FULTON COUNTY HEALTH CENTER: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- FULTON COUNTY HEALTH CENTER (EIN 34-4428214)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-10
- IRS object ID
- 201123149349301647
- Schema version
- 2010v3.4
- 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 H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-10T11:47:41-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 65 EAST STATE ST STE 600 | AddressLine1 |
| City | COLUMBUS | City |
| State | OH | State |
| ZIP Code | 43215 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 344428214 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FULTON COUNTY HEALTH CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FULT | NameControl |
| Phone | 4193352015 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 725 SOUTH SHOOP AVENUE | AddressLine1 |
| City | WAUSEON | City |
| State | OH | State |
| ZIP Code | 435671701 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DEAN BECK | Name |
| Title | ADMINISTRATOR | Title |
| Phone | 4193352015 | Phone |
| Date Signed | 2011-11-01 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6148493000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DALE NAFZIGER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 725 SOUTH SHOOP AVENUE | AddressLine1 |
| City | WAUSEON | City |
| State | OH | State |
| ZIP Code | 435671701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 72606567 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.FULTONCOUNTYHEALTHCENTER.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1973 | YearFormation |
| State Legal Domicile | OH | StateLegalDomicile |
| Activity Or Mission Description | PROMOTION OF HEALTH CARE TO THE GENERAL PUBLIC. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 905 | TotalNbrEmployees |
| Total Nbr Volunteers | 204 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 123879 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 72931 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 72900381 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 70539222 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 354888 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1288418 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 145582 | OtherRevenuePriorYear |
| Other Revenue Current Year | 205011 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 73524730 | TotalRevenuePriorYear |
| Total Revenue Current Year | 72105582 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 37668651 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 37335294 | 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 | 34894066 | OtherExpensePriorYear |
| Other Expenses Current Year | 34780298 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 72562717 | TotalExpensesPriorYear |
| Total Expenses Current Year | 72115592 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 962013 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -10010 | RevenuesLessExpensesCY |
| Total Assets BOY | 77256820 | TotalAssetsBOY |
| Total Assets EOY | 76504967 | TotalAssetsEOY |
| Total Liabilities BOY | 37354327 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 38332118 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 39902493 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 38172849 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE FULTON COUNTY HEALTH CENTER CONTINUALLY STRIVES TO REACH A HIGH DEGREE OF EXCELLENCE IN MEETING THE NEEDS OF BOTH INTERNAL AND EXTERNAL CUSTOMERS 100% OF THE TIME. QUALITY OF PATIENT/RESIDENT CARE AND ALL OF THE INSTITUTIONAL PRACTICES IS THE PRIMARY CRITERION UTILIZED TO MONITOR THE HEALTH CENTER SERVICES AND TO EVALUATE PROPOSED CHANGES OF PROPOSED NEW SERVICES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 51727604 | Expense |
| Grants | 0 | Grants |
| Revenue | 70605654 | Revenue |
| Description | SEE SCHEDULE OLOCATION: THE FULTON COUNTY HEALTH CENTER IS LOCATED AT 725 SOUTH SHOOP AVENUE, WAUSEON, OH 43567. THE HEALTH CENTER IS EASILY ACCESSIBLE FROM INTERSTATE 80/90 (OHIO TURNPIKE) AND STATE ROUTE 2. IT IS CENTRALLY LOCATED WITHIN FULTON COUNTY WHERE WAUSEON IS THE COUNTY SEAT.PHILOSOPHY/AUSPICES: THE FULTON COUNTY HEALTH CENTER IS A PRIVATE, NON-PROFIT HOSPITAL, LONG-TERM CARE & INDEPENDENT LIVING FACILITY GOVERNED BY A BOARD OF DIRECTORS. THE HEALTH CENTER IS OPERATED ON THE PRINCIPLE THAT EVERY INDIVIDUAL HAS A BASIC RIGHT TO ATTAIN THE HIGHEST DEGREE OF WELLNESS POSSIBLE BASED ON HIS OR HER OWN NEEDS. THE SERVICES OF THE HOSPITAL SHALL BE AVAILABLE TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, SEX, AGE, NATIONAL