FISHER TITUS HEALTH: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- FISHER TITUS HEALTH (EIN 34-1476935)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-13
- IRS object ID
- 202113179349301611
- Schema version
- 2020v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-13T10:15:04-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9200 WORTHINGTON RD STE 200 | AddressLine1Txt |
| City | WESTERVILLE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43082 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341476935 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FISHER-TITUS HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FISH | BusinessNameControlTxt |
| Phone | 4196688101 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 272 BENEDICT AVENUE | AddressLine1Txt |
| City | NORWALK | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44857 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SCOTT E ENDSLEY | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 4196688101 | PhoneNum |
| Signature | 2021-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SCOTT | PersonFirstNm |
| Person Last | ENDSLEY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | NATHAN A RODGERS CPA | PreparerPersonNm |
| PTIN | P01568275 | PTIN |
| Phone | 6148852583 | PhoneNum |
| Preparation | 2021-11-09 | 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 | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BRENT W BURKEY MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 272 BENEDICT AVENUE | AddressLine1Txt |
| City | NORWALK | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44857 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $17,782,265 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | NONE | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1985 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | FISHER-TITUS HEALTH PROVIDES DIRECTION TO EACH SUPPORTED 501(C)(3) ORGANATION. FISHER-TITUS HEALTH COORDINATES LONG TERM PLANNING, PROVIDES MANAGMENT AND CENTRALIZED CONTROL OVER THE SYSTEMS OPERATIONS AND PROGRAMS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 169 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,351,938 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,730,226 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$67,704 | PYInvestmentIncomeAmt |
| CY Investment Income | $16,621 | CYInvestmentIncomeAmt |
| PY Other Revenue | $20,191 | PYOtherRevenueAmt |
| CY Other Revenue | $14,982 | CYOtherRevenueAmt |
| PY Total Revenue | $13,304,425 | PYTotalRevenueAmt |
| CY Total Revenue | $17,761,829 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,199,663 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $20,726,663 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,388,552 | PYOtherExpensesAmt |
| CY Other Expenses | $6,276,838 | CYOtherExpensesAmt |
| PY Total Expenses | $23,588,215 | PYTotalExpensesAmt |
| CY Total Expenses | $27,003,501 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$10,283,790 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$9,241,672 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $25,224,851 | TotalAssetsBOYAmt |
| Total Assets EOY | $24,384,959 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,547,570 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,840,714 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,677,281 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,544,245 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO OVERSEE AND COORDINATE HEALTH-RELATED SERVICES OF FISHER-TITUS HEALTH MEMBERS AND TO SUPPORT THEIR INDIVIDUAL MISSIONS OF ENHANCING THE HEALTH, WELFARE, AND SAFETY OF THEIR PATIENTS AND OF THE RESIDENTS IN THE COMMUNITIES THEY SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $26,906,550 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $17,615,536 | RevenueAmt |
