2012-03-12T14:13:45-05:00 2011-04-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2010-05-01 440655986 JOHN FITZGIBBON MEMORIAL HOSPITAL JOHN 6608867431 2305 S 65 HIGHWAY PO BOX 250 MARSHALL MO 65340 RONALD A OTT 6608867431 2012-03-05 true Brian D Todd 4178658701 2010 2016-02-24 21:20:13Z RONALD A OTT 2305 S 65 HIGHWAY MARSHALL MO 65340 55887331 false X www.fitzgibbon.org X 1961 MO TO IMPROVE THE HEALTH OF OUR COMMUNITY BY OFFERING QUALITY HEALTH CARE SERVICES, IMPROVING ACCESS & OUTCOMES, EMPOWERING THE COMMUNITY & PEOPLE WE SERVE, & PARTICIPATING IN HEALTH CARE PARTNERSHIPS. 12 10 571 50 0 0 98434 326412 48021297 50352024 233923 193607 6229 -238396 48359883 50633647 71779 17379 0 0 21432094 22173271 0 0 0 24172702 26575897 45676575 48766547 2683308 1867100 51857906 54036579 22543087 22819048 29314819 31217531 X TO IMPROVE THE HEALTH OF OUR COMMUNITY. false false 36900998 40366959 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. 3924393 3781098 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 15,497 PATIENTS. THE HOSPITAL ALSO SUPPORTS A SEPARATE OUT-PATIENT CLINIC ON CAMPUS FOR FAMILY MEDICINE, OB/GYN, GENERAL SURGERY, & PSYCHIATRY STAFFED BY MEDICAL PROFESSIONALS PRACTICING IN THESE SPECIALTIES. FOR FISCAL YEAR 2011, THIS CLINIC PROVIDED SERVICES FOR 13,303 PATIENT VISITS. TWO SATELLITE FAMILY PRACTICE CLINICS ARE ALSO SUPPORTED BY THE HOSPITAL. THESE CLINICS PROVIDED SERVICES FOR 10,300 PATIENT VISITS. 928113 12000 1779975 COMMUNITY HEALTH SERVICES - HOSPICE, HOME HEALTH, & HOMEMAKER SERVICES. HOSPICE PROVIDED 2,982 PALLIATIVE CARE VISITS, 167 WERE FREE FOR PATIENTS W/O INSURANCE. HOME HEALTH PROVIDED 5,577 VISITS & HOMEMAKER PERFORMED 11,617 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 3,500 RIDERS DURING FY 2011. 461745 5379 4423992 42215249 true true false true false false false false true true false false false true false false true false false false false false false true false true true true false true true false false false false false false false false true false false false false false false true true false false false true 102 0 true 571 true false false false false false true true false false false false X 12 10 true false false false false true false true true false true true true true true true true true false false false X NANCY HARRIS 6608313722 2305 S 65 HIGHWAY PO BOX 250 MARSHALL MO 65340 X FRED UTLAUT 1.0 X X 0 0 0 WILLIAM L SUMMERS 1.0 X X 0 0 0 DON VOGELSMEIER 1.0 X X 0 0 0 VIRGINIA HUPP 1.0 X 0 0 0 ROOK EVANS 1.0 X 0 0 0 B F KNIPSCHILD MD 1.0 X 0 0 0 RANDY MORROW 1.0 X 0 0 0 JAMES SOWASH MD 1.0 X 0 0 0 JACK UHRIG MD 1.0 X 0 0 0 GAYLE CARTER 1.0 X 0 0 0 CRAIG MCCOY DO 1.0 X 120100 0 0 BILL JACKSON 1.0 X 0 0 0 RONALD A OTT 40.0 X 232031 0 18210 NANCY HARRIS 40.0 X 124620 0 8700 LYNNE OTT 40.0 X 156594 0 7920 DENNIS SOUSLEY 40.0 X 161945 0 9154 KELLY ROSS DO 40.0 X 450941 0 2000 DEVINDER GUPTA MD 40.0 X 347415 0 19281 JOHN BRIZENDINE MD 40.0 X 330654 0 19281 LORENZO ROMNEY DO 40.0 X 304012 0 19915 CRAIG SIMONS DO 40.0 X 291239 0 19481 2519551 0 123942 15 false true false PHARMACY SYSTEMS INC PHARMACY MGMT 624383 THOMAS LAIRD MD ER PHYSICIAN 239629 BKD LLP AUDIT & CONSULTING 175405 PAUL T BRIZENDINE MD ER PHYSICIAN 141318 MEDICAL PHYSICS CONSULTING ONCOLOGY THERAPY 139759 13 54442 9046 262924 14628 326412 NET PATIENT SERVICE REVENUES 900099 50042190 50042190 CAFETERIA 722210 209958 209958 OTHER 900099 39876 39876 MANAGEMENT FEES 561000 60000 60000 50352024 185097 185097 0 0 5209696 8510 5209696 8510 8510 8510 45106 54442 43988 1118 1118 0 0 LOSS EXTINGUISHMENT OF DEBT 900099 -239514 -239514 -239514 50633647 50352024 -44789 17379 17379 0 0 0 839274 455713 383561 42813 42813 17619635 15082367 2537268 274416 236859 37557 2149950 1851200 298750 1247183 1063660 183523 0 82706 82706 190320 190320 0 0 5175 4334 841 4808482 3754050 1054432 109971 48892 61079 2216758 1813428 403330 0 0 787207 672852 114355 198506 174971 23535 0 59255 26174 33081 985598 825335 160263 0 3099361 2595389 503972 645790 546589 99201 BAD DEBT 6135120 6135120 LICENSES, DUES & SUBSCRIPTIONS 182319 105708 76611 RECRUITING 371072 69996 301076 MEDICAL SUPPLIES & DRUGS 4411128 4405291 5837 MEDICAID RELATED EXPENSE 2287129 2287129 48766547 42215249 6551298 0 5711384 4392747 10388101 14273107 139811 1667 5664301 6736879 1117088 1153318 1011528 928877 49393940 26298586 23508581 23095354 4206608 3421840 110504 32790 51857906 54036579 3275103 4365808 17352660 17055755 613510 267848 1301814 1129637 22543087 22819048 X 28395400 30232173 464202 530141 455217 455217 29314819 31217531 51857906 54036579 X 1867100 35612 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 6934 6934 false OTHER LOBBYING ACTIVITIES SCHEDULE C, PART II-B, LINE 1(I) THE ORGANIZATION PAYS DUES TO THE MISSOURI HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THESE DUES ARE ALLOCATED TO LOBBYING. 677227 21898 4296 60 694769 618998 25296 36603 3670 677227 579322 39676 618998 1.00000 false false 71000 71000 20495826 6075538 14420288 2506181 1489907 1016274 24407184 18103232 6303952 1913749 629909 1283840 23095354 0 DUE TO RELATED PARTY 288362 EST AMT DUE TO 3RD PARTY 841275 1129637 50633647 48766547 1867100 35612 35612 1902712 50669259 35612 35612 50633647 50633647 48766547 48766547 48766547 ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 4 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. UNCERTAIN TAX POSITION SCHEDULE D, PART X, LINE 2 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. SPRING FLING 37479 16608 20871 0 0 0 3874 0 19239 GOLF TOURNEY 30302 14221 16081 4445 2489 1224 2039 0 2524 1 17639 9485 8154 0 0 0 0 0 8154 85420 40314 45106 4445 2489 1224 5913 0 29917 43988 1118 true true X true X true X true true true false true true 344859 344859 0.00810 8411619 7514141 897478 0.02110 8756478 7514141 1242337 0.02920 22860 22860 289522 289522 0.00680 568704 568704 0.01330 17379 17379 0.00040 898465 898465 0.02050 9654943 7514141 2140802 0.04970 true 2568625 1078823 10886012 11381334 -495322 X true true 1 1 JOHN FITZGIBBON MEMORIAL HOSPITAL

2305 S 65 HIGHWAY MARSHALL MO 65340

X X X ORTHO, WOUND CARE, REHAB, ONCOLOGY, PAIN, NEOUROLOGIC JOHN FITZGIBBON MEMORIAL HOSPITAL 1 4 GRAND RIVER MEDICAL CLINIC

815 EAST BROADWAY BRUNSWICK MO 65236

OFFSITE MEDICAL CLINIC AKEMAN MCBURNEY MEDICAL CLINIC

420 WEST FRONT STREET SLATER MO 65349

OFFSITE MEDICAL CLINIC FITZGIBBON PROFESSIONAL BUILDING

2301 S 65 HIGHWAY MARSHALL MO 65340

OB/GYN, SURGERY, FAMILY PRACTICE, MENTAL HEALTH CLINIC FITZGIBBON COMMUNITY HOME HEALTH CARE

2299 S 65 HIGHWAY MARSHALL MO 65340

HOME HEALTH, HOSPICE, HOMEMAKER PERCENT OF TOTAL EXPENSE SCHEDULE H, PART I, LINE 7, COLUMN F TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990 ($48,766,547) WAS REDUCED BY BAD DEBT EXPENSE ($6,135,120). BAD DEBT EXPENSE SCHEDULE H, PART III, SECTION A, LINE 4 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: THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. THE ORGANIZATION CALCULATED BAD DEBT AT COST BY TAKING THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TIMES THE RATIO OF PATIENT CARE COST TO CHARGES USED FOR SCHEDULE H, PART I CALCULATIONS. 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. COMMUNITY BENEFIT RATIONAL SCHEDULE H, PART III, SECTION B, LINE 8 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. COLLECTION POLICY SCHEDULE H, PART III, SECTION C, LINE 9B 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. 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. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE 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. 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. STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI MO, true OATS INC 2501 MCGUIRE BLVD COLUMBIA MO 65201 431016961 501(C)(3) 12000 COMMUNITY SERVICES ST LOUIS REGIONAL DSH FUNDING AUTHORITY PO BOX 6766 JEFFERSON CITY MO 651026766 061642698 501(C)(3) 5379 SUPPORT 2 MONITORING USE OF GRANT FUNDS SCHEDULE I, PART I, LINE 2 THE HOSPITAL WORKS IN CONJUCTION 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. THROUGH AMENDMENT 3 OF THE ORGANIZATION'S AGREEMENT WITH MHA MANAGEMENT SERVICES CORPORATION AND INCREASED DISPROPORTIONATE SHARE HOSPITAL PAYMENTS TO ALL MISSOURI HOSPITALS UNDER THE FEDERAL REIMBURSEMENT ALLOWANCE PROGRAM, THE HOSPITAL MADE CHARITABLE CONTRIBUTIONS TO THE DSH FUNDING AUTHORITY. THESE CONTRIBUTIONS ARE USED TO SUSTAIN THE VARIOUS CHARITY CARE CLINICS IN THE ST. LOUIS AREA, WITH LOCAL COMMUNITY HOSPITALS ABSORBING THE INPATIENT AND OUTPATIENT NEEDS OF THE COMMUNITY'S MEDICALLY INDIGENT POPULATION. X X false false false false false false false true false RONALD A OTT 177031 0 55000 0 0 0 2000 0 16210 0 250241 0 KELLY ROSS DO 434990 0 0 0 15951 0 2000 0 0 0 452941 0 DEVINDER GUPTA MD 318915 0 22500 0 6000 0 2000 0 17281 0 366696 0 JOHN BRIZENDINE MD 317000 0 0 0 13654 0 2000 0 17281 0 349935 0 LORENZO ROMNEY DO 253862 0 35000 0 15150 0 2000 0 17915 0 323927 0 CRAIG SIMONS DO 256239 0 35000 0 0 0 2000 0 17481 0 310720 0 LYNNE OTT 120594 0 36000 0 0 0 2000 0 5920 0 164514 0 DENNIS SOUSLEY 151945 0 10000 0 0 0 2000 0 7154 0 171099 0 NON-FIXED PAYMENTS SCHEDULE J, PART I, LINE 7 ACCORDING TO THEIR RESPECTIVE CONTRACTS, PHYSICIANS ARE DUE AN ANNUAL INCENTIVE COMPENSATION NOT TO EXCEED 15% OF THEIR RESPECTIVE BASE SALARIES. THIS INCENTIVE IS BASED ON DEVELOPMENT OF PROTOCOLS; UTILIZATION OF STANDING ORDERS WHICH INCLUDE APPROPRIATE CARE MEASURES AS DEFINED BY CMS; COOPERATION WITH CARE COORDINATION AND UTILIZATION MANAGEMENT; COMPLETION OF ACCURATE AND TIMELY DOCUMENTATION; PATIENT SATISFACTION SCORES; AND ATTENDING CE PROVIDED BY HOSPITAL. IT IS NOT BASED ON HOSPITAL EARNINGS. NON-FIXED PAYMENTS MADE TO RONALD OTT, NANCY HARRIS, LYNNE OTT, AND DENNIS SOUSLEY 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. INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO 431386697 79516LAD6 2005-12-22 10000000 CONSTRUCTION REVENUE BONDS false false false INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO 430980296 79516LBC7 2010-11-29 12218468 1998 BOND REFINANCING false false false 0 0 10365462 0 0 0 193724 0 10171738 0 0 0 2007 false false true true 0 0 12218468 0 0 11985656 232812 0 0 0 0 0 2010 true false true true false false false false false 0.00000 0.00000 0.00000 true false false false false false false false false false false false false JUDY VOGELSMEIER SPOUSE OF DON VOGELSMEIER 42813 EMPLOYEE COMPENSATION false PROGRAM SERVICES ACTIVITY #1 FORM 990, PART III, LINE 4A FOR THE FISCAL YEAR ENDED APRIL 30, 2011, THE EMERGENCY ROOM EXPERIENCED 12,487 PATIENT VISITS. THE SURGICAL TEAM PERFORMED 426 IN-PATIENT AND 2,184 OUT-PATIENT PROCEDURES. THE RADIOLOGY GROUP PERFORMED 35,987 PROCEDURES WHICH INCLUDED 4,273 MAMMOGRAMS, 5,636 CT SCANS, 1,859 MRI'S, 3,858 ULTRASOUND IMAGES AND 2,903 NUCLEAR MEDICINE SCANS. THE LABORATORY TEAM PERFORMED 98,243 TESTS. THE RESPIRATORY THERAPY DEPARTMENT CONDUCTED 31,812 PATIENT TREATMENTS AND THE REHABILITATIVE SERVICES GROUP WHICH INCLUDES PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES PROVIDED 21,755 PATIENT ENCOUNTERS. OTHER PROGRAM SERVICES FORM 990, PART III, LINE 4D 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 4,670 PATIENT VISITS AT THE FACILITY. IN ADDITION, THE STAFF EDUCATED 767 RESIDENTS IN THE SURROUNDING COMMUNITIES AT NO CHARGE THROUGH PARTICIPATION IN HEALTH FAIRS AND OTHER SOCIAL VENUES. FITZGIBBON ALSO SPONSORS A FREE BICYCLE SAFETY CLINIC FOR CHILDREN. IN FY 2011, 391 KINDERGARTEN STUDENTS ATTENDED, AND EACH CHILD RECEIVED A FREE HELMET AT THE END OF THE PROGRAM. 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. RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 2 RONALD OTT, PRESIDENT AND CEO, IS MARRIED TO LYNNE OTT, VP OF PATIENT CARE SERVICES, KEY EMPLOYEE. MEMBERS, STOCKHOLDERS, OR OTHER PERSONS FORM 990, PART VI, SECTION A, LINE 7A THE MEDICAL STAFF OF THE ORGANIZATION ELECTS THE CHIEF OF MEDICAL STAFF WHO IS A VOTING MEMBER OF THE BOARD. REVIEW OF FORM 990 FORM 990, PART VI, SECTION B, LINE 11B 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 CFO AND THE CEO BEFORE BEING FINALIZED. THE 990 IS THEN PRESENTED TO THE BOARD BEFORE IT IS FILED. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C 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. ANY BOARD MEMBER WITH A CONFLICT OF INTEREST WOULD ABSTAIN FROM VOTING ON ANY DECISION RELATED TO THAT CONFLICT OF INTEREST. COMPENSATION DETERMINATION FORM 990, PART VI, SECTION B, LINE 15A & 15B 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. DOCUMENT DISCLOSURE FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO BE VIEWED IN THE ADMINISTRATION DEPARTMENT UPON WRITTEN REQUEST. BOARD MEMBER COMPENSATION FORM 990, PART VII CRAIG MCCOY, DO, RECEIVES COMPENSATION FOR HIS SERVICES AS AN INDEPENDENT CONTRACTOR. NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR SERVICES AS BOARD MEMBERS. TAX-EXEMPT BONDS FORM 990, PART X, LINE 20 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 BOOK AND AUDIT PURPOSES. INFORMATION ABOUT THE BONDS ARE REPORTED ON JOHN FITZGIBBON MEMORIAL HOSPITAL'S SCHEDULE K. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 5 35,612 UNREALIZED GAIN ON INVESTMENTS FITZGIBBON HEALTH SERVICES 2305 S 65 HWY PO BOX 250 MARSHALL MO 65340 431731173 NURSING HOME MO 501(C)(3) 9 NA false false false false false false false false false false true false true true true true false false FITZGIBBON HEALTH SERVICES K 60000 FITZGIBBON HEALTH SERVICES O 127062 FITZGIBBON HEALTH SERVICES P 507939