2022-11-14T21:24:33-06:00 2021-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2021-01-01 310645626 FAIRFIELD MEDICAL CENTER FAIR 7406878051 401 NORTH EWING STREET LANCASTER OH 431303371 JOHN R JANOSO JR PRESIDENT & CEO 7406878051 2022-11-14 1 JOHN JANOSO JR 999009999 NATHAN A RODGERS CPA P01568275 3176334705 2022-11-08 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z JOHN R JANOSO JR 401 NORTH EWING STREET LANCASTER OH 431303371 371317644 0 X WWW.FMCHEALTH.ORG X 1982 OH FAIRFIELD MEDICAL CENTER DELIVERS OUTSTANDING HEALTHCARE FOR OUR PATIENTS, THEIR FAMILIES AND OUR COMMUNITIES. 15 13 2357 156 274836 206432 39391249 1003645 264487191 302024320 -1191465 1480143 6512254 16013175 309199229 320521283 170910 119365 0 0 119710131 118106737 0 0 0 156044665 166925356 275925706 285151458 33273523 35369825 368796028 354412820 223237255 200313757 145558773 154099063 FAIRFIELD MEDICAL CENTER DELIVERS OUTSTANDING HEALTHCARE FOR OUR PATIENTS, THEIR FAMILIES AND OUR COMMUNITIES. 0 0 224248977 119365 317674551 A) PATIENT CARE: INPATIENT MEDICAL, SURGICAL, EMERGENCY, MATERNITY, ICU, PSYCHIATRY, AND NURSING SERVICES (71,109 DISCHARGES, PROCEDURES & VISITS) B) PATIENT CARE: LABORATORY, CARDIOVASCULAR, RADIOLOGY, THERAPY, PHARMACY, AND MEDICAL SUPPLY SERVICES (6,497,684 PROCEDURES & DOSAGES) C) PATIENT CARE: NUTRITIONAL SERVICES (420,617 MEALS SERVED) PATIENT CARE: LAUNDRY SERVICES (1,218,898 POUNDS) PATIENT CARE: PLANT ENGINEERING, POLICE, HOUSEKEEPING, CENTRAL TRANSPORT, INTEREST & DEPRECIATION (750,056 SQUARE FEET) 224248977 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 158 0 1 2357 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 13 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OH X JOHN R JANOSO JR 7406896825 401 NORTH EWING STREET LANCASTER OH 431303371 JOHN R JANOSO JR DIRECTOR, PRESIDENT, & CEO 55.00 1.00 X X 820576 0 32730 ALAN F GREENSLADE CIO, TREASURER 40.00 2.00 X 332297 0 37089 LAURA MOORE CHIEF BUSINESS & STRATEGY OFFICER 40.00 0.00 X 317132 0 36984 MARK T DARNELL MD CMO-TERM BEGAN FEB'21 40.00 0.00 X 323598 0 12109 JONATHAN KELLY CFO-TERM BEGAN FEB'21 40.00 0.00 X 242824 0 26864 HELEN F HARDING CNO-TERM ENDED JAN'21 40.00 0.00 X 261346 0 7840 MARK E VANDERHOFF CHIEF NURSING OFFICER 40.00 0.00 X 229675 0 33403 ROBERT L ZEE DO RESIDENCY PROGRAM DIRECTOR 32.00 0.00 X 208156 0 13483 MICHAEL MEYER DIRECTOR, FINANCIAL SERVICES 40.00 0.00 X 180478 0 26964 PAMELA STARLIN DIRECTOR, ENVIRONMENTAL SVCS 26.00 0.00 X 165996 0 28396 THERESA DYAR DO DIRECTOR/RESIDENCY PRGRM D 27.00 0.00 X 182559 0 8950 ELIZABETH BRENDSEL STAFF PHARMACIST 41.00 0.00 X 159666 0 28453 JEFFREY COLLINS DIRECTOR, PATIENT SERVICES 40.00 0.00 X 165176 0 14593 LAURA TUSSING CHAIR 3.00 1.00 X X 0 0 0 BRADLEY HEDGES PHD VICE CHAIR 3.00 0.00 X X 0 0 0 MATTHEW WIDEMAN SECRETARY 3.00 0.00 X X 0 0 0 RON BURRIS DIRECTOR-TERM BEGAN JUNE'21 