COLUMBIA LUTHERAN CHARITIES: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- COLUMBIA LUTHERAN CHARITIES (EIN 93-0583856)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-12
- IRS object ID
- 201813169349302871
- Schema version
- 2017v2.3
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-12T11:40:26-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 930418710 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELAP LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5885 MEADOWS ROAD NO 200 | AddressLine1Txt |
| City | LAKE OSWEGO | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97035 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930583856 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA LUTHERAN CHARITIES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COLU | BusinessNameControlTxt |
| Phone | 5033254321 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2111 EXCHANGE STREET | AddressLine1Txt |
| City | ASTORIA | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 971033329 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ZACHARY SCHMITT | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5033254321 | PhoneNum |
| Signature | 2018-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARK E EKLUND CPA | PreparerPersonNm |
| PTIN | P00156145 | PTIN |
| Phone | 5036974118 | PhoneNum |
| Preparation | 2018-11-09 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 76.14.192.226 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-09 | IPDt |
| IP Tm | 09:25:14 | IPTm |
| IP Timezone | PS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DE3CBF9142AB1A9C45D327EC0B3FC07BFC578F99 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | FA70ACD58588B72794AC0476217EF7922E055C68 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ZACHARY SCHMITT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2111 EXCHANGE STREET | AddressLine1Txt |
| City | ASTORIA | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 971033329 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $115,992,452 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.COLUMBIAMEMORIAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1958 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE EXCELLENCE, LEADERSHIP & COMPASSION IN THE ENHANCEMENT OF HEALTH FOR THOSE WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 717 | TotalEmployeeCnt |
| Total Volunteers | 94 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $111,078 | PYContributionsGrantsAmt |
| CY Contributions Grants | $603,087 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $98,803,882 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $109,436,077 | CYProgramServiceRevenueAmt |
| PY Investment Income | $888,833 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,665,474 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,724,310 | PYOtherRevenueAmt |
| CY Other Revenue | $2,681,927 | CYOtherRevenueAmt |
| PY Total Revenue | $102,528,103 | PYTotalRevenueAmt |
| CY Total Revenue | $114,386,565 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $80,160 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $179,319 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $52,977,583 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $54,299,381 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $454,737 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $42,189,272 | PYOtherExpensesAmt |
| CY Other Expenses | $47,662,989 | CYOtherExpensesAmt |
| PY Total Expenses | $95,247,015 | PYTotalExpensesAmt |
| CY Total Expenses | $102,141,689 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,281,088 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $12,244,876 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $126,358,995 | TotalAssetsBOYAmt |
| Total Assets EOY | $138,380,163 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $75,290,523 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $69,872,722 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $51,068,472 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $68,507,441 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF COLUMBIA MEMORIAL HOSPITAL IS TO PROVIDE EXCELLENCE, LEADERSHIP, AND COMPASSION IN THE ENHANCEMENT OF HEALTH FOR THOSE WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $87,480,441 | ExpenseAmt |
| Grant | $179,319 | GrantAmt |
| Revenue | $114,386,565 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
| Total Program Service Expenses | $87,480,441 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 102 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 717 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ZACHARY SCHMITT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5033384613 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2111 EXCHANGE STREET | AddressLine1Txt |
| City | ASTORIA | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97103 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| BILL LANDWEHR | ||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID PHILLIPS | ||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| JEAN DANFORTH | ||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVE NYGAARD | ||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| ED NELSON JR | ||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| MARK SMITH | ||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| DOUG KAUP | ||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| NANCY MCALLISTER | ||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| HEATHER SEPPA | ||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| CONSTANCE WAISANEN | ||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| KEVIN BAXTER | ||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $298,764 | $0 | $45,186 | |||
