2015-01-30T11:58:33-06:00 2014-06-30 430352985 KERBER ECK & BRAECKEL LLP 1116 W MAIN ST CARBONDALE IL 629012335 990 2013-07-01 370661202 FAIRFIELD MEMORIAL HOSPITAL ASSOC FAIR 6188422611 303 NW 11TH ST FAIRFIELD IL 62837 KATHY CLAYTON CFO 6188422611 2015-01-12 true MARK DALLAS P00187265 6185291040 2015-01-30 2013 2016-03-07 17:11:31Z KATHERINE BUNTING 303 NW 11TH ST FAIRFIELD IL 62837 27060091 false X WWW.FAIRFIELDMEMORIAL.ORG X 1943 IL THE MISSION OF FAIRFIELD MEMORIAL HOSPITAL IS TO MAINTAIN AND IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. 9 6 322 49 0 457411 617561 25143695 25574524 13167 161774 813409 706232 26427682 27060091 0 0 12902387 12983828 0 0 12829401 13387906 25731788 26371734 695894 688357 25285680 25122686 11983932 11132581 13301748 13990105 X THE MISSION OF FAIRFIELD MEMORIAL HOSPITAL IS TO MAINTAIN AND IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. false false 26371734 27029406 AS A NON-FOR-PROFIT COMMUNITY HOSPITAL, FAIRFIELD MEMORIAL HOSPITAL IS A CHARITABLE ORGANIZATION THAT EXISTS TO ADVANCE THE HEALTH OF THE RESIDENTS OF WAYNE COUNTY AND SURROUNDING COMMUNITIES. FAIRFIELD MEMORIAL HOSPITAL OPERATES A RURAL HEALTHCARE FACILITY WITH 25 ACUTE CARE BEDS AND 30 SKILLED CARE BEDS. IN AUGUST 2008 THE HOPSITAL OPENED AN OUTPATIENT PHYSICIAN CLINIC. FAIRFIELD MEMORIAL HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF FAIFIELD MEMORIAL HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH THIS CORPORATION'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE,CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST,AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR INDIVIDUALS INABILITY TO PAY COEXISTS. THE COMMUNITY BENEFITS CAN BE MEASURED IN MANY WAYS INCLUDING: DIRECT PATIENT CARE, SCREENINGS, EDUCATION, FUNDRAISING, AND COMMUNITY SERVICE EFFORTS OF OUR COLLEAGUES. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, PROVIDING SERVICES TO BOTH MEDICARE AND MEDICAID PATIENTS. CHARITY CARE IS ALSO PROVIDED THROUGH THE HOSPITAL'S INTERNAL POLICY AND IN FY 2014 THIS AMOUNTED TO 860,638. 26371734 true true false false false false false false false false true false false false true true true false false false false false false false false false true true false false true false false false false false false true false false false false false false true false false false true 23 0 true 322 true false false false false false false false false false false false false X 9 6 false false false false false false false true true false false true true true true true true true true false IL X KATHY CLAYTON 6188422611 303 NW 11TH ST FAIRFIELD IL 62837 PATRICK MOLT MD PRESIDENT 10.00 X 60600 0 0 MARTY HEFLIN SECRETARY/TR 