2017-08-10T09:50:33-05:00 2016-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2015-10-01 440584290 SKAGGS COMMUNITY HOSPITAL ASSOCIATION % DAVID STRONG SKAG 4173357000 525 BRANSON LANDING BOULEVARD BRANSON MO 65615 DAVID STRONG CFO 2017-04-24 true Brian D Todd P00422601 4178658701 2015 2021-01-29 14:40:06Z X COX MEDICAL CENTER BRANSON MR WILLIAM MAHONEY 525 BRANSON LANDING BOULEVARD BRANSON MO 65615 199183570 false X WWW.COXHEALTH.COM X 1950 MO IMPROVES LIVES VIA EDUCATION, PREVENTION, AND ADVOCACY; BY THE USE OF TECHNOLOGY; AND BY PROVIDING COMFORT AND PRIVACY WHILE PRESERVING DIGNITY. SEE SCHEDULE O FOR MORE INFORMATION. 15 10 1483 227 28970 -123255 261964 613899 193499026 190726382 1452033 1759124 169750 0 195382773 193099405 98363 153578 0 0 66028833 71080664 0 0 0 116524042 115571192 182651238 186805434 12731535 6293971 203850893 196199649 98373295 82102177 105477598 114097472 X THE HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH QUALITY HEALTH CARE, EDUCATION AND RESEARCH. false false 138657072 153578 167280039 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. 33433897 23446343 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. 172090969 true true false true false false false false false false true false false false true false false true false false false false false false false false true true true false true false false false false false false false true false false false false true true false false false true X 72 0 true 1483 true true true false false false false false false false false false X 15 10 false false true false true true true true true false false true true true true true true true true true false X DAVID STRONG 4173357789 525 BRANSON LANDING BOULEVARD BRANSON MO 65615 X BOB MCDOWELL VICE CHAIRMAN 3.0 5.0 X X 0 0 0 ANTHONY WHEELER DIRECTOR 3.0 0.0 X 0 0 0 DOUG HAYTER DIRECTOR 3.0 0.0 X 0 0 0 DENNIS NEWKIRK DIRECTOR 3.0 0.0 X 0 0 0 PHILLIP LOYD CHAIRMAN 3.0 5.0 X X 0 0 0 JACOB MCWAY DIRECTOR 3.0 40.0 X 0 769634 139481 LARRY SCHMITT TREASURER 3.0 0.0 X X 0 0 0 RAEANNE PRESLEY SECRETARY END 2/2016;DIRECTOR 3.0 0.0 X X 0 0 0 RICHARD BLUBAUGH DIRECTOR 3.0 0.0 X 0 0 0 STEVE EDWARDS DIRECTOR 3.0 0.0 X 0 1355943 259919 HOLLY WHERRY DIRECTOR 3.0 0.0 X 352861 0 6800 BOB COX DIRECTOR 3.0 0.0 X 0 0 0 CHARITY ELMER DIRECTOR 3.0 40.0 X 0 451420 94158 SUE HEAD DIRECTOR BEG 11/2015 3.0 0.0 X 0 0 0 RICK TODD DIRECTOR BEG 1/2016 3.0 0.0 X 0 0 0 WILLIAM MAHONEY PRESIDENT 40.0 0.0 X 507838 0 71247 DAVID STRONG CFO 40.0 0.0 X 294945 0 52862 BARBARA STEWART SECRETARY BEG 2/2016 3.0 0.0 X 52571 0 9277 CAROL MARTIN VP ADMINISTRATION END 05/2016 40.0 0.0 X 233450 0 35995 BRIAN CLONTS MD CMO 40.0 0.0 X 564788 0 27688 LYNNE YAGGY CNO 40.0 0.0 X 188772 0 22041 CHAD EFIRD PHYSICIAN 40.0 0.0 X 1109828 0 38135 NARIN ARUNAKUL PHYSICIAN 40.0 0.0 X 963116 0 45522 MITTIE DRAGOSLJVICH PHYSICIAN 40.0 0.0 X 606296 0 27871 PRASER VIJITBENJARONK PHYSICIAN 40.0 0.0 X 618550 0 45513 CHARLIE RASMUSSEN PHYSICIAN 40.0 0.0 X 565679 0 45190 6058694 2576997 921699 60 false true false 360 DEGREE MEDICINE LLC PHYSICIAN SERVICES 6031775 CHG COMPANIES PHYSICIAN SERVICES 2470394 WEATHERBY LOCUMS INC PHYSICIAN SERVICES 1478298 WHITE RIVER ANESTHESIA ASSOCIATES ANESTHESIA SERVICES 1341669 SHIFTWISE ST PAUL MN 551709705 STAFFING MGMT 760355 17 373908 239991 613899 NET PATIENT SERVICE REVENUE 624100 186349565 186349565 EHR MEANINGFULD USE REVENUE 624100 495049 495049 LAB REVENUE 621500 1074702 1045732 28970 CAFETERIA 722514 1137312 1137312 FITNESS CENTER 713940 402309 402309 1267445 1267445 190726382 2142150 2142150 0 0 0 0 0 5695148 5991 5255845 828320 439303 -822329 -383026 -383026 0 0 0 0 193099405 190697412 28970 1759124 X 153578 153578 0 0 0 2421135 1162950 1258185 0 56659239 48043116 8616123 1458742 1458742 6690331 6365662 324669 3851217 3642276 208941 0 3931 3931 141607 141607 0 0 278924 255874 23050 38367703 36057613 2310090 53737 49296 4441 4576413 4223732 352681 582963 534789 48174 0 4533327 4158705 374622 499374 458107 41267 0 37063 34000 3063 3009373 2760687 248686 0 8001487 7340266 661221 725504 665550 59954 MEDICAL SUPPLIES & DRUGS 27753197 27753197 BAD DEBT 19655988 19655988 STATE PROVIDER TAX 6942065 6942065 LICENSES, DUES, SUBSCRIPTIONS 256512 235315 21197 152024 139461 12563 186805434 172090969 14714465 0 19071472 6162797 26628742 19518786 0 0 23928069 25168743 0 0 0 0 0 0 2600938 2894423 960564 776995 130291785 29201297 102375481 101090488 13758072 15913393 7966979 8318819 3351295 6393339 551500 551500 2657781 9410366 203850893 196199649 10234349 11469412 0 0 0 0 58234767 58234767 0 0 0 0 13396465 11016735 0 0 16507714 1381263 98373295 82102177 X 96259324 104321828 1251295 1456825 7966979 8318819 105477598 114097472 203850893 196199649 X 6293971 -331467 2657370 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 19302 19302 false SCHEDULE C, PART II-B, LINE 1 (I) OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAID DUES OF $42,207 TO THE MISSOURI HOSPITAL ASSOCIATION AND $18,569 TO THE AMERICAN HOSPITAL ASSOCIATION, OF WHICH $15,194 (36%) AND $4,107 (22.12%) RESPECTIVELY IS ATTRIBUTABLE TO LOBBYING PURPOSES. 