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COLUMBIA LUTHERAN CHARITIES: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
COLUMBIA LUTHERAN CHARITIES (EIN 93-0583856)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-08-17
IRS object ID
201542309349300809
Schema version
2014v5.0
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

FieldValueIRS element (for citing)
Return2015-08-17T12:54:36-05:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN930418710PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DELAP LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15885 MEADOWS ROAD NO 200AddressLine1Txt
CityLAKE OSWEGOCityNm
State AbbreviationORStateAbbreviationCd
ZIP97035ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN930583856EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COLUMBIA LUTHERAN CHARITIESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOLUBusinessNameControlTxt
Phone5033254321PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12111 EXCHANGE STREETAddressLine1Txt
CityASTORIACityNm
State AbbreviationORStateAbbreviationCd
ZIP971033329ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSTEPHANIE D BRENDENPersonNm
Person TitleCFOPersonTitleTxt
Phone5033254321PhoneNum
Signature2015-08-18SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMARK E EKLUND CPAPreparerPersonNm
PTINP00156145PTIN
Phone5036974118PhoneNum
Preparation2015-08-18PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-04-25 22:37:26ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1COLUMBIA MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerSTEPHANIE D BRENDENPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12111 EXCHANGE STREETAddressLine1Txt
CityASTORIACityNm
State AbbreviationORStateAbbreviationCd
ZIP971033329ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$80,254,326GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.COLUMBIAMEMORIAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1958FormationYr
Legal Domicile StateORLegalDomicileStateCd
Activity Or MissionPROVIDE EXCELLENCE, LEADERSHIP & COMPASSION IN THE ENHANCEMENT OF HEALTH FOR THOSE WE SERVE.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee610TotalEmployeeCnt
Total Volunteers103TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$857,064PYContributionsGrantsAmt
CY Contributions Grants$733,743CYContributionsGrantsAmt
PY Program Service Revenue$67,712,027PYProgramServiceRevenueAmt
CY Program Service Revenue$76,151,726CYProgramServiceRevenueAmt
PY Investment Income$429,765PYInvestmentIncomeAmt
CY Investment Income$698,482CYInvestmentIncomeAmt
PY Other Revenue$2,383,349PYOtherRevenueAmt
CY Other Revenue$2,590,754CYOtherRevenueAmt
PY Total Revenue$71,382,205PYTotalRevenueAmt
CY Total Revenue$80,174,705CYTotalRevenueAmt
PY Grants And Similar Paid$65,100PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$38,065CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$39,941,801PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$41,698,697CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$241,576CYTotalFundraisingExpenseAmt
PY Other Expenses$27,626,143PYOtherExpensesAmt
CY Other Expenses$33,427,207CYOtherExpensesAmt
PY Total Expenses$67,633,044PYTotalExpensesAmt
CY Total Expenses$75,163,969CYTotalExpensesAmt
PY Revenues Less Expenses$3,749,161PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,010,736CYRevenuesLessExpensesAmt
Total Assets BOY$90,849,713TotalAssetsBOYAmt
Total Assets EOY$93,169,432TotalAssetsEOYAmt
Total Liabilities BOY$47,251,547TotalLiabilitiesBOYAmt
Total Liabilities EOY$50,819,948TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$43,598,166NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$42,349,484NetAssetsOrFundBalancesEOYAmt
MissionTHE 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 Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$64,462,154ExpenseAmt
Grant$38,065GrantAmt
Revenue$78,423,371RevenueAmt
DescSEE SCHEDULE ODesc
Total Program Service Expenses$64,462,154TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan OutstandingYes (1)LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document116IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee610EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind0Form8899Filedind
Form1098 C Filed0Form1098CFiledInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local ChaptersYes (1)LocalChaptersInd
Policies Reference ChaptersYes (1)PoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or Procedure0WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldORStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1STEPHANIE D BRENDEN CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5033387505PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12111 EXCHANGE STREETAddressLine1Txt
CityASTORIACityNm
State AbbreviationORStateAbbreviationCd
ZIP97103ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
DAVID PHILLIPS
BOARD MEMBER3.00Yes (X)$0$0$0
BILL LIND
BOARD MEMBER3.00Yes (X)$0$0$0
HEATHER SEPPA
BOARD MEMBER3.00Yes (X)$0$0$0
KEVIN BAXTER
BOARD MEMBER3.00Yes (X)$0$0$0
BILL LANDWEHR
BOARD MEMBER3.00Yes (X)$0$0$0
NANCY MCALLISTER
BOARD MEMBER3.00Yes (X)$0$0$0
KATHERINE HELLBERG
BOARD MEMBER3.00Yes (X)$0$0$0
ED NELSON JR
BOARD MEMBER3.00Yes (X)$0$0$0
NORMAN SHATTO
BOARD MEMBER3.00Yes (X)$0$0$0
MALCOLM SMITH
BOARD MEMBER3.00Yes (X)$0$0$0
MARK SMITH
BOARD MEMBER3.00Yes (X)$0$0$0
CONSTANCE WAISANEN
BOARD MEMBER3.00Yes (X)$0$0$0
HOUMAN SABAHI
BOARD MEMBER3.00Yes (X)$0$0$0
ROBERT HOLLAND
BOARD MEMBER40.00Yes (X)$301,878$0$32,160
ERIK THORSEN
CEO40.00$339,845$0$21,465Yes (X)
STEPHANIE D BRENDEN
CFO40.00$201,642$0$29,483Yes (X)
TERESA L GURRAD
CCO40.00$179,163$0$28,049Yes (X)
JARROD P KARNOFSKI
VP - ANCILLIARY SERVICES40.00$155,004$0$43,742Yes (X)
KATRINA M MCPHERSON
VP - MEDICAL GROUP OPERATIONS40.00$222,962$0$44,428Yes (X)
DOUGLAS ABBOTT MD
PHYSICIAN40.00$583,342$0$51,354Yes (X)
RICHARD CRASS MD
PHYSICIAN40.00$370,448$0$42,762Yes (X)
EDOUARD DURET MD
PHYSICIAN40.00$363,287$0$51,493Yes (X)
CHRISTOPHER NYTE MD
PHYSICIAN40.00$384,300$0$37,532Yes (X)
DAVID LEIBEL DO
PHYSICIAN40.00$318,001$0$46,636Yes (X)
WILLIAM G RIVERS
FORMER CIO40.00$179,578$0$9,525Yes (X)
KENNETH M BOUCHER
