COLUMBIA LUTHERAN CHARITIES: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- COLUMBIA LUTHERAN CHARITIES (EIN 93-0583856)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-17
- IRS object ID
- 201423219349305667
- Schema version
- 2013v3.0
- 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
- 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 | 2014-11-17T12:27:46-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | 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 | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5885 MEADOWS ROAD NO 200 | AddressLine1 |
| City | LAKE OSWEGO | City |
| State | OR | State |
| ZIP Code | 97035 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | 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 | BusinessNameLine1 |
| 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 | AddressLine1 |
| City | ASTORIA | City |
| State | OR | State |
| ZIP Code | 971033329 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHANIE D BRENDEN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5033254321 | PhoneNum |
| Signature | 2014-11-17 | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA MEMORIAL HOSPITAL | BusinessNameLine1 |
| 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 | AddressLine1 |
| City | ASTORIA | City |
| State | OR | State |
| ZIP Code | 971033329 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $73,215,117 | 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 | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 576 | TotalEmployeeCnt |
| Total Volunteers | 105 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $241,709 | PYContributionsGrantsAmt |
| CY Contributions Grants | $857,064 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $64,446,382 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $67,712,027 | CYProgramServiceRevenueAmt |
| PY Investment Income | $427,803 | PYInvestmentIncomeAmt |
| CY Investment Income | $429,765 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,502,188 | PYOtherRevenueAmt |
| CY Other Revenue | $2,383,349 | CYOtherRevenueAmt |
| PY Total Revenue | $67,618,082 | PYTotalRevenueAmt |
| CY Total Revenue | $71,382,205 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $76,471 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $65,100 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $37,735,475 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $39,941,801 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $11,250 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $246,353 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $25,155,620 | PYOtherExpensesAmt |
| CY Other Expenses | $27,626,143 | CYOtherExpensesAmt |
| PY Total Expenses | $62,978,816 | PYTotalExpensesAmt |
| CY Total Expenses | $67,633,044 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,639,266 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,749,161 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $83,916,777 | TotalAssetsBOYAmt |
| Total Assets EOY | $90,849,713 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $52,551,952 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $47,251,547 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $31,364,825 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $43,598,166 | 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 | $58,398,366 | ExpenseAmt |
| Grant | $65,100 | GrantAmt |
| Revenue | $69,827,866 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
| Total Program Service Expenses | $58,398,366 | 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 | Yes (1) | 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 | 131 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 576 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | 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 |
| 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 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5033387505 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2111 EXCHANGE STREET | AddressLine1 |
| City | ASTORIA | City |
| State | OR | State |
| ZIP Code | 97103 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 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 | |||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| KEVIN BAXTER | |||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| BILL LANDWEHR | |||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| NANCY MCALLISTER | |||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| KATHERINE HELLBERG | |||||||
| 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 | ||
| MALCOLM SMITH | |||||||
| 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 | ||
| HOUMAN SABAHI | |||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| ERIK THORSEN | |||||||
| CEO | 40.00 | $333,548 | $0 | $22,365 | Yes (X) | ||
| WILLIAM G RIVERS | |||||||
| CIO | 40.00 | $190,819 | $0 | $24,011 | Yes (X) | ||
