2016-08-11T14:18:03-05:00 2015-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2014-10-01 440584290 SKAGGS COMMUNITY HOSPITAL ASSOCIATION % DAVID STRONG SKAG 4173357000 251 SKAGGS ROAD BRANSON MO 65615 DAVID STRONG COX MEDICAL CENTER B 4173357000 2016-08-09 true Brian D Todd P00422601 4178658701 2014 2017-02-10 21:41:12Z COX MEDICAL CENTER BRANSON MR WILLIAM MAHONEY 251 SKAGGS ROAD BRANSON MO 65615 208480494 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 1483 250 25491 -97152 2107369 261964 173235995 193499026 946870 1452033 -440928 169750 175849306 195382773 145769 98363 0 0 68516551 66028833 0 0 0 106841835 116524042 175504155 182651238 345151 12731535 195885210 203850893 103111709 98373295 92773501 105477598 X THE HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH QUALITY HEALTH CARE, EDUCATION AND RESEARCH. false false 137128945 98363 167615167 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. 32074710 25883859 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. 169203655 true true false true false false false false false false true false false false true false false true false false false false false false false false true true true false true false false false false false false false true false false false false true true false false false true X 86 0 true 1483 true true true false false false false false false false false false X 14 10 false false true false true true true true true false false true true true true true true true true true false X DAVID STRONG 4173357789 251 SKAGGS ROAD BRANSON MO 65615 X BOB MCDOWELL VICE CHAIRMAN 3.0 5.0 X X 0 0 0 ANTHONY WHEELER DIRECTOR 3.0 0.0 X 0 0 0 DOUG HAYTER DIRECTOR 3.0 0.0 X 0 0 0 BOB SIMMONS DIRECTOR 3.0 0.0 X 0 0 0 DENNIS NEWKIRK DIRECTOR 3.0 0.0 X 0 0 0 PHILLIP LOYD CHAIRMAN 3.0 5.0 X X 0 0 0 JAKE MCWAY DIRECTOR 3.0 40.0 X 0 726795 141589 JAMES BERRY DIRECTOR ENDING 12/13 3.0 0.0 X 0 0 0 JANICE WILLIAMS DIRECTOR 3.0 0.0 X 0 0 0 LARRY SCHMITT TREASURER 3.0 0.0 X X 0 0 0 RAEANNE PRESLEY SECRETARY 3.0 0.0 X X 0 0 0 RICHARD BLUBAUGH DIRECTOR 3.0 0.0 X 0 0 0 STEVE EDWARDS DIRECTOR 3.0 40.0 X 0 1230233 262993 HOLLY WHERRY DIRECTOR 3.0 0.0 X 309077 0 14664 BOB COX DIRECTOR 3.0 0.0 X 0 0 0 WILLIAM MAHONEY CEO 40.0 5.0 X 473553 0 70126 DAVID STRONG CFO 30.0 10.0 X 271499 0 52329 CAROL MARTIN VP ADMINISTRATION 40.0 0.0 X 198868 0 42597 BRIAN CLONTS MD CMO 40.0 1.0 X 378017 0 27370 LYNNE YAGGY CNO 40.0 0.0 X 178760 0 21938 CHAD EFIRD PHYSICIAN 40.0 0.0 X 766811 0 27313 NARIN ARUNAKUL PHYSICIAN 40.0 0.0 X 671707 0 45261 DENNIS DANIELS PHYSICIAN 40.0 0.0 X 596690 0 14706 MITTIE DRAGOSLJVICH PHYSICIAN 40.0 0.0 X 606296 0 28247 PRASER VIJITBENJARONK PHYSICIAN 40.0 0.0 X 481328 0 45261 4932606 1957028 794394 64 false true false 360 DEGREE MEDICINE LLC PHYSICIAN SERVICES 5842801 CHG COMPANIES PHYSICIAN SERVICES 2962586 WEATHERBY LOCUMS INC PHYSICIAN SERVICES 1140722 WHITE RIVER ANESTHESIA ASSOCIATES ANESTHESIA SERVICES 1104617 NUCLEAR DIAGNOSIS INC MEDICAL TESTING 775399 16 215240 46724 261964 NET PATIENT SERVICE REVENUE 624100 188901754 188901754 EHR MEANINGFUL USE REVENUE 624100 1631919 1631919 LAB REVENUE 621500 1231876 1206385 25491 CAFETERIA REVENUE 722514 777627 777627 FITNESS CENTER REVENUE 713940 413956 413956 541894 541894 193499026 940548 940548 0 0 0 0 0 13594143 15063 13070882 26839 523261 -11776 511485 511485 0 0 0 LOSS ON INVESTMENT IN EQUITY INVESTEE 900099 169750 169750 169750 195382773 193473535 25491 1621783 X 98363 98363 0 0 0 2038798 929826 1108972 0 52445854 44409573 8036281 1326781 1326781 6550605 6233089 317516 3666795 3466814 199981 0 12164 12164 133405 133405 0 0 912140 835596 76544 33666967 31847516 1819451 172597 158113 14484 3954033 3592199 361834 307186 281408 25778 0 4052687 3712597 340090 540743 495365 45378 0 62169 56952 5217 2930356 2684449 245907 0 