2024-11-12T16:10:14-06:00 2023-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2023-01-01 310679012 COLUMBUS MEDICAL ASSOCIATION FOUNDATION COLU 6142407410 1390 DUBLIN ROAD COLUMBUS OH 43215 LAURIE HAWKINS CFO 6142407410 2024-11-12 1 1 AMY CIMINELLO P00796388 6148493000 2024-11-12 2023 2024-10-15 13:58:12Z LAURIE HAWKINS 1390 DUBLIN ROAD COLUMBUS OH 43215 747371 0 X WWW.CMAFOHIO.ORG X 1958 OH THROUGH GRANT-MAKING, CMAF IMPROVES THE HEALTH OF RESIDENTS IN CENTRAL OHIO. 17 17 12 40 -11977 48253 36845 46236 123809 120350 692670 429957 49590 61104 902914 657647 1855942 2044912 0 0 550435 739116 0 0 169813 1130752 1152120 3537129 3936148 -2634215 -3278501 97507010 104053058 2306502 2212060 95200508 101840998 THE COLUMBUS MEDICAL ASSOCIATION FOUNDATION, THROUGH THE GOVERNANCE AND OVERSIGHT OF ITS BOARD OF PHYSICIANS AND OTHER EXPERTS, EFFECTS CHANGE WITHIN SPECIFIC PRIORITY AREAS TO IMPROVE THE HEALTH AND WELLBEING OF THE RESIDENTS AND PHYSICIANS OF CENTRAL OHIO. 0 0 2274951 2044912 120350 THE COLUMBUS MEDICAL ASSOCIATION FOUNDATION EXISTS TO EFFECT CHANGE WITHIN SPECIFIC PRIORITY AREAS TO IMPROVE THE HEALTH OF ALL CENTRAL OHIO RESIDENTS.PRIORITIES: -TRANSFORMING CLINICAL HEALTHCARE DELIVERY -SUPPORTING AND IMPROVING HEALTHCARE SAFETY NET CLINICAL SERVICES TO UNINSURED AND UNDERINSURED POPULATIONS -SAVING AND IMPROVING LIVES THROUGH THE COORDINATION OF TRAUMA AND EMERGENCY HEALTHCARE RESOURCES -PROVIDING PHYSICIANS THE LEADERSHIP SKILLS TO FURTHER ENHANCE THE PATIENT/DOCTOR RELATIONSHIP 2274951 1 0 0 0 0 1 0 0 0 0 1 1 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 21 0 1 12 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X LAURIE HAWKINS 6142407410 1390 DUBLIN ROAD COLUMBUS OH 43215 JAMES L NICHOLS SECRETARY/TREASURER 5.00 1.00 X X 0 0 0 MARC L PARNES MD PRESIDENT 2.00 3.00 X X 0 8500 0 ALVIN RODACK TRUSTEE 1.00 1.00 X 0 0 0 EDWARD T BOPE MD TRUSTEE 1.00 1.00 X 0 0 0 JASMINE GREEN TRUSTEE 1.00 1.00 X 0 0 0 MARK STAMM TRUSTEE 1.00 1.00 X 0 0 0 BRET KOCKENTIET MD TRUSTEE 1.00 1.00 X 0 0 0 KAREN KING MD VICE PRESIDENT 1.00 1.00 X X 0 0 0 BARBARA LACH TRUSTEE 1.00 1.00 X 0 0 0 JEFF HALL MD TRUSTEE 1.00 1.00 X 0 0 0 DON BROWN TRUSTEE 1.00 1.00 X 0 0 0 ANITA SOMANI MD TRUSTEE TERM ENDED - PART YEAR 1.00 2.00 X 0 0 0 SUGAT PATEL MD TRUSTEE TERM ENDED - PART YEAR 1.00 1.00 X 0 0 0 CATHERINE ROMANOS MD TRUSTEE 1.00 2.00 X 0 0 0 AHMAD MOSTAFAVIFAR MD TRUSTEE 1.00 1.00 X 0 0 0 KANNY GREWAL MD TRUSTEE 1.00 2.00 X 0 0 0 LUIS ALCALDE TRUSTEE 1.00 1.00 X 0 0 0 LISA WESOLEK TRUSTEE 1.00 1.00 X 0 0 0 JACOB LIU TRUSTEE 1.00 1.00 X 0 0 0 ROBERT E FALCONE MD CEO 27.00 13.00 X 271931 0 1365 LAURIE HAWKINS CFO/COO 26.00 14.00 X 159081 0 35976 431012 8500 37341 2 0 1 0 0 46236 8800 46236 RENTAL FROM AFFILIATES 900099 116552 116552 PROGRAMS 900099 3798 3798 120350 429957 -61753 491710 139500 89724 49776 49776 49776 INSURANCE PROCEEDS 524298 11328 11328 11328 657647 120350 -11977 503038 2044912 2044912 468355 91367 292812 84176 175819 22034 119447 34338 18344 3579 11468 3297 60007 11706 37516 10785 16591 15501 847 243 2310 2310 66888 66888 373322 373322 83509 34624 41505 7380 41299 19282 22017 13512 90 13333 89 190930 183507 7423 4080 4080 39662 31856 7741 65 83359 83359 174153 174153 TAXES & LICENSES 70691 0 70691 0 UBI TAX 8405 8405 3936148 2274951 1491384 169813 205510 285509 340499 113815 79150 103498 4579147 2355537 2325844 2223610 94556007 101326626 97507010 104053058 194454 186809 11625 1800191 1665193 311857 348433 2306502 2212060 X 93947282 100478733 1253226 1362265 95200508 101840998 97507010 104053058 -3278501 9918991 0 X X 0 1 X 1 0 X X 1 COLUMBUS MEDICAL ASSOCIATION FOUNDATION UNLIMITED 200385860 10 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 5 50 355877 1006388 1 1 253580 253580 2047215 667782 1379433 1395450 919763 475687 589957 528373 61584 292945 239619 53326 2223610 OTHER SECURITIES 101326626 F 101326626 REIMBURSEMENT TO AFFILIATES 192854 ASSETS HELD FOR OTHERS 155579 348433 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 HEALTHCARE COLLABORATIVE OF GREATER COLUMBUS 855 GRANDVIEW AVE STE 210 COLUMBUS OH 43215 510426050 501 (C)(3) 300000 0 TO SUPPORT ITS CORE SERVICES COTS 1390 DUBLIN ROAD COLUMBUS OH 43215 311592734 501 (C)(3) 360000 0 TO SUPPORT ITS CORE SERVICES PHYSICIANS CARE CONNECTION 1390 DUBLIN ROAD COLUMBUS OH 43215 311373719 501 (C)(3) 816912 0 TO PROVIDE FREE PRIMARY & SPECIALTY MEDICAL CARE FOR THE UNINSURED AND UNDERSERVED PHYSICIANS LEADERSHIP ACADEMY 1390 DUBLIN ROAD COLUMBUS OH 43215 822152009 501 (C)(3) 302000 0 TO EDUCATE PHYSICIANS THROUGH LEADERSHIP TRAINING THE COLUMBUS FOUNDATION 1234 EAST BROAD STREET COLUMBUS OH 43205 521311159 501 (C)(3) 250000 0 TO SUPPORT ADAMH CRISIS CENTER CAMPAIGN FUND 5 0 PART I, LINE 2: A MEMORANDUM OF AGREEMENT IS SIGNED BETWEEN THE GRANTEE AND GRANTOR THAT DESCRIBES THE CONDITIONS FOR THE GRANT TO INCLUDE PAYMENT AND REPORTING PROCESSES. X 1 1 X X 0 0 0 0 0 0 0 0 0 ROBERT E FALCONE MD CEO 271931 0 0 0 0 0 0 0 1365 0 273296 0 0 0 LAURIE HAWKINS CFO/COO 159081 0 0 0 0 0 9928 0 26048 0 195057 0 0 0 PART I, LINE 1A COLUMBUS MEDICAL ASSOCIATION FOUNDATION PROVIDES A MEMBERSHIP TO AN ATHLETIC CLUB FOR THE CEO. THE PRIMARY PURPOSE OF THIS MEMBERSHIP IS FOR THE CEO TO BE ABLE TO HOLD MEETINGS AT THIS LOCATION. FORM 990, PART VI, SECTION A, LINE 6 COLUMBUS MEDICAL ASSOCIATION IS THE ORGANIZATION'S SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE AUTHORITY TO ELECT AND REMOVE DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS THE AUTHORITY TO ELECT AND REMOVE DIRECTORS AND APPROVE CHANGES IN THE BY-LAWS AND CODE OF