2022-08-10T13:44:31-05:00 2021-09-30 FORVIS LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2020-10-01 440584290 SKAGGS COMMUNITY HOSPITAL ASSOCIATION % DAVID STRONG SKAG 4173357000 525 BRANSON LANDING BOULEVARD BRANSON MO 65615 JACOB MCWAY COXHEALTH CFO 4178317283 2022-08-15 true JACOB MCWAY 999009999 Brian D Todd P00422601 4178658701 2 2020 2022-09-23 18:48:47Z COX MEDICAL CENTER BRANSON WILLIAM MAHONEY 525 BRANSON LANDING BOULEVARD BRANSON MO 65615 255344220 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. 15 10 1818 176 20221 0 1452880 13289281 190044418 225243595 3539751 2111305 0 0 195037049 240644181 24210 25250 0 0 83820191 90831207 0 0 0 106294543 116063368 190138944 206919825 4898105 33724356 287179209 315755529 125708755 113741418 161470454 202014111 X THE HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH QUALITY HEALTH CARE, EDUCATION AND RESEARCH. false false 171582389 25250 208295566 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. 19047225 16948029 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. 190629614 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 false false true false false false false false false true false false false false false true true false false false true 0 0 1818 true true true false false false false false false false false false false false X 15 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 STEVE EDWARDS BOARD MEMBER AND COXHEALTH CEO 1.0 39.0 X X 0 2398016 319700 CHAD EFIRD PHYSICIAN 40.0 0.0 X 1158379 0 51897 JAKE MCWAY BOARD MEMBER AND COXHEALTH CFO 1.0 39.0 X X 0 938444 206555 PATRICK FINKBONE PHYSICIAN 40.0 0.0 X 946515 0 32917 PRASER VIJITBENJARONK PHYSICIAN 40.0 0.0 X 924312 0 52808 NARIN ARUNAKUL PHYSICIAN 40.0 0.0 X 836625 0 50433 SUTHIPONG SOONTRAPA PHYSICIAN 40.0 0.0 X 830934 0 52413 CHARITY ELMER BOARD MEMBER 1.0 39.0 X 0 666702 144541 WILLIAM MAHONEY PRESIDENT 40.0 0.0 X 668364 0 101006 SHAWN USERY CMO END 04/20 40.0 0.0 X 439140 0 26012 DAVID STRONG CFO 40.0 0.0 X 188738 188738 82137 HOLLY WHERRY BOARD MEMBER 40.0 0.0 X 382472 0 14320 CODY HOEFLICKER BOARD MEMBER 1.0 0.0 X 325686 0 32958 LYNNE YAGGY CNO 40.0 0.0 X 210232 0 17707 SIMON WAJNBOLM VP 40.0 0.0 X 187557 0 27693 BARBARA STEWART SECRETARY END 04/21 40.0 0.0 X 60786 0 4454 NITA AYRES SECOND VICE CHAIR 1.0 0.0 X X 0 0 0 SUE HEAD FIRST VICE CHAIR 1.0 0.0 X X 0 0 0 BRAD SWOFFORD BOARD MEMBER 1.0 0.0 X 0 0 0 RANDY BRASHERS 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 PAM YANCEY BOARD MEMBER 1.0 0.0 X 0 0 0 PHILLIP LOYD BOARD MEMBER 1.0 0.0 X 0 0 0 ROBERT F MCDOWELL BOARD MEMBER 1.0 0.0 X 0 0 0 ROBERT T COX CHAIR 1.0 0.0 X X 0 0 0 ERIKA GETTLING SECRETARY BEG 05/21 40.0 0.0 X 0 0 0 MATTHEW TURNER VP BEG 06/21 40.0 0.0 X 0 0 0 7159740 4191900 1217551 100 false true false WHITE RIVER ANESTHESIA ASSOCIATES PO BOX 1308 BRANSON MO 65615 ANESTHESIA SERVICES 598558 MPLT