2014-11-17T10:31:54-06:00 2013-12-31 351178661 BLUE & CO LLC 8800 LYRA DRIVE SUITE 450 COLUMBUS OH 43240 990 2013-01-01 344430716 FISHER-TITUS MEDICAL CENTER FISH 4196688101 272 BENEDICT AVENUE NORWALK OH 44857 DUANE WOODS JR VP OF FINANCE & CFO 4196688101 2014-11-12 1 ROBERT M MORELAND P00418596 6148852583 2014-11-12 2013 2015-11-30 17:44:51Z LORNA STRAYER 272 BENEDICT AVENUE NORWALK OH 44857 165691251 0 X WWW.FTMC.COM X 1911 OH PROVIDE QUALITY HEALTHCARE IN A COST EFFECTIVE MANNER, WHILE RESPECTING THE DIGNITY AND UNIQUENESS OF EACH INDIVIDUAL WE SERVE. 11 7 1108 251 1090285 94561 36739 78006 113659343 117779460 570568 3408497 1058327 1012473 115324977 122278436 289673 248606 0 0 58430475 60915998 0 0 0 52373485 56329215 111093633 117493819 4231344 4784617 193347072 206627032 71718381 59311711 121628691 147315321 X PROVIDE QUALITY HEALTHCARE IN A COST EFFECTIVE MANNER, WHILE RESPECTING THE DIGNITY AND UNIQUENESS OF EACH INDIVIDUAL WE SERVE. 0 0 95506027 248606 110723043 SEE SCHEDULE O 4873327 7056417 SEE SCHEDULE O 100379354 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 1 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 0 0 1 224 0 1 1108 1 1 1 0 0 0 0 0 0 0 0 0 X 11 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OH X DAVID WILSON MBACMA 4196688101 272 BENEDICT AVENUE NORWALK OH 44857 LESLIE D STONEHAM CHAIRMAN 15.00 X X 0 0 0 CHARLES F FUREY VICE CHAIRMAN - THRU 7/ 2013 8.00 X X 0 0 0 MATT GROSS TREASURER/ VICE CHAIRMAN 12.00 3.00 X X 0 0 0 REV FRED WIECHERS SECRETARY 8.00 X X 0 0 0 JOHN D PAYNE CPA TREASURER/ DIRECTOR 10.00 4.00 X X 0 0 0 PERRY DRYDEN DIRECTOR 4.00 2.00 X 0 0 0 WILLIAM B CORNELL MD DIRECTOR 8.00 X 0 0 0 THOMAS C BLEILE DIRECTOR 8.00 X 0 0 0 VIRGINIA H POLING DIRECTOR 6.00 X 0 0 0 ERIC SCHMIDT MD DIRECTOR 4.00 2.00 X 0 0 0 GLENN TRIPPE MD DIRECTOR 8.00 2.00 X 0 0 0 ROSS MATLACK PRESIDENT - BEGINNING 6/ 2013 49.50 15.50 X X 209686 0 17351 PATRICK J MARTIN PRESIDENT/ SPECIAL PROJECT MGR 49.50 15.50 X X 726735 0 174328 LORNA STRAYER SENIOR VP, ADMIN & BUSINES 50.00 X 221585 0 82967 DUANE WOODS VP OF FINANCE/CFO 44.00 6.00 X 250523 0 47771 GARY MOORMAN VP MEDICAL AFFAIRS THRU 8/2013 45.00 X 260418 0 17949 CHERIE M SPRAGG SENIOR VP OF NURSING SERVI 50.00 X 214581 0 89599 PHILLIP J ANNARINO VP HUMAN RESOURCES 45.00 X 202324 0 44914 JOHN BRITTON VP INFORMATION SERVICES 45.00 X 198490 0 16898 GEORGE B ELMER DIRECTOR OF ASSET MGMT/EMS 50.30 4.70 X 180491 0 26468 MITCH ESCH DIRECTOR OF PHARMACY 40.00 X 162102 0 92512 SUZANNE S INGLIS ASST VP NURSING & SURGICAL SVCS 40.00 X 141440 0 14736 SCOTT P STEINMETZ DIRECTOR OF INFORMATION SVCS 40.00 X 140473 0 13164 SHARON HARWOOD RISK MANAGER 40.00 X 130595 0 40509 3039443 0 679166 24 0 1 0 THE ROBINS & MORTON GROUP 5500 MARYLAND WAY SUITE 100 BRENTWOOD TN 37027 BUILDING CONTRACTOR 6926529 CERNER CORPORATION 2800 ROCKCREEK PARKWAY KANSAS CITY MO 64117 HEALTHCARE INFORMATION TECHNOLOGY 2773201 HOSPITAL MEDICINE ASSOCIATES OF OHIO PO BOX 634850 CINCINNATI OH 45263 HOSPITALIST 2353470 BOSTWICK DESIGN PARTNERSHIP 2729 PROSPECT AVE CLEVELAND OH 44115 ARCHITECTS 868768 LABORATORY CORP OF AMERICA PO BOX 12140 BURLINGTON NC 27216 BLOOD ADMIN & LAB TESTING 717265 18 235 77771 48896 78006 NET PATIENT SERVICES 900099 109632758 109632758 NET NURSING HOME & ASSISTED LIVIN 623000 7056417 7056417 MEDICAL LABORATORY 621500 1055553 1055553 HEALTH AND ALLIED SERVICES 621990 34732 34732 117779460 895926 895926 132 132 45925129 125 43062230 350585 2862899 -350460 2512439 2512439 CAFETERIA SALES 722210 480666 480666 OTHER HOSPITAL REVENUE 900099 273141 273141 AUXILIARY SALES 453220 258666 258666 1012473 122278436 116689175 1090285 4420970 241746 241746 6860 6860 2776120 1784470 991650 41086913 35187078 5899835 4505217 3858295 646922 9346025 8013992 1332033 3201723 2741974 459749 435551 326663 108888 129600 64800 64800 112072 112072 8966150 6486194 2479956 498260 487685 10575 3938240 2254857 1683383 3967275 3054329 912946 1943127 1229743 713384 168497 114466 54031 391312 126304 265008 898577 859736 38841 8628035 8225390 402645 673159 478653 194506 MEDICAL SUPPLIES 16678593 16674833 3760 BAD DEBT EXPENSES 5606219 5606219 OHIO HOSPITAL TAX & SN 1879481 1879481 UBI INCOME TAX 65745 61388 4357 1349322 614198 735124 117493819 100379354 17114465 0 5225 5275 8946760 2435468 12665479 12473388 222121 0 1534477 3470745 2163680 2339813 2040024 2052470 171832970 70452355 88493373 101380615 74581195 79734512 245374 0 229542 217542 2219822 2517204 193347072 206627032 39791474 28754609 292163 270271 31515000 30205000 119744 81831 71718381 59311711 X 121610373 147296985 18318 18336 121628691 147315321 193347072 206627032 X 4784617 7908294 12993719 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 0 1 7483 7483 0 PART II-B, LINE 1: EXECUTIVE MEMBERS OF THE ORGANIZATION, ON AN OCCASIONAL BASIS, MAY WRITE OR SPEAK TO LEGISLATIVE MEMBERS CONCERNING PROPOSED LEGISLATION THAT MIGHT IMPACT THE LOCAL DELIVERY OF HEALTHCARE SERVICES. THE MEDICAL CENTER HAS MEMBERSHIPS IN VARIOUS HEALTHCARE RELATED ASSOCIATIONS, WHICH PROVIDE STATE AND NATIONAL LEADERSHIP ON LEGAL, REGULATORY, QUALITY AND ACCREDITATION ISSUES. AS A PART OF THAT LEADERSHIP ROLE THESE ORGANIZATIONS DO CONTACT LEGISLATORS TO EXPRESS THEIR ASSOCIATION'S POSITIONS ON MATTERS IMPORTANT TO THEIR MEMBERSHIP. THE FOLLOWING ORGANIZATIONS LISTED BELOW SHOW THE PERCENTAGE OF THE DUES THAT REFLECT LOBBYING AS DETERMINED BY THE IRS: OHIO HEALTH CARE ASSOCIATION -19.01% OF DUES; OHIO HOSPITAL ASSOCIATION - 3.4% OF DUES AND AMERICAN HOSPITAL ASSOCIATION - 23.65% OF DUES. 1659169 1659169 110081434 41622339 68459095 53600793 26164835 27435958 6491574 2665181 3826393 101380615 X 146722055 7908294 16926408 24834702 121887353 391083 391083 122278436 120361213 3182659 3182659 117178554 315265 315265 117493819 PART X, LINE 2: MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THESE ENTITIES, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2013 AND 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE, RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. FISHER-TITUS MEDICAL CENTER INDIVIDUAL ACCRUED UNCERTAIN TAX POSITION WAS $0.00 PART XI, LINE 2D - OTHER ADJUSTMENTS: HEALTH PROMOTIONS OF NORWALK REVENUE 499,259. FASB 158 PROVISIONS 5,365,507. RETIRMENT PLAN CURTAILMENT GAIN 7,130,019. FISHER-TITUS PAIN MANAGEMENT LLC REVENUE 4,431,623. TRANSFERS TO AFFILATED ENTITY, NORWALK AREA HEALTH SYSTEMS -500,000. PART XI, LINE 4B - OTHER ADJUSTMENTS: HOSPITAL AUXIIARY REVENUE 258,917. HOSPITAL EXPENSE ADJUSTMENTS TO REVENUES 132,166. PART XII, LINE 2D - OTHER ADJUSTMENTS: HEALTH PROMOTIONS OF NORWALK EXPENSES 464,302. FISHER-TITUS PAIN MANAGEMENT LLC EXPENSES 2,718,357. PART XII, LINE 4B - OTHER ADJUSTMENTS: HOSPITAL AUXILIARY EXPENSES 183,073. HOSPITAL EXPENSE ADJUSTMENTS TO REVENUES 132,166. AUDIT EXPENSE MAPPING ADJUSTMENT 26. 