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COLUMBUS COMMUNITY HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
COLUMBUS COMMUNITY HOSPITAL (EIN 74-1394418)
Tax period
2010-05-01 to 2011-04-30
Filed
2012-03-15
IRS object ID
201240759349301229
Schema version
2010v3.4
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)
Timestamp2012-03-15T15:53:17-05:00Timestamp
Tax Period End Date2011-04-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DURBIN & COMPANY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12950 50TH STREETAddressLine1
CityLUBBOCKCity
StateTXState
ZIP Code79413ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-05-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN741394418EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COLUMBUS COMMUNITY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOLUNameControl
Phone9797322371Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 865AddressLine1
CityCOLUMBUSCity
StateTXState
ZIP Code78934ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROB THOMAS CPAName
TitleCEO/ ADMINISTRATORTitle
Phone9797322371Phone
Date Signed2012-03-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone8067911591Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonROB THOMASNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 865AddressLine1
CityCOLUMBUSCity
StateTXState
ZIP Code78934ZIPCode
FieldValueIRS element (for citing)
Gross Receipts41861520GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.COLUMBUSCH.COMWebSite
Type Of Organization OtherXTypeOfOrganizationOther
Year Formation1950YearFormation
State Legal DomicileTXStateLegalDomicile
Activity Or Mission DescriptionIT IS OUR GOAL TO PROVIDE ACCESSIBLE, QUALITY, COST-EFFECTIVE HEALTHCARE TO OUR COMMUNITY. WE ARE RESOLVED TO FOSTER A SAFE AND POSITIVE ENVIROMENT OF ENCOURAGEMENT, GROWTH, CHALLENGE AND CONTINUOUS IMPROVEMENT.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees230TotalNbrEmployees
Total Nbr Volunteers50TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year330550ContributionsGrantsPriorYear
Contributions Grants Current Year392196ContributionsGrantsCurrentYear
Program Service Revenue Prior Year39141622ProgramServiceRevenuePriorYear
Program Service Revenue CY41217949ProgramServiceRevenueCY
Investment Income Prior Year122983InvestmentIncomePriorYear
Investment Income Current Year105229InvestmentIncomeCurrentYear
Other Revenue Prior Year195258OtherRevenuePriorYear
Other Revenue Current Year146146OtherRevenueCurrentYear
Total Revenue Prior Year39790413TotalRevenuePriorYear
Total Revenue Current Year41861520TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year8432468SalariesEtcPriorYear
Salaries Etc Current Year9073176SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year30701280OtherExpensePriorYear
Other Expenses Current Year31635445OtherExpensesCurrentYear
Total Expenses Prior Year39133748TotalExpensesPriorYear
Total Expenses Current Year40708621TotalExpensesCurrentYear
Revenues Less Expenses Prior Year656665RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1152899RevenuesLessExpensesCY
Total Assets BOY19224070TotalAssetsBOY
Total Assets EOY41085970TotalAssetsEOY
Total Liabilities BOY4957847TotalLiabilitiesBOY
Total Liabilities EOY4611403TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY14266223NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY36474567NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO FOSTER A WELLNESS STATE FOR OUR COMMUNITY THROUGH EDUCATION, SUPPORT AND COOPERATION WITH OTHER HEALTH CARE ORGANIZATIONS.TO EMPOWER OUR STAFF TO BE PART OF A COHESIVE PROFESSIONAL DEDICATED INTERDISCIPLINARY TEAM.TO ASSESS THE NEEDS OF OUR COMMUNITY AND PROVIDE APPROPRIATE SERVICES FOR OUR CHANGING HEALTH CARE ENVIRONMENT.TO PROMOTE COLLABORATIVE RELATIONSHIPS WITH OTHER PROVIDERS TO FACILITATE A CONTINUUM OF CARE WITH SHARED SERVICES.TO ESTABLISH AND MAINTAIN AN ECONOMICALLY STABLE FACILITY THROUGH COMMUNITY SUPPORT AND FUNDING WHILE MEETING OUR CHARITABLE GOALS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense39034606Expense
Revenue41469324Revenue
DescriptionCOLUMBUS COMMUNITY HOSPITAL IS A 40 BED ACUTE CARE FACILITY OFFERING COMPREHENSIVE HEALTH CARE. THE HOSPITAL HAD 3,762 ACUTE DAYS WITH TOTAL NURSERY DAYS OF 347. THERE WERE 215 BIRTHS AT COLUMBUS HOSPITAL DURING THE FISCAL YEAR. THERE WERE 5,838 ER VISITS WITH 2,160 SUGERIES. LAB PROCEDURES AVERAGED 7,760 PER MONTH AND RADIOLOGY PROCEDURES AVERAGING 1,534.Description
Total Program Service Expense39034606TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109645NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding0ComplianceWithBackupWitholding
Number Of Employees230NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form8899 Filed0Form8899Filed
Form1098 C Filed0Form1098CFiled
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1COLUMBUS COMMUNITY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9797322371TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1110 SHULT DRIVEAddressLine1
CityCOLUMBUSCity
StateTXState
ZIP Code78934ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
PAT GILLESPIE
CHAIRMAN OF THE BOARD1.00X000
GEORGE FOX
VICE-CHAIRMAN OF THE BOARD1.00X000
TY PRAUSE
SECRETARY1.00X000
JIMMIE CARTER
OFFICER1.00X000
DWAIN DUNGEN
OFFICER1.00X000
JERRY HALUSKA
OFFICER1.00X000
RIANA JAMISON
OFFICER1.00X000
MODINA MANGINI
OFFICER1.00X000
TRAVIS WEGENHOFT
OFFICER1.00X000
ROBERT F THOMAS
CEO50.0013629205452X
REGINA WICKE
CFO50.008988603491X
JENO HARGROVE
DON50.0010397304036X
FieldValueIRS element (for citing)
Total Reportable Comp From Org330151TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation12979TotalOtherCompensation
Number Individuals GT100 K3NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SDS PHYSICAL THERAPY
PO BOX 335-MILAM STCOLUMBUSTX78934PHYSICAL THERAPY852980
NEXTGEN IP SOLUTIONS
PO BOX 511383LOS ANGELESCA90051COMPUTER SOFTWARE489523
TROY MILLICAN
1158 ABEL ROADNEW ULMTX78950PHYSICIAN397510
HEALTHCARE SERVICES GROUP INC
3220 TILLMAN DR STE 300BENALEMPA19020HOUSEKEEPING/DIETARY322550
COLUMBUS EYE ASSOC
100 SWEETBRIAR LANECOLUMBUSTX78934PHYSICIAN305689
FieldValueIRS element (for citing)
Number Of Contractors GT100 K17NumberOfContractorsGT100K
All Other Contributions392196AllOtherContributions
Total Contributions392196TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionMEDICAL SERVICESDescription
Business Code621990BusinessCode
Total Revenue Column41217949TotalRevenueColumn
Related Or Exempt Function Income41217949RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue41217949TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column105229TotalRevenueColumn
Related Or Exempt Function Income105229RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA INCOME6219909066790667
CLINIC RENT6219904173541735

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column13744TotalRevenueColumn
Related Or Exempt Function Income13744RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue146146TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column41861520TotalRevenueColumn
Related Or Exempt Function Income41469324RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total330151Total
Program Services103973ProgramServices
Management And General226178ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6888281Total
Program Services6476276ProgramServices
Management And General412005ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1854744Total
Program Services1623232ProgramServices
Management And General231512ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total176886Total
Program Services176886ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total814217Total
Program Services814217ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
CONTRACTUAL ALLOWANCES1637151816371518
SUPPLIES AND OTHER106731589868838804320
BAD DEBT EXPENSE26763762676376
CHARITY CARE816492816492
PROFESSIONAL FEES AND P106798106798

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total40708621Total
Program Services39034606ProgramServices
Management And General1674015ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1109846BOY
EOY1884832EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3534658BOY
EOY3373410EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3599774BOY
EOY3402475EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY105595BOY
EOY94599EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY507886BOY
EOY572706EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY70095BOY
EOY69856EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis17052866LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec7102333LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY9797649BOY
EOY9950533EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY498567BOY
EOY21737559EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY19224070BOY
EOY41085970EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1030325BOY
EOY960245EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3832485BOY
EOY3651158EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY95037BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY4957847BOY
EOY4611403EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY14266223BOY
EOY36474567EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14266223BOY
EOY36474567EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY19224070BOY
EOY41085970EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1152899ReconcilationRevenueExpenses
Reconcilation Other Changes21055445ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

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 D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis443314OtherCostOrOtherBasis
Book Value443314BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis9458296OtherCostOrOtherBasis
Depreciation2371001Depreciation
Book Value7087295BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis233452OtherCostOrOtherBasis
Depreciation100570Depreciation
Book Value132882BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis5979656OtherCostOrOtherBasis
Depreciation4602086Depreciation
Book Value1377570BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis938148OtherCostOrOtherBasis
Depreciation28676Depreciation
Book Value909472BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings9950533TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
INTERCOMPANY ACCOUNTS208000
EMPLOYEE BENEFIT FUND26317
DUE FROM THIRD PARTY189765
INTEREST IN NET ASSETS OF COLUMBUS COMMNITY HOSPITAL FOUNDATION21313477
FieldValueIRS element (for citing)
Total Book Value Other Assets21737559TotalBookValueOtherAssets
Total Revenue41861520TotalRevenue
Total Expenses40708621TotalExpenses
Excess Or Deficit For Year1152899ExcessOrDeficitForYear
Other$21,055,445OtherAmount
Total Adjustments21055445TotalAdjustments
Excess Or Deficit Per FS22208344ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt41756141TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal41756141RevenueSubtotal
Other Revenues Not Included105379OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt105379RevenueNotRptdOnFinStmt
Total Revenue Per Form99041861520TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt23520611TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal23520611ExpensesSubtotal
Other Expenses Not Included17188010OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt17188010ExpensesNotRptdOnFinStmt
Total Expenses Per Form99040708621TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
ExplanationPART XI, LINE 8: NET ASSETS IN COLUMBUS COMMUNITY HOSPITAL FOUNDATIONExplanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1343984TotalCommunityBenefitExpense
Direct Offsetting Revenue598449DirectOffsettingRevenue
Net Community Benefit Expense745535NetCommunityBenefitExpense
Percent Of Total Expense0.01830PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense1363599TotalCommunityBenefitExpense
Direct Offsetting Revenue3988870DirectOffsettingRevenue
Net Community Benefit Expense-2625271NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense2707583TotalCommunityBenefitExpense
Direct Offsetting Revenue4587319DirectOffsettingRevenue
Net Community Benefit Expense-1879736NetCommunityBenefitExpense
Percent Of Total Expense0.01830PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1603585TotalCommunityBenefitExpense
Net Community Benefit Expense1603585NetCommunityBenefitExpense
Percent Of Total Expense0.03940PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense1603585TotalCommunityBenefitExpense
Net Community Benefit Expense1603585NetCommunityBenefitExpense
Percent Of Total Expense0.03940PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense4311168TotalCommunityBenefitExpense
Direct Offsetting Revenue4587319DirectOffsettingRevenue
Net Community Benefit Expense-276151NetCommunityBenefitExpense
Percent Of Total Expense0.05770PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$1,343,984BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare6076146AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare18516880CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-12440734MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
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 HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1PO BOX 865AddressLine1
CityCOLUMBUSCity
StateTXState
ZIP Code78934ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1COLUMBUS COMMUNITY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Consulting ProcessXConsultingProcess
Needs Assessment Conducted10NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available0CHNAWidelyAvailable
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed1AllNeedsAddressed
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent150.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent400.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Collection Activities1CollectionActivities
Report To Credit AgencyXReportToCreditAgency
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Medicare RateXMedicareRate
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
FOUR OAKS MEDICAL CLINIC
109 SHULT DRIVECOLUMBUSTX78934OUTPATIENT CLINIC
COLUMBUS MEDICAL CLINIC
2122 HWY 71 SCOLUMBUSTX78934OUTPATIENT CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (6 entries)

ExplanationExplanationIdentifierIdentifier
PART III, LINE 8: THE HOSPITAL CONTINUES TO PROVIDE SERVICES TO THE COMMUNITY DESPITE THE SHORTFALL FROM SUBSIDIZED PROGRAMS SUCH AS MEDICARE AND MEDICAID.
PART III, LINE 9B: THE DEBT COLLECTION POLICY PROVIDES A PROVISION THAT EXCLUDES THOSE WHO QUALIFY FOR CHARITY FROM EVER BEING A PART OF THE BAD DEBT.
PART V, SECTION B, LINE 3: BOARD MEMBERS, COMMUNITY LEADERS ARE ALL ASKED HOW THE HOSPITAL CAN EITHER EXPAND OR IMPLEMENT NEW SERVICES TO BETTER SERVE THE COMMUNITY.COLUMBUS COMMUNITY HOSPITAL
PART VI, LINE 2: THE COMMUNITY'S NEEDS ARE ASSESSED THROUGH FORMAL AND INFORMAL FEEDBACK. REAL-TIME FEEDBACK ON THE COMMUNITY'S NEEDS IS SECURED THROUGH INVOLVEMENT AND REPRESENTATION OF THE BOARD OF DIRECTORS.
PART VI, LINE 3: THE HOSPITAL POSTS A SUMMARY OF ITS CHARITY CARE POLICY IN ADMISSION AREAS, EMERGENCY ROOMS, AND OTHER AREAS WHERE ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. THE HOSPITALS CONDITION OF ADMISSION CONSENT INFORMS THE PATIENTS THAT THEY MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE OR CHARITY CARE AND THEY MAY REQUEST INFORMATION ABOUT THESE PROGRAMS. A SUMMARY OF THE FINANCIALS ASSISTANCE PROGRAM IS PROVIDED TO THE PATIENT DURING THE INTAKE AND DISCHARGE PROCESSES. PATIENTS ARE INFORMED, WHERE APPLICABLE, OF AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID, AND ASSISTS THE PATIENTS WITH THE QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE.
PART VI, LINE 4: AS OF THE CENSUS OF 2000, THERE WERE 3,916 PEOPLE, 1,497 HOUSEHOLDS, AND 946 FAMILIES RESIDING IN THE CITY. THE POPULATION DENSITY WAS 1,387.5 PEOPLE PER SQUARE MILE. THE RACIAL MAKEUP OF THE CITY WAS 66.55% WHITE, 19.94% AFRICAN AMERICAN, 0.36% NATIVE AMERICAN, 0.33% ASIAN, 0.03% PACIFIC ISLANDER, 10.52% FROM OTHER RACES, AND 2.27% FROM TWO OR MORE RACES. HISPANIC OR LATINO OF ANY RACE WERE 17.62% OF THE POPULATION.THERE WERE 1,497 HOUSEHOLDS OUT OF WHICH 28.4% HAD CHILDREN UNDER THE AGE OF 18 LIVING WITH THEM, 45.8% WERE MARRIED COUPLES LIVING TOGETHER, 14.0% HAD A FEMALE HOUSEHOLDER WITH NO HUSBAND PRESENT, AND 36.8% WERE NON-FAMILIES. 33.0% OF ALL HOUSEHOLDS WERE MADE UP OF INDIVIDUALS AND 19.6% HAD SOMEONE LIVING ALONE WHO WAS 65 YEARS OF AGE OR OLDER. THE AVERAGE HOUSEHOLD SIZE WAS 2.40 AND THE AVERAGE FAMILY SIZE WAS 3.04.IN THE CITY THE POPULATION WAS SPREAD OUT WITH 23.4% UNDER THE AGE OF 18, 8.2% FROM 18 TO 24, 24.2% FROM 25 TO 44, 19.6% FROM 45 TO 64, AND 24.5% WHO WERE 65 YEARS OF AGE OR OLDER. THE MEDIAN AGE WAS 40 YEARS. FOR EVERY 100 FEMALES THERE WERE 88.2 MALES. FOR EVERY 100 FEMALES AGE 18 AND OVER, THERE WERE 84.2 MALES.THE MEDIAN INCOME FOR A HOUSEHOLD IN THE CITY WAS $29,175, AND THE MEDIAN INCOME FOR A FAMILY WAS $40,197. MALES HAD A MEDIAN INCOME OF $30,104 VERSUS $19,077 FOR FEMALES. THE PER CAPITA INCOME FOR THE CITY WAS $15,822. ABOUT 15.5% OF FAMILIES AND 20.5% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING 32.7% OF THOSE UNDER AGE 18 AND 16.1% OF THOSE AGE 65 OR OVER.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION B, LINE 11THE 990 RETURN IS REVIEWED AND APPROVED BY MANAGEMENT. IT IS THEN PRESENTED TO THE BOARD AFTER FILING.
THE BOARD IS REQUIRED TO FILL OUT A CONFLICT OF INTEREST FORM ANNUALLY.FORM 990, PART VI, SECTION B, LINE 12C
ANNUAL PERFORMANCE-BASED MERIT INCREASE COUPLED WITH REVIEW OF SALARY SURVEY DATA FOR LIKE-SIZED HOSPITALS.FORM 990, PART VI, SECTION B, LINE 15A
NO GOVERNING DOCUMENTS, CONFLICT OF INTEREST STATEMENTS OR FINANCIALS STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET ASSETS IN FOUNDATION 21055444. ROUNDING 1. TOTAL TO FORM 990, PART XI, LINE 5: 21055445.FORM 990, PART XI, LINE 5:
FINANCIAL STATEMENTS AND REPORTINGTHE ORGANIZATION'S BOARD OVERSEES THE AUDIT AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT.PART XII