COLUMBIA LUTHERAN CHARITIES: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- COLUMBIA LUTHERAN CHARITIES (EIN 93-0583856)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-09-21
- IRS object ID
- 201612659349300901
- Schema version
- 2015v2.1
- 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 H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-09-21T15:19:39-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 930418710 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELAP LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5885 MEADOWS ROAD NO 200 | AddressLine1Txt |
| City | LAKE OSWEGO | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97035 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930583856 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA LUTHERAN CHARITIES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COLU | BusinessNameControlTxt |
| Phone | 5033254321 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2111 EXCHANGE STREET | AddressLine1Txt |
| City | ASTORIA | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 971033329 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHANIE D BRENDEN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5033254321 | PhoneNum |
| Signature | 2016-09-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARK E EKLUND CPA | PreparerPersonNm |
| PTIN | P00156145 | PTIN |
| Phone | 5036974118 | PhoneNum |
| Preparation | 2016-09-06 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEPHANIE D BRENDEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2111 EXCHANGE STREET | AddressLine1Txt |
| City | ASTORIA | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 971033329 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $92,696,805 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.COLUMBIAMEMORIAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1958 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE EXCELLENCE, LEADERSHIP & COMPASSION IN THE ENHANCEMENT OF HEALTH FOR THOSE WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 688 | TotalEmployeeCnt |
| Total Volunteers | 115 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $733,743 | PYContributionsGrantsAmt |
| CY Contributions Grants | $290,234 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $76,151,726 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $88,271,302 | CYProgramServiceRevenueAmt |
| PY Investment Income | $698,482 | PYInvestmentIncomeAmt |
| CY Investment Income | $738,811 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,590,754 | PYOtherRevenueAmt |
| CY Other Revenue | $3,310,549 | CYOtherRevenueAmt |
| PY Total Revenue | $80,174,705 | PYTotalRevenueAmt |
| CY Total Revenue | $92,610,896 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $38,065 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $52,761 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $41,698,697 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $48,043,025 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $214,006 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $33,427,207 | PYOtherExpensesAmt |
| CY Other Expenses | $40,420,807 | CYOtherExpensesAmt |
| PY Total Expenses | $75,163,969 | PYTotalExpensesAmt |
| CY Total Expenses | $88,516,593 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,010,736 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,094,303 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $93,169,432 | TotalAssetsBOYAmt |
| Total Assets EOY | $96,537,167 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $50,819,948 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $52,248,520 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $42,349,484 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $44,288,647 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF COLUMBIA MEMORIAL HOSPITAL IS TO PROVIDE EXCELLENCE, LEADERSHIP, AND COMPASSION IN THE ENHANCEMENT OF HEALTH FOR THOSE WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $74,360,283 | ExpenseAmt |
| Grant | $52,761 | GrantAmt |
| Revenue | $90,664,955 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
| Total Program Service Expenses | $74,360,283 | 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 | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | 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 | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| 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 | 109 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 688 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 |
| Form8899 Filedind | 0 | Form8899Filedind |
| Form1098 C Filed | 0 | Form1098CFiledInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| 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 | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEPHANIE D BRENDEN CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5033387505 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2111 EXCHANGE STREET | AddressLine1Txt |
| City | ASTORIA | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97103 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| DAVID PHILLIPS | |||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| BILL LIND | |||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| HEATHER SEPPA | |||||||
| PRESIDENT | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| KEVIN BAXTER | |||||||
| SECRETARY | 3.00 | Yes (X) | $197,008 | $0 | $16,260 | ||
