FISHER TITUS MEDICAL CENTER: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- FISHER TITUS MEDICAL CENTER (EIN 34-4430716)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-17
- IRS object ID
- 201433219349303513
- Schema version
- 2013v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-17T10:31:54-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8800 LYRA DRIVE SUITE 450 | AddressLine1 |
| City | COLUMBUS | City |
| State | OH | State |
| ZIP Code | 43240 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 344430716 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FISHER-TITUS MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FISH | BusinessNameControlTxt |
| Phone | 4196688101 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 272 BENEDICT AVENUE | AddressLine1 |
| City | NORWALK | City |
| State | OH | State |
| ZIP Code | 44857 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DUANE WOODS JR | PersonNm |
| Person Title | VP OF FINANCE & CFO | PersonTitleTxt |
| Phone | 4196688101 | PhoneNum |
| Signature | 2014-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ROBERT M MORELAND | PreparerPersonNm |
| PTIN | P00418596 | PTIN |
| Phone | 6148852583 | PhoneNum |
| Preparation | 2014-11-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LORNA STRAYER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 272 BENEDICT AVENUE | AddressLine1 |
| City | NORWALK | City |
| State | OH | State |
| ZIP Code | 44857 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $165,691,251 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FTMC.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1911 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE QUALITY HEALTHCARE IN A COST EFFECTIVE MANNER, WHILE RESPECTING THE DIGNITY AND UNIQUENESS OF EACH INDIVIDUAL WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 1108 | TotalEmployeeCnt |
| Total Volunteers | 251 | TotalVolunteersCnt |
| Total Gross UBI | $1,090,285 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $94,561 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $36,739 | PYContributionsGrantsAmt |
| CY Contributions Grants | $78,006 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $113,659,343 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $117,779,460 | CYProgramServiceRevenueAmt |
| PY Investment Income | $570,568 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,408,497 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,058,327 | PYOtherRevenueAmt |
| CY Other Revenue | $1,012,473 | CYOtherRevenueAmt |
| PY Total Revenue | $115,324,977 | PYTotalRevenueAmt |
| CY Total Revenue | $122,278,436 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $289,673 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $248,606 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $58,430,475 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $60,915,998 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $52,373,485 | PYOtherExpensesAmt |
| CY Other Expenses | $56,329,215 | CYOtherExpensesAmt |
| PY Total Expenses | $111,093,633 | PYTotalExpensesAmt |
| CY Total Expenses | $117,493,819 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,231,344 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,784,617 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $193,347,072 | TotalAssetsBOYAmt |
| Total Assets EOY | $206,627,032 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $71,718,381 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $59,311,711 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $121,628,691 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $147,315,321 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PROVIDE QUALITY HEALTHCARE IN A COST EFFECTIVE MANNER, WHILE RESPECTING THE DIGNITY AND UNIQUENESS OF EACH INDIVIDUAL WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $95,506,027 | ExpenseAmt |
| Grant | $248,606 | GrantAmt |
| Revenue | $110,723,043 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,873,327 | ExpenseAmt |
| Revenue | $7,056,417 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $100,379,354 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | Yes (1) | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 224 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1108 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID WILSON MBACMA | PersonNm |
| Phone | 4196688101 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 272 BENEDICT AVENUE | AddressLine1 |
| City | NORWALK | City |
| State | OH | State |
| ZIP Code | 44857 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| LESLIE D STONEHAM | |||||||||
| CHAIRMAN | 15.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| CHARLES F FUREY | |||||||||
| VICE CHAIRMAN - THRU 7/ 2013 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| MATT GROSS | |||||||||
| TREASURER/ VICE CHAIRMAN | 12.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | 3.00 | ||
| REV FRED WIECHERS | |||||||||
| SECRETARY | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JOHN D PAYNE CPA | |||||||||
| TREASURER/ DIRECTOR | 10.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | 4.00 | ||
| PERRY DRYDEN | |||||||||
| DIRECTOR | 4.00 | Yes (X) | $0 | $0 | $0 | 2.00 | |||
| WILLIAM B CORNELL MD | |||||||||
| DIRECTOR | 8.00 | Yes (X) | $0 | $0 | $0 | ||||
| THOMAS C BLEILE | |||||||||
| DIRECTOR | 8.00 | Yes (X) | $0 | $0 | $0 | ||||
| VIRGINIA H POLING | |||||||||
| DIRECTOR | 6.00 | Yes (X) | $0 | $0 | $0 | ||||
| ERIC SCHMIDT MD | |||||||||
| DIRECTOR | 4.00 | Yes (X) | $0 | $0 | $0 | 2.00 | |||
| GLENN TRIPPE MD | |||||||||
| DIRECTOR | 8.00 | Yes (X) | $0 | $0 | $0 | 2.00 | |||
| ROSS MATLACK | |||||||||
| PRESIDENT - BEGINNING 6/ 2013 | 49.50 | Yes (X) | Yes (X) | $209,686 | $0 | $17,351 | 15.50 | ||
| PATRICK J MARTIN | |||||||||
| PRESIDENT/ SPECIAL PROJECT MGR | 49.50 | Yes (X) | Yes (X) | $726,735 | $0 | $174,328 | 15.50 | ||
| LORNA STRAYER | |||||||||
| SENIOR VP, ADMIN & BUSINES | 50.00 | Yes (X) | $221,585 | $0 | $82,967 | ||||
| DUANE WOODS | |||||||||
| VP OF FINANCE/CFO | 44.00 | Yes (X) | $250,523 | $0 | $47,771 | 6.00 | |||
| GARY MOORMAN | |||||||||
| VP MEDICAL AFFAIRS THRU 8/2013 | 45.00 | $260,418 | $0 | $17,949 | Yes (X) | ||||
| CHERIE M SPRAGG | |||||||||
| SENIOR VP OF NURSING SERVI | 50.00 | $214,581 | $0 | $89,599 | Yes (X) | ||||
| PHILLIP J ANNARINO | |||||||||
| VP HUMAN RESOURCES | 45.00 | $202,324 | $0 | $44,914 | Yes (X) | ||||
| JOHN BRITTON | |||||||||
| VP INFORMATION SERVICES | 45.00 | $198,490 | $0 | $16,898 | Yes (X) | ||||
| GEORGE B ELMER | |||||||||
| DIRECTOR OF ASSET MGMT/EMS | 50.30 | $180,491 | $0 | $26,468 | 4.70 | Yes (X) | |||
| MITCH ESCH | |||||||||
| DIRECTOR OF PHARMACY | 40.00 | $162,102 | $0 | $92,512 | Yes (X) | ||||
| SUZANNE S INGLIS | |||||||||
| ASST VP NURSING & SURGICAL SVCS | 40.00 | $141,440 | $0 | $14,736 | Yes (X) | ||||
| SCOTT P STEINMETZ | |||||||||
| DIRECTOR OF INFORMATION SVCS | 40.00 | $140,473 | $0 | $13,164 | Yes (X) | ||||
| SHARON HARWOOD | |||||||||
| RISK MANAGER | 40.00 | $130,595 | $0 | $40,509 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,039,443 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $679,166 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 24 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| THE ROBINS & MORTON GROUP | |||||
| 5500 MARYLAND WAY SUITE 100 | BRENTWOOD | TN | 37027 | BUILDING CONTRACTOR | $6,926,529 |
| CERNER CORPORATION | |||||
| 2800 ROCKCREEK PARKWAY | KANSAS CITY | MO | 64117 | HEALTHCARE INFORMATION TECHNOLOGY | $2,773,201 |
| HOSPITAL MEDICINE ASSOCIATES OF OHIO | |||||
| PO BOX 634850 | CINCINNATI | OH | 45263 | HOSPITALIST | $2,353,470 |
| BOSTWICK DESIGN PARTNERSHIP | |||||
| 2729 PROSPECT AVE | CLEVELAND | OH | 44115 | ARCHITECTS | $868,768 |
| LABORATORY CORP OF AMERICA | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | BLOOD ADMIN & LAB TESTING | $717,265 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 18 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $235 | MembershipDuesAmt |
| Related Organizations | $77,771 | RelatedOrganizationsAmt |
| Noncash Contributions | $48,896 | NoncashContributionsAmt |
| Total Contributions | $78,006 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICES | 900099 | $109,632,758 | $109,632,758 | |
| NET NURSING HOME & ASSISTED LIVIN | 623000 | $7,056,417 | $7,056,417 | |
| MEDICAL LABORATORY | 621500 | $1,055,553 | $1,055,553 | |
| HEALTH AND ALLIED SERVICES | 621990 | $34,732 | $34,732 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $117,779,460 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $895,926 | TotalRevenueColumnAmt |
| Exclusion | $895,926 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $132 | TotalRevenueColumnAmt |
| Exclusion | $132 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $45,925,129 | SecuritiesAmt |
| Other | $125 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $43,062,230 | SecuritiesAmt |
| Other | $350,585 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,862,899 | SecuritiesAmt |
| Other | -$350,460 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,512,439 | TotalRevenueColumnAmt |
| Exclusion | $2,512,439 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA SALES | 722210 | $480,666 | $480,666 |
| OTHER HOSPITAL REVENUE | 900099 | $273,141 | $273,141 |
