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      <Desc>FISHER-TITUS AFFILIATED SERVICES, D.B.A. NORTH CENTRAL EMS PROVIDED 7,863 BILLED SERVICE CALLS IN 2023 TO THE AREA OF HURON, ERIE, OTTAWA, LORAIN, SANDUSKY, SENECA &amp; THE SURROUNDING COUNTIES. THESE RUNS WERE CLASSIFIED AS FOLLOWS: EMERGENCY - 5,369, TRANSPORTATION - 2,253 AND WHEELCHAIR - 241.[CONTINUED ON SCHEDULE O]NORTH CENTRAL EMS PROVIDES RAPID AND SKILLED EMERGENCY ADVANCED LIFE SUPPORT AND TRANSPORTATION SERVICES TO THE COMMUNITIES WE SERVE TO SAVE LIVES AND REDUCE THE EFFECT OF TRAUMA ON THE INJURED. THEIR ARRIVAL TO EMERGENCIES WITHIN THE CITY OF NORWALK AVERAGED 5:49 MINUTES FROM THE RECEIPT OF THE CALL, AND AVERAGED ONLY 7:21 MINUTES FOR ALL CALLS RECEIVED WITHIN THE 600 SQ. MILE SERVICE AREA IN 2023. THIS QUICK RESPONSE DECREASES THE MORTALITY RATE, SHOCK AND DISABLING CONDITIONS THAT WOULD OTHERWISE OCCUR WITHOUT SUCH A HIGH-LEVEL RAPID RESPONSE SERVICE. IN ADDITION, NORTH CENTRAL EMS PROVIDES NON-EMERGENCY TRANSPORTATION SERVICES THROUGHOUT NORTHERN OHIO COVERING OVER A 2,000 SQ. MILE SERVICE AREA.THE EMERGENCY SERVICES LOST $928,515 FROM OPERATIONS IN 2023 DUE TO THE NECESSITY FOR A 24 HOUR A DAY, 365 DAY A YEAR, SEVEN STATION OPERATION. THE TRANSPORTATION AND WHEELCHAIR UNIT SERVICES PROVIDED TO THE COMMUNITIES HELPED OFFSET SOME OF THIS LOSS.NORTH CENTRAL EMS SERVES AS ONE OF THE PUBLIC SERVICE ANSWERING POINTS FOR THE HURON AND ERIE COUNTY 911 EMERGENCY SYSTEMS. THEY ALSO PROVIDES DISPATCHING SERVICES FOR THE VILLAGE OF MILAN POLICE AND FIRE DEPARTMENTS AND BERLIN TOWNSHIP POLICE AND FIRE DEPARTMENTS.IN 2023, NORTH CENTRAL EMS RECEIVED A GRANT THROUGH THE NORTHWEST HOSPITAL COUNCIL FOR A COMMUNITY PARAMEDICINE RURAL PROGRAM. THEY ARE ONE OF THREE EMERGENCY MEDICAL SERVICE ORGANIZATIONS IN THE STATE OF OHIO TO RECEIVE THIS GRANT. THIS GRANT PROVIDES NORTH CENTRAL EMS WITH UP TO $379,000 OVER A THREE-YEAR PERIOD TO IMPLEMENT A COMMUNITY PARAMEDICINE PROGRAM FOCUSED ON HEALTH CARE IN A RURAL AREA.IN 2023, THE THOMAS HINMAN FAMILY CHARITABLE TRUST RECOGNIZED THE NEED FOR NEW LIFESAVING EQUIPMENT AND AWARDED NORTH CENTRAL EMS TWO GRANTS. ONE FOR $16,799 FOR AN AUTO PULSE UNIT, AND A 2ND GRANT FOR $63,773 GRANT TO PURCHASE A POWER COT AND LOADING SYSTEM FOR NORTH CENTRAL EMS CREWS.NORTH CENTRAL PROVIDES THE FOLLOWING PROGRAMS TO THE MEMBERS OF THE COMMUNITIES IN WHICH WE PROVIDE SERVICES:1. PROVIDE COMMUNITY FIRST AID/CPR/AED CLASSES TO ANY GROUP OR ORGANIZATION. IN 2023, NORTH CENTRAL EMS SPONSORED 48 CLASSES WITH 439 PEOPLE ATTENDING. AN AVERAGE OF 1 MEDIC TAUGHT THE COURSE, LASTING ON AVERAGE 5.26 HOURS WITH 1 HOUR PREP. THERE IS A $60.00 CLASS FEE PER PERSON WITH ONE INDIVIDUAL ATTENDING FOR FREE. THIRTEEN CLASSES CHARGED $50.00 FOR THE 196 INDIVIDUALS ATTENDING, ONE CLASS CHARGED $28.00 PER PERSON FOR 32 INDIVIDUALS, AND ONE CLASS CHARGED $40.00 PER PERSON FOR 8 INDIVIDUALS ATTENDING.(TOTAL HOURS SPENT: 287; NET GAIN OF THE PROGRAM $5,229)2. PROVIDE COMMUNITY AUTOMATIC EXTERNAL DEFIBRILLATOR (AED) CLASSES TO ANY GROUP OR ORGANIZATION. IN 2023, NORTH CENTRAL EMS SPONSORED 34 AED/CPR TRAINING CLASSES LASTING ON AVERAGE 2.51 HOURS WITH 1-HOUR PREP. AN AVERAGE OF 1 TO 2 MEDICS TAUGHT THE COURSE, WITH 303 PEOPLE ATTENDING. THERE IS A $40.00 CLASS FEE PER PERSON.