0 0 0 0 0 0 0 0 0 0 MIDDLE EAST AND NORTH AFRICA MEDICAL SUPPLIES TO HOSPITALS IN SYRIA 6860 CARDIOVASCULAR & MISC MEDICAL SUPPLIES FMV 1 0 0 0 0 0 0 1 1 X 1 X 1 X 1 1 1 0 1 1 1 1852 2115804 564992 1550812 0.01390 1 14422734 12207239 2215495 0.01980 2 1852 16538538 12772231 3766307 0.03370 38 65220 823900 57215 766685 0.00690 3 140 97264 7540 89724 0.00080 1 1079779 323840 755939 0.00680 1 47879 47879 0.00040 7 1150 356031 356031 0.00320 50 66510 2404853 388595 2016258 0.01810 52 68362 18943391 13160826 5782565 0.05180 1 42 1873 1873 0.00000 1 13 4089 4089 0.00000 1 107 27766 27766 0.00020 3 162 33728 33728 0.00020 1 5606219 1681866 25691661 33809751 -8118090 X 1 1 1 NORTH CENTRAL CARENET PHYSICIAN-HOSPITAL ORGANIZATION 0.50000 0.06380 0.43620 2 FISHER-TITUS PAIN MANAGEMENT LLC PAIN MANAGEMENT 0.51000 0.49000 1 1 FISHER-TITUS MEMORIAL HOSPITAL 272 BENEDICT AVENUE NORWALK OH 44857 X X X FISHER-TITUS MEMORIAL HOSPITAL 1 1 X X X X X X X X X 11 1 1 1 X WWW.FISHER-TITUS.ORG/COMMUNITY-SERVICES/O X HTTP://WWW.HCNO.ORG/COMMUNITY/REPORT.HTML X X X X X X X X X 0 0 1 1 150.000000000000 1 200.000000000000 1 X X X X X 1 1 X X X X X 1 1 X X X X 1 X 0 1 FISHER-TITUS MEMORIAL HOSPITAL PART V, SECTION B, LINE 3: HURON COUNTY CONTRACTED WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO, A NON-PROFIT HOSPITAL ASSOCIATION LOCATED IN TOLEDO, OHIO TO COORDINATE AND MANAGE THE HEALTH ASSESSMENT PROCESS. THE PROJECT COORDINATOR FROM THE HOSPITAL COUNCIL OF NW OHIO CONDUCTED A SERIES OF MEETINGS WITH THE PLANNING COMMITTEE FROM HURON COUNTY. DURING THESE MEETINGS, BANKS OF POTENTIAL SURVEYQUESTIONS FROM THE BEHAVIORAL RISK FACTOR SURVEILLANCE AND YOUTH RISK BEHAVIOR SURVEILLANCE WERE REVIEWED AND DISCUSSED. BASED ON INPUT FROM THE HURON COUNTY PLANNING COMMITTEE, THE PROJECT COORDINATOR COMPOSED DRAFTS OF SURVEYS CONTAINING 115 ITEMS FOR THE ADULT SURVEY AND 75 ITEMS FOR THE ADOLESCENT SURVEY. THE DRAFTS WERE REVIEWED AND APPROVED BY THE HEALTH RESEARCHERS AT THE UNIVERSITY OF TOLEDO. THE NEEDS OF THE POPULATION, ESPECIALLY THOSE WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS AND POPULATIONS WITH CHRONIC DISEASE NEEDS WERE TAKEN INTO ACCOUNT THROUGH THE SAMPLE METHODOLOGY THAT SURVEYED THESE POPULATIONS. IN ADDITION, THE ORGANIZATIONS THAT SERVE THESE POPULATIONS PARTICIPATED IN THE HEALTH ASSESSMENT PROCESS. THE PARTICIPANTS WHO HAVE A (PH) AFTER THEIR NAME INDICATES THEY WORK IN THE PUBLIC HEALTH FIELD. THE PARTICIPANTS INCLUDED: TIMOTHY HOLLINGER (PH), ANGELA SMITH (PH) AND KATIE SPAAR (PH) ALL FROM HURON COUNTY GENERAL HEALTH DISTRICT; ANNE WAGONER (PH) AND EMILY HUESTISS (PH) BOTH FROM MERCY WILLARD HOSPITAL; LORNA STRAYER (PH) FISHER-TITUS MEDICAL CENTER; JEAN KING (PH) HURON COUNTY ADAMHS BOARD; KARI SMITH (PH) HURON COUNTY BOARD OF DEVELOPMENT DISABILITIES; RENEE GEROME (PH) FIRELANDS COUNSELING & RECOVERY SERVICES; DEBRA FISHER (PH) ERIE-HURON COUNTIES, CAC; CHARLOTTE WAGNER, NORTH POINT EDUCATIONAL SERVICE CENTER DIRECTOR; KIM SCHUBERT, BELLEVUE CITY SCHOOLS SUPERINTENDENT; DAVID STUBBLEBINE, MONROEVILLE LOCAL SCHOOLS SUPERINTENDENT; CAROL GIRTON, NEW LONDON LOCAL SCHOOLS SUPERINTENDENT; DENNIS DOUGHTY, NORWALK CITY SCHOOLS SUPERINTENDENT; BENJAMIN CHAFFEE JR, SOUTH CENTRAL SCHOOLS SUPERINTENDENT; RODGE WILSON, WESTERN RESERVE LOCAL SCHOOLS SUPERINTENDENT AND DAN DANHOFF WILLARD CITY SCHOOLS SUPERINTERDENT. FISHER-TITUS MEMORIAL HOSPITAL PART V, SECTION B, LINE 4: MERCY HOSPITAL OF WILLARD, THE BELLEVUE HOSPITAL AND FIRELANDS REGIONALHOSPITAL (COUNSELING & RECOVERY CENTER) FISHER-TITUS MEMORIAL HOSPITAL PART V, SECTION B, LINE 7: EACH OF THE HEALTH NEEDS LISTED BELOW IS IMPORTANT AND IS BEING ADDRESSED BY NUMEROUS PROGRAMS AND INITIATIVES SUPPORTED BY FISHER-TITUS MEDICAL CENTER AND OTHER COMMUNITY PARTNERS OF THE HOSPITAL. THE MEDICAL CENTER DOES NOT ADDRESS THESE NEEDS LISTED BELOW AS PART OF THIS IMPLEMENTATION PLAN DUE TO LIMITED FINANCIAL AND HUMAN RESOURCES AND THE NEED TO ALLOCATE SIGNIFICANTRESOURCES ON THE THREE PRIORITY HEALTH NEEDS LISTED IN THE IMPLENTATION PLAN. NEEDS NOT ADDRESSED: 1. 12% OF HURON COUNTY ADULTS WERE WITHOUT HEALTH CARE COVERAGE; 2. 22 % OF HURON COUNTY ADULTS ARE DIAGNOSED WITH ARTHRITIS; 3. 10% OF HURON COUNTY ADULTS AND 18% OF YOUTHS WERE DIAGNOSED WITH ASTHMA;4. INSECTS AND MOLD WERE REPORTED AS THE TWO MOST THREATENING ENVIRONMENTAL HEALTH ISSUES BY RESPONDENTS AND 5. 45% OF ADULTS HAD NOT VISITED A DENTIST OR DENTAL CLINIC IN THE PAST YEAR. FISHER-TITUS MEMORIAL HOSPITAL PART V, SECTION B, LINE 17E: AS PART OF ITS FINANCIAL ASSISTANCE POLICY, FISHER - TITUS MEDICAL CENTER (THE HOSPITAL) MAKES A CONCERTED EFFORT TO DETERMINE IF AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE PRIOR TO PROCEEDING WITH COLLECTION ACTIVITIES BY THE HOSPITAL OR BY ENGAGING A THIRD PARTY. THESE EFFORTS INCLUDE NOTIFYING THE INDIVIDUAL OF THE FINANCIAL ASSISTANCE POLICY (FAP) ON ADMISSION, INCLUDING INFORMATION ABOUT THE FAP IN COMMUNICATIONS ABOUT THE INDIVIDUAL'S BILLS AND DOCUMENTING THE HOSPITAL'S DETERMINATION OF AN INDIVIDUAL'S ELIGIBILITY TO RECEIVE ASSISTANCE UNDER THE FAP. IF THE RESULT OF THESE EFFORTS IS UNSUCCESSFUL, THE HOSPITAL WILL PROCEED WITH COLLECTIONS ACTIVITY. THESE ACTIVITIES INCLUDE REPORTING THE INDIVIDUAL TO THE APPROPRIATE CREDIT AGENCY, LEGAL ACTIONS OR LIENS AS DEEMED NECESSARY. IF IT IS DETERMINED THAT AN INDIVIDUAL IS ELIGIBLE UNDER THE FAP SUBSEQUENT TO COLLECTION ACTIVITY BEGINNING, ALL COLLECTION ACTIVITY WILL CEASE. FISHER-TITUS MEMORIAL HOSPITAL PART V, SECTION B, LINE 20D: FISHER - TITUS MEDICAL CENTER INITIALLY CHARGES ALL CLASSES OF PATIENTS THE SAME GROSS CHARGE FOR ANY PARTICULAR SERVICE AND IS REFLECTED AS SUCH ON ALL INITIAL BILLS. AT THE TIME OF ADMISSION, FTMC ATTEMPTS TO COLLECT INFORMATION ON THE INTENDED MEANS OF PAYING FOR SERVICES, INCLUDING DISTRIBUTING INFORMATION ON APPLYING FOR FINANCIAL ASSISTANCE, BUT DO NOT RESTRICT ACCESS BASED ON WHETHER THE INTENDED HAS MEANS OF PAYING FOR SERVICES PROVIDED. PATIENTS WHO APPLY FOR FINANCIAL ASSISTANCE, EITHER AT THE TIME OF SERVICE OF SUBSEQUENT TO THE SERVICES BEING PROVIDED, HAVE THEIR BILLS PUT ON "HOLD" STATUS AS SOON AS PATIENTS MAKE ANY CONTACT WITH OUR FINANCIAL COUNSELING STAFF. UPON REVIEW AND APPROVAL OF APPLICATIONS AND ANY DISCUSSION WITH OUR FINANCIAL COUNSELORS, GROSS