JOHN FITZGIBBON MEMORIAL HOSPITAL INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: JOHN FITZGIBBON MEMORIAL HOSPITAL INC (EIN 44-0655986)
Tax period: 2013-05-01 to 2014-04-30
Filed: 2015-03-14
IRS object ID: 201510739349300401
Schema version: 2013v4.0
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 O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-03-14T07:42:43-05:00	ReturnTs
Tax Period End	2014-04-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	910 E ST LOUIS 200/PO BOX 1190	AddressLine1
City	SPRINGFIELD	City
State	MO	State
ZIP Code	658062523	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2013-05-01	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	BusinessNameLine1

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 65 HIGHWAY	AddressLine1
Address Line2	PO BOX 250 Suite	AddressLine2
City	MARSHALL	City
State	MO	State
ZIP Code	65340	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	ANGELA P LITTRELL	PersonNm
Person Title	CFO/COO	PersonTitleTxt
Phone	6608867431	PhoneNum
Signature	2015-03-13	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	6608867431	PhoneNum

Field	Value	IRS element (for citing)
Tax	2013	TaxYr
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	RONALD A OTT	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2305 S 65 HIGHWAY	AddressLine1
City	MARSHALL	City
State	MO	State
ZIP Code	65340	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$53,943,446	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 & OUTCOMES, EMPOWERING THE COMMUNITY WE SERVE, & PARTICIPATING IN HEALTH CARE PARTNERSHIPS.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	612	TotalEmployeeCnt
Total Volunteers	54	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$208,149	PYContributionsGrantsAmt
CY Contributions Grants	$351,465	CYContributionsGrantsAmt
PY Program Service Revenue	$54,489,658	PYProgramServiceRevenueAmt
CY Program Service Revenue	$53,211,274	CYProgramServiceRevenueAmt
PY Investment Income	$249,357	PYInvestmentIncomeAmt
CY Investment Income	$318,770	CYInvestmentIncomeAmt
PY Other Revenue	$14,541	PYOtherRevenueAmt
CY Other Revenue	$8,721	CYOtherRevenueAmt
PY Total Revenue	$54,961,705	PYTotalRevenueAmt
CY Total Revenue	$53,890,230	CYTotalRevenueAmt
PY Grants And Similar Paid	$12,000	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$12,000	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$24,747,211	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$24,650,738	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$66,624	CYTotalFundraisingExpenseAmt
PY Other Expenses	$27,653,450	PYOtherExpensesAmt
CY Other Expenses	$29,440,363	CYOtherExpensesAmt
PY Total Expenses	$52,412,661	PYTotalExpensesAmt
CY Total Expenses	$54,103,101	CYTotalExpensesAmt
PY Revenues Less Expenses	$2,549,044	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$212,871	CYRevenuesLessExpensesAmt
Total Assets BOY	$58,481,007	TotalAssetsBOYAmt
Total Assets EOY	$60,869,702	TotalAssetsEOYAmt
Total Liabilities BOY	$22,842,176	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$25,561,293	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$35,638,831	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$35,308,409	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	$38,828,226	ExpenseAmt
Revenue	$39,465,109	RevenueAmt
Desc	HOSPITAL SERVICE - FITZGIBBON HOSPITAL IS A 60 BED ACUTE CARE FACILITY SERVING MARSHALL, MO & THE SURROUNDING COMMUNITIES. THE FACILITY PROVIDES STATE OF THE ART 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 BEHAVIOR HEALTH UNIT AND A 24 HOUR HOSPITALIST PROGRAM TO SERVE IN-PATIENT NEEDS AT ALL TIMES. ANCILLARY SERVICES SUCH AS RADIOLOGY, LABORATORY, RESPIRATORY THERAPY & 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	$6,413,284	ExpenseAmt
Revenue	$6,708,704	RevenueAmt
Desc	CLINIC SERVICE-SPECIALTY CLINICS WITHIN THE HOSPITAL PROVIDE ORTHOPEDIC, WOUND CARE, NEUROLOGIC & PAIN MANAGEMENT SERVICES TO BOTH IN & OUT-PATIENTS. THESE CLINICS PROVIDED SERVICES TO 9,346 PATIENTS. THE HOSPITAL ALSO SUPPORTS A SEPARATE OUT-PATIENT CLINIC ON CAMPUS FOR FAMILY MEDICINE, OB/GYN, GENERAL SURGERY & PSYCHIATRY STAFFED MEDICAL PROFESSIONALS PRACTICING IN THESE SPECIALTIES FOR FISCAL YEAR 2014. THIS CLINIC PROVIDED SERVICES FOR 19,962 PATIENT VISITS. TWO SATELLITE FAMILY PRACTICE CLINICS ARE ALSO SUPPORTED BY THE HOSPITAL. THESE CLINICS PROVIDED SERVICES FOR 6,747 PATIENT VISITS.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$1,455,416	ExpenseAmt
Grant	$12,000	GrantAmt
Revenue	$1,295,396	RevenueAmt
Desc	COMMUNITY HEALTH SERVICES - HOSPICE, HOME HEALTH, & HOMEMAKER SERVICES. HOSPICE PROVIDED 83 PALLIATIVE CARE VISITS, HOME HEALTH PROVIDED 6,148 VISITS & HOMEMAKER PERFORMED 13,336 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 DONATES $12,000 ANNUALLY TO OATS TO HELP SUSTAIN IT IN THE MARSHALL COMMUNITY. THE PROGRAM PROVIDED TRANSPORTATION FOR 3,653 RIDERS DURING FY 2014.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$697,715	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue	$5,742,065	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$47,394,641	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	false	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	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	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	135	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	612	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	12	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	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 65 HIGHWAY PO BOX 250	AddressLine1
City	MARSHALL	City
State	MO	State
ZIP Code	65340	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 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
FRED UTLAUT
PRESIDENT	1.0	1.0	Yes (X)	Yes (X)
WILLIAM L SUMMERS
VICE PRESIDENT	1.0	1.0	Yes (X)	Yes (X)
DON VOGELSMEIER
SECRETARY/TREASURER	1.0	1.0	Yes (X)	Yes (X)
VIRGINIA HUPP
DIRECTOR	1.0	1.0	Yes (X)
ROOK EVANS
DIRECTOR	1.0	1.0	Yes (X)
B F KNIPSCHILD MD
DIRECTOR	1.0	1.0	Yes (X)
RANDY MORROW
DIRECTOR	1.0	1.0	Yes (X)
JAMES SOWASH MD
DIRECTOR	1.0	1.0	Yes (X)
JACK UHRIG MD
DIRECTOR	1.0	1.0	Yes (X)
GAYLE CARTER
DIRECTOR	1.0	1.0	Yes (X)
SHARI THOMPSON MD
MEDICAL STAFF PRESIDENT	40.0	1.0	Yes (X)		$90,823	$0	$2,000
BILL JACKSON
DIRECTOR	1.0	1.0	Yes (X)
RONALD A OTT
PRESIDENT/CEO	40.0	1.0		Yes (X)	$276,761	$0	$11,477
ROBERTA NIENHUESER
VP FINANCIAL SERVICES	40.0	1.0		Yes (X)	$144,921	$0	$12,547
LYNNE OTT
VP PATIENT CARE SERVICES	40.0	0.0			$172,157	$0	$5,914	Yes (X)
DENNIS SOUSLEY
VP CLINICAL SERVICES	40.0	0.0			$170,604	$0	$4,734	Yes (X)
KELLY ROSS DO
ORTHOPEDIC SURGEON	40.0	0.0			$580,415	$0	$2,000		Yes (X)
JOHN B BRIZENDINE MD
GENERAL SURGEON	40.0	0.0			$338,252	$0	$2,000		Yes (X)
DARIN HAUG DO
HOSPITALIST/CMO	40.0	0.0			$381,779	$0	$336		Yes (X)
SHASHI KATUKOORI
HOSPITALIST	40.0	0.0			$254,531	$0	$6,947		Yes (X)
LORENZO ROMNEY DO
HOSPITALIST/FP PHYSICIAN	40.0	0.0			$322,518	$0	$2,466		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,732,761	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$50,421	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	21	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

