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COLUMBUS COMMUNITY HOSPITAL INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
COLUMBUS COMMUNITY HOSPITAL INC (EIN 47-0542043)
Tax period
2012-05-01 to 2013-04-30
Filed
2013-12-10
IRS object ID
201343449349300209
Schema version
2012v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-12-10T10:00:44-06:00Timestamp
Tax Period End Date2013-04-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11212 North 96th Street Suite 300AddressLine1
CityOmahaCity
StateNEState
ZIP Code68114ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-05-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN470542043EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COLUMBUS COMMUNITY HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% MIKE ADAMYInCareOfName
Name ControlCOLUNameControl
Phone4025623357Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1800AddressLine1
Address Line2SuiteAddressLine2
CityCOLUMBUSCity
StateNEState
ZIP Code68602ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHAEL T HANSENName
TitleCHIEF EXECUTIVE OFFICERTitle
Phone4025623357Phone
Date Signed2013-12-09DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameAdam C StarkName
Phone4023481450Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJ Joseph BarbagliaNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line14600 38th StreetAddressLine1
CityColumbusCity
StateNEState
ZIP Code68601ZIPCode
FieldValueIRS element (for citing)
Gross Receipts73984956GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.columbushosp.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1972YearFormation
State Legal DomicileNEStateLegalDomicile
Activity Or Mission DescriptionOUR MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees649TotalNbrEmployees
Total Nbr Volunteers333TotalNbrVolunteers
Total Gross UBI17330TotalGrossUBI
Net Unrelated Business Txbl Income-39795NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year303177ContributionsGrantsPriorYear
Contributions Grants Current Year117549ContributionsGrantsCurrentYear
Program Service Revenue Prior Year68343052ProgramServiceRevenuePriorYear
Program Service Revenue CY72520573ProgramServiceRevenueCY
Investment Income Prior Year1233315InvestmentIncomePriorYear
Investment Income Current Year321804InvestmentIncomeCurrentYear
Other Revenue Prior Year664081OtherRevenuePriorYear
Other Revenue Current Year1025030OtherRevenueCurrentYear
Total Revenue Prior Year70543625TotalRevenuePriorYear
Total Revenue Current Year73984956TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1334804GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1469342GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year30379279SalariesEtcPriorYear
Salaries Etc Current Year33905776SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year27885114OtherExpensePriorYear
Other Expenses Current Year29781927OtherExpensesCurrentYear
Total Expenses Prior Year59599197TotalExpensesPriorYear
Total Expenses Current Year65157045TotalExpensesCurrentYear
Revenues Less Expenses Prior Year10944428RevenuesLessExpensesPriorYear
Revenues Less Expenses CY8827911RevenuesLessExpensesCY
Total Assets BOY100607338TotalAssetsBOY
Total Assets EOY97892656TotalAssetsEOY
Total Liabilities BOY18331472TotalLiabilitiesBOY
Total Liabilities EOY6956170TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY82275866NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY90936486NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionOUR MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense61819521Expense
Grants60383Grants
Revenue73265127Revenue
DescriptionGeneral 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. We launched our certified STAR Program at Columbus Community Hospital in November of 2012. We are one of only three hospitals in Nebraska to have achieved the STAR Program certification for cancer rehabilitation. STAR stands for Survivorship Training and Rehab. We have had at least 39 formal STAR Program referrals resulting in consultations for potential rehabilitation needs. Many of our STAR Program participants have needed physical therapy, speech therapy or occupational therapy and some have needed nutritional consults as well as psychosocial referrals. Some patients who have participated have had pulmonary concerns and cardiovascular factors. There also have been some STAR Program graduates that have transitioned to medical wellness here at CCH. STAR Program co-coordinators are Jill Jakub MOTR/L, CLT, and Michell Ruskamp MS, CCC-SLP. They are joined by 23 other clinicians including physicians, nurses, respiratory therapists, dieticians, social workers, and therapists who are STAR Program certified at CCH. The STAR Program Cancer Rehab Certification at CCH is funded by the Columbus Community Hospital Foundation. Our Certified Provider Team for the STAR Program is made up of 3 physicians, 6 physical therapists, 4 occupational therapists, 2 speech therapists, 4 nurses, 1 respiratory therapist, 3 social workers and 2 nutritionists. CCH HAS 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 assiStance from this regions medicare providers. CCH feels we are well prepared to handle a natural disaster or pandemic should oneDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense1403561Expense
