Freeman Health System

“Review of the 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, the 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.”

“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. If a conflict is found, the interested person will not participate in the discussion or vote on a transaction involving his or her conflict. The conflict of interest policy was updated in fiscal year 2011 to require an attestation form from all employed physicians and level four supervisors/managers and up. Corporate officers and key employees are also required to annually disclose conflicts of interest.”

“Freeman health system compensation review: executive compensation philosophy & 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 its 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 context of fhs's 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 board's 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 consultants, 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 the year, each member will review the organization's 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 sha”

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

“Board member compensation: no directors receive compensation for their services as board members. Board members larry mcintire, john cox and rodney mcfarland are employees of the organization and compensated as physicians. Additionally, paula baker receives compensation for her duties as president/ceo of both freeman health system and freeman neosho hospital.”

“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. Freeman health system in joplin, missouri is a 404 bed, three hospital system providing comprehensive healthcare and behavioral health services to an area that includes more than 450,000 from missouri, arkansas, oklahoma, and kansas.”

“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, women's services, and behavioral healthcare. Freeman accepts medicaid and medicare patients and offers charity care and payment plans, providing a safety net to a 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. Freeman fast facts fy 2014 (joplin & neosho combined) - outpatient registrations: 384,436 - emergency/trauma/urgent care visits: 108,365 - freeman occumed visits: 46,201 - admissions: 20,897 - surgical procedures: 11,197 - births: 2,455 - babies in neonatal intensive care unit: 334 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 fifth annual diabetes expo in november 2013. It featured freeman endocrinologist dr. Allison galloway, who discussed new diabetes medications for treating type 2 diabetes, as well as diabetes-related product demonstrations and samples. Another community benefit related to diabetes and obesity, freeman hosted an american diabetes association alert day event in march 2014. During this free event, freeman diabetes educators administered a free diabetes risk assessment to any member of the public who wanted one. Participants received preventative tips and education. Additionally, the event raised awareness about diabetes and its impact on health. To help ensure the community has the physicians it needs, freeman brought 27 new physicians into the community during 2013 and 12 in 2014, providing a great benefit, in terms of both healthcare and economics. According to the missouri hospital association, family physicians make an economic impact of more than $1 million each year on the communities they serve. For 23 years, freeman orthopaedics & sports medicine and freeman rehabilitation services have provided free annual preseason physical exams for hundreds of athletes attending area schools. More than 75 volunteers, including doctors, nurses, therapists, and other clinicians, assist with the exams, scheduled at specific times throughout the year. These free preseason physicals provide comprehensive evaluation and assessment to athletes participating in a sanctioned sport in a school-based program; through the area's parks and recreation departments, ymcas, or local leagues; or in training to compete in a specific event, such as a marathon or triathlon. A huge community benefit in fy 2014, this program helped hundreds of families by providing required medical examinations free of charge. On a related note, freeman began offering free saturday morning sports injury clinics in fy 2014. Thanks to dr. Robert lieurance, a bo”

“OUTPATIENT SERVICES: CANCER CARE FREEMAN CANCER INSTITUTE PROVIDES PHYSICAL AND EMOTIONAL CARE FOR PATIENTS AND FAMILIES THROUGH COMPREHENSIVE SERVICES AND THE MOST UP-TO-DATE TECHNOLOGICAL ADVANCES, ALL LOCATED IN ONE CONVENIENT AND COMFORTABLE SETTING. FREEMAN CANCER INSTITUTE ACCEPTS MEDICAID AND MEDICARE PATIENTS. FREEMAN CANCER INSTITUTE EMPLOYS A SOCIAL WORKER TO HELP PATIENTS DEAL WITH THE ISSUES SURROUNDING TkREATMENT AND RECOVERY. FREEMAN STAFF WORK WITH DRUG COMPANIES AND OTHER ORGANIZATIONS TO PROCURE FREE CANCER MEDICATIONS FOR PATIENTS WHO CANNOT AFFORD THEM. TO HELP CATCH BREAST CANCER WHILE IT IS TREATABLE, THE FREEMAN HELPING FRIENDS MAMMOGRAM FUND, ADMINISTERED THROUGH FREEMAN FOUNDATION, PROVIDES MAMMOGRAMS FOR WOMEN WHO CAN'T AFFORD THEM. IN FY 2014, HELPING FRIENDS MAMMOGRAM FUND HELPED 27 WOMEN BY PROVIDING $8,858 IN MAMMOGRAMS, AS WELL AS EDUCATIONAL MATERIALS. FREEMAN CANCER SUPPORT GROUP OFFERS AN OPPORTUNITY FOR CANCER PATIENTS, SURVIVORS, AND FAMILY MEMBERS TO TALK ABOUT THEIR EXPERIENCES AND LEARN ABOUT SUPPORT AND RESOURCES IN A CARING AND INFORMATIVE ENVIRONMENT. MEETINGS, WHICH ARE FREE AND OPEN TO THE PUBLIC, ARE HELD MONTHLY. A SPECIAL SUPPORT GROUP FOR PATIENTS WITH GYNECOLOGICAL CANCER WAS STARTED IN FY 2014. IT MEETS QUARTERLY TO HELP PATIENTS WITH CANCER OF THE REPRODUCTIVE ORGANS AND CANCER SURVIVORS, AS WELL. THE SUPPORT GROUP PROVIDES PATIENTS, SURVIVORS, AND FAMILY MEMBERS AN OPPORTUNITY TO TALK ABOUT THEIR EXPERIENCES WITH THE DISEASE. SUPPORT AND RESOURCES ARE OFFERED IN CARING AND INFORMATIVE ENVIRONMENT. ALL MEETINGS ARE FREE AND OPEN TO THE PUBLIC. EMERGENCY SERVICES THE 2011 TORNADO THAT TORE THROUGH JOPLIN, MISSOURI, DESTROYED ONE OF THE CITY'S TWO FULL-SERVICE HOSPITALS. THIS LEFT FREEMAN HOSPITAL WEST AS THE ONLY LEVEL II TRAUMA CENTER IN THE AREA. FREEMAN RETAINED THIS STATUS THROUGH FY 2014. THE EMERGENCY DEPARTMENT/TRAUMA CENTER AT FREEMAN HOSPITAL WEST TREATS APPROXIMATELY 45,000 PATIENTS EACH YEAR. EMERGENCY ROOMS ROUTINELY DEAL WITH HOMELESS, MENTALLY ILL, AND SUBSTANCE-ADDICTED PATIENTS. FREEMAN PLACES MENTAL HEALTH COUNSELORS IN THE EMERGENCY ROOM ON AN AROUND-THE-CLOCK BASIS. THESE COUNSELORS ARE AVAILABLE TO TALK WITH PATIENTS WHO SHOW SIGNS OF MENTAL HEALTH OR SUBSTANCE ABUSE CONDITIONS. AFTER THOROUGH EVALUATION, THE COUNSELORS OFFER RECOMMENDATIONS REGARDING FOLLOW-UP CARE RANGING FROM ASSESSMENT OF SUICIDALITY AND NEED FOR INPATIENT PSYCHIATRIC HOSPITALIZATION TO MAKING OUTPATIENT THERAPY APPOINTMENTS FOR PATIENTS BEFORE THEY LEAVE THE EMERGENCY ROOM. IF EVALUATION MANDATES HOSPITALIZATION, COUNSELORS HELP FIND AN APPROPRIATE BED AND TRANSPORTATION. ON AVERAGE, COUNSELORS EVALUATE AND RECOMMEND TREATMENT FOR 54 PSYCHIATRIC PATIENTS EACH WEEK. AS A RESULT OF THIS INTERVENTION, MANY PREVIOUS FREQUENT VISITORS TO THE EMERGENCY ROOM HAVE BEEN REDIRECTED TO APPROPRIATE PSYCHIATRIC OR SUBSTANCE ABUSE PROGRAMS. EVERY TWO MINUTES, SOMEWHERE IN AMERICA, SOMEONE IS SEXUALLY ASSAULTED. FREEMAN DOCTORS AND NURSES OFFER COMPASSIONATE AND COMPREHENSIVE CARE TO VICTIMS OF SEXUAL ASSAULT IN THE EMERGENCY ROOM THROUGH THE SEXUAL ASSAULT NURSE EXAMINER (SANE) PROGRAM. THE PROGRAM PROVIDES A COORDINATED HOSPITAL RESPONSE AND CONTINUUM OF CARE FOR VICTIMS OF SEXUAL VIOLENCE AND ENSURES A MEDICAL EVALUATION, STANDARDIZED FORENSIC EXAMINATION WITH EVIDENCE COLLECTION, AND EFFECTIVE INTERFACE WITH LAW ENFORCEMENT AND ADVOCACY SERVICES. IT ALSO PROVIDES EDUCATION TO LOCAL COMMUNITIES ON SEXUAL VIOLENCE AWARENESS, PREVENTION, AND AVAILABLE SERVICES. THE NURSE EXAMINER REPORTS THE CRIME AND/OR COLLECTS EVIDENCE OF THE SEXUAL ASSAULT ONLY AT THE VICTIM'S REQUEST. THE SANE PROGRAM AT FREEMAN IS THE ONLY ONE OF ITS KIND IN THE AREA. IN PARTNERSHIP WITH LAFAYETTE HOUSE, THE PROGRAM ALSO OFFERS EMERGENCY SHELTER AND SERVICES. MANY PATIENTS, WHO DON'T HAVE A PRIMARY CARE PHYSICIAN, TURN THE FREEMAN EMERGENCY ROOM FOR ROUTINE MEDICAL CARE. WHILE FREEMAN TRIES TO EDUCATE THE COMMUNITY OF THE BENEFI”

“Inpatient services: freeman joplin inpatient services totaled 19,942 cases, of which, 4,559 or 23%, were medicaid cases. Additionally, 1,734 inpatient cases, or 9% of the total, fell into the self-pay (no insurance) category. Critical care after the 2011 tornado, freeman found that the community needed a hospital with the ability to treat large numbers of critical care patients. While freeman has a 33-bed intensive care unit and a seven-bed cardiovascular intensive care unit, the health system decided to increase its capacity to serve patients needing critical care services by dedicating the entire sixth floor to critical care as well. The sixth floor includes the area's first transitional care unit (tcu), which cares for patients too ill for the general medical floor, but well enough that they no longer require the level of services provided by the intensive care unit. Additionally, the sixth floor includes cardiac/medical unit 2 (cmu-2) to serve kidney patients needing dialysis. All nurses in this unit have advanced cardiac and dialysis training. Freeman joplin critical care services totaled 4,414 cases, of which, 469, or 11%, were medicaid cases. Additionally, 8% of the critical care cases fell into the self-pay (no insurance) category. Freeman pediatric unit the freeman pediatric unit provides care to children from birth to age 18 and works with families to make their children's hospitalization less traumatic by encouraging parental involvement. Chair beds in each room, as well as meal trays for parents, enable families to remain together during difficult times. Each room has a tv/vcr; videos and video games are available upon request. The unit includes a brightly decorated examination room and a playroom filled with books and toys. Freeman joplin inpatient pediatric services totaled 427 cases, of which, 243, or 57%, were medicaid cases. Additionally, 3% of the pediatric inpatient cases fell into the self-pay (no insurance) category. Maternity services designed to give new mothers and their families the comforts of home within the security of a hospital, freeman maternity center delivered 2,455 babies in fy 2014. The unit includes board-certified obstetricians available 24 hours a day and the region's only board-certified perinatologist caring for patients with high-risk pregnancies. In fy 2014, freeman maternity center served 1,134 medicaid patients, or 52% of its caseload. Self-pay patients (those with no insurance) represented 4% of the mothers delivering babies at freeman. As these statistics indicate, freeman provides a safety net for expectant mothers who live in poverty and receive government assistance and those who scrape by without assistance but have no health insurance. Medicaid reimbursement does not cover the cost of providing the level of treatment required. Nicu freeman has the region's only neonatal intensive care unit (nicu) providing immediate critical care for premature and critically ill infants. The unit includes skilled and experienced physicians and staff who stand ready to provide the immediate critical care premature babies need. Freeman nicu provides specialized care using state-of-the-art technology and decades of experience. Survival rates for infants less than three pounds have increased significantly as a result of the outstanding medical care provided by the freeman nicu team of doctors, neonatal nurse practitioners, specialized developmental therapists, and nurses. In fy 2014, freeman nicu served 334 prematurely born or critically ill babies. Of these tiny patients, 233 received medicaid, which represents 70% of freeman nicu's caseload. Self-pay patients (those with no insurance) represented 2% of freeman nicu patients. Neonatal intensive care is extremely expensive to provide, and medicaid reimbursement does not cover the cost of providing the level of treatment required.”

“Heart/cardiovascular services: freeman has been recognized by anthem blue cross and blue shield of missouri as a blue distinction center for cardiac care, a distinction that honors healthcare providers for demonstrating expertise in delivering specialty care safely and effectively. Additionally, freeman has earned 90 2014 awards from the carechex quality rating system, including: top 10% in the nation patient safety award for cardiac care, top 100 hospitals in the nation patient safety award for interventional coronary care, and top 10% in the nation patient safety award for stroke care. Freeman heart & vascular institute includes a team of board-certified physicians who provide both inpatient and outpatient care. The team includes six cardiologists and two cardiothoracic surgeons. The cardiologists at freeman heart & vascular institute use a variety of noninvasive tests to diagnose heart disease and conditions such as angina (chest pain). These tests include state-of-the-art echocardiography, contrast echo, and regular treadmill, stress echo, dobutamine stress echo, and nuclear medicine stress tests. Additionally, freeman offers computed tomography (ct) and positron emission tomography/computed tomography (pet) imaging. Freeman board-certified cardiothoracic surgeons treat patients for a wide range of conditions affecting the heart, as well as the respiratory and circulatory systems. They combine use innovative technology to provide the latest in vascular and endovascular surgical options. Many of the procedures performed by freeman cardiothoracic surgeons use minimally invasive approaches through small incisions and with video assistance devices. Minimally-invasive beating-heart surgery results in less pain and trauma, reduced recovery time, and reduced risk of infection. Patients experience better outcomes, spend less time away from home, and return to work sooner. History in accordance with freeman's mission of improving the health of the communities it serves through contemporary, innovative quality healthcare solutions, freeman heart & vascular institute was established in 1999 to provide essential heart services to the people of joplin and surrounding communities. Before the institute opened, many patients had to drive to distant cities for heart care, treatment, and rehabilitation. Restoring blood flow to the heart freeman heart & vascular institute has an outstanding record with door-to-balloon time, or the time it takes to restore blood flow to the heart after a heart attack. Freeman continually beats national standards by more than 40 percent. The national standard for restoring blood flow to the heart is 90 minutes - freeman averages 44 minutes. To achieve this record, freeman provides education to emergency medical technicians who transport patients to the hospital, helping them shave minutes off the time it takes to restore blood flow by transmitting heart data from the ambulance to the hospital and showing emts how their efforts have helped save patients. Helping patients with chronic heart diseases the freeman heartwise program helps people with chronic cardiac conditions live healthy, happy lives. While the heart of a patient with chronic heart disease no longer works as well as it should, many people live with chronic heart conditions without ever suffering a heart attack. The heartwise team of heart care professionals helps patients by prescribing medications and devices, as needed, and helping patients adopt lifestyle changes. Improving the level of specialty care provided to patients, heartwise also helps reduce hospital readmission rates, which helps lower the cost of healthcare. Clinical trials freeman also offers cardiac patients the opportunity to participate in clinical trials. A clinical trial is a carefully designed study in which patients willingly participate in research investigations and treatments under close supervision of a physician and other medical professionals. Clinical trials take place”

“Common paymaster arrangement & salaries: freeman health system files all w-2's on behalf of freeman neosho hospital (fnh), a related organization. The amount of w-2's filed for the year on part v, line 2a, includes the amount of w-2's filed on behalf of fnh for those that work primarily for fnh and the w-2's filed for freeman health system employees. Salary and benefits expenses are allocated from freeman health system to fnh for those employees who work primarily for fnh.”