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 2015 (joplin & neosho combined) - outpatient registrations: 391,619 - emergency/trauma/urgent care visits: 115,237 - freeman occumed visits: 44,333 - admissions: 20,864 - surgical procedures: 11,197 - births: 2,357 - babies in neonatal intensive care unit: 348 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 sixth annual diabetes expo in november 2014. It featured presentations by freeman endocrinologists and diabetes educators, as well as diabetes-related product demonstrations. To help ensure the community has the physicians it needs, freeman brought nine physicians into the community during fy 2015, 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 24 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 2015, this program helped hundreds of families by providing required medical examinations free of charge. On a related note, freeman continues offering free saturday morning sports injury clinics in fy 2015. Thanks to dr. Robert lieurance, a board-certified freeman orthopaedics & sports medicine physician who fellowship-trained in sports medicine, student athletes can obtain free medical care for injuries sustained during the previous week's games at these clinics. The clinic includes the services of dr. Lieurance, a physician assistant, and freeman athletic trainers. This is a great community benefit for the families of injured athletes. Through the chaplains fund, freeman offers help to patients upon dismissal from the”

“Outpatient services: 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 2015. 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 benefits of using urgent care clinics and establishing a relationship with a primary care physician, patients still visit the freeman emergency room for care of colds, stomach aches, bumps and bruises that could be more efficiently treated in other venues. The cost of providing treatment in the emergency room setting is extremely expensive, and many of the patients seeking emergency care have no insurance. As a result, freeman health system often has to pick up the cost of emergency treatment. Freeman ambulance service covers the entire 540-mile mcdonald county area, averaging more than 60,000 miles per year per ambulance. With two state-of-the art ambulances, freeman ambulance service provides reliable, safe, and comfortable transportation across the often-difficult, steep, twisting roads of mcdonald county, an area that has been designated "medically underserved" by the health resources and services administration. The need for services in this area is dramatic, and freeman ambulance service operates at a loss. All patients are served regardless of ability to pay for the service. Pediatric specialty care freeman health system now partners with children's mercy to enhance care for children in the four-state area. As part of this collaboration, children's mercy opened a permanent location with several specialty clinics on the freeman campus. These new joplin clinics, known as children's kansas city, are an extension of children's mercy, a nationally ranked pediatric medical center in kansas city, with full support of its 600 pediatric specialists. Pediatric specialties offered at”

“Inpatient services: freeman joplin inpatient services totaled 19,844 cases, of which, 4,231 or 21%, were medicaid cases. Additionally, 1,652 inpatient cases, or 8% 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. In fy2015, freeman added a new, expanded inpatient dialysis unit on the sixth floor to improve services to critically ill kidney patients. Additionally in fy2015, freeman held the first-ever march o' the kidney fundraiser in support of kidney patients on dialysis. The one-mile walk, held march 14, 2015, at northpark mall, drew participants from around the four states to help patients who struggle with medical, nutritional and transportation expenses. More than $30,000 was raised with 100 percent of the proceeds going directly to those in need through the new freeman dialysis patient fund. Freeman joplin critical care services totaled 4,185 cases, of which, 394, or 9%, were medicaid cases. Additionally, 7% 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 444 cases, of which, 265, or 60%, were medicaid cases. Additionally, 5% 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 2,357 babies in fy 2015. 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 fy2015, freeman health system was one of 19 hospitals in missouri recognized by the march of dimes for having zero elective early inductions or cesarean deliveries performed before the 39th week of pregnancy. The march of dimes said this gives more babies a healthy start in life, noting that babies delivered before full term are at increased risk of serious health problems and death in their first year of life. Recent research by the march of dimes, the national institutes of health and the u.s. Food and drug administration found that the risk of death more than doubles for infants born at 37 weeks of pregnancy when compared to babies born at 40 weeks for all races and ethnicities. Babies born just a few weeks early also have higher rates of hospitalization and illness than full-term infants. In fy 2015, freeman maternity center served 1,077 medicaid patients, or 46% 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 expectan”

“Freeman cancer institute: freeman cancer institute employs a social worker to help patients deal with the issues surrounding treatment and recovery. Additionally, freeman staff work with drug companies and other organizations to procure free cancer medications for patients who cannot afford them. Freeman cancer patients have the opportunity to take advantage of a special resource at freeman cancer institute. Hair loss is a very real concern for women undergoing cancer treatment. Women in joplin and surrounding areas have the opportunity to receive a free headdress from american cancer society resource center, located inside freeman cancer institute. The cancer resource center is dedicated to boosting a woman's confidence during this difficult period in her life. The resource center wig room offers wigs as gifts to women who cannot afford them. Scarves and hats are also available. Women are invited to select their choice of headdress, and with the help of a staff member, select a piece most becoming to them. To help catch breast cancer while it is treatable, helping friends mammogram fund, administered through freeman development office, provides mammograms for women who can't afford them. In fy2015, helping friends mammogram fund helped 13 women by providing $3,932.50 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. Additionally, a breast cancer support group was started in fy2015 specifically to address the needs of women facing breast cancer. It meets monthly to give 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. Clinical trials for cancer patients freeman also offers cancer 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 in phases. They are reviewed by an independent board to protect the rights and welfare of participants; sponsored by various organizations, such as medical institutions and pharmaceutical companies; and monitored and supported by government agencies, such the u.s. Department of health and human services and the u.s. Food and drug administration. Clinical trials keep participating patients informed of what's happening during the course of the trial. These patients often become the best advocates in advancing medical research. While patients receive no pay for participation in clinical trials, they do get a chance to try emerging therapies, helping themselves and others in the future. In fy 2015, construction began on the new freeman radiation oncology center and continued into fy 2016. The program includes the acquisition of a top-of-the-line varian truebeam linear accelerator - the best on the market today. This technology helps a team of physicians treat a broad range of cancers with high energy x-rays that destroy cancer cells while minimizing damage to the surrounding tissue. The accelerator pinpoints hard-to-reach tumors through precise shaping of the x-ray beam and allows patients to experience shorter, more comfortable treatments with fewer complications. This new program will enable oncologists to communicate seamlessly with radiation oncologists to ensure the best outcomes for patients.”

“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.”

“Other changes in net assets: $(2,715,653) writeoff of uncollectible pledges”