| BILL LANDWEHR | |||||||
| TREASURER | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| NANCY MCALLISTER | |||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| ED NELSON JR | |||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| NORMAN SHATTO | |||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| MARK SMITH | |||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| CONSTANCE WAISANEN | |||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT HOLLAND | |||||||
| BOARD MEMBER | 3.00 | Yes (X) | $306,147 | $0 | $25,580 | ||
| BRUCE BOBEK | |||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| ERIK THORSEN | |||||||
| CEO | 40.00 | $424,109 | $0 | $77,493 | Yes (X) | ||
| STEPHANIE D BRENDEN | |||||||
| CFO | 40.00 | $241,888 | $0 | $30,099 | Yes (X) | ||
| TERESA L GURRAD | |||||||
| CCO | 40.00 | $191,263 | $0 | $25,264 | Yes (X) | ||
| JARROD P KARNOFSKI | |||||||
| VP - ANCILLIARY SERVICES | 40.00 | $178,306 | $0 | $38,594 | Yes (X) | ||
| KATRINA M MCPHERSON | |||||||
| VP - MEDICAL GRP OPERATION | 40.00 | $257,312 | $0 | $38,360 | Yes (X) | ||
| DOUGLAS ABBOTT MD | |||||||
| PHYSICIAN | 40.00 | $592,364 | $0 | $44,112 | Yes (X) | ||
| RICHARD CRASS MD | |||||||
| PHYSICIAN | 40.00 | $380,560 | $0 | $36,591 | Yes (X) | ||
| EDOUARD DURET MD | |||||||
| PHYSICIAN | 40.00 | $393,021 | $0 | $45,591 | Yes (X) | ||
| PETER BALES MD | |||||||
| PHYSICIAN | 40.00 | $539,121 | $0 | $31,016 | Yes (X) | ||
| CAMILO ROSALES MD | |||||||
| PHYSICIAN | 40.00 | $361,578 | $0 | $24,426 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,062,677 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $433,386 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 68 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ANESTHESIA ASSOCIATES NORTHWEST LLC | |||||
| 6400 SE LAKE RD STE 130 | PORTLAND | OR | 97222 | ANESTHESIOLOGY PHYSICIANS | $1,611,792 |
| NORTH COAST EMERGENCY PHYSICIANS PC | |||||
| 2111 EXCHANGE STREET | ASTORIA | OR | 97103 | EMERGENCY ROOM PHYSICIANS | $1,527,314 |
| RICKENBACH CONSTRUCTIONS INC | |||||
| 37734 EAGLE LANE | ASTORIA | OR | 97103 | GENERAL CONTRACTOR | $830,142 |
| WALSH CONSTRUCTION CO | |||||
| 2905 SW 1ST AVENUE | PORTLAND | OR | 97201 | GENERAL CONTRACTOR | $819,403 |
| HEALTHCARE RESOURCE GROUP INC | |||||
| 12610 EAST MIRABEAU PKWY STE 800 | SPOKANE VALLEY | WA | 99216 | BILLING & CODING SERVICES | $718,747 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 22 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $60,078 | GovernmentGrantsAmt |
| All Other Contributions | $230,156 | AllOtherContributionsAmt |
| Total Contributions | $290,234 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| OUTPATIENT REVENUE | 621990 | $97,878,252 | $97,878,252 |
| EMERGENCY ROOM REVENUE | 621990 | $40,564,076 | $40,564,076 |
| INPATIENT REVENUE | 621990 | $36,882,543 | $36,882,543 |
| PROVISION FOR CHARITY CARE | 621990 | -$1,980,872 | -$1,980,872 |
| CONTRACTUAL ALLOWANCE | 621990 | -$84,270,816 | -$84,270,816 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$801,881 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$801,881 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $88,271,302 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $473,593 | TotalRevenueColumnAmt |
| Exclusion | $473,593 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $261,104 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $34,816 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $226,288 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $226,288 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $226,288 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $316,311 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $51,093 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $265,218 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $265,218 | TotalRevenueColumnAmt |
| Exclusion | $265,218 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| JOINT VENTURE | 621500 | $1,192,364 | $1,192,364 |
| COST SETTLEMENT | 900099 | $692,121 | $692,121 |
| HOSPITALIST | 621110 | $562,101 | $562,101 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $637,675 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $287,052 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $350,623 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,084,261 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $92,610,896 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $91,231,228 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,089,434 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,761 | TotalAmt |
| Program Services | $52,761 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,640,833 | TotalAmt |
| Management And General | $1,640,833 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,332,082 | TotalAmt |
| Program Services | $31,044,085 | ProgramServicesAmt |
| Management And General | $4,141,882 | ManagementAndGeneralAmt |
| Fundraising | $146,115 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,070,806 | TotalAmt |
| Program Services | $2,695,894 | ProgramServicesAmt |
| Management And General | $361,274 | ManagementAndGeneralAmt |
| Fundraising | $13,638 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,252,152 | TotalAmt |
| Program Services | $4,447,635 | ProgramServicesAmt |
| Management And General | $781,028 | ManagementAndGeneralAmt |
| Fundraising | $23,489 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,747,152 | TotalAmt |
