COLUMBUS COLONY FOR ELDERLY CARE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: COLUMBUS COLONY FOR ELDERLY CARE INC (EIN 31-0951208)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-05-28
IRS object ID: 201321489349300617
Schema version: 2012v2.0
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 D
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-05-28T12:45:39-07:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	WILLIAM POWELSON CPA	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	1515 WEST LANE AVE STE 4	AddressLine1
City	COLUMBUS	City
State	OH	State
ZIP Code	43221	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	310951208	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	COLUMBUS COLONY FOR ELDERLY CARE INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	COLU	NameControl
Phone	6148915055	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1150 COLONY DRIVE	AddressLine1
City	WESTERVILLE	City
State	OH	State
ZIP Code	43081	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	HOWARD SNYDER	Name
Title	BOARD TREASURER	Title
Phone	6148915055	Phone
Date Signed	2013-05-20	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	WILLIAM POWELSON	Name
Phone	6144814409	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	RICHARD HUEBNER	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	901 S SUNBURY RD	AddressLine1
City	WESTERVILLE	City
State	OH	State
ZIP Code	43081	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	10318550	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.ColumbusColony.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1977	YearFormation
State Legal Domicile	OH	StateLegalDomicile
Activity Or Mission Description	Provide skilled nursing care for the elderly - specialized in caring for the hearing impaired.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	11	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	11	NbrIndependentVotingMembers
Total Nbr Employees	221	TotalNbrEmployees
Total Nbr Volunteers	4	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	21184	ContributionsGrantsPriorYear
Contributions Grants Current Year	1490	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	10562050	ProgramServiceRevenuePriorYear
Program Service Revenue CY	10273136	ProgramServiceRevenueCY
Investment Income Prior Year	862	InvestmentIncomePriorYear
Investment Income Current Year	457	InvestmentIncomeCurrentYear
Other Revenue Prior Year	20117	OtherRevenuePriorYear
Other Revenue Current Year	43467	OtherRevenueCurrentYear
Total Revenue Prior Year	10604213	TotalRevenuePriorYear
Total Revenue Current Year	10318550	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	4774422	SalariesEtcPriorYear
Salaries Etc Current Year	4957987	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	5262734	OtherExpensePriorYear
Other Expenses Current Year	5306989	OtherExpensesCurrentYear
Total Expenses Prior Year	10037156	TotalExpensesPriorYear
Total Expenses Current Year	10264976	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	567057	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	53574	RevenuesLessExpensesCY
Total Assets BOY	6052984	TotalAssetsBOY
Total Assets EOY	5701527	TotalAssetsEOY
Total Liabilities BOY	4448912	TotalLiabilitiesBOY
Total Liabilities EOY	4043881	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	1604072	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	1657646	NetAssetsOrFundBalancesEOY
Mission Description	Provide skilled nursing care	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	9274253	Expense
Revenue	10318550	Revenue
Description	LONG TERM CARE -SKILLED NURSING HOME - 150 BEDS	Description
Total Program Service Expense	9274253	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	true	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	1	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	221	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Excess Business Holdings	false	ExcessBusinessHoldings
Taxable Distributions	false	TaxableDistributions
Distribution To Donor	false	DistributionToDonor
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	11	NbrVotingGoverningBodyMembers
Number Independent Voting Members	11	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	false	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	false	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	false	RegularMonitoringEnforcement
Whistleblower Policy	false	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	OH	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	RICHARD STEPP	NamePerson
Telephone Number	6148915055	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1150 COLONY DRIVE	AddressLine1
City	WESTERVILLE	City
State	OH	State
ZIP Code	43081	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Key EmployeeKeyEmployee	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Individual Trustee Or DirectorIndividualTrusteeOrDirector
ROBERT GRIGGS
Administrator	40.00	X	65663	0	0
RICHARD HUEBNER
Bd President	2.00		0	0	0	X
JOHN BRADLEY
Bd. Secretary	1.00		0	0	0	X
STEVE RIDENOUR
Bd. V.P.	1.00		0	0	0	X
HOWARD SNYDER
Treasurer	1.00		0	0	0	X
WENDELL CLARK
Board Member	1.00		0	0	0	X
RICHARD CROSSEN
Board Member	1.00		0	0	0	X
HARVEY CRUM
Board Member	1.00		0	0	0	X
DELFINA ZEIGLER
Board member	1.00		0	0	0	X
WILLIAM NOBLE
Board Member	1.00		0	0	0	X
RICK SCHULTZ
Board Member	1.00		0	0	0	X
KIM SUTTON
Board Member	1.00		0	0	0	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	65663	TotalReportableCompFromOrg
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	THERAPY PARTNERS	BusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	MIDDLEBURG HEIGHTS	AddressLine1
City	SPRAGUE	City
State	OH	State
ZIP Code	44130	ZIPCode

Field	Value	IRS element (for citing)
Description Of Services	Therapy Services	DescriptionOfServices
Compensation	596741	Compensation

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	1	NumberOfContractorsGT100K
All Other Contributions	1490	AllOtherContributions
Total Contributions	1490	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	Routine/ancilliary	Description
Business Code	623000	BusinessCode
Total Revenue Column	10273136	TotalRevenueColumn

Field	Value	IRS element (for citing)
Total Program Service Revenue	10273136	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	457	TotalRevenueColumn
Exclusion	$457	ExclusionAmount

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	Miscellaneous	Description
Business Code	623000	BusinessCode
Total Revenue Column	43467	TotalRevenueColumn
Related Or Exempt Function Income	43467	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	43467	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	10318550	TotalRevenueColumn
Related Or Exempt Function Income	10316603	RelatedOrExemptFunctionIncome
Exclusion	$457	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	101672	Total
Program Services	0	ProgramServices
Management And General	101672	ManagementAndGeneral
Fundraising	0	Fundraising

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	4616257	Total
Program Services	4313479	ProgramServices
Management And General	302778	ManagementAndGeneral
Fundraising	0	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	136139	Total
Program Services	136139	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	103919	Total
Program Services	103919	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	192000	Total
Program Services	0	ProgramServices
Management And General	192000	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	9127	Total
Program Services	0	ProgramServices
Management And General	9127	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	56198	Total
Program Services	0	ProgramServices
Management And General	56198	ManagementAndGeneral
Fundraising	0	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	51037	Total
Program Services	0	ProgramServices
Management And General	51037	ManagementAndGeneral
Fundraising	0	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	39761	Total
Program Services	0	ProgramServices
Management And General	39761	ManagementAndGeneral
Fundraising	0	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	17136	Total
Program Services	0	ProgramServices
Management And General	17136	ManagementAndGeneral
Fundraising	0	Fundraising

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	177926	Total
Program Services	177926	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	208395	Total
Program Services	208395	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	335988	Total
Program Services	335988	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	88939	Total
Program Services	88939	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Management And GeneralManagementAndGeneral
Bad debts	57204	57204
Comunications	18138	18138
Employee Screening	8577	8577
Auto mileage	5434	5434

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	4041129	Total
Program Services	3909468	ProgramServices
Management And General	131661	ManagementAndGeneral
Fundraising	0	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	10264976	Total
Program Services	9274253	ProgramServices
Management And General	990723	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	221050	BOY
EOY	318580	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	1314683	BOY
EOY	1125794	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	23334	BOY
EOY	23334	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	32056	BOY
EOY	33516	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	9209226	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	5380360	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	4076864	BOY
EOY	3828866	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	384997	BOY
EOY	371437	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	6052984	BOY
EOY	5701527	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	1509352	BOY
EOY	1389051	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	2898393	BOY
EOY	2622250	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	41167	BOY
EOY	32580	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	4448912	BOY
EOY	4043881	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1604072	BOY
EOY	1657646	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	1604072	BOY
EOY	1657646	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	6052984	BOY
EOY	5701527	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	53574	ReconcilationRevenueExpenses
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Separate	X	FinancialStatementSeparate

Field	Value	IRS element (for citing)
Audit Committee	true	AuditCommittee
Federal Grant Audit Required	true	FederalGrantAuditRequired
Federal Grant Audit Performed	true	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	X	PubliclySupportedOrg509a2
Public Support Total170	0	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Total	0	Total

Field	Value	IRS element (for citing)
Public Support Pertcentage170	0	PublicSupportPertcentage170

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	3765	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	3274	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	3839	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	21184	CurrentTaxYearMinus1Year
Current Tax Year	1490	CurrentTaxYear
Total	33552	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	8782743	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	8957923	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	9729047	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	10582167	CurrentTaxYearMinus1Year
Current Tax Year	10316603	CurrentTaxYear
Total	48368483	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	8786508	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	8961197	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	9732886	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	10603351	CurrentTaxYearMinus1Year
Current Tax Year	10318093	CurrentTaxYear
Total	48402035	Total

Field	Value	IRS element (for citing)
Public Support Total509	48402035	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	16399	CurrentTaxYearMinus4Years
Current Tax Year Minus2 Years	1889	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	862	CurrentTaxYearMinus1Year
Current Tax Year	457	CurrentTaxYear
Total	19607	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	16399	CurrentTaxYearMinus4Years
Current Tax Year Minus2 Years	1889	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	862	CurrentTaxYearMinus1Year
Current Tax Year	457	CurrentTaxYear
Total	19607	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Total	48421642	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.99960	PublicSupportPercentage509
Prior Year Support Percentage	0.99870	PriorYearSupportPercentage
Investment Income Percentage	0.00040	InvestmentIncomePercentage
Prior Yr Invest Income Percentage	0.00130	PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	188801	OtherCostOrOtherBasis
Book Value	188801	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	5568299	OtherCostOrOtherBasis
Depreciation	2757185	Depreciation
Book Value	2811114	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	505146	OtherCostOrOtherBasis
Depreciation	418456	Depreciation
Book Value	86690	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2786648	OtherCostOrOtherBasis
Depreciation	2044387	Depreciation
Book Value	742261	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	160332	OtherCostOrOtherBasis
Depreciation	160332	Depreciation

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	3828866	TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescription	Book ValueBookValue
Resident funds	33459
Mortgage escrow deposits	99788
Replacement reserve fund	176853
Residual receipts fund
Deferred financing costs	60337
Other assets	1000

Field	Value	IRS element (for citing)
Total Book Value Other Assets	371437	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	Resident personal funds	Description
Amount	$32,580	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	32580	TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt	10318550	TotRevenueEtcAuditedFinclStmt
Revenue Subtotal	10318550	RevenueSubtotal
Total Revenue Per Form990	10318550	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	10264976	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	10264976	ExpensesSubtotal
Total Expenses Per Form990	10264976	TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifier	ExplanationExplanation
Pt VI, Line 19	Upon request
Pt VI, Line 11b	Form 990 reviewed at Board meeting
Pt VI, Line 6	Elected Board
Pt VI, Line 7a	Elected Board
Pt VI, Line 7b	Board resolutions voted upon
Pt VI, Line 15a	Board reviews compensation in relation to nursing home
	administrators
Pt VI, Line 15b	Board review administrator and DON compensation
Form 990, Part IX, Line 24f	ADMINISTRATIVE SERVICES 11988. 11988. 0. SECURITY SERVICES 263. 263. 0. DUES AND SUBSCRIPTIONS 7164. 7164. 0. LICENSE 1825. 1825. 0. COMPUTER SUPPLIES 5865. 5865. COMPUTER MAINTENANCE 74667. 74667. 0. LEASE EQUIP/SHED 29889. 29889. 0. MAINT. CONTRACTS 96226. 96226. 0. 0. MAINT. SUPPLIES 39039. 39039. 0. 0. TRASH REMOVAL 19640. 19640. 0. 0. GOVT MANADATED FEES 638244. 638244. 0. 0. REAL ESTATE TAXES 11263. 11263. 0. 0. WORKMEN COMPENSATION 47042. 47042. 0. 0. DIETARY PURCHASED SERVICE 31120. 3112

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	COLUMBUS COLONY INC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	901 S SUNBURY RD	AddressLine1
City	WESTERVILLE	City
State	OH	State
ZIP Code	43081	ZIPCode

Field	Value	IRS element (for citing)
EIN	341265105	EIN
Primary Activities	MANAGEMENT	PrimaryActivities
Legal Domicile State	OH	LegalDomicileState
Exempt Code Section	501(c)3	ExemptCodeSection

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	X	BusinessNameLine1

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	false	DividendsRelatedOrganization
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	false	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	false	SharingOfPaidEmployees
Reimbursement Paid To Other Org	true	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

Field	Value	IRS element (for citing)
Business Name Line1	COLUMBUS COLONY INC - MANAGEMENT FEE	BusinessNameLine1

Field	Value	IRS element (for citing)
Transaction Type	o	TransactionType
Amount Involved	192000	AmountInvolved
Method Of Amt Determination	cost	MethodOfAmtDetermination