JOHN FITZGIBBON MEMORIAL HOSPITAL INC: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization: JOHN FITZGIBBON MEMORIAL HOSPITAL INC (EIN 44-0655986)
Tax period: 2024-05-01 to 2025-04-30
Filed: 2026-03-16
IRS object ID: 202640759349301039
Schema version: 2024v5.1
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)
Return	2026-03-16T12:46:10+00:00	ReturnTs
Tax Period End	2025-04-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	440160260	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	Forvis Mazars 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	2024-05-01	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)
Business Name Control	JOHN	BusinessNameControlTxt
Phone	6608867431	PhoneNum

US Address USAddress

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

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	NANCY HARRIS	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	6608867431	PhoneNum
Signature	2026-03-16	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Brian Todd	PreparerPersonNm
PTIN	P00422601	PTIN
Phone	4178658701	PhoneNum
Preparation	2026-03-16	PreparationDt

Field	Value	IRS element (for citing)
Tax	2024	TaxYr
Build TS	2025-03-06 01:10:19Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

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

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ANGELA P LITTRELL	BusinessNameLine1Txt

US Address USAddress

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

Field	Value	IRS element (for citing)
Gross Receipts	$62,781,338	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	5	VotingMembersGoverningBodyCnt
Voting Members Independent	4	VotingMembersIndependentCnt
Total Employee	529	TotalEmployeeCnt
Total Volunteers	98	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,781,688	PYContributionsGrantsAmt
CY Contributions Grants	$540,227	CYContributionsGrantsAmt
PY Program Service Revenue	$60,753,913	PYProgramServiceRevenueAmt
CY Program Service Revenue	$61,871,702	CYProgramServiceRevenueAmt
PY Investment Income	$300,414	PYInvestmentIncomeAmt
CY Investment Income	$259,782	CYInvestmentIncomeAmt
PY Other Revenue	$67,607	PYOtherRevenueAmt
CY Other Revenue	$72,061	CYOtherRevenueAmt
PY Total Revenue	$62,903,622	PYTotalRevenueAmt
CY Total Revenue	$62,743,772	CYTotalRevenueAmt
PY Grants And Similar Paid	$19,031	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$10,991	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$34,900,718	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$35,294,485	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$114,319	CYTotalFundraisingExpenseAmt
PY Other Expenses	$33,370,987	PYOtherExpensesAmt
CY Other Expenses	$32,477,562	CYOtherExpensesAmt
PY Total Expenses	$68,290,736	PYTotalExpensesAmt
CY Total Expenses	$67,783,038	CYTotalExpensesAmt
PY Revenues Less Expenses	-$5,387,114	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$5,039,266	CYRevenuesLessExpensesAmt
Total Assets BOY	$39,059,902	TotalAssetsBOYAmt
Total Assets EOY	$31,328,396	TotalAssetsEOYAmt
Total Liabilities BOY	$33,501,918	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$31,642,885	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$5,557,984	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	-$314,489	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	Yes (true)	SignificantChangeInd
Expense	$49,521,428	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$54,081,105	RevenueAmt
Desc	HOSPITAL SERVICE - FITZGIBBON HOSPITAL IS A 60 BED ACUTE CARE FACILITY SERVING MARSHALL, MO AND THE SURROUNDING COMMUNITIES. THE FACILITY PROVIDES HEALTH CARE WITH A 24 HOUR PHYSICIAN-STAFFED EMERGENCY DEPARTMENT, IN AND OUT-PATIENT MEDICAL/SURGICAL SERVICES, AN OBSTETRICS UNIT, A BEHAVIORAL 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 THE FISCAL YEAR ENDED APRIL 30, 2025, THE EMERGENCY ROOM EXPERIENCED 14,013 PATIENT VISITS. THE SURGICAL TEAM PERFORMED 168 INPATIENT PROCEDURES AND 1,381 OUTPATIENT PROCEDURES. THE RADIOLOGY GROUP PERFORMED 15,604 PROCEDURES WHICH INCLUDE 2,567 MAMMOGRAMS, 6,775 CT SCANS, 1,546 MRI'S, 4,012 ULTRASOUND IMAGES AND 704 NUCLEAR MEDICINE SCANS. THE LABORATORY TEAM PERFORMED 216,648 TESTS. THE RESPIRATORY THERAPY DEPARTMENT CONDUCTED 11,681 PROCEDURES AND THE REHABILITATIVE SERVICES GROUP WHICH INCLUDES PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES PROVIDED 50,714 PROCEDURES.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$4,931,690	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$5,385,774	RevenueAmt
Desc	CLINIC SERVICE - SPECIALTY CLINICS WITHIN THE HOSPITAL PROVIDE ORTHOPEDIC, WOUND CARE, AND PAIN MANAGEMENT SERVICES TO BOTH IN AND OUTPATIENTS. THESE CLINICS PROVIDED SERVICES TO 4,646 PATIENTS. THE HOSPITAL ALSO SUPPORTS A SEPARATE OUTPATIENT CLINIC ON CAMPUS FOR FAMILY MEDICINE, OB/GYN, GENERAL SURGERY, CHIROPRACTIC, AND PSYCHIATRY STAFFED MEDICAL PROFESSIONALS PRACTICING IN THESE SPECIALTIES. FOR FISCAL YEAR 2025, THIS CLINIC PROVIDED SERVICES FOR 29,585 PATIENT VISITS. SIX SATELLITE FAMILY PRACTICE CLINICS ARE ALSO SUPPORTED BY THE HOSPITAL. THESE CLINICS PROVIDED SERVICES FOR 28,229 PATIENT VISITS.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$375,077	ExpenseAmt
Grant	$10,991	GrantAmt
Revenue	$409,613	RevenueAmt
Desc	COMMUNITY HEALTH SERVICES - HOSPICE AND HOME HEALTH. HOSPICE PROVIDED 853 PALLIATIVE CARE VISITS AND HOME HEALTH PROVIDED 2,650 VISITS. THE HOSPITAL DONATED $10,990.75 TO OATS IN 2025 AND WILL BE DONATING ANNUALLY TO HELP SUSTAIN IT IN THE MARSHALL COMMUNITY. THE PROGRAM PROVIDED TRANSPORTATION FOR 1,068 RIDERS DURING FY 2025.	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$1,826,990	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$1,995,210	RevenueAmt
Desc	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 1,299 PATIENT VISITS AT THE FACILITY. IN ADDITION, THE STAFF EDUCATED OVER 1,500 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.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$1,826,990	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue	$1,995,210	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$56,655,185	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
Donor Rstr Or Quasi Endowments	Yes (true)	DonorRstrOrQuasiEndowmentsInd
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 With35 Ctrl Ent	Yes (true)	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	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	79	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	529	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
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	5	GoverningBodyVotingMembersCnt
Independent Voting Member	4	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Policies Reference Chapters	false	PoliciesReferenceChaptersInd
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
Written Policy Or Procedure	false	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	NANCY HARRIS	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	6608313271	PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Jan Stapleton
Vice President	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
Scott Hartwig
Secretary/Treasurer	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
William L Summers
President	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
Jared Romney
President of Medical Staff	40.0	1.0	Yes (X)		$428,605	$0	$34,599
Mary Lou Porter
Director	1.0	1.0	Yes (X)		$0	$0	$0
Angela Littrell
President/CEO	40.0	1.0		Yes (X)	$406,463	$0	$50,737
Nancy K Harris
COO/CFO	40.0	1.0		Yes (X)	$261,843	$0	$18,187
Andrew Wyant
ED Physician	40.0	0			$466,270	$0	$49,457	Yes (X)
Darin L Haug
ER Physician	40.0	0			$609,827	$0	$52,244	Yes (X)
Karla Dobbs
ED Physician	40.0	0			$472,460	$0	$30,292	Yes (X)
Kelly Ross
Orthopedic Surgeon	40.0	0			$655,787	$0	$5,692	Yes (X)
William Smith
OB/GYN Physisican	40.0	0			$558,521	$0	$19,862	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$3,859,776	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$261,070	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	71	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)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	Address Line2ContractorAddress/USAddress/AddressLine2Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
CPS Telepharmacy Inc
655 METRO PLACE SOUTH	SUITE 450	DUBLIN	OH	43017	Pharmacy	$798,903
ShiftKey LLC
2816 THOMAS AVE 5		Dallas	TX	75204	Contract Labor	$459,818
Next Move Inc
1617 MAIN ST 300		KANSAS CITY	MO	64108	Contract Labor	$447,780
RAWMedical LLC
3706 CROSS TIMBER CT		Columbia	MO	65203	Physician	$399,000
Forvis Mazars LLP
910 E ST LOUIS 200		SPRINGFIELD	MO	658062523	ACCOUNTING SERVICES	$355,721