Grants1403561Grants
DescriptionCharity 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. Reduce to $1,200, adjustments will be done from oldest to newest.Description
FieldValueIRS element (for citing)
Total Program Service Expense63223082TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgtrueTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109644NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees649NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMIKE ADAMYNamePerson
Telephone Number4025623382TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14600 38TH STREETAddressLine1
CityCOLUMBUSCity
StateNEState
ZIP Code68601ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
JAMES PILLEN DVM
CHAIR1.00.0XX000
ANTHONY RAIMONDO JR
TREASURER1.00.0XX000
JEFFREY GOTSCHALL MD
VICE CHAIR1.00.0XX000
RONALD ERNST MD
DIRECTOR1.00.0X000
JOHN C MCCLURE
DIRECTOR1.00.0X000
REBECCA RAYmond
DIRECTOR1.00.0X000
BONNIE MCPHILLIPS
DIRECTOR1.00.0X000
BRIAN SCHMIDT
DIRECTOR1.00.0X000
CLARK LEHR
DIRECTOR1.00.0X000
BETH PRZYMUS
DIRECTOR1.00.0X000
MARK HOWERTER MD
DIRECTOR/PHYSICIAN40.00.0X430238017254
MICHAEL HANSEN
PRESIDENT/CEO/SECRETARY39.01.0X285748015096
AMY BLASER
VP BUSINESS DEVELOPMENT40.00.0X117753012122
J JOSEPH BARBAGLIA
VP FINANCE40.00.0X206436018584
LINDA WALLINE
VP NURSING40.00.0X177977016505
JAMES GOULET
VP OPERATIONS40.00.0X174841019653
ROBERT MILLER MD
PHYSICIAN40.00.0232484015626X
MICHAEL MCGUIRE MD
PHYSICIAN40.00.041735704997X
RICHARD CIMPL MD
PHYSICIAN40.00.038284306885X
EDWARD FEHRINGER MD
PHYSICIAN40.00.034019205108X
ALEX KAZOS MD
PHYSICIAN40.00.0229409010082X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2995278TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation141912TotalOtherCompensation
Number Individuals GT100 K26NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
INPATIENT PHYSICIAN ASSOC
3200 PINE LAKE RD STE ALINCOLNNE68516HOSPITALIST SVCS819497
FOCUSONE SOLUTIONS LLC
13609 California St 300OMAHANE68154STAFFING AGENCY201879
TSP CONSTRUCTION SERVICES INC
1112 N WEST AVESIOUX FALLSSD571041333CONSTRUCTION SVCS1743118
SUNQUEST INFORMATION SYSTEMS
250 South Williams BlvdTUCSONAZ85711IT SERVICES151341
MCKESSON TECHNOLOGIES INC
PO Box 98347CHICAGOIL60693IT Consulting1265326
FieldValueIRS element (for citing)
Number Of Contractors GT100 K9NumberOfContractorsGT100K
Related Organizations117549RelatedOrganizations
Total Contributions117549TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SVC REVENUE6211107231325472313254
MEANINGFUL USE PAYMENT900099207319207319
FieldValueIRS element (for citing)
Total Program Service Revenue72520573TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column318431TotalRevenueColumn
Exclusion$318,431ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other3373Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other3373Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column3373TotalRevenueColumn
Exclusion$3,373ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
MEALS ON WHEELS9000995002150021
CAFETERIA722100263146$263,146
OTHER REVENUE90009971186369453317330
FieldValueIRS element (for citing)
Total Other Revenue1025030TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column73984956TotalRevenueColumn
Related Or Exempt Function Income73265127RelatedOrExemptFunctionIncome
Unrelated Business Revenue17330UnrelatedBusinessRevenue
Exclusion$584,950ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total65781Total
Program Services65781ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total1403561Total
Program Services1403561ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total962755Total
Management And General962755ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total27012666Total
Program Services27012666ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total920503Total
Program Services920503ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3101733Total
Program Services3101733ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1908119Total
Program Services1908119ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total72106Total
Management And General72106ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total163123Total
Management And General163123ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total5786Total
Management And General5786ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2713479Total
Program Services2713479ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total188284Total
Management And General188284ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total9060357Total
Program Services8811024ProgramServices
Management And General249333ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1420413Total
Program Services1420413ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1151503Total
Program Services1151503ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total192992Total
Management And General192992ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total99584Total
Management And General99584ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total216286Total
Program Services216286ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5341079Total
