2017-11-03T04:27:32-00:00 2016-12-31 990 2016-01-01 310645626 Fairfield Medical Center FAIR 7406878000 401 North Ewing Street Lancaster OH 431303371 Sky L Gettys CFO Treasurer 2017-11-03 false 127.0.0.1 2017-11-03 16:26:52 ED 3142862017307qw36qjm 2017-11-03 P 68198CF905BABD3D5EE838CAC143C831963E09EB 68198CF905BABD3D5EE838CAC143C831963E09EB 2016 2017-02-10 21:41:12Z John R Janoso Jr 401 North Ewing Street Lancaster OH 43130 303614356 false X www.fmchealth.org X 1982 OH Fairfield Medical Center delivers outstanding healthcare for our patients, their families and our communities. 15 15 2540 264 356542 23777 124272 239245347 257172196 4870552 1553117 3755025 2697047 247894701 261546632 0 0 110986165 117628354 0 0 118863880 125650665 229850045 243279019 18044656 18267613 278507402 291691301 124203212 128102514 154304190 163588787 Fairfield Medical Center delivers outstanding healthcare for our patients, their families and our communities. false false 87997958 123959591 Patient Care Inpatient Medical, Surgical, Emergency, Maternity, ICU, Psychiatry, and Nursing Services 79,477 admissions, procedures visits 84202342 120489820 Patient Care Laboratory, Cardiovascular, Radiology, Therapy, Pharmacy, and Medical Supply Services 2,845,863 procedures dosages 23916211 1086803 Patient Care Nutritional Services 546,967 meals served Patient Care Laundry Services 1,577,382 pounds Patient Care Plant Engineering, Police, Housekeeping, Central Transport, Interest Depreciation 686,778 square feet 196116511 true true false false false false false false false false true false false true true false false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false true true true true true false true 198 0 true 2540 true true true false false false false false false false false false false X 15 15 true false false false false false false true true false false false true true true true true true true true true OH X Sky L Gettys 7406878011 401 North Ewing Street Lancaster OH 431303371 Linda Sheridan Chair 003.00 X X 0 0 0 Ron Burris Vice Chair/Secretary 003.00 X X 0 0 0 Angela Krile Director 002.00 X 0 0 0 Adam Custer Director 002.00 X 0 0 0 Theresa Dyar DO Director 002.00 X 0 0 0 Dan Fruth Director 002.00 X 0 0 0 Barry Ritchey Director 002.00 X 0 0 0 Bradley Hedges PhD Director 002.00 X 0 0 0 Susan Nixon Stoughton Director 002.00 X 0 0 0 Milt Taylor Jr Director 002.00 X 0 0 0 Louis Varga Director 002.00 X 0 0 0 Renee Wagner Director 002.00 X 0 0 0 William Yaple Director 002.00 X 0 0 0 Jeffrey Yenchar MD Director 002.00 X 0 0 0 John R Janoso Jr Director, President CEO 055.00 001.00 X X 458804 0 64655 Sky L Gettys CFO, Treasurer 048.00 002.00 X 309639 0 25787 Terrence B Welsh MD Chief of Medical Affairs 040.00 X 260071 0 22674 Helen F Harding Chief Nursing Officer 040.00 X 199069 0 20324 Martha Buckley MD Chief Quality Officer 040.00 X 327525 0 19521 Debra L Palmer Chief HR Officer 040.00 X 188281 0 20659 Alan F Greenslade Chief Information Officer 040.00 X 196254 0 25673 Randy L Brown Staff Pharmacist 041.00 X 165409 0 16971 Teresa R Ryan Director, Patient Services 040.00 X 151987 0 17221 Jeffrey M Ayers MD Residency Prog. Dir. 030.00 X 144700 0 28563 Pamela L Reed Director OP Services 034.00 X 142674 0 12087 Grant R Brame Physicians Assistant 040.00 X 152552 0 22865 Mina H Ubbing Former President CEO X 511121 0 0 3208086 297000 44 true true false McKesson PO Box 98347 Chicago IL 606930001 Information Technology Services 3650724 Renovo Solutions 1801 E Parkcourt Place Bldg D Santa Ana CA 92701 Biomedical Services 3272738 East Main Shopping 123 S Broad Street Lancaster OH 43130 Real Estate 433277 EMP Management Group Ltd 4535 Dressler Rd NW Canton OH 44718 Physician Services 686000 Bricker & Eckler 100 South Third Street Columbus OH 43215 Attorney Fees 584738 23 124272 124272 Patient Service Revenue Net 257172196 257172196 1528926 643410 496040 147370 147370 41431407 164468 41389675 182009 41732 -17541 24191 Cafeteria Sales 1004487 1004487 Patronage Dividends 900099 520330 520330 Outside Reference Lab 621500 316917 316917 707943 668318 39625 2549677 261546632 668318 356542 1524817 X 0 0 0 0 2159009 850304 1308705 0 89973113 78724814 11248299 4818459 4275581 542878 14027728 11669051 2358677 6650045 5681758 968287 0 1148094 1148094 102700 102700 0 0 24417738 10785207 