HEALTHCARE LLC 5810 CORAL RIDGE DR STE 250 CORAL SPRINGS FL 33076 PHYSICIAN STAFFING 436942 SHIFTWISE PO BOX 70870 ST PAUL MN 551709705 STAFFING MGMT 427693 REHABCARE GROUP MGT SERVICES PO BOX 502096 ST LOUIS MO 63150 MANAGEMENT FEE 367216 4 34206 12169518 1085557 13289281 NET PATIENT SERVICE REVENUE 624100 222600911 222600911 CAFETERIA 722514 1124258 1124258 FITNESS CENTER 624100 227546 227546 LAB REVENUE 621500 150632 130411 20221 OTHER REVENUE 900099 1140248 1140248 225243595 1984344 1984344 0 0 0 0 0 14827000 14700039 126961 126961 126961 0 0 0 0 0 0 0 0 0 0 240644181 225223374 20221 2111305 X 25250 25250 0 0 0 2728195 1663778 1064417 0 73474166 63119357 10354809 2026589 2026589 7781235 7394424 386811 4821022 4566333 254689 0 454 454 87060 87060 0 0 0 47348824 44937817 2411007 0 3378 3099 279 0 5372418 4892754 479664 672823 617223 55600 0 2125450 1949809 175641 582292 534173 48119 0 16146 14812 1334 3043271 2791784 251487 0 7905278 7252008 653270 581064 533046 48018 MEDICAL SUPPLIES & DRUGS 38272964 38272964 STATE PROVIDER TAX 9839543 9839543 LICENSES, DUES, SUBSCRIPTIONS 212403 194851 17552 206919825 190629614 16290211 0 2145983 7431742 124313297 140960981 0 0 21107604 24724622 0 0 0 0 0 0 2875575 3062954 692763 703685 160484567 67119923 96624166 93364644 27651628 33661213 9192733 10455425 1086549 222501 551500 551500 937411 616262 287179209 315755529 14976360 15756249 0 0 11365274 201684 68753147 68165183 0 0 0 0 6485692 6088513 0 0 24128282 23529789 125708755 113741418 X 151230212 191369213 10240242 10644898 161470454 202014111 287179209 315755529 X 33724356 6414645 404656 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 18468 18468 false SCHEDULE C, PART II-B, LINE 1 (I) OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAID DUES OF $42,248 TO THE MISSOURI HOSPITAL ASSOCIATION AND $20,496 TO THE AMERICAN HOSPITAL ASSOCIATION, OF WHICH $13,688 (32.4%) AND $4,780 (23.32%) RESPECTIVELY IS ATTRIBUTABLE TO LOBBYING PURPOSES. 5522712 5522712 65289469 18933499 46355970 4334390 1459987 2874403 76865093 43451739 33413354 8472903 3274698 5198205 93364644 0 DUE TO THIRD PARTY 17716385 DUE TO RELATED PARTY 4192235 ESTIMATED INSURANCE COST 311403 DEFERRED PAYROLL TAX 1309766 23529789 SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. 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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: IMPROVE ACCESS TO CULTURALLY APPROPRIATE RESOURCES -SUMMARY: COXHEALTH SERVES A DIVERSE POPULATION WITH A VARIETY OF HEALTH NEEDS. THESE PATIENTS NEED ACCESS TO APPROPRIATE EDUCATIONAL MATERIALS IN THEIR PREFERRED LANGUAGE. WHILE COXHEALTH DOES HAVE SOME OF THESE MATERIALS AVAILABLE ON DEMAND, THERE IS OPPORTUNITY FOR THE SYSTEM TO UTILIZE A SINGLE SOURCE FOR EVIDENCE-BASED EDUCATIONAL MATERIALS IN A MORE COMPREHENSIVE GROUP OF LANGUAGES. COXHEALTH WILL IDENTIFY AND IMPLEMENT SUCH A RESOURCE WITHIN THE CHIP CYCLE TO ENABLE PATIENTS TO RECEIVE EDUCATION MATERIALS AND RESOURCES IN THEIR PREFERRED LANGUAGE. -TACTICS: INCREASE RANGE OF EDUCATION TOOLS FOR EXPANDED LANGUAGES. EXISTING PATIENT EDUCATION MATERIAL WAS MADE AVAILABLE IN MULTIPLE LANGUAGES. ADDITIONALLY, COVID-19 RELATED EDUCATION MATERIAL WAS CREATED AND TRANSLATED FOR PATIENT USE. DECREASE TOBACCO USE RATES -SUMMARY: TOBACCO USE IN THE COMMUNITIES COXHEALTH SERVES HAS BEEN A COMMON THREAD IN ADDRESSING ASSESSED HEALTH ISSUES (AHI) FOR EVERY CYCLE OF THE CHNA. THIS IS A COMPLEX AND HIGH- IMPACT ISSUE THAT NECESSITATES A MULTIPRONGED APPROACH. COXHEALTH IS EXPANDING UPON THE PREVIOUS CHIP'S TOBACCO RELATED OBJECTIVE BY INCORPORATING SUPPORT OF LOCAL POLICY CHANGE AND THE TRAINING OF ADDITIONAL TOBACCO TREATMENT SPECIALISTS IN THE SERVICE AREA. -TACTICS: INCREASE REFERRALS AND COUNSELING FOR TOBACCO CESSATION EDUCATION; WORK WITH COMMUNITY PARTNERS TO IMPLEMENT T21 POLICY; INCREASE ACCESS TO NICOTINE REPLACEMENT THERAPY (NRT) FOR PATIENTS ENROLLED IN CESSATION PROGRAM; BRANSON WAS AWARDED $5,000 FOR THE 2019- 2020 SERVICE YEAR WITH AN ADDITIONAL $8,000 AWARDED FOR THE 2020-2021 CYCLE FOR NRT. INCREASE NUMBER OF TRAINED TOBACCO TREATMENT SPECIALISTS; COXHEALTH POPULATION HEALTH SERVICES HOSTED A TOBACCO TREATMENT SPECIALIST TRAINING IN OCTOBER 2019. THE UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL CURRICULUM WAS UTILIZED TO TRAIN 11 NEW SPECIALISTS FROM SURROUNDING AREAS INCLUDING THE BRANSON COMMUNITY. IN MAY 2022, THE TRAINING WAS OFFERED AGAIN, RESULTING IN 19 NEW SPECIALISTS BASED THROUGHOUT COXHEALTH SERVICE AREAS. INCREASE AWARENESS OF SUBSTANCE ABUSE PREVENTION RESOURCES -SUMMARY: SUBSTANCE ABUSE IS ONE OF THE GREATEST PUBLIC HEALTH CONCERNS IN OUR NATION. AS A HEALTHCARE SYSTEM, COXHEALTH HAS AN IMPORTANT ROLE IN THE COMMUNITY REGARDING THIS ISSUE. THROUGH STRENGTHEN COMMUNITY PARTNERSHIPS AND ROBUST DATA MONITORING, THE SYSTEM WILL BE ABLE TO ACCURATELY TRACK OVERDOSES AND IN A TIMELY MANNER. THIS WILL ALLOW THE HOSPITAL TO DEVELOP AND IMPLEMENT PREVENTION AND TREATMENT PROGRAMS IN THE COMMUNITIES THAT NEED THEM MOST. -TACTICS: IMPLEMENT OPIOID MAPPING SYSTEM (ODMAP) IMPLEMENT WEB-BASED PREVENTION EDUCATION SYSTEM FOR AREA SCHOOLS. DUE TO COVID RESTRICTIONS, COMMITTEE MEETINGS/DISCUSSIONS FOR IMPLEMENTING ODMAP WERE HALTED; HOWEVER, CMCB HAS REPRESENTATION ON THE SW MO DRUG POISONING TASK FORCE WORKING WITH SPRINGFIELD-GREENE COUNTY HEALTH DEPARTMENT TO IMPLEMENT AN OVERDOSE DASHBOARD UTILIZING DATA FROM LAW ENFORCEMENT AND FIRST RESPONDERS. INCREASE AWARENESS OF MENTAL HEALTH SERVICES FOR POPULATIONS AT RISK -SUMMARY: MENTAL HEALTH IS A COMPLEX HEALTH ISSUE THAT AFFECT MANY AT-RISK -POPULATIONS IN THE COXHEALTH SERVICE AREA. MOST OF THESE PATIENTS HAVE LIMITED ACCESS TO CARE DUE TO GEOGRAPHICAL LIMITATIONS OF OUR SPECIALTY CARE NETWORK. THROUGH THE UTILIZATION OF ADVANCED CARE TECHNOLOGIES, COXHEALTH IS EXPANDING THE RURAL TELEHEALTH PROGRAM SO PATIENTS WITH MENTAL HEALTH NEEDS CAN RECEIVE CARE IN A MORE CONVENIENT WAY. -TACTICS: INCREASE UTILIZATION OF MENTAL HEALTH SCREENING TOOLS; INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES BY EXPANDING RURAL TELEHEALTH PROGRAMS; HRSA FUNDED THE TELE-BEHAVIORAL OPIOID PRIORITY RESPONSE (TOPR) GRANT PROGRAM WHICH MADE BEHAVIORAL HEALTH SERVICES AVAILABLE TO MULTIPLE BRANSON AREA CLINICS THROUGH TELEHEALTH. HRSA ALSO FUNDED THE SOUTHWEST MISSOURI COMMUNITIES OPIOID RESPONSE PROGRAM (SMCORP) AIMED AT REDUCING THE MORBIDITY AND MORTALITY ASSOCIATED WITH SUBSTANCE USE DISORDER AND OPIOID OVERDOSES IN HIGH-RISK RURAL COMMUNITIES, INCLUDING STONE AND TANEY COUNTIES. IMPROVE CHRONIC DISEASE SELF-MANAGEMENT -SUMMARY: PATIENTS LIVING WITH COMPLEX CHRONIC CONDITIONS ARE MORE COSTLY WITH POOR OUTCOMES AS COMPARED TO THEIR COUNTERPARTS DUE TO LACK OF SKILLS TO SELF-MANAGE THEIR CONDITIONS. COXHEALTH'S CARE MANAGEMENT PROGRAMS ARE AIMED AT REDUCING AMBULATORY-CARE SENSITIVE/ED VISITS AND REDUCING TOTAL COST OF CARE BY HELPING PATIENTS CONNECT WITH THE APPROPRIATE LEVEL OF CARE. -TACTICS: INCREASE REFERRAL TO SELF-MANAGEMENT CLASSES; INCREASE ENROLLMENT IN POPULATION HEALTH CARE MANAGEMENT PROGRAMS; DECREASE COPD READMISSION RATES; DECREASE CHF READMISSION RATES. CHRONIC DISEASE SELF-MANAGEMENT EDUCATION IS AVAILABLE TO ALL SERVICE AREAS. COXHEALTH ALSO PARTNERS WITH COMMUNITY ORGANIZATIONS TO PROVIDE CLASSES AND EDUCATION. DECREASE POTENTIALLY AVOIDABLE EMERGENCY DEPARTMENT (ED) UTILIZATION -SUMMARY: COMPREHENSIVE ASSESSMENTS THAT INCLUDE THE MEDICAL, BEHAVIORAL, PHARMACEUTICAL AND SOCIAL NEEDS OF THE PATIENT HELP TO PROMOTE AND FACILITATE BEHAVIOR CHANGE AND ADHERENCE. THIS INVOLVES INDIVIDUALIZED EDUCATION, GOAL PLANNING AND PREVENTIVE CARE AND SELF-MANAGEMENT TIPS. COXHEALTH COORDINATES CARE BETWEEN PROVIDERS AND SUPPORTS PATIENTS USING A MULTI- DISCIPLINARY TEAM OF HEALTHCARE PROFESSIONALS IN AN EFFORT TO PREVENT THE EXACERBATION OF THE CONDITION OR ILLNESS AND HOSPITAL READMISSIONS. -TACTICS: INCREASE ACCESS TO ALTERNATIVE CARE DELIVERY MODEL. 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. 27 COX HEART CENTER BRANSON 1150 STATE HWY 248 STE 202 BRANSON MO 65616 CLINIC COX HYPERBARIC MEDICINE & WOUND CARE BRA 101 SKAGGS RD STE 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 CLINI 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 BRANSON HWY 24 1150 STATE HWY 248 SUITE 202 BRANSON MO 65616 CLINIC COXHEALTH HOSPITALIST 525 BRANSON LANDING BLVD BRANSON MO 65616 CLINIC COXHEALTH INTERNAL MEDICINE & INFECTIOUS 525 BRANSON LANDING SUITE 407 BRANSON MO 65616 CLINIC COXHEALTH OCCUPATIONAL MEDICINE 121 CAHILL ROAD SUITE 205 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 & REHABILITA 