Program Services5341079ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total259560Total
Program Services259560ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
PROVISION FOR BAD DEBTS39632813963281
MINOR EQUIP. & FINANCING AGRMT20272582027258
PURCHASED SERVICES12903641290364
RECRUITING282795282795

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1333677Total
Program Services1333677ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total65157045Total
Program Services63223082ProgramServices
Management And General1933963ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY5507494BOY
EOY1933467EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY8997202BOY
EOY9233671EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1454475BOY
EOY1077673EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1418337BOY
EOY1512950EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis86726440LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec49024725LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY37861816BOY
EOY37701715EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY45055102BOY
EOY46218318EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY312912BOY
EOY214862EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY100607338BOY
EOY97892656EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6699617BOY
EOY6956170EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY11631855BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY18331472BOY
EOY6956170EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY82275866BOY
EOY90936486EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY82275866BOY
EOY90936486EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY100607338BOY
EOY97892656EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses8827911ReconcilationRevenueExpenses
Reconcilation Other Changes-167291ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
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 Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$5,786OtherActivitiesAmount
Total Lobbying Expenditures IIB5786TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierOTHER ACTIVITIESIdentifier
Return ReferenceSCHEDULE C, PART II-B, LINE 1IReturnReference
ExplanationDUES PAID TO AMERICAN HOSPITAL ASSOCIATION ALLOCATED TO LOBBYING $3,126 DUES PAID TO NEBRASKA HOSPITAL ASSOCIATION ALLOCATED TO LOBBYING $2,660Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1667736BeginningOfYearBalance
Contributions74389Contributions
End Of Year Balance1742125EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1573063BeginningOfYearBalance
Contributions94673Contributions
End Of Year Balance1667736EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1506660BeginningOfYearBalance
Contributions66403Contributions
End Of Year Balance1573063EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1426826BeginningOfYearBalance
Contributions79844Contributions
Investment Earnings Or Losses-10InvestmentEarningsOrLosses
End Of Year Balance1506660EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1299402BeginningOfYearBalance
Contributions127424Contributions
End Of Year Balance1426826EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis639544OtherCostOrOtherBasis
Book Value639544BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis43742952OtherCostOrOtherBasis
Depreciation18261210Depreciation
Book Value25481742BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis37107980OtherCostOrOtherBasis
Depreciation29053953Depreciation
Book Value8054027BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5235964OtherCostOrOtherBasis
Depreciation1709562Depreciation
Book Value3526402BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings37701715TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability
Total Of Amounts0TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FIN 48 FOOTNOTESCHEDULE D, PART XThe 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 2013 and 2012, management determined that there are no income tax positions requiring recognition in the financial statements.
SCHEDULE DPART V, LINE 4ENDOWMENT 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

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served693PersonsServed
Total Community Benefit Expense745712TotalCommunityBenefitExpense
Net Community Benefit Expense745712NetCommunityBenefitExpense
Percent Of Total Expense0.01220PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense4065048TotalCommunityBenefitExpense
Direct Offsetting Revenue1387451DirectOffsettingRevenue
Net Community Benefit Expense2677597NetCommunityBenefitExpense
Percent Of Total Expense0.04380PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served693PersonsServed
Total Community Benefit Expense4810760TotalCommunityBenefitExpense
Direct Offsetting Revenue1387451DirectOffsettingRevenue
Net Community Benefit Expense3423309NetCommunityBenefitExpense
Percent Of Total Expense0.05600PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Persons Served63565PersonsServed
Total Community Benefit Expense492166TotalCommunityBenefitExpense
Direct Offsetting Revenue1955DirectOffsettingRevenue
Net Community Benefit Expense490211NetCommunityBenefitExpense
Percent Of Total Expense0.00800PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Persons Served811PersonsServed