5.00 X 0 0 0 JAMIE POLLARD TRUSTEE 1.00 X 0 0 0 SANDY SIMPSON TRUSTEE 1.00 X 0 0 0 DONNA SULLIVAN TRUSTEE 4.00 X 0 0 0 JOSEPH HUNGERFORD TRUSTEE 1.00 X 0 0 0 DALE WARREN VICE PRESIDE 2.00 X 0 0 0 JARED VAUGHN TRUSTEE 4.00 X 0 0 0 KATHERINE BUNTING CEO 40.00 X 228869 0 12077 ANN IGNAS CNO 40.00 X 108338 0 9200 KATHY CLAYTON CFO 40.00 X 77403 0 11963 WESLEY THOMPSON PHYSICIAN 40.00 X 373112 0 30910 CHRIS BALLARD PHYSICIAN 40.00 X 328923 0 29447 KYLE KAKAC PHYSCIAN 40.00 X 274658 0 24562 ALEXIS KING CRNA 40.00 X 223503 0 25047 KIMBERLY KING CRNA 40.00 X 222007 0 24916 1897413 168122 10 false true false WAY-FAIR NURSING & REHABILITATION CE 305 NW 11TH ST FAIRFIELD IL 62837 DIETARY 745129 ARAMARK UNIFORM SERVICE 25259 NETWORK PLACE CHICAGO IL 606731252 LAUNDRY 598877 AMERISOURCE BERGEN DRUG COMPANY PO BOX 27550 CHICAGO IL 606731275 PHARMACEUTICALS 514407 DR RODNEY BEELER 2142 KETTLES HILL COURT EVANSVILLE IN 47725 ER PHYSICIAN 341782 JE SHEKELL 424 W TENNESSEE STREET EVANSVILLE IN 477102448 GENERATOR PROJE 117902 20 153475 447330 16756 8300 617561 NET PATIENT SERVICE REVENUE 25574524 25574524 25574524 161774 161774 235397 235397 235397 235397 MISCELLANEOUS 194492 194492 CAFETERIA SERVICES 106276 106276 MEDICARE EHR REVENUE 102873 102873 67194 67194 470835 27060091 26442530 X 414610 414610 10217312 10217312 128376 128376 1507088 1507088 716442 716442 6702 6702 35120 35120 4990954 4990954 97709 97709 2273158 2273158 962981 962981 179529 179529 370043 370043 1302658 1302658 328727 328727 DRUGS 903424 903424 REPAIRS AND MAINTENANCE 631977 631977 BED AND PROVIDER TAX ASMT 573319 573319 FOOD 456705 456705 274900 274900 26371734 26371734 0 0 2640 1745 2729891 2096369 4676914 5519809 330331 292309 123718 276767 35912845 19967599 15707073 15945246 300800 300800 1414313 689641 25285680 25122686 2300464 2556486 191058 84212 8616672 7765310 18933 527612 856805 198961 11983932 11132581 X 12371703 13644291 929476 345245 569 569 13301748 13990105 25285680 25122686 688357 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 421396 421396 19213974 7821638 11392336 16108545 12121828 3986717 168930 24133 144797 15945246 THIRD PARTY REIMBURSEMENT PROGRAMS 198961 198961 X 27060091 27060091 27060091 26371734 26371734 26371734 SCHEDULE D, PAGE 3, PART X THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY UPON THE ADOPTION OF ASC TOPIC 740-10-25 OR AT JUNE 30, 2014. true true true X true X true true true false false 316406 316406 0.01200 1487805 573319 914486 0.03470 1804211 573319 1230892 0.04670 22673 22673 0.00090 22673 22673 0.00090 1826884 573319 1253565 0.04750 true 1022943 255736 12857373 13619669 -762296 X true true 2 1 FAIRFIELD MEMORIAL HOSPITAL 303 NW 11TH ST