FISHER TITUS MEDICAL CENTER: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- FISHER TITUS MEDICAL CENTER (EIN 34-4430716)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-15
- IRS object ID
- 201213209349305251
- Schema version
- 2011v1.2
- 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) |
|---|---|---|
| Timestamp | 2012-11-15T13:19:41-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351178661 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| 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 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 344430716 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FISHER-TITUS MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FISH | NameControl |
| Phone | 4196688101 | Phone |
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 |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DUANE WOODS JR | Name |
| Title | VP OF FINANCE & CFO | Title |
| Phone | 4196688101 | Phone |
| Date Signed | 2012-11-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ROBERT M MORELAND | Name |
| PTIN | P00418596 | PTIN |
| Phone | 6148852583 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | PATRICK MARTIN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| 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 | 131868568 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.FTMC.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1911 | YearFormation |
| State Legal Domicile | OH | StateLegalDomicile |
| Activity Or Mission Description | SEE SCHEDULE O | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1081 | TotalNbrEmployees |
| Total Nbr Volunteers | 290 | TotalNbrVolunteers |
| Total Gross UBI | 1276818 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 245757 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 71950 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 103445 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 111729373 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 113348908 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -2317815 | InvestmentIncomePriorYear |
| Investment Income Current Year | 989771 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 923594 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1083121 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 110407102 | TotalRevenuePriorYear |
| Total Revenue Current Year | 115525245 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 137479 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 173780 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 57489634 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 58358974 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 53352621 | OtherExpensePriorYear |
| Other Expenses Current Year | 52898605 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 110979734 | TotalExpensesPriorYear |
| Total Expenses Current Year | 111431359 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -572632 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 4093886 | RevenuesLessExpensesCY |
| Total Assets BOY | 181032523 | TotalAssetsBOY |
| Total Assets EOY | 186179952 | TotalAssetsEOY |
| Total Liabilities BOY | 61750318 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 67931873 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 119282205 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 118248079 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | PROVIDE QUALITY HEALTHCARE IN A COST EFFECTIVE MANNER, WHILE RESPECTING THE DIGNITY AND UNIQUENESS OF EACH INDIVIDUAL WE SERVE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 87868683 | Expense |
| Grants | 173780 | Grants |
| Revenue | 105318041 | Revenue |
| Description | SEE SCHEDULE O | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4937865 | Expense |
| Revenue | 6745049 | Revenue |
| Description | SEE SCHEDULE O | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 92806548 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 1 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 115 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1081 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | OH | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DAVID WILSON MBACMA | NamePerson |
| Telephone Number | 4196688101 | TelephoneNumber |
Address US AddressUS
| 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 Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| JOHN D PAYNE CPA | ||||||||
| DIRECTOR | 10.00 | X | 0 | 0 | 0 | |||
| LESLIE D STONEHAM | ||||||||
| CHAIRMAN | 15.00 | X | 0 | 0 | 0 | X | ||
| MARJORIE A HARPER | ||||||||
| DIRECTOR | 4.00 | X | 0 | 0 | 0 | |||
| CHARLES F FUREY | ||||||||
| VICE CHAIRMAN | 8.00 | X | 0 | 0 | 0 | X | ||
| GLENN TRIPPE MD | ||||||||
| DIRECTOR | 8.00 | X | 0 | 0 | 0 | |||
| WILLIAM B CORNELL MD | ||||||||
| DIRECTOR | 8.00 | X | 0 | 0 | 0 | |||
| VIRGINIA H POLING | ||||||||
| DIRECTOR | 6.00 | X | 0 | 0 | 0 | |||
| THOMAS C BLEILE | ||||||||
| DIRECTOR | 8.00 | X | 0 | 0 | 0 | |||
| REV FRED WIECHERS | ||||||||
| SECRETARY | 8.00 | X | 0 | 0 | 0 | X | ||
| MATT GROSS | ||||||||
| TREASURER | 12.00 | X | 0 | 0 | 0 | X | ||
| PATRICK J MARTIN | ||||||||
| PRESIDENT | 53.00 | X | 618887 | 0 | 462942 | X | ||
| MARGARET BAIRD | ||||||||
| EXECUTIVE VICE PRESIDENT - RETIRED SEPT 2011 | 50.00 | 524637 | 0 | 171895 | X | |||
| DUANE WOODS | ||||||||
| VP OF FINANCE/CFO | 44.50 | 204577 | 0 | 22743 | X | |||
| LORNA STRAYER | ||||||||
| SENIOR VP, ADMIN & BUSINESS DEVELOPMENT | 50.00 | 168910 | 0 | 77170 | X | |||
| CHERIE M SPRAGG | ||||||||
| SENIOR VP OF NURSING SERVICES | 50.00 | 182754 | 0 | 89319 | X | |||
| JOHN BRITTON | ||||||||
| VP INFORMATION SERVICES | 45.00 | 176733 | 0 | 12827 | X | |||
| PHILLIP J ANNARINO | ||||||||
| VP HUMAN RESOURCES | 45.00 | 165054 | 0 | 20447 | X | |||
| JOHN K HUGHES | ||||||||
| PHYSICIAN | 40.00 | 209532 | 0 | 31407 | X | |||
| GEORGE B ELMER | ||||||||
| DIRECTOR OF ASSET MGMT/EMS CFO | 40.00 | 168581 | 0 | 27835 | X | |||
| CHRISTINA CANFIELD | ||||||||
| PHYSICIAN | 40.00 | 167721 | 0 | 16074 | X | |||
| JOSEPH E CENTA | ||||||||
| PHYSICIAN | 40.00 | 258734 | 0 | 27753 | X | |||
| KATHLEEN A MEEHAN - DE LA CRUZ | ||||||||
