2024-11-13T18:28:32-06:00 2023-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2023-01-01 310645626 FAIRFIELD MEDICAL CENTER FAIR 7406878051 401 NORTH EWING STREET LANCASTER OH 431303371 JOHN R JANOSO JR PRESIDENT & CEO 7406878051 2024-11-13 1 1 EMILIE M KNIERIEM CPA P01330194 3176334705 2024-11-13 2023 2024-10-15 13:58:12Z JOHN R JANOSO JR 401 NORTH EWING STREET LANCASTER OH 431303371 383825873 0 X WWW.FMCHEALTH.ORG X 1982 OH FAIRFIELD MEDICAL CENTER DELIVERS OUTSTANDING HEALTHCARE FOR OUR PATIENTS, THEIR FAMILIES AND OUR COMMUNITIES. 15 13 2030 140 301425 230035 3719 140 301278700 315876820 529590 1771994 11306828 6689161 313118837 324338115 180519 3500 0 0 130127925 130688141 0 0 0 181295466 192757290 311603910 323448931 1514927 889184 312187807 284488383 186879567 176068285 125308240 108420098 FAIRFIELD MEDICAL CENTER DELIVERS OUTSTANDING HEALTHCARE FOR OUR PATIENTS, THEIR FAMILIES AND OUR COMMUNITIES. 0 0 253228386 3500 320344789 A) PATIENT CARE: INPATIENT MEDICAL, SURGICAL, EMERGENCY, MATERNITY, ICU, AND NURSING SERVICES (74,633 DISCHARGES, PROCEDURES & VISITS) B) PATIENT CARE: LABORATORY, CARDIOVASCULAR, RADIOLOGY, THERAPY, PHARMACY, AND MEDICAL SUPPLY SERVICES (6,580,441 PROCEDURES & DOSAGES) C) PATIENT CARE: NUTRITIONAL SERVICES (461,138 MEALS SERVED) PATIENT CARE: LAUNDRY SERVICES (1,109,708 POUNDS) PATIENT CARE: PLANT ENGINEERING, POLICE, HOUSEKEEPING, CENTRAL TRANSPORT, INTEREST & DEPRECIATION (734,265 SQUARE FEET) 253228386 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 135 0 1 2030 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 13 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OH X JOHN R JANOSO JR 7406896825 401 NORTH EWING STREET LANCASTER OH 431303371 JOHN R JANOSO JR DIRECTOR, PRESIDENT, & CEO 55.00 1.00 X X 688696 0 121634 BRADLEY HEDGES PHD CHAIR 3.00 0.00 X X 0 0 0 MATTHEW WIDEMAN VICE CHAIR 3.00 0.00 X X 0 0 0 LAURI LACH SECRETARY 2.00 0.00 X X 0 0 0 RON BURRIS DIRECTOR 2.00 1.00 X 0 0 0 DAN FRUTH DIRECTOR 2.00 1.00 X 0 0 0 ANGELA KRILE DIRECTOR 2.00 0.00 X 0 0 0 MIKE LIEBER DIRECTOR 2.00 0.00 X 0 0 0 LAURIANNE SCOTT DO DIRECTOR 2.00 0.00 X 0 0 0 STEPHEN SWICK DIRECTOR 2.00 0.00 X 0 0 0 LAURA TUSSING DIRECTOR 3.00 1.00 X 0 0 0 MARIE WARD PHD DIRECTOR 2.00 0.00 X 0 0 0 THERESA DYAR DO DIRECTOR /RESIDENCY PROGRAM DIRECTOR 28.00 0.00 X 185475 0 8346 NATALIE FURNISS DIRECTOR 2.00 0.00 X 0 0 0 ALAN F GREENSLADE CIO, TREASURER 40.00 2.00 X 326580 0 50609 LAURA MOORE CHIEF BUSINESS STRATEGY & DEV OFFICER 40.00 0.00 X 310471 0 42312 MARK T DARNELL MD CMO 40.00 0.00 X 391892 0 10831 JONATHAN KELLY CFO 40.00 0.00 X 290822 0 27639 MARK E VANDERHOFF CHIEF NURSING OFFICER 40.00 0.00 X 251598 0 40981 MARY NASH CHIEF HUMAN RESOURCES OFFICER 40.00 0.00 X 172044 0 8078 TROY HAMPTON RESIDENCY PROGRAM