| AUXILIARY SALES | 453220 | $258,666 | $258,666 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,012,473 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $122,278,436 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $116,689,175 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,090,285 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,420,970 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $241,746 | TotalAmt |
| Program Services | $241,746 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,860 | TotalAmt |
| Program Services | $6,860 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,776,120 | TotalAmt |
| Program Services | $1,784,470 | ProgramServicesAmt |
| Management And General | $991,650 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,086,913 | TotalAmt |
| Program Services | $35,187,078 | ProgramServicesAmt |
| Management And General | $5,899,835 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,505,217 | TotalAmt |
| Program Services | $3,858,295 | ProgramServicesAmt |
| Management And General | $646,922 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,346,025 | TotalAmt |
| Program Services | $8,013,992 | ProgramServicesAmt |
| Management And General | $1,332,033 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,201,723 | TotalAmt |
| Program Services | $2,741,974 | ProgramServicesAmt |
| Management And General | $459,749 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $435,551 | TotalAmt |
| Program Services | $326,663 | ProgramServicesAmt |
| Management And General | $108,888 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,600 | TotalAmt |
| Program Services | $64,800 | ProgramServicesAmt |
| Management And General | $64,800 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,072 | TotalAmt |
| Management And General | $112,072 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,966,150 | TotalAmt |
| Program Services | $6,486,194 | ProgramServicesAmt |
| Management And General | $2,479,956 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $498,260 | TotalAmt |
| Program Services | $487,685 | ProgramServicesAmt |
| Management And General | $10,575 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,938,240 | TotalAmt |
| Program Services | $2,254,857 | ProgramServicesAmt |
| Management And General | $1,683,383 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,967,275 | TotalAmt |
| Program Services | $3,054,329 | ProgramServicesAmt |
| Management And General | $912,946 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,943,127 | TotalAmt |
| Program Services | $1,229,743 | ProgramServicesAmt |
| Management And General | $713,384 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,497 | TotalAmt |
| Program Services | $114,466 | ProgramServicesAmt |
| Management And General | $54,031 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $391,312 | TotalAmt |
| Program Services | $126,304 | ProgramServicesAmt |
| Management And General | $265,008 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $898,577 | TotalAmt |
| Program Services | $859,736 | ProgramServicesAmt |
| Management And General | $38,841 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,628,035 | TotalAmt |
| Program Services | $8,225,390 | ProgramServicesAmt |
| Management And General | $402,645 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $673,159 | TotalAmt |
| Program Services | $478,653 | ProgramServicesAmt |
| Management And General | $194,506 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $16,678,593 | $16,674,833 | $3,760 |
| BAD DEBT EXPENSES | $5,606,219 | $5,606,219 | |
| OHIO HOSPITAL TAX & SN | $1,879,481 | $1,879,481 | |
| UBI INCOME TAX | $65,745 | $61,388 | $4,357 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,349,322 | TotalAmt |
| Program Services | $614,198 | ProgramServicesAmt |
| Management And General | $735,124 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,493,819 | TotalAmt |
| Program Services | $100,379,354 | ProgramServicesAmt |
| Management And General | $17,114,465 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,225 | BOYAmt |
| EOY | $5,275 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,946,760 | BOYAmt |
| EOY | $2,435,468 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,665,479 | BOYAmt |
| EOY | $12,473,388 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $222,121 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,534,477 | BOYAmt |
| EOY | $3,470,745 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,163,680 | BOYAmt |
| EOY | $2,339,813 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,040,024 | BOYAmt |
| EOY | $2,052,470 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $171,832,970 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $70,452,355 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,493,373 | BOYAmt |
| EOY | $101,380,615 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,581,195 | BOYAmt |
| EOY | $79,734,512 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $245,374 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $229,542 | BOYAmt |
| EOY | $217,542 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,219,822 | BOYAmt |
| EOY | $2,517,204 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,347,072 | BOYAmt |
| EOY | $206,627,032 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,791,474 | BOYAmt |
| EOY | $28,754,609 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $292,163 | BOYAmt |
| EOY | $270,271 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,515,000 | BOYAmt |
| EOY | $30,205,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $119,744 | BOYAmt |
| EOY | $81,831 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,718,381 | BOYAmt |
| EOY | $59,311,711 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $121,610,373 | BOYAmt |
| EOY | $147,296,985 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,318 | BOYAmt |
| EOY | $18,336 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $121,628,691 | BOYAmt |
| EOY | $147,315,321 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,347,072 | BOYAmt |
| EOY | $206,627,032 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,784,617 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $7,908,294 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $12,993,719 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $7,483 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $7,483 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | EXECUTIVE MEMBERS OF THE ORGANIZATION, ON AN OCCASIONAL BASIS, MAY WRITE OR SPEAK TO LEGISLATIVE MEMBERS CONCERNING PROPOSED LEGISLATION THAT MIGHT IMPACT THE LOCAL DELIVERY OF HEALTHCARE SERVICES. THE MEDICAL CENTER HAS MEMBERSHIPS IN VARIOUS HEALTHCARE RELATED ASSOCIATIONS, WHICH PROVIDE STATE AND NATIONAL LEADERSHIP ON LEGAL, REGULATORY, QUALITY AND ACCREDITATION ISSUES. AS A PART OF THAT LEADERSHIP ROLE THESE ORGANIZATIONS DO CONTACT LEGISLATORS TO EXPRESS THEIR ASSOCIATION'S POSITIONS ON MATTERS IMPORTANT TO THEIR MEMBERSHIP. THE FOLLOWING ORGANIZATIONS LISTED BELOW SHOW THE PERCENTAGE OF THE DUES THAT REFLECT LOBBYING AS DETERMINED BY THE IRS: OHIO HEALTH CARE ASSOCIATION -19.01% OF DUES; OHIO HOSPITAL ASSOCIATION - 3.4% OF DUES AND AMERICAN HOSPITAL ASSOCIATION - 23.65% OF DUES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,659,169 | OtherCostOrOtherBasisAmt |
| Book Value | $1,659,169 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $110,081,434 | OtherCostOrOtherBasisAmt |
| Depreciation | $41,622,339 | DepreciationAmt |
| Book Value | $68,459,095 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $53,600,793 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,164,835 | DepreciationAmt |
| Book Value | $27,435,958 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,491,574 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,665,181 | DepreciationAmt |
| Book Value | $3,826,393 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $101,380,615 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $146,722,055 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $7,908,294 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $16,926,408 | OtherRevenueAmt |
| Revenue Not Reported | $24,834,702 | RevenueNotReportedAmt |
| Revenue Subtotal | $121,887,353 | RevenueSubtotalAmt |
| Other Revenues Not Included | $391,083 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $391,083 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $122,278,436 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $120,361,213 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $3,182,659 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $3,182,659 | ExpensesNotReportedAmt |
| Expenses Subtotal | $117,178,554 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $315,265 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $315,265 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $117,493,819 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THESE ENTITIES, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2013 AND 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE, RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. FISHER-TITUS MEDICAL CENTER INDIVIDUAL ACCRUED UNCERTAIN TAX POSITION WAS $0.00 |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | HEALTH PROMOTIONS OF NORWALK REVENUE 499,259. FASB 158 PROVISIONS 5,365,507. RETIRMENT PLAN CURTAILMENT GAIN 7,130,019. FISHER-TITUS PAIN MANAGEMENT LLC REVENUE 4,431,623. TRANSFERS TO AFFILATED ENTITY, NORWALK AREA HEALTH SYSTEMS -500,000. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | HOSPITAL AUXIIARY REVENUE 258,917. HOSPITAL EXPENSE ADJUSTMENTS TO REVENUES 132,166. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | HEALTH PROMOTIONS OF NORWALK EXPENSES 464,302. FISHER-TITUS PAIN MANAGEMENT LLC EXPENSES 2,718,357. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | HOSPITAL AUXILIARY EXPENSES 183,073. HOSPITAL EXPENSE ADJUSTMENTS TO REVENUES 132,166. AUDIT EXPENSE MAPPING ADJUSTMENT 26. |
