SKAGGS COMMUNITY HOSPITAL ASSOCIATION: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: SKAGGS COMMUNITY HOSPITAL ASSOCIATION (EIN 44-0584290)
Tax period: 2016-10-01 to 2017-09-30
Filed: 2018-08-14
IRS object ID: 201832269349301023
Schema version: 2016v3.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-08-14T12:11:59-05:00	ReturnTs
Tax Period End	2017-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	910 E ST LOUIS 200/PO BOX 1190	AddressLine1Txt
City	SPRINGFIELD	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	658062523	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	440584290	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SKAGGS COMMUNITY HOSPITAL ASSOCIATION	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% DAVID STRONG	InCareOfNm
Business Name Control	SKAG	BusinessNameControlTxt
Phone	4173357000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	525 BRANSON LANDING BOULEVARD	AddressLine1Txt
City	BRANSON	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	65615	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JACOB MCWAY	PersonNm
Person Title	COXHEALTH CFO	PersonTitleTxt
Signature	2018-01-18	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Brian D Todd	PreparerPersonNm
PTIN	P00422601	PTIN
Phone	4178658701	PhoneNum

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	COX MEDICAL CENTER BRANSON	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	WILLIAM MAHONEY	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	525 BRANSON LANDING BOULEVARD	AddressLine1Txt
City	BRANSON	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	65615	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$210,839,575	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.COXHEALTH.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1950	FormationYr
Legal Domicile State	MO	LegalDomicileStateCd
Activity Or Mission	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.	ActivityOrMissionDesc
Voting Members Governing Body	14	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	1601	TotalEmployeeCnt
Total Volunteers	203	TotalVolunteersCnt
Total Gross UBI	$42,272	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$205,550	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$613,899	PYContributionsGrantsAmt
CY Contributions Grants	$516,517	CYContributionsGrantsAmt
PY Program Service Revenue	$190,726,382	PYProgramServiceRevenueAmt
CY Program Service Revenue	$206,582,530	CYProgramServiceRevenueAmt
PY Investment Income	$1,759,124	PYInvestmentIncomeAmt
CY Investment Income	$1,303,887	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$193,099,405	PYTotalRevenueAmt
CY Total Revenue	$208,402,934	CYTotalRevenueAmt
PY Grants And Similar Paid	$153,578	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$102,971	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$71,080,664	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$75,931,437	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$115,571,192	PYOtherExpensesAmt
CY Other Expenses	$121,530,358	CYOtherExpensesAmt
PY Total Expenses	$186,805,434	PYTotalExpensesAmt
CY Total Expenses	$197,564,766	CYTotalExpensesAmt
PY Revenues Less Expenses	$6,293,971	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$10,838,168	CYRevenuesLessExpensesAmt
Total Assets BOY	$196,199,649	TotalAssetsBOYAmt
Total Assets EOY	$208,691,315	TotalAssetsEOYAmt
Total Liabilities BOY	$82,102,177	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$79,712,701	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$114,097,472	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$128,978,614	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	THE HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH QUALITY HEALTH CARE, EDUCATION AND RESEARCH.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$150,395,197	ExpenseAmt
Grant	$102,971	GrantAmt
Revenue	$196,445,558	RevenueAmt
Desc	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.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$32,296,274	ExpenseAmt
Revenue	$20,136,972	RevenueAmt
Desc	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.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$182,691,471	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (true)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	50	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1601	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	14	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	DAVID STRONG	PersonNm
Phone	4173357789	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	525 BRANSON LANDING BOULEVARD	AddressLine1Txt
City	BRANSON	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	65615	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
BOB MCDOWELL
VICE CHAIRMAN	3.0	5.0	Yes (X)	Yes (X)	$0	$0	$0
ANTHONY WHEELER
DIRECTOR	3.0	0.0	Yes (X)		$0	$0	$0
DOUG HAYTER
DIRECTOR	3.0	0.0	Yes (X)		$0	$0	$0
DENNIS NEWKIRK
DIRECTOR	3.0	0.0	Yes (X)		$0	$0	$0
PHILLIP LOYD
CHAIRMAN	3.0	5.0	Yes (X)	Yes (X)	$0	$0	$0
JACOB MCWAY
DIRECTOR/COXHEALTH CFO	3.0	40.0	Yes (X)	Yes (X)	$0	$794,156	$152,014
LARRY SCHMITT
TREASURER	3.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
RICHARD BLUBAUGH
DIRECTOR	3.0	0.0	Yes (X)		$0	$0	$0
STEVE EDWARDS
DIRECTOR/COXHEALTH CEO	3.0	40.0	Yes (X)	Yes (X)	$0	$1,532,608	$276,827
HOLLY WHERRY
DIRECTOR	3.0	0.0	Yes (X)		$355,602	$0	$7,139
BOB COX
DIRECTOR	3.0	0.0	Yes (X)		$0	$0	$0
CHARITY ELMER
DIRECTOR	3.0	40.0	Yes (X)		$0	$521,029	$111,158
SUE HEAD
DIRECTOR	3.0	0.0	Yes (X)		$0	$0	$0
RICK TODD
DIRECTOR	3.0	0.0	Yes (X)		$0	$0	$0
WILLIAM MAHONEY
PRESIDENT	40.0	0.0		Yes (X)	$567,001	$0	$72,038
DAVID STRONG
CFO	40.0	0.0		Yes (X)	$322,212	$0	$54,367
BARBARA STEWART
SECRETARY	40.0	0.0		Yes (X)	$51,912	$0	$9,517
BRIAN CLONTS
CMO ENDING 01/01/17	40.0	0.0			$606,135	$0	$28,259	Yes (X)
LYNNE YAGGY
CNO	40.0	0.0			$188,108	$0	$22,687	Yes (X)
CHAD EFIRD
PHYSICIAN	40.0	0.0			$1,153,606	$0	$45,837		Yes (X)
NARIN ARUNAKUL
PHYSICIAN	40.0	0.0			$833,440	$0	$46,267		Yes (X)
MITTIE DRAGOSLJVICH
PHYSICIAN	40.0	0.0			$583,466	$0	$28,439		Yes (X)
PRASER VIJITBENJARONK
PHYSICIAN	40.0	0.0			$635,357	$0	$46,167		Yes (X)
SABERA SHABNAM
PHYSICIAN	40.0	0.0			$571,746	$0	$38,138		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$5,868,585	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,847,793	TotReportableCompRltdOrgAmt
Total Other Compensation	$938,854	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	86	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
360 DEGREE MEDICINE
108 SUNNY LANE	BRANSON WEST	MO	65737	PHYSICIAN SERVICES	$6,114,635
CHG COMPANIES
PO BOX 972651	DALLAS	TX	75397	PHYSICIAN SERVICES	$1,967,969
SHIFTWISE
PO BOX 70870	ST PAUL	MN	55170	STAFFING MANAGEMENT	$1,482,330
WHITE RIVER ANESTHESIA ASSOC
PO BOX 1308	BRANSON	MO	65615	ANESTHESIA SERVICES	$1,212,659
NUCLEAR DIAGNOSIS INC
19600 E 39TH ST RM 30335	INDEPENDENCE	MO	64057	MEDICAL TESTS	$863,248

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	15	CntrctRcvdGreaterThan100KCnt
Related Organizations	$8,526	RelatedOrganizationsAmt
All Other Contributions	$507,991	AllOtherContributionsAmt
Total Contributions	$516,517	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE	624100	$202,139,080	$202,139,080
CAFETERIA	722514	$1,338,166	$1,338,166
PHARMACY	446110	$933,299	$933,299
LAB REVENUE	621500	$875,728	$833,456	$42,272
FITNESS CENTER	713940	$413,915	$413,915

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$882,342	TotalRevenueColumnAmt
Related Or Exempt Func Income	$882,342	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$206,582,530	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$993,019	TotalRevenueColumnAmt
Exclusion	$993,019	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$2,747,509	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$2,436,641	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$310,868	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$310,868	TotalRevenueColumnAmt