(TOTAL HOURS SPENT: 119; NET GAIN OF THE PROGRAM $2,890) 3. PROVIDE FREE EMERGENCY COVERAGE AT 1 LOCAL FAIRGROUNDS IN 2023. DURING THE FAIR, BETWEEN TWO AND THREE PARAMEDICS WERE UTILIZED WORKING BETWEEN FIVE AND EIGHT-HOUR SHIFTS EACH DAY DURING THE 6 DAY LONG FAIR WEEK.(TOTAL HOURS SPENT: 103; COST OF THE PROGRAM $3,212)4. NORTH CENTRAL EMS PROVIDED CHARITY CARE BY TO PATIENTS BASED ON THEIR ABILITY TO PAY. INDIVIDUALS ARE INTERVIEWED TO ASSIST THEM IN DETERMINING EACH PERSON'S ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS AVAILABLE EXTERNALLY. CHARITY CARE PROVIDED TO PATIENTS IN OUR SERVICE AREA DURING 2023 WAS $1,483.</Desc>
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        <CompensationBasedOnRltdOrgsAmt>260816</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>54857</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>54728</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>39700</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>31435</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>441536</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>29929</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MATTHEW E MATTNER</PersonNm>
        <TitleTxt>CHIEF OPERATIONS OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>254704</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>7921</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>56198</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>42218</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>23924</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>384965</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>31437</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SCOTT E ENDSLEY</PersonNm>
        <TitleTxt>CHIEF FINANCIAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>273172</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>7055</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>34591</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>35135</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>17758</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>367711</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>25580</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>PART I LINE 4B &amp; PART II, LINE 3 - INCLUDED IN DR. HUGHES'S TOTAL CONTRIBUTION TO DEFERRED COMPENSATION OF $39,700 REPORTED IN COLUMN C IS $13,200 OF VESTED DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $26,500 FOR THE CURRENT YEAR ACCRUAL OF A NON-VESTED, NON-QUALIFIED RETIREMENT PLAN. THIS PLAN PROVIDES AN ADDITIONAL BENEFIT BASED ON YEARS OF ELIGIBLE SERVICE AND VESTED STATUS AND REMAINS SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. PART I LINE 4B &amp; PART II, LINE 1 -INCLUDED IN DR. BURKEY'S TOTAL CONTRIBUTION TO DEFERRED COMPENSATION OF $60,524 REPORTED IN COLUMN C IS $12,200 OF VESTED DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $48,324 FOR THE CURRENT YEAR ACCRUAL OF A NON-VESTED, NON-QUALIFIED RETIREMENT PLAN. THIS PLAN PROVIDES AN ADDITIONAL BENEFIT BASED ON YEARS OF ELIGIBLE SERVICE AND VESTED STATUS AND