JOHN FITZGIBBON MEMORIAL HOSPITAL INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: JOHN FITZGIBBON MEMORIAL HOSPITAL INC (EIN 44-0655986)
Tax period: 2012-05-01 to 2013-04-30
Filed: 2014-03-14
IRS object ID: 201420739349300037
Schema version: 2012v2.3
Source: Download XML · Original 990 at ProPublica

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

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

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-03-14T14:07:19-05:00	Timestamp
Tax Period End Date	2013-04-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	910 E ST LOUIS 200/PO BOX 1190	AddressLine1
City	SPRINGFIELD	City
State	MO	State
ZIP Code	658062523	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-05-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	440655986	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	JOHN FITZGIBBON MEMORIAL HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
In Care Of Name	% ROBERTA NIENHUESER	InCareOfName
Name Control	JOHN	NameControl
Phone	6608867431	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2305 S 65 HIGHWAY	AddressLine1
Address Line2	PO BOX 250 Suite	AddressLine2
City	MARSHALL	City
State	MO	State
ZIP Code	65340	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	RONALD A OTT	Name
Title	PRESIDENT/CEO	Title
Phone	6608867431	Phone
Date Signed	2014-03-06	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Brian D Todd	Name
Phone	4178658701	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	RONALD A OTT	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	2305 S 65 HIGHWAY	AddressLine1
City	MARSHALL	City
State	MO	State
ZIP Code	65340	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	55079871	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.fitzgibbon.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1923	YearFormation
State Legal Domicile	MO	StateLegalDomicile
Activity Or Mission Description	TO IMPROVE THE HEALTH OF OUR COMMUNITY BY OFFERING QUALITY HEALTH CARE SERVICES, IMPROVING ACCESS & OUTCOMES, EMPOWERING THE COMMUNITY & PEOPLE WE SERVE, & PARTICIPATING IN HEALTH CARE PARTNERSHIPS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	12	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	627	TotalNbrEmployees
Total Nbr Volunteers	60	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	215558	ContributionsGrantsPriorYear
Contributions Grants Current Year	208149	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	54203327	ProgramServiceRevenuePriorYear
Program Service Revenue CY	54489658	ProgramServiceRevenueCY
Investment Income Prior Year	227551	InvestmentIncomePriorYear
Investment Income Current Year	249357	InvestmentIncomeCurrentYear
Other Revenue Prior Year	45384	OtherRevenuePriorYear
Other Revenue Current Year	14541	OtherRevenueCurrentYear
Total Revenue Prior Year	54691820	TotalRevenuePriorYear
Total Revenue Current Year	54961705	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	12000	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	12000	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	22977067	SalariesEtcPriorYear
Salaries Etc Current Year	24747211	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	40852	TotalFundrsngExpCurrentYear
Other Expense Prior Year	29846908	OtherExpensePriorYear
Other Expenses Current Year	27653450	OtherExpensesCurrentYear
Total Expenses Prior Year	52835975	TotalExpensesPriorYear
Total Expenses Current Year	52412661	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	1855845	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	2549044	RevenuesLessExpensesCY
Total Assets BOY	55752440	TotalAssetsBOY
Total Assets EOY	58481007	TotalAssetsEOY
Total Liabilities BOY	22649341	TotalLiabilitiesBOY
Total Liabilities EOY	22842176	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	33103099	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	35638831	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	TO IMPROVE THE HEALTH OF OUR COMMUNITY.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	38352421	Expense
Revenue	42472220	Revenue
Description	HOSPITAL SERVICE - FITZGIBBON HOSPITAL IS A 60 BED ACUTE CARE FACILITY SERVING MARSHALL, MO & THE SURROUNDING COMMUNITIES. THE FACILITY PROVIDES STATE OF THE ART HEALTH CARE WITH A 24 HOUR PHYSICIAN-STAFFED EMERGENCY DEPARTMENT, AN INTENSIVE CARE UNIT, IN AND OUT-PATIENT MEDICAL/SURGICAL SERVICES, AN OBSTETRICS UNIT, A BEHAVIOR HEALTH UNIT AND A 24 HOUR HOSPITALIST PROGRAM TO SERVE IN-PATIENT NEEDS AT ALL TIMES. ANCILLARY SERVICES SUCH AS RADIOLOGY, LABORATORY, RESPIRATORY THERAPY & REHABILITATIVE SERVICES ARE AVAILABLE ON SITE. FOR MORE INFORMATION, SEE SCHEDULE O.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	5104257	Expense
Revenue	5259248	Revenue
Description	CLINIC SERVICE-SPECIALTY CLINICS WITHIN THE HOSPITAL PROVIDE ORTHOPEDIC, WOUND CARE, NEUROLOGIC & PAIN MANAGEMENT SERVICES TO BOTH IN & OUT-PATIENTS. THESE CLINICS PROVIDED SERVICES TO 13,448 PATIENTS. THE HOSPITAL ALSO SUPPORTS A SEPARATE OUT-PATIENT CLINIC ON CAMPUS FOR FAMILY MEDICINE, OB/GYN, GENERAL SURGERY & PSYCHIATRY STAFFED MEDICAL PROFESSIONALS PRACTICING IN THESE SPECIALTIES FOR FISCAL YEAR 2013. THIS CLINIC PROVIDED SERVICES FOR 18,789 PATIENT VISITS. TWO SATELLITE FAMILY PRACTICE CLINICS ARE ALSO SUPPORTED BY THE HOSPITAL. THESE CLINICS PROVIDED SERVICES FOR 14,544 PATIENT VISITS.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	1204018	Expense
Grants	12000	Grants
Revenue	1957520	Revenue
Description	COMMUNITY HEALTH SERVICES - HOSPICE, HOME HEALTH, & HOMEMAKER SERVICES. HOSPICE PROVIDED 4,043 PALLIATIVE CARE VISITS, 168 WERE FREE FOR PATIENTS W/O INSURANCE. HOME HEALTH PROVIDED 6,740 VISITS & HOMEMAKER PERFORMED 11,854 HOURS OF SERVICE TO RESIDENTS. THE COMMUNITY SERVICES GROUP ALSO COORDINATES PARTICIPATION IN THE OATS TRANSPORTATION PROGRAM BY PERFORMING THE SCHEDULING FOR ALL RIDERS. THE HOSPITAL DONATES $12,000 ANNUALLY TO OATS TO HELP SUSTAIN IT IN THE MARSHALL COMMUNITY. THE PROGRAM PROVIDED TRANSPORTATION FOR 3,587 RIDERS DURING FY 2013.	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	639732	TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev	4800670	TotalOfOtherProgramServiceRev
Total Program Service Expense	45300428	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	true	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	true	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	true	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	true	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	true	RelatedOrgControlledEntity
Transaction Related Entity	true	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	127	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	627	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	true	QuidProQuoContributions
Quid Pro Quo Disclosure	true	QuidProQuoDisclosure
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	12	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	NumberIndependentVotingMembers
Family Or Business Relationship	true	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	false	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	ROBERTA NIENHUESER	NamePerson
Telephone Number	6608313251	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2305 S 65 HIGHWAY PO BOX 250	AddressLine1
City	MARSHALL	City
State	MO	State
ZIP Code	65340	ZIPCode