| STEPHANIE D BRENDEN | |||||||
| CFO | 40.00 | $161,393 | $0 | $36,254 | Yes (X) | ||
| KENNETH M BOUCHER | |||||||
| COO | 40.00 | $150,756 | $0 | $15,761 | Yes (X) | ||
| TERESA L GURRAD | |||||||
| CCO | 40.00 | $115,689 | $0 | $14,275 | Yes (X) | ||
| DOUGLAS ABBOTT MD | |||||||
| PHYSICIAN | 40.00 | $599,538 | $0 | $32,889 | Yes (X) | ||
| RICHARD CRASS MD | |||||||
| PHYSICIAN | 40.00 | $370,848 | $0 | $38,419 | Yes (X) | ||
| EDOUARD DURET MD | |||||||
| PHYSICIAN | 40.00 | $407,237 | $0 | $45,472 | Yes (X) | ||
| ROBERT HOLLAND MD | |||||||
| PHYSICIAN | 40.00 | $304,355 | $0 | $27,453 | Yes (X) | ||
| DAVID LEIBEL DO | |||||||
| PHYSICIAN | 40.00 | $313,897 | $0 | $43,042 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,948,080 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $299,941 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 51 | 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/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| RICKENBACK CONSTRUCTION INC | |||||
| 37734 EAGLE LANE | ASTORIA | OR | 97103 | GENERAL CONTRACTOR | $2,091,472 |
| NORTH COAST EMERGENCY | |||||
| 2111 EXCHANGE STREET | ASTORIA | OR | 97103 | EMERGENCY ROOM PHYSICIANS | $1,946,254 |
| BIG RIVER CONSTRUCTION INC | |||||
| 1050 OLNEY AVENUE | ASTORIA | OR | 97103 | GENERAL CONTRACTOR | $680,277 |
| P&C CONTRUCTION | |||||
| 2133 NW YORK STREET | PORTLAND | OR | 97210 | GENERAL CONTRACTOR | $497,586 |
| APOGEE MEDICAL MANAGEMENT | |||||
| 2525 E CAMELBACK ROAD | PHOENIX | AZ | 85016 | HOSPITALIST PHYSICIANS | $383,320 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 23 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $38,543 | RelatedOrganizationsAmt |
| Government Grants | $95,222 | GovernmentGrantsAmt |
| All Other Contributions | $723,299 | AllOtherContributionsAmt |
| Total Contributions | $857,064 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| OUTPATIENT REVENUE | 621990 | $74,860,422 | $74,860,422 |
| EMERGENCY ROOM REVENUE | 621990 | $28,231,866 | $28,231,866 |
| INPATIENT REVENUE | 621990 | $24,278,181 | $24,278,181 |
| PROVISION FOR CHARITY CARE | 621990 | -$3,142,648 | -$3,142,648 |
| CONTRACTUAL ALLOWANCE | 621990 | -$51,519,613 | -$51,519,613 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$4,996,181 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$4,996,181 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $67,712,027 | TotalProgramServiceRevenueAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $330,085 | TotalRevenueColumnAmt |
| Exclusion | $330,085 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $329,818 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $50,704 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $279,114 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $279,114 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $279,114 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,881,888 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,782,208 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $99,680 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $99,680 | TotalRevenueColumnAmt |
| Exclusion | $99,680 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| JOINT VENTURE | 621500 | $827,404 | $827,404 | |
| CAFETERIA AND VENDING | 722210 | $267,510 | $267,510 | |
| PHARMACY SERVICES | 446110 | $165,788 | $165,788 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $843,533 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $843,533 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,104,235 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $71,382,205 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $69,827,866 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $697,275 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,100 | TotalAmt |
| Program Services | $65,100 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,064,872 | TotalAmt |
| Management And General | $1,064,872 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,339,542 | TotalAmt |
| Program Services | $26,233,824 | ProgramServicesAmt |
| Management And General | $2,942,782 | ManagementAndGeneralAmt |
| Fundraising | $162,936 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,252,563 | TotalAmt |
| Program Services | $2,934,642 | ProgramServicesAmt |
| Management And General | $300,403 | ManagementAndGeneralAmt |
| Fundraising | $17,518 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,917,389 | TotalAmt |
| Program Services | $3,373,914 | ProgramServicesAmt |
| Management And General | $517,250 | ManagementAndGeneralAmt |
| Fundraising | $26,225 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,367,435 | TotalAmt |
| Program Services | $2,046,963 | ProgramServicesAmt |
| Management And General | $299,642 | ManagementAndGeneralAmt |
| Fundraising | $20,830 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $327,674 | TotalAmt |
