JOHN FITZGIBBON MEMORIAL HOSPITAL INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: JOHN FITZGIBBON MEMORIAL HOSPITAL INC (EIN 44-0655986)
Tax period: 2015-05-01 to 2016-04-30
Filed: 2017-03-14
IRS object ID: 201700739349300330
Schema version: 2015v3.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-03-14T14:11:48-05:00	ReturnTs
Tax Period End	2016-04-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	910 E ST LOUIS 200/PO BOX 1190	AddressLine1Txt
City	SPRINGFIELD	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	658062523	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-05-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	440655986	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JOHN FITZGIBBON MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% ANGELA LITTRELL	InCareOfNm
Business Name Control	JOHN	BusinessNameControlTxt
Phone	6608867431	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2305 S 65 HIGHWAY	AddressLine1Txt
City	MARSHALL	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	65340	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	ANGELA P LITTRELL	PersonNm
Person Title	CFO/COO	PersonTitleTxt
Signature	2016-12-07	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Brian D Todd	PreparerPersonNm
PTIN	P00422601	PTIN
Phone	4178658701	PhoneNum

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	DARIN L HAUG	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2305 S 65 HIGHWAY PO BOX 250	AddressLine1Txt
City	MARSHALL	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	65340	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$57,401,074	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.FITZGIBBON.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1923	FormationYr
Legal Domicile State	MO	LegalDomicileStateCd
Activity Or Mission	TO IMPROVE THE HEALTH OF OUR COMMUNITY BY OFFERING QUALITY SERVICES, IMPROVING ACCESS AND OUTCOMES, EMPOWERING THE COMMUNITY WE SERVE, AND PARTICIPATING IN HEALTH CARE PARTNERSHIPS.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	581	TotalEmployeeCnt
Total Volunteers	50	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$277,054	PYContributionsGrantsAmt
CY Contributions Grants	$275,200	CYContributionsGrantsAmt
PY Program Service Revenue	$59,060,003	PYProgramServiceRevenueAmt
CY Program Service Revenue	$56,869,873	CYProgramServiceRevenueAmt
PY Investment Income	$288,088	PYInvestmentIncomeAmt
CY Investment Income	$362,911	CYInvestmentIncomeAmt
PY Other Revenue	-$23,285	PYOtherRevenueAmt
CY Other Revenue	-$166,654	CYOtherRevenueAmt
PY Total Revenue	$59,601,860	PYTotalRevenueAmt
CY Total Revenue	$57,341,330	CYTotalRevenueAmt
PY Grants And Similar Paid	$14,000	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$35,905	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$26,937,470	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$27,997,108	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$75,877	CYTotalFundraisingExpenseAmt
PY Other Expenses	$31,993,598	PYOtherExpensesAmt
CY Other Expenses	$31,391,316	CYOtherExpensesAmt
PY Total Expenses	$58,945,068	PYTotalExpensesAmt
CY Total Expenses	$59,424,329	CYTotalExpensesAmt
PY Revenues Less Expenses	$656,792	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$2,082,999	CYRevenuesLessExpensesAmt
Total Assets BOY	$59,879,610	TotalAssetsBOYAmt
Total Assets EOY	$56,391,967	TotalAssetsEOYAmt
Total Liabilities BOY	$23,950,841	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$22,541,421	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$35,928,769	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$33,850,546	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	TO IMPROVE THE HEALTH OF OUR COMMUNITY.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$41,718,206	ExpenseAmt
Revenue	$39,493,374	RevenueAmt
Desc	HOSPITAL SERVICE - FITZGIBBON HOSPITAL IS A 60 BED ACUTE CARE FACILITY SERVING MARSHALL, MO AND 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 AND REHABILITATIVE SERVICES ARE AVAILABLE ON SITE. FOR MORE INFORMATION, SEE SCHEDULE O.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$7,982,337	ExpenseAmt
Revenue	$8,296,115	RevenueAmt
Desc	CLINIC SERVICE-SPECIALTY CLINICS WITHIN THE HOSPITAL PROVIDE ORTHOPEDIC, WOUND CARE, NEUROLOGIC AND PAIN MANAGEMENT SERVICES TO BOTH IN AND OUT-PATIENTS. THESE CLINICS PROVIDED SERVICES TO 11,388 PATIENTS. THE HOSPITAL ALSO SUPPORTS A SEPARATE OUT-PATIENT CLINIC ON CAMPUS FOR FAMILY MEDICINE, OB/GYN, GENERAL SURGERY AND PSYCHIATRY STAFFED MEDICAL PROFESSIONALS PRACTICING IN THESE SPECIALTIES FOR FISCAL YEAR 2016. THIS CLINIC PROVIDED SERVICES FOR 24,393 PATIENT VISITS. THREE SATELLITE FAMILY PRACTICE CLINICS ARE ALSO SUPPORTED BY THE HOSPITAL. THESE CLINICS PROVIDED SERVICES FOR 11,323 PATIENT VISITS.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$1,497,047	ExpenseAmt
Grant	$14,400	GrantAmt
Revenue	$1,167,131	RevenueAmt
Desc	COMMUNITY HEALTH SERVICES - HOSPICE, HOME HEALTH, AND HOMEMAKER SERVICES. HOSPICE PROVIDED 168 PALLIATIVE CARE VISITS, HOME HEALTH PROVIDED 6,815 VISITS AND HOMEMAKER PERFORMED 8,481 HOURS OF SERVICE TO RESIDENTS. THE COMMUNITY SERVICES GROUP ALSO COORDINATES PARTICIPATION IN THE OATS TRANSPORTATION PROGRAM BY PERFORMING THE SCHEDULING FOR ALL RIDERS. THE HOSPITAL DONATED $14,400 TO OATS IN 2016 AND WILL BE DONATING $14,400 ANNUALLY TO HELP SUSTAIN IT IN THE MARSHALL COMMUNITY. THE PROGRAM PROVIDED TRANSPORTATION FOR 3,998 RIDERS DURING FY 2016.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$688,411	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant	$21,505	TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue	$7,913,253	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$51,886,001	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (true)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	Yes (true)	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	123	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	581	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (true)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (true)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	8	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	false	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	ANGELA LITTRELL	PersonNm
Phone	6608313251	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2305 S 65 HIGHWAY PO BOX 250	AddressLine1Txt
City	MARSHALL	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	65340	ZIPCd

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

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
FRED UTLAUT
PRESIDENT	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
WILLIAM SUMMERS
VICE PRESIDENT	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
DON VOGELSMEIER
SECRETARY/TREASURER	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
GAYLE CARTER
DIRECTOR	1.0	1.0	Yes (X)		$0	$0	$0
ROOK EVANS
DIRECTOR	1.0	1.0	Yes (X)		$0	$0	$0
JACK UHRIG MD
DIRECTOR/MEDICAL DIRECTOR	1.0	1.0	Yes (X)		$14,400	$0	$0
JAMES SOWASH MD
DIRECTOR END 1/2016	1.0	1.0	Yes (X)		$0	$0	$0
RANDY MORROW
DIRECTOR	1.0	1.0	Yes (X)		$0	$0	$0
JACQUELYN EIDSON
DIRECTOR BEG 9/2015	1.0	1.0	Yes (X)		$0	$0	$0
SCOTT HARTWIG
DIRECTOR BEG 9/2015	1.0	1.0	Yes (X)		$0	$0	$0
JAN STAPLETON
DIRECTOR BEG 9/2015	1.0	1.0	Yes (X)		$0	$0	$0
LORENZO M ROMNEY DO
DIRECTOR, SEE SCHEDULE O	40.0	1.0	Yes (X)		$335,467	$0	$2,508
DARIN HAUG DO
PRESIDENT/CEO, SEE SCHEDULE O	40.0	1.0		Yes (X)	$434,907	$0	$4,866
ANGELA LITTRELL
CFO/COO	40.0	1.0		Yes (X)	$194,715	$0	$9,890
KATHRYN LYNNE OTT
VICE PRESIDENT OF NURSING SERV	40.0	1.0			$189,780	$0	$5,668	Yes (X)
DENNIS SOUSLEY
VP OF CLINICAL SERVICES	40.0	1.0			$175,933	$0	$5,051	Yes (X)
KELLY ROSS
ORTHOPEDIC SURGEON	40.0	0.0			$601,226	$0	$2,000		Yes (X)
JOHN B BRIZENDINE
GENERAL SURGEON	40.0	0.0			$416,978	$0	$2,000		Yes (X)
KAREN SONG
OB/GYN	40.0	0.0			$347,677	$0	$366		Yes (X)
BRIAN ELLEFSEN
ORTHOPEDIC SURGEON	40.0	0.0			$313,143	$0	$2,312		Yes (X)
RAVINDER ARORA
NEUROLOGIST	40.0	0.0			$279,418	$0	$0		Yes (X)
RONALD OTT
PRESIDENT/CEO END 4/2015	0.0	0.0			$279,627	$0	$4,270			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$3,583,271	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$38,931	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	30	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
BOYCE
BYNUM	COLUMBIA	MO	65205	PATHOLOGY	$306,164
PHARMACY SYSTEMS INC
				PHARMACY MANAGEMENT	$614,743
SIEMENS MEDICAL SOLUTIONS
				MAINTENANCE	$351,766
PAUL T BRIZENDINE MD
				ER PHYSICIAN	$312,665
AMERI EBO
LLC	MANITOWOC	WI	54221	COLLECTIONS	$278,468

