2014-08-15T03:37:20-00:00 2013-12-31 990 2013-01-01 310645626 Fairfield Medical Center FAIR 7406878000 401 North Ewing Street Lancaster OH 431303371 Sky L Gettys CFO Treasurer 7406878011 2014-08-15 false 2013 2015-11-30 17:44:51Z Mina H Ubbing 401 North Ewing Street Lancaster OH 43130 259740803 false X www.fmchealth.org X 1982 OH Our mission is to provide efficient, compassionate, safe, high quality healthcare for patients and their families. Fairfield Medical Center provides this care to all patients regardless of race, creed, sex, national origin, handicap, age or ability to pay. 15 15 2377 220 352871 497848 293840 203944056 224105357 1855604 2724692 6505323 5992542 212802831 233116431 0 0 100726632 107142906 0 0 98468771 105561521 199195403 212704427 13607428 20412004 207783812 262521097 92223240 131499494 115560572 131021603 Our mission is to provide efficient, compassionate, safe, high quality healthcare for patients and their families. Fairfield Medical Center provides this care to all patients regardless of race, creed, sex, national origin, handicap, age or ability to pay. false false 76396996 95061119 Patient Care Inpatient Medical, Surgical, Emergency, Maternity, ICU, Psychiatry, and Nursing Services 72,913 admissions, procedures visits 73669130 130612536 Patient Care Laboratory, Cardiovascular, Radiology, Therapy, Pharmacy, and Medical Supply Services 2,605,974 procedures dosages 19785225 968765 Patient Care Nutritional Services 495,327 meals served Patient Care Laundry Services 1,603,149 pounds Patient Care Plant Engineering, Police, Housekeeping, Central Transport, Interest Depreciation 500,075 square feet 169851351 true true false false false false false false false false true false false true true false false true false false false false false false false false true true true false true true false true false false false false false false false false false false false false true true true true true false true 145 0 true 2377 true true true false false false false false false false false false X 15 15 true false false false false false false true true false false false true true true true true true true true true OH X Sky L Gettys 7406878011 401 North Ewing Street Lancaster OH 431303371 Carol Seubert Marx Chair 003.00 X X 0 0 0 Debra Smith Vice Chair 003.00 X X 0 0 0 Ron Burris Secretary 003.00 X X 0 0 0 James Christian Director 002.00 X 0 0 0 Adam Custer Director 002.00 X 0 0 0 Joseph Ginty MD Director 002.00 X 0 0 0 Dave Oehlers Director 002.00 X 0 0 0 Barry Ritchey Director 002.00 001.00 X 0 0 0 Linda Sheridan Director 002.00 X 0 0 0 Susan Nixon Stoughton Director 002.00 001.00 X 0 0 0 Milt Taylor Jr Director 002.00 X 0 0 0 Louis Varga Director 002.00 X 0 0 0 Renee Wagner Director 002.00 X 0 0 0 William Yaple Director 002.00 X 0 0 0 Jeffrey Yenchar MD Director 002.00 X 0 0 0 Mina H Ubbing President CEO 055.00 001.00 X 562873 0 32912 Sky L Gettys CFO, Treasurer 048.00 002.00 X 288937 0 30582 Steven D Cox MD VP - CMO 042.00 005.00 X 318807 120673 32058 Howard Sniderman Chief Operating Officer 045.00 X 263547 0 31928 Cynthia Pearsall VP - CNO 050.00 X 213571 0 15124 Jean L Robertson MD Chief Med. Info. Officer 024.00 X 144593 0 14669 Grant R Brame Physicians Assistant 040.00 X 180957 0 26800 Heather B Schultz Advanced Practice Nurse 040.00 X 161810 0 11303 Jeffrey M Ayers MD Residency Prog. Dir. 043.00 001.00 X 159866 0 24266 Betsy L Winsley Pharmacy Supervisor 043.00 X 153038 0 11014 Randy L Brown Pharmacy Manager 043.00 X 151759 0 23037 2599758 120673 253693 45 false true false McKesson PO Box 98347 Chicago IL 606930001 Information Technology Services 3234939 Aramark Healthcare 12483 Collections Center Drive Chicago IL 60693 Biomedical Services 2520440 Renovo Solutions 1801 E Parkcourt Place Bldg D Suite Santa Ana CA 92701 Biomedical Services 765995 Fairfield Emergency Physicians 401 North Ewing Street Lancaster OH 43130 Physician Services 730040 Central Ohio Orthopedic Consultants 2405 N Columbus Street Suite 120 Lancaster OH 43130 Physician Services 528925 14 293840 293840 Patient Service Revenue Net 224105357 224105357 224105357 1151201 1151201 649652 439933 209719 209719 27707593 50337 25725421 459018 1982172 -408681 1573491 Cafeteria Sales 863025 863025 Patronage Dividends 900099 544003 544003 Outside Reference Lab 621500 306247 306247 4069548 4022924 46624 5782823 233116431 228128281 352871 2558229 0 0 0 0 1956712 1038831 917881 0 82286632 71868561 10418071 4627537 4288980 338557 12128136 8206575 3921561 6143889 5238716 905173 0 604927 604927 96575 96575 0 0 20282811 9223245 11059566 0 0 0 0 3680090 3339284 340806 0 0 0 3104005 2824645 279360 0 12515117 8288655 4226462 1095195 1095195 Supplies 45234354 44980651 253703 Physician Fees 7710220 7546045 164175 Other Expenses 11238227 3007163 8231064 0 212704427 169851351 42853076 0 14096893 8833417 9971448 47925724 22080093 24785317 3640422 3872371 3556960 3704573 226205778 139953087 84508237 86252691 44534619 55696669 4515499 4515499 20879641 26934836 207783812 262521097 15510410 14101009 61700147 98479656 1137601 1684695 13875082 17234134 92223240 131499494 