Exclusion	$310,868	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$0	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$208,402,934	TotalRevenueColumnAmt
Related Or Exempt Func Income	$206,540,258	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$42,272	UnrelatedBusinessRevenueAmt
Exclusion	$1,303,887	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$102,971	TotalAmt
Program Services	$102,971	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$2,284,977	TotalAmt
Program Services	$1,207,932	ProgramServicesAmt
Management And General	$1,077,045	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$61,102,299	TotalAmt
Program Services	$51,991,651	ProgramServicesAmt
Management And General	$9,110,648	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,669,544	TotalAmt
Program Services	$1,669,544	ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$6,856,397	TotalAmt
Program Services	$6,550,917	ProgramServicesAmt
Management And General	$305,480	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$4,018,220	TotalAmt
Program Services	$3,819,790	ProgramServicesAmt
Management And General	$198,430	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$9,788	TotalAmt
Management And General	$9,788	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$100,500	TotalAmt
Management And General	$100,500	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$357,729	TotalAmt
Program Services	$328,167	ProgramServicesAmt
Management And General	$29,562	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$38,000,281	TotalAmt
Program Services	$35,785,694	ProgramServicesAmt
Management And General	$2,214,587	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$25,819	TotalAmt
Program Services	$23,685	ProgramServicesAmt
Management And General	$2,134	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,835,474	TotalAmt
Program Services	$4,435,932	ProgramServicesAmt
Management And General	$399,542	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$545,836	TotalAmt
Program Services	$500,730	ProgramServicesAmt
Management And General	$45,106	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$4,362,699	TotalAmt
Program Services	$4,002,178	ProgramServicesAmt
Management And General	$360,521	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$457,601	TotalAmt
Program Services	$419,786	ProgramServicesAmt
Management And General	$37,815	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$47,968	TotalAmt
Program Services	$44,004	ProgramServicesAmt
Management And General	$3,964	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$2,975,640	TotalAmt
Program Services	$2,729,741	ProgramServicesAmt
Management And General	$245,899	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$7,678,102	TotalAmt
Program Services	$7,043,605	ProgramServicesAmt
Management And General	$634,497	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$820,267	TotalAmt
Program Services	$752,482	ProgramServicesAmt
Management And General	$67,785	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS	$28,855,657	$28,855,657
BAD DEBT	$23,831,112	$23,831,112
STATE PROVIDER TAX	$8,262,946	$8,262,946
LICENSES, DUES, SUBSCRIPTIONS	$312,306	$286,498	$25,808

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$50,633	TotalAmt
Program Services	$46,449	ProgramServicesAmt
Management And General	$4,184	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$197,564,766	TotalAmt
Program Services	$182,691,471	ProgramServicesAmt
Management And General	$14,873,295	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$6,162,797	BOYAmt
EOY	$13,064,197	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$19,518,786	BOYAmt
EOY	$21,072,170	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$25,168,743	BOYAmt
EOY	$24,832,447	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,894,423	BOYAmt
EOY	$2,777,448	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$776,995	BOYAmt
EOY	$170,064	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$134,650,728	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$37,753,549	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$101,090,488	BOYAmt
EOY	$96,897,179	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$15,913,393	BOYAmt
EOY	$18,392,962	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$8,318,819	BOYAmt
EOY	$8,825,277	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$6,393,339	BOYAmt
EOY	$7,442,466	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$551,500	BOYAmt
EOY	$551,500	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$9,410,366	BOYAmt
EOY	$14,665,605	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$196,199,649	BOYAmt
EOY	$208,691,315	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$11,469,412	BOYAmt
EOY	$10,636,815	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$58,234,767	BOYAmt
EOY	$57,377,359	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$11,016,735	BOYAmt
EOY	$10,345,990	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,381,263	BOYAmt
EOY	$1,352,537	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$82,102,177	BOYAmt
EOY	$79,712,701	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$104,321,828	BOYAmt
EOY	$118,958,544	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,456,825	BOYAmt
EOY	$1,194,793	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$8,318,819	BOYAmt
EOY	$8,825,277	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$114,097,472	BOYAmt
EOY	$128,978,614	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$196,199,649	BOYAmt
EOY	$208,691,315	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$10,838,168	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$1,698,548	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$2,344,426	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$17,753	OtherActivitiesAmt
Total Lobbying Expenditures	$17,753	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART II-B, LINE 1 (I)	FormAndLineReferenceDesc
Explanation	OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAID DUES OF $42,588 TO THE MISSOURI HOSPITAL ASSOCIATION AND $18,940 TO THE AMERICAN HOSPITAL ASSOCIATION, OF WHICH $13,628 (32%) AND $4,125 (21.78%) RESPECTIVELY IS ATTRIBUTABLE TO LOBBYING PURPOSES.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,471,256	OtherCostOrOtherBasisAmt
Book Value	$5,471,256	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$59,514,604	OtherCostOrOtherBasisAmt
Depreciation	$9,090,585	DepreciationAmt
Book Value	$50,424,019	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,334,390	OtherCostOrOtherBasisAmt
Depreciation	$786,449	DepreciationAmt
Book Value	$3,547,941	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$57,254,956	OtherCostOrOtherBasisAmt
Depreciation	$26,266,431	DepreciationAmt
Book Value	$30,988,525	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$8,075,522	OtherCostOrOtherBasisAmt
Depreciation	$1,610,084	DepreciationAmt
Book Value	$6,465,438	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$96,897,179	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
DUE FROM THIRD-PARTY PAYERS	$182,702
OTHER RECEIVABLES	$640,386
INTEREST RECEIVABLE	$445
DUE FROM RELATED PARTY	$13,842,072

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$14,665,605	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	DUE TO THIRD PARTY	Desc
Amt	$1,352,537	Amt

Field	Value	IRS element (for citing)
Total Liability	$1,352,537	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE D, PART X, LINE 2	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	false	FPGReferenceFreeCareInd
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,257,302	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$8,257,302	NetCommunityBenefitExpnsAmt
