FURP.ORG / PUBLIC DATA EXPLORER

COLUMBIA MEMORIAL HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
COLUMBIA MEMORIAL HOSPITAL (EIN 14-1338373)
Tax period
2010-01-01 to 2010-12-31
Filed
2012-05-11
IRS object ID
201201329349301205
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-05-11T10:28:50-00:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Columbia Memorial HospitalBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line171 Prospect AvenueAddressLine1
CityHudsonCity
StateNYState
ZIP Code12534ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN141338373EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Columbia Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOLUNameControl
Phone5188287601Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line171 Prospect AvenueAddressLine1
CityHudsonCity
StateNYState
ZIP Code12534ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJane EhrlichName
TitlePresident CEOTitle
Date Signed2011-11-14DateSigned
Authorize Third PartyfalseAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJohn GallagherName
Phone5188288181Phone
Date Prepared2011-11-14DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJane Ehrlich President CEONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line171 Prospect AvenueAddressLine1
CityHudsonCity
StateNYState
ZIP Code12534ZIPCode
FieldValueIRS element (for citing)
Gross Receipts140607314GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.columbiamemorial.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1905YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionThe mission of Columbia Memorial Hospital is to provide our communities with safe, high quality, comprehensive health care services in a dignified and compassionate environment. 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.ActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees1585TotalNbrEmployees
Total Nbr Volunteers55TotalNbrVolunteers
Total Gross UBI289441TotalGrossUBI
Net Unrelated Business Txbl Income46981NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1003395ContributionsGrantsPriorYear
Contributions Grants Current Year2581235ContributionsGrantsCurrentYear
Program Service Revenue Prior Year125941407ProgramServiceRevenuePriorYear
Program Service Revenue CY127576925ProgramServiceRevenueCY
Investment Income Prior Year-91932InvestmentIncomePriorYear
Investment Income Current Year554791InvestmentIncomeCurrentYear
Other Revenue Prior Year2147985OtherRevenuePriorYear
Other Revenue Current Year-641016OtherRevenueCurrentYear
Total Revenue Prior Year129000855TotalRevenuePriorYear
Total Revenue Current Year130071935TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year70580910SalariesEtcPriorYear
Salaries Etc Current Year76128821SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year53309813OtherExpensePriorYear
Other Expenses Current Year55248090OtherExpensesCurrentYear
Total Expenses Prior Year123890723TotalExpensesPriorYear
Total Expenses Current Year131376911TotalExpensesCurrentYear
Revenues Less Expenses Prior Year5110132RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1304976RevenuesLessExpensesCY
Total Assets BOY70927010TotalAssetsBOY
Total Assets EOY81803944TotalAssetsEOY
Total Liabilities BOY47885348TotalLiabilitiesBOY
Total Liabilities EOY60022952TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY23041662NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY21780992NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe mission of Columbia Memorial Hospital is to provide our communities with safe, high quality, comprehensive health care services in a dignified and compassionate environment.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense44826230Expense
Revenue51677849Revenue
DescriptionAcute Inpatient Hospital services 32,686 patient days. Hospital Emergency Medical Care available to all 32,764 visits.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense57010916Expense
Revenue65760268Revenue
DescriptionOutpatient Surgery Outreach Clinics spanning 3 Counties. 282,081 visitsDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense7601455Expense
Revenue8791105Revenue
DescriptionOur Nursing Home provides skilled care resident rehabilitative services. 40,544 patient daysDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp2347508TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev2695436TotalOfOtherProgramServiceRev
Total Program Service Expense111786109TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundstrueDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgtrueTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109685NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1585NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionstrueTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Indoor Tanning ServicesfalseIndoorTanningServices
Nbr Voting Governing Body Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Columbia Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5188287601TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line171 Prospect AvenueAddressLine1
CityHudsonCity
StateNYState
ZIP Code12534ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationFormerFormerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
James Warren
Chair008.00XX000
Mary Gail Biebel
Vice-Chair008.00XX000
Donald Gibson
Treasurer008.00XX000
Winnie Thorn
Secretary008.00XX000
V Richard Back MD
Trustee008.00X664700X
HLouis Clinton MD
Trustee008.00X000
Stephen Dunn
Trustee008.00X000
David Ginsberg
Trustee008.00X000
Clara Kellner
Trustee008.00X000
Aven Kerr
Trustee008.00X000
James M Kingsbury
Trustee008.00X000
James Lapenn
Trustee008.00X000
James Reynolds
Trustee008.00X000
William Van Slyke
Trustee008.00X000
George Davis MD
Trustee032.00X11369700
Ananthakrishnan Ramani MD
Trustee040.00X372055010750
Jane Ehrlich
Pres. CEO040.00XX4825920209465X
Jay Cahalan
COO040.00X361885051834X
Vincent J Dingman III
CFO040.00X257605038375X
Christopher Gorcznyski MD
Physician040.0060597700X
Andrew Packard MD
Physician040.0055153400X
Monoj Subudhi MD
Physician040.004923280750X
Karuvath Enu MD
Physician040.0042800900X
Louis DiGiovanni MD
Physician040.0041921200X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4091541TotalReportableCompFromOrg
Total Other Compensation311174TotalOtherCompensation
Number Individuals GT100 K76NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
LabCorp
20 Johnson DriveRaritanNJ08869Laboratory Services1371141
Dennis Marcus MD PC
PO Box 797ValatieNY12184Psychiatric Services1055861
Pain Management of Upstate New York
c/o CMH 71 Prospect AttnTomasz AndrWestwoodMA02090Physician Services810000
Medical Information Technology Inc
Medictech CircleWestwoodMA02090Software Provider Services649148
Donald Blair Architechs
100 Lafeyette Street Suite 604New YorkNY10013Architectural376269
FieldValueIRS element (for citing)
Number Of Contractors GT100 K22NumberOfContractorsGT100K
Related Organizations687869RelatedOrganizations
Government Grants1847768GovernmentGrants
All Other Contributions45598AllOtherContributions
Noncash Contributions36460NoncashContributions
Total Contributions2581235TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
I/P O/P Svcs.- Medicare/Medicaid Paymts9000997328558773285587
I/P O/P Services - Other Direct Payments9000994915834749158347
Other Government Payments90009951329915132991
FieldValueIRS element (for citing)
Total Program Service Revenue127576925TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column229256TotalRevenueColumn
Exclusion$229,256ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities10860613Securities
Other301Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities10535379Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities325234Securities
Other301Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column325535TotalRevenueColumn
Exclusion$325,535ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionUnrealized Gain on InvestmentsDescription
Business Code900099BusinessCode
Total Revenue Column421504TotalRevenueColumn
Related Or Exempt Function Income421504RelatedOrExemptFunctionIncome

