2016-08-11T14:14:34-05:00 2015-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2014-10-01 440577118 LESTER E COX MEDICAL CENTERS % JACOB M MCWAY LEST 4172693000 1423 N JEFFERSON ST SPRINGFIELD MO 65802 JACOB MCWAY CFO 4172693000 2016-08-05 true Brian D Todd P00422601 4178658701 2014 2016-12-15 16:53:06Z STEVE EDWARDS 1423 N JEFFERSON ST SPRINGFIELD MO 65802 1243742703 false X WWW.COXHEALTH.COM X 1923 MO THE ORGANIZATION PROVIDES QUALITY HEALTH CARE, EDUCATION AND RESEARCH IN ORDER TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES. 13 10 8701 15 2829928 250245 2509785 2611043 1031461157 1044032909 39434234 17673354 10587729 -10713627 1083992905 1053603679 1591995 1085920 0 0 405590091 388201252 0 0 638002 613841869 634962000 1021023955 1024249172 62968950 29354507 1403872850 1420537175 729411456 756535309 674461394 664001866 X MISSION: TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH QUALITY HEALTH CARE, EDUCATION AND RESEARCH. false false 673211446 732310432 HOSPITAL SERVICES: AS A COMMUNITY OWNED, NON-PROFIT HOSPITAL, LESTER E. COX MEDICAL CENTERS PROVIDES THE KIND OF CARE AND PROGRAMS THAT ARE NEEDED TO SERVE MANY OF THE MOST VULNERABLE IN OUR COMMUNITIES - THE UNDERINSURED AND UNINSURED. COMMUNITY BENEFIT TOTALED $143,136,606 SYSTEM-WIDE IN THESE CATEGORIES: SHORT-FALLS IN REIMBURSEMENT AND CHARITY CARE; COMMUNITY OUTREACH SERVICES INCLUDING COMMUNITY EDUCATION, HEALTH SCREENINGS, SUPPORT GROUPS AND IMMUNIZATIONS; HEALTH PROFESSIONALS EDUCATION AND RESEARCH, INCLUDING THE UN-REIMBURSED COST OF COX FAMILY MEDICINE RESIDENCY AND SCHOOLS OF ALLIED HEALTH PROFESSIONS; AND FOUNDATION GRANTS, FINANCIAL CONTRIBUTIONS AND IN-KIND DONATIONS. 221233236 185268189 PHYSICIAN CARE: EMPLOYED PHYSICIANS AT LESTER E. COX MEDICAL CENTERS PLAY AN IMPORTANT ROLE IN ACCESS TO MEDICAL CARE THROUGH THEIR PRACTICE AT RURAL HEALTH CLINICS IN UNDER-SERVED AREAS OF SOUTHWEST MISSOURI. PHYSICIANS WITH COX FAMILY MEDICINE RESIDENCY ARE MAKING A VISIBLE DIFFERENCE IN CARE FOR UNINSURED PATIENTS AS WELL AS PATIENTS COVERED BY MEDICAID. THESE PATIENTS REPRESENT 18% AND 32% PERCENT OF TOTAL PATIENTS SEEN IN THE CLINIC RESPECTIVELY. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 29796528 25978398 HOME CARE: LESTER E. COX MEDICAL CENTERS' HOME CARE SERVICES ARE PROVIDED BY OXFORD HEALTHCARE HOME CARE AND HOSPICE AND COX HOME SUPPORT DURABLE MEDICAL EQUIPMENT. OXFORD STRIVES TO MEET THE HOME CARE AND HOSPICE NEEDS FOR CLIENTS OF ALL AGES. THEIR SERVICES INCLUDE NURSING CARE, MEDICATION SUPERVISION, IV THERAPY, PERSONAL CARE, HOUSEKEEPING, LAUNDRY, MEAL PREPARATION, SHOPPING, ERRANDS, TRANSPORTATION, COMPANIONSHIP, TELEMONITORING AND LIFELINE PERSONAL EMERGENCY RESPONSE SYSTEM. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 30935993 1085920 100475890 955177203 true true false true false false false false false true true false true false true false false true false false true false false false true false true true true true true true false false false false false false false false true true false false false false true true true true true false true 473 0 true 8701 true true true true CJ false false false true true false false false false X 13 10 false false false false true true true true true false false true true true true true true true true false X JACOB M MCWAY 4172698811 3800 S NATIONAL SPRINGFIELD MO 65807 X JAMES HUTCHESON CHAIRMAN OF THE BOARD 1.0 1.0 X X 0 0 0 GRANT HADEN 1ST VICE CHAIRMAN OF THE BOARD 1.0 1.0 X X 0 0 0 JOSEPH TURNER 2ND VICE CHAIRMAN OF THE BOARD 1.0 5.0 X X 0 0 0 DENNIS HEIM 3RD VICE CHAIRMAN OF THE BOARD 1.0 1.0 X X 0 0 0 JACK PRIM BOARD MEMBER 1.0 1.0 X 0 0 0 CHARLES CHALENDER BOARD MEMBER 1.0 1.0 X 0 0 0 PATRICIA DIX MD BOARD MEMBER 40.0 1.0 X 327105 0 39136 JANICE HARRIS BOARD MEMBER 1.0 1.0 X 0 0 0 ROBERT MCDOWELL BOARD MEMBER 1.0 1.0 X 0 0 0 ROBERT FULP BOARD MEMBER 1.0 1.0 X 0 0 0 RONALD PONDS BOARD MEMBER 1.0 1.0 X 0 0 0 DAVID ZOLFAGHARI MD BOARD MEMBER 40.0 1.0 X 0 890181 0 JERRY JARED BOARD MEMBER 1.0 1.0 X 0 0 0 STEVE EDWARDS PRESIDENT AND CEO 20.0 20.0 X 1230233 0 262993 JAKE MCWAY SR VP AND CFO 20.0 20.0 X 726795 0 141589 KATHY RIGGER BOARD SECRETARY 20.0 20.0 X 53124 0 9618 JOHN DUFF MD SR VP CHIEF CORP SVCS END 6/15 20.0 20.0 X 645634 0 51452 RON PRENGER SR VP, CHIEF HOSPITAL OFFICER 40.0 0.0 X 295876 0 71371 CHARITY ELMER SR VP AND GENERAL COUNSEL 20.0 20.0 X 446773 0 97012 ROBERT FERGUSON VP FERRELL DUNCAN CLINIC 40.0 0.0 X 313998 0 23367 DAVID TAYLOR VP REGIONAL SERVICES 40.0 0.0 X 281000 0 27725 JOHN HURSH VP HUMAN RESOURCES END 7/15 20.0 20.0 X 256969 0 43698 RODNEY SCHAFFER VP FACILITIES MANAGEMENT 20.0 20.0 X 236447 0 19251 KAREN KRAMER VP, CNO 40.0 0.0 X 280847 0 43478 BETTY BRESHEARS VP CORPORATE COMPLIANCE 20.0 20.0 X 184603 0 22688 BRUCE ROBISON CIO 20.0 20.0 X 196798 0 23439 FRANK ROMERO VP MEDICAL AFFAIRS BEG 12/14 20.0 20.0 X 407694 0 26854 TIM JONES JOC CHAIR 20.0 20.0 X 348134 0 27301 BOYD CROCKETT MD PHYSICIAN 40.0 0.0 X 647053 0 27301 ARIJIT CHOWDHURY MD PHYSICIAN 40.0 0.0 X 501412 0 27296 CARY MARQUIS MD PHYSICIAN 40.0 0.0 X 526828 0 44825 RUSSELL R BOND JR DO PHYSICIAN 40.0 0.0 X 449306 0 43467 MARTIN JONES MD PHYSICIAN 40.0 0.0 X 447190 0 22101 8803819 890181 1095962 337 false true false BECK KILLIAN A JOINT VENTURE PROJECT MANAGEMENT 42123220 EMERGENCY PHYSICIANS OF SPFD PHYS REMUNERATION 14163211 SPFD NEUROLOGICAL INSTITUTE PHYS REMUNERATION 14119407 OZARK ANESTHESIA ASSOCIATES ANESTHESIA SERVICES 7632169 HC BECK LTD PROJECT MANAGEMENT 4984768 76 89378 35500 2486165 2611043 NET PATIENT SERVICE REVENUE 900099 1012618643 1012618643 NET PATIENT SERVICE - UNRELATED LAB 621500 722263 722263 NET PATIENT SERVICE - UNRELATED RETAIL DME 446199 2107665 2107665 CAFETERIA, MEALS & VENDING 722514 4655697 4655697 FITNESS CENTERS 713940 3095009 3095009 20833632 20833632 1044032909 9686584 9686584 124802 124802 0 1628487 1269953 358534 0 358534 358534 196508027 185797 188748498 83358 7759529 102439 7861968 7861968 22638 89378 37215 -14577 -14577 0 0 LOSS ON INVESTMENT IN EQUITY INVESTEE 900099 -135570 -135570 CHANGE IN INTEREST IN NET ASSETS OF SUBS 900099 13021657 13021657 LOSS ON EXTINGUISHMENT OF DEBT 900099 -23943671 -23943671 -11057584 1053603679 1041202981 2829928 6959727 X 38864 38864 1047056 1047056 0 0 7163002 3118127 4044875 517963 494010 23953 300819607 281969591 18647266 202750 1565537 1550311 6585 8641 55557823 51592009 3950692 15122 22577320 20929215 1648105 0 139883 139883 332798 332798 150283 150283 0 1271944 1271944 237302319 208875833 28318960 107526 585490 515261 70229 15462374 13561268 1855445 45661 11070949 9743003 1327946 0 20792881 20097375 662781 32725 1990568 1751802 238766 0 1613512 1419973 193539 15284936 13943966 1340970 0 32564698 29707613 2856936 149 3880927 3540448 340479 MEDICAL SUPPLIES & DRUGS 148505520 148505520 BAD DEBT 92816355 92816355 STATE PROVIDER TAX 43622370 43622370 LICENSES, DUES, SUBSCRIPTIONS 1255183 1104625 150558 6319010 5232608 860974 225428 1024249172 955177203 68433967 638002 1277135 1246040 146720586 123251896 0 0 131288489 122731108 0 0 0 0 16089046 7616000 11983158 12819630 8318318 12012090 1038690270 609227970 369674109 429462300 474169034 452992941 27271558 29985410 158589886 170997691 25538561 25411228 32952970 32010841 1403872850 1420537175 199881969 213943534 0 0 3551190 4124618 459278000 469838811 0 0 0 0 12038113 10661804 11161029 10678829 43501155 47287713 729411456 756535309 X 634508141 627394433 21021113 18338781 18932140 18268652 674461394 664001866 1403872850 1420537175 X 29354507 -23574803 -16239232 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 112428 false true 37855 150283 false SCHEDULE C, PART II-B, LINE 1G DIRECT CONTACT WITH LEGISLATORS, ETC: THE ORGANIZATION CONTRACTED PENMAN & WINTON CONSULTING GROUP AND KELLER MCINTYRE & ASSOCIATES, LOBBYING AND ASSOCIATION MANAGEMENT FIRMS, TO LOBBY ISSUES THAT BENEFIT THE INTERESTS OF THE COMMUNITY, COXHEALTH AND ITS AFFILIATES. SCHEDULE C, PART II-B, LINE 1I OTHER LOBBYING ACTIVITIES: MEMBERS OF THE ADMINISTRATIVE STAFF CONTACT LEGISLATORS REGARDING KEY HEALTHCARE ISSUES. ALSO, PORTIONS OF DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION ARE USED FOR LOBBYING PURPOSES. IN FISCAL YEAR 2015, THE AMOUNT ATTRIBUTABLE TO LOBBYING WAS $35,495. IN ADDITION, $2,333 OF DUES PAID TO THE SPRINGFIELD AREA CHAMBER OF COMMERCE AND $27 OF DUES PAID TO THE AICPA WERE ATTRIBUTABLE TO LOBBYING. 