COLUMBIA CENTER INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- COLUMBIA CENTER INC (EIN 39-2016396)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-16
- IRS object ID
- 201631379349306378
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-16T13:43:42-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12237 | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 543072237 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 392016396 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COLU | BusinessNameControlTxt |
| Phone | 4143262230 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4425 N PORT WASHINGTON ROAD | AddressLine1Txt |
| City | GLENDALE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53212 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KAREN J CASEY | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 4143262230 | PhoneNum |
| Signature | 2016-05-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRI REXRODE CPA MST | PreparerPersonNm |
| PTIN | P00096513 | PTIN |
| Phone | 9206620016 | PhoneNum |
| Preparation | 2016-05-16 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-12-15 16:53:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KAREN J CASEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4425 N PORT WASHINGTON ROAD | AddressLine1Txt |
| City | GLENDALE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53212 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,927,402 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | THEBIRTHHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH QUALITY BIRTHING SERVICES, OUTPATIENT ELECTIVE STERILIZATION, AND CONTRACEPTIVE SERVICES TO FAMILIES IN OZAUKEE AND WASHINGTON COUNTIES, AS WELL AS THE NORTHERN REGION OF MILWAUKEE COUNTY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 70 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $202,500 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,566,845 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,099,797 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,668 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,508 | CYInvestmentIncomeAmt |
| PY Other Revenue | $25,707 | PYOtherRevenueAmt |
| CY Other Revenue | $618,597 | CYOtherRevenueAmt |
| PY Total Revenue | $5,598,220 | PYTotalRevenueAmt |
| CY Total Revenue | $6,927,402 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,378,252 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,458,055 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,678,016 | PYOtherExpensesAmt |
| CY Other Expenses | $2,973,374 | CYOtherExpensesAmt |
| PY Total Expenses | $6,056,268 | PYTotalExpensesAmt |
| CY Total Expenses | $6,431,429 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$458,048 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $495,973 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,821,101 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,277,813 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $462,931 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $559,873 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $17,358,170 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $17,717,940 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE HIGH QUALITY BIRTHING SERVICES, OUTPATIENT ELECTIVE STERILIZATION, AND CONTRACEPTIVE SERVICES TO FAMILIES IN THE METRO AND NORTHERN MILWAUKEE AREAS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,862,164 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $6,718,394 | RevenueAmt |
| Desc | COLUMBIA CENTER IS AN INDEPENDENT, STATE-OF-THE-ART, BIRTHING HOSPITAL LOCATED ON THE CAMPUS OF COLUMBIA ST. MARY'S HOSPITAL OZAUKEE IN MEQUON, WISCONSIN. COLUMBIA CENTER STRIVES TO MAINTAIN HIGHER-THAN-AVERAGE STAFF-TO-PATIENT RATIOS, ALLOWING ITS SKILLED LABOR AND DELIVERY NURSING STAFF TO PROVIDE A HIGH LEVEL OF PERSONALIZED ATTENTION TO ITS NEW MOTHERS-TO-BE. COLUMBIA CENTER STAFF MEMBERS HAVE AN AVERAGE OF 19 YEARS EXPERIENCE, AND IN 2015, ASSISTED IN OVER 519 CHILDBIRTHS. COLUMBIA CENTER OFFERS WISCONSIN'S ONLY HOSPITAL-BASED DOULA PROGRAM. A DOULA PROVIDES NON-MEDICAL EMOTIONAL AND PHYSICAL SUPPORT TO WOMEN DURING LABOR AND BIRTH. IN ADDITION TO INPATIENT CHILDBIRTH SERVICES, COLUMBIA CENTER OFFERS A COMPREHENSIVE RANGE OF PREGNANCY, CHILDBIRTH AND EARLY PARENTING EDUCATIONAL CLASSES. COLUMBIA CENTER ALSO PROVIDES REPRODUCTIVE PLANNING AND ELECTIVE STERILIZATION SERVICES, INCLUDING OUTPATIENT TUBAL LIGATIONS AND VASECTOMIES. | Desc |
