9 locations registered under this record — data as of November 8, 2026
Critical access hospital · FAIRFIELD, IL
FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION
Taking partYesLast certifiedAugust 11, 2026
- 9Registered locations
- 1Associated locations
- 22Contract pharmacies
- 11With no end date
- July 1, 2011In 340B since
Where this record sits: among the 56 Critical access hospitals in Illinois, the median open contract-pharmacy count is 7.5; this record’s open count ranks 20.
Every Medicare cost report this hospital has filed is on its cost-report record.
Finances, as filed
From this hospital’s Medicare cost report for the year ended June 30, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $154,300,561 | CMS-2552-10 worksheet G300000 line 100 column 100 |
| Contractual allowances | $105,785,065 | CMS-2552-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $48,515,496 | CMS-2552-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $51,929,545 | CMS-2552-10 worksheet G300000 line 400 column 100 |
| Income from service to patients | −$3,414,049 | CMS-2552-10 worksheet G300000 line 500 column 100 |
| Charity care, at charges | $742,941 | CMS-2552-10 worksheet S100001 line 2000 column 300 |
| Charity care, at cost | $270,904 | CMS-2552-10 worksheet S100001 line 2300 column 300 |
| Bad debt expense | $5,839,549 | CMS-2552-10 worksheet S100001 line 2600 column 100 |
| Bad debt other than Medicare, at cost | $2,115,536 | CMS-2552-10 worksheet S100001 line 2900 column 100 |
| Uncompensated care, at cost | $2,386,440 | CMS-2552-10 worksheet S100001 line 3000 column 100 |
| Total facility beds | 25 | CMS-2552-10 worksheet S300001 line 1400 column 200 |
| Cost-to-charge ratio | 0.3646 | CMS-2552-10 worksheet S100001 line 100 column 100 |
Cost report filed under CMS certification number 141311 for July 1, 2024 to June 30, 2025, as submitted. The public file it was read from.
Community benefit, as filed
From IRS Form 990 Schedule H, Part I, filed by FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION (employer identification number 370661202) for tax year 2022. The return lists this hospital as its one hospital facility.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total community benefit expense (line 7k) | $6,060,891 | IRS Form 990 Schedule H, Part I, <TotalCommunityBenefitsGrp><NetCommunityBenefitExpnsAmt> |
| Financial assistance at cost (line 7a) | $905,825 | IRS Form 990 Schedule H, Part I, <FinancialAssistanceAtCostTyp><NetCommunityBenefitExpnsAmt> |
| Medicaid (line 7b) | $4,770,033 | IRS Form 990 Schedule H, Part I, <UnreimbursedMedicaidGrp><NetCommunityBenefitExpnsAmt> |
| Financial assistance and means-tested government programs (line 7d) | $5,675,858 | IRS Form 990 Schedule H, Part I, <TotalFinancialAssistanceTyp><NetCommunityBenefitExpnsAmt> |
| Other benefits (line 7j) | $385,033 | IRS Form 990 Schedule H, Part I, <TotalOtherBenefitsGrp><NetCommunityBenefitExpnsAmt> |
| Total, fraction of total expense (line 7k, column f) | 0.1164 | IRS Form 990 Schedule H, Part I, <TotalCommunityBenefitsGrp><TotalExpensePct> |
E-file object id 202431289349301538. The IRS archive it was read from.
Executive and director compensation, as filed
From IRS Form 990 Part VII, Section A, filed by FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION (employer identification number 370661202) for tax year 2022. The return lists this hospital as its one hospital facility.
