FULTON COUNTY HEALTH CENTER: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- FULTON COUNTY HEALTH CENTER (EIN 34-4428214)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-10-25
- IRS object ID
- 202212989349301216
- Schema version
- 2021v4.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-10-25T14:14:19-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 S HIGH ST SUITE 100 | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43215 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 344428214 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FULTON COUNTY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FULT | BusinessNameControlTxt |
| Phone | 4193352015 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 725 SOUTH SHOOP AVENUE | AddressLine1Txt |
| City | WAUSEON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 435671701 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PATRICIA A FINN | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 4193352015 | PhoneNum |
| Signature | 2022-10-24 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | PATRICIA | PersonFirstNm |
| Person Last | FINN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMY CIMINELLO | PreparerPersonNm |
| PTIN | P00796388 | PTIN |
| Phone | 6148493000 | PhoneNum |
| Preparation | 2022-10-24 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PATRICIA A FINN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 725 SOUTH SHOOP AVENUE | AddressLine1Txt |
| City | WAUSEON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 435671701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $102,232,937 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FULTONCOUNTYHEALTHCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | SERVE THE PUBLIC BY PROMOTING AND PROVIDING THE MEANS FOR CONTINUED HEALTH AND WELLNESS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 995 | TotalEmployeeCnt |
| Total Volunteers | 75 | TotalVolunteersCnt |
| Total Gross UBI | $1,362,573 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $6,354,274 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,157,107 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $82,310,835 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $93,789,337 | CYProgramServiceRevenueAmt |
| PY Investment Income | $183,745 | PYInvestmentIncomeAmt |
| CY Investment Income | $596,956 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,963,828 | PYOtherRevenueAmt |
| CY Other Revenue | $4,472,797 | CYOtherRevenueAmt |
| PY Total Revenue | $91,812,682 | PYTotalRevenueAmt |
| CY Total Revenue | $102,016,197 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $18,300 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $16,500 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $44,428,431 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $50,275,870 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $46,059,953 | PYOtherExpensesAmt |
| CY Other Expenses | $51,621,390 | CYOtherExpensesAmt |
| PY Total Expenses | $90,506,684 | PYTotalExpensesAmt |
| CY Total Expenses | $101,913,760 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,305,998 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $102,437 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $125,796,322 | TotalAssetsBOYAmt |
| Total Assets EOY | $119,762,304 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $70,422,550 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $62,408,437 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $55,373,772 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $57,353,867 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE FULTON COUNTY HEALTH CENTER CONTINUALLY STRIVES TO REACH A HIGH DEGREE OF EXCELLENCE IN MEETING THE NEEDS OF BOTH INTERNAL AND EXTERNAL CUSTOMERS 100% OF THE TIME. QUALITY OF PATIENT/RESIDENT CARE AND ALL OF THE INSTITUTIONAL PRACTICES ARE THE PRIMARY CRITERION UTILIZED TO MONITOR THE HEALTH CENTER SERVICES AND TO EVALUATE PROPOSED CHANGES OF PROPOSED NEW SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $87,246,604 | ExpenseAmt |
| Grant | $16,500 | GrantAmt |
| Revenue | $96,046,053 | RevenueAmt |
| Desc | SEE SCHEDULE O LOCATION: THE FULTON COUNTY HEALTH CENTER IS LOCATED AT 725 SOUTH SHOOP AVENUE, WAUSEON, OH 43567. THE HEALTH CENTER IS EASILY ACCESSIBLE FROM INTERSTATE 80/90 (OHIO TURNPIKE) AND STATE ROUTE 2. IT IS CENTRALLY LOCATED WITHIN FULTON COUNTY WHERE WAUSEON IS THE COUNTY SEAT. PHILOSOPHY/AUSPICES: THE FULTON COUNTY HEALTH CENTER IS A PRIVATE, NON-PROFIT HOSPITAL, LONG-TERM CARE & INDEPENDENT LIVING FACILITY GOVERNED BY A BOARD OF DIRECTORS. THE HEALTH CENTER IS OPERATED ON THE PRINCIPLE THAT EVERY INDIVIDUAL HAS A BASIC RIGHT TO ATTAIN THE HIGHEST DEGREE OF WELLNESS POSSIBLE BASED ON HIS OR HER OWN NEEDS. THE SERVICES OF THE HOSPITAL SHALL BE AVAILABLE TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, SEX, AGE, NATIONAL ORIGIN, RELIGIOUS CREED, ECONOMIC CONDITION OR DISABILITY. COMMITMENT TO QUALITY: THE FULTON COUNTY HEALTH CENTER CONTINUALLY STRIVES TO REACH A HIGH DEGREE OF EXCELLENCE IN MEETING THE NEEDS OF BOTH INTERNAL AND EXTERNAL CUSTOMERS 100% OF THE TIME. QUALITY OF PATIENT/RESIDENT CARE AND ALL OF THE INSTITUTIONAL PRACTICES IS THE PRIMARY CRITERION UTILIZED TO MONITOR THE HEALTH CENTER SERVICES AND TO EVALUATE PROPOSED CHANGES OF PROPOSED NEW SERVICES. LEVEL OF CARE: THE HEALTH CENTER IS A SHORT-TERM GENERAL HOSPITAL OFFERING A FULL RANGE OF SERVICES RELATED TO ACUTE CARE. INCLUDED IN THESE SERVICES AREA A WIDE RANGE OF OUTPATIENT SERVICES THAT INVOLVE DIAGNOSTIC AND REHABILITATIVE TREATMENT. THE HEALTH CENTER ALSO HAS LONG-TERM CARE AND INDEPENDENT LIVING AVAILABLE TO OFFER THE CONTINUUM OF CARE. THE LEVEL OF CARE PROVIDED TO ALL PATIENTS AND RESIDENTS IS THE SAME WHETHER INPATIENT OR OUTPATIENT. THIS IS ACCOMPLISHED THROUGH PROGRESSIVE HEALTH AWARENESS. CENTERS OF EXCELLENCE: AMONG THE SPECIAL STRENGTHS OF THE HEALTH CENTER ARE AN OBSTETRICAL UNIT, A CRITICAL CARE/CARDIAC CARE UNIT, A SHORT TERM INPATIENT AND INTENSIVE OUTPATIENT GERIATRIC PSYCHIATRIC UNIT, ADULT OUTPATIENT AND PARTIAL HOSPITALIZATION, AN EMERGENCY DEPARTMENT THAT IS STAFFED WITH