LESTER E COX MEDICAL CENTER: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: LESTER E COX MEDICAL CENTER (EIN 44-0577118)
Tax period: 2018-10-01 to 2019-09-30
Filed: 2020-08-11
IRS object ID: 202002249349301880
Schema version: 2018v3.3
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-08-11T16:50:11-05:00	ReturnTs
Tax Period End	2019-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	910 E ST LOUIS 200/PO BOX 1190	AddressLine1Txt
City	SPRINGFIELD	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	658062523	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	440577118	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LESTER E COX MEDICAL CENTERS	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% JACOB M MCWAY	InCareOfNm
Business Name Control	LEST	BusinessNameControlTxt
Phone	4172693000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1423 N JEFFERSON ST	AddressLine1Txt
City	SPRINGFIELD	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	65802	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JAKE MCWAY	PersonNm
Person Title	EXECUTIVE VP & CFO	PersonTitleTxt
Phone	4172698811	PhoneNum
Signature	2020-08-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Brian D Todd	PreparerPersonNm
PTIN	P00422601	PTIN
Phone	4178658701	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	167.68.126.162	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	43032920202245000029	FederalOriginalSubmissionId
Federal Original Submission Id	2020-08-11	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	74C51B083D6172D3D43AC87F1A33B4712A418457	AtSubmissionCreationDeviceId
At Submission Filing Device Id	707D1959215E1734E70291BECA2AB3AECE192F1C	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-09-23 17:36:50Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	STEVE EDWARDS	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1423 N JEFFERSON ST	AddressLine1Txt
City	SPRINGFIELD	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	65802	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$1,515,303,916	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.COXHEALTH.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1923	FormationYr
Legal Domicile State	MO	LegalDomicileStateCd
Activity Or Mission	THE ORGANIZATION PROVIDES QUALITY HEALTH CARE, EDUCATION AND RESEARCH IN ORDER TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES.	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	11422	TotalEmployeeCnt
Total Volunteers	15	TotalVolunteersCnt
Total Gross UBI	$906,278	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$248,684	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$3,707,224	PYContributionsGrantsAmt
CY Contributions Grants	$4,177,936	CYContributionsGrantsAmt
PY Program Service Revenue	$1,198,109,827	PYProgramServiceRevenueAmt
CY Program Service Revenue	$1,195,207,493	CYProgramServiceRevenueAmt
PY Investment Income	$19,931,522	PYInvestmentIncomeAmt
CY Investment Income	$8,415,557	CYInvestmentIncomeAmt
PY Other Revenue	$17,836,092	PYOtherRevenueAmt
CY Other Revenue	$25,329,726	CYOtherRevenueAmt
PY Total Revenue	$1,239,584,665	PYTotalRevenueAmt
CY Total Revenue	$1,233,130,712	CYTotalRevenueAmt
PY Grants And Similar Paid	$1,188,060	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,673,310	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$438,017,467	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$473,182,944	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$796,788	CYTotalFundraisingExpenseAmt
PY Other Expenses	$735,504,839	PYOtherExpensesAmt
CY Other Expenses	$680,366,111	CYOtherExpensesAmt
PY Total Expenses	$1,174,710,366	PYTotalExpensesAmt
CY Total Expenses	$1,155,222,365	CYTotalExpensesAmt
PY Revenues Less Expenses	$64,874,299	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$77,908,347	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,621,399,974	TotalAssetsBOYAmt
Total Assets EOY	$1,753,434,894	TotalAssetsEOYAmt
Total Liabilities BOY	$711,853,525	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$803,578,470	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$909,546,449	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$949,856,424	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	MISSION: TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH QUALITY HEALTH CARE, EDUCATION AND RESEARCH.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$699,445,008	ExpenseAmt
Revenue	$942,656,136	RevenueAmt
Desc	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 $240,976,997 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.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$196,102,444	ExpenseAmt
Revenue	$203,092,124	RevenueAmt
Desc	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. THESE PATIENTS REPRESENT 36.9 PERCENT OF TOTAL PATIENTS SEEN IN THE CLINIC. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$30,498,094	ExpenseAmt
Revenue	$33,837,780	RevenueAmt
Desc	HOME CARE: LESTER E. COX MEDICAL CENTERS' HOME CARE SERVICES, HOSPICE AND DURABLE MEDICAL EQUIPMENT ARE PROVIDED BY COXHEALTH AT HOME. COXHEALTH AT HOME STRIVES TO MEET THE HOME CARE AND HOSPICE NEEDS FOR CLIENTS OF ALL AGES. THEIR SERVICES INCLUDE NURSING CARE, MEDICATION SUPERVISION, IV THERAPY, PERSONAL CARE, HOUSEKEEPING, LAUNDRY, MEAL PREPARATION, SHOPPING, ERRANDS, TRANSPORTATION, COMPANIONSHIP, TELEMONITORING AND LIFELINE PERSONAL EMERGENCY RESPONSE SYSTEM. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$20,408,302	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant	$1,673,310	TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue	$15,621,453	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$946,453,848	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	Yes (true)	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	Yes (true)	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	Yes (true)	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	Yes (true)	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	519	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	11422	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	Yes (true)	ForeignFinancialAccountInd