2.00 0.00 X 0 0 0 DAN FRUTH DIRECTOR 2.00 1.00 X 0 0 0 ANGELA KRILE DIRECTOR 2.00 0.00 X 0 0 0 LAURI LACH DIRECTOR-TERM BEGAN AUG'21 2.00 0.00 X 0 0 0 RON LINEHAN MD DIRECTOR 2.00 0.00 X 0 0 0 MICAH RIGGENBACH DIRECTOR 2.00 0.00 X 0 0 0 LAURIANNE SCOTT DIRECTOR 2.00 0.00 X 0 0 0 STEPHEN SWICK DIRECTOR-TERM BEGAN JUNE'21 2.00 0.00 X 0 0 0 MARIE WARD DIRECTOR-TERM BEGAN AUG'21 2.00 0.00 X 0 0 0 WILLIAM YAPLE DIRECTOR 2.00 0.00 X 0 0 0 AUNDREA CORDLE DIRECTOR-TERM ENDED MAR'21 2.00 1.00 X 0 0 0 SUSAN NIXON STOUGHTON DIRECTOR-TERM ENDED MAY'21 2.00 0.00 X 0 0 0 MILT TAYLOR JR DIRECTOR-TERM ENDED MAY'21 2.00 0.00 X 0 0 0 3589479 0 307858 94 0 1 0 FAIRFIELD ANESTHESIA ASSOCIATES PO BOX 427 LANCASTER OH 43130 PHYSICIAN SERVICES 3503232 RENOVO SOLUTIONS 1801 E PARKCOURT PLACE BLDG D SANTA ANA CA 92701 BIOMEDICAL SERVICES 1718171 SPECIALTY CARE MISS SERVICES DEPT 1614 BIRMINGHAM AL 35246 PERSONNEL SERVICES 1386965 US ACUTE CARE SOLUTIONS 4535 DRESSLER RD NW CANTON OH 44718 PHYSICIAN SERVICES 1132167 COMTEX 575 HARMON AVE COLUMBUS OH 43223 LAUNDRY SERVICES 870075 26 528 1003117 1003645 PATIENT SERVICE REVENUE 621110 302024320 302024320 302024320 1332732 1332732 288920 24926 1087550 0 -798630 24926 -773704 24926 -798630 49811217 45005 49447130 261681 364087 -216676 147411 147411 JOINT VENTURE INCOME 900099 4702974 4702974 CAFETERIA SALES 722514 886738 886738 OUTSIDE REFERENCE LAB 621500 245062 245062 10952105 10947257 4848 16786879 320521283 317674551 274836 1568251 X 119365 119365 2905976 2625279 280697 90434431 81699099 8735332 5125958 4579844 546114 12904486 11529657 1374829 6735886 6018252 717634 13900658 13900658 1273147 1273147 138741 138741 41561800 25374113 16187687 602900 350186 252714 2611799 2133233 478566 27567 16012 11555 4867434 2213619 2653815 221721 181095 40626 6303590 5339639 963951 16612451 11937485 4674966 679617 550465 129152 MEDICAL SUPPLIES 67893572 67441317 452255 FRANCHISE FEE 6152966 6152966 DIETARY 1455891 1189125 266766 RECRUITMENT 442958 361794 81164 2178544 589398 1589146 285151458 224248977 60902481 0 73535454 15587672 14244387 14937470 34701554 35657913 1353442 1110704 4865907 6066816 4397708 6817466 366465324 218445097 151995576 148020227 47683283 88001767 13519879 15303820 7527642 7527642 14971196 15381323 368796028 354412820 28750613 27785859 85395301 83317397 9560908 4310908 99530433 84899593 223237255 200313757 X 145558773 154099063 145558773 154099063 368796028 354412820 X 35369825 4270007 -31099542 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4405 4405 0 PART II-B, LINE 1: PORTION OF DUES PAID TO OHIO HOSPITAL ASSOCIATION ATTRIBUTABLE TO LOBBYING. 