2019-03-14T14:54:13-05:00 2018-04-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2017-05-01 440655986 JOHN FITZGIBBON MEMORIAL HOSPITAL % ANGELA LITTRELL JOHN 6608867431 2305 S HIGHWAY 65 MARSHALL MO 65340 ANGELA P LITTRELL CFO/COO 2019-03-15 true Brian D Todd P00422601 4178658701 167.68.126.162 43032920190735000065 2019-03-14 P ECBB081BC1D4959671984B85820F93BB4DFE00A7 39CBA67CBDC84C24964593991C1F330368A3BFFE 2017 2019-02-21 02:37:17Z FITZGIBBON HOSPITAL DARIN L HAUG 2305 S HIGHWAY 65 MARSHALL MO 65340 61773034 false X WWW.FITZGIBBON.ORG X 1923 MO TO IMPROVE THE HEALTH OF OUR COMMUNITY BY OFFERING QUALITY SERVICES, IMPROVING ACCESS AND OUTCOMES, EMPOWERING THE COMMUNTY WE SERVE, AND PARTICIPATING IN HEALTH CARE PARTNERSHIPS. 7 4 585 60 0 0 945899 420689 59006905 60813451 263041 209296 19141 166626 60234986 61610062 32690 42566 0 0 28485673 29336836 0 0 91713 31758289 35819350 60276652 65198752 -41666 -3588690 56648528 53287837 22871000 23136878 33777528 30150959 X TO IMPROVE THE HEALTH OF OUR COMMUNITY. false false 45889749 48950282 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. 9135860 9745160 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. 1211516 42566 1292316 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. 774069 825693 57011194 true true false true false false false false false true true false false true true false false true false false false false false false true false true true true false true true false false false false false false false false true true true true false false false true true true false false true 99 0 true 585 true false false false false false true true false false false false X 7 4 false false false false false true false true true false false false true true true true true false false false X ANGELA LITTRELL 6608313251 2305 S HIGHWAY 65 PO BOX 250 MARSHALL MO 65340 X WILLIAM SUMMERS PRESIDENT 1.0 1.0 X X 0 0 0 JAN STAPLETON VICE PRESIDENT 1.0 1.0 X X 0 0 0 SCOTT HARTWIG SECRETARY/TREAS STARTING 2/18 1.0 1.0 X X 0 0 0 J BRIAN BRIZENDINE MD DIRECTOR/PRESIDENT OF MEDICAL 40.0 1.0 X 324778 0 2472 JILL HARRIMAN LILLEMAN JD LLM DIRECTOR 1.0 1.0 X 0 0 0 MARY LOU PORTER DIRECTOR 1.0 1.0 X 0 0 0 JACK UHRIG MD DIRECTOR/MEDICAL DIRECTOR 1.0 1.0 X 15600 0 0 DON VOGELSMEIER SECRETARY/TREASURER END 2/18 1.0 1.0 X X 0 0 0 JACQUELYN EIDSON DIRECTOR END 4/18 1.0 1.0 X 0 0 0 ROOK EVANS DIRECTOR END 5/17 1.0 1.0 X 0 0 0 ANGELA P LITTRELL CFO/COO 40.0 1.0 X 180807 0 13064 DARIN HAUG DO PRESIDENT/CEO 40.0 1.0 X 469423 0 2920 DENNIS SOUSLEY VP OF CLINICAL SERVICES 40.0 1.0 X 169807 0 4772 KELLY ROSS ORTHOPEDIC SURGEON 40.0 0.0 X 570291 0 2000 RAVINDER ARORA NEUROLOGIST 40.0 0.0 X 402745 0 2000 CLINTON PICKETT ORTHOPEDIC SURGEON 40.0 0.0 X 392675 0 9334 KAREN SONG OB/GYN 40.0 0.0 X 384960 0 2472 LORENZO ROMNEY HOSPITALIST 40.0 0.0 X 358148 0 2626 RONALD A OTT FORMER PRESIDENT/CEO 0.0 0.0 X 123261 0 0 3392495 0 41660 30 true true false PHARMACY SYSTEMS INC 5050 BRADENTON AVE DUBLIN OH 43017 PHARMACY MANAGEMENT 737792 BOYCE BYNUM PATHOLOGY LABORATORIE PO BOX 7406 COLUMBIA MO 65205 PATHOLOGY 381567 PAUL BRIZENDINE MD 485 NW RIVEN ROCK TRAIL LEES SUMMIT MO 64081 ED PHYSICIAN 275292 AMERICOLLECT PO BOX 1566 MANITOWOC WI 54221 COLLECTION 267084 BKD LLP 910 E ST LOUIS STREET SPRINGFIELD MO 65801 AUDIT/TAX/CONSULTING 263156 12 123371 8850 288468 66663 420689 NET PATIENT SERVICE REVENUE 900099 59710440 59710440 EHR INCENTIVE REVENUE 900099 202681 202681 CAFETERIA 722514 281740 281740 MANAGEMENT FEES 561000 60000 60000 304(B) REVENUE 900099 512811 512811 45779 45779 60813451 198286 198286 0 0 284428 104168 180260 0 180260 180260 11010 11010 11010 11010 45170 58804 -13634 -13634 0 0 0 0 0 0 0 61610062 60813451 375922 42566 42566 0 0 0 1175643 513429 662214 456265 333004 123261 22367004 19949984 2334968 82052 0 3793852 3336359 457493 1544072 1348480 189567 6025 0 5036 5036 197285 197285 0 0 0 5822670 4127102 1695568 204889 204889 3244075 1823207 1417232 3636 0 0 662600 570893 91707 203024 183909 19115 0 90273 66359 23914 705358 590663 114695 0 3182083 2664660 517423 533492 533492 BAD DEBT 11590755 11590755 MEDICAL SUPPLIES & DRUGS 6741922 6741922 PROVIDER TAX 2380805 2380805 RECRUITING & RETENTION 255083 213605 41478 65198752 57011194 8095845 91713 X 4980775 840346 12953186 10211568 0 0 6781867 10756690 0 0 0 0 0 0 1069800 1053171 861928 684736 66403502 44505667 23032756 21897835 3039277 1469531 0 0 0 0 2089816 3220950 1839123 3153010 56648528 53287837 4330629 5493655 0 0 0 0 12911350 12280406 0 0 0 0 5041266 4892628 0 0 587755 470189 22871000 23136878 X 32436860 28562391 885451 1133351 455217 455217 33777528 30150959 56648528 53287837 -3588690 -37879 X false true X true false X false false false false false false true 891 false true 10225 11116 false 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. 743657 51481 24622 819760 743732 13257 13332 743657 724023 23258 3549 743732 701570 28779 6326 724023 733363 8693 1000 39486 701570 0.30500 0.60140 0.09360 false false 71000 71000 31425827 15182684 16243143 33393040 28146704 5246336 1513635 1176279 337356 21897835 INTEREST RECEIVABLE 17780 OTHER RECEIVABLES 190485 EST AMT DUE FROM 3RD PTY PYRS 1742083 DUE FROM RELATED PARTY 1202662 3153010 0 EST AMT DUE TO 3RD PTY PYRS 29811 EST SELF INSURANCE COSTS 440378 470189 49934379 -11423640 -11423640 61358019 252043 252043 61610062 53770969 162972 162972 53607997 11590755 11590755 65198752 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 SPRING FLING 118267 95817 22450 14089 20442 GOLF TOURNAMENT 30107 14938 15169 5895 3690 3184 1662 269 3 20167 12616 7551 9573 168541 123371 45170 5895 3690 3184 15751 30284 58804 -13634 true true X true X true X 180. true true true false false 215276 215276 0.00400 4016093 3255472 760621 0.01420 4231369 3255472 975897 0.01820 106651 4524 102127 0.00190 174551 174551 0.00330 6564161 2858532 3705629 0.06910 28166 28166 0.00050 6873529 2863056 4010473 0.07480 11104898 6118528 4986370 0.09300 1382 1382 8456 8456 0.00020 9838 9838 0.00020 true 11590755 1808158 12331339 12884062 -552723 X true true 1 1 JOHN FITZGIBBON MEMORIAL HOSPITAL 2305 S HIGHWAY 65 MARSHALL MO 65340 WWW.FITZGIBBON.ORG 27-56 X X X ORTHO, WOUND CARE, REHAB, ONCOLOGY, PAIN, NEUROLOGY JOHN FITZGIBBON MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 15 true false true true X HTTPS://WWW.FITZGIBBON.ORG X X true 15 false true false true X 100 180. X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: THE HOSPITAL LAUNCHED AN ONLINE SURVEY IN 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. 6 FITZGIBBON PROFESSIONAL BUILDING 2301 S 65 HIGHWAY MARSHALL MO 65340 OB/GYN, SURGERY, CHIROPRACTIC, FAMILY PRACTICE, MENTAL HEALTH CLINIC FITZGIBBON COMMUNITY HOME HEALTH CARE 2303 S 65 HIGHWAY MARSHALL MO 65340 HOME HEALTH, HOSPICE, 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 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. true OATS INC 2501 MCGUIRE BLVD COLUMBIA MO 65201 431016961 501(C)(3) 14400 COMMUNITY SERVICES 1 SCHEDULE I, PART I, LINE 2 MONITORING USE OF GRANT FUNDS: THE HOSPITAL WORKS IN CONJUNCTION WITH THE LOCAL OATS TRANSPORTATION PROGRAM TO COORDINATE TRANSPORTATION FOR MEMBERS OF THE COMMUNITY. THE ORGANIZATION WITNESSES FIRSTHAND THE WORK DONE BY OATS IN THE COMMUNITY. X X X true false false false false false false true false J BRIAN BRIZENDINE MD DIRECTOR/PRESIDENT OF MEDICAL 324778 0 0 0 0 0 2000 0 472 0 327250 0 0 0 ANGELA P LITTRELL CFO/COO 179835 0 0 0 972 0 2000 0 11064 0 193871 0 0 0 DARIN HAUG DO PRESIDENT/CEO 468951 0 0 0 472 0 2000 0 920 0 472343 0 0 0 KELLY ROSS ORTHOPEDIC SURGEON 546291 0 0 0 24000 0 2000 0 0 0 572291 0 0 0 RAVINDER ARORA NEUROLOGIST 254341 0 125872 0 22532 0 2000 0 0 0 404745 0 0 0 CLINTON PICKETT ORTHOPEDIC SURGEON 371934 0 0 0 20741 0 2000 0 7334 0 402009 0 0 0 KAREN SONG OB/GYN 314520 0 52008 0 18432 0 2000 0 472 0 387432 0 0 0 LORENZO ROMNEY HOSPITALIST 325221 0 0 0 32927 0 2000 0 626 0 360774 0 0 0 DENNIS SOUSLEY VP OF CLINICAL SERVICES 162500 0 0 0 7307 0 2000 0 2772 0 174579 0 0 0 RONALD A OTT FORMER PRESIDENT/CEO 0 0 0 0 123261 0 0 0 0 0 123261 0 0 0 SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS: RONALD OTT RECEIVED 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. A INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO 430980296 79516LBC7 2010-11-29 12218468 1998 BOND REFINANCING false false false B INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO 430980296 2016-03-14 7550000 REFINANCING OF SERIES 2005 BONDS false false false A 3635000 0 12218468 1129788 0 11985656 232812 0 0 0 0 0 2010 true false true true B 605000 0 7550000 0 0 0 170000 0 0 0 7380000 0 2016 true false true true A 0 B false false false false 0 false false false true A false false false true false false 0 false 0 false true B false true false false false false 0 false 0 false true A true B true SCHEDULE K, PART IV, LINE 2C, COLUMN A DATE OF REBATE COMPUTATION: THE REBATE COMPUTATION OCCURRED ON JANUARY 6, 2016. RED CROSS PHARMACY SEE PART V 182263 PHARMACY false KATHRYN LYNNE OTT SEE PART V 57712 COMPENSATION false PAUL BRIZENDINE SEE PART V 275292 COMPENSATION false SCHEDULE L, PART IV, LINE 1, COLUMN B: TRANSACTIONS WITH INTERESTED PERSONS: (1) SCOTT HARTWIG, TRUSTEE, OWNS 47.5% OF RED CROSS PHARMACY. (2) KATHRYN LYNNE OTT WAS VICE PRESIDENT OF NURSING SERVICES AND RETIRED 1/4/16. SHE IS MARRIED TO RON OTT, FORMER PRESIDENT/CEO. (3) PAUL BRIZENDINE IS THE FATHER OF TRUSTEE J. BRIAN BRIZENDINE, MD AND RECEIVES COMPENSATION AS AN INDEPENDENT CONTRACTOR. X 11 4480 COST X 6674 COST X 1 51481 FMV X 20 4028 COST false true false SCHEDULE M, PART I, COLUMN B NUMBER OF CONTRIBUTIONS: THE NUMBER OF CONTRIBUTIONS WAS DETERMINED BY THE NUMBER OF ITEMS CONTRIBUTED FOR EACH TYPE OF ITEM. FORM 990, PART III, LINE 4A PROGRAM SERVICES ACTIVITY #1: FOR THE FISCAL YEAR ENDED APRIL 30, 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. FITZGIBBON HEALTH SERVICES 2506 LINDEN TREE PARKWAY MARSHALL MO 65340 431731173 NURSING HOME MO 501(C)(3) 10 JF MEM HOSP true false false false false false false false false false false false true false true true true true false false FITZGIBBON HEALTH SERVICES L 107296 FMV FITZGIBBON HEALTH SERVICES P 110519 FMV FITZGIBBON HEALTH SERVICES Q 608010 FMV