| Program Services | $100 | ProgramServicesAmt |
| Management And General | $327,574 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,919 | TotalAmt |
| Management And General | $147,569 | ManagementAndGeneralAmt |
| Fundraising | $16,350 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,084,420 | TotalAmt |
| Program Services | $4,676,653 | ProgramServicesAmt |
| Management And General | $407,767 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $315,839 | TotalAmt |
| Program Services | $1,415 | ProgramServicesAmt |
| Management And General | $314,424 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $295,103 | TotalAmt |
| Program Services | $180,491 | ProgramServicesAmt |
| Management And General | $114,511 | ManagementAndGeneralAmt |
| Fundraising | $101 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,144,192 | TotalAmt |
| Program Services | $445,269 | ProgramServicesAmt |
| Management And General | $698,923 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,642,049 | TotalAmt |
| Program Services | $1,374,941 | ProgramServicesAmt |
| Management And General | $267,108 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $238,441 | TotalAmt |
| Program Services | $66,833 | ProgramServicesAmt |
| Management And General | $171,608 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $357,982 | TotalAmt |
| Program Services | $293,583 | ProgramServicesAmt |
| Management And General | $64,185 | ManagementAndGeneralAmt |
| Fundraising | $214 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $831,444 | TotalAmt |
| Program Services | $831,444 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,254,600 | TotalAmt |
| Program Services | $2,774,574 | ProgramServicesAmt |
| Management And General | $480,026 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $580,911 | TotalAmt |
| Program Services | $580,911 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & PHAR | $7,823,961 | $7,823,961 | |
| REPAIRS & MAINTENANCE | $1,204,951 | $1,112,140 | $92,811 |
| OTHER PURCHASED SERVICE | $839,107 | $653,167 | $185,940 |
| OUTSIDE MEDICAL SERVICE | $645,846 | $644,614 | $1,232 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,875,704 | TotalAmt |
| Program Services | $2,283,827 | ProgramServicesAmt |
| Management And General | $589,698 | ManagementAndGeneralAmt |
| Fundraising | $2,179 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,633,044 | TotalAmt |
| Program Services | $58,398,366 | ProgramServicesAmt |
| Management And General | $8,988,325 | ManagementAndGeneralAmt |
| Fundraising | $246,353 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,797,050 | BOYAmt |
| EOY | $5,676,971 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,579,570 | BOYAmt |
| EOY | $12,030,548 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,667 | BOYAmt |
| EOY | $28,889 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,219 | BOYAmt |
| EOY | $179,810 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,217,037 | BOYAmt |
| EOY | $1,380,522 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,539,612 | BOYAmt |
| EOY | $1,000,508 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $64,010,786 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $31,009,013 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,271,794 | BOYAmt |
| EOY | $33,001,773 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,600,464 | BOYAmt |
| EOY | $31,257,760 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $900,818 | BOYAmt |
| EOY | $777,767 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,832,546 | BOYAmt |
| EOY | $5,515,165 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,916,777 | BOYAmt |
| EOY | $90,849,713 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,912,200 | BOYAmt |
| EOY | $11,105,782 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,919,646 | BOYAmt |
| EOY | $30,917,985 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,720,106 | BOYAmt |
| EOY | $5,227,780 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,551,952 | BOYAmt |
| EOY | $47,251,547 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,260,907 | BOYAmt |
| EOY | $43,528,835 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,918 | BOYAmt |
| EOY | $69,331 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,364,825 | BOYAmt |
| EOY | $43,598,166 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,916,777 | BOYAmt |
| EOY | $90,849,713 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,749,161 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,129,807 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $7,354,373 | 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) |
|---|---|---|
| Other Cost Or Other Basis | $920,043 | OtherCostOrOtherBasisAmt |
| Book Value | $920,043 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,629,997 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,563,663 | DepreciationAmt |