6307362 6307362 132499 113646389 71080498 42698390 11379485 3679323 7700162 225007100 140167832 84839268 9992489 3517444 6475045 148020227 OTHER LIABILITIES 17554618 FINANCE LEASE LIABILITY 38326545 OPERATING LEASE LIABILITY 5396115 REFUNDABLE ADVANCE 23622315 84899593 X PART X, LINE 2: THE INTERNAL REVENUE SERVICES (IRS) HAS RULED THAT THE HOSPITAL AND FHP ARE TAX EXEMPT UNDER SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). ACCORDINGLY, NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN MADE IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEARS ENDING DECEMBER 31, 2021 AND 2020. 1 1 1 X 1 X 1 1 0 1 1 2827640 2320245 507395 0.00180 42060128 38458148 3601980 0.01260 44887768 40778393 4109375 0.01440 17 20 1089815 38600 1051215 0.00370 4 5268928 3394062 1874866 0.00660 1 6838389 6765877 72512 0.00030 1 114294 114294 0.00040 3 64522 64522 0.00020 26 20 13375948 10198539 3177409 0.01120 26 20 58263716 50976932 7286784 0.02560 1 8850 8850 0.00000 1 5387 5387 0.00000 1 8478 8478 0.00000 1 20702 20702 0.00010 1 15778 15778 0.00010 5 59195 59195 0.00020 1 17202463 60886613 59637223 1249390 X 1 1 FAIRFIELD MEDICAL CENTER 401 NORTH EWING STREET LANCASTER OH 43130 WWW.FMCHEALTH.ORG X X X X FAIRFIELD MEDICAL CENTER 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X FMCHEALTH.ORG X HTTPS://WWW.MYFDH.ORG/PDF/FC-2019-CHA-REPORT.PDF X 1 19 1 FMCHEALTH.ORG 0 1 X 100.000000000000 300.000000000000 X X X 1 1 X X X X 1 X FMCHEALTH.ORG X FMCHEALTH.ORG X FMCHEALTH.ORG X X X X X 1 X 0 X X X X 1 X 0 0 FAIRFIELD MEDICAL CENTER PART V, SECTION B, LINE 5: FAIRFIELD MEDICAL CENTER CONTRACTED WITH ILLUMINOLOGY, A CENTRAL OHIO BASED RESEARCH FIRM, AND THE CENTER FOR PUBLIC HEALTH PRACTICE, WITHIN THE OHIO STATE UNIVERSITY COLLEGE OF PUBLIC HEALTH, TO ASSIST WITH THIS WORK. THE PRIMARY PHASES OF THE ASSESS NEEDS AND RESOURCES PROCESS, AS ADAPTED FOR USE IN FAIRFIELD COUNTY, INCLUDED THE FOLLOWING STEPS:(1) PREPARE TO ASSESS / GENERATE QUESTIONS. COMMUNITY PARTNERS WERE CLOSELY INVOLVED WITH THE FAIRFIELD COUNTY 2019 COMMUNITY HEALTH ASSESSMENT. ON FEBRUARY 25TH, 2019, 17 COMMUNITY LEADERS, STAKEHOLDERS, AND EMPLOYEES FROM PARTICIPATING ORGANIZATIONS GATHERED TO DISCUSS THEIR PERSPECTIVES ON EMERGING HEALTH ISSUES IN FAIRFIELD COUNTY. FACILITATED BY ILLUMINOLOGY, THIS SESSION PROVIDED AN OPPORTUNITY FOR COMMUNITY MEMBERS TO BETTER UNDERSTAND THE UPCOMING COMMUNITY HEALTH ASSESSMENT PROCESS, TO PARTICIPATE IN CONVERSATION WITH ONE ANOTHER ABOUT THE CURRENT STATE OF HEALTH IN THE COUNTY, AND TO SUGGEST INDICATORS TO BE CONSIDERED IN THE COMMUNITY HEALTH ASSESSMENT. BOTH SMALL GROUP DISCUSSIONS AND LARGE GROUP REPORT-OUTS OCCURRED DURING THIS SESSION. ILLUMINOLOGY USED THE INFORMATION FROM THIS SESSION AND ADDITIONAL FEEDBACK FROM THE FAIRFIELD DEPARTMENT OF HEALTH AND FAIRFIELD MEDICAL CENTER TO IDENTIFY WHICH INDICATORS COULD BE ASSESSED VIA SECONDARY SOURCES AND WHICH INDICATORS NEEDED TO BE INCLUDED AS PART OF THE PRIMARY DATA COLLECTION EFFORTS.