Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 01-01-2013 , 2013, and ending 12-31-2013
BCheck if applicable:
CName of organization
FISHER-TITUS MEDICAL CENTER
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
272 BENEDICT AVENUE
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
NORWALK, OH44857
D Employer identification number

34-4430716
E Telephone number

G Gross receipts $ 165,691,251
F Name and address of principal officer:
LORNA STRAYER
272 BENEDICT AVENUE
NORWALK,OH44857
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.FTMC.COM
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1911
M State of legal domicile: OH
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: PROVIDE QUALITY HEALTHCARE IN A COST EFFECTIVE MANNER, WHILE RESPECTING THE DIGNITY AND UNIQUENESS OF EACH INDIVIDUAL WE SERVE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 11
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 7
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 1,108
6 Total number of volunteers (estimate if necessary) ............. 6 251
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 1,090,285
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 94,561
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 36,739 78,006
9 Program service revenue (Part VIII, line 2g) ......... 113,659,343 117,779,460
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 570,568 3,408,497
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,058,327 1,012,473
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 115,324,977 122,278,436
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 289,673 248,606
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 58,430,475 60,915,998
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 52,373,485 56,329,215
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 111,093,633 117,493,819
19 Revenue less expenses. Subtract line 18 from line 12....... 4,231,344 4,784,617
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 193,347,072 206,627,032
21 Total liabilities (Part X, line 26)............. 71,718,381 59,311,711
22 Net assets or fund balances. Subtract line 21 from line 20..... 121,628,691 147,315,321
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: PROVIDE QUALITY HEALTHCARE IN A COST EFFECTIVE MANNER, WHILE RESPECTING THE DIGNITY AND UNIQUENESS OF EACH INDIVIDUAL WE SERVE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 95,506,027 including grants of $ 248,606 ) (Revenue $ 110,723,043 )
SEE SCHEDULE O
4b (Code:   ) (Expenses $ 4,873,327 including grants of $   ) (Revenue $ 7,056,417 )
SEE SCHEDULE O
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet100,379,354
Form 990 (2013)
Form 990 (2013)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
 
No
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV......... Click to see attachment
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
Yes
 
