2020-08-11T16:51:05-05:00 2019-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2018-10-01 440584290 SKAGGS COMMUNITY HOSPITAL ASSOCIATION % DAVID STRONG SKAG 4173357000 525 BRANSON LANDING BOULEVARD BRANSON MO 65615 JACOB MCWAY COXHEALTH CFO 2020-05-15 true Brian D Todd P00422601 4178658701 167.68.126.162 43032920202245000035 2020-08-11 P 74C51B083D6172D3D43AC87F1A33B4712A418457 707D1959215E1734E70291BECA2AB3AECE192F1C 2018 2020-09-23 17:36:50Z COX MEDICAL CENTER BRANSON WILLIAM MAHONEY 525 BRANSON LANDING BOULEVARD BRANSON MO 65615 233588455 false X WWW.COXHEALTH.COM X 1950 MO IMPROVES LIVES VIA EDUCATION, PREVENTION, AND ADVOCACY; BY THE USE OF TECHNOLOGY; AND BY PROVIDING COMFORT AND PRIVACY WHILE PRESERVING DIGNITY. SEE SCHEDULE O FOR MORE INFORMATION. 14 10 1791 190 20308 -147681 242194 133715 214987792 197619472 1676264 2207146 0 0 216906250 199960333 372211 99325 0 0 79705392 84293329 0 0 0 125166753 102307378 205244356 186700032 11661894 13260301 223061524 246460112 79324809 90186432 143736715 156273680 X THE HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH QUALITY HEALTH CARE, EDUCATION AND RESEARCH. false false 146209125 99325 175437511 HOSPITAL SERVICES - COX MEDICAL CENTER BRANSON PROVIDES THE FOLLOWING AREAS OF SERVICE: CANCER, CARDIAC, DIABETES AND ENDOCRINOLOGY, EAR NOSE AND THROAT, EMERGENCY, URGENT CARE, FAMILY MEDICINE, IMAGING AND RADIOLOGY, LABORATORY AND PATHOLOGY, NEPHROLOGY AND DIALYSIS, NEUROLOGY, OCCUPATIONAL HEALTH, ORTHOPEDICS, PEDIATRICS, PSYCHIATRY, PULMONOLOGY/CRITICAL CARE, REHABILITATION AND THERAPY, RHEUMATOLOGY, SLEEP DISORDER CENTER, SOCIAL SERVICES, SURGERY, UROLOGY, WOMEN'S SERVICES AND WOUND CARE. SEE SCHEDULE O FOR MORE INFORMATION. 25026362 22181961 CLINIC SERVICES - CLINIC SERVICES INCLUDE FAMILY MEDICINE, OB-GYN SERVICES, GENERAL SURGERY, INTERNAL MEDICINE, INFECTIOUS DISEASE TREATMENT AND PULMONOLOGY. COORDINATION OF CARE IS ENHANCED BY A PHYSICIAN LIAISON. 171235487 true true false true false false false false false false true false false true true false false true false false false false false false false false true true true false true false false false false false false false false false false false false true true false false false true 0 0 1791 true true true false false false false false false false false false false false X 14 10 true false false false true true true true true false false true true true true true true true true false X DAVID STRONG 4173357789 525 BRANSON LANDING BOULEVARD BRANSON MO 65615 X HOLLY WHERRY BOARD MEMBER 40.0 0.0 X 359267 0 2644 NITA AYRES BOARD MEMBER 1.0 0.0 X 0 0 0 CHARITY ELMER BOARD MEMBER 1.0 39.0 X 0 586278 125714 JAKE MCWAY BOARD MEMBER/COXHEALTH CFO 1.0 39.0 X 0 891941 168179 RICHARD BLUBAUGH BOARD MEMBER 1.0 0.0 X 0 0 0 SUE HEAD TREASURER 1.0 0.0 X X 0 0 0 DENNIS NEWKIRK BOARD MEMBER 1.0 0.0 X 0 0 0 J TRAVIS BRAWNER BOARD MEMBER 1.0 0.0 X 0 0 0 JOE LOTH BOARD MEMBER 1.0 0.0 X 0 0 0 BRAD SWOFFORD BOARD MEMBER 1.0 0.0 X 0 0 0 ROBERT T COX INTERIM CHAIR 1.0 0.0 X X 0 0 0 PHILLIP LOYD BOARD MEMBER 1.0 0.0 X 0 0 0 STEVE EDWARDS BOARD MEMBER/COXHEALTH CEO 1.0 39.0 X 0 1501873 295293 ROBERT F MCDOWELL BOARD MEMBER 1.0 0.0 X 0 0 0 RICK TODD VICE CHAIR END 07/2019 1.0 0.0 X X 0 0 0 WILLIAM MAHONEY PRESIDENT 40.0 0.0 X 596766 0 78135 DAVID STRONG CFO 40.0 0.0 X 179199 179197 58885 BARBARA STEWART SECRETARY 40.0 0.0 X 57335 0 3750 SIMON WAJNBOLM VP 40.0 0.0 X 150127 0 21227 SHAWN USERY CMO 40.0 0.0 X 391431 0 29730 LYNNE YAGGY CNO 40.0 0.0 X 194576 0 24678 CHAD EFIRD PHYSICIAN 40.0 0.0 X 1096315 0 48235 PATRICK FINKBONE PHYSICIAN 40.0 0.0 X 901810 0 29730 NARIN ARUNAKUL PHYSICIAN 40.0 0.0 X 653243 0 48785 PRASER VIJITBENJARONK PHYSICIAN 40.0 0.0 X 652020 0 48685 BRIAN CLONTS PHYSICIAN 40.0 0.0 X 659082 0 48759 5891171 3159289 1032429 93 false true false WHITE RIVER ANESTHESIA ASSOC PO BOX 1308 BRANSON MO 65615 ANESTHESIA SERVICES 1956855 SHIFTWISE PO BOX 70870 ST PAUL MN 55170 STAFFING MANAGEMENT 1116501 2 795 132920 133715 NET PATIENT SERVICE REVENUE 624100 192042195 192042195 PHARMACY 446110 1815700 1815700 CAFETERIA 722514 1432904 1432904 LAB REVENUE 621500 809934 789626 20308 FITNESS CENTER 624100 353184 353184 1165555 1165555 197619472 1590921 1590921 0 0 0 0 0 33240253 1004094 32427489 1200633 812764 -196539 616225 616225 0 0 0 0 0 0 0 0 0 0 199960333 197599164 20308 2207146 X 99325 99325 0 0 0 2118307 1173680 944627 0 67883841 57833887 10049954 1788297 1767122 21175 8102880 7717032 385848 4400004 4178674 221330 0 0 102012 102012 0 0 0 40084532 38165197 1919335 0 40968 37583 3385 5856561 5426877 429684 982905 901680 81225 0 4356461 3996455 360006 527406 483823 43583 0 46283 42458 3825 2917976 2676843 241133 0 7299608 6696389 603219 453522 416044 37478 MEDICAL SUPPLIES & DRUGS 31847642 31847642 STATE PROVIDER TAX 7589093 7589093 LICENSES, DUES, SUBSCRIPTIONS 200714 184128 16586 MISCELLANEOUS EXPENSE 1695 1555 140 186700032 171235487 15464545 0 22738958 2661627 27038134 66345332 0 0 25869170 24271895 0 0 0 0 0 0 2877378 2780020 178384 693959 143988545 51728765 91507842 92259780 19324784 25208211 9051418 8910337 9174807 6572204 551500 551500 14749149 16205247 223061524 246460112 11587793 12363482 0 0 0 36800 56907278 69122244 0 0 0 0 8877201 7656256 0 0 1952537 1007650 79324809 90186432 X 133543934 146221979 1141363 1141364 9051418 8910337 143736715 156273680 223061524 246460112 X 13260301 -582255 -141081 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 17317 17317 false SCHEDULE C, PART II-B, LINE 1 (I) OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAID DUES OF $43,964 TO THE MISSOURI HOSPITAL ASSOCIATION AND $19,899 TO THE AMERICAN HOSPITAL ASSOCIATION, OF WHICH $12,794 (29.1%) AND $4,523 (22.73%) RESPECTIVELY IS ATTRIBUTABLE TO LOBBYING PURPOSES. 5522712 5522712 60379061 13898617 46480444 4334390 1125596 3208794 61409311 34296676 27112635 12343071 2407876 9935195 92259780 OTHER RECEIVABLES 632096 INTEREST RECEIVABLE 2809 DUE FROM RELATED PARTY 15570342 16205247 0 DUE TO THIRD PARTY 1007650 1007650 SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: 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. true true X false true X true true true false true true 11470733 11470733 0.06140 27632979 24672081 2960898 0.01590 39103712 24672081 14431631 0.07730 10741 10741 0.00010 1341963 114101 1227862 0.00660 10309353 4312871 5996482 0.03210 267564 267564 0.00140 11929621 4426972 7502649 0.04020 51033333 29099053 21934280 0.11750 false 20637713 2971831 94368833 104277783 -9908950 X true true 1 1 SKAGGS COMMUNITY HEALTH CENTER 251 SKAGGS RD BRANSON MO 65616 WWW.COXHEALTH.COM 52-57 X X X SKAGGS COMMUNITY HEALTH CENTER 1 false false true X X X X X X X X X 18 true true true true X SEE PART V, SECTION C X SEE PART V, SECTION C X X true 18 true SEE PART V, SECTION C false true X 0. 