| PHYSICIAN | 40.00 | 197826 | 0 | 30173 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3043946 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 990585 | TotalOtherCompensation |
| Number Individuals GT100 K | 28 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| THE ROBINS & MORTON GROUP | |||||
| 5500 MARYLAND WAY SUITE 100 | BRENTWOOD | TN | 37027 | BUILDING CONTRACTOR | 3609895 |
| CERNER CORPORATION | |||||
| 2800 ROCKCREEK PARKWAY | KANSAS CITY | MO | 64117 | HEALTHCARE INFORMATION TECHNOLOGY | 1909613 |
| HOSPITAL MEDICINE ASSOCIATES | |||||
| PO BOX 634850 | CINCINNATI | OH | 45263 | HOSPITALISTS | 1455015 |
| BOSTWICK DESIGN PARTNERSHIP | |||||
| 2729 PROSPECT AVE | CLEVELAND | OH | 44115 | ARCHITECTS | 591266 |
| LABORATORY CORP OF AMERICA | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | LAB TESTING & BLOOD ADMIN | 570906 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 19 | NumberOfContractorsGT100K |
| Membership Dues | 409 | MembershipDues |
| Related Organizations | 50429 | RelatedOrganizations |
| All Other Contributions | 52607 | AllOtherContributions |
| Noncash Contributions | 43122 | NoncashContributions |
| Total Contributions | 103445 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PATIENT SERVICES | 622110 | 105318041 | 105318041 | |
| NET NURSING HOME & ASS | 623000 | 6754049 | 6754049 | |
| MEDICAL LABORATORY | 621500 | 1265692 | 1265692 | |
| HEALTH AND ALLIED SERV | 621990 | 11126 | 11126 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 113348908 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 420593 | TotalRevenueColumn |
| Exclusion | $420,593 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 16907546 | Securities |
| Other | 4955 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 16012096 | Securities |
| Other | 331227 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 895450 | Securities |
| Other | -326272 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 569178 | TotalRevenueColumn |
| Exclusion | $569,178 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| CAFETERIA SALES | 722210 | 476717 | $476,717 |
| AUXILIARY SALES | 453220 | 359982 | $359,982 |
| OTHER HOSPITAL REVENUE | 900099 | 246422 | $246,422 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1083121 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 115525245 | TotalRevenueColumn |
| Related Or Exempt Function Income | 112072090 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1276818 | UnrelatedBusinessRevenue |
| Exclusion | $2,072,892 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 161792 | Total |
| Program Services | 161792 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11988 | Total |
| Program Services | 11988 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2898897 | Total |
| Program Services | 1988860 | ProgramServices |
| Management And General | 910037 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40458639 | Total |
| Program Services | 34683252 | ProgramServices |
| Management And General | 5775387 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3590596 | Total |
| Program Services | 3078046 | ProgramServices |
| Management And General | 512550 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8028759 | Total |
| Program Services | 6892670 | ProgramServices |
| Management And General | 1136089 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3382083 | Total |
| Program Services | 2899297 | ProgramServices |
| Management And General | 482786 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 233733 | Total |
| Program Services | 175300 | ProgramServices |
| Management And General | 58433 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 112738 | Total |
| Program Services | 56369 | ProgramServices |
| Management And General | 56369 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11043008 | Total |
| Program Services | 7003480 | ProgramServices |
| Management And General | 4039528 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 518508 | Total |
| Program Services | 507972 | ProgramServices |
| Management And General | 10536 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3975596 | Total |
| Program Services | 2792242 | ProgramServices |
| Management And General | 1183354 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2893284 | Total |
| Program Services | 378079 | ProgramServices |
| Management And General | 2515205 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2026624 | Total |
| Program Services | 1495444 | ProgramServices |
| Management And General | 531180 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 113052 | Total |
| Program Services | 101293 | ProgramServices |
| Management And General | 11759 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 301754 | Total |
| Program Services | 235218 | ProgramServices |
| Management And General | 66536 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1371587 | Total |
| Program Services | 1264676 | ProgramServices |
| Management And General | 106911 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7354126 | Total |
| Program Services | 6975332 | ProgramServices |
| Management And General | 378794 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 999427 | Total |
| Program Services | 804820 | ProgramServices |
| Management And General | 194607 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| UBI INCOME TAX | 149151 | 0 | 149151 |
| MEDICAL SUPPLIES | 14244410 | 14242972 | 1438 |
| BAD DEBT EXPENSES | 5162657 | 5162657 | |
| OHIO HOSPITAL TAX & SNF | 1302245 | 1302245 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1096705 | Total |
| Program Services | 592544 | ProgramServices |
| Management And General | 504161 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 111431359 | Total |
| Program Services | 92806548 | ProgramServices |
| Management And General | 18624811 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5475 | BOY |
| EOY | 5225 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17263330 | BOY |
| EOY | 18518902 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19438399 | BOY |
| EOY | 14202026 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 286880 | BOY |
| EOY | 245321 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 669314 | BOY |
| EOY | 586299 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1887494 | BOY |
