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← FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION

Form 990 for tax year 2024

Filed by FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION.

Totals

Total revenue
$49,314,974
Total expenses
$51,012,895
Contributions and grants received
$47,957
Grants paid
$60,864
Program service revenue
$48,528,777
Investment income
$102,825
Other revenue
$635,415
Total assets, end of year
$51,331,074
Total liabilities, end of year
$33,776,082
Net assets or fund balances, end of year
$17,554,992
Program services expenses (Part IX)
$37,728,160
Management and general expenses
$13,284,735
Fundraising expenses
$0
Program service expenses (Part III)
$37,728,160

Program services were 74.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $8,500

  • 1e · Government grants (contributions)

    $20,470

  • 1f · All other contributions, gifts and grants

    $18,987

  • 2a · Program service revenue: NET PATIENT REVENUE

    total $43,444,719 · related or exempt $43,444,719

  • 2b · Program service revenue: CLINIC REVENUE

    total $5,070,777 · related or exempt $5,070,777

  • 2c · Program service revenue: MEDICAL RECORDS FEE

    total $13,281 · related or exempt $13,281

  • 3 · Investment income

    total $102,573 · excluded $102,573

  • 6a · Gross rents

    real property $282,243

  • 6b · Less rental expenses

    real property $81,440

  • 6c · Rental income or loss

    real property $200,803

  • 6d · Net rental income or loss

    total $200,803 · related or exempt $200,803

  • 7a · Gross sales of assets other than inventory

    other assets $252

  • 7b · Less cost or other basis and sales expenses

    other assets $0

  • 7c · Gain or loss

    other assets $252

  • 7d · Net gain or loss

    total $252 · excluded $252

  • 11a · Other revenue: CAFETERIA & CATERING

    total $274,893 · related or exempt $265,077 · excluded $9,816

  • 11b · Other revenue: REBATES

    total $6,261 · related or exempt $6,261

  • 11d · All other revenue

    total $153,458 · related or exempt $153,458

  • 11e · Other revenue, total

    $434,612

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $18,380 · program services $18,380

  • 2 · Grants to domestic individuals

    total $42,484 · program services $42,484

  • 5 · Compensation of officers, directors and key employees

    total $1,131,603 · program services $846,976 · management and general $284,627

  • 6 · Compensation of disqualified persons

    total $236,538 · program services $177,043 · management and general $59,495

  • 7 · Other salaries and wages

    total $20,715,217 · program services $15,504,808 · management and general $5,210,409

  • 8 · Pension plan contributions

    total $171,431 · program services $128,312 · management and general $43,119

  • 9 · Other employee benefits

    total $5,048,272 · program services $3,778,502 · management and general $1,269,770

  • 10 · Payroll taxes

    total $1,585,464 · program services $1,186,679 · management and general $398,785

  • 11b · Fees: legal

    total $110,949 · management and general $110,949

  • 11c · Fees: accounting

    total $319,009 · management and general $319,009

  • 11d · Fees: lobbying

    total $11,870 · management and general $11,870

  • 11g · Fees: other

    total $7,017,105 · program services $5,524,216 · management and general $1,492,889

  • 12 · Advertising and promotion

    total $70,020 · program services $20,490 · management and general $49,530

  • 13 · Office expenses

    total $37,102 · program services $10,857 · management and general $26,245

  • 16 · Occupancy

    total $2,825,951 · program services $939,114 · management and general $1,886,837

  • 17 · Travel

    total $72,131 · program services $21,108 · management and general $51,023

  • 20 · Interest

    total $842,791 · program services $594,478 · management and general $248,313

  • 22 · Depreciation, depletion and amortization

    total $3,023,717 · program services $3,023,717

  • 23 · Insurance

    total $742,869 · management and general $742,869

  • 24a · Other expenses: MEDICAL SUPPLIES AND DR

    total $4,956,938 · program services $4,348,717 · management and general $608,221

  • 24b · Other expenses: MEDICAID ASSESSMENT TAX

    total $1,178,250 · program services $1,178,250

  • 24c · Other expenses: CAFETERIA EXPENSES

    total $347,738 · program services $235,646 · management and general $112,092

  • 24d · Other expenses: DUES AND SUBSCRIPTIONS

    total $250,987 · program services $73,447 · management and general $177,540

  • 24e · All other expenses

    total $256,079 · program services $74,936 · management and general $181,143

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $259,111 · end of year $430,531