| Program Services | $2,325,218 | ProgramServicesAmt |
| Management And General | $409,178 | ManagementAndGeneralAmt |
| Fundraising | $12,756 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $309,707 | TotalAmt |
| Management And General | $309,707 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,807 | TotalAmt |
| Management And General | $130,799 | ManagementAndGeneralAmt |
| Fundraising | $18,008 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,661,301 | TotalAmt |
| Program Services | $7,443,694 | ProgramServicesAmt |
| Management And General | $1,217,607 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,805 | TotalAmt |
| Program Services | $425 | ProgramServicesAmt |
| Management And General | $220,380 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $284,815 | TotalAmt |
| Program Services | $175,177 | ProgramServicesAmt |
| Management And General | $109,638 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,286,751 | TotalAmt |
| Program Services | $1,044,479 | ProgramServicesAmt |
| Management And General | $242,272 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,784,506 | TotalAmt |
| Program Services | $1,475,546 | ProgramServicesAmt |
| Management And General | $308,960 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,450 | TotalAmt |
| Program Services | $92,623 | ProgramServicesAmt |
| Management And General | $15,827 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $478,602 | TotalAmt |
| Program Services | $294,480 | ProgramServicesAmt |
| Management And General | $184,122 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,150,067 | TotalAmt |
| Program Services | $1,150,067 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,344,462 | TotalAmt |
| Program Services | $3,303,913 | ProgramServicesAmt |
| Management And General | $1,040,549 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,240,558 | TotalAmt |
| Program Services | $1,240,558 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & PHAR | $11,546,500 | $11,546,500 | |
| OTHER PURCHASED SERVICE | $2,827,118 | $907,869 | $1,919,249 |
| REPAIRS & MAINTENANCE | $1,573,121 | $1,536,784 | $36,337 |
| CONTRACT LABOR | $735,958 | $735,958 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,719,279 | TotalAmt |
| Program Services | $2,846,617 | ProgramServicesAmt |
| Management And General | $872,662 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,516,593 | TotalAmt |
| Program Services | $74,360,283 | ProgramServicesAmt |
| Management And General | $13,942,304 | ManagementAndGeneralAmt |
| Fundraising | $214,006 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,034 | BOYAmt |
| EOY | $61,386 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,389,152 | BOYAmt |
| EOY | $4,889,203 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,245,687 | BOYAmt |
| EOY | $16,568,058 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,222 | BOYAmt |
| EOY | $9,444 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $151,735 | BOYAmt |
| EOY | $92,320 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,794,224 | BOYAmt |
| EOY | $2,380,933 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $971,257 | BOYAmt |
| EOY | $857,847 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $83,968,526 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $41,510,299 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,901,209 | BOYAmt |
| EOY | $42,458,227 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,664,385 | BOYAmt |
| EOY | $25,548,785 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,881,411 | BOYAmt |
| EOY | $1,814,415 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $722,194 | BOYAmt |
| EOY | $743,067 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,392,922 | BOYAmt |
| EOY | $1,113,482 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,169,432 | BOYAmt |
| EOY | $96,537,167 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,379,141 | BOYAmt |
| EOY | $10,528,211 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,113,084 | BOYAmt |
| EOY | $29,285,002 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $400,000 | BOYAmt |
| EOY | $200,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,927,723 | BOYAmt |
| EOY | $12,235,307 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,819,948 | BOYAmt |
| EOY | $52,248,520 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,286,216 | BOYAmt |
| EOY | $44,225,380 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,268 | BOYAmt |
| EOY | $63,267 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,349,484 | BOYAmt |
| EOY | $44,288,647 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,169,432 | BOYAmt |
| EOY | $96,537,167 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,094,303 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$811,586 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $786 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$1,344,340 | 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $7,480,255 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $1,147,635 | OtherCostOrOtherBasisAmt |
| Book Value | $8,627,890 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $6,975,139 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $24,437,957 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,223,623 | DepreciationAmt |
| Book Value | $15,189,473 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,511,343 | OtherCostOrOtherBasisAmt |