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

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
FRED UTLAUT
PRESIDENT	1.0	1.0	X	X	0	0	0
WILLIAM L SUMMERS
VICE PRESIDENT	1.0	1.0	X	X	0	0	0
DON VOGELSMEIER
SECRETARY/TREASURER	1.0	1.0	X	X	0	0	0
VIRGINIA HUPP
DIRECTOR	1.0	1.0	X		0	0	0
ROOK EVANS
DIRECTOR	1.0	1.0	X		0	0	0
B F KNIPSCHILD MD
DIRECTOR	1.0	1.0	X		0	0	0
RANDY MORROW
DIRECTOR	1.0	1.0	X		0	0	0
JAMES SOWASH MD
DIRECTOR	1.0	1.0	X		0	0	0
JACK UHRIG MD
DIRECTOR	1.0	1.0	X		0	0	0
GAYLE CARTER
DIRECTOR	1.0	1.0	X		0	0	0
SHARI THOMPSON MD
MEDICAL STAFF PRESIDENT	40.0	1.0	X		129242	0	2000
BILL JACKSON
DIRECTOR	1.0	1.0	X		0	0	0
RONALD A OTT
PRESIDENT/CEO	40.0	1.0		X	282546	0	12704
ROBERTA NIENHUESER
VP FINANCIAL SERVICES	40.0	1.0		X	141922	0	8728
LYNNE OTT
VP PATIENT CARE SERVICES	40.0				175416	0	3414	X
DENNIS SOUSLEY
VP CLINICAL SERVICES	40.0				174809	0	4735	X
KELLY ROSS DO
ORTHOPEDIC SURGEON	40.0				561501	0	2000		X
JOHN B BRIZENDINE MD
GENERAL SURGEON	40.0				333253	0	7000		X
CRAIG SIMMONS DO
HOSPITALIST/ER PHYSICIAN	40.0				317695	0	2466		X
REUEL GREGORY DO
ER PHYSICIAN	40.0				245928	0	7643		X
LORENZO ROMNEY DO
HOSPITALIST/FP PHYSICIAN	40.0				255455	0	2466		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2617767	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	53156	TotalOtherCompensation
Number Individuals GT100 K	18	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Description Of ServicesDescriptionOfServices	CompensationCompensation
PHARMACY SYSTEMS INC
PHARMACY MANAGEMENT	620202
WATERSTONE BENEFIT
ADMINISTRATOR	514658
SIEMENS MEDICAL SOLUTIONS
MAINTENANCE	364006
SEPTAGON CONSTRUCTION CO
CONSTRUCTION	288232
THOMAS LAIRD MD
ER PHYSICIAN	268343

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	24	NumberOfContractorsGT100K
Fundraising Events	91774	FundraisingEvents
Government Grants	42225	GovernmentGrants
All Other Contributions	74150	AllOtherContributions
Total Contributions	208149	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE	900099	52482745	52482745
EHR INCENTIVE REVENUE	900099	1651000	1651000
CAFETERIA	722514	246869	246869
MANAGEMENT FEES	561000	60000	60000
OTHER REVENUE	900099	49044	49044

Field	Value	IRS element (for citing)
Total Program Service Revenue	54489658	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	231983	TotalRevenueColumn
Exclusion	$231,983	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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

Royalties Revenue RoyaltiesRevenue

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

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	3722	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	3722	Real
Personal	0	Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	3722	TotalRevenueColumn
Exclusion	$3,722	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	96910	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	79536	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Other	17374	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	17374	TotalRevenueColumn
Exclusion	$17,374	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	49449	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	91774	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	38630	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	10819	TotalRevenueColumn
Exclusion	$10,819	ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