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 SKAGGS ORTHONEURO CENTER 101 CAHILL RD BRANSON MO 65606 OUTPATIENT DEPTS PHYSICIAN CLINICS CMCB OUTPATIENT CENTER 545 N BRANSON LANDING BLVD BRANSON MO 65606 OUTPATIENT DEPTS PHYSICIAN CLINICS COXHEALTH GENERAL SURGERY 545 N BRANSON LANDING BLVD BRANSON MO 65606 CLINIC FITNESS CENTER BRANSON 1500 BRANSON HILLS PARKWAY BRANSON MO 65606 FITNESS CENTER COXHEALTH ACCESS CLINIC 1150 STATE HWY 248 STE 202 BRANSON MO 65606 CLINIC FDC UROLOGYGI 525 BRANSON LANDING BLVD BRANSON MO 65606 CLINIC COXHEALTH INPATIENT PSYCHIATRY 525 BRANSON LANDING BLVD BRANSON MO 65616 CLINIC COXHEALTH PEDIATRIC SPECIALTIES BRANSON 525 BRANSON LANDING SUITE 501 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 $4,487,267. 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, 2021. 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 2019. 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. X true true X X X X X false true false false false true false false false WILLIAM MAHONEY PRESIDENT 487450 0 116567 0 64347 0 81954 0 19052 0 769370 0 56302 0 DAVID STRONG CFO 150080 150080 20857 20858 17801 17800 31542 31543 9526 9526 229806 229807 17173 17173 HOLLY WHERRY BOARD MEMBER 382472 0 0 0 0 0 5344 0 8976 0 396792 0 0 0 STEVE EDWARDS BOARD MEMBER AND COXHEALTH CEO 0 1186103 0 358539 0 853374 0 291517 0 28183 0 2717716 0 840800 JAKE MCWAY BOARD MEMBER AND COXHEALTH CFO 0 659023 0 143419 0 136002 0 180779 0 25776 0 1144999 0 124246 CHARITY ELMER BOARD MEMBER 0 497425 0 84766 0 84511 0 125625 0 18916 0 811243 0 0 CODY HOEFLICKER BOARD MEMBER 325146 0 0 0 540 0 14025 0 18933 0 358644 0 0 0 CHAD EFIRD PHYSICIAN 1158083 0 0 0 296 0 33005 0 18892 0 1210276 0 0 PATRICK FINKBONE PHYSICIAN 946219 0 0 0 296 0 14025 0 18892 0 979432 0 0 0 PRASER VIJITBENJARONK PHYSICIAN 923022 0 0 0 1290 0 33750 0 19058 0 977120 0 0 0 SUTHIPONG SOONTRAPA PHYSICIAN 830664 0 0 0 270 0 33525 0 18888 0 883347 0 0 0 NARIN ARUNAKUL PHYSICIAN 835335 0 0 0 1290 0 33750 0 16683 0 887058 0 0 0 SIMON WAJNBOLM VP 177900 0 9357 0 300 0 8918 0 18775 0 215250 0 0 0 SHAWN USERY CMO END 04/20 438878 0 0 0 262 0 7125 0 18887 0 465152 0 0 0 LYNNE YAGGY CNO 195767 0 13175 0 1290 0 8486 0 9221 0 227939 0 0 0 MATTHEW TURNER VP BEG 06/21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE J, PART I, LINE 1A INFORMATION REGARDING BENEFITS PROVIDED: MONTHLY SOCIAL CLUB DUES ARE INCLUDED IN THE TAXABLE COMPNESATION OF STEVE EDWARDS, CEO. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: STEVE EDWARDS, JACOB MCWAY, CHARITY ELMER, 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 $277,267. - STEVE EDWARDS RECEIVED A 457(F) DISTRIBUTION OF $840,800, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - JACOB MCWAY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $147,029. - JACOB MCWAY RECEIVED A 457(F) DISTRIBUTION OF $124,246, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - CHARITY ELMER RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $92,100. - CHARITY ELMER RECEIVED A 457(F) DISTRIBUTION OF $73,903, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - WILLIAM MAHONEY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $49,704. - WILLIAM MAHONEY RECEIVED A 457(F) DISTRIBUTION OF $56,302, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - DAVID STRONG RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $30,375. - DAVID STRONG RECEIVED A 457(F) DISTRIBUTION OF $34,346, 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. JENNA YAGGY DAUGHTER OF LYNNE YAGGY 14723 WAGES false BRIANNA WILLIAMS IN-LAW OF LYNNE YAGGY 48219 WAGES false 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: IVANTAGE HEALTH ANALYTICS RECOGNIZED COX MEDICAL CENTER BRANSON FOR OVERALL EXCELLENCE IN OUTCOMES AMONG ALL ACUTE CARE HOSPITALS IN THE NATION, AND AS ONE OF SEVEN RURAL MISSOURI HOSPITALS FOR EXCELLENCE IN QUALITY, ACCORDING TO ITS HOSPITAL STRENGTH INDEX. COX MEDICAL CENTER BRANSON EACH RECEIVED A 4-STAR RATING FROM HOSPITAL COMPARE STAR RATINGS, AS DETERMINED BY QUALITY, SAFETY AND PATIENT EXPERIENCE DATA REPORTED TO THE CENTERS FOR MEDICARE; MEDICAID SERVICES. COX MEDICAL CENTER BRANSON RECEIVED HIGH PATIENT SAFETY AND PATIENT OUTCOMES SCORES FROM CONSUMER REPORTS. COX MEDICAL CENTER BRANSON IS AMONG A SELECT FEW HEALTH SYSTEMS IN THE NATION TO RECEIVE THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES - STROKE GOLD PLUS PERFORMANCE ACHIEVEMENT AWARD. COX MEDICAL CENTER BRANSON HAS BEEN NAMED TO THE TARGET: STROKE HONOR ROLL ELITE LIST. COX MEDICAL CENTER BRANSON IS A LEVEL 2 STROKE CENTER. COX MEDICAL CENTER BRANSON'S IMPLEMENTED CATERING PREGNANCY -A PILOT GROUP PROGRAM FOR PRENATAL CARE. THE NATIONAL PROGRAM CAME TO BRANSON IN JUNE 2016 THROUGH FUNDING FROM THE MARCH OF DIMES AND SKAGGS FOUNDATION. THE CONCEPT OF CENTERING PREGNANCY IS A MODEL OF CARE THAT LOOKS A LOT DIFFERENT FROM TRADITIONAL PRENATAL VISITS, WHICH ARE OFTEN BRIEF AND ONE-ON-ONE WITH A WOMAN'S HEALTHCARE PROVIDER. IN THE NEW PROGRAM, EXPECTANT MOMS SKIP THE WAITING ROOM AND HAVE APPOINTMENTS THE SAME DAY AND TIME EACH MONTH IN SUPPORT-GROUP STYLE. THE OPEN FORUM ALLOWS MOMS TO SUPPORT EACH OTHER BY SHARING THEIR PREGNANCY WORRIES AND EXCITEMENT. 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 V, LINE 2 NUMBER OF EMPLOYEES REPORTED ON FORM W-3: LESTER E. COX MEDICAL CENTERS, A RELATED ORGANIZATION, FILES ALL REQUIRED W-2'S FOR THE HEALTH SYSTEM. THE NUMBER REPORTED ON FORM 990, PART V, LINE 2A REPRESENTS THE NUMBER OF W-2'S FILED ON BEHALF OF THE ORGANIZATION. 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). 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: COXHEALTH 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, CHARITY ELMER, AND CODY HOEFLICKER 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: $ (1,262,692) CHANGE IN BENEFICIAL INTEREST IN TRUST 858,036 CHANGE IN INTEREST IN NET ASSETS SKAGGS FOUNDATION ------------ $ 404,656 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER CONTRACTED SERVICES TOTAL FEES:29904135 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED LABOR TOTAL FEES:14780901 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED EQUIPMENT SERVICES TOTAL FEES:862736 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED RADIOLOGY SERVICES TOTAL FEES:721643 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED LAUNDRY SERVICES TOTAL FEES:379049 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED HOUSEKEEPING TOTAL FEES:230178 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED LAB SERVICES TOTAL FEES:180095 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED COURIER SERVICES TOTAL FEES:114066 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED COLLECTION SERVICES TOTAL FEES:99265 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED CONSULTING SERVICES TOTAL FEES:76756 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 COXHEALTH FOUNDATION 3525 S NATIONAL SUITE 204 SPRINGFIELD MO 65807 436810485 FUNDRAISING MO 501(C)(3) 11 A I 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 HPS OZKS INC DBA COXHEALTH AT HOME 2220 W SUNSET SPRINGFIELD MO 65807 431641927 HOME HEALTH MO 501(C)(3) 10 LESTER E COX false HC SVCS OZARKS INC DBA COXHEALTH AT HOME PO BOX 10939 SPRINGFIELD MO 65808 431641928 HOME HEALTH MO 501(C)(3) 10 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 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 MEDICAL CENTERS 1423 N JEFFERSON ST SPRINGFIELD MO 65802 440577118 HOSPITAL MO 501(C)(3) 3 COXHEALTH false LESTER E COX MED CTRPROF LIAB 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 ST SPRINGFIELD MO 65802 471087427 HOLDING CO MO 501(C)(3) 12 B II NA false COX MEDICAL GROUP 1423 N JEFFERSON ST SPRINGFIELD MO 65802 411087566 PHYSICIANS MO 501(C)(3) 10 COXHEALTH false COXHEALTH SYSTEMS HMO PO BOX 5750 SPRINGFIELD MO 65801 431757075 HMO MO 501(C)(4) LESTER E COX false COXHEALTH SYSTEMS INSURANCE COMPANY PO BOX 5750 SPRINGFIELD MO 65801 431684044 INSURANCE MO 501(C)(4) LESTER E COX false COX MEDICAL GROUP CLINICS 3801 S NATIONAL SPRINGFIELD MO 65807 371830627 HEALTHCARE MO 501(C)(3) 10 COXHEALTH false COX BARTON COUNTY HOSPITAL 29 NW 1ST LANE LAMAR MO 64759 823300758 HOSPITAL MO 501(C)(3) 3 COXHEALTH false COX COLLEGE 1423 N JEFFERSON SPRINGFIELD MO 65802 475148345 EDUCATION MO 501(C)(3) 2 LESTER E COX false MEDICAL DEVELOPMENTS INC 1423 N JEFFERSON AVE SPRINGFIELD MO 65802 431622182 PHARMACY MO LESTER E COX C CORP false COXHEALTH RISK SOLUTIONS GRAND PAVILION CORPORATE CENTRE GRAND CAYMAN CJ KY1-110 CAPTIVE INSURANCE CJ 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 true true