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II.................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV..................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M............. Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
224
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
1,108
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2013)
Form 990 (2013)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
11
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
7
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
OH
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletDAVID WILSON MBACMA272 BENEDICT AVENUENORWALKOH44857 (419) 668-8101
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) LESLIE D STONEHAM........................................................................
CHAIRMAN
 15.00
.......................   		X   X       0 0 0
(2) CHARLES F FUREY........................................................................
VICE CHAIRMAN - THRU 7/ 2013
 8.00
.......................   		X   X       0 0 0
(3) MATT GROSS........................................................................
TREASURER/ VICE CHAIRMAN
 12.00
.......................3.00 		X   X       0 0 0
(4) REV FRED WIECHERS........................................................................
SECRETARY
 8.00
.......................   		X   X       0 0 0
(5) JOHN D PAYNE CPA........................................................................
TREASURER/ DIRECTOR
 10.00
.......................4.00 		X   X       0 0 0
(6) PERRY DRYDEN........................................................................
DIRECTOR
 4.00
.......................2.00 		X           0 0 0
(7) WILLIAM B CORNELL MD........................................................................
DIRECTOR
 8.00
.......................   		X           0 0 0
(8) THOMAS C BLEILE........................................................................
DIRECTOR
 8.00
.......................   		X           0 0 0
(9) VIRGINIA H POLING........................................................................
DIRECTOR
 6.00
.......................   		X           0 0 0
(10) ERIC SCHMIDT MD........................................................................
DIRECTOR
 4.00
.......................2.00 		X           0 0 0
(11) GLENN TRIPPE MD........................................................................
DIRECTOR
 8.00
.......................2.00 		X           0 0 0
(12) ROSS MATLACK........................................................................
PRESIDENT - BEGINNING 6/ 2013
 49.50
.......................15.50 		X   X       209,686 0 17,351
(13) PATRICK J MARTIN........................................................................
PRESIDENT/ SPECIAL PROJECT MGR
 49.50
.......................15.50 		X   X       726,735 0 174,328
(14) LORNA STRAYER........................................................................
SENIOR VP, ADMIN & BUSINES
 50.00
.......................   		    X       221,585 0 82,967
(15) DUANE WOODS........................................................................
VP OF FINANCE/CFO
 44.00
.......................6.00 		    X       250,523 0 47,771
(16) GARY MOORMAN........................................................................
VP MEDICAL AFFAIRS THRU 8/2013
 45.00
.......................   		      X     260,418 0 17,949
(17) CHERIE M SPRAGG........................................................................
SENIOR VP OF NURSING SERVI
 50.00
.......................   		      X     214,581 0 89,599
Form 990 (2013)
Form 990 (2013)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) PHILLIP J ANNARINO........................................................................
VP HUMAN RESOURCES
 45.00
.......................   		      X     202,324 0 44,914
(19) JOHN BRITTON........................................................................
VP INFORMATION SERVICES
 45.00
.......................   		      X     198,490 0 16,898
(20) GEORGE B ELMER........................................................................
DIRECTOR OF ASSET MGMT/EMS
 50.30
.......................4.70 		        X   180,491 0 26,468
(21) MITCH ESCH........................................................................
DIRECTOR OF PHARMACY
 40.00
.......................   		        X   162,102 0 92,512
(22) SUZANNE S INGLIS........................................................................
ASST VP NURSING & SURGICAL SVCS
 40.00
.......................   		        X   141,440 0 14,736
(23) SCOTT P STEINMETZ........................................................................
DIRECTOR OF INFORMATION SVCS
 40.00
.......................   		        X   140,473 0 13,164
(24) SHARON HARWOOD........................................................................
RISK MANAGER
 40.00
.......................   		        X   130,595 0 40,509