| Depreciation | $665,264 | DepreciationAmt |
| Book Value | $846,079 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $41,487,624 | OtherCostOrOtherBasisAmt |
| Depreciation | $24,621,412 | DepreciationAmt |
| Book Value | $16,866,212 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $928,573 | OtherCostOrOtherBasisAmt |
| Book Value | $928,573 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $42,458,227 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| MEDICAL MALPRACTICE CLAIMS | $1,164,445 |
| ACCRUED RETIREMENT PLAN LIABILITY | $10,932,862 |
| ESTIMATED 3RD PARTY PAYOR | $138,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $12,235,307 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $91,459,849 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$811,586 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $34,816 | OtherRevenueAmt |
| Revenue Not Reported | -$776,770 | RevenueNotReportedAmt |
| Revenue Subtotal | $92,236,619 | RevenueSubtotalAmt |
| Other Revenues Not Included | $374,277 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $374,277 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $92,610,896 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $88,177,131 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $34,816 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $34,816 | ExpensesNotReportedAmt |
| Expenses Subtotal | $88,142,315 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $374,278 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $374,278 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $88,516,593 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSE 34,816. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | INCOME REPORTED AS EXPENSES ON FORM 990 374,277. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSE 34,816. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | INCOME REPORTED AS EXPENSES ON FORM 990 374,278. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,058,243 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,941 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,051,302 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01190 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,279,138 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,342,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,937,138 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02190 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,337,381 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,348,941 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,988,440 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03380 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $722,904 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $63,729 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $659,175 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00740 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $104,609 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $104,609 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $96,482 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $96,482 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $923,995 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $63,729 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $860,266 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00970 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,261,376 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,412,670 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,848,706 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04350 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,455,000 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $2,063,516 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $33,325,862 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $56,484,511 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$23,158,649 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct | Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct |
|---|---|---|
| 1 COASTAL HEALTH ASSURANCE | ||
| CE/PHYSICIAN ASSC. MEDICAL CONTRACTS | 0.50000 | 0.50000 |
| 2 ASTORIA IMAGING LLC | ||
| MRI JOINT VENTURE | 0.51000 | 0.51000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2111 EXCHANGE STREET | AddressLine1Txt |
| City | ASTORIA | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.COLUMBIAMEMORIAL.ORG | WebsiteAddressTxt |
| State License | 141146 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | OTHER | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.COLUMBIAMEMORIAL.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Legal Judicial Process | Yes (X) | PermitLegalJudicialProcessInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Engaged Legal Judicial Process | Yes (X) | EngagedLegalJudicialProcessInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | COLUMBIA MEMORIAL HOSPITAL | FormAndLineReferenceDesc |