Total Community Benefit Expense1218981TotalCommunityBenefitExpense
Direct Offsetting Revenue17111DirectOffsettingRevenue
Net Community Benefit Expense1201870NetCommunityBenefitExpense
Percent Of Total Expense0.01960PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense1612TotalCommunityBenefitExpense
Net Community Benefit Expense1612NetCommunityBenefitExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Persons Served601PersonsServed
Total Community Benefit Expense11649TotalCommunityBenefitExpense
Net Community Benefit Expense11649NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Persons Served64977PersonsServed
Total Community Benefit Expense1724408TotalCommunityBenefitExpense
Direct Offsetting Revenue19066DirectOffsettingRevenue
Net Community Benefit Expense1705342NetCommunityBenefitExpense
Percent Of Total Expense0.02780PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Persons Served65670PersonsServed
Total Community Benefit Expense6535168TotalCommunityBenefitExpense
Direct Offsetting Revenue1406517DirectOffsettingRevenue
Net Community Benefit Expense5128651NetCommunityBenefitExpense
Percent Of Total Expense0.08380PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense1250TotalCommunityBuildingExpense
Net Community Building Expense1250NetCommunityBuildingExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served650PersonsServed
Total Community Building Expense2295TotalCommunityBuildingExpense
Net Community Building Expense2295NetCommunityBuildingExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense2624TotalCommunityBuildingExpense
Net Community Building Expense2624NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served3935PersonsServed
Total Community Building Expense51909TotalCommunityBuildingExpense
Direct Offsetting Revenue6700DirectOffsettingRevenue
Net Community Building Expense45209NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served799PersonsServed
Total Community Building Expense9157TotalCommunityBuildingExpense
Direct Offsetting Revenue600DirectOffsettingRevenue
Net Community Building Expense8557NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Persons Served5384PersonsServed
Total Community Building Expense67235TotalCommunityBuildingExpense
Direct Offsetting Revenue7300DirectOffsettingRevenue
Net Community Building Expense59935NetCommunityBuildingExpense
Percent Of Total Expense0.00080PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$3,963,281BadDebtExpenseAmount
Amount Reimbursed By Medicare21114039AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare22457569CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1343530MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
HEALTHPARK LLC
PROPERTY MANAGEMENT0.71000
ZARZ LLC
PROPERTY MANAGEMENT0.50000
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Columbus Community Hospital INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line14600 38th StreetAddressLine1
CityColumbusCity
StateNEState
ZIP Code686011800ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours
Other47 Bed acute care Hospital w/ 24 HR ER ServicesOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1COLUMBUS COMMUNITY HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiestrueOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Other MethodXOtherMethod
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs AddressedfalseAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent100FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent200.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Medicaid MedicareXMedicaidMedicare
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Average Negotiated RatesXAverageNegotiatedRates
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities9NumberOfOtherFacilities

Other Facilities OtherFacilities (9 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
PREMIER PHYSICAL THERAPY OF CCH
US 30 CTR BLDG 3100-23RD st ste 15COLUMBUSNE686013161PHYSICAL & AQUATIC THERAPY, SPORTS TRAINING SERVICES
WIGGLES & GIGGLES THERAPY FOR KIDS
2108-13TH STREETCOLUMBUSNE686015100PEDIATRIC THERAPY SERVICES
OCCUPATIONAL HEALTH SERVICES OF CCH
3005-19TH ST SUITE 300COLUMBUSNE686014252EMP. HEALTH CARE SVCS TO PREVENT & TREAT WORK INJURIES
WOUND HEALING CENTER
4600-38TH STREET SUITE 165COLUMBUSNE68601WOUND TREATMENT CENTER
HUMPHREY CLINIC OF CCH
3003 MAIN STREETHUMPHREYNE686423155CLINIC IN SMALL TOWN TO OFFER MEDICAL SVCS TO RESIDENTS
HOSPICE OF COLUMBUS COMMUNITY HOSPITAL
3005-19TH STREET SUITE 600COLUMBUSNE686014248HOSPICE SERVICES
COLUMBUS COMMUNITY HOSPITAL SLEEP LAB
3020-19TH STREET SUITE 100COLUMBUSNE686014252POLYSOMNOGRAPHIC SLEEP TESTING
HOME HEALTH OF COLUMBUS COMMUNITY HOSP
3005-19TH STREET SUITE 600COLUMBUSNE686014248HOME HEALTH SERVICES
COLUMBUS ORTHOPEDIC & SPORTS MED CLINIC
4508 38TH STREET STE 133COLUMBUSNE686011668FREE STANDING CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
PART I, LINE 3CN/A
PART I, LINE 6AA 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 7To 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 reported on Line 7 of the table. The denominator used to calculate column (F) is the total operating expenses in Part IX, less the bad debt amount of $3,963,281 to arrive to the denomination of $61,193,764.
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. WE PROVIDE FREE FLU SHOTS TO RESIDENTS OF HARBOR OF HOPE, A HOMELESS SHELTER. -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 4Financial statements do not include any text for bad debt. The amount in Line 2 is the book bad debt amount. Charity care is kept separate from bad debt.
PART III, LINE 8In 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 9BCHARITY (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. Reduce to $1,200, 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' Part V, Section B, Line 3 Mobilizing for Action through Planning and Partnership (MAPP) process was developed by and is recommended for community assessment by the National Association of City and County Health Officials (NACCHO) and Center for Disease Control (CDC). MAPP was also a recommended community assessment by the Nebraska Rural Health Association in its "Community Health Assessment Collaborative Preliminary recommendations for Nebraska's community, nonprofit hospitals to comply with new requirements for tax exempt status enacted by the Patient Protection and Affordable Care Act" (September of 2011). MAPP was chosen in part because the process allows for input from parties who represent broad interests in the communities. Input from diverse sectors including medically underserved, low-income, minority populations and individuals from diverse age groups was obtained through surveys, targeted focus groups, open public meetings and target invitations to community leaders and agencies. The current MAPP assessment that CCH is involved with is the most thorough assessment to date with the most participation having over 100 individuals participate in the process to date from the district, this does not count the 1,000 individuals surveyed or the participants in focus groups. Part V, Section B, Line 4 -Alegent Health Memorial Hospital, Schuyler -Genoa Community Hospital -Boone County Health Center Part V, Section B, Line 5c THE DETAILED ASSESSMENT AND RELATED COMPONENTS ARE AVAILABLE VIA LINK ON http://www.columbushosp.org/news_events/community_health_needs_assessment_ chna.aspx; AVAILABLE ON REQUEST AND AVAILABLE FOR REVIEW AT Columbus Community Hospital. THE IMPLEMENTATION STRATEGY IS AVAILABLE VIA LINK ON http://www.columbushosp.org/news_events/chip_implementation_plan.aspx. Part V, Section B, Line 7 IDENTIFY THE PRIORITIES FOR AREAS THAT WE ARE NOT DIRECTLY ADDRESSING BUT THAT WE WILL MAINTAIN ACTIVE PARTNERSHIPS WITH AND REMAIN SUPPORTIVE OF THE LEAD ORGANIZATIONS FOCUSED ON THESE PRIORITIES.
NEEDS ASSESSMENTIn 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 AN 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 ASSISTANCEHere 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 INFORMATIONThe 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 PLASTICS, MEDICAL EQUIPMENT, ETHANOL AND THE LOCAL BEEF PACKING PLANT. COLUMBUS COMMUNITY HOSPITAL IS LOCATED IN 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; PILLEN FAMILY FARMS; VISHAY; BD MEDICAL PLANTS, 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 45,403 VISITS FOR THE FISCAL YEAR ENDING APRIL, 2013. THIS REPRESENTS A 0.6% 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 19% INCREASE IN OUR OUTPATIENT VISITS OVER THE PAST SIX 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 1,141 PATIENTS/VISITS AS OF APRIL 30, 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. OUR NURSES ARE WCOM CERTIFIED, SO IN ADDITION TO WOUND CARE OUR PATIENTS WHO HAVE CHALLENGES WITH OSTOMY APPLIANCES AND SKIN CARE ARE TREATED. CCH INSTALLED 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. WE REDUCED OUR MAMMOGRAPHY PROCEDURE PRICING 21% ON 2/8/12 AND SOUGHT AND RECEIVED A SUSAN G. KOMEN GRANT, WHICH THE HOSPITAL FOUNDATION MATCHED, TO PROMOTE MAMMOGRAPHY SCREENING FOR WOMEN IN THE COMMUNITY. 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 PROVIDES POLYSOMNOGRAPHIC SLEEP TESTING. IN ADDITION, WE ARE EXPLORING THE POSSIBILITY OF 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, 59 PHYSICIANS IN TOTAL HAVE BEEN RECRUITED TO SERVE THE NEEDS OF OUR PRIMARY AND SECONDARY SERVICE AREAS TO INCLUDE 54 MD'S AND 5 MIDLEVELS; 39 ARE FULL TIME PROVIDERS AND THE OTHER 28 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 SYSTEMN/A
STATE FILING OF COMMUNITY BENEFIT REPORTNONE
PART V, LINE 14GINFORMATION 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

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
COLUMBUS COMMUNITY HOSPITAL FOUNDATION
4600 38TH STREETCOLUMBUSNE68601470836747501(C)(3)60383TO SUPPORT EXEMPT
American Heart Association Inc
7272 Greenville AveDallasTX75231135613797501(c)(3)5398To support exempt
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantCHARITY CARE TO PATIENTSTypeOfGrant
Number Of Recipients693NumberOfRecipients
Amount Of Non Cash Assistance1403561AmountOfNonCashAssistance
Method Of ValuationBOOKMethodOfValuation
Description Of Non Cash AssistanceWRITE-OFF OF MED EXPDescriptionOfNonCashAssistance

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierGENERAL INFORMATION ON GRANTS AND ASSISTANCEIdentifier
Return ReferenceSchedule I, Part I, Line 2ReturnReference
ExplanationCOLUMBUS 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

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MARK HOWERTER MD
DIRECTOR/PHYSICIAN43023800000100000125230452761000
MICHAEL HANSEN
PRESIDENT/CEO/SECRETARY26874800017000010000096610305409000
J JOSEPH BARBAGLIA
VP FINANCE18944000016996087300129360228102000
LINDA WALLINE
VP NURSING16172700016250066510124760197104000
JAMES GOULET
VP OPERATIONS15675100018090073990151130197353000
ROBERT MILLER MD
PHYSICIAN2324840000093740102260252084000
MICHAEL MCGUIRE MD
PHYSICIAN417357000000089830426340000
RICHARD CIMPL MD
PHYSICIAN3828430000000108710393714000
EDWARD FEHRINGER MD
PHYSICIAN3274520001274000083540348546000
ALEX KAZOS MD
PHYSICIAN229409000005130089260243465000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierQUESTIONS REGARDING COMPENSATIONIdentifier
Return ReferencePART I, LINE 1AReturnReference
ExplanationTHE 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 O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
GOVERNANCE, MANAGEMENT AND DISCLOSUREFORM 990, PART VI, LINE 15The 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 DISCLOSUREForm 990, Part VI, Line 19At 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 DISCLOSUREForm 990, Part VI, Line 12CColumbus 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.
GOVERNANCE, MANAGEMENT AND DISCLOSUREPART VI, LINE 11BThe 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.
RECONCILIATION OF NET ASSETSPART XI, LINE 9CHANGE IN INTEREST IN HEALTHPARK LLC & ZARZ LLC (167,291)

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
COLUMBUS COMMUNITY HOSPITAL FOUNDATION
4600 38TH STREETCOLUMBUSNE68601470836747FUNDRAISINGNE501(c)(3)LINE 11, ICCHtrue
HEALTHPARK TITLE CO
4600 38TH STREETCOLUMBUSNE68601470830945HOLDING CO.NE501(c)(3)N/ACCHtrue

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
ZARZ LLC
PO BOX 1800COLUMBUSNE68602273676428PROPERTY MGMTNEHLTHPK TITLE COrelated00false$0false0.50000
HEALTHPARK LLC
PO BOX 1800COLUMBUSNE68602470836733PROPERTY MGMTNEHLTHPK TITLE COrelated00false$0false0.29000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
COLUMBUS COMMUNITY HOSPITAL FOUNDATION
b60383Cash
COLUMBUS COMMUNITY HOSPITAL FOUNDATION
c117549cash
COLUMBUS COMMUNITY HOSPITAL FOUNDATION
e10387717BOOK
COLUMBUS COMMUNITY HOSPITAL FOUNDATION
m155955book
HEALTHPARK TITLE COMPANY
k285372BOOK

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierPart V, Line 2 (3)Identifier
ExplanationCOLUMBUS 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. The bonds were paid off In January, 2013.Explanation