4800435 486859 149724 22800 303188 5111030 4452776 513875 154886 27000 294102 4800435 4159597 695884 162212 14600 550317 4452776 3887423 527957 162356 48350 369789 4159597 3472905 676849 151329 26610 387050 3887423 1.00000 false true true 26660304 26660304 375597557 169913975 205683582 4848038 3914817 933221 593643063 424166142 169476921 37941308 11233036 26708272 429462300 INT IN NA OF TAX EXEMPT SUBS 170997691 C 170997691 0 INTEREST RATE BASIS SWAP 3278528 EST AMT DUE TO 3RD PARTIES 3664486 SELF INSURANCE CLAIMS PAYABLE 40344699 47287713 924343896 -23574803 -108385640 -131960443 1056304339 -2700660 -2700660 1053603679 931457604 1296731 1296731 930160873 1271944 92816355 94088299 1024249172 SCHEDULE D, PART V, LINE 4 INTENDED USE OF ENDOWMENTS: COXHEALTH FOUNDATION, A RELATED ORGANIZATION, HOLDS 29 ENDOWMENT FUNDS WHICH INCLUDE MONIES DONATED TO BE USED FOR SPECIFIC EXPENSES, AND THE INCOME FROM EACH FUND IS TO BE SPENT ON SPECIFIC SERVICES AND PROGRAM FUNCTIONS ON A FUND-BY-FUND BASIS. ENDOWMENT FUNDS HELD BY THE FOUNDATION ARE INTENDED FOR BUT NOT LIMITED TO EXPENDITURES RELATING TO CANCER SERVICES, HEALTH EDUCATION, PURCHASE OF EQUIPMENT AND INDIGENT CARE. THESE SERVICES AND FUNCTIONS BENEFIT COXHEALTH AND ITS AFFILIATES, AS WELL AS SCHOLARSHIPS FOR INDIVIDUALS PURSUING DEGREES. 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: $ (20,159,031) DEFINED BENEFIT LOSS 1,418,276 NET ASSETS RELEASED FROM RESTRICTION (751,921) RETURN OF CAPITAL (1,271,944) INVESTMENT FEES (92,816,355) BAD DEBT EXPENSE 5,195,335 TRANSFER FROM AFFILIATES ----------------- $ (108,385,640) SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ (3,380,558) CHANGE IN INTEREST OF NET ASSETS OF SUBSIDIARIES 2,018,374 TEMPORARILY RESTRICTED CONTRIBUTIONS 93,615 TEMPORARILY RESTRICTED INVESTMENT RETURN (37,215) SPECIAL EVENTS EXPENSES (1,259,516) RENTAL EXPENSES RECLASSED FROM EXPENSES (135,360) PERMANENTLY RESTRICTED CONTRIBUTIONS -------------- $ (2,700,660) SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 1,259,516 RENTAL EXPENSES RECLASSED FROM EXPENSES 37,215 SPECIAL EVENTS EXPENSES ---------------- $ 1,296,731 SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 92,816,355 BAD DEBT EXPENSE Central America and the Caribbean 1 Program Services CAPTIVE INSURANCE 1202375 Central America and the Caribbean Investments 157409711 1 1 158612086 158612086 true false true true false false SCHEDULE F, PART I, LINE 3, COLUMN F ACCOUNTING METHOD: THE AMOUNT OF PROGRAM SERVICE EXPENDITURES REPORTED ON LINE 1 ARE REPORTED BASED ON THE AMOUNTS INCLUDED IN THE AUDITED FINANCIAL STATEMENTS OF THE INSURANCE COMPANY OF SPRINGFIELD, INC., THE CAPTIVE INSURANCE COMPANY. THESE AUDITED FINANCIAL STATEMENTS USED GENERALLY ACCEPTED ACCOUNTING PRINCIPLES ESTABLISHED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD. WRAP IT UP 53930 47152 6778 68 6368 400 2904 GOLF TOURNEY 38384 27756 10628 276 2700 15382 869 1 19702 14470 5232 187 545 7516 112016 89378 22638 276 2955 21750 945 11289 37215 -14577 true true X false true X true true false true true 31712190 31712190 0.03400 137420249 115212633 22207616 0.02380 169132439 115212633 53919806 0.05780 176530 176530 0.00020 16945136 11039250 5905886 0.00630 17671494 12981532 4689962 0.00500 1085920 1085920 0.00120 35879080 24020782 11858298 0.01270 205011519 139233415 65778104 0.07050 false 92816355 19120169 321354233 391695040 -70340807 X true true 3 1 LESTER E COX MEDICAL CENTERS - SOUTH 3801 S NATIONAL AVE SPRINGFIELD MO 65807 WWW.COXHEALTH.COM 500-8 X X X X X 1 2 LESTER E COX MEDICAL CENTERS - NORTH 1423 N JEFFERSON ST SPRINGFIELD MO 65802 WWW.COXHEALTH.COM 500-8 X X X 1 3 MEYER ORTHOPEDIC HOSPITAL 1000 E WALNUT LAWN SPRINGFIELD MO 65807 WWW.COXHEALTH.COM 500-8 X X 1 FACILITY REPORTING GROUP #1 false false true X X X X X X X X X 12 true true false true X HTTP://WWW.COXHEALTH.COM/BODY.CFM?ID=834 X WWW.SWMOCOUNTS.ORG X true 12 true HTTP://WWW.COXHEALTH.COM/BODY.CFM?ID=834 false false true X 0. 300. X X X X X X true true X X X X true X SEE PART V SECTION C X SEE PART V SECTION C X SEE PART V SECTION C X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: THE PUBLIC HEALTH SURVEY WAS SENT TO SERVICE AREA PUBLIC HEALTH NURSES, PUBLIC SCHOOL ADMINISTRATORS AND NURSES, COMMUNITY ORGANIZATION LEADERS AND REGIONAL CLINICAL LEADERS. APPENDIX 5: PUBLIC HEALTH SURVEY SHOWS TO WHICH ORGANIZATIONS THE SURVEY WAS SENT IN AND AROUND THE COXHEALTH SYSTEM AREA. LISTED ON PAGES 106 AND 107 OF THE CHNA ARE THESE INDIVIDUALS WHO RESPONDED TO THE SURVEY. SCHEDULE H, PART V, SECTION B, LINE 6A CHNA CONDUCTED WITH OTHER HOSPITALS: THE CHNA WAS CONDUCTED FOR THE REPORTING GROUP #1, AS REPORTED ON SCHEDULE H, PART V, SECTION A, INCLUDING LESTER E. COX MEDICAL CENTERS - SOUTH, LESTER E. COX MEDICAL CENTERS - NORTH, AND COX WALNUT LAWN ORTHOPEDIC HOSPITAL. IN ADDITION, COX-MONETT HOSPITAL, INC., A RELATED ORGANIZATION, WAS ALSO INCLUDED IN THE CHNA. SCHEDULE H, PART V, SECTION B, LINE 11 IMPLEMENTATION STRATEGY: CARDIAC KIDS THE CARDIAC KIDS PROGRAM CONTINUES IN 12 AREA SCHOOL DISTRICTS. IT IS ALMOST COMPLETELY FUNDED BY GRANTS PROVIDED BY KOHL'S FOUNDATION AND CHILDREN'S MIRACLE NETWORK. -MONETT -ST. LAWRENCE -AURORA -VERONA -MT. VERNON -PURDY -MARIONVILLE -MILLER -SARCOXIE -EXETER -SHELL KNOB -PIERCE CITY -NIXA -HOLLISTER OVER THE PAST YEAR 19% OF THE STUDENTS PARTICIPATING IN THE CARDIAC KIDS PROGRAM HAVE A POSITIVE LIPID PROFILE RESULT. STUDENTS WERE SCREENED THE PAST SCHOOL YEAR FOR BODY MASS INDEX AND BLOOD PRESSURE -40 % HAD A BODY MASS INDEX OVER THE 85TH PERCENTILE -35% WITH A MILD RISK BLOOD PRESSURE -57% OF THE STUDENTS RETESTED FOR A POSITIVE LIPID PROFILE SHOWED IMPROVEMENT OVER THE PAST YEAR 257 TOTAL PARTICIPANTS (PARENTS AND STUDENTS) ATTENDED CARDIAC FAMILY FUN NIGHTS. HEALTHY FOOD PANTRY COLLABORATIVE (HFPC) DEVELOPMENT COMMUNICATION WITH HFPC MEMBERS OCCURS THROUGH A VARIETY OF WAYS: THE NEWSLETTER - THE PANTRY BUZZ, EMAIL INFORMATION ABOUT PRODUCT SHARING (LIST SERVE), ORGANIZER SUBCOMMITTEE PLANNING AND COLLABORATION MEETINGS, AND A FORMAL MEETING ON APRIL 7, 2016 FOR ALL MEMBERSHIP. THE FOCUS CONTINUES TO BE "BRINGING TOGETHER PARTNERS WHO SERVE OUR COMMUNITY IN NEED OF HEALTHY FOOD AND WORKING TOGETHER TO PROMOTE THE MESSAGE ABOUT THE NEEDS OF THIS POPULATION". THE PARTNERSHIP INCLUDES: MSU, UNIVERSITY OF MISSOURI-EXTENSION, COUNCIL OF CHURCHES, OZARKS REGIONAL FOOD POLICY COUNCIL, OZARKS FOOD HARVEST (OFH), COXHEALTH AND 25 PLUS INDIVIDUAL FOOD PANTRIES. THE FOLLOWING ARE SOME ACCOMPLISHMENTS THIS YEAR: -THE PANTRY BUZZ-PREPARED BY MSU INTERNS, WHICH FEATURED SCHWEITZER FOOD PANTRY, WAS EMAILED TO ALL PARTNERS, PANTRIES AND ORGANIZATIONS GERMANE TO THE HFPC MISSION. -APRIL 7TH, 2016 HFPC MEETING HELD AT CENTRAL ASSEMBLY WITH BREAKFAST PROVIDED. MEETING LOCATION TO BE ROTATED AMONG PARTICIPATING PANTRIES. TOURS OF THE PANTRY FOLLOW THE MEETING, GIVING PARTICIPANTS THE OPPORTUNITY TO LEARN NEW WAYS TO DISTRIBUTE/DISPLAY FOOD PRODUCTS. -NEXT MEETING PLANNED FOR SEPTEMBER 8TH AT 10:00, LOCATION TBD. WILL CONTINUE MEETING SPRING AND FALL. -HEALTHY FOOD DRIVE AT COXHEALTH IN COLLABORATION WITH CROSSLINES 11/9/15-11/23/15. A TOTAL OF 1,163 POUNDS OF FOOD WAS COLLECTED. -TEMPLATE OF DONOR LETTER: BECAUSE OF THE FOCUS ON 'HEALTHY FOOD DONATIONS', A TEMPLATE TO SEND TO DONOR ORGANIZATIONS WAS DEVELOPED FOR THE PANTRIES TO USE. THIS LETTER CAN BE USED WITH BUSINESSES, CHURCHES, INDIVIDUALS, ETC. AND WILL ALLOW THE PANTRIES TO EDUCATE THEIR DONORS ON 'HEALTHY FOOD CONTRIBUTIONS' WITHOUT SOUNDING UNGRATEFUL FOR WHAT THEY RECEIVE. -TWO COMMUNITY PROJECTS PROMOTED BY HFPC: COMMUNITY GARDENS: PLANT A ROW CONCEPT AND THE MILK DRIVE. -HFPC COLLABORATED WITH CROSSLINES SUBMITTED AN APPLICATION TO COXHEALTH FOR A COMMUNITY SPONSORSHIP, WHICH UNFORTUNATELY WAS NOT FUNDED. THE NEED FOR 'MONEY' AS A DONATION IS AT THE TOP OF THE PRIORITY LIST. THESE DONATIONS EXPAND THE BUYING POWER OF THE PANTRIES FOR PURCHASING HEALTHY FOODS. -FUTURE INITIATIVES BEING CONSIDERED: FEEDING AMERICA, HOPE FOR DINNER, "DIABESITY" (OBESITY AND DIABETES) AND PROMOTING BEST PRACTICES AMONG THE PANTRIES. -MSU INTERN PROGRAM CONTINUE TO PROVIDE EDUCATION ON HOW TO PREPARE FRESH VEGETABLES AND INCORPORATE THEM INTO THEIR MEALS AND THE EXTENSION STAFF ALSO PARTICIPATE IN THIS PROCESS. -"HEALTHY FOOD WISH LIST" PROMOTED DURING THE YEAR AT VARIOUS MEETINGS AND WITH DESIGNATED ORGANIZATIONS. THE LIST OF FOODS WAS ALSO INCORPORATED ON THE TEMPLATE DONOR LETTER. COMMUNITY IN MOTION THE COMMUNITY IN MOTION PROGRAM WAS DESIGNED AS A WEIGHT LOSS CHALLENGE THAT INCORPORATED AND COORDINATED MULTIPLE WEIGHT LOSS OFFERINGS THROUGHOUT THE COMMUNITY. THE FOLLOWING IS AN UPDATE ON CURRENT OFFERINGS BY COXHEALTH. MOST OF THESE PROGRAMS ARE FULLY INTEGRATED AND OPERATIONAL, WHILE SOME COMPONENTS OF "HEALTHY SCHOOLS, HEALTHY COMMUNITIES" ARE CURRENTLY IN PROGRESS AND BEING DEVELOPED. COMMITTED TO KIDS -ADOLESCENT WEIGHT MANAGEMENT PROGRAM FOR AGES 11-14 -FAMILY AFFAIR - EACH MEMBER OF THE FAMILY WEIGHS IN, TURNS IN FOOD LOGS, WEARS PEDOMETER, AND PARTICIPATES IN CLASS EXERCISE, LEARNING SESSIONS, AND DISCUSSIONS JOURNEYS -20-WEEK ADULT WEIGHT MANAGEMENT PROGRAM THAT FOCUSES ON YOUR MENTAL, PHYSICAL AND EMOTIONAL HEALTH. -INCORPORATES THREE COMPONENTS FOR SUCCESSFUL WEIGHT LOSS AND WEIGHT MAINTENANCE: BEHAVIOR CHANGE, NUTRITION EDUCATION AND MEAL PLANNING, AND ACTIVITY AND EXERCISE PROGRAMS. LEANER LIFE -DEVELOPS STRATEGIES TO HELP YOU LOSE WEIGHT, CONTINUE HEALTHY LIFESTYLE CHOICES AND MAINTAIN WEIGHT LOSS -MEET OTHERS IN THE SAME SITUATION FOR DISCUSSION, SUPPORT AND WEEK-TO-WEEK ACCOUNTABILITY HEALTHY SCHOOLS, HEALTHY COMMUNITIES - REDUCE CHILDHOOD OBESITY BY 5% OVER 5 YEARS IN MONETT AND PIERCE CITY SCHOOLS -EXPAND ACCESS TO HEALTHY FOODS -"HEALTHY MEAL NIGHT" PROGRAM -HEALTHY RETAILER/MENU GUIDE FOR LOCAL BUSINESSES -REVIVAL OF THE MONETT FARMER'S MARKET -HEALTHY FOODS SERVED AT CONCESSIONS -"KIDS IN THE KITCHEN" -EXPAND ACCESS TO PHYSICAL ACTIVITY -COMPLETE STREET PROJECT -GREENWAY IMPROVEMENTS/PROMOTION -EQUIPMENT CHECKOUT PROGRAM AT PARKS -PIERCE CITY AFTER SCHOOL PROGRAM -PIERCE CITY COMMUNITY POOL PROGRAM -INCREASE AWARENESS OF HEALTHY EATING AND PHYSICAL ACTIVITY OPPORTUNITIES -COMMUNITY SURVEY ON HEALTH LIVING -COMMUNITY SOCIAL MEDIA SITES/COMMUNICATION -BUILD A STRONG, ENGAGED, AND DIVERSE 'HEALTHY COMMUNITY PARTNERSHIP' -BIMONTHLY MEETINGS WITH COMMUNITY LEADERS -EXPAND RELATIONSHIPS WITH MINORITIES WITHIN THE COMMUNITY -EXPAND HEALTHY LIVING EFFORTS ALREADY ESTABLISHED -INCREASE HEALTH CARE PROVIDERS' ENGAGEMENT IN HEALTHY LIFESTYLES -HEALTHY LIVING PRESENTATION AT SENIOR LEADERS SEMINAR -HEALTHY LIVING REFERRAL RESOURCES -DISCUSSION OF LIFESTYLE CHOICES WITH PATIENTS OTHER OBESITY/HEALTHY LIVING OFFERINGS FROM COX FITNESS CENTERS -MED MILE KIDS RUN TRAINING IN MAY 2016 -MEDICAL MILE 5K RUN IN JUNE 2016 -GIRLS JUST WANNA RUN RACE IN JULY 2016 -REPUBLIC SENIORFEST IN MAY 2016 -GALLOWAY RUN/WALK TRAINING FOR BASS PRO MARATHON AND HALF MARATHON IN APRIL 2016 -FITLIFE MEDICAL FITNESS PROGRAM OTHER OBESITY/HEALTHY LIVING OFFERINGS FROM A PARTNERSHIP BETWEEN COX MONETT AND MONETT YMCA -VERY ACTIVE SPIN PROGRAM FOR EMPLOYEES AND COMMUNITY -CLASSES OFFERED EVERY DAY SCHEDULE H, PART V, SECTION B, LINE 13A CCRITERIA USED TO DETERMINE ELIGIBILITY FOR FREE CARE: IN GENERAL, THE ORGANIZATION'S CHARITY CARE POLICY DOES NOT PROVIDE FOR DISCOUNTS OF 100%. THEREFORE, IT IS EXPECTED THAT THE PATIENT OR GUARANTOR WILL HOLD A RESPONSIBILITY FOR PAYMENT OF AT LEAST A PORTION OF THE SERVICES, REGARDLESS OF THE LEVEL OF ELIGIBILITY. IT IS OUR INTENTION TO WORK WITH INDIVIDUALS ON THEIR OUT-OF-POCKET RESPONSIBILITY TO ESTABLISH FEASIBLE MONTHLY PAYMENTS WHEN NECESSARY. IN THE EVENT THAT A PATIENT OR GUARANTOR IS DETERMINED TO HAVE NO MEANS OF PAYING THE AMOUNT INDICATED AS THEIR RESPONSIBILITY DUE TO EXTENUATING CIRCUMSTANCES, CONSIDERATION MAY BE GIVEN TO WAIVING DEDUCTIBLES AND/OR INCREASING THE DISCOUNT AMOUNT UP TO A 100% DISCOUNT OF THE PATIENT PORTION. THESE EXTENUATING CASES ARE SUBJECT TO THE DISCRETION AND APPROVAL OF THE PFS DIRECTOR AND/OR THE CHIEF FINANCIAL OFFICER WITHIN THE APPROVAL LIMITS DEFINED AT THE END OF THE POLICY. SCHEDULE H, PART V, SECTION B, LINE 13H OTHER CRITERIA USED TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY: PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: 1. STATE FUNDED PRESCRIPTION PROGRAMS; 2. HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC; 3. PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); 4. FOOD STAMP ELIGIBILITY; 5. SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY; 6. ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G. MEDICAID SPEND DOWN); 7. PATIENT IS DECEASED WITH NO KNOWN ESTATE. SCHEDULE H, PART V, SECTION B, LINE 16A FINANCIAL ASSISTANCE POLICY AVAILABILITY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE AT THE FOLLOWING URL: WWW.COXHEALTH.COM/BODY.CFM?ID=5445 SCHEDULE H, PART V, SECTION B, LINE 16B FINANCIAL ASSISTANCE POLICY APPLICATION FORM AVAILABILITY: THE FINANCIAL ASSISTANCE POLICY APPLICATION FORM IS AVAILABLE AT THE FOLLOWING URL: WWW.COXHEALTH.COM/BODY.CFM?ID=5445 SCHEDULE H, PART V, SECTION B, LINE 16C FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY AVAILABILITY: THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE AT THE FOLLOWING URL: WWW.COXHEALTH.COM/BODY.CFM?ID=5445 SCHEDULE H, PART V, SECTION B, LINE 16I MEASURES TO PUBLICIZE THE POLICY: FINANCIAL ASSISTANCE AVAILABILITY IS 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, 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. 72 SPRINGFIELD INPATIENT PHYSICIANS 3801 S NATIONAL AVE 5TH FL SPRINGFIELD MO 65807 MEDICAL OFFICES ADULT MEDICINE & ENDOCRINOLOGY SPECLST 960 E WALNUT LAWN SUITE 201 SPRINGFIELD MO 65807 CLINIC FAMILY MEDICAL CARE CENTER 1423 N JEFFERSON ST B-100 SPRINGFIELD MO 65802 CLINIC PHYSICIANS FOR WOMEN 3850 S NATIONAL AVE 400 SPRINGFIELD MO 65807 CLINIC COXHEALTH CENTER STEEPLECHASE 1530 E REPUBLIC RD SPRINGFIELD MO 65804 CLINIC PEDIATRIC CENTER 3443 S NATIONAL AVE SPRINGFIELD MO 65807 CLINIC REGIONAL PERINATAL CENTER 1000 E PRIMROSE 360 SPRINGFIELD MO 65807 CLINIC SOUTHWEST SPINE & SPORTS MEDICINE 3555 S NATIONAL AVE 302 SPRINGFIELD MO 65807 CLINIC COX FAMILY MEDICINE ASSOCIATES 3850 S NATIONAL AVE 520 SPRINGFIELD MO 65807 CLINIC COXHEALTH CENTER NIXA 411 N MCCROSKEY NIXA MO 65714 CLINIC DIAGNOSTIC CLINIC 3800 S NATIONAL 600 SPRINGFIELD MO 65807 CLINIC FAMILY PRACTICE & OBSTETRICS OF MONETT 815 N LINCOLN STE G MONETT MO 65708 CLINIC NORTHSIDE PEDIATRICS & ADOLESCENTS 1443 N ROBBERSON 200 SPRINGFIELD MO 65802 CLINIC COXHEALTH NEWBORN MEDICINE SPECIALISTS 3801 S NATIONAL AVE SPRINGFIELD MO 65807 CLINIC COXHEALTH CENTER WILLOW SPRINGS 816 E MAIN WILLOW SPRINGS MO 65793 CLINIC SUN RIVER ORTHOPAEDICS 3800 S NATIONAL AVE 700 SPRINGFIELD MO 65807 CLINIC COXHEALTH INTERNAL MEDICINE FOR WOMEN 3850 S NATIONAL AVE 700 SPRINGFIELD MO 65807 CLINIC FAMILY & OCCUPATIONAL MEDICINE OF MONETT 2200 E CLEVELAND MONETT MO 65708 CLINIC COX FAMILY MEDICINE OF MONETT 307 W BENTON MONETT MO 65708 CLINIC COXHEALTH CENTER AURORA 106 COMMERCE DRIVE AURORA MO 65605 CLINIC COXHEALTH CENTER SOUTHERN HILLS 2702 E SUNSHINE SPRINGFIELD MO 65804 CLINIC COXHEALTH CENTER ELFINDALE 1429 W SUNSHINE SPRINGFIELD MO 65807 CLINIC COXHEALTH CENTER BRANSON 890 HWY 248 BRANSON MO 65616 CLINIC COXHEALTH PEDIATRICS 1000 E PRIMROSE 300 SPRINGFIELD MO 65807 CLINIC COXHEALTH CENTER LEBANON 510 E HWY 32 LEBANON MO 65536 CLINIC COXHEALTH CENTER CHESTERFIELD 1925 CHESTERFIELD BLVD SPRINGFIELD MO 65807 CLINIC COXHEALTH CENTER WILLARD 304 E JACKSON 5H WILLARD MO 65781 CLINIC COXHEALTH CENTER MOUNTAIN GROVE 1602-A N MAIN ST MOUNTAIN GROVE MO 65711 CLINIC COX SENIOR HEALTH CENTER 1423 N JEFFERSON ST SPRINGFIELD MO 65802 CLINIC COX SENIOR HEALTH CENTER SOUTH 3525 S NATIONAL 207 SPRINGFIELD MO 65807 CLINIC COXHEALTH CENTER MARSHFIELD 941 EAST HUBBLE DRIVE MARSHFIELD MO 65706 CLINIC COXHEALTH CENTER MT VERNON 10763 HWY 39 SUITE 200 MT VERNON MO 65712 CLINIC COXHEALTH CENTER OZARK 1741 S 15TH STREET OZARK MO 65721 CLINIC COXHEALTH CENTER CRANE 102 CORTNEY LANE CRANE MO 65633 CLINIC COXHEALTH CENTER REPUBLIC 820 ILLINOIS AVE REPUBLIC MO 65738 CLINIC MONETT SURGICAL ASSOCIATES 801 N LINCOLN MONETT MO 65708 CLINIC COXHEALTH CENTER AVA 806 SW 13TH AVE AVA MO 65608 CLINIC COXHEALTH INPATIENT PSYCHIATRY 1423 N JEFFERSON ST SPRINGFIELD MO 65802 CLINIC COXHEALTH CENTER BUFFALO 119 N ASH BUFFALO MO 65622 CLINIC COXHEALTH CENTER ROGERSVILLE 151 JOHNSTOWN DR ROGERSVILLE MO 65742 CLINIC COXHEALTH CENTER FOR ADDICTIONS 1423 N JEFFERSON ST SPRINGFIELD MO 65802 CLINIC THE CLINIC AT WALMART #0444 3315 S CAMPBELL SPRINGFIELD MO 65807 CLINIC COXHEALTH PEDIATRIC SPECIALTIES 1000 E PRIMROSE 200 SPRINGFIELD MO 65807 CLINIC COXHEALTH CENTER SEYMOUR 202 COMMERCIAL SEYMOUR MO 65746 CLINIC COXHEALTH CENTER SHELL KNOB 25376 STATE HWY 39 SUITE 301 SHELL KNOB MO 65747 CLINIC THE CLINIC AT WALMART #0379 2004 W MARLER LANE OZARK MO 65721 CLINIC THE CLINIC AT WALMART #2221 2021 E INDEPENDENCE SPRINGFIELD MO 65804 CLINIC THE CLINIC AT WALMART #1009 1150 US HWY 60 EAST REPUBLIC MO 65738 CLINIC COXHEALTH CENTER CAMPBELL 2750 S CAMPBELL SPRINGFIELD MO 65807 CLINIC PEDIATRIC HOSPITAL AFFILIATES 3801 S NATIONAL AVE 7TH FL SPRINGFIELD MO 65807 CLINIC SPRINGFIELD NEUROLOGICAL AND SPINE 2900 S NATIONAL AVE SPRINGFIELD MO 65804 CLINIC COXHEALTH PSYCHOLOGICAL SERVICES 3800 S NATIONAL 770 SPRINGFIELD MO 65807 CLINIC MARTIN CENTER 3901 S FREMONT SPRINGFIELD MO 65807 CLINIC OZARK HEALTH VENTURES 3550 S NATIONAL AVE SPRINGFIELD MO 65807 CLINIC BONE & JOINT CENTER 3555 S NATIONAL AVE SPRINGFIELD MO 65807 CLINIC FERRELL-DUNCAN CLINIC 1000 E PRIMROSE SPRINGFIELD MO 65807 MEDICAL OFFICES MEYER CENTER FITNESS & REHAB 3545 S NATIONAL AVE SPRINGFIELD MO 65807 FITNESS AND REHAB CENTER COX HYPERBARIC MEDICINE & WOUND CARE 3525 S NATIONAL AVE 101 SPRINGFIELD MO 65807 CLINIC MEDICAL OFFICE BUILDING-COX WALNUT LAWN 3525 S NATIONAL AVE SPRINGFIELD MO 65807 MEDICAL OFFICES TURNER WOMEN & CHILDREN'S CENTER 1000 E PRIMROSE SPRINGFIELD MO 65807 MEDICAL OFFICES WHEELER HEART & VASCULAR 3800 S NATIONAL AVE 700 SPRINGFIELD MO 65807 MEDICAL OFFICES HULSTON CANCER CENTER 3850 S NATIONAL AVE SPRINGFIELD MO 65807 MEDICAL OFFICES MEDICAL TOWERS 1443 N ROBBERSON SPRINGFIELD MO 65802 MEDICAL OFFICES CASSVILLE MEDICAL CARE ASSOCIATES 75 SMITHSON DRIVE SUITE A CASSVILLE MO 65625 CLINIC COXHEALTH INFECTIOUS DISEASES SPECIALTY 3800 S NATIONAL LL100 SPRINGFIELD MO 65807 CLINIC COX CARE MOBILE 3525 S NATIONAL AVE 105 SPRINGFIELD MO 65807 CLINIC THE CLINIC AT WALMART #86 2825 N KANSAS EXPWAY SPRINGFIELD MO 65803 CLINIC SENIOR ADVANTAGE 1000 E WALNUT LAWN SPRINGFIELD MO 65807 CLINIC COXHEALTH CENTER CASSVILLE 75 SMITHSON DRIVE STE B CASSVILLE MO 65625 CLINIC COXHEALTH SPECIALTY CLINIC 1001 E PRIMROSE STREET SPRINGFIELD MO 65807 CLINIC PANTHER CLINIC OPERATED BY COXHEALTH 900 N BENTON AVENUE SPRINGFIELD MO 65802 CLINIC COXHEALTH ADULT & PEDIATRIC URGENT CARE 1000 E PRIMROSE SPRINGFIELD MO 65807 CLINIC SCHEDULE H, PART I, LINE 3C ELIGIBILITY FOR FREE CARE: IN GENERAL, THE ORGANIZATION'S CHARITY CARE POLICY DOES NOT PROVIDE FOR DISCOUNTS OF 100%. THEREFORE, IT IS EXPECTED THAT THE PATIENT OR GUARANTOR WILL HOLD A RESPONSIBILITY FOR PAYMENT OF AT LEAST A PORTION OF THE SERVICES, REGARDLESS OF THE LEVEL OF ELIGIBILITY. IT IS OUR INTENTION TO WORK WITH INDIVIDUALS ON THEIR OUT-OF-POCKET RESPONSIBILITY TO ESTABLISH FEASIBLE MONTHLY PAYMENTS WHEN NECESSARY. IN THE EVENT THAT A PATIENT OR GUARANTOR IS DETERMINED TO HAVE NO MEANS OF PAYING THE AMOUNT INDICATED AS THEIR RESPONSIBILITY DUE TO EXTENUATING CIRCUMSTANCES, CONSIDERATION MAY BE GIVEN TO WAIVING DEDUCTIBLES AND/OR INCREASING THE DISCOUNT AMOUNT UP TO A 100% DISCOUNT OF THE PATIENT PORTION. THESE EXTENUATING CASES ARE SUBJECT TO THE DISCRETION AND APPROVAL OF THE PFS DIRECTOR AND/OR THE CHIEF FINANCIAL OFFICER WITHIN THE APPROVAL LIMITS DEFINED AT THE END OF THE POLICY. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: 1. STATE FUNDED PRESCRIPTION PROGRAMS; 2. HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC; 3. PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); 4. FOOD STAMP ELIGIBILITY; 5. SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY; 6. ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G. MEDICAID SPEND DOWN); 7. PATIENT IS DECEASED WITH NO KNOWN ESTATE. SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990 WAS REDUCED BY BAD DEBT EXPENSE OF $92,816,355. SCHEDULE H, PART I, LINE 7G SUBSIDIZED SERVICES: THE ORGANIZATION HAS INCLUDED COSTS ASSOCIATED WITH RURAL HEALTH CENTERS (RHC) IN THE CALCULATION OF SUBSIDIZED SERVICES ON LINE 7G, WITH A NET SUBSIDY FROM RHCS OF $4,689,962. LESTER E. COX MEDICAL CENTERS 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. LESTER E. COX MEDICAL CENTERS CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. COST COMPUTED ON IRS WORKSHEETS 5 AND 6 WERE COMPUTED FROM THE MEDICARE COST REPORT, INCLUDING DIRECT COSTS PLUS OVERHEAD ALLOCATIONS COMPUTED IN THE COST REPORT STEP-DOWN PROCESS. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: THE BAD DEBT EXPENSE LISTED ON LINE 2 IS THE BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: THE BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. USING DATA FROM 2010-2014, APPROXIMATELY 20.6 PERCENT OF GREENE COUNTY WAS CONSIDERED TO LIVE IN POVERTY. 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: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION POLICY: THE ORGANIZATION WILL NOT PURSUE LEGAL ACTION FOR NONPAYMENT OF ANY AMOUNTS DISCOUNTED AS A RESULT OF AN APPROVED OR PARTIALLY APPROVED REQUEST FOR FINANCIAL ASSISTANCE. BALANCES REMAINING AFTER SUCH DISCOUNTS ARE APPLIED WILL, HOWEVER, BE SUBJECT TO COLLECTION ACTIVITY, INCLUDING LEGAL ACTION. IN ADDITION, THE ORGANIZATION WILL NOT CHARGE INTEREST ON THE BALANCE REMAINING AFTER APPLYING THE FINANCIAL ASSISTANCE DISCOUNT. HOWEVER, THE ORGANIZATION MAY, IN ITS SOLE DISCRETION, CHARGE INTEREST ON THE BALANCE OWED IF 1) THE GUARANTOR DEFAULTS ON HIS OR HER PAYMENT AGREEMENT OR 2) THE BALANCE IS REFERRED TO THE COLLECTION AGENCY FOR COLLECTION. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: LESTER E. COX MEDICAL CENTERS HAS PERFORMED AN ENVIRONMENTAL SCAN ANNUALLY SINCE 2006. IN 2012, THE FIRST "COMMUNITY HEALTH NEEDS ASSESSMENT" AS REQUIRED BY THE IRS WAS PUT IN PROCESS. THE ENVIRONMENTAL SCAN AND THE COMMUNITY HEALTH NEEDS ASSESSMENT ARE VERY SIMILAR IN THAT SOME OF THE SAME ELEMENTS ARE PRESENT IN BOTH DOCUMENTS. A PUBLIC PERCEPTION STUDY OF AREA HEADS OF HOUSEHOLDS IS CONDUCTED ANNUALLY. THE MOST RECENT STUDY SURVEYED 876 HOUSEHOLDS IN OUR SERVICE AREA TO DETERMINE "WHAT SERVICES ARE NEEDED." WE ALSO PERFORM A PUBLIC HEALTH SURVEY, WHICH ASKS COMMUNITY LEADERS AND HEALTH PROFESSIONALS WHAT THEIR PRIORITIES ARE AND WHAT HEALTH SERVICES ARE LACKING IN THEIR COMMUNITY. THE PUBLIC HEALTH SURVEY IS SENT TO COUNTY PUBLIC HEALTH DEPARTMENTS, LOCAL AGENCIES, REGIONAL SERVICES CLINICS, MENTAL HEALTH FACILITIES, AND PUBLIC SCHOOLS THROUGHOUT THE TOTAL SERVICE AREA. LESTER E. COX MEDICAL CENTERS REFERENCES UNITED HEALTH FOUNDATION STATE-BY-STATE HEALTH RANKINGS AS WELL AS ROBERT WOOD JOHNSON AND UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE COUNTY HEALTH RANK FOR HEALTH OUTCOMES AND HEALTH FACTORS. COXHEALTH ALSO REFERENCES "ASSESSING THE HEALTH OF THE COMMUNITY", WHICH IS AN ANALYSIS OF BEHAVIORS AND OUTCOMES FOR THE SPECIFIC COUNTIES OF THE SERVICE AREA BY THE MISSOURI HOSPITAL ASSOCIATION. DEMOGRAPHIC AND ECONOMIC ANALYSIS IS PERFORMED FOR THE 22-COUNTY SERVICE AREA. NIELSEN CLARITAS DEMOGRAPHIC ESTIMATES AND PROJECTIONS ARE USED TO EVALUATE THE CHANGE IN POPULATION CHARACTERISTICS. UNEMPLOYMENT, HOME FORECLOSURE, AND INPATIENT PAYER DATA IS ALSO ASSESSED. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: LESTER E. COX MEDICAL CENTERS USES A VARIETY OF METHODS TO INFORM AND EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE PROGRAMS OR UNDER THE ORGANIZATION'S POLICY: - AVAILABILITY OF FINANCIAL ASSISTANCE THROUGH THE ORGANIZATION IS COMMUNICATED TO PATIENTS THROUGH THE USE OF SIGNAGE AND BROCHURES/INFORMATION PACKETS AVAILABLE AT CHECK-IN LOCATIONS. - LESTER E. COX MEDICAL CENTERS ALSO PROACTIVELY COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE ON PATIENT BILLS AND STATEMENTS; AND ITS EARLY-OUT VENDOR RESPONSIBLE FOR PATIENT BALANCE COLLECTIONS IS EXPECTED TO PROACTIVELY INFORM SELF PAY PATIENTS OF THE AVAILABILITY WHEN SPEAKING TO THEM ON THE PHONE. - FOR ASSISTANCE UNDER FEDERAL AND STATE PROGRAMS LESTER E. COX MEDICAL CENTERS UTILIZES AN OUTSOURCE ELIGIBILITY VENDOR WHO MEETS WITH SELF PAY INPATIENTS AT THE BEDSIDE TO COMPLETE AN ELIGIBILITY SCREENING, INFORM THE PATIENTS OF POTENTIAL AVAILABILITY, AND WILL WORK WITH THE PATIENT TO HELP THEM THROUGH THE PROCESS. OUTPATIENTS ARE REFERRED TO THE VENDOR AFTER CARE AND THOSE ARE WORKED IN A SIMILAR FASHION WITH THE EXPECTATION THAT THE FIRST CONTACT IS THROUGH MAIL OR PHONE RATHER THAN AT THE BEDSIDE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: THE PRIMARY SERVICE AREA ("PSA") COUNTIES SERVED BY LESTER E. COX MEDICAL CENTERS INCLUDE: BARRY, CHRISTIAN, GREENE, LAWRENCE, STONE, TANEY, WEBSTER, AND WRIGHT (ALL PSA COUNTIES ARE LOCATED IN MISSOURI). THE SECONDARY SERVICE AREA ("SSA") COUNTIES SERVED BY LESTER E. COX MEDICAL CENTERS INCLUDE: BAXTER - AR, BOONE - AR, CEDAR, DADE, DALLAS, DOUGLAS, HICKORY, HOWELL, JASPER, LACLEDE, OZARK, POLK, PULASKI, AND TEXAS (ALL SSA COUNTIES ARE LOCATED IN MISSOURI EXCEPT BOONE AND BAXTER COUNTIES IN ARKANSAS). THE SERVICE AREA HAS EXCEEDED THE ONE MILLION PERSON MARK AND APPROXIMATELY 56% OF THE 22-COUNTY POPULATION IS IN THE EIGHT COUNTY PRIMARY SERVICE AREA. 51% OF THE MARKET IS FEMALE AND ALMOST 19% OF THE MARKET IS FEMALES BETWEEN THE AGES OF 15 AND 44. THE SEGMENT OF THE POPULATION OVER 65 IS PROJECTED TO GROW AT ABOUT A 13% RATE. THE AVERAGE HOUSEHOLD INCOME IS $48,766 IN THE 22-COUNTY SERVICE AREA COMPARED WITH $58,796 FOR THE STATE OF MISSOURI. DIVERSITY IS NEARLY NONEXISTENT IN THE 22-COUNTY MARKET. YEAR-TO-YEAR UNEMPLOYMENT RATES HAVE BEEN DECLINING IN THE AREA. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: LESTER E. COX MEDICAL CENTERS' MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH QUALITY HEALTH CARE, EDUCATION AND RESEARCH. WE ACTIVELY LIVE THIS MISSION BY PROVIDING QUALITY HEALTH CARE WITH MULTIPLE ACCESS POINTS FOR CARE INCLUDING THREE HOSPITALS AND MORE THAN 60 PHYSICIAN CLINICS (INCLUDING RETAIL CLINICS). THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY THROUGH A COMMUNITY BOARD, HEALTH RELATED AD CAMPAIGNS, PROVISION OF WELLNESS SERVICES AND VACCINATIONS, PROVISION OF CARE FOR INDIGENT SEGMENTS OF THE POPULATION, FUNDING OF CARE QUALIFIED COMMUNITY MEMBERS THROUGH A NOT-FOR-PROFIT FOUNDATION, COMMUNITY EDUCATION CLASSES RELATED TO HEALTH AND WELLNESS, COMMUNITY ADVISORY COUNCILS AND HEALTH IMPROVEMENT EFFORTS IN PARTNERSHIP WITH PUBLIC HEALTH DEPARTMENTS, SCHOOL SYSTEMS AND OTHER REGIONAL HEALTH CARE PROVIDERS. A MAJORITY OF LESTER E. COX MEDICAL CENTERS' BOARD IS COMPRISED OF INDIVIDUALS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA, WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO PHYSICIANS IN THE COMMUNITY IF THEY QUALIFY. SCHEDULE H, PART VI, LINE 6 COXHEALTH'S HOME CARE SERVICES ARE PROVIDED BY OXFORD HEALTHCARE, HOME PARENTERAL SERVICES (INFUSION THERAPY) AND HOME SUPPORT (DURABLE MEDICAL EQUIPMENT). OXFORD HEALTHCARE SUPPORTED THE COMMUNITY THROUGH MONTHLY NUTRITION AND FALL PREVENTION SEMINARS AT 20 AREA SENIOR CENTERS THROUGHOUT SOUTHWEST MISSOURI. OXFORD ALSO PROVIDED FREE BONE DENSITY SCREENINGS AT 34 COMMUNITY EVENTS, AND VITAL SIGN SCREENINGS AT MANY MORE. THROUGH AN ANNUAL FAN DRIVE, OXFORD COLLECTED AND DISTRIBUTED MORE THAN 600 BOX FANS TO SENIORS AND THE DISABLED WHO LACK ADEQUATE ACCESS TO COOLING DURING THE SUMMER MONTHS. HOME PARENTERAL SERVICES RECEIVED A SECOND GRANT AWARD FROM THE MISSOURI FOUNDATION FOR HEALTH ORGANIZATION. THIS GRANT ALLOWS HPS TO SERVE PATIENTS THAT FALL THROUGH THE CRACKS DUE TO HAVING NO REIMBURSEMENT OF ANY KIND, SERVING PATIENTS THROUGHOUT SOUTHERN MISSOURI. COXHEALTH HOME CARE SERVICES OF THE MIDWEST SUPPORTS THE COMMUNITY BY PROVIDING IN-HOME PRIVATE DUTY SERVICES, HOME HEALTHCARE AND THERAPY SUPPORT SERVICES, ASSISTANCE TO COXHEALTH SYSTEM IN DEVELOPING AN INTEGRATED HEALTH SYSTEM, AND SERVICE TO MEDICAID PATIENTS. COX-MONETT HOSPITAL SUPPORTS THE MONETT, MISSOURI AND SURROUNDING COMMUNITY BY PROVIDING A VARIETY OF SERVICES WHICH INCLUDE UROLOGY, ENT (EAR, NOSE & THROAT), PULMONOLOGY, ORTHOPEDICS, CARDIOLOGY, PODIATRY, OBSTETRICS, RADIOLOGY (CT, MRI, NUCLEAR MEDICINE & MAMMOGRAPHY), LABORATORY, 24-HOUR EMERGENCY CENTER, GENERAL SURGICAL SERVICES, SAME-DAY SURGERY, DIABETES CENTER, SLEEP CENTER, CARDIOPULMONARY REHAB, MEDICAL-SURGICAL UNIT, PHARMACY AND COMMUNITY WELLNESS. COXHEALTH FOUNDATION SUPPORTS THE COMMUNITY BY RAISING FUNDS TO DISPERSE TO PATIENTS FOR THOSE NEEDS FOR WHICH THEY HAVE NO RESOURCES OR FUNDING, BUT WHICH ARE CRITICAL TO THE PATIENT'S HEALTH AND WELL BEING. COXHEALTH AUXILIARY SUPPORTS THE COMMUNITY THROUGH FINANCIAL AND NON-FINANCIAL MEANS. THE ORGANIZATION PROVIDES SCHOLARSHIPS TO NURSING AND MEDICAL TECHNOLOGY STUDENTS AT COX COLLEGE. IN ADDITION, THE AUXILIARY PROVIDES SLEEP SACKS TO ALL NEWBORNS BORN AT LESTER E. COX MEDICAL CENTERS AND CAR SEATS TO THOSE IN NEED TO ENSURE THE SAFETY OF ANY NEWBORN LEAVING LESTER E. COX MEDICAL CENTERS. IN JANUARY 2013, SKAGGS COMMUNITY HOSPITAL ASSOCIATION D/B/A COX MEDICAL CENTER BRANSON (CMCB) BECAME A PART OF THE COXHEALTH NETWORK. UNDER THE AGREEMENT, A MEMBER SUBSTITUTION MODEL, CMCB CONTINUES TO MAINTAIN ITS OWN HOSPITAL BOARD WHILE BECOMING A SUBSIDIARY OF LESTER E. COX MEDICAL CENTERS. LESTER E. COX MEDICAL CENTERS, AS THE PARENT COMPANY, ASSUMES THE RESPONSIBILITIES PREVIOUSLY HELD BY THE CMCB BOARD OF TRUSTEES. THE CMCB BOARD WILL HAVE REPRESENTATION ON THE LESTER E. COX MEDICAL CENTERS BOARD. THIS ALLOWS BOTH PARTIES TO ACT TOGETHER AS ONE ENTITY FOR THE PURPOSES OF CONTRACTING, RECRUITMENT AND GROWTH. CMCB HAS BEEN SERVING SOUTHWEST MISSOURI RESIDENTS FOR MORE THAN 62 YEARS AND OFFERS OVER 25 MAJOR SERVICE AREAS. THE HOSPITAL'S AVERAGE DAILY PATIENT CENSUS EXCEEDS 90 WITH 165 LICENSED HOSPITAL BEDS. A STAFF OF OVER 1,000 PERSONNEL IS REQUIRED TO OPERATE THE HOSPITAL AND ITS NUMEROUS CLINICS. IN THE PRIOR FISCAL YEAR, A NEW PARENT ORGANIZATION OF LESTER E. COX MEDICAL CENTERS, COXHEALTH, WAS ESTABLISHED, AS WAS COX MEDICAL GROUP TO PROVIDE ADDITIONAL SERVICES TO THE AREA. true MHA CENTER FOR EDUCATION PO BOX 60 JEFFERSON CITY MO 65102 430898947 501(C)(3) 37700 1 CHILDREN'S MIRACLE NETWORK -SPECIAL NEEDS GRANT 2249 173508 CHILDREN'S MIRACLE NETWORK -FAMILY CARE GRANTS 95 155157 CHILDREN'S MIRACLE NETWORK -COMMUNITY OUTREACH GRA 100000 112310 CHILDREN'S MIRACLE NETWORK -LESTER E COX MC GRANTS 9762 370085 CHILDREN'S MIRACLE NETWORK -OTHER GRANTS 38425 235996 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S.: THROUGH THE CHILDREN'S MIRACLE NETWORK, LESTER E. COX MEDICAL CENTERS DISTRIBUTES FUNDS TO INDIVIDUALS THROUGHOUT THE COMMUNITY. SEE BELOW FOR A SUMMARY OF PROGRAMS THROUGH WHICH FUNDS ARE DISTRIBUTED. DURING FISCAL YEAR 2015, APPROXIMATELY 150,531 CHILDREN WERE SERVED: SPECIAL NEEDS FUND - $173,508 - DIRECT FINANCIAL ASSISTANCE TO FAMILIES, WHICH INCLUDES: TRAVEL ASSISTANCE, ORTHOPEDIC BRACES, PRESCRIPTIONS, EYE GLASSES, ETC. FAMILY CARE GRANTS - $155,157 - DIRECT FINANCIAL ASSISTANCE TO FAMILIES, WHICH INCLUDES: SPEECH, OCCUPATIONAL AND PHYSICAL THERAPY BILLS, HOSPITAL BILLS, ETC. COMMUNITY GUARANTEED GRANTS - $112,310 TOTAL *CARDIAC PROGRAM (A PORTION TO COX- MONETT HOSPITAL, INC.) - $76,545 *"NEVER SHAKE A BABY" PROGRAM - $15,000 *BICYCLE SAFETY PROGRAM - $6,965 *WASTED PROGRAM - $5,000 *CAR SEAT SAFETY PROGRAM - $7,700 *WATER SAFETY PROGRAM - $1,100 LESTER E. COX MEDICAL CENTERS GUARANTEED GRANTS - $370,085 TOTAL *CHILD LIFE PROGRAM - $118,493 *C.A.R.E. MOBILE - $251,592 DISCRETIONARY AND OPEN FUNDS - $235,996 - THESE ARE FUNDS THAT DO NOT FALL INTO ONE OF THE ABOVE CATEGORIES AND CAN INCLUDE OPTIONAL GRANT FUNDING AND OTHERS. THROUGH AMENDMENT 3 OF THE ORGANIZATION'S AGREEMENT WITH MHA MANAGEMENT SERVICES CORPORATION AND INCREASED DISPROPORTIONATE SHARE HOSPITAL PAYMENTS TO ALL MISSOURI HOSPITALS UNDER THE FEDERAL REIMBURSEMENT ALLOWANCE PROGRAM, THE HOSPITAL MADE CHARITABLE CONTRIBUTIONS TO THE MHA CENTER FOR EDUCATION. THESE CONTRIBUTIONS ARE USED FOR FUNDING SCHOLARSHIPS TO MEDICAL, NURSING AND ALLIED HEALTH PROFESSIONALS, AND WORKFORCE INITIATIVES TO ADDRESS THE SHORTAGES OF NURSING AND ALLIED HEALTH PROFESSIONALS. TOTAL CONTRIBUTION RELATING TO THIS AGREEMENT IN FISCAL YEAR 2015 EQUALED $37,700. X true true X X X X X false true false false false true false false false STEVE EDWARDS PRESIDENT AND CEO 876096 0 240385 0 113752 0 238287 0 24706 0 1493226 0 105971 0 JAKE MCWAY SR VP AND CFO 506845 0 115045 0 104905 0 121770 0 19819 0 868384 0 96844 0 PATRICIA DIX MD BOARD MEMBER 324804 0 0 0 2301 0 26000 0 13136 0 366241 0 0 0 DAVID ZOLFAGHARI MD BOARD MEMBER 0 890181 0 0 0 0 0 0 0 0 0 890181 0 0 BOYD CROCKETT MD PHYSICIAN 646753 0 0 0 300 0 12649 0 14652 0 674354 0 0 0 ARIJIT CHOWDHURY MD PHYSICIAN 501142 0 0 0 270 0 12649 0 14647 0 528708 0 0 0 CARY MARQUIS MD PHYSICIAN 526384 0 0 0 444 0 30149 0 14676 0 571653 0 0 0 RUSSELL R BOND JR DO PHYSICIAN 448016 0 0 0 1290 0 30500 0 12967 0 492773 0 0 0 MARTIN JONES MD PHYSICIAN 446890 0 0 0 300 0 12649 0 9452 0 469291 0 0 0 JOHN DUFF MD SR VP CHIEF CORP SVCS END 6/15 489209 0 70293 0 86132 0 30500 0 20952 0 697086 0 68470 0 RON PRENGER SR VP, CHIEF HOSPITAL OFFICER 281556 0 13030 0 1290 0 59501 0 11870 0 367247 0 0 0 CHARITY ELMER SR VP AND GENERAL COUNSEL 377560 0 60250 0 8963 0 77691 0 19321 0 543785 0 0 0 ROBERT FERGUSON VP FERRELL DUNCAN CLINIC 294631 0 18077 0 1290 0 13000 0 10367 0 337365 0 0 0 DAVID TAYLOR VP REGIONAL SERVICES 260333 0 17562 0 3105 0 13000 0 14725 0 308725 0 0 0 JOHN HURSH VP HUMAN RESOURCES END 7/15 242437 0 12231 0 2301 0 30498 0 13200 0 300667 0 0 0 RODNEY SCHAFFER VP FACILITIES MANAGEMENT 223179 0 11315 0 1953 0 11890 0 7361 0 255698 0 0 0 KAREN KRAMER VP, CNO 266644 0 12936 0 1267 0 30500 0 12978 0 324325 0 0 0 BETTY BRESHEARS VP CORPORATE COMPLIANCE 174285 0 8365 0 1953 0 9538 0 13150 0 207291 0 0 0 BRUCE ROBISON CIO 185239 0 9606 0 1953 0 10223 0 13216 0 220237 0 0 0 FRANK ROMERO VP MEDICAL AFFAIRS BEG 12/14 313406 0 93838 0 450 0 12649 0 14205 0 434548 0 0 0 TIM JONES JOC CHAIR 272366 0 75468 0 300 0 12649 0 14652 0 375435 0 0 0 SCHEDULE J, PART I, LINE 1A INFORMATION REGARDING BENEFITS PROVIDED: MONTHLY SOCIAL CLUB DUES ARE INCLUDED IN THE TAXABLE COMPENSATION OF STEVE EDWARDS, CEO. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: STEVE EDWARDS, JAKE MCWAY, JOHN DUFF, CHARITY ELMER AND RON PRENGER PARTICIPATE IN A 457(F) NONQUALIFIED RETIREMENT PLAN WITH LESTER E. COX MEDICAL CENTERS. - STEVE EDWARDS RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $225,638. - STEVE EDWARDS RECEIVED A 457(F) DISTRIBUTION OF $105,971, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - JAKE MCWAY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $91,520. - JAKE MCWAY RECEIVED A 457(F) DISTRIBUTION OF $96,844, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - JOHN DUFF RECEIVED AN EXECUTIVE 457(F) DISTRIBUTION OF $68,470, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - CHARITY ELMER RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $47,542. -RON PRENGER RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $29,001. SCHEDULE J, PART I, LINE 6A COMPENSATION CONTINGENT ON THE NET EARNINGS OF THE ORGANIZATION: KEY EMPLOYEES HAVE NET EARNINGS AS ONE COMPONENT OF A BALANCED SCORECARD METRIC CONTAINED WITHIN A BONUS PROGRAM. EMPLOYED PHYSICIANS ARE PAID BASED ON A SALARY, A FORMULA USING COLLECTIONS AND EXPENSES, AN AMOUNT PER RVU, OR A COMBINATION OF THESE. PHYSICIANS LISTED ON PART VII THAT ARE SUBJECT TO THESE COMPENSATION ARRANGEMENTS ARE RUSSELL BOND JR, MARTIN JONES, ARIJIT CHOWDHURY, CARY MARQUIS, AND BOYD CROCKETT. EXECUTIVE LEVEL STAFF ARE ELIGIBLE FOR ADDITIONAL COMPENSATION BASED ON A VARIETY OF PERFORMANCE INDICATORS IN QUALITY, CUSTOMER AND EMPLOYEE SATISFACTION AND BUSINESS PERFORMANCE MEASURES. SCHEDULE J, PART II; AND FORM 990, PART VII BOARD MEMBER COMPENSATION: NO COMPENSATION WAS PROVIDED FOR RESPONSIBILITIES ASSOCIATED WITH BEING A BOARD 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 J, PART II, COLUMN F COMPENSATION REPORTED IN 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. A HEALTH & EDUCATIONAL FACILITIES AUTH - STATE OF MO 431178966 60637AEA6 2013-04-17 215764775 NEW INFRASTRUCTURE/CURRENT REFUNDI false false false B HEALTH & EDUCATIONAL FACILITIES AUTH - STATE OF MO 431178966 2008-10-15 70000000 NEW INFRASTRUCTURE AND EQUIPMENT false false false C HEALTH & EDUCATIONAL FACILITIES AUTH - STATE OF MO 431178966 60635R427 2008-09-25 157078759 1997 & 2002 BOND RFDING; NEW INFRA true false false D HEALTH & EDUCATIONAL FACILITIES AUTH - STATE OF MO 431178966 2008-10-15 35000000 NEW INFRASTRUCTURE & EQUIPMENT false false false A 0 0 216268835 0 16377190 0 2222341 0 0 155950900 29708339 12010065 true false false true B 0 0 70469521 0 783050 0 501052 2121540 0 67063878 0 0 2012 false false true true C 0 130000000 158173261 3080540 1387574 0 1448411 0 0 66262892 72482407 0 2012 true false true true D 0 0 35028548 0 421299 0 271929 803381 0 33531939 0 0 2012 false false true true A false false false false 0.01050 0.01050 false false false true B false false false false 0.00830 0.00830 false false false true C false true false false 0 false false false true D false false false false 0.00830 0.00830 false false false true A false true false false false false 0 false 0 false true B false false false true true false 0 false 0 false true C false false false true false false 0 false 0 false true D false false false true true false 0 false 0 false true A true B true C true D true SCHEDULE K, PART II, LINE 3, COLUMNS A, B, C, D & (II)B TOTAL PROCEEDS OF ISSUE: THE TOTAL PROCEEDS OF THE ISSUE EXCEEDED THE ISSUE PRICE BY THE INVESTMENT EARNINGS AS OF 09/30/2015. SCHEDULE K, PART II, LINE 11, COLUMNS A, C & (II)B OTHER PROCEEDS SPENT: THE OTHER SPENT PROCEEDS RELATE TO THE CURRENT OR ADVANCE REFUNDING PROCEEDS OF THE ISSUE. SCHEDULE K, PART IV, LINE 2C, COLUMNS B, C, D & (II)A DATE REBATE COMPUTATION WAS PERFORMED: REBATE CALCULATION/ANALYSIS WERE COMPLETED AS FOLLOWS: -BOND SERIES ISSUE B ON 11/14/2013 -BOND SERIES ISSUE C ON 10/15/2013 -BOND SERIES ISSUE D ON 11/14/2013 -BOND SERIES ISSUE (II)A ON 10/10/2012 A HEALTH & EDUCATIONAL FACILITIES AUTH - STATE OF MO 431178966 60637AEA6 2007-02-22 5000000 CAPITAL EQUIPMENT FINANCING false false false B HEALTH & EDUCATIONAL FACILITIES AUTH - STATE OF MO 431178966 60637AHS4 2015-04-22 142209927 REFINANCE 80% 2008A false false false A 0 0 5000000 0 0 0 50000 0 0 4900000 0 0 2007 false false true true B 0 0 142209978 0 0 0 1326793 0 0 0 140824492 58693 false true false true A false false false false 0.01000 0.01000 false false false true B false false false false 0 false false false true A false false false true false false 0 false 0 false true B false true false false false false 0 false 0 false true A true B true WILLIAM BRESHEARS B BRESHEARS - SEE PART V 15208 WAGES AND BENEFITS false VICKIE HOCKENSMITH S EDWARDS - SEE PART V 96398 WAGES AND BENEFITS false TERRY HAMMER S EDWARDS - SEE PART V 104474 WAGES AND BENEFITS false LISA ESPY K KRAMER - SEE PART V 37806 WAGES false JASON PRENGER R PRENGER - SEE PART V 21708 WAGES AND BENEFITS false FAITH SCHAFFER R SCHAFFER - SEE PART V 147658 WAGES AND BENEFITS false BETTY EDWARDS S EDWARDS - SEE PART V 23953 RETIREMENT BENEFITS false HADEN COWHERD AND BULLOCK G HADEN - SEE PART V 549672 LEGAL SERVICES false CONNIE ROMERO F ROMERO - SEE PART V 70758 WAGES AND BENEFITS false SCHEDULE L, PART IV BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (1)BETTY BRESHEARS' HUSBAND, WILLIAM BRESHEARS, IS AN EMPLOYEE OF LESTER E. COX MEDICAL CENTERS, AND BETTY IS VICE PRESIDENT OF CORPORATE COMPLIANCE. (2,3,7)STEVE EDWARDS, CEO, HAS THREE FAMILY MEMBERS WHO WORK FOR OR RECEIVE RETIREMENT BENEFITS FROM LESTER E. COX MEDICAL CENTERS. VICKIE HOCKENSMITH IS HIS SISTER, TERRY HAMMER IS HIS BROTHER-IN-LAW, AND BETTY B. EDWARDS IS HIS MOTHER. (4)KAREN KRAMER'S SISTER, LISA ESPY, IS AN EMPLOYEE AT LESTER E. COX MEDICAL CENTERS, AND KAREN IS VICE PRESIDENT AND CHIEF NURSING OFFICER. (5)RON PRENGER'S SON, JASON PRENGER, IS AN EMPLOYEE AT LESTER E. COX MEDICAL CENTERS, AND RON IS A SENIOR VICE PRESIDENT AND CHIEF HOSPITAL OFFICER. (6)RODNEY SCHAFFER'S SPOUSE, FAITH SCHAFFER, IS AN EMPLOYEE AT LESTER E. COX MEDICAL CENTERS, AND RODNEY IS THE VICE PRESIDENT OF FACILITIES MANAGEMENT. (8)GRANT HADEN, FIRST VICE CHAIRMAN OF THE BOARD OF DIRECTORS, IS AN OWNER OF HADEN, COWHERD & BULLOCK, LLC. (9)FRANK ROMERO'S WIFE, CONNIE ROMERO, IS AN EMPLOYEE OF LESTER E. COX MEDICAL CENTERS AND FRANK IS VICE PRESIDENT OF MEDICAL AFFAIRS. FORM 990, PART III, LINE 4B ADDITIONAL INFORMATION ABOUT PHYSICIAN CARE: AFFORDABLE, CONVENIENT CARE IS ALSO PROVIDED IN OUR RETAIL CLINICS. LESTER E. COX MEDICAL CENTERS CONTINUES TO PARTNER WITH WAL-MART AND HYVEE AND CURRENTLY HAS 6 PARTNERSHIP CLINICS. COXHEALTH HAS ALSO INVESTED IN TELEMEDICINE INFRASTRUCTURE TO FURTHER EXPAND ITS ABILITY TO OFFER COST EFFECTIVE AND CONVENIENT CARE TO OUR COMMUNITY. FORM 990, PART III, LINE 4C EXEMPT PURPOSE ACHIEVEMENTS - ADDITIONAL INFORMATION ABOUT HOME CARE: OXFORD SUPPORTS THE COMMUNITY THROUGH THEIR ASSOCIATION SUPPORT (I.E. ALZHEIMER'S ASSOCIATION, DIABETES ASSOCIATION, HEART ASSOCIATION, ETC,) THEY WORK DILIGENTLY TO RAISE FUNDS FOR PATIENTS THROUGH DONATIONS FROM THEIR EMPLOYEES AND A COMMUNITY WIDE FAN DRIVE FOR PATIENTS WITHOUT AIR CONDITIONING. HOME SUPPORT HAS PROVIDED DURABLE MEDICAL EQUIPMENT AND SERVICES TO PATIENTS IN SOUTHWEST MISSOURI FOR OVER 30 YEARS AND AS THE COMPANY HAS GROWN IT HAS STEADILY BECOME MORE INVOLVED IN AN EFFORT TO BETTER MEET THE NEEDS OF THE COMMUNITY AS A WHOLE. THE STAFF SUPPORT THEIR PATIENTS AND FAMILIES IN MANY WAYS BY CONTACTING HOME HEALTH CARE AGENCIES, DIVISION OF AGING AND OTHER LOCAL CHARITIES. THEY REGULARLY DONATE MEDICAL EQUIPMENT TO CONVOY OF HOPE AND OTHER AGENCIES THAT SUPPORT DISASTER AND RELIEF EFFORTS BOTH LOCALLY AND ABROAD. COMMUNITY BENEFIT ACTIVITIES INCLUDE DONATED EMPLOYEE TIME AND PARTS TO INSTALL AN OVERHEAD LIFT FOR AN ORGANIZATION CALLED "HORSES OF HOPE" THAT AIDS IN HELPING DISABLED PATIENTS RIDE HORSES. FORM 990, PART III, LINES 4A-4D EXEMPT PURPOSE ACHIEVEMENTS - COMMUNITY BENEFIT REPORT: LESTER E. COX MEDICAL CENTERS IS PROUD TO OFFER NATIONALLY RECOGNIZED QUALITY CARE AND THE LATEST IN MEDICAL TECHNOLOGY AND SERVICES TO IMPROVE OUR COMMUNITY'S HEALTH. DESPITE INNOVATION AND QUALITY, THERE ARE STILL COMMUNITY NEEDS THAT ARE NOT MET THROUGH REGULAR COURSE OF CARE. THAT IS WHY AS A COMMUNITY-OWNED, NOT-FOR-PROFIT HOSPITAL SYSTEM, WE PROVIDE THE KIND OF CARE AND PROGRAMS THAT ARE NEEDED TO SERVE ALL IN OUR COMMUNITIES, INCLUDING SOME OF THE MOST VULNERABLE - THE UNDERINSURED AND UNINSURED. PROGRAMS THAT HELP THE INDIVIDUALS AND FAMILIES OF OUR COMMUNITY ARE AN INVESTMENT IN FRIENDS, FAMILY, AND NEIGHBORS. LESTER E. COX MEDICAL CENTERS DOES THIS THROUGH INITIATIVES LIKE KOHL'S CARDIAC KIDS AND HEALTHY FOOD PANTRY COLLABORATIVE, BUT IS ALSO EVIDENT IN COMMUNITY AND HEALTH CARE EDUCATION, SUPPORT GROUPS, PREVENTIVE SCREENINGS, SPONSORSHIPS, AND DONATIONS. COMMUNITY BENEFIT MEDICARE, MEDICAID AND UNINSURED SUBSIDIES $ 141,114,203 THIS FIGURE INCLUDES THE ESTIMATED UNPAID COSTS OF PROVIDING CARE TO MEDICARE AND MEDICAID PATIENTS AND REPRESENTS THE SHORTFALL BETWEEN THE COST OF PROVIDING CARE AND THE PAYMENTS RECEIVED BY THE GOVERNMENT AND COVERED INDIVIDUALS. ALSO, IT INCLUDES THE ESTIMATED UNPAID COST OF PROVIDING FREE OR DISCOUNTED CARE TO PERSONS WHO CANNOT AFFORD TO PAY FOR ANY OR ALL OF THE SERVICES THEY RECEIVE AND WHO ARE NOT ELIGIBLE FOR PUBLIC PROGRAMS. COMMUNITY OUTREACH SERVICES $ 309,578 INCLUDES ACTIVITIES CARRIED OUT TO IMPROVE COMMUNITY HEALTH AND SERVICES THAT ARE SUBSIDIZED BECAUSE THEY ARE NEEDED IN THE COMMUNITY. EXAMPLES ARE COMMUNITY EDUCATION, HEALTH SCREENINGS, SUPPORT GROUPS, IMMUNIZATIONS, COALITION BUILDING AND SUBSIDY OF HEALTH CARE SERVICES. HEALTH PROFESSIONALS EDUCATION AND RESEARCH $ 489,982 THIS FIGURE IS THE COST OF PROVIDING CLINICAL PLACEMENTS FOR PHYSICIANS AND OTHER HEALTH PROFESSIONALS PLUS THE UN-REIMBURSED COST OF COX FAMILY MEDICINE RESIDENCY AND SCHOOLS OF ALLIED HEALTH PROFESSIONS. IT INCLUDES THE UN-REIMBURSED EXPENSE OF STUDIES ON THERAPEUTIC PROTOCOLS AND RESEARCH. FOUNDATION GRANTS, FINANCIAL CONTRIBUTIONS AND IN-KIND DONATIONS $ 1,222,843 THIS FIGURE INCLUDES CASH AND IN-KIND DONATIONS TO SUPPORT COMMUNITY ORGANIZATIONS, PATIENT ADVOCACY AND EDUCATION, AS WELL AS CONTRIBUTIONS FOR NOT-FOR-PROFIT COMMUNITY ORGANIZATIONS AND EVENT SPONSORSHIPS. TOTAL COMMUNITY BENEFIT: $ 143,136,606 ECONOMIC IMPACT: RESTRICTED FOUNDATION GRANTS $ 7,370,979 THIS FIGURE INCLUDES CASH DONATIONS PAID BY THE COXHEALTH SYSTEM TO SUPPORT COMMUNITY ORGANIZATIONS, PATIENT ADVOCACY AND EDUCATION, AS WELL AS CONTRIBUTIONS FOR NON-FOR-PROFIT COMMUNITY ORGANIZATIONS AND EVENT SPONSORSHIPS. REAL ESTATE AND PROPERTY TAXES $ 1,057,479 TOTAL REAL ESTATE AND PROPERTY TAXES PAID BY LESTER E. COX MEDICAL CENTERS FOR MEDICAL OFFICE BUILDINGS AND PHYSICIAN OFFICES AND CLINIC. CAPITAL INVESTMENTS $ 136,560,033 AS A NON-PROFIT ORGANIZATION, LESTER E. COX MEDICAL CENTERS REINVESTS ITS REVENUE IN THE SERVICES IT PROVIDES TO THE COMMUNITY, INCLUDING THE COST OF MEDICAL TECHNOLOGY, EQUIPMENT AND SERVICES. THIS AMOUNT INCLUDES THE TOTAL INVESTMENT MADE THROUGH PURCHASING AND LEASING OF MEDICAL EQUIPMENT AND TECHNOLOGY, AS WELL AS RENTAL FACILITIES, SUCH AS MEDICAL OFFICES. PAYROLL & BENEFITS $ 430,164,856 THE COXHEALTH SYSTEM IS ONE OF THE LARGEST EMPLOYERS IN SOUTHWEST MISSOURI. IN CALENDAR YEAR 2014, LESTER E. COX MEDICAL CENTERS ALONE EMPLOYED APPROXIMATELY 8,701 PEOPLE, AND THE REMAINING COXHEALTH SYSTEM AFFILIATES CARRY THE TOTAL EMPLOYED FIGURE TO OVER 10,000 PEOPLE. THIS DOLLAR AMOUNT INCLUDES THE COST OF PAYROLL AND BENEFITS OF OUR DEDICATED TEAM FOR LESTER E. COX MEDICAL CENTERS. IT ALSO INCLUDES A SIGNIFICANT INVESTMENT ON CONTRACT PERSONNEL IN VARIOUS MEDICAL SPECIALTIES AS WELL AS MONIES TO OTHER PROFESSIONALS WHO RESIDE LOCALLY. TOTAL ECONOMIC IMPACT: $ 567,782,368 TOTAL CONTRIBUTIONS TO THE COMMUNITY: $ 710,918,974 FORM 990, PART VI, SECTION A, LINES 6, 7A & 7B MEMBERS, STOCKHOLDERS, OR OTHER PERSONS: PER BYLAW CHANGES MADE DURING THE FISCAL YEAR, COXHEALTH IS NOW THE SOLE MEMBER OF LESTER E. COX MEDICAL CENTERS. THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE SOLELY AND SPECIFICALLY RESERVED TO THE MEMBER; (A) TO ESTABLISH AND CHANGE THE BUSINESS PURPOSES, MISSION, VISION OR VALUES OF CMC; (B) TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF CMC AS PROVIDED THEREIN; (C) TO APPROVE AMENDMENTS TO THE BYLAWS OF CMC; (D) TO APPROVE THE ADOPTION OF AND ANY REVISION TO THE CHARTERS FOR ALL COMMITTEES ESTABLISHED BY THE BOARD; (E) TO APPOINT AND REMOVE THE DIRECTORS OF CMC, SUBJECT TO THE REQUIREMENTS OF ARTICLE FIVE, SECTION 1 AND TO APPOINT AND REMOVE THE OFFICERS OF THE BOARD AND CMC; (F) AFTER CONSULTATION WITH THE BOARD, TO APPROVE THE APPOINTMENT AND REMOVAL OF THE PRESIDENT AND CEO OF CMC; (G) TO APPOINT THE AUDITOR AND THE CORPORATE COUNSEL FOR CMC AND ITS CONTROLLED SUBSIDIARIES OR REMOTELY CONTROLLED SUBSIDIARIES; (H) TO ESTABLISH CENTRALIZED EMPLOYEE BENEFIT, INSURANCE, INVESTMENT, FINANCING, MARKETING, LEGAL, CORPORATE, COMPLIANCE, PERFORMANCE ASSESSMENT AND IMPROVEMENT AND OTHER OPERATIONAL AND SUPPORT PROGRAMS; TO REQUIRE THE PARTICIPATION OF CMC IN SUCH PROGRAMS; AND TO AUTHORIZE THE OPENING AND CLOSING OF BANK ACCOUNTS AND INVESTMENT ACCOUNTS IN THE NAME OF CMC; (I) TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF CMC OR THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF CMC; (J) TO APPROVE THE FORMATION OF A CONTROLLED SUBSIDIARY OR A REMOTELY SUBSIDIARY; (K) TO APPROVE THE ACQUISITION OR DISPOSITION BY CMC OF ANOTHER LEGAL ENTITY OR AN INTEREST IN ANOTHER LEGAL ENTITY; (L) AFTER RECEIVING INPUT FROM THE BOARD, TO APPROVE THE STRATEGIC PLAN AND THE OPERATING AND CAPITAL BUDGETS OF CMC; (M) APPROVAL OF CMC'S UNBUDGETED DEBT AND CAPITAL EXPENDITURES OF ONE HUNDRED THOUSAND DOLLARS ($100,000) OR GREATER; (N) TO AUTHORIZE OR APPROVE THE ACQUISITION OR DISPOSITION BY CMC OF REAL PROPERTY OR ANY INTEREST IN REAL PROPERTY HAVING A VALUE OF ONE HUNDRED THOUSAND DOLLARS ($100,000) OR GREATER; (O) TO APPROVE THE SALE OR PURCHASE OF ANY PROPERTY OF CMC HAVING A VALUE OF ONE HUNDRED THOUSAND DOLLARS ($100,000) OR GREATER; (P) TO AUTHORIZE AND APPROVE BORROWING MONEY OR ENTERING INTO FINANCIAL GUARANTIES BY CMC, INCLUDING ACTIONS RELATING TO THE FORMATION, JOINING, OPERATION, WITHDRAWAL FROM AND TERMINATION OF A CREDIT GROUP OR AN OBLICATED GROUP AND THE GRANTING OF SECURITY INTERESTS IN THE PROPERTY OF CMC; (Q) TO REQUIRE CMC TO TRANSFER ASSETS, INCLUDING BUT NOT LIMITED TO CASH, TO THE MEMBER; (R) TO APPROVE THE TRANSFER OF ASSETS BY CMC TO ANY ENTITY OTHER THAN THE MEMBER, OTHER THAN TRANSFERS MADE IN THE ORDINARY COURSE OF OPERATIONS OF CMC WHICH WILL NOT REQUIRE APPROVAL OF THE MEMBER; (S) TO APPROVE THE RATE OF PAYMENT, COMPENSATION OR RENT AND/OR ANY PROVISIONS CONCERNING EXCLUSIVITY WITH RESPECT TO ANY CONTRACT FOR PHYSICIAN SERVICES AND ANY LEASE/TIMESHARE AGREEMENT BETWEEN ANY PHYSICIAN OR PHYSICIAN GROUP, ON THE ONE HAND, AND CMC OR ANY CONTROLLED SUBSIDIARY OR REMOTELY CONTROLLED SUBSIDIARY, ON THE OTHER HAND, ALL IN ACCORDANCE WITH SUCH POLICIES AND PROCESSES WHICH MAY BE PROMULGATED FROM TIME TO TIME BY THE MEMBER; (T) TO APPROVE CHANGES TO THE TYPE OF OR RELOCATION OF PHYSICIAN PROFESSIONAL MEDICAL SERVICES OFFERED BY CMC, WHERE THE CHANGE INVOLVES (A) SERVICES OFFERED OR PROVIDED BY CMG PHYSICIANS AND (B) (I) A CHANGE IN VENUE OR PROVIDER STATUS OF THE MEDICAL SERVICE, (II) THE CESSATION OF A PRE-EXISTING MEDICAL SERVICE, OR (III) THE OFFERING OF A NEW MEDICAL SERVICE; (U) TO ENGAGE, APPROVE, AND TO FINALIZE ANY AND ALL CONTRACTS OR AGREEMENTS WITH ANY THIRD PARTY HOSPITAL-BASED PHYSICIAN GROUPS (ANESTHESIOLOGISTS, PATHOLOGISTS, RADIOLOGISTS, OR EMERGENCY MEDICINE PHYSICIANS) THAT WILL RENDER PROFESSIONAL SERVICES TO CMC; (V) TO OVERRIDE AND REVERSE ANY DECISION MADE OR ACTION AUTHORIZED BY THE CMC BOARD TO THE EXTENT THAT SUCH DECISION OR ACTION CONFLICTS WITH A DECISION MADE OR ACTION AUTHORIZED BY THE JOINT OPERATIONS COMMITTEE OF THE MEMBER; (W) TO DETERMINE THE EXTENT TO WHICH AND THE MANNER IN WHICH THE POWERS DESCRIBED IN THIS SECTION WHICH ARE RESERVED TO THE MEMBER WITH RESPECT TO CMC ARE TO BE INCLUDED IN THE GOVERNING DOCUMENTS OF ANY CONTROLLED SUBSIDIARY OR REMOTELY CONTROLLED SUBSIDIARY AND EXERCISED WITH RESPECT TO ANY CONTROLLED SUBSIDIARY OR ANY REMOTELY CONTROLLED SUBSIDIARY. THE BOARD SHALL BE ELECTED BY THE MEMBER. PRIOR TO THE ANNUAL MEETING, THE BOARD SHALL NOMINATE A SLATE OF PERSONS FOR ELECTION AS CMC DIRECTORS AND OFFICERS TO SUBMIT TO COXHEALTH FOR APPOINTMENT. COXHEALTH WILL ACT IN GOOD FAITH AND NOT UNREASONABLY WITHHOLD APPOINTMENT. FORM 990, PART VI, SECTION B, LINE 11B 990 REVIEW POLICY: 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. PRIOR TO FILING, FORM 990 IS FIRST REVIEWED BY MEMBERS OF TOP MANAGEMENT. ONCE THEY HAVE APPROVED THE DRAFT, A FINAL COPY IS PRESENTED TO THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. IN ADDITION, A FINAL COPY IS PROVIDED TO THE BOARD OF DIRECTORS THROUGH THE ONLINE BOARD PORTAL PRIOR TO FILING. 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, 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 LESTER E. COX MEDICAL CENTERS. FORM 990, PART VI, SECTION B, LINES 15A & 15B COMPENSATION REVIEW POLICY: LESTER E. COX MEDICAL CENTERS EMPLOYS 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 EXECUTIVES OF THE ORGANIZATION 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 1 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: LESTER E. COX MEDICAL CENTERS MAKES AVAILABLE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE FOR ALL LEGITIMATE BUSINESS PURPOSES AS DETERMINED BY MANAGEMENT. IN ADDITION, AS A CONTINUING DISCLOSURE REQUIREMENT OF CERTAIN DEBT COVENANTS THE ORGANIZATION PROVIDES ITS AUDITED FINANCIAL STATEMENTS AND SPECIFIC QUARTERLY FINANCIAL INFORMATION TO DEFINED REPOSITORIES FOR REVIEW BY PARTIES OR INDIVIDUALS INTERESTED IN THE INFORMATION. FORM 990, PART VII, SECTION A BOARD MEMBER COMPENSATION: DRS. DIX AND ZOLFAGHARI 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 IX, LINE 11G OTHER FEES FOR SERVICES: $ 99,162,468 PHYSICIAN REMUNERATION 92,231,273 PURCHASED AFFILIATE SERVICES 11,134,437 OTHER PURCHASED SERVICES 5,820,319 ANESTHESIA SERVICES 4,737,340 CONTRACTED REPAIRS & MAINTENANCE 4,652,807 BILLING/COLLECTION SERVICES 4,597,870 PURCHASED LAB SERVICES 4,556,060 HOUSEKEEPING/LAUNDRY 2,759,920 CONSULTING 1,663,146 PROFESSIONAL FEES 1,480,872 PHARMACY 1,430,439 MEDICAL DIRECTOR 1,368,503 CONTRACT LABOR 1,051,310 PURCHASED MANAGEMENT SERVICES 361,930 COURIER SERVICES 271,355 SPECIAL SERVICES 77,797 OCCUPATIONAL THERAPY SERVICES 72,661 RADIOLOGY SERVICES 22,095 MEDICAL TRANSCRIPTION -------------- $ 237,302,319 FORM 990, PART XI, LINE 9 OTHER CHANGES TO NET ASSETS: $ (751,921) RETURN OF CAPITAL (20,159,031) DEFINED BENEFIT PENSION PLAN LOSS 4,740,335 TRANSFER FROM AFFILIATES (68,615) CHANGE IN BENEFICIAL INTEREST IN TRUST --------------- $ (16,239,232) FERRELL DUNCAN CLINIC 1001 E PRIMROSE SPRINGFIELD MO 65807 542183221 PHYSICIANS MO 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