LICENSED PHYSICIANS 24 HOURS PER DAY, EVERY DAY OF THE YEAR, AN INPATIENT AND OUTPATIENT SURGICAL UNIT, SLEEP DISORDER CENTER, WOUND CARE AND HYPERBARIC CENTER, RAINBOW HEMATOLOGY/ONCOLOGY TREATEMENT CENTER AND OTHER DIAGNOSTIC AND THERAPEUTIC SERVICES. IN ADDITON, A HOSPITALIST IS AVAILABLE TO INPATIENTS 24/7, TELEMEDICNE STROKE NETWORK WITH UTMC AND MERCY ST VS. DAILY OUTPATIENT SPECIALTY CLINICS OFFER THE CONSULTATIVE AND DIAGNOSTIC SERVICES OF SEVERAL TYPES OF MEDICAL SPECIALISTS. LONG-TERM CARE AND INDEPENDENT LIVING FACILITY OFFERING THE CONTINUUM OF CARE FROM THE HOSPITAL AREA. A WIDE RANGE OF ORGANIZED EDUCATIONAL AND HEALTH PROMOTION OPPORTUNITIES, INCLUDING A COMPREHENSIVE DIABETIC EDUCATION PROGRAM, ARE PROVIDED FOR PATIENTS, RESIDENTS, EMPLOYEES AND MEMBERS OF THE SURROUNDING COMMUNITIES. IN 2021 FULTON COUNTY HEALTH CENTER WAS HONORED WITH THE 2021 HEALTHY WORKPLACE GOLD LEVEL AWARD. THIS AWARD WAS PRESENTED AS A RESULT OF THE HEALTH CENTER'S COMPREHENSIVE WORKPLACE HEALTH PROMOTION AND WELLNESS PROGRAMS. FCHC WAS ONE OF THE 100 OHIO EMPLOYERS THAT WERE RECOGNIZED FOR THEIR HEALTH WORKPLACE PRACTICES. IN 2021 FULTON COUNTY HEALTH CENTER CELEBRATED 42 YEARS OF OFFERING H.O.P.E (HELPING OTHER PARENTS EXPERIENCE GRIEF). H.O.P.E SUPPORT GROUP OFFERS SUPPORT FOR PARENTS WHO HAVE EXPERIENCED MISSCARIAGE, STILLBIRTH, OR DEATH OF INFANTS, YOUNG CHILDREN, TEENAGERS, OR ADULTS DUE TO ILLNESS, AN ACCIDENT OR SUICIDE.IN 2021, FULTON COUNTY HEALTH CENTER CELBRATED 40 YEARS OF OFFERING BEHAVIORAL HEALTH SERVICES. FCHC BEHAVIORAL HEALTH OFFERS TWO TYPES OF SERVICES: A HOSPITAL-BASED BASED ADULT INPATIENT AND PARTIAL HOSPITALIZATION/INTENSIVE OUTPATIENT, AS WELL AS A FREESTANDING OUTPATIENT CLINIC. LIMITATIONS: PATIENTS IN NEED OF TERTIARY CARE ARE REFERRED TO AREA SPECIALTY CENTERS. POPULATION SERVED: THE FULTON COUNTY HEALTH CENTER SERVES THE POPULATION IN FULTON COUNTY AND PATIENTS IN THE IMMEDIATE BORDER AREAS OF ADJACENT COUNTIES. TOTAL POPULATION OF OUR SERVICE AREA IS ESTIMATED BETWEEN 42,000 - 45,000. OUR BEHAVIOR HEALTH SERVICES UNIT PRIMARILY SERVES A FOUR COUNTY AREA INCLUDING FULTON, DEFIANCE, HENRY AND WILLIAMS COUNTIES AS WELL AS FROM OUTSIDE OUR IMMEDIATE GEOGRAPHIC AREA. INSTITUTIONAL RELATIONSHIPS: THE HEALTH CENTER MAINTAINS RELATIONSHIPS WITH AREA NURSING HOMES, CITY AND COUNTY ORGANIZATIONS, AND REGIONAL TERTIARY CARE CENTERS. THE HEALTH CENTER IS A CLINIC-TRAINING SITE FOR A WIDE RANGE OF HEALTH CARE DISCIPLINES.EDUCATION: THE HEALTH CENTER MAINTAINS AN ACTIVE AND ONGOING IN-SERVICE AND CONTINUING EDUCATION PROGRAM FOR OUR STAFF TO KEEP THEM KNOWLEDGEABLE AND CURRENT ON DEVELOPMENTS IN HEALTH CARE DELIVERY. THE HEALTH CENTER ALSO ENCOURAGES EMPLOYEES TO PURSUE HIGHER EDUCATION. | Desc |
| Total Program Service Expenses | $87,246,604 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 96 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 995 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JENEE SEIBERT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4193352015 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 725 SOUTH SHOOP AVE | AddressLine1Txt |
| City | WAUSEON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43567 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MARK HAGANS | ||||||||
| TREASURER | 0.80 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SANDY BARBER | ||||||||
| PRESIDENT | 0.80 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BRETT KOLB | ||||||||
| VICE PRESIDENT | 0.80 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SHARON GILLESPIE | ||||||||
| SECRETARY | 0.80 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ANTHONY URBIES | ||||||||
| DIRECTOR/PHYSICIAN | 0.80 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JON RUPP | ||||||||
| DIRECTOR | 0.80 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| RICK KAZMIERCZAK | ||||||||
| DIRECTOR | 0.80 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES JAY LEFEVRE | ||||||||
| DIRECTOR | 0.80 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BROCK MEALER | ||||||||
| DIRECTOR | 0.80 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID GRIESER | ||||||||
| DIRECTOR | 0.80 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JENNIFER MCCULLOUGH | ||||||||
| DIRECTOR | 0.80 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ALLEN LIECHTY | ||||||||
| DIRECTOR | 0.80 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| PATRICIA A FINN | ||||||||
| CHIEF EXECUTIVE OFFICER | 45.00 | 0.00 | Yes (X) | $234,057 | $0 | $39,733 | ||
| REBECCA TAYLOR | ||||||||
| CHIEF OPERATING OFFICER | 45.00 | 0.00 | Yes (X) | $168,201 | $0 | $16,472 | ||
| JENEE SEIBERT | ||||||||
| DIRECTOR OF FINANCE | 45.00 | 0.00 | Yes (X) | $137,729 | $0 | $18,008 | ||
| TIFFANY SEIGEL | ||||||||
| DIRECTOR OF NURSING | 45.00 | 0.00 | Yes (X) | $137,615 | $0 | $17,624 | ||
| MARY JO SMALLMAN | ||||||||
| FM ADMINISTRATOR | 45.00 | 0.00 | Yes (X) | $116,978 | $0 | $23,350 | ||
| DANIEL MCKERNAN | ||||||||
| PHYSICIAN | 45.00 | 0.00 | $786,342 | $0 | $29,545 | Yes (X) | ||
| CHRISTOPHER SPIELES | ||||||||
| PHYSICIAN | 45.00 | 0.00 | $691,597 | $0 | $34,400 | Yes (X) | ||
| CHARLES LASH | ||||||||
| PHYSICIAN | 45.00 | 0.00 | $447,594 | $0 | $10,578 | Yes (X) | ||
| SEMEGHAGHA FOFUNG | ||||||||
| PHYSICIAN | 45.00 | 0.00 | $323,862 | $0 | $23,019 | Yes (X) | ||
| ALAN RIVERA | ||||||||
| HOSPITALIST | 45.00 | 0.00 | $330,834 | $0 | $9,524 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,374,809 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $222,253 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 39 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| R&F INC | |||||
| 1133 CORPORATE DR SUITE B | HOLLAND | OH | 43528 | OCCUPATIONAL/SPEECH/PHYSICAL THERAPY | $1,613,319 |
| ALLIED MEDICAL SERVICES | |||||
| 1133 CORPORATE DR SUITE B | HOLLAND | OH | 43528 | RESPIRATORY THERAPY | $980,580 |
| NORTHERN ANESTHESIA PROVIDERS | |||||
| PO BOX 182 | ARCHBOLD | OH | 46502 | ANESTHESIOLOGY | $840,000 |
| APRN SLEEP | |||||
| 1133 CORPORATE DR SUITE B | HOLLAND | OH | 43528 | SLEEP DIAGNOSTIC | $798,330 |
| INLAND NORTHWEST HEALTH SERVICES | |||||
