2013-11-14T05:13:34-00:00 2012-12-31 Columbia Memorial Hospital 71 Prospect Avenue Hudson NY 12534 990 2012-01-01 141338373 Columbia Memorial Hospital COLU 5188287601 71 Prospect Avenue Hudson NY 12534 Jay P Cahalan 2013-11-14 false John M Gallagher 5188288181 2013-11-14 X 2012 2016-02-25 16:41:14Z Jane Ehrlich 71 Prospect Avenue Hudson NY 12534 160879462 false X www.columbiamemorial.com X NY The mission of Columbia Memorial Hospital is to provide our communities with safe, high quality, comprehensive health care services in a dignified and compassionate environment. 17 13 1605 45 119857 23879 2090556 4085085 137810264 150008281 347167 288320 -1974625 262655 138273362 154644341 0 0 81772622 89731756 0 0 56838502 61807810 138611124 151539566 -337762 3104775 84080999 92451460 65443019 71274731 18637980 21176729 X The mission of Columbia Memorial Hospital is to provide our communities with safe, high quality, comprehensive health care services in a dignified and compassionate environment. false false 42430400 49429254 Acute Inpatient Hospital services 32,537 patient days. Hospital Emergency Medical Care available to all 32,727 visits. 75158725 87426115 Outpatient Surgery Outreach Clinics spanning 3 Counties. 373,496 visits 7891020 9134027 Our Nursing Home provides skilled care resident rehabilitative services. 40,709 patient days 3880829 4018885 129360974 true true false false false true false false false true true false false false true true false true false false false false false false false false true true false false true true false false false false false false false false false true true false false false false true false true false true 100 0 true 1605 true true true false false false false false false false false false true false false X 17 13 false false false false false false false true true false false true true true true true true true false true true NY X Columbia Memorial Hospital 5188287601 71 Prospect Avenue Hudson NY 12534 James Warren 008.00 X X 0 0 0 Mary Gail Biebel 008.00 X X 0 0 0 Donald Gibson 008.00 X X 0 0 0 Winnie Thorn 008.00 X X 0 0 0 VRichard Back MD 008.00 X 30 0 0 HLouis Clinton MD 008.00 X 403167 0 0 Stephen Dunn 008.00 X 0 0 0 David Ginsberg 008.00 X 0 0 0 Clara Kellner 008.00 X 0 0 0 Aven Kerr 008.00 X 0 0 0 James M Kingsbury 008.00 X 0 0 0 James Lapenn 008.00 X 0 0 0 James Reynolds 008.00 X 0 0 0 William Van Slyke 008.00 X 0 0 0 Marie Ostoyich RN 008.00 X 0 0 0 Ananthakrishnan Ramani MD 040.00 X 377974 0 0 John Mathews MD 008.00 X 395070 0 0 Patti Matheney 008.00 X 0 0 0 Jane Ehrlich 040.00 X X 463147 0 0 Jay Cahalan 040.00 X 364256 0 0 Vincent J Dingman III 040.00 X 256201 0 0 Norm Chapin MD 040.00 X 320363 0 0 Leitha Pierro 040.00 X 192896 0 0 Christopher Gorczynski MD 040.00 X 652249 0 0 Ersno Eromo MD 040.00 X 562490 0 0 Andrew Packard MD 040.00 X 526223 0 0 Monoj Subudhi MD 040.00 X 492680 0 0 Karuvath Enu MD 040.00 X 483316 0 0 5490062 99 false true false AOW Associates Inc 30 Essex Street Albany NY 12206 Contractor 2601614 LabCorp PO Box 12140 Burlington NC 27216 Laboratory 1446207 Dennis Marcus MD PC PO Box 797 Valatie NY 12184 Psychiatric Services 1134901 Atlas 60 Grider Street Buffalo NY 14215 Laundry Service 605371 Sodexho Clinical 113 Seaboard Lane - Suite B201 Franklin TN 37067 BioMed Services 440550 36 1328785 2635604 120696 314481 4085085 I/P O/P Svcs.- Medicare/Medicaid Paymts 900099 84665256 84665256 I/P O/P Services - Other Direct Payments 900099 58889863 58889863 Other Government Payments 900099 6453162 6453162 150008281 259592 259592 6240473 23376 6235121 5352 23376 28728 28728 Unrealized Gain on Investments 900099 462283 462283 Unrelated Business Income 531190 119857 119857 262655 154644341 150151079 119857 288320 0 0 0 0 5490062 3893199 1596863 0 68746943 60043992 8702951 1824247 1719497 104750 8862489 8046423 816066 4808015 4226730 581285 0 318196 75889 242307 149835 149835 0 0 12854914 11281377 1573537 553541 559 552982 19305248 18083351 1221897 931305 514087 417218 0 4075185 3177556 897629 172568 50399 122169 0 154503 39556 114947 1590943 1590943 37241 7742 29499 7083838 4622605 2461233 2781125 2555574 225551 Maintenance 2227068 1703324 523744 Miscellaneous 379382 126196 253186 Provision for Bad Debt 8544080 8544080 Assessment 648838 648838 0 151539566 129360974 22178592 0 6467684 4614404 10872613 11588400 1465692 1741737 1472291 1316555 115040243 65686178 40944184 49354065 12056292 12822061 2149638 1490606 4966145 5530164 3686460 3993468 84080999 92451460 9861731 12422953 32298995 32702094 137329 68329 23144964 26081355 65443019 71274731 X 16170358 18306946 1481957 1883118 985665 986665 18637980 21176729 84080999 92451460 X 3104775 5501 -571527 X false X true X true true true X 0.00000 0.00000 0.00000 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 7920 27688 true true false 6367304 4449006 535580 4305681 7046209 6708314 1929661 -298828 1971843 6367304 6309608 1082856 515830 1199980 6708314 6110594 749034 592695 1142715 6309608 7632997 3220130 -1514973 3227560 6110594 0.24000 0.14000 0.62000 false true true 782850 782850 64797685 28962960 35834725 48583690 36148278 12435412 876018 574940 301078 49354065 Financial derivatives and other financial products Closely-held equity interests Federal income taxes Accrued Vacation PTO 3570646 Estimated Payables to 3rd Party Reimbursement Agencies 3239000 Accrued Pension 7369118 Obligations Under Capital Leases 3264270 Interest Rate Swaps 2739983 Asset Retirement Obligation 1229640 Deferred Liability - Exec. Life Insurance Policies 2744698 Professional Liability Insurance Reserve 1828000 Kaaterskill Commons - Ground Lease 96000 26081355 X 151389727 151389727 3254614 3254614 154644341 151763261 151763261 -223695 -223695 151539566 X 2 Audited Statement Footnote 1t, Income Taxes The hospital and KCI are Internal Revenue Code Section 501c3 organizations and , as such, are exempt from Federal Income Taxes on related income pursuant to Section 501a. The Hospital recognizes effect, if any, of income tax positions only if they are more likely than not, sustainable under current income tax regulations. Recoginzed income tax positions are measured at the largest amount that is greater than 50 likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs. The Hospital has no uncertain tax positions at December 2012 or 2011. XI 4b Not included in revenue on Part XII, Line 1, but included as revenue on the Hospitals consolidated financials are restricted Gifts Grants 3,365,249 which are adjustments to temporary Permanently Restricted Net Assets Revenue from Kaaterskill commons, Inc. 110,971 Net Worth of a related organization which is not recorded on the Hospitals books 336. XII 4b Not included in Expenses on Part XII, Line 3, but included as expense on the Hospitals consolidated financials are the expenses for Kaaterskill Commons, Inc. 223,695. true true true X true X true true true false true true 512745 512745 0.00340 32217486 24164047 8053439 0.05310 32730231 24164047 8566184 0.05650 498765 76563 422202 0.00280 76752 7285 69467 0.00050 66374381 51961867 14412514 0.09510 66949898 52045715 14904183 0.09840 99680129 76209762 23470367 0.15490 230255 230255 0.00150 230255 230255 0.00150 8544080 205496 60550709 59418529 1132180 X true Tri-Way Interventional Ownership/Rental of Vascular Equipment 0.33000 0.33000 1 1 Columbia Memorial Hospital

71 Prospect Avenue Hudson NY 12534

X X X CMH CMH 1 true X X X X X X 12 true true true X X X X X true false true true 0000000001.000000000000 true 0000000004.000000000000 true X X X X X X X true true X X X true X X X true X X X X X X false X false true 1 Kaaterskill Care Skilled Nursing & Rehab

161 Jefferson Heights Catskill NY 12414

Skilled Nursing Rehab Part I Line 7 For the purposes of calculating the Hospitals total community benefits expense at cost, the Hospital used a cost-to-charge ratio, consistent with the calculation derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. Part II The hospitals community building activities consist of ongoing workforce development and community training sessions, for which the Hospital receives a very nominal fee, if any. These free or low-cost programs increase community awareness of health issues, provide an opportunity for ongoing education of community providers and caregivers, and support improved health habits for the community the Hospital serves. Part III Line 4 The Hospital used the Bad Debt Expense derived from the audited Statement of Operations for the period-ended December 31, 2012. Bad Debts are estimated at cost on an ongoing basis, and charged to expense when management deems it probable that the revenue will not be collected. Discounts provided to patients are considered an adjustment in calculating Net Patient Service Revenue, and are not included as a component of Bad Debt Expense. Part III Line 4 The Hospitals discusses the availability of charity care with patients during the registration process, and enrolls all eligible patients based on the information provided by the patient. Part III Line 4 The Hospitals audited financial statements contain the following information regarding bad debt expense The amount of the provision for bad debts is based on managements assessment of historical and expected net collections, based on business and economic conditions, trends in federal and state governmental health care coverage and other collection indicators. Part III Line 8 The Hospitals costing methodology used to determine the Medicare allowable costs reported in the organizations Medicare Cost Report is based upon the ratio of patient care cost to charges. Part III Line 9b The Hospital follows a consistent collections policy for all patients. Part V Line 19d The Hospital determines the maximum amounts charged to Financial Assistance Policy FAP individuals based upon the payment rates negotiated with the commercial insurer with the highest volume of services performed at our facility and outpatient locations. Part VI Line 2 The Hospital continuously monitors changes in the demographics of the 2 counties it serves, through community outreach, discussions with local political and business leader, and working with a variety of state and local agencies to assess the needs of the community. The Community Service plan is continuously updated and available on the Hospitals public website. The Hospital serves the people of Columbia and Greene Counties and part of Northern Dutchess County, with a combined population of approximately 115,000, which, is distributed between one small city and 32 towns. The two counties combined, cover an area of nearly 1,300 square miles, most of which is agricultural or rural. Columbia County is located in the northeastern region of the Mid-Hudson Valley of New York State. It is bordered on the north by Rensselaer County, on the south by Dutchess County, on the east by the Berkshire County of the Commonwealth of Massachsetts and on the west by the Hudson River, opposite Greene County. Columbia County is rural in nature and includes the City of Hudson and 18 towns. Greene County is situated between the Hudson River on the east and the Catskill Mountains at the Southern Western ends. It is bordered by Albany County to the north, Rensselaer County to the northeast, Columbia County to the east, Ulster County to the south, Delaware County to the west and Schoharie County to the northwest. Greene County is two hours north of the major metropolitan areas of New York City, and a half-hour south of Albany, New York States Capital District. Part VI Line 3 The Hospitals written Bad Debt Charity Care policy broadly applies to the outstanding balance for patient or insurer. The Hopital advertises throughout the facility, discusses directly with patients during the registration process, and again during collections process re availability for charity care. As patients enroll in Charity Care, adjustment to their o/s balance is charged against net patient service revenue, and not considered a component of bad debt expense. Part VI Line 6 The Hospital is not part of an affiliated health care system, and files a community benefit report only in New York State. Part VI, Line 7 NY X X X X X false false false false false false false false false HLouis Clinton MD 403167 750 403917 Ananthakrishnan Ramani MD 257716 120000 258 15750 27000 420724 John Mathews MD 395070 395070 Jane Ehrlich 396839 52917 13391 4044 75750 542941 Jay Cahalan 282667 70500 11089 51384 720 416360 Vincent J Dingman III 206237 47500 2464 38375 3185 297761 Norm Chapin MD 305146 15000 216 750 3854 324966 Leitha Pierro 174340 17500 396 660 192896 Christopher Gorczynski MD 652195 54 652249 Ersno Eromo MD 562490 562490 Andrew Packard MD 526223 396 526619 Monoj Subudhi MD 492422 258 750 493430 Karuvath Enu MD 482080 1236 483316 1 3 The compensation of the Hospitals CEO is determined by the Compensation Committee of the Board of Trustees. This Committee bases their decision on CEO compensation surveys from healthcare industry organizations, Form 990 for comparable organizations and general industry knowledge. The CEO compensation package is formalized in a written employment contract and approved by that Committee. A Columbia County Industrial Development Agency 141636496 197511AR9 2008-01-30 11730000 Refinancing false B Columbia County Capital Resource Corp 271072117 197505AA8 2010-03-01 12945000 Refinancing New Construction false A 11730000 603669 3852910 7273421 2010 false false true true B 12945000 762958 9574523 2607519 2012 false false false true A false true true HSBC 0000000010.000000000000 false false false false B false true true HSBC 0000000010.000000000000 false false false false James Reynolds CMH Board Trustee 61969 Refer to Schedule L, Part V false David Ginsberg CMH Board Trustee 695218 Refer to Schedule L. Part V false IV 1 James Reynolds, a Columbia Memorial Hospital Board Trustee, is President of Mid-Hudson Cablevision, Inc. 52,667, and Mid-Hudson Media 9,302. Those companies provide cable internet service to various locations belonging to the Hospital. IV 1 David Ginsberg, a Columbia Memorial Hospital Board Trustee, is also the Owner, President and CEO of Ginsbergs Institutional Foods, Inc. His company provided 695,218 in food, paper products, etc. during 2012. X 1 300000 Sale of Comparable Properties X 1 14481 Paving Mat.Labor-Pkg.Lot 1 false true false Form 990, Part III, Line 4d Program Service Expenses 3,880,829, Grants and allocations 0, Revenue 4,018,885 Miscellaneous Ancillary services Form 990 Part VI Section B Line 11b - GOVERNING BODYS REVIEW OF FORM 990 Form 990 and its supporting schedules are mailed to the Executive and/or Finance Committees for their review, in advance of a meeting to be held whereby feedback is obtained from members of those committees. As result of that meetings, changes agreed upon, if any, are made to said documents prior to the presentation made by the Chief Financial Officer of Columbia Memorial Hospital at the General Board of Trustees Meeting. Form 990 Part VI Section B Line 12c CONFLICT OF INTEREST All members of the Board of Trustees are required to complete and execute the Hospital policy on Organizational Ethics as well as a Conflict of Interest Questionaire for Trustees and Confidentiality Agreement for Board Members. In addition to these forms being completed by new members, they are also required from all encumbent trustees on an annual basis. The Governance Committee reviews, monitors enforces conflicts of interest issues, and reports the same to all members at General Board Meetings. Form 990 Part VI Section B Line 15a COMPENSATION OF CEO OTHER KEY EMPLOYEES Performance review and recommendations pertaining to salary are undertaken by the Compensation Committee on an annual basis. The Compensation Committee is comprised of select member of the Board of Trustees who may employ outside consultants, use data industry standards, etc. to formulate conclusions. Form 990 Part VI Section B Line 19 DISCLOSURE Columbia Memorial Hospital makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Form 990 Part XI Line 9 RECONCILIATION OF NET ASSETS Combined total of -571,527 adjustment doe to the following Pension valuation -35,169, Net assests released from restriction -236,022, change in net assets of Auxiliary not booked by CMH -336. Columbia-Greene Hospital Foundation 71 Prospect Avenue Hudson NY 12534 141761112 Fund Raising NY 501c3 170b1Aiv N/A false The Second Show Inc 519 Warren Street Hudson NY 12534 141796715 Thrift Shop NY 501c3 170b1Aiv N/A false Columbia Medical Complex LLC 839 North Jefferson Street Milwaukee WI 53202 201017545 Healthcare WI N/A Related false false Tri-Way Interventional LLC c/o 71 Prospect Avenue Hudson NY 12534 320041811 Healthcare NY N/A Related 73097 86926 false false 0.33340 Capital Health Network LLC 125 Wolf Road Albany NY 12205 141794727 Healthcare NY N/A Investment false false United Lab Network LLC 125 Wolf Road Albany NY 12205 141827292 Healthcare NY N/A Investment false false United Lab Network IPA LLC 125 Wolf Road Albany NY 12205 141832018 Healthcare NY N/A Investment false false Columbia-Greene Services Inc c/o CMH 71 Prospect Avenue Hudson NY 12534 141758524 Healthcare NY N/A C Corp 1.00000 false false false true false false false false false false false false false true false false false true false false Columbia-Greene Hospital Foundation c 1692766 Columbia-Greene Hospital Foundation m 61873 Columbia-Greene Hospital Foundation q 196393 The Second Show Inc q 67101