JOHN FITZGIBBON MEMORIAL HOSPITAL INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- JOHN FITZGIBBON MEMORIAL HOSPITAL INC (EIN 44-0655986)
- Tax period
- 2017-05-01 to 2018-04-30
- Filed
- 2019-03-14
- IRS object ID
- 201940739349300244
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-03-14T14:54:13-05:00 | ReturnTs |
| Tax Period End | 2018-04-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-05-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 440655986 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN FITZGIBBON MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % ANGELA LITTRELL | InCareOfNm |
| Business Name Control | JOHN | BusinessNameControlTxt |
| Phone | 6608867431 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2305 S HIGHWAY 65 | AddressLine1Txt |
| City | MARSHALL | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65340 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANGELA P LITTRELL | PersonNm |
| Person Title | CFO/COO | PersonTitleTxt |
| Signature | 2019-03-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brian D Todd | PreparerPersonNm |
| PTIN | P00422601 | PTIN |
| Phone | 4178658701 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.126.162 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 43032920190735000065 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-03-14 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | ECBB081BC1D4959671984B85820F93BB4DFE00A7 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 39CBA67CBDC84C24964593991C1F330368A3BFFE | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FITZGIBBON HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DARIN L HAUG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2305 S HIGHWAY 65 | AddressLine1Txt |
| City | MARSHALL | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65340 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $61,773,034 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FITZGIBBON.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1923 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH OF OUR COMMUNITY BY OFFERING QUALITY SERVICES, IMPROVING ACCESS AND OUTCOMES, EMPOWERING THE COMMUNTY WE SERVE, AND PARTICIPATING IN HEALTH CARE PARTNERSHIPS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 585 | TotalEmployeeCnt |
| Total Volunteers | 60 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $945,899 | PYContributionsGrantsAmt |
| CY Contributions Grants | $420,689 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $59,006,905 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $60,813,451 | CYProgramServiceRevenueAmt |
| PY Investment Income | $263,041 | PYInvestmentIncomeAmt |
| CY Investment Income | $209,296 | CYInvestmentIncomeAmt |
| PY Other Revenue | $19,141 | PYOtherRevenueAmt |
| CY Other Revenue | $166,626 | CYOtherRevenueAmt |
| PY Total Revenue | $60,234,986 | PYTotalRevenueAmt |
| CY Total Revenue | $61,610,062 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $32,690 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $42,566 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $28,485,673 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $29,336,836 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $91,713 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $31,758,289 | PYOtherExpensesAmt |
| CY Other Expenses | $35,819,350 | CYOtherExpensesAmt |
| PY Total Expenses | $60,276,652 | PYTotalExpensesAmt |
| CY Total Expenses | $65,198,752 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$41,666 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,588,690 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $56,648,528 | TotalAssetsBOYAmt |
| Total Assets EOY | $53,287,837 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $22,871,000 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $23,136,878 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $33,777,528 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $30,150,959 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO IMPROVE THE HEALTH OF OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $45,889,749 | ExpenseAmt |
| Revenue | $48,950,282 | RevenueAmt |
| Desc | 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. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $9,135,860 | ExpenseAmt |
| Revenue | $9,745,160 | RevenueAmt |
| Desc | 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 9,112 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 2018 THIS CLINIC PROVIDED SERVICES FOR 20,848 PATIENT VISITS. THREE SATELLITE FAMILY PRACTICE CLINICS ARE ALSO SUPPORTED BY THE HOSPITAL. THESE CLINICS PROVIDED SERVICES FOR 10,609 PATIENT VISITS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,211,516 | ExpenseAmt |
| Grant | $42,566 | GrantAmt |
| Revenue | $1,292,316 | RevenueAmt |
| Desc | COMMUNITY HEALTH SERVICES - HOSPICE, HOME HEALTH, AND HOMEMAKER SERVICES. HOSPICE PROVIDED 2,142 PALLIATIVE CARE VISITS, HOME HEALTH PROVIDED 5,012 VISITS AND HOMEMAKER PERFORMED 6,772 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 2018 AND WILL BE DONATING $14,400 ANNUALLY TO HELP SUSTAIN IT IN THE MARSHALL COMMUNITY. THE PROGRAM PROVIDED TRANSPORTATION FOR 1,860 RIDERS DURING FY 2018. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $774,069 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $825,693 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $57,011,194 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | Yes (true) | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 99 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 585 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANGELA LITTRELL | PersonNm |
