Citizens Memorial Hospital organized as a district governmental entity under Missouri law. Citizens Memorial Healthcare Foundation, established in 1986 as a not-for-profit 501(c)(3) entity, was organized to assist the hospital in the community health system. The Foundation was a necessary part in the planned growth of CMH, as Missouri law did not provide for the ownership of allied health facilities by the hospital, organized under the district hospital laws.

A six-member board of directors governs CMH; a nine-member board governs the Foundation: two members are affiliated with the hospital's board of directors and seven are independent members. CMH board members are elected officials that are accountable to the communities in which they serve by standing for re-election every six years. 

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