Schedule F IRS990ScheduleF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continutation Total Office | 0 | ContinutationTotalOfficeCnt |
| Continutation Total Employee | 0 | ContinutationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $0 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $0 | TotalSpentAmt |
Grants To Org Outside US GrantsToOrgOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | MIDDLE EAST AND NORTH AFRICA | RegionTxt |
| Purpose Of Grant | MEDICAL SUPPLIES TO HOSPITALS IN SYRIA | PurposeOfGrantTxt |
| Non Cash Assistance | $6,860 | NonCashAssistanceAmt |
| Description Of Non Cash Asst | CARDIOVASCULAR & MISC MEDICAL SUPPLIES | DescriptionOfNonCashAsstTxt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Org | 1 | TotalOtherOrgCnt |
| Transfer To Foreign Corp | 0 | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | 0 | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | 0 | PassiveForeignInvestmestCoInd |
| Foreign Partnership | 0 | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 1852 | PersonsServedCnt |
| Total Community Benefit Expns | $2,115,804 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $564,992 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,550,812 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01390 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $14,422,734 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,207,239 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,215,495 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01980 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 1852 | PersonsServedCnt |
| Total Community Benefit Expns | $16,538,538 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,772,231 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,766,307 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03370 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 38 | ActivitiesOrProgramsCnt |
| Persons Served | 65220 | PersonsServedCnt |
| Total Community Benefit Expns | $823,900 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $57,215 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $766,685 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00690 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 140 | PersonsServedCnt |
| Total Community Benefit Expns | $97,264 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,540 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $89,724 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $1,079,779 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $323,840 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $755,939 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00680 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $47,879 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $47,879 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 1150 | PersonsServedCnt |
| Total Community Benefit Expns | $356,031 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $356,031 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00320 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 50 | ActivitiesOrProgramsCnt |
| Persons Served | 66510 | PersonsServedCnt |
| Total Community Benefit Expns | $2,404,853 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $388,595 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,016,258 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01810 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 52 | ActivitiesOrProgramsCnt |
| Persons Served | 68362 | PersonsServedCnt |
| Total Community Benefit Expns | $18,943,391 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,160,826 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,782,565 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05180 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 42 | PersonsServedCnt |
| Total Community Benefit Expns | $1,873 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,873 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 13 | PersonsServedCnt |
| Total Community Benefit Expns | $4,089 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,089 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 107 | PersonsServedCnt |
| Total Community Benefit Expns | $27,766 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $27,766 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 162 | PersonsServedCnt |
| Total Community Benefit Expns | $33,728 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $33,728 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,606,219 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,681,866 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $25,691,661 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $33,809,751 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$8,118,090 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct | Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct | Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct |
|---|---|---|---|
| 1 NORTH CENTRAL CARENET | |||
| PHYSICIAN-HOSPITAL ORGANIZATION | 0.50000 | 0.06380 | 0.43620 |
| 2 FISHER-TITUS PAIN MANAGEMENT LLC | |||
| PAIN MANAGEMENT | 0.51000 | 0.49000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FISHER-TITUS MEMORIAL HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 272 BENEDICT AVENUE | AddressLine1 |
| City | NORWALK | City |
| State | OH | State |
| ZIP Code | 44857 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FISHER-TITUS MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 11 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.FISHER-TITUS.ORG/COMMUNITY-SERVICES/O | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | HTTP://WWW.HCNO.ORG/COMMUNITY/REPORT.HTML | OtherWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Other Actions | Yes (X) | OtherActionsInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FISHER-TITUS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 3: HURON COUNTY CONTRACTED WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO, A NON-PROFIT HOSPITAL ASSOCIATION LOCATED IN TOLEDO, OHIO TO COORDINATE AND MANAGE THE HEALTH ASSESSMENT PROCESS. THE PROJECT COORDINATOR FROM THE HOSPITAL COUNCIL OF NW OHIO CONDUCTED A SERIES OF MEETINGS WITH THE PLANNING COMMITTEE FROM HURON COUNTY. DURING THESE MEETINGS, BANKS OF POTENTIAL SURVEYQUESTIONS FROM THE BEHAVIORAL RISK FACTOR SURVEILLANCE AND YOUTH RISK BEHAVIOR SURVEILLANCE WERE REVIEWED AND DISCUSSED. BASED ON INPUT FROM THE HURON COUNTY PLANNING COMMITTEE, THE PROJECT COORDINATOR COMPOSED DRAFTS OF SURVEYS CONTAINING 115 ITEMS FOR THE ADULT SURVEY AND 75 ITEMS FOR THE ADOLESCENT SURVEY. THE DRAFTS WERE REVIEWED AND APPROVED BY THE HEALTH RESEARCHERS AT THE UNIVERSITY OF TOLEDO. THE NEEDS OF THE POPULATION, ESPECIALLY THOSE WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS AND POPULATIONS WITH CHRONIC DISEASE NEEDS WERE TAKEN INTO ACCOUNT THROUGH THE SAMPLE METHODOLOGY THAT SURVEYED THESE POPULATIONS. IN ADDITION, THE ORGANIZATIONS THAT SERVE THESE POPULATIONS PARTICIPATED IN THE HEALTH ASSESSMENT PROCESS. THE PARTICIPANTS WHO HAVE A (PH) AFTER THEIR NAME INDICATES THEY WORK IN THE PUBLIC HEALTH FIELD. THE PARTICIPANTS INCLUDED: TIMOTHY HOLLINGER (PH), ANGELA SMITH (PH) AND KATIE SPAAR (PH) ALL FROM HURON COUNTY GENERAL HEALTH DISTRICT; ANNE WAGONER (PH) AND EMILY HUESTISS (PH) BOTH FROM MERCY WILLARD HOSPITAL; LORNA STRAYER (PH) FISHER-TITUS MEDICAL CENTER; JEAN KING (PH) HURON COUNTY ADAMHS BOARD; KARI SMITH (PH) HURON COUNTY BOARD OF DEVELOPMENT DISABILITIES; RENEE GEROME (PH) FIRELANDS COUNSELING & RECOVERY SERVICES; DEBRA FISHER (PH) ERIE-HURON COUNTIES, CAC; CHARLOTTE WAGNER, NORTH POINT EDUCATIONAL SERVICE CENTER DIRECTOR; KIM SCHUBERT, BELLEVUE CITY SCHOOLS SUPERINTENDENT; DAVID STUBBLEBINE, MONROEVILLE LOCAL SCHOOLS SUPERINTENDENT; CAROL GIRTON, NEW LONDON LOCAL SCHOOLS SUPERINTENDENT; DENNIS DOUGHTY, NORWALK CITY SCHOOLS SUPERINTENDENT; BENJAMIN CHAFFEE JR, SOUTH CENTRAL SCHOOLS SUPERINTENDENT; RODGE WILSON, WESTERN RESERVE LOCAL SCHOOLS SUPERINTENDENT AND DAN DANHOFF WILLARD CITY SCHOOLS SUPERINTERDENT. |
| FISHER-TITUS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 4: MERCY HOSPITAL OF WILLARD, THE BELLEVUE HOSPITAL AND FIRELANDS REGIONALHOSPITAL (COUNSELING & RECOVERY CENTER) |
| FISHER-TITUS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 7: EACH OF THE HEALTH NEEDS LISTED BELOW IS IMPORTANT AND IS BEING ADDRESSED BY NUMEROUS PROGRAMS AND INITIATIVES SUPPORTED BY FISHER-TITUS MEDICAL CENTER AND OTHER COMMUNITY PARTNERS OF THE HOSPITAL. THE MEDICAL CENTER DOES NOT ADDRESS THESE NEEDS LISTED BELOW AS PART OF THIS IMPLEMENTATION PLAN DUE TO LIMITED FINANCIAL AND HUMAN RESOURCES AND THE NEED TO ALLOCATE SIGNIFICANTRESOURCES ON THE THREE PRIORITY HEALTH NEEDS LISTED IN THE IMPLENTATION PLAN. NEEDS NOT ADDRESSED: 1. 12% OF HURON COUNTY ADULTS WERE WITHOUT HEALTH CARE COVERAGE; 2. 22 % OF HURON COUNTY ADULTS ARE DIAGNOSED WITH ARTHRITIS; 3. 10% OF HURON COUNTY ADULTS AND 18% OF YOUTHS WERE DIAGNOSED WITH ASTHMA;4. INSECTS AND MOLD WERE REPORTED AS THE TWO MOST THREATENING ENVIRONMENTAL HEALTH ISSUES BY RESPONDENTS AND 5. 45% OF ADULTS HAD NOT VISITED A DENTIST OR DENTAL CLINIC IN THE PAST YEAR. |
| FISHER-TITUS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 17E: AS PART OF ITS FINANCIAL ASSISTANCE POLICY, FISHER - TITUS MEDICAL CENTER (THE HOSPITAL) MAKES A CONCERTED EFFORT TO DETERMINE IF AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE PRIOR TO PROCEEDING WITH COLLECTION ACTIVITIES BY THE HOSPITAL OR BY ENGAGING A THIRD PARTY. THESE EFFORTS INCLUDE NOTIFYING THE INDIVIDUAL OF THE FINANCIAL ASSISTANCE POLICY (FAP) ON ADMISSION, INCLUDING INFORMATION ABOUT THE FAP IN COMMUNICATIONS ABOUT THE INDIVIDUAL'S BILLS AND DOCUMENTING THE HOSPITAL'S DETERMINATION OF AN INDIVIDUAL'S ELIGIBILITY TO RECEIVE ASSISTANCE UNDER THE FAP. IF THE RESULT OF THESE EFFORTS IS UNSUCCESSFUL, THE HOSPITAL WILL PROCEED WITH COLLECTIONS ACTIVITY. THESE ACTIVITIES INCLUDE REPORTING THE INDIVIDUAL TO THE APPROPRIATE CREDIT AGENCY, LEGAL ACTIONS OR LIENS AS DEEMED NECESSARY. IF IT IS DETERMINED THAT AN INDIVIDUAL IS ELIGIBLE UNDER THE FAP SUBSEQUENT TO COLLECTION ACTIVITY BEGINNING, ALL COLLECTION ACTIVITY WILL CEASE. |
| FISHER-TITUS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 20D: FISHER - TITUS MEDICAL CENTER INITIALLY CHARGES ALL CLASSES OF PATIENTS THE SAME GROSS CHARGE FOR ANY PARTICULAR SERVICE AND IS REFLECTED AS SUCH ON ALL INITIAL BILLS. AT THE TIME OF ADMISSION, FTMC ATTEMPTS TO COLLECT INFORMATION ON THE INTENDED MEANS OF PAYING FOR SERVICES, INCLUDING DISTRIBUTING INFORMATION ON APPLYING FOR FINANCIAL ASSISTANCE, BUT DO NOT RESTRICT ACCESS BASED ON WHETHER THE INTENDED HAS MEANS OF PAYING FOR SERVICES PROVIDED. PATIENTS WHO APPLY FOR FINANCIAL ASSISTANCE, EITHER AT THE TIME OF SERVICE OF SUBSEQUENT TO THE SERVICES BEING PROVIDED, HAVE THEIR BILLS PUT ON "HOLD" STATUS AS SOON AS PATIENTS MAKE ANY CONTACT WITH OUR FINANCIAL COUNSELING STAFF. UPON REVIEW AND APPROVAL OF APPLICATIONS AND ANY DISCUSSION WITH OUR FINANCIAL COUNSELORS, GROSS CHARGES ARE THEN ADJUSTED ACCORDING TO FTMC CHARITY POLICY BEFORE ANY FURTHER BILLING PROCESSES ARE RESUMED. |
| FISHER-TITUS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 22: SEE EXPLANATION OF CHARGES - LINE 20 |
| PART V, SECTION B 19(D) | THE DISCOUNT RATE FOR SELF-PAY PATIENTS WAS SET TO MATCH THE RATE OF OUR TWO PREDOMINANT COMMERCIAL INSURANCE CONTRACTS WHICH MAKE UP 2/3RDS OF OUR POPULATION COVERED BY THIRD PARTY INSURANCE. |
| PART V, SECTION B LINE 6 | THE ADOPTED IMPLEMENTATION STRATEGY CAN BE FOUND ON THE MEDICAL CENTER'S WEBSITE AT: HTTP://WWW.FISHER-TITUS.ORG/IMAGES/IMPLEMENTATION_STRATEGIES_FOR_2011_CHNA.PDF |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| NORWALK MEMORIAL HOME | ||||
| 272 BENEDICT AVENUE | NORWALK | OH | 44857 | INTERMEDIATE & SKILLED NURSING FACILITY |
| THE CARRIAGE HOUSE OF FISHER-TITUS | ||||
| 175 SHADY LANE DRIVE | NORWALK | OH | 44857 | ASSISTED LIVING FACILITY |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE COSTING METHODOLOGY USED FOR THE CHARITY CARE SEGMENT OF THE LINE 7 TABLE WAS THE IRS WORKSHEET 1 "CHARITY CARE AT COSTS" IN THE INSTRUCTIONS. COST TO CHARGE RATIOS WERE CARRIED OVER FROM THE IRS WORKSHEET 2 AS A BASIS TO ESTIMATE EXPENSES AND WAS APPLIED TO THE GROSS PATIENT CHARITY CARE CHARGES RECORDED IN 2013. THE COSTING METHODOLOGY USED FOR THE UNREIMBURSED MEDICAID SEGMENT OF THE LINE 7 TABLE WERE CALCULATED USING A COST TO CHARGE RATIO EXTRACTED FROM THE MEDICAID COST REPORT DATA. THE COSTING METHODOLOGY USED FOR "OTHER BENEFITS" SEGMENT OF THE LINE 7 TABLE WERE CALCULATED USING A COMBINATION OF DIRECT COSTS AND OUR COST ACCOUNTING SYSTEM, WHICH TAKES INTO CONSIDERATION ALL PATIENT TYPES AND SEGMENTS. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 5,606,219. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | IN 2013, FISHER-TITUS'S COMMUNITY BUILDING ACTIVITIES AND BENEFITS PROVIDED $13.9 MILLION TO SUPPORT PROGRAMS THAT IMPACTED THE OVERALL HEALTH OF OUR COMMUNITIES AND THE QUALITY OF LIFE OF OUR RESIDENTS. WHILE HOSPITAL-BASED MEDICAL SERVICES ARE THE MOST OBVIOUS WAY WE HELP, FTMC FULFILLS THE HEALTH-CARE NEEDS OF OUR AREA WITH COMMUNITY HEALTH SCREENINGS, EDUCATION CLASSES, PATIENT ASSISTANCE PROGRAMS AND SUPPORT OF HEALTH-RELATED ACTIVITIES. FTMC EMPLOYEES SERVE ON COMMUNITY AND CIVIC BOARDS, HEALTH-ORIENTED ORGANIZATIONS AND ARE INVOLVED IN ECONOMIC DEVELOPMENT ACTIVITIES THROUGHOUT THE COUNTY. FTMC ALSO WORKS WITH SCHOOLS; WORK SITES AND SAFETY NET PROVIDERS TO PROMOTE HEALTH AND WELLNESS AND PREVENT DISEASE. FISHER-TITUS IS A LEADER IN ENVIRONMENTAL STEWARDSHIP, HAVING EARNED NUMEROUS STATE AND NATIONAL AWARDS. |
| PART III, LINE 4: | THE COSTING METHODOLOGY USED FOR COMPLETING THE SCHEDULE H PART III, LINE 2 IS DERIVED FROM THE BAD DEBT EXPENSE INCLUDED IN THE AUDITED FINANCIAL STATEMENTS ADJUSTED BY THE AMOUNT OF THE WRITE-OFFS OF THE ACCOUNTS THAT WENT TO BAD DEBT. COST TO CHARGE RATIOS WERE CARRIED OVER FROM IRS WORKSHEET 2 "RATIO OF PATIENT CARE COSTS TO CHARGES" AS A BASIS TO ESTIMATE EXPENSE AND WAS APPLIED TO THE BAD DEBT EXPENSE RECORDED IN 2013. |
| PART III, LINE 3 | AS A TAX-EXEMPT HOSPITAL, WE MUST PROVIDE NECESSARY MEDICAL CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES PROVIDED. AS A NOT-FOR-PROFIT, PATIENT CARE IS PROVIDED TO ALL, REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR CARE. MAKING QUALITY PATIENT CARE AVAILABLE TO ALL IN OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC MEANS, QUALIFIES BAD DEBTS AS COMMUNITY BENEFIT. THE IDENTIFICATION OF PATIENTS ELIGIBLE FOR CHARITY CARE IS SOLELY BASED ON THE COOPERATION OF THE PATIENT TO PROVIDE THE ORGANIZATION ENOUGH FAMILY AND FINANCIAL INFORMATION TO DETERMINE ELIGIBILTY TO MATCH OUR PROGRAMS. HISTORICALLY, IN ADDITION TO THE INTERNALLY IDENTIFIED CHARITY, 13-15% OF THE ACCOUNT BALANCES TURNED TO COLLECTION WERE SUBSEQUENTLY IDENTIFIED BY THE AGENCY AS CHARITY AND RETURNED. THIS CHARITY IS RECORDED ONLY WHEN IT HAS BEEN IDENTIFIED THROUGH VERIFICATION OF INABILITY TO PAY. WE DO BELIEVE THERE IS A SECOND, RELATIVELY EQUAL SEGMENT OF THE BAD DEBT THAT WOULD QUALIFY FOR CHARITY. PATIENTS WITH POOR CREDIT RATINGS AND MULTIPLE CREDITORS MAKING COLLECTION EFFORT FINDS LITTLE VALUE IN COMPLETING THE CHARITY APPLCIATION PROCESS TO ONLY ELIMINATE ONE CREDITOR AND HAVE NO IMPROVEMENT TO THEIR FINANCIAL STATUS.WE ESTIMATE THAT UNDER THE CURRENT ECONOMIC CONDITIONS UNIDENTIFIED CHARITY IN BAD DEBT EXPENSE IS ESTIMATED TO BE AN ADDITIONAL $1,681,866 OR 30% OF BAD DEBT. SINCE THIS CALCUALTION IS ON AN ACCRUAL BASIS, WE BELEIVE ESTIMATING 15% FOR CHARITY TO BE IDENTIFIED IN FUTURE YEARS AND AN ADDITIONAL 15% FOR BALANCES NEVER IDENTIFIED AS CHARITY IS A VERY CONSERVATIVE AND REASONABLE ESTIMATE OF THIS CHARITY CARE VALUE. |
| PART III, LINE 4 | THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN THE HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON SPECIFIC ACCOUNTS, HISTORICAL WRITE OFF EXPERIENCE AND CURRENT MARKET CONDITIONS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH THE MOST UP TO DATE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. |
| PART III, LINE 8: | FISHER-TITUS MEDICAL CENTER'S MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO EXTRACTED FROM THE MEDICARE COST REPORT DATA. THE MEDICAL CENTER BELIEVES THAT ALL OF THE $8.1 MILLION DOLLAR SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT, BECAUSE OUR MISSION IS TO PROMOTE HEALTH IN THE COMMUNITY AND WE DO NOT LIMIT THE CARE AVAILABLE TO ANY PATIENTS, INCLUDING THOSE COVERED BY MEDICARE. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY. THIS YEAR, MEDICARE ACCOUNTED FOR 44% OF HOSPITAL REVENUES AND THESE MEDICARE BENEFICIARIES WERE PROVIDED CARE IN SPITE OF THIS SHORTFALL. CARING FOR THE MEDICARE BENEFICIARIES RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE TRUE COST FOR THEIR CARE AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. TAX EXEMPT HOSPITALS ARE ALSO EXPECTED TO PARTICIPATE IN THE MEDICARE PROGRAM. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE MEDICAL CENTER IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. |
| PART III, LINE 9B | THE CHARITY POLICY IS A SUBSET OF THE OVERALL COLLLECTION POLICY. WHEN PATIENTS ARE IDENTIFIED AS QUALIFYING FOR ANY OF THE CHARITY CATEGORIES WE SEARCH ACCOUNTS RECEIVABLE AND ACCOUNTS PLACED WITH COLLECTION AGENCIES AND PACKAGE THEM WITH THE APPLICATION. IN ADDITION, CHARITY INFORMATION IS SHARED WITH OUR RELATED ORGANIZATIONS AND FORMS THE BASIS FOR THEIR CHARITY ADJUSTMENTS. IN ADDITION, WITH PATIENT APPROVAL, WE MAY CONTACT LOCAL PHYSICIAN PRACTICES WITH THE INFORMATION AS MANY WILL ADJUST THEIR BALANCES BASED UPON THE INFORMATION PROVIDED. |
