2012-08-15T08:59:44-00:00 2011-12-31 990 2011-01-01 310645626 Fairfield Medical Center FAIR 7406878000 401 North Ewing Street Lancaster OH 431303371 Sky L Gettys 2012-08-10 false 2011 2016-02-24 21:20:13Z Mina H Ubbing 401 North Ewing Street Lancaster OH 43130 225153704 false X www.fmchealth.org X 1982 OH Our mission is to provide efficient, compassionate, safe, high quality healthcare for patients and their families. Fairfield Medical Center provides this care to all patients regardless of race, creed, sex, national origin, handicap, age or ability to pay. 14 14 2356 177 369579 222749 226761 192609502 205693710 1751291 1811182 3695911 3667630 198279453 211399283 0 0 90639541 97776072 0 0 98192332 103335318 188831873 201111390 9447580 10287893 186675728 195128210 81905531 91249309 104770197 103878901 Our mission is to provide efficient, compassionate, safe, high quality healthcare for patients and their families. Fairfield Medical Center provides this care to all patients regardless of race, creed, sex, national origin, handicap, age or ability to pay. false false 76459612 84141740 Patient Care Inpatient Medical, Surgical, Emergency, Maternity, ICU, Psychiatry, and Nursing Services 77,022 admissions, procedures visits 70055449 110498084 Patient Care Laboratory, Cardiovascular, Radiology, Therapy, Pharmacy, and Medical Supply Services 2,577,144 procedures dosages 18739628 985026 Patient Care Nutritional Services 488,562 meals served Patient Care Laundry Services 1,627,100 pounds Patient Care Plant Engineering, Police, Housekeeping, Central Transport, Interest Depreciation 530,700 square feet 165254689 true true 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 false false true true false false false false false false false false false false false false false false true true true true true false true 125 0 true 2356 true true true false false false false false false false false false X 14 14 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 David Conley MD 003.00 X X 0 0 0 Carol Seubert Marx 003.00 X X 0 0 0 Debra Smith 003.00 X X 0 0 0 Lawrence Q Burgess PhD 002.00 X 0 0 0 Ron Burris 002.00 X 0 0 0 James Christian 002.00 X 0 0 0 Adam Custer 002.00 X 0 0 0 Dave Harcum 002.00 X 0 0 0 Dave Oehlers 002.00 X 0 0 0 Barry Ritchey 002.00 X 0 0 0 Dave Scoggin MD 002.00 X 0 0 0 Linda Sheridan 002.00 X 0 0 0 Mina H Ubbing 055.00 X 540191 0 33250 Sky L Gettys 048.00 X 260135 0 26544 Steven D Cox MD 042.00 X 306306 0 27933 Howard Sniderman 045.00 X 234098 0 22137 Cynthia Pearsall 050.00 X 194583 0 13704 Jean L Robertson MD 024.00 X 149159 0 0 Randy L Brown 040.00 X 152379 0 23837 Grace Edwards 039.00 X 146992 0 7437 Chris D Anders 039.00 X 130126 0 19762 Pamela R Reed 040.00 X 159568 0 15673 Betsy L Winsley 040.00 X 153050 0 10495 Louis Varga 002.00 X 0 0 0 Molly Weiland 002.00 X 0 0 0 2426587 200772 31 false true false McKesson PO Box 98347 Chicago IL 606930001 Information Technology Services 3202578 Aramark Healthcare 12483 Collections Center Drive Chicago IL 60693 Biomedical Services 2904049 Fairfield Emergency Physicians 401 North Ewing Street Lancaster OH 43130 Emergency Physician Services 860080 Bricker & Eckler 100 South Third Street Columbus OH 43215 Legal Services 446506 East Main Shopping 123 Broad Street Suite 211 Lancaster OH 43130 Rent 366300 14 226761 226761 Patient Service Revenue Net 205693710 205693710 205693710 1042584 1042584 646556 349009 297547 297547 14163610 10400 13396467 8945 767143 1455 768598 Cafeteria Sales 844731 844731 Patronage Dividends 900099 320451 320451 Outside Reference Lab 621500 329647 329647 1875254 1835322 39932 3370083 211399283 207529032 369579 2207766 0 0 0 0 1817001 951307 865694 0 76843579 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4493874 467363 51409893 55074443 -3664550 true true Southeast Ohio Sleep Disorders Sleep Lab 0.51000 0.49000 Fairfield Diagnostic Imaging Imaging Center 0.65000 0.35000 1 1 Fairfield Medical Center

401 North Ewing Street Lancaster OH 43130