CHARGES ARE THEN ADJUSTED ACCORDING TO FTMC CHARITY POLICY BEFORE ANY FURTHER BILLING PROCESSES ARE RESUMED. FISHER-TITUS MEMORIAL HOSPITAL PART V, SECTION B, LINE 22: SEE EXPLANATION OF CHARGES - LINE 20 PART V, SECTION B 19(D) THE DISCOUNT RATE FOR SELF-PAY PATIENTS WAS SET TO MATCH THE RATE OF OUR TWO PREDOMINANT COMMERCIAL INSURANCE CONTRACTS WHICH MAKE UP 2/3RDS OF OUR POPULATION COVERED BY THIRD PARTY INSURANCE. PART V, SECTION B LINE 6 THE ADOPTED IMPLEMENTATION STRATEGY CAN BE FOUND ON THE MEDICAL CENTER'S WEBSITE AT: HTTP://WWW.FISHER-TITUS.ORG/IMAGES/IMPLEMENTATION_STRATEGIES_FOR_2011_CHNA.PDF 2 NORWALK MEMORIAL HOME 272 BENEDICT AVENUE NORWALK OH 44857 INTERMEDIATE & SKILLED NURSING FACILITY THE CARRIAGE HOUSE OF FISHER-TITUS 175 SHADY LANE DRIVE NORWALK OH 44857 ASSISTED LIVING FACILITY PART I, LINE 7: THE COSTING METHODOLOGY USED FOR THE CHARITY CARE SEGMENT OF THE LINE 7 TABLE WAS THE IRS WORKSHEET 1 "CHARITY CARE AT COSTS" IN THE INSTRUCTIONS. COST TO CHARGE RATIOS WERE CARRIED OVER FROM THE IRS WORKSHEET 2 AS A BASIS TO ESTIMATE EXPENSES AND WAS APPLIED TO THE GROSS PATIENT CHARITY CARE CHARGES RECORDED IN 2013. THE COSTING METHODOLOGY USED FOR THE UNREIMBURSED MEDICAID SEGMENT OF THE LINE 7 TABLE WERE CALCULATED USING A COST TO CHARGE RATIO EXTRACTED FROM THE MEDICAID COST REPORT DATA. THE COSTING METHODOLOGY USED FOR "OTHER BENEFITS" SEGMENT OF THE LINE 7 TABLE WERE CALCULATED USING A COMBINATION OF DIRECT COSTS AND OUR COST ACCOUNTING SYSTEM, WHICH TAKES INTO CONSIDERATION ALL PATIENT TYPES AND SEGMENTS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 5,606,219. PART II, COMMUNITY BUILDING ACTIVITIES: IN 2013, FISHER-TITUS'S COMMUNITY BUILDING ACTIVITIES AND BENEFITS PROVIDED $13.9 MILLION TO SUPPORT PROGRAMS THAT IMPACTED THE OVERALL HEALTH OF OUR COMMUNITIES AND THE QUALITY OF LIFE OF OUR RESIDENTS. WHILE HOSPITAL-BASED MEDICAL SERVICES ARE THE MOST OBVIOUS WAY WE HELP, FTMC FULFILLS THE HEALTH-CARE NEEDS OF OUR AREA WITH COMMUNITY HEALTH SCREENINGS, EDUCATION CLASSES, PATIENT ASSISTANCE PROGRAMS AND SUPPORT OF HEALTH-RELATED ACTIVITIES. FTMC EMPLOYEES SERVE ON COMMUNITY AND CIVIC BOARDS, HEALTH-ORIENTED ORGANIZATIONS AND ARE INVOLVED IN ECONOMIC DEVELOPMENT ACTIVITIES THROUGHOUT THE COUNTY. FTMC ALSO WORKS WITH SCHOOLS; WORK SITES AND SAFETY NET PROVIDERS TO PROMOTE HEALTH AND WELLNESS AND PREVENT DISEASE. FISHER-TITUS IS A LEADER IN ENVIRONMENTAL STEWARDSHIP, HAVING EARNED NUMEROUS STATE AND NATIONAL AWARDS. PART III, LINE 4: THE COSTING METHODOLOGY USED FOR COMPLETING THE SCHEDULE H PART III, LINE 2 IS DERIVED FROM THE BAD DEBT EXPENSE INCLUDED IN THE AUDITED FINANCIAL STATEMENTS ADJUSTED BY THE AMOUNT OF THE WRITE-OFFS OF THE ACCOUNTS THAT WENT TO BAD DEBT. COST TO CHARGE RATIOS WERE CARRIED OVER FROM IRS WORKSHEET 2 "RATIO OF PATIENT CARE COSTS TO CHARGES" AS A BASIS TO ESTIMATE EXPENSE AND WAS APPLIED TO THE BAD DEBT EXPENSE RECORDED IN 2013. PART III, LINE 3 AS A TAX-EXEMPT HOSPITAL, WE MUST PROVIDE NECESSARY MEDICAL CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES PROVIDED. AS A NOT-FOR-PROFIT, PATIENT CARE IS PROVIDED TO ALL, REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR CARE. MAKING QUALITY PATIENT CARE AVAILABLE TO ALL IN OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC MEANS, QUALIFIES BAD DEBTS AS COMMUNITY BENEFIT. THE IDENTIFICATION OF PATIENTS ELIGIBLE FOR CHARITY CARE IS SOLELY BASED ON THE COOPERATION OF THE PATIENT TO PROVIDE THE ORGANIZATION ENOUGH FAMILY AND FINANCIAL INFORMATION TO DETERMINE ELIGIBILTY TO MATCH OUR PROGRAMS. HISTORICALLY, IN ADDITION TO THE INTERNALLY IDENTIFIED CHARITY, 13-15% OF THE ACCOUNT BALANCES TURNED TO COLLECTION WERE SUBSEQUENTLY IDENTIFIED BY THE AGENCY AS CHARITY AND RETURNED. THIS CHARITY IS RECORDED ONLY WHEN IT HAS BEEN IDENTIFIED THROUGH VERIFICATION OF INABILITY TO PAY. WE DO BELIEVE THERE IS A SECOND, RELATIVELY EQUAL SEGMENT OF THE BAD DEBT THAT WOULD QUALIFY FOR CHARITY. PATIENTS WITH POOR CREDIT RATINGS AND MULTIPLE CREDITORS MAKING COLLECTION EFFORT FINDS LITTLE VALUE IN COMPLETING THE CHARITY APPLCIATION PROCESS TO ONLY ELIMINATE ONE CREDITOR AND HAVE NO IMPROVEMENT TO THEIR FINANCIAL STATUS.WE ESTIMATE THAT UNDER THE CURRENT ECONOMIC CONDITIONS UNIDENTIFIED CHARITY IN BAD DEBT EXPENSE IS ESTIMATED TO BE AN ADDITIONAL $1,681,866 OR 30% OF BAD DEBT. SINCE THIS CALCUALTION IS ON AN ACCRUAL BASIS, WE BELEIVE ESTIMATING 15% FOR CHARITY TO BE IDENTIFIED IN FUTURE YEARS AND AN ADDITIONAL 15% FOR BALANCES NEVER IDENTIFIED AS CHARITY IS A VERY CONSERVATIVE AND REASONABLE ESTIMATE OF THIS CHARITY CARE VALUE. PART III, LINE 4 THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN THE HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON SPECIFIC ACCOUNTS, HISTORICAL WRITE OFF EXPERIENCE AND CURRENT MARKET CONDITIONS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH THE MOST UP TO DATE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. PART III, LINE 8: FISHER-TITUS MEDICAL CENTER'S MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO EXTRACTED FROM THE MEDICARE COST REPORT DATA. THE MEDICAL CENTER BELIEVES THAT ALL OF THE $8.1 MILLION DOLLAR SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT, BECAUSE OUR MISSION IS TO PROMOTE HEALTH IN THE COMMUNITY AND WE DO NOT LIMIT THE CARE AVAILABLE TO ANY PATIENTS, INCLUDING THOSE COVERED BY MEDICARE. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY. THIS YEAR, MEDICARE ACCOUNTED FOR 44% OF HOSPITAL REVENUES AND THESE MEDICARE BENEFICIARIES WERE PROVIDED CARE IN SPITE OF THIS SHORTFALL. CARING FOR THE MEDICARE BENEFICIARIES RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE TRUE COST FOR THEIR CARE AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. TAX EXEMPT HOSPITALS ARE ALSO EXPECTED TO PARTICIPATE IN THE MEDICARE PROGRAM. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE MEDICAL CENTER IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. PART III, LINE 9B THE CHARITY POLICY IS A SUBSET OF THE OVERALL COLLLECTION POLICY. WHEN PATIENTS ARE IDENTIFIED AS QUALIFYING FOR ANY OF THE CHARITY CATEGORIES WE SEARCH ACCOUNTS RECEIVABLE AND ACCOUNTS PLACED WITH COLLECTION AGENCIES AND PACKAGE THEM WITH THE APPLICATION. IN ADDITION, CHARITY INFORMATION IS SHARED WITH OUR RELATED ORGANIZATIONS AND FORMS THE BASIS FOR THEIR CHARITY ADJUSTMENTS. IN ADDITION, WITH PATIENT APPROVAL, WE MAY CONTACT LOCAL PHYSICIAN PRACTICES WITH THE INFORMATION AS MANY WILL ADJUST THEIR BALANCES BASED UPON THE INFORMATION PROVIDED. PART VI, LINE 2: FISHER-TITUS SPONSORED AND COLLABORATED WITH THE HURON COUNTY GENERAL HEALTH DISTRICT AND OTHER HEALTH-RELATED ORGANIZATIONS (CALLED HURON COUNTY HEALTH PARTNERS) TO DEVELOP AND FUND THE HURON COUNTY HEALTH NEEDS ASSESSMENT IN 2011. LOCAL COMMUNITY AGENCIES WERE INVITED TO PARTICIPATE IN THE HEALTH ASSESSMENT PROCESS, INCLUDING CHOOSING QUESTIONS FOR THE SURVEYS, PROVIDING LOCAL DATA, REVIEWING DRAFT REPORTS AND PLANNING THE COMMUITY RELEASE OF THE DATA AND SETTING PRIORITIES. THERE WERE OVER 50 KEY LEADERS FROM THE COMMUNITY THAT REPRESENTED PUBLIC HEALTH, LAW ENFORCEMENT, SCHOOLS, CHURCHES, LOCAL OFFICIALS, SOCIAL AGENCIES AND OTHER VARIOUS COMMUNITY MEMBERS IN ATTENDANCE AT THE PUBLIC RELEASE OF THECOMMUNITY HEALTH NEEDS ASSESSMENT. AT THE EVENT, PARTICIPANTS, PARTICIPATED IN FOCUS GROUPS AND PRIORITIES WERE CHOOSEN FOR HURON COUNTY TO FOCUS ON OVER THE NEXT FEW YEARS. FTMC ALSO USES THIS INFORMATION TO ADD AND EXPAND SERVICES AND TO RECRUIT PHYSICIANS TO MEET THE THEN IDENTIFIED MEDICAL NEEDS OF OUR COMMUNITY. FROM THESE PRIOTIES, FTMC HAS DEVELOPED NUMEROUS PROGRAMS TARGETING THE HURON COUNTY'S HIGH RATE OF OBESITY, DIABETES AND CARDIOVASCULAR ISSUES. PROGRAMS INCLUDING DIABETESSCREENINGS AT HISPANIC HEALTH FAIRS AND VARIOUS LOCATIONS IN THE COUNTY, NUTRITION AND FITNESS FOR SCHOOL CHILDREN, DEVELOPING A COMMUNITY GARDEN AND A COUNTY-WIDE WALKING PROGRAM IN PARTNERSHIP WITH THE AMERICAN HEART ASSOCIATION AND LOCAL PHYSICIANS AND BUSINESSES. PART VI, LINE 3: PATIENTS ARE INTERVIEWED AFTER REGISTRATION TO ASSIST THEM IN DETERMINING EACH PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS AVAILABLE INTERNALLY AND EXTERNALLY. FTMC HAS BILINGUAL SIGNAGE POSTED IN THE ADMITTING/REGISTRATION AREAS, BILLING OFFICE AND FINANCIAL COUNSELING OFFICES, AND IN THE INPATIENT GUIDES IN ALL PATIENT ROOMS. THE FTMC WEBSITE HAS A SECTION ABOUT THE FINANCIAL ASSISTANCE PROGRAM AND CONTRACT INFORMATION. A MESSAGE ABOUT FINANCIAL ASSISTANCE AND CHARITY CARE ALSO IS INCLUDED ON THE BILLS THAT ARE SENT TO THE PATIENTS. MANY MATERIALS ARE BILINGUAL AND INTERPRETATION SERVICES ARE AVAILABLE. THE MEDICAL CENTER SUPPORTS AN OUTSIDE COUNSELOR DEDICATED TO HELPING PATIENTS BECOME QUALIFIED FOR MEDICAID OR OTHER GOVERNMENT PROGRAMS. THEY ALSO REFER PATIENTS WHO DON'T QUALIFY FOR THOSE PROGRAMS TO OUR FTMC FINANCIAL COUNSELORS FOR ASSISTANCE WITH H.C.A.P., FISHER-TITUS CHARITY AND FISHER-TITUS COMMUNITY ASSISTANCE PROGRAMS. OUR SOCIAL SERVICES DEPARTMENT REGULARLY REFERS PATIENTS IN NEED TO OUR FINANCIAL COUNSELORS FOR ASSISTANCE. WE ALSO TAKE REFERRALS FROM THE LOCAL COUNTY HUMAN SERVICES AGENCIES, VICTIMS OF VIOLENT CRIMES, LOCAL HEALTH DEPARTMENTS, LOCAL LAW ENFORCEMENT AGENCIES, CHURCHES, ETC. FTMC IS VERY PROACTIVE IN TAKING THE MESSAGE TO OUR COMMUNITY. BROCHURES ARE AVAILABLE AT COMMUNITY OUTREACH EVENTS HELD IN THE HOSPITAL AND AT OUTSIDE COMMUNITY EVENTS. FTMC COMMUNICATES THE INFORMATION ABOUT CHARITY CARE PROGRAMS THROUGH ITS COMMUNITY NEWSLETTER AND LOCAL NEWS MEDIA. PART VI, LINE 4: THE FISHER-TITUS MEDICAL CENTER PROVIDES COMPREHENSIVE STATE-OF-THE ART HEALTH CARE SERVICES TO THE RESIDENTS OF HURON, ERIE AND THE ADJACENT SURROUNDING COMMUNITIES WITH THE LATEST MEDICAL ADVANCEMENTS. THE PRIMARY AREA IS THE GREATER HURON COUNTY AREA IN NORTH CENTRAL OHIO, WHICH IS HOME TO AROUND 60,000 RESIDENTS. FTMC'S 50 ACRE CAMPUS IS IN THE COUNTY SEAT OF NORWALK, WHICH IS THE LARGEST CITY IN THE COUNTY WITH OVER 17,000 RESIDENTS. FTMC HAS NUMEROUS MEDICAL OFFICES THROUGHOUT THE COUNTY IN SMALLER CITIES TO PROVIDE EASIER ACCESS TO PHYSICIANS FOR COMMUNITY MEMBERS. THE COUNTY IS HOME TO SEVERAL LARGE MANUFACTURERS WHO HAVE EXPERIENCED MAJOR JOB LOSSES OVER THE PAST 10 YEARS. HURON COUNTY HAD THE SEVENTH HIGHEST UNEMPLOYMENT RATE IN OHIO WITH AN ANNUAL AVERAGE OF 10.8%. THE LARGEST PERCENTAGE OF RESIDENTS ARE CHILDREN UNDER 18 WITH THOSE 65 AND OLDER MAKING UP THE 2ND LARGEST PERCENTAGE. 91% OF THE RESIDENTS ARE CAUCASIAN WITH A GROWING HISPANIC POPULATION OF 5.9%. THE MEDIAN HOUSEHOLD INCOME IN HURON COUNTY (IN 2010 INFLATION-ADJUSTED DOLLARS) WAS $62,033 WITH 12.9% OF THE FAMILIES LIVING BELOW THE POVERTY LEVEL AND 26.3% LIVING BELOW 200% OF THE POVERTY RATE IN 2010. 12% OF HURON COUNTY ADULTS WERE WITHOUT HEALTH COVERAGE. THE OVERALL TRENDS INDICATE A DECLINE IN EMPLOYMENT-BASED MEDICAL INSURANCE AND INCREASING UNINSURED AND RELIANCE ON GOVERNMENT PROGRAMS. PART VI, LINE 5: THE BOARD OF DIRECTORS IS COMPOSED OF AREA RESIDENTS INCLUDING BUSINESS AND COMMUNITY LEADERS, PHYSICIANS AND OTHER INTERESTED PERSONS. THESE VOLUNTEERS GIVE COUNTLESS HOURS OF SERVICE TO THE MEDICAL CENTER IN THEIR OVERSIGHT ROLE. THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS, IN FUNDRAISING, AND IN GENERAL STEWARDHSIP. FTMC'S MEDICAL STAFF IS OPEN AND PRIVILEGES ARE GRANTED TO ALL QUALIFIED PHYSICIANS WHO APPLY AND MEET THE STANDARDS OF THE MEDICAL CENTER PRIVILEGING PROCESS. THE MEDICAL CENTER UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND TO EXPAND ACCESS POINTS OF CARE TO PATIENTS THROUGHOUT THE COMMUNITY INCLUDING, BUT NOT LIMITED TO THE FOLLOWING:1. EDUCATIONAL PROGRAMS THAT PROVIDE CLASSES AND INFORMATION ON TOBACCO CESSATION, HEALTHY AGING, CHILDBIRTH, INFANT CARE, EARLY PREGNANCY AND MORE2. FREE BLOOD PRESSURE AND DIABETES SCREENINGS, AND MAMMOGRAMS TO QUALIFYING INDIVIDUALS, FREE OR LOW-COST SCREENINGS FOR BREAST, PROSTATE, SKIN AND COLORECTAL CANCERS AS WELL AS OSTEOPOROSIS ASSESSMENTS. 1 AMERICAN HEART ASSOCIATION 5455 N HIGH ST COLUMBUS OH 43215 135613797 501(C)(3) 5000 SPONSORSHIP OF HURON COUNTY HEART WALK AMERICAN RED CROSS PO BOX 73013 CHICAGO IL 60673 341027291 501(C)(3) 8194 CONTRIBUTION FOR RELIEF EFFORTS DUE TO THE OKLAHOMA MOORE DISASTER BERLIN-MILAN BOARD OF EDUCATION 140 SOUTH MAIN ST MILAN OH 44846 115 6700 GRANT IN SUPPORT OF FITNESS TRAIL CITY OF NORWALK - ERNSTHAUSEN 100 REPUBLIC ST NORWALK OH 44857 115 5000 SPONSORSHIP OF EARTH WEEK WALK FISHER-TITUS FOUNDATION 272 BENEDICT AVE NORWALK OH 44857 341476934 501(C)(3) 11000 PLEDGE TO HELP PURCHASE NEW MAIN CAMPUS POLE SIGNS NORWALK AREA UNITED FUND 10 WEST MAIN ST NORWALK OH 44857 340906312 501(C)(3) 20000 CONTRIBUTION TO HELP THE LOCAL COMMUNITY NORWALK CATHOLIC SCHOOLS 93 EAST MAIN ST NORWALK OH 44857 115 5000 GRANT IN SUPPORT OF LOCAL SCHOOL SYSTEM NORWALK CITY SCHOOLS 134 BENEDICT AVE NORWALK OH 44857 115 50000 SUPPORT OF THEIR ALL-SPORTS COMPLEX NORWALK ECONOMIC DEVELOPMENT 10 1/2 WEST MAIN ST NORWALK OH 44857 341787391 501(C)(3) 5000 CONTRIBUTION TO HELP THE LOCAL COMMUNITY SHELBY CHRISTIAN & MISSIONARY ALLIANCE 105 E SMILEY AVE SHELBY OH 