2019-11-14T15:11:49-06:00 2018-12-31 990 2018-01-01 344428218 FIRELANDS REGIONAL MEDICAL CENTER FIRE 4195577400 1111 HAYES AVE SANDUSKY OH 448703323 DANIEL J MONCHER EXECUTIVE VP / CFO 4195577400 2019-11-14 67.59.56.31 2019-11-14 09:22:58 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 F23B626FF7BA699FD824818B7D825A8FA45A01E7 2018 2020-04-17 16:48:07Z DANIEL J MONCHER 1111 HAYES AVE SANDUSKY OH 448703323 438331874 0 X WWW.FIRELANDS.COM X 1919 OH OUR MISSION IS TO BE THE HEALTHCARE PROVIDER OF CHOICE FOR PHYSICIANS, THEIR PATIENTS, OUR VOLUNTEERS AND EMPLOYEES AS WE STRIVE TOGETHER TO IMPROVE THE HEALTH OF THOSE WE SERVE. 42 33 2703 245 26510 25510 1624377 3043737 257225279 253321678 11802138 15813271 10658740 12340608 281310534 284519294 488404 73281 0 0 127838473 126856915 0 0 435302 128760560 136444893 257087437 263375089 24223097 21144205 481267261 438830568 243285689 229195542 237981572 209635026 X OUR MISSION IS TO BE THE HEALTHCARE PROVIDER OF CHOICE FOR PHYSICIANS, THEIR PATIENTS, OUR VOLUNTEERS AND EMPLOYEES AS WE STRIVE TOGETHER TO IMPROVE THE HEALTH AND WELL BEING OF THOSE WE SERVE. 0 0 206631018 73281 253107294 FIRELANDS REGIONAL MEDICAL CENTER IS A 400-BED FACILITY SERVING THE GREATER ERIE COUNTY REGION WITH HIGH-QUALITY HEALTHCARE SERVICES DESIGNED TO HELP THE PEOPLE IN OUR COMMUNITIES LIVE HEALTHIER, HAPPIER LIVES. AS A NON-PROFIT ORGANIZATION, FIRELANDS IS COMMITTED TO ITS MISSION OF IMPROVING THE HEALTH OF THOSE WE SERVE. FIRELANDS IS DEDICATED TO PROVIDING CARE TO ALL THOSE IN OUR COMMUNITY REGARDLESS OF ABILITY TO PAY. A RESULT OF COMBINING THREE ORIGINAL HOSPITALS: GOOD SAMARITAN HOSPITAL AND MEMORIAL HOSPITAL IN 1985 AND THEN ADDING PROVIDENCE HOSPITAL IN 2001, FIRELANDS REGIONAL MEDICAL CENTER TODAY CARRIES ON THE PROUD TRADITION OF DELIVERING A FULL-RANGE OF ALLOPATHIC AND OSTEOPATHIC MEDICAL SERVICES TO NEARLY 300,000 RESIDENTS IN A FIVE-COUNTY AREA. AS THE LARGEST YEAR-ROUND EMPLOYER IN ERIE COUNTY, FIRELANDS REGIONAL MEDICAL CENTER PLAYS AN IMPORTANT ROLE IN THE LOCAL COMMUNITY. WITH 2,488 INDIVIDUALS EMPLOYED IN THE HEALTH SYSTEM IN 2018, $1.76 MILLION WAS PAID IN CITY AND SCHOOL PAYROLL TAXES IN 2018, AND $20.08 MILLION OF GOODS AND SERVICES WERE PURCHASED FROM BUSINESSES IN FIRELANDS' SERVICE AREA.IN TERMS OF HEALTHCARE SERVICES PROVIDED IN 2018, INPATIENT CARE WAS GIVEN TO 9,931 INDIVIDUALS, AND THE HOSPITAL PROVIDED CARE THROUGH 275,588 OUTPATIENT VISITS. THERE WERE 68,836 PERSONS TREATED IN THE EMERGENCY ROOM AND URGENT CARE, PROVIDING MULTIPLE LEVELS OF EMERGENCY AND URGENT CARE SERVICES FOR MAJOR AND MINOR INJURIES AND ILLNESSES. FIRELANDS HAD 802 BIRTHS IN 2018.CONSISTENT WITH OUR COMMITMENT TO PROVIDE CARE TO ALL, REGARDLESS OF ABILITY TO PAY, FIRELANDS GAVE BACK TO THE COMMUNITY OVER $40.57 MILLION OF SERVICES IN FREE OR DISCOUNTED PROGRAMS OR SERVICES PER THE TABLE BELOW. ADDITIONAL CHARITY CARE WAS PROVIDED BY INDEPENDENT PHYSICIANS WHO ARE ON THE MEDICAL STAFF OF FIRELANDS. SPECIFICALLY, IN TERMS OF FREE OR DISCOUNTED CARE PROVIDED, FIRELANDS SERVED THE FOLLOWING NUMBER OF PERSONS WITHIN EACH CATEGORY, AMOUNTING TO SIGNIFICANT DOLLARS INVESTED IN THE COMMUNITY FOR WHICH FIRELANDS DID NOT RECEIVE COMPENSATION:PERSONS SERVED CATEGORY COST OF PROVIDING CARE36,747 COSTS OF SERVICES $10,177,712 NOT COVERED BY MEDICAID 35,777 COMMUNITY HEALTH $435,836 IMPROVEMENT 143 HEALTH PROFESSIONS $2,752,257 EDUCATION 17,696 FINANCIAL ASSISTANCE $3,386,023 AT COST IN-KIND DONATIONS $84,179FIRELANDS' COMMUNITY OUTREACH DEPARTMENT IS DEDICATED TO PROVIDING SCREENINGS, COMMUNITY EDUCATION PROGRAMS, AND PREVENTIVE SERVICES ALL DESIGNED TO IMPROVE THE HEALTH OF THE COMMUNITIES SERVED BY FIRELANDS. THESE SERVICES ARE PROVIDED AT FREE OR DISCOUNTED RATES. FIRELANDS ALSO WORKS IN CONJUNCTION WITH OTHER HEALTHCARE FACILITIES TO BRING SPECIALIZED PEDIATRIC CLINICS TO THE AREA, SUCH AS CARDIOLOGY, GASTROENTEROLOGY, NEUROLOGY, ORTHOPEDIC, PHYSIATRY, PULMONARY, AND RHEUMATOLOGY.FIRELANDS HAS SEEN SIGNIFICANT GROWTH IN BRINGING ADVANCED PROCEDURES TO THE LOCAL COMMUNITY SO THAT PERSONS RESIDING IN THE FIVE-COUNTY AREA CAN STAY CLOSER TO HOME FOR ADVANCED CARE SUCH AS HEART SURGERY, SPINE SURGERY, VASCULAR SURGERY AND ADVANCED CARE IN MEDICAL ONCOLOGY AND RADIATION ONCOLOGY SERVICES. IN 2018, FIRELANDS WELCOMED 9 NEW PHYSICIANS SPECIALIZING IN THE AREAS OF NEURORADIOLOGY, ANESTHESIOLOGY, NEUROSURGERY, VASCULAR SURGERY, AND PSYCHIATRY AS WELL AS PEDIATRIC AND ADULT HOSPITALISTS. IN ADDITION, FIRELANDS COUNSELING & RECOVERY SERVICES IS THE LARGEST PROVIDER OF MENTAL HEALTH AND ADDICTION SERVICES IN A SEVEN-COUNTY AREA AND THE LARGEST "HOSPITAL BASED" PROGRAM IN THE STATE OF OHIO. FIRELANDS' 24/7/365 CRISIS HOTLINE HANDLED 23,078 CALLS IN 2018. 