X X X Part I line 3c Fairfield Medical Center uses Federal Poverty Guidelines to assess Charity Care eligibility. 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. Part III line 4 Bad debt expense represents total estimated uncollected charges AT COST. Fairfield Co has 10.4 of the population living below the poverty level, so that percentage was applied in order to approximate Charitable Bad Debt. Because we cant require patients to disclose their income, we were not able to determine exact amounts, but we believe our methodology to be reasonable and supportable. Since we do not choose our patients, we consider it fair to include bad debt as a part of Community Benefit. Part III line 8 We believe the entire amount on line 7 should be considered Community Benefit. As a smaller regional hospital, we are limited in the quantities of scale that we have access to, which could decrease our expenses. In spite of all the cost-cutting measures we have implemented, we still lose money in our Medicare program. Because we treat patients for the good of the community, we believe the total Medicare shortfall should be considered Community Benefit. We use the Ohio Hospital Association model to compute Medicare shortfall using the Medicare Cost Report as submitted to Medicare. Part III line 8 The total for Medicare Cost is taken directly from the Medicare Cost Report, which is an exhaustive analysis. We believe that the shortfall should be included as Community Benefit because we cannot choose our patients. The cost report shows that our costs are in line with Medicare allowances and are therefore as low as possible. We cannot and would not want to turn Medicare patients away, but we treat them as part of our community service. 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. Part III line 9b We do all we can to work with the patient and have the following options 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 15 days. 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 3 A representative from the Contracts and Collections Department meets with patients before discharge and explains the financial assistance available. That information is also on the back of each bill sent out by the hospital, along with eligibility guidelines. A poster is prominently displayed at each registration area asking people to inform us of financial need at the time of registration. It further states that financial counselors are available to help with the application process. Every effort is made to inform patients of the availability of financial assistance when the criteria is met. Patients are asked to fill out a Determination of Eligibility for Uncompensated Services in order for staff to identify those who are eligible, while at the same time preserving his or her dignity. If a patient is determined to be eligible for HCAP, he or she is asked to complete an application and verification of Ohio residency. Those persons stating they have no income are required to submit a notarized statement. Part VI Line 4 The geographic area of Fairfield Co. is 505.11 square miles. The overall population isapproximately 147,066. About 15,295 people live at or below the poverty level. 35.4 of thepopulation do not have employer-based insurance. 90.9 have graduated from high school. 18 are smokers and over 30 are obese.About 6.2 of the population is less than five years old 25.7 are less than 18 years old.Additionally, approximately 12.6 are age 65 or older, so there is a wide demographic range,but quite evenly spaced, also. Sources US Census Bureau website for 2011 and Ohio County Profiles. Part VI Line 5 Fairfield Medical Centers greatest asset has always been its compassionate, caring and dynamic employees who are passionate about sharing what they know with the community around them. Our Contracts and Collections Dept. is active in the Ohio Senior Health Insurance Information OSHIIP program through the Ohio Insurance Association. This program helps our senior citizens better understand their options with Medicare in order to make a more informed decision regarding the best program for them. We are only one of six hospitals in Ohio participating in the program and have won awards for our participation. The 2010 Community Health Needs Assessment revealed an alarming rate of obesity in our area of over 30 of the respondents. FMC quickly joined forces with other area hospitals to form FitTogether to educate and motivate the population to decrease their weight and increase their activity levels. Weve also partnered with area restaurants to offer Fit menu selections. This program will be an on-going partnership for healthier area residents. Opiate usage in Fairfield County is among the Part VI Line 5 highest in Ohio. FMC has been active in the community to educate the population regarding drug usage. Its heart-breaking to see drug addicted infants in the nursery and to know the damage the drugs are doing to our residents. Our staff is active in the Tour de Cause bicycle race each summer to raise funds for the Recovery Center of Fairfield Co. who help addicts break the addiction. We also have several staff members on the Opiate Awareness Task Force, as well as employees who speak to area organizations regarding the epidemic to raise awareness. Those employees have been featured in newspaper articles which further increase awareness. During 2011, we saw the need to increase medical availability to our lower income population. The Fairfield Community Health Center already had a good direction for doing this, so FMC engineered a grant to not only increase their funds, but also provided doctors and clinic space to greatly improve the Health Centers community impact. FMC partners with many community organizations to maximize the benefits to our community. Though insurance coverage ends with Part VI Line 5 discharge, we realize that its important to the health of new mothers and infants for a nurse to check them again to assure all is well after discharge. To that end, a maternity nurse visits each mother and newborn after discharge. When an out-of-town relative visits a hospital patient, there is often limited means for staying in a hotel after traveling. FMC offers a Hospitality House for out-of-town guests. We look for opportunities to improve the health of our community. We would rather meet them at an educational class than in a hospital room. To that end, we offer numerous educational classes on various health topics, such as stress reduction and Living Wills. X X X X false true false false false false false true false Mina H Ubbing 426217 51003 62971 17150 16100 573441 Sky L Gettys 233044 25891 1200 17150 9394 286679 Steven D Cox MD 276512 28594 1200 16866 11067 334239 Howard Sniderman 210446 22452 1200 16660 5477 256235 Cynthia Pearsall 175140 17243 2200 13167 537 208287 Randy L Brown 146538 5241 600 10902 12935 176216 Grace Edwards 146992 7437 154429 Pamela R Reed 136014 7498 16056 11399 4274 175241 Betsy L Winsley 153050 10099 396 163545 County of Fairfield Ohio 316400066 304286AK3 2003-12-23 34490356 To construct a parking garage and add additional space to hospital. false false County of Fairfield Ohio 316400066 2010-06-30 20000000 To refund prior issue to fund capital purchases. false false County of Fairfield Ohio 316400066 2010-12-22 10000000 To fund capital purchases. false false 30161142 1815250 2507003 1123902 29037240 2005 false false true true 12605608 20000000 91148 7303244 2010 true false true 10000000 57471 9942529 2011 false false false false false false false true false false false false true false false false false true false false false false false false false false false false false false false false false false false false Form 990 Part VI 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 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 12c Directors, President, Vice Presidents, 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 15a 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 19 The governing documents, conflict of interest, and financials are made available to the public by requests made to FMC management. Form 990 Part XI 5 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. 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 Presidents, 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 15a 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 XI Line 5 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 51 51 false true 0.51000 Simplified Healthcare Solutions LLC 5980 Wilcox Place Suite F Dublin OH 43016 201720030 Claims review/processing OH Fairfield Medical Center Related 100 100 false true 1.00000 Access Health Fairfield LLC 401 North Ewing Street PO Box 2003 Lancaster OH 43130 311682788 Coordination OH N/A Related 38 38 false false 0.37500 Fairfield Diagnostic Imaging LLC 1241 River Valley Blvd Lancaster OH 43130 311584889 Radiology OH Fairfield Medical Center Related 65 100 false false 1.00000 Gordon B Snider Cardio Inst Co-Mgt Co LLC 401 North Ewing Street Lancaster OH 43130 274462210 Management OH N/A Related 21 21 false false 0.20930 FMC Surgical Svcs Co-Mgt Co LLC 401 North Ewing Street Lancaster OH 43130 450672131 Management OH N/A Related 50 50 false false 0.50000 Zane Properties Corporation 401 North Ewing Street Lancaster OH 43130 311202009 Holding Company OH Fairfield Medical Center C Corp 100 100 1.00000 true true false false false true false false false false false false false true false true true false Southeast Ohio Sleep Disorders Center LLC a 47220 Fairfield Healthcare Professionals Inc a 28500 Gordon B Snider Cardiovascular Institute Co-Mgt Co LLC b 31500 FMC Surgical Services Co-Mgt Co LLC b 161000 Fairfield Healthcare Professionals Inc f 946170 Fairfield Healthcare Professionals Inc n 3461978 Fairfield Healthcare Professionals Inc p 1760000 Zane Properties Corporation p 176885 Fairfield Healthcare Professionals Inc q 1364141