X 115560572 131021603 115560572 131021603 207783812 262521097 X 20412004 4898310 -9849283 X false true X true false X 0.00000 0.00000 0.00000 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false 5439732 5439721 87455 93621396 52129553 41579298 3207382 3068116 139266 115898355 81664768 34233587 7951458 3090639 4860819 86252691 Financial derivatives and other financial products Closely-held equity interests Unamortized bond financing expense 1069780 Due from related organizations 6173073 Notes receivable/income guarantee 2123226 Investment in subsidiary 11775669 Other receivables 2252619 Third party settlements 3540469 26934836 Federal income taxes Accrued payroll and benefits 17234134 17234134 true true true X true X true true false true true 5199227 2881438 2317789 0.01090 26708323 20595029 6113294 0.02870 31907550 23476467 8431083 0.03960 2396481 78637 2317844 0.01090 2042325 1750 2040575 0.00960 16197829 10863258 5334571 0.02510 6923 6923 243859 243859 0.00110 20887417 10943645 9943772 0.04670 52794967 34420112 18374855 0.08630 27883 27883 0.00010 5685 5685 11481 11481 0.00010 121219 121219 0.00060 2509 2509 168777 168777 0.00080 true 9032426 1029697 56273473 55342936 930537 X true true Southeast Ohio Sleep Disorders Sleep Lab 0.51000 0.49000 1 1 Fairfield Medical Center 401 North Ewing Street Lancaster OH 43130 www.fmchealth.org X X X 1 1 true X X X X X X X X X 13 true false true X fmchealth.org X X X X X X X X X false false true true 0000000001.000000000000 true 0000000002.000000000000 true X X X X true true X X X X X X true false X X X X true X false false Group Fairfield Medical Center Line Part V, Section B, Line 5d Fairfield Medical Center presented the CHNA to various organizations in the community during 2013. Group Fairfield Medical Center Line Part V, Section B, Line 7 While most of the issues were addressed in multiple ways, due to funding issues we were not able to address the problems of sexual behavior, pregnancy outcomes or possession of firearms in the home. Part III Line 3 Bad debt expense represents total estimated uncollected charges. Fairfield Co has 11.5 of the population living below the poverty level, so that percentage was applied in order to approximate Charitable Bad Debt. Because we cant require patients to disclose their income, we were not able to determine exact amounts, but we believe our methodology to be reasonable and supportable. Since we do not choose our patients, we consider it fair to include bad debt as a part of Community Benefit. Part III Line 4 An allowance for uncollectible accounts is established on an aggregate basis by using historical write-off factors applied to unpaid accounts based on aging. Loss rate factors are based on historical loss experience and adjusted for economic conditions and other trends affecting the Centers ability to collect outstanding amounts. Uncollectible amounts are written off against the allowance for doubtful accounts in the period they are determined to be uncollectible. The information can be found on page 8 of the financial statements. Part III Line 8 The total for Medicare Cost is taken directly from the Medicare Cost Report. Part III Line 9b In all instances of debt collection, patients are given information regarding financial assistance available. In addition, patients are made aware of the availability of financial assistance with an acknowledgement letter of services rendered, regardless of ability to pay or payment source. FMC will do everything possible to help those who qualify for charity care to be made aware of the assistance available. We also provide financial counselors to assist patients in filling out the necessary forms for assistance. Part III Line 9b We do all we can to work with the patient and have the following options available A. Payment in the form of cash, credit card or checks. A discount is offered with payment at the time of service and within 15 days. B. H.E.L.P. Bank Financial Program C. Hospital Payment Program D. Assistance with application to Medicare or Medicaid E. Hospital Care Assurance Program HCAP F. Hospital Assistance Program summary defining Fairfield Medical Centers financial opportunities. G. Assistance for the uninsured patient. Part VI Line 2 During 2013, a Community Health Needs Assessment CHNA was conducted to assess the health care needs of the community. This was conducted through a collaboration with The Hospital Council of Northwest Ohio and public health researchers at The University of Toledo. The local collaborators were theFairfield Department of Health, Fairfield Medical Center, Fairfield Community Health Center and the United Way of Fairfield County. Part VI Line 3 An employee from Contracts and Collections meets with patients before discharge to discuss the many options available under the organizations charity care policy. Those policies are also posted throughout the hospital and go into the billing envelopes. Part VI Line 4 Fairfield Medical Center serves Fairfield County and surrounding counties. The demographics include the edge of the Appalacian community. We stay in touch