| Book Value | $11,066,334 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,257,051 | OtherCostOrOtherBasisAmt |
| Depreciation | $282,390 | DepreciationAmt |
| Book Value | $974,661 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,125,476 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,162,960 | DepreciationAmt |
| Book Value | $15,962,516 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,078,219 | OtherCostOrOtherBasisAmt |
| Book Value | $4,078,219 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $33,001,773 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER ASSETS | $202,421 |
| INSURANCE ANNUITIES - DEFERRED COMP PLAN | $179,878 |
| ESTIMATED THIRD-PARTY PAYOR RECEIVABLES | $2,134,922 |
| RENTAL AND OTHER PROPERTY HELD FOR FUTURE DEVELOPMENT | $2,997,944 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $5,515,165 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| MEDICAL MALPRACTICE CLAIMS | $476,616 |
| ACCRUED RETIREMENT PLAN LIABILITY | $4,751,164 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,227,780 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $72,121,208 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $1,129,807 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $50,704 | OtherRevenueAmt |
| Revenue Not Reported | $1,180,511 | RevenueNotReportedAmt |
| Revenue Subtotal | $70,940,697 | RevenueSubtotalAmt |
| Other Revenues Not Included | $441,508 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $441,508 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $71,382,205 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $67,252,883 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $61,347 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $61,347 | ExpensesNotReportedAmt |
| Expenses Subtotal | $67,191,536 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $441,508 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $441,508 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $67,633,044 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSE 50,704. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | INCOME REPORTED AS EXPENSES ON FORM 990 441,508. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSE 50,704. CONTRIBUTION FROM FOUNDATION 10,643. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | INCOME REPORTED AS EXPENSES ON FORM 990 441,508. |
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 | $1,720,364 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $399,760 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,320,604 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01950 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,706,350 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,651,003 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,055,347 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03040 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,426,714 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,050,763 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,375,951 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04990 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $96,452 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $150 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $96,302 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,800 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,500 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,300 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $208,759 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $208,759 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $320,011 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,650 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $315,361 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00470 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,746,725 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,055,413 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,691,312 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05460 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $68,819 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,925 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $52,894 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $68,819 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,925 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $52,894 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,812,892 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $18,041,769 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $31,477,680 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$13,435,911 | 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 | ||
| 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 | 4 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (4 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Critical Access HospitalCriticalAccessHospitalInd | Emergency Room24 HrsEmergencyRoom24HrsInd | OtherOtherDesc |