FAIRFIELD IL 62837 X X X X 2 HORIZON HEALTHCARE 1021 HARDING ST FAIRFIELD IL 62837 OUTPATIENT PHYSCIAN CLINIC FAIRFIELD MEMORIAL HOSPITAL 1 true X X X X X X X X X X 12 false false true X WWW.FAIRFIELDMEMORIAL.ORG X X X X X X X X X true false true true 200.000000000000 true 300.000000000000 true X X X true true X X X X X X true X X true X X X X X X true X false false HORIZON HEALTHCARE 2 true X X X X X X X X X X 12 false false true X WWW.FAIRFIELDMEMORIAL.ORG X X X X X X X X X true false true true 200.000000000000 true 300.000000000000 true X X X true true X X X X X X true X X true X X X X X X true X false false FACILITY 1, FAIRFIELD MEMORIAL HOSPITAL - PART V, LINE 14G THE POLICY IS VERBALLY DISCUSSED WITH ALL SELF-PAY PATIENTS. FACILITY 1, FAIRFIELD MEMORIAL HOSPITAL - PART V, LINE 20D IF A PATIENT APPLIES FOR FINANCIAL ASSISTANCE AND THEY ARE APPROVED THE BILL IS REDUCED TO ZERO. IF THE PATIENT QUALIFIES FOR THE PATIENT DISCOUNT ACT, THEN THE CURRENT ASSIGNED PERCENTAGE IS CHARGED. IF NEITHER APPLY, THEN THE PATIENT IS OFFERED A 20% DISCOUNT IF PAID IN FULL OR AN OFFER OF REASONABLE INTEREST FREE PAYMENTS ARE SET UP. FACILITY 2, HORIZON HEALTHCARE - PART V, LINE 14G POLICY IS VERBALLY DISCUSSED WITH ALL SELF-PAY PATIENTS. FACILITY 2, HORIZON HEALTHCARE - PART V, LINE 20D IF A PATIENT APPLIES FOR FINANCIAL ASSISTANCE AND THEY ARE APPROVED THE BILL IS REDUCED TO ZERO. IF THE PATIENT QUALIFIES FOR THE PATIENT DISCOUNT ACT, THEN THE CURRENT ASSIGNED PERCENTAGE IS CHARGED. IF NEITHER APPLY, THEN THE PATIENT IS OFFERED A 20% DISCOUNT IF PAID IN FULL OR AN OFFER OF REASONABLE INTEREST FREE PAYMENTS ARE SET UP. PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE 2,782,454 PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION THE FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION USED A COST TO CHARGE RATIO AS CALCULATED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, INCLUDED IN THE SCHEDULE H INSTRUCTIONS TO DETERMINE THE AMOUNTS ON LINES 7A AND 7B OF PART I OF SCHEDULE H. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY THE HOSPITAL CALCULATED BAD DEBT EXPENSE AT COST USING THE COST TO CHARGE RATIO AS CALCULATED USING WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT ONLY AFTER ALL COLLECTION PROCEDURES HAVE BEEN EXHAUSTED AS OUTLINED IN SCHEDULE H, PART III, LINE 9B. PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AFTER ALL DISCOUNTS AND PAYMENTS HAVE BEEN APPLIED. BASED ON THE HOSPITAL'S EXPERIENCE WITH ALL ITS PATIENTS, THEY ESTIMATE THAT IT IS LIKELY THAT UP TO ONE FOURTH OF THE PATIENT ACCOUNTS WRITTEN OFF TO BAD DEBTS MAY QUALIFY FOR CHARITY CARE OR OTHER ASSISTANCE BUT CHOSE NOT TO APPLY. THEREFORE, 25% OF THE BAD DEBT EXPENSE WAS INCLUDED ON PART III, LINE 3 AT COST. FOLLOWING IS NOTE C - UNCOMPENSATED CARE AND COMMUNITY BENEFIT COPIED DIRECTLY FROM THE AUDITED FINANCIAL STATEMENTS: IN SUPPORT OF ITS MISSION, THE HOSPITAL VOLUNTARILY PROVIDES CARE TO PATIENTS AT LESS THAN ITS ESTABLISHED CHARGES FOR PATIENTS THAT MEET THE HOSPITAL'S CHARITY CARE CRITERIA. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED IN NET PATIENT SERVICES REVENUE. CHARGES EXCLUDED FROM REVENUE UNDER THE HOSPITAL'S CHARITY CARE POLICY WERE APPROXIMATELY 860,638 AND 2,550,666 FOR 2014 AND 2013. IN ADDITION, THE HOSPITAL PROVIDES SERVICES TO OTHER MEDICALLY INDIGENT PATIENTS UNDER CERTAIN GOVERNMENT-REIMBURSED PUBLIC AID PROGRAMS. SUCH PROGRAMS PAY PROVIDERS AMOUNTS WHICH ARE LESS THAN ESTABLISHED CHARGES FOR THE SERVICES PROVIDED TO THE RECIPIENTS AND MANY TIMES THE PAYMENTS ARE LESS THAN THE COST OF RENDERING THE SERVICES PROVIDED. THE HOSPITAL'S TOTAL COST OF UNCOMPENSATED CARE RELATING TO THESE SERVICES AND OTHER SERVICES ARE AS FOLLOWS: CHARITY CARE 316,406 STATE MEDICAID AND OTHER PUBLIC PROGRAMS 914,486 UNCOLLECTIBLE ACCOUNTS 1,022,943 THE UNCOMPENSATED CARE COST OF STATE MEDICAID AND OTHER PUBLIC AID PROGRAMS IS DETERMINED BY COMPUTING THE COST OF PROVIDING THAT CARE LESS AMOUNTS PAID BY THE PROGRAM. IN ADDITION TO THE ABOVE COST OF UNCOMPENSATED CARE, THE HOSPITAL ALSO COMMITS SIGNIFICANT TIME AND RESOURCES TO ENDEAVORS AND CRITICAL SERVICES WHICH MEET OTHERWISE UNFILLED COMMUNITY NEEDS. MANY OF THESE ACTIVITIES ARE SPONSORED WITH KNOWLEDGE THAT THEY WILL NOT BE SELF-SUPPORTING OR FINANCIALLY VIABLE. PART III, LINE 8 - MEDICARE EXPLANATION UNPAID COST OF MEDICARE REPRESENTS THE COST (DETERMINED USING THE OVERALL COST TO CHARGE RATIO) OF PROVIDING SERVICES TO PRIMARILY ELDERLY BENEFICIARIES OF THE MEDICARE PROGRAM, IN EXCESS OF PAYMENTS FOR THOSE SERVICES. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFTIS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION THE FAIRFIELD MEMORIAL HOSPITAL APPLIES ITS COLLECTION PRACTICES EQUALLY TO ALL PATIENTS, BOTH CHARITY CARE ELIGIBLE AND NON-CHARITY CARE PATIENTS. THE PROCEDURES FOR COLLECTION ON PATIENT ACCOUNTS ARE AS FOLLOWS: SELF-PAY ACCOUNTS AND ACCOUNTS WITH BALANCES AFTER INSURANCE ARE SENT A LETTER REQUESTING PAYMENT. IF NO RESPONSE IS RECEIVED WITHIN 35 DAYS, THE ACCOUNT IS TRANSFERRED TO OUR EARLY-OUT DEPARTMENT FOR A FOLLOW-UP STATEMENT/PHONE CALL TO THE PATIENT. THE HOSPITAL OFFERS THE PATIENTS SEVERAL PAYMENT ALTERNATIVES: 1. CASH/CHECK FOR THE FULL AMOUNT 2. MASTERCARD/VISA/DISCOVER 3. SHORT-TERM MONTHLY INSTALLMENTS BASED ON OUTSTANDING BALANCE SPECIAL PAYMENT ARRANGEMENTS CAN BE MADE UPON REQUEST AND COMPLETION OF A