| Phone | 6608313251 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2305 S HIGHWAY 65 PO BOX 250 | AddressLine1Txt |
| City | MARSHALL | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65340 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM SUMMERS | ||||||||||
| PRESIDENT | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JAN STAPLETON | ||||||||||
| VICE PRESIDENT | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| SCOTT HARTWIG | ||||||||||
| SECRETARY/TREAS STARTING 2/18 | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| J BRIAN BRIZENDINE MD | ||||||||||
| DIRECTOR/PRESIDENT OF MEDICAL | 40.0 | 1.0 | Yes (X) | $324,778 | $0 | $2,472 | ||||
| JILL HARRIMAN LILLEMAN JD LLM | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| MARY LOU PORTER | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| JACK UHRIG MD | ||||||||||
| DIRECTOR/MEDICAL DIRECTOR | 1.0 | 1.0 | Yes (X) | $15,600 | $0 | $0 | ||||
| DON VOGELSMEIER | ||||||||||
| SECRETARY/TREASURER END 2/18 | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JACQUELYN EIDSON | ||||||||||
| DIRECTOR END 4/18 | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| ROOK EVANS | ||||||||||
| DIRECTOR END 5/17 | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| ANGELA P LITTRELL | ||||||||||
| CFO/COO | 40.0 | 1.0 | Yes (X) | $180,807 | $0 | $13,064 | ||||
| DARIN HAUG DO | ||||||||||
| PRESIDENT/CEO | 40.0 | 1.0 | Yes (X) | $469,423 | $0 | $2,920 | ||||
| DENNIS SOUSLEY | ||||||||||
| VP OF CLINICAL SERVICES | 40.0 | 1.0 | $169,807 | $0 | $4,772 | Yes (X) | ||||
| KELLY ROSS | ||||||||||
| ORTHOPEDIC SURGEON | 40.0 | 0.0 | $570,291 | $0 | $2,000 | Yes (X) | ||||
| RAVINDER ARORA | ||||||||||
| NEUROLOGIST | 40.0 | 0.0 | $402,745 | $0 | $2,000 | Yes (X) | ||||
| CLINTON PICKETT | ||||||||||
| ORTHOPEDIC SURGEON | 40.0 | 0.0 | $392,675 | $0 | $9,334 | Yes (X) | ||||
| KAREN SONG | ||||||||||
| OB/GYN | 40.0 | 0.0 | $384,960 | $0 | $2,472 | Yes (X) | ||||
| LORENZO ROMNEY | ||||||||||
| HOSPITALIST | 40.0 | 0.0 | $358,148 | $0 | $2,626 | Yes (X) | ||||
| RONALD A OTT | ||||||||||
| FORMER PRESIDENT/CEO | 0.0 | 0.0 | $123,261 | $0 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,392,495 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $41,660 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 30 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PHARMACY SYSTEMS INC | |||||
| 5050 BRADENTON AVE | DUBLIN | OH | 43017 | PHARMACY MANAGEMENT | $737,792 |
| BOYCE BYNUM PATHOLOGY LABORATORIE | |||||
| PO BOX 7406 | COLUMBIA | MO | 65205 | PATHOLOGY | $381,567 |
| PAUL BRIZENDINE MD | |||||
| 485 NW RIVEN ROCK TRAIL | LEES SUMMIT | MO | 64081 | ED PHYSICIAN | $275,292 |
| AMERICOLLECT | |||||
| PO BOX 1566 | MANITOWOC | WI | 54221 | COLLECTION | $267,084 |
| BKD LLP | |||||
| 910 E ST LOUIS STREET | SPRINGFIELD | MO | 65801 | AUDIT/TAX/CONSULTING | $263,156 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $123,371 | FundraisingAmt |
| Government Grants | $8,850 | GovernmentGrantsAmt |
| All Other Contributions | $288,468 | AllOtherContributionsAmt |
| Noncash Contributions | $66,663 | NoncashContributionsAmt |
| Total Contributions | $420,689 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 900099 | $59,710,440 | $59,710,440 |
| EHR INCENTIVE REVENUE | 900099 | $202,681 | $202,681 |
| CAFETERIA | 722514 | $281,740 | $281,740 |
| MANAGEMENT FEES | 561000 | $60,000 | $60,000 |
| 304(B) REVENUE | 900099 | $512,811 | $512,811 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,779 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $45,779 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $60,813,451 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $198,286 | TotalRevenueColumnAmt |
| Exclusion | $198,286 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $284,428 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $104,168 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $180,260 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $180,260 | TotalRevenueColumnAmt |
| Exclusion | $180,260 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $11,010 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $11,010 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,010 | TotalRevenueColumnAmt |
| Exclusion | $11,010 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $45,170 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $58,804 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$13,634 | TotalRevenueColumnAmt |
| Exclusion | -$13,634 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $61,610,062 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $60,813,451 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $375,922 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,566 | TotalAmt |
| Program Services | $42,566 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,175,643 | TotalAmt |
| Program Services | $513,429 | ProgramServicesAmt |
| Management And General | $662,214 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $456,265 | TotalAmt |
| Program Services | $333,004 | ProgramServicesAmt |
| Management And General | $123,261 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,367,004 | TotalAmt |
| Program Services | $19,949,984 | ProgramServicesAmt |
| Management And General | $2,334,968 | ManagementAndGeneralAmt |
| Fundraising | $82,052 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,793,852 | TotalAmt |
| Program Services | $3,336,359 | ProgramServicesAmt |
| Management And General | $457,493 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,544,072 | TotalAmt |
| Program Services | $1,348,480 | ProgramServicesAmt |
| Management And General | $189,567 | ManagementAndGeneralAmt |
| Fundraising | $6,025 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,036 | TotalAmt |
| Management And General | $5,036 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $197,285 | TotalAmt |
| Management And General | $197,285 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,822,670 | TotalAmt |
| Program Services | $4,127,102 | ProgramServicesAmt |
| Management And General | $1,695,568 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,889 | TotalAmt |
| Management And General | $204,889 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,244,075 | TotalAmt |
| Program Services | $1,823,207 | ProgramServicesAmt |
| Management And General | $1,417,232 | ManagementAndGeneralAmt |
| Fundraising | $3,636 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $662,600 | TotalAmt |
| Program Services | $570,893 | ProgramServicesAmt |
| Management And General | $91,707 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $203,024 | TotalAmt |
| Program Services | $183,909 | ProgramServicesAmt |
| Management And General | $19,115 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,273 | TotalAmt |
| Program Services | $66,359 | ProgramServicesAmt |
| Management And General | $23,914 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $705,358 | TotalAmt |
| Program Services | $590,663 | ProgramServicesAmt |
| Management And General | $114,695 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,182,083 | TotalAmt |
| Program Services | $2,664,660 | ProgramServicesAmt |
| Management And General | $517,423 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $533,492 | TotalAmt |
| Program Services | $533,492 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $11,590,755 | $11,590,755 | |
| MEDICAL SUPPLIES & DRUGS | $6,741,922 | $6,741,922 | |
| PROVIDER TAX | $2,380,805 | $2,380,805 | |
| RECRUITING & RETENTION | $255,083 | $213,605 | $41,478 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,198,752 | TotalAmt |
| Program Services | $57,011,194 | ProgramServicesAmt |
| Management And General | $8,095,845 | ManagementAndGeneralAmt |
| Fundraising | $91,713 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,980,775 | BOYAmt |
| EOY | $840,346 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,953,186 | BOYAmt |
| EOY | $10,211,568 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,781,867 | BOYAmt |
| EOY | $10,756,690 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,069,800 | BOYAmt |
| EOY | $1,053,171 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $861,928 | BOYAmt |
| EOY | $684,736 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $66,403,502 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $44,505,667 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,032,756 | BOYAmt |
| EOY | $21,897,835 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,039,277 | BOYAmt |
| EOY | $1,469,531 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,089,816 | BOYAmt |
| EOY | $3,220,950 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,839,123 | BOYAmt |
| EOY | $3,153,010 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,648,528 | BOYAmt |
| EOY | $53,287,837 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,330,629 | BOYAmt |
| EOY | $5,493,655 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,911,350 | BOYAmt |
| EOY | $12,280,406 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,041,266 | BOYAmt |
| EOY | $4,892,628 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $587,755 | BOYAmt |
| EOY | $470,189 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,871,000 | BOYAmt |
| EOY | $23,136,878 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,436,860 | BOYAmt |
| EOY | $28,562,391 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $885,451 | BOYAmt |
| EOY | $1,133,351 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $455,217 | BOYAmt |
| EOY | $455,217 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,777,528 | BOYAmt |
| EOY | $30,150,959 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,648,528 | BOYAmt |
| EOY | $53,287,837 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$3,588,690 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$37,879 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (true) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $891 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $10,225 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $11,116 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE C, PART II-B, LINE 1(G) | DIRECT CONTACT: MANAGEMENT ATTENDED AN MHA-SPONSORED TRIP AND AHA ORGANIZED TRIP TO WASHINGTON DC, WHICH INCLUDED TIME SPENT WITH LEGISLATORS AND OTHER HOSPITAL ADVOCATES IN AN EFFORT TO EDUCATE LEGISLATORS ABOUT HEALTHCARE LEGISLATIVE ISSUES. |
| 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. |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $743,657 | BeginningYearBalanceAmt |
| Contributions | $51,481 | ContributionsAmt |
| Investment Earnings Or Losses | $24,622 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $819,760 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $743,732 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $13,257 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $13,332 | OtherExpendituresAmt |
| End Year Balance | $743,657 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $724,023 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $23,258 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $3,549 | OtherExpendituresAmt |
| End Year Balance | $743,732 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $701,570 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $28,779 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $6,326 | OtherExpendituresAmt |
| End Year Balance | $724,023 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $733,363 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $8,693 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,000 | GrantsOrScholarshipsAmt |
| Other Expenditures | $39,486 | OtherExpendituresAmt |
| End Year Balance | $701,570 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.30500 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.60140 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.09360 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $71,000 | OtherCostOrOtherBasisAmt |
| Book Value | $71,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $31,425,827 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,182,684 | DepreciationAmt |
| Book Value | $16,243,143 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $33,393,040 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,146,704 | DepreciationAmt |
| Book Value | $5,246,336 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,513,635 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,176,279 | DepreciationAmt |
| Book Value | $337,356 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $21,897,835 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INTEREST RECEIVABLE | $17,780 |
| OTHER RECEIVABLES | $190,485 |
| EST AMT DUE FROM 3RD PTY PYRS | $1,742,083 |
| DUE FROM RELATED PARTY | $1,202,662 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,153,010 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| EST AMT DUE TO 3RD PTY PYRS | $29,811 |
| EST SELF INSURANCE COSTS | $440,378 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $470,189 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $49,934,379 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$11,423,640 | OtherRevenueAmt |
| Revenue Not Reported | -$11,423,640 | RevenueNotReportedAmt |
| Revenue Subtotal | $61,358,019 | RevenueSubtotalAmt |
| Other Revenues Not Included | $252,043 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $252,043 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $61,610,062 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $53,770,969 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $162,972 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $162,972 | ExpensesNotReportedAmt |
| Expenses Subtotal | $53,607,997 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $11,590,755 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $11,590,755 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $65,198,752 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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: $ (11,590,755) BAD DEBT EXPENSE 167,115 NET ASSETS RELEASED FROM RESTRICTION ------------- $ (11,423,640) |
| SCHEDULE D, PART XI, LINE 4B | OTHER REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT LINE 1: $ ( 58,804) SPECIAL EVENTS EXPENSES 415,015 TEMPORARILY RESTRICTED CONTRIBUTIONS ( 104,168) RENTAL EXPENSES ------------- $ 252,043 |
| SCHEDULE D, PART XII, LINE 2D | OTHER EXPENSE INCLUDED ON LINE 1, BUT NOT FORM 990, PART IX, LINE 25: $ 58,804 SPECIAL EVENTS EXPENSES 104,168 RENTAL EXPENSES ------------- $ 162,972 |
| SCHEDULE D, PART XII, LINE 4B | OTHER EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT LINE 1: $ 11,590,755 BAD DEBT EXPENSE |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | SPRING FLING | Event1Nm |
| Gross Receipts Event1 | $118,267 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $95,817 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $22,450 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $14,089 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $20,442 | OtherDirectExpensesEvent1Amt |
| Event2 | GOLF TOURNAMENT | Event2Nm |
| Gross Receipts Event2 | $30,107 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $14,938 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $15,169 | GrossRevenueEvent2Amt |
| Cash Prizes Event2 | $5,895 | CashPrizesEvent2Amt |
| Non Cash Prizes Event2 | $3,690 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $3,184 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $1,662 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $269 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 3 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $20,167 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $12,616 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $7,551 | GrossRevenueOtherEventsAmt |
| Oth Direct Expnss Other Events | $9,573 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $168,541 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $123,371 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $45,170 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $5,895 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $3,690 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $3,184 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $15,751 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $30,284 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $58,804 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$13,634 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 180. | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $215,276 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $215,276 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00400 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,016,093 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,255,472 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $760,621 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01420 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,231,369 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,255,472 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $975,897 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01820 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $106,651 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,524 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $102,127 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $174,551 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $174,551 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00330 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,564,161 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,858,532 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,705,629 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06910 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,166 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $28,166 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,873,529 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,863,056 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,010,473 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07480 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,104,898 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,118,528 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,986,370 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09300 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,382 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,382 | NetCommunityBenefitExpnsAmt |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,456 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,456 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,838 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,838 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $11,590,755 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,808,158 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $12,331,339 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $12,884,062 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$552,723 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN FITZGIBBON MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2305 S HIGHWAY 65 | AddressLine1Txt |
| City | MARSHALL | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65340 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.FITZGIBBON.ORG | WebsiteAddressTxt |
| State License | 27-56 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | ORTHO, WOUND CARE, REHAB, ONCOLOGY, PAIN, NEUROLOGY | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN FITZGIBBON MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.FITZGIBBON.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | false | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (true) | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 180. | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | COMMUNITY INPUT: THE HOSPITAL LAUNCHED AN ONLINE SURVEY IN FEBRUARY 2016 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, PROVIDERS, NURSING STAFF, SOCIAL WORKERS, AND MEDICAL HOME STAFF, MARSHALL MINISTERIAL ALLIANCE, FITZGIBBON HOSPITAL AUXILIARY AMBASSADORS, CONAGRA NURSING STAFF, CARGILL MEAT SOLUTIONS NURSING STAFF, AND 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 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 -CONAGRA -CARGILL -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 20 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 AND LANGUAGE BARRIERS. THE CHNA COMMITTEE AGGREGATED AND ANALYZED PRIMARY AND SECONDARY DATA SOURCES AT LENGTH AND COMPARED TO THE INVENTORY OF EXISTING SERVICES IN THE COMMUNITY AND EVALUATED PROGRAMMING WHICH ADDRESS IDENTIFIED HEALTH NEEDS. CONSIDERATION OF COMMUNITY RESOURCES, BUDGETARY CONSTRAINTS, AVAILABLE PERSONNEL AND HOSPITAL MISSION AND VISION WERE ALL CONSIDERATIONS IN SELECTING WHICH HEALTH NEEDS TO PRIORITIZE. WE ALSO USED A TREND ANALYSIS FROM THE ROBERT WOODS JOHNSON FOUNDATION SHOWING THE IDENTIFIED HEALTH NEEDS FROM THE 2013 CHNA. THIS COMPARATIVE SNAPSHOT GAVE THE COMMITTEE AN IDEA OF WHAT PROGRAMS WERE POSITIVELY IMPACTED. UPDATE FOR SCHEDULE H, SPECIFICALLY COVER ACTIVITIES FOR THE PERIOD MAY 1, 2017, TO APRIL 30, 2018, ADDRESSING THE CHNA ADOPTED BY THE BOARD OF TRUSTEES IN THE SPRING OF 2016. OF SPECIAL NOTE IS THAT FINAL PREPARATION OF THE 2016 CHNA WAS OCCURRING SIMULTANEOUSLY TOWARD THE END OF THAT TAX YEAR, AS DATA GATHERING OCCURRED IN LATE 2015 INTO EARLY 2016. THE CHNA WAS OFFICIALLY ADOPTED BY THE BOARD IN APRIL 2016. IN RESPONSE TO THE RESULTS OF THE ORGANIZATIONS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION 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 OBESITY THE HOSPITAL-EMPLOYED REGISTERED DIETICIAN CONDUCTED DIABETES SUPPORT GROUPS AND HELD SPEAKING ENGAGEMENTS AT THE YMCA, THE SPORTS NUTRITION CLASSES AT THE LOCAL HIGH SCHOOL AND HOSTED STUDENTS IN A JOB SHADOW ROLE, TO ENCOURAGE THIS AGE GROUP TO PURSUE ADVANCED STUDY IN DIETETICS AND GOOD NUTRITION. MARKETING AND PUBLIC RELATIONS DEPARTMENT STAFF SUPPORTED THESE SPEAKING ENGAGEMENTS BY UPDATING FLIERS AND OTHER MATERIALS AND PUBLICIZED THE AVAILABILITY OF DIABETES EDUCATION CLASSES IN AREA PRINT NEWS OUTLETS AND VIA SOCIAL MEDIA. MULTIPLE EDUCATIONAL PRESS RELEASES WERE COMPILED REGARDING OBESITY PREVENTION AND MANAGEMENT OF THE CHRONIC DISEASES WHICH ARE A CAUSED BY OBESITY. THESE ARTICLES WERE PRINTED IN AREA NEWS MEDIA, DISPLAYED ON THE HOSPITAL WEBSITE, LINKED TO THE HOSPITAL SOCIAL MEDIA PAGE AND DEPICTED ON INTERNAL VIDEO MESSAGE CENTERS SEEN BY PATIENTS AND EMPLOYEES. TOPICS INCLUDED NEW ACCREDITATION FOR THE DIABETES EDUCATION PROGRAM, THE KETOGENIC DIET EXPLAINED, IDENTIFYING AND TREATING COMMON EATING DISORDERS, CARDIOVASCULAR HEALTH AS IT RELATES TO OBESITY, DIABETES EDUCATION AND CONTROL, CELIAC DISEASE AWARENESS AND THE BENEFITS OF GOOD NUTRITION, AMONG OTHER TOPICS. HOSPITAL PERSONNEL COLLABORATED WITH THE LOCAL SCHOOL DISTRICT AS PART OF THE DISTRICTS WELLNESS COMMITTEE AND PUBLICIZED THE AVAILABILITY OF THE HOSPITALS ANNUAL HEALTH FAIR, WHICH OFFERS LOW-COST SCREENINGS FOR CHOLESTEROL, THYROID FUNCTION, PROSTATE SPECIFIC ANTIGEN AND BLOOD SUGARS, AMONG OTHERS. HOSPITAL PERSONNEL ALSO PUBLICIZED THESE AND OTHER EVENTS AT THE INTERAGENCY COUNCIL AND MINISTERIAL ALLIANCES, TWO ENTITIES WHICH REPRESENT MORE THAN 30 SOCIAL SERVICE AGENCIES AND MOST IF NOT ALL OF THE CHURCHES OPERATING IN MARSHALL. THEY ALSO STAFFED BOOTHS AT BACK-TO-SCHOOL EVENTS FOR TWO AREA SCHOOL DISTRICTS, AT WHICH EDUCATION ABOUT BLOOD GLUCOSE LEVELS OCCURRED, AND ACTUAL BLOOD GLUCOSE LEVELS WERE MEASURED. APPROXIMATELY 500 AREA INDIVIDUALS WERE SERVED AT THESE EVENTS, AND SEVERAL PEOPLE WITH ELEVATED BLOOD GLUCOSE WERE IDENTIFIED AND REFERRED FOR FOLLOWUP CARE. DIETARY PERSONNEL CONTINUED TO WORK TO OFFER HEALTHY SELECTIONS IN THE CAFETERIA AND TO ENSURE THE HOSPITALS VENDING MACHINE COMPANY STOCKED HEALTHY CHOICES IN BOTH THE HOT AND COLD FOOD MACHINES WHICH ARE AVAILABLE TO THE PUBLIC WHEN THE CAFETERIA LINE IS NOT OPEN. THIS INFORMATION AIDS WITH EMPLOYEE AND VISITOR SELECTION OF HEALTHIER FOOD ITEMS. BECAUSE OBESITY IS ONE OF THE CO-MORBIDITIES FOR PATIENT QUALIFICATION OF THE NCQA-RECOGNIZED PRIMARY CARE HEALTH HOME MODEL THAT HAS BEEN INTEGRATED INTO THE HOSPITAL-OPERATED RURAL HEALTH CLINICS, NURSE CARE MANAGERS ASSISTED PATIENTS WITH A DIAGNOSIS OF OBESITY OR DIABETES, ENCOURAGING THEM TO TAKE CONTROL OF THEIR WEIGHT. THEY PROVIDED GUIDANCE AND PROMOTED PERSONAL EMPOWERMENT FOR HEALTHIER CHOICES AND IDENTIFYING DIABETES COMPLICATIONS BY REGULAR MEASUREMENTS OF THEIR A1C LEVELS. HOSPITAL STAFF ALSO PROVIDED HEALTH AND DIETARY EDUCATION TO AREA EMPLOYERS AT NO CHARGE. A SCREENING FOR BLOOD PRESSURE WAS CONDUCTED ON-SITE AT A LARGE LOCAL EMPLOYER, AND HEALTH EDUCATIONAL MATERIALS WERE DISTRIBUTED. THE HOSPITAL ALSO HOSTED ITS ANNUAL HEALTH FAIR, AT WHICH A VARIETY OF SCREENINGS ARE CONDUCTED, INCLUDING A DIABETES SCREEN (A1C) AND BLOOD PRESSURE. THESE TESTS ARE PROVIDED ON A COST-ONLY BASIS FOR ANYONE IN THE COMMUNITY. THIS TYPE OF HEALTH FAIR WAS CONDUCTED IN TWO LOCATIONS, BOTH IN MARSHALL, MISSOURI, AND AT THE RURAL HEALTH CLINIC IN BRUNSWICK, MISSOURI. THE HEALTH HOME (CLINIC) ALSO PRODUCES AND DISTRIBUTES A MONTHLY NEWSLETTER TO HEALTH HOME PATIENTS AND FAMILIES. THE NEWSLETTER IS FULL OF PREVENTATIVE HEALTH INFORMATION, HEALTHY RECIPES AND OTHER HELPFUL INFORMATION AND TIPS. EMPLOYEES WHO PARTICIPATE IN ACTIVE LIFESTYLES, SUCH AS 5Ks AND OTHER COMPETITIVE RUNNING OR EXERCISE EVENTS, ARE FEATURED MONTHLY IN THE HOSPITALS EMPLOYEE NEWSLETTER. DEPICTING THESE ACTIVITIES SERVES AS MOTIVATION FOR OTHERS TO INCREASE THEIR ACTIVITY LEVELS. AS PART OF THE ANNUAL BREAST CANCER AWARENSS EVENTS, THE HOSPITAL SPONSORS A FUN 5K RUN DESIGNED TO GET PARTICIPANTS OUT AND MOVING. PREVENTIVE CARE AND WELLNESS ONGOING PARTNERSHIPS WITH THE AREA SCHOOL DISTRICTS, LOCAL MEDIA OUTLETS, INTERAGENCY COUNCIL, MINISTERIAL ALLIANCE AND LOCAL COLLEGE HIGHLIGHTED THE NEED FOR INDIVIDUALS TO SEEK PREVENTATIVE CARE AND EARLY DISEASE SCREENINGS, WHICH ARE NOW COVERED BY INSURANCE AS REQUIRED BY THE AFFORDABLE CARE ACT. THE MARKETING AND PUBLIC RELATIONS DEPARTMENT HAS DEVELOPED FLIERS HIGHLIGHTING INSURANCE COVERAGE FOR PREVENTATIVE CARE AND EARLY DISEASE DETECTION. THESE TIPS HAVE BEEN DISTRIBUTED AT NUMEROUS COMMUNITY EVENTS INCLUDING: COMMUNITY-WIDE HOMECOMING AND CHRISTMAS PARADES, INCORPORATION ONTO THE SCORECARD USED AT THE ANNUAL FOUNDATION GOLF TOURNAMENT, DISTRIBUTION AT A DAY IN THE PARK EVENT IN JULY FOR FAMILIES, WHICH INCLUDED DISTRIBUTION OF FREE SUNSCREEN AND SUN SAFETY TIPS TO REDUCE THE INCIDENCE OF SKIN CANCER. EDUCATIONAL FLIERS ALSO WERE DISTRIBUTED THROUGHOUT MID-SEPTEMBER AND THROUGH THE MONTH OF OCTOBER FOCUSING ON CANCER SCREENING AND AWARENESS. HOSPITAL STAFF AND PHYSICIANS CONDUCTED A NUMBER OF COMMUNITY PRESENTATIONS TO AREA SERVICE AND LADIES GROUPS, SCHOOL PE AND HEALTH CLASSES, SENIOR CITIZENS GROUPS AND AT THE AREA YMCA. TOPICS VARIED WIDELY BUT WERE FOCUSED ON THE IMPORTANCE OF OBTAINING PREVENTIVE HEALTH CARE AND LIVING A HEALTHY LIFESTYLE. THEY INCLUDED: THE NEED FOR REGULAR MAMMOGRAMS, CAPACITY OF THE HOSPITALS 3D MAMMOGRAPHY MACHINE, CERVICAL CANCER SCREENING, COLONOSCOPY FOR COLON CANCER SCREENING, PSA TESTING, FLU SHOTS AND VARIOUS IMMUNIZATIONS. HOSPITAL STAFF ALSO CONDUCTED FLU SHOT CLINICS FOR AREA SCHOOLS AND PROVIDED NO-COST FLU SHOTS FOR ITS AUXILIARY VOLUNTEERS. THE HOSPITAL ALSO PARTICPATED IN COMMUNITY-WIDE EDUCATIONAL CAMPAIGNS FOCUSING ON IDENTIFICATION AND TREATMENT OF SEPSIS, AND ANTIBIOTIC STEWARDSHIP, FOCUSED ON DECREASING THE OVERUSE OF ANTIBIOTICS AND HOW TO PROPERLY TAKE MEDICATIONS WHEN PRESCRIBED. THESE CAMPAIGNS FEATURED INCREASED EDUCATIONAL MATERIALS DISTRIBUTED BOTH INTERNALLY AND EXTERNALLY. HOSPITAL STAFF ALSO PROVIDED FREE SPORTS PHYSICALS, WHICH ARE A STATE REQUIREMENT FOR PARTICIPATION IN HIGH SCHOOL ATHLETICS, TO SIX AREA SCHOOL DISTRICTS AND SERVED MORE THAN 300 ATHLETES. BY ENSURING THESE ATHLETES COMPLETED THEIR REQUIRED PHYSICALS IN TIME FOR THEIR SPORTS SEASON THE HOSPITAL MADE SURE NO ATHLETE WAS PROHIBTED FROM PARTICIPATING IN HEALTHY ACTIVITIES DUE TO COST. IDENTIFIED HEALTH PROBLEMS ALSO WERE REFERRED BACK TO THE ATHLETE AND PARENT FOR FOLLOWUP. AS PART OF THE DISCHARGE PROCESS IN THE HOSPITAL, STAFF PROVIDE INTENSIVE BEDSIDE EDUCATION FOR PATIENTS NEWLY DIAGNOSED WITH CONGESTIVE HEART FAILURE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, INSULIN-DEPENDENT DIABETES AND ANTICOAGULATION THERAPIES. THIS EDUCATION, WHICH FOCUSES ON MANAGEMENT OF CHRONIC DISEASE, IS BEYOND THE ROUTINE DISCHARGE PLANNING AND EDUCATION WHICH OCCURS FOR OTHER ADMISSIONS. TO OBTAIN PREVENTIVE CARE, COMMUNITY MEMBERS MUST BE WILLING TO ACCESS CARE, AND FEAR ABOUT FINANCIAL BURDENS MUST BE ADDRESSED. TO TACKLE T |
| SCHEDULE H, PART V, SECTION B, 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. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 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, HOMEMAKER |
| 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 |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 $11,590,755. |
| 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 ORGANIZATION REPORTED BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS FROM THE AUDITED FINANCIAL STATEMENTS. |
| 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 READS AS FOLLOWS: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. |
| 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 MARCH 4, 2019, SHOWS THE FOLLOWING: A JULY 2017 POPULATION ESTIMATE OF 22,660. SALINE COUNTY DATA FOR 2017, ACCORDING TO A JULY 1, 2017 U.S. CENSUS BUREAU REPORT, SHOWED THE MEDIAN HOUSEHOLD INCOME WAS $41,567. THE AGE DISTRIBUTION OF THE POPULATION IN SALINE COUNTY IN 2017 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 AND 2016, 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. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OATS INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2501 MCGUIRE BLVD | AddressLine1Txt |
| City | COLUMBIA | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 431016961 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $14,400 | CashGrantAmt |
| Purpose Of Grant | COMMUNITY SERVICES | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| J BRIAN BRIZENDINE MD | ||||||||||||||
| DIRECTOR/PRESIDENT OF MEDICAL | $324,778 | $0 | $0 | $0 | $0 | $0 | $2,000 | $0 | $472 | $0 | $327,250 | $0 | $0 | $0 |
| ANGELA P LITTRELL | ||||||||||||||
| CFO/COO | $179,835 | $0 | $0 | $0 | $972 | $0 | $2,000 | $0 | $11,064 | $0 | $193,871 | $0 | $0 | $0 |
| DARIN HAUG DO | ||||||||||||||
| PRESIDENT/CEO | $468,951 | $0 | $0 | $0 | $472 | $0 | $2,000 | $0 | $920 | $0 | $472,343 | $0 | $0 | $0 |
| KELLY ROSS | ||||||||||||||
| ORTHOPEDIC SURGEON | $546,291 | $0 | $0 | $0 | $24,000 | $0 | $2,000 | $0 | $0 | $0 | $572,291 | $0 | $0 | $0 |
| RAVINDER ARORA | ||||||||||||||
| NEUROLOGIST | $254,341 | $0 | $125,872 | $0 | $22,532 | $0 | $2,000 | $0 | $0 | $0 | $404,745 | $0 | $0 | $0 |
| CLINTON PICKETT | ||||||||||||||
| ORTHOPEDIC SURGEON | $371,934 | $0 | $0 | $0 | $20,741 | $0 | $2,000 | $0 | $7,334 | $0 | $402,009 | $0 | $0 | $0 |
| KAREN SONG | ||||||||||||||
| OB/GYN | $314,520 | $0 | $52,008 | $0 | $18,432 | $0 | $2,000 | $0 | $472 | $0 | $387,432 | $0 | $0 | $0 |
| LORENZO ROMNEY | ||||||||||||||
| HOSPITALIST | $325,221 | $0 | $0 | $0 | $32,927 | $0 | $2,000 | $0 | $626 | $0 | $360,774 | $0 | $0 | $0 |
| DENNIS SOUSLEY | ||||||||||||||
| VP OF CLINICAL SERVICES | $162,500 | $0 | $0 | $0 | $7,307 | $0 | $2,000 | $0 | $2,772 | $0 | $174,579 | $0 | $0 | $0 |
| RONALD A OTT | ||||||||||||||
| FORMER PRESIDENT/CEO | $0 | $0 | $0 | $0 | $123,261 | $0 | $0 | $0 | $0 | $0 | $123,261 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 4A | SEVERANCE PAYMENTS: RONALD OTT RECEIVED A SEVERANCE PAYMENT 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. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO | ||||||||
| A | 430980296 | 79516LBC7 | 2010-11-29 | $12,218,468 | 1998 BOND REFINANCING | false | false | false |
| INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO | ||||||||
| B | 430980296 | 2016-03-14 | $7,550,000 | REFINANCING OF SERIES 2005 BONDS | false | false | false | |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $3,635,000 | $0 | $12,218,468 | $1,129,788 | $0 | $11,985,656 | $232,812 | $0 | $0 | $0 | $0 | $0 | 2010 | Yes (true) | false | Yes (true) | Yes (true) |
| B | $605,000 | $0 | $7,550,000 | $0 | $0 | $0 | $170,000 | $0 | $0 | $0 | $7,380,000 | $0 | 2016 | Yes (true) | false | Yes (true) | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Private Bus Use By OthersPrivateBusUseByOthersPct | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Remedial Action TakenRemedialActionTakenInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | ||||||||
| B | 0 | false | false | false | false | false | false | false | Yes (true) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Business Name Line1GICProviderName/BusinessNameLine1Txt | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|---|
| 0 | ||||||||||
| A | false | false | false | Yes (true) | false | false | false | 0 | false | Yes (true) |
| 0 | ||||||||||
| B | false | Yes (true) | false | false | false | false | false | 0 | false | Yes (true) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (true) |
| B | Yes (true) |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART IV, LINE 2C, COLUMN A | FormAndLineReferenceDesc |
| Explanation | DATE OF REBATE COMPUTATION: THE REBATE COMPUTATION OCCURRED ON JANUARY 6, 2016. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| RED CROSS PHARMACY | |||
| SEE PART V | $182,263 | PHARMACY | false |
| KATHRYN LYNNE OTT | |||
| SEE PART V | $57,712 | COMPENSATION | false |
| PAUL BRIZENDINE | |||
| SEE PART V | $275,292 | COMPENSATION | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART IV, LINE 1, COLUMN B: | FormAndLineReferenceDesc |
| Explanation | 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. (3) PAUL BRIZENDINE IS THE FATHER OF TRUSTEE J. BRIAN BRIZENDINE, MD AND RECEIVES COMPENSATION AS AN INDEPENDENT CONTRACTOR. | ExplanationTxt |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 11 | ContributionCnt |
| Noncash Contributions Rpt F990 | $4,480 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Historical Treasures | ArtHistoricalTreasuresGrp | |
| Art Fractional Interest | ArtFractionalInterestGrp | |
| Books And Publications | BooksAndPublicationsGrp |
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $6,674 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cars And Other Vehicles | CarsAndOtherVehiclesGrp | |
| Boats And Planes | BoatsAndPlanesGrp | |
| Intellectual Property | IntellectualPropertyGrp |
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $51,481 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities Closely Held Stock | SecuritiesCloselyHeldStockGrp | |
| Secur Prtnrshp Trust Intrsts | SecurPrtnrshpTrustIntrstsGrp | |
| Securities Miscellaneous | SecuritiesMiscellaneousGrp | |
| Qualified Contrib Hist Struct | QualifiedContribHistStructGrp | |
| Qualified Contrib Other | QualifiedContribOtherGrp | |
| Real Estate Residential | RealEstateResidentialGrp | |
| Real Estate Commercial | RealEstateCommercialGrp | |
| Real Estate Other | RealEstateOtherGrp | |
| Collectibles | CollectiblesGrp |
Food Inventory FoodInventoryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 20 | ContributionCnt |
| Noncash Contributions Rpt F990 | $4,028 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Drugs And Medical Supplies | DrugsAndMedicalSuppliesGrp | |
| Taxidermy | TaxidermyGrp | |
| Historical Artifacts | HistoricalArtifactsGrp | |
| Scientific Specimens | ScientificSpecimensGrp | |
| Archaeological Artifacts | ArchaeologicalArtifactsGrp | |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE M, PART I, COLUMN B | FormAndLineReferenceDesc |
| Explanation | NUMBER OF CONTRIBUTIONS: THE NUMBER OF CONTRIBUTIONS WAS DETERMINED BY THE NUMBER OF ITEMS CONTRIBUTED FOR EACH TYPE OF ITEM. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A | PROGRAM SERVICES ACTIVITY #1: FOR THE FISCAL YEAR ENDED APRIL 30, 2018, THE EMERGENCY ROOM EXPERIENCED 11,699 patient VISITS. THE SURGICAL TEAM PERFORMED 468 IN-PATIENT PROCEDURES AND 1,897 OUT-PATIENT PROCEDURES. THE RADIOLOGY GROUP PERFORMED 25,988 PROCEDURES WHICH INCLUDE 2,031 MAMMOGRAMS, 4,617 CT SCANS, 1,832 MRI'S, 2,494 ULTRASOUND IMAGES AND 870 NUCLEAR MEDICINE SCANS. THE LABORATORY TEAM PERFORMED 99,629 TESTS. THE RESPIRATORY THERAPY DEPARTMENT CONDUCTED 18,442 PROCEDURES AND THE REHABILITATIVE SERVICES GROUP WHICH INCLUDES PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES PROVIDED 21,619 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 1,712 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, LINES 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 HOSPITALS 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. |
| 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. BRIAN BRIZENDINE RECEIVED COMPENSATION FOR HIS ROLE AS A GENERAL SURGEON. |
| 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. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FITZGIBBON HEALTH SERVICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2506 LINDEN TREE PARKWAY | AddressLine1Txt |
| City | MARSHALL | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65340 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431731173 | EIN |
| Primary Activities | NURSING HOME | PrimaryActivitiesTxt |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 10 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JF MEM HOSP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| FITZGIBBON HEALTH SERVICES | ||
| L | $107,296 | FMV |
| FITZGIBBON HEALTH SERVICES | ||
| P | $110,519 | FMV |
| FITZGIBBON HEALTH SERVICES | ||
| Q | $608,010 | FMV |