4A (Expenses $ 24218311 including grants of $ 43840) (Revenue $ 31891827)
INPATIENT AND OUTPATIENT SERVICES PROVIDED AT THE MONETT FACILITY MAKE UP THE ORGANIZATION'S LARGEST PROGRAM SERVICE ACTIVITY. USERS ARE ABLE TO SAVE TIME AND MONEY BY SEEING SPECIALISTS IN THEIR COMMUNITY. SERVICES INCLUDE PULMONOLOGY, ENT (EAR, NOSE AND THROAT), ORTHOPEDICS, CARDIOLOGY, OBSTETRICS, RADIOLOGY (CT, MRI, NUCLEAR MEDICINE, ULTRASOUND AND MAMMOGRAPHY), LABORATORY, 24-HOUR EMERGENCY CENTER, GENERAL SURGICAL SERVICES, SAME-DAY SURGERY, DIABETES CENTER, SLEEP CENTER, CARDIOPULMONARY REHAB, MEDICAL-SURGICAL UNIT, PHARMACY AND COMMUNITY WELLNESS.

4B (Expenses $ 10925286 including grants of $ 0) (Revenue $ 14386938)
SERVICES PROVIDED AT THE HOSPITAL'S NETWORK OF RURAL HEALTH CLINICS MAKE UP THE SECOND LARGEST PROGRAM SERVICE ACTIVITY. DURING THE YEAR THESE CLINICS SAW 61,711 PATIENT VISITS.

4C (Expenses $ 1653010 including grants of $ 0) (Revenue $ 2176762)
REHABILITATION SERVICES PROVIDED THROUGH COX-MONETT CREATE THE THIRD LARGEST PROGRAM SERVICE ACTIVITY. THE TEAM MEMBERS AT THIS FACILITY ARE THE EXPERTS IN HUMAN MOTION. SERVICES INCLUDE PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH PATHOLOGY, ATHLETIC TRAINING AND SPORTS MEDICINE. WHETHER ONE IS SUFFERING FROM BACK PAIN OR RECOVERING FROM A TOTAL JOINT REPLACEMENT, THERE ARE SERVICES TO GET THE PATIENT BACK ON THEIR FEET QUICKLY.