Foreign Country	CJ	ForeignCountryCd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (true)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (true)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	15	GoverningBodyVotingMembersCnt
Independent Voting Member	11	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	JACOB M MCWAY	PersonNm
Phone	4172698811	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3800 S NATIONAL	AddressLine1Txt
City	SPRINGFIELD	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	65807	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
CHARLES CHUCK CHALENDER
1ST VICE CHAIR	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
PATRICIA DIX MD
BOARD MEMBER	40.0	1.0	Yes (X)		$363,260	$0	$41,496
DENNIS HEIM
CHAIR OF THE BOARD	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
ROBERT MCDOWELL
BOARD MEMBER	1.0	1.0	Yes (X)		$0	$0	$0
JAN BAUMGARTNER
BOARD MEMBER	1.0	1.0	Yes (X)		$0	$0	$0
HAL HIGDON
3RD VICE CHAIR	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
JAMES HUTCHESON
BOARD MEMBER	1.0	1.0	Yes (X)		$0	$0	$0
BRIAN JARED
BOARD MEMBER	1.0	1.0	Yes (X)		$0	$0	$0
DAVID ZOLFAGHARI MD
BOARD MEMBER	1.0	40.0	Yes (X)		$0	$1,125,716	$16,320
ROBERT FULP
2ND VICE CHAIR OF THE BOARD	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
JANICE HARRIS
BOARD MEMBER	1.0	1.0	Yes (X)		$0	$0	$0
JOHN JACK PRIM
BOARD MEMBER	1.0	1.0	Yes (X)		$0	$0	$0
JOSEPH TURNER
BOARD MEMBER	1.0	1.0	Yes (X)		$0	$0	$0
IBRAHIM ABE ABDALLA MD
BOARD MEMBER	40.0	1.0	Yes (X)		$0	$983,315	$16,320
STACI NIEMOTH MD
BOARD MEMBER	1.0	40.0	Yes (X)		$0	$571,029	$16,320
STEVE EDWARDS
PRESIDENT AND CEO COXHEALTH	5.0	40.0		Yes (X)	$0	$1,501,873	$295,293
JACOB MCWAY
SR VP AND CFO COXHEALTH	5.0	40.0		Yes (X)	$0	$891,941	$168,179
VICKIE NELSON
SECRETARY TO THE BOARD	5.0	40.0		Yes (X)	$0	$65,580	$10,981
DAVID STRONG
VP HOSPITAL REVENUE & CFO CMCB	20.0	20.0			$179,197	$179,199	$58,885	Yes (X)
RON PRENGER
SR VP, CHIEF HOSPITAL OFFICER	40.0	0.0			$466,289	$0	$46,352	Yes (X)
GENICE MAROC
VP CLINICAL SERVICES	40.0	0.0			$218,559	$0	$15,338	Yes (X)
MAX BUETOW
VP REGIONAL SERVICES	40.0	0.0			$234,492	$0	$30,217	Yes (X)
JEFF HAWKINS
VP CLINICAL SERVICES	40.0	0.0			$192,346	$0	$17,781	Yes (X)
FRANK ROMERO
VP MEDICAL AFFAIRS	40.0	0.0			$437,331	$0	$30,400	Yes (X)
ROBERT FERGUSON
VP FERRELL DUNCAN CLINIC	40.0	0.0			$314,343	$0	$25,232	Yes (X)
KAREN KRAMER
VP, CHIEF NURSING OFFICER	40.0	0.0			$300,728	$0	$46,229	Yes (X)
AMANDA HEDGPETH
VP CLINICAL SERVICES	40.0	0.0			$188,271	$0	$17,303	Yes (X)
LOUIS KRENN MD
PHYSICIAN	40.0	0.0			$633,710	$0	$29,735		Yes (X)
ARMIN KAMYAB MD
PHYSICIAN	40.0	0.0			$1,127,346	$0	$39,688		Yes (X)
NAGIB CHOWDHURY MD
PHYSICIAN	40.0	0.0			$533,874	$0	$39,688		Yes (X)
GREGORY STAMPS MD
PHYSICIAN	40.0	0.0			$671,374	$0	$48,685		Yes (X)
ARJIT CHOWDHURY MD
PHYSICIAN	40.0	0.0			$593,202	$0	$29,735		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$6,454,322	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$5,318,653	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,040,177	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	531	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
SPRINGFIELD NEUROLOGICAL INSTITUTE
3801 S NATIONAL AVE	SPRINGFIELD	MO	65804	PHYS REMUNERATION	$16,688,149
OZARK ANESTHESIA ASSOCIATES
1000 E PRIMROSE ST 520	SPRINGFIELD	MO	65807	ANESTHESIA SERVICES	$9,680,954
360 DEGREE MEDICINE
108 SUNNY LANE	BRANSON WEST	MO	65737	PHYSICIAN SERVICES	$6,498,213
GE PRECISION HEALTHCARE LLC
PO BOX 843553	DALLAS	TX	75284	EQUIP MAINTENANCE	$5,102,564
FERRELL DUNCAN BUILDING CO
1001 E PRIMROSE AVE	SPRINGFIELD	MO	65737	RENTAL SPACE	$3,469,220

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	95	CntrctRcvdGreaterThan100KCnt
Membership Dues	$1,920	MembershipDuesAmt
Fundraising	$47,880	FundraisingAmt
Related Organizations	$2,769,003	RelatedOrganizationsAmt
All Other Contributions	$1,359,133	AllOtherContributionsAmt
Total Contributions	$4,177,936	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE	900099	$1,169,746,295	$1,169,746,295
NET PATIENT SERVICE - UNRELATED LAB	621500	$292,265		$292,265
NET PATIENT SERVICE - UNRELATED RETAIL DME	446199	$614,013		$614,013
CAFETERIA, MEALS & VENDING	722514	$5,551,998	$5,551,998
FITNESS CENTERS	713940	$3,092,747	$3,092,747

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$15,910,175	TotalRevenueColumnAmt
Related Or Exempt Func Income	$15,910,175	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$1,195,207,493	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,100,596	TotalRevenueColumnAmt
Exclusion	$11,100,596	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$48,278	TotalRevenueColumnAmt
Exclusion	$48,278	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$1,830,700	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$1,342,489	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$488,211	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$488,211	TotalRevenueColumnAmt
Exclusion	$488,211	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$277,739,077	SecuritiesAmt
Other	$65,322	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$280,125,393	SecuritiesAmt
Other	$412,323	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$2,386,316	SecuritiesAmt
Other	-$347,001	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$2,733,317	TotalRevenueColumnAmt
Exclusion	-$2,733,317	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$19,469	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$47,880	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$24,190	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$4,721	TotalRevenueColumnAmt