5471256 5471256 58006881 6728643 51278238 4334390 616876 3717514 54342303 20619703 33722600 8136955 1236075 6900880 101090488 0 DUE TO THIRD PARTY 1381263 1381263 174280011 -331467 -17555988 -17887455 192167466 931939 931939 193099405 166217507 -931939 -931939 167149446 19655988 19655988 186805434 SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $(19,655,988) BAD DEBT 2,100,000 CHANGE IN INVESTMENT IN SKAGGS FOUNDATION ------------ $(17,555,988) SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 931,939 LAB REVENUE SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ (931,939) LAB REVENUE SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 19,655,988 BAD DEBT true true X false true X true true true false true true 6989228 6989228 0.04180 27426088 21600061 5826027 0.03490 34415316 21600061 12815255 0.07670 42 42 3700 3700 12462035 4962386 7499649 0.04490 492983 492983 0.00290 12958760 4962386 7996374 0.04780 47374076 26562447 20811629 0.12450 true 19655988 3027022 88129005 79145132 8983873 X true true 1 1 SKAGGS COMMUNITY HEALTH CENTER 251 SKAGGS ROAD BRANSON MO 65616 WWW.SKAGGS.NET 52-57 X X X SKAGGS COMMUNITY HEALTH CENTER 1 false false true X X X X X X X X X 15 true true true true X SEE PART V, SECTION C X SEE PART V, SECTION C X X true 15 true SEE PART V false true X 0. 300. X X X X X X true true X X X X true X SEE PART V X SEE PART V X SEE PART V X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: 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: (A) The Center for Health Improvement (CHI) employs a skilled team of healthcare professionals who provide support and education for chronic disease management. They provide tools designed to increase self-management of chronic conditions including diabetes, chronic pain, weight loss, and more. (B) The experts at CHI collaborate with all campuses, including CMCB, to coordinate services and ensure consistency among materials and education provided. Additionally, the staff floats from campus to campus serving as a resource and maintaining an ongoing presence. (C) CHI provides instruction, resources, and help to those living with ongoing health challenges such as arthritis, asthma, chronic pain, fibromyalgia, weight issues, diabetes, and heart disease. Classes offered to the community cover a wide variety of topics and accommodate all age groups. 2. Reduce avoidable hospital readmissions (A) CoxHealth implemented a Patient Readmission Interview form to identify common themes for avoidable readmissions. When a patient is readmitted within thirty days, a case manager meets with the patient to discuss the readmission. Topics covered include quality of 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 primary care provider being scheduled and attended; and reasons for readmission from the patients perspective. (B) The Care Management Team has been instrumental in setting up follow-up appointments with patients. They are working to expand their services to ensure even more patients have a follow-up appointment scheduled before leaving the hospital. Transitional Care Pharmacists work with patients being discharged to ensure the patient leaves the hospital with their medications. (C) The Health Guides program was made possible by a Skaggs Legacy Endowment grant. Through community collaboration, Health Guides improves access to healthcare for uninsured residents of Stone and Taney counties by using Community Health Workers (CHWs) to help people overcome barriers to receiving needed care. CHWs connect people to health and social services to improve health outcomes, access, and quality of care. Health Guides expects to impact 530 uninsured and underinsured residents of Stone and Taney counties who have a history of chronic illness, have used the emergency department multiple times throughout the year, and have complex social issues that affect their health and ability to access care. Health Guides