44875 341354574 501(C)(3) 125852 FMV MISCELLANEOUS SUPPLIES PROVIDE SUPPLIED TO AID IN CARRYING OUT ORGANIZATION'S CHARITABLE PURPOSE 10 0 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 ROSS MATLACK PRESIDENT - BEGINNING 6/ 2013 186324 0 23000 0 362 0 5931 0 11420 0 227037 0 0 0 PATRICK J MARTIN PRESIDENT/ SPECIAL PROJECT MGR 434224 0 153760 0 138751 0 156288 0 18040 0 901063 0 115391 0 LORNA STRAYER SENIOR VP, ADMIN & BUSINES 176251 0 44712 0 622 0 57345 0 25622 0 304552 0 0 0 DUANE WOODS VP OF FINANCE/CFO 208824 0 41215 0 484 0 33021 0 14750 0 298294 0 0 0 GARY MOORMAN VP MEDICAL AFFAIRS THRU 8/2013 204861 0 54164 0 1393 0 8750 0 9199 0 278367 0 0 0 CHERIE M SPRAGG SENIOR VP OF NURSING SERVI 160947 0 34986 0 18648 0 80624 0 8975 0 304180 0 0 0 PHILLIP J ANNARINO VP HUMAN RESOURCES 159564 0 41732 0 1028 0 27264 0 17650 0 247238 0 0 0 JOHN BRITTON VP INFORMATION SERVICES 165451 0 32803 0 236 0 16898 0 0 0 215388 0 0 0 GEORGE B ELMER DIRECTOR OF ASSET MGMT/EMS 156875 0 22602 0 1014 0 3346 0 23122 0 206959 0 0 0 MITCH ESCH DIRECTOR OF PHARMACY 147261 0 13461 0 1380 0 76162 0 16350 0 254614 0 0 0 SUZANNE S INGLIS ASST VP NURSING & SURGICAL SVCS 127236 0 12010 0 2194 0 5726 0 9010 0 156176 0 0 0 SCOTT P STEINMETZ DIRECTOR OF INFORMATION SVCS 130792 0 9284 0 397 0 4724 0 8440 0 153637 0 0 0 SHARON HARWOOD RISK MANAGER 121583 0 8642 0 370 0 26279 0 14230 0 171104 0 0 0 PART I LINE 4B & PART II, LINE 1 INCLUDED IN MR. MARTIN'S TOTAL W-2 COMPENSATION OF $726,735 IS $115,391 WHICH REPRESENTS THE CURRENT YEAR PAYMENT OF DEFERRED COMPENSATION FROM A NON-QUALIFIED RETIREMENT PLAN WHICH WAS DEFERRED ON PRIOR FORM 990'S. ALSO INCLUDED IN MR. MARTIN'S TOTAL W-2 COMPENSATION OF $726,735 IS $415,023 WHICH REPRESENTS THE PORTION OF MR. MARTIN'S SALARY ALLOCABLE TO HIS POSITION AS PRESIDENT AND CEO WHICH HE RETIRED FROM ON JULY 1, 2013. INCLUDED IN THE TOTAL CONTRIBUTION TO DEFERRED COMPENSATON OF $156,288 IN COLUMN C IS $132,901 OF VESTED DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $23,387 FOR THE CURRENT YEAR ACCRUAL OF A NON-VESTED, NON-QUALIFIED RETIREMENT PLAN. THIS PLAN PROVIDES AN ADDITIONAL RETIREMENT BENEFIT BASED UPON YEARS OF ELIGIBLE SERVICE AND VESTED STATUS AND REMAINS SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. PART I LINE 4B & PART II, LINE 4 INCLUDED IN DUANE WOOD'S TOTAL W-2 COMPENSATION OF $250,523 IS $37,621 WHICH REPRESENTS THE PORTION OF MR. WOOD'S SALARY ALLOCABLE TO THE NORWALK MEMORIAL HOME, A DIVISION OF FISHER-TITUS MEDICAL CENTER. INCLUDED IN THE TOTAL CONTRIBUTION TO DEFERRED COMPESATION OF $33,021 IN COLUMN C IS $8,750 OF DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $24,271 FOR THE CURRENT YEAR AND PRIOR YEAR ACCRUAL OF A NON-VESTED, NON-QUALIFIED RETIREMENT PLAN. THIS PLAN PROVIDES AN ADDITIONAL RETIREMENT BENEFIT BASED ON YEARS OF ELIBIGLE SERVICE AND VESTED STATUS AND REMAINS SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. PART I LINE 4B & PART II, LINE 8 INCLUDED IN MR. ANNARINO'S TOTAL CONTRIBUTIONS TO DEFERRED COMPENSATION OF $27,264 IS $8,334 OF DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $18,930 FOR THE CURRENT YEAR AND PRIOR YEAR ACCRUAL OF A NON-VESTED, NON-QUALIFIED RETIREMENT PLAN. THIS PLAN PROVIDES AN ADDITIONAL RETIREMENT BENEFIT BASED ON YEARS OF ELIGIBLE SERVICE AND VESTED STATUS AND REMAINS SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. PART I LINE 3 RESPONSIBILITY FOR DETERMINING AND RECOMMENDING EXECUTIVE COMPENSATION RESTS WITH THE JOINT PERSONNEL COMMITTEE OF THE FISHER-TITUS MEDICAL CENTER AND NORWALK AREA HEALTH SYSTEMS, INC. BOARDS. THE COMMITTEE RETAINS AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO HELP ESTABLISH CASH COMPENSATION TARGET RANGES AND IDENTIFY REASONABLE AND CUSTOMARY BENEFIT PROGRAMS FOR EXECUTIVES. THE INDEPENDENT CONSULTANT REPORTS TO THE JOINT PERSONNEL COMMITTEE ON RELEVANT PEER GROUPS, CASH COMPENSATION REPORTED IN AVAILABLE SALARY SURVEYS FOR THE PEER GROUP AND TRENDS IN BENEFITS AND PERQUISITE PROGRAMS CUSTOMARILY AVAILABLE AMONG THE PEER GROUP FOR EXECUTIVES. RECOMMENDATIONS BY THE CONSULTANT ARE PRESENTED TO THE JOINT PERSONNEL COMMITTEE WHICH PREPARES MINUTES OF ITS DELIBERATIONS REGARDING EXECUTIVE COMPENSATION INCLUDING RECOMMENDATIONS THAT ARE PROVIDED TO EACH OF THE DIRECTORS OF FTMC AND NAHS. THE RECOMMENDATIONS TO BE ACTED ON MUST BE APPROVED FIRST BY THE JOINT PERSONNEL COMMITTEE AND THEN BY THE MEDICAL CENTER'S BOARD OF DIRECTORS BEFORE FINALLY BEING CONSIDERED BY THE SYSTEM'S BOARD OF DIRECTORS. THE MINUTES OF EACH BOARD MEETING WHERE ACTION IS TAKEN REFLECT SUCH ACTION. THE PROCESS IS PERFORMED ANNUALLY IN THE SPRING AND WAS LAST DONE IN MAY 2013. A COUNTY OF HURON OHIO 346400672 447540CC7 2007-06-28 28622597 SEE PART V BELOW 0 0 0 B COUNTY OF HURON OHIO 346400672 447540BN4 2003-01-08 30000000 SEE PART V BELOW 0 0 0 A 28838308 564200 7215711 21058397 2008 1 0 1 1 B 30714144 524983 263425 27308799 2616937 2005 1 0 1 1 A 0 0 0 1 1 0 0 0 B 0 0 0 1 1 0 0 0 A 0 0 1 0 0 0 0 0 1 B 0 0 1 0 1 0 0 0 1 A 0 B 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, LINE 3, COLUMN A INCLUDED IN THE TOTAL PROCEEDS OF $28,838,308 IS INVESTMENT EARNINGS OF $215,711. PART II, LINE 11, COLUMN A $21,058,397 OF THE PROCEEDS WERE USED TO REFUND THE HOSPITAL'S COUNTY OF HURON REVENUE BONDS, SERIES 1996B AND A PORTION OF SERIES 2003A BONDS. PART II, COLUMN B, LINE 3 INCLUDED IN THE TOTAL PROCEEDS OF $30,714,144 IS INVESTMENT EARNINGS OF $714,144. PART II, COLUMN B, LINE 11 $2,616,937 OF THE PROCEEDS WERE USED TO REFUND THE HOSPITAL'S COUNTY OF HURON REVENUE BONDS, SERIES 1995A BONDS. MRS JOHN BRITTON SPOUSE OF KEY EMPLOYEE 50041 EMPLOYMENT 0 BAYLESS PATHMARK SEE PART V 140833 INDEPENDENT CONTRACTOR 0 MS SCHWAB FAMILY MEMBER OF OFFICER, LORNA STRAYER 68379 EMPLOYMENT 0 MS RILEY FAMILY MEMBER OF DIRECTOR, MATT GROSS 75185 EMPLOYMENT 0 BATTLES INSURANCE AGENCY SEE PART V 675103 VENDOR 0 BLEILE ENTERPRISE SEE PART V 203263 VENDOR 0 PART IV PART IV LINE 2 - RELATIONSHIP OF INTERESTED PARTY: DR. WILLIAM CORNELL, M.D. IS A PARTNER OF BAYLESS PATHMARK.PART IV LINE 3 - RELATIONSHIP OF INTERESTED PARTY: FAMILY MEMBER OF OFFICER, LORNA STRAYERPART IV LINE 4 - RELATIONSHIP OF INTERESTED PARTY: FAMILY MEMBER OF DIRECTOR, MATT GROSSPART IV, LINE 5 - PERRY DRYDEN, BOARD MEMBER, IS THE PRESIDENT OF BATTLES INSURANCE AGENCYPART IV LINE 6 - THOMAS BLEILE, BOARD MEMBER, HAS A FAMILY RELATIONSHIP WITH THE OWNER OF BLEILE ENTERPRISE, INC X 2 32601 FAIR MARKET VALUE X WALKING PATH 1 16295 FAIR MARKET VALUE 0 1 0 PART III, LINE 4A/4B FISHER-TITUS