| Explanation | PART V, SECTION B, LINE 5: THERE ARE SEVERAL SOURCES OF PRIMARY AND SECONDARY DATA FOR THE CHNA ON WHICH THE GOALS AND OUTCOMES OF THIS REPORT ARE BASED: PRIMARY DATA:ENVIRONMENT ASSESSMENT - CONDUCTED IN JUNE 2013 BY AN INDEPENDENT CONSULTANT, STROUDWATER ASSOCIATES, THIS ASSESSMENT UPDATED THE ENVIRONMENT AND PROVIDER NEED ASSESSMENT DATA GATHERED IN 2011 IN SUPPORT OF THE DEVELOPMENT OF COLUMBIA MEMORIAL HOSPITAL'S 2014 TO 2016 STRATEGIC PLAN. COMMUNITY OPINION SURVEY AND PROVIDER NEED ASSESSMENT - CONDUCTED IN JULY 2011 BY AN INDEPENDENT CONSULTANT, HEALTH FACILITIES PLANNING & DEVELOPMENT, THIS SURVEY AND ASSESSMENT DATA PROVIDES INSIGHT INTO COMMUNITY AWARENESS, PERCEPTIONS AND PRIORITIES FOR THE LOCAL HEALTH SYSTEM.KEY INFORMANT INTERVIEWS - FACE-TO-FACE INTERVIEWS WITH BOTH INDEPENDENT AND EMPLOYED PROVIDERS WERE CONDUCTED IN 2011, 2012, AND 2013 TO ASSESS THE NEEDS OF THE COMMUNITY FROM THE PROVIDER PERSPECTIVE. IN ADDITION, A COMMUNITY LEADERSHIP ROUND TABLE WAS HELD IN 2011 AND INCLUDED REPRESENTATIVES FROM THE CITY OF ASTORIA, U.S. COAST GUARD, CLATSOP COUNTY HEALTH DEPARTMENT, COASTAL FAMILY HEALTH CLINIC, CLATSOP CARE CENTER AND OTHERS.FOCUS GROUPS, PATIENT & FAMILY ADVISORY COUNCIL, AND COMMUNITY LEADERSHIP COUNCIL -A) PATIENT FOCUS GROUPS CONSISTING OF PREVIOUS INPATIENT, EMERGENCY, OUTPATIENT, AND CLINIC PATIENTS WERE CONDUCTED IN BOTH SEPTEMBER OF 2011 AND DECEMBER OF 2012 TO GATHER INFORMATION ABOUT AWARENESS, PATIENT-CENTERED PRACTICES, AND OPINIONS ABOUT OPPORTUNITIES FOR IMPROVEMENT FOR LOCAL HEALTHCARE.B) A PATIENT & FAMILY ADVISORY COUNCIL (PFAC) WAS ESTABLISHED IN 2012 TO FORM A CONTINUOUS FEEDBACK LOOP TO IDENTIFY OPPORTUNITIES.C) A COMMUNITY LEADERSHIP COUNCIL REPRESENTING LOCAL GOVERNMENT, SCHOOL DISTRICTS, AND LOCAL BUSINESSES WAS RECENTLY ESTABLISHED IN LATE 2013 TO SUPPORT THE NEXT STEPS IN CREATING A HEALTHIER COMMUNITY. SECONDARY DATA:CLATSOP COUNTY COMMUNITY ASSESSMENT JULY 2013, THIS ASSESSMENT CREATES A FOUNDATION OF SHARED KNOWLEDGE ABOUT THE COMMUNITY HEALTH AND WELL-BEING IN CLATSOP COUNTY. AT LEAST 75% OF CMH PATIENTS RESIDE IN CLATSOP COUNTY, WITH THE REMAINDER LARGELY RESIDING IN PACIFIC COUNTY, WASHINGTON. | ExplanationTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 16 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - ONCOLOGY & INFUSION CLINIC | ||||
| 2158 EXCHANGE ST | ASTORIA | OR | 97103 | ONCOLOGY CLINIC |
| 2 - ASTORIA IMAGING LLC | ||||
| 2111 EXCHANGE STREET | ASTORIA | OR | 97103 | MRI JOINT VENTURE |
| 3 - ORTHOPEDIC CLINIC | ||||
| 2265 EXCHANGE ST | ASTORIA | OR | 97103 | ORTHOPEDIC CLINIC |
| 4 - WARRENTON PRIMARY CARE (RHC) | ||||
| 1639 SE ENSIGN LANE SUITE B103 | WARRENTON | OR | 97146 | PRIMARY CARE CLINIC |
| 5 - WOMENS CENTER CLINIC | ||||
| 2265 EXCHANGE ST | ASTORIA | OR | 97103 | WOMENS CENTER CLINIC |
| 6 - GENERAL SURGERY CLINIC | ||||
| 2265 EXCHANGE ST | ASTORIA | OR | 97103 | GENERAL SURGERY CLINIC |
| 7 - PEDIATRIC CLINIC | ||||
| 2265 EXCHANGE ST | ASTORIA | OR | 97103 | PEDIATRIC CLINIC |
| 8 - LOWER COLUMBIA HOSPICE | ||||
| 2158 EXCHANGE STREET SUITE 206 | ASTORIA | OR | 97103 | HOSPICE SERVICES |
| 9 - URGENT CARE CLINIC | ||||
| 2265 EXCHANGE ST | ASTORIA | OR | 97103 | URGENT CARE CLINIC |
| 10 - UROLOGY CLINIC | ||||
| 2265 EXCHANGE ST | ASTORIA | OR | 97103 | UROLOGY CLINIC |
| 11 - CARDIOLOGY CLINIC | ||||
| 2095 EXCHANGE ST SUITE 301 | ASTORIA | OR | 97103 | CARDIOLOGY CLINIC |
| 12 - CMH HOME HEALTH | ||||
| 2158 EXCHANGE STREET SUITE 206 | ASTORIA | OR | 97103 | HOME SERVICES |
| 13 - ENDOCRINOLOGY | ||||
| 2185 EXCHANGE ST SUITE 205 | ASTORIA | OR | 97103 | ENDOCRINOLOGY |
| 14 - PULMONOLOGY | ||||
| 2055 EXCHANGE ST SUITE 210 | ASTORIA | OR | 97103 | PULMONOLOGY |
| 15 - ENT CLINIC | ||||
| 2055 EXCHANGE ST | ASTORIA | OR | 97103 | ENT CLINIC |
| 16 - WOUND CARE CLINIC | ||||
| 2265 EXCHANGE ST | ASTORIA | OR | 97103 | WOUND CARE CLINIC |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 4: | THE COLLECTION OF RECEIVABLES FROM THIRD PARTY PAYERS AND PATIENTS IS THE HOSPITAL'S PRIMARY SOURCE OF CASH AND IS CRITICAL TO ITS OPERATING PERFORMANCE. WHEN THE HOSPITAL PROVIDES CARE TO PATIENTS, IT DOES NOT REQUIRE COLLATERAL; HOWEVER, IT MAINTAINS AN ESTIMATED ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE PRIMARY COLLECTION RISKS RELATE TO UNINSURED PATIENT ACCOUNTS AND PATIENT ACCOUNTS FOR WHICH THE PRIMARY INSURANCE PAYOR HAS PAID, BUT PATIENT RESPONSIBILITY AMOUNTS (GENERALLY DEDUCTIBLES AND CO PAYMENTS) REMAIN OUTSTANDING. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS ESTIMATED BASED PRIMARILY UPON THE HOSPITAL'S HISTORICAL COLLECTION EXPERIENCE, THE AGE OF THE PATIENT'S ACCOUNT, MANAGEMENT'S ESTIMATE OF THE PATIENT'S ECONOMIC ABILITY TO PAY AND THE EFFECTIVENESS OF COLLECTION EFFORTS. PATIENT ACCOUNTS RECEIVABLE BALANCES ARE ROUTINELY REVIEWED IN CONJUNCTION WITH HISTORICAL COLLECTION RATES AND OTHER ECONOMIC CONDITIONS WHICH MIGHT ULTIMATELY AFFECT THE COLLECTIBILITY OF PATIENT ACCOUNTS WHEN CONSIDERING THE ADEQUACY OF THE AMOUNTS RECORDED IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.ACTUAL WRITE-OFFS HAVE HISTORICALLY BEEN WITHIN MANAGEMENT'S EXPECTATIONS. SIGNIFICANT CHANGES IN PAYOR MIX, BUSINESS OFFICE OPERATIONS, ECONOMIC CONDITIONS, OR TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTHCARE COVERAGE COULD AFFECT THE HOSPITAL'S COLLECTION OF PATIENT ACCOUNTS RECEIVABLE, CASH FLOWS, AND RESULTS OF OPERATIONS. |
| PART III, LINE 8: | AS A MISSION-DRIVEN HOSPITAL, HEALTHCARE SERVICES ARE OFFERED TO THE COMMUNITY EVEN WHEN THE COST OF THAT CARE IS KNOWN TO BE MORE THAN THE REVENUE THAT WILL BE RECEIVED. AS THE HOSPITAL ABSORBS THESE LOSSES FROM MEDICARE (DETERMINED BY THE RATIOS USED IN THE MEDICARE COST REPORT), THE ENTIRE COMMUNITY BENEFITS BECAUSE MANY OF THESE PROGRAMS/SERVICES WOULD NOT EXIST WITHOUT HOSPITAL SUPPORT. |