REMAINS SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. PART I LINE 4B &amp; PART II, LINE 4 -INCLUDED IN MR. ENDSLEY'S TOTAL CONTRIBUTION TO DEFERRED COMPENSATION OF $35,135 REPORTED IN COLUMN C IS $9,149 OF VESTED DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $25,986 FOR THE CURRENT YEAR ACCRUAL OF A NON-VESTED, NON-QUALIFIED RETIREMENT PLAN. THIS PLAN PROVIDES AN ADDITIONAL BENEFIT BASED ON YEARS OF ELIGIBLE SERVICE AND VESTED STATUS AND REMAINS SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. PART I LINE 4B &amp; PART II, LINE 2 - INCLUDED IN MR. MATTNER'S TOTAL CONTRIBUTIONS TO DEFERRED COMPENSATION OF $42,218 REPORTED IN COLUMN C IS $13,041 OF VESTED DEFERRED WAGES AND QUALIFIED RETIREMENT PLAN CONTRIBUTIONS AND $29,177 FOR THE CURRENT YEAR ACCRUAL OF A NON-VESTED, NON-QUALIFIED RETIREMENT PLAN. THIS PLAN PROVIDES AND ADDITIONAL BENEFIT BASED ON YEARS OF ELIGIBLE SERVICE AND VESTED STATUS AND REMAINS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II LINES 1, 2, AND 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>DR. BRENT BURKEY, SCOTT ENDSLEY AND MATTHEW MATTNER ALL RECEIVED THEIR COMPENSATION FROM FISHER-TITUS MEDICAL CENTER, A RELATED ORGANIZATION. THIS INCLUDES COMPENSATION FOR A SIGNIFICANT AMOUNT OF DR. BURKEY'S 65 HOUR AVERAGE WORK WEEK, MR. ENDSLEY'S 60 HOUR AVERAGE WORK WEEK, AND MR. MATTNER'S 50 HOUR AVERAGE WORK WEEK DEVOTED TO THE FUNCTIONING OF FISHER-TITUS MEDICAL CENTER AS WELL AS UNCOMPENSATED TIME DEVOTED TO OTHER COMMONLY CONTROLLED ORGANIZATIONS LISTED IN SCHEDULE R.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART 1 LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>RESPONSIBILTY FOR DETERMINING AND RECOMMENDING EXECUTIVE COMPENSATION RESTS WITH THE PERSONNEL COMMITTEE OF THE FISHER-TITUS HEALTH BOARD. 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 PERSONNEL COMMITTEE ON RELEVANT PEER GROUPS, CASH COMPENSATION REPORTED IN AVAILABLE SALARY SURVEYS FOR THE PEER GROUP AND TRENDS IN PERQUISITE PROGRAMS CUSTOMARILY AVAILABLE AMONG THE PEER GROUP FOR EXECUTIVES. RECOMMENDATIONS BY THE CONSULTANT ARE PRESENTED TO THE PERSONNEL COMMITTEE WHICH PREPARES MINUTES OF ITS DELIBERATIONS REGARDING EXECUTIVE COMPENSATION INCLUDING RECOMMENDATIONS THAT ARE THEN PROVIDED TO EACH OF THE DIRECTORS OF THE FISHER-TITUS HEALTH BOARD. THE RECOMMENDATIONS TO BE ACTED ON MUST BE APPROVED BY THE PERSONNEL COMMITTEE AND THEN BY THE FISHER-TITUS HEALTH BOARD OF DIRECTORS. THE MINUTES OF EACH BOARD MEETING WHERE SUCH ACTION IS TAKEN REFLECT SUCH ACTION. THIS IS DONE ANNUALLY AND WAS LAST DONE IN MARCH 2023.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>BATTLES INSURANCE AGENCY</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SEE PART V</RelationshipDescriptionTxt>
        <TransactionAmt>193287</TransactionAmt>
        <TransactionDesc>VENDOR</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE L, PART IV, LINE 1</FormAndLineReferenceDesc>
        <ExplanationTxt>PERRY DRYDEN, BOARD MEMBER IS PRESIDENT OF BATTLES INSURANCE AGENCY AND 50% OWNER.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SOLE MEMBER OF FISHER-TITUS AFFILIATED SERVICES IS THE PARENT COMPANY FISHER-TITUS HEALTH, AN OHIO NON-PROFIT CORPORATION</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTOS SHALL BE COMPOSED OF THOSE INDIVIDUALS WHO ARE VOTING DIRECTORS OF THE MEMBER AT ANY TIME, AS DETERMINED UNDER THE CODE OF REGULATIONS OF THE MEMBER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOLLOWING POWERS ARE RESERVED EXCLUSIVELY TO THE MEMBER (FISHER-TITUS HEALTH): A) AMEND OR REPEAL THE ARTICLES OF INCORPORATION AND THE CODE OF REGULATIONS; B) TO APPROVE ANY MERGER OF THE CORPORATION OR ANY SALE OF SUBSTANTIALLY ALL OF ITS ASSETS AND C) TO DISSOLVE OR TERMINATE THE EXISTENCE OF THE CORPORATION AND TO DETERMINE THE DISTRIBUTION OF ASSTES UPON TERMINATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS OF THE FISHER-TITUS AFFILIATED SERVICES DELEGATED THE RESPONSIBILITY FOR THE REVIEW OF THE AFFILIATED SERVICES FORM 990, PLUS ALL REQUIRED SCHEDULES AND ATTACHMENTS, TO THE FISHER-TITUS 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 SERVICES FORM 990 PRIOR TO FILING AND REPORTED TO THE SERVICES BOARD OF DIRECTORS REGARDING THE RESULTS OF THEIR REVIEW. IN ADDITION, EACH MEMBER OF THE SERVICES BOARD OF DIRECTORS HAD ACCESS TO A COPY OF THE FORM 990 FOR VIEWING PRIOR TO FILING VIA A SECURE INTERNET WEBSITE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>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 FISHER-TITUS MEDICAL CENTER ADMINISTRATION. AREAS OF CONFLICT ARE REVIEWED AND ADDRESSED AS NECESSARY FOR THE TRANSACTIONS OF THE BOARD. WHEN 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FISHER-TITUS AFFILIATED SERVICES (EMS) OFFICERS RECEIVE ALL OF THEIR COMPENSATION FROM THE FISHER-TITUS MEDICAL CENTER, (FTMC) A RELATED ORGANIZATION. SUCH COMPENSATION IS SUBJECT TO THE GUIDANCE OF THE PERSONNEL COMMITTEE OF THE FISHER-TITUS HEALTH BOARD. 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 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 PERSONNEL COMMITTEE WHICH PREPARES MINUTES OF ITS DELIBERATIONS REGARDING EXECUTIVE COMPENSATION INCLUDING RECOMMENDATIONS THAT ARE PROVIDED TO EACH OF THE DIRECTORS OF FISHER-TITUS HEALTH. THE RECOMMENDATIONS TO BE ACTED ON MUST BE APPROVED FIRST BY THE JOINT PERSONNEL COMMITTEE AND THEN BY THE FISHER-TITUS HEALTH'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 MARCH 2023.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 18</FormAndLineReferenceDesc>
        <ExplanationTxt>AS REQUIRED, WE OFFER A TIMELY RESPONSE TO WRITTEN REQUESTS FOR COPIES OF THE 990, AS WELL AS HAVING THEM AVAILABLE ON THE PREMISES FOR THE PUBLIC TO REVIEW &amp; ON THE GUIDESTAR INTERNET WEBSITE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>OUR CONFLICT OF INTEREST, CODE OF REGULATIONS, GOVERNING DOCUMENTS &amp; FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VII, SECTION A, LINES 1 ,2 &amp; 4</FormAndLineReferenceDesc>
        <ExplanationTxt>DR. BRENT BURKEY, SCOTT ENDSLEY AND MATTHEW MATTNER ALL RECEIVED THEIR COMPENSATION FROM FISHER-TITUS MEDICAL CENTER, A RELATED ORGANIZATION. THIS INCLUDES COMPENSATION FOR A SIGNIFICANT AMOUNT OF DR. BURKEY'S 65 HOUR AVERAGE WORK WEEK, MR. ENDSLEY'S 60 HOUR AVERAGE WORK WEEK, AND MR. MATTNER'S 50 HOUR AVERAGE WORK WEEK DEVOTED TO THE FUNCTIONING OF FISHER-TITUS MEDICAL CENTER AS WELL AS UNCOMPENSATED TIME DEVOTED TO OTHER COMMONLY CONTROLLED ORGANIZATIONS LISTED IN SCHEDULE R.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C</FormAndLineReferenceDesc>
        <ExplanationTxt>NO PROCESSES HAVE CHANGED FROM PRIOR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>FISHER-TITUS MEDICAL CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>272 BENEDICT AVENUE</AddressLine1Txt>
          <CityNm>NORWALK</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44857</ZIPCd>
        </USAddress>
        <EIN>344430716</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>FISHER-TITUS HEALTH</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>FISHER-TITUS FOUNDATION</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>272 BENEDICT AVENUE</AddressLine1Txt>
          <CityNm>NORWALK</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44857</ZIPCd>
        </USAddress>
        <EIN>341476937</EIN>
        <PrimaryActivitiesTxt>FOUNDATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 7</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>FISHER-TITUS HEALTH</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>FISHER-TITUS HEALTH</BusinessNameLine1Txt>
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          <AddressLine1Txt>272 BENEDICT AVENUE</AddressLine1Txt>
          <CityNm>NORWALK</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44857</ZIPCd>
        </USAddress>
        <EIN>341476935</EIN>
        <PrimaryActivitiesTxt>SYSTEM PARENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12C, III-FI</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
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        <RelatedOrganizationName>
          <BusinessNameLine1Txt>FISHER-TITUS PAIN MANAGEMENT LLC</BusinessNameLine1Txt>
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          <AddressLine1Txt>272 BENEDICT AVENUE</AddressLine1Txt>
          <CityNm>NORWALK</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44857</ZIPCd>
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        <EIN>271471272</EIN>
        <PrimaryActivitiesTxt>PAIN MANAGEMENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>FISHER-TITUS SHARED SERVICES</BusinessNameLine1Txt>
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          <AddressLine1Txt>272 BENEDICT AVENUE</AddressLine1Txt>
          <CityNm>NORWALK</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44857</ZIPCd>
        </USAddress>
        <EIN>834555068</EIN>
        <PrimaryActivitiesTxt>PARTNERSHIP IN SURGERY CENTER</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>THE SURGERY CENTER OF NORTH CENTRAL OHIO</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>7110 CROSSROADS BLVD SUITE 200</AddressLine1Txt>
          <CityNm>BRENTWOOD</CityNm>
          <StateAbbreviationCd>TN</StateAbbreviationCd>
          <ZIPCd>37027</ZIPCd>
        </USAddress>
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        <PrimaryActivitiesTxt>SURGERY CENTER</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TN</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>1</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>