MEDICAL CENTER (FTMC) IS AN INDEPENDENT NON-PROFIT COMMUNITY HEALTHCARE ORGANIZATION GOVERNED BY A BOARD OF DIRECTORS COMPOSED OF AREA RESIDENTS INCLUDING BUSINESS AND COMMUNITY LEADERS, PHYSICIANS AND OTHER INTERESTED INDIVIDUALS. FTMC IS COMPOSED OF THE FOLLOWING FOUR OPERATING DIVISIONS: FISHER-TITUS MEMORIAL HOSPITAL THE HOSPITAL PROVIDES INPATIENT AND OUTPATIENT HEALTHCARE SERVICES TO THE RESIDENTS OF HURON, ERIE AND THE ADJACENT COUNTIES OF SANDUSKY, CRAWFORD, LORAIN, ASHLAND AND RICHLAND. IN 2013, THE HOSPITAL PROVIDED 13,907 DAYS OF INPATIENT CARE TO 3,926 PATIENTS. THE HOSPITAL ALSO PROVIDED 91,137 PATIENTS WITH 133,481 OUTPATIENT AND 27,107 EMERGENCY ROOM VISITS DURING THE YEAR. THE NORWALK MEMORIAL HOME THE NORWALK MEMORIAL HOME PROVIDES SKILLED AND LONG-TERM CARE IN ITS TRANSITIONAL AND EXTENDED CARE UNITS. DURING 2013, THE HOME SERVED 411 RESIDENTS AND PROVIDED 23,473 DAYS OF CARE. THE HOME HEALTH CENTER HOME HEALTH AGENCY THE HOME HEALTH CENTER PROVIDED 13,444 HOME VISITS TO 316 DIFFERENT PATIENTS IN 2013. THE CARRIAGE HOUSE OF FISHER-TITUS OPENED IN 1998, THE CARRIAGE HOUSE IS A 48-UNIT ASSISTED LIVING FACILITY, WHICH PROVIDED 15,914 DAYS OF ASSISTED LIVING CARE TO 61 RESIDENTS IN 2013. PROGRAM EXPANSIONS, IMPROVEMENTS, AND ACCREDITATIONS AMONG HEALTHCARE'S MOST WIRED HOSPITALS IN THE NATION - IN 2013 FISHER-TITUS WAS NAMED ONE OF HEALTHCARE'S TOP 100 MOST WIRED U.S. HOSPITALS FOR THE SECOND CONSECUTIVE YEAR. THE AWARD RECOGNIZES FISHER-TITUS FOR ITS ACCOMPLISHMENTS AS THE NATION'S FIRST ALL-DIGITAL SMART COMMUNITY HOSPITAL AND CONTINUED ADVANCEMENTS IN PATIENT-FOCUSED TECHNOLOGY AIMED AT PROVIDING THE HIGHEST LEVEL OF CLINICAL QUALITY, PATIENT SAFETY, AND COORDINATION OF CARE. AS A CERNER CORPORATION SHOWCASE SITE, FISHER-TITUS HAS HOSTED HOSPITALS FROM ALL OVER THE WORLD INCLUDING THE CLEVELAND CLINIC, THE VETERANS ADMINISTRATION, AND BRAZIL'S HOSPITAL ALBERT EINSTEIN TO SEE THIS FULLY INTEGRATED ELECTRONIC HEALTH RECORD SYSTEM AND INTERACTIVE PATIENT-ROOM TECHNOLOGY IN ACTION. ELECTRONIC MEDICAL RECORDS - FISHER TITUS MEDICAL CENTER ACHIEVED THE HEALTH INFORMATION AND MANAGEMENT SYSTEMS SOCIETY, HIMSS LEVEL 6 (THE HIGHEST LEVEL BEING LEVEL 7) FOR ELECTRONIC MEDICAL RECORD (EMR) ADOPTION. FACILITY AND PROGRAM EXPANSIONS WHEN THE NEW EMERGENCY DEPARTMENT OPENED IN 2012, CONSTRUCTION BEGAN ON AN EXPANSION AND "REPOSITIONING" OF IMAGING SERVICES WHICH OPENED IN APRIL 2013. THE RENOVATED SPACE PROVIDES QUICKER ACCESS FOR EMERGENCY PATIENTS TO LIFE-SAVING IMAGING TECHNOLOGY, AND A MORE COMFORTABLE AND PRIVATE AREA FOR OUTPATIENTS RECEIVING DIAGNOSTIC TESTING BY THE DEPARTMENT'S STATE-OF-ART TECHNOLOGY. WHILE MOST OF THE EXISTING IMAGING EQUIPMENT WAS MOVED, A NEW OPEN-BORE MAGNETIC RESONANCE IMAGING (MRI) UNIT REPLACED THE FORMER ONE TO MEET THE NEEDS OF BOTH CLAUSTROPHOBIC AND BARIATRIC PATIENTS. THE NEW MRI SUITE FEATURES SCENIC CEILING PANELS AND SIDE LIGHTS TO PROVIDE A COMFORTING ENVIRONMENT. IN ADDITION, X-RAY TECHNOLOGY WAS UPGRADED TO DIGITAL WIRELESS X-RAYS. THE IMAGING SERVICES EXPANSION ALSO INCLUDED NEW CONSTRUCTION FOR AN INFUSION SERVICES AREA AND PRE-ADMISSION TESTING, EARLY COMPONENTS OF A $16 MILLION, FIVE-PHASE 42,000-SQUARE-FOOT SURGERY CONSTRUCTION PROJECT. THE SURGERY EXPANSION PROJECT BEGAN IN MARCH 2013 AND IS ONE OF THE MOST COMPLEX CONSTRUCTION PROJECTS TO-DATE AT FISHER-TITUS BECAUSE OF THE LOCATION OF THE DEPARTMENT IN THE CENTER OF THE OLDER PART OF THE FACILITY AND THE ADDITIONAL CHALLENGE OF MAINTAINING OPERATIONS WHILE UNDER CONSTRUCTION. PHASE 1, WHICH INCLUDED A NEW SURGERY SEATING AREA, TWO NEW ORS, SURGERY CONTROL ROOM, STERILE PROCESSING AND FROZEN SECTION AREAS, WAS COMPLETED IN 2013. THE PROJECT IS SCHEDULED TO BE FULLY COMPLETED IN APRIL OF 2015. IN JUNE OF 2013, FISHER-TITUS AND NEIGHBORING BELLEVUE HOSPITAL FORGED A UNIQUE CLINICAL AFFILIATION WITH CLEVELAND CLINIC'S SYDELL AND ARNOLD MILLER FAMILY HEART & VASCULAR INSTITUTE. THE AFFILIATION BRINGS WORLD-CLASS HEART CARE TO AREA RESIDENTS AND PROVIDES GREATER ACCESS TO CLEVELAND CLINIC'S ACADEMIC, CLINICAL AND RESEARCH BEST PRACTICES IN CARDIOVASCULAR MEDICINE AND THORACIC SURGERY. WHILE EACH ORGANIZATION REMAINS INDEPENDENT, THE AFFILIATION WITH CLEVELAND CLINIC'S HEART AND VASCULAR INSTITUTE STRENGTHENS ALL ELEMENTS OF HEART AND VASCULAR MEDICINE AND THORACIC SURGERY TO PROVIDE THE HIGHEST LEVEL OF CARDIOVASCULAR AND THORACIC CARE TO THE SEVEN-COUNTY REGION SERVED BY FISHER-TITUS AND THE BELLEVUE HOSPITAL. AS PART OF THE AFFILIATION, CLEVELAND CLINIC EMPLOYS A PHYSICIAN TEAM THAT INCLUDES TWO CARDIOLOGISTS, A VASCULAR SURGEON AND A THORACIC SURGEON IN THE LOCAL HOSPITALS. A SECOND CLEVELAND CLINIC AFFILIATION WAS FORMED IN AUGUST 2013 AND IS PROVIDING WORLD-CLASS SPINE SURGERY SERVICES TO AREA RESIDENTS THROUGH A PROGRAM CALLED CLEVELAND CLINIC SPINE SURGERY AT FISHER-TITUS. THE ADDITION OF THIS SPINE SPECIALIZATION TO THE CURRENT SURGICAL TEAM COMPLEMENTS SPINE PROGRAMS IN PAIN MANAGEMENT, NEUROLOGY, AND REHABILITATION. EDUCATION AND RESEARCH - TO ENSURE THAT WE HAVE THE QUALITY WORKFORCE WE NEED TO CARE FOR OUR COMMUNITY IN THE FUTURE, WE ARE COMMITTED TO THE EDUCATION OF CURRENT AND FUTURE CAREGIVERS, AND WE WORK WITH EHOVE CAREER CENTER, FIRELANDS BOWLING GREEN STATE UNIVERSITY CAMPUS, LORAIN COUNTY COMMUNITY COLLEGE, NORTH CENTRAL STATE COLLEGE, TERRA COMMUNITY COLLEGE, THE OHIO STATE UNIVERSITY, AND OHIO UNIVERSITY TO PROVIDE INTERNSHIPS, INSTRUCTORS, CLASSROOM SPACE, AND CLINICAL TRAINING. WE ARE PLEASED TO BE ABLE TO OFFER A COMPREHENSIVE LEARNING EXPERIENCE UTILIZING OUR STATE-OF-THE-ART FACILITIES AND ADVANCED TECHNOLOGY. AWARDS AND ACCREDITATIONS - THROUGHOUT THE YEARS FISHER-TITUS HAS BEEN HIGHLY SUCCESSFUL IN MEETING THE CHALLENGES OF AN INCREASINGLY COMPLEX HEALTH-CARE INDUSTRY AND HAS PROVIDED EXCEPTIONAL SERVICE QUALITY TO MEMBERS OF THE SURROUNDING COMMUNITIES. FISHER-TITUS IS ACCREDITED BY THE HEALTHCARE FACILITIES ACCREDITATION PROGRAM (HFAP), IS A LEVEL 3 TRAUMA CENTER, PRIMARY STROKE CENTER, AND A FULLY ACCREDITED CHEST PAIN CENTER. IN 2013, FOR THE SECOND CONSECUTIVE YEAR, FISHER-TITUS EARNED AN A HOSPITAL SAFETY SCORE BY THE LEAPFROG GROUP ON ITS NATIONAL REPORT CARD ON PREVENTABLE MEDICAL ERRORS, INJURIES, ACCIDENTS, AND INFECTIONS. ALSO, IN 2013, FISHER-TITUS RECEIVED HEALTH CARE'S MOST WIRED HOSPITAL FOR THE SECOND YEAR IN A ROW. IN ADDITION, THE MEDICAL CENTER'S FOCUS ON QUALITY CARE AND EXCEPTIONAL SERVICE IS EVIDENCED BY THE MANY DEPARTMENTAL ACCREDITATIONS AND AWARDS AND RECOGNITIONS RECEIVED BY THE MEDICAL CENTER IN 2013: -PRIMARY STROKE CENTER, HFAP -OHIO DEPARTMENT OF HEALTH MAMMOGRAPHY QUALITY STANDARDS -AMERICAN COLLEGE OF RADIOLOGY (ACR) 3-YEAR ACCREDITATION IN NUCLEAR MEDICINE -AMERICAN ASSOCIATION OF RESPIRATORY CARE, QUALITY RESPIRATORY CARE AWARD -AMERICAN DIABETES ASSOCIATION EDUCATION RECOGNITION CERTIFICATE -HOMECARE ELITE TOP 100 AGENCY (FISHER-TITUS HOME HEALTH CENTER) -LABORATORY SERVICES CAP ACCREDITATION -BLOOD GAS LABORATORY CAP ACCREDITATION FISHER-TITUS EMPLOYS 960 AREA RESIDENTS AND IS LARGEST EMPLOYER IN HURON COUNTY. THE MEDICAL CENTER HAS BEEN AMONG THE TOP 100 BEST PLACES TO WORK IN HEALTHCARE BY MODERN HEALTHCARE MAGAZINE AND IS A PLATINUM-LEVEL AMERICAN HEART ASSOCIATION FIT-FRIENDLY FACILITY IN RECOGNITION OF ITS COMMITMENT TO PROVIDE VALUE-ADDED BENEFITS TO IMPACT THE OVERALL HEALTH AND FITNESS OF ITS EMPLOYEES INCLUDING WEIGHT WATCHERS, A FULLY OUTFITTED EMPLOYEE FITNESS CENTER, SMOKING CESSATION PROGRAMMING AND WALKING PROGRAMS. IN 2013, FISHER-TITUS ALSO BEGAN A LEADERSHIP DEVELOPMENT INSTITUTE THROUGH THE STUDER GROUP. EXCELLENT PHYSICIANS: FISHER-TITUS IS COMMITTED TO RECRUITING PHYSICIANS TO SERVE THE UNIQUE HEALTH-CARE NEEDS OF OUR COMMUNITY MEMBERS. IN 2013, TIMOTHY ADAMOWICZ, D.O., HEMATOLOGY/ONCOLOGY; NICHOLAS BROWN, D.P.M., PODIATRY; YILAN CHANG, M.D., PATHOLOGIST; GARY FENNIG, D.O., ANESTHESIOLOGIST; EDUARDO MARTINEZ, M.D., RADIOLOGIST; AND TIMOTHY WOISNET, M.D., RADIOLOGIST, JOINED THE FISHER-TITUS MEDICAL STAFF AS MEMBERS WITH FULL PRIVILEGES. AS PART OF THE CLEVELAND CLINIC HEART AND VASCULAR AFFILIATION, TWO CARDIOLOGISTS, JOHN ABBOUD, M.D. AND MICHAEL DAVIS, M.D. JOINED THE MEDICAL STAFF AND ARE SERVING PATIENTS AT FISHER-TITUS AND BELLEVUE HOSPITAL. IN ADDITION, A TEAM OF CLEVELAND CLINIC VASCULAR AND THORACIC SURGEONS ARE ON-SITE 24/7/365 PROVIDING THEIR SERVICES TO PATIENTS WHILE RECRUITING CONTINUES TO FILL THOSE ROLES WITH PERMANENT PHYSICIANS AT FISHER-TITUS. PART III, LINE 4A/4B CONTINUED COMMUNITY HEALTH AND OUTREACH PROGRAMS FTMC COMMUNITY BENEFITS EXTEND OUTSIDE OUR WALLS TO FAMILIES, BUSINESS, SCHOOLS, CHURCHES AND NEIGHBORHOODS THROUGH OUTREACH PROGRAMS AND OTHER COORDINATED CARE ACTIVITIES THAT MAKE OUR COMMUNITIES HEALTHIER PLACES TO LIVE, WORK AND WORSHIP. OUR GOAL IS TO HELP ALL RESIDENTS EQUALLY ACCESS THE CARE THEY NEED, AND HELP THEM LEARN TO MANAGE THEIR CONDITIONS AND LIVE HEALTHIER SAFER LIVES. FISHER-TITUS PROVIDED LEADERSHIP AND FUNDING FOR THE HURON COUNTY HEALTH ASSESSMENT ISSUED IN LATE 2011 AND IS ADDRESSING THE NEEDS IDENTIFIED IN THE HEALTH ASSESSMENT. THE PRIORITIES OF FISHER-TITUS' COMMUNITY OUTREACH AND COMMUNITY BENEFIT PROGRAMS IN 2013 WERE ALIGNED WITH THE GOALS IDENTIFIED BY THE HURON COUNTY HEALTH PARTNERS. FISHER-TITUS HEALTH PROFESSIONALS LEAD AND SERVE ON COMMUNITY-WIDE TASK FORCES THAT ARE ADDRESSING OBESITY, RISKY BEHAVIORS AMONG YOUTH, AND MENTAL HEALTH RESOURCES. IN ADDITION, FISHER-TITUS PROVIDED LEADERSHIP TO BEGIN WORK ON THE NEXT COUNTY-WIDE HEALTH ASSESSMENT TO BE COMPLETED IN 2014. FTMC SUPPORTS OTHER AREA NON-PROFIT COMMUNITY ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICE AND EMPLOYEE VOLUNTEERISM. MANY OF OUR COMMUNITY BENEFIT PROGRAMS ARE ORGANIZED TO WORK COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS. IN 2013, WE OFFERED COMMUNITY HEALTH EDUCATION PROGRAMS, INCLUDING SCHOOL-BASED PROGRAMS, SUPPORT GROUPS, COMMUNITY-BASED HEALTH FAIRS AND SCREENINGS, AND WALKING AND FITNESS PROGRAMS THAT IMPACTED OUR RESIDENTS THROUGH 66,510 ENCOUNTERS. AUXILIARY AND VOLUNTEER SERVICE: - DURING 2013, OUR 241 CARING VOLUNTEERS DONATED 48,260 HOURS OF AUXILIARY AND VOLUNTEER SERVICES TO THE MEDICAL CENTER. VOLUNTEERS PROVIDE A VARIETY OF SERVICES INCLUDING HELPING FAMILY MEMBERS, PROVIDING TRANSPORTATION, ASSISTING AT COMMUNITY HEALTH PROGRAMS, DELIVERING REFRESHMENTS, MAIL AND FLOWERS TO HOSPITAL PATIENTS AND RESIDENTS OF THE NORWALK MEMORIAL HOME PLUS ESCORTING PATIENTS THROUGHOUT THE BUILDING. THEY ALSO PERFORM CLERICAL DUTIES, STAFF THE MEDICAL CENTER'S GIFT SHOP AND ORGANIZE SEVERAL FUND-RAISING EVENTS THROUGHOUT THE YEAR. VOLUNTEER "AMBASSADORS" HAVE INSTRUCTED PATIENTS SINCE APRIL, 2010 ON THE USE OF THE TELEVISION/COMPUTER SCREENS LOCATED IN EACH PATIENT ROOM. VOLUNTEERS WORKING IN THIS CAPACITY ARE AT FISHER-TITUS MEDICAL CENTER SEVEN DAYS PER WEEK EACH MORNING FOR 2 HOURS. AMONG THE ITEMS PATIENTS ARE INSTRUCTED ON ARE HOW TO ACCESS THE DAY'S MENU, MEDICAL INFORMATION PERTAINING TO THE PERSON'S HEALTH PROBLEMS, ACCESSING THE INTERNET, PLAYING GAMES, OBTAINING THE NAMES OF CAREGIVERS AS THEY ENTER THE PATIENT'S ROOM, CHOOSING MOVIES, ETC. THE PATIENT THEN MAY USE A REMOTE CONTROL OR A WIRELESS KEYBOARD TO ACCESS THIS INFORMATION. INFORMATION SERVICES PROVIDES ALL COMPUTER TRAINING FOR VOLUNTEERS THAT WORK IN THIS CAPACITY . COMMUNITY HEALTH IMPROVEMENT SERVICES: NUMEROUS HEALTH SCREENINGS ARE OFFERED THROUGHOUT THE YEAR AT THE MEDICAL CENTER AND AT VARIOUS COMMUNITY LOCATIONS AND EVENTS THROUGHOUT OUR SERVICE AREA. THESE PROGRAMS INCLUDE SCREENING FOR BLOOD PRESSURE, BLOOD GLUCOSE, CHOLESTEROL LEVELS, SKIN CANCER, PROSTATE CANCER, OSTEOPOROSIS AND SCREENING MAMMOGRAMS. IN ADDITION, THE MEDICAL CENTER SPONSORS NUMEROUS SUPPORT GROUPS TO PROVIDE EDUCATION, CARE AND EMOTIONAL SUPPORT TO INDIVIDUALS AND FAMILIES AFFECTED BY DISABILITIES AND CHRONIC MEDICAL CONDITIONS. FTMC'S HEALTH MINISTRY PROGRAM, FORMED IN 2000, HAS BEEN A VERY EFFECTIVE GRASSROOTS INITIATIVE TO GATHER INFORMATION AND PROVIDE HEALTH PROGRAMS THROUGHOUT HURON COUNTY. CURRENTLY 50 AREA CONGREGATIONS ARE MEMBERS OF THE FTMC HEALTH MINISTRY PROGRAM WHICH PROVIDES HEALTH AND WELLNESS INFORMATION AND PROGRAMS IN AREA CHURCHES. THE MEDICAL CENTER IN PARTNERSHIP WITH ITS PHYSICIANS AND OTHER COMMUNITY ORGANIZATIONS PROVIDES PUBLIC FORUMS AND EDUCATIONAL SESSIONS ON A VARIETY OF TOPICS, WHICH ARE SOMETIMES HELD IN TANDEM WITH THE HEALTH SCREENINGS PROVIDED. WE ALSO PROVIDE NUMEROUS HEALTH FAIRS DURING THE YEAR IN SEVERAL LOCATIONS THROUGHOUT THE COUNTY AND SURROUNDING COMMUNITIES IN OUR SERVICE AREA. THESE COMMUNITY HEALTH IMPROVEMENT SERVICES BENEFITED 65,220 PEOPLE IN 2013 AT A COST OF $766,685. PROFESSIONAL MEDICAL EDUCATION: THE MEDICAL CENTER SUPPORTS THE FAMILY PRACTICE RESIDENCY PROGRAM AT FIRELANDS REGIONAL MEDICAL CENTER TO ENHANCE THE AVAILABILITY OF FAMILY PRACTICE PHYSICIANS WITHIN THE LOCAL COMMUNITY. FTMC FUNDS THE COST OF A FAMILY PRACTICE RESIDENT THAT SHARES TIME BETWEEN THE HOSPITAL'S EMERGENCY ROOM AND THE COUNTY HEALTH DEPARTMENT CARING FOR THE UNDERSERVED. IN ADDITION, FTMC