|---|---|---|---|---|---|---|---|---|---|---|---|
| COLUMBIA MEMORIAL HOSPITAL | |||||||||||
| 1 | 2111 EXCHANGE STREET | ASTORIA | OR | 97103 | WWW.COLUMBIAMEMORIAL.ORG | 141146 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | OTHER |
| ASTORIA IMAGING LLC | |||||||||||
| 2 | 2111 EXCHANGE STREET | ASTORIA | OR | 97103 | WWW.COLUMBIAMEMORIAL.ORG | 141146 | MRI JOINT VENTURE | ||||
| CMH HOME HEALTH | |||||||||||
| 3 | 2158 EXCHANGE STREET SUITE 206 | ASTORIA | OR | 97103 | WWW.COLUMBIAMEMORIAL.ORG | 13141146 | HOME SERVICES | ||||
| LOWER COLUMBIA HOSPICE | |||||||||||
| 4 | 2158 EXCHANGE STREET SUITE 206 | ASTORIA | OR | 97103 | WWW.LOWERCOLUBIAHOSPICE.ORG | 161047 | HOSPICE SERVICES | ||||
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.COLUMBIAMEMORIAL.ORG | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| Other Factors | Yes (X) | OtherFactorsInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Lawsuit | Yes (X) | PermitLawsuitInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Lawsuit | Yes (X) | LawsuitInd |
| 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 3: 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 NEEDASSESSMENT DATA GATHERED IN 2011 IN SUPPORT OF THE DEVELOPMENT OF COLUMBIAMEMORIAL HOSPITAL'S 2014 TO 2016 STRATEGIC PLAN. COMMUNITY OPINION SURVEY AND PROVIDER NEED ASSESSMENT - CONDUCTED IN JULY2011 BY AN INDEPENDENT CONSULTANT, HEALTH FACILITIES PLANNING & DEVELOPMENT, THISSURVEY AND ASSESSMENT DATA PROVIDES INSIGHT INTO COMMUNITY AWARENESS, PERCEPTIONSAND PRIORITIES FOR THE LOCAL HEALTH SYSTEM.KEY INFORMANT INTERVIEWS - FACE-TO-FACE INTERVIEWS WITH BOTH INDEPENDENT ANDEMPLOYED PROVIDERS WERE CONDUCTED IN 2011, 2012, AND 2013 TO ASSESS THE NEEDS OFTHE COMMUNITY FROM THE PROVIDER PERSPECTIVE. IN ADDITION, A COMMUNITY LEADERSHIPROUND 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 LEADERSHIPCOUNCIL -O PATIENT FOCUS GROUPS CONSISTING OF PREVIOUS INPATIENT, EMERGENCY, OUTPATIENT,AND CLINIC PATIENTS WERE CONDUCTED IN BOTH SEPTEMBER OF 2011 AND DECEMBEROF 2012 TO GATHER INFORMATION ABOUT AWARENESS, PATIENT-CENTERED PRACTICES,AND OPINIONS ABOUT OPPORTUNITIES FOR IMPROVEMENT FOR LOCAL HEALTHCARE.O A PATIENT & FAMILY ADVISORY COUNCIL (PFAC) WAS ESTABLISHED IN 2012 TO FORM ACONTINUOUS FEEDBACK LOOP TO IDENTIFY OPPORTUNITIES.O A COMMUNITY LEADERSHIP COUNCIL REPRESENTING LOCAL GOVERNMENT, SCHOOLDISTRICTS, AND LOCAL BUSINESSES WAS RECENTLY ESTABLISHED IN LATE 2013 TO SUPPORTTHE NEXT STEPS IN CREATING A HEALTHIER COMMUNITY. SECONDARY DATA:CLATSOP COUNTY COMMUNITY ASSESSMENT JULY 2013, THIS ASSESSMENT CREATES AFOUNDATION OF SHARED KNOWLEDGE ABOUT THE COMMUNITY HEALTH AND WELL-BEING INCLATSOP COUNTY. AT LEAST 75% OF CMH PATIENTS RESIDE IN CLATSOP COUNTY, WITH THEREMAINDER LARGELY RESIDING IN PACIFIC COUNTY, WASHINGTON. | ExplanationTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CMH PROFESSIONAL OFFICE BUILDING I | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2055 EXCHANGE STREET | AddressLine1 |
| City | ASTORIA | City |
| State | OR | State |
| ZIP Code | 97103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | OFFICE SPACE LEASED TO PRIVATE HEALTHCARE PROVIDERS | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART II, COMMUNITY BUILDING ACTIVITIES: | CMH CONTINUES TO TAKE AN ACTIVE ROLL IN ASSURING THAT ADEQUATE FOOD IS AVAILABLE TO THE RESIDENTS OF CLATSOP COUNTY, RAISING OVER $10,000 AND DONATING OVER 50 TONS OF FOOD IN 2013. OPERATION BUNNY SUITE IS A CMH OUTREACH PROGRAM IN WHICH FIFTH GRADE AREA ELEMENTARY SCHOOL CHILDREN SPEND THE DAY AT CMH LEARNING ABOUT THE SURGERY PROGRAM, AS WELL AS PROGRAMS IN NON SMOKING, NUTRITION, AND PHYSICAL THERAPY. CMH'S COMMUNITY BASED SPORTS TRAINING PROGRAM INCLUDES PRE AND POST CONCUSSION ASSESSMENTS AS WELL AS LOCAL COACHES RECEIVING EDUCATION ON ASSESSING PLAYERS ON THE FIELD. CMH CREATED DOC WALK WHICH SUPPORTS HEART HEALTH EDUCATION WITH A WEEKLY SUMMERTIME WALK WITH CARDIOLOGIST DR. DIANA RINKEVICH. CMH PARTICIPATES IN RELAY FOR LIFE AND THE MARCH FOR BABIES, SUPPORTS PROGRAMS FOR FOSTER CHILDREN IN NEED OF SCHOOL CLOTHES, AND CHAMPIONS THE WARRENTON SCHOOL DISTRICTS WALK FOR HEALTH AND OTHER WALK/RUNS THROUGHOUT THE COUNTY. |
| 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/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|
| CLATSOP COMMUNITY COLLEGE | ||||||
| 1651 LEXINGTON AVE | ASTORIA | OR | 97103 | 930505508 | $5,100 | SCHOLARSHIPS |
| CITY OF ASTORIA | ||||||
| 1095 DUANE ST | ASTORIA | OR | 97103 | $25,000 | GARDEN OF SURGING WAVES, CITY OF ASTORIA BICENTENNIAL LEGACY GIFT | |
| CLATSOP COMMUNITY COLLEGE | ||||||
