2011-05-13T14:59:10-05:00 2010-06-30 Pershing Yoakley & Associates P C One Cherokee Mills 2220 Sutherland Knoxville TN 379192363 990 2009-07-01 581501642 COLUMBUS REGIONAL MEDICAL FOUNDATION INC COLU 7066606303 707 CENTER STREET COLUMBUS GA 31901 Roland L Thacker 7065711927 2011-05-13 1 8656730844 2009 2016-02-24 21:20:13Z Larry S Sanders 707 CENTER STREET COLUMBUS GA 31901 3216351 0 X COLUMBUSREGIONAL.COM X 1983 GA THE MISSION OF COLUMBUS REGIONAL Medical Foundation, INC. IS TO PROMOTE THE HEALTH AND HEALING OF OUR PATIENTS. 33 32 0 2 0 0 2890777 2383657 0 -530332 -39285 263880 211013 2624325 2555385 1344718 1030173 0 287151 303664 0 589416 584534 680744 2216403 2014581 407922 540804 8749330 10490189 44484 201544 8704846 10288645 THE COLUMBUS REGIONAL MEDICAL FOUNDATION, INC. (THE "FOUNDATION") IS A NOT-FOR-PROFIT FOUNDATION established TO ENDOW AND PROMOTE THE MEDICAL, CHARITABLE AND EDUCATIONAL SERVICES OF THE MEDICAL CENTER. PRIMARY FUNCTIONS OF THE FOUNDATION INCLUDE FUND-RAISING TO SUPPORT THE JOHN B. AMOS CANCER CENTER AT THE MEDICAL CENTER AND THE CHILDREN'S MIRACLE NETWORK, TO SUPPORT CLINICAL EDUCATION THROUGH STUDENT SCHOLARSHIPS AND FELLOWSHIPS, AND TO PROVIDE FUNDING FOR THE MEDICAL CENTER TO PURCHASE HEALTH, MEDICAL AND RELATED EQUIPMENT TO BENEFIT PATIENTS AND ENHANCE SERVICES TO THE COMMUNITY. 0 0 167256 167256 JOHN B. AMOS CANCER CENTERIn 1989, the Foundation launched a $3 million capital campaign to develop and equip a comprehensive community cancer center at The Medical Center. The Foundation committed $2.3 million in advanced diagnostic and treatment equipment and $700,000 to support patient, family and community education. In 2002, the Foundation launched a $20 million campaign to build a free-standing John B. Amos Cancer Center. The new facility opened in early 2005. The center offers advanced diagnostic and treatment services, patient and family support services, and a growing clinical oncology research program. The Foundation also supports continuing education programs for physicians, nurses and allied health professionals who treat cancer patients and their families.In support of the John B. Amos Cancer Center, the Foundation hosts the Celebrity Classic which features two signature events, golf and tennis and also includes 5K and 10K runs and the Wheels to Heal Bike Ride. This event not only features events for adults but also brings in the youth of the area to take advantage of the opportunity to learn from great tennis and golf pros in juniors' clinics in each event. 147816 147816 CLINICAL EDUCATIONThe Columbus Regional Medical Foundation is responsible for the administration of various scholarship and fellowship funds to support the continuing education of health care personnel at The Medical Center and to provide financial support to students enrolled in the study of health sciences. - The Bunch McClellan Nursing Scholarship Support to nursing students is provided through this scholarship, which was established in 1978 to honor the long-time director of The Medical Center's School of Nursing. Eight scholarships were awarded during fiscal year 2010.- The Fred Aranas Memorial Scholarship Established in 1988 in memory of local radiologist Dr. Fred Aranas, the scholarship provides support to students enrolled in the radiologic technology program at Columbus Technical College. Other funds administered through the Foundation include:- The A. Beaty Pemberton ScholarshipEstablished in 1988 in honor of a local physician, the scholarship supports students enrolled in professional respiratory therapy programs. - The Sue Schley Mathews Pediatric FellowshipThe fund was established in 1986 to honor a local pediatric nurse and provide clinical training opportunities for nurses in The Medical Center's high-risk nursery and Labor and Delivery. Since 1996 the fund has been used to underwrite the Sue Schley Mathews Pediatric Nursing Conference hosted by The Medical Center's Women's and Children's Services department.- The Dorothy Freeman ScholarshipAlso established in 1993, the scholarship fund was created in memory of a past director of The Medical Center's former School of Radiologic Technology. The scholarship provides financial assistance to students in the radiologic technology program at Columbus Technical College. -The Simon Schwob Medical Library FundFunds are used to support the advanced research and information services provided through The Medical Center's library, which is one of the largest hospital-based libraries in the southeast. The fund was established in 1948 to honor a prominent Columbus manufacturer. The library houses a current journals collection, textbooks, monographs and bound journals in its permanent collection. The library also has a CD-Rom system that provides immediate access to a vast database of reference materials, and direct access to the Internet.- The John Watson Oncology Education FundThis fund was established in 1995 in recognition of the accomplishments and contributions of a retired physician who pioneered the development of radiation therapy services in the region. It provides financial assistance to oncology professionals for continuing education.- The William G. Love Surgery Library FundThe fund was established in 1993 with a gift from a former patient of the Columbus surgeon for whom the fund is named. Funds are used to enhance the surgical reference collection at the Simon Schwob Medical Library.- The High-Risk Nursery FundEstablished in 1983, the fund supports the capital equipment and patient care needs of The Medical Center's infant intensive care program.- The Mary Marler Development FundThis fund was created through the transfer of assets when the Columbus Developmental Center dissolved. Funds are used to further education in the area of developmental disabilities.- The Charles Stamey, M.D. OB/GYN Lectureship FundThis fund was established by a benefactor in 2003 in honor of Charles Stamey, M.D. The lectureship program would be focused in the areas of obstetrics, gynecology, perinatology, neonatology or pediatrics.- The Fran Branch Memorial Education GrantThis grant was established by friends and family of Fran Branch to provide an on-going source of funds for continuing medical education for staff members of the John B. Amos Cancer Center.- The Health Education FundThis fund was established in 1993 to support advanced training for health care providers.- The Children's Health Fund This fund was established in 1993 in support of pediatric and infant needs at The Medical Center.- Women's Medical Services FundEstablished in 1983, this fund supports continuing education needs of the OB/GYN Department at The Medical Center.- Family Practice Development FundEstablished in 1992, this fund was established to support the Family Practice Residency Program at The Medical Center.- The Blanchard Memorial FoundationThis fund, established in 1983, supports pediatric research and education.- The Pharmacy Research and Education FundThe Fund was transferred from The Medical Center to the Foundation by the Department of Pharmacy for the purchase of equipment, supplies or services to support the practice, research or educational endeavors of the department.- The Internal Medicine Book FundEstablished in 1996, funds are used to purchase internal medicine books and periodicals for the Medical Library at The Medical Center. 393378 393378 CHILDREN'S MIRACLE NETWORKIn keeping with its tax-exempt mission, the Columbus Regional Medical Foundation continues to seek and develop opportunities to enhance the quality of care available to the community it serves. In August 1995, The Medical Center affiliated with the international Children's Miracle Network. The local program is administered through the Foundation. All funds raised in an 18-county area through various fundraising events benefit pediatric programs and services at The Medical Center. Since 1995, over $3 million has been raised through the Children's Miracle Network to benefit children receiving care at The Medical Center. During fiscal year 2010, some of the major Children's Miracle Network fundraising events were the Snake Eyes, Reindeer Run for Kids, Miracle Friday, and Scott's Ride for Miracles. These four events raised approximately $694,000 to help provide specialized services and equipment for pediatric programs at The Medical Center. Other fundraising events were hosted by the Columbus Regional Medical Foundation to support the programs of the Children's Miracle Network. 391189 321723 Other programs and fundraising conducted to support The Medical Center and its services. 391189 321723 1099639 1 1 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 1 0 0 0 33 32 1 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 GA X Roland L Thacker Treasurer 7066606303 710 Center Street Columbus GA 31901 X Larry S Sanders 40.00 X X 0 1570869 639148 Sam Wellborn 2.00 X 0 0 0 Lee Brantley 2.00 X 0 0 0 Carmen Cavezza 2.00 X 0 0 0 Roy D COPELAND 2.00 X 0 0 0 Michael A Eddings 2.00 X 0 0 0 Tom Flowers 2.00 X 0 0 0 Robert George 2.00 X 0 0 0 W Lloyd Hudson Jr MD 2.00 X 0 0 0 Carolyn Hugley 2.00 X 0 0 0 Ruby Jackson 2.00 X 0 0 0 George W Jeter 2.00 X 0 0 0 Joey Loudermilk 2.00 X 0 0 0 ANDREW MARKS SR 2.00 X 0 0 0 Chris Martin 2.00 X 0 0 0 Jerry Newman 2.00 X 0 0 0 ALLEN OWEN III 2.00 X 0 0 0 Beth Parsons 2.00 X 0 0 0 Mary Sue Polleys 2.00 X 0 0 0 Ben Richardson 2.00 X 0 0 0 Kenneth A Roberts 2.00 X 0 0 0 Mary Schley MD 2.00 X 0 0 0 Murray Solomon 2.00 X 0 0 0 Franklin J Star MD 2.00 X 0 0 0 Warren Steele 2.00 X 0 0 0 Henry W Swift Jr 2.00 X 0 0 0 Richard B Swift 2.00 X 0 0 0 Teresa Pike Tomlinson 2.00 X 0 0 0 Melissa Thomas 2.00 X 0 0 0 John Turner 2.00 X 0 0 0 Mike Venable 2.00 X 0 0 0 Will White 2.00 X 0 0 0 Rebecca Yarbrough 2.00 X 0 0 0 Lance B Duke 40.00 X 0 470327 83023 Roland L Thacker 40.00 X 0 373107 54252 Thomas Titus 40.00 X 0 266832 28271 Karen Smith 40.00 X 0 72827 16363 0 2753962 821057 0 0 1 0 Solomon Smith Barney 945 Broadway Columbus GA 31901 Investment Services 645036 1 217315 370000 1796342 93140 2383657 263211 263211 302496 -302496 -302496 -302496 569483 217315 358470 211013 211013 2555385 0 0 171728 1016173 1016173 14000 14000 224768 47169 177599 3266 686 2580 60048 14397 45651 15582 2957 12625 26014 26014 409352 409352 29720 29720 112439 4069 56676 51694 90 90 3476 1469 2007 590 590 1063 1063 883 883 Professional Dues 73930 73930 Equipment Rental 22713 22713 Sales Tax 188 188 Non-Capitalized Equipme 175 175 111 111 2014581 1099639 325526 589416 204279 319995 273045 191766 69217 117792 28346 19415 31465 31274 1254 191 8173189 9841030 8749330 10490189 44484 201544 44484 201544 X 1683179 2675429 7021667 7613216 8704846 10288645 8749330 10490189 X 0 1 1 X 0 X 3624405 2954293 2192590 2890777 2290517 13952582 3624405 2954293 2192590 2890777 2290517 13952582 4995781 8956801 618045 1790771 415370 713623 263211 3801020 17753602 1471165 0.50450 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 31169 31169 515180849 515212018 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 19908 24849 21646 31169 97572 250000 250000 250000 250000 1000000 1500000 7021667 1610260 1035802 886299 1168214 7613216 7131525 2280411 -1190665 1304714 -105110 7021667 1.00000 0 0 31465 31274 191 191 Part V, Line 4: Description of Intended Use of Endowment Funds: Operations of The Medical Center Part X: Description of Uncertain Tax Positions Under FIN 48: The organization is exempt from federal income taxes under Section 501(a)as an organization described in Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. At June 30, 2010, management does not believe the organization holds any uncertain tax positions that would require financial statement recognition or disclosure under ASC 740. Celebrity Classic 533938 122686 411252 69670 27336 6468 156921 Breast Cancer Event 67325 4105 63220 39910 5 185535 90524 95011 58165 786798 217315 569483 69670 27336 6468 254996 358470 211013 1 The Medical Center Inc 710 Center St Columbus GA 31901 581685139 501(c)(3) 865974 To Support programs of The Medical Center, Inc. Auburn Univ - School of Nursing 133 Miller Hall Auburn AL 36849 636022422 501(c)(3) 39249 To Support nursing programs of the Unviersity. School of Radiology - Cols Tec 928 Manchester Expwy Columbus GA 31904 581873978 501(c)(3) 6400 To Support the profession of Radiology Columbus Technical Institute 928 Manchester Expwy Columbus GA 31904 581873978 501(c)(3) 100000 To Support nursing programs of the Institute 4 Bunch McClellan Scholarships 8 14000 Health Studies Scholarships Other Information: Part IV: Part I - Line 2 -- Columbus Regional Healthcare System, Inc. and its affiliates acknowledge their responsibility as good corporate citizens to support worthwhile activities, services and efforts in the community, state and nation. To effectively carry out that responsibility and ensure its resources for this purpose are used in ways which are of lasting value and importance, certain procedures have been established to appropriately allocate corporate resources to outside agencies, organizations and efforts. All gifts or donations or money or other resources of the system must be approved by Columbus Regional. The total amounts of funds set aside for purposes of donation or contribution to outside organizations is established annually during the corporate budget process and the amount may vary from year to year. The management of Columbus Regional Healthcare System, Inc. is required to establish criteria and standards to assist in allocating resources. A community service committee shall be established to review certain requests and make recommendations on the appropriateness and level of support to be considered. The committee shall be chaired by the Senior Vice President of Marketing and shall be comprised of the following individuals: Manager of Marketing and Communications, Columbus Regional Director of Pastoral Care, Columbus Regional President of The Medical Center, Inc., and the Senior Vice President of Physician Services. 0 1 0 0 0 0 0 0 0 Larry S Sanders 0 514542 0 52084 0 1004243 0 623075 0 16073 0 2210017 0 527520 Lance B Duke 0 346247 0 64853 0 59227 0 65075 0 17948 0 553350 0 254665 Roland L Thacker 0 288992 0 53662 0 30453 0 40975 0 13277 0 427359 0 123676 Thomas Titus 0 171904 0 32197 0 62731 0 20875 0 7396 0 295103 0 134628 Part I, Line 4a Employer contribution to 457(f) executive retirement benefit plan Larry Sanders $587,000 Lance Duke $ 44,400 Roland Thacker $ 22,000 Supplemental Information Part III Part II, Column C Larry Sanders - During 2009, CRHS (and affiliates) terminated an existing deferred compensation arrangement for Mr. Sanders that resulted in a total payout to him of $953,513. Mr. Sanders has been an officer of the organization or its predecessor since 1981 and has served as Chairman and CEO since 1989. Compensation in the amount of $527,520 has been reported in previous Forms 990 associated with the terminated arrangement. A new arrangement was adopted subsequent to the termination of the prior arrangement. The payout from the previous arrangement was actuarially considered (as a reduction in benefits) in the design of the new deferred compensation plan. X Gifts in Kind 20 93140 FMV of Similar items 0 1 0 Form 990, Part VI, Section A, line 2 Henry Swift, board member, is the father of Richard Swift, board member. Form 990, Part VI, Section A, line 6 The Board of Directors of columbus regional medical foundation, Inc. is appointed by the Board of Columbus Regional Healthcare System, Inc. - a related 501(c)(3) organization. Form 990, Part VI, Section A, line 7a The Board of Directors of columbus regional medical foundation, Inc. is appointed by the Board of Columbus Regional Healthcare System, Inc. - a related 501(c)(3) organization. Form 990, Part VI, Section A, line 7b The Board of Directors of columbus regional medical foundation, Inc. is appointed by the Board of Columbus Regional Healthcare System, Inc. - a related 501(c)(3) organization. Form 990, Part VI, Section B, line 11 Information for Form 990 was provided to an independent CPA firm for preparation of return. After return was prepared it was reviewed by the treasurer of the organization. Currently, a copy of the Form 990 is not provided to the governing body prior to filing. The organization is currently reviewing this process. Form 990, Part VI, Section B, line 12c It is the policy of Columbus Regional that employees and agents cannot participate in any activities that conflict with, or appear to conflict with, their professional responsibilities to the organization. It is the policy of Columbus Regional to provide mechanisms by which employees, medical staff,and other associates of the organization may report suspected violations of government laws or corporate policies without fear of retaliation or termination of employment. Employees and agents have a responsibility to report suspected violations, provided they are reporting in good faith and have evidence to support their suspicion. Columbus Regional encourages the development of an "open door" policy by managers to welcome comments, concerns and questions from their employees and agents. Suspected Conflict of Interest violations may be reported to managers or supervisors. Violations may also be reported to the Corporate Compliance Officer (by phone, e-mail or in person), by completing a form, or by contacting the Compliance Helpline. If an individual is hesitant about using any of these reporting mechanisms, he/she may contact Columbus Regional's Chairman and Chief Executive Officer. All reports of suspected violations are investigated in a prompt and reasonable manner by the Corporate Compliance Officer or, as appropriate, by a member of the Corporate Compliance Committee. An inherent and important part of Columbus Regional's corporate compliance program involves measuring the effectiveness of the program in adhering to specific governmental regulations, corporate policies and business ethical standards. At the designation of management, compliance activities are reviewed. The Corporate Compliance Officer ensures that the results of compliance-related audits, Helpline activity, employee compliance activities and other compliance issues deemed relevant are reported on a periodic basis to Columbus Regional's CEO and Finance and Planning Committee. Form 990, Part VI, Section B, line 15 Columbus Regional takes very seriously the responsibility to appropriately and effectively manage the executive compensation and benefits program for its key executives. Setting the compensation of the Chairman and Chief Executive Officer, approving the compensation of other senior executives, and overseeing the executive compensation program as a whole, are the responsibilities of the compensation committee of the board. Columbus Regional has had a compensation committee for many years. The committee is currently chaired by a 20+ year board member. To assist the committee, the board has engaged the services of a nationally recognized executive compensation consulting firm. Columbus Regional's executive compensation program is designed to attract and retain highly qualified executives to fulfill Columbus Regional's mission of promoting the health and healing of patients. Columbus Regional's peer group consists of non-profit healthcare organizations of similar size and complexity from across the nation. Base salaries of executives are positioned at specific percentile targets of Columbus Regional's peer group. Current studies indicate that our base salaries are at targeted levels. Columbus Regional strives to provide all executives with retirement benefits that are equivalent for all employees. Retirement contributions are based on a clearly stated income replacement target as determined by retirement plan consultants. The goal of Columbus Regional is to provide market competitive compensation and benefits programs for all employees at all levels of the organization. Form 990, Part VI, Section C, line 19 The conflict of interest policy, in addition to other corporate and governing policies, is not made available to the public. 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