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FAIRFIELD MEDICAL CENTER: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
FAIRFIELD MEDICAL CENTER (EIN 31-0645626)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-16
IRS object ID
202033219349309698
Schema version
2019v5.1
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

FieldValueIRS element (for citing)
Return2020-11-16T02:18:51-00:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN310645626EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Fairfield Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFAIRBusinessNameControlTxt
Phone7406878000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 North Ewing StreetAddressLine1Txt
CityLancasterCityNm
State AbbreviationOHStateAbbreviationCd
ZIP431303371ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonAlan GreensladePersonNm
Person TitleTreasurerPersonTitleTxt
Signature2020-11-16SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address98.100.80.8IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-11-16IPDt
IP Tm13:43:55IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id1642A84CA0E6585E1340AB113A79CDB5F947B270AtSubmissionCreationDeviceId
At Submission Filing Device Id1642A84CA0E6585E1340AB113A79CDB5F947B270AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1John R Janoso JrBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 North Ewing StreetAddressLine1Txt
CityLancasterCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43130ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$315,814,930GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.fmchealth.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1982FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionFairfield Medical Center delivers outstanding healthcare for our patients, their families and our communities.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee2560TotalEmployeeCnt
Total Volunteers266TotalVolunteersCnt
Total Gross UBI$364,676TotalGrossUBIAmt
PY Contributions Grants$101,616PYContributionsGrantsAmt
CY Contributions Grants$150,717CYContributionsGrantsAmt
PY Program Service Revenue$254,140,935PYProgramServiceRevenueAmt
CY Program Service Revenue$275,149,943CYProgramServiceRevenueAmt
PY Investment Income$2,911,905PYInvestmentIncomeAmt
CY Investment Income$2,455,044CYInvestmentIncomeAmt
PY Other Revenue$2,599,110PYOtherRevenueAmt
CY Other Revenue$2,217,548CYOtherRevenueAmt
PY Total Revenue$259,753,566PYTotalRevenueAmt
CY Total Revenue$279,973,252CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$118,591,258PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$122,558,199CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$133,592,948PYOtherExpensesAmt
CY Other Expenses$139,819,420CYOtherExpensesAmt
PY Total Expenses$252,184,206PYTotalExpensesAmt
CY Total Expenses$262,377,619CYTotalExpensesAmt
PY Revenues Less Expenses$7,569,360PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$17,595,633CYRevenuesLessExpensesAmt
Total Assets BOY$302,962,502TotalAssetsBOYAmt
Total Assets EOY$332,181,004TotalAssetsEOYAmt
Total Liabilities BOY$151,448,549TotalLiabilitiesBOYAmt
Total Liabilities EOY$181,786,041TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$151,513,953NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$150,394,963NetAssetsOrFundBalancesEOYAmt
MissionFairfield Medical Center delivers outstanding healthcare for our patients, their families and our communities.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$92,811,752ExpenseAmt
Revenue$142,735,327RevenueAmt
DescPatient Care Inpatient Medical, Surgical, Emergency, Maternity, ICU, Psychiatry, and Nursing Services 70,638 discharges, procedures visitsDesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$93,809,816ExpenseAmt
Revenue$132,322,951RevenueAmt
DescPatient Care Laboratory, Cardiovascular, Radiology, Therapy, Pharmacy, and Medical Supply Services 5,722,960 procedures dosagesDesc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$28,193,878ExpenseAmt
Revenue$366,278RevenueAmt
DescPatient Care Nutritional Services 511,160 meals served Patient Care Laundry Services 1,383,539 pounds Patient Care Plant Engineering, Police, Housekeeping, Central Transport, Interest Depreciation 715,747 square feetDesc
FieldValueIRS element (for citing)
Total Program Service Expenses$214,815,446TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (true)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document235IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee2560EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Form8886 T FiledfalseForm8886TFiledInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonAlan GreensladePersonNm
Phone7406896825PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 North Ewing StreetAddressLine1Txt
CityLancasterCityNm
State AbbreviationOHStateAbbreviationCd
ZIP431303371ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndInstitutional TrusteeInstitutionalTrusteeInd
John R Janoso Jr
Director, President CEO055.00001.00Yes (X)Yes (X)$587,684$0$68,136
Renee A Wagner MD
Chief Medical Officer040.00$382,246$0$34,587Yes (X)
Sky L Gettys
CFO, Treasurer048.00002.00Yes (X)$325,697$0$30,595
Alan F Greenslade
Chief Information Officer040.00$299,118$0$35,802Yes (X)
Laura Moore
Chief Business Strategy and Dev. Officer040.00$272,897$0$35,556Yes (X)
Debra L Palmer
Chief HR Officer040.00$269,042$0$28,497Yes (X)
Helen F Harding
Chief Nursing Officer040.00$257,991$0$27,597Yes (X)
Mark E Vanderhoff
Director, Patient Services040.00$188,504$0$30,227Yes (X)
Robert L Zee DO
Residency Program Director029.00$189,880$0$23,581Yes (X)
Doralea Metzger
Director, Patient Services040.00$178,308$0$17,639Yes (X)
Pamela L Reed
Director, Patient Services040.00$176,738$0$8,112Yes (X)
Theresa Dyar DO
Director, Residency Prog Director029.00Yes (X)$175,000$0$7,778Yes (X)
Aundrea Cordle
Director002.00001.00Yes (X)$0$0$0
Micah Riggenbach
Director002.00Yes (X)$0$0$0
Angela Krile
Director002.00Yes (X)$0$0$0
Ron Linehan MD
Director002.00Yes (X)$0$0$0
Dan Fruth
Chair003.00001.00Yes (X)Yes (X)$0$0$0
Matthew Wideman
Director002.00Yes (X)$0$0$0
Bradley Hedges PhD
Secretary003.00Yes (X)Yes (X)$0$0$0
Susan Nixon Stoughton
Director002.00Yes (X)$0$0$0
Milt Taylor Jr
Director002.00Yes (X)$0$0$0Yes (X)
Laura Tussing
Vice Chair003.00Yes (X)Yes (X)$0$0$0
William Yaple
Director002.00Yes (X)$0$0$0
Laurianne Scott DO
Director002.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,303,105TotalReportableCompFromOrgAmt
Total Other Compensation$348,107TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K84IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Renovo Solutions
1801 E Parkcourt Place Bldg DSanta AnaCA92701Biomedical Services$2,805,671
Fairfield Anesthesia Associates
PO Box 427LancasterOH43130Physician Services$2,386,062
Lancaster Properties II LLC
200 Public Sq CM23ClevelandOH44114Rent$1,500,000
Comtex
701 Brickell Ave Suite 1550MiamiFL33131Laundry Services$871,625
Porter Wright Morris & Arthur LLP
41 S High Street Suites 2800-3200ColumbusOH43215Legal Services$786,171
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K36CntrctRcvdGreaterThan100KCnt
All Other Contributions$150,717AllOtherContributionsAmt
Total Contributions$150,717TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient Service Revenue NetDesc
Total Revenue Column$275,149,943TotalRevenueColumnAmt
Related Or Exempt Func Income$275,149,943RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$275,149,943TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,075,115TotalRevenueColumnAmt
Exclusion$1,075,115ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$285,358RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$726,944RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$441,586RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$441,586TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$36,494,663SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$35,114,734SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$1,379,929SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,379,929TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtBusinessBusinessCdUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Cafeteria Sales$1,095,000$1,095,000
Patronage Dividends$603,907$603,907900099
Outside Reference Lab$329,709621500$329,709

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$630,518TotalRevenueColumnAmt
Related Or Exempt Func Income$595,551RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$34,967UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,659,134OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$279,973,252TotalRevenueColumnAmt
Related Or Exempt Func Income$275,745,494RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$364,676UnrelatedBusinessRevenueAmt
Exclusion$2,774,022ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,663,936TotalAmt
Program Services$1,019,598ProgramServicesAmt
Management And General$1,644,338ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$94,235,642TotalAmt
Program Services$83,868,314ProgramServicesAmt
Management And General$10,367,328ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$4,740,782TotalAmt
Program Services$4,238,880ProgramServicesAmt
Management And General$501,902ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$13,854,951TotalAmt
Program Services$12,311,569ProgramServicesAmt
Management And General$1,543,382ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$7,062,888TotalAmt
Program Services$6,182,568ProgramServicesAmt
Management And General$880,320ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,467,260TotalAmt
Management And General$1,467,260ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$110,750TotalAmt
Management And General$110,750ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Fees For Services Prof FundraisingFeesForServicesProfFundraising

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$28,728,483TotalAmt
Program Services$12,608,419ProgramServicesAmt
Management And General$16,120,064ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$4,332,114TotalAmt
Program Services$3,747,623ProgramServicesAmt
Management And General$584,491ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$5,889,693TotalAmt
Program Services$4,970,901ProgramServicesAmt
Management And General$918,792ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$14,560,246TotalAmt
Program Services$10,063,860ProgramServicesAmt
Management And General$4,496,386ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,711,403TotalAmt
Program Services$1,361,168ProgramServicesAmt
Management And General$350,235ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Supplies$37,299,094$36,983,760$315,334
Physician Fees$7,575,162$7,410,330$164,832
Other Expenses$38,145,215$30,048,456$8,096,759

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$262,377,619TotalAmt
Program Services$214,815,446ProgramServicesAmt
Management And General$47,562,173ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$9,207,637BOYAmt
EOY$9,598,760EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$13,511,591BOYAmt
EOY$13,885,642EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$60,562,740BOYAmt
EOY$40,939,668EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$6,272,737BOYAmt
EOY$4,255,868EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$9,644,905BOYAmt
EOY$14,836,593EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$366,536,360LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$207,422,662LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$124,276,546BOYAmt
EOY$159,113,698EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$48,047,433BOYAmt
EOY$55,517,073EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$7,527,642BOYAmt
EOY$7,527,642EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$23,911,271BOYAmt
EOY$26,506,060EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$302,962,502BOYAmt
EOY$332,181,004EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$23,727,844BOYAmt
EOY$23,542,931EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$89,261,109BOYAmt
EOY$87,373,205EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$9,473,346BOYAmt
EOY$9,560,908EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$28,986,250BOYAmt
EOY$61,308,997EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$151,448,549BOYAmt
EOY$181,786,041EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$151,513,953BOYAmt
EOY$150,394,963EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$151,513,953BOYAmt
EOY$150,394,963EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$302,962,502BOYAmt
EOY$332,181,004EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$17,595,633ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$7,054,486NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments-$335,815PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$25,433,294OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd
Public Support CY1700.00000PublicSupportCY170Pct
Public Support CY5090.00000PublicSupportCY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Incl Escrow Custodial Acct LiabfalseInclEscrowCustodialAcctLiabInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,307,362OtherCostOrOtherBasisAmt
Book Value$6,307,362BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$132,499InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$114,082,636OtherCostOrOtherBasisAmt
Depreciation$65,957,095DepreciationAmt
Book Value$48,258,040BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,348,383OtherCostOrOtherBasisAmt
Depreciation$3,178,406DepreciationAmt
Book Value$7,169,977BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$230,697,947OtherCostOrOtherBasisAmt
Depreciation$135,074,219DepreciationAmt
Book Value$95,623,728BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,967,533OtherCostOrOtherBasisAmt
Depreciation$3,212,942DepreciationAmt
Book Value$1,754,591BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$159,113,698TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDesc
Financial derivatives and other financial products
Closely-held equity interests

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
Due from related organizations$4,393,819
Notes receivable/income guarantee$1,390,786
Investment in subsidiary$16,671,883
Other receivables$900,962
Operating Lease Right-of-Use Asset$3,148,610
FieldValueIRS element (for citing)
Total Book Value Other Assets$26,506,060TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
Federal income taxes
Accrued payroll and benefits$13,261,849
Other Liabilities$6,428,192
Third Party Settlements$403,085
Finance Lease Liability$37,820,376
Operating Lease Liability$3,395,495
FieldValueIRS element (for citing)
Total Liability$61,308,997TotalLiabilityAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,139,251TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,618,335DirectOffsettingRevenueAmt
Net Community Benefit Expns$520,916NetCommunityBenefitExpnsAmt
Total Expense0.00200TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$37,408,600TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$23,490,181DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,918,419NetCommunityBenefitExpnsAmt
Total Expense0.05300TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$41,547,851TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$27,108,516DirectOffsettingRevenueAmt
Net Community Benefit Expns$14,439,335NetCommunityBenefitExpnsAmt
Total Expense0.05500TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,519,852TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,957DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,514,895NetCommunityBenefitExpnsAmt
Total Expense0.00580TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,458,314TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,527,482DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,930,832NetCommunityBenefitExpnsAmt
Total Expense0.01500TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,701,309TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,109,176DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,592,133NetCommunityBenefitExpnsAmt
Total Expense0.00990TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$192,939TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$192,939NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$132,593TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$132,593NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,005,007TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,641,615DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,363,392NetCommunityBenefitExpnsAmt
Total Expense0.03190TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$59,552,858TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$36,750,131DirectOffsettingRevenueAmt
Net Community Benefit Expns$22,802,727NetCommunityBenefitExpnsAmt
Total Expense0.08690TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,313TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,313NetCommunityBenefitExpnsAmt

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,036TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$11,036NetCommunityBenefitExpnsAmt

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,180TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$12,180NetCommunityBenefitExpnsAmt

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$89,962TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$89,962NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$21,222TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$21,222NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$142,713TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$142,713NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$14,068,705BadDebtExpenseAmt
Bad Debt Expense Attributable$1,591,846BadDebtExpenseAttributableAmt
Reimbursed By Medicare$67,976,858ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$66,718,009CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$1,258,849MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost Accounting SystemYes (X)CostAccountingSystemInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Fairfield Medical CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 North Ewing StreetAddressLine1Txt
CityLancasterCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43130ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.fmchealth.orgWebsiteAddressTxt
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Teaching HospitalYes (X)TeachingHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Facility Reporting Group1FacilityReportingGroupCd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line11BusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted19CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLfmchealth.orgOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLhttps//www.myfdh.org/pdf/FC-2019-CHA-Report.pdfOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLfmchealth.orgStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care0000000100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care0000000300.000000000000FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLfmchealth.orgFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLfmchealth.orgFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLfmchealth.orgFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Group Fairfield Medical Center Line Part V, Section B, Line 5Fairfield Medical Center contracted with Illuminology, a central Ohio based research firm, and the Center for Public Health Practice, within The Ohio State University College of Public Health, to assist with this work. The primary phases of the Assess Needs and Resources process, as adapted for use in Fairfield County, included the following steps 1 Prepare to assess / generate questions. Community partners were closely involved with the Fairfield County 2019 Community Health Assessment. On February 25th, 2019, 17 community leaders, stakeholders, and employees from participating organizations gathered to discuss their perspectives on emerging health issues in Fairfield County. Facilitated by Illuminology, this session provided an opportunity for community members to better understand the upcoming community health assessment process, to participate in conversation with one another about the current state of health in the county, and to suggest indicators to be considered in the community health assessment. Both small group discussions and large group report-outs occurred during this session. Illuminology used the information from this session and additional feedback from the Fairfield Department of Health and Fairfield Medical Center to identify which indicators could be assessed via secondary sources and which indicators needed to be included as part of the primary data collection efforts. 2 Collect secondary data. Secondary data for this health assessment came from national sources e.g., U.S. Department of Health and Human Services Healthy People 2020 U.S. Census Bureau, state sources e.g., Ohio Department of Healths Data Warehouse, and local sources e.g., Fairfield Medical Center. Rates and/or percentages were calculated when necessary. The Center for Public Health Practice located and recorded this information into a secondary data repository. All data sources are identified in the Reference section at the end of the report. To ensure community stakeholders are able to use this report to make well-informed decisions, only the most recent data available at the time of report preparation are presented. To be considered for inclusion in the Fairfield County 2019 Community Health Assessment, secondary data must have been collected or published in 2013 or later. 3 Collect primary data. Primary data for this health assessment came from the 2019 Fairfield County Health Survey, a representative survey of Fairfield County adult residents. Fielded in multiple waves from April 25, 2019 through July 8, 2019, the questionnaires could be completed via Internet or by mail.
Group Fairfield Medical Center Line Part V, Section B, Line 6bThe CHNA was conducted in association with Fairfield Dept of Health and Fairfield Medical Center as a collaborative effort including Dalan Starrit Adult Group Home, Fairfield Community Health Center, Fairfield Count 2-1-1 211, Fairfield County ADAMH Board, Fairfield County Job Family Services, Fairfield County Sheriffs Office, Fairfield Department of Health, Fairfield Medical Center, Lancaster Fairfield Community Action Agency, Lancaster Fairfield Public Transit, Mount Carmel Health System, Ohio State University Extension Office, OhioGuidestone, Project FORT/Major Crimes Unit, Southeastern Ohio Center for Independent Living, United Way of Fairfield County, Violet Township Fire Department.
Group Fairfield Medical Center Line Part V, Section B, Line 11This section lists Fairfield Countys prioritized health needs, as identified by the community partners during their October 7, 2019 meeting. The significant health needs facing Fairfield County residents are Obesity, Substance Use/Addiction, and Mental Health focusing on Depression. These health needs are interrelated, if not co-occurring/co-morbid. For example, poor mental health can increase the risk of substance use behaviors, and weight problems can co-occur with depression. Obesity, with its related categories of poor diet and lack of exercise, is the top priority for Fairfield County. Obesity can lead to a range of cardiovascular issues, including coronary artery disease which is the leading cause of mortality in Fairfield County. Obesity also increases risks of heart attack, stroke, and atrial flutter, which commonly occur among county residents. Substance use and addiction is the second highest priority health need. Continued use of alcohol, tobacco, or other drugs can lead to addiction and negative impacts on health, including COPD and cancer. Additionally, substance use in youth is associated with an increased chance of continued use and potential abuse later in life. The third highest priority for Fairfield County is mental health, specifically depression. Depression can lead to suicidal thoughts and behaviors. Victims of domestic violence, child abuse, and bullying may be at special risk to experience mental health issues.
Group Fairfield Medical Center Line Part V, Section B, Line 6aDiley Ridge Medical Center

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part IIKnowing that a strong economy can help build strong people, we have dedicated ourselves to helping our local economy through donations to organizations helping to draw more business to the area and by participating in local Chambers of Commerce. Fairfield Medical Center FMC supports our communities with Police assistance and by emergency planning with other community organizations. Good leaders are important to the future of our community, so we are actively involved in leadership development and training. We also recognize the importance of recycling as a way to improve the health of our planet, and therefore our people, with environmental improvements. Participation with other community entities by Coalition Building also helps us to keep our pulse on the health of the community through grassroots involvement.
Part III Line 4An allowance for uncollectible accounts is established on an aggregate basis by using historical write-off factors applied to unpaid accounts based on aging. Loss rate factors are based on historical loss experience and adjusted for economic conditions and other trends affecting the Centers ability to collect outstanding amounts. Uncollectible amounts are written off against the allowance for doubtful accounts in the period they are determined to be uncollectible.
Part III Line 8All Medicare shortfall is considered Community Benefit because Fairfield Medical Center treats all patients, regardless of ability to pay and regardless of supplemental insurance coverage, in the case of Medicare patients. It is for the betterment of the community that we treat Medicare patients, regardless of the shortfall or surplus.
Part III Line 8The total for Medicare Cost is taken directly from the Medicare Cost Report.
Part III Line 9bIn all instances of debt collection, patients are given information regarding financial assistance available. In addition, patients are made aware of the availability of financial assistance with an acknowledgement letter of services rendered, regardless of ability to pay or payment source. FMC will do everything possible to help those who qualify for charity care to be made aware of the assistance available. We also provide financial counselors to assist patients in filling out the necessary forms for assistance. The following options are available A. Payment in the form of cash, credit card or checks. A discount is offered with payment at the time of service and within 10 days of receiving the hospital bill. B. H.E.L.P. Bank Financial Program C. Hospital Payment Program D. Assistance with application to Medicare or Medicaid E. Hospital Care Assurance Program HCAP F. Hospital Assistance Program summary defining Fairfield Medical Centers financial opportunities. G. Assistance for the uninsured patient.
Part VI Line 2A new Community Health Needs Assessment was made available in 2019. Fairfield Medical Center met with community leaders to help determine the needs of the assessment that could be met with local expertise and available funding. In addition to the needs prioritized by the county, FMC also decided to focus on Cancer, Cardiopulmonary Disease and Access to Care. Fairfield Medical Center is heavily involved with other health care organizations in the area, such as the Fairfield Community Health Center, to assess the health care needs of the community. We also host local EMS meetings to futher assess needs. Personnel are also aware of the needs in the Community Health Needs Assessment and work with other community organizations to help meet the needs with the resources available. 70.2 percent of the people in Fairfield Co. are considered to be either overweight or obese. Fairfield Medical Center has programs to encourage exercise. There is also a Diabetes Support Group to assist those with diabetes. We also have cooking demonstrations to encourage healthy cooking. Project DAWN educates the public regarding drug abuse and Narcan disbursement. Womens Health, Cancer and Heart screenings are also available. FMCs strategic planning process assesses new services and providers that can be brought to the community to improve access to care. Fairfield Medical Center acknowledges the wide range of health issues impacting our community and were identified during the CHNA process. We have determined that we can only focus on the needs that we currently have the resources available for and ability to positively impact. We will not be addressing the following health needs Income and Poverty While we are the largest employer in the county, we do not plan to directly address this need through our portfolio of available health services. Access to Transportation We do not have the resources available to directly impact this particular need. Alzheimers Disease and Dementia While we are committed to providing care for patients in need, we do not plan to directly address this need. There are community partners who have more specific resources to deal with this need.
Part VI Line 3There are prominent signs in Registration and in Contracts and Collections showing our financial policy. Every hospital bill sent to patients has a flyer included with our financial policy clearly described. Financial counselors meet with patients before theyre discharged from the hospital so that each patient is personally made aware of our policy and also to identify those who qualify for financial assistance, then the financial counselors assist with completing the assistance information should help be needed.
Part VI Line 4Fairfield Medical Center serves Fairfield County and surrounding counties including Perry and Hocking Counties.
Part VI, Line 7OH

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Fairfield Medical Center FoundationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 North Ewing StreetAddressLine1Txt
CityLancasterCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43130ZIPCd
FieldValueIRS element (for citing)
Recipient EIN208952945RecipientEIN
IRC Section501c3IRCSectionDesc
Cash Grant$273,861CashGrantAmt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountOther Compensation Filing OrgOtherCompensationFilingOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt
Theresa Dyar DO
Director, Residency Prog Director$175,000$7,778$182,778
Laura Moore
Chief Business Strategy and Dev. Officer$255,037$16,566$308,453$16,660$1,200$18,990
Sky L Gettys
CFO, Treasurer$324,209$16,800$356,292$1,488$13,795
Renee A Wagner MD
Chief Medical Officer$355,548$16,800$416,833$24,498$2,200$17,787
Helen F Harding
Chief Nursing Officer$232,428$14,264$285,588$23,155$2,408$13,333
Robert L Zee DO
Residency Program Director$189,661$11,413$213,461$219$12,168
Doralea Metzger
Director, Patient Services$166,538$10,717$195,947$9,570$2,200$6,922
Mark E Vanderhoff
Director, Patient Services$178,594$11,559$218,731$8,385$1,525$18,668
Pamela L Reed
Director, Patient Services$170,633$6,509$184,850$5,880$225$1,603
John R Janoso Jr
Director, President CEO$553,069$35,800$655,820$34,615$32,336
Debra L Palmer
Chief HR Officer$242,166$16,286$297,539$25,438$1,438$12,211
Alan F Greenslade
Chief Information Officer$246,529$16,800$334,920$50,320$2,269$19,002

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1County of Fairfield OhioBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN316400066BondIssuerEIN
CUSIP304286AM9CUSIPNum
Bond Issued2013-06-27BondIssuedDt
Issue Price$98,511,516IssuePriceAmt
PurposeTo refund prior issue and to fund new surgical unit.PurposeDesc

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$56,264,480RetiredAmt
In Reserve Fund$6,320,525InReserveFundAmt
Issuance Costs From Proceeds$926,511IssuanceCostsFromProceedsAmt
Capital Expenditures$35,000,000CapitalExpendituresAmt
Refunding Tax Exempt BondsYes (true)RefundingTaxExemptBondsInd
Refunding Taxable BondsfalseRefundingTaxableBondsInd
Final Allocation MadefalseFinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropfalseMgmtContractBondFincdPropInd
Any Research AgreementsfalseAnyResearchAgreementsInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetfalseRebateNotDueYetInd
Exception To RebatefalseExceptionToRebateInd
No Rebate DuefalseNoRebateDueInd
Variable Rate IssuefalseVariableRateIssueInd
Hedge Identified In Bks And RecfalseHedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsfalseWrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionfalseProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, Line 2Various members of the Board of Directors are key employees and/or officers of organizations that may conduct normal, arms length transactions with one another.
Form 990, Part VI, Section B, Line 11bThe 990 is reviewed by the Treasurer of the organization after review by the Director of Financial Services. Then, it is made available for Board Member review prior to filing.
Form 990, Part VI, Section B, Line 12cDirectors, President, Vice Presidents, Managers, Case Management employees, Contracts Collections employees, employees with direct purchasing responsibilities, employed physicians, and employees who are contracted or shared with other organizations are required to complete an annual questionnaire disclosing potential conflicts of interest. If a known or perceived conflict of interest arises, the Compliance Officer investigates, documents, and works to resolve the conflict of interest.
Form 990, Part VI, Section B, Line 15a bAnnually, the Compensation Committee compares officer and key employee compensation to regional industry averages. This committee consists of independent members of the Board of Directors. Compensation adjustment recommendations are submitted, to be included in the budget, to the Finance and Audit Committee. Compensation adjustments are taken to the Board of Directors for final approval, and if approved are then implemented.
Form 990, Part VI, Section C, Line 19The governing documents, conflict of interest, and financials are made available to the public by request made to FMC management.
Form 990, Part IX, Line 11gOther fees for services include lab testing, administrative consulting, outsourced biomedical services, outsourced collection services, outsourced IT services and other general purchased services.
Form 990, Part XI, Line 9The other change in net assets reported represents intercompany transfers between Fairfield Medical Center and related organizations see Schedule R for fixed asset purchases, shared employees, expenses and other intercompany transactions.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Home Health ResourcesBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 North Ewing StreetAddressLine1Txt
CityLancasterCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43130ZIPCd
FieldValueIRS element (for citing)
EIN311159707EIN
Primary ActivitiesDurable Med. Equip.PrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Zane Properties CorporationBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Fairfield Healthcare Professionals Inc
401 North Ewing StreetLancasterOH43130311425884Physician PracticesOH501c311aFairfield Medical Centerfalse
Fairfield Medical Center Foundation
401 North Ewing StreetLancasterOH43130208952945FundraisingOH501c37falseN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
Zane Properties Corporation
401 North Ewing StreetLancasterOH43130311202009Holding CompanyOHFairfield Medical CenterC Corp1.00000false
& Rehab Inc
2405 N Columbus St Suite 210LancasterOH43130311639119PhysiatristsOHFairfield Healthcare ProfessionalsC Corpfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgYes (true)AssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (8 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
Fairfield Healthcare Professionals Inc
g$426,612
Zane Properties Corporation
k$128,360
Fairfield Healthcare Professionals Inc
o$15,317,471
Zane Properties Corporation
p$146,979
Fairfield Healthcare Professionals Inc
p$4,607,314
Fairfield Healthcare Professionals Inc
r$9,930,000
Zane Properties Corporation
q$70,953
Zane Properies Corporation
s$300,000