4D (Expenses $ 12814047 including grants of $ 0) (Revenue $ 16874148)
EXEMPT PURPOSE ACHIEVEMENTS: COX-MONETT HOSPITAL EMBRACES A MISSION STATEMENT AND BY-LAWS THAT REFLECT A COMMITMENT TO CHARITABLE PURPOSE AND COMMUNITY BENEFIT. COX-MONETT PROVIDES MANY SERVICES TO THE COMMUNITY FREE OF CHARGE OR WITH LITTLE FINANCIAL GAIN. OUR GOAL IS TO KEEP OUR COMMUNITY HEALTHY. THE FOLLOWING IS A LIST OF SERVICES PROVIDED TO THE MONETT COMMUNITY DURING THE FISCAL YEAR ENDING SEPTEMBER 30, 2022. ADDITIONALLY, THE SUBSIDIES NOTED BELOW ARE CALCULATED USING INTERNAL COST ACCOUNTING METHODS RATHER THAN THE IRS WORKSHEETS FOR SCHEDULE H. SEE SCHEDULE H FOR THE COMPUTATION OF THESE SUBSIDIES USING THE SCHEDULE H WORKSHEETS. *PARTICIPATED IN THE MEDICAID PROGRAM WITH UNREIMBURSED COST OF CARING FOR PATIENTS AND PROVIDED CHARITY CARE AND OTHER UNCOMPENSATED CARE SERVICES. SEE SCHEDULE H FOR AMOUNTS RELATED TO THESE SERVICES. *RENDERED HEALTH CARE SERVICES AND EDUCATIONAL SERVICES SPECIFICALLY DESIGNED TO IMPROVE COMMUNITY HEALTH ARE AS FOLLOWS: -COMMUNITY WELLNESS SERVICES: COX MONETT TEAMED UP WITH THE MISSOURI EXTENSION OFFICE TO OFFER A NEW PRE-DIABETES PROGRAM. ONE IN THREE ADULTS ARE PRE-DIABETIC, AND 90 PERCENT ARE UNAWARE. THE PROGRAM CAN REDUCE THEIR RISK OF GETTING TYPE 2 DIABETES BY 58 PERCENT. THE GOAL OF THE PROGRAM IS TO HELP PARTICIPANTS LOSE 5-7 PERCENT OF THEIR BODYWEIGHT AND WORK UP TO 150 MINUTES OF PHYSICAL ACTIVITY PER WEEK BY THE END OF THE 12-MONTH COURSE. THE PROGRAM ALSO FUNCTIONS AS A SUPPORT GROUP, WHERE MEMBERS CAN WORK TOGETHER TO SHARE INFORMATION. -TUITION REIMBURSEMENT FOR STAFF WANTING TO CONTINUE THEIR EDUCATION. *ENCOURAGE AND PROVIDE OPPORTUNITIES FOR VOLUNTEER EFFORTS TO SERVE IN THE COMMUNITY. MANY EMPLOYEES SERVE ON LOCAL NOT-FOR-PROFIT BOARDS AND ARE INVOLVED IN VARIOUS COMMUNITY ORGANIZATIONS AND ARE ASKED OFTEN TO SPEAK ON HEALTH-RELATED TOPICS. *OPERATE 24-HOUR EMERGENCY CENTER. ER VISITS TOTALED 15,557. *PROVIDE MANY COMMUNITY HEALTH AND EDUCATION PROGRAMS AND PROJECTS SPECIFICALLY DESIGNED TO IMPROVE THE HEALTH STATUS OF OUR COMMUNITY AT NO CHARGE OR AT A REDUCED RATE, SUCH AS - FREE MAMMOGRAPHY SCREENINGS FOR THE UNDERINSURED OR UNINSURED WOMEN IN OUR COMMUNITY - COMMUNITY HEALTH FAIR, INCLUDING CHOLESTEROL, BLOOD SUGAR AND BLOOD PRESSURE SCREENINGS (ONLY HELD BLOOD DRAW DUE TO COVID-19) *IN FISCAL YEAR 2022, BIRTHS TOTALED 261. COMBINED RADIOLOGY TESTS TOTALED 28,056, INPATIENT AND OUTPATIENT SURGERIES TOTALED 1,597. *THE HOSPITAL OWNS SIX RURAL HEALTH CLINICS IN MONETT AND THE SURROUNDING COMMUNITIES AND PHYSICIAN OFFICE VISITS TOTALED 61,711.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - COX-MONETT HOSPITAL, INC. COMMUNITY INPUT: IN 2021, ORGANIZATIONS ACROSS THE OZARKS RECONVENED UNDER THE UMBRELLA OF THE OZARKS HEALTH COMMISSION (OHC) TO ASSESS THE HEALTH NEEDS OF OUR REGION. THE OHC REGION INCLUDES 30 COUNTIES LOCATED WITHIN THE STATES OF MISSOURI, KANSAS AND OKLAHOMA. IT IS CENTERED IN SOUTHWEST MISSOURI, AND REPRESENTS THE COMBINED SERVICE AREAS OF OHC REGION HEALTHCARE PARTNERS COXHEALTH, FREEMAN HEALTH SYSTEM, AND MERCY HOSPITALS. SEVEN MULTI-COUNTY COMMUNITIES WERE DEFINED BASED ON HOSPITAL SERVICE AREAS AND NAMED FOR A MAJOR CITY WITHIN THE COMMUNITY: BOLIVAR, BRANSON, JOPLIN, LEBANON, MONETT, MOUNTAIN VIEW, AND SPRINGFIELD. THE 2022 REGIONAL HEALTH ASSESSMENT (RHA) BUILDS UPON THE SUCCESS OF THE 2016 AND 2019 RHAS TO BETTER UNDERSTAND