7346610 6730103 616507 782778 717089 65689 BAD DEBT 27644242 27644242 MEDICAL SUPPLIES & DRUGS 26063053 26063053 STATE PROVIDER TAX 7676155 7676155 LICENSES, DUES, SUBSCRIPTIONS 228202 209052 19150 38555 35320 3235 182651238 169203655 13447583 0 15001968 19071472 23524530 26628742 0 0 22842768 23928069 0 0 0 0 0 0 1936089 2600938 1800926 960564 122703742 20328261 96446284 102375481 21161967 13758072 8447121 7966979 1392607 3351295 689000 551500 2641950 2657781 195885210 203850893 10056886 10234349 0 0 137953 0 58366210 58234767 0 0 0 0 15207556 13396465 0 0 19343104 16507714 103111709 98373295 X 82930264 96259324 1396116 1251295 8447121 7966979 92773501 105477598 195885210 203850893 X 12731535 -1502475 1475037 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 27553 27553 false SCHEDULE C, PART II-B, LINE 1 (I) OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAID DUES OF $42,389 TO THE MISSOURI HOSPITAL ASSOCIATION, OF WHICH $27,553 (65%) IS ATTRIBUTABLE TO LOBBYING PURPOSES. 5310000 5310000 56414052 4673825 51740227 4302683 448888 3853795 48736492 14323574 34412918 7940515 881974 7058541 102375481 0 DUE TO THIRD PARTY 599516 DUE TO RELATED PARTY 15908198 16507714 167297556 -1502475 -25544242 -27046717 194344273 1038500 1038500 195382773 153968496 -1038500 -1038500 155006996 27644242 27644242 182651238 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. SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $(27,644,242) BAD DEBT 2,100,000 CHANGE IN INVESTMENT IN SKAGGS FOUNDATION ------------- $(25,544,242) SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 1,038,500 LAB REVENUE SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ (1,038,500) LAB REVENUE SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 27,644,242 BAD DEBT true true X false true X true true false true true 7205440 7205440 0.04650 26133131 22325931 3807200 0.02460 33338571 22325931 11012640 0.07110 36118 36118 0.00020 8616710 5262484 3354226 0.02160 113203 113203 0.00070 8766031 5262484 3503547 0.02250 42104602 27588415 14516187 0.09360 true 27644242 4823920 79552861 80310247 -757386 X true true 1 1 SKAGGS COMMUNITY HEALTH CENTER 251 SKAGGS ROAD BRANSON MO 65616 WWW.SKAGGS.NET 52-57 X X X SKAGGS COMMUNITY HEALTH CENTER 1 false false true X X X X X X X X X 14 true false false true X HTTP://WWW.SKAGGS.NET/MAIN/ABOUTUS.ASPX X true 14 true HTTP://WWW.SKAGGS.NET/MAIN/ABOUTUS.ASPX false false true X 0. 300. X X X X X true true X X X X true X SEE PART V X SEE PART V X SEE PART V 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: THE CHNA PROCESS INVOLVED: - COLLECTION AND ANALYSIS OF A LARGE RANGE OF DATA, INCLUDING DEMOGRAPHIC, SOCIOECONOMIC AND HEALTH STATISTICS, AND HEALTH CARE RESOURCES - INTERVIEWS WITH KEY INFORMANTS WHO REPRESENT A) BROAD INTERESTS OF THE COMMUNITY, B) POPULATIONS OF NEED OR C) PERSONS WITH SPECIALIZED KNOWLEDGE IN PUBLIC HEALTH. THE FOLLOWING STEPS WERE CONDUCTED AS PART OF HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT: - THE "COMMUNITY" SERVED BY THE HOSPITAL WAS DEFINED BY UTILIZING INPATIENT AND OUTPATIENT DATA REGARDING PATIENT ORIGIN. THIS PROCESS IS FURTHER DESCRIBED IN COMMUNITY SERVED BY THE HOSPITAL. - POPULATION DEMOGRAPHICS AND SOCIOECONOMIC CHARACTERISTICS OF THE COMMUNITY WERE GATHERED AND REPORTED UTILIZING VARIOUS THIRD PARTIES (SEE REFERENCES IN APPENDICES). THE HEALTH STATUS OF THE COMMUNITY WAS THEN REVIEWED. INFORMATION ON THE LEADING CAUSES OF DEATH AND MORBIDITY INFORMATION WAS ANALYZED IN CONJUNCTION WITH HEALTH OUTCOMES AND FACTORS REPORTED FOR THE COMMUNITY BY COUNTYHEALTHRANKINGS.ORG. HEALTH FACTORS WITH SIGNIFICANT OPPORTUNITY FOR IMPROVEMENT WERE NOTED. - AN INVENTORY OF HEALTH CARE FACILITIES AND RESOURCES WAS PREPARED - COMMUNITY INPUT WAS PROVIDED THROUGH KEY INFORMANT INTERVIEWS OF 14 STAKEHOLDERS. RESULTS