13632531 0 0 0 0 4566611 4125265 441346 0 0 0 4646458 4228277 418181 0 13561509 9378547 4182962 1585698 1585698 Supplies 55316485 55283470 33015 Physician Fees 9280891 8580194 700697 Other Expenses 11024481 2534043 8490438 0 243279019 196116511 47162508 0 19266404 17387885 15900345 16620644 23951652 30651368 4313915 5462149 4765919 4763905 293991856 171249679 118110827 122742177 59984010 62476167 4515499 4597273 27698831 26989733 278507402 291691301 6501672 7720995 95307216 92791917 1348089 900364 21046235 26689238 124203212 128102514 X 154304190 163588787 154304190 163588787 278507402 291691301 X 18267613 1852554 -10835570 X false true X true false X 0.00000 0.00000 0.00000 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false 6251052 6251041 87455 115431971 59511397 56008029 3206339 2913755 292584 153764869 106084495 47680374 15250170 2740021 12510149 122742177 Financial derivatives and other financial products Closely-held equity interests Unamortized bond financing expense Due from related organizations 6280174 Notes receivable/income guarantee 1112376 Investment in subsidiary 14590476 Other receivables 5006707 Third party settlements 26989733 Federal income taxes Accrued payroll and benefits 18787810 Other Liabilities 6402619 Third Party Settlements 1498809 26689238 true true true X true X true true false true true 2256115 2617619 40179367 29320533 10858834 0.04460 42435482 31938152 10858834 0.04460 2047305 124732 1922573 0.00790 5974209 4322696 1651513 0.00680 17289620 10649749 6639871 0.02730 131353 131353 0.00050 148390 148390 0.00060 25590877 15097177 10493700 0.04310 68026359 47035329 21352534 0.08770 16444 0.00010 13769 0.00010 10497 79733 0.00030 10429 1468 132340 0.00050 true 8954145 1045128 65773340 65401989 371351 X true true Southeast Ohio Sleep Disorders Sleep Lab 0.51000 0.49000 1 1 Fairfield Medical Center 401 North Ewing Street Lancaster OH 43130 www.fmchealth.org X X X 1 1 1 false false true X X X X X X X X 16 true true true true X fmchealth.org X myfdh.org/pdf/2016-Fairfield-County-Community-Health-Assessment.pdf X X true 16 true fmchealth.org false true X 0000000100.000000000000 0000000300.000000000000 X X X true true X X X X true X fmchealth.org X fmchealth.org X fmchealth.org X X X X X true X false X X X X true X false false Group Fairfield Medical Center Line Part V, Section B, Line 5 Fairfield County contracted with the Hospital Council of Northwest Ohio, a non-profit hospital association, to coordinate and manage the health assessment process. During planning meetings, banks of potential survey questions were reviewed and discussed. Based on input from the Fairfield County planning committee, the Project Coordinator composed drafts of surveys containing 116 items for the adult survey and a draft youth survey containing 76 items. The needs of the population, especially those who are medically underserved, low-income, minority populations and populations with chronic disease needs, were taken into account through the sample methodology that surveyed these populations and over-sampled minority populations. Group Fairfield Medical Center Line Part V, Section B, Line 6b The CHNA was conducted in association with Bloom Carroll District Schools, The Fairfield Department of Health, Fairfield Community Health Center, Fairfield County ADAMH Board, Fairfield County Injury Prevention Program, United Way of Fairfield County, Fairfield County Family, Adult and Children First Council, Fairfield County Commissioners Office, Head Start/Fairfield County Community Action and Southeastern Ohio Center for Independent Living. Group Fairfield Medical Center Line Part V, Section B, Line 11 An initial meeting was held in October 2016, to review the process and timeline, as well as choosing priorities based on quantitative and qualitative data to prioritize target impact areas. The health problems were ranked on the basis of magnitude, seriousness of consequences and feasiblity of correcting. To assess resource need, the committee determined existing programs, services and activities in the community that address the priority target impact areas and looked at the number of programs that address each outcome, geographic area served, and prevention programs already in place. It was determined that there would not be sufficient resources to address every outcome in the needs assessment. In addition, Fairfield Medical Center held meetings individually to determine strengths of the hospital to complement what is being done in the community. For instance, we have an in-depth drug prevention/treatment program in place, which is a key area of need. The Hospital Implementation Plan was finalized and approved by the Board in December of 2016. Group Fairfield Medical Center Line Part V, Section B, Line 6a Diley Ridge Medical Center Group Fairfield Medical Center Line Part V, Section B, Line 7d A copy of the full report was given to key leaders at a community event Part II Knowing that a strong economy can help build strong people, we have dedicated ourselves to helping our local economy through donations to organizations helping to draw more business to the area and by participating in local Chambers of Commerce. We also recognize the importance of recycling as a way to improve the health of our planet, and therefore our people, with environmental improvements. Participation with other community entities by Coalition Building also helps us to keep our pulse on the health of the community through grassroots involvement. Part III Line 4 An allowance for uncollectible accounts is established on an aggregate basis by using historical write-off 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 Centers 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. The information can be found on page 8 of the financial statements. Part III Line 8 The total for Medicare Cost is taken directly from the Medicare Cost Report. Part III Line 9b In all instances of debt collection, patients are given information regarding financial assistance available. In addition, patients are made aware of the availability of financial assistance with an acknowledgement letter of services rendered, regardless of ability to pay or payment source. FMC will do everything possible to help those who qualify for charity care to be made aware of the assistance available. We also provide financial counselors to assist patients in filling out the necessary forms for assistance. The following options are available A. Payment in the form of cash, credit card or checks. A discount is offered with payment at the time of service and within 10 days of receiving the hospital bill. B. H.E.L.P. Bank Financial Program C. Hospital Payment Program D. Assistance with application to Medicare or Medicaid E. Hospital Care Assurance Program HCAP F. Hospital Assistance Program summary defining Fairfield Medical Centers financial opportunities. G. Assistance for the uninsured patient. Part VI Line 2 Fairfield Medical Center participates in a Community Health Needs Assessment every three years, as required, and it also stays in constant contact with other health organizations in the community to keep abreast of the health needs that we might not yet be aware of. Part VI Line 3 There are prominent signs at Registration and Collections stating our Financial Assistance Policy. It is also printed on the back of bills that are sent out. The FAP is also posted at the Fairfield County Health Center so that all are aware of our policy. Part VI Line 4 Fairfield Medical Center serves Fairfield County and surrounding counties. We have labs and health centers in outlying areas to better serve those who find it difficult to drive to Lancaster for health needs. Part VI Line 5 We know that a strong economy builds strong people and strong families, so we encourage economic development through donations and service organization participation. We also partner with many organizations in the community to help us keep our pulse on the health of the community, as well as the needs of the community that we may be able to help to meet. We help to build other organizations by helping them to raise funds and by lending valuable skills through Board participation. We also lend expertise by teaching valuable skills to other community organizations. Part VI, Line 7 OH true Fairfield Medical Center Foundation 401 North Ewing Street Lancaster OH 43130 208952945 501c3 402637 1 true true false false false false false true false Mina H Ubbing Former President CEO 511121 511121 Sky L Gettys CFO, Treasurer 308274 1300 18550 7237 335361 Terrence B Welsh MD Chief of Medical Affairs 258563 1508 17347 5327 282745 Helen F Harding Chief Nursing Officer 196946 2123 14149 6175 219393 Randy L Brown Staff Pharmacist 164859 550 11901 5070 182380 Teresa R Ryan Director, Patient Services 151087 900 11147 6074 169208 Jeffrey M Ayers MD Residency Prog. Dir. 143538 1162 10185 18378 173263 Pamela L Reed Director OP Services 141449 1225 8701 3386 154761 John R Janoso Jr Director, President CEO 433804 25000 36550 28105 523459 Martha Buckley MD Chief Quality Officer 324525 3000 18550 971 347046 Debra L Palmer Chief HR Officer 186619 1662 13532 7127 208940 Alan F Greenslade Chief Information Officer 195054 1200 13774 11899 221927 Grant R Brame Physicians Assistant 147226 4403 923 9530 13335 175417 A County of Fairfield Ohio 316400066 304286AM9 2013-06-27 98511516 To refund prior issue and to fund new surgical unit. A 56264480 6320525 926511 35000000 true false false true A false false false false A false false false false false false false false false A false Form 990, Part VI, Section A, Line 2 Various members of the Board of Directors are key employees and/or officers of organizations that may conduct normal, arms length transactions with one another. Form 990, Part VI, Section B, Line 11b The 990 is reviewed by the President and Treasurer of the organization after review by the Controller. Then it is made available for Board Member review prior to filing. Form 990, Part VI, Section B, Line 12c Directors, President, Vice President, Managers, Case Management employees, Contracts Collections employees, employees with direct purchasing responsibilities, employed physicians, and employees who are contracted or shared with other organizations are required to complete an annual questionnaire disclosing potential conflicts of interest. If a known or perceived conflict of interest arises, the Compliance Officer investigates, documents, and works to resolve the conflict of interest. Form 990, Part VI, Section B, Line 15 a b Annually, the Compensation Committee compares officer and key employee compensation to regional industry averages. This committee consists of independent members of the Board of Directors. Compensation adjustment recommendations are submitted, to be included in the budget, to the Finance and Audit Committee. Compensation adjustments are taken to the Board of Directors for final approval, and if approved are then implemented. Form 990, Part VI, Section C, Line 19 The governing documents, conflict of interest, and financials are made available to the public by requests made to FMC management. Form 990, Part IX, Line 11g Other fees for services include lab testing, administrative consulting, outsourced biomedical services, outsourced collection services, outsourced IT services and other general purchased services. Form 990, Part XI, Line 9 The other change in net assets reported represents intercompany transfers between Fairfield Medical Center and related organizations see Schedule R for fixed asset purchases, shared employees, expenses and other intercompany transactions. Home Health Resources 401 North Ewing Street Lancaster OH 43130 311159707 Durable Med. Equip. OH Zane Properties Corporation Fairfield Healthcare Professionals Inc 401 North Ewing Street Lancaster OH 43130 311425884 Physician Practices OH 501c3 11a Fairfield Medical Center false Fairfield Medical Center Foundation 401 North Ewing Street Lancaster OH 43130 208952945 Fundraising OH 501c3 7 N/A false Southeast Ohio Sleep Disorders Center LLC 135 North Ewing Street FL 3 Lancaster OH 43130 311639116 Sleep disorder trmt OH Fairfield Medical Center Related false true 0.51000 Zane Properties Corporation 401 North Ewing Street Lancaster OH 43130 311202009 Holding Company OH Fairfield Medical Center C Corp 1.00000 false true false false false false false true false false false true false false false true true true true false Southeast Ohio Sleep Disorders Center LLC a 42525 Fairfield Healthcare Professionals Inc a 41208 Fairfield Healthcare Professionals Inc g 376192 Zane Properties Corporation k 192540 Fairfield Healthcare Professionals Inc o 8397171 Zane Properties Corporation p 85577 Fairfield Healthcare Professionals Inc q 4760000 Fairfield Healthcare Professionals Inc r 2182244 Zane Properties Corporation q 76235 Zane Properies Corporation r 440014