2025-08-14T11:22:27+00:00 2024-09-30 440160260 Forvis Mazars LLP 901 E ST LOUIS 200 PO BOX 1190 SPRINGFIELD MO 658062523 990 2023-10-01 440577118 LESTER E COX MEDICAL CENTERS LEST 4172693000 1423 N JEFFERSON SPRINGFIELD MO 65802 MAX BUETOW PRESIDENT AND CEO 4172693000 2025-08-14 true BRIAN D TODD P00422601 4178658701 2025-08-14 2023 2025-03-06 01:10:19Z MAX BUETOW 1423 N JEFFERSON SPRINGFIELD MO 65802 1995075796 false X WWW.COXHEALTH.COM X 1923 MO The organization provides quality health care, education and research in order to improve the health of the communities it serves. 6 5 13423 6 9452437 647929 72556069 10152147 1614365441 1772645515 24393639 44569422 -71560413 3027682 1639754736 1830394766 1713242 1979951 0 671431278 710994045 0 0 637499 938773924 1057460592 1611918444 1770434588 27836292 59960178 1932352204 2055262059 758239286 803779952 1174112918 1251482107 Mission: To improve the health of the communities we serve through quality healthcare, education and research. false false 1238583424 1979951 1511218596 HOSPITAL SERVICES: AS A COMMUNITY OWNED, NON-PROFIT HOSPITAL, LESTER E. COX MEDICAL CENTERS PROVIDES THE KIND OF CARE AND PROGRAMS THAT ARE NEEDED TO SERVE MANY OF THE MOST VULNERABLE IN OUR COMMUNITIES - THE UNDERINSURED AND UNINSURED. COMMUNITY BENEFIT TOTALED $1,366,169,119 SYSTEM-WIDE IN THESE CATEGORIES: SHORT-FALLS IN REIMBURSEMENT AND CHARITY CARE; COMMUNITY OUTREACH SERVICES INCLUDING COMMUNITY EDUCATION, HEALTH SCREENINGS, SUPPORT GROUPS AND IMMUNIZATIONS; HEALTH PROFESSIONALS EDUCATION AND RESEARCH, INCLUDING THE UN-REIMBURSED COST OF COX FAMILY MEDICINE RESIDENCY AND SCHOOLS OF ALLIED HEALTH PROFESSIONS; AND FOUNDATION GRANTS, FINANCIAL CONTRIBUTIONS AND IN-KIND DONATIONS. THE HOSPITAL ALSO OPERATES COX COLLEGE, A PRIVATE, NON-PROFIT SINGLE PURPOSE COLLEGE ACCREDITED TO PROVIDE ACADEMIC PROGRAMMING IN A VARIETY OF ALLIED HEALTH FIELDS. 320982585 0 261426919 PHYSICIAN CARE: EMPLOYED PHYSICIANS AT LESTER E. COX MEDICAL CENTER PLAY AN IMPORTANT ROLE IN ACCESS TO MEDICAL CARE THROUGH THEIR PRACTICE AT RURAL HEALTH CLINICS IN UNDER-SERVED AREAS OF SOUTHWEST MISSOURI. PHYSICIANS WITH COX FAMILY MEDICINE RESIDENCY ARE MAKING A VISIBLE DIFFERENCE IN CARE FOR UNINSURED PATIENTS AS WELL AS PATIENTS COVERED BY MEDICAID. AFFORDABLE, CONVENIENT CARE IS ALSO PROVIDED IN OUR RETAIL CLINICS. LESTER E. COX MEDICAL CENTERS CONTINUES TO ADD SUPER CLINICS BRINGING ADVANCED CARE TO THE PATIENT INCLUDING PHYSICAL THERAPY, IMAGING AND PHARMACY SERVICES WITHIN THE CLINIC. COXHEALTH HAS ALSO INVESTED IN TELEMEDICINE INFRASTRUCTURE TO FURTHER EXPAND ITS ABILITY TO OFFER COST EFFECTIVE AND CONVENIENT CARE TO OUR COMMUNITY. 1559566009 true true false true false false false false true true true false false true false false true false false true false false false false false true true true true true true false false false false false false false false true true false false false false true true true true true false true X 493 0 true 13423 true true true true CJ false false false true true false false false false true false X 6 5 true false true false true true true true true false false true true true true true true true true false X JACOB M MCWAY 4172698811 3800 S NATIONAL SPRINGFIELD MO 65807 HAL L HIGDON CHAIR 1.0 5.0 X X 0 0 0 BRAD E ERWIN BOARD MEMBER 1.0 5.0 X 0 0 0 JEFFERSON M TYNES BOARD MEMBER 1.0 5.0 X 0 0 0 LARRY W LIPSCOMB BOARD MEMBER 1.0 5.0 X 0 0 0 ROBERT C FULP BOARD MEMBER 1.0 5.0 X 0 0 0 SALLY HARGIS BOARD MEMBER 1.0 5.0 X 0 0 0 JACOB M MCWAY EVP, COXHEALTH CFO 1.0 48.0 X 0 1311928 221113 MAX D BUETOW PRESIDENT & CEO 1.0 50.0 X 0 1617479 305452 VICKIE J NELSON SECRETARY 1.0 45.0 X 0 80046 11742 ASHLEY CASAD PRESIDENT, SHG 40.0 0 X 413347 0 24206 BETH G POLIVKA SVP, CNO 40.0 0 X 362495 0 28774 DARREN BASS VP, CLINICAL SERVICES 40.0 0.0 X 0 133885 12064 ELLEN HAMMOCK VP, CMG 40.0 0 X 306296 0 22402 JEFF HAWKINS VP, CLINICAL SERVICES 40.0 0 X 322004 0 25108 JONATHAN B SHAMEL SVP, CMG 40.0 0 X 393115 0 32211 SHAWN USERY MD SVP, CMO 40.0 0 X 635446 0 25855 Gregory Stamps PHYSICIAN 40.0 0 X 763815 0 24874 Karim Welaya PHYSICIAN 40.0 0 X 1014319 0 33805 Louis Krenn PHYSICIAN 40.0 1.0 X 956238 0 33805 Mimi Propst PHYSICIAN 40.0 0 X 822105 0 22611 Rajesh Banderudrappagari PHYSICIAN 40.0 0 X 790118 0 37679 DAVID STRONG FORMER VP, HOSPITAL REVENUE 0.0 0.0 X 57647 57647 0 KAREN KRAMER FORMER SVP, PRES SPRINGFIELD HOSP 0.0 0 X 233712 0 43414 STEVE EDWARDS FORMER PRESIDENT & CEO 0.0 0.0 X 0 718423 34105 7070657 3919408 939220 1122 true true false MPLT Healthcare LLC 5810 Coral Ridge Dr Ste 250 Coral Springs FL 33076 Phys Services/Locum 18263950 SPFD NEUROLOGICAL INSTITUTE 1411 E PRIMROSE STE C SPRINGFIELD MO 65804 PHYS REMUNERATION 16161588 OZARK ANATHESIA ASSOCIATES 1000 E PRIMROSE STE 520 SPRINGFIELD MO 65807 ANESTHESIA SERVICES 14034847 INTELLIHARTX LLC 29 E CRAWFORD ST STE 360 FINDLAY OH 45840 ACCOUNT COLLECTIONS 12660039 360 DEGREE MEDICINE 108 SUNNY LANE BRANSON WEST MO 65737 PHYSICIAN SERVICES 9342762 107 575028 2491250 7085869 10152147 NET PATIENT SERVICE REVENUE 900099 1692152595 1692152595 NET PATIENT SERVICE-UNRELATED LAB 621500 1060189 1060189 NET PATIENT SERVICE-UNRELATED RETAIL D 446199 8392248 8392248 TUITION AND FEES 611600 12120272 12120272 CAFE 722514 7159841 7159841 51760370 51760370 0 0 1772645515 18888155 18888155 4432692 1049443 3383249 0 3383249 3383249 188697925 75134 162900599 191193 25797326 -116059 25681267 25681267 333411 539795 -206384 -206384 LOSS ON INVESTMENT IN EQUITY INVESTEE 900099 -149183 -149183 0 0 0 0 -149183 1830394766 1763193078 9452437 47597104 X 264139 264139 1715812 1715812 2591257 1929956 661301 516629 139442 377187 573675046 518231528 55151418 292100 25605806 23112181 2482670 10955 63139414 57012219 6127195 0 45465893 41018242 4426817 20834 11740 11740 148941 148941 262247 262247 1048154 1048154 485404085 375063210 110324971 15904 213375 108400 31962 73013 20799098 15689249 5026570 83279 9273451 7161798 2111653 0 21185520 17171851 4013669 0 2103124 1617600 476948 8576 212918 164213 48418 287 19488874 17779086 1709788 0 45795138 41765250 4016501 13387 32969861 25462310 7507551 0 MEDICAL SUPPLIES & DRUGS 348023323 348023323 0 0 STATE PROVIDER TAX 51669911 51669911 0 0 REPAIRS AND MAINTENANCE 12405107 9580346 2824761 0 RECRUITMENT AND RENTENTION 4613904 3563274 1050630 0 1831821 1322669 389988 119164 1770434588 1559566009 210231080 637499 2819309 5836720 152868578 66192830 201882275 215481633 0 0 0 0 24146907 36967468 23931092 28901000 41581550 20472586 1295076027 752458925 491996974 542617102 486325002 553720100 299114927 382646964 69536454 76559660 25263742 25263742 112885394 100602254 1932352204 2055262059 174725703 182031028 12499381 11158185 456215915 447388480 0 0 28765259 30295597 5757770 5327375 80275258 127579287 758239286 803779952 X 1132883080 1209317552 41229838 42164555 1174112918 1251482107 1932352204 2055262059 X 59960178 103812631 -86403620 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 173814 false true 88433 262247 false Schedule C, Part II-B, Line 1i DIRECT CONTACT WITH LEGISLATORS, ETC THE ORGANIZATION CONTRACTED WINTON POLICY GROUP AND MERCHANT MCINTYRE & ASSOCIATES, LOBBYING AND ASSOCIATION MANAGEMENT FIRMS, TO LOBBY ISSUES THAT BENEFIT THE INTERESTS OF THE COMMUNITY, COXHEALTH AND ITS AFFILIATES. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY MEMBERS OF THE ADMINISTRATIVE STAFF CONTACT LEGISLATORS REGARDING KEY HEALTHCARE ISSUES. ALSO, PORTIONS OF DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION ARE USED FOR LOBBYING PURPOSES. IN FISCAL YEAR 2024, THE AMOUNT ATTRIBUTABLE TO LOBBYING WAS $88,433. 8487254 420865 206029 0 386861 8727287 8158191 521369 202858 0 395164 8487254 8434210 621805 193160 0 1090984 0 8158191 4429596 4232438 135287 0 363111 0 8434210 4315153 351222 104830 0 341609 0 4429596 0.0 0.4565 0.5435 false true true 43868544 43868544 498347360 267085858 231261502 3428052 3135155 292897 684749230 468417898 216331332 64682841 13820014 50862827 542617102 INVEST IN WHOLLY OWNED C-CORP 198576 C INVESTMENTS IN PARTNERSHIPS 240841577 C INVEST IN NON-PTS CORPS 141606811 C 382646964 DUE TO AFFILIATES 25860084 EST AMT DUE TO 3RD PARTIES 22200000 SELF INSURANCE CLAIMS PAYABLE 57549093 OTHER LIABILITIES 21970110 127579287 Schedule D, Part X, Line 2 UNCERTAIN TAX POSITIONS MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. Schedule D, Part V, Line 4 Intended uses of endowment funds COXHEALTH FOUNDATION, A RELATED ORGANIZATION, HOLDS ENDOWMENT FUNDS WHICH INCLUDE MONIES DONATED TO BE USED FOR SPECIFIC EXPENSES, AND THE INCOME FROM EACH FUND IS TO BE SPENT ON SPECIFIC SERVICES AND PROGRAM FUNCTIONS ON A FUND-BY-FUND BASIS. ENDOWMENT FUNDS HELD BY THE FOUNDATION ARE INTENDED FOR BUT NOT LIMITED TO EXPENDITURES RELATING TO CANCER SERVICES, HEALTH EDUCATION, PURCHASE OF EQUIPMENT AND INDIGENT CARE. THESE SERVICES AND FUNCTIONS BENEFIT COXHEALTH AND ITS AFFILIATES. SCHEDULE D, PART V, LINE 1B, COLUMN A INCLUDES AN AMOUNT REPRESENTING THE BALANCE OF FUNDS THAT ARE HELD FOR THE BENEFIT OF COX COLLEGE, A RELATED ENTITY. THESE FUNDS WERE TRANSFERRED TO LESTER E. COX MEDICAL CENTERS DURING FISCAL YEAR ENDING 9/30/2024. Central America and the Caribbean 0 1 Investments CAPTIVE INSURANCE 11235189 Central America and the Caribbean 0 0 Investments 185796307 0 1 0 0 0 1 197031496 0 197031496 true false true true false false Schedule F, Part I, Line 3 Method used to account for expenditures on org's financial statements CENTRAL AMERICA AND THE CARIBBEAN-Other:THE AMOUNT OF PROGRAM SERVICE EXPENDITURES REPORTED ON LINE 1 ARE REPORTED BASED ON THE AMOUNTS INCLUDED IN THE AUDITED FINANCIAL STATEMENTS OF COXHEALTH RISK SOLUTIONS,THE CAPTIVE INSURANCE COMPANY. THESE AUDITED FINANCIAL STATEMENTS USED GENERALLY ACCEPTED ACCOUNTING PRINCIPLES ESTABLISHED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD. true true X false true X true true true false true true 35395200 35395200 0.0200 302572119 231115918 71456201 0.0404 0 0.0 0 0 337967319 231115918 106851401 0.0604 245374 245374 0.0001 24815401 16632760 8182641 0.0046 7125779 4941065 2184714 0.0012 0 0.0 1788963 1788963 0.0010 0 0 33975517 21573825 12401692 0.0070 0 0 371942836 252689743 119253093 0.0674 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 95598658 13479411 594057568 781729266 -187671698 X true true 3 1 LESTER E COX MEDICAL CENTERS-NORTH 1423 N JEFFERSON ST SPRINGFIELD MO 65802 WWW.COXHEALTH.COM 500 X X X 1 2 MEYER ORTHOPEDIC HOSPITAL 1000 E WALNUT LAWN SPRINGFIELD MO 65807 WWW.COXHEALTH.COM 500 X X 1 3 FACILITY REPORTING GROUP #1 3801 S NATIONAL AVE SPRINGFIELD MO 65807 WWW.COXHEALTH.COM 500 X X X X X 1 1 3 false false true X X X X X X X X X 21 true true true true X HTTP://WWW.COXHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/ X (SEE STATEMENT) X true 21 true HTTPS://WWW.COXHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/ false true X 300.0 X X X X X X true true X X X true X HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/ X X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility 1, 1 Facility 1, 1 - MERCY HOSPITAL. MERCY HOSPITAL SYSTEM SERVES MILLIONS EACH YEAR. MERCY IS A CUTTING-EDGE HEALTHCARE PROVIDER THAT IS CHARGED WITH "PROVIDING THE REGION WITH HIGH-QUALITY CARE AND AN EXPERIENCE THAT IS EASIER AND MORE PERSONAL." MERCY HOSPITAL SPRINGFIELD HOUSES 886 BEDS THAT SERVE PEOPLE THROUGHOUT SOUTHWEST MISSOURI AND NORTHWEST ARKANSAS. Schedule H, Part V, Section B, Line 5 Facility 1, 2 Facility 1, 2 - BURRELL BEHAVIORAL HEALTH. BURRELL BEHAVIORAL HEALTH IS THE THIRD LARGEST CERTIFIED COMMUNITY BEHAVIORAL HEALTH CENTER IN THE NATION WITH MULTIPLE LOCATIONS THROUGHOUT SPRINGFIELD AND SURROUNDING AREAS. BURRELL HAS MORE THAN 400 LICENSED PROVIDERS OFFERING A FULL CONTINUUM OF CARE THROUGH THEIR INTEGRATED NETWORK. BURRELL HAS CONTINUED TO EXPAND THEIR REACH AND PARTNERSHIPS IN THE COMMUNITY THROUGH OFFERING COMMUNITY-BASED SERVICES IN COORDINATION WITH SCHOOLS AND OTHER ORGANIZATIONS, SUCH AS BOYS & GIRLS CLUBS SPRINGFIELD TO MEET THE BEHAVIORAL HEALTH NEEDS OF THE COMMUNITY. Schedule H, Part V, Section B, Line 5 Facility 1, 3 Facility 1, 3 - JORDAN VALLEY COMMUNITY HEALTH CENTER. JORDAN VALLEY COMMUNITY HEALTH CENTER IS MISSOURI'S LARGEST FEDERALLY QUALIFIED HEALTH CENTER SERVING 75,000 PATIENTS IN THE OZARKS EACH YEAR. FOUNDED IN 2003, THEIR MISSION TO IMPROVE THE COMMUNITY'S HEALTH THROUGH ACCESS AND RELATIONSHIPS HAS DRIVEN THEIR GROWTH FROM THEIR FIRST MEDICAL CLINIC LOCATED IN A STRIP MALL TO NINE CLINICS, THREE SCHOOL-BASED CLINICS AND A FLEET OF MOBILE UNITS THAT VISIT SCHOOLS AND ORGANIZATIONS PROVIDING MEDICAL, DENTAL, VISION AND BEHAVIORAL HEALTH CARE SERVICES IN SOUTHWEST MISSOURI. JORDAN VALLEY COMMUNITY HEALTH CENTER PROVIDES AN INTEGRATED MODEL OF CARE, SIMPLIFYING HEALTHCARE BY GIVING ACCESS TO A MULTITUDE OF SERVICES IN EACH CLINIC Schedule H, Part V, Section B, Line 5 Facility 1, 4 Facility 1, 4 - OZARKS HEALTH COMMISSION. BUILDING UPON THE SUCCESS OF THE 2016 AND 2019 REGIONAL HEALTH ASSESSMENTS, IN 2021 PARTNERS AGAIN SOUGHT TO BETTER UNDERSTAND THE HEALTH STATUS, BEHAVIORS AND NEEDS OF THE POPULATIONS SERVED. THE RESULTING 2022 REGIONAL HEALTH ASSESSMENT (RHA) COMBINES MORE THAN 200 HOSPITAL AND COMMUNITY INDICATORS, INCLUDING FEEDBACK FROM STAKEHOLDERS AND CITIZENS, ACROSS A 30-COUNTY REGION THAT INCLUDES SOUTHWEST MISSOURI, SOUTHEAST KANSAS AND NORTHEAST OKLAHOMA. THE FULL OZARKS HEALTH COMMISSION RHA CAN BE FOUND AT HTTP://OZARKSHEALTHCOMMISSION.ORG/. Schedule H, Part V, Section B, Line 5 Facility 1, 5 Facility 1, 5 - CHRISTIAN COUNTY HEALTH DEPARTMENT. IN 1968 A PUBLIC HEALTH OFFICE WAS ESTABLISHED IN OZARK, MISSOURI, UNDER THE AUSPICES OF THE OZARKS AREA COMMUNITY ACTION AGENCY CORPORATION, WITH FUNDING SHARED BY THE FEDERAL GOVERNMENT AND THE MISSOURI DEPARTMENT OF HEALTH. TWO YEARS LATER THE CHRISTIAN COUNTY HEALTH DEPARTMENT (CCHD) WAS CREATED BY A VOTE OF THE RESIDENTS OF THE COUNTY. CCHD'S MISSION IS TO SERVE AND PROTECT THE COUNTY CITIZENS BY PROMOTING HEALTHY BEHAVIORS, INCREASING UNDERSTANDING OF HEALTH ISSUES AND IMPROVING THE QUALITY OF THE ENVIRONMENT. THE DEPARTMENT OFFERS A VARIETY OF PROGRAMS TO SERVE THE NEEDS OF CHRISTIAN COUNTY RESIDENTS. Schedule H, Part V, Section B, Line 5 Facility 1, 6 Facility 1, 6 - WEBSTER COUNTY HEALTH DEPARTMENT. THE WEBSTER COUNTY HEALTH DEPARTMENT (WCHD) WAS ESTABLISHED IN 1957 IN ORDER TO PRESERVE AND PROTECT PUBLIC HEALTH OF THE COMMUNITY. WCHD'S FOCUS IS ON TEACHING, PROTECTING AND EMPOWERING PEOPLE SO THAT THEY DON'T GET SICK. BY PROVIDING VACCINATIONS, OFFERING NUTRITION EDUCATION, ENSURING CLEAN WATER AND SAFE FOOD, AND PROVIDING SCREENING AND TESTING SERVICES, WCHD PROTECTS INDIVIDUAL AND COMMUNITY HEALTH. Schedule H, Part V, Section B, Line 5 Facility 1, 7 Facility 1, 7 - SPRINGFIELD-GREENE COUNTY HEALTH (SGCHD). SPRINGFIELD-GREENE COUNTY HEALTH (SGCHD) WAS ESTABLISHED BY THE CITY OF SPRINGFIELD IN 1873 AS THE SPRINGFIELD DEPARTMENT OF HEALTH. THE NAME WAS CHANGED, AND SERVICES WERE EXPANDED TO THE ENTIRE COUNTY IN 1976. THE MISSION OF SCGHD IS TO PROTECT AND IMPROVE COMMUNITY HEALTH THROUGH EDUCATION, COLLABORATION AND PREVENTION. THROUGH CHRONIC DISEASE PREVENTION, COMMUNITY HEALTH & EPIDEMIOLOGY, ENVIRONMENTAL HEALTH AND OTHER PROGRAMS, SGCHD CAN HELP THE CITIZENS OF GREENE COUNTY LIVE LONGER, HAPPIER AND HEALTHIER LIVES. Schedule H, Part V, Section B, Line 6a Facility 1, 1 Facility 1, 1 - REPORTING GROUP #1. 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 MERCY HEALTH. 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, 1 Facility 1, 1 - REPORTING GROUP #1. THE CHNA WAS ALSO CONDUCTED WITH THE FOLLOWING OTHER NON-HOSPITAL ORGANIZATIONS: -CHRISTIAN COUNTY HEALTH DEPARTMENT -SPRINGFIELD-GREENE COUNTY HEALTH DEPARTMENT - WEBSTER COUNTY HEALTH DEPARTMENT Schedule H, Part V, Section B, Line 7 Facility 1, 1 Facility 1, 1 - REPORTING GROUP #1. PRINTED COPIES ARE AVAILABLE BY REQUEST THROUGH HOSPITAL OR PUBLIC HEALTH PARTNERS OR AT OZARKSHEALTHCOMMISSION.ORG AND NEWS RELEASE WAS SENT OUT TO ENCOURAGE MEDIA COVERAGE WITH LINKS TO THE REPORT AND KEY MESSAGES FOR THE PUBLIC. CHNA OTHER WEBSITES: 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, 1 Facility 1, 1 - REPORTING GROUP #1. (1) SPECIAL HEALTH ISSUE - COVID 19 (A) DECREASE HOSPITALIZATION RELATED TO COVID 19 (I) PROPOSED TACTIC - SUPPORT COMMUNITY INITIATIVES, INCLUDING INCREASE PERCENT OF FULLY VACCINATED INDIVIDUALS AS RECOMMENDED BY CDC (2) SUBSTANCE USE AND RECOVERY (A) DECREASE TOBACCO AND VAPE USE RATES (I) INCREASE ACCESS TO CLINICAL EDUCATION AND TRAINING RELATED TO TOBACCO AND VAPE CESSATION (B) INCREASE AWARENESS OF SUBSTANCE USE PREVENTION AND TREATMENT RESOURCES (I) PROMOTE EDUCATION AND TRAIING RELATED TO SUBSTANCE USE (EXAMPLES: HARM REDUCTION, NALOXONE, MENTAL HEALTH FIRST AID) (3) MENTAL HEALTH (A) INCREASE AWARENESS OF MENTAL HEALTH SERVICES (I) INCREASE ACCESS THROUGH ALTERNATIVE CARE MODELS (II) IMPLEMENT TRAUMA INFORMED CARE TRAINING AND EDUCATION (4) DIABETES (A) IMPROVE CHRONIC DISEASE SELF MANAGEMENT (I) INCREASE ENROLLMENT IN CARE MANAGEMENT PROGRAMS (II) PROMOTE ACCESS TO SCHOOL-AGE PREVENTION EDUCATION AND CARE PROGRAMS (ALL) (A) ENGAGE IN MULTI-SECTOR CARE COORDINATION TO REDUCE HEALTH DISPARITIES AND IMPROVE HEALTH OUTCOMES (I) IMPLEMENT COMMUNITY INFORMATION EXCHANGE (CIE) Schedule H, Part V, Section B, Line 13 Facility 1, 1 Facility 1, 1 - REPORTING GROUP #1. 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 V, Section B, Line 13 Facility 1, 1 Facility 1, 1 - REPORTING GROUP #1. 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 16 Facility 1, 1 Facility 1, 1 - REPORTING GROUP #1. 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. 101 SPRINGFIELD INPATIENT PHYSICIANS 3801 S NATIONAL AVE 5TH FLOOR SPRINGFIELD MO 65807 MEDICAL OFFICES Family Medical Care Center 3800 S National Ave Suite 700 Springfield MO 65807 CLINIC CoxHealth Center Steeplechase 1530 E Republic Road Springfield MO 65804 CLINIC Pediatric Center 3443 S National Springfield MO 65807 CLINIC CoxHealth Center Willow Springs 816 E Main Willow Springs MO 65793 CLINIC CoxHealth Pediatrics 1000 E Primrose 300 Springfield MO 65807 CLINIC CoxHealth Center Lebanon 510 E Hwy 32 Lebanon MO 65536 CLINIC CoxHealth Center Chesterfield 3805 S Kansas Expressway Suite B Springfield MO 65807 CLINIC CoxHealth Center Willard 304 E Jackson 5H Willard MO 65781 CLINIC CoxHealth Center Mountain Grove 1602-A North Main Street Mountain Grove MO 65711 CLINIC CoxHealth Center Marshfield 1245 Banning Street Marshfield MO 65706 CLINIC CoxHealth Center Rogersville 151 Johnstown Drive Rogersville MO 65742 CLINIC CoxHealth Inpatient Psychiatry 1423 N Jefferson Street Springfield MO 65802 CLINIC CoxHealth Center Seymour 202 Commercial Seymour MO 65746 CLINIC CoxHealth Center Campbell 2750 S Campbell Springfield MO 65807 CLINIC CoxHealth Psychological Services 3525 S National Avenue Suite 206 Springfield MO 65807 CLINIC CoxHealth Pediatric Surgical Specialties 1011 E Montclair Springfield MO 65807 CLINIC CoxHealth Occupational Medicine 1499 N Robberson Ave K500 Springfield MO 65802 CLINIC CoxHealth Pediatric Place 3850 S National Avenue Suite 400 Springfield MO 65807 CLINIC CoxHealth Skin Care 1530 E Republic Road Springfield MO 65804 CLINIC Glycemic Management Services 3801 S National Avenue Springfield MO 65807 CLINIC CoxHealth Vein Center 3555 SNational Ave Suite 502 Springfield MO 65807 CLINIC CoxHealth Obstetrics and Gynecology 3801 S National Avenue Springfield MO 65807 CLINIC CoxHealth Center Buffalo 119 N Ash St Buffalo MO 65622 CLINIC CoxHealth Harrison 1401 Highway 62 65 N Suite 200 Harrison AR 72601 CLINIC CoxHealth Urgent Care Lebanon 1216 Deadra Drive Lebanon MO 65536 URGENT CARE CoxHealth Nixa Clinic 501 N Old Wilderness Road Nixa MO 65714 CLINIC Coxhealth Urgent Care Nixa 501 N Old Wilderness Road Nixa MO 65714 URGENT CARE CoxHealth Ozark Clinic 5100 N Towne Centre Drive Ozark MO 65721 CLINIC Coxhealth Urgent Care Ozark 5100 N Towne Centre Drive Ozark MO 65721 URGENT CARE CoxHealth Republic 3203 E Old Stone Avenue Republic MO 65738 CLINIC CoxHealth East Battlefield Clinic 3525 E Battlefield Road Springfield MO 65809 CLINIC MEYER CENTER FITNESS AND REHAB 3545 S NATIONAL AVE SPRINGFIELD MO 65807 FITNESS AND REHAB CENTER MEDICAL OFFICE BUILDING-MORH 3525 S NATIONAL AVE SPRINGFIELD MO 65807 MEDICAL OFFICES TURNER WOMEN AND CHILDREN'S CENTER 1000 E PRIMROSE SPRINGFIELD MO 65807 MEDICAL OFFICES WHEELER HEART AND VASCULAR 3800 S NATIONAL AVE 700 SPRINGFIELD MO 65807 MEDICAL OFFICES HULSTON CANCER CENTER 3850 S NATIONAL AVE SPRINGFIELD MO 65807 MEDICAL OFFICES MEDICAL TOWERS 1443 N ROBBERSON SPRINGFIELD MO 65802 MEDICAL OFFICES Radiation Oncology 3850 S National Avenue Springfield MO 65807 CLINIC Northside Pediatrics & Adolescents 1443 N Robberson 200 Springfield MO 65802 CLINIC O'Reilly Automotive Health & Wellness Clinic 233 S Patterson Ave Springfield MO 65802 CLINIC CoxHealth Center Southern Hills 2702 E Sunshine Springfield MO 65804 CLINIC CoxHealth Springfield Inpatient Physicians 3801 S National Avenue Springfield MO 65807 CLINIC FDC Plastic Surgery 3555 S National Avenue Suite 500 Springfield MO 65807 CLINIC FDC ENT (Otolaryngology) 960 E Walnut Lawn Street Suite 102 Springfield MO 65807 CLINIC CoxHealth Weight Loss & Advanced Surgery Center 1001 E Primrose Street Springfield MO 65807 CLINIC Cox Hyperbaric Medicine & Wound Care 3525 S National 101 Springfield MO 65807 CLINIC CoxHealth Gastroenterology 3901 S Fremont Avenue 4th Floor Springfield MO 65807 CLINIC FDC Urology 1001 E Primrose Street Springfield MO 65807 CLINIC CoxHealth General Surgery 1001 E Primrose Street Springfield MO 65807 CLINIC FDC Colon & Rectal Surgery 1001 E Primrose Street Springfield MO 65807 CLINIC CoxHealth Med Spa 3555 S National Avenue Suite 501 Springfield MO 65807 CLINIC FDC Orthopedic Surgery 3555 S National Avenue 2nd 3rd Floo r Springfield MO 65807 CLINIC FDC Physical Medicine and Rehabilitation 3555 S National Avenue 3rd Floor Springfield MO 65807 CLINIC FDC Sports Medicine 3555 S National Avenue 1st Floor Springfield MO 65807 CLINIC CoxHealth Vascular Surgery & Medicine 3800 S National Avenue Suite 160 Springfield MO 65807 CLINIC CoxHealth Cardiovascular Services 3800 S National Avenue Suite 400 Springfield MO 65807 CLINIC CoxHealth Rheumatology 3555 S National Avenue Suite 102 Springfield MO 65807 CLINIC Adult Medicine & Endocrinology Specialists 960 E Walnut Lawn Suite 201 Springfield MO 65807 CLINIC CoxHealth Physicians for Women 1000 E Primrose Suite 210 Springfield MO 65807 CLINIC CoxHealth Primrose OBGYN 1000 E Primrose Suite 270 Springfield MO 65807 CLINIC Regional Perinatal Center 1000 E Primrose 360 Springfield MO 65807 CLINIC FDC OBGYN 1000 E Primrose Street Suite 400 Springfield MO 65807 CLINIC CoxHealth Pediatric Specialties 1011 E Montclair Springfield MO 65807 CLINIC CoxHealth Labor and Delivery Hospitalist 3801 S National Ave Suite G108A Springfield MO 65807 CLINIC CoxHealth Newborn Intensive Care Specialists 3801 S National Avenue Springfield MO 65807 CLINIC CoxHealth Pediatric Critical Care Medicine 3801 S National Avenue Springfield MO 65807 CLINIC CoxHealth Adult & Pediatric Urgent Care 1000 E Primrose Suite 170 Springfield MO 65807 URGENT CARE RS Post Acute Care 3525 S National Springfield MO 65808 CLINIC The Breast Care Surgeons at CoxHealth 3850 S National Avenue Suite 320 Springfield MO 65808 CLINIC CoxHealth Advanced Medicine Specialists 961 E Walnut Lawn Suite 202 Springfield MO 65808 CLINIC CoxHealth Center for Addictions - North 1423 N Jefferson Street Springfield MO 65802 CLINIC CoxHealth Virtual Visits On Demand 1423 N Jefferson Ave Springfield MO 65802 CLINIC CoxHealth Advantage Care Clinic 1819 S National Ave Springfield MO 65804 CLINIC CoxHealth Urgent Care Sunshine and National 1819 S National Ave Springfield MO 65804 URGENT CARE CoxHealth Inpatient Palliative Care 3801 S National Avenue Springfield MO 65807 CLINIC CoxHealth Pulmonology 3800 S National Avenue Suite 510 Springfield MO 65807 CLINIC CoxHealth Consulting Services and Aviation Medicine 3555 S National Suite 300 Springfield MO 65807 CLINIC CoxHealth Trauma & Acute Care Surgery Clinic 3800 S National Ave 600 Springfield MO 65807 CLINIC Interventional Pain Management 1001 E Primrose St Springfield MO 65807 CLINIC FDC Neurology 3801 S National Avenue Suite 900 Springfield MO 65807 CLINIC CoxHealth Neuropsychology Services 3801 S National Ave Suite 900 Springfield MO 65807 CLINIC CoxHealth Electrophysiology 3800 S National Avenue Suite 170 Springfield MO 65807 CLINIC CoxHealth Dermatology 1925 W Chesterfield Blvd Springfield MO 65807 CLINIC CoxHealth Allergy 1001 E Primrose Street Springfield MO 65807 CLINIC CoxHealth Medical Oncology 3850 S National Avenue Suite 520 Springfield MO 65807 CLINIC FDC Gynecological Oncology 3850 S National Avenue Suite 700 Springfield MO 65807 CLINIC CoxHealth Infectious Diseases Specialty Clinic 3800 S National LL100 Springfield MO 65807 CLINIC RS Pediatric Inpatient Physicians 3801 S National Avenue Springfield MO 65807 CLINIC CoxHealth OBGYN Laborist 3801 S National Ave Suite G108B Springfield MO 65807 CLINIC CoxHealth Care Mobile 3805 S Kansas Expressway Ste A Springfield MO 65807 CLINIC FDC Internal Medicine Family Medicine 1001 E Primrose Street Springfield MO 65807 CLINIC Coxhealth Urgent Care East Battlefield 3525 East Battlefield Rd Springfield MO 65809 URGENT CARE MARTIN CENTER 3801 S FREMONT SPRINGFIELD MO 65807 CLINIC CoxHealth Center Crane 102 Cortney Ln Crane MO 65633 CLINIC CoxHealth Center Forsyth 13852 US Hwy 160 Forsyth MO 65653 CLINIC CoxHealth Center Mt Vernon 10763 Hwy 39 Ste 200 Mt Vernon MO 65712 CLINIC CoxHealth Harrison Clinic 1401 Hwy 65 North Ste 200 Harrision AR 72601 CLINIC CoxHealth Nephrology Clinic 3525 S National Ave Ste 207 Springfield MO 65807 CLINIC CoxHealth Republic Clinic 3203 E Old Stone Ave Brookline MO 65619 CLINIC FDC Radiology 3801 S National Ave Springfield MO 65807 CLINIC 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 I, Line 7 COSTING METHODOLOGY THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. COST COMPUTED ON IRS WORKSHEETS 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 7 PERCENT OF TOTAL EXPENSE TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990. Schedule H, Part I, Line 7g SUBSIDIZED SERVICES THE ORGANIZATION HAS INCLUDED COSTS ASSOCIATED WITH RURAL HEALTH CENTERS (RHC) IN THE CALCULATION OF SUBSIDIZED SERVICES ON LINE 7G, WITH A NET SUBSIDY FROM RHCS OF $2,649,195. LESTER E. COX MEDICAL CENTERS PROVIDES PRIMARY CARE SERVICES TO THE SURROUNDING COMMUNITIES AT THE CENTERS. THESE SERVICES ARE PROVIDED IN RURAL AREAS WHERE THERE WOULD BE A SHORTAGE OF QUALITY MEDICAL CARE WITHOUT THE SERVICES. LESTER E. COX MEDICAL CENTERS CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED. 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, 2024. 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 DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU. USING DATA FROM 2019-2023, APPROXIMATELY 14.1% PERCENT OF GREENE COUNTY WAS CONSIDERED TO LIVE IN POVERTY. 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 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 1 - FACILITY REPORTING GROUP #1: Line 16a URL: HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/; Schedule H, Part V, Section B, Line 16b FAP Application website 1 - FACILITY REPORTING GROUP #1: 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 1 - FACILITY REPORTING GROUP #1: 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 ENVIRONMENTAL SCAN ANNUALLY SINCE 2006. COMMUNITY HEALTH NEEDS ASSESSMENTS AS REQUIRED BY THE IRS WERE COMPLETED IN 2022. OHC REGION STAKEHOLDERS BEGAN THE RHA PROCESS WITH ANALYSIS OF PUBLICLY AVAILABLE HEALTH DATA (SECONDARY DATA) AND PARTICIPATING HEALTH SYSTEMS' EMERGENCY DEPARTMENT 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 COLLECTED BETWEEN SEPTEMBER AND OCTOBER 2021. ACROSS THE OHC REGION THESE VIEWPOINTS WERE SOLICITED VIA 75 INDIVIDUAL INTERVIEWS, 10 FOCUS GROUPS AND 2,638 SURVEYS. SPECIFICALLY IN THE SPRINGFIELD COMMUNITY, 20 INDIVIDUAL INTERVIEWS WERE HELD WITH STAKEHOLDERS AND 3 VIRTUAL FOCUS GROUPS WERE HELD WITH LOCAL HEALTH SYSTEM LEADERS, COMMUNITY OUTREACH ORGANIZATIONS, AND A LOCAL DRUG TASK FORCE AS WELL AS OTHER SECTORS OF THE SPRINGFIELD COMMUNITY TO ALLOW VOICES TO HIGHLIGHT CHALLENGES THAT THEY SEE AS THE BIGGEST HEALTH RELATED NEEDS. FURTHER, APPROXIMATELY 31% OF REGIONAL SURVEY RESPONDENTS WERE FROM THE SPRINGFIELD 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 HEALTH ASSESSMENT. THIS PRIORITIZATION INFORMATION CAN BE USED BY ORGANIZATIONS TO DEVELOP COMMUNITY HEALTH IMPROVEMENT PLANS, GUIDE DECISION MAKING, FOSTER COLLABORATION ACROSS INITIATIVES FOR COLLECTIVE COMMUNITY IMPACT AND INCREASE FUNDING BY USING EVIDENCE TO DESCRIBE ISSUES AND PROPOSE SOLUTIONS. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance LESTER E. COX MEDICAL CENTERS 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. - LESTER E. COX MEDICAL CENTERS 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 LESTER E. COX MEDICAL CENTERS 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 LESTER E. COX MEDICAL CENTERS INCLUDE: BARRY, CHRISTIAN, GREENE, LAWRENCE, STONE, TANEY, AND WEBSTER (ALL PSA COUNTIES ARE LOCATED IN MISSOURI). THE SECONDARY SERVICE AREA (SSA) COUNTIES SERVED BY LESTER E. COX MEDICAL CENTERS INCLUDE: BARTON, 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 OVER 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 SLIGHTLY MORE THAN 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 25-COUNTY SERVICE AREA AS 91% OF THE POPULATION IS WHITE ALONE. Schedule H, Part VI, Line 5 Promotion of community health LESTER E. COX MEDICAL CENTERS' MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH QUALITY HEALTH CARE, EDUCATION AND RESEARCH. WE ACTIVELY LIVE THIS MISSION BY PROVIDING QUALITY HEALTH CARE WITH MULTIPLE ACCESS POINTS FOR CARE INCLUDING THREE HOSPITALS AND MORE THAN 60 PHYSICIAN CLINICS (INCLUDING RETAIL CLINICS). THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY THROUGH A COMMUNITY BOARD, HEALTH RELATED AD CAMPAIGNS, PROVISION OF WELLNESS SERVICES AND VACCINATIONS, PROVISION OF CARE FOR INDIGENT SEGMENTS OF THE POPULATION, FUNDING OF CARE QUALIFIED COMMUNITY MEMBERS THROUGH A NOT-FOR-PROFIT FOUNDATION, COMMUNITY EDUCATION CLASSES RELATED TO HEALTH AND WELLNESS, COMMUNITY ADVISORY COUNCILS AND HEALTH IMPROVEMENT EFFORTS IN PARTNERSHIP WITH PUBLIC HEALTH DEPARTMENTS, SCHOOL SYSTEMS AND OTHER REGIONAL HEALTH CARE PROVIDERS. A MAJORITY OF LESTER E. COX MEDICAL CENTERS' BOARD IS COMPRISED OF INDIVIDUALS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA, WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO PHYSICIANS IN THE COMMUNITY IF THEY QUALIFY. Schedule H, Part VI, Line 6 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. IN OCTOBER 2017, COXHEALTH SIGNED A LETTER OF INTENT WITH BCMH TO ACQUIRE ITS OPERATION AND TO LEASE ITS PROPERTY. BCMH WAS STRUGGLING AS A RURAL HOSPITAL TO KEEP UP WITH DECLINING REVENUE. COXHEALTH'S ACQUISITION ALLOWS FOR THE PATIENTS PREVIOUSLY SERVED BY BCMH TO BECOME A PART OF THE COXHEALTH SYSTEM. COX BARTON COUNTY WILL CONTINUE THE SERVICES PREVIOUSLY PROVIDED BY BCMH AND INTENDS TO EXPAND THESE SERVICES FURTHER IN THE FUTURE AS WELL. true MHA CENTER FOR EDUCATION PO BOX 60 JEFFERSON CITY MO 65102 430898947 501(C)(3) 150341 COMMUNITY BENEFIT SKAGGS COMMUNITY HOSPITAL ASSOCIATION 525 BRANSON LANDING BLVD BRANSON MO 65615 440584290 501(C)(3) 38261 SUPPORT COX-MONETT HOSPITAL INC 1000 E US HWY 60 MONETT MO 65708 431656689 501(C)(3) 13171 SUPPORT COXHEALTH 1423 N JEFFERSON SPRINGFIELD MO 65802 471087427 501(C)(3) 62366 SUPPORT 4 0 CHILDREN'S MIRACLE NETWORK - SPECIAL NEEDS GRANTS 1946 166280 CHILDREN'S MIRACLE NETWORK - FAMILY CARE GRANTS 31 70054 CHILDREN'S MIRACLE NETWORK - COMMUNITY OUTREACH GRANTS 507992 121105 CHILDREN'S MIRACLE NETWORK - LESTER E MC GRANTS 33489 294586 CHILDREN'S MIRACLE NETWORK - OTHER GRANTS 50317 557509 TUITION DISCOUNTS 331 456278 CARE ACT DISBURSEMENTS 109 50000 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. THROUGH THE CHILDREN'S MIRACLE NETWORK, LESTER E. COX MEDICAL CENTERS DISTRIBUTES FUNDS TO INDIVIDUALS THROUGHOUT THE COMMUNITY. SEE BELOW FOR A SUMMARY OF PROGRAMS THROUGH WHICH FUNDS ARE DISTRIBUTED. DURING FISCAL YEAR 2024, MORE THAN 91,000 CHILDREN WERE SERVED: SPECIAL NEEDS FUND - $166,280 - DIRECT FINANCIAL ASSISTANCE TO FAMILIES, WHICH INCLUDES: *KIDS CHECKS - $59,865 *MEAL TRAYS - $78,689 *MEAL VOUCHERS - $10,906 *GIFT CARDS - $16,820 FAMILY CARE GRANTS - $70,054 - DIRECT FINANCIAL ASSISTANCE TO FAMILIES, WHICH INCLUDES: SPEECH, OCCUPATIONAL AND PHYSICAL THERAPY BILLS, HOSPITAL BILLS, ETC. COMMUNITY GUARANTEED GRANTS - $121,105 TOTAL *CARDIAC PROGRAM (A PORTION TO COX- MONETT HOSPITAL, INC.) - $25,855 *"NEVER SHAKE A BABY" PROGRAM - $18,750 *BICYCLE SAFETY PROGRAM - $13,500 *WASTED PROGRAM - $3,750 *WATER SAFETY PROGRAM - $8,750 *CAR SEAT SAFETY PROGRAM - $12,500 *FIREARM SAFETY - $13,000 *INFANT SLEEP & SAFETY - $8,750 *FARM SAFETY PROGRAM - $7,500 *HOME SAFETY PROGRAM - $8,750 LESTER E. COX MEDICAL CENTERS GUARANTEED GRANTS - $294,586 TOTAL *CHILD LIFE PROGRAM - $123,301 *C.A.R.E. MOBILE - $171,285 DISCRETIONARY AND OPEN FUNDS - $557,509 - THESE ARE FUNDS THAT DO NOT FALL INTO ONE OF THE ABOVE CATEGORIES AND INCLUDES FUNDS TO DEPARTMENTS FOR EQUIPMENT AND OTHER THERAPEUTIC ITEMS FOR CHILDREN. THE FUNDS ARE AS FOLLOWS: PEDIATRICS - $33,330.70 RESPIRATORY CARE - $55,899.66 ACUTE CARE THERAPY - $7,499.00 BRANSON MATERNITY - $19,560.41 COX NORTH EDUCATION CENTER - $40,954.58 BRANSON CASE MANAGEMENT - $4,846.92 OUTPATIENT NEURO THERAPY - $13,992.79 OUTPATIENT REHAB NORTH - $4,353.58 COX SOUTH SURGERY CENTER - $193,485.74 MOHR OUTPATIENT - $5,799.00 NICU - $115,395.00 WOMEN AND NEWBORN - $9,996.00 OZARK THERAPY SERVICES - $5,419.43 CASE MANAGEMENT - $5,493.09 CHILD-ADOLESCENT PSYCHIATRY - $14,187.13 COX AIR CARE - $19,236.00 TRAUMA SERVICES - $8,060.00 THE ORGANIZATION ALSO PROVIDED SUPPORT OF OTHER LOCAL ORGANIZATIONS THROUGH SPONSORSHIPS AS PART OF THEIR COMMUNITY BUILDING ACTIVITIES. THE USE OF THE FUNDS CAN BE SEEN AT EVENTS AND IN COMMUNITY PROJECTS. STUDENTS MUST MEET THE ELIGIBILITY REQUIREMENTS SPECIFIED IN THE APPLICABLE SCHOLARSHIP IN ORDER TO BE CONSIDERED FOR AWARD. THESE REQUIREMENTS INCLUDE SUCH THINGS AS GRADE POINT AVERAGES, ECONOMIC NEED, ENROLLMENT IN A PARTICULAR PROGRAM, ETC. AS APPLICABLE, THE COLLEGE FOLLOWS FEDERAL, STATE, AND INSTITUTIONAL GUIDELINES FOR AWARDS X X X X X false true false false false true false false false DAVID STRONG FORMER VP, HOSPITAL REVENUE 45522 45522 12125 12125 0 0 0 0 0 0 57647 57647 0 0 STEVE EDWARDS FORMER PRESIDENT & CEO 0 218675 0 205935 0 293813 0 16500 0 17605 0 752528 0 292665 KAREN KRAMER FORMER SVP, PRES SPRINGFIELD HOSP 233712 0 0 0 0 0 29017 0 14397 0 277126 0 0 0 MAX D BUETOW PRESIDENT & CEO 0 1041070 0 556570 0 19839 0 289441 0 16011 0 1922931 0 0 JACOB M MCWAY EVP, COXHEALTH CFO 0 769096 0 354929 0 187903 0 200249 0 20864 0 1533041 0 153057 ASHLEY CASAD PRESIDENT, SHG 328187 0 84891 0 269 0 16200 0 8006 0 437553 0 0 0 ELLEN HAMMOCK VP, CMG 245075 0 61221 0 0 0 9429 0 12973 0 328698 0 0 0 JEFF HAWKINS VP, CLINICAL SERVICES 257292 0 62732 0 1980 0 16356 0 8752 0 347112 0 0 0 BETH G POLIVKA SVP, CNO 286943 0 74871 0 681 0 16500 0 12274 0 391269 0 0 0 JONATHAN B SHAMEL SVP, CMG 314339 0 78507 0 269 0 16200 0 16011 0 425326 0 0 0 SHAWN USERY MD SVP, CMO 500564 0 134582 0 300 0 8250 0 17605 0 661301 0 0 0 Karim Welaya PHYSICIAN 1014019 0 0 0 300 0 16200 0 17605 0 1048124 0 0 0 Louis Krenn PHYSICIAN 955788 0 0 0 450 0 16200 0 17605 0 990043 0 0 0 Mimi Propst PHYSICIAN 821835 0 0 0 270 0 6600 0 16011 0 844716 0 0 0 Rajesh Banderudrappagari PHYSICIAN 789726 0 0 0 392 0 20074 0 17605 0 827797 0 0 0 Gregory Stamps PHYSICIAN 740025 0 0 0 23790 0 16500 0 8374 0 788689 0 0 0 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan STEVE EDWARDS, MAX BEUTOW, JACOB MCWAY, AND DAVID STRONG PARTICIPATE IN A 457(F) NONQUALIFIED RETIREMENT PLAN WITH LESTER E. COX MEDICAL CENTERS: -STEVE EDWARDS RECEIVED AN EXECUTIVE 457(F) DISTRIBUTION OF $292,665, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - JACOB MCWAY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $183,749. - JACOB MCWAY RECEIVED A 457(F) DISTRIBUTION OF $153,057, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - MAX BUETOW RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $273,241. - DAVID STRONG RECEIVED AN EXECUTIVE 457(F) DISTRIBUTION OF $91,044 WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A FORM 990. Schedule J, Part I, Line 6a Compensation contingent on net earnings of the organization KEY EMPLOYEES HAVE NET EARNINGS AS ONE COMPONENT OF A BALANCED SCORECARD METRIC CONTAINED WITHIN A BONUS PROGRAM. EMPLOYED PHYSICIANS ARE PAID BASED ON A SALARY, A FORMULA USING COLLECTIONS AND EXPENSES, AN AMOUNT PER RVU, OR A COMBINATION OF THESE. PHYSICIANS LISTED ON PART VII THAT ARE SUBJECT TO THESE COMPENSATION ARRANGEMENTS ARE GREGORY STAMPS, LOUIS KRENN, MIMI PROPST, KARIM WELAYA, AND KATHRYN CAMERON. EXECUTIVE LEVEL STAFF ARE ELIGIBLE FOR ADDITIONAL COMPENSATION BASED ON A VARIETY OF PERFORMANCE INDICATORS IN QUALITY, CUSTOMER AND EMPLOYEE SATISFACTION AND BUSINESS PERFORMANCE MEASURES. Schedule J, Part I, Line 1a HEALTH AND SOCIAL CLUB DUES A RELATED ENTITY, COXHEALTH, INCLUDES MONTHLY SOCIAL CLUB DUES IN THE TAXABLE COMPENSATION OF JAKE MCWAY, CFO. Schedule J, Part II BOARD MEMBER COMPENSATION NO COMPENSATION WAS PROVIDED FOR RESPONSIBILITIES ASSOCIATED WITH BEING A BOARD DIRECTOR. COMPENSATION REPORTED FOR SEVERAL BOARD MEMBERS LISTED ON SCHEDULE J REPRESENTS EMPLOYEE OR INDEPENDENT CONTRACTOR COMPENSATION UNRELATED TO SERVICE AS A BOARD MEMBER. Schedule J, Part II, Column (F) COMPENSATION REPORTED IN PRIOR FORM 990 COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS VESTED OR PAID TO THE INDIVIDUAL. A HEALTH & EDUCCATIONAL FACILITIES AUTH-STATE OF MO 431178966 60637AHS4 2015-04-22 142209927 REFINANCE 80% 2008A false false false B HEALTH & EDUCATIONAL FACILITIES AUTH-STATE OF MO 431178966 60635R5B9 2008-10-15 35000000 NEW INFRASTRUCTURE & EQUIPMENT false false false C HEALTH & EDUCATIONAL FACILITIES-AUTH STATE OF MO 431178966 60637AEA6 2013-04-17 215764755 NEW INFRASTRUCTURE/CURRENT REFUND false false false D HEALTH & EDUCATIONAL FACILITIES AUTH-STATE OF MO 431178966 60637ANY4 2019-04-17 132217208 NEW INFRASTRUCTURE & EQUIPMENT false false false A 8030000 0 142209927 0 0 0 1385435 0 0 0 140824492 0 2015 false true true true B 3075000 0 35028548 0 421299 0 271292 803381 0 0 33532576 0 2012 true false true true C 11100000 0 215764775 0 18784325 0 2272111 0 0 194708339 0 0 2015 false false true true D 360000 0 132217208 0 5878142 0 1335157 0 0 95003909 30000000 0 2021 false true true true A false true false false 0.0 0.0009 0.0009 false false true B false true false false 0.0 0.0 0.0 false false true C false true true true false 0.0003 0.0 0.0003 false false true D false true false false 0.0 0.0002 0.0002 false false true A false false false true false false false false true B false false false true true false false false true C false false false true false false false false true D false false false true false false false false true A true B true C true D true Schedule K, Part II, Line 3 GROUP 1 - COLUMNS B, C, & D, GROUP 2 - COLUMNS A & B THE TOTAL PROCEEDS OF THE ISSUE EXCEEDED THE ISSUE PRICE BY THE INVESTMENT EARNINGS AS OF 09/30/2024. Schedule K, Part II, Line 11 GROUP 1 - COLUMNS B & D, GROUP 2 - COLUMN A THE OTHER SPENT PROCEEDS RELATE TO THE CURRENT REFUNDING PROCEEDS OF THE ISSUE. Schedule K, Part IV, Line 2c GROUP 1 - COLUMNS B, C, & D, GROUP 2 - COLUMN B REBATE CALCULATION/ANALYSIS WERE COMPLETED AS FOLLOWS: -BOND SERIES ISSUE B ON 04/30/2020 -BOND SERIES ISSUE C ON 11/20/2018 -BOND SERIES ISSUE D ON 03/20/2018 -BOND SERIES ISSUE B ON 11/19/2018 A HEALTH & EDUCATIONAL FACILITIES AUTH-STATE OF MO 431178966 60636G1A8 2008-10-15 70000000 NEW INFRASTRUCTURE & EQUIPMENT false false false A 250000 0 70469521 0 783050 0 501052 2121540 0 67063879 0 0 2013 true false true true A false true false false 0.0 0.0 0.0 false false true A false false false true true false false false true A true Colton Nelson Son of Vickie Nelson, Secretary of Board 69839 wages false Sabrina Nelson Daughter in Law of Vickie Nelson, Secretary of Board 42413 wages false Jefferson Tynes 2nd Vice Chair 166751 Business Relationship - Supplies false JOSH HAWKINS SON OF JEFF HAWKINS , VP: 69603 WAGES false FORM 990, PART III, LINES 4A- 4B - EXEMPT PURPOSE ACHIEVEMENTS - COMMUNITY BENEFIT REPORT LESTER E. COX MEDICAL CENTERS IS PROUD TO OFFER NATIONALLY RECOGNIZED QUALITY CARE AND THE LATEST IN MEDICAL TECHNOLOGY AND SERVICES TO IMPROVE OUR COMMUNITY'S HEALTH. DESPITE INNOVATION AND QUALITY, THERE ARE STILL COMMUNITY NEEDS THAT ARE NOT MET THROUGH REGULAR COURSE OF CARE. THAT IS WHY AS A COMMUNITY-OWNED, NOT-FORPROFIT HOSPITAL SYSTEM, WE PROVIDE THE KIND OF CARE AND PROGRAMS THAT ARE NEEDED TO SERVE ALL IN OUR COMMUNITIES, INCLUDING SOME OF THE MOST VULNERABLE - THE UNDERINSURED AND UNINSURED. PROGRAMS THAT HELP THE INDIVIDUALS AND FAMILIES OF OUR COMMUNITY ARE AN INVESTMENT IN FRIENDS, FAMILY, AND NEIGHBORS. LESTER E. C MEDICAL CENTERS DOES THIS THROUGH INITIATIVES LIKE AMANDA BELLE FARM, KOHLS CARDIAC KIDS AND HEALTHY FOOD PANTRY COLLABORATIVE, BUT IS ALSO EVIDENT IN COMMUNITY AND HEALTH CARE EDUCATION, SUPPORT GROUPS, PREVENTIVE SCREENINGS, SPONSORSHIPS, AND DONATIONS. COMMUNITY BENEFIT MEDICARE, MEDICAID AND UNINSURED SUBSIDIES $ 267,576,550 CMC $ 313,317,259 SYSTEM-WIDE THIS FIGURE INCLUDES THE ESTIMATED UNPAID COSTS OF PROVIDING C TO MEDICARE AND MEDICAID PATIENTS AND REPRESENTS THE SHORTFALL BETWEEN THE COST OF PROVIDING CARE AND THE PAYMENTS RECEIVED BY THE GOVERNMENT AND COVERED INDIVIDUALS. ALSO, IT INCLUDES THE ESTIMATED UNPAID COST OF PROVIDING FREE OR DISCOUNTED CARE TO PERSONS WHO CANNOT AFFORD TO PAY FOR ANY OR ALL OF THE SERVICES THEY RECEIVE AND WHO ARE NOT ELIGIBLE FOR PUBLIC PROGRAMS. COMMUNITY OUTREACH SERVICES $ 245,374 CMC $ 248,414 SYSTEM-WIDE INCLUDES ACTIVITIES CARRIED OUT TO IMPROVE COMMUNITY HEALTH AND SERVICES THAT ARE SUBSIDIZED BECAUSE THEY ARE NEEDED THE COMMUNITY. EXAMPLES ARE COMMUNITY EDUCATION, HEALTH SCREENINGS, SUPPORT GROUPS, IMMUNIZATIONS, COALITION BUILDING AND SUBSIDY OF HEALTH CARE SERVICES. HEALTH PROFESSIONALS EDUCATION AND RESEARCH $ 7,724,738 CMC $ 9,277,876 SYSTEM-WIDE THIS FIGURE IS THE COST OF PROVIDING CLINICAL PLACEMENTS FOR PHYSICIANS AND OTHER HEALTH PROFESSIONALS PLUS THE UN-REIMBURSED COST OF COX FAMILY MEDICINE RESIDENCY AND SCHOOLS OF ALLIED HEALTH PROFESSIONS. IT INCLUDES THE UN-REIMBURSED EXPENSE OF STUDIES ON THERAPEUTIC PROTOCOLS AND RESEARCH. FOUNDATION GRANTS, FINANCIAL CONTRIBUTIONS AND IN-KIND DONATIONS $ 1,788,963 CMC $ 1,822,950 SYSTEM-WIDE THIS FIGURE INCLUDES CASH AND IN-KIND DONATIONS TO SUPPORT COMMUNITY ORGANIZATIONS, PATIENT ADVOCACY AND EDUCATION, AS WELL AS CONTRIBUTIONS FOR NOT FOR- PROFIT COMMUNITY ORGANIZATIONS AND EVENT SPONSORSHIPS. TOTAL COMMUNITY BENEFIT: $ 277,335,625 CMC $ 324,666,500 SYSTEM-WIDE ECONOMIC IMPACT RESTRICTED FOUNDATION GRANTS $ 7,298,746 CMC $ 8,533,598 SYSTEM-WIDE THIS FIGURE INCLUES GRANTS TO ORGANIZATIONS IN THE COMMUNITY FOR SPECIFIC RESTRICTED REQUESTS. REAL ESTATE AND PROPERTY TAXES $ 2,128,323 CMC $ 2,461,515 SYSTEM-WIDE TOTAL REAL ESTATE AND PROPERTY TAXES PAID BY LESTER E. COX MEDICAL CENTERS FOR MEDICAL OFFICE BUILDINGS AND PHYSICIAN OFFICES AND CLINIC. CAPITAL INVESTMENTS $ 98,590,566 CMC $ 125,683,662 SYSTEM-WIDE AS A NON-PROFIT ORGANIZATION, LESTER E. COX MEDICAL CENTERS REINVESTS ITS REVENUE IN THE SERVICES IT PROVIDES TO THE COMMUNITY INCLUDING THE COST OF MEDICAL TECHNOLOGY, EQUIPMENT AND SERVICES. THIS AMOUNT INCLUDES THE TOTAL INVESTMENT MADE THROUGH PURCHASING AND LEASING OF MEDICAL EQUIPMENT AND TECHNOLOGY, AS WELL AS RENTAL FACILITIES, SUCH AS MEDICAL OFFICES. PAYROLL & BENEFITS $ 707,450,689 CMC $ 904,823,844 SYSTEM-WIDE THE COXHEALTH SYSTEM IS ONE OF THE LARGEST EMPLOYERS IN SOUTHWEST MISSOURI. IN FISCAL YEAR 2024, LESTER E. COX MEDICAL CENTERS ALONE EMPLOYED NEARLY 13,423 PEOPLE, AND THE REMAINING COXHEALTH SYSTEM AFFILIATES CARRY THE TOTAL EMPLOYED FIGURE TO 16,867 PEOPLE. THIS DOLLAR AMOUNT INCLUDES THE COST OF PAYROLL AND BENEFITS OF OUR DEDICATED TEAM FOR LESTER E. COX MEDICAL CENTERS. IT ALSO INCLUDES A SIGNIFICANT INVESTMENT ON CONTRACT PERSONNEL IN VARIOUS MEDICAL SPECIALTIES AS WELL AS MONIES TO OTHER PROFESSIONALS WHO RESIDE LOCALLY. TOTAL ECONOMIC IMPACT: $ 815,468,324 CMC $ 1,041,502,619 SYSTEM-WIDE TOTAL CONTRIBUTIONS TO THE COMMUNITY: $ 1,092,803,949 CMC $ 1,366,169,119 SYSTEM-WIDE Form 990, Part V, Line 2a PAYROLL FILINGS LESTER E. COX MEDICAL CENTERS FILES PAYROLL TAX FORMS, INCLUDING FORMS W-2, FOR MANY RELATED ORGANIZATIONS. THE AMOUNT REPORTED ON PART V, LINE 2A INCLUDES THE W-2S FILED FOR RELATED ORGANIZATIONS. Form 990, Part VI, Line 4 Significant changes to organizational documents THE ORGANIZATION AMENDED THEIR BYLAWS DURING THE YEAR WITH THE FOLLOWING: f) REMOVED LANGUAGE RELATED TO THE APPOINTMENT AND REMOVAL OF THE CEO ARTICLE 5: REMOVED LANGUAGE STATING -OF THE MEMBER PLUS THE PRESIDENT AND CEO OF THE MEMBER WHO SHALL SERVE EX OFFICIO WITH VOTE. REMOVED - THE PRESIDENT OF THE MEDICAL STAFF SHALL BE AN EX OFFICIO MEMBER WITHOUT VOTE. ARTICLE 7: SECTION 1: REMOVED LANGUAGE - AND THE OFFICERS OF CMC AND THE OFFICERS OF COXHEALTH AND SHALL SERVE AS LONG AS THE OFFICERS OF THE MEMBER AND THE OFFICERS OF COXHEALTH REMAIN IN SAID OFFICE. ADDED LANGUAGE: AND SHALL SERVE AS LONG AS THE OFFICERS OF THE MEMBER REMAIN IN SAID OFFICE. THE OFFICERS OF CMC SHALL BE PRESIDENT, CHIEF FINANCIAL OFFICER (CFO) AND SECRETARY, NONE OF WHOM SHALL BE A DIRECTOR. ADDED SECTION 2: APPOINTMENT AND TERM OF OFFICE - OFFICERS OF THE BOARD. THE OFFICERS OF THE BOARD SHALL SERVE AS LONG AS THE OFFICERS OF THE MEMBER REMAIN IN SAID OFFICE. OFFICERS OF CMC. PRESIDENT. THE PRESIDENT OF CMC SHALL BE APPOINTED BY THE MEMBER AS PROVIDED IN ARTICAL TWO, SECTION 3, SHALL BE AN EMPLOYEE OF THE MEMBER OR ONE OF ITS CONTROLLED SUBSIDIARIES OR REMOTELY CONTROLLED SUBSIDIARIES AND SHALL SERVE AT THE PLEASURE OF THE MEMBER IN ACCORDANCE WITH ANY WRITTEN CONTRACT, AS APPLICABLE, AND THE MEMBER'S POLICIES AND PROCEDURES. CFO. THE CFO SHALL BE THE SAME PERSON WHO HOLDS THE CORRESPONDING OFFICE OF CFO OF COXHEALTH. SECRETARY. THE SECRETARY OF CMC SHALL BE THE SAME PERSON WHO HOLDS THE CORRESPONDING OFFICE OF SECRETARY OF THE BOARD OF COXHEALTH. SECTION 3: REMOVAL AND RESIGNATION. OFFICERS OF THE BOARD. IF THE OFFICE OF ANY OFFICER OF THE BOARD BECOMES VACANT, THE VACANCY SHALL BE FILLED AS SET FORTH IN ARTICLE SEVEN, SECTION 2. OFFICERS OF CMC. PRESIDENT. IF THE OFFICE OF PRESIDENT OF CMC BECOMES VACANT, OR IF THE PRESIDENT OF CMC NOTIFIES THE BOARD OF THE INTENT TO RESIGN OR RETIRE, THE MEMBER SHALL APPOINT A REPLACEMENT AS SET FORTH IN THIS ARTICLE SEVEN, SECTION 2. IN THE INTERIM, THE MEMBER MAY APPOINT AN ACTING PRESIDENT. SECRETARY. IF THE OFFICE OF SECRETARY OF CMC BECOMES VACANT, THE VACANCY SHALL BE FILLED AS SET FORTH IN ARTICLE SEVEN, SECTION 2. DUTIES OF OFFICERS OF CMC REMOVED ALL LANGUAGE RELATING TO CEO. DESCRIPTION OF CHIEF FINANCIAL OFFICER NOW STATES THAT THE CFO SHALL HAVE THE SAME DUTIES AND RESPONSIBILITIES AS SET FORTH IN THE BYLAWS OF COXHEALTH FOR THE CFO OF COXHEALTH EXCEPT SUCH DUTIES AND RESPONSIBILITIES SHALL APPLY TO CMC. SECRETARY OF CMC DESCRIPTION REMOVES CEO LANGUAGE ARTICLE EIGHT (g) REMOVAL OF CEO IN DESCRIPTION Form 990, Part VI, Line 6 Classes of members or stockholders LESTER E COX MEDICAL CENTERS SHALL HAVE ONE MEMBER WHICH SHALL BE COXHEALTH. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE SOLELY & SPECIFICALLY RESERVED TO THE MEMBER; (A) TO ESTABLISH AND CHANGE THE BUSINESS PURPOSES, MISSION, VISION OR VALUES OF CMC; (B) TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF CMC AS PROVIDED THEREIN; (C) TO APPROVE AMENDMENTS TO THE BYLAWS OF CMC; (D) TO APPROVE THE ADOPTION OF AND ANY REVISION TO THE CHARTERS FOR ALL COMMITTEES ESTABLISHED BY THE BOARD; (E) TO APPOINT AND REMOVE THE DIRECTORS OF CMC, SUBJECT TO THE REQUIREMENTS OF ARTICLE FIVE, SECTION 1 AND TO APPOINT AND REMOVE THE OFFICERS OF THE BOARD AND CMC; (F) AFTER CONSULTATION WITH THE BOARD, TO APPROVE THE APPOINTMENT AND REMOVAL OF THE PRESIDENT OF CMC; (G) TO APPOINT THE AUDITOR AND THE CORPORATE COUNSEL FOR CMC AND ITS CONTROLLED SUBSIDIARIES OR REMOTELY CONTROLLED SUBSIDIARIES; (H) TO ESTABLISH CENTRALIZED EMPLOYEE BENEFIT, INSURANCE, INVESTMENT, FINANCING, MARKETING, LEGAL, CORPORATE, COMPLIANCE, PERFORMANCE ASSESSMENT AND IMPROVEMENT AND OTHER OPERATIONAL AND SUPPORT PROGRAMS; TO REQUIRE THE PARTICIPATION OF CMC IN SUCH PROGRAMS; AND TO AUTHORIZE THE OPENING AND CLOSING OF BANK ACCOUNTS AND INVESTMENT ACCOUNTS IN THE NAME OF CMC; (I) TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF CMC OR THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF CMC; (J) TO APPROVE THE FORMATION OF A CONTROLLED SUBSIDIARY OR A REMOTELY SUBSIDIARY; (K) TO APPROVE THE ACQUISITION OR DISPOSITION BY CMC OF ANOTHER LEGAL ENTITY OR AN INTEREST IN ANOTHER LEGAL ENTITY; (L) AFTER RECEIVING INPUT FROM THE BOARD, TO APPROVE THE STRATEGIC PLAN AND THE OPERATING AND CAPITAL BUDGETS OF CMC; (M) APPROVAL OF CMC'S UNBUDGETED DEBT AND CAPITAL EXPENDITURES OF ONE HUNDRED THOUSAND DOLLARS ($100,000) OR GREATER; (N) TO AUTHORIZE OR APPROVE THE ACQUISITION OR DISPOSITION BY CMC OF REAL PROPERTY OR ANY INTEREST IN REAL PROPERTY HAVING A VALUE OF ONE HUNDRED THOUSAND DOLLARS ($100,000) OR GREATER; (O) TO APPROVE THE SALE OR PURCHASE OF ANY PROPERTY OF CMC HAVING A VALUE OF ONE HUNDRED THOUSAND DOLLARS ($100,000) OR GREATER; (P) TO AUTHORIZE AND APPROVE BORROWING MONEY OR ENTERING INTO FINANCIAL GUARANTIES BY CMC, INCLUDING ACTIONS RELATING TO THE FORMATION, JOINING, OPERATION, WITHDRAWAL FROM AND TERMINATION OF A CREDIT GROUP OR AN OBLIGATED GROUP AND THE GRANTING OF SECURITY INTERESTS IN THE PROPERTY OF CMC; (Q) TO REQUIRE CMC TO TRANSFER ASSETS, INCLUDING BUT NOT LIMITED TO CASH, TO THE MEMBER; (R) TO APPROVE THE TRANSFER OF ASSETS BY CMC TO ANY ENTITY OTHER THAN THE MEMBER, OTHER THAN TRANSFERS MADE IN THE ORDINARY COURSE OF OPERATIONS OF CMC WHICH WILL NOT REQUIRE APPROVAL OF THE MEMBER; (S) TO APPROVE THE RATE OF PAYMENT, COMPENSATION OR RENT AND/OR ANY PROVISIONS CONCERNING EXCLUSIVITY WITH RESPECT TO ANY CONTRACT FOR PHYSICIAN SERVICES AND ANY LEASE/TIMESHARE AGREEMENT BETWEEN ANY PHYSICIAN OR PHYSICIAN GROUP, ON THE ONE HAND, AND CMC OR ANY CONTROLLED SUBSIDIARY OR REMOTELY CONTROLLED SUBSIDIARY, ON THE OTHER HAND, ALL IN ACCORDANCE WITH SUCH POLICIES AND PROCESSES WHICH MAY BE PROMULGATED FROM TIME TO TIME BY THE MEMBER; (T) TO APPROVE CHANGES TO THE TYPE OF OR RELOCATION OF PHYSICIAN PROFESSIONAL MEDICAL SERVICES OFFERED BY CMC, WHERE THE CHANGE INVOLVES (A) SERVICES OFFERED OR PROVIDED BY CMG PHYSICIANS AND (B) (I) A CHANGE IN VENUE OR PROVIDER STATUS OF THE MEDICAL SERVICE, (II) THE CESSATION OF A PRE-EXISTING MEDICAL SERVICE, OR (III) THE OFFERING OF A NEW MEDICAL SERVICE; (U) TO ENGAGE, APPROVE, AND TO FINALIZE ANY AND ALL CONTRACTS OR AGREEMENTS WITH ANY THIRD PARTY HOSPITAL-BASED PHYSICIAN GROUPS (ANESTHESIOLOGISTS, PATHOLOGISTS, RADIOLOGISTS, OR EMERGENCY MEDICINE PHYSICIANS) THAT WILL RENDER PROFESSIONAL SERVICES TO CMC; (V) TO DETERMINE THE EXTENT TO WHICH AND THE MANNER IN WHICH THE POWERS DESCRIBED IN THIS SECTION WHICH ARE RESERVED TO THE MEMBER WITH RESPECT TO CMC ARE TO BE INCLUDED IN THE GOVERNING DOCUMENTS OF ANY CONTROLLED SUBSIDIARY OR REMOTELY CONTROLLED SUBSIDIARY AND EXERCISED WITH RESPECT TO ANY CONTROLLED SUBSIDIARY OR ANY REMOTELY CONTROLLED SUBSIDIARY. THE BOARD SHALL BE ELECTED BY THE MEMBER. PRIOR TO THE ANNUAL MEETING, THE BOARD SHALL NOMINATE A SLATE OF PERSONS FOR ELECTION AS CMC DIRECTORS AND OFFICERS TO SUBMIT TO COXHEALTH FOR APPOINTMENT. COXHEALTH WILL ACT IN GOOD FAITH AND NOT UNREASONABLY WITHHOLD APPOINTMENT. W) TO CONTRACT ON BEHALF OF CMC WITH RESPECT TO ANY MATTER THAT IMPACTS ONE OR MORE OF MEMBER'S SUBSIDIARIES OR WHERE MEMBER DETERMINES IN ITS DISCRETION THAT CONTRACTING ON BEHALF OF ITSELF AND SOME OR ALL OF ITS SUBSIDIARIES IS IN THE BEST INTEREST OF THE HEALTH SYSTEM. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders SUBJECT TO THE POWERS AND RESPONSIBILITIES RESERVED TO THE MEMBER PURSUANT TO THESE BYLAWS (INCLUDING WITHOUT LIMITATION IN ARTICLE TWO, SECTION 3) AND THE ARTICLES OF INCORPORATION, THE BOARD SHALL HAVE GENERAL CHARGE OF THE BUSINESS AND AFFAIRS OF CMC AND MAY DO AND PERFORM ALL ACTS NECESSARY TO CARRY OUT ITS PURPOSES AND, WHEN NOT OTHERWISE PROVIDED, IN SUCH WAY AS THE BOARD SHALL DEEM BEST. THE BOARD MAY PROVIDE FOR BUILDING, EQUIPPING AND FURNISHING ALL NECESSARY BUILDINGS. THE BOARD MAY BORROW MONEY AND PROVIDE FOR THE REPAYMENT OF SUCH AND FOR SECURING THE SAME BY DEED OF TRUST, OR OTHER LIEN, ON ANY PROPERTY OWNED BY CMC OR OTHERWISE, AND MAY PROVIDE FOR THE EXECUTION OF ALL NECESSARY OR PROPER INSTRUMENTS OF ANY KIND FOR THAT PURPOSE. THE BOARD MAY ACCEPT CONTRIBUTIONS OF EVERY KIND AND CONVEYANCES OF PROPERTY OF ALL KINDS TO CMC. THE BOARD MAY PROVIDE FOR PROCURING ALL NECESSARY OR PROPER FUNDS AND PROVIDE FOR ALL EXPENDITURES. THE ENUMERATION OF THE ABOVE POWERS OF THE BOARD SHALL NOT IN ANY WAY LIMIT ITS GENERAL POWERS, BUT SAID BOARD SHALL DO AND PERFORM ANY AND ALL ACTS DEEMED BY IT DESIRABLE TO CARRY OUT THE PURPOSES OF CMC AS EXPRESSED IN ITS ARTICLES OF INCORPORATION WITHOUT LIMITATION, EXCEPT AS MAY BE PROVIDED BY THESE BYLAWS. Form 990, Part VI, Line 11b Review of form 990 by governing body 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, FORM 990 IS FIRST REVIEWED BY MEMBERS OF TOP MANAGEMENT. ONCE THEY HAVE APPROVED THE DRAFT, A FINAL COPY IS PRESENTED TO THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. IN ADDITION, A FINAL COPY IS PROVIDED TO THE BOARD OF DIRECTORS THROUGH THE ONLINE BOARD PORTAL PRIOR TO FILING. Form 990, Part VI, Line 12c Conflict of interest policy COXHEALTH OFFICERS, DIRECTORS AND KEY EMPLOYEES, AS WELL AS OFFICERS, DIRECTORS AND KEY EMPLOYEES OF THE COXHEALTH AFFILIATES AND/OR COMMITTEES WITH DELEGATED AUTHORITY TO MAKE DECISIONS, ARE ANNUALLY REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST FOLLOWING THE POLICY, SET FORTH BELOW. THE POLICY REQUIRES THAT BOARD MEMBERS MAKE DECISIONS THAT ARE CONFLICT FREE, OR IF A CONFLICT IS PRESENT, THAT IT IS FULLY DISCLOSED FOR THE BOARD'S CONSIDERATION. COXHEALTH'S EMPLOYEES AND BOARD MEMBERS MUST AVOID ALL ACTIVITIES, ASSOCIATIONS OR INTERESTS THAT CREATE A CONFLICT OF INTEREST. CONFLICTS OF INTEREST FOR EMPLOYEES MUST BE REPORTED TO THE CORPORATE INTEGRITY DEPARTMENT. A FILE WILL BE MAINTAINED OF ALL REPORTED CONFLICTS OF INTEREST. FOR MEDICAL STAFF MEMBERS, THE CONFLICT OF INTEREST PROCESS MAY BE ACCESSED THROUGH THE MEDICAL STAFF OFFICE. FOR BOARD MEMBERS, THE CONFLICT OF INTEREST PROCESS IS HANDLED THROUGH THE GOVERNANCE SUB-COMMITTEE OF COXHEALTH WITH THE ASSISTANCE OF THE EXECUTIVE OFFICE AND IS DEFINED IN THE CHARTER OF THE GOVERNANCE SUB-COMMITTEE. IF ANY OFFICER OR DIRECTOR IS FOUND TO HAVE A CONFLICT OF INTEREST, SUCH PERSON SHALL NEITHER VOTE NOR USE HIS OR HER INFLUENCE TO AFFECT ANY DECISION RELATING TO THE CONFLICT, AND SUCH PERSON SHOULD NOT BE INCLUDED IN DETERMINING WHETHER A QUORUM PARTICIPATED IN THE DECISION. SUCH PERSON IS PERMITTED TO BRIEFLY STATE HIS OR HER POSITION ON THE MATTER, AND ANSWER PERTINENT QUESTIONS ABOUT IT, IF HIS OR HER KNOWLEDGE OR EXPERTISE COULD ASSIST THOSE PARTICIPATING IN THE DECISION. Form 990, Part VI, Line 15a Process to establish compensation of top management official COXHEALTH EMPLOYS A DEFINED GOVERNANCE STRUCTURE AROUND EXECUTIVE COMPENSATION. THE BOARD OF DIRECTORS MAINTAINS A COMPENSATION COMMITTEE THAT IS CHARGED WITH CARRYING OUT THE FUNCTIONS OF EVALUATING AND SETTING EXECUTIVE COMPENSATION THROUGH FORMAL DOCUMENTED MEETINGS THAT OCCUR SEVERAL TIMES DURING THE YEAR. THE COMPENSATION COMMITTEE UTILIZES A WELL RESPECTED INDEPENDENT EXTERNAL ADVISOR TO PROVIDE THIRD PARTY ASSESSMENT AND RECOMMENDATIONS REGARDING COMPENSATION LEVELS AND BENEFIT PROGRAMS FOR THE TOP EXECUTIVES OF THE ORGANIZATION TO ENSURE THE COMPENSATION PROGRAM IS COMPETITIVE AND WITHIN FAIR MARKET VALUE. AFTER A FULL REVIEW OF THE DATA AND THOROUGH DISCUSSION THE COMMITTEE MAKES A SELF DETERMINATION OF COMPENSATION LEVELS SET JANUARY 1 OF EACH YEAR. ANNUALLY THE STEPS NECESSARY TO DOCUMENT REBUTTABLE PRESUMPTION ARE TAKEN AND RECORDED. ADDITIONALLY, COMPENSATION LEVELS FOR THE VICE PRESIDENT TIER OF MANAGEMENT IS OVERSEEN BY THE CEO USING EXTERNAL COMPARABLE DATA FOR ASSESSMENT AND IS PROVIDED TO THE COMPENSATION COMMITTEE FOR REVIEW ON AN ANNUAL BASIS. Form 990, Part VI, Line 15b Process to establish compensation of other employees COMPENSATION LEVELS FOR THE VICE PRESIDENT TIER OF MANAGEMENT IS OVERSEEN BY THE CEO USING EXTERNAL COMPARABLE DATA FOR ASSESSMENT AND IS PROVIDED TO THE COMPENSATION COMMITTEE FOR REVIEW ON AN ANNUAL BASIS. Form 990, Part VI, Line 19 Required documents available to the public LESTER E. COX MEDICAL CENTERS MAKES AVAILABLE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE FOR ALL LEGITIMATE BUSINESS PURPOSES AS DETERMINED BY MANAGEMENT. IN ADDITION, AS A CONTINUING DISCLOSURE REQUIREMENT OF CERTAIN DEBT COVENANTS THE ORGANIZATION PROVIDES ITS AUDITED FINANCIAL STATEMENTS AND SPECIFIC QUARTERLY FINANCIAL INFORMATION TO DEFINED REPOSITORIES FOR REVIEW BY PARTIES OR INDIVIDUALS INTERESTED IN THE INFORMATION. Form 990, Part VIII, Line 2f Other Program Service Revenue - Total Revenue: 51760370, Related or Exempt Function Revenue: 51760370, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees PURCHASED AFFILIATE SERVICES - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 57481795, Fundraising Expenses: ; PHYSICAL REMUNERATION - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 41514598, Fundraising Expenses: ; CONTRACT LABOR - Total Expense: 14656122, Program Service Expense: 11318923, Management and General Expenses: 3337199, Fundraising Expenses: ; ANESTHESIA SERVICES - Total Expense: 12814235, Program Service Expense: 9896434, Management and General Expenses: 2917801, Fundraising Expenses: ; PURCHASED LAB SERVICES - Total Expense: 5995702, Program Service Expense: 4630481, Management and General Expenses: 1365221, Fundraising Expenses: ; OTHER PURCHASED SERVICES - Total Expense: 3846351, Program Service Expense: 3156171, Management and General Expenses: 674276, Fundraising Expenses: 15904; HOUSEKEEPING SERVICES - Total Expense: 3501067, Program Service Expense: 2703874, Management and General Expenses: 797193, Fundraising Expenses: ; MEDICAL DIRECTOR - Total Expense: 2952201, Program Service Expense: 2279985, Management and General Expenses: 672216, Fundraising Expenses: ; RADIOLOGY - Total Expense: 2756047, Program Service Expense: 2128495, Management and General Expenses: 627552, Fundraising Expenses: ; BILLING/COLLECTION SERVICES - Total Expense: 2359501, Program Service Expense: 1822243, Management and General Expenses: 537258, Fundraising Expenses: ; CONSULTING - Total Expense: 1147768, Program Service Expense: 886421, Management and General Expenses: 261347, Fundraising Expenses: ; SPECIAL SERVICES - Total Expense: 379218, Program Service Expense: 292870, Management and General Expenses: 86348, Fundraising Expenses: ; COURIER - Total Expense: 229104, Program Service Expense: 176937, Management and General Expenses: 52167, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances DEFINED BENEFIT PENSION PLAN LOSS & SETTLEMENT - 17936673; CHANGE IN BENEFICIAL INTEREST IN TRUST - 131672; CHANGE IN NET ASSETS OF SUBSIDIARIES - 5850232; TRANSFER TO AFFILIATE - -XXX-XX-XXXX; FERRELL DUNCAN CLINIC 1001 E PRIMROSE SPRINGFIELD MO 65807 542183221 PHYSICIANS MO 0 0 LESTER E COX OXFORD HEALTHCARE HOME HEALTH AGENCY 3550 S NATIONAL SPRINGFIELD MO 65807 770700975 HOME HEALTH MO 0 0 LESTER E COX REGIONAL SERVICES 3800 S NATIONAL SUITE 540 SPRINGFIELD MO 65807 542183222 HEALTHCARE MO 0 0 LESTER E COX OB GYN FERRELL DUNCAN CLINIC 1000 E PRIMROSE SPRINGFIELD MO 65807 431878984 PHYSICIANS MO 0 0 LESTER E COX COXHEALTH HOME SUPPORT SYSTEMS 2224 E SUNSET SPRINGFIELD MO 65807 542183216 HOME HEALTH MO 0 0 LESTER E COX SPRINGFIELD NEUROLOGICAL AND SPINE INSTI 2900 S NATIONAL AVE SPRINGFIELD MO 65807 274296628 PHYSICIANS MO 0 0 LESTER E COX FERRELL DUNCAN CLINIC BRANSON 251 SKAGGS ROAD BRANSON MO 65616 464039135 PHYSICIANS MO 0 0 LESTER E COX TRIPLE STARS PROPERTIES LLC 901 ST LOUIS STREET SUITE 600 SPRINGFIELD MO 65807 271117213 MANAGEMENT MO 0 0 LESTER E COX COXHEALTH INNOVATIONS LLC 3850 S NATIONAL SPRINGFIELD MO 65807 271117213 MANAGEMENT MO 0 0 LESTER E COX COXHEALTH FOUNDATION 3525 S NATIONAL SUITE 204 SPRINGFIELD MO 65807 436810485 FUNDRAISING MO 501(c)(3) Type I LESTER E COX true COX-MONETT HOSPITAL INC 801 N LINCOLN MONETT MO 65708 431656689 HOSPITAL MO 501(c)(3) 3 COX HEALTH false COX HPS OZARKS INC DBA COXHEALTH AT HOME 2220 W SUNSET SPRINGFIELD MO 65807 431641927 HOME HEALTH MO 501(c)(3) 10 COX HEALTH false PRIMROSE PLACE INC 1115 E PRIMROSE SPRINGFIELD MO 65807 431183783 SUPPORT MO 501(c)(3) Type I LESTER E COX true LESTER E COX MED CTRPROF LIAB LOSS FUND 1423 N JEFFERSON SPRINGFIELD MO 65802 366668576 SELF INSURANCE MO 501(c)(3) Type I LESTER E COX true HC SVCS OZARKS INC DBA COXHEALTH AT HOME PO BOX 10939 SPRINGFIELD MO 65808 431641928 HOME HEALTH MO 501(c)(3) 10 HPS OF OZARK true SKAGGS COMM HOSP ASSOC (COX MC BRANSON) 525 BRANSON LANDING BOULEVARD BRANSON MO 65616 440584290 HOSPITAL MO 501(c)(3) 3 COX HEALTH false COXHEALTH 1423 N JEFFERSON SPRINGFIELD MO 65802 471087427 HOLDING CO MO 501(c)(3) Type II NA false COX MEDICAL GROUP 1423 N JEFFERSON SPRINGFIELD MO 65802 471087566 PHYSICIANS MO 501(c)(3) Type I LESTER E COX true COXHEALTH SYSTMS HMO PO BOX 5750 SPRINGFIELD MO 65801 431757075 HMO MO 501(c)(4) LESTER E COX true COX BARTON COUNTY HOSPITAL 1423 N JEFFERSON SPRINGFIELD MO 65802 823300758 HOSPITAL MO 501(c)(3) 3 COXHEALTH false COX MEDICAL GROUP CLINICS 3801 S NATIONAL SPRINGFIELD MO 65807 371830627 HEALTHCARE MO 501(c)(3) 10 COXHEALTH false COX HEALTH SYSTEMS INSURANCE COMPANY PO BOX 5750 SPRINGFIELD MO 65801 431684044 INSURANCE MO 501(c)(4) LESTER E COX true MEDICAL DEVELOPMENTS INC 1423 N JEFFERSON SPRINGFIELD MO 65802 431622182 PHARMACY MO LESTER E XCOX C Corporation 1230388 0 1 true COX TAXABLE CLOSE CORPORATION 1423 N JEFFERSON AVE SPRINGFIELD MO 65802 472573263 MEDICAL CLINICS MO COX MED GROUP C Corporation 0 0 false FERRELL-DUNCAN CLINIC INC 1001 E PRIMROSE SPRINGFIELD MO 65808 430991578 PHYSICIANS MO CTCC C Corporation 0 0 false COXHEALTH RISK SOLUTIONS GRAND PAVILLION CORPORATE CENTRE KY GRAND CAYMAN CJ 1 CAPTIVE INSURANCE CJ LESTER E COX C Corporation 11235189 35928609 1 true false true true false false false false false false true true false false false false true true true true COXHEALTH FOUNDATION C 575028 COST COX HEALTH SYSTEM HMO INC P 4146563 COST COXHEALTH RISK SOLUTIONS P 12713959 COST COX HEALTH SYSTEM HMO INC Q 6839454 COST FERRAL DUNCAN CLINIC INC Q 145126927 COST COXHEALTH FOUNDATION S 755891 COST PRIMROSE PLACE S 2510308 COST MEDICAL DEVELOPMENTS S 557675 COST COX HEALTH SYSTEM HMO INC S 5380559 COST