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COLUMBUS AMBULATORY HEALTHCARE SERVICES INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
COLUMBUS AMBULATORY HEALTHCARE SERVICES INC (EIN 58-1719867)
Tax period
2018-07-01 to 2019-06-30
Filed
2020-05-15
IRS object ID
202011369349302801
Schema version
2018v3.3
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)
Return2020-05-15T11:08:26-05:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1300 North Greene Street Suite 400AddressLine1Txt
CityGreensboroCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27401ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN581719867EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Columbus Ambulatory Healthcare Services IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% MARIE GAFFNEYInCareOfNm
Business Name ControlCOLUBusinessNameControlTxt
Phone7066606103PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1707 Center StreetAddressLine1Txt
CityColumbusCityNm
State AbbreviationGAStateAbbreviationCd
ZIP31901ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARIE GAFFNEYPersonNm
Person TitleVP CORPORATE FINANCEPersonTitleTxt
Phone4044251303PhoneNum
Signature2020-05-14SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSHAWN M HUTCHINSONPreparerPersonNm
PTINP01048557PTIN
Phone3362753394PhoneNum
Preparation2020-05-14PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address199.206.0.5IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id56038220201365000024FederalOriginalSubmissionId
Federal Original Submission Id2020-05-15FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id2F91BA52B61FEB008F3980E6EE57B14852305A4EAtSubmissionCreationDeviceId
At Submission Filing Device Id1272C807EE2CFB18DB9032F475C1250F2D6A8CEAAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSCOTT HILLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1707 Center StreetAddressLine1Txt
CityColumbusCityNm
State AbbreviationGAStateAbbreviationCd
ZIP31901ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$34,730,321GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.columbusregional.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1986FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee496TotalEmployeeCnt
Total Volunteers14TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$23,468,025PYProgramServiceRevenueAmt
CY Program Service Revenue$32,633,001CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$2,097,320CYOtherRevenueAmt
PY Total Revenue$23,468,025PYTotalRevenueAmt
CY Total Revenue$34,730,321CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$22,615,366PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$32,609,991CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$13,353,771PYOtherExpensesAmt
CY Other Expenses$15,277,398CYOtherExpensesAmt
PY Total Expenses$35,969,137PYTotalExpensesAmt
CY Total Expenses$47,887,389CYTotalExpensesAmt
PY Revenues Less Expenses-$12,501,112PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$13,157,068CYRevenuesLessExpensesAmt
Total Assets BOY$3,563,619TotalAssetsBOYAmt
Total Assets EOY$9,318,465TotalAssetsEOYAmt
Total Liabilities BOY$69,565,416TotalLiabilitiesBOYAmt
Total Liabilities EOY$79,583,957TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$66,001,797NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$70,265,492NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE IN A PROGRESSIVE ENVIRONMENT, GUIDED BY PHYSICIANS, DELIVERED BY PROFESSIONALS, AND INSPIRED BY THE COMMUNITIES WE SERVE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$41,993,025ExpenseAmt
Revenue$34,730,321RevenueAmt
DescCOLUMBUS AMBULATORY HEALTHCARE SERVICES, INC., IS A NOT-FOR-PROFIT COMPANY SERVING COLUMBUS AND SURROUNDING COUNTIES. IN KEEPING WITH ITS TAX-EXEMPT MISSION, COLUMBUS AMBULATORY HEALTHCARE SERVICES PROVIDES A WIDE VARIETY OF PRIMARY AND SPECIALTY PHYSICIAN SERVICES TO ALL PATIENTS REQUESTING SUCH SERVICES, REGARDLESS OF ABILITY TO PAY. MANY OF THESE PATIENTS ARE CLASSIFIED AS INDIGENT RESIDENTS OF MUSCOGEE COUNTY, AND AS SUCH ARE COVERED THROUGH A CONTRACTUAL AGREEMENT THE MEDICAL CENTER, INC. (A TAX-EXEMPT AFFILIATE) HAS WITH THE COLUMBUS CONSOLIDATED GOVERNMENT.Desc
Total Program Service Expenses$41,993,025TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee496EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARIE GAFFNEYPersonNm
Phone4702716007PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12727 PACES FERRY RD BLDG 2 STE 70AddressLine1Txt
CityATLANTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP30339ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Scott Hill
DIRECTOR2.547.5Yes (X)Yes (X)$0$1,256,604$58,967
Warren Steele II
Chairman2.06.0Yes (X)$0$0$0
Max Brabson Jr
DIRECTOR2.06.0Yes (X)$0$0$0
Cecil Cheves
DIRECTOR2.06.0Yes (X)$0$0$0
Dr Shane Darrah
DIRECTOR2.06.0Yes (X)$0$0$0
W Ronald Duffey
DIRECTOR2.06.0Yes (X)$0$0$0
John Dale Hester
DIRECTOR2.06.0Yes (X)$0$0$0
Dr Todd Jarrell
DIRECTOR2.06.0Yes (X)$0$0$0
Joey Loudermilk
DIRECTOR2.06.0Yes (X)$0$0$0
Michael Mandl
DIRECTOR2.053.0Yes (X)$0$938,721$99,386
Liliana McDaniel
DIRECTOR2.06.0Yes (X)$0$0$0
Dr Susan McWhirter
DIRECTOR2.06.0Yes (X)$0$0$0
Dr William Roundtree
DIRECTOR2.06.0Yes (X)$0$0$0
William Brouwer
President/CRMG40.00.0Yes (X)$423,220$0$36,643
Dr Andrew Pippas
Medical Director & Physician40.00.0$810,459$0$45,366Yes (X)
Dr Peter Jiang
Physician - Oncologist40.00.0$814,965$0$41,917Yes (X)
Dr Suresh Nukala
Physician - Oncologist40.00.0$844,135$0$43,512Yes (X)
Dr Mukesh Kumar
Physician40.00.0$742,194$0$40,318Yes (X)
Dr James Cunningham
Physician40.00.0$622,406$0$38,125Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,257,379TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,195,325TotReportableCompRltdOrgAmt
Total Other Compensation$404,234TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ATHENAHEALTH INC
Arsenal StreetWATERTOWNMA02472IT Services$1,889,004
HENRY SCHEIN MEDICAL
4315 Lake Hill RdEL DORADO SPRINGMO64744Healthcare$404,271
NAVIGANT CONSULTING
1180 Peachtree St NE 1900ATLANTAGA30309Consulting$246,079
MCKESSON MEDICAL-SUR
1005 Satellite BlvdSUWANEEGA30024Healthcare$232,258
Comphealth Associates
4021 South 700 East Suite 300SALT LAKE CITYUT84107Staffing$155,730
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICEDesc
Business621110BusinessCd
Total Revenue Column$32,633,001TotalRevenueColumnAmt
Related Or Exempt Func Income$32,633,001RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$32,633,001TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER REVENUEDesc
Business900099BusinessCd
Total Revenue Column$2,097,320TotalRevenueColumnAmt
Related Or Exempt Func Income$2,097,320RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,097,320OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$34,730,321TotalRevenueColumnAmt
Related Or Exempt Func Income$34,730,321RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$423,220TotalAmt
Program Services$351,273ProgramServicesAmt
Management And General$71,947ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$26,930,268TotalAmt
Program Services$22,352,122ProgramServicesAmt
Management And General$4,578,146ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,582,686TotalAmt
Program Services$2,973,629ProgramServicesAmt
Management And General$609,057ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,673,817TotalAmt
Program Services$1,389,268ProgramServicesAmt
Management And General$284,549ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$92,833TotalAmt
Management And General$92,833ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,213,619TotalAmt
Program Services$5,213,619ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$9,505TotalAmt
Management And General$9,505ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$356,084TotalAmt
Program Services$353,389ProgramServicesAmt
Management And General$2,695ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,365,188TotalAmt
Program Services$3,230,581ProgramServicesAmt
Management And General$134,607ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$71,621TotalAmt
Program Services$46,615ProgramServicesAmt
Management And General$25,006ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$40,760TotalAmt
Program Services$34,371ProgramServicesAmt
Management And General$6,389ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$277,483TotalAmt
Program Services$260,834ProgramServicesAmt
Management And General$16,649ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$659,108TotalAmt
Program Services$619,562ProgramServicesAmt
Management And General$39,546ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
BAD DEBT EXPENSE$2,711,778$2,711,778
MEDICAL SUPPLIES & DRUGS$1,874,302$1,874,302
DUES AND MEMBERSHIPS$144,241$144,241
PROFESSIONAL FEES$70,296$70,296

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$390,580TotalAmt
Program Services$367,145ProgramServicesAmt
Management And General$23,435ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$47,887,389TotalAmt
Program Services$41,993,025ProgramServicesAmt
Management And General$5,894,364ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$125,457BOYAmt
EOY$145,193EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,295,251BOYAmt
EOY$5,609,371EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$336,856BOYAmt
EOY$769,545EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$3,152,998LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$358,642LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,987,905BOYAmt
EOY$2,794,356EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY-$181,850BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,563,619BOYAmt
EOY$9,318,465EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,519,235BOYAmt
EOY$3,189,374EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$66,046,181BOYAmt
EOY$76,394,583EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$69,565,416BOYAmt
EOY$79,583,957EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$66,001,797BOYAmt
EOY-$70,265,492EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$66,001,797BOYAmt
EOY-$70,265,492EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,563,619BOYAmt
EOY$9,318,465EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$13,157,068ReconcilationRevenueExpnssAmt
Prior Period Adjustments$17,329,895PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$8,436,522OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Organization Belongs Afflt GrpYes (X)OrganizationBelongsAffltGrpInd

Total Grassroots Lobbying TotalGrassrootsLobbyingGrp

FieldValueIRS element (for citing)
Affiliated Group Total$0AffiliatedGroupTotalAmt

Total Direct Lobbying TotalDirectLobbyingGrp

FieldValueIRS element (for citing)
Affiliated Group Total$0AffiliatedGroupTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Affiliated Group Total$0AffiliatedGroupTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Affiliated Group Total$0AffiliatedGroupTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Affiliated Group Total$0AffiliatedGroupTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Affiliated Group Total$0AffiliatedGroupTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Affiliated Group Total$0AffiliatedGroupTotalAmt

Tot Lbbyng Grassroot Mns Non Tx TotLbbyngGrassrootMnsNonTxGrp

FieldValueIRS element (for citing)
Affiliated Group Total$0AffiliatedGroupTotalAmt

Tot Lbby Expend Mns Lbbyng Non Tx TotLbbyExpendMnsLbbyngNonTxGrp

FieldValueIRS element (for citing)
Affiliated Group Total$0AffiliatedGroupTotalAmt

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Current Year Minus3$1,000,000CurrentYearMinus3Amt
Total$1,000,000TotalAmt
FieldValueIRS element (for citing)
Lobbying Ceiling$1,500,000LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year Minus3$25,509CurrentYearMinus3Amt
Total$25,509TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Current Year Minus3$250,000CurrentYearMinus3Amt
Total$250,000TotalAmt
FieldValueIRS element (for citing)
Grassroots Ceiling$375,000GrassrootsCeilingAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$379,800OtherCostOrOtherBasisAmt
Depreciation$59,140DepreciationAmt
Book Value$320,660BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,320,032OtherCostOrOtherBasisAmt
Depreciation$299,502DepreciationAmt
Book Value$2,020,530BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$453,166OtherCostOrOtherBasisAmt
Book Value$453,166BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,794,356TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
INTERCOMPANY PAYABLE$73,888,744
OTHER ACCRUED LIABILITIES$9,097
OTHER LONG TERM LIABILITIES$166,799
INSURANCE LIABILITIES$2,329,943
FieldValueIRS element (for citing)
Total Liability$76,394,583TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationThe System accounts for income taxes under the provisions of ASC 740, Income Taxes (ASC 740).Under the requirements of ASC 740, tax-exempt organizations may be required to record an obligation as the result of a tax position they have historically taken on various uncertain tax exposure items. There were no material uncertain tax positions at June 30, 2019.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmt
William Brouwer
President/CRMG$320,973$68,088$34,159$9,739$0$26,904$0$459,863$0$0$0
Dr Andrew Pippas
Medical Director & Physician$644,969$139,267$26,223$17,998$0$27,368$0$855,825$0$0$0
Dr Peter Jiang
Physician - Oncologist$642,783$145,422$26,760$13,868$0$28,049$0$856,882$0$0$0
Dr Suresh Nukala
Physician - Oncologist$452,342$322,045$69,748$17,268$0$26,244$0$887,647$0$0$0
Dr Mukesh Kumar
Physician$346,847$394,780$567$13,496$0$26,822$0$782,512$0$0$0
Dr James Cunningham
Physician$420,748$161,369$40,289$13,138$0$24,987$0$660,531$0$0$0
Scott Hill
DIRECTOR$0$0$0$0$29,901$0$29,066$0$1,315,571$0$0$758,528$278,980$219,096
Michael Mandl
DIRECTOR$0$0$0$0$90,625$0$8,761$0$1,038,107$0$0$585,596$161,917$191,208

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 3: COMPENSATION OF THE CEO/EXECUTIVE DIRECTORFormAndLineReferenceDesc
ExplanationTHE COMPENSATION FOR THE PRESIDENT/CEO OF COLUMBUS AMBULATORY HEALTHCARE SERVICES IS SET BY THE ENTITY'S PARENT, PIEDMONT HEALTHCARE, INC. PLEASE SEE THE SCHEDULE O NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A & 15B FOR ADDITIONAL INFORMATION. SCHEDULE J, PART I, LINE 4B: SUPPLEMENTAL COMPENSATION INFORMATION THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS: MICHAEL MANDL PIEDMONT COLUMBUS REGIONAL MAINTAINS A SERP PLAN THAT VESTS EVERY THREE YEARS FOR ITS PARTICIPATING OFFICERS. THE LAST VESTING OCCURED ON JUNE 30, 2017; THEREFORE, NO PAYMENT WAS MADE IN THE FISCAL YEAR ENDED JUNE 30, 2019. THERE WERE NO EMPLOYER CONTRIBUTIONS TO 457(F) EXECUTIVE RETIREMENT BENEFIT PLANS IN THE FISCAL YEAR ENDED JUNE 30, 2019. SCHEDULE J, PART I, LINE 7: NON-FIXED PAYMENTS CERTAIN EMPLOYEES PARTICIPATED IN AN "ANNUAL INCENTIVE PLAN" UNDER WHICH THEY RECEIVED NON-FIXED BONUS PAYMENTS BASED ON JOB LEVEL AND SEVERAL DIFFERENT PERFORMACE METRICS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINE 1A: NUMBER OF FORMS 1099 FILEDALL CALENDAR YEAR 2018 FORMS 1099 WERE FILED ON BEHALF OF THE COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC. BY ITS SOLE MEMBER, PIEDMONT HEALTHCARE, INC. (EIN 58-1503902), PURSUANT TO AN AGREEMENT WITH THE IRS TO FILE ALL FORMS 1099 FOR THE PIEDMONT HEALTHCARE SYSTEM ON A COMBINED BASIS. FORM 990, PART VI, SECTION A, LINE 6: ORGANIZATION'S SOLE MEMBER PIEDMONT Healthcare, Inc. (EIN: 58-1719994) IS THE SOLE MEMBER OF COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF GOVERNING BODY THE BOARD OF PIEDMONT HEALTHCARE, COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC.'S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC. FORM 990 PART VI, SECTION A, LINE 7B: DECISIONS OF GOVERNING BODY COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC.'S BOARD POLICIES AND DECISIONS MUST BE FILED, IMMEDIATELY AFTER ADOPTION, WITH THE SECRETARY OF THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS. SUCH POLICIES AND DECISIONS OF THE COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC.'S BOARD OF DIRECTORS ARE NOT SUBJECT TO THE APPROVAL OF OR RATIFICATION BY THE PIEDMONT HEALTHCARE BOARD, BUT SHOULD THE NEED ARISE, THEY MAY BE RESCINDED BY THE PIEDMONT HEALTHCARE BOARD THROUGH A MAJORITY VOTE OF ITS DIRECTORS. FORM 990 PART VI, LINE 11A: 990 REVIEW PROCESS INFORMATION NEEDED TO PREPARE THE COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC.'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC.S CONTROLLER AND VP/CFO. THE 990 IS THEN PREPARED BY AN EXTERNAL TAX PREPARER. PRIOR TO FILING, COPIES OF FORM 990 ARE PROVIDED TO THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC., THE ORGANIZATION'S SOLE MEMBER, FOR BOARD REVIEW. Form 990, Part VI, Line 12c: CONFLICT OF INTEREST POLICY COMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY ORGANIZATION MANAGEMENT IN COORDINATION WITH PIEDMONT HEALTHCARE'S CHIEF COMPLIANCE OFFICER. ALL SENIOR LEADERS, BOARD MEMBERS, PHYSICIAN EMPLOYEES, NURSE PRACTITIONERS/PHYSICIAN ASSISTANTS AND EMPLOYEES AND NON-EMPLOYEES ENGAGED IN RESEARCH ARE REQUIRED TO ANNUALLY DISCLOSE ALL MATTERS WHICH COULD POTENTIALLY CONSTITUTE A CONFLICT OF INTEREST. MATTERS DISCLOSED UNDER THE POLICY MUST BE REVIEWED IN WRITING BY THE PIEDMONT HEALTHCARE CONFLICT OF INTEREST COMMITTEE IN ORDER TO DETERMINE WHETHER A CONFLICT EXISTS AND, IF SO, WHETHER TO ELIMINATE OR MANAGE THE CONFLICT. ALL BOARD MEMBERS AND EMPLOYEES OF COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC. ARE PROVIDED TRAINING ON CONFLICT OF INTEREST ISSUES, INCLUDING REPORTING REQUIREMENTS, AT NEW EMPLOYEE ORIENTATION AND AT LEAST ANNUALLY THEREAFTER. NONCOMPLIANCE WITH THE CONFLICT OF INTEREST POLICY MUST BE REPORTED TO PIEDMONT HEALTHCARE'S SENIOR VICE PRESIDENT OF COMPLIANCE FOR INVESTIGATION, AND REMEDIAL STEPS MUST BE TAKEN AS APPROPRIATE UNDER THE PIEDMONT HEALTHCARE DISCIPLINARY POLICIES. FORM 990, PART VI, LINE 15A: EXECUTIVE COMPENSATION COMPENSATION FOR EXECUTIVES OF COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC. IS SET BY THE BOARD OF DIRECTORS OF AND PAID ON BEHALF OF THE ORGANIZATION BY PIEDMONT HEALTHCARE, INC. THE PIEDMONT HEALTHCARE, INC., BOARD OF DIRECTOR'S EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE ("THE COMMITTEE") IS COMPOSED OF AT LEAST THREE MEMBERS OF THE PHC BOARD OF DIRECTORS, SERVING TERMS OF THREE YEARS, AND THE MAJORITY OF WHICH ARE COMMUNITY DIRECTORS WHO GENERALLY DO NOT HAVE CONFLICTS OF INTEREST RELATED TO FULFILLMENT OF THE DUTIES AS OUTLINED BELOW. THE EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE OVERSEES EXECUTIVE PERFORMANCE AND COMPENSATION ON BEHALF OF THE PHC BOARD, SUBJECT TO THE ULTIMATE AUTHORITY AND OVERSIGHT OF THE BOARD. THE COMMITTEE ALSO FORMULATES POLICIES AND MAKES DECISIONS IN ORDER TO ENSURE A HIGH LEVEL OF EXECUTIVE PERFORMANCE. THE COMMITTEE IS AUTHORIZED TO ACT ON BEHALF OF THE PHC BOARD AS SET OUT IN ITS CHARTER, AND THE COMMITTEE IS ALSO CHARGED WITH PROVIDING RECOMMENDATIONS AND PERIODIC REPORTS TO THE PHC BOARD REGARDING EXECUTIVE PERFORMANCE AND COMPENSATION. ALL DECISIONS AND COMPARABILITY DATA ARE DOCUMENTED IN THE COMMITTEE MEETING MINUTES. FUNCTIONS OF THE COMMITTEE - ASSESS AND IMPLEMENT POLICIES REGARDING PERFORMANCE, COMPENSATION AND BENEFITS OF THE PRESIDENT/CEO AND OTHER EXECUTIVES AS DETERMINED BY THE COMMITTEE - SELECT AN EXECUTIVE COMPENSATION CONSULTANT WHO REPORTS TO THE COMMITTEE - ANNUALLY REVIEW THE PRESIDENT/CEO SUCCESSION PLAN - FORMULATE AND IMPLEMENT ANNUAL PERFORMANCE OBJECTIVES FOR THE PRESIDENT/CEO, AND REVIEW AND APPROVE ANNUALLY RECOMMENDATIONS FROM THE PRESIDENT/CEO RELATING TO COMPENSATION, PERFORMANCE OBJECTIVES, AND SUCCESSION PLANS FOR EVP EXECUTIVES - ANNUALLY ASSESS PRESIDENT/CEO PERFORMANCE; IF NECESSARY, IMPLEMENT ACTION PLAN WITH PRESIDENT/CEO INPUT TO IMPROVE HIS/HER PERFORMANCE ADJUST COMPENSATION AS APPROPRIATE; THE COMMITTEE CHAIR SHALL CONSULT WITH THE PHC GOVERNANCE COMMITTEE CHAIR AND THE PHC BOARD CHAIR AND SHALL COORDINATE THE ANNUAL PERFORMANCE REVIEW OF THE PHC PRESIDENT/CEO, UNLESS THE PHC BOARD CHAIR HAS A REAL OR PERCEIVED CONFLICT OF INTEREST, IN WHICH CASE THE COMMITTEE CHAIR SHALL DETERMINE THE PROPER REVIEW PROCESS - REVIEW AND APPROVE LONG TERM AND SHORT TERM GOALS TO BE USED IN CONNECTION WITH EVP COMPENSATION PROGRAMS AS RECOMMENDED BY THE PRESIDENT/CEO AND VALIDATED BY THE COMPENSATION CONSULTANT - PERIODICALLY REVIEW COMPENSATION, IF ANY, FOR THE PHC BOARD CHAIR AND ALL BOARD CHAIRS OF THE PHC SUBSIDIARIES - ESTABLISH OTHER POLICIES AND PROCEDURES, AND PERFORM OTHER TASKS, RELATED TO EXECUTIVE PERFORMANCE AND COMPENSATION, INCLUDING BUT NOT LIMITED TO, APPROVAL OF EXECUTIVE EMPLOYMENT CONTRACTS AND BENEFITS - PERIODICALLY REPORT SIGNIFICANT DECISIONS AND ANY ADDITIONAL REQUESTED INFORMATION TO THE PHC BOARD LIMITED TO, APPROVAL OF EXECUTIVE EMPLOYMENT CONTRACTS AND BENEFITS. FORM 990, PART VI, SECTION C, LINE 19: DOCUMENTS AND POLICIES GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS SHOULD BE REQUESTED FROM PIEDMONT HEALTHCARE, INC.'S LEGAL COUNSEL.
FORM 990, PART XI, LINE 9: Changes in Net AssetsINTERCOMPANY TRANSFER -8,436,522
FORM 990 PART IX LINE 11GDESCRIPTION:PURCHASED SERVICES TOTAL FEES:5083007
FORM 990 PART IX LINE 11GDESCRIPTION:CONSULTING SERVICES TOTAL FEES:130612

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (21 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
THE MEDICAL CENTER INC
707 CENTER STREETCOLUMBUSGA31901581685139HOSPITALGA501(C)(3)3CRHSfalse
COLUMBUS REGIONAL HEALTHCARE SYSTEM INC
707 CENTER STREETCOLUMBUSGA31901581719994MANAGEMENTGA501(C)(3)12B, IIPHCfalse
COLUMBUS REGIONAL MEDICAL FOUNDATIONINC
707 center streetcolumbusGA31901581501642fundraisingGA501(C)(3)7CRHSfalse
HUGHSTON HOSPITAL INC
707 center streetcolumbusGA31901331216751HOSPITALGA501(C)(3)3CRHSfalse
PIEDMONT HEALTHCARE INC
1800 HOWELL MILL RD STE 850ATLANTAGA30318581503902MANAGEMENTGA501(C)(3)12C, III-FINAfalse
PIEDMONT HOSPITAL INC
1968 PEACHTREE ROAD NATLANTAGA30309580566213HOSPITALGA501(C)(3)3PHCfalse
FAYETTE COMMUNITY HOSPITAL INC
1255 HIGHWAY 54 WESTFAYETTEVILLEGA30214582232328HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT HENRY HOSPITAL INC
1133 EAGLES LANDING PARKWAYSTOCKBRIDGEGA30281582200195HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT NEWNAN HOSPITAL INC
745 POPLAR ROADNEWNANGA30265205077249HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT HEALTHCARE FOUNDATION INC
2001 PEACHTREE RD NE STE 400ATLANTAGA30309581272768FUNDRAISINGGA501(C)(3)12B, IIPHCfalse
PIEDMONT HEART INSTITUTE INC
95 COLLIER ROAD NW STE 2045ATLANTAGA30309263553500HEALTHCAREGA501(C)(3)10PHCfalse
PIEDMONT NEWTON HOSPITAL INC
5126 HOSPITAL DRIVE NECOVINGTONGA30014582155150HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT ATHENS REGIONAL FOUNDATION INC
1199 PRINCE AVENUEATHENSGA30606581978389FUNDRAISINGGA501(C)(3)12B, IIPARMCfalse
PIEDMONT ATHENS REG HEALTH RESOURCES
1199 PRINCE AVENUEATHENSGA30606581930580DEVELOPMENTGA501(C)(3)12B, IIPARMCfalse
PIEDMONT ATHENS REGIONAL MEDICAL CENTER
1199 PRINCE AVENUEATHENSGA30606582179986HOSPITALGA501(C)(3)3PHCfalse
ATHENS REGIONAL PHYSICIAN SERVICES INC
1199 PRINCE AVENUEATHENSGA30606582332921HEALTHCAREGA501(C)(3)12B, IIPARMCfalse
REGIONAL FIRSTCARE INC
1199 PRINCE AVENUEATHENSGA30606582362733URGENT CAREGA501(C)(3)12B, IIPARMCfalse
ATHENS REGIONAL SPECIALTY SERVICES INC
1199 PRINCE AVENUEATHENSGA30606271975001HEALTHCAREGA501(C)(3)3PARMCfalse
PIEDMONT ROCKDALE HOSPITAL INC
1412 MILSTEAD AVECONYERSGA30012300999841HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT WALTON HOSPITAL INC
2151 WEST SPRING STMONROEGA30655824194264HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT MOUNTAINSIDE HOSPITAL INC
1266 HIGHWAY 515 SOUTHJASPERGA30143352228583HOSPITALGA501(C)(3)3PHCfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndUBI Code VUBICodeVAmtGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPct
PCHTREE ORTHO SURG
2001 PCHTREE RDATLGA30309582562721SURGERYGANAN/A$0$0false$0false0.00000
DIG HLTHCR GA ENDO
95 COLLIER RDATLGA30309582406657HEALTHCAREGANAN/A$0$0false$0false0.00000
FOUR WINDS HEALTH
3350 RVRWD PKWYATLGA30339451273930HEALTHCAREGANAN/A$0$0false$0false0.00000
GA HLTH COLLAB
2727 PACES FRY RDATLGA30339461500639HEALTHCAREGANAN/A$0$0false$0false0.00000

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtControlled OrganizationControlledOrganizationIndOwnershipOwnershipPctAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
Columbus Health Services Inc
PO BOX 790COLUMBUGA31902581640939HEALTHCAREGANAC-CORP$0$0false
PIEDMONT MEDICAL CARE CORPORATION
2727 PACES FERRY RD STE 1-1100ATLANTAGA30339582092768HEALTHCAREGANAC CORP$0$0false0.00000
THE PIEDMONT CLINIC INC
2727 PACES FERRY RD STE 1-1100ATLANTAGA30339582005358HEALTHCAREGANAC CORP$0$0false
PIEDMONT HEART INSTITUTE PHYSICIANS INC
95 COLLIER ROAD NW STE 2045ATLANTAGA30309260593850HEALTHCAREGANAC CORP$0$0false
AMSTER MCRAE INSURANCE COMPANY
980427603RELATED INSUR.NAC CORP$0$0falsePO BOX 1159 GRAND CAYMANGRAND CAYMANCJCJ KY1-1102CJ
PIEDMONT WELLSTAR HEALTHPLANS INC
2859 PACES FERRY RD STE 600ATLANTAGA30339461922499HEALTH INSUR.GANAC CORP$0$0false
COLUMBUS HEALTHCARE RESOURCES
PO BOX 790COLUMBUSGA31902581717754HEALTHCAREGANAC-CORP$0$0false
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Affiliated Group Schedule AffiliatedGroupSchedule

Affiliated Schedule AffiliatedScheduleGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINElecting OrganizationElectingOrganizationIndTotal Grassroots LobbyTotalGrassrootsLobbyAmtTotal Direct LobbyTotalDirectLobbyAmtTotal Lobby ExpenditureTotalLobbyExpenditureAmtOther Exempt Purpose ExpendOtherExemptPurposeExpendAmtTotal Exempt Purpose ExpendTotalExemptPurposeExpendAmtLobby NontxLobbyNontxAmtGrassroots NontxGrassrootsNontxAmtTotal Lobby Grssroot Mns NontxTotalLobbyGrssrootMnsNontxAmtTot Lbby Expend Mns Lobby NontxTotLbbyExpendMnsLobbyNontxAmtShare Excess Lobby ExpendShareExcessLobbyExpendAmt
COLUMBUS REGIONAL HEALTHCARE
707 CENTER STREETCOLUMBUSGA31901581719994Yes (X)$0$0$0$0$0$0$0$0$0$0
THE MEDICAL CENTER INC
707 CENTER STREETCOLUMBUSGA31901581685139$0$0$0$0$0$0$0$0$0$0
CRHS LONG TERM & HOME CARE
707 CENTER STREETCOLUMBUSGA31901581778572$0$0$0$0$0$0$0$0$0$0
COLUMBUS REGIONAL MEDICAL FO
707 CENTER STREETCOLUMBUSGA31901581501642$0$0$0$0$0$0$0$0$0$0
COLUMBUS REGIONAL SENIOR LIV
707 CENTER STREETCOLUMBUSGA31901582628502$0$0$0$0$0$0$0$0$0$0
HUGHSTON HOSPITAL INC
707 CENTER STREETCOLUMBUSGA31901331216751$0$0$0$0$0$0$0$0$0$0
COLUMBUS REGIONAL AUXILIARY
707 CENTER STREETCOLUMBUSGA31901580917974$0$0$0$0$0$0$0$0$0$0