| Total Program Service Expenses | $3,862,164 | 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 | 0 | 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 | 0 | 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 With Officer Ent | 0 | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 14 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 70 | 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 |
| 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 | 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 | 0 | 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 | KAREN J CASEY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4143262230 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4425 N PORT WASHINGTON RD | AddressLine1Txt |
| City | GLENDALE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53212 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| PATRICIA J DOLHUN MD | ||||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ROBERTA M DREWS | ||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| POLLY W BEAL | ||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DANIEL F MCKEITHAN | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DON S SCHOONENBERG | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ELIZABETH R HAGEN MD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JILL G PELISEK | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LINDA T MELLOWES | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LORI J LANGHOLZ | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PATRICK T REGAN MD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| POLLY H VAN DYKE END 092014 | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TERRANCE J WILKINS MD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| WARNER C FRAZIER | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KAREN J CASEY | ||||||||
| PRESIDENT & CEO | 1.00 | Yes (X) | $0 | $263,376 | $17,229 | 40.00 | ||
| VICKI PHILIPS | ||||||||
| CRNA | 40.00 | $198,761 | $0 | $9,161 | Yes (X) | |||
| JAMES TALLEY | ||||||||
| CRNA | 36.00 | $155,611 | $0 | $24,846 | Yes (X) | |||
| JEFFREY TUSHAUS | ||||||||
| CRNA | 36.00 | $169,812 | $0 | $547 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $524,184 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $263,376 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $51,783 | 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 |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| TRIMEDX LLC | |||||
| 5451 LAKEVIEW PARKWAY S DRIVE | INDIANAPOLIS | IN | 46268 | EQUIPMENT REPAIR SERVICES | $111,099 |
| MCDILL DESIGN | |||||
| 626 N WATER STREET | MILWAUKEE | WI | 53202 | MARKETING SERVICES | $102,371 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $200,000 | RelatedOrganizationsAmt |
| Government Grants | $2,500 | GovernmentGrantsAmt |
| Total Contributions | $202,500 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 621990 | $6,098,917 | $6,098,917 |
| INSTRUCTIONAL CLASSES | 900099 | $880 | $880 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,099,797 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,508 | TotalRevenueColumnAmt |
| Exclusion | $6,508 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $618,597 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $618,597 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $618,597 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,927,402 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,718,394 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $6,508 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,759,320 | TotalAmt |
| Program Services | $2,646,953 | ProgramServicesAmt |
| Management And General | $112,367 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,982 | TotalAmt |
| Program Services | $89,893 | ProgramServicesAmt |
| Management And General | $3,089 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $422,053 | TotalAmt |
| Program Services | $408,030 | ProgramServicesAmt |
| Management And General | $14,023 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,700 | TotalAmt |
| Program Services | $177,257 | ProgramServicesAmt |
| Management And General | $6,443 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,208 | TotalAmt |
| Management And General | $8,208 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $203,646 | TotalAmt |
| Management And General | $203,646 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,236,177 | TotalAmt |
| Management And General | $1,236,177 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $262,186 | TotalAmt |
| Management And General | $262,186 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,905 | TotalAmt |
| Management And General | $7,905 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,627 | TotalAmt |
| Management And General | $93,627 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48 | TotalAmt |
| Management And General | $48 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,233 | TotalAmt |
| Management And General | $5,233 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $524,575 | TotalAmt |
| Management And General | $524,575 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,981 | TotalAmt |
| Management And General | $79,981 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| PATIENT CARE SUPPLIES | $259,474 | $259,474 |
| BAD DEBT EXPENSE | $169,629 | $169,629 |
| HOSPITAL ASSESSMENT TAX | $110,928 | $110,928 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,757 | TotalAmt |
| Management And General | $11,757 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,431,429 | TotalAmt |
| Program Services | $3,862,164 | ProgramServicesAmt |
| Management And General | $2,569,265 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,631,297 | BOYAmt |
| EOY | $7,128,902 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $661,365 | BOYAmt |
| EOY | $882,013 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,625 | BOYAmt |
| EOY | $3,500 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,684 | BOYAmt |
| EOY | $35,976 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $14,899,210 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,749,344 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,611,041 | BOYAmt |
| EOY | $10,149,866 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,956 | BOYAmt |
| EOY | $77,556 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $831,133 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,821,101 | BOYAmt |
| EOY | $18,277,813 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $462,931 | BOYAmt |
| EOY | $389,223 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $170,650 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $462,931 | BOYAmt |
| EOY | $559,873 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,290,214 | BOYAmt |
| EOY | $17,640,384 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,956 | BOYAmt |
| EOY | $77,556 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,358,170 | BOYAmt |
| EOY | $17,717,940 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,821,101 | BOYAmt |
| EOY | $18,277,813 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $495,973 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$136,203 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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) |
|---|---|---|
| Other Cost Or Other Basis | $283,200 | OtherCostOrOtherBasisAmt |
| Book Value | $283,200 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,085,462 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,918,726 | DepreciationAmt |
| Book Value | $8,166,736 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,530,548 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,830,618 | DepreciationAmt |
| Book Value | $1,699,930 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,149,866 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATE | Desc |
