COLUMBUS MEDICAL ASSOCIATION FOUNDATION: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- COLUMBUS MEDICAL ASSOCIATION FOUNDATION (EIN 31-0679012)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-11
- IRS object ID
- 202033169349305303
- Schema version
- 2019v5.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule F
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-11T16:02:54-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 S HIGH ST SUITE 100 | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43215 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 310679012 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBUS MEDICAL ASSOCIATION FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COLU | BusinessNameControlTxt |
| Phone | 6142407410 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1390 DUBLIN ROAD | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43215 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT E FALCONE | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6142407410 | PhoneNum |
| Signature | 2020-11-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMY CIMINELLO | PreparerPersonNm |
| PTIN | P00796388 | PTIN |
| Phone | 6148493000 | PhoneNum |
| Preparation | 2020-11-04 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 76.196.244.133 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-11-06 | IPDt |
| IP Tm | 11:54:36 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | A37BA3EEF2DF157CE517102B87C1825C045A57BE | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT E FALCONE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1390 DUBLIN ROAD | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43215 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,080,617 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CMAFOHIO.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1958 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | THROUGH GRANT-MAKING, CMAF IMPROVES THE HEALTH OF RESIDENTS IN CENTRAL OHIO. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 18 | VotingMembersIndependentCnt |
| Total Employee | 19 | TotalEmployeeCnt |
| Total Volunteers | 38 | TotalVolunteersCnt |
| Total Gross UBI | $49,404 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $54,325 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $56,263 | PYContributionsGrantsAmt |
| CY Contributions Grants | $105,257 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $216,764 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $208,640 | CYProgramServiceRevenueAmt |
| PY Investment Income | $765,633 | PYInvestmentIncomeAmt |
| CY Investment Income | $680,265 | CYInvestmentIncomeAmt |
| PY Other Revenue | $46,706 | PYOtherRevenueAmt |
| CY Other Revenue | $59,359 | CYOtherRevenueAmt |
| PY Total Revenue | $1,085,366 | PYTotalRevenueAmt |
| CY Total Revenue | $1,053,521 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,502,076 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,671,422 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $675,067 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $791,111 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $309,762 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,102,550 | PYOtherExpensesAmt |
| CY Other Expenses | $1,157,060 | CYOtherExpensesAmt |
| PY Total Expenses | $3,279,693 | PYTotalExpensesAmt |
| CY Total Expenses | $3,619,593 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,194,327 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,566,072 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $77,061,682 | TotalAssetsBOYAmt |
| Total Assets EOY | $88,162,725 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,248,758 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,143,842 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $73,812,924 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $85,018,883 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE 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 Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,940,758 | ExpenseAmt |
| Grant | $1,671,422 | GrantAmt |
| Revenue | $208,640 | RevenueAmt |
| Desc | THE 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 RELATIONSHIP | Desc |
| Total Program Service Expenses | $1,940,758 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | Yes (1) | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | Yes (1) | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 19 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Taxable Distributions | 0 | TaxableDistributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 18 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAURIE HAWKINS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6142407410 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1390 DUBLIN ROAD | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43215 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| ROBERT E FALCONE MD | |||||||
| CEO | 22.00 | 17.00 | Yes (X) | $251,375 | $0 | $16,124 | |
| WELDON MILBOURNE | |||||||
| EXECUTIVE DIRECTOR (UNTIL 8/19) | 39.00 | 1.00 | Yes (X) | $166,421 | $0 | $9,374 | |
