2020-11-13T07:37:57-06:00 2019-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST STE 200 INDIANAPOLIS IN 46204 990 2019-01-01 344430716 FISHER-TITUS MEDICAL CENTER FISH 4196688101 272 BENEDICT AVENUE NORWALK OH 448572374 SCOTT ENDSLEY CHIEF FINANCIAL OFFICER 4196688101 2020-11-13 1 NATHAN A RODGERS CPA P01568275 3172757444 2020-11-13 76.245.71.191 2020-11-13 07:00:58 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 50BA67CF2BE9AFE4130FCD26086E06618A5B98E5 2019 2021-01-29 14:40:06Z BRENT W BURKEY MD 272 BENEDICT AVENUE NORWALK OH 448572374 169445709 0 X WWW.FISHER-TITUS.ORG X 1911 OH PROVIDE QUALITY HEALTHCARE IN A COST EFFECTIVE MANNER, WHILE RESPECTING THE DIGNITY AND UNIQUENESS OF EACH INDIVIDUAL WE SERVE. 11 7 1000 145 3988504 23933 15180 632102 138726836 145648131 4981181 4337193 1044260 1136701 144767457 151754127 184350 195762 0 0 68800771 70683635 0 0 0 63144729 67555721 132129850 138435118 12637607 13319009 206665508 217431403 59966913 69099614 146698595 148331789 X PROVIDE QUALITY HEALTHCARE IN A COST EFFECTIVE MANNER, WHILE RESPECTING THE DIGNITY AND UNIQUENESS OF EACH INDIVIDUAL WE SERVE. 0 0 114768765 195762 133921342 SEE SCHEDULE O 3966554 7738285 SEE SCHEDULE O 118735319 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 1 0 0 1 1 1 0 0 0 1 1 1 1 0 0 1 98 0 1 1000 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 OH X DAVID V WILSON MBACMA 4196688101 272 BENEDICT AVENUE NORWALK OH 448572374 X DENNIS DOUGHTY CHAIRMAN 15.00 3.00 X X 0 0 0 PERRY DRYDEN VICE CHAIRMAN 10.00 4.00 X X 0 0 0 DENNIS C CAMP TREASURER 11.00 2.00 X X 0 0 0 REV FRED WIECHERS SECRETARY 7.00 2.00 X X 0 0 0 MARK E CORIELL DIRECTOR 4.00 2.00 X 0 0 0 SUSAN S HAZEL DIRECTOR 4.00 2.00 X 0 0 0 JEFFERY C HUBER DIRECTOR 4.00 3.00 X 0 0 0 NICHOLAS J LIBEN JR DO DIRECTOR 4.00 2.00 X 0 0 0 JONATHAN D ZAHLER DO DIRECTOR 4.00 2.00 X 0 0 0 JULIE S ROBERTS DDS DIRECTOR 4.00 2.00 X 0 0 0 JAMES GERKEN DIRECTOR - END JUNE 2019 4.00 2.00 X 0 0 0 BRENT W BURKEY MD PRESIDENT 50.50 14.50 X X 441927 0 58911 MATTHEW C GROSS CEO-END MAR '19/SR. ADVISOR TO BOARD 50.50 14.50 X X 284739 0 34802 SCOTT E ENDSLEY CHIEF FINANCIAL OFFICER 52.00 8.00 X 213060 0 39561 STEVEN FRIES CHIEF OPERATIONS OFFICER 45.00 0.00 X 141475 0 16573 MATTHEW MATTNER-START AUG 2019 CHIEF OPERATIONS OFFICER 45.00 0.00 X 104441 0 8222 PHILLIP J ANNARINO-END APR '19 CHIEF HUMAN RESOURCE OFFICER 40.00 0.00 X 251023 0 15205 KATIE CHIEDA CHIEF NURSING OFFICER 45.00 0.00 X 199617 0 68281 GARY MOORMAN CHIEF MEDICAL OFFICER-START JAN 2019 45.00 0.00 X 317280 0 29712 CHERIE M SPRAGG-END NOV 2019 CHIEF POPULATION HEALTH OFFICER 50.00 0.00 X 202059 0 110571 LINDA STEVENSON-START FEB 2019 CHIEF INFORMATION OFFICER 45.00 0.00 X 161054 0 20956 GREGORY P COOK MD PHYSICIAN 40.00 0.00 X 692354 0 43632 DANIEL D MULLIGAN MD PHYSICIAN 40.00 0.00 X 216640 0 23668 ROBERT W RICE MD PHYSICIAN 40.00 0.00 X 666268 0 49595 DONALD L SMITH JR MD PHYSICIAN 40.00 0.00 X 554209 0 37611 PATRICK R WATERS MD PHYSICIAN 40.00 0.00 X 786205 0 45810 5232351 0 603110 39 0 1 0 CERNER CORPORATION 2800 ROCKCREEK PATHWAY KANSAS CITY MO 64117 HEALTHCARE INFORMATION TECHNOLOGY 5377224 JANOTTA & HERNER 309 MONROE STREET MONROEVILLE OH 44847 BUILDING CONTRACTOR 1935355 METROHEALTH SYSTEMS PO BOX 73122 CLEVELAND OH 441931861 SPINE CENTER PROFESSIONAL FEE & TRAUMA P 962184 NORTHERN OHIO MEDICAL SPECIALISTS 3004 HAYES AVENUE SANDUSKY OH 44870 ORTHOPEDIC PROFESSIONAL FEES 824456 LABORATORY CORPORATION OF AMERICA PO BOX 12140 BURLINGTON NC 272162140 BLOOD ADMINISTRATION 567096 21 40 375062 257000 256413 632102 HOSPITAL NET PATIENT SERVICES 623000 131173087 131173087 NURSING HOME & ASSISTED LIVING RE 623000 7738285 7738285 KAISER PHARMACY 446110 3780809 3780809 MEDICAL LABORATORY 621500 201332 201332 HEALTH & ALLIED SERVICES 621990 6363 6363 2748255 2748255 145648131 2166318 2166318 17318 17318 19795819 49320 17365292 326290 2430527 -276970 2153557 2153557 CAFETERIA SALES 722210 464285 464285 HOSPITAL AUXILARY SALES 453220 397343 397343 MISC. OTHER HOSPITAL REVENUE 900099 275073 275073 1136701 151754127 141659627 3988504 5473894 X 195762 195762 2719469 1760496 958973 51752622 44051090 7701532 1604775 1365961 238814 10660315 9073907 1586408 3946454 3359165 587289 395127 296255 98872 144561 72281 72280 194312 194312 17051889 14400677 2651212 713140 702395 10745 3811007 2092375 1718632 5063262 2802326 2260936 2113750 1539570 574180 157776 141086 16690 253895 113893 140002 818157 736007 82150 6388967 5882107 506860 1146884 867268 279616 MEDICAL SUPPLIES 21108297 21106106 2191 BAD DEBT EXPENSES 5583486 5583486 OHIO HOSPITAL TAX & SNF 2004364 2004364 UBI INCOME TAX -682 -682 607529 589424 18105 138435118 118735319 19699799 0 5375 5375 7405050 7845815 12645143 17327635 80000 355306 607553 2640568 2202989 2073798 3008071 207619081 105461398 102365247 102157683 75585659 78862408 586506 638643 727760 707884 2275096 3987347 206665508 217431403 30422571 36927369 42782 32893 27280192 24858223 2972516 2221368 4308613 59966913 69099614 X 146679983 148313355 18612 18434 146698595 148331789 206665508 217431403 X 13319009 7248388 -18934203 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 0 1 9271 9271 0 PART II-B, LINE 1: EXECUTIVE MEMBERS OF THE ORGANIZATION, ON AN OCCASIONAL BASIS, MAY WRITE OR SPEAK TO LEGISLATIVE MEMBERS CONCERNING PROPOSED LEGISLATION THAT MIGHT IMPACT THE LOCAL DELIVERY OF HEALTHCARE SERVICES. THE MEDICAL CENTER HAS MEMBERSHIPS IN VARIOUS HEALTHCARE RELATED ASSOCIATIONS, WHICH PROVIDE STATE AND NATIONAL LEADERSHIP ON LEGAL, REGULATORY, QUALITY AND ACCREDITATION ISSUES. AS A PART OF THAT LEADERSHIP ROLE, THESE ORGANIZATIONS DO CONTACT LEGISLATORS TO EXPRESS THEIR ASSOCIATION'S POSITIONS ON MATTERS IMPORTANT TO THEIR MEMBERSHIP. THE FOLLOWING ORGANIZATIONS LISTED BELOW SHOW THE PERCENTAGE OF THE DUES THAT REFLECT LOBBYING AS DETERMINED BY THE IRS: OHIO HEALTH CARE ASSOCIATION - 21.08% OF DUES; OHIO HOSPITAL ASSOCIATION - 5.9% OF DUES AND AMERICAN HOSPITAL ASSOCIATION - 23.32% OF DUES. 1045057 1045057 143781957 64017296 79764661 54205529 36854862 17350667 8586538 4589240 3997298 102157683 CAPITAL LEASE OBLIGATIONS 3654619 OPERATING LEASE OBLIGATIONS 653994 4308613 X 141922196 7248388 -16384445 -9136057 151058253 695874 695874 151754127 140029581 2304883 2304883 137724698 710420 710420 138435118 PART X, LINE 2: MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THESE ENTITIES, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2019 AND 2018, 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 MEDICAL CENTER INDIVIDUAL ACCRUED UNCERTAIN TAX POSITION WAS $0.00. PART XI, LINE 2D - OTHER ADJUSTMENTS: TRANSFERS TO VARIOUS AFFILIATED ENTITIES -18,219,220. PROFIT SHARING RELATED TO THE PAIN MANAGEMENT JOINT VENTURE 154,577. CHANGE IN INTEREST SWAP VALUE -95,854. HEALTH PROMOTION OF NORWALK REVENUE 539,575. FISHER-TITUS PAIN MANAGEMENT LLC REVENUE 3,523,402. ADJUSTMENT TO FASB #158 CHANGE IN PENSION LIABILITY -2,048,901. NET PERIODIC PENSION & POSTRETIREMENT BENEFIT COST -238,024. PART XI, LINE 4B - OTHER ADJUSTMENTS: HOSPITAL AUXILIARY REVENUE 397,409. HOSPITAL EXPENSE ADJUSTMENTS TO REVENUE 298,465. PART XII, LINE 2D - OTHER ADJUSTMENTS: HEALTH PROMOTIONS OF NORWALK EXPENSES 416,090. FISHER-TITUS PAIN MANAGEMENT LLC EXPENSES 1,888,793. PART XII, LINE 4B - OTHER ADJUSTMENTS: HOSPITAL AUXILIARY EXPENSES 411,955. HOSPITAL EXPENSE ADJUSTMENTS TO REVENUES 298,465. 1 1 X 1 X 1 X 1 1 0 1 1 1 1587 870558 184883 685675 0.00500 1 12530314 11426148 1104166 0.00800 2 1587 13400872 11611031 1789841 0.01300 18 46548 301783 28188 273595 0.00200 1 83 29472 2600 26872 0.00020 1 632857 398596 234261 0.00170 5 290 254351 0 254351 0.00180 25 46921 1218463 429384 789079 0.00570 27 48508 14619335 12040415 2578920 0.01870 1 5583486 1395872 33151177 33311273 -160096 X 1 1 1 FISHER-TITUS PAIN MANAGEMENT LLC PAIN MANAGEMENT 0.51000 0.49000 1 1 FISHER-TITUS MEMORIAL HOSPITAL 272 BENEDICT AVENUE NORWALK OH 44857 HTTPS://WWW.FISHER-TITUS.ORG X X X FISHER-TITUS MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 17 1 1 1 1 X WWW.FISHERTITUS.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT X WWW.HCNO.ORG/COMMUNITY-SERVICES/COMMUNITY-HEALTH-ASESSMENTS/ X 1 18 1 WWW.FISHERTITUS.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT 0 1 X 200.000000000000 300.000000000000 X X 1 1 X X X 1 X WWW.FISHERTITUS.ORG/FINANCIAL-SERVICES X WWW.FISHERTITUS.ORG/FINANCIAL-SERVICES X WWW.FISHERTITUS.ORG/FINANCIAL-SERVICES X X X X X 1 X 0 X X X X 1 X 0 0 FISHER-TITUS MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: THE HOSPITAL PARTICIPATED IN A COMMUNITY WIDE HEALTH NEEDS ASSESSMENT IN CONJUNCTION WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO WHO WORKED WITH A THIRD PARTY CONSULTANT TO REVIEW AND DRAFT THE QUESTIONS. INPUT WAS TAKEN FROM REPRESENTATIVES WITH BROAD INTEREST IN THE COMMUNITY AS WELL AS THE PUBLIC HEALTH DEPARTMENT AND THOSE AGENCIES WITH KNOWLEDGE, INFORMATION, OR EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY AS WELL AS MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS AND THOSE WITH CHRONIC HEALTH NEEDS. IN NOVEMBER OF 2016, THE CHNA PROCESS STARTED WITH THE RESULTS GIVEN TO THE WORK GROUPS IN SEPTEMBER OF 2017. THEN THROUGH THE MAPP PROCESS BY MEETINGS, FOCUS GROUPS, AND SURVEYS FROM REPRESENTATIVES OF THE LOCAL COMMUNITY, THE RESULTS WERE ANALYZED BY REPRESENTATIVES FROM HURON COUNTY PUBLIC HEALTH, MERCY HEALTH-WILLARD HOSPITAL, THE BELLEVUE HOSPITAL, FIRELANDS COUNSELING AND RECOVERY SERVICES, HURON COUNTY MENTAL HEALTH AND ADDICTION SERVICES, FAMILY LIFE COUNSELING AND PSYCHIATRIC SERVICES, HURON COUNTY BOARD OF DEVELOPMENTAL DISABILITIES, HURON COUNTY JOB AND FAMILY SERVICES, HURON COUNTY SERVICE FOR AGING/SENIOR ENRICHMENT SERVICES, NATIONAL ALLIANCE ON MENTAL ILLNESS HURON COUNTY, LOCAL SCHOOL DISTRICTS, NORWALK PARKS AND RECREATION, LAW ENFORCEMENT AS WELL AS CHURCHES. ADDITIONAL DETAILS CAN BE FOUND ON OUR WEBSITE: HTTPS://WWW.FISHERTITUS.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT FISHER-TITUS MEMORIAL HOSPITAL PART V, SECTION B, LINE 6A: MERCY HEALTH-WILLARD HOSPITAL AND THE BELLEVUE HOSPITAL FISHER-TITUS MEMORIAL HOSPITAL PART V, SECTION B, LINE 6B: MEMBERS OF THE HURON COUNTY HEALTH PARTNERS (THE GROUP WHO WORKED ON THE CHNA) - HURON COUNTY PUBLIC HEALTH, FAMILY LIFE COUNSELING AND PSYCHIATRIC SERVICES, FIRELANDS COUNSELING AND RECOVERY SERVICES, HURON COUNTY BOARD OF DEVELOPMENTAL DISABILTIES, HURON COUNTY MENTAL HEALTH AND ADDICTION SERVICES, HURON COUNTY JOB AND FAMILY SERVICES, HURON COUNTY SERVICES FOR AGING/SENIOR ENRICHMENT SERVICES, NATIONAL ALLIANCE ON MENTAL ILLNESS HURON COUNTY, BELLEVUE CITY SCHOOLS, IMMACCULATE CONCEPTION SCHOOL, MONROEVILLE LOCAL SCHOOLS, NEW LONDON LOCAL SCHOOLS, NORWALK CATHOLIC SCHOOLS, NORWALK CITY SCHOOLS, WESTERN RESERVE LOCAL SCHOOLS, WILLARD CITY SCHOOLS, NORWALK LION'S CLUB, CITY OF NORWALK, THE DOMESTIC VIOLENCE SHELTER, EHOVE, HURON COUNTY CLERK OF COURTS, HURON COUNTY COMMISSIONERS, HURON COUNTY HELP ME GROW, HURON COUNTY JOB AND FAMILY SERVICES, HURON COUNTY JUVENILE COURT, HURON COUNTY MASTER GARDENERS, NORWALK ECONOMIC DEVELOPMENT CORPORATION, NORWALK PARKS AND RECREATION, NORWALK UNITED FUND, OHIO STATE HIGHWAY PATROL-NORWALK POST, OHIO STATE UNIVERSITY EXTENSION OFFICE-HURON COUNTY, REACH OUR YOUTH, SECOND HARVEST FOOD BANK, WILLARD FIRE AND RESCUE. FISHER-TITUS MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: PRIORITIZED HEALTH NEEDS FROM THE MOST RECENT CHNA DONE IN 2017 AND ADOPTED IN 2018, WHICH WERE ALSO IDENTIFIED IN THE PREVIOUS CHNA DONE IN 2014 AND ADOPTED IN 2015 SO WORK CONTINUED IN 2019 ARE:PHYSICAL HEALTH-PROMOTE HEALTH AND REDUCE CHRONIC DISEASE BY PARTNERING WITH LOCAL SCHOOLS, SUPPORTING LOCAL PROGRAMS THAT ARE PROVIDING HEALTHY MEALS TO CHILDREN, SUPPORTING COMMUNITY BASED PHYSICAL ACTIVITY PROGRAMS, WORKING WITH EMPLOYERS TO EDUCATE EMPLOYEES, PROVIDED WEIGHT LOSS EDUCATION. INCREASING PUBLIC KNOWLEDGE ON DIABETES, CARDIOVASCULAR AND PULMONARY DISEASES. HEALTH SCREENINGS AND WORKING WITH PHYSICIAN OFFICES FOR THOSE ENROLLED IN MEDICARE TO INCREASE THE NUMBER OF WELLNESS VISITS AND CHRONIC CARE MANAGEMENT. ALSO WORKING WITH LOCAL SCHOOLS TO PROVIDE SEXUAL HEALTH PROGRAMS.MENTAL HEALTH AND ADDICTION-COLLABORATING ON PROJECTS WITH OTHER MENTAL HEALTH AGENCIES. COLLABORATING WITH OTHER LOCAL AGENCIES ON OPIOID THRESHOLD ALERT, SUPPORTING LOCAL AGENCIES TO GET ADDICTED INDIVIDUALS INTO APPROPRIATE FACILITIES FOR TREATMENT.ACCESS TO CARE-ASSISTING COMMUNITY MEMBERS TO GET INTO PRESCRIPTIONS TO REMAIN HEALTHY. INCREASING PUBLIC KNOWLEGE OF IMPORTANCE OF SCREENING MAMMOGRAMS AND REMOVING BARRIERS TO GETTING MAMMOGRAMS.UNINTENTIONAL INJURY-ADDRESSING UNINTENTIONAL INJURIES BY COLLABORATING WITH ORGANIZATIONS WITHIN THE COMMUNITY TO PROVIDE PROGRAMS FOR BIKE HELMETS AND SMOKE DETECTORS. WE ACKNOWLEDGE THE IMPORTANCE OF THESE SIGNIFICANT HEALTH NEEDS BUT ARE UNABLE TO ADDRESS THE FOLLOWING DUE TO LIMITED FINANCIAL RESOURCES. THE AREAS NOT ADDRESSED ARE ORAL HEALTH AND TRANSPORTATION. 2 1 - NORWALK MEMORIAL HOME 272 BENEDICT AVENUE NORWALK OH 44857 INTERMEDIATE & SKILLED NURSING FACILITY 2 - THE CARRIAGE HOUSE OF FISHER-TITUS 175 SHADY LANE DRIVE NORWALK OH 44857 ASSISTED LIVING FACILITY PART I, LINE 3C: ALONG WITH THE FEDERAL POVERTY GUIDELINES, FISHER-TITUS USES MEDICAL INDIGENCY AND UNDERINSURANCE STATUS TO HELP DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. PART I, LINE 7: THE COSTING METHODOLOGY USED FOR THE CHARITY CARE SEGMENT OF THE LINE 7 TABLE WAS THE IRS WORKSHEET 1, "CHARITY CARE AT COSTS" IN THE INSTRUCTIONS. COST TO CHARGE RATIOS WERE CARRIED OVER FROM THE IRS WORKSHEET 2 AS A BASIS TO ESTIMATE EXPENSES AND WAS APPLIED TO THE GROSS PATIENT CHARIY CARE CHARGES RECORDED IN 2019. THE COSTING METHODOLOGY USED FOR THE UNREIMBURSED MEDICAID SEGMENT ON THE LINE 7 TABLE WERE CALCULATED USING A COST TO CHARGE RATIO EXTRACTED FROM THE MEDICAID COST REPORT DATA. THE COSTING METHODOLOGY USED FOR THE "OTHER BENEFITS" SEGMENT OF THE LINE 7 TABLE WERE CALCULATED USING A COMBINATION OF DIRECT COSTS AND OUR COST ACCOUNTING SYSTEM WHICH TAKES INTO CONSIDERATION ALL PATIENT TYPES AND SEGMENTS. PART II, COMMUNITY BUILDING ACTIVITIES: IN 2019, FISHER-TITUS'S COMMUNITY BUILDING ACTIVITIES BENEFITS PROVIDED $2.8 MILLION TO SUPPORT PROGRAMS THAT IMPACTED THE OVERALL HEALTH OF OUR COMMUNITIES AND THE QUALITY OF LIFE OF OUR RESIDENTS. WHILE HOSPITAL-BASED MEDICAL SERVICES ARE THE MOST OBVIOUS WAY WE HELP, FTMC FULFILLS THE HEALTH-CARE NEEDS OF OUR AREA WITH COMMUNITY HEALTH SCREENINGS, EDUCATION CLASSES, PATIENT ASSISTANCE PROGRAMS AND SUPPORT OF HEALTH-RELATED ACTIVITIES. FTMC EMPLOYEES SERVE ON COMMUNITY AND CIVIC BOARDS, HEALTH-ORIENTED ORGANIZATIONS AND ARE INVOLVED IN ECONOMIC DEVELOPMENT ACTIVITIES THROUGHOUT THE COUNTY. FTMC ALSO WORKS WITH SCHOOLS; WORK SITES AND SAFETY NET PROVIDERS TO PROMOTE HEALTH AND WELLNESS AND PREVENT DISEASE. FISHER-TITUS IS A LEADER IN ENVIRONMENTAL STEWARDSHIP, HAVING EARNED NUMEROUS STATE AND NATIONAL AWARDS. PART III, LINE 2: THE COSTING METHODOLOGY USED FOR COMPLETING THE SCHEDULE H PART III, LINE 2 IS DERIVED FROM THE BAD DEBT EXPENSE INCLUDED IN THE AUDITED FINANCIAL STATEMENTS ADJUSTED BY THE AMOUNT OF THE WRITE-OFFS OF THE ACCOUNTS THAT WENT TO BAD DEBT. PART III, LINE 3: AS A TAX-EXEMPT HOSPITAL, NOT-FOR-PROFIT ORGANIZATION WE MUST PROVIDE NECESSARY MEDICAL CARE TO ALL, REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES PROVIDED. MAKING QUALITY PATIENT CARE AVAILABLE TO ALL IN OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC MEANS, QUALIFIES BAD DEBT AS COMMUNITY BENEFIT. THE IDENTIFICATION OF PATIENTS ELIGIBLE FOR CHARITY CARE IS SOLEY BASED ON THE COOPERATION OF THE PATIENT TO PROVIDE THE ORGANIZATION ENOUGH FAMILY AND FINANCIAL INFORMATION TO DETERMINE ELIGIBILITY TO MATCH OUR PROGRAMS. HISTORICALLY, IN ADDITION TO THE INTERNALLY IDENTIFIED CHARITY, 10-13% OF THE ACCOUNT BALANCES TURNED TO COLLECTION WERE SUBSEQUENTLY IDENTIFIED BY THE AGENCY AS CHARITY AND RETURNED. THIS CHARITY IS RECORDED ONLY WHEN IT HAS BEEN IDENTIFIED THROUGH VERIFICATION OF INABILITY TO PAY. WE DO BELIEVE THERE IS A SECOND, RELATIVELY EQUAL SEGMENT OF THE BAD DEBT THAT WOULD QUALIFY FOR CHARITY. PATIENTS WITH POOR CREDIT RATINGS AND MULTIPLE CREDITORS MAKING COLLECTION EFFORT FINDS LITTLE VALUE IN COMPLETING THE CHARITY APPLICATION PROCESS TO ONLY ELIMINATE ONE CREDITOR AND HAVE NO IMPROVEMENT TO THEIR FINANCIAL STATUS. WE ESTIMATE THAT UNDER THE CURRENT ECONOMIC CONDITIONS UNIDENTIFIED CHARITY IN BAD DEBT EXPENSE IS ESTIMATED TO BE AN ADDITIONAL $1,395,872 OR 25% OF BAD DEBT. SINCE THIS CALCULATION IS ON AN ACCRUAL BASIS, WE BELIEVE ESTIMATING 10% FOR CHARITY TO BE IDENTIFIED IN FUTURE YEARS AND AN ADDITIONAL 15% FOR BALANCES NEVER IDENTIFIED AS CHARITY IS A VERY CONSERVATIVE AND REASONABLE ESTIMATE OF THIS CHARITY CARE VALUE. PART III, LINE 4: THE FOOTNOTE THAT DISCUSSES BAD DEBT EXPENSE TREATMENT IN THE AUDIT FINANCIAL STATEMENTS IS ON PAGE 16. PART III, LINE 8: FISHER-TITUS MEDICAL CENTER'S MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO EXTRACTED FROM THE MEDICARE COST REPORT DATA. THE MEDICAL CENTER BELIEVES THAT ALL OF THE $160,096 SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT, BECAUSE OUR MISSION IS TO PROMOTE HEALTH IN THE COMMUNITY AND WE DO NOT LIMIT MEDICALLY NECESSARY CARE TO ANY PATIENTS, INCLUDING THOSE COVERED BY MEDICARE. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY. THIS YEAR, MEDICARE ACCOUNTED FOR 45.4% OF HOSPITAL REVENUES AND THESE MEDICARE BENEFICIARIES WERE PROVIDED CARE IN SPITE OF THIS SHORTFALL. CARING FOR THE MEDICARE BENEFICIARIES RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE TRUE COST FOR THEIR CARE AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. TAX EXEMPT HOSPITALS ARE ALSO EXPECTED TO PARTICIPATE IN THE MEDICARE PROGRAM. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE MEDICAL CENTER IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. PART III, LINE 9B: THE CHARITY POLICY IS A SUBSET OF THE OVERALL COLLECTION POLICY. WHEN PATIENTS ARE IDENTIFIED AS QUALIFYING FOR ANY OF THE CHARITY CATEGORIES WE SEARCH ACCOUNTS RECEIVABLE AND ACCOUNTS PLACED WITH COLLECTION AGENCIES AND PACKAGE THEM WITH THE APPLICATION. CHARITY INFORMATION IS SHARED WITH OUR RELATED ORGANIZATIONS AND FORMS THE BASIS FOR THEIR CHARITY ADJUSTMENTS. IN ADDITION WITH PATIENT APPROVAL, WE MAY CONTACT LOCAL PHYSICIAN PRACTICES WITH THE INFORMATION AS MANY WILL ADJUST THEIR BALANCES BASED UPON THE INFORMATION PROVIDED. PART VI, LINE 2: USING A SEVERITY AND SIZE COMPARISON INFORMATION THE HOSPITAL ALSO COMPARED DATA FROM HEALTHY PEOPLE 2020 AND OHIO 2017-2019 STATE IMPROVEMENT PLAN, HOSPITAL ADMISSIONS, LOCAL HEALTH CARE PROVIDER OFFICE VISITS AND LOCAL UNITED FUND DATA, AS WELL AS UNDERSERVED, LOW INCOME AGENCIES ALONG WITH THE CHNA. PART VI, LINE 3: PATIENTS ARE INTERVIEWED AFTER REGISTRATION TO ASSIST THEM IN DETERMINING EACH PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS AVAILABLE INTERNALLY AND EXTERNALLY. FTMC HAS BILINGUAL SIGNAGE POSTED IN THE ADMITTING/REGISTRATION AREAS, BILLING OFFICE AND FINANCIAL COUNSELING OFFICES, AND IN THE INPATIENT GUIDES IN THE PATIENT ROOMS. THE FTMC WEBSITE HAS A SECTION ABOUT THE FINANCIAL ASSISTANCE PROGRAM AND CONTACT INFORMATION. A MESSAGE ABOUT FINANCIAL ASSISTANCE AND CHARITY CARE ALSO IS INCLUDED ON THE BILLS THAT ARE SENT TO THE PATIENTS. MANY MATERIALS ARE BILINGUAL AND INTERPRETATION SERVICES ARE AVAILABLE. OUR SOCIAL SERVICES DEPARTMENT REGULARLY REFERS PATIENTS IN NEED TO OUR FINANCIAL COUNSELORS FOR ASSISTANCE. WE ALSO TAKE REFERRALS FROM THE LOCAL COUNTY HUMAN SERVICES AGENCIES, VICTIMS OF VIOLENT CRIMES, LOCAL HEALTH DEPARTMENTS, LOCAL LAW ENFORCEMENT AGENCIES, CHURCHES, ETC. FTMC IS VERY PROACTIVE IN TAKING THE MESSAGE TO OUR COMMUNITY. BROCHURES ARE AVAILABLE AT COMMUNITY OUTREACH EVENTS HELD IN THE HOSPITAL AND AT OUTSIDE COMMUNITY EVENTS. FTMC COMMUNICATES THE INFORMATION ABOUT CHARITY CARE PROGRAMS THROUGH ITS COMMUNITY NEWSLETTER AND LOCAL NEWS MEDIA. PART VI, LINE 4: THE FISHER-TITUS MEDICAL CENTER PROVIDES COMPREHENSIVE STATE-OF-THE ART HEALTH CARE SERVICES TO THE RESIDENTS OF HURON AND ERIE AS WELL AS PORTIONS OF OTHER CONTIGUOUS COUNTIES WITH THE LATEST MEDICAL ADVANCEMENTS. FISHER-TITUS'S PRIMARY AREA IS THE GREATER HURON COUNTY AREA IN NORTH CENTRAL OHIO, WHICH IS HOME TO AROUND 58,300 RESIDENTS. FISHERS-TITUS'S 50 ACRE CAMPUS IS IN THE COUNTY SEAT OF NORWALK, WHICH IS THE LARGEST CITY IN THE COUNTY WITH OVER 16,800 RESIDENTS. FISHERS-TITUS HAS NUMEROUS MEDICAL OFFICES LOCATED THROUGHOUT THE COUNTY TO PROVIDE EASY ACCESS TO PHYSICIANS FOR COMMUNITY RESIDENTS. HURON COUNTY HAD THE 12TH HIGHEST LEVEL OF UNEMPLOYMENT WITH AN AVERAGE OF 5.9% IN 2019. THE LARGEST PERCENTAGE OF RESIDENTS ARE CHILDREN UNDER 18 WITH THOSE INDIVIDUALS 65 AND OLDER MAKING UP 17.6% OF THE POPULATION. 89.9% OF THE RESIDENTS ARE CAUCASIAN WITH 6.9% OF THE POPULATION BEING HISPANIC OR LATINO (OF ANY RACE). IN 2018, MEDIAN HOUSEHOLD INCOME WAS $51,560 COMPARED TO OHIO'S MEDIAN HOUSEHOLD INCOME OF $54,535. IN 2018, 13.6% OF INDIVIDUALS WERE LIVING IN POVERTY WITH THOSE UNDER THE AGE OF 18 LIVING IN POVERTY ESTIMATED TO BE 21.0%. PART VI, LINE 5: THE BOARD OF DIRECTORS IS COMPOSED OF AREA RESIDENTS INCLUDING BUSINESS AND COMMUNITY LEADERS, PHYSICIANS AND OTHER INTERESTED PERSONS. THESE VOLUNTEERS GIVE COUNTLESS HOURS OF SERVICE TO THE MEDICAL CENTER IN THEIR OVERSIGHT ROLE. THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS, IN FUNDRAISING, AND IN GENERAL STEWARDSHIP. FTMC'S MEDICAL STAFF IS OPEN AND PRIVILEGES ARE GRANTED TO ALL QUALIFIED PHYSICIANS WHO APPLY AND MEET THE STANDARDS OF THE MEDICAL CENTER PRIVILEGING PROCESS. THE MEDICAL CENTER UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND TO EXPAND ACCESS POINTS OF CARE TO PATIENTS THROUGHOUT THE COMMUNITY INCLUDING, BUT NOT LIMITED TO THE FOLLOWING:1. EDUCATIONAL PROGRAMS THAT PROVIDE CLASSES AND INFORMATION ON TOBACCO CESSATION, HEALTHY AGING, CHILDBIRTH, INFANT CARE, EARLY PREGNANCY AND MORE.2. FREE MAMOGRAMS TO QUALIFYING INDIVIDUALS, FREE OR LOW-COST SCREENINGS FOR HEART DISEASE, BREAST, PROSTATE, SKIN AND COLORECTAL CANCER AS WELL AS OSTEOPOROSIS ASSESSMENTS. 1 FISHER TITUS FOUNDATION 272 BENEDICT AVE NORWALK OH 44857 341476934 501(C)(3) 25000 FMV SUPPORT HIGH SCHOOL CONCUSSION PROGRAM NORWALK AREA UNITED FUND PO BOX 134 NORWALK OH 44857 340906312 501(C)(3) 10000 FMV CONTRIBUTION TO HELP THE LOCAL COMMUNITY TEEN LEADERSHIP CORPS 11 E AIN ST NORWALK OH 44857 260324010 501(C)(3) 5000 FMV SUPPORT TEEN LEADERSHIP CLASSES BGSU FOUNDATION INC MILETI ALUMNI CENTER BOWLING GREEN OH 43403 346007199 501(C)(3) 10000 FMV ALLIED HEALTH & SCIENCE BDG. PROJECT SHELBY CHRISTIAN AND MISSIONARY CHURCH 105 E SMILEY AVE SHELBY OH 44875 341354574 501(C)(3) 92233 FMV MISC. OPERATING AND MEDICAL SUPPLIES SUPPLIES TO AID IN CARRYING OUT THE ORGANIZATION'S CHARITABLE PURPOSE SHELBY CHRISTIAN AND MISSIONARY CHURCH 105 E SMILEY AVE SHELBY OH 44875 341354574 501(C)(3) 53529 FMV MISC. CATH LAB MEDICAL SUPPLIES SUPPLIES TO AID IN CARRYING OUT THE ORGANIZATION'S CHARITABLE PURPOSE 5 PART I, LINE 2: THE MEDICAL CENTER REVIEWS EACH GRANT OR DONATION REQUEST BEFORE THE GRANT OR DONATION IS MADE. X 0 0 X X X X X X 1 1 0 0 0 0 0 0 0 BRENT W BURKEY MD PRESIDENT 400465 0 36800 0 4662 0 55911 0 3000 0 500838 0 0 0 MATTHEW C GROSS CEO-END MAR '19/SR. ADVISOR TO BOARD 238657 0 0 0 46082 0 9995 0 24807 0 319541 0 0 0 SCOTT E ENDSLEY CHIEF FINANCIAL OFFICER 192645 0 10000 0 10415 0 30267 0 9294 0 252621 0 0 0 STEVEN FRIES CHIEF OPERATIONS OFFICER 140144 0 0 0 1331 0 5227 0 11346 0 158048 0 0 0 PHILLIP J ANNARINO-END APR '19 CHIEF HUMAN RESOURCE OFFICER 90993 0 0 0 160030 0 2860 0 12345 0 266228 0 0 0 KATIE CHIEDA CHIEF NURSING OFFICER 187815 0 10000 0 1802 0 35338 0 32943 0 267898 0 0 0 GARY MOORMAN CHIEF MEDICAL OFFICER-START JAN 2019 315114 0 0 0 2166 0 11083 0 18629 0 346992 0 0 0 CHERIE M SPRAGG-END NOV 2019 CHIEF POPULATION HEALTH OFFICER 175948 0 0 0 26111 0 100193 0 10378 0 312630 0 0 0 LINDA STEVENSON-START FEB 2019 CHIEF INFORMATION OFFICER 149838 0 10000 0 1216 0 5663 0 15293 0 182010 0 0 0 GREGORY P COOK MD PHYSICIAN 560679 0 110220 0 21455 0 16823 0 26809 0 735986 0 0 0 DANIEL D MULLIGAN MD PHYSICIAN 214193 0 1264 0 1183 0 8134 0 15534 0 240308 0 0 0 ROBERT W RICE MD PHYSICIAN 518177 0 145970 0 2121 0 16712 0 32883 0 715863 0 0 0 DONALD L SMITH JR MD PHYSICIAN 394016 0 138951 0 21242 0 14291 0 23320 0 591820 0 0 0 PATRICK R WATERS MD PHYSICIAN 661064 0 103659 0 21482 0 16936 0 28874 0 832015 0 0 0 PART I, LINES 4A-B PART I LINE 4B & PART II, LINE 1 - INCLUDED IN DR. BURKEY'S TOTAL CONTRIBUTION TO DEFERRED COMPENSATION OF $55,911 REPORTED IN COLUMN C IS $13,071 OF VESTED DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $42,840 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 4A & PART II, LINE 2 - INCLUDED IN MR. GROSS'S TOTAL W-2 COMPENSATION OF $284,739 IS $44,662 IN SEVERANCE PAY WHICH WAS A ONE TIME PAYMENT. HIS LAST DAY WAS DEC-31-2019. PART I LINE 4B & PART II, LINE 3 - INCLUDED IN MR. ENDSLEY'S TOTAL CONTRIBUTION TO DEFERRED COMPENSATION OF $30,267 REPORTED IN COLUMN C IS $8,674 OF VESTED DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $21,593 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 4A & PART II, LINE 5 - INCLUDED IN MR. ANNARINO'S TOTAL W-2 COMPENSATION OF $251,023 IS $154,429 IN SEVERANCE PAY. PART I LINE 4B & PART II, LINE 6 - INCLUDED IN MS. CHIEDA'S TOTAL CONTRIBUTIONS TO DEFERRED COMPENSATION OF $35,338 REPORTED IN COLUMN C IS $7,929 OF VESTED DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $27,409 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 I LINE 4A & PART II, LINE 8 - INCLUDED IN MS. SPRAGG'S TOTAL W-2 COMPENSATION OF $202,059 IS $24,500 IN SEVERANCE PAY. PART I LINE 1A MEMBERSHIP IN A GOLF COUNTRY CLUB WAS ISSUED TO 3 CORPORATE OFFICERS AND WAS NOT TREATED AS TAXABLE COMPENSATION. PART I LINE 1B THE CEO DETERMINED AND MADE THE DECISION. PART 1 LINE 3: RESPONSIBILITY FOR DETERMINING AND RECOMMENDING EXECUTIVE COMPENSATION RESTS WITH THE PERSONNEL COMMITTEE OF THE FISHER-TITUS HEALTH, INC. 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 BENEFITS AND 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 PROVIDED TO EACH OF THE DIRECTORS OF FISHER-TITUS HEALTH. THE RECOMMENDATIONS TO BE ACTED ON MUST BE APPROVED FIRST BY THE PERSONNEL COMMITTEE AND THEN BY THE FISHER-TITUS HEALTH'S BOARD OF DIRECTORS. THE MINUTES OF EACH BOARD MEETING WHERE ACTION IS TAKEN REFLECT SUCH ACTION. THE PROCESS IS PERFORMED ANNUALLY IN THE SPRING AND WAS LAST DONE IN MARCH 2019. A COUNTY OF HURON OHIO 346400672 2015-04-01 9420000 SEE PART VI BELOW 0 0 0 B COUNTY OF HURON OHIO 346400672 2017-08-15 17825000 SEE PART VI BELOW 0 0 0 A 9420000 50000 9370000 2015 1 0 1 1 B 17825500 239217 6645200 10941083 2017 1 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 1 0 0 1 1 PNC 6.800000000000 1 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 0 B 0 PART I, LINE A: SERIES 2015A BONDS - PURPOSE WAS TO REFUND THE HOSPITAL'S COUNTY OF HURON REVENUE BONDS, SERIES 2003A BONDS. PART 1, LINE B: SERIES 2017A BONDS - PURPOSE WAS TO REFUND THE HOSPITAL'S COUNTY OF HURON REVENUE BONDS, SERIES 2007A BONDS AND ACQUIRE ADDITIONAL HOSPITAL EQUIPMENT. PART II, LINE 11, COLUMN A: INCLUDED IN COLUMN A $9,370,000 OF THE PROCEEDS WERE USED TO REFUND THE HOSPITAL'S COUNTY OF HURON REVENUE BONDS, SERIES 2003A BONDS. PART II, LINE 11, COLUMN B: INCLUDED IN COLUMN B $10,941,083 OF THE PROCEEDS WERE USED TO REFUND THE HOSPITAL'S COUNTY OF HURON REVENUE BONDS, SERIES 2007A BONDS. BRENT BURKEY PRESIDENT SEE PART V X 80000 80000 0 1 1 80000 MR FRIES MS. FRIES HAS A FAMILY RELATIONSHIP WITH OFFICER STEVEN FRIES. 56096 EMPLOYMENT 0 BATTLES INSURANCE AGENCY PERRY DRYDEN, BOARD MEMBER IS PRESIDENT OF BATTLES INSURANCE AGENCY AND 50% 813201 VENDOR 0 ZZZ ANESTHESIA NICHOLAS LIBEN, BOARD MEMBER IS OWNER OF ZZZ ANESTHESIA. 395000 VENDOR 0 PART IV: PART IV, LINE 5 - PERRY DRYDEN, BOARD MEMBER IS PRESIDENT OF BATTLES INSURANCE AGENCY AND 50% OWNER. PART IV: PART II LINE 1 - THE LOAN REPRESENTS THE VALUE OF THE PURCHASE OF A SPLIT-DOLLOAR LIFE INSURANCE POLICY TO SUPPLEMENT RETIREMENT INCOME AND RETURN PREMIUMS TO THE ORGANIZATION BASED ON THE AGREEMENT. X 1 14413 FMV X 1 242000 FMV X MEDICAL EQUIPMENT 1 7991 FMV 0 1 0 FORM 990, PART III, LINE 4A: FISHER-TITUS MEDICAL CENTER (FTMC) IS AN INDEPENDENT NON-PROFIT COMMUNITY HEALTHCARE ORGANIZATION GOVERNED BY A BOARD OF DIRECTORS COMPOSED OF AREA RESIDENTS INCLUDING BUSINESS AND COMMUNITY LEADERS, PHYSICIANS AND OTHER INTERESTED INDIVIDUALS. FTMC IS COMPOSED OF THE FOLLOWING FIVE OPERATING DIVISIONS: FISHER-TITUS MEMORIAL HOSPITAL THE HOSPITAL PROVIDES INPATIENT AND OUTPATIENT HEALTHCARE SERVICES TO THE RESIDENTS OF HURON, ERIE AND THE ADJACENT COUNTIES OF SANDUSKY, CRAWFORD, LORAIN, ASHLAND AND RICHLAND. IN 2019, THE HOSPITAL PROVIDED 10,192 DAYS OF INPATIENT CARE TO 3,421 PATIENTS. THE HOSPITAL HAD 144,599 OUTPATIENT AND 28,028 EMERGENCY ROOM VISITS DURING THE YEAR. THE NORWALK MEMORIAL HOME THE NORWALK MEMORIAL HOME PROVIDES SKILLED AND LONG-TERM CARE IN ITS TRANSITIONAL AND EXTENDED CARE UNITS. DURING 2019, THE HOME SERVED 370 RESIDENTS AND PROVIDED 23,644 DAYS OF CARE. THE HOME HEALTH CENTER HOME HEALTH AGENCY THE HOME HEALTH CENTER PROVIDED 14,847 HOME VISITS TO 366 DIFFERENT PATIENTS IN 2019. THE CARRIAGE HOUSE OF FISHER-TITUS OPENED IN 1998, THE CARRIAGE HOUSE IS A 48-UNIT ASSISTED LIVING FACILITY, WHICH PROVIDED 15,764 DAYS OF ASSISTED LIVING CARE TO 57 RESIDENTS IN 2019. KAISER COMMUNITY PHARMACY AND HOME MEDICAL EQUIPMENT OPENED IN 1941, KAISER-WELLS PHARMACY IS A COMMUNITY LOCAL PHARMACY AND MEDICAL EQUIPMENT STORE. IN NOV-2016, KAISER-WELLS WAS ACQUIRED BY FISHER-TITUS MEDICAL CENTER. FACILITY AND PROGRAM EXPANSIONS DR. BRENT W. BURKEY ASSUMED LEADERSHIP AS PRESIDENT & CEO OF FISHER-TITUS IN FEBRUARY 2019. HE WAS PREVIOUSLY APPOINTED AS PRESIDENT OF FISHER-TITUS IN MARCH 2018 AND SERVED ALONGSIDE CEO, MATTHEW GROSS FOR ONE YEAR. PRIOR TO JOINING FISHER-TITUS, DR. BURKEY WAS CHIEF MEDICAL OFFICER AT CLEVELAND CLINIC AVON HOSPITAL. HE SPENT 14 YEARS WITH THE CLEVELAND CLINIC IN LEADERSHIP POSITIONS ACROSS A VARIETY OF DISCIPLINES INCLUDING CLINICAL, INFORMATION TECHNOLOGY, AND OPERATIONS. IN FEBRUARY 2019, FISHER-TITUS ANNOUNCED IT WAS EXPANDING THE LEVEL OF CARDIAC CARE AVAILABLE TO PATIENTS AT THE SNYDER/WHITE HEART & VASCULAR CENTER. THE HEART & VASCULAR CENTER WAS CERTIFIED BY THE OHIO DEPARTMENT OF HEALTH AS A LEVEL II ADULT CARDIAC CATHETERIZATION LABORATORY ON FEBRUARY 14 ALLOWING PATIENT TO RECEIVE INTERVENTIONAL HEART CATHETERIZATIONS. FISHER-TITUS AND LOCAL SURGEONS ANNOUNCED A COLLABORATION ON A REGIONAL SURGERY CENTER IN AUGUST OF 2019. FISHER-TITUS AND CERTAIN SURGEONS FROM BAY AREA DIGESTIVE HEALTH, NOMS ACCESS ORTHOPEDICS AND NOMS EAR, NOSE & THROAT, NORTHERN OHIO FOOT AND ANKLE SPECIALISTS, AND NORTH CENTRAL EYE ASSOCIATES, ALONG WITH HEALTH CARE FACILITIES PARTNERS, HAVE ENTERED INTO A JOINT BUSINESS VENTURE TO PLAN, CONSTRUCT AND OPEN AN AMBULATORY SURGERY CENTER IN NORWALK. THE SURGERY CENTER OF NORTH CENTRAL OHIO WILL SERVE AREA RESIDENTS WITH AFFORDABLE OUTPATIENT SURGICAL SERVICES AND PROCEDURES. IT IS EXPECTED TO OPEN IN LATE 2020. FISHER-TITUS FAMILY MEDICINE NEW LONDON BROKE GROUND ON A NEW FACILITY IN SEPTEMBER OF 2019. THE NEW BUILDING FEATURES 3,500 SQUARE FEET THAT INCLUDES TWO MEDICAL OFFICE SUITES, EIGHT PATIENT EXAM ROOMS, TWO NURSE STATIONS AND WORK AREAS, AND OFFICE SPACE FOR PROVIDERS. THE UPDATED FACILITY OPENED TO PATIENTS IN FEBRUARY 2020. EDUCATION AND RESEARCH - TO ENSURE THAT WE HAVE THE QUALITY WORKFORCE WE NEED TO CARE FOR OUR COMMUNITY IN THE FUTURE, WE ARE COMMITTED TO THE EDUCATION OF CURRENT AND FUTURE CAREGIVERS, AND WE WORK WITH EHOVE CAREER CENTER, ASHLAND UNIVERSITY, BOWLING GREEN STATE UNIVERSITY FIRELANDS CAMPUS, LORAIN COUNTY COMMUNITY COLLEGE, NORTH CENTRAL STATE COLLEGE, TERRA COMMUNITY COLLEGE, OHIO UNIVERSITY AND MORE TO PROVIDE INTERNSHIPS, INSTRUCTORS, CLASSROOM SPACE, AND CLINICAL TRAINING. WE ARE PLEASED TO BE ABLE TO OFFER A COMPREHENSIVE LEARNING EXPERIENCE UTILIZING OUR STATE-OF-THE-ART FACILITIES AND ADVANCED TECHNOLOGY. EXCELLENT PHYSICIANS - THE MEDICAL STAFF IS COMPOSED OF BOTH INDEPENDENT PRACTITIONERS AS WELL AS PHYSICIANS AND PROVIDERS EMPLOYED BY FISHER-TITUS UNDER THE NAME FISHER-TITUS MEDICAL CARE. OVERALL, THE MEDICAL STAFF INCLUDES 237 PHYSICIANS AND ALLIED HEALTH PROFESSIONALS, REPRESENTING 35 MEDICAL SPECIALTIES. THE MEDICAL CARE EMPLOYED GROUP INCLUDES PRACTITIONERS REPRESENTING PRIMARY CARE, PEDIATRICS, WOMEN'S HEALTH, DIGESTIVE HEALTH, UROLOGY, BEHAVIORAL HEALTH, UROLOGY, ENDOCRINOLOGY, PULMONOLOGY, CARDIOLOGY, AND VASCULAR CARE. IN 2019, 2 BEHAVIORAL HEALTH, 3 CONVENIENT CARE, 2 WOMEN'S HEALTH, 1 FAMILY MEDICINE, AND 1 VASCULAR PROVIDER JOINED THE GROUP. AWARDS AND ACCREDITATIONS - THROUGHOUT THE YEARS FISHER-TITUS HAS BEEN HIGHLY SUCCESSFUL IN MEETING THE CHALLENGES OF AN INCREASINGLY COMPLEX HEALTH-CARE INDUSTRY AND HAS PROVIDED EXCEPTIONAL SERVICE QUALITY TO MEMBERS OF THE SURROUNDING COMMUNITIES. THE MEDICAL CENTER IS ACCREDITED BY THE HEALTHCARE FACILITIES ACCREDITATION PROGRAM (HFAP), WITH ITS LAST THREE-YEAR SURVEY OCCURRING IN 2016. FISHER-TITUS ALSO IS A LEVEL 3 TRAUMA CENTER, HFAP PRIMARY STROKE CENTER, A LEVEL 2 ADULT CARDIAC CATHETERIZATION LABORATORY, AND HAS ALSO BEEN ACCREDITED BY THE COMMISSION ON CANCER SINCE 1989. THE MEDICAL CENTER'S FOCUS ON QUALITY CARE AND EXCEPTIONAL SERVICE IS EVIDENCED BY THE MANY HOSPITAL AND DEPARTMENTAL ACCREDITATIONS, AWARDS, AND RECOGNITIONS RECEIVED IN 2019: THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES TARGET: STROKE HONOR ROLL GOLD PLUS QUALITY ACHIEVEMENT AWARD RECOGNIZES THE HOSPITAL'S COMMITMENT TO ENSURING STROKE PATIENTS RECEIVE THE MOST APPROPRIATE TREATMENT ACCORDING TO NATIONALLY RECOGNIZED, RESEARCH-BASED GUIDELINES BASED ON THE LATEST SCIENTIFIC EVIDENCE. NORWALK MEMORIAL HOME RECEIVED TWO AWARDS FOR THE CARE THEY PROVIDE RESIDENTS. THE CENTERS FOR MEDICARE AND MEDICAID SERVICES NURSING HOME COMPARE AWARDED NORWALK MEMORIAL HOME A 5-STAR RATING. ON THE OHIO DEPARTMENT OF AGING FAMILY SATISFACTION SURVEY, NORWALK MEMORIAL HOME RECEIVED AN AVERAGE SCORE OF 90.6% ABOVE THE STATE AVERAGE OF 77.8%. IN ADDITION, THE MEDICAL CENTER MAINTAINS THE FOLLOWING ONGOING ACCREDITATIONS: COMMISSION ON CANCER ACCREDITATION, ONCOLOGY, LABORATORY, PHARMACY DEPARTMENTS. FISHER-TITUS ENDOSCOPY CENTER, AMERICAN SOCIETY OF GASTROINTESTINAL ENDOSCOPY (ASGE) RECOGNITION FOR COMMITMENT TO PATIENT SAFETY AND QUALITY IN ENDOSCOPY SERVICES. CARDIOVASCULAR CATH LAB, OHIO DEPARTMENT OF HEALTH FISHER-TITUS SLEEP CENTER, ACCREDITATION COMMISSION FOR HEALTH CARE (ACHC) OHIO DEPARTMENT OF HEALTH MAMMOGRAPHY QUALITY STANDARDS AMERICAN COLLEGE OF RADIOLOGY, MAMMOGRAPHY OHIO DEPARTMENT OF HEALTH, RADIOLOGY NORWALK MEMORIAL HOME AND CARRIAGE HOUSE ASSISTED LIVING, OHIO DEPARTMENT OF HEALTH HOME HEALTH DEPARTMENT, OHIO DEPARTMENT OF HEALTH NUCLEAR MEDICINE, OHIO DEPARTMENT OF HEALTH INTERSOCIETY COMMISSION FOR THE ACCREDITATION OF VASCULAR LAB, ULTRASOUND COLLEGE OF PATHOLOGISTS (CAP) ACCREDITATION - DEPARTMENT OF PATHOLOGY & LABORATORY SERVICES & BLOOD GAS LAB COLLEGE OF PATHOLOGISTS (CAP) PULMONARY MEDICINE AMERICAN COLLEGE OF RADIOLOGY ACCREDITATION FOR MAGNETIC RESONANCE IMAGING AMERICAN DIABETES ASSOCIATION EDUCATION RECOGNITION CERTIFICATE INTERSOCIETAL ACCREDITATION COMMISSION (IAC) ECHO MATERNITY, OHIO DEPARTMENT OF HEALTH SURVEY FORM 990, PART III, LINE 4A: COMMUNITY HEALTH AND OUTREACH PROGRAMS FISHER-TITUS MEDICAL CENTER'S COMMUNITY BENEFITS EXTEND OUTSIDE OUR WALLS TO FAMILIES, BUSINESS, SCHOOLS, CHURCHES AND NEIGHBORHOODS THROUGH OUTREACH PROGRAMS AND OTHER COORDINATED CARE ACTIVITIES THAT MAKE OUR COMMUNITIES HEALTHIER PLACES TO LIVE, WORK AND WORSHIP. OUR GOAL IS TO HELP ALL RESIDENTS EQUALLY ACCESS THE CARE THEY NEED, AND HELP THEM LEARN TO MANAGE THEIR CONDITIONS AND LIVE HEALTHIER, SAFER LIVES. IN 2017 A NEW HURON COUNTY HEALTH NEEDS ASSESSMENT WAS COMPLETED AND PUBLISHED. FISHER-TITUS WAS A LEADER IN THE PROCESS AND PARTNERED WITH HEALTH-RELATED AND CIVIC ORGANIZATIONS THROUGHOUT THE COUNTY TO BOTH FUND THE PROJECT AND ASSIST IN THE ASSESSMENT PROCESS. FROM THAT REPORT, THE BOARD OF DIRECTORS OF FISHER-TITUS MEDICAL CENTER DETERMINED THAT CERTAIN HEALTH NEEDS IDENTIFIED IN THE ASSESSMENT SHOULD BE ADDRESSED AS THE HIGHEST PRIORITY THROUGH AN IMPLEMENTATION STRATEGY. THE PRIORITIES INCLUDE: SUPPORTING INITIATIVES GEARED TO HEALTHY WEIGHT; IMPROVING ACCESS TO MENTAL HEALTH SERVICES; REDUCING SUBSTANCE ABUSED THROUGH PREVENTION, SCREENING AND TREATMENT; IMPROVING ACCESS TO CARE; AND IMPROVING THE PUBLIC HEALTH INFRASTRUCTURE. FISHER-TITUS SUPPORTS OTHER AREA NON-PROFIT COMMUNITY ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICE AND EMPLOYEE VOLUNTEERISM. MANY OF OUR COMMUNITY BENEFIT PROGRAMS ARE ORGANIZED TO WORK COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS. IN 2019, WE OFFERED COMMUNITY HEALTH EDUCATION PROGRAMS, INCLUDING SCHOOL-BASED PROGRAMS, SUPPORT GROUPS, COMMUNITY-BASED HEALTH FAIRS AND SCREENINGS, AND WALKING AND FITNESS PROGRAMS THAT IMPACTED OUR RESIDENTS THROUGH 48,805 ENCOUNTERS. AUXILIARY AND VOLUNTEER SERVICE: - DURING 2019, OUR 134 CARING VOLUNTEERS DONATED 44,065 HOURS OF AUXILIARY AND VOLUNTEER SERVICES TO THE MEDICAL CENTER. VOLUNTEERS PROVIDE A VARIETY OF SERVICES INCLUDING HELPING FAMILY MEMBERS, PROVIDING TRANSPORTATION, ASSISTING AT COMMUNITY HEALTH PROGRAMS, DELIVERING REFRESHMENTS, MAIL AND FLOWERS TO HOSPITAL PATIENTS AND RESIDENTS OF THE NORWALK MEMORIAL HOME PLUS ESCORTING PATIENTS THROUGHOUT THE BUILDING. THEY ALSO PERFORM CLERICAL DUTIES, STAFF THE MEDICAL CENTER'S GIFT SHOP, AND ORGANIZE SEVERAL FUND-RAISING EVENTS THROUGHOUT THE YEAR. VOLUNTEER "AMBASSADORS" HAVE INSTRUCTED PATIENTS SINCE APRIL 2010 ON THE USE OF THE TELEVISION/COMPUTER SCREENS LOCATED IN EACH PATIENT ROOM. VOLUNTEERS WORKING IN THIS CAPACITY ARE AT FISHER-TITUS MEDICAL CENTER SEVEN DAYS PER WEEK EACH MORNING FOR 2 HOURS. AMONG THE ITEMS PATIENTS ARE INSTRUCTED ON ARE HOW TO ACCESS THE DAY'S MENU, MEDICAL INFORMATION PERTAINING TO THE PERSON'S HEALTH PROBLEMS, ACCESSING THE INTERNET, PLAYING GAMES, OBTAINING THE NAMES OF CAREGIVERS AS THEY ENTER THE PATIENT'S ROOM, CHOOSING MOVIES, ETC. THE PATIENT THEN MAY USE A REMOTE CONTROL OR A WIRELESS KEYBOARD TO ACCESS THIS INFORMATION. INFORMATION SERVICES PROVIDES ALL COMPUTER TRAINING FOR VOLUNTEERS THAT WORK IN THIS CAPACITY. COMMUNITY HEALTH IMPROVEMENT SERVICES: NUMEROUS HEALTH SCREENINGS ARE OFFERED THROUGHOUT THE YEAR AT THE MEDICAL CENTER AND AT VARIOUS COMMUNITY LOCATIONS AND EVENTS THROUGHOUT OUR SERVICE AREA. THESE PROGRAMS INCLUDE SCREENING FOR BLOOD PRESSURE, BLOOD GLUCOSE, CHOLESTEROL LEVELS, SKIN CANCER, PROSTATE CANCER, OSTEOPOROSIS AND SCREENING MAMMOGRAMS. IN ADDITION, THE MEDICAL CENTER SPONSORS NUMEROUS SUPPORT GROUPS TO PROVIDE EDUCATION, CARE AND EMOTIONAL SUPPORT TO INDIVIDUALS AND FAMILIES AFFECTED BY DISABILITIES AND CHRONIC MEDICAL CONDITIONS. FTMC'S HEALTH MINISTRY PROGRAM, FORMED IN 2000, HAS BEEN A VERY EFFECTIVE GRASSROOTS INITIATIVE TO GATHER INFORMATION AND PROVIDE HEALTH PROGRAMS THROUGHOUT HURON COUNTY. CURRENTLY 50 AREA CONGREGATIONS ARE MEMBERS OF THE FTMC HEALTH MINISTRY PROGRAM WHICH PROVIDES HEALTH AND WELLNESS INFORMATION AND PROGRAMS IN AREA CHURCHES. THE MEDICAL CENTER IN PARTNERSHIP WITH ITS PHYSICIANS AND OTHER COMMUNITY ORGANIZATIONS PROVIDES PUBLIC FORUMS AND EDUCATIONAL SESSIONS ON A VARIETY OF TOPICS, WHICH ARE SOMETIMES HELD IN TANDEM WITH THE HEALTH SCREENINGS PROVIDED. WE ALSO PROVIDE NUMEROUS HEALTH FAIRS DURING THE YEAR IN SEVERAL LOCATIONS THROUGHOUT THE COUNTY AND SURROUNDING COMMUNITIES IN OUR SERVICE AREA. THESE COMMUNITY HEALTH IMPROVEMENT SERVICES BENEFITED 46,845 PEOPLE IN 2019 AT A COST OF $273,595. PROFESSIONAL MEDICAL EDUCATION: THE MEDICAL CENTER SUPPORTS THE FAMILY PRACTICE RESIDENCY PROGRAM AT FIRELANDS REGIONAL MEDICAL CENTER TO ENHANCE THE AVAILABILITY OF FAMILY PRACTICE PHYSICIANS WITHIN THE LOCAL COMMUNITY. FTMC FUNDS THE COST OF A FAMILY PRACTICE RESIDENT THAT SHARES TIME BETWEEN THE HOSPITAL'S EMERGENCY ROOM AND THE COUNTY HEALTH DEPARTMENT CARING FOR THE UNDERSERVED. IN ADDITION, FTMC SUPPORTS AND STAFFS SEVERAL CLASSES FOR HEALTH PROFESSIONALS INCLUDING HEALTHCARE PROVIDER CPR, ADVANCED CARDIAC LIFE SUPPORT, BASIC LIFE SUPPORT INSTRUCTOR COURSE AND PEDIATRIC ADVANCE LIFE SUPPORT. THE TOTAL COST OF PROFESSIONAL MEDICAL EDUCATION PROVIDED TO 83 PARTICIPANTS WAS $26,872. SUBSIDIZED HEALTH SERVICES: THE MEDICAL CENTER ALSO SUBSIDIZES CERTAIN HEALTH SERVICES AND PROCESSES IN ORDER TO ADDRESS SPECIFIC HEALTH ISSUES IN THE COMMUNITY, PROVIDE CARE TO THE UNDERSERVED, OR ENHANCE THE OVERALL QUALITY OF HEALTHCARE WITHIN THE COMMUNITY. THE COST ASSOCIATED WITH THE HEALTH SERVICES IN 2019 WAS $234,261. DONATIONS AND COMMUNITY SUPPORT: THE MEDICAL CENTER MAKES CASH AND NON-CASH CONTRIBUTIONS ANNUALLY TO LOCAL NON-PROFIT ORGANIZATIONS THAT BENEFIT THE HEALTH AND DEVELOPMENT OF OUR LOCAL COMMUNITY AND ITS RESIDENTS. IN ADDITION, THE MEDICAL CENTER SUPPORTS AREA SCHOOLS BY AWARDING SPECIAL HEALTH EDUCATION GRANTS TO SCHOOL DISTRICTS IN OUR SERVICE TERRITORY TO FUND INNOVATIVE PROGRAMS IN THE AREAS OF SCIENCE, MATH, HEALTH AND HEALTH RELATED EDUCATION. THE TOTAL COST OF THESE DONATIONS AND SUPPORT IN 2019 WAS $254,351. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF FISHER-TITUS MEDICAL CENTER IS THE PARENT COMPANY FISHER-TITUS HEALTH, AN OHIO NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS SHALL BE COMPOSED OF THOSE INDIVIDUALS WHO ARE VOTING DIRECTORS OF THE MEMBER AT ANY TIME, AS DETERMINED UNDER THE CODE OF REGULATIONS OF THE MEMBER (FISHER-TITUS HEALTH). FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING POWERS ARE RESERVED EXCLUSIVELY TO THE MEMBER (FISHER-TITUS HEALTH): A) TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION AND THE CODE OF REGULATIONS; B) TO APPROVE ANY MERGER OF THE CORPORATION OR ANY SALE OF SUBSTANTIALLY ALL OF ITS ASSETS; TO DISSOLVE OR TERMINATE THE EXISTENCE OF THE CORPORATION AND TO DETERMINE THE DISTRIBUTION OF ASSETS UPON SUCH TERMINATION. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS OF THE FISHER-TITUS MEDICAL CENTER DELEGATED THE RESPONSIBILITY FOR THE REVIEW OF THE MEDICAL CENTER'S 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 MEDICAL CENTER'S FORM 990 PRIOR TO FILING AND REPORTED TO THE MEDICAL CENTER'S BOARD OF DIRECTORS REGARDING THE RESULTS OF THEIR REVIEW. IN ADDITION, EACH MEMBER OF THE MEDICAL CENTER'S BOARD OF DIRECTORS HAD ACCESS TO A COPY OF THE FORM 990 FOR VIEWING PRIOR TO FILING VIA A SECURE INTERNET WEBSITE AND A PAPER COPY WAS AVAILABLE FOR REVIEW AT THE BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C ALL OF OUR AFFILIATED 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 ADMINISTRATION. AREAS OF CONFLICT ARE REVIEWED AND ADDRESSED AS NECESSARY TO THE TRANSACTIONS OF THE BOARD. IF AN AREA OF CONFLICT ARISES, BOARD MEMBERS ARE EXCUSED AND PROHIBITED FROM PARTICIPATING IN THE BOARD'S DELIBERATIONS AND DISCUSSIONS REGARDING THE AREA OF CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 RESPONSIBILITY 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 BENEFITS AND 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 PROVIDED TO EACH OF THE DIRECTORS OF FISHER-TITUS HEALTH. THE RECOMMENDATIONS TO BE ACTED ON MUST BE APPROVED FIRST BY THE JOINT PERSONNEL COMMITTEE AND THEN BY THE FISHER-TITUS HEALTH'S BOARD OF DIRECTORS. THE MINUTES OF EACH BOARD MEETING WHERE ACTION IS TAKEN REFLECT SUCH ACTION. THE PROCESS IS PERFORMED ANNUALLY IN THE SPRING AND WAS LAST DONE IN MARCH 2019. FORM 990, PART VI, SECTION C, LINE 19 WE ISSUE AN ANNUAL REPORT TO THE COMMUNITY THAT IS PLACED IN THE LOCAL NEWSPAPER AND ON OUR WEBSITE THAT PROVIDES OUR OPERATING FINANCIAL STATEMENT, COMMUNITY BENEFIT FIGURES BROKEN DOWN BY CHARITY CARE & FINANCIAL ASSISTANCE, UNPAID COSTS OF MEDICAID, COMMUNITY HEALTH & OUTREACH PROGRAMS, DONATIONS & COMMUNITY SUPPORT, SUBSIDIZED HEALTH SERVICES & PROFESSIONAL MEDICAL EDUCATION, & UNPAID COSTS OF MEDICARE & BAD DEBT. AS REQUIRED, WE OFFER A TIMELY RESPONSE TO WRITTEN REQUESTS FOR COPIES OF THE 990S AS WELL AS HAVING THE 990S AVAILABLE UPON THE PREMISES FOR THE PUBLIC TO REVIEW AND ON THE GUIDESTAR INTERNET WEBSITE. ADDITIONALLY, OUR CONFLICT OF INTEREST POLICY, CODE OF REGULATIONS, AND GOVERNING DOCUMENTS ARE ALSO AVAILABLE UPON WRITTEN REQUEST. FORM 990, PART VI, SECTION A, LINE 1B: INFORMATION RELATING TO FAMILY MEMBERS OF SOME OF THE ORGANIZATION'S GOVERNING BODY COMPENSATED BY THE ORGANIZATION OR INVOLVED IN BUSINESS TRANSACTIONS WITH THE ORGANIZATION IS INCLUDED IN PART IV OF SCHEDULE L, TRANSACTIONS WITH INTERESTED PERSONS. HOWEVER, MEMBERS OF THE ORGANIZATION'S GOVERNING BODY ARE PROMINENT CITIZENS IN THE COMMUNITIES SERVED BY THE ORGANIZATION FOR PURPOSES OF SATISFYING THE COMMUNITY BENEFIT STANDARD ESTABLISHED BY REVENUE RULING 69-545, 1969-2 C.B. 117. FORM 990, PART VII, SECTION B: THE AMOUNT OF COMPENSATION PAID TO JANOTTA & HERNER FOR BUILDING CONTRACTOR SERVICES CONTAINS PAYMENTS FOR BOTH SERVICES AND MATERIALS. THESE AMOUNTS ARE NOT ABLE TO BE SEPARATED FOR REPORTING PURPOSES. FORM 990, PART IX, LINE 11G HEALTHCARE PROVIDERS: PROGRAM SERVICE EXPENSES 2,653,903. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,653,903. HARDWARE/SOFTWARE MAINTENANCE FEES: PROGRAM SERVICE EXPENSES 2,068,779. MANAGEMENT AND GENERAL EXPENSES 335,469. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,404,248. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 9,677,995. MANAGEMENT AND GENERAL EXPENSES 2,315,743. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,993,738. FORM 990, PART XI, LINE 9: FASB #158 ADJUSTMENT (CHANGE IN PENSION LIABILTIY) -2,048,901. PROFIT SHARING RELATED TO PAIN MANAGEMENT 154,577. INTER-SYSTEM TRANSFER OF FUNDS BETWEEN AFFLIATED 501(C)(3) ORGANIZATIONS -17,844,220. CHANGE IN BOND INTEREST SWAP VALUE -95,854. PAIN MANAGMENT JOINT VENTURE DIVIDEND PAYMENTS TO FISHER-TITUS 1,138,219. NET PERIODIC PENSION & POSTRETIREMENT BENEFIT COST -238,024. 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