300. X X X X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: IN 2017, A VARIETY OF ORGANIZATIONS ACROSS THE OZARKS RECONVENED UNDER THE UMBRELLA OF THE OZARKS HEALTH COMMISSION TO ASSESS THE HEALTH NEEDS OF OUR REGION. BUILDING UPON THE SUCCESS OF THE 2016 REGIONAL HEALTH ASSESSMENT, PARTNERS AGAIN SOUGHT TO BETTER UNDERSTAND THE HEALTH STATUS, BEHAVIORS AND NEEDS OF THE POPULATIONS THEY SERVE. THIS 2019 ASSESSMENT COMBINES MORE THAN 140 HOSPITAL AND COMMUNITY DATA INDICATORS AS WELL AS FEEDBACK FROM STAKEHOLDERS AND THE BROADER COMMUNITY. THIS PROCESS RESULTED IN THREE PRIORITIES: LUNG DISEASE, CARDIOVASCULAR DISEASE AND MENTAL HEALTH. WEAVING AMONG THE ISSUES IDENTIFIED WERE FIVE COMMON THREADS: ACCESS TO HEALTH CARE, MENTAL HEALTH, PHYSICAL ACTIVITY, SOCIAL DETERMINANTS OF HEALTH AND TOBACCO USE. ADDITIONALLY, THE HEALTH STATUS OF POPULATIONS OF INTEREST - SUCH AS PEOPLE IN POVERTY, MINORITIES AND THE ELDERLY--WERE ALSO ANALYZED. RECOGNIZING THE VALUE OF ASSESSING AND ACTING TOGETHER ON LOCAL HEALTH ISSUES, KEY PLAYERS FROM LOCAL HOSPITAL SYSTEMS, PUBLIC HEALTH ENTITIES, AND OTHERS FORMED A WORKING GROUP TO BEGIN THE TASK OF A REGIONAL HEALTH ASSESSMENT. THIS GROUP GREW UNDER THE UMBRELLA OF THE LOCAL OZARKS HEALTH COMMISSION (OHC) AND PUBLISHED THE FIRST ASSESSMENTS IN 2016. SINCE THAT TIME, THE PROCESS HAS BEEN RECOGNIZED AT THE ANNUAL MEETING OF THE AMERICAN PUBLIC HEALTH ASSOCIATION, HONORED AS A PROMISING PRACTICE BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS, AND AWARDED THE GROUP MERIT AWARD FROM THE MISSOURI PUBLIC HEALTH ASSOCIATION. COLLECTIVELY, THE ASSESSMENTS SPAN FOUR STATES - MISSOURI, OKLAHOMA, ARKANSAS, AND KANSAS, 29 COUNTIES AND THREE HOSPITAL SYSTEMS. THIS FOOTPRINT WILL BE REFERRED TO THROUGHOUT THE REPORT AS THE OHC REGION. PRIORITIZATION PROCESS INCLUDED THE FOLLOWING STAKEHOLDERS: CITY OF SPRINGFIELD - PLANNING DEPARTMENT -COMMUNITY PARTNERSHIP OF THE OZARKS -COXHEALTH -DREW LEWIS FOUNDATION -MERCY -MISSOURI ALLIANCE OF YMCA -MISSOURI STATE UNIVERSITY -MISSOURI JOB CENTER -OZARKS FOOD HARVEST -OZARK GREENWAYS -SPRINGFIELD AREA CHAMBER OF COMMERCE -SPRINGFIELD-GREENE COUNTY HEALTH DEPARTMENT -SPRINGFIELD-GREENE COUNTY PARKS SCHEDULE H, PART V, SECTION B, LINE 6A CHNA CONDUCTED WITH OTHER HOSPITALS: THE CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITY PARTNERS: -FREEMAN HEALTH SYSTEM -MERCY -LESTER E. COX MEDICAL CENTERS -COX-MONETT HOSPITAL, INC -COX BARTON COUNTY HOSPITAL SCHEDULE H, PART V, SECTION B, LINE 6B CHNA CONDUCTED WITH OTHER ORGANIZATIONS: THE CHNA WAS ALSO CONDUCTED WITH THE FOLLOWING OTHER NON-HOSPITAL ORGANIZATIONS: -JASPER COUNTY HEALTH DEPARTMENT -JOPLIN HEALTH DEPARTMENT -SPRINGFIELD GREENE COUNTY HEALTH DEPARTMENT -TANEY COUNTY HEALTH DEPARTMENT SCHEDULE H, PART V, SECTION B, LINE 7A CHNA HOSPITAL FACILITY'S WEBSITE: HTTPS://WWW.COXHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/ SCHEDULE H, PART V, SECTION B, LINE 7B CHNA OTHER WEBSITES: HTTP://WWW.OZARKSHEALTHCOMMISSION.ORG HTTP://WWW.MERCY.NET HTTP://WWW.COXHEALTH.COM HTTP://WWW.FREEMANHEALTH.COM SCHEDULE H, PART V, SECTION B, LINE 7D OTHER METHODS TO MAKE THE CHNA REPORT AVAILABLE TO THE PUBLIC: PRINTED COPIES ARE AVAILABLE BY REQUEST THROUGH HOSPITAL OR PUBLIC HEALTH PARTNERS OR AT OZARKSHEALTHCOMMISSION.ORG AND NEWS RELEASE WAS SENT OUT TO ENCOURAGE MEDIA COVERAGE WITH LINKS TO THE REPORT AND KEY MESSAGES FOR THE PUBLIC. SCHEDULE H, PART V, SECTION B, LINE 10A IMPLEMENTATON STRATEGY WEBSITE: HTTPS://WWW.COXHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/ SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING IDENTIFIED NEEDS: 1. INCREASE PATIENT ENGAGEMENT IN CHRONIC CONDITION SELF-MANAGEMENT -THE CENTER FOR HEALTH IMPROVEMENT EMPLOYS A SKILLED TEAM OF HEALTHCARE PROFESSIONALS WHO DELIVER SUPPORT AND EDUCATION FOR CHRONIC DISEASE MANAGEMENT, MEDICAL NUTRITION THERAPY, AND ADVANCE CARE PLANNING. THEY PROVIDE TOOLS DESIGNED TO INCREASE SELF- MANAGEMENT OF CHRONIC CONDITIONS INCLUDING DIABETES, AUTOIMMUNE DISORDERS, METABOLIC SYNDROME, AND MORE. -IN THE FIRST QUARTER CALENDAR YEAR 2018, A CURRENT STATE ASSESSMENT OF THE CENTER FOR HEALTH IMPROVEMENT WAS CONDUCTED TO DETERMINE THE EFFICACY OF VARIOUS PROGRAMS. AS A RESULT OF THE ASSESSMENT, THE TEAM REFINED THE SCOPE OF OFFERINGS TO AN EVIDENCE-BASED, TARGETED PROGRAM SUITE THAT FOCUSES HEAVILY ON IMPROVING CHRONIC CONDITION MANAGEMENT OF PATIENTS. -IN ADDITION TO THE PROGRAMS ALREADY OFFERED, THE CENTER FOR HEALTH IMPROVEMENT ADDED A NEW SIX-WEEK, EVIDENCE-BASED COURSE FOCUSED ON CHRONIC PAIN CONDITIONS. -THE NURSING EDUCATION DEPARTMENT AND THE JOINT REPLACEMENT EDUCATORS AT MEYER ORTHOPEDIC CENTER DEVELOPED A PROCESS TO INCREASE TIGR VIDEO EDUCATION VIEWS. MANDATORY EDUCATION WAS EXPANDED TO INCLUDE ALL ADULT PATIENTS WITH A DIAGNOSIS OF PNEUMONIA, HEART FAILURE, ACUTE MI, TOTAL HIP/KNEE REPLACEMENT, OR COPD TO HELP ACHIEVE BEST OUTCOMES WHILE REDUCING READMISSIONS. -TIGR VIDEO VIEWS INCREASED FROM 4,694 VIEWS IN MAY 2018 TO 6,284 IN MAY 2019. 2. REDUCE AVOIDABLE HOSPITAL READMISSIONS - COXHEALTH NURSING ADMINISTRATION BEGAN TRAINING NURSES ON LIGHT DUTY TO COMPLETE PATIENT READMISSION INTERVIEW FORMS IN 2018. WHEN A PATIENT IS READMITTED WITHIN THIRTY DAYS, A CASE MANAGER MEETS WITH THE PATIENT TO DISCUSS THE READMISSION. TOPICS COVERED IN THE INTERVIEW INCLUDE: >FREQUENCY OF GOOD COMMUNICATION IN THE HOSPITAL REGARDING DIAGNOSIS AND MEDICATIONS. >COMMUNICATION ABOUT DISCHARGE INSTRUCTIONS AND ABILITY TO UNDERSTAND INSTRUCTIONS. >MEDICATION COMPLIANCE AND REASONS FOR ANY DIFFICULTY REMAINING COMPLIANT. >FOLLOW UP APPOINTMENTS WITH A PCP BEING SCHEDULED AND ATTENDED. >REASONS FOR READMISSION, FROM THE PATIENTS PERSPECTIVE. >>THE INFORMATION GATHERED BY THE CASE MANAGER COMES DIRECTLY FROM THE PATIENT AND IS ENTERED INTO REPORTABLE FIELDS THAT ALLOW FOR DATA COLLECTION. COMMON THEMES FOR AVOIDABLE READMISSIONS WILL BE EASIER TO IDENTIFY AND PREVENT THROUGH THIS PROCESS. -EVIDENCE-BASED BEST PRACTICES TO REDUCE AVOIDABLE READMISSIONS HAVE BEEN IMPLEMENTED AND CONTINUE TO EXPAND. >COXHEALTH HIRED TRANSITIONAL CARE PHARMACISTS WHO DEDICATE THEIR TIME WORKING WITH PATIENTS BEING DISCHARGED TO ENSURE THE PATIENT LEAVES THE HOSPITAL WITH THEIR MEDICATIONS. >NEW EFFORTS ARE IN PLACE TO INCREASE THE NUMBER OF PATIENTS WHO LEAVE THE HOSPITAL WITH THEIR MEDICATIONS THROUGH THE USE OF A FOCUSED, FAST-PACED I-90 PROJECT. >THE CLINIC SUPPORT TEAM HAS BEEN INSTRUMENTAL IN SCHEDULING FOLLOW-UP APPOINTMENTS WITH PATIENTS. THE MAJORITY OF INPATIENT UNITS ARE COVERED BY THE CLINIC SUPPORT TEAM, WHICH MEANS MOST PATIENTS HAVE A FOLLOW UP APPOINTMENT SCHEDULED PRIOR TO LEAVING THE HOSPITAL. >A SUBGROUP COMPRISED OF FRONTLINE STAFF, LEADERS, AND QUALITY IMPROVEMENT EXPERTS HAS BEEN FORMED TO FOCUS SPECIFICALLY ON REDUCING HEART FAILURE READMISSIONS. THE GROUP WILL USE DATA TO INFORM DECISIONS ON HOW TO BEST MANAGE OUR PATIENTS WITH FREQUENT INPATIENT STAYS DUE TO HEART FAILURE. 