participants will be able to better manage their health and have fewer barriers to actualizing care. This collaboration will work toward creating a sustainable model for lasting change in the Tri-Lakes area. 3. Increase access to tobacco cessation resources for patients and families presenting to our hospitals and clinics: (A) The Tobacco Free Council, a group of subject matter experts from across the CoxHealth enterprise, was reinstated with the goal of developing a coordinated, evidence-based approach to improve access to tobacco cessation resources. (B) Through a Missouri Foundation for Health grant, CMCB continues to provide community support and resources for tobacco cessation. CMCBs dedicated, certified tobacco educator recently attended the UMass "Train the Trainer in Tobacco Treatment" program. This will allow him to provide a curriculum approved by the Association for the Treatment of Tobacco Use and Dependence (ATTUD) locally for individuals who wish to be trained in tobacco cessation treatment. Increasing the number of trained individuals will allow improved capacity within the community to offer cessation counseling. (C) As the two-year anniversary mark approaches, the City of Branson continues to benefit from the passage of the Comprehensive Smoke-free Ordinance. The success in Branson was recently highlighted at a meeting of the newly formed Regional Tobacco Collaborative. During this meeting, members of the local smoke-free coalition, Tri-Lakes Clean Air Alliance (TLCAA), were joined by likeminded groups from southwest Missouri including health departments, health systems, and advocacy organizations. (D) Influenced by the local coalitions success in facilitating the passage of the smoke-free ordinance, TLCAA announced that the Americans for Nonsmokers Rights groups would be hosting their "Clearing the Air Institute" meeting in Branson in May 2018. (E) TLCAA hosted a training session of the "Adolescent Cessation in Every School" (ACES) program featuring Jenna Wintemberg of the University of Missouri. Local school superintendents also received an introduction to the ACES program and toolkit booklets were provided. Community educators are reaching out to schools to assist with implementation plans. (F) Year-over-year participation and quit rates continues to increase. To date, 355 individuals have enrolled in cessation classes since the start of the program. Current participation has resulted in a 79% quit rate for those who complete all sessions of the cessation classes. To increase participation further by alleviating financial barriers, a sliding scale fee continues to be used and additional approaches are being explored. (G) Tobacco Kick Butt pickup events were held Branson West and Forsyth. During the Forsyth Butt Pickup event, the City Supervisor stopped to engage with volunteers, and an informational packet was delivered to the Public Works office. 4. Decrease childhood obesity: (A) CMCBs registered dietitians are available to work with children and their families to educate on the importance of healthy diets and good nutrition. They emphasize that maintaining a good diet and fit body during childhood can decrease the chance of developing chronic diseases later in life. (B) Professionals at CoxHealths Center for Health Improvement collaborate with all campuses, including CMCB, to coordinate nutrition services and ensure consistency among materials and education provided. Additionally, the staff floats from campus to campus serving as a resource and maintaining an ongoing presence. (C) Although intentions are admirable, people often donate unhealthy, high-sugar, high-sodium foods. As the number of people across the Ozarks relying on food pantries to meet their daily needs increases, CMCB is proud to participate in the Healthy Food Drive. This collaboration between CoxHealth and community partners aims to fill local pantries with foods that are low in sugar, salt, and fat. Bransons food donations are sent to pantries operated by Christian Action Ministries to provide a selection of healthy, nutritious food for area children and families. 