| 601 W 1ST AVENUE | SPOKANE | WA | 99201 | CIP - EXPANSE IMPLEMENTATION | $674,981 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 28 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $27,150 | MembershipDuesAmt |
| Fundraising | $42,068 | FundraisingAmt |
| Government Grants | $3,057,516 | GovernmentGrantsAmt |
| All Other Contributions | $30,373 | AllOtherContributionsAmt |
| Total Contributions | $3,157,107 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICES | 622110 | $93,670,824 | $93,670,824 |
| REBATES AND REFUNDS | 900099 | $73,955 | $73,955 |
| EDUCATION SERVICES | 611710 | $44,558 | $44,558 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $93,789,337 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $508,856 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$5,840 | UnrelatedBusinessRevenueAmt |
| Exclusion | $514,696 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $497,261 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $202,000 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $295,261 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $295,261 | TotalRevenueColumnAmt |
| Exclusion | $295,261 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $88,100 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $88,100 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $88,100 | TotalRevenueColumnAmt |
| Exclusion | $88,100 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $14,559 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $42,068 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $13,940 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $619 | TotalRevenueColumnAmt |
| Exclusion | $619 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $372 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $800 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$428 | TotalRevenueColumnAmt |
| Exclusion | -$428 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| RETAIL PHARMACY | 446110 | $3,493,330 | $2,124,917 | $1,368,413 | |
| FOOD SALES | 621110 | $402,951 | $402,951 | ||
| FITNESS MEMBERSHIPS | 621110 | $131,799 | $131,799 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $149,265 | TotalRevenueColumnAmt |
| Exclusion | $149,265 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,177,345 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $102,016,197 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $96,046,053 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,362,573 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,450,464 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,500 | TotalAmt |
| Program Services | $12,500 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,000 | TotalAmt |
| Program Services | $4,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $909,768 | TotalAmt |
| Management And General | $909,768 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,802,221 | TotalAmt |
| Program Services | $34,868,391 | ProgramServicesAmt |
| Management And General | $3,933,830 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,389,271 | TotalAmt |
| Program Services | $1,255,175 | ProgramServicesAmt |
| Management And General | $134,096 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,419,004 | TotalAmt |
| Program Services | $5,743,367 | ProgramServicesAmt |
| Management And General | $675,637 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,755,606 | TotalAmt |
| Program Services | $2,433,200 | ProgramServicesAmt |
| Management And General | $322,406 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,354 | TotalAmt |
| Management And General | $56,354 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,133 | TotalAmt |
| Management And General | $95,133 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,008 | TotalAmt |
| Management And General | $121,008 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,681,555 | TotalAmt |
| Program Services | $10,131,388 | ProgramServicesAmt |
| Management And General | $550,167 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $304,314 | TotalAmt |
| Program Services | $94,738 | ProgramServicesAmt |
| Management And General | $209,576 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,011,296 | TotalAmt |
| Program Services | $3,080,191 | ProgramServicesAmt |
| Management And General | $3,931,105 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,330,708 | TotalAmt |
| Program Services | $1,874,201 | ProgramServicesAmt |
| Management And General | $456,507 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,146,947 | TotalAmt |
| Program Services | $3,290,477 | ProgramServicesAmt |
| Management And General | $856,470 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,192 | TotalAmt |
| Program Services | $46,446 | ProgramServicesAmt |
| Management And General | $2,746 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,412,692 | TotalAmt |
| Program Services | $1,412,692 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,653,920 | TotalAmt |
| Program Services | $3,685,166 | ProgramServicesAmt |
| Management And General | $1,968,754 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $594,814 | TotalAmt |
| Program Services | $179,047 | ProgramServicesAmt |
| Management And General | $415,767 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $15,889,355 | $15,875,523 | $13,832 |
| BAD DEBT EXPENSE | $3,254,492 | $3,254,492 | $0 |
| GIFT SHOP EXPENSES | $14,000 | $0 | $14,000 |
| INDEPENDENT LIVING | $5,610 | $5,610 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,913,760 | TotalAmt |
| Program Services | $87,246,604 | ProgramServicesAmt |
| Management And General | $14,667,156 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,103,207 | BOYAmt |
| EOY | $715,033 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,294,346 | BOYAmt |
| EOY | $11,590,400 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,472,284 | BOYAmt |
| EOY | $19,398,642 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,189,918 | BOYAmt |
| EOY | $2,266,433 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,575,253 | BOYAmt |