THE HEALTH STATUS, BEHAVIORS AND NEEDS OF THE POPULATIONS AND COMMUNITIES SERVED. THIS ASSESSMENT TAKES A COMPREHENSIVE, DATA-DRIVEN APPROACH TO LOOK AT THE HEALTH CHARACTERISTICS AND BEHAVIORS OF RESIDENTS IN THE OHC REGION BY PRESENTING MORE THAN 200 PUBLIC HEALTH AND EMERGENCY ROOM UTILIZATION DATA INDICATORS INCLUDING DEMOGRAPHICS, HEALTH MORBIDITY AND MORTALITY, HEALTH STATUS AND BEHAVIORS, AND SOCIAL DETERMINANTS OF HEALTH. THE OHC STEERING COMMITTEE ELECTED TO UTILIZE CONSULTATIVE SERVICES TO ACQUIRE RELIABLE AND REPRESENTATIVE INPUT FROM THE 30-COUNTY OHC REGION. TO THAT END, A CONSULTING FIRM WAS HIRED TO GATHER BOTH QUANTITATIVE AND QUALITATIVE DATA THROUGH 3 AVENUES: COMMUNITY SURVEYS, FOCUS GROUPS AND INTERVIEWS. THE PROCESS RESULTED IN THE IDENTIFICATION OF THE FOLLOWING HEALTH PRIORITIES: JOPLIN COMMUNITY (ENCOMPASSES COX BARTON COUNTY HOSPITAL SERVICE AREA): MENTAL HEALTH, DIABETES, LUNG DISEASE, HEART DISEASE; SPRINGFIELD, BRANSON AND MONETT COMMUNITIES: MENTAL HEALTH, SUBSTANCE USE AND RECOVERY, DIABETES. ALL COMMUNITIES IDENTIFIED COVID-19 AS A SPECIAL HEALTH ISSUE. ADDITIONALLY, INDICATORS THAT COULD IMPACT MULTIPLE ASSESSED HEALTH ISSUES, REFERRED TO HERE AS SOCIAL DETERMINANTS OF HEALTH, WERE NOTED IN EVERY COMMUNITY. BROADLY, THESE SOCIAL DETERMINANTS OF HEALTH FALL INTO SIX CATEGORIES: ECONOMIC STABILITY, EDUCATION ACCESS AND QUALITY, HEALTHCARE ACCESS AND QUALITY, NEIGHBORHOOD AND BUILT ENVIRONMENT, SOCIAL AND COMMUNITY CONTEXT, AND HEALTH BEHAVIORS. THE OHC HIGHLIGHTED KEY FACTORS AND POPULATIONS OF INTEREST WITH DISPARATE NEEDS, CHALLENGES AND GREATER VULNERABILITY THAN COMPARABLE AREAS WITH THE SAME POPULATION IN OTHER COUNTIES. HISTORICALLY DISENFRANCHISED POPULATIONS, SUCH AS PEOPLE IN POVERTY, MINORITIES AND THE ELDERLY, OFTEN EXPERIENCE HIGHER RATES OF CHRONIC ILLNESS AND WORSE HEALTH OUTCOMES, DUE TO A MULTITUDE OF STRUCTURAL AND ENVIRONMENTAL FACTORS. THIS CAN LEAD TO HEALTH DISPARITIES BETWEEN VARIOUS SOCIOECONOMIC CLASSES AND/OR DEMOGRAPHIC GROUPS. THE PRIORITIZATION OF ASSESSED HEALTH ISSUES PROCESS INCLUDED THE FOLLOWING COMMUNITY STAKEHOLDERS. SPRINGFIELD COMMUNITY: -COXHEALTH -MERCY -SPRINGFIELD-GREENE COUNTY HEALTH DEPARTMENT -COMMUNITY PARTNERSHIP OF THE OZARKS -COMMUNITY FOUNDATION OF THE OZARKS -OZARKS REGIONAL YMCA -GLO CENTER -MISSOURI STATE UNIVERSITY -SPRINGFIELD PUBLIC SCHOOLS -BURRELL BEHAVIORAL HEALTH -JORDAN VALLEY COMMUNITY HEALTH CENTER -OZARKS FOOD HARVEST -THE CONNECTING GROUNDS -BETTER LIFE IN RECOVERY -CATHOLIC CHARITIES OF SOUTHERN MISSOURI -HAND IN HAND MULTICULTURAL CENTER -PROMO MONETT COMMUNITY: -COXHEALTH -COX MONETT HOSPITAL -CLARK COMMUNITY MENTAL HEALTH CENTER -MOSWITCH -AURORA CHAMBER OF COMMERCE -LAWRENCE COUNTY HEALTH DEPARTMENT -MONETT SCHOOL DISTRICT -BARRY COUNTY HEALTH DEPARTMENT -DRURY UNIVERSITY -OACAC BRANSON COMMUNITY: -COXHEALTH -COX MEDICAL CENTER BRANSON -SKAGGS FOUNDATION -TANEY COUNTY AMBULANCE DISTRICT -TANEY COUNTY HEALTH DEPARTMENT -GIFT OF HOPE -FAITH COMMUNITY HEALTH -TABLE ROCK LAKE CHAMBER OF COMMERCE -STONE COUNTY HEALTH DEPARTMENT -CHRISTIAN ACTION MINISTRIES JOPLIN COMMUNITY (ENCOMPASSES COX BARTON COUNTY HOSPITAL) -COXHEALTH -COX BARTON COUNTY HOSPITAL -FREEMAN HEALTH -MERCY -UNITED WAY -MISSOURI HEALTH CARE FOR ALL -CITIZEN POTAWATOMI NATION -ONE JOPLIN -ALLIANCE OF SOUTHWEST MISSOURI -UNIVERSITY OF MISSOURI -ACCESS FAMILY CARE MEDICAL AND DENTAL CLINICS -CITY OF JOPLIN HEALTH DEPARTMENT

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - COX-MONETT HOSPITAL, INC. CHNA CONDUCTED WITH OTHER HOSPITALS: THE CHNA WAS CONDUCTED FOR THE ENTIRE REPORTING GROUP #1, AS REPORTED ON SCHEDULE H, PART V, SECTION A, INCLUDING LESTER E. COX MEDICAL CENTERS - SOUTH, LESTER E. COX MEDICAL CENTERS - NORTH, AND MEYER ORTHOPEDIC HOSPITAL. OTHER HOSPITAL FACILITY PARTNERS INCLUDED FREEMAN HEALTH SYSTEM, AND MERCY HOSPITALS. THE CHNA WAS ALSO CONDUCTED WITH RELATED ORGANIZATIONS COX MEDICAL CENTER BRANSON, COX BARTON COUNTY HOSPITAL AND COX MONETT HOSPITAL.

Schedule H, Part V, Section B, Line 6b Facility , 1
Facility , 1 - COX-MONETT HOSPITAL, INC. CHNA CONDUCTED WITH OTHER ORGANIZATIONS: THE CHNA WAS ALSO CONDUCTED WITH THE FOLLOWING OTHER NON-HOSPITAL ORGANIZATIONS: -BURRELL BEHAVIORAL HEALTH -CHRISTIAN COUNTY HEALTH DEPARTMENT -CITY OF JOPLIN HEALTH DEPARTMENT -JASPER COUNTY HEALTH DEPARTMENT -LAWRENCE COUNTY HEALTH DEPARTMENT -SPRINGFIELD-GREENE COUNTY HEALTH DEPARTMENT -TANEY COUNTY HEALTH DEPARTMENT -VERNON COUNTY HEALTH DEPARTMENT

Schedule H, Part V, Section B, Line 7 Facility , 1
Facility , 1 - COX-MONETT HOSPITAL, INC. OTHER METHODS TO MAKE THE CHNA REPORT AVAILABLE TO THE PUBLIC: PRINTED COPIES ARE AVAILABLE BY REQUEST THROUGH HOSPITAL AND PUBLIC HEALTH PARTNERS. ELECTRONIC AND PRINTABLE VERSIONS ARE AVAILABLE AT COXHEALTH.COM AND OZARKSHEALTHCOMMISSION.ORG. NEWS RELEASE WAS HELD TO ENCOURAGE MEDIA COVERAGE WITH LINKS TO THE REPORT AND KEY MESSAGES FOR THE PUBLIC.

Schedule H, Part V, Section B, Line 7 Facility , 2
Facility , 2 - COX-MONETT HOSPITAL, INC. CHNA OTHER WEBSITE: HTTP://WWW.OZARKSHEALTHCOMMISSION.ORG HTTP://WWW.MERCY.NET HTTP://WWW.COXHEALTH.COM HTTP://WWW.FREEMANHEALTH.COM

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - COX-MONETT HOSPITAL, INC. ADDRESSING IDENTIFIED NEEDS: 1. DECREASE HOSPITALIZATIONS RELATED TO COVID-19 -SUPPORT COMMUNITY INITIATIVES, INCLUDING INCREASE PERCENT OF FULLY VACCINATED INDIVIDUALS AS RECOMMENDED BY THE CDC 2. DECREASE TOBACCO AND VAPE USE RATES -INCREASE ACCESS TO CLINICAL EDUCATION AND TRAINING RELATED TO TOBACCO AND VAPE CESSATION 3. INCREASE AWARENESS OF SUBSTANCE USE PREVENTION AND TREATMENT RESOURCES -PROMOTE EDUCATION AND TRAINING RELATED TO SUBSTANCE USE (EXAMPLES: HARM REDUCTION, NALOXONE, MENTAL HEALTH FIRST AID) 4. INCREASE AWARENESS OF MENTAL HEALTH SERVICES -INCREASE ACCESS THROUGH ALTERNATIVE CARE MODELS -IMPLEMENT TRAUMA INFORMED CARE TRAINING AND EDUCATION 5. IMPROVE CHRONIC DISEASE SELF-MANAGEMENT -INCREASE REFERRALS TO SELF-MANAGEMENT EDUCATION -INCREASE ENROLLMENT IN CARE MANAGEMENT PROGRAMS -PROMOTE ACCESS TO SCHOOL-AGE PREVENTION EDUCATION AND CARE PROGRAMS 6. ENGAGE IN MULTI-SECTOR CARE COORDINATION TO REDUCE HEALTH DISPARITIES AND IMPROVE HEALTH OUTCOMES -IMPLEMENT COMMUNITY INFORMATION EXCHANGE PLATFORM

Schedule H, Part V, Section B, Line 13 Facility , 1
Facility , 1 - COX-MONETT HOSPITAL, INC. OTHER CRITERIA USED TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY: MEDICAL HARDSHIP MAY ALSO BE USED TO DETERMINE FINANCIAL ELIGIBILITY. COXHEALTH SHALL MAKE A DECISION ABOUT A PATIENT/GUARANTOR'S MEDICAL HARDSHIP BY REVIEWING THE FINANCIAL ASSISTANCE APPLICATION, INCLUDING ACCOMPANYING FINANCIAL DOCUMENTATION, IN ADDITION TO OTHER RELEVANT DOCUMENTATION THAT SUPPORTS THE MEDICAL HARDSHIP OF THE PATIENT.

Schedule H, Part V, Section B, Line 13 Facility , 2
Facility , 2 - COX-MONETT HOSPITAL, INC. ELIGIBILITY FOR FREE CARE: IN GENERAL, THE ORGANIZATION'S CHARITY CARE POLICY DOES NOT PROVIDE FOR DISCOUNTS OF 100%. THEREFORE, IT IS EXPECTED THAT THE PATIENT OR GUARANTOR WILL HOLD A RESPONSIBILITY FOR PAYMENT OF AT LEAST A PORTION OF THE SERVICES, REGARDLESS OF THE LEVEL OF ELIGIBILITY. IT IS OUR INTENTION TO WORK WITH INDIVIDUALS ON THEIR OUT-OF-POCKET RESPONSIBILITY TO ESTABLISH FEASIBLE MONTHLY PAYMENTS WHEN NECESSARY. IN THE EVENT THAT A PATIENT OR GUARANTOR IS DETERMINED TO HAVE NO MEANS OF PAYING THE AMOUNT INDICATED AS THEIR RESPONSIBILITY DUE TO EXTENUATING CIRCUMSTANCES, CONSIDERATION MAY BE GIVEN TO WAIVING DEDUCTIBLES AND/OR IINCREASING THE DISCOUNT AMOUNT UP TO A 100% DISCOUNT OF THE PATIENT PORTION. THESE EXTENUATING CASES ARE SUBJECT TO THE DISCRETION AND APPROVAL OF THE PFS DIRECTOR AND/OR THE CHIEF FINANCIAL OFFICER WITHIN THE APPROVAL LIMITS DEFINED AT THE END OF THE POLICY.

Schedule H, Part V, Section B, Line 16 Facility , 1
Facility , 1 - COX-MONETT HOSPITAL, INC. MEASURES TO PUBLICIZE THE POLICY: FINANCIAL ASSISTANCE AVAILABILITY IS PROACTIVELY COMMUNICATED TO UNINSURED PATIENTS BY CUSTOMER SERVICE STAFF AND BY OUR EARLY OUT AND BAD DEBT VENDORS; ANYONE RECOGNIZED AS UNINSURED IS TOLD ABOUT THE FA AVAILABILITY AND ENCOURAGED TO PARTICIPATE.

Schedule H, Part I, Line 7 PERCENT OF TOTAL EXPENSE
TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER FORM 990.

Schedule H, Part I, Line 7g SUBSIDIZED SERVICES
THE ORGANIZATION HAS INCLUDED COSTS ASSOCIATED WITH RURAL HEALTH CENTER (RHC) IN THE CALCULATION OF SUBSIDIZED SERVICES ON LINE 7G, WITH A NET SUBSIDY FROM RHCS OF $6,103,593. COX-MONETT HOSPITAL PROVIDES PRIMARY CARE SERVICES TO THE CASSVILLE COMMUNITY AT THE CENTER. THESE SERVICES ARE PROVIDED IN A RURAL AREA WHERE THERE WOULD BE A SHORTAGE OF QUALITY MEDICAL CARE WITHOUT THE SERVICES. THE ORGANIZATION CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED.

Schedule H, Part I, Line 7 COSTING METHODOLOGY
THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEET 1. COST COMPUTED ON IRS WORKSHEETS 3, 5 AND 6 WERE COMPUTED FROM THE MEDICARE COST REPORT, INCLUDING DIRECT COSTS PLUS OVERHEAD ALLOCATIONS COMPUTED IN THE COST REPORT STEP-DOWN PROCESS.

Schedule H, Part I, Line 3c ELIGIBILITY FOR FREE CARE:
IN GENERAL, THE ORGANIZATION'S CHARITY CARE POLICY DOES NOT PROVIDE FOR DISCOUNTS OF 100%. THEREFORE, IT IS EXPECTED THAT THE PATIENT OR GUARANTOR WILL HOLD A RESPONSIBILITY FOR PAYMENT OF AT LEAST A PORTION OF THE SERVICES, REGARDLESS OF THE LEVEL OF ELIGIBILITY. IT IS OUR INTENTION TO WORK WITH INDIVIDUALS ON THEIR OUT-OF-POCKET RESPONSIBILITY TO ESTABLISH FEASIBLE MONTHLY PAYMENTS WHEN NECESSARY. IN THE EVENT THAT A PATIENT OR GUARANTOR IS DETERMINED TO HAVE NO MEANS OF PAYING THE AMOUNT INDICATED AS THEIR RESPONSIBILITY DUE TO EXTENUATING CIRCUMSTANCES, CONSIDERATION MAY BE GIVEN TO WAIVING DEDUCTIBLES AND/OR INCREASING THE DISCOUNT AMOUNT UP TO A 100% DISCOUNT OF THE PATIENT PORTION. THESE EXTENUATING CASES ARE SUBJECT TO THE DISCRETION AND APPROVAL OF THE PFS DIRECTOR AND/OR THE CHIEF FINANCIAL OFFICER WITHIN THE APPROVAL LIMITS DEFINED AT THE END OF THE POLICY.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2022. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
THE BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS ESTIMATED USING THE PERCENTAGE OF THE POPULATION THAT IS BELOW THE POVERTY LINE IN THE HOSPITAL'S SERVICE AREA.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
"THE AUDIT FOOTNOTE ADDRESSING BAD DEBT EXPENSE AND PATIENT ACCOUNTS RECEIVABLE IS FOUND ON PAGE 12 OF THE AUDITED FINANCIAL STATEMENTS UNDER NOTE 1, SUBTITLED ""PATIENT ACCOUNTS RECEIVABLE."""

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
THE ORGANIZATION WILL NOT PURSUE LEGAL ACTION FOR NONPAYMENT OF ANY AMOUNTS DISCOUNTED AS A RESULT OF AN APPROVED OR PARTIALLY APPROVED REQUEST FOR FINANCIAL ASSISTANCE. BALANCES REMAINING AFTER SUCH DISCOUNTS ARE APPLIED WILL, HOWEVER, BE SUBJECT TO COLLECTION ACTIVITY, INCLUDING LEGAL ACTION. IN ADDITION, THE ORGANIZATION WILL NOT CHARGE INTEREST ON THE BALANCE REMAINING AFTER APPLYING THE FINANCIAL ASSISTANCE DISCOUNT. HOWEVER, THE ORGANIZATION MAY, IN ITS SOLE DISCRETION, CHARGE INTEREST ON THE BALANCE OWED IF 1) THE GUARANTOR DEFAULTS ON HIS OR HER PAYMENT AGREEMENT OR 2) THE BALANCE IS REFERRED TO THE COLLECTION AGENCY FOR COLLECTION.

Schedule H, Part V, Section B, Line 16a FAP website
- COX-MONETT HOSPITAL, INC: Line 16a URL: HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/;

Schedule H, Part V, Section B, Line 16b FAP Application website
- COX-MONETT HOSPITAL, INC: Line 16b URL: HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- COX-MONETT HOSPITAL, INC: Line 16c URL: HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/;

Schedule H, Part VI, Line 2 Needs assessment
LESTER E. COX MEDICAL CENTERS HAS PERFORMED AN ENVIROMENTAL SCAN ANNUALLY SINCE 2006. COMMUNITY HEALTH NEEDS ASSESSMENTS AS REQUIRED BY THE IRS WERE COMPLETED IN 2022. Commission stakeholders began the RHA process with analysis of publicly available health data (secondary data) and participating health systems' emergency room utilization data (primary data) to identify health issues of greatest concern across the region. The result was a ranked list of eight Ozarks Health Commission Region health issues. A full description of the health issues and indicators used can be found in the OHC Regional Health Assessment. To represent diverse views from across the region and population, qualitative data was garnered. Across the OHC Region, these viewpoints were solicited via 75 individual interviews, 10 focus groups and 2,638 surveys. Methodologies used for the initial scoring/ranking of the health issues and the full report of the qualitative work can be found in the OHC Regional Report. This prioritization information can be used by organizations to develop community health improvement plans, guide decision-making, and foster collaboration across initiatives. During September and October 2021, four individual interviews, in addition to ten virtual focus group discussions in both Barry and Lawrence Counties were completed. Those interviewed represented health and social service organizations, education and community collaboratives. Of the 2,628 survey respondents from the Region, 5.28% indicated they lived in the Monett Community. Respondents were asked to rank perceived community needs. Those interviewed represented health and social service organizations, education and community collaboratives. Stakeholders, education and community individual interviews and focus groups agreed that a top challenge was access to mental health services and healthcare. This information was considered during the process of establishing health priorities for the Monett Community. Methodologies used for the initial scoring/ranking of the health issues and the full report of the qualitative work can be found in the OHC Regional Report. This prioritization information can be used by organizations to develop community health improvement plans, guide decision-making, and foster collaboration across initiatives.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
THE COXHEALTH SYSTEM USES A VARIETY OF METHODS TO INFORM AND EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE PROGRAMS OR UNDER THE ORGANIZATION'S POLICY: - AVAILABILITY OF FINANCIAL ASSISTANCE THROUGH THE ORGANIZATION IS COMMUNICATED TO PATIENTS THROUGH THE USE OF SIGNAGE AND BROCHURES/INFORMATION PACKETS AVAILABLE AT CHECK-IN LOCATIONS. - THE COXHEALTH SYSTEM ALSO PROACTIVELY COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE ON PATIENT BILLS AND STATEMENTS; AND ITS EARLY-OUT VENDOR RESPONSIBLE FOR PATIENT BALANCE COLLECTIONS IS EXPECTED TO PROACTIVELY INFORM SELF PAY PATIENTS OF THE AVAILABILITY WHEN SPEAKING TO THEM ON THE PHONE. - FOR ASSISTANCE UNDER FEDERAL AND STATE PROGRAMS THE COXHEALTH SYSTEM UTILIZES AN OUTSOURCE ELIGIBILITY VENDOR WHO MEETS WITH SELF PAY INPATIENTS AT THE BEDSIDE TO COMPLETE AN ELIGIBILITY SCREENING, INFORM THE PATIENTS OF POTENTIAL AVAILABILITY, AND WILL WORK WITH THE PATIENT TO HELP THEM THROUGH THE PROCESS. OUTPATIENTS ARE REFERRED TO THE VENDOR AFTER CARE AND THOSE ARE WORKED IN A SIMILAR FASHION WITH THE EXPECTATION THAT THE FIRST CONTACT IS THROUGH MAIL OR PHONE RATHER THAN AT THE BEDSIDE.

Schedule H, Part VI, Line 4 Community information
THE PRIMARY SERVICE AREA (PSA) COUNTIES SERVED BY THE COXHEALTH SYSTEM INCLUDE: BARRY, BARTON, CHRISTIAN, GREENE, LAWRENCE, STONE, TANEY, AND WEBSTER (ALL PSA COUNTIES ARE LOCATED IN MISSOURI). THE SECONDARY SERVICE AREA (SSA) COUNTIES SERVED BY THE COXHEALTH SYSTEM INCLUDE: BAXTER - AR, BOONE - AR, CARROLL - AR, CEDAR, DADE, DALLAS, DOUGLAS, HICKORY, HOWELL, LACLEDE, MARION - AR, OREGON, OZARK, POLK, PULASKI, TEXAS, AND WRIGHT (ALL SSA COUNTIES ARE LOCATED IN MISSOURI EXCEPT BAXTER, BOONE, CARROLL, AND MARION COUNTIES IN ARKANSAS). THE TOTAL POPULATION IN THE SERVICE AREA IS APPROACHING THE ONE MILLION AND APPROXIMATELY 58% OF THE TOTAL 25-COUNTY POPULATION IS IN THE SEVEN COUNTY PRIMARY SERVICE AREA. SLIGHTLY MORE THAN 50% OF THE MARKET IS FEMALE AND ALMOST NEARLY 18% OF THE SERVICE AREA IS FEMALE BETWEEN THE AGES OF 15 AND 44. THE SEGMENT OF THE POPULATION OVER THE AGE OF 65 IS ALMOST 20% OF THE TOTAL POPULATION AND IS PROJECTED TO INCREASE 12% BETWEEN 2020 AND 2025. THE AVERAGE HOUSEHOLD INCOME IS $64,665 IN THE TOTAL 25-COUNTY SERVICE AREA COMPARED WITH $79,915 FOR THE STATE OF MISSOURI. DIVERSITY IS VERY LOW IN THE 24-COUNTY SERVICE AREA AS 91% OF THE POPULATION IS WHITE ALONE.

Schedule H, Part VI, Line 5 Promotion of community health
COX MONETT HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. WE ACTIVELY LIVE THIS MISSION BY PROVIDING QUALITY HEALTH CARE. OUR GOAL IS TO PROVIDE QUALITY, AFFORDABLE CARE TO THE COMMUNITIES WE SERVE. COMMUNITY INVOLVEMENT INCLUDES SUPPORTING ORGANIZATIONS THAT ALIGN WITH OUR MISSION, VISION AND VALUES. WE WERE ABLE TO ACHIEVE THIS IN THE FOLLOWING WAYS, INCLUDING COLLABORATING WITH THE MISSOURI EXTENSION OFFICE TO ROLLOUT A PRE-DIABETES PROGRAM. THIS PROGRAM TEACHES PARTICIPANTS HOW TO LIVE A HEALTHY LIFESTYLE. THE LIVE WELL SCREENING OFFERED WITH COVID-19 PRECAUTIONS CONTINUED SO WE COULD OFFER REDUCED COST LAB SCREENINGS SO OUR COMMUNITY MEMBERS COULD CONTINUE TO MONITOR THEIR HEALTH EVEN DURING A PANDEMIC. THE EVENT ALLOWED FOR SOCIAL DISTANCING. COX MONETT PARTNERS WITH THE BREAST CANCER FOUNDATION OF THE OZARKS TO OFFER FREE SCREENING MAMMOGRAMS FOR THE UNINSURED OR UNDERINSURED. COXHEALTH.COM PROVIDES ONLINE HEALTH EDUCATION AND INCORPORATES PODCASTS, HEALTH SURVEYS AND QUIZZES INTO OUR EDUCATION COMPONENTS. COX MONETT'S ADMINISTRATIVE LEADERS PARTICIPATE IN MANY CIVIC ORGANIZATIONS WHOSE PURPOSE IS TO IMPROVE THE LIVES OF COMMUNITY MEMBERS. EXAMPLES INCLUDE THE MONETT CHAMBER OF COMMERCE. - DINING FOR DIABETES IS A YEARLY EVENT THAT RAISES MONEY FOR THE COX MONETT DIABETES CENTER. THE EVENT RAISES FUNDS TO HELP PATIENTS WITH SUPPLIES NEEDED TO MANAGE THE DISEASE. LAST YEAR, THE EVENT RAISED OVER $100,000.

Schedule H, Part VI, Line 6 Affiliated health care system
AFFILIATED HEALTH CARE SYSTEM: COXHEALTH IS THE PARENT OF LESTER E. COX MEDICAL CENTERS AND ITS WHOLLY OWNED AND/OR CONTROLLED SUBSIDIARIES PLUS CERTAIN AFFILIATED NOT-FOR-PROFIT ENTITIES AND IS COLLECTIVELY REFERRED TO AS COXHEALTH. COXHEALTH (THE HEALTH SYSTEM) OPERATES AS AN INTEGRATED DELIVERY SYSTEM INCLUDING FOUR HOSPITALS, A SURGICAL CENTER, AN INPATIENT REHABILITATION FACILITY, HOME CARE COMPANIES, PHYSICIAN SERVICES, MENTAL HEALTH SERVICES, INSURANCE COMPANIES AND A FOUNDATION. COXHEALTH'S HOME CARE SERVICES ARE PROVIDED BY COXHEALTH AT HOME AND INCLUDE HOME HEALTH SERVICES, INFUSION THERAPY AND DURABLE MEDICAL EQUIPMENT. COXHEALTH AT HOME SUPPORTED THE COMMUNITY THROUGH MONTHLY NUTRITION AND FALL PREVENTION SEMINARS AT 20 AREA SENIOR CENTERS THROUGHOUT SOUTHWEST MISSOURI. THEY ALSO PROVIDED FREE BONE DENSITY SCREENINGS AT 34 COMMUNITY EVENTS, AND VITAL SIGN SCREENINGS AT MANY MORE. THROUGH AN ANNUAL FAN DRIVE, COXHEALTH AT HOME COLLECTED AND DISTRIBUTED BOX FANS TO SENIORS AND THE DISABLED WHO LACK ADEQUATE ACCESS TO COOLING DURING THE SUMMER MONTHS. INFUSION THERAPY RECEIVED A SECOND GRANT AWARD FROM THE MISSOURI FOUNDATION FOR HEALTH ORGANIZATION. THIS GRANT ALLOWS US TO SERVE PATIENTS THAT FALL THROUGH THE CRACKS DUE TO HAVING NO REIMBURSEMENT OF ANY KIND, SERVING PATIENTS THROUGHOUT SOUTHERN MISSOURI. ASSISTANCE TO COXHEALTH SYSTEM IN DEVELOPING AN INTEGRATED HEALTH SYSTEM, AND SERVICE TO MEDICAID PATIENTS. COX-MONETT HOSPITAL SUPPORTS THE MONETT, MISSOURI AND SURROUNDING COMMUNITY BY PROVIDING A VARIETY OF SERVICES WHICH INCLUDE UROLOGY, ENT (EAR, NOSE AND THROAT), PULMONOLOGY, ORTHOPEDICS, CARDIOLOGY, PODIATRY, OBSTETRICS, RADIOLOGY (CT, MRI, NUCLEAR MEDICINE AND MAMMOGRAPHY), LABORATORY, 24-HOUR EMERGENCY CENTER, GENERAL SURGICAL SERVICES, SAME-DAY SURGERY, DIABETES CENTER, SLEEP CENTER, CARDIOPULMONARY REHAB, MEDICAL-SURGICAL UNIT, URGENT CARE, PHARMACY AND COMMUNITY WELLNESS. COXHEALTH FOUNDATION SUPPORTS THE COMMUNITY BY RAISING FUNDS TO DISPERSE TO PATIENTS FOR THOSE NEEDS FOR WHICH THEY HAVE NO RESOURCES OR FUNDING, BUT WHICH ARE CRITICAL TO THE PATIENT'S HEALTH AND WELL BEING. SKAGGS COMMUNITY HOSPITAL ASSOCIATION D/B/A COX MEDICAL CENTER BRANSON (CMCB) HAS BEEN SERVING SOUTHWEST MISSOURI RESIDENTS FOR MORE THAN 63 YEARS AND OFFERS OVER 25 MAJOR SERVICE AREAS. THE HOSPITAL'S AVERAGE DAILY PATIENT CENSUS EXCEEDS 85 WITH 165 LICENSED HOSPITAL BEDS. A STAFF OF OVER 1,100 PERSONNEL IS REQUIRED TO OPERATE THE HOSPITAL AND ITS NUMEROUS CLINICS. COXHEALTH ADDED A FOURTH HOSPITAL IN 2018, COX BARTON COUNTY HOSPITAL (COX BARTON COUNTY). THE FACILITY WAS A COUNTY HOSPITAL OWNED AND OPERATED BY BARTON COUNTY MEMORIAL HOSPITAL (BCMH). IT WAS BUILT IN 2007 AND IS A 25-BED CRITICAL ACCESS HOSPITAL IN LAMAR, MISSOURI OFFERING AN EMERGENCY DEPARTMENT, AS WELL AS SPECIALIZED CARE IN DIABETES, CARDIOLOGY, ORTHOPEDICS AND SPORTS MEDICINE, NEUROLOGY, WOMEN'S HEALTH AND MORE.