Form 990 for tax year 2022

Revenue

Part VIII, the statement of revenue.

• 1f · All other contributions, gifts and grants

  $566,582

• 3 · Investment income

  total -$40,282 · excluded -$40,282

• 7a · Gross sales of assets other than inventory

  securities $1,523

• 7b · Less cost or other basis and sales expenses

  securities $1,555

• 7c · Gain or loss

  securities -$32

• 7d · Net gain or loss

  total -$32 · excluded -$32

Functional expenses

Part IX, the statement of functional expenses.

• 2 · Grants to domestic individuals

  total $25,590 · program services $25,590

• 11f · Fees: investment management

  total $2,250 · management and general $2,250

• 24a · Other expenses: HOSPICE EXPENSES

  total $6,258 · program services $6,258

• 24b · Other expenses: OTHER PROGRAM EXPENSES

  total $3,639 · program services $3,639

Balance sheet

Part X, book values.

• 2 · Savings and temporary cash investments

  beginning of year $65,749 · end of year $125,255

• 3 · Pledges and grants receivable

  beginning of year $10,439 · end of year $3,791

• 11 · Investments: publicly traded securities

  beginning of year $1,966,573 · end of year $2,024,644

• 15 · Other assets

  beginning of year $9,000 · end of year $9,000

• 25 · Other liabilities

  beginning of year $12,735 · end of year $13,058

• 27 · Net assets without donor restrictions

  beginning of year $1,756,301 · end of year $1,434,904

• 28 · Net assets with donor restrictions

  beginning of year $282,725 · end of year $714,728

The filer's explanations (Part III)

PART I, LINE 4B

ERIK THORSEN, CEO, IS PARTICIPATING IN A 457(F) PLAN OF A RELATED ORGNIZATION WHICH STARTED IN 2015. COLUMBIA MEMORIAL HOSPITAL CONTRIBUTED $67,650 TO THE PLAN IN 2022. CONTRIBUTIONS ARE MADE THROUGHOUT THE YEAR AND DISTRIBUTED AT THE BEGINNING OF THE FOLLOWING YEAR. THE DISTRIBUTION IS INCLUDED IN TAXABLE INCOME.

PART I, LINE 3

COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE OF RELATED ORGANIZATION: COMPENSATION OF ALL OFFICERS IS REVIEWED WITH COMPARABILITY DATA BY A THIRD PARTY CONSULTANT. THE RESULTS OF THE STUDY ARE REVIEWED AND DISCUSSED AT THE BOARD OF TRUSTEES MEETING.

PART I LINE 1A

DISCRETIONARY SPENDING ACCOUNT: BASED ON SIGNED EMPLOYMENT CONTRACTS, COLUMBIA MEMORIAL HOSPITAL PAID ONE LUMP SUM PAYMENT ON THE FIRST PAY-PERIOD OF EACH YEAR TO COVER DISCRETIONARY EXPENSE OF ERIK THORSEN, CEO, ($2,500), IN ADDITION, COLUMBIA MEMORIAL HOSPITAL PAID $609.78 PER MONTH TO COVER THE CEO CAR, ($609.78/MONTH - $7,317.36 ANNUALLY). THE CAR IS ONLY USED FOR BUSINESS PURPOSE AND NOT INCLUDED IN TAXABLE INCOME. THE DISCRETIONARY EXPENSE ACCOUNT IS INCLUDED IN TAXABLE INCOME HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: BASED ON SIGNED EMPLOYMENT CONTRACTS, COLUMBIA MEMORIAL HOSPITAL REIMBURSED MONTHLY COUNTRY CLUB MEMBERSHIP DUES FOR ERIK THORSEN, CEO ($365/MONTH FROM JANURARY TO JUNE AND $375/MONTH FROM JULY TO DECEMBER - $4,440 ANNUALLY) AND ROTARY CLUB DUES FOR ERIK THORSEN, CEO, OF $200 QUARTERLY ($800 ANNUALLY). THESE EXPENSES WERE SUBMITTED ON MONTHLY EXPENSE REPORTS OR DIRECT INVOICES FROM THE CLUB AND WERE REVIEWED AND APPROVED IN ACCORDANCE WITH THE ORGANIZATION'S FINANCIAL AUTHORITY POLICY AND BUSINESS EXPENSE POLICY.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

• COASTAL HEALTH ASSURANCE INC

  C · PHYSICIAN ASSOCIATION, MEDICAL CONTRACT MANAGEMENT · OR