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

Net Income Or Loss NetIncomeOrLoss

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

Field	Value	IRS element (for citing)
Total Other Revenue	0	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	54961705	TotalRevenueColumn
Related Or Exempt Function Income	54489658	RelatedOrExemptFunctionIncome
Exclusion	$263,898	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	12000	Total
Program Services	12000	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	921294	Total
Program Services	471869	ProgramServices
Management And General	449425	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	42852	Total
Program Services	42852	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	19831492	Total
Program Services	16957144	ProgramServices
Management And General	2837700	ManagementAndGeneral
Fundraising	36648	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	214826	Total
Program Services	184211	ProgramServices
Management And General	30615	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	2301152	Total
Program Services	1978513	ProgramServices
Management And General	322639	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	1435595	Total
Program Services	1222008	ProgramServices
Management And General	210833	ManagementAndGeneral
Fundraising	2754	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	55448	Total
Management And General	55448	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	114600	Total
Management And General	114600	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	4462223	Total
Program Services	3260971	ProgramServices
Management And General	1201252	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	155498	Total
Program Services	95747	ProgramServices
Management And General	59751	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	3296148	Total
Program Services	2611001	ProgramServices
Management And General	683697	ManagementAndGeneral
Fundraising	1450	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	0	Total

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	589270	Total
Program Services	506579	ProgramServices
Management And General	82691	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	229452	Total
Program Services	201969	ProgramServices
Management And General	27483	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	78133	Total
Program Services	32615	ProgramServices
Management And General	45518	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	862989	Total
Program Services	722662	ProgramServices
Management And General	140327	ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	2875324	Total
Program Services	2407781	ProgramServices
Management And General	467543	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	608431	Total
Program Services	468649	ProgramServices
Management And General	139782	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
BAD DEBT	6829363	6829363
MEDICAL SUPPLIES & DRUGS	4443540	4443540
PROVIDER TAX	2731309	2731309
RECRUITING & RETENTION	321722	119645	202077

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	52412661	Total
Program Services	45300428	ProgramServices
Management And General	7071381	ManagementAndGeneral
Fundraising	40852	Fundraising

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

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	4144337	BOY
EOY	4477769	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	14273733	BOY
EOY	16881503	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	9132104	BOY
EOY	5484045	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	1067081	BOY
EOY	1095723	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	956364	BOY
EOY	926046	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	54289889	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	31561274	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	21813547	BOY
EOY	22728615	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	4150421	BOY
EOY	3170309	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	214853	BOY
EOY	3716997	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	55752440	BOY
EOY	58481007	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	5410671	BOY
EOY	4758316	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	16554667	BOY
EOY	16879280	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Loans From Officers Directors LoansFromOfficersDirectors

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	684003	BOY
EOY	1204580	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	22649341	BOY
EOY	22842176	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	32105961	BOY
EOY	34550755	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	541921	BOY
EOY	632859	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	455217	BOY
EOY	455217	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	33103099	BOY
EOY	35638831	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	55752440	BOY
EOY	58481007	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	2549044	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	-13312	ReconciliationUnrealizedInvest
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	true	AuditCommittee
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

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)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbying
Total Direct Lobbying		TotalDirectLobbying
Total Lobbying Expenditures		TotalLobbyingExpenditures
Other Exempt Purpose Expenditures		OtherExemptPurposeExpenditures
Total Exempt Purpose Expenditures		TotalExemptPurposeExpenditures
Lobbying Nontaxable		LobbyingNontaxableAmount
Grassroots Nontaxable		GrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non Tx		TotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying Nontx		TotLobbyExpendMnsLobbyingNontx
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	false	GrantsOtherOrganizations
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	true	OtherActivities
Other Activities	$5,897	OtherActivitiesAmount
Total Lobbying Expenditures IIB	5897	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	OTHER LOBBYING ACTIVITIES	Identifier
Return Reference	SCHEDULE C, PART II-B, LINE 1(I)	ReturnReference
Explanation	THE ORGANIZATION PAYS DUES TO THE MISSOURI HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THESE DUES ARE ALLOCATED TO LOBBYING.	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	719060	BeginningOfYearBalance
Investment Earnings Or Losses	20163	InvestmentEarningsOrLosses
Grants Or Scholarships	1000	GrantsOrScholarships
Other Expenditures	4800	OtherExpenditures
Administrative Expenses	60	AdministrativeExpenses
End Of Year Balance	733363	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	694769	BeginningOfYearBalance
Investment Earnings Or Losses	24351	InvestmentEarningsOrLosses
Administrative Expenses	60	AdministrativeExpenses
End Of Year Balance	719060	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	677227	BeginningOfYearBalance
Investment Earnings Or Losses	21898	InvestmentEarningsOrLosses
Other Expenditures	4296	OtherExpenditures
Administrative Expenses	60	AdministrativeExpenses
End Of Year Balance	694769	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	618998	BeginningOfYearBalance
Contributions	25296	Contributions
Investment Earnings Or Losses	36603	InvestmentEarningsOrLosses
Other Expenditures	3670	OtherExpenditures
End Of Year Balance	677227	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	579322	BeginningOfYearBalance
Investment Earnings Or Losses	39676	InvestmentEarningsOrLosses
End Of Year Balance	618998	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.26620	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.62073	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.11308	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	71000	OtherCostOrOtherBasis
Book Value	71000	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	23830723	OtherCostOrOtherBasis
Depreciation	9438198	Depreciation
Book Value	14392525	BookValue

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovements

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	27739552	OtherCostOrOtherBasis
Depreciation	21370422	Depreciation
Book Value	6369130	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2648614	OtherCostOrOtherBasis
Depreciation	752654	Depreciation
Book Value	1895960	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	22728615	TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescription	Book ValueBookValue
INTEREST RECEIVABLE	48177
OTHER RECEIVABLES	2677964
EST AMT DUE FROM 3RD PTY PYRS	908569
DUE FROM RELATED PARTY	82287

Field	Value	IRS element (for citing)
Total Book Value Other Assets	3716997	TotalBookValueOtherAssets
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
EST AMT DUE TO 3RD PTY PYRS	$904,007
ESTIMATED SELF INSURANCE COSTS	$300,573

Field	Value	IRS element (for citing)
Total Of Amounts	1204580	TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt	48157660	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	-13312	NetUnrealizedGainsInvestments
Other Revenues	-6829363	OtherRevenues
Revenue Not Rptd F990	-6842675	RevenueNotRptdF990
Revenue Subtotal	55000335	RevenueSubtotal
Other Revenues Not Included	-38630	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	-38630	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	54961705	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	45621928	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	38630	OtherExpensesIncluded
Expenses Not Rptd F990	38630	ExpensesNotRptdF990
Expenses Subtotal	45583298	ExpensesSubtotal
Other Expenses Not Included	6829363	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	6829363	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	52412661	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ENDOWMENT FUNDS	SCHEDULE D, PART V, LINE 4	THE ORGANIZATION HAS ENDOWMENT FUNDS FROM THE L.P. ADAMS FUND. PER THE AGREEMENT, THE INCOME FROM THE FUND IS USED FOR GENERAL PURPOSES OF THE HOSPITAL. THE ORGANIZATION ALSO HAS FUNDS FROM THE BUCKNER ENDOWMENT. THESE FUNDS ARE RESTRICTED TO INVESTMENTS IN EQUIPMENT FOR THE BUCKNER WELLNESS CENTER. FINALLY, THE ORGANIZATION HAS FUNDS FROM THE NURSING ENDOWMENT SCHOLARSHIP FUND. THIS FUND WAS CREATED TO PROVIDE NURSING SCHOLARSHIPS TO SALINE COUNTY RESIDENTS ATTENDING THE NURSING PROGRAM AT THE MO VALLEY COLLEGE IN MARSHALL, MISSOURI. IN THE EVENT THAT THE MO VALLEY COLLEGE DOES NOT HAVE A NURSING PROGRAM, SCHOLARSHIPS CAN BE USED FOR NURSING PROGRAMS IN SURROUNDING AREAS.
UNCERTAIN TAX POSITION	SCHEDULE D, PART X, LINE 2	MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
OTHER REVENUE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12	SCHEDULE D, PART XI, LINE 2D	$ (6,829,363) BAD DEBT EXPENSE
OTHER REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1	SCHEDULE D, PART XI, LINE 4B	$ (38,630) SPECIAL EVENTS EXPENSES
OTHER EXPENSE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25	SCHEDULE D, PART XII, LINE 2D	$ 38,630 SPECIAL EVENTS EXPENSES
OTHER EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1	SCHEDULE D, PART XII, LINE 4B	$ 6,829,363 BAD DEBT EXPENSE

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	SPRING FLING	NameOfEvent1
Gross Receipts Event1	58402	GrossReceiptsEvent1
Charitable Contributions Event1	39880	CharitableContributionsEvent1
Gross Revenue Event1	18522	GrossRevenueEvent1
Rent Facility Costs Event1	1093	RentFacilityCostsEvent1
Food And Beverage Event1	5356	FoodAndBeverageEvent1
Other Direct Expenses Event1	6521	OtherDirectExpensesEvent1
Name Of Event2	GOLF TOURNEY	NameOfEvent2
Gross Receipts Event2	38276	GrossReceiptsEvent2
Charitable Contributions Event2	19042	CharitableContributionsEvent2
Gross Revenue Event2	19234	GrossRevenueEvent2
Cash Prizes Event2	5245	CashPrizesEvent2
Non Cash Prizes Event2	4001	NonCashPrizesEvent2
Rent Facility Costs Event2	1492	RentFacilityCostsEvent2
Food And Beverage Event2	1668	FoodAndBeverageEvent2
Other Direct Expenses Event2	1561	OtherDirectExpensesEvent2
Total Number Of Other Events	2	TotalNumberOfOtherEvents
Gross Receipts Other Events	44545	GrossReceiptsOtherEvents
Charitable Contrib Other Events	32852	CharitableContribOtherEvents
Gross Revenue Other Events	11693	GrossRevenueOtherEvents
Food And Beverage Other Events	220	FoodAndBeverageOtherEvents
Other Direct Expenses Other Events	11473	OtherDirectExpensesOtherEvents
Gross Receipts Total	141223	GrossReceiptsTotal
Charitable Contributions Total	91774	CharitableContributionsTotal
Gross Revenue Total Events	49449	GrossRevenueTotalEvents
Cash Prizes Total Events	5245	CashPrizesTotalEvents
Non Cash Prizes Total Events	4001	NonCashPrizesTotalEvents
Rent Facility Costs Total Events	2585	RentFacilityCostsTotalEvents
Food And Beverage Total Events	7244	FoodAndBeverageTotalEvents
Other Direct Expenses Total Events	19555	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	38630	DirectExpenseSummaryEvents
Net Income Summary	10819	NetIncomeSummary

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent100	X	Pcent100
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent200 D	X	Pcent200D
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	false	ExpensesExceededBudget
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	181874	TotalCommunityBenefitExpense
Net Community Benefit Expense	181874	NetCommunityBenefitExpense
Percent Of Total Expense	0.00400	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	10505458	TotalCommunityBenefitExpense
Direct Offsetting Revenue	8511115	DirectOffsettingRevenue
Net Community Benefit Expense	1994343	NetCommunityBenefitExpense
Percent Of Total Expense	0.04370	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	10687332	TotalCommunityBenefitExpense
Direct Offsetting Revenue	8511115	DirectOffsettingRevenue
Net Community Benefit Expense	2176217	NetCommunityBenefitExpense
Percent Of Total Expense	0.04770	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	27282	TotalCommunityBenefitExpense
Direct Offsetting Revenue	8126	DirectOffsettingRevenue
Net Community Benefit Expense	19156	NetCommunityBenefitExpense
Percent Of Total Expense	0.00040	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	620864	TotalCommunityBenefitExpense
Net Community Benefit Expense	620864	NetCommunityBenefitExpense
Percent Of Total Expense	0.01360	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	5815433	TotalCommunityBenefitExpense
Direct Offsetting Revenue	4666131	DirectOffsettingRevenue
Net Community Benefit Expense	1149302	NetCommunityBenefitExpense
Percent Of Total Expense	0.02520	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	12000	TotalCommunityBenefitExpense
Net Community Benefit Expense	12000	NetCommunityBenefitExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6475579	TotalCommunityBenefitExpense
Direct Offsetting Revenue	4674257	DirectOffsettingRevenue
Net Community Benefit Expense	1801322	NetCommunityBenefitExpense
Percent Of Total Expense	0.03950	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	17162911	TotalCommunityBenefitExpense
Direct Offsetting Revenue	13185372	DirectOffsettingRevenue
Net Community Benefit Expense	3977539	NetCommunityBenefitExpense
Percent Of Total Expense	0.08720	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$6,829,363	BadDebtExpenseAmount
Amount Attributable To	2868333	AmountAttributableTo
Amount Reimbursed By Medicare	12522306	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	14046353	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-1524047	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	JOHN FITZGIBBON MEMORIAL HOSPITAL	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	2305 S 65 HIGHWAY	AddressLine1
City	MARSHALL	City
State	MO	State
ZIP Code	65340	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours
Other	ORTHO, WOUND CARE, REHAB, ONCOLOGY, PAIN, NEUROLOGIC	Other

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	JOHN FITZGIBBON MEMORIAL HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	true	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Information Gaps	X	InformationGaps
Needs Assessment Conducted	12	NeedsAssessmentConducted
Take Into Account	true	TakeIntoAccount
Other Facilities	false	OtherFacilities
CHNA Widely Available	true	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Other Method	X	OtherMethod
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Participate Community Plan	X	ParticipateCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Adopt Budget	X	AdoptBudget
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	false	AllNeedsAddressed
Organization Incur Excise Tax	false	OrganizationIncurExciseTax
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	100	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	200.	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Provided On Admission	X	ProvidedOnAdmission
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	true	ActionsOnNonpayment
Permit Other Actions	X	PermitOtherActions
Collection Activities	false	CollectionActivities
Notify Upon Admission	X	NotifyUponAdmission
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Lowest Negotiated Rates	X	LowestNegotiatedRates
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	5	NumberOfOtherFacilities

Other Facilities OtherFacilities (5 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
FITZGIBBON PROFESSIONAL BUILDING
2301 S 65 HIGHWAY	MARSHALL	MO	65340	OB/GYN, SURGERY, FAMILY PRACTICE, MENTAL HEALTH CLINIC
FITZGIBBON COMMUNITY HOME HEALTH CARE
2303 S 65 HIGHWAY	MARSHALL	MO	65340	HOME HEALTH, HOSPICE, HOMEMAKER
AKEMAN MCBURNEY MEDICAL CLINIC
420 WEST FRONT STREET	SLATER	MO	65349	OFFSITE MEDICAL CLINIC
GRAND RIVER MEDICAL CLINIC
815 EAST BROADWAY	BRUNSWICK	MO	65236	OFFSITE MEDICAL CLINIC
BUCKNER WELLNESS CENTER
2299 S 65 HIGHWAY	MARSHALL	MO	65340	CARDIAC/PULMONARY WELLNESS