AND FINDINGS ARE DESCRIBED IN THE KEY INFORMANT SECTION OF THE CHNA REPORT. - INFORMATION GATHERED IN THE ABOVE STEPS WAS ANALYZED AND REVIEWED TO IDENTIFY HEALTH ISSUES OF UNINSURED PERSONS, LOW-INCOME PERSONS AND MINORITY GROUPS AND THE COMMUNITY AS A WHOLE. THE HOSPITAL USED THE UPDATED INFORMATION AND RESULTS FROM THE KEY INFORMANT INTERVIEWS TO FOCUS RESOURCES AND EFFORTS ON PRIORITY AREAS THAT HAVE HAD MINIMAL IMPROVEMENT, ARE STILL A NEED, AND ALREADY HAVE RESOURCES DIRECTED TO MAKE IMPROVEMENTS IN THOSE AREAS. - RECOMMENDATIONS BASED ON THIS ASSESSMENT HAVE BEEN COMMUNICATED TO HOSPITAL MANAGEMENT. SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING IDENTIFIED NEEDS: THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT REVEALED MANY OF THE SAME RESULTS OF THE 2012 COMMUNITY HEALTH NEEDS ASSESSMENT. THE PRIORITY AREAS THAT WERE IDENTIFIED IN THE PREVIOUS ASSESSMENT WERE SIMILAR TO THAT IN 2015. IN PRIORITIZING HEALTH NEEDS FOR THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT, THE HOSPITAL WANTED TO EXPAND UPON THE FOCUS AREAS THAT CONTINUE TO POSE A PROBLEM AND WOULD HAVE THE GREATEST IMPACT ON IMPROVING OVERALL COMMUNITY HEALTH. CHANGES IN THE PREVIOUSLY DOCUMENTED HEALTH PRIORITIES WERE ASSESSED TO IDENTIFY IMPROVEMENTS IN STATISTICS FOR KEY HEALTH INDICATORS. THIS DATA REVEALED THE FOLLOWING FOR EACH PRIORITY AREA: AFFORDABLE CARE/UNINSURED RESIDENTS - THERE HAS BEEN ESSENTIALLY NO IMPROVEMENTS IN THE PERCENTAGE OF ADULTS WHO ARE INSURED. STONE COUNTY EXPERIENCED A DECREASE IN THE PERCENTAGE OF ADULTS WHO ARE INSURED (81% TO 79%), WHILE TANEY COUNTY EXPERIENCED NO CHANGE (78%) IN THE PERCENTAGE OF INSURED ADULTS. DISEASES OF THE HEART - A POSITIVE IMPROVEMENT EXPERIENCED WITH A DECREASE IN DEATH RATES DUE TO HEART DISEASE IN TANEY (237.9 TO 224.3) AND STONE (216.9 TO 198.1) COUNTIES, BUT STILL OCCURRING AT A HIGHER RATE THAN THE NATIONAL BENCHMARK. FOR ADULT OBESITY PERCENTAGE, TANEY COUNTY EXPERIENCED A DECREASE (32% TO 31%), WHILE STONE COUNTY EXPERIENCED AN INCREASE (30% TO 33%). ACCESS TO SPECIALISTS/SHORTAGE OF PHYSICIANS - BOTH TANEY (1,433:1 TO 1,127:1) AND STONE (3,499:1 TO 3,157:1) COUNTIES EXPERIENCED A POSITIVE IMPROVEMENT IN THE RATIO OF POPULATION TO PRIMARY CARE PHYSICIANS IN THE COMMUNITY. ACCESS TO RECREATIONAL FACILITIES - IN 2012, BOTH TANEY (12) AND STONE (6) COUNTIES HAD LOW RATES OF RECREATIONAL FACILITIES PER 100,000 POPULATION COMPARED TO THE NATIONAL BENCHMARK (16). HOWEVER, THERE IS NO DATA COLLECTED ON THIS HEALTH INDICATOR FOR THE CURRENT YEAR. ADULT SMOKING - BOTH TANEY (26% TO 31%) AND STONE (22% TO 25%) COUNTIES EXPERIENCED AN INCREASE IN THE PERCENTAGE OF ADULTS SMOKING. TRANSPORTATION - WHILE THE NEED FOR THIS WAS IDENTIFIED THROUGH INTERVIEWS WITH KEY STAKEHOLDERS, DATA FROM THE U.S. CENSUS BUREAU'S AMERICAN COMMUNITY SURVEY REVEALS THE LACK OF TRANSPORTATION OPTIONS IN STONE AND TANEY COUNTIES. THE STONE AND TANEY COUNTY AVERAGES OF THE PERCENTAGE OF PEOPLE THAT CARPOOL TO WORK ARE 15.0% AND 16.3%, RESPECTFULLY, AND ARE BOTH HIGHER THAN THE STATE (9.4%) AND NATIONAL (9.6%) AVERAGES. ALSO, IN STONE COUNTY, 0.0% REPORTED TAKING PUBLIC TRANSPORTATION TO WORK, WHILE 1.0% OF TANEY COUNTY RESIDENTS REPORTED THE SAME. IT IS IMPORTANT TO NOTE THAT ALTHOUGH SOME OF THESE HEALTH PRIORITIES EXPERIENCED AN IMPROVEMENT, THEY ARE STILL PERFORMING POORER COMPARED TO STATE AND NATIONAL BENCHMARKS. WE UTILIZED THESE STATISTICS AND THE RESULTS OF THE COMMUNITY KEY INFORMANT INTERVIEWS TO DETERMINE THAT CMCB COMMUNITY RESOURCES WOULD BE BEST UTILIZED ON A FEW KEY HEALTH PRIORITIES THAT CONTINUE TO BE AN ISSUE AND HAVE THE POTENTIAL FOR GREATEST IMPACT ON COMMUNITY HEALTH. THESE SELECTED FOUR HEALTH PRIORITIES INCLUDE: -AFFORDABLE CARE/UNINSURED RESIDENTS -ACCESS TO SPECIALISTS/SHORTAGE OF PHYSICIANS -ADULT SMOKING -TRANSPORTATION SCHEDULE H, PART V, SECTION B, LINE 16A FINANCIAL ASSISTANCE POLICY AVAILABILITY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE AT THE FOLLOWING URL: WWW.COXHEALTH.COM/BODY.CFM?ID=5445 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: WWW.COXHEALTH.COM/BODY.CFM?ID=5445 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: WWW.COXHEALTH.COM/BODY.CFM?ID=5445 SCHEDULE H, PART V, SECTION B, LINE 16I MEASURES TO PUBLICIZE THE POLICY: FINANCIAL ASSISTANCE AVAILABILITY IS FURTHER PUBLICIZED BY INCLUSION OF NOTICES IN PATIENT BILLS AND BY POSTINGS IN ADMISSION OFFICES AND OTHER AREAS WITHIN THE HOSPITAL ADMITTING LOCATIONS. SCHEDULE H, PART V, SECTION B, LINE 22D DETERMINATION OF MAXIMUM CHARGES TO FAP-ELIGIBLE INDIVIDUALS: AMOUNTS GENERALLY BILLED WILL BE CALCULATED UTILIZING THE LOOK BACK METHOD. THIS IS A PERCENTAGE CALCULATED NO LESS FREQUENTLY THAN ANNUALLY BY DIVIDING THE SUM OF COMMERCIAL AND MEDICARE CLAIMS PAID TO THE HOSPITAL FACILITY BY THE SUM OF THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS. COX WILL MAKE THIS CALCULATION ON OR ABOUT AUGUST 15TH OF EACH YEAR AND BEGIN APPLYING ITS AGB PERCENTAGE(S) BY OCTOBER 1ST. FAP ELIGIBLE INDIVIDUALS WILL NOT BE CHARGED MORE THAN THE AMOUNTS GENERALLY BILLED (AGB) FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. 22 SKAGGS ORTHONEURO CENTER 101 CAHILL RD BRANSON MO 65616 OUTPATIENT DEPTS PHYSICIAN CLINICS CMCB OUTPATIENT CENTER 545 N BRANSON LANDING BLVD BRANSON MO 65616 OUTPATIENT DEPTS PHYSICIAN CLINICS MARY'S WELL HOUSE 5136 HWY 265 BRANSON MO 65616 PHYSICIAN CLINIC CMCB HEART CENTER 1150 STATE HWY 248 SUITE 202 BRANSON MO 65616 CLINIC COXHEALTH HOSPITALIST 525 BRANSON LANDING BLVD BRANSON MO 65616 CLINIC FDC UROLOGYGI 525 BRANSON LANDING BLVD BRANSON MO 65616 CLINIC COXHEALTH FAMILY MEDICINE & OB 525 BRANSON LANDING BLVD BRANSON MO 65616 CLINIC COXHEALTH FAMILY MEDICINE 248 1150 STATE HWY 248 SUITE 202 BRANSON MO 65616 CLINIC COXHEALTH FORSYTH 13852 US HWY 160 FORSYTH MO 65653 CLINIC COXHEALTH KIMBERLING CITY 2 KIMBERLING BLVD KIMBERLING CITY MO 65686 CLINIC COXHEALTH GENERAL SURGERY 525 BRANSON LANDING BLVD BRANSON MO 65616 CLINIC COXHEALTH DIABETES & ENDOCRINOLOGY 1150 HWY 248 SUITE 312 BRANSON MO 65616 CLINIC COXHEALTH INTERN MEDINFECTIOUS DISEASE 525 BRANSON LANDING BLVD 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 PULMONOLOGY & SLEEP MEDICINE 525 BRANSON LANDING BLVD SUITE 306 BRANSON MO 65616 CLINIC COX HYPERBARIC MEDICINE & WOUND CARE 101 SKAGGS ROAD SUITE 103 BRANSON MO 65616 CLINIC COXHEALTH URGENT CARE 525 BRANSON LANDING BLVD SUIE 100 BRANSON MO 65616 CLINIC COXHEALTH OCCUPATIONAL HEALTH 121 CAHILL ROAD SUITE 201 BRANSON MO 65616 CLINIC COXHEALTH RHEUMATOLOGY 525 BRANSON LANDING BLVD SUITE 301 BRANSON MO 65616 CLINIC COXHEALTH BRANSON WEST 18452 BUSINESS HWY 13 BRANSON WEST MO 65737 CLINIC FITNESS CENTER BRANSON 1500 BRANSON HILLS PARKWAY BRANSON MO 65616 FITNESS CENTER 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 TH 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 WHICH EQUALS TOTAL OPERATING EXPENSES PER FORM 990, PART IX, LINE 25 WAS REDUCED BY BAD DEBT EXPENSE OF $27,644,242. 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 $3,354,226. 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 ORGANIZATION CALCULATED BAD DEBT EXPENSE USING THE AMOUNTS CALCULATED IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, 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 AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE: THE HEALTH SYSTEM REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HEALTH SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. 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: (A) COX WILL NOT PURSUE LEGAL ACTION FOR NONPAYMENT OF ANY AMOUNTS DISCOUNTED AS A RESULT OF AN APPROVED OR PARTIAL APPROVED REQUEST FOR FINANCIAL ASSISTANCE. BALANCES REMAINING AFTER SUCH DISCOUNTS ARE APPLIED WILL, HOWEVER, BE SUBJECT TO COLLECTION ACTIVITY, INCLUDING LEGAL ACTION. (B) COX WILL NOT CHARGE INTEREST ON THE BALANCE REMAINING AFTER APPLYING THE FINANCIAL ASSISTANCE DISCOUNT. HOWEVER, COX 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. (C) COX PROHIBITS ENGAGING IN COLLECTION ACTIVITY IN THE EMERGENCY AND URGENT CARE DEPARTMENTS FROM INDIVIDUALS SEEKING EMERGENT OR URGENT MEDICAL CARE BEFORE THE INDIVIDUAL HAS BEEN TRIAGED AND SEEN BY A LICENSED PHYSICIAN, NURSE PRACTITIONER OR PHYSICIAN ASSISTANT. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: COX MEDICAL CENTER BRANSON (CMCB) WORKS CLOSELY WITH ITS COMMUNITY THROUGH ITS RELATIONSHIP WITH THE COXHEALTH SYSTEM, INCLUDING LESTER E. COX MEDICAL CENTERS. IN THE FISCAL YEAR CMCB TOOK THE LEAD IN BRINGING TOGETHER AREA ORGANIZATIONS WITH THE SIMILAR GOAL OF NEEDS ASSESSMENT: ADDRESSING THE HEALTHCARE NEEDS OF THE COMMUNITY, AS IDENTIFIED BY THE COMMUNITY NEEDS ASSESSMENT: UNHEALTHY BODY WEIGHT, ACCESS TO CARE, MENTAL HEALTH, AND SUBSTANCE ABUSE - INCLUDING TOBACCO, AND CHILD AND FAMILY SAFETY. THE COALITION IS NAMED OWNIT AND IS LED BY A STEERING COMMITTEE AND MEMBERS MAKE UP SUCH AGENCIES AND ORGANIZATIONS AS THE TANEY AND STONE COUNTY HEALTH DEPARTMENTS AND MORE. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: CMCB SCREENS ALL SELF-PAY PATIENTS FOR MEDICAID BY OUTSOURCING SELF-PAY TO SEE IF PATIENTS QUALIFY FOR ENTITLEMENT. IF THEY DO NOT QUALIFY, THEY WILL TALK TO A FINANCIAL COUNSELOR, WHO WILL SCREEN THEM FOR CHARITY. WE ALSO HAVE SIGNS THAT INCLUDE THIS HOSPITAL DOES PARTICIPATE IN THE MEDICAID PROGRAM. 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 14-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. -COX HEALTH SYSTEMS HMO, INC. -MEDICAL DEVELOPMENTS, INC. -INSURANCE COMPANY OF SPRINGFIELD, INC. -COXHEALTH ALLIANCE, LLC -COX-MONETT HOSPITAL -COXHEALTH FOUNDATION -COX HPS OF THE OZARKS, INC. -COX ALTERNATIVE CARE OF THE OZARKS, INC., HEALTHCARE SERVICES OF THE OZARKS, INC. AND COX HEALTHCARE SERVICES OF THE MIDWEST, INC. COLLECTIVELY REFERRED TO AS OXFORD HOME HEALTH CARE -PRIMROSE PLACE, INC. -COXHEALTH IS THE PARENT COMPANY FOR LESTER E. COX MEDICAL CENTERS AND ITS WHOLLY OWNED AFFILIATES, AND COX MEDICAL GROUP. -COX MEDICAL GROUP IS THE SOLE MEMBER OF THE COX TAXABLE CLOSE CORPORATION, A FOR-PROFIT ENTITY THAT IS THE SOLE SHAREHOLDER OF FDCI. true SKAGGS FOUNDATION PO BOX 650 BRANSON MO 65616 300107007 501(C)(3) 74758 SUPPORT BRANSON CHAMBER OF COMMERCE PO BOX 1897 BRANSON MO 65615 440586242 501(C)(6) 19709 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 SKAGGS FOUNDATION BY REVIEWING THE EXPENSES INCURRED BY THE FOUNDATION ON A MONTHLY BASIS TO ENSURE THE FUNDS WERE PROPERLY DISTRIBUTED AND USED FOR THE INTENDED PURPOSE. THE FUNDS ARE USUALLY USED TO PURCHASE EQUIPMENT FOR THE HOSPITAL. THE FUNDS PAID TO BRANSON CHAMBER OF COMMERCE WERE FOR SPONSORSHIPS OF VARIOUS CHAMBER EVENTS. X X X X X false true false false false false false false false JAKE MCWAY DIRECTOR 0 506845 0 115045 0 104905 0 121770 0 19819 0 868384 0 96844 STEVE EDWARDS DIRECTOR 0 876096 0 240385 0 113752 0 238287 0 24706 0 1493226 0 105971 WILLIAM MAHONEY CEO 418615 0 48488 0 6450 0 55449 0 14677 0 543679 0 0 0 DAVID STRONG CFO 237930 0 26879 0 6690 0 37600 0 14729 0 323828 0 0 0 HOLLY WHERRY DIRECTOR 303297 0 5407 0 373 0 0 0 14664 0 323741 0 0 0 CHAD EFIRD PHYSICIAN 753629 0 12809 0 373 0 12649 0 14664 0 794124 0 0 0 NARIN ARUNAKUL PHYSICIAN 646068 0 24686 0 953 0 30500 0 14761 0 716968 0 0 0 DENNIS DANIELS PHYSICIAN 577621 0 18448 0 621 0 0 0 14706 0 611396 0 0 0 MITTIE DRAGOSLJVICH PHYSICIAN 603926 0 0 0 2370 0 13250 0 14997 0 634543 0 0 0 PRASER VIJITBENJARONK PHYSICIAN 473182 0 7193 0 953 0 30500 0 14761 0 526589 0 0 0 CAROL MARTIN VP ADMINISTRATION 182438 0 12197 0 4233 0 27419 0 15178 0 241465 0 0 0 BRIAN CLONTS MD CMO 332911 0 44389 0 717 0 12649 0 14721 0 405387 0 0 0 LYNNE YAGGY CNO 172499 0 5597 0 664 0 7150 0 14788 0 200698 0 0 0 SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: STEVE EDWARDS, JAKE MCWAY, WILLIAM MAHONEY AND DAVID STRONG PARTICIPATE IN A 457(F) NONQUALIFIED RETIREMENT PLAN THROUGH LESTER E. COX MEDICAL CENTERS, A RELATED ORGANIZATION. - STEVE EDWARDS RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $225,638. - STEVE EDWARDS RECEIVED A 457(F) DISTRIBUTION OF $105,971, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - JAKE MCWAY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $91,520. - JAKE MCWAY RECEIVED A 457(F) DISTRIBUTION OF $96,844, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - WILLIAM MAHONEY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $42,800. - DAVID STRONG RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $24,600. LAKES REGION IMAGING LLC SEE PART V 81250 PURCHASED SERVICES false SCHEDULE L, PART IV, COLUMN B TRANSACTIONS WITH INTERESTED PERSONS: (3) ANTHONY WHEELER, A BOARD MEMBER OF COX MEDICAL CENTER BRANSON, IS A 50% OWNER OF LAKES REGION IMAGING, LLC. FORM 990, PART I, LINE 1 ORGANIZATION'S MISSION SUMMARY 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: IN THE SPRING OF 2015, COX MEDICAL CENTER BRANSON COMPLETED A $30 MILLION EMERGENCY DEPARTMENT AND CRITICAL CARE UNIT EXPANSION. THE 60,000-SQUARE-FOOT RENOVATION AND CONSTRUCTION PROJECT BEGAN IN SEPTEMBER 2013. THE NEW DESIGN ALLOWS FOR OPTIMIZED PATIENT FLOW TO HELP DECREASE PATIENT WAIT TIMES. THE NEW SPACE ALLOWS FOR MORE EFFICIENT AND EFFECTIVE USE OF MEDICAL TECHNOLOGIES AS WELL AS IMPROVES THE HUMAN SIDE OF PATIENT CARE BY OPTIMIZING BEDSIDE NURSING. IN JULY 2015, COX MEDICAL CENTER BRANSON OPENED A NEWLY RENOVATED CARDIAC CATHETERIZATION LAB. THE CATHETERIZATION LAB IS AN EXAMINATION ROOM WITH DIAGNOSTIC IMAGING EQUIPMENT THAT ALLOWS DOCTORS TO VISUALIZE THE ARTERIES AND CHAMBERS OF THE HEART AND THEN TREAT ANY STENOSIS OR ABNORMALITY DISCOVERED. THE NEW TECHNOLOGY ALLOWS DOCTORS TO SEE UP TO SIX DIFFERENT IMAGES DURING A PROCEDURE. THE NEW IMAGING EQUIPMENT IS ALSO A LOW-DOSE RADIATION MACHINE, WHICH MEANS IT IS SAFER FOR PATIENTS. HONORS COX MEDICAL CENTER BRANSON HAS ALSO RECEIVED THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES - STROKE SILVER PLUS QUALITY ACHIEVEMENT AWARD. THE AWARD RECOGNIZES THE HOSPITAL'S COMMITMENT AND SUCCESS IN ENSURING STROKE PATIENTS RECEIVE THE MOST APPROPRIATE TREATMENT ACCORDING TO NATIONALLY RECOGNIZED, RESEARCH-BASED GUIDELINES BASED ON THE LATEST SCIENTIFIC EVIDENCE. TO RECEIVE THE SILVER PLUS QUALITY ACHIEVEMENT AWARD, COX MEDICAL CENTER BRANSON HAD TO ACHIEVE AN 85 PERCENT OR HIGHER ADHERENCE TO ALL GET WITH THE GUIDELINES-STROKE ACHIEVEMENT INDICATORS FOR AT LEAST 12 CONSECUTIVE MONTHS AND DURING THE SAME PERIOD ACHIEVE 75 PERCENT OR HIGHER COMPLIANCE WITH FIVE OF EIGHT GET WITH THE GUIDELINES-STROKE QUALITY MEASURES. THESE QUALITY MEASURES ARE DESIGNED TO HELP HOSPITAL TEAMS PROVIDE THE MOST UP-TO-DATE, EVIDENCE-BASED GUIDELINES WITH THE GOAL OF SPEEDING RECOVERY AND REDUCING DEATH AND DISABILITY FOR STROKE PATIENTS. ADDITIONAL PROGRAMS ACCORDING TO INFORMATION FROM TANEY COUNTY HEALTH DEPARTMENT (TCHD), MISSOURI RANKS NO. 6 FOR HIGHEST TOBACCO USAGE AND TANEY COUNTY, WHERE COX MEDICAL CENTER BRANSON IS LOCATED, HAS BEEN IDENTIFIED AS HAVING THE HIGHEST TOBACCO USE RATE IN THE STATE. TOBACCO USAGE HAS BEEN IDENTIFIED BY TCHD AS A TOP HEALTH PRIORITY. COX MEDICAL CENTER BRANSON IS WORKING DILIGENTLY TO HELP REDUCE TOBACCO USAGE IN OUR AREA. WE EMPLOYEE A FULLTIME TOBACCO CESSATION SPECIALIST WHO, SINCE