2020-03-14T13:18:35-05:00 2019-04-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2018-05-01 440655986 JOHN FITZGIBBON MEMORIAL HOSPITAL % ANGELA LITTRELL JOHN 6608867431 2305 S HIGHWAY 65 MARSHALL MO 65340 ANGELA P LITTRELL CFO/COO 2020-02-25 true Brian D Todd P00422601 4178658701 167.68.126.162 43032920200745000045 2020-03-14 P 74C51B083D6172D3D43AC87F1A33B4712A418457 AECC51588B8B05B8A6088E029F5570AF8FA04FA6 2018 2020-09-23 17:36:50Z FITZGIBBON HOSPITAL DARIN L HAUG 2305 S HIGHWAY 65 MARSHALL MO 65340 50595924 false X WWW.FITZGIBBON.ORG X 1923 MO TO IMPROVE THE HEALTH OF OUR COMMUNITY BY OFFERING QUALITY SERVICES, IMPROVING ACCESS AND OUTCOMES, EMPOWERING THE COMMUNITY WE SERVE, AND PARTICIPATING IN HEALTH CARE PARTNERSHIPS. 7 4 578 60 0 0 420689 439554 60813451 49691976 209296 155470 166626 148549 61610062 50435549 42566 20760 0 0 29336836 29640716 0 0 91061 35819350 27050685 65198752 56712161 -3588690 -6276612 53287837 46616921 23136878 24862997 30150959 21753924 X TO IMPROVE THE HEALTH OF OUR COMMUNITY. false false 38783982 40464175 HOSPITAL SERVICE - FITZGIBBON HOSPITAL IS A 60 BED ACUTE CARE FACILITY SERVING MARSHALL, MO AND THE SURROUNDING COMMUNITIES. THE FACILITY PROVIDES HEALTH CARE WITH A 24 HOUR PHYSICIAN-STAFFED EMERGENCY DEPARTMENT, AN INTENSIVE CARE UNIT, IN AND OUT-PATIENT MEDICAL/SURGICAL SERVICES, AN OBSTETRICS UNIT, A BEHAVIORAL HEALTH UNIT AND A 24 HOUR HOSPITALIST PROGRAM TO SERVE IN-PATIENT NEEDS AT ALL TIMES. ANCILLARY SERVICES SUCH AS RADIOLOGY, LABORATORY, RESPIRATORY THERAPY AND REHABILITATIVE SERVICES ARE AVAILABLE ON SITE. FOR MORE INFORMATION, SEE SCHEDULE O. 7311249 7627986 CLINIC SERVICE - SPECIALTY CLINICS WITHIN THE HOSPITAL PROVIDE ORTHOPEDIC, WOUND CARE, NEUROLOGIC AND PAIN MANAGEMENT SERVICES TO BOTH IN AND OUT-PATIENTS. THESE CLINICS PROVIDED SERVICES TO 8,633 PATIENTS. THE HOSPITAL ALSO SUPPORTS A SEPARATE OUT-PATIENT CLINIC ON CAMPUS FOR FAMILY MEDICINE, OB/GYN, GENERAL SURGERY, CHIROPRACTIC, AND PSYCHIATRY STAFFED MEDICAL PROFESSIONALS PRACTICING IN THESE SPECIALTIES FOR FISCAL YEAR 2019 THIS CLINIC PROVIDED SERVICES FOR 21,070 PATIENT VISITS. THREE SATELLITE FAMILYPRACTICE CLINICS ARE ALSO SUPPORTED BY THE HOSPITAL. THESE CLINICS PROVIDED SERVICES FOR 9,834 PATIENT VISITS. 899632 20760 938606 COMMUNITY HEALTH SERVICES - HOSPICE, HOME HEALTH, AND HOMEMAKER SERVICES. HOSPICE PROVIDED 1,057 PALLIATIVE CARE VISITS, HOME HEALTH PROVIDED 5,039 VISITS AND HOMEMAKER PERFORMED 4,139 HOURS OF SERVICE TO RESIDENTS. THE COMMUNITY SERVICES GROUP ALSO COORDINATES PARTICIPATION IN THE OATS TRANSPORTATION PROGRAM BY PERFORMING THE SCHEDULING FOR ALL RIDERS. THE HOSPITAL DONATED $14,400 TO OATS IN 2019 AND WILL BE DONATING ANNUALLY TO HELP SUSTAIN IT IN THE MARSHALL COMMUNITY. THE PROGRAM PROVIDED TRANSPORTATION FOR 1,500 RIDERS DURING FY 2019. 633753 661209 47628616 true true false true false false false false false true true false false true true false false true false false false false false false true false true true true false true true false false false false false false false false true true true true false false false true true true false false true 107 0 true 578 true false false false false false true true false false false false false false X 7 4 false false false false false true false true true false false false true true true true true false false false X ANGELA LITTRELL 6608313251 2305 S HIGHWAY 65 PO BOX 250 MARSHALL MO 65340 X WILLIAM SUMMERS PRESIDENT 1.0 1.0 X X 0 0 0 JAN STAPLETON VICE PRESIDENT 1.0 1.0 X X 0 0 0 SCOTT HARTWIG SECRETARY/TREASURER 1.0 1.0 X X 0 0 0 JILL HARRIMAN LILLEMAN JD LLM DIRECTOR 1.0 1.0 X 0 0 0 MARY LOU PORTER DIRECTOR 1.0 1.0 X 0 0 0 JACK UHRIG MD DIRECTOR/MEDICAL DIRECTOR 1.0 1.0 X 14400 0 0 CHRISTOPHER SPORLEDER DO DIRECTOR/PRES MED STAFF 40.0 1.0 X 135547 0 2000 ANGELA P LITTRELL CFO/COO 40.0 1.0 X 183853 0 11126 DARIN HAUG DO PRESIDENT/CEO 40.0 1.0 X 504540 0 2000 DENNIS SOUSLEY VP OF CLINICAL SERVICES 40.0 1.0 X 172368 0 2799 KELLY ROSS ORTHOPEDIC SURGEON 40.0 0.0 X 568291 0 0 RAVINDER ARORA NEUROLOGIST 40.0 0.0 X 401395 0 2650 CLINTON PICKETT ORTHOPEDIC SURGEON 40.0 0.0 X 397359 0 2650 KAREN SONG OB/GYN 40.0 0.0 X 361702 0 0 LORENZO ROMNEY HOSPITALIST 40.0 0.0 X 365224 0 0 RONALD A OTT FORMER PRESIDENT/CEO 0.0 0.0 X 123261 0 0 3227940 0 23225 36 true true false BOYCE AND BYNUM PATHOLOGY LABORATOR PO BOX 7406 COLUMBIA MO 65205 PATHOLOGY 594525 PHARMACY SYSTEMS INC 5050 BRADENTON AVE DUBLIN OH 43017 PHARMACY