206631018 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 1 1 1 0 1 190 0 1 2703 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 42 33 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 OH X DENNIS J KOPCO DIRECTOR OF FINANCE 4195577094 1111 HAYES AVE SANDUSKY OH 448703323 JOHN O BACON CHAIR 2.00 0.00 X X 0 0 0 J WILLIAM SPRINGER DIRECTOR 1.00 0.00 X 0 0 0 LEON J WIEBER DIRECTOR 1.00 0.00 X 0 0 0 CAROL B STEUK DIRECTOR 1.00 0.00 X 0 0 0 TIMOTHY MAYLES DIRECTOR 1.00 0.00 X 0 0 0 MARY JANE HILL DIRECTOR 1.00 0.00 X 0 0 0 EUGENE SANDERS DIRECTOR 1.00 0.00 X 0 0 0 WENDY SCHMIEDL DIRECTOR 1.00 0.00 X 0 0 0 SHELLY CHESBRO DIRECTOR 1.00 0.00 X 0 0 0 GERALD GUERRA DIRECTOR 1.00 0.00 X 0 0 0 ROGER M GUNDLACH DIRECTOR 1.00 0.00 X 0 0 0 JOHN HOTY DIRECTOR 1.00 0.00 X 0 0 0 FREDRIC ITZKOWITZ DO DIRECTOR 1.00 0.00 X 35939 0 0 BRIAN KASPER DIRECTOR 1.00 0.00 X 0 0 0 THEODORE A KASTOR DIRECTOR 1.00 0.00 X 0 0 0 DANIEL KELLER DIRECTOR 1.00 0.00 X 0 0 0 RICHARD R KELLER MD DIRECTOR 1.00 0.00 X 0 0 0 STEVE LICHTCSIEN DIRECTOR 1.00 0.00 X 0 0 0 CARLOS LOWELL DO DIRECTOR 1.00 0.00 X 3613 0 0 M LEE MCDERMOND JR DIRECTOR 1.00 0.00 X 0 0 0 PATRICK MCGUINN MD DIRECTOR 1.00 0.00 X 2286 0 0 DUFFIELD E MILKIE DIRECTOR 1.00 0.00 X 0 0 0 JAMES MILLER DIRECTOR 1.00 0.00 X 0 0 0 ALLEN R NICKLES DIRECTOR 1.00 0.00 X 0 0 0 KARL OBERER DO DIRECTOR 1.00 0.00 X 0 0 0 JAMES E PRESTON DO DIRECTOR 1.00 0.00 X 0 0 0 THOMAS WILLIAMSON MD DIRECTOR 1.00 0.00 X 0 0 0 PAULA J RENGEL DIRECTOR 1.00 0.00 X 0 0 0 THOMAS M ROUTH VICE CHAIR 2.00 0.00 X X 0 0 0 JAMES V STOUFFER JR DIRECTOR 1.00 0.00 X 0 0 0 DAVID A VOIGHT SR DIRECTOR 1.00 0.00 X 0 0 0 JOHN WALDOCK JR DIRECTOR 1.00 0.00 X 0 0 0 KAM WONG MD DIRECTOR 1.00 0.00 X 0 0 0 JAMES O WIBLE DIRECTOR 1.00 0.00 X 0 0 0 CARL E WILL DIRECTOR 1.00 0.00 X 0 0 0 CAROL A WOLFE DIRECTOR 1.00 0.00 X 0 0 0 LUVADA WILSON DIRECTOR 1.00 0.00 X 0 0 0 LEE A ALEXAKOS DIRECTOR 1.00 0.00 X 0 0 0 SCOTT M CAMPBELL MD DIRECTOR 1.00 0.00 X 0 0 0 DARLENE CROOKS DIRECTOR 1.00 0.00 X 0 0 0 JANICE W WARNER DIRECTOR 1.00 0.00 X 0 0 0 DANIEL J MONCHER EXECUTIVE VP/CFO/TREASURER 40.00 0.00 X 570199 0 95057 ROBERT M MOORE VP LEGAL/SECRETARY 40.00 0.00 X 367651 0 91821 JEREMY NORMINGTON-SLAY CEO 40.00 0.00 X 143802 0 12632 ERIC MAST DIRECTOR MEDICAL ED/RESIDE 40.00 0.00 X 307972 0 46273 JAMES SPICER ASSISTANT VP OPERATIONS 40.00 0.00 X 263170 0 13383 JIM SENNISH VP HUMAN RESOURCES 40.00 0.00 X 261717 0 98002 BEV SCHRICKEL VP OPERATIONS 40.00 0.00 X 294854 0 126094 ANUPAM JHA PHYSICIAN 40.00 0.00 X 411310 0 45134 MARTIN E TURSKY FORMER PRESIDENT/CEO 0.00 0.00 X 815927 0 63026 3478440 0 591422 9 1 1 0 NORTH COAST PROFESSIONAL CO 1031 PIERCE ST SUITE D SANDUSKY OH 44870 PHYSICIAN SERVICES 3088550 UNIVERSITY HOSPITALS PO BOX 78000 DEPT 781887 DETROIT MI 482781887 PHYSICIAN STAFF 2544716 TELAMON CONSTRUCTION INC 5505 MILAN ROAD SANDUSKY OH 44870 CONSTRUCTION SERVICES 2214838 LABORATORY CORPORATION OF AMERICA PO BOX 12140 BURLINGTON NC 27216 HEALTH CARE DIAGNOSTICS 1258782 BRIDGE HOMECARE PARTNERS 5335 FAR HILLS AVE SUITE 224 DAYTON OH 45429 HOMECARE MANAGEMENT SERVICES 1254000 89 83300 46002 912228 2002207 3043737 NET PATIENT SERVICE REVENUE 623000 248913215 248913215 PARTNERSHIP INCOME RELATED TO GRO 541900 448802 450360 -1558 SCHOOL OF NURSING 611600 412207 412207 PROGRAM SERVICE INVESTMENTS 525990 197158 197158 3350296 3350296 253321678 8786111 8786111 160663457 81327 153704029 13595 6959428 67732 7027160 28068 6999092 225460 83300 94956 130504 130504 EMPLOYEE PHARMACY 446110 7637200 7637200 OFFICE RENTS 531190 1853591 1853591 DIETARY SERVICES 722210 1493917 1493917 1225396 -215942 1441338 12210104 284519294 253107294 26510 28341753 50281 50281 23000 23000 4028025 1857458 2170567 97169765 73687547 23296427 185791 4782386 3611771 1170615 13683613 10285536 3374853 23224 7193126 5373679 1805234 14213 759871 763278 -3407 79051 79051 145154 145154 907081 907081 26147516 19359903 6781129 6484 950177 1142 786002 163033 49940666 45088497 4837393 14776 5299087 5299087 6498687 1946557 4552130 749912 495144 241681 13087 56977 56977 4698810 4698810 15297193 15297193 1425593 823830 601763 CHARITY CARE 10699415 10699415 BAD DEBTS 6582568 6582568 FRANCHISE TAX 2951381 2951381 AFFILIATION FEES 598463 594963 3500 2657291 2439065 207032 11194 263375089 206631018 56308769 435302 10419 10688 14058152 13568855 687439 616114 36750600 33544116 4608168 4818762 3867378 5001643 351623265 190839962 162814361 160783303 244932458 213429382 2601718 2740839 8300000 0 213403 0 2423165 4316866 481267261 438830568 73873159 56226165 146382127 142566921 23030403 30402456 243285689 229195542 X 220472933 194703035 13028640 10972531 4479999 3959460 237981572 209635026 481267261 438830568 X 21144205 -17027275 -32463477 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3033 3033 0 PART II-B, LINE 1: FIRELANDS REGIONAL MEDICAL CENTER PAID DUES TO THE OHIO HOSPITAL ASSOCIATION OF WHICH 4.6% WAS USED FOR LOBBYING ACTIVITIES. 0 16316411 -1099381 1330271 93932 13792827 14443170 2296787 333636 89910 16316411 13672195 1223748 369900 82873 14443170 14679814 -537109 384564 85946 13672195 14249152 863616 346433 86521 14679814 0.00000 1.00000 0.00000 1 0 11698653 11698653 158820559 65676066 93144493 5943539 4749048 1194491 166935894 117321224 49614670 8224620 3093624 5130996 160783303 CAPITAL LEASE 1278012 SELF-INSURANCE RESERVE 6875000 ACCRUED POST-RETIREMENT & PENSION 21169527 DEFERRED INCOME GUARANTEE 1079524 DUE TO RELATED PARTIES 393 30402456 X PART V, LINE 4: ENDOWMENT FUND EXPENDITURES FOR FACILITIES AND PROGRAMS ARE USED TO PROMOTE PHYSICAL AND MENTAL WELL-BEING IN THE COMMUNITY. PART X, LINE 2: FINANCIAL STATEMENTS FOR FIRELANDS REGIONAL MEDICAL CENTER ARE PART OF THE CONSOLIDATED AND AUDITED FINANCIAL STATEMENTS OF FIRELANDS REGIONAL HEALTH SYSTEM. FASHION WEEK 150365 38540 111825 0 0 18367 18825 1570 6077 CADDYSHACK OPEN 158395 44760 113635 715 9501 10948 12330 10457 6166 0 0 0 0 0 0 0 0 0 308760 83300 225460 715 9501 29315 31155 12027 12243 94956 130504 1 1 1 X 1 X 1 1 1 0 1 1 5123191 1737168 3386023 0.01380 31238721 21061009 10177712 0.04140 36361912 22798177 13563735 0.05520 543151 107315 435836 0.00180 6203867 3451610 2752257 0.01120 84179 84179 0.00030 6831197 3558925 3272272 0.01330 43193109 26357102 16836007 0.06850 1 4 750 750 0.00000 1 10000 10000 0.00000 1 1000 1000 0.00000 1 18223 520698 197281 323417 0.00120 4 18227 532448 197281 335167 0.00120 1 2301266 653176 94177727 113784192 -19606465 X 1 1 1 NORTHERN OHIO SURGICAL PROPERTIES PROPERTY OWNERSHIP/MANAGEMENT 0.50000 0.50000 1 1 FIRELANDS REGIONAL MEDICAL CENTER 1111 HAYES AVENUE SANDUSKY OH 44870 WWW.FIRELANDS.COM STATE REG. #1164 X X X X FIRELANDS REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X X 16 1 0 1 1 X WWW.FIRELANDS.COM X WWW.ERIECOHEALTHOHIO.ORG X 1 16 0 1 0 1 X 200.000000000000 300.000000000000 X 1 1 X X X X 1 X WWW.FIRELANDS.COM X WWW.FIRELANDS.COM X WWW.FIRELANDS.COM X X X X X X X 1 X 0 X X X X 1 X 0 0 FIRELANDS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 3J: OTHER TOPICS THAT THE CHNA REPORT ADDRESSED INCLUDE WEIGHT CONTROL, TOBACCO USE, ALCOHOL CONSUMPTION, DRUG USE, SEXUAL BEHAVIOR, MENTAL HEALTH AND SUICIDE, YOUTH SAFETY, YOUTH VIOLENCE AND PARENTING. FIRELANDS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6B: THE CHNA REPORT WAS COMMISSIONED BY THE ERIE COUNTY COMMUNITY HEALTH ASSESSMENT WORKGROUP, WHICH IS COMPRISED OF THE ERIE COUNTY COMMUNITY HEALTH CENTER, ERIE COUNTY HEALTH DEPARTMENT, ERIE-OTTAWA MENTAL HEALTH AND RECOVERY BOARD, FAMILY AND CHILDREN FIRST COUNCIL, FIRELANDS REGIONAL MEDICAL CENTER, UNITED WAY OF ERIE COUNTY, AND PARTNERS FOR PREVENTION OF ERIE COUNTY. PROJECT MANAGEMENT AND REPORT DEVELOPMENT WAS PROVIDED BY THE HOSPITAL COUNCIL OF NORTHWEST OHIO WHILE DATA COLLECTION AND ANALYSIS WAS PERFORMED BY REPRESENTATIVES OF THE UNIVERSITY OF TOLEDO. FIRELANDS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: NEEDS IDENTIFIED IN THE CHNA REPORT THAT WERE NOT ADDRESSED INCLUDED THE FOLLOWING: DENTAL - PROVIDED BY ERIE COUNTY HEALTH DEPARTMENT; SMOKING CESSATION AND RISKY YOUTH BEHAVIOR WERE ADDRESSED BY BOTH FIRELANDS REGIONAL MEDICAL CENTER AND THE COUNTY HEALTH DEPARTMENT; HEALTH ACCESS BARRIERS WERE ADDRESSED BY BOTH FIRELANDS AND FAMILY HEALTH SERVICES. IMPLEMENTATION STRATEGY FOR THE CHNA IS ATTACHED TO THIS RETURN. FIRELANDS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 16J: FIRELANDS REGIONAL MEDICAL CENTER UTILIZES NEWSLETTERS AND BILLBOARDS AND HAS FINANCIAL SERVICES STAFF ATTEND APPROXIMATELY TEN MARKETING EVENTS EACH CALENDAR YEAR AS ADDITIONAL METHODS OF PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. PART V, SECTION B, LINE 20A FIRELANDS REGIONAL MEDICAL CENTER PROVIDES A WRITTEN NOTICE ABOUT UPCOMING ECAS AND NOTIFIES THE RECIPIENT ABOUT WHERE THEY CAN FIND A PLAIN LANGUAGE SUMMARY OF THE FAP AT LEAST 30 DAYS BEFORE INITIATING THOSE ECAS. 25 1 - FIRELANDS REGIONAL MEDICAL CENTER OUTPAT 904 PIERCE ST SANDUSKY OH 44870 OUTPATIENT DIALYSIS 2 - FIRELANDS REGIONAL MEDICAL CENTER OP THE 1912 HAYES AVE SANDUSKY OH 44870 OP THERAPIES & SLEEP LAB 3 - FIRELANDS REGIONAL MEDICAL CENTER SURGER 2800 HAYES AVE BLD E SANDUSKY OH 44870 OUTPATIENT SURGERY 4 - FIRELANDS REGIONAL MEDICAL CENTER HOME H 5420 MILAN ROAD SANDUSKY OH 44870 HOME HEALTH AGENCY 5 - FIRELANDS REGIONAL MEDICAL CENTER OUTPAT 290 PROGRESS DR STE A BELLEVUE OH 44811 OUTPATIENT DIALYSIS 6 - FIRELANDS REGIONAL MEDICAL CENTER OP IMA 2500 W STRUB RD SANDUSKY OH 44870 OP IMAGING CENTER 7 - FIRELANDS COUNSELING & RECOVERY SERVICES 1925 HAYES AVE SANDUSKY OH 44870 OP MENTAL HEALTH & CD 8 - FIRELANDS COUNSELING & RECOVERY SERVICES 292 BENEDICT AVE NORWALK OH 44857 OP MENTAL HEALTH & CD 9 - FIRELANDS COUNSELING & RECOVERY SERVICES 290 PROGRESS DR SUITE B BELLEVUE OH 44811 OP MENTAL HEALTH & CD 10 - FIRELANDS COUNSELING & RECOVERY SERVICES 1100 NEAL ZICK RD WILLARD OH 44890 OP MENTAL HEALTH & CD 11 - FIRELANDS COUNSELING & RECOVERY SERVICES 76 ASHWOOD RD TIFFIN OH 44883 OP MENTAL HEALTH & CD 12 - FIRELANDS COUNSELING & RECOVERY SERVICES 675 BARSTON RD FREMONT OH 43420 OP MENTAL HEALTH & CD 13 - FIRELANDS COUNSELING & RECOVERY SERVICES 554 N LEAVITT RD AMHERST OH 44001 OP MENTAL HEALTH & CD 14 - FIRELANDS COUNSELING & RECOVERY SERVICES 335 BUCKEYE BLVD PORT CLINTON OH 43452 OP MENTAL HEALTH & CD 15 - FIRELANDS COUNSELING & RECOVERY SERVICES 22052 W STATE RT 51 GENOA OH 43430 OP MENTAL HEALTH & CD 16 - FIRELANDS REGIONAL MEDICAL CENTER OP PHY 348 MILAN AVE 2 NORWALK OH 44857 OP PHYSICAL THERAPY 17 - FIRELANDS COUNSELING & RECOVERY SERVICES 122 WEST CENTER ST FOSTORIA OH 44830 OP MENTAL HEALTH & CD 18 - FIRELANDS REGIONAL MEDICAL CENTER OP PHY 2012 CLEVELAND RD W HURON OH 44839 OP PHYSICAL THERAPY 19 - FIRELANDS REGIONAL MEDICAL CENTER OP PHY 101 S WASHINGTON ST CASTALIA OH 44824 OP PHYSICAL THERAPY 20 - FIRELANDS COUNSELING & RECOVERY SERVICES 97 HOUPT DR UPPER SANDUSKY OH 43351 OP MENTAL HEALTH & CD 21 - FIRELANDS REGIONAL MEDICAL CENTER OP IMA 1605 STATE ROUTE 60 VERMILION OH 44089 OP IMAGING & PHYSICAL THERAPY 22 - FIRELANDS REGIONAL MEDICAL CENTER OP IMA 1470 W MCPHERSON HWY CLYDE OH 43410 OP IMAGING CENTER 23 - FIRELANDS REGIONAL MEDICAL CENTER OP IMA 1401 BONE CREEK DRIVE SANDUSKY OH 44870 OP IMAGING & PHYSICAL THERAPY 24 - FIRELANDS REGIONAL MEDICAL CENTER OP WOU 615 FULTON ST PORT CLINTON OH 43452 OP WOUND CARE 25 - FIRELANDS OP PHYS THER DIAG READIOLOGY 3960 E HARBOR ROAD PORT CLINTON OH 43452 OP PHYSICAL THERAPY, IMAGING, AND LAB PART I, LINE 3C: FIRELANDS REGIONAL MEDICAL CENTER DOES USE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. PART I, LINE 6A: FIRELANDS REGIONAL MEDICAL CENTER PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT. PART I, LINE 7: TO DERIVE COSTS OF CHARITY CARE AND OTHER COMMUNITY BENEFITS, A COMBINATION OF COST ACCOUNTING SYSTEM AND COST-TO-CHARGE RATIOS WAS USED. THE LATTER WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. OUR COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT TYPES AND PAYER SOURCES. PART II, COMMUNITY BUILDING ACTIVITIES: SEE NARRATIVE UNDER PART VI, LINE 5 PART III, LINE 2: THE RATIO DERIVED ON WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES WAS APPLIED TO THE ORGANIZATION'S BAD DEBT PROVISION IN ORDER TO COMPUTE THE BAD DEBT EXPENSE. PART III, LINE 3: FOR ESTIMATING THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER ITS FINANCIAL ASSISTANCE POLICY, FIRELANDS REGIONAL MEDICAL CENTER UTILIZED A COMBINATION OF HISTORICAL PATIENT VISIT AND THIRD-PARTY DATA BASED ON ESTIMATED FAMILY SIZE, INCOME AND OTHER DEMOGRAPHICS. ALL ACCOUNTS PLACED INTO BAD DEBT DURING THE YEAR WITH NO PAYMENT ACTIVITY WERE SCORED BASED ON THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, AND ALL WHO MET THE INCOME CRITERIA BASED ON FAMILY SIZE WERE ASSUMED TO BE ELIGIBLE FOR CHARITY AND THUS TREATABLE AS COMMUNITY BENEFIT. PART III, LINE 4: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE 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 SYSTEM'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THAT THEY ARE DETERMINED TO BE UNCOLLECTIBLE. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYERS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYERS. PART III, LINE 8: FIRELANDS REGIONAL MEDICAL CENTER'S COST ACCOUNTING SYSTEM WAS USED TO DETERMINE MEDICARE COSTS REFLECTED IN PART III, LINE 6. THE ORGANIZATION BELIEVES THAT ALL OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT SINCE THESE SERVICES ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND PROMOTE THE WELL-BEING OF THE COMMUNITY. FURTHERMORE, IT RELIEVES THE BURDEN ON LOCAL GOVERNMENTS. PART III, LINE 9B: WHEN A PATIENT IS UNINSURED OR INSURANCE PAYMENTS HAVE BEEN RECEIVED AND APPLIED, THEY ARE CLASSIFIED AS SELF PAY. OVER A 90-DAY PERIOD EACH PATIENT RECEIVES A MINIMUM OF 2 BALANCE-DUE STATEMENTS AND 1 FINAL STATEMENT. DURING THAT PERIOD THE PATIENT HAS THE OPPORTUNITY TO PAY THE ACCOUNT IN FULL, SET UP PAYMENT ARRANGEMENTS, OR APPLY FOR FINANCIAL AID. IN THE EVENT THE PATIENT DOES NOT PAY THE ACCOUNT IN FULL, SET UP PAYMENT ARRANGEMENTS, APPLY FOR FINANCIAL AID OR MAKE AN EFFORT TO CONTACT THE FACILITY WITH SPECIAL CIRCUMSTANCES CONCERNING THE UNPAID BALANCE, THE ACCOUNT IS PLACED IN BAD DEBT COLLECTION AT OR ABOUT 120 DAYS FROM THE FIRST STATEMENT OR LAST PAYMENT. SHOULD AN ACCOUNT BE PLACED IN COLLECTION, THE PATIENT HAS AN ADDITIONAL OPPORTUNITY TO APPLY FOR FINANCIAL AID, SET UP PAYMENT ARRANGEMENTS, OR SUPPLY ADDITIONAL INFORMATION RELATED TO THE ACCOUNT. IF ANY OF THESE EVENTS OCCUR, THE COLLECTION ACCOUNT IS EITHER PLACED ON HOLD, BILLED TO INSURANCE, UPDATED WITH THE PAYMENT ARRANGEMENT, OR TAKEN OUT OF BAD DEBT AND ADJUSTED ACCORDING TO FINANCIAL AID GUIDELINES. PRIOR TO PLACING AN ACCOUNT IN BAD DEBT, THE ACCOUNT IS SCREENED BY SELF PAY COMPASS, A SOFTWARE APPLICATION THAT SCORES THE PATIENT'S INCOME BASED ON SEVERAL FINANCIAL RESOURCE DATABASES. THE APPLICATION IDENTIFIES ALL ACCOUNTS THAT MEET THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY GUIDELINES BASED ON INCOME. ACCOUNTS THAT MEET 100% OF FPL ARE WRITTEN OFF TO PRESUMPTIVE CHARITY AND NOT PLACED IN BAD DEBT COLLECTION. PART VI, LINE 2: FIRELANDS REGIONAL MEDICAL CENTER USES SEVERAL RESOURCES TO DETERMINE THE HEALTHCARE NEEDS OF THE COMMUNITY IN WHICH IT SERVES. IT WORKS IN CONJUNCTION WITH THE LOCAL HEALTH DEPARTMENT AND HELPS TO FUND A COMMUNITY NEEDS ASSESSMENT, WHICH IS DONE EVERY FEW YEARS. RESULTS OF THE ASSESSMENT ARE ANALYZED AND USED TO DETERMINE THE NEED FOR NEW PROGRAMS, SERVICES, EDUCATIONAL PROGRAMS, AND ACCESS NEEDS. THE MEDICAL CENTER ALSO COMMISSIONS A PHYSICIAN NEEDS STUDY EVERY FEW YEARS TO DETERMINE THE TYPES AND NUMBERS OF PHYSICIANS NEEDED TO ADEQUATELY MEET THE NEEDS OF THE COMMUNITY. ADDITIONALLY, EVERY THREE YEARS A COMMUNITY RESEARCH STUDY IS PERFORMED WHICH ASKS LOCAL RESIDENTS THEIR PERCEPTIONS OF HEALTHCARE SERVICES IN THE AREA AND DETERMINES IF ADDITIONAL SERVICES ARE NEEDED. SECONDARY DATA OF THE REGION IS ANALYZED TO DETERMINE UTILIZATION OF SPECIFIC SERVICES, OUTMIGRATION OF LOCAL RESIDENTS TO RECEIVE SERVICES, ETC. PROJECTED UTILIZATION STUDIES ENSURE THAT ANY NEW PROGRAMS OR SERVICES EXPLORED MEET THE NEEDS OF THE COMMUNITY. PART VI, LINE 3: HOSPITAL CARE ASSURANCE PROGRAM SIGNS ARE POSTED IN ALL REGISTRATION AND EMERGENCY AREAS. BILLING AND FINANCIAL ASSISTANCE BROCHURES ARE AVAILABLE WITH INSTRUCTIONS ON WHOM TO CONTACT AND HOW TO APPLY FOR SERVICES. FINANCIAL ASSISTANCE GUIDELINES AND APPLICATIONS ARE ALSO AVAILABLE ON OUR WEBSITE (WWW.FIRELANDS.COM). EVERY PATIENT STATEMENT CONTAINS CHARITY GUIDELINES AND AN APPLICATION. SELF-PAY INPATIENTS ARE SEEN ON-SITE BY A CONTRACTED AGENCY THAT DISCUSSES AND ASSISTS PATIENTS WITH APPLICATIONS FOR MEDICAID OR DISABILITY. THESE PATIENTS ARE ALSO SEEN BY FINANCIAL COUNSELOR WHO EXPLAINS THE HOSPITAL'S CHARITY POLICIES, ASSISTS WITH THE APPLICATION AND/OR SUPPLIES THEM WITH A CONTACT IF QUESTIONS SHOULD ARISE AFTER DISCHARGE. SELF-PAY INPATIENTS ARE MONITORED DAILY TO IDENTIFY PATIENTS WHO ARE ELIGIBLE FOR MEDICAID AND HAVE NO PRIOR INSURANCE COVERAGE. ALL SELF-PAY ACCOUNTS WITH A BALANCE OF $1,500 OR MORE ARE SCREENED BY A THIRD PARTY AND A MEDICAID APPLICATION IS STARTED FOR THOSE THAT MEET ELIGIBILTY GUIDELINES. DURING THE SCHEDULING PROCESS, IF A PATIENT STATES THEY HAVE NO INSURANCE OR ARE CONCERNED ABOUT THEIR FINANCIAL LIABILITY, THE PATIENT CALL IS FORWARDED TO A FINANCIAL COUNSELOR WHO WILL EXPLAIN OUR CHARITY PROGRAM AND OFFER TO ASSIST WITH AND/OR MAIL THE FINANCIAL ASSISTANCE APPLICATION. REGISTRATION STAFF SUPPLIES THE PATIENT WITH A BROCHURE AND APPLICATION IF A FINANCIAL COUNSELOR IS NOT AVAILABLE UPON DISCHARGE. FINANCIAL COUNSELING STAFF IS AVAILABLE MONDAY - FRIDAY 8:00 AM TO 4:30 PM. A PATIENT NAVIGATOR IS ALSO AVAILABLE IN THE CANCER CENTER TO ASSIST UNINSURED AND UNDERINSURED PATIENTS WITH CHARITY CARE AND MEDICAID APPLICATIONS, AS WELL AS PHARMACY VENDOR PROGRAMS FOR ONCOLOGY DRUGS. PART VI, LINE 4: FIRELANDS REGIONAL MEDICAL CENTER SERVES A FIVE-COUNTY AREA OF APPROXIMATELY 300,000 RESIDENTS. THE PRIMARY SERVICE AREA IS ERIE COUNTY, WHICH HAS A POPULATION OF ABOUT 75,000 PERSONS AND IS LOCATED ON THE SOUTHERN SHORE OF LAKE ERIE, HALFWAY BETWEEN CLEVELAND, OH AND TOLEDO, OH. BASED UPSON THE LATEST CENSUS DATA, THE MAJORITY OF THE POPULATION'S RACE IS CAUCASIAN, WITH 14% MINORITY; 92.2% OF THE POPULATION HAS A HIGH SCHOOL EDUCATION OR SOME COLLEGE. THE COUNTY'S MEDIAN AGE IS 45 AND THE MEDIAN HOUSEHOLD INCOME IS $54,958. APPROXIMATELY 66% OF THE COUNTY'S RESIDENTS OWN THEIR HOME, WITH THE MEDIAN HOME VALUE OF $152,100. SECONDARY SERVICE AREAS CONSIST OF THE CONTIGUOUS COUNTINES OF OTTAWA, HURON, AND SANDUSKY, WHICH HAVE A COMBINED POPULATION OF APPROXIMATELY 158,000 INDIVIDUALS. FIRELANDS COUNSELING AND RECOVERY SERVICES REACHES EVEN FURTHER, SERVING 7 SURROUNDING COUNTIES INCLUDING THE COUNTIES ERIE, HURON, LORAIN, OTTAWA, SANDUSKY, SENECA, AND WYANDOT. HOME HEALTH SERVICES PROVIDED BY THE MEDICAL CENTER COVERS 13 COUNTIES. DEMOGRAPHICS OF THESE COUNTIES ARE SIMILAR TO THE PRIMARY AREA OF ERIE COUNTY. PART VI, LINE 5: FIRELANDS REGIONAL MEDICAL CENTER ESTABLISHED THE FIRELANDS GARDEN DISTRICT PLAN IN 2007 WITH THE GOAL OF ENHANCING AND REVITALIZING THE MEDICAL CENTER'S NEIGHBORHOOD IN TERMS OF ATTRACTIVENESS, SAFETY, AND APPEAL. THIS REVITALIZATION IS ACCOMPLISHED THROUGH A PROGRAM PROVIDING FIRELANDS' EMPLOYEES THE RESOURCES NEEDED TO MAKE A DOWN PAYMENT FOR THE PURCHASE OR RESTORATION OF HOMES FOR OCCUPANCY. FIRELANDS PARTICIPATES IN THE NORTHWEST OHIO PUBLIC INFORMATION OFFICER COMMITTEE TO BRING ADDITIONAL SKILLS TO THE AREA REGARDING DISASTER READINESS. IN ADDITION TO MEETING THE REQUIRED INCIDENT COMMAND TRAINING COURSES, THE MEDICAL CENTER HAS GONE ABOVE AND BEYOND BY ATTENDING REGIONAL MEETINGS, COMPLETING CRISIS AND EMERGENCY RISK COMMUNICATION TRAINING, PUBLIC INFORMATION OFFICER TRAINING THROUGH THE OHIO EMERGENCY MANAGEMENT AGENCY AND THE DEPARTMENT OF HOMELAND SECURITY, AS WELL AS INCORPORATING SOCIAL MEDIA IN ITS CRISIS COMMUNICATION METHODS. MANAGEMENT STAFF OF FIRELANDS REGIONAL MEDICAL CENTER IS ENCOURAGED TO PARTICIPATE IN LOCAL AND REGIONAL BOARDS AND ACTIVITIES THAT IMPROVE THE LOCAL COMMUNITY. ADVOCACY INCLUDES SUCH ACTIVITIES AS FINANCIAL SUPPORT TO A LOCAL CLINIC THAT SERVES UNINSURED AND UNDERINSURED ALONG WITH EFFORTS TO ORGANIZE A FEDERALLY QUALIFIED HEALTH CENTER FOR THE COMMUNITY, BOARD LEVEL WORK FOR COMMUNITY HEALTH EDUCATION ENTITIES AND AREA NON-PROFIT ORGANIZATIONS THAT WORK TO IMPROVE THE HEALTH OF THE COMMUNITY. 1 ERIE COUNTY ECONOMIC DEVELOPMENT 247 COLUMBUS AVE SANDUSKY OH 44870 341530226 501(C)(3) 10000 GENERAL SUPPORT SANDUSKY CENTRAL CATHOLIC SCHOOL 410 W JEFFERSON ST SANDUSKY OH 44870 431961776 501(C)(3) 7300 GENERAL SUPPORT SANDUSKY STATE THEATER INC 107 COLUMBUS AVE SANDUSKY OH 44870 341568622 501(C)(3) 7500 GENERAL SUPPORT 3 EDUCATION PAYMENT PROGRAM SCHOLARSHIPS 23 23000 PART II LINE 1 TO BE ELIGIBLE FOR THE "EDUCATION PAYMENT PROGRAM" SCHOLARSHIPS, A CANDIDATE MUST BE A QUALIFIED FAMILY MEMBER OF A CURRENT ACTIVE EMPLOYEE AND BE SPONSORED BY THEIR FIRELANDS-EMPLOYED FAMILY MEMBER, BE A HIGH SCHOOL GRADUATE (OR EQUIVALENT) OR A HIGH SCHOOL SENIOR PLANNING TO BEGIN OR CONTINUE COURSE WORK AT AN ACCREDITED EDUCATIONAL INSTITUTION WITHIN ONE YEAR OF SUBMITTING A PROGRAM APPLICATION AND HAVE A CUMMULATIVE ACADEMIC AVERAGE OF "C OR BETTER. AWARD RECIPIENTS ARE SELECTED BASED ON APPLICATION, PAST ACADEMIC PERFORMANCE, FIELD OF STUDY, EDUCATIONAL INSTITUTION, ECONOMIC NEED AND AVAILABILITY OF FUNDS. THIS PROGRAM IS ADMINISTERED WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, AGE, ANCESTRY, NATIONAL ORIGIN OR DISABILITY. FUNDS ARE PAID DIRECTLY TO THE SCHOOL ON BEHALF OF THE RECIPIENT. PART I LINE 2: THE USE OF FUNDS CONTRIBUTED IS MONITORED BY THE REVIEW OF FINANCIAL AND PERFORMANCE RESULTS. X X X X X 0 1 0 0 0 1 0 0 0 DANIEL J MONCHER EXECUTIVE VP/CFO/TREASURER 463285 0 104592 0 2322 0 59000 0 36057 0 665256 0 0 0 ROBERT M MOORE VP LEGAL/SECRETARY 315774 0 48288 0 3589 0 59000 0 32821 0 459472 0 0 0 JEREMY NORMINGTON-SLAY CEO 123802 0 20000 0 0 0 0 0 12632 0 156434 0 0 0 ERIC MAST DIRECTOR MEDICAL ED/RESIDE 294849 0 11856 0 1267 0 8100 0 38173 0 354245 0 0 0 JAMES SPICER ASSISTANT VP OPERATIONS 232543 0 30116 0 511 0 0 0 13383 0 276553 0 0 0 JIM SENNISH VP HUMAN RESOURCES 219100 0 39116 0 3501 0 61000 0 37002 0 359719 0 0 0 BEV SCHRICKEL VP OPERATIONS 249984 0 41281 0 3589 0 95000 0 31094 0 420948 0 0 0 ANUPAM JHA PHYSICIAN 410824 0 0 0 486 0 8100 0 37034 0 456444 0 0 0 MARTIN E TURSKY FORMER PRESIDENT/CEO 627262 0 188447 0 218 0 0 24171 38855 0 854782 24171 0 0 PART I LINE 4B NORTH COAST PROFESSIONAL CORPORATION, A RELATED ENTITY, CONTRIBUTED TO A 409A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ON THE BEHALF OF MARTIN TURSKY, PRESIDENT, IN THE AMOUNT OF $24,171.07. PART I LINE 6A BONUS COMPENSATION IS BASED ON A SUCCESS SHARING PLAN MEASURED BY PATIENT QUALITY, PATIENT SATISFACTION, AND OPERATING RESULTS AS COMPARED TO BUDGET. A COUNTY OF ERIE OHIO 346400428 29514PAV4 2016-08-15 62145000 SEE PART VI 0 0 0 B COUNTY OF ERIE OHIO 346400428 29514PAW2 2016-08-15 15000000 SEE PART VI 0 0 0 C COUNTY OF ERIE OHIO 346400428 29514PBD3 2016-03-31 62930000 SEE PART VI 0 0 0 D COUNTY OF ERIE OHIO 346400428 2017-07-11 18380000 SEE PART VI 0 0 0 A 62152439 64416279 2008 1 0 1 1 B 15000000 15358141 2008 1 0 1 1 C 15410000 62930000 72456425 2013 1 0 1 1 D 2940800 18380000 64200 9924677 8391338 1 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 1 1 1 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K SUPPLENTAL INFORMATION PART I LINE A, COLUMN (F): CURRENTLY REFUND THE COUNTY OF ERIE, OHIO HOSPITAL FACILITIES REVENUE BONDS, SERIES 2006A (FIRELANDS REGIONAL MEDICAL CENTER PROJECT) ISSUED JUNE 1, 2006, WHICH WERE PREVIOUSLY DEEMED REISSUED ON AUGUST 6, 2014, AS A RESULT OF A DEEMED REISSUANCE OF SUCH BONDS ON AUGUST 15, 2016. PART I LINE B, COLUMN (F): CURRENTLY REFUND THE COUNTY OF ERIE, OHIO HOSPITAL FACILITIES REVENUE BONDS, SERIES 2006B (FIRELANDS REGIONAL MEDICAL CENTER PROJECT) ISSUED JUNE 1, 2006, WHICH WERE PREVIOUSLY DEEMED REISSUED ON AUGUST 