(2) COLLECT SECONDARY DATA. SECONDARY DATA FOR THIS HEALTH ASSESSMENT CAME FROM NATIONAL SOURCES (E.G., U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES: HEALTHY PEOPLE 2020; U.S. CENSUS BUREAU), STATE SOURCES (E.G., OHIO DEPARTMENT OF HEALTH'S DATA WAREHOUSE), AND LOCAL SOURCES (E.G., FAIRFIELD MEDICAL CENTER). RATES AND/OR PERCENTAGES WERE CALCULATED WHEN NECESSARY. THE CENTER FOR PUBLIC HEALTH PRACTICE LOCATED AND RECORDED THIS INFORMATION INTO A SECONDARY DATA REPOSITORY. ALL DATA SOURCES ARE IDENTIFIED IN THE REFERENCE SECTION AT THE END OF THE REPORT. TO ENSURE COMMUNITY STAKEHOLDERS ARE ABLE TO USE THIS REPORT TO MAKE WELL-INFORMED DECISIONS, ONLY THE MOST RECENT DATA AVAILABLE AT THE TIME OF REPORT PREPARATION ARE PRESENTED. TO BE CONSIDERED FOR INCLUSION IN THE FAIRFIELD COUNTY 2019 COMMUNITY HEALTH ASSESSMENT, SECONDARY DATA MUST HAVE BEEN COLLECTED OR PUBLISHED IN 2013 OR LATER.(3) COLLECT PRIMARY DATA. PRIMARY DATA FOR THIS HEALTH ASSESSMENT CAME FROM THE 2019 FAIRFIELD COUNTY HEALTH SURVEY, A REPRESENTATIVE SURVEY OF FAIRFIELD COUNTY ADULT RESIDENTS. FIELDED IN MULTIPLE WAVES FROM APRIL 25, 2019 THROUGH JULY 8, 2019, THE QUESTIONNAIRES COULD BE COMPLETED VIA INTERNET OR BY MAIL. FAIRFIELD MEDICAL CENTER PART V, SECTION B, LINE 6A: DILEY RIDGE MEDICAL CENTER FAIRFIELD MEDICAL CENTER PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED IN ASSOCIATION WITH FAIRFIELD DEPT OF HEALTH AND FAIRFIELD MEDICAL CENTER AS A COLLABORATIVE EFFORT INCLUDING; DALAN & STARRIT ADULT GROUP HOME, FAIRFIELD COMMUNITY HEALTH CENTER, FAIRFIELD COUNT 2-1-1 (211), FAIRFIELD COUNTY ADAMH BOARD, FAIRFIELD COUNTY JOB & FAMILY SERVICES, FAIRFIELD COUNTY SHERIFF'S OFFICE, FAIRFIELD DEPARTMENT OF HEALTH, FAIRFIELD MEDICAL CENTER, LANCASTER FAIRFIELD COMMUNITY ACTION AGENCY, LANCASTER FAIRFIELD PUBLIC TRANSIT, MOUNT CARMEL HEALTH SYSTEM, OHIO STATE UNIVERSITY EXTENSION OFFICE, OHIOGUIDESTONE, PROJECT FORT/MAJOR CRIMES UNIT, SOUTHEASTERN OHIO CENTER FOR INDEPENDENT LIVING, UNITED WAY OF FAIRFIELD COUNTY, VIOLET TOWNSHIP FIRE DEPARTMENT. FAIRFIELD MEDICAL CENTER PART V, SECTION B, LINE 11: FAIRFIELD MEDICAL CENTER REVIEWED THE HEALTH NEEDS IDENTIFIED IN THE CHNA PROCESS AND DETERMINED THE FOLLOWING ALIGNED WITH OUR MISSION, GOALS, RESOURCES AND STRATEGIC PRIORITIES: MENTAL HEALTH, SUBSTANCE USE/ABUSE, CANCER CARE, CARDIOPULMONARY DISEASE, OBESITY AND ACCESS TO CARE. WE THEN DEVELOPED A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) OUTLINING TACTICS, AN IMPLEMENTATION TIMELINE, RESOURCES AND MEASURES OF SUCCESS FOR EACH AREA. THERE WERE SEVERAL AREAS WHICH WERE IDENTIFIED IN THE CHNA WHICH FMC DOES NOT HAVE THE RESOURCES OR ABILITY TO POSITIVELY IMPACT AND/OR OTHER COMMUNITY PARTNERS HAVE SPECIFIC RESOURCES AND CAPABILITIES TO MORE EFFECTIVELY ADDRESS: INCOME AND POVERTY, ACCESS TO TRANSPORTATION, ALZHEIMER'S AND DEMENTIA. IN 2021, WE MONITORED OUR PROGRESS ON THE CHIP AND MADE ADJUSTMENTS BASED ON THE SHIFTING NEEDS OF THE COMMUNITY LARGELY DUE