5. Increase the number of women who breastfeed their infants after delivery: (A) In addition to breastfeeding classes led by certified lactation consultants, CMCB has launched a new program for moms-to-be that blends a medical checkup with an emotional tune-up. Centering Pregnancy, a pilot group program for prenatal care, is a national program that came to Branson in June 2016 through funding from the March of Dimes and Skaggs Foundation. This innovative model for providing complete prenatal care within a group setting is guided by a physician, registered nurse, and lactation specialist who challenge the moms to open up about issues such as breastfeeding versus formula feeding. For 10 sessions, a group of 8-10 expectant moms can skip the waiting room and have appointments the same day and time each month in support-group style. They discuss everything from labor and nutrition to exercise and breastfeeding. They also receive private, one-on-one time with the physician for physical checkups. 6. Increase referrals to community oral health resources for patients presenting to the ED for dental issues: (A) Community partnerships with local resources have been strengthened and refined to ensure staff feel empowered to refer patients to facilities like Jordan Valley Hollister for the right level of care for oral health issues. When evaluating the chief complaints of patients that presented to the CMCB Emergency Department (ED) five or more times in a 12-month period for non-emergent care, dental issues was one of the highest. Grant funding awarded by the Missouri Foundation for Health allowed for the creation of a 0.5 FTE social worker position for the CMCB ED. Protocols were developed for patients that present with complaints of 'tooth pain' in the ED. After the medical screening exam is completed, the patient is referred to Jordan Valley Hollister for dental care. Quick access to the dental clinic allowed has CoxHealth ED physicians to discontinue prescribing narcotics to patients who presented with tooth pain. SCHEDULE H, PART V, SECTION B, LINE 13A ELIGIBILITY FOR FREE CARE: IN GENERAL, THE ORGANIZATION'S CHARITY CARE POLICY DOES NOT PROVIDE FOR DISCOUNTS OF 100%. THEREFORE, IT IS EXPECTED THAT THE PATIENT OR GUARANTOR WILL HOLD A RESPONSIBILITY FOR PAYMENT OF AT LEAST A PORTION OF THE SERVICES, REGARDLESS OF THE LEVEL OF ELIGIBILITY. IT IS OUR INTENTION TO WORK WITH INDIVIDUALS ON THEIR OUT-OF-POCKET RESPONSIBILITY TO ESTABLISH FEASIBLE MONTHLY PAYMENTS WHEN NECESSARY. IN THE EVENT THAT A PATIENT OR GUARANTOR IS DETERMINED TO HAVE NO MEANS OF PAYING THE AMOUNT INDICATED AS THEIR RESPONSIBILITY DUE TO EXTENUATING CIRCUMSTANCES, CONSIDERATION MAY BE GIVEN TO WAIVING DEDUCTIBLES AND/OR INCREASING THE DISCOUNT AMOUNT UP TO A 100% DISCOUNT OF THE PATIENT PORTION. THESE EXTENUATING CASES ARE SUBJECT TO THE DISCRETION AND APPROVAL OF THE PFS DIRECTOR AND/OR THE CHIEF FINANCIAL OFFICER WITHIN THE APPROVAL LIMITS DEFINED AT THE END OF THE POLICY. SCHEDULE H, PART V, SECTION B, LINE 13H OTHER CRITERIA USED TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY: MEDICAL HARDSHIP MAY ALSO BE USED TO DETERMINE FINANCIAL ELIGIBILITY. COXHEALTH SHALL MAKE A DECISION ABOUT A PATIENT/GUARANTOR'S MEDICAL HARDSHIP BY REVIEWING THE FINANCIAL ASSISTANCE APPLICATION, INCLUDING ACCOMPANYING FINANCIAL DOCUMENTATION, IN ADDITION TO OTHER RELEVANT DOCUMENTATION THAT SUPPORTS THE MEDICAL HARDSHIP OF THE PATIENT. SCHEDULE H, PART V, SECTION B, LINE 16A FINANCIAL ASSISTANCE POLICY AVAILABILITY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, SECTION B, LINE 16B FINANCIAL ASSISTANCE POLICY APPLICATION FORM AVAILABILITY: THE FINANCIAL ASSISTANCE POLICY APPLICATION FORM IS AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, SECTION B, LINE 16C FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY AVAILABILITY: THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, SECTION B, LINE 16I MEASURES TO PUBLICIZE THE POLICY: FINANCIAL ASSISTANCE AVAILABILITY IS FURTHER PUBLICIZED BY INCLUSION OF NOTICES IN PATIENT BILLS AND BY POSTINGS IN ADMISSION OFFICES AND OTHER AREAS WITHIN THE HOSPITAL ADMITTING LOCATIONS. SCHEDULE H, PART V, SECTION B, LINE 22D DETERMINATION OF MAXIMUM CHARGES TO FAP-ELIGIBLE INDIVIDUALS: AMOUNTS GENERALLY BILLED WILL BE CALCULATED UTILIZING THE LOOK BACK METHOD. THIS IS A PERCENTAGE CALCULATED NO LESS FREQUENTLY THAN ANNUALLY BY DIVIDING THE SUM OF COMMERCIAL AND MEDICARE CLAIMS PAID TO THE HOSPITAL FACILITY BY THE SUM OF THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS. COX WILL MAKE THIS CALCULATION ON OR ABOUT AUGUST 15TH OF EACH YEAR AND BEGIN APPLYING ITS AGB PERCENTAGE(S) BY OCTOBER 1ST. FAP ELIGIBLE INDIVIDUALS WILL NOT BE CHARGED MORE THAN THE AMOUNTS GENERALLY BILLED (AGB) FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. 22 SKAGGS ORTHONEURO CENTER 101 CAHILL RD BRANSON MO 65616 OUTPATIENT DEPTS PHYSICIAN CLINICS CMCB OUTPATIENT CENTER 545 N BRANSON LANDING BLVD BRANSON MO 65616 OUTPATIENT DEPTS PHYSICIAN CLINICS MARY'S WELL HOUSE 5136 HWY 265 BRANSON MO 65616 PHYSICIAN CLINIC CMCB HEART CENTER 1150 STATE HWY 248 SUITE 202 BRANSON MO 65616 CLINIC COXHEALTH HOSPITALIST 525 BRANSON LANDING BLVD BRANSON MO 65616 CLINIC FDC UROLOGYGI 525 BRANSON LANDING BLVD BRANSON MO 65616 CLINIC COXHEALTH FAMILY MEDICINE & OB 525 BRANSON LANDING BLVD BRANSON MO 65616 CLINIC COXHEALTH FAMILY MEDICINE 248 1150 STATE HWY 248 SUITE 202 BRANSON MO 65616 CLINIC COXHEALTH FORSYTH 13852 US HWY 160 FORSYTH MO 65653 CLINIC COXHEALTH KIMBERLING CITY 2 KIMBERLING BLVD KIMBERLING CITY MO 65686 CLINIC COXHEALTH GENERAL SURGERY 525 BRANSON LANDING BLVD BRANSON MO 65616 CLINIC COXHEALTH DIABETES & ENDOCRINOLOGY 1150 HWY 248 SUITE 312 BRANSON MO 65616 CLINIC COXHEALTH INTERN MEDINFECTIOUS DISEASE 525 BRANSON LANDING BLVD BRANSON MO 65616 CLINIC COXHEALTH ORTHOPEDICS 121 CAHILL ROAD SUITE 206 BRANSON MO 65616 CLINIC COXHEALTH PAIN 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 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 $19,655,988. 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 $7,499,649. 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. (C) COX PROHIBITS ENGAGING IN COLLECTION ACTIVITY IN THE EMERGENCY AND URGENT CARE DEPARTMENTS FROM INDIVIDUALS SEEKING EMERGENT OR URGENT MEDICAL CARE BEFORE THE INDIVIDUAL HAS BEEN TRIAGED AND SEEN BY A LICENSED PHYSICIAN, NURSE PRACTITIONER OR PHYSICIAN ASSISTANT. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: 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. true SKAGGS FOUNDATION PO BOX 650 BRANSON MO 65616 300107007 501(C)(3) 71500 SUPPORT COLLEGE OF THE OZARKS 1 OPPORTUNITY AVE POINT LOOKOUT MO 65726 440556862 501(C)(3) 30000 SUPPORT THE CARING PEOPLE 1338 E KINGSLEY SPRINGFIELD MO 65804 431748286 501(C)(3) 15000 SUPPORT 4 PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S.: THE HOSPITAL MONITORS THE USE OF THE FUNDS DONATED TO SKAGGS FOUNDATION BY REVIEWING THE EXPENSES INCURRED BY THE FOUNDATION ON A MONTHLY BASIS TO ENSURE THE FUNDS WERE PROPERLY DISTRIBUTED AND USED FOR THE INTENDED PURPOSE. THE FUNDS ARE USUALLY USED TO PURCHASE EQUIPMENT FOR THE HOSPITAL. X X X X X true true false false false false false false false WILLIAM MAHONEY PRESIDENT 448620 0 52280 0 6938 0 56976 0 14271 0 579085 0 0 0 DAVID STRONG CFO 257948 0 30049 0 6948 0 38588 0 14274 0 347807 0 0 0 CHAD EFIRD PHYSICIAN 1109548 0 0 0 280 0 23935 0 14200 0 1147963 0 0 0 NARIN ARUNAKUL PHYSICIAN 962399 0 0 0 717 0 31250 0 14272 0 1008638 0 0 0 MITTIE DRAGOSLJVICH PHYSICIAN 603926 0 0 0 2370 0 13250 0 14621 0 634167 0 0 0 PRASER VIJITBENJARONK PHYSICIAN 617890 0 0 0 660 0 31250 0 14263 0 664063 0 0 0 CHARLIE RASMUSSEN PHYSICIAN 565367 0 0 0 312 0 30985 0 14205 0 610869 0 0 0 CAROL MARTIN VP ADMINISTRATION END 05/2016 133416 0 11142 0 88892 0 28704 0 7291 0 269445 0 0 0 BRIAN CLONTS MD CMO 501101 0 62419 0 1268 0 13250 0 14438 0 592476 0 0 0 LYNNE YAGGY CNO 177480 0 10575 0 717 0 7803 0 14238 0 210813 0 0 0 JACOB MCWAY DIRECTOR 0 543290 0 117120 0 109224 0 125251 0 14230 0 909115 0 100511 STEVE EDWARDS DIRECTOR 0 936243 0 265782 0 153918 0 245648 0 14271 0 1615862 0 147034 HOLLY WHERRY DIRECTOR 352861 0 0 0 0 0 0 0 6800 0 359661 0 0 0 CHARITY ELMER DIRECTOR 0 396518 0 47133 0 7769 0 79953 0 14205 0 545578 0 0 SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENT: THE ORGANIZATION MADE A SEVERANCE PAYMENT TO CAROL MARTIN IN THE AMOUNT OF $86,380. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: STEVE EDWARDS AND JACOB MCWAY PARTICIPATE IN A 457(F) NONQUALIFIED RETIREMENT PLAN THROUGH LESTER E. COX MEDICAL CENTERS, A RELATED ORGANIZATION. - STEVE EDWARDS RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $232,398. - STEVE EDWARDS RECEIVED A 457(F) DISTRIBUTION OF $147,034, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - JACOB MCWAY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $94,266. - JACOB MCWAY RECEIVED A 457(F) DISTRIBUTION OF $100,511, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. LAKES REGION IMAGING LLC SEE PART V 78988 PURCHASED SERVICES false SCHEDULE L, PART IV, COLUMN B TRANSACTIONS WITH INTERESTED PERSONS: (1) ANTHONY WHEELER, A BOARD MEMBER OF COX MEDICAL CENTER BRANSON, IS A 50% OWNER OF LAKES REGION IMAGING, LLC. FORM 990, PART I, LINE 1 ORGANIZATION'S MISSION: VISION: THE HOSPITAL'S VISION IS TO BE THE BEST FOR THOSE WHO NEED US. WE VALUE SAFETY, COMPASSION, RESPECT AND INTEGRITY. THE HOSPITAL HAS BEEN SERVING SOUTHWEST MISSOURI FOR MORE THAN 65 YEARS AND OFFERS OVER 25 MAJOR SERVICE AREAS. THE HOSPITAL'S AVERAGE DAILY PATIENT CENSUS EXCEEDS 80 PATIENTS WITH 157 LICENSED HOSPITAL BEDS. A STAFF OF OVER 1,100 PERSONNEL OPERATE THE HOSPITAL AND ITS NUMEROUS CLINICS. FORM 990, PART III, LINE 4A PROGRAM SERVICE ACHIEVEMENT #1: iVantage Health Analytics recognized Cox Medical Center Branson for overall excellence in outcomes among all acute care hospitals in the nation, and as one of seven rural Missouri hospitals for Excellence in Quality, according to its Hospital Strength INDEX. Cox Medical Center Branson each received a 4-star rating from Hospital Compare Star Ratings, as determined by quality, safety and patient experience data reported to the Centers for Medicare & Medicaid Services. Cox Medical Center Branson received high patient safety and patient outcomes scores from Consumer Reports. Cox Medical Center Branson is among a select few health systems in the nation to receive the American Heart Association/American Stroke Association's Get with the Guidelines - Stroke Gold Plus Performance Achievement Award. Cox Medical Center Branson has been named to the Target: Stroke Honor Roll Elite list. Cox Medical Center Branson is a Level 2 Stroke Center. Cox Medical Center Bransons implemented Catering Pregnancy - a pilot group program for prenatal care. The national program came to Branson in June 2016 through funding from the March of Dimes and Skaggs Foundation. The concept of Centering Pregnancy is a model of care that looks a lot different from traditional prenatal visits, which are often brief and one-on-one with a womans healthcare provider. In the new program, expectant moms skip the waiting room and have appointments the same day and time each month in support-group style. The open forum allows moms to support each other by sharing their pregnancy worries and excitement. FORM 990, PART IV, LINE 24A TAX EXEMPT BONDS: LESTER E. COX MEDICAL CENTERS, A RELATED ORGANIZATION, REPORTS BONDS RELATED TO COX BRANSON ON ITS FORM 990, SCHEDULE K. AN ALLOCATION OF COX BRANSON'S PORTION OF RELATED BONDS IS REPORTED ON PART X, LINE 20. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES TO ORGANIZATION'S BYLAWS: THE ORGANIZATION'S BYLAWS WERE AMENDED TO REFLECT THE FOLLOWING CHANGES: - THE ORGANIZATION'S ADDRESS WAS CHANGED FROM 251 SKAGGS ROAD TO 525 BRANSON LANDING. - DUE TO A CHANGE IN THE LESTER E. COX MEDICAL CENTER (MEMBER) BOARD REQUIREMENTS, THE ORGANIZATION ONLY HAS ONE REPRESENTATIVE ON THE MEMBER BOARD. THEREFORE THE ORGANIZATION'S BYLAWS WERE UPDATED TO RECOGNIZE THAT A SECOND DIRECTOR OF THE BOARD MAY ATTEND MEMBER BOARD MEETINGS AS A NON-VOTING OBSERVER. - THE SECRETARY OF THE BOARD POSITION IS NOW FULFILLED BY AN EMPLOYEE OF THE ORGANIZATION RATHER THAN A DIRECTOR OF THE BOARD AND THEREFORE WILL NO LONGER BE A MEMBER OF THE EXECUTIVE COMMITTEE. AN AT LARGE MEMBER WILL FILL THE VACATED SPOT ON THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS: THE ORGANIZATION HAS ONLY ONE MEMBER - LESTER E COX MEDICAL CENTERS. FORM 990, PART VI, SECTION A, LINE 7A MEMBER'S POWER TO ELECT GOVERNING BODY: THE BOARD SHALL BE ELECTED BY THE MEMBER. NO LATER THAN SEPTEMBER 1 OF EACH YEAR, THE BOARD SHALL NOMINATE A SLATE OF PERSONS FOR ELECTION AS COX BRANSON DIRECTORS AND OFFICERS TO SUBMIT TO THE LESTER E. COX MEDICAL CENTERS BOARD FOR APPOINTMENT. THE LESTER E. COX MEDICAL CENTERS BOARD WILL ACT IN GOOD FAITH AND NOT UNREASONABLY WITHHOLD APPOINTMENT. IF FOR ANY REASON A NOMINATED PERSON IS NOT APPOINTED BY THE LESTER E. COX MEDICAL CENTERS BOARD, THE BOARD HAS THE RIGHT TO NOMINATE ANOTHER PERSON FOR CONSIDERATION. FORM 990, PART VI, SECTION A, LINE 7B GOVERNANCE DECISIONS RESERVED TO MEMBERS: THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE SOLELY AND SPECIFICALLY RESERVED TO THE MEMBER; A. ELECTION, APPOINTMENT AND REMOVAL OF COX BRANSON BOARD OF DIRECTORS ("BOARD") AFTER NOMINATION BY THE BOARD; B. APPOINTMENT AND REMOVAL OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF COX BRANSON ("PRESIDENT AND CEO OF COX BRANSON") AFTER RECOMMENDATION BY/CONSULTATION WITH THE BOARD; C. APPROVAL OF COX BRANSON'S UNBUDGETED DEBT AND CAPITAL EXPENDITURES EXCEEDING $250,000; D. APPROVAL OF COX BRANSON'S OPERATING AND CAPITAL BUDGETS AND FINANCIAL REPORTS, MERGERS, CONSOLIDATIONS, ACQUISITIONS, AFFILIATIONS, AND REORGANIZATION OR DISPOSITION OF ASSETS EXCEEDING THE THEN FAIR VALUE OF $250,000; E. AMENDMENT, REPEAL OR ADOPTION OF COX BRANSON'S ARTICLES OF INCORPORATION AND BYLAWS EXCEPT AS OTHERWISE PROVIDED IN THE BYLAWS. FINAL DECISIONS MADE BY THE BOARD OF THE DIRECTORS MUST ALSO BE APPROVED BY THE LESTER E. COX MEDICAL CENTERS BOARD AS WELL. THE MEMBER SHALL NOT EXERCISE ITS POWERS WITHOUT FIRST OBTAINING APPROVAL FROM TWO-THIRDS (2/3) MAJORITY OF THE BOARD IN THE FOLLOWING CIRCUMSTANCES: A. TRANSFER ANY OF ITS COX BRANSON MEMBERSHIP TO ANY OTHER ENTITY; B. SELL OR LEASE ALL OR SUBSTANTIALLY ALL OF COX BRANSON'S ASSETS; AND C. ENTER INTO A MANAGEMENT AGREEMENT FOR ALL OR SUBSTANTIALLY ALL OF COX BRANSON'S OPERATION. THE MEMBER MAY NOT TERMINATE OR SUBSTANTIALLY LIMIT THE FOLLOWING COX BRANSON SERVICE LINES WITHOUT FIRST OBTAINING APPROVAL FROM TWO-THIRDS (2/3) MAJORITY OF THE BOARD: EMERGENCY DEPARTMENT, CARDIOLOGY, ORTHOPEDICS, PRIMARY CARE, RADIATION AND MEDICAL ONCOLOGY, RADIOLOGY, PATHOLOGY, ANESTHESIA, GENERAL SURGERY, ICU, MEDICAL/SURGICAL SERVICES, ACUTE REHABILITATION SERVICES, WOMEN'S HEALTH SERVICES, GERIATRICS, NEUROSCIENCES, PAIN MANAGEMENT, PSYCHIATRY, UROLOGY AND ENDOCRINOLOGY. NOTWITHSTANDING THE ABOVEMENTIONED LIMITATION, THESE SERVICE LINES MAY BE TERMINATED OR SUBSTANTIALLY LIMITED BY THE MEMBER WITHOUT TWO-THIRDS (2/3) MAJORITY OF THE COX BRANSON BOARD IF (I) THERE IS A LOSS OF A LICENSE OR ACCREDITATION REQUIRED TO MAINTAIN SUCH SERVICE, OR A LOSS OF MEDICARE OR MEDICAID CERTIFICATION REQUIRED FOR SUCH SERVICE, IN EACH CASE, OTHER THAN DUE TO THE ACTIONS OR INACTIONS OF THE MEMBER OR COX BRANSON OR (II) THERE IS DESTRUCTION OR MATERIAL DAMAGE TO A FACILITY (PENDING THE PERFORMANCE OR REPAIR OR REPLACEMENT EFFORTS). FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. A DRAFT VERSION OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO SUBMISSION. WHILE THE DRAFT IS PROVIDED TO ALL BOARD MEMBERS, IT IS THE MEMBERS OF THE FINANCE COMMITTEE THAT GO THROUGH AND REVIEW THE RETURN IN DETAIL. UPON RECEIVING THE APPROVAL OF THE BOARD OF DIRECTORS, THE DRAFT IS THEN FINALIZED AND SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: DIRECTORS AND COMMITTEE MEMBERS SHALL FILE A DISCLOSURE STATEMENT ANNUALLY WITH THE PRESIDENT AND CEO OF COX BRANSON OR HIS/HER DESIGNEE, WHICH DOCUMENT SHALL BE DISCLOSED TO THE BOARD AND THE AUDIT AND COMPLIANCE COMMITTEE OF THE MEMBER. DIRECTORS AND COMMITTEE MEMBERS SHALL INFORM THE BOARD OR COMMITTEE, AS THE CASE MAY BE, OF ANY DUALITY OF INTEREST OR ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN ANY MATTER UNDER CONSIDERATION. SUCH PERSON SHALL NEITHER VOTE NOR USE HIS/HER INFLUENCE TO AFFECT THE DECISION ON THE MATTER, AND SHALL NOT BE COUNTED IN DETERMINING WHETHER A QUORUM PARTICIPATED IN THE DECISION, EVEN WHEN PERMITTED BY LAW. THE MINUTES OF THE MEETING SHALL REFLECT THE DISCLOSURE, ABSTENTION FROM VOTING, AND QUORUM STATUS. NOTHING HEREIN PREVENTS THE BOARD FROM AUTHORIZING, APPROVING OR RATIFYING A BUSINESS RELATIONSHIP OR REACHING A CONCLUSION ON AN ISSUE DESPITE A CONFLICT OF INTEREST OR DUALITY OF INTEREST, SO LONG AS THE PROCEDURES DESCRIBED IN THE BYLAWS ARE FOLLOWED. DISCUSSION: THE PROCEDURES ABOVE SHALL NOT PREVENT THE DIRECTOR OR COMMITTEE MEMBER FROM BRIEFLY STATING HIS/HER POSITION ON THE MATTER, OR FROM ANSWERING PERTINENT QUESTIONS ABOUT IT, IF THE DUTIES SET FORTH HEREIN ARE SUBJECT TO THE RESERVED POWERS OF THE MEMBER'S KNOWLEDGE OR EXPERTISE COULD ASSIST THOSE PARTICIPATING IN THE DECISION. ALL DIRECTORS SHALL BE INFORMED OF THIS ARTICLE BY THE PRESIDENT AND CEO OF COX BRANSON UPON TAKING OFFICE. VOTING: DIRECTORS AND COMMITTEE MEMBERS SHALL INFORM THE BOARD OR COMMITTEE, AS THE CASE MAY BE, OF ANY DUALITY OF INTEREST OR ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN ANY MATTER UNDER CONSIDERATION. SUCH PERSON SHALL NEITHER VOTE NOR USE HIS/HER INFLUENCE TO AFFECT THE DECISION ON THE MATTER, AND SHALL NOT BE COUNTED IN DETERMINING WHETHER A QUORUM PARTICIPATED IN THE DECISION, EVEN WHEN PERMITTED BY LAW. THE MINUTES OF THE MEETING SHALL REFLECT THE DISCLOSURE, ABSTENTION FROM VOTING, AND QUORUM STATUS. NOTHING HEREIN PREVENTS THE BOARD FROM AUTHORIZING, APPROVING OR RATIFYING A BUSINESS RELATIONSHIP OR REACHING A CONCLUSION ON AN ISSUE DESPITE A CONFLICT OF INTEREST OR DUALITY OF INTEREST, SO LONG AS THE PROCEDURES DESCRIBED IN THIS ARTICLE ARE FOLLOWED. THE POLICY ABOVE SHALL NOT PREVENT THE DIRECTOR OR COMMITTEE MEMBER FROM BRIEFLY STATING HIS/HER POSITION ON THE MATTER, OR FROM ANSWERING PERTINENT QUESTIONS ABOUT IT, IF THE DUTIES SET FORTH HEREIN ARE SUBJECT TO THE RESERVED POWERS OF THE MEMBER'S KNOWLEDGE OR EXPERTISE COULD ASSIST THOSE PARTICIPATING IN THE DECISION. NOTICE: ALL DIRECTORS SHALL BE INFORMED OF THIS ARTICLE BY THE PRESIDENT AND CEO OF COX BRANSON UPON TAKING OFFICE. FORM 990, PART VI, SECTION B, 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 AND JACOB MCWAY ARE OFFICERS OF LESTER E. COX MEDICAL CENTERS, A RELATED ORGANIZATION, AS WELL AS MEMBERS OF THE COX BRANSON BOARD OF DIRECTORS. CHARITY ELMER IS A KEY EMPLOYEE OF COXHEALTH, A RELATED ORGANIZATION, AS WELL AS A MEMBER OF THE COX BRANSON BOARD OF DIRECTORS. THEIR COMPENSATION IS PAID BY LESTER E. COX MEDICAL CENTERS FOR SERVICES PERFORMED RELATED TO THEIR ROLES AS OFFICERS. HOLLY WHERRY IS AN EMPLOYEE OF COX BRANSON AS WELL AS A MEMBER OF THE BOARD OF DIRECTORS. HER COMPENSATION IS RELATED TO HER ROLE AS AN EMPLOYEE. NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS BOARD MEMBERS. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES: OTHER FEES FOR SERVICES ARE COMPRISED OF THE FOLLOWING CATEGORIES: $14,986,195 CONTRACTED LABOR 19,941,608 OTHER CONTRACTED SERVICES 246,916 CONTRACTED CONSULTING SERVICES 311,202 CONTRACTED COLLECTION AGENCY 284,425 CONTRACTED LAB SERVICES 597 CONTRACTED TRANSCRIPTION SERVICES 265,755 CONTRACTED HOUSEKEEPING 71,814 CONTRACTED COURIER SERVICES 1,059,047 CONTRACTED BILLING SERVICES 750,676 CONTRACTED RADIOLOGY SERVICES 449,468 CONTRACTED LAUNDRY SERVICES ----------- $38,367,703 FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ 2,305,530 CHANGE IN INVESTMENT IN SKAGGS FOUNDATION 351,840 CHANGE IN BENEFICIAL INTEREST IN TRUST ----------- $ 2,657,370 SKAGGS EMERGENCY PHYSICIANS PO BOX 650 BRANSON MO 65615 352275232 BILLING MO 0 0 CMCB BRANSON HEART CENTER PO BOX 650 BRANSON MO 65615 300497209 BILLING MO 0 0 CMCB SKAGGS OCCUPATIONAL HEALTH PO BOX 650 BRANSON MO 65615 383774737 BILLING MO 0 0 CMCB BRANSON FAMILY MEDICINE CLINIC PO BOX 650 BRANSON MO 65615 322331834 BILLING MO 0 0 CMCB BRANSON ORTHONEURO CENTER LLC PO BOX 650 BRANSON MO 65615 171952089 MED BLDG MO 0 0 CMCB COX ALTERNATIVE CARE OF THE OZARKS INC PO BOX 10939 SPRINGFIELD MO 65808 431641925 HOME HEALTH MO 501(C)(3) 9 LESTER E COX false COXHEALTH FOUNDATION 3525 S NATIONAL SUITE 204 SPRINGFIELD MO 65807 436810485 FUNDRAISING MO 501(C)(3) 11 A I LESTER E COX false COXHEALTH HOME CARE SVCS OF THE MIDWEST PO BOX 10939 SPRINGFIELD MO 65808 264781194 HOME HEALTH MO 501(C)(3) 9 LESTER E COX false COX HPS OF THE OZARKS INC 2220 W SUNSET SPRINGFIELD MO 65807 431641927 HOME HEALTH MO 501(C)(3) 9 LESTER E COX false COX-MONETT HOSPITAL INC 801 LINCOLN AVE MONETT MO 65708 431656689 HOSPITAL MO 501(C)(3) 3 LESTER E COX false COX-MONETT HOSPITAL AUXILIARY 801 LINCOLN AVE MONETT MO 65708 431852817 FUNDRAISING MO 501(C)(3) 9 LESTER E COX false HEALTH ENRICHMENT SERVICES INC 3801 S NATIONAL SPRINGFIELD MO 65807 363263313 MED 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) 9 LESTER E COX false PRIMROSE PLACE INC 1115 E PRIMROSE SPRINGFIELD MO 65807 431183783 SUPPORT MO 501(C)(3) 11 A I LESTER E COX false COXHEALTH AUXILIARY 3801 S NATIONAL SPRINGFIELD MO 65807 431090590 SUPPORT MO 501(C)(3) 9 LESTER E COX false COX MEDICAL CTR GENPROF LIAB LOSS FUND 1423 N JEFFERSON SPRINGFIELD MO 65802 366668576 SELF-INSURAN MO 501(C)(3) 11 A I LESTER E COX false LESTER E COX MEDICAL CENTERS 1423 N JEFFERSON ST SPRINGFIELD MO 65802 440577118 HOSPITAL MO 501(C)(3) 3 COXHEALTH false COXHEALTH 1423 N JEFFERSON ST SPRINGFIELD MO 65802 471087427 HOLDING CO MO 501(C)(3) 11 B II NA false COX MEDICAL GROUP 1423 N JEFFERSON ST SPRINGFIELD MO 65802 411087566 PHYSICIANS MO 501(C)(3) 9 COXHEALTH false COX HEALTH SYSTEMS HMO INC PO BOX 5750 SPRINGFIELD MO 658015750 431757075 HMO MO 501(C)(4) LESTER E COX false 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) 9 COXHEALTH false COX HEALTH SYSTEMS INSURANCE COMPANY PO BOX 5750 SPRINGFIELD MO 65801 431684044 INSURANCE MO 501(C)(4) LESTER E COX false MEDICAL DEVELOPMENTS INC 1423 N JEFFERSON AVE SPRINGFIELD MO 65802 431622182 PHARMACY MO LESTER E COX C CORP false INSURANCE COMPANY OF SPRINGFIELD INC GRAND PAVILION CORPORATE CENTRE GRAND CAYMAN CJ CAPTIVE INSURANCE MO LESTER E COX C CORP false COX TAXABLE CLOSE CORPORATION 1423 N JEFFERSON SPRINGFIELD MO 65802 472573263 MEDICAL CLINIC MO COX MED GROUP C CORP false FERRELL-DUNCAN CLINIC INC 1001 E PRIMROSE SPRINGFIELD MO 65808 430991578 PHYSICIANS MO CTCC C CORP false false false true false false false false false false false true false false false false true true false true