| EOY | $2,073,723 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $125,580,085 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $67,062,118 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,791,955 | BOYAmt |
| EOY | $58,517,967 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,547,225 | BOYAmt |
| EOY | $24,663,960 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $822,134 | BOYAmt |
| EOY | $536,146 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,796,322 | BOYAmt |
| EOY | $119,762,304 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,793,479 | BOYAmt |
| EOY | $9,138,766 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,419 | BOYAmt |
| EOY | $7,633 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,286,349 | BOYAmt |
| EOY | $51,433,291 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $295,303 | BOYAmt |
| EOY | $1,828,747 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,422,550 | BOYAmt |
| EOY | $62,408,437 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,321,772 | BOYAmt |
| EOY | $57,301,867 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,000 | BOYAmt |
| EOY | $52,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,373,772 | BOYAmt |
| EOY | $57,353,867 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,796,322 | BOYAmt |
| EOY | $119,762,304 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $102,437 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,877,350 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $308 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $8,347 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $8,347 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | TOTAL DUES PAYMENTS TO OHA AND AHA THAT WERE USED BY THE ORGANIZATIONS FOR LOBBY PURPOSES: -OHIO HOSPITAL ASSOCIATION: 6.20% OF $34,115; $2,115, -AMERICAN HOSPITAL ASSOCIATION: 26.47% OF $20,500; $5,426 -OCHA DUES: 19.64% OF $4,105; $806 | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $407,236 | BeginningYearBalanceAmt |
| Contributions | $1,200 | ContributionsAmt |
| Investment Earnings Or Losses | $1,071 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $409,507 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $405,509 | BeginningYearBalanceAmt |
| Contributions | $75 | ContributionsAmt |
| Investment Earnings Or Losses | $1,652 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $407,236 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $399,448 | BeginningYearBalanceAmt |
| Contributions | $985 | ContributionsAmt |
| Investment Earnings Or Losses | $5,076 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $405,509 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $397,597 | BeginningYearBalanceAmt |
| Contributions | $460 | ContributionsAmt |
| Investment Earnings Or Losses | $1,391 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $399,448 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $335,521 | BeginningYearBalanceAmt |
| Contributions | $61,123 | ContributionsAmt |
| Investment Earnings Or Losses | $953 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $397,597 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.86470 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.13530 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,587,651 | OtherCostOrOtherBasisAmt |
| Book Value | $2,587,651 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $63,211,283 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,340,548 | DepreciationAmt |
| Book Value | $32,870,735 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $48,664,613 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,458,309 | DepreciationAmt |
| Book Value | $18,206,304 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,116,538 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,263,261 | DepreciationAmt |
| Book Value | $4,853,277 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $58,517,967 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| CAPITAL LEASE OBLIGATION | $668,930 |
| COST REPORT SETTLEMENT PAYABLE | $1,159,817 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,828,747 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4: | FormAndLineReferenceDesc |
| Explanation | ENDOWMENT FUNDS WILL BE USED AS DIRECTED BY THE DONOR. BOARD DESIGNATED FUNDS ARE A MEMORIAL ACCOUNT AND FUNDS WILL BE SPENT AS DIRECTED BY THE BOARD OF DIRECTORS. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF OUTING | Event1Nm |
| Gross Receipts Event1 | $56,107 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $41,548 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $14,559 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $7,602 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $5,053 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $903 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $250 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $56,107 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $41,548 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $14,559 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $7,602 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $5,053 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $903 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $250 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $13,808 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $751 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,321,902 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $105,216 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,216,686 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04270 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,449,830 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,976,250 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,473,580 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05540 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $272,443 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $150,346 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $122,097 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,044,175 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,231,812 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,812,363 