2014-03-14T11:32:57-05:00 2013-04-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2012-05-01 440584290 SKAGGS COMMUNITY HOSPITAL ASSOCIATION % DAVID STRONG SKAG 4173357000 251 SKAGGS ROAD Suite BRANSON MO 65615 DAVID STRONG 4173357700 2014-02-28 true Brian D Todd 4178658701 2012 2016-02-25 16:41:14Z COX MEDICAL CENTER BRANSON MR WILLIAM MAHONEY 251 SKAGGS ROAD BRANSON MO 65615 189162153 false X WWW.SKAGGS.NET X 1950 MO THE HOSPITAL IMPROVES YOUR LIFE VIA EDUCATION, PREVENTION, AND ADVO- CACY; BY THE USE OF TECHNOLOGY; AND BY PROVIDING COMFORT AND PRIVACY WHILE PRESERVING DIGNITY. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 14 6 1423 275 0 0 587515 745045 181820734 186099475 422840 517611 1158507 1057748 183989596 188419879 385787 372526 0 0 67610329 72562875 0 0 0 115478413 109029820 183474529 181965221 515067 6454658 108670196 152039918 58180699 61582892 50489497 90457026 X THE HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH QUALITY HEALTH CARE, EDUCATION AND RESEARCH. false false 128272172 184185 158289235 HOSPITAL SERVICES - DURING THE FISCAL YEAR THE HOSPITAL EXPERIENCED A 9.46% DECREASE IN PATIENT ADMISSION WITH A TOTAL OF 6,267. EMERGENCY ROOM VISITS ALSO SAW A DECREASE OF 6.57% FOR A TOTAL OF 36,128 FOR THE FISCAL YEAR. OUTPATIENT VISITS INCREASED BY LESS THAN 1% TO 90,060 FOR THE FISCAL YEAR. THE HOSPITAL ALSO EXPERIENCED A DECREASE IN ITS AVERAGE OCCUPANCY RATE FROM 43.43% FOR FISCAL YEAR 2012 TO 41.62% FOR FISCAL YEAR 2013. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 32565842 24686025 CLINIC SERVICES - DURING THE FISCAL YEAR THE HOSPITAL HAD 112,952 TOTAL CLINIC VISITS, AN INCREASE OF 10.19% COMPARED TO THE PRIOR FISCAL YEAR. 1863804 188341 3124215 HOME HEALTH SERVICES - HOME HEALTH AND HOSPICE VISITS TOTALED 12,071 FOR THE FISCAL YEAR ENDED 4/30/13. THIS IS A DECREASE OF 23.38% AS COMPARED TO THE PREVIOUS FISCAL YEAR. HOME HEALTH SERVICES INCLUDE SKILLED NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, MEDICAL SOCIAL SERVICE, PERSONAL CARE ASSISTANCE, NUTRITIONAL CONSULTATIONS AND RESPIRATORY CONSULTATION. 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FITNESS CENTER ELIGIBILITY FOR FREE CARE SCHEDULE H, PART I, LINE 3A PATIENTS WHOSE FAMILY INCOME IS AT OR BELOW 150% OF THE FPL ARE ELIGIBLE TO RECEIVE NONELECTIVE/MEDICALLY NECESSARY CARE DISCOUNTED AT 100% AFTER A $20 ENCOUNTER PAYMENT. PERCENT OF TOTAL EXPENSE SCHEDULE H, PART I, LINE 7, COLUMN F TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER FORM 990, PART IX, LINE 25 ($181,965,221) WAS REDUCED BY BAD DEBT EXPENSE ($29,236,303). COST TO CHARGE RATIO SCHEDULE H, PART I, LINE 7 THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATIONS ON IRS WORKSHEETS 1, 3, AND 6. BAD DEBT EXPENSE SCHEDULE H, PART III, SECTION A, LINE 4 DUE TO THE AFFILIATION WITH COXHEALTH THE HOSPITAL DID NOT HAVE AN AUDIT FOR THE FISCAL YEAR ENDED 4/30/13. THE ORGANIZATION CALCULATED BAD DEBT USING THE AMOUNTS CALCULATED IN THE ORGANIZATION'S INTERNAL FINANCIAL STATEMENTS. 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. COMMUNITY BENEFIT RATIONALE SCHEDULE H, PART III, SECTION B, LINE 8 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. COMMUNITY INPUT SCHEDULE H, PART V, SECTION B, LINE 3 THE CHNA PROCESS INVOLVED: - COLLECTION AND ANALYSIS OF A LARGE RANGE OF DATA, INCLUDING DEMOGRAPHIC, SOCIOECONOMIC AND HEALTH STATISTICS, HEALTH CARE RESOURCES AND PATIENT USE RATES. - INTERVIEWS WITH KEY INFORMANTS WHO REPRESENT A) BROAD INTERESTS OF THE COMMUNITY, B) POPULATIONS OF NEED OR C) PERSONS WITH SPECIALIZED KNOWLEDGE IN PUBLIC HEALTH. - CIRCULATION OF A COMMUNITY HEALTH INPUT QUESTIONNAIRE THAT GATHERED A WIDE RANGE OF INFORMATION WHICH WAS WIDELY DISTRIBUTED TO MEMBERS OF THE COMMUNITY. THE FOLLOWING STEPS WERE CONDUCTED AS PART OF HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT: - THE "COMMUNITY" SERVED BY THE HOSPITAL WAS DEFINED BY UTILIZING INPATIENT AND OUTPATIENT DATA REGARDING PATIENT ORIGIN. THIS PROCESS IS FURTHER DESCRIBED IN COMMUNITY SERVED BY THE HOSPITAL. - POPULATION DEMOGRAPHICS AND SOCIOECONOMIC CHARACTERISTICS OF THE COMMUNITY WERE GATHERED AND REPORTED UTILIZING VARIOUS THIRD PARTIES (SEE REFERENCES IN APPENDICES). THE HEALTH STATUS OF THE COMMUNITY WAS THEN REVIEWED. INFORMATION ON THE LEADING CAUSES OF DEATH AND MORBIDITY INFORMATION WAS ANALYZED IN CONJUNCTION WITH HEALTH OUTCOMES AND FACTORS REPORTED FOR THE COMMUNITY BY COUNTYHEALTHRANKINGS.ORG. HEALTH FACTORS WITH SIGNIFICANT OPPORTUNITY FOR IMPROVEMENT WERE NOTED. - AN INVENTORY OF HEALTH CARE FACILITIES AND RESOURCES WAS PREPARED AND ESTIMATED A DEMAND FOR PHYSICIAN AND HOSPITAL SERVICES WAS ESTIMATED. BOTH WERE EVALUATED FOR UNMET NEEDS. - COMMUNITY INPUT WAS PROVIDED THROUGH KEY INFORMANT INTERVIEWS OF 15 STAKEHOLDERS AND A COMMUNITY HEALTH INPUT QUESTIONNAIRE WAS WIDELY DISTRIBUTED. THE COMMUNITY HEALTH INPUT QUESTIONNAIRE WAS COMPLETED BY 547 INDIVIDUALS. RESULTS AND FINDINGS ARE DESCRIBED IN THE KEY INFORMANT AND COMMUNITY HEALTH INPUT QUESTIONNAIRE SECTIONS OF THE CHNA REPORT. - INFORMATION GATHERED IN THE ABOVE STEPS WAS ANALYZED AND REVIEWED TO IDENTIFY HEALTH ISSUES OF UNINSURED PERSONS, LOW-INCOME PERSONS AND MINORITY GROUPS AND THE COMMUNITY AS A WHOLE. HEALTH NEEDS WERE RANKED UTILIZING A WEIGHTING METHOD THAT CONSIDERS 1) THE ABILITY OF THE HOSPITAL TO IMPACT CHANGE, 2) THE SIZE OF THE PROBLEM, 3) THE SERIOUSNESS OF THE PROBLEM AND 4) THE PREVALENCE OF COMMON THEMES. - HEALTH NEEDS WERE THEN PRIORITIZED TAKING INTO ACCOUNT THE PERCEIVED DEGREE OF INFLUENCE THE HOSPITAL HAS TO IMPACT THE NEED AND THE HEALTH NEEDS IMPACT ON THE OVERALL HEALTH OF THE COMMUNITY. INFORMATION GAPS WERE IDENTIFIED DURING THE PRIORITIZATION PROCESS AND ARE ALSO REPORTED. - RECOMMENDATIONS BASED ON THIS ASSESSMENT HAVE BEEN COMMUNICATED TO HOSPITAL MANAGEMENT. IMPLEMENTATION STRATEGY SCHEDULE H, PART V, SECTION B, LINE 6 IN RESPONSE TO THE RESULTS OF THE MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION ADOPTED AN IMPLEMENTATION STRATEGY. THE IMPLEMENTATION CAN BE FOUND AT THE FOLLOWING URL: HTTP://WWW.SKAGGS.NET/UPLOADS/PUBLIC/IMPLEMENTATION%20PLAN-FINAL%20VERSION %204%2030%2013.PDF ADDRESSING IDENTIFIED NEEDS SCHEDULE H, PART V, SECTION B, LINE 7 THE 2012 COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIES A NUMBER OF UNMET OR PARTIALLY MET HEALTH NEEDS THROUGHOUT THE SERVICE AREA. ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT DATA PROVIDED A MEANS TO EVALUATE AND PRIORITIZE AREAS OF GREATEST NEED. HEALTH NEEDS WERE RANKED ON A SCALE OF ONE TO FIVE WITH A FIVE MEANING THAT THE HOSPITAL COULD HAVE THE GREATEST IMPACT ON THAT NEED, WHILE A ONE DENOTES THE LEAST IMPACT. THESE HEALTH WERE FURTHER RANKED ON FOUR FACTORS: - THE ABILITY OF COX MEDICAL CENTER BRANSON TO EVALUATE AND MEASURE OUTCOMES. - HOW MANY PEOPLE ARE AFFECTED BY THE ISSUE OR SIZE OF THE PROBLEM? - WHAT ARE THE CONSEQUENCES OF NOT ADDRESSING THE PROBLEM? - PREVALENCE OF COMMON THEMES. BY ADDRESSING THESE NEEDS, COMMUNITY HEALTH WILL LIKELY IMPROVE. THEY HAVE THE GREATEST IMPACT ON OVERALL COMMUNITY HEALTH AND THE HOSPITAL HAS THE ABILITY TO MAKE AN IMPACT. OVER THE LAST YEAR, THE HOSPITAL HAS BEGUN TO DEVELOP TOOLS FOR INTERVENTION, AND THROUGH THIS PLAN, CURRENT INTERVENTIONS WILL BE EXPANDED UPON AND NEW INTERVENTIONS WILL BE CREATED AND IMPLEMENTED IN ORDER TO IMPACT THE GREATEST NUMBER OF RESIDENTS. AS A RESULT OF THE ANALYSIS, AFFORDABLE CARE, UNINSURED RESIDENTS, DISEASES OF THE HEART, ACCESS TO SPECIALISTS, SHORTAGE OF PHYSICIANS, ACCESS TO RECREATIONAL FACILITIES, ADULT SMOKING AND TRANSPORTATION WERE IDENTIFIED AS THE PRIORITY AREAS ON WHICH WE WILL FOCUS. THERE WERE OTHER AREAS OF NEED IDENTIFIED THROUGH THE ASSESSMENT THAT ARE CLEARLY IMPORTANT TO IMPROVING THE HEALTH OF THE COMMUNITY. WHILE THEY ARE DEEMED TO HAVE A LESS IMMEDIATE IMPACT, IF OPPORTUNITY ARISES, THEY WILL BE INTEGRATED INTO THIS PLAN AS A SUB-OBJECTIVE ACTIVITY. UNFORTUNATELY, AS WITH MOST OF RURAL AMERICA, COX MEDICAL CENTER BRANSON IS WITHOUT THE NECESSARY RESOURCES TO ADEQUATELY ADDRESS THE PANDEMIC INCREASE IN PEOPLE WHO ARE IMPACTED BY MENTAL HEALTH AND SUBSTANCE ABUSE ISSUES. DETERMINATION OF MAXIMUM AMOUNTS CHARGED SCHEDULE H, PART V, SECTION B, LINE 20 ALL UNINSURED PATIENTS RECEIVE A 30% DISCOUNT, THIS AMOUNT IS LESS THAN ANY OF OUR MANAGED CARE CONTRACTS. THE FINANCIAL ASSISTANCE PATIENTS WHO RECEIVE 100% CHARITY ARE REQUIRED TO PAY A $20 ENCOUNTER PAYMENT. PATIENTS APPROVED FOR 75% CHARITY CARE, WILL PAY 25% OF CHARGES, WITH A $40 ENCOUNTER PAYMENT. PATIENTS APPROVED FOR 50% CHARITY CARE ARE REQUIRED TO PAY 50% OF CHARGES WITH A $40 ENCOUNTER PAYMENT. THE ENCOUNTER PAYMENT AMOUNT IS BASED ON AVERAGE INSURANCE CO-PAYMENTS. THE MAXIMUM AMOUNT CHARGED TO OUR QUALIFYING PATIENTS, AS A PERCENTAGE OF GROSS CHARGES IS LESS THAN ANY OF OUR MANAGED CARE CONTRACTS. NEEDS ASSESSMENT COX MEDICAL CENTER BRANSON (CMCB) WORKS CLOSELY WITH ITS COMMUNITY THROUGH ITS RELATIONSHIP WITH COXHEALTH. IN THE FISCAL YEAR CMCB TOOK THE LEAD IN BRINGING TOGETHER AREA ORGANIZATIONS WITH THE SIMILAR GOAL OF ADDRESSING THE HEALTHCARE NEEDS OF THE COMMUNITY, AS IDENTIFIED BY THE COMMUNITY NEEDS ASSESSMENT: UNHEALTHY BODY WEIGHT, ACCESS TO CARE, MENTAL HEALTH, AND SUBSTANCE ABUSE - INCLUDING TOBACCO, AND CHILD AND FAMILY SAFETY. THE COALITION IS NAMED OWNIT AND IS LED BY A STEERING COMMITTEE AND MEMBERS MAKE UP SUCH AGENCIES AND ORGANIZATIONS AS THE TANEY AND STONE COUNTY HEALTH DEPARTMENTS AND MORE. 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." 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. PROMOTION OF COMMUNITY HEALTH CMCB HAS A 14-MEMBER BOARD OF DIRECTORS. SEVERAL THOUSANDS OF DOLLARS ARE SPENT EACH YEAR OFFERING FREE OR LOW-COST SCREENINGS TO THE COMMUNITY AND EDUCATIONAL PROGRAMS. CMCB PHYSICIANS AND STAFF ARE COMMITTED TO EDUCATING THE COMMUNITY TO HELP ENSURE A HEALTHIER FUTURE. CPR CLASSES, SMOKING CESSATION CLASSES, PRENATAL CLASSES, ETC. ARE ALL FOCUSED ON GIVING OUR COMMUNITY MEMBERS THE RESOURCES THEY NEED TO MAKE INFORMED DECISIONS. AFFILIATED HEALTH CARE SYSTEM EFFECTIVE 1/1/2013, COX BRANSON BECAME A SUBSIDIARY OF COXHEALTH. COXHEALTH PROVIDES QUALITY HEALTH CARE, EDUCATION, AND RESEARCH IN ORDER TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES, INCLUDING SPRINGFIELD AND SURROUNDING AREAS. THE FOLLOWING ACTIVITIES RELATE TO ACTIVITIES PROVIDED THROUGH COXHEALTH'S AFFILIATED HEALTH CARE SYSTEM: 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 THE 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 COXHEALTH AND CAR SEATS TO THOSE IN NEED TO ENSURE THE SAFETY OF ANY NEWBORN LEAVING COXHEALTH. true SKAGGS FOUNDATION PO BOX 650 BRANSON MO 65615 300107007 501(C)(3) 70157 SUPPORT BRANSON CBMC PO BOX 1246 BRANSON MO 65615 621841451 501(C)(3) 10000 SUPPORT 2 TUITION ASSISTANCE 25 39717 HOME HEALTH CARE 8 188341 TOBACCO CESSATIION 3 13046 FMV SUPPLIES CAREERS IN HEALTH 24 5896 FMV SUPPLIES PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S. PART I, LINE 2 SKAGGS FOUNDATION FILED WITH THE INTERNAL REVENUE SERVICE TO BECOME A COMMUNITY FOUNDATION EFFECTIVE JANUARY 1, 2013. PRIOR TO THIS, SKAGGS FOUNDATION WAS A RELATED ORGANIZATION WHICH SHARED FINANCIALS WITH COX MEDICAL CENTER BRANSON. AS A RESULT, COX BRANSON WAS ABLE TO MONITOR THE USE OF GRANT FUNDS. FUNDS PAID TO CBMC WERE FOR A ONE-TIME SPONSORSHIP OF THE MAYOR'S PRAYER BREAKFAST. THE FUNDS DONATED WERE USED IMMEDIATELY TO SUPPORT THE EVENT. FOLLOWING COMPLETION OF THE COURSE(S), IT IS THE GRANTEE'S RESPONSIBILITY TO REQUEST, IN WRITING, A REIMBURSEMENT REQUEST FOR THE SEMESTER'S TUITION FEES NOT TO EXCEED $1,000 PER SEMESTER AND NO MORE THAN $2,000 PER YEAR. THE REQUEST MUST BE ACCOMPANIED WITH A STATEMENT FROM THE SCHOOL WITH A BREAKDOWN OF CHARGES ALONG WITH A COPY OF THE GRADES FOR THE COURSES BEING REIMBURSED. ALL DOCUMENTS SHOULD THEN BE SUBMITTED FOR REVIEW AND APPROVAL. THE HOME HEALTH CARE PROGRAM RECEIVES GRANT MONEY FROM THE SOUTHWEST MO OFFICE ON AGING IN TANEY COUNTY FOR USE TO COVER EXPENSES RELATED TO THE HOMEMAKER PROGRAM. EMPLOYEES WHO INCUR EXPENSES RELATED TO THIS PROGRAM ARE REIMBURSED WITH THIS GRANT MONEY. THE HOSPITAL'S HOME HEALTH DEPARTMENT MONITORS THE USE OF THESE GRANT FUNDS. THE TOBACCO CESSATION PROGRAM AND THE CAREERS IN HEALTH CLUB WERE FUNDED FROM DONATIONS RECEIVED FROM THE MISSOURI FOUNDATION FOR HEALTH. THE TOBACCO CESSATION PROGRAM OFFERS CLASSES AND SUPPLIES TO MEMBERS OF THE COMMUNITY/EMPLOYEES TO ASSIST THEM WITH SMOKING CESSATION. THIS PROGRAM IS MONITORED BY THE HEALTH AND WELLNESS DEPARTMENT. THE CAREERS IN HEALTH CLUB WAS SET-UP TO ENCOURAGE AND EXPOSE STUDENTS TO CONSIDER HEALTHCARE AS A CAREER CHOICE. THIS PROGRAM IS MONITORED BY THE HEALTH AND WELLNESS DEPARTMENT AND BRANSON SCHOOLS. X false true X X X X X false true false false false false false true false JAKE MCWAY 0 417213 0 110374 0 107730 0 89979 0 17867 0 743163 0 85023 JOHN DUFF 0 333629 0 90783 0 69163 0 117838 0 21250 0 632663 0 34836 STEVE EDWARDS 0 630893 0 120585 0 150077 0 123397 0 19731 0 1044683 0 139676 WILLIAM MAHONEY 396030 0 32725 0 363 0 5000 0 27290 0 461408 0 0 0 DAVID STRONG 220190 0 0 0 7149 0 4699 0 25760 0 257798 0 0 0 DIANE CORNELISON 515928 0 1800 0 1765 0 15411 0 10696 0 545600 0 0 0 JOHN HUFFMAN 527931 0 0 0 0 0 15636 0 16971 0 560538 0 0 0 MITTIE DRAGOSLJVICH 645850 0 0 0 1944 0 18131 0 25149 0 691074 0 0 0 NARIN ARUNAKUL 768110 0 1800 0 27163 0 10500 0 23122 0 830695 0 0 0 PRASERT VIJITBENJARONK 531851 0 1800 0 17016 0 5000 0 23272 0 578939 0 0 0 SHERYL TILUS 173679 0 0 0 17 0 3597 0 23947 0 201240 0 0 0 CAROL MURROW 149127 0 0 0 17074 0 6047 0 10812 0 183060 0 0 0 PETER MARCELLUS 172931 0 0 0 863 0 7273 0 20805 0 201872 0 0 0 GROSS-UP PAYMENTS SCHEDULE J, PART I, LINE 1 DOCTOR ARUNAKUL RECEIVED GROSS-UP PAYMENTS ON FORGIVEN PRINCIPAL AND INTEREST. STRONG, MURROW, TILUS AND VIJITBENJARONK RECEIVED GROSS-UP PAYMENTS ON GIFT CARDS. ALL AMOUNTS WERE TREATED AS TAXABLE. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B STEVE EDWARDS, JACOB MCWAY, AND JOHN DUFF PARTICIPATE IN A 457(F) NONQUALIFIED RETIREMENT PLAN THROUGH LESTER E. COX MEDICAL CENTERS, A RELATED ORGANIZATION. - STEVE EDWARDS RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $110,897. - STEVE EDWARDS RECEIVED A 457(F) DISTRIBUTION OF $139,676, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - JACOB MCWAY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $77,479. - JACOB MCWAY RECEIVED A 457(F) DISTRIBUTION OF $85,023, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - JOHN DUFF RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $105,338. - JOHN DUFF RECEIVED A 457(F) DISTRIBUTION OF $34,836, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. INCENTIVE PAYMENTS SCHEDULE J, PART I, LINE 7 THE PHYSICIANS ARE ELIGIBLE FOR AN INCENTIVE PAYMENT, BASED ON REACHING A THRESHOLD SET BY THE CEC. ONCE THE PHYSICIANS' WORK RELATIVE VALUE UNITS (WRVU) ARE IN EXCESS OF THIS THRESHOLD ON AN ANNUAL BASIS THE PHYSICIAN RECEIVES A INCENTIVE. THE INCENTIVE IS CALCULATED ON 15% OF THE PHYSICIANS WRVU BASE RATE MULTIPLIED BY THE NUMBER OF WRVU'S IN EXCESS OF THAT THRESHOLD. THIS INCENTIVE IS ONLY COMPENSATED ONCE A YEAR AND IS CALCULATED IN OCTOBER. PHYSICIANS WHO HAVE A GUARANTEE ARE NOT ELIGIBLE FOR THE INCENTIVE. A THE INDUSTRIAL DEVELOPMENT AUTHORITY OF TANEY CO 431288274 87539NBQ8 2005-11-17 17635000 CONSTRUCT AND EQUIP HOSPITAL FACIL true false false A 3745000 13890000 18700518 0 562209 0 0 0 0 16910892 0 0 2009 false false true true A false true true true false 0.00000 0.00000 0.00000 false false 0.00000 false true A false true false false 0 true AIG MATCHED FUND CO 23.4 true true true A true TAX EXEMPT BOND SCHEDULE K, PART II, LINE 3, COLUMN A THE AMOUNT ENTERED IN PART II, LINE 3, COLUMN A IS GREATER THAN THE "ISSUE PRICE" OF THE BONDS ENTERED ON PART I, LINE A, COLUMN (E) BECAUSE OF INVESTMENT EARNINGS THAT WERE EARNED ON THE BOND PROCEEDS DEPOSITED IN THE PROJECT FUND AND DEBT SERVICE RESERVE FUND. INVESTMENT EARNINGS ON THE DEBT SERVICE RESERVE FUND WERE ONLY TAKEN INTO ACCOUNT THROUGH THE END OF THE "PROJECT PERIOD." GROSS PROCEEDS IN RESERVE FUNDS SCHEDULE K, PART II, LINE 4, COLUMN A THE BONDS ARE NO LONGER OUTSTANDING. ALL AMOUNTS IN THE DEBT SERVICE RESERVE FUND WERE USED TO REDEEM THE BONDS ON MAY 6, 2013. NO REBATE DUE SCHEDULE K, PART IV, LINE 2(C), COLUMN A THE FINAL REBATE COMPUTATION WAS PERFORMED AS OF MAY 6, 2013. 0 SKAGGS HEALTH SYSTEMS SEE PART V. 175800 PHO DUES & ADMIN FEES false WHITE RIVER VALLEY ELECTRIC COOP SEE PART V. 156479 LOAN REPAYMENT & ELECTRIC SVC false CONNIE MARCELLUS SPOUSE OF PETER MARCELLUS 19444 COMPENSATION false 360 DEGREE MEDICINE SEE PART V 4706184 CONTRACTED PHYSICIANS false TRANSACTIONS WITH INTERESTED PERSONS SCHEDULE L, PART IV, COLUMN B (1) SKAGGS HEALTH SYSTEMS AND COX MEDICAL CENTER BRANSON SHARE COMMON BOARD MEMBERS, INCLUDING: JAMES BERRY, PHIL LOYD, AND DENNIS NEWKIRK. ADDITIONALLY, CEO WILLIAM MAHONEY AND CFO DAVID STRONG SERVE ON THE BOARD OF SKAGGS HEALTH SYSTEMS. (2) BOB SIMMONS, A BOARD MEMBER OF COX MEDICAL CENTER BRANSON, IS ALSO A BOARD MEMBER OF WHITE RIVER VALLEY ELECTRIC COOP. (4) RICHARD BLUBAUGH, A BOARD MEMBER OF COX MEDICAL CENTER BRANSON, IS ALSO A BOARD MEMBER AND MANAGING PARTNER OF 360 DEGREE MEDICINE. ORGANIZATION'S MISSION SUMMARY FORM 990, PART I, LINE 1 VISION: THE HOSPITAL'S VISION IS TO BE THE BEST FOR THOSE WHO NEED US. WE VALUE SAFETY, COMPASSION, RESPECT AND INTEGRITY. THE HOSPITAL HAS BEEN SERVING SOUTHWEST MISSOURI RESIDENTS FOR MORE THAN 62 YEARS AND OFFERS OVER 25 MAJOR SERVICE AREAS. THE HOSPITAL'S AVERAGE DAILY PATIENT CENSUS EXCEEDS 90 WITH 165 LICENSED HOSPITAL BEDS. A STAFF OF OVER 1,000 PERSONNEL IS REQUIRED TO OPERATE THE HOSPITAL AND ITS NUMEROUS CLINICS. ON JUNE 28, 2012, THE HOSPITAL SIGNED A NONBINDING LETTER OF INTENT WITH LESTER E. COX MEDICAL CENTERS (COXHEALTH) TO EXCLUSIVELY NEGOTIATE A DEFINITIVE AGREEMENT WHEREBY COXHEALTH REPLACES THE TRUSTEES OF THE HOSPITAL TO BECOME THE SOLE MEMBER AND OWNER. THE LETTER OF INTENT WAS THE RESULT OF A FOUR MONTH PROCESS WHICH BEGAN IN FEBRUARY 2012 WITH THE HOSPITAL ISSUING A REQUEST FOR PROPOSAL. COXHEALTH AND ONE OTHER FINALIST WERE SELECTED TO UNDERGO THE INITIAL DUE DILIGENCE PROCESS AND NEGOTIATE A LETTER OF INTENT. COXHEALTH WAS SELECTED AS THE FINALISTS BY THE HOSPITAL'S BOARD. UNDER THE AGREEMENT, A MEMBER SUBSTITUTION MODEL, THE HOSPITAL CONTINUES TO MAINTAIN ITS OWN HOSPITAL BOARD WHILE BECOMING A SUBSIDIARY OF COXHEALTH. COXHEALTH, AS THE PARENT COMPANY, ASSUMES THE RESPONSIBILITIES PREVIOUSLY HELD BY THE SKAGGS BOARD OF TRUSTEES. ADDITIONALLY, COXHEALTH WILL HAVE REPRESENTATION ON THE SKAGGS BOARD AND SKAGGS WILL HAVE REPRESENTATION ON THE COXHEALTH BOARD. THIS ALLOWS BOTH PARTIES TO ACT TOGETHER AS ONE ENTITY FOR THE PURPOSES OF CONTRACTING, RECRUITMENT AND GROWTH. IN JANUARY 2013 THE HOSPITAL BECAME A PART OF THE COXHEALTH NETWORK, DOING BUSINESS AS COX MEDICAL CENTER BRANSON. PROGRAM SERVICE ACHIEVEMENT #1 FORM 990, PART III, LINE 4A COX MEDICAL CENTER BRANSON PROVIDES THE FOLLOWING AREAS OF SERVICE: CANCER, CARDIAC, DIABETES & ENDOCRINOLOGY, EAR NOSE & THROAT, EMERGENCY, URGENT CARE, FAMILY MEDICINE, IMAGING & RADIOLOGY, LABORATORY & PATHOLOGY, NEPHROLOGY & DIALYSIS, NEUROLOGY, OCCUPATIONAL HEALTH, ORTHOPEDICS, PEDIATRICS, PSYCHIATRY, PULMONOLOGY/CRITICAL CARE, REHABILITATION & THERAPY, RHEUMATOLOGY, SLEEP DISORDER CENTER, SOCIAL SERVICES, SURGERY, UROLOGY, WOMEN'S SERVICES AND WOUND CARE. IN THE FISCAL YEAR COX BRANSON BEGAN PROVIDING THE FULLTIME SERVICES OF A PHYSICIAN'S ASSISTANT AT FAITH COMMUNITY HEALTH CLINIC, WHICH PROVIDES TREATMENT AND PREVENTATIVE HEALTHCARE FOR THE UNINSURED AND UNDERINSURED MEMBERS OF THE COMMUNITY. ADDITIONALLY, MARKETING AND COMMUNICATIONS EFFORTS WERE PROVIDED TO THE CLINIC BY COX BRANSON. IN THE FISCAL YEAR COX BRANSON TOOK THE LEAD IN BRINGING TOGETHER AREA ORGANIZATIONS WITH THE SIMILAR GOAL OF ADDRESSING THE HEALTHCARE NEEDS OF THE COMMUNITY, AS IDENTIFIED BY THE COMMUNITY NEEDS ASSESSMENT: UNHEALTHY BODY WEIGHT, ACCESS TO CARE, MENTAL HEALTH, AND SUBSTANCE ABUSE - INCLUDING TOBACCO, AND CHILD AND FAMILY SAFETY. THE COALITION IS NAMED OWNIT AND IS LED BY A STEERING COMMITTEE AND MEMBERS MAKE UP SUCH AGENCIES AND ORGANIZATIONS AS THE TANEY AND STONE COUNTY HEALTH DEPARTMENTS AND MORE. INITIATIVES THAT HAVE BEEN CREATED AS A RESULT OF THIS COALITION ARE: - "STAYING FIT" - A GRANT FUNDED PROGRAM THAT TARGETS AREA YOUTH AND OBESITY. - "TRI-LAKES CLEAN AIR ALLIANCE" - A GRANT FUNDED PROGRAM THAT EDUCATES THE COMMUNITY OF THE DANGERS OF TOBACCO USE AND DRIVES AN INITIATIVE TO CHANGE POLICY. IN FEBRUARY OF 2013, COX BRANSON PRESENTED A ONE DAY HEALTH FAIR. THE EVENT INCLUDED LOW-COST AND FREE HEALTH SCREENINGS, FREE HEALTH PRESENTATIONS AND FREE FITNESS CLASSES. APPROXIMATELY 500 PEOPLE ATTENDED WITH 250 PARTICIPATING IN THE LOW-COST SCREENINGS. IN APRIL OF 2013, THANKS IN PART TO GRANT FUNDING SECURED BY SKAGGS FOUNDATION, COX BRANSON BEGAN PROVIDING TOBACCO CESSATION CLASSES, LED BY AN INSTRUCTOR WHO IS A CERTIFIED TOBACCO TREATMENT SPECIALIST THROUGH THE MAYO CLINIC AND CERTIFIED THROUGH THE ALA AS A FREEDOM FROM SMOKING FACILITATOR. SUBSTANCE ABUSE, INCLUDING TOBACCO USE, IS IDENTIFIED AS A HEALTHCARE NEED IN THE COMMUNITY HEALTH ASSESSMENT. IN APRIL OF 2013, COX BRANSON PRESENTED THE SAFE SUMMER INJURY PREVENTION EXPO FOR KIDS AND FAMILIES. THE FREE, ONE DAY EVENT HIGHLIGHTED THE COMMON INJURIES CHILDREN SUFFER DURING THE SUMMER MONTHS: WATER-RELATED, BICYCLE AND OTHER WHEELED SPORTS, AND PEDESTRIAN INJURIES. THROUGH FISCAL YEAR 2013 A TOTAL OF TWO COMMUNITY SCREENINGS WERE HELD AT COX MEDICAL CENTER BRANSON'S MAIN CAMPUS AND A SATELLITE CLINIC IN KIMBERLING CITY. A TOTAL OF 50 PEOPLE TOOK PART IN THE LOW-COST AND FREE SCREENINGS PROVIDED. LOW-COST SCREENINGS INCLUDE: CHOLESTEROL, A1C AND PSA AND A COMPLETE LIPID PANEL. FREE SCREENINGS INCLUDE: BMI, BODY FAT, HEIGHT, WEIGHT, BLOOD PRESSURE. NEW EQUIPMENT/SERVICES IN FISCAL YEAR 2013 COX BRANSON PURCHASED THE BECKMAN COULTER POWER PROCESSOR SAMPLE HANDLING SYSTEM AND CLINICAL CHEMISTRY SYSTEM, WHICH UPDATES EQUIPMENT THAT WAS EIGHT YEARS OLD. THIS ELECTRONIC, AUTOMATED ASSEMBLY LINE READS BAR-CODED TUBES OF BLOOD AND MUCH MORE. THE OUTCOME IS PATIENTS' LAB RESULTS BEING PROCESSED FASTER - MORE THAN 300 SAMPLES PER HOUR. THE COST OF THE NEW EQUIPMENT IS $1 MILLION DOLLARS, TO BE PAID FOR OVER THE NEXT SEVEN YEARS. INTERVENTIONAL CARDIOLOGISTS AT COXHEALTH CARDIOLOGY BRANSON ARE ON THE CUTTING EDGE OF CARDIAC CATHETERIZATION, INTRODUCING IN FISCAL YEAR 2013, A NEW ACCESS POINT, THE RADIAL ARTERY, TO REDUCE RECOVERY TIME, BLEEDING AND SAVE MONEY. ADDITIONAL PROGRAMS WITH A FOCUS ON ADDRESSING THE COMMUNITY'S UNHEALTHY BODY WEIGHT, AS IDENTIFIED BY THE COMMUNITY NEEDS ASSESSMENT, THE FOLLOWING PROGRAMS WERE OFFERED BY COXHEALTH FITNESS CENTER BRANSON IN FISCAL YEAR 2013: "THE 101 DAY WEIGHT LOSS CHALLENGE" AND "MAINTAIN DON'T GAIN." THESE PROGRAMS PROVIDED A DISCOUNT TO ACCESS THE FITNESS CENTER AND ATTEND UNLIMITED BOOT CAMPS WITH CERTIFIED PERSONAL TRAINERS. PROGRAM SERVICE ACHIEVEMENT #3 FORM 990, PART III, LINE 4C OUR INTERDISCIPLINARY TEAM WORKS HARD TO PROVIDE THE FINEST IN HOME HEALTH CARE, ALLOWING THE PATIENT COMFORT AND PRIVACY IN HIS/HER OWN SURROUNDINGS. BY DELIVERING THIS TYPE OF APPROPRIATE CARE UNDER THE SUPERVISION OF A PHYSICIAN, WE CAN HELP PATIENTS AVOID HOSPITALIZATION. HOWEVER, IF HOSPITALIZATION DOES BECOME NECESSARY, WE CAN HELP PATIENTS RECUPERATE MORE QUICKLY. AUDITED FINANCIAL STATEMENTS FORM 990, PART IV, LINE 20B THE ORGANIZATION DID NOT RECEIVE AN AUDIT FOR THE FISCAL YEAR ENDING APRIL 30, 2013. IN ACCORDANCE WITH THE BYLAWS, WHICH WERE UPDATED AS A RESULT OF THE AGREEMENT WITH COXHEALTH, THE ORGANIZATION HAS ADOPTED A NEW FISCAL YEAR, ENDING SEPTEMBER 3O. COX MEDICAL CENTER BRANSON IS INCLUDED IN THE CONSOLIDATED AUDIT OF THE COXHEALTH SYSTEM FOR THE YEAR ENDED SEPTEMBER 30, 2013, WHICH IS ATTACHED TO THIS RETURN. SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS FORM 990, PART VI, SECTION A, LINE 4 ON JUNE 28, 2012, THE HOSPITAL SIGNED A NONBINDING LETTER OF INTENT WITH LESTER E. COX MEDICAL CENTERS (COXHEALTH) TO EXCLUSIVELY NEGOTIATE A DEFINITIVE AGREEMENT WHEREBY COXHEALTH REPLACES THE TRUSTEES OF THE HOSPITAL TO BECOME THE SOLE MEMBER AND OWNER. UNDER THE AGREEMENT, A MEMBER SUBSTITUTION MODEL, THE HOSPITAL CONTINUES TO MAINTAIN ITS OWN HOSPITAL BOARD WHILE BECOMING A SUBSIDIARY OF COXHEALTH. COXHEALTH, AS THE PARENT COMPANY, ASSUMES THE RESPONSIBILITIES PREVIOUSLY HELD BY THE SKAGGS BOARD OF TRUSTEES. ADDITIONALLY, COXHEALTH WILL HAVE REPRESENTATION ON THE SKAGGS BOARD AND SKAGGS WILL HAVE REPRESENTATION ON THE COXHEALTH BOARD. THIS ALLOWS BOTH PARTIES TO ACT TOGETHER AS ONE ENTITY FOR THE PURPOSES OF CONTRACTING, RECRUITMENT AND GROWTH. AS PART OF THE AGREEMENT, SKAGGS COMMUNITY HOSPITAL ASSOCIATION, DOING BUSINESS AS COX MEDICAL CENTER BRANSON, AMENDED ITS BYLAWS. SIGNIFICANT CHANGES RELATED TO THE AGREEMENT ARE AS FOLLOWS: - IN JANUARY 2013 THE HOSPITAL BECAME A PART OF THE COXHEALTH NETWORK, DOING BUSINESS AS COX MEDICAL CENTER BRANSON. - COX BRANSON SHALL HAVE ONE MEMBER WHICH SHALL BE LESTER E. COX MEDICAL CENTERS (COXHEALTH). THE POWERS AND DUTIES OF THE MEMBER WERE ALSO UPDATED. SEE NARRATIVE FOR FORM 990, PART VI, LINES 6, 7A & 7B FOR ADDITIONAL DETAILS. - THE AFFAIRS OF COX BRANSON SHALL BE MANAGED, SUPERVISED AND CONTROLLED BY A BOARD CONSISTING OF AT LEAST ELEVEN (11), BUT NOT MORE THAN FIFTEEN (15) MEMBERS. THE BOARD SHALL CONSIST OF THE FOLLOWING REPRESENTATIVES OF THE MEMBER: PRESIDENT AND CEO OF THE MEMBER; A MEMBER DESIGNATED BY THE PRESIDENT AND CEO OF THE MEMBER AND THE CHO OF THE MEMBER ("MEMBER DIRECTORS"). THREE (3) DIRECTORS SHALL BE FROM THE ACTIVE COX BRANSON MEDICAL STAFF. THESE NON-MEMBER REPRESENTATIVE DIRECTORS SHALL HAVE THEIR PRIMARY RESIDENCE IN THE BRANSON, MISSOURI AREA UNLESS A MAJORITY OF THE APPROVES OTHERWISE. - THE FISCAL YEAR OF COX BRANSON SHALL BEGIN OCTOBER 1 AND END SEPTEMBER 30. MEMBERS, STOCKHOLDERS, OR OTHER PERSONS FORM 990, PART VI, SECTION A, LINES 6, 7A & 7B THE ORGANIZATION HAS ONLY ONE MEMBER - LESTER E COX MEDICAL CENTERS (COXHEALTH). THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE SOLELY AND SPECIFICALLY RESERVED TO THE MEMBER; A. ELECTION, APPOINTMENT AND REMOVAL OF COX BRANSON BOARD OF DIRECTORS ("BOARD") AFTER NOMINATION BY THE BOARD; B. APPOINTMENT AND REMOVAL OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF COX BRANSON ("PRESIDENT AND CEO OF COX BRANSON") AFTER RECOMMENDATION BY/CONSULTATION WITH THE BOARD; C. APPROVAL OF COX BRANSON'S UNBUDGETED DEBT AND CAPITAL EXPENDITURES EXCEEDING $250,000; D. APPROVAL OF COX BRANSON'S OPERATING AND CAPITAL BUDGETS AND FINANCIAL REPORTS, MERGERS, CONSOLIDATIONS, ACQUISITIONS, AFFILIATIONS, AND REORGANIZATION OR DISPOSITION OF ASSETS EXCEEDING THE THEN FAIR VALUE OF $250,000; E. AMENDMENT, REPEAL OR ADOPTION OF COX BRANSON'S ARTICLES OF INCORPORATION AND BYLAWS EXCEPT AS OTHERWISE PROVIDED IN THE BYLAWS. THE BOARD SHALL BE ELECTED BY THE MEMBER. NO LATER THAN SEPTEMBER 1 OF EACH YEAR, THE BOARD SHALL NOMINATE A SLATE OF PERSONS FOR ELECTION AS COX BRANSON DIRECTORS AND OFFICERS TO SUBMIT TO THE COXHEALTH BOARD FOR APPOINTMENT. THE COXHEALTH BOARD WILL ACT IN GOOD FAITH AND NOT UNREASONABLY WITHHOLD APPOINTMENT. IF FOR ANY REASON A NOMINATED PERSON IS NOT APPOINTED BY THE COXHEALTH BOARD, THE BOARD HAS THE RIGHT TO NOMINATE ANOTHER PERSON FOR CONSIDERATION. FINAL DECISIONS MADE BY THE BOARD OF THE DIRECTORS MUST ALSO BE APPROVED BY THE COXHEALTH 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). REVIEW OF FORM 990 FORM 990, PART VI, SECTION B, LINE 11B 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. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C 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. COMPENSATION REVIEW FORM 990, PART VI, SECTION B, LINES 15A & 15B THE COMPENSATION AND BENEFITS COMMITTEE, COMPRISED OF INDEPENDENT DIRECTORS, MET ON 10/23/2012 TO REVIEW THE COMPENSATION AND BENEFITS FOR THE CEO OF THE HOSPITAL. THE CEO REVIEWS THE COMPENSATION OF THE VICE PRESIDENTS AND MAKES RECOMMENDATIONS TO THE COMPENSATION COMMITTEE WHO FORMALLY APPROVES THE COMPENSATION. THE COMMITTEE OBTAINED COMPARABILITY DATA OF TOTAL COMPENSATION AND BENEFITS FOR COMPARABLE POSITIONS FROM INTEGRATED HEALTHCARE STRATEGIES, MERCER AND SULLIVAN COTTER. AFTER CONSIDERING ALL DATA, COMPENSATION WAS DETERMINED TO BE REASONABLE AND WAS APPROVED. THIS PROCESS WAS DOCUMENTED IN THE MINUTES OF THE EXECUTIVE COMMITTEE MEETING. DOCUMENT DISCLOSURE FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. OTHER FEES FOR SERVICES FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES ARE COMPRISED OF THE FOLLOWING CATEGORIES: $ 6,642,284 CONTRACT SERVICES 4,074,111 OTHER CONTRACTS 4,080,277 NON-LABOR CONTRACTED SERVICES 4,124,251 PHYSICIAN CONTRACT LABOR 3,043,297 CONTRACTED LAB SERVICES 1,131,186 NON-PHYSICIAN CONTRACT LABOR 763,180 CONTRACTED COLLECTION AGENCY 689,518 CONTRACTED CONSULTING SERVICES 306,269 CONTRACTED TRANSCRIPTION SERVICES 104,017 CONTRACTED X-RAY SERVICES ---------- $24,958,390 TOTAL OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 $30,334,482 ASSET FAIR VALUE ADJUSTMENT 1,494,623 CHANGE IN INVESTMENT IN SKAGGS FOUNDATION 630,231 CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST ---------- $32,459,336 TOTAL SKAGGS EMERGENCY PHYSICIANS PO BOX 650 BRANSON MO 65615 352275232 BILLING MO 0 0 CMCB BRANSON HEART CENTER PO BOX 650 BRANSON MO 65615 300497209 BILLING MO 0 0 CMCB SKAGGS OCCUPATIONAL HEALTH PO BOX 650 BRANSON MO 65615 383774737 BILLING MO 0 0 CMCB BRANSON FAMILY MEDICINE CLINIC PO BOX 650 BRANSON MO 65615 322331834 BILLING MO 0 0 CMCB BRANSON ORTHONEURO CENTER LLC PO BOX 650 BRANSON MO 65615 171952089 MED BLDG MO 641636 8189932 CMCB COX ALTERNATIVE CARE OF THE OZARKS INC PO BOX 10939 SPRINGFIELD MO 65808 431641925 HOME HEALTH MO 501(C)(3) 9 COXHEALTH false COXHEALTH FOUNDATION 3525 S NATIONAL SUITE 204 SPRINGFIELD MO 65807 436810485 FUNDRAISING MO 501(C)(3) 11 A I COXHEALTH false COXHEALTH HME CRE SVCS OF THE MDWST INC 3850 S NATIONAL SPRINGFIELD MO 65807 264781194 HOME HEALTH MO 501(C)(3) 9 COXHEALTH false COX HPS OF THE OZARKS INC 2220 W SUNSET SPRINGFIELD MO 65807 431641927 HOME HEALTH MO 501(C)(3) 9 COXHEALTH false COX-MONETT HOSPITAL INC 801 LINCOLN AVE MONETT MO 65708 431656689 HOSPITAL MO 501(C)(3) 3 COXHEALTH false COX-MONETT HOSPITAL AUXILIARY 801 LINCOLN AVE MONETT MO 65708 431852817 FUNDRAISING MO 501(C)(3) 9 COXHEALTH false HEALTH ENRICHMENT SERVICES INC 3801 S NATIONAL SPRINGFIELD MO 65807 363263313 MED SVC MO 501(C)(3) 7 COXHEALTH false HEALTHCARE SERVICES OF THE OZARKS INC PO BOX 10939 SPRINGFIELD MO 65808 431641928 HOME HEALTH MO 501(C)(3) 9 COXHEALTH false PRIMROSE PLACE INC 1115 E PRIMROSE SPRINGFIELD MO 65807 431183783 NURSING HOME MO 501(C)(3) 11 a i COXHEALTH false COXHEALTH AUXILIARY 3801 S NATIONAL SPRINGFIELD MO 65807 431090590 SUPPORT MO 501(C)(3) 9 COXHEALTH false COX MEDICAL CTR GENPROF LIAB LOSS FUND 1423 N JEFFERSON SPRINGFIELD MO 65802 366668576 SELF-INSURAN MO 501(C)(3) 11 a i COXHEALTH false LESTER E COX MEDICAL CENTERS 1423 N JEFFERSON ST SPRINGFIELD MO 65802 440577118 HOSPITAL MO 501(C)(3) 3 NA false SKAGGS-COX HEALTH ALLIANCE LL 1423 N JEFFERSON AVENUE SPRINGFIELD MO 65807 271117343 HEALTHCARE MO COXHEALTH RELATED 0 -64196 false 0 false 0.40000 PCRMC-COX HEALTH ALLIANCE LLC 1423 N JEFFERSON AVENUE SPRINGFIELD MO 65807 300649009 HEALTHCARE MO NA COX HEALTH SYSTEMS HMO INC PO BOX 5750 SPRINGFIELD MO 658015750 431757075 HMO MO NA C CORP false COX HEALTH SYSTEMS INSURANCE COMPANY 3525 S NATIONAL SUITE 205 SPRINGFIELD MO 65807 431684044 INSURANCE MO NA C CORP false MEDICAL DEVELOPMENTS INC 1423 N JEFFERSON AVE SPRINGFIELD MO 65802 431622182 PHARMACY MO NA C CORP 0.00000 false INSURANCE COMPANY OF SPRINGFIELD INC GRAND PAVILION CORPORATE CENTRE GRAND CAYMAN CJ CJ CAPTIVE INSUR MO NA C CORP 0.00000 false false false true false false false false false false false false false false false false false false false false