2026-03-16T12:46:10+00:00 2025-04-30 440160260 Forvis Mazars LLP 910 E St Louis 200 PO Box 1190 Springfield MO 658062523 990 2024-05-01 440655986 JOHN FITZGIBBON MEMORIAL HOSPITAL JOHN 6608867431 2305 S HIGHWAY 65 MARSHALL MO 65340 NANCY HARRIS CFO 6608867431 2026-03-16 true Brian Todd P00422601 4178658701 2026-03-16 2024 2025-03-06 01:10:19Z FITZGIBBON HOSPITAL ANGELA P LITTRELL 2305 S HIGHWAY 65 MARSHALL MO 65340 62781338 false X WWW.FITZGIBBON.ORG X 1923 MO 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. 5 4 529 98 0 0 1781688 540227 60753913 61871702 300414 259782 67607 72061 62903622 62743772 19031 10991 0 34900718 35294485 0 114319 33370987 32477562 68290736 67783038 -5387114 -5039266 39059902 31328396 33501918 31642885 5557984 -314489 X TO IMPROVE THE HEALTH OF OUR COMMUNITY. false true 49521428 0 54081105 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. 4931690 0 5385774 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. 375077 10991 409613 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. 1826990 0 1995210 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. 1826990 1995210 56655185 true true false true false false false false false true true false false false true false false true false false false false false false true false true true true false true true false false false false false false false false false true false false false false false true true true false false true 79 0 true 529 true false false false false false true true false false false false false false X 5 4 false false false false false true false true true false false false false true true true true true false false false false X NANCY HARRIS 6608313271 2305 S HIGHWAY 65 PO BOX 250 MARSHALL MO 65340 Jan Stapleton Vice President 1.0 1.0 X X 0 0 0 Scott Hartwig Secretary/Treasurer 1.0 1.0 X X 0 0 0 William L Summers President 1.0 1.0 X X 0 0 0 Jared Romney President of Medical Staff 40.0 1.0 X 428605 0 34599 Mary Lou Porter Director 1.0 1.0 X 0 0 0 Angela Littrell President/CEO 40.0 1.0 X 406463 0 50737 Nancy K Harris COO/CFO 40.0 1.0 X 261843 0 18187 Andrew Wyant ED Physician 40.0 0 X 466270 0 49457 Darin L Haug ER Physician 40.0 0 X 609827 0 52244 Karla Dobbs ED Physician 40.0 0 X 472460 0 30292 Kelly Ross Orthopedic Surgeon 40.0 0 X 655787 0 5692 William Smith OB/GYN Physisican 40.0 0 X 558521 0 19862 3859776 0 261070 71 false true false CPS Telepharmacy Inc 655 METRO PLACE SOUTH SUITE 450 DUBLIN OH 43017 Pharmacy 798903 ShiftKey LLC 2816 THOMAS AVE 5 Dallas TX 75204 Contract Labor 459818 Next Move Inc 1617 MAIN ST 300 KANSAS CITY MO 64108 Contract Labor 447780 RAWMedical LLC 3706 CROSS TIMBER CT Columbia MO 65203 Physician 399000 Forvis Mazars LLP 910 E ST LOUIS 200 SPRINGFIELD MO 658062523 ACCOUNTING SERVICES 355721 16 62049 478178 540227 NET PATIENT SERVICE REVENUE 624100 57091829 57091829 340(B) REVENUE 446100 4179495 4179495 MANAGEMENT FEES 561000 125000 125000 CAFETERIA 725514 261399 261399 OTHER PROGRAM SERVICE REVENUE 900099 213979 213979 0 0 0 0 61871702 246526 246526 82809 82809 0 82809 82809 13256 0 13256 13256 13256 26818 62049 37566 -10748 -10748 0 0 0 0 0 62743772 61871702 0 331843 X 10991 10991 1200434 463204 737230 28554320 25475290 2974545 104485 222 188 34 3549380 3058469 490911 1990129 1686029 297925 6175 403902 403902 229817 229817 11074092 8925104 2147245 1743 40830 40830 2291065 793894 1495255 1916 698213 621664 76549 167230 146467 20763 49386 37879 11507 537703 455253 82450 2042360 1729190 313170 1101244 765244 336000 MEDICAL SUPPLIES & DRUGS 9684639 9620089 64550 PROVIDER TAX 2134520 2134520 REPAIRS & MAINTENANCE 1898016 626262 1271754 RECRUITING & RETENTION 124545 105448 19097 0 0 0 0 67783038 56655185 11013534 114319 388039 1237839 4764578 4373692 0 0 9549034 8480483 0 0 0 0 0 0 1141569 995390 547448 298236 71695571 58651067 14652791 13044504 3146402 1994854 0 0 0 0 4870041 903398 39059902 31328396 14009933 15182286 0 0 1022 0 7841525 6965435 0 0 0 0 5835256 5890335 0 0 5814182 3604829 33501918 31642885 X 1191424 -4686942 4366560 4372453 0 0 0 0 0 0 5557984 -314489 39059902 31328396 X -5039266 30122 -485231 -378098 X false true true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 14439 14439 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY 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. 1909838 -207662 1702176 580327 1215421 138329 24239 1909838 578974 1353 580327 587582 -8608 578974 573306 14276 587582 0.6975 0.3012 0.0013 false false 71000 71000 32526880 22927779 9599101 37412527 33806122 3606405 1685164 1917166 -232002 13044504 Federal Income Taxes ESTIMATED SELF INSURANCE COSTS 2242118 ROU LIABILITY 220278 ESTIMATED AMOUNT DUE TO 3RD PARTY PAYOR 1142433 3604829 62278288 0 0 62278288 -37566 -37566 62240722 67299479 37566 37566 67261913 0 0 67261913 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. 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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. 9 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 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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chedule 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. true Oats Inc 2501 McGuire Blvd Columbial MO 65201 431016961 501(C) (3) 10991 Community Services 1 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds THE HOSPITAL WORKS IN CONJUNCTION WITH THE LOCAL OATS TRANSPORTATION PROGRAM TO COORDINATE TRANSPORTATION FOR MEMBERS OF THE COMMUNITY. THE ORGANIZATION WITNESSES FIRSTHAND THE WORK DONE BY OATS IN THE COMMUNITY. X X X X X false false false false false false false false false Jared Romney President of Medical Staff 428475 0 0 0 130 0 0 0 34599 0 463204 0 0 0 Angela Littrell President/CEO 402831 0 0 0 3632 0 1300 0 49437 0 457200 0 0 0 Nancy K Harris COO/CFO 261567 0 0 0 276 0 1950 0 16237 0 280030 0 0 0 Kelly Ross Orthopedic Surgeon 655667 0 0 0 120 0 0 0 5692 0 661479 0 0 0 Darin L Haug ER Physician 609104 0 0 0 723 0 0 0 52244 0 662071 0 0 0 William Smith OB/GYN Physisican 558444 0 0 0 77 0 0 0 19862 0 578383 0 0 0 Karla Dobbs ED Physician 472220 0 0 0 240 0 0 0 30292 0 502752 0 0 0 Andrew Wyant ED Physician 465634 0 0 0 636 0 0 0 49457 0 515727 0 0 0 A INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO 430980296 000000000 2016-03-14 7550000 REFINANCING OF SERIES 2005 BONDS false false false B INDUSTRIAL DEVELOPMENT AUTHORITY - CO OF SALINE MO 430980296 79516LBC7 2010-12-29 12218468 1998 BOND REFINANCING false false false A 2790000 7550000 170000 7380000 2016 true false true true B 8600000 12218468 1111417 11985565 232812 2010 true false true true A false false false false false false 0 0 0.0 false false 0 false true B false false false false false false 0 0 0.0 false false 0 false true A false false false true false false 0 false false false 0 false false true B false false false true false false 0 false false false 0 false false true A true B true 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 SCOTT HARTWIG BOARD MEMBER, OWNER RED CROSS PHARMACY 35117 PHARMACY false 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; FITZGIBBON HEALTH SERVICES 2506 LINDEN TREE PARKWAY MARSHALL MO 65340 431731173 NURSING HOME MO 501(c)(3) 10 JF MEM HOSP true false false false false false false false false false false false false false true true false true true false FITZGIBBON HEALTH SERVICES Q 574242 FMV FITZGIBBON HEALTH SERVICES R 378098 FMV