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	16	CntrctRcvdGreaterThan100KCnt
Fundraising	$62,049	FundraisingAmt
All Other Contributions	$478,178	AllOtherContributionsAmt
Total Contributions	$540,227	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE	624100	$57,091,829	$57,091,829
340(B) REVENUE	446100	$4,179,495	$4,179,495
MANAGEMENT FEES	561000	$125,000	$125,000
CAFETERIA	725514	$261,399	$261,399
OTHER PROGRAM SERVICE REVENUE	900099	$213,979	$213,979

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$61,871,702	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$246,526	TotalRevenueColumnAmt
Exclusion	$246,526	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$82,809	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$82,809	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$82,809	TotalRevenueColumnAmt
Exclusion	$82,809	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$13,256	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$13,256	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$13,256	TotalRevenueColumnAmt
Exclusion	$13,256	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$26,818	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$62,049	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$37,566	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$10,748	TotalRevenueColumnAmt
Exclusion	-$10,748	ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

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

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$62,743,772	TotalRevenueColumnAmt
Related Or Exempt Func Income	$61,871,702	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$331,843	ExclusionAmt

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

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$10,991	TotalAmt
Program Services	$10,991	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,200,434	TotalAmt
Program Services	$463,204	ProgramServicesAmt
Management And General	$737,230	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$28,554,320	TotalAmt
Program Services	$25,475,290	ProgramServicesAmt
Management And General	$2,974,545	ManagementAndGeneralAmt
Fundraising	$104,485	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$222	TotalAmt
Program Services	$188	ProgramServicesAmt
Management And General	$34	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$3,549,380	TotalAmt
Program Services	$3,058,469	ProgramServicesAmt
Management And General	$490,911	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,990,129	TotalAmt
Program Services	$1,686,029	ProgramServicesAmt
Management And General	$297,925	ManagementAndGeneralAmt
Fundraising	$6,175	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$403,902	TotalAmt
Management And General	$403,902	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$229,817	TotalAmt
Management And General	$229,817	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$11,074,092	TotalAmt
Program Services	$8,925,104	ProgramServicesAmt
Management And General	$2,147,245	ManagementAndGeneralAmt
Fundraising	$1,743	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$40,830	TotalAmt
Management And General	$40,830	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,291,065	TotalAmt
Program Services	$793,894	ProgramServicesAmt
Management And General	$1,495,255	ManagementAndGeneralAmt
Fundraising	$1,916	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$698,213	TotalAmt
Program Services	$621,664	ProgramServicesAmt
Management And General	$76,549	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$167,230	TotalAmt
Program Services	$146,467	ProgramServicesAmt
Management And General	$20,763	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$49,386	TotalAmt
Program Services	$37,879	ProgramServicesAmt
Management And General	$11,507	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$537,703	TotalAmt
Program Services	$455,253	ProgramServicesAmt
Management And General	$82,450	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$2,042,360	TotalAmt
Program Services	$1,729,190	ProgramServicesAmt
Management And General	$313,170	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,101,244	TotalAmt
Program Services	$765,244	ProgramServicesAmt
Management And General	$336,000	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS	$9,684,639	$9,620,089	$64,550
PROVIDER TAX	$2,134,520	$2,134,520
REPAIRS & MAINTENANCE	$1,898,016	$626,262	$1,271,754
RECRUITING & RETENTION	$124,545	$105,448	$19,097

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$67,783,038	TotalAmt
Program Services	$56,655,185	ProgramServicesAmt
Management And General	$11,013,534	ManagementAndGeneralAmt
Fundraising	$114,319	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$388,039	BOYAmt
EOY	$1,237,839	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$4,764,578	BOYAmt
EOY	$4,373,692	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	$9,549,034	BOYAmt
EOY	$8,480,483	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,141,569	BOYAmt
EOY	$995,390	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$547,448	BOYAmt
EOY	$298,236	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$71,695,571	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$58,651,067	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$14,652,791	BOYAmt
EOY	$13,044,504	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$3,146,402	BOYAmt
EOY	$1,994,854	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

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	$4,870,041	BOYAmt
EOY	$903,398	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$39,059,902	BOYAmt
EOY	$31,328,396	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$14,009,933	BOYAmt
EOY	$15,182,286	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	$1,022	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$7,841,525	BOYAmt
EOY	$6,965,435	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	$5,835,256	BOYAmt
EOY	$5,890,335	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	$5,814,182	BOYAmt
EOY	$3,604,829	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$33,501,918	BOYAmt
EOY	$31,642,885	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,191,424	BOYAmt
EOY	-$4,686,942	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,366,560	BOYAmt
EOY	$4,372,453	EOYAmt

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

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

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

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

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$5,557,984	BOYAmt
EOY	-$314,489	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$39,059,902	BOYAmt
EOY	$31,328,396	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$5,039,266	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$30,122	NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments	-$485,231	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	-$378,098	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	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	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$14,439	OtherActivitiesAmt
Total Lobbying Expenditures	$14,439	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,909,838	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$207,662	InvestmentEarningsOrLossesAmt
End Year Balance	$1,702,176	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$580,327	BeginningYearBalanceAmt
Contributions	$1,215,421	ContributionsAmt
Investment Earnings Or Losses	$138,329	InvestmentEarningsOrLossesAmt
Administrative Expenses	$24,239	AdministrativeExpensesAmt
End Year Balance	$1,909,838	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$578,974	BeginningYearBalanceAmt
Investment Earnings Or Losses	$1,353	InvestmentEarningsOrLossesAmt
End Year Balance	$580,327	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$587,582	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$8,608	InvestmentEarningsOrLossesAmt
End Year Balance	$578,974	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$573,306	BeginningYearBalanceAmt
Investment Earnings Or Losses	$14,276	InvestmentEarningsOrLossesAmt
End Year Balance	$587,582	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.6975	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.3012	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.0013	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	$32,526,880	OtherCostOrOtherBasisAmt
Depreciation	$22,927,779	DepreciationAmt
Book Value	$9,599,101	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$37,412,527	OtherCostOrOtherBasisAmt
Depreciation	$33,806,122	DepreciationAmt
Book Value	$3,606,405	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,685,164	OtherCostOrOtherBasisAmt
Depreciation	$1,917,166	DepreciationAmt
Book Value	-$232,002	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$13,044,504	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
Federal Income Taxes
ESTIMATED SELF INSURANCE COSTS	$2,242,118
ROU LIABILITY	$220,278
ESTIMATED AMOUNT DUE TO 3RD PARTY PAYOR	$1,142,433

Field	Value	IRS element (for citing)
Total Liability	$3,604,829	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$62,278,288	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	$0	OtherRevenueAmt
Revenue Not Reported	$0	RevenueNotReportedAmt
Revenue Subtotal	$62,278,288	RevenueSubtotalAmt
Other Revenues Not Included	-$37,566	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	-$37,566	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$62,240,722	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$67,299,479	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$37,566	OtherExpensesIncludedAmt
Expenses Not Reported	$37,566	ExpensesNotReportedAmt
Expenses Subtotal	$67,261,913	ExpensesSubtotalAmt
Other Expenses Not Included	$0	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$67,261,913	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