ORIGIN, RELIGIOUS CREED, ECONOMIC CONDITION OR DISABILITY.COMMITMENT TO QUALITY: THE FULTON COUNTY HEALTH CENTER CONTINUALLY STRIVES TO REACH A HIGH DEGREE OF EXCELLENCE IN MEETING THE NEEDS OF BOTH INTERNAL AND EXTERNAL CUSTOMERS 100% OF THE TIME. QUALITY OF PATIENT/RESIDENT CARE AND ALL OF THE INSTITUTIONAL PRACTICES IS THE PRIMARY CRITERION UTILIZED TO MONITOR THE HEALTH CENTER SERVICES AND TO EVALUATE PROPOSED CHANGES OF PROPOSED NEW SERVICES.LEVEL OF CARE: THE HEALTH CENTER IS A SHORT-TERM GENERAL HOSPITAL OFFERING A FULL RANGE OF SERVICES RELATED TO ACUTE CARE. INCLUDED IN THESE SERVICES AREA A WIDE RANGE OF OUTPATIENT SERVICES THAT INVOLVE DIAGNOSTIC AND REHABILITATIVE TREATMENT. THE HEALTH CENTER ALSO HAS LONG-TERM CARE AND INDEPENDENT LIVING AVAILABLE TO OFFER THE CONTINUUM OF CARE. THE LEVEL OF CARE PROVIDED TO ALL PATIENTS AND RESIDENTS IS THE SAME WHETHER INPATIENT OR OUTPATIENT. THIS IS ACCOMPLISHED THROUGH PROGRESSIVE HEALTH AWARENESS.CENTERS OF EXCELLENCE: AMONG THE SPECIAL STRENGTHS OF THE HEALTH CENTER ARE AN OBSTETRICAL UNIT, A CRITICAL CARE/CARDIAC CARE UNIT, A SHORT TERM INPATIENT AND OUTPATIENT ADULT PSYCHIATRIC UNIT, AN EMERGENCY DEPARTMENT THAT IS STAFFED WITH LICENSED PHYSICIANS 24 HOURS PER DAY, EVERY DAY OF THE YEAR, AN INPATIENT AND OUTPATIENT SURGICAL UNIT AND OTHER DIAGNOSTIC AND THERAPEUTIC SERVICES. DAILY OUTPATIENT SPECIALTY CLINICS OFFER THE CONSULTATIVE AND DIAGNOSTIC SERVICES OF SEVERAL TYPES OF MEDICAL SPECIALISTS. LONG-TERM CARE AND INDEPENDENT LIVING FACILITY OFFERING THE CONTINUUM OF CARE FROM THE HOSPITAL AREA. A WIDE RANGE OF ORGANIZED EDUCATIONAL AND HEALTH PROMOTION OPPORTUNITIES ARE PROVIDED FOR PATIENTS, RESIDENTS, EMPLOYEES AND MEMBERS OF THE SURROUNDING COMMUNITIES.FOR 2011, FULTON COUNTY HEALTH CENTER HAS EARNED FROM HEALTHGRADES A FIVE STAR JOINT REPLACEMENT AND TOTAL KNEE REPLACEMENT AWARD. HEALTHGRADES IS A LEADING HEALTHCARE RANKING SERVICE THAT IS RECOGNIZED THROUGHOUT THE COUNTRY IN IDENTIFYING QUALITY HEALTH PROGRAMS. THIS AWARD ALSO MEANS THAT FCHC IS RANKED IN THE TOP 15% NATIONWIDE IN JOINT REPLACEMENTS INCLUDING TOTAL KNEE AND TOTAL HIP IN OVERALL CLINICAL PERFORMANCE. THIS AWARD AFFIRMS THE QUALITY OUTCOMES BY ALL WHO PROVIDE CARE FOR PATIENTS THAT RECEIVE JOINT REPLACEMENT SURGERY HERE AT FCHC.THE 2011 FIVE STAR JOINT REPLACEMENT AWARD IS DESIGNED TO IDENTIFY HOSPITALS WHO HAVE THE LOWEST COMPLICATION RATES IN JOINT REPLACEMENTS. HEALTHGRADES IS A LEADING INDEPENDENT HEALTHCARE RATING ORGANIZATION WHO RATES HOSPITALS THROUGH ANNUAL REVIEWS OF SEVERAL PUBLIC AND PRIVATE SOURCES, INCLUDING CENTER FOR MEDICARE AND MEDICAID SERVICES.LIMITATIONS: PATIENTS IN NEED OF TERTIARY CARE ARE REFERRED TO AREA SPECIALTY CENTERS.POPULATION SERVED: THE FULTON COUNTY HEALTH CENTER SERVES THE POPULATION IN FULTON COUNTY AND PATIENTS IN THE IMMEDIATE BORDER AREAS OF ADJACENT COUNTIES. TOTAL POPULATION OF OUR SERVICE AREA IS ESTIMATED BETWEEN 40,000 - 45,000. THE STRESS UNIT PRIMARILY SERVES A FOUR COUNTY AREA INCLUDING FULTON, DEFIANCE, HENRY AND WILLIAMS COUNTIES AS WELL AS FROM OUTSIDE OUR IMMEDIATE GEOGRAPHIC AREA.INSTITUTIONAL RELATIONSHIPS: THE HEALTH CENTER MAINTAINS RELATIONSHIPS WITH AREA NURSING HOMES, CITY AND COUNTY ORGANIZATIONS, AND REGIONAL TERTIARY CARE CENTERS. THE HEALTH CENTER IS A CLINIC-TRAINING SITE FOR A WIDE RANGE OF HEALTH CARE DISCIPLINES.EDUCATION: THE HEALTH CENTER MAINTAINS AN ACTIVE AND ONGOING IN-SERVICE AND CONTINUING EDUCATION PROGRAM FOR OUR STAFF TO KEEP THEM KNOWLEDGEABLE AND CURRENT ON DEVELOPMENTS IN HEALTH CARE DELIVERY. THE HEALTH CENTER ALSO ENCOURAGES EMPLOYEES TO PURSUE HIGHER EDUCATION. | Description |
| Total Program Service Expense | 51727604 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | 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 | 1 | 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 | 0 | 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 | 0 | FinancialStmtAttached |
| Grants To Organizations | 0 | 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 | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 1 | 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 | 75 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 905 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| 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 | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | 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 | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 1 | 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 | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | OH | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DARRELL TOPMILLER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4193352015 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 725 SOUTH SHOOP AVE | AddressLine1 |