| PART VI, LINE 2: | FISHER-TITUS SPONSORED AND COLLABORATED WITH THE HURON COUNTY GENERAL HEALTH DISTRICT AND OTHER HEALTH-RELATED ORGANIZATIONS (CALLED HURON COUNTY HEALTH PARTNERS) TO DEVELOP AND FUND THE HURON COUNTY HEALTH NEEDS ASSESSMENT IN 2011. LOCAL COMMUNITY AGENCIES WERE INVITED TO PARTICIPATE IN THE HEALTH ASSESSMENT PROCESS, INCLUDING CHOOSING QUESTIONS FOR THE SURVEYS, PROVIDING LOCAL DATA, REVIEWING DRAFT REPORTS AND PLANNING THE COMMUITY RELEASE OF THE DATA AND SETTING PRIORITIES. THERE WERE OVER 50 KEY LEADERS FROM THE COMMUNITY THAT REPRESENTED PUBLIC HEALTH, LAW ENFORCEMENT, SCHOOLS, CHURCHES, LOCAL OFFICIALS, SOCIAL AGENCIES AND OTHER VARIOUS COMMUNITY MEMBERS IN ATTENDANCE AT THE PUBLIC RELEASE OF THECOMMUNITY HEALTH NEEDS ASSESSMENT. AT THE EVENT, PARTICIPANTS, PARTICIPATED IN FOCUS GROUPS AND PRIORITIES WERE CHOOSEN FOR HURON COUNTY TO FOCUS ON OVER THE NEXT FEW YEARS. FTMC ALSO USES THIS INFORMATION TO ADD AND EXPAND SERVICES AND TO RECRUIT PHYSICIANS TO MEET THE THEN IDENTIFIED MEDICAL NEEDS OF OUR COMMUNITY. FROM THESE PRIOTIES, FTMC HAS DEVELOPED NUMEROUS PROGRAMS TARGETING THE HURON COUNTY'S HIGH RATE OF OBESITY, DIABETES AND CARDIOVASCULAR ISSUES. PROGRAMS INCLUDING DIABETESSCREENINGS AT HISPANIC HEALTH FAIRS AND VARIOUS LOCATIONS IN THE COUNTY, NUTRITION AND FITNESS FOR SCHOOL CHILDREN, DEVELOPING A COMMUNITY GARDEN AND A COUNTY-WIDE WALKING PROGRAM IN PARTNERSHIP WITH THE AMERICAN HEART ASSOCIATION AND LOCAL PHYSICIANS AND BUSINESSES. |
| PART VI, LINE 3: | PATIENTS ARE INTERVIEWED AFTER REGISTRATION TO ASSIST THEM IN DETERMINING EACH PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS AVAILABLE INTERNALLY AND EXTERNALLY. FTMC HAS BILINGUAL SIGNAGE POSTED IN THE ADMITTING/REGISTRATION AREAS, BILLING OFFICE AND FINANCIAL COUNSELING OFFICES, AND IN THE INPATIENT GUIDES IN ALL PATIENT ROOMS. THE FTMC WEBSITE HAS A SECTION ABOUT THE FINANCIAL ASSISTANCE PROGRAM AND CONTRACT INFORMATION. A MESSAGE ABOUT FINANCIAL ASSISTANCE AND CHARITY CARE ALSO IS INCLUDED ON THE BILLS THAT ARE SENT TO THE PATIENTS. MANY MATERIALS ARE BILINGUAL AND INTERPRETATION SERVICES ARE AVAILABLE. THE MEDICAL CENTER SUPPORTS AN OUTSIDE COUNSELOR DEDICATED TO HELPING PATIENTS BECOME QUALIFIED FOR MEDICAID OR OTHER GOVERNMENT PROGRAMS. THEY ALSO REFER PATIENTS WHO DON'T QUALIFY FOR THOSE PROGRAMS TO OUR FTMC FINANCIAL COUNSELORS FOR ASSISTANCE WITH H.C.A.P., FISHER-TITUS CHARITY AND FISHER-TITUS COMMUNITY ASSISTANCE PROGRAMS. OUR SOCIAL SERVICES DEPARTMENT REGULARLY REFERS PATIENTS IN NEED TO OUR FINANCIAL COUNSELORS FOR ASSISTANCE. WE ALSO TAKE REFERRALS FROM THE LOCAL COUNTY HUMAN SERVICES AGENCIES, VICTIMS OF VIOLENT CRIMES, LOCAL HEALTH DEPARTMENTS, LOCAL LAW ENFORCEMENT AGENCIES, CHURCHES, ETC. FTMC IS VERY PROACTIVE IN TAKING THE MESSAGE TO OUR COMMUNITY. BROCHURES ARE AVAILABLE AT COMMUNITY OUTREACH EVENTS HELD IN THE HOSPITAL AND AT OUTSIDE COMMUNITY EVENTS. FTMC COMMUNICATES THE INFORMATION ABOUT CHARITY CARE PROGRAMS THROUGH ITS COMMUNITY NEWSLETTER AND LOCAL NEWS MEDIA. |
| PART VI, LINE 4: | THE FISHER-TITUS MEDICAL CENTER PROVIDES COMPREHENSIVE STATE-OF-THE ART HEALTH CARE SERVICES TO THE RESIDENTS OF HURON, ERIE AND THE ADJACENT SURROUNDING COMMUNITIES WITH THE LATEST MEDICAL ADVANCEMENTS. THE PRIMARY AREA IS THE GREATER HURON COUNTY AREA IN NORTH CENTRAL OHIO, WHICH IS HOME TO AROUND 60,000 RESIDENTS. FTMC'S 50 ACRE CAMPUS IS IN THE COUNTY SEAT OF NORWALK, WHICH IS THE LARGEST CITY IN THE COUNTY WITH OVER 17,000 RESIDENTS. FTMC HAS NUMEROUS MEDICAL OFFICES THROUGHOUT THE COUNTY IN SMALLER CITIES TO PROVIDE EASIER ACCESS TO PHYSICIANS FOR COMMUNITY MEMBERS. THE COUNTY IS HOME TO SEVERAL LARGE MANUFACTURERS WHO HAVE EXPERIENCED MAJOR JOB LOSSES OVER THE PAST 10 YEARS. HURON COUNTY HAD THE SEVENTH HIGHEST UNEMPLOYMENT RATE IN OHIO WITH AN ANNUAL AVERAGE OF 10.8%. THE LARGEST PERCENTAGE OF RESIDENTS ARE CHILDREN UNDER 18 WITH THOSE 65 AND OLDER MAKING UP THE 2ND LARGEST PERCENTAGE. 91% OF THE RESIDENTS ARE CAUCASIAN WITH A GROWING HISPANIC POPULATION OF 5.9%. THE MEDIAN HOUSEHOLD INCOME IN HURON COUNTY (IN 2010 INFLATION-ADJUSTED DOLLARS) WAS $62,033 WITH 12.9% OF THE FAMILIES LIVING BELOW THE POVERTY LEVEL AND 26.3% LIVING BELOW 200% OF THE POVERTY RATE IN 2010. 12% OF HURON COUNTY ADULTS WERE WITHOUT HEALTH COVERAGE. THE OVERALL TRENDS INDICATE A DECLINE IN EMPLOYMENT-BASED MEDICAL INSURANCE AND INCREASING UNINSURED AND RELIANCE ON GOVERNMENT PROGRAMS. |
| PART VI, LINE 5: | THE BOARD OF DIRECTORS IS COMPOSED OF AREA RESIDENTS INCLUDING BUSINESS AND COMMUNITY LEADERS, PHYSICIANS AND OTHER INTERESTED PERSONS. THESE VOLUNTEERS GIVE COUNTLESS HOURS OF SERVICE TO THE MEDICAL CENTER IN THEIR OVERSIGHT ROLE. THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS, IN FUNDRAISING, AND IN GENERAL STEWARDHSIP. FTMC'S MEDICAL STAFF IS OPEN AND PRIVILEGES ARE GRANTED TO ALL QUALIFIED PHYSICIANS WHO APPLY AND MEET THE STANDARDS OF THE MEDICAL CENTER PRIVILEGING PROCESS. THE MEDICAL CENTER UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND TO EXPAND ACCESS POINTS OF CARE TO PATIENTS THROUGHOUT THE COMMUNITY INCLUDING, BUT NOT LIMITED TO THE FOLLOWING:1. EDUCATIONAL PROGRAMS THAT PROVIDE CLASSES AND INFORMATION ON TOBACCO CESSATION, HEALTHY AGING, CHILDBIRTH, INFANT CARE, EARLY PREGNANCY AND MORE2. FREE BLOOD PRESSURE AND DIABETES SCREENINGS, AND MAMMOGRAMS TO QUALIFYING INDIVIDUALS, FREE OR LOW-COST SCREENINGS FOR BREAST, PROSTATE, SKIN AND COLORECTAL CANCERS AS WELL AS OSTEOPOROSIS ASSESSMENTS. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (10 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc |
|---|---|---|---|---|---|---|---|---|---|---|
| AMERICAN HEART ASSOCIATION | ||||||||||
| 5455 N HIGH ST | COLUMBUS | OH | 43215 | 135613797 | 501(C)(3) | $5,000 | SPONSORSHIP OF HURON COUNTY HEART WALK | |||
| AMERICAN RED CROSS | ||||||||||
| PO BOX 73013 | CHICAGO | IL | 60673 | 341027291 | 501(C)(3) | $8,194 | CONTRIBUTION FOR RELIEF EFFORTS DUE TO THE OKLAHOMA MOORE DISASTER | |||
| BERLIN-MILAN BOARD OF EDUCATION | ||||||||||
| 140 SOUTH MAIN ST | MILAN | OH | 44846 | 115 | $6,700 | GRANT IN SUPPORT OF FITNESS TRAIL | ||||
| CITY OF NORWALK - ERNSTHAUSEN | ||||||||||
| 100 REPUBLIC ST | NORWALK | OH | 44857 | 115 | $5,000 | SPONSORSHIP OF EARTH WEEK WALK | ||||
| FISHER-TITUS FOUNDATION | ||||||||||
| 272 BENEDICT AVE | NORWALK | OH | 44857 | 341476934 | 501(C)(3) | $11,000 | PLEDGE TO HELP PURCHASE NEW MAIN CAMPUS POLE SIGNS | |||
| NORWALK AREA UNITED FUND | ||||||||||
| 10 WEST MAIN ST | NORWALK | OH | 44857 | 340906312 | 501(C)(3) | $20,000 | CONTRIBUTION TO HELP THE LOCAL COMMUNITY | |||
| NORWALK CATHOLIC SCHOOLS | ||||||||||
| 93 EAST MAIN ST | NORWALK | OH | 44857 | 115 | $5,000 | GRANT IN SUPPORT OF LOCAL SCHOOL SYSTEM | ||||
| NORWALK CITY SCHOOLS | ||||||||||
| 134 BENEDICT AVE | NORWALK | OH | 44857 | 115 | $50,000 | SUPPORT OF THEIR ALL-SPORTS COMPLEX | ||||
| NORWALK ECONOMIC DEVELOPMENT | ||||||||||
| 10 1/2 WEST MAIN ST | NORWALK | OH | 44857 | 341787391 | 501(C)(3) | $5,000 | CONTRIBUTION TO HELP THE LOCAL COMMUNITY | |||
| SHELBY CHRISTIAN & MISSIONARY ALLIANCE | ||||||||||
| 105 E SMILEY AVE | SHELBY | OH | 44875 | 341354574 | 501(C)(3) | PROVIDE SUPPLIED TO AID IN CARRYING OUT ORGANIZATION'S CHARITABLE PURPOSE | $125,852 | FMV | MISCELLANEOUS SUPPLIES | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 10 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE MEDICAL CENTER REVIEWS EACH GRANT OR DONATION REQUEST BEFORE IT IS MADE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROSS MATLACK | ||||||||||||||
| PRESIDENT - BEGINNING 6/ 2013 | $186,324 | $0 | $23,000 | $0 | $362 | $0 | $5,931 | $0 | $11,420 | $0 | $227,037 | $0 | $0 | $0 |
| PATRICK J MARTIN | ||||||||||||||
| PRESIDENT/ SPECIAL PROJECT MGR | $434,224 | $0 | $153,760 | $0 | $138,751 | $0 | $156,288 | $0 | $18,040 | $0 | $901,063 | $0 | $115,391 | $0 |
| LORNA STRAYER | ||||||||||||||
| SENIOR VP, ADMIN & BUSINES | $176,251 | $0 | $44,712 | $0 | $622 | $0 | $57,345 | $0 | $25,622 | $0 | $304,552 | $0 | $0 | $0 |
| DUANE WOODS | ||||||||||||||
| VP OF FINANCE/CFO | $208,824 | $0 | $41,215 | $0 | $484 | $0 | $33,021 | $0 | $14,750 | $0 | $298,294 | $0 | $0 | $0 |
| GARY MOORMAN | ||||||||||||||
| VP MEDICAL AFFAIRS THRU 8/2013 | $204,861 | $0 | $54,164 | $0 | $1,393 | $0 | $8,750 | $0 | $9,199 | $0 | $278,367 | $0 | $0 | $0 |
| CHERIE M SPRAGG | ||||||||||||||
| SENIOR VP OF NURSING SERVI | $160,947 | $0 | $34,986 | $0 | $18,648 | $0 | $80,624 | $0 | $8,975 | $0 | $304,180 | $0 | $0 | $0 |
| PHILLIP J ANNARINO | ||||||||||||||
| VP HUMAN RESOURCES | $159,564 | $0 | $41,732 | $0 | $1,028 | $0 | $27,264 | $0 | $17,650 | $0 | $247,238 | $0 | $0 | $0 |
| JOHN BRITTON | ||||||||||||||
| VP INFORMATION SERVICES | $165,451 | $0 | $32,803 | $0 | $236 | $0 | $16,898 | $0 | $0 | $0 | $215,388 | $0 | $0 | $0 |
| GEORGE B ELMER | ||||||||||||||
| DIRECTOR OF ASSET MGMT/EMS | $156,875 | $0 | $22,602 | $0 | $1,014 | $0 | $3,346 | $0 | $23,122 | $0 | $206,959 | $0 | $0 | $0 |
| MITCH ESCH | ||||||||||||||
| DIRECTOR OF PHARMACY | $147,261 | $0 | $13,461 | $0 | $1,380 | $0 | $76,162 | $0 | $16,350 | $0 | $254,614 | $0 | $0 | $0 |
| SUZANNE S INGLIS | ||||||||||||||
| ASST VP NURSING & SURGICAL SVCS | $127,236 | $0 | $12,010 | $0 | $2,194 | $0 | $5,726 | $0 | $9,010 | $0 | $156,176 | $0 | $0 | $0 |
| SCOTT P STEINMETZ | ||||||||||||||
| DIRECTOR OF INFORMATION SVCS | $130,792 | $0 | $9,284 | $0 | $397 | $0 | $4,724 | $0 | $8,440 | $0 | $153,637 | $0 | $0 | $0 |
| SHARON HARWOOD | ||||||||||||||
| RISK MANAGER | $121,583 | $0 | $8,642 | $0 | $370 | $0 | $26,279 | $0 | $14,230 | $0 | $171,104 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I LINE 4B & PART II, LINE 1 | INCLUDED IN MR. MARTIN'S TOTAL W-2 COMPENSATION OF $726,735 IS $115,391 WHICH REPRESENTS THE CURRENT YEAR PAYMENT OF DEFERRED COMPENSATION FROM A NON-QUALIFIED RETIREMENT PLAN WHICH WAS DEFERRED ON PRIOR FORM 990'S. ALSO INCLUDED IN MR. MARTIN'S TOTAL W-2 COMPENSATION OF $726,735 IS $415,023 WHICH REPRESENTS THE PORTION OF MR. MARTIN'S SALARY ALLOCABLE TO HIS POSITION AS PRESIDENT AND CEO WHICH HE RETIRED FROM ON JULY 1, 2013. INCLUDED IN THE TOTAL CONTRIBUTION TO DEFERRED COMPENSATON OF $156,288 IN COLUMN C IS $132,901 OF VESTED DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $23,387 FOR THE CURRENT YEAR ACCRUAL OF A NON-VESTED, NON-QUALIFIED RETIREMENT PLAN. THIS PLAN PROVIDES AN ADDITIONAL RETIREMENT BENEFIT BASED UPON YEARS OF ELIGIBLE SERVICE AND VESTED STATUS AND REMAINS SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. |
| PART I LINE 4B & PART II, LINE 4 | INCLUDED IN DUANE WOOD'S TOTAL W-2 COMPENSATION OF $250,523 IS $37,621 WHICH REPRESENTS THE PORTION OF MR. WOOD'S SALARY ALLOCABLE TO THE NORWALK MEMORIAL HOME, A DIVISION OF FISHER-TITUS MEDICAL CENTER. INCLUDED IN THE TOTAL CONTRIBUTION TO DEFERRED COMPESATION OF $33,021 IN COLUMN C IS $8,750 OF DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $24,271 FOR THE CURRENT YEAR AND PRIOR YEAR ACCRUAL OF A NON-VESTED, NON-QUALIFIED RETIREMENT PLAN. THIS PLAN PROVIDES AN ADDITIONAL RETIREMENT BENEFIT BASED ON YEARS OF ELIBIGLE SERVICE AND VESTED STATUS AND REMAINS SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. |
| PART I LINE 4B & PART II, LINE 8 | INCLUDED IN MR. ANNARINO'S TOTAL CONTRIBUTIONS TO DEFERRED COMPENSATION OF $27,264 IS $8,334 OF DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $18,930 FOR THE CURRENT YEAR AND PRIOR YEAR ACCRUAL OF A NON-VESTED, NON-QUALIFIED RETIREMENT PLAN. THIS PLAN PROVIDES AN ADDITIONAL RETIREMENT BENEFIT BASED ON YEARS OF ELIGIBLE SERVICE AND VESTED STATUS AND REMAINS SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. |
| PART I LINE 3 | RESPONSIBILITY FOR DETERMINING AND RECOMMENDING EXECUTIVE COMPENSATION RESTS WITH THE JOINT PERSONNEL COMMITTEE OF THE FISHER-TITUS MEDICAL CENTER AND NORWALK AREA HEALTH SYSTEMS, INC. BOARDS. THE COMMITTEE RETAINS AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO HELP ESTABLISH CASH COMPENSATION TARGET RANGES AND IDENTIFY REASONABLE AND CUSTOMARY BENEFIT PROGRAMS FOR EXECUTIVES. THE INDEPENDENT CONSULTANT REPORTS TO THE JOINT PERSONNEL COMMITTEE ON RELEVANT PEER GROUPS, CASH COMPENSATION REPORTED IN AVAILABLE SALARY SURVEYS FOR THE PEER GROUP AND TRENDS IN BENEFITS AND PERQUISITE PROGRAMS CUSTOMARILY AVAILABLE AMONG THE PEER GROUP FOR EXECUTIVES. RECOMMENDATIONS BY THE CONSULTANT ARE PRESENTED TO THE JOINT PERSONNEL COMMITTEE WHICH PREPARES MINUTES OF ITS DELIBERATIONS REGARDING EXECUTIVE COMPENSATION INCLUDING RECOMMENDATIONS THAT ARE PROVIDED TO EACH OF THE DIRECTORS OF FTMC AND NAHS. THE RECOMMENDATIONS TO BE ACTED ON MUST BE APPROVED FIRST BY THE JOINT PERSONNEL COMMITTEE AND THEN BY THE MEDICAL CENTER'S BOARD OF DIRECTORS BEFORE FINALLY BEING CONSIDERED BY THE SYSTEM'S BOARD OF DIRECTORS. THE MINUTES OF EACH BOARD MEETING WHERE ACTION IS TAKEN REFLECT SUCH ACTION. THE PROCESS IS PERFORMED ANNUALLY IN THE SPRING AND WAS LAST DONE IN MAY 2013. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| COUNTY OF HURON OHIO | ||||||||
| A | 346400672 | 447540CC7 | 2007-06-28 | $28,622,597 | SEE PART V BELOW | 0 | 0 | 0 |
| COUNTY OF HURON OHIO | ||||||||
| B | 346400672 | 447540BN4 | 2003-01-08 | $30,000,000 | SEE PART V BELOW | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Credit EnhancementCreditEnhancementAmt |
|---|---|---|---|---|---|---|---|---|---|---|
| A | $28,838,308 | $564,200 | $7,215,711 | $21,058,397 | 2008 | Yes (1) | 0 | Yes (1) | Yes (1) | |
| B | $30,714,144 | $524,983 | $27,308,799 | $2,616,937 | 2005 | Yes (1) | 0 | Yes (1) | Yes (1) | $263,425 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Engage Bond Counsel ResearchEngageBondCounselResearchInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | Yes (1) | Yes (1) | 0 | 0 | 0 |
| B | 0 | 0 | 0 | Yes (1) | Yes (1) | 0 | 0 | 0 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | 0 |
| B | 0 |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE A | SERIES 2007A BONDS - PURPOSE WAS TO ACQUIRE, CONSTRUCT AND INSTALL A VASCULAR HEART ADDITION TO THE HOSPITAL'S MAIN CAMPUS AS WELL AS SUPPORT SERVICES AND THE RENOVATION OF THE EXISTING EMERGENCY ROOM. |
| PART I, LINE B | SERIES 2003A BONDS - PURPOSE WAS TO ACQUIRE, CONSTRUCT AND INSTALL A MULTI-STORY ADDITION TO THE HOSPITAL'S MAIN CAMPUS DEVOTED TO INPATIENT SERVICES AS WELL AS SUPPORT SERVICES AND THE RENOVATION OF SEVERAL AREAS OF THE EXISTING FACILITY. |
| PART II, LINE 3, COLUMN A | INCLUDED IN THE TOTAL PROCEEDS OF $28,838,308 IS INVESTMENT EARNINGS OF $215,711. |
| PART II, LINE 11, COLUMN A | $21,058,397 OF THE PROCEEDS WERE USED TO REFUND THE HOSPITAL'S COUNTY OF HURON REVENUE BONDS, SERIES 1996B AND A PORTION OF SERIES 2003A BONDS. |
| PART II, COLUMN B, LINE 3 | INCLUDED IN THE TOTAL PROCEEDS OF $30,714,144 IS INVESTMENT EARNINGS OF $714,144. |
| PART II, COLUMN B, LINE 11 | $2,616,937 OF THE PROCEEDS WERE USED TO REFUND THE HOSPITAL'S COUNTY OF HURON REVENUE BONDS, SERIES 1995A BONDS. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (6 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| MRS JOHN BRITTON | |||
| SPOUSE OF KEY EMPLOYEE | $50,041 | EMPLOYMENT | 0 |
| BAYLESS PATHMARK | |||
| SEE PART V | $140,833 | INDEPENDENT CONTRACTOR | 0 |
| MS SCHWAB | |||
| FAMILY MEMBER OF OFFICER, LORNA STRAYER | $68,379 | EMPLOYMENT | 0 |
| MS RILEY | |||
| FAMILY MEMBER OF DIRECTOR, MATT GROSS | $75,185 | EMPLOYMENT | 0 |
| BATTLES INSURANCE AGENCY | |||
| SEE PART V | $675,103 | VENDOR | 0 |
| BLEILE ENTERPRISE | |||
| SEE PART V | $203,263 | VENDOR | 0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV | FormAndLineReferenceDesc |
| Explanation | PART IV LINE 2 - RELATIONSHIP OF INTERESTED PARTY: DR. WILLIAM CORNELL, M.D. IS A PARTNER OF BAYLESS PATHMARK.PART IV LINE 3 - RELATIONSHIP OF INTERESTED PARTY: FAMILY MEMBER OF OFFICER, LORNA STRAYERPART IV LINE 4 - RELATIONSHIP OF INTERESTED PARTY: FAMILY MEMBER OF DIRECTOR, MATT GROSSPART IV, LINE 5 - PERRY DRYDEN, BOARD MEMBER, IS THE PRESIDENT OF BATTLES INSURANCE AGENCYPART IV LINE 6 - THOMAS BLEILE, BOARD MEMBER, HAS A FAMILY RELATIONSHIP WITH THE OWNER OF BLEILE ENTERPRISE, INC | ExplanationTxt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $32,601 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | WALKING PATH | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $16,295 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 4A/4B | FISHER-TITUS MEDICAL CENTER (FTMC) IS AN INDEPENDENT NON-PROFIT COMMUNITY HEALTHCARE ORGANIZATION GOVERNED BY A BOARD OF DIRECTORS COMPOSED OF AREA RESIDENTS INCLUDING BUSINESS AND COMMUNITY LEADERS, PHYSICIANS AND OTHER INTERESTED INDIVIDUALS. FTMC IS COMPOSED OF THE FOLLOWING FOUR OPERATING DIVISIONS: FISHER-TITUS MEMORIAL HOSPITAL THE HOSPITAL PROVIDES INPATIENT AND OUTPATIENT HEALTHCARE SERVICES TO THE RESIDENTS OF HURON, ERIE AND THE ADJACENT COUNTIES OF SANDUSKY, CRAWFORD, LORAIN, ASHLAND AND RICHLAND. IN 2013, THE HOSPITAL PROVIDED 13,907 DAYS OF INPATIENT CARE TO 3,926 PATIENTS. THE HOSPITAL ALSO PROVIDED 91,137 PATIENTS WITH 133,481 OUTPATIENT AND 27,107 EMERGENCY ROOM VISITS DURING THE YEAR. THE NORWALK MEMORIAL HOME THE NORWALK MEMORIAL HOME PROVIDES SKILLED AND LONG-TERM CARE IN ITS TRANSITIONAL AND EXTENDED CARE UNITS. DURING 2013, THE HOME SERVED 411 RESIDENTS AND PROVIDED 23,473 DAYS OF CARE. THE HOME HEALTH CENTER HOME HEALTH AGENCY THE HOME HEALTH CENTER PROVIDED 13,444 HOME VISITS TO 316 DIFFERENT PATIENTS IN 2013. THE CARRIAGE HOUSE OF FISHER-TITUS OPENED IN 1998, THE CARRIAGE HOUSE IS A 48-UNIT ASSISTED LIVING FACILITY, WHICH PROVIDED 15,914 DAYS OF ASSISTED LIVING CARE TO 61 RESIDENTS IN 2013. PROGRAM EXPANSIONS, IMPROVEMENTS, AND ACCREDITATIONS AMONG HEALTHCARE'S MOST WIRED HOSPITALS IN THE NATION - IN 2013 FISHER-TITUS WAS NAMED ONE OF HEALTHCARE'S TOP 100 MOST WIRED U.S. HOSPITALS FOR THE SECOND CONSECUTIVE YEAR. THE AWARD RECOGNIZES FISHER-TITUS FOR ITS ACCOMPLISHMENTS AS THE NATION'S FIRST ALL-DIGITAL SMART COMMUNITY HOSPITAL AND CONTINUED ADVANCEMENTS IN PATIENT-FOCUSED TECHNOLOGY AIMED AT PROVIDING THE HIGHEST LEVEL OF CLINICAL QUALITY, PATIENT SAFETY, AND COORDINATION OF CARE. AS A CERNER CORPORATION SHOWCASE SITE, FISHER-TITUS HAS HOSTED HOSPITALS FROM ALL OVER THE WORLD INCLUDING THE CLEVELAND CLINIC, THE VETERANS ADMINISTRATION, AND BRAZIL'S HOSPITAL ALBERT EINSTEIN TO SEE THIS FULLY INTEGRATED ELECTRONIC HEALTH RECORD SYSTEM AND INTERACTIVE PATIENT-ROOM TECHNOLOGY IN ACTION. ELECTRONIC MEDICAL RECORDS - FISHER TITUS MEDICAL CENTER ACHIEVED THE HEALTH INFORMATION AND MANAGEMENT SYSTEMS SOCIETY, HIMSS LEVEL 6 (THE HIGHEST LEVEL BEING LEVEL 7) FOR ELECTRONIC MEDICAL RECORD (EMR) ADOPTION. FACILITY AND PROGRAM EXPANSIONS WHEN THE NEW EMERGENCY DEPARTMENT OPENED IN 2012, CONSTRUCTION BEGAN ON AN EXPANSION AND "REPOSITIONING" OF IMAGING SERVICES WHICH OPENED IN APRIL 2013. THE RENOVATED SPACE PROVIDES QUICKER ACCESS FOR EMERGENCY PATIENTS TO LIFE-SAVING IMAGING TECHNOLOGY, AND A MORE COMFORTABLE AND PRIVATE AREA FOR OUTPATIENTS RECEIVING DIAGNOSTIC TESTING BY THE DEPARTMENT'S STATE-OF-ART TECHNOLOGY. WHILE MOST OF THE EXISTING IMAGING EQUIPMENT WAS MOVED, A NEW OPEN-BORE MAGNETIC RESONANCE IMAGING (MRI) UNIT REPLACED THE FORMER ONE TO MEET THE NEEDS OF BOTH CLAUSTROPHOBIC AND BARIATRIC PATIENTS. THE NEW MRI SUITE FEATURES SCENIC CEILING PANELS AND SIDE LIGHTS TO PROVIDE A COMFORTING ENVIRONMENT. IN ADDITION, X-RAY TECHNOLOGY WAS UPGRADED TO DIGITAL WIRELESS X-RAYS. THE IMAGING SERVICES EXPANSION ALSO INCLUDED NEW CONSTRUCTION FOR AN INFUSION SERVICES AREA AND PRE-ADMISSION TESTING, EARLY COMPONENTS OF A $16 MILLION, FIVE-PHASE 42,000-SQUARE-FOOT SURGERY CONSTRUCTION PROJECT. THE SURGERY EXPANSION PROJECT BEGAN IN MARCH 2013 AND IS ONE OF THE MOST COMPLEX CONSTRUCTION PROJECTS TO-DATE AT FISHER-TITUS BECAUSE OF THE LOCATION OF THE DEPARTMENT IN THE CENTER OF THE OLDER PART OF THE FACILITY AND THE ADDITIONAL CHALLENGE OF MAINTAINING OPERATIONS WHILE UNDER CONSTRUCTION. PHASE 1, WHICH INCLUDED A NEW SURGERY SEATING AREA, TWO NEW ORS, SURGERY CONTROL ROOM, STERILE PROCESSING AND FROZEN SECTION AREAS, WAS COMPLETED IN 2013. THE PROJECT IS SCHEDULED TO BE FULLY COMPLETED IN APRIL OF 2015. IN JUNE OF 2013, FISHER-TITUS AND NEIGHBORING BELLEVUE HOSPITAL FORGED A UNIQUE CLINICAL AFFILIATION WITH CLEVELAND CLINIC'S SYDELL AND ARNOLD MILLER FAMILY HEART & VASCULAR INSTITUTE. THE AFFILIATION BRINGS WORLD-CLASS HEART CARE TO AREA RESIDENTS AND PROVIDES GREATER ACCESS TO CLEVELAND CLINIC'S ACADEMIC, CLINICAL AND RESEARCH BEST PRACTICES IN CARDIOVASCULAR MEDICINE AND THORACIC SURGERY. WHILE EACH ORGANIZATION REMAINS INDEPENDENT, THE AFFILIATION WITH CLEVELAND CLINIC'S HEART AND VASCULAR INSTITUTE STRENGTHENS ALL ELEMENTS OF HEART AND VASCULAR MEDICINE AND THORACIC SURGERY TO PROVIDE THE HIGHEST LEVEL OF CARDIOVASCULAR AND THORACIC CARE TO THE SEVEN-COUNTY REGION SERVED BY FISHER-TITUS AND THE BELLEVUE HOSPITAL. AS PART OF THE AFFILIATION, CLEVELAND CLINIC EMPLOYS A PHYSICIAN TEAM THAT INCLUDES TWO CARDIOLOGISTS, A VASCULAR SURGEON AND A THORACIC SURGEON IN THE LOCAL HOSPITALS. A SECOND CLEVELAND CLINIC AFFILIATION WAS FORMED IN AUGUST 2013 AND IS PROVIDING WORLD-CLASS SPINE SURGERY SERVICES TO AREA RESIDENTS THROUGH A PROGRAM CALLED CLEVELAND CLINIC SPINE SURGERY AT FISHER-TITUS. THE ADDITION OF THIS SPINE SPECIALIZATION TO THE CURRENT SURGICAL TEAM COMPLEMENTS SPINE PROGRAMS IN PAIN MANAGEMENT, NEUROLOGY, AND REHABILITATION. EDUCATION AND RESEARCH - TO ENSURE THAT WE HAVE THE QUALITY WORKFORCE WE NEED TO CARE FOR OUR COMMUNITY IN THE FUTURE, WE ARE COMMITTED TO THE EDUCATION OF CURRENT AND FUTURE CAREGIVERS, AND WE WORK WITH EHOVE CAREER CENTER, FIRELANDS BOWLING GREEN STATE UNIVERSITY CAMPUS, LORAIN COUNTY COMMUNITY COLLEGE, NORTH CENTRAL STATE COLLEGE, TERRA COMMUNITY COLLEGE, THE OHIO STATE UNIVERSITY, AND OHIO UNIVERSITY TO PROVIDE INTERNSHIPS, INSTRUCTORS, CLASSROOM SPACE, AND CLINICAL TRAINING. WE ARE PLEASED TO BE ABLE TO OFFER A COMPREHENSIVE LEARNING EXPERIENCE UTILIZING OUR STATE-OF-THE-ART FACILITIES AND ADVANCED TECHNOLOGY. AWARDS AND ACCREDITATIONS - THROUGHOUT THE YEARS FISHER-TITUS HAS BEEN HIGHLY SUCCESSFUL IN MEETING THE CHALLENGES OF AN INCREASINGLY COMPLEX HEALTH-CARE INDUSTRY AND HAS PROVIDED EXCEPTIONAL SERVICE QUALITY TO MEMBERS OF THE SURROUNDING COMMUNITIES. FISHER-TITUS IS ACCREDITED BY THE HEALTHCARE FACILITIES ACCREDITATION PROGRAM (HFAP), IS A LEVEL 3 TRAUMA CENTER, PRIMARY STROKE CENTER, AND A FULLY ACCREDITED CHEST PAIN CENTER. IN 2013, FOR THE SECOND CONSECUTIVE YEAR, FISHER-TITUS EARNED AN A HOSPITAL SAFETY SCORE BY THE LEAPFROG GROUP ON ITS NATIONAL REPORT CARD ON PREVENTABLE MEDICAL ERRORS, INJURIES, ACCIDENTS, AND INFECTIONS. ALSO, IN 2013, FISHER-TITUS RECEIVED HEALTH CARE'S MOST WIRED HOSPITAL FOR THE SECOND YEAR IN A ROW. IN ADDITION, THE MEDICAL CENTER'S FOCUS ON QUALITY CARE AND EXCEPTIONAL SERVICE IS EVIDENCED BY THE MANY DEPARTMENTAL ACCREDITATIONS AND AWARDS AND RECOGNITIONS RECEIVED BY THE MEDICAL CENTER IN 2013: -PRIMARY STROKE CENTER, HFAP -OHIO DEPARTMENT OF HEALTH MAMMOGRAPHY QUALITY STANDARDS -AMERICAN COLLEGE OF RADIOLOGY (ACR) 3-YEAR ACCREDITATION IN NUCLEAR MEDICINE -AMERICAN ASSOCIATION OF RESPIRATORY CARE, QUALITY RESPIRATORY CARE AWARD -AMERICAN DIABETES ASSOCIATION EDUCATION RECOGNITION CERTIFICATE -HOMECARE ELITE TOP 100 AGENCY (FISHER-TITUS HOME HEALTH CENTER) -LABORATORY SERVICES CAP ACCREDITATION -BLOOD GAS LABORATORY CAP ACCREDITATION FISHER-TITUS EMPLOYS 960 AREA RESIDENTS AND IS LARGEST EMPLOYER IN HURON COUNTY. THE MEDICAL CENTER HAS BEEN AMONG THE TOP 100 BEST PLACES TO WORK IN HEALTHCARE BY MODERN HEALTHCARE MAGAZINE AND IS A PLATINUM-LEVEL AMERICAN HEART ASSOCIATION FIT-FRIENDLY FACILITY IN RECOGNITION OF ITS COMMITMENT TO PROVIDE VALUE-ADDED BENEFITS TO IMPACT THE OVERALL HEALTH AND FITNESS OF ITS EMPLOYEES INCLUDING WEIGHT WATCHERS, A FULLY OUTFITTED EMPLOYEE FITNESS CENTER, SMOKING CESSATION PROGRAMMING AND WALKING PROGRAMS. IN 2013, FISHER-TITUS ALSO BEGAN A LEADERSHIP DEVELOPMENT INSTITUTE THROUGH THE STUDER GROUP. EXCELLENT PHYSICIANS: FISHER-TITUS IS COMMITTED TO RECRUITING PHYSICIANS TO SERVE THE UNIQUE HEALTH-CARE NEEDS OF OUR COMMUNITY MEMBERS. IN 2013, TIMOTHY ADAMOWICZ, D.O., HEMATOLOGY/ONCOLOGY; NICHOLAS BROWN, D.P.M., PODIATRY; YILAN CHANG, M.D., PATHOLOGIST; GARY FENNIG, D.O., ANESTHESIOLOGIST; EDUARDO MARTINEZ, M.D., RADIOLOGIST; AND TIMOTHY WOISNET, M.D., RADIOLOGIST, JOINED THE FISHER-TITUS MEDICAL STAFF AS MEMBERS WITH FULL PRIVILEGES. AS PART OF THE CLEVELAND CLINIC HEART AND VASCULAR AFFILIATION, TWO CARDIOLOGISTS, JOHN ABBOUD, M.D. AND MICHAEL DAVIS, M.D. JOINED THE MEDICAL STAFF AND ARE SERVING PATIENTS AT FISHER-TITUS AND BELLEVUE HOSPITAL. IN ADDITION, A TEAM OF CLEVELAND CLINIC VASCULAR AND THORACIC SURGEONS ARE ON-SITE 24/7/365 PROVIDING THEIR SERVICES TO PATIENTS WHILE RECRUITING CONTINUES TO FILL THOSE ROLES WITH PERMANENT PHYSICIANS AT FISHER-TITUS. |
| PART III, LINE 4A/4B CONTINUED | COMMUNITY HEALTH AND OUTREACH PROGRAMS FTMC COMMUNITY BENEFITS EXTEND OUTSIDE OUR WALLS TO FAMILIES, BUSINESS, SCHOOLS, CHURCHES AND NEIGHBORHOODS THROUGH OUTREACH PROGRAMS AND OTHER COORDINATED CARE ACTIVITIES THAT MAKE OUR COMMUNITIES HEALTHIER PLACES TO LIVE, WORK AND WORSHIP. OUR GOAL IS TO HELP ALL RESIDENTS EQUALLY ACCESS THE CARE THEY NEED, AND HELP THEM LEARN TO MANAGE THEIR CONDITIONS AND LIVE HEALTHIER SAFER LIVES. FISHER-TITUS PROVIDED LEADERSHIP AND FUNDING FOR THE HURON COUNTY HEALTH ASSESSMENT ISSUED IN LATE 2011 AND IS ADDRESSING THE NEEDS IDENTIFIED IN THE HEALTH ASSESSMENT. THE PRIORITIES OF FISHER-TITUS' COMMUNITY OUTREACH AND COMMUNITY BENEFIT PROGRAMS IN 2013 WERE ALIGNED WITH THE GOALS IDENTIFIED BY THE HURON COUNTY HEALTH PARTNERS. FISHER-TITUS HEALTH PROFESSIONALS LEAD AND SERVE ON COMMUNITY-WIDE TASK FORCES THAT ARE ADDRESSING OBESITY, RISKY BEHAVIORS AMONG YOUTH, AND MENTAL HEALTH RESOURCES. IN ADDITION, FISHER-TITUS PROVIDED LEADERSHIP TO BEGIN WORK ON THE NEXT COUNTY-WIDE HEALTH ASSESSMENT TO BE COMPLETED IN 2014. FTMC SUPPORTS OTHER AREA NON-PROFIT COMMUNITY ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICE AND EMPLOYEE VOLUNTEERISM. MANY OF OUR COMMUNITY BENEFIT PROGRAMS ARE ORGANIZED TO WORK COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS. IN 2013, WE OFFERED COMMUNITY HEALTH EDUCATION PROGRAMS, INCLUDING SCHOOL-BASED PROGRAMS, SUPPORT GROUPS, COMMUNITY-BASED HEALTH FAIRS AND SCREENINGS, AND WALKING AND FITNESS PROGRAMS THAT IMPACTED OUR RESIDENTS THROUGH 66,510 ENCOUNTERS. AUXILIARY AND VOLUNTEER SERVICE: - DURING 2013, OUR 241 CARING VOLUNTEERS DONATED 48,260 HOURS OF AUXILIARY AND VOLUNTEER SERVICES TO THE MEDICAL CENTER. VOLUNTEERS PROVIDE A VARIETY OF SERVICES INCLUDING HELPING FAMILY MEMBERS, PROVIDING TRANSPORTATION, ASSISTING AT COMMUNITY HEALTH PROGRAMS, DELIVERING REFRESHMENTS, MAIL AND FLOWERS TO HOSPITAL PATIENTS AND RESIDENTS OF THE NORWALK MEMORIAL HOME PLUS ESCORTING PATIENTS THROUGHOUT THE BUILDING. THEY ALSO PERFORM CLERICAL DUTIES, STAFF THE MEDICAL CENTER'S GIFT SHOP AND ORGANIZE SEVERAL FUND-RAISING EVENTS THROUGHOUT THE YEAR. VOLUNTEER "AMBASSADORS" HAVE INSTRUCTED PATIENTS SINCE APRIL, 2010 ON THE USE OF THE TELEVISION/COMPUTER SCREENS LOCATED IN EACH PATIENT ROOM. VOLUNTEERS WORKING IN THIS CAPACITY ARE AT FISHER-TITUS MEDICAL CENTER SEVEN DAYS PER WEEK EACH MORNING FOR 2 HOURS. AMONG THE ITEMS PATIENTS ARE INSTRUCTED ON ARE HOW TO ACCESS THE DAY'S MENU, MEDICAL INFORMATION PERTAINING TO THE PERSON'S HEALTH PROBLEMS, ACCESSING THE INTERNET, PLAYING GAMES, OBTAINING THE NAMES OF CAREGIVERS AS THEY ENTER THE PATIENT'S ROOM, CHOOSING MOVIES, ETC. THE PATIENT THEN MAY USE A REMOTE CONTROL OR A WIRELESS KEYBOARD TO ACCESS THIS INFORMATION. INFORMATION SERVICES PROVIDES ALL COMPUTER TRAINING FOR VOLUNTEERS THAT WORK IN THIS CAPACITY . COMMUNITY HEALTH IMPROVEMENT SERVICES: NUMEROUS HEALTH SCREENINGS ARE OFFERED THROUGHOUT THE YEAR AT THE MEDICAL CENTER AND AT VARIOUS COMMUNITY LOCATIONS AND EVENTS THROUGHOUT OUR SERVICE AREA. THESE PROGRAMS INCLUDE SCREENING FOR BLOOD PRESSURE, BLOOD GLUCOSE, CHOLESTEROL LEVELS, SKIN CANCER, PROSTATE CANCER, OSTEOPOROSIS AND SCREENING MAMMOGRAMS. IN ADDITION, THE MEDICAL CENTER SPONSORS NUMEROUS SUPPORT GROUPS TO PROVIDE EDUCATION, CARE AND EMOTIONAL SUPPORT TO INDIVIDUALS AND FAMILIES AFFECTED BY DISABILITIES AND CHRONIC MEDICAL CONDITIONS. FTMC'S HEALTH MINISTRY PROGRAM, FORMED IN 2000, HAS BEEN A VERY EFFECTIVE GRASSROOTS INITIATIVE TO GATHER INFORMATION AND PROVIDE HEALTH PROGRAMS THROUGHOUT HURON COUNTY. CURRENTLY 50 AREA CONGREGATIONS ARE MEMBERS OF THE FTMC HEALTH MINISTRY PROGRAM WHICH PROVIDES HEALTH AND WELLNESS INFORMATION AND PROGRAMS IN AREA CHURCHES. THE MEDICAL CENTER IN PARTNERSHIP WITH ITS PHYSICIANS AND OTHER COMMUNITY ORGANIZATIONS PROVIDES PUBLIC FORUMS AND EDUCATIONAL SESSIONS ON A VARIETY OF TOPICS, WHICH ARE SOMETIMES HELD IN TANDEM WITH THE HEALTH SCREENINGS PROVIDED. WE ALSO PROVIDE NUMEROUS HEALTH FAIRS DURING THE YEAR IN SEVERAL LOCATIONS THROUGHOUT THE COUNTY AND SURROUNDING COMMUNITIES IN OUR SERVICE AREA. THESE COMMUNITY