HE BEGAN IN APRIL 2013, HAS HELPED 138 PEOPLE QUIT TOBACCO. TOBACCO CESSATION CLASSES ARE OFFERED TO EMPLOYEES FREE OF CHARGE AND SCHOLARSHIPS ARE AVAILABLE TO INDIVIDUALS IN THE COMMUNITY. COX MEDICAL CENTER BRANSON WAS ALSO SUPPORTIVE AND ACTIVELY INVOLVED OF THE PASSAGE OF BRANSON'S SMOKE-FREE ORDINANCE THAT WENT INTO EFFECT JULY 1, 2015. TRI-LAKES CLEAN AIR ALLIANCE, WHICH WORKED WITH CITY OFFICIALS ON THE PASSAGE OF THE ORDINANCE, IS MADE POSSIBLE THROUGH A MISSOURI FOUNDATION FOR HEALTH GRANT AWARDED TO COX MEDICAL CENTER BRANSON. ANOTHER FOCUS IS ON ADDRESSING UNHEALTHY BODY WEIGHT IN THE COMMUNITY DUE TO POOR NUTRITION, ANOTHER OF THE HEALTH DEPARTMENT'S TOP HEALTH PRIORITIES. COX MEDICAL CENTER BRANSON OPERATES A FITNESS CENTER, OFFERS NUMEROUS PROGRAMS AT THE FITNESS CENTER, INCLUDING BOOTCAMPS, TO ENCOURAGE LOCAL RESIDENTS TO REACH A HEALTHIER BODY WEIGHT. OTHER WORK TO ADDRESS UNHEALTHY BODY WEIGHT INCLUDES NUMEROUS CLASSES HOSTED AT COX MEDICAL CENTER BRANSON THAT FOCUS ON HEALTHY LIFESTYLES. 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 4 SIGNIFICANT CHANGES TO ORGANIZATION'S BYLAWS: THE ORGANIZATION'S BYLAWS WERE AMENDED TO REMOVE THE SECTION CONTAINING THE DETAILED CONFLICT OF INTEREST POLICY, BUT THE SEPARATE CONFLICT OF INTEREST POLICY REMAINS UNCHANGED. 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 ABOVEMENTIONED 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). 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 CONFLICT OF INTEREST POLICY: DIRECTORS AND COMMITTEE MEMBERS SHALL FILE A DISCLOSURE STATEMENT ANNUALLY WITH THE PRESIDENT AND CEO OF COX BRANSON OR HIS/HER DESIGNEE, WHICH DOCUMENT SHALL BE DISCLOSED TO THE BOARD AND THE AUDIT AND COMPLIANCE COMMITTEE OF THE MEMBER. DIRECTORS AND COMMITTEE MEMBERS SHALL INFORM THE BOARD OR COMMITTEE, AS THE CASE MAY BE, OF ANY DUALITY OF INTEREST OR ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN ANY MATTER UNDER CONSIDERATION. SUCH PERSON SHALL NEITHER VOTE NOR USE HIS/HER INFLUENCE TO AFFECT THE DECISION ON THE MATTER, AND SHALL NOT BE COUNTED IN DETERMINING WHETHER A QUORUM PARTICIPATED IN THE DECISION, EVEN WHEN PERMITTED BY LAW. THE MINUTES OF THE MEETING SHALL REFLECT THE DISCLOSURE, ABSTENTION FROM VOTING, AND QUORUM STATUS. NOTHING HEREIN PREVENTS THE BOARD FROM AUTHORIZING, APPROVING OR RATIFYING A BUSINESS RELATIONSHIP OR REACHING A CONCLUSION ON AN ISSUE DESPITE A CONFLICT OF INTEREST OR DUALITY OF INTEREST, SO LONG AS THE PROCEDURES DESCRIBED IN THE BYLAWS ARE FOLLOWED. DISCUSSION: THE PROCEDURES ABOVE SHALL NOT PREVENT THE DIRECTOR OR COMMITTEE MEMBER FROM BRIEFLY STATING HIS/HER POSITION ON THE MATTER, OR FROM ANSWERING PERTINENT QUESTIONS ABOUT IT, IF THE DUTIES SET FORTH HEREIN ARE SUBJECT TO THE RESERVED POWERS OF THE MEMBER'S KNOWLEDGE OR EXPERTISE COULD ASSIST THOSE PARTICIPATING IN THE DECISION. ALL DIRECTORS SHALL BE INFORMED OF THIS ARTICLE BY THE PRESIDENT AND CEO OF COX BRANSON UPON TAKING OFFICE. VOTING: DIRECTORS AND COMMITTEE MEMBERS SHALL INFORM THE BOARD OR COMMITTEE, AS THE CASE MAY BE, OF ANY DUALITY OF INTEREST OR ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN ANY MATTER UNDER CONSIDERATION. SUCH PERSON SHALL NEITHER VOTE NOR USE HIS/HER INFLUENCE TO AFFECT THE DECISION ON THE MATTER, AND SHALL NOT BE COUNTED IN DETERMINING WHETHER A QUORUM PARTICIPATED IN THE DECISION, EVEN WHEN PERMITTED BY LAW. THE MINUTES OF THE MEETING SHALL REFLECT THE DISCLOSURE, ABSTENTION FROM VOTING, AND QUORUM STATUS. NOTHING HEREIN PREVENTS THE BOARD FROM AUTHORIZING, APPROVING OR RATIFYING A BUSINESS RELATIONSHIP OR REACHING A CONCLUSION ON AN ISSUE DESPITE A CONFLICT OF INTEREST OR DUALITY OF INTEREST, SO LONG AS THE PROCEDURES DESCRIBED IN THIS ARTICLE ARE FOLLOWED. THE POLICY ABOVE SHALL NOT PREVENT THE DIRECTOR OR COMMITTEE MEMBER FROM BRIEFLY STATING HIS/HER POSITION ON THE MATTER, OR FROM ANSWERING PERTINENT QUESTIONS ABOUT IT, IF THE DUTIES SET FORTH HEREIN ARE SUBJECT TO THE RESERVED POWERS OF THE MEMBER'S KNOWLEDGE OR EXPERTISE COULD ASSIST THOSE PARTICIPATING IN THE DECISION. NOTICE: ALL DIRECTORS SHALL BE INFORMED OF THIS ARTICLE BY THE PRESIDENT AND CEO OF COX BRANSON UPON TAKING OFFICE. 