TO THE COVID-19 PANDEMIC. PROGRESS WAS MADE ON MOST ACTIONS WITH THE EXCEPTION OF COMMUNITY EDUCATION, OUTREACH, SCREENINGS AND FITNESS ACTIVITIES WHICH HAD TO BE CANCELLED OR SIGNIFICANTLY SCALED BACK DUE TO THE PANDEMIC. NEW INITIATIVES THAT WERE ADDED AS A RESULT OF THE PANDEMIC INCLUDED: SERVICES TO CARE FOR COVID-19 PATIENTS (INPATIENT UNIT, TESTING CAPABILITIES, DRIVE-IN SCREENING, ETC.), TELEPHONE AND TELEHEALTH VISITS TO INCREASE ACCESS TO CARE AND RELOCATION OF CERTAIN SERVICES TO SAFER LOCATIONS OFF OF THE HOSPITAL CAMPUS. WE ALSO ADDED SEVERAL INITIATIVES TO THE CHIP AS A RESULT OF NEW OR EMERGING STRATEGIC INITIATIVES INCLUDING: TAVR AND ADVANCED EP SERVICES, A NEW LINEAR ACCELERATOR FOR CANCER CARE, TOBACCO CESSATION, HOSPITALIST SERVICES FOR OB AND PEDIATRICS, RELOCATION OF RESIDENCY CLINIC AND FREE TRANSPORTATION FOR SELECT PATIENTS. PART II, COMMUNITY BUILDING ACTIVITIES: KNOWING THAT A STRONG ECONOMY CAN HELP BUILD STRONG PEOPLE, WE HAVE DEDICATED OURSELVES TO HELPING OUR LOCAL ECONOMY THROUGH DONATIONS TO ORGANIZATIONS HELPING TO DRAW MORE BUSINESS TO THE AREA AND BY PARTICIPATING IN LOCAL CHAMBERS OF COMMERCE. FAIRFIELD MEDICAL CENTER (FMC) SUPPORTS OUR COMMUNITIES WITH POLICE ASSISTANCE AND BY EMERGENCY PLANNING WITH OTHER COMMUNITY ORGANIZATIONS. GOOD LEADERS ARE IMPORTANT TO THE FUTURE OF OUR COMMUNITY, SO WE ARE ACTIVELY INVOLVED IN LEADERSHIP DEVELOPMENT AND TRAINING. WE ALSO RECOGNIZE THE IMPORTANCE OF RECYCLING AS A WAY TO IMPROVE THE HEALTH OF OUR PLANET, AND THEREFORE OUR PEOPLE, WITH ENVIRONMENTAL IMPROVEMENTS. PARTICIPATION WITH OTHER COMMUNITY ENTITIES BY COALITION BUILDING ALSO HELPS US TO KEEP OUR PULSE ON THE HEALTH OF THE COMMUNITY THROUGH GRASSROOTS INVOLVEMENT. PART III, LINE 2: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE CENTER'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. PART III, LINE 4: SEE PAGES 12 & 13 OF THE DECEMBER 31, 2021 AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: ALL MEDICARE SHORTFALL IS CONSIDERED COMMUNITY BENEFIT BECAUSE FAIRFIELD MEDICAL CENTER TREATS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY AND REGARDLESS OF SUPPLEMENTAL INSURANCE COVERAGE, IN THE CASE OF MEDICARE PATIENTS. IT IS FOR THE BETTERMENT OF THE COMMUNITY THAT WE TREAT MEDICARE PATIENTS, REGARDLESS OF THE SHORTFALL OR SURPLUS.THE TOTAL FOR MEDICARE COST IS TAKEN DIRECTLY FROM THE MEDICARE COST REPORT. PART III, LINE 9B: IN ALL INSTANCES OF DEBT COLLECTION, PATIENTS ARE GIVEN INFORMATION REGARDING FINANCIAL ASSISTANCE AVAILABLE. IN ADDITION, PATIENTS ARE MADE AWARE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE WITH AN ACKNOWLEDGEMENT LETTER OF SERVICES RENDERED, REGARDLESS OF ABILITY TO PAY OR PAYMENT SOURCE. FMC WILL DO EVERYTHING POSSIBLE TO HELP THOSE WHO QUALIFY FOR CHARITY CARE TO BE MADE AWARE OF THE ASSISTANCE AVAILABLE. WE ALSO PROVIDE FINANCIAL COUNSELORS TO ASSIST PATIENTS IN FILLING OUT THE NECESSARY FORMS FOR ASSISTANCE. THE FOLLOWING OPTIONS ARE AVAILABLE:A. PAYMENT IN THE FORM OF CASH, CREDIT CARD OR CHECKS. A DISCOUNT IS OFFERED WITH PAYMENT AT THE TIME OF SERVICE AND WITHIN 10 DAYS OF RECEIVING THE HOSPITAL BILL. B. H.E.L.P. BANK FINANCIAL PROGRAMC. HOSPITAL PAYMENT PROGRAM D. ASSISTANCE WITH APPLICATION TO MEDICARE OR MEDICAIDE. HOSPITAL CARE ASSURANCE PROGRAM (HCAP) F. HOSPITAL ASSISTANCE PROGRAM SUMMARYDEFINING FAIRFIELD MEDICAL CENTER'S FINANCIAL OPPORTUNITIES. G. ASSISTANCE FOR THE UNINSURED PATIENT. PART VI, LINE 2: IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR FAIRFIELD COUNTY AS REPORTED IN PART V, SECTION B, FAIRFIELD MEDICAL CENTER ASSESSES THE HEALTH CARE NEEDS OF THE BROADER COMMUNITY WE SERVE BY PARTICIPATING IN THE PERRY COUNTY COMMUNITY HEALTH NEEDS ASSESSMENTS AND COMMUNITY HEALTH IMPROVEMENT PLAN. ADDITIONALLY, WE PARTICIPATE IN LOCAL HEALTH NETWORKS FOR PERRY, HOCKING AND FAIRFIELD COUNTIES WHICH MEET ON A MONTHLY BASIS TO DISCUSS EVOLVING HEALTH ISSUES AND CONCERNS. WE ALSO PARTICIPATE IN THE LOGAN, PERRY AND LANCASTER CHAMBER OF COMMERCE AS WELL AS NUMEROUS GROUPS OR NETWORKS FOCUSING ON SPECIFIC POPULATIONS INCLUDING THE ELDERLY (OLDER ADULT NETWORK, ADULT FAMILY CHILD FIRST COUNCIL), CHILDREN (SAFE KIDS/SAFE COMMUNITIES, YMCA), AND MENTAL HEALTH (INNERSYSTEMS). ADDITIONALLY, FMC'S STRATEGIC PLANNING PROCESS ASSESSES NEW SERVICES, TECHNOLOGIES AND PROVIDERS THAT FMC CAN OFFER LOCALLY SO THAT RESIDENTS DO NOT HAVE TO LEAVE THE COMMUNITY AND TRAVEL LONG DISTANCES TO RECEIVE NECESSARY SERVICES. PART VI, LINE 3: THERE ARE PROMINENT SIGNS IN REGISTRATION AND IN CONTRACTS AND COLLECTIONS SHOWING OUR FINANCIAL POLICY. EVERY HOSPITAL BILL SENT TO PATIENTS HAS A FLYER INCLUDED WITH OUR FINANCIAL POLICY CLEARLY DESCRIBED. FINANCIAL COUNSELORS MEET WITH PATIENTS BEFORE THEY'RE DISCHARGED FROM THE HOSPITAL SO THAT EACH PATIENT IS PERSONALLY MADE AWARE OF OUR POLICY AND ALSO TO IDENTIFY THOSE WHO QUALIFY FOR FINANCIAL ASSISTANCE, THEN THE FINANCIAL COUNSELORS ASSIST WITH COMPLETING THE ASSISTANCE INFORMATION SHOULD HELP BE NEEDED. PART VI, LINE 4: FAIRFIELD MEDICAL CENTER SERVES A THREE COUNTY AREA IN SOUTH EASTERN OHIO COMPRISED OF FAIRFIELD, HOCKING AND PERRY COUNTIES. THE TOTAL POPULATION IS 224,000 WITH 35% OF THE POPULATION LIVING IN A RURAL AREA. THE SOUTHERN PORTION OF PERRY COUNTY IS A LARGELY UNDERSERVED REGION IN THE RURAL HILLS OF APPALACHIA. PART VI, LINE 5: FAIRFIELD MEDICAL CENTER HAS AN OPEN MEDICAL STAFF, COMMUNITY BOARD AND FOUNDATION WHICH PLAYS A VITAL ROLE IN SUPPORTING ACCESS TO MEDICAL CARE AND WELLNESS PROGRAMS THROUGHOUT FAIRFIELD, HOCKING AND PERRY COUNTIES. WE ALSO SPONSOR COMMUNITY HEART WATCH WHICH IS A COLLABORATIVE EFFORT OF AREA EMS, BUSINESSES, SCHOOLS AND OTHER ORGANIZATIONS DEDICATED TO IMPROVING SURVIVAL FROM CARDIAC ARREST. PART VI, LINE 7: OH 1 FAIRFIELD MEDICAL CENTER FOUNDATION 401 NORTH EWING STREET LANCASTER OH 43130 208952945 501(C)(3) 119365 0 SUPPORT TO COVER OPERATING EXPENSES 1 PART I, LINE 2: THE ORGANIZATION WORKS CLOSELY ALONGSIDE THE FOUNDATION TO MONITOR FUNDS; THE FOUNDATION'S ACCOUNTING IS DONE BY EMPLOYEES OF FMC. X X X X 0 1 0 0 0 0 0 1 0 JOHN R JANOSO JR DIRECTOR, PRESIDENT, & CEO 590814 0 164116 0 65646 0 17400 0 15330 0 853306 0 0 0 ALAN F GREENSLADE CIO, TREASURER 292421 0 36553 0 3323 0 17400 0 19689 0 369386 0 0 0 LAURA MOORE CHIEF BUSINESS & STRATEGY OFFICER 275239 0 40688 0 1205 0 17400 0 19584 0 354116 0 0 0 MARK T DARNELL MD CMO-TERM BEGAN FEB'21 322595 0 0 0 1003 0 10983 0 1126 0 335707 0 0 0 JONATHAN KELLY CFO-TERM BEGAN FEB'21 241828 0 0 0 996 0 11425 0 15439 0 269688 0 0 0 HELEN F HARDING CNO-TERM ENDED JAN'21 9069 0 0 0 252277 0 7840 0 0 0 269186 0 0 0 MARK E VANDERHOFF CHIEF NURSING OFFICER 204526 0 23702 0 1447 0 14150 0 19253 0 263078 0 0 0 ROBERT L ZEE DO RESIDENCY PROGRAM DIRECTOR 208156 0 0 0 0 0 12483 0 1000 0 221639 0 0 0 MICHAEL MEYER DIRECTOR, FINANCIAL SERVICES 159182 0 10576 0 10720 0 7948 0 19016 0 207442 0 0 0 PAMELA STARLIN DIRECTOR, ENVIRONMENTAL SVCS 151388 0 12699 0 1909 0 10150 0 18246 0 194392 0 0 0 THERESA DYAR DO DIRECTOR/RESIDENCY PRGRM D 182559 0 0 0 0 0 8209 0 741 0 191509 0 0 0 ELIZABETH BRENDSEL STAFF PHARMACIST 159379 0 0 0 287 0 10207 0 18246 0 188119 0 0 0 JEFFREY COLLINS DIRECTOR, PATIENT SERVICES 164234 0 0 0 942 0 7526 0 7067 0 179769 0 0 0 A COUNTY OF FAIRFIELD OHIO 316400066 304286AM9 2013-06-27 98511516 TO REFUND PRIOR ISSUE AND TO FUND NEW SURGICAL UNIT 0 0 0 A 56264480 6320525 926511 35000000 1 0 0 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 FORM 990, PART VI, SECTION A, LINE 2 VARIOUS MEMBERS OF THE BOARD OF DIRECTORS ARE KEY EMPLOYEES AND/OR OFFICERS OF ORGANIZATIONS THAT MAY CONDUCT NORMAL, ARMS LENGTH TRANSACTIONS WITH ONE ANOTHER. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY THE TREASURER OF THE ORGANIZATION AFTER REVIEW BY THE DIRECTOR OF FINANCIAL SERVICES. THEN, IT IS MADE AVAILABLE FOR BOARD MEMBER REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, PRESIDENT, VICE PRESIDENTS, MANAGERS, CASE MANAGEMENT EMPLOYEES, CONTRACTS & COLLECTIONS EMPLOYEES, EMPLOYEES WITH DIRECT PURCHASING RESPONSIBILITIES, EMPLOYED PHYSICIANS, AND EMPLOYEES WHO ARE CONTRACTED OR SHARED WITH OTHER ORGANIZATIONS ARE REQUIRED TO COMPLETE AN ANNUAL QUESTIONNAIRE DISCLOSING POTENTIAL CONFLICTS OF INTEREST. IF A KNOWN OR PERCEIVED CONFLICT OF INTEREST ARISES, THE COMPLIANCE OFFICER INVESTIGATES, DOCUMENTS, AND WORKS TO RESOLVE THE CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 ANNUALLY, THE COMPENSATION COMMITTEE COMPARES OFFICER AND KEY EMPLOYEE COMPENSATION TO REGIONAL INDUSTRY AVERAGES. THIS COMMITTEE CONSISTS OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. COMPENSATION ADJUSTMENT RECOMMENDATIONS ARE SUBMITTED, TO BE INCLUDED IN THE BUDGET, TO THE FINANCE AND AUDIT COMMITTEE. COMPENSATION ADJUSTMENTS ARE TAKEN TO THE BOARD OF DIRECTORS FOR FINAL APPROVAL, AND IF APPROVED ARE THEN IMPLEMENTED. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST, AND FINANCIALS ARE MADE AVAILABLE TO THE PUBLIC BY REQUEST MADE TO FMC MANAGEMENT. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 18,497,429. MANAGEMENT AND GENERAL EXPENSES 13,348,776. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,846,205. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 6,649,644. MANAGEMENT AND GENERAL EXPENSES 2,745,182. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,394,826. CONSULTANT FEES: PROGRAM SERVICE EXPENSES 227,040. MANAGEMENT AND GENERAL EXPENSES 93,729. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 320,769. FORM 990, PART XI, LINE 9: ASSET TRANSFER TO AFFILIATES -30,313,659. CHANGE IN INTEREST OF NET ASSETS OF FAIRFIELD MEDICAL CENTER FOUNDATION -785,883. FORM 990, PART XII, LINE 2C: THE PROCESS OF SELECTING AN INDEPENDENT ACCOUNTANT AND OVERSIGHT OF THE AUDIT HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990 PART IX LINE 11G OTHER FEES FOR SERVICES INCLUDE LAB TESTING, ADMINISTRATIVE CONSULTING, OUTSOURCED BIOMEDICAL SERVICES, OUTSOURCED COLLECTION SERVICES, OUTSOURCED IT SERVICES AND OTHER GENERAL PURCHASED SERVICES. FORM 990 PART XI LINE 9 THE OTHER CHANGE IN NET ASSETS REPORTED REPRESENTS INTERCOMPANY TRANSFERS BETWEEN FAIRFIELD MEDICAL CENTER AND RELATED ORGANIZATIONS (SEE SCHEDULE R) FOR FIXED ASSET PURCHASES, SHARED EMPLOYEES, EXPENSES AND OTHER INTERCOMPANY TRANSACTIONS. HOME HEALTH RESOURCES 401 NORTH EWING STREET LANCASTER OH 43130 311159707 DURABLE MED. EQUIP. OH 0 0 ZANE PROPERTIES CO FAIRFIELD HEALTHCARE PROFESSIONALS INC 401 NORTH EWING LANCASTER OH 43130 311425884 PHYSICIAN PRACTICES OH 501(C)(3) LINE 11 FAIRFIELD MEDICAL CENTER 0 FAIRFIELD MEDICAL CENTER FOUNDATION 401 NORTH EWING LANCASTER OH 43130 208952945 FUNDRAISING OH 501(C)(3) LINE 7 N/A 0 FAIRFIELD MEDICAL CENTER TWIG II 1724 E MAIN STREET LANCASTER OH 43130 237146033 SUPPORT FAIRFIELD MEDICAL CENTER OH 501(C)(3) LINE 12D, III-O N/A 0 ZANE PROPERTIES CORPORATION 401 NORTH EWING STREET LANCASTER OH 43130 311202009 HOLDING COMPANY OH FAIRFIELD MEDICAL CENTER C 79554 2818574 1.00000 0 OHIO PHYSICAL MEDICINE & REHAB INC 2405 N COLUMBUS ST SUITE 210 LANCASTER OH 43130 311639119 PHYSIATRISTS OH N/A S 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 1 1 1 1 1 FAIRFIELD HEALTHCARE PROFESSIONALS INC G 169891 FAIRFIELD HEALTHCARE PROFESSIONALS INC O 18246479 FAIRFIELD HEALTHCARE PROFESSIONALS INC P 3899071 ZANE PROPERTIES CORPORATION P 8290 ZANE PROPERTIES CORPORATION Q 76801 FAIRFIELD HEALTHCARE PROFESSIONALS INC R 6626000 ZANE PROPERTIES CORPORATION S 240000