HEALTH IMPROVEMENT SERVICES BENEFITED 65,220 PEOPLE IN 2013 AT A COST OF $766,685. PROFESSIONAL MEDICAL EDUCATION: THE MEDICAL CENTER SUPPORTS THE FAMILY PRACTICE RESIDENCY PROGRAM AT FIRELANDS REGIONAL MEDICAL CENTER TO ENHANCE THE AVAILABILITY OF FAMILY PRACTICE PHYSICIANS WITHIN THE LOCAL COMMUNITY. FTMC FUNDS THE COST OF A FAMILY PRACTICE RESIDENT THAT SHARES TIME BETWEEN THE HOSPITAL'S EMERGENCY ROOM AND THE COUNTY HEALTH DEPARTMENT CARING FOR THE UNDERSERVED. IN ADDITION, FTMC SUPPORTS AND STAFFS SEVERAL CLASSES FOR HEALTH PROFESSIONALS INCLUDING HEALTHCARE PROVIDER CPR, ADVANCED CARDIAC LIFE SUPPORT, BASIC LIFE SUPPORT INSTRUCTOR COURSE AND PEDIATRIC ADVANCE LIFE SUPPORT. THE TOTAL COST OF PROFESSIONAL MEDICAL EDUCATION PROVIDED TO 140 PARTICIPANTS WAS $89,724. SUBSIDIZED HEALTH SERVICES: THE MEDICAL CENTER ALSO SUBSIDIZES CERTAIN HEALTH SERVICES AND PROCESSES IN ORDER TO ADDRESS SPECIFIC HEALTH ISSUES IN THE COMMUNITY, PROVIDE CARE TO THE UNDERSERVED, OR ENHANCE THE OVERALL QUALITY OF HEALTHCARE WITHIN THE COMMUNITY. ALSO, THE MEDICAL CENTER SUBSIDIZED THE COST OF ELECTRONIC MEDICAL RECORD SOFTWARE USED BY PHYSICIANS IN OUR SERVICE AREA. THE SOFTWARE ENHANCES THE ACCURACY AND SPEED OF MEDICAL INFORMATION AVAILABLE TO HEALTHCARE PROVIDERS WITHIN THE AREA AND TO ASSIST THE COMMUNITY IN MOVING TOWARD A REGIONAL HEALTH INFORMATION DATABASE. THE COST ASSOCIATED WITH THE HEALTH SERVICES AND ELECTRONIC MEDICAL RECORDS SYSTEM IN 2013 WAS $755,939. DONATIONS AND COMMUNITY SUPPORT: THE MEDICAL CENTER MAKES CASH AND NON-CASH CONTRIBUTIONS ANNUALLY TO LOCAL NON-PROFIT ORGANIZATIONS THAT BENEFIT THE HEALTH AND DEVELOPMENT OF OUR LOCAL COMMUNITY AND ITS RESIDENTS. IN ADDITION, THE MEDICAL CENTER SUPPORTS AREA SCHOOLS BY AWARDING SPECIAL HEALTH EDUCATION GRANTS TO SCHOOL DISTRICTS IN OUR SERVICE TERRITORY TO FUND INNOVATIVE PROGRAMS IN THE AREAS OF SCIENCE, MATH, HEALTH AND HEALTH RELATED EDUCATION. THE TOTAL COST OF THESE DONATIONS AND SUPPORT IN 2013 WAS $356,031. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF FISHER-TITUS MEDICAL CENTER IS THE PARENT COMPANY NORWALK AREA HEALTH SYSTEMS, INC., AN OHIO NONPROFIT CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE FOLLOWING POWERS ARE RESERVED EXCLUSIVELY TO THE MEMBER (NORWALK AREA HEALTH SYSTEM, INC): A) TO ELECT THE DIRECTORS OF THE CORPORATION, AND TO REMOVE THEM AT WILL OR WITHOUT CAUSE. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING POWERS ARE RESERVED EXCLUSIVELY TO THE MEMBER (NORWALK AREA HEALTH SYSTEM, INC): A) TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION AND THE CODE OF REGULATIONS; B) TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION; C) TO APPROVE ANY CAPITAL OR OTHER EXTRAORDINARY EXPENDITURES IN EXCESS OF THE AMOUNT PRESCRIBED FROM TIME TO TIME BY THE MEMBER, WHICH AMOUNT SHALL BE REVIEWED BY THE MEMBER ANNUALLY; D) TO APPROVE ANY BORROWING OF ANY SUM OF MONEY FOR ANY PURPOSE IN EXCESS OF THE AMOUNT PRESCRIBED FROM TIME TO TIME BY THE MEMBER, WHICH AMOUNT SHALL BE REVIEWED BY THE MEMBER ANNUALLY; E) TO APPROVE ANY MERGER OF THE CORPORATION OR ANY SALE OF SUBSTANTIALLY ALL ITS ASSETS; TO DISSOLVE OR TERMINATE THE EXSISTENCE OF THE CORPORATION AND TO DETERMINE THE DISTRIBUTION OF ASSETS UPON SUCH DISSOLUTION OR TERMINATION. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE BOARD OF DIRECTORS OF THE FISHER-TITUS MEDICAL CENTER DELEGATED THE RESPONSIBILITY FOR THE REVIEW OF THE MEDICAL CENTER'S FORM 990, PLUS ALL REQUIRED SCHEDULES AND ATTACHMENTS, TO THE MEDICAL CENTER'S AUDIT COMMITTEE. THE MEMBERS OF THIS COMMITTEE HAVE A STRONG BACKGROUND IN ACCOUNTING, LEGAL, FINANCE, AND BUSINESS AND HAVE THE TECHNICAL EXPERTISE TO PERFORM A SUBSTANTIVE REVIEW. THE AUDIT COMMITTEE REVIEWED THE MEDICAL CENTER'S FORM 990 PRIOR TO FILING AND REPORTED TO THE MEDICAL CENTER'S BOARD OF DIRECTORS REGARDING THE RESULTS OF THEIR REVIEW. IN ADDITION, EACH MEMBER OF THE MEDICAL CENTER'S BOARD OF DIRECTORS HAD ACCESS TO A COPY OF THE FORM 990 FOR VIEWING PRIOR TO FILING VIA A SECURE INTERNET WEBSITE AND A PAPER COPY WAS AVAILABLE FOR REVIEW AT THE BOARD MEETINGS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL OF OUR AFFILIATED CORPORATE BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT UPON JOINING THE BOARD AND ANNUALLY THROUGHOUT THEIR TENURE. THESE ARE RETAINED BY ADMINISTRATION. AREAS OF CONFLICT ARE REVIEWED AND ADDRESSED AS NECESSARY TO THE TRANSACTIONS OF THE BOARD. IF AN AREA OF CONFLICT ARISES, BOARD MEMBERS ARE EXCUSED AND PROHIBITED FROM PARTICIPATING IN THE BOARD'S DELIBERATIONS AND DISCUSSIONS REGARDING THE AREA OF CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | RESPONSIBILITY FOR DETERMINING AND RECOMMENDING EXECUTIVE COMPENSATION RESTS WITH THE JOINT PERSONNEL COMMITTEE OF THE FISHER-TITUS MEDICAL CENTER AND NORWALK AREA HEALTH SYSTEMS, INC. BOARDS. THE COMMITTEE RETAINS AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO HELP ESTABLISH CASH COMPENSATION TARGET RANGES AND IDENTIFY REASONABLE AND CUSTOMARY BENEFIT PROGRAMS FOR EXECUTIVES. THE INDEPENDANT CONSULTANT REPORTS TO THE JOINT PERSONNEL COMMITTEE ON RELEVANT PEER GROUPS, CASH COMPENSATION REPORTED IN AVAILABLE SALARY SURVEYS FOR THE PEER GROUP, AND TRENDS IN BENEFITS AND PERQUISITE PROGRAMS CUSTOMARILY AVAILABLE AMONG THE PEER GROUP FOR EXECUTIVES. RECOMMENDATIONS BY THE CONSULTANT ARE PRESENTED TO THE JOINT PERSONNEL COMMITTEE WHICH PREPARES MINUTES OF ITS DELIBERATIONS REGARDING EXECUTIVE COMPENSATION INCLUDING RECOMMENDATIONS THAT ARE PROVIDED TO EACH OF THE DIRECTORS OF FTMC AND NAHS. THE RECOMMENDATIONS TO BE ACTED ON MUST BE APPROVED FIRST BY THE JOINT PERSONNEL COMMITTEE AND THEN BY THE MEDICAL CENTER'S BOARD OF DIRECTORS BEFORE FINALLY BEING CONSIDERED BY THE SYSTEM'S BOARD OF DIRECTORS. THE MINUTES OF EACH BOARD MEETING WHERE ACTION IS TAKEN REFLECT SUCH ACTION. THE PROCESS IS PERFORMED ANNUALLY IN THE SPRING AND WAS LAST DONE IN MAY 2013. |
| FORM 990, PART VI, SECTION C, LINE 19 | WE ISSUE AN ANNUAL REPORT TO THE COMMUNITY THAT IS PLACED IN THE LOCAL NEWSPAPER AND ON OUR WEBSITE THAT PROVIDES OUR OPERATING FINANCIAL STATEMENT, COMMUNITY BENEFIT FIGURES BROKEN DOWN BY CHARITY CARE & FINANCIAL ASSISTANCE, UPAID COSTS OF MEDICAID, COMMUNITY HEALTH & OUTREACH PROGRAMS, DONATIONS & COMMUNITY SUPPORT, SUBSIDIZED HEALTH SERVICES & PROFESSIONAL MEDICAL EDUCATION, & UNPAID COSTS OF MEDICARE & BAD DEBT. AS REQUIRED, WE OFFER A TIMELY RESPONSE TO WRITTEN REQUESTS FOR COPIES OF THE 990S AS WELL AS HAVING THE 990S AVAILABLE UPON THE PREMISES FOR THE PUBLIC TO REVIEW AND ON THE GUIDESTAR INTERNET WEBSITE. ADDITIONALLY, OUR CONFLICT OF INTEREST POLICY, CODE OF REGULATIONS, AND GOVERNING DOCUMENTS ARE ALSO AVAILABLE UPON WRITTEN REQUEST. |
| FORM 990, PART XI, LINE 9: | FASB #158 ADJUSTMENT 5,365,507. RETIRMENT PLAN CURTAILMENT 7,130,019. TRANSFER OF FUNDS TO AFFILIATED ORGANIZATION, NORWALK AREA HEALTH SYSTEMS -500,000. PAIN MANAGEMENT LLC DIVIDEND PAYMENT TO JOINT VENTURE MEMBER NORWALK PAIN M 998,167. AUDIT EXPENSE MAPPING ADJUSTMENT 26. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| FTMC HOLDING 265 LLC | |||||||||
| 265 BENEDICT AVENUE | NORWALK | OH | 44857 | 344430716 | REAL ESTATE | OH | $42,462 | $1,137,946 | FISHER TITUS MEDICAL CENTER |
| NORTH CENTRAL HOLDING LLC | |||||||||
| 272 BENEDICT AVENUE | NORWALK | OH | 44857 | 344430716 | REAL ESTATE | OH | $0 | $0 | FISHER TITUS MEDICAL CENTER |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NORWALK AREA HEALTH SYSTEMS | |||||||||||
| 272 BENEDICT AVENUE | NORWALK | OH | 44857 | 341476935 | SYSTEM PARENT | OH | 501(C)(3) | LINE 11C, III-FI | N/A | 0 | |
| FISHER-TITUS FOUNDATION | |||||||||||
| 272 BENEDICT AVENUE | NORWALK | OH | 44857 | 341476937 | FOUNDATION | OH | 501(C)(3) | LINE 7 | 0 | NORWALK AREA HEALTH SYSTEMS | |
| NORWALK AREA HEALTH SERVICES | |||||||||||
| 272 BENEDICT AVENUE | NORWALK | OH | 44857 | 341476934 | AMBULANCE | OH | 501(C)(3) | LINE 9 | 0 | NORWALK AREA HEALTH SYSTEMS | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FISHER-TITUS PAIN MANAGEMENT LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 272 BENEDICT AVENUE | AddressLine1 |
| City | NORWALK | City |
| State | OH | State |
| ZIP Code | 44857 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 271471272 | EIN |
| Primary Activities | PAIN MANAGEMENT | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FISHER TITUS MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $873,766 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $626,010 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.51000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH PROMOTIONS OF NORWALK | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 272 BENEDICT AVENUE | AddressLine1 |
| City | NORWALK | City |
| State | OH | State |
| ZIP Code | 44857 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341502102 | EIN |
| Primary Activities | SUPPORT PROF. | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FISHER TITUS MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $104,263 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $553,821 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | Yes (1) | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FISHER - TITUS PAIN MANAGEMENT LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | F | TransactionTypeTxt |
| Involved | $998,167 | InvolvedAmt |
| Method Of Amount Determination | OWNERSHIP PERCENTAGE | MethodOfAmountDeterminationTxt |