2011-11-11T09:18:13-06:00 2010-12-31 BLUE & CO LLC 8800 LYRA DRIVE SUITE 450 COLUMBUS OH 43240 990 2010-01-01 344430716 FISHER-TITUS MEDICAL CENTER FISH 4196688101 272 BENEDICT AVENUE NORWALK OH 44857 DUANE WOODS JR 4196688101 2011-11-10 1 NANCY KIRCHNER 6148852583 2010 2016-03-07 17:11:31Z PATRICK MARTIN 272 BENEDICT AVENUE NORWALK OH 44857 141837224 0 X WWW.FTMC.COM X 1911 OH SEE SCHEDULE O 11 9 1111 299 1339412 405543 481897 71950 111328419 111729373 -2391486 -2317815 930556 923594 110349386 110407102 505000 137479 0 0 55493309 57489634 0 0 -5775 50795154 53352621 106793463 110979734 3555923 -572632 178217521 181032523 63557138 61750318 114660383 119282205 X PROVIDE QUALITY HEALTHCARE IN A COST EFFECTIVE MANNER, WHILE RESPECTING THE DIGNITY AND UNIQUENESS OF EACH INDIVIDUAL WE SERVE. 0 0 89640176 137479 103314731 SEE SCHEDULE O 5739534 0 7075230 SEE SCHEDULE O 95379710 1 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0 0 0 0 0 1 0 0 1 1 1 0 0 0 1 1 0 0 0 0 1 135 0 1 1111 1 1 1 0 0 0 0 0 0 0 0 0 X 11 9 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OH X DAVID WILSON MBACMAFHFMA 4196688101 272 BENEDICT AVENUE NORWALK OH 44857 JOHN D PAYNE CPA 8.00 X X 0 0 0 LESLIE D STONEHAM 6.00 X X 0 0 0 MARJORIE A HARPER 3.00 X X 0 0 0 CHARLES F FUREY 5.00 X X 0 0 0 GLENN TRIPPE MD 4.00 X 0 0 0 JAMES E GERKEN 4.00 X 0 0 0 WILLIAM B CORNELL MD 4.00 X 0 0 0 VIRGINIA H POLING 4.00 X 0 0 0 THOMAS C BLEILE 4.00 X 0 0 0 JAMES R RAMSEY 4.00 X 0 0 0 REV FRED WIECHERS 4.00 X 0 0 0 DAVID W DEEHR DO 4.00 X 0 0 0 MATT GROSS 5.00 X 0 0 0 PATRICK J MARTIN 53.00 X X 585668 0 362648 MARGARET BAIRD 60.00 X 309144 0 365052 DUANE WOODS 44.50 X 183100 0 22475 CHERIE M SPRAGG 50.00 X 178181 0 58151 LORNA STRAYER 45.00 X 164127 0 51903 JOHN BRITTON 45.00 X 161653 0 11657 JOHN K HUGHES 40.00 X 172518 0 26081 GEORGE B ELMER 40.00 X 161426 0 24469 CHRISTINA CANFIELD 40.00 X 170999 0 16472 JOHN M KOVESDI 40.00 X 162904 0 21673 JOSEPH E CENTA 40.00 X 334177 0 10192 WENDY MELCHING 24.00 X 107835 0 13985 2691732 0 984758 14 1 1 0 CERNER CORPORATION 2800 ROCKCREEK PARKWAY KANSAS CITY MO 64117 HEALTHCARE INFORMATION TECHNOLOGY 4332522 JANOTTA & HERNER 309 MONROE STREET MONROEVILLE OH 44847 BUILDING CONTRACTOR 1112338 INPATIENT CARE UNIFIED INC PO BOX 389 AKRON OH 44309 HOSPITALISTS 1038094 LABORATORY CORP OF AMERICA PO BOX 12140 BURLINGTON NC 27216 BLOOD ADMINISTRATION 463484 AMERICAN RED CROSS PO BOX 73013 CHICAGO IL 73013 BLOOD TESTING 449759 15 482 71468 45145 71950 NET PATIENT SERVICES 622110 103314731 103314731 NET NURSING HOME & ASS 623000 7075230 7075230 MEDICAL LABORATORY 621500 1335978 1335978 HEALTH AND ALLIED SERV 621990 3434 3434 111729373 536167 536167 28520440 55700 31191943 238179 -2671503 -182479 -2853982 -2853982 CAFETERIA SALES 722210 488474 488474 AUXILIARY SALES 453220 275928 275928 OTHER HOSPITAL REVENUE 900099 159192 159192 923594 110407102 110389961 1339412 -1394221 137479 137479 2453759 1798547 655212 41209712 35342256 5867456 3324397 2851068 473329 6934960 5962225 972735 3566806 3058963 507843 232691 174518 58173 100435 50218 50217 9534121 7138894 2401002 -5775 573723 562930 10793 21449964 20206430 1243534 1964442 249165 1715277 2096912 1518972 577940 117206 107266 9940 307220 88716 218504 1436871 1362171 74700 7139775 6797923 341852 539387 327569 211818 UBI INCOME TAX 158700 158700 BAD DEBT EXPENSES 5860067 5860067 STATE FRANCHISE FEE 1153357 1153357 DUES AND SUBSCRIPTIONS 263376 47902 215474 PHYSICIAN RECRUITMENT 259600 259600 164774 164774 110979734 95379710 15605799 -5775 5475 5475 26296826 17263330 13830675 19438399 286880 258331 669314 