2025-11-17T15:03:48-06:00 2024-12-31 331498605 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2024-01-01 344428218 FIRELANDS REGIONAL MEDICAL CENTER FIRE 4195577400 1111 HAYES AVE SANDUSKY OH 448703323 KEVIN RILEY CHIEF FINANCIAL OFFICER 4195577400 2025-11-17 1 1 AMY CIMINELLO P00796388 6148493000 2025-11-17 2024 2025-03-06 01:10:19Z KEVIN RILEY 1111 HAYES AVE SANDUSKY OH 448703323 355665225 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 AND WELL BEING OF THOSE WE SERVE. 38 32 2213 129 -43494 0 6540336 6101061 256849515 260735993 6068286 23238459 17872476 23499920 287330613 313575433 251317 69200 0 0 129681568 133932483 0 0 517735 144797339 150046406 274730224 284048089 12600389 29527344 519944951 527496388 235805302 205493941 284139649 322002447 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 211969023 69200 260735993 FIRELANDS REGIONAL MEDICAL CENTER IS A 287-BED FACILITY SERVING THE GREATER ERIE COUNTY REGION. AS A NON-PROFIT ORGANIZATION, FIRELANDS IS COMMITTED TO ITS MISSION TO: "PROVIDE EXCELLENT HEALTHCARE, PROMOTE COMMUNITY WELLNESS, AND IMPROVE THE LIVES WE SERVE." FIRELANDS IS DEDICATED TO PROVIDING CARE TO ALL THOSE IN THE COMMUNITY REGARDLESS OF ABILITY TO PAY. 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 ONE OF THE LARGEST YEAR-ROUND EMPLOYERS IN ERIE COUNTY, FIRELANDS REGIONAL MEDICAL CENTER PLAYS AN IMPORTANT ROLE IN THE LOCAL COMMUNITY. WITH OVER 2085 INDIVIDUALS EMPLOYED IN THE HEALTH SYSTEM IN 2024, $1.68 MILLION WAS PAID IN CITY AND SCHOOL PAYROLL TAXES IN 2024, AND OVER $15 MILLION OF GOODS AND SERVICES WERE PURCHASED FROM BUSINESSES IN FIRELANDS' SERVICE AREA. IN TERMS OF HEALTHCARE SERVICES PROVIDED IN 2024, INPATIENT CARE WAS GIVEN TO 9,101 INDIVIDUALS, AND THE HOSPITAL PROVIDED CARE THROUGH 323,258 OUTPATIENT VISITS. THERE WERE 42,275 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 589 BIRTHS IN 2024.CONSISTENT WITH ITS COMMITMENT TO PROVIDE CARE TO ALL, REGARDLESS OF ABILITY TO PAY, FIRELANDS GAVE BACK TO THE COMMUNITY OVER $45.7 MILLION OF SERVICES IN FREE OR DISCOUNTED PROGRAMS OR SERVICES. 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 CARE32,914 COSTS OF SERVICES NOT COVERED BY MEDICAID $2,590,30715,689 COMMUNITY HEALTH IMPROVEMENT $451,47985 HEALTH PROFESSIONS EDUCATION $4,092,3487,809 FINANCIAL ASSISTANCE AT COST $2,143,163IN-KIND DONATIONS $36,030FIRELANDS' COMMUNITY OUTREACH DEPARTMENT IS DEDICATED TO PROVIDING SCREENINGS, COMMUNITY EDUCATION PROGRAMS AND PREVENTIVE SERVICES ALL DESIGNED TO IMPROVE THE HEALTH OF THE COMMUNITIES THEY SERVE. 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, GASTROENTEROLOGY, NEPHROLOGY, NEUROLOGY, ORTHOPEDIC AND PULMONARY CARE.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 SPINE SURGERY, VASCULAR SURGERY AND ADVANCED CARE IN MEDICAL ONCOLOGY AND RADIATION ONCOLOGY SERVICES. IN 2024, FIRELANDS WELCOMED SEVEN NEW PHYSICIANS SPECIALIZING IN THE AREAS OF, GASTROENTEROLOGY, EMERGENCY MEDICINE, NEUROSURGERY, FAMILY MEDICINE, UROLOGY, OPHTHALMOLOGY AND PATHOLOGY. 211969023 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 0 1 0 1 271 0 1 2213 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 38 32 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 1 1 OH X JACKIE SPRINGER CONTROLLER 4195575544 1111 HAYES AVE SANDUSKY OH 448703323 THOMAS WILLIAMSON MD DIRECTOR/PHYSICIANS 1.00 40.00 X 355544 0 56958 KARL OBERER DO DIRECTOR/PHYSICIANS 1.00 40.00 X 276582 0 53068 FREDRIC ITZKOWITZ DO DIRECTOR 1.00 0.00 X 24717 0 0 W PATRICK MCGUINN MD DIRECTOR 1.00 0.00 X 13472 0 0 STEVEN BENEDICT DIRECTOR 1.00 0.00 X 5275 0 0 BRADLEY MITCHEL DIRECTOR 1.00 0.00 X 1700 0 0 CARLOS LOWELL DO DIRECTOR 1.00 0.00 X 635 0 0 JAMES MILLER CHAIR 2.00 3.00 X X 0 0 0 LEE A ALEXAKOS VICE CHAIR 2.00 2.00 X X 0 0 0 JOHN O BACON DIRECTOR 1.00 1.00 X 0 0 0 SHELLY CHESBRO DIRECTOR 1.00 1.00 X 0 0 0 DARLENE CROOKS DIRECTOR 1.00 0.00 X 0 0 0 GREGORY GRAVES DIRECTOR 1.00 1.00 X 0 0 0 ROGER M GUNDLACH DIRECTOR 1.00 2.00 X 0 0 0 JAMES HART DIRECTOR 1.00 1.00 X 0 0 0 MARY JANE HILL DIRECTOR 1.00 1.00 X 0 0 0 JOHN HOTY DIRECTOR 1.00 0.00 X 0 0 0 CURITS JOHNSON JR DIRECTOR 1.00 0.00 X 0 0 0 BRYAN KASPER DIRECTOR 1.00 2.00 X 0 0 0 THEODORE A KASTOR DIRECTOR 1.00 1.00 X 0 0 0 DANIEL KELLER DIRECTOR 1.00 1.00 X 0 0 0 RICHARD R KELLER MD DIRECTOR 1.00 1.00 X 0 0 0 KEVIN KIEFFER DIRECTOR 1.00 0.00 X 0 0 0 MATTHEW KOSIOR DIRECTOR 1.00 0.00 X 0 0 0 STEVE LICHTCSIEN DIRECTOR 1.00 1.00 X 0 0 0 TIMOTHY MAYLES DIRECTOR 1.00 1.00 X 0 0 0 ALLEN R NICKLES DIRECTOR 1.00 1.00 X 0 0 0 JAMES E PRESTON DO DIRECTOR 1.00 0.00 X 0 0 0 PAULA J RENGEL DIRECTOR 1.00 2.00 X 0 0 0 EUGENE SANDERS DIRECTOR 1.00 0.00 X 0 0 0 JAMES SCHERGER DDS DIRECTOR 1.00 0.00 X 0 0 0 WENDY SCHMIEDL DIRECTOR 1.00 0.00 X 0 0 0 JAMES V STOUFFER JR DIRECTOR 1.00 1.00 X 0 0 0 JANICE W WARNER DIRECTOR 1.00 0.00 X 0 0 0 JAMES O WIBLE DIRECTOR 1.00 2.00 X 0 0 0 LUVADA WILSON DIRECTOR 1.00 1.00 X 0 0 0 CHRISSY WOSTON DIRECTOR 1.00 1.00 X 0 0 0 JEREMY NORMINGTON-SLAY PRESIDENT & CEO 40.00 4.00 X 976582 0 191614 SCOTT M CAMPBELL MD VP & CHIEF MEDICAL OFFICER (NON-VOTING) 40.00 4.00 X 606504 0 110380 KEVIN RILEY CHIEF FINANCIAL OFFICER, TREASURER (NON-VOTING) 40.00 4.00 X 484910 0 109109 GEORGE KOROMIA PHYSICIAN 40.00 0.00 X 590541 0 19304 LINDA NJOROGE PHYSICIAN 40.00 0.00 X 581302 0 53980 ADEYEMI MARCUS MD PHYSICIAN 40.00 0.00 X 427449 0 63819 JAMES SPICER VP OPERATIONS 40.00 0.00 X 400761 0 16896 DENISE PARRISH VP & CHIEF NURSING OFFICER 40.00 0.00 X 353055 0 91699 5099029 0 766827 10 0 1 0 COMMUNITY HOSPITALISTS LLC 7500 RIALTO BLVD BLDG 1 SUITE 140 AUSTIN TX 78735 MEDICAL SERVICES 6511516 PREMIER ANESTHESIA PO BOX 638144 CINCINNATI OH 45263 ANESTHESIA SERVICES 2840904 GE MEDICAL SYSTEMS INFORMATION 9900 W INNOVATION DR WAUWATOSA WI 53226 PATIENT FOCUSED TECHNOLOGIES 1893823 MEDICAL INFORMATION TECHNOLOGY 7 BLUE HILL RIVER ROAD CANTON MA 02021 MEDITECH HEALTH INFORMATION 1518971 MCPC INC 21500 AEROSPACE PKWY CLEVELAND OH 44142 INFORMATION TECHNOLOGY SERVICES 1410182 107 55450 49423 4510695 1485493 6101061 NET PATIENT SERVICE REVENUE 623000 257567463 257567463 COMM. HOSP. PATIENT CARE FEES 900099 578275 578275 SCHOOL OF NURSING 611600 551832 551832 PROGRAM SERVICE INVESTMENTS 525990 127116 127116 1911307 1911307 260735993 17725330 17725330 46390702 1107309 41979326 5556 4411376 1101753 5513129 5513129 282169 55450 104910 177259 177259 EMPLOYEE PHARMACY 456110 17913786 17913786 OFFICE RENTS 531190 2402625 2402625 DIETARY SERVICES 722514 945703 945703 2060547 -43494 2104041 23322661 313575433 260735993 -43494 46781873 X 56007 56007 13193 13193 5820058 3782675 2037383 102568970 72894801 29442995 231174 7051542 5082092 1953533 15917 10782427 7641738 3116633 24056 7709486 5460114 2232812 16560 1506069 278794 1227275 532318 532318 180000 180000 1114563 1114563 33953208 25321575 8625493 6140 765836 584601 181235 60000408 55391219 4588820 20369 8825352 8825352 5740547 1077022 4663525 530234 428450 101695 89 47139 47139 6221117 6221117 17012423 17012423 996031 -242390 1238421 FRANCHISE TAX 8292802 8292802 PHYSICIAN RECRUITMENT 1536511 1536511 AFFILIATION FEES 544032 536682 7350 BELLEVUE PROMISSORY NOT 500000 500000 1747816 1184198 548773 14845 284048089 211969023 71561331 517735 9838 9838 23636117 25735395 22019 37978 33572843 41585800 6132378 6391502 20835754 9262863 395965737 241387154 158579084 154578583 262677032 280228815 5833533 5726127 8646353 3939487 519944951 527496388 61109733 53886754 136225002 130736269 38470567 20870918 235805302 205493941 X 267401272 303957119 16738377 18045328 284139649 322002447 519944951 527496388 X 29527344 8259658 75796 X 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 2683 2683 0 PART II-B, LINE 1: OHIO HOSPITAL ASSOCIATION ANNUAL DUES OF WHICH 3.7% IS RELATED TO LOBBYING ACTIVITIES. 0 15310750 2087356 733867 104345 16559894 14138897 2032457 764560 96044 15310750 18066638 -2956325 882155 89261 14138897 16884280 2048359 762850 103151 18066638 15226787 2498063 745247 95323 16884280 1.00000 1 0 13777276 13777276 188788791 97460611 91328180 7543432 2868910 4674522 173609156 137368042 36241114 12247082 3689591 8557491 154578583 CAPITAL LEASE 9373676 SELF-INSURANCE RESERVE 6770000 ACCRUED POST-RETIREMENT & PENSION 354075 DEFERRED INCOME GUARANTEE 3280320 DUE TO RELATED PARTIES 1092847 20870918 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. CADDYSHACK OPEN 161119 250 160869 500 2150 11100 7782 7605 11887 BEST SUMMER BASH 176500 55200 121300 0 0 620 27511 22750 13005 0 337619 55450 282169 500 2150 11720 35293 30355 24892 104910 177259 1 1 1 X 1 X 302.000000000000 1 1 1 0 1 1 2143163 0 2143163 0.00750 43068818 40478511 2590307 0.00910 45211981 40478511 4733470 0.01660 561888 110409 451479 0.00160 7358300 3265952 4092348 0.01440 36030 0 36030 0.00010 7956218 3376361 4579857 0.01610 53168199 43854872 9313327 0.03270 1 35306 612421 110144 502277 0.00180 1 35306 612421 110144 502277 0.00180 1 4239983 256756 105457037 138314413 -32857376 X 1 1 1 NORTHERN OHIO SURGICAL PROPERTIES PROPERTY OWNERSHIP/MANAGEMENT 0.50000 0.30730 2 ERIE SHORES SURGERY CENTER OWNERSHIP OF AMBULATORY SURGICAL CENTER 0.56730 0.26730 3 BBD PROFESSIONAL PROPERTY MANAGEMENT PROPERTY OWNERSHIP/MANAGEMENT 0.25000 0.75000 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 22 1 0 1 1 X FIRELANDS.COM X ERIECOHEALTHOHIO.COM X 1 22 0 1 0 1 X 200.000000000000 302.000000000000 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 SOCIAL DETERMINANTS, PERSONAL HEALTH STATUS, ACCESS TO HEALTH CARE, MENTAL HEALTH, ORAL HEALTH, SMOKING/TOBACCO USE, ALCOHOL AND SUBSTANCE ABUSE, MATERNAL/INFANT/CHILD HEALTH, HEALTHY LIVING, COMMUNICABLE DISEASES, VACCINATIONS AND PREVENTION SERVICES, CHRONIC DISEASE MANAGEMENT, TRANSPORTATION, HOUSING, ENVIRONMENTAL QUALITY, SAFETY/INJURY/VIOLENCE, AND REPRODUCTIVE/SEXUAL HEALTH. FIRELANDS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6B: THE CHNA REPORT WAS FUNDED BY THE ERIE COUNTY HEALTH DEPARTMENT, FIRELANDS HEALTH - FIRELANDS REGIONAL MEDICAL CENTER, AND THE ADAMHS BOARD OF ERIE COUNTY. PROJECT MANAGEMENT AND REPORT DEVELOPMENT WAS PROVIDED BY THE CENTER FOR REGIONAL DEVELOPMENT AT BGSU. FIRELANDS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: THE CHNA IDENTIFIED TOP PRIORITY HEALTH NEEDS IN OUR REGION BASED ON SURVEY DATA, HEALTH DATA, AND DEMOGRAPHIC DATA. THOSE PRIORITY NEEDS INCLUDE ACCESS TO HEALTH CARE, ALCOHOL & SUBSTANCE ABUSE, CHANGING DEMOGRAPHICS AND SOCIAL DETERMINANTS OF HEALTH, MENTAL HEALTH, AND OBESITY & HEALTHY LIFESTYLE CHOICES. FIRELANDS REGIONAL MEDICAL CENTER INCLUDED PLANS TO ADDRESS EACH OF THESE NEEDS IN THE CHNA IMPLEMENTATION PLAN 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. 19 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 HOME H 5420 MILAN ROAD SANDUSKY OH 44870 HOME HEALTH AGENCY 4 - FIRELANDS REGIONAL MEDICAL CENTER OUTPAT 290 PROGRESS DR SUITE A BELLEVUE OH 44811 OUTPATIENT DIALYSIS 5 - FIRELANDS REGIONAL MEDICAL CENTER OP IMA 2500 W STRUB RD SANDUSKY OH 44870 OP IMAGING CENTER 6 - FIRELANDS COUNSELING & RECOVERY SERVICES 1925 HAYES AVE SANDUSKY OH 44870 OP MENTAL HEALTH & CD 7 - FIRELANDS COUNSELING & RECOVERY SERVICES 292 BENEDICT AVE NORWALK OH 44857 OP MENTAL HEALTH & CD 8 - FIRELANDS COUNSELING & RECOVERY SERVICES 290 PROGRESS DR SUITE B BELLEVUE OH 44811 OP MENTAL HEALTH & CD 9 - FIRELANDS COUNSELING & RECOVERY SERVICES 76 ASHWOOD RD TIFFIN OH 44883 OP MENTAL HEALTH & CD 10 - FIRELANDS COUNSELING & RECOVERY SERVICES 675 BARSTON RD FREMONT OH 43420 OP MENTAL HEALTH & CD 11 - FIRELANDS COUNSELING & RECOVERY SERVICES 335 BUCKEYE BLVD PORT CLINTON OH 43452 OP MENTAL HEALTH & CD 12 - FIRELANDS REGIONAL MEDICAL CENTER OP PHY 348 MILAN AVE 2 NORWALK OH 44857 OP PHYSICAL THERAPY 13 - FIRELANDS REGIONAL MEDICAL CENTER OP PHY 101 S WASHINGTON ST CASTALIA OH 44824 OP PHYSICAL THERAPY 14 - FIRELANDS REGIONAL MEDICAL CENTER OP IMA 1470 W MCPHERSON HWY CLYDE OH 43410 OP IMAGING CENTER 15 - FIRELANDS REGIONAL MEDICAL CENTER OP IMA 1401 BONE CREEK DRIVE SANDUSKY OH 44870 OP IMAGING & PHYSICAL THERAPY 16 - FIRELANDS OP DIAG RADIOLOGY AND LAB SE 3960 E HARBOR ROAD PORT CLINTON OH 43452 OP IMAGING, AND LAB 17 - FIRELANDS REGIONAL MEDICAL CENTER OP PHY 2801 CLEVELAND ROAD SANDUSKY OH 44870 OP PHYSICAL & SPEECH THERAPY 18 - FIRELANDS REGIONAL MEDICAL CENTER OP RAD 2520 COLUMBUS AVE SUITE C SANDUSKY OH 44870 OP IMAGING CENTER 19 - FIRELANDS REGIONAL MEDICAL CENTER OP LAB 2520 COLUMBUS AVE SUITE D SANDUSKY OH 44870 OP LAB 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 BAD DEBT EXPENSE. PART III, LINE 3: FOR ESTIMATING THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER ITS FINANCIAL 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 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.AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGEING. LOSS RATE ACTORS 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. 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 IT 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 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 FOR THEIR PERCEPTIONS OF HEALTHCARE SERVICES IN THE AREA AND DETERMINES IF ADDITIONAL SERVICES ARE NEEDED. SECONDARY DATA OF THE REGION IS ANALYZED ANNUALLY 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 SCREENED BY A FINANCIAL COUNSELOR WHO EXPLAINS THE HOSPITAL'S CHARITY PROCESS, 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 ELIGIBILITY 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 FOUR-COUNTY AREA OF APPROXIMATELY 233,000 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 UPON THE LATEST CENSUS DATA, THE MAJORITY OF THE POPULATION'S RACE IS CAUCASIAN, WITH 18% MINORITY; 96.1% OF THE POPULATION HAS A HIGH SCHOOL EDUCATION OR AT LEAST SOME COLLEGE. THE COUNTY'S MEDIAN AGE IS 47 AND THE MEDIAN HOUSEHOLD INCOME IS $61,648. APPROXIMATELY, 70% OF THE COUNTY'S RESIDENTS OWN THEIR HOME, WITH THE MEDIAN HOME VALUE OF $197,000. SECONDARY SERVICE AREAS CONSIST OF THE CONTIGUOUS COUNTIES OF OTTAWA, HURON AND SANDUSKY, WHICH HAVE A COMBINED POPULATION OF 158,000 INDIVIDUALS. FIRELANDS COUNSELING AND RECOVERY SERVICES REACHES EVEN FURTHER, SERVING 5 SURROUNDING COUNTIES INCLUDING THE COUNTIES OF ERIE, HURON, SANDUSKY, OTTAWA, SENECA. 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 PATIENTS ALONG WITH EFFORTS TO ORGANIZE A FEDERALLY QUALIFIED HEALTH CENTER FOR THE COMMUNITY, AND BOARD LEVEL WORK FOR COMMUNITY HEALTH EDUCATION ENTITIES AND AREA NON-PROFIT ORGANIZATIONS THAT WORK TO IMPROVE THE HEALTH OF THE COMMUNITY. 1 FIRELANDS PHYSICIANS REGIONAL HEALTH CARE 1111 HAYES AVE SANDUSKY OH 44870 341829898 501(C) (3) 22837 0 FINANCIAL ASSISTANCE TO RELATED ORGANIZATION 0 1 EDUCATION PAYMENT PROGRAM SCHOLARSHIPS 14 13193 N/A N/A PART I, LINE 2: THE USE OF FUNDS CONTRIBUTED IS MONITORED BY THE REVIEW OF FINANCIAL AND PERFORMANCE RESULTS. PART III 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 CUMULATIVE 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. X X X X X 0 1 0 0 0 1 0 0 0 JEREMY NORMINGTON-SLAY PRESIDENT & CEO 707535 0 268268 0 779 0 129740 0 61874 0 1168196 0 0 0 SCOTT M CAMPBELL MD VP & CHIEF MEDICAL OFFICER (NON-VOTI 603077 0 0 0 3427 0 89209 0 21171 0 716884 0 0 0 LINDA NJOROGE PHYSICIAN 519446 0 61557 0 299 0 1965 0 52015 0 635282 0 0 0 GEORGE KOROMIA PHYSICIAN 525681 0 64607 0 253 0 0 0 19304 0 609845 0 0 0 KEVIN RILEY CHIEF FINANCIAL OFFICER, TREASURER ( 384515 0 98162 0 2233 0 56179 0 52930 0 594019 0 0 0 ADEYEMI MARCUS MD PHYSICIAN 414081 0 12866 0 502 0 13800 0 50019 0 491268 0 0 0 DENISE PARRISH VP & CHIEF NURSING OFFICER 279823 0 70999 0 2233 0 42495 0 49204 0 444754 0 0 0 JAMES SPICER VP OPERATIONS 319764 0 80218 0 779 0 0 0 16896 0 417657 0 0 0 THOMAS WILLIAMSON MD DIRECTOR/PHYSICIANS 305123 0 39250 0 11171 0 13800 0 43158 0 412502 0 0 0 KARL OBERER DO DIRECTOR/PHYSICIANS 225263 0 48070 0 3249 0 11212 0 41856 0 329650 0 0 0 PART I LINE 4B NORTH COAST PROFESSIONAL COMPANY, A RELATED PARTY, CONTRIBUTED TO A 409A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN ON THE BEHALF OF JEREMY NORMINGTON-SLAY, PRESIDENT, IN THE AMOUNT $115,940. NORTH COAST PROFESSIONAL COMPANY, A RELATED PARTY, CONTRIBUTED TO A 409A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN ON THE BEHALF OF SCOTT CAMPBELL, CHIEF MEDICAL OFFICER, IN THE AMOUNT $75,409. NORTH COAST PROFESSIONAL COMPANY, A RELATED PARTY, CONTRIBUTED TO A 409A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN ON THE BEHALF OF KEVIN RILEY, CHIEF FINANCIAL OFFICER, IN THE AMOUNT $42,379. NORTH COAST PROFESSIONAL COMPANY, A RELATED PARTY, CONTRIBUTED TO A 409A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN ON THE BEHALF OF DENISE PARRISH, CHIEF NURSING OFFICE, IN THE AMOUNT $31,022. PART I LINE 6A BONUS COMPENSATION IS BASED ON A SUCCESS SHARING PLAN MEASURED BY PATIENT SATISFACTION, QUALITY/ACCREDITATION, FINANCIAL PERFORMANCE, AND EMPLOYEE ENGAGEMENT. A COUNTY OF ERIE OHIO 346400428 000000000 2019-12-23 10000000 SEE PART VI 0 0 0 B COUNTY OF ERIE OHIO 346400428 000000000 2020-04-15 13968800 SEE PART VI 0 0 0 C COUNTY OF ERIE OHIO 346400428 000000000 2023-02-15 121260000 SEE PART VI 0 0 0 A 2860000 10108088 54600 10053488 2021 0 0 1 1 B 7083250 13968800 13968800 2017 1 0 1 1 C 6305000 121260000 394571 120865429 2013 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 0 1 1 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 SCHEDULE K SUPPLENTAL INFORMATION PART I LINE A, COLUMN (F): (I) ACQUIRE, CONSTRUCT, RENOVATE, INSTALL AND EQUIP HOSPITAL FACILITIES; AND (II) PAY COSTS OF ISSUANCE. PART I LINE B, COLUMN (F): CURRENTLY REFUND THE COUNTY OF ERIE, OHIO HOSPITAL FACILITIES REVENUE AND REVENUE REFUNDING BONDS, SERIES 2017 (FIRELANDS REGIONAL MEDICAL CENTER PROJECT), ISSUED JULY 11, 2017 AND WHICH WERE DEEMED REISSUED ON