  • 2 · Savings and temporary cash investments

    beginning of year $1,685,342 · end of year $2,130,445

  • 4 · Accounts receivable

    beginning of year $10,867,020 · end of year $8,752,912

  • 7 · Other notes and loans receivable

    beginning of year $337 · end of year $347

  • 8 · Inventories for sale or use

    beginning of year $1,307,600 · end of year $1,301,929

  • 9 · Prepaid expenses and deferred charges

    beginning of year $801,830 · end of year $584,487

  • 10a · Land, buildings and equipment: cost or other basis

    $76,961,263

  • 10b · Land, buildings and equipment: accumulated depreciation

    $38,832,601

  • 10c · Land, buildings and equipment, net

    beginning of year $40,436,233 · end of year $38,128,662

  • 11 · Investments: publicly traded securities

    beginning of year $1,761 · end of year $1,761

  • 17 · Accounts payable and accrued expenses

    beginning of year $5,858,258 · end of year $7,861,664

  • 23 · Secured mortgages and notes payable

    beginning of year $25,599,592 · end of year $25,127,494

  • 24 · Unsecured notes and loans payable

    beginning of year $177,721 · end of year $300,000

  • 25 · Other liabilities

    beginning of year $957,646 · end of year $486,924

  • 27 · Net assets without donor restrictions

    beginning of year $22,563,471 · end of year $17,352,446

  • 28 · Net assets with donor restrictions

    beginning of year $202,546 · end of year $202,546

Mission and programs · 2024

Mission

THE MISSION OF FAIRFIELD MEMORIAL HOSPITAL IS TO MAINTAIN AND IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE.

  • AS A NOT-FOR-PROFIT COMMUNITY HOSPITAL, FAIRFIELD MEMORIAL IS A CHARITABLE ORGANIZATION THAT EXISTS TO ADVANCE THE HEALTH OF THE RESIDENTS OF WAYNE COUNTY AND SURROUNDING COMMUNITIES. FAIRFIELD MEMORIAL HOSPITAL OPERATES A RURAL HEALTHCARE FACILITY WITH 25 ACUTE CARE BEDS AND 30 SKILLED CARE BEDS. IN AUGUST 2008, THE HOSPITAL OPENED A RURAL HEALTH CLINIC. TODAY IT OPERATES RURAL HEALTH CLINICS PROVIDING MEDICAL AND BEHAVIORAL HEALTH SERVICES IN FAIRFIELD, CISNE, AND CARMI, AS WELL AS, OPERATING OUTPATIENT SURGICAL SPECIALTY CLINICS, TO INCLUDE GENERAL SURGERY, WOUND CARE, AND PAIN MANAGEMENT. FAIRFIELD MEMORIAL HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE TO ALL PERSONS WITHOUT REGARD TO AND DOES NOT DISCRIMINATE ON THE BASIS OF RACE, COLOR, RELIGION (CREED), GENDER, GENDER SEX EXPRESSION, AGE, NATIONAL ORIGIN (ANCESTRY), PHYSICAL OR MENTAL DISABILITY, MARITAL STATUS, GENDER IDENTITY, SEXUAL ORIENTATION, SOCIAL ECONOMIC STATUS, ETHNICITY, CULTURE, LANGUAGE, MILITARY STATUS, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF FAIRFIELD MEMORIAL HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH THIS CORPORATION'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITIES WE SERVE. THE COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST, AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR INDIVIDUALS INABILITY TO PAY COEXISTS. THE COMMUNITY BENEFITS CAN BE MEASURED IN MANY WAYS INCLUDING: DIRECT PATIENT CARE, SCREENINGS, EDUCATION, FUNDRAISING, AND COMMUNITY SERVICE EFFORTS OF OUR COLLEAGUES. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, PROVIDING SERVICES TO BOTH MEDICARE AND MEDICAID PATIENTS. CHARITY CARE IS ALSO PROVIDED THROUGH THE HOSPITAL'S INTERNAL FINANCIAL ASSISTANCE POLICY.