| Name | Title | Role | Reportable comp, from this organization | Reportable comp, from related organizations | Other compensation |
|---|---|---|---|---|---|
| ALEXIS KING | CRNA | Highest-compensated employee | $342,472 | $0 | $9,373 |
| AMY MARSH GRAY | CFO | Officer | $134,151 | $0 | $3,537 |
| ANITA POND | SECRETARY/TREASURER | Trustee/director, Officer | $0 | $0 | $0 |
| CHRISTOPHER BALLARD | PHYSICIAN | Highest-compensated employee | $359,333 | $0 | $15,483 |
| D JAMIE POLLARD | DIRECTOR | Trustee/director | $0 | $0 | $0 |
| DANA TAYLOR | COO | Officer | $139,234 | $0 | $9,039 |
| DONNA MASTERSON | DIRECTOR | Trustee/director | $0 | $0 | $0 |
| DOUG WILSON | DIRECTOR | Trustee/director | $0 | $0 | $0 |
| HAZEL VEST | CNO (END 07/22) | Officer | $93,907 | $0 | $11,465 |
| JOEY HUNGERFORD | VICE PRESIDENT | Trustee/director, Officer | $0 | $0 | $0 |
| JOSH SCOTT | DIRECTOR (BEG 01/23) | Trustee/director | $0 | $0 | $0 |
| KATHERINE BUNTING | CEO | Officer | $353,526 | $0 | $15,856 |
| KORY BLANK | ORTHOPEDIC SURGEON | Highest-compensated employee | $731,776 | $0 | $3,167 |
| LOUIS REMYNSE | UROLOGIST | Highest-compensated employee | $440,887 | $0 | $5,690 |
| MARLA LAFIKES | PHYSICIAN | Highest-compensated employee | $307,287 | $0 | $17,377 |
| MATTHEW SENG | DIRECTOR | Trustee/director | $0 | $0 | $0 |
| MICHAEL COPELAND | DIRECTOR | Trustee/director | $0 | $0 | $0 |
| PATRICK MOLT MD | PRESIDENT/CMO | Trustee/director, Officer | $104,670 | $0 | $0 |
| RACHEL EWING | CNO (BEG 09/22) | Officer | $110,733 | $0 | $7,605 |
| TOBY HUCKER | DIRECTOR (END 07/22) | Trustee/director | $0 | $0 | $0 |
E-file object id 202431289349301538. The IRS archive it was read from.
The full report for FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION
Every figure on this page as a document you can keep, file or send on: the finances as filed with the worksheet, line and column each one came from, five hospitals of a similar size in the same state, the contract-pharmacy network year by year, and what changed on the record.
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Where this hospital sits among its peers
A position, not a grade. Each line names the figure, how it is measured, and the hospitals it is placed among: critical access hospitals in the same state and the same bed-size band, each on its latest filed year. Under it, the same figure across every hospital that filed for the year — a larger set, and a different one.
- 53rdpercentile of 40 hospitals in IL, same facility class, 25 to 49 bedsNet patient revenue, in dollars, as filed
Net patient revenue across every hospital that filed for 2025, in every state and of every size, with this one marked.
Net patient revenue (CMS-2552-10 worksheet G300000 line 300 column 100)
Middle half between $26,780,592 and $275,353,989, median $73,049,131, across 5,659 hospitals that filed for 2025, in every state and of every size.
- 65thpercentile of 40 hospitals in IL, same facility class, 25 to 49 bedsTotal operating expenses, in dollars, as filed
Total operating expenses across every hospital that filed for 2025, in every state and of every size, with this one marked.
Total operating expenses (CMS-2552-10 worksheet G300000 line 400 column 100)
Middle half between $27,953,478 and $268,914,289, median $72,935,955, across 5,819 hospitals that filed for 2025, in every state and of every size.
- 42ndpercentile of 38 hospitals in IL, same facility class, 25 to 49 bedsCharity care, at cost, in dollars, as filed
- 77thpercentile of 39 hospitals in IL, same facility class, 25 to 49 bedsUncompensated care, at cost, in dollars, as filed
- 100thpercentile of 40 hospitals in IL, same facility class, 25 to 49 bedsTotal facility beds, a count of beds, as filed
Total facility beds across every hospital that filed for 2025, in every state and of every size, with this one marked.
Total facility beds (CMS-2552-10 worksheet S300001 line 1400 column 200)
Middle half between 25 and 168, median 64, across 5,777 hospitals that filed for 2025, in every state and of every size.
- 49thpercentile of 39 hospitals in IL, same facility class, 25 to 49 bedsCost-to-charge ratio, the ratio, as filed
Cost-to-charge ratio across every hospital that filed for 2025, in every state and of every size, with this one marked.
Cost-to-charge ratio (CMS-2552-10 worksheet S100001 line 100 column 100)
Middle half between 0.1809 and 0.4503, median 0.2651, across 4,413 hospitals that filed for 2025, in every state and of every size.
Changes recorded
Nothing on this record has moved since it was first read here on September 6, 2026.
Every Medicare cost report this hospital has filed, every change this record has shown since it was first read here, and five hospitals of its own size in Illinois beside it — each figure with the cell it came from — are in the report above.