APRIL 15, 2020. PART I LINE C, COLUMN (F): CURRENTLY REFUND THE (A) 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; (B) 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; (C) COUNTY OF ERIE, OHIO HOSPITAL FACILITIES REVENUE AND REVENUE REFUNDING BONDS, SERIES 2012A/B (FIRELANDS REGIONAL MEDICAL CENTER) ISSUED AUGUST 15, 2012, WHICH WERE PREVIOUSLY DEEMED REISSUED ON AUGUST 6, 2014 AND MARCH 31, 2016, AS A RESULT OF A DEEMED REISSUANCE OF SUCH BONDS ON NOVEMBER 5, 2021; AND (D) CITY OF BELLEVUE, OHIO, HOSPITAL FACILITIES REVENUE BONDS, SERIES 2003 (FIRELANDS REGIONAL MEDICAL CENTER) ISSSUED SEPTEMBER 16, 2003; AND (II) PAY COSTS OF ISSUANCE. PART II LINE 3, COLUMN A: TOTAL PROCEEDS OF THE ISSUE ARE COMPRISED OF $10,000,000 SALE PROCEEDS AND $108,088 OF INVESTMENT PROCEEDS. CLARITY CARE LLC BUSINESS ENTITY 384302 NEUROLOGY COVERAGE COMPENSATION 0 PART IV LINE 1 BOARD MEMBER STEVEN BENEDICT FULLY OWNS CLARITY CARE LLC. 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 990S 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 AS PROVIDED IN THE CODE OF REGULATIONS FOR FIRELANDS REGIONAL HEALTH SYSTEM, FIRELANDS REGIONAL MEDICAL CENTER, AND THE FOUNDATION FOR FIRELANDS (COLLECTIVELY KNOWN AS "FIRELANDS"), ANNUALLY, CONFLICT OF INTEREST QUESTIONNAIRES ARE PREPARED AND PROVIDED TO THE DIRECTORS, OFFICERS, AND COMMITTEE MEMBERS OF FIRELANDS. DURING THE ANNUAL MEETINGS OF THE HEALTH SYSTEM, MEDICAL CENTER AND FOUNDATION, THE GENERAL COUNSEL / CORPORATE COMPLIANCE OFFICER PRESENTS A SUMMARY TO THE DIRECTORS, OFFICERS, AND COMMITTEE MEMBERS OF FIRELANDS' CONFLICT OF INTEREST PROGRAM. PART OF THAT SUMMARY IS A REMINDER TO THOSE DIRECTORS, OFFICERS AND COMMITTEE MEMBERS THAT THEY HAVE A DUTY DURING THE YEAR TO REPORT TO THE CHAIR, VICE CHAIR, PRESIDENT/CEO, OR THE GENERAL COUNSEL / CORPORATE COMPLIANCE OFFICER OF A POTENTIAL CONFLICT OF INTEREST. ALL DIRECTORS, OFFICERS AND COMMITTEE MEMBERS ARE REQUIRED TO RETURN THEIR ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE TO THE FIRELANDS LEGAL DEPARTMENT. IF A POTENTIAL CONFLICT OF INTEREST DOES ARISE, THEN THE BOARD POLICY ON RESOLVING CONFLICT, ADMINISTRATIVE POLICY 100.17, IS UTILIZED. THE CONFLICT OF INTEREST QUESTIONNAIRES ARE ON FILE WITH THE FIRELANDS LEGAL DEPARTMENT AND ARE RETAINED FOR A MINIMUM OF TEN (10) YEARS 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. THE 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 CONSTITUANTS, BOND HOLDERS OR INTERESTED PARTIES WHO REQUEST TO BE ON THE DISTRIBUTION LIST. QUARTERLY REPORTS AND THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS ARE ALSO 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 IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 5,791,248. MANAGEMENT AND GENERAL EXPENSES 6,634,247. FUNDRAISING EXPENSES 6,140. TOTAL EXPENSES 12,431,635. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 16,624,364. MANAGEMENT AND GENERAL EXPENSES 1,238,882. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,863,246. PURCHASED MAINTENANCE: PROGRAM SERVICE EXPENSES 2,098,360. MANAGEMENT AND GENERAL EXPENSES 400,081. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,498,441. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 807,603. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 807,603. COLLECTION AGENCY FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 352,283. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 352,283. FORM 990, PART XI, LINE 9: SCHOOL OF NURSING FUNDING -80,053. PENSION ADJUSTMENTS 15,971,857. NET TRANSFER (TO)/FROM AFFILIATES -15,860,505. PARTNERSHIP INCOME/(LOSS) RELATED TO SCHEDULE K-1S 43,497. RECLASS SCHOLARSHIPS 1,000. FORM 990, PART XII, LINE 2: FINANCIAL STATEMENTS FOR FIRELANDS REGIONAL MEDICAL CENTER ARE AUDITED BY PLANTE MORAN, PLLC AS PART OF THE CONSOLIDATED FINANCIAL STATEMENTS OF FIRELANDS REGIONAL HEALTH SYSTEM. FIRELANDS VOCATIONAL REHABILITATION LLC 1111 HAYES AVE SANDUSKY OH 44870 455448705 VOCATIONAL REHABILITATION OH -647 56071 FIRELANDS REGIONAL MEDICAL CENTER FIRELANDS HOLDING CO LLC 1111 HAYES AVE SANDUSKY OH 44870 841894622 MEDICAL SERVICES OH 25543 403947 FIRELANDS REGIONAL MEDICAL CENTER FIRELANDS REGIONAL HEALTH SYSTEM 1111 HAYES AVE SANDUSKY OH 44870 341401659 HOSPITAL SUPPORT OH 501(C)(3) LINE 12A, I N/A 0 THE FOUNDATION FOR FIRELANDS 1111 HAYES AVE SANDUSKY OH 44870 341401660 HOSPITAL SUPPORT OH 501(C)(3) LINE 12A, I FIRELANDS REGIONAL HEALTH SYSTEM 0 FIRELANDS-BELLEVUE URGENT CARE REAL ESTATE HOLDING CO 1111 HAYES AVE SANDUSKY OH 44870 464069354 REAL ESTATE HOLDINGS OH FIRELANDS REGIONAL MEDICAL CENTER RELATED 11310 721233 0 1 0.75000 FIRELANDS-BELLEVUE URGENT CARE OPERATING CO 1111 HAYES AVE SANDUSKY OH 44870 464042889 MEDICAL SERVICES OH FIRELANDS REGIONAL MEDICAL CENTER RELATED -186884 26787 0 1 0.75000 ERIE SHORES SURGERY CENTER 3004 HAYES AVE SANDUSKY OH 44870 834395754 MEDICAL SERVICES OH FIRELANDS REGIONAL MEDICAL CENTER RELATED 101917 670294 0 1 0.56700 FIRELANDS PROFESSIONAL CENTER 2 CONDO 1111 HAYES AVE SANDUSKY OH 44870 203131059 CONDO ASSOCIATION OH N/A C 290617 0.94000 1 FIRELANDS PHYSICIANS REGIONAL HEALTH CARE 1111 HAYES AVE SANDUSKY OH 44870 341829898 PHO OH N/A C -5641 0.51000 1 NORTH COAST PROFESSIONAL CO LLC 1111 HAYES AVE SANDUSKY OH 44870 341608091 PHYSICIAN PRACTICE MGT OH N/A C 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 1 NORTH COAST PROFESSIONAL COMPANY LLC J 980049 CASH NORTH COAST PROFESSIONAL COMPANY LLC P 1819105 CASH NORTH COAST PROFESSIONAL COMPANY LLC Q 7517536 CASH THE FOUNDATION FOR FIRELANDS R 13157867 CASH FIRELANDS-BELLEVUE URGENT CARE OPERATING CO Q 57811 CASH FIRELANDS-BELLEVUE URGENT CARE OPERATING CO R 155759 CASH FIRELANDS-BELLEVUE REAL ESTATE HOLDING CO Q 57502 CASH FIRELANDS-BELLEVUE REAL ESTATE HOLDING CO S 300000 CASH NORTH COAST PROFESSIONAL COMPANY LLC P 294266 INTERCOMPANY TRANSFER NORTH COAST PROFESSIONAL COMPANY LLC Q 2496904 INTERCOMPANY TRANSFER