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. EACH JANUARY 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 AND JAKE MCWAY ARE OFFICERS OF LESTER E. COX MEDICAL CENTERS, A RELATED ORGANIZATION, AS WELL AS MEMBERS OF THE COX BRANSON BOARD OF DIRECTORS. THEIR COMPENSATION IS PAID BY LESTER E. COX MEDICAL CENTERS FOR SERVICES PERFORMED RELATED TO THEIR ROLES AS OFFICERS. HOLLY WHERRY IS AN EMPLOYEE OF COX BRANSON AS WELL AS A MEMBER OF THE BOARD OF DIRECTORS. HER COMPENSATION IS RELATED TO HER ROLE AS AN EMPLOYEE. NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS BOARD MEMBERS. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES: OTHER FEES FOR SERVICES ARE COMPRISED OF THE FOLLOWING CATEGORIES: $13,334,843 CONTRACTED LABOR 18,551,103 OTHER CONTRACTED SERVICES 38,125 CONTRACTED MGMT SERVICES 109,845 CONTRACTED CONSULTING SERVICES 249,408 CONTRACTED COLLECTION AGENCY 383,546 CONTRACTED LAB SERVICES 531 CONTRACTED TRANSCRIPTION SERVICES 140,844 CONTRACTED HOUSEKEEPING 59,512 CONTRACTED COURIER SERVICES 799,210 CONTRACTED BILLING SERVICES ------------ $33,666,967 TOTAL FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $1,955,179 CHANGE IN INVESTMENT IN SKAGGS FOUNDATION (480,142) CHANGE IN BENEFICIAL INTEREST IN TRUST ----------- $1,475,037 SKAGGS EMERGENCY PHYSICIANS 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) 9 LESTER E COX false COXHEALTH FOUNDATION 3525 S NATIONAL SUITE 204 SPRINGFIELD MO 65807 436810485 FUNDRAISING MO 501(C)(3) 11 A I LESTER E COX false COXHEALTH HOME CARE SVCS OF THE MIDWEST 1400 HERIFORD RD STE 104 COLUMBIA MO 65202 264781194 HOME HEALTH MO 501(C)(3) 9 LESTER E COX false COX HPS OF THE OZARKS INC 2220 W SUNSET SPRINGFIELD MO 65807 431641927 HOME HEALTH MO 501(C)(3) 9 LESTER E COX false COX-MONETT HOSPITAL INC 801 LINCOLN AVE MONETT MO 65708 431656689 HOSPITAL MO 501(C)(3) 3 LESTER E COX false COX-MONETT HOSPITAL AUXILIARY 801 LINCOLN AVE MONETT MO 65708 431852817 FUNDRAISING MO 501(C)(3) 9 LESTER E COX false HEALTH ENRICHMENT SERVICES INC 3801 S NATIONAL SPRINGFIELD MO 65807 363263313 MED SVC 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) 9 LESTER E COX false PRIMROSE PLACE INC 1115 E PRIMROSE SPRINGFIELD MO 65807 431183783 NURSING HOME MO 501(C)(3) 11 A I LESTER E COX false COXHEALTH AUXILIARY 3801 S NATIONAL SPRINGFIELD MO 65807 431090590 SUPPORT MO 501(C)(3) 9 LESTER E COX false COX MEDICAL CTR GENPROF LIAB LOSS FUND 1423 N JEFFERSON SPRINGFIELD MO 65802 366668576 SELF-INSURAN MO 501(C)(3) 11 A I LESTER E COX false LESTER E COX MEDICAL CENTERS 1423 N JEFFERSON ST SPRINGFIELD MO 65802 440577118 HOSPITAL MO 501(C)(3) 3 COXHEALTH false COXHEALTH 1423 N JEFFERSON ST SPRINGFIELD MO 65802 471087427 HOLDING CO MO 501(C)(3) 11 B II NA false COX MEDICAL GROUP 1423 N JEFFERSON ST SPRINGFIELD MO 65802 411087566 PHYSICIANS MO 501(C)(3) 9 COXHEALTH false COX HEALTH SYSTEMS HMO INC PO BOX 5750 SPRINGFIELD MO 658015750 431757075 HMO MO 501(C)(4) LESTER E COX false PCRMC-COX HEALTH ALLIANCE LLC 1423 N JEFFERSON AVENUE SPRINGFIELD MO 65807 300649009 HEALTHCARE MO MEDICAL DEVELOPMENTS INC 1423 N JEFFERSON AVE SPRINGFIELD MO 65802 431622182 PHARMACY MO LESTER E COX C CORP false INSURANCE COMPANY OF SPRINGFIELD INC GRAND PAVILION CORPORATE CENTRE GRAND CAYMAN CJ CAPTIVE INSUR 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 false false true false false false false false false true false false false false false true true false false