2015-08-13T12:26:05-05:00 2014-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2013-10-01 440584290 SKAGGS COMMUNITY HOSPITAL ASSOCIATION % DAVID STRONG SKAG 4173357000 251 SKAGGS ROAD Suite BRANSON MO 65615 DAVID STRONG CFO 4173357000 2015-08-03 true Brian D Todd P00422601 4173357000 2013 2016-02-25 16:41:14Z COX MEDICAL CENTER BRANSON MR WILLIAM MAHONEY 251 SKAGGS ROAD BRANSON MO 65615 177416938 false X WWW.SKAGGS.NET 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 7 1446 287 20452 -28465 187965 2107369 79312729 173235995 495343 946870 -989715 -440928 79006322 175849306 204732 145769 0 0 32376604 68516551 0 0 0 48839068 106841835 81420404 175504155 -2414082 345151 178412958 195885210 87490809 103111709 90922149 92773501 X THE HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH QUALITY HEALTH CARE, EDUCATION AND RESEARCH. false true 123233887 145769 151439987 HOSPITAL SERVICES - COX MEDICAL CENTER BRANSON PROVIDES THE FOLLOWING AREAS OF SERVICE: CANCER, CARDIAC, DIABETES & ENDOCRINOLOGY, EAR NOSE & THROAT, EMERGENCY, URGENT CARE, FAMILY MEDICINE, IMAGING & RADIOLOGY, LABORATORY & PATHOLOGY, NEPHROLOGY & DIALYSIS, NEUROLOGY, OCCUPATIONAL HEALTH, ORTHOPEDICS, PEDIATRICS, PSYCHIATRY, PULMONOLOGY/CRITICAL CARE, REHABILITATION & THERAPY, RHEUMATOLOGY, SLEEP DISORDER CENTER, SOCIAL SERVICES, SURGERY, UROLOGY, WOMEN'S SERVICES AND WOUND CARE. 30432483 21796008 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. 153666370 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 true true false false false false false false false true false false false false true true false false false true X 123 0 true 1446 true true true false false false false false false false false false X 14 7 false false false 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 SECRETARY 3.0 5.0 X X 0 0 0 TONY WHEELER DIRECTOR 3.0 0.0 X 0 0 0 JIM KANEASTER CHAIRMAN 3.0 0.0 X 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 VICE CHAIRMAN 3.0 5.0 X X 0 0 0 JAKE MCWAY DIRECTOR 3.0 46.0 X 0 651585 116266 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 JOHN DUFF DIRECTOR 3.0 45.0 X 0 471145 147078 RAEANNE PRESLEY DIRECTOR 3.0 0.0 X 0 0 0 RICHARD BLUBAUGH DIRECTOR 3.0 0.0 X 0 0 0 STEVE EDWARDS DIRECTOR 3.0 47.0 X 0 1177948 243844 HOLLY WHERRY DIRECTOR 3.0 0.0 X 345772 0 11898 WILLIAM MAHONEY CEO 40.0 0.0 X 444348 0 79520 DAVID STRONG CFO 40.0 0.0 X 258952 0 111090 CAROL MARTIN VP ADMINISTRATION 40.0 0.0 X 200684 0 36989 NARIN ARUNAKUL PHYSICIAN 40.0 0.0 X 745585 0 32578 MITTIE DRAGOSLJVICH PHYSICIAN 40.0 0.0 X 579757 0 28555 PRASERT VIJITBENJARONK PHYSICIAN 40.0 0.0 X 576585 0 32505 ROBERT DORSEY PHYSICIAN 40.0 0.0 X 532168 0 24699 JOHN HUFFMAN PHYSICIAN 40.0 0.0 X 499041 0 27499 4182892 2300678 892521 63 false true false NUCLEAR DIAGNOSIS INC MEDICAL TESTING 243663 BENJAMIN LEAVITT PHYSICIAN SERVICES 212913 2 107477 1999892 2107369 PATIENT SERVICE REVENUE 624100 169211616 169191164 20452 CAFETERIA 722514 746107 746107 GIFT SHOP 713940 53537 53537 FITNESS CENTER 541900 335570 335570 AUDIT BILLING REVENUE 561000 114400 114400 2774765 2774765 173235995 964849 964849 0 0 1189795 1547653 -357858 0 -357858 -357858 2000 19979 -17979 -17979 -17979 0 0 0 LOSS ON INVESTMENT IN EQUITY INVESTEE 900099 -83070 -83070 -83070 175849306 173215543 20452 505942 X 138269 138269 7500 7500 0 0 1489253 357670 1131583 0 55871442 44364997 11506445 1326160 1053044 273116 5965224 5423613 541611 3864472 3490063 374409 0 61083 61083 157831 157831 0 0 0 29866711 24082636 5784075 520393 476723 43670 3814414 3117505 696909 1045230 957517 87713 0 2097149 1921162 175987 550085 503923 46162 0 183955 168518 15437 2072787 1898844 173943 0 7382019 6762540 619479 1424809 1305243 119566 BAD DEBT 26425318 26425318 MEDICAL SUPPLIES & DRUGS 23099746 23099746 PROVIDER TAX 7797528 7797528 LICENSES, DUES, SUBSCRIPTIONS 276604 253392 23212 66173 60619 5554 175504155 153666370 21837785 0 11862430 15001968 42686171 23524530 0 0 20556432 22842768 0 0 0 0 0 0 1990283 1936089 1886779 1800926 108258837 11812553 74511251 96446284 11418073 21161967 8093681 8447121 1263337 1392607 1239000 689000 2905521 2641950 178412958 195885210 11565783 10056886 0 0 62013 137953 58628786 58366210 0 0 0 0 14366717 15207556 0 0 2867510 19343104 87490809 103111709 X 81648200 82930264 1263338 1396116 8010611 8447121 90922149 92773501 178412958 195885210 X 345151 966980 539221 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 22551 22551 false SCHEDULE C, PART II-B, LINE 1(I) OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAID DUES OF $42,162 TO THE MISSOURI HOSPITAL ASSOCIATION, OF WHICH $18,299 (43.4%) IS ATTRIBUTABLE TO LOBBYING PURPOSES. THE ORGANIZATION ALSO PAID DUES OF $17,980 TO THE AMERICAN HOSPITAL ASSOCIATION, OF WHICH $4,252 (23.65%) IS ATTRIBUTABLE TO LOBBYING PURPOSES. 5310000 5310000 51500588 2700328 48800260 4302683 285656 4017027 38252563 8274030 29978533 8893003 552539 8340464 96446284 0 DUE TO RELATED PARTY 18903347 DUE TO 3rd PARTY 439757 19343104 151908554 966980 -26425318 -25458338 177366892 -1517586 -1517586 175849306 150626490 1547653 1547653 149078837 26425318 26425318 175504155 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: $(26,425,318) BAD DEBT SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ (1,547,653) RENTAL EXPENSES 38,043 TEMPORARILY RESTRICTED CONTRIBUTIONS (7,976) TEMPORARILY RESTRICTED INVESTMENT RETURN ------------- $ (1,517,586) SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 1,547,653 RENTAL EXPENSES SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 26,425,318 BAD DEBT true true X false true X true true false true true 4617074 4617074 0.03100 22147155 15734029 6413126 0.04300 26764229 15734029 11030200 0.07400 3431 3431 9433005 6057566 3375439 0.02260 238510 238510 0.00160 9674946 6057566 3617380 0.02420 36439175 21791595 14647580 0.09820 true 26425318 5707869 49607797 57489168 -7881371 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 true X X X X X X X X X 12 true false true X HTTP://WWW.SKAGGS.NET/MAIN/ABOUTUS.ASPX X X X X X X X X X false false true false true 300. true X X X X X true true X X X X X X X true false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 3 COMMUNITY INPUT: THE CHNA PROCESS INVOLVED: - COLLECTION AND ANALYSIS OF A LARGE RANGE OF DATA, INCLUDING DEMOGRAPHIC, SOCIOECONOMIC AND HEALTH STATISTICS, HEALTH CARE RESOURCES AND PATIENT USE RATES. - 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. - CIRCULATION OF A COMMUNITY HEALTH INPUT QUESTIONNAIRE THAT GATHERED A WIDE RANGE OF INFORMATION WHICH WAS WIDELY DISTRIBUTED TO MEMBERS OF THE COMMUNITY. 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 AND ESTIMATED A DEMAND FOR PHYSICIAN AND HOSPITAL SERVICES WAS ESTIMATED. BOTH WERE EVALUATED FOR UNMET NEEDS. - COMMUNITY INPUT WAS PROVIDED THROUGH KEY INFORMANT INTERVIEWS OF 15 STAKEHOLDERS AND A COMMUNITY HEALTH INPUT QUESTIONNAIRE WAS WIDELY DISTRIBUTED. THE COMMUNITY HEALTH INPUT QUESTIONNAIRE WAS COMPLETED BY 547 INDIVIDUALS. RESULTS AND FINDINGS ARE DESCRIBED IN THE KEY INFORMANT AND COMMUNITY HEALTH INPUT QUESTIONNAIRE SECTIONS 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. HEALTH NEEDS WERE RANKED UTILIZING A WEIGHTING METHOD THAT CONSIDERS: 1) THE ABILITY OF THE HOSPITAL TO IMPACT CHANGE, 2) THE SIZE OF THE PROBLEM, 3) THE SERIOUSNESS OF THE PROBLEM AND 4) THE PREVALENCE OF COMMON THEMES. - HEALTH NEEDS WERE THEN PRIORITIZED TAKING INTO ACCOUNT THE PERCEIVED DEGREE OF INFLUENCE THE HOSPITAL HAS TO IMPACT THE NEED AND THE HEALTH NEEDS IMPACT ON THE OVERALL HEALTH OF THE COMMUNITY. INFORMATION GAPS WERE IDENTIFIED DURING THE PRIORITIZATION PROCESS AND ARE ALSO REPORTED. - RECOMMENDATIONS BASED ON THIS ASSESSMENT HAVE BEEN COMMUNICATED TO HOSPITAL MANAGEMENT. SCHEDULE H, PART V, SECTION B, LINE 6 IMPLEMENTATION STRATEGY: IN RESPONSE TO THE RESULTS OF THE MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION ADOPTED AN IMPLEMENTATION STRATEGY. THE IMPLEMENTATION STRATEGY CAN BE FOUND AT THE FOLLOWING URL: HTTP://WWW.SKAGGS.NET/UPLOADS/PUBLIC/IMPLEMENTATION%20PLAN-FINAL%20VERSION %204%2030%2013.PDF SCHEDULE H, PART V, SECTION B, LINE 7 ADDRESSING IDENTIFIED NEEDS: THE 2012 COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIES A NUMBER OF UNMET OR PARTIALLY MET HEALTH NEEDS THROUGHOUT THE SERVICE AREA. ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT DATA PROVIDED A MEANS TO EVALUATE AND PRIORITIZE AREAS OF GREATEST NEED. HEALTH NEEDS WERE RANKED ON A SCALE OF ONE TO FIVE WITH A FIVE MEANING THAT THE HOSPITAL COULD HAVE THE GREATEST IMPACT ON THAT NEED, WHILE A ONE DENOTES THE LEAST IMPACT. THESE HEALTH NEEDS WERE FURTHER RANKED ON FOUR FACTORS: - THE ABILITY OF COX MEDICAL CENTER BRANSON TO EVALUATE AND MEASURE OUTCOMES. - HOW MANY PEOPLE ARE AFFECTED BY THE ISSUE OR SIZE OF THE PROBLEM? - WHAT ARE THE CONSEQUENCES OF NOT ADDRESSING THE PROBLEM? - PREVALENCE OF COMMON THEMES. BY ADDRESSING THESE NEEDS, COMMUNITY HEALTH WILL LIKELY IMPROVE. THEY HAVE THE GREATEST IMPACT ON OVERALL COMMUNITY HEALTH AND THE HOSPITAL HAS THE ABILITY TO MAKE AN IMPACT. OVER THE LAST YEAR, THE HOSPITAL HAS BEGUN TO DEVELOP TOOLS FOR INTERVENTION, AND THROUGH THIS PLAN, CURRENT INTERVENTIONS WILL BE EXPANDED UPON AND NEW INTERVENTIONS WILL BE CREATED AND IMPLEMENTED IN ORDER TO IMPACT THE GREATEST NUMBER OF RESIDENTS. AS A RESULT OF THE ANALYSIS, AFFORDABLE CARE, UNINSURED RESIDENTS, DISEASES OF THE HEART, ACCESS TO SPECIALISTS, SHORTAGE OF PHYSICIANS, ACCESS TO RECREATIONAL FACILITIES, ADULT SMOKING AND TRANSPORTATION WERE IDENTIFIED AS THE PRIORITY AREAS ON WHICH WE WILL FOCUS. THERE WERE OTHER AREAS OF NEED IDENTIFIED THROUGH THE ASSESSMENT THAT ARE CLEARLY IMPORTANT TO IMPROVING THE HEALTH OF THE COMMUNITY. WHILE THEY ARE DEEMED TO HAVE A LESS IMMEDIATE IMPACT, IF OPPORTUNITY ARISES, THEY WILL BE INTEGRATED INTO THIS PLAN AS A SUB-OBJECTIVE ACTIVITY. UNFORTUNATELY, AS WITH MOST OF RURAL AMERICA, COX MEDICAL CENTER BRANSON IS WITHOUT THE NECESSARY RESOURCES TO ADEQUATELY ADDRESS THE PANDEMIC INCREASE IN PEOPLE WHO ARE IMPACTED BY MENTAL HEALTH AND SUBSTANCE ABUSE ISSUES. SCHEDULE H, PART V, SECTION B, LINE 10 CRITERIA USED TO DETERMINE 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. SCHEDULE H, PART V, SECTION B, LINE 14G MEASURES TO PUBLICIZE THE POLICY: FINANCIAL ASSISTANCE AVAILABILITY IS PROACTIVELY COMMUNICATED TO UNINSURED PATIENTS BY CUSTOMER SERVICE STAFF AND BY OUR EARLY OUT AND ABAD DEBT VENDORS; ANYONE RECOGNIZED AS UNINSURED IS TOLD ABOUT THE FA AVAILABILITY AND ENCOURAGED TO PARTICIPATE. 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 COX HEALTH CENTER BRANSON 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 BRANSON HWY 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 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. SCHEDULE 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 $26,425,318. 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 $3,375,439. 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 PARTIALLY 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 OR 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. IS THE SOLE OWNER OF COX HEALTH SYSTEMS INSURANCE COMPANY AND COX HEALTH PLANS, LLC -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 WILL BE THE SOLE SHAREHOLDER OF FDCI ONCE THE ACQUISITION IS COMPLETED. -IN SEPTEMBER 2014, THE NEWLY FORMED COXHEALTH SIGNED A LETTER OF INTENT WITH FERRELL-DUNCANCLINIC, INC. (FDCI), IN WHICH FDCI WOULD BECOME A WHOLLY OWNED AFFILIATE OF COXHEALTH AS A PARTOF COX MEDICAL GROUP. THE AFFILIATION WILL ALLOW FOR DEEPER CLINICAL INTEGRATION, COMMUNITY BENEFITS, PATIENT CARE IMPROVEMENT AND ECONOMIES FOR COXHEALTH AND ITS EXISTING AFFILIATES AND FDCI. COXHEALTH AND FDCI FINALIZED THEIR TRANSACTION ON DECEMBER 31, 2014. true SKAGGS FOUNDATION PO BOX 650 BRANSON MO 65616 300107007 501(C)(3) 118658 SUPPORT BRANSON CBMC PO BOX 1246 BRANSON MO 65615 621841451 501(C)(3) 6000 SUPPORT BRANSON CHAMBER OF COMMERCE PO BOX 1897 BRANSON MO 65615 440586242 501(C)(6) 10000 SUPPORT 2 1 TUITION ASSISTANCE 8 7500 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 CBMC WERE FOR THE SPONSORSHIP OF THE MAYOR'S PRAYER BREAKFAST. THE FUNDS WERE USED IMMEDIATELY TO SUPPORT THE EVENT. THE FUNDS PAID TO BRANSON CHAMBER OF COMMERCE WERE FOR THE BUSINESS DEVELOPMENT PARTNERSHIP. FOLLOWING COMPLETION OF THE COURSE(S), IT IS THE GRANTEE'S RESPONSIBILITY TO REQUEST, IN WRITING, A REIMBURSEMENT REQUEST FOR THE SEMESTER'S TUITION FEES NOT TO EXCEED $1,000 PER SEMESTER AND NO MORE THAN $2,000 PER YEAR. THE REQUEST MUST BE ACCOMPANIED WITH A STATEMENT FROM THE SCHOOL WITH A BREAKDOWN OF CHARGES ALONG WITH A COPY OF THE GRADES FOR THE COURSES BEING REIMBURSED. ALL DOCUMENTS SHOULD THEN BE SUBMITTED FOR REVIEW AND APPROVAL. X X X X X false true false false false false false false false JAKE MCWAY DIRECTOR 0 460867 0 80463 0 110255 0 97407 0 18859 0 767851 0 86365 JOHN DUFF DIRECTOR 0 370576 0 66180 0 34389 0 124836 0 22242 0 618223 0 0 STEVE EDWARDS DIRECTOR 0 850275 0 162334 0 165339 0 223121 0 20723 0 1421792 0 155171 WILLIAM MAHONEY CEO 407689 0 36226 0 433 0 65806 0 13714 0 523868 0 0 0 DAVID STRONG CFO 237489 0 20799 0 664 0 97320 0 13770 0 370042 0 0 0 HOLLY WHERRY DIRECTOR 345286 0 0 0 486 0 0 0 11898 0 357670 0 0 0 NARIN ARUNAKUL PHYSICIAN 726843 0 0 0 18742 0 12495 0 20083 0 778163 0 0 0 MITTIE DRAGOSLJVICH PHYSICIAN 578515 0 0 0 1242 0 12495 0 16060 0 608312 0 0 0 PRASERT VIJITBENJARONK PHYSICIAN 558312 0 0 0 18273 0 12495 0 20010 0 609090 0 0 0 ROBERT DORSEY PHYSICIAN 529846 0 0 0 2322 0 12495 0 12204 0 556867 0 0 0 JOHN HUFFMAN PHYSICIAN 495477 0 0 0 3564 0 12495 0 15004 0 526540 0 0 0 CAROL MARTIN VP ADMINISTRATION 199170 0 0 0 1514 0 22970 0 14019 0 237673 0 0 0 SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: STEVE EDWARDS, JACOB MCWAY, AND JOHN DUFF 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 $210,371. - STEVE EDWARDS RECEIVED A 457(F) DISTRIBUTION OF $155,171, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - JACOB MCWAY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $84,657. - JACOB MCWAY RECEIVED A 457(F) DISTRIBUTION OF $86,365, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - JOHN DUFF RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $112,086. - WILLIAM MAHONEY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $53,056. - DAVID STRONG RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $84,657. 0 360 DEGREE MEDICINE SEE PART V 1464481 CONTRACTED PHYSICIANS false WHITE RIVER VALLEY ELECTRIC COOP SEE PART V 204845 LOAN REPAYMENT & ELECTRIC SVC false LAKES REGION IMAGING LLC SEE PART V 144304 PURCHASED SERVICES false SCHEDULE L, PART IV, COLUMN B TRANSACTIONS WITH INTERESTED PERSONS: (1) RICHARD BLUBAUGH, A BOARD MEMBER OF COX MEDICAL CENTER BRANSON, IS ALSO A BOARD MEMBER AND MANAGING PARTNER OF 360 DEGREE MEDICINE. (2) BOB SIMMONS, A BOARD MEMBER OF COX MEDICAL CENTER BRANSON, IS ALSO A BOARD MEMBER OF WHITE RIVER VALLEY ELECTRIC COOP. (3) ANTHONY WHEELER, A BOARD MEMBER OF COX MEDICAL CENTER BRANSON, IS AN 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 RESIDENTS FOR MORE THAN 62 YEARS AND OFFERS OVER 25 MAJOR SERVICE AREAS. THE HOSPITAL'S AVERAGE DAILY PATIENT CENSUS EXCEEDS 90 WITH 165 LICENSED HOSPITAL BEDS. A STAFF OF OVER 1,000 PERSONNEL IS REQUIRED TO OPERATE THE HOSPITAL AND ITS NUMEROUS CLINICS. FORM 990, PART III, LINE 3 CHANGE IN PROGRAM SERVICE: THE ORGANIZATION NO LONGER OFFERS HOME HEALTH SERVICES. FORM 990, PART III, LINE 4A PROGRAM SERVICE ACHIEVEMENT #1: IN SEPTEMBER 2014, COX MEDICAL CENTER BRANSON OPENED THE FIRST PHASE OF A TWO-PHASE $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 SEPTEMBER 2014, COX MEDICAL CENTER BRANSON JOINED AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES-STROKE, A QUALITY IMPROVEMENT PROGRAM CREATED TO HELP HOSPITAL TEAMS PROVIDE GUIDELINE-BASED CARE FOR STROKE PATIENTS. AS A GWTG-STROKE PARTICIPATING HOSPITAL, COX BRANSON IS ENCOURAGED TO DEVELOP A COMPREHENSIVE SYSTEM FOR PROVIDING RAPID DIAGNOSIS AND TREATMENT OF STROKE WHEN PATIENTS ARE ADMITTED TO THE EMERGENCY DEPARTMENT. THIS INCLUDES ALWAYS BEING EQUIPPED TO PROVIDE BRAIN-IMAGING SCANS, MAKING NEUROLOGISTS AVAILABLE TO CONDUCT PATIENT EVALUATIONS AND USING CLOT-BUSTING MEDICATIONS WHEN APPROPRIATE. IN MAY 2014, MORE THAN 400 BRANSON JUNIOR HIGH AND HIGH SCHOOL STUDENTS RECEIVED FREE SPORTS PHYSICALS AT BRANSON HIGH SCHOOL THANKS TO DOZENS OF VOLUNTEERS FROM COX MEDICAL CENTER BRANSON. COX BRANSON PARTNERED WITH BRANSON PULIC SCHOOLS TO MAKE THE FREE EVENT POSSIBLE. MORE THAN 30 COX MEDICAL CENTER BRANSON PROVIDERS AND OTHER 30-PLUS COX BRANSON STAFF MEMBERS VOLUNTEERED THEIR TIME TO MAKE THE EVENT POSSIBLE. THROUGHOUT THE YEAR, COX MEDICAL CENTER BRANSON CONTINUED TO PROVIDE TOBACCO CESSATION CLASSES, LED BY AN INSTRUCTOR WHO IS A CERTIFIED TOBACCO TREATMENT SPECIALIST THROUGH THE MAYO CLINIC AND CERTIFIED THROUGH THE ALA AS A FREEDOM FROM SMOKING FACILITATOR. ADDITIONAL PROGRAMS WITH A FOCUS ON ADDRESSING THE COMMUNITY'S UNHEALTHY BODY WEIGHT, AS IDENTIFIED BY THE COMMUNITY NEEDS ASSESSMENT, "THE 101 DAY WEIGHT LOSS CHALLENGE" WAS HELD JANUARY-MAY 2013. THE PROGRAM PROVIDED A DISCOUNT TO ACCESS THE FITNESS CENTER AND ATTEND UNLIMITED BOOT CAMPS WITH CERTIFIED PERSONAL TRAINERS. IN JULY 2014, COX BRANSON HELD ITS FIRST AQUATHON. THE AQUATHON SERIES COMBINED BOTH SWIMMING AND RUNNING INTO ONE RACE FOUR TIMES DURING THE MONTH. 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, LINES 6, 7A & 7B MEMBERS, STOCKHOLDERS, OR OTHER PERSONS: THE ORGANIZATION HAS ONLY ONE MEMBER - LESTER E COX MEDICAL CENTERS. 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. 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. 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, JAKE MCWAY, AND JOHN DUFF 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: $ 13,659,135 CONTRACTED LABOR 11,717,291 OTHER CONTRACTED SERVICES 2,554,602 CONTRACTED MGMT SERVICES 710,082 CONTRACTED CONSULTING SERVICES 645,744 CONTRACTED COLLECTION AGENCY 275,416 CONTRACTED LAB SERVICES 199,844 CONTRACTED TRANSCRIPTION SERVICES 65,248 CONTRACTED HOUSEKEEPING 32,365 CONTRACTED COURIER SERVICES 6,984 CONTRACTED BILLING SERVICES ---------- $ 29,866,711 TOTAL FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ 436,510 CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 102,711 CHANGE IN INVESTMENT IN SKAGGS FOUNDATION ---------- $ 539,221 TOTAL 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 HME CRE SVCS OF THE MDWST INC 3850 S NATIONAL SPRINGFIELD MO 65807 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) 9 NA false COX MEDICAL GROUP 1423 N JEFFERSON ST SPRINGFIELD MO 65802 411087566 PHYSICIANS MO 501(C)(3) 9 COXHEALTH false PCRMC-COX HEALTH ALLIANCE LLC 1423 N JEFFERSON AVENUE SPRINGFIELD MO 65807 300649009 HEALTHCARE MO N/A COX HEALTH SYSTEMS HMO INC PO BOX 5750 SPRINGFIELD MO 658015750 431757075 HMO MO LESTER E COX C CORP false COX HEALTH SYSTEMS INSURANCE COMPANY 3525 S NATIONAL SUITE 205 SPRINGFIELD MO 65807 431684044 INSURANCE MO COX HMO C CORP false 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 CTCC ACQUISITION CORP 1423 N JEFFERSON SPRINGFIELD MO 65802 472494138 MEDICAL CLINIC MO COXHEALTH C CORP false COX TAXABLE CLOSE CORP 1423 N JEFFERSON SPRINGFIELD MO 65802 472573263 MEDICAL CLINIC MO COX MEDICAL GRO C CORP false false false false false false false false false false true true false false false false true true false false