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 V, Line 4 Intended uses of 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. 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. FINALLY, THE ORGANIZATION HAS ENDOWMENT FUNDS FROM THE RRH NURSING ENDOWMENT SCHOLARSHIP FUND. THE PURPOSE OF THE FUND IS TO FUND SCHOLARSHIPS FOR STUDENTS PURSING A DEGREE OR CERTIFICATE IN NURSING OR HEALTHCARE, TO FUND EDUCATION, OR TO PROVIDE FINANCIAL SUPPORT TO RETAIN NURSING/HEALTHCARE PROFESSIONAL IN SALINE COUNTY, MISSOURI. THE FUND CAN ALSO BE USED TO FUND OTHER SCHOLARSHIPS IF THE FIRST TO PRIORITIES DO NOT UTILIZE ALL THE INCOME GENERATED IN A GIVEN YEAR.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	FLING	Event1Nm
Gross Receipts Event1	$56,544	GrossReceiptsEvent1Amt
Charitable Contri Event1	$42,082	CharitableContriEvent1Amt
Gross Revenue Event1	$14,462	GrossRevenueEvent1Amt
Food And Beverage Event1	$14,628	FoodAndBeverageEvent1Amt
Entertainment Event1	$200	EntertainmentEvent1Amt
Other Direct Expenses Event1	$12,226	OtherDirectExpensesEvent1Amt
Event2	GOLF	Event2Nm
Gross Receipts Event2	$23,308	GrossReceiptsEvent2Amt
Charitable Contri Event2	$15,967	CharitableContriEvent2Amt
Gross Revenue Event2	$7,341	GrossRevenueEvent2Amt
Cash Prizes Event2	$50	CashPrizesEvent2Amt
Non Cash Prizes Event2	$91	NonCashPrizesEvent2Amt
Rent Facility Costs Event2	$7,000	RentFacilityCostsEvent2Amt
Other Direct Expenses Event2	$3,013	OtherDirectExpensesEvent2Amt
Other Events Total	1	OtherEventsTotalCnt
Gross Receipts Other Events	$9,015	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$4,000	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$5,015	GrossRevenueOtherEventsAmt
Cash Prizes Other Events	$300	CashPrizesOtherEventsAmt
Food And Beverage Other Events	$58	FoodAndBeverageOtherEventsAmt
Gross Receipts Total	$88,867	GrossReceiptsTotalAmt
Charitable Contributions Tot	$62,049	CharitableContributionsTotAmt
Gross Revenue Total Events	$26,818	GrossRevenueTotalEventsAmt
Cash Prizes Total Events	$350	CashPrizesTotalEventsAmt
Non Cash Prizes Total Events	$91	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$7,000	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$14,686	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$200	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$15,239	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$37,566	DirectExpenseSummaryEventsAmt
Net Income Summary	-$10,748	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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$96,415	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$96,415	NetCommunityBenefitExpnsAmt
Total Expense	0.00142	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,626,359	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,064,275	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$4,722,774	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,064,275	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$96,415	NetCommunityBenefitExpnsAmt
Total Expense	0.00142	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$46,364	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$46,364	NetCommunityBenefitExpnsAmt
Total Expense	0.00068	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$52,150	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$52,150	NetCommunityBenefitExpnsAmt
Total Expense	0.00077	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,552,271	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,416,995	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,135,276	NetCommunityBenefitExpnsAmt
Total Expense	0.07576	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,991	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,991	NetCommunityBenefitExpnsAmt
Total Expense	0.00016	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$8,661,776	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,416,995	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,244,781	NetCommunityBenefitExpnsAmt
Total Expense	0.07738	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$13,384,550	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,481,270	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,341,196	NetCommunityBenefitExpnsAmt
Total Expense	0.07880	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$11,610,382	BadDebtExpenseAmt
Bad Debt Expense Attributable	$1,985,375	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$12,216,723	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$12,544,376	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$327,653	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost Accounting System	Yes (X)	CostAccountingSystemInd