2343941 1887494 3010303 1946136 134321801 54415208 77754431 79906593 52155068 57058369 200308 271050 394121 366431 1968042 1933052 178217521 181032523 27725438 27178703 357826 335945 35075000 33945000 398874 290670 63557138 61750318 X 114642162 119263921 18221 18284 114660383 119282205 178217521 181032523 X -572632 5194454 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 8244 8244 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: 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 - 36.64% OF DUES; OHIO HOSPITAL ASSOCIATION - 5% OF DUES; AMERICAN HOSPITAL ASSOCIATION - 24.42% OF DUES. 1165800 1165800 91805807 33363540 58442267 35050284 18590697 16459587 6299910 2460971 3838939 79906593 110407102 110979734 -572632 6085311 -158268 5927043 5354411 117785498 6085311 1602244 7687555 110097943 309159 309159 110407102 112519287 1737778 1737778 110781509 198225 198225 110979734 PART XI, LINE 8 - OTHER ADJUSTMENTS: FASB #158 ADJUSTMENT -97,273. CONSOLIDATING ADJUSTMENT TO DONATIONS ERROR -26,323. CHANGES IN NET ASSETS FOR HEALTH PROMOTIONS OF NORWALK 20,605. FISHER-TITUS PAIN MANAGEMENT JOINT VENTURE CAPITAL CONTRIBUTION 88,200. TRANSFER OF FUNDS TO AFFILIATED ORGANIZATION, NORWALK AREA HEALTH SYSTEMS -500,000. CHANGES IN NET ASSETS FOR FISHER TITUS PAIN MANAGEMENT 441,134. CHANGES IN NET ASSETS FOR FISHER TITUS AUXILIARY -84,611. PART XII, LINE 2D - OTHER ADJUSTMENTS: TRANSFER TO AFFILIATED ENTITY NORWALK AREA HEALTH SYSTEMS -500,000. FASB 158 PROVISIONS -97,273. HEALTH PROMOTIONS OF NORWALK REVENUE 402,105. FISHER-TITUS PAIN MANAGEMENT LLC REVENUE 1,797,412. PART XII, LINE 4B - OTHER ADJUSTMENTS: HOSPITAL AUXIIARY REVENUE 276,448. HOSPITAL EXPENSE ADJUSTMENTS TO REVENUES 6,388. CONSOLIDATING ADJUSTMENT DONATIONS 26,323. PART XIII, LINE 2D - OTHER ADJUSTMENTS: HEALTH PROMOTIONS OF NORWALK EXPENSES 381,500. FISHER-TITUS PAIN MANAGEMENT LLC EXPENSES 1,356,278. PART XIII, LINE 4B - OTHER ADJUSTMENTS: HOSPITAL AUXILIARY EXPENSES 191,837. HOSPITAL EXPENSE ADJUSTMENTS TO REVENUES 6,388. 1 1 X 1 X 1 X 1 1 1 0 1 1 1 2562 2293325 464062 1829263 0.01740 1 16285 10754327 6541174 4213153 0.03800 2 18847 13047652 7005236 6042416 0.05540 754 63533 1007633 64169 943464 0.00850 48 171 64557 8835 55722 0.00050 4 878876 145961 732915 0.00660 355753 355753 0.00320 806 63704 2306819 218965 2087854 0.01880 808 82551 15354471 7224201 8130270 0.07420 1 614 5578 5578 0.00010 1 160 322 322 0.00000 9 901 11668 11668 0.00010 11 1675 17568 17568 0.00020 1 2881005 864301 24506049 30940547 -6434498 X 1 1 1 NORTH CENTRAL CARENET PHYSICIAN-HOSPITAL ORGANIZATION 0.50000 0.05060 0.44940 2 FISHER-TITUS PAIN MANAGEMENT LLC PAIN MANAGEMENT 0.51000 0.49000 1 1 FISHER-TITUS MEMORIAL HOSPITAL

272 BENEDICT AVENUE NORWALK OH 44857

X X X FISHER-TITUS MEMORIAL HOSPITAL 1 2 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 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 2010. THE COSTING METHODOLOGY USED FOR THE UNREIMBURSED MEDICAID SEGMENT OF THE LINE 7 TABLE WERE CALCULATED USING A COST TO CHARGE RATIO EXTRACTED FROM THE MEDICAID COST REPORT DATA. THE COSTING METHODOLOGY USED FOR "OTHER BENEFITS" SEGMENT OF THE LINE 7 TABLE WERE CALCULATED USING A COMBINATION OF DIRECT COSTS AND OUR COST ACCOUNTING SYSTEM, WHICH TAKES INTO CONSIDERATION ALL PATIENT TYPES AND SEGMENTS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 5860067. PART I, LINE 3C: NOT APPLICABLE PART I, LINE 6A: NOT APPLICABLE PART I, LINE 7G NOT APPLICABLE PART II: IN 2010, FISHER-TITUS'S COMMUNITY BUILDING ACTIVITIES AND BENEFITS PROVIDED $15 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 