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column289441TotalRevenueColumn
Unrelated Business Revenue289441UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue-641016TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column130071935TotalRevenueColumn
Related Or Exempt Function Income126646468RelatedOrExemptFunctionIncome
Unrelated Business Revenue289441UnrelatedBusinessRevenue
Exclusion$554,791ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total4091541Total
Program Services2982812ProgramServices
Management And General1108729ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total59459043Total
Program Services51790931ProgramServices
Management And General7668112ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8342566Total
Program Services6776143ProgramServices
Management And General1566423ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4235671Total
Program Services3612735ProgramServices
Management And General622936ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total363649Total
Program Services48653ProgramServices
Management And General314996ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total139485Total
Management And General139485ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Fees For Services Prof FundraisingFeesForServicesProfFundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total11409042Total
Program Services9879206ProgramServices
Management And General1529836ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total476771Total
Program Services6553ProgramServices
Management And General470218ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total17065311Total
Program Services15777506ProgramServices
Management And General1287805ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total584359Total
Program Services361832ProgramServices
Management And General222527ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3763084Total
Program Services2668900ProgramServices
Management And General1094184ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total156576Total
Program Services43415ProgramServices
Management And General113161ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total174201Total
Program Services46877ProgramServices
Management And General127324ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1524740Total
Management And General1524740ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4282285Total
Program Services3155596ProgramServices
Management And General1126689ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total4285168Total
Program Services4083903ProgramServices
Management And General201265ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Maintenance15987301396370202360
Miscellaneous349457101782247675
Provision for Bad Debt85455418545541
Assessment507305507305
Membership Dues223864922337