3. INCREASE ACCESS TO TOBACCO CESSATION RESOURCES FOR PATIENTS AND FAMILIES PRESENTING TO OUR HOSPITALS AND CLINICS -AN ASSET ASSESSMENT AND GAP ANALYSIS OF THE SYSTEMS TOBACCO TREATMENT OFFERINGS WAS CONDUCTED. RECOMMENDATIONS FROM THAT ASSESSMENT INCLUDED CREATION AND IMPLEMENTATION OF A CLEARLY OUTLINED REFERRAL PROCESS AND DEFINED RESOURCES AND PROMOTION OF THE ASK, ADVISE, ACT/REFER MODEL TO INITIATE INTERVENTION. -IN MAY 2018, WE PROVIDED TRAINING TO 12 KEY COXHEALTH STAFF MEMBERS AND 3 COMMUNITY EDUCATORS. COMPLETION OF THE UMASS MEDICAL SCHOOL EDUCATION CURRICULUM, REQUIRED EXAMS, AND PRACTICE HOURS MADE CLASS PARTICIPANTS ELIGIBLE FOR CERTIFICATION AS TOBACCO TREATMENT SPECIALISTS. AS A RESULT OF THIS EDUCATION, THE NUMBER OF CESSATION RESOURCES AVAILABLE WITHIN THE SYSTEM INCREASED. THE TRAINING WILL BE OFFERED AGAIN IN OCTOBER 2019 TO FURTHER INCREASE RESOURCES. -THE QUIT RATE FOR OUR TOBACCO CESSATION PROGRAM HAS CONTINUED TO SHOW POSITIVE RESULTS SINCE ITS INCEPTION IN 2013, WITH THE CURRENT QUIT RATE FOR 2019 TO DATE AT 64%. AVERAGING ACROSS THE HISTORY OF THE PROGRAM, THE AGGREGATED QUIT RATE IS 55%. -DUE TO THE SUCCESS OF THIS PROGRAM, FOLLOWING THE STONE AND TANEY COUNTY MFH TOBACCO GRANTS END ON MAY 31, 2018, WE WERE ABLE TO HIRE A FULL TIME TOBACCO CESSATION COORDINATOR WHO IS RESPONSIBLE FOR COORDINATING SYSTEM EFFORTS TO STANDARDIZE POLICIES AND REFERRAL PROCESSES ACROSS ALL CAMPUSES AND SETTINGS. 4. DECREASE CHILDHOOD OBESITY -THE CARDIAC KIDS PROGRAM IS IMPLEMENTED IN 13 RURAL SCHOOLS IN THE COXHEALTH SERVICE AREA. ITS MAIN OBJECTIVE IS TO SCREEN 5TH GRADE STUDENTS FOR HEALTH INDICATORS THAT PUT THEM AT HIGH RISK FOR DEVELOPING CARDIAC DISEASE. SCREENING BY COXHEALTH STAFF INCLUDES HEIGHT AND WEIGHT MEASUREMENT, BMI CONSULT, AND HEALTH/NUTRITION EDUCATION. -APPROXIMATELY 400 CHILDREN ARE SCREENED ANNUALLY. THOSE WHO ARE DEEMED HIGH RISK ARE REFERRED TO THE COMMITTED TO KIDS PROGRAM. THIS 8-WEEK PROGRAM IS AN INTENSIVE INTERVENTION FOR AT-RISK CHILDREN AND THEIR FAMILIES FOCUSING ON HEATHY BEHAVIOR AND NUTRITION EDUCATION. 5. INCREASE THE NUMBER OF WOMEN WHO BREASTFEED THEIR INFANTS AFTER DELIVERY -COXHEALTH AND THE SPRINGFIELD-GREENE COUNTY HEALTH DEPARTMENT ARE CURRENTLY ENGAGED IN A COMMUNITY BREASTFEEDING COALITION WITH THE GOAL OF STRATEGICALLY ALIGNING EFFORTS TO HELP MOVE THE CHIP INITIATIVE FORWARD. -IN ADDITION TO EDUCATION PRESENTED IN OUR GENERAL PRENATAL CLASSES, THE COXHEALTH LACTATION CONSULTANTS FACILITATE A MONTHLY BREAST FEEDING SUPPORT GROUP CALLED THE LACTATION CLUB. -THE ANNUAL COXHEALTH BABY FAIR IS A FREE EVENT THAT FEATURES VENDOR DISPLAYS, DEMONSTRATIONS, DOOR PRIZES, AND CLASSES WITH A VARIETY OF TOPICS INCLUDING BREASTFEEDING. 6. INCREASE DETECTION AND TREATMENT OF THE EARLIEST STAGES OF LUNG CANCER NODULES -COXHEALTH OFFERS LOW-DOSE CT SCANS AS A DIAGNOSTIC SCREENING FOR LUNG CANCER. LOW-DOSE CT SCANS USE LOWER AMOUNTS OF RADIATION TO HELP IDENTIFY LUNG NODULES IN THE EARLIEST STAGES OF LUNG CANCER WHEN IT IS MOST TREATABLE. STUDIES HAVE SHOWN THAT PATIENTS WHO PARTICIPATE IN A LOW-DOSE CT LUNG CANCER PROGRAM ARE 20% LESS LIKELY TO DIE FROM LUNG CANCER THAN THOSE WHO WERE NOT SCREENED WHEN APPROPRIATE. -SINCE THE PROGRAM BEGAN, THE NUMBER OF INDIVIDUALS WHO HAD A LOW-DOSE CT SCAN COMPLETED HAS CONTINUED TO INCREASE. 7. INCREASE REFERRALS TO COMMUNITY ORAL HEALTH RESOURCES FOR PATIENTS PRESENTING TO THE ED FOR DENTAL ISSUES -COMMUNITY PARTNERSHIPS WITH LOCAL RESOURCES HAVE BEEN STRENGTHENED AND REFINED TO ENSURE STAFF FEEL EMPOWERED TO REFER PATIENTS TO FACILITIES LIKE THE JORDAN VALLEY COMMUNITY HEALTH CENTER (JVCHC) FOR THE APPROPRIATE LEVEL OF CARE FOR ORAL HEALTH ISSUES. -WHEN EVALUATING THE CHIEF COMPLAINTS OF PATIENTS THAT PRESENTED TO THE EMERGENCY DEPARTMENT (ED) FIVE OR MORE TIMES IN A 12-MONTH PERIOD FOR NON-EMERGENT CARE, DENTAL COMPLAINTS RANKED AMONG THE HIGHEST. -PROTOCOLS WERE DEVELOPED FOR PATIENTS THAT PRESENT WITH TOOTH PAIN IN THE ED. AFTER THE MEDICAL SCREENING EXAM COMPLETION, THE PATIENT IS TRANSITIONED TO JVCHC FOR IMMEDIATE DENTAL CARE. -COXHEALTH WORKED IN COLLABORATION WITH JVCHC TO APPLY FOR A GRANT THAT ALLOWED FOR THE HIRE OF ADDITIONAL DENTISTS. TO ENSURE SAME-DAY OR NEXT DAY APPOINTMENTS, THE DENTAL CLINIC EXPANDED TO ADD SATURDAY HOURS. -QUICK ACCESS TO THE DENTAL CLINIC ALLOWED COXHEALTH ED PHYSICIANS TO DISCONTINUE PRESCRIBING NARCOTICS TO PATIENTS WHO PRESENTED WITH TOOTH PAIN. SCHEDULE H, PART V, SECTION B, LINE 13A ELIGIBILITY FOR FREE CARE: IN GENERAL, THE ORGANIZATION'S CHARITY CARE POLICY DOES NOT PROVIDE FOR DISCOUNTS OF 100%. THEREFORE, IT IS EXPECTED THAT THE PATIENT OR GUARANTOR WILL HOLD A RESPONSIBILITY FOR PAYMENT OF AT LEAST A PORTION OF THE SERVICES, REGARDLESS OF THE LEVEL OF ELIGIBILITY. IT IS OUR INTENTION TO WORK WITH INDIVIDUALS ON THEIR OUT-OF-POCKET RESPONSIBILITY TO ESTABLISH FEASIBLE MONTHLY PAYMENTS WHEN NECESSARY. IN THE EVENT THAT A PATIENT OR GUARANTOR IS DETERMINED TO HAVE NO MEANS OF PAYING THE AMOUNT INDICATED AS THEIR RESPONSIBILITY DUE TO EXTENUATING CIRCUMSTANCES, CONSIDERATION MAY BE GIVEN TO WAIVING DEDUCTIBLES AND/OR INCREASING THE DISCOUNT AMOUNT UP TO A 100% DISCOUNT OF THE PATIENT PORTION. THESE EXTENUATING CASES ARE SUBJECT TO THE DISCRETION AND APPROVAL OF THE PFS DIRECTOR AND/OR THE CHIEF FINANCIAL OFFICER WITHIN THE APPROVAL LIMITS DEFINED AT THE END OF THE POLICY. SCHEDULE H, PART V, SECTION B, LINE 13H OTHER CRITERIA USED TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY: MEDICAL HARDSHIP MAY ALSO BE USED TO DETERMINE FINANCIAL ELIGIBILITY. COXHEALTH SHALL MAKE A DECISION ABOUT A PATIENT/GUARANTOR'S MEDICAL HARDSHIP BY REVIEWING THE FINANCIAL ASSISTANCE APPLICATION, INCLUDING ACCOMPANYING FINANCIAL DOCUMENTATION, IN ADDITION TO OTHER RELEVANT DOCUMENTATION THAT SUPPORTS THE MEDICAL HARDSHIP OF THE PATIENT. SCHEDULE H, PART V, SECTION B, LINE 16A FINANCIAL ASSISTANCE POLICY AVAILABILITY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, SECTION B, LINE 16B FINANCIAL ASSISTANCE POLICY APPLICATION FORM AVAILABILITY: THE FINANCIAL ASSISTANCE POLICY APPLICATION FORM IS AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, SECTION B, LINE 16C FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY AVAILABILITY: THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, SECTION B, LINE 16J MEASURES TO PUBLICIZE THE POLICY: FINANCIAL ASSISTANCE AVAILABILITY IS PROACTIVELY COMMUNICATED TO UNINSURED PATIENTS BY CUSTOMER SERVICE STAFF AND BY OUR EARLY OUT AND BAD DEBT VENDORS; ANYONE RECOGNIZED AS UNINSURED IS TOLD ABOUT THE FA AVAILABILITY AND ENCOURAGED TO PARTICIPATE. 