| Amt | $170,650 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $170,650 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $6,982,059 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $360,489 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | -$169,629 | OtherRevenueAmt |
| Revenue Not Reported | $190,860 | RevenueNotReportedAmt |
| Revenue Subtotal | $6,791,199 | RevenueSubtotalAmt |
| Other Revenues Not Included | $136,203 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $136,203 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $6,927,402 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,622,289 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $360,489 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | -$169,629 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $190,860 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,431,429 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,431,429 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE -169,629. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | AFFILIATE TRANSFER COLUMBIA HEALTH SYSTEM 145,803. CHANGE IN INTEREST IN NET ASSETS -9,600. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE -169,629. |
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 |
| Percent300 | Yes (X) | Percent300Ind |
| 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 | $6,409 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,409 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,434,895 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $414,289 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,020,606 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.16300 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,441,304 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $414,289 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,027,015 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.16400 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,829 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $12,829 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,728 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,728 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,557 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $16,557 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00260 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,457,861 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $414,289 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,043,572 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.16660 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $34,725 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $34,725 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00550 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $34,725 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $34,725 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00550 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $120,097 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $11,381 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $19,273 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$7,892 | 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 |
| 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 CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 13125 N PORT WASHINGTON RD | AddressLine1Txt |
| City | MEQUON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53097 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | THEBIRTHHOSPITAL.ORG | WebsiteAddressTxt |
| State License | 300 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Other | BIRTHING HOSPITAL | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA CENTER INC | 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 |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 12 | 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 |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | THEBIRTHHOSPITAL.ORG/RESOURCES/COMMUNITY-NEEDS-ASSESSMENT | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 12 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | THEBIRTHHOSPITAL.ORG/RESOURCES/COMMUNITY-NEEDS-ASSESSMENT | StrategyWebsiteURLTxt |