FORMER COO40.00$235,884$0$20,616Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,835,334TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$459,245TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K59IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
P&C CONTRUCTION
2133 NW YORK STREETPORTLANDOR97210GENERAL CONTRACTOR$7,178,794
CERNER CORPORATION
2800 ROCKCREEK PKWYKANSAS CITYMO64117HOSPITAL SOFTWARE$2,872,131
NORTH COAST EMERGENCY
2111 EXCHANGE STREETASTORIAOR97103EMERGENCY ROOM PHYSICIANS$1,833,465
ANESTHESIA ASSOC NW LLC
6400 SE LAKE RD STE 130PORTLANDOR97222ANESTHESIOLOGY PHYSICIANS$1,422,844
RICKENBACK CONSTRUCTION INC
37734 EAGLE LANEASTORIAOR97103GENERAL CONTRACTOR$1,246,538
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K22CntrctRcvdGreaterThan100KCnt
Related Organizations$7,047RelatedOrganizationsAmt
Government Grants$36,769GovernmentGrantsAmt
All Other Contributions$689,927AllOtherContributionsAmt
Total Contributions$733,743TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
OUTPATIENT REVENUE621990$83,693,608$83,693,608
EMERGENCY ROOM REVENUE621990$33,220,776$33,220,776
INPATIENT REVENUE621990$29,276,504$29,276,504
PROVISION FOR CHARITY CARE621990-$1,445,114-$1,445,114
CONTRACTUAL ALLOWANCE621990-$66,811,842-$66,811,842

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,782,206TotalRevenueColumnAmt
Related Or Exempt Func Income-$1,782,206RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$76,151,726TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$59,213TotalRevenueColumnAmt
Exclusion$59,213ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$382,075TotalRevenueColumnAmt
Exclusion$382,075ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$309,590RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$50,704RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$258,886RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$258,886TotalRevenueColumnAmt
Related Or Exempt Func Income$258,886RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$286,111SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$28,917SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$257,194SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$257,194TotalRevenueColumnAmt
Exclusion$257,194ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
JOINT VENTURE621500$1,078,476$1,078,476
CAFETERIA AND VENDING722210$319,109$319,109
PHARMACY SERVICES446110$174,629$174,629

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$759,654TotalRevenueColumnAmt
Related Or Exempt Func Income$759,654RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,331,868OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$80,174,705TotalRevenueColumnAmt
Related Or Exempt Func Income$78,423,371RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,017,591ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$38,065TotalAmt
Program Services$38,065ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,711,387TotalAmt
Management And General$1,711,387ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$31,317,648TotalAmt
Program Services$28,065,318ProgramServicesAmt
Management And General$3,079,316ManagementAndGeneralAmt
Fundraising$173,014FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,855,014TotalAmt
Program Services$1,598,206ProgramServicesAmt
Management And General$243,235ManagementAndGeneralAmt
Fundraising$13,573FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,341,006TotalAmt
Program Services$3,802,000ProgramServicesAmt
Management And General$514,060ManagementAndGeneralAmt
Fundraising$24,946FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,473,642TotalAmt
Program Services$2,148,276ProgramServicesAmt
Management And General$312,843ManagementAndGeneralAmt
Fundraising$12,523FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$229,264TotalAmt
Management And General$229,264ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$127,460TotalAmt
Management And General$109,940ManagementAndGeneralAmt
Fundraising$17,520FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$6,541,735TotalAmt
Program Services$5,902,280ProgramServicesAmt
Management And General$639,455ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$255,525TotalAmt
Program Services$3,675ProgramServicesAmt
Management And General$251,850ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$274,401TotalAmt
Program Services$169,030ProgramServicesAmt
Management And General$105,371ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,397,613TotalAmt
Program Services$1,223,104ProgramServicesAmt
Management And General$174,509ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,635,641TotalAmt
Program Services$1,365,124ProgramServicesAmt
Management And General$270,517ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$60,173TotalAmt
Program Services$51,888ProgramServicesAmt
Management And General$8,285ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$435,768TotalAmt
Program Services$240,590ProgramServicesAmt
Management And General$195,178ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$940,615TotalAmt
Program Services$940,615ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,089,496TotalAmt
Program Services$3,156,209ProgramServicesAmt
Management And General$933,287ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$931,647TotalAmt
Program Services$931,647ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & PHAR$9,640,856$9,640,856
OTHER PURCHASED SERVICE$1,667,320$675,776$991,544
REPAIRS & MAINTENANCE$1,294,219$1,265,347$28,872
OUTSIDE MEDICAL SERVICE$691,899$688,362$3,537

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,213,575TotalAmt
Program Services$2,555,786ProgramServicesAmt
Management And General$657,789ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$75,163,969TotalAmt
Program Services$64,462,154ProgramServicesAmt
Management And General$10,460,239ManagementAndGeneralAmt
Fundraising$241,576FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,676,971BOYAmt
EOY$2,422,186EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$12,030,548BOYAmt
EOY$19,245,687EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$28,889BOYAmt
EOY$22,222EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$179,810BOYAmt
EOY$151,735EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,380,522BOYAmt
EOY$1,794,224EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,000,508BOYAmt
EOY$971,257EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$79,304,172LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$37,402,963LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$33,001,773BOYAmt
EOY$41,901,209EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$29,322,648BOYAmt
EOY$22,664,385EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$1,935,112BOYAmt
EOY$1,881,411EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$777,767BOYAmt
EOY$722,194EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,515,165BOYAmt
EOY$1,392,922EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$90,849,713BOYAmt
EOY$93,169,432EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$11,105,782BOYAmt
EOY$9,379,141EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$30,917,985BOYAmt
EOY$30,513,084EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,227,780BOYAmt
EOY$10,927,723EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$47,251,547BOYAmt
EOY$50,819,948EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$43,528,835BOYAmt
EOY$42,286,216EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$69,331BOYAmt
EOY$63,268EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$43,598,166BOYAmt
EOY$42,349,484EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$90,849,713BOYAmt
EOY$93,169,432EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,010,736ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$309,509NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$6,568,927OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$7,480,255InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$1,125,135OtherCostOrOtherBasisAmt
Book Value$8,605,390BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$6,905,421InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$23,807,239OtherCostOrOtherBasisAmt
Depreciation$15,040,522DepreciationAmt
Book Value$15,672,138BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,257,051OtherCostOrOtherBasisAmt
Depreciation$473,468DepreciationAmt
Book Value$783,583BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$38,631,961OtherCostOrOtherBasisAmt
Depreciation$21,888,973DepreciationAmt
Book Value$16,742,988BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$97,110OtherCostOrOtherBasisAmt
Book Value$97,110BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$41,901,209TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
MEDICAL MALPRACTICE CLAIMS$576,616
ACCRUED RETIREMENT PLAN LIABILITY$9,963,107
ESTIMATED 3RD PARTY PAYOR$388,000
FieldValueIRS element (for citing)
Total Liability$10,927,723TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$80,199,609TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$309,508NetUnrealizedGainsInvstAmt
Other Revenue$50,704OtherRevenueAmt
Revenue Not Reported$360,212RevenueNotReportedAmt
Revenue Subtotal$79,839,397RevenueSubtotalAmt
Other Revenues Not Included$335,308OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$335,308RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$80,174,705TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$74,880,348TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$50,704OtherExpensesIncludedAmt
Expenses Not Reported$50,704ExpensesNotReportedAmt
Expenses Subtotal$74,829,644ExpensesSubtotalAmt
Other Expenses Not Included$334,325OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$334,325ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$75,163,969TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSE 50,704.
PART XI, LINE 4B - OTHER ADJUSTMENTS:INCOME REPORTED AS EXPENSES ON FORM 990 335,308.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSE 50,704.
PART XII, LINE 4B - OTHER ADJUSTMENTS:INCOME REPORTED AS EXPENSES ON FORM 990 334,325.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,184,505TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$58,542DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,125,963NetCommunityBenefitExpnsAmt
Total Expense0.01500TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$17,099,588TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,378,970DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,720,618NetCommunityBenefitExpnsAmt
Total Expense0.03620TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,284,093TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,437,512DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,846,581NetCommunityBenefitExpnsAmt
Total Expense0.05120TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$141,100TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,150DirectOffsettingRevenueAmt
Net Community Benefit Expns$139,950NetCommunityBenefitExpnsAmt
Total Expense0.00190TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,930TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,000DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,930NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$246,644TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$246,644NetCommunityBenefitExpnsAmt
Total Expense0.00330TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$402,674TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,150DirectOffsettingRevenueAmt
Net Community Benefit Expns$398,524NetCommunityBenefitExpnsAmt
Total Expense0.00540TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,686,767TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,441,662DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,245,105NetCommunityBenefitExpnsAmt
Total Expense0.05660TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$72,464TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,046DirectOffsettingRevenueAmt
Net Community Benefit Expns$63,418NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$72,464TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,046DirectOffsettingRevenueAmt
Net Community Benefit Expns$63,418NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$3,485,540BadDebtExpenseAmt
Bad Debt Expense Attributable$2,732,910BadDebtExpenseAttributableAmt
Reimbursed By Medicare$17,099,588ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$32,682,530CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$15,582,942MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)

Primary ActivitiesPrimaryActivitiesTxtOrg Profit Or OwnershipOrgProfitOrOwnershipPctPhysicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 COASTAL HEALTH ASSURANCE
PHYSICIAN ASSC. MEDICAL CONTRACTS0.500000.50000
2 ASTORIA IMAGING LLC
MRI JOINT VENTURE0.510000.51000
FieldValueIRS element (for citing)
Hospital Facilities4HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (4 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndCritical Access HospitalCriticalAccessHospitalIndEmergency Room24 HrsEmergencyRoom24HrsIndOtherOtherDesc
COLUMBIA MEMORIAL HOSPITAL
12111 EXCHANGE STREETASTORIAOR97103WWW.COLUMBIAMEMORIAL.ORG141146Yes (X)Yes (X)Yes (X)Yes (X)OTHER
ASTORIA IMAGING LLC
22111 EXCHANGE STREETASTORIAOR97103WWW.COLUMBIAMEMORIAL.ORG141146MRI JOINT VENTURE
CMH HOME HEALTH
32158 EXCHANGE STREET SUITE 206ASTORIAOR97103WWW.COLUMBIAMEMORIAL.ORG13141146HOME SERVICES
LOWER COLUMBIA HOSPICE
42158 EXCHANGE STREET SUITE 206ASTORIAOR97103WWW.LOWERCOLUMBIAHOSPICE.ORG161047HOSPICE SERVICES

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1COLUMBIA MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
OtherYes (X)OtherInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTP://COLUMBIAMEMORIAL.NETRETURNS.BIZ/CLIENT_FILES/COLUMBIAMEMORIAL/CM/SYSOwnWebsiteURLTxt
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt13ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.COLUMBIAMEMORIAL.ORGStrategyWebsiteURLTxt
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Permit Legal Judicial ProcessYes (X)PermitLegalJudicialProcessInd
Collection ActivitiesYes (1)CollectionActivitiesInd
Reporting To Credit AgencyYes (X)ReportingToCreditAgencyInd
Engaged Legal Judicial ProcessYes (X)EngagedLegalJudicialProcessInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp

FieldValueIRS element (for citing)
Form And Line ReferenceCOLUMBIA MEMORIAL HOSPITALFormAndLineReferenceDesc
ExplanationPART V, SECTION B, LINE 5: THERE ARE SEVERAL SOURCES OF PRIMARY AND SECONDARY DATA FOR THE CHNA ON WHICH THE GOALS AND OUTCOMES OF THIS REPORT ARE BASED: PRIMARY DATA:ENVIRONMENT ASSESSMENT - CONDUCTED IN JUNE 2013 BY AN INDEPENDENT CONSULTANT,STROUDWATER ASSOCIATES, THIS ASSESSMENT UPDATED THE ENVIRONMENT AND PROVIDER NEEDASSESSMENT DATA GATHERED IN 2011 IN SUPPORT OF THE DEVELOPMENT OF COLUMBIAMEMORIAL HOSPITAL'S 2014 TO 2016 STRATEGIC PLAN. COMMUNITY OPINION SURVEY AND PROVIDER NEED ASSESSMENT - CONDUCTED IN JULY2011 BY AN INDEPENDENT CONSULTANT, HEALTH FACILITIES PLANNING & DEVELOPMENT, THISSURVEY AND ASSESSMENT DATA PROVIDES INSIGHT INTO COMMUNITY AWARENESS, PERCEPTIONSAND PRIORITIES FOR THE LOCAL HEALTH SYSTEM.KEY INFORMANT INTERVIEWS - FACE-TO-FACE INTERVIEWS WITH BOTH INDEPENDENT ANDEMPLOYED PROVIDERS WERE CONDUCTED IN 2011, 2012, AND 2013 TO ASSESS THE NEEDS OFTHE COMMUNITY FROM THE PROVIDER PERSPECTIVE. IN ADDITION, A COMMUNITY LEADERSHIPROUND TABLE WAS HELD IN 2011 AND INCLUDED REPRESENTATIVES FROM THE CITY OF ASTORIA,U.S. COAST GUARD, CLATSOP COUNTY HEALTH DEPARTMENT, COASTAL FAMILY HEALTH CLINIC,CLATSOP CARE CENTER AND OTHERS.FOCUS GROUPS, PATIENT & FAMILY ADVISORY COUNCIL, AND COMMUNITY LEADERSHIPCOUNCIL -O PATIENT FOCUS GROUPS CONSISTING OF PREVIOUS INPATIENT, EMERGENCY, OUTPATIENT,AND CLINIC PATIENTS WERE CONDUCTED IN BOTH SEPTEMBER OF 2011 AND DECEMBEROF 2012 TO GATHER INFORMATION ABOUT AWARENESS, PATIENT-CENTERED PRACTICES,AND OPINIONS ABOUT OPPORTUNITIES FOR IMPROVEMENT FOR LOCAL HEALTHCARE.O A PATIENT & FAMILY ADVISORY COUNCIL (PFAC) WAS ESTABLISHED IN 2012 TO FORM ACONTINUOUS FEEDBACK LOOP TO IDENTIFY OPPORTUNITIES.O A COMMUNITY LEADERSHIP COUNCIL REPRESENTING LOCAL GOVERNMENT, SCHOOLDISTRICTS, AND LOCAL BUSINESSES WAS RECENTLY ESTABLISHED IN LATE 2013 TO SUPPORTTHE NEXT STEPS IN CREATING A HEALTHIER COMMUNITY. SECONDARY DATA:CLATSOP COUNTY COMMUNITY ASSESSMENT JULY 2013, THIS ASSESSMENT CREATES AFOUNDATION OF SHARED KNOWLEDGE ABOUT THE COMMUNITY HEALTH AND WELL-BEING INCLATSOP COUNTY. AT LEAST 75% OF CMH PATIENTS RESIDE IN CLATSOP COUNTY, WITH THEREMAINDER LARGELY RESIDING IN PACIFIC COUNTY, WASHINGTON.ExplanationTxt
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CMH PROFESSIONAL OFFICE BUILDING IBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12055 EXCHANGE STREETAddressLine1Txt
CityASTORIACityNm
State AbbreviationORStateAbbreviationCd
ZIP97103ZIPCd
FieldValueIRS element (for citing)
FacilityOFFICE SPACE LEASED TO PRIVATE HEALTHCARE PROVIDERSFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART II, COMMUNITY BUILDING ACTIVITIES:PART II: COMMUNITY BUILDING ACTIVITIES: CMH CONTINUES TO TAKE AN ACTIVE ROLE IN ASSURING THAT ADEQUATE FOOD IS AVAILABLE TO THE RESIDENCE OF CLATSOP COUNTY, RAISING $7,775 AND DONATING OVER 50 TONS OF FOOD IN 2014. CMH HOSTED OPERATION BUNNY SUITE, OUTREACH PROGRAM IN WHICH FIFTH GRADE AREA ELEMENTARY SCHOOL CHILDREN SPEND THE DAY AT CMH LEARNING ABOUT THE SURGERY PROGRAM, AS WELL AS PROGRAMS IN NON SMOKING, NUTRITION, AND PHYSICAL THERAPY. CMH'S COMMUNITY BASED SPORTS TRAINING PROGRAM INCLUDES PRE AND POST CONCUSSION ASSESSMENTS AS WELL AS LOCAL COACHES RECEIVING EDUCATION ON ASSESSING PLAYERS ON THE FIELD. NEW IN 2014, CMH HOSTED A HEART HEALTH FAIR FOR THE LOCAL COMMUNITY. THIS INCLUDED FREE BOOTH SPACES AND EDUCATIONAL PRESENTATIONS FROM STAFF AND PHYSICIANS SUCH AS CARDIOLOGIST DIANA RINKEVICH. CMH PARTICIPATES IN RELAY FOR LIFE, MARCH FOR BABIES, AND UNITED WAY. WE SUPPORT PROGRAMS FOR FOSTER CHILDREN IN NEED OF SCHOOL CLOTHES AND WE CHAMPION THE WARRENTON SCHOOL DISTRICTS WALK FOR HEALTH AS WELL AS OTHER WALK RUNS THROUGHOUT OUT THE COUNTY. IN ORDER TO DELIVER PRESCRIPTIONS TO HOME BOUND PATIENTS, CMH COVERS THE COST OF TRANSPORTATION FROM A PHARMACY TO THE PATIENTS' HOME. THE HOSPITAL'S EDUCATION DEPARTMENT PUT ON MULTIPLE COMMUNITY EDUCATION CLASSES THROUGHOUT THE YEAR. IN 2014 WE HOSTED: STRONG WOMEN STRONG BONES, LIVING WELL WITH CHRONIC CONDITIONS, HEALTH EATING, A MATTER OF BALANCE, AS WELL DONATING CONFERENCE SPACE TO LOCAL COMMUNITY NEEDS. THE STAFF OF CMH CONTINUES TO DONATE THEIR TIME AND SERVICES TO VARIOUS COMMUNITY EVENTS AND NEEDS YEAR ROUND.
PART III, LINE 4:THE COLLECTION OF RECEIVABLES FROM THIRD PARTY PAYERS AND PATIENTS IS THE HOSPITAL'S PRIMARY SOURCE OF CASH AND IS CRITICAL TO ITS OPERATING PERFORMANCE. WHEN THE HOSPITAL PROVIDES CARE TO PATIENTS, IT DOES NOT REQUIRE COLLATERAL; HOWEVER, IT MAINTAINS AN ESTIMATED ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE PRIMARY COLLECTION RISKS RELATE TO UNINSURED PATIENT ACCOUNTS AND PATIENT ACCOUNTS FOR WHICH THE PRIMARY INSURANCE PAYOR HAS PAID, BUT PATIENT RESPONSIBILITY AMOUNTS (GENERALLY DEDUCTIBLES AND CO PAYMENTS) REMAIN OUTSTANDING. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS ESTIMATED BASED PRIMARILY UPON THE HOSPITAL'S HISTORICAL COLLECTION EXPERIENCE, THE AGE OF THE PATIENT'S ACCOUNT, MANAGEMENT'S ESTIMATE OF THE PATIENT'S ECONOMIC ABILITY TO PAY AND THE EFFECTIVENESS OF COLLECTION EFFORTS. PATIENT ACCOUNTS RECEIVABLE BALANCES ARE ROUTINELY REVIEWED IN CONJUNCTION WITH HISTORICAL COLLECTION RATES AND OTHER ECONOMIC CONDITIONS WHICH MIGHT ULTIMATELY AFFECT THE COLLECTIBILITY OF PATIENT ACCOUNTS WHEN CONSIDERING THE ADEQUACY OF THE AMOUNTS RECORDED IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.ACTUAL WRITE-OFFS HAVE HISTORICALLY BEEN WITHIN MANAGEMENT'S EXPECTATIONS. SIGNIFICANT CHANGES IN PAYOR MIX, BUSINESS OFFICE OPERATIONS, ECONOMIC CONDITIONS, OR TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTHCARE COVERAGE COULD AFFECT THE HOSPITAL'S COLLECTION OF PATIENT ACCOUNTS RECEIVABLE, CASH FLOWS, AND RESULTS OF OPERATIONS.
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 STATESOR

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
CLATSOP COMMUNITY COLLEGE
1651 LEXINGTON AVEASTORIAOR97103930505508501(C)3$5,310$0SCHOLARSHIPS
ASTORIA-WARRENTON CHAMBER OF COMMERCE
PO BOX 176ASTORIAOR97103930115760501(C)6$10,000$0GREAT COLUMBIA CROSSING RUN/WALK EVENT
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org1TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PART I, LINE 2:FormAndLineReferenceDesc
ExplanationA CMH EMPLOYEE IS ASSIGNED TO MANAGE THE GRANT REVENUE PROGRAM PER THE TERMS OF EACH GRANT AGREEMENT. THE ACCOUNTING DEPARTMENT KEEPS COPIES OF ALL GRANT AGREEMENTS, MAINTAINS DETAILED REVENUE AND EXPENDITURE RECORDS FOR EACH GRANT, AND ASSISTS IN THE PREPARATION OF ANY REQUIRED FINANCIAL REPORTING.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred 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 OrgsCompReportPrior990RltdOrgsAmt
ROBERT HOLLAND
BOARD MEMBER$296,878$0$0$0$5,000$0$0$0$32,160$0$334,038$0$0$0
ERIK THORSEN
CEO$309,238$0$29,419$0$1,188$0$19,500$0$1,965$0$361,310$0$0$0
STEPHANIE D BRENDEN
CFO$186,680$0$14,500$0$462$0$16,094$0$13,389$0$231,125$0$0$0
TERESA L GURRAD
CCO$166,922$0$10,875$0$1,366$0$2,739$0$25,310$0$207,212$0$0$0
JARROD P KARNOFSKI
VP - ANCILLIARY SERVICES$142,731$0$12,199$0$74$0$12,400$0$31,342$0$198,746$0$0$0
KATRINA M MCPHERSON
VP - MEDICAL GROUP OPERATIONS$207,416$0$15,546$0$0$0$12,268$0$32,160$0$267,390$0$0$0
DOUGLAS ABBOTT MD
PHYSICIAN$566,676$0$0$0$16,666$0$19,194$0$32,160$0$634,696$0$0$0
RICHARD CRASS MD
PHYSICIAN$354,746$0$15,702$0$0$0$16,926$0$25,836$0$413,210$0$0$0
EDOUARD DURET MD
PHYSICIAN$352,645$0$10,642$0$0$0$19,500$0$31,993$0$414,780$0$0$0
CHRISTOPHER NYTE MD
PHYSICIAN$374,171$0$10,129$0$0$0$6,500$0$31,032$0$421,832$0$0$0
DAVID LEIBEL DO
PHYSICIAN$318,001$0$0$0$0$0$20,800$0$25,836$0$364,637$0$0$0
WILLIAM G RIVERS
FORMER CIO$162,517$0$16,500$0$561$0$0$0$9,525$0$189,103$0$0$0
KENNETH M BOUCHER
FORMER COO$221,195$0$13,455$0$1,234$0$11,171$0$9,445$0$256,500$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1AASTORIA GOLF AND COUNTRY CLUB DUES FOR CEO ERIK THORSEN WERE PAID BY THE ORGANIZATION.
PART I, LINE 6MANAGEMENT BONUSES ARE CONTINGENT ON THE NET EARNINGS OF THE ORGANIZATION.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1THE HOSPITAL FACILITIES AUTHORITY OF THE CITY OF ASTORIABusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN270034718BondIssuerEIN
CUSIP046279BS3CUSIPNum
Bond Issued2012-09-27BondIssuedDt
Issue Price$31,993,533IssuePriceAmt
PurposeFINANCE EHR SYSTEM, ASSET ACQUISTION, REFUNDING OF 2002 & 2007 BOND ISSUESPurposeDesc
DefeasedYes (1)DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$31,993,533TotalProceedsAmt
In Reserve Fund$2,463,279InReserveFundAmt
Capitalized Interest$268,129CapitalizedInterestAmt
Issuance Costs From Proceeds$889,525IssuanceCostsFromProceedsAmt
Capital Expenditures$7,708,816CapitalExpendituresAmt
Unspent$1,785,404UnspentAmt
Substantial Completion2014SubstantialCompletionYr
Current RefundingYes (1)CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation Made0FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research AgreementsYes (1)AnyResearchAgreementsInd
Engage Bond Counsel Research0EngageBondCounselResearchInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)

Relationship With OrgRelationshipWithOrgTxtLoan PurposeLoanPurposeTxtLoan From OrganizationLoanFromOrganizationIndOriginal PrincipalOriginalPrincipalAmtBalance DueBalanceDueAmtDefaultDefaultIndBoard Or Committee ApprovalBoardOrCommitteeApprovalIndWritten AgreementWrittenAgreementInd
ANALIZA JUSTO
EMPLOYEESIGN ON BONUSYes (X)$20,000$5,5550Yes (1)Yes (1)
PETER BALES
EMPLOYEESIGN ON BONUSYes (X)$20,000$16,6670Yes (1)Yes (1)
FieldValueIRS element (for citing)
Total Balance Due$22,222TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
DAVID PHILLIPS
CMH BOARD MEMBER$3,219REIMBURSEMENT FOR TRAVEL AND CONFERENCE EXPENSES0
KEVIN BAXTER DO
CMH BOARD MEMBER$72,000HOSPICE MEDICAL DIRECTOR AT BAXTER FAMILY MEDICINE AND MEDICAL DIRECTOR FOR LOWER COLUMBIA HOSPICE, PART OF COLUMBIA MEMORIAL HOSPITAL0
SCOTT SEPPA
SPOUSE OF CMH BOARD MEMBERPARTNER AT KNUTSEN INSURANCE, WHICH PROVIDES INSURANCE FOR COLUMBIA MEMORIAL HOSPITAL0
HEATHER SEPPA
CMH BOARD MEMBEROFFICER AT COLUMBIA STATE BANK, ONE OF THE PRIMARY BANKS USED BY CMH.0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11A 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 12CTHE 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 15COMPENSATION 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 19THE 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 XI, LINE 9:DEFINED BENEFIT RETIREMENT PLAN ADJUSTMENT -6,606,427. NET ASSETS RELEASED FROM RESTRICTION - CITY OF ASTORIA GRANT 37,500.
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 ACCOMPLISHMENTSKEY STATISTICS FOR 2014: INPATIENT ADMISSION, INCLUDING NEWBORNS: 1,899 INPATIENT DAYS, INCLUDING NEWBORNS: 4,937 SURGERY PATIENTS: 2,265 (INCLUDES OP 1,890 AND IP 375) ANCILLARY VISITS: 60,441 (THIS INCLUDES CARDIAC REHAB VISITS OF 10,695 AND INFUSION OF 2,867) LABORATORY TESTS: 133,867 IMAGING TOTALS: 35,263 CLINIC VISITS: 52,891 EMERGENCY & TRAUMA VISITS: 13,046 HOME HEALTH VISITS: 2,963 HOSPICE PATIENT DAYS: 5,246 COLUMBIA MEMORIAL HOSPITAL'S (CMH) MISSION IS TO PROVIDE EXCELLENCE, LEADERSHIP, AND COMPASSION IN THE ENHANCEMENT OF HEALTH FOR THOSE WE SERVE. THE CMH 2013-2015 THREE-YEAR STRATEGIC PLAN INCLUDED SEVERAL GOALS LISTED UNDER THE FOLLOWING PILLARS; QUALITY AND CUSTOMER SERVICE, EMPLOYEE DEVELOPMENT, GROWTH, PROVIDER RELATIONS, AND FINANCIAL PERFORMANCE. AS OF THE YEAR ENDED DECEMBER 31ST, 2014 MANY GOALS HAVE BEEN ACHIEVED ALLOWING CMH TO CONTINUE TO FULFILL THE MISSION OF THE ORGANIZATION AND TO RAISE BOTH THE QUALITY AND RANGE OF SERVICES PROVIDED TO THE LOCAL COMMUNITY. QUALITY AND CUSTOMER SERVICE: -CMH HAS BEEN A PLANETREE AFFILIATED HOSPITAL SINCE 2001 EMBRACING THE PHILOSOPHY OF PATIENT-CENTERED CARE TO PERSONALIZE, HUMANIZE, AND DEMYSTIFY HEALTHCARE FOR THE PATIENTS OF OUR COMMUNITY. IN 2013 THE HOSPITAL OFFICIALLY BECAME A DESIGNATED HOSPITAL. CMH IS NOW ONE OF 20 HOSPITALS IN THE UNITED STATES TO RECEIVE THIS HONOR AND THE 40TH HOSPITAL WORLD-WIDE. RECERTIFICATION WILL TAKE PLACE IN 2016. CMH WON 2014 PLANETREE COMMUNITY OUTREACH PROGRAM AWARD IN SPORTS MEDICINE. THERE WAS A SPORTS MEDICINE PROGRAM IMPLEMENTED. -THE CMH LABORATORY HAS MAINTAINED ALL CRITERIA FOR LABORATORY ACCREDITATION BY COLA, A NATIONAL HEALTHCARE ACCREDITATION ORGANIZATION. ACCREDITATION IS GIVEN ONLY TO LABORATORIES THAT APPLY RIGID STANDARDS OF QUALITY IN DAY-TO-DAY OPERATIONS, DEMONSTRATE CONTINUED ACCURACY IN THE PERFORMANCE OF PROFICIENCY TESTING, AND PASS A RIGOROUS ON-SITE LABORATORY SURVEY. CMH HAS EARNED COLA ACCREDITATION AS A RESULT OF A LONG-TERM COMMITMENT TO PROVIDE QUALITY SERVICE TO ITS PATIENTS. -ACHIEVED THE AMERICAN HOSPITAL ASSOCIATION'S (AHA) MOST-WIRED HOSPITAL AWARD IN 2011 THROUGH 2014. -CMH WENT LIVE WITH CERNER EMR SYSTEM IN MARCH OF 2014. THIS WILL ENSURE INCREASED PATIENT EXPERIENCES AND SATISFACTION ALONG WITH THE COMMITMENT TO "ONE PATIENT, ONE RECORD" GOAL. THIS PROJECT TOOK FIFTEEN MONTHS OF PREPARATION AND A TREMENDOUS SHOWING OF TEAMWORK AND TENACITY. THIS RECORD CAN NOW BE ACCESSED BY PROVIDERS IN ANY CMH CLINIC OR SERVICE AREA. -THE LOWER COLUMBIA HOSPICE PROGRAM WAS NAMED A 2014 HOSPICE HONORS RECIPIENT. HOSPICE HONORS IS A PRESTIGIOUS ANNUAL HONOR RECOGNIZING THE HOSPICES THAT CONTINUOUSLY PROVIDE THE HIGHEST LEVEL OF SATISFACTION THROUGH THEIR CARE AS MEASURED FROM THE CAREGIVERS POINT OF VIEW. -CMH IMAGING DEPARTMENT SUCCESSFULLY ACHIEVED CERTIFICATION ACR/MSQA FOR THEIR MAMMOGRAPHY PROGRAM IN 2014. -THE CMH MEDICAL RECORDS DEPARTMENT WORKED TO PREPARE FOR THE ICD-10-CM IMPLEMENTATION SCHEDULED FOR OCTOBER 2015. ICD-10-CM IS A CODING SYSTEM THAT ASSIGNS ALPHA-NUMERIC CODES TO DISEASES AND IS USED TO SUBMIT INFORMATION TO INSURANCE COMPANIES FOR PAYMENT, RESEARCH, QUALITY IMPROVEMENT AND VARIOUS OTHER REPORTING REQUIREMENTS. -THE CARDIOLOGY CLINIC MAINTAINED ACCREDITATION IN ECHOCARDIOGRAPHY FOR A THREE-YEAR TERM BEGINNING IN 2013 FROM THE INTERSOCIETAL ACCREDITATION COMMISSION (IAC). ONLY TWO OTHER FACILITIES HAVE BEEN ACCREDITED IN ALL THREE MODALITIES: OHSU AND OREGON HEART AND VASCULAR INSTITUTE IN SPRINGFIELD. ADDITIONALLY. THE CMH CARDIAC REHAB PROGRAM WAS GRANTED 2013 AACVPR PROGRAM CERTIFICATION. CERTIFICATION IS GIVEN AFTER STRINGENT STANDARDS ARE MET WITH THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION. STAFF DEVELOPMENT: -91.9% OF ALL EMPLOYEES COMPLETED THEIR COMPLIANCE MODULES IN 2014. ADDITIONALLY OVER 83 EMPLOYEES ATTENDED THE CLINICAL SKILLS FAIR. BOOTHS RANGED FROM INFORMATION STATIONS TO DEMONSTRATIONS AND VIDEOS. FOCUS FOR SPECIALIZED DEPARTMENTS WILL BE IN THOSE AREAS IN THE FUTURE AND THE SKILLS FAIR PROVIDED MORE HOUSE WIDE INFORMATION. THE MAIN FOCUS FOR THE FAIR EVOLVED PATIENT CENTERED CARE AND DIRECTION FROM MANAGER. -CMH EMPLOYEES TEAMED UP WITH A NEIGHBORING HOSPITAL AND RAISED DONATION FOR THE REGIONAL FOOD BANK. THROUGH INCREDIBLE GENEROSITY, THE TWO GROUPS DONATED 101,141 POINTS, WHICH EQUAL 50 TONS OF FOOD, AND $7,774 TO THE REGIONAL FOOD BANK. -THE WELLNESS A-TEAM HOSTED AN EMPLOYEE HEALTH & WELLNESS FAIR IN JANUARY 2014. MORE THAN 150 EMPLOYEES ATTENDED. -CMH LEADERS INCLUDING ADMINISTRATION AND ALL DEPARTMENT MANAGERS ARE PARTICIPATING IN ONGOING LEADERSHIP DEVELOPMENT. TOGETHER WE ARE ALL WORKING TO IMPROVE OUR CULTURE AND COMMUNICATION. IN 2015 THE ENTIRE CMH TEAM WILL BEGIN PARTICIPATING IN STAFF DEVELOPMENT SESSIONS. GROWTH: -CMH EXPANDED THE WARRENTON URGENT CARE AND PRIMARY CARE CLINIC DURING 2014AND IS SCHEDULE TO REOPENED IN 2015. THE CLINIC APPROXIMATELY HAS DOUBLED ITS ORIGINAL SIZE TO ACCOMMODATE THE GROWING DEMAND FOR SERVICES. -THE REMODEL OF THE MATERNITY DEPARTMENT WAS COMPLETED IN JANUARY 2014. THIS REMODEL INCLUDED 2 LDRPS, NURSES LOUNGE, DOCTOR SLEEPING ROOM AND A NEW NURSERY. -CMH ACQUIRED ADJACENT REAL ESTATE TO BE CLEARED AND TURNED INTO ADDITIONAL PARKING IN 2014-2015 TO ENHANCE EMPLOYEE AND PATIENT CONVENIENCE/EXPERIENCE WHILE AT CMH. -THE CARDIAC REHABILITATION SPACE WAS EXPANDED IN 2014 TO APPROXIMATELY TWICE THE SIZE TO ACCOMMODATE THE GROWING CARDIAC AND PULMONARY REHABILITATION PROGRAM OVERSEEN BY THE CMH AND OHSU CARDIOLOGY CLINIC. -THE ASTORIA SPORTS COMPLEX WAS COMPLETED IN OCT 2014. CMH TOOK OWNERSHIP OF THE JOHN WARREN FIELD WHEN THE SPORTS COMPLEX WAS COMPLETED. CMH'S FUTURE ON THE EXISTING CAMPUS IS NOW SECURED FOR DECADES TO COME. THE FIRST PROJECT ON THE JOHN WARREN FIELD WILL BE A PARKING LOT EXPANSION EXPECTED TO BEGIN THE SPRING OF 2015. -THE CCU REMODEL DESIGN PROCESS WAS APPROVED AND IS CURRENTLY UNDERWAY EXPECTED TO BE COMPLETED EARLY 2015. -CMH PURCHASED THE ELLIS PROPERTY IN 2014 FOR FURTHER EXPANSION. -CMH OPENED THE CMH FOOT AND ANKLE CLINIC IN THE WELLNESS PAVILION AND NEW CMH LAB SERVICES LOCATED IN THE PARK MEDICAL BUILDING. PROVIDER RELATIONS: -CMH MARKETING COMPLETED A PROVIDER GUIDE IN 2014. THIS 24 PAGE GUIDE IS A HELPFUL TOOL TO INFORM OUR COMMUNITY ON THE AVAILABLE PROVIDER SERVICES AT CMH, PROVIDES INSIGHT INTO MANY OF OUR ANCILLARY SERVICES AS WELL AS OUR COMMITMENT TO PATIENT CENTERED CARE. -CMH ADDED SIX NEW PROVIDERS DURING 2014. THERE ARE IN THE FOLLOWING DEPARTMENTS: ORTHOPEDICS, GENERAL SURGERY, AND PODIATRY, PEDIATRICS, URGENT CARE (NURSE PRACTITIONER) AND ONCOLOGY (NURSE PRACTITIONER). -CMH ADDED A NEW ALLIANCE WITH ANESTHESIA ASSOCIATES NORTHWEST IN 2014. FINANCIAL PERFORMANCE: -CMH FOUNDATION HELD THEIR ANNUAL DENIM & DIAMONDS FUNDRAISING GALA, AUCTION, AND GOLF TOURNAMENT IN JUNE 2014. THIS EVENT RAISED $90,000 TOWARD BRINGING EXPANDED CANCER TREATMENT SERVICES TO THE COMMUNITY AND MAKING SIGNIFICANT PROGRESS TOWARD PROVIDING MOST CANCER TREATMENTS LOCALLY WITHOUT THE NEED FOR LONG DISTANCE TRAVEL. -CMH FOUNDATION INCREASED THEIR DONATION TOWARDS LOCAL CANCER CARE SERVICES BY "PUTTIN' ON THE GLITZ" AT THEIR ANNUAL FASHION SHOW. THE FASHION SHOW RAISED $10,848 TOWARDS BUILDING A NEW CANCER CARE CENTER IN ASTORIA, OREGON.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtControlled OrganizationControlledOrganizationInd
COLUMBIA MEMORIAL HOSPITAL FOUNDATION
2111 EXCHANGE STREETASTORIAOR97103931091701FUNDRAISING FOR THE HOSPITALOR501(C)3LINE 11A, IYes (1)
COLUMBIA MEMORIAL HOSPITAL AUXILIARY
2111 EXCHANGE STREETASTORIAOR97103931306211PROVIDE VOLUNTEERSOR501(C)3LINE 11A, I0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ASTORIA IMAGING LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12111 EXCHANGE STREETAddressLine1Txt
CityASTORIACityNm
State AbbreviationORStateAbbreviationCd
ZIP97103ZIPCd
FieldValueIRS element (for citing)
EIN800240381EIN
Primary ActivitiesMRI JOINT VENTUREPrimaryActivitiesTxt
Legal Domicile StateORLegalDomicileStateCd
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income$848,422ShareOfTotalIncomeAmt
Share Of EOY Assets$1,860,766ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing PartnerYes (1)GeneralOrManagingPartnerInd
Ownership0.51000OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1COASTAL HEALTH ASSURANCE INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12111 EXCHANGE STREETAddressLine1Txt
CityASTORIACityNm
State AbbreviationORStateAbbreviationCd
ZIP97103ZIPCd
FieldValueIRS element (for citing)
EIN911818894EIN
Primary ActivitiesPHYSICAN ASSOCIATION, MEDICAL CONTRACT MANAGEMENTPrimaryActivitiesTxt
Legal Domicile StateORLegalDomicileStateCd
Entity TypeCEntityTypeTxt
Share Of Total Income-$102ShareOfTotalIncomeAmt
Share Of EOY Assets$20,637ShareOfEOYAssetsAmt
Ownership0.50000OwnershipPct
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
CMH FOUNDATION (IN-KIND CONTRIBUTIONS)
B$18,848ACTUAL
CMH FOUNDATION (IN-KIND CONTRIBUTIONS SALARY EXPENSES)
O$233,384ACTUAL
ASTORIA IMAGING LLC (SALARY EXPENSES FOR MRI MGMT TECHS & REGISTRATION)
O$293,531ACTUAL
CMH FOUNDATION (TOTAL QUARTERLY TRANSFERS)
Q$90,300ACTUAL
CMH FOUNDATION (TRANSFER OF RESTRICTED FUNDS TO CMH DIABETIC ED)
S$400ACTUAL