| LAURIE HAWKINS | |||||||
| CFO | 24.00 | 16.00 | Yes (X) | $138,040 | $0 | $32,057 | |
| MARC L PARNES MD | |||||||
| PRESIDENT | 2.00 | 3.00 | Yes (X) | $0 | $7,000 | $0 | Yes (X) |
| JAMES L NICHOLS | |||||||
| SECRETARY/TREASURER | 4.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| LINDA SIEFKAS | |||||||
| VICE PRESIDENT | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| NEDRA HADLEY | |||||||
| TRUSTEE | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |
| ALVIN RODACK | |||||||
| TRUSTEE | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |
| EDWARD T BOPE MD | |||||||
| TRUSTEE | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |
| JASMINE GREEN | |||||||
| TRUSTEE | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |
| MARK STAMM | |||||||
| TRUSTEE | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |
| BRET KOCKENTIET MD | |||||||
| TRUSTEE | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |
| GREG SAWCHYN MD | |||||||
| TRUSTEE | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |
| KAREN KING MD | |||||||
| TRUSTEE | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |
| BARBARA LACH | |||||||
| TRUSTEE | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |
| MYSHEIKA WILLIAMS ROBERTS MD | |||||||
| TRUSTEE | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |
| JEFF HALL MD | |||||||
| TRUSTEE | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |
| DON BROWN | |||||||
| TRUSTEE | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |
| ANITA SOMANI MD | |||||||
| TRUSTEE | 1.00 | 2.00 | $0 | $0 | $0 | Yes (X) | |
| JEFFERY JANIS MD | |||||||
| TRUSTEE | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |
| BETH LISTON MD | |||||||
| TRUSTEE | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $555,836 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,000 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $57,555 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $105,257 | AllOtherContributionsAmt |
| Total Contributions | $105,257 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| RENTAL INCOME | 900099 | $144,814 | $144,814 |
| CAM | 900099 | $49,619 | $49,619 |
| PROGRAMS | 900099 | $14,207 | $14,207 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $208,640 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $680,265 | TotalRevenueColumnAmt |
| Exclusion | $680,265 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $76,500 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $27,096 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $49,404 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,404 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $49,404 | UnrelatedBusinessRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| INSURANCE PROCEEDS | 900099 | $8,832 | $8,832 |
| VENDING MACHINE | 900099 | $793 | $793 |
| CREDIT CARD REWARDS | 900099 | $330 | $330 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $9,955 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,053,521 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $208,640 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $49,404 | UnrelatedBusinessRevenueAmt |
| Exclusion | $690,220 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,671,422 | TotalAmt |
| Program Services | $1,671,422 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $618,707 | TotalAmt |
| Program Services | $177,970 | ProgramServicesAmt |
| Management And General | $272,561 | ManagementAndGeneralAmt |
| Fundraising | $168,176 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,750 | TotalAmt |
| Program Services | $10,859 | ProgramServicesAmt |
| Management And General | $16,630 | ManagementAndGeneralAmt |
| Fundraising | $10,261 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,773 | TotalAmt |
| Program Services | $4,537 | ProgramServicesAmt |
| Management And General | $6,948 | ManagementAndGeneralAmt |
| Fundraising | $4,288 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,947 | TotalAmt |
| Program Services | $14,655 | ProgramServicesAmt |
| Management And General | $22,444 | ManagementAndGeneralAmt |
| Fundraising | $13,848 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,934 | TotalAmt |
| Program Services | $19,541 | ProgramServicesAmt |
| Management And General | $29,927 | ManagementAndGeneralAmt |
| Fundraising | $18,466 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,702 | TotalAmt |
| Management And General | $7,702 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,596 | TotalAmt |
| Management And General | $44,596 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $369,144 | TotalAmt |
| Management And General | $369,144 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,472 | TotalAmt |
| Program Services | $13,844 | ProgramServicesAmt |
| Management And General | $37,518 | ManagementAndGeneralAmt |
| Fundraising | $19,110 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,470 | TotalAmt |
| Program Services | $21,342 | ProgramServicesAmt |
| Management And General | $18,614 | ManagementAndGeneralAmt |
| Fundraising | $42,514 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $280,781 | TotalAmt |
| Program Services | $211 | ProgramServicesAmt |
| Management And General | $260,950 | ManagementAndGeneralAmt |
| Fundraising | $19,620 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,480 | TotalAmt |
| Management And General | $3,480 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,073 | TotalAmt |
| Program Services | $6,377 | ProgramServicesAmt |
| Management And General | $6,217 | ManagementAndGeneralAmt |
| Fundraising | $13,479 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,004 | TotalAmt |
| Management And General | $80,004 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $191,198 | TotalAmt |
| Management And General | $191,198 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | TAXES & LICENSES | Desc |
| Total | $1,140 | TotalAmt |
| Management And General | $1,140 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,619,593 | TotalAmt |
| Program Services | $1,940,758 | ProgramServicesAmt |
| Management And General | $1,369,073 | ManagementAndGeneralAmt |
| Fundraising | $309,762 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $166,822 | BOYAmt |
| EOY | $255,765 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,205 | BOYAmt |
| EOY | $122,987 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,220 | BOYAmt |
| EOY | $11,148 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,387,997 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,695,900 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,809,768 | BOYAmt |
| EOY | $2,692,097 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,857,063 | BOYAmt |
| EOY | $85,080,728 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,604 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,061,682 | BOYAmt |
| EOY | $88,162,725 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $197,289 | BOYAmt |
| EOY | $542,425 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,279,349 | BOYAmt |
| EOY | $2,167,994 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $772,120 | BOYAmt |
| EOY | $433,423 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,248,758 | BOYAmt |
| EOY | $3,143,842 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,545,453 | BOYAmt |
| EOY | $83,835,334 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,267,471 | BOYAmt |
| EOY | $1,183,549 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,812,924 | BOYAmt |
| EOY | $85,018,883 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,061,682 | BOYAmt |
| EOY | $88,162,725 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,566,072 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $13,772,032 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBUS MEDICAL ASSOCIATION FOUNDATION UNLIMITED | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200385860 | EIN |
| Organization Type | 10 | OrganizationTypeCd |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | Yes (1) | MajorityDirTrstSupportedOrgInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Donor Advised Funds Held | 3 | DonorAdvisedFundsHeldCnt |
| Funds And Other Accounts Held | 5 | FundsAndOtherAccountsHeldCnt |
| Donor Advised Funds Contri | $71,998 | DonorAdvisedFundsContriAmt |
| Funds And Other Accounts Contri | $4,535 | FundsAndOtherAccountsContriAmt |
| Donor Advised Funds Grants | $214,035 | DonorAdvisedFundsGrantsAmt |
| Funds And Other Accounts Grants | $3,000 | FundsAndOtherAccountsGrantsAmt |
| Donor Advised Funds Vl EOY | $439,327 | DonorAdvisedFundsVlEOYAmt |
| Funds And Other Accounts Vl EOY | $744,224 | FundsAndOtherAccountsVlEOYAmt |
| Disclosed Org Leg Ctrl | Yes (1) | DisclosedOrgLegCtrlInd |
| Disclosed For Charitable Prps | Yes (1) | DisclosedForCharitablePrpsInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $253,580 | OtherCostOrOtherBasisAmt |
| Book Value | $253,580 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,047,215 | OtherCostOrOtherBasisAmt |
| Depreciation | $433,814 | DepreciationAmt |
| Book Value | $1,613,401 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,243,803 | OtherCostOrOtherBasisAmt |
| Depreciation | $546,325 | DepreciationAmt |
| Book Value | $697,478 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $561,801 | OtherCostOrOtherBasisAmt |
| Depreciation | $508,296 | DepreciationAmt |
| Book Value | $53,505 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $281,598 | OtherCostOrOtherBasisAmt |
| Depreciation | $207,465 | DepreciationAmt |
| Book Value | $74,133 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,692,097 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER SECURITIES | Desc |
| Book Value | $85,080,728 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $85,080,728 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| REIMBURSEMENT TO AFFILIATES | $155,543 |
| ASSETS HELD FOR OTHERS | $277,880 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $433,423 | TotalLiabilityAmt |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | ASIA | RegionTxt |
| Offices | 0 | OfficesCnt |
| Employee | 0 | EmployeeCnt |
| Type Of Activities Conducted | INVESTMENTS | TypeOfActivitiesConductedTxt |
| Specific Services Provided | N/A | SpecificServicesProvidedTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continuation Total Office | 0 | ContinuationTotalOfficeCnt |
| Continuation Total Employee | 0 | ContinuationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $0 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $0 | TotalSpentAmt |
| Transfer To Foreign Corp | 0 | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | 0 | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | 0 | PassiveForeignInvestmestCoInd |
| Foreign Partnership | 0 | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART III ACCOUNTING METHOD: | FormAndLineReferenceDesc |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| HEALTHCARE COLLABORATIVE OF GREATER COLUMBUS | |||||||
| 855 GRANDVIEW AVE STE 210 | COLUMBUS | OH | 43215 | 510426050 | 501 (C)(3) | $275,000 | TO SUPPORT ITS CORE SERVICES |
| CENTRAL OHIO TRAUMA SYSTEM | |||||||
| 1390 DUBLIN ROAD | COLUMBUS | OH | 43215 | 311592734 | 501 (C)(3) | $340,000 | TO SUPPORT ITS CORE SERVICES |
| PHYSICIANS CARE CONNECTION | |||||||
| 1390 DUBLIN ROAD | COLUMBUS | OH | 43215 | 311373719 | 501 (C)(3) | $540,000 | TO PROVIDE FREE PRIMARY & SPECIALTY MEDICAL CARE FOR THE UNINSURED AND UNDERSERVED |
| PHYSICIANS LEADERSHIP ACADEMY | |||||||
| 1390 DUBLIN ROAD | COLUMBUS | OH | 43215 | 822152009 | 501 (C)(3) | $280,000 | TO EDUCATE PHYSICIANS THROUGH LEADERSHIP TRAINING |
| COLUMBUS FOUNDATION | |||||||
| 1234 EAST BROAD STREET | COLUMBUS | OH | 43205 | 316044264 | 501 (C)(3) | $98,565 | PROGRAM SUPPORT |
| ANTHEM CARES INC | |||||||
| 220 VIRGINIA AVE | INDIANAPOLIS | IN | 46204 | 831172556 | 501 (C)(3) | $112,636 | PROGRAM SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 6 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | A 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT E FALCONE MD | ||||||||||||||
| CEO | $251,375 | $0 | $0 | $0 | $0 | $0 | $14,643 | $0 | $1,481 | $0 | $267,499 | $0 | $0 | $0 |
| WELDON MILBOURNE | ||||||||||||||
| EXECUTIVE DIRECTOR (UNTIL 8/19) | $93,076 | $0 | $0 | $0 | $73,345 | $0 | $7,484 | $0 | $1,890 | $0 | $175,795 | $0 | $0 | $0 |
| LAURIE HAWKINS | ||||||||||||||
| CFO | $138,040 | $0 | $0 | $0 | $0 | $0 | $8,695 | $0 | $23,362 | $0 | $170,097 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | COLUMBUS 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. |
| PART I, LINE 4A | WELDON MILBOURNE RECEIVED SEVERANCE PAYMENTS IN THE AMOUNT OF $41,176. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | COLUMBUS MEDICAL ASSOCIATION IS THE ORGANIZATION'S SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER HAS THE AUTHORITY TO ELECT AND REMOVE DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE 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 11B | THE RETURN IS PROVIDED TO THE BOARD MEMBERS FOR THEIR REVIEW BEFORE THE RETURN IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE 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 15 | THE 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 UPDATE IN 2019. 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 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XII, LINE 2C | THE 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/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| COLUMBUS MEDICAL ASSOCIATION FOUNDATION UNLIMITED | |||||||||||
| 1390 DUBLIN ROAD | COLUMBUS | OH | 43215 | 200385860 | PROVIDING HEALTH AND WELLNESS SERVICES | OH | 501(C)(3) | LINE 7 | COLUMBUS MEDICAL ASSOCIATION FOUNDATION | Yes (1) | |
| COLUMBUS MEDICAL ASSOCIATION | |||||||||||
| 1390 DUBLIN ROAD | COLUMBUS | OH | 43215 | 314411074 | ADVANCING COMMUNITY HEALTH THROUGH ADVOCACY, EDUCATION AND SERVICE | OH | 501(C)(6) | 0 | N/A | ||
| CENTAL OHIO TRAUMA SYSTEM | |||||||||||
| 1390 DUBLIN ROAD | COLUMBUS | OH | 43215 | 311592734 | REDUCING INJURIES AND SAVING LIVES BY IMPROVING TRAUMA CARE | OH | 501(C)(3) | LINE 7 | COLUMBUS MEDICAL ASSOCIATION | Yes (1) | |
| PHYSICIANS CARE CONNECTION | |||||||||||
| 1390 DUBLIN ROAD | COLUMBUS | OH | 43215 | 311373719 | COORDINATING VOLUNTARY HEALTH CARE SERVICES | OH | 501(C)(3) | LINE 3 | COLUMBUS MEDICAL ASSOCIATION | Yes (1) | |
| PHYSICIANS LEADERSHIP ACADEMY | |||||||||||
| 1390 DUBLIN ROAD | COLUMBUS | OH | 43215 | 822152009 | SUPPORT PHYSICIANS WITH LEADERSHIP TRAINING | OH | 501(C)(3) | LINE 2 | COLUMBUS MEDICAL ASSOCIATION | Yes (1) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (10 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CENTRAL OHIO TRAUMA SYSTEMS | ||
| B | $340,000 | GRANT |
| PHYSICIANS CARE CONNECTION | ||
| B | $540,000 | GRANT |
| CENTRAL OHIO TRAUMA SYSTEMS | ||
| A | $69,311 | PER SQ FT |
| COLUMBUS MEDICAL ASSOCIATION | ||
| O | $74,771 | AGREED UPON % OF TIME |
| CENTRAL OHIO TRAUMA SYSTEMS | ||
| O | $146,418 | AGREED UPON % OF TIME |
| PHYSICIANS CARE CONNECTION | ||
| O | $113,677 | AGREED UPON % OF TIME |
| COLUMBUS MEDICAL ASSOCIATION | ||
| A | $11,428 | PER SQ FT |
| PHYSICIANS CARE CONNECTION | ||
| A | $51,509 | PER SQ FT |
| PHYSICIANS LEADERSHIP ACADEMY | ||
| B | $280,000 | GRANT |
| PHYSICIANS LEADERSHIP ACADEMY | ||
| A | $8,441 | PER SQ FT |