6, 2014, AS A RESULT OF A DEEMED REISSUANCE OF SUCH BONDS ON AUGUST 15, 2016. PART I LINE C, COLUMN (F): CURRENTLY REFUND THE COUNTY OF ERIE, OHIO HOSPITAL FACILITIES REVENUE AND REVENUE REFUNDING BONDS, SERIES 2012A/B (FIRELANDS REGIONAL MEDICAL CENTER) ISSUED AUGUST 15, 2012 AS A RESULT OF A DEEMED REISSUANCE OF SUCH BONDS ON MARCH 31, 2016. PART I LINE D, COLUMN (F): (I) CURRENTLY REFUND A PORTION OF THE COUNTY OF ERIE, OHIO HOSPITAL FACILITIES REVENUE AND REVENUE REFUNDING BONDS, SERIES 2012 A/B (FIRELANDS REGIONAL MEDICAL CENTER), ISSUED AUGUST 15, 2012 AND REISSUED MARCH 31, 2016 AND (II) ACQUIRE, CONSTRUCT, RENOVATE, INSTALL AND EQUIP HOSPITAL FACILITIES AND (III) PAY COSTS OF ISSUANCE. PART II LINE 3, COLUMN A: TOTAL PROCEEDS OF THE ISSUE ARE COMPRISED OF $62,145,000 SALE PROCEEDS AND $7439.03 OF INVESTMENT PROCEEDS. PART II LINE 3, COLUMN D: TOTAL PROCEEDS OF THE ISSUE ARE COMPRISED OF $18,380,000 SALE PROCEEDS AND 219.57 OF INVESTMENT PROCEEDS ALICE SPRINGER FAMILY MEMBER 97071 EMPLOYMENT 0 PART IV LINE 1 ALICE SPRINGER IS THE WIFE OF BOARD MEMBER J. WILLIAM SPRINGER (NON-VOTING). SHE IS EMPLOYED BY FIRELANDS REGIONAL MEDICAL CENTER AS DIRECTOR OF DEVELOPMENT FORM 990, PART VI, SECTION B, LINE 11B THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE HAS BEEN DELEGATED THE AUTHORITY BY THE FIRELANDS REGIONAL HEALTH SYSTEM BOARD OF DIRECTORS TO REVIEW AND APPROVE ALL FORM 990'S FOR ALL COMPANIES IN THE SYSTEM. THE FINAL VERSION OF THE RESPECTIVE FORM 990 IS MADE AVAILABLE TO THE CHAIR OF THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE FOR REVIEW AND APPROVAL PRIOR TO THE FORM 990 BEING SUBMITTED TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C FIRELANDS REGIONAL MEDICAL CENTER AUDIT AND CORPORATE COMPLIANCE COMMITTEE ANNUALLY REVIEWS ALL CONFLICT OF INTEREST STATEMENTS TO ASSURE PERSONS IDENTIFIED IN THE CONFLICT OF INTEREST POLICY ARE IN COMPLIANCE. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION IS DELEGATED BY THE BOARD OF DIRECTORS TO THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE APPOINTS A COMPENSATION SUB-COMMITTEE WHICH UTILIZES AN INDEPENDENT THIRD PARTY TO EVALUATE THE APPROPRIATE PAY RANGE FOR THE CEO AND OTHER KEY MANAGEMENT POSITIONS AT LIKE-SIZED AND SIMILAR HOSPITALS IN THE SAME GEOGRAPHIC REGION. THIS SUB-COMMITTEE MAKES A RECOMMENDATION TO THE EXECUTIVE COMMITTEE BASED ON THEIR RESEARCH AND FINDINGS. THE EXECUTIVE COMMITTEE APPROVES THE ANNUAL SALARIES OF THE CEO AND ALL VICE PRESIDENTS. THIS PROCESS IS COMPLETED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS OF THE ORGANIZATION ARE MADE AVAILABLE VIA A QUARTERLY "REPORT TO BOND HOLDERS" WHICH IS SENT TO ANY CONSTITUENTS, BOND HOLDERS, OR INTERESTED PARTIES WHO REQUEST TO BE ON THE DISTRIBUTION LIST. QUARTERLY REPORTS AND THE THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS ARE POSTED TIMELY AT HTTP://WWW.MSRB.ORG/ UTILIZING THE EMMA SYSTEM. GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC BY SPECIAL REQUEST. FORM 990, PART XI, LINE 9: SCHOOL OF NURSING FUNDING 7,506. PENSION ADJUSTMENTS -9,711,530. NET TRANSFER (TO)/FROM AFFILIATES -13,873,994. RECLASS CONTRIBUTIONS -102,085. PARTNERSHIP INCOME RELATED TO GROUP PURCHASING PROGRAM SERVICES -349,374. RECLASS SCHOLARSHIPS 1,000. GOODWILL IMPAIRMENT -8,435,000. FORM 990, PART IX, SECTION FEES FOR SERVICES, LINE 11G: TOTAL OTHER FEES FOR SERVICES IN THE AMOUNT $26,147,515 IS MADE UP OF PURCHASED SERVICES $12,583,200, PHYSICIAN FEES $9,111,416, PURCHASED MAINTENANCE $2,803,004, PROFESSIONAL FEES $1,414,378 AND COLLECTION AGENCY FEES $235,518. PURCHASED SERVICES $12,583,200 CAN BE FURTHER CATEGORIZED AS PROGRAM $7,615,828, MANAGEMENT $4,960,888, AND FUNDRAISING $6,484. PHYSICIAN FEES $9,111,416 CAN BE FURTHER CATEGORIZED AS PROGRAM $7,913,289 AND MANAGEMENT $1,198,127. PURCHASED MAINTENANCE $2,803,004 CAN BE FURTHER CATEGORIZED AS PROGRAM $2,416,408 AND MANAGEMENT $386,596. PROFESSIONAL FEES $1,414,378 CAN BE FURTHER CATEGORIZED AS PROGRAM $1,414,378. COLLECTION AGENCY FEES $235,518 CAN BE FURTHER CATEGORIZED AS MANAGEMENT $235,518. 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