FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION (EIN 37-0661202)
- Tax period
- 2024-07-01 to 2025-06-30
- Filed
- 2026-05-14
- IRS object ID
- 202601349349310095
- Schema version
- 2024v5.5
- 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 H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2026-05-14T15:34:41-05:00 | ReturnTs |
| Tax Period End | 2025-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2650 EASTPOINT PKWY SUITE 300 | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 40223 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370661202 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FAIR | BusinessNameControlTxt |
| Phone | 6168422611 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 303 NW 11TH STREET | AddressLine1Txt |
| City | FAIRFIELD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62837 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID ANDREW FLEMER JR | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6168422611 | PhoneNum |
| Signature | 2026-05-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | EMILIE M KNIERIEM CPA | PreparerPersonNm |
| PTIN | P01330194 | PTIN |
| Phone | 5029923500 | PhoneNum |
| Preparation | 2026-05-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JIM BASCH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 303 NW 11TH STREET | AddressLine1Txt |
| City | FAIRFIELD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62837 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $49,396,414 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | FAIRFIELDMEMORIAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1948 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF FAIRFIELD MEMORIAL HOSPITAL IS TO MAINTAIN AND IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 460 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $822,570 | PYContributionsGrantsAmt |
| CY Contributions Grants | $47,957 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $45,160,074 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $48,528,777 | CYProgramServiceRevenueAmt |
| PY Investment Income | $70,992 | PYInvestmentIncomeAmt |
| CY Investment Income | $102,825 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,242,187 | PYOtherRevenueAmt |
| CY Other Revenue | $635,415 | CYOtherRevenueAmt |
| PY Total Revenue | $48,295,823 | PYTotalRevenueAmt |
| CY Total Revenue | $49,314,974 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $130,396 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $60,864 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $29,039,974 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $28,888,525 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $24,436,769 | PYOtherExpensesAmt |
| CY Other Expenses | $22,063,506 | CYOtherExpensesAmt |
| PY Total Expenses | $53,607,139 | PYTotalExpensesAmt |
| CY Total Expenses | $51,012,895 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$5,311,316 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,697,921 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $55,359,234 | TotalAssetsBOYAmt |
| Total Assets EOY | $51,331,074 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $32,593,217 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $33,776,082 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $22,766,017 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $17,554,992 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF FAIRFIELD MEMORIAL HOSPITAL IS TO MAINTAIN AND IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $37,728,160 | ExpenseAmt |
| Grant | $60,864 | GrantAmt |
| Revenue | $49,154,376 | RevenueAmt |
| Desc | AS A NOT-FOR-PROFIT COMMUNITY HOSPITAL, FAIRFIELD MEMORIAL 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 HOSPITAL OPENED A RURAL HEALTH CLINIC. TODAY IT OPERATES RURAL HEALTH CLINICS PROVIDING MEDICAL AND BEHAVIORAL HEALTH SERVICES IN FAIRFIELD, CISNE, AND CARMI, AS WELL AS, OPERATING OUTPATIENT SURGICAL SPECIALTY CLINICS, TO INCLUDE GENERAL SURGERY, WOUND CARE, AND PAIN MANAGEMENT. FAIRFIELD MEMORIAL HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE TO ALL PERSONS WITHOUT REGARD TO AND DOES NOT DISCRIMINATE ON THE BASIS OF RACE, COLOR, RELIGION (CREED), GENDER, GENDER SEX EXPRESSION, AGE, NATIONAL ORIGIN (ANCESTRY), PHYSICAL OR MENTAL DISABILITY, MARITAL STATUS, GENDER IDENTITY, SEXUAL ORIENTATION, SOCIAL ECONOMIC STATUS, ETHNICITY, CULTURE, LANGUAGE, MILITARY STATUS, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF FAIRFIELD 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 COMMUNITIES WE SERVE. 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 FINANCIAL ASSISTANCE POLICY. | Desc |
| Total Program Service Expenses | $37,728,160 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 42 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 460 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JIM BASCH CFO | PersonNm |
| Phone | 6188478260 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 303 NW 11TH | AddressLine1Txt |
| City | FAIRFIELD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62837 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| PATRICK MOLT MD | ||||||||
| PRESIDENT/CMO | 5.00 | 0.00 | Yes (X) | Yes (X) | $364 | $0 | $0 | |
| JOEY HUNGERFORD | ||||||||
| VICE PRESIDENT (END 06/25) | 1.75 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ANITA POND | ||||||||
| SECRETARY/TREASURER | 1.75 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MICHAEL COPELAND | ||||||||
| DIRECTOR | 1.75 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DONNA MASTERSON | ||||||||
| DIRECTOR | 1.75 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| D JAMIE POLLARD | ||||||||
| DIRECTOR | 1.75 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MATTHEW SENG | ||||||||
| DIRECTOR | 1.75 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DOUG WILSON | ||||||||
| DIRECTOR | 1.75 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSH SCOTT | ||||||||
| DIRECTOR | 1.75 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JARED FLORENCE | ||||||||
| DIRECTOR | 1.75 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CRAIG SELF | ||||||||
| DIRECTOR | 1.75 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KATHERINE BUNTING | ||||||||
| CEO | 40.00 | 0.00 | Yes (X) | $204,297 | $0 | $2,728 | ||
| DANA TAYLOR | ||||||||
| COO | 50.00 | 0.00 | Yes (X) | $137,498 | $0 | $8,504 | ||
| RACHEL EWING | ||||||||
| CNO (END 06/25) | 50.00 | 0.00 | Yes (X) | $108,118 | $0 | $10,784 | ||
| KRISTIN BOLDT | ||||||||
| INTERIM CFO (END 08/24) | 50.00 | 0.00 | Yes (X) | $107,999 | $0 | $7,120 | ||
| MICHAEL COOPER | ||||||||
| CEO (BEG 07/24) | 40.00 | 0.00 | Yes (X) | $122,877 | $0 | $11,121 | ||
| JIM BASCH | ||||||||
| CFO (BEG 08/24-11/24, 06/25) | 40.00 | 0.00 | Yes (X) | $249,901 | $0 | $0 | ||
| WILLIAM GILES | ||||||||
| CFO (08/24-06/25) | 40.00 | 0.00 | Yes (X) | $44,697 | $0 | $1,807 | ||
| JENNIFER GILPIN | ||||||||
| CNO (BEG 06/25) | 40.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KORY BLANK | ||||||||
| ORTHOPEDIC SURGEON | 40.00 | 0.00 | $692,880 | $0 | $21,051 | Yes (X) | ||
| ARUNIMA SAXENA | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $350,735 | $0 | $15,202 | Yes (X) | ||
| LAUREN WILLIAMS | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $414,027 | $0 | $12,487 | Yes (X) | ||
| CHRISTOPHER BALLARD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $351,410 | $0 | $22,667 | Yes (X) | ||
| KIMBERLY KING | ||||||||
| CRNA/PAIN MANAGEMENT PROVIDER | 40.00 | 0.00 | $373,196 | $0 | $20,730 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,157,999 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $134,201 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 34 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| DR RODNEY BEELER | |||||
| 2142 KETTLES HILL CT | EVANSVILLE | IN | 47725 | ER PHYSICIAN | $459,211 |
| DR DOUGLAS FRANKEL | |||||
| 407 S MARKET STREET | MARION | IL | 62959 | ER PHYSICIAN | $416,523 |
| DR MARK ROTICH | |||||
| 1401 DANIELLE CT | MARION | IL | 62959 | ER PHYSICIAN | $388,611 |
| DR JAMES GRUBER | |||||
| 2025 ST MEINRAD ROAD | ST MEINRAD | IN | 47577 | ER PHYSICIAN | $342,562 |
| DR JASIRI KENNEDY | |||||
| 11817 BORDEN ROAD | HERALD | CA | 956389707 | ER PHYSICIAN | $280,478 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $8,500 | RelatedOrganizationsAmt |
| Government Grants | $20,470 | GovernmentGrantsAmt |
| All Other Contributions | $18,987 | AllOtherContributionsAmt |
| Total Contributions | $47,957 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 622110 | $43,444,719 | $43,444,719 |
| CLINIC REVENUE | 622110 | $5,070,777 | $5,070,777 |
| MEDICAL RECORDS FEE | 622110 | $13,281 | $13,281 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $48,528,777 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $102,573 | TotalRevenueColumnAmt |
| Exclusion | $102,573 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $282,243 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $81,440 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $200,803 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $200,803 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $200,803 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $252 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $252 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $252 | TotalRevenueColumnAmt |
| Exclusion | $252 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| CAFETERIA & CATERING | 722514 | $274,893 | $265,077 | $9,816 |
| REBATES | 900099 | $6,261 | $6,261 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $153,458 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $153,458 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $434,612 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,314,974 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $49,154,376 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $112,641 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,380 | TotalAmt |
| Program Services | $18,380 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,484 | TotalAmt |
| Program Services | $42,484 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,131,603 | TotalAmt |
| Program Services | $846,976 | ProgramServicesAmt |
| Management And General | $284,627 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $236,538 | TotalAmt |
| Program Services | $177,043 | ProgramServicesAmt |
| Management And General | $59,495 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,715,217 | TotalAmt |
| Program Services | $15,504,808 | ProgramServicesAmt |
| Management And General | $5,210,409 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,431 | TotalAmt |
| Program Services | $128,312 | ProgramServicesAmt |
| Management And General | $43,119 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,048,272 | TotalAmt |
| Program Services | $3,778,502 | ProgramServicesAmt |
| Management And General | $1,269,770 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,585,464 | TotalAmt |
| Program Services | $1,186,679 | ProgramServicesAmt |
| Management And General | $398,785 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,949 | TotalAmt |
| Management And General | $110,949 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $319,009 | TotalAmt |
| Management And General | $319,009 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,870 | TotalAmt |
| Management And General | $11,870 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,017,105 | TotalAmt |
| Program Services | $5,524,216 | ProgramServicesAmt |
| Management And General | $1,492,889 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,020 | TotalAmt |
| Program Services | $20,490 | ProgramServicesAmt |
| Management And General | $49,530 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,102 | TotalAmt |
| Program Services | $10,857 | ProgramServicesAmt |
| Management And General | $26,245 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,825,951 | TotalAmt |
| Program Services | $939,114 | ProgramServicesAmt |
| Management And General | $1,886,837 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,131 | TotalAmt |
| Program Services | $21,108 | ProgramServicesAmt |
| Management And General | $51,023 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $842,791 | TotalAmt |
| Program Services | $594,478 | ProgramServicesAmt |
| Management And General | $248,313 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,023,717 | TotalAmt |
| Program Services | $3,023,717 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $742,869 | TotalAmt |
| Management And General | $742,869 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES AND DR | $4,956,938 | $4,348,717 | $608,221 |
| MEDICAID ASSESSMENT TAX | $1,178,250 | $1,178,250 | |
| CAFETERIA EXPENSES | $347,738 | $235,646 | $112,092 |
| DUES AND SUBSCRIPTIONS | $250,987 | $73,447 | $177,540 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $256,079 | TotalAmt |
| Program Services | $74,936 | ProgramServicesAmt |
| Management And General | $181,143 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,012,895 | TotalAmt |
| Program Services | $37,728,160 | ProgramServicesAmt |
| Management And General | $13,284,735 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $259,111 | BOYAmt |
| EOY | $430,531 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,685,342 | BOYAmt |
| EOY | $2,130,445 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,867,020 | BOYAmt |
| EOY | $8,752,912 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $337 | BOYAmt |
| EOY | $347 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,307,600 | BOYAmt |
| EOY | $1,301,929 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $801,830 | BOYAmt |
| EOY | $584,487 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $76,961,263 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $38,832,601 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,436,233 | BOYAmt |
| EOY | $38,128,662 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,761 | BOYAmt |
| EOY | $1,761 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,359,234 | BOYAmt |
| EOY | $51,331,074 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,858,258 | BOYAmt |
| EOY | $7,861,664 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,599,592 | BOYAmt |
| EOY | $25,127,494 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $177,721 | BOYAmt |
| EOY | $300,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $957,646 | BOYAmt |
| EOY | $486,924 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,593,217 | BOYAmt |
| EOY | $33,776,082 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,563,471 | BOYAmt |
| EOY | $17,352,446 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $202,546 | BOYAmt |
| EOY | $202,546 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,766,017 | BOYAmt |
| EOY | $17,554,992 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,359,234 | BOYAmt |
| EOY | $51,331,074 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,697,921 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$3,513,104 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | 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) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $11,870 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $11,870 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | FMH PAID FOR IHA MEMBERSHIP DUES IN FYE 2025. THE PORTION OF MEMBERSHIP DUES ATTRIBUTABLE TOWARDS LOBBYING EXPENDITURES WERE 44.60%. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $474,079 | OtherCostOrOtherBasisAmt |
| Book Value | $474,079 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $47,006,455 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,599,468 | DepreciationAmt |
| Book Value | $26,406,987 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,318,626 | OtherCostOrOtherBasisAmt |
| Depreciation | $897,978 | DepreciationAmt |
| Book Value | $420,648 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,162,103 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,335,155 | DepreciationAmt |
| Book Value | $10,826,948 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $38,128,662 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED THIRD PARTY SETTLEMENTS | Desc |
| Amt | $486,924 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $486,924 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $49,396,414 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $81,440 | OtherRevenueAmt |
| Revenue Not Reported | $81,440 | RevenueNotReportedAmt |
| Revenue Subtotal | $49,314,974 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $49,314,974 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $51,094,335 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $81,440 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $81,440 | ExpensesNotReportedAmt |
| Expenses Subtotal | $51,012,895 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $51,012,895 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HOSPITAL HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATD BUSINESS TAXABLE INCOME. THE HOSPITAL FILES TAX RETURNS IN THE U.S. FEDERAL JURISDICTION. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RENT EXPENSES 81,440. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENT EXPENSES 81,440. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $270,904 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $270,904 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00530 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,647,924 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,869,619 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,778,305 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05450 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,918,828 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,869,619 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,049,209 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05980 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,819 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $24,819 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $258,799 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $258,799 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00510 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $283,618 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $283,618 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00560 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,202,446 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,869,619 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,332,827 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06540 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,839,549 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $6,197,328 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $18,079,264 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$11,881,936 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | 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 | FAIRFIELD MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 303 NW 11TH STREET | AddressLine1Txt |
| City | FAIRFIELD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62837 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.FAIRFIELDMEMORIAL.ORG | WebsiteAddressTxt |
| State License | 0000679 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAIRFIELD MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 25 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.FAIRFIELDMEMORIAL.ORG/RESOURCES/COMMUNITY-REPORTS/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 25 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.FAIRFIELDMEMORIAL.ORG/RESOURCES/COMMUNITY-REPORTS/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.FAIRFIELDMEMORIAL.ORG/ASSISTANCE/FINANCIAL-ASSISTANCE/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.FAIRFIELDMEMORIAL.ORG/ASSISTANCE/FINANCIAL-ASSISTANCE/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.FAIRFIELDMEMORIAL.ORG/ASSISTANCE/FINANCIAL-ASSISTANCE/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FAIRFIELD MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. THESE INCLUDED THOSE WITH SPECIAL KNOWLEDGE OF, OR EXPERTISE IN PUBLIC HEALTH (LOCAL, REGIONAL, STATE AND/OR TRIBAL), MEMBERS OF THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS SERVED BY THE HOSPITAL AND/OR INDIVIDUALS OR ORGANIZATIONS REPRESENTING THE INTERESTS OF SUCH POPULATIONS. THE MEDICALLY UNDERSERVED ARE MEMBERS OF A POPULATION WHO EXPERIENCE HEALTH DISPARITIES, ARE AT RISK OF NOT RECEIVING ADEQUATE MEDICAL CARE AS A RESULT OF BEING UNINSURED OR UNDERINSURED, AND/OR EXPERIENCING BARRIERS TO HEALTHCARE DUE TO GEOGRAPHIC, LANGUAGE, FINANCIAL, AND OTHER BARRIERS. MEMBERS OF THE CHNA STEERING COMMITTEE, ALONG WITH THOSE WHO PARTICIPATED IN FOCUS GROUPS, AND THE NEEDS INDENTIFICATION AND PRIORITIZATION PROCESS, WERE CHOSEN BASED ON THEIR UNIQUE EXPERTISE AND EXPERIENCE, INFORMED PERSPECTIVE, AND INVOLVEMENT WITH THE COMMUNITY. THE CHNA STEERING COMMITTEE MEMBERS INCLUDED:-HEALTHCARE PROVIDERS-COMMUNITY LEADERS-COMMUNITY SERVICE PROVIDERS-SCHOOL LEADERS-PUBLIC HEALTH REPRESENTATIVES-OTHER RELEVANT STAKEHOLDERS |
| FAIRFIELD MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: THE IMPLEMENTATION STRATEGY WAS DEVELOPED THROUGH A FACILITATED MEETING INVOLVING KEY ADMINISTRATIVE STAFF OF FAIRFIELD MEMORIAL HOSPITAL IN MAY 2025. THE GROUP REVIEWED THE NEEDS ASSESSMENT PROCESS COMPLETED TO THAT POINT AND CONSIDERED THE PRIORITIZED SIGNIFICANT NEEDS AND SUPPORTING DOCUMENTS. THEY ALSO EVALUATED INTERNAL AND EXTERNAL RESOURCES THAT COULD POTENTIALLY ADDRESS THE CURRENT PRIORITIZED NEEDS.THE GROUP THEN CONSIDERED EACH OF THE PRIORITIZED NEEDS. FOR EACH PRIORITY AREA, FMH HAS IDENTIFIED THE ACTIONS IT INTENDS TO TAKE, ALONG WITH THE ANTICIPATED IMPACT OF THESE ACTIONS, THE RESOURCES IT PLANS TO COMMIT TO THESE ACTIONS, AND THE EXTERNAL COLLABORATORS TO COOPERATE WITH TO ADDRESS THE NEEDS.THE PLAN WILL BE EVALUATED THROUGH PERIODIC REVIEWS OF MEASURABLE OUTCOME INDICATORS, IN CONJUNCTION WITH ANNUAL REVIEWS AND REPORTING. THE GROUP ASSESSED THE NEEDS WITH THE FOLLOWING STRATEGIES:1. PRIORITY #1: ACCESS TO MENTAL HEALTH: IMPROVE ACCESS TO, AND KNOWLEDGE OF, MENTAL HEALTH SERVICES.ACTIONS TO ADDRESS THE HEALTH NEED:- PROMOTION OF THE RESOURCES AVAILABLE AT FMH EMPLOYS ONE PSYCHIATRIC NURSE PRACTITIONER- DEVELOP A CAMPAIGN FOR THE COMMUNITY THAT ADDRESSES THE STIGMA ASSOCIATED WITH SEEKING MENTAL HEALTH TREATMENT- PARTNER WITH SCHOOLS TO INCREASE AWARENESS OF AVAILABLE RESOURCES AND HELP NORMALIZE THE NEED FOR MENTAL HEALTH SERVICES WHEN NECESSARY- PROVIDE "LUNCH AND LEARN" EDUCATIONAL OFFERINGS TO THE COMMUNITY ON TOPICS RELATED TO MENTAL HEALTH, SUCH AS WORK-LIFE BALANCE, DEPRESSION, AND ANXIETY- CONTINUE RECRUITING ADDITIONAL MENTAL HEALTH PROVIDERS2. PRIORITY #2: WORKFORCE DEVELOPMENT/YOUTH: DEVELOP RELATIONSHIPS WITH SCHOOLS TO IMPROVE STUDENTS' KNOWLEDGE OF HEALTH TOPICS, INCLUDING HEALTH CAREERS. ACTIONS TO ADDRESS THE HEALTH NEED:- INVESTIGATE WAYS TO COLLABORATE WITH SCHOOLS TO PROVIDE STUDENTS WITH EDUCATION ON HEALTH LIVING. THIS CAN INCLUDE MENTAL, PHYSICAL, AND SEXUAL HEALTH.- EDUCATE STUDENTS ON THE RESOURCES THAT ARE AVAILABLE IN THIS COMMUNITY THAT CAN ASSIST WITH HEALTHY LIVING- EDUCATE STUDENTS ON HEALTH CAREER OPPORTUNITIES AT FMH- OFFER JOB SHADOWING OPPORTUNITIES FOR STUDENTS TO GAIN A DEEPER UNDERSTANDING OF HEALTH CAREERS3. PRIORITY #3: HEALTH IMPROVEMENT: DEVELOP EDUCATIONAL OFFERINGS AND SUPPORT TO HELP PEOPLE ENHANCE THEIR KNOWLEDGE OF WAYS TO IMPROVE THEIR HEALTH. ACTIONS TO ADDRESS THE HEALTH NEED: - USING LIVE AND PODCAST VENUES, CREATE EDUCATIONAL PROGRAMMING THAT MEETS BASIC HEALTH EDUCATIONAL NEEDS AS WELL AS ADVANCED ON SELECTED TOPICS- FOCUS ON THE RESOURCES AVAILABLE IN THE COMMUNITY AND HOW TO HELP PEOPLE ACCESS THEM. - FOCUS ON CONNECTING INTERNAL AND EXTERNAL RESOURCES THROUGH THE CARE COORDINATION AND DISCHARGE PLANNING TEAMS TO ENSURE THAT WHEN PEOPLE ARE DISCHARGED, THEY HAVE BEEN LINKED TO THE RESOURCES THEY REQUIRE.- FOCUS ON CONTROLLING HYPERTENSION THROUGH EDUCATION AND HEALTHY LIFESTYLE ACTIVITIES- FOCUS EDUCATION ON SMOKING AND VAPING CESSATION WITH STUDENTS AND THE COMMUNITY - CREATE PROGRAMS FOR HEALTHY LIVING AND EXERCISE THAT ARE EITHER LOW- OR NO-COST. POTENTIALLY PARTNER WITH THE PARKS AND RECREATION WITHIN THE COMMUNITY - REACH OUT TO THE MINISTRIAL ALLIANCE OR CHURCHES TO SHARE RESOURCES AND ASSESS THEIR NEEDS. CONSIDER OFFERING SCREENINGS AND EDUCATION TO THEIR CONGREGANTS.- COLLABORATE WITH COMMUNITY BUSINESSES TO OFFER EDUCATIONAL PROGRAMS AND SCREENINGS FOR EMPLOYEES- INVESTIGATE THE FORMATION OF SUPPORT GROUPS FOR PEOPLE WITH HEALTH CONDITIONS SUCH AS DIABETES- LEVERAGE THE NEW LABORATORY TESTING PLATFORMS FOR SEXUALLY TRANSMITTED INFECTIONS (STIS). |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - HORIZON HEALTHCARE | ||||
| 213 NW 10TH STREET STE A | FAIRFIELD | IL | 62837 | OUTPATIENT RURAL HEALTH CLINIC |
| 2 - HORIZON HEALTHCARE CISNE MEDICAL CLINIC | ||||
| 413 PARK STREET | CISNE | IL | 62823 | OUTPATIENT RURAL HEALTH CLINIC |
| 3 - HORIZON HEALTHCARE CARMI MEDICAL CLINIC | ||||
| 1103 W MAIN STREET | CARMI | IL | 62821 | OUTPATIENT RURAL HEALTH CLINIC |
| 4 - FMH URGENT CARE CLINIC | ||||
| 303 NW 11TH STREET | FAIRFIELD | IL | 62837 | OUTPATIENT RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | AS PART OF ITS MISSION, FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION PROVIDES CHARITY CARE TO PATIENTS WHO LACK THE ABILITY TO PAY. THE DETERMINATION OF THE ABILITY TO PAY MAY TAKE INTO ACCOUNT A NUMBER OF FINANCIAL VARIABLES, INCLUDING BUT NOT LIMITED TO: INCOME LEVEL, FAMILY SIZE, AND AMOUNT OF HOSPITAL CHARGES IN ORDER TO DETERMINE ELIGIBILITY FOR THE LEVELS OF FINANCIAL ASSISTANCE. IN CERTAIN EXTRAORDINARY CASES WHERE THESE FACTORS MAY NOT ACCURATELY REFLECT THE PATIENT'S ABILITY TO PAY, THE PATIENT FINANCIAL SERVICES DIRECTOR ALONG WITH THE CFO MAY REVIEW AND DETERMINE IF ADDITIONAL FINANCIAL ASSISTANCE IS MERITED. |
| PART I, LINE 7: | THE FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION USED A COST TO CHARGE RATIO AS CALCULATED FROM THE FILED 6/30/2025 COST REPORT TO DETERMINE THE AMOUNTS ON LINES 7A AND 7B OF PART I OF SCHEDULE H. |
| PART III, LINE 2: | FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION CALCULATED BAD DEBT EXPENSE AT COST. 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. |
| PART III, LINE 3: | 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. |
| PART III, LINE 4: | SEE PAGES 10-12 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS. PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS 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. |
| PART III, LINE 8: | FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION IS COMMITTED TO SERVING PATIENTS, REGARDLESS OF ABILITY TO PAY OR IF THE PAYMENTS TO BE RECEIVED WILL BE LESS THAN THE COST TO PROVIDE THE SERVICE, AS IS THE CASE FOR MEDICARE AND MEDICAID PATIENTS. THE MEDICARE ALLOWABLE COSTS REPORTED ON LINE 6 OF PART III HAVE BEEN CALCULATED BY USING THE MEDICARE COST TO CHARGE RATIO. THE AMOUNT IS COMPARED TO TOTAL MEDICARE PAYMENTS RECEIVED. SHOULD THERE BE A SHORTFALL, IT WOULD BE TREATED AS A COMMUNITY BENEFIT AS IT REFLECTS UN-REIMBURSED COSTS FOR PROVIDING MEDICAL SERVICES TO THE MEDICARE RESIDENTS OF THE COMMUNITY. THE FYE 2025 COST REPORT WAS USED TO CALCULATE THE MEDICARE SHORTFALL. |
| PART III, LINE 9B: | FAIRFIELD MEMORIAL HOSPITAL APPLIES ITS COLLECTION PRACTICES EQUALLY TO ALL PATIENTS, BOTH CHARITY CARE ELIGIBLE AND NON CHARITY CARE ELIGIBLE. THE PROCEDURE FOR COLLECTION ON PATIENT ACCOUNTS IS 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 EARLY-OUT DEPARTMENT FOR A FOLLOW UP STATEMENT/PHONE CALL TO THE PATIENT. THE HOSPITAL OFFERS PATIENTS SEVERAL PAYMENT ALTERNATIVES, INCLUDING CASH/CHECK FOR THE FULL AMOUNT, CREDIT CARD, 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 ARRANGEMENTS AS OUTLINED ABOVE ARE NOT MADE, THE ACCOUNT WILL PROCEED THROUGH A COLLECTION PROCESS AS FOLLOWS:DAY 1 - 1ST NOTICEDAY 7-14 - FIRST PHONE CALL IS MADE; AT LEAST ONE PHONE CALL OR NOTICE PER WEEK FOR THE REMAINDER OF THE 90 DAYS DAY 75 - DEMAND NOTICE DAY 90 - ACCOUNT IS SENT TO COLLECTIONS. ANY ACCOUNT THAT IS SENT TO COLLECTIONS MAY BE TURNED OVER TO AN ATTORNEY, AND ADDITIONAL COSTS ASSOCIATED WITH COLLECTIONS WILL BE ADDED TO THE ACCOUNT. |
| PART VI, LINE 2: | THE DETERMINATION OF CURRENT AND FUTURE HEALTHCARE NEEDS OF THE COMMUNITY OR COMMUNITIES SERVED BY FAIRFIELD MEMORIAL HOSPITAL IS BASED ON ALL OR A COMBINATION OF THE FOLLOWING FACTORS: EXISTENCE OR NON EXISTENCE OF SERVICES, OPPORTUNITY, SUPPLY, DEMONSTRATED NEED, "VOICE OF THE CUSTOMER," COLLABORATIVE EFFORTS WITH OUTSIDE ENTITIES, COMMUNITY BASED NEEDS ASSESSMENT, GOVERNMENT AGENCIES, OTHER HEALTHCARE PROVIDERS THAT WOULD ENABLE THE FILLING OF A NEED OR ENHANCE AND COMPLIMENT AN ALREADY EXISTING SERVICE. DATA IS GATHERED CONSTANTLY THROUGH BENCHMARKING, MARKET RESEARCH, CUSTOMER SURVEYS, PHYSICIAN 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 THE STRATEGIC PLANNING PROCESS. |
| PART VI, LINE 3: | SIGNS ARE POSTED IN THE FACILITY. THE PATIENT'S BILL INFORMS THEM OF THE FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL WEBSITE HAS A LINK TO THE FINANCIAL ASSISTANCE APPLICATION. THE SOCIAL SERVICES DEPARTMENT SPEAKS TO ALL INPATIENTS ABOUT THE PROGRAM. |
| PART VI, LINE 4: | FAIRFIELD MEMORIAL HOSPITAL SERVES THE POPULATION OF WAYNE COUNTY AND THE SURROUNDING COMMUNITIES WITHOUT REGARD TO AGE, GENDER, INCOME, ETHNIC ORIGIN, INSURANCE COVERAGE, OR ABILITY TO PAY. WAYNE COUNTY IS A RURAL AREA WITH AN ESTIMATED POPULATION OF 34,606 BASED OFF OF THE REPORT AREA DEFINED IN THE MOST CURRENT 2025 CHNA. THE AVERAGE HOUSEHOLD INCOME FOR THE SERVICE MARKET AREA, BASED ON THE LATEST 5-YEAR AMERICAN COMMUNITY SURVEY ESTIMATES, WAS $69,666. THE IL STATE AVERAGE HOUSEHOLD INCOME IS $108,873. THE AVERAGE HOUSEHOLD SIZE IN THE AREA, AT 2.28, IS LOWER THAN BOTH THE STATE OF IL AND THE UNITED STATES. THE UNEMPLOYMENT RATE WAS 3.9%, WHICH IS UNDER BOTH THE STATE OF IL AND THE UNITED STATES UNEMPLOYMENT RATE AVERAGES. 15% OF HOUSEHOLDS ARE BELOW THE POVERTY LEVEL, OR ROUGHLY 2,220 HOUSEHOLDS. |
| PART VI, LINE 5: | FAIRFIELD MEMORIAL HOSPITAL HAS A COMMUNITY BOARD, MADE UP OF MEMBERS FROM DIFFERENT OCCUPATIONS IN THE COMMUNITY, INCLUDING MEDICAL, EDUCATION, LOCAL BUSINESSES, FARMING INDUSTRY AND BANKING. |
| PART VI, LINE 6: | EFFECTIVE APRIL 1, 2024, THE HOSPITAL ENTERED INTO A MANAGEMENT SERVICES AGREEMENT (THE "AGREEMENT") WITHDEACONESS REGIONAL HEALTHCARE NETWORK, LLC ("DEACONESS"), AS AFFILIATE OF DEACONESS HEALTH SYSTEM. AS ARESULT, THE HOSPITAL'S ARTICLES OF INCORPORATION AND BY-LAWS WERE AMENDED TO PROVIDE FOR TWO REPRESENTATIVESOUT OF ELEVEN ON THE HOSPITAL'S BOARD OF DIRECTORS TO BE APPOINTED BY DEACONESS.UNDER THE AGREEMENT, SUPPORT PROVIDED TO THE HOSPITAL CONSISTS OF MANAGEMENT PERSONNEL, FACILITYPLANNING, STRATEGIC PLANNING, RECRUITING, AND SEVERAL OTHER SUPPORT AND OVERSIGHT SERVICES. THE INITIAL TERMOF THE AGREEMENT IS FOR A FIVE-YEAR PERIOD, WHICH CAN BE EXTENDED IF SO DESIRED. THE AGREEMENT CAN BETERMINATED BY EITHER PARTY WITH A 365-DAY NOTICE WITHOUT RECOURSE ANY TIME AFTER THE FIRST ANNIVERSARY OFTHE EFFECTIVE DATE. AFTER THE SECOND ANNIVERSARY OF THE EFFECTIVE DATE, THE AGREEMENT CAN BE TERMINATEDWITH 180-DAY WRITTEN NOTICE. IF THE AGREEMENT IS TERMINATED BY THE HOSPITAL WITHIN THE INITIAL FIVE-YEARTERM, THE HOSPITAL WILL BE ASSESSED A PENALTY IN THE AMOUNT OF $1,400,000 TO BE PAYABLE TO DRHNI. UNDERTHE AGREEMENT, THE HOSPITAL REIMBURSES DRHNI THE DIRECT COST OF MANAGEMENT PERSONNEL, EMERGENCYROOM COVERAGE, CERTAIN IT COSTS, AS WELL AS VARIOUS SUPPLIES AND TRAINING RELATED COSTS ON A MONTHLY BASIS,IN ADDITION TO A MANAGEMENT AGREEMENT FEE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IL |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 2 | RecipientCnt |
| Cash Grant | $42,484 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | SCHOLARSHIPS ARE AWARDED IN A FIELD THAT FMH HAS IDENTIFIED A NEED FOR. THE SCHOLARSHIPS ARE PAID EITHER UPON PRESENTATION OF THE COMPLETED DIPLOMA AND RECEIPTS, OR FMH WILL PAY THE SCHOOL OR UNIVERSITY DIRECTLY. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KORY BLANK | ||||||||||||||
| ORTHOPEDIC SURGEON | $599,781 | $0 | $93,099 | $0 | $0 | $0 | $6,900 | $0 | $14,151 | $0 | $713,931 | $0 | $0 | $0 |
| LAUREN WILLIAMS | ||||||||||||||
| PHYSICIAN | $389,944 | $0 | $24,083 | $0 | $0 | $0 | $0 | $0 | $12,487 | $0 | $426,514 | $0 | $0 | $0 |
| KIMBERLY KING | ||||||||||||||
| CRNA/PAIN MANAGEMENT PROVIDER | $308,798 | $0 | $64,398 | $0 | $0 | $0 | $6,900 | $0 | $13,830 | $0 | $393,926 | $0 | $0 | $0 |
| CHRISTOPHER BALLARD | ||||||||||||||
| PHYSICIAN | $300,536 | $0 | $50,874 | $0 | $0 | $0 | $6,900 | $0 | $15,767 | $0 | $374,077 | $0 | $0 | $0 |
| ARUNIMA SAXENA | ||||||||||||||
| PHYSICIAN | $327,614 | $0 | $23,121 | $0 | $0 | $0 | $0 | $0 | $15,202 | $0 | $365,937 | $0 | $0 | $0 |
| JIM BASCH | ||||||||||||||
| CFO (BEG 08/24-11/24, 06/25) | $249,901 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $249,901 | $0 | $0 | $0 |
| KATHERINE BUNTING | ||||||||||||||
| CEO | $204,297 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $2,728 | $0 | $207,025 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| BRADLEY AUGUST | |||
| SON-IN-LAW OF CEO | $111,415 | COMPENSATION | 0 |
| MELINDA BUNTING | |||
| DAUGHTER-IN-LAW TO CEO | $33,850 | COMPENSATION | 0 |
| ALLISSA KEOUGHAN | |||
| DAUGHTER OF BOARD MEMBER | $45,984 | COMPENSATION | 0 |
| DIANNA SENG | |||
| SPOUSE OF BOARD MEMBER | $33,118 | COMPENSATION | 0 |
| REBECCA BUNTING | |||
| GRANDDAUGHTER OF CEO | $12,171 | COMPENSATION | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | BEGINNING IN APRIL 2024, FAIRFIELD MEMORIAL HOSPITAL ("FMH") AFFILIATED WITH DEACONESS REGIONAL HEALTHCARE NETWORK ILLINOIS, LLC THROUGH A MANAGEMENT SERVICES AGREEMENT. IN THIS AFFILIATION MANAGEMENT SERVICES AGREEMENT, THEY EMPLOY THE CEO AND CFO TO HELP MANAGE THE ORGANIZATION. TWO MEMBERS OF DEACONESS ALSO SERVE ON THE BOARD OF DIRECTORS FOR FMH. DEACONESS PROVIDES ASSISTANCE IN THE EVALUATION OF OFFICERS, PROVIDES ADMINISTRATIVE RESOURCES, CONSULTING SERVICES, AND ASSISTS WITH REGULATORY ISSUES AND EDUCATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CFO REVIEWS THE 990 AFTER IT IS COMPLETED, PRIOR TO BEING FINALIZED. ONCE REVIEWED, IT IS GIVEN TO THE CEO FOR REVIEW. AFTER THE DOCUMENT IS REVIEWED BY THE CEO, IT IS AVAILABLE FOR THE BOARD TO REVIEW. THE 990 PREPARERS ARE NOTIFIED THAT THE DOCUMENT IS APPROVED AND READY TO BE FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, EACH BOARD MEMBER RECEIVES THE CORPORATE COMPLIANCE POLICY WHICH INCLUDES A CONFLICT OF INTEREST POLICY, TO REVIEW AND SIGN STATING THEY HAVE READ, AND DISCLOSED ANY CONFLICT OF INTERESTS; ALL SIGNED DOCUMENTS ARE KEPT ON FILE WITH THE ADMINISTRATION OFFICE. |
| FORM 990, PART VI, SECTION B, LINE 15 | LINE 15A: THE CEO AND CFO SALARIES ARE DETERMINED BY THE BOARD OF DIRECTORS AND DEACONESS REGIONAL HEALTHCARE NETWORK, LLC. MARKET SURVEYS AND CONSIDERATION OF YEARS OF EXPERIENCE AND RESPONSIBILITIES ARE FACTORED INTO DETERMINING THE COMPENSATION. THIS PROCESS IS REVIEWED ANNUALLY BY THE BOARD AND COMPENSATION COMMITTEE, AND IS DOCUMENTED WITHIN THE BOARD MINUTES. LINE 15B: COMPENSATION FOR ALL OTHER OFFICERS OF THE ORGANIZATION IS DETERMINED BY THE BOARD OF DIRECTORS BASED ON WEIGHTED PERFORMANCE APPRAISALS. THIS PROCESS IS REVIEWED ANNUALLY AND IS DOCUMENTED WITHIN THE HR ANNUAL EVALUATION FORMS. |
| FORM 990, PART VI, SECTION C, LINE 19 | COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, FINANCIAL STATEMENTS AND THE FEDERAL FORM 990 ARE AVAILABLE UPON REQUEST FROM THE ADMINISTRATIVE OFFICES. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,994,620. MANAGEMENT AND GENERAL EXPENSES 1,425,141. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,419,761. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,109,924. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,109,924. COLLECTION FEES: PROGRAM SERVICE EXPENSES 28,027. MANAGEMENT AND GENERAL EXPENSES 67,748. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 95,775. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 2,166,285. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,166,285. DIAGNOSTIC MAMMOGRAPHY SERVICES: PROGRAM SERVICE EXPENSES 225,360. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 225,360. |
| FORM 990, PART XI, LINE 9: | ADJUSTMENT FOR CHANGE IN BEGINNING BALANCE THIRD PARTY RECEIVABLES -3,513,104. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAIRFIELD MEMORIAL HOSPITAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 303 NW 11TH ST | AddressLine1Txt |
| City | FAIRFIELD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62837 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 371185754 | EIN |
| Primary Activities | SUPPORT THE HOSPITAL | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12B, II | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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