Total Expense	0.04750	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$25,041,105	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$20,138,838	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,902,267	NetCommunityBenefitExpnsAmt
Total Expense	0.02820	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$33,298,407	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$20,138,838	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$13,159,569	NetCommunityBenefitExpnsAmt
Total Expense	0.07570	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$38,709	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$38,709	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,211	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$10,211	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,283,919	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,370,121	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,913,798	NetCommunityBenefitExpnsAmt
Total Expense	0.03980	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$228,967	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$228,967	NetCommunityBenefitExpnsAmt
Total Expense	0.00130	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,561,806	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,370,121	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,191,685	NetCommunityBenefitExpnsAmt
Total Expense	0.04140	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$44,860,213	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$24,508,959	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$20,351,254	NetCommunityBenefitExpnsAmt
Total Expense	0.11710	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$23,831,112	BadDebtExpenseAmt
Bad Debt Expense Attributable	$3,562,751	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$83,699,045	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$94,038,120	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$10,339,075	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SKAGGS COMMUNITY HEALTH CENTER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	251 SKAGGS ROAD	AddressLine1Txt
City	BRANSON	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	65616	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.COXHEALTH.COM	WebsiteAddressTxt
State License	52-57	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	SKAGGS COMMUNITY HEALTH CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	SEE PART V, SECTION C	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	0.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5	COMMUNITY INPUT: A COMMITTEE WAS FORMED TO CREATE AND IMPLEMENT THE SURVEY USED IN THE ASSESSMENT. THE COMMITTEE BEGAN MEETING IN JUNE 2015 AND WAS COMPRISED OF HOSPITAL, ACADEMIC AND PUBLIC HEALTH PARTNERS. THE COMMITTEE CREATED A SURVEY AND THE FOCUS OF THIS SURVEY WAS TO GARNER FEEDBACK FROM RESIDENTS IN THE REGION ON PRIORITIZING ISSUES THAT ARE BARRIERS TO IMPROVED HEALTH. IN ADDITION, THE COMMITTEE DETERMINED THAT THERE WAS SIGNIFICANT VALUE IN OBTAINING PERSPECTIVES ON HEALTH FROM BOTH INDIVIDUALS AND ORGANIZATIONS THAT PROVIDE SERVICES TO THE COMMUNITY. AS A RESULT, AN ADDITIONAL SURVEY THAT HAD MINOR ADJUSTMENTS MADE FOR THE ORGANIZATIONAL PERSPECTIVE WAS ALSO ADMINISTERED. AFTER THE SURVEY WAS DEVELOPED, IT WAS APPROVED THROUGH THE INTUITIONAL REVIEW BOARD THROUGH THE OFFICE OF RESEARCH ADMINISTRATION AT MISSOURI STATE UNIVERSITY AND TRANSLATED INTO SPANISH. THE FULL SURVEY CAN BE FOUND IN THE APPENDIX J OF THE REPORT. SURVEY MONKEY WAS USED TO STREAMLINE THE DATA COLLECTION, COMPILATION AND ANALYSIS. THE SURVEY INCLUDED FOUR POTENTIAL PATHS BASED ON 2 LINKS (ENGLISH AND SPANISH) AND THE FIRST QUESTION (INDIVIDUAL OR ORGANIZATION). THE ANNOUNCEMENT OF THE SURVEY WAS MADE THROUGH A JOINT EFFORT OF ALL PARTICIPATING PARTNERS WITH A COORDINATED PRESS RELEASE. INDIVIDUAL ORGANIZATIONS PROMOTED THE COMPLETION OF THE SURVEY THROUGH EMAIL, NETWORKING, SOCIAL MEDIA AND PROMOTION AT POINT OF SERVICE WITHIN FACILITIES. INCENTIVES WERE NOT OFFERED TO PARTICIPANTS AT ANY POINT OF SURVEY COLLECTION. TO MAXIMIZE THE RESPONSE RATE, THE SURVEY WAS KEPT OPEN AND PROMOTED FROM AUGUST 2015 UNTIL DECEMBER 2015. PRELIMINARY RESULTS WERE COLLECTED AT THE BEGINNING OF NOVEMBER 2015 TO INFORM THE LINE OF QUESTIONING DEVELOPED FOR THE FOCUS GROUPS. FINAL RESULTS WERE THEN TABULATED IN DECEMBER 2015 AND JANUARY 2016. FOCUS GROUPS WERE ALSO USED TARGETING UNDERSERVED, CHRONICALLY ILL AND LOW-POPULATIONS IN EACH COMMUNITY. A RESEARCHER FROM MISSOURI STATE UNIVERSITY'S SOCIOLOGY DEPARTMENT WAS CONTRACTED TO COMPLETE THE FOCUS GROUPS. THE RESEARCHER HAS EXPERIENCE WITH HEALTHCARE AND FOCUS GROUPS. THE RESEARCHER ALSO SERVED ON THE SURVEY COMMITTEE AND WAS AN INTEGRAL PART OF THE PROCESS. AFTER THE TOPICS OF FOCUS WERE IDENTIFIED IN AUGUST 2015, THE RESEARCHER DEVELOPED THE FOCUS GROUP QUESTIONS AND SUBMITTED THEM TO THE SURVEY COMMITTEE AND THE STEERING COMMITTEE TO REVIEW AND PROVIDE FEEDBACK. THE SURVEY COMMITTEE ALSO HELPED DETERMINE THE NUMBER OF FOCUS GROUPS AND THE TARGET AUDIENCE FOR THE FOCUS GROUPS. THE COMMITTEE DETERMINED THAT RESIDENTS WERE THE MOST IMPORTANT GROUP FROM WHICH TO RECEIVE IN-DEPTH FEEDBACK. ADDITIONALLY, THE COMMITTEE DETERMINED THAT IT WAS NECESSARY TO CONDUCT FOCUS GROUPS IN EACH OF THE NINE COMMUNITIES DUE TO VARIANCES IN LOCAL PERCEPTIONS AND BARRIERS. FOCUS GROUP FACILITATOR TRAININGS WERE CONDUCTED IN SEPTEMBER AND OCTOBER 2015, WITH FOCUS GROUPS OCCURRING IN NOVEMBER AND DECEMBER 2015. IN ADDITION, SECONDARY DATA WAS COLLECTED FROM COMMUNITYCOMMONS.ORG AND OTHER SOURCES AND EMERGENCY DEPARTMENT DATA WAS OBTAINED FROM HOSPITAL PARTNERS.
SCHEDULE H, PART V, SECTION B, LINE 6A	CHNA CONDUCTED WITH OTHER HOSPITALS: THE CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITY PARTNERS: -CITIZENS MEMORIAL HEALTHCARE -FREEMAN HEALTH SYSTEM -MERCY -LESTER E. COX MEDICAL CENTERS -COX-MONETT 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: -BURRELL BEHAVIORAL HEALTH -JASPER COUNTY HEALTH DEPARTMENT -JOPLIN HEALTH DEPARTMENT -POLK COUNTY HEALTH CENTER -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 HTTP://WWW.CITIZENSMEMORIAL.COM
SCHEDULE H, PART V, SECTION B, LINE 7D	OTHER METHODS TO MAKE THE CHNA REPORT AVAILABLE TO THE PUBLIC: PRINTED COPIES ARE AVAILABLE BY REQUEST THROUGH HOSPITAL OR PUBLIC HEALTH PARTNERS OR AT OZARKSHEALTHCOMMISSION.ORG AND NEWS RELEASE WAS SENT OUT TO ENCOURAGE MEDIA COVERAGE WITH LINKS TO THE REPORT AND KEY MESSAGES FOR THE PUBLIC.
SCHEDULE H, PART V, SECTION B, LINE 10A	IMPLEMENTATON STRATEGY WEBSITE: https://www.coxhealth.com/about-us/community-health-needs-assessments/
SCHEDULE H, PART V, SECTION B, LINE 11	ADDRESSING IDENTIFIED NEEDS: 1. INCREASE PATIENT ENGAGEMENT IN CHRONIC CONDITION SELF-MANAGEMENT -THE CENTER FOR HEALTH IMPROVEMENT EMPLOYS A SKILLED TEAM OF HEALTHCARE PROFESSIONALS WHO DELIVER SUPPORT AND EDUCATION FOR CHRONIC DISEASE MANAGEMENT, NUTRITION SERVICES, AND ADVANCED CARE PLANNING. THEY PROVIDE TOOLS DESIGNED TO INCREASE SELF-MANAGEMENT OF CHRONIC CONDITIONS INCLUDING DIABETES, LUNG DISEASE, CHRONIC PAIN, AND MORE. -IN THE FIRST QUARTER CALENDAR YEAR 2018, A CURRENT STATE ASSESSMENT OF THE CENTER FOR HEALTH IMPROVEMENT WAS CONDUCTED TO DETERMINE THE EFFICACY OF VARIOUS PROGRAMS. AS A RESULT OF THE ASSESSMENT, THE TEAM IS REFINING THE SCOPE OF OFFERINGS TO AN EVIDENCE-BASED, TARGETED PROGRAM SUITE THAT FOCUSES HEAVILY ON IMPROVING CHRONIC CONDITION MANAGEMENT OF PATIENTS. THIS REORGANIZATION AND RESTRUCTURE REMAINS IN PROCESS WITH PLANS FOR FULL IMPLEMENTATION IN THE NEAR FUTURE. -THE NURSING EDUCATION DEPARTMENT AND THE JOINT REPLACEMENT EDUCATORS AT MEYER ORTHOPEDIC CENTER DEVELOPED A PROCESS TO INCREASE TIGR VIDEO EDUCATION VIEWS. MANDATORY EDUCATION WAS EXPANDED TO INCLUDE ALL ADULT PATIENTS WITH A DIAGNOSIS OF PNEUMONIA, HEART FAILURE, ACUTE MI, TOTAL HIP/KNEE REPLACEMENT, OR COPD TO HELP ACHIEVE BEST OUTCOMES WHILE REDUCING READMISSIONS. -AS A RESULT OF THIS INTERVENTION, TIGR VIDEO VIEWS INCREASED FROM 1,618 VIEWS IN JUNE 2017, TO 4,694 VIEWS IN MAY 2018. 2. REDUCE AVOIDABLE HOSPITAL READMISSIONS -IN FEBRUARY 2017, COXHEALTH IMPLEMENTED A PATIENT READMISSION INTERVIEW FORM. WHEN A PATIENT IS READMITTED WITHIN THIRTY DAYS, A CASE MANAGER MEETS WITH THE PATIENT TO DISCUSS THE READMISSION. TO INCREASE THE NUMBER OF PATIENTS INTERVIEWED, COXHEALTH NURSING ADMINISTRATION BEGAN TRAINING NURSES ON LIGHT DUTY TO COMPLETE THE INTERVIEWS IN 2018. TOPICS COVERED IN THE INTERVIEW INCLUDE: >FREQUENCY OF GOOD COMMUNICATION IN THE HOSPITAL REGARDING DIAGNOSIS AND MEDICATIONS. >COMMUNICATION ABOUT DISCHARGE INSTRUCTIONS AND ABILITY TO UNDERSTAND INSTRUCTIONS. >MEDICATION COMPLIANCE AND REASONS FOR ANY DIFFICULTY REMAINING COMPLIANT. >FOLLOW UP APPOINTMENTS WITH A PCP BEING SCHEDULED AND ATTENDED. >REASONS FOR READMISSION, FROM THE PATIENTS PERSPECTIVE. >>THE INFORMATION GATHERED BY THE CASE MANAGER COMES DIRECTLY FROM THE PATIENT AND IS ENTERED INTO REPORTABLE FIELDS THAT ALLOW FOR DATA COLLECTION. COMMON THEMES FOR AVOIDABLE READMISSIONS WILL BE EASIER TO IDENTIFY AND PREVENT THROUGH THIS PROCESS. -EVIDENCE-BASED BEST PRACTICES TO REDUCE AVOIDABLE READMISSIONS HAVE BEEN IMPLEMENTED AND CONTINUE TO EXPAND. >COXHEALTH HIRED TRANSITIONAL CARE PHARMACISTS WHO DEDICATE THEIR TIME WORKING WITH PATIENTS BEING DISCHARGED TO ENSURE THE PATIENT LEAVES THE HOSPITAL WITH THEIR MEDICATIONS. >NEW EFFORTS ARE IN PLACE TO INCREASE THE NUMBER OF PATIENTS WHO LEAVE THE HOSPITAL WITH THEIR MEDICATIONS THROUGH THE USE OF A FOCUSED, FAST-PACED I-90 PROJECT. >THE CLINIC SUPPORT TEAM HAS BEEN INSTRUMENTAL IN SCHEDULING FOLLOW-UP APPOINTMENTS WITH PATIENTS. THE MAJORITY OF INPATIENT UNITS ARE COVERED BY THE CLINIC SUPPORT TEAM, WHICH MEANS MOST PATIENTS HAVE A FOLLOW UP APPOINTMENT SCHEDULED PRIOR TO LEAVING THE HOSPITAL. >A SUBGROUP COMPRISED OF FRONTLINE STAFF, LEADERS, AND QUALITY IMPROVEMENT EXPERTS HAS FORMED TO FOCUS SPECIFICALLY ON REDUCING HEART FAILURE READMISSIONS. THE GROUP WILL USE DATA TO INFORM DECISIONS ON HOW TO BEST MANAGE OUR PATIENTS WITH FREQUENT INPATIENT STAYS DUE TO HEART FAILURE. 3. INCREASE ACCESS TO TOBACCO CESSATION RESOURCES FOR PATIENTS AND FAMILIES PRESENTING TO OUR HOSPITALS AND CLINICS -AN ASSET ASSESSMENT AND GAP ANALYSIS OF THE SYSTEMS CURRENT TOBACCO TREATMENT OFFERINGS WAS CONDUCTED EARLIER THIS YEAR. RECOMMENDATIONS FROM THAT ASSESSMENT INCLUDE CREATION AND IMPLEMENTATION OF A CLEARLY OUTLINED REFERRAL PROCESS AND DEFINED RESOURCES; PROMOTION OF THE ASK, ADVISE, ACT/REFER MODEL TO INITIATE INTERVENTION; DEVELOPMENT AND IMPLEMENTATION OF PREOPERATIVE PROTOCOL TO PROMOTE TOBACCO CESSATION 12 HOURS PRE- AND POST-SURGERY. -EARLIER THIS YEAR, WE PROVIDED TRAINING TO 12 KEY COXHEALTH STAFF MEMBERS AND 3 COMMUNITY EDUCATORS. COMPLETION OF THE UMASS EDUCATION CURRICULUM, REQUIRED EXAMS, AND PRACTICE HOURS MAKE CLASS PARTICIPANTS ELIGIBLE FOR CERTIFICATION AS TOBACCO TREATMENT SPECIALISTS. AS A RESULT OF THIS EDUCATION, THERE WILL BE A LARGE INCREASE IN THE AMOUNT OF CESSATION RESOURCES AVAILABLE WITHIN THE SYSTEM. -THE QUIT RATE FOR OUR MFH STONE AND TANEY COUNTIES TOBACCO CESSATION GRANT HAS STEADILY INCREASED SINCE ITS INCEPTION IN 2013, WITH THE CURRENT QUIT RATE FOR 2018 TO DATE AT 75%. AVERAGING ACROSS THE HISTORY OF THE PROGRAM, THE AGGREGATED QUIT RATE IS 53%. -DUE TO THE SUCCESS OF THIS PROGRAM, FOLLOWING THE GRANTS END ON MAY 31, 2018, WE WERE ABLE TO HIRE A FULL TIME TOBACCO CESSATION COORDINATOR WHO WILL BE RESPONSIBLE FOR COORDINATING SYSTEM EFFORTS TO STANDARDIZE POLICIES AND REFERRAL PROCESSES ACROSS ALL CAMPUSES AND SETTINGS. 4. DECREASE CHILDHOOD OBESITY -THE CARDIAC KIDS PROGRAM IS IMPLEMENTED IN 13 RURAL SCHOOLS IN THE COXHEALTH SERVICE AREA. ITS MAIN OBJECTIVE IS TO SCREEN 5TH GRADE STUDENTS FOR HEALTH INDICATORS THAT PUT THEM AT HIGH RISK FOR DEVELOPING CARDIAC DISEASE. SCREENING BY COXHEALTH STAFF INCLUDES HEIGHT AND WEIGHT MEASUREMENT, BMI CONSULT, AND HEALTH/NUTRITION EDUCATION. -APPROXIMATELY 400 CHILDREN ARE SCREENED ANNUALLY. THOSE WHO ARE DEEMED HIGH RISK ARE REFERRED TO THE COMMITTED TO KIDS PROGRAM. THIS 8-WEEK PROGRAM IS AN INTENSIVE INTERVENTION FOR AT-RISK CHILDREN AND THEIR FAMILIES FOCUSING ON HEATHY BEHAVIOR AND NUTRITION EDUCATION. -PLANS ARE IN PLACE TO FURTHER INTEGRATE THE TWO PROGRAMS TO PROVIDE A COHESIVE UNIT AND BETTER UTILIZE RESOURCES TO SERVE AT-RISK COMMUNITIES. 5. INCREASE THE NUMBER OF WOMEN WHO BREASTFEED THEIR INFANTS AFTER DELIVERY -COXHEALTH AND THE SPRINGFIELD-GREENE COUNTY HEALTH DEPARTMENT ARE CURRENTLY ENGAGED IN A COMMUNITY BREASTFEEDING COALITION WITH THE GOAL OF STRATEGICALLY ALIGNING EFFORTS TO HELP MOVE THE CHIP INITIATIVE FORWARD. -IN ADDITION TO EDUCATION PRESENTED IN OUR GENERAL PRENATAL CLASSES, THE COXHEALTH LACTATION CONSULTANTS FACILITATE A MONTHLY BREASTFEEDING SUPPORT GROUP CALLED THE LACTATION CLUB. -THE ANNUAL COXHEALTH BABY FAIR IS A FREE EVENT THAT FEATURES VENDOR DISPLAYS, DEMONSTRATIONS, DOOR PRIZES, AND CLASSES WITH A VARIETY OF TOPICS INCLUDING BREASTFEEDING. 6. INCREASE DETECTION AND TREATMENT OF THE EARLIEST STAGES OF LUNG CANCER NODULES -COXHEALTH OFFERS LOW-DOSE CT SCANS AS A DIAGNOSTIC SCREENING FOR LUNG CANCER. LOW-DOSE CT SCANS USE LOWER AMOUNTS OF RADIATION TO HELP IDENTIFY LUNG NODULES IN THE EARLIEST STAGES OF LUNG CANCER WHEN IT IS MOST TREATABLE. STUDIES HAVE SHOWN THAT PATIENTS WHO PARTICIPATE IN A LOW-DOSE CT LUNG CANCER PROGRAM ARE 20% LESS LIKELY TO DIE FROM LUNG CANCER THAN THOSE WHO WERE NOT SCREENED WHEN APPROPRIATE. -SINCE THE PROGRAM BEGAN, THE NUMBER OF INDIVIDUALS WHO HAD A LOW-DOSE CT SCAN COMPLETED HAS INCREASED NEARLY THREE-FOLD. AS A RESULT, 354 PEOPLE HAVE BEEN SCREENED FOR EARLY STAGE LUNG CANCER USING LOW-DOSE CT SCAN TECHNOLOGY. -THE GOAL OF DEVELOPING A REFERRAL PATHWAY BETWEEN THE CLINIC AND SYSTEM TOBACCO CESSATION RESOURCES IS UNDERWAY. 7. INCREASE REFERRALS TO COMMUNITY ORAL HEALTH RESOURCES FOR PATIENTS PRESENTING TO THE ED FOR DENTAL ISSUES -COMMUNITY PARTNERSHIPS WITH LOCAL RESOURCES HAVE BEEN STRENGTHENED AND REFINED TO ENSURE STAFF FEEL EMPOWERED TO REFER PATIENTS TO FACILITIES LIKE THE JORDAN VALLEY COMMUNITY HEALTH CENTER (JVCHC) FOR THE APPROPRIATE LEVEL OF CARE FOR ORAL HEALTH ISSUES. -WHEN EVALUATING THE CHIEF COMPLAINTS OF PATIENTS THAT PRESENTED TO THE EMERGENCY DEPARTMENT (ED) FIVE OR MORE TIMES IN A 12-MONTH PERIOD FOR NON-EMERGENT CARE, DENTAL COMPLAINTS RANKED AMONG THE HIGHEST. -PROTOCOLS WERE DEVELOPED FOR PATIENTS THAT PRESENT WITH TOOTH PAIN IN THE ED. AFTER THE MEDICAL SCREENING EXAM COMPLETION, THE PATIENT IS TRANSITIONED TO JVCHC FOR IMMEDIATE DENTAL CARE. -COXHEALTH WORKED IN COLLABORATION WITH JVCHC TO APPLY FOR A GRANT THAT ALLOWED FOR THE HIRE OF ADDITIONAL DENTISTS. TO ENSURE SAME-DAY OR NEXT DAY APPOINTMENTS, THE DENTAL CLINIC EXPANDED TO ADD SATURDAY HOURS. -QUICK ACCESS TO THE DENTAL CLINIC ALLOWED COXHEALTH ED PHYSICIANS TO DISCONTINUE PRESCRIBING NARCOTICS TO PATIENTS WHO PRESENTED WITH TOOTH PAIN. IN 2017, 2,098 INDIVIDUALS WHO PRESENTED TO THE SPRINGFIELD ED WITH NON-EMERGENT DENTAL PAIN WERE REFERRED TO JORDAN VALLEY FOR TREATMENT. OF THOSE INDIVIDUALS, 1,061 (50.5%) RECEIVED TREATMENT. -FOLLOWING A JOINT EFFORT BETWEEN PROGRAM ADMINISTRATORS AT COXHEALTH AND JORDAN VALLEY TO IMPROVE COMMUNICATION AND DATA REPORTING, THE MONTHLY REFERRAL COMPLETION RATE TO DATE HAS INCREASED EXPONENTIALLY TO 91.0%. -IN 2017, OF THE 612 INDIVIDUALS WHO PRESENTED TO COX BRANSON ED WITH DENTAL PAIN, 426 WERE REFERRED TO APPROPRIATE DENTAL CARE. OF THOSE REFERRAL PATIENTS WHO COULD BE REACHED FOR FOLLOW-UP, 31.5% HAD FULFILLED THEIR REFERRAL APPOINTMENT. THE LOW COMPLETION RATE CAN BE CORREL
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.
