2014-11-13T12:45:37-06:00 2013-12-31 990 2013-01-01 344428218 FIRELANDS REGIONAL MEDICAL CENTER FIRE 4195577400 1111 HAYES AVENUE SANDUSKY OH 448703323 DANIEL J MONCHER EXECUTIVE VP/CFO 4195577400 2014-11-12 2013 2015-11-30 17:44:51Z DANIEL J MONCHER 1111 HAYES AVE SANDUSKY OH 448703323 301960802 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. 37 24 2277 268 3311 2311 769282 1247071 226656601 230148725 3581223 10692990 7063000 7477725 238070106 249566511 282958 308130 0 0 98742566 102377098 0 0 277981 119980001 121487784 219005525 224173012 19064581 25393499 415796088 436269224 267959407 227357027 147836681 208912197 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 OF THOSE WE SERVE. 0 0 179282129 308130 230145414 SEE SCHEDULE OFIRELANDS REGIONAL MEDICAL CENTER IS A 400-BED FACILITY SERVING THE GREATER ERIE COUNTY REGION WITH TOP 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, TODAYS FIRELANDS REGIONAL MEDICAL CENTER CARRIES ON THE PROUD TRADITION OF DELIVERING A FULL RANGE OF ALLOPATHIC AND OSTEOPATHIC MEDICAL SERVICES TO NEARLY 300,000 RESIDENTS IN THE 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 2,255 INDIVIDUALS EMPLOYED IN THE HEALTH SYSTEM IN 2013, $988,765 WAS PAID IN CITY AND SCHOOL PAYROLL TAXES IN 2013, AND $20.2 MILLION OF GOODS AND SERVICES WERE PURCHASED FROM BUSINESSES IN FIRELANDS' SERVICE AREA.IN TERMS OF HEALTHCARE SERVICES PROVIDED IN 2013, INPATIENT CARE WAS GIVEN TO 8,666 INDIVIDUALS, AND THE HOSPITAL PROVIDED CARE THROUGH 241,595 OUTPATIENT VISITS. THROUGH THE EMERGENCY ROOM, INCLUDING EMERGENCY QUICKCARE, SENIOR ER AND URGENT CARE, 70,310 PERSONS WERE TREATED. FIRELANDS HAD 713 BIRTHS IN 2013.CONSISTENT WITH OUR COMMITMENT TO PROVIDE CARE TO ALL, REGARDLESS OF ABILITY TO PAY, FIRELANDS GAVE THE COMMUNITY BACK $12.1 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:CATEGORY: COSTS OF SERVICES NOT COVERED BY MEDICAIDPERSONS SERVED: 23,985COST OF PROVIDING: $4,946,197CATEGORY: COMMUNITY HEALTHPERSONS SERVED: 25,956COST OF PROVIDING: $231,634CATEGORY: HEALTH PROFESSIONSPERSONS SERVED: 145COST OF PROVIDING: $2,160,127CATEGORY: FINANCIAL ASSISTANCEPERSONS SERVED: 15,088COST OF PROVIDING: $ 4,742,344CATEGORY: IN-KIND DONATIONS PERSONS SERVED: COST OF PROVIDING: $50,835FIRELANDS' 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. ADDITIONALLY IN 2013 THE MEDICAL CENTER CONTINUED SEVERAL INITIATIVES 179282129 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 0 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 0 1 1 1 1 0 1 155 0 1 2277 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 X 37 24 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 4195577094 1111 HAYES AVE SANDUSKY OH 448703323 J WILLIAM SPRINGER VICE CHAIR 2.00 2.00 X 0 0 0 JOHN O BACON CHAIR 2.00 2.00 X 0 0 0 THOMAS AYLWARD DIRECTOR 1.00 0.00 X 0 0 0 ROGER M GUNDLACH DIRECTOR 1.00 1.00 X 0 0 0 FREDRIC ITZKOWITZ DO DIRECTOR 1.00 1.00 X 0 0 0 BRIAN KASPER DIRECTOR 1.00 1.00 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 1.00 X 0 0 0 M LEE MCDERMOND JR DIRECTOR 1.00 1.00 X 0 0 0 PATRICK MCGUINN MD DIRECTOR 1.00 0.00 X 0 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 1.00 X 0 0 0 KARL OBERER DO DIRECTOR 1.00 0.00 X 0 0 0 CAROL B STEUK SECRETARY 2.00 2.00 X 0 0 0 JAMES V STOUFFER JR DIRECTOR 1.00 0.00 X 0 0 0 DAVID A VOIGHT SR DIRECTOR 1.00 1.00 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 LEON J WIEBER TREASURER 2.00 2.00 X 0 0 0 GEORGE L MYLANDER CHAIR EMERITUS 2.00 0.00 X 0 0 0 CARLOS LOWELL DO 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 1.00 X 0 0 0 THOMAS M ROUTH DIRECTOR 1.00 1.00 X 0 0 0 JOHN WALDOCK JR DIRECTOR 1.00 0.00 X 0 0 0 GERALD GUERRA DIRECTOR 1.00 0.00 X 0 0 0 STEVE LICHTCSIEN DIRECTOR 1.00 0.00 X 0 0 0 DOUGLAS PHARES DIRECTOR 1.00 0.00 X 0 0 0 JOHN HOTY 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 VINCENTA GASPAR-YOO MD DIRECTOR 1.00 0.00 X 0 0 0 SHELLY CHESBRO DIRECTOR 1.00 0.00 X 0 0 0 LISA CRESCIMANO DIRECTOR 1.00 0.00 X 0 0 0 KAM WONG MD DIRECTOR 1.00 0.00 X 0 0 0 CAROL A WOLFE DIRECTOR 1.00 1.00 X 0 0 0 DANIEL J MONCHER EXEC VP/CFO/NON-VOTING 40.00 2.00 X 440227 0 65574 MARTIN E TURSKY PRESIDENT/CEO 40.00 2.00 X 576956 0 112165 ROBERT M MOORE VP LEGAL SERVICES 40.00 2.00 X 281357 0 66796 ERIC MAST DIR MED ED/RESIDENCY 40.00 0.00 X 250993 0 29862 BEV SCHRICKEL VP OPERATIONS 40.00 0.00 X 235418 0 79683 JIM SENNISH VP HUMAN RESOURCES 40.00 0.00 X 221335 0 52896 MIKE CANFIELD VP OPERATIONS 40.00 0.00 X 237494 0 38150 2243780 0 445126 61 0 1 0 JANOTTA & HERNER INC 309 MONROE ST MONROEVILLE OH 44847 ARCHITECTURAL 4886740 UNIVERSITY HOSPITALS HEALTH SYSTEM PO BOX 70328 CLEVELAND OH 44190 PHYSICIAN STAFF 3124960 BRIDGE HOMECARE PARTNERS 5335 FAR HILLS AVE DAYTON OH 45429 HOME CARE MANAGEMENT 1588843 PREMIER ANESTHESIA OF SANDUSKY PO BOX 638144 CINCINNATI OH 45263 ANESTHESIOLOGY SVCS 1344786 MEDICAL INFORMATION PO BOX 74569 CHICAGO IL 60696 HEALTHCARE INFOMATION SYSTEMS 1195814 59 2789 48051 1196231 1247071 NET PATIENT SERVICE REVENUE 623000 225032780 225032780 SCHOOL OF NURSING 611600 797118 797118 PROGRAM SERVICE INVESTMENTS 525990 722102 722102 PARTNERSHIP INCOME RELATED TO GRO 541900 116946 113635 3311 3479779 3479779 230148725 7581881 7581881 55342362 70156 51842787 458622 3499575 -388466 3111109 3111109 202599 2789 92882 109717 109717 EMPLOYEE PHARMACY 446110 4089051 4089051 DIETARY SERVICES 722210 1553647 1553647 OFFICE RENTS 531190 1491209 1491209 234101 234101 7368008 249566511 230145414 3311 18170715 X 283630 283630 24500 24500 2825880 1210894 1614986 77848696 57960466 19765954 122276 6479979 4853083 1626896 9417846 7006148 2396413 15285 5804697 4273276 1522067 9354 965218 563495 401723 164916 164916 138875 138875 447632 447632 22490781 14699830 7729587 61364 763569 1587 747271 14711 39979070 39350542 581448 47080 3285829 3285829 4917118 1655403 3261715 621774 212439 401424 7911 33648 33648 4204726 4204726 14137157 14137157 1280002 787484 492518 CHARITY CARE 15625137 15625137 BAD DEBTS 7753479 7753479 FRANCHISE TAX 2460998 2460998 PHYSICIAN RECRUITMENT 526208 526208 1691647 1691647 224173012 179282129 44612902 277981 7829 7929 10865815 10619594 135424 85827 28128523 28287389 2853757 3133983 7183093 7478295 331037754 159088814 174454662 171948940 171823173 194381320 632567 679672 17321378 17321378 1280418 1067015 1109449 1257882 415796088 436269224 69602704 50955452 156212152 151397540 42144551 25004035 267959407 227357027 X 134639821 193660706 9319298 10854761 3877562 4396730 147836681 208912197 415796088 436269224 X 25393499 29396781 6285236 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 1838 0 0 1838 0 PART II-B, LINE 1: PART II-B LINE 1G- FIRELANDS REGIONAL MEDICAL CENTER PAID MEMBERSHIP DUES TO THE OHIO HOSPITAL ASSOCIATION OF WHICH 3.4% OR $1,838 WAS USED FOR LOBBYING ACTIVITIES. 12258468 2441019 368015 82320 14249152 11090402 1591037 339359 83612 12258468 12085032 -581145 334843 78642 11090402 10976812 1502602 323668 70714 12085032 9189157 2221977 364993 69329 10976812 0.00000 1.00000 0.00000 1 0 11810585 11810585 153665275 50216437 103448838 2722963 1610186 1112777 157271535 103838938 53432597 5567396 3423253 2144143 171948940 CAPITAL LEASE 294354 SELF-INSURANCE RESERVE 5000000 ACCRUED POST-RETIREMENT AND PENSION 17189219 DEFERRED INCOME GUARANTEE 2453639 DUE TO RELATED PARTIES 66823 25004035 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: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITION TAKEN BY THE SYSTEM AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAKING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR NAY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2010. PART X LINE 1 FINANCIAL STATEMENTS FOR FIRELANDS REGIONAL MEDICAL CENTER ARE PART OF THE CONSOLIDATED AND AUDITED FINANCIAL STATEMENTS FOR FIRELANDS REGIONAL HEALTH SYSTEM. RECONCILIATION IS NOT REQUIRED FOR PARTS XI AND XII. FASHION SHOW 99249 1934 97315 14820 6519 7851 10060 1494 GOLF OUTING 77568 855 76713 550 8903 11741 9299 3954 1483 1 28571 28571 1750 9273 2275 2910 205388 2789 202599 550 23723 20010 26423 16289 5887 92882 109717 1 1 1 X 1 X 1 1 0 1 1 6716607 1974263 4742344 0.02360 18126113 13179916 4946197 0.02460 24842720 15154179 9688541 0.04820 316715 91765 224950 0.00110 5693522 3533395 2160127 0.01080 50843 8 50835 0.00030 6061080 3625168 2435912 0.01220 30903800 18779347 12124453 0.06040 1 4 2010 2010 0.00000 1 12500 12500 0.00010 5 6691 6691 0.00000 1 10971 573281 114692 458589 0.00230 8 10975 594482 114692 479790 0.00240 0 2712167 920170 82417936 102879363 -20461427 X 1 1 1 NORTHERN OHIO SURGICAL PROPERTIES PROPERTY OWNERSHIP/MANAGEMENT 0.50000 0.00000 0.50000 1 1 FIRELANDS REGIONAL MEDICAL CENTER 1111 HAYES AVENUE SANDUSKY OH 44870 WWW.FIRELANDS.COM STATE REGIS X X X X FIRELANDS REGIONAL MEDICAL CENTER 1 1 X X X X X X X X X X 13 1 0 1 X WWW.FIRELANDS.COM X WWW.ERIECOHEALTHOHIO.ORG X X X X X X X X X 0 0 1 1 200.000000000000 1 300.000000000000 1 X X 1 1 X X X X 1 0 1 X 0 0 FIRELANDS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 1J: FIRELANDS REGIONAL MEDICAL CENTER, PART V, SECTION B, LINE 1J, OTHER TOPICS THAT THE CHNA REPORT ADDRESSED INCLUDE WEIGHT CONTROL, TOBACCO USE, ALCOHOL CONSUMPTION, DRUG USE, SEXUAL BEHAVIOR, YOUTH SAFETY, YOUTH VIOLENCE AND PARENTING. FIRELANDS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 3: FIRELANDS REGIONAL MEDICAL CENTER, PART V, SECTION B, LINE 3, THE CHNA REPORT WAS COMMISSIONED BY THE ERIE COUNTY COMMUNITY HEALTH ASSESSMENT WORKGROUP, WHICH IS COMPRISED OF THE ERIE COUNTY HEALTH DEPARTMENT, ERIE COUNTY BOARD OF DEVELOPMENTALLY DISABLED, ERIE COUNTY JOB & FAMILY SERVICES, ERIE-OTTAWA MENTAL HEALTH AND RECOVERY BOARD, FAMILY AND CHILDREN FIRST COUNCIL AND UNITED WAY OF ERIE COUNTY. PROJECT MANAGEMENT AND REPORT DEVELOPMENT WAS PROVIDED BY THE HEALTHY COMMUNITIES FOUNDATION OF 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 7: FIRELANDS REGIONAL MEDICAL CENTER, PART V, SECTION B, LINE 7, 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. IMPLEMENTATION STRATEGY FOR THE CHNA CAN BE FOUND ON THE HOSPITAL'S WEBSITE (WWW.FIRELANDS.COM/ABOUT-US/PUBLICATIONS.ASPX). FIRELANDS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 20D: FIRELANDS REGIONAL MEDICAL CENTER, PART V, SECTION B, LINE 20D, PATIENTS WHOSE FAMILY INCOME FALLS AT 200% OR LESS THAN THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR FREE CARE. THOSE WHOSE FAMILY INCOME FALLS BETWEEN 201-300% OF THE FPG ARE PROVIDED A 25% DISCOUNT OFF BILLED CHARGES. 18 FIRELANDS REG MED CTR SURGERY CENTER 2800 HAYES AVE BLD E SANDUSKY OH 44870 OUTPATIENT SURGERY FIRELANDS REG MED CTR OUTPAT DIALYSIS 904 PIERCE ST SANDUSKY OH 44870 OUTPATIENT DIALYSIS FIRELANDS REG MED CTR OUTPAT DIALYSIS 290 PROGRESS DR STE A BELLEVUE OH 44811 OUTPATIENT DIALYSIS FIRELANDS REG MED CTR HOME HEALTH 1031 PIERCE ST SANDUSKY OH 44870 HOME HEALTH AGENCY FIRELANDS COUNS & REC SVCS OF ERIE CO 1925 HAYES AVE SANDUSKY OH 44870 OP MENTAL HEALTH & CD FIRELANDS COUNS & REC SVCS OF OTTAWA CO 127 WEST PERRY ST STE 106 PORT CLINTON OH 43452 OP MENTAL HEALTH & CD FIRELANDS COUNS & REC SVCS OF HURON CO 292 BENEDICT AVE NORWALK OH 44857 OP MENTAL HEALTH & CD FIRELANDS COUNS & REC SVCS OF HURON CO 290 PROGRESS DR STE B BELLEVUE OH 44811 OP MENTAL HEALTH & CD FIRELANDS COUNS & REC SVCS OF HURON CO 390 E HOWARD ST STE B WILLARD OH 44890 OP MENTAL HEALTH & CD FIRELANDS COUNS & REC SVCS OF SENECA CO 76 ASHWOOD RD TIFFIN OH 44883 OP MENTAL HEALTH & CD FIRELANDS COUNS & REC SVCS OF SAND CO 675 BARSTON RD FREMONT OH 43420 OP MENTAL HEALTH & CD FIRELANDS COUNS & REC SVCS OF LORAIN CO 315 LEAVITT RD STE A AMHERST OH 44001 OP MENTAL HEALTH & CD FIRELANDS COUNS & REC SVCS OF SENECA CO 125 WEST CENTER ST FOSTORIA OH 44830 OP MENTAL HEALTH & CD FIRELANDS REG MED CTR OP PHYS THERAPY 2012 CLEVELAND RD W HURON OH 44839 OP PHYSICAL THERAPY FIRELANDS COUNS & REC SVCS OF WYANDOT CO 777 NORTH SANDUSKY AVE UPPER SANDUSKY OH 43351 OP MENTAL HEALTH & CD FIRELANDS REG MED CTR OP PHYS THERAPY 101 S WASHINGTON ST CASTALIA OH 44824 OP PHYSICAL THERAPY FIRELANDS REG MED CTR OP PHYS THERAPY 348 MILAN AVE 2 NORWALK OH 44857 OP PHYSICAL THERAPY FIRELANDS REG MED CTR OP THERAPY 1605 STATE ROUTE 60 VERMILION OH 44089 OP PHYSICAL THERAPY 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, SEE NARRATIVE UNDER PART VI, LINE 5 PART I, LN 7 COL(F): THE BAD DEBT AND CHARITY CARE EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $23,378,616. 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. 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. 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 PART III LINE 9B, 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 PART III LINE 9B, PAYMENT ARRANGEMENT, OR TAKEN OUT OF BAD DEBT AND ADJUSTED ACCORDING TO FINANCIAL AID GUIDELINES. 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 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 SEEN BY A FINANCIAL COUNSELOR WHO EXPLAINS THE HOSPITAL CHARITY POLICY, ASSISTS WITH THE APPLICATION AND/OR SUPPLIES THEM WITH A CONTACT IF QUESTIONS SHOULD ARISE AFTER DISCHARGE. SELF-PAY INPATIENT ACCOUNTS ARE MONITORED DAILY TO IDENTIFY PATIENTS THAT ARE ELIGIBLE FOR MEDICAID AND HAVE NO PRIOR INSURANCE COVERAGE.ALL SELF-PAY OUTPATIENT 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 THE PATIENT STATES THAT 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.A FINANCIAL COUNSELOR IS AVAILABLE DURING THE FIRST SHIFT IN THE EMERGENCY DEPARTMENT TO ASSIST PATIENTS WITH CHARITY CARE APPLICATIONS. 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 THROUGH FRIDAY FROM 7:30 AM TO 5:00 PM. A FINANCIAL COUNSELOR 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 NEARLY 77,000 PERSONS AND IS LOCATED ON THE SOUTHERN SHORELINE 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 12.5% MINORITY. EIGHTY-NINE (89)% OF THE POPULATION HAS A HIGH SCHOOL EDUCATION OR SOME COLLEGE. THE COUNTY'S MEDIAN AGE IS 43.3 AND THE MEDIAN HOUSEHOLD INCOME IS $46,906. APPROXIMATELY 70% OF THE COUNTY'S RESIDENTS OWN THEIR OWN HOME, WITH THE MEDIAN HOME VALUE OF $139,100.SECONDARY SERVICE AREAS CONSIST OF THE CONTIGUOUS COUNTIES OF OTTAWA, HURON AND SANDUSKY, WHICH HAVE A COMBINED POPULATION OF APPROXIMATELY 162,000 INDIVIDUALS. FIRELANDS COUNSELING AND RECOVERY SERVICES REACHES EVEN FURTHER, SERVING 7 SURROUNDING COUNTIES INCLUDING THE COUNTIES OF ERIE, HURON, OTTAWA, SANDUSKY, SENECA, WYANDOT AND LORAIN. HOME HEALTH SERVICES PROVIDED BY THE MEDICAL CENTER REACHES INTO 13 DIFFERENT COUNTIES. DEMOGRAPHICS OF THE COUNTIES ARE SIMILAR TO THE PRIMARY SERVICE 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, CHARM AND SAFETY. 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 THROUGH 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 WHICH WORK TO IMPROVE THE HEALTH OF THE COMMUNITY. 1 FAMILY HEALTH SERVICES OF ERIE COUNTY 1912 HAYES AVE SANDUSKY OH 44870 263607741 501(C)(3) 249996 GENERAL SUPPORT TEEN LEADERSHIP CORPS 26 E CEDAR POINT RD SANDUSKY OH 44870 260324101 501(C)(3) 6500 GENERAL SUPPORT ERIE COUNTY ECONOMIC DEVELOPMENT 247 COLUMBUS AVE SANDUSKY OH 44870 341590450 501(C)(3) 12500 GENERAL SUPPORT 3 SCHOLARSHIPS TO BEGIN OR CONTINUE COURSE WORK 24 24500 PART II LINE 1 PART II LINE 1. TO EXPAND THE DELIVERY OF HEALTH CARE SERVICES AND PROMOTE A HEALTHY QUALITY OF LIFE FOR THE MEDICALLY UNDERSERVED PERSONS OF ERIE COUNTY, OHIO. FIRELANDS REGIONAL MEDICAL CENTER SUPPORTS THE MISSION OF FAMILY HEALTH SERVICES OF ERIE COUNTY TO ATTAIN THE DESIGNATION OF FEDERALLY QUALIFIED HEALTH CENTER AND DELIVER ITS INTENDED SERVICES. THE USE OF FUNDS CONTRIBUTED IS MONITORED BY THE REVIEW OF FINANCIAL AND PERFORMANCE REPORTS. PART III LINE 1 PART III LINE 1. SCHOLARSHIPS - TO BE ELIGIBLE FOR THE "EDUCATION PAYMENT PROGRAM", 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. PART III LINE 1 PART III LINE 1. 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 0 1 0 0 0 0 0 0 0 DANIEL J MONCHER EXEC VP/CFO/NON-VOTING 327851 0 67000 0 45376 0 38000 0 27574 0 505801 0 0 0 MARTIN E TURSKY PRESIDENT/CEO 494334 0 82250 0 372 0 72797 0 39368 0 689121 0 0 0 ROBERT M MOORE VP LEGAL SERVICES 222747 0 54000 0 4610 0 44000 0 22796 0 348153 0 0 0 ERIC MAST DIR MED ED/RESIDENCY 244733 0 5500 0 760 0 7530 0 22332 0 280855 0 0 0 BEV SCHRICKEL VP OPERATIONS 188110 0 32000 0 15308 0 61000 0 18683 0 315101 0 0 0 JIM SENNISH VP HUMAN RESOURCES 181355 0 32000 0 7980 0 31000 0 21896 0 274231 0 0 0 MIKE CANFIELD VP OPERATIONS 202008 0 35000 0 486 0 26911 0 11239 0 275644 0 0 0 PART I, LINE 4B PART 1 LINE 4B- FIRELANDS REGIONAL MEDICAL CENTER CONTRIBUTED TO A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ON BEHALF OF MARTIN TURSKY, PRESIDENT, IN THE AMOUNT OF $72,797 AND MIKE CANFIELD, VP OF OPERATIONS, IN THE AMOUNT OF $19,786. PART I, LINE 6 PART I LINE 6A - BONUS AND INCENTIVE COMPENSATION LISTED IN PART II IS PRIMARILY BASED ON A SUCCESS SHARING PLAN MEASURED BY BOTH OPERATING RESULTS COMPARED TO BUDGET AND PATIENT SATISFACTION. A COUNTY OF ERIE OHIO 346400428 29514PAV4 2006-06-01 65951557 SEE PART VI 0 0 0 B COUNTY OF ERIE OHIO 346400428 29514PAW2 2006-06-01 15000000 SEE PART VI 0 0 0 C COUNTY OF ERIE OHIO 346400428 29514BPD3 2012-08-15 72711827 SEE PART VI 0 0 0 D COUNTY OF ERIE OHIO 346400428 29514PAU6 2012-08-15 62711827 REFUNDING 0 0 0 A 1110000 68365573 3265889 580938 64416279 2008 0 0 1 1 B 15492204 134063 15358141 2008 0 0 1 1 C 1825000 72720689 1227738 264264 72456425 2013 1 0 1 1 D 68023634 68260967 237333 2012 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 NA 0 0 1 C 0 0 0 1 1 0 0 NA 0 0 1 D 0 0 0 0 0 0 0 0 0 A 1 B 1 C 1 SCHEDULE K SUPPLENTAL INFORMATION PART I LINE A, COLUMN (F): FINANCE THE ACQUISITION, CONSTRUCTION, FURNISHMENT AND EQUIPMENT OF ADDITIONS AND IMPROVEMENTS TO HOSPITAL FACILITIES. PART I LINE B, COLUMN (F): FINANCE THE ACQUISITION, CONSTRUCTION, FURNISHMENT AND EQUIPMENT OF ADDITIONS AND IMPROVEMENTS TO HOSPITAL FACILITIES. PART I LINE C, COLUMN (F): $62,493,562.83 OF SALES PROCEEDS OF THE BONDS WERE USED TO CURRENTLY REFUND THE COUNTY OF ERIE HOSPITAL FACILITITES REVENUE BONDS, SERIES 2002 (FIRELANDS REGIONAL MEDICAL CENTER) AND $10,218,264.17 OF SALES PROCEEDS OF THE BONDS WERE USED TO FINANCE THE ACQUISITION, CONSTRUCTION AND EQUIPPING OF TECHNOLOGY IMPROVEMENTS AND RENOVATIONS MADE TO HOSPITAL FACILITIES. PART II LINE 3, COLUMN A. TOTAL PROCEEDS OF THE ISSUE ARE COMPRISED OF $65,951,556.50 OF SALES PROCEEDS AND $2,414,015.82 OF INVESTMENT PROCEEDS. PART II LINE 3, COLUMN B. TOTAL PROCEEDS OF THE ISSUE ARE COMPRISED OF $15,000,000 OF SALES PROCEEDS AND $492,203.75 OF INVESTMENT PROCEEDS. PART II LINE 3, COLUMN C. TOTAL PROCEEDS OF THE ISSUE ARE COMPRISED OF $72,711,826.90 OF SALES PROCEEDS AND $8,861.75 OF INVESTMENT PROCEEDS. PART IV LINE 2C, COLUMN A. THE REBATE COMPUTATION WAS PERFORMED JULY 15, 2011. PART IV LINE 2C, COLUMN B. THE REBATE COMPUTATION WAS PERFORMED JULY 15, 2011. PART IV LINE 2C, COLUMN C. THE REBATE COMPUTATION WAS PERFORMED OCTOBER 28, 2013. JANOTTA