REGULATIONS. IN ADDITION THE SOLE MEMBER HAS THE AUTHORITY TO APPROVE DECISIONS SUCH AS DISSOLVING THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN IS PROVIDED TO THE BOARD MEMBERS FOR THEIR REVIEW BEFORE THE RETURN IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ANNUALLY SENDS A DISCLOSURE FORM TO ALL DIRECTORS, OFFICERS, AND KEY EMPLOYEES REQUIRING THEM TO DISCLOSE ANY CONFLICTS OF INTEREST. ANY NEW BOARD MEMBERS ARE ADVISED OF THE POLICY UPON ENTERING THE DUTIES OF HIS/HER OFFICE. THOSE CONFLICTS ARE THEN ADDRESSED BY THE BOARD. VOTING AND PARTICIPATION RESTRICTIONS ARE IMPOSED ON THOSE WITH ANY CONFLICTS. THE BOARD PRESIDENT AND SECRETARY/TREASURER ARE AUTHORIZED AND DIRECTED TO SEE THAT THIS POLICY IS FOLLOWED. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION PERFORMS COMPENSATION REVIEWS. THE CEO REVIEW IS HANDLED BY THE COLUMBUS MEDICAL ASSOCIATION FOUNDATION BOARD AND THE CEO EVALUATION COMMITTEE. THE CEO HAS AN EMPLOYMENT CONTRACT AND IT WAS LAST UPDATED IN 2023. THE CEO REVIEWS THE COMPENSATION FOR ALL STAFF. THE CEO ESTABLISHES COMPENSATION BASED ON INFLATION RATES, AN INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEYS AND STUDIES AND APPROVAL BY THE JOINT FINANCE COMMITTEE AND THE BOARD. THE OUTSIDE REVIEW IS CONDUCTED EVERY THREE YEARS AND THE LAST ONE WAS IN 2021. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C THE TREASURERS OF THE FILING ORGANIZATION AND ITS RELATED ENTITIES ARE MEMBERS OF THE JOINT FINANCE COMMITTEE. THIS COMMITTEE MAKES DECISIONS CONCERNING THE SELECTION OF THE INDEPENDENT AUDITORS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. COLUMBUS MEDICAL ASSOCIATION FOUNDATION UNLIMITED 1390 DUBLIN ROAD COLUMBUS OH 43215 200385860 FUND PHILANTHROPIC INTERESTS OH 501(C)(3) LINE 7 COLUMBUS MEDICAL ASSOCIATION FOUNDATION 1 COLUMBUS MEDICAL ASSOCIATION 1390 DUBLIN ROAD COLUMBUS OH 43215 314411074 ADVANCING COMMUNITY HEALTH THROUGH ADVOCACY, EDUCATION AND SERVICE OH 501(C)(6) N/A 0 COTS 1390 DUBLIN ROAD COLUMBUS OH 43215 311592734 REDUCING INJURIES AND SAVING LIVES BY IMPROVING EMERGENCY SERVICES OH 501(C)(3) LINE 7 COLUMBUS MEDICAL ASSOCIATION 1 PHYSICIANS CARE CONNECTION 1390 DUBLIN ROAD COLUMBUS OH 43215 311373719 OPTIMIZING THE HEALTH OF THE MOST VULNERABLE IN CENTRAL OHIO OH 501(C)(3) LINE 3 COLUMBUS MEDICAL ASSOCIATION 1 PHYSICIANS LEADERSHIP ACADEMY 1390 DUBLIN ROAD COLUMBUS OH 43215 822152009 SUPPORT PHYSICIANS WITH LEADERSHIP TRAINING OH 501(C)(3) LINE 2 COLUMBUS MEDICAL ASSOCIATION 1 1 1 0 0 0 0 0 0 0 1 0 1 0 1 1 1 1 0 0 COTS B 360000 GRANT PHYSICIANS CARE CONNECTION B 816912 GRANT COTS A 60352 PER SQ FT COLUMBUS MEDICAL ASSOCIATION A 4401 PER SQ FT PHYSICIANS CARE CONNECTION A 46226 PER SQ FT PHYSICIANS LEADERSHIP ACADEMY B 302000 GRANT PHYSICIANS LEADERSHIP ACADEMY A 5573 PER SQ FT