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total131376911Total
Program Services111786109ProgramServices
Management And General19590802ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY5576459BOY
EOY5372631EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY11156493BOY
EOY10124480EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1432111BOY
EOY1443930EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY841803BOY
EOY1231570EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis94484357LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec54077952LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY37888624BOY
EOY40406405EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY9784550BOY
EOY12699400EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY1725618BOY
EOY2100836EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY4733745EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2521352BOY
EOY3690947EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY70927010BOY
EOY81803944EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY9740352BOY
EOY8975565EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY22095152BOY
EOY33672032EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY275329BOY
EOY206329EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY15774515BOY
EOY17169026EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY47885348BOY
EOY60022952EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY19491754BOY
EOY18817576EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2566243BOY
EOY1978751EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY983665BOY
EOY984665EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY23041662BOY
EOY21780992EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY70927010BOY
EOY81803944EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-1304976ReconcilationRevenueExpenses
Reconcilation Other Changes44306ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii
Public Support Pertcentage1700.00000PublicSupportPertcentage170
Public Support Percentage5090.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierII-B,Identifier
Return ReferencegReturnReference
ExplanationOur President CEO, and on occasion, other Executive Staff of Columbia Memorial, maintain contact with legislators to share data and concerns relative to healthcare in general, and particularly, the local area that our hospital serves.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Number DA Fs Held1NumberDAFsHeld
Donor Advised Contributions4480DonorAdvisedContributions
Aggregate DAF Value35887AggregateDAFValue
Disclosed Orgs Legal ControltrueDisclosedOrgsLegalControl
Disclosed For Charitable PurposestrueDisclosedForCharitablePurposes
Included On FSfalseIncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance6309608BeginningOfYearBalance
Contributions1082856Contributions
Investment Earnings Or Losses515830InvestmentEarningsOrLosses
Other Expenditures1199980OtherExpenditures
End Of Year Balance6708314EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance6110594BeginningOfYearBalance
Contributions749034Contributions
Investment Earnings Or Losses592695InvestmentEarningsOrLosses
Other Expenditures1142715OtherExpenditures
End Of Year Balance6309608EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance7632997BeginningOfYearBalance
Contributions3220130Contributions
Investment Earnings Or Losses-1514973InvestmentEarningsOrLosses
Other Expenditures3227560OtherExpenditures
End Of Year Balance6110594EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.25000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.14000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.61000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis698850OtherCostOrOtherBasis
Book Value698850BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis53899956OtherCostOrOtherBasis
Depreciation24134633Depreciation
Book Value29765323BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis39055253OtherCostOrOtherBasis
Depreciation29440883Depreciation
Book Value9614370BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis830298OtherCostOrOtherBasis
Depreciation502436Depreciation
Book Value327862BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings40406405TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (9 entries)

DescriptionDescriptionAmountAmount
ACCRUED VACATION PTO$2,931,537
ESTIMATED PAYABLES TO 3RD PARTY REIMBURSEMENT AGENCIES$2,626,000
ACCRUED PENSION$4,550,944
OBLIGATIONS UNDER CAPITAL LEASES$710,986
INTEREST RATE SWAPS$963,854
ASSET RETIREMENT OBLIGATION$860,000
DEFERRED LIABILITY - EXEC. LIFE INSURANCE POLICIES$2,138,038
PROFESSIONAL LIABILITY INSURANCE RESERVE$2,289,000
KAATERSKILL COMMONS - GROUND LEASE$98,667
FieldValueIRS element (for citing)
Total Of Amounts17169026TotalOfAmounts
Total Revenue130071935TotalRevenue
Total Expenses131376911TotalExpenses
Excess Or Deficit For Year-1304976ExcessOrDeficitForYear
Other-$1,575,712OtherAmount
Total Adjustments-1575712TotalAdjustments
Excess Or Deficit Per FS-2880688ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt128564305TotRevenueEtcAuditedFinclStmt
Revenue Subtotal128564305RevenueSubtotal
Other Revenues Not Included1507630OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1507630RevenueNotRptdOnFinStmt
Total Revenue Per Form990130071935TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt131444993TotExpensesEtcAuditedFinclStmt
Expenses Subtotal131444993ExpensesSubtotal
Other Expenses Not Included-68082OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt-68082ExpensesNotRptdOnFinStmt
Total Expenses Per Form990131376911TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
X,2FOOTNOTE 1,R 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 the effect, if any, of income tax positions only if those positions are more likely than not of being sustained. Recognized income tax positions are measured at the largest amount that is greater than 50 likely of being realized. Changes in recognition or
X,2measurement are reflected in the period in which the change in judgment occurs. The Hospital has no uncertain tax positions at December 31, 2010 or 2009.
XI8,Not included in Revenue or Expenses on Lines 1 2, but included as adjustments to net assets on the Hospitals consolidtated financial statements are Restricted Gifts and Grants 1,483,575, which are adjustments to Temporarily and Permanently Restricted Net Assets Revenue received from a related organization - Kaaterskill Commons, Inc.- which is eliminated upon consolidation 60,000 the net loss from Kaaterskill Commons, Inc. which is included in the Hospitals consolidated financial
XI8statements 44,732, and the net worth of a related organization which is not recorded on the Hospitals books -12,595.
XII4b,Not included in Revenue on Part XII, Line 3, but included as revenue on the Hospitals consolidated financial statements are Restricted Gifts and Grants 1,483,575, which are adjustments to Temporarily and Permanently Restricted Net Assets Revenue from Kaaterskill Commons, Inc., a consolidated entity 36,650 and the net worth of a related organization which is not recorded on the Hospitals books -12,595.
VIII4b.Not included in Expenses on Part XIII, Line 3, but included as expenses on the Hospitals consolidated financial statements are the expenses for Kaaterskill Commons, Inc., a conlosidated entity 68,082.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense340641TotalCommunityBenefitExpense
Net Community Benefit Expense340641NetCommunityBenefitExpense
Percent Of Total Expense0.00260PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense27533519TotalCommunityBenefitExpense
Direct Offsetting Revenue21526381DirectOffsettingRevenue
Net Community Benefit Expense6007138NetCommunityBenefitExpense
Percent Of Total Expense0.04570PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense27874160TotalCommunityBenefitExpense
Direct Offsetting Revenue21526381DirectOffsettingRevenue
Net Community Benefit Expense6347779NetCommunityBenefitExpense
Percent Of Total Expense0.04830PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense360049TotalCommunityBenefitExpense
Direct Offsetting Revenue42024DirectOffsettingRevenue
Net Community Benefit Expense318025NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense360049TotalCommunityBenefitExpense
Direct Offsetting Revenue42024DirectOffsettingRevenue
Net Community Benefit Expense318025NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense28234209TotalCommunityBenefitExpense
Direct Offsetting Revenue21568405DirectOffsettingRevenue
Net Community Benefit Expense6665804NetCommunityBenefitExpense
Percent Of Total Expense0.05070PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense115970TotalCommunityBuildingExpense
Net Community Building Expense115970NetCommunityBuildingExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense115970TotalCommunityBuildingExpense
Net Community Building Expense115970NetCommunityBuildingExpense
Percent Of Total Expense0.00090PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$4,041,186BadDebtExpenseAmount
Amount Attributable To2020593AmountAttributableTo
Amount Reimbursed By Medicare50615152AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare47927514CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall2687638MedicareSurplusOrShortfall
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursOtherOther
Columbia Memorial Hospital
171 Prospect AvenueHudsonNY12534XXX
Kaaterskill Care Skilled Nursing & Rehab
2161 Jefferson HeightsCatskillNY12414Skilled Nursing Facility

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrgOther Compensation Filing OrgOtherCompensationFilingOrg
Ananthakrishnan Ramani MD
25205512000010750382805387398
Jane Ehrlich
3960246490420946569205770705121664
Jay Cahalan
28605868783518344137194168487044
Vincent J Dingman III
20360850000383752959803074313997
Christopher Gorcznyski MD
605977605977568451
Andrew Packard MD
45161999915551534527446
Monoj Subudhi MD
492328750493078503708
Karuvath Enu MD
39016937850428019428930
Louis DiGiovanni MD
419212419212415565
George F Davis MD
113697113697117694
V Richard Back MD
66476647

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeased
Columbia County Industrial Development Agency
141636496197511AR92008-01-3011730000Refinancingfalse
Columbia County Capital Resource Corp
271072117197505AA82010-03-0112945000Refinancing New Constructionfalse

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds11730000TotalProceeds
Issuance Costs From Proceeds603669IssuanceCostsFromProceeds
Working Capital Expenditures3815256WorkingCapitalExpenditures
Capital Expenditures7273421CapitalExpenditures
Amount Unspent37654AmountUnspent
Year Of Subst Completion2010YearOfSubstCompletion
Current RefundingfalseCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsTerm Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminatedGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
HSBC
falsetruetrue0000000010.000000000000falsefalsefalsefalsefalse
HSBC
falsetruetrue0000000010.000000000000falsefalsefalsefalsefalse

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
James Reynolds
Board Trustee371480Refer to Schedule L, Part V.false
David Ginsberg
Board Trustee695143Refer to Schedule L, Part V.false

Form990 Schedule L Part V Form990ScheduleLPartV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
IV,1James Reynolds, a Columbia Memorial Hospital Board Trustee, is also President of Mid-Hudson Cablevision and Mid-Hudson Media. Those companies provided 74,163 in cable internet access to various locations belonging to the Hospital. Mr. Reynolds is also on the Board of Directors of Tech Valley Communications whom provided 297,317 in communications equipment to the Hospital.
IV,2David Ginsberg, a Columbia Memorial Hospital Board Trustee, is also the Owner, President CEO of Ginsbergs Foods, Inc. His company provided 695,143 in food, paper products, etc. during 2010

Schedule M IRS990ScheduleM

Clothing And Household Goods ClothingAndHouseholdGoods

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F99036460NoncashContribsRptdF990
Method Of Determining RevenuesSelling priceMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990 PART III- STATEMENT OF PROGRAM SERVICE, LN.4d, OTHER Total of Other Operating Revenue of 2,695,436 to include Government Grants 1,847,768 Funds from related organizations 687,869 Smaller contributions 45,598 A non-cash donation reported on Schedule B 36,460.
Form 990 PART VISECTION B, POLICIES, LN. 11a - GOVERNING BODYS REVIEW OF FORM 990 The 990 and its supporting schedules are presented to the finance Committee by the Chief Financial Officer of Columbia Memorial Hospital. The Finance Committee is comprised of select members of the Board of Trustees who after review of the documents, present the same to all members of the Board of Trustees.
FORM 990 PART VISECTION B, POLICIES, LN. 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.
FORM 990 PART VISECTION B, POLICIES, LN.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 members of the Board of Trustees who may employ outside consultants, use data industry standards, etc. to formulate conculusions.
FORM 990 PART IV,SECTION C, DISCLOSURE - LN.19 Columbia Memorial Hospital makes its governing documents, conflict of interest policy and financial statements available to the public upon request.
Form 990 Part III Program Service AccomplishmentsProgram Service Expenses 2,347,508, Grants and allocations 0, Revenue 2,695,436 Miscellaneous Ancillary servicesLine 4d Other Activities
Form 990, Part III, Line 4d Program Service Expenses 2,347,508, Grants and allocations 0, Revenue 2,695,436 Miscellaneous Ancillary services FORM 990 PART III - STATEMENT OF PROGRAM SERVICE, LN.4d, OTHER Total of Other Operating Revenue of 2,695,436 to include Government Grants 1,847,768 Funds from related organizations 687,869 Smaller contributions 45,598 A non-cash donation reported on Schedule B 36,460. Form 990 PART VI SECTION B, POLICIES, LN. 11a - GOVERNING BODYS REVIEW OF FORM 990 The 990 and its supporting schedules are presented to the finance Committee by the Chief Financial Officer of Columbia Memorial Hospital. The Finance Committee is comprised of select members of the Board of Trustees who after review of the documents, present the same to all members of the Board of Trustees. FORM 990 PART VI SECTION B, POLICIES, LN. 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. FORM 990 PART VI SECTION B, POLICIES, LN.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 members of the Board of Trustees who may employ outside consultants, use data industry standards, etc. to formulate conculusions. FORM 990 PART IV, SECTION C, DISCLOSURE - LN.19 Columbia Memorial Hospital makes its governing documents, conflict of interest policy and financial statements available to the public upon request.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
Columbia-Greene Hospital Foundation
71 Prospect AvenueHudsonNY12534141761112Fund RaisingNY501c3170b1AivN/Afalse
The Second Show Inc
519 Warren StreetHudsonNY12534141796715Thrift ShopNY501c3170b1AivN/Afalse

Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
Columbia Medical Complex LLC
839 North Jefferson StreetMilwaukeeWI53202201017545HealthcareWIN/ARelatedfalsefalse
Tri-Way Interventional LLC
c/o 71 Prospect AvenueHudsonNY12534320041811HealthcareNYN/ARelatedfalsefalse41253141140.33340
Capital Health Network LLC
125 Wolf RoadAlbanyNY12205141794727HealthcareNYN/AInvestmentfalsefalse
United Lab Network LLC
125 Wolf RoadAlbanyNY12205141827292HealthcareNYN/AInvestmentfalsefalse
United Lab Network IPA LLC
125 Wolf RoadAlbanyNY12205141832018HealthcareNYN/AInvestmentfalsefalse

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Columbia-Greene Services IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1c/o CMH 71 Prospect AvenueAddressLine1
CityHudsonCity
StateNYState
ZIP Code12534ZIPCode
FieldValueIRS element (for citing)
EIN141758524EIN
Primary ActivityHealthcarePrimaryActivity
Legal Domicile StateNYLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityC CorpTypeOfEntity
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Columbia-Greene Hospital Foundation
c700464
Columbia-Greene Hospital Foundation
l57798
Columbia-Greene Hospital Foundation
m
Columbia-Greene Hospital Foundation
p192919
The Second Show Inc
p70266