| Strategy Attached | Yes (1) | 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 | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://THEBIRTHHOSPITAL.ORG/RESOURCES/FINANCIAL-ASSISTANCE/ | FAPAppAvailableOnWebsiteURLTxt |
| 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 Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| 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 (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| COLUMBIA CENTER, INC. | PART V, SECTION B, LINE 5: COLUMBIA CENTER PARTNERED WITH KIRSTEN JOHNSON, MPH, OZAUKEE COUNTY DEPARTMENT OF HEALTH; JENNIFER DOERRING, RN, PHD, UNIVERSITY OF WISCONSIN-MILWAUKEE; AND MS. ROSE EICHENHOEFER, CSW, MEQUON-BASED LICENSED SOCIAL WORKER. |
| COLUMBIA CENTER, INC. | PART V, SECTION B, LINE 11: COLUMBIA CENTER ACTIVELY PARTICIPATES IN COMMUNITY HEALTH DISCUSSIONS. THE EMPLOYEES AND MANAGEMENT ARE CONTINUALLY LOOKING FOR WAYS TO IMPROVE HEALTH CARE AND ITS AVAILABILITY IN THE LOCAL COMMUNITY. MANAGEMENT ALSO WORKS WITH THE LOCAL HEALTH DEPARTMENT TO LOCATE GAPS WITHIN HEALTH CARE OFFERINGS TO FILL THE HEALTH CARE NEEDS OF THE COMMUNITY. ANNUALLY, A COMMUNITY BENEFIT REPORT IS SUBMITTED TO THE STATE COMPILING COMMUNITY BENEFIT INFORMATION AS REQUESTED.DURING FY15, COLUMBIA CENTER DONATED $10,000 TO THE MOM'S MENTAL HEALTH INITIATIVE THROUGH MCDILL DESIGN TO BUILD A WEBSITE TO PROVIDE GREATER ACCESS AND HELP ADDRESS THE ISSUE OF MOTHERS SUFFERING FROM POSTPARTUM DEPRESSION. |
| COLUMBIA CENTER, INC. | PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME BETWEEN 200-300% OF THE POVERTY LEVEL QUALIFY FOR REDUCED PATIENT FINANCIAL RESPONSIBILTY BASED ON A TIERED SCALE - THE MOST THEY WOULD BE RESPONSIBLE FOR IS 60% (I.E. A 40% DISCOUNT), WITH A MAX AMOUNT OF 10% OF THEIR INCOME. PATIENTS WITH INCOME LESS THAN 300% OF THE POVERTY LEVEL QUALIFY FOR 100% FINANCIAL ASSISTANCE. |
| PART V, SECTION B, LINE 16 | FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY |
| COLUMBIA CENTER, INC. PART V, SECTION B, LINE 16B WEBSITE: | HTTP://THEBIRTHHOSPITAL.ORG/RESOURCES/FINANCIAL-ASSISTANCE/ |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE COST OF PROVIDING CHARITY CARE, MEANS TESTED GOVERNMENT PROGRAMS, AND COMMUNITY BENEFIT PROGRAMS IS ESTIMATED USING INTERNAL COST DATA. THE ORGANIZATION USES A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS (FOR EXAMPLE, INPATIENT, OUTPATIENT, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, OR SELF PAY). THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. FOR CERTAIN CATEGORIES IN THE TABLE, THIS WAS A COST ACCOUNTING SYSTEM; IN OTHER CATEGORIES, A SPECIFIC COST-TO-CHARGE RATIO WAS APPLIED. |
| PART I, LN 7 COL(F): | BAD DEBT IS CALCULATED FROM THE AUDITED FINANCIAL STATEMENTS USING AN AVERAGE COST TO CHARGE RATIO. THE SAME RATIO IS USED TO CALCULATE ALL OF THE EXPENSES AT COST WITHIN SCHEDULE H. TOTAL BAD DEBT EXPENSE FROM THE INCOME STATEMENT TO WHICH THE COST TO CHARGE RATIO IS APPLIED IS $169,629. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | COLUMBIA CENTER SUPPORTS HEALTHY BABIES, HEALTHY MOTHERS, AND HEALTHY FAMILIES IN THE COUNTIES THEY SERVE. ANNUAL SUPPORT IS PROVIDED THROUGH EDUCATIONAL CLASSES FOCUSED ON HEALTHY PREGNANCIES, HEALTHY NUTRITION, AND POSTPARTUM SUPPORT FOR MOTHERS. THESE CLASSES ARE OFFERED FREE OF CHARGE TO ANYONE INTERESTED. DURING FISCAL YEAR 2015 COLUMBIA CENTER SPONSORED AN INFANT CPR AND SAFETY CLASS TO EDUCATE PARENTS AND CAREGIVERS ON THE CPR AS PROMOTED BY THE AMERICAN HEART ASSOCIATION. |
| PART III, LINE 2: | BAD DEBT IS CALCULATED FROM THE AUDITED FINANCIAL STATEMENTS USING AN AVERAGE COST TO CHARGE RATIO. THE SAME RATIO IS USED TO CALCULATE ALL OF THE EXPENSES AT COST WITHIN SCHEDULE H. TOTAL BAD DEBT EXPENSE FROM THE INCOME STATEMENT TO WHICH THE COST TO CHARGE RATIO IS APPLIED IS $169,629. |