HERNER BUSINESS ENTITY 4886740 CONSTRUCTION SERVICES 0 KAMAL CHABAN MD BOARD MEMBER 323930 EMPLOYMENT 0 FREDERICK ITZKOWITZ DO BOARD MEMBER 254026 CONTRACTED MEDICAL SERVICES 0 PATRICK MCGWINN MD BOARD MEMBER 150561 CONTRACTED MEDICAL SERVICES 0 ALICE SPRINGER FAMILY MEMBER 64676 EMPLOYMENT 0 JODY SENNISH FAMILY MEMBER 28603 EMPLOYMENT 0 PART IV LINE 1 FIRELANDS REGIONAL MEDICAL CENTER BOARD MEMBER, THEODORE A KASTOR, IS THE DIRECTOR OF MARKETING AND SALES FOR GENERAL CONTRACTOR JANOTTA & HERNER INC. MR. KASTOR HAS RECUSED HIMSELF FROM VOTING OR COMMENTING ON ISSUES CONCERNING JANOTTA & HERNER CONSTRUCTION PROJECTS. PART IV LINE 2 KAMAL CHABAN, MD IS EMPLOYED BY RELATED ORGANIZATION NORTH COASTPROFESSIONAL CORPORATION AS A PULMANARY, CRITICAL CARE AND SLEEP MEDICINE SPECIALIST. PART IV LINE 3 FREDERICK ITZKOWITZ, DO IS A PARTNER IN AN INDEPENDENTLY CONTRACTED COMPANYTHAT PROVIDES TRAUMA COVERAGE FOR FIRELANDS REGIONAL MEDICAL CENTER AND IS ALSO COMPENSATED FOR HIS TIME SPENT AS AN ACTING MEDICAL DIRECTOR. PART IV LINE 4 PATRICK MCGWINN, MD IS A MEMBER OF AN INDEPENDENTLY CONTRACTED COMPANY THATPROVIDES CATH LAB COVERAGE FOR FIRELANDS REGIONAL MEDCIAL CENTER. PART IV LINE 5 ALICE SPRINGER IS THE WIFE OF BOARD MEMBER J WILLIAM SPRINGER AND ISEMPLOYED BY FIRELANDS REGIONAL MEDICAL CENTER AS DIRECTOR OF DEVELOPMENT. PART IV LINE 6 JODY SENNISH IS THE WIFE OF JIM SENNISH VP OF HUMAN RESOURCES AND ISEMPLOYED BY FIRELANDS REGIONAL MEDICAL CENTER IN THE NURSING DEPARTMENT.SCHEDULE FORM 990, PART VI, SECTION B, LINE 11 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 ALL MEMBERS 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 THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE ANNUALLY REVIEWS ALL CONFLICT OF INTEREST STATEMENTS FOR ALL APPROPRIATE INDIVIDUALS 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 OF THE UNITED STATES. 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 DONE 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 ALONG WITH 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 XI LINE 9: OTHER CHANGES IN NET ASSETS TOTALING $6,402,182 INCLUDE THE FOLLOWING: PENSION ADJUSTMENT $13,326,249, TRANSFERS TO AFFILIATES $(6,911,531), FUNDING FOR SCHOOL OF NURSING $(11,961) AND OTHER $(575). FORM 990, PART IX, LINE 11G OTHER: PROGRAM SERVICE EXPENSES 14,699,830. MANAGEMENT AND GENERAL EXPENSES 7,729,587. FUNDRAISING EXPENSES 61,364. TOTAL EXPENSES 22,490,781. FORM 990, PART XI, LINE 9: SCHOOL OF NURSING FUNDING -11,961. PENSION ADJUSTMENTS 13,326,249. TRANSFER (TO) FROM AFFILIATES -6,911,531. OTHER -575. PARTNERSHIP INCOME RELATED TO GROUP PURCHASING PROGRAM SERVICES -116,946. 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