| Desc | FISHER-TITUS MEDICAL CARE, LLC IS A MULTISPECIALTY PHYSICIAN AND ALLIED HEALTH PROFESSIONAL PRACTICE WITH OFFICES LOCATED THROUGHOUT THE PRIMARY AND SECONDARY SERVICE AREAS. THESE PRACTICES SEEK TO IMPROVE THE HEALTH AND WELLNESS OF ALL PEOPLE IN THE COMMUNITY BY INTEGRATING ALL ASPECTS OF CARE. WE DO THIS BY DELIVERING HIGH QUALITY, HIGH VALUE CARE COORDINATED ACROSS THE CONTINUUM FOCUSED ON THE PATIENTS WE SERVE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $80,919 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | FISHER-TITUS HEALTH BELIEVES IN LOCAL GUIDANCE AND COORDINATION OF HEALTH CARE SERVICES. TO THAT END, FISHER-TITUS HEALTH CONTRIBUTED FUNDING TO THE BELLEVUE HOSPITAL TO PARTICIPATE IN THE OWNERSHIP AND BOARD REPRESENTATION OF THEIR LOCAL HOSPITAL. BECAUSE OF FISHER-TITUS HEALTH'S FUNDING AND SIMILAR FUNDING BY ANOTHER 501(C)(3) HOSPITAL, THE BELLEVUE COMMUNITY WAS ABLE TO BUILD A NEW, FULL SERVICE COMMUNITY HOSPITAL TO SERVE THE PATIENTS OF THEIR SERVICE AREA. CLEARLY, THIS WILL ENHANCE THE SERVICE CAPABILITIES IN THE BELLEVUE COMMUNITY AND ALLOW FOR EXPANSION AND GROWTH BETWEEN BELLEVUE AND FISHER-TITUS HEALTH AND BRING MORE MEDICAL SERVICES TO BOTH OF OUR AREAS, THROUGH THIS COOPERATIVE EFFORT IN JOINTLY RECRUITING PHYSICIANS AND MUTUALLY DEVELOPING SERVICES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,204 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $114,690 | RevenueAmt |
| Desc | FISHER-TITUS HEALTH PROVIDES GENERAL DIRECTION TO EACH SUPPORTED 501(C)(3) ORGANIZATION. FISHER-TITUS HEALTH COORDINATES LONG TERM STRATEGIC PLANNING, PROVIDES MANAGEMENT AND CENTRALIZED CONTROL OVER THE SYSTEMS OPERATIONS AND PROGRAMS DESIGNED TO ENHANCE THE HEALTH AND WELFARE OF RESIDENTS IN THE COMMUNITIES SERVED BY THE SUPPORTED ORGANIZATIONS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $26,992,673 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (1) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 28 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 169 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID WILSON MBACMAFHFMA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4196688101 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 272 BENEDICT AVENUE | AddressLine1Txt |
| City | NORWALK | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44857 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 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 |
|---|---|---|---|---|---|---|---|---|
| BRENT W BURKEY MD | ||||||||
| PRESIDENT & CEO | 5.00 | 60.00 | Yes (X) | Yes (X) | $0 | $505,149 | $56,365 | |
| JOHN K HUGHES MD | ||||||||
| DIRECTOR-STARTED 05/20 | 41.00 | 5.00 | Yes (X) | $294,428 | $0 | $69,805 | ||
| DENNIS DOUGHTY | ||||||||
| CHAIRMAN | 1.50 | 16.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PERRY DRYDEN | ||||||||
| VICE CHAIRMAN | 1.00 | 11.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DENNIS C CAMP | ||||||||
| TREASURER | 1.00 | 13.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| REV FRED E WIECHERS | ||||||||
| SECRETARY-ENDED 04/20 | 1.00 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JULIE S ROBERTS DDS | ||||||||
| DIRECTOR/SECRETARY | 1.00 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SUSAN S HAZEL | ||||||||
| DIRECTOR | 1.00 | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| JEFFREY C HUBER | ||||||||
| DIRECTOR | 1.00 | 6.00 | Yes (X) | $0 | $0 | $0 | ||
| JONATHAN D ZAHLER DO | ||||||||
| DIRECTOR | 1.00 | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| MARK E CORIELL | ||||||||
| DIRECTOR | 1.00 | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN A LENDRUM | ||||||||
| DIRECTOR-STARTED 05/20 | 1.00 | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| NICHOLAS J LIBEN JR DO | ||||||||
| DIRECTOR-ENDED 12/20 | 1.00 | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| SCOTT E ENDSLEY | ||||||||
| CHIEF FINANCIAL OFFICER | 3.00 | 57.00 | Yes (X) | $0 | $246,977 | $40,664 | ||
| MATTHEW E MATTNER | ||||||||
| CHIEF OPERATIONS OFFICER | 2.50 | 47.50 | Yes (X) | $0 | $300,823 | $65,439 | ||
| MAHER SALAM MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $853,120 | $0 | $43,600 | Yes (X) | ||
| PATRICK R WATERS MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $761,105 | $0 | $41,142 | Yes (X) | ||
| SULIEMAN ABDAL RAHEEM MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $697,837 | $0 | $43,738 | Yes (X) | ||
| GREGORY P COOK MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $678,499 | $0 | $39,341 | Yes (X) | ||
| DONALD L SMITH JR MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $627,427 | $0 | $34,475 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,912,416 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,052,949 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $434,569 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 43 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CERNER CORPORATION | |||||
| 2800 ROCKCREEK PARKWAY | KANSAS CITY | MO | 64117 | HEALTHCARE INFORMATION TECHNOLOGY | $240,936 |
| TRUST HEALTH CONSULTING | |||||
| 2042 SOUTH BRENTWOOD BLVD | SPRINGFIELD | MO | 65804 | PROFESSIONAL FEE CODING | $115,635 |
| VIKRAM KUMAR MD | |||||
| 673 EAST RIVER STREET | ELYRIA | OH | 44035 | ENDOCRINOLOGY PROFESSIONAL FEE | $105,300 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET MEDICAL CARE LLC REVENUE | 621100 | $17,615,536 | $17,615,536 |
| RENTAL INCOME | 621300 | $114,690 | $114,690 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,730,226 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,779 | TotalRevenueColumnAmt |
| Exclusion | $18,779 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $600 | TotalRevenueColumnAmt |
| Exclusion | $600 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $30,600 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $15,618 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $14,982 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,982 | TotalRevenueColumnAmt |
| Exclusion | $14,982 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,060 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $4,818 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$2,758 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$2,758 | TotalRevenueColumnAmt |
| Exclusion | -$2,758 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,761,829 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,730,226 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $31,603 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,652,415 | TotalAmt |
| Program Services | $17,652,415 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $548,897 | TotalAmt |
| Program Services | $548,897 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,467,176 | TotalAmt |
| Program Services | $1,467,176 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,058,175 | TotalAmt |
| Program Services | $1,058,175 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,135,361 | TotalAmt |
| Program Services | $2,127,645 | ProgramServicesAmt |
| Management And General | $7,716 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294,412 | TotalAmt |
| Program Services | $291,300 | ProgramServicesAmt |
| Management And General | $3,112 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,234 | TotalAmt |
| Program Services | $70,234 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $994,191 | TotalAmt |
| Program Services | $994,191 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,805 | TotalAmt |
| Program Services | $5,805 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,901 | TotalAmt |
| Program Services | $141,901 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,870 | TotalAmt |
| Program Services | $82,870 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $840,227 | TotalAmt |
| Program Services | $840,227 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $513,944 | TotalAmt |
| Program Services | $513,944 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLIES | $1,197,328 | $1,197,328 |
| DUES AND SUBSCRIPTIONS | $539 | $539 |
| UBI INCOME TAX | $26 | $26 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,003,501 | TotalAmt |
| Program Services | $26,992,673 | ProgramServicesAmt |
| Management And General | $10,828 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,089,972 | BOYAmt |
| EOY | $647,211 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,151,798 | BOYAmt |
| EOY | $1,163,707 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $119,215 | BOYAmt |
| EOY | $43,576 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $408,471 | BOYAmt |
| EOY | $384,129 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $87,397 | BOYAmt |
| EOY | $125,278 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $205,935 | BOYAmt |
| EOY | $353,956 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $10,523,568 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,410,696 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,609,272 | BOYAmt |
| EOY | $7,112,872 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $224,817 | BOYAmt |
| EOY | $224,380 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $489,825 | BOYAmt |
| EOY | $442,607 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,838,149 | BOYAmt |
| EOY | $13,887,243 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,224,851 | BOYAmt |
| EOY | $24,384,959 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,200,994 | BOYAmt |
| EOY | $1,936,378 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,166,658 | BOYAmt |
| EOY | $2,664,016 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $179,918 | BOYAmt |
| EOY | $240,320 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,547,570 | BOYAmt |
| EOY | $4,840,714 | 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 | $19,677,281 | BOYAmt |
| EOY | $19,544,245 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,677,281 | BOYAmt |
| EOY | $19,544,245 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,224,851 | BOYAmt |
| EOY | $24,384,959 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$9,241,672 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $9,108,636 | OtherChangesInNetAssetsAmt |
| 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 | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| Supported Organizations | 3 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (3 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| FISHER-TITUS MEDICAL CENTER | ||||
| 344430716 | 3 | Yes (1) | $0 | $0 |
| FISHER-TITUS FOUNDATION | ||||
| 341476937 | 7 | Yes (1) | $0 | $0 |
| FISHER-TITUS AFFILIATED SERVICES | ||||
| 341476934 | 10 | Yes (1) | $261,000 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 3 | SupportedOrganizationsTotalCnt |
| Support Sum | $261,000 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timely Provided Documents | Yes (1) | TimelyProvidedDocumentsInd |
| Officers Close Relationship | Yes (1) | OfficersCloseRelationshipInd |
| Supported Org Voice Investment | 0 | SupportedOrgVoiceInvestmentInd |
Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Parent Supported Org | Yes (X) | ParentSupportedOrgInd |
| Appoint Elect Majority Officer | Yes (1) | AppointElectMajorityOfficerInd |
| Exercise Direction Policies | Yes (1) | ExerciseDirectionPoliciesInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, SECTION E, LINE 3A | THE BOARD OF DIRECTORS OF FISHER-TITUS HEALTH ARE THE SAME BOARD MEMBERS FOR FISHER-TITUS MEDICAL CENTER AND FISHER-TITUS AFFILIATED SERVICES. THE FISHER-TITUS HEALTH BOARD OF DIRECTORS HAS THE POWER TO APPOINT THE BOARD OF DIRECTORS OF THE FISHER-TITUS FOUNDATION. THE SENIOR LEADERSHIP TEAM OF FISHER-TITUS HEALTH OVERSEES THE MANAGEMENT OF ALL OF THE SUPPORTED ORGANIZATIONS. |
| PART IV, SECTION E, LINE 3B | THE BOARD OF DIRECTORS OF FISHER-TITUS HEALTH ARE THE SAME BOARD MEMBERS FOR FISHER-TITUS MEDICAL CENTER AND FISHER-TITUS AFFILIATED SERVICES. THE FISHER-TITUS HEALTH BOARD OF DIRECTORS HAS THE POWER TO APPOINT THE BOARD OF DIRECTORS OF THE FISHER-TITUS FOUNDATION. THE SENIOR LEADERSHIP TEAM OF FISHER-TITUS HEALTH OVERSEES THE MANAGEMENT OF ALL OF THE SUPPORTED ORGANIZATIONS. |
| PART IV, SECTION D, LINE 1 | NOTIFICATION OF TYPE OF SUPPORT AND AMOUNT OF SUPPORT FOR EACH SUPPORTED ORGANIZATION IS GIVEN ON A MORE FREQUENT BASIS THAN THE ANNUAL WRITTEN NOTIFICATION. COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS ARE ON FILE WITH THE ORGANIZATION'S PRINCIPAL OFFICER WHO IS THE SAME PERSON FOR EACH OF THE SUPPORTED ORGANIZATIONS. ANY CHANGES TO THE ORGANIZATION'S GOVERNING DOCUMENTS ARE UPDATED AND GIVEN TO THE PRINCIPAL OFFICER. |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $17,600 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $191,130 | OtherCostOrOtherBasisAmt |
| Book Value | $208,730 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $403,082 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $1,740,138 | OtherCostOrOtherBasisAmt |
| Depreciation | $919,421 | DepreciationAmt |
| Book Value | $1,223,799 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $117,629 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $7,839,701 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,356,805 | DepreciationAmt |
| Book Value | $5,600,525 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $18,292 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $195,996 | OtherCostOrOtherBasisAmt |
| Depreciation | $134,470 | DepreciationAmt |
| Book Value | $79,818 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,112,872 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| EQUITY IN THE BELLEVUE HOSPITAL | $12,623,574 |
| DUE FROM AFFILIATED ENTITIES | $309,349 |
| INVESTMENT FT SHARED SERVICES | $714,000 |
| RIGHT OF USE ASSET | $240,320 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $13,887,243 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OPERATING LEASE | Desc |
| Amt | $240,320 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $240,320 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $18,406,886 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $638,793 | OtherRevenueAmt |
| Revenue Not Reported | $638,793 | RevenueNotReportedAmt |
| Revenue Subtotal | $17,768,093 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$6,264 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$6,264 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $17,761,829 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $26,919,810 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $6,264 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $6,264 | ExpensesNotReportedAmt |
| Expenses Subtotal | $26,913,546 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $89,955 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $89,955 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $27,003,501 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THESE ENTITIES, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2020 AND 2019, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE ENTITIES ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. FISHER-TITUS HEALTH INDIVIDUAL ACCRUED UNCERTAIN TAX POSITION WAS $0.00. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | NORWALK AREA HEALTH SYSTEMS GAIN/LOSS ON HOSPITAL INVESTMENT 728,748. BELLEVUE INTEREST EXPENSE ADJUSTMENTS TO REVENUES -80,919. MEDICAL CARE LLC ADJUSTMENTS TO REVENUES -9,036. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENTAL EXPENSES -6,264. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 6,264. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | SYSTEM EXPENSE ADJUSTMENTS TO REVENUES 80,919. MEDICAL CARE LLC ADJUSTMENTS TO REVENUES 9,036. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MAHER SALAM MD | ||||||||||||||
| PHYSICIAN | $796,798 | $0 | $34,157 | $0 | $22,165 | $0 | $9,974 | $0 | $33,626 | $0 | $896,720 | $0 | $0 | $0 |
| PATRICK R WATERS MD | ||||||||||||||
| PHYSICIAN | $570,703 | $0 | $168,263 | $0 | $22,139 | $0 | $11,400 | $0 | $29,742 | $0 | $802,247 | $0 | $0 | $0 |
| SULIEMAN ABDAL RAHEEM MD | ||||||||||||||
| PHYSICIAN | $560,646 | $0 | $134,508 | $0 | $2,683 | $0 | $11,400 | $0 | $32,338 | $0 | $741,575 | $0 | $0 | $0 |
| GREGORY P COOK MD | ||||||||||||||
| PHYSICIAN | $541,285 | $0 | $115,189 | $0 | $22,025 | $0 | $11,400 | $0 | $27,941 | $0 | $717,840 | $0 | $0 | $0 |
| DONALD L SMITH JR MD | ||||||||||||||
| PHYSICIAN | $409,765 | $0 | $195,838 | $0 | $21,824 | $0 | $11,400 | $0 | $23,075 | $0 | $661,902 | $0 | $0 | $0 |
| BRENT W BURKEY MD | ||||||||||||||
| PRESIDENT & CEO | $0 | $445,250 | $0 | $15,000 | $0 | $44,899 | $0 | $55,440 | $0 | $925 | $0 | $561,514 | $0 | $42,237 |
| MATTHEW E MATTNER | ||||||||||||||
| CHIEF OPERATIONS OFFICER | $0 | $264,040 | $0 | $15,000 | $0 | $21,783 | $0 | $39,960 | $0 | $25,479 | $0 | $366,262 | $0 | $0 |
| JOHN K HUGHES MD | ||||||||||||||
| DIRECTOR-STARTED 05/20 | $275,789 | $0 | $500 | $0 | $18,139 | $0 | $40,936 | $0 | $28,869 | $0 | $364,233 | $0 | $0 | $0 |
