2025-08-14T11:08:57+00:00 2024-09-30 440160260 Forvis Mazars LLP 910 E St Louis 200 PO Box 1190 Springfield MO 658062523 990 2023-10-01 823300758 Cox Barton County Hospital COXB 4176815100 29 NW 1ST LANE LAMAR MO 64759 JACOB MCWAY COXHEALTH CFO 4176815100 2025-08-14 true BRIAN D TODD P00422601 4178658701 2025-08-14 2023 2025-03-06 01:10:19Z ANDREA MCKAY 29 NW 1ST LANE LAMAR MO 64759 33039969 false X WWW.COXHEALTH.COM X 2017 MO THE ORGANIZATION PROVIDES QUALITY HEALTH CARE, EDUCATION AND RESEARCH IN ORDER TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES. 6 5 261 6 281968 0 995043 47863 31826153 32805727 158281 185479 1904 900 32981381 33039969 5303 36221 0 16198942 17123321 0 0 11637719 12899642 27841964 30059184 5139417 2980785 25786285 26814488 18662900 16935203 7123385 9879285 TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH QUALITY HEALTH CARE, EDUCATION AND RESEARCH. false false 21555091 36221 26852672 INPATIENT AND OUTPATIENT SERVICES PROVIDED AT THE HOSPITAL MAKE UP THE ORGANIZATION'S LARGEST PROGRAM SERVICE ACTIVITY. USERS ARE ABLE TO SAVE TIME AND MONEY BY SEEING SPECIALISTS IN THEIR COMMUNITY. SERVICES INCLUDE GENERAL SURGERY, RADIOLOGY (X-RAY, CT, MRI, NUCLEAR MEDICINE, ULTRASOUND, AND MAMMOGRAPHY), LABORATORY, 24-HOUR EMERGENCY DEPARTMENT, SLEEP CENTER, CARDIOPULMONARY REHAB, MEDICAL SURGICAL UNIT, PHARMACY AND COMMUNITY WELLNESS. 4778617 0 5953055 SERVICES PROVIDED AT THE HOSPITAL'S RURAL HEALTH CLINIC LOCATIONS MAKE UP THE SECOND LARGEST PROGRAM SERVICE ACTIVITY. DURING THE YEAR THESE CLINICS SAW 22,354 PATIENT VISITS. 26333708 true true false true false false false false false true false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true X 0 0 261 true true true false false false false false false false false false false false X 6 5 true false false false true true true true true false false true true true true true true true false false X JOSHUA POWELL 4176815100 29 NW 1ST LANE LAMAR MO 64759 HAL L HIGDON CHAIR 1.0 5.0 X X 0 0 0 BRAD E ERWIN BOARD MEMBER 1.0 5.0 X 0 0 0 JEFFERSON M TYNES BOARD MEMBER 1.0 5.0 X 0 0 0 LARRY W LIPSCOMB BOARD MEMBER 1.0 5.0 X 0 0 0 ROBERT C FULP BOARD MEMBER 1.0 5.0 X 0 0 0 SALLY HARGIS BOARD MEMBER 1.0 5.0 X 0 0 0 ANDREA MCKAY PRESIDENT 20.0 20.0 X 155917 155917 24381 JACOB M MCWAY EVP, COXHEALTH CFO 1.0 48.0 X 0 1311928 221113 MAX D BUETOW PRESIDENT & CEO 1.0 50.0 X 0 1617479 305452 VICKIE J NELSON SECRETARY 1.0 45.0 X 0 80046 11742 Clinton R Loy Physician 40.0 0 X 478962 0 34105 David M Steele Physician 40.0 0 X 432334 0 25855 Jeremy L Sturgell Physician 40.0 1.0 X 330331 0 25855 John Willis Physician 40.0 0 X 296192 0 32820 Jonathan Etheridge Physician 40.0 0 X 321715 0 34105 CHRISTOPHER B WYATT FORMER PRESIDENT 0.0 0 X 231610 0 28309 STEVE EDWARDS FORMER PRESIDENT & CEO 0.0 0.0 X 0 718423 34105 2247061 3883793 777842 30 true true false SHIFTWISE PO BOX 70870 ST PAUL MN 551709705 STAFFING 629129 BRYAN TELEMEDICINE 2222 16TH ST STE 401A LINCOLN NE 65802 TELEMEDICINE SERVICES 278595 BAXLEY ANESTHETICS 10850 COUNTY LN 253 WEBB CITY MO 64870 ANESTHESIA SERVICES 266117 SHARED MEDICAL SERVICES 209 LIMESTONE PASS COTTAGE GROCE WI 53527 MRI SERVICES 196815 PREMIER SPECIALTY NETWORK 3610 BUTTONWOOD DR STE 200 COLUMBIA MO 65201 PHYSICIAN SERVICES 146124 5 47863 47863 NET PATIENT SERVICE REVENUE 900099 30941323 30941323 PHARMACY REVENUE 456110 641265 359297 281968 OTHER REVENUE 446110 1137618 1137618 CAFETERIA REVENUE 722514 85521 85521 0 0 0 0 32805727 185479 185479 900 900 0 900 900 0 0 0 0 0 0 0 33039969 32523759 281968 186379 X 36221 36221 168108 168108 259919 259919 13876413 12263671 1612742 409858 397786 12072 1458289 1400806 57483 950734 895913 54821 12491 12491 6110511 5257410 853101 0 6326 5033 1293 642618 513528 129090 191855 152634 39221 662909 527389 135520 51306 40817 10489 2088 1661 427 258887 205962 52925 857991 682591 175400 410843 326854 83989 MEDICAL SUPPLIES & DRUGS 2444296 2444296 PROVIDER TAX 922793 922793 RECRUITMENT AND RETENTION 258610 205742 52868 LICENSES, DUES, SUBSCRIPTION 58204 46305 11899 7914 6296 1618 0 30059184 26333708 3725476 0 1240 1240 4534102 4674518 3642856 4012027 0 0 0 0 376848 260681 58606 135031 17826629 5643074 12187246 12183555 0 0 4985387 5547436 25786285 26814488 1524905 1533374 0 0 0 12416378 12018641 4721617 3383188 18662900 16935203 X 7123385 9879285 7123385 9879285 25786285 26814488 X 2980785 0 0 0 0 -224885 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 7432 7432 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY PORTIONS OF DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION (MHA) ARE USED FOR LOBBYING PURPOSES. FOR THE FISCAL YEAR 2024, THE AMOUNT ATTRIBUTABLE TO LOBBYING WAS $7,432. 180776 180776 12012056 2303304 9708752 5432530 3337396 2095134 201267 2374 198893 12183555 DUE FROM 3RD PARTY 1113294 OTHER RECEIVABLES 1102507 DEFERRED ASSET 3331635 5547436 DUE TO 3RD PARTY 2100000 DUE TO AFFILIATE 240024 ESTIMATED INSURANCE COSTS 1043164 3383188 Schedule D, Part X, Line 2 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. true true X false true X true true true false true true 980635 0 980635 0.0326 6418170 6425105 0 0.0 0 0 0 0.0 0 0 7398805 6425105 980635 0.0326 0 0 0 0.0 0 0 0 0.0 4842928 2766308 2076620 0.0691 149511 0 149511 0.0050 36221 0 36221 0.0012 0 0 5028660 2766308 2262352 0.0753 0 0 12427465 9191413 3242987 0.1079 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 2717449 421205 16469571 14922752 1546819 X true true 1 1 COX BARTON COUNTY HOSPITAL 29 NW 1ST LANE LAMAR MO 64759 WWW.COXHEALTH.COM 247-4 X X X X 1 1 1 false false true X X X X X X X X X 21 true true true true X HTTPS://WWW.COXHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/ X (SEE STATEMENT) X X true 21 true HTTPS://WWW.COXHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/ false true X 300.0 X X X X X X true true X X X true X HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE X HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE X HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE X X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility 1, 1 Facility 1, 1 - COX BARTON COUNTY HOSPITAL. IN 2021, ORGANIZATIONS ACROSS THE OZARKS RECONVENED UNDER THE UMBRELLA OF THE OZARKS HEALTH COMMISSION (OHC) TO ASSESS THE HEALTH NEEDS OF OUR REGION. THE OHC REGION INCLUDES 30 COUNTIES LOCATED WITHIN THE STATES OF MISSOURI, KANSAS AND OKLAHOMA. IT IS CENTERED IN SOUTHWEST MISSOURI, AND REPRESENTS THE COMBINED SERVICE AREAS OF OHC REGION HEALTHCARE PARTNERS COXHEALTH, FREEMAN HEALTH SYSTEM, AND MERCY HOSPITALS. SEVEN MULTI-COUNTY COMMUNITIES WERE DEFINED BASED ON HOSPITAL SERVICE AREAS AND NAMED FOR A MAJOR CITY WITHIN THE COMMUNITY: BOLIVAR, BRANSON, JOPLIN, LEBANON, MONETT, MOUNTAIN VIEW, AND SPRINGFIELD. THE 2023 REGIONAL HEALTH ASSESSMENT (RHA) BUILDS UPON THE SUCCESS OF THE 2016 AND 2019 RHAS TO BETTER UNDERSTAND THE HEALTH STATUS, BEHAVIORS AND NEEDS OF THE POPULATIONS AND COMMUNITIES SERVED. THIS ASSESSMENT TAKES A COMPREHENSIVE, DATA-DRIVEN APPROACH TO LOOK AT THE HEALTH CHARACTERISTICS AND BEHAVIORS OF RESIDENTS IN THE OHC REGION BY PRESENTING MORE THAN 200 PUBLIC HEALTH AND EMERGENCY ROOM UTILIZATION DATA INDICATORS INCLUDING DEMOGRAPHICS, HEALTH MORBIDITY AND MORTALITY, HEALTH STATUS AND BEHAVIORS, AND SOCIAL DETERMINANTS OF HEALTH. THE OHC STEERING COMMITTEE ELECTED TO UTILIZE CONSULTATIVE SERVICES TO ACQUIRE RELIABLE AND REPRESENTATIVE INPUT FROM THE 30- COUNTY OHC REGION. TO THAT END, A CONSULTING FIRM WAS HIRED TO GATHER BOTH QUANTITATIVE AND QUALITATIVE DATA THROUGH 3 AVENUES: COMMUNITY SURVEYS, FOCUS GROUPS AND INTERVIEWS. THE PROCESS RESULTED IN THE IDENTIFICATION OF THE FOLLOWING HEALTH PRIORITIES: JOPLIN COMMUNITY (ENCOMPASSES COX BARTON COUNTY HOSPITAL SERVICE AREA): MENTAL HEALTH, DIABETES, LUNG DISEASE, HEART DISEASE; SPRINGFIELD, BRANSON AND MONETT COMMUNITIES: MENTAL HEALTH, SUBSTANCE USE AND RECOVERY, DIABETES. ALL COMMUNITIES IDENTIFIED COVID-19 AS A SPECIAL HEALTH ISSUE. ADDITIONALLY, INDICATORS THAT COULD IMPACT MULTIPLE ASSESSED HEALTH ISSUES, REFERRED TO HERE AS SOCIAL DETERMINANTS OF HEALTH, WERE NOTED IN EVERY COMMUNITY. BROADLY, THESE SOCIAL DETERMINANTS OF HEALTH FALL INTO SIX CATEGORIES: ECONOMIC STABILITY, EDUCATION ACCESS AND QUALITY, HEALTHCARE ACCESS AND QUALITY, NEIGHBORHOOD AND BUILT ENVIRONMENT, SOCIAL AND COMMUNITY CONTEXT, AND HEALTH BEHAVIORS. THE OHC HIGHLIGHTED KEY FACTORS AND POPULATIONS OF INTEREST WITH DISPARATE NEEDS, CHALLENGES AND GREATER VULNERABILITY THAN COMPARABLE AREAS WITH THE SAME POPULATION IN OTHER COUNTIES. HISTORICALLY DISENFRANCHISED POPULATIONS, SUCH AS PEOPLE IN POVERTY, MINORITIES AND THE ELDERLY, OFTEN EXPERIENCE HIGHER RATES OF CHRONIC ILLNESS AND WORSE HEALTH OUTCOMES, DUE TO A MULTITUDE OF STRUCTURAL AND ENVIRONMENTAL FACTORS. THIS CAN LEAD TO HEALTH DISPARITIES BETWEEN VARIOUS SOCIOECONOMIC CLASSES AND/OR DEMOGRAPHIC GROUPS. THE PRIORITIZATION OF ASSESSED HEALTH ISSUES PROCESS INCLUDED THE FOLLOWING COMMUNITY STAKEHOLDERS. SPRINGFIELD COMMUNITY: -COXHEALTH -MERCY -SPRINGFIELD-GREENE COUNTY HEALTH DEPARTMENT -COMMUNITY PARTNERSHIP OF THE OZARKS -COMMUNITY FOUNDATION OF THE OZARKS -OZARKS REGIONAL YMCA -GLO CENTER -MISSOURI STATE UNIVERSITY -SPRINGFIELD PUBLIC SCHOOLS -BURRELL BEHAVIORAL HEALTH -JORDAN VALLEY COMMUNITY HEALTH CENTER -OZARKS FOOD HARVEST -THE CONNECTING GROUNDS -BETTER LIFE IN RECOVERY -CATHOLIC CHARITIES OF SOUTHERN MISSOURI -HAND IN HAND MULTICULTURAL CENTER -PROMO MONETT COMMUNITY: -COXHEALTH -COX MONETT HOSPITAL -CLARK COMMUNITY MENTAL HEALTH CENTER -MOSWITCH -AURORA CHAMBER OF COMMERCE -LAWRENCE COUNTY HEALTH DEPARTMENT -MONETT SCHOOL DISTRICT -BARRY COUNTY HEALTH DEPARTMENT -DRURY UNIVERSITY -OACAC BRANSON COMMUNITY: -COXHEALTH -COX MEDICAL CENTER BRANSON -SKAGGS FOUNDATION -TANEY COUNTY AMBULANCE DISTRICT -TANEY COUNTY HEALTH DEPARTMENT -GIFT OF HOPE -FAITH COMMUNITY HEALTH -TABLE ROCK LAKE CHAMBER OF COMMERCE -STONE COUNTY HEALTH DEPARTMENT -CHRISTIAN ACTION MINISTRIES JOPLIN COMMUNITY (ENCOMPASSES COX BARTON COUNTY HOSPITAL) -COXHEALTH -COX BARTON COUNTY HOSPITAL -FREEMAN HEALTH -MERCY -UNITED WAY -MISSOURI HEALTH CARE FOR ALL -CITIZEN POTAWATOMI NATION -ONE JOPLIN -ALLIANCE OF SOUTHWEST MISSOURI -UNIVERSITY OF MISSOURI -ACCESS FAMILY CARE MEDICAL AND DENTAL CLINICS -CITY OF JOPLIN HEALTH DEPARTMENT Schedule H, Part V, Section B, Line 6a Facility 1, 1 Facility 1, 1 - COX BARTON COUNTY HOSPITAL. THE CHNA WAS CONDUCTED FOR THE ENTIRE 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 MEYER ORTHOPEDIC HOSPITAL. OTHER HOSPITAL FACILITY PARTNERS INCLUDED FREEMAN HEALTH SYSTEM, AND MERCY HOSPITALS. THE CHNA WAS ALSO CONDUCTED WITH RELATED ORGANIZATIONS COX MEDICAL CENTER BRANSON, COX BARTON COUNTY HOSPITAL AND COX MONETT HOSPITAL. Schedule H, Part V, Section B, Line 6b Facility 1, 1 Facility 1, 1 - COX BARTON COUNTY HOSPITAL. THE CHNA WAS ALSO CONDUCTED WITH THE FOLLOWING OTHER NON-HOSPITAL ORGANIZATIONS: -BURRELL BEHAVIORAL HEALTH -CHRISTIAN COUNTY HEALTH DEPARTMENT -CITY OF JOPLIN HEALTH DEPARTMENT -JASPER COUNTY HEALTH DEPARTMENT -LAWRENCE COUNTY HEALTH DEPARTMENT -SPRINGFIELD-GREENE COUNTY HEALTH DEPARTMENT -TANEY COUNTY HEALTH DEPARTMENT -VERNON COUNTY HEALTH DEPARTMENT Schedule H, Part V, Section B, Line 7 Facility 1, 1 Facility 1, 1 - COX BARTON COUNTY HOSPITAL. PRINTED COPIES ARE AVAILABLE BY REQUEST THROUGH HOSPITAL AND PUBLIC HEALTH PARTNERS. ELECTRONIC AND PRINTABLE VERSIONS ARE AVAILABLE AT COXHEALTH.COM AND OZARKSHEALTHCOMMISSION.ORG. NEWS RELEASE WAS HELD TO ENCOURAGE MEDIA COVERAGE WITH LINKS TO THE REPORT AND KEY MESSAGES FOR THE PUBLIC. CHNA OTHER WEBSITES: HTTP://WWW.OZARKSHEALTHCOMMISSION.ORG HTTP://WWW.MERCY.NET HTTP://WWW.COXHEALTH.COM HTTP://WWW.FREEMANHEALTH.COM Schedule H, Part V, Section B, Line 11 Facility 1, 1 Facility 1, 1 - COX BARTON COUNTY HOSPITAL. 1. DECREASE HOSPITALIZATIONS RELATED TO COVID-19 -SUPPORT COMMUNITY INITIATIVES, INCLUDING INCREASE PERCENT OF FULLY VACCINATED INDIVIDUALS AS RECOMMENDED BY THE CDC 2. DECREASE TOBACCO AND VAPE USE RATES -INCREASE ACCESS TO CLINICAL EDUCATION AND TRAINING RELATED TO TOBACCO AND VAPE CESSATION 3. INCREASE AWARENESS OF SUBSTANCE USE PREVENTION AND TREATMENT RESOURCES -PROMOTE EDUCATION AND TRAINING RELATED TO SUBSTANCE USE (EXAMPLES: HARM REDUCTION, NALOXONE, MENTAL HEALTH FIRST AID) 4. INCREASE AWARENESS OF MENTAL HEALTH SERVICES -INCREASE ACCESS THROUGH ALTERNATIVE CARE MODELS -IMPLEMENT TRAUMA INFORMED CARE TRAINING AND EDUCATION -IMPROVE PROCESS FOR SECURING MENTAL HEALTH SERVICES 5. IMPROVE CHRONIC DISEASE SELF-MANAGEMENT -INCREASE REFERRALS TO SELF-MANAGEMENT EDUCATION -INCREASE ENROLLMENT IN CARE MANAGEMENT PROGRAMS -PROMOTE ACCESS TO SCHOOL-AGE PREVENTION EDUCATION AND CARE PROGRAMS 6. ENGAGE IN MULTI-SECTOR CARE COORDINATION TO REDUCE HEALTH DISPARITIES AND IMPROVE HEALTH OUTCOMES -IMPLEMENT COMMUNITY INFORMATION EXCHANGE PLATFORM Schedule H, Part V, Section B, Line 13 Facility 1, 1 Facility 1, 1 - COX BARTON COUNTY HOSPITAL. MEDICAL HARDSHIP MAY ALSO BE USED TO DETERMINE FINANCIAL ELIGIBILITY. COXHEALTH SHALL MAKE A DECISION ABOUT A PATIENT/GUARANTOR'S MEDICAL HARDSHIP BY REVIEWING THE FINANCIAL ASSISTANCE APPLICATION, INCLUDING ACCOMPANYING FINANCIAL DOCUMENTATION, IN ADDITION TO OTHER RELEVANT DOCUMENTATION THAT SUPPORTS THE MEDICAL HARDSHIP OF THE PATIENT. Schedule H, Part V, Section B, Line 13 Facility 1, 2 Facility 1, 2 - COX BARTON COUNTY HOSPITAL. 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. Schedule H, Part V, Section B, Line 16 Facility 1, 1 Facility 1, 1 - COX BARTON COUNTY HOSPITAL. 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 FAP AVAILABILITY AND ENCOURAGED TO PARTICIPATE. 2 MEDICAL ONE CLINIC 29 NW 1ST LANE LAMAR MO 64759 RURAL HEALTH CLINIC GOLDEN CITY CLINIC 403 MAIN ST GOLDEN CITY MO 64748 RURAL HEALTH CLINIC 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. Schedule H, Part I, Line 7 PERCENT OF TOTAL EXPENSE THE PERCENT OF TOTAL EXPENSE ON SCHEDULE H, PART I, LINE 7, COLUMN (F), WAS CALCULATED USING TOTAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A). 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. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 014-09. UNDER ASU 2014- 09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HEALTH SYSTEM DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HEALTH SYSTEM'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30 2024. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2 Schedule H, Part III, Line 3 Bad Debt Expense Methodology 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 2019-2023, APPROXIMATELY 15.5 PERCENT OF BARTON COUNTY WAS CONSIDERED TO LIVE IN POVERTY. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE AUDIT FOOTNOTE ADDRESSING BAD DEBT EXPENSE AND PATIENT ACCOUNTS RECEIVABLE IS FOUNDION THE AUDITED FINANCIAL STATEMENTS UNDER NOTE 1, SUBTITLED "PATIENT ACCOUNTS RECEIVABLE." Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs 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, Line 9b Collection practices for patients eligible for financial assistance 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 V, Section B, Line 16a FAP website 1 - COX BARTON COUNTY HOSPITAL: Line 16a URL: HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE; Schedule H, Part V, Section B, Line 16b FAP Application website 1 - COX BARTON COUNTY HOSPITAL: Line 16b URL: HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE; Schedule H, Part V, Section B, Line 16c FAP plain language summary website 1 - COX BARTON COUNTY HOSPITAL: Line 16c URL: HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE; Schedule H, Part VI, Line 2 Needs assessment LESTER E. COX MEDICAL CENTERS HAS PERFORMED AN ENVIRONMENTAL SCAN ANNUALLY SINCE 2006. COMMUNITY HEALTH NEEDS ASSESSMENTS AS REQUIRED BY THE IRS WERE COMPLETED IN 2023. COMMISSION STAKEHOLDERS BEGAN THE RHA PROCESS WITH ANALYSIS OF PUBLICLY AVAILABLE HEALTH DATA (SECONDARY DATA) AND PARTICIPATING HEALTH SYSTEMS' EMERGENCY ROOM UTILIZATION DATA (PRIMARY DATA) TO IDENTIFY HEALTH ISSUES OF GREATEST CONCERN ACROSS THE REGION. THE RESULT WAS A RANKED LIST OF EIGHT OZARKS HEALTH COMMISSION REGION HEALTH ISSUES. A FULL DESCRIPTION OF THE HEALTH ISSUES AND INDICATORS USED CAN BE FOUND IN THE OHC REGIONAL HEALTH ASSESSMENT. TO REPRESENT DIVERSE VIEWS FROM ACROSS THE REGION AND POPULATION, QUALITATIVE DATA WAS GARNERED. ACROSS THE OHC REGION THESE VIEWPOINTS WERE SOLICITED VIA 75 INDIVIDUAL INTERVIEWS, 10 FOCUS GROUPS AND 2,638 SURVEYS. METHODOLOGIES USED FOR THE INITIAL SCORING/RANKING OF THE HEALTH ISSUES AND THE FULL REPORT OF THE QUALITATIVE WORK CAN BE FOUND IN OHC REGIONAL REPORT. THIS PRIORITIZATION INFORMATION CAN BE USED BY ORGANIZATIONS TO DEVELOP COMMUNITY HEALTH IMPROVEMENT PLANS, GUIDE DECISION MAKING, AND FOSTER COLLABORATION ACROSS INITIATIVES. DURING SEPT. AND OCT. 2022, 25 INDIVIDUAL INTERVIEWS AND THREE FOCUS GROUPS WERE CONDUCTED IN THE JOPLIN COMMUNITY. THOSE INTERVIEWED REPRESENTED HEALTH AND SOCIAL SERVICE ORGANIZATIONS, EDUCATION AND COMMUNITY COLLABORATIVES. OF THE 2,628 SURVEY RESPONDENTS FROM THE REGION, 45% INDICATED THEY LIVED IN THE JOPLIN COMMUNITY. RESPONDENTS WERE ASKED TO RANK PERCEIVED COMMUNITY NEEDS. THOSE INTERVIEWED REPRESENTED HEALTH AND SOCIAL SERVICE ORGANIZATIONS, EDUCATION AND COMMUNITY COLLABORATIVES. STAKEHOLDERS PARTICIPATING IN INDIVIDUAL INTERVIEWS AND FOCUS GROUPS AGREED WITH SURVEY RESPONDENTS ABOUT AFFORDABLE HOUSING, MENTAL HEALTH SERVICES AND CARE COORDINATION. HOWEVER, IN CONTRAST TO SURVEY RESPONDENTS, THOSE INTERVIEWED RANKED FOOD INSECURITY AND TRANSPORTATION AS TOP CONCERNS. ALSO JUXTAPOSED WAS A LACK OF PRIORITY FOR JOB TRAINING BY THOSE SURVEYED, WHERE THOSE INTERVIEWED FELT FREE TRAINING AND EDUCATION WOULD BE A "MAGIC WAND" TO INCREASE QUALITY OF LIFE. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance COX BARTON COUNTY HOSPITAL 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. - COX BARTON COUNTY HOSPITAL 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 COX BARTON COUNTY HOSPITAL 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 COUNTIES SERVED BY COX BARTON COUNTY HOSPITAL ARE BARTON, DADE, CEDAR AND VERNON COUNTIES WITH THE MAJORITY RESIDING IN BARTON COUNTY. BARTON COUNTY IS A RURAL, PRIMARILY FARMING COMMUNITY WITH THREE SMALL TOWNS, ALL OF WHICH HAVE SCHOOL SYSTEMS. LAMAR, A TOWN OF 7,809, IS THE COUNTY SEAT. THE COUNTY OF BARTON HAS A TOTAL OF 11,720 PERSONS WHO LIVE IN A 591.76 SQUARE MILE AREA. DIVERSITY IS LOW AS 95% OF THE POPULATION IS WHITE ALONE. ACCORDING TO THE ROBERT WOOD JOHNSON COUNTY HEALTH RANKINGS, BARTON COUNTY RANKS 47 OUT OF 115 COUNTIES FOR HEALTH OUTCOMES AND 70 OUT OF 115 COUNTIES FOR HEALTH FACTORS. THE LOWER THE RANKING INDICATES BETTER PERFORMANCE IN THE RESPECTIVE SUMMARY RANKINGS. BARTON COUNTY'S MEDIAN HOUSEHOLD INCOME AND UNEMPLOYMENT RATES ARE BELOW STATE AND NATIONAL AVERAGES. BARTON COUNTY QUALIFIES AS A HEALTH PROFESSIONAL SHORTAGE AREA. ACCORDING TO THE NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION. THE PERCENT OF ADULTS IN BARTON COUNTY WITH BMI GREATER THAN 30 IS 52.9% BELOW BOTH STATE AND NATIONAL AVERAGES. THE PERCENT OF UNINSURED POPULATION IS 14.4% AND IS HIGHER THAN STATE AND NATIONAL AVERAGES. Schedule H, Part VI, Line 5 Promotion of community health COX BARTON COUNTY HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH QUALITY HEALTHCARE, EDUCATION AND RESEARCH. WE ACTIVELY LIVE THIS MISSION BY PROVIDING QUALITY HEALTH CARE WITH A HOSPITAL IN LAMAR AND TWO ACCESS POINTS TO RURAL HEALTH CLINICS WITHIN OUR SERVICE AREA. OUR GOAL IS TO PROVIDE QUALITY, AFFORDABLE HEALTHCARE TO THE COMMUNITIES WE SERVE. COMMUNITY INVOLVEMENT IS ACHIEVED IN A VARIETY OF WAYS. TO ADDRESS THE ABOVE AVERAGE OBESITY RATE (32%) COMPARED TO THE STATE AVERAGE (30%) COX BARTON COUNTY HOSPITAL PARTNERS WITH THE BARTON COUNTY HEALTH DEPARTMENT TO PROVIDE PROGRAMS AND CHALLENGES IN HEALTHY LIVING AS WELL AS A FREE DIABETES SELF MANAGEMENT PROGRAM. OUR REGISTERED DIETITIAN PROVIDES EDUCATION AT SCHOOL HEALTH FAIRS, CARDIAC REHABILITATION PROGRAM, AND IN COMMUNITY SUPPORT GROUPS. BECAUSE OF COVID-19, WE HAVE HAD TO MODIFY OR MOVE TO AN ONLINE FORMAT MANY OF OUR COMMUNITY EVENTS. PRIOR TO COVID-19, COX BARTON COUNTY PROVIDED AN ANNUAL COMMUNITY HEALTH FAIR WITH MULTIPLE FREE SCREENINGS AND HEALTH EDUCATION FOR THE COMMUNITY. COX BARTON COUNTY PROVIDES OUTREACH THROUGH FREE OR LOW COST HEALTH EDUCATION AND SCREENINGS TO LOCAL BUSINESSES. COX BARTON COUNTY HOSTS A MONTHLY DIABETES SUPPORT GROUP AT NO COST TO ATTENDEES. OUR CLINIC PROVIDERS PROVIDED FREE PHYSICALS TO SIX AREA SCHOOLS. WE PARTNER WITH THE BREAST CANCER FOUNDATION OF THE OZARKS TO PROVIDE MAMMOGRAMS AT LITTLE TO NO COST. COX BARTON COUNTY HOSPITAL PARTNERS WITH THE BARTON COUNTY HEALTH DEPARTMENT TO PROVIDE WOMEN'S HEALTH SERVICES THROUGH THE SHOW ME HEALTHY WOMEN PROGRAM. HOSPITAL EMPLOYEES PROVIDE TWICE MONTHLY BLOOD PRESSURE CHECKS AT THE SENIOR CITIZENS CENTER. HEALTHY FOOD DONATIONS ARE PROVIDED ON A MONTHLY BASIS TO A LOCAL AGENCY THAT PROVIDES SUMMER AND AFTER SCHOOL PROGRAMS TO CHILDREN. COX BARTON COUNTY HOSPITAL ALSO PARTNERS WITH THE TRUMAN AREA TRANSPORTATION SYSTEM TO PROVIDE TRANSPORTATION TO LOCAL RESIDENTS FOR HEALTHCARE APPOINTMENTS AND OTHER NEEDS. COX BARTON LEADERS PARTICIPATE IN CIVIC ORGANIZATIONS AND ARE ELECTED AS MEMBERS OF BOARDS WHOSE PURPOSE IS TO IMPROVE THE LIVES OF COMMUNITY MEMBERS. EXAMPLES INCLUDE ROTARY, CHAMBER OF COMMERCE, AND MANY OTHER LOCAL BOARDS. Schedule H, Part VI, Line 6 Affiliated health care system COXHEALTH IS THE PARENT OF LESTER E. COX MEDICAL CENTERS AND ITS WHOLLY OWNED AND/OR CONTROLLED SUBSIDIARIES PLUS CERTAIN AFFILIATED NOT-FOR-PROFIT ENTITIES AND IS COLLECTIVELY REFERRED TO AS COXHEALTH. COXHEALTH (THE HEALTH SYSTEM) OPERATES AS AN INTEGRATED DELIVERY SYSTEM INCLUDING FOUR HOSPITALS, A SURGICAL CENTER, AN INPATIENT REHABILITATION FACILITY, HOME CARE COMPANIES, PHYSICIAN SERVICES, MENTAL HEALTH SERVICES, INSURANCE COMPANIES AND A FOUNDATION. COXHEALTH'S HOME CARE SERVICES ARE PROVIDED BY OXFORD HEALTHCARE, HOME PARENTERAL SERVICES (INFUSION THERAPY) AND HOME SUPPORT (DURABLE MEDICAL EQUIPMENT). COXHEALTH AT HOME 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. INFUSION THERAPY 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. COX-MONETT HOSPITAL SUPPORTS THE MONETT, MISSOURI AND SURROUNDING COMMUNITY BY PROVIDING A VARIETY OF SERVICES WHICH INCLUDE UROLOGY, ENT (EAR, NOSE AND THROAT), PULMONOLOGY, ORTHOPEDICS, CARDIOLOGY, PODIATRY, OBSTETRICS, RADIOLOGY (CT, MRI, NUCLEAR MEDICINE AND MAMMOGRAPHY), LABORATORY, 24-HOUR EMERGENCY CENTER, GENERAL SURGICAL SERVICES, SAME-DAY SURGERY, DIABETES CENTER, SLEEP CENTER, CARDIOPULMONARY REHAB, MEDICAL-SURGICAL UNIT, 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. 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 COXHEALTH. COXHEALTH, AS THE PARENT COMPANY, ASSUMES THE RESPONSIBILITIES PREVIOUSLY HELD BY THE CMCB BOARD OF TRUSTEES. THE CMCB BOARD 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. CMCB HAS BEEN SERVING SOUTHWEST MISSOURI RESIDENTS FOR MORE THAN 63 YEARS AND OFFERS OVER 25 MAJOR SERVICE AREAS. THE HOSPITAL'S AVERAGE DAILY PATIENT CENSUS EXCEEDS 90 WITH 165 LICENSED HOSPITAL BEDS. A STAFF OF OVER 1,000 PERSONNEL IS REQUIRED TO OPERATE THE HOSPITAL AND ITS NUMEROUS CLINICS. COXHEALTH ADDED A FOURTH HOSPITAL IN 2018, COX BARTON COUNTY HOSPITAL (COX BARTON COUNTY). THE FACILITY WAS A COUNTY HOSPITAL OWNED AND OPERATED BY BARTON COUNTY MEMORIAL HOSPITAL (BCMH). IT WAS BUILT IN 2007 AND IS A 25-BED CRITICAL ACCESS HOSPITAL IN LAMAR, MISSOURI OFFERING AN EMERGENCY DEPARTMENT, AS WELL AS SPECIALIZED CARE IN DIABETES, CARDIOLOGY, ORTHOPEDICS AND SPORTS MEDICINE, NEUROLOGY, WOMEN'S HEALTH AND MORE. IN OCTOBER 2017, COXHEALTH SIGNED A LETTER OF INTENT WITH BCMH TO ACQUIRE ITS OPERATION AND TO LEASE ITS PROPERTY. BCMH WAS STRUGGLING AS A RURAL HOSPITAL TO KEEP UP WITH DECLINING REVENUE. COXHEALTH'S ACQUISITION ALLOWS FOR THE PATIENTS PREVIOUSLY SERVED BY BCMH TO BECOME A PART OF THE COXHEALTH SYSTEM. COX BARTON COUNTY WILL CONTINUE THE SERVICES PREVIOUSLY PROVIDED BY BCMH AND INTENDS TO EXPAND THESE SERVICES FURTHER IN THE FUTURE AS WELL. TO COMPLETE THE TRANSACTION, COXHEALTH FORMED TWO ENTITIES, COX BARTON COUNTY HOSPITAL, A MISSOURI NONPROFIT CORPORATION, AND CBCH, LLC, A MISSOURI LIMITED LIABILITY COMPANY. BOTH ENTITIES HAVE THE SAME CORPORATE PARENT, COXHEALTH, WHICH IS A MISSOURI NONPROFIT CORPORATION. THE OPERATION AND ASSETS OF THE HOSPITAL HAVE BEEN HELD BY CBCH, LLC SINCE JANUARY 1, 2018 AND WILL BE TRANSFERRED TO COX BARTON COUNTY HOSPITAL EFFECTIVE OCTOBER 1, 2019. false true false false false true false false STEVE EDWARDS FORMER PRESIDENT & CEO 0 218675 0 205935 0 293813 0 16500 0 17605 0 752528 0 292665 CHRISTOPHER B WYATT FORMER PRESIDENT 194660 0 33372 0 3578 0 12268 0 16041 0 259919 0 0 0 MAX D BUETOW PRESIDENT & CEO 0 1041070 0 556570 0 19839 0 289441 0 16011 0 1922931 0 0 ANDREA MCKAY PRESIDENT 132169 132170 23103 23102 645 645 8004 8003 4187 4187 168108 168107 0 0 JACOB M MCWAY EVP, COXHEALTH CFO 0 769096 0 354929 0 187903 0 200249 0 20864 0 1533041 0 153057 David M Steele Physician 428524 0 0 0 3810 0 8250 0 17605 0 458189 0 0 0 Jeremy L Sturgell Physician 307542 0 0 0 22789 0 8250 0 17605 0 356186 0 0 0 Jonathan Etheridge Physician 321415 0 0 0 300 0 16500 0 17605 0 355820 0 0 0 Clinton R Loy Physician 476982 0 0 0 1980 0 16500 0 17605 0 513067 0 0 0 John Willis Physician 295811 0 0 0 381 0 15215 0 17605 0 329012 0 0 0 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan STEVE EDWARDS, MAX BEUTOW, AND JACOB MCWAY PARTICIPATE IN A 457(F) NONQUALIFIED RETIREMENT PLAN WITH LESTER E. COX MEDICAL CENTERS: -STEVE EDWARDS RECEIVED AN EXECUTIVE 457(F) DISTRIBUTION OF $292,665, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - JACOB MCWAY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $183,749. - JACOB MCWAY RECEIVED A 457(F) DISTRIBUTION OF $153,057, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - MAX BUETOW RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $273,241. Schedule J, Part I, Line 6a Compensation contingent on 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 SALARY, A FORMULA USING COLLECTIONS AND EXPENSE, AN AMOUNT PER RVU, OR A COMBINATION OF THESE. EXECUTIVE LEVEL STAFF ARE ELIGIBLE FOR ADDITIONAL COMPENSATION BASED ON A VARIETY OF PERFORMANCE INDICATORS IN QUALITY, CUSTOMER AND EMPLOYEE SATISFACTION AND BUSINESS PERFORMANCE MEASURES. Schedule J, Part I, Line 1a HEALTH AND SOCIAL CLUB DUES A RELATED ENTITY, COXHEALTH, INCLUDES MONTHLY SOCIAL CLUB DUES IN THE TAXABLE COMPENSATION OF JAKE MCWAY, CFO. Schedule J, Part I, Line 3 ESTABLISHMENT OF TOP MANAGEMENT OFFICIAL COMPENSATION LESTER E. COX MEDICAL CENTERS, A RELATED PARTY OF THE ORGANIZATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE COXHEALTH TOP MANAGEMENT OFFICIAL: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. Schedule J, Part II 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 ON PRIOR FORM 990 COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS VESTED OR PAID TO THE INDIVIDUAL. Form 990, Part I, Line 6 THE ORGANIZATION'S BOARD OF DIRECTORS IS A VOLUNTEER BOARD. Form 990, Part V, Line 2a LESTER E. COX MEDICAL CENTERS, A RELATED ORGANIZATION, FILES ALL REQUIRED W-2'S FOR THE HEALTH SYSTEM. THE NUMBER REPORTED ON FORM 990, PART V, LINE 2A REPRESENTS THE NUMBER OF W-2'S FILED ON BEHALF OF THE ORGANIZATION. Form 990, Part VI, Line 8b THE ORGANIZATION'S GOVERNING BODY DOES NOT HAVE ANY COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. Form 990, Part VI, Line 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS OFFICERS AND KEY EMPLOYEES ARE EMPLOYED BY COXHEALTH AND ITS AFFILIATES AND THEREFORE SHARE A BUSINESS RELATIONSHIP. Form 990, Part VI, Line 6 Classes of members or stockholders COX-BARTON COUNTY SHALL HAVE ONE MEMBER WHICH SHALL BE COXHEALTH. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE FOLLOWING RESERVED POWERS MAY BE EXERCISED BY THE PARENT WITHOUT PRIOR ACTION BY THE BOARD. SAID RESERVED POWERS ARE: (A) TO ESTABLISH AND CHANGE THE BUSINESS PURPOSES, MISSION, VISION OR VALUES OF COX-BARTON COUNTY; (B) TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF COX-BARTON COUNTY AS PROVIDED THEREIN; (C) TO APPROVE AMENDMENTS TO THE BYLAWS OF COX-BARTON COUNTY; (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 COX-BARTON COUNTY, SUBJECT TO THE REQUIREMENTS OF ARTICLE FIVE OF THE BYLAWS, AND TO APPOINT AND REMOVE THE OFFICERS OF THE BOARD AND COX-BARTON COUNTY; (F) TO APPROVE THE APPOINTMENT AND REMOVAL OF THE PRESIDENT OF COX-BARTON COUNTY; (G) TO APPOINT THE AUDITOR AND THE CORPORATE COUNSEL FOR COX-BARTON COUNTY 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 COXBARTON COUNTY IN SUCH PROGRAMS; AND TO AUTHORIZE THE OPENING AND CLOSING OF BANK ACCOUNTS AND INVESTMENT ACCOUNTS IN THE NAME OF COX-BARTON COUNTY; (I) TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF COX-BARTON COUNTY OR THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF COX-BARTON COUNTY; (J) TO APPROVE THE FORMATION OF A CONTROLLED SUBSIDIARY OR A REMOTELY CONTROLLED SUBSIDIARY; (K) TO APPROVE THE ACQUISITION OR DISPOSITION BY COX-BARTON COUNTY OF ANOTHER LEGAL ENTITY OR AN INTEREST IN ANOTHER LEGAL ENTITY; (L) TO APPROVE THE STRATEGIC PLAN AND THE OPERATING AND CAPITAL BUDGETS OF COXBARTON COUNTY; (M) APPROVAL OF COX-BARTON COUNTY'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 COX-BARTON COUNTY 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 COX-BARTON COUNTY 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 COX-BARTON COUNTY, INCLUDING ACTIONS RELATING TO THE FORMATION, JOINING, OPERATION, WITHDRAWAL FROM AND TERMINATION OF A CREDIT GROUP OR AN OBLIGATED GROUP AND THE GRANTING OF SECURITY INTERESTS IN THE PROPERTY OF COXBARTON COUNTY; (Q) TO REQUIRE COX-BARTON COUNTY TO TRANSFER ASSETS, INCLUDING BUT NOT LIMITED TO CASH, TO THE MEMBER AND/OR PARENT; (R) TO APPROVE THE TRANSFER OF ASSETS BY COX-BARTON COUNTY TO ANY ENTITY OTHER THAN THE MEMBER AND/OR PARENT, OTHER THAN TRANSFERS MADE IN THE ORDINARY COURSE OF OPERATIONS OF COX-BARTON COUNTY WHICH WILL NOT REQUIRE APPROVAL OF THE PARENT; (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 COX-BARTON COUNTY 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 AND/OR PARENT; (T) TO APPROVE CHANGES TO THE TYPE OF OR RELOCATION OF PHYSICIAN PROFESSIONAL MEDICAL SERVICES OFFERED BY COX-BARTON COUNTY, WHERE THE CHANGE INVOLVES (A) SERVICES OFFERED OR PROVIDED BY CMG PHYSICIANS (AS DEFINED IN THE MEMBER'S BYLAWS) 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 COX-BARTON COUNTY; (V) TO DETERMINE THE EXTENT TO WHICH AND THE MANNER IN WHICH THE POWERS DESCRIBED WHICH ARE RESERVED TO THE MEMBERS WITH RESPECT TO COX-BARTON COUNTY 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 REMOTELY CONTROLLED SUBSIDIARY. (W) TO CONTRACT ON BEHALF OF COX BARTON COUNTY WITH RESPECT TO ANY MATTER THAT IMPACTS ONE OR MORE OF MEMBER'S SUBSIDIARIES OR WHERE MEMBER DETERMINES IN ITS DISCRETION THAT CONTRACTING ON BEHALF OF ITSELF AND SOME OR ALL OF ITS SUBSIDIARIES IS IN THE BEST INTEREST OF THE HEALTH SYSTEM. Form 990, Part VI, Line 11b Review of form 990 by governing body 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 PROVIDED TO THE BOARD OF DIRECTORS THROUGH THE ONLINE BOARD PORTAL. Form 990, Part VI, Line 12c Conflict of interest policy COXHEALTH OFFICERS, DIRECTORS AND KEY EMPLOYEES, AS WELL AS OFFICERS, DIRECTORS, AND KEY EMPLOYEES OF THE COXHEALTH AFFILIATES AND/OR COMMITTEES WITH DELEGATED AUTHORITY TO MAKE DECISIONS, ARE ANNUALLY REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST FOLLOWING THE CORPORATE COMPLIANCE POLICY, AS STATED BELOW: 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 MEMBER THE CONFLICT OF INTEREST PROCESS IS HANDLED THROUGH THE GOVERNANCE SUBCOMMITTEE 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. Form 990, Part VI, Line 15a Process to establish compensation of top management official COXHEALTH 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 SYSTEM CEO USING EXTERNAL COMPARABLE DATA FOR ASSESSMENT AND IS PROVIDED TO THE COMPENSATION COMMITTEE FOR REVIEW ON AN ANNUAL BASIS. Form 990, Part VI, Line 19 Required documents available to the public GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON WRITTEN REQUEST FOR A LEGITIMATE BUSINESS PURPOSE (AS DETERMINED BY TOP MANAGEMENT). APPROVED DOCUMENTS CAN BE VIEWED AT THE COX BARTON COUNTY HOSPITAL ADMINISTRATIVE OFFICES. Form 990, Part IX, Line 11g Other Fees PURCHASED SERVICES - Total Expense: 3711994, Program Service Expense: 2953145, Management and General Expenses: 758849, Fundraising Expenses: ; PHYSICIAN RENUMERATION - Total Expense: 1099084, Program Service Expense: 1099084, Management and General Expenses: , Fundraising Expenses: ; CONTRACT LABOR - Total Expense: 380258, Program Service Expense: 302521, Management and General Expenses: 77737, Fundraising Expenses: ; ANESTHESIA SERVICES - Total Expense: 309313, Program Service Expense: 309313, Management and General Expenses: , Fundraising Expenses: ; OUTSIDE RADIOLOGY - Total Expense: 293007, Program Service Expense: 293007, Management and General Expenses: , Fundraising Expenses: ; MEDICAL DIRECTOR - Total Expense: 110724, Program Service Expense: 110724, Management and General Expenses: , Fundraising Expenses: ; PHARMACY SERVICES - Total Expense: 63979, Program Service Expense: 63979, Management and General Expenses: , Fundraising Expenses: ; EQUIPMENT SERVICES - Total Expense: 56799, Program Service Expense: 45187, Management and General Expenses: 11612, Fundraising Expenses: ; COURIER SERVICES - Total Expense: 28555, Program Service Expense: 28555, Management and General Expenses: , Fundraising Expenses: ; BILLING SERVICES - Total Expense: 24253, Program Service Expense: 24253, Management and General Expenses: , Fundraising Expenses: ; CONSULTING SERVICES - Total Expense: 23538, Program Service Expense: 18726, Management and General Expenses: 4812, Fundraising Expenses: ; LAUNDRY SERVICES - Total Expense: 5774, Program Service Expense: 5774, Management and General Expenses: , Fundraising Expenses: ; OUTSIDE LAB - Total Expense: 2787, Program Service Expense: 2787, Management and General Expenses: , Fundraising Expenses: ; OTHER FEES - Total Expense: 446, Program Service Expense: 355, Management and General Expenses: 91, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances TRANSFERS TO AFFILIATES - -224885; COXHEALTH FOUNDATION 3525 S NATIONAL SUITE 204 SPRINGFIELD MO 65807 436810485 FUNDRAISING MO 501(c)(3) Type I LESTER E COX false COX HPS OZKS INC DBA COXHEALTH AT HOME 2220 W SUNSET SPRINGFIELD MO 65807 431641927 HOME HEALTH MO 501(c)(3) 10 COXHEALTH false COX-MONETT HOSPITAL INC 1000 E US HIGHWAY 60 MONETT MO 65708 431656689 HOSPITAL MO 501(c)(3) 3 COXHEALTH false COXHEALTH SYSTEMS HMO PO BOX 5750 SPRINGFIELD MO 658015750 431757075 HMO MO 501(c)(4) LESTER E COX false COX MEDICAL GROUP CLINICS 3801 S NATIONAL SPRINGFIELD MO 65807 371830627 HEALTHCARE MO 501(c)(3) 10 COXHEALTH false COX HEALTH SYSTEMS INSURANCE COMPANY PO BOX 5750 SPRINGFIELD MO 65801 431684044 INSURANCE MO 501(c)(4) LESTER E COX false HC SVCS OZARKS INC DBA COXHEALTH AT HOME PO BOX 10939 SPRINGFIELD MO 65808 431641928 HOME HEALTH MO 501(c)(3) 10 COXHEALTH false PRIMROSE PLACE INC 1115 E PRIMROSE SPRINGFIELD MO 65807 431183783 SUPPORT MO 501(c)(3) Type I LESTER E COX false LESTER E COX MED CTRPROF LIAB LOSS FUND 1423 N JEFFERSON AVE SPRINGFIELD MO 65802 366668576 SELF INSURANCE MO 501(c)(3) Type I LESTER E COX false SKAGGS COMM HOSP ASSOC (COX MC BRANSON) DBA COX MC BRANSON 525 BRANSON BRANSON MO 65616 440584290 HOSPITAL MO 501(c)(3) 3 COXHEALTH false LESTER E COX MEDICAL CENTER 1423 N JEFFERSON AVE SPRINGFIELD MO 65802 440577118 HOSPITAL MO 501(c)(3) 3 COXHEALTH false COX MEDICAL GROUP 1423 N JEFFERSON AVE SPRINGFIELD MO 65802 471087566 PHYSICIANS MO 501(c)(3) Type I LESTER E COX false COXHEALTH 1423 N JEFFERSON AVE SPRINGFIELD MO 65802 471087427 HOLDING CO MO 501(c)(3) Type II NA false MEDICAL DEVELOPMENTS INC 1423 N JEFFERSON SPRINGFIELD MO 65802 431622182 PHARMACY MO LESTER E COX C Corporation false COX TAXABLE CLOSE CORPORATION 1423 N JEFFERSON SPRINGFIELD MO 65802 472573263 MEDICAL CLINIC MO COX MED GROUP C Corporation false COXHEALTH RISK SOLUTIONS GRAND PAVILION CORPORATE CENTRE GRAND CAYMAN CJ KY1110 CAPTIVE INSURANCE CJ LESTER E COX C Corporation false FERRELL DUNCAN CLINIC INC 1001 PRIMROSE AVE SPRINGFIELD MO 65807 430991578 PHYSICIANS MO CTCC C Corporation false false false true false true false false false false false false false false false true true true true false