MANAGEMENT 582317 BKD LLP 910 E ST LOUIS STREET SPRINGFIELD MO 65801 AUDIT/TAX/CONSULTING 355597 AMERICOLLECT PO BOX 1566 MANITOWOC WI 54221 COLLECTION 296947 PAUL BRIZENDINE MD 485 NW RIVEN ROCK TRAIL LEES SUMMIT MO 64081 ED PHYSICIAN 273920 11 143222 8717 287615 15305 439554 NET PATIENT SERVICE REVENUE 624100 48540120 48540120 304(B) REVENUE 446110 780035 780035 CAFETERIA 722514 241362 241362 MANAGEMENT FEES 561000 60000 60000 EHR INCENTIVE REVENUE 624100 8500 8500 61959 61959 49691976 155470 155470 0 0 276069 108091 167978 0 167978 167978 0 32855 143222 52284 -19429 -19429 0 0 0 0 0 0 0 50435549 49691976 304019 X 20760 20760 0 0 0 1028633 327114 701519 454893 331632 123261 23000020 20550924 2367931 81165 0 3650884 3251284 398878 722 1506286 1332164 168563 5559 0 0 261630 261630 0 0 0 6431886 4532653 1898783 450 141873 141873 4103351 2014273 2085913 3165 0 0 663133 572860 90273 167468 149528 17940 0 82866 62684 20182 670099 561137 108962 0 3547638 2970774 576864 450771 450771 MEDICAL SUPPLIES & DRUGS 8065329 8065329 PROVIDER TAX 2280687 2280687 RECRUITING & RETENTION 183954 154042 29912 56712161 47628616 8992484 91061 X 840346 544556 10211568 7215735 0 0 10756690 9848132 0 0 0 0 0 0 1053171 1022793 684736 600891 67194233 47197610 21897835 19996623 1469531 1407059 0 0 0 0 3220950 3574848 3153010 2406284 53287837 46616921 5493655 7994584 0 0 0 0 12280406 11622719 0 0 0 0 4892628 4744094 0 0 470189 501600 23136878 24862997 X 28562391 20045636 1133351 1253071 455217 455217 30150959 21753924 53287837 46616921 X -6276612 3056 -2123479 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 11717 11717 false SCHEDULE C, PART II-B, LINE 1(I) OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE MISSOURI HOSPITAL ASSOCIATION, THE AMERICAN HOSPITAL ASSOCIATION, AND THE SAFETY NET HOSPITALS FOR PHARMACEUTICAL ACCESS. A PORTION OF THESE DUES ARE ALLOCATED TO LOBBYING. 819760 10420 10477 252954 587703 743657 51481 24622 819760 743732 13257 13332 743657 724023 23258 3549 743732 701570 28779 6326 724023 0.42540 0.42410 0.15050 false false 71000 71000 31422815 16395583 15027232 34016418 29564046 4452372 1684000 1237981 446019 19996623 INTEREST RECEIVABLE 13025 OTHER RECEIVABLES 294561 EST AMT DUE FROM 3RD PTY PYRS 2098698 2406284 0 EST AMT DUE TO 3RD PTY PYRS 164262 EST SELF INSURANCE COSTS 337338 501600 50384606 3350 204934 208284 50176322 259227 259227 50435549 56875886 3350 160375 163725 56712161 56712161 SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS: THE ORGANIZATION HAS ENDOWMENT FUNDS FROM THE L.P. ADAMS FUND. PER THE AGREEMENT, THE INCOME FROM THE FUND IS USED FOR GENERAL PURPOSES OF THE HOSPITAL. THE ORGANIZATION ALSO HAS FUNDS FROM THE BUCKNER ENDOWMENT. THESE FUNDS ARE RESTRICTED TO INVESTMENTS IN EQUIPMENT FOR THE BUCKNER WELLNESS CENTER. FINALLY, THE ORGANIZATION HAS FUNDS FROM THE NURSING ENDOWMENT SCHOLARSHIP FUND. THIS FUND WAS CREATED TO PROVIDE NURSING SCHOLARSHIPS TO SALINE COUNTY RESIDENTS ATTENDING THE NURSING PROGRAM AT THE MO VALLEY COLLEGE IN MARSHALL, MISSOURI. IN THE EVENT THAT THE MO VALLEY COLLEGE DOES NOT HAVE A NURSING PROGRAM, SCHOLARSHIPS CAN BE USED FOR NURSING PROGRAMS IN SURROUNDING AREAS. SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITION: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D OTHER REVENUE INCLUDED ON LINE 1, BUT NOT FORM 990, PART VIII, LINE 12: $ 204,934 NET ASSETS RELEASED FROM RESTRICTION SCHEDULE D, PART XI, LINE 4B OTHER REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT LINE 1: $ ( 52,284) SPECIAL EVENTS EXPENSES 419,602 TEMPORARILY RESTRICTED CONTRIBUTIONS (108,091) RENTAL EXPENSES ----------- $ 259,227 SCHEDULE D, PART XII, LINE 2D OTHER EXPENSE INCLUDED ON LINE 1, BUT NOT FORM 990, PART IX, LINE 25: $ 59,744 SPECIAL EVENTS EXPENSES 108,091 RENTAL EXPENSES ----------- $ 160,375 SPRING FLING 130449 110874 19575 1500 12754 12410 GOLF TOURNAMENT 29830 19340 10490 6895 4042 3903 1683 189 3 15798 13008 2790 526 8382 176077 143222 32855 6895 4042 5403 14963 20981 52284 -19429 true true X true X true X true true true false false 207660 207660 0.00480 4539049 4602192 -63143 0.00000 4746709 4602192 144517 0.00480 87846 1415 86431 0.00200 134365 134365 0.00310 6540331 2742852 3797479 0.08850 20760 20760 0.00050 6783302 2744267 4039035 0.09410 11530011 7346459 4183552 0.09890 21146 21146 0.00040 21146 21146 0.00040 true 13947440 2064221 13049012 14694534 -1645522 X true true 1 1 JOHN FITZGIBBON MEMORIAL HOSPITAL 2305 S HIGHWAY 65 MARSHALL MO 65340 WWW.FITZGIBBON.ORG 27 X X X ORTHO, WOUND CARE, REHAB, ONCOLOGY, PAIN, NEUROLOGY JOHN FITZGIBBON MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 18 true false true true X HTTPS://WWW.FITZGIBBON.ORG X X true 18 false true false true X 100 200. X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: THE HOSPITAL LAUNCHED AN ONLINE SURVEY IN DECEMBER 2018 WITH INDIVIDUAL OUTREACH TO PERSONS AND ORGANIZATIONS ACROSS THE BROAD SPECTRUM OF COMMUNITY ORGANIZATIONS, SPECIFICALLY SEEKING INPUT FROM THE HEALTH DISPARITIES, LOW-INCOME, DISABILITIES, THE CHRONICALLY ILL, LANGUAGE BARRIERS AND VARYING SOCIO-ECONOMIC BACKGROUNDS. THOSE RECEIVING THE E-MAILED SURVEY INVITATION AND PERSONAL TELEPHONE OUTREACH INCLUDED FITZGIBBON HOSPITAL MEDICAL STAFF AND PROVIDERS, PATIENT-CENTERED MEDICAL HOME STAFF AND SOCIAL WORKERS, PATIENT CARE COUNCIL AND PATIENT CARE COORDINATORS, QUALITY IMPROVEMENT AND INFECTION PREVENTIONIST, NURSING STAFF, AUXILIARY AMBASSADORS, MARSHALL MINISTERIAL ALLIANCE, SALVATION ARMY, OTHER MINISTRIES INCLUDING JAIL, REST HOME AND JAIL, SALINE COUNTY INTERAGENCY COUNCIL AND ATTENDEES; WHICH INCLUDES THE SALINE COUNTY HEALTH DEPARTMENT, KATY TRAIL COMMUNITY HEALTH, MO VALLEY COMMUNITY ACTION AGENCY, SALINE COUNTY MENTAL HEALTH, SALT FORK YMCA AND TWENTY THREE OTHER SOCIAL SERVICE AGENCIES. SCHEDULE H, PART V, SECTION B, LINE 6B CHNA CONDUCTION: THE ORGANIZATION'S CHNA WAS CONDUCTED ALONG WITH THE FOLLOWING: -MARSHALL MINISTERIAL ALLIANCE -SALINE COUNTY INTERAGENCY COUNCIL, WHICH INCLUDES SALINE COUNTY HEALTH PUBLIC HEALTH DEPARTMENT, KATY TRAIL COMMUNITY HEALTH, MO VALLEY COMMUNITY ACTION AGENCY, SALINE COUNTY MENTAL HEALTH, SALT FORK YMCA, AND 23 OTHER SOCIAL SERVICE AGENCIES. SCHEDULE H, PART V, SECTION B, LINE 7D CHNA AVAILABILITY TO PUBLIC: DESCRIPTION OF THE CHNA AND ITS FINDINGS WERE DISCUSSED AT THE SALINE COUNTY INTERAGENCY COUNCIL MEETING, WHICH IS ATTENDED BY A BROAD CROSS-SECTION OF SOCIAL SERVICE AGENCY REPRESENTATIVES AND RECEIVES MEDIA COVERAGE. THE PAPER COPY AVAILABLE FOR PUBLIC INSPECTION WITHOUT CHARGE AT THE HOSPITAL FACILITY INCLUDED CONTACT INFORMATION IN THE INTRODUCTORY SECTION DESCRIBING THE FINDINGS. SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING IDENTIFIED NEEDS: THE NEEDS NOT DIRECTLY ADDRESSED IN THE CHNA IMPLEMENTATION PLAN WERE AS FOLLOWS: - COST AND ABILITY TO PAY FOR CARE - TRANSPORTATION - CANCER - LACK OF HEALTH INSURANCE - LACK OF DENTAL CARE - MENTAL HEALTH CONCERNS - POVERTY - TEEN PREGNANCY RATES - LANGUAGE BARRIERS DELIBERATION IN PRIORITIZING THE HEALTH NEEDS TO TARGET INCLUDED SPECIAL CONSIDERATION OF ORGANIZATIONAL BUDGETARY CONSTRAINTS AND RESOURCE ALLOCATION, THE MISSION OF OUR ORGANIZATION, THE EVALUATION OF EXISTING OR EMERGING PROGRAMS OFFERED BY OTHER AGENCIES ENGAGED IN COMMUNITY HEALTH AND THE OVERARCHING CAPACITY OF THE ORGANIZATION TO POSITIVELY IMPACT ITS IDENTIFIED HEALTH NEEDS. SPECIAL CONSIDERATION WAS GIVEN IN REGARD TO REACHING DISPARATE SEGMENTS OF OUR COMMUNITY, ESPECIALLY THE UNDERSERVED, AND THE UNIQUE SOCIAL DETERMINANTS OF HEALTH WHICH EXIST IN OUR COMMUNITY: - POVERTY AND LITERACY RATES - PHYSICAL ENVIRONMENT - HEALTHY BEHAVIORS AND ACCESS TO HEALTH CARE SERVICES. IN SELECTING WHICH HEALTH NEEDS TO TARGET, THE CHNA COMMITTEE ALSO CONSIDERED THE FOLLOWING VARIABLES POOR HEALTH OUTCOMES WHICH EXCEEDED STATE AND NATIONAL AVERAGES, LOCAL SURVEY RESULTS IDENTIFYING BARRIERS TO CARE, COLLABORATIVE ACTIVITIES WITH A HISTORY OF SUCCESS WHICH MAY ALREADY BE UNDERWAY OR IN CURRENT PLANNING STAGES, SELF-REPORTED SOCIAL AND ECONOMIC BARRIERS TO ACHIEVING OPTIMAL HEALTH AND A TREND ANALYSIS COMPARING ROBERTS WOODS JOHNSON COUNTY HEALTH RANKINGS HEALTH OUTCOMES CITED IN PRIOR CHNAS CONDUCTED IN 2013 AND 2016. THIS UPDATE FOR SCHEDULE H SPECIFICALLY COVERS ACTIVITIES FOR THE PERIOD MAY 1, 2018, TO APRIL 30, 2019, ADDRESSING THE CHNA ADOPTED BY THE BOARD OF TRUSTEES IN THE SPRING OF 2016. IT SHOULD BE NOTED THAT SIMULTANEOUSLY, A CHNA WAS BEING CONDUCTED TOWARD THE END OF THE TAX YEAR - IN THE FALL OF 2018 FOR ADOPTION BY THE BOARD ON APRIL 23, 2019. DATA GATHERING OCCURRED IN LATE 2018 INTO EARLY 2019. IN RESPONSE TO THE ORGANIZATIONS 2016 CHNA, THE ORGANIZATION HAD ADOPTED AN IMPLEMENTATION STRATEGY DELINEATING ACTIVITIES, BOTH INDEPENDENT AND COLLABORATIVE, WHICH COULD IMPACT THE THREE MOST PRESSING HEALTH NEEDS IN OUR COMMUNITY AS IDENTIFIED VIA THE PREVIOUSLY DESCRIBED PROCESS: - OBESITY AND RELATED CHRONIC DISEASES OF DIABETES AND HIGH BLOOD PRESSURE - PREVENTIVE CARE AND WELLNESS - HEALTH LITERACY IMPROVEMENT AND EARLY HEALTH EDUCATION AN IMPLEMENTATION PLAN FOR THE CHNA ADOPTED ON APRIL 23, 2019, WAS ADOPTED FOLLOWING THE CONCLUSION OF THE 2019 TAX YEAR, AND THEREFORE THOSE ACTIVITIES WILL BE DELINEATED IN THE SCHEDULE H FOR TAX YEAR ENDING IN 2020. ACTIVITIES FOR THE TIME PERIOD MAY 1, 2018, THROUGH APRIL 30, 2019, INCLUDED OBESITY EDUCATION AND OUTREACH PERFORMED BY A HOSPITAL-EMPLOYED REGISTERED DIETITIAN, WHO CONDUCTED DIABETES SUPPORT GROUPS AND ADDRESSED AUDIENCES AT AREA SCHOOLS AND CIVIC GROUP, COLLABORATING WITH THE YMCA AND SCHOOL DISTRICTS, TO ENCOURAGE HEALTHY EATING HABITS, GOOD NUTRITION AND CONTROL OF DIABETES. MARKETING AND PUBLIC RELATIONS STAFF FIELDED REQUESTS FROM THE PUBLIC AND COMMUNITY GROUPS TO ARRANGE SPEAKERS ON A VARIETY OF TOPICS, INCLUDING WOMENS HEALTH, CANCER PREVENTION AND GRIEF RECOVERY. STAFF PREPARED AND PRINTED EDUCATIONAL MATERIALS PER TOPIC AND UPDATED RELEVANT FLIERS, INCLUDING THOSE PROMOTING DIABETES EDUCATION CLASSES, AND ALSO POSTED ANNOUNCEMENTS AND HEALTH INFORMATION ON SOCIAL MEDIA PLATFORMS. MARKETING STAFF ALSO PREPARED DOZENS OF EDUCATIONAL COLUMNS AIMED AT IMPROVING HEALTH LITERACY AND EMPHASIZING THE IMPORTANCE OF PREVENTATIVE HEALTH CARE ON TOPICS INCLUDING COLONOSCOPY, HEALTHY DIETS, RISK OF VAPING AND TOBACCO USE, HEART DISEASE, HAND HYGIENE IN PREVENTION OF DISEASE, 3D MAMMOGRAPHY, CERVICAL CANCER DETECTION, GRIEF COUNSELING, SUICIDE PREVENTION, HEALTH INSURANCE MARKETPLACE OPEN ENROLLMENT, CELIAC DISEASE, ALZHEIMERS DISEASE SUPPORT GROUPS, THE NEED FOR CHILDHOOD IMMUNIZATIONS, AVOIDING HEAT STROKE, TICK SEASON RISKS, OPIOID RISKS, HEART HEALTH, WHEN TO SEEK CARE FOR THE FLU, ORGAN DONATION, SEASONAL AFFECTIVE DISORDER AND MORE TOPICS RELATED TO HEALTH PROMOTION, HEALTH LITERACY AND OBESITY PREVENTION. THESE ARTICLES WERE PRINTED IN AREA NEWS MEDIA OUTLETS, DISPLAYED ON THE HOSPITALS WEBSITE, LINKED TO THE HOSPITAL SOCIAL MEDIA PAGES AND DEPICTED ON INTERNAL VIDEO MESSAGING BOARDS FOR PUBLIC VIEWING AT HOSPITAL-OPERATED CLINIC SITES AND WAITING AREAS WITHIN THE HOSPITAL. HOSPITAL PERSONNEL COLLABORATED WITH AREA SCHOOL DISTRICTS BY PROVIDING FREE SCHOOL SPORTS PHYSICALS TO ENSURE THAT ANY STUDENT WHO WISHES TO PARTICIPATE IN A SPORT MAY DO SO WITHOUT THE BARRIER OF BEING ABLE TO AFFORD THE STATE-REQUIRED PHYSICAL NEEDED FOR PARTICIPATION. THE HOSPITAL ALSO EMPLOYS A CERTIFIED ATHLETIC TRAINER PERMANENTLY STATIONED AT MARSHALL HIGH SCHOOL TO OFFER CONCUSSION DETECTION AND PREVENTION AND TREATMENT OF THE SCHOOLS ATHLETES ON THE SIDELINE AND AT PRACTICES. THIS LEADS TO AREA STUDENTS BETTER ABLE TO LEAD AN ACTIVE AND HEALTHY LIFESTYLE FOR ALL STUDENTS WHO WISH TO PARTICIPATE IN ORGANIZED SPORTS. HOSPITAL PERSONNEL ALSO SIT ON THE SCHOOL DISTRICTS WELLNESS COMMITTEE, OFFERING ADVICE AND RESOURCES TO LOCAL SCHOOLS ON TOPICS THEY REQUEST. THE HOSPITAL HOSTS ANNUAL HEALTH FAIRS FOR THE COMMUNITY ONE AT THE HOSPITAL AND ONE AT A COMMUNITY-BASED RURAL HEALTH CLINIC ABOUT 30 MILES AWAY, OFFERING COST-BASED LAB TESTING FOR THYROID FUNCTION, LIPID PROFILE, A1C (BLOOD SUGAR), PROSTATE SPECIFIC ANTIGEN AND OTHER BASIC HEALTH SCREENINGS FOR LITTLE OR NO COST. HOSPITAL PERSONNEL PUBLICIZED THE EVENT NOT ONLY VIA TRADITIONAL PRINT AND RADIO MEDIA PARTNERS WHO HELP SPONSOR THE EVENT BUT ALSO VIA SOCIAL MEDIA AND THROUGH ATTENDANCE AT THE MINISTERIAL ALLIANCE, WHICH REPRESENTS MOST, IF NOT ALL, LOCAL CHURCHES; AND THE INTERAGENCY COUNCIL, WHICH REPRESENTS APPROXIMATELY 30 SOCIAL SERVICE AGENCIES IN OUR COUNTY. HOSPITAL PERSONNEL ALSO STAFFED EDUCATIONAL BOOTHS AT BACK-TO-SCHOOL EVENTS AND BROUGHT ON-SITE INFLUENZA IMMUNIZATIONS TO FOUR AREA SCHOOLS IN AN EFFORT TO PREVENT THE FLU AND REDUCE ABSENTEEISM AMONG TEACHERS AND STAFF. HOSPITAL STAFF SIT ON THE SALINE COUNTY MENTAL HEALTH ASSOCIATION BOARD AND MARKETING STAFF PRODUCED AND PRINTED MORE THAN 1,000 WALLET CARDS INCLUDING BEHAVIORAL HEALTH CRISIS PHONE NUMBERS FOR DISTRIBUTION TO AREA HIGH SCHOOL STUDENTS DURING A WEEK-LONG MENTAL HEALTH AWARENESS EVENT. THE HOSPITAL DISTRIBUTED SUN SAFETY TIPS AND FREE SUNSCREEN AT A COMMUNITY COLLABORATION CO-SPONSORED BY THE MARSHALL PARKS AND RECREATION DEPARTMENT AND THE HOSPITAL CALLED DAY IN THE PARK, OFFERING A VARIETY OF FAMILY-FRIENDLY ACTIVITIES. WE ESTIMATE THAN MORE THAN 2,000 TOTAL PEOPLE WERE SERVED AT THESE EVENTS THROUGHOUT OUR SERVICE AREA. WITHIN THE HOSPITAL, DIETARY PERSONNEL CONTINUE TO OFFER HEALTH CHOICES FOR HOSPITAL EMPLOYEES, AND THE EMPLOYEE NEWSLETTER INCLUDES A SPECIAL SECTION HIGHLIGHTING THOSE WHO PARTICIPATE IN AREA 5KS AND OTHER COMPETITIVE RUNS. AGAIN, THE GOAL IS TO PROMOTE A HEALTHY LIFESTYLE. THE HOSPITAL ALSO PARTICIPATED IN SEPSIS PREVENTION AND ANTIBIOTIC STEWARDSHIP PROGRAMS OF INTERNAL AND EXTERNAL EDUCATION BY PUBLISHING HOSPITAL ASSOCIATION-SPONSORED EDUCATIONAL TIPS AND ARTICLES VIA INTERNAL AND EXTERNAL MEDIA SOURCES. HEALTH LITERACY IMPROVEMENT WAS ALSO TARGETED WHEN THE MARKETING AND PUBLIC RELATIONS DEPARTMENT TOOK ON A BI-LINGUAL STUDENT INTERN FROM THE LOCAL COLLEGE WHO HAD THE CAPACITY TO ASSIST IN TRANSLATING SOME HEALTH EDUCATION MATERIALS INTO SPANISH. FINALLY, HOSPITAL EMPLOYEE VOLUNTEERS ATTEND A SERIES OF LOCAL PARADES AND HAND OUT EDUCATIONAL FLIERS, INCLUDING TIPS FOR CANCER DETECTION, PREVENTION AND TREATMENT AMONG OTHER TOPICS. SCHEDULE H, PART V, SECTION C, LINES 16A-C FAP, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY: HTTPS://WWW.FITZGIBBON.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, LINE 16I LEP FAP TRANSLATIONS: THERE ARE NO GROUPS WITH LIMITED ENGLISH PROFICIENCY THAT RISE TO THE THRESHOLD REQUIRED UNDER IRC SECTION 501(R). HOWEVER, A LANGUAGE TRANSLATION LINE IS AVAILABLE TO OUR PATIENTS AT NO COST. THIS SERVICE IS AVAILABLE THROUGHOUT THE HOSPITAL AND CLINICS WHEN PATIENTS HAVE QUESTIONS OR NEED INFORMATION TRANSLATED. THIS WOULD BE USED WITH A PATIENT THAT WOULD NEED THE FAP INFORMATION TRANSLATED TO THEM AND TO ANSWER ANY QUESTIONS WHICH THEY MAY HAVE. IN ADDITION, THE EXTENDED BUSINESS OFFICE HAS STAFF WHICH TRANSLATE FOR PATIENTS. 6 FITZGIBBON PROFESSIONAL BUILDING 2301 S 65 HIGHWAY MARSHALL MO 65340 OB/GYN, SURGERY, CHIROPRACTIC, FAMILY PRACTICE, MENTAL HEALTH CLINIC FITZGIBBON COMMUNITY HOME HEALTH CARE 2303 S 65 HIGHWAY MARSHALL MO 65340 HOME HEALTH, HOSPICE AKEMAN MCBURNEY MEDICAL CLINIC 420 WEST FRONT STREET SLATER MO 65349 OFFSITE MEDICAL CLINIC GRAND RIVER MEDICAL CLINIC 815 EAST BROADWAY BRUNSWICK MO 65236 OFFSITE MEDICAL CLINIC BUCKNER WELLNESS CENTER 2299 S 65 HIGHWAY MARSHALL MO 65340 CARDIAC/PULMONARY WELLNESS FITZGIBBON FAMILY HEALTH 600 W MORRISON FAYETTE MO 65248 OFFSITE MEDICAL CLINIC SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990, WAS REDUCED BY BAD DEBT EXPENSE OF $13,947,440. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEET 1. IRS WORKSHEETS 3 AND 6 USED INTERNAL COST ACCOUNTING METHODOLOGY. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION HAS SEVERAL EMPLOYEES INVOLVED IN LOCAL COMMUNITY BOARDS AS WELL AS STATE BOARDS, WHICH ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT AND ADVOCACY. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HEALTH SYSTEMS DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HEALTH SYSTEM'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED APRIL 30, 2019. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. THIS AMOUNT EXPENSED BY THE ORGANIZATION IS ATTRIBUTABLE TO LOW INCOME INDIVIDUALS IN THEIR TARGET COMMUNITY AND IS CONSIDERED A COMMUNITY BENEFIT. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE. THAT FOOTNOTE CAN BE FOUND ON PAGE 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION B, LINE 8 COMMUNITY BENEFIT: MEDICARE DATA COMPUTED USING THE MEDICARE COST REPORT FILED WITH CMS WAS UTILIZED FOR THE COMPUTATIONS IN PART III, SECTION B. SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION POLICY: THE ORGANIZATION'S BILLING AND PAYMENT POLICY NOTES: IF ACCOUNTS HAVE ALREADY BEEN CONSIDERED BAD DEBT BY FITZGIBBON HOSPITAL AND CLINICS, THEN FINANCIAL ASSISTANCE/CHARITY CARE IS AN OPTION UNTIL 240 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT. BAD DEBT IS DEFINED AS EXPENSES RESULTING FROM TREATMENT FOR SERVICES PROVIDED TO A PATIENT WHO HAS NOT MET THEIR FINANCIAL OBLIGATION NOR SET UP AN AGREEABLE PAYMENT ARRANGEMENT WITH FITZGIBBON HOSPITAL AND CLINICS WITHIN 120 DAYS FROM THE DATE THE PATIENT HAS BEEN MADE RESPONSIBLE FOR ANY BALANCES DUE EITHER AFTER INSURANCE HAS PAID THEIR PORTION OR WHEN NO INSURANCE IS INVOLVED. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: OUR MISSION AT FITZGIBBON HOSPITAL IS TO IMPROVE THE HEALTH OF OUR COMMUNITY. IN ORDER TO MEET THIS MISSION WE STRIVE TO UNDERSTAND THE NEEDS OF OUR COMMUNITY IN SEVERAL DIFFERENT WAYS. OUR LEADERSHIP AND STAFF ARE MEMBERS OF CIVIC CLUBS, BOARDS, AND COMMITTEES. OUR BOARD OF TRUSTEES IS COMPRISED OF MEMBERS FROM COUNTIES THROUGHOUT OUR SERVICE AREA. WE WORK CLOSELY WITH THE HEALTH DEPARTMENT AND OTHER COMMUNITY AGENCIES. STATE, REGIONAL AND LOCAL MEDIAS ARE USED TO MONITOR NEEDS AT ALL LEVELS. WE ALSO BELONG TO MANY HEALTHCARE RELATED ORGANIZATIONS THAT PROVIDE INFORMATION REGARDING USAGE AND NEEDS OF HEALTHCARE IN OUR SERVICE AREA WHICH IS USED TO EVALUATE WHAT WE NEED TO FOCUS ON TO IMPROVE THE HEALTH IN OUR COMMUNITY. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE HOSPITAL USES SEVERAL AVENUES TO PROVIDE PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE. ALL PATIENTS WILL BE OFFERED A PLAIN LANGUAGE SUMMARY AND AN APPLICATION FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY (FAP) AS PART OF THE INTAKE OR DISCHARGE PROCESS TO/FROM FH. INFORMATION REGARDING THE FAP MAY BE AVAILABLE THROUGH THE HOSPITAL'S PATIENT ACCOUNTS DEPARTMENT AT (660) 831-3730, FH WEBSITE AT WWW.FITZGIBBON.ORG, OR THE FH FACILITY AT 2305 SOUTH 65 HIGHWAY, MARSHALL, MO 65340. THE PATIENT ACCOUNTS DEPARTMENT DEVELOPED A BROCHURE WHICH IS AVAILABLE TO PATIENTS AT THE TIME OF REGISTRATION. THE BROCHURE OUTLINES WHAT THE PATIENT IS TO EXPECT IN THE BILLING PROCESS, HOW TO CONTACT THE DEPARTMENT, AND WHAT ASSISTANCE IS AVAILABLE. WE HAVE A DETAILED POLICY WHICH OUTLINES PATIENT RESPONSIBILITY AND QUALIFICATIONS FOR CHARITY CARE. OUR PATIENT ACCOUNTS REPRESENTATIVES MEET WITH SELF PAY PATIENTS WHEN THEY ARE IN THE FACILITY TO DISCUSS OUR POLICY. OUR CARE COORDINATORS AND SOCIAL WORKERS ALSO EDUCATE OUR PATIENTS ON ASSISTANCE THEY MAY BE ELIGIBLE FOR UNDER FEDERAL, STATE AND LOCAL GOVERNMENT PROGRAMS. WE ALSO UTILIZE AN OUTSIDE AGENCY TO MAKE CONTACT WITH PATIENTS AND IDENTIFY THOSE THAT MIGHT BE ELIGIBLE FOR ASSISTANCE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: FITZGIBBON HOSPITAL'S PRIMARY SERVICE AREA IS SALINE COUNTY, MISSOURI WHICH IS A MID-MISSOURI AGRICULTURAL REGION AND INCLUDES THE TOWNS OF MARSHALL AND SLATER, MO. THE SECONDARY SERVICE AREA IS PORTIONS OF THE CONTIGUOUS COUNTIES SURROUNDING SALINE COUNTY. A REPORT FROM THE MISSOURI CENSUS DATA CENTER, POPULATION ESTIMATES WITH COMPONENTS OF CHANGE 2010-2018, EXTRACTED ON FEBRUARY 19, 2020, SHOWS THE FOLLOWING: A JULY 2018 POPULATION ESTIMATE OF 22,895. SALINE COUNTY DATA FOR 2018, ACCORDING TO A JULY 1, 2018 U.S. CENSUS BUREAU REPORT, SHOWED THE MEDIAN HOUSEHOLD INCOME WAS $41,567. THE AGE DISTRIBUTION OF THE POPULATION IN SALINE COUNTY IN 2018 SHOWED 17.8% AGED 65 AND OVER. ITS DEMOGRAPHICS ARE PRIMARILY WHITE, WITH 89.5% AS WHITE, NON-LATINO; 10.1% HISPANIC OR LATINO; 5.3% AFRICAN-AMERICAN; 2.5% TWO OR MORE RACES; 1.0% PACIFIC ISLANDER AND .9% ASIAN. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: FITZGIBBON HOSPITAL ENGAGED IN NUMEROUS ACTIVITIES RELATED TO ITS MISSION, IMPROVING THE HEALTH OF OUR COMMUNITY. WHILE MANY OF THESE ACTIVITIES WERE GUIDED BY THE IMPLEMENTATION PLAN AS A RESULT OF A COMMUNITY HEALTH NEEDS ASSESSMENT PUBLISHED IN 2013, 2016 AND 2019, MANY HEALTH PROMOTION ACTIVITIES OCCUR IN THE COURSE OF DOING BUSINESS AND ARE A RESULT OF COMPREHENSIVE PATIENT CARE PROGRAMS WHICH ENCOURAGE WELLNESS, PATIENT SAFETY AND FAMILY ENGAGEMENT. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ANY QUALIFIED PHYSICIAN WHO APPLIES AND MEETS THE HOSPITAL CREDENTIALING STANDARDS. CREDENTIALING IS REQUIRED TO ENSURE PROPER TRAINING, LICENSURE AND MALPRACTICE INSURANCE COVERAGE AND HELPS TO ENSURE THE SAFETY OF THE HOSPITAL'S PATIENTS. FITZGIBBON IS LOCATED WITHIN A HEALTH PROFESSIONAL SHORTAGE AREA SCORED AS A 17 FOR PRIMARY CARE AND WELCOMES THE ADDITION OF NEW PHYSICIANS TO ITS STAFF. ENSURING ACCESS TO HIGH QUALITY HEALTH CARE IS A VITAL PART OF ITS MISSION AND IS EVIDENCED BY THE OPERATION OF FOUR RURAL HEALTH CLINICS, ONE OF WHICH IS A NATIONAL HEALTH SERVICES CORPS SITE WHICH WELCOMED AN NHSC SCHOLAR IN 2014. ANY SURPLUS FUNDS ARE USED TO IMPROVE PATIENT CARE AND MEDICAL EDUCATION. SOME ACTIVITIES INCLUDE SCHOLARSHIPS AND PRECEPTOR COLLABORATION FOR A BACHELOR'S DEGREE PROGRAM IN NURSING AT A LOCAL LIBERAL ARTS COLLEGE, MISSOURI VALLEY COLLEGE. IMPROVING PATIENT CARE IS THE HOSPITAL'S OVERRIDING CONCERN AS EVIDENCED BY THE RESOURCES DEDICATED TO TRAINING IN SUCH AREAS AS INFECTION CONTROL, BEST PRACTICE PATIENT CARE, REDUCING HOSPITAL READMISSIONS, AND ENSURING THAT LANGUAGE TRANSLATIONS OCCUR IN A CULTURALLY COMPETENT MANNER. IN EVERYTHING FITZGIBBON HOSPITAL UNDERTAKES, IMPROVEMENT IN THE HEALTH OF THE COMMUNITY REMAINS THE GUIDING PRINCIPLE. PARTICIPATION IN PROCESS IMPROVEMENT TRAINING, EDUCATION AND COLLABORATING WITH OTHER HEALTH ENTITIES IS VITAL TO ENSURING PROMOTION OF COMMUNITY AND PUBLIC HEALTH. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: THE AFFILIATED HEALTH SYSTEM INCLUDES THE ACTIVITIES OF JOHN FITZGIBBON MEMORIAL HOSPITAL AND FITZGIBBON HEALTH SERVICES, DOING BUSINESS AS THE LIVING CENTER, (COLLECTIVELY, THE COMPANIES OR THE HOSPITAL). JOHN FITZGIBBON MEMORIAL HOSPITAL PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT, EMERGENCY CARE, PSYCHIATRIC AND SKILLED NURSING SERVICES TO PATIENTS IN THE MARSHALL, MISSOURI, AREA. IT ALSO OPERATES A HOME HEALTH AGENCY IN THE SAME GEOGRAPHIC AREA. IT WAS DESIGNATED AS A MEDICARE DEPENDENT HOSPITAL BY MEDICARE EFFECTIVE JANUARY 1, 2007. IN MARCH 2012, THE HOSPITAL WAS DESIGNATED AS A SOLE COMMUNITY HOSPITAL BY MEDICARE. THE COMPANIES ALSO OPERATE A LONG-TERM CARE FACILITY IN MARSHALL, MISSOURI, DOING BUSINESS AS THE LIVING CENTER. true OATS INC 2501 MCGUIRE BLVD COLUMBIA MO 65201 431016961 501(C)(3) 14400 COMMUNITY SERVICES 1 SCHEDULE I, PART I, LINE 2 MONITORING USE OF GRANT FUNDS: THE HOSPITAL WORKS IN CONJUNCTION WITH THE LOCAL OATS TRANSPORTATION PROGRAM TO COORDINATE TRANSPORTATION FOR MEMBERS OF THE COMMUNITY. THE ORGANIZATION WITNESSES FIRSTHAND THE WORK DONE BY OATS IN THE COMMUNITY. X X X X X true false false false false false false true false ANGELA P LITTRELL CFO/COO 182461 0 0 0 1392 0 0 0 11126 0 194979 0 0 0 DARIN HAUG DO PRESIDENT/CEO 504216 0 0 0 324 0 0 0 2000 0 506540 0 0 0 KELLY ROSS ORTHOPEDIC SURGEON 546291 0 0 0 22000 0 0 0 0 0 568291 0 0 0 RAVINDER ARORA NEUROLOGIST 250847 0 129048 0 21500 0 0 0 2650 0 404045 0 0 0 CLINTON PICKETT ORTHOPEDIC SURGEON 378360 0 0 0 18999 0 0 0 2650 0 400009 0 0 0 KAREN SONG OB/GYN 308015 0 34941 0 18746 0 0 0 0 0 361702 0 0 0 LORENZO ROMNEY HOSPITALIST 322141 0 10000 0 33083 0 0 0 0 0 365224 0 0 0 DENNIS SOUSLEY VP OF CLINICAL SERVICES 164940 0 0 0 7428 0 0 0 2799 0 175167 0 0 0 RONALD A OTT FORMER PRESIDENT/CEO 0 0 0 0 123261 0 0 0 0 0 123261 0 0 0 SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS: RONALD OTT RECEIVED SEVERANCE PAYMENTS OF $123,261 AS PART OF A SEPARATION AGREEMENT. SCHEDULE J, PART I, LINE 7 NONFIXED PAYMENTS: PHYSICIAN BONUSES WERE BASED ON THEIR INDIVIDUAL RVU BASED CONTRACTS. A INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO 430980296 79516LBC7 2010-11-29 12218468 REFINANCING OF SERIES 2005 BONDS false false false B INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO 430980296 2016-03-14 7550000 REFINANCING OF SERIES 2005 BONDS false false false A 4240000 0 12218468 1147261 0 11985656 232812 0 0 0 0 0 2010 true false true true B 885000 0 7550000 0 0 0 170000 0 0 0 7380000 0 2016 true false true true A false false false false 0 false false false true B 0 A false true false false false false 0 false 0 false true B false true false false 0 false 0 false true A true B true SCHEDULE K, PART IV, LINE 2C, COLUMN A DATE OF REBATE COMPUTATION: THE REBATE COMPUTATION OCCURRED ON JANUARY 6, 2016. RED CROSS PHARMACY SEE PART V 33760 PHARMACY false KATHRYN LYNNE OTT SEE PART V 57712 COMPENSATION false SCHEDULE L, PART IV, LINE 1, COLUMN B: TRANSACTIONS WITH INTERESTED PERSONS: (1) SCOTT HARTWIG, TRUSTEE, OWNS 47.5% OF RED CROSS PHARMACY. (2) KATHRYN LYNNE OTT WAS VICE PRESIDENT OF NURSING SERVICES AND RETIRED 1/4/16. SHE IS MARRIED TO RON OTT, FORMER PRESIDENT/CEO. X 8 2205 COST X 9836 COST X 19 3164 COST X 1 100 COST false true false SCHEDULE M, PART I, COLUMN B NUMBER OF CONTRIBUTIONS: THE NUMBER OF CONTRIBUTIONS WAS DETERMINED BY THE NUMBER OF ITEMS CONTRIBUTED FOR EACH TYPE OF ITEM. FORM 990, PART III, LINE 4A PROGRAM SERVICES ACTIVITY #1: FOR THE FISCAL YEAR ENDED APRIL 30, 2019, THE EMERGENCY ROOM EXPERIENCED 11,529 PATIENT VISITS. THE SURGICAL TEAM PERFORMED 349 IN-PATIENT PROCEDURES AND 1,681 OUT-PATIENT PROCEDURES. THE RADIOLOGY GROUP PERFORMED 26,324 PROCEDURES WHICH INCLUDE 2,049 MAMMOGRAMS, 4,586 CT SCANS, 1,831 MRI'S, 3,381 ULTRASOUND IMAGES AND 782 NUCLEAR MEDICINE SCANS. THE LABORATORY TEAM PERFORMED 127,976 TESTS. THE RESPIRATORY THERAPY DEPARTMENT CONDUCTED 15,654 PROCEDURES AND THE REHABILITATIVE SERVICES GROUP WHICH INCLUDES PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES PROVIDED 26,961 PROCEDURES. FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES: A CARDIO-PULMONARY WELLNESS CENTER IS LOCATED ON THE CAMPUS AND STAFFED BY A REGISTERED DIETICIAN AND A REGISTERED NURSE TO COUNSEL AND EDUCATE PATIENTS ON HEALTHY LIVING THROUGH EXERCISE AND NUTRITION WITH SPECIAL EMPHASIS ON DIABETES MANAGEMENT. THROUGHOUT THE YEAR, THE STAFF ENCOUNTERED 1,553 PATIENT VISITS AT THE FACILITY. IN ADDITION, THE STAFF EDUCATED OVER 1,500 RESIDENTS IN THE SURROUNDING COMMUNITIES AT NO CHARGE THROUGH PARTICIPATION IN HEALTH FAIRS AND OTHER SOCIAL VENUES. THE HOSPITAL OFFERS CHILDBIRTH CLASSES AT A MINIMAL FEE WHICH COVERS THE COST OF THE EDUCATIONAL MATERIAL PRESENTED TO EACH PARTICIPANT. EACH YEAR, THE HOSPITAL HOSTS A COMMUNITY HEALTH FAIR OFFERING EDUCATION ON A VARIETY OF HEALTH ISSUES AND ROUTINE HEALTH SCREENINGS. MOST TESTING IS FREE, HOWEVER, PARTICIPANTS REQUESTING CERTAIN BLOOD TESTS PAY ONLY WHAT IT COSTS THE HOSPITAL FOR LABORATORY PROCESSING. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS, STOCKHOLDERS, OR OTHER PERSONS: THE MEDICAL STAFF OF THE ORGANIZATION ELECTS THE CHIEF OF MEDICAL STAFF WHO IS A VOTING MEMBER OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. A DRAFT OF THE RETURN IS REVIEWED WITH MANAGEMENT BEFORE BEING FINALIZED. THE 990 IS THEN PRESENTED TO THE BOARD OF TRUSTEES AFTER IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE COMPLIANCE OFFICER MONITORS THE CONFLICT OF INTEREST POLICY AND ANNUALLY REQUIRES OFFICERS AND TRUSTEES TO SIGN A CONFLICT OF INTEREST DISCLOSURE FORM. ALL CONFLICTS MUST BE REVIEWED BY THE CEO AND/OR BOARD OF TRUSTEES. ANY BOARD MEMBER WITH A CONFLICT OF INTEREST WOULD ABSTAIN FROM VOTING ON ANY DECISION RELATED TO THAT CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A & 15B COMPENSATION DETERMINATION: THE ORGANIZATION USES INDUSTRY DATA IN DETERMINING COMPENSATION FOR THE CEO AND OTHER OFFICERS/KEY EMPLOYEES. THE COMPENSATION FOR DR. DARIN HAUG WAS ESTABLISHED BY UTILIZING BENCHMARK DATA FROM THREE SOURCES. FITZGIBBON HOSPITAL HAD AN AGREEMENT WITH BOONE HOSPITAL CENTER WHICH ALLOWED BOONE HOSPITAL TO OVERSEE AND ASSIST IN EVALUATION OF THE WORK AND PERFORMANCE OF THE PRESIDENT OF THE HOSPITAL AND IN DETERMINING THE COMPENSATION AND BENEFITS TO WHICH THE PRESIDENT WILL BE ENTITLED. THE COMPENSATION WAS DETERMINED BY FITZGIBBON HOSPITAL BOARD REPRESENTATIVE FROM BOONE HOSPITAL CENTER IN CONSULTATION WITH THE FITZGIBBON HOSPITAL BOARD PRESIDENT AND FITZGIBBON HOSPITAL'S FORMER PRESIDENT/CEO. DR. HAUG ALSO PERFORMS DUTIES AS THE CHIEF MEDICAL OFFICER (CMO) AND AN EMERGENCY ROOM PHYSICIAN. THE COMPENSATION REPORTED IS FOR HIS ROLES AS PRESIDENT/CEO, CMO AND EMERGENCY ROOM PHYSICIAN. AN INDEPENDENT COMPENSATION CONSULTANT WAS ENGAGED AND THEIR REPORT WAS REVIEWED BY AN EXECUTIVE COMMITTEE OF THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ANNUAL FORM 990 INCLUDES THE ANNUAL AUDITED FINANCIAL STATEMENTS AND ARE AVAILABLE TO THE PUBLIC. THE ORGANIZATION DOES NOT MAKE THE CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS, OR OTHER FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION A TRUSTEE COMPENSATION: NO TRUSTEES RECEIVE COMPENSATION FOR THEIR DUTIES AS TRUSTEES. JACK UHRIG, MD RECEIVED NONEMPLOYEE COMPENSATION FOR OTHER CLINICAL SERVICES PROVIDED TO THE ORGANIZATION. CHRISTOPHER SPORLEDER, DO RECEIVED COMPENSATION FOR HIS ROLE AS A PROVIDER IN AN ORGANIZATION FAMILY PRACTICE CLINIC. FORM 990, PART X, LINE 20 TAX EXEMPT BONDS: JOHN FITZGIBBON MEMORIAL HOSPITAL RECEIVED QUALIFIED HOSPITAL BOND PROCEEDS FROM 2010 AND 2016 BOND ISSUES. A PORTION OF THE BOND PROCEEDS WERE ALLOCATED TO FITZGIBBON HEALTH SERVICES FOR BOOK AND AUDIT PURPOSES. INFORMATION ABOUT THE BONDS ARE REPORTED ON JOHN FITZGIBBON MEMORIAL HOSPITAL'S SCHEDULE K. FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT SERVICES TOTAL FEES:2706831 FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:2211516 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:685225 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION FEES TOTAL FEES:484542 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING TOTAL FEES:260780 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL FEES TOTAL FEES:82992 FITZGIBBON HEALTH SERVICES 2506 LINDEN TREE PARKWAY MARSHALL MO 65340 431731173 NURSING HOME MO 501(C)(3) 10 JF MEM HOSP true false false false false false false false false false false false true false true true false true false false FITZGIBBON HEALTH SERVICES L 73985 FMV FITZGIBBON HEALTH SERVICES Q 579083 FMV