SCHEDULE H, PART V	REV. PROC. 2015-21 DISCLOSURE: COXHEALTH PROACTIVELY MONITORS COMPLIANCE WITH IRC 501(R) REGULATIONS. DURING REGULARLY SCHEDULED INTERNAL AUDIT PROCEDURES, THE ORGANIZATION IDENTIFIED CERTAIN AREAS THAT NEEDED MINOR MODIFICATIONS TO MORE FULLY COMPLY WITH THE FOLLOWING SECTIONS OF 501(R): - THE ORGANIZATION IS CURRENTLY IN THE PROCESS OF DETERMINING THE BEST COURSE OF ACTION TO MAKE SURE THAT IT HAS MADE ADEQUATE NOTIFICATION TO MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE ABOUT AVAILABILITY OF THE FAP. - THE ORGANIZATION HAS TRANSLATORS AVAILABLE IN MANY LANGUAGES, INCLUDING SPANISH, ASIAN, AND ENDO-EUROPEAN LANGUAGES. HOWEVER, THE ORGANIZATION HAS NOT YET PUBLICIZED A TRANSLATED FAP AND RELATED DOCUMENTS FOR LEP POPULATIONS, BUT IS IN THE PROCESS OF DOING SO. -THE ORGANIZATION IS IN THE PROCESS OF UPDATING CONSPICUOUS PUBLIC DISPLAYS THROUGHOUT ALL FACILITIES AND CLINICS. WHILE THE ORGANIZATION DOES HAVE DISPLAYS IN MANY AREAS, DISPLAYS ARE BEING UPDATED TO BE MORE CONSPICUOUS AND CONSISTENT THROUGHOUT. -THE ORGANIZATION HAS IDENTIFIED THAT IN SOME SITUATIONS, IT MAY NOT HAVE TECHNICALLY COMPLIED WITH ALL OF THE 501(R) PREREQUISITES REQUIRED FOR TAKING AN EXTRAORDINARY COLLECTION ACTION (ECA). THE ORGANIZATION IS IMPLEMENTING NEW PROCEDURES AND TRAINING FOR STAFF TO ENSURE THE REQUIREMENTS OF 501(R) ARE MET PRIOR TO INITIATING AN ECA INDLUDING MODIFYING OR REVERSING CERTAIN ECAS WHERE DETERMINED APPROPRIATE. THE ORGANIZATION DOES NOT BELIEVE THERE WERE ANY FAP-ELIGIBLE INDIVIDUALS THAT PAID MORE THAN AGB, AND THEREFORE NO CORRECTIONS NECESSARY.

Field	Value	IRS element (for citing)
Facility	21	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (21 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
SKAGGS ORTHONEURO CENTER
101 CAHILL RD	BRANSON	MO	65616	OUTPATIENT DEPTS PHYSICIAN CLINICS
CMCB OUTPATIENT CENTER
545 N BRANSON LANDING BLVD	BRANSON	MO	65616	OUTPATIENT DEPTS PHYSICIAN CLINICS
MARY'S WELL HOUSE
5136 HWY 265	BRANSON	MO	65616	PHYSICIAN CLINIC
CMCB HEART CENTER
1150 STATE HWY 248 SUITE 202	BRANSON	MO	65616	CLINIC
COXHEALTH HOSPITALIST
525 BRANSON LANDING BLVD	BRANSON	MO	65616	CLINIC
FDC UROLOGYGI
525 BRANSON LANDING BLVD	BRANSON	MO	65616	CLINIC
COXHEALTH FAMILY MEDICINE & OB
525 BRANSON LANDING BLVD	BRANSON	MO	65616	CLINIC
COXHEALTH FAMILY MEDICINE 248
1150 STATE HWY 248 SUITE 202	BRANSON	MO	65616	CLINIC
COXHEALTH FORSYTH
13852 US HWY 160	FORSYTH	MO	65653	CLINIC
COXHEALTH 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 AND 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 SUITE 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

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 WHICH EQUALS TOTAL OPERATING EXPENSES PER FORM 990, PART IX, LINE 25 WAS REDUCED BY BAD DEBT EXPENSE OF $23,831,112.
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 $6,913,798. 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: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HEALTH SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HEALTH SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HEALTH SYSTEM RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
SCHEDULE H, PART III, SECTION B, LINE 8	COMMUNITY BENEFIT RATIONALE: THE HOSPITAL IS DESIGNATED BY MEDICARE AS A SOLE COMMUNITY HOSPITAL AND AS SUCH, IS THE SOLE SOURCE OF HOSPITAL CARE WITHIN A 35-MILE RADIUS. AS A LARGE RURAL HOSPITAL, MINIMUM STAFFING MUST BE MAINTAINED REGARDLESS OF SWINGS IN PATIENT VOLUME. WITHOUT THE HOSPITAL, MEDICARE PATIENTS WOULD NEED TO TRAVEL SIGNIFICANT DISTANCES TO RECEIVE HOSPITAL CARE. SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.
SCHEDULE H, PART III, SECTION C, LINE 9B	COLLECTION POLICY: (A) COX WILL NOT PURSUE LEGAL ACTION FOR NONPAYMENT OF ANY AMOUNTS DISCOUNTED AS A RESULT OF AN APPROVED OR PARTIAL APPROVED REQUEST FOR FINANCIAL ASSISTANCE. BALANCES REMAINING AFTER SUCH DISCOUNTS ARE APPLIED WILL, HOWEVER, BE SUBJECT TO COLLECTION ACTIVITY, INCLUDING LEGAL ACTION. (B) COX WILL NOT CHARGE INTEREST ON THE BALANCE REMAINING AFTER APPLYING THE FINANCIAL ASSISTANCE DISCOUNT. HOWEVER, COX MAY, IN ITS SOLE DISCRETION, CHARGE INTEREST ON THE BALANCE OWED IF 1) THE GUARANTOR DEFAULTS ON HIS OR HER PAYMENT AGREEMENT OR 2) THE BALANCE IS REFERRED TO THE COLLECTION AGENCY FOR COLLECTION.
SCHEDULE H, PART VI, LINE 2	NEEDS ASSESSMENT: Recognizing the value of assessing and acting together on local health issues, key players from local hospital systems, public health entities, behavioral health systems 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, a collaboration spanning 51 counties and four hospital systems in Missouri, Oklahoma, Arkansas, and Kansas. The 2015 Community Health Needs Assessment (CHNA) was replaced by the 2016 CHNA conducted by the Ozarks Health Commission (OHC). This larger, concerted approach will leverage common strengths and strategies to move in the same direction on significant health concerns. This assessment, along with the resulting implementation plan, will allow decision-makers to have a more holistic and up-to-date picture with which to strategically address community health concerns in their own jurisdictions. In July 2016, OHC members agreed upon common goals for the three health priorities identified. CoxHealth formed a steering committee whose purpose was to identify both system-wide initiatives and hospital-specific initiatives that maximize resources and ensure consistency and high reliability in the communities we serve. The steering committee included executive leaders from Springfield, Branson, and Monett, and service line leaders in the areas of cardiovascular, pulmonary, and mental/behavioral health.The steering committee appointed a representative from each community who was responsible to coordinate hospital initiatives with internal resources and community partners. Initiative selection was finalized August 2016. The Community Health Implementation Plan (CHIP) was approved by the Cox Medical Center Branson (CMCB) board of directors October 27, 2016. CMCB will implement, track, and evaluate the documented CHIP initiatives through September 2019. During this period, we will continue our collaborative efforts under the Ozarks Health Commission to harness the value of identifying and acting upon common strategies for improving the health of our communities.
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 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. -COX HEALTH SYSTEMS HMO, INC. -MEDICAL DEVELOPMENTS, INC. -INSURANCE COMPANY OF SPRINGFIELD, INC. -COXHEALTH ALLIANCE, LLC -COX-MONETT HOSPITAL -COXHEALTH FOUNDATION -COX HPS OF THE OZARKS, INC. -COX ALTERNATIVE CARE OF THE OZARKS, INC., HEALTHCARE SERVICES OF THE OZARKS, INC. AND COX HEALTHCARE SERVICES OF THE MIDWEST, INC. COLLECTIVELY REFERRED TO AS OXFORD HOME HEALTH CARE -PRIMROSE PLACE, INC. -COXHEALTH IS THE PARENT COMPANY FOR LESTER E. COX MEDICAL CENTERS AND ITS WHOLLY OWNED AFFILIATES, AND COX MEDICAL GROUP. -COX MEDICAL GROUP IS THE SOLE MEMBER OF THE COX TAXABLE CLOSE CORPORATION, A FOR-PROFIT ENTITY THAT IS THE SOLE SHAREHOLDER OF FDCI.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	Yes (true)	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
WILLIAM MAHONEY
PRESIDENT	$448,836	$0	$64,406	$0	$53,759	$0	$57,121	$0	$14,917	$0	$639,039	$0	$53,069	$0
DAVID STRONG
CFO	$262,818	$0	$33,482	$0	$25,912	$0	$39,450	$0	$14,917	$0	$376,579	$0	$25,222	$0
JACOB MCWAY
DIRECTOR/COXHEALTH CFO	$0	$547,968	$0	$141,318	$0	$104,870	$0	$130,967	$0	$21,047	$0	$946,170	$0	$95,346
STEVE EDWARDS
DIRECTOR/COXHEALTH CEO	$0	$956,727	$0	$331,733	$0	$244,148	$0	$253,616	$0	$23,211	$0	$1,809,435	$0	$238,103
HOLLY WHERRY
DIRECTOR	$355,332	$0	$0	$0	$270	$0	$0	$0	$7,139	$0	$362,741	$0	$0	$0
CHARITY ELMER
DIRECTOR	$0	$454,193	$0	$54,772	$0	$12,064	$0	$90,431	$0	$20,727	$0	$632,187	$0	$4,307
CHAD EFIRD
PHYSICIAN	$1,153,306	$0	$0	$0	$300	$0	$30,985	$0	$14,852	$0	$1,199,443	$0	$0	$0
NARIN ARUNAKUL
PHYSICIAN	$832,150	$0	$0	$0	$1,290	$0	$31,250	$0	$15,017	$0	$879,707	$0	$0	$0
MITTIE DRAGOSLJVICH
PHYSICIAN	$581,144	$0	$0	$0	$2,322	$0	$13,250	$0	$15,189	$0	$611,905	$0	$0	$0
PRASER VIJITBENJARONK
PHYSICIAN	$634,667	$0	$0	$0	$690	$0	$31,250	$0	$14,917	$0	$681,524	$0	$0	$0
BRIAN CLONTS
CMO ENDING 01/01/17	$604,893	$0	$0	$0	$1,242	$0	$13,250	$0	$15,009	$0	$634,394	$0	$0	$0
LYNNE YAGGY
CNO	$174,231	$0	$13,187	$0	$690	$0	$7,791	$0	$14,896	$0	$210,795	$0	$0	$0
SABERA SHABNAM
PHYSICIAN	$571,393	$0	$0	$0	$353	$0	$30,985	$0	$7,153	$0	$609,884	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 4B	SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: STEVE EDWARDS, CHARITY ELMER, JACOB MCWAY, WILLIAM MAHONEY, AND DAVID STRONG PARTICIPATE IN A 457(F) NONQUALIFIED RETIREMENT PLAN THROUGH COXHEALTH AND RELATED AFFILIATES. - STEVE EDWARDS RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $240,366. - STEVE EDWARDS RECEIVED A 457(F) DISTRIBUTION OF $238,103, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - JACOB MCWAY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $99,982. - JACOB MCWAY RECEIVED A 457(F) DISTRIBUTION OF $95,346, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - CHARITY ELMER RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $59,946. - CHARITY ELMER RECEIVED A 457(F) DISTRIBUTION OF $4,307, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - WILLIAM MAHONEY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $46,186. - WILLIAM MAHONEY RECEIVED A 457(F) DISTRIBUTION OF $53,069, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - DAVID STRONG RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $26,200. - DAVID STRONG RECEIVED A 457(F) DISTRIBUTION OF $25,222, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990.
SCHEDULE J, PART II, COLUMN F	COMPENSATION REPORTED ON PRIOR FORM 990: COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS VESTED OR PAID TO THE INDIVIDUAL.
SCHEDULE J, PART II; AND FORM 990, PART VII	BOARD MEMBER COMPENSATION: NO COMPENSATION WAS PROVIDED FOR RESPONSIBILITIES ASSOCIATED WITH BEING A DIRECTOR. COMPENSATION REPORTED FOR SEVERAL BOARD MEMBERS LISTED ON SCHEDULE J REPRESENTS EMPLOYEE OR INDEPENDENT CONTRACTOR COMPENSATION UNRELATED TO SERVICE AS A BOARD MEMBER.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
LAKES REGION IMAGING LLC
SEE PART V	$86,618	PURCHASED SERVICES	false
SONYA HAYTER
D HAYTER SEE PART V	$101,919	WAGES AND BENEFITS	false
JENNA YAGGY
L YAGGY SEE PART V	$9,005	WAGES AND BENEFITS	false

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE L, PART IV, COLUMN B	FormAndLineReferenceDesc
Explanation	TRANSACTIONS WITH INTERESTED PERSONS: (1) ANTHONY WHEELER, A BOARD MEMBER OF COX MEDICAL CENTER BRANSON, IS A 50% OWNER OF LAKES REGION IMAGING, LLC. (2) DOUG HAYTER'S SPOUSE, SONYA HAYTER, IS EMPLOYED BY COX COLLEGE AND DOUG IS A BOARD MEMBER. (3) LYNNE YAGGY'S DAUGHTER, JENNA YAGGY, IS EMPLOYED BY COX MEDICAL CENTER BRANSON AND LYNNE IS CHIEF NURSING OFFICER.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (22 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART I, LINE 1	ORGANIZATION'S MISSION: VISION: THE HOSPITAL'S VISION IS TO BE THE BEST FOR THOSE WHO NEED US. WE VALUE SAFETY, COMPASSION, RESPECT AND INTEGRITY. THE HOSPITAL HAS BEEN SERVING SOUTHWEST MISSOURI FOR MORE THAN 65 YEARS AND OFFERS OVER 25 MAJOR SERVICE AREAS. THE HOSPITAL'S AVERAGE DAILY PATIENT CENSUS EXCEEDS 80 PATIENTS WITH 157 LICENSED HOSPITAL BEDS. A STAFF OF OVER 1,100 PERSONNEL OPERATE THE HOSPITAL AND ITS NUMEROUS CLINICS.
