STRATEGY STUDIO / PUBLIC DATA EXPLORER

COLUMBUS REGIONAL SENIOR LIVING INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
COLUMBUS REGIONAL SENIOR LIVING INC (EIN 58-2628502)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-02-14
IRS object ID
201420459349301712
Schema version
2012v2.1
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)
Timestamp2014-02-14T12:16:34-06:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN621517792EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PERSHING YOAKLEY & ASSOCIATES P CBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1ONE CHEROKEE MILLS 2220 SUTHERLANDAddressLine1
Address Line2AVEAddressLine2
CityKNOXVILLECity
StateTNState
ZIP Code37919ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN582628502EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COLUMBUS REGIONAL SENIOR LIVING INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOLUNameControl
Phone7066606103Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1707 CENTER STREETAddressLine1
CityCOLUMBUSCity
StateGAState
ZIP Code31901ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCHARLES A STARKName
TitlePRESIDENT & CEOTitle
Phone7066606103Phone
Date Signed2014-02-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSUSAN P CLARKName
PTINP00017549PTIN
Phone8656730844Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCHARLES A STARKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1707 CENTER STREETAddressLine1
CityCOLUMBUSCity
StateGAState
ZIP Code31901ZIPCode
FieldValueIRS element (for citing)
Gross Receipts5524295GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteCOLUMBUSREGIONAL.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2001YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionTO OPERATE A CONTINUING CARE RETIREMENT COMMUNITY OWNED BY THE MEDICAL CENTER HOSPITAL AUTHORITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees283TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year5220436ProgramServiceRevenuePriorYear
Program Service Revenue CY5524295ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year5220436TotalRevenuePriorYear
Total Revenue Current Year5524295TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year5220436SalariesEtcPriorYear
Salaries Etc Current Year5524295SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year0OtherExpensePriorYear
Other Expenses Current Year0OtherExpensesCurrentYear
Total Expenses Prior Year5220436TotalExpensesPriorYear
Total Expenses Current Year5524295TotalExpensesCurrentYear
Revenues Less Expenses Prior Year0RevenuesLessExpensesPriorYear
Revenues Less Expenses CY0RevenuesLessExpensesCY
Total Assets BOY951263TotalAssetsBOY
Total Assets EOY295788TotalAssetsEOY
Total Liabilities BOY951263TotalLiabilitiesBOY
Total Liabilities EOY295788TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY0NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY0NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionCOLUMBUS REGIONAL SENIOR LIVING, INC. MANAGES A CONTINUING CARE RETIREMENT COMMUNITY PROVIDING INDEPENDENT LIVING FOR OLDER ADULTS AND COMPREHENSIVE HEALTH AND MEDICAL SERVICES, INCLUDING ASSISTED LIVING, ALZHEIMER'S DISEASE CARE AND LONG-TERM NURSING CARE RESIDENTS NEED. COLUMBUS REGIONAL SENIOR LIVING, INC'S CARING PROFESSIONAL STAFF IS COMMITTED TO PROVIDING HIGH QUALITY RETIREMENT LIVING AND PROMOTING A VIBRANT INDEPENDENT LIFESTYLE WHILE MEETING AND EXCEEDING THE PHYSICAL, EMOTIONAL AND SPIRITUAL NEEDS OF OUR RESIDENTS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense4782470Expense
Revenue5524295Revenue
DescriptionCOLUMBUS REGIONAL SENIOR LIVING, INC. EMPLOYS THE PROFESSIONAL STAFF AND PERSONNEL NECESSARY TO OPERATE SPRING HARBOR AT GREEN ISLAND, A CONTINUING CARE RETIREMENT COMMUNITY OWNED BY THE MEDICAL CENTER HOSPITAL AUTHORITY. SPRING HARBOR PROVIDES INDEPENDENT LIVING FOR OLDER ADULTS AND COMPREHENSIVE HEALTH AND MEDICAL SERVICES THEY NEED. THESE SERVICES INCLUDE: ASSISTED LIVING, ALZHEIMER'S DISEASE CARE AND LONG-TERM NURSING CARE.Description
Total Program Service Expense4782470TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109624NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees283NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CHARLES A STARKBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7066606484TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1707 CENTER STREETAddressLine1
CityCOLUMBUSCity
StateGAState
ZIP Code31901ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (10 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
SCOTT HILL
CHAIRMAN2.0040.00XX01298852338
EUGENE A DEMONET
DIRECTOR2.00X000
C ROBERT KOON
DIRECTOR2.00X000
LAMAR POWERS
DIRECTOR2.00X000
CAROLE RUTLAND PHD
DIRECTOR2.00X000
REBECCA RUMOR
DIRECTOR2.00X000
MURRAY SOLOMON
DIRECTOR2.00X000
CHARLES A STARK
PRESIDENT & CEO2.0040.00X0889364201352
ROLAND L THACKER
SENIOR VP & CFO2.0040.00X0441879106748
KAREN SMITH
CORPORATE SECRETARY2.0040.00X07081024448
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1531938TotalReportableCompFrmRltdOrgs
Total Other Compensation334886TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CRSALCS MANAGEMENT
400 LOCUST STREET SUITE 820DES MOINESIA50309MANAGEMENT450429
HERITAGE HEALTHCARE
536 OLD HOWELL ROADGREENVILLESC29615THERAPY233105
SEASONAL CONCEPTS
5901A WARM SPRINGS ROADCOLUMBUSGA31909LAWN SERVICE177894
COLUMBUS REGIONAL HEALTHCARE SYSTEM INC
707 CENTER STREETCOLUMBUSGA31901MANAGEMENT171600
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPROGRAM SERVICE REVENUDescription
Business Code623000BusinessCode
Total Revenue Column5524295TotalRevenueColumn
Related Or Exempt Function Income5524295RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue5524295TotalProgramServiceRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column5524295TotalRevenueColumn
Related Or Exempt Function Income5524295RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4460451Total
Program Services3858930ProgramServices
Management And General601521ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total752215Total
Program Services650741ProgramServices
Management And General101474ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total311629Total
Program Services272799ProgramServices
Management And General38830ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total5524295Total
Program Services4782470ProgramServices
Management And General741825ManagementAndGeneral
Fundraising0Fundraising

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY951263BOY
EOY295788EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY951263BOY
EOY295788EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY951263BOY
EOY295788EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY951263BOY
EOY295788EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY951263BOY
EOY295788EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses0ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type3 Func IntXSupportingOrg509a3Type3FuncInt
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (2 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
THE MEDICAL CENTER HOSPITAL AUTHORITY INC
5809050946011$0
THE MEDICAL CENTER INC
5816851393111$0
FieldValueIRS element (for citing)
Total Number Of Supported Orgs2TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Org Belongs To Affiliated GroupXOrgBelongsToAffiliatedGroup

Total Direct Lobbying TotalDirectLobbying

FieldValueIRS element (for citing)
Affiliated Group Totals32191AffiliatedGroupTotals

Total Lobbying Expenditures TotalLobbyingExpenditures

FieldValueIRS element (for citing)
Affiliated Group Totals32191AffiliatedGroupTotals

Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures

FieldValueIRS element (for citing)
Affiliated Group Totals518575354AffiliatedGroupTotals

Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures

FieldValueIRS element (for citing)
Affiliated Group Totals518607545AffiliatedGroupTotals

Lobbying Nontaxable LobbyingNontaxableAmount

FieldValueIRS element (for citing)
Affiliated Group Totals1000000AffiliatedGroupTotals

Grassroots Nontaxable GrassrootsNontaxableAmount

FieldValueIRS element (for citing)
Affiliated Group Totals250000AffiliatedGroupTotals

Tot Lobbying Grassroot Minus Non Tx TotLobbyingGrassrootMinusNonTx

FieldValueIRS element (for citing)
Affiliated Group Totals0AffiliatedGroupTotals

Tot Lobby Expend Mns Lobbying Nontx TotLobbyExpendMnsLobbyingNontx

FieldValueIRS element (for citing)
Affiliated Group Totals0AffiliatedGroupTotals

Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus31000000CurrentYearMinus3
Current Year Minus21000000CurrentYearMinus2
Current Year Minus11000000CurrentYearMinus1
Current Year1000000CurrentYear
Total4000000Total
FieldValueIRS element (for citing)
Lobbying Ceiling$6,000,000LobbyingCeilingAmount

Total Lobbying Expenditures2 TotalLobbyingExpenditures2

FieldValueIRS element (for citing)
Current Year Minus331169CurrentYearMinus3
Current Year Minus227379CurrentYearMinus2
Current Year Minus132330CurrentYearMinus1
Current Year32191CurrentYear
Total123069Total

Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus3250000CurrentYearMinus3
Current Year Minus2250000CurrentYearMinus2
Current Year Minus1250000CurrentYearMinus1
Current Year250000CurrentYear
Total1000000Total
FieldValueIRS element (for citing)
Grassroots Ceiling$1,500,000GrassrootsCeilingAmount

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionDUE FROM HOSPITAL AUTHORITYDescription
Book Value295788BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets295788TotalBookValueOtherAssets
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X, LINE 2:ReturnReference
ExplanationCOLUMBUS REGIONAL SENIOR LIVING, INC. IS EXEMPT FROM FEDERAL INCOME TAX UNDER 501(A) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. AT JUNE 30, 2013, MANAGEMENT DOES NOT BELIEVE THE ORGANIZATION HOLDS ANY UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE UNDER ASC 740.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
CHARLES A STARK
PRESIDENT & CEO063097002550000339401857500156020109071600
ROLAND L THACKER
SENIOR VP & CFO03172350111250013394092050014698054862700

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 4BReturnReference
ExplanationEMPLOYER CONTRIBUTION TO 457(F) EXECUTIVE RETIREMENT BENEFIT PLAN: CHARLES STARK $ 182,000 ROLAND THACKER $ 57,400Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION HAS A MANAGEMENT AGREEMENT WITH CRSA MANAGEMENT LLC. THE MANAGEMENT AGREEMENT WAS NEGOTIATED AT ARM'S LENGTH. CRSA MANAGEMENT EMPLOYS THE EXECUTIVE DIRECTOR OF COLUMBUS REGIONAL SENIOR LIVING. ALL OTHER PROFESSIONAL STAFF AND SUPPORT PERSONNEL ARE EMPLOYED BY COLUMBUS REGIONAL SENIOR LIVING.
FORM 990, PART VI, SECTION A, LINE 6THE BOARD OF DIRECTORS OF COLUMBUS REGIONAL SENIOR LIVING, INC. IS APPOINTED BY THE BOARD OF COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. - A RELATED 501(C)(3) ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE BOARD OF DIRECTORS OF COLUMBUS REGIONAL SENIOR LIVING, INC. IS APPOINTED BY THE BOARD OF COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. - A RELATED 501(C)(3) ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7BTHE BOARD OF DIRECTORS OF COLUMBUS REGIONAL SENIOR LIVING, INC. IS APPOINTED BY THE BOARD OF COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. - A RELATED 501(C)(3) ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11INFORMATION FOR FORM 990 WAS PROVIDED TO AN INDEPENDENT CPA FIRM FOR PREPARATION OF RETURN. AFTER RETURN WAS PREPARED IT WAS REVIEWED BY THE PRESIDENT AND CEO OF THE ORGANIZATION. CURRENTLY, A COPY OF THE FORM 990 IS NOT PROVIDED TO THE GOVERNING BODY PRIOR TO FILING. THE BOARD IS PROVIDED A THOROUGH AND CONDENSED OVERVIEW OF INFORMATION ON THE FORM 990 BY THE PRESIDENT OF THE ORGANIZATION. PRESENTATION OF THIS INFORMATION TO THE BOARD WILL BE MADE AS CLOSE TO THE FILING DATE AS POSSIBLE, BUT MAY NOT BE PRIOR TO THE FILING DATE.
FORM 990, PART VI, SECTION B, LINE 12CCOLUMBUS REGIONAL HEALTHCARE SYSTEM AND ITS AFFILIATES ARE ACCOUNTABLE TO GOVERNMENTAL AUTHORITIES AS WELL AS TO MEMBERS OF THE PUBLIC FOR BOTH THE INTEGRITY OF ITS ACTIONS AS WELL AS PERCEPTIONS AS RELATED TO THOSE ACTIONS. CONSEQUENTLY, THERE EXISTS BETWEEN COLUMBUS REGIONAL AND THE PUBLIC THE FIDUCIARY RESPONSIBILITY WHICH CARRIES WITH IT A BROAD AND UNBENDING DUTY OF LOYALTY AND FIDELITY. COLUMBUS REGIONAL AGENTS (I.E., BOARD MEMBERS, MANAGEMENT, EMPLOYEES, CONTRACTED PARTIES AND CREDENTIALED STAFF) HAVE THE RESPONSIBILITY OF ADMINISTERING THE AFFAIRS OF THE ORGANIZATION HONESTLY AND PRUDENTLY, AND OF EXERCISING THE BEST CARE, SKILL AND JUDGMENT FOR THE SOLE BENEFIT OF COLUMBUS REGIONAL. THOSE AGENTS SHALL EXERCISE THE UTMOST GOOD FAITH IN ALL TRANSACTIONS INVOLVED IN THEIR DUTIES AND SHALL NOT USE THEIR POSITIONS WITH COLUMBUS REGIONAL OR KNOWLEDGE GAINED FOR THEIR PERSONAL BENEFIT IN ANY MANNER. THE INTEREST OF THE ORGANIZATION MUST BE THE FIRST PRIORITY IN ALL RELATED DECISIONS AND ACTIONS. THIS POLICY IS ALSO DIRECTED TOWARD ANYONE WHO HAS PROPRIETARY INFORMATION CONCERNING COLUMBUS REGIONAL. IT IS THE POLICY OF COLUMBUS REGIONAL HEALTHCARE SYSTEM AND ITS AFFILIATES, IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, ASSOCIATED AGENTS MUST ANNUALLY DISCLOSE THE EXISTENCE OF A FINANCIAL OR OTHERWISE BENEFICIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE CHIEF COMPLIANCE OFFICER ASSOCIATED WITH THE PROPOSED CONFLICTING TRANSACTION OR ARRANGEMENT. A CONFLICT OF INTEREST MAY ARISE IN THE RELATIONSHIPS WITH COLUMBUS REGIONAL AGENTS WITH PERSONS AND FIRMS SUPPLYING GOODS AND SERVICES TO THE ORGANIZATION; PERSONS AND FIRMS FROM WHOM THE COMPANY LEASES PROPERTY AND EQUIPMENT; PERSONS AND FIRMS WITH WHOM COLUMBUS REGIONAL IS DEALING OR PLANNING TO DEAL IN CONNECTION WITH THE GIFT, PURCHASE OR SALE OF REAL ESTATE, SECURITIES OR OTHER PROPERTY; COMPETING OR AFFINITY ORGANIZATIONS; DONORS, MEMBERS OR OTHERS SUPPORTING THE ORGANIZATION; AGENCIES, ORGANIZATIONS AND ASSOCIATIONS WHICH AFFECT THE OPERATIONS OF THE COMPANY; AND FAMILY MEMBERS, FRIENDS AND OTHER EMPLOYEES. CONFLICTS OF INTEREST MAY ARISE IN A NUMBER OF DIFFERENT CIRCUMSTANCES AND TRANSACTIONS. IT IS ASSUMED THAT COLUMBUS REGIONAL AGENTS WILL RECOGNIZE SUCH AREAS AND RELATION BY ANALOGY. TRANSACTIONS WITH PARTIES WITH WHOM A CONFLICTING INTEREST EXISTS MAY BE UNDERTAKEN ONLY IF ALL OF THE FOLLOWING ARE OBSERVED: THE CONFLICT OF INTEREST IS FULLY DISCLOSED; THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION; A COMPETITIVE BID OR COMPARABLE VALUATION EXISTS FOR PURCHASING OR RELATED DECISIONS; AND THE CHIEF COMPLIANCE OFFICER IN CONSULTATION WITH OTHERS AS APPROPRIATE HAS DETERMINED THAT THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION. ALL DISCLOSURES MUST BE MADE TO THE CHIEF COMPLIANCE OFFICER (OR IF SHE/HE IS THE ONE WITH THE CONFLICT, THEN THE BOARD CHAIR), WHO WILL BRING THE MATTER TO THE ATTENTION OF THE BOARD AS NECESSARY. THE CHIEF COMPLIANCE OFFICER, IN CONSULTATION WITH OTHERS AS APPROPRIATE, SHALL DETERMINE WHETHER A CONFLICT EXISTS AND IN THE CASE OF AN EXISTING CONFLICT, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR AND REASONABLE TO COLUMBUS REGIONAL. THE DECISION OF THE CHIEF COMPLIANCE OFFICER AND/OR BOARD ON THESE MATTERS WILL REST IN THEIR SOLE DISCRETION AND THEIR CONCERN MUST BE FOR THE WELFARE OF COLUMBUS REGIONAL IN THE ADVANCEMENT OF ITS PURPOSE. EACH MEMBER OF MANAGEMENT AND EMPLOYEES WITH DELEGATED POWERS WHO CAN INFLUENCE THE ACTIONS OF COLUMBUS REGIONAL SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON: HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY AND COMPLETED THE DISCLOSURE STATEMENT; HAS READ AND UNDERSTANDS THE POLICY; AND HAS AGREED TO COMPLY WITH THE POLICY. IN ADDITION, SHOULD A POTENTIAL CONFLICT OCCUR DURING THE YEAR BUT PRIOR TO THE ANNUAL DISCLOSURE, THE INDIVIDUAL IS OBLIGATED TO CONTACT THE COMPLIANCE OFFICER AND UPDATE THEIR DISCLOSURE STATEMENT IN A TIMELY MANNER. IF THE CHIEF COMPLIANCE OFFICER HAS REASONABLE CAUSE TO BELIEVE A COLUMBUS REGIONAL AGENT HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, HE/SHE SHALL INFORM THAT INDIVIDUAL OF THE BASIS OF SUCH BELIEF AND AFFORD HIM/HER THE OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE INDIVIDUAL'S RESPONSE AND AFTER MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, THE CHIEF COMPLIANCE OFFICER DETERMINES THE INDIVIDUAL HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, HE/SHE SHALL FORWARD THE INFORMATION TO THE HUMAN RESOURCES DEPARTMENT AND/OR THE BOARD OF DIRECTORS TO TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION.
FORM 990, PART VI, SECTION B, LINE 15COLUMBUS REGIONAL TAKES VERY SERIOUSLY THE RESPONSIBILITY TO APPROPRIATELY AND EFFECTIVELY MANAGE THE EXECUTIVE COMPENSATION AND BENEFITS PROGRAM FOR ITS KEY EXECUTIVES. SETTING THE COMPENSATION OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, APPROVING THE COMPENSATION OF OTHER SENIOR EXECUTIVES, AND OVERSEEING THE EXECUTIVE COMPENSATION PROGRAM AS A WHOLE, ARE THE RESPONSIBILITIES OF THE COMPENSATION COMMITTEE OF THE BOARD. TO ASSIST THE COMMITTEE, THE BOARD HAS ENGAGED THE SERVICES OF A NATIONALLY RECOGNIZED EXECUTIVE COMPENSATION CONSULTING FIRM. COLUMBUS REGIONAL'S EXECUTIVE COMPENSATION PROGRAM IS DESIGNED TO ATTRACT AND RETAIN HIGHLY QUALIFIED EXECUTIVES TO FULFILL COLUMBUS REGIONAL'S MISSION OF PROMOTING THE HEALTH AND HEALING OF PATIENTS. COLUMBUS REGIONAL'S PEER GROUP CONSISTS OF NON-PROFIT HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE AND COMPLEXITY FROM ACROSS THE NATION. BASE SALARIES OF EXECUTIVES ARE POSITIONED AT SPECIFIC PERCENTILE TARGETS OF COLUMBUS REGIONAL'S PEER GROUP. CURRENT STUDIES INDICATE THAT OUR BASE SALARIES ARE AT TARGETED LEVELS. COLUMBUS REGIONAL STRIVES TO PROVIDE ALL EXECUTIVES WITH RETIREMENT BENEFITS THAT ARE EQUIVALENT FOR ALL EMPLOYEES. RETIREMENT CONTRIBUTIONS ARE BASED ON A CLEARLY STATED INCOME REPLACEMENT TARGET AS DETERMINED BY RETIREMENT PLAN CONSULTANTS. THE GOAL OF COLUMBUS REGIONAL IS TO PROVIDE MARKET COMPETITIVE COMPENSATION AND BENEFITS PROGRAMS FOR ALL EMPLOYEES AT ALL LEVELS OF THE ORGANIZATION.
FORM 990, PART VI, SECTION C, LINE 19THE CONFLICT OF INTEREST POLICY, AS WELL AS FINANCIAL STATEMENTS AND OTHER GOVERNING DOCUMENTS, ARE NOT MADE AVAILABLE TO THE PUBLIC.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
COLUMBUS REGIONAL HEALTHCARE SYSTEM INC
707 CENTER STREETCOLUMBUSGA31901581719994HEALTH SYSTEM MANAGEMENTGA501(C)(3)LINE 11B, IIN/A0
THE MEDICAL CENTER INC
707 CENTER STREETCOLUMBUSGA31901581685139ACUTE CARE HOSPITALGA501(C)(3)LINE 30COLUMBUS REGIONAL HEALTHCARE SYSTEM INC
COLUMBUS AMBULATORY HEALTHCARE SERVICES INC
707 CENTER STREETCOLUMBUSGA31901581719867AMBULATORY CAREGA501(C)(3)LINE 30COLUMBUS REGIONAL HEALTHCARE SYSTEM INC
COLUMBUS REGIONAL MEDICAL FOUNDATION INC
707 CENTER STREETCOLUMBUSGA31901581501642FUNDRAISINGGA501(C)(3)LINE 70COLUMBUS REGIONAL HEALTHCARE SYSTEM INC
DOCTOR'S HOSPITAL INC
707 CENTER STREETCOLUMBUSGA31901261739383ACUTE CARE HOSPITALGA501(C)(3)LINE 30COLUMBUS REGIONAL HEALTHCARE SYSTEM INC
HUGHSTON HOSPITAL INC
707 CENTER STREETCOLUMBUSGA31901331216751ORTHOPEDIC HOSPITALGA501(C)(3)LINE 30COLUMBUS REGIONAL HEALTHCARE SYSTEM INC
COLUMBUS REGIONAL AUXILIARY (FKA MEDICAL CENTER AUXILIARY)
707 CENTER STREETCOLUMBUSGA31901580917974HOSITAL AUXILIARYGA501(C)(3)LINE 11C, III-FI0THE MEDICAL CENTER INC
CRHS LONG TERM AND HOME CARE INC
707 CENTER STREETCOLUMBUSGA31901581719867NURSING HOMEGA501(C)(3)LINE 30COLUMBUS REGIONAL HEALTHCARE SYSTEM INC
DOCTOR'S HOSPITAL AUXILIARY
616 19TH STREETCOLUMBUSGA31901581295777HOSITAL AUXILIARYGA501(C)(3)LINE 11C, III-FI0DOCTOR'S HOSPITAL INC
THE MEDICAL CENTER HOSPITAL AUTHORITY INC
707 CENTER STREETCOLUMBUSGA31901580905094HOSP AUTHORITYGA501(C)(3)LINE 3N/A0

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
EVERGREEN MEDICAL GROUP LLC
PO BOX 790COLUMBUSGA31902582244760MEDICAL SERVICESGAN/A
COLUMBUS DIAGNOSTIC IMAGING
116 INTRACOASTAL POINTE DR 300JUPITERFL33477262291768DIAGNOSTIC IMAGINGGAN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrg
COLUMBUS HEALTH SERVICES INC
707 CENTER STREETCOLUMBUSGA31901581640939PHARMACIESGAN/AC0
COLUMBUS HEALTHCARE RESOURCES INC
707 CENTER STREETCOLUMBUSGA31901581717754PROPERTY MANAGEMENTGAN/AC0
WOMEN'S MEDICAL SERVICES
707 CENTER STREETCOLUMBUSGA31901581695456MANAGEMENTGAN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Affiliated Group Schedule AffiliatedGroupSchedule

Affiliated Schedule AffiliatedSchedule (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINElecting OrgElectingOrgTotal Grassroots LobbyingTotalGrassrootsLobbyingTotal Direct LobbyingTotalDirectLobbyingTotal Lobbying ExpendituresTotalLobbyingExpendituresOther Exempt Purpose ExpendituresOtherExemptPurposeExpendituresTotal Exempt Purpose ExpendituresTotalExemptPurposeExpendituresLobbying NontaxableLobbyingNontaxableAmountGrassroots NontaxableGrassrootsNontaxableAmountTot Lobbying Grassroot Minus NontxTotLobbyingGrassrootMinusNontxTot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontxShare Of Excess Lobbying ExpendtrsShareOfExcessLobbyingExpendtrs
COLUMBUS REGIONAL HEALTHCARE SYSTEM INC
707 CENTER STREETCOLUMBUSGA31901581719994X032191321913636550036397691$1,000,000$250,000000
CRHS LONG TERM & HOME CARE INC
707 CENTER STREETCOLUMBUSGA31901581778572000443610443610$88,722$22,181000
COLUMBUS AMBULATORY HEALTHCARE SERVICES
707 CENTER STREETCOLUMBUSGA319015817198670002997575029975750$1,000,000$250,000000
COLUMBUS REGIONAL SENIOR LIVING INC
707 CENTER STREETCOLUMBUSGA3190158262850200055242955524295$426,215$106,554000
COLUMBUS REGIONAL AUXILIARY
707 CENTER STREETCOLUMBUSGA31901580917974000687315687315$128,097$32,024000
DOCTOR'S HOSPITAL INC
707 CENTER STREETCOLUMBUSGA319012617393830005606265756062657$1,000,000$250,000000
HUGHSTON HOSPITAL INC
707 CENTER STREETCOLUMBUSGA319013312167510006301343763013437$1,000,000$250,000000
THE MEDICAL CENTER INC
707 CENTER STREETCOLUMBUSGA31901581685139000323099234323099234$1,000,000$250,000000
COLUMBUS REGIONAL MEDICAL FOUNDATION INC
707 CENTER STREETCOLUMBUSGA3190158150164200033506913350691$317,535$79,384000
DOCTOR'S HOSPITAL AUXILIARY
616 19TH STREETCOLUMBUSGA319015812957770005286552865$10,573$2,643000