| City | WAUSEON | City |
| State | OH | State |
| ZIP Code | 43567 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (26 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| DALE L NAFZIGER | |||||||
| PRESIDENT | 0.80 | X | X | 0 | 0 | 0 | |
| CARL HILL | |||||||
| VICE PRESIDENT | 0.80 | X | X | 0 | 0 | 0 | |
| SANDY BARBER | |||||||
| SECRETARY | 0.80 | X | X | 0 | 0 | 0 | |
| SHARON GILLESPIE | |||||||
| TREASURER (FEB-CURRENT) | 0.80 | X | X | 0 | 0 | 0 | |
| MATTHEW J MCQUADE | |||||||
| DIRECTOR | 0.80 | X | 0 | 0 | 0 | ||
| BRETT KOLB | |||||||
| DIRECTOR (FEB-CURRENT) | 0.80 | X | 0 | 0 | 0 | ||
| DAVID GRIESER | |||||||
| DIRECTOR | 0.80 | X | 0 | 0 | 0 | ||
| JENNIFER MCCULLOUGH | |||||||
| DIRECTOR | 0.80 | X | 0 | 0 | 0 | ||
| DR CHRIS SPIELES | |||||||
| DIRECTOR | 40.00 | X | 650000 | 0 | 17344 | ||
| MARK HAGANS | |||||||
| DIRECTOR | 0.80 | X | 0 | 0 | 0 | ||
| ALLEN LIECHTY | |||||||
| DIRECTOR | 0.80 | X | 0 | 0 | 0 | ||
| WILLIAM ANDERSON | |||||||
| DIRECTOR | 0.80 | X | 0 | 0 | 0 | ||
| STANLEY MULTHAUF | |||||||
| DIRECTOR | 0.80 | X | 0 | 0 | 0 | ||
| MERRILL NOFZIGER | |||||||
| TREASURER (JAN-FEB) | 0.80 | X | X | 0 | 0 | 0 | |
| DR LEE DAVIS | |||||||
| DIRECTOR (JAN-FEB) | 0.80 | X | 0 | 0 | 0 | ||
| ALAN SCHAFFNER | |||||||
| DIRECTOR | 0.80 | X | 0 | 0 | 0 | ||
| DEAN BECK | |||||||
| ADMINISTRATOR | 40.00 | X | 232877 | 0 | 19822 | ||
| PATRICIA FINN | |||||||
| ASST. ADMINISTRATOR | 40.00 | X | 128107 | 0 | 23716 | ||
| DARRELL TOPMILLER | |||||||
| DIRECTOR OF FINANCE | 40.00 | X | 109824 | 0 | 17155 | ||
| JOANN SHORT | |||||||
| DIRECTOR OF NURSING | 40.00 | X | 99570 | 0 | 12202 | ||
| MARY JO SMALLMAN | |||||||
| FM ADMINISTRATOR | 40.00 | X | 85010 | 0 | 15748 | ||
| EDWARD W CLAUSING | |||||||
| DIRECTOR OF PHARMACY | 40.00 | 101847 | 0 | 17375 | X | ||
| HARRY E MURTIFF | |||||||
| PHYSICIAN | 40.00 | 187816 | 0 | 11581 | X | ||
| SEMEGHAGHA J FOFUNG | |||||||
| PHYSICIAN | 40.00 | 229094 | 0 | 6555 | X | ||
| DANIEL J MCKERNAN | |||||||
| PHYSICIAN | 40.00 | 800010 | 0 | 17344 | X | ||
| RONALD E MUSIC | |||||||
| PHYSICIAN | 40.00 | 165006 | 0 | 17344 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2789161 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 176186 | TotalOtherCompensation |
| Number Individuals GT100 K | 10 | 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 |
|---|---|---|---|---|---|
| AMERISOURCE - BERGEN | |||||
| 27550 NETWORK PLACE | CHICAGO | IL | 60673 | DRUGS / SUPPLIES | 4860924 |
| ZIMMER US INC | |||||
| 14235 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | ORTHOPEDIC SURGERY PRODUCTS | 1716433 |
| AMERICAN PHYSICAL REHABILITATION | |||||
| 6444 MONROE STREET SUITE 5 | SYLVANIA | OH | 43560 | OCCUPATIONAL/PHYSICAL/SPEECH THERAPY | 1495984 |
| SENECA MEDICAL INC | |||||
| PO BOX 636696 | CINCINNATI | OH | 45263 | MEDICAL SUPPLIES | 1223202 |
| GORDON FOODS | |||||
| PAYMENT PROCESSING CENTER DEPT CH | PALATINE | IL | 600550490 | FOOD | 825919 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 52 | NumberOfContractorsGT100K |
| All Other Contributions | 72931 | AllOtherContributions |
| Total Contributions | 72931 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICES | 622110 | 70204797 | 70204797 |
| REBATES AND REFUNDS | 900099 | 135759 | 135759 |
| OTHER INCOME | 900099 | 113838 | 113838 |
| EDUCATION SERVICES | 611710 | 84828 | 84828 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 70539222 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 285280 | TotalRevenueColumn |
| Exclusion | $285,280 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 336812 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 487224 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -150412 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -150412 | TotalRevenueColumn |
| Related Or Exempt Function Income | 23785 | RelatedOrExemptFunctionIncome |
| Exclusion | -$174,197 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 981000 | Securities |
| Other | 35899 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 13761 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 981000 | Securities |
| Other | 22138 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1003138 | TotalRevenueColumn |
| Exclusion | $1,003,138 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| FOOD SALES | 621110 | 312694 | $312,694 | |
| FITNESS MEMBERSHIPS | 621110 | 41681 | 41681 | |
| K-1 INCOME | 621110 | 966 | 966 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 82 | TotalRevenueColumn |
| Exclusion | $82 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 355423 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 72105582 | TotalRevenueColumn |
| Related Or Exempt Function Income | 70605654 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,426,997 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1411376 | Total |
| Management And General | 1411376 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27858027 | Total |
| Program Services | 20336360 | ProgramServices |
| Management And General | 7521667 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1145052 | Total |
| Program Services | 835888 | ProgramServices |
| Management And General | 309164 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4990541 | Total |
| Program Services | 3643095 | ProgramServices |
| Management And General | 1347446 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1930298 | Total |
| Program Services | 1409118 | ProgramServices |
| Management And General | 521180 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 96914 | Total |
| Management And General | 96914 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 177478 | Total |
| Management And General | 177478 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7630544 | Total |
| Program Services | 5570297 | ProgramServices |
| Management And General | 2060247 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 214716 | Total |
| Management And General | 214716 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14566334 | Total |
| Program Services | 10633424 | ProgramServices |
| Management And General | 3932910 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 553976 | Total |
| Program Services | 404402 | ProgramServices |
| Management And General | 149574 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2470397 | Total |
| Program Services | 1803390 | ProgramServices |
| Management And General | 667007 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5743 | Total |
| Program Services | 4192 | ProgramServices |
| Management And General | 1551 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 712930 | Total |
| Program Services | 413499 | ProgramServices |
| Management And General | 299431 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3943561 | Total |
| Program Services | 2287265 | ProgramServices |
| Management And General | 1656296 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 756314 | Total |
| Program Services | 756314 | ProgramServices |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 3573497 | 3573497 | |
| EDUCATION PROGRAMS | 54207 | 39571 | 14636 |
| INDEPENDENT LIVING | 23687 | 17292 | 6395 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72115592 | Total |
| Program Services | 51727604 | ProgramServices |
| Management And General | 20387988 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1197020 | BOY |
| EOY | 452029 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13122936 | BOY |
| EOY | 17018325 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9984732 | BOY |
| EOY | 11560026 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1514965 | BOY |
| EOY | 1545022 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 805189 | BOY |
| EOY | 857854 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 72472125 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 34277436 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40497230 | BOY |
| EOY | 38194689 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6729320 | BOY |
| EOY | 5843932 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62141 | BOY |
| EOY | 37500 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3343287 | BOY |
| EOY | 995590 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 77256820 | BOY |
| EOY | 76504967 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5215191 | BOY |
| EOY | 5580904 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38924 | BOY |
| EOY | 48441 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28435000 | BOY |
| EOY | 28406250 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3665212 | BOY |
| EOY | 4296523 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37354327 | BOY |
| EOY | 38332118 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39850493 | BOY |
| EOY | 38120849 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52000 | BOY |
| EOY | 52000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39902493 | BOY |
| EOY | 38172849 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 77256820 | BOY |
| EOY | 76504967 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -10010 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -1719634 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| 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 | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $5,518 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 5518 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | DUES PAYMENTS TO OHA AND AHA THAT WERE USED BY THAT ORGANIZATION FOR LOBBYING PURPOSES. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 347069 | BeginningOfYearBalance |
| Contributions | 6305 | Contributions |
| Investment Earnings Or Losses | 556 | InvestmentEarningsOrLosses |
| End Of Year Balance | 353930 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 463238 | BeginningOfYearBalance |
| Contributions | 5300 | Contributions |
| Investment Earnings Or Losses | 923 | InvestmentEarningsOrLosses |
| Other Expenditures | 121940 | OtherExpenditures |
| Administrative Expenses | 452 | AdministrativeExpenses |
| End Of Year Balance | 347069 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 458802 | BeginningOfYearBalance |
| Contributions | 875 | Contributions |
| Investment Earnings Or Losses | 7133 | InvestmentEarningsOrLosses |
| Administrative Expenses | 3572 | AdministrativeExpenses |
| End Of Year Balance | 463238 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.85310 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.14690 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 858990 | OtherCostOrOtherBasis |
| Book Value | 858990 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 39770636 | OtherCostOrOtherBasis |
| Depreciation | 14270628 | Depreciation |
| Book Value | 25500008 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 29873544 | OtherCostOrOtherBasis |
| Depreciation | 19328087 | Depreciation |
| Book Value | 10545457 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1968955 | OtherCostOrOtherBasis |
| Depreciation | 678721 | Depreciation |
| Book Value | 1290234 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 38194689 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| FAIR VALUE OF INTEREST RATE SWAP | $2,722,804 |
| OBLIGATIONS UNDER CAPITAL LEASES | $1,573,719 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 4296523 | TotalOfAmounts |
| Total Revenue | 72105582 | TotalRevenue |
| Total Expenses | 72115592 | TotalExpenses |
| Excess Or Deficit For Year | -10010 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 148635 | NetUnrealizedGLOnInvestments |
| Other | -$1,868,269 | OtherAmount |
| Total Adjustments | -1719634 | TotalAdjustments |
| Excess Or Deficit Per FS | -1729644 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 72740475 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 148635 | NetUnrealizedGainsInvestments |
| Other Revenues | 486258 | OtherRevenues |
| Revenue Not Rptd F990 | 634893 | RevenueNotRptdF990 |
| Revenue Subtotal | 72105582 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 72105582 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 70735513 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | -1380079 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | -1380079 | ExpensesNotRptdF990 |
| Expenses Subtotal | 72115592 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 72115592 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | ENDOWMENT FUNDS WILL BE USED AS DIRECTED BY THE DONOR. BOARD DESIGNATED FUNDS ARE A MEMORIAL ACCOUNT AND FUNDS WILL BE SPEND AS DIRECTED BY THE BOARD OF DIRECTORS. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -1,867,303. K-1 INCOME -966. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RECLASS OF RENTAL EXPENSES 487,224. CHANGE IN FAIR VALUE OF INTEREST SWAP AGREEMENTS K-1 INCOME -966. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | RECLASS OF RENTAL EXPENSES 487,224. CHANGE IN FAIR VALUE OF INTEREST SWAP AGREEMENTS -1,867,303. | |
| PART XI LINE 8 - CHANGE IN FAIR VALUE OF INTEREST RATE SWAP |
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 |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| 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) |
|---|---|---|
| Total Community Benefit Expense | 1241434 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 71320 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1170114 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01710 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5381498 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2505802 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2875696 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04200 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1107470 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 334740 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 772730 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01130 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7730402 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2911862 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4818540 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07040 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 664949 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 84828 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 580121 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00850 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 58112 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 55112 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10618 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4424 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6194 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 733679 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 92252 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 641427 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00940 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8464081 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3004114 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5459967 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07980 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $1,887,926 | BadDebtExpenseAmount |
| Amount Attributable To | 56638 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 15317017 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 14966224 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 350793 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| 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 | FULTON COUNTY HEALTH CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 725 S SHOOP AVE | AddressLine1 |
| City | WAUSEON | City |
| State | OH | State |
| ZIP Code | 43567 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| 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 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
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 |
|---|---|---|---|---|
| FULTON MANOR | ||||
| 725 SOUTH SHOOP AVENUE | WAUSEON | OH | 43567 | SKILLED NURSING FACILITY |
| FCHC MEDICAL CARE | ||||
| 725 SOUTH SHOOP AVENUE | WAUSEON | OH | 43567 | PHYSICIAN PRACTICES |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| ExplanationExplanation |
|---|
| PART I, LINE 3C: FCHC USES THE FEDERAL POVERTY GUIDELINES FOR DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE. |
| PART I, LINE 6A: NOT APPLICABLE |
| PART I, LINE 7: COST OF CHARITY CARE IS CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2. COST OF MEDICAID IS PER THE MEDICAID COST REPORT. THE REMAINING ITEMS ARE CALCULATED BASED ON ACTUAL COSTS OF SPECIFIC PROGRAMS WITHOUT THE USE OF A COST ACCOUNTING SYSTEM. |
| PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE THAT WAS REMOVED FROM THE CALCULATION IN PART I LINE 7 COLUMN (F) TOTALED $3,573,497. |
| PART II: N/A |
| PART III, LINE 4: FINANCIAL STATEMENT FOOTNOTE REGARDING BAD DEBT: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL LOSS-RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS-RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS, INCLUDING INTERIM PAYMENT ADVANCES, IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES.FCHC USES THE COST TO CHARGE RATIO FROM WORKSHEET 2 TO DETERMINE THE COST OF THE BAD DEBT EXPENSE.THROUGHOUT ALL OF OUR COLLECTION PROCESSES, WE MAKE OUR BEST EFFORT TO GET ALL PATIENTS CLASSIFIED CORRECTLY. THIS IS ESPECIALLY TRUE FOR ANY OF OUR PATIENTS THAT ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. WE PROVIDE INFORMATION TO OUR PATIENTS THROUGH POSTED SIGNS, PRINTED APPLICATIONS AND FOLLOW-UP PHONE CONVERSATIONS. WITH ALL OF THIS, WE REALIZE THAT SOME PATIENTS WILL EITHER NOT RESPOND TO OUR EFFORTS OR WILL FAIL TO PROVIDE ALL NECESSARY INFORMATION TO PROPERLY CLASSIFY THEM. BECAUSE OF THIS, WE KNOW THAT A PORTION OF OUR BAD DEBT EXPENSE WOULD QUALIFY FOR CHARITY CARE. WE ESTIMATE THIS PORTION TO BE 3% OF THE TOTAL BAD DEBT EXPENSE AT COST. |
| PART III, LINE 8: MEDICARE ALLOWABLE COSTS WERE CALCULATED BY USING THE COST TO CHARGE RATIO FROM WORKSHEET 2. AS A CRITICAL ACCESS HOSPITAL, MEDICARE PAYS FCHC AT COST. THEREFORE, FCHC DOES NOT HAVE A MEDICARE SHORTFALL. |
| PART III, LINE 9B: THE CRITERION FULTON COUNTY HEALTH CENTER UTILIZES TO COLLECT FROM PATIENTS INCLUDES: PATIENTS ARE SENT STATEMENTS FOR OUTSTANDING BALANCES FOR A PERIOD OF TIME NOT LESS THAN 105 DAYS, AFTER AN EFFORT HAS BEEN MADE TO COLLECT THE BALANCE OR PLAN A PATIENT-PAY ACCOUNT PAYMENT PLAN THROUGH A SERIES OF 4 LETTERS AND 2 TELEPHONE CONTACTS DURING THE AFOREMENTIONED 105 DAY PERIOD, THE ACCOUNT IS TURNED OVER TO A COLLECTION AGENCY FOR FURTHER COLLECTION EFFORTS OR LEGAL ACTION.COLLECTION EFFORTS ARE NOT ENFORCED FOR BALANCES KNOWN TO QUALIFY UNDER CHARITY CARE OR OTHER FINANCIAL ASSISTANCE CRITERIA. |
| PART VI, LINE 2: EVERY FIVE YEARS, THE ORGANIZATION PERFORMS A COMMUNITY HEALTH NEEDS ASSESSMENT TO DETERMINE THE CURRENT HEALTH NEEDS WITHIN THE COMMUNITY. IN ADDITION, THE MEDICAL STAFF PROVIDES THE HOSPITAL WITH HEALTH CARE NEEDS WITHIN THE COMMUNITY BASED ON THEIR OWN PATIENTS HEALTH CARE NEEDS. |
| PART VI, LINE 3: FCHC HAS SIGNS POSTED AT EACH PLACE THAT REGISTERS PATIENTS TO INFORM THEM OF FINANCIAL ASSISTANCE AVAILABLE. ALSO, EACH BILLING STATEMENT SENT TO THE PATIENTS PROVIDES INFORMATION ON WHO THE PATIENT MAY CONTACT FOR INFORMATION REGARDING FINANCIAL ASSISTANCE. FINALLY, FINANCIAL COUNSELORS VISIT CERTAIN PATIENTS IN THE EMERGENCY DEPARTMENT AND ON THE INPATIENT FLOORS TO DISCUSS THE FINANCIAL ASSISTANCE AVAILABLE TO THEM. |
| PART VI, LINE 4: FCHC SERVES FULTON COUNTY, OHIO AS THE PRIMARY SERVICE AREA, AS WELL AS PORTIONS OF HENRY & WILLIAMS COUNTIES IN OHIO AND MORENCI, MICHIGAN AS THE SECONDARY SERVICE AREA. THE ORGANIZATION IS A RURAL COMMUNITY. THE HOSPITAL SERVES ALL RESIDENTS WITH VARIOUS DEMOGRAPHIC CHARACTERISTICS. THE POPULATION THAT THE HOSPITAL SERVICES RANGES FROM 40,000 TO 45,000. THERE ARE NO OTHER HOSPITALS IN FULTON COUNTY. THE PERCENTAGE OF PERSONS BELOW THE POVERTY LEVEL IS APPROXIMATELY 9-10%. THE AVERAGE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $53,000. |
| PART VI, LINE 6: ALL OF THE ORGANIZATION'S BOARD MEMBERS RESIDE IN THE SERVICE AREA OF THE HOSPITAL. BOARD MEMBERS REPRESENT AND LIVE IN THE CITIES AND VILLAGES OF FULTON COUNTY. WITH THE EXCEPTION OF DR. CHRIS SPIELES WHO IS A BOARD MEMBER AS CHIEF OF STAFF, THE BOARD MEMBERS ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIES PHYSICIANS IN ITS COMMUNITY THAT MEET THE MEDICAL STAFF BYLAW REQUIREMENTS. THE ORGANIZATION REINVESTS SURPLUS FUNDS INTO THE ORGANIZATION IN THE FORM OF NEW EQUIPMENT, RENOVATIONS, AND ADDITIONAL SERVICES. THE ORGANIZATION HAD 13% OF ITS REVENUE SOURCED FROM MEDICAID AND UNINSURED PATIENTS.FCHC INCURRED $252,528 EXPENSES RELATED TO RECRUITING AND MAINTAINING QUALIFIED PHYSICIANS AND SPECIALISTS TO THE HOSPITAL. THESE PHYSICIANS AND SPECIALISTS ARE CRITICAL TO ENHANCING THE HEALTH AND LEVEL OF CARE PROVIDED TO THE COMMUNITY. WITHOUT FCHC RECRUITING AND MAINTAINING THESE PHYSICIANS, THE COMMUNITY WOULD NOT HAVE ACCESS TO THESE DOCTORS. AS SUCH, FCHC CONSIDERS THESE PHYSICIAN RECRUITMENT COSTS TO BE A COMMUNITY BENEFIT SERVICE. |
| PART VI, LINE 7: N/A |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR CHRIS SPIELES | |||||||||||||
| 650000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 17344 | 0 | 667344 | 0 | 0 | 0 |
| DEAN BECK | |||||||||||||
| 232877 | 0 | 0 | 0 | 0 | 0 | 11644 | 0 | 8178 | 0 | 252699 | 0 | 0 | 0 |
| PATRICIA FINN | |||||||||||||
| 128107 | 0 | 0 | 0 | 0 | 0 | 6405 | 0 | 17311 | 0 | 151823 | 0 | 0 | 0 |
| HARRY E MURTIFF | |||||||||||||
| 187816 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 11581 | 0 | 199397 | 0 | 0 | 0 |
| SEMEGHAGHA J FOFUNG | |||||||||||||
| 225014 | 0 | 0 | 0 | 4080 | 0 | 0 | 0 | 6555 | 0 | 235649 | 0 | 0 | 0 |
| DANIEL J MCKERNAN | |||||||||||||
| 800010 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 17344 | 0 | 817354 | 0 | 0 | 0 |
| RONALD E MUSIC | |||||||||||||
| 165006 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 17344 | 0 | 182350 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COUNTY OF FULTON OHIO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 346400540 | IssuerEIN |
| CUSIP Number | 360241AA1 | CUSIPNumber |
| Date Issued | 2005-12-01 | DateIssued |
| Issue Price | 28500000 | IssuePrice |
| Description Of Purpose | FUNDS FOR EXPANSION AND RENOVATION AND CURRENT BOND REFUNDING | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 29238057 | TotalProceeds |
| Issuance Costs From Proceeds | 310443 | IssuanceCostsFromProceeds |
| Working Capital Expenditures | 231601 | WorkingCapitalExpenditures |
| Capital Expenditures | 17546274 | CapitalExpenditures |
| Year Of Subst Completion | 2009 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 1 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 1 | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | 1 | BondCounselRoutinelyEngaged |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 1 | HedgeIdentifiedInBooksAndRecds |
Name Of Hedge Provider NameOfHedgeProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MORGAN STANLEY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 30.000000000000 | TermOfHedge |
| Superintegrated Hedge | 0 | SuperintegratedHedge |
| Hedge Terminated | 0 | HedgeTerminated |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 1 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| FORM 990, SCHEDULE K, PART III, LINE 3A: | FOOTNOTE: MANAGEMENT CONTRACTS DO NOT RESULT IN PRIVATE BUSINESS USE UNDER THE SAFE-HARBOR PROVISIONS OF REVENUE PROCEDURE 97-13. |
| FORM 990, SCHEDULE K, PART III, LINE 3B: | FOOTNOTE: FULTON COUNTY HEALTH CENTER'S ONCOLOGY DEPARTMENT PARTICIPATES IN THE TOLEDO ONCOLOGY PROGRAM. THIS AGREEMENT DOES NOT RESULT IN PRIVATE BUSINESS USE FOR FULTON COUNTY HEALTH CENTER. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PROVIDED TO AND REVIEWED BY THE ORGANIZATION'S GOVERNING BODY INCLUDING DARRELL TOPMILLER, DIRECTOR OF FINANCE, THE BOARD OF DIRECTORS, AND DEAN BECK, THE ORGANIZATION'S ADMINISTRATOR, BEFORE THE FORM IS FILED. | |
| CONFLICT OF INTEREST QUESTIONNAIRES ARE DISTRIBUTED ANNUALLY TO THE BOARD OF DIRECTORS AND DEPARTMENT HEADS. VENDORS ARE REVIEWED REGULARLY BY DEPARTMENT HEADS TO DETERMINE IF ANY RELATIONSHIPS EXIST PER THE CONFLICT OF INTEREST QUESTIONNAIRES. AN OFFICER, DIRECTOR, OR KEY EMPLOYEE WHO HAS A CONFLICT OF INTEREST SHALL DISCLOSE THE CONFLICT OF INTEREST WHEN IT ARISES, AND BEFORE ACTION ON THE TRANSACTION OR CLAIM IN QUESTION. DISCLOSURE IS REQUIRED EVEN IF A DECISION CONCERNING THE TRANSACTION OR CLAIM IS NOT SUBJECT TO APPROVAL BY THE OFFICER, DIRECTOR, OR KEY EMPLOYEE OR THE BOARD OR COMMITTEE ON WHICH THE OFFICER, DIRECTOR, OR KEY EMPLOYEE SERVES. THE POLICY PROVIDES A PROCEDURE FOR REPORTING POTENTIAL CONFLICTS WHEN THEY ARISE AND BEFORE ACTION TO APPROVE OR AUTHORIZE THE TRANSACTION IS TAKEN. THE POLICY COVERS DIRECTORS, OFFICERS, EMPLOYEES OR AGENTS OF FULTON COUNTY HEALTH CENTER AND MEMBERS OF COMMITTEES AUTHORIZED TO APPROVE TRANSACTIONS OR ASSERT CLAIMS ON BEHALF OF THE FULTON COUNTY HEALTH CENTER. THE BOARD OF DIRECTORS, OTHER THAN ANY BOARD MEMBER DIRECTLY INVOLVED WITH THE CONFLICT, DETERMINES WHETHER A CONFLICT OF INTEREST INVOLVING AN INDIVIDUAL COVERED BY THE POLICY EXISTS AND REVIEWS ACTUAL CONFLICTS. INDIVIDUALS WITH CONFLICTS ARE NOT PERMITTED TO PARTICIPATE IN DELIBERATIONS OR VOTE TO AUTHORIZE A TRANSACTION OR ASSERTION OF A CLAIM. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE COMPENSATION OF THE ORGANIZATION'S ADMINISTRATOR, DEAN BECK, IS APPROVED BY THE BOARD OF DIRECTORS. THE ORGANIZATION PARTICIPATES WITH THE OHA AND USES THEIR WAGE SURVEYS TO HELP DETERMINE THE ADIMISTRATOR'S COMPENSATION. THE ADMINISTRATOR'S COMPENSATION IS REVIEWED ANNUALLY AND DECISIONS ARE DOCUMENTED IN THE BOARD OF DIRECTOR MEETING MINUTES. THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES ARE REVIEWED BY THE BOARD OF DIRECTORS. THE ORGANIZATION PARTICIPATES WITH THE OHA AND USES THEIR WAGE SURVEYS TO HELP DETERMINE OFFICER COMPENSATION. THE BOARD APPROVES THE COMPENSATION OF EMPLOYEES IN THE AGGREGATE. OFFICER COMPENSATION IS REVIEWED ANNUALLY AND DECISIONS ARE DOCUMENTED IN THE BOARD OF DIRECTOR MEETING MINUTES. THE COMPENSATION REVIEW PROCESS FOR THE ADMINISTRATOR, OFFICERS, AND KEY EMPLOYEES WAS LAST PERFORMED IN OCTOBER 2010. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. | FORM 990, PART VI, SECTION C, LINE 19 | |
| MERRILL NOFZIGER 720 SIEGEL DRIVE ARCHBOLD, OH 43502 DR. LEE DAVIS 629 MEADOW LANE WAUSEON, OH 43567 | PART VI, LINE 9: | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED GAINS ON INVESTMENTS: 148,635. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -1,867,303. K-1 INCOME -966. TOTAL TO FORM 990, PART XI, LINE 5: -1,719,634. | FORM 990, PART XI, LINE 5: |
| COMMITTEE OVERVIEW OF FINANCIAL STATEMENTS | THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS HAS NOT CHANGED SINCE THE PRIOR YEAR. | FORM 990, PART XII, LINE 2C: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|
| FCHC MEDICAL CARE LLC | |||||||||
| 725 S SHOOP AVE | WAUSEON | OH | 435671702 | 010877201 | PHYSICIAN BILLING AND PHYSICIAN PRACTICES | OH | -1466310 | 2352028 | N/A |
| FCHC MEDICAL SERVICES LLC | |||||||||
| 725 S SHOOP AVE | WAUSEON | OH | 435671702 | HOLD LAND | OH | 0 | 452433 | N/A | |