| PART III, LINE 4: | THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBTS. WE HAVE ADDED OUR PATIENT RECEIVABLES AND CREDIT POLICY BELOW AS AN EXPLANATION:PATIENT RECEIVABLES AND CREDIT POLICYPATIENT ACCOUNTS RECEIVABLE ARE UNCOLLATERALIZED PATIENT OBLIGATIONS THAT ARE STATED AT THE AMOUNT MANAGEMENT EXPECTS TO COLLECT FROM OUTSTANDING BALANCES. THESE OBLIGATIONS ARE PRIMARILY FROM LOCAL RESIDENTS, MOST OF WHOM ARE INSURED UNDER THIRD-PARTY PAYER AGREEMENTS. THE CENTER BILLS THIRD-PARTY PAYORS ON THE PATIENTS' BEHALF, OR IF A PATIENT IS UNINSURED, THE PATIENT IS BILLED DIRECTLY. ONCE CLAIMS ARE SETTLED WITH THE PRIMARY PAYER, ANY SECONDARY INSURANCE IS BILLED, AND PATIENTS ARE BILLED FOR COPAY AND DEDUCTIBLE AMOUNTS THAT ARE THE PATIENTS' RESPONSIBILITY. PAYMENTS ON PATIENT ACCOUNTS RECEIVABLE ARE APPLIED TO THE SPECIFIC CLAIM IDENTIFIED ON THE REMITTANCE ADVICE OR STATEMENT.THE CARRYING AMOUNTS OF PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY ALLOWANCES THAT REFLECT MANAGEMENT'S BEST ESTIMATE OF THE AMOUNTS THAT WILL NOT BE COLLECTED. MANAGEMENT PROVIDES FOR CONTRACTUAL ADJUSTMENTS UNDER TERMS OF THIRD-PARTY REIMBURSEMENT AGREEMENTS THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. IN ADDITION, MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE.COLUMBIA CENTER USES HFMA STATEMENT #15 AND THEREFORE NO AMOUNTS OF OUR BAD DEBT EXPENSE SHOULD BE ATTRIBUTABLE TO PATIENTS UNDER OUR FINANCIAL ASSISTANCE POLICY. |
| PART III, LINE 8: | COLUMBIA CENTER DOES NOT TREAT MEDICARE SHORTFALLS AS COMMUNITY BENEFIT. |
| PART III, LINE 9B: | THE ORGANIZATION HAS A WRITTEN DEBT COLLECTION POLICY THAT ALSO INCLUDES A PROVISION ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. IF A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE CERTAIN COLLECTION PRACTICES DO NOT APPLY. |
| PART VI, LINE 2: | COLUMBIA CENTER ACTIVELY PARTICIPATES IN COMMUNITY HEALTH CARE DISCUSSIONS. THE EMPLOYEES AND MANAGEMENT ARE CONTINUALLY LOOKING FOR WAYS TO IMPROVE HEALTH CARE AND IT'S AVAILABILITY IN THE LOCAL COMMUNITY. MANAGEMENT ALSO WORKS WITH THE LOCAL HEALTH DEPARTMENT TO LOCATE GAPS WITHIN HEALTH CARE OFFERINGS TO FILL THE HEALTH CARE NEEDS OF THE COMMUNITY. ANNUALLY, A COMMUNITY BENEFIT REPORT IS SUBMITTED TO THE STATE COMPILING COMMUNITY BENEFIT INFORMATION AS REQUESTED. |
| PART VI, LINE 3: | PATIENTS AND THEIR FAMILIES ARE ADVISED OF THE HOSPITAL'S POLICIES, INCLUDING THE FINANCIAL ASSISTANCE PROGRAM AND THE AVAILABILITY OF NEED-BASED FINANCIAL ASSISTANCE IN EASILY UNDERSTOOD TERMS, AS WELL AS IN ANY LANGUAGE COMMONLY USED BY PATIENTS IN OUR COMMUNITY. FINANCIAL COUNSELORS ARE AVAILABLE TO ALL PATIENTS.FINANCIAL ASSISTANCE AND CHARITY CARE INFORMATION IS ALSO AVAILABLE ON COLUMBIA CENTER'S WEBSITE FOR EASY ACCESSIBILITY. |
| PART VI, LINE 4: | COLUMBIA CENTER SERVES OZAUKEE AND WASHINGTON COUNTIES, AS WELL AS THE NORTHERN REGION OF MILWAUKEE COUNTY, BUT PATIENTS COME FROM OUTSIDE THESE AREAS FOR THE EXCEPTIONAL CARE OFFERED TO PATIENTS. |
| PART VI, LINE 5: | COLUMBIA CENTER ACTIVELY PARTICIPATES IN NURSE INTERNSHIP TRAINING. OVER 400 HOURS OF COLUMBIA CENTER STAFF TIME WAS USED PROVIDING PRACTICAL TRAINING FOR NURSES FINISHING THEIR EDUCATION. ALSO, DONATIONS ARE MADE TO LOCAL CHARITIES TO ASSIST THEM IN PROVIDING BENEFITS WITHIN OZAUKEE COUNTY. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | 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 (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KAREN J CASEY | ||||||||||||||
| PRESIDENT & CEO | $0 | $191,226 | $0 | $72,150 | $0 | $0 | $0 | $4,329 | $0 | $12,900 | $0 | $280,605 | $0 | $0 |
| VICKI PHILIPS | ||||||||||||||
| CRNA | $174,610 | $0 | $0 | $0 | $24,151 | $0 | $0 | $0 | $9,161 | $0 | $207,922 | $0 | $0 | $0 |
| JAMES TALLEY | ||||||||||||||
| CRNA | $149,447 | $0 | $0 | $0 | $6,164 | $0 | $0 | $0 | $24,846 | $0 | $180,457 | $0 | $0 | $0 |
| JEFFREY TUSHAUS | ||||||||||||||
| CRNA | $155,786 | $0 | $0 | $0 | $14,026 | $0 | $0 | $0 | $547 | $0 | $170,359 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | COLUMBIA HEALTH SYSTEM, INC., THE SPONSORING ORGANIZATION OF COLUMBIA CENTER, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT AND CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | COLUMBIA CENTER (CC) HAS A SOLE CORPORATE MEMBER, COLUMBIA HEALTH SYSTEM, INC. (CHS) |
| FORM 990, PART VI, SECTION A, LINE 7A | CHS, THE SOLE MEMBER, HAS THE ABILITY TO ELECT MEMBERS/INDIVIDUALS TO THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7B | ALL DECISIONS THAT HAVE A MATERIAL IMPACT TO COLUMBIA CENTER'S FINANCIAL INFORMATION OR CORPORATION AS A WHOLE ARE SUBJECT TO APPROVAL BY ITS SOLE CORPORATE MEMBER, COLUMBIA HEALTH SYSTEM. COLUMBIA HEALTH SYSTEM HAS THE POWER TO APPROVE NEW MEMBERS AND IMPORTANT BUSINESS DECISIONS, SUCH AS THE SALE, LEASE OR DISPOSAL OF ASSETS IN EXCESS OF A PRE-DETERMINED AMOUNT, OR THE SALE, TRANSFER, EXCHANGE OR OTHER DISPOSAL OF ALL OR SUBSTANTIALLY ALL OF THE COLUMBIA CENTER ASSETS, AND THE COMBINATION, DISSOLUTION, MERGER OR CONSOLIDATION INVOLVING COLUMBIA CENTER OR ANY OTHER STRUCTURAL CHANGES. |
| FORM 990, PART VI, SECTION B, LINE 11 | MANAGEMENT WORKS DILIGENTLY TO COMPLETE THE FORM 990 AND ATTACHED SCHEDULES IN A THOROUGH MANNER. MANAGEMENT PRESENTS THE FORM TO THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS TO REVIEW AND ANSWER ANY QUESTIONS. PRIOR TO FILING THE RETURN, COMMITTEE MEMBERS ARE PROVIDED THE FORM 990 AND MANAGEMENT TEAM MEMBERS ARE AVAILABLE TO ANSWER ANY BOARD MEMBERS QUESTIONS. |
| FORM 990, PART VI, SECTION B, LINE 12C | COLUMBIA CENTER HAS A WRITTEN CONFLICT OF INTEREST POLICY. THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY IN THAT ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE REMAINING INDIVIDUALS ON THE GOVERNING BOARD OR COMMITTEE MEETING WILL DECIDE IF CONFLICTS OF INTEREST EXIST. EACH DIRECTOR, PRINCIPAL OFFICER, AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX EXEMPT PURPOSE. IF A CONFLICT OF INTEREST ARISES, THE BOARD MEMBER WILL RECUSE THEMSELVES FROM THE MEETING DURING THE DISCUSSION, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | 15A & B. IN DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO WAS COMPARED TO OTHER HOSPITALS OF SIMILAR SIZE AND SCOPE IN THE AREA THAT HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN A MEMO FROM THE BOARD CHAIR TO THE CEO. THE CEO WAS NOT PRESENT WHEN HER COMPENSATION WAS DECIDED. NO OTHER INDIVIDUALS ARE CONSIDERED KEY EMPLOYEES OR OFFICERS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION WILL PROVIDE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIALS OPEN TO PUBLIC INSPECTION UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 32,872. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,872. ADMINISTRATIVE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 534,308. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 534,308. ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 91,320. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 91,320. MATERIALS MANAGEMENT/LINENS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 35,986. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 35,986. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 488,493. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 488,493. DIETARY SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 53,198. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 53,198. |
| FORM 990, PART XI, LINE 9: | CHANGE IN TEMP RESTRICTED NET ASSETS - INTEREST IN COLUMBIA ST MARYS FDN 9,600. AFFILATE TRANSFER COLUMBIA HEALTH SYSTEM -145,803. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION'S FINANCIAL STATEMENTS HAVE BEEN AUDITED BY AN INDEPENDENT AUDIT FIRM. THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT AUDITORS. NO CHANGES HAVE OCCURRED SINCE THE PRIOR YEAR. |
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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| COLUMBIA ST MARY'S FOUNDATION | |||||||||||
| 4425 NORTH PORT WASHINGTON RD | GLENDALE | WI | 53212 | 391494981 | FOUNDATION | WI | 501(C)(3) | 7 | COLUMBIA HEALTH SYSTEM INC | Yes (1) | |
| COLUMBIA HEALTH SYSTEM INC | |||||||||||
| 4425 NORTH PORT WASHINGTON RD | GLENDALE | WI | 53212 | 391494977 | HEALTH SYSTEM | WI | 501(C)(3) | 11 | 0 | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| COLUMBIA ST MARY'S FOUNDATION INC | ||
| C | $200,000 | ACTUAL COST |
| COLUMBIA HEALTH SYSTEM INC | ||
| C | $360,489 | FAIR MARKET VALUE |
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