| 1651 LEXINGTON AVE | ASTORIA | OR | 97103 | 930505508 | $35,000 | NURSING PROGRAM |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | A CMH EMPLOYEE IS ASSIGNED TO MANAGE THE GRANT REVENUE PROGRAM PER THE TERMS OF EACH GRANT AGREEMENT. THE ACCOUNTING DEPARTMENT KEEPS COPIES OF ALL GRANT AGREEMENTS, MAINTAINS DETAILED REVENUE AND EXPENDITURE RECORDS FOR EACH GRANT, AND ASSISTS IN THE PREPARATION OF ANY REQUIRED FINANCIAL REPORTING. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| 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 | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 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 (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ERIK THORSEN | ||||||||||||||
| CEO | $304,513 | $0 | $27,895 | $0 | $1,140 | $0 | $20,400 | $0 | $1,965 | $0 | $355,913 | $0 | $0 | $0 |
| WILLIAM G RIVERS | ||||||||||||||
| CIO | $178,078 | $0 | $12,051 | $0 | $690 | $0 | $9,469 | $0 | $14,542 | $0 | $214,830 | $0 | $0 | $0 |
| STEPHANIE D BRENDEN | ||||||||||||||
| CFO | $151,131 | $0 | $10,000 | $0 | $262 | $0 | $12,846 | $0 | $23,408 | $0 | $197,647 | $0 | $0 | $0 |
| KENNETH M BOUCHER | ||||||||||||||
| COO | $145,163 | $0 | $5,000 | $0 | $593 | $0 | $3,498 | $0 | $12,263 | $0 | $166,517 | $0 | $0 | $0 |
| DOUGLAS ABBOTT MD | ||||||||||||||
| PHYSICIAN | $574,538 | $0 | $0 | $0 | $25,000 | $0 | $6,375 | $0 | $26,514 | $0 | $632,427 | $0 | $0 | $0 |
| RICHARD CRASS MD | ||||||||||||||
| PHYSICIAN | $355,446 | $0 | $15,402 | $0 | $0 | $0 | $16,330 | $0 | $22,089 | $0 | $409,267 | $0 | $0 | $0 |
| EDOUARD DURET MD | ||||||||||||||
| PHYSICIAN | $352,997 | $0 | $54,240 | $0 | $0 | $0 | $19,125 | $0 | $26,347 | $0 | $452,709 | $0 | $0 | $0 |
| ROBERT HOLLAND MD | ||||||||||||||
| PHYSICIAN | $298,306 | $0 | $6,049 | $0 | $0 | $0 | $0 | $0 | $27,453 | $0 | $331,808 | $0 | $0 | $0 |
| DAVID LEIBEL DO | ||||||||||||||
| PHYSICIAN | $310,860 | $0 | $3,037 | $0 | $0 | $0 | $20,400 | $0 | $22,642 | $0 | $356,939 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 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 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 | BusinessNameLine1 |
| 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 |
| Retired | $1,001,661 | RetiredAmt |
| Total Proceeds | $31,993,533 | TotalProceedsAmt |
| In Reserve Fund | $2,128,275 | InReserveFundAmt |
| Capitalized Interest | $541,030 | CapitalizedInterestAmt |
| Issuance Costs From Proceeds | $889,525 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $2,310,003 | CapitalExpendituresAmt |
| Unspent | $13,186,481 | UnspentAmt |
| 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 | Yes (1) | AnyResearchAgreementsInd |
| Engage Bond Counsel Research | 0 | EngageBondCounselResearchInd |
| 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 |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)
| Relationship With OrgRelationshipWithOrgTxt | Loan PurposeLoanPurposeTxt | Loan From OrganizationLoanFromOrganizationInd | Original PrincipalOriginalPrincipalAmt | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|---|---|---|---|---|
| DOUGLAS ABBOTT | |||||||
| EMPLOYEE | SIGN ON BONUS | Yes (X) | $75,000 | $16,667 | 0 | Yes (1) | Yes (1) |
| ANALIZA JUSTO | |||||||
| EMPLOYEE | SIGN ON BONUS | Yes (X) | $20,000 | $12,222 | 0 | Yes (1) | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $28,889 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| HEATHER SEPPA | |||
| CMH BOARD MEMBER | $10,946 | PRESIDENT OF BANK OF ASTORIA, WHERE COLUMBIA MEMORIAL HOSPITAL HAS SEVERAL BANK ACCOUNTS AND PAYS ROUTINE BANKING TRANSACTION FEES | 0 |
| KEVIN BAXTER DO | |||
| CMH BOARD MEMBER | $72,000 | HOSPICE MEDICAL DIRECTOR AT BAXTER FAMILY MEDICINE AND MEDICAL DIRECTOR FOR LOWER COLUMBIA HOSPICE, PART OF COLUMBIA MEMORIAL HOSPITAL | 0 |
| SCOTT SEPPA | |||
| SPOUSE OF CMH BOARD MEMBER | PARTNER AT KNUTSEN INSURANCE, WHICH PROVIDES INSURANCE FOR COLUMBIA MEMORIAL HOSPITAL | 0 | |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | THE BYLAWS WERE REVISED IN NOVEMBER 2013. |
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT OF THE 990 IS MAILED 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 7,316,873. 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 | KEY STATISTICS FOR 2013: INPATIENT ADMISSION, INCLUDING NEWBORNS: 1,855 INPATIENT DAYS, INCLUDING NEWBORNS: 4,818 SURGERY PATIENTS: 2,454 ANCILLARY VISITS: 41,545 LABORATORY TESTS: 135,647 IMAGING TOTALS: 33,576 CLINIC VISITS: 44,044 EMERGENCY & TRAUMA VISITS: 13,149 HOME HEALTH VISITS: 3,394 HOSPICE PATIENT DAYS: 5,790 COLUMBIA MEMORIAL HOSPITAL'S (CMH) MISSION IS TO PROVIDE EXCELLENCE, LEADERSHIP, AND COMPASSION IN THE ENHANCEMENT OF HEALTH FOR THOSE WE SERVE. THE CMH 2011 TO 2013 THREE-YEAR STRATEGIC PLAN WAS DEVELOPED IN 2010 AND INCLUDED SEVERAL GOALS LISTED UNDER THE FOLLOWING PILLARS; QUALITY AND CUSTOMER SERVICE, STAFF DEVELOPMENT, PROVIDER RELATIONS, GROWTH, AND FINANCIAL PERFORMANCE. AS OF THE YEAR ENDED DECEMBER 31ST, 2013 MANY GOALS HAVE BEEN ACHIEVED ALLOWING CMH TO CONTINUE TO FULFILL THE MISSION OF THE ORGANIZATION AND TO RAISE BOTH THE QUALITY AND RANGE OF SERVICES PROVIDED TO THE LOCAL COMMUNITY. QUALITY AND CUSTOMER SERVICE: -CMH ACHIEVED ACCREDITATION IN THE FALL OF 2011 FOR THREE YEARS THROUGH THE HEALTHCARE FACILITIES ACCREDITATION PROGRAM (HFAP). SURVEYORS ARE ANTICIPATED TO ARRIVE UNANNOUNCED IN 2014 TO VERIFY COMPLIANCE WITH INTERNAL POLICIES AS WELL AS WITH EXTERNAL REGULATIONS. -CMH HAS BEEN A PLANETREE AFFILIATED HOSPITAL SINCE 2001 EMBRACING THE PHILOSOPHY OF PATIENT-CENTERED CARE TO PERSONALIZE, HUMANIZE, AND DEMYSTIFY HEALTHCARE FOR THE PATIENTS OF OUR COMMUNITY. THE 2011 2013 STRATEGIC PLAN INCLUDED A GOAL TO ACHIEVE PLANETREE "DESIGNATION", WHICH IS A PROCESS INVOLVING RIGOROUS CRITERIA AND MEASUREMENTS TO RECOGNIZE HOSPITALS THAT SUSTAIN EXCELLENCE IN THE DELIVERY OF PATIENT-CENTERED CARE. IN 2011, A NEW PLANETREE COUNCIL AND TEN ACTION TEAMS WERE ESTABLISHED AND SET TO WORK ON THIS LOFTY GOAL. IN 2012, THE OFFICIAL APPLICATION FOR DESIGNATION WAS SUBMITTED TO PLANETREE AND WAS ACCEPTED CONTINGENT ON A SITE VISIT AND THE FULFILLMENT OF CERTAIN PATIENT SATISFACTION AND QUALITY MEASUREMENT REQUIREMENTS. THE RESULTS OF THESE INCREASED EFFORTS WERE REALIZED THROUGH A SHARP INCREASE IN BOTH PATIENT SATISFACTION AND QUALITY MEASURES, IN PARTICULAR BETWEEN THE MONTHS OF AUGUST AND DECEMBER 2012. THE DECEMBER SITE VISIT LEFT CMH WITH 5 OPPORTUNITIES OR "GAPS" FOR IMPROVEMENT. LEADERSHIP FORMED ACTION TEAMS DURING THE FINAL PUSH TO TACKLE THESE OPPORTUNITIES AND BECAME AN OFFICIALLY DESIGNATED PLANETREE HOSPITAL IN JULY OF 2013! CMH IS NOW ONE OF 20 HOSPITALS IN THE UNITED STATES TO RECEIVE THIS HONOR AND THE 40TH HOSPITAL WORLD-WIDE. CMH ACCEPTED THE PLANETREE PATIENT-CENTERED DESIGNATION AWARD IN MONTREAL, QUEBEC ON OCTOBER 10TH, 2013, WHERE HOSPITAL REPRESENTATIVES ATTENDED THE ANNUAL PLANETREE CONFERENCE AND BROUGHT BACK MANY NEW IDEAS FOR THE PLANETREE COUNCIL TO PRIORITIZE AND IMPLEMENT IN THE COMING YEAR. -THE CMH LABORATORY MET ALL CRITERIA FOR LABORATORY ACCREDITATION BY COLA, A NATIONAL HEALTHCARE ACCREDITATION ORGANIZATION. ACCREDITATION IS GIVEN ONLY TO LABORATORIES THAT APPLY RIGID STANDARDS OF QUALITY IN DAY-TO-DAY OPERATIONS, DEMONSTRATE CONTINUED ACCURACY IN THE PERFORMANCE OF PROFICIENCY TESTING, AND PASS A RIGOROUS ON-SITE LABORATORY SURVEY. CMH HAS EARNED COLA ACCREDITATION AS A RESULT OF A LONG-TERM COMMITMENT TO PROVIDE QUALITY SERVICES TO ITS PATIENTS. -ACHIEVED THE AMERICAN HOSPITAL ASSOCIATION'S (AHA) MOST-WIRED HOSPITAL AWARD IN 2011,2012 AND 2013 AND ATTESTED TO THE CENTER FOR MEDICARE AND MEDICAID SERVICES (CMS) MEANINGFUL USE CRITERIA. THESE ACHIEVEMENTS HAVE SUCCESSFULLY POSITIONED CMH TO FULFILL THE GOAL OF "ONE PATIENT, ONE RECORD" AND WILL ASSIST IN ESTABLISHING A FULLY ELECTRONIC PATIENT MEDICAL RECORD IN 2013/2014. -THE CMH MEDICAL RECORDS DEPARTMENT WORKED TO PREPARE FOR THE ICD-10-CM IMPLEMENTATION SCHEDULED FOR OCTOBER 2014. ICD-10-CM IS A CODING SYSTEM THAT ASSIGNS ALPHA-NUMERIC CODES TO DISEASES AND IS USED TO SUBMIT INFORMATION TO INSURANCE COMPANIES FOR PAYMENT, RESEARCH, QUALITY IMPROVEMENT AND VARIOUS OTHER REPORTING REQUIREMENTS. -THE CARDIOLOGY CLINIC ACHIEVED ACCREDITATION IN ECHOCARDIOGRAPY FOR A THREE-YEAR TERM FROM THE INTERSOCIETAL ACCREDITATION COMMISSION, (IAC). ONLY TWO OTHER FACILITIES HAVE BEEN ACCREDITED IN ALL THREE MODALITIES: OHSU AND OREGON HEART AND VASCULAR INSTITUTE IN SPRINGFIELD. ADDITIONALLY, THE CMH CARDIAC REHAB PROGRAM WAS GRANTED 2013 AACVPR PROGRAM CERTIFICATION. CERTIFICATION IS GIVEN AFTER STRINGENT STANDARDS ARE MET WITH THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION. -LOWER COLUMBIA HOSPICE INVITED THE OREGON HOSPICE ASSOCIATION TO DO AN AGENCY SURVEY JULY 31 TO AUG 2 TO GAIN ACCREDITATION FOR OUR HOSPICE SERVICE. IN NOVEMBER 2013 HOSPICE WAS NOTIFIED THAT FULL ACCREDITATION HAD BEEN GRANTED. THE INTENT OF THIS ACCREDITATION IS TO ENSURE HOSPICE PROVIDERS IMPROVE STANDARDS OF CARE AND MEET REGULATORY REQUIREMENTS ON A CONTINUING BASIS. -CMH HAS RECEIVED THE IBCLC CARE AWARD IN RECOGNITION FOR THE COMMITMENT TO PROVIDING LACTATION SUPPORT TO BREASTFEEDING MOTHERS IN THE LOWER COLUMBIA REGION. STAFF DEVELOPMENT: -87% OF ALL EMPLOYEES PARTICIPATED IN PATIENT-CENTERED CARE RETREATS DURING 2013 WITH EMPHASIS ON THE CMH SERVICE EXCELLENCE STANDARDS, AIDET, AND CARE FOR THE CAREGIVER. ADDITIONALLY OVER 136 EMPLOYEES ATTENDED THE SKILLS FAIR IN OCTOBER FOR ANNUAL COMPETENCIES WITH EMPHASIS IN HOURLY ROUNDING AND BED-SIDE REPORT INVOLVING THE PATIENT AND THEIR CARE PARTNER(S) IN THEIR CARE PLAN. -CMH EMPLOYEES TEAMED UP WITH A NEIGHBORING HOSPITAL AND RAISED DONATIONS FOR THE REGIONAL FOOD BANK DURING THE MONTH OF NOVEMBER. THROUGH INCREDIBLE GENEROSITY, THE TWO GROUPS DONATED 60,538 POINTS WORTH OF FOOD AND $7,659 TO THE REGIONAL FOOD BANK. GROWTH: -THE NEW EAR, NOSE & THROAT, (ENT) CLINIC OPENED WITH A NEW ADDITION TO THE CMH MEDICAL GROUP, DR. NYTE, IN FEBRUARY 2013. -DR MICHAEL LEWIS, PULMONOLIGIST, BEGAN PRACTICING TWO WEEKS A MONTH IN THE CMH CARDIOLOGY CLINIC IN MAY 2013. -CMH OPENED A NEW WARRENTON URGENT CARE AND PRIMARY CARE CLINIC DURING THE SUMMER OF 2013. DR BRIAN COX, THE LOCUMS TENENS INTERNAL MEDICINE PHYSICIAN PROVIDING SERVICES IN WARRENTON SIGNED A PERMANENT EMPLOYMENT CONTRACT WITH CMH AND JOINED THE CMH MEDICAL GROUP IN NOVEMBER 2013. -CMH OPENED A NEW ENDOCRINOLOGY CLINIC IN JUNE 2013. ANA MARINA, ENDOCRINOLOGIST, IS ORIGINALLY FROM THE UKRAINE AND COMPLETED HER FELLOWSHIP IN SEATTLE AT THE UNIVERSITY OF WASHINGTON. -THE REMODEL OF THE MATERNITY DEPARTMENT IS NEARLY COMPLETE AND PLANNING AN OPEN HOUSE IN JANUARY 2014. THIS REMODEL INCLUDED 2 LDRPS, A NURSES LOUNGE, DOCTOR SLEEPING ROOOM AND A NEW NURSERY. -CMH ACQUIRED ADJACENT REAL ESTATE TO BE CLEARED AND TURNED INTO ADDITIONAL PARKING IN 2014-2015 TO ENHANCE EMPLOYEE AND PATIENT CONVENIENCE/EXPERIENCE WHILE AT CMH -THE CARDIAC REHABILITATION SPACE WAS EXPANDED IN 2013 TO APPROXIMATELY TWICE THE SIZE TO ACCOMMODATE THE GROWING CARDIAC AND PULOMONARY REHABILITATION PROGRAM OVERSEEN BY THE CMH AND OHSU CARDIOLOGY CLINIC. -THE ASTORIA SCHOOL DISTRICT, CITY OF ASTORIA AND CMH HAVE FINALIZED AND APPROVED THE FINAL ARCHITECT DRAWINGS FOR A SPORTS COMPLEX, BEING BUILT BY CMH AND THEN EXCHANGED ONCE COMPLETED FOR THE SCHOOL DISTRICT'S CURRENT FOOTBALL FIELD, SITTING ON AN ADJACENT PLOT TO THE CMH CAMPUS. WORK WILL RESUME ON THE SPORTS COMPLEX IN JANUARY 2014 AND IS SCHEDULED FOR THE COMPLETION BY THE FALL OF 2014. -THE CCU AND EMERGENCY REMODEL DESIGN PROCESS IS CURRENTLY UNDERWAY WITH PLANS FOR CONSTRUCTION IN 2014/2015. PROVIDER RELATIONS: -INVITED INDEPENDENT PROVIDERS TO PARTICIPATE ON "DOC TALK", A LOCAL RADIO SHOW WHERE PROVIDERS AND HEALTHCARE PROFESSIONALS CAN DISCUSS THEIR SPECIALTIES, CURRENT HEALTHCARE TOPICS AND UPCOMING EVENTS IN THE HEALTHCARE INDUSTRY -EXPANDED CMH WEBSITE TO INCLUDE A NEW MOBILE DEVICE THAT HELPS CONSUMERS FIND A LOCAL PROVIDER MORE EASILY. -CMH MARKETING COMPLETED A PROVIDER GUIDE IN MAY 2013. THIS 24 PAGE GUIDE IS A HELPFUL TOOL TO INFORM OUR COMMUNITY ON THE AVAILABLE PROVIDER SERVICES AT CMH, PROVIDES INSIGHT INTO MANY OF OUR ANCILLARY SERVICES AS WELL AS OUR COMMITMENT TO PATIENT CENTERED CARE. |
| FORM 990, PART III, LINE 4A: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | FINANCIAL PERFORMANCE: -WOMEN'S HEART HEALTH EDUCATION RECIEVED A BOOST FROM THE CMH FOUNDATION'S COMMUNITY RELATIONS COMMITTEE FIFTH ANNUAL CHAMPAGNE TEA, "ART FOR THE HEART", HELD SATURDAY FEBRUARY 9TH AT THE ELKS' BALLROOM. THE ART AUCTION AND TEA EVENT NETTED $17,000, WHICH INCLUDED A MATCH FOR THE AMOUNTS RASIED DURING A SPECIAL APPEAL BY OHSU, THE TITLE SPONSOR. -CMH FOUNDATION AND MARKETING DEPARTMENTS TEAMED UP TO PUT ON A PHIL VASSAR CONCERT AND FUNDRAISING EVENT WITH PROCEEDS OF APPROXIMATELY $17,000 WERE ALLOCATED TO THE CANCER CARE PHASE II PROJECT. -CMH FOUNDATION ALSO HELD THEIR ANNUAL DENIM & DIAMONDS FUNDRAISING GALA AND AUCTION IN JUNE 2013. THIS EVENT RAISED OVER $100,000 TOWARD BRINGING EXPANDED CANCER TREATMENT SERVICES TO THE COMMUNITY AND MAKING SIGNIFICANT PROGRESS TOWARD PROVIDING MOST CANCER TREATMENTS LOCALLY WITHOUT THE NEED FOR LONG DISTANCE TRAVEL. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | 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 | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASTORIA IMAGING LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2111 EXCHANGE STREET | AddressLine1 |
| City | ASTORIA | City |
| State | OR | State |
| ZIP Code | 97103 | ZIPCode |
| 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 | $683,992 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $1,957,803 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | 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 | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2111 EXCHANGE STREET | AddressLine1 |
| City | ASTORIA | City |
| State | OR | State |
| ZIP Code | 97103 | ZIPCode |
| 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 Total Income | -$181 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $20,739 | 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 | 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 | 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 | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CMH FOUNDATION (IN-KIND CONTRIBUTIONS) | ||
| B | $34,967 | ACTUAL |
| CMH FOUNDATION (IN-KIND CONTRIBUTIONS SALARY EXPENSES) | ||
| O | $249,386 | ACTUAL |
| ASTORIA IMAGING LLC (SALARY EXPENSES FOR MRI MGMT TECHS & REGISTRATION) | ||
| O | $274,129 | ACTUAL |
| CMH FOUNDATION (TOTAL GRANTS & ALLOCATIONS) | ||
| C | $2,724 | ACTUAL |
| CMH FOUNDATION (TOTAL QUARTERLY TRANSFERS) | ||
| Q | $100,378 | ACTUAL |
| CMH FOUNDATION (TRANSFER OF RESTRICTED FUNDS TO CMH DIABETIC ED) | ||
| S | $385 | ACTUAL |
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