25 SKAGGS ORTHONEURO CENTER 101 CAHILL RD BRANSON MO 65616 OUTPATIENT DEPTS PHYSICIAN CLINICS COX HEART CENTER BRANSON 1150 STATE HWY 248 STE 202 BRANSON MO 65616 CLINIC COX HYPERBARIC MEDICINE AND WOUND CARE 101 SKAGGS ROAD SUITE 103 BRANSON MO 65616 CLINIC COXHEALTH CENTER BRANSON WEST 18452 BUSINESS HWY 13 BRANSON WEST MO 65737 CLINIC COXHEALTH CENTER FORSYTH 13852 US HWY 160 FORSYTH MO 65653 CLINIC COXHEALTH DIABETES & ENDOCRINOLOGY 121 CAHILL ROAD SUITE 201 BRANSON MO 65616 CLINIC COXHEALTH FAMILY MEDICINE & OB 525 BRANSON LANDING BLVD SUITE 50 BRANSON MO 65616 CLINIC COXHEALTH FAMILY MEDICINE 1150 STATE HWY 248 SUITE 202 BRANSON MO 65616 CLINIC COXHEALTH HOSPITALIST 525 BRANSON LANDING BLVD BRANSON MO 65616 CLINIC COXHEALTH INTERN MEDINFECTIOUS DISEASE 525 BRANSON LANDING SUITE 407 BRANSON MO 65616 CLINIC COXHEALTH OCCUPATIONAL MEDICINE 121 CAHILL ROAD SUITE 201 BRANSON MO 65616 CLINIC COXHEALTH ORTHOPEDICS 121 CAHILL ROAD SUITE 206 BRANSON MO 65616 CLINIC COXHEALTH PAIN & NEUROLOGY 121 CAHILL ROAD SUITE 204 BRANSON MO 65616 CLINIC COXHEALTH PHYSICAL MEDICINE AND REHAB 525 BRANSON LANDING BLVD SUITE 40 BRANSON MO 65616 CLINIC COXHEALTH PSYCHIATRY SERVICES BRANSON 525 BRANSON LANDING BLVD BRANSON MO 65616 CLINIC COXHEALTH PULMONOLOGY & SLEEP MEDICINE 525 BRANSON LANDING BLVD SUITE 30 BRANSON MO 65616 CLINIC COXHEALTH RHEUMATOLOGY 525 BRANSON LANDING SUITE 301 BRANSON MO 65616 CLINIC COXHEALTH URGENT CARE 525 BRANSON LANDING BLVD SUITE 10 BRANSON MO 65616 CLINIC COXHEALTH WOMEN'S CENTER BRANSON 525 BRANSON LANDING BLVD SUITE 40 BRANSON MO 65616 CLINIC MARY'S WELL HOUSE 5136 STATE HWY 265 BRANSON MO 65616 PHYSICIAN CLINIC CMCB OUTPAITENT CENTER 545 N BRANSON LANDING BLVD BRANSON MO 65616 OUTPATIENT DEPTS PHYSICIAN CLINICS COXHEALTH GENERAL SURGERY 525 BRANSON LANDING BLVD BRANSON MO 65616 CLINIC FITNESS CENTER BRANSON 1500 BRANSON HILLS PARKWAY BRANSON MO 65616 FITNESS CENTER COXHEALTH ACCESS CLINIC 1150 STATE HWY 248 STE 202 BRANSON MO 65616 CLINIC FDC UROLOGYGI 525 BRANSON LANDING BLVD BRANSON MO 65616 CLINIC SCHEDULE H, PART I, LINE 3C ELIGIBILITY FOR FREE CARE: IN GENERAL, THE ORGANIZATION'S CHARITY CARE POLICY DOES NOT PROVIDE FOR DISCOUNTS OF 100%. THEREFORE, IT IS EXPECTED THAT THE PATIENT OR GUARANTOR WILL HOLD A RESPONSIBILITY FOR PAYMENT OF AT LEAST A PORTION OF THE SERVICES, REGARDLESS OF THE LEVEL OF ELIGIBILITY. IT IS OUR INTENTION TO WORK WITH INDIVIDUALS ON THEIR OUT-OF-POCKET RESPONSIBILITY TO ESTABLISH FEASIBLE MONTHLY PAYMENTS WHEN NECESSARY. IN THE EVENT THAT A PATIENT OR GUARANTOR IS DETERMINED TO HAVE NO MEANS OF PAYING THE AMOUNT INDICATED AS THEIR RESPONSIBILITY DUE TO EXTENUATING CIRCUMSTANCES, CONSIDERATION MAY BE GIVEN TO WAIVING DEDUCTIBLES AND/OR INCREASING THE DISCOUNT AMOUNT UP TO A 100% DISCOUNT OF THE PATIENT PORTION. THESE EXTENUATING CASES ARE SUBJECT TO THE DISCRETION AND APPROVAL OF THE PFS DIRECTOR AND/OR THE CHIEF FINANCIAL OFFICER WITHIN THE APPROVAL LIMITS DEFINED AT THE END OF THIS POLICY. SCHEUDLE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR EQUALS TOTAL OPERATING EXPENSES PER FORM 990, PART IX, LINE 25. SCHEDULE H, PART I, LINE 7 COST TO CHARGE RATIO: THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATIONS ON IRS WORKSHEET 1 AND 3. WORKSHEET 6 USED INTERNAL COST CALCULATIONS. SCHEDULE H, PART I, LINE 7G SUBSIDIZED SERVICES: THE ORGANIZATION HAS INCLUDED COSTS ASSOCIATED WITH RURAL HEALTH CENTERS (RHC) IN THE CALCULATION OF SUBSIDIZED SERVICES ON LINE 7G, WITH A NET SUBSIDY FROM RHCS OF $5,996,482. COX MEDICAL CENTER BRANSON PROVIDES PRIMARY CARE SERVICES TO THE SURROUNDING COMMUNITIES AT THE CENTERS. THESE SERVICES ARE PROVIDED IN RURAL AREAS WHERE THERE WOULD BE A SHORTAGE OF QUALITY MEDICAL CARE WITHOUT THE SERVICES. COX MEDICAL CENTER BRANSON CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: 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 HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2019. 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 VI, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS ESTIMATED USING THE PERCENTAGE OF THE POPULATION THAT IS BELOW THE POVERTY LINE IN THE HOSPITAL'S SERVICE AREA. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE FOOTNOTE: THE AUDIT FOOTNOTE ADDRESSING BAD DEBT EXPENSE AND PATIENT ACCOUNTS RECEIVABLE IS FOUND ON PAGE 11 OF THE AUDITED FINANCIAL STATEMENTS UNDER NOTE 1, SUBTITLED "PATIENT ACCOUNTS RECEIVABLE." SCHEDULE H, PART III, SECTION B, LINE 8 COMMUNITY BENEFIT RATIONALE: THE HOSPITAL IS DESIGNATED BY MEDICARE AS A SOLE COMMUNITY HOSPITAL AND AS SUCH, IS THE SOLE SOURCE OF HOSPITAL CARE WITHIN A 35-MILE RADIUS. AS A LARGE RURAL HOSPITAL, MINIMUM STAFFING MUST BE MAINTAINED REGARDLESS OF SWINGS IN PATIENT VOLUME. WITHOUT THE HOSPITAL, MEDICARE PATIENTS WOULD NEED TO TRAVEL SIGNIFICANT DISTANCES TO RECEIVE HOSPITAL CARE. 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, SECTION C, LINE 9B COLLECTION POLICY: THE ORGANIZATION WILL NOT PURSUE LEGAL ACTION FOR NONPAYMENT OF ANY AMOUNTS DISCOUNTED AS A RESULT OF AN APPROVED OR PARTIALLY APPROVED REQUEST FOR FINANCIAL ASSISTANCE. BALANCES REMAINING AFTER SUCH DISCOUNTS ARE APPLIED WILL, HOWEVER, BE SUBJECT TO COLLECTION ACTIVITY, INCLUDING LEGAL ACTION. IN ADDITION, THE ORGANIZATION WILL NOT CHARGE INTEREST ON THE BALANCE REMAINING AFTER APPLYING THE FINANCIAL ASSISTANCE DISCOUNT. HOWEVER, THE ORGANIZATION MAY, IN ITS SOLE DISCRETION, CHARGE INTEREST ON THE BALANCE OWED IF 1) THE GUARANTOR DEFAULTS ON HIS OR HER PAYMENT AGREEMENT OR 2) THE BALANCE IS REFERRED TO THE COLLECTION AGENCY FOR COLLECTION. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: LESTER E. COX MEDICAL CENTERS HAS PERFORMED AN ENVIRONMENTAL SCAN ANNUALLY SINCE 2006. COMMUNITY HEALTH NEEDS ASSESSMENTS AS REQUIRED BY THE IRS WERE COMPLETED IN EARLY 2016. A PUBLIC PERCEPTION STUDY OF AREA HEADS OF HOUSEHOLDS IS CONDUCTED ANNUALLY. THE MOST RECENT STUDY SURVEYED 876 HOUSEHOLDS IN OUR SERVICE AREA TO DETERMINE WHAT SERVICES ARE NEEDED. WE ALSO PERFORM A PUBLIC HEALTH SURVEY, WHICH ASKS COMMUNITY LEADERS AND HEALTH PROFESSIONALS WHAT THEIR PRIORITIES ARE AND WHAT HEALTH SERVICES ARE LACKING IN THEIR COMMUNITY. THE PUBLIC HEALTH SURVEY IS SENT TO COUNTY PUBLIC HEALTH DEPARTMENTS, LOCAL AGENCIES, REGIONAL SERVICES CLINICS, MENTAL HEALTH FACILITIES, AND PUBLIC SCHOOLS THROUGHOUT THE TOTAL SERVICE AREA. LESTER E. COX MEDICAL CENTERS REFERENCES UNITED HEALTH FOUNDATION STATE-BY-STATE HEALTH RANKINGS AS WELL AS ROBERT WOOD JOHNSON AND UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE COUNTY HEALTH RANK FOR HEALTH OUTCOMES AND HEALTH FACTORS. COXHEALTH ALSO REFERENCES "ASSESSING THE HEALTH OF THE COMMUNITY", WHICH IS AN ANALYSIS OF BEHAVIORS AND OUTCOMES FOR THE SPECIFIC COUNTIES OF THE SERVICE AREA BY THE MISSOURI HOSPITAL ASSOCIATION. DEMOGRAPHIC AND ECONOMIC ANALYSIS IS PERFORMED FOR THE 22-COUNTY SERVICE AREA. NIELSEN CLARITAS DEMOGRAPHIC ESTIMATES AND PROJECTIONS ARE USED TO EVALUATE THE CHANGE IN POPULATION CHARACTERISTICS. UNEMPLOYMENT, HOME FORECLOSURE, AND INPATIENT PAYER DATA IS ALSO ASSESSED. IN 2016, COXHEALTH PERFORMED A COMMUNITY HEALTH NEEDS ASSESSMENT AS PART OF A COLLABORATIVE EFFORT, CONSISTING OF A VARIETY OF ORGANIZATIONS ACROSS THE OZARKS, TO BETTER UNDERSTAND THE HEALTH STATUS, BEHAVIORS, AND NEEDS OF THE POPULATIONS WE SERVE. UNDER THE UMBRELLA OF THE LOCAL OZARKS HEALTH COMMISSION, THIS FIRST-TIME COLLABORATION WAS THE LARGEST IN THE REGION SPANNING FOUR STATES-MISSOURI, OKLAHOMA, ARKANSAS AND KANSAS-29 COUNTIES AND THREE HOSPITAL SYSTEMS. THE WORKING GROUP SAW THE VALUE OF USING A SYSTEMATIC, DATA-DRIVEN ASSESSMENT TO INFORM DECISIONS AND GUIDE EFFORTS TO IMPROVE COMMUNITY HEALTH AND WELLNESS ON A REGIONAL LEVEL. THIS LARGER, CONCERTED APPROACH WILL LEVERAGE COMMON STRENGTHS AND STRATEGIES TO MOVE IN THE SAME DIRECTION ON SIGNIFICANT HEALTH CONCERNS. THE 2019 ASSESSMENT PROCESS BUILDS ON THE METHODOLOGY DEVELOPED DURING THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT. IT INCLUDES MORE THAN 140 HOSPITAL AND COMMUNITY DATA INDICATORS. THIS DATA WAS COMPARED TO THE NATION AND PAST PERFORMANCE AND USED TO IDENTIFY THE SIX ASSESSED HEALTH ISSUES (AHI): CANCER, LUNG DISEASE, CARDIOVASCULAR DISEASE, MENTAL HEALTH, DIABETES, AND ORAL HEALTH. LOCAL STAKEHOLDERS UTILIZED A COMBINATION OF PUBLIC HEALTH AND HOSPITAL DATA, ALONG WITH A COMMUNITY SURVEY DATA, TO PRIORITIZE THE AHI BASED ON FEASIBILITY AND COMMUNITY READINESS. THIS PRIORITIZATION PROCESS RESULTED IN THREE PRIORITIES FOR THE SPRINGFIELD COMMUNITY: LUNG DISEASE, CARDIOVASCULAR DISEASE AND MENTAL HEALTH. ALTHOUGH OTHER AHI WERE IDENTIFIED AS HEALTH ISSUES FOR THE SPRINGFIELD COMMUNITY, RESOURCES WOULD BE DILUTED IN AN EFFORT TO ADDRESS SEVERAL HEALTH ISSUES, THUS MINIMIZING THE ABILITY TO CREATE MEANINGFUL IMPACT. BY PRIORITIZING THE AHI BY FEASIBILITY AND COMMUNITY READINESS, THE COMMUNITY WILL BE ABLE TO HAVE A GREATER IMPACT ON OVERALL COMMUNITY HEALTH THROUGH EFFICIENT AND EFFECTIVE RESOURCE ALLOCATION. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: LESTER E. COX MEDICAL CENTERS, PARENT ORGANIZATION, USES A VARIETY OF METHODS TO INFORM AND EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE PROGRAMS OR UNDER THE ORGANIZATION'S POLICY: - AVAILABILITY OF FINANCIAL ASSISTANCE THROUGH THE ORGANIZATION IS COMMUNICATED TO PATIENTS THROUGH THE USE OF SIGNAGE AND BROCHURES/INFORMATION PACKETS AVAILABLE AT CHECK-IN LOCATIONS. - LESTER E. COX MEDICAL CENTERS ALSO PROACTIVELY COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE ON PATIENT BILLS AND STATEMENTS; AND ITS EARLY-OUT VENDOR RESPONSIBLE FOR PATIENT BALANCE COLLECTIONS IS EXPECTED TO PROACTIVELY INFORM SELF PAY PATIENTS OF THE AVAILABILITY WHEN SPEAKING TO THEM ON THE PHONE. - FOR ASSISTANCE UNDER FEDERAL AND STATE PROGRAMS LESTER E. COX MEDICAL CENTERS UTILIZES AN OUTSOURCE ELIGIBILITY VENDOR WHO MEETS WITH SELF PAY INPATIENTS AT THE BEDSIDE TO COMPLETE AN ELIGIBILITY SCREENING, INFORM THE PATIENTS OF POTENTIAL AVAILABILITY, AND WILL WORK WITH THE PATIENT TO HELP THEM THROUGH THE PROCESS. OUTPATIENTS ARE REFERRED TO THE VENDOR AFTER CARE AND THOSE ARE WORKED IN A SIMILAR FASHION WITH THE EXPECTATION THAT THE FIRST CONTACT IS THROUGH MAIL OR PHONE RATHER THAN AT THE BEDSIDE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: CMCB CONSIDERS TANEY AND STONE COUNTIES AS ITS PRIMARY SERVICE AREA WITH CHRISTIAN COUNTY, BOONE COUNTY AND PARTS OF CARROLL COUNTY IN NORTHERN ARKANSAS AS ITS SECONDARY SERVICE AREA. THE TOTAL POPULATION OF ZIP CODES SERVED BY CMCB IS APPROXIMATELY 144,000. THE PROJECTED POPULATION GROWTH IN THESE AREAS, ESPECIALLY THE CONTINUING MIGRATION INTO THE AREA OF RETIREES, IS A SIGNIFICANT FACTOR IN THE EVER-INCREASING NEED FOR HIGH-TECH MEDICAL SERVICES. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: CMCB HAS A 15-MEMBER BOARD OF DIRECTORS. SEVERAL THOUSANDS OF DOLLARS ARE SPENT EACH YEAR OFFERING FREE LOW-COST SCREENINGS TO THE COMMUNITY AND EDUCATIONAL PROGRAMS. CMCB PHYSICIANS AND STAFF ARE COMMITTED TO EDUCATING THE COMMUNITY TO HELP ENSURE A HEALTHIER FUTURE. CPR CLASSES, SMOKING CESSATION CLASSES, PRENATAL CLASSES, ETC. ARE ALL FOCUSED ON GIVING OUR COMMUNITY MEMBERS THE RESOURCES THEY NEED TO MAKE INFORMED DECISIONS. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: CMCB IS PART OF THE COXHEALTH SYSTEM, WHICH INCLUDES THE FOLLOWING: LESTER E. COX MEDICAL CENTERS, WHICH OPERATES AS AN INTEGRATED DELIVERY SYSTEM INCLUDING FOUR HOSPITALS, A SURGICAL CENTER, AN INPATIENT REHABILITATION FACILITY, HOME CARE COMPANIES, PHYSICIAN SERVICES, MENTAL HEALTH SERVICES, INSURANCE COMPANIES AND A FOUNDATION. THE HEALTH SYSTEM PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT, EMERGENCY CARE, INPATIENT REHABILITATION, HOME CARE, PHYSICIAN SERVICES AND HEALTH INSURANCE PRODUCTS TO PATIENTS AND EMPLOYERS IN SPRINGFIELD, MISSOURI, AND THE SURROUNDING SOUTHWEST MISSOURI AREA. COXHEALTH IS THE PARENT OF LESTER E. COX MEDICAL CENTERS AND ITS WHOLLY OWNED SUBSIDIARIES PLUS CERTAIN AFFILIATED NOT-FOR-PROFIT ENTITIES AND IS COLLECTIVELY REFERRED TO AS COXHEALTH. COXHEALTH (THE HEALTH SYSTEM) OPERATES AS AN INTEGRATED DELIVERY SYSTEM INCLUDING FOUR HOSPITALS, A SURGICAL CENTER, AN INPATIENT REHABILITATION FACILITY, HOME CARE COMPANIES, PHYSICIAN SERVICES, MENTAL HEALTH SERVICES, INSURANCE COMPANIES AND A FOUNDATION. COXHEALTH'S HOME CARE SERVICES ARE PROVIDED BY COXHEALTH AT HOME AND INCLUDE HOME HEALTH SERVICES, INFUSION THERAPY AND DURABLE MEDICAL EQUIPMENT. COXHEALTH AT HOME SUPPORTED THE COMMUNITY THROUGH MONTHLY NUTRITION AND FALL PREVENTION SEMINARS AT 20 AREA SENIOR CENTERS THROUGHOUT SOUTHWEST MISSOURI. THEY ALSO PROVIDED FREE BONE DENSITY SCREENINGS AT 34 COMMUNITY EVENTS, AND VITAL SIGN SCREENINGS AT MANY MORE. THROUGH AN ANNUAL FAN DRIVE, COXHEALTH AT HOME COLLECTED AND DISTRIBUTED BOX FANS TO SENIORS AND THE DISABLED WHO LACK ADEQUATE ACCESS TO COOLING DURING THE SUMMER MONTHS. INFUSION THERAPY RECEIVED A SECOND GRANT AWARD FROM THE MISSOURI FOUNDATION FOR HEALTH ORGANIZATION. THIS GRANT ALLOWS US TO SERVE PATIENTS THAT FALL THROUGH THE CRACKS DUE TO HAVING NO REIMBURSEMENT OF ANY KIND, SERVING PATIENTS THROUGHOUT SOUTHERN MISSOURI. ASSISTANCE TO COXHEALTH SYSTEM IN DEVELOPING AN INTEGRATED HEALTH SYSTEM, AND SERVICE TO MEDICAID PATIENTS. COX-MONETT HOSPITAL SUPPORTS THE MONETT, MISSOURI AND SURROUNDING COMMUNITY BY PROVIDING A VARIETY OF SERVICES WHICH INCLUDE UROLOGY, ENT (EAR, NOSE AND THROAT), PULMONOLOGY, ORTHOPEDICS, CARDIOLOGY, PODIATRY, OBSTETRICS, RADIOLOGY (CT, MRI, NUCLEAR MEDICINE AND MAMMOGRAPHY), LABORATORY, 24-HOUR EMERGENCY CENTER, GENERAL SURGICAL SERVICES, SAME-DAY SURGERY, DIABETES CENTER, SLEEP CENTER, CARDIOPULMONARY REHAB, MEDICAL-SURGICAL UNIT, URGENT CARE, PHARMACY AND COMMUNITY WELLNESS. COXHEALTH FOUNDATION SUPPORTS THE COMMUNITY BY RAISING FUNDS TO DISPERSE TO PATIENTS FOR THOSE NEEDS FOR WHICH THEY HAVE NO RESOURCES OR FUNDING, BUT WHICH ARE CRITICAL TO THE PATIENT'S HEALTH AND WELL BEING. SKAGGS COMMUNITY HOSPITAL ASSOCIATION D/B/A COX MEDICAL CENTER BRANSON (CMCB) HAS BEEN SERVING SOUTHWEST MISSOURI RESIDENTS FOR MORE THAN 63 YEARS AND OFFERS OVER 25 MAJOR SERVICE AREAS. THE HOSPITAL'S AVERAGE DAILY PATIENT CENSUS EXCEEDS 85 WITH 165 LICENSED HOSPITAL BEDS. A STAFF OF OVER 1,100 PERSONNEL IS REQUIRED TO OPERATE THE HOSPITAL AND ITS NUMEROUS CLINICS. COXHEALTH ADDED A FOURTH HOSPITAL IN 2018, COX BARTON COUNTY HOSPITAL (COX BARTON COUNTY). THE FACILITY WAS A COUNTY HOSPITAL OWNED AND OPERATED BY BARTON COUNTY MEMORIAL HOSPITAL (BCMH). IT WAS BUILT IN 2007 AND IS A 25-BED CRITICAL ACCESS HOSPITAL IN LAMAR, MISSOURI OFFERING AN EMERGENCY DEPARTMENT, AS WELL AS SPECIALIZED CARE IN DIABETES, CARDIOLOGY, ORTHOPEDICS AND SPORTS MEDICINE, NEUROLOGY, WOMEN'S HEALTH AND MORE. IN OCTOBER 2017, COXHEALTH SIGNED A LETTER OF INTENT WITH BCMH TO ACQUIRE ITS OPERATION AND TO LEASE ITS PROPERTY. BCMH WAS STRUGGLING AS A RURAL HOSPITAL TO KEEP UP WITH DECLINING REVENUE. COXHEALTH'S ACQUISITION ALLOWS FOR THE PATIENTS PREVIOUSLY SERVED BY BCMH TO BECOME A PART OF THE COXHEALTH SYSTEM. COX BARTON COUNTY WILL CONTINUE THE SERVICES PREVIOUSLY PROVIDED BY BCMH AND INTENDS TO EXPAND THESE SERVICES FURTHER IN THE FUTURE AS WELL. TO COMPLETE THE TRANSACTION, COXHEALTH FORMED TWO ENTITIES, COX BARTON COUNTY HOSPITAL, A MISSOURI NONPROFIT CORPORTATION, AND CBCH, LLC, A MISSOURI LIMITED LIABILITY COMPANY. BOTH ENTITIES HAVE THE SAME CORPORATE PARENT, COXHEALTH, WHICH IS A MISSOURI NONPROFIT CORPORATION. THE OPERATION AND ASSETS OF THE HOSPITAL HAVE BEEN HELD BY CBCH, LLC SINCE JANUARY 1, 2018 AND WILL BE TRANSFERRED TO COX BARTON COUNTY HOSPITAL EFFECTIVE OCTOBER 1, 2019. true MHA HEALTH INSTITUTE PO BOX 60 JEFFERSON CITY MO 65102 430898947 501(C)(3) 16736 SUPPORT BOYS & GIRLS CLUB OF THE OZARKS 1460 BEE CREEK ROAD BRANSON MO 65616 431664669 501(C)(3) 10000 SUPPORT 2 PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S.: THE HOSPITAL MONITORS THE USE OF THE FUNDS DONATED TO COMMUNITY FOUNDATION OF THE OZARKS AND COXHEALTH FOUNDATION THROUGH GRANT MANAGEMENT AND OVERSIGHT OF DISBURSEMENTS AND REIMBURSEMENTS BY ORGANIZATION OFFICIALS. X true true X X X X X false true false false false true false false false WILLIAM MAHONEY PRESIDENT 469500 0 68731 0 58535 0 61700 0 16435 0 674901 0 50345 0 DAVID STRONG CFO 139123 139122 19251 19251 20825 20824 21175 21175 8268 8267 208642 208639 17180 17179 HOLLY WHERRY BOARD MEMBER 358967 0 0 0 300 0 2594 0 50 0 361911 0 0 0 CHARITY ELMER BOARD MEMBER 0 469874 0 58237 0 58167 0 103444 0 22270 0 711992 0 50259 JAKE MCWAY BOARD MEMBER/COXHEALTH CFO 0 605649 0 148486 0 137806 0 144963 0 23216 0 1060120 0 126919 STEVE EDWARDS BOARD MEMBER/COXHEALTH CEO 0 1113707 0 377807 0 10359 0 269727 0 25566 0 1797166 0 0 CHAD EFIRD PHYSICIAN 1096015 0 0 0 300 0 31865 0 16370 0 1144550 0 0 0 PATRICK FINKBONE PHYSICIAN 901540 0 0 0 270 0 13365 0 16365 0 931540 0 0 0 NARIN ARUNAKUL PHYSICIAN 651953 0 0 0 1290 0 32250 0 16535 0 702028 0 0 0 PRASER VIJITBENJARONK PHYSICIAN 651330 0 0 0 690 0 32250 0 16435 0 700705 0 0 0 BRIAN CLONTS PHYSICIAN 657946 0 0 0 1136 0 32250 0 16509 0 707841 0 0 0 SIMON WAJNBOLM VP 140002 0 9877 0 248 0 7151 0 14076 0 171354 0 0 0 SHAWN USERY CMO 391161 0 0 0 270 0 13365 0 16365 0 421161 0 0 0 LYNNE YAGGY CNO 180567 0 12719 0 1290 0 8080 0 16598 0 219254 0 0 0 SCHEDULE J, PART I, LINE 1A INFORMATION REGARDING BENEFITS PROVIDED: CHARTER TRAVEL IS PROVIDED FOR STEVE EDWARDS AND JACOB MCWAY FOR TRAVEL TO COLLABORATIVE MEETINGS REPRESENTING COXHEALTH FOR EXPEDIENCY. AS THERE WAS NO PERSONAL USE PORTION OF THIS BENEFIT, NONE WAS INCLUDED IN TAXABLE WAGES. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: STEVE EDWARDS, CHARITY ELMER, JACOB MCWAY, WILLIAM MAHONEY, AND DAVID STRONG PARTICIPATE IN A 457(F) NONQUALIFIED RETIREMENT PLAN THROUGH COXHEALTH AND RELATED AFFILIATES. - STEVE EDWARDS RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $255,977. - JACOB MCWAY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $113,098. - JACOB MCWAY RECEIVED A 457(F) DISTRIBUTION OF $126,919, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - CHARITY ELMER RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $71,194. - CHARITY ELMER RECEIVED A 457(F) DISTRIBUTION OF $50,259, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - WILLIAM MAHONEY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $47,950. - WILLIAM MAHONEY RECEIVED A 457(F) DISTRIBUTION OF $50,345, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - DAVID STRONG RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $28,600. - DAVID STRONG RECEIVED A 457(F) DISTRIBUTION OF $34,359, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. SCHEDULE J, PART I, LINE 6A COMPENSATION CONTINGENT ON THE NET EARNINGS OF THE ORGANIZATION: KEY EMPLOYEES HAVE NET EARNINGS AS ONE COMPONENT OF A BALANCED SCORECARD METRIC CONTAINED WITHIN A BONUS PROGRAM. EMPLOYED PHYSICIANS ARE PAID BASED ON A SALARY, A FORMULA USING COLLECTIONS AND EXPENSES, AN AMOUNT PER RVU, OR A COMBINATION OF THESE. EXECUTIVE LEVEL STAFF ARE ELIGIBLE FOR ADDITIONAL COMPENSATION BASED ON A VARIETY OF PERFORMANCE INDICATORS IN QUALITY, CUSTOMER AND EMPLOYEE SATISFACTION AND BUSINESS PERFORMANCE MEASURES. FORM 990, PART I, LINE 1 ORGANIZATION'S MISSION: VISION: THE HOSPITAL'S VISION IS TO BE THE BEST FOR THOSE WHO NEED US. WE VALUE SAFETY, COMPASSION, RESPECT AND INTEGRITY. THE HOSPITAL HAS BEEN SERVING SOUTHWEST MISSOURI FOR MORE THAN 65 YEARS AND OFFERS OVER 25 MAJOR SERVICE AREAS. THE HOSPITAL'S AVERAGE DAILY PATIENT CENSUS EXCEEDS 80 PATIENTS WITH 157 LICENSED HOSPITAL BEDS. A STAFF OF OVER 1,100 PERSONNEL OPERATE THE HOSPITAL AND ITS NUMEROUS CLINICS. FORM 990, PART III, LINE 4A PROGRAM SERVICE ACHIEVEMENT #1: CMCB DESIGNATED AS A LEVEL II STEMI CENTER BY THE MISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES. THIS MEANS THE HOSPITAL IS EQUIPPED TO PROVIDE CARE FOR A LARGE NUMBER OF STEMI PATIENTS, PERFORMS A MINIMUM NUMBER OF CARDIAC