services$1,726,544ProgramServicesAmt
Management And General$1,249,257ManagementAndGeneralAmt
Fundraising$174,681FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$255,765BOYAmt
EOY$285,639EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$122,987BOYAmt
EOY$246,156EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$11,148BOYAmt
EOY$12,471EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$4,510,804LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,881,966LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,692,097BOYAmt
EOY$2,628,838EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$85,080,728BOYAmt
EOY$95,084,677EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$88,162,725BOYAmt
EOY$98,257,781EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$542,425BOYAmt
EOY$189,424EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,167,994BOYAmt
EOY$2,051,439EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$433,423BOYAmt
EOY$361,682EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,143,842BOYAmt
EOY$2,602,545EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$83,835,334BOYAmt
EOY$94,420,771EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,183,549BOYAmt
EOY$1,234,465EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$85,018,883BOYAmt
EOY$95,655,236EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$88,162,725BOYAmt
EOY$98,257,781EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$2,123,414ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$12,859,767NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$100,000OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1COLUMBUS MEDICAL ASSOCIATION FOUNDATION UNLIMITEDBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN200385860EIN
Organization Type10OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$0SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd
FieldValueIRS element (for citing)
Majority Dir Trst Supported OrgYes (1)MajorityDirTrstSupportedOrgInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Donor Advised Funds Held2DonorAdvisedFundsHeldCnt
Funds And Other Accounts Held5FundsAndOtherAccountsHeldCnt
Donor Advised Funds Contri$2,275DonorAdvisedFundsContriAmt
Funds And Other Accounts Contri$130FundsAndOtherAccountsContriAmt
Donor Advised Funds Grants$100,000DonorAdvisedFundsGrantsAmt
Funds And Other Accounts Grants$0FundsAndOtherAccountsGrantsAmt
Donor Advised Funds Vl EOY$363,360DonorAdvisedFundsVlEOYAmt
Funds And Other Accounts Vl EOY$870,735FundsAndOtherAccountsVlEOYAmt
Disclosed Org Leg CtrlYes (1)DisclosedOrgLegCtrlInd
Disclosed For Charitable PrpsYes (1)DisclosedForCharitablePrpsInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$253,580OtherCostOrOtherBasisAmt
Book Value$253,580BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,047,215OtherCostOrOtherBasisAmt
Depreciation$492,304DepreciationAmt
Book Value$1,554,911BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,363,416OtherCostOrOtherBasisAmt
Depreciation$638,494DepreciationAmt
Book Value$724,922BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$561,801OtherCostOrOtherBasisAmt
Depreciation$531,278DepreciationAmt
Book Value$30,523BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$284,792OtherCostOrOtherBasisAmt
Depreciation$219,890DepreciationAmt
Book Value$64,902BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,628,838TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescOTHER SECURITIESDesc
Book Value$95,084,677BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$95,084,677TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
REIMBURSEMENT TO AFFILIATES$175,351
ASSETS HELD FOR OTHERS$186,331
FieldValueIRS element (for citing)
Total Liability$361,682TotalLiabilityAmt

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

FieldValueIRS element (for citing)
RegionASIARegionTxt
Offices0OfficesCnt
Employee0EmployeeCnt
Type Of Activities ConductedINVESTMENTSTypeOfActivitiesConductedTxt
Specific Services ProvidedN/ASpecificServicesProvidedTxt
FieldValueIRS element (for citing)
Subtotal Offices0SubtotalOfficesCnt
Subtotal Employees0SubtotalEmployeesCnt
Continuation Total Office0ContinuationTotalOfficeCnt
Continuation Total Employee0ContinuationTotalEmployeeCnt
Total Office0TotalOfficeCnt
Total Employee0TotalEmployeeCnt
Subtotal Spent$0SubtotalSpentAmt
Continuation Spent$0ContinuationSpentAmt
Total Spent$0TotalSpentAmt
Transfer To Foreign Corp0TransferToForeignCorpInd
Interest In Foreign Trust0InterestInForeignTrustInd
Foreign Corp Ownership0ForeignCorpOwnershipInd
Passive Foreign Investmest Co0PassiveForeignInvestmestCoInd
Foreign Partnership0ForeignPartnershipInd
Boycott Countries0BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART III ACCOUNTING METHOD:FormAndLineReferenceDesc

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
HEALTHCARE COLLABORATIVE OF GREATER COLUMBUS
855 GRANDVIEW AVE STE 210COLUMBUSOH43215510426050501 (C)(3)$300,000TO SUPPORT ITS CORE SERVICES
CENTRAL OHIO TRAUMA SYSTEM
1390 DUBLIN ROADCOLUMBUSOH43215311592734501 (C)(3)$340,000TO SUPPORT ITS CORE SERVICES
PHYSICIANS CARE CONNECTION
1390 DUBLIN ROADCOLUMBUSOH43215311373719501 (C)(3)$600,000TO PROVIDE FREE PRIMARY & SPECIALTY MEDICAL CARE FOR THE UNINSURED AND UNDERSERVED
PHYSICIANS LEADERSHIP ACADEMY
1390 DUBLIN ROADCOLUMBUSOH43215822152009501 (C)(3)$237,000TO EDUCATE PHYSICIANS THROUGH LEADERSHIP TRAINING
FieldValueIRS element (for citing)
Total501c3 Org4Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationA MEMORANDUM OF AGREEMENT IS SIGNED BETWEEN THE GRANTEE AND GRANTOR THAT DESCRIBES THE CONDITIONS FOR THE GRANT TO INCLUDE PAYMENT AND REPORTING PROCESSES.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ROBERT E FALCONE MD
CEO$260,169$0$0$0$0$0$0$1,829$0$1,404$260,169$3,233$0$0
LAURIE HAWKINS
CFO$146,886$0$0$0$0$0$0$9,251$0$19,931$146,886$29,182$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 1AFormAndLineReferenceDesc
ExplanationCOLUMBUS MEDICAL ASSOCIATION FOUNDATION PROVIDES A MEMBERSHIP TO AN ATHLETIC CLUB FOR THE CEO. THE PRIMARY PURPOSE OF THIS MEMBERSHIP IS FOR THE CEO TO BE ABLE TO HOLD MEETINGS AT THIS LOCATION.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6COLUMBUS MEDICAL ASSOCIATION IS THE ORGANIZATION'S SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE MEMBER HAS THE AUTHORITY TO ELECT AND REMOVE DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BTHE SOLE MEMBER HAS THE AUTHORITY TO ELECT AND REMOVE DIRECTORS AND APPROVE CHANGES IN THE BY-LAWS AND CODE OF REGULATIONS. IN ADDITION THE SOLE MEMBER HAS THE AUTHORITY TO APPROVE DECISIONS SUCH AS DISSOLVING THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11BTHE RETURN IS PROVIDED TO THE BOARD MEMBERS FOR THEIR REVIEW BEFORE THE RETURN IS FILED.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION ANNUALLY SENDS A DISCLOSURE FORM TO ALL DIRECTORS, OFFICERS, AND KEY EMPLOYEES REQUIRING THEM TO DISCLOSE ANY CONFLICTS OF INTEREST. ANY NEW BOARD MEMBERS ARE ADVISED OF THE POLICY UPON ENTERING THE DUTIES OF HIS/HER OFFICE. THOSE CONFLICTS ARE THEN ADDRESSED BY THE BOARD. VOTING AND PARTICIPATION RESTRICTIONS ARE IMPOSED ON THOSE WITH ANY CONFLICTS. THE BOARD PRESIDENT AND SECRETARY/TREASURER ARE AUTHORIZED AND DIRECTED TO SEE THAT THIS POLICY IS FOLLOWED.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATION PERFORMS COMPENSATION REVIEWS. THE CEO REVIEW IS HANDLED BY THE COLUMBUS MEDICAL ASSOCIATION FOUNDATION BOARD AND THE CEO EVALUATION COMMITTEE. THE CEO HAS AN EMPLOYMENT CONTRACT AND IT WAS LAST UPDATED IN 2020. THE CEO REVIEWS THE COMPENSATION FOR ALL STAFF. THE CEO ESTABLISHES COMPENSATION BASED ON INFLATION RATES, AN INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEYS AND STUDIES AND APPROVAL BY THE JOINT FINANCE COMMITTEE AND THE BOARD. THE OUTSIDE REVIEW IS CONDUCTED EVERY THREE YEARS AND THE LAST ONE WAS IN 2018.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XII, LINE 2CTHE TREASURERS OF THE FILING ORGANIZATION AND ITS RELATED ENTITIES ARE MEMBERS OF THE JOINT FINANCE COMMITTEE. THIS COMMITTEE MAKES DECISIONS CONCERNING THE SELECTION OF THE INDEPENDENT AUDITORS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
COLUMBUS MEDICAL ASSOCIATION FOUNDATION UNLIMITED
1390 DUBLIN ROADCOLUMBUSOH43215200385860FUND PHILANTHROPIC INTERESTSOH501(C)(3)LINE 7COLUMBUS MEDICAL ASSOCIATION FOUNDATIONYes (1)
COLUMBUS MEDICAL ASSOCIATION
1390 DUBLIN ROADCOLUMBUSOH43215314411074ADVANCING COMMUNITY HEALTH THROUGH ADVOCACY, EDUCATION AND SERVICEOH501(C)(6)0N/A
CENTAL OHIO TRAUMA SYSTEM
1390 DUBLIN ROADCOLUMBUSOH43215311592734REDUCING INJURIES AND SAVING LIVES BY IMPROVING EMERGENCY SERVICES AND PREPAOH501(C)(3)LINE 7COLUMBUS MEDICAL ASSOCIATIONYes (1)
PHYSICIANS CARE CONNECTION
1390 DUBLIN ROADCOLUMBUSOH43215311373719OPTIMIZING THE HEALTH OF THE MOST VULNERABLE IN CENTRAL OHIOOH501(C)(3)LINE 3COLUMBUS MEDICAL ASSOCIATIONYes (1)
PHYSICIANS LEADERSHIP ACADEMY
1390 DUBLIN ROADCOLUMBUSOH43215822152009SUPPORT PHYSICIANS WITH LEADERSHIP TRAININGOH501(C)(3)LINE 2COLUMBUS MEDICAL ASSOCIATIONYes (1)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (11 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
CENTRAL OHIO TRAUMA SYSTEMS
B$340,000GRANT
PHYSICIANS CARE CONNECTION
B$600,000GRANT
CENTRAL OHIO TRAUMA SYSTEMS
A$75,681PER SQ FT
COLUMBUS MEDICAL ASSOCIATION
O$73,996AGREED UPON % OF TIME
CENTRAL OHIO TRAUMA SYSTEMS
O$129,857AGREED UPON % OF TIME
PHYSICIANS CARE CONNECTION
O$111,608AGREED UPON % OF TIME
COLUMBUS MEDICAL ASSOCIATION
A$9,450PER SQ FT
PHYSICIANS CARE CONNECTION
A$49,863PER SQ FT
PHYSICIANS LEADERSHIP ACADEMY
B$267,000GRANT
PHYSICIANS LEADERSHIP ACADEMY
A$6,867PER SQ FT
PHYSICIANS CARE CONNECTION
R$100,000TRANSFER