| SCOTT E ENDSLEY | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $0 | $220,055 | $0 | $15,000 | $0 | $11,922 | $0 | $32,266 | $0 | $8,398 | $0 | $287,641 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | RESPONSIBILTY FOR DETERMINING AND RECOMMENDING EXECUTIVE COMPENSATION RESTS WITH THE PERSONNEL COMMITTEE OF THE FISHER-TITUS HEALTH BOARD. THE COMMITTEE RETAINS AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO HELP ESTABLISH CASH COMPENSATION TARGET RANGES AND IDENTIFY REASONABLE AND CUSTOMARY BENEFIT PROGRAMS FOR EXECUTIVES. THE INDEPENDENT CONSULTANT REPORTS TO THE PERSONNEL COMMITTEE ON RELEVANT PEER GROUPS, CASH COMPENSATION REPORTED IN AVAILABLE SALARY SURVEYS FOR THE PEER GROUP AND TRENDS IN PERQUISITE PROGRAMS CUSTOMARILY AVAILABLE AMONG THE PEER GROUP FOR EXECUTIVES. RECOMMENDATIONS BY THE CONSULTANT ARE PRESENTED TO THE PERSONNEL COMMITTEE WHICH PREPARES MINUTES OF ITS DELIBERATIONS REGARDING EXECUTIVE COMPENSATION INCLUDING RECOMMENDATIONS THAT ARE THEN PROVIDED TO EACH OF THE DIRECTORS OF THE FISHER-TITUS HEALTH BOARD. THE RECOMMENDATIONS TO BE ACTED ON MUST BE APPROVED BY THE PERSONNEL COMMITTEE AND THEN BY THE FISHER-TITUS HEALTH BOARD OF DIRECTORS. THE MINUTES OF EACH BOARD MEETING WHERE SUCH ACTION IS TAKEN REFLECT SUCH ACTION. THIS IS DONE ANNUALLY AND WAS LAST DONE IN MARCH 2020. |
| PART I LINE 4B & PART II, LINE 8 | INCLUDED IN DR. HUGHES'S TOTAL CONTRIBUTION TO DEFERRED COMPENSATION OF $40,936 REPORTED IN COLUMN C IS $11,400 OF VESTED DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $29,536 FOR THE CURRENT YEAR ACCRUAL OF A NON-VESTED, NON-QUALIFIED RETIREMENT PLAN. THIS PLAN PROVIDES AN ADDITIONAL BENEFIT BASED ON YEARS OF ELIGIBLE SERVICE AND VESTED STATUS AND REMAINS SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. |
| PART I LINE 4B & PART II, LINE 6 | INCLUDED IN DR. BURKEY'S TOTAL CONTRIBUTION TO DEFERRED COMPENSATION OF $55,440 REPORTED IN COLUMN C IS $11,400 OF VESTED DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $44,040 FOR THE CURRENT YEAR ACCRUAL OF A NON-VESTED, NON-QUALIFIED RETIREMENT PLAN. THIS PLAN PROVIDES AN ADDITIONAL BENEFIT BASED ON YEARS OF ELIGIBLE SERVICE AND VESTED STATUS AND REMAINS SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. |
| PART I LINE 4B & PART II, LINE 9 | INCLUDED IN MR. ENDSLEY'S TOTAL CONTRIBUTION TO DEFERRED COMPENSATION OF $32,266 REPORTED IN COLUMN C IS $9,027 OF VESTED DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $23,238 FOR THE CURRENT YEAR ACCRUAL OF A NON-VESTED, NON-QUALIFIED RETIREMENT PLAN. THIS PLAN PROVIDES AN ADDITIONAL BENEFIT BASED ON YEARS OF ELIGIBLE SERVICE AND VESTED STATUS AND REMAINS SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. |
| PART I LINE 4B & PART II, LINE 7 | INCLUDED IN MR. MATTNER'S TOTAL CONTRIBUTIONS TO DEFERRED COMPENSATION OF $39,960 REPORTED IN COLUMN C IS $11,400 OF VESTED DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $28,560 FOR THE CURRENT YEAR ACCRUAL OF A NON-VESTED, NON-QUALIFIED RETIREMENT PLAN. THIS PLAN PROVIDES AND ADDITIONAL BENEFIT BASED ON YEARS OF ELIGIBLE SERVICE AND VESTED STATUS AND REMAINS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. |
| PART II LINES 6, 7, AND 9 | DR. BRENT BURKEY, SCOTT ENDSLEY AND MATTHEW MATTNER ALL RECEIVED THEIR COMPENSATION FROM FISHER-TITUS MEDICAL CENTER, A RELATED ORGANIZATION. THIS INCLUDES COMPENSATION FOR A SIGNIFICANT AMOUNT OF DR. BURKEY'S 65 HOUR AVERAGE WORK WEEK, MR. ENDSLEY'S 60 HOUR AVERAGE WORK WEEK, AND MR. MATTNER'S 50 HOUR AVERAGE WORK WEEK DEVOTED TO THE FUNCTIONING OF FISHER-TITUS MEDICAL CENTER AS WELL AS UNCOMPENSATED TIME DEVOTED TO OTHER COMMONLY CONTROLLED ORGANIZATIONS LISTED IN SCHEDULE R. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COUNTY OF HURON OHIO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 346400672 | BondIssuerEIN |
| Bond Issued | 2015-04-02 | BondIssuedDt |
| Issue Price | $5,335,000 | IssuePriceAmt |
| Purpose | SEE PART VI | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $5,335,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $50,000 | IssuanceCostsFromProceedsAmt |
| Other Spent Proceeds | $5,285,000 | OtherSpentProceedsAmt |
| Substantial Completion | 2015 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (1) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PNC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 6.800000000000 | TermOfHedgePct |
| Superintegrated Hedge | Yes (1) | SuperintegratedHedgeInd |
| Hedge Terminated | 0 | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I LINE A | FormAndLineReferenceDesc |