Exclusion	-$4,721	ExclusionAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$535,978	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$268,809	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$267,169	TotalRevenueColumnAmt
Exclusion	$267,169	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
GAIN ON INVESTMENT IN EQUITY INVESTEE	900099	$322,534	$322,534
CHANGE IN INTEREST IN NET ASSETS OF SUBS	900099	$25,104,615	$25,104,615
LOSS ON EXTINGUISHMENT OF DEBT	900099	-$848,082	-$848,082

Field	Value	IRS element (for citing)
Other Revenue Total	$24,579,067	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,233,130,712	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,194,301,215	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$906,278	UnrelatedBusinessRevenueAmt
Exclusion	$33,745,283	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$160,250	TotalAmt
Program Services	$160,250	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$1,513,060	TotalAmt
Program Services	$1,513,060	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$3,988,669	TotalAmt
Program Services	$2,663,103	ProgramServicesAmt
Management And General	$1,325,566	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$814,454	TotalAmt
Program Services	$455,514	ProgramServicesAmt
Management And General	$358,940	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$371,949,637	TotalAmt
Program Services	$275,088,011	ProgramServicesAmt
Management And General	$96,579,300	ManagementAndGeneralAmt
Fundraising	$282,326	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$19,026,702	TotalAmt
Program Services	$18,367,642	ProgramServicesAmt
Management And General	$652,721	ManagementAndGeneralAmt
Fundraising	$6,339	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$48,514,498	TotalAmt
Program Services	$46,721,634	ProgramServicesAmt
Management And General	$1,792,764	ManagementAndGeneralAmt
Fundraising	$100	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$28,888,984	TotalAmt
Program Services	$27,771,354	ProgramServicesAmt
Management And General	$1,099,793	ManagementAndGeneralAmt
Fundraising	$17,837	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$35,000	TotalAmt
Management And General	$35,000	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$299,359	TotalAmt
Management And General	$299,359	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$161,625	TotalAmt
Management And General	$161,625	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$1,134,635	TotalAmt
Management And General	$1,134,635	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$318,004,531	TotalAmt
Program Services	$235,156,205	ProgramServicesAmt
Management And General	$82,833,786	ManagementAndGeneralAmt
Fundraising	$14,540	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$174,254	TotalAmt
Program Services	$126,639	ProgramServicesAmt
Management And General	$44,695	ManagementAndGeneralAmt
Fundraising	$2,920	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$20,783,827	TotalAmt
Program Services	$15,255,169	ProgramServicesAmt
Management And General	$5,385,533	ManagementAndGeneralAmt
Fundraising	$143,125	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$6,774,999	TotalAmt
Program Services	$5,006,425	ProgramServicesAmt
Management And General	$1,766,954	ManagementAndGeneralAmt
Fundraising	$1,620	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$20,400,869	TotalAmt
Program Services	$16,045,832	ProgramServicesAmt
Management And General	$4,320,684	ManagementAndGeneralAmt
Fundraising	$34,353	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$2,191,959	TotalAmt
Program Services	$1,617,470	ProgramServicesAmt
Management And General	$570,865	ManagementAndGeneralAmt
Fundraising	$3,624	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$2,204,917	TotalAmt
Program Services	$1,623,220	ProgramServicesAmt
Management And General	$572,895	ManagementAndGeneralAmt
Fundraising	$8,802	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$17,622,962	TotalAmt
Program Services	$16,076,874	ProgramServicesAmt
Management And General	$1,546,088	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$38,397,602	TotalAmt
Program Services	$35,027,151	ProgramServicesAmt
Management And General	$3,368,507	ManagementAndGeneralAmt
Fundraising	$1,944	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$5,008,470	TotalAmt
Program Services	$3,701,923	ProgramServicesAmt
Management And General	$1,306,547	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES & DRUGS	$193,368,541	$193,368,541
STATE PROVIDER TAX	$44,145,756	$44,145,756
LICENSES, DUES, SUBSCRIPTIONS	$1,519,320	$1,122,979	$396,341
MISCELLANEOUS	$8,137,485	$5,439,096	$2,419,131	$279,258

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,155,222,365	TotalAmt
Program Services	$946,453,848	ProgramServicesAmt
Management And General	$207,971,729	ManagementAndGeneralAmt
Fundraising	$796,788	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$5,847,089	BOYAmt
EOY	$3,052,465	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$180,125,784	BOYAmt
EOY	$233,751,408	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$150,412,515	BOYAmt
EOY	$157,985,142	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$726,662	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$10,019,995	BOYAmt
EOY	$11,214,893	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$13,736,953	BOYAmt
EOY	$12,891,454	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$11,733,114	BOYAmt
EOY	$10,072,476	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$1,178,156,065	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$751,328,337	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$436,420,088	BOYAmt
EOY	$426,827,728	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$407,434,678	BOYAmt
EOY	$483,926,814	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$107,389,119	BOYAmt
EOY	$81,981,906	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$248,352,878	BOYAmt
EOY	$274,546,314	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$25,263,742	BOYAmt
EOY	$25,263,742	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$23,937,357	BOYAmt
EOY	$31,920,552	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,621,399,974	BOYAmt
EOY	$1,753,434,894	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$180,320,066	BOYAmt
EOY	$226,888,481	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$4,469,935	BOYAmt
EOY	$6,236,004	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$447,791,927	BOYAmt
EOY	$489,782,673	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$15,346,290	BOYAmt
EOY	$10,929,954	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$7,455,266	BOYAmt
EOY	$7,303,227	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$56,470,041	BOYAmt
EOY	$62,438,131	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$711,853,525	BOYAmt
EOY	$803,578,470	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$866,288,448	BOYAmt
EOY	$902,288,994	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$22,758,349	BOYAmt
EOY	$26,942,077	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$20,499,652	BOYAmt
EOY	$20,625,353	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$909,546,449	BOYAmt
EOY	$949,856,424	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,621,399,974	BOYAmt
EOY	$1,753,434,894	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$77,908,347	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$8,840,449	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$46,438,821	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	Yes (true)	DirectContactLegislatorsInd
Direct Contact Legislators	$116,024	DirectContactLegislatorsAmt
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$45,601	OtherActivitiesAmt
Total Lobbying Expenditures	$161,625	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE C, PART II-B, LINE 1G	DIRECT CONTACT WITH LEGISLATORS, ETC: THE ORGANIZATION CONTRACTED WINTON POLICY GROUP AND KELLER 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 1I	OTHER LOBBYING ACTIVITIES: MEMBERS OF THE ADMINISTRATIVE STAFF CONTACT LEGISLATORS REGARDING KEY HEALTHCARE ISSUES. ALSO, PORTIONS OF DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION (MHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA) ARE USED FOR LOBBYING PURPOSES. IN FISCAL YEAR 2019, THE AMOUNT ATTRIBUTABLE TO LOBBYING WAS $31,160 FOR MHA AND $14,441 FOR AHA.

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,225,941	BeginningYearBalanceAmt
Contributions	$394,384	ContributionsAmt
Investment Earnings Or Losses	$99,139	InvestmentEarningsOrLossesAmt
Other Expenditures	$404,311	OtherExpendituresAmt
End Year Balance	$4,315,153	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,044,690	BeginningYearBalanceAmt
Contributions	$418,547	ContributionsAmt
Investment Earnings Or Losses	$101,204	InvestmentEarningsOrLossesAmt
Other Expenditures	$338,500	OtherExpendituresAmt
End Year Balance	$4,225,941	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,820,777	BeginningYearBalanceAmt
Contributions	$426,535	ContributionsAmt
Investment Earnings Or Losses	$107,185	InvestmentEarningsOrLossesAmt
Other Expenditures	$309,807	OtherExpendituresAmt
End Year Balance	$4,044,690	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$5,111,030	BeginningYearBalanceAmt
Contributions	$653,117	ContributionsAmt
Investment Earnings Or Losses	$107,994	InvestmentEarningsOrLossesAmt
Other Expenditures	$2,051,364	OtherExpendituresAmt
End Year Balance	$3,820,777	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,800,435	BeginningYearBalanceAmt
Contributions	$486,859	ContributionsAmt
Investment Earnings Or Losses	$149,724	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$22,800	GrantsOrScholarshipsAmt
Other Expenditures	$303,188	OtherExpendituresAmt
End Year Balance	$5,111,030	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.45990	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.54010	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$27,397,064	OtherCostOrOtherBasisAmt
Book Value	$27,397,064	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$400,842,465	OtherCostOrOtherBasisAmt
Depreciation	$208,752,301	DepreciationAmt
Book Value	$192,090,164	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,770,006	OtherCostOrOtherBasisAmt
Depreciation	$4,252,114	DepreciationAmt
Book Value	$517,892	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$714,641,146	OtherCostOrOtherBasisAmt
Depreciation	$523,631,950	DepreciationAmt
Book Value	$191,009,196	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$30,505,384	OtherCostOrOtherBasisAmt
Depreciation	$14,691,972	DepreciationAmt
Book Value	$15,813,412	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$426,827,728	TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

Field	Value	IRS element (for citing)
Desc	INT IN NA OF TAX EXEMPT SUBS	Desc
Book Value	$274,546,314	BookValueAmt
Method Valuation	C	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Program Rltd	$274,546,314	TotalBookValueProgramRltdAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
COXHEALTH AUXILIARY LIABILITIES	$55,005
EST AMT DUE TO 3RD PARTIES	$6,751,073
DUE TO AFFILIATES	$18,467,000
SELF INSURANCE CLAIMS PAYABLE	$37,165,053

Field	Value	IRS element (for citing)
Total Liability	$62,438,131	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE D, PART V, LINE 4

INTENDED USE OF ENDOWMENTS: COXHEALTH FOUNDATION, A RELATED ORGANIZATION, HOLDS 19 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 1E, COLUMN C INCLUDES AN AMOUNT REPRESENTING THE BALANCE OF FUNDS THAT ARE HELD FOR THE BENEFIT OF COX COLLEGE, A RELATED ENTITY. THESE FUNDS WERE PREVIOUSLY HELD FOR THE BENEFIT OF LESTER E. COX MEDICAL CENTERS. IN FYE 9/30/16, COX COLLEGE WAS CREATED AND THESE FUNDS WERE DEEMED HELD FOR THE BENEFIT OF COX COLLEGE.

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 F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp (2 entries)

RegionRegionTxt	OfficesOfficesCnt	EmployeeEmployeeCnt	Type Of Activities ConductedTypeOfActivitiesConductedTxt	Specific Services ProvidedSpecificServicesProvidedTxt	Region Total ExpendituresRegionTotalExpendituresAmt
Central America and the Caribbean	0	1	Investments	CAPTIVE INSURANCE	$1,161,995
Central America and the Caribbean	0		Investments		$113,219,299

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	1	SubtotalEmployeesCnt
Total Office	0	TotalOfficeCnt
Total Employee	1	TotalEmployeeCnt
Subtotal Spent	$114,381,294	SubtotalSpentAmt
Total Spent	$114,381,294	TotalSpentAmt
Transfer To Foreign Corp	Yes (true)	TransferToForeignCorpInd
Interest In Foreign Trust	false	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (true)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	Yes (true)	PassiveForeignInvestmestCoInd
Foreign Partnership	false	ForeignPartnershipInd
Boycott Countries	false	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE F, PART I, LINE 3, COLUMN F	FormAndLineReferenceDesc
Explanation	ACCOUNTING METHOD: THE AMOUNT OF PROGRAM SERVICE EXPENDITURES REPORTED ON LINE 1 ARE REPORTED BASED ON THE AMOUNTS INCLUDED IN THE AUDITED FINANCIAL STATEMENTS OF THE INSURANCE COMPANY OF SPRINGFIELD, INC., THE CAPTIVE INSURANCE COMPANY. THESE AUDITED FINANCIAL STATEMENTS USED GENERALLY ACCEPTED ACCOUNTING PRINCIPLES ESTABLISHED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD.	ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	SCRAMBLE FOR MI	Event1Nm
Gross Receipts Event1	$46,706	GrossReceiptsEvent1Amt
Charitable Contri Event1	$31,911	CharitableContriEvent1Amt
Gross Revenue Event1	$14,795	GrossRevenueEvent1Amt
Cash Prizes Event1	$1,248	CashPrizesEvent1Amt
Rent Facility Costs Event1	$15,674	RentFacilityCostsEvent1Amt
Other Direct Expenses Event1	$557	OtherDirectExpensesEvent1Amt
Event2	WRAP IT UP	Event2Nm
Gross Receipts Event2	$20,643	GrossReceiptsEvent2Amt
Charitable Contri Event2	$15,969	CharitableContriEvent2Amt
Gross Revenue Event2	$4,674	GrossRevenueEvent2Amt
Rent Facility Costs Event2	$4,674	RentFacilityCostsEvent2Amt
Entertainment Event2	$300	EntertainmentEvent2Amt
Other Direct Expenses Event2	$1,737	OtherDirectExpensesEvent2Amt
Other Events Total	0	OtherEventsTotalCnt
Gross Receipts Total	$67,349	GrossReceiptsTotalAmt
Charitable Contributions Tot	$47,880	CharitableContributionsTotAmt
Gross Revenue Total Events	$19,469	GrossRevenueTotalEventsAmt
Cash Prizes Total Events	$1,248	CashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$20,348	RentFcltyCostsTotalEventsAmt
Entertainment Total Events	$300	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$2,294	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$24,190	DirectExpenseSummaryEventsAmt
Net Income Summary	-$4,721	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	false	FPGReferenceFreeCareInd
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$43,296,516	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$43,296,516	NetCommunityBenefitExpnsAmt
Total Expense	0.03750	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$159,807,372	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$140,552,948	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$19,254,424	NetCommunityBenefitExpnsAmt
Total Expense	0.01670	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$203,103,888	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$140,552,948	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$62,550,940	NetCommunityBenefitExpnsAmt
Total Expense	0.05420	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$135,406	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$135,406	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$22,392,815	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,986,397	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,406,418	NetCommunityBenefitExpnsAmt
Total Expense	0.00730	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,811,400	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,635,406	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,175,994	NetCommunityBenefitExpnsAmt
Total Expense	0.00360	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,046,727	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,046,727	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$35,386,348	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$20,621,803	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$14,764,545	NetCommunityBenefitExpnsAmt
Total Expense	0.01280	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$238,490,236	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$161,174,751	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$77,315,485	NetCommunityBenefitExpnsAmt
Total Expense	0.06700	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$91,301,578	BadDebtExpenseAmt
Bad Debt Expense Attributable	$14,151,745	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$389,781,583	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$509,256,732	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$119,475,149	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	3	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (3 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Childrens HospitalChildrensHospitalInd	Teaching HospitalTeachingHospitalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	Facility Reporting GroupFacilityReportingGroupCd
LESTER E COX MEDICAL CENTERS - SOUTH
1	3801 S NATIONAL AVE	SPRINGFIELD	MO	65807	WWW.COXHEALTH.COM	500	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	1
LESTER E COX MEDICAL CENTERS - NORTH
2	1423 N JEFFERSON ST	SPRINGFIELD	MO	65802	WWW.COXHEALTH.COM	500	Yes (X)			Yes (X)	Yes (X)	1
MEYER ORTHOPEDIC HOSPITAL
3	1000 E WALNUT LAWN	SPRINGFIELD	MO	65807	WWW.COXHEALTH.COM	500	Yes (X)			Yes (X)		1

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	FACILITY REPORTING GROUP #1	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	13	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	18	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	SEE PART V, SECTION C	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	18	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	0.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5	COMMUNITY INPUT: IN 2017, A VARIETY OF ORGANIZATIONS ACROSS THE OZARKS RECONVENED UNDER THE UMBRELLA OF THE OZARKS HEALTH COMMISSION TO ASSESS THE HEALTH NEEDS OF OUR REGION. BUILDING UPON THE SUCCESS OF THE 2016 REGIONAL HEALTH ASSESSMENT, PARTNERS AGAIN SOUGHT TO BETTER UNDERSTAND THE HEALTH STATUS, BEHAVIORS AND NEEDS OF THE POPULATIONS THEY SERVE. THIS 2019 ASSESSMENT COMBINES MORE THAN 140 HOSPITAL AND COMMUNITY DATA INDICATORS AS WELL AS FEEDBACK FROM STAKEHOLDERS AND THE BROADER COMMUNITY. THIS PROCESS RESULTED IN THREE PRIORITIES: LUNG DISEASE, CARDIOVASCULAR DISEASE AND MENTAL HEALTH. WEAVING AMONG THE ISSUES IDENTIFIED WERE FIVE COMMON THREADS: ACCESS TO HEALTH CARE, MENTAL HEALTH, PHYSICAL ACTIVITY, SOCIAL DETERMINANTS OF HEALTH AND TOBACCO USE. ADDITIONALLY, THE HEALTH STATUS OF POPULATIONS OF INTEREST - SUCH AS PEOPLE IN POVERTY, MINORITIES AND THE ELDERLY--WERE ALSO ANALYZED. RECOGNIZING THE VALUE OF ASSESSING AND ACTING TOGETHER ON LOCAL HEALTH ISSUES, KEY PLAYERS FROM LOCAL HOSPITAL SYSTEMS, PUBLIC HEALTH ENTITIES, AND OTHERS FORMED A WORKING GROUP TO BEGIN THE TASK OF A REGIONAL HEALTH ASSESSMENT. THIS GROUP GREW UNDER THE UMBRELLA OF THE LOCAL OZARKS HEALTH COMMISSION (OHC) AND PUBLISHED THE FIRST ASSESSMENTS IN 2016. SINCE THAT TIME, THE PROCESS HAS BEEN RECOGNIZED AT THE ANNUAL MEETING OF THE AMERICAN PUBLIC HEALTH ASSOCIATION, HONORED AS A PROMISING PRACTICE BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS, AND AWARDED THE GROUP MERIT AWARD FROM THE MISSOURI PUBLIC HEALTH ASSOCIATION. COLLECTIVELY, THE ASSESSMENTS SPAN FOUR STATES - MISSOURI, OKLAHOMA, ARKANSAS, AND KANSAS, 29 COUNTIES AND THREE HOSPITAL SYSTEMS. THIS FOOTPRINT WILL BE REFERRED TO THROUGHOUT THE REPORT AS THE OHC REGION. PRIORITIZATION PROCESS INCLUDED THE FOLLOWING STAKEHOLDERS: CITY OF SPRINGFIELD - PLANNING DEPARTMENT -COMMUNITY PARTNERSHIP OF THE OZARKS -COXHEALTH -DREW LEWIS FOUNDATION -MERCY -MISSOURI ALLIANCE OF YMCA -MISSOURI STATE UNIVERSITY -MISSOURI JOB CENTER -OZARKS FOOD HARVEST -OZARK GREENWAYS -SPRINGFIELD AREA CHAMBER OF COMMERCE -SPRINGFIELD-GREENE COUNTY HEALTH DEPARTMENT -SPRINGFIELD-GREENE COUNTY PARKS
SCHEDULE H, PART V, SECTION B, LINE 6A	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. 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	CHNA CONDUCTED WITH OTHER ORGANIZATIONS: THE CHNA WAS ALSO CONDUCTED WITH THE FOLLOWING OTHER NON-HOSPITAL ORGANIZATIONS: -JASPER COUNTY HEALTH DEPARTMENT -JOPLIN HEALTH DEPARTMENT -SPRINGFIELD-GREENE COUNTY HEALTH DEPARTMENT -TANEY COUNTY HEALTH DEPARTMENT
SCHEDULE H, PART V, SECTION B, LINE 7A	CHNA HOSPITAL FACILITY'S WEBSITE: HTTPS://WWW.COXHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/
SCHEDULE H, PART V, SECTION B, LINE 7B	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 7D	OTHER METHODS TO MAKE THE CHNA REPORT AVAILABLE TO THE PUBLIC: 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.
SCHEDULE H, PART V, SECTION B, LINE 10A	IMPLEMENTATION STRATEGY WEBSITE: HTTPS://WWW.COXHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/
SCHEDULE H, PART V, SECTION B, LINE 11	ADDRESSING IDENTIFIED NEEDS: 1. INCREASE PATIENT ENGAGEMENT IN CHRONIC CONDITION SELF-MANAGEMENT -THE CENTER FOR HEALTH IMPROVEMENT EMPLOYS A SKILLED TEAM OF HEALTHCARE PROFESSIONALS WHO DELIVER SUPPORT AND EDUCATION FOR CHRONIC DISEASE MANAGEMENT, MEDICAL NUTRITION THERAPY, AND ADVANCE CARE PLANNING. THEY PROVIDE TOOLS DESIGNED TO INCREASE SELF- MANAGEMENT OF CHRONIC CONDITIONS INCLUDING DIABETES, AUTOIMMUNE DISORDERS, METABOLIC SYNDROME, AND MORE. -IN THE FIRST QUARTER CALENDAR YEAR 2018, A CURRENT STATE ASSESSMENT OF THE CENTER FOR HEALTH IMPROVEMENT WAS CONDUCTED TO DETERMINE THE EFFICACY OF VARIOUS PROGRAMS. AS A RESULT OF THE ASSESSMENT, THE TEAM REFINED THE SCOPE OF OFFERINGS TO AN EVIDENCE-BASED, TARGETED PROGRAM SUITE THAT FOCUSES HEAVILY ON IMPROVING CHRONIC CONDITION MANAGEMENT OF PATIENTS. -IN ADDITION TO THE PROGRAMS ALREADY OFFERED, THE CENTER FOR HEALTH IMPROVEMENT ADDED A NEW SIX-WEEK, EVIDENCE-BASED COURSE FOCUSED ON CHRONIC PAIN CONDITIONS. -THE NURSING EDUCATION DEPARTMENT AND THE JOINT REPLACEMENT EDUCATORS AT MEYER ORTHOPEDIC CENTER DEVELOPED A PROCESS TO INCREASE TIGR VIDEO EDUCATION VIEWS. MANDATORY EDUCATION WAS EXPANDED TO INCLUDE ALL ADULT PATIENTS WITH A DIAGNOSIS OF PNEUMONIA, HEART FAILURE, ACUTE MI, TOTAL HIP/KNEE REPLACEMENT, OR COPD TO HELP ACHIEVE BEST OUTCOMES WHILE REDUCING READMISSIONS. -TIGR VIDEO VIEWS INCREASED FROM 4,694 VIEWS IN MAY 2018 TO 6,284 IN MAY 2019. 2. REDUCE AVOIDABLE HOSPITAL READMISSIONS - COXHEALTH NURSING ADMINISTRATION BEGAN TRAINING NURSES ON LIGHT DUTY TO COMPLETE PATIENT READMISSION INTERVIEW FORMS IN 2018. WHEN A PATIENT IS READMITTED WITHIN THIRTY DAYS, A CASE MANAGER MEETS WITH THE PATIENT TO DISCUSS THE READMISSION. TOPICS COVERED IN THE INTERVIEW INCLUDE: >FREQUENCY OF GOOD COMMUNICATION IN THE HOSPITAL REGARDING DIAGNOSIS AND MEDICATIONS. >COMMUNICATION ABOUT DISCHARGE INSTRUCTIONS AND ABILITY TO UNDERSTAND INSTRUCTIONS. >MEDICATION COMPLIANCE AND REASONS FOR ANY DIFFICULTY REMAINING COMPLIANT. >FOLLOW UP APPOINTMENTS WITH A PCP BEING SCHEDULED AND ATTENDED. >REASONS FOR READMISSION, FROM THE PATIENTS PERSPECTIVE. >>THE INFORMATION GATHERED BY THE CASE MANAGER COMES DIRECTLY FROM THE PATIENT AND IS ENTERED INTO REPORTABLE FIELDS THAT ALLOW FOR DATA COLLECTION. COMMON THEMES FOR AVOIDABLE READMISSIONS WILL BE EASIER TO IDENTIFY AND PREVENT THROUGH THIS PROCESS. -EVIDENCE-BASED BEST PRACTICES TO REDUCE AVOIDABLE READMISSIONS HAVE BEEN IMPLEMENTED AND CONTINUE TO EXPAND. >COXHEALTH HIRED TRANSITIONAL CARE PHARMACISTS WHO DEDICATE THEIR TIME WORKING WITH PATIENTS BEING DISCHARGED TO ENSURE THE PATIENT LEAVES THE HOSPITAL WITH THEIR MEDICATIONS. >NEW EFFORTS ARE IN PLACE TO INCREASE THE NUMBER OF PATIENTS WHO LEAVE THE HOSPITAL WITH THEIR MEDICATIONS THROUGH THE USE OF A FOCUSED, FAST-PACED I-90 PROJECT. >THE CLINIC SUPPORT TEAM HAS BEEN INSTRUMENTAL IN SCHEDULING FOLLOW-UP APPOINTMENTS WITH PATIENTS. THE MAJORITY OF INPATIENT UNITS ARE COVERED BY THE CLINIC SUPPORT TEAM, WHICH MEANS MOST PATIENTS HAVE A FOLLOW UP APPOINTMENT SCHEDULED PRIOR TO LEAVING THE HOSPITAL. >A SUBGROUP COMPRISED OF FRONTLINE STAFF, LEADERS, AND QUALITY IMPROVEMENT EXPERTS HAS BEEN FORMED TO FOCUS SPECIFICALLY ON REDUCING HEART FAILURE READMISSIONS. THE GROUP WILL USE DATA TO INFORM DECISIONS ON HOW TO BEST MANAGE OUR PATIENTS WITH FREQUENT INPATIENT STAYS DUE TO HEART FAILURE. 3. INCREASE ACCESS TO TOBACCO CESSATION RESOURCES FOR PATIENTS AND FAMILIES PRESENTING TO OUR HOSPITALS AND CLINICS -AN ASSET ASSESSMENT AND GAP ANALYSIS OF THE SYSTEMS TOBACCO TREATMENT OFFERINGS WAS CONDUCTED. RECOMMENDATIONS FROM THAT ASSESSMENT INCLUDED CREATION AND IMPLEMENTATION OF A CLEARLY OUTLINED REFERRAL PROCESS AND DEFINED RESOURCES AND PROMOTION OF THE ASK, ADVISE, ACT/REFER MODEL TO INITIATE INTERVENTION. -IN MAY 2018, WE PROVIDED TRAINING TO 12 KEY COXHEALTH STAFF MEMBERS AND 3 COMMUNITY EDUCATORS. COMPLETION OF THE UMASS MEDICAL SCHOOL EDUCATION CURRICULUM, REQUIRED EXAMS, AND PRACTICE HOURS MADE CLASS PARTICIPANTS ELIGIBLE FOR CERTIFICATION AS TOBACCO TREATMENT SPECIALISTS. AS A RESULT OF THIS EDUCATION, THE NUMBER OF CESSATION RESOURCES AVAILABLE WITHIN THE SYSTEM INCREASED. THE TRAINING WILL BE OFFERED AGAIN IN OCTOBER 2019 TO FURTHER INCREASE RESOURCES. -THE QUIT RATE FOR OUR TOBACCO CESSATION PROGRAM HAS CONTINUED TO SHOW POSITIVE RESULTS SINCE ITS INCEPTION IN 2013, WITH THE CURRENT QUIT RATE FOR 2019 TO DATE AT 64%. AVERAGING ACROSS THE HISTORY OF THE PROGRAM, THE AGGREGATED QUIT RATE IS 55%. -DUE TO THE SUCCESS OF THIS PROGRAM, FOLLOWING THE STONE AND TANEY COUNTY MFH TOBACCO GRANTS END ON MAY 31, 2018, WE WERE ABLE TO HIRE A FULL TIME TOBACCO CESSATION COORDINATOR WHO IS RESPONSIBLE FOR COORDINATING SYSTEM EFFORTS TO STANDARDIZE POLICIES AND REFERRAL PROCESSES ACROSS ALL CAMPUSES AND SETTINGS. 4. DECREASE CHILDHOOD OBESITY -THE CARDIAC KIDS PROGRAM IS IMPLEMENTED IN 13 RURAL SCHOOLS IN THE COXHEALTH SERVICE AREA. ITS MAIN OBJECTIVE IS TO SCREEN 5TH GRADE STUDENTS FOR HEALTH INDICATORS THAT PUT THEM AT HIGH RISK FOR DEVELOPING CARDIAC DISEASE. SCREENING BY COXHEALTH STAFF INCLUDES HEIGHT AND WEIGHT MEASUREMENT, BMI CONSULT, AND HEALTH/NUTRITION EDUCATION. -APPROXIMATELY 400 CHILDREN ARE SCREENED ANNUALLY. THOSE WHO ARE DEEMED HIGH RISK ARE REFERRED TO THE COMMITTED TO KIDS PROGRAM. THIS 8-WEEK PROGRAM IS AN INTENSIVE INTERVENTION FOR AT-RISK CHILDREN AND THEIR FAMILIES FOCUSING ON HEATHY BEHAVIOR AND NUTRITION EDUCATION. 5. INCREASE THE NUMBER OF WOMEN WHO BREASTFEED THEIR INFANTS AFTER DELIVERY -COXHEALTH AND THE SPRINGFIELD-GREENE COUNTY HEALTH DEPARTMENT ARE CURRENTLY ENGAