COLUMBUS AMBULATORY HEALTHCARE SERVICES INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- COLUMBUS AMBULATORY HEALTHCARE SERVICES INC (EIN 58-1719867)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-13
- IRS object ID
- 201341339349303054
- 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 C
- Schedule D
- Schedule J
- Schedule O
- Schedule R
- Affiliated Group Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-13T13:08:12-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 621517792 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PERSHING YOAKLEY & ASSOCIATES P C | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE CHEROKEE MILLS 2220 SUTHERLAND | AddressLine1 |
| City | KNOXVILLE | City |
| State | TN | State |
| ZIP Code | 379192363 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581719867 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBUS AMBULATORY HEALTHCARE SERVICES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COLU | NameControl |
| Phone | 7066606303 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 707 CENTER STREET | AddressLine1 |
| City | COLUMBUS | City |
| State | GA | State |
| ZIP Code | 31901 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ROLAND L THACKER | Name |
| Title | TREASURER | Title |
| Phone | 7066606303 | Phone |
| Date Signed | 2013-05-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SUSAN P CLARK CPA | Name |
| PTIN | P00017549 | PTIN |
| Phone | 8656730844 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CHARLES A STARK | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 707 CENTER STREET | AddressLine1 |
| City | COLUMBUS | City |
| State | GA | State |
| ZIP Code | 31901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 10011906 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | COLUMBUSREGIONAL.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1986 | YearFormation |
| State Legal Domicile | GA | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC. IS TO PROMOTE THE HEALTH AND HEALING OF OUR PATIENTS THROUGH THE PROVISION OF PHYSICIAN SERVICES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 71 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1348 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 10735553 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 10011906 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 10736901 | TotalRevenuePriorYear |
| Total Revenue Current Year | 10011906 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 400 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 10446418 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 11952435 | 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 | 6672810 | OtherExpensePriorYear |
| Other Expenses Current Year | 4375447 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 17119228 | TotalExpensesPriorYear |
| Total Expenses Current Year | 16328282 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -6382327 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -6316376 | RevenuesLessExpensesCY |
| Total Assets BOY | 8188360 | TotalAssetsBOY |
| Total Assets EOY | 8241523 | TotalAssetsEOY |
| Total Liabilities BOY | 8049261 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 7633943 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 139099 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 607580 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC. IS TO PROMOTE THE HEALTH AND HEALING OF OUR PATIENTS THROUGH THE PROVISION OF PHYSICIAN SERVICES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 13432960 | Expense |
| Grants | 400 | Grants |
| Revenue | 7406351 | Revenue |
| Description | COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC., IS A NOT-FOR-PROFIT COMPANY SERVING COLUMBUS AND SURROUNDING COUNTIES. IN KEEPING WITH ITS TAX-EXEMPT MISSION, COLUMBUS AMBULATORY HEALTHCARE SERVICES PROVIDES A WIDE VARIETY OF PRIMARY AND SPECIALTY PHYSICIAN SERVICES TO ALL PATIENTS REQUESTING SUCH SERVICES, REGARDLESS OF ABILITY TO PAY. MANY OF THESE PATIENTS ARE CLASSIFIED AS INDIGENT RESIDENTS OF MUSCOGEE COUNTY, AND AS SUCH ARE COVERED THROUGH A CONTRACTUAL AGREEMENT THE MEDICAL CENTER, INC. (A TAX-EXEMPT AFFILIATE) HAS WITH THE COLUMBUS CONSOLIDATED GOVERNMENT.SEVERAL OBJECTIVES ARE ACCOMPLISHED THROUGH THE PROVISION BY COLUMBUS AMBULATORY HEALTHCARE SERVICES OF THESE NON-CRITICAL SERVICES:- THE BURDEN ON THE MEDICAL CENTER'S EMERGENCY DEPARTMENT IS RELIEVED AS THAT SERVICE IS USED LESS OFTEN AS A PRIMARY SOURCE OF CARE. THIS ENABLES EMERGENCY SERVICE PERSONNEL TO CONCENTRATE ON TRUE EMERGENCIES. - THE OVERALL HEALTH CARE COST TO THE COMMUNITY IS REDUCED, SINCE IT IS LESS COSTLY TO TREAT A NON-CRITICAL PATIENT THROUGH AMBULATORY SERVICES THAN AN EMERGENCY SERVICE, WHICH IS STAFFED AND MAINTAINED TO RESPOND TO LIFE-THREATENING CONDITIONS. - INDIGENT PATIENTS RECEIVE WHAT COULD BE THEIR ONLY SOURCE OF AFFORDABLE, AVAILABLE CARE THROUGH MULTIPLE SPECIALTY CLINICS AND THE SERVICES OF VISITING SPECIALISTS. - ACCESS TO A MULTITUDE OF SERVICES IS INCREASED FOR INDIGENT AND LOW-INCOME PATIENTS AS CLINIC STAFF NETWORK WITH SUPPORT GROUPS, CHARITABLE ORGANIZATIONS AND SOCIAL SERVICE AGENCIES IN THE AREA.INDIGENT CARE PROGRAMCOLUMBUS AMBULATORY HEALTHCARE SERVICES, INC. AND THE MEDICAL CENTER - ALSO AN AFFILIATE OF COLUMBUS REGIONAL HEALTHCARE SYSTEM - PROVIDE OUTPATIENT AND INPATIENT SERVICES TO THE CITY'S INDIGENT THROUGH A CONTRACTUAL AGREEMENT WITH THE COLUMBUS CONSOLIDATED GOVERNMENT. THE OBJECTIVE OF THIS INDIGENT CARE PROGRAM IS TO PROVIDE COMPREHENSIVE HEALTH CARE FOR COLUMBUS RESIDENTS WHO ARE NOT COVERED UNDER A PRIVATE OR GOVERNMENTAL INSURANCE PLAN. INDIVIDUALS MEETING RESIDENCY AND INCOME REQUIREMENTS HAVE ACCESS TO A PRIMARY CARE CLINIC AND VARIOUS SPECIALTY CLINICS STAFFED BY QUALIFIED PHYSICIANS AND OTHER HEALTH CARE PERSONNEL. THE CLINICS PROVIDE DIAGNOSIS AND TREATMENT AND HEALTH EDUCATION.IF INPATIENT ADMISSION IS REQUIRED, PATIENTS RECEIVE CARE AT THE MEDICAL CENTER, WHERE THEY HAVE ACCESS TO A FULL RANGE OF DIAGNOSTIC AND TREATMENT SERVICES. IN ADDITION TO ENSURING CARE FOR THE CITY'S INDIGENT POPULATION, THE AGREEMENT WITH THE COLUMBUS CONSOLIDATED GOVERNMENT ALSO PROVIDES FOR ACUTE INPATIENT CARE AND CERTAIN OUTPATIENT CARE FOR THE COMMUNITY'S PRISON POPULATION.DURING FISCAL YEAR 2012, 2,706 FAMILIES, OR 4,841 INDIVIDUALS, WERE ENROLLED IN THE INDIGENT CARE PROGRAM. DURING THE SAME PERIOD, THERE WERE 19,659 OUTPATIENT CLINIC VISITS AND 332 INPATIENT ADMISSIONS FOR QUALIFIED RESIDENTS AND PRISONERS. ADDITIONALLY, 118,174 PRESCRIPTIONS FOR INDIGENT CARE PROGRAM ENROLLEES WERE FILLED IN THE AMBULATORY CARE PHARMACY.IN FISCAL YEAR 2012, TOTAL CHARGES TO PROVIDE INPATIENT AND OUTPATIENT SERVICES THROUGH THE INDIGENT CARE PROGRAM WERE $27,517,369.TOTAL PAYMENTS FROM THE COLUMBUS CONSOLIDATED GOVERNMENT TO THE MEDICAL CENTER, INC. FOR INDIGENT HEALTH CARE SERVICES PROVIDED BY ALL AFFILIATES WERE $12,803,682, LEAVING A DEFICIT OF $14,713,687.OUTPATIENT CLINICSTHE MAJORITY OF SERVICES PROVIDED UNDER THE INDIGENT CARE PROGRAM ARE THROUGH THE OUTPATIENT CLINICS OF COLUMBUS AMBULATORY HEALTHCARE SERVICES. INDIGENT PATIENTS ALSO ARE ELIGIBLE FOR OUTPATIENT, DIAGNOSTIC AND THERAPEUTIC SERVICES OFFERED THROUGH THE MEDICAL CENTER.THE MEDICINE CLINIC OF COLUMBUS AMBULATORY HEALTHCARE SERVICES IS THE PRIMARY CONTACT POINT FOR PATIENTS AND THE "GATE-KEEPER" FOR REFERRAL TO THE SPECIALTY CLINICS. HERE, PATIENTS RECEIVE INITIAL ASSESSMENTS, TREATMENT AND REFERRAL AS APPROPRIATE. PATIENT EDUCATION AND REFERRALS TO SOCIAL SERVICE AGENCIES AND SUPPORT GROUPS AS NEEDED ALSO ARE PROVIDED THROUGH THIS CLINIC. OUTPATIENT CLINIC UTILIZATION FOR QUALIFIED RESIDENTS DURING FISCAL YEAR 2012 IS SUMMARIZED IN THE TABLE BELOW:CLINIC VOLUME- EYE 1,331- CARDIOLOGY 217- COLPOSC/TUMOR/GYN 77- MEDICINE 10,679- NEUROLOGY 112- PODIATRY 100- SURGERY 396- NEPHROLOGY 163- GASTROENTEROLOGY - ADULT 177- PULMONARY 44- COUMADIN 435- LABS AND INJECTIONS 4,709- PHARMACOTHERAPY 1,219TOTAL CLINIC VISITS 19,659FAMILY PRACTICE CENTERTHE FAMILY PRACTICE CENTER, ALSO OFFERED THROUGH COLUMBUS AMBULATORY HEALTHCARE SERVICES AND THE MEDICAL CENTER, INC. PROVIDES A VARIETY OF HEALTH AND MEDICAL SERVICES TO FAMILIES OF THE REGION, REGARDLESS OF THEIR ABILITY TO PAY. SERVICES OFFERED THROUGH THE FAMILY PRACTICE CENTER INCLUDE FAMILY MEDICINE, OCCUPATIONAL MEDICINE, GERIATRIC SERVICES, PRENATAL AND PEDIATRIC SERVICES, OBSTETRICS, X-RAY AND LABORATORY SERVICES, COUNSELING AND TRAVEL IMMUNIZATIONS.THE FAMILY PRACTICE CENTER IS OPERATED BY THE FACULTY OF THE FAMILY PRACTICE RESIDENCY PROGRAM, WHICH WAS ESTABLISHED BY THE MEDICAL CENTER IN 1972 TO TRAIN PRIMARY CARE PHYSICIANS TO SERVE PRIMARILY IN RURAL AND OTHER MEDICALLY UNDERSERVED AREAS. THE CENTER SERVES AS A TRAINING SITE FOR PROGRAM RESIDENTS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1824621 | Expense |
| Revenue | 2605555 | Revenue |
| Description | IN AUGUST 2010, COLUMBUS RADIATION ONCOLOGY TREATMENT CENTER, LLC, A LIMITED LIABILITY COMPANY WHOSE SOLE MEMBER IS COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC., PURCHASED COLUMBUS RADIATION ONCOLOGY ASSOCIATES, P.C. THE CANCER CENTER WAS FOUNDED BY DR. JACK TIDWELL IN THE 1990S. DR. TIDWELL AND HIS STAFF CONTINUE PROVIDING HIGH-QUALITY RADIATION ONCOLOGY SERVICES AND PROVIDING EXCEPTIONAL PATIENT AND CUSTOMER SERVICE. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 15257581 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 71 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | GA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | ROLAND L THACKER TREASURER | NamePerson |
| Telephone Number | 7066606303 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 707 CENTER STREET | AddressLine1 |
| City | COLUMBUS | City |
| State | GA | State |
| ZIP Code | 31901 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| CHARLES A STARK | |||||||
| PRESIDENT & CEO - HIRE DATE 02/06/12 | 40.00 | X | X | 0 | 0 | 0 | |
| EUGENE A DEMONET | |||||||
| CHAIRMAN | 2.00 | X | 0 | 0 | 0 | ||
| LARRY S SANDERS | |||||||
| CHAIRMAN & CEO - RETIRED 09/30/11 | 40.00 | X | X | 0 | 3055822 | 77341 | |
| MAX BRABSON JR | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| KATHRYN CHEEK MD | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| CECIL CHEVES | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| MICHAEL GORUM MD | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| JULIUS HUNTER JR ESQ | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| GEORGE JETER | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| JOEY LOUDERMILK | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| WILLIAM ROUNDTREE MD | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| CAROLE RUTLAND PHD | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| WARREN STEELE | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| HENRY W SWIFT JR | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| LANCE B DUKE | |||||||
| EXECUTIVE VP & COO | 40.00 | X | 0 | 675595 | 136516 | ||
| ROLAND L THACKER | |||||||
| SR. VICE PRESIDENT & CFO | 40.00 | X | 0 | 427987 | 100636 | ||
| DONALD ELDER | |||||||
| SR. VICE PRESIDENT | 40.00 | X | 0 | 323678 | 146938 | ||
| KAREN SMITH | |||||||
| CORPORATE SECRETARY | 40.00 | X | 0 | 65443 | 22829 | ||
| CHRISTOPHER JOHNSON MD | |||||||
| PHYSICIAN | 40.00 | 424801 | 0 | 25747 | X | ||
| MICHAEL MENDES MD | |||||||
| PHYSICIAN | 40.00 | 673477 | 0 | 26260 | X | ||
| THOMAS STEWART MD | |||||||
| PHYSICIAN | 40.00 | 403080 | 0 | 28941 | X | ||
| LEILANI SHIVERS MD | |||||||
| PHYSICIAN | 40.00 | 246875 | 0 | 19710 | X | ||
| NAJAN VALADI MD | |||||||
| PHYSICIAN | 40.00 | 270048 | 0 | 24831 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2018281 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4548525 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 609749 | TotalOtherCompensation |
| Number Individuals GT100 K | 23 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| ATHENAHEALTH INC | |||||
| ARSENAL STREET | WATERTOWN | MA | 20472 | BILLING SERVICES | 497499 |
| HEALTHCARE PARTNERS | |||||
| 3080 PREMIERE PARKWAY SUITE 175 | DULUTH | GA | 30097 | RECRUITMENT SERVICES | 355691 |
| LABORATORY CORPORATION OF AMERICA | |||||
| 231 MAPLE AVE | BURLINGTON | NC | 27261 | LAB TESTING SERVICES | 166388 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT REVENUE | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 10011906 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10011906 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 10011906 | TotalProgramServiceRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10011906 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10011906 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 400 | Total |
| Program Services | 400 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10429253 | Total |
| Program Services | 10429253 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 999684 | Total |
| Program Services | 999684 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 523498 | Total |
| Program Services | 523498 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9324 | Total |
| Management And General | 9324 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1881419 | Total |
| Program Services | 1881419 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23717 | Total |
| Program Services | 23717 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 455867 | Total |
| Program Services | 455867 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2601 | Total |
| Program Services | 2601 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 593812 | Total |
| Program Services | 561375 | ProgramServices |
| Management And General | 32437 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63869 | Total |
| Program Services | 63869 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15545 | Total |
| Program Services | 15545 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 227943 | Total |
| Management And General | 227943 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34188 | Total |
| Management And General | 34188 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 760891 | Total |
| Management And General | 760891 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| SUPPLIES | 250411 | 250411 |
| PROFESSIONAL DUES | 17054 | 17054 |
| EQUIPMENT RENTAL | 14190 | 14190 |
| NON-CAPITALIZED EQUIPME | 7784 | 7784 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16832 | Total |
| Program Services | 10914 | ProgramServices |
| Management And General | 5918 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16328282 | Total |
| Program Services | 15257581 | ProgramServices |
| Management And General | 1070701 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -4321352 | BOY |
| EOY | -4015157 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1834278 | BOY |
| EOY | 1628361 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35608 | BOY |
| EOY | 21577 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 12095548 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1488806 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10639826 | BOY |
| EOY | 10606742 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8188360 | BOY |
| EOY | 8241523 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 125676 | BOY |
| EOY | 106537 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7923585 | BOY |
| EOY | 7527406 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8049261 | BOY |
| EOY | 7633943 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 139099 | BOY |
| EOY | 607580 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 139099 | BOY |
| EOY | 607580 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8188360 | BOY |
| EOY | 8241523 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -6316376 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 6784857 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Belongs To Affiliated Group | X | OrgBelongsToAffiliatedGroup |
Total Direct Lobbying TotalDirectLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Affiliated Group Totals | 32330 | AffiliatedGroupTotals |
Total Lobbying Expenditures TotalLobbyingExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Affiliated Group Totals | 32330 | AffiliatedGroupTotals |
Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Affiliated Group Totals | 531600193 | AffiliatedGroupTotals |
Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Affiliated Group Totals | 531632523 | AffiliatedGroupTotals |
Lobbying Nontaxable LobbyingNontaxableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Affiliated Group Totals | 1000000 | AffiliatedGroupTotals |
Grassroots Nontaxable GrassrootsNontaxableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Affiliated Group Totals | 250000 | AffiliatedGroupTotals |
Tot Lobbying Grassroot Minus Non Tx TotLobbyingGrassrootMinusNonTx
| Field | Value | IRS element (for citing) |
|---|---|---|
| Affiliated Group Totals | 0 | AffiliatedGroupTotals |
Tot Lobby Expend Mns Lobbying Nontx TotLobbyExpendMnsLobbyingNontx
| Field | Value | IRS element (for citing) |
|---|---|---|
| Affiliated Group Totals | 0 | AffiliatedGroupTotals |
Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | 1000000 | CurrentYearMinus3 |
| Current Year Minus2 | 1000000 | CurrentYearMinus2 |
| Current Year Minus1 | 1000000 | CurrentYearMinus1 |
| Current Year | 1000000 | CurrentYear |
| Total | 4000000 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Lobbying Ceiling | $6,000,000 | LobbyingCeilingAmount |
Total Lobbying Expenditures2 TotalLobbyingExpenditures2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | 21646 | CurrentYearMinus3 |
| Current Year Minus2 | 31169 | CurrentYearMinus2 |
| Current Year Minus1 | 27379 | CurrentYearMinus1 |
| Current Year | 32330 | CurrentYear |
| Total | 112524 | Total |
Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | 250000 | CurrentYearMinus3 |
| Current Year Minus2 | 250000 | CurrentYearMinus2 |
| Current Year Minus1 | 250000 | CurrentYearMinus1 |
| Current Year | 250000 | CurrentYear |
| Total | 1000000 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grassroots Ceiling | $1,500,000 | GrassrootsCeilingAmount |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12095548 | OtherCostOrOtherBasis |
| Depreciation | 1488806 | Depreciation |
| Book Value | 10606742 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 10606742 | TotalOfBookValueLandBuildings |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | THE SYSTEM AND AFFILIATES ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. AT JUNE 30, 2012, MANAGEMENT DOES NOT BELIEVE THE SYSTEM HOLDS ANY UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE UNDER ASC 740. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LARRY S SANDERS | |||||||||||||
| 0 | 428600 | 0 | 80831 | 0 | 2546391 | 0 | 65671 | 0 | 11670 | 0 | 3133163 | 0 | 0 |
| LANCE B DUKE | |||||||||||||
| 0 | 386915 | 0 | 45000 | 0 | 243680 | 0 | 124475 | 0 | 12041 | 0 | 812111 | 0 | 0 |
| ROLAND L THACKER | |||||||||||||
| 0 | 305438 | 0 | 38750 | 0 | 83799 | 0 | 86775 | 0 | 13861 | 0 | 528623 | 0 | 0 |
| DONALD ELDER | |||||||||||||
| 0 | 208211 | 0 | 26875 | 0 | 88592 | 0 | 133175 | 0 | 13763 | 0 | 470616 | 0 | 0 |
| CHRISTOPHER JOHNSON MD | |||||||||||||
| 370408 | 0 | 25000 | 0 | 29393 | 0 | 9423 | 0 | 16324 | 0 | 450548 | 0 | 0 | 0 |
| MICHAEL MENDES MD | |||||||||||||
| 671155 | 0 | 0 | 0 | 2322 | 0 | 9423 | 0 | 16837 | 0 | 699737 | 0 | 0 | 0 |
| THOMAS STEWART MD | |||||||||||||
| 401590 | 0 | 0 | 0 | 1490 | 0 | 15171 | 0 | 13770 | 0 | 432021 | 0 | 0 | 0 |
| LEILANI SHIVERS MD | |||||||||||||
| 237134 | 0 | 9250 | 0 | 491 | 0 | 13260 | 0 | 6450 | 0 | 266585 | 0 | 0 | 0 |
| NAJAN VALADI MD | |||||||||||||
| 249965 | 0 | 19676 | 0 | 407 | 0 | 10132 | 0 | 14699 | 0 | 294879 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 4B | ReturnReference |
| Explanation | EMPLOYER CONTRIBUTION TO 457(F) EXECUTIVE RETIREMENT BENEFIT PLAN: LANCE B. DUKE $ 92,400 DONALD ELDER $ 50,000 ROLAND THACKER $ 57,400 PART I, LINE 4B: PAYOUT FROM 457(F) EXECUTIVE RETIREMENT BENEFIT PLAN (INCLUDED IN REPORTABLE COMPENSATION). LARRY SANDERS $2,309,841 LANCE B. DUKE $ 142,742 DONALD ELDER $ 81,980 ROLAND THACKER $ 70,728 DURING 2012, ALL PREVIOUSLY ACCRUED OBLIGATIONS UNDER THE SERP WERE PAID TO THE RESPECTIVE MEMBERS OF MANAGEMENT AND A NEW SERP THAT IS CONSISTENT IN STRUCTURE WAS IMPLEMENTED. DURING THE FISCAL YEAR, MR. SANDERS RETIRED FROM COLUMBUS REGIONAL HEALTHCARE SYSTEMS AFTER SERVING AS ITS CHAIRMAN AND CEO FOR 30 YEARS. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE BOARD OF DIRECTORS OF COLUMBUS AMBULATORY HEALTHCARE SERVICES. IS APPOINTED BY THE BOARD OF COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. - A RELATED 501(C)(3) ORGANIZATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS OF COLUMBUS AMBULATORY HEALTHCARE SERVICES. IS APPOINTED BY THE BOARD OF COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. - A RELATED 501(C)(3) ORGANIZATION. | |
| FORM 990, PART VI, SECTION A, LINE 7B | THE BOARD OF DIRECTORS OF COLUMBUS AMBULATORY HEALTHCARE SERVICES. IS APPOINTED BY THE BOARD OF COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. - A RELATED 501(C)(3) ORGANIZATION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | INFORMATION FOR FORM 990 WAS PROVIDED TO AN INDEPENDENT CPA FIRM FOR PREPARATION OF RETURN. AFTER RETURN WAS PREPARED IT WAS REVIEWED BY THE TREASURER OF THE ORGANIZATION. CURRENTLY, A COPY OF THE FORM 990 IS NOT PROVIDED TO THE GOVERNING BODY PRIOR TO FILING. THE BOARD IS PROVIDED A CONDENSED AND THOROUGH OVERVIEW OF INFORMATION ON THE FORM 990 BY THE TREASURER OF THE ORGANIZATION. PRESENTATION OF THIS INFORMATION TO THE BOARD WILL BE MADE AS CLOSE TO THE FILING DATE AS POSSIBLE, BUT MAY NOT BE PRIOR TO THE FILING DATE. | |
| FORM 990, PART VI, SECTION B, LINE 12C | IT IS THE POLICY OF COLUMBUS REGIONAL THAT EMPLOYEES AND AGENTS CANNOT PARTICIPATE IN ANY ACTIVITIES THAT CONFLICT WITH, OR APPEAR TO CONFLICT WITH, THEIR PROFESSIONAL RESPONSIBILITIES TO THE ORGANIZATION. IT IS THE POLICY OF COLUMBUS REGIONAL TO PROVIDE MECHANISMS BY WHICH EMPLOYEES, MEDICAL STAFF,AND OTHER ASSOCIATES OF THE ORGANIZATION MAY REPORT SUSPECTED VIOLATIONS OF GOVERNMENT LAWS OR CORPORATE POLICIES WITHOUT FEAR OF RETALIATION OR TERMINATION OF EMPLOYMENT. EMPLOYEES AND AGENTS HAVE A RESPONSIBILITY TO REPORT SUSPECTED VIOLATIONS, PROVIDED THEY ARE REPORTING IN GOOD FAITH AND HAVE EVIDENCE TO SUPPORT THEIR SUSPICION. COLUMBUS REGIONAL ENCOURAGES THE DEVELOPMENT OF AN "OPEN DOOR" POLICY BY MANAGERS TO WELCOME COMMENTS, CONCERNS AND QUESTIONS FROM THEIR EMPLOYEES AND AGENTS. SUSPECTED CONFLICT OF INTEREST VIOLATIONS MAY BE REPORTED TO MANAGERS OR SUPERVISORS. VIOLATIONS MAY ALSO BE REPORTED TO THE CORPORATE COMPLIANCE OFFICER (BY PHONE, E-MAIL OR IN PERSON), BY COMPLETING A FORM, OR BY CONTACTING THE COMPLIANCE HELPLINE. IF AN INDIVIDUAL IS HESITANT ABOUT USING ANY OF THESE REPORTING MECHANISMS, HE/SHE MAY CONTACT COLUMBUS REGIONAL'S PRESIDENT AND CHIEF EXECUTIVE OFFICER. ALL REPORTS OF SUSPECTED VIOLATIONS ARE INVESTIGATED IN A PROMPT AND REASONABLE MANNER BY THE CORPORATE COMPLIANCE OFFICER OR, AS APPROPRIATE, BY A MEMBER OF THE CORPORATE COMPLIANCE COMMITTEE. AN INHERENT AND IMPORTANT PART OF COLUMBUS REGIONAL'S CORPORATE COMPLIANCE PROGRAM INVOLVES MEASURING THE EFFECTIVENESS OF THE PROGRAM IN ADHERING TO SPECIFIC GOVERNMENTAL REGULATIONS, CORPORATE POLICIES AND BUSINESS ETHICAL STANDARDS. AT THE DESIGNATION OF MANAGEMENT, COMPLIANCE ACTIVITIES ARE REVIEWED. THE CORPORATE COMPLIANCE OFFICER ENSURES THAT THE RESULTS OF COMPLIANCE-RELATED AUDITS, HELPLINE ACTIVITY, EMPLOYEE COMPLIANCE ACTIVITIES AND OTHER COMPLIANCE ISSUES DEEMED RELEVANT ARE REPORTED ON A PERIODIC BASIS TO COLUMBUS REGIONAL'S CEO AND FINANCE AND PLANNING COMMITTEE AS DESIGNATED. | |
| FORM 990, PART VI, SECTION B, LINE 15 | COLUMBUS REGIONAL TAKES VERY SERIOUSLY THE RESPONSIBILITY TO APPROPRIATELY AND EFFECTIVELY MANAGE THE EXECUTIVE COMPENSATION AND BENEFITS PROGRAM FOR ITS KEY EXECUTIVES. SETTING THE COMPENSATION OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, APPROVING THE COMPENSATION OF OTHER SENIOR EXECUTIVES, AND OVERSEEING THE EXECUTIVE COMPENSATION PROGRAM AS A WHOLE, ARE THE RESPONSIBILITIES OF THE COMPENSATION COMMITTEE OF THE BOARD. COLUMBUS REGIONAL HAS HAD A COMPENSATION COMMITTEE FOR MANY YEARS. THE COMMITTEE IS CURRENTLY CHAIRED BY A 20+ YEAR BOARD MEMBER. TO ASSIST THE COMMITTEE, THE BOARD HAS ENGAGED THE SERVICES OF A NATIONALLY RECOGNIZED EXECUTIVE COMPENSATION CONSULTING FIRM. COLUMBUS REGIONAL'S EXECUTIVE COMPENSATION PROGRAM IS DESIGNED TO ATTRACT AND RETAIN HIGHLY QUALIFIED EXECUTIVES TO FULFILL COLUMBUS REGIONAL'S MISSION OF PROMOTING THE HEALTH AND HEALING OF PATIENTS. COLUMBUS REGIONAL'S PEER GROUP CONSISTS OF NON-PROFIT HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE AND COMPLEXITY FROM ACROSS THE NATION. BASE SALARIES OF EXECUTIVES ARE POSITIONED AT SPECIFIC PERCENTILE TARGETS OF COLUMBUS REGIONAL'S PEER GROUP. CURRENT STUDIES INDICATE THAT OUR BASE SALARIES ARE AT TARGETED LEVELS. COLUMBUS REGIONAL STRIVES TO PROVIDE ALL EXECUTIVES WITH RETIREMENT BENEFITS THAT ARE EQUIVALENT FOR ALL EMPLOYEES. RETIREMENT CONTRIBUTIONS ARE BASED ON A CLEARLY STATED INCOME REPLACEMENT TARGET AS DETERMINED BY RETIREMENT PLAN CONSULTANTS. THE GOAL OF COLUMBUS REGIONAL IS TO PROVIDE MARKET COMPETITIVE COMPENSATION AND BENEFITS PROGRAMS FOR ALL EMPLOYEES AT ALL LEVELS OF THE ORGANIZATION. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE CONFLICT OF INTEREST POLICY, IN ADDITION TO OTHER CORPORATE AND GOVERNING POLICIES, IS NOT MADE AVAILABLE TO THE PUBLIC. | |
| FORM 990, PART XI, LINE 5: | TRANSFER TO AFFILIATES 6,784,857. TOTAL TO FORM 990, PART XI, LINE 5: 6,784,857. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|
| REGIONAL ORTHOPEDICS LLC | |||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 582578658 | PHYSICIANS | GA | 0 | 0 | N/A |
| REGIONAL PHYSICIANS GROUP LLC | |||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 582578657 | PHYSICIANS | GA | 0 | 0 | N/A |
| STADIUM DIAGNOSTIC CENTER LLC | |||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 020574744 | PHYSICIANS | GA | 0 | 0 | N/A |
| STADIUM ACUTE CARE CENTER LLC | |||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 020574738 | ACUTE CARE CENTER | GA | 0 | 0 | N/A |
| REGIONAL ONCOLOGY LLC | |||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 582578648 | ONCOLOGY BILLING | GA | 0 | 0 | N/A |
| REGIONAL ANESTHESIA ASSOCIATES LLC | |||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 582634874 | ANESTHESIA BILLING | GA | 0 | 0 | N/A |
| COLUMBUS RADIATION ONCOLOGY TREATMENT CENTER LLC | |||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 273019214 | ONCOLOGY | GA | 2796178 | 8241523 | N/A |
Form990 Schedule R Part II Form990ScheduleRPartII (9 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 | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| THE MEDICAL CENTER INC | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 581685139 | ACUTE CARE HOSPITAL | GA | 501(C)(3) | LINE 3 | COLUMBUS REGIONAL HEALTHCARE SYSTEM INC | 0 | |
| COLUMBUS REGIONAL MEDICAL FOUNDATION INC | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 581501642 | FUNDRAISING/INVESTMENT | GA | 501(C)(3) | LINE 7 | COLUMBUS REGIONAL HEALTHCARE SYSTEM INC | 0 | |
| CRHS LONG TERM AND HOME CARE INC | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 581778572 | SKILLED NURSING | GA | 501(C)(3) | LINE 3 | COLUMBUS REGIONAL HEALTHCARE SYSTEM INC | 0 | |
| COLUMBUS REGIONAL HEALTHCARE SYSTEM INC | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 581719994 | SYSTEM PARENT | GA | 501(C)(3) | LINE 11A, I | 0 | N/A | |
| COLUMBUS REGIONAL SENIOR LIVING INC | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 582628502 | RETIREMENT COMMUNITY | GA | 501(C)(3) | LINE 11A, I | COLUMBUS REGIONAL HEALTHCARE SYSTEM INC | 0 | |
| DOCTOR'S HOSPITAL INC | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 261739383 | ACUTE CARE HOSPITAL | GA | 501(C)(3) | LINE 3 | COLUMBUS REGIONAL HEALTHCARE SYSTEM INC | 0 | |
| HUGHSTON HOSPITAL INC | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 331216751 | ORTHOPEDIC HOSPITAL | GA | 501(C)(3) | LINE 3 | COLUMBUS REGIONAL HEALTHCARE SYSTEM INC | 0 | |
| MEDICAL CENTER AUXILIARY | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 580917974 | HOSPITAL AUXILIARY | GA | 501(C)(3) | LINE 11C, III-FI | THE MEDICAL CENTER INC | 0 | |
| DOCTOR'S HOSPITAL AUXILIARY | |||||||||||
| 616 19TH STREET | COLUMBUS | GA | 31901 | 581295777 | HOSPITAL AUXILIARY | GA | 501(C)(3) | LINE 11D, III-O | DOCTOR'S HOSPITAL INC | 0 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|
| EVERGREEN MEDICAL GROUP LLC | |||||||
| PO BOX 790 | COLUMBUS | GA | 31902 | 582244760 | MEDICAL SERVICES | GA | N/A |
| COLUMBUS DIAGNOSTIC IMAGING | |||||||
| 116 INTRACOASTAL POINTE DR 300 | JUPITER | FL | 33477 | 262291768 | DIAGNOSTIC IMAGING | FL | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| COLUMBUS HEALTHCARE RESOURCES INC | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 581717754 | PROPERTY MANAGEMENT | GA | N/A | C | |||
| COLUMBUS HEALTH SERVICES INC | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 581640939 | PHARMACIES | GA | N/A | C | 2566107 | 3019506 | 1.00000 |
| WOMEN'S MEDICAL SERVICES INC | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 581695456 | MANAGEMENT | GA | N/A | C | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBUS HEALTH SERVICES INC | BusinessNameLine1 |
Affiliated Group Schedule AffiliatedGroupSchedule
Affiliated Schedule AffiliatedSchedule (10 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Electing OrgElectingOrg | Total Grassroots LobbyingTotalGrassrootsLobbying | Total Direct LobbyingTotalDirectLobbying | Total Lobbying ExpendituresTotalLobbyingExpenditures | Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures | Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures | Lobbying NontaxableLobbyingNontaxableAmount | Grassroots NontaxableGrassrootsNontaxableAmount | Tot Lobbying Grassroot Minus NontxTotLobbyingGrassrootMinusNontx | Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx | Share Of Excess Lobbying ExpendtrsShareOfExcessLobbyingExpendtrs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COLUMBUS REGIONAL HEALTHCARE SYSTEM INC | |||||||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 581719994 | X | 0 | 32330 | 32330 | 29455872 | 29488202 | $1,000,000 | $250,000 | 0 | 0 | 0 |
| CRHS LONG TERM & HOME CARE INC | |||||||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 581778572 | 0 | 0 | 0 | 5557193 | 5557193 | $427,860 | $106,965 | 0 | 0 | 0 | |
| COLUMBUS AMBULATORY HEALTHCARE SERVICES | |||||||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 581719867 | 0 | 0 | 0 | 16328282 | 16328282 | $966,414 | $241,604 | 0 | 0 | 0 | |
| COLUMBUS REGIONAL SENIOR LIVING INC | |||||||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 582628502 | 0 | 0 | 0 | 5220436 | 5220436 | $411,022 | $102,756 | 0 | 0 | 0 | |
| MEDICAL CENTER AUXILIARY | |||||||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 580917974 | 0 | 0 | 0 | 691813 | 691813 | $128,772 | $32,193 | 0 | 0 | 0 | |
| DOCTOR'S HOSPITAL INC | |||||||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 261739383 | 0 | 0 | 0 | 75751307 | 75751307 | $1,000,000 | $250,000 | 0 | 0 | 0 | |
| HUGHSTON HOSPITAL INC | |||||||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 331216751 | 0 | 0 | 0 | 60517098 | 60517098 | $1,000,000 | $250,000 | 0 | 0 | 0 | |
| THE MEDICAL CENTER INC | |||||||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 581685139 | 0 | 0 | 0 | 334968921 | 334968921 | $1,000,000 | $250,000 | 0 | 0 | 0 | |
| COLUMBUS REGIONAL MEDICAL FOUNDATION INC | |||||||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 581501642 | 0 | 0 | 0 | 3043392 | 3043392 | $302,170 | $75,543 | 0 | 0 | 0 | |
| DOCTOR'S HOSPITAL AUXILIARY | |||||||||||||||
| 616 19TH STREET | COLUMBUS | GA | 31901 | 581295777 | 0 | 0 | 0 | 65879 | 65879 | $13,176 | $3,294 | 0 | 0 | 0 | |