| EOY | 1934718 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1946136 | BOY |
| EOY | 1999792 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 138615532 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 60232599 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 79906593 | BOY |
| EOY | 78382933 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57058369 | BOY |
| EOY | 67547461 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 271050 | BOY |
| EOY | 245374 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 366431 | BOY |
| EOY | 348961 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1933052 | BOY |
| EOY | 2162940 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 181032523 | BOY |
| EOY | 186179952 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27178703 | BOY |
| EOY | 34681434 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 335945 | BOY |
| EOY | 314054 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33945000 | BOY |
| EOY | 32760000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 290670 | BOY |
| EOY | 176385 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 61750318 | BOY |
| EOY | 67931873 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 119263921 | BOY |
| EOY | 118229778 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18284 | BOY |
| EOY | 18301 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 119282205 | BOY |
| EOY | 118248079 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 181032523 | BOY |
| EOY | 186179952 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 4093886 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -5128012 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $11,701 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 11701 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| 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 - 41.4% OF DUES; OHIO HOSPITAL ASSOCIATION - 5.9% OF DUES; AMERICAN HOSPITAL ASSOCIATION - 24.6% OF DUES AND HOSPITAL COUNCIL OF NW OHIO - 24% OF DUES. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1165800 | OtherCostOrOtherBasis |
| Book Value | 1165800 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 92372631 | OtherCostOrOtherBasis |
| Depreciation | 37072620 | Depreciation |
| Book Value | 55300011 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 39514716 | OtherCostOrOtherBasis |
| Depreciation | 21171161 | Depreciation |
| Book Value | 18343555 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5562385 | OtherCostOrOtherBasis |
| Depreciation | 1988818 | Depreciation |
| Book Value | 3573567 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 78382933 | TotalOfBookValueLandBuildings |
| Total Revenue | 115525245 | TotalRevenue |
| Total Expenses | 111431359 | TotalExpenses |
| Excess Or Deficit For Year | 4093886 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -306869 | NetUnrealizedGLOnInvestments |
| Other | -$4,689,523 | OtherAmount |
| Total Adjustments | -4996392 | TotalAdjustments |
| Excess Or Deficit Per FS | -902506 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 112425233 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -306869 | NetUnrealizedGainsInvestments |
| Other Revenues | -2430705 | OtherRevenues |
| Revenue Not Rptd F990 | -2737574 | RevenueNotRptdF990 |
| Revenue Subtotal | 115162807 | RevenueSubtotal |
| Other Revenues Not Included | 362438 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 362438 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 115525245 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 113327740 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 2126159 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 2126159 | ExpensesNotRptdF990 |
| Expenses Subtotal | 111201581 | ExpensesSubtotal |
| Other Expenses Not Included | 229778 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 229778 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 111431359 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | FASB #158 ADJUSTMENT -4,775,201. TRANSFER OF FUNDS TO AFFILIATED ORGANIZATION, NORWALK AREA HEALTH SYSTEMS -500,000. AUDIT ADJUSTMENT EXPENSE ERROR 16,210. AUDIT CONSOLIDATING ADJUSTMENT TO DONATIONS OF NEGATIVE -9,907. PAIN MANAGEMENT LLC DIVIDEND PAYMENT TO JOINT VENTURE MEMBER NORWALK PAIN M 397,755. NET ASSETS BALANCE SHEET CHANGE FOR HEALTH PROMOTIONS 50,000. TOTAL TO SCHEDULE D, PART XI, LINE 8: -4,821,143. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | TRANSFER TO AFFILIATED ENTITY NORWALK AREA HEALTH SYSTEMS -500,000. FASB 158 PROVISIONS -4,775,201. HEALTH PROMOTIONS OF NORWALK REVENUE 610,466. FISHER-TITUS PAIN MANAGEMENT LLC REVENUE 2,648,019. PAIN MANAGEMENT LLC DIVIDEND PAYMENT TO FTMC OF NEGATIVE -413,989. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | HOSPITAL AUXIIARY REVENUE 360,428. HOSPITAL EXPENSE ADJUSTMENTS TO REVENUES 2,010. |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | HEALTH PROMOTIONS OF NORWALK EXPENSES 540,213. FISHER-TITUS PAIN MANAGEMENT LLC EXPENSES 1,585,946. |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | HOSPITAL AUXILIARY EXPENSES 221,466. HOSPITAL EXPENSE ADJUSTMENTS TO REVENUES 8,312. |
Schedule F IRS990ScheduleF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Number Of Offices | 0 | SubtotalNumberOfOffices |
| Subtotal Number Of Employees | 0 | SubtotalNumberOfEmployees |
| Cont Number Of Offices | 0 | ContNumberOfOffices |
| Cont Number Of Employees | 0 | ContNumberOfEmployees |
| Total Number Of Offices | 0 | TotalNumberOfOffices |
| Total Number Of Employees | 0 | TotalNumberOfEmployees |
| Subtotal Amount Spent | 0 | SubtotalAmountSpent |
| Cont Amount Spent | 0 | ContAmountSpent |
| Total Amount Spent | 0 | TotalAmountSpent |
Grants To Orgs Outside US GrantsToOrgsOutsideUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | SOUTH AMERICA | Region |
| Purpose Of Grant | DONATION OF SUPPLIES TO HOSPITAL IN COLUMBIA | PurposeOfGrant |
| Amount Of Non Cash Assistance | 11987 | AmountOfNonCashAssistance |
| Description Of Non Cash Assistance | DONATION OF SUPPLIES TO COLUMBIAN HOSPITAL | DescriptionOfNonCashAssistance |
| Method Of Valuation | FMV | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of501c3 Orgs | 1 | TotalNumberOf501c3Orgs |
| Transfer To Foreign Corp | 0 | TransferToForeignCorp |