| ROBERT HOLLAND | ||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $351,314 | $0 | $31,229 | |||
| ZACHARY SCHMITT EFFECTIVE 1118 | ||||||||
| CFO | 40.00 | $0 | $0 | $0 | Yes (X) | |||
| TERESA L GURRAD | ||||||||
| CCO | 40.00 | $229,283 | $0 | $32,361 | Yes (X) | |||
| ERIK THORSEN | ||||||||
| CEO | 40.00 | $553,371 | $0 | $91,733 | Yes (X) | |||
| GALINA GANDY | ||||||||
| VP - HEALTH INFO SERVICES | 40.00 | $266,873 | $0 | $35,341 | Yes (X) | |||
| KATRINA M MCPHERSON | ||||||||
| VP - MEDICAL GROUP OPERATI | 40.00 | $298,251 | $0 | $44,429 | Yes (X) | |||
| JARROD P KARNOFSKI | ||||||||
| VP - ANCILLIARY SERVICES | 40.00 | $229,826 | $0 | $36,194 | Yes (X) | |||
| MICHAEL MITCHELL MD | ||||||||
| PHYSICIAN | 40.00 | $363,767 | $0 | $36,600 | Yes (X) | |||
| RICHARD CRASS MD | ||||||||
| PHYSICIAN | 40.00 | $426,214 | $0 | $45,793 | Yes (X) | |||
| CAMILO ROSALES MD | ||||||||
| PHYSICIAN | 40.00 | $429,278 | $0 | $37,987 | Yes (X) | |||
| PETER BALES MD | ||||||||
| PHYSICIAN | 40.00 | $605,322 | $0 | $50,100 | Yes (X) | |||
| DOUGLAS ABBOTT MD | ||||||||
| PHYSICIAN | 40.00 | $633,102 | $0 | $41,382 | Yes (X) | |||
| THOMAS SAFLEY | ||||||||
| EX-OFFICIO | 40.00 | $291,874 | $0 | $16,227 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,977,239 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $544,562 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 59 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| P&C CONSTRUCTION | |||||
| 2133 NW YORK STREET | PORTLAND | OR | 97210 | CONSTRUCTION COMPANY | $7,731,936 |
| OHSU (EMERGENCY) | |||||
| 3181 SW JACKSON PARK RD MAIL CODE | PORTLAND | OR | 972393098 | EMERGENCY PHYSICIANS | $2,197,001 |
| ANESTHESIA ASSOCIATES NORTHWEST LLC | |||||
| 6400 SE LAKE RD STE 130 | PORTLAND | OR | 97222 | ANESTHESIOLOGY PHYSICIANS | $1,854,084 |
| CERNER CORPORATION | |||||
| 2800 ROCKCREEK PARKWAY | KANSAS CITY | MO | 64117 | SOFTWARE SERVICE | $1,452,605 |
| OHSU (CARDIOSURGERY) | |||||
| 3181 SW JACKSON PARK RD MAIL CODE | PORTLAND | OR | 972393098 | CARDIO/SURGERY PHYSICIANS | $1,329,921 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 37 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $288,866 | RelatedOrganizationsAmt |
| Government Grants | $39,488 | GovernmentGrantsAmt |
| All Other Contributions | $274,733 | AllOtherContributionsAmt |
| Noncash Contributions | $268,866 | NoncashContributionsAmt |
| Total Contributions | $603,087 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| OUTPATIENT REVENUE | 621990 | $130,752,906 | $130,752,906 |
| EMERGENCY ROOM REVENUE | 621990 | $50,635,859 | $50,635,859 |
| INPATIENT REVENUE | 621990 | $42,236,415 | $42,236,415 |
| PROVISION FOR CHARITY CARE | 621990 | -$2,363,634 | -$2,363,634 |
| CONTRACTUAL ALLOWANCE | 621990 | -$110,200,735 | -$110,200,735 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,624,734 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$1,624,734 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $109,436,077 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $916,502 | TotalRevenueColumnAmt |
| Exclusion | $916,502 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $258,146 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $301,349 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$43,203 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$43,203 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$43,203 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,052,866 | SecuritiesAmt |
| Other | $644 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,237,562 | SecuritiesAmt |
| Other | $66,976 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $815,304 | SecuritiesAmt |
| Other | -$66,332 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $748,972 | TotalRevenueColumnAmt |
| Exclusion | $748,972 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| JOINT VENTURE | 621500 | $1,500,956 | $1,500,956 | |
| HOSPITALIST | 621110 | $483,410 | $483,410 | |
| CAFETERIA AND VENDING | 722210 | $385,647 | $385,647 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $355,117 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $355,117 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,725,130 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $114,386,565 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $111,732,357 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,051,121 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,319 | TotalAmt |
| Program Services | $179,319 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,935,623 | TotalAmt |
| Management And General | $1,935,623 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,656,855 | TotalAmt |
| Program Services | $34,539,212 | ProgramServicesAmt |
| Management And General | $4,912,857 | ManagementAndGeneralAmt |
| Fundraising | $204,786 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,600,195 | TotalAmt |
| Program Services | $3,223,545 | ProgramServicesAmt |
| Management And General | $374,732 | ManagementAndGeneralAmt |
| Fundraising | $1,918 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,924,211 | TotalAmt |
| Program Services | $5,207,579 | ProgramServicesAmt |
| Management And General | $683,918 | ManagementAndGeneralAmt |
| Fundraising | $32,714 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,182,497 | TotalAmt |
| Program Services | $2,708,789 | ProgramServicesAmt |
| Management And General | $457,264 | ManagementAndGeneralAmt |
| Fundraising | $16,444 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $337,740 | TotalAmt |
| Management And General | $337,740 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,676 | TotalAmt |
| Management And General | $181,823 | ManagementAndGeneralAmt |
| Fundraising | $1,853 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,567,237 | TotalAmt |
| Program Services | $9,684,562 | ProgramServicesAmt |
| Management And General | $844,258 | ManagementAndGeneralAmt |
| Fundraising | $38,417 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $185,953 | TotalAmt |
| Program Services | $48 | ProgramServicesAmt |
| Management And General | $185,905 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,040,486 | TotalAmt |
| Program Services | $1,855,308 | ProgramServicesAmt |
| Management And General | $1,118,576 | ManagementAndGeneralAmt |
| Fundraising | $66,602 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,883,788 | TotalAmt |
| Program Services | $1,601,150 | ProgramServicesAmt |
| Management And General | $282,518 | ManagementAndGeneralAmt |
| Fundraising | $120 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,428,476 | TotalAmt |
| Program Services | $3,246,482 | ProgramServicesAmt |
| Management And General | $176,933 | ManagementAndGeneralAmt |
| Fundraising | $5,061 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,769 | TotalAmt |
| Program Services | $73,977 | ProgramServicesAmt |
| Management And General | $14,792 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $613,426 | TotalAmt |
| Program Services | $306,214 | ProgramServicesAmt |
| Management And General | $291,558 | ManagementAndGeneralAmt |
| Fundraising | $15,654 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,288,321 | TotalAmt |
| Program Services | $4,266,181 | ProgramServicesAmt |
| Management And General | $1,022,140 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $909,573 | TotalAmt |
| Program Services | $909,573 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES & PHAR | $16,889,639 | $16,889,639 | ||
| OTHER PURCHASED SERVICE | $2,517,745 | $1,229,911 | $1,243,082 | $44,752 |
| REPAIRS & MAINTENANCE | $1,412,467 | $1,359,393 | $52,279 | $795 |
| OUTSIDE MEDICAL SERVICE | $118,203 | $118,203 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $197,490 | TotalAmt |
| Program Services | $81,356 | ProgramServicesAmt |
| Management And General | $90,513 | ManagementAndGeneralAmt |
| Fundraising | $25,621 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,141,689 | TotalAmt |
| Program Services | $87,480,441 | ProgramServicesAmt |
| Management And General | $14,206,511 | ManagementAndGeneralAmt |
| Fundraising | $454,737 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,593 | BOYAmt |
| EOY | $27,511 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,470,356 | BOYAmt |
| EOY | $16,521,615 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,300,222 | BOYAmt |
| EOY | $13,681,757 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,778 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $424,737 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,434,432 | BOYAmt |
| EOY | $2,609,348 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,244,330 | BOYAmt |
| EOY | $1,277,670 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $101,458,996 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $44,618,335 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,393,272 | BOYAmt |
| EOY | $56,840,661 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,818,379 | BOYAmt |
| EOY | $43,692,713 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,800,570 | BOYAmt |
| EOY | $1,956,390 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,000 | BOYAmt |
| EOY | $75,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,370,326 | BOYAmt |
| EOY | $1,697,498 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $126,358,995 | BOYAmt |
| EOY | $138,380,163 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,372,372 | BOYAmt |
| EOY | $11,557,202 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,686,405 | BOYAmt |
| EOY | $46,821,111 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,231,746 | BOYAmt |
| EOY | $11,494,409 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,290,523 | BOYAmt |
| EOY | $69,872,722 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,068,472 | BOYAmt |
| EOY | $68,507,441 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,068,472 | BOYAmt |
| EOY | $68,507,441 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $126,358,995 | BOYAmt |
| EOY | $138,380,163 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $12,244,876 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,549,225 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$62,652 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $2,707,520 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $7,480,255 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $2,141,830 | OtherCostOrOtherBasisAmt |
| Book Value | $9,622,085 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $7,248,011 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $34,240,726 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,787,019 | DepreciationAmt |
| Book Value | $22,701,718 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,509,421 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,028,100 | DepreciationAmt |
| Book Value | $481,321 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $48,667,057 | OtherCostOrOtherBasisAmt |
| Depreciation | $24,803,216 | DepreciationAmt |
| Book Value | $23,863,841 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $171,696 | OtherCostOrOtherBasisAmt |
| Book Value | $171,696 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $56,840,661 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED 3RD PARTY PAYOR | $1,085,000 |
| DEFERRED COMPENSATION | $910,493 |
| MEDICAL MALPRACTICE CLAIMS | $1,112,443 |
| ACCRUED RETIREMENT PLAN LIABILITY | $8,386,473 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $11,494,409 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | INCOME TAX POSITIONS THAT MEET A "MORE-LIKELY-THAN-NOT" RECOGNITION THRESHOLD ARE MEASURED AT THE LARGEST AMOUNT OF INCOME TAX BENEFIT THAT IS MORE THAN 50% LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH INCOME TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE WOULD BE REFLECTED AS A LIABILITY FOR UNRECOGNIZED INCOME TAX BENEFITS IN CHARITIES' CONSOLIDATED BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED INCOME TAX BENEFITS WOULD BE CLASSIFIED AS INCOME TAXES IN CHARITIES' CONSOLIDATED STATEMENTS OF OPERATIONS. THERE WERE NO UNRECOGNIZED INCOME TAX BENEFITS, NOR ANY INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED INCOME TAX BENEFITS, ACCRUED OR EXPENSED AS OF AND FOR THE YEARS ENDED DECEMBER 31, 2017 AND 2016. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 299.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,029,656 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,029,656 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01010 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,625,358 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,548,657 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,076,701 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01050 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,655,014 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,548,657 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,106,357 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02060 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $218,686 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $28,770 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $189,916 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $175,725 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $175,725 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $394,411 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $28,770 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $365,641 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,049,425 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,577,427 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,471,998 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02420 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $124,390 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $124,390 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $124,390 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $124,390 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,872,640 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $2,363,634 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $44,239,135 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $109,143,563 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$64,904,428 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct | Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct |
|---|---|---|
| 1 COASTAL HEALTH ASSURANCE | ||
| CE/PHYSICIAN ASSC. MEDICAL CONTRACTS | 0.50000 | 0.50000 |
| 2 ASTORIA IMAGING LLC | ||
| MRI JOINT VENTURE | 0.51000 | 0.51000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2111 EXCHANGE STREET | AddressLine1Txt |
| City | ASTORIA | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.COLUMBIAMEMORIAL.ORG | WebsiteAddressTxt |
| State License | 141146 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.COLUMBIAMEMORIAL.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.COLUMBIAMEMORIAL.ORG | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 299.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Explained Basis | 0 | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.COLUMBIAMEMORIAL.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.COLUMBIAMEMORIAL.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.COLUMBIAMEMORIAL.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Selling Debt | Yes (X) | PermitSellingDebtInd |
| Permit Legal Judicial Process | Yes (X) | PermitLegalJudicialProcessInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| COLUMBIA MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: COMMUNITY REPRESENTATION FOR PRIMARY DATA:PRIMARY DATA IS THE INFORMATION THAT HAS BEEN COLLECTED BY PARTNERS SPECIFICALLY FOR USE IN THIS ASSESSMENT. THEY INCLUDE HOSPITAL UTILIZATION DATA, A COMMUNITY HEALTH SURVEY, KEY STAKEHOLDER INTERVIEWS AND COMMUNITY LISTENING SESSIONS. SECONDARY DATA IS INFORMATION THAT HAS BEEN COLLECTED BY OTHERS FOR PURPOSES OTHER THAN THIS ASSESSMENT, BUT PROVIDE IMPORTANT CONTEXT OR OTHER DATA POINTS. THESE INCLUDE CLATSOP COUNTY PUBLIC HEALTH, COLUMBIA PACIFIC CCO, COUNTY HEALTH RANKINGS, ANNIE E CASEY KIDS COUNT REPORT AND OTHERS. |
| COLUMBIA MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6A: CHNA - CONDUCTED WITH PROVIDENCE SEASIDE HOSPITAL |
| COLUMBIA MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: BASED UPON THE VARIOUS SOURCES OF INFORMATION IN THE CHNA ASSESSMENT, ITEMS THAT WERE CORROBORATED BY TWO OR MORE SOURCES WERE IDENTIFIED AS KEY UNMET HEALTH NEEDS. THESE NEEDS WERE THEN GROUPED INTO FOUR ACTIONABLE CATAGORIES, WHICH WILL GUIDE EFFORTS IN DEVELOPING THE "COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). DUE TO THE INITIAL IDENTIFICATION OF NEEDS, THIS PRIORITIZATION INCLUDED WORSENING TRENDS, VALUES WORSE THAN STATE AVERAGES, AND A DISPROPORTIONATE IMPACT ON COMMUNITIES OF COLOR, LOW-INCOME, OR OTHERWISE MARGINALIZED GROUPS. ADDITIONAL PRIORITIZATION REGARDING FEASIBILITY, EFFECTIVENESS OF INTERVENTIONS, AND ABILITY TO PARTNER WITH COMMUNITY ORGANIZATIONS WILL BE APPLIED DURING CHIP DEVELOPMENT. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 17 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (17 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - INFUSION CLINIC | ||||
| 1905 EXCHANGE ST | ASTORIA | OR | 97103 | INFUSION SERVICES |
| 2 - ASTORIA IMAGING LLC | ||||
| 2111 EXCHANGE ST | ASTORIA | OR | 97103 | MRI SERVICES |
| 3 - CARDIOLOGY CLINIC | ||||
| 2095 EXCHANGE ST SUITE 301 | ASTORIA | OR | 97103 | CARDIOLOGY SERVICES |
| 4 - WARRENTON PRIMARY CARE (RHC) | ||||
| 1639 SE ENSIGN LANE SUITE B103 | WARRENTON | OR | 97146 | PRIMARY CARE SERVICES |
| 5 - WOMENS CENTER CLINIC | ||||
| 2265 EXCHANGE ST | ASTORIA | OR | 97103 | WOMEN'S SERVICES |
| 6 - ORTHOPEDIC CLINIC | ||||
| 2265 EXCHANGE ST | ASTORIA | OR | 97103 | ORTHOPEDIC SERVICES |
| 7 - GENERAL SURGERY CLINIC | ||||
| 2055 EXCHANGE ST SUITE 270 | ASTORIA | OR | 97103 | GENERAL SURGERY SERVICES |
| 8 - PEDIATRIC CLINIC | ||||
| 2265 EXCHANGE ST | ASTORIA | OR | 97103 | PEDIATRIC SERVICES |
| 9 - LOWER COLUMBIA HOSPICE | ||||
| 2158 EXCHANGE ST SUITE 206 | ASTORIA | OR | 97103 | HOSPICE SERVICES |
| 10 - URGENT CARE CLINIC | ||||
| 2265 EXCHANGE ST | ASTORIA | OR | 97103 | URGENT CARE SERVICES |
| 11 - FOOT & ANKLE CLINIC | ||||
| 2265 EXCHANGE ST 3RD FLOOR | ASTORIA | OR | 97103 | PODIATRY SERVICES |
| 12 - RADIATION ONCOLOGY CLINIC | ||||
| 1905 EXCHANGE ST | ASTORIA | OR | 97103 | RADIATION THERAPY SERVICES |
| 13 - MEDICAL ONCOLOGY CLINIC | ||||
| 1905 EXCHANGE ST | ASTORIA | OR | 97103 | MEDICAL ONCOLOGY SERVICES |
| 14 - UROLOGY CLINIC | ||||
| 2265 EXCHANGE ST | ASTORIA | OR | 97103 | UROLOGY SERVICES |
| 15 - ENDOCRINOLOGY | ||||
| 2158 EXCHANGE ST SUITE 205 | ASTORIA | OR | 97103 | ENDOCRINOLOGY SERVICES |
| 16 - PULMONOLOGY | ||||
| 2055 EXCHANGE ST SUITE 210 | ASTORIA | OR | 97103 | PULMONOLOGY SERVICES |
| 17 - WOUND CARE CLINIC | ||||
| 2265 EXCHANGE ST | ASTORIA | OR | 97103 | WOUND CARE SERVICES |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 4: | SEE PAGES 7-8 OF ATTACHED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | AS A MISSION-DRIVEN HOSPITAL, HEALTHCARE SERVICES ARE OFFERED TO THE COMMUNITY EVEN WHEN THE COST OF THAT CARE IS KNOWN TO BE MORE THAN THE REVENUE THAT WILL BE RECEIVED. AS THE HOSPITAL ABSORBS THESE LOSSES FROM MEDICARE (DETERMINED BY THE RATIOS USED IN THE MEDICARE COST REPORT), THE ENTIRE COMMUNITY BENEFITS BECAUSE MANY OF THESE PROGRAMS/SERVICES WOULD NOT EXIST WITHOUT HOSPITAL SUPPORT. |
| PART III, LINE 9B: | PERSONAL PAY ACCOUNTS AND THE BALANCE AFTER INSURANCE ARE SUBJECT TO A MINIMUM PAYMENT SCHEDULE. IF THE PATIENT OR GUARANTOR IS UNABLE TO MEET THIS PAYMENT SCHEDULE, APPLICATION MAY BE MADE THROUGH PATIENT FINANCIAL SERVICES CREDIT AND COLLECTION CLERK'(S) AND OR THE PATIENT FINANCIAL SERVICES MANAGER FOR CHARITY, FINANCIAL ASSISTANCE, OR REDUCED PAYMENTS. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | OR |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| ASTORIA-WARRENTON CHAMBER OF COMMERCE | |||||||
| PO BOX 176 | ASTORIA | OR | 97103 | 930115760 | 501(C)6 | $10,000 | GENERAL ASSISTANCE |
| ASTORIA REGATTA ASSOCIATION | |||||||
| PO BOX 24 | ASTORIA | OR | 97103 | 936082269 | 501(C)4 | $7,570 | GENERAL ASSISTANCE |
| CLATSOP COMMUNITY COLLEGE FOUNDATION | |||||||
| 1651 LEXINGTON AVENUE | ASTORIA | OR | 97103 | 930505508 | 501(C)3 | $54,060 | GENERAL ASSISTANCE |
| RESTORATION HOUSE | |||||||
| PO BOX 641 | SEASIDE | OR | 97138 | 931271134 | 501(C)3 | $30,000 | GENERAL ASSISTANCE |
| CARING FOR CLATSOP COALITION | |||||||
| 800 EXCHANGE ST | ASTORIA | OR | 97103 | 810729203 | 501(C)3 | $50,000 | GENERAL ASSISTANCE |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN BAXTER | ||||||||||||||
| BOARD MEMBER | $279,577 | $0 | $15,206 | $0 | $3,981 | $0 | $15,336 | $0 | $29,850 | $0 | $343,950 | $0 | $0 | $0 |
| ROBERT HOLLAND | ||||||||||||||
| BOARD MEMBER | $303,000 | $0 | $9,274 | $0 | $39,040 | $0 | $250 | $0 | $30,979 | $0 | $382,543 | $0 | $0 | $0 |
| TERESA L GURRAD | ||||||||||||||
| CCO | $194,618 | $0 | $19,894 | $0 | $14,771 | $0 | $15,949 | $0 | $16,412 | $0 | $261,644 | $0 | $0 | $0 |
| ERIK THORSEN | ||||||||||||||
| CEO | $405,119 | $0 | $88,064 | $0 | $60,188 | $0 | $70,954 | $0 | $20,779 | $0 | $645,104 | $0 | $0 | $0 |
| GALINA GANDY | ||||||||||||||
| VP - HEALTH INFO SERVICES | $189,856 | $0 | $38,297 | $0 | $38,720 | $0 | $10,997 | $0 | $24,344 | $0 | $302,214 | $0 | $0 | $0 |
| KATRINA M MCPHERSON | ||||||||||||||
| VP - MEDICAL GROUP OPERATI | $254,725 | $0 | $18,293 | $0 | $25,233 | $0 | $14,620 | $0 | $29,809 | $0 | $342,680 | $0 | $0 | $0 |
| JARROD P KARNOFSKI | ||||||||||||||
| VP - ANCILLIARY SERVICES | $182,027 | $0 | $21,478 | $0 | $26,321 | $0 | $16,219 | $0 | $19,975 | $0 | $266,020 | $0 | $0 | $0 |
| MICHAEL MITCHELL MD | ||||||||||||||
| PHYSICIAN | $363,539 | $0 | $228 | $0 | $0 | $0 | $6,750 | $0 | $29,850 | $0 | $400,367 | $0 | $0 | $0 |
| RICHARD CRASS MD | ||||||||||||||
| PHYSICIAN | $356,779 | $0 | $34,223 | $0 | $35,212 | $0 | $21,600 | $0 | $24,193 | $0 | $472,007 | $0 | $0 | $0 |
| CAMILO ROSALES MD | ||||||||||||||
| PHYSICIAN | $364,000 | $0 | $32,203 | $0 | $33,075 | $0 | $20,250 | $0 | $17,737 | $0 | $467,265 | $0 | $0 | $0 |
| PETER BALES MD | ||||||||||||||
| PHYSICIAN | $558,272 | $0 | $26,650 | $0 | $20,400 | $0 | $20,250 | $0 | $29,850 | $0 | $655,422 | $0 | $0 | $0 |
| DOUGLAS ABBOTT MD | ||||||||||||||
| PHYSICIAN | $587,943 | $0 | $26,928 | $0 | $18,231 | $0 | $21,407 | $0 | $19,975 | $0 | $674,484 | $0 | $0 | $0 |
| THOMAS SAFLEY | ||||||||||||||
| EX-OFFICIO | $144,884 | $0 | $122,085 | $0 | $24,905 | $0 | $0 | $0 | $16,227 | $0 | $308,101 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | ASTORIA GOLF AND COUNTRY CLUB DUES FOR CEO ERIK THORSEN AND CCO TERESA GURRAD WERE PAID BY THE ORGANIZATION. |
| PART I, LINE 4B | ERIK THORSEN, CEO IS PARTICIPATING IN A 457(F) PLAN WHICH STARTED IN 2015. |
| PART I, LINE 6 | MANAGEMENT BONUSES ARE CONTINGENT ON THE NET EARNINGS OF THE ORGANIZATION. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| THE HOSPITAL FACILITIES AUTHORITY OF THE CITY OF ASTORIA | ||||||||
| A | 270034718 | 046279BS3 | 2012-09-27 | $31,993,533 | FINANCE EHR SYSTEM, ASSET ACQUISTION, REFUNDING OF 2002 & 2007 BOND ISSUES | Yes (1) | 0 | 0 |
| THE HOSPITAL FACILITIES AUTHORITY OF THE CITY OF ASTORIA | ||||||||
| B | 270034718 | 046279CAI | 2016-07-07 | $20,451,436 | BUILDING OF THE CMH-OHSU KNIGHT CANCER COLLABORATIVE AND ER REMODEL | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceedsAmt | Capitalized InterestCapitalizedInterestAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | In Reserve FundInReserveFundAmt | Refunding EscrowRefundingEscrowAmt | Capital ExpendituresCapitalExpendituresAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $31,993,533 | $31,385 | $893,237 | 2015 | Yes (1) | 0 | Yes (1) | Yes (1) | |||
| B | $20,451,436 | $292,436 | $356,050 | 2017 | 0 | 0 | 0 | Yes (1) | $15,013,441 | $23,613 | $2,531,967 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | 0 |
| B | 0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART 1 SECTION (C) CUSIP # 2016 BOND | 046279CAI 046279B27 046279C89 |
| FORM 990, PART III, LINE 4A: STATMENT OF PROGRAM SERVICE ACCOMPLISHMENTS |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PETER BALES | PersonNm |
| Relationship With Org | EMPLOYEE | RelationshipWithOrgTxt |
| Loan Purpose | SIGN ON BONUS | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $20,000 | OriginalPrincipalAmt |
| Balance Due | $0 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | HEATHER SEPPA | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | CMH PRESIDENT | RelationshipDescriptionTxt |
| Transaction | OFFICER AT COLUMBIA STATE BANK, ONE OF THE PRIMARY BANKS USED BY CMH. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule M IRS990ScheduleM
Real Estate Residential RealEstateResidentialGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $268,866 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | NET BOOK VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | A DRAFT OF THE 990 IS MADE AVAILABLE, ELECTRONICALLY, TO THE BOARD OF TRUSTEES, PRIOR TO THE BOARD MEETING. THE 990 IS REVIEWED AND DISCUSSED AT THE BOARD FINANCE COMMITTEE MEETING PRIOR TO FINALIZING AND FILING THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS REVIEWED BY THE BOARD OF TRUSTEES, OFFICERS, AND KEY EMPLOYEES ANNUALLY. ALL BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES MUST SIGN AND DATE THE CONFLICT OF INTEREST POLICY ACKNOWLEDGEMENT, QUESTIONNAIRE, AND DISCLOSURE STATEMENT. ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST AT THE BOARD OR OFFICER LEVEL ARE DISCUSSED AT THE BOARD MEETING. ACTUAL CONFLICTS OF INTEREST ARE ADDRESSED, DOCUMENTED, AND FILED IN THE CONFIDENTIAL PERSONNEL FILE. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION OF ALL OFFICERS WAS REVIEWED WITH COMPARABILITY DATA BY A THIRD-PARTY CONSULTANT. THE RESULTS OF THE STUDY WERE REVIEWED AND DISCUSSED AT A BOARD OF TRUSTEES' MEETING. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL INFORMATION REPORTED IN THE 990 ARE AVAILABLE UPON REQUEST AT THE HOSPITAL. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 9,684,562. MANAGEMENT AND GENERAL EXPENSES 844,258. FUNDRAISING EXPENSES 38,417. TOTAL EXPENSES 10,567,237. |
| FORM 990, PART XI, LINE 9: | DEFINED BENEFIT RETIREMENT PLAN ADJUSTMENT 3,338,557. NET ASSETS RELEASED FROM RESTRICTION - CITY OF ASTORIA GRANT 92,970. HOSPICE EQUITY TRANSFER TO FOUNDATION -724,007. |
| FROM 990, PART XI, LINE 2C: | THE BOARD OF TRUSTEE FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT, REVIEW, AND SELECTION OF AN INDEPENDENT AUDIT FIRM. TRADITIONALLY, A THREE YEAR CONTRACT WITH A SELECTED AUDIT FIRM IS APPROVED. ANNUALLY, A SPECIAL BOARD MEETING IS HELD AND THE AUDIT FIRM PRESENTS THE AUDITED FINANCIAL STATEMENTS TO THE BOARD OF TRUSTEES. DURING THE MEETING, THE BOARD MEMBERS ARE GIVEN THE OPPORTUNITY TO ASK QUESTIONS WITHOUT MANAGEMENT PRESENT. FOLLOW-UP INFORMATION ON THE MANAGEMENT LETTER RECOMMENDATIONS IS ALSO PRESENTED SEMI-ANNUALLY TO THE BOARD FINANCE COMMITTEE. |
| FORM 990, PART III, LINE 4A: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | MISSION STATEMENT: THE MISSION OF COLUMBIA MEMORIAL HOSPITAL IS TO PROVIDE EXCELLENCE, LEADERSHIP, AND COMPASSION IN THE ENHANCEMENT OF HEALTH FOR THOSE WE SERVE. UTILIZATION STATISTICES: YEAR ENDING 2015 2016 2017 AVAILABLE BEDS 25 25 25 ADMISSIONS 1,597 1,587 1,653 PATIENT DAYS 4,595 4,613 4,836 OBSERVATIONS 536 516 318 AVERAGE LENGTH OF STAY (IN DAYS) 2.88 2.91 2.93 OCCUPANCY RATE 50.4% 50.4% 53.0% DELIVERIES 317 344 302 EMERGENCY ROOM VISITS 13,255 13,786 13,133 URGENT CARE VISITS 12,854 13,984 14,781 OUTPATIENT VISITS (NET OF ER) 160,544 177,896 186,694 SURGICAL CASES: 2,448 2,554 3,000 PLANETREE DESIGNATION THE HOSPITAL HAS ADOPTED A PHILOSOPHY OF PROVIDING PATIENT-CENTERED CARE THROUGHOUT ITS FACILITIES. IN 2000, THE HOSPITAL JOINED AN ORGANIZATION CALLED PLANETREE, INC ("PLANETREE") AS AN AFFILIATE MEMBER. PLANETREE PARTNERS WITH HEALTHCARE ORGANIZATIONS AROUND THE WORLD TO DEVELOP AND ADVANCE PATIENT CENTERED APPROACHES TO CARE. IN 2013, THE HOSPITAL BECAME ONLY THE SECOND HOSPITAL IN OREGON TO ACHIEVE THE PRESTIGIOUS PLANETREE DESIGNATION STATUS. PLANETREE-DESIGNATION REPRESENTS THE HIGHEST LEVEL OF ACHIEVEMENT IN PATIENT/PERSON-CENTERED CARE BASED ON EVIDENCE AND STANDARDS, ACCORDING TO PLANETREE. PLANETREE-DESIGNATED HOSPITALS MUST DEMONSTRATE THEIR COMMITMENT AND SUCCESSFUL ADOPTION OF THE PATIENT CENTERED CARE PRINCIPLES BY PASSING A RIGOROUS SURVEY PROCESS, PERFORMED BY PLANETREE EVERY THREE YEARS. COLUMBIA MEMORIAL HOSPITAL WAS AWARDED RE-DESIGNATION FOR ANOTHER THREE YEARS IN NOVEMBER 2016 AT THE ANNUAL PLANTREE CONFERENCE. THE HOSPITAL HAS MAINTAINED PLANETREE DESIGNATION BY CREATING AN ORGANIZATIONAL CULTURE COMMITTED TO PROVIDING THE LATEST IN MEDICAL TECHNOLOGY IN A HEALING, NURTURING ENVIRONMENT THAT ENCOURAGES A PATIENT'S INVOLVEMENT IN THE CARE THAT THEY RECEIVE. THE HOSPITAL CONTINUALLY STRIVES TO OFFER PEACEFUL, COMFORTABLE SURROUNDINGS, WARM AND SUPPORTIVE CAREGIVERS, ACCESS TO HEALTH INFORMATION ALTERNATIVE THERAPIES, AND EDUCATION TO HELP PATIENTS GET WELL FASTER AND STAY WELL LONGER. COLUMBIA MEMORIAL HOSPITAL RECENT ACCREDITATIONS: 1. HEALTHCARE FACILITIES ACCREDITATION PROGRAM (HFAP) - NATIONALLY RECOGNIZED ACCREDITATION - ORGANIZATION WITH DEEMING AUTHORITY FROM THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) 2. COMMISSION OF OFFICE LABORATORY ACCREDITATION (COLA) - LABORATORY ACCREDITATION 3. AMERICAN COLLEGE OF RADIOLOGY MAMMOGRAPHY QUALITY STANDARDS ACT (ACR/MSQA) - IMAGING SERVICES/MAMO ACCRED. 4. INTER-SOCIETAL ACCREDITATION COMMISSION (IAC) - ECHOCARDIOGRAPHY ACCREDITATION 5. AMERICAN ASSOCIATION OF CARDIOVASULAR REHABILITATION (AACVP) - CARDIAC REHABILITATION ACCREDITATION 6. AMERICAN ASSOC. FOR RESPIRATORY CARE QUALITY RESPIRATORY CARE RECOGNITION (AARC'S QRCR) RESPIRATORY THERAPY ACCREDITATION INFORMATION TECHNOLOGY: THE HOSPITAL'S INVESTMENT IN THE HEALTHCARE INFORMATION TECHNOLOGY ALONG WITH THE NESESSARY HUMAN RESOURCES AND ASSOCIATED PROCESS CHANGE HAVE RESULTED IN IMPROVED CLINICAL OPERATIONS, QUALITY, PATIENT SAFETY, AND OVERALL EFFICIENCY. THE HOSPITAL RECEIVED THE MOST WIRED AWARD FROM THE AMERICAN HOSPITAL ASSOCIATION IN SEVEN CONSECUTIVE YEAR OF 2011- 2017. THE HOSPITAL HAS ALSO ACHIEVED COMPLIANCE WITH THE AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009 MEANINGFUL USE OF HEALTHCARE IT CRITERIA BOTH STAGE 1 AND STAGE 2. SINCE 2012, THE HOSPITAL HAS REALIZED MEANINGFUL USE INCENTIVE REVENUES OF APPROXIMATELY $3,164,000. THE HOSPITAL INVESTED IN AN INDUSTRY LEADING BUSINESS INTELLIGENCE PLATFORM WHICH IS UTILIZED IN OPTIMIZING OPERATIONS AND FINANCIAL PERFORMANCE. CMH MEDICAL GROUP: THE HOSPITAL OWNS AND OPERATES A NUMBER OF PROVIDER-BASED PRIMARY, URGENT CARE, AND SPECIALTY CARE CLINICS ORGANIZED AND COLLECTIVELY KNOW AS THE CMH MEDICAL GROUP. THE CLINICS OPERATE IN 3 SEPERATE ASTORIA LOCATIONS AND 1 WARRENTON, OREGON LOCATION. THE WARRENTON LOCATION OPERATES AS A PROVIDER-BASED RURAL HEALTH CLINIC, WHICH EXPANDED AND DOUBLED THE CAPACITY TO PROVIDE PRIMARY CARE SERVICES FOR THE COMMUNITY IN 2015. THERE ARE THIRTY-SIX (34) PHYSICIANS AND MID-LEVEL PROVIDERS EMPLOYED WITHIN THE CMH MEDICAL GROUP IN ELEVEN DIFFERENT MEDICAL SPECIALTIES. THESE SPECIALTIES INCLUDE: GENERAL SURGERY, PEDIATRICS, PRIMARY CARE, URGENT CARE, UROLOGY, ENDOCRINOLOGY, ORTHOPEDICS, PODIATRY, AND WOMEN'S HEALTHCARE, ONCOLOGY IN COLLABORATION WITH OHSU, CARIOLLOGY AND GENERAL SURGERY ALSO IN COLLABORATION WITH OHSU. CLINICAL COLLABORATIONS: IN ORDER TO ENHANCE THE SERVICES THAT THE HOSPITAL PROVIDES TO THE COMMUNITY, THE HOSPITAL ESTABLISHED A CLINICAL ALLIANCE WITH OHSU IN 2010. THROUGH THIS ALLIANCE, THE HOSPITAL AND OHSU INITIALLY CREATED THE CMH/OHSU CANCER CARE CENTER WHICH WAS DEDICATED TO PROVIDING COMPREHENSIVE, INTER-DISCIPLINARY, CONSULTATIVE, AND ONGOING ONCOLOGY AND HEMATOLOGY CARE. IN 2011, THE HOSPITAL AND OHSU ESTABLISHED THE CMH/OHSU CARDIOLOGY CLINIC, WHICH PROVIDES COMPREHENSIVE CARE FOR A RANGE OF HEART HEALTH AND HEART DIISEASE PREVENTION NEEDS IN THE COMMUNITY. SINCE 2011, THE ALLIANCE HAS BROADENED SUBSTANTIALLY AND NOW INCLUDES CLINICAL OVERSIGHT AND STAFFING OF THE HOSPITAL'S EMERGENCY DEPARTMENT, GENERAL SURGERY AND RESIDENCY PROGRAMS, TELEMEDICINE, A WOMEN'S HEART HEALTH PROJECT AND CONTINUING MEDICAL EDUCATION. IN TOTAL, THERE ARE APPROXIMATELY 13 OHSU PHYSICIANS WORKING FULL-TIME IN THE HOSPITAL'S FACILITIES. JOINT OPERATING AGREEMENT: IN THE FIRST QUARTER OF 2015, THE HOSPITAL ENTERED INTO A JOINT OPERATING AGREEMENT (JOA) WITH OHSU THROUGH THE OHSU KNIGHT CANCER INSTITUTE TO BETTER SERVE THE ONCOLOGY CARE NEEDS OF ASTORIA AND SURROUNDING COMMUNITIES IN OREGON AND SOUTHWEST WASHINGTON. A BOND WAS SECURED IN JULY OF 2016 TO PROVIDE FOR THE FINANCING OF A 19,000 SQUARE-FOOT, TWO-STORY COMPREHENSIVE CANCER TREATMENT CENTER AND EQUIPMENT. CONSTRUCTION ON THE CANCER TREATMENT CENTER BEGAN IN AUGUST OF 2016 AND WAS COMPLETED IN THE FALL OF 2017. THE JOA AND ADDITIONAL SPACE AND EQUIPMENT PROVIDED CMH THE OPPORTUNITY TO EXPAND SERVICES TO INCLUDE RADIATION THERAPY IN ADDITION TO MEDICAL ONCOLOGY AND INFUSION THERAPY SERVICES. COLUMBIA MEMORIAL HOSPITAL & OHSU KNIGHT CANCER COLLABORATION IS THE ONLY PROVIDER ON THE NORTH OREGON COAST THAT PROVIDES RADIATION THERAPY SERVICES. CMH FOUNDATION: THE HOSPITAL BENEFITS FORM SUBSTANTIAL COMMUNITY SUPPORT. THE FOUNDATION PROVIDES A DIRECT LINK TO THE REGION'S NEED FOR COMPASSIONATE HEALTH CARE BY SUPPORTING THE ENHANCEMENT OF THE HOSPITAL'S PROGRAMS AND SERVICES. THE FOUNDATION WAS INCORPORATED IN 1991 BY A GROUP OF CITIZENS TO SERVE AS THE BRIDGE BETWEEN THE COMMUNITY AND THE HOSPITAL TO ENCOURAGE FINANCIAL SUPPORT OF HEALTH PROGRAMS AND SERVICES. THE FOUNDATION IS A DEDICATED FUND DEVELOPMENT ENITY THAT HAS SUCCESSFULLY RAISED OVER $5,000,000. IN 2010, THE FOUNDATION CONTRIBUTED $500,000 TO THE HOSPITAL TO ASSIST WITH THE SURGERY CENTER RENOVATION. THIS SUPPORT CONTINUED WITH A $185,000 DONATION IN 2012 FOR THE CONTINUED EXPANSION OF THE CANCER CENTER AND HAS RAISED AN ADDITION OF $2,000,000 TO BENEFIT THAT PROGRAM. THE FOUNDATION FOCUSES ON WORKING WITH DONORS WHO WISH TO MAKE MAJOR AND PLANNED GIFTS IN SUPPORT OF THE HOSPITAL. IN SOME CASES, THE FOUNDATION WILL RAISE FUNDS TO SUPPORT A VARIETY OF PRIORITIES AS IDENTIFIED BY THE HOSPITAL AND IN PARTNERSHIP WITH DONORS. THE FOUNDATION PROVIDES OPPORTUNITIES FOR DONORS TO SUPPORT A MISSION THAT MATCHES THEIR OWN INTERESTS SUCH AS PROVIDING EQUIPMENT, CREATING PROGRAMS TO SERVE THE COMMUNITY OR FUNDING THE FUTURE ENDOWMENT. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EXCHANGE STREET LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2111 EXCHANGE STREET | AddressLine1Txt |
| City | ASTORIA | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | HOLDS TITLE TO REAL PROPERTY | PrimaryActivitiesTxt |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Total Income | $4,217 | TotalIncomeAmt |
| End Of Year Assets | $745,959 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA LUTHERAN CHARITIES | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| COLUMBIA MEMORIAL HOSPITAL FOUNDATION | |||||||||
| 2111 EXCHANGE STREET | ASTORIA | OR | 97103 | 931091701 | FUNDRAISING-CMH | OR | 501(C)3 | LINE 12C, III-FI | Yes (1) |
| COLUMBIA MEMORIAL HOSPITAL AUXILIARY | |||||||||
| 2111 EXCHANGE STREET | ASTORIA | OR | 97103 | 931306211 | PROVIDE VOLUNTEERS | OR | 501(C)3 | LINE 12A, I | 0 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASTORIA IMAGING LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2111 EXCHANGE STREET | AddressLine1Txt |
| City | ASTORIA | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 800240381 | EIN |
| Primary Activities | MRI JOINT VENTURE | PrimaryActivitiesTxt |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $1,506,899 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $1,993,213 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (1) | GeneralOrManagingPartnerInd |
| Ownership | 0.51000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COASTAL HEALTH ASSURANCE INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2111 EXCHANGE STREET | AddressLine1Txt |
| City | ASTORIA | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911818894 | EIN |
| Primary Activities | PHYSICAN ASSOCIATION, MEDICAL CONTRACT MANAGEMENT | PrimaryActivitiesTxt |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Entity Type | C | EntityTypeTxt |
| Ownership | 0.50000 | OwnershipPct |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt | Transaction TypeTransactionTypeTxt |
|---|---|---|
| COLUMBIA MEMORIAL HOSPITAL FOUNDATION | ||
| $196,520 | ACTUAL | |
| COLUMBIA MEMORIAL HOSPITAL FOUNDATION | ||
| $259,569 | ACTUAL | O |
| ASTORIA IMAGING LLC | ||
| $178,639 | ACTUAL | O |
| COLUMBIA MEMORIAL HOSPITAL FOUNDATION | ||
| $268,866 | NET BOOK VALUE | C |
| COLUMBIA MEMORIAL HOSPITAL FOUNDATION | ||
| $644,827 | ACTUAL | R |