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
PERCENT OF TOTAL EXPENSE	SCHEDULE H, PART I, LINE 7, COLUMN F	TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990 ($52,412,661) WAS REDUCED BY BAD DEBT EXPENSE ($6,829,363).
COSTING METHODOLOGY	SCHEDULE H, PART I, LINE 7	THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. IRS WORKSHEET 6 USED INTERNAL COST ACCOUNTING METHODOLOGY.
BAD DEBT EXPENSE	SCHEDULE H, PART III, SECTION A, LINES 2, 3 & 4	THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE. THAT FOOTNOTE READS AS FOLLOWS: 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. THE ORGANIZATION REPORTED BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS FROM THE AUDITED FINANCIAL STATEMENTS. 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.
COMMUNITY BENEFIT RATIONALE	SCHEDULE H, PART III, SECTION B, LINE 8	MEDICARE DATA COMPUTED USING THE MEDICARE COST REPORT FILED WITH CMS WAS UTILIZED FOR THE COMPUTATIONS IN PART III, SECTION B. SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.
COLLECTION POLICY	SCHEDULE H, PART III, SECTION C, LINE 9B	THE ORGANIZATION'S BILLING AND PAYMENT POLICY NOTES: IF ACCOUNTS HAVE ALREADY BEEN CONSIDERED "BAD DEBT" BY FITZGIBBON HOSPITAL AND CLINICS THEN FINANCIAL ASSISTANCE/CHARITY CARE IS NOT AN OPTION. "BAD DEBT" IS DEFINED AS EXPENSES RESULTING FROM TREATMENT FOR SERVICES PROVIDED TO A PATIENT WHO HAS NOT MET THEIR FINANCIAL OBLIGATION NOR SET UP AN AGREEABLE PAYMENT ARRANGEMENT WITH FITZGIBBON HOSPITAL AND CLINICS WITHIN 120 DAYS FROM THE DATE THE PATIENT HAS BEEN MADE RESPONSIBLE FOR ANY BALANCES DUE EITHER AFTER INSURANCE HAS PAID THEIR PORTION OR WHEN NO INSURANCE IS INVOLVED.
CHNA COMMUNITY INPUT	SCHEDULE H, PART V, SECTION B, LINE 3	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.
CHNA AVAILABILITY TO PUBLIC	SCHEDULE H, PART V, SECTION B, LINE 5C	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.
IMPLEMENTATION STRATEGY	SCHEDULE H, PART V, SECTION B, LINE 6	IN RESPONSE TO THE RESULTS OF THE ORGANIZATION'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION ADOPTED AN IMPLEMENTATION STRATEGY. THE IMPLEMENTATION PLAN IS ATTACHED TO THE RETURN.
ADDRESSING NEEDS IDENTIFIED IN THE CHNA	SCHEDULE H, PART V, SECTION B, LINE 7	THE NEEDS NOT DIRECTLY ADDRESSED IN THE CHNA IMPLEMENTATION STRATEGY 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.
COLLECTION ACTIONS	SCHEDULE H, PART V, SECTION B, LINE 16E	COLLECTION ACTIONS AGAINST THE PATIENT WHICH ARE PERMITTED BEFORE MAKING REASONABLE EFFORTS TO DETERMINE THE PATIENT'S ELIGIBILITY UNDER THE FINANCIAL ASSISTANCE POLICY INCLUDE REQUESTING A DEPOSIT FOR ANY NON-LIFE THREATENING SERVICES AND SENDING CLAIMS TO PATIENT FOR 120 DAYS. THIS 120 DAY PERIOD IS TO ALLOW PATIENT TIME TO CONTACT FACILITY FOR FINANCIAL ASSISTANCE OR PAYMENT ARRANGEMENTS BEFORE FURTHER COLLECTION EFFORTS ARE MADE.
NEEDS ASSESSMENT	SCHEDULE H, PART VI, LINE 2	OUR MISSION AT FITZGIBBON HOSPITAL IS TO "IMPROVE THE HEALTH OF OUR COMMUNITY". IN ORDER TO MEET THIS MISSION WE STRIVE TO UNDERSTAND THE NEEDS OF OUR COMMUNITY IN SEVERAL DIFFERENT WAYS. OUR LEADERSHIP AND STAFF ARE MEMBERS OF CIVIC CLUBS, BOARDS, AND COMMITTEES. OUR BOARD OF DIRECTORS IS COMPRISED OF MEMBERS FROM COUNTIES THROUGHOUT OUR SERVICE AREA. WE WORK CLOSELY WITH THE HEALTH DEPARTMENT AND OTHER COMMUNITY AGENCIES. STATE, REGIONAL AND LOCAL MEDIAS ARE USED TO MONITOR NEEDS AT ALL LEVELS. WE ALSO BELONG TO MANY HEALTHCARE RELATED ORGANIZATIONS THAT PROVIDE INFORMATION REGARDING USAGE AND NEEDS OF HEALTHCARE IN OUR SERVICE AREA WHICH IS USED TO EVALUATE WHAT WE NEED TO FOCUS ON TO IMPROVE THE HEALTH IN OUR COMMUNITY.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	SCHEDULE H, PART VI, LINE 3	HOSPITAL USES SEVERAL AVENUES TO PROVIDE PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE. THE PATIENT ACCOUNTS DEPARTMENT DEVELOPED A BROCHURE WHICH IS AVAILABLE TO PATIENTS AT THE TIME OF REGISTRATION. THE BROCHURE OUTLINES WHAT THE PATIENT IS TO EXPECT IN THE BILLING PROCESS, HOW TO CONTACT THE DEPARTMENT, AND WHAT ASSISTANCE IS AVAILABLE. WE HAVE A DETAILED POLICY WHICH OUTLINES PATIENT RESPONSIBILITY AND QUALIFICATIONS FOR CHARITY CARE. OUR PATIENT ACCOUNTS REPRESENTATIVES MEET WITH SELF PAY PATIENTS WHEN THEY ARE IN THE FACILITY TO DISCUSS OUR POLICY. OUR CARE COORDINATORS AND SOCIAL WORKERS ALSO EDUCATE OUR PATIENTS ON ASSISTANCE THEY MAY BE ELIGIBLE FOR UNDER FEDERAL, STATE AND LOCAL GOVERNMENT PROGRAMS. WE ALSO UTILIZE AN OUTSIDE AGENCY TO MAKE CONTACT WITH PATIENTS AND IDENTIFY THOSE THAT MIGHT BE ELIGIBLE FOR ASSISTANCE.
COMMUNITY INFORMATION	SCHEDULE H, PART VI, LINE 4	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.
AFFILIATED HEALTH CARE SYSTEM	SCHEDULE H, PART VI, LINE 6	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)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

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

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2501 MCGUIRE BLVD	AddressLine1
City	COLUMBIA	City
State	MO	State
ZIP Code	65201	ZIPCode

Field	Value	IRS element (for citing)
EIN Of Recipient	431016961	EINOfRecipient
IRC Section	501(C)(3)	IRCSection
Amount Of Cash Grant	12000	AmountOfCashGrant
Purpose Of Grant	COMMUNITY SERVICES	PurposeOfGrant

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	1	TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	MONITORING USE OF GRANT FUNDS	Identifier
Return Reference	SCHEDULE I, PART I, LINE 2	ReturnReference
Explanation	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.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	false	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	true	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
RONALD A OTT
PRESIDENT/CEO	214261	0	67685	0	600	0	2000	0	10704	0	295250	0	0	0
ROBERTA NIENHUESER
VP FINANCIAL SERVICES	121772	0	20000	0	150	0	0	0	8728	0	150650	0	0	0
LYNNE OTT
VP PATIENT CARE SERVICES	145816	0	29000	0	600	0	2000	0	1414	0	178830	0	0	0
DENNIS SOUSLEY
VP CLINICAL SERVICES	156811	0	17000	0	998	0	2000	0	2735	0	179544	0	0	0
KELLY ROSS DO
ORTHOPEDIC SURGEON	521550	0	0	0	39951	0	2000	0	0	0	563501	0	0	0
JOHN B BRIZENDINE MD
GENERAL SURGEON	320000	0	0	0	13252	0	2000	0	5000	0	340253	0	0	0
CRAIG SIMMONS DO
HOSPITALIST/ER PHYSICIAN	316843	0	0	0	852	0	2000	0	466	0	320161	0	0	0
REUEL GREGORY DO
ER PHYSICIAN	211313	0	0	0	34616	0	0	0	7643	0	253571	0	0	0
LORENZO ROMNEY DO
HOSPITALIST/FP PHYSICIAN	239369	0	0	0	16087	0	2000	0	466	0	257921	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII

Field	Value	IRS element (for citing)
Identifier	NON-FIXED PAYMENTS	Identifier
Return Reference	SCHEDULE J, PART I, LINE 7	ReturnReference
Explanation	NON-FIXED PAYMENTS MADE TO RONALD OTT, ROBERTA NIENHUESER, LYNNE OTT, AND DENNIS SOUSLEY WERE BASED ON PERFORMANCE OF THE INDIVIDUALS AND ORGANIZATION. BONUSES ARE PAID TO INDIVIDUALS WHO HAVE CONTRIBUTED POSITIVELY TO THE ORGANIZATION AND THEIR PERFORMANCE HAS ALLOWED THE ORGANIZATION TO MEET DEPARTMENTAL AND ORGANIZATIONAL GOALS AS OUTLINED ON THE ANNUAL PERFORMANCE APPRAISAL. THESE GOALS INCLUDE, BUT ARE NOT LIMITED TO, SAFETY, PATIENT SATISFACTION AND FINANCIAL PERFORMANCE. FITZGIBBON HOSPITAL HAS AN AGREEMENT WITH BOONE HOSPITAL CENTER WHICH ALLOWS BOONE HOSPITAL TO OVERSEE AND ASSIST IN EVALUATING THE WORK AND PERFORMANCE OF THE PRESIDENT OF THE HOSPITAL AND IN DETERMINING THE COMPENSATION AND BENEFITS TO WHICH THE PRESIDENT WILL BE ENTITLED. THEREFORE, THE BONUSES WERE DETERMINED BY BOONE HOSPITAL IN CONSULTATION WITH THE FITZGIBBON HOSPITAL BOARD PRESIDENT. THE BONUS AMOUNTS WERE A PERCENTAGE OF THE BASE SALARIES.	Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCd	Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO
A	431386697	79516LAD6	2005-12-22	10000000	CONSTRUCTION REVENUE BONDS	false	false	false
INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO
B	430980296	79516lbc7	2010-11-29	12218468	1998 BOND REFINANCING	false	false	false

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCd	Amount RetiredAmountRetired	Amount Bond DefeasedAmountBondDefeased	Total ProceedsTotalProceeds	Amount In Reserve FundAmountInReserveFund	Capitalized InterestCapitalizedInterest	Refunding EscrowRefundingEscrow	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Credit EnhancementCreditEnhancement	Working Capital ExpendituresWorkingCapitalExpenditures	Capital ExpendituresCapitalExpenditures	Other Spent ProceedsOtherSpentProceeds	Amount UnspentAmountUnspent	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A	0	0	10365462	0	0	0	193724	0	9806276	0	0	0	2007	false	false	true	true
B	0	0	12218468	0	0	11985656	232812	0	0	0	0	0	2010	false	false	true	true

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers	Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI	Total Private Business UseTotalPrivateBusinessUse	Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest	Change In Use Bond Financed PropChangeInUseBondFinancedProp	Remedial Action TakenRemedialActionTaken	Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A	false	false	false	false	0.00000	0.00000	0.00000	false	false	false	true
B					0

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiled	No Rebate DueNoRebateDue	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Business Name Line1NameOfGICProvider/BusinessNameLine1	Gross Proceeds InvestedGrossProceedsInvested	Written Proc To Monitor ReqsWrittenProcToMonitorReqs	Rebate Not Due YetRebateNotDueYet
0
A	false	true	false	false	false	0	false	true
0
B	false		false	false	false	0	false	true	true

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCd	Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A	true
B	true

Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
TOTAL PROCEEDS OF ISSUE	SCHEDULE K, PART II, LINE 3	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).
DATE OF REBATE COMPUTATION	SCHEDULE K, PART IV, LINE 2C, COLUMN A	THE REBATE COMPUTATION FOR THE PERIOD OF DECEMBER 22, 2005 TO DECEMBER 1, 2010 OCCURED ON JANUARY 21, 2011.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Field	Value	IRS element (for citing)
Name Person	JUDY VOGELSMEIER	NamePerson

Field	Value	IRS element (for citing)
Relationship	SPOUSE OF DON VOGELSMEIER	Relationship
Amount Of Transaction	42852	AmountOfTransaction
Description Of Transaction	EMPLOYEE COMPENSATION	DescriptionOfTransaction
Sharing Of Revenues	false	SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
PROGRAM SERVICES ACTIVITY #1	FORM 990, PART III, LINE 4A	FOR THE FISCAL YEAR ENDED APRIL 30, 2013, THE EMERGENCY ROOM EXPERIENCED 11,991 PATIENT VISITS. THE SURGICAL TEAM PERFORMED 385 IN-PATIENT AND 1,833 OUT-PATIENT PROCEDURES. THE RADIOLOGY GROUP PERFORMED 32,958 PROCEDURES WHICH INCLUDED 3,985 MAMMOGRAMS, 4,788 CT SCANS, 1,889 MRI'S, 3,282 ULTRASOUND IMAGES AND 2,458 NUCLEAR MEDICINE SCANS. THE LABORATORY TEAM PERFORMED 96,413 TESTS. THE RESPIRATORY THERAPY DEPARTMENT CONDUCTED 45,345 PATIENT TREATMENTS AND THE REHABILITATIVE SERVICES GROUP WHICH INCLUDES PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES PROVIDED 18,078 PATIENT ENCOUNTERS.
OTHER PROGRAM SERVICES	FORM 990, PART III, LINE 4D	A CARDIO-PULMONARY WELLNESS CENTER IS LOCATED ON THE CAMPUS AND STAFFED BY A REGISTERED DIETICIAN AND A REGISTERED NURSE TO COUNSEL AND EDUCATE PATIENTS ON HEALTHY LIVING THROUGH EXERCISE AND NUTRITION WITH SPECIAL EMPHASIS ON DIABETES MANAGEMENT. THROUGHOUT THE YEAR, THE STAFF ENCOUNTERED 1,327 PATIENT VISITS AT THE FACILITY. IN ADDITION, THE STAFF EDUCATED 697 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.
FAMILY RELATIONSHIPS	FORM 990, PART VI, SECTION A, LINE 2	RONALD OTT, PRESIDENT AND CEO, IS MARRIED TO LYNNE OTT, VP OF PATIENT CARE SERVICES, KEY EMPLOYEE.
MEMBERS, STOCKHOLDERS, OR OTHER PERSONS	FORM 990, PART VI, SECTION A, LINE 7A	THE MEDICAL STAFF OF THE ORGANIZATION ELECTS THE CHIEF OF MEDICAL STAFF WHO IS A VOTING MEMBER OF THE BOARD.
REVIEW OF FORM 990	FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. A DRAFT OF THE RETURN IS REVIEWED BY THE VP OF FINANCIAL SERVICES AND THE CEO BEFORE BEING FINALIZED. THE 990 IS THEN PRESENTED TO THE BOARD AFTER IT IS FILED.
MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY	FORM 990, PART VI, SECTION B, LINE 12C	THE COMPLIANCE OFFICER MONITORS THE CONFLICT OF INTEREST POLICY AND ANNUALLY REQUIRES OFFICERS, DIRECTORS, AND KEY EMPLOYEES TO SIGN A CONFLICT OF INTEREST DISCLOSURE FORM. 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.
COMPENSATION DETERMINATION	FORM 990, PART VI, SECTION B, LINE 15A & 15B	THE ORGANIZATION USES INDUSTRY DATA IN DETERMINING COMPENSATION FOR THE CEO AND OTHER OFFICERS/KEY EMPLOYEES. FITZGIBBON HOSPITAL HAS AN AGREEMENT WITH BOONE HOSPITAL CENTER WHICH ALLOWS BOONE HOSPITAL TO OVERSEE AND ASSIST IN EVALUATING THE WORK AND PERFORMANCE OF THE PRESIDENT OF THE HOSPITAL AND IN DETERMINING THE COMPENSATION AND BENEFITS TO WHICH THE PRESIDENT WILL BE ENTITLED, THEREFORE, THE COMPENSATION WAS DETERMINED BY BOONE HOSPITAL IN CONSULTATION WITH THE FITZGIBBON HOSPITAL BOARD PRESIDENT.
DOCUMENT DISCLOSURE	FORM 990, PART VI, SECTION C, LINE 19	GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO BE VIEWED IN THE ADMINISTRATION DEPARTMENT UPON WRITTEN REQUEST.
BOARD MEMBER COMPENSATION	FORM 990, PART VII, SECTION A	NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS DIRECTORS. BOARD MEMBER SHARI THOMPSON IS EMPLOYED BY JOHN FITZGIBBON MEMORIAL HOSPITAL AND COMPENSATED FOR HER ROLE AS A FAMILY PRACTICE PHYSICIAN.
TAX EXEMPT BONDS	FORM 990, PART X, LINE 20	JOHN FITZGIBBON MEMORIAL HOSPITAL RECEIVED QUALIFIED HOSPITAL BOND PROCEEDS FROM 2005 AND 2010 BOND ISSUES. A PORTION OF THE BOND PROCEEDS WERE ALLOCATED TO FITZGIBBON HEALTH SERVICES FOR AUDIT AND TAX PURPOSES. INFORMATION ABOUT THE BONDS ARE REPORTED ON JOHN FITZGIBBON MEMORIAL HOSPITAL'S SCHEDULE K.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	FITZGIBBON HEALTH SERVICES	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2305 S 65 HWY PO BOX 250	AddressLine1
City	MARSHALL	City
State	MO	State
ZIP Code	65340	ZIPCode

Field	Value	IRS element (for citing)
EIN	431731173	EIN
Primary Activities	NURSING HOME	PrimaryActivities
Legal Domicile State	MO	LegalDomicileState
Exempt Code Section	501(C)(3)	ExemptCodeSection
Public Charity Status	9	PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	JF MEM HOSP	BusinessNameLine1

Field	Value	IRS element (for citing)
Controlled Org	true	ControlledOrg

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	false	DividendsRelatedOrganization
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	true	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	false	PerformOfServicesByOtherOrgs
Sharing Of Facilities	true	SharingOfFacilities
Sharing Of Paid Employees	true	SharingOfPaidEmployees
Reimbursement Paid To Other Org	true	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	true	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
FITZGIBBON HEALTH SERVICES
L	60000	FMV
FITZGIBBON HEALTH SERVICES
P	146926	FMV
FITZGIBBON HEALTH SERVICES
Q	377136	FMV