SUPPORTS AND STAFFS SEVERAL CLASSES FOR HEALTH PROFESSIONALS INCLUDING HEALTHCARE PROVIDER CPR, ADVANCED CARDIAC LIFE SUPPORT, BASIC LIFE SUPPORT INSTRUCTOR COURSE AND PEDIATRIC ADVANCE LIFE SUPPORT. THE TOTAL COST OF PROFESSIONAL MEDICAL EDUCATION PROVIDED TO 140 PARTICIPANTS WAS $89,724. SUBSIDIZED HEALTH SERVICES: THE MEDICAL CENTER ALSO SUBSIDIZES CERTAIN HEALTH SERVICES AND PROCESSES IN ORDER TO ADDRESS SPECIFIC HEALTH ISSUES IN THE COMMUNITY, PROVIDE CARE TO THE UNDERSERVED, OR ENHANCE THE OVERALL QUALITY OF HEALTHCARE WITHIN THE COMMUNITY. ALSO, THE MEDICAL CENTER SUBSIDIZED THE COST OF ELECTRONIC MEDICAL RECORD SOFTWARE USED BY PHYSICIANS IN OUR SERVICE AREA. THE SOFTWARE ENHANCES THE ACCURACY AND SPEED OF MEDICAL INFORMATION AVAILABLE TO HEALTHCARE PROVIDERS WITHIN THE AREA AND TO ASSIST THE COMMUNITY IN MOVING TOWARD A REGIONAL HEALTH INFORMATION DATABASE. THE COST ASSOCIATED WITH THE HEALTH SERVICES AND ELECTRONIC MEDICAL RECORDS SYSTEM IN 2013 WAS $755,939. DONATIONS AND COMMUNITY SUPPORT: THE MEDICAL CENTER MAKES CASH AND NON-CASH CONTRIBUTIONS ANNUALLY TO LOCAL NON-PROFIT ORGANIZATIONS THAT BENEFIT THE HEALTH AND DEVELOPMENT OF OUR LOCAL COMMUNITY AND ITS RESIDENTS. IN ADDITION, THE MEDICAL CENTER SUPPORTS AREA SCHOOLS BY AWARDING SPECIAL HEALTH EDUCATION GRANTS TO SCHOOL DISTRICTS IN OUR SERVICE TERRITORY TO FUND INNOVATIVE PROGRAMS IN THE AREAS OF SCIENCE, MATH, HEALTH AND HEALTH RELATED EDUCATION. THE TOTAL COST OF THESE DONATIONS AND SUPPORT IN 2013 WAS $356,031. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF FISHER-TITUS MEDICAL CENTER IS THE PARENT COMPANY NORWALK AREA HEALTH SYSTEMS, INC., AN OHIO NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE FOLLOWING POWERS ARE RESERVED EXCLUSIVELY TO THE MEMBER (NORWALK AREA HEALTH SYSTEM, INC): A) TO ELECT THE DIRECTORS OF THE CORPORATION, AND TO REMOVE THEM AT WILL OR WITHOUT CAUSE. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING POWERS ARE RESERVED EXCLUSIVELY TO THE MEMBER (NORWALK AREA HEALTH SYSTEM, INC): A) TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION AND THE CODE OF REGULATIONS; B) TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION; C) TO APPROVE ANY CAPITAL OR OTHER EXTRAORDINARY EXPENDITURES IN EXCESS OF THE AMOUNT PRESCRIBED FROM TIME TO TIME BY THE MEMBER, WHICH AMOUNT SHALL BE REVIEWED BY THE MEMBER ANNUALLY; D) TO APPROVE ANY BORROWING OF ANY SUM OF MONEY FOR ANY PURPOSE IN EXCESS OF THE AMOUNT PRESCRIBED FROM TIME TO TIME BY THE MEMBER, WHICH AMOUNT SHALL BE REVIEWED BY THE MEMBER ANNUALLY; E) TO APPROVE ANY MERGER OF THE CORPORATION OR ANY SALE OF SUBSTANTIALLY ALL ITS ASSETS; TO DISSOLVE OR TERMINATE THE EXSISTENCE OF THE CORPORATION AND TO DETERMINE THE DISTRIBUTION OF ASSETS UPON SUCH DISSOLUTION OR TERMINATION. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF DIRECTORS OF THE FISHER-TITUS MEDICAL CENTER DELEGATED THE RESPONSIBILITY FOR THE REVIEW OF THE MEDICAL CENTER'S FORM 990, PLUS ALL REQUIRED SCHEDULES AND ATTACHMENTS, TO THE MEDICAL CENTER'S AUDIT COMMITTEE. THE MEMBERS OF THIS COMMITTEE HAVE A STRONG BACKGROUND IN ACCOUNTING, LEGAL, FINANCE, AND BUSINESS AND HAVE THE TECHNICAL EXPERTISE TO PERFORM A SUBSTANTIVE REVIEW. THE AUDIT COMMITTEE REVIEWED THE MEDICAL CENTER'S FORM 990 PRIOR TO FILING AND REPORTED TO THE MEDICAL CENTER'S BOARD OF DIRECTORS REGARDING THE RESULTS OF THEIR REVIEW. IN ADDITION, EACH MEMBER OF THE MEDICAL CENTER'S BOARD OF DIRECTORS HAD ACCESS TO A COPY OF THE FORM 990 FOR VIEWING PRIOR TO FILING VIA A SECURE INTERNET WEBSITE AND A PAPER COPY WAS AVAILABLE FOR REVIEW AT THE BOARD MEETINGS. FORM 990, PART VI, SECTION B, LINE 12C ALL OF OUR AFFILIATED CORPORATE BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT UPON JOINING THE BOARD AND ANNUALLY THROUGHOUT THEIR TENURE. THESE ARE RETAINED BY ADMINISTRATION. AREAS OF CONFLICT ARE REVIEWED AND ADDRESSED AS NECESSARY TO THE TRANSACTIONS OF THE BOARD. IF AN AREA OF CONFLICT ARISES, BOARD MEMBERS ARE EXCUSED AND PROHIBITED FROM PARTICIPATING IN THE BOARD'S DELIBERATIONS AND DISCUSSIONS REGARDING THE AREA OF CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 RESPONSIBILITY FOR DETERMINING AND RECOMMENDING EXECUTIVE COMPENSATION RESTS WITH THE JOINT PERSONNEL COMMITTEE OF THE FISHER-TITUS MEDICAL CENTER AND NORWALK AREA HEALTH SYSTEMS, INC. BOARDS. THE COMMITTEE RETAINS AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO HELP ESTABLISH CASH COMPENSATION TARGET RANGES AND IDENTIFY REASONABLE AND CUSTOMARY BENEFIT PROGRAMS FOR EXECUTIVES. THE INDEPENDANT CONSULTANT REPORTS TO THE JOINT PERSONNEL COMMITTEE ON RELEVANT PEER GROUPS, CASH COMPENSATION REPORTED IN AVAILABLE SALARY SURVEYS FOR THE PEER GROUP, AND TRENDS IN BENEFITS AND PERQUISITE PROGRAMS CUSTOMARILY AVAILABLE AMONG THE PEER GROUP FOR EXECUTIVES. RECOMMENDATIONS BY THE CONSULTANT ARE PRESENTED TO THE JOINT PERSONNEL COMMITTEE WHICH PREPARES MINUTES OF ITS DELIBERATIONS REGARDING EXECUTIVE COMPENSATION INCLUDING RECOMMENDATIONS THAT ARE PROVIDED TO EACH OF THE DIRECTORS OF FTMC AND NAHS. THE RECOMMENDATIONS TO BE ACTED ON MUST BE APPROVED FIRST BY THE JOINT PERSONNEL COMMITTEE AND THEN BY THE MEDICAL CENTER'S BOARD OF DIRECTORS BEFORE FINALLY BEING CONSIDERED BY THE SYSTEM'S BOARD OF DIRECTORS. THE MINUTES OF EACH BOARD MEETING WHERE ACTION IS TAKEN REFLECT SUCH ACTION. THE PROCESS IS PERFORMED ANNUALLY IN THE SPRING AND WAS LAST DONE IN MAY 2013. FORM 990, PART VI, SECTION C, LINE 19 WE ISSUE AN ANNUAL REPORT TO THE COMMUNITY THAT IS PLACED IN THE LOCAL NEWSPAPER AND ON OUR WEBSITE THAT PROVIDES OUR OPERATING FINANCIAL STATEMENT, COMMUNITY BENEFIT FIGURES BROKEN DOWN BY CHARITY CARE & FINANCIAL ASSISTANCE, UPAID COSTS OF MEDICAID, COMMUNITY HEALTH & OUTREACH PROGRAMS, DONATIONS & COMMUNITY SUPPORT, SUBSIDIZED HEALTH SERVICES & PROFESSIONAL MEDICAL EDUCATION, & UNPAID COSTS OF MEDICARE & BAD DEBT. AS REQUIRED, WE OFFER A TIMELY RESPONSE TO WRITTEN REQUESTS FOR COPIES OF THE 990S AS WELL AS HAVING THE 990S AVAILABLE UPON THE PREMISES FOR THE PUBLIC TO REVIEW AND ON THE GUIDESTAR INTERNET WEBSITE. ADDITIONALLY, OUR CONFLICT OF INTEREST POLICY, CODE OF REGULATIONS, AND GOVERNING DOCUMENTS ARE ALSO AVAILABLE UPON WRITTEN REQUEST. FORM 990, PART XI, LINE 9: FASB #158 ADJUSTMENT 5,365,507. RETIRMENT PLAN CURTAILMENT 7,130,019. TRANSFER OF FUNDS TO AFFILIATED ORGANIZATION, NORWALK AREA HEALTH SYSTEMS -500,000. PAIN MANAGEMENT LLC DIVIDEND PAYMENT TO JOINT VENTURE MEMBER NORWALK PAIN M 998,167. AUDIT EXPENSE MAPPING ADJUSTMENT 26. 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