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09930 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $674,084 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $44,559 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $629,525 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00640 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,198,354 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,500,137 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,698,217 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01720 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $30,458 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,882 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $27,576 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,902,896 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,547,578 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,355,318 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02390 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,947,071 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,779,390 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,167,681 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12320 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $146,815 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $146,815 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $146,815 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $146,815 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,254,492 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $195,270 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $17,328,801 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $18,093,507 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$764,706 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FULTON COUNTY HEALTH CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 725 S SHOOP AVE | AddressLine1Txt |
| City | WAUSEON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43567 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.FULTONCOUNTYHEALTHCENTER.ORG/ | WebsiteAddressTxt |
| State License | 1177AHR | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FULTON COUNTY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 20 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.FULTONCOUNTYHEALTHCENTER.ORG/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 20 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, PAGE 8 | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, PAGE 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, PAGE 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, PAGE 8 | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FULTON COUNTY HEALTH CENTER | PART V, SECTION B, LINE 5: FULTON COUNTY CONTRACTED WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO, A NON-PROFIT HOSPITAL ASSOCIATION, LOCATED IN TOLEDO, OHIO, TO COORDINATE AND MANAGE THE HEALTH ASSESSMENT PROCESS. THE HOSPITAL COUNCIL HAS BEEN COMPLETING COMPREHENSIVE HEALTH ASSESSMENTS SINCE 1999. THE PROJECT COORDINATOR FROM THE HOSPITAL COUNCIL OF NW OHIO HOLDS A MASTER'S DEGREE IN PUBLIC HEALTH AND CONDUCTED A SERIES OF MEETINGS WITH THE PLANNING COMMITTEE FROM FULTON COUNTY. DURING THESE MEETINGS, BANKS OF POTENTIAL SURVEY QUESTIONS FROM THE BRFSS, YRBSS, AND NSCH SURVEYS WERE REVIEWED AND DISCUSSED. BASED ON INPUT FROM THE FULTON COUNTY PLANNING COMMITTEE, THE PROJECT COORDINATOR COMPOSED A DRAFT SURVEY CONTAINING 112 ITEMS.THE DRAFTS WERE REVIEWED AND APPROVED BY HEALTH RESEARCHERS AT THE UNIVERSITY OF TOLEDO.LOCAL COMMUNITY AGENCIES WERE INVITED TO PARTICIPATE IN THE HEALTH ASSESSMENT PROCESS, INCLUDING CHOOSING QUESTIONS FOR THE SURVEYS, PROVIDING LOCAL DATA, REVIEWING DRAFT REPORTS AND PLANNING THE COMMUNITY EVENT, RELEASE OF THE DATA AND SETTING PRIORITIES. THE NEEDS OF THE POPULATION, ESPECIALLY THOSE WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS AND POPULATIONS WITH CHRONIC DISEASE NEEDS, WERE TAKEN INTO ACCOUNT THROUGH THE SAMPLE METHODOLOGY THAT SURVEYED THESE POPULATIONS. IN ADDITION, THE ORGANIZATIONS THAT SERVE THESE POPULATIONS PARTICIPATED IN THE HEALTH ASSESSMENT AND COMMUNITY PLANNING PROCESS, SUCH AS UNITED WAY OF FULTON COUNTY, FULTON COUNTY JOB & FAMILY SERVICES, NORTHWEST OHIO COMMUNITY ACTION COMMISSION, ETC. THESE ARE THE ORGANIZATIONS WHO PARTICIPATED IN THE HEALTH ASSESSMENT AND STRATEGIC PLANNING PROCESS: A RENEWED MIND, CROSSROADS EVANGELICAL CHURCH, FOUR COUNTY ADAMHS BOARD, FOUR COUNTY SUICIDE PREVENTION COALITION, FULTON COUNTY AGING CONSORTIUM, FULTON COUNTY BOARD OF DEVELOPMENTAL DISABILITIES, FULTON COUNTY COMMISSIONERS OFFICE, FULTON COUNTY ECONOMIC DEVELOPMENT, FULTON COUNTY FAMILY & CHILDREN FIRST COUNCIL, FULTON COUNTY HEALTH CENTER, FULTON COUNTY HEALTH DEPARTMENT, FULTON COUNTY JOB & FAMILY SERVICES, FULTON COUNTY SAFE COMMUNITIES, FULTON COUNTY SCHOOLS, FULTON COUNTY SENIOR CENTER, FULTON COUNTY SHERIFF'S OFFICE, HEALTHY CHOICES CARING COMMUNITIES, MAUMEE VALLEY GUIDANCE CENTER, NORTH STAR BLUESCOPE STEEL, NORTHWESTERN OHIO COMMUNITY ACTION, OHIO FARM BUREAU, OHIO STATE UNIVERSITY EXTENSION, RECOVERY SERVICES OF NORTHWEST OHIO, TRINITY LUTHERAN CHURCH OF DELTA, UNITED WAY OF FULTON COUNTY, VILLAGE OF DELTA POLICE DEPARTMENT, VILLAGE OF SWANTON, AND WAUSEON POLICE DEPARTMENT. |
| FULTON COUNTY HEALTH CENTER | PART V, SECTION B, LINE 6B: THESE ARE THE ORGANIZATIONS WHO PARTICIPATED IN THE HEALTH ASSESSMENT AND STRATEGIC PLANNING PROCESS: A RENEWED MIND, CROSSROADS EVANGELICAL CHURCH, FOUR COUNTY ADAMHS BOARD, FOUR COUNTY SUICIDE PREVENTION COALITION, FULTON COUNTY AGING CONSORTIUM, FULTON COUNTY BOARD OF DEVELOPMENTAL DISABILITIES, FULTON COUNTY COMMISSIONERS OFFICE, FULTON COUNTY ECONOMIC DEVELOPMENT, FULTON COUNTY FAMILY & CHILDREN FIRST COUNCIL, FULTON COUNTY HEALTH CENTER, FULTON COUNTY HEALTH DEPARTMENT, FULTON COUNTY JOB & FAMILY SERVICES, FULTON COUNTY SAFE COMMUNITIES, FULTON COUNTY SCHOOLS, FULTON COUNTY SENIOR CENTER, FULTON COUNTY SHERIFF'S OFFICE, HEALTHY CHOICES CARING COMMUNITIES, MAUMEE VALLEY GUIDANCE CENTER, NORTH STAR BLUESCOPE STEEL, NORTHWESTERN OHIO COMMUNITY ACTION, OHIO FARM BUREAU, OHIO STATE UNIVERSITY EXTENSION, RECOVERY SERVICES OF NORTHWEST OHIO, TRINITY LUTHERAN CHURCH OF DELTA, UNITED WAY OF FULTON COUNTY, VILLAGE OF DELTA POLICE DEPARTMENT, VILLAGE OF SWANTON, AND WAUSEON POLICE DEPARTMENT. |