| Interest In Foreign Trust | 0 | InterestInForeignTrust |
| Own Foreign Corp | 0 | OwnForeignCorp |
| Passive Foreign Invest Co | 0 | PassiveForeignInvestCo |
| Foreign Partnership | 0 | ForeignPartnership |
| Boycott Countries | 0 | BoycottCountries |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 1580 | PersonsServed |
| Total Community Benefit Expense | 1732178 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 556418 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1175760 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01060 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 16285 | PersonsServed |
| Total Community Benefit Expense | 11488647 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6978512 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4510135 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04050 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 17865 | PersonsServed |
| Total Community Benefit Expense | 13220825 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7534930 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5685895 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05110 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 626 | NumberOfActivitiesOrPrograms |
| Persons Served | 63283 | PersonsServed |
| Total Community Benefit Expense | 925897 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 59804 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 866093 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00780 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 30 | NumberOfActivitiesOrPrograms |
| Persons Served | 166 | PersonsServed |
| Total Community Benefit Expense | 60865 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7520 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 53345 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 960029 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 189115 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 770914 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00690 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 293615 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 293615 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00260 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 666 | NumberOfActivitiesOrPrograms |
| Persons Served | 63449 | PersonsServed |
| Total Community Benefit Expense | 2240406 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 256439 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1983967 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01780 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 668 | NumberOfActivitiesOrPrograms |
| Persons Served | 81314 | PersonsServed |
| Total Community Benefit Expense | 15461231 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7791369 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7669862 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06890 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 615 | PersonsServed |
| Total Community Building Expense | 5700 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 5700 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 174 | PersonsServed |
| Total Community Building Expense | 1031 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1031 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 24 | PersonsServed |
| Total Community Building Expense | 9745 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 9745 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 10 | NumberOfActivitiesOrPrograms |
| Persons Served | 382 | PersonsServed |
| Total Community Building Expense | 6475 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6475 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 14 | NumberOfActivitiesOrPrograms |
| Persons Served | 1195 | PersonsServed |
| Total Community Building Expense | 22951 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 22951 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $5,162,657 | BadDebtExpenseAmount |
| Amount Attributable To | 1548797 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 22724813 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 31020478 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -8295665 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|---|
| 1 NORTH CENTRAL CARENET | |||
| PHYSICIAN-HOSPITAL ORGANIZATION | 0.50000 | 0.04260 | 0.45740 |
| 2 FISHER-TITUS PAIN MANAGEMENT LLC | |||
| PAIN MANAGEMENT | 0.51000 | 0.49000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FISHER-TITUS MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| 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 | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FISHER-TITUS MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 150.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Uninsured Discount | X | UninsuredDiscount |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 1 | CollectionActivities |
| Other Actions | X | OtherActions |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| NORWALK MEMORIAL HOME | ||||
| 272 BENEDICT AVENUE | NORWALK | OH | 44857 | SKILLED NURSING FACILITY |
| THE CARRIAGE HOUSE OF FISHER-TITUS | ||||
| 175 SHADY LANE DRIVE | NORWALK | OH | 44857 | ASSISTED LIVING FACILITY |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| 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 2011. 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 II: IN 2011, FISHER-TITUS'S COMMUNITY BUILDING ACTIVITIES AND BENEFITS PROVIDED $14.8 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 WAS THE IRS WORKSHEET A "ESTIMATED BAD DEBT EXPENSE (AT COST)" IN THE INSTRUCTIONS. 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 2011. | ||
| 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 $1,548,797 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. | CHARITY IN BAD DEBT EXPENSE: | PART III, LINE 3 |
| 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. | FOOTNOTE "ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS": | PART III, LINE 4 |
| 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 $8.3 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 8: | |
| 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 III, LINE 9B | |