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 HIGHWAY 65 PO BOX 250	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	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
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	24	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	HTTPS://WWW.FITZGIBBON.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT	OwnWebsiteURLTxt
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	24	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	100.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	200.0	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
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	HTTPS://WWW.FITZGIBBON.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	HTTPS://WWW.FITZGIBBON.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	HTTPS://WWW.FITZGIBBON.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
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 Facility , 1	Facility , 1 - JOHN FITZGIBBON MEMORIAL HOSPITAL. KEY INDIVIDUALS FROM WHICH INPUT WAS SOUGHT INCLUDED PERSONS WITH EXPERIENCE IN CONDUCTING PRIOR NEEDS ASSESSMENTS, STAFF FAMILIAR WITH ASPECTS OF PUBLIC HEALTH, THOSE INVOLVED IN CARRYING OUT KEY ACTIVITIES DELINEATED UNDER PRIOR IMPLEMENTATION PLANS AND THOSE FAMILIAR WITH APPLICABLE REGULATIONS REGARDING CONDUCTING AND DISSEMINATING THE CHNA. STAFF ALSO INCLUDED THOSE WHOSE ROLES WOULD ENSURE THAT WE RECEIVED INPUT FROM VULNERABLE, CHRONICALLY ILL AND UNDER-SERVED POPULATIONS. STAFF MEMBERS INVOLVED AND WERE: - ANGY LITTRELL, PRESIDENT AND CHIEF EXECUTIVE OFFICER - NANCY HARRIS, CHIEF FINANCIAL OFFICER AND CHIEF OPERATING OFFICER - AMY WEBER, DIRECTOR OF PAYOR, PUBLIC & GOVERNMENTAL RELATIONS - KAREN MOSS, LCSW, BEHAVIORAL HEALTH CONSULTANT FOR RURAL HEALTH CLINICS AND MEDICAL HOME MODEL OF CARE, SERVING PRIMARILY LOW-INCOME AND CHRONICALLY ILL INDIVIDUALS - GINA GLISSON, BSN, R.N., CLINICAL QUALITY DIRECTOR, FITZGIBBON HOSPITAL - RICHARD DEFORD, MANAGER OF MARKETING AND SPIRITUAL CARE, AND BOARD-CERTIFIED CHAPLAIN FOR THE HOSPITAL AND FITZGIBBON MARY MONTGOMERY HOSPICE - CINDY EAGLE, NURSING ADMINISTRATION SPECIAL PROJECTS AND MARKETING STAFF MEMBER THE PROCESS FOR COLLECTING PRIMARY AND SECONDARY DATA WERE REVIEWED, INCLUDING THE FUNCTIONALITY OF THE COMMUNITYCOMMONS.ORG WEBSITE. STAFF ALSO REVIEWED EDUCATIONAL MATERIALS FROM BOTH THE MISSOURI HOSPITAL ASSOCIATION AND FORVIS CONSULTING IN REGARD TO MEETING COMPLIANCE FOR OUR 2025 CHNA.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - JOHN FITZGIBBON MEMORIAL HOSPITAL. A PRIMARY PATHWAY TO SOLICIT PRIMARY DATA COLLECTION INPUT WAS VIA A GROUP E-MAILING OF FORMER AND CURRENT PATIENTS SEEN AT THE FITZGIBBON CLINICS OR ITS HOSPITAL. THIS WAS A DEFINED LIST OF PRIOR PATIENTS MAINTAINED BY THE HOSPITAL MARKETING DEPARTMENT, AS WELL AS RELEASING A LINK TO THE SURVEY IN SOCIAL MEDIA POSTS AND A NEWS RELEASE DISSEMINATED TO AREA NEWS OUTLETS, INCLUDING RADIO AND PRINT. THE HOSPITAL LAUNCHED ITS ONLINE SURVEY ON SEPT. 27, 2024, AND IT REMAINED OPEN UNTIL DEC. 23, 2024. A LINK TO THE ONLINE SURVEY WAS PUBLICLY PROMOTED VIA A NEWS RELEASE IN THE LOCAL NEWSPAPER, PUBLICATION ON THE HOSPITAL WEBSITE, AND DETAILS WERE ANNOUNCED AT VARIOUS SOCIAL SERVICE AGENCY'S MEETINGS. THESE AGENCIES INCLUDED THE MARSHALL MINISTERIAL ALLIANCE, REPRESENTING NEARLY TWO DOZEN LOCAL PASTORS AND CONGREGATIONS, THE SALVATION ARMY AND A TRANSIENT MINISTRY, A JAIL MINISTRY AND A REST HOME MINISTRY, AND THE INTERAGENCY COUNCIL. KEY INDIVIDUALS FROM WHICH INPUT WAS SOUGHT INCLUDED PERSONS WITH EXPERIENCE IN CONDUCTING PRIOR NEEDS ASSESSMENTS, STAFF FAMILIAR WITH ASPECTS OF PUBLIC HEALTH, THOSE INVOLVED IN CARRYING OUT KEY ACTIVITIES DELINEATED UNDER PRIOR IMPLEMENTATION PLANS AND THOSE FAMILIAR WITH APPLICABLE REGULATIONS REGARDING CONDUCTING AND DISSEMINATING THE CHNA. STAFF ALSO INCLUDED THOSE WHOSE ROLES WOULD ENSURE THAT WE RECEIVED INPUT FROM VULNERABLE, CHRONICALLY ILL AND UNDER-SERVED POPULATIONS. THE INTERAGENCY COUNCIL IS A COLLABORATIVE GROUP OF SOCIAL SERVICE AND OTHER GOVERNMENTAL AGENCIES. MEMBERSHIP AND ATTENDEES INCLUDE: - SALINE COUNTY PUBLIC HEALTH DEPARTMENT - KATY TRAIL COMMUNITY HEALTH (FEDERALLY QUALIFIED HEALTH CENTER) - MISSOURI VALLEY COMMUNITY ACTION AGENCY - SALINE COUNTY MENTAL HEALTH ASSOCIATION - THE COMMUNITY FOOD PANTRY - HABITAT FOR HUMANITY - MISSOURI MANAGED MEDICAID PLANS - CENTER FOR HUMAN SERVICES, WHICH PROVIDES EMPLOYMENT SERVICES FOR THE DISABLED - THE FOSTER GRANDPARENTS PROGRAM - BURRELL BEHAVIORAL HEALTH - MARSHALL PUBLIC SCHOOLS NURSES AND SOCIAL WORKERS - THE SALINE COUNTY CAREER CENTER, WHICH OFFERS VOCATIONAL AND ADULT EDUCATION - MISSOURI VALLEY COLLEGE - POWERHOUSE MINISTRIES AND POWERHOUSE COMMUNITY ACTION AGENCY - SALT FORK YMCA - THE AMERICAN RED CROSS - UNITED WAY OF SALINE COUNTY - THE CHILDREN'S THERAPY CENTER - TOWER REALTY - MARSHALL PUBLIC LIBRARY - SALINE COUNTY CIVIL AIR PATROL - UNIVERSITY OF MISSOURI EXTENSION SERVICES - BABY GRACE, A COMMUNITY SUPPORT PROGRAM FOR FAMILIES WITH INFANTS AND TODDLERS - FIFTEENTH JUDICIAL CIRCUIT CASA, OR COURT-APPOINTED SPECIAL ADVOCATES - WILS - WEST CENTRAL INDEPENDENT LIVING SOLUTIONS, FOCUSING ON INDEPENDENT LIVING SOLUTIONS FOR PERSONS WITH DISABILITIES WE ALSO REACHED OUT VIA ELECTRONIC MEDIA, COMPANY EMAIL AND INTRANET TO CIRCULATE A LINK. THIS ENCOURAGED HEALTHCARE STAFF TO ACTIVELY PARTICIPATE IN THE SURVEY. THOSE RECEIVING THE EMAIL INCLUDED: - FITZGIBBON HOSPITAL MEDICAL STAFF AND PROVIDERS - FITZGIBBON HOSPITAL PATIENT-CENTERED MEDICAL HOME STAFF AND SOCIAL WORKERS - FITZGIBBON HOSPITAL PATIENT CARE COORDINATORS - FITZGIBBON HOSPITAL QUALITY IMPROVEMENT, COMPLIANCE AND INFECTION PREVENTION STAFF - FITZGIBBON HOME HEALTH NURSES AND STAFF - FITZGIBBON MARY MONTGOMERY HOSPICE NURSES AND STAFF - FITZGIBBON HOSPITAL AUXILIARY AMBASSADORS LEADERSHIP A SECOND PRONG OF OUR DATA COLLECTION AIMED TO VALIDATE OUR CONCLUSIONS REGARDING THE SOCIAL DETERMINANTS OF HEALTH AND THEIR IMPACT ON SALINE COUNTIANS. WE DID SO VIA THE USE OF ADDITIONAL SECONDARY DATA SOURCES THAT SPOKE TO SPECIFIC SOCIOECONOMIC INDICATORS, SUCH AS POVERTY, MEDICAID ENROLLMENT FIGURES AND HEALTH LITERACY RATES. A FINAL PRONG OF FITZGIBBON HOSPITAL'S APPROACH TO ITS 2025 CHNA WAS PRIMARY DATA COLLECTION, OR DIRECT OUTREACH TO COMMUNITY STAKEHOLDERS TO PROVIDE INPUT ON ITS ACTIONS AND ACTIVITIES SINCE OUR LAST CHNA WAS PUBLISHED. THROUGH THE SURVEY, WE ALSO SOUGHT INPUT ON CURRENT COMMUNITY HEALTH ISSUES AND OPINIONS ON COMMUNITY HEALTH NEEDS. WE SOUGHT INDIVIDUAL OUTREACH TO PERSONS AND ORGANIZATIONS ACROSS THE BROAD SPECTRUM OF COMMUNITY ORGANIZATIONS, SPECIFICALLY SEEKING INPUT FROM THOSE SUFFERING FROM HEALTH DISPARITIES, LOW-INCOME, DISABILITIES, THE CHRONICALLY ILL, THOSE WITH LANGUAGE BARRIERS AND VARYING SOCIO-ECONOMIC BACKGROUNDS. AT THE END OF THE ONLINE SURVEY IN DECEMBER 2024, A TOTAL OF 276 DIRECT RESPONSES HAD BEEN COLLECTED.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - JOHN FITZGIBBON MEMORIAL HOSPITAL. IN SELECTING THE HEALTH NEEDS TO ADDRESS, RESULTS WERE AGGREGATED AND ANALYZED. RAW PRIMARY DATA WAS COMPARED WITH SECONDARY DATA, AND THE INVENTORY OF EXISTING SERVICES AND PROGRAMMING WHICH ADDRESS IDENTIFIED HEALTH NEEDS WAS EVALUATED. CONSIDERATION OF EXISTING COMMUNITY RESOURCES, BUDGETARY CONSTRAINTS, AVAILABLE PERSONNEL AND HOSPITAL "MISSION AND VISION" WERE ALL VARIABLES IN SELECTING WHICH HEALTH NEEDS TO PRIORITIZE. SPECIAL CONSIDERATION WAS GIVEN IN REGARD TO REACHING DISPARATE SEGMENTS OF OUR COMMUNITY, ESPECIALLY THE UNDERSERVED, AND THE UNIQUE SOCIAL DETERMINANTS OF HEALTH WHICH EXIST IN OUR COMMUNITY: POVERTY AND LITERACY RATES, PHYSICAL ENVIRONMENTS, HEALTHY BEHAVIORS AND ACCESS TO HEALTH CARE SERVICES. IN SELECTING WHICH HEALTH NEEDS TO TARGET, THE CHNA COMMITTEE ALSO CONSIDERED THE FOLLOWING VARIABLES - POOR HEALTH OUTCOMES WHICH EXCEEDED STATE AND NATIONAL AVERAGES, LOCAL SURVEY RESULTS IDENTIFYING BARRIERS TO CARE, COLLABORATIVE ACTIVITIES WITH A HISTORY OF SUCCESS WHICH MAY ALREADY BE UNDERWAY OR IN CURRENT PLANNING STAGES, SELF-REPORTED SOCIAL AND ECONOMIC BARRIERS TO ACHIEVING OPTIMAL HEALTH. WE ALSO CONDUCTED A TREND ANALYSIS COMPARING ROBERT WOODS JOHNSON COUNTY HEALTH RANKINGS HEALTH OUTCOMES CITED IN PRIOR YEAR'S CHNAS. DELIBERATION IN PRIORITIZING THE HEALTH NEEDS TO TARGET INCLUDED THE FOLLOWING: - POOR HEALTH OUTCOMES IN SALINE COUNTY THAT EXCEEDED MISSOURI AND NATIONAL AVERAGES - LOCAL SURVEY RESULTS IDENTIFYING THE TOP BARRIERS TO HEALTH CARE - THE ORGANIZATION'S CAPACITY TO ADDRESS THE IDENTIFIED ISSUES - OTHER COMMUNITY ORGANIZATIONS' ROLES AND PROGRAMS ADDRESSING THE IDENTIFIED ISSUES - COLLABORATIVE ACTIVITIES WITH A HISTORY OF SUCCESS, ALREADY UNDERWAY OR IN CURRENT PLANNING STAGES - INDIVIDUALLY REPORTED BARRIERS TO ACHIEVING OPTIMAL HEALTH AND HEALTH EQUITY A TREND ANALYSES TO COMPARE ROBERT WOODS JOHNSON COUNTY HEALTH RANKINGS HEALTH OUTCOMES FOR SALINE COUNTY FOR THE YEARS ENCOMPASSING PRIOR CHNA REPORTS. ADDITIONAL HEALTH NEEDS AND/OR BARRIERS TO OPTIMAL AND EQUITABLE ACCESS TO HEALTHCARE WERE IDENTIFIED AS: - COST AND ABILITY TO PAY FOR CARE - TRANSPORTATION BARRIERS - LACK OF HEALTH INSURANCE DUE TO COST - NEED FOR ANTI-SMOKING ORDINANCES - MENTAL HEALTH CONCERNS - POVERTY - HOUSING INSTABILITY - LACK OF AVAILABILITY OF HEALTHY FOODS - LACK OF ACCESS TO SPECIALTY CARE - DRUG ABUSE - FEAR OF AN ADVERSE DIAGNOSIS, TREATMENT PLAN OR THE HEALTHCARE EXPERIENCE WHILE THOSE HEALTH NEEDS WERE IDENTIFIED, THE COMMITTEE BELIEVES THAT INTERVENTIONS AROUND OVERALL PREVENTIVE CARE AND WELLNESS AS WELL AS HEALTH LITERACY IMPROVEMENT COULD HAVE A "TRICKLE DOWN" EFFECT ON MANY OF THE IDENTIFIED NEEDS, INCLUDING CANCER, SMOKING AND MENTAL HEALTH CONCERNS. AFTER DELIBERATION AND THOROUGH CONSIDERATION OF ALL THE FACTORS ABOVE, THE FOLLOWING WERE NAMED AS OUR POPULATION'S TOP THREE TARGETED HEALTH NEEDS: - HEALTH LITERACY IMPROVEMENT, PRIMARILY TAKING THE FORM OF HEALTH EDUCATION SO COMMUNITY MEMBERS WOULD BETTER UNDERSTAND BOTH THE NAVIGATION OF THE HEALTHCARE SYSTEM AND THE MEANS TO IMPROVE THEIR OWN HEALTH. - HEALTHY LIFESTYLE ADVOCACY, TAKING THE FORM OF PROVIDING PATHWAYS TOWARD ADDITIONAL HEALTHY LIFESTYLE CHOICES SUCH AS EXERCISE, QUITTING SMOKING AND MAKING HEALTHIER