with community organizations of all kinds to keep current on the needs of the community. A committee meets regularly to keep in touch with the perceptions of the community in order to better serve our constituents. Part VI Line 5 Fairfield Medical Center actively promotes community health through education at community groups, newspaper articles and collaboration with other community groups. Part VI, Line 7 OH true Fairfield Medical Center Foundation 401 North Ewing Street Lancaster OH 43130 208952945 501c3 220975 1 X X X X false true false false false false false true false Mina H Ubbing President CEO 438642 51197 73034 17850 15062 595785 Sky L Gettys CFO, Treasurer 250276 37461 1200 17850 12732 319519 Steven D Cox MD VP - CMO 275527 42080 1200 17850 14208 350865 Howard Sniderman Chief Operating Officer 230781 31566 1200 17850 14078 295475 Cynthia Pearsall VP - CNO 188688 23683 1200 14586 538 228695 Jean L Robertson MD Chief Med. Info. Officer 140498 4095 10383 4286 159262 Grant R Brame Physicians Assistant 100488 80469 13032 13768 207757 Heather B Schultz Advanced Practice Nurse 102513 59297 11303 173113 Jeffrey M Ayers MD Residency Prog. Dir. 159866 11304 12962 184132 Betsy L Winsley Pharmacy Supervisor 151895 1143 10618 396 164052 Randy L Brown Pharmacy Manager 149270 1889 600 10847 12190 174796 A County of Fairfield Ohio 316400066 304286AM9 2013-06-27 98511516 To refund prior issue and to fund new surgical unit. A 56264480 6320525 926511 35000000 true false false true A false false false false A false false false false false false false false false A false Form 990, Part VI, Section A, Line 2 Various members of the Board of Directors are key employees and/or officers of organizations that may conduct normal, arms length transactions with one another. Form 990, Part VI, Section B, Line 11b The 990 is reviewed by the President and Treasurer of the organization after review by the Controller. Then it is made available for Board Member review prior to filing. Form 990, Part VI, Section B, Line 12c Directors, President, Vice Presidents, Managers, Case Management employees, Contracts Collections employees, employees with direct purchasing responsibilities, employed physicians, and employees who are contracted or shared with other organizations are required to complete an annual questionnaire disclosing potential conflicts of interest. If a known or perceived conflict of interest arises, the Compliance Officer investigates, documents, and works to resolve the conflict of interest. Form 990, Part VI, Section B, Line 15 a b Annually, the Compensation Committee compares officer and key employee compensation to regional industry averages. This committee consists of independent members of the Board of Directors. Compensation adjustment recommendations are submitted, to be included in the budget, to the Finance and Audit Committee. Compensation adjustments are taken to the Board of Directors for final approval, and if approved are then implemented. Form 990, Part VI, Section C, Line 19 The governing documents, conflict of interest, and financials are made available to the public by requests made to FMC management. Form 990, Part XI, Line 9 The other change in net assets reported represents intercompany transfers between Fairfield Medical Center and related organizations see Schedule R for fixed asset purchases, shared employees, expenses, and other intercompany transactions, loss on early extinguishment of debt related to the refunding of bond debt, and the recognition of future employee separation agreement liability amounts as required by Generally Accepted Accounting Principles. Home Health Resources 401 North Ewing Street Lancaster OH 43130 311159707 Durable Med. Equip. OH Zane Properties Corporation Fairfield Healthcare Professionals Inc 401 North Ewing Street Lancaster OH 43130 311425884 Physician Practices OH 501c3 11a Fairfield Medical Center false Fairfield Medical Center Foundation 401 North Ewing Street Lancaster OH 43130 208952945 Fundraising OH 501c3 7 N/A false Southeast Ohio Sleep Disorders Center LLC 135 North Ewing Street FL 3 Lancaster OH 43130 311639116 Sleep disorder trmt OH Fairfield Medical Center Related false true 0.51000 Simplified Healthcare Solutions LLC 5980 Wilcox Place Suite F Dublin OH 43016 201720030 Claims review/processing OH Fairfield Medical Center Related false true 1.00000 Zane Properties Corporation 401 North Ewing Street Lancaster OH 43130 311202009 Holding Company OH Fairfield Medical Center C Corp 1.00000 false true false false false false false true true false false true false true false true true true true false Southeast Ohio Sleep Disorders Center LLC a 47220 Fairfield Healthcare Professionals Inc a 12000 Fairfield Healthcare Professionals Inc g 247286 Zane Properties Corporation h 689200 Zane Properties Corporation k 192540 Simplified Healthcare Solutions LLC m 268542 Fairfield Healthcare Professionals Inc o 5085587 Zane Properties Corporation p 225801 Fairfield Healthcare Professionals Inc r 2860000 Fairfield Healthcare Professionals Inc q 2393495 Zane Properties Corporation q 629577