1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 3,039,443 0 679,166
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet24
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
THE ROBINS & MORTON GROUP5500 MARYLAND WAY SUITE 100BRENTWOODTN37027 BUILDING CONTRACTOR 6,926,529
CERNER CORPORATION2800 ROCKCREEK PARKWAYKANSAS CITYMO64117 HEALTHCARE INFORMATION TECHNOLOGY 2,773,201
HOSPITAL MEDICINE ASSOCIATES OF OHIOPO BOX 634850CINCINNATIOH45263 HOSPITALIST 2,353,470
BOSTWICK DESIGN PARTNERSHIP2729 PROSPECT AVECLEVELANDOH44115 ARCHITECTS 868,768
LABORATORY CORP OF AMERICAPO BOX 12140BURLINGTONNC27216 BLOOD ADMIN & LAB TESTING 717,265
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet18
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b 235
c Fundraising events....1c  
d Related organizations...1d 77,771
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines
1a-1f:$ 		48,896
h Total. Add lines 1a-1f.......MediumBullet 78,006
Program Service RevenueAmt Business Code
2a NET PATIENT SERVICES 900099 109,632,758 109,632,758    
b NET NURSING HOME & ASSISTED LIVIN 623000 7,056,417 7,056,417    
c MEDICAL LABORATORY 621500 1,055,553   1,055,553  
d HEALTH AND ALLIED SERVICES 621990 34,732   34,732  
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 117,779,460
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 895,926     895,926
4 Income from investment of tax-exempt bond proceeds..MediumBullet 132     132
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 45,925,129 125
b Less: cost or other basis and sales expenses 43,062,230 350,585
c Gain or (loss) 2,862,899 -350,460
d Net gain or (loss)..........MediumBullet 2,512,439     2,512,439
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a CAFETERIA SALES 722210 480,666     480,666
b OTHER HOSPITAL REVENUE 900099 273,141     273,141
c AUXILIARY SALES 453220 258,666     258,666
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 1,012,473
12 Total revenue. See Instructions......MediumBullet 122,278,436 116,689,175 1,090,285 4,420,970
Form 990 (2013)
Form 990 (2013)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 241,746 241,746
2 Grants and other assistance to individuals in the United States. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 6,860 6,860
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 2,776,120 1,784,470 991,650  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 41,086,913 35,187,078 5,899,835  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 4,505,217 3,858,295 646,922  
9 Other employee benefits ....... 9,346,025 8,013,992 1,332,033  
10 Payroll taxes ........... 3,201,723 2,741,974 459,749  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 435,551 326,663 108,888  
c Accounting ........... 129,600 64,800 64,800  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 112,072   112,072  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 8,966,150 6,486,194 2,479,956  
12 Advertising and promotion .... 498,260 487,685 10,575  
13 Office expenses ....... 3,938,240 2,254,857 1,683,383  
14 Information technology ...... 3,967,275 3,054,329 912,946  
15 Royalties ..        
16 Occupancy ........... 1,943,127 1,229,743 713,384  
17 Travel ............ 168,497 114,466 54,031  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 391,312 126,304 265,008  
20 Interest ........... 898,577 859,736 38,841  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 8,628,035 8,225,390 402,645  
23 Insurance .............. 673,159 478,653 194,506  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 16,678,593 16,674,833 3,760  
b BAD DEBT EXPENSES 5,606,219 5,606,219    
c OHIO HOSPITAL TAX & SN 1,879,481 1,879,481    
d UBI INCOME TAX 65,745 61,388 4,357  
e All other expenses 1,349,322 614,198 735,124  
25 Total functional expenses. Add lines 1 through 24e 117,493,819 100,379,354 17,114,465 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 5,225 1 5,275
2 Savings and temporary cash investments ......... 8,946,760 2 2,435,468
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 12,665,479 4 12,473,388
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
222,121 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net ............. 1,534,477 7 3,470,745
8 Inventories for sale or use .............. 2,163,680 8 2,339,813
9 Prepaid expenses and deferred charges .......... 2,040,024 9 2,052,470
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 171,832,970
b Less: accumulated depreciation ..... 10b 70,452,355 88,493,373 10c 101,380,615
11 Investments—publicly traded securities .......... 74,581,195 11 79,734,512
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 ..... 245,374 13 0
14 Intangible assets ............... 229,542 14 217,542
15 Other assets. See Part IV, line 11 ........... 2,219,822 15 2,517,204
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 193,347,072 16 206,627,032
Liabilities 17 Accounts payable and accrued expenses ......... 39,791,474 17 28,754,609
18 Grants payable .................   18  
19 Deferred revenue ................ 292,163 19 270,271
20 Tax-exempt bond liabilities ............. 31,515,000 20 30,205,000
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 119,744 23 81,831
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................   25  
26 Total liabilities. Add lines 17 through 25......... 71,718,381 26 59,311,711
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 121,610,373 27 147,296,985
28 Temporarily restricted net assets ........... 18,318 28 18,336
29 Permanently restricted net assets ...........   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 121,628,691 33 147,315,321
34 Total liabilities and net assets/fund balances ........ 193,347,072 34 206,627,032
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
122,278,436
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
117,493,819
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
4,784,617
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
121,628,691
5
Net unrealized gains (losses) on investments ...............
5
7,908,294
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
12,993,719
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
147,315,321
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
FISHER-TITUS MEDICAL CENTER
 
Employer identification number

34-4430716
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
 
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
Total  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here.................................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Name of the organization
FISHER-TITUS MEDICAL CENTER
 
Employer identification number

34-4430716
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 2
Name of organization
FISHER-TITUS MEDICAL CENTER
  		Employer identification number

34-4430716
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

   
RESTRICTED
RESTRICTED
RESTRICTED, RESTRICTEDRESTRICTED

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 3
Name of organization
FISHER-TITUS MEDICAL CENTER
  		Employer identification number

34-4430716
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 4
Name of organization
FISHER-TITUS MEDICAL CENTER
  		Employer identification number

34-4430716
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet See separate instructions.SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
FISHER-TITUS MEDICAL CENTER
 
Employer identification number

34-4430716
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2013

Schedule C (Form 990 or 990-EZ) 2013
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2013


Schedule C (Form 990 or 990-EZ) 2013
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
7,483
j
Total. Add lines 1c through 1i ...............................
7,483
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
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.
Schedule C (Form 990 or 990EZ) 2013

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
FISHER-TITUS MEDICAL CENTER
 
Employer identification number

34-4430716
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   1,659,169 1,659,169
b Buildings ................   110,081,434 41,622,339 68,459,095
c Leasehold improvements ............        
d Equipment ................   53,600,793 26,164,835 27,435,958
e Other .................   6,491,574 2,665,181 3,826,393
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 101,380,615
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet  
2. Liability for uncertain tax positions In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 146,722,055
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a 7,908,294
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 16,926,408
e Add lines 2a through 2d ..................... 2e 24,834,702
3 Subtract line 2e from line 1..................... 3 121,887,353
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b 391,083
c Add lines 4a and 4b....................... 4c 391,083
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 122,278,436
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 120,361,213
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d 3,182,659
e Add lines 2a through 2d...................... 2e 3,182,659
3 Subtract line 2e from line 1..................... 3 117,178,554
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b 315,265
c Add lines 4a and 4b....................... 4c 315,265
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 117,493,819
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
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.
Schedule D (Form 990) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
FISHER-TITUS MEDICAL CENTER
 
Employer identification number

34-4430716
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers.Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? ...............................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total expenditures
for and investments
in region
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 0 0 0
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 0 0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
MIDDLE EAST AND NORTH AFRICA MEDICAL SUPPLIES TO HOSPITALS IN SYRIA     6,860 CARDIOVASCULAR & MISC MEDICAL SUPPLIES FMV
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
 
3
Enter total number of other organizations or entities .......................MediumBullet
1
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A).......................................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)...............................................
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713)................................................
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2013
Additional Data


Software ID:  
Software Version:  



SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
FISHER-TITUS MEDICAL CENTER
 
Employer identification number

34-4430716
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		1 1,852 2,115,804 564,992 1,550,812 1.390 %
b Medicaid (from Worksheet 3,
column a) .... 		1   14,422,734 12,207,239 2,215,495 1.980 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		2 1,852 16,538,538 12,772,231 3,766,307 3.370 %
Other Benefits
 38 65,220 823,900 57,215 766,685 0.690 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		3 140 97,264 7,540 89,724 0.080 %
g Subsidized health services
(from Worksheet 6) .. 		1   1,079,779 323,840 755,939 0.680 %
h Research (from Worksheet 7) 1   47,879   47,879 0.040 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		7 1,150 356,031   356,031 0.320 %
j Total. Other Benefits .. 50 66,510 2,404,853 388,595 2,016,258 1.810 %
k Total. Add lines 7d and 7j . 52 68,362 18,943,391 13,160,826 5,782,565 5.180 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing 1 42 1,873   1,873 0 %
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members 1 13 4,089   4,089 0 %
6 Coalition building 1 107 27,766   27,766 0.020 %
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total 3 162 33,728   33,728 0.020 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
5,606,219
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
1,681,866
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
25,691,661
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
33,809,751
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-8,118,090
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
11 NORTH CENTRAL CARENET
  		PHYSICIAN-HOSPITAL ORGANIZATION 50.000 % 6.380 % 43.620 %
22 FISHER-TITUS PAIN MANAGEMENT LLC
  		PAIN MANAGEMENT 51.000 %   49.000 %
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 FISHER-TITUS MEMORIAL HOSPITAL
272 BENEDICT AVENUE
NORWALK,OH44857 		X X         X      
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
FISHER-TITUS MEMORIAL HOSPITAL
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 11
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 150.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 200.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17 Yes  
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22 Yes  
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference Explanation
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
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?2
Name and address Type of Facility (describe)
1 NORWALK MEMORIAL HOME
272 BENEDICT AVENUE
NORWALK,OH44857 		INTERMEDIATE & SKILLED NURSING FACILITY
2 THE CARRIAGE HOUSE OF FISHER-TITUS
175 SHADY LANE DRIVE
NORWALK,OH44857 		ASSISTED LIVING FACILITY
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
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
Schedule H (Form 990) 2013
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
FISHER-TITUS MEDICAL CENTER
 
Employer identification number
34-4430716
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) AMERICAN HEART ASSOCIATION
5455 N HIGH ST
COLUMBUS,OH43215 		13-5613797 501(C)(3) 5,000       SPONSORSHIP OF HURON COUNTY HEART WALK
(2) AMERICAN RED CROSS
PO BOX 73013
CHICAGO,IL60673 		34-1027291 501(C)(3) 8,194       CONTRIBUTION FOR RELIEF EFFORTS DUE TO THE OKLAHOMA MOORE DISASTER
(3) BERLIN-MILAN BOARD OF EDUCATION
140 SOUTH MAIN ST
MILAN,OH44846 		115 6,700       GRANT IN SUPPORT OF FITNESS TRAIL
(4) CITY OF NORWALK - ERNSTHAUSEN
100 REPUBLIC ST
NORWALK,OH44857 		115 5,000       SPONSORSHIP OF EARTH WEEK WALK
(5) FISHER-TITUS FOUNDATION
272 BENEDICT AVE
NORWALK,OH44857 		34-1476934 501(C)(3) 11,000       PLEDGE TO HELP PURCHASE NEW MAIN CAMPUS POLE SIGNS
(6) NORWALK AREA UNITED FUND
10 WEST MAIN ST
NORWALK,OH44857 		34-0906312 501(C)(3) 20,000       CONTRIBUTION TO HELP THE LOCAL COMMUNITY
(7) NORWALK CATHOLIC SCHOOLS
93 EAST MAIN ST
NORWALK,OH44857 		115 5,000       GRANT IN SUPPORT OF LOCAL SCHOOL SYSTEM
(8) NORWALK CITY SCHOOLS
134 BENEDICT AVE
NORWALK,OH44857 		115 50,000       SUPPORT OF THEIR ALL-SPORTS COMPLEX
(9) NORWALK ECONOMIC DEVELOPMENT
10 1/2 WEST MAIN ST
NORWALK,OH44857 		34-1787391 501(C)(3) 5,000       CONTRIBUTION TO HELP THE LOCAL COMMUNITY
(10) SHELBY CHRISTIAN & MISSIONARY ALLIANCE
105 E SMILEY AVE
SHELBY,OH44875 		34-1354574 501(C)(3)   125,852 FMV MISCELLANEOUS SUPPLIES PROVIDE SUPPLIED TO AID IN CARRYING OUT ORGANIZATION'S CHARITABLE PURPOSE




2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
10
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2013

Schedule I (Form 990) 2013
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
PART I, LINE 2: THE MEDICAL CENTER REVIEWS EACH GRANT OR DONATION REQUEST BEFORE IT IS MADE.
Schedule I (Form 990) 2013


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
FISHER-TITUS MEDICAL CENTER
 
Employer identification number

34-4430716
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)ROSS MATLACKPRESIDENT - BEGINNING 6/ 2013 (i)
(ii)		 186,324
0 		23,000
0 		362
0 		5,931
0 		11,420
0 		227,037
0 		0
0
(2)PATRICK J MARTINPRESIDENT/ SPECIAL PROJECT MGR (i)
(ii)		 434,224
0 		153,760
0 		138,751
0 		156,288
0 		18,040
0 		901,063
0 		115,391
0
(3)LORNA STRAYERSENIOR VP, ADMIN & BUSINES (i)
(ii)		 176,251
0 		44,712
0 		622
0 		57,345
0 		25,622
0 		304,552
0 		0
0
(4)DUANE WOODSVP OF FINANCE/CFO (i)
(ii)		 208,824
0 		41,215
0 		484
0 		33,021
0 		14,750
0 		298,294
0 		0
0
(5)GARY MOORMANVP MEDICAL AFFAIRS THRU 8/2013 (i)
(ii)		 204,861
0 		54,164
0 		1,393
0 		8,750
0 		9,199
0 		278,367
0 		0
0
(6)CHERIE M SPRAGGSENIOR VP OF NURSING SERVI (i)
(ii)		 160,947
0 		34,986
0 		18,648
0 		80,624
0 		8,975
0 		304,180
0 		0
0
(7)PHILLIP J ANNARINOVP HUMAN RESOURCES (i)
(ii)		 159,564
0 		41,732
0 		1,028
0 		27,264
0 		17,650
0 		247,238
0 		0
0
(8)JOHN BRITTONVP INFORMATION SERVICES (i)
(ii)		 165,451
0 		32,803
0 		236
0 		16,898
0 		0
0 		215,388
0 		0
0
(9)GEORGE B ELMERDIRECTOR OF ASSET MGMT/EMS (i)
(ii)		 156,875
0 		22,602
0 		1,014
0 		3,346
0 		23,122
0 		206,959
0 		0
0
(10)MITCH ESCHDIRECTOR OF PHARMACY (i)
(ii)		 147,261
0 		13,461
0 		1,380
0 		76,162
0 		16,350
0 		254,614
0 		0
0
(11)SUZANNE S INGLISASST VP NURSING & SURGICAL SVCS (i)
(ii)		 127,236
0 		12,010
0 		2,194
0 		5,726
0 		9,010
0 		156,176
0 		0
0
(12)SCOTT P STEINMETZDIRECTOR OF INFORMATION SVCS (i)
(ii)		 130,792
0 		9,284
0 		397
0 		4,724
0 		8,440
0 		153,637
0 		0
0
(13)SHARON HARWOODRISK MANAGER (i)
(ii)		 121,583
0 		8,642
0 		370
0 		26,279
0 		14,230
0 		171,104
0 		0
0
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
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.
Schedule J (Form 990) 2013

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
FISHER-TITUS MEDICAL CENTER
 
Employer identification number
34-4430716
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A COUNTY OF HURON OHIO
  		34-6400672 447540CC7 06-28-2007 28,622,597 SEE PART V BELOW   X   X   X
B COUNTY OF HURON OHIO
  		34-6400672 447540BN4 01-08-2003 30,000,000 SEE PART V BELOW   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . .        
2 Amount of bonds legally defeased . . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . . 28,838,308 30,714,144    
4 Gross proceeds in reserve funds . . . . . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 564,200 524,983    
8 Credit enhancement from proceeds . . . . . . . . . . . 263,425 263,425    
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 7,215,711 27,308,799    
11 Other spent proceeds . . . . . . . . . . . . . . 21,058,397 2,616,937    
12 Other unspent proceeds . . . . . . . . . . . . . .        
13 Year of substantial completion . . . . . . . . . . . . 2008 2005
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X   X          
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X        
16 Has the final allocation of proceeds been made? . . . . . . . . X   X          
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X          
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X        
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X        
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .   X   X        
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X          
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X          
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet        
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet        
6 Total of lines 4 and 5 . . . . . . . . . . . . .        
7 Does the bond issue meet the private security or payment test? . . . . .   X   X        
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X        
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		  X   X        
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X        
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X        
b Exception to rebate? . . . . . . . . X   X          
c No rebate due? . . . . . . . .   X   X        
If you checked "No rebate due" in line 2c, provide in
Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .   X X          
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X        
b Name of provider . . . . . . . . .  
  		 
  		 
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X        
b Name of provider . . . . . . . . .  
  		 
  		 
  		 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X        
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X          
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?   X   X        
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
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.
Schedule K (Form 990) 2013

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
FISHER-TITUS MEDICAL CENTER
 
Employer identification number

34-4430716
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2013
Schedule L (Form 990 or 990-EZ) 2013
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) MRS JOHN BRITTON SPOUSE OF KEY EMPLOYEE 50,041 EMPLOYMENT   No
(2) BAYLESS PATHMARK
  		SEE PART V 140,833 INDEPENDENT CONTRACTOR   No
(3) MS SCHWAB FAMILY MEMBER OF OFFICER, LORNA STRAYER 68,379 EMPLOYMENT   No
(4) MS RILEY FAMILY MEMBER OF DIRECTOR, MATT GROSS 75,185 EMPLOYMENT   No
(5) BATTLES INSURANCE AGENCY
  		SEE PART V 675,103 VENDOR   No
(6) BLEILE ENTERPRISE
  		SEE PART V 203,263 VENDOR   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
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
Schedule L (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageInformation about Schedule M (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
FISHER-TITUS MEDICAL CENTER
 
Employer identification number

34-4430716
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies . X 2 32,601 FAIR MARKET VALUE
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( WALKING PATH ) X 1 16,295 FAIR MARKET VALUE
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that
it must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2013)
Schedule M (Form 990) (2013)
Page 2
Part II
Supplemental Information. Provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
Schedule M (Form 990) (2013)
Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
FISHER-TITUS MEDICAL CENTER
 
Employer identification number

34-4430716
Return Reference Explanation
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.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
FISHER-TITUS MEDICAL CENTER
 
Employer identification number

34-4430716
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity
(1) FTMC HOLDING 265 LLC
265 BENEDICT AVENUE
NORWALK,OH44857
34-4430716 		REAL ESTATE OH 42,462 1,137,946 FISHER TITUS MEDICAL CENTER
 
(2) NORTH CENTRAL HOLDING LLC
272 BENEDICT AVENUE
NORWALK,OH44857
34-4430716 		REAL ESTATE OH 0 0 FISHER TITUS MEDICAL CENTER
 








Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) NORWALK AREA HEALTH SYSTEMS

272 BENEDICT AVENUE

NORWALK,OH44857
34-1476935 		SYSTEM PARENT OH 501(C)(3) LINE 11C, III-FI N/A
 
No
(2) FISHER-TITUS FOUNDATION

272 BENEDICT AVENUE

NORWALK,OH44857
34-1476937 		FOUNDATION OH 501(C)(3) LINE 7 NORWALK AREA HEALTH SYSTEMS
 
 
No
(3) NORWALK AREA HEALTH SERVICES

272 BENEDICT AVENUE

NORWALK,OH44857
34-1476934 		AMBULANCE OH 501(C)(3) LINE 9 NORWALK AREA HEALTH SYSTEMS
 
 
No








For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) FISHER-TITUS PAIN MANAGEMENT LLC

272 BENEDICT AVENUE
NORWALK,OH44857
27-1471272 		PAIN MANAGEMENT OH FISHER TITUS MEDICAL CENTER
  		RELATED 873,766 626,010   No     No 51.000 %












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) HEALTH PROMOTIONS OF NORWALK

272 BENEDICT AVENUE
NORWALK,OH44857
34-1502102 		SUPPORT PROF. OH FISHER TITUS MEDICAL CENTER
  		C 104,263 553,821 100.000 %   No












Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
Yes
 
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) FISHER - TITUS PAIN MANAGEMENT LLC

 F 998,167 OWNERSHIP PERCENTAGE





Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V?UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2013
Additional Data


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