PROCEDURES A YEAR, HAS 24/7 CATH LAB SERVICES AVAILABLE AND HAS PROCESSES IN PLACE TO QUICKLY AND SAFELY TRANSFER PATIENTS FOR HEART SURGERY IF NEEDED. CMCB RECEIVED ONE OF THE HIGHEST RECOGNITIONS FOR OUTSTANDING STROKE CARE BY RECEIVING THE AMERICAN HEART ASSOCIATION/STROKE ASSOCIATIONS GET WITH THE GUIDELINES STROKE GOLD PLUS ACHIEVEMENT AWARD WITH TARGET: STROKE HONOR ROLL ELITE. THE AWARD RECOGNIZES THE HOSPITALS COMMITMENT TO PROVIDING THE MOST APPROPRIATE STROKE TREATMENT ACCORDING TO NATIONALLY RECOGNIZED RESEARCH-BASED GUIDELINES BASED ON THE LATEST SCIENTIFIC EVIDENCE. CMCBS ACUTE REHAB UNIT WAS AWARDED A NUMBER ELEVEN RANKING AMONG 105 OTHER REHAB UNITS AT THE KINDRED REHABILITATION SERVICES NATIONAL MEETING. THE RANKING IS BASED ON A PERFORMANCE EVALUATION MODEL (PEM) WHICH USES INDICATORS OF EFFICIENCY AND EFFECTIVENESS TO MEASURE HIGH-PERFORMING FACILITIES FOR THEIR DELIVERY OF QUALITY CARE WHEN COMPARED TO ALL FACILITIES. CMCBS PUBLIC SAFETY TEAM HAS WAS THE FIRST HOSPITAL IN THE STATE TO RECEIVE THE INTERNATIONAL ASSOCIATION FOR HEALTHCARE SECURITY AND SAFETYS PROGRAM OF DISTINCTION AWARD IN 2017. ONLY 49 HOSPITALS IN THE UNITED STATES AND CANADA HAVE RECEIVED THIS HONOR. THIS MEANS THAT 70% OF THE HOSPITALS OFFICERS, GUARDS, MANAGERS AND DIRECTORS STUDIED AND PASSED THE IAHSS INTENSIVE CERTIFICATION EXAM. U.S. NEWS & WORLD REPORT NAMES CMCB AS HIGH PERFORMING IN THE CARE OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND HEART FAILURE. COXHEALTH SYSTEM IS ISO-9001 QUALITY MANAGEMENT SYSTEM STANDARD CERTIFIED WHICH ASSESSES BUSINESS PRACTICE PERFORMANCE TO MEET CUSTOMER NEEDS WITH BEST PRACTICES AND CONTINUOUS PROCESS IMPROVEMENT. COXHEALTH DIABETES AND ENDOCRINOLOGY IN BRANSON HAS EARNED RECOGNITION BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA) AS A LEVEL III PATIENT-CENTERED SPECIALTY PRACTICE. ACCORDING TO NCQA, LEVEL III STATUS IS THE HIGHEST LEVEL OF RECOGNITION FOR SPECIALTY PRACTICES THAT ARE COMMITTED TO ACCESS, COMMUNICATION AND CARE COORDINATION. FORM 990, PART IV, LINE 24A TAX EXEMPT BONDS: LESTER E. COX MEDICAL CENTERS, A RELATED ORGANIZATION, REPORTS BONDS RELATED TO COX BRANSON ON ITS FORM 990, SCHEDULE K. AN ALLOCATION OF COX BRANSON'S PORTION OF RELATED BONDS IS REPORTED ON PART X, LINE 20. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS: BOARD MEMBERS WHO RECEIVE COMPENSATION, OFFICERS, AND KEY EMPLOYEES ARE EMPLOYED BY COXHEALTH AND ITS AFFILIATES AND THEREFORE SHARE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS: THE ORGANIZATION HAS ONLY ONE MEMBER - LESTER E COX MEDICAL CENTERS. FORM 990, PART VI, SECTION A, LINE 7A MEMBER'S POWER TO ELECT GOVERNING BODY: THE BOARD SHALL BE ELECTED BY THE MEMBER. NO LATER THAN SEPTEMBER 1 OF EACH YEAR, THE BOARD SHALL NOMINATE A SLATE OF PERSONS FOR ELECTION AS COX BRANSON DIRECTORS AND OFFICERS TO SUBMIT TO THE LESTER E. COX MEDICAL CENTERS BOARD FOR APPOINTMENT. THE LESTER E. COX MEDICAL CENTERS BOARD WILL ACT IN GOOD FAITH AND NOT UNREASONABLY WITHHOLD APPOINTMENT. IF FOR ANY REASON A NOMINATED PERSON IS NOT APPOINTED BY THE LESTER E. COX MEDICAL CENTERS BOARD, THE BOARD HAS THE RIGHT TO NOMINATE ANOTHER PERSON FOR CONSIDERATION. FORM 990, PART VI, SECTION A, LINE 7B GOVERNANCE DECISIONS RESERVED TO MEMBERS: THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE SOLELY AND SPECIFICALLY RESERVED TO THE MEMBER; A. ELECTION, APPOINTMENT AND REMOVAL OF COX BRANSON BOARD OF DIRECTORS (BOARD) AFTER NOMINATION BY THE BOARD; B. APPOINTMENT AND REMOVAL OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF COX BRANSON (PRESIDENT AND CEO OF COX BRANSON) AFTER RECOMMENDATION BY/CONSULTATION WITH THE BOARD; C. APPROVAL OF COX BRANSON'S UNBUDGETED DEBT AND CAPITAL EXPENDITURES EXCEEDING $250,000; D. APPROVAL OF COX BRANSON'S OPERATING AND CAPITAL BUDGETS AND FINANCIAL REPORTS, MERGERS, CONSOLIDATIONS, ACQUISITIONS, AFFILIATIONS, AND REORGANIZATION OR DISPOSITION OF ASSETS EXCEEDING THE THEN FAIR VALUE OF $250,000; E. AMENDMENT, REPEAL OR ADOPTION OF COX BRANSON'S ARTICLES OF INCORPORATION AND BYLAWS EXCEPT AS OTHERWISE PROVIDED IN THE BYLAWS. FINAL DECISIONS MADE BY THE BOARD OF THE DIRECTORS MUST ALSO BE APPROVED BY THE LESTER E. COX MEDICAL CENTERS BOARD AS WELL. THE MEMBER SHALL NOT EXERCISE ITS POWERS WITHOUT FIRST OBTAINING APPROVAL FROM TWO-THIRDS (2/3) MAJORITY OF THE BOARD IN THE FOLLOWING CIRCUMSTANCES: A. TRANSFER ANY OF ITS COX BRANSON MEMBERSHIP TO ANY OTHER ENTITY; B. SELL OR LEASE ALL OR SUBSTANTIALLY ALL OF COX BRANSON'S ASSETS; AND C. ENTER INTO A MANAGEMENT AGREEMENT FOR ALL OR SUBSTANTIALLY ALL OF COX BRANSON'S OPERATION. THE MEMBER MAY NOT TERMINATE OR SUBSTANTIALLY LIMIT THE FOLLOWING COX BRANSON SERVICE LINES WITHOUT FIRST OBTAINING APPROVAL FROM TWO-THIRDS (2/3) MAJORITY OF THE BOARD: EMERGENCY DEPARTMENT, CARDIOLOGY, ORTHOPEDICS, PRIMARY CARE, RADIATION AND MEDICAL ONCOLOGY, RADIOLOGY, PATHOLOGY, ANESTHESIA, GENERAL SURGERY, ICU, MEDICAL/SURGICAL SERVICES, ACUTE REHABILITATION SERVICES, WOMEN'S HEALTH SERVICES, GERIATRICS, NEUROSCIENCES, PAIN MANAGEMENT, PSYCHIATRY, UROLOGY AND ENDOCRINOLOGY. NOTWITHSTANDING THE ABOVE MENTIONED LIMITATION, THESE SERVICE LINES MAY BE TERMINATED OR SUBSTANTIALLY LIMITED BY THE MEMBER WITHOUT TWO-THIRDS (2/3) MAJORITY OF THE COX BRANSON BOARD IF (I) THERE IS A LOSS OF A LICENSE OR ACCREDITATION REQUIRED TO MAINTAIN SUCH SERVICE, OR A LOSS OF MEDICARE OR MEDICAID CERTIFICATION REQUIRED FOR SUCH SERVICE, IN EACH CASE, OTHER THAN DUE TO THE ACTIONS OR INACTIONS OF THE MEMBER OR COX BRANSON OR (II) THERE IS DESTRUCTION OR MATERIAL DAMAGE TO A FACILITY (PENDING THE PERFORMANCE OR REPAIR OR REPLACEMENT EFFORTS). (PENDING THE PERFORMANCE OR REPAIR OR REPLACEMENT EFFORTS). FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF FORM 990: 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 VERSION OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO SUBMISSION. WHILE THE DRAFT IS PROVIDED TO ALL BOARD MEMBERS, IT IS THE MEMBERS OF THE FINANCE COMMITTEE THAT GO THROUGH AND REVIEW THE RETURN IN DETAIL. UPON RECEIVING THE APPROVAL OF THE BOARD OF DIRECTORS, THE DRAFT IS THEN FINALIZED AND SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: COXHEALTH OFFICERS, DIRECTORS AND KEY EMPLOYEES, AS WELL AS OFFICERS, DIRECTORS AND KEY EMPLOYEES OF THE COXHEALTH AFFILIATES AND/OR COMMITTEES WITH DELEGATED AUTHORITY TO MAKE DECISIONS, ARE ANNUALLY REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST FOLLOWING THE POLICY, SET FORTH BELOW. THE POLICY REQUIRES THAT BOARD MEMBERS MAKE DECISIONS THAT ARE CONFLICT FREE, OR IF A CONFLICT IS PRESENT, THAT IT IS FULLY DISCLOSED FOR THE BOARD'S CONSIDERATION. COXHEALTH'S EMPLOYEES AND BOARD MEMBERS MUST AVOID ALL ACTIVITIES, ASSOCIATIONS OR INTERESTS THAT CREATE A CONFLICT OF INTEREST. CONFLICTS OF INTEREST FOR EMPLOYEES MUST BE REPORTED TO THE CORPORATE INTEGRITY DEPARTMENT. A FILE WILL BE MAINTAINED OF ALL REPORTED CONFLICTS OF INTEREST. FOR MEDICAL STAFF MEMBERS, THE CONFLICT OF INTEREST PROCESS MAY BE ACCESSED THROUGH THE MEDICAL STAFF OFFICE. FOR BOARD MEMBERS, THE CONFLICT OF INTEREST PROCESS IS HANDLED THROUGH THE GOVERNANCE SUB-COMMITTEE OF COXHEALTH WITH THE ASSISTANCE OF THE EXECUTIVE OFFICE AND IS DEFINED IN THE CHARTER OF THE GOVERNANCE SUB-COMMITTEE. IF ANY OFFICER OR DIRECTOR IS FOUND TO HAVE A CONFLICT OF INTEREST, SUCH PERSON SHALL NEITHER VOTE NOR USE HIS OR HER INFLUENCE TO AFFECT ANY DECISION RELATING TO THE CONFLICT, AND SUCH PERSON SHOULD NOT BE INCLUDED IN DETERMINING WHETHER A QUORUM PARTICIPATED IN THE DECISION. SUCH PERSON IS PERMITTED TO BRIEFLY STATE HIS OR HER POSITION ON THE MATTER, AND ANSWER PERTINENT QUESTIONS ABOUT IT, IF HIS OR HER KNOWLEDGE OR EXPERTISE COULD ASSIST THOSE PARTICIPATING IN THE DECISION. FOR VENDORS, THE POLICY IS DISTRIBUTED WITH THEIR INITIAL CONTRACT WITH COX MEDICAL CENTER BRANSON. FORM 990, PART VI, SECTION B, LINES 15A & 15B COMPENSATION REVIEW: COX MEDICAL CENTERS EMPLOY A DEFINED GOVERNANCE STRUCTURE AROUND EXECUTIVE COMPENSATION. THE BOARD OF DIRECTORS MAINTAINS A COMPENSATION COMMITTEE THAT IS CHARGED WITH CARRYING OUT THE FUNCTIONS OF EVALUATING AND SETTING EXECUTIVE COMPENSATION THROUGH FORMAL DOCUMENTED MEETINGS THAT OCCUR SEVERAL TIMES DURING THE YEAR. THE COMPENSATION COMMITTEE UTILIZES A WELL RESPECTED INDEPENDENT EXTERNAL ADVISOR TO PROVIDE THIRD PARTY ASSESSMENT AND RECOMMENDATIONS REGARDING COMPENSATION LEVELS AND BENEFIT PROGRAMS FOR THE TOP THREE EXECUTIVES TIERS OF THE ORGANIZATION; THE CEO, CFO AND SENIOR VPS TO ENSURE THE COMPENSATION PROGRAM IS COMPETITIVE AND WITHIN FAIR MARKET VALUE. AFTER A FULL REVIEW OF THE DATA AND THOROUGH DISCUSSION THE COMMITTEE MAKES A SELF DETERMINATION OF COMPENSATION LEVELS SET JANUARY OF EACH YEAR. ANNUALLY THE STEPS NECESSARY TO DOCUMENT REBUTTABLE PRESUMPTION ARE TAKEN AND RECORDED. ADDITIONALLY, COMPENSATION LEVELS FOR THE VICE PRESIDENT TIER OF MANAGEMENT IS OVERSEEN BY THE CEO USING EXTERNAL COMPARABLE DATA FOR ASSESSMENT AND IS PROVIDED TO THE COMPENSATION COMMITTEE FOR REVIEW ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION A BOARD MEMBER COMPENSATION: STEVE EDWARDS, JACOB MCWAY, HOLLY WHERRY, AND CHARITY ELMER ARE RECEIVING COMPENSATION RELATED TO THEIR ROLES AS EMPLOYEES UNDER COXHEALTH AND RELATED AFFILIATES. NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS BOARD MEMBERS. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ (141,081) CHANGE IN BENEFICIAL INTEREST IN TRUST FORM 990 PART IX LINE 11G DESCRIPTION:OTHER CONTRACTED SERVICES TOTAL FEES:25004879 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED LABOR TOTAL FEES:11701018 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED BILLING SERVICES TOTAL FEES:1094161 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED RADIOLOGY SERVICES TOTAL FEES:621066 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED EQUIPMENT SERVICES TOTAL FEES:522308 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED LAUNDRY SERVICES TOTAL FEES:359336 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED LAB SERVICES TOTAL FEES:251561 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED HOUSEKEEPING TOTAL FEES:182584 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED COLLECTION SERVICES TOTAL FEES:166590 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED CONSULTING SERVICES TOTAL FEES:95101 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED COURIER SERVICES TOTAL FEES:85928 SKAGGS EMERGENCY PHYSICISNS PO BOX 650 BRANSON MO 65615 352275232 BILLING MO 0 0 CMCB BRANSON HEART CENTER PO BOX 650 BRANSON MO 65615 300497209 BILLING MO 0 0 CMCB SKAGGS OCCUPATIONAL HEALTH PO BOX 650 BRANSON MO 65615 383774737 BILLING MO 0 0 CMCB BRANSON FAMILY MEDICINE CLINIC PO BOX 650 BRANSON MO 65615 322331834 BILLING MO 0 0 CMCB BRANSON ORTHONEURO CENTER LLC PO BOX 650 BRANSON MO 65615 171952089 MED BLDG MO 0 0 CMCB COX ALTERNATIVE CARE OF THE OZARKS INC PO BOX 10939 SPRINGFIELD MO 65808 431641925 HOME HEALTH MO 501(C)(3) 10 LESTER E COX false COXHEALTH FOUNDATION 3525 S NATIONAL STE 204 SPRINGFIELD MO 65807 436810485 FUNDRAISING MO 501(C)(3) 12 A I LESTER E COX false COXHEALTH HOME CARE SVCS OF THE MIDWEST PO BOX 10939 SPRINGFIELD MO 65808 264781194 HOME HEALTH MO 501(C)(3) 10 LESTER E COX false COX HPS OF THE OZARKS INC 2220 W SUNSET SPRINGFIELD MO 65807 431641927 HOME HEALTH MO 501(C)(3) 10 LESTER E COX false COX-MONETT HOSPITAL INC 801 N LINCOLN AVE MONETT MO 65708 431656689 HOSPITAL MO 501(C)(3) 3 LESTER E COX false HEALTH ENRICHMENT SERVICES INC 3801 S NATIONAL SPRINGFIELD MO 65807 363263313 MED SERVICES MO 501(C)(3) 7 LESTER E COX false HEALTHCARE SERVICES OF THE OZARKS INC PO BOX 10939 SPRINGFIELD MO 65808 431641928 HOME HEALTH MO 501(C)(3) 10 LESTER E COX false PRIMROSE PLACE INC 1115 E PRIMROSE SPRINGFIELD MO 65807 431183783 SUPPORT MO 501(C)(3) 12 A I LESTER E COX false LESTER E COX MED CTRPROF LIEB LOSS FUND 1423 N JEFFERSON SPRINGFIELD MO 65802 366668576 SELF INSURANC MO 501(C)(3) 12 A I LESTER E COX false COXHEALTH 1423 N JEFFERSON SPRINGFIELD MO 65802 471087427 HOLDING CO MO 501(C)(3) 12 B II NA false COX MEDICAL GROUP 1423 N JEFFERSON SPRINGFIELD MO 65802 471087566 PHYSICIANS MO 501(C)(3) 10 COXHEALTH false LESTER E COX MEDICAL CENTERS 1423 N JEFFERSON SPRINGFIELD MO 65802 440577118 HOSPITAL MO 501(C)(3) 3 COXHEALTH false COXHEALTH SYSTEMS HMO INC PO BOX 5750 SPRINGFIELD MO 658015750 431757075 HMO MO 501(C)(4) LESTER E COX false COX COLLEGE 1423 N JEFFERSON SPRINGFIELD MO 65802 475148345 EDUCATION MO 501(C)(3) 2 LESTER E COX false COX MEDICAL GROUP CLINICS 3801 S NATIONAL SPRINGFIELD MO 65807 371830627 HEALTHCARE MO 501(C)(3) 10 COXHEALTH false COX HEALTH SYSTEMS INSURANCE COMPANY PO BOX 5750 SPRINGFIELD MO 65801 431684044 INSURANCE MO 501(C)(4) LESTER E COX false COX BARTON COUNTY HOSPITAL 1423 N JEFFERSON SPRINGFIELD MO 65802 823300758 HOSPITAL MO 501(C)(3) 3 COXHEALTH false MEDICAL DEVELOPMENTS INC 1423 N JEFFERSON SPRINGFIELD MO 65802 431622182 PHARMACY MO LESTER E COX C CORP false COX TAXABLE CLOSE CORPORATION 1423 N JEFFERSON SPRINGFIELD MO 65802 472573263 MEDICAL CLINIC MO COX MED GROUP C CORP false FERRELL-DUNCAN CLINIC INC 1001 E PRIMROSE SPRINGFIELD MO 65808 430991578 PHYSICIANS MO CTCC C CORP false INSURANCE CO OF SPRINGFIELD INC GRAND PAVILION CORPORATE CENTRE GRAND CAYMAN CJ KY1-110 430991578 CAPTIVE INSURANCE CJ LESTER E COX C CORP false false false true false false false false false false true true false false false false true true true true