COLUMBUS COLONY FOR ELDERLY CARE INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: COLUMBUS COLONY FOR ELDERLY CARE INC (EIN 31-0951208)
Tax period: 2010-01-01 to 2010-12-31
Filed: 2011-06-27
IRS object ID: 201121789349300552
Schema version: 2010v3.2
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	2011-06-27T07:52:26-07:00	Timestamp
Tax Period End Date	2010-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	WILLIAM POWELSON	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	2010-01-01	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	RICHARD HUEBNER	Name
Title	PRESIDENT	Title
Phone	6148915055	Phone
Date Signed	2011-05-09	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Name	WILLIAM POWELSON	Name
Phone	6144814409	Phone
Self Employed	X	SelfEmployed

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-02-24 21:20:13Z	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	9761313	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	268	TotalNbrEmployees
Total Nbr Volunteers	4	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	3274	ContributionsGrantsPriorYear
Contributions Grants Current Year	3839	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	8957923	ProgramServiceRevenuePriorYear
Program Service Revenue CY	9729047	ProgramServiceRevenueCY
Investment Income Prior Year	6319	InvestmentIncomePriorYear
Investment Income Current Year	1889	InvestmentIncomeCurrentYear
Other Revenue Prior Year	22997	OtherRevenuePriorYear
Other Revenue Current Year	26538	OtherRevenueCurrentYear
Total Revenue Prior Year	8990513	TotalRevenuePriorYear
Total Revenue Current Year	9761313	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	4970986	SalariesEtcPriorYear
Salaries Etc Current Year	4849442	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	4395351	OtherExpensePriorYear
Other Expenses Current Year	4888607	OtherExpensesCurrentYear
Total Expenses Prior Year	9366337	TotalExpensesPriorYear
Total Expenses Current Year	9738049	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-375824	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	23264	RevenuesLessExpensesCY
Total Assets BOY	5162222	TotalAssetsBOY
Total Assets EOY	5742965	TotalAssetsEOY
Total Liabilities BOY	4148471	TotalLiabilitiesBOY
Total Liabilities EOY	4705950	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	1013751	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	1037015	NetAssetsOrFundBalancesEOY
Mission Description	Provide skilled nursing care for the elderly - specialized in	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	8964154	Expense
Revenue	9761313	Revenue
Description	LONG TERM CARE -SKILLED NURSING HOME - 150 BEDS	Description
Total Program Service Expense	8964154	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
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	7	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	268	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
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	85138	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	85138	TotalReportableCompFromOrg
Number Individuals GT100 K	0	NumberIndividualsGT100K
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	494620	Compensation

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	1	NumberOfContractorsGT100K
All Other Contributions	3839	AllOtherContributions
Total Contributions	3839	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	Routine/ancilliary	Description
Business Code	623000	BusinessCode
Total Revenue Column	9729047	TotalRevenueColumn

Field	Value	IRS element (for citing)
Total Program Service Revenue	9729047	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1889	TotalRevenueColumn
Exclusion	$1,889	ExclusionAmount

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	Miscellaneous	Description
Business Code	623000	BusinessCode
Total Revenue Column	26538	TotalRevenueColumn
Related Or Exempt Function Income	26538	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	26538	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	9761313	TotalRevenueColumn
Related Or Exempt Function Income	9755585	RelatedOrExemptFunctionIncome
Exclusion	$1,889	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	116118	Total
Program Services	0	ProgramServices
Management And General	116118	ManagementAndGeneral
Fundraising	0	Fundraising

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	4546546	Total
Program Services	4247502	ProgramServices
Management And General	299044	ManagementAndGeneral
Fundraising	0	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	123375	Total
Program Services	123375	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	63403	Total
Program Services	63403	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	22477	Total
Program Services	0	ProgramServices
Management And General	22477	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	54823	Total
Program Services	0	ProgramServices
Management And General	54823	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	82000	Total
Program Services	0	ProgramServices
Management And General	82000	ManagementAndGeneral
Fundraising	0	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	76693	Total
Program Services	0	ProgramServices
Management And General	76693	ManagementAndGeneral
Fundraising	0	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	29620	Total
Program Services	0	ProgramServices
Management And General	29620	ManagementAndGeneral
Fundraising	0	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	48843	Total
Program Services	0	ProgramServices
Management And General	48843	ManagementAndGeneral
Fundraising	0	Fundraising

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	214832	Total
Program Services	214832	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	2617	Total
Program Services	0	ProgramServices
Management And General	2617	ManagementAndGeneral
Fundraising	0	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	205489	Total
Program Services	205489	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	290904	Total
Program Services	290904	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	100357	Total
Program Services	100357	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Management And GeneralManagementAndGeneral
Bad debts	29	29
Comunications	21427	21427
Employee Screening	4780	4780
Copier	3618	3618
Dues/subscriptions	10345	10345

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	3719753	Total
Program Services	3718292	ProgramServices
Management And General	1461	ManagementAndGeneral
Fundraising	0	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	9738049	Total
Program Services	8964154	ProgramServices
Management And General	773895	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	193506	BOY
EOY	151428	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	666596	BOY
EOY	1095867	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	27381	BOY
EOY	42630	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	8640664	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	4755317	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	3438494	BOY
EOY	3885347	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	812911	BOY
EOY	544359	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	5162222	BOY
EOY	5742965	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	1063567	BOY
EOY	1501536	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	3023253	BOY
EOY	3157549	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	61651	BOY
EOY	46865	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	4148471	BOY
EOY	4705950	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1013751	BOY
EOY	1037015	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	1013751	BOY
EOY	1037015	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	5162222	BOY
EOY	5742965	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	23264	ReconcilationRevenueExpenses
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
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	22045	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	39264	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	3765	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	3274	CurrentTaxYearMinus1Year
Current Tax Year	3839	CurrentTaxYear
Total	72187	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	8876971	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	9012233	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	8782743	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	8957923	CurrentTaxYearMinus1Year
Current Tax Year	9729047	CurrentTaxYear
Total	45358917	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	8899016	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	9051497	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	8786508	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	8961197	CurrentTaxYearMinus1Year
Current Tax Year	9732886	CurrentTaxYear
Total	45431104	Total

Field	Value	IRS element (for citing)
Public Support Total509	45431104	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	41340	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	42018	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	16399	CurrentTaxYearMinus2Years
Current Tax Year	1889	CurrentTaxYear
Total	101646	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	41340	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	42018	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	16399	CurrentTaxYearMinus2Years
Current Tax Year	1889	CurrentTaxYear
Total	101646	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Total	45532750	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.99780	PublicSupportPercentage509
Prior Year Support Percentage	0.99710	PriorYearSupportPercentage
Investment Income Percentage	0.00220	InvestmentIncomePercentage
Prior Yr Invest Income Percentage	0.00290	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	5395503	OtherCostOrOtherBasis
Depreciation	2444002	Depreciation
Book Value	2951501	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	502766	OtherCostOrOtherBasis
Depreciation	374723	Depreciation
Book Value	128043	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2393262	OtherCostOrOtherBasis
Depreciation	1784726	Depreciation
Book Value	608536	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	160332	OtherCostOrOtherBasis
Depreciation	151866	Depreciation
Book Value	8466	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	3885347	TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescription	Book ValueBookValue
Resident funds	46865
Mortgage escrow deposits	101691
Replacement reserve fund	320282
Residual receipts fund
Deferred financing costs	74521
Other assets	1000

Field	Value	IRS element (for citing)
Total Book Value Other Assets	544359	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	Resident personal funds	Description
Amount	$46,865	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	46865	TotalOfAmounts
Total Revenue	9761313	TotalRevenue
Total Expenses	9738049	TotalExpenses
Excess Or Deficit For Year	23264	ExcessOrDeficitForYear
Excess Or Deficit Per FS	23264	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	9761313	TotRevenueEtcAuditedFinclStmt
Revenue Subtotal	9761313	RevenueSubtotal
Total Revenue Per Form990	9761313	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	9738049	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	9738049	ExpensesSubtotal
Total Expenses Per Form990	9738049	TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifier	ExplanationExplanation
Pt VI-C, Line 19	Upon request
Pt VI-B, Line 11a	Form 990 reviewed at Board meeting
Pt VI-A, Line 6	Elected Board
Pt VI-A, Line 7a	Elected Board
Pt VI-A, Line 7b	Board resolutions voted upon
Pt VI-B, Line 15	Board reviews compensation in relation to nursing home
	administrators
Form 990, Part IX, Line 24f	LICENSE 175. 0. 175. 0. OTHER 1286. 0. 1286. 0. MAINT. CONTRACTS 66590. 66590. 0. 0. MAINT. SUPPLIES 58799. 58799. 0. 0. GOVT MANADATED FEES 658854. 658854. 0. 0. DIETARY PURCHASED SERVICE 32807. 32807. 0. 0. FOOD 339911. 339911. 0. 0. DIETARY SUPPLIES 57359. 57359. 0. 0. HOUSKEEPING SUPPLIES 51526. 51526. 0. 0. OTHER MEDICAL 14319. 14319. 0. 0. MEDICAL SUPPLIES 82477. 82477. 0. 0. PHARMACY PURCHASED SERV. 9175. 9175. 0. 0. LAUNDRY/LINEN 13491. 13491. 0. 0. LAUNDRY SUPPLIES 7462. 7462. 0. 0. ACT

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
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	false	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	true	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	1q	TransactionType
Amount Involved	82000	AmountInvolved
Method Of Amt Determination	cost	MethodOfAmtDetermination