COLUMBUS COUNTY HOSPITAL FOUNDATION INC: Form 990EZ, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- COLUMBUS COUNTY HOSPITAL FOUNDATION INC (EIN 01-0673231)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-07-01
- IRS object ID
- 201531829349200803
- Schema version
- 2013v4.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-07-01T11:02:50-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 560747981 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1 |
| City | ASHEVILLE | City |
| State | NC | State |
| ZIP Code | 28806 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010673231 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBUS COUNTY HOSPITAL FOUNDATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COLU | BusinessNameControlTxt |
| Phone | 9106421703 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 JEFFERSON STREET | AddressLine1 |
| City | WHITEVILLE | City |
| State | NC | State |
| ZIP Code | 284723696 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TERRIE PRIEST | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 9106421703 | PhoneNum |
| Signature | 2015-07-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMY BIBBY | PreparerPersonNm |
| PTIN | P00445891 | PTIN |
| Phone | 8282542254 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Website Address | WWW.CRHEALTHCARE.ORG | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $72,806 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Investment Income | $26 | InvestmentIncomeAmt |
| Fundraising Gross Income | $72,780 | FundraisingGrossIncomeAmt |
| Special Events Direct Expenses | $20,927 | SpecialEventsDirectExpensesAmt |
| Special Events Net Income Loss | $51,853 | SpecialEventsNetIncomeLossAmt |
| Total Revenue | $51,879 | TotalRevenueAmt |
| Salaries Other Comp Empl Bnft | $33,601 | SalariesOtherCompEmplBnftAmt |
| Fees And Other Pymt To Ind Cntrct | $23,042 | FeesAndOtherPymtToIndCntrctAmt |
| Printing Publications Postage | $146 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $45,948 | OtherExpensesTotalAmt |
| Total Expenses | $102,737 | TotalExpensesAmt |
| Excess Or Deficit For Year | -$50,858 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | -$103,192 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | -$72,780 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | -$226,830 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $154,602 | BOYAmt |
| EOY | $92,655 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $154,602 | BOYAmt |
| EOY | $92,655 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $257,794 | BOYAmt |
| EOY | $319,485 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$103,192 | BOYAmt |
| EOY | -$226,830 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | TO SUPPORT COLUMBUS REGIONAL HEALTHCARE SYSTEM AND PROMOTE COMMUNITY BENEFIT PROGRAMS WITHIN COLUMBUS COUNTY, NORTH CAROLINA. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | THE FOUNDATION SUPPORTS COLUMBUS REGIONAL HEALTHCARE SYSTEM IN PROVIDING SCHOLARSHIPS TO AREA HIGH SCHOOL STUDENTS THAT ARE PARTICIPATING IN THE HEALTH OCCUPATIONS STUDENTS OF AMERICA PROGRAMS (HOSA) AT THEIR HIGH SCHOOL. | DescriptionProgramSrvcAccomTxt |
| Grants And Allocations | $61,787 | GrantsAndAllocationsAmt |
| Program Service Expenses | $123,664 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $123,664 | TotalProgramServiceExpensesAmt |
| Info In Schedule O Part IV | Yes (X) | InfoInScheduleOPartIVInd |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (12 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| JOHN HODGSON | ||||
| CHAIRMAN | 1.00 | $0 | $0 | $0 |
| BRENDA JOLLY | ||||
| VICE CHAIRMAN | 1.00 | $0 | $0 | $0 |
| BUTCH HOOKS | ||||
| TREASURER | 1.00 | $0 | $0 | $0 |
| LINDA BELL | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| PEGGY BLACKMON | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| LUIS DONAYRE MD | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| ABIGAL EDWARDS | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| JUDY ENZOR | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| PAUL GERALD | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| DANIEL HILBURN | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| LOU HOOKS | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| BRIAN JENKINS | ||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | 0 | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | 0 | OrganizationHadUBIInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Direct Indirect Pltcl Expend | $0 | DirectIndirectPltclExpendAmt |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficersInd |
| Tax Imposed Under IRC4911 | $0 | TaxImposedUnderIRC4911Amt |
| Tax Imposed Under IRC4912 | $0 | TaxImposedUnderIRC4912Amt |
| Tax Imposed Under IRC4955 | $0 | TaxImposedUnderIRC4955Amt |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| Tax Imposed On Organization Mgr | $0 | TaxImposedOnOrganizationMgrAmt |
| Tax Reimbursed By Organization | $0 | TaxReimbursedByOrganizationAmt |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TERRIE PRIEST | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 JEFFERSON STREET | AddressLine1 |
| City | WHITEVILLE | City |
| State | NC | State |
| ZIP Code | 28742 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9106421703 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Donor Advised Fnds | 0 | DonorAdvisedFndsInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Tanning Services Provided | 0 | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| School Operating | 0 | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (1) | FiledScheduleAInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBUS REGIONAL HEALTHCARE SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560538020 | EIN |
| Organization Type | 3 | OrganizationTypeDesc |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
Fundraiser Activity Info FundraiserActivityInfoGrp
Organization Business Name OrganizationBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CUSTOM DEVELOPMENT SOLUTIONS | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 721 LONG POINT ROAD SUITE 405 | AddressLine1 |
| City | MT PLEASANT | City |
| State | SC | State |
| ZIP Code | 29464 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | FUNDRAISING CONSULTANT | ActivityTxt |
| Fundraiser Control Of Funds | 0 | FundraiserControlOfFundsInd |
| Gross Receipts | $0 | GrossReceiptsAmt |
| Retained By Contractor | $162,500 | RetainedByContractorAmt |
| Net To Organization | $162,500 | NetToOrganizationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Retained By Contractors | $162,500 | TotalRetainedByContractorsAmt |
| Total Net To Organization | $162,500 | TotalNetToOrganizationAmt |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | THE ANNUAL HOSPITAL GALA | NameOfEvent1Amt |
| Gross Receipts Event1 | $72,780 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $72,780 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $3,300 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $1,000 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $7,480 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $3,500 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $5,647 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $72,780 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $72,780 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $3,300 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $1,000 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $7,480 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $3,500 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $5,647 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $20,927 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $51,853 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990-EZ, PART I, LINE 4 - OTHER INVESTMENT INCOME | DESCRIPTION: INTEREST INCOME. AMOUNT: 26. |
| FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES | DESCRIPTION: BANKING FEES. AMOUNT: 186. DESCRIPTION: FOOD. AMOUNT: 852. DESCRIPTION: SUPPLIES. AMOUNT: 1,050. DESCRIPTION: COMMUNITY BENEFIT. AMOUNT: 3,000. DESCRIPTION: FUNDRAISING EXPENSES. AMOUNT: 40,860. TOTAL TO FORM 990-EZ, LINE 16: 45,948. |
| FORM 990-EZ, PART I, LINE 20 - OTHER CHANGES IN NET ASSETS | DESCRIPTION: SPECIAL EVENTS INCOME. AMOUNT: -72,780. |
| FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIES | DESCRIPTION: DUE TO CRHS. BEG. OF YEAR AMOUNT: 256,983. END OF YEAR AMOUNT: 319,485. DESCRIPTION: FOUNDATION FUNDRAISER PAYABLE. BEG. OF YEAR AMOUNT: 811. END OF YEAR AMOUNT: 0. |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT. | DeclarationDesc |