    Expenses $37,728,160 · Grants $60,864 · Revenue $49,154,376

As filed on the 2024 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Patrick Molt MD

    PRESIDENT/CMO

    Total calculated
    $364
    From this org
    $364
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • Joey Hungerford

    VICE PRESIDENT (END 06/25)

    Total calculated
    $0
    Hours/week
    1.75

  • Anita Pond

    SECRETARY/TREASURER

    Total calculated
    $0
    Hours/week
    1.75

  • Michael Copeland

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.75

  • Donna Masterson

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.75

  • D Jamie Pollard

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.75

  • Matthew Seng

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.75

  • Doug Wilson

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.75

  • Josh Scott

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.75

  • Jared Florence

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.75

  • Craig Self

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.75

  • Katherine Bunting

    CEO

    Total calculated
    $207,025
    From this org
    $204,297
    From related orgs
    $0
    Other
    $2,728
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $204,297
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $2,728
    Filer's total
    $207,025

  • Dana Taylor

    COO

    Total calculated
    $146,002
    From this org
    $137,498
    From related orgs
    $0
    Other
    $8,504
    Hours/week
    50

  • Rachel Ewing

    CNO (END 06/25)

    Total calculated
    $118,902
    From this org
    $108,118
    From related orgs
    $0
    Other
    $10,784
    Hours/week
    50

  • Kristin Boldt

    INTERIM CFO (END 08/24)

    Total calculated
    $115,119
    From this org
    $107,999
    From related orgs
    $0
    Other
    $7,120
    Hours/week
    50

  • Michael Cooper

    CEO (BEG 07/24)

    Total calculated
    $133,998
    From this org
    $122,877
    From related orgs
    $0
    Other
    $11,121
    Hours/week
    40

  • Jim Basch

    CFO (BEG 08/24-11/24, 06/25)

    Total calculated
    $249,901
    From this org
    $249,901
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $249,901
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $249,901

  • William Giles

    CFO (08/24-06/25)

    Total calculated
    $46,504
    From this org
    $44,697
    From related orgs
    $0
    Other
    $1,807
    Hours/week
    40

  • Jennifer Gilpin

    CNO (BEG 06/25)

    Total calculated
    $0
    Hours/week
    40

  • Kory Blank

    ORTHOPEDIC SURGEON

    Total calculated
    $713,931
    From this org
    $692,880
    From related orgs
    $0
    Other
    $21,051
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $599,781
    Bonus
    $93,099
    Other
    $0
    Deferred
    $6,900
    Nontaxable benefits
    $14,151
    Filer's total
    $713,931

  • Arunima Saxena

    PHYSICIAN

    Total calculated
    $365,937
    From this org
    $350,735
    From related orgs
    $0
    Other
    $15,202
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $327,614
    Bonus
    $23,121
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $15,202
    Filer's total
    $365,937

  • Lauren Williams

    PHYSICIAN

    Total calculated
    $426,514
    From this org
    $414,027
    From related orgs
    $0
    Other
    $12,487
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $389,944
    Bonus
    $24,083
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $12,487
    Filer's total
    $426,514

  • Christopher Ballard

    PHYSICIAN

    Total calculated
    $374,077
    From this org
    $351,410
    From related orgs
    $0
    Other
    $22,667
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $300,536
    Bonus
    $50,874
    Other
    $0
    Deferred
    $6,900
    Nontaxable benefits
    $15,767
    Filer's total
    $374,077

  • Kimberly King

    CRNA/PAIN MANAGEMENT PROVIDER

    Total calculated
    $393,926
    From this org
    $373,196
    From related orgs
    $0
    Other
    $20,730
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $308,798
    Bonus
    $64,398
    Other
    $0
    Deferred
    $6,900
    Nontaxable benefits
    $13,830
    Filer's total
    $393,926

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 3 · Compensation committee
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2024
Filed
14 May 2026
IRS schema version
2024v5.5
Source object
202601349349310095

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