Register detail and identifiers
Participation, as filed
- Participating
- TRUE
- Participation start date
- July 1, 2011
- Certification date
- August 11, 2026
- Record last edited
- August 11, 2026
Identifiers
- 340B ID
- CAH141311-00
- Entity type as filed
- CAH
- CMS certification number
- 141311
- NPI
- 1255422416 (IL)
- Rural
- Yes
303 NW 11TH STREET, FAIRFIELD IL 62837
Locations registered under this record
Browse all of them as a list →
| CAH141311-01 | Horizon Healthcare | CAH | FAIRFIELD, IL | Yes |
| CAH141311-02 | Horizon Healthcare Cisne Medical Clinic | CAH | Cisne, IL | Yes |
| CAH141311-03 | Pain Center of Fairfield Memorial Hospital - Pain Center | CAH | Fairfield, IL | Yes |
| CAH141311-04 | Emergency Department - Emergency Department | CAH | Fairfield, IL | Yes |
| CAH141311-05 | Urology Surgical Clinic of Fairfield Memorial Hospital - Urology | CAH | Fairfield, IL | Yes |
| CAH141311-06 | Horizon Healthcare Grayvile Medical Clinic - Family Practice | CAH | Grayville, IL | No |
| CAH141311-07 | Horizon Healthcare Carmi Medical Clinic - Family Practice | CAH | Carmi, IL | Yes |
| CAH141311-08 | Orthopedic Surgical Clinic of Fairfield Memorial Hospital - Orthopedics | CAH | Fairfield, IL | Yes |
| CAH141311-09 | General Surgery Clinic of Fairfield Memorial Hospital - General Surgery | CAH | Fairfield, IL | Yes |
Associated locations
| FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION | 303 NW 11TH STREET | FAIRFIELD IL 62837 |
Pharmacy contracts
No end date filed11
| BANDY'S APOTHECARY SHOPS INC. | WAYNE CITY, IL | October 1, 2026 | no end date filed |
| PLUM STREET PHARMACY LLC | CARMI, IL | January 1, 2027 | no end date filed |
| POTTS FAMILY LLC | FAIRFIELD, IL | October 1, 2026 | no end date filed |
| RIGG FAMILYCARE PHARMACY | ALBION, IL | October 1, 2026 | no end date filed |
| WAL-MART CENTRAL FILL 10-2670 | SPRING, TX | October 1, 2017 | no end date filed |
| WAL-MART PHARMACY 10-0454 | FAIRFIELD, IL | October 1, 2014 | no end date filed |
| WAL-MART PHARMACY 10-0506 | FLORA, IL | January 1, 2027 | no end date filed |
| WAL-MART PHARMACY 10-0833 | CARMI, IL | January 1, 2027 | no end date filed |
| WAL-MART PHARMACY 10-5997 | ORLANDO, FL | October 1, 2017 | no end date filed |
| WALMART PHARMACY 10-5169 | ROGERS, AR | April 1, 2023 | no end date filed |
| Walmart Pharmacy 10-7611 | Plainfield, IN | January 1, 2024 | no end date filed |
An end date is filed11
An end date still in the future is a termination already filed, not one that has happened. Both are printed here as the file carries them.
| BANDY'S APOTHECARY SHOPS INC. | WAYNE CITY, IL | January 1, 2024 | December 31, 2025 |
| CVS CAREMARK | WILKES BARRE, PA | January 1, 2024 | December 31, 2025 |
| CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC | MT PROSPECT, IL | January 1, 2024 | December 31, 2025 |
| EDS MEDICENTER PHARMACY | FAIRFIELD, IL | April 1, 2019 | September 22, 2020 |
| HIGHLAND PARK CVS, L.L.C. | FAIRFIELD, IL | January 1, 2024 | December 31, 2025 |
| HIGHLAND PARK CVS, L.L.C. | FLORA, IL | January 1, 2024 | December 31, 2025 |
| HIGHLAND PARK CVS, L.L.C. | OLNEY, IL | January 1, 2024 | December 31, 2025 |
| HIGHLAND PARK CVS, L.L.C. | CARMI, IL | January 1, 2024 | December 31, 2025 |
| POTTS FAMILY LLC | FAIRFIELD, IL | January 1, 2024 | December 31, 2025 |
| RIGG FAMILYCARE PHARMACY | ALBION, IL | January 1, 2024 | December 31, 2025 |
| THE MEDICINE SHOPPE | FAIRFIELD, IL | January 1, 2013 | November 14, 2016 |
How this page is built
- What is counted
- One row per registration in the register. This page is the row for this 340B ID; a figure that reads across a record and its locations counts the rows the register lists under this record as well.
- As of
- November 8, 2026 — the date of the register file this record was last listed in.
- Contract-pharmacy arrangements
- Each arrangement the register files between a covered entity and a pharmacy counts once. An arrangement counts among those with no end date where the register prints no termination date for it, and among the rest where it prints one.
Every figure on this page comes from HRSA 340B OPAIS Covered Entity Daily Report.
Every figure on this page is printed as it appears in the HRSA 340B OPAIS Covered Entity Daily Report, file 340B_CoveredEntity_Daily_20261108_071011.xlsx, stamped by its publisher November 8, 2026. This record has been read here since September 6, 2026.
How this page was built: the HRSA 340B OPAIS Covered Entity Daily Report, file 340B_CoveredEntity_Daily_20261108_071011.xlsx, read November 8, 2026.