2021-11-13T10:15:04-06:00 2020-12-31 351178661 BLUE & CO LLC 9200 WORTHINGTON RD STE 200 WESTERVILLE OH 43082 990 2020-01-01 341476935 FISHER-TITUS HEALTH FISH 4196688101 272 BENEDICT AVENUE NORWALK OH 44857 SCOTT E ENDSLEY CHIEF FINANCIAL OFFICER 4196688101 2021-11-12 1 SCOTT ENDSLEY 999009999 NATHAN A RODGERS CPA P01568275 6148852583 2021-11-09 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z BRENT W BURKEY MD 272 BENEDICT AVENUE NORWALK OH 44857 17782265 0 X NONE X 1985 OH 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. 11 7 169 12 0 0 0 0 13351938 17730226 -67704 16621 20191 14982 13304425 17761829 0 0 0 0 18199663 20726663 0 0 0 5388552 6276838 23588215 27003501 -10283790 -9241672 25224851 24384959 5547570 4840714 19677281 19544245 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. 0 0 26906550 0 17615536 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. 80919 0 0 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. 5204 0 114690 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. 26992673 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 1 1 0 0 0 0 1 1 1 1 1 0 1 28 0 1 169 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 OH X DAVID WILSON MBACMAFHFMA 4196688101 272 BENEDICT AVENUE NORWALK OH 44857 BRENT W BURKEY MD PRESIDENT & CEO 5.00 60.00 X X 0 505149 56365 JOHN K HUGHES MD DIRECTOR-STARTED 05/20 41.00 5.00 X 294428 0 69805 DENNIS DOUGHTY CHAIRMAN 1.50 16.50 X X 0 0 0 PERRY DRYDEN VICE CHAIRMAN 1.00 11.00 X X 0 0 0 DENNIS C CAMP TREASURER 1.00 13.00 X X 0 0 0 REV FRED E WIECHERS SECRETARY-ENDED 04/20 1.00 8.00 X X 0 0 0 JULIE S ROBERTS DDS DIRECTOR/SECRETARY 1.00 8.00 X X 0 0 0 SUSAN S HAZEL DIRECTOR 1.00 5.00 X 0 0 0 JEFFREY C HUBER DIRECTOR 1.00 6.00 X 0 0 0 JONATHAN D ZAHLER DO DIRECTOR 1.00 5.00 X 0 0 0 MARK E CORIELL DIRECTOR 1.00 5.00 X 0 0 0 JOHN A LENDRUM DIRECTOR-STARTED 05/20 1.00 5.00 X 0 0 0 NICHOLAS J LIBEN JR DO DIRECTOR-ENDED 12/20 1.00 5.00 X 0 0 0 SCOTT E ENDSLEY CHIEF FINANCIAL OFFICER 3.00 57.00 X 0 246977 40664 MATTHEW E MATTNER CHIEF OPERATIONS OFFICER 2.50 47.50 X 0 300823 65439 MAHER SALAM MD PHYSICIAN 40.00 0.00 X 853120 0 43600 PATRICK R WATERS MD PHYSICIAN 40.00 0.00 X 761105 0 41142 SULIEMAN ABDAL RAHEEM MD PHYSICIAN 40.00 0.00 X 697837 0 43738 GREGORY P COOK MD PHYSICIAN 40.00 0.00 X 678499 0 39341 DONALD L SMITH JR MD PHYSICIAN 40.00 0.00 X 627427 0 34475 3912416 1052949 434569 43 0 1 0 CERNER CORPORATION 2800 ROCKCREEK PARKWAY KANSAS CITY MO 64117 HEALTHCARE INFORMATION TECHNOLOGY 240936 TRUST HEALTH CONSULTING 2042 SOUTH BRENTWOOD BLVD SPRINGFIELD MO 65804 PROFESSIONAL FEE CODING 115635 VIKRAM KUMAR MD 673 EAST RIVER STREET ELYRIA OH 44035 ENDOCRINOLOGY PROFESSIONAL FEE 105300 3 NET MEDICAL CARE LLC REVENUE 621100 17615536 17615536 RENTAL INCOME 621300 114690 114690 17730226 18779 18779 600 600 30600 15618 14982 14982 14982 2060 4818 -2758 -2758 -2758 17761829 17730226 0 31603 17652415 17652415 548897 548897 1467176 1467176 1058175 1058175 2135361 2127645 7716 294412 291300 3112 70234 70234 994191 994191 5805 5805 141901 141901 82870 82870 840227 840227 513944 513944 MEDICAL SUPPLIES 1197328 1197328 DUES AND SUBSCRIPTIONS 539 539 UBI INCOME TAX 26 26 27003501 26992673 10828 0 1089972 647211 2151798 1163707 119215 43576 408471 384129 87397 125278 205935 353956 10523568 3410696 7609272 7112872 224817 224380 489825 442607 12838149 13887243 25224851 24384959 2200994 1936378 3166658 2664016 179918 240320 5547570 4840714 X 19677281 19544245 19677281 19544245 25224851 24384959 X -9241672 9108636 X 0 1 X 1 0 X X 3 FISHER-TITUS MEDICAL CENTER 344430716 3 1 0 0 FISHER-TITUS FOUNDATION 341476937 7 1 0 0 FISHER-TITUS AFFILIATED SERVICES 341476934 10 1 261000 0 3 261000 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 X 1 1 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. 17600 191130 208730 403082 1740138 919421 1223799 117629 7839701 2356805 5600525 18292 195996 134470 79818 7112872 EQUITY IN THE BELLEVUE HOSPITAL 12623574 DUE FROM AFFILIATED ENTITIES 309349 INVESTMENT FT SHARED SERVICES 714000 RIGHT OF USE ASSET 240320 13887243 OPERATING LEASE 240320 240320 X 18406886 638793 638793 17768093 -6264 -6264 17761829 26919810 6264 6264 26913546 89955 89955 27003501 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. X X X X X X 0 1 0 0 0 0 0 0 0 MAHER SALAM MD PHYSICIAN 796798 0 34157 0 22165 0 9974 0 33626 0 896720 0 0 0 PATRICK R WATERS MD PHYSICIAN 570703 0 168263 0 22139 0 11400 0 29742 0 802247 0 0 0 SULIEMAN ABDAL RAHEEM MD PHYSICIAN 560646 0 134508 0 2683 0 11400 0 32338 0 741575 0 0 0 GREGORY P COOK MD PHYSICIAN 541285 0 115189 0 22025 0 11400 0 27941 0 717840 0 0 0 DONALD L SMITH JR MD PHYSICIAN 409765 0 195838 0 21824 0 11400 0 23075 0 661902 0 0 0 BRENT W BURKEY MD PRESIDENT & CEO 0 445250 0 15000 0 44899 0 55440 0 925 0 561514 0 42237 MATTHEW E MATTNER CHIEF OPERATIONS OFFICER 0 264040 0 15000 0 21783 0 39960 0 25479 0 366262 0 0 JOHN K HUGHES MD DIRECTOR-STARTED 05/20 275789 0 500 0 18139 0 40936 0 28869 0 364233 0 0 0 SCOTT E ENDSLEY CHIEF FINANCIAL OFFICER 0 220055 0 15000 0 11922 0 32266 0 8398 0 287641 0 0 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. A COUNTY OF HURON OHIO 346400672 2015-04-02 5335000 SEE PART VI 0 0 0 A 5335000 50000 5285000 2015 1 0 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 1 1 PNC 6.800000000000 1 0 0 0 1 A 0 PART I LINE A 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. MAHER SALAM PHYSICIAN SEE PART V X 176614 43576 0 0 1 43576 BATTLES INSURANCE AGENCY SEE PART V 568290 VENDOR 0 MS SPETTEL SEE PART V 88749 EMPLOYMENT 0 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. 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. FISHER-TITUS MEDICAL CARE LLC 272 BENEDICT AVENUE NORWALK OH 44857 161768258 PHYSICIAN GROUP PRACTICE OH 17615536 9066587 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 FISHER TITUS MEDICAL CENTER 272 BENEDICT AVENUE NORWALK OH 44857 344430716 HOSPITAL OH 501(C)(3) LINE 3 1 FISHER TITUS FOUNDATION 272 BENEDICT AVENUE NORWALK OH 44857 341476937 FOUNDATION OH 501(C)(3) LINE 7 1 FISHER-TITUS AFFILIATED SERVICES 272 BENEDICT AVENUE NORWALK OH 44857 341476934 AMBULANCE SERVICE OH 501(C)(3) LINE 10 1 FISHER-TITUS PAIN MANAGEMENT LLC 272 BENEDICT AVENUE NORWALK OH 44857 271471272 PAIN MANAGEMENT OH 1 0 FISHER-TITUS SHARED SERVICES LLC 272 BENEDICT AVENUE NORWALK OH 44857 834555068 PARTNERSHIP IN SURGERY CENTER OH HEALTH RELATED 1196 723656 1 0 0.70000 HEALTH PROMOTIONS OF NORWALK 272 BENEDICT AVENUE NORWALK OH 44857 341502102 SUPPORT PROF. OH N/A C 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 1 1 FISHER-TITUS AFFILIATED SERVICES A 114690 SEE PART VII FISHER-TITUS AFFILIATED SERVICES R 285000 SEE PART VII FISHER-TITUS MEDICAL CENTER O 55020 PAYROLL SYSTEM FISHER-TITUS MEDICAL CENTER K 659748 SEE PART VII FISHER-TITUS AFFILIATED SERVICES R -243415 SEE PART VII 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.