DIRECTOR 26.00 0.00 X 169150 0 9661 CAROLINE V SEGELKEN STAFF PHARMACIST 42.00 0.00 X 174713 0 28648 ELIZABETH BRENDSEL STAFF PHARMACIST 40.00 0.00 X 166044 0 30664 CINDY L DOWNS TEAM LEADER IV 58.00 0.00 X 181205 0 22377 JEFFREY COLLINS DIRECTOR OF PATIENT SERVICES 40.00 0.00 X 165012 0 22307 3473702 0 424087 131 0 1 0 FAIRFIELD ANESTHESIA ASSOCIATES PO BOX 427 LANCASTER OH 43130 PHYSICIAN SERVICES 3783650 RENOVO SOLUTIONS 4 EXECUTIVE CIRCLE IRVINE CA 92614 BIOMEDICAL SERVICES 2354180 SPECIALTY CARE MISS SERVICES DEPT 1614 BIRMINGHAM AL 352461614 PERSONNEL SERVICES 1457060 EMP OF LANCASTER PO BOX 645948 CINCINNATI OH 452645948 PHYSICIAN SERVICES 1192500 BLUE & CO LLC 500 N MERIDIAN ST STE 200 INDIANAPOLIS IN 46204 ACCOUNTING SERVICES 972184 18 140 140 PATIENT SERVICE REVENUE 621110 315876820 315876820 315876820 1932475 1932475 116550 28484 612971 0 -496421 28484 -467937 28484 -496421 57114845 1599461 57021475 1853312 93370 -253851 -160481 -160481 JOINT VENTURE INCOME 900099 3769220 3769220 CAFETERIA SALES 722514 1011762 1011762 OUTSIDE REFERENCE LAB 621500 264890 264890 2111226 698749 8051 1404426 7157098 324338115 320344789 301425 3691761 X 3500 3500 2928009 2645184 282825 100451319 90748426 9702893 5134525 4587499 547026 14708908 13141838 1567070 7465380 6670027 795353 14818831 14818831 1066699 1066699 269928 269928 58002007 36681551 21320456 454548 264018 190530 4166525 3403083 763442 10200 5925 4275 4494507 2044018 2450489 164722 134540 30182 6535345 5535954 999391 15835234 11378987 4456247 973912 788834 185078 MEDICAL SUPPLIES 73453477 72964186 489291 FRANCHISE FEE 8753927 8753927 DIETARY 1828976 1493848 335128 RECRUITMENT 394039 321838 72201 1534413 415130 1119283 323448931 253228386 70220545 0 4094323 4055607 33842811 27015946 35675843 36742113 745452 409911 7015704 6033479 2193594 6608392 360583662 236711107 138640709 123872555 46351503 49786643 14610238 8779458 7527642 7527642 21489988 13656637 312187807 284488383 40205995 37796107 81139493 78851589 8750905 6825905 56783174 52594684 186879567 176068285 X 125308240 108420098 125308240 108420098 312187807 284488383 X 889184 4563586 -22340912 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 4430 4430 0 PART II-B, LINE 1: PORTION OF DUES PAID TO AMERICAN HEART ASSOCIATION AND OHIO HOSPITAL ASSOCIATION ATTRIBUTABLE TO LOBBYING. 5550394 5550394 163298809 106972018 56326791 11390496 4308095 7082401 180233681 125430994 54802687 110282 110282 123872555 OTHER LIABILITIES 11971998 FINANCE LEASE LIABILITY 36054298 OPERATING LEASE LIABILITY 4568388 52594684 X PART X, LINE 2: THE INTERNAL REVENUE SERVICES (IRS) HAS RULED THAT THE HOSPITAL AND FHP ARE TAX EXEMPT UNDER SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). ACCORDINGLY, NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN MADE IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEARS ENDING DECEMBER 31, 2023 AND 2022. 1 1 1 X 1 X 1 1 0 1 1 2690468 2195897 494571 0.00150 37548838 33121406 4427432 0.01370 40239306 35317303 4922003 0.01520 16 6 1303137 63429 1239708 0.00380 3 5269865 3694537 1575328 0.00490 1 5596292 5835334 0 0.00000 1 84777 84777 0.00030 3 84925 84925 0.00030 24 6 12338996 9593300 2984738 0.00930 24 6 52578302 44910603 7906741 0.02450 1 2500 2500 0.00000 1 5039 5039 0.00000 1 8083 8083 0.00000 1 12618 12618 0.00000 4 28240 28240 0.00000 1 14723639 54877423 56408924 -1531501 X 1 1 FAIRFIELD MEDICAL CENTER 401 NORTH EWING STREET LANCASTER OH 43130 WWW.FMCHEALTH.ORG 1167 X X X X FAIRFIELD MEDICAL CENTER 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X FMCHEALTH.ORG X HTTPS://WWW.FMCHEALTH.ORG/ARTICLES-EVENTS-RESOURCES/COMMUNITY-SERVICES/ X 1 22 1 FMCHEALTH.ORG 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X X 1 X HTTPS://WWW.FMCHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE/ X HTTPS://WWW.FMCHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE/ X HTTPS://WWW.FMCHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE/ X X X X X 1 X 0 X X X 1 X 0 0 FAIRFIELD MEDICAL CENTER PART V, SECTION B, LINE 5: THE 2022 FAIRFIELD COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IS A COLLABORATIVE EFFORT OF FAIRFIELD MEDICAL CENTER, FAIRFIELD COUNTY HEALTH DEPARTMENT, FAIRFIELD COMMUNITY HEALTH CENTER, ADAMH BOARD AND THE UNITED WAY WHICH IS CONDUCTED EVERY THREE YEARS. AN INDEPENDENT MARKET RESEARCH FIRM, ILLUMINOLOGY, WAS CONTRACTED TO CONDUCT THE ASSESSMENT.THE 2022 ASSESSMENT, STARTED IN FEBRUARY OF 22 AND WAS COMPLETED IN THE FALL, WAS BASED ON INPUT FROM 30 COMMUNITY ORGANIZATIONS WHO PARTICIPATED IN GROUP DISCUSSIONS AND/OR ONE-ON-ONE INTERVIEWS. PARTICIPATING ORGANIZATIONS INCLUDE:ALZHEIMER'S ASSOCIATION CENTRAL OHIO CHAPTERBALTIMORE VILLAGEBLOOM-CARROLL LOCAL SCHOOL DISTRICTFAIRFIELD COMMUNITY HEALTH CENTERFAIRFIELD COUNTY 211FAIRFIELD COUNTY ADAMH BOARDFAIRFIELD COUNTY BOARD OF COMMISSIONERSFAIRFIELD COUNTY BOARD OF HEALTHFAIRFIELD COUNTY EMERGENCY MANAGEMENTFAIRFIELD COUNTY FAMILY, ADULT AND CHILDREN FIRST COUNCILFAIRFIELD COUNTY FOUNDATIONFAIRFIELD COUNTY HEALTH DEPARTMENTFAIRFIELD COUNTY JOB AND FAMILY SERVICESFAIRFIELD COUNTY LIBRARYFAIRFIELD COUNTY PROTECTIVE SERVICESFAIRFIELD MEDICAL CENTERJUVENILE COURTLANCASTER CITY SCHOOLSLANCASTER-FAIRFIELD COMMUNITY ACTION AGENCYMAJOR CRIMES UNITMEALS ON WHEELSMOUNT CARMEL HEALTH SYSTEMNEW HORIZONSOHIOGUIDESTONEOSU EXTENSION OFFICEPICKERINGTON LOCAL SCHOOL DISTRICTROBERT K. FOX FAMILY YMCASOUTHEASTERN OHIO CENTER FOR INDEPENDENT LIVINGUNITED WAYVIOLET TOWNSHIP FIRE DEPARTMENTIN ADDITION TO COMMUNITY ORGANIZATIONS AND LEADERS, 700 AREA RESIDENTS PROVIDED INPUT IN A MAIL SURVEY CONDUCTED IN APRIL OF 2022. FAIRFIELD MEDICAL CENTER PART V, SECTION B, LINE 6A: ONE OTHER HOSPITAL PARTICIPATED IN THE CHNA: MOUNT CARMEL HEALTH SYSTEM (DILEY RIDGE MEDICAL CENTER FACILITY IS IN FAIRFIELD COUNTY) FAIRFIELD MEDICAL CENTER PART V, SECTION B, LINE 6B: OTHER ORGANIZATIONS THAT CONDUCTED THE CHNA ARE: FAIRFIELD COUNTY HEALTH DEPARTMENT, FAIRFIELD COMMUNITY HEALTH CENTER, ADAMH BOARD AND THE UNITED WAY. FAIRFIELD MEDICAL CENTER PART V, SECTION B, LINE 11: FAIRFIELD MEDICAL CENTER REVIEWED THE HEALTH NEEDS IDENTIFIED IN THE CHNA PROCESS AND DEVELOPED A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) TO ADDRESS AREAS OF NEED THAT MOST CLOSELY ALIGN WITH OUR MISSION, RESOURCES AND STRATEGIC INITIATIVES: 1) CARDIOVASCULAR DISEASE 2) ACCESS TO CARE 3) CANCER CARE. THE CHIP OUTLINES TACTICS, AN IMPLEMENTATION TIMELINE, RESOURCES AND MEASURES OF SUCCESS FOR EACH AREA. FMC ACKNOWLEDGES THE WIDE RANGE OF HEALTH ISSUES IMPACTING OUR COMMUNITY THAT WERE IDENTIFIED DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. ALTHOUGH OUR FOCUS IS ON THE ITEMS LISTED ABOVE, THERE ARE OTHER NEEDS IN OUR COMMUNITY. FMC WILL NOT BE TAKING THE LEAD ON THESE INITIATIVES BUT WILL PARTNER WITH OTHER AREA AGENCIES WHO HAVE THE RESOURCES TO ADDRESS. THESE INCLUDE:-SUBSTANCE USE TREATMENT AND PREVENTION: WHILE NOT AN AREA OF FOCUS, WE WILL: ENSURE PATIENTS ARE REFERRED TO RESOURCES IN THE COMMUNITY, CONTINUE TO PARTNER WITH THE FAIRFIELD HEALTH DEPARTMENT ON PROJECT DAWN, PARTICIPATE IN THE OARRS PRESCRIPTION REPORTING SYSTEM AND COLLABORATE WITH ADAHM.-MENTAL HEALTHCARE: WHILE NOT AN AREA OF FOCUS, WE WILL CONTINUE TO PROVIDE INPATIENT AND OUTPATIENT MENTAL HEALTH SERVICE FOR THE COMMUNITY AND EAP SERVICES FOR OUR EMPLOYEES, MAINTAIN CHAPLAINS AND BEHAVIORAL HEALTH COUNSELORS IN THE EMERGENCY DEPARTMENT AND PROVIDE SUPPORT TO OTHER ORGANIZATIONS ADDRESSING THIS NEED.-TRANSPORTATION: WHILE NOT AN AREA OF FOCUS FOR FMC, WE WILL WORK WITH LANCASTER TRANSIT, PERRY COUNTY TRANSIT, FUN BUS AND OTHER AGENCIES TO FACILITATE TRANSPORTATION FOR PATIENTS IN NEED AND WILL PROVIDE TELEHEALTH APPOINTMENTS FOR PATIENTS WITH TRANSPORTATION ISSUES AS APPROPRIATE.-OBESITY: WHILE NOT AN AREA OF FOCUS, WE WILL CONTINUE TO OFFER EDUCATION AND COUNSELING ON NUTRITION, WEIGHT LOSS AND FITNESS. PART II, COMMUNITY BUILDING ACTIVITIES: KNOWING THAT A STRONG ECONOMY CAN HELP BUILD STRONG PEOPLE, WE HAVE DEDICATED OURSELVES TO HELPING OUR LOCAL ECONOMY THROUGH DONATIONS TO ORGANIZATIONS HELPING TO DRAW MORE BUSINESS TO THE AREA AND BY PARTICIPATING IN LOCAL CHAMBERS OF COMMERCE. FAIRFIELD MEDICAL CENTER (FMC) SUPPORTS OUR COMMUNITIES WITH POLICE ASSISTANCE AND BY EMERGENCY PLANNING WITH OTHER COMMUNITY ORGANIZATIONS. GOOD LEADERS ARE IMPORTANT TO THE FUTURE OF OUR COMMUNITY, SO WE ARE ACTIVELY INVOLVED IN LEADERSHIP DEVELOPMENT AND TRAINING. WE ALSO RECOGNIZE THE IMPORTANCE OF RECYCLING AS A WAY TO IMPROVE THE HEALTH OF OUR PLANET, AND THEREFORE OUR PEOPLE, WITH ENVIRONMENTAL IMPROVEMENTS. PARTICIPATION WITH OTHER COMMUNITY ENTITIES BY COALITION BUILDING ALSO HELPS US TO KEEP OUR PULSE ON THE HEALTH OF THE COMMUNITY THROUGH GRASSROOTS INVOLVEMENT. PART III, LINE 2: 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 CENTER'S 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: SEE PAGE 15 OF THE DECEMBER 31, 2023 AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: ALL MEDICARE SHORTFALL IS CONSIDERED COMMUNITY BENEFIT BECAUSE FAIRFIELD MEDICAL CENTER TREATS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY AND REGARDLESS OF SUPPLEMENTAL INSURANCE COVERAGE, IN THE CASE OF MEDICARE PATIENTS. IT IS FOR THE BETTERMENT OF THE COMMUNITY THAT WE TREAT MEDICARE PATIENTS, REGARDLESS OF THE SHORTFALL OR SURPLUS.THE TOTAL FOR MEDICARE COST IS TAKEN DIRECTLY FROM THE MEDICARE COST REPORT. PART III, LINE 9B: IN ALL INSTANCES OF DEBT COLLECTION, PATIENTS ARE GIVEN INFORMATION REGARDING FINANCIAL ASSISTANCE AVAILABLE. IN ADDITION, PATIENTS ARE MADE AWARE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE WITH AN ACKNOWLEDGEMENT LETTER OF SERVICES RENDERED, REGARDLESS OF ABILITY TO PAY OR PAYMENT SOURCE. FMC WILL DO EVERYTHING POSSIBLE TO HELP THOSE WHO QUALIFY FOR CHARITY CARE TO BE MADE AWARE OF THE ASSISTANCE AVAILABLE. WE ALSO PROVIDE FINANCIAL COUNSELORS TO ASSIST PATIENTS IN FILLING OUT THE NECESSARY FORMS FOR ASSISTANCE. THE FOLLOWING OPTIONS ARE AVAILABLE:A. PAYMENT IN THE FORM OF CASH, CREDIT CARD OR CHECKS. A DISCOUNT IS OFFERED WITH PAYMENT AT THE TIME OF SERVICE AND WITHIN 10 DAYS OF RECEIVING THE HOSPITAL BILL. B. H.E.L.P. BANK FINANCIAL PROGRAMC. HOSPITAL PAYMENT PROGRAM D. ASSISTANCE WITH APPLICATION TO MEDICARE OR MEDICAIDE. HOSPITAL CARE ASSURANCE PROGRAM (HCAP) F. HOSPITAL ASSISTANCE PROGRAM SUMMARYDEFINING FAIRFIELD MEDICAL CENTER'S FINANCIAL OPPORTUNITIES. G. ASSISTANCE FOR THE UNINSURED PATIENT. PART VI, LINE 2: IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR FAIRFIELD COUNTY AS REPORTED IN PART V, SECTION B, FAIRFIELD MEDICAL CENTER ASSESSES THE HEALTH CARE NEEDS OF THE BROADER COMMUNITY WE SERVE BY PARTICIPATING IN THE PERRY COUNTY COMMUNITY HEALTH NEEDS ASSESSMENTS AND COMMUNITY HEALTH IMPROVEMENT PLAN. ADDITIONALLY, WE PARTICIPATE IN LOCAL HEALTH NETWORKS FOR PERRY, HOCKING AND FAIRFIELD COUNTIES WHICH MEET ON A REGULAR BASIS TO DISCUSS EVOLVING HEALTH ISSUES AND CONCERNS. WE ALSO PARTICIPATE IN THE HOCKING, PERRY AND LANCASTER CHAMBER OF COMMERCE AS WELL AS NUMEROUS GROUPS OR NETWORKS FOCUSING ON SPECIFIC POPULATIONS INCLUDING THE ELDERLY (OLDER ADULT NETWORK, ADULT FAMILY CHILD FIRST COUNCIL), CHILDREN (SAFE KIDS/SAFE COMMUNITIES, YMCA), AND MENTAL HEALTH (INNERSYSTEMS). ADDITIONALLY, FMC'S STRATEGIC PLANNING PROCESS ASSESSES NEW SERVICES, TECHNOLOGIES AND PROVIDERS THAT FMC CAN OFFER LOCALLY SO THAT RESIDENTS DO NOT HAVE TO LEAVE THE COMMUNITY AND TRAVEL LONG DISTANCES TO RECEIVE NECESSARY SERVICES. PART VI, LINE 3: THERE ARE PROMINENT SIGNS IN REGISTRATION AREAS AND IN FINANCIAL NAVIGATION SHOWING OUR FINANCIAL POLICY. EVERY HOSPITAL BILL SENT TO PATIENTS HAS A FLYER INCLUDED WITH OUR FINANCIAL POLICY CLEARLY DESCRIBED. FINANCIAL COUNSELORS MEET WITH PATIENTS BEFORE THEY'RE DISCHARGED FROM THE HOSPITAL SO THAT EACH PATIENT IS PERSONALLY MADE AWARE OF OUR POLICY AND ALSO TO IDENTIFY THOSE WHO QUALIFY FOR FINANCIAL ASSISTANCE, THEN THE FINANCIAL COUNSELORS ASSIST WITH COMPLETING THE ASSISTANCE INFORMATION SHOULD HELP BE NEEDED. PART VI, LINE 4: FAIRFIELD MEDICAL CENTER SERVES A THREE COUNTY AREA IN SOUTH EASTERN OHIO COMPRISED OF FAIRFIELD, HOCKING AND PERRY COUNTIES. THE TOTAL POPULATION IS 224,000 WITH 35% OF THE POPULATION LIVING IN A RURAL AREA. THE SOUTHERN PORTION OF PERRY COUNTY IS A LARGELY UNDERSERVED REGION IN THE RURAL HILLS OF APPALACHIA. PART VI, LINE 5: FAIRFIELD MEDICAL CENTER HAS AN OPEN MEDICAL STAFF, COMMUNITY BOARD AND FOUNDATION WHICH PLAYS A VITAL ROLE IN SUPPORTING ACCESS TO MEDICAL CARE AND WELLNESS PROGRAMS THROUGHOUT FAIRFIELD, HOCKING AND PERRY COUNTIES. WE ALSO SPONSOR COMMUNITY HEART WATCH WHICH IS A COLLABORATIVE EFFORT OF AREA EMS, BUSINESSES, SCHOOLS AND OTHER ORGANIZATIONS DEDICATED TO IMPROVING SURVIVAL FROM CARDIAC ARREST. PART VI, LINE 7: OH X X X X 0 1 0 0 0 0 0 0 0 JOHN R JANOSO JR DIRECTOR, PRESIDENT, & CEO 657016 0 24793 0 6887 0 102300 0 19334 0 810330 0 0 0 MARK T DARNELL MD CMO 390677 0 0 0 1215 0 9900 0 931 0 402723 0 0 0 ALAN F GREENSLADE CIO, TREASURER 325437 0 0 0 1143 0 19800 0 30809 0 377189 0 0 0 LAURA MOORE CHIEF BUSINESS STRATEGY & DEV OFFICE 309291 0 0 0 1180 0 18947 0 23365 0 352783 0 0 0 JONATHAN KELLY CFO 163529 0 0 0 127293 0 12021 0 15618 0 318461 0 0 0 MARK E VANDERHOFF CHIEF NURSING OFFICER 250441 0 0 0 1157 0 15672 0 25309 0 292579 0 0 0 CINDY L DOWNS TEAM LEADER IV 180426 0 0 0 779 0 11164 0 11213 0 203582 0 0 0 CAROLINE V SEGELKEN STAFF PHARMACIST 174573 0 0 0 140 0 10808 0 17840 0 203361 0 0 0 ELIZABETH BRENDSEL STAFF PHARMACIST 165762 0 0 0 282 0 10426 0 20238 0 196708 0 0 0 THERESA DYAR DO DIRECTOR /RESIDENCY PROGRAM DIRECTOR 185123 0 0 0 352 0 8346 0 0 0 193821 0 0 0 JEFFREY COLLINS DIRECTOR OF PATIENT SERVICES 163131 0 957 0 924 0 9408 0 12899 0 187319 0 0 0 MARY NASH CHIEF HUMAN RESOURCES OFFICER 131803 0 39742 0 499 0 4172 0 3906 0 180122 0 0 0 TROY HAMPTON RESIDENCY PROGRAM DIRECTOR 168998 0 0 0 152 0 9661 0 0 0 178811 0 0 0 A COUNTY OF FAIRFIELD OHIO 316400066 304286AM9 2013-06-27 98511516 TO REFUND PRIOR ISSUE AND TO FUND NEW SURGICAL UNIT 0 0 0 A 19059060 98511516 6320525 926511 35000000 56264480 2015 1 0 0 1 A 0 0 0 0 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 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 FINANCE BOARD AND AUDIT COMMITTEE OF THE ORGANIZATION AFTER REVIEW BY THE CHIEF FINANCIAL OFFICER. 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 15 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 REQUEST MADE TO FMC MANAGEMENT. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 20,002,180. MANAGEMENT AND GENERAL EXPENSES 14,434,687. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,436,867. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 16,459,695. MANAGEMENT AND GENERAL EXPENSES 6,795,079. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 23,254,774. CONSULTANT FEES: PROGRAM SERVICE EXPENSES 219,676. MANAGEMENT AND GENERAL EXPENSES 90,690. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 310,366. FORM 990, PART XI, LINE 9: ASSET TRANSFER TO AFFILIATES -20,876,087. CHANGE IN INTEREST OF NET ASSETS OF 301,805. PRIOR PERIOD ADJUSTMENT DUE TO RESTATEMENT OF AUDIT -1,766,630. FORM 990, PART XII, LINE 2C: THE PROCESS OF SELECTING AN INDEPENDENT ACCOUNTANT AND OVERSIGHT OF THE AUDIT HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990 PART IX LINE 11G OTHER FEES FOR SERVICES INCLUDE LAB TESTING, ADMINISTRATIVE CONSULTING, OUTSOURCED BIOMEDICAL SERVICES, OUTSOURCED COLLECTION SERVICES, OUTSOURCED IT SERVICES AND OTHER GENERAL PURCHASED SERVICES. FORM 990 PART XI LINE 9 THE OTHER CHANGE IN NET ASSETS REPORTED REPRESENTS INTERCOMPANY TRANSFERS BETWEEN FAIRFIELD MEDICAL CENTER AND RELATED ORGANIZATIONS (SEE SCHEDULE R) FOR FIXED ASSET PURCHASES, SHARED EMPLOYEES, EXPENSES AND OTHER INTERCOMPANY TRANSACTIONS. FAIRFIELD HEALTHCARE PROFESSIONALS INC 401 NORTH EWING LANCASTER OH 43130 311425884 PHYSICIAN PRACTICES OH 501(C)(3) LINE 11 FAIRFIELD MEDICAL CENTER 0 FAIRFIELD MEDICAL CENTER FOUNDATION 401 NORTH EWING LANCASTER OH 43130 208952945 FUNDRAISING OH 501(C)(3) LINE 7 N/A 0 FAIRFIELD MEDICAL CENTER TWIG II 1724 E MAIN STREET LANCASTER OH 43130 237146033 SUPPORT FAIRFIELD MEDICAL CENTER OH 501(C)(3) LINE 12D, III-O N/A 0 ZANE PROPERTIES CORPORATION 401 NORTH EWING STREET LANCASTER OH 43130 311202009 HOLDING COMPANY OH FAIRFIELD MEDICAL CENTER C -378478 2885185 1.00000 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 FAIRFIELD HEALTHCARE PROFESSIONALS INC G 122192 FAIRFIELD HEALTHCARE PROFESSIONALS INC P 1947779 FAIRFIELD HEALTHCARE PROFESSIONALS INC R 17722668 ZANE PROPERTIES CORPORATION Q 63585 ZANE PROPERTIES CORPORATION R 687655 ZANE PROPERTIES CORPORATION P 67419