| PART III, LINE 9B: | PERSONAL PAY ACCOUNTS AND THE BALANCE AFTER INSURANCE ARE SUBJECT TO A MINIMUM PAYMENT SCHEDULE. IF THE PATIENT OR GUARANTOR IS UNABLE TO MEET THIS PAYMENT SCHEDULE, APPLICATION MAY BE MADE THROUGH PATIENT FINANCIAL SERVICES CREDIT AND COLLECTION CLERK'(S) AND OR THE PATIENT FINANCIAL SERVICES MANAGER FOR CHARITY, FINANCIAL ASSISTANCE, OR REDUCED PAYMENTS. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | OR |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| CLATSOP COMMUNITY COLLEGE | |||||||
| 1651 LEXINGTON AVE | ASTORIA | OR | 97103 | 930505508 | 501(C)3 | $14,560 | SCHOLARSHIPS |
| ASTORIA-WARRENTON CHAMBER OF COMMERCE | |||||||
| PO BOX 176 | ASTORIA | OR | 97103 | 930115760 | 501(C)6 | $10,000 | GREAT COLUMBIA CROSSING RUN/WALK EVENT |
| WILSON SAFETY LLC | |||||||
| 1104 E MEAD AVE | YAKIMA | WA | 98903 | 203983891 | $13,380 | DEFIBRILLATOR PROGRAM | |
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 |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 | Yes (1) | 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 (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN BAXTER | ||||||||||||||
| SECRETARY | $193,328 | $0 | $0 | $0 | $3,680 | $0 | $0 | $0 | $16,260 | $0 | $213,268 | $0 | $0 | $0 |
| ROBERT HOLLAND | ||||||||||||||
| BOARD MEMBER | $296,878 | $0 | $0 | $0 | $9,269 | $0 | $250 | $0 | $25,330 | $0 | $331,727 | $0 | $0 | $0 |
| ERIK THORSEN | ||||||||||||||
| CEO | $355,902 | $0 | $16,475 | $0 | $51,732 | $0 | $64,828 | $0 | $12,665 | $0 | $501,602 | $0 | $0 | $0 |
| STEPHANIE D BRENDEN | ||||||||||||||
| CFO | $216,911 | $0 | $9,900 | $0 | $15,077 | $0 | $19,314 | $0 | $10,785 | $0 | $271,987 | $0 | $0 | $0 |
| TERESA L GURRAD | ||||||||||||||
| CCO | $178,433 | $0 | $10,998 | $0 | $1,832 | $0 | $10,213 | $0 | $15,051 | $0 | $216,527 | $0 | $0 | $0 |
| JARROD P KARNOFSKI | ||||||||||||||
| VP - ANCILLIARY SERVICES | $154,364 | $0 | $6,649 | $0 | $17,293 | $0 | $14,203 | $0 | $24,391 | $0 | $216,900 | $0 | $0 | $0 |
| KATRINA M MCPHERSON | ||||||||||||||
| VP - MEDICAL GRP OPERATION | $241,463 | $0 | $5,279 | $0 | $10,570 | $0 | $13,969 | $0 | $24,391 | $0 | $295,672 | $0 | $0 | $0 |
| DOUGLAS ABBOTT MD | ||||||||||||||
| PHYSICIAN | $573,934 | $0 | $5,000 | $0 | $13,430 | $0 | $19,721 | $0 | $24,391 | $0 | $636,476 | $0 | $0 | $0 |
| RICHARD CRASS MD | ||||||||||||||
| PHYSICIAN | $363,510 | $0 | $1,000 | $0 | $16,050 | $0 | $16,627 | $0 | $19,964 | $0 | $417,151 | $0 | $0 | $0 |
| EDOUARD DURET MD | ||||||||||||||
| PHYSICIAN | $374,836 | $0 | $4,145 | $0 | $14,040 | $0 | $21,200 | $0 | $24,391 | $0 | $438,612 | $0 | $0 | $0 |
| PETER BALES MD | ||||||||||||||
| PHYSICIAN | $524,854 | $0 | $5,000 | $0 | $9,267 | $0 | $6,625 | $0 | $24,391 | $0 | $570,137 | $0 | $0 | $0 |
| CAMILO ROSALES MD | ||||||||||||||
| PHYSICIAN | $350,002 | $0 | $6,642 | $0 | $4,934 | $0 | $4,462 | $0 | $19,964 | $0 | $386,004 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | ASTORIA GOLF AND COUNTRY CLUB DUES FOR CEO ERIK THORSEN WERE PAID BY THE ORGANIZATION. |
| PART I, LINE 4B | ERIK THORSEN, CEO IS NOW PARTICIPATING IN A 457(F) PLAN. THIS PLAN STARTED IN 2015. |
| PART I, LINE 6 | MANAGEMENT BONUSES ARE CONTINGENT ON THE NET EARNINGS OF THE ORGANIZATION. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE HOSPITAL FACILITIES AUTHORITY OF THE CITY OF ASTORIA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 270034718 | BondIssuerEIN |
| CUSIP | 046279BS3 | CUSIPNum |
| Bond Issued | 2012-09-27 | BondIssuedDt |
| Issue Price | $31,993,533 | IssuePriceAmt |
| Purpose | FINANCE EHR SYSTEM, ASSET ACQUISTION, REFUNDING OF 2002 & 2007 BOND ISSUES | PurposeDesc |
| Defeased | Yes (1) | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $31,993,533 | TotalProceedsAmt |
| Capitalized Interest | $137,103 | CapitalizedInterestAmt |
| Issuance Costs From Proceeds | $893,237 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $2,481,822 | CapitalExpendituresAmt |
| Substantial Completion | 2015 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | 0 | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PETER BALES | PersonNm |
| Relationship With Org | EMPLOYEE | RelationshipWithOrgTxt |
| Loan Purpose | SIGN ON BONUS | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $20,000 | OriginalPrincipalAmt |
| Balance Due | $9,444 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $9,444 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| TransactionTransactionAmt | Sharing Of RevenuesSharingOfRevenuesInd | Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionDesc |
|---|---|---|---|
| (no name) | |||
| $72,000 | 0 | ||
| HEATHER SEPPA | |||
| 0 | CMH PRESIDENT | OFFICER AT COLUMBIA STATE BANK, ONE OF THE PRIMARY BANKS USED BY CMH. | |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT OF THE 990 IS MADE AVAILABLE, ELECTRONICALLY, TO THE BOARD OF TRUSTEES, PRIOR TO THE BOARD MEETING. THE 990 IS REVIEWED AND DISCUSSED AT THE BOARD FINANCE COMMITTEE MEETING PRIOR TO FINALIZING AND FILING THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS REVIEWED BY THE BOARD OF TRUSTEES, OFFICERS, AND KEY EMPLOYEES ANNUALLY. ALL BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES MUST SIGN AND DATE THE CONFLICT OF INTEREST POLICY ACKNOWLEDGEMENT, QUESTIONNAIRE, AND DISCLOSURE STATEMENT. ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST AT THE BOARD OR OFFICER LEVEL ARE DISCUSSED AT THE BOARD MEETING. ACTUAL CONFLICTS OF INTEREST ARE ADDRESSED, DOCUMENTED, AND FILED IN THE CONFIDENTIAL PERSONNEL FILE. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION OF ALL OFFICERS WAS REVIEWED WITH COMPARABILITY DATA BY A THIRD PARTY CONSULTANT. THE RESULTS OF THE STUDY WERE REVIEWED AND DISCUSSED AT A BOARD OF TRUSTEES' MEETING. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL INFORMATION REPORTED IN THE 990 ARE AVAILABLE UPON REQUEST AT THE HOSPITAL. |
| FORM 990, PART XI, LINE 9: | DEFINED BENEFIT RETIREMENT PLAN ADJUSTMENT -1,381,840. NET ASSETS RELEASED FROM RESTRICTION - CITY OF ASTORIA GRANT 37,500. |
| FROM 990, PART XI, LINE 2C: | THE BOARD OF TRUSTEE FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT, REVIEW, AND SELECTION OF AN INDEPENDENT AUDIT FIRM. TRADITIONALLY, A THREE YEAR CONTRACT WITH A SELECTED AUDIT FIRM IS APPROVED. ANNUALLY, A SPECIAL BOARD MEETING IS HELD AND THE AUDIT FIRM PRESENTS THE AUDITED FINANCIAL STATEMENTS TO THE BOARD OF TRUSTEES. DURING THE MEETING, THE BOARD MEMBERS ARE GIVEN THE OPPORTUNITY TO ASK QUESTIONS WITHOUT MANAGEMENT PRESENT. FOLLOW-UP INFORMATION ON THE MANAGEMENT LETTER RECOMMENDATIONS IS ALSO PRESENTED SEMI-ANNUALLY TO THE BOARD FINANCE COMMITTEE. |
| FORM 990, PART III, LINE 4A: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | MISSION STATEMENT: THE MISSION OF COLUMBIA MEMORIAL HOSPITAL IS TO PROVIDE EXCELLENCE, LEADERSHIP, AND COMPASSION IN THE ENHANCEMENT OF HEALTH FOR THOSE WE SERVE. UTILIZATION STATISTICS FOR 2015: AVAILABLE BEDS: 25 ADMISSIONS: 1,789 PATIENT DAYS: 4,595 OBSERVATIONS: 536 AVERAGE LENGTH-OF-STAY: 2.57 DAYS OCCUPANCY RATE: 50.4% DELIVERIES: 317 EMERGENCY ROOM VISITS: 13,255 URGENT CARE VISITS: 14,806 OUTPATIENT VISITS (NET OF ER): 160,544 SURGICAL CASES: 2,448 PLANETREE THE HOSPITAL HAS ADOPTED A PHILOSOPHY OF PROVIDING PATIENT-CENTERED CARE THROUGHOUT ITS FACILITIES. IN 2000, THE HOSPITAL JOINED AN ORGANIZATION CALLED PLANETREE, INC. ("PLANETREE") AS AN AFFILIATE MEMBER. PLANETREE PARTNERS WITH HEALTHCARE ORGANIZATIONS AROUND THE WORLD TO DEVELOP AND ADVANCE PATIENT-CENTERED APPROACHES TO CARE. IN 2013, THE HOSPITAL BECAME ONLY THE SECOND HOSPITAL IN OREGON TO ACHIEVE THE PRESTIGIOUS PLANETREE-DESIGNATION STATUS. PLANETREE-DESIGNATION REPRESENTS THE HIGHEST LEVEL OF ACHIEVEMENT IN PATIENT-/PERSON-CENTERED CARE BASED ON EVIDENCE AND STANDARDS, ACCORDING TO PLANETREE. PLANETREE-DESIGNATED HOSPITALS MUST DEMONSTRATE THEIR COMMITMENT AND SUCCESSFUL ADOPTION OF THE PATIENT CENTER CARE PRINCIPLES BY PASSING A RIGOROUS SURVEY PROCESS, PERFORMED BY PLANETREE EVERY THREE (3) YEARS. THE HOSPITAL HAS MAINTAINED PLANETREE-DESIGNATION BY CREATING AN ORGANIZATIONAL CULTURE COMMITTED TO PROVIDING THE LATEST IN MEDICAL TECHNOLOGY IN A HEALING, NURTURING ENVIRONMENT THAT ENCOURAGES A PATIENT'S INVOLVEMENT IN THE CARE THAT THEY RECEIVE. THE HOSPITAL CONTINUALLY STRIVES TO OFFER PEACEFUL, COMFORTABLE SURROUNDINGS, WARM AND SUPPORTIVE CAREGIVERS, ACCESS TO HEALTH INFORMATION ALTERNATIVE THERAPIES, AND EDUCATION TO HELP PATIENTS GET WELL FASTER AND STAY WELL LONGER. COLUMBIA MEMORIAL HOSPITAL RECENT ACCREDITATIONS: HEALTHCARE FACILITIES ACCREDITATION PROGRAM (HFAP) A NATIONALLY RECOGNIZED ACCREDITATION ORGANIZATION WITH DEEMING AUTHORITY FROM THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS). COMMISSION ON OFFICE LABORATORY ACCREDITATION (COLA) - LABORATORY ACCREDITATION AMERICAN COLLEGE OF RADIOLOGY MAMMOGRAPHY QUALITY STANDARDS ACT (ACR/MSQA) - IMAGING SERVICES - MAMMOGRAPHY ACCREDITATION INTERSOCIETAL ACCREDITATION COMMISSION (IAC) - ECHOCARDIOGRAPHY ACCREDITATION AMERICAN ASSOCIATION OF CARDIOVASULAR PULMONARY REHABILITATION (AACVP) - CARDIAC REHABILITATION ACCREDITATION AMERICAN ASSOCIATION FOR RESPIRATORY CARE QUALITY RESPIRATORY CARE RECOGNITION (AARC'S QRCR) - RESPIRATORY THERAPY ACCREDITATION INFORMATION TECHNOLOGY: THE HOSPITAL'S INVESTMENTS IN THE HEALTHCARE INFORMATION TECHNOLOGY ALONG WITH THE NECESSARY HUMAN RESOURCES AND ASSOCIATED PROCESS CHANGE HAVE RESULTED IN IMPROVED CLINICAL OPERATIONS, QUALITY, PATIENT SAFETY, AND OVERALL EFFICIENCY. THE HOSPITAL RECEIVED THE MOST WIRED AWARD FROM THE AMERICAN HOSPITAL ASSOCIATION IN FIVE CONSECUTIVE YEARS OF 2011- 2015. THE HOSPITAL ALSO ACHIEVED COMPLIANCE WITH THE AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009 MEANINGFUL USE OF HEALTHCARE IT CRITERIA BOTH STAGE 1 AND STAGE 2. SINCE 2012, THE HOSPITAL HAS REALIZED MEANINGFUL USE INCENTIVE REVENUES OF APPROXIMATELY $3,164,000 FROM ITS HOSPITAL AND OWNED PHYSICIAN PROVIDERS. THE HOSPITAL INVESTED IN AN INDUSTRY LEADING BUSINESS INTELLIGENCE PLATFORM WHICH IS UTILIZED IN OPTIMIZING OPERATIONS AND FINANCIAL PERFORMANCE. THE CMH MEDICAL GROUP THE HOSPITAL OWNS AND OPERATES A NUMBER OF PROVIDER-BASED PRIMARY, URGENT CARE, AND SPECIALTY CARE CLINICS ORGANIZED AND COLLECTIVELY KNOWN AS THE CMH MEDICAL GROUP. THE CLINICS OPERATE IN THREE (3) SEPARATE ASTORIA LOCATIONS AND ONE (1) WARRENTON, OREGON LOCATION. THE WARRENTON LOCATION OPERATES AS A PROVIDER-BASED RURAL HEALTH CLINIC, WHICH EXPANDED AND DOUBLED THE CAPACITY TO PROVIDE PRIMARY CARE SERVICES FOR THE COMMUNITY IN 2015. THERE ARE THIRTY (30) PHYSICIANS AND MID-LEVEL PROVIDERS EMPLOYED WITHIN THE CMH MEDICAL GROUP IN ELEVEN (11) DIFFERENT MEDICAL SPECIALTIES. THESE SPECIALTIES INCLUDE: GENERAL SURGERY, PEDIATRICS, PRIMARY CARE, URGENT CARE, UROLOGY, ENDOCRINOLOGY, ORTHOPEDICS, PODIATRY, AND WOMEN'S HEALTHCARE, ONCOLOGY IN COLLABORATION WITH OHSU, AND CARDIOLOGY IN COLLABORATION WITH OHSU. CLINICAL COLLABORATIONS IN ORDER TO ENHANCE THE SERVICES THAT THE HOSPITAL PROVIDES TO THE COMMUNITY, THE HOSPITAL ESTABLISHED A CLINICAL ALLIANCE WITH OHSU IN 2010. THROUGH THIS ALLIANCE, THE HOSPITAL AND OHSU INITIALLY CREATED THE CMH/OHSU CANCER CARE CENTER, WHICH IS DEDICATED TO PROVIDING COMPREHENSIVE, INTERDISCIPLINARY, CONSULTATIVE, AND ONGOING ONCOLOGY AND HEMATOLOGY CARE. IN 2011, THE HOSPITAL AND OHSU ESTABLISHED THE CMH/OHSU CARDIOLOGY CLINIC, WHICH PROVIDES COMPREHENSIVE CARE FOR A RANGE OF HEART HEALTH AND HEART DISEASE PREVENTION NEEDS IN THE COMMUNITY. SINCE 2011, THE ALLIANCE HAS BROADENED SUBSTANTIALLY AND NOW INCLUDES CLINICAL OVERSIGHT AND STAFFING OF THE HOSPITAL'S EMERGENCY DEPARTMENT, GENERAL SURGERY AND RESIDENCY PROGRAMS, TELEMEDICINE, A WOMEN'S HEART HEALTH RESEARCH PROJECT, AND CONTINUING MEDICAL EDUCATION. IN TOTAL, THERE ARE APPROXIMATELY SIXTEEN (16) OHSU PHYSICIANS WORKING FULL-TIME IN THE HOSPITAL'S FACILITIES. IN MARCH 2015, THE HOSPITAL ENTERED INTO A NEW JOINT OPERATING AGREEMENT ("JOA") WITH OHSU THROUGH THE OHSU KNIGHT CANCER INSTITUTE TO BETTER SERVE THE ONCOLOGY CARE NEEDS OF THE ASTORIA AREA AND SURROUNDING COMMUNITIES. THE JOA WILL ADD RADIATION ONCOLOGY SERVICES TO THE EXISTING CMH/OHSU CANCER CARE CENTER MEDICAL ONCOLOGY PROGRAM AND REBRAND THE CENTER AS THE CMH - OHSU KNIGHT CANCER COLLABORATIVE. IT IS ANTICIPATED THAT THIS NEW COLLABORATION WILL PROVIDE FOR HIGH-QUALITY, COST-EFFICIENT, SAFE, AND EFFECTIVE ONCOLOGY SERVICES FOR THE RESIDENTS OF ASTORIA AND SURROUNDING COMMUNITIES. A NEW BOND ISSUE IS ANTICIPATED IN 2016 TO PROVIDE FINANCING FOR THE CONSTRUCTION AND EQUIPPING OF A NEW 19,000 SQUARE-FOOT, TWO-STORY COMPREHENSIVE CANCER TREATMENT CENTER (THE "CANCER CENTER"). THE CANCER CENTER WILL INCORPORATE AND ALLOW FOR THE EXPANSION OF THE CURRENT MEDICAL ONCOLOGY AND INFUSION THERAPY CLINIC. IN ADDITION, THE CANCER CENTER WILL BRING RADIATION ONCOLOGY SERVICES TO THE REGION. THERE ARE CURRENTLY NO RADIATION THERAPY SERVICES AVAILABLE ON THE NORTH OREGON COAST. CMH FOUNDATION THE HOSPITAL BENEFITS FROM SUBSTANTIAL COMMUNITY SUPPORT. THE FOUNDATION PROVIDES A DIRECT LINK TO THE REGION'S NEED FOR COMPASSIONATE HEALTH CARE BY SUPPORTING THE ENHANCEMENT OF THE HOSPITAL'S PROGRAMS AND SERVICES. THE FOUNDATION WAS INCORPORATED IN 1991 BY A GROUP OF CITIZENS TO SERVE AS THE BRIDGE BETWEEN THE COMMUNITY AND THE HOSPITAL TO ENCOURAGE FINANCIAL SUPPORT OF HEALTH PROGRAMS AND SERVICES. THE FOUNDATION IS A DEDICATED FUND DEVELOPMENT ENTITY THAT HAS SUCCESSFULLY RAISED OVER $5,000,000. IN 2010, THE FOUNDATION CONTRIBUTED $500,000 TO THE HOSPITAL TO ASSIST WITH THE SURGERY CENTER RENOVATION. THIS SUPPORT CONTINUED WITH A $185,000 DONATION IN 2012 FOR THE CONTINUED EXPANSION OF THE CANCER CENTER AND HAS RAISED AN ADDITION $2,000,000 TO BENEFIT THAT PROGRAM. THE FOUNDATION FOCUSES ON WORKING WITH DONORS WHO WISH TO MAKE MAJOR AND PLANNED GIFTS IN SUPPORT OF THE HOSPITAL. IN SOME CASES, THE FOUNDATION WILL SELECT ONE PROJECT TO FUND, AND IN OTHER CASES, THE FOUNDATION RAISES FUNDS TO SUPPORT A VARIETY OF PRIORITIES AS IDENTIFIED BY THE HOSPITAL AND IN PARTNERSHIP WITH DONORS. THE FOUNDATION PROVIDES OPPORTUNITIES FOR DONORS TO SUPPORT A MISSION THAT MATCHES THEIR OWN INTERESTS SUCH AS PROVIDING EQUIPMENT, CREATING PROGRAMS TO SERVE THE COMMUNITY, OR FUNDING THE FUTURE THROUGH ENDOWMENT. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| COLUMBIA MEMORIAL HOSPITAL FOUNDATION | |||||||||
| 2111 EXCHANGE STREET | ASTORIA | OR | 97103 | 931091701 | FUNDRAISING FOR THE HOSPITAL | OR | 501(C)3 | LINE 11A, I | Yes (1) |
| COLUMBIA MEMORIAL HOSPITAL AUXILIARY | |||||||||
| 2111 EXCHANGE STREET | ASTORIA | OR | 97103 | 931306211 | PROVIDE VOLUNTEERS | OR | 501(C)3 | LINE 11A, I | 0 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASTORIA IMAGING LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2111 EXCHANGE STREET | AddressLine1Txt |
| City | ASTORIA | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 800240381 | EIN |
| Primary Activities | MRI JOINT VENTURE | PrimaryActivitiesTxt |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $950,298 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $1,793,587 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (1) | GeneralOrManagingPartnerInd |
| Ownership | 0.51000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COASTAL HEALTH ASSURANCE INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2111 EXCHANGE STREET | AddressLine1Txt |
| City | ASTORIA | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911818894 | EIN |
| Primary Activities | PHYSICAN ASSOCIATION, MEDICAL CONTRACT MANAGEMENT | PrimaryActivitiesTxt |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Entity Type | C | EntityTypeTxt |
| Share Of EOY Assets | $20,828 | ShareOfEOYAssetsAmt |
| Ownership | 0.50000 | OwnershipPct |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | 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 (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CMH FOUNDATION (IN-KIND CONTRIBUTIONS) | ||
| B | $19,148 | ACTUAL |
| CMH FOUNDATION (IN-KIND CONTRIBUTIONS SALARY EXPENSES) | ||
| O | $198,229 | ACTUAL |
| ASTORIA IMAGING LLC (SALARY EXPENSES FOR MRI MGMT TECHS & REGISTRATION) | ||
| O | $362,793 | ACTUAL |
| CMH FOUNDATION (TOTAL QUARTERLY TRANSFERS) | ||
| Q | $124,259 | ACTUAL |
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