| FULTON COUNTY HEALTH CENTER | PART V, SECTION B, LINE 7D: THE ASSESSMENT IS AVAILABLE ON THE FOLLOWING ADDITIONAL WEBSITES: FULTON COUNTY HEALTH DEPARTMENTHTTPS://FULTONCOUNTYHEALTHDEPT.COM/DATA-RESOURCES/HEALTH-ASSESSMENTSHOSPITAL COUNCIL OF NORTHWEST OHIOHTTP://WWW.HCNO.ORG/COMMUNITY-SERVICES/COMMUNITY-HEALTH-ASSESSMENTS/ALSO, PRINTED COPIES WERE GIVEN TO ALL KEY LEADERS AT COMMUNITY EVENT. |
| FULTON COUNTY HEALTH CENTER | PART V, SECTION B, LINE 11: BASED ON THE 2020 CHNA, KEY ISSUES WERE IDENTIFIED AND COMMITTEE MEMBERS COMPLETED A KEY RANKING EXERCISE, GIVING A SCORE FOR MAGNITUDE, SERIOUSNESS OF THE CONSEQUENCE AND FEASIBILITY OF CORRECTING, RESULTING IN AN AVERAGE SCORE FOR EACH ISSUE IDENTIFIED. EACH COMMITTEE MEMBER THEN RANKED THE ISSUES FROM 1-10, DISCUSSED THEIR RANKING WITH SECTOR PARTNERS AND SUBMITTED THEIR SCORES. BASED ON THIS EXERCISE, THE FOLLOWING PRIORITIES WERE SELECTED: MENTAL HEALTH & ADDICTION AND CHRONIC DISEASE. ALL NEEDS ARE BEING ADDRESSED EITHER BY FULTON COUNTY HEALTH CENTER OR OTHER COMMUNITY PARTNERS. STRATEGIES ARE LISTED BELOW.THE FULTON COUNTY HEALTH CENTER WILL ADDRESS MENTAL HEALTH/ADDICTION THROUGH THE FOLLOWING STRATEGIES: BUILD COMMUNITY CESSATION PARTNERS TO INCREASE OPPORTUNITIES THROUGH TOBACCO CESSATION TELEPHONIC TOBACCO CESSATION PROGRAMOTHER PARTNERS IN FULTON COUNTY WILL ADDRESS MENTAL HEALTH/ADDICTION THROUGH THE FOLLOWING STRATEGIES: IMPLEMENT MENTAL HEALTH WELLNESS MEDIAC CAMPAIGN (FULTON COUNTY HEALTH DEPARTMENT AND FOUR COUNTY ADAMHS BOARD) IMPLEMENT A UNIVERSAL SCHOOL-BASED SUICIDE AWARENESS AND EDUCATION PROGRAM (MAUMEE VALLEY GUIDANCE CENTER) INCREASE YOUTH AND ADULT MENTAL HEALTH FIRST AID TRAINING EXPAND OUR SCHOOL-BASED SCREENING, BRIEF INTERVENTION AND REFERRAL TO TREATMENT (SBIRT) MODEL (FULTON COUNTY HEALTH DEPARTMENT AND FOUR COUNTY ADAMHS BOARD) PROVIDE VAPING PRESENTATIONS TO MIDDLE SCHOOL STUDENTS ANNUALLY ENSURE OUR SCHOOL BASED SOCIAL AND EMOTIONAL INSTRUCTION CONTINUES TO BE SUSTAINABLE (FULTON COUNTY HEALTH DEPARTMENT AND RECOVERY SERVICES OF NORTHWEST OHIO)THE FULTON COUNTY HEALTH CENTER WILL ADDRESS CHRONIC DISEASE THROUGH THE FOLLOWING STRATEGIES: IMPLEMENT DIABETES PREVENTION PROGRAM HYPERTENSION SCREENING AND FOLLOW UP INCREASE POINT-OF-PURCHASE PROMPTS FOR HEALTHY FOODS IMPLEMENT COMPETITIVE PRICING FOR HEALTHY FOODS IMPLEMENT FARM-TO-INSTITUTION PROGRAM EXPAND INDIVIDUALLY-ADAPTED PHYSICAL ACTIVITY PROGRAMS EXPAND COMMUNITY FITNESS PROGRAMSOTHER PARTNERS IN FULTON COUNTY WILL ADDRESS CHRONIC DISEASE THROUGH THE FOLLOWING STRATEGIES: IMPLEMENT SOCIAL SUPPORT INTERVENTIONS FOR HEALTHY EATING IN THE COMMUNITY (FULTON COUNTY HEALTH DEPARTMENT) IMPLEMENT A SCHOOL-BASED NUTRITION EDUCATION PROGRAM (FULTON COUNTY HEALTH DEPARTMENT AND FULTON COUNTY SCHOOLS) IMPLEMENT SOCIAL SUPPORT INTERVENTIONS FOR PHYSICAL ACTIVITY IN THE COMMUNITY (FULTON COUNTY HEALTH DEPARTMENT) |
| FULTON COUNTY HEALTH CENTER | PART V, SECTION B, LINE 16J: FCHC HAS SIGNS POSTED AT EACH PLACE THAT REGISTERS PATIENTS TO INFORM THEM OF FINANCIAL ASSISTANCE AVAILABLE. ALSO, EACH BILLING STATEMENT SENT TO THE PATIENT PROVIDES INFORMATION ON WHO THE PATIENT MAY CONTACT FOR INFORMATION REGARDING FINANCIAL ASSISTANCE. IN ADDITION, FINANCIAL COUNSELORS VISIT CERTAIN PATIENTS IN THE EMERGENCY DEPARTMENT AND ON THE INPATIENT FLOORS TO DISCUSS THE FINANCIAL ASSISTANCE AVAILABLE TO THEM. FINALLY, FCHC PUBLICIZED THEIR POLICY THROUGH THE FOLLOWING WAYS: POSTED ON THE HOSPITAL FACILITY'S WEBSITE, ATTACHED TO BILLING INVOICES, POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOMS AND WAITING ROOMS, POSTED IN THE HOSPITAL FACILITY'S ADMISSIONS OFFICES, PROVIDED IN WRITING TO PATIENTS ON ADMISSION TO THE HOSPITAL FACILITY, AND MADE AVAILABLE UPON REQUEST. |
| PART V, LINE 10A | HTTPS://FULTONCOUNTYHEALTHDEPT.COM/DATA-RESOURCES/HEALTH-ASSESSMENTS |
| PART V, LINE 16 | 16A: HTTPS://WWW.FULTONCOUNTYHEALTHCENTER.ORG/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE/16B: HTTPS://WWW.FULTONCOUNTYHEALTHCENTER.ORG/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE/16C: HTTPS://WWW.FULTONCOUNTYHEALTHCENTER.ORG/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - FULTON MANOR | ||||
| 725 SOUTH SHOOP AVENUE | WAUSEON | OH | 43567 | SKILLED NURSING HOME |
| 2 - FCHC MEDICAL CARE LLC | ||||
| 725 SOUTH SHOOP AVENUE | WAUSEON | OH | 43567 | PHYSICIAN PRACTICES |
| 3 - FCHC PHARM LLC | ||||
| 725 SOUTH SHOOP AVENUE | WAUSEON | OH | 43567 | RETAIL PHARMACY |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | COST OF CHARITY CARE IS CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2. COST OF MEDICAID IS PER THE MEDICAID COST REPORT. THE REMAINING ITEMS ARE CALCULATED BASED ON ACTUAL COSTS OF SPECIFIC PROGRAMS WITHOUT THE USE OF A COST ACCOUNTING SYSTEM. |
| PART I, LN 7 COL(F): | THE AMOUNT OF BAD DEBT THAT WAS REMOVED FROM THE CALCULATION IN PART I COLUMN (F) TOTALED $3,254,492 |
| PART II, COMMUNITY BUILDING ACTIVITIES: | FCHC INCURRED $146,815 EXPENSES RELATED TO RECRUITING AND MAINTAINING QUALIFIED PHYSICIANS AND SPECIALISTS TO THE HOSPITAL. THESE PHYSICIANS AND SPECIALISTS ARE CRITICAL TO ENHANCING THE HEALTH AND LEVEL OF CARE PROVIDED TO THE COMMUNITY. WITHOUT FCHC RECRUITING AND MAINTAINING THESE PHYSICIANS, THE COMMUNITY WOULD NOT HAVE ACCESS TO THESE DOCTORS. |
| PART III, LINE 2: | FCHC CALCULATES BAD DEBT EXPENSE PER THE FINANCIAL STATEMENTS. |
| PART III, LINE 3: | FCHC USED A 6% CALCULATION OF TOTAL BAD DEBT PER THE FINANCIAL STATEMENTS IN ORDER TO ESTIMATE THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WOULD HAVE BEEN ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE PERCENTAGE IS ESTIMATED BASED ON PRIOR HISTORY AND REVIEW OF CHARITY LOGS.ANY BAD DEBT EXPENSE THAT IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY FINANCIAL ASSISTANCE POLICY WOULD BE RECLASSIFIED FROM BAD DEBT TO CHARITY CARE ONCE IT IS IDENTIFIED. THE ENTIRE AMOUNT OF THE BAD DEBT EXPENSE IS REVERSED AND ASSIGNED TO CHARITY CARE. |
| PART III, LINE 4: | FINANCIAL STATEMENT FOOTNOTE REGARDING BAD DEBT: ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS UNPAID CLAIMS BY CERTAIN PAYORS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS.IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OR REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRDPARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. |
| PART III, LINE 8: | THE MEDICARE SHORTFALL IS A COMMUNITY BENEFIT BECAUSE PROVIDING SERVICES TO THE ELDERLY IS A TAX EXEMPT PURPOSE CONSISTENT WITH FULTON'S OVERALL EXEMPT STATUS, AND THE HOSPITAL ACCEPTS THESE PATIENTS REGARDLESS OF ITS IMPACT ON OVERALL PROFITABILITY. MEDICARE ALLOWABLE COSTS TAKEN FROM THE FILED MEDICARE COST REPORT WERE CALCULATED USING A COST TO CHARGE RATIO. |
| PART III, LINE 9B: | THE PRACTICES FULTON COUNTY HEALTH CENTER UTILIZES TO COLLECT FROM PATIENTS INCLUDES: PATIENTS ARE SENT STATEMENTS FOR OUTSTANDING BALANCES FOR A PERIOD OF TIME NOT LESS THAN 105 DAYS, AFTER AN EFFORT HAS BEEN MADE TO COLLECT THE BALANCE OR PLAN A PATIENT-PAY ACCOUNT PAYMENT PLAN THROUGH A SERIES OF 4 LETTERS AND 2 TELEPHONE CONTACTS DURING THE AFTERMENTIONED 120 DAY PERIOD, THE ACCOUNT IS TURNED OVER TO A COLLECTION AGENCEY FOR FURTHER COLLECTION EFFORTS OR LEGAL ACTION. COLLECTION EFFORTS ARE NOT ENFORCED FOR BALANCES KNOWN TO QUALIFY UNDER CHARITY CARE OR OTHER FINANCIAL ASSISTANCE CRITERIA. |
| PART VI, LINE 2: | EVERY THREE YEARS, THE ORGANIZATION PERFORMS A COMMUNITY HEALTH NEEDS ASSESSMENT TO DETERMINE THE CURRENT HEALTH NEEDS WITHIN THE COMMUNITY. IN ADDITION, THE MEDICAL STAFF PROVIDES THE HOSPITAL WITH HEALTH CARE NEEDS WITHIN THE COMMUNITY BASED ON THEIR OWN PATIENT HEALTH CARE NEEDS. |
| PART VI, LINE 3: | FCHC HAS SIGNS POSTED AT EACH PLACE THAT REGISTERS PATIENTS TO INFORM THEM OF FINANCIAL ASSISTANCE AVAILABLE. ALSO, EACH BILLING STATEMENT SENT TO THE PATIENT PROVIDES INFORMATION ON WHO THE PATIENT MAY CONTACT FOR INFORMATION REGARDING FINANCIAL ASSISTANCE. IN ADDITION, FINANCIAL COUNSELORS VISIT CERTAIN PATIENTS IN THE EMERGENCY DEPARTMENT AND ON THE INPATIENT FLOORS TO DISCUSSS THE FINANCIAL ASSISTANCE AVAILABLE TO THEM. FINALLY, FCHC PUBLICIZED THEIR POLICY THROUGH THE FOLLOWING WAYS: POSTED ON THE HOSPITAL FACILITY'S WEBSITE, ATTACHED TO BILLING INVOICES, POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOMS AND WAITING ROOMS, POSTED IN THE HOSPITAL FACILITY'S ADMISSIONS OFFICES, PROVIDED IN WRITING TO PATIENTS ON ADMISSION TO THE HOSPITAL FACILITY, AND MADE AVAILABLE UPON REQUEST. |
| PART VI, LINE 4: | FCHC SERVES FULTON COUNTY, OHIO AS THE PRIMARY SERVICE AREA, AS WELL AS PORTIONS OF HENRY AND WILLIAMS COUNTIES IN OHIO AND MORENCI, MICHIGAN AS THE SECONDARY SERVICE AREA. THE ORGANIZATION IS A RURAL COMMUNITY. THE HOSPITAL SERVES ALL RESIDENTS WITH VARIOUS DEMOGRAPHIC CHARACTERISTICS. THE POPULATION THAT THE HOSPITAL SERVICES RANGES FROM 40,000 TO 45,000. THERE ARE NO OTHER HOSPITALS IN FULTON COUNTY. THE PERCENTAGE OF PERSONS BELOW THE POVERTY LEVEL IS APPROXIMATELY 8-10%. THE AVERAGE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $61,290. APPROXIMATELY 8.6% OF FULTON COUNTY RESIDENTS ARE UNINSURED. ALMOST 70% OF RESIDENTS ARE ADULTS OVER THE AGE OF 18, 5.7% ARE UNDER THE AGE OF 5 AND 19% ARE OVER THE AGE OF 65. THE MAJORITY (86.5%) OF THE POPULATION ARE CAUCASIAN. HISPANICS (9.3%), AFRICAN AMERICANS (<1%), ASIAN (<1%) AND TWO OR MORE RACES (1.5%) COMPRISE THE REST OF THE POPULATION. |
| PART VI, LINE 5: | ALL OF THE ORGANIZATION'S BOARD MEMBERS RESIDE IN THE SERVICE AREA OF THE HOSPITAL. BOARD MEMBERS REPRESENT THE INDIVIDUALS WHO LIVE IN THE CITIES AND VILLAGES OF FULTON COUNTY AND ARE NOT INDEPENDENT CONTRACTORS OF THE ORGANIZATION. IN ADDITION, IN 2020, OUR BOARD HAD ONE EMPLOYED FCHC DOCTOR WHO IS REPRESENTING THE MEDICAL STAFF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY THAT MEET THE MEDICAL STAFF BYLAW REQUIREMENTS. THE ORGANIZATION REINVESTS SURPLUS FUNDS INTO THE ORGANIZATION IN THE FORM OF NEW EQUIPMENT, RENOVATIONS, AND ADDITIONAL SERVICES. THE ORGANIZATION HAD 14% OF ITS REVENUE SOURCED FROM MEDICAID AND UNINSURED PATIENTS. |
| PART VI, LINE 6: | N/A |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FULTON COUNTY HISTORICAL SOCIETY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 104 | AddressLine1Txt |
| City | WAUSEON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43567 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 341413958 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $10,000 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | CAPITAL FUND FOR MUSEUM & WELCOME CENTER OF FULTON COUNTY | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | FCHC REVIEWS MANY GRANT REQUESTS THROUGHOUT THE YEAR. ALL GRANTS ARE AT THE DISCRETION OF THE EXECUTIVE DIRECTOR AND BOARD MEMBERS WHO DETERMINE THE AMOUNT OF GRANTS BASED ON THE NEEDS OF THE COMMUNITY. FCHC ROUTINELY ISSUES DONATIONS TO LOCAL NONPROFIT ORGANIZATIONS AND CHARITIES. EMPLOYEES AND BOARD MEMBERS OF FCHC ARE ABLE TO INDIRECTLY MONITOR THE NONPROFITS IN WHICH THEY DONATE TO DUE TO THE NATURE OF THE SMALL COMMUNITY WHERE THE HOSPITAL RESIDES. IN 2021, THERE WAS ONE ORGANIZATIONAL GRANT GREATER THAN $5,000. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DANIEL MCKERNAN | ||||||||||||||
| PHYSICIAN | $786,342 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $29,545 | $0 | $815,887 | $0 | $0 | $0 |
| CHRISTOPHER SPIELES | ||||||||||||||
| PHYSICIAN | $691,597 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $34,400 | $0 | $725,997 | $0 | $0 | $0 |
| CHARLES LASH | ||||||||||||||
| PHYSICIAN | $447,594 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $10,578 | $0 | $458,172 | $0 | $0 | $0 |
| SEMEGHAGHA FOFUNG | ||||||||||||||
| PHYSICIAN | $323,862 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $23,019 | $0 | $346,881 | $0 | $0 | $0 |
| ALAN RIVERA | ||||||||||||||
| HOSPITALIST | $330,834 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $9,524 | $0 | $340,358 | $0 | $0 | $0 |
| PATRICIA A FINN | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $234,057 | $0 | $0 | $0 | $0 | $0 | $12,068 | $0 | $27,665 | $0 | $273,790 | $0 | $0 | $0 |
| REBECCA TAYLOR | ||||||||||||||
| CHIEF OPERATING OFFICER | $168,201 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $16,472 | $0 | $184,673 | $0 | $0 | $0 |
| JENEE SEIBERT | ||||||||||||||
| DIRECTOR OF FINANCE | $137,729 | $0 | $0 | $0 | $0 | $0 | $7,057 | $0 | $10,951 | $0 | $155,737 | $0 | $0 | $0 |
| TIFFANY SEIGEL | ||||||||||||||
| DIRECTOR OF NURSING | $137,615 | $0 | $0 | $0 | $0 | $0 | $7,134 | $0 | $10,490 | $0 | $155,239 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| DAWN M KOLB | |||
| EMPLOYEE OF FCHC/WIFE TO BRETT KOLB (BOARD MEMBER) | $61,962 | W-2 WAGES | 0 |
| JANET M BUEHRER | |||
| EMPLOYEE OF FCHC/SISTER TO SHARON GILLEPSIE (BOARD MEMBER) | $62,071 | W-2 WAGES | 0 |
| CLAIRE KOLB | |||
| EMPLOYEE OF FCHC/DAUGHTER TO BRETT KOLB (BOARD MEMBER) | $23,690 | W-2 WAGES | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 IS PROVIDED TO AND REVIEWED BY EACH OF THE ORGANIZATION'S BOARD OF DIRECTORS, DIRECTOR OF FINANCE - JENEE SEIBERT, AND CHIEF EXECUTIVE OFFICER - PATRICIA A. FINN, BEFORE THE FORM IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST QUESTIONNAIRES ARE DISTRIBUTED ANNUALLY TO THE BOARD OF DIRECTORS AND DEPARTMENT HEADS. NEW BOARD MEMBERS ARE INTERVIEWED BY THE ADMINISTRATOR AND AT THAT TIME, DISCUSS WHETHER ANY CONFLICTS OF INTEREST EXIST. THE BOARD MEMBER IS PRESENTED TO THE EXECUTIVE COMMITTEE WHO REVIEWS ALL PERTINENT INFORMATION TO DETERMINE IF THERE IS A CONFLICT OF INTEREST AND WHETHER THAT PERSON CAN SERVE AS A BOARD MEMBER. VENDORS ARE REVIEWED REGULARLY BY DEPARTMENT HEADS TO DETERMINE IF ANY RELATIONSHIPS EXIST PER THE CONFLICT OF INTEREST QUESTIONNAIRES. AN OFFICER, DIRECTOR, OR KEY EMPLOYEE WHO HAS A CONFLICT OF INTEREST SHALL DISCLOSE THE CONFLICT OF INTEREST WHEN IT ARISES, AND BEFORE ACTION ON THE TRANSACTION OR CLAIM IN QUESTION. DISCLOSURE IS REQUIRED EVEN IF A DECISION CONCERNING THE TRANSACTION OR CLAIM IS NOT SUBJECT TO APPROVAL BY THE OFFICER, DIRECTOR, OR KEY EMPLOYEE OR THE BOARD OR COMMITTEE ON WHICH THE OFFICER, DIRECTOR, OR KEY EMPLOYEE SERVES. THE POLICY PROVIDES A PROCEDURE FOR REPORTING POTENTIAL CONFLICTS WHEN THEY ARISE AND BEFORE ACTION TO APPROVE OR AUTHORIZE THE TRANSACTION IS TAKEN. THE POLICY COVERS DIRECTORS, OFFICERS, EMPLOYEES OR AGENTS OF FULTON COUNTY HEALTH CENTER AND MEMBERS OF COMMITTEES AUTHORIZED TO APPROVE TRANSACTIONS OR ASSERT CLAIMS ON BEHALF OF THE FULTON COUNTY HEALTH CENTER. THE BOARD OF DIRECTORS, OTHER THAN ANY BOARD MEMBER DIRECTLY INVOLVED WITH THE CONFLICT, DETERMINES WHETHER A CONFLICT OF INTEREST INVOLVING AN INDIVIDUAL COVERED BY THE POLICY EXISTS AND REVIEWS ACTUAL CONFLICTS. INDIVIDUALS WITH CONFLICTS ARE NOT PERMITTED TO PARTICIPATE IN DELIBERATIONS OR VOTE TO AUTHORIZE A TRANSACTION OR ASSERTION OF A CLAIM. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER, PATRICIA A. FINN, IS APPROVED BY THE BOARD OF DIRECTORS. THE ORGANIZATION PARTICIPATES WITH THE OHA AND USES THEIR WAGE SURVEYS TO HELP DETERMINE THE CEO'S COMPENSATION. THE CEO'S COMPENSATION IS REVIEWED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AND DECISIONS ARE DOCUMENTED IN THE BOARD OF DIRECTOR MEETING MINUTES. THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES ARE REVIEWED BY THE BOARD OF DIRECTORS. THE ORGANIZATION PARTICIPATES WITH THE OHA AND USES THEIR WAGE SURVEYS TO HELP DETERMINE OFFICER COMPENSATION. THE BOARD APPROVES THE COMPENSATION OF EMPLOYEES IN THE AGGREGATE. OFFICER COMPENSATION IS REVIEWED ANNUALLY AND DECISIONS ARE DOCUMENTED IN THE BOARD OF DIRECTOR MEETING MINUTES. THE COMPENSATION REVIEW PROCESS FOR THE CEO, OFFICERS, AND KEY EMPLOYEES WAS LAST PERFORMED IN FEBRUARY 2021. A COST OF LIVING RAISE WAS LAST RECEIVED AT THE BEGINNING OF 2020. THIS WAGE INCREASE WAS CONSISTENT WITH THE WAGE INCREASE FOR ALL FCHC PERSONNEL. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 6,005,874. MANAGEMENT AND GENERAL EXPENSES 182,032. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,187,906. HUMAN RESOURCES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 50,016. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 50,016. CONSULTING: PROGRAM SERVICE EXPENSES 2,484. MANAGEMENT AND GENERAL EXPENSES 150,706. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 153,190. DIRECTORSHIP/HOUSEKEEPING/OTHER SERVICES: PROGRAM SERVICE EXPENSES 505,942. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 505,942. BILLING & COLLECTIONS: PROGRAM SERVICE EXPENSES 754,507. MANAGEMENT AND GENERAL EXPENSES 42,598. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 797,105. CONTRACTED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 2,589,574. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,589,574. RECRUITMENT: PROGRAM SERVICE EXPENSES 71,616. MANAGEMENT AND GENERAL EXPENSES 93,212. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 164,828. DATA PROCESSING: PROGRAM SERVICE EXPENSES 82,118. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 82,118. MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 58,823. MANAGEMENT AND GENERAL EXPENSES 31,603. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 90,426. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 60,450. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 60,450. |
| FORM 990, PART XI, LINE 9: | MEDICAL STAFF & AUXILIARY TRIAL BALANCE ADJUSTMENT 308. |
| FORM 990, PART XII, LINE 2C: | THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS HAS NOT CHANGED SINCE THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| FCHC MEDICAL CARE LLC | |||||||||
| 725 S SHOOP AVE | WAUSEON | OH | 435671702 | 010877201 | PHYSICIAN BILLING AND PHYSICIAN PRACTICES | OH | $9,855,761 | $2,990,813 | FULTON COUNTY HEALTH CENTER |
| FCHC MEDICAL SERVICES LLC | |||||||||
| 725 S SHOOP AVE | WAUSEON | OH | 435671702 | 010877202 | HOLD LAND | OH | $0 | $188,848 | FULTON COUNTY HEALTH CENTER |
| FULTON COUNTY HOLDINGS LLC | |||||||||
| 725 S SHOOP AVE | WAUSEON | OH | 435671702 | 852814768 | HOLD LAND | OH | $0 | $1,757,917 | FULTON COUNTY HEALTH CENTER |
| FCHC PHARM LLC | |||||||||
| 725 S SHOOP AVE | WAUSEON | OH | 435671702 | 833101408 | RETAIL PHARMACY | OH | $3,493,330 | $708,788 | FULTON COUNTY HEALTH CENTER |