| Explanation | PURPOSE WAS TO REFUND THE FISHER-TITUS HEALTH COUNTY OF HURON REVENUE BONDS, SERIES 2003B BONDS. THE 2003B BONDS WERE USED TO PROVIDE "FOR THE COST OF HOSPITAL FACILITIES" FOR THE BELLEVUE HOSPITAL, A 501(C)(3) NON-PROFIT ORGANIZATION, TO CONSTRUCT AND EQUIP A NEW ACUTE CARE HOSPITAL ON 109 ACRES IN THE CITY OF BELLEVUE. FISHER-TITUS HEALTH TOGETHER WITH FIRELANDS REGIONAL HEALTH SYSTEMS AND THE BELLEVUE HOSPITAL ASSOCIATION HAVE AGREED TO JOINTLY FINANCE THIS PROJECT. | ExplanationTxt |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MAHER SALAM | PersonNm |
| Relationship With Org | PHYSICIAN | RelationshipWithOrgTxt |
| Loan Purpose | SEE PART V | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $176,614 | OriginalPrincipalAmt |
| Balance Due | $43,576 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | 0 | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $43,576 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| BATTLES INSURANCE AGENCY | |||
| SEE PART V | $568,290 | VENDOR | 0 |
| MS SPETTEL | |||
| SEE PART V | $88,749 | EMPLOYMENT | 0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART II LINE 1 | FISHER-TITUS MEDICAL CENTER PROVIDED DR. SALAM WITH FINANCIAL ASSISTANCE TO COMPLETE A THREE-YEAR FELLOWSHIP TRAINING PROGRAM IN GASTROENTEROLOGY BEGINNING IN JULY 2009. IN AUGUST 2015, DR. SALAM ENTERED INTO AN EMPLOYMENT AGREEMENT WITH FISHER-TITUS MEDICAL CARE LLC ESTABLISHING A PRACTICE IN THE FISHER-TITUS MEDICAL CENTER'S SERVICEAREA. UPON ENTERING THE EMPLOYMENT AGREEMENT, THE FISHER-TITUS MEDICAL CARE LLC ASSUMED HIS FELLOWSHIP TRAINING FINANCIAL ASSISTANCE LOAN. THE FELLOWSHIP TRAINING FINANCIAL ASSISTANCE CONTAINED A TERM REQUIREMENT WHERE DR. SALAM AGREED TO PRACTICE IN THE MEDICAL CENTER'S SERVICE AREA FOR A PERIOD OF 7 YEARS. AS TIME EXPIRES ON THE 7 YEAR AGREEMENT TO SERVE THE LOCAL POPULATION, A PRORATED SHARE OF THE FELLOWSHIP FINANCIAL ASSISTANCE WAS FORGIVEN AND REPORTED AS INCOME TO DR. SALAM. |
| PART IV LINE 1 | PERRY DRYDEN, BOARD MEMBER IS PRESIDENT OF BATTLES INSURANCE AGENCY AND 50% OWNER |
| PART IV LINE 2 | MS. SPETTEL HAS A FAMILY RELATIONSHIP WITH BOARD MEMBER JULIE ROBERTS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARD OF DIRECTORS OF FISHER-TITUS HEALTH DELEGATED THE RESPONSIBILITY FOR THE REVIEW OF THE FISHER-TITUS HEALTH FORM 990 PLUS ALL REQUIRED SCHEDULES AND ATTACHMENTS TO THE FISHER-TITUS AUDIT COMMITTEE. THE MEMBERS OF THIS COMMITTEE HAVE A STRONG BACKGROUND IN ACCOUNTING, LEGAL, FINANCE AND BUSINESS AND HAVE THE TECHNICAL EXPERTISE TO PERFORM A SUBSTANTIVE REVIEW. THE AUDIT COMMITTEE REVIEWED THE FISHER-TITUS HEALTH'S FORM 990 PRIOR TO FILING AND REPORTED TO THE FISHER-TITUS HEALTH'S BOARD OF DIRECTORS REGARDING THE RESULTS OF THEIR REVIEW. IN ADDITION, EACH MEMBER OF THE FISHER-TITUS HEALTH'S BOARD OF DIRECTORS HAD ACCESS TO A COPY OF THE FORM 990 FOR VIEWING PRIOR TO FILING VIA A SECURE INTERNET WEBSITE. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL OF OUR AFFILATED CORPORATE BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT UPON JOINING THE BOARD AND ANNUALLY THROUGHOUT THEIR TENURE. THESE ARE RETAINED BY FISHER-TITUS MEDICAL CENTER ADMINISTRATION. AREAS OF CONFLICT ARE REVIEWED AND ADDRESSED AS NECESSARY FOR THE TRANSACTIONS OF THE BOARD. WHEN AN AREA OF CONFLICT ARISES, BOARD MEMBERS ARE EXCUSED AND PROHIBITED FROM PARTICIPATING IN THE BOARD'S DELIBERATIONS AND DECISIONS REGARDING THE AREA OF CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE FISHER-TITUS HEALTH OFFICERS RECEIVE ALL OF THEIR COMPENSATION FROM FISHER-TITUS MEDICAL CENTER, (FTMC) A RELATED ORGANIZATION. SUCH COMPENSATION IS SUBJECT TO THE GUIDANCE OF THE PERSONNEL COMMITTEE OF THE FISHER-TITUS HEALTH BOARD. THE COMMITTEE RETAINS AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO HELP ESTABLISH CASH COMPENSATION TARGET RANGES AND IDENTIFY REASONABLE AND CUSTOMARY BENEFIT PROGRAMS FOR EXECUTIVES. THE INDEPENDENT CONSULTANT REPORTS TO THE PERSONNEL COMMITTEE ON RELEVANT PEER GROUPS, CASH COMPENSATION REPORTED IN AVAILABLE SALARY SURVEYS FOR THE PEER GROUP AND TRENDS IN PERQUISITE PROGRAMS CUSTOMARILY AVAILABLE AMONG THE PEER GROUP FOR EXECUTIVES. RECOMMENDATIONS BY THE CONSULTANT ARE PRESENTED TO THE PERSONNEL COMMITTEE WHICH PREPARES MINUTES OF ITS DELIBERATIONS REGARDING EXECUTIVE COMPENSATION INCLUDING RECOMMENDATIONS THAT ARE THEN PROVIDED TO EACH OF THE DIRECTORS OF FISHER-TITUS HEALTH BOARD. THE RECOMMENDATIONS TO BE ACTED ON MUST BE APPROVED BY THE PERSONNEL COMMITTEE AND THEN BY THE FISHER-TITUS HEALTH BOARD OF DIRECTORS. THE MINUTES OF EACH BOARD MEETING WHERE SUCH ACTION IS TAKEN REFLECT SUCH ACTION. THIS IS DONE ANNUALLY AND WAS LAST DONE IN MARCH 2020. |
| FORM 990, PART VI, SECTION C, LINE 18 | AS REQUIRED, WE OFFER A TIMELY RESPONSE TO WRITTEN REQUESTS FOR COPIES OF THE 990, AS WELL AS HAVING THEM AVAILABLE ON THE PREMISES FOR THE PUBLIC TO REVIEW & ON THE GUIDESTAR INTERNET WEBSITE. |
| FORM 990, PART VI, SECTION C, LINE 19 | OUR CONFLICT OF INTEREST, CODE OF REGULATIONS, GOVERNING DOCUMENTS & FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST. |
| FORM 990, PART XI, LINE 9: | UNREALIZED GAIN/LOSS ON BELLEVUE HOSPITAL EQUITY METHOD INVESTMENT 728,748. THREE INTER-SYSTEM TRANSFER OF FUNDS BETWEEN AFFILIATED 501(C)(3) ORG. 8,401,765. PNC BANK SWAP PAYABLE VALUE CHANGE -21,877. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (3 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 |
|---|---|---|---|---|---|---|---|---|---|
| FISHER-TITUS MEDICAL CARE LLC | |||||||||
| 272 BENEDICT AVENUE | NORWALK | OH | 44857 | 161768258 | PHYSICIAN GROUP PRACTICE | OH | $17,615,536 | $9,066,587 | FISHER-TITUS HEALTH |
| FISHER-TITUS GASTROENTEROLOGY SPECIALISTS LLC | |||||||||
| 272 BENEDICT AVENUE | NORWALK | OH | 44857 | 812114911 | PHYSICIAN PRACTICE | OH | $0 | $0 | FISHER-TITUS HEALTH |
| FISHER-TITUS PEDIATRICS LLC | |||||||||
| 272 BENEDICT AVENUE | NORWALK | OH | 44857 | 814799855 | PHYSICIAN PRACTICE | OH | $0 | $0 | FISHER-TITUS HEALTH |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| FISHER TITUS MEDICAL CENTER | |||||||||
| 272 BENEDICT AVENUE | NORWALK | OH | 44857 | 344430716 | HOSPITAL | OH | 501(C)(3) | LINE 3 | Yes (1) |
| FISHER TITUS FOUNDATION | |||||||||
| 272 BENEDICT AVENUE | NORWALK | OH | 44857 | 341476937 | FOUNDATION | OH | 501(C)(3) | LINE 7 | Yes (1) |
| FISHER-TITUS AFFILIATED SERVICES | |||||||||
| 272 BENEDICT AVENUE | NORWALK | OH | 44857 | 341476934 | AMBULANCE SERVICE | OH | 501(C)(3) | LINE 10 | Yes (1) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FISHER-TITUS PAIN MANAGEMENT LLC | |||||||||||||
| 272 BENEDICT AVENUE | NORWALK | OH | 44857 | 271471272 | PAIN MANAGEMENT | OH | Yes (1) | 0 | |||||
| FISHER-TITUS SHARED SERVICES LLC | |||||||||||||
| 272 BENEDICT AVENUE | NORWALK | OH | 44857 | 834555068 | PARTNERSHIP IN SURGERY CENTER | OH | Yes (1) | 0 | HEALTH | RELATED | $1,196 | $723,656 | 0.70000 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH PROMOTIONS OF NORWALK | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 272 BENEDICT AVENUE | AddressLine1Txt |
| City | NORWALK | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44857 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341502102 | EIN |
| Primary Activities | SUPPORT PROF. | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| FISHER-TITUS AFFILIATED SERVICES | ||
| A | $114,690 | SEE PART VII |
| FISHER-TITUS AFFILIATED SERVICES | ||
| R | $285,000 | SEE PART VII |
| FISHER-TITUS MEDICAL CENTER | ||
| O | $55,020 | PAYROLL SYSTEM |
| FISHER-TITUS MEDICAL CENTER | ||
| K | $659,748 | SEE PART VII |
| FISHER-TITUS AFFILIATED SERVICES | ||
| R | -$243,415 | SEE PART VII |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V LINE 2 | ORGANIZATION #1 FISHER-TITUS AFFILIATED SERVICES OF $114,690. METHOD OF VALUATION: RENT WAS CALCULATED ON ALL RENTAL PROPERTY BASED ON AN AVERAGE 18 YEAR DEPRECIABLE LIFE FOR THE BUILDINGS. EACH YEAR RENT IS INCREASED BY THE ANNUAL CPI INDEX. MONTHLY INVOICES WERE THEN WRITTEN UP AND BILLED TO THE RELATED ORGANIZATION. |
| PART V LINE 2 | ORGANIZATION #2 FISHER-TITUS AFFILIATED SERVICES OF $285,000. METHOD OF VALUATION WAS AS NEEDED TO COVER OPERATING CASH FLOW. |
| PART V LINE 2 | ORGANIZATION #4 FISHER-TITUS MEDICAL CENTER OF $659,748. METHOD OF VALUATION: RENT WAS CALCULATED ON ALL RENTAL PROPERTY BASED ON AN AVERAGE SQUARE FOOTAGE IN THE LOCAL AREA FOR THE BUILDINGS. EACH YEAR RENT IS INCREASED BY THE ANNUAL CPI INDEX. MONTHLY INVOICES WERE THEN WRITTEN UP AND BILLED TO THE RELATED ORGANIZATION. |
| PART V LINE 2 | ORGANIZATION #5 FISHER-TITUS AFFILIATED SERVICES FOR NEGATIVE ($243,415). METHOD OF VALUATION WAS LOAN BALANCE AT THE END OF DEC-2020. |