COLUMBIA LUTHERAN CHARITIES: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- COLUMBIA LUTHERAN CHARITIES (EIN 93-0583856)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-08-15
- IRS object ID
- 201302279349303520
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-15T15:06:36-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930418710 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELAP LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| 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 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930583856 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA LUTHERAN CHARITIES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COLU | NameControl |
| Phone | 5033254321 | Phone |
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 |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | STEPHANIE D BRENDEN | Name |
| Title | CFO | Title |
| Phone | 5033254321 | Phone |
| Date Signed | 2013-08-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WESLEY B HANSEN | Name |
| PTIN | P00226581 | PTIN |
| Phone | 5036974118 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | STEPHANIE D BRENDEN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| 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 | 68174711 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.COLUMBIAMEMORIAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1958 | YearFormation |
| State Legal Domicile | OR | StateLegalDomicile |
| Activity Or Mission Description | PROVIDE EXCELLENCE, LEADERSHIP & COMPASSION IN THE ENHANCEMENT OF HEALTH FOR THOSE WE SERVE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 528 | TotalNbrEmployees |
| Total Nbr Volunteers | 95 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 103601 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 241709 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 66254871 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 64446382 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 505421 | InvestmentIncomePriorYear |
| Investment Income Current Year | 427803 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1923423 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2502188 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 68787316 | TotalRevenuePriorYear |
| Total Revenue Current Year | 67618082 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 120148 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 76471 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 36566995 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 37735475 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 27000 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 11250 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 263649 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 27676408 | OtherExpensePriorYear |
| Other Expenses Current Year | 25155620 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 64390551 | TotalExpensesPriorYear |
| Total Expenses Current Year | 62978816 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4396765 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 4639266 | RevenuesLessExpensesCY |
| Total Assets BOY | 64810107 | TotalAssetsBOY |
| Total Assets EOY | 83916777 | TotalAssetsEOY |
| Total Liabilities BOY | 36176559 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 52551952 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 28633548 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 31364825 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE MISSION OF COLUMBIA MEMORIAL HOSPITAL IS TO PROVIDE EXCELLENCE, LEADERSHIP, AND COMPASSION IN THE ENHANCEMENT OF HEALTH FOR THOSE WE SERVE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 54755416 | Expense |
| Grants | 76471 | Grants |
| Revenue | 66875331 | Revenue |
| Description | SEE SCHEDULE O | Description |
| Total Program Service Expense | 54755416 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 1 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 153 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 528 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Form8899 Filed | 0 | Form8899Filed |
| Form1098 C Filed | 0 | Form1098CFiled |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 1 | LocalChapters |
| Policies Reference Chapters | 1 | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | OR | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEPHANIE D BRENDEN CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5033387505 | TelephoneNumber |
Address US AddressUS
| 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 Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| DAVID PHILLIPS | ||||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | |||
| BILL LIND | ||||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | |||
| HEATHER SEPPA | ||||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | |||
| KEVIN BAXTER | ||||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | |||
| BILL LANDWEHR | ||||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | |||
| NANCY MCALLISTER | ||||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | |||
| KATHERINE HELLBERG | ||||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | |||
| ED NELSON JR | ||||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | |||
| NORMAN SHATTO | ||||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | |||
| MALCOLM SMITH | ||||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | |||
| PAUL F VOELLER | ||||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | |||
| CONSTANCE WAISANEN | ||||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | |||
| HOUMAN SABAHI | ||||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | |||
| ERIK THORSEN | ||||||||
| CEO | 40.00 | 313913 | 0 | 26426 | X | |||
| WILLIAM G RIVERS | ||||||||
| CIO | 40.00 | 177005 | 0 | 39011 | X | |||
| STEPHANIE D BRENDEN | ||||||||
| CFO | 40.00 | 113131 | 0 | 37789 | X | |||
| DOUGLAS ABBOTT MD | ||||||||
| PHYSICIAN | 40.00 | 593203 | 0 | 41598 | X | |||
| RICHARD CRASS MD | ||||||||
| PHYSICIAN | 40.00 | 355002 | 0 | 33515 | X | |||
| EDOUARD DURET MD | ||||||||
| PHYSICIAN | 40.00 | 379415 | 0 | 60791 | X | |||
| ROBERT HOLLAND MD | ||||||||
| PHYSICIAN | 40.00 | 293791 | 0 | 36771 | X | |||
| DAVID LEIBEL DO | ||||||||
| PHYSICIAN | 40.00 | 299374 | 0 | 54104 | X | |||
| JOSEPH DAFOE | ||||||||
| FORMER CCO | 40.00 | 105945 | 0 | 13646 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2630779 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 343651 | TotalOtherCompensation |
| Number Individuals GT100 K | 43 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| NORTH COAST EMERGENCY PHYSICIANS | |||||
| 2111 EXCHANGE ST | ASTORIA | OR | 97103 | EMERGENCY ROOM PHYSICIANS | 1872139 |
| RICKENBACH CONSTRUCTION | |||||
| PO BOX 5837 | ALOHA | OR | 97006 | GENERAL CONTRACTOR | 1438389 |
| CPSI | |||||
| 6600 WALL ST | MOBILE | AL | 36695 | SOFTWARE SUPPORT | 251218 |
| DELAP LLP | |||||
| 5885 MEADOWS ROAD NO 200 | LAKE OSWEGO | OR | 97035 | ACCOUNTING | 194158 |
| PETER STOLOFF PC | |||||
| 5285 MEADOWS RD SUITE 235 | LAKE OSWEGO | OR | 97035 | ATTORNEY | 178564 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 21 | NumberOfContractorsGT100K |
| Related Organizations | 143596 | RelatedOrganizations |
| Government Grants | 66957 | GovernmentGrants |
| All Other Contributions | 31156 | AllOtherContributions |
| Total Contributions | 241709 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| OUTPATIENT REVENUE | 621990 | 67967714 | 67967714 |
| EMERGENCY ROOM REVENUE | 900099 | 27492365 | 27492365 |
| INPATIENT REVENUE | 900099 | 22527484 | 22527484 |
| PROVISION FOR CHARITY | 900099 | -3002370 | -3002370 |
| CONTRACTUAL ALLOWANCE | 900099 | -46121913 | -46121913 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -4416898 | TotalRevenueColumn |
| Related Or Exempt Function Income | -4416898 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 64446382 | TotalProgramServiceRevenue |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 433017 | TotalRevenueColumn |
| Exclusion | $433,017 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 342431 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 478480 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -136049 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -136049 | TotalRevenueColumn |
| Exclusion | -$136,049 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 72655 | Securities |
| Other | 280 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 73554 | Securities |
| Other | 4595 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -899 | Securities |
| Other | -4315 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -5214 | TotalRevenueColumn |
| Exclusion | -$5,214 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Gaming | 830 | GrossIncomeGaming |
| Gaming Direct Expenses | 0 | GamingDirectExpenses |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 830 | TotalRevenueColumn |
| Related Or Exempt Function Income | 830 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| MEANINGFUL USE REVENUE | 900099 | 1157213 | 1157213 | |
| JOINT VENTURE | 621500 | 583379 | 583379 | |
| CAFETERIA AND VENDING | 722210 | 209288 | $209,288 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 687527 | TotalRevenueColumn |
| Related Or Exempt Function Income | 687527 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2637407 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 67618082 | TotalRevenueColumn |
| Related Or Exempt Function Income | 66875331 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $501,042 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 73946 | Total |
| Program Services | 73946 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2525 | Total |
| Program Services | 2525 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 950477 | Total |
| Management And General | 826867 | ManagementAndGeneral |
| Fundraising | 123610 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26702226 | Total |
| Program Services | 23814093 | ProgramServices |
| Management And General | 2813157 | ManagementAndGeneral |
| Fundraising | 74976 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2023082 | Total |
| Program Services | 1959098 | ProgramServices |
| Management And General | 56682 | ManagementAndGeneral |
| Fundraising | 7302 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5888091 | Total |
| Program Services | 5126936 | ProgramServices |
| Management And General | 747084 | ManagementAndGeneral |
| Fundraising | 14071 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2171599 | Total |
| Program Services | 1940178 | ProgramServices |
| Management And General | 218227 | ManagementAndGeneral |
| Fundraising | 13194 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 216665 | Total |
| Program Services | 90982 | ProgramServices |
| Management And General | 125683 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 144660 | Total |
| Management And General | 128560 | ManagementAndGeneral |
| Fundraising | 16100 | Fundraising |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11250 | Total |
| Fundraising | 11250 | Fundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23385 | Total |
| Program Services | 23385 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6832833 | Total |
| Program Services | 6295115 | ProgramServices |
| Management And General | 537718 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 296622 | Total |
| Program Services | 45308 | ProgramServices |
| Management And General | 251314 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9748594 | Total |
| Program Services | 9231746 | ProgramServices |
| Management And General | 515803 | ManagementAndGeneral |
| Fundraising | 1045 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 750470 | Total |
| Program Services | 511863 | ProgramServices |
| Management And General | 238607 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 778634 | Total |
| Program Services | 698530 | ProgramServices |
| Management And General | 80104 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64108 | Total |
| Program Services | 53012 | ProgramServices |
| Management And General | 11096 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 278585 | Total |
| Program Services | 196326 | ProgramServices |
| Management And General | 82259 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 259884 | Total |
| Program Services | 198811 | ProgramServices |
| Management And General | 61073 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3019119 | Total |
| Program Services | 2666719 | ProgramServices |
| Management And General | 352400 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 786557 | Total |
| Program Services | 118746 | ProgramServices |
| Management And General | 667811 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| REPAIRS AND MAINTENANCE | 1067710 | 1057968 | 9742 |
| LOSS ON EXTINGUISHMENT | 288482 | 288482 | |
| RECRUITMENT FEES | 171027 | 165235 | 5792 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 428285 | Total |
| Program Services | 196412 | ProgramServices |
| Management And General | 229772 | ManagementAndGeneral |
| Fundraising | 2101 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 62978816 | Total |
| Program Services | 54755416 | ProgramServices |
| Management And General | 7959751 | ManagementAndGeneral |
| Fundraising | 263649 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4219237 | BOY |
| EOY | 8797050 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11558704 | BOY |
| EOY | 10579570 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 41667 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 271616 | BOY |
| EOY | 136219 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1055965 | BOY |
| EOY | 1217037 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1167278 | BOY |
| EOY | 1539612 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 55438546 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 28166752 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26943819 | BOY |
| EOY | 27271794 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14048998 | BOY |
| EOY | 28600464 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 216193 | BOY |
| EOY | 900818 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5328297 | BOY |
| EOY | 4832546 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 64810107 | BOY |
| EOY | 83916777 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7083599 | BOY |
| EOY | 6912200 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19169761 | BOY |
| EOY | 31919646 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9923199 | BOY |
| EOY | 13720106 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36176559 | BOY |
| EOY | 52551952 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28633548 | BOY |
| EOY | 31260907 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 103918 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28633548 | BOY |
| EOY | 31364825 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 64810107 | BOY |
| EOY | 83916777 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 4639266 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 829076 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -2737065 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 788734 | OtherCostOrOtherBasis |
| Book Value | 788734 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 21909796 | OtherCostOrOtherBasis |
| Depreciation | 10746539 | Depreciation |
| Book Value | 11163257 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 754644 | OtherCostOrOtherBasis |
| Depreciation | 147635 | Depreciation |
| Book Value | 607009 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 30354106 | OtherCostOrOtherBasis |
| Depreciation | 17272578 | Depreciation |
| Book Value | 13081528 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1631266 | OtherCostOrOtherBasis |
| Book Value | 1631266 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 27271794 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated (4 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| BOARD DESIGNATED - FUNDED DEPRECIATION | 12859963 | F |
| HELD BY TRUSTEE UNDER BOND INDENTURE AGR | 15178058 | F |
| BOARD DESIGNATED - HOSPICE | 558417 | F |
| BOARD DESIGNATED - CHAPLIANCY | 4026 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 28600464 | TotalOfBookValueProgramRelated |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| RENTAL AND OTHER PROPERTY HELD FOR FUTURE DEVELOPMENT | 2975336 |
| OTHER ASSETS | 1857210 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 4832546 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ESTIMATED THIRD-PARTY PAYOR PAYMENT | $914,000 |
| UNEARNED GRANT REVENUE | $262,500 |
| MEDICAL MALPRACTICE CLAIMS | $621,090 |
| RETIREMENT PLAN LIABILITY | $11,922,516 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 13720106 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 68563553 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 829076 | NetUnrealizedGainsInvestments |
| Other Revenues | 478480 | OtherRevenues |
| Revenue Not Rptd F990 | 1307556 | RevenueNotRptdF990 |
| Revenue Subtotal | 67255997 | RevenueSubtotal |
| Other Revenues Not Included | 362085 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 362085 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 67618082 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 63095211 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 478480 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 478480 | ExpensesNotRptdF990 |
| Expenses Subtotal | 62616731 | ExpensesSubtotal |
| Other Expenses Not Included | 362085 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 362085 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 62978816 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSE 478,480. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RECLASS OTHER INCOME 362,085. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSE 478,480. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | RECLASS FROM OTHER INCOME 362,085. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1611883 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 396914 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1214969 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01930 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8657870 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6570453 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2087417 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03310 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10269753 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6967367 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3302386 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05240 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 161532 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 161532 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00260 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13780 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4500 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9280 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 147425 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 147425 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00230 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 322737 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4500 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 318237 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00500 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10592490 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6971867 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3620623 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05740 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 52997 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 52997 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 52997 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 52997 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,354,206 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 18903543 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 28557435 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -9653892 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|
| 1 COASTAL HEALTH ASSURANCE | ||
| PHYSICIAN ASSC. MEDICAL CONTRACTS | 0.50000 | 0.50000 |
| 2 ASTORIA IMAGING LLC | ||
| MRI JOINT VENTURE | 0.51000 | 0.49000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 3 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (3 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Critical Access HospitalCriticalAccessHospital | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|---|---|
| COLUMBIA MEMORIAL HOSPITAL | |||||||||
| 1 | 2111 EXCHANGE STREET | ASTORIA | OR | 97103 | X | X | X | X | OTHER |
| ASTORIA IMAGING LLC | |||||||||
| 2 | 2111 EXCHANGE STREET | ASTORIA | OR | 97103 | MRI JOINT VENTURE | ||||
| CMH HOME HEALTH AND HOSPICE | |||||||||
| 3 | 486 12TH STREET | ASTORIA | OR | 97103 | X | HOME SERVICES | |||
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 400.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Other Factors | X | OtherFactors |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CMH PROFESSIONAL OFFICE BUILDING | BusinessNameLine1 |
Address Address
| 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 Type | OFFICE SPACE LEASED TO PRIVATE HEALTHCARE PROVIDERS | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (4 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| 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. | ||
| OR | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 0 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLATSOP COMMUNITY COLLEGE | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6540 LIBERTY LANE | AddressLine1 |
| City | ASTORIA | City |
| State | OR | State |
| ZIP Code | 97103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 930505508 | EINOfRecipient |
| Amount Of Cash Grant | 40650 | AmountOfCashGrant |
| Purpose Of Grant | SPONSORSHIPS | PurposeOfGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE I, PART I, LINE 2: | Identifier |
| 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. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ERIK THORSEN | ||||||||||||||
| CEO | 279363 | 0 | 24650 | 0 | 9900 | 0 | 24626 | 0 | 1800 | 0 | 340339 | 0 | 0 | 0 |
| WILLIAM G RIVERS | ||||||||||||||
| CIO | 168315 | 0 | 8000 | 0 | 690 | 0 | 8830 | 0 | 30181 | 0 | 216016 | 0 | 0 | 0 |
| STEPHANIE D BRENDEN | ||||||||||||||
| CFO | 101531 | 0 | 11600 | 0 | 0 | 0 | 9131 | 0 | 28658 | 0 | 150920 | 0 | 0 | 0 |
| DOUGLAS ABBOTT MD | ||||||||||||||
| PHYSICIAN | 562953 | 0 | 0 | 0 | 30250 | 0 | 4606 | 0 | 36992 | 0 | 634801 | 0 | 0 | 0 |
| RICHARD CRASS MD | ||||||||||||||
| PHYSICIAN | 348319 | 0 | 0 | 0 | 6683 | 0 | 4038 | 0 | 29477 | 0 | 388517 | 0 | 0 | 0 |
| EDOUARD DURET MD | ||||||||||||||
| PHYSICIAN | 345815 | 0 | 0 | 0 | 33600 | 0 | 24185 | 0 | 36606 | 0 | 440206 | 0 | 0 | 0 |
| ROBERT HOLLAND MD | ||||||||||||||
| PHYSICIAN | 282427 | 0 | 0 | 0 | 11364 | 0 | 0 | 0 | 36771 | 0 | 330562 | 0 | 0 | 0 |
| DAVID LEIBEL DO | ||||||||||||||
| PHYSICIAN | 299374 | 0 | 0 | 0 | 0 | 0 | 22500 | 0 | 31604 | 0 | 353478 | 0 | 0 | 0 |
| JOSEPH DAFOE | ||||||||||||||
| FORMER CCO | 88550 | 0 | 0 | 0 | 17395 | 0 | 0 | 0 | 13646 | 0 | 119591 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | ASTORIA GOLF AND COUNTRY CLUB DUES FOR OFFICER 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
Form990 Schedule K Part I Form990ScheduleKPartI
| 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 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 270034718 | IssuerEIN |
| CUSIP Number | 046279BS3 | CUSIPNumber |
| Date Issued | 2013-09-27 | DateIssued |
| Issue Price | 31993533 | IssuePrice |
| Description Of Purpose | HOSPITAL REVENUE & REFUNDING BONDS | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Amount Retired | 18080686 | AmountRetired |
| Total Proceeds | 31993533 | TotalProceeds |
| Amount In Reserve Fund | 2125275 | AmountInReserveFund |
| Capitalized Interest | 117233 | CapitalizedInterest |
| Issuance Costs From Proceeds | 889525 | IssuanceCostsFromProceeds |
| Capital Expenditures | 458472 | CapitalExpenditures |
| Amount Unspent | 15178058 | AmountUnspent |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 0 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 1 | AnyResearchAgreements |
| Engage Bond Counsel Research | 0 | EngageBondCounselResearch |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 1 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 0 | RebateNotDueYet |
| Exception To Rebate | 0 | ExceptionToRebate |
| No Rebate Due | 0 | NoRebateDue |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqs |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DOUGLAS ABBOTT | NamePerson |
| Relationship With Organization | EMPLOYEE | RelationshipWithOrganization |
| Purpose Of Loan | SIGN ON BONUS | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $75,000 | OriginalPrincipalAmount |
| Balance Due | 41667 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 41667 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| HEATHER SEPPA | |||
| CMH BOARD MEMBER | 11211 | PRESIDENT OF BANK OF ASTORIA WHERE THE HOSPITAL HAS SEVERAL BANK ACCOUNTS AND PAYS ROUTINE BANKING TRANSACTION FEES. | 0 |
| KEVIN BAXTER DO | |||
| CMH BOARD MEMBER | 72000 | HOSPICE MEDICAL DIRECTOR - BAXTER FAMILY MEDICINE, MEDICAL DIRECTOR FOR LOWER COLUMBIA HOSPICE (PART OF COLUMBIA MEMORIAL HOSPITAL) | 0 |
| SCOTT SEPPA | |||
| SPOUSE OF CMH BOARD MEMBER | 18618 | PARTNER OF KNUTSEN INSURANCE. PROVIDED INSURANCE FOR THE HOSPITAL. | 0 |
| RANDY STEMPER | |||
| FORMER BOARD PRESIDENT (THROUGH NOVEMBER 1, 2012) | 0 | FORMER BOARD PRESIDENT WAS THE PROJECT MANAGER FOR THE CONSTRUCTION OF THE SPORTS COMPLEX. NO PAYMENT WAS MADE RELATED TO THIS NEW ROLE UNTIL 2013. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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 IX, LINE 11G | OTHER: PROGRAM SERVICE EXPENSES 6,295,115. MANAGEMENT AND GENERAL EXPENSES 537,718. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,832,833. | OTHER FEES |
| FORM 990, PART XI, LINE 9: | DEFINED BENEFIT RETIREMENT PLAN ADJUSTMENT -3,017,056. NET ASSETS RELEASED FROM RESTRICTION 103,918. CITY OF ASTORIA GRANT 37,500. CMF FOUNDATION CONTRIBUTION 138,573. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| 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, 4A: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | KEY STATISTICS FOR 2012: INPATIENT ADMISSION INCLUDING NEWBORNS: 1,836 INPATIENT DAYS INCLUDING NEWBORNS: 4,915 SURGERY PATIENTS: 2,529 ANCILLARY VISITS: 43,055 LABORATORY TESTS: 129,315 IMAGING TOTALS: 32,924 CLINIC VISITS: 28,259 EMERGENCY & TRAUMA VISITIS: 13,124 URGENT CARE CLINIC VISITS: 5,961 HOME HEALTH VISITS: 3,250 HOSPICE PATIENT DAYS: 6,258 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, 2012 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). THIS WAS NO SMALL TASK WITH THE INCREASED REQUIREMENTS TO PASS RIGOROUS QUALITY, SAFETY, AND COMPLIANCE AUDITS. SURVEYORS ARRIVE UNANNOUNCED TO VERIFY COMPLIANCE WITH INTERNAL POLICIES AS WELL AS WITH EXTERNAL REGULATIONS. -A NEW QUALITY PLAN, PROGRAM, AND ORGANIZATIONAL SCORECARD WERE DEVELOPED AND IMPLEMENTED WITH OVERSIGHT FROM THE BOARD OF TRUSTEES. -A PATIENT AND FAMILY ADVISORY COUNCIL (PFAC) BEGAN IN JANUARY OF 2012 AND HAS ASSISTED IN THE ENHANCEMENTS AND IMPLEMENTATION OF PATIENT-CENTERED CARE INITIATIVES THROUGHOUT THE HOSPITAL AND CLINICS. -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 2012 YEAR ENDED WITH A VERY SUCCESSFUL PLANETREE DESIGNATION SITE VISIT LEAVING ONLY A FEW FOLLOW-UP ITEMS REMAINING FOR COMPLETION IN 2013. -THE SAFETY COMMITTEES WERE EXPANDED AND SPLIT INTO TWO GROUPS; ONE FOR PATIENT SAFETY AND ONE FOR GENERAL SAFETY. EMPLOYEE PARTICIPATION WAS GREATLY INCREASED AND LED TO INCREASED SAFETY TRAINING SOME IMPROVED SAFETY SCORES IN THE AGENCY FOR HEALTHCARE RESEARCH AND QUALITY (AHRQ) SAFETY SURVEYS. -IMPLEMENTED BOTH LEADERSHIP ROUNDING AND NURSING HOURLY ROUNDING TO IMPROVE COMMUNICATION AND PRO-ACTIVE PATIENT-CENTERED CARE. -IMPLEMENTED ROOM SERVICE, MASSAGE THERAPY, AROMATHERAPY, AND OTHER COMFORT MEASURES FOR PATIENTS AT CMH. -ACHIEVED THE AMERICAN HOSPITAL ASSOCIATION'S (AHA) MOST-WIRED HOSPITAL AWARD IN BOTH 2011 AND 2012 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. STAFF DEVELOPMENT: -STANDARDS OF EXCELLENCE WERE ESTABLISHED AND REINFORCED THROUGH CUSTOMER SERVICE TRAINING EFFORTS IN 2011 AND 2012. -AN EMPLOYEE WELLNESS PROGRAM WAS IMPLEMENTED IN 2011 AND EXPANDED PROGRAMS WERE INTRODUCED IN 2012. -AN EMPLOYEE TUITION REIMBURSEMENT POLICY WAS WRITTEN IN 2012 TO ASSIST STAFF MEMBERS WHO WISH TO GO ABOVE AND BEYOND THE STANDARD OR REQUIRED TRAINING FOR THEIR CURRENT POSITIONS AT CMH. -TEAM INTERVIEW PROCEDURES INCLUDING BEHAVIORAL QUESTIONS WERE ESTABLISHED TO HIRE RIGHT THE FIRST TIME AND TO RAISE THE LEVEL OF AWARENESS AND EXPECTATIONS IN MEETING BOTH THE STANDARDS OF EXCELLENCE AND THE MISSION OF THE ORGANIZATION. GROWTH: -A PARTNERSHIP WITH OHSU TO BRING ONCOLOGY, CARDIOLOGY, AS WELL AS KEY TELEMEDICINE SERVICES TO THE COMMUNITY BEGAN IN 2010. EXPANSION OF THESE SUCCESSFUL CLINICS OCCURRED IN 2011 AND 2012. -CMH LEASED SPACE FOR A CMH COMMUNITY CENTER ALLOWING FOR INCREASED COMMUNITY OUTREACH AND SUPPORT INCLUDING SEVERAL NEW COMMUNITY EDUCATION CLASSES. -IMPLEMENTED A HOSPITALIST PROGRAM -RENOVATED THE SURGERY DEPARTMENT -BUILT A SECOND PROFESSIONAL OFFICE BUILDING TO HOUSE THE MAIN HOSPITAL LABORATORY AND 3 CLINICS -AUXILIARY GIFT SHOP RELOCATION AND EXPANSION -OPENED A NEW WOUND CARE CLINIC -EXPANDED THE CARDIAC REHABILITATION PROGRAM AND ADDED A PULMONARY REHABILITATION PROGRAM -SUCCESSFUL RECRUITMENT OF 2 GENERAL SURGEONS AND 2 OB/GYN PHYSICIANS INTO THE COMMUNITY -THE GROWTH AND EXPANSION OF CLINICS AND OTHER SERVICES PROVIDED AN INCREASE IN FULL TIME EQUIVALENTS (FTE'S) OF APPROXIMATELY 10% BETWEEN 2010 AND 2012 BOOSTING LOCAL EMPLOYMENT. PROVIDER RELATIONS: -IMPROVED FREQUENCY, PARTICIPATION, AND RESULTS OF PROVIDER SATISFACTION SURVEYS -PROVIDER SUPPORT IN EDUCATION, MARKETING, AND IT -CREATION AND DISTRIBUTION OF NEW ANNUAL PROVIDER DIRECTORIES -PROVIDED SEVERAL OPPORTUNITIES FOR PROVIDER NETWORKING AND INTERACTION TO IMPROVE COMMUNICATION AND TO PROMOTE LOCAL REFERRALS FINANCIAL PERFORMANCE: -ESTABLISHED AND BEGAN THE IMPLEMENTATION OF "PATIENT FRIENDLY" BILLING CRITERIA -REFINANCED BOND DEBT TO FIXED RATE BONDS AND SET ASIDE PROJECT FUNDS FOR FUTURE HOSPITAL RENOVATION AND EXPANSION |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| COLUMBIA MEMORIAL HOSPITAL FOUNDATION | |||||||||
| 2111 EXCHANGE STREET | ASTORIA | OR | 97103 | 931091701 | FUNDRAISING FOR THE HOSPITAL | OR | 501(C)3 | LINE 11A, I | 1 |
| COLUMBIA MEMORIAL HOSPITAL AUXILIARY | |||||||||
| 2111 EXCHANGE STREET | ASTORIA | OR | 97103 | 931306211 | PROVIDE VOLUNTEERS | OR | 501(C)3 | 0 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ASTORIA IMAGING LLC | ||||||||||||
| 2111 EXCHANGE STREET | ASTORIA | OR | 97103 | 800240381 | MRI JOINT VENTURE | OR | RELATED | 535232 | 1754712 | 0 | 0 | 0.51000 |
| COASTAL HEALTH ASSURANCE | ||||||||||||
| 2111 EXCHANGE STREET | ASTORIA | OR | 97103 | 911818894 | PHO | OR | -222 | 20923 | 0 | 0 | 0.49000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| COLUMBIA MEMORIAL HOSPITAL FOUNDATION (IN-KIND CONTRIBUTION) | ||
| B | 30495 | ACTUAL |
| COLUMBIA MEMORIAL HOSPITAL FOUNDATION (IN-KIND CONTRIBUTION SALARY EXP) | ||
| O | 248641 | ACTUAL |
| ASTORIA IMAGING LLC (SALARY EXPENSE FOR MRI MNGMT TECHS & REGISTRATION) | ||
| O | 253040 | ACTUAL |
| COLUMBIA MEMORIAL HOSPITAL FOUNDATION | ||
| C | 242660 | ACTUAL |
| COLUMBIA MEMORIAL HOSPITAL FOUNDATION | ||
| Q | 98231 | ACTUAL |
| COLUMBIA MEMORIAL HOSPITAL FOUNDATION | ||
| S | 52410 | ACTUAL |