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 executivesother 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 shall rec”

“Board member compensation: no directors receive compensation for their services as board members. Board members larry mcintire, joshua ball and john cox 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.”

“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): Heart Walk Freeman Health System employees continued their pledge to make the area a healthier place to live by joining the 2016 Four States Heart Walk. Money raised benefitted American Heart Association for research, public health education and providing science-based treatment guidelines to healthcare professionals. Joplin Christmas Parade For the third year in a row, Freeman Health System managed the Joplin Christmas Parade. Freeman donated countless man-hours to organize and orchestrate the parade, a commitment that included publicizing the event, coordinating parade entries, ensuring the parade flows smoothly, awarding prizes and more. City of Joplin Assistant Director of Public Works Operations Lynden Lawson said Freeman was chosen to manage the parade for two reasons its proven ability to successfully communicate with both the city and the citizens of Joplin and its ability to mobilize a group of volunteers who could handle a parade of that magnitude. 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.”

“Outpatient Services: Emergency Services 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 victims request. In partnership with Lafayette House, the program also offers emergency shelter and services. Many patients, who dont have a primary care physician, turn to the Freeman Emergency room for routine medical care. While Freeman tries to educate the community on 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. Wes & Jan Houser Womens Pavilion For those needing a mammogram, bone density screening or other diagnostic procedure, Wes & Jan Houser Womens Pavilion provides care in a comfortable, soothing, compassionate and respectful atmosphere. The Freeman team of surgeons, radiologists and registered mammography technologists use the latest technologies to ensure patients receive the best care, advice and treatment. Wes & Jan Houser Women's Pavilion is designated Breast Imaging Center of Excellence by the American College of Radiology (ACR). By awarding facilities the status of Breast Imaging Center of Excellence, the ACR recognizes breast imaging centers that have earned accreditation in mammography, stereotactic breast biopsy and breast ultrasound. Through the Freeman Helping Friends Mammogram Fund, Freeman”

“Inpatient Services: Renovations to the Medical/Oncology floor at Freeman Hospital West were completed in FY17. Improvements included new communication boards, TVs and bathroom flooring, as well as an increase in the number of private patient rooms available in the unit. Freeman Health System was honored with an "A" grade in the Leapfrog Group Fall 2016 Hospital Safety Score. Freeman was one of 17 hospitals in Missouri to receive the top grade. The score rates how well hospitals protect patients from errors, accidents, injuries and infections. In FY17, Freeman Health System continued to play a leading role in bringing a medical school to Joplin, Missouri. Demonstrating continued commitment to medical education and whole-hearted support for Kansas City University-Joplin, Freeman pledged a multi-million gift to the development of the satellite campus. Freeman will provide residence and training opportunities for KCU students. Freeman Joplin inpatient services totaled 19,173 cases, of which, 3,856 or 20%, were Medicaid cases. Additionally, 1,461 inpatient cases, or 8% of the total, fell into the self-pay (no insurance) category. Critical Care Patients rely on the Intensive Care Unit (ICU) for lifesaving treatment. In the ICU, physicians lead critical care services and oversee the care of critically ill patients. Freemans specialized team of critical care physicians, nurses and respiratory therapists provides exceptional care in the state-of-the-art, 33-bed ICU and 7-bed Cardiovascular Intensive Care Unit (CVICU). Additionally, Freeman Hospital West is the first hospital in the area to offer a Transitional Care Unit (TCU), a 12-bed unit for patients who are still too ill for the medical floor but have progressed to the point where they no longer need the level of care provided in the Intensive Care Unit (ICU). Freeman Joplin critical care services totaled 4,132 cases, of which, 400, or 10%, were Medicaid cases. Additionally, 0.60% of the critical care cases fell into the self-pay (no insurance) category. Stroke Care Freeman Health System is the first and only hospital in an 80-mile radius designated as a Level II Stroke Center by the Missouri Department of Health & Senior Services. This certification means the state has verified that Freeman is able to provide the highest level of expert care to patients who have experienced stroke or a TIA. When stroke occurs, every minute matters and quality of care is vital. Timely treatment can mean the difference between returning to work or becoming permanently disabled, living at home or living in a nursing home. The state of Missouri created the Time Critical Diagnosis system to coordinate 911, emergency response and hospitals to improve both the speed and quality of care to stroke patients. Freeman offers a free online stroke assessment to help people help learn about their risk of stroke. Because anyone can suffer a stroke, public education is vital. Freeman provides free stroke presentations to area businesses and organizations. Because of its efforts to provide rapid, expert care, Freeman was recognized in FY17 by the American Heart Association and American Stroke Association for "Silver Plus" achievement in the "Get with the Guidelines Stroke" quality program. Neurosciences Freeman NeuroSpine provides surgical and nonsurgical treatments for conditions ranging from back pain, work-related injuries and carpal tunnel syndrome to stroke and complex spinal diseases. Freemans expert, multidisciplinary team includes neurosurgeons, neurologists, rehabilitation specialists, surgical assistants, physical therapists, massage therapists and athletic trainers. Anthem Blue Cross Blue Shield of Missouri named Freeman Health System as a Blue Distinction Center for Spine Surgery. Hospitals designated as Blue Distinction Centers for Spine Surgery demonstrate expertise in cervical and lumbar fusion, cervical laminectomy and lumbar laminectomy/discectomy procedures, with fewer patient complications and ho”

“Freeman Heart Care: Services include preventive care, emergency interventions, diagnostics, open-heart surgeries, structural heart clinic (FY18), rehabilitation, cardiology clinics and education. The facility, a three-story wing adjacent to Freeman Hospital West, includes cardiologist and cardiothoracic surgeon offices, three state-of-the-art operating suites and four cardiovascular catheterization labs. It also includes a cardiopulmonary rehabilitation unit that improves a patients ability to perform the normal activities of daily living. By teaching techniques for dealing with chest pain and shortness of breath, eating habits, cholesterol levels and weight loss, Freemans rehabilitation program provides a comfortable and familiar environment for recovery. Diagnosis and testing 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. Registered vascular technology specialists staff Freemans noninvasive, diagnostic lab for vascular testing using state-of-the-art ultrasound equipment. Tests include cerebral vascular testing, peripheral arterial testing, peripheral venous testing and abdominal Doppler exams. Hybrid CVOR new in FY2017 In late 2016, Freeman Health System completed upgrades to its state-of-the-art hybrid cardiovascular operating room (CVOR) at Freeman Heart & Vascular Institute. This upgrade will give Freeman maximum flexibility to use the treatments most appropriate for each patient, including structural heart procedures. This new set-up will enable physicians from different disciplines to merge their expertise in one room for the benefit of the patient. For instance, two teams the cardiothoracic surgeons team and the cardiologists team can work as one to achieve optimal results while improving patient care and efficiency. Access to minimally invasive procedures and complex procedures, along with accuracy, are key in successful cardiac outcomes. In the hybrid CVOR, Freeman has installed the Infinix Elite from Toshiba America Medical Systems, Inc. As a customizable cardiovascular x-ray imaging system, this best-in-class technology provides Freeman with the flexibility and performance to meet any patient need. Information is power when it comes to diagnosis, and the Infinix Elites combination of comfort, safety and efficiency enables Freeman to provide the right care solutions to patients. The resolution is higher and more precise, which will enables surgeons to perform procedures usually found at cardiac centers in university hospital settings, such as structural heart repair. The Infinix Elites C-arm design offers conformity to any patient, allowing for optimal angulations, streamlined positioning and customizable configuration. In addition, ergonomic enhancements improve clinician speed and precision while reducing the potential for strain and injury. The system also includes a full suite of dose management optimization tools to facilitate safer exams for both the patient and the physician. Having the ability to perform simultaneous imaging studies and interventions in a CVOR eliminates the need to move patients during a procedure and potentially reduces the risk of infection. Patients also benefit through shorter procedure times. By combining first-rate imaging capabilities within an advanced operating suite, Freeman cardiothoracic surgeons have flexibility in real time to do whats best for the patient. This innovative environment also provides the potential to revolutionize the way Freeman treats patients by integrating traditional cardiac surgery with endovascular surgery techniques and technology, further bridging the best of”

“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.”