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	13	CntrctRcvdGreaterThan100KCnt
Fundraising	$195,724	FundraisingAmt
Government Grants	$9,606	GovernmentGrantsAmt
All Other Contributions	$69,870	AllOtherContributionsAmt
Noncash Contributions	$31,363	NoncashContributionsAmt
Total Contributions	$275,200	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE	900099	$55,775,018	$55,775,018
EHR INCENTIVE REVENUE	900099	$632,197	$632,197
CAFETERIA	722514	$267,719	$267,719
MANAGEMENT FEES	561000	$60,000	$60,000
OTHER REVENUE	900099	$134,939	$134,939

Field	Value	IRS element (for citing)
Total Program Service Revenue	$56,869,873	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$322,102	TotalRevenueColumnAmt
Exclusion	$322,102	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$5,721	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$5,721	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,721	TotalRevenueColumnAmt
Exclusion	$5,721	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$40,809	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$40,809	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$40,809	TotalRevenueColumnAmt
Exclusion	$40,809	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$43,665	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$195,724	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$59,744	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$16,079	TotalRevenueColumnAmt
Exclusion	-$16,079	ExclusionAmt

Net Income From Gaming NetIncomeFromGamingGrp

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	LOSS ON EXTINGUISHMENT OF DEBT	Desc
Business	900099	BusinessCd
Total Revenue Column	-$156,296	TotalRevenueColumnAmt
Exclusion	-$156,296	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	-$156,296	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$57,341,330	TotalRevenueColumnAmt
Related Or Exempt Func Income	$56,869,873	RelatedOrExemptFuncIncomeAmt
Exclusion	$196,257	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$35,905	TotalAmt
Program Services	$35,905	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

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

Foreign Grants ForeignGrantsGrp

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

Benefits To Members BenefitsToMembersGrp

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

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,373,185	TotalAmt
Program Services	$728,807	ProgramServicesAmt
Management And General	$644,378	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$283,897	TotalAmt
Management And General	$283,897	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$21,442,030	TotalAmt
Program Services	$18,974,619	ProgramServicesAmt
Management And General	$2,399,773	ManagementAndGeneralAmt
Fundraising	$67,638	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$253,431	TotalAmt
Program Services	$224,604	ProgramServicesAmt
Management And General	$28,827	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$3,134,120	TotalAmt
Program Services	$2,755,822	ProgramServicesAmt
Management And General	$378,298	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,510,445	TotalAmt
Program Services	$1,317,674	ProgramServicesAmt
Management And General	$187,573	ManagementAndGeneralAmt
Fundraising	$5,198	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

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

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$159,813	TotalAmt
Management And General	$159,813	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$155,877	TotalAmt
Management And General	$155,877	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

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

Fees For Services Prof Fundraising FeesForServicesProfFundraising

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

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

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

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$4,662,474	TotalAmt
Program Services	$3,689,936	ProgramServicesAmt
Management And General	$972,389	ManagementAndGeneralAmt
Fundraising	$149	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$139,312	TotalAmt
Management And General	$139,312	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,364,056	TotalAmt
Program Services	$2,460,562	ProgramServicesAmt
Management And General	$900,771	ManagementAndGeneralAmt
Fundraising	$2,723	FundraisingAmt

Information Technology InformationTechnologyGrp

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

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$726,411	TotalAmt
Program Services	$630,130	ProgramServicesAmt
Management And General	$96,281	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$214,348	TotalAmt
Program Services	$195,164	ProgramServicesAmt
Management And General	$19,015	ManagementAndGeneralAmt
Fundraising	$169	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

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

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$106,286	TotalAmt
Program Services	$66,151	ProgramServicesAmt
Management And General	$40,135	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$910,802	TotalAmt
Program Services	$762,701	ProgramServicesAmt
Management And General	$148,101	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$3,023,147	TotalAmt
Program Services	$2,531,567	ProgramServicesAmt
Management And General	$491,580	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$645,227	TotalAmt
Program Services	$546,579	ProgramServicesAmt
Management And General	$98,648	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
BAD DEBT	$7,875,869	$7,875,869
MEDICAL SUPPLIES & DRUGS	$6,547,838	$6,547,838
PROVIDER TAX	$2,433,059	$2,433,059
RECRUITING & RETENTION	$426,797	$109,014	$317,783

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$59,424,329	TotalAmt
Program Services	$51,886,001	ProgramServicesAmt
Management And General	$7,462,451	ManagementAndGeneralAmt
Fundraising	$75,877	FundraisingAmt

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

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$7,931,679	BOYAmt
EOY	$6,130,820	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$16,113,318	BOYAmt
EOY	$14,839,547	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$6,890,179	BOYAmt
EOY	$7,777,359	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,011,379	BOYAmt
EOY	$1,159,674	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,029,321	BOYAmt
EOY	$1,181,563	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$60,515,324	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$39,500,547	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$22,459,120	BOYAmt
EOY	$21,014,777	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$3,315,458	BOYAmt
EOY	$3,027,816	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$1,129,156	BOYAmt
EOY	$1,260,411	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$59,879,610	BOYAmt
EOY	$56,391,967	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$4,281,949	BOYAmt
EOY	$4,039,504	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$14,952,378	BOYAmt
EOY	$13,872,640	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$3,415,640	BOYAmt
EOY	$3,337,590	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,300,874	BOYAmt
EOY	$1,291,687	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$23,950,841	BOYAmt
EOY	$22,541,421	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$34,711,567	BOYAmt
EOY	$32,660,900	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$761,985	BOYAmt
EOY	$734,429	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$455,217	BOYAmt
EOY	$455,217	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$35,928,769	BOYAmt
EOY	$33,850,546	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$59,879,610	BOYAmt
EOY	$56,391,967	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$2,082,999	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$4,776	NetUnrlzdGainsLossesInvstAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	Yes (true)	DirectContactLegislatorsInd
Direct Contact Legislators	$2,762	DirectContactLegislatorsAmt
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$21,170	OtherActivitiesAmt
Total Lobbying Expenditures	$23,932	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE C, PART II-B, LINE 1(G)	DIRECT CONTACT: MANAGEMENT ATTENDED AN MHA-SPONSORED TRIP AND AHA ORGANIZED TRIP TO WASHINGTON DC, WHICH INCLUDED TIME SPENT WITH LEGISLATORS AND OTHER HOSPITAL ADVOCATES DISCUSSING LEGISLATION FOR HEALTHCARE.
SCHEDULE C, PART II-B, LINE 1(I)	OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE MISSOURI HOSPITAL ASSOCIATION, THE AMERICAN HOSPITAL ASSOCIATION, AND THE SAFETY NET HOSPITALS FOR PHARMACEUTICAL ACCESS. A PORTION OF THESE DUES ARE ALLOCATED TO LOBBYING.

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$724,023	BeginningYearBalanceAmt
Investment Earnings Or Losses	$23,258	InvestmentEarningsOrLossesAmt
Other Expenditures	$3,549	OtherExpendituresAmt
End Year Balance	$743,732	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$701,570	BeginningYearBalanceAmt
Investment Earnings Or Losses	$28,779	InvestmentEarningsOrLossesAmt
Other Expenditures	$6,326	OtherExpendituresAmt
End Year Balance	$724,023	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$733,363	BeginningYearBalanceAmt
Investment Earnings Or Losses	$8,693	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$1,000	GrantsOrScholarshipsAmt
Other Expenditures	$39,486	OtherExpendituresAmt
End Year Balance	$701,570	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

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

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.35393	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.61450	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.03157	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$71,000	OtherCostOrOtherBasisAmt
Book Value	$71,000	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$28,705,873	OtherCostOrOtherBasisAmt
Depreciation	$12,697,838	DepreciationAmt
Book Value	$16,008,035	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$30,154,430	OtherCostOrOtherBasisAmt
Depreciation	$25,802,269	DepreciationAmt
Book Value	$4,352,161	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,584,021	OtherCostOrOtherBasisAmt
Depreciation	$1,000,440	DepreciationAmt
Book Value	$583,581	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$21,014,777	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
DUE TO RELATED PARTY	$550,851
EST AMT DUE TO 3RD PTY PYRS	$124,843
EST SELF INSURANCE COSTS	$615,993

Field	Value	IRS element (for citing)
Total Liability	$1,291,687	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$49,305,936	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	-$7,810,816	OtherRevenueAmt
Revenue Not Reported	-$7,810,816	RevenueNotReportedAmt
Revenue Subtotal	$57,116,752	RevenueSubtotalAmt
Other Revenues Not Included	$224,578	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$224,578	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$57,341,330	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$51,608,204	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$59,744	OtherExpensesIncludedAmt
Expenses Not Reported	$59,744	ExpensesNotReportedAmt
Expenses Subtotal	$51,548,460	ExpensesSubtotalAmt
Other Expenses Not Included	$7,875,869	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$7,875,869	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$59,424,329	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4	ENDOWMENT FUNDS: THE ORGANIZATION HAS ENDOWMENT FUNDS FROM THE L.P. ADAMS FUND. PER THE AGREEMENT, THE INCOME FROM THE FUND IS USED FOR GENERAL PURPOSES OF THE HOSPITAL. THE ORGANIZATION ALSO HAS FUNDS FROM THE BUCKNER ENDOWMENT. THESE FUNDS ARE RESTRICTED TO INVESTMENTS IN EQUIPMENT FOR THE BUCKNER WELLNESS CENTER. FINALLY, THE ORGANIZATION HAS FUNDS FROM THE NURSING ENDOWMENT SCHOLARSHIP FUND. THIS FUND WAS CREATED TO PROVIDE NURSING SCHOLARSHIPS TO SALINE COUNTY RESIDENTS ATTENDING THE NURSING PROGRAM AT THE MO VALLEY COLLEGE IN MARSHALL, MISSOURI. IN THE EVENT THAT THE MO VALLEY COLLEGE DOES NOT HAVE A NURSING PROGRAM, SCHOLARSHIPS CAN BE USED FOR NURSING PROGRAMS IN SURROUNDING AREAS.
SCHEDULE D, PART X, LINE 2	UNCERTAIN TAX POSITION: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
SCHEDULE D, PART XI, LINE 2D	OTHER REVENUE INCLUDED ON LINE 1, BUT NOT FORM 990, PART VIII, LINE 12: $ (7,875,869) BAD DEBT 65,053 NET ASSETS RELEASED FROM RESTRICTION ------------ $ (7,810,816)
SCHEDULE D, PART XI, LINE 4B	OTHER REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT LINE 1: $ ( 59,744) SPECIAL EVENTS EXPENSES 284,322 TEMPORARILY RESTRICTED CONTRIBUTIONS ------------ $ 224,578
SCHEDULE D, PART XII, LINE 2D	OTHER EXPENSE INCLUDED ON LINE 1, BUT NOT FORM 990, PART IX, LINE 25: $ 59,744 SPECIAL EVENTS EXPENSES
SCHEDULE D, PART XII, LINE 4B	OTHER EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT LINE 1: $ 7,875,869 BAD DEBT EXPENSE

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	SPRING FLING	Event1Nm
Gross Receipts Event1	$122,145	GrossReceiptsEvent1Amt
Charitable Contri Event1	$108,581	CharitableContriEvent1Amt
Gross Revenue Event1	$13,564	GrossRevenueEvent1Amt
Food And Beverage Event1	$13,353	FoodAndBeverageEvent1Amt
Other Direct Expenses Event1	$14,916	OtherDirectExpensesEvent1Amt
Event2	GOLF TOURNAMENT	Event2Nm
Gross Receipts Event2	$28,116	GrossReceiptsEvent2Amt
Charitable Contri Event2	$11,138	CharitableContriEvent2Amt
Gross Revenue Event2	$16,978	GrossRevenueEvent2Amt
Cash Prizes Event2	$5,484	CashPrizesEvent2Amt
Non Cash Prizes Event2	$4,890	NonCashPrizesEvent2Amt
Rent Facility Costs Event2	$3,850	RentFacilityCostsEvent2Amt
Food And Beverage Event2	$2,124	FoodAndBeverageEvent2Amt
Other Direct Expenses Event2	$2,004	OtherDirectExpensesEvent2Amt
Other Events Total	3	OtherEventsTotalCnt
Gross Receipts Other Events	$89,128	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$76,005	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$13,123	GrossRevenueOtherEventsAmt
Food And Beverage Other Events	$378	FoodAndBeverageOtherEventsAmt
Oth Direct Expnss Other Events	$12,745	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$239,389	GrossReceiptsTotalAmt
Charitable Contributions Tot	$195,724	CharitableContributionsTotAmt
Gross Revenue Total Events	$43,665	GrossRevenueTotalEventsAmt
Cash Prizes Total Events	$5,484	CashPrizesTotalEventsAmt
Non Cash Prizes Total Events	$4,890	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$3,850	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$15,855	FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events	$29,665	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$59,744	DirectExpenseSummaryEventsAmt
Net Income Summary	-$16,079	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent100	Yes (X)	Percent100Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	180.	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$284,828	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$284,828	NetCommunityBenefitExpnsAmt
Total Expense	0.00550	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,796,111	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,968,454	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$827,657	NetCommunityBenefitExpnsAmt
Total Expense	0.01610	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,080,939	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,968,454	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,112,485	NetCommunityBenefitExpnsAmt
Total Expense	0.02160	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$45,812	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,584	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$37,227	NetCommunityBenefitExpnsAmt
Total Expense	0.00070	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$339,530	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,587	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$334,942	NetCommunityBenefitExpnsAmt
Total Expense	0.00650	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,225,797	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,630,285	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,595,512	NetCommunityBenefitExpnsAmt
Total Expense	0.05040	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,505	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$21,505	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,632,644	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,643,456	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,989,186	NetCommunityBenefitExpnsAmt
Total Expense	0.05800	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,713,583	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,611,910	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,101,671	NetCommunityBenefitExpnsAmt
Total Expense	0.07960	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,592	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,592	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,592	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,592	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$7,875,869	BadDebtExpenseAmt
Bad Debt Expense Attributable	$1,299,518	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$12,757,654	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$13,527,840	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$770,186	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JOHN FITZGIBBON MEMORIAL HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2305 S 65 HIGHWAY	AddressLine1Txt
City	MARSHALL	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	65340	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.FITZGIBBON.ORG	WebsiteAddressTxt
State License	27-56	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Other	ORTHO, WOUND CARE, REHAB, ONCOLOGY, PAIN, NEUROLOGIC	OtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	JOHN FITZGIBBON MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	www.fitzgibbon.org/page.php?p=2252	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	false	StrategyPostedWebsiteInd
Strategy Attached	Yes (true)	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	100	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	180.	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	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
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5	COMMUNITY INPUT: THE HOSPITAL LAUNCHED AN ONLINE SURVEY IN FEBRUARY 2016 WITH INDIVIDUAL OUTREACH TO PERSONS AND ORGANIZATIONS ACROSS THE BROAD SPECTRUM OF COMMUNITY ORGANIZATIONS, SPECIFICALLY SEEKING INPUT FROM THE HEALTH DISPARITIES, LOW-INCOME, DISABILITIES, THE CHRONICALLY ILL, LANGUAGE BARRIERS AND VARYING SOCIO-ECONOMIC BACKGROUNDS. THOSE RECEIVING THE E-MAILED SURVEY INVITATIONS, PERSONAL TELEPHONE OUTREACH AND MINORITY POPULATIONS INCLUDED FITZGIBBON HOSPITAL MEDICAL STAFF, PROVIDERS, NURSING STAFF, SOCIAL WORKERS, AND MEDICAL HOME STAFF, MARSHALL MINISTERIAL ALLIANCE, FITZGIBBON HOSPITAL AUXILIARY AMBASSADORS, CONAGRA NURSING STAFF, CARGILL MEAT SOLUTIONS NURSING STAFF, AND SALINE COUNTY INTERAGENCY COUNCIL AND ATTENDEES; WHICH INCLUDES THE SALINE COUNTY HEALTH DEPARTMENT, KATY TRAIL COMMUNITY HEALTH, MO VALLEY COMMUNITY ACTION AGENCY, SALINE COUNTY MENTAL HEALTH, SALT FORK YMCA AND TWENTY OTHER SOCIAL SERVICE AGENCIES.
SCHEDULE H, PART V, SECTION B, LINE 6B	CHNA CONDUCTION: THE ORGANIZATION'S CHNA WAS CONDUCTED ALONG WITH THE FOLLOWING: -MARSHALL MINISTERIAL ALLIANCE -CONAGRA -CARGILL -SALINE COUNTY INTERAGENCY COUNCIL, WHICH INCLUDES, SALINE COUNTY HEALTH PUBLIC HEALTH DEPARTMENT, KATY TRAIL COMMUNITY HEALTH, MO VALLEY COMMUNITY ACTION AGENCY, SALINE COUNTY MENTAL HEALTH, SALT FORK YMCA, AND 30 OTHER SOCIAL SERVICE AGENCIES.
SCHEDULE H, PART V, SECTION B, LINE 7D	CHNA AVAILABILITY TO PUBLIC: DESCRIPTION OF THE CHNA AND ITS FINDINGS WERE DISCUSSED AT THE SALINE COUNTY INTERAGENCY COUNCIL MEETING, WHICH IS ATTENDED BY A BROAD CROSS-SECTION OF SOCIAL SERVICE AGENCY REPRESENTATIVES AND RECEIVES MEDIA COVERAGE. THE PAPER COPY AVAILABLE FOR PUBLIC INSPECTION WITHOUT CHARGE AT THE HOSPITAL FACILITY INCLUDED CONTACT INFORMATION IN THE INTRODUCTORY SECTION DESCRIBING THE FINDINGS.
SCHEDULE H, PART V, SECTION B, LINE 11	ADDRESSING IDENTIFIED NEEDS: THE NEEDS NOT DIRECTLY ADDRESSED IN THE CHNA IMPLEMENTATION PLAN WERE AS FOLLOWS: -COST AND ABILITY TO PAY FOR CARE -TRANSPORTATION-CANCER -LACK OF HEALTH INSURANCE -LACK OF DENTAL CARE -MENTAL HEALTH CONCERNS -POVERTY -TEEN PREGNANCY RATES AND LANGUAGE BARRIERS. THE CHNA COMMITTEE AGGREGATED AND ANALYZED PRIMARY AND SECONDARY DATA SOURCES AT LENGTH AND COMPARED TO THE INVENTORY OF EXISTING SERVICES AND PROGRAMMING WHICH ADDRESS IDENTIFIED HEALTH NEEDS WAS EVALUATED. CONSIDERATION OF COMMUNITY RESOURCES, BUDGETARY CONSTRAINTS, AVAILABLE PERSONNEL AND HOSPITAL MISSION AND VISION WERE ALL CONSIDERATIONS IN SELECTING WHICH HEALTH NEEDS TO PRIORITIZE GOING FORWARD. UPDATE FOR SCHEDULE H, SPECIFICALLY COVERING ACTIVITIES FOR THE PERIOD MAY 1, 2015, TO APRIL 30, 2016, ADDRESSING THE CHNA ADOPTED BY THE BOARD OF TRUSTEES IN THE SPRING OF 2013. OF SPECIAL NOTE IS INITIAL WORK ON THE 2016 CHNA WAS OCCURRING SIMULTANEOUSLY TOWARD THE END OF THIS TAX YEAR, AS DATA GATHERING OCCURRED IN LATE 2015 INTO EARLY 2016, WITH THE CHNA OFFICIALLY ADOPTED BY THE BOARD IN APRIL 2016. IN RESPONSE TO THE RESULTS OF THE ORGANIZATIONS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION ADOPTED AN IMPLEMENTATION STRATEGY DELINEATING ACTIVITIES BOTH INDEPENDENT AND COLLABORATIVE WHICH COULD IMPACT THE THREE MOST-PRESSING HEALTH NEEDS IN OUR COMMUNITY: -OBESITY -SMOKING -PREVENTIVE CARE AND WELLNESS. OBESITY - HOSPITAL-EMPLOYED REGISTERED DIETICIANS, IN CONJUNCTION WITH MARKETING AND PUBLIC RELATIONS DEPARTMENT, DEVELOPED DIABETES EDUCATION FLIERS AND OTHER MATERIALS AND PUBLICIZED THE AVAILABILITY OF DIABETES EDUCATION CLASSES IN THE LOCAL MEDIA AND TO AREA SERVICE GROUPS. MULTIPLE EDUCATIONAL COLUMNS WERE COMPILED REGARDING OBESITY PREVENTION AND MANAGEMENT OF THE CHRONIC DISEASES WHICH ARE A CAUSED BY OBESITY. THESE COLUMNS WERE PRINTED IN LOCAL NEWS MEDIA AND DISPLAYED ON THE HOSPITAL WEBSITE. TOPICS INCLUDED CARDIOVASCULAR HEALTH AS IT RELATES TO OBESITY, DIABETES EDUCATION AND CONTROL, LIVING WITH HYPERTENSION, SURVIVING THE HOLIDAYS WHILE DIABETIC AND THE BENEFITS OF GOOD NUTRITION. EXCERPTS FROM THESE ARTICLES ALSO APPEARED ON SOCIAL MEDIA ON THE HOSPITAL FACEBOOK PAGE AND ON THE HOSPITAL INSTAGRAM PAGE. DIETARY PERSONNEL CONTINUED TO WORK TO OFFER HEALTHIER SELECTIONS IN THE CAFETERIA AND TO WORK WITH THE HOSPITALS VENDING MACHINE COMPANY TO ENSURE HEALTHY CHOICES WERE AVAILABLE IN BOTH THE HOT AND COLD FOOD MACHINES WHICH ARE AVAILABLE TO THE PUBLIC WHEN THE CAFETERIA LINE IS NOT OPEN. THIS INFORMATION AIDS WITH EMPLOYEE AND VISITOR SELECTION OF HEALTHIER FOOD ITEMS. BECAUSE OBESITY IS ONE OF THE CO-MORBIDITIES FOR PATIENT QUALIFICATION OF THE NCQA-ACCREDITED PRIMARY CARE HEALTH HOME MODEL THAT HAS BEEN INTEGRATED INTO THE HOSPITAL-OPERATED RURAL HEALTH CLINICS, NURSE CARE MANAGERS ASSISTED PATIENTS WITH A DIAGNOSIS OF OBESITY, ENCOURAGING THEM TO TAKE CONTROL OF THEIR WEIGHT AND PROVIDING GUIDANCE FOR HEALTHIER CHOICES. HOSPITAL STAFF ALSO PROVIDED HEALTH AND DIETARY EDUCATION TO AREA EMPLOYERS AT NO CHARGE. A SCREENING FOR BLOOD PRESSURE WAS CONDUCTED ON-SITE AT A LARGE LOCAL EMPLOYER, AND HEALTH EDUCATIONAL MATERIALS WERE DISTRIBUTED. IN ADDITION, INFORMATION ON HEALTHY LIFESTYLES WAS PROVIDED DURING A COLLABORATIVE EVENT AIMED AT VETERANS, CALLED THE VETERANS STAND DOWN, IN DECEMBER 2015, IN WHICH MORE THAN 50 AREA VETERANS IN NEED ATTENDED AND WERE PROVIDED A FREE MEAL AS WELL AS INFORMATION ON HEALTH AND SOCIAL SERVICES AVAILABLE IN THE AREA. SMOKING - THE WOMENS CENTER STAFF CONTINUED THE WORK VIA A GRANT FROM THE MARCH OF DIMES TO IMPLEMENT A PROGRAM CALLED "BABY AND ME TOBACCO FREE" FOR EXPECTANT MOTHERS WHO WISH TO QUIT SMOKING. ACTIVITIES UNDER THAT GRANT LAUNCHED EARLY, IN DECEMBER 2014, WHICH AN OFFICIAL GRANT-FUNDING LAUNCH OF JUNE 2015. VIA THIS PROGRAM, EXPECTANT MOTHERS ARE PROVIDED EDUCATION AND TESTING FOR THE PRESENCE OF NICOTINE IN THEIR BLOODSTREAM. THE PROGRAM THAN "REWARDS" THOSE MOTHERS AFTER DELIVERY WHO CONTINUE TO BE SMOKE-FREE WITH VOUCHERS FOR DIAPERS. CONTINUED DISTRIBUTION OF EDUCATIONAL MATERIALS REGARDING THE DANGERS OF SMOKING DURING PREGNANCY AND THE DANGERS OF SECOND-HAND SMOKE IN THE HOME OCCURRED AS PART OF THIS PROGRAM. THE HOPE IS THAT SMOKING CESSATION WILL BE LONG-TERM FOR THOSE MOTHERS WHO PARTICIPATE. HOSPITAL STAFF ALSO INVESTIGATED AMERICAN LUNG ASSOCIATION TRAINING TO RECEIVE CERTIFICATION TO TEACH SMOKING CESSATION CLASSES. TOBACCO-FREE ADVOCACY BY THE HOSPITAL INCLUDED SUCH ITEMS AS AN INCREASED ENFORCEMENT OF HOSPITAL "NO SMOKING" SIGNS ON HOSPITAL GROUNDS AND PUBLICIZING TOBACCO-FREE ZONES AND QUIT-SMOKING MESSAGING ON OUR PUBLIC VIDEO DISPLAYS. THE HOSPITAL ALSO COMPILED TOBACCO CESSATION AND TOBACCO EDUCATION MATERIALS WHICH ARE DISTRIBUTED TO EVERY INPATIENT WHO INDICATES THEY USE TOBACCO. PREVENTIVE CARE AND WELLNESS - THE WEEKLY NEWSPAPER COLUMNS FEATURED A PLETHORA OF EDUCATIONAL HEALTH TOPICS, AIMED AT IMPROVING THE HEALTH OF THE COMMUNITY. THIS COLUMN IS PUBLISHED WEEKLY IN THE LOCAL MARSHALL NEWSPAPER, AND SOMETIMES OTHER AREA NEWSPAPERS, AND IS ALMOST ALWAYS PURELY EDUCATIONAL ON A TOPIC OF HEALTH. THE GOAL OF THESE COLUMNS IS TO INCREASE PUBLIC HEALTH LITERACY OR TO EDUCATE THE PUBLIC REGARDING HEALTHY LIFESTYLE CHOICES, DISEASE DIAGNOSIS, EARLY HEALTH SCREENING AND PREVENTION. COLUMN TOPICS HAVE INCLUDED RECOMMENDATIONS FOR COLON CANCER SCREENING, BREAST CANCER SCREENING, THE IMPORTANCE OF FLU VACCINATIONS, SUICIDE PREVENTION, EARLY TREATMENT OF STROKE, SUN SAFETY AND MANY OTHERS. THE COLUMNS ARE PRINTED AS NEWS ITEMS ON THE PAPERS "HEALTH" PAGE. FITZGIBBON HOSPITAL HOSTED LOW-COST LAB SCREENING AT IS ANNUAL HEALTH FAIR HELD IN APRIL 2016. COLLABORATIVE ACTIVITIES SURROUNDING OUR NCQA-ACCREDITED PRIMARY CARE HEALTH HOME, WHICH TARGETS LOW-INCOME MEDICAID ENROLLEES WITH MULTIPLE CHRONIC CONDITIONS, TOOK PLACE AT OUR FOUR FEDERALLY DESIGNATED RURAL HEALTH CLINICS, WITH LOCATIONS IN MARSHALL, SLATER, BRUNSWICK AND FAYETTE, MO. THE CONCEPT OF THE PRIMARY CARE HEALTH HOME EMPHASIZES A TEAM APPROACH, INCREASED PATIENT AND FAMILY ENGAGEMENT AND INTENSIVE NURSE CARE MANAGER INTERVENTION WITH THE PATIENT. THE GOAL IS TO ENGAGE THE PATIENT AND THEIR FAMILY IN THEIR OWN HEALTH IMPROVEMENT INITIATIVES RATHER THAN WAITING UNTIL AN ACUTE EVENT FORCES THEM TO SEEK CARE IN A MORE COSTLY SETTING. HOSPITAL PHYSICIANS AND ADVANCED PRACTICE PROVIDERS ALSO STAFFED FREE SCHOOL PHYSICALS FOR ATHLETES IN THE MARSHALL SCHOOL DISTRICT IN MAY 2015. THE GOAL WAS TO ENSURE ALL ATHLETES WHO NEED A SCHOOL PHYSICAL WOULD BE ABLE TO RECEIVE ONE, ENSURING THAT PARTICIPATION IN A HIGH SCHOOL SPORT WOULD NOT BE HINDERED BY A STUDENTS FINANCIAL BARRIER TO RECEIVE A PHYSICAL. THE MISSOURI STATE HIGH SCHOOL ATHLETIC ASSOCIATION REQUIRES ATHLETES TO HAVE A YEARLY PHYSICAL FORM ON FILE AT THE SCHOOL STATING THE ATHLETE IS MEDICALLY CLEARED TO PARTICIPATE. ULTIMATELY THE GOAL IS INCREASED ACTIVITY LEVEL, LIFELONG LOVE OF EXERCISE AND HEALTHIER LONG-TERM LIFESTYLE. OTHER COLLABORATIVE ACTIVITIES INCLUDED PROVIDING HEALTH SCREENINGS AND PARTICIPATING IN SCHOOL-BASED "HEALTH FAIRS" THROUGHOUT THE 2015-2016 ACADEMIC YEAR. THESE FAIRS INCLUDED OUR REGISTERED DIETICIAN VISITING THE ELEMENTARY GRADES TO PROVIDING BASIC ON-SITE HEALTH SCREENINGS SUCH AS HEIGHT, WEIGHT, BLOOD PRESSURE AND BODY MASS INDEX AT SEVERAL AREA EMPLOYERS. DURING BREAST CANCER AWARENESS MONTH, THE HOSPITAL PRODUCED A VARIETY OF CANCER AWARENESS MATERIALS DISTRIBUTED AT BREAST CANCER AWARENESS EVENTS DURING THE MONTH OF OCTOBER 2014. THE SETTINGS AT WHICH THOSE MATERIALS WERE DISTRIBUTED INCLUDED AREA SCHOOLS AND COMMUNITY EVENTS. NOT ONLY WERE THESE MATERIALS IN PAPER FORM, BUT MANY OF THE SAME MATERIALS WERE PRODUCED AND PUBLISHED ON HOSPITAL SOCIAL MEDIA OUTLETS. HEALTH AND PREVENTIVE CARE REMINDERS WERE ALSO DISTRIBUTED ON SCORECARDS AT THE ANNUAL GOLF TOURNAMENT AND DISTRIBUTED DURING PINK OUT ACTIVITIES IN OCTOBER AND VARIOUS PARADES AT WHICH OUR ORGANIZATION WAS REPRESENTED. TRAINING DEDICATED STAFF MEMBERS TO ASSIST PATIENTS WITH QUESTIONS ABOUT THE HEALTH INSURANCE MARKETPLACE WAS ANOTHER INITIATIVE. REPRESENTATIVES FROM BUSINESS DEVELOPMENT AND FINANCIAL SERVICES ENGAGED WITH THE COVER MISSOURI COALITION AND OTHER RESOURCES TO OBTAIN EDUCATION ABOUT THE INSURANCE MARKETPLACE TO ASSIST PATIENTS AND MEMBERS OF THE PUBLIC WITH ENROLLMENT QUESTIONS. THE GOAL WAS TO ENSURE THAT UNINSURED PATIENTS - AT THE POINT OF ACCESSING CARE - ARE PROVIDED WITH EDUCATIONAL ASSISTANCE AND ENCOURAGED TO ENROLL IN INSURANCE AND, THEREBY, REDUCE THE FINANCIAL BARRIER TO RECEIVING CARE. ADDITIONAL HEALTH NEEDS AND/OR BARRIERS TO OPTIMAL HEALTH IDENTIFIED WERE: -COST AND ABILITY TO PAY FOR CARE (WE DO HAVE A FINANCIAL ASSISTANCE POLICY IN PLACE AND UTILIZE A SLIDING FEE SCHEDULE FOR THOSE IN NEED BOTH AT OUR CERTIFIED RURAL HEALTH CLINICS AND ACROSS OUR ORGANIZATION. WE ALSO OFFER PAYMENT PLANS AND DISCOUNTS FOR PROMPT PAYM
SCHEDULE H, PART V, SECTION C, LINES 16A-C	FAP, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY: http://www.fitzgibbon.org/page.php?p=2454
SCHEDULE H, PART V, SECTION B, LINE 22D	MAXIMUM AMOUNT CHARGED TO FAP-ELIGIBLE INDIVIDUALS: AMOUNT GENERALLY BILLED (AGB) IS CALCULATED BY REVIEWING ALL PAST CLAIMS THAT HAVE BEEN PAID TO FH FOR MEDICAL CARE BY MEDICARE FEE-FOR-SERVICE AND PRIVATE INSURANCES IN A PRIOR TWELVE (12) MONTH PERIOD. THIS AMOUNT CAN INCLUDE CO-INSURANCE, COPAYMENTS, AND DEDUCTIBLES. THE AGB WILL BE CALCULATED AT LEAST ANNUALLY. THE AMOUNT GENERALLY BILLED (AGB) EFFECTIVE MAY 1, 2015 WAS CALCULATED BASED ON A ROLLING TWELVE MONTH PERIOD OF APRIL 2015 THROUGH MARCH 2016. MEDICARE FEE-FOR-SERVICE AND PRIVATE INSURANCE CLAIMS WERE USED TO DETERMINE THE AGB OF FORTY PERCENT (40%).
SCHEDULE H, PART V	501(R) FAILURE DISCLOSURE: IN MARCH 2017, DURING PREPARATION OF THE FORM 990, THE ORGANIZATION DISCOVERED THAT THE FINANCIAL ASSISTANCE POLICY AND PLAIN LANGUAGE SUMMARY WERE NOT ON THE ORGANIZATION'S WEBSITE. THE ORGANIZATION ADDED THESE DOCUMENTS TO THE WEBSITE BEFORE FILING OF THE FORM 990. THIS FAILURE DID NOT AFFECT ANY AMOUNTS BILLED TO FAP-ELIGIBILE INDIVIDUALS AND THEREFORE NO CORRECTIONS WERE NECESSARY.

Field	Value	IRS element (for citing)
Facility	6	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
FITZGIBBON PROFESSIONAL BUILDING
2301 S 65 HIGHWAY	MARSHALL	MO	65340	OB/GYN, SURGERY FAMILY PRACTICE, MENTAL HEALTH CLINIC
FITZGIBBON COMMUNITY HOME HEALTH CARE
2303 S 65 HIGHWAY	MARSHALL	MO	65340	HOME HEALTH, HOSPICE, HOMEMAKER
AKEMAN MCBURNEY MEDICAL CLINIC
420 WEST FRONT STREET	SLATER	MO	65349	OFFSITE MEDICAL CLINIC
GRAND RIVER MEDICAL CLINIC
815 EAST BROADWAY	BRUNSWICK	MO	65236	OFFSITE MEDICAL CLINIC
BUCKNER WELLNESS CENTER
2299 S 65 HIGHWAY	MARSHALL	MO	65340	CARDIAC/PULMONARY WELLNESS
FITZGIBBON FAMILY HEALTH
600 W MORRISON	FAYETTE	MO	65248	OFFSITE MEDICAL CLINIC

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7, COLUMN F	PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990, WAS REDUCED BY BAD DEBT EXPENSE OF $7,875,869.
SCHEDULE H, PART I, LINE 7	COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEET 1. IRS WORKSHEETS 3 AND 6 USED INTERNAL COST ACCOUNTING METHODOLOGY.
SCHEDULE H, PART II	COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION HAS SEVERAL EMPLOYEES INVOLVED IN LOCAL COMMUNITY BOARDS AS WELL AS STATE BOARDS, WHICH ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT AND ADVOCACY.
SCHEDULE H, PART III, SECTION A, LINE 2	BAD DEBT EXPENSE: THE ORGANIZATION REPORTED BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS FROM THE AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, SECTION A, LINE 3	BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. THIS AMOUNT EXPENSED BY THE ORGANIZATION IS ATTRIBUTABLE TO LOW INCOME INDIVIDUALS IN THEIR TARGET COMMUNITY AND IS CONSIDERED A COMMUNITY BENEFIT.
SCHEDULE H, PART III, SECTION A, LINE 4	BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE. THAT FOOTNOTE READS AS FOLLOWS: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL),THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
SCHEDULE H, PART III, SECTION B, LINE 8	COMMUNITY BENEFIT: MEDICARE DATA COMPUTED USING THE MEDICARE COST REPORT FILED WITH CMS WAS UTILIZED FOR THE COMPUTATIONS IN PART III, SECTION B. SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.
SCHEDULE H, PART III, SECTION C, LINE 9B	COLLECTION POLICY: THE ORGANIZATION'S BILLING AND PAYMENT POLICY NOTES: IF ACCOUNTS HAVE ALREADY BEEN CONSIDERED "BAD DEBT" BY FITZGIBBON HOSPITAL AND CLINICS, THEN FINANCIAL ASSISTANCE/CHARITY CARE IS AN OPTION UNTIL 240 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT. BAD DEBT IS DEFINED AS EXPENSES RESULTING FROM TREATMENT FOR SERVICES PROVIDED TO A PATIENT WHO HAS NOT MET THEIR FINANCIAL OBLIGATION NOR SET UP AN AGREEABLE PAYMENT ARRANGEMENT WITH FITZGIBBON HOSPITAL AND CLINICS WITHIN 120 DAYS FROM THE DATE THE PATIENT HAS BEEN MADE RESPONSIBLE FOR ANY BALANCES DUE EITHER AFTER INSURANCE HAS PAID THEIR PORTION OR WHEN NO INSURANCE IS INVOLVED.
SCHEDULE H, PART VI, LINE 2	NEEDS ASSESSMENT: OUR MISSION AT FITZGIBBON HOSPITAL IS TO IMPROVE THE HEALTH OF OUR COMMUNITY. IN ORDER TO MEET THIS MISSION WE STRIVE TO UNDERSTAND THE NEEDS OF OUR COMMUNITY IN SEVERAL DIFFERENT WAYS. OUR LEADERSHIP AND STAFF ARE MEMBERS OF CIVIC CLUBS, BOARDS, AND COMMITTEES. OUR BOARD OF DIRECTORS IS COMPRISED OF MEMBERS FROM COUNTIES THROUGHOUT OUR SERVICE AREA. WE WORK CLOSELY WITH THE HEALTH DEPARTMENT AND OTHER COMMUNITY AGENCIES. STATE, REGIONAL AND LOCAL MEDIAS ARE USED TO MONITOR NEEDS AT ALL LEVELS. WE ALSO BELONG TO MANY HEALTHCARE RELATED ORGANIZATIONS THAT PROVIDE INFORMATION REGARDING USAGE AND NEEDS OF HEALTHCARE IN OUR SERVICE AREA WHICH IS USED TO EVALUATE WHAT WE NEED TO FOCUS ON TO IMPROVE THE HEALTH IN OUR COMMUNITY.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE HOSPITAL USES SEVERAL AVENUES TO PROVIDE PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE. ALL PATIENTS WILL BE OFFERED A PLAIN LANGUAGE SUMMARY AND AN APPLICATION FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY (FAP) AS PART OF THE INTAKE OR DISCHARGE PROCESS TO/FROM FH. INFORMATION REGARDING THE FAP MAY BE AVAILABLE THROUGH THE HOSPITALS PATIENT ACCOUNTS DEPARTMENT AT (660) 831-3730, FH WEBSITE AT WWW.FITZGIBBON.ORG, OR THE FH FACILITY AT 2305 SOUTH 65 HIGHWAY, MARSHALL, MO 65340. THE PATIENT ACCOUNTS DEPARTMENT DEVELOPED A BROCHURE WHICH IS AVAILABLE TO PATIENTS AT THE TIME OF REGISTRATION. THE BROCHURE OUTLINES WHAT THE PATIENT IS TO EXPECT IN THE BILLING PROCESS, HOW TO CONTACT THE DEPARTMENT, AND WHAT ASSISTANCE IS AVAILABLE. WE HAVE A DETAILED POLICY WHICH OUTLINES PATIENT RESPONSIBILITY AND QUALIFICATIONS FOR CHARITY CARE. OUR PATIENT ACCOUNTS REPRESENTATIVES MEET WITH SELF PAY PATIENTS WHEN THEY ARE IN THE FACILITY TO DISCUSS OUR POLICY. OUR CARE COORDINATORS AND SOCIAL WORKERS ALSO EDUCATE OUR PATIENTS ON ASSISTANCE THEY MAY BE ELIGIBLE FOR UNDER FEDERAL, STATE AND LOCAL GOVERNMENT PROGRAMS. WE ALSO UTILIZE AN OUTSIDE AGENCY TO MAKE CONTACT WITH PATIENTS AND IDENTIFY THOSE THAT MIGHT BE ELIGIBLE FOR ASSISTANCE.
SCHEDULE H, PART VI, LINE 4	COMMUNITY INFORMATION: FITZGIBBON HOSPITAL'S PRIMARY SERVICE AREA IS SALINE COUNTY, MISSOURI WHICH IS A MID-MISSOURI AGRICULTURAL REGION AND INCLUDES THE TOWNS OF MARSHALL AND SLATER, MO. THE SECONDARY SERVICE AREA IS PORTIONS OF THE CONTIGUOUS COUNTIES SURROUNDING SALINE COUNTY. THE SALINE COUNTY POPULATION IN 2014 WAS 23,347 RESIDENTS. SALINE COUNTY DATA FOR 2014 SHOWED THE MEDIAN HOUSEHOLD INCOME WAS $39,027. THE AGE DISTRIBUTION OF THE POPULATION IN SALINE COUNTY IN 2014 WAS 72% AGE 54 AND UNDER AND 28% WERE 55 AND OLDER.
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH: FITZGIBBON HOSPITAL ENGAGED IN NUMEROUS ACTIVITIES RELATED TO ITS MISSION, "IMPROVING THE HEALTH OF OUR COMMUNITY." WHILE MANY OF THESE ACTIVITIES WERE GUIDED BY THE IMPLEMENTATION PLAN AS A RESULT OF A COMMUNITY HEALTH NEEDS ASSESSMENT PUBLISHED IN 2013 AND 2016, MANY HEALTH PROMOTION ACTIVITIES OCCUR IN THE COURSE OF DOING BUSINESS AND ARE A RESULT OF COMPREHENSIVE PATIENT CARE PROGRAMS WHICH ENCOURAGE WELLNESS, PATIENT SAFETY AND FAMILY ENGAGEMENT. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ANY QUALIFIED PHYSICIAN WHO APPLIES AND MEETS THE HOSPITAL CREDENTIALING STANDARDS. CREDENTIALING IS REQUIRED TO ENSURE PROPER TRAINING, LICENSURE AND MALPRACTICE INSURANCE COVERAGE AND HELPS TO ENSURE THE SAFETY OF THE HOSPITAL'S PATIENTS. FITZGIBBON IS LOCATED WITHIN A HEALTH PROFESSIONAL SHORTAGE AREA SCORED AS A 17 FOR PRIMARY CARE AND WELCOMES THE ADDITION OF NEW PHYSICIANS TO ITS STAFF. ENSURING ACCESS TO HIGH QUALITY HEALTH CARE IS A VITAL PART OF ITS MISSION AND IS EVIDENCED BY THE OPERATION OF FOUR RURAL HEALTH CLINICS, ONE OF WHICH IS A NATIONAL HEALTH SERVICES CORPS SITE WHICH WELCOMED AN NHSC SCHOLAR IN 2014. ANY SURPLUS FUNDS ARE USED TO IMPROVE PATIENT CARE AND MEDICAL EDUCATION. SOME ACTIVITIES INCLUDE SCHOLARSHIPS AND PRECEPTOR COLLABORATION FOR A BACHELOR'S DEGREE PROGRAM IN NURSING AT A LOCAL LIBERAL ARTS COLLEGE, MISSOURI VALLEY COLLEGE. IMPROVING PATIENT CARE IS THE HOSPITAL'S OVERRIDING CONCERN AS EVIDENCED BY THE RESOURCES DEDICATED TO TRAINING IN SUCH AREAS AS INFECTION CONTROL, BEST PRACTICE PATIENT CARE, REDUCING HOSPITAL READMISSIONS, AND ENSURING THAT LANGUAGE TRANSLATIONS OCCUR IN A CULTURALLY COMPETENT MANNER. IN EVERYTHING FITZGIBBON HOSPITAL UNDERTAKES, IMPROVEMENT IN THE HEALTH OF THE COMMUNITY REMAINS THE GUIDING PRINCIPLE. PARTICIPATION IN PROCESS IMPROVEMENT TRAINING, EDUCATION AND COLLABORATING WITH OTHER HEALTH ENTITIES IS VITAL TO ENSURING PROMOTION OF COMMUNITY AND PUBLIC HEALTH.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM: THE AFFILIATED HEALTH SYSTEM INCLUDES THE ACTIVITIES OF JOHN FITZGIBBON MEMORIAL HOSPITAL AND FITZGIBBON HEALTH SERVICES, DOING BUSINESS AS THE LIVING CENTER, (COLLECTIVELY, THE "COMPANIESTHE "HOSPITAL"). JOHN FITZGIBBON MEMORIAL HOSPITAL PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT, EMERGENCY CARE, PSYCHIATRIC AND SKILLED NURSING SERVICES TO PATIENTS IN THE MARSHALL, MISSOURI, AREA. IT ALSO OPERATES A HOME HEALTH AGENCY IN THE SAME GEOGRAPHIC AREA. IT IS DESIGNATED AS A MEDICARE DEPENDENT HOSPITAL BY MEDICARE EFFECTIVE JANUARY 1, 2007. IN MARCH 2012, THE HOSPITAL WAS DESIGNATED AS A SOLE COMMUNITY HOSPITAL BY MEDICARE. THE COMPANIES ALSO OPERATE A LONG-TERM CARE FACILITY IN MARSHALL, MISSOURI, DOING BUSINESS AS THE LIVING CENTER.
SCHEDULE H, PART VI, LINE 7	STATE FILING OF COMMUNITY BENEFIT REPORT: MISSOURI

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
OATS INC
2501 MCGUIRE BLVD	COLUMBIA	MO	65201	431016961	501(C)(3)	$14,400	COMMUNITY SERVICES
CITY OF MARSHALL MO
214 NORTH LAFAYETTE	MARSHALL	MO	65340	446000217	CITY OF MARSHAL	$15,000	COMMUNITY SAFETY

Field	Value	IRS element (for citing)
Total501c3 Org	2	Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	MONITORING USE OF GRANT FUNDS: THE HOSPITAL WORKS IN CONJUNCTION WITH THE LOCAL OATS TRANSPORTATION PROGRAM TO COORDINATE TRANSPORTATION FOR MEMBERS OF THE COMMUNITY. THE ORGANIZATION WITNESSES FIRSTHAND THE WORK DONE BY OATS IN THE COMMUNITY.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	false	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 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
DARIN HAUG DO
PRESIDENT/CEO, SEE SCHEDULE O	$429,487	$0	$5,000	$0	$420	$0	$2,000	$0	$2,866	$0	$439,773	$0	$0	$0
ANGELA LITTRELL
CFO/COO	$163,791	$0	$30,000	$0	$924	$0	$0	$0	$9,890	$0	$204,605	$0	$0	$0
RONALD OTT
PRESIDENT/CEO END 4/2015	$90,832	$0	$73,956	$0	$114,839	$0	$2,000	$0	$2,270	$0	$283,897	$0	$0	$0
KELLY ROSS
ORTHOPEDIC SURGEON	$561,275	$0	$0	$0	$39,951	$0	$2,000	$0	$0	$0	$603,226	$0	$0	$0
JOHN B BRIZENDINE
GENERAL SURGEON	$337,500	$0	$0	$0	$79,478	$0	$2,000	$0	$0	$0	$418,978	$0	$0	$0
KAREN SONG
OB/GYN	$347,492	$0	$0	$0	$185	$0	$0	$0	$366	$0	$348,043	$0	$0	$0
LORENZO M ROMNEY DO
DIRECTOR, SEE SCHEDULE O	$318,798	$0	$0	$0	$16,669	$0	$2,000	$0	$508	$0	$337,975	$0	$0	$0
BRIAN ELLEFSEN
ORTHOPEDIC SURGEON	$313,143	$0	$0	$0	$0	$0	$2,000	$0	$312	$0	$315,455	$0	$0	$0
KATHRYN LYNNE OTT
VICE PRESIDENT OF NURSING SERV	$152,655	$0	$34,950	$0	$2,175	$0	$2,000	$0	$3,668	$0	$195,448	$0	$0	$0
DENNIS SOUSLEY
VP OF CLINICAL SERVICES	$163,041	$0	$5,000	$0	$7,892	$0	$2,000	$0	$3,051	$0	$180,984	$0	$0	$0
RAVINDER ARORA
NEUROLOGIST	$279,418	$0	$0	$0	$0	$0	$0	$0	$0	$0	$279,418	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE J, PART I, LINE 7

NON-FIXED PAYMENTS: NON-FIXED PAYMENTS MADE 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 ORGANIZATION 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 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.

SCHEDULE J, PART I, LINE 4A

SEVERANCE PAYMENT: RONALD OTT RECEIVED A SEVERANCE PAYMENT OF $80,594 AS PART OF A SEPARATION AGREEMENT.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO
A	430980296	79516LBC7	2010-11-29	$12,218,468	1998 BOND REFINANCING	false	false	false
INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO
B	430980296		2016-03-14	$7,550,000	REFINANCING OF SERIES 2005 BONDS	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$530,000	$0	$12,218,468	$1,142,213	$0	$11,985,656	$232,812	$0	$0	$0	$0	$0	2010	Yes (true)	false	Yes (true)	Yes (true)
B	$0	$0	$7,550,000	$0	$0	$0	$170,000	$0	$0	$0	$7,380,000	$0	2016	Yes (true)	false	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

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

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Business Name Line1GICProviderName/BusinessNameLine1Txt	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
A	false	false	false	Yes (true)	false	false	false	0	false	Yes (true)
0
B	false	Yes (true)	false	false	false	false	false	0	false	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE K, PART IV, LINE 2C, COLUMN A	FormAndLineReferenceDesc
Explanation	DATE OF REBATE COMPUTATION: THE REBATE COMPUTATION OCCURRED ON JANUARY 6, 2016.	ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	RED CROSS PHARMACY	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	SEE PART V	RelationshipDescriptionTxt
Transaction	$134,098	TransactionAmt
Transaction	PHARMACY	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	TRANSACTIONS WITH INTERESTED PERSONS	FormAndLineReferenceDesc
Explanation	SCHEDULE L, PART IV, LINE 1, COLUMN B: SCOTT HARTWIG, BOARD MEMBER, OWNS 47.5% OF RED CROSS PHARMACY.	ExplanationTxt

Schedule M IRS990ScheduleM

Works Of Art WorksOfArtGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	9	ContributionCnt
Noncash Contributions Rpt F990	$5,019	NoncashContributionsRptF990Amt
Method Of Determining Revenues	COST	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Art Historical Treasures		ArtHistoricalTreasuresGrp
Art Fractional Interest		ArtFractionalInterestGrp
Books And Publications		BooksAndPublicationsGrp

Clothing And Household Goods ClothingAndHouseholdGoodsGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Noncash Contributions Rpt F990	$4,915	NoncashContributionsRptF990Amt
Method Of Determining Revenues	COST	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Cars And Other Vehicles		CarsAndOtherVehiclesGrp
Boats And Planes		BoatsAndPlanesGrp
Intellectual Property		IntellectualPropertyGrp
Securities Publicly Traded		SecuritiesPubliclyTradedGrp
Securities Closely Held Stock		SecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust Intrsts		SecurPrtnrshpTrustIntrstsGrp
Securities Miscellaneous		SecuritiesMiscellaneousGrp
Qualified Contrib Hist Struct		QualifiedContribHistStructGrp
Qualified Contrib Other		QualifiedContribOtherGrp
Real Estate Residential		RealEstateResidentialGrp
Real Estate Commercial		RealEstateCommercialGrp
Real Estate Other		RealEstateOtherGrp
Collectibles		CollectiblesGrp

Food Inventory FoodInventoryGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	27	ContributionCnt
Noncash Contributions Rpt F990	$6,139	NoncashContributionsRptF990Amt
Method Of Determining Revenues	COST	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Drugs And Medical Supplies		DrugsAndMedicalSuppliesGrp
Taxidermy		TaxidermyGrp
Historical Artifacts		HistoricalArtifactsGrp
Scientific Specimens		ScientificSpecimensGrp
Archaeological Artifacts		ArchaeologicalArtifactsGrp

Other Non Cash Contri Table OtherNonCashContriTableGrp (3 entries)

Non Cash CheckboxNonCashCheckboxInd	DescDesc	ContributionContributionCnt	Noncash Contributions Rpt F990NoncashContributionsRptF990Amt	Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)	VACATION PKGS	2	$8,000	COST
Yes (X)	EQUIPMENT	1	$6,000	FMV
Yes (X)	TICKETS	3	$1,290	COST

Field	Value	IRS element (for citing)
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (true)	ReviewProcessUnusualNCGiftsInd
Third Parties Used	false	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE M, PART I, COLUMN B	FormAndLineReferenceDesc
Explanation	NUMBER OF CONTRIBUTIONS: THE NUMBER OF CONTRIBUTIONS WAS DETERMINED BY THE NUMBER OF ITEMS CONTRIBUTED FOR EACH TYPE OF ITEM.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 4A	PROGRAM SERVICES ACTIVITY #1: FOR THE FISCAL YEAR ENDED APRIL 30, 2016, THE EMERGENCY ROOM EXPERIENCED 12,119 PATIENT VISITS. THE SURGICAL TEAM PERFORMED 293 IN-PATIENT PROCEDURES AND 1,912 OUT-PATIENT PROCEDURES. THE RADIOLOGY GROUP PERFORMED 29,388 PROCEDURES WHICH INCLUDE 2,776 MAMMOGRAMS, 4,424 CT SCANS, 2,261 MRI'S, 2,608 ULTRASOUND IMAGES AND 2,247 NUCLEAR MEDICINE SCANS. THE LABORATORY TEAM PERFORMED 89,667 TESTS. THE RESPIRATORY THERAPY DEPARTMENT CONDUCTED 32,269 PATIENT TREATMENTS AND THE REHABILITATIVE SERVICES GROUP WHICH INCLUDES PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES PROVIDED 45,170 PROCEDURES.
FORM 990, PART III, LINE 4D	OTHER PROGRAM SERVICES: A CARDIO-PULMONARY WELLNESS CENTER IS LOCATED ON THE CAMPUS AND STAFFED BY A REGISTERED DIETICIAN AND A REGISTERED NURSE TO COUNSEL AND EDUCATE PATIENTS ON HEALTHY LIVING THROUGH EXERCISE AND NUTRITION WITH SPECIAL EMPHASIS ON DIABETES MANAGEMENT. THROUGHOUT THE YEAR, THE STAFF ENCOUNTERED 1,278 PATIENT VISITS AT THE FACILITY. IN ADDITION, THE STAFF EDUCATED OVER 1,615 RESIDENTS IN THE SURROUNDING COMMUNITIES AT NO CHARGE THROUGH PARTICIPATION IN HEALTH FAIRS AND OTHER SOCIAL VENUES. THE HOSPITAL OFFERS CHILDBIRTH CLASSES AT A MINIMAL FEE WHICH COVERS THE COST OF THE EDUCATIONAL MATERIAL PRESENTED TO EACH PARTICIPANT. EACH YEAR, THE HOSPITAL HOSTS A COMMUNITY HEALTH FAIR OFFERING EDUCATION ON A VARIETY OF HEALTH ISSUES AND ROUTINE HEALTH SCREENINGS. MOST TESTING IS FREE, HOWEVER, PARTICIPANTS REQUESTING CERTAIN BLOOD TESTS PAY ONLY WHAT IT COSTS THE HOSPITAL FOR LABORATORY PROCESSING. FITZGIBBON IS A WILLING PARTICIPANT IN A COMMUNITY COMMITTEE TO HELP IMPROVE ACCESS TO HEALTH CARE IN THE AREA. HOSPITAL PERSONNEL ARE ENCOURAGED AND PROVIDED OPPORTUNITIES TO SERVE THE COMMUNITY THROUGH INVOLVEMENT IN VARIOUS COMMUNITY ORGANIZATIONS AS VOLUNTEER MEMBERS, OFFICERS, AND SPEAKERS ON HEALTH RELATED TOPICS.
FORM 990, PART VI, SECTION A, LINE 7A	MEMBERS, STOCKHOLDERS, OR OTHER PERSONS: THE MEDICAL STAFF OF THE ORGANIZATION ELECTS THE CHIEF OF MEDICAL STAFF WHO IS A VOTING MEMBER OF THE BOARD.
FORM 990, PART VI, SECTION B, LINE 11B	REVIEW OF FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. A DRAFT OF THE RETURN IS REVIEWED WITH MANAGEMENT BEFORE BEING FINALIZED. THE 990 IS THEN PRESENTED TO THE BOARD AFTER IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C	MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE COMPLIANCE OFFICER MONITORS THE CONFLICT OF INTEREST POLICY AND ANNUALLY REQUIRES OFFICERS, DIRECTORS, AND KEY EMPLOYEES TO SIGN A CONFLICT OF INTEREST DISCLOSURE FORM. ALL CONFLICTS MUST BE REVIEWED BY THE CEO AND/OR BOARD OF DIRECTORS. ANY BOARD MEMBER WITH A CONFLICT OF INTEREST WOULD ABSTAIN FROM VOTING ON ANY DECISION RELATED TO THAT CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINES 15A & 15B	COMPENSATION DETERMINATION: THE ORGANIZATION USES INDUSTRY DATA IN DETERMINING COMPENSATION FOR THE CEO AND OTHER OFFICERS/KEY EMPLOYEES. THE COMPENSATION FOR DR. DARIN HAUG WAS ESTABLISHED BY UTILIZING BENCHMARK DATA FROM THREE SOURCES. FITZGIBBON HOSPITAL HAD AN AGREEMENT WITH BOONE HOSPITAL CENTER WHICH ALLOWED BOONE HOSPITAL TO OVERSEE AND ASSIST IN EVALUATION OF THE WORK AND PERFORMANCE OF THE PRESIDENT OF THE HOSPITAL AND IN DETERMINING THE COMPENSATION AND BENEFITS TO WHICH THE PRESIDENT WILL BE ENTITLED. THE COMPENSATION WAS DETERMINED BY FITZGIBBON HOSPITAL BOARD REPRESENTATIVE FROM BOONE HOSPITAL CENTER IN CONSULTATION WITH THE FITZGIBBON HOSPITAL BOARD PRESIDENT AND FITZGIBBON HOSPITALS FORMER PRESIDENT/CEO. DR. HAUG ALSO PERFORMS DUTIES AS THE CHIEF MEDICAL OFFICER (CMO) AND AN EMERGENCY ROOM PHYSICIAN. THE COMPENSATION REPORTED IS FOR HIS ROLES AS PRESIDENT/CEO, CMO AND EMERGENCY ROOM PHYSICIAN.
FORM 990, PART VI, SECTION C, LINE 19	DOCUMENT DISCLOSURE: THE ANNUAL FORM 990 INCLUDES THE ANNUAL AUDITED FINANCIAL STATEMENTS AND ARE AVAILABLE TO THE PUBLIC. THE ORGANIZATION DOES NOT MAKE THE CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS, OR OTHER FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART VII, SECTION A	BOARD MEMBER COMPENSATION: NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS DIRECTORS. BOARD MEMBER LORENZO ROMNEY IS EMPLOYED BY JOHN FITZGIBBON MEMORIAL HOSPITAL AND COMPENSATED FOR HIS ROLES AS HOSPITALIST & CLINIC PHYSICIAN. HE ALSO SERVES AS THE MEDICAL STAFF PRESIDENT. JACK UHRIG, MD, RECEIVED NONEMPLOYEE COMPENSATION FOR OTHER SERVICES PROVIDED TO THE ORGANIZATION. OFFICER DARIN HAUG, DO, BEGAN AS PRESIDENT/CEO IN MAY 2015. HE ALSO SERVES AS CHIEF MEDICAL OFFICER & EMERGENCY ROOM PHYSICIAN. THE COMPENSATION LISTED IN FORM 990, PART VII, SECTION A, IS FOR CALENDAR YEAR 2015 AND INCLUDES HIS COMPENSATION FOR HIS ROLES AS PRESIDENT/CEO, CHIEF MEDICAL OFFICER, AND EMERGENCY ROOM PHYSICIAN.
FORM 990, PART X, LINE 20	TAX EXEMPT BONDS: JOHN FITZGIBBON MEMORIAL HOSPITAL RECEIVED QUALIFIED HOSPITAL BOND PROCEEDS FROM 2010 AND 2016 BOND ISSUES. A PORTION OF THE BOND PROCEEDS WERE ALLOCATED TO FITZGIBBON HEALTH SERVICES FOR BOOK AND AUDIT PURPOSES. INFORMATION ABOUT THE BONDS ARE REPORTED ON JOHN FITZGIBBON MEMORIAL HOSPITAL'S SCHEDULE K.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	FITZGIBBON HEALTH SERVICES	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2506 LINDEN TREE PARKWAY	AddressLine1Txt
City	MARSHALL	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	65340	ZIPCd

Field	Value	IRS element (for citing)
EIN	431731173	EIN
Primary Activities	NURSING HOME	PrimaryActivitiesTxt
Legal Domicile State	MO	LegalDomicileStateCd
Exempt Code Section	501(C)(3)	ExemptCodeSectionTxt
Public Charity Status	9	PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	JF MEM HOSP	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Controlled Organization	Yes (true)	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
FITZGIBBON HEALTH SERVICES
L	$60,000	FMV
FITZGIBBON HEALTH SERVICES
P	$106,654	FMV
FITZGIBBON HEALTH SERVICES
Q	$686,360	FMV