2011-11-14T16:58:37-06:00 2010-12-31 PLANTE & MORAN PLLC 65 EAST STATE ST STE 600 COLUMBUS OH 43215 990 2010-01-01 310679012 COLUMBUS MEDICAL ASSOCIATION FOUNDATION COLU 6142407410 431 EAST BROAD STREET COLUMBUS OH 43215 X 6142407410 2011-11-14 1 BERNIE OSTROWSKI 6148493000 2010 2016-02-24 21:20:13Z PHILIP CASS 431 EAST BROAD STREET COLUMBUS OH 43215 2908510 0 X WWW.GOODHEALTHCOLUMBUS.ORG X 1958 OH THE COLUMBUS MEDICAL ASSOCIATION FOUNDATION EXISTS TO EFFECT CHANGE WITHIN SPECIFIC PRIORITY AREAS TO IMPROVE THE HEALTH OF ALL CENTRAL OHIO RESIDENTS. 18 18 15 18 0 0 214047 138370 92411 121020 1889820 2326947 39020 318478 2235298 2904815 1314242 1067625 0 0 906677 901592 0 0 219904 704268 773408 2925187 2742625 -689889 162190 65561151 71821410 994713 1029470 64566438 70791940 X THE COLUMBUS MEDICAL ASSOCIATION FOUNDATION EXISTS TO EFFECT CHANGE WITHIN SPECIFIC PRIORITY AREAS TO IMPROVE THE HEALTH OF ALL CENTRAL OHIO RESIDENTS. 0 0 1501079 1067625 435836 SEE SCHEDULE OTHE COLUMBUS MEDICAL ASSOCIATION FOUNDATION EXISTS TO EFFECT CHANGE WITHIN SPECIFIC PRIORITY AREAS TO IMPROVE THE HEALTH OF ALL CENTRAL PRIORITY AREAS TO IMPROVE THE HEALTH OF ALL CENTRAL OHIO RESIDENTS.PRIORITIES:- TRANSFORMING CLINICAL HEALTH CARE DELIVERY TO: BE PATIENT CENTERED, BE BASED ON HEALTH / WELLNESS PARADIGM, BE BASED ON CLEARLY DEFINED PATIENT / DOCTOR RESPONSIBILITY, BE A PARTNERSHIP BETWEEN PATIENT / DOCTOR / PAYER- SUPPORTING AND IMPROVING HEALTH CARE SAFETY NET CLINICAL SERVICES TO UNINSURED AND UNDERINSURED POPULATIONS SUCH AS SUPPORT FOR THE NEWLY CONSOLIDATED PHYSICIANS FREE CLINIC / VOLUNTARY CARE NETWORK. - SAVING AND IMPROVING LIVES THROUGH A COORDINATION OF TRAUMA AND EMERGENCY HEALTH CARE RESOURCES THROUGH SUPPORT FOR THE CENTRAL OHIO TRAUMA SYSTEM- ADVANCING THE CAPABILITIES OF MEDICAL PROFESSIONALS AND INCREASING THE DIVERSITY OF THE HEALTH CARE WORKFORCE, ESPECIALLY WITHIN PRIMARY CARE- ADVANCING LEADERSHIP CAPACITY OF YOUTH TO ENGAGE IN HEALTH PHILANTHROPY 1501079 1 1 0 0 1 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 24 0 1 15 1 0 0 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 OH X RUTHANN GARD 6142407420 431 EAST BROAD STREET COLUMBUS OH 43215 X JAMES L NICHOLS 1.00 X X 0 0 0 DWIGHT SCARBOROUGH MD 1.00 X X 0 0 0 TERESA C LONG 1.00 X 0 0 0 NEDRA HADLEY 1.00 X 0 0 0 OLIVIA THOMAS 1.00 X 0 0 0 JOYCE PENN 1.00 X 0 0 0 ANNE TAYLOR MD 1.00 X 0 0 0 LINDA SIEFKAS 1.00 X 0 0 0 RONALD BERGGREN 1.00 X 0 0 0 BEN ESPY 1.00 X 0 0 0 MARC L PARNES 1.00 X 0 0 0 WARREN W TYLER 1.00 X 0 0 0 MARK A BECHTEL MD 1.00 X 0 0 0 JEFFREY BELL MD 1.00 X 0 0 0 JENNIFER WRENN MD 1.00 X 0 0 0 EDWARD T BOPE 1.00 X 0 0 0 CLAIRE V WOLFE 1.00 X 0 0 0 M VALERIANA MOELLER 1.00 X 0 0 0 PHILIP CASS 20.00 X 0 201453 24701 JUDY D'ANDREA 23.80 X 118353 0 19649 WELDON MILBOURNE 40.00 X 112938 0 9556 231291 201453 53906 2 0 1 0 0 138370 138370 RENT FROM AFFILIATES 532000 102000 102000 PROGRAMS 900099 19020 19020 121020 2330642 2330642 3695 -3695 -3695 -3695 REIMBURSEMENTS 900099 314816 314816 INSURANCE PROCEEDS 900099 2371 2371 LITIGATION PROCEEDS 900099 1291 1291 318478 2904815 435836 0 2330609 1067625 1067625 260496 62946 160225 37325 380576 152230 190288 38058 17088 6835 8544 1709 197160 78864 98580 19716 46272 18509 23136 4627 9600 9600 30635 30635 292201 292201 25366 6536 13139 5691 130614 57372 8762 64480 23777 3539 15122 5116 8646 1288 5498 1860 127497 26663 74171 26663 3776 3776 25233 6113 13007 6113 3319 351 2617 351 73339 5867 61605 5867 7327 1532 4263 1532 DUES & SUBSCRIPTIONS 7549 796 5957 796 VOLUNTEER ACTIVITIES 4013 4013 TAXES & LICENSES 516 516 2742625 1501079 1021642 219904 379738 443934 217698 244193 15039 14884 2277025 868791 1384456 1408234 63486877 69630503 77343 79662 65561151 71821410 184610 296847 250000 560103 732623 994713 1029470 X 63639447 69460132 520238 818525 406753 513283 64566438 70791940 65561151 71821410 X 162190 6063310 X X 0 1 1 X 0 X X 0 0 0 COLUMBUS MEDICAL ASSOCIATION 314411074 501 (C)(6) 0 0 1 0 SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: THE FOUNDATION PROVIDES SUPPORT THROUGH USE OF SHARED EMPLOYEES, FACILITIES, AND REIMBURSEMENTS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 14 121948 56500 993492 1 1 636000 636000 864842 292833 572009 116956 63840 53116 453982 339709 114273 205245 172409 32836 1408234 REIMBURSEMENT TO AFFILIATES 340014 ASSETS HELD FOR OTHERS 392609 732623 1 ACCESS HEALTHCOLUMBUS 22 E GAY STREET SUITE 801 COLUMBUS OH 43215 510426050 501 (C)(3) 350000 TO SUPPORT PHASE 1 FOR PATIENT CENTER MEDICAL HOME PROJECT CENTRAL OHIO TRAUMA SYSTEM 431 E BROAD STREET COLUMBUS OH 43215 311592734 501 (C)(3) 275600 TO SUPPORT ITS 2010 CORE SERVICES COLUMBUS MEDICAL ASSOCIATION PHYSICIANS FREE CLINIC 431 E BROAD STREET COLUMBUS OH 43215 311373719 501 (C)(3) 560000 TO PROVIDE FREE PRIMARY & SPECIALTY MEDICAL CARE FOR THE UNINSURED AND UNDERSERVEDTO PROVIDE FREE PRIMARY & SPECIALTY MEDICAL CARE FOR THE UNINSURED AND UNDERSERVED FRANKLIN PARK CONSERVATORY WOMEN'S BOARD 1777 E BROAD STREET COLUMBUS OH 43203 311191469 501 (C)(3) 10000 FOR HORICULTURE & EDUCATION PROGRAMS AT THE CONSERVATORY BBB EDUCATIONAL FOUNDATION OF CENTRAL OHIO 1169 DUBLIN ROAD COLUMBUS OH 43215 300022212 501 (C)(3) 10000 FOR CENTER OF CAREER ETHICS - TORCHBEARER SPONSORSHIP TO CREATE PRO-BONO MEDICAL HEALTH CLINIC 5 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: A MEMORANDUM OF AGREEMENT IS SIGNED BETWEEN THE GRANTEE AND GRANTOR THAT DESCRIBES THE CONDITIONS FOR THE GRANT TO INCLUDE PAYMENT AND REPORTING PROCESSES. X 1 1 X X X X 0 0 0 0 0 0 0 0 0 PHILIP CASS 0 201453 0 0 0 0 0 11897 0 12804 0 226154 0 0 FORM 990, PART VI, SECTION A, LINE 6 COLUMBUS MEDICAL ASSOCIATION IS THE ORGANIZATION'S SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE AUTHORITY TO ELECT AND REMOVE DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS THE AUTHORITY TO ELECT AND REMOVE DIRECTORS AND APPROVE CHANGES IN THE BY-LAWS AND CODE OF REGULATIONS. IN ADDITION THE SOLE MEMBER HAS THE AUTHORITY TO APPROVE DECISIONS SUCH AS DISSOLVING THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 THE RETURN IS PROVIDED TO THE BOARD MEMBERS FOR THEIR REVIEW BEFORE THE RETURN IS FILED. IN ADDITION, THE RETURN IS REVIEWED BY THE COO WITH MEMBERS OF THE FINANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ANNUALLY SENDS A DISCLOSURE FORM TO ALL DIRECTORS, OFFICERS, AND KEY EMPLOYEES REQUIRING THEM TO DISCLOSE ANY CONFLICTS OF INTEREST. THOSE CONFLICTS ARE THEN ADDRESSED BY THE BOARD. VOTING AND PARTICIPATION RESTRICTIONS ARE IMPOSED ON THOSE WITH ANY CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 COLUMBUS MEDICAL ASSOCIATION AND COLUMBUS MEDICAL ASSOCIATION FOUNDATION PERFORM THE COMPENSATION REVIEWS. THE BOARD OF DIRECTORS REVIEWS THE EXECUTIVE DIRECTOR'S COMPENSATION. THEN THE EXECUTIVE DIRECTOR REVIEWS THE COMPENSATION OF ALL OF THE OFFICERS. THE BOARD ESTABLISHES COMPENSATION BASED ON AN INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD. THE LAST COMPENSATION REVIEW WAS IN 2008. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 1023 AND 990 ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VII THE HOURS DISTRIBUTION FOR RELATED ENTITIES ARE AS FOLLOWS: PHILIP CASS: A. COLUMBUS MEDICAL ASSOCIATION PHYSICIANS FREE CLINIC - 5 HOURS B. COLUMBUS MEDICAL ASSOCIATION FOUNDATION UNLIMITED - 0.1 HOURS C. COLUMBUS MEDICAL ASSOCIATION - 21.3 HOURS D. CENTRAL OHIO TRAUMA SYSTEM - 3.8 HOURS JUDY D'ANDREA: A. COLUMBUS MEDICAL ASSOCIATION PHYSICIANS FREE CLINIC - 7.5 HOURS B. COLUMBUS MEDICAL ASSOCIATION FOUNDATION UNLIMITED - 0.1 HOURS C. COLUMBUS MEDICAL ASSOCIATION - 11.3 HOURS D. CENTRAL OHIO TRAUMA SYSTEM - 7.5 HOURS CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 6,063,310. FORM 990, LINE XII, LINE 2C THE TREASURERS OF THE FILING ORGANIZATION AND ITS RELATED ENTITIES ARE MEMBERS OF THE JOINT FINANCE COMMITTEE. THIS COMMITTEE MAKES DECISIONS CONCERNING THE SELECTION OF THE INDEPENDENT AUDITORS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. COLUMBUS MEDICAL ASSOCIATION FOUNDATION UNLIMITED 431 E BROAD STREET COLUMBUS OH 43215 200385860 PROVIDING HEALTH AND WELLNESS SERVICES OH 501(C)(3) LINE 7 COLUMBUS MEDICAL ASSOCIATION 1 COLUMBUS MEDICAL ASSOCIATION 431 E BROAD STREET COLUMBUS OH 43215 314411074 ADVANCING COMMUNITY HEALTH THROUGH ADVOCACY, EDUCATION AND SERVICE OH 501(C)(6) N/A 0 CENTAL OHIO TRAUMA SYSTEM 431 E BROAD STREET COLUMBUS OH 43215 311592734 REDUCING INJURIES AND SAVING LIVES BY IMPROVING TRAUMA CARE OH 501(C)(3) LINE 7 COLUMBUS MEDICAL ASSOCIATION 1 COLUMBUS MEDICAL ASSOCIATION PHYSICIANS FREE CLINIC 431 E BROAD STREET COLUMBUS OH 43215 311373719 COORDINATING VOLUNTARY HEALTH CARE SERVICES OH 501(C)(3) LINE 3 COLUMBUS MEDICAL ASSOCIATION 1 0 1 0 0 0 0 0 0 1 0 1 0 1 1 1 1 0 0 COLUMBUS MEDICAL ASSOCIATION P 100716 ACCRUAL TRANSACTION CENTRAL OHIO TRAUMA SYSTEM P 100306 ACCRUAL TRANSACTION COLUMBUS MEDICAL ASSOCIATION PHYSICIANS FREE CLINIC P 93982 ACCRUAL TRANSACTION COLUMBUS MEDICAL ASSOCIATION PHYSICIANS FREE CLINIC K 111885 MARKET RATE COLUMBUS MEDICAL ASSOCIATION PHYSICIANS FREE CLINIC B 560000 ACCRUAL TRANSACTION CENTRAL OHIO TRAUMA SYSTEM K 118206 MARKET RATE CENTRAL OHIO TRAUMA SYSTEM B 275600 ACCRUAL TRANSACTION