Freeman Neosho Hospital Inc

“Common paymaster arrangement & salaries: a related organization, freeman health system (fhs), files all w-2s on behalf of the organization. The amount of w-2s filed for the year on part v, line 2a, is the amount of w-2s filed on behalf of freeman neosho for those that work primarily for freeman neosho. The amount listed in column d of part vii, section a, as paid by the organization was paid through w-2s filed by fhs, but has been shown in column d for the individuals who work primarily for freeman neosho. Additionally, the applicable amounts were listed on part ix, line 5 as officer compensation from the organization. Other salaries and benefits allocated to the organization for those employees who worked primarily for freeman neosho.”

“Members/stockholders/other persons: freeman health system is the sole member of the organization. Directors and officers of the organization are appointed and removed by the organization's sole member. The board of freeman neosho hospital must obtain approval from the organization's sole member, freeman health system, to perform certain actions. These actions include: all governance decisions of interest to the member affecting the operation of the corporation; appointment review and removal of the administrator; development and adoption of strategic plans, budget and fiscal policy; approval of any financing or refinancing plans; any investment of the organization's funds; appointment and removal of directors of subsidiaries; amendment of the articles of incorporation and bylaws or any policies, rules, and regulations pertaining to the medical staff; the sale, lease, or exchange of all or substantially all of the organization's property or assets; taking any action that would affect the existence of the corporation, including merger, consolidation, affiliation, or dissolution; adoption or amendment of any corporate compliance program; and any other matter that by law requires the approval of members of a nonprofit corporation.”

“Review of form 990: the form 990 is prepared by an independent accounting firm based on the audited financial statements and information provided by the accounting department of the organization. Prior to filing, a draft of the form 990 is reviewed by members of top management. Once a final draft is ready, a power point presentation is made to the board members at the board of directors meeting to explain the 990 and its uses. The board reviews the document for key information included. Paper copies are made available to the board members at their request.”

“Monitoring compliance with conflict of interest policy: the conflict of interest policy is reviewed by the board of directors each year in april. The board members are asked to sign a new conflict of interest policy and list any possible conflicts. This information is reviewed and maintained in the administrative offices. If a board member encounters a transaction that would cause a possible conflict of interest, a form detailing the transaction is completed and submitted to the board for review and approval. Corporate officers and key employees are also required to annually disclose conflicts of interest.”

“Freeman health system compensation review: executive compensation philosophy and strategy i. Key principles freeman health system (fhs) desires to ensure that its executive compensation program is competitive, fair, and equitable; compliant with regulatory guidelines; and representative of market best practices. Key principles that guide fhs's executive compensation decision-making process include: -executive compensation programs will support fhs's mission, values, strategic direction, and tax-exempt status. -fhs competes in a national market for its executives and thus will consider pay practices that are representative of the industry. -the relative pay levels of fhs executives will over time reflect both individual and organizational performance. -fhs intends to establish the rebuttable presumption of reasonableness under irs intermediate sanctions regulations. Thus, executive compensation programs and decisions will be approved, in advance of their implementation by the executive compensation committee (hereafter the committee) of the board of directors: *the committee is comprised of members of the board of directors, who are independent of fhs's management, have no personal interest in the compensation arrangements, are not related to, or under the control of any individual whose compensation arrangement is being reviewed and have no material business relationship with fhs. *the committee will rely upon appropriate, independent comparability data to support its decision making process. *the committee will adequately document its deliberations, decisions, and actions on a timely basis. Ii. Primary program components fhs's executive total compensation program consists of the following components: -base salary -annual at risk compensation -standard all employee benefits -supplemental benefits and perquisites -severance annually, the committee will direct the review of the components of the executive compensation program and approve program modifications as appropriate. The committee may also authorize unique program components which support the achievements of fhs's mission. Iii. Market comparators fhs will consider a national peer group of healthcare organizations comparable to fhs in size (i.e., net revenues) and complexity to determine the market values for each of its executive positions. This peer group will primarily be comprised of not-for-profit healthcare organizations (but for-profit organizations may be considered selectively) for functionally comparable positions as reported in surveys conducted by independent firms. -cash compensation the following organizations/markets are the primary comparators for compensation purposes: *system level executives: health systems of comparable size to fhs, based on net revenue. These will be based on national healthcare labor markets. *hospital level executives: hospitals of comparable size to the fhs entity, based on net revenue. These will be based on national healthcare labor markets. *other executives: organizations of comparable size in relevant market segments such as medical group practices, home health, and the like. These will be based on national healthcare labor market. -executive benefits fhs will develop and administer executive benefit (i.e., standard benefits, supplemental executive benefits, and perquisites) plans that are based on national healthcare industry market norms. Iv. Market position targets fhs has established a target market position for each of the components of its executive total compensation program. -base salaries: fhs will manage its executives' base salaries around the 50th percentile of base salaries paid in the market. Salaries will vary from the 50th percentile based an executive's experience and performance. For example: *executives who are new to the organization and/or have limited or no prior executive-level experience should have salaries that are 80 to 90 percent of the 50th percentile. *experienced executives (with approximately 5”

“Freeman health system compensation review (continued): executive compensation committee charter this executive compensation committee charter was adopted by the board of directors (the "board") of freeman health system (hereafter "fhs") on april 25, 2008. This charter applies to fhs and all of its business entities, including freeman neosho hospital, ozark center, and the freeman foundation (hereafter the "system"). This charter is a component of the flexible framework within which the board, assisted by its committees, directs the affairs of fhs. While the charter should be interpreted in the context of all applicable laws and regulations, as well as in the content of fhss articles of incorporation and bylaws, it is not intended to establish by its own force any legally binding obligations. I. Purpose the executive compensation committee (hereafter the "committee") is authorized to act on the boards behalf in (i) determining appropriate compensation for system executives and other disqualified persons as defined in the irs intermediate sanctions regulations; (ii) evaluating system executives and other disqualified persons cash compensation plans, policies, and programs; (iii) reviewing benefit plans for system executives and other disqualified persons; and (iv) verifying that compensation information is appropriately and fully disclosed. - a disqualified person: is any person who is or was in a position to exercise substantial influence over the affairs of the applicable tax-exempt organization. It is not necessary that the person actually exercise substantial influence, only that the person be in a position to do so. -for purposes of this charter, "executives" are defined as system executives and other disqualified persons validated by the committee. In discharging its role, the committee is empowered to investigate any matter brought to its attention with access to all books, records, facilities, and personnel of the system. It has the authority to retain outside advisors (e.g., legal counsel, compensation, consultations, or other experts) and will receive adequate funding from the system to engage such advisors. It shall have the sole authority to retain, compensate, terminate, and oversee its advisors, who shall be accountable ultimately to the committee. To support the committee, a timetable and resource book will be developed containing the necessary data, information, and documents the committee will need to carry out its duties. The resource book will be distributed to the committee in advance of its meetings and fhs will maintain these books at its corporate office. The committee also will receive training in compensation plan design and administration, including legal and regulatory issues (as needed). Ii. Committee membership the committee is a standing committee of the board. In accordance with the corporate bylaws, it shall consist of at least three, but not more than five, members of the board. Each committee member has been determined by the board to be "independent" in accordance with irs intermediate sanctions regulations. At the start of this year, each member will review the organizations conflict of interest policy to ensure he or she has no conflict of interest and is "independent". If a real, potential, or perceived conflict of interest is identified, the committee member will review the issue with the committee chair and legal counsel to determine the appropriate action. In addition, no director may serve on the committee unless he or she is a "non-employee" member of a system board. The fhs board will appoint a committee chair to convene all sessions, set agendas for meetings, and determine the information needs of the committee. Before debating and voting on any compensation arrangement, each member shall determine whether he or she has a conflict of interest regarding the compensation arrangement. Any member with a conflict of interest regarding a particular compensation arrangement or transaction sh”

“Document disclosure: the organization's governing documents, conflict of interest policy, and financial statements are not made available to the public”

“Organizations vision: vision to be the leading provider of patient centered, physician directed healthcare in an environment of compassion and trust, supported by dedicated employees with a desire to provide excellence in care and service.”

“PROGRAM SERVICES: Freeman Health System, not-for-profit, community-owned, and locally governed by a volunteer Board of Directors, provides full-service healthcare to southwest Missouri, southeast Kansas, northeast Oklahoma, and northwest Arkansas. A three-hospital health system, Freeman provides comprehensive services including cancer care, heart care, orthopaedics, neurosurgery, womens services and behavioral healthcare. Freeman accepts Medicaid and Medicare patients and offers financial assistance and payment plans, providing a safety net to one-third of the local population with household incomes below $25,000. Freeman asks all employees and volunteers to embrace the mission of improving the health of the communities served through contemporary, innovative, quality healthcare solutions. The Freeman medical team, which includes more than 300 physicians representing 60 specialties, uses the latest techniques, best practices, and technologies to provide lifesaving medical care, providing constituents with the healthcare they need right in their own back yard. Joplin-area patients do not have to travel to big cities to receive heart interventions, cardiothoracic surgeries, neurosurgeries, pain therapies, intensive care, trauma care, and advanced diagnostic services. The close-to-home availability of progressive healthcare services eases stress on patients, for whom travel can be uncomfortable, and their families, for whom travel can present a great financial burden. Diabetes Obesity and diabetes are growing problems with serious health implications. According to the Missouri Department of Health and Senior Services, 12.6 percent of southwestern Missouri residents have diabetes. To address the problem and provide education to the community, Freeman Diabetes Education hosted the eighth annual Diabetes Expo in November 2016. It featured presentations by Freeman endocrinologists and diabetes educators, a healthy cooking demonstration and diabetes-related product demonstrations. ADDITIONALLY, FREEMAN HELD AN "OUTSTANDING DIABETES!" EVENT IN MAY 2016 to give participants a chance to explore interactive demonstrations that covered topics such as diabetic foot care, reading labels, portion sizes and ways to lower blood sugar. It featured a panel discussion in which Freeman physicians answered questions about diabetes. Free hemoglobin A1c tests were offered to the first 100 participants. Freeman also provided health tips, healthy food samples, a cooking demonstration and a yoga tutorial on Diabetes Alert Day in March 2017. During the event, Freeman Diabetes Educators helped participants complete an online diabetes risk assessment. The event was free and open to the public. KCU Medical School in Joplin For decades, Freeman Health System has worked with respected medical schools to train tomorrows physicians, providing a training ground for medical students. With the opening of the new Kansas City University (KCU) medical school in Joplin, Freemans tradition of providing medical education facilities, classrooms, programs, preceptors and faculty continues for the benefit of the community. The school is expected to open in fall 2017. The physician-training program in place at Freeman dates back more than 40 years. As a teaching hospital, Freeman plays a key role in the education and training of physicians in Missouri and serves as the flagship health system in the opening of the new medical school in Joplin. It is often difficult to attract new physicians to cities located in largely rural areas, like Joplin. One of the great benefits of having a medical school in Joplin is that it will bring new doctors into the community many of the physicians who train here will decide to make Joplin their home and open their medical practices in the four-state area. Additionally, the new medical school will open a door for many local students who, otherwise, might not be able to obtain the training it takes to become a doctor. Its a golden opportunity f”

“PROGRAM SERVICES (CONTINUED): Helping the community Freeman helps many organizations that, in turn, help some of the most fragile members of the community. For instance, for $1 per year, Freeman leases the land and building at 34th Street and Indiana Avenue to Childrens Center of Southwest Missouri, a not-for-profit agency that protects and advocates for children who have been victims of abuse. Similarly, Freeman leases land to Ronald McDonald House Charities of the Four States for $1 per year, and Freeman maintains the grounds and provides housekeeping services, services with an annual retail value of $9,000. Careers Freeman Health System contributes to the health of the community by creating a wide range of career opportunities. Professionals in many fields at Freeman earn above-average wages and salaries, and the benefits Freeman offers help attract and maintain an affluent middle class, whose members buy homes, spend money and boost the area economy. In FY17, Freeman Health System provided payroll and benefits totaling $230,000,000. To help ensure a steady supply of physicians, nurses, and other clinicians in the future, Freeman educates young people about healthcare careers. High school and college students participate in a summer "FUTURES" VOLUNTEER PROGRAM, WORKING WITH HEALTHCARE PROFESSIONALS IN real-life hospital situations. The program earned the Award for Excellence from the Midwest Association for Healthcare Volunteer Resource Professionals. An eight-week summer educational program for students interested in careers in healthcare, the program gives participants behind-the-scenes experience in a hospital setting. After orientation, students are assigned to a unit and work four-hour shifts under the supervision of a nurse or technician. Program participants wear scrubs like hospital team members and assist with assigned tasks. They attend lunch-and-learns and work with patients, providing magazines, snacks and linens as needed. Joplin High School students can receive one-half credit toward graduation if they complete 80 hours as a Freeman Student Volunteer. The program also offers participants the opportunity to earn a $500 scholarship. Additionally, Freeman Health Academy, provided at no cost to families, reaches out to middle school students to help them prepare for healthcare careers. The first program of its kind in the community, it gives students the opportunity to learn about healthcare careers from Freeman physicians and staff. It encourages students to graduate from high school and helps them choose high school courses, such as science and math, to prepare them for further education and healthcare careers. Nursing Scholarships Freeman Auxiliary gave $14,000 to seven local nursing programs Carthage Technical Center, Crowder College, Franklin Technical Center, Labette Community College, Missouri Southern State University, Northeastern Oklahoma A&M College and Pittsburg State University each received $2,000. Free Marketplace Assistance In FY17, Freeman continued offering Health Insurance Marketplace education and enrollment to help people understand available health insurance options. With a grant from Missouri Foundation for Health, Freeman worked with other area healthcare organizations to conduct free events throughout the year in several southwestern Missouri communities. Donor Council Freeman is committed to improving the health of all people living within the communities served by Freeman. To this end, Freeman Donor Council, composed of Freeman caregivers who volunteer their time to promote organ, eye, and tissue donation awareness, has provided education to patients for decades. Freeman Advantage Senior Citizen Driving Courses Freeman Advantage, a wellness and lifestyle program for older adults, OFFERED LOW-COST DRIVER SAFETY CLASSES IN FY17. THESE AARP SMART DRIVER courses gave older drivers the opportunity to refresh their skills, brush up on rules of the road, and make the public streets safer for al”

“PROGRAM SERVICES (CONTINUED): Disaster Drill In November 2016, Freeman sponsored a full-scale disaster exercise at Freeman Hospital West. Area healthcare providers and emergency medical teams were invited to participate. The exercise simulated the May 22, 2011, tornado that struck Joplin, Missouri. During the exercise, Freeman set up and staffed a new 24-bed portable minor care/triage shelter, operated the Freeman Emergency Mobile Communications Unit, set up child care centers and medical surge units, and performed a simulated hospital evacuation. The goal was to evaluate communication, resources, logistics, mass care, citizen evacuation, emergency public information, emergency operations and recovery. Freeman Neosho Hospital is a critical-access facility that serves the needs of largely rural Newton and McDonald counties in southwest Missouri. Freeman Neosho Hospital provides the community with emergency services; pediatric services; surgical services; cardiology and orthopaedic specialty clinics; and cardiac, physical therapy, speech therapy rehabilitation services, and digital mammography and other diagnostic services. Freeman Neosho hosted blood drives, participated in the Heart Walk, participated in Freeman Auxiliary and Volunteer services projects, and hosted quarterly Freeman Advantage educational meetings.”

“Outpatient services: people living in rural areas face healthcare problems not encountered by people dwelling in more densely populated areas. Access to medical care can be limited for people in remote locations a particular concern when an emergency such as appendicitis or a car accident injury occurs. Rural towns typically have a hard time attracting doctors and specialists to live in their communities. Many residents of rural areas dont want or cant afford to travel long distances for routine wellness exams and screenings consequently, by the time they get to a healthcare provider for diagnosis and treatment, their conditions are often more advanced and harder to treat than they would have been if they lived closer to a medical care facility. Therapeutic services freeman neosho provides access to outpatient services such as physical therapy and digital mammography, along with cardiac rehabilitation and infusion treatments through the la-z-boy therapeutic center. Womens health freeman neosho womens pavilion was established to provide the community with state-of-the-art digital mammography and diagnostic tools. Digital mammography offers the best technology available for breast cancer screening. Breast cancer is the second most common form of cancer among women in the u.s., preceded only by skin cancer. Deaths linked to breast cancer have declined throughout the past two decades, thanks largely to improved diagnostic screening. Digital mammography uses compression and x-rays to examine a breast, capturing a digital image on a computer. When compared to film mammography, digital offers greater contrast, detail, and penetration of dense breast tissue. Through the use of digital mammography, a radiologist can manipulate an image to better examine breast tissue. School-based medicine because of the success of its school-based medicine program in the neosho public schools, freeman neosho launched additional school-based medicine partnerships with the seneca and mcdonald county schools in the fall of 2016. Students and staff at these schools now have priority scheduling at freeman clinics, as well as remote access to freeman providers via tele-health. Freemans school partnerships increase access to healthcare, decrease time lost from school for students and staff and reduce time lost from work for parents. This service significantly reduces absenteeism for students and staff and improves the overall health of the community.”

“Inpatient services: in july of 2016, freeman neosho hospital celebrated completion of renovations that expanded the waiting area on the first floor. The larger space ensures confidentiality for patients registering for outpatient procedures, while providing an aesthetically pleasing environment. To make room for the expanded waiting area, the chapel was moved to the second floor, where it is centrally located and closer to patient rooms. In the fall of 2016, freeman neosho broke ground on the largest expansion project at the hospital since 1983. The project will add 1,700 square feet to the building and will renovate an additional 1,300 square feet of space. The purpose of the expansion is to make room for new, state-of-the-art imaging equipment. The suite will be called the larry d. Neff ct-mri suite and is expected to open in the fall of 2017. The project will greatly benefit patients by providing them with convenient and timely services with the latest technologies. General surgery freeman neosho continues to enjoy the services of a board-certified general surgeon. Because the hospital has a general surgeon on staff, patients do not have to travel out of town for surgical services including minimally invasive surgeries that cover a wide range of concerns or problems. Having a general surgeon on staff with particular experience in breast and colon cancers and reconstruction techniques adds exceptional depth to the freeman neosho surgical program. Freeman neosho hospital provides intensive care, general care and swing-bed inpatient services. Freeman neosho inpatient services totaled 880 cases, of which, 73, or 8%, were medicaid cases. Additionally, 68 inpatient cases, or 8% of the total, fell into the self-pay (no insurance) category.”

“Emergency room/trauma services in response to the departments increasing annual patient count, freeman neosho hospital expanded its emergency room from six beds to nine in february 2012, allowing for a greater patient load and providing more services to the community. Of the rooms added, one is a fast-track room intended for the less acutely ill or injured. The remaining additional rooms are for critically ill or injured patients. The project was designed with the goal of giving patients faster treatment. Also as a result of this expansion, freeman neosho emergency room has added to its clinical staff. Recent expansion projects have positioned freeman neosho hospital to better serve its growing number of emergency room patients. According to data from missouri hospital association, freeman neosho has one of the states busiest emergency rooms for critical access hospitals. The freeman neosho emergency department treated 14,425 cases, of which 4,479 were medicaid cases, representing 31% of the total emergency room volume. In addition, the emergency room treated 3,116 cases, or 22%, that were self-pay (no insurance).”

“Other program services: freeman neosho hospital also provided contributions to local organizations. The majority of these funds were given for the creation of a medical school in joplin community. See schedule i for more information.”

“Tax exempt bond liability: the tax-exempt bond liability being reported is an allocation of a 2013 series bond from freeman health system, a related party. As such, details regarding the bond is reported on freeman health systems from 990, schedule k. Since the bond details are being reported once, freeman neosho hospital is not required to include a schedule k with its form 990.”

“Other changes in net assets: $ 2,909 change in interest in affiliates”