ServicesServicesDesc	CompensationCompensationAmt
PHARMACY SYSTEMS INC
PHARMACY MANAGEMENT	$561,352
CAREFUSION SOLUTIONS
ADMINISTRATOR	$575,179
SIEMENS MEDICAL SOLUTIONS
MAINTENANCE	$347,012
SEPTAGON CONSTRUCTION CO
CONSTRUCTION	$3,009,816
PAUL T BRIZENDINE MD
ER PHYSICIAN	$292,296

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	16	CntrctRcvdGreaterThan100KCnt
Fundraising	$120,187	FundraisingAmt
Government Grants	$21,645	GovernmentGrantsAmt
All Other Contributions	$209,633	AllOtherContributionsAmt
Total Contributions	$351,465	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE	900099	$52,072,080	$52,072,080
EHR INCENTIVE REVENUE	900099	$699,000	$699,000
CAFETERIA	722514	$246,275	$246,275
MANAGEMENT FEES	561000	$60,000	$60,000
OTHER REVENUE	900099	$133,919	$133,919

Field	Value	IRS element (for citing)
Total Program Service Revenue	$53,211,274	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$321,720	TotalRevenueColumnAmt
Exclusion	$321,720	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	$3,600	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$3,600	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,600	TotalRevenueColumnAmt
Exclusion	$3,600	ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$2,950	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$2,950	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$2,950	TotalRevenueColumnAmt
Exclusion	-$2,950	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$55,387	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$120,187	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$50,266	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,121	TotalRevenueColumnAmt
Exclusion	$5,121	ExclusionAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

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	$53,890,230	TotalRevenueColumnAmt
Related Or Exempt Func Income	$53,211,274	RelatedOrExemptFuncIncomeAmt
Exclusion	$327,491	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$12,000	TotalAmt
Program Services	$12,000	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	$909,606	TotalAmt
Program Services	$455,141	ProgramServicesAmt
Management And General	$454,465	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$22,436	TotalAmt
Program Services	$22,436	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$20,131,729	TotalAmt
Program Services	$17,310,348	ProgramServicesAmt
Management And General	$2,761,597	ManagementAndGeneralAmt
Fundraising	$59,784	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$81,378	TotalAmt
Program Services	$73,519	ProgramServicesAmt
Management And General	$7,859	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$2,092,584	TotalAmt
Program Services	$1,837,295	ProgramServicesAmt
Management And General	$255,289	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,413,005	TotalAmt
Program Services	$1,225,178	ProgramServicesAmt
Management And General	$182,714	ManagementAndGeneralAmt
Fundraising	$5,113	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	$20,434	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$20,434	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$118,100	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$118,100	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

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	$4,341,860	TotalAmt
Program Services	$3,343,325	ProgramServicesAmt
Management And General	$998,535	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$189,651	TotalAmt
Program Services	$114,521	ProgramServicesAmt
Management And General	$75,028	ManagementAndGeneralAmt
Fundraising	$102	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,428,513	TotalAmt
Program Services	$2,704,924	ProgramServicesAmt
Management And General	$722,544	ManagementAndGeneralAmt
Fundraising	$1,045	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	$605,236	TotalAmt
Program Services	$520,391	ProgramServicesAmt
Management And General	$84,845	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$243,893	TotalAmt
Program Services	$216,464	ProgramServicesAmt
Management And General	$26,849	ManagementAndGeneralAmt
Fundraising	$580	FundraisingAmt

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	$81,080	TotalAmt
Program Services	$55,420	ProgramServicesAmt
Management And General	$25,660	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$883,156	TotalAmt
Program Services	$739,550	ProgramServicesAmt
Management And General	$143,606	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$2,987,564	TotalAmt
Program Services	$2,501,770	ProgramServicesAmt
Management And General	$485,794	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$541,315	TotalAmt
Program Services	$443,813	ProgramServicesAmt
Management And General	$97,502	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
BAD DEBT	$7,843,290	$7,843,290
MEDICAL SUPPLIES & DRUGS	$5,351,116	$5,351,116
PROVIDER TAX	$2,459,507	$2,459,507
RECRUITING & RETENTION	$345,648	$164,633	$181,015

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$54,103,101	TotalAmt
Program Services	$47,394,641	ProgramServicesAmt
Management And General	$6,641,836	ManagementAndGeneralAmt
Fundraising	$66,624	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	$4,477,769	BOYAmt
EOY	$3,839,823	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$16,881,503	BOYAmt
EOY	$16,114,738	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	$5,484,045	BOYAmt
EOY	$6,767,325	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	$1,095,723	BOYAmt
EOY	$956,581	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$926,046	BOYAmt
EOY	$1,118,492	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$58,652,366	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$34,012,659	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$22,728,615	BOYAmt
EOY	$24,639,707	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$3,170,309	BOYAmt
EOY	$4,672,529	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	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$3,716,997	BOYAmt
EOY	$2,760,507	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$58,481,007	BOYAmt
EOY	$60,869,702	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$4,758,316	BOYAmt
EOY	$5,294,511	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	$16,037,242	BOYAmt
EOY	$15,504,713	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	$842,038	BOYAmt
EOY	$3,495,239	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	$1,204,580	BOYAmt
EOY	$1,266,830	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$22,842,176	BOYAmt
EOY	$25,561,293	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$34,550,755	BOYAmt
EOY	$34,252,135	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$632,859	BOYAmt
EOY	$601,057	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	$35,638,831	BOYAmt
EOY	$35,308,409	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$58,481,007	BOYAmt
EOY	$60,869,702	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$212,871	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$117,551	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

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

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	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$8,552	OtherActivitiesAmt
Total Lobbying Expenditures	$8,552	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART II-B, LINE 1(I)	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

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	$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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$719,060	BeginningYearBalanceAmt
Investment Earnings Or Losses	$20,163	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$1,000	GrantsOrScholarshipsAmt
Other Expenditures	$4,800	OtherExpendituresAmt
Administrative Expenses	$60	AdministrativeExpensesAmt
End Year Balance	$733,363	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$694,769	BeginningYearBalanceAmt
Investment Earnings Or Losses	$24,351	InvestmentEarningsOrLossesAmt
Administrative Expenses	$60	AdministrativeExpensesAmt
End Year Balance	$719,060	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$677,227	BeginningYearBalanceAmt
Investment Earnings Or Losses	$21,898	InvestmentEarningsOrLossesAmt
Other Expenditures	$4,296	OtherExpendituresAmt
Administrative Expenses	$60	AdministrativeExpensesAmt
End Year Balance	$694,769	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$618,998	BeginningYearBalanceAmt
Contributions	$25,296	ContributionsAmt
Investment Earnings Or Losses	$36,603	InvestmentEarningsOrLossesAmt
Other Expenditures	$3,670	OtherExpendituresAmt
End Year Balance	$677,227	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.31874	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.64885	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.03241	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	$27,402,724	OtherCostOrOtherBasisAmt
Depreciation	$10,426,244	DepreciationAmt
Book Value	$16,976,480	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$28,816,251	OtherCostOrOtherBasisAmt
Depreciation	$22,765,598	DepreciationAmt
Book Value	$6,050,653	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,362,391	OtherCostOrOtherBasisAmt
Depreciation	$820,817	DepreciationAmt
Book Value	$1,541,574	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$24,639,707	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
DUE TO RELATED PARTY	$377,121
EST AMT DUE TO 3RD PTY PYRS	$615,000
EST SELF INSURANCE COSTS	$274,709

Field	Value	IRS element (for citing)
Total Liability	$1,266,830	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$45,824,424	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	-$7,843,290	OtherRevenueAmt
Revenue Not Reported	-$7,843,290	RevenueNotReportedAmt
Revenue Subtotal	$53,667,714	RevenueSubtotalAmt
Other Revenues Not Included	$222,516	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$222,516	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$53,890,230	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$46,310,077	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$50,266	OtherExpensesIncludedAmt
Expenses Not Reported	$50,266	ExpensesNotReportedAmt
Expenses Subtotal	$46,259,811	ExpensesSubtotalAmt
Other Expenses Not Included	$7,843,290	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$7,843,290	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$54,103,101	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: $ (7,843,290) BAD DEBT EXPENSE
SCHEDULE D, PART XI, LINE 4B	OTHER REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT LINE 1: $ (50,266) SPECIAL EVENTS EXPENSES 272,782 TEMPORARILY RESTRICTED CONTRIBUTIONS ----------- $ 222,516
SCHEDULE D, PART XII, LINE 2D	OTHER EXPENSE INCLUDED ON LINE 1, BUT NOT FORM 990, PART IX, LINE 25: $ 50,266 SPECIAL EVENTS EXPENSES
SCHEDULE D, PART XII, LINE 4B	OTHER EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT LINE 1: $ 7,843,290 BAD DEBT EXPENSE

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Name Of Event1	SPRING FLING	NameOfEvent1Amt
Gross Receipts Event1	$89,198	GrossReceiptsEvent1Amt
Charitable Contri Event1	$58,559	CharitableContriEvent1Amt
Gross Revenue Event1	$30,639	GrossRevenueEvent1Amt
Rent Facility Costs Event1	$870	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$9,489	FoodAndBeverageEvent1Amt
Other Direct Expenses Event1	$7,676	OtherDirectExpensesEvent1Amt
Name Of Event2	GOLF TOURNEY	NameOfEvent2Amt
Gross Receipts Event2	$29,788	GrossReceiptsEvent2Amt
Charitable Contri Event2	$21,447	CharitableContriEvent2Amt
Gross Revenue Event2	$8,341	GrossRevenueEvent2Amt
Cash Prizes Event2	$5,045	CashPrizesEvent2Amt
Non Cash Prizes Event2	$5,305	NonCashPrizesEvent2Amt
Rent Facility Costs Event2	$2,880	RentFacilityCostsEvent2Amt
Food And Beverage Event2	$766	FoodAndBeverageEvent2Amt
Other Direct Expenses Event2	$1,578	OtherDirectExpensesEvent2Amt
Other Events Total	3	OtherEventsTotalCnt
Gross Receipts Other Events	$56,588	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$40,181	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$16,407	GrossRevenueOtherEventsAmt
Food And Beverage Other Events	$250	FoodAndBeverageOtherEventsAmt
Oth Direct Expnss Other Events	$16,407	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$175,574	GrossReceiptsTotalAmt
Charitable Contributions Tot	$120,187	CharitableContributionsTotAmt
Gross Revenue Total Events	$55,387	GrossRevenueTotalEventsAmt
Cash Prizes Total Events	$5,045	CashPrizesTotalEventsAmt
Non Cash Prizes Total Events	$5,305	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$3,750	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$10,505	FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events	$25,661	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$50,266	DirectExpenseSummaryEventsAmt
Net Income Summary	$5,121	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
Percent200 D	Yes (X)	Percent200DInd
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	false	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$155,686	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$155,686	NetCommunityBenefitExpnsAmt
Total Expense	0.00330	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,598,875	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,489,679	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,109,196	NetCommunityBenefitExpnsAmt
Total Expense	0.02400	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,754,561	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,489,679	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,264,882	NetCommunityBenefitExpnsAmt
Total Expense	0.02730	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,566	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,655	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,911	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$445,688	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,250	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$443,438	NetCommunityBenefitExpnsAmt
Total Expense	0.00960	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,693,075	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,912,862	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,780,213	NetCommunityBenefitExpnsAmt
Total Expense	0.06010	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$17,832	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$17,832	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,183,161	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,923,767	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,259,394	NetCommunityBenefitExpnsAmt
Total Expense	0.07050	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,937,722	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,413,446	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,524,276	NetCommunityBenefitExpnsAmt
Total Expense	0.09780	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$19,242	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$19,242	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$19,242	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$19,242	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$7,843,290	BadDebtExpenseAmt
Bad Debt Expense Attributable	$3,294,182	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$11,576,175	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$13,624,624	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$2,048,449	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	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2305 S 65 HIGHWAY	AddressLine1
City	MARSHALL	City
State	MO	State
ZIP Code	65340	ZIPCode

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, NEUROLOGIC	OtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	JOHN FITZGIBBON MEMORIAL HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
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
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	12	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.FITZGIBBON.ORG	OwnWebsiteURLTxt
Rpt Available Upon Request	Yes (X)	RptAvailableUponRequestInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Adopt Implementation Strategy	Yes (X)	AdoptImplementationStrategyInd
Exec Implementation Strategy	Yes (X)	ExecImplementationStrategyInd
Develop Community Wide Plan	Yes (X)	DevelopCommunityWidePlanInd
Exec Community Wide Plan	Yes (X)	ExecCommunityWidePlanInd
Include Operational Plan	Yes (X)	IncludeOperationalPlanInd
Adopt Budget	Yes (X)	AdoptBudgetInd
Prioritize Health Needs	Yes (X)	PrioritizeHealthNeedsInd
Prioritize Services	Yes (X)	PrioritizeServicesInd
All Needs Addressed	false	AllNeedsAddressedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Used Deter Elig Free Care	Yes (true)	FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care	100	FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt Care	Yes (true)	FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care	200.	FPGFamilyIncmLmtDscntCarePct
Explained Basis	Yes (true)	ExplainedBasisInd
Income Level	Yes (X)	IncomeLevelInd
Medical Indigency	Yes (X)	MedicalIndigencyInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
Posted On Website	Yes (X)	PostedOnWebsiteInd
Provided On Admission	Yes (X)	ProvidedOnAdmissionInd
Available On Request	Yes (X)	AvailableOnRequestInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Lowest Negotiated Rates	Yes (X)	LowestNegotiatedRatesInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 3	COMMUNITY INPUT: KEY COMMUNITY HEALTH AND SOCIAL SERVICE STAKEHOLDERS WERE ENGAGED TO ASSIST IN THE PROCESS TO ENSURE INPUT FROM THE UNDERSERVED, CHRONICALLY ILL, LOW INCOME AND MINORITY POPULATIONS IN OUR SERVICE AREA. KEY COMMUNITY PARTNERS INVOLVED WITH THE PROCESS WERE FITZGIBBON HOSPITAL, SALINE COUNTY HEALTH DEPARTMENT, SALT FORK YMCA AND MARSHALL HOUSING AUTHORITY. TO ENSURE PUBLIC HEALTH EXPERTS COULD PROVIDE THEIR EXPERTISE, THE COMMITTEE SOUGHT INPUT THROUGH PERSONAL INTERVIEWS AND FOCUS GROUPS FROM SALINE COUNTY HEALTH DEPARTMENT, FITZGIBBON HOSPITAL PRIMARY CARE SITE NURSES, JACK UHRIG, M.D. PRIVATE PRACTICE PHYSICIAN, MELANIE ELFRINK, M.D. SALINE COUNTY HEALTH DEPARTMENT, MARSHALL PUBLIC SCHOOL NURSING STAFF, AND REV CHARLES STEPHENSON, EXECUTIVE DIRECTOR OF POWERHOUSE COMMUNITY DEVELOPMENT AGENCY. IN ADDITION, AN ONLINE SURVEY WAS CONDUCTED. THE SURVEY WAS AVAILABLE FOR A SIX-WEEK PERIOD WITH VARIOUS NOTICES TO THE PUBLIC ON ACCESSING AND COMPLETING THE SURVEY. SURVEY INTAKE STAFF WAS POSITIONED AT HOSPITAL-OPERATED RURAL HEALTH CLINICS, MARSHALL HOUSING AUTHORITY, SALINE COUNTY HEALTH DEPARTMENT, AND MARSHALL SENIOR CENTER TO ASSIST IN ACCESSING THE SURVEY.
SCHEDULE H, PART V, SECTION B, LINE 5D	CHNA AVAILABILITY TO PUBLIC: PRESS RELEASES WERE SENT TO THE LOCAL DAILY NEWSPAPER, THE MARSHALL DEMOCRAT NEWS, AND AREA WEEKLY NEWSPAPERS. IN ADDITION, ONLINE ACCESS WAS MADE AVAILABLE VIA WWW.MARSHALLNEWS.COM WITH A LINK THROUGH TO THE COMPLETE CHNA REPORT WHICH IS HOUSED PERMANENTLY ON THE HOSPITAL WEB SITE. A FLIER DESCRIBING THE ONLINE AND PRINTED ACCESS TO THE REPORT WAS DISTRIBUTED AT THE FITZGIBBON HOSPITAL APRIL 2013 COMMUNITY HEALTH FAIR AND WAS DISTRIBUTED TO THE PARTNER SITES FOR BROAD DISTRIBUTION TO THEIR CLIENT BASE.
SCHEDULE H, PART V, SECTION B, LINE 6	IMPLEMENTATION STRATEGY: IN RESPONSE TO THE RESULTS OF THE ORGANIZATION'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION ADOPTED AN IMPLEMENTATION STRATEGY. THE IMPLEMENTATION PLAN IS ATTACHED TO THE RETURN.
SCHEDULE H, PART V, SECTION B, LINE 7	ADDRESSING IDENTIFIED NEEDS: THE IMPLEMENTATION STRATEGY IDENTIFIED THREE HEALTH NEEDS AS HAVING THE GREATEST IMPACT TO OVERALL HEALTH IN THE COMMUNITY: SMOKING, OBESITY, AND PREVENTIVE CARE & WELLNESS. TO ADDRESS SMOKING, DURING FY 2014, FITZGIBBON STAFF TOOK THE LEAD IN CREATING AND PUSHING FORTH A GRASSROOTS ENTITY CALLED "BREATHE EASY MARSHALL," WHICH WAS A COMMUNITY COALITION ADVOCATING FOR A SMOKE-FREE ORDINANCE IN MARSHALL, MO. FORMED IN MAY OF 2013, AND UNDER THE DIRECTION OF THE CITY MAYOR, THE GROUP MET TWICE MONTHLY IN HOSPITAL SPACE, WITH BREAKFAST PROVIDED BY THE HOSPITAL. IT WAS COMPRISED OF HOSPITAL EMPLOYEES, CITY OFFICIALS, PHYSICIANS, HEALTH ADVOCATES AND REPRESENTATIVES OF THE UNDERSERVED COMMUNITY VIA POWERHOUSE MINISTRIES AND THE MARSHALL MINISTERIAL ALLIANCE. MANY OF THESE WERE THE SAME INDIVIDUALS WHO PROVIDED INPUT INTO THE ORIGINAL CHNA. REGARDING OBESITY, REGISTERED DIETICIAN LESLIE HESSE BEGAN UNDERTAKING EFFORTS OUTLINED IN THE IMPLEMENTATION STRATEGY BY ESTABLISHING AN INTERNAL ELECTRONIC DISTRIBUTION CALLED "90 DAYS TO A HEALTHIER YOU." THE TIPS RANGED FROM EXERCISE AND DIET TIPS TO ANTI-SMOKING AND DIABETES CONTROL MESSAGING. THIS DISTRIBUTION GREW TO INCLUDE MANY COMMUNITY ENTITIES WHICH INDICATED THEY WERE SHARING THIS WELLNESS INFORMATION WITH THEIR EMPLOYEES VIA INTEROFFICE EMAIL OR EMPLOYEE NEWSLETTER. WEEKLY EMAIL DELIVERY OF THE MESSAGES BEGAN IN MAY 2013, CONTINUED THROUGH FY2014 AND, INDEED, HAS CONTINUED TODAY. WE RECEIVE MUCH POSITIVE FEEDBACK REGARDING THIS MESSAGING, AS THEY ARE COMPLETELY EDUCATIONAL, INCLUDE HEALTH LITERACY, HEALTHY EATING, EXERCISE AND COOKING TIPS. A SERIES OF FITNESS TIPS TO ENCOURAGE THE USE OF THE STAIRS ALSO WERE DEVELOPED, PRINTED AND PERMANENTLY MOUNTED IN LUCITE FRAMES IN MARCH OF 2014 IN THE STAIRWELL AND BY THE PUBLIC ELEVATOR INSIDE THE HOSPITAL. THESE TIPS INCLUDED FACTS ABOUT THE BENEFITS OF EXERCISE IN PREVENTING GESTATIONAL DIABETES AND HOW MANY CALORIES A PERSON BURNS IN ONE MINUTE PERIOD WALKING VERSUS CLIMBING THE STAIRS. INCREASED AWARENESS AND EDUCATION ABOUT THE BENEFITS OF EXERCISE WAS THE GOAL. THE LAST NEED IDENTIFIED WAS PREVENTIVE CARE AND WELLNESS. A KEY INITIATIVE WAS THE PRIMARY CARE HEALTH HOME DEMONSTRATION PROJECT AND LEARNING COLLABORATIVE CONDUCTED BY THE MISSOURI HEALTHNET DIVISION, OR MISSOURI MEDICAID. WHILE NOT DIRECTLY IDENTIFIED ON THE IMPLEMENTATION PLAN, THIS INITIATIVE IS FOCUSED ON THE MOST AT-RISK PATIENTS - THOSE WITH MULTIPLE CHRONIC CONDITIONS WHO ARE INCOME ELIGIBLE UNDER MISSOURI MEDICAID. THAT PROJECT EMPHASIZES A TEAM APPROACH, INCREASED PATIENT AND FAMILY ENGAGEMENT IN DISEASE MANAGEMENT AND INTENSIVE NURSE CARE MANAGER INTERVENTION. MANY OF THE ACTIVITIES OF THE HEALTH HOME ARE FOCUSED ON DISEASE AND WELLNESS EDUCATION, AND AFTER HOURS OUTREACH. DURING PINK WEEK CELEBRATIONS OF OCTOBER 2013 THE HOSPITAL DEVELOPED AND DISTRIBUTED AN EDUCATIONAL FLIER ABOUT THE IMPORTANCE OF MAMMOGRAMS ALONG WITH A REMINDER THAT SCREENING MAMMOGRAMS SHOULD BE 100% COVERED UNDER THE AFFORDABLE CARE ACT, GIVEN CERTAIN GUIDELINES. EDUCATION ABOUT OTHER SERVICES CONSIDERED "COVERED" UNDER THE ACA WAS ALSO INCLUDED IN EDUCATIONAL COLUMNS AND MATERIALS DISSEMINATED ON SOCIAL MEDIA. THE EMPHASIS WAS TO URGE PATIENTS TO OBTAIN PREVENTATIVE CARE AND NOT LET A FEAR OF FINANCIAL OBLIGATION BECOME A BARRIER TO CARE. STAFF MEMBERS OF FITZGIBBON HOSPITAL ALSO ACTIVELY ENGAGED IN THE COVER MISSOURI COALITION, A STATEWIDE COLLABORATIVE ENCOURAGING ENROLLMENT IN THE NEW HEALTH INSURANCE MARKETPLACE. REPRESENTATIVES FROM BUSINESS DEVELOPMENT AND FINANCIAL SERVICES ATTENDED SEVERAL MONTHLY CONVENING MEETINGS OF THE COVER MISSOURI COALITION TO RECEIVE EDUCATION ABOUT ASSISTING PATIENTS TO ENROLL. ADDITIONAL EDUCATION REGARDING ENSURING PATIENT OBTAIN INSURANCE COVERAGE CAME FROM CMS TELECONFERENCES. THE IDENTIFIED HEALTH NEEDS NOT DIRECTLY ADDRESSED IN THE CHNA IMPLEMENTATION PLAN WERE AS FOLLOWS: COST AND ABILITY TO PAY FOR CARE, ALCOHOL AND DRUG ABUSE, CANCER, LACK OF HEALTH INSURANCE, LACK OF DENTAL CARE, MENTAL HEALTH CONCERNS, COST OF PRESCRIPTION MEDICATION AND TEEN PREGNANCY. THE CHNA COMMITTEE USED A DECISION MATRIX TO PRIORITIZE WHICH HEALTH NEEDS WOULD BE ADDRESSED BY THE COMMITTEE GOING FORWARD. IN ADDITION, CONSIDERATION WAS GIVEN TO PARTNER AGENCY CAPACITIES WHICH WOULD HAVE THE HIGHEST IMPACT ON RESIDENTS IN THE COMMUNITY WITH PLANS FOR COMMUNITY HEALTH CHANGE. OTHER FACTORS INFLUENCING THE COMMITTEE'S DECISION TO NOT ADDRESS NEEDS IDENTIFIED INCLUDED THE CONSEQUENCES OF NOT INTERVENING, COMMUNITY OPINION, AND NUMBERS OF PEOPLE AFFECTED. HOWEVER, SOME ACTIVITIES AROUND COST AND ABILITY TO PAY FOR CARE, CANCER, LACK OF DENTAL CARE OCCURRED. INCLUDED IN THESE ACTIVITIES WERE: STAFF MEMBERS ENGAGING WITH COVER MISSOURI COALITION, PRELIMINARY PLANNING FOR A DENTIST ON CAMPUS, AND OPERATION OF A CANCER CENTER AND OTHER ACTIVITIES SURROUNDING CANCER AWARENESS.

Field	Value	IRS element (for citing)
Facility	5	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	FacilityFacilityTxt
FITZGIBBON MEDICAL OFFICE BUILDING
2305 S 65 HIGHWAY	MARSHALL	MO	65340	OB/GYN, SURGERY, 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

Supplemental Information Detail SupplementalInformationDetail (10 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 $7,843,290.
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 BOARD, WHICH ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT AND ADVOCACY.
SCHEDULE H, PART III, SECTION A, LINES 2 & 3	BAD DEBT EXPENSE METHODOLOGY: THE ORGANIZATION REPORTED BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS FROM THE AUDITED FINANCIAL STATEMENTS. 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 DOUBTFUL 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 DOUBTFUL 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 DOUBTFUL 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 DOUBTFUL 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 NOT AN OPTION. "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 DIRECTORS 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: HOSPITAL USES SEVERAL AVENUES TO PROVIDE PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE. 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. THE SALINE COUNTY POPULATION IN 2009 WAS 22,586 RESIDENTS. SALINE COUNTY DATA FOR 2009 SHOWED 61.3% OF HOUSEHOLDS WITH INCOME UNDER $49,999. OF THIS NUMBER, 42.3% OF HOUSEHOLDS FELL INTO THE $34,999 AND BELOW BRACKET. THE AGE DISTRIBUTION OF THE POPULATION IN SALINE COUNTY IN 2009 WAS 72.8% AGE 54 AND UNDER AND 27.2% WERE 55 AND OLDER.
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 CONDUCTED IN 2012 AND PUBLISHED IN 2013, 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 THREE 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 IS 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	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2501 MCGUIRE BLVD	AddressLine1
City	COLUMBIA	City
State	MO	State
ZIP Code	65201	ZIPCode

Field	Value	IRS element (for citing)
Recipient EIN	431016961	RecipientEIN
IRC Section	501(C)(3)	IRCSectionDesc
Cash Grant	$12,000	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)
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	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 (9 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
RONALD A OTT
PRESIDENT/CEO	$221,621	$0	$54,000	$0	$1,140	$0	$2,000	$0	$9,477	$0	$288,238	$0	$0	$0
ROBERTA NIENHUESER
VP FINANCIAL SERVICES	$118,221	$0	$22,000	$0	$4,700	$0	$2,000	$0	$10,547	$0	$157,468	$0	$0	$0
LYNNE OTT
VP PATIENT CARE SERVICES	$144,017	$0	$27,000	$0	$1,140	$0	$2,000	$0	$3,914	$0	$178,071	$0	$0	$0
DENNIS SOUSLEY
VP CLINICAL SERVICES	$155,706	$0	$10,000	$0	$4,898	$0	$2,000	$0	$2,734	$0	$175,338	$0	$0	$0
KELLY ROSS DO
ORTHOPEDIC SURGEON	$540,464	$0	$0	$0	$39,951	$0	$2,000	$0	$0	$0	$582,415	$0	$0	$0
JOHN B BRIZENDINE MD
GENERAL SURGEON	$325,000	$0	$0	$0	$13,252	$0	$2,000	$0	$0	$0	$340,252	$0	$0	$0
DARIN HAUG DO
HOSPITALIST/CMO	$366,479	$0	$15,000	$0	$300	$0	$0	$0	$336	$0	$382,115	$0	$0	$0
SHASHI KATUKOORI
HOSPITALIST	$224,423	$0	$30,000	$0	$108	$0	$2,000	$0	$4,947	$0	$261,478	$0	$0	$0
LORENZO ROMNEY DO
HOSPITALIST/FP PHYSICIAN	$306,504	$0	$0	$0	$16,014	$0	$2,000	$0	$466	$0	$324,984	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE J, PART I, LINE 7	FormAndLineReferenceDesc
Explanation	NON-FIXED PAYMENTS: NON-FIXED PAYMENTS MADE TO RONALD OTT, ROBERTA NIENHUESER, LYNNE OTT, DENNIS SOUSLEY, DARIN HAUG, AND SHASHI KATUKOORI WERE BASED ON PERFORMANCE OF THE INDIVIDUALS AND ORGANIZATION. BONUSES ARE PAID TO INDIVIDUALS WHO HAVE CONTRIBUTED POSITIVELY TO THE ORGANIZATION AND THEIR PERFORMANCE HAS ALLOWED THE ORGANIZATION TO MEET DEPARTMENTAL AND ORGANIZATIONAL GOALS AS OUTLINED ON THE ANNUAL PERFORMANCE APPRAISAL. THESE GOALS INCLUDE, BUT ARE NOT LIMITED TO, SAFETY, PATIENT SATISFACTION AND FINANCIAL PERFORMANCE. FITZGIBBON HOSPITAL HAS AN AGREEMENT WITH BOONE HOSPITAL CENTER WHICH ALLOWS BOONE HOSPITAL TO OVERSEE AND ASSIST IN EVALUATING THE WORK AND PERFORMANCE OF THE PRESIDENT OF THE HOSPITAL AND IN DETERMINING THE COMPENSATION AND BENEFITS TO WHICH THE PRESIDENT WILL BE ENTITLED. THEREFORE, THE BONUSES WERE DETERMINED BY BOONE HOSPITAL IN CONSULTATION WITH THE FITZGIBBON HOSPITAL BOARD PRESIDENT. THE BONUS AMOUNTS WERE A PERCENTAGE OF THE BASE SALARIES.	ExplanationTxt

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	431386697	79516LAD6	2005-12-22	$10,000,000	CONSTRUCTION REVENUE BONDS	false	false	false
INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO
B	430980296	79516LBC7	2010-11-29	$12,218,468	1998 BOND REFINANCING	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	$0	$0	$10,365,462	$0	$0	$0	$193,724	$0	$9,806,276	$0	$0	$0	2007	false	false	Yes (true)	Yes (true)
B	$0	$0	$12,218,468	$0	$0	$11,985,656	$232,812	$0	$0	$0	$0	$0	2010	Yes (true)	false	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	false	false	false	0	false	false	false	Yes (true)
B					0

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/BusinessNameLine1	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 (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE K, PART II, LINE 3	TOTAL PROCEEDS OF ISSUE: TOTAL PROCEEDS OF ISSUE INCLUDE INVESTMENT EARNINGS ON BOND PROCEEDS WITH ISSUE PRICE OF $10,000,000 REPORTED ON SCHEDULE K, PART 1, LINE A, COLUMN (E).
SCHEDULE K, PART IV, LINE 2C, COLUMN A	DATE OF REBATE COMPUTATION: THE REBATE COMPUTATION FOR THE PERIOD OF DECEMBER 22, 2005 TO DECEMBER 1, 2010 OCCURED ON JANUARY 21, 2011.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	JUDY VOGELSMEIER	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	SPOUSE OF DON VOGELSMEIER	RelationshipDescriptionTxt
Transaction	$22,436	TransactionAmt
Transaction	EMPLOYEE COMPENSATION	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 4A	PROGRAM SERVICES ACTIVITY #1: FOR THE FISCAL YEAR ENDED APRIL 30, 2014, THE EMERGENCY ROOM EXPERIENCED 11,192 PATIENT VISITS. THE SURGICAL TEAM PERFORMED 337 IN-PATIENT AND 1,976 OUT-PATIENT PROCEDURES. THE RADIOLOGY GROUP PERFORMED 27,473 PROCEDURES WHICH INCLUDED 2,105 MAMMOGRAMS, 4,529 CT SCANS, 1,881 MRI'S, 2,874 ULTRASOUND IMAGES AND 1,945 NUCLEAR MEDICINE SCANS. THE LABORATORY TEAM PERFORMED 87,351 TESTS. THE RESPIRATORY THERAPY DEPARTMENT CONDUCTED 37,661 PATIENT TREATMENTS AND THE REHABILITATIVE SERVICES GROUP WHICH INCLUDES PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES PROVIDED 41,210 PATIENT ENCOUNTERS.
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 1,192 PATIENT VISITS AT THE FACILITY. IN ADDITION, THE STAFF EDUCATED 724 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. FITZGIBBON IS A WILLING PARTICIPANT IN A COMMUNITY WIDE COMMITTEE TO HELP IMPROVE ACCESS TO HEALTH CARE IN THE AREA. HOSPITAL PERSONNEL ARE ENCOURAGED AND PROVIDED OPPORTUNITIES TO SERVE THE COMMUNITY THROUGH INVOLVEMENT IN VARIOUS COMMUNITY ORGANIZATIONS AS VOLUNTEER MEMBERS, OFFICERS, AND SPEAKERS ON HEALTH RELATED TOPICS.
FORM 990, PART VI, SECTION A, LINE 2	FAMILY RELATIONSHIPS: RONALD OTT, PRESIDENT AND CEO, IS MARRIED TO LYNNE OTT, VP OF PATIENT CARE SERVICES, KEY EMPLOYEE.
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 BY THE VP OF FINANCIAL SERVICES AND THE CEO BEFORE BEING FINALIZED. THE 990 IS THEN PRESENTED TO THE BOARD 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, DIRECTORS, AND KEY EMPLOYEES TO SIGN A CONFLICT OF INTEREST DISCLOSURE FORM. ALL CONFLICTS MUST BE REVIEWED BY THE CEO AND/OR BOARD OF DIRECTORS. ANY BOARD MEMBER WITH A CONFLICT OF INTEREST WOULD ABSTAIN FROM VOTING ON ANY DECISION RELATED TO THAT CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15A & 15B	COMPENSATION DETERMINATION: THE ORGANIZATION USES INDUSTRY DATA IN DETERMINING COMPENSATION FOR THE CEO AND OTHER OFFICERS/KEY EMPLOYEES. FITZGIBBON HOSPITAL HAS AN AGREEMENT WITH BOONE HOSPITAL CENTER WHICH ALLOWS BOONE HOSPITAL TO OVERSEE AND ASSIST IN EVALUATING THE WORK AND PERFORMANCE OF THE PRESIDENT OF THE HOSPITAL AND IN DETERMINING THE COMPENSATION AND BENEFITS TO WHICH THE PRESIDENT WILL BE ENTITLED, THEREFORE, THE COMPENSATION WAS DETERMINED BY BOONE HOSPITAL IN CONSULTATION WITH THE FITZGIBBON HOSPITAL BOARD PRESIDENT.
FORM 990, PART VI, SECTION C, LINE 19	DOCUMENT DISCLOSURE: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO BE VIEWED IN THE ADMINISTRATION DEPARTMENT UPON WRITTEN REQUEST.
FORM 990, PART VII, SECTION A	BOARD MEMBER COMPENSATION: NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS DIRECTORS. BOARD MEMBER SHARI THOMPSON IS EMPLOYED BY JOHN FITZGIBBON MEMORIAL HOSPITAL AND COMPENSATED FOR HER ROLE AS A FAMILY PRACTICE PHYSICIAN.
FORM 990, PART X, LINE 20	TAX EXEMPT BONDS: JOHN FITZGIBBON MEMORIAL HOSPITAL RECEIVED QUALIFIED HOSPITAL BOND PROCEEDS FROM 2005 AND 2010 BOND ISSUES. A PORTION OF THE BOND PROCEEDS WERE ALLOCATED TO FITZGIBBON HEALTH SERVICES FOR AUDIT AND TAX 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	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2305 S 65 HWY PO BOX 250	AddressLine1
City	MARSHALL	City
State	MO	State
ZIP Code	65340	ZIPCode

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	9	PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	JF MEM HOSP	BusinessNameLine1

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	$60,000	FMV
FITZGIBBON HEALTH SERVICES
P	$132,403	FMV
FITZGIBBON HEALTH SERVICES
Q	$371,868	FMV