FORM 990, PART III, LINE 4A	PROGRAM SERVICE ACHIEVEMENT #1: CMCB DESIGNATED AS A LEVEL II STEMI CENTER BY THE MISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES. THE MEDICAL CENTER IS ONLY ONE OF 19 IN THE STATE TO RECEIVE THIS CLASSIFICATION. THIS MEANS THE HOSPITAL IS EQUIPPED TO PROVIDE CARE FOR A LARGE NUMBER OF STEMI PATIENTS, PERFORMS A MINIMUM NUMBER OF CARIDIAC PROCEDURES A YEAR, HAS 24/7 CATH LAB SERVICES AVAILABLE WITHIN 30 MINUTES OR LESS AND HAS PROCESSES IN PLACE TO QUICKLY AND SAFELY TRANSFER PATIENTS FOR HEART SURGERY IF NEEDED. FOR THE SECOND YEAR IN A ROW, CMCB RECEIVED ONE OF THE HIGHEST RECOGNITIONS FOR OUTSTANDING STROKE CARE BY RECEIVING THE AMERICAN HEART ASSOCIATION/STROKE ASSOCIATIONS GET WITH THE GUIDELINES STROKE GOLD PLUS ACHIEVEMENT AWARD WITH TARGET: STROKE HONOR ROLL ELITE. THE AWARD RECOGNIZES THE HOSPITALS COMMITMENT TO PROVIDING THE MOST APPROPRIATE STROKE TREATMNET ACCORDING TO NATIONALY RECOGNIZED RESEARCH-BASED GUIDELINES BASED ON THE LATEST SCIENTIFIC EVIDENCE. CMCBS ACUTE REHAB UNIT WAS AWARDED A NUMBER SEVEN RANKING AMONG 106 OTHER REHAB UNITS AT THE KINDRED REHABILITATION SERVICES NATIONAL MEETING IN NASHVILLE. THE RANKING IS BASED ON A PERFORMANCE EVALUATION MODEL (PEM) WHICH USES INDICATORS OF EFFICIENCY AND EFFECTIVENESS TO MEASURE HIGH-PERFORMING FACILITIES FOR THEIR DELIVERY OF QUALITY CARE WHEN COMPARED TO ALL FACILITIES. CMCBS PUBLIC SAFETY TEAM HAS BECOME THE FIRST HOSPITAL IN THE STATE TO RECEIVE THE INTERNATIONAL ASSOCIATION FOR HEALTHCARE SECURITY AND SAFETYS PROGRAM OF DISTINCTION AWARD. ONLY 40 HOSPITALS IN THE UNITED STATES AND CANADA HAVE RECEIVED THIS HONOR. THIS MEANS THAT 70% OF THE HOSPITALS OFFICERS, GUARDS, MANAGERS AND DIRECTORS STUDIED AND PASSED THE IAHSS INTENSIVE CERTIFICATION EXAM. U.S. NEWS & WORLD REPORT NAMES TWO COXHEALTH HSOPITALS AS BEST REGIONAL HOSPITALS. COX SOUTH AND COX BRANSON HAVE BEEN RECOGNIZED AS BEST REGIONAL HOSPITALS FOR 2017-2018 BY U.S. NEWS AS PART OF THE PATIENT PORTAL, DESIGNED TO HELP PATIENTS MAKE INFORMED DECISIONS ABOUT WHERE TO RECEIVE CARE FOR LIFE-THREATENING CONDITIONS OR FOR COMMON ELECTIVE PROCEDURES. COX BRANSON WAS NAMED 10TH IN THE STATE AND RECOGNIZED AS HIGH PERFORMING FOR CONGESTIVE HEART FAILURE, COPD AND KNEE REPLACEMENT.
FORM 990, PART IV, LINE 24A	TAX EXEMPT BONDS: LESTER E. COX MEDICAL CENTERS, A RELATED ORGANIZATION, REPORTS BONDS RELATED TO COX BRANSON ON ITS FORM 990, SCHEDULE K. AN ALLOCATION OF COX BRANSON'S PORTION OF RELATED BONDS IS REPORTED ON PART X, LINE 20. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS: BOARD MEMBERS WHO RECEIVE COMPENSATION, OFFICERS, AND KEY EMPLOYEES ARE EMPLOYED BY COXHEALTH AND ITS AFFILIATES AND THEREFORE SHARE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6	MEMBERS: THE ORGANIZATION HAS ONLY ONE MEMBER - LESTER E COX MEDICAL CENTERS.
FORM 990, PART VI, SECTION A, LINE 7A	MEMBER'S POWER TO ELECT GOVERNING BODY: THE BOARD SHALL BE ELECTED BY THE MEMBER. NO LATER THAN SEPTEMBER 1 OF EACH YEAR, THE BOARD SHALL NOMINATE A SLATE OF PERSONS FOR ELECTION AS COX BRANSON DIRECTORS AND OFFICERS TO SUBMIT TO THE LESTER E. COX MEDICAL CENTERS BOARD FOR APPOINTMENT. THE LESTER E. COX MEDICAL CENTERS BOARD WILL ACT IN GOOD FAITH AND NOT UNREASONABLY WITHHOLD APPOINTMENT. IF FOR ANY REASON A NOMINATED PERSON IS NOT APPOINTED BY THE LESTER E. COX MEDICAL CENTERS BOARD, THE BOARD HAS THE RIGHT TO NOMINATE ANOTHER PERSON FOR CONSIDERATION.
FORM 990, PART VI, SECTION A, LINE 7B	GOVERNANCE DECISIONS RESERVED TO MEMBERS: THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE SOLELY AND SPECIFICALLY RESERVED TO THE MEMBER; A. ELECTION, APPOINTMENT AND REMOVAL OF COX BRANSON BOARD OF DIRECTORS ("BOARD") AFTER NOMINATION BY THE BOARD; B. APPOINTMENT AND REMOVAL OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF COX BRANSON ("PRESIDENT AND CEO OF COX BRANSON") AFTER RECOMMENDATION BY/CONSULTATION WITH THE BOARD; C. APPROVAL OF COX BRANSON'S UNBUDGETED DEBT AND CAPITAL EXPENDITURES EXCEEDING $250,000; D. APPROVAL OF COX BRANSON'S OPERATING AND CAPITAL BUDGETS AND FINANCIAL REPORTS, MERGERS, CONSOLIDATIONS, ACQUISITIONS, AFFILIATIONS, AND REORGANIZATION OR DISPOSITION OF ASSETS EXCEEDING THE THEN FAIR VALUE OF $250,000; E. AMENDMENT, REPEAL OR ADOPTION OF COX BRANSON'S ARTICLES OF INCORPORATION AND BYLAWS EXCEPT AS OTHERWISE PROVIDED IN THE BYLAWS. FINAL DECISIONS MADE BY THE BOARD OF THE DIRECTORS MUST ALSO BE APPROVED BY THE LESTER E. COX MEDICAL CENTERS BOARD AS WELL. THE MEMBER SHALL NOT EXERCISE ITS POWERS WITHOUT FIRST OBTAINING APPROVAL FROM TWO-THIRDS (2/3) MAJORITY OF THE BOARD IN THE FOLLOWING CIRCUMSTANCES: A. TRANSFER ANY OF ITS COX BRANSON MEMBERSHIP TO ANY OTHER ENTITY; B. SELL OR LEASE ALL OR SUBSTANTIALLY ALL OF COX BRANSON'S ASSETS; AND C. ENTER INTO A MANAGEMENT AGREEMENT FOR ALL OR SUBSTANTIALLY ALL OF COX BRANSON'S OPERATION. THE MEMBER MAY NOT TERMINATE OR SUBSTANTIALLY LIMIT THE FOLLOWING COX BRANSON SERVICE LINES WITHOUT FIRST OBTAINING APPROVAL FROM TWO-THIRDS (2/3) MAJORITY OF THE BOARD: EMERGENCY DEPARTMENT, CARDIOLOGY, ORTHOPEDICS, PRIMARY CARE, RADIATION AND MEDICAL ONCOLOGY, RADIOLOGY, PATHOLOGY, ANESTHESIA, GENERAL SURGERY, ICU, MEDICAL/SURGICAL SERVICES, ACUTE REHABILITATION SERVICES, WOMEN'S HEALTH SERVICES, GERIATRICS, NEUROSCIENCES, PAIN MANAGEMENT, PSYCHIATRY, UROLOGY AND ENDOCRINOLOGY. NOTWITHSTANDING THE ABOVE MENTIONED LIMITATION, THESE SERVICE LINES MAY BE TERMINATED OR SUBSTANTIALLY LIMITED BY THE MEMBER WITHOUT TWO-THIRDS (2/3) MAJORITY OF THE COX BRANSON BOARD IF (I) THERE IS A LOSS OF A LICENSE OR ACCREDITATION REQUIRED TO MAINTAIN SUCH SERVICE, OR A LOSS OF MEDICARE OR MEDICAID CERTIFICATION REQUIRED FOR SUCH SERVICE, IN EACH CASE, OTHER THAN DUE TO THE ACTIONS OR INACTIONS OF THE MEMBER OR COX BRANSON OR (II) THERE IS DESTRUCTION OR MATERIAL DAMAGE TO A FACILITY (PENDING THE PERFORMANCE OR REPAIR OR REPLACEMENT EFFORTS). (PENDING THE PERFORMANCE OR REPAIR OR REPLACEMENT EFFORTS). FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. A DRAFT VERSION OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO SUBMISSION. WHILE THE DRAFT IS PROVIDED TO ALL BOARD MEMBERS, IT IS THE MEMBERS OF THE FINANCE COMMITTEE THAT GO THROUGH AND REVIEW THE RETURN IN DETAIL. UPON RECEIVING THE APPROVAL OF THE BOARD OF DIRECTORS, THE DRAFT IS THEN FINALIZED AND SUBMITTED TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: COXHEALTH OFFICERS, DIRECTORS AND KEY EMPLOYEES, AS WELL AS OFFICERS, DIRECTORS AND KEY EMPLOYEES OF THE COXHEALTH AFFILIATES AND/OR COMMITTEES WITH DELEGATED AUTHORITY TO MAKE DECISIONS, ARE ANNUALLY REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST FOLLOWING THE POLICY, SET FORTH BELOW. THE POLICY REQUIRES THAT BOARD MEMBERS MAKE DECISIONS THAT ARE CONFLICT FREE, OR IF A CONFLICT IS PRESENT, THAT IT IS FULLY DISCLOSED FOR THE BOARD'S CONSIDERATION. COXHEALTH'S EMPLOYEES AND BOARD MEMBERS MUST AVOID ALL ACTIVITIES, ASSOCIATIONS OR INTERESTS THAT CREATE A CONFLICT OF INTEREST. CONFLICTS OF INTEREST FOR EMPLOYEES MUST BE REPORTED TO THE CORPORATE INTEGRITY DEPARTMENT. A FILE WILL BE MAINTAINED OF ALL REPORTED CONFLICTS OF INTEREST. FOR MEDICAL STAFF MEMBERS, THE CONFLICT OF INTEREST PROCESS MAY BE ACCESSED THROUGH THE MEDICAL STAFF OFFICE. FOR BOARD MEMBERS, THE CONFLICT OF INTEREST PROCESS IS HANDLED THROUGH THE GOVERNANCE SUB-COMMITTEE OF COXHEALTH WITH THE ASSISTANCE OF THE EXECUTIVE OFFICE AND IS DEFINED IN THE CHARTER OF THE GOVERNANCE SUB-COMMITTEE. IF ANY OFFICER OR DIRECTOR IS FOUND TO HAVE A CONFLICT OF INTEREST, SUCH PERSON SHALL NEITHER VOTE NOR USE HIS OR HER INFLUENCE TO AFFECT ANY DECISION RELATING TO THE CONFLICT, AND SUCH PERSON SHOULD NOT BE INCLUDED IN DETERMINING WHETHER A QUORUM PARTICIPATED IN THE DECISION. SUCH PERSON IS PERMITTED TO BRIEFLY STATE HIS OR HER POSITION ON THE MATTER, AND ANSWER PERTINENT QUESTIONS ABOUT IT, IF HIS OR HER KNOWLEDGE OR EXPERTISE COULD ASSIST THOSE PARTICIPATING IN THE DECISION. FOR VENDORS, THE POLICY IS DISTRIBUTED WITH THEIR INITIAL CONTRACT WITH COX MEDICAL CENTER BRANSON.
FORM 990, PART VI, SECTION B, LINE 15A & 15B	COMPENSATION REVIEW: COX MEDICAL CENTERS EMPLOY A DEFINED GOVERNANCE STRUCTURE AROUND EXECUTIVE COMPENSATION. THE BOARD OF DIRECTORS MAINTAINS A COMPENSATION COMMITTEE THAT IS CHARGED WITH CARRYING OUT THE FUNCTIONS OF EVALUATING AND SETTING EXECUTIVE COMPENSATION THROUGH FORMAL DOCUMENTED MEETINGS THAT OCCUR SEVERAL TIMES DURING THE YEAR. THE COMPENSATION COMMITTEE UTILIZES A WELL RESPECTED INDEPENDENT EXTERNAL ADVISOR TO PROVIDE THIRD PARTY ASSESSMENT AND RECOMMENDATIONS REGARDING COMPENSATION LEVELS AND BENEFIT PROGRAMS FOR THE TOP THREE EXECUTIVES TIERS OF THE ORGANIZATION; THE CEO, CFO AND SENIOR VPS TO ENSURE THE COMPENSATION PROGRAM IS COMPETITIVE AND WITHIN FAIR MARKET VALUE. AFTER A FULL REVIEW OF THE DATA AND THOROUGH DISCUSSION THE COMMITTEE MAKES A SELF DETERMINATION OF COMPENSATION LEVELS SET JANUARY OF EACH YEAR. ANNUALLY THE STEPS NECESSARY TO DOCUMENT REBUTTABLE PRESUMPTION ARE TAKEN AND RECORDED. ADDITIONALLY, COMPENSATION LEVELS FOR THE VICE PRESIDENT TIER OF MANAGEMENT IS OVERSEEN BY THE CEO USING EXTERNAL COMPARABLE DATA FOR ASSESSMENT AND IS PROVIDED TO THE COMPENSATION COMMITTEE FOR REVIEW ON AN ANNUAL BASIS.
FORM 990, PART VI, SECTION C, LINE 19	DOCUMENT DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART VII, SECTION A	BOARD MEMBER COMPENSATION: STEVE EDWARDS, JACOB MCWAY, AND CHARITY ELMER ARE RECEIVING COMPENSATION RELATED TO THEIR ROLES AS EMPLOYEES UNDER COXHEALTH AND RELATED AFFILIATES. NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS BOARD MEMBERS.
FORM 990, PART XI, LINE 9	OTHER CHANGES IN NET ASSETS: $ 1,837,968 CHANGE IN INVESTMENT IN SKAGGS FOUNDATION 506,458 CHANGE IN BENEFICIAL INTEREST IN TRUST ----------- $ 2,344,426
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER CONTRACTED SERVICES TOTAL FEES:20640697
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACTED LABOR TOTAL FEES:13908692
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACTED BILLING SERVICES TOTAL FEES:1114785
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACTED RADIOLOGY SERVICES TOTAL FEES:803997
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACTED LAB SERVICES TOTAL FEES:388396
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACTED LAUNDRY SERVICES TOTAL FEES:385025
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACTED COLLECTION SERVICES TOTAL FEES:307082
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACTED HOUSEKEEPING TOTAL FEES:260424
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACTED CONSULTING SERVICES TOTAL FEES:106421
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACTED COURIER SERVICES TOTAL FEES:79769
FORM 990 PART IX LINE 11G	DESCRIPTION:TRANSCRIPTION SERVICES TOTAL FEES:4993

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
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

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (18 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
COX ALTERNATIVE CARE OF THE OZARKS INC
PO BOX 10939	SPRINGFIELD	MO	65808	431641925	HOME HEALTH	MO	501(C)(3)	10	LESTER E COX	false
COXHEALTH FOUNDATION
3525 S NATIONAL SUITE 204	SPRINGFIELD	MO	65807	436810485	FUNDRAISING	MO	501(C)(3)	12 A I	LESTER E COX	false
COXHEALTH HOME CARE SVCS OF THE MIDWEST
PO BOX 10939	SPRINGFIELD	MO	65808	264781194	HOME HEALTH	MO	501(C)(3)	10	LESTER E COX	false
COX HPS OF THE OZARKS INC
2220 W SUNSET	SPRINGFIELD	MO	65807	431641927	HOME HEALTH	MO	501(C)(3)	10	LESTER E COX	false
COX-MONETT HOSPITAL INC
801 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)	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
HEALTHCARE SERVICES OF THE OZARKS INC
PO BOX 10939	SPRINGFIELD	MO	65808	431641928	HOME HEALTH	MO	501(C)(3)	10	LESTER E COX	false
PRIMROSE PLACE INC
1115 E PRIMROSE	SPRINGFIELD	MO	65807	431183783	SUPPORT	MO	501(C)(3)	12 A I	LESTER E COX	false
COXHEALTH AUXILIARY
3801 S NATIONAL	SPRINGFIELD	MO	65807	431090590	SUPPORT	MO	501(C)(3)	10	LESTER E COX	false
COX MEDICAL CTR GENPROF LIAB LOSS FUND
1423 N JEFFERSON	SPRINGFIELD	MO	65802	366668576	SELF-INSURAN	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
COXHEALTH
1423 N JEFFERSON ST	SPRINGFIELD	MO	65802	471087427	HOLDING CO	MO	501(C)(3)	11 B II	NA	false
COX MEDICAL GROUP
1423 N JEFFERSON ST	SPRINGFIELD	MO	65802	411087566	PHYSICIANS	MO	501(C)(3)	10	COXHEALTH	false
COX HEALTH SYSTEMS HMO INC
PO BOX 5750	SPRINGFIELD	MO	658015750	431757075	HMO	MO	501(C)(4)		LESTER E COX	false
COX COLLEGE
1423 N JEFFERSON	SPRINGFIELD	MO	65802	475148345	EDUCATION	MO	501(C)(3)	2	LESTER E COX	false
COX MEDICAL GROUP CLINICS
3801 S NATIONAL	SPRINGFIELD	MO	65807	371830627	HEALTHCARE	MO	501(C)(3)	10	COXHEALTH	false
COX HEALTH SYSTEMS INSURANCE COMPANY
PO BOX 5750	SPRINGFIELD	MO	65801	431684044	INSURANCE	MO	501(C)(4)		LESTER E COX	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd
MEDICAL DEVELOPMENTS INC
1423 N JEFFERSON AVE	SPRINGFIELD	MO	65802	431622182	PHARMACY	MO	LESTER E COX	C CORP	false
INSURANCE COMPANY OF SPRINGFIELD INC
					CAPTIVE INSURANCE	MO	LESTER E COX	C CORP	false	GRAND PAVILION CORPORATE CENTRE	GRAND CAYMAN	CJ
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

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd