COLUMBUS COUNTY HOSPITAL FOUNDATION INC: Form 990EZ, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- COLUMBUS COUNTY HOSPITAL FOUNDATION INC (EIN 01-0673231)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-14
- IRS object ID
- 201322269349201197
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-14T13:03:38-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560747981 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1 |
| City | ASHEVILLE | City |
| State | NC | State |
| ZIP Code | 28806 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010673231 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBUS COUNTY HOSPITAL FOUNDATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COLU | NameControl |
| Phone | 9106421703 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 JEFFERSON STREET | AddressLine1 |
| City | WHITEVILLE | City |
| State | NC | State |
| ZIP Code | 284723696 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TERRIE PRIEST | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Phone | 9106421703 | Phone |
| Date Signed | 2013-08-09 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHAEL RAUCHWARG | Name |
| PTIN | P00439551 | PTIN |
| Phone | 8282542254 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Schedule B Not Required | X | ScheduleBNotRequired |
| Web Site | WWW.CRHEALTHCARE.ORG | WebSite |
| Organization501c3 | X | Organization501c3 |
| Gross Receipts | 69825 | GrossReceipts |
| Info In Schedule O Part I | X | InfoInScheduleOPartI |
| Contributions Gifts Grants Etc | 49119 | ContributionsGiftsGrantsEtc |
| Investment Income | 51 | InvestmentIncome |
| Fundraising Gross Income | 20655 | FundraisingGrossIncome |
| Special Events Direct Expenses | 23423 | SpecialEventsDirectExpenses |
| Special Events Net Income Loss | -2768 | SpecialEventsNetIncomeLoss |
| Total Revenue | 46402 | TotalRevenue |
| Salaries Other Comp Empl Benefits | 46883 | SalariesOtherCompEmplBenefits |
| Fees And Oth Pymt To Ind Contractors | 381 | FeesAndOthPymtToIndContractors |
| Other Expenses Total | 10229 | OtherExpensesTotal |
| Total Expenses | 57493 | TotalExpenses |
| Excess Or Deficit For Year | -11091 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 109139 | NetAssetsOrFundBalancesBOY |
| Other Changes In Net Assets | 0 | OtherChangesInNetAssets |
| Net Assets Or Fund Balances EOY | 98048 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part II | X | InfoInScheduleOPartII |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 242023 | BOY |
| EOY | 288332 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 242023 | BOY |
| EOY | 288332 | EOY |
Sum Of Total Liabilities SumOfTotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 132884 | BOY |
| EOY | 190284 | EOY |
Net Assets Or Fund Balances NetAssetsOrFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 109139 | BOY |
| EOY | 98048 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Primary Exempt Purpose | TO SUPPORT COLUMBUS REGIONAL HEALTHCARE SYSTEM AND PROMOTE COMMUNITY BENEFIT PROGRAMS WITHIN COLUMBUS COUNTY, NORTH CAROLINA. | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Service Accom | THE FOUNDATION SUPPORTS COLUMBUS REGIONAL HEALTHCARE SYSTEM IN PROVIDING SCHOLARSHIPS TO AREA HIGH SCHOOL STUDENTS THAT ARE PARTICIPATING IN THE HEALTH OCCUPATIONS STUDENTS OF AMERICA PROGRAMS (HOSA) AT THEIR HIGH SCHOOL. | DescriptionProgramServiceAccom |
| Grants And Allocations | 0 | GrantsAndAllocations |
| Program Service Expenses | 57493 | ProgramServiceExpenses |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | 57493 | TotalProgramServiceExpenses |
| Info In Schedule O Part IV | X | InfoInScheduleOPartIV |
Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (12 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation | Contri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtc | Expense Account Other AllowancesExpenseAccountOtherAllowances |
|---|---|---|---|---|---|---|---|---|
| JOHN HODGSON MD | ||||||||
| 500 JEFFERSON STREET | WHITEVILLE | NC | 28472 | CHAIRMAN | 2.00 | 0 | 0 | 0 |
| BRENDA JOLLY | ||||||||
| 500 JEFFERSON STREET | WHITEVILLE | NC | 28472 | VICE CHAIRMAN | 1.00 | 0 | 0 | 0 |
| BUTCH HOOKS | ||||||||
| 500 JEFFERSON STREET | WHITEVILLE | NC | 28472 | SECRETARY/TREASURER | 1.00 | 0 | 0 | 0 |
| PEGGY BLACKMON | ||||||||
| 500 JEFFERSON STREET | WHITEVILLE | NC | 28472 | BOARD MEMBER | 2.00 | 0 | 0 | 0 |
| LINDA BELL | ||||||||
| 500 JEFFERSON STREET | WHITEVILLE | NC | 28472 | BOARD MEMBER | 0.50 | 0 | 0 | 0 |
| LUIS DONAYRE MD | ||||||||
| 500 JEFFERSON STREET | WHITEVILLE | NC | 28472 | BOARD MEMBER | 0.50 | 0 | 0 | 0 |
| ABIGAIL EDWARDS | ||||||||
| 500 JEFFERSON STREET | WHITEVILLE | NC | 28472 | BOARD MEMBER | 2.00 | 0 | 0 | 0 |
| JUDY ENZOR | ||||||||
| 500 JEFFERSON STREET | WHITEVILLE | NC | 28472 | BOARD MEMBER | 0.50 | 0 | 0 | 0 |
| PAUL GERALD JR | ||||||||
| 500 JEFFERSON STREET | WHITEVILLE | NC | 28472 | BOARD MEMBER | 0.50 | 0 | 0 | 0 |
| BRIAN JENKINS | ||||||||
| 500 JEFFERSON STREET | WHITEVILLE | NC | 28472 | BOARD MEMBER | 2.00 | 0 | 0 | 0 |
| RICHARD BERRY MD | ||||||||
| 500 JEFFERSON STREET | WHITEVILLE | NC | 28472 | BOARD MEMBER | 2.00 | 0 | 0 | 0 |
| HENRY HAWTHORNE | ||||||||
| 500 JEFFERSON STREET | WHITEVILLE | NC | 28472 | BOARD MEMBER | 0.50 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRpt |
| Made Changes To Orgnzng Etc Doc | 0 | MadeChangesToOrgnzngEtcDoc |
| Organization Had UBI | 0 | OrganizationHadUBI |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtc |
| Direct Indirect Political Expend | 0 | DirectIndirectPoliticalExpend |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficers |
| Tax Imposed Under IRC4911 | 0 | TaxImposedUnderIRC4911 |
| Tax Imposed Under IRC4912 | 0 | TaxImposedUnderIRC4912 |
| Tax Imposed Under IRC4955 | 0 | TaxImposedUnderIRC4955 |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTrans |
| Amount Of Tax Imposed On Org Mgr | 0 | AmountOfTaxImposedOnOrgMgr |
| Amount Of Tax Reimbursed By Org | 0 | AmountOfTaxReimbursedByOrg |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TERRIE PRIEST | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 JEFFERSON STREET | AddressLine1 |
| City | WHITEVILLE | City |
| State | NC | State |
| ZIP Code | 28742 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9106421703 | TelephoneNumber |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Foreign Office | 0 | ForeignOffice |
| Maintain Any Donor Advised Funds | 0 | MaintainAnyDonorAdvisedFunds |
| Does Org Have Hospital | 0 | DoesOrgHaveHospital |
| Tanning Services Provided | 0 | TanningServicesProvided |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Engage Political Cmpgn Activities | 0 | EngagePoliticalCmpgnActivities |
| Engage In Lobbying Activities | 0 | EngageInLobbyingActivities |
| Operating School | 0 | OperatingSchool |
| Trnsfrs Exempt Non Char Related Org | 0 | TrnsfrsExemptNonCharRelatedOrg |
| Part VI Of Comp Of Highest Paid Empl | NONE | PartVIOfCompOfHighestPaidEmpl |
| Part VIA Hghst Paid Cntrct Prof Ser | NONE | PartVIAHghstPaidCntrctProfSer |
| Filed Schedule A | 1 | FiledScheduleA |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBUS REGIONAL HEALTHCARE SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560538020 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Amount | $0 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | CRHSF GALA | NameOfEvent1 |
| Gross Receipts Event1 | 56855 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 36200 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 20655 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 23423 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 56855 | GrossReceiptsTotal |
| Charitable Contributions Total | 36200 | CharitableContributionsTotal |
| Gross Revenue Total Events | 20655 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 23423 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 23423 | DirectExpenseSummaryEvents |
| Net Income Summary | -2768 | NetIncomeSummary |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OTHER INVESTMENT INCOME | FORM 990-EZ, PART I, LINE 4 | INTEREST INCOME 51.. |
| OTHER EXPENSES | FORM 990-EZ, PART I, LINE 16 | DESCRIPTION: SUPPLIES. AMOUNT: 7,995. DESCRIPTION: BANKING FEES. AMOUNT: 92. DESCRIPTION: REPAIRS & MAINTENANCE. AMOUNT: 1,059. DESCRIPTION: REGISTRATION FEES. AMOUNT: 1,083. TOTAL TO FORM 990-EZ, LINE 16: 10,229. |
| OTHER LIABILITIES | FORM 990-EZ, PART II, LINE 26 | DESCRIPTION: DUE TO CRHS. BEG. OF YEAR AMOUNT: 132,784. END OF YEAR AMOUNT: 190,284. DESCRIPTION: FUNDRAISER PAYABLE. BEG. OF YEAR AMOUNT: 100. END OF YEAR AMOUNT: 0. |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT. | Declaration |