CREDIT APPLICATION WHICH WILL BE VERIFIED AND APPROVED BY THE BUSINESS OFFICE DIRECTOR. IF PAYMENT OR SATISFACTORY PAYMENT ARRANGMENTS AS OUTLINED ABOVE ARE NOT MADE, THE ACCOUNT WILL PROCEED THROUGH A COLLECTION PROCESS AS FOLLOWS: DAY 1 - 1ST NOTICE SENT DAY 7-14 - FIRST PHONE CALL IS MADE. AT LEAST ONE PHONE CALL OR NOTICE PER WEEK FOR THE REMAINDER OF THE EARLY-OUT 90 DAY PERIOD DAY 75 - DEMAND NOTICE IS SENT DAY 90 - ACCOUNT IS SENT TO COLLECTIONS ANY ACCOUNT THAT IS SENT TO COLLECTIONS MAY BE TURNED OVER TO AN ATTORNEY AND ANY ADDITIONAL COSTS ASSOCIATED WITH COLLECTIONS WILL BE ADDED TO THE ACCOUNT BALANCE. PART VI, LINE 2 - NEEDS ASSESSMENT GENERALLY SPEAKING, THE DETERMINATION OF CURRENT AND FUTURE HEALTH CARE NEEDS OF THE COMMUNITY OR COMMUNITIES SERVED BY FAIRFIELD MEMORIAL HOSPITAL IS BASED ON ALL OR A COMBINATION OF THE FOLLOWING FACTORS; EXISTENCE OR NONEXISTENCE OF SERVICES, OPPORTUNITY, SUPPLY, DEMONSTRATED NEED, "VOICE OF THE CUSTOMER", AND /OR COLLABORATIVE EFFORTS WITH OUTSIDE ENTITIES, GOVERMENT AGENCIES, AND OTHER HEALTH CARE PROVIDERS THAT WOULD ENABLE THE FILLING OF A NEED OR ENHANCE AND COMPLIMENT AN ALREADY EXISTING SERVICE. DATA IS GATHERED CONSTANTLY THROUGH BENCHMARKETING, MARKET RESEARCH, CUSTOMER SURVEYS, PHYSCIAN INPUT, AND THROUGH CONSTANT MONITORING OF STATE AND FEDERAL GUIDELINES. THIS INFORMATION IS REVIEWED AND ANALYZED BY THE HOSPITAL'S SENIOR LEADERSHIP AND INCORPORATED INTO STRATEGIC PLANNING PROCESSES. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SIGNS ARE POSTED IN THE FACILITY. THE PATIENT'S BILL INFORMS THEM OF FINANCIAL ASSISTANCE PROGRAM. OUR HOSPITAL WEBSITE HAS A LINK TO THE FINANCIAL ASSISTANCE APPLICATION. SOCIAL SERVICE DEPARTMENT SPEAKS TO INPATIENTS ABOUT THE PROGRAM. PART VI, LINE 4 - COMMUNITY INFORMATION FAIRFIELD MEMORIAL HOSPITAL SERVES THE POPULATIONS OF WAYNE COUNTY AND THE SURROUNDING COMMUNITIES WITHOUT REGARD TO AGE, GENDER, INCOME , ETHIC ORGIN, INSURANCE COVERAGE, OR ABILITY TO PAY. WAYNE COUNTY IS A RURAL AREA WITH AN ESTIMATED POPULATION OF 16,612 . THE MEDIAN HOUSEHOLD INCOME IN 2012 WAS 41,446, WHICH WAS 73% OF ILLINOIS' AVERAGE AND 78% OF THE US AVERAGE. THE PERCENTAGE OF INDIVIDUALS BELOW POVERTY LEVEL WAS 13.0%. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT ILLINOIS X X X X X false false false false false false false false false KATHERINE BUNTING CEO 228869 11184 893 240946 WESLEY THOMPSON PHYSICIAN 373112 27017 3893 404022 CHRIS BALLARD PHYSICIAN 328923 25554 3893 358370 KYLE KAKAC PHYSCIAN 274658 23669 893 299220 ALEXIS KING CRNA 223503 24154 893 248550 KIMBERLY KING CRNA 222007 24023 893 246923 CHARLOTTE ST LEDGER EMPLOYEE 41776 WIFE OF PRESIDENT false NICOLE FYIE PHYSICIAN 63718 WIFE OF BOARD MEMBER false PATRICK MOLT PHYSICIAN 60600 BOARD MEMBER false FORM 990, PAGE 1, PART I, LINE 6 VOLUNTEERS ARE PART OF THE HOSPITAL AUXILIARY WHO RUN FUNDRAISERS ON BEHALF OF THE HOSPITAL AND OPERATE THE GIFT SHOP. FORM 990, PAGE 2, PART III, LINE 4A COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE,CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST,AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR INDIVIDUALS INABILITY TO PAY COEXISTS. THE COMMUNITY BENEFITS CAN BE MEASURED IN MANY WAYS INCLUDING: DIRECT PATIENT CARE, SCREENINGS, EDUCATION, FUNDRAISING, AND COMMUNITY SERVICE EFFORTS OF OUR COLLEAGUES. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, PROVIDING SERVICES TO BOTH MEDICARE AND MEDICAID PATIENTS. CHARITY CARE IS ALSO PROVIDED THROUGH THE HOSPITAL'S INTERNAL POLICY AND IN FY 2014 THIS AMOUNTED TO 860,638. FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 WAS REVIEWED BY THE CFO AND FINANCE COMMITTEE. AFTER THE FINANCE COMMITTEE IT WAS TAKEN TO THE FULL BOARD FOR APPROVAL. FORM 990, PAGE 6, PART VI, LINE 12C ANNUALLY EACH BOARD MEMBER RECEIVES THE CORPORATE COMPLIANCE POLICY WHICH INCLUDES THE CONFLICT OF INTEREST POLICY WITHIN IT TO REVIEW AND SIGN THAT THEY HAVE READ THE POLICY AND HAVE NO COMFLICTS. ALL SIGNED DOCUMENTS ARE KEPT ON FILE IN ADMINISTRATION OFFICE. FORM 990, PAGE 6, PART VI, LINE 15A THE CEO'S COMPENSATION PROCESS INVOLVES ALLIANT, THE HOSPITAL'S MANAGEMENT COMPANY, BRINGING EVALUATION TIME SALARY INFORMATION FOR OTHER ALLIANT HOSPITALS WHICH INCLUDE HOSPITAL'S IN THE FOLLOWING STATES: ILLINOIS, KENTUCKY, AND INDIANIA; AS WELL AS SALARY INFORMATION FOR CEO'S FROM OTHER HOSPITAL'S IN RELEVANT SIZE (IN REVENUES) TO FMH. THE SALARY COMPARISON INFORMATION IS PRESENTED TO THE PERSONNEL COMMITTEE OF THE BOARD IN WHICH THEY REVIEW THE INFORMATION AND ESTABLISH THE RATE FOR THE CEO. FORM 990, PAGE 6, PART VI, LINE 15B MARKET WAGE DATA FOR THE HEALTHCARE INDUSTRY IS REVIEWED FOR COMPARABLE RATES FROM THREE SALARY SURVEYS INCLUDING ALLIANT AS ONE. THE CEO DETERMINES THE AMOUNTS FOR THE OFFICERS. FORM 990, PAGE 6, PART VI, LINE 19 COPIES OF THE ORGANIZATIONS GOVERING DOCUMENTS, CONFLICT OF INTEREST POLICIES, FINANCIAL STATEMENTS, AND THE FEDERAL FORM 990 TAX RETURN ARE AVAILABLE UPON REQUEST FROM THE ADMINISTRATIVE OFFICES. FORM 990, PART IX, LINE 11G PROFESSIONAL SERVICES 3,393,311 0 0 PHYSICIANS FEES 1,597,643 0 0 FAIRFIELD MEMORIAL HOSPITAL FOUNDAT 303 NW 11TH STREET FAIRFIELD IL 62837 371185754 SUPPORT IL 501C3 11B N/A false false false true false false false false false false false false false false false false false false false false FMH FOUNDATION C 143475 ACTUAL CASH RECEIVED