JOHN FITZGIBBON MEMORIAL HOSPITAL INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- JOHN FITZGIBBON MEMORIAL HOSPITAL INC (EIN 44-0655986)
- Tax period
- 2014-05-01 to 2015-04-30
- Filed
- 2016-03-14
- IRS object ID
- 201630749349300548
- Schema version
- 2014v6.0
- 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 M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-03-14T12:20:12-05:00 | ReturnTs |
| Tax Period End | 2015-04-30 | 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 | 2014-05-01 | 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 |
| Phone | 6608867431 | PhoneNum |
| Signature | 2016-03-08 | 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 | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | 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 | $59,654,006 | 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 | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 587 | TotalEmployeeCnt |
| Total Volunteers | 54 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $351,465 | PYContributionsGrantsAmt |
| CY Contributions Grants | $277,054 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $53,211,274 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $59,060,003 | CYProgramServiceRevenueAmt |
| PY Investment Income | $318,770 | PYInvestmentIncomeAmt |
| CY Investment Income | $288,088 | CYInvestmentIncomeAmt |
| PY Other Revenue | $8,721 | PYOtherRevenueAmt |
| CY Other Revenue | -$23,285 | CYOtherRevenueAmt |
| PY Total Revenue | $53,890,230 | PYTotalRevenueAmt |
| CY Total Revenue | $59,601,860 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $12,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $14,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $24,650,738 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $26,937,470 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $70,327 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $29,440,363 | PYOtherExpensesAmt |
| CY Other Expenses | $31,993,598 | CYOtherExpensesAmt |
| PY Total Expenses | $54,103,101 | PYTotalExpensesAmt |
| CY Total Expenses | $58,945,068 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$212,871 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $656,792 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $60,869,702 | TotalAssetsBOYAmt |
| Total Assets EOY | $59,879,610 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $25,561,293 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $23,950,841 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $35,308,409 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $35,928,769 | 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 | $41,185,035 | ExpenseAmt |
| Revenue | $42,597,036 | 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 | $7,702,823 | ExpenseAmt |
| Revenue | $7,900,856 | 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 9,885 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 2015. THIS CLINIC PROVIDED SERVICES FOR 22,498 PATIENT VISITS. THREE SATELLITE FAMILY PRACTICE CLINICS ARE ALSO SUPPORTED BY THE HOSPITAL. THESE CLINICS PROVIDED SERVICES FOR 10,878 PATIENT VISITS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,499,990 | ExpenseAmt |
| Grant | $14,000 | GrantAmt |
| Revenue | $1,244,408 | RevenueAmt |
| Desc | COMMUNITY HEALTH SERVICES - HOSPICE, HOME HEALTH, AND HOMEMAKER SERVICES. HOSPICE PROVIDED 110 PALLIATIVE CARE VISITS, HOME HEALTH PROVIDED 7,760 VISITS AND HOMEMAKER PERFORMED 10,680 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 $14,000 TO OATS IN 2015 AND WILL BE DONATING $14,400 ANNUALLY TO HELP SUSTAIN IT IN THE MARSHALL COMMUNITY. THE PROGRAM PROVIDED TRANSPORTATION FOR 3,820 RIDERS DURING FY 2015. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $697,859 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $7,317,703 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $51,085,707 | 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 | false | 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 | 132 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 587 | 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANGELA LITTRELL | PersonNm |
| Phone | 6608313251 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2305 S 65 HIGHWAY PO BOX 250 | 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 (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| FRED UTLAUT | |||||||||
| PRESIDENT | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM L 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 | ||
| VIRGINIA HUPP | |||||||||
| DIRECTOR ENDING 8/14 | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| ROOK EVANS | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| BF KNIPSCHILD MD | |||||||||
| DIRECTOR ENDING 8/14 | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| RANDY MORROW | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| JAMES SOWASH MD | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| JACK UHRIG MD | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| GAYLE CARTER | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| BILL JACKSON | |||||||||
| DIRECTOR ENDING 7/14 | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| LORENZO ROMNEY DO | |||||||||
| MEDICAL STAFF PRESIDENT | 40.0 | 1.0 | Yes (X) | $315,702 | $0 | $2,466 | |||
| RONALD A OTT | |||||||||
| PRESIDENT/CEO | 40.0 | 1.0 | Yes (X) | $269,926 | $0 | $10,932 | |||
| ANGELA LITTRELL | |||||||||
| CFO/COO BEGINNING 6/14 | 40.0 | 1.0 | Yes (X) | $75,731 | $0 | $5,044 | |||
| LYNNE OTT | |||||||||
| VP OF NURSING SERVICES | 40.0 | 0.0 | $185,441 | $0 | $6,269 | Yes (X) | |||
| DENNIS SOUSLEY | |||||||||
| VP OF CLINICAL SERVICES | 40.0 | 0.0 | $162,184 | $0 | $5,184 | Yes (X) | |||
| JOHN B BRIZENDINE MD | |||||||||
| GENERAL SURGEON | 40.0 | 0.0 | $391,743 | $0 | $2,000 | Yes (X) | |||
| BRIAN ELLEFSEN DO | |||||||||
| ORTHOPEDIC SURGEON | 40.0 | 0.0 | $499,606 | $0 | $2,384 | Yes (X) | |||
| DARIN HAUG DO | |||||||||
| ER PHYSICIAN/CMO | 40.0 | 0.0 | $381,349 | $0 | $4,836 | Yes (X) | |||
| KELLY ROSS DO | |||||||||
| ORTHOPEDIC SURGEON | 40.0 | 0.0 | $575,488 | $0 | $2,000 | Yes (X) | |||
| DAVID CARR MD | |||||||||
| OB/GYN | 40.0 | 0.0 | $274,625 | $0 | $2,000 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,131,795 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $43,115 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 28 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| ServicesServicesDesc | CompensationCompensationAmt |
|---|---|
| SEPTAGON CONSTRUCTION CO | |
| CONSTRUCTION | $857,990 |
| PHARMACY SYSTEMS INC | |
| PHARMACY MANAGEMENT | $611,980 |
| SIEMENS MEDICAL SOLUTIONS | |
| MAINTENANCE | $411,627 |
| MICROPORT ORTHOPEDICS INC | |
| SURGICAL SUPPLIES | $348,070 |
| PAUL T BRIZENDINE MD | |
| ER PHYSICIAN | $310,883 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $171,680 | FundraisingAmt |
| Government Grants | $21,429 | GovernmentGrantsAmt |
| All Other Contributions | $83,945 | AllOtherContributionsAmt |
| Noncash Contributions | $29,937 | NoncashContributionsAmt |
| Total Contributions | $277,054 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 900099 | $57,177,761 | $57,177,761 |
| EHR INCENTIVE REVENUE | 900099 | $816,675 | $816,675 |
| CAFETERIA | 722514 | $272,718 | $272,718 |
| MANAGEMENT FEES | 561000 | $60,000 | $60,000 |
| OTHER REVENUE | 900099 | $732,849 | $732,849 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $59,060,003 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $288,088 | TotalRevenueColumnAmt |
| Exclusion | $288,088 | 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 |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $28,861 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $171,680 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $52,146 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$23,285 | TotalRevenueColumnAmt |
| Exclusion | -$23,285 | ExclusionAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $59,601,860 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $59,060,003 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $264,803 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,000 | TotalAmt |
| Program Services | $14,000 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,038,879 | TotalAmt |
| Program Services | $677,246 | ProgramServicesAmt |
| Management And General | $361,633 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,811,296 | TotalAmt |
| Program Services | $18,235,795 | ProgramServicesAmt |
| Management And General | $3,513,463 | ManagementAndGeneralAmt |
| Fundraising | $62,038 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $293,000 | TotalAmt |
| Program Services | $250,999 | ProgramServicesAmt |
| Management And General | $42,001 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,330,247 | TotalAmt |
| Program Services | $2,000,377 | ProgramServicesAmt |
| Management And General | $329,870 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,464,048 | TotalAmt |
| Program Services | $1,246,138 | ProgramServicesAmt |
| Management And General | $213,355 | ManagementAndGeneralAmt |
| Fundraising | $4,555 | 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 | $26,528 | TotalAmt |
| Management And General | $26,528 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,685 | TotalAmt |
| Management And General | $161,685 | 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 | $4,204,985 | TotalAmt |
| Program Services | $3,200,694 | ProgramServicesAmt |
| Management And General | $1,003,379 | ManagementAndGeneralAmt |
| Fundraising | $912 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,161 | TotalAmt |
| Management And General | $139,761 | ManagementAndGeneralAmt |
| Fundraising | $1,400 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,487,520 | TotalAmt |
| Program Services | $2,581,074 | ProgramServicesAmt |
| Management And General | $905,209 | ManagementAndGeneralAmt |
| Fundraising | $1,237 | 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 | $665,088 | TotalAmt |
| Program Services | $579,254 | ProgramServicesAmt |
| Management And General | $85,834 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $257,826 | TotalAmt |
| Program Services | $233,677 | ProgramServicesAmt |
| Management And General | $24,149 | ManagementAndGeneralAmt |
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 | $84,776 | TotalAmt |
| Program Services | $69,425 | ProgramServicesAmt |
| Management And General | $15,166 | ManagementAndGeneralAmt |
| Fundraising | $185 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $922,477 | TotalAmt |
| Program Services | $772,477 | ProgramServicesAmt |
| Management And General | $150,000 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,262,325 | TotalAmt |
| Program Services | $2,731,854 | ProgramServicesAmt |
| Management And General | $530,471 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $586,384 | TotalAmt |
| Program Services | $500,091 | ProgramServicesAmt |
| Management And General | $86,293 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $9,037,615 | $9,037,615 | |
| MEDICAL SUPPLIES & DRUGS | $6,422,869 | $6,422,869 | |
| PROVIDER TAX | $2,373,616 | $2,373,616 | |
| RECRUITING & RETENTION | $358,743 | $158,506 | $200,237 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,945,068 | TotalAmt |
| Program Services | $51,085,707 | ProgramServicesAmt |
| Management And General | $7,789,034 | ManagementAndGeneralAmt |
| Fundraising | $70,327 | 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 | $3,839,823 | BOYAmt |
| EOY | $7,931,679 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,114,738 | BOYAmt |
| EOY | $16,113,318 | 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 | $6,767,325 | BOYAmt |
| EOY | $6,890,179 | 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 | $956,581 | BOYAmt |
| EOY | $1,011,379 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,118,492 | BOYAmt |
| EOY | $1,029,321 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $59,551,259 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $37,092,139 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,639,707 | BOYAmt |
| EOY | $22,459,120 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,672,529 | BOYAmt |
| EOY | $3,315,458 | 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 | $2,760,507 | BOYAmt |
| EOY | $1,129,156 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,869,702 | BOYAmt |
| EOY | $59,879,610 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,294,511 | BOYAmt |
| EOY | $4,281,949 | 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 | $15,504,713 | BOYAmt |
| EOY | $14,952,378 | 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 | $3,495,239 | BOYAmt |
| EOY | $3,415,640 | 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 | $1,266,830 | BOYAmt |
| EOY | $1,300,874 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,561,293 | BOYAmt |
| EOY | $23,950,841 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,252,135 | BOYAmt |
| EOY | $34,711,567 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $601,057 | BOYAmt |
| EOY | $761,985 | 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 | $35,308,409 | BOYAmt |
| EOY | $35,928,769 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,869,702 | BOYAmt |
| EOY | $59,879,610 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $656,792 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$36,432 | 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 | $266 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $21,947 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $22,213 | 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 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 | $701,570 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $28,779 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $6,326 | OtherExpendituresAmt |
| End Year Balance | $724,023 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| 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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| 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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $694,769 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $24,351 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $60 | AdministrativeExpensesAmt |
| End Year Balance | $719,060 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $677,227 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $21,898 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $4,296 | OtherExpendituresAmt |
| Administrative Expenses | $60 | AdministrativeExpensesAmt |
| End Year Balance | $694,769 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.33934 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.62873 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.03193 | 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 | $28,611,984 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,554,932 | DepreciationAmt |
| Book Value | $17,057,052 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $29,345,891 | OtherCostOrOtherBasisAmt |
| Depreciation | $24,626,445 | DepreciationAmt |
| Book Value | $4,719,446 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,522,384 | OtherCostOrOtherBasisAmt |
| Depreciation | $910,762 | DepreciationAmt |
| Book Value | $611,622 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $22,459,120 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED PARTY | $626,630 |
| EST AMT DUE TO 3RD PTY PYRS | $374,262 |
| EST SELF INSURANCE COSTS | $299,982 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,300,874 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $50,432,563 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$8,982,042 | OtherRevenueAmt |
| Revenue Not Reported | -$8,982,042 | RevenueNotReportedAmt |
| Revenue Subtotal | $59,414,605 | RevenueSubtotalAmt |
| Other Revenues Not Included | $187,255 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $187,255 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $59,601,860 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $49,959,599 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $52,146 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $52,146 | ExpensesNotReportedAmt |
| Expenses Subtotal | $49,907,453 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $9,037,615 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $9,037,615 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $58,945,068 | 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: $ (9,037,615) BAD DEBT EXPENSE 55,573 NET ASSETS RELEASED FROM RESTRICTION ------------ $ (8,982,042) |
| SCHEDULE D, PART XI, LINE 4B | OTHER REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT LINE 1: $ (52,146) SPECIAL EVENTS EXPENSES 239,401 TEMPORARILY RESTRICTED CONTRIBUTIONS ----------- $ 187,255 |
| SCHEDULE D, PART XII, LINE 2D | OTHER EXPENSE INCLUDED ON LINE 1, BUT NOT FORM 990, PART IX, LINE 25: $ 52,146 SPECIAL EVENTS EXPENSES |
| SCHEDULE D, PART XII, LINE 4B | OTHER EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT LINE 1: $ 9,037,615 BAD DEBT EXPENSE |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | SPRING FLING | Event1Nm |
| Gross Receipts Event1 | $117,218 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $104,653 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $12,565 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $11,580 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $10,316 | OtherDirectExpensesEvent1Amt |
| Event2 | GOLF TOURNAMENT | Event2Nm |
| Gross Receipts Event2 | $33,491 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $29,475 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $4,016 | GrossRevenueEvent2Amt |
| Cash Prizes Event2 | $5,145 | CashPrizesEvent2Amt |
| Non Cash Prizes Event2 | $4,985 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $3,278 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $1,605 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $2,519 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 3 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $49,832 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $37,552 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $12,280 | GrossRevenueOtherEventsAmt |
| Food And Beverage Other Events | $438 | FoodAndBeverageOtherEventsAmt |
| Oth Direct Expnss Other Events | $12,280 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $200,541 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $171,680 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $28,861 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $5,145 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $4,985 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $3,278 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $13,623 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $25,115 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $52,146 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$23,285 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $244,895 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $244,895 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00490 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,634,495 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,038,074 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $596,421 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01200 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,879,390 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,038,074 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $841,316 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01690 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $37,191 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,427 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $31,764 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $431,462 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,250 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $429,212 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00860 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,878,039 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,782,671 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,095,368 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04200 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,360,692 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,790,348 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,570,344 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05150 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,240,082 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,828,422 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,411,660 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06840 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,645 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,645 | NetCommunityBenefitExpnsAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,645 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,645 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $9,037,615 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,626,771 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $13,043,802 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $14,090,049 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,046,247 | 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 | 12 | 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 | 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 | 12 | 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 | 200. | 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 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 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 All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Lowest Negotiated Rates | Yes (X) | LowestNegotiatedRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | COMMUNITY INPUT: KEY COMMUNITY HEALTH AND SOCIAL SERVICE STAKEHOLDERS WERE ENGAGED TO ASSIST IN THE PROCESS TO ENSURE INPUT FROM THE UNDERSERVED, CHRONICALLY ILL, LOW INCOME AND MINORITY POPULATIONS IN OUR SERVICE AREA. KEY COMMUNITY PARTNERS INVOLVED WITH THE PROCESS WERE FITZGIBBON HOSPITAL, SALINE COUNTY HEALTH DEPARTMENT, SALT FORK YMCA AND MARSHALL HOUSING AUTHORITY. TO ENSURE PUBLIC HEALTH EXPERTS COULD PROVIDE THEIR EXPERTISE THE COMMITTEE SOUGHT INPUT THROUGH PERSONAL INTERVIEWS AND FOCUS GROUPS FROM SALINE COUNTY HEALTH DEPARTMENT, FITZGIBBON HOSPITAL PRIMARY CARE SITE NURSES, JACK UHRIG, M.D. PRIVATE PRACTICE PHYSICIAN, MELANIE ELFRINK, M.D. SALINE COUNTY HEALTH DEPARTMENT, MARSHALL PUBLIC SCHOOL NURSING STAFF, AND REV CHARLES STEPHENSON, EXECUTIVE DIRECTOR OF POWERHOUSE COMMUNITY DEVELOPMENT AGENCY. IN ADDITION, AN ONLINE SURVEY WAS CONDUCTED. THE SURVEY WAS AVAILABLE FOR A SIX-WEEK PERIOD WITH VARIOUS NOTICES TO THE PUBLIC ON ACCESSING AND COMPLETING THE SURVEY. SURVEY INTAKE STAFF WAS POSITIONED AT HOSPITAL-OPERATED RURAL HEALTH CLINICS, MARSHALL HOUSING AUTHORITY, SALINE COUNTY HEALTH DEPARTMENT, AND MARSHALL SENIOR CENTER TO ASSIST IN ACCESSING THE SURVEY. |
| SCHEDULE H, PART V, SECTION B, LINE 6B | CHNA CONDUCTION: THE ORGANIZATION'S CHNA WAS CONDUCTED ALONG WITH THE FOLLOWING: -SALT FORK YMCA -SALINE COUNTY HEALTH DEPARTMENT -MARSHALL HOUSING AUTHORITY |
| SCHEDULE H, PART V, SECTION B, LINE 7D | CHNA AVAILABILITY TO PUBLIC: PRESS RELEASES WERE SENT TO THE LOCAL DAILY NEWSPAPER. THE MARSHALL DEMOCRAT NEWS, AND AREA WEEKLY NEWSPAPERS. IN ADDITION, ONLINE ACCESS WAS MADE AVAILABLE VIA WWW.MARSHALLNEWS.COM WITH A LINK THROUGH TO THE COMPLETE CHNA REPORT WHICH IS HOUSED PERMANENTLY ON THE HOSPITAL WEB SITE. A FLIER DESCRIBING THE ONLINE AND PRINTED ACCESS TO THE REPORT WAS DISTRIBUTED AT THE FITZGIBBON HOSPITAL APRIL 2013 COMMUNITY HEALTH FAIR AND WAS DISTRIBUTED TO THE PARTNER SITES FOR BROAD DISTRIBUTION TO THEIR CLIENT BASE. |
| SCHEDULE H, PART V, SECTION B, LINE 11 | ADDRESSING IDENTIFIED NEEDS: THE NEEDS NOT DIRECTLY ADDRESSED IN THE CHNA IMPLEMENTATION PLAN WERE AS FOLLOWS: -COST AND ABILITY TO PAY FOR CARE -ALCOHOL AND DRUG ABUSE -CANCER -LACK OF HEALTH INSURANCE -LACK OF DENTAL CARE -MENTAL HEALTH CONCERNS -COST OF PRESCRIPTION MEDICATION AND TEEN PREGNANCY THE CHNA COMMITTEE USED A DECISION MATRIX TO PRIORITIZE WHICH HEALTH NEEDS WOULD BE ADDRESSED BY THE COMMITTEE GOING FORWARD. IN ADDITION, CONSIDERATION WAS GIVEN TO PARTNER AGENCY CAPACITIES WHICH WOULD HAVE THE HIGHEST IMPACT ON RESIDENTS IN THE COMMUNITY WITH PLANS FOR COMMUNITY HEALTH CHANGE. OTHER FACTORS INFLUENCING THE COMMITTEE'S DECISION TO NOT ADDRESS NEEDS IDENTIFIED INCLUDED THE CONSEQUENCES OF NOT INTERVENING, COMMUNITY OPINION, AND NUMBERS OF PEOPLE AFFECTED. IN RESPONSE TO THE RESULTS OF THE ORGANIZATION'S 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 DIETICIAN LESLIE HESSE CONTINUED TO DISTRIBUTE WEEKLY WELLNESS TIPS VIA EMAIL TO COMMUNITY PARTNERS AND LARGE COMMUNITY EMPLOYERS. THESE TIPS FOCUSED ON THE BENEFITS OF EXERCISE, HEALTHY EATING AND HEALTHY LIFESTYLE ENCOURAGEMENT. THE DISTRIBUTION LIST FOR THESE TIPS INCLUDED NOT ONLY INTERNAL WITHIN THE HOSPITAL, BUT ALSO TO MANY LOCAL BUSINESSES, INCLUDING THE MARSHALL PARKS AND RECREATION DEPARTMENT, MU EXTENSION OFFICE, SALINE COUNTY HEALTH DEPARTMENT, AREA SCHOOL DISTRICTS, THE CITY OF MARSHALL AND SEVERAL LARGE EMPLOYERS IN THE AREA. WE RECEIVED MUCH POSITIVE FEEDBACK ON THESE TIPS, AS THEY ARE COMPLETELY EDUCATIONAL. TOPICS RANGED FROM HEALTHY RECIPES, NUTRIENT AND FAT CONTENT OF FOODS, HEALTH BENEFITS EXERCISE AND TIPS FOR PLANNING AND IMPLEMENTING A HEALTHY LIFESTYLE. AGAIN, THESE WERE PUBLISHED WEEKLY VIA EMAIL AND ON HOSPITAL SOCIAL MEDIA OUTLETS. HOSPITAL EMPLOYEES ALSO WORKED TO CALCULATE THE NUMBER OF STEPS FROM VARIOUS LOCATIONS AND PARKING LOTS ON CAMPUS, PRODUCED SIGNAGE AND POSTED THEM FOR THE PUBLIC. THIS WAS COMPLETED IN MAY 2014. THE GOAL OF THIS WAS TO EDUCATE AND POTENTIALLY SPUR A DESIRE TO PARTICIPATE IN MORE EXERCISE. AS OF MAY 2014 THE INTERNAL HOSPITAL CAFETERIA ALSO INTRODUCED AT LEAST THREE HEALTHY CHOICES FOR THE MENU, WITH NUTRITIONAL INFORMATION POSTED. IN ADDITION, DIETARY PERSONNEL WORKED WITH THE VENDING MACHINE COMPANY TO ENSURE HEALTHY CHOICES WERE AVAILABLE IN 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. 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. SMOKING - THE ADVOCACY GROUP, BREATHE EASY MARSHALL, SPEARHEADED BY EMPLOYEES WITHIN THE HOSPITAL IN COLLABORATION WITH LOCAL STAKEHOLDERS INTERESTED IN ENACTING A CLEAN AIR ORDINANCE, CONTINUED TO DISTRIBUTE INFORMATION ON THE RISKS OF SMOKING. THE GROUP ESTABLISHED ITS OWN SOCIAL MEDIA PAGE - WITH THE ASSISTANCE OF HOSPITAL STAFF - AND IT CONTINUES TO ADVOCATE FOR A CLEAN AIR POLICY WITHIN THE CITY VIA DISTRIBUTION OF EDUCATIONAL MATERIALS. INTERNALLY, A CROSS-FUNCTIONAL TEAM WORKED TO IMPLEMENT A SMOKING CESSATION SUPPORT PACKET, TO BE DISTRIBUTED TO EVERY INPATIENT WHO INDICATED THEY WERE A SMOKER AT REGISTRATION. THE PACKET WAS MADE PART OF AN OFFICIAL POLICY ON NICOTINE USE AND WITHDRAWAL MANAGEMENT FOR PATIENTS, WHICH WAS IN DRAFT FORM AS OF APRIL 2015. THIS INCLUDES POLICIES REGARDING PATIENT ASSESSMENT, INTERVENTIONS AND TEACHING TO SUPPORT PATIENTS WHO INDICATE THEY WOULD LIKE TO QUIT SMOKING. BECAUSE OUR COUNTY SMOKING RATE IS SO HIGH, ONE POPULATION THAT WE IDENTIFIED TO IMPACT WAS EXPECTANT MOTHERS. THE WOMEN'S CENTER STAFF APPLIED FOR A GRANT FROM THE MARCH OF DIMES AND COLLABORATED WITH THAT ENTITY TO SUPPORT EXPECTANT MOTHERS WHO EXPRESS A DESIRE TO QUIT SMOKING. ACTIVITIES UNDER THAT GRANT LAUNCHED IN DECEMBER 2014 AND CONTINUE THROUGH DECEMBER 2016. EDUCATION AND TESTING FOR THE PRESENCE OF NICOTINE IN THE MOTHER'S BLOODSTREAM WERE PART OF THE PROGRAM, AND "REWARDING" THOSE MOTHERS AFTER DELIVERY WHO CONTINUE TO BE SMOKE-FREE WITH VOUCHERS FOR DIAPERS. DEVELOPMENT 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 ATTENDED INITIAL STARTUP ADVOCACY MEETINGS AS A COLLABORATOR WITH A GROUP CALLED "RAISE YOUR HAND FOR KIDS," WHICH WILL BE ADVOCATING FOR AN INCREASE IN THE CIGARETTE TAX IN MISSOURI. WHILE PROCEEDS FROM THAT TAX INCREASE ARE TO BE TARGETED AT INCREASING FUNDING FOR EARLY CHILDHOOD EDUCATION, THE HOSPITAL INTEREST IN THIS GROUP IS PURELY HEALTH-RELATED, AS STATISTICS SHOW THE SMOKING RATE DECLINES AS THE COST OF CIGARETTES INCREASES. TOBACCO-FREE ADVOCACY BY THE HOSPITAL INCLUDED SUCH ITEMS AS AN INCREASED ENFORCEMENT OF HOSPITAL "NO SMOKING" SIGNS ON HOSPITAL GROUNDS TO REMOVING CANDY CIGARETTES AND CIGARS FROM THE GIFT SHOP AND SHREDDED BUBBLE GUM WHICH IMITATED CHEWING TOBACCO FROM THE CAFETERIA. PREVENTIVE CARE AND WELLNESS - MANY OF THE EMAILED MESSAGES TO LOCAL EMPLOYERS ADDRESSED THIS AREA, AS DOES A WEEKLY COLUMN THE HOSPITAL STAFF WRITES AND SUBMITS FOR PUBLICATION IN AREA NEWSPAPERS. 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 PAPER'S "HEALTH" PAGE. COLLABORATIVE ACTIVITIES SURROUNDING OUR NCQA-ACCREDITED PRIMARY CARE HEALTH HOME, WHICH TARGETS LOW-INCOME MEDICAID ENROLLEES WITH MULTIPLE CHRONIC CONDITIONS, WERE ALSO EXPANDED TO INCLUDE OTHER RURAL HEALTH CLINIC LOCATIONS IN 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 SCHOOL PHYSICALS FOR ATHLETES IN THE LOCAL SCHOOL DISTRICT IN MAY 2014. THESE PHYSICALS WERE AVAILABLE AT A NOMINAL CHARGE OF $10, AND THE PROCEEDS WERE DONATED BACK TO THE DISTRICT FOR PURCHASE OF NEEDED EQUIPMENT USED BY THE ATHLETIC TRAINER. THE GOAL WAS TO ENSURE ALL ATHLETES WHO NEED A SCHOOL PHYSICAL WOULD BE ABLE TO RECEIVE ONE AND PARTICIPATION IN A HIGH SCHOOL SPORT WOULD NOT BE HINDERED BY A STUDENT'S 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 A HEALTHIER LONG-TERM LIFESTYLE. OTHER COLLABORATIVE ACTIVITIES INCLUDED PROVIDING HEALTH SCREENINGS FOR EMPLOYEES OF A NEARBY SCHOOL DISTRICT IN MARCH OF 2015, PROVIDING BASIC ON-SITE HEALTH SCREENINGS SUCH AS HEIGHT, WEIGHT, BLOOD PRESSURE AND BODY MASS INDEX AT SEVERAL AREA EMPLOYERS AND PRODUCTION OF MANY DIFFERENT TYPES 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. IN MAY 2014 THE HOSPITAL PROVIDED HEALTHY SNACKS FOR SUMMER READING PROGRAM AT THE LOCAL LIBRARY. THE PROGRAM RAN EVERY WEDNESDAY FOR SEVERAL MONTHS. DURING SPRING SEMESTER 2014 THE HOSPITAL COMPILED AND FORWARDED AN ELECTRONIC EDUCATIONAL PRESENTATION FOR A LOCAL COLLEGE ON PROPER SANITATION. HOSPITAL STAFF SPENT SIGNIFICANT RESOURCES DEVELOPING MATERIALS FOR PUBLIC DISTRIBUTION AT ITS BENEFIT GOLF TOURNAMENT DURING JULY 2014 AND FOR ITS HEALTH FAIR IN APRIL 2015. THESE MATERIALS EXPLAIN NEW COVERAGE FOR SCREENING AND PREVENTIVE SERVICES UNDER THE AFFORDABLE CARE ACT. MATERIALS INCLUDED PREVENTIVE SERVICE COVERAGE UN |
| SCHEDULE H, PART V, SECTION C, LINE 16A & B | FAP APPLICATION FORM WEBSITE AVAILABILITY: HTTP://WWW.FITZGIBBON.ORG/PAGE.PHP?P=2453 |
| 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 MEDICAL OFFICE BUILDING | ||||
| 2305 S 65 HIGHWAY | MARSHALL | MO | 65340 | OB/GYN, SURGERY, FAMILY PRACTICE, MENTAL HEALTH CLINIC |
| FITZGIBBON COMMUNITY HOME HEALTH CARE | ||||
| 2303 S 65 HIGHWAY | MARSHALL | MO | 65340 | HOME HEALTH, HOSPICE, HOMEMAKER |
| AKEMAN MCBURNEY MEDICAL CLINIC | ||||
| 420 WEST FRONT STREET | SLATER | MO | 65349 | OFFSITE MEDICAL CLINIC |
| GRAND RIVER MEDICAL CLINIC | ||||
| 815 EAST BROADWAY | BRUNSWICK | MO | 65236 | OFFSITE MEDICAL CLINIC |
| BUCKNER WELLNESS CENTER | ||||
| 2299 S 65 HIGHWAY | MARSHALL | MO | 65340 | CARDIAC/PULMONARY WELLNESS |
| FITZGIBBON FAMILY HEALTH | ||||
| 600 W MORRISON | FAYETTE | MO | 65248 | OFFSITE MEDICAL CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 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 $9,037,615. |
| 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 NOT AN OPTION. "BAD DEBT" IS DEFINED AS EXPENSES RESULTING FROM TREATMENT FOR SERVICES PROVIDED TO A PATIENT WHO HAS NOT MET THEIR FINANCIAL OBLIGATION NOR SET UP AN AGREEABLE PAYMENT ARRANGEMENT WITH FITZGIBBON HOSPITAL AND CLINICS WITHIN 120 DAYS FROM THE DATE THE PATIENT HAS BEEN MADE RESPONSIBLE FOR ANY BALANCES DUE EITHER AFTER INSURANCE HAS PAID THEIR PORTION OR WHEN NO INSURANCE IS INVOLVED. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESSMENT: OUR MISSION AT FITZGIBBON HOSPITAL IS TO "IMPROVE THE HEALTH OF OUR COMMUNITY". IN ORDER TO MEET THIS MISSION WE STRIVE TO UNDERSTAND THE NEEDS OF OUR COMMUNITY IN SEVERAL DIFFERENT WAYS. OUR LEADERSHIP AND STAFF ARE MEMBERS OF CIVIC CLUBS, BOARDS, AND COMMITTEES. OUR BOARD OF DIRECTORS IS COMPRISED OF MEMBERS FROM COUNTIES THROUGHOUT OUR SERVICE AREA. WE WORK CLOSELY WITH THE HEALTH DEPARTMENT AND OTHER COMMUNITY AGENCIES. STATE, REGIONAL AND LOCAL MEDIAS ARE USED TO MONITOR NEEDS AT ALL LEVELS. WE ALSO BELONG TO MANY HEALTHCARE RELATED ORGANIZATIONS THAT PROVIDE INFORMATION REGARDING USAGE AND NEEDS OF HEALTHCARE IN OUR SERVICE AREA WHICH IS USED TO EVALUATE WHAT WE NEED TO FOCUS ON TO IMPROVE THE HEALTH IN OUR COMMUNITY. |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: HOSPITAL USES SEVERAL AVENUES TO PROVIDE PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE. THE PATIENT ACCOUNTS DEPARTMENT DEVELOPED A BROCHURE WHICH IS AVAILABLE TO PATIENTS AT THE TIME OF REGISTRATION. THE BROCHURE OUTLINES WHAT THE PATIENT IS TO EXPECT IN THE BILLING PROCESS, HOW TO CONTACT THE DEPARTMENT, AND WHAT ASSISTANCE IS AVAILABLE. WE HAVE A DETAILED POLICY WHICH OUTLINES PATIENT RESPONSIBILITY AND QUALIFICATIONS FOR CHARITY CARE. OUR PATIENT ACCOUNTS REPRESENTATIVES MEET WITH SELF PAY PATIENTS WHEN THEY ARE IN THE FACILITY TO DISCUSS OUR POLICY. OUR CARE COORDINATORS AND SOCIAL WORKERS ALSO EDUCATE OUR PATIENTS ON ASSISTANCE THEY MAY BE ELIGIBLE FOR UNDER FEDERAL, STATE AND LOCAL GOVERNMENT PROGRAMS. WE ALSO UTILIZE AN OUTSIDE AGENCY TO MAKE CONTACT WITH PATIENTS AND IDENTIFY THOSE THAT MIGHT BE ELIGIBLE FOR ASSISTANCE. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION: FITZGIBBON HOSPITAL'S PRIMARY SERVICE AREA IS SALINE COUNTY, MISSOURI WHICH IS A MID-MISSOURI AGRICULTURAL REGION AND INCLUDES THE TOWNS OF MARSHALL AND SLATER, MO. THE SECONDARY SERVICE AREA IS PORTIONS OF THE CONTIGUOUS COUNTIES SURROUNDING SALINE COUNTY. THE SALINE COUNTY POPULATION IN 2009 WAS 22,586 RESIDENTS. SALINE COUNTY DATA FOR 2009 SHOWED 61.3% OF HOUSEHOLDS WITH INCOME UNDER $49,999. OF THIS NUMBER, 42.3% OF HOUSEHOLDS FELL INTO THE $34,999 AND BELOW BRACKET. THE AGE DISTRIBUTION OF THE POPULATION IN SALINE COUNTY IN 2009 WAS 72.8% AGE 54 AND UNDER AND 27.2% WERE 55 AND OLDER. |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH: FITZGIBBON HOSPITAL ENGAGED IN NUMEROUS ACTIVITIES RELATED TO ITS MISSION, "IMPROVING THE HEALTH OF OUR COMMUNITY." WHILE MANY OF THESE ACTIVITIES WERE GUIDED BY THE IMPLEMENTATION PLAN AS A RESULT OF A COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN 2012 AND PUBLISHED IN 2013, MANY HEALTH PROMOTION ACTIVITIES OCCUR IN THE COURSE OF DOING BUSINESS AND ARE A RESULT OF COMPREHENSIVE PATIENT CARE PROGRAMS WHICH ENCOURAGE WELLNESS, PATIENT SAFETY AND FAMILY ENGAGEMENT. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ANY QUALIFIED PHYSICIAN WHO APPLIES AND MEETS THE HOSPITAL CREDENTIALING STANDARDS. CREDENTIALING IS REQUIRED TO ENSURE PROPER TRAINING, LICENSURE AND MALPRACTICE INSURANCE COVERAGE AND HELPS TO ENSURE THE SAFETY OF THE HOSPITAL'S PATIENTS. FITZGIBBON IS LOCATED WITHIN A HEALTH PROFESSIONAL SHORTAGE AREA SCORED AS A 17 FOR PRIMARY CARE AND WELCOMES THE ADDITION OF NEW PHYSICIANS TO ITS STAFF. ENSURING ACCESS TO HIGH QUALITY HEALTH CARE IS A VITAL PART OF ITS MISSION AND IS EVIDENCED BY THE OPERATION OF THREE RURAL HEALTH CLINICS, ONE OF WHICH IS A NATIONAL HEALTH SERVICES CORPS SITE WHICH WELCOMED AN NHSC SCHOLAR IN 2014. ANY SURPLUS FUNDS ARE USED TO IMPROVE PATIENT CARE AND MEDICAL EDUCATION. SOME ACTIVITIES INCLUDE SCHOLARSHIPS AND PRECEPTOR COLLABORATION FOR A BACHELOR'S DEGREE PROGRAM IN NURSING AT A LOCAL LIBERAL ARTS COLLEGE, MISSOURI VALLEY COLLEGE. IMPROVING PATIENT CARE IS THE HOSPITAL'S OVERRIDING CONCERN AS EVIDENCED BY THE RESOURCES DEDICATED TO TRAINING IN SUCH AREAS AS INFECTION CONTROL, BEST PRACTICE PATIENT CARE, REDUCING HOSPITAL READMISSIONS, AND ENSURING THAT LANGUAGE TRANSLATIONS OCCUR IN A CULTURALLY COMPETENT MANNER. IN EVERYTHING FITZGIBBON HOSPITAL UNDERTAKES, IMPROVEMENT IN THE HEALTH OF THE COMMUNITY REMAINS THE GUIDING PRINCIPLE. PARTICIPATION IN PROCESS IMPROVEMENT TRAINING, EDUCATION AND COLLABORATING WITH OTHER HEALTH ENTITIES IS VITAL TO ENSURING PROMOTION OF COMMUNITY AND PUBLIC HEALTH. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM: THE AFFILIATED HEALTH SYSTEM INCLUDES THE ACTIVITIES OF JOHN FITZGIBBON MEMORIAL HOSPITAL AND FITZGIBBON HEALTH SERVICES, DOING BUSINESS AS THE LIVING CENTER, (COLLECTIVELY, THE "COMPANIES" OR THE "HOSPITAL"). JOHN FITZGIBBON MEMORIAL HOSPITAL PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT, EMERGENCY CARE, PSYCHIATRIC AND SKILLED NURSING SERVICES TO PATIENTS IN THE MARSHALL, MISSOURI, AREA. IT ALSO OPERATES A HOME HEALTH AGENCY IN THE SAME GEOGRAPHIC AREA. IT IS DESIGNATED AS A MEDICARE DEPENDENT HOSPITAL BY MEDICARE EFFECTIVE JANUARY 1, 2007. IN MARCH 2012, THE HOSPITAL WAS DESIGNATED AS A SOLE COMMUNITY HOSPITAL BY MEDICARE. THE COMPANIES ALSO OPERATE A LONG-TERM CARE FACILITY IN MARSHALL, MISSOURI, DOING BUSINESS AS THE LIVING CENTER. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OATS INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2501 MCGUIRE BLVD | AddressLine1Txt |
| City | COLUMBIA | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 431016961 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $14,000 | CashGrantAmt |
| Purpose Of Grant | COMMUNITY SERVICES | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | MONITORING USE OF GRANT FUNDS: THE HOSPITAL WORKS IN CONJUNCTION WITH THE LOCAL OATS TRANSPORTATION PROGRAM TO COORDINATE TRANSPORTATION FOR MEMBERS OF THE COMMUNITY. THE ORGANIZATION WITNESSES FIRSTHAND THE WORK DONE BY OATS IN THE COMMUNITY. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LORENZO ROMNEY DO | ||||||||||||||
| MEDICAL STAFF PRESIDENT | $299,616 | $0 | $0 | $0 | $16,086 | $0 | $2,000 | $0 | $466 | $0 | $318,168 | $0 | $0 | $0 |
| RONALD A OTT | ||||||||||||||
| PRESIDENT/CEO | $226,851 | $0 | $42,000 | $0 | $1,075 | $0 | $2,000 | $0 | $8,932 | $0 | $280,858 | $0 | $0 | $0 |
| JOHN B BRIZENDINE MD | ||||||||||||||
| GENERAL SURGEON | $325,000 | $0 | $0 | $0 | $66,743 | $0 | $2,000 | $0 | $0 | $0 | $393,743 | $0 | $0 | $0 |
| BRIAN ELLEFSEN DO | ||||||||||||||
| ORTHOPEDIC SURGEON | $499,606 | $0 | $0 | $0 | $0 | $0 | $2,000 | $0 | $384 | $0 | $501,990 | $0 | $0 | $0 |
| DARIN HAUG DO | ||||||||||||||
| ER PHYSICIAN/CMO | $380,949 | $0 | $0 | $0 | $400 | $0 | $2,000 | $0 | $2,836 | $0 | $386,185 | $0 | $0 | $0 |
| KELLY ROSS DO | ||||||||||||||
| ORTHOPEDIC SURGEON | $535,537 | $0 | $0 | $0 | $39,951 | $0 | $2,000 | $0 | $0 | $0 | $577,488 | $0 | $0 | $0 |
| DAVID CARR MD | ||||||||||||||
| OB/GYN | $273,203 | $0 | $0 | $0 | $1,422 | $0 | $2,000 | $0 | $0 | $0 | $276,625 | $0 | $0 | $0 |
| LYNNE OTT | ||||||||||||||
| VP OF NURSING SERVICES | $144,742 | $0 | $39,000 | $0 | $1,699 | $0 | $2,000 | $0 | $4,269 | $0 | $191,710 | $0 | $0 | $0 |
| DENNIS SOUSLEY | ||||||||||||||
| VP OF CLINICAL SERVICES | $154,572 | $0 | $0 | $0 | $7,612 | $0 | $2,000 | $0 | $3,184 | $0 | $167,368 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | NON-FIXED PAYMENTS: NON-FIXED PAYMENTS MADE TO RONALD OTT AND LYNNE OTT WERE BASED ON PERFORMANCE OF THE INDIVIDUALS AND ORGANIZATION. BONUSES ARE PAID TO INDIVIDUALS WHO HAVE CONTRIBUTED POSITIVELY OT 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. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO | ||||||||
| A | 431386697 | 79516LAD6 | 2005-12-22 | $10,000,000 | CONSTRUCTION REVENUE BONDS | false | false | false |
| INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO | ||||||||
| B | 430980296 | 79516LBC7 | 2010-11-29 | $12,218,468 | 1998 BOND REFINANCING | false | false | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $1,685,000 | $0 | $10,365,462 | $683,736 | $0 | $0 | $193,724 | $0 | $0 | $9,806,276 | $0 | $0 | 2007 | false | false | Yes (true) | Yes (true) |
| B | $1,975,000 | $0 | $12,218,468 | $1,128,766 | $0 | $11,985,656 | $232,812 | $0 | $0 | $0 | $0 | $0 | 2010 | Yes (true) | false | Yes (true) | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Remedial Action TakenRemedialActionTakenInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|
| A | false | false | false | false | 0 | false | false | false | Yes (true) |
| B | 0 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Business Name Line1GICProviderName/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 (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE K, PART II, LINE 3 | TOTAL PROCEEDS OF ISSUE: TOTAL PROCEEDS OF ISSUE INCLUDE INVESTMENT EARNINGS ON BOND PROCEEDS WITH ISSUE PRICE OF $10,000,000 REPORTED ON SCHEDULE K, PART 1, LINE A, COLUMN (E). |
| SCHEDULE K, PART IV, LINE 2C, COLUMN A | DATE OF REBATE COMPUTATION: THE REBATE COMPUTATION FOR THE PERIOD OF DECEMBER 22, 2005 TO DECEMBER 1, 2010 OCCURED ON JANUARY 21, 2011. |
Schedule 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 | $2,608 | 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 | $7,167 | 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 | 19 | ContributionCnt |
| Noncash Contributions Rpt F990 | $2,608 | 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) | OFFICE EQUIP | 13 | $10,015 | FMV |
| Yes (X) | VACATION PKGS | 3 | $5,730 | COST |
| Yes (X) | TICKETS | 11 | $1,809 | 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 (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A | PROGRAM SERVICES ACTIVITY #1: FOR THE FISCAL YEAR ENDED APRIL 30, 2015, THE EMERGENCY ROOM EXPERIENCED 12,781 PATIENT VISITS. THE SURGICAL TEAM PERFORMED 389 IN-PATIENT AND 2,031 OUT-PATIENT PROCEDURES. THE RADIOLOGY GROUP PERFORMED 28,995 PROCEDURES WHICH INCLUDED 2,199 MAMMOGRAMS, 4,277 CT SCANS, 2,147 MRI'S, 2,781 ULTRASOUND IMAGES AND 1,977 NUCLEAR MEDICINE SCANS. THE LABORATORY TEAM PERFORMED 89,592 TESTS. THE RESPIRATORY THERAPY DEPARTMENT CONDUCTED 32,761 PATIENT TREATMENTS AND THE REHABILITATIVE SERVICES GROUP WHICH INCLUDES PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES PROVIDED 43,361 PATIENT ENCOUNTERS. |
| FORM 990, PART III, LINE 4D | OTHER PROGRAM SERVICES: A CARDIO-PULMONARY WELLNESS CENTER IS LOCATED ON THE CAMPUS AND STAFFED BY A REGISTERED DIETICIAN AND A REGISTERED NURSE TO COUNSEL AND EDUCATE PATIENTS ON HEALTHY LIVING THROUGH EXERCISE AND NUTRITION WITH SPECIAL EMPHASIS ON DIABETES MANAGEMENT. THROUGHOUT THE YEAR, THE STAFF ENCOUNTERED 1,689 PATIENT VISITS AT THE FACILITY. IN ADDITION, THE STAFF EDUCATED 1,623 RESIDENTS IN THE SURROUNDING COMMUNITIES AT NO CHARGE THROUGH PARTICIPATION IN HEALTH FAIRS AND OTHER SOCIAL VENUES. THE HOSPITAL OFFERS CHILDBIRTH CLASSES AT A MINIMAL FEE WHICH COVERS THE COST OF THE EDUCATIONAL MATERIAL PRESENTED TO EACH PARTICIPANT. EACH YEAR, THE HOSPITAL HOSTS A COMMUNITY HEALTH FAIR OFFERING EDUCATION ON A VARIETY OF HEALTH ISSUES AND ROUTINE HEALTH SCREENINGS. MOST TESTING IS FREE, HOWEVER, PARTICIPANTS REQUESTING CERTAIN BLOOD TESTS PAY ONLY WHAT IT COSTS THE HOSPITAL FOR LABORATORY PROCESSING. FITZGIBBON IS A WILLING PARTICIPANT IN A COMMUNITY WIDE COMMITTEE TO HELP IMPROVE ACCESS TO HEALTH CARE IN THE AREA. HOSPITAL PERSONNEL ARE ENCOURAGED AND PROVIDED OPPORTUNITIES TO SERVE THE COMMUNITY THROUGH INVOLVEMENT IN VARIOUS COMMUNITY ORGANIZATIONS AS VOLUNTEER MEMBERS, OFFICERS, AND SPEAKERS ON HEALTH RELATED TOPICS. |
| FORM 990, PART VI, SECTION A, LINE 2 | FAMILY RELATIONSHIPS: RONALD OTT, PRESIDENT AND CEO, IS MARRIED TO LYNNE OTT, VP OF NURSING SERVICES, KEY EMPLOYEE. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBERS, STOCKHOLDERS, OR OTHER PERSONS: THE MEDICAL STAFF OF THE ORGANIZATION ELECTS THE CHIEF OF MEDICAL STAFF WHO IS A VOTING MEMBER OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11B | REVIEW OF FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. A DRAFT OF THE RETURN IS REVIEWED 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, LINE 15A & 15B | COMPENSATION DETERMINATION: THE ORGANIZATION USES INDUSTRY DATA IN DETERMINING COMPENSATION FOR THE CEO AND OTHER OFFICERS/KEY EMPLOYEES. FITZGIBBON HOSPITAL HAS AN AGREEMENT WITH BOONE HOSPITAL CENTER WHICH ALLOWS BOONE HOSPITAL TO OVERSEE AND ASSIST IN EVALUATING THE WORK AND PERFORMANCE OF THE PRESIDENT OF THE HOSPITAL AND IN DETERMINING THE COMPENSATION AND BENEFITS TO WHICH THE PRESIDENT WILL BE ENTITLED, THEREFORE, THE COMPENSATION WAS DETERMINED BY BOONE HOSPITAL IN CONSULTATION WITH THE FITZGIBBON HOSPITAL BOARD PRESIDENT. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO BE VIEWED IN THE ADMINISTRATION DEPARTMENT UPON WRITTEN REQUEST. |
| FORM 990, PART VII, SECTION A | BOARD MEMBER COMPENSATION: NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS DIRECTORS. BOARD MEMBER LORENZO ROMNEY IS EMPLOYED BY JOHN FITZGIBBON MEMORIAL HOSPITAL AND COMPENSATED FOR HIS ROLES AS A HOSPITALIST & FAMILY PRACTICE PHYSICIAN. |
| FORM 990, PART X, LINE 20 | TAX EXEMPT BONDS: JOHN FITZGIBBON MEMORIAL HOSPITAL RECEIVED QUALIFIED HOSPITAL BOND PROCEEDS FROM 2005 AND 2010 BOND ISSUES. A PORTION OF THE BOND PROCEEDS WERE ALLOCATED TO FITZGIBBON HEALTH SERVICES FOR AUDIT AND TAX PURPOSES. INFORMATION ABOUT THE BONDS ARE REPORTED ON JOHN FITZGIBBON MEMORIAL HOSPITAL'S SCHEDULE K. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FITZGIBBON HEALTH SERVICES | 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 | $115,258 | FMV |
| FITZGIBBON HEALTH SERVICES | ||
| Q | $663,126 | FMV |