| PART V, SECTION B, LINE 16E: 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 INDIVIDUALS BILLS AND DOCUMENTING THE HOSPITALS DETERMINATION OF AN INDIVIDUALS 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 | |
| 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 19(D) | |
| 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 DON'T RESTRICT ACCESS BASED ON WHETHER IT IS PROVIDED. PATIENTS WHO APPLY FOR FINANCIAL ASSISTANCE, EITHER AT THE TIME OF SERVICE OR AT SOME TIME AFTER SERVICES ARE PROVIDED, HAVE THEIR BILLS PUT ON A "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. | PART V, SECTION B 20 & 21 | |
| 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 PROVIDED SERVICES TO THE RESIDENTS OF HURON, ERIE, AND THE ADJACENT COUNTIES OF SANDUSKY, CRAWFORD, LORAIN, RICHLAND AND ASHLAND. THE PRIMARY AREA IS THE GREATER HURON COUNTY AREA IN NORTH CENTRAL OHIO, WHICH IS HOME TO OVER 62,000 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 TENTH HIGHEST UNEMPLOYMENT RATE IN OHIO IN 2011 WITH AN ANNUAL AVERAGE OF 11.7%. THE LARGEST PERCENTAGE OF RESIDENTS IS 65 AND OLDER. 92% OF THE RESIDENTS ARE CAUCASIAN WITH A GROWING HISPANIC POPULATION OF 5.6%. THE MEDIAN HOUSEHOLD INCOME IN 2010 WAS $45,542 WITH 12.9% OF THE FAMILIES LIVING BELOW THE POVERTY LEVEL AND 26.3% LIVING BELOW 200% OF THE POVERTY RATE. 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 AGINING, 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 ANS WELL AS OSTEOPOROSIS ASSESSMENTS. | ||
| FISHER-TITUS SPONSORED AND COLLABORATED WITH THE HURON COUNTY HEALTH DEPARTMENT AND OTHER HEALTH-RELATED ORGANIZATIONS (CALLED HURON COUNTY HEALTH PARTNERS) TO DEVELOP AND FUND THE HURON COUNTY NEEDS ASSESSMENT IN 2011. THE HURON COUNTY HEALTH PARTNERS AND FISHER-TITUS USED THE RESULTS TO ADDRESS AND MONITOR HEALTH PRIORITIES IN THE COUNTY. 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 PRIORITIES, FTMC HAS DEVELOPED NUMEROUS PROGRAMS TARGETING THE HURON COUNTY'S HIGH RATE OF OBESITY, DIABETES AND CARDIOVASCULAR ISSUES. PROGRAMS INCLUDE DIABETES SCREENINGS AT HISPANIC HEALTH FAIRS AND AT SALVATION ARMY SOUP KITCHENS, NUTRITION AND FITNESS FOR SCHOOL CHILDREN AND A COUNTY-WIDE WALKING PROGRAM IN PARTNERSHIP WITH THE AMERICAN HEART ASSOCIATION AND LOCAL BUSINESS. | PART VI LINE 2 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance |
|---|---|---|---|---|---|---|---|---|---|---|
| SERVICES FOR AGING INC | ||||||||||
| 130 SHADY LANE DR | NORWALK | OH | 44857 | 341108780 | 501(C)(3) | 12500 | HELP ASSIST SENIORS IN THE LOCAL COMMUNITY IN GETTING LOW-COST HEALTHCARE SERVICES. | |||
| HURON COUNTY HEALTH DEPARTMENT | ||||||||||
| 180 MILAN AVE | NORWALK | OH | 44857 | 10000 | DONATION FOR THE HURON COUNTY HEALTH DEPARTMENT CLINIC AND SERVICES | |||||
| NORWALK AREA UNITED FUND | ||||||||||
| 10 WEST MAIN ST | NORWALK | OH | 44857 | 340906312 | 501(C)(3) | 20000 | CONTRIBUTE TO THE UNITED WAY PACESETTER CAMPAIGN TO HELP THE LOCAL COMMUNITY | |||
| NORWALK ECONOMIC DEVELOPMENT CORP | ||||||||||
| 10 1/2 WEST MAIN STREET | NORWALK | OH | 44857 | 341787391 | 501(C)(3) | 10000 | CONTRIBUTION TO THE NORWALK ECONOMIC DEVELOPMENT CORP TO HELP THE LOCAL COMMUNITY | |||
| SHELBY CHRISTIAN & MISSIONARY ALLIANCE CHURCH | ||||||||||
| 105 E SMILEY AVENUE | SHELBY | OH | 44875 | 341354574 | 501(C)(3) | DONATED MISCELLANEOUS SUPPLIES TO CHURCH MISSION PROGRAM | 29982 | FMV | MISCELLANEOUS OPERATING ROOM MEDICAL SUPPLIES | |
| SHELBY CHRISTIAN & MISSIONARY ALLIANCE CHURCH | ||||||||||
| 105 E SMILEY AVENUE | SHELBY | OH | 44875 | 341354574 | 501(C)(3) | DONATED MISCELLANEOUS SUPPLIES TO CHURCH MISSION PROGRAM | 34158 | FMV | MISCELLANEOUS CATH LAB MEDICAL SUPPLIES | |
| HURON COUNTY HEALTH DEPARTMENT | ||||||||||
| 180 MILAN AVE | NORWALK | OH | 44857 | 10500 | HELP WITH COUNTY WIDE 2011 HEALTH ASSESMENT | |||||
| CITY OF NORWALK | ||||||||||
| 100 REPUBLIC STREET | NORWALK | OH | 44857 | 9000 | DONATION TO NORWALK PARKS AND RECREATION DEPARTMENT FOR "GET ACTIVE" PROGRAM | |||||
| MERCY HEALTH FOUNDATION JOPLIN | ||||||||||
| 3016 MCCLELLAN BLVD | JOPLIN | MO | 64804 | 501(C)(3) | 25652 | CONTRIBUTE TO ST JOHNS REGIONAL MEDICAL CENTER FOR RELIEF EFFORTS DUE TO TORNADO IN JOPLIN, MO | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 5 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 2 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: THE MEDICAL CENTER REVIEWS EACH GRANT OR DONATION REQUEST BEFORE IT IS MADE. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PATRICK J MARTIN | |||||||||||||
| 474001 | 0 | 139571 | 0 | 5315 | 0 | 444538 | 0 | 18404 | 0 | 1081829 | 0 | 0 | 0 |
| MARGARET BAIRD | |||||||||||||
| 210835 | 0 | 49692 | 0 | 264110 | 0 | 159060 | 0 | 12835 | 0 | 696532 | 0 | 260064 | 0 |
| DUANE WOODS | |||||||||||||
| 176422 | 0 | 27758 | 0 | 397 | 0 | 8250 | 0 | 14493 | 0 | 227320 | 0 | 0 | 0 |
| LORNA STRAYER | |||||||||||||
| 152448 | 0 | 15931 | 0 | 531 | 0 | 51565 | 0 | 25605 | 0 | 246080 | 0 | 0 | 0 |
| CHERIE M SPRAGG | |||||||||||||
| 165000 | 0 | 6712 | 0 | 11042 | 0 | 80448 | 0 | 8871 | 0 | 272073 | 0 | 0 | 0 |
| JOHN BRITTON | |||||||||||||
| 152101 | 0 | 24440 | 0 | 192 | 0 | 12827 | 0 | 0 | 0 | 189560 | 0 | 0 | 0 |
| PHILLIP J ANNARINO | |||||||||||||
| 143704 | 0 | 20452 | 0 | 898 | 0 | 4263 | 0 | 16184 | 0 | 185501 | 0 | 0 | 0 |
| JOHN K HUGHES | |||||||||||||
| 200994 | 0 | 7136 | 0 | 1402 | 0 | 8250 | 0 | 23157 | 0 | 240939 | 0 | 0 | 0 |
| GEORGE B ELMER | |||||||||||||
| 146513 | 0 | 21572 | 0 | 496 | 0 | 5230 | 0 | 22605 | 0 | 196416 | 0 | 0 | 0 |
| CHRISTINA CANFIELD | |||||||||||||
| 144570 | 0 | 22111 | 0 | 1040 | 0 | 2894 | 0 | 13180 | 0 | 183795 | 0 | 0 | 0 |
| JOSEPH E CENTA | |||||||||||||
| 224432 | 0 | 2500 | 0 | 31802 | 0 | 7596 | 0 | 20157 | 0 | 286487 | 0 | 0 | 0 |
| KATHLEEN A MEEHAN - DE LA CRUZ | |||||||||||||
| 191701 | 0 | 2500 | 0 | 3625 | 0 | 8250 | 0 | 21923 | 0 | 227999 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SUPPLEMENTAL INFORMATION | PART III | PART 1 LINE 4B - INCLUDED IN MR. MARTIN'S TOTAL CONTRIBUTIONS TO DEFERRED COMPENSATION OF $444,538 IS $144,236 OF VESTED DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $300,302 FOR THE CURRENT 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. |
| SUPPLEMENTAL INFORMATION | PART III | PART II LINE 1 - INCLUDED IN PATRICK MARTIN'S TOTAL W-2 COMPENSATION OF $618,887 IS $192,259 WHICH REPRESENTS THE PORTION OF MR. MARTIN'S SALARY ALLOCABLE TO THE NORWALK MEMORIAL HOME, A DIVISION OF FISHER-TITUS MEDICAL CENTER. |
| SUPPLEMENTAL INFORMATION | PART III | PART 1 LINE 4B & PART II, LINE 2 - INCLUDED IN MARGARET BAIRD'S TOTAL W-2 COMPENSATION OF $264,110 IS $260,064 WHICH REPRESENTS THE CURRENT YEAR PAYMENT OF DEFERRED COMPENSATION FROM A NON-QUALIFIED RETIREMENT PLAN WHICH WAS DEFERRED ON PRIOR FORM 990'S. MARGARET BAIRD RETIRED AS OUR EXCEUTIVE VICE PRESIDENT ON SEPTEMBER 30, 2011. INCLUDED IN HER TOTAL W-2 COMPENSATION OF $524,637 IS $68,084 WHICH REPRESENTS THE PORTION OF MS. BAIRD'S SALARY ALLOCABLE TO THE NORWALK MEMORIAL HOME, A DIVISION OF FISHER-TITUS MEDICAL CENTER. INCLUDED IN THE TOTAL CONTRIBUTION TO DEFERRED COMPENSATION OF $159,060 IN COLUMN C IS $159,060 OF VESTED DEFERRED WAGES AND NON QUALIFIED RETIREMENT PLAN CONTRIBUTIONS. |
| SUPPLEMENTAL INFORMATION | PART III | PART II LINE 3 - INCLUDED IN DUANE WOOD'S TOTAL W-2 COMPENSATION OF $204,577 IS $31,934 WHICH REPRESENTS THE PORTION OF MR. WOOD'S SALARY ALLOCABLE TO THE NORWALK MEMORIAL HOME, A DIVISION OF FISHER-TITUS MEDICAL CENTER. |
| SUPPLEMENTAL INFORMATION | PART III | PART I LINE 4B - ON DECEMBER 21, 2011 THE BOARD APPROVED A NEW SERP, NON-VEST, NON-QUALIFIED RETIREMENT PLAN FOR DUANE WOODS AND PHILLIP ANNARINO AND THAT THE RETIREMENT PLAN WOULD BE RETROACTIVE BACK TO JAN-01-2011. HOWEVER NO AMOUNT WAS ACCRUED FOR 2011 FOR THIS RETIREMENT BENEFIT. |
| SUPPLEMENTAL INFORMATION | PART III | PART 1, 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 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 2011. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| COUNTY OF HURON OHIO | |||||||
| 346400672 | 447540CC7 | 2007-06-28 | 28622597 | SEE PART V BELOW | 0 | 0 | 0 |
| COUNTY OF HURON OHIO | |||||||
| 346400672 | 447540BN4 | 2003-01-08 | 30000000 | SEE PART V BELOW | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Other Spent ProceedsOtherSpentProceeds | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Credit EnhancementCreditEnhancement |
|---|---|---|---|---|---|---|---|---|---|
| 28838308 | 564200 | 7215711 | 21058397 | 2008 | 1 | 0 | 1 | 1 | |
| 30714144 | 524983 | 27308799 | 2616937 | 2005 | 1 | 0 | 1 | 1 | 263425 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 1 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part VI Form990ScheduleKPartVI (6 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| 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 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, COLUMN A, LINE 3 | INCLUDED IN THE TOTAL PROCEEDS OF $28,838,308 IS INVESTMENT EARNINGS OF $215,711. |
| PART II, COLUMN A, LINE 11 | $21,058,397 OF THE PROCEEDS WERE USED TO REFUND THE HOSPITAL'S COUNTY OF HURON REVENUE BONDS, SERIES 1996B AND A PORTION OF THE 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
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | CHRISTINA CANFIELD | NamePerson |
| Purpose Of Loan | PRIVATE PRACTICE OPERATING LOANS | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $373,304 | OriginalPrincipalAmount |
| Balance Due | 245321 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 245321 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| MRS JOHN BRITTON | |||
| SPOUSE OF KEY EMPLOYEE | 52075 | EMPLOYEMENT | 0 |
| BAYLESS PATHMARK | |||
| SEE PART V | 130000 | INDEPENDENT CONTRACTOR | 0 |
| BLEILE ENTERPRISE | |||
| SEE PART V | 134066 | VENDOR TRANSACTION | 0 |
Form990 Schedule L Part V Form990ScheduleLPartV (3 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART II LINE 1 | PURPOSE OF LOAN: PRIVATE PRACTICE OPERATING LOANS BEFORE PRACTICEACQUISTION. BEGINNING IN 1998 AND CONTINUING THROUGH 2005, FISHER-TITUS MEDICAL CENTER ADVANCED FUNDS TO DR. CHRISTINA CANFIELD AND IN THREE INSTANCES, TO DR. CANFIELD AND HER PROFESSIONAL CORPORATION, "WAKEMAN AREA FAMILY CARE CENTER, INC." (THE CORPORATION). THE CORPORATION IS AN OHIO PROFESSIONAL CORPORATION THAT WAS FORMED IN 1998. DR. CANFIELD IS THE SOLE SHAREHOLDER. THE FUNDS WERE PRIMARILY ADVANCED UNDER INTEREST BEARING LINES OF CREDIT TO FACILITATE DR. CANFIELD'S INITIAL ESTABLISHMENT AND CONTINUATION OF A FAMILY MEDICAL PRACTICE IN WAKEMAN, OH. WAKEMAN, OHIO IS WITHIN THE SERVICE AREA OF FISHER-TITUS MEDICAL CENTER AND IS AN UNDERSERVED AREA, WITH NO OTHER PROVIDERS AND A HIGHER PROPORTION OF UNINSURED. THE ADVANCES ALSO WERE INTENDED TO ASSIST DR. CANFIELD'S PRACTICE WITH OPERATIONAL EXPENSES INCLUDING TRANSITION FROM A THIRD-PARTY BILLING SERVICE TO AN IN-HOUSE BILLING AND COLLECTION OPERATION AND EXPENSES ASSOCIATED WITH ATTEMPTS TO ADD ADDITIONAL PHYSICIANS TO THE MEDICAL PRACTICE. THE MEDICAL CENTER PROVIDED THE ADVANCES UNDER THE LINES OF CREDIT TO ENHANCE THE ABILITY OF DR. CANFIELD AND HER CORPORATION TO PROVIDE QUALITY MEDICAL SERVICES TO RESIDENTS OF WAKEMAN, OHIO. PRIOR TO THE OPENING, DR. CANFIELD'S PRACTICE, RESIDENTS OF WAKEMAN NEEDING MEDICAL CARE WERE REQUIRED TO TRAVEL 10-15 MILES TO OTHER COMMUNITIES TO RECEIVE CARE AS THERE WERE NO PHYSICIANS IN THE WAKEMAN COMMUNITY. THE ADVANCES WERE NECESSARY TO IMPROVE THE QUALITY OF HEALTH CARE IN THE WAKEMAN AREA AND PROVIDE ACCESS TO NEEDED HEALTH SERVICES, BOTH BEING CONSISTENT WITH THE MEDICAL CENTER'S EXEMPT PURPOSE OF PROVIDING MEDICAL CARE AND PROMOTING HEALTH IN ITS SERVICE AREA. SUBSEQUENT TO THE LINE OF CREDIT ADVANCES, DR. CANFIELD AND HER CORPORATION SOLD THE CORPORATION'S ASSETS AND ACCOUNTS RECEIVABLE TO FTMC MEDICAL CARE, LLC. FTMC MEDICAL CARE, LLC IS AN OHIO LIMITED LIABILITY COMPANY. FISHER-TITUS MEDICAL CENTER IS THE SOLE MEMBER OF THE LLC. THE PURCHASE PRICE OF THE ASSETS WAS BASED ON AN INDEPENDENT APPRAISAL. THE ASSET PURCHASE AGREEMENT PROVIDED THAT AFTER PAYMENT OF TRADE PAYABLES OF THE PRACTICE, THE PURCHASE PRICE WOULD BE USED TO PAY OFF THE CORPORATION'S OBLIGATIONS ON THE LINES OF CREDIT, AND TO THE EXTENT PURCHASE PRICE PROCEEDS WERE STILL AVAILABLE, WOULD BE DISTRIBUTED TO DR. CANFIELD WHO WAS REQUIRED TO USE THEM TO PAY BALANCES STILL OUTSTANDING ON LINES OF CREDIT ON WHICH SHE WAS PERSONALLY OBLIGATED. DR. CANFIELD SIMULTANEOULY BECAME AN EMPLOYEE OF THE LLC. |
| PART IV, LINE 2 | RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DIRECTOR WILLAIM CORNELL, MD IS A PARTNER OF BAYLESS PATHMARK. |
| PART IV, LINE 3 | RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DIRECTOR THOMAS BLEILE IS A FAMILY MEMBER OF THE INDIVIDUAL WHO OWNS BLEILE ENTERPRISE. |
Schedule M IRS990ScheduleM
Cars And Other Vehicles CarsAndOtherVehicles
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 4940 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenues |
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 38182 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 1 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| MISSION STATEMENT | PART I, LINE 1 | PROVIDE QUALITY HEALTHCARE IN A COST EFFECTIVE MANNER WHILE RESPECTING THE DIGNITY AND UNIQUENESS OF EACH INDIVIDUAL WE SERVE. |
| STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | 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 2011, THE HOSPITAL PROVIDED 15,671 DAYS OF INPATIENT CARE TO 4,169 PATIENTS. THE HOSPITAL ALSO PROVIDED 90,925 PATIENTS WITH 132,277 OUTPATIENT VISITS, AND THERE WERE 26,779 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 2011, THE HOME SERVED 377 RESIDENTS AND PROVIDED 24,000 DAYS OF CARE. THE HOME HEALTH CENTER HOME HEALTH AGENCY THE HOME HEALTH CENTER PROVIDED 13,352 HOME VISITS TO 487 DIFFERENT PATIENTS IN 2011. THE CARRIAGE HOUSE OF FISHER-TITUS OPENED IN 1998, THE CARRIAGE HOUSE IS A 48-UNIT ASSISTED LIVING FACILITY, WHICH PROVIDED 17,018 DAYS OF ASSISTED LIVING CARE TO 63 RESIDENTS IN 2011. PROGRAM EXPANSIONS, IMPROVEMENTS, AND ACCREDITATIONS AMERICAS FIRST ALL-DIGITAL SMART HOSPITAL: IN APRIL 2011, FISHER-TITUS CELEBRATED ITS ONE-YEAR ANNIVERSARY AS THE NATIONS FIRST ALL-DIGITAL SMART COMMUNITY HOSPITAL RECOGNIZING THE AMAZING ACCOMPLISHMENT OF MEDICAL CENTER PHYSICIANS, CAREGIVERS AND EMPLOYEES IN PARTNERSHIP WITH LEADING INTERNATIONAL HEALTH-CARE TECHNOLOGY COMPANY CERNER CORPORATION FOR DESIGNING AND IMPLEMENTING THE SYSTEM. OVER THE PAST YEAR, OUR PATIENTS HAVE BEEN AMONG THE FIRST TO EXPERIENCE THIS PATIENT-FOCUSED TECHNOLOGY AIMED AT PROVIDING THE HIGHEST QUALITY AND SAFEST CARE POSSIBLE THROUGH A FULLY INTEGRATED ELECTRONIC HEALTH RECORD SYSTEM AND INTERACTIVE TECHNOLOGY IN SMART HOSPITAL ROOMS. FISHER-TITUS IS NOW AMONG JUST 5% OF HOSPITALS IN THE NATION FOR THIS LEVEL OF MEDICAL TECHNOLOGY BRINGING US TO AN EVEN GREATER LEVEL OF CLINICAL QUALITY, PATIENT SAFETY, AND COORDINATION OF CARE. AS A CERNER SHOWCASE SITE, FISHER-TITUS HAS HOSTED HOSPITALS FROM ALL OVER THE WORLD INCLUDING THE CLEVELAND CLINIC, THE VETERANS ADMINISTRATION, AND BRAZILS HOSPITAL ALBERT EINSTEIN TO SEE THIS STATE-OF-THE-ART 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. FTMC IS AMONG 5% OF HOSPITALS THAT HAVE ACHIEVED THIS LEVEL OF TECHNOLOGY TOWARD A PAPERLESS PATIENT RECORD ENVIRONMENT BRINGING US TO AN EVEN GREATER LEVEL OF SAFE AND HIGH-QUALITY PATIENT-FOCUSED CARE. FACILITY AND PROGRAM EXPANSIONS NEW EMERGENCY DEPARTMENT / REGISTRATION-ADMITTING / AND OUTPATIENT LABORATORY SERVICES RESIDENTS IN MAY 2011, FISHER-TITUS BROKE GROUND ON A $12.5 MILLION FACILITY THAT NOW HOUSES THE MEDICAL CENTERS EMERGENCY DEPARTMENT, REGISTRATION/ADMITTING AREAS, AND OUTPATIENT LABORATORY SERVICES. THIS EXPANSION, WHICH OPENED IN MAY 2012, ALLOWED FISHER-TITUS MEDICAL CENTER TO RE-ENGINEER THE ER PATIENT PROCESSFROM ADMISSION AND REGISTRATION TO THE DELIVERY OF CARETO ENSURE THE BEST OUTCOMES AND THE BEST OVERALL EXPERIENCE FOR PATIENTS AND THEIR FAMILIES. IN 2011, THE PAIN MANAGEMENT CENTER EXPANDED SERVICES WITH NEW PHYSICIAN OFFICE LOCATIONS AT NORTHERN OHIO MEDICAL SPECIALISTS IN SANDUSKY AND IN ASHLAND IN COOPERATION WITH SAMARITAN REGIONS HEALTH SYSTEM. THE PAIN MANAGEMENT TEAM OF INTERVENTIONAL PAIN SPECIALISTS DR. ADAM HEDAYA AND DR. ZACH ZUMBAR SEE PATIENTS AT THOSE LOCATIONS AND PERFORM INTERVENTIONAL PROCEDURES AT THE STATE-OF-THE-ART PAIN MANAGEMENT CENTER AT FISHER-TITUS. PHYSICIAN ASSISTANT PAM SNYDER ALSO JOINED THE PAIN MANAGEMENT CENTER TEAM OF PROVIDERS. 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. FTMC OFFERS FINANCIAL ASSISTANCE TO COMMUNITY MEMBERS AND MEDICAL CENTER EMPLOYEES TO PURSUE TRAINING IN MEDICAL SHORTAGE AREAS, SUCH AS REGISTERED NURSING, RESPIRATORY THERAPY, RADIOLOGY TECHNOLOGISTS, REHABILITATION SPECIALISTS AND LABORATORY TECHNICIANS. AWARDS AND ACCREDITATIONS - THROUGHOUT THE YEARS, FTMC 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. FTMC IS ONE OF LESS THAN 2% OF HOSPITALS IN THE NATION DUALLY ACCREDITED BY THE JOINT COMMISSION (TJC) AND THE HEALTHCARE FACILITIES ACCREDITATION PROGRAM (HFAP). IN 2011 WE BECAME THE COUNTYS FIRST FULLY-ACCREDITED CHEST PAIN CENTER AND CERTIFIED AS A HFAP PRIMARY STROKE CENTER. THESE ACCREDITATIONS, ALONG WITH OUR STATUS AS A LEVEL 3 TRAUMA CENTER PROVIDE OUR COMMUNITY MEMBERS THE ASSURANCE THAT THEY WILL RECEIVE THE HIGHEST QUALITY OF CARE AT FISHER-TITUS IN AN EMERGENCY AS WELL AS FOLLOW-UP CARE. OUR CANCER CARE CENTER EARNED A THREE-YEAR ACCREDITATION WITH COMMENDATION BY THE COMMISSION ON CANCER OF THE AMERICAN COLLEGE OF SURGEONS. OUR CANCER PROGRAM HAS BEEN ACCREDITED SINCE 1989. THE MEDICAL CENTERS FOCUS ON QUALITY CARE AND EXCEPTIONAL SERVICE IS EVIDENCED BY THE MANY DEPARTMENTAL ACCREDITATIONS AND AWARDS AND RECOGNITIONS RECEIVED BY THE MEDICAL CENTER IN 2011: -MAMMOGRAPHY ANNUAL QUALITY INSPECTION -AMERICAN COLLEGE OF RADIOLOGY ACCREDITATION IN DIGITAL MAMMOGRAPHY -AMERICAN ASSOCIATION OF RESPIRATORY CARE, QUALITY RESPIRATORY CARE AWARD -AMERICAN COLLEGE OF SURGEONS COMMISSION ON CANCER ACCREDITATION WITH COMMENDATIONS -LABORATORY SERVICES CAP ACCREDITATION -BLOOD GAS LABORATORY CAP ACCREDITATION -NUCLEAR MEDICINE AMERICAN COLLEGE OF RADIOLOGY ACCREDITATION -INTERSOCIETAL COMMISSION FOR ACCREDITATION OF VASCULAR LABORATORIES -OHIO HOSPITAL ASSOCIATION SAFETY AWARD -MELVIN CREELEY ENVIRONMENTAL LEADERSHIP AWARD FTMC EMPLOYS 950 AREA RESIDENTS AND IS THE SECOND LARGEST EMPLOYER IN HURON COUNTY AND IS PROUD TO HAVE BEEN NAMED AMONG THE TOP 100 BEST PLACES TO WORK IN HEALTHCARE BY MODERN HEALTHCARE MAGAZINE THREE OF THE FOUR PAST YEARS. FISHER-TITUS ALSO IS A AMERICAN HEART ASSOCIATION FIT-FRIENDLY FACILITY WITH PLATINUM-LEVEL STATUS RECOGNITION FOR 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. EXCELLENT PHYSICIANS: FISHER-TITUS IS COMMITTED TO RECRUITING PHYSICIANS TO SERVE THE UNIQUE HEALTH-CARE NEEDS OF OUR COMMUNITY MEMBERS. IN 2011, WE WELCOMED THESE NEW PHYSICIANS TO OUR MEDICAL STAFF: RICHARD COLE, DO, FAMILY PRACTICE; TARA KERSEY-BARRETT, DO, FAMILY PRACTICE; JAMES MARCH JR., DO, ANESTHESIOLOGY; GARY MOORMAN, DO, EMERGENCY MEDICINE AND ADMINISTRATION; JAMES PRESTON, DO, FAMILY PRACTICE & PALLIATIVE CARE; AMY WILBER, DO, OBSTETRICS/GYNECOLOGY; JONATHAN ZAHLER, DO, OPHTHALMOLOGY; AND ZACHARY ZUMBAR, MD, PAIN MANAGEMENT. NEW MEMBERS TO THE FISHER-TITUS HOSPITALISTS TEAM, INTERNAL MEDICINE PHYSICIANS WHO SERVE PATIENTS IN THE HOSPITALS, INCLUDED ALAA ALAHMAD, MD; MICHAEL JOURDEN, MD; RONOBIR MALLICK, DO, MS; MBANEFO OJUKWU, MD; AND BASHAR SALEM, MD. |
| 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. FISHER-TITUS HAS PROVIDED LEADERSHIP AND FUNDING FOR THE HURON COUNTY HEALTH ASSESSMENT AND IN 2011 A NEW HEALTH ASSESSMENT WAS PUBLISHED AND DISTRIBUTED. THE ASSESSMENT'S FINDINGS PROVIDE FISHER-TITUS THE FOUNDATION TO DEVELOP PROGRAMS AND WORK IN PARTNERSHIP WITH OUR PHYSICIANS, RESIDENTS AND COMMUNITY LEADERS, AS WELL AS CIVIC, SOCIAL AND MEDICAL ORGANIZATIONS TO ADDRESS THESE HEALTH NEEDS AND PROVIDE HIGH-QUALITY CARE FOR OUR RESIDENTS. THE 2011 FINDINGS SOLIDIFIED THE TREND OF HEART DISEASE, DIABETES, OBESITY AND TOBACCO-USE AS LEADING HEALTH ISSUES IN HURON COUNTY. THE INCREASING RATES OF DIABETES AND OBESITY, AND THE HEALTH CHALLENGES THESE TWO CONDITIONS PRESENT CONTINUE TO BE THE FOCUS OF OUR COMMUNITY PROGRAMS. WE REACH OUT TO THESE HIGH RISK CONSTITUENTS THROUGH CHURCHES, LOCAL COMMUNITY ORGANIZATIONS AND OTHER GRASSROOTS EFFORTS. 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 MEDICAL CENTER COLLABORATED WITH THE NORWALK LIONS CLUB, CITY OF NORWALK PARKS N RECREATION, AND CURVES, WITH SUPPORT FROM LOCAL MEDIA, TO PUT A FOCUS ON DIABETES IN A FUN AND ENGAGING PROGRAM CALLED THE HEALTHIEST LOSER CHALLENGE. THE COMMUNITY WATCHED AND LEARNED WHILE 146 AREA RESIDENTS AT RISK FOR DIABETES OR DIAGNOSED WITH DIABETES OR PRE-DIABETES UNDERTOOK A THREE-MONTH CHALLENGE TOWARD A HEALTHIER LIFESTYLE. THE PROGRAMS GOAL WAS TO HELP PARTICIPANTS MANAGE THEIR DIABETES RISK AND WEIGHT BY PROVIDING THEM TOOLS TO DEVELOP NEW HEALTHY HABITS INCLUDING EXERCISE, HEALTHY EATING, AND GAINING KNOWLEDGE ABOUT DIABETES AND RELATED HEALTH ISSUES. PARTICIPANTS RECEIVED HEALTH ASSESSMENTS INCLUDING A1C GLUCOSE TESTS, A RESOURCE BOOK, AND VOUCHERS FOR LOCAL FITNESS CENTER FEES AND EQUIPMENT. OF THE 70 WHO FINISHED THE CHALLENGE 62 LOST AN AVERAGE OF 14 POUNDS AND 46 DECREASED THEIR A1C SCORES. THE WINNER LOST 53.2 POUNDS. 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 2011, WE OFFERED COMMUNITY HEALTH EDUCATION PROGRAMS, INCLUDING SCHOOL-BASED PROGRAMS, SUPPORT GROUPS, COMMUNITY-BASED HEALTH FAIRS AND SCREENINGS THAT IMPACTED OUR RESIDENTS THROUGH 66,017 ENCOUNTERS. AUXILIARY AND VOLUNTEER SERVICE: DURING 2011,OUR 280 CARING VOLUNTEERS DONATED 53,878 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 CENTERS 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 DAYS MENU, MEDICAL INFORMATION PERTAINING TO THE PERSONS HEALTH PROBLEMS, ACCESSING THE INTERNET, PLAYING GAMES, OBTAINING THE NAMES OF CAREGIVERS AS THEY ENTER THE PATIENTS 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. IN APPRECIATION FOR THEIR WORK IN 2011, THE MEDICAL CENTER PROVIDED 12,618 FREE MEALS TO THE VOLUNTEER STAFF AT A COST OF $77,222. 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. FTMCS 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 64,478 PEOPLE IN 2011 AT A COST OF $888,611. 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 HOSPITALS 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 166 PARTICIPANTS WAS $53,345. 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 2011 WAS $770,914. 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 2011 WAS $293,615. | |
| 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 2011. | |
| 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. | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -306,869. FASB #158 ADJUSTMENT -4,775,201. TRANSFER OF FUNDS TO AFFILIATED ORGANIZATION, NORWALK AREA HEALTH SYSTEMS -500,000. AUDIT ADJUSTMENT EXPENSE ERROR 16,210. AUDIT CONSOLIDATING ADJUSTMENT TO DONATIONS OF NEGATIVE -9,907. PAIN MANAGEMENT LLC DIVIDEND PAYMENT TO JOINT VENTURE MEMBER NORWALK PAIN M 397,755. NET ASSETS BALANCE SHEET CHANGE FOR HEALTH PROMOTIONS 50,000. TOTAL TO FORM 990, PART XI, LINE 5: -5,128,012. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| FTMC MEDICAL CARE LLC | |||||||||
| 272 BENEDICT AVENUE | NORWALK | OH | 44857 | 161768258 | MEDICAL CARE | OH | 2005320 | 693266 | FISHER TITUS MEDICAL CENTER |
| FTMC HOLDING 265 LLC | |||||||||
| 265 BENEDICT AVENUE | NORWALK | OH | 44857 | 344430716 | REAL ESTATE | OH | 7077 | 1172568 | FISHER TITUS MEDICAL CENTER |
| NORTH CENTRAL HOLDING LLC | |||||||||
| 272 BENEDICT AVENUE | NORWALK | OH | 44857 | 344430716 | REAL ESTATE | OH | FISHER TITUS MEDICAL CENTER | ||
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | 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 | |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FISHER-TITUS PAIN MANAGEMENT LLC | BusinessNameLine1 |
Address US AddressUS
| 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 Activity | PAIN MANAGEMENT | PrimaryActivity |
| Legal Domicile State | OH | LegalDomicileState |
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 | PredominantIncomeType |
| Share Of Total Income | 541656 | ShareOfTotalIncome |
| Share Of EOY Assets | 530417 | ShareOfEOYAssets |
| Disproportionate Allocations | 0 | DisproportionateAllocations |
| General Or Managing Partner | 0 | GeneralOrManagingPartner |
| Percentage Ownership | 0.51000 | PercentageOwnership |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH PROMOTIONS OF NORWALK | BusinessNameLine1 |
Address US AddressUS
| 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 Activity | SUPPORT PROF. | PrimaryActivity |
| Legal Domicile State | OH | LegalDomicileState |
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) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 86013 | ShareOfTotalIncome |
| Share Of EOY Assets | 452485 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 1 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |