COLUMBUS COMMUNITY HOSPITAL INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: COLUMBUS COMMUNITY HOSPITAL INC (EIN 47-0542043)
Tax period: 2011-05-01 to 2012-04-30
Filed: 2013-03-06
IRS object ID: 201340659349300474
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-03-06T14:53:42-06:00	Timestamp
Tax Period End Date	2012-04-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	KPMG LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	Two Central Park Plaza Suite 1501	AddressLine1
City	Omaha	City
State	NE	State
ZIP Code	681021626	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-05-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	470542043	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	COLUMBUS COMMUNITY HOSPITAL INC	BusinessNameLine1

Field	Value	IRS element (for citing)
In Care Of Name	% MIKE ADAMY	InCareOfName
Name Control	COLU	NameControl
Phone	4025623357	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 1800	AddressLine1
City	COLUMBUS	City
State	NE	State
ZIP Code	68602	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Michael T Hansen	Name
Title	CHIEF EXECUTIVE OFFICER	Title
Date Signed	2013-02-08	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Phone	4023481450	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	J Joseph Barbaglia	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	4600 38th Street	AddressLine1
City	Columbus	City
State	NE	State
ZIP Code	68601	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	70543625	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.columbushosp.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1972	YearFormation
State Legal Domicile	NE	StateLegalDomicile
Activity Or Mission Description	OUR MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	11	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	625	TotalNbrEmployees
Total Nbr Volunteers	299	TotalNbrVolunteers
Total Gross UBI	19147	TotalGrossUBI
Net Unrelated Business Txbl Income	-37854	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	140646	ContributionsGrantsPriorYear
Contributions Grants Current Year	303177	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	64569556	ProgramServiceRevenuePriorYear
Program Service Revenue CY	68343052	ProgramServiceRevenueCY
Investment Income Prior Year	-185651	InvestmentIncomePriorYear
Investment Income Current Year	1233315	InvestmentIncomeCurrentYear
Other Revenue Prior Year	738418	OtherRevenuePriorYear
Other Revenue Current Year	664081	OtherRevenueCurrentYear
Total Revenue Prior Year	65262969	TotalRevenuePriorYear
Total Revenue Current Year	70543625	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	1297521	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	1334804	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	29018478	SalariesEtcPriorYear
Salaries Etc Current Year	30379279	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	26681899	OtherExpensePriorYear
Other Expenses Current Year	27885114	OtherExpensesCurrentYear
Total Expenses Prior Year	56997898	TotalExpensesPriorYear
Total Expenses Current Year	59599197	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	8265071	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	10944428	RevenuesLessExpensesCY
Total Assets BOY	88904691	TotalAssetsBOY
Total Assets EOY	100607338	TotalAssetsEOY
Total Liabilities BOY	16813490	TotalLiabilitiesBOY
Total Liabilities EOY	18331472	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	72091201	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	82275866	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	OUR MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE.	MissionDescription
Significant New Program Services	true	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	56497758	Expense
Grants	155321	Grants
Revenue	68746731	Revenue
Description	General Hospital and Health Care: Columbus Community Hospital ("CCH") is a 47 bed acute care Hospital which currently employs over 600 people. It is a significant, positive economic force for Columbus and the area, returning dollars into the economy through local purchases by the organization, and salaries that return to the community. It is also a needed asset for the local communities where patients can obtain quality healthcare without the need to drive over 50 miles for care. In providing the care necessary for local communities, CCH has a variety of services. Following is a brief summary of some of the areas of service provided by CCH. -The main focus is acute care services For patients needing an extended recovery. the beds at CCH are also certified as swing beds. -To assist our non-English speaking patients, CCH uses competent, dedicated medical interpreters as a liaison between the care providers and the patient. Since this is the interpreters' full time job at the Hospital, they are available when needed, in house or on call 24/7. -To make the patient's stay successful and comfortable, CCH offers icu, medical surgical, OB, and an orthopedic service line along with a variety of complimentary ancillary services (wound care, diabetic education, cardiac rehab) and clinical pharmacy services provided. CCH uses barcoded medication administrated smart pumps and computerized physician order entry to enhance safety. -CCH offers rehabilitative services such as physical therapy, speech therapy, occupational therapy and drive rehab therapy, so patients don't have to travel so far to get adult therapy. Pediatric physical therapy, speech therapy, and occupational therapy are offered at our off-site location, Wiggles & Giggles Therapy (includes physicial, speech, and occupational therapies) for Kids. CCH has PTs, OTs and STs with specialized certification in cancer rehab. They just recently started a specialized parkinsens treatment approach, which facilitates support groups for parkinsens, TBI and stroke patients. -Nurses in the Same Day Services Department prepare patients for surgery and if going home the same day, care for them after surgery. The department oversees several outpatient procedures, including seventy to ninety endoscopy procedures each month, also infusions and chemotherapy infusions. -CCH offers some of the most advanced imaging services including MRI, CT, Digital Mammography, Ultrasound, etc. Radiologists are on campus and/or available 24-7 to read the various scans. The dictation used by the radiologists is voice recognized and becomes part of the digital image. All images are digital, meaning there are no films. -CCH has an up to date Laboratory which performs over 12,000 tests on average per month, for both inpatients and outpatients. -CCH has highly trained, employed emergency physicians and nurses in their Emergency Department (ed) and offers 24-7 care. The Department includes support from qualified staff in respiratory care, social work, laboratory, medical interpreting, and diagnostic imaging. The ED was designated as a Level III Trauma Center in May, 2006. The Medical Staff and personnel in the Trauma Center have received specialized training to resuscitate and stabilize trauma patients. The trauma program provides systematic review of the trauma care and participates in injury prevention activities throughout the community. -CCH opened wound care services in August of 2008 with three patients. The identified service area includes a 45-mile radius around Columbus. By January, 2009 a second day was added to support the demand. This service has taken off far beyond what was expected. Previously, patients seeking this specialized treatment were required to travel on average 75 miles to see a wound clinic specialist. It was a much needed service for the local communities. Columbus commuinty hospital currently sees over 100 patients per month for wound care. -Centering on services outside the Hospital, the larger services are Home Health and Hospice services. Home Health is skilled health services for patients at their place of residence. The program is medically directed, therefore, it must be ordered by the attending physician. The program is Medicare and Medicaid certified and meets the requirements of the Joint Commission. Services provided within the program are: A) Supervision and administration of medications B) Intravenous therapy C) Teaching diabetic management D) Nutritional assessments E) Home Health Aides F) Personal Care services G) Occupational, Speech and Physical Therapies H) social work care management Hospice services are provided to persons who are no longer receiving curative treatment and whose life expectancy is six months or less. Care is provided by an interdisciplinary team which consists of the physician, nurse, social worker, therapist, home health aide, spiritual advisor, volunteer and other health professionals. -Our local Healthy Family Nebraska Program (HFN) targets young, primarily single, pregnant mothers and their families. Our voluntary HFN home visitation program targets the most vulnerable young women and their families by offering them, intense, in home education, support and resources. This home visiting program covers families in a four county area. The HFN requires each mother/family to actively participate in building an individualized family plan. This strength based approach promotes self-improvement, and enhances self-esteem and independence for our young parents that will help them make better decisions, and break out of destructive cycles. -CCH's Sleep Lab offers complete polysomnographic sleep testing for the purpose of diagnosing obstructive/central sleep apnea by trained and licensed sleep technicians. -Occupational Health Services (OHS) offers a menu of health care services designed to prevent and treat injuries in the workplace. Partnering with employers in more than 900 companies and with other health care professionals, OHS provides a comprehensive health and safety program specific to the needs of each business. A comprehensive testing procedure called the Physical Capacity Profile (pcp) matches employees to the job and is designed to accommodate individuals with handicaps. The PCP system was developed by an orthopedic physician. Through use of this testing, musculoskeletal imbalances are detected which helps employers place employees in the appropriate job to minimize the potential of injury. -Lifeline, an in home emergency response program, provides the vital safety net that many people need to continue living at home in familiar and comforting surroundings. The program is completely focused on ensuring the patient's independence, safety and well-being in their home. It operates with a bracelet worn by the patient with a button that can be pressed if help is needed. predetermined responders are summoned to their home or emergency transfer can be called if needed. This gives security to the patient and comfort to the patient's relatives. -Meals on Wheels are prepared by the Nutrition Services Department and are delivered by community volunteers. Seniors and physically handicapped adults qualify for the program. Special diets can also be accommodated. Financial assistance is available through the Nebraska Department of Social Services. -The Hospital participates in and has hosted county wide natural disasters and pandemic drills. CCH is a member of a larger preparedness team, RROMRS. This allows CCH to assist or receive assitance from this regions medicare providers. CCH feels we are well prepared to handle a natural disaster or pandemic should one arise.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	1179483	Expense
Grants	1179483	Grants
Description	Charity Care: CCH offers a Charity/Financial Aid Program to provide uncompensated services to people who are unable to pay. CCH Charity/Financial Aid Policy reflects the mission, vision and values of CCH. It is intended to assist low-income, underinsured, and uninsured individuals whose financial status, under the hospital's qualification criteria, makes it impractical or impossible to pay for necessary medical services. CCH has a fiduciary responsibility to seek payment for services from those who can pay, and every effort will be made to apply consistent, fair and equitable financial aid practices in a manner consistent with all applicable federal and state laws and regulations. CCH follows the Federal Poverty Guidelines (FPG) to determine both eligibility for free care, 100% of FPG, and discounted care, 200% FPG. CCH also offers catastrophic charity assistance. If the applicant qualifies for partial Charity/Financial Assistance and the total balance after all write-off's is $1,200 or greater, an additional write-off will be done as outlined below. $1,200 - $5,000 Reduce to $1,200 adjustments will be done from oldest to newest $5,001 - $10,000 Reduce to $1,400 >$10,001 Reduce to $1,800	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	57677241	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	false	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	true	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	true	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	true	RelatedOrgControlledEntity
Transaction Related Entity	true	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	true	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	38	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	625	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	true	UnrelatedBusinessIncome
Form990-T Filed	true	Form990-TFiled
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	11	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	MIKE ADAMY	NamePerson
Telephone Number	4025623382	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	4600 38TH STREET	AddressLine1
City	COLUMBUS	City
State	NE	State
ZIP Code	68601	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
JAMES PILLEN DVM
CHAIR	1.0	X	X	0	0	0
RONALD ERNST MD
DIRECTOR	1.0	X
JOHN C MCCLURE
DIRECTOR	1.0	X
ANNE HALL
DIRECTOR	1.0	X
ANTHONY RAIMONDO JR
TREASURER	1.0	X	X
REBECCA RAYMAN
DIRECTOR	1.0	X
MARK HOWERTER MD
DIRECTOR/PHYSICIAN	40.0	X		417398		16629
JEFFREY GOTSCHALL MD
VICE CHAIR	1.0	X	X
BONNIE MCPHILLIPS
DIRECTOR	1.0	X
BRIAN SCHMIDT
DIRECTOR	1.0	X
CLARK LEHR
DIRECTOR	1.0	X
J JOSEPH BARBAGLIA
VP FINANCE	40.0		X	162437		18487
MICHAEL HANSEN
PRESIDENT/CEO/SECRETARY	40.0		X	222191		7915
AMY BLASER
VP BUSINESS DEVELOPMENT	40.0		X	112606		11321
JAMES GOULET
VP OPERATIONS	40.0			167690		16936	X
LINDA WALLINE
VP NURSING	40.0			152451		15118	X
PHIL POWERS CRNA
CRNA	40.0			206032		20295		X
JOHN SAFRANEK MD
PHYSICIAN	40.0			198628		16871		X
ROBERT MILLER MD
PHYSICIAN	40.0			260574		14517		X
MARK SWOPE
CRNA	40.0			193390		17834		X
ALEX KAZOS MD
PHYSICIAN	40.0			249701		23887		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2343098	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	179810	TotalOtherCompensation
Number Individuals GT100 K	21	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
INPATIENT PHYSICIAN ASSOC
3200 PINE LAKE RD STE A	LINCOLN	NE	68516	HOSPITALIST SVCS	1121062
TSP CONSTRUCTION SERVICES INC
1112 N WEST AVE	SIOUX FALLS	SD	571041333	CONSTRUCTION SVCS	6883837
B-D CONSTRUCTION INC
2154 E 32ND AVE	COLUMBUS	NE	68601	CONSTRUCTION SVCS	778342
GEHRING CONSTRUCTION READY MIX CO
5424 WEST MEADOW DRIVE	COLUMBUS	NE	68601	CONSTRUCTION SVCS	462228
MCKESSON TECHNOLOGIES INC
PO Box 98347	CHICAGO	IL	60693	IT Consulting	137988

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	10	NumberOfContractorsGT100K
Related Organizations	303177	RelatedOrganizations
Total Contributions	303177	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	NET PATIENT SVC REVENUE	Description
Business Code	621110	BusinessCode
Total Revenue Column	68343052	TotalRevenueColumn
Related Or Exempt Function Income	68343052	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	68343052	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1174915	TotalRevenueColumn
Exclusion	$1,174,915	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	58400	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Other	58400	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	58400	TotalRevenueColumn
Exclusion	$58,400	ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
OTHER REVENUE	900099	422826	403679	19147
CAFETERIA	722100	241255			$241,255

Field	Value	IRS element (for citing)
Total Other Revenue	664081	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	70543625	TotalRevenueColumn
Related Or Exempt Function Income	68746731	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	19147	UnrelatedBusinessRevenue
Exclusion	$1,474,570	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	155321	Total
Program Services	155321	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	1179483	Total
Program Services	1179483	ProgramServices

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	908248	Total
Management And General	908248	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	23964260	Total
Program Services	23964260	ProgramServices

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	792235	Total
Program Services	792235	ProgramServices

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	3002646	Total
Program Services	3002646	ProgramServices

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	1711890	Total
Program Services	1711890	ProgramServices

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	81622	Total
Management And General	81622	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	174978	Total
Management And General	174978	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	5490	Total
Management And General	5490	ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	2965404	Total
Program Services	2965404	ProgramServices

Advertising Advertising

Field	Value	IRS element (for citing)
Total	166991	Total
Management And General	166991	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	7509205	Total
Program Services	7288375	ProgramServices
Management And General	220830	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	1205425	Total
Program Services	1205425	ProgramServices

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	1064262	Total
Program Services	1064262	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	226313	Total
Management And General	226313	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	137484	Total
Management And General	137484	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	282533	Total
Program Services	282533	ProgramServices

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	5120114	Total
Program Services	5120114	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	221942	Total
Program Services	221942	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
PROVISION FOR BAD DEBTS	3888614	3888614
MINOR EQUIP. & FINANCING AGRMT	2094451	2094451
PURCHASED SERVICES	896700	896700
DEFERRED FINANCING COSTS	75815	75815

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	1767771	Total
Program Services	1767771	ProgramServices

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	59599197	Total
Program Services	57677241	ProgramServices
Management And General	1921956	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	1621171	BOY
EOY	5507494	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	9468918	BOY
EOY	8997202	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	1271025	BOY
EOY	1454475	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	802965	BOY
EOY	1418337	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	83106570	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	45244754	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	30905511	BOY
EOY	37861816	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	44723764	BOY
EOY	45055102	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	111337	BOY
EOY	312912	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	88904691	BOY
EOY	100607338	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	3987593	BOY
EOY	6699617	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	12825897	BOY
EOY	11631855	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Loans From Officers Directors LoansFromOfficersDirectors

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	16813490	BOY
EOY	18331472	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	72091201	BOY
EOY	82275866	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	72091201	BOY
EOY	82275866	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	88904691	BOY
EOY	100607338	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	10944428	ReconcilationRevenueExpenses
Reconcilation Other Changes	-759763	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbying
Total Direct Lobbying		TotalDirectLobbying
Total Lobbying Expenditures		TotalLobbyingExpenditures
Other Exempt Purpose Expenditures		OtherExemptPurposeExpenditures
Total Exempt Purpose Expenditures		TotalExemptPurposeExpenditures
Lobbying Nontaxable		LobbyingNontaxableAmount
Grassroots Nontaxable		GrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non Tx		TotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying Nontx		TotLobbyExpendMnsLobbyingNontx
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	false	GrantsOtherOrganizations
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	true	OtherActivities
Other Activities	$5,490	OtherActivitiesAmount
Total Lobbying Expenditures IIB	5490	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	OTHER ACTIVITIES	Identifier
Return Reference	SCHEDULE C, PART II-B, LINE 1I	ReturnReference
Explanation	DUES PAID TO AMERICAN HOSPITAL ASSOCIATION ALLOCATED TO LOBBYING $3,042 DUES PAID TO NEBRASKA HOSPITAL ASSOCIATION ALLOCATED TO LOBBYING $2,448	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1573063	BeginningOfYearBalance
Contributions	94673	Contributions
End Of Year Balance	1667736	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1506660	BeginningOfYearBalance
Contributions	66403	Contributions
End Of Year Balance	1573063	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1426826	BeginningOfYearBalance
Contributions	79844	Contributions
Investment Earnings Or Losses	-10	InvestmentEarningsOrLosses
End Of Year Balance	1506660	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1299402	BeginningOfYearBalance
Contributions	127424	Contributions
End Of Year Balance	1426826	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	1.00000	PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	true	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	true	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	696969	OtherCostOrOtherBasis
Book Value	696969	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	41937820	OtherCostOrOtherBasis
Depreciation	16890992	Depreciation
Book Value	25046828	BookValue

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovements

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	35879827	OtherCostOrOtherBasis
Depreciation	26765494	Depreciation
Book Value	9114333	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	4591954	OtherCostOrOtherBasis
Depreciation	1588268	Depreciation
Book Value	3003686	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	37861816	TotalOfBookValueLandBuildings
Federal Income Tax Liability	0	FederalIncomeTaxLiability
Total Of Amounts	0	TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
FIN 48 FOOTNOTE	SCHEDULE D, PART X	The Hospital adopted Financial Accounting Standards Board (FASB) Interpretation No. 48, Accounting for Uncertainty in Income Taxes - an Interpretation of FASB Statement No. 109 (FIN 48). FIN 48 provides specific guidance on how to address uncertainty in accounting for income tax assets and liabilities, prescribing recognition thresholds and measurement attributes. The adoption of FIN 48 by Columbus Community Hospital did not have a material impact on the Hospital's financial position, results of operations, or cash flows. In Fiscal Years Ending 2012 and 2011, management determined that there are no income tax positions requiring recognition in the financial statements.
SCHEDULE D	PART V, LINE 4	ENDOWMENT FUNDS ARE HELD AND MAINTAINED BY COLUMBUS COMMUNITY HOSPITAL FOUNDATION. THE ENDOWMENT FUNDS EXIST IN SUPPORT OF IMPROVED HEALTH SERVICES BY COLUMBUS COMMUNITY HOSPITAL.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent100	X	Pcent100
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent200 D	X	Pcent200D
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	true	ExpensesExceededBudget
Unable To Provide Care	false	UnableToProvideCare
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Persons Served	821	PersonsServed
Total Community Benefit Expense	652251	TotalCommunityBenefitExpense
Net Community Benefit Expense	652251	NetCommunityBenefitExpense
Percent Of Total Expense	0.01170	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3805014	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1821057	DirectOffsettingRevenue
Net Community Benefit Expense	1983957	NetCommunityBenefitExpense
Percent Of Total Expense	0.03570	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Persons Served	821	PersonsServed
Total Community Benefit Expense	4457265	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1821057	DirectOffsettingRevenue
Net Community Benefit Expense	2636208	NetCommunityBenefitExpense
Percent Of Total Expense	0.04740	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	19	NumberOfActivitiesOrPrograms
Persons Served	58967	PersonsServed
Total Community Benefit Expense	560082	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5620	DirectOffsettingRevenue
Net Community Benefit Expense	554462	NetCommunityBenefitExpense
Percent Of Total Expense	0.01000	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	47	PersonsServed
Total Community Benefit Expense	681	TotalCommunityBenefitExpense
Net Community Benefit Expense	681	NetCommunityBenefitExpense

Research Research

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Total Community Benefit Expense	18083	TotalCommunityBenefitExpense
Net Community Benefit Expense	18083	NetCommunityBenefitExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	5	NumberOfActivitiesOrPrograms
Persons Served	589	PersonsServed
Total Community Benefit Expense	22757	TotalCommunityBenefitExpense
Net Community Benefit Expense	22757	NetCommunityBenefitExpense
Percent Of Total Expense	0.00040	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	26	NumberOfActivitiesOrPrograms
Persons Served	59603	PersonsServed
Total Community Benefit Expense	601603	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5620	DirectOffsettingRevenue
Net Community Benefit Expense	595983	NetCommunityBenefitExpense
Percent Of Total Expense	0.01070	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	26	NumberOfActivitiesOrPrograms
Persons Served	60424	PersonsServed
Total Community Benefit Expense	5058868	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1826677	DirectOffsettingRevenue
Net Community Benefit Expense	3232191	NetCommunityBenefitExpense
Percent Of Total Expense	0.05810	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	30	PersonsServed
Total Community Building Expense	3414	TotalCommunityBuildingExpense
Net Community Building Expense	3414	NetCommunityBuildingExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	650	PersonsServed
Total Community Building Expense	1540	TotalCommunityBuildingExpense
Net Community Building Expense	1540	NetCommunityBuildingExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Total Community Building Expense	841	TotalCommunityBuildingExpense
Net Community Building Expense	841	NetCommunityBuildingExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Total Community Building Expense	2491	TotalCommunityBuildingExpense
Net Community Building Expense	2491	NetCommunityBuildingExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Total Community Building Expense	75	TotalCommunityBuildingExpense
Net Community Building Expense	75	NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	640	PersonsServed
Total Community Building Expense	81851	TotalCommunityBuildingExpense
Net Community Building Expense	81923	NetCommunityBuildingExpense
Percent Of Total Expense	0.00150	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	31	PersonsServed
Total Community Building Expense	45758	TotalCommunityBuildingExpense
Net Community Building Expense	45758	NetCommunityBuildingExpense
Percent Of Total Expense	0.00080	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	9	NumberOfActivitiesOrPrograms
Persons Served	1351	PersonsServed
Total Community Building Expense	135970	TotalCommunityBuildingExpense
Net Community Building Expense	136042	NetCommunityBuildingExpense
Percent Of Total Expense	0.00230	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReported
Bad Debt Expense	$3,888,614	BadDebtExpenseAmount
Amount Attributable To	2150792	AmountAttributableTo
Amount Reimbursed By Medicare	20306573	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	21544395	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-1237822	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivity	Physicans Profit Or OwnershipPhysicansProfitOrOwnership
HEALTHPARK LLC
PROPERTY MANAGEMENT	0.71000
ZARZ LLC
PROPERTY MANAGEMENT	0.50000

Field	Value	IRS element (for citing)
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Columbus Community Hospital Inc	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	4600-38th Street	AddressLine1
City	Columbus	City
State	NE	State
ZIP Code	686011800	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours
Other	47 BED ACUTE CARE HOSPITAL W/ 24 HOUR ER SERVICES	Other

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Columbus Community Hospital Inc	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	100	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	200.	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Medicaid Medicare	X	MedicaidMedicare
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Attached To Invoices	X	AttachedToInvoices
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Provided On Admission	X	ProvidedOnAdmission
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	true	ActionsOnNonpayment
Collection Activities	false	CollectionActivities
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Average Negotiated Rates	X	AverageNegotiatedRates
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	9	NumberOfOtherFacilities

Other Facilities OtherFacilities (9 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
PREMIER PHYSICAL THERAPY OF CCH
US 30 CTR BLDG 3100-23RD st ste 15	COLUMBUS	NE	686013161	PHYSICIAL & AQUATIC THERAPY, SPORTS TRAINING SERVICES
WIGGLES & GIGGLES THERAPY FOR KIDS
2108-13TH STREET	COLUMBUS	NE	686015100	PEDIATRIC THERAPY SERVICES
OCCUPATIONAL HEALTH SERVICES OF CCH
3005-18TH ST SUITE 300	COLUMBUS	NE	686014252	EMP. HEALTH CARE SVCS TO PREVENT & TREAT WORK INJURIES
WOUND HEALING CENTER
4600-38TH STREET SUITE 165	COLUMBUS	NE	68601	WOUND TREATMENT CENTER
HUMPHREY CLINIC OF CCH
3003 MAIN STREET	HUMPHREY	NE	686423155	CLINIC IN SMALL TOWN TO OFFER MEDICAL SVCS TO RESIDENTS
HOSPICE OF COLUMBUS COMMUNITY HOSPITAL
3005-19TH STREET SUITE 600	COLUMBUS	NE	686014248	HOSPICE SERVICES
COLUMBUS COMMUNITY HOSPITAL SLEEP LAB
3020-18TH STREET SUITE 14	COLUMBUS	NE	686014254	POLYSOMNOGRAPHIC SLEEP TESTING
HOME HEALTH OF COLUMBUS COMMUNITY HOSP
3005-19TH STREET SUITE 600	COLUMBUS	NE	686014248	HOME HEALTH SERVICES
COLUMBUS ORTHOPEDIC & SPORTS MEDICINE CL
4508 38TH STREET STE 133	COLUMBUS	NE	686011668	FREE STANDING CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
PART I, LINE 3C	N/A
PART I, LINE 6A	A Community Benefit report is included each year in the Hospital's quarterly newsletter "Housecall" with an electronic version of the newsletter housed on the Hospital's website. A separate landing page on the website was also created for the report to provide easy access to the report.
PART I, LINE 7	To determine costs associated with Charity Care and Community Benefits costs, the Hospital has used the worksheets offered in the Schedule H instructions. The ratio of patient care costs to charges on Worksheet 2 was used to calculate the amounts on reported on Line 7 of the table. Bad debt amounting to $3,888,614 included in the functional expense total in Part IX, Line 25 did not include $59,599,197 of the total operating expenses used to calculate the Table 7 percentage.
PART II	-Hospital continues to collaborate with local Chamber of Commerce to recruit skilled professionals to fill job openings in the community. Provides support and staff time to assist in highlighting the health care community, providing specific department or hospital tours in order to recruit skilled professions to live and work here in the community. -Hospital sold land to the City to provide space for a twelve-acre urban lake and 20 acres of land for a future fire station on this property. The urban lake is equipped with a nice wooden dock that makes it very accessible for strollers, wheelchairs and other assistive devices to roll down the dock to fish or watch the waterfowl on the lake. Local assisted living and nursing care centers bring their wheel chair vans with residents to the lake as they can drive right up to the accessible dock. This urban lake, waterfowl area provides a community space within the city limits for the whole community, young and old alike. -Hospital continues to partner in several projects and community disease prevention initiatives with our local District Public Health Department and Community Health Center (CHC). The hospital provides financial support and much professional staff time as liaisons to these community partnerships throughout the year working on multiple chronic disease and accident prevention strategies. Some of these community initiatives include type II diabetes, hypertension and heart disease, pre- and post natal newborn care, physical activity and exercise, colon cancer prevention and early detection as well as community preparedness to natural and manmade disasters. Several other initiatives are addressed throughout the year as community health issues arise. Thousands of community members are reached with these community initiative campaigns each year and these make a real difference in people's lives that are living with chronic health issues. -Additionally CCH is in attendance in over a dozen Community Health Fairs/Community events each year, providing medical screenings and information for all community members. -CCH also partners with local day cares, schools and colleges to provide speakers and hands on learning events for students to encourage entry into the medical professions.	COMMUNITY BUILDING ACTIVITIES
PART III, LINE 4	Financial statements do not include any text for bad debt. The amount in Line 2 was based on the bad debt charges multiplied by the ratio of patient care cost to charge from worksheet 2, Line 11. Charity care is kept separate from bad debt.
PART III, LINE 8	In accordance with 42 CFR 413.24, Columbus Community Hospital uses the "Step-down Method" as its costing methodology. Departments within a provider are usually divided into two types: 1) Those that produce patient care revenue (e.g., routine services, radiology), and 2) Those that do not directly generate patient care revenue but are utilized as a service by other departments (e.g., laundry and linen, dietary). The two types of departments are commonly referred to as "revenue-producing cost centers" and "nonrevenue-producing cost centers," respectively. Although nonrevenue-producing cost centers do not directly produce patient care revenue, they contribute indirectly to patient care revenue generated by "serving" as a service to the revenue-producing centers and also to other nonrevenue-producing centers. Therefore, for the purpose of proper matching of revenue and expenses, the cost of the revenue-producing centers should include both its direct expenses and its proportionate share of the costs of each nonrevenue-producing center (indirect costs) based on the amount of services received. The process of allocating the cost of a particular nonrevenue-producing center to other nonrevenue-producing centers and revenue-producing centers is performed by utilizing a set of statistics (e.g., pounds of laundry for allocating "laundry and linen" costs, square feet for allocating "depreciation building" costs). Every nonrevenue-producing cost center has the potential of being allocated to every other nonrevenue-producing cost center in addition to the revenue-producing cost centers. This precludes a simple allocation of the direct expense of the nonrevenue-producing cost center because the indirect costs derived from allocation of other nonrevenue-producing cost centers must be computed in determining the "full cost" (direct and indirect costs) of the nonrevenue-producing cost center being allocated. The "Step-down Method" recognizes that services furnished by certain nonrevenue-producing departments are utilized by certain other nonrevenue-producing centers as well as by the revenue-producing centers. All costs of nonrevenue-producing centers are allocated to all centers that they serve, regardless of whether or not these centers produce revenue. The cost of the nonrevenue-producing center serving the greatest number of other centers, while receiving benefits from the least number of centers, is apportioned first. Following the apportionment of the cost of the nonrevenue-producing center, that center will be considered "closed" and no further costs are apportioned to that center. This applies even though it may have received some service from a center whose cost is apportioned later. Generally, if two centers furnish services to an equal number of centers while receiving benefits from an equal number, that center which has the greatest amount of expense should be allocated first.
PART III, LINE 9B	CHARITY (FINANCIAL AID) PROGRAM POLICY/PROCEDURE Columbus Community Hospital (CCH) offers a Charity/Financial Aid Program to provide uncompensated services to people who are unable to pay. CCH Charity/Financial Aid Policy reflects the mission, vision and values of CCH. It is intended to assist low-income, underinsured, and uninsured individuals whose financial status, under the hospital's qualification criteria, makes it impractical or impossible to pay for necessary medical services. CCH has a fiduciary responsibility to seek payment for services from those who can pay, and every effort will be made to apply consistent, fair and equitable financial aid practices in a manner consistent with all applicable federal and state laws and regulations. 1. Charity Policy a. Our Charity/Financial Aid Policy does not eliminate the personal responsibility and financial discounts are always secondary to other government-sponsored programs. However, CCH is committed to serve those without the means to pay and work with Good Neighbor Community Health Center and Medicaid services. 2. Health Insurance a. If a patient or guarantor has access to employer-based or government-sponsored health insurance, yet elected not to enroll or failed to maintain eligibility, they may be considered. They will be encouraged to obtain coverage at the next eligible period. b. If patient or guarantor has a Medical Savings Account, this needs to be expended before they are eligible for assistance. c. "Presumptive" financial assistance may be taken into consideration when a patient has expired and there is no estate. An incomplete financial assistance form may be on file because documentation was lacking that would support the provision of financial aid. In this case: i. A family member is contacted to insure no estate exits. ii. Family member may be asked to sign and date a statement to the effect that no estate exits. iii. The county in which the deceased patient resided is contacted to verify that no estate exits. d. CCH's Charity/Financial Aid is not a substitute for employer-sponsored, public or individually-purchased insurance, nor is CCH's financial aid policy a substitute for the responsibility of government and employers to expand access to health care coverage for all persons. 3. Accounts with a Balance a. Charity/Financial Aid may apply to balances due from insured patients for deductibles, co-payments, or co-insurance, or other types of patient payment responsibility. 4. Receiving an application a. CCH is diligent in its efforts to determine, at the earliest point in time, the patient's ability to pay. Information on Charity/Financial Assistance is available in key areas of the hospital on how to apply or obtain further information, as well as hospital website and patient statements. i. Hospital staff members who work closely with patients are educated on how to communicate financial aid availability and how to direct patients to staff responsible for the financial aid application process. ii. Staff members are trained to treat financial aid applicants with courtesy, confidentiality, and cultural sensitivity. iii. These principles and guidelines are for those patients who truly cannot afford health care services. b. Any person requesting financial aid information will be directed to the Patient Accounts or Social Services Departments. An application for the Charity/Financial Aid Program needs to be completed before an eligibility determination can be made. The application is also available in Spanish. Once the application is submitted with written proof of income, a determination will be made in a timely manner. One or more of the following are required as verification of income: i. A letter of rejection from the Department of Social Services (Medicaid) if applicable. ii. Signed copy of previous year's tax return. iii. Copy of most recent pay stub, with accumulative earnings. iv. Copy of recent three months of bank statements with an explanation of all deposits. v. Copy of any compensation received, i.e., unemployment, if applicable. vi. Social Security determination if applicable. c. A family is defined as anyone living together in a household; this will include college students, regardless of their residence, who are supported by their parents. 5. Review Process a. All completed applications are reviewed and approved by the Patient Financial Services Director and overseen by the Vice-President of Finance. b. Any applications that are in need of further assistance are taken to the Vice-President of Finance. c. All write-offs greater than $5,000 are reviewed by Vice President of Finance. d. Monthly the Vice-President of Finance oversees the Charity and Medicare Bad Debt statistical reports. e. If the applicant's income is above Poverty Guidelines, but is still in need of assistance, a sliding scale will be used. This scale is adjusted according to the current year's Poverty Guidelines. If the applicant qualifies for partial Charity/Financial Assistance, acceptable monthly payment arrangements must be agreed upon. f. If the applicant qualifies for partial Charity/Financial Assistance and the total balance after all write-off's is $1,200 or greater, an additional write-off will be done as outlined below. $1,200 - $5,000 Reduce to $1,200 $5,001 - $10,000 Reduce to $1,400 >$10,001 Reduce to $1,800 Adjustments will be done from oldest to newest. g. A letter will be sent to the Guarantor informing them of the determination for charity/financial assistance along with a Monthly Payment Agreement for those who qualified for partial approval or denied applicants. This Agreement needs to be signed and returned to the Patient Accounts Department within 10 days. 6. Documentation of Processed Accounts a. The Patient Financial Services Director will maintain a yearly log of all applicants. Documentation of approved accounts that have been written off or denied will be maintained. 7. Archived Applications a. All charity applications are scanned into HBF under Document Type 'Charity Applications'
NEEDS ASSESSMENT	In 2010, the Columbus community Hospital's five year strategic plan was implemented. The plan includes a thorough assessment of the organization's external environment in terms of opportunities and threats in order to determine its internal strengths and weaknesses. The plan also includes strategic issues, goals, and related strategies for future organizational effectiveness. Six Organizational Pillars were identified: quality, culture, people, service, facilities, and finance. 1) Quality - Quality efforts have been focused on evidence based processes and educating staff on the importance of use and integration into daily operations. Cch has implemented an electronic medical record to afford ease of information access and communication across the continuum of care. 2) Culture - In effort to achieve a high performance organization, cch is in the process of implementing a 4-part culture improvement initiative including teamstepps, just culture, studer, and lean/six sigma process improvement. A 3-year implementation time frame has been established. 3) People - CCH has continued to employ aggressive employee and physician recruitment efforts to attract and retain the workforce needed to support strategic growth initiatives across all service lines. 4) Services - cch performs annual, comprehensive program review of existing and new services and has ranked priority to begin service line development in areas such as hospital medicine, orthopedics, cardiology, cancer, and rehab services. 5) Facilities - CCH has developed a comprehensive master facilities plan that is able to adapt to current and future patient care needs. An emergency department expansion was completed in 2012.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	Here is a sample of what is available on our CCH Web Site with detailed links as well as hard copy information in a special wall unit located inside each patient room as well as outpatient areas in brochures. There is also a tutorial listed for each step of the way letting the patient know what they will need to bring along or have available to show for coping purposes. Monthly Payment Option If you are unable to pay your balance in full, please call Patient Accounts Department to set up an acceptable payment arrangement. Patient Charity/Financial Assistance Program If you feel your income is not sufficient to pay for your services at Columbus Community Hospital, please contact Patient Accounts Department AND/OR SOCIAL WORKERS for information regarding Charity/Financial Assistance. Further information about Medicare/Medicaid / Charity Care is provided in both English and Spanish. The state has their Medicaid applications available online. Our patient accounts and social services staff have financial/charity applications available in both English and Spanish to provide to our patients. Additionally, signage is posted directing patients to call as needed for financial help, and referrals are built into the Medical Admission software, so if patients voice concerns about the cost, or their lack of coverage a referral is generated to Social Services staff who will see patients individually and counsel on specific circumstances. Monthly statements have information on: 1)Payment plans 2)Charity/financial assistance program 3)24/7 online business office, which includes information on payment plans, charity/financial assistance, and downloadable financial/charity applications (available in English and Spanish).
COMMUNITY INFORMATION	The local economy- Our Hospital service area remains in a small pocket that has been relatively protected from the recession. As we currently have over 300 skilled level positions available in several manufacturing companies, including wind generation, plastics, medical equipment, ethanol and the local beef packing plant. Columbus Community Hospital is located Columbus, Nebraska, which is the largest city in Platte County. With a growing population of 32,000, Platte County is the largest of the seven county service area . From June 30, 2008 to December 31, 2009, unemployment in the City of Columbus increased slightly from 3.0% or 566 jobless to 3.7% or 693 jobless. During this same period of time, the Nebraska jobless rate was 4.6% and the National average was reported at 10%. Since November, 2008 job availability in Columbus has increased by 23%. The unemployment rate reported for Columbus in May, 2010 was 4.6%, while the State reported 4.8% and the National average was 9.5%. As reported in Money Magazine, Columbus is listed as the third best place in the U.S. to find employment and in the "Top 100 Best Small Towns to Live". Three counties in Nebraska were listed in the top ten counties in the U.S. to live and work, including Platte, Madison (which is contiguous to Platte County) and Sarpy County near Lincoln, Nebraska. Our local economy is based on agriculture and manufacturing, with many industrial companies attracted by plentiful, low-priced hydroelectric power. Among the major employers are Archer Daniels Midland (ADM), an ethanol manufacturing company; FLEX-CON; Central Confinement Service" Vishay; BD Medical, a medical equipment company; Behlen Manufacturing, which manufactures steel buildings; and Nebraska Public Power, with headquarters located in Columbus. Due to successful economic and industrial development in our area, this large manufacturing base remains intact. A hard-working, well-educated workforce, low energy costs and a local environment friendly to business, provide encouragement for strong economic and industrial development within our service. According to the Nebraska Department of Labor, Columbus is considered a major hub for the manufacturing industry and has a greater share of manufacturing employment than other Nebraska metropolitan areas. We continue to see an influx of single and young families moving into our area seeking employment. Our community growth correlates to our continuing increase in Hospital outpatient visits. Outpatient visits reached an all-time high of 45,151 year to date visits for the fiscal year ending April, 2012. This represents a 2% increase in visits over the same twelve month period the prior year. In 2005, our outpatient visits over a twelve month period totaled 38,129. This 27% increase in our outpatient visits over the past five years is a reflection of the significant impact the Demonstration Project has had on our Hospital. Service Capacity: THE WOUND CENTER OPENED AUGUST OF 2008 WITH THREE PATIENTS. IT HAS GROWN TO 691 PATIENTS AS OF JANUARY 9, 2013. THE IDENTIFIED SERVICE AREA INCLUDES A 45-MILE RADIUS AROUND COLUMBUS. THE WOUND CENTER IS LOCATED IN THE VISITING PHYSICIAN OFFICE SUITE OF THE ATTACHED MEDICAL OFFICE BUILDING. THE CENTER OPERATES TWO DAYS PER WEEK. ADDITIONAL NURSE STAFF TIME IS SPENT EACH WEEK ASSISTING CLIENTS WITH WOUND APPLICATIONS, SCHEDULING APPOINTMENTS AND OTHER RESPONSIBILITIES SUCH AS ORDERING SUPPLIES AND MAINTAINING COMPLIANCE WITH NATIONAL STANDARDS. PREVIOUSLY, PATIENTS SEEKING THIS SPECIALIZED TREATMENT WERE REQUIRED TO TRAVEL ON AVERAGE 75 MILES TO SEE A WOUND CENTER SPECIALIST. THE VOLUME WE ARE SEEING AT THIS WOUND CENTER REINFORCES THE AMOUNT OF COMMUNITY NEED THAT EXIST FOR THIS SERVICE AND HAS GREATLY INCREASED THE LOCAL ACCESS TO SERVICE FOR SO MANY OF OUR HIGHER ACUITY PATIENTS AND THEIR FAMILIES. CCH WILL BE INSTALLING A NEW CT SCANNER, NEW RADIOLOGIC/FLUSUSCOPY SYSTEM AND NUCLEAR MEDICINE CAMERA. THESE REPLACE EXISTING SYSTEMS WHICH ARE OUTDATED. WE RECENTLY OPENED A WOMEN'S IMAGING AREA WITHIN THE HOSPITAL WHICH IS SEPERATE FROM THE RADIOLOGY DEPARTMENT. A NEW REGISTRATION AREA RECENTLY OPENED WHICH PROVIDES PATIENT PRIVACY. BONE DENSITY, UPGRADED FROM CONTRACTING WITH A MOBILE SERVICE UNIT TO PURCHASING OUR OWN BONE DENSITY STATIONARY EQUIPMENT AND THE NECESSARY SUPPORT EQUIPMENT AND STAFF WHICH WAS ADDED IN EARLY 2010. THIS IS A GREAT ADDED BENEFIT TO THE COMMUNITY, INCREASING ACCESS FOR OUR PATIENTS AND PROVIDERS WHO NO LONGER HAVE TO AWAIT DIAGNOSIS WITH THE MOBILE UNITS' INTERMITTENT SERVICE. THIS IS ANOTHER NEW PROGRAM THAT INCREASES ACCESS AND ELIMINATES THE NEED TO TRAVEL TO OUT OF TOWN UNITS FOR PROMPT DIAGNOSIS THAT IS MADE POSSIBLE BY THE DEMONSTRATION PROJECT. The Demonstration Project has allowed us to purchase additional equipment, eliminating the wait for diagnosis due to the intermittent service of mobile units. This reduces the need to travel out of town for diagnosis and improves access to care for our community. Columbus Community Hospital is a 47 bed, acute care Hospital serving needs offering a variety of surgical procedures and short term hospitalizations. All 47 beds are licensed for either acute care or swing bed patients. In addition, we provide comprehensive outpatient laboratory, radiology, respiratory and rehabilitative services. We also provide free interpreter services 24/7. Our facility offers comprehensive care, including Intensive Care, Medical-Surgical Care, Inpatient and outpatient surgical procedures (general, ENT, urology, podiatry, orthopedic), as well as other complimentary ancillary services including respiratory, wound care, diabetes education, endoscopies and cardiopulmonary rehabilitation. In 2006, the Hospital's Emergency Department was designated as a Level III Trauma Center with nurses certified in TNCC, ACLS and PALS. Eight of the Emergency Department nurses are also certified in ENPC. A 30,000 square foot addition to the Hospital, provided the Emergency Department with expanded space the Emergency Department added two trauma bays a two-bay ambulance garage a dedicated decontamination area, a dedicated family grief and counseling room, covered drive-up access and a negative air-pressure room, which allows patients with communicable diseases to be treated while protecting other patients and staff. Our Home Health/Hospice interdisciplinary services are provided to patients within a 30 mile radius of Columbus and can provide in home Telehealth monitoring. The Hospital's Sleep Lab provide polysomnographic sleep testing. In addition, we are exploring the possibility making available both daytime and home sleep tests. In January 2010, the Hospital hired a fulltime RN as the Orthopedic Service Line Coordinator. A multi-disciplinary team was organized to review, standardize and improve the patient's total joint process from diagnosis to post-surgical recovery and in November 2010 a new orthopedic service line was implemented. In MARCH, 2012 the Hospital acquired Columbus Orthopedic and Sports Medicine Clinic, enabling the Hospital to expand the service line and ensure the community's aging population orthopedic services close to home. Three cardiologists have relocated to Columbus, providing full time cardiology services to the area. Since 2010, 40 physicians in total have been recruited to serve the needs of our primary and secondary service areas to include 36 MD's and 4 Midlevels; 20 are full time providers and the other 20 are serving the community in a visiting capacity. The Hospital has completed construction on three road projects on and around the campus to increase access to the facility. Two clinic buildings, one for a family practice group and one for a pharmacy have been completed as well.
PROMOTION OF COMMUNITY HEALTH	-The Hospital reinvests capital to improve patient care, attract the best qualified staff to provide quality care for our patients, provide medical education and prevention activities in the community. -Our Hospital is living our Mission and Vision within the community: OUR MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE OUR VISION IS TO COMPASSIONATELY DELIVER THE STATE'S HIGHEST QUALITY PATIENT CARE -CORE VALUES CCH Core Values are: INTEGRITY COMPASSION (changed from "Commitment" as part of the communication of this strategic plan) ACCOUNTABILITY RESPECT EXCELLENCE -The Hospital has prioritized our capital reinvestment by aligning it to the Strategic Plan. Our plan consists of SIX Organizational Pillars with goals and strategies associated with each. The SIX Pillars of Excellence consist of: Quality Culture People Services Facilities *FINANCE Measurement of ongoing operational performance is organized around these Pillars of Excellence. These pillars were strategically identified as common measures around which operational performance is organized in many health care institutions and adapted for CCH. COLUMBUS COMMUNITY HOSPITAL HAS AN INDEPENDENT BOARD OF DIRECTORS MADE UP OF COMMUNITY LEADERS WITH DIVERSE BACKGROUNDS. COLUMBUS COMMUNITY HOSPITAL HAS AN OPEN EMERGENCY ROOM AVAILABLE TO ALL IN NEED NO MATTER OF RACE, CREED, AGE, OR ABILITY TO PAY. THE HOSPITAL ALSO HAS AN OPEN MEDICAL STAFF.
AFFILIATED HEALTH CARE SYSTEM	N/A
STATE FILING OF COMMUNITY BENEFIT REPORT	NONE
PART V, LINE 13G	INFORMATION BROCHURES ON FINANCIAL/CHARITY ASSISTANCE (F/C) ARE AVAILABLE IN KEY AREAS OF THE HOSPITAL. THE CCH WEBSITE HAS INFORMATION REGARDING F/C ASSISTANCE, AS WELL AS APPLICATIONS IN BOTH SPANISH AND ENGLISH. THE PATIENT STATEMENTS HAS INFORMATION REGARDING F/C ASSISTANCE. THE F/C APPLICATIONS ARE AVAILABLE TO ALL STAFF ON THE H DRIVE UNDER FORMS. THE EMERGENCY REGISTRATION, MAIN REGISTRATION, PATIENT ACCOUNTS AND SOCIAL SERVICES DEPARTMENTS HAVE THE F/C APPLICATIONS IN BOTH ENGLISH AND SPANISH AVAILABLE.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
COLUMBUS COMMUNITY HOSPITAL FOUNDATION INC
4600 38TH STREET	COLUMBUS	NE	68601	470836747	501(C)(3)	132783	TO SUPPORT EXEMPT
AMERCIAN HEART ASSOCIATION INC
7272 GREENVILLE AVENUE	DALLAS	TX	75231	135613797	501(C)(3)	12440	TO SUPPORT EXEMPT

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	2	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	CHARITY CARE TO PATIENTS	TypeOfGrant
Number Of Recipients	825	NumberOfRecipients
Amount Of Cash Grant	219	AmountOfCashGrant
Amount Of Non Cash Assistance	1179264	AmountOfNonCashAssistance
Method Of Valuation	BOOK	MethodOfValuation
Description Of Non Cash Assistance	WRITE-OFF OF MED EXP	DescriptionOfNonCashAssistance

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	GENERAL INFORMATION ON GRANTS AND ASSISTANCE	Identifier
Return Reference	Schedule I, Part I, Line 2	ReturnReference
Explanation	COLUMBUS COMMUNITY HOSPITAL does not typically give out donations, but occasionally a request is brought forward and the Board determines that it is in the best interest of the community to provide a particular grant. Prior to providing the grant, the Hospital determines that the organization it gives to is a 501(c)(3) organization or a government agency. The Hospital will also make grants to their related organizations as necessary to support their exempt purpose.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	true	WrittenPolicyReTAndEExpenses
Substantiation Required	true	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Form990 Of Other Organizations	X	Form990OfOtherOrganizations
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	false	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Other Compensation Filing OrgOtherCompensationFilingOrg	Deferred Comp Filing OrgDeferredCompFilingOrg	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Total Compensation Filing OrgTotalCompensationFilingOrg
J JOSEPH BARBAGLIA
145937	16500	6666	2742	171845
JAMES GOULET
157940	9750	6796	12880	187366
LINDA WALLINE
135951	16500	5897	11557	169905
PHIL POWERS CRNA
202849	3183	8466	15931	230429
MARK HOWERTER MD
417398		9800	5332	432530
JOHN SAFRANEK MD
182128	16500	8130	12797	219555
ROBERT MILLER MD
260574		9577	9907	280058
MICHAEL HANSEN
205691	16500	7915		230106
MARK SWOPE
185474	7916	7005	14662	215057
ALEX KAZOS MD
249701		9800	18143	277644

Form990 Schedule J Part III Form990ScheduleJPartIII

Field	Value	IRS element (for citing)
Identifier	QUESTIONS REGARDING COMPENSATION	Identifier
Return Reference	PART I, LINE 1A	ReturnReference
Explanation	THE ORGANIZATION PAID FOR SOCIAL AND HEALTH CLUB DUES AS PART OF THE CEO'S EMPLOYMENT AGREEMENT. These amounts were reflected on the CEO's W-2.	Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	HOSPITAL AUTHO NO 1 OF PLATTE COUNTY NE	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	470830844	IssuerEIN
CUSIP Number	000000000	CUSIPNumber
Date Issued	2010-05-04	DateIssued
Issue Price	23000000	IssuePrice
Description Of Purpose	REFUND PRIOR BONDS	DescriptionOfPurpose
Defeased	false	Defeased
On Behalf Of Issuer	false	OnBehalfOfIssuer
Pool Financing	false	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Amount Retired	11359661	AmountRetired
Amount Bond Defeased	0	AmountBondDefeased
Total Proceeds	23000000	TotalProceeds
Amount In Reserve Fund	0	AmountInReserveFund
Capitalized Interest	0	CapitalizedInterest
Refunding Escrow	0	RefundingEscrow
Issuance Costs From Proceeds	0	IssuanceCostsFromProceeds
Credit Enhancement	0	CreditEnhancement
Working Capital Expenditures	0	WorkingCapitalExpenditures
Capital Expenditures	0	CapitalExpenditures
Other Spent Proceeds	23000000	OtherSpentProceeds
Amount Unspent	0	AmountUnspent
Year Of Subst Completion	2002	YearOfSubstCompletion
Current Refunding	true	CurrentRefunding
Advance Refunding	false	AdvanceRefunding
Final Allocation Made	true	FinalAllocationMade
Adequate Books And Recds Maintaind	true	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Owning Bond Financed Property	false	OwningBondFinancedProperty
Any Lease Arrangements	false	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	true	MngmentCntrctBondFinancdPrprty
Engage Bond Counsel Contracts	true	EngageBondCounselContracts
Any Research Agreements	false	AnyResearchAgreements
Engage Bond Counsel Research	false	EngageBondCounselResearch
Prcntge Prvt Business Use By Others	0	PrcntgePrvtBusinessUseByOthers
Post Issuance Compliance Procdrs	true	PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Form8038 T Filed	false	Form8038TFiled
Variable Rate Issue	false	VariableRateIssue
Hedge Identified In Books And Recds	false	HedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1

Field	Value	IRS element (for citing)
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1

Field	Value	IRS element (for citing)
Gross Proceeds Invested	false	GrossProceedsInvested
Exception To Rebate	true	ExceptionToRebate

Form990 Schedule K Part VI Form990ScheduleKPartVI (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SCHEDULE K, PART III, LINE 3A	0	COLUMBUS COMMUNITY HOSPITAL HAS THE FOLLOWING CONTRACTS, ALL OF WHICH HAVE BEEN REVIEWED BY OUR ATTORNEYS AND ARE 97-13 COMPLIANT: 1. HOSPITALISTS SERVICES AGREEMENT FOR HOSPITAL CONTRACTED WITH IPA COLUMBUS, 2. FOOD SERVICE MANAGEMENT AGREEMENT CONTRACTED WITH ARAMARK HEALTHCARE SUPPORT SERVICES, LLC, 3. TRAUMA SURGERY CALL FOR EMERGENCY AGREEMENT, REQUIRED WITH LEVEL III TRAUMA STATUS, WITH RON ERNST, M.D., 4. ORTHOPEDIC EMERGENCY ROOM CALL FOR PATIENTS REQUIRING THAT SPECIALTY SERVICE WITH MICHAEL MCGUIRE, M.D., 5. WOUND CARE HEALING CENTER MEDICAL DIRECTOR AND PROVIDER WITH RON ERNST, M.D., 6. PROFESSIONAL SERVICES AND MEDICAL DIRECTOR FOR HUMPHREY CLINIC WITH COLUMBUS FAMILY PRACTICE, PC, 7. HOME HEALTH/HOSPICE ASSOCIATE MEDICAL DIRECTOR AGREEMENT WITH DRS. ED DISCO, M.D. AND DALE ZARUBA, M.D.
SCHEDULE K, PART III, LINE 5	0	ALL UNRELATED BUSINESS INCOME IS GENERATED FROM PROPERTY NOT FINANCED BY BONDS REPORTED ON SCHEDULE K.
SCHEDULE K, PART III, LINE 7	0	POLICIES ARE IN PLACE, BUT ARE PRESENTLY UNWRITTEN. COLUMBUS COMMUNITY HOSPITAL IS CURRENTLY IN THE PROCESS OF PUTTING CURRENT POLICY IN WRITING.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
GOVERNANCE, MANAGEMENT AND DISCLOSURE	FORM 990, PART VI, LINE 15	The Hospital's Executive Compensation Committee, made up of independent Hospital Board members, reviews the CEO's compensation annually. The wage range is compared to information provided by third party consultants, from salary surveys. Decisions are documented.
GOVERNANCE, MANAGEMENT AND DISCLOSURE	Form 990, Part VI, Line 19	At Columbus Community Hospital, a 3-ring binder exists in the Executive Assistant's office labeled "For Public Disclosure" which includes the most current of the following: -Governing Documents which are the Hospital Bylaws -Conflict of Interest Policy -Audited Financial Statements -Forms 990 and 990-T
GOVERNANCE, MANAGEMENT AND DISCLOSURE	Form 990, Part VI, Line 12C	Columbus Community Hospital does monitor any conflict of interests based on their conflict of interest policy. EMPLOYEES AND VOLUNTEERS are required to fully disclose any conflict of interest that may exist or appears to exist. Hospital reviews any of these conflicts and works with the Compliance Officer and the Vice President or CEO to determine if a conflict exists. If one does exist, the Hospital initiates actions to manage, reduce, or eliminate the conflict.
COMPENSATION OF OFFICERS	FORM 990,PART VII	Michael Hansen (President/CEO) DEVOTED ON AVERAGE 2 HOURS PER WEEK TO THE COLUMBUS COMMUNITY HOSPITAL FOUNDATION (RELATED ORGANIZATION) IN ADDITION TO HIS TIME SPENT AS CEO/PRESIDENT OF COLUMBUS COMMUNITY HOSPITAL. MR. HANSEN WAS PAID BY THE HOSPITAL FOR HIS SERVICES.
GOVERNANCE, MANAGEMENT AND DISCLOSURE	PART VI, LINE 11B	The Form 990 will be available for all members of the finance committee to review. Upon committee review, the 990 will then be submitted to the Board for review and the Board will make any corrections if applicable. If changes are made, a final copy of the 990 will be emailed to the Board members (via secure email) prior to filing with the IRS.
RECONCILIATION OF NET ASSETS	PART XI, LINE 5	CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION (759,763)
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:JAMES PILLEN DVM TITLE:CHAIR HOURS:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg
COLUMBUS COMMUNITY HOSPITAL FOUNDATION
4600 38TH STREET	COLUMBUS	NE	68601	470836747	FUNDRAISING	NE	501(C)(3)	LINE 11, I	CCH	true
HEALTHPARK TITLE CO
4600 38TH STREET	COLUMBUS	NE	68601	470830945	HOLDING CO.	NE	501(C)(3)	N/A	CCH	true

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	Code VCodeVAmount	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership
ZARZ LLC
PO BOX 1800	COLUMBUS	NE	68602	273676428	PROPERTY MGMT	NE	HLTHPK TITLE CO	RELATED	0	0	false	$0	false	0.00000
HEALTHPARK LLC
PO BOX 1800	COLUMBUS	NE	68602	470836733	PROPERTY MGMT	NE	HLTHPK TITLE CO	RELATED	0	0	false	$0	false	0.00000

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	true	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	true	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	true	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	true	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	true	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	true	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	true	PerformOfServicesByOtherOrgs
Sharing Of Facilities	true	SharingOfFacilities
Sharing Of Paid Employees	true	SharingOfPaidEmployees
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	true	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
COLUMBUS COMMUNITY HOSPITAL FOUNDATION
C	303177	CASH
COLUMBUS COMMUNITY HOSPITAL FOUNDATION
L	150275	BOOK
COLUMBUS COMMUNITY HOSPITAL FOUNDATION
E	11631855	BOOK
COLUMBUS COMMUNITY HOSPITAL FOUNDATION
B	132783	CASH
HEALTHPARK TITLE COMPANY
J	198922	BOOK

Form990 Schedule R Part VII Form990ScheduleRPartVII

Field	Value	IRS element (for citing)
Identifier	PART V, LINE 2	Identifier
Explanation	COLUMBUS COMMUNITY HOSPITAL FOUNDATION IS LISTED AS BACKING THE COLUMBUS COMMUNITY HOSPITAL, INC.'S TAX EXEMPT BOND. THIS IS COVERED WITH THE FOUNDATION'S NON-ENDOWED FUNDS.	Explanation