ACTIVITES. FTMC EMPLOYEES SERVE ON COMMUNITY AND CIVIC BOARDS, HEALTH-ORIENTED ORGANIZATONS, 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 2010. CHARITY IN BAD DEBT EXPENSE: PART III, LINE 3 AS A TAX-EXEMPT HOSPITAL, WE MUST PROVIDE NECESSARY MEDICAL CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES PROVIDED. AS A NOT-FOR-PROFIT, PATIENT CARE IS PROVIDED TO ALL, REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR CARE. MAKING QUALITY PATIENT CARE AVAILABLE TO ALL IN OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC MEANS, QUALIFIES BAD DEBTS AS COMMUNITY BENEFIT. THE IDENTIFICATION OF PATIENTS ELIGIBLE FOR CHARITY CARE IS SOLELY BASED ON THE COOPERATION OF THE PATIENT TO PROVIDE THE ORGANIZATION ENOUGH FAMILY AND FINANCIAL INFORMATION TO DETERMINE ELIGIBILTY TO MATCH OUR PROGRAMS. HISTORICALLY, IN ADDITION TO THE INTERNALLY IDENTIFIED CHARITY, 13-15% OF THE ACCOUNT BALANCES TURNED TO COLLECTION WERE SUBSEQUENTLY IDENTIFIED BY THE AGENCY AS CHARITY AND RETURNED. THIS CHARITY IS RECORDED ONLY WHEN IT HAS BEEN IDENTIFIED THROUGH VERIFICATION OF INABILITY TO PAY. WE DO BELIEVE THERE IS A SECOND, RELATIVELY EQUAL SEGMENT OF THE BAD DEBT THAT WOULD QUALIFY FOR CHARITY. PATIENTS WITH POOR CREDIT RATINGS AND MULTIPLE CREDITORS MAKING COLLECTION EFFORT FINDS LITTLE VALUE IN COMPLETING THE CHARITY APPLCIATION PROCESS TO ONLY ELIMINATE ONE CREDITOR AND HAVE NO IMPROVEMENT TO THEIR FINANCIAL STATUS.WE ESTIMATE THAT UNDER THE CURRENT ECONOMIC CONDITIONS UNIDENTIFIED CHARITY IN BAD DEBT EXPENSE IS ESTIMATED TO BE AN ADDITIONAL $864,301 OR 30% OF BAD DEBT AT COST. 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 REASONABLE ESTIMATE OF THIS CHARITY CARE VALUE. FOOTNOTE "ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS": PART III, LINE 4 THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN THE HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON SPECIFIC ACCOUNTS, HISTORICAL WRITE OFF EXPERIENCE AND CURRENT MARKET CONDITIONS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH THE MOST UP TO DATE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. PART III, LINE 8: FISHER-TITUS MEDICAL CENTER'S MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO EXTRACTED FROM THE MEDICARE COST REPORT DATA. THE MEDICAL CENTER BELIEVES THAT ALL OF THE 6.4 MILLION DOLLAR SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT, BECAUSE OUR MISSION IS TO PROMOTE HEALTH IN THE COMMUNITY AND WE DO NOT LIMIT THE CARE AVAILABLE TO ANY PATIENTS, INCLUDING THOSE COVERED BY MEDICARE. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY. THIS YEAR, MEDICARE ACCOUNTED FOR 44% OF HOSPITAL REVENUES AND THESE MEDICARE BENEFICIARIES WERE PROVIDED CARE IN SPITE OF THIS SHORTFALL. CARING FOR THE MEDICARE BENEFICIARIES RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE TRUE COST FOR THEIR CARE AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. TAX EXEMPT HOSPITALS ARE ALSO EXPECTED TO PARTICIPATE IN THE MEDICARE PROGRAM. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE MEDICAL CENTER IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. PART III, LINE 9B THE CHARITY POLICY IS A SUBSET OF THE OVERALL COLLLECTION POLICY. WHEN PATIENTS ARE IDENTIFIED AS QUALIFYING FOR ANY OF THE CHARITY CATEGORIES WE SEARCH ACCOUNTS RECEIVABLE AND ACCOUNTS PLACED WITH COLLECTION AGENCIES AND PACKAGE THEM WITH THE APPLICATION. IN ADDITION, CHARITY INFORMATION IS SHARED WITH OUR RELATED ORGANIZATIONS AND FORMS THE BASIS FOR THEIR CHARITY ADJUSTMENTS. IN ADDITON, WITH PATIENT APPROVAL, WE MAY CONTACT LOCAL PHYSICIAN PRACTICES WITH THE INFORMATION AS MANY WILL ADJUST THEIR BALANCES BASED UPON THE INFORMATION PROVIDED. PART VI, LINE 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, ETC. FTMC IS VERY PROACTIVE IN TAKING THE MESSAGE TO THE 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, 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 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 2010 WITH AN ANNUAL AVERAGE OF 13.5%. THE LARGEST PERCENTAGE OF RESIDENTS ARE 65 AND OLDER. 92% OF THE RESIDENTS ARE CAUCASIAN WITH A GROWING HISPANIC POPULATION OF 5.6% THE MEDIAN HOUSEHOLD INCOME IN 2010 WAS $46,542 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 6: 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. PART VI, LINE 2 FISHER-TITUS SPONSORED AND COLLABORATED WITH THE HURON COUNTY HEALTH DEPARTMENT AND OTHER HEALTH-RELATED ORGANIZATONS (CALLED HURON COUNTY HEALTH PARTNERS) TO DEVELOP AND FUND THE HURON COUNTY NEEDS ASSESSMENT IN 2007. 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 THE COMMUNITY. FROM THESE PRIORITIES, FTMC HAS DEVELOPED NUMEROUS PROGRAMS TARGETING THE HURON COUNTY'S HIGH RATE OF OBESITY, DIABETES AND CARDIOVASCULAR ISSUES. PROGRAMS INCLUDED 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. 1 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 15000 HELP THE LOCAL COMMUNITY IN PROVIDING LOW-COST HEALTH CARE 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 AMERICAN RED CROSS PO BOX 73013 CHICAGO IL 60673 501(C)(3) 15887 CONTRIBUTE FUNDS TO HAITI RELIEF FUND NORWALK ECONOMIC DEVELOPMENT CORP 10 1/2 WEST MAIN STREET NORWALK OH 44857 341787391 501(C)(3) 5000 CONTRIBUTION TO THE NORWALK ECONOMIC DEVELOPMENT CORP TO HELP THE LOCAL COMMUNITY AMERICAN HEART ASSOCIATION 5455 N HIGH ST COLUMBUS OH 43214 501(C)(3) 17500 CORPORATE SPONSORSHIP FOR THE HURON COUNTY HEART WALK SHELBY CHRISTIAN & MISSIONARY ALLIANCE CHURCH 105 E SMILEY AVENUE SHELBY OH 44875 341354574 501(C)(3) 43951 FMV MISCELLANEOUS OPERATING ROOM MEDICAL SUPPLIES DONATED MISCELLANEOUS OPERATING ROOM MEDICAL SUPPLIES TO CHURCH THIRD WORLD MISSION SHELBY CHRISTIAN & MISSIONARY ALLIANCE CHURCH 105 E SMILEY AVENUE SHELBY OH 44875 341354574 501(C)(3) 25849 FMV MISCELLANEOUS CATH LAB MEDICAL SUPPLIES DONATED MISCELLANEOUS CATH LAB MEDICAL SUPPLIES TO CHURCH THIRD WORLD MISSION VILLAGE OF WAKEMAN 59 HYDE STREET WAKEMAN OH 44889 80592 BOOK BUILDING & LAND DONATED BUILDING TO LOCAL GOVERNMENT MUNICIPALITY FOR USE AS A COMMUNITY CENTER NORTH CENTRAL STATE COLLEGE 2441 KENWOOD CIRCLE MANSFIELD OH 44901 20000 FMV PATIENT BEDS DONATED USED PATIENT BEDS TO BE UTILIZED IN THE NURSING LABS 7 2 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE MEDICAL CENTER REVIEWS EACH GRANT OR DONATION REQUEST BEFORE IT IS MADE. X X X X X X 0 1 0 0 0 0 0 0 0 PATRICK J MARTIN 429592 0 113659 0 42417 0 340126 0 22522 0 948316 0 0 0 MARGARET BAIRD 238992 0 26563 0 43589 0 345331 0 19721 0 674196 0 0 0 DUANE WOODS 142194 0 25684 0 15222 0 7499 0 14976 0 205575 0 0 0 CHERIE M SPRAGG 134502 0 4297 0 39382 0 47471 0 10680 0 236332 0 0 0 LORNA STRAYER 132392 0 17501 0 14234 0 29395 0 22508 0 216030 0 0 0 JOHN BRITTON 132440 0 16160 0 13053 0 10847 0 810 0 173310 0 0 0 JOHN K HUGHES 155308 0 0 0 17210 0 6614 0 19467 0 198599 0 0 0 GEORGE B ELMER 134429 0 16556 0 10441 0 4983 0 19486 0 185895 0 0 0 CHRISTINA CANFIELD 119706 0 23040 0 28253 0 3475 0 12997 0 187471 0 0 0 JOHN M KOVESDI 149993 0 0 0 12911 0 4118 0 17555 0 184577 0 0 0 JOSEPH E CENTA 98136 0 0 0 236041 0 1290 0 8902 0 344369 0 0 0 WENDY MELCHING 77790 0 15001 0 15044 0 4398 0 9587 0 121820 0 0 0 SUPPLEMENTAL INFORMATION PART III PART 1 LINE 4B - INCLUDED IN MR. MARTIN'S TOTAL CONTRIBUTIONS TO DEFERRED COMPENSATION OF $340,126 IS $93,459 OF VESTED DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $246,667 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 $585,668 IS $180,860 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 $309,144 IS $129,282 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 $345,331 IN COLUMN C IS $166,207 OF VESTED DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTION AND $179,124 FOR THE CURRENT YEAR ACCRUAL OF A NON-VESTED, NON-QUALIFIED RETIREMENT PLAN. SUPPLEMENTAL INFORMATION PART III PART II LINE 3 - INCLUDED IN DUANE WOOD'S TOTAL W-2 COMPENSATION OF $183,100 IS $28,014 WHICH REPRESENTS THE PORTION OF MR. WOOD'S SALARY ALLOCABLE TO THE NORWALK MEMORIAL HOME, A DIVISION OF FISHER-TITUS MEDICAL CENTER. 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 28838308 564200 7215711 21058397 2008 1 0 1 1 30714144 524983 263425 27308799 2616937 2005 1 0 1 1 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 PART I, LINE A SERIES 2007A BONDS: PURPOSE WAS TO ACQUIRE, CONSTRUCT AND INSTALL A VASCULAR HEART ADDITION TO THE HOSPITAL'S MAIN CAMPUS AS WELL AS SUPPORT SERVICES AND THE RENOVATION OF THE EXISTING EMERGENCY ROOM. PART I, LINE B SERIES 2003A BONDS: PURPOSE WAS TO ACQUIRE, CONSTRUCT AND INSTALL A MULTI-STORY ADDITION TO THE HOSPITAL'S MAIN CAMPUS DEVOTED TO INPATIENT SERVICES AS WELL AS SUPPORT SERVICES AND THE RENOVATION OF SEVERAL AREAS OF THE EXISTING FACILITY. PART II, COLUMN A, LINE 3 INLCUDED IN THE TOTAL PROCEEDS OF $28,838,308 IS INVESTMENT EARNINGS OF $175,711. 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 PORTION OF THE SERIES 2003A. 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. CHRISTINA CANFIELD PRIVATE PRACTICE OPERATING LOANS X 373304 257848 0 1 1 JOSEPH CENTA PRIVATE PRRACTICE GUARANTEE AGREEMENT BEFORE PRACTICE ACQUISITION. X 889562 29032 0 1 1 286880 MRS JOHN BRITTON SPOUSE OF KEY EMPLOYEE 52075 EMPLOYEMENT 0 BAYLESS PATHMARK DIRECTOR WILLIAM CORNELL IS A PARTNER OF BAYLESS PATHMARK. 130000 INDEPENDENT CONTRACTOR 0 SCHEDULE L, TRANSACTIONS WITH INTERESTED PERSONS PART II, LOANS TO INTERESTED PERSON - DR. CANFIELD 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 ITS 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, OHIO. WAKEMAN, OHIO IS WITHIN THE SERVICE AREA OF FISHER-TITUS MEDICAL CENTER AND IS AN UNDERSERVED AREA, WITH NO OTHER PROVIDERS AND A HIGHER PORPORTION 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 OF 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 AEA.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 LIABIITY COMPANY. FISHER-TITUS MEDICAL CENTER IS THE SOLE MEMBER OF THE LLC. THE PURCHASE PRICE FOR 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 THE LINES OF CREDIT ON WHICH SHE WAS PERSONALLY OBLIGATED. DR. CANFIELD SIMULTANEOUSLY BECAME AN EMPLOYEE OF THE LLC. THE EMPLOYMENT AGREEMENT ALSO PROVIDED FOR A DEDUCTION AGAINST HER COMPENSATION TO BE APPLIED TO OUTSTANDING BALANCES ON THE LINES OF CREDIT. BOTH TRANSACTIONS WERE INTENDED TO FACILITATE REPAYMENT OF THE ADVANCES TO FISHER-TITUS MEDICAL CENTER. SCHEDULE L, TRANSACTIONS WITH INTERESTED PERSONS PART II, LOANS TO INTERESTED PERSON - DR. CENTA IN DECEMBER OF 2005, DR. CENTA ENTERED INTO A GUARANTEE AGREEMENT FOR ASSISTANCE IN ESTABLISHING A SURGICAL PRACTICE IN THE MEDICAL CENTER'S SERVICE AREA. THE ADVANCES WERE NECESSARY TO IMPROVE THE QUALITY OF HEALTH CARE IN THE 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. IN ADDITION, THE RECRUITMENT OF DR. CENTA SUPPORTED THE ESTABLISHMENT OF TRAUMA SERVICES IN THE MEDICAL CENTER'S 40-MILE SERVICE AREA. START UP AND OPERATING EXPENSES WERE ADVANCED TO SUPPORT THE PRACTICE OVER A THREE YEAR PERIOD IN EXCHANGE FOR THE GUARANTEE THAT DR. CENTA PRACTICE IN THE AREA FOR 5 YEARS. AS TIME EXPIRED ON THE 5 YEAR AGREEMENT TO SERVE THE LOCAL POPULATION, A PRORATED SHARE OF THE ADVANCES WERE FORGIVEN AND REPORTED AS INCOME TO DR. CENTA ANNUALLY. THE REMAINING BALANCE AT THE END OF 2010 IS REPORTED ON SCHEDULE L. SUBSEQUENT TO THE END OF THE 5 YEAR GUARANTEE PERIOD, DR. CENTA SOLD THE CORPORATION 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 FOR THE ASSETS WAS BASED ON AN INDEPENDENT APPRAISAL. DR. CENTA SIMULTANEOUSLY BECAME AN EMPLOYEE OF THE LLC. X 1 45145 FAIR MARKET VALUE 0 1 0 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 2010, THE HOSPITAL PROVIDED 18,106 DAYS OF DAYS OF INPATIENT CARE TO 4,545 PATIENTS. THE HOSPITAL ALSO PROVIDED 83,055 PATIENTS WITH 131,029 OUTPATIENT VISITS, AND THERE WERE 25,849 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 2010, THE HOME SERVED 404 RESIDENTS AND PROVIDED 23,780 DAYS OF CARE. THE HOME HEALTH CENTER HOME HEALTH AGENCY THE HOME HEALTH CENTER PROVIDED 14,677 HOME VISITS TO 410 DIFFERENT PATIENTS IN 2010. THE CARRIAGE HOUSE OF FISHER-TITUS OPENED IN 1998, THE CARRIAGE HOUSE IS A 48 UNIT ASSISTED LIVING FACILITY WHICH PROVIDED 16,755 DAYS OF ASSISTED LIVING CARE TO 61 RESIDENTS IN 2010. PROGRAM EXPENSION, IMPROVEMENTS, AND ACCREDITATIONS AMERICA'S FIRST ALL-DIGITAL SMART HOSPITAL: AT MIDNIGHT ON APRIL, 27, 2010, FISHER-TITUS MEDICAL CENTER BECAME THE NATION'S FIRST ALL-DIGITAL SMART COMMUNITY HOSPITAL BY IMPLEMENTING A FULLY INTEGRATED ELECTRONIC HEALTH RECORD SYSTEM AND INTERACTIVE TECHNOLOGY IN "SMART" HOSPITAL ROOMS TO EMPOWER PATIENTS TO MORE ACTIVELY PARTICIPATE IN THEIR CARE. IN PARTNERSHIP WITH LEADING INTERNATIONAL HEALTH-CARE TECHNOLOGY COMPANY, CERNER CORPORATION, FISHER-TITUS PHYSICIANS, CAREGIVERS, AND EMPLOYEES, REPRESENTING ALL AREAS OF THE MEDICAL CENTER, HELPED DESIGN THE SYSTEM TO ENHANCE CLINICAL QUALITY, PATIENT SAFETY, AND COORDINATION OF CARE. FISHER-TITUS IS NOW AMONG JUST 5% OF HOSPITALS IN THE NATION HAVING THIS LEVEL OF MEDICAL TECHNOLOGY, BRINGING US TO AN EVEN GREATER LEVEL OF SAFE AND HIGH-QUALITY PATIENT-FOCUSED CARE. ELECTRONIC MEDICAL RECORDS - FISHER TITUS MEDICAL CENTER REACHED A HIMSS LEVEL 6 (THE HIGHEST LEVEL BEING LEVEL 7) FOR ELECTRONIC MEDICAL RECORD (EMR) ADOPTION. FTMC IS AMONG 4% OF HOSPITALS THAT HAVE ACHIEVED THIS LEVEL OF TECHNOLOGY TOWARDS A PAPERLESS PATIENT RECORD ENVIRONMENT. 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 CURRRENT AND FUTURE CAREGIVERS, AND WE WORK WITH EHOVE, FIRELANDS BGSU, 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 FINANCIAL ASSISTANCE TO COMMUNITY MEMBERS AND MEDICAL CENTER EMPLOYEES TO PURSUE TRAINING IN MEDICAL "SHORTAGE" AREAS, SUCH AS REGISTERED NURSING, RESPIRATORY THERAPY, RADIOLOGY TECHNOLOGISTS, REHABILITIATION SPECIALISTS, AND LABORATORY TECHNICIANS. AWARDS AND ACCREDITATIONS: THROUGHOUT THE YEARS, FTMC HAS BEEN HIGHLY SUCCESSFUL IN MEETING THE CHALLENGES OF AN INCREASINGLY COMPLEX HEALTHCARE 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 AMERICAN OSTEOPATHIC ASSOCIATION(AOA). FTMC WAS RE-ACCREDITIED BY BOTH ORGANIZATIONS IN 2009. IN 2010, FTMC WAS THE FIRST AREA HOSPITAL DESIGNATED AS A LEVEL 3 TRAUMA CENTER. FTMC WAS ACCREDITIED IN 2010 AS A PRIMARY STROKE CENTER BY THE JOINT COMMISSION AND WAS THE FIRST HOSPITAL BETWEEN CLEVELAND AND TOLEDO TO ACHIEVE THIS DESIGNATION. THE MEDICAL CENTER'S FOCUS ON QUALITY CARE AND EXCEPTIONAL SERVICE IS EVIDENCED BY THE MANY AWARDS AND RECOGNITIONS EARNED IN 2010 INCLUDING THE FOLLOWING: TOP 100 BEST PLACES TO WORK IN HEALTHCARE/MODERN HEALTH CARE MAGAZINE: FTMC EMPLOYS 950 AREA RESIDENTS AND IS THE SECOND LARGEST EMPLOYER IN HURON COUNTY. IN 2010 FTMC WAS RECOGNIZED FOR THE THIRD CONSECUTIVE YEAR AS ONE OF THE TOP 100 BEST PLACES TO WORK IN HEALTHCARE BY MODERN HEALTHCARE MAGAZINE AND WAS THE ONLY HOSPITAL IN OHIO TO ACHIEVE THIS RECOGNITION 3 YEARS IN A ROW. HEALTHGRADES OUTSTANDING PATIENT EXPERIENCE AWARD 2010: FOR TWO YEARS IN A ROW, FTMC WAS RECOGNIZED AMONG THE NATION'S TOP 10 PERCENT OF HOSPITALS NATIONWIDE FOR PATIENT EXPERIENCE. HEALTHGRADES IS THE NATION'S LEADING HEALTH-CARE RATINGS ORGANIZATION. AMERICAN HEART ASSOCIATION FIT-FRIENDLY HOSPITAL: FTMC EARNED 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 FITNESS CENTER, SMOKING CESSATION PROGRAMMING, AND THE FISHER-TITUS STRIDERS WALKING PROGRAM. AMERICAN ASSOCIATION FOR RESPIRATORY CARE'S QUALITY RESPIRATORY CARE RECOGNITION: FTMC'S PULMONARY MEDICINE DEPARTMENT WAS NAMED A "QUALITY RESPIRATORY CARE PROVIDER" FOR THE SEVENTH CONSECUTIVE YEAR. FTMC IS THE ONLY AREA HOSPTIAL TO HAVE RECEIVED THIS AWARD EVERY YEAR SINCE THE PROGRAM'S INCEPTION IN 2003. JUST 15% OF U.S. HOSPITALS HAVE EARNED THIS RECOGNITION. EXCELLENT PHYSICIANS: FTMC IS COMMITTED TO RECRUITING PHYSICIANS TO SERVE THE UNIQUE HEALTH-CARE NEEDS OF OUR COMMUNITY MEMBERS. IN 2010, WE WELCOMED THESE NEW PHYSICIANS TO OUR MEDICAL STAFF: DR. DONALD SMITH JOINED EXECUTIVE UROLOGY, DR. AMY BROWNE, FAMILY PRACTITIONER, JOINED DR. GOTTFRIED AND ROGERS, AND DR. JONATHAN ZAHLER, OPHTHALMOLOGIST, JOINED NORTH CENTRAL EYE ASSOCIATES. COMMUNITY HEALTH AND OUTREACH PROGRAMS FTMC COMMUNITY BENEFITS EXTEND OUTSIDE OUR WALLS TO FAMILIES, BUSINESSES, SCHOOLS, CHURCHES, AND AND NEIGHBORHOODS THROUGH OUTREACH PROGRAMS AND OTHER COORDINATED CARE ACTIVITES THAT MAKE OUR COMMUNITIES HEALTHIER PLACES TO LIVE, WORK AND WORSHIP. OVER THE PAST TWO YEARS, FISHER-TITUS HAS USED THE 2007 HURON COUNTY HEALTH ASSESSMENT FINDINGS TO DEVELOP PROGRAMS AND WORK IN PARTNERHSIP 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 NEEDS ASSESSMENT IDENTIFIED 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. FTMC SUPPORTS NON-PROFIT COMMUNITY ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICE, AND EMPLOYEE VOLUNTEERISM. MANY OF COUR 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 2010, WE OFFERED COMMUNITY HEALTH EDUCATION PROGRAMS, INCLUDING SCHOOL-BASED PROGRAMS, SUPPORT GROUPS, COMMUNITY-BASED HEALTH FAIRS, AND SCREENING THAT IMPACTED OUR RESIDENTS THROUGH 66,869 ENCOUNTERS. AUXILIARY AND VOLUNTEER SERVICE: DURING 2010, OUR 285 CARING VOLUNTEERS DONATED 58,693 HOURS OF AUXILIARY AND VOLUNTEER SERVICES TO THE MEDICAL CENTER. VOLUNTEERS PROVIDE A VARIETY OF SERVICES INCLUDING HELPING FAMILY MEMBERS, PROVIDING TRANSPORTATION, ASSISTING AT COMMUNITY HEALTH PROGRAMS, DELIVERING REFRESHMENTS, MAIL, AND FLOWERS TO HOSPITAL PATIENTS AND RESIDENTS OF THE NORWALK MEMORIAL HOME, PLUS ESCORTING PATIENTS THROUGHOUT THE BUILDING. THEY ALSO PERFORM CLERICAL DUTIES, STAFF THE MEDICAL CENTER'S GIFT SHOP, AND ORGANIZE SEVERAL FUND-RAISING EVENTS THROUGHOUT THE YEAR. VOLUNTEER "AMBASSADORS" HAVE INSTRUCTED PATIENTS SINCE APRIL, 2010 ON THE USE OF THE TELEVISION/COMPUTER SCREENS LOCATED IN EACH PATIENT ROOM. VOLUNTEERS WORKING IN THIS CAPACITY ARE AT FISHER-TITUS MEDICAL CENTER SEVEN DAYS PER WEEK EACH MORNING FOR 2 HOURS. AMONG THE ITEMS PATIENTS ARE INSTRUCTED ON ARE HOW TO ACCESS THE DAY'S MENU, MEDICAL INFORMATION PERTAINING TO THE PERSON'S HEALTH PROBLEMS, ACCESSING THE INTERNET, PLAYING GAMES, OBTAINING THE NAMES OF CAREGIVERS AS THEY ENTER THE PATIENT'S ROOM, CHOOSING MOVIES, ETC. THE PATIENT 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. PART III, LINE 4A/4B CONTINUED IN APPRECIATION FOR THEIR WORK IN 2010, THE MEDICAL CENTER PROVIDED 8,846 FREE MEALS TO THE VOLUNTEER STAFF AT A COST OF $52,015. COMMUNITY HEALTH IMPROVEMENT SERVICES: NUMEROUS HEALTH SCREENINGS ARE OFFERED THROUGHOUT THE YEAR AT THE MEDICAL CENTER AND AT VARIOUS COMMUNITY LOCATIONS AND EVENTS THROUGHOUT OUR SERVICE AREA. THESE PROGRAMS INCLUDE SCREENING FOR BLOOD PRESSURE, BLOOD GLUCOSE, CHOLESTEROL LEVELS, SKIN CANCER, PROSTATE CANCER, OSTEOPOROSIS AND SCREENING MAMMOGRAMS. IN ADDITION, THE MEDICAL CENTER SPONSORS NUMEROUS SUPPORT GROUPS TO PROVIDE EDUCATION, CARE AND EMOTIONAL SUPPORT TO INDIVIDUALS AND FAMILIES AFFECTED BY DISABILITIES AND CHRONIC MEDICAL CONDITIONS. FTMC'S HEALTH MINISTRY PROGRAM, FORMED IN 2000, HAS BEEN A VERY EFFECTIVE GRASSROOTS INITIATIVE TO GATHER INFORMATION AND PROVIDE HEALTH PROGRAMS THROUGHOUT HURON COUNTY. CURRENTLY 50 AREA CONGREGATIONS ARE MEMBERS OF THE FTMC HEALTH MINISTRY PROGRAM WHICH PROVIDES HEALTH AND WELLNESS INFORMATION AND PROGRAMS IN AREA CHURCHES. THE MEDICAL CENTER IN PARTNERSHIP WITH ITS PHYSICIANS AND OTHER COMMUNITY ORGANIZATIONS PROVIDES PUBLIC FORUMS AND EDUCATIONAL SESSIONS ON A VARIETY OF TOPICS, WHICH ARE SOMETIMES HELD IN TANDEM WITH THE HEALTH SCREENINGS PROVIDED. WE ALSO PROVIDE NUMEROUS HEALTH FAIRS DURING THE YEAR IN SEVERAL LOCATIONS THROUGHOUT THE COUNTY AND SURROUNDING COMMUNITIES. THESE COMMUNITY HEALTH IMPROVEMENT SERVICES BENEFITED 63,533 PEOPLE IN 2010 AT A COST OF $943,464. PROFESSIONAL MEDICAL EDUCATION: THE MEDICAL CENTER SUPPORTS THE FAMILY PRACTICE RESIDENCY PROGRAM AT FIRELANDS REGIONAL MEDICAL CENTER TO ENHANCE THE AVAILABILITY OF FAMILY PRACTICE PHYSICIANS WITHIN THE LOCAL COMMUNITY. FTMC FUNDS THE COST OF A FAMILY PRACTICE RESIDENT THAT SHARES TIME BETWEEN THE HOSPITAL'S EMERGENCY ROOM AND THE COUNTY HEALTH DEPARTMENT CARING FOR THE UNDERSERVED. IN ADDITION, FTMC SUPPORTS AND STAFFS SEVERAL CLASSES FOR HEALTH PROFESSIONALS INCLUDING HEALTHCARE PROVIDER CPR, ADVANCED CARDIAC LIFE SUPPORT, BASIC LIFE SUPPORT INSTRUCTOR COURSE AND PEDIATRIC ADVANCE LIFE SUPPORT. THE TOTAL COST OF PROFESSIONAL MEDICAL EDUCATION PROVIDED TO 171 PARTICIPANTS WAS $55,722. 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 2010 WAS $732,915. PART III, LINE 4A/4B CONTINUED 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 THE 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 2010 WAS $355,753. FORM 990, PART VI, SECTION A, LINE 4 IN MAY 2009, THE BOARD OF TRUSTEES OF FISHER-TITUS MEDICAL CENTER INCREASED THE AUTHORIZED NUMBER OF DIRECTORS OF FISHER-TITUS MEDICAL CENTER WITH VOTING RIGHTS. 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 APPROVING EXECUTIVE COMPENSATION PROGRAMS 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 2010. 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 GAINS ON INVESTMENTS 6,085,311. FASB #158 ADJUSTMENT -97,273. CONSOLIDATING ADJUSTMENT TO DONATIONS ERROR -26,323. NET ASSETS BEGINNING BALANCE FOR HEALTH PROMOTIONS OF NORWALK -175,461. FISHER-TITUS PAIN MANAGEMENT JOINT VENTURE CAPITAL CONTRIBUTION -91,800. TRANSFER OF FUNDS TO AFFILIATED ORG., NORWALK AREA HEALTH SYSTEMS, INC. -500,000. TOTAL TO FORM 990, PART XI, LINE 5: 5,194,454. PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM PRIOR YEARS. 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