FOOD CHOICES. - PREVENTIVE CARE AND WELLNESS, TO INCLUDE EDUCATION REGARDING THE NEED FOR REGULAR SCREENING CHECK-UPS AND EARLY DISEASE INTERVENTIONS, RECOMMENDED VACCINATIONS, DANGERS OF VAPING AND TOBACCO USE AND ADDRESSING MENTAL AND BEHAVIORAL HEALTH ISSUES, SUBSTANCE ABUSE AND TREATMENTS FOR ANXIETY AND DEPRESSION. THIS UPDATE FOR SCHEDULE H SPECIFICALLY COVERS ACTIVITIES FOR THE PERIOD OF MAY 1, 2024, TO APRIL 30 2025, ADDRESSING LONGITUDINAL ACTIVITIES AND EVALUATIONS FROM THE 2022 CHNA. HEALTH LITERACY IMPROVEMENT: HEALTH LITERACY IMPROVEMENT (OR LOW HEALTH LITERACY) WAS IDENTIFIED IN OUR SURVEY BY 66.4% OF RESPONDENTS IN THAT PEOPLE IN THE COMMUNITY "DON'T UNDERSTAND WHAT TO DO TO IMPROVE THEIR HEALTH." TACTICS TO IMPROVE HEALTH LITERACY INCLUDE IMPROVING THE UNDERSTANDING OF HEALTH TOPICS FOR THE GENERAL POPULATION AND ALSO ENGAGING WITH DIVERSE POPULATIONS AND BROADENING OUR REACH WITH NON-ENGLISH SPEAKERS IN OUR COMMUNITY. THE HOSPITAL MADE A CONCERTED EFFORT IN THIS DIRECTION BY ENSURING ITS MOST IMPORTANT PATIENT EDUCATION MATERIALS ARE TRANSLATED INTO SPANISH. EARLY HEALTH EDUCATION ALSO HAS BEEN A FOCUS THROUGH COLLABORATION WITH MARSHALL PUBLIC SCHOOLS, WITH FITZGIBBON HAVING A PRESENCE AT ONSITE SCHOOL-BASED HEALTH FAIRS AND PROVIDING GUEST SPEAKERS ON A VARIETY OF HEALTH TOPICS, INCLUDING SEXUAL HEALTH, PREGNANCY PREVENTION AND THE IMPORTANCE OF EXERCISE TO UNDERSTANDING FOOD LABELS AND HEALTHY FOOD PREPARATION. HEALTH LITERACY ALSO INCLUDES EDUCATION TO THE ELDERLY OR THOSE BECOMING ELIGIBLE FOR MEDICARE. AT THE TIME OF OPEN ENROLLMENT, THE HOSPITAL PUBLISHED EDUCATIONAL ARTICLES ABOUT BOTH THE MARKETPLACE PLANS AND THEIR AVAILABILITY IN OUR AREA AND ALSO WHICH MEDICARE PLANS WERE OFFERED AND HOW BENEFITS MAY VARY BY PLAN SELECTION. THE HOSPITAL ALSO PUBLICIZES THE AVAILABILITY OF A LANGUAGE TRANSLATION SERVICE TO THOSE WITH LIMITED ENGLISH PROFICIENCY TO ALL PATIENTS WHO ARE NON-ENGLISH SPEAKERS.
Schedule H, Part V, Section B, Line 11 Facility , 2	Facility , 2 - JOHN FITZGIBBON MEMORIAL HOSPITAL. HEALTHY LIFESTYLE ADVOCACY: MARKETING AND PUBLIC RELATIONS STAFF FIELDED NUMEROUS REQUESTS FROM THE PUBLIC AND COMMUNITY GROUPS TO ARRANGE SPEAKERS ON A VARIETY OF TOPICS, INCLUDING OBESITY AND RELATED CHRONIC DISEASES AS WELL AS A NUMBER OF OTHER HEALTH TOPICS SUCH AS GETTING ADEQUATE EXERCISE AND RECOVERING FROM GRIEF. STAFF PREPARED AND PRINTED EDUCATIONAL MATERIALS PER TOPIC AND UPDATED RELEVANT FLIERS, POSTED ANNOUNCEMENTS AND INFORMATIONAL VIDEOS ON SOCIAL MEDIA PLATFORMS, AND MESSAGING WAS DISPLAYED ON THE HOSPITAL WEBSITE. SIGNAGE ALSO DEPICTED ON AN INTERNAL VIDEO MESSAGING BOARD SEEN BY PATIENTS AND EMPLOYEES. TOPICS INCLUDED DIABETES EDUCATION, HEALTHY DIETS, OSTEOPOROSIS SCREENING, COLON CANCER SCREENING OPTIONS, CARDIOVASCULAR HEALTH AS IT RELATES TO OBESITY AND HEALTHY LIFESTYLES, AMONG OTHER TOPICS. HOSPITAL PERSONNEL PUBLICIZED THE AVAILABILITY OF ITS ANNUAL HEALTH FAIR, WHICH OFFERS AT-COST SCREENINGS FOR CHOLESTEROL, THYROID FUNCTION, PROSTATE SPECIFIC ANTIGEN AND BLOOD SUGARS, AMONG OTHERS. HOSPITAL PERSONNEL ALSO PUBLICIZED THESE EVENTS AT THE INTERAGENCY COUNCIL, A MULTI-AGENCY GROUP REPRESENTING SOCIAL SERVICE AGENCIES REACHING ACROSS THE SPECTRUM IN OUR COMMUNITY AND COUNTY. OTHER PUBLICITY INCLUDED SHARING INFORMATION WITH THE MINISTERIAL ALLIANCE, WITH REPRESENTATION OF MORE THAN 20 CHURCHES. THEY ALSO PROVIDED HEALTH INFORMATION AT BACK-TO-SCHOOL EVENTS AT WHICH STUDENTS AND THEIR FAMILIES COLLECT FREE MATERIALS AND SUPPLIES PRIOR TO THE START OF SCHOOL IN AUGUST. HOSPITAL-OPERATED CLINICS CONTINUED PARTICIPATION IN THE PRIMARY CARE HEALTH HOME MODEL, IN WHICH NURSE CARE MANAGERS ASSISTED PATIENTS WITH A DIAGNOSIS OF OBESITY OR DIABETES, ENCOURAGING THEM TO TAKE CONTROL OF THEIR WEIGHT. NURSE MANAGERS PROVIDED GUIDANCE AND PROMOTED PERSONAL EMPOWERMENT FOR HEALTHIER CHOICES. THEY ALSO STRESSED THE IMPORTANCE OF IDENTIFYING DIABETES COMPLICATIONS BY REGULAR MEASUREMENT OF A1C LEVELS. BECAUSE THE HOSPITAL DELIVERS 200+ INFANTS EACH YEAR, IT ALSO EMPLOYS A LACTATION CONSULTANT, WHO MEETS WITH NEW MOTHERS TO PROMOTE AND SUPPORT BREASTFEEDING. A LARGE PART OF THAT ROLE IS EDUCATING THE MOTHER REGARDING THE BENEFITS OF BREASTFEEDING AND ITS LONG-TERM POSITIVE IMPACT ON THE BABY'S HEALTH, BRAIN DEVELOPMENT AND IMMUNITY. AN ANNUAL HEALTH FAIR CONDUCTED BY FITZGIBBON STAFF IN APRIL ALSO OFFERED SCREENING FOR A1C AND BLOOD PRESSURE. THESE TYPES OF HEALTH FAIRS OCCURRED IN TWO LOCATIONS: IN MARSHALL AND AT THE CERTIFIED RURAL HEALTH CLINIC IN BRUNSWICK, MO., KNOWN AS GRAND RIVER MEDICAL CLINIC. THE HEALTH HOME ALSO PRODUCED A MONTHLY NEWSLETTER FOR HEALTH HOME PATIENTS (MOST OF WHOM HAVE A CHRONIC HEALTH CONDITION) AND THEIR FAMILIES. THE NEWSLETTER CONTAINS PREVENTIVE HEALTH INFORMATION, RECIPES AND OTHER HELPFUL TIPS AND REMINDERS. A LARGE PART OF HEALTHY LIFESTYLE IS GETTING ADEQUATE EXERCISE AND ENCOURAGING YOUTH TO PARTICIPATE IN ORGANIZED SPORTS. THE GOAL IS LIFELONG PARTICIPATION IN SPORTS OR ADOPTING AN OTHERWISE ACTIVE LIFESTYLE IN THE LONG TERM. THE FITZGIBBON ORGANIZATION PROVIDED FREE SCHOOL SPORTS PHYSICALS AT MANY SCHOOLS THROUGHOUT OUR SERVICES AREA TO ENSURE THAT ANY STUDENT WHO WISHES TO PARTICIPATE IN A SPORT MAY DO SO WITHOUT THE BARRIER OF BEING ABLE TO AFFORD THE STATE-REQUIRED PHYSICAL EXAM NEEDED FOR PARTICIPATION. AN ESTIMATED 600 PROSPECTIVE STUDENT ATHLETES PARTICIPATED IN THESE FREE PHYSICALS, WHICH OCCURRED ON-SITE AT AREA SCHOOLS. ANY IDENTIFIED HEALTH PROBLEMS WERE REFERRED BACK TO THE ATHLETE AND PARENT FOR FOLLOW-UP. THE HOSPITAL ALSO EMPLOYS A CERTIFIED ATHLETIC TRAINER PERMANENTLY STATIONED AT MARSHALL HIGH SCHOOL TO OFFER CONCUSSION DETECTION AND PREVENTION AND TREATMENT OF THE SCHOOL'S ATHLETES ON THE SIDELINE AND AT PRACTICES. THIS LEADS TO AREA STUDENTS' BEING BETTER ABLE TO LEAD ACTIVE AND HEALTHY LIFESTYLES AND ALLOWS ALL STUDENTS WHO WISH TO PARTICIPATE IN ORGANIZED SPORTS TO DO SO. ANOTHER COLLABORATIVE ACTIVITY WAS THE ADMINISTRATION OF INFLUENZA INJECTIONS AT AREA SCHOOLS, ALLOWING TEACHERS AND THEIR FAMILIES TO RECEIVE THE SHOTS CONVENIENTLY ON-SITE, THUS REDUCING ILLNESS AND ABSENTEEISM. INTERNALLY, THE HOSPITAL RECOGNIZES EMPLOYEES AND MEDICAL STAFF MEMBERS WHO PARTICIPATE IN ORGANIZED RUNS AND OTHER COMPETITIVE ACTIVITIES, WITH PHOTOS PUBLISH MONTHLY IN ITS EMPLOYEE NEWSLETTER. PREVENTIVE CARE AND WELLNESS : A LARGE PART OF HEALTHY LIFESTYLE PROMOTION INCLUDED ENCOURAGEMENT OF HEALTH SCREENINGS THAT ARE NOW FULLY COVERED VIA THE AFFORDABLE CARE ACT. THESE INCLUDE SCHEDULING RECOMMENDED IMMUNIZATIONS AND PREVENTATIVE DIAGNOSTIC EXAMS SUCH AS MAMMOGRAMS AND COLONOSCOPY. A CAMPAIGN REGARDING THE NEED FOR AN ANNUAL MEDICARE WELLNESS VISIT ALSO OCCURRED EARLY IN THE CALENDAR YEAR. THE HOSPITAL, IN PARTNERSHIP WITH AREA NEWS OUTLETS, ALSO PUBLISHES A WEEKLY HEATH COLUMN AIMED AT HEALTH EDUCATION, ENCOURAGING ENROLLMENT IN HEALTH INSURANCE, MEDICARE, MEDICAID AND OFFERING HEALTHY LIFESTYLE TIPS. ARTICLES EMPHASIZED THE IMPORTANCE OF EARLY TESTING AND DISEASE DETECTION AND ALSO INCLUDED PREVENTATIVE HEALTH CARE ON TOPICS SUCH AS THE NEED FOR COLONOSCOPY, HEALTHY DIETS, RISK OF VAPING AND TOBACCO USE, HEART DISEASE, HAND HYGIENE IN PREVENTION OF DISEASE, 3D MAMMOGRAPHY, CERVICAL CANCER DETECTION, GRIEF COUNSELING, SUICIDE PREVENTION, HEALTH INSURANCE MARKETPLACE OPEN ENROLLMENT, BREASTFEEDING BENEFITS, ALZHEIMER'S DISEASE SUPPORT GROUPS, THE NEED FOR CHILDHOOD IMMUNIZATIONS, AVOIDING HEAT STROKE, TICK SEASON RISKS, OPIOID RISKS, HEART HEALTH, WHEN TO SEEK CARE FOR THE FLU, SEASONAL ALLERGIES, ORGAN DONATION, SEASONAL AFFECTIVE DISORDER AND MORE TOPICS RELATED TO HEALTH PROMOTION, HEALTHY LIFESTYLE ADVOCACY AND OBESITY PREVENTION. THESE ARTICLES APPEARED IN AREA NEWS MEDIA OUTLETS, DISPLAYED ON THE HOSPITAL'S WEBSITE, LINKED TO THE HOSPITAL SOCIAL MEDIA PAGES AND DISPLAYED ON INTERNAL VIDEO MESSAGING BOARDS FOR PUBLIC VIEWING AT HOSPITAL-OPERATED CLINIC SITES AND WAITING AREAS WITHIN THE HOSPITAL. AT LEAST SIX DIFFERENT PRINT NEWSPAPERS IN THE ADJACENT COUNTIES PRINTED SOME OF THE ARTICLES THAT WERE SUBMITTED. THE HOSPITAL ALSO HAS ONGOING PARTICIPATION IN SEPSIS PREVENTION AND ANTIBIOTIC STEWARDSHIP INITIATIVES VIA PROGRAMS OF INTERNAL AND EXTERNAL EDUCATION, SOME CO-SPONSORED BY THE MISSOURI HOSPITAL ASSOCIATION. THESE PROGRAMS FOCUS ON DECREASING THE OVERUSE OF ANTIBIOTICS AND HOW TO PROPERLY TAKE MEDICATIONS WHEN PRESCRIBED. EDUCATIONAL ITEMS WERE PUSHED OUT ON SOCIAL MEDIA PLATFORMS AND NEWS MEDIA OUTLETS. ANOTHER EDUCATIONAL INITIATIVE FOCUSES ON REDUCING VIOLENT INCIDENTS FOR HEALTH CARE WORKERS. AS PART OF THE DISCHARGE PROCESS AT FITZGIBBON, STAFF PROVIDE INTENSIVE BESIDE EDUCATION FOR PATIENTS NEWLY DIAGNOSED WITH CONGESTIVE HEART FAILURE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, INSULIN-DEPENDENT DIABETES AND ANTICOAGULATION THERAPIES. THIS EDUCATION, WHICH FOCUSES ON MANAGEMENT OF CHRONIC DISEASE, IS BEYOND THE ROUTINE DISCHARGE PLANNING AND EDUCATION WHICH OCCURS FOR OTHER ADMISSIONS. TO OBTAIN PREVENTIVE CARE, COMMUNITY MEMBERS MUST BE WILLING TO ACCESS CARE, AND FEAR ABOUT FINANCIAL BURDENS MUST BE ADDRESSED. TO TACKLE THIS ISSUE, THE MARKETING DEPARTMENT DEVELOPED OUTREACH ACTIVITIES AND WEBPAGES FOR THE HOSPITAL'S WEBSITE HIGHLIGHTING FINANCIAL ASSISTANCE POLICIES AND ENROLLMENT IN MEDICAID AND THE HEALTH INSURANCE MARKETPLACE. THE HOSPITAL ALSO CONTRACTED WITH AN OUTSIDE ENTITY TO WHICH PATIENTS WHO MAY BE ELIGIBLE FOR MEDICAID ARE REFERRED FOR ASSISTANCE WITH ENROLLMENT INTO BOTH MEDICAID AND MARKETPLACE PLANS.
Schedule H, Part V, Section B, Line 16 Facility , 1	Facility , 1 - LUTHERAN HOSPITAL ASSOC OF THE SAN LUIS. THE FINANCIAL ASSISTANCE POLICY CAN ALSO BE FOUND BY GOING TO THE HOME PAGE OF ORGANIZATION'S WEBSITE, UNDER QUICK LINKS CLICK ON GET FINANCIAL ASSISTANCE AND THERE WILL BE A FINANCIAL ASSISTANCE POLICY HYPERLINK. THE FAP APPLICATION FORM CAN ALSO BE FOUND BY GOING TO THE HOME PAGE OF ORGANIZATION'S WEBSITE, UNDER QUICK LINKS CLICK ON "GET FINANCIAL ASSISTANCE THERE WILL BE AN "APPLICATION" HYPERLINK. THE PLAIN LANGUAGE SUMMARY CAN ALSO BE FOUND BY GOING TO THE HOME PAGE OF ORGANIZATION'S WEBSITE, UNDER QUICK LINKS CLICK ON "GET FINANCIAL ASSISTANCE THERE WILL BE A "PLAIN LANGUAGE SUMMARY" HYPERLINK.

Field	Value	IRS element (for citing)
Facility	9	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
FITZGIBBON PROFESSIONAL BUILDING
2301 S 65 HIGHWAY	MARSHALL	MO	65340	OB/GYN, SURGERY FAMILY PRACTICE, MENTAL HEALTH CLINIC
FITZGIBBON COMMUNITY HOME HEALTH CARE
2303 S 65 HIGHWAY	MARSHALL	MO	65340	HOME HEALTH, HOSPICE, HOMEMAKER
AKEMAN MCBURNEY MEDICAL CLINIC
420 WEST FRONT STREET	SLATER	MO	65349	OFFSITE MEDICAL CLINIC
GRAND RIVER MEDICAL CLINIC
815 EAST BROADWAY	BRUNSWICK	MO	65236	OFFSITE MEDICAL CLINIC
BUCKNER WELLNESS CENTER
2299 S 65 HIGHWAY	MARSHALL	MO	65340	CARDIAC/PULMONARY WELLNESS
FITZGIBBON FAMILY HEALTH
600 W MORRISON	FAYETTE	MO	65248	OFFSITE MEDICAL CLINIC
MID MO FAMILY HEALTH
4 N JEFFERSON AVE	MARSHALL	MO	65340	OFF-SITE MEDICAL CLINIC
PILOT GROVE MEDICAL CLINIC
212 COLLEGE ST	PILOT GROVE	MO	65276	OFF-SITE MEDICAL CLINIC
MISSOURI VALLEY PHYSICIANS
2303 S HIGHWAY 65 ST A	MARSHALL	MO	65340	INTERNAL MEDICINE CLINIC

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 7 PERCENT OF TOTAL EXPENSE	TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	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, Line 2 Bad debt expense - methodology used to estimate amount	THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HEALTH SYSTEMS DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HEALTH SYSTEM'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED APRIL 30, 2025. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	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, Line 4 Bad debt expense - financial statement footnote	THE AUDIT FOOTNOTE ADDRESSING BAD DEBT EXPENSE AND PATIENT ACCOUNTS RECEIVABLE IS FOUND ON THE AUDITED FINANCIAL STATEMENTS UNDER NOTE 1, SUBTITLED "PATIENT ACCOUNTS RECEIVABLE."
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	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, Line 9b Collection practices for patients eligible for financial assistance	IF ACCOUNTS HAVE ALREADY BEEN CONSIDERED BAD DEBT BY FITZGIBBON HOSPITAL AND CLINICS, THEN FINANCIAL ASSISTANCE/CHARITY CARE IS AN OPTION UNTIL 240 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT. BAD DEBT IS DEFINED AS EXPENSES RESULTING FROM TREATMENT FOR SERVICES PROVIDED TO A PATIENT WHO HAS NOT MET THEIR FINANCIAL OBLIGATION NOR SET UP AN AGREEABLE PAYMENT ARRANGEMENT WITH FITZGIBBON HOSPITAL AND CLINICS WITHIN 120 DAYS FROM THE DATE THE PATIENT HAS BEEN MADE RESPONSIBLE FOR ANY BALANCES DUE EITHER AFTER INSURANCE HAS PAID THEIR PORTION OR WHEN NO INSURANCE IS INVOLVED.
Schedule H, Part V, Section B, Line 16a FAP website	- JOHN FITZGIBBON MEMORIAL HOSPITAL: Line 16a URL: HTTPS://WWW.FITZGIBBON.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE;
Schedule H, Part V, Section B, Line 16b FAP Application website	- JOHN FITZGIBBON MEMORIAL HOSPITAL: Line 16b URL: HTTPS://WWW.FITZGIBBON.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- JOHN FITZGIBBON MEMORIAL HOSPITAL: Line 16c URL: HTTPS://WWW.FITZGIBBON.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE;
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 TRUSTEES IS COMPRISED OF MEMBERS FROM COUNTIES THROUGHOUT OUR SERVICE AREA. WE WORK CLOSELY WITH THE HEALTH DEPARTMENT AND OTHER COMMUNITY AGENCIES. STATE, REGIONAL AND LOCAL MEDIAS ARE USED TO MONITOR NEEDS AT ALL LEVELS. WE ALSO BELONG TO MANY HEALTHCARE RELATED ORGANIZATIONS THAT PROVIDE INFORMATION REGARDING USAGE AND NEEDS OF HEALTHCARE IN OUR SERVICE AREA WHICH IS USED TO EVALUATE WHAT WE NEED TO FOCUS ON TO IMPROVE THE HEALTH IN OUR COMMUNITY.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	THE HOSPITAL USES SEVERAL AVENUES TO PROVIDE PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE. ALL PATIENTS WILL BE OFFERED A PLAIN LANGUAGE SUMMARY AND AN APPLICATION FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY (FAP) AS PART OF THE INTAKE OR DISCHARGE PROCESS TO/FROM FH. INFORMATION REGARDING THE FAP MAY BE AVAILABLE THROUGH THE HOSPITAL'S PATIENT ACCOUNTS DEPARTMENT AT (660) 831-3730, FH WEBSITE AT WWW.FITZGIBBON.ORG, OR THE FH FACILITY AT 2305 SOUTH 65 HIGHWAY, MARSHALL, MO 65340. THE PATIENT ACCOUNTS DEPARTMENT DEVELOPED A BROCHURE WHICH IS AVAILABLE TO PATIENTS AT THE TIME OF REGISTRATION. THE BROCHURE OUTLINES WHAT THE PATIENT IS TO EXPECT IN THE BILLING PROCESS, HOW TO CONTACT THE DEPARTMENT, AND WHAT ASSISTANCE IS AVAILABLE. WE HAVE A DETAILED POLICY WHICH OUTLINES PATIENT RESPONSIBILITY AND QUALIFICATIONS FOR CHARITY CARE. OUR PATIENT ACCOUNTS REPRESENTATIVES MEET WITH SELF PAY PATIENTS WHEN THEY ARE IN THE FACILITY TO DISCUSS OUR POLICY. OUR CARE COORDINATORS AND SOCIAL WORKERS ALSO EDUCATE OUR PATIENTS ON ASSISTANCE THEY MAY BE ELIGIBLE FOR UNDER FEDERAL, STATE AND LOCAL GOVERNMENT PROGRAMS. WE ALSO UTILIZE AN OUTSIDE AGENCY TO MAKE CONTACT WITH PATIENTS AND IDENTIFY THOSE THAT MIGHT BE ELIGIBLE FOR ASSISTANCE.
Schedule H, Part VI, Line 4 Community information	FITZGIBBON HOSPITAL'S PRIMARY SERVICE AREA IS SALINE COUNTY, MISSOURI WHICH IS A MID-MISSOURI AGRICULTURAL REGION AND INCLUDES THE TOWNS OF MARSHALL AND SLATER, MO. THE SECONDARY SERVICE AREA IS PORTIONS OF THE CONTIGUOUS COUNTIES SURROUNDING SALINE COUNTY. A REPORT FROM THE MISSOURI CENSUS DATA CENTER, POPULATION ESTIMATES WITH COMPONENTS OF CHANGE 2020-2025, EXTRACTED ON APRIL 22, 2025, SHOWS THE FOLLOWING: A JULY 2025 POPULATION ESTIMATE OF 23,141 SALINE COUNTY DATA FOR 2025, ACCORDING TO A JULY 1, 2025 U.S. CENSUS BUREAU REPORT, SHOWED THE MEDIAN HOUSEHOLD INCOME WAS $56,566. THE AGE DISTRIBUTION OF THE POPULATION IN SALINE COUNTY IN 2025 SHOWED 18.01% AGED 65 AND OVER. ITS DEMOGRAPHICS ARE PRIMARILY WHITE, WITH 85.9% AS WHITE, NON-LATINO; 13.4% HISPANIC OR LATINO; 6.4% AFRICAN-AMERICAN; 3.1% TWO OR MORE RACES; 2.4% PACIFIC ISLANDER; 1.3% ASIAN AND .09% AMERICAN INDIAN.
Schedule H, Part VI, Line 5 Promotion of community health	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
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 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	Columbial	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	$10,991	CashGrantAmt
Purpose Of Grant	Community Services	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds	FormAndLineReferenceDesc
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.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
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	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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
Jared Romney
President of Medical Staff	$428,475	$0	$0	$0	$130	$0	$0	$0	$34,599	$0	$463,204	$0	$0	$0
Angela Littrell
President/CEO	$402,831	$0	$0	$0	$3,632	$0	$1,300	$0	$49,437	$0	$457,200	$0	$0	$0
Nancy K Harris
COO/CFO	$261,567	$0	$0	$0	$276	$0	$1,950	$0	$16,237	$0	$280,030	$0	$0	$0
Kelly Ross
Orthopedic Surgeon	$655,667	$0	$0	$0	$120	$0	$0	$0	$5,692	$0	$661,479	$0	$0	$0
Darin L Haug
ER Physician	$609,104	$0	$0	$0	$723	$0	$0	$0	$52,244	$0	$662,071	$0	$0	$0
William Smith
OB/GYN Physisican	$558,444	$0	$0	$0	$77	$0	$0	$0	$19,862	$0	$578,383	$0	$0	$0
Karla Dobbs
ED Physician	$472,220	$0	$0	$0	$240	$0	$0	$0	$30,292	$0	$502,752	$0	$0	$0
Andrew Wyant
ED Physician	$465,634	$0	$0	$0	$636	$0	$0	$0	$49,457	$0	$515,727	$0	$0	$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO
A	430980296	000000000	2016-03-14	$7,550,000	REFINANCING OF SERIES 2005 BONDS	false	false	false
INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO
B	430980296	79516LBC7	2010-12-29	$12,218,468	1998 BOND REFINANCING	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	In Reserve FundInReserveFundAmt	Refunding EscrowRefundingEscrowAmt
A	$2,790,000	$7,550,000	$170,000	$7,380,000	2016	Yes (true)	false	Yes (true)	Yes (true)
B	$8,600,000	$12,218,468	$232,812		2010	Yes (true)	false	Yes (true)	Yes (true)	$1,111,417	$11,985,565

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Engage Bond Counsel ResearchEngageBondCounselResearchInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Private Bus Concerning UBIPrivateBusConcerningUBIPct	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropPct	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	false	false	false	false	false	0	0	0.0	false	false	0	false	Yes (true)
B	false	false	false	false	false	false	0	0	0.0	false	false	0	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Term Of HedgeTermOfHedgePct	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Term Of GICTermOfGICPct	Regulatory Safe Harbor StsfdRegulatorySafeHarborStsfdInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	false	false	false	Yes (true)	false	false	0	false	false	false	0	false	false	Yes (true)
B	false	false	false	Yes (true)	false	false	0	false	false	false	0	false	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 IV, Line 2c COLUMN A	Issuer name: INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO The calculation for computing no rebate due was performed on 03/14/2021
Schedule K, Part IV, Line 2c COLUMN B	Issuer name: INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO The calculation for computing no rebate due was performed on 11/29/2020

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SCOTT HARTWIG	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Relationship Description	BOARD MEMBER, OWNER RED CROSS PHARMACY	RelationshipDescriptionTxt
Transaction	$35,117	TransactionAmt
Transaction	PHARMACY	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part III, Line 3 Significant changes in program services	FITZGIBBON MEMORIAL HOSPITAL CLOSED ITS CHIROPRACTIC CLINIC IN APRIL OF 2025.
Form 990, Part III, Line 4d Description of other program services	(Expenses $ 1,826,990 including grants of $ 0)(Revenue $ 1,995,210) 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 1,299 PATIENT VISITS AT THE FACILITY. IN ADDITION, THE STAFF EDUCATED OVER 1,500 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.
Form 990, Part IV, Line 20b Audited Financial Statement	THE CURRENT YEAR AUDITED FINANCIAL STATEMENTS WERE NOT COMPLETE AT THE TIME OF FILING. ATTACHED ARE THE PRIOR YEAR AUDITED FINANCIAL STATEMENTS. THE RETURN WILL BE AMENDED WHEN THE CURRENT YEAR AUDITED FINANCIAL STATEMENTS ARE COMPLETE.
Form 990, Part VI, Line 15 COMPENSATION INFORMATION	AN INDEPENDENT COMPENSATION CONSULTANT WAS ENGAGED TO REVIEW THE COMPENSATION OF ANGELA LITTRELL AS WELL AS OTHER OFFICERS AND KEY EMPLOYEES AND THEIR REPORT WAS REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	THE MEDICAL STAFF OF THE ORGANIZATION ELECTS THE CHIEF OF MEDICAL STAFF WHO IS A VOTING MEMBER OF THE BOARD.
Form 990, Part VI, Line 11b Review of form 990 by governing body	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, Line 12c 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, Line 19 Required documents available to the public	THE ANNUAL FORM 990 INCLUDES THE ANNUAL AUDITED FINANCIAL STATEMENTS AND ARE AVAILABLE TO THE PUBLIC. THE ORGANIZATION DOES NOT MAKE THE CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS, OR OTHER FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
Form 990, Part VII, Section A TRUSTEE COMPENSATION	NO TRUSTEES RECEIVE COMPENSATION FOR THEIR DUTIES AS TRUSTEES. JARED ROMNEY, MD RECEIVED COMPENSATION FOR HIS ROLE AS A PROVIDERS IN THE ORGANIZATION'S HOSPITAL SERVICES.
Form 990, Part IX, Line 11g Other Fees	CONTRACT SERVICES - Total Expense: 2309428, Program Service Expense: 2154360, Management and General Expenses: 155068, Fundraising Expenses: 0; OUTSIDE SERVICES - Total Expense: 5735051, Program Service Expense: 4755098, Management and General Expenses: 978210, Fundraising Expenses: 1743; PROFESSIONAL FEES - Total Expense: 1862450, Program Service Expense: 1862450, Management and General Expenses: 0, Fundraising Expenses: 0; MEDICAL FEES - Total Expense: 132196, Program Service Expense: 132196, Management and General Expenses: 0, Fundraising Expenses: 0; COLLECTION SERVICES - Total Expense: 412690, Program Service Expense: 0, Management and General Expenses: 412690, Fundraising Expenses: 0; CONSULTING FEES - Total Expense: 622277, Program Service Expense: 21000, Management and General Expenses: 601277, Fundraising Expenses: 0;
Form 990, Part X, Line 20 TAX EXEMPT BONDS	JOHN FITZGIBBON MEMORIAL HOSPITAL RECEIVED QUALIFIED HOSPITAL BOND PROCEEDS FROM 2010 AND 2016 BOND ISSUES. A PORTION OF THE BOND PROCEEDS WERE ALLOCATED TO FITZGIBBON HEALTH SERVICES FOR BOOK AND AUDIT PURPOSES. INFORMATION ABOUT THE BONDS ARE REPORTED ON JOHN FITZGIBBON MEMORIAL HOSPITAL'S SCHEDULE K.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	TRANSFER TO AFFILIATES - -378098; Total - -378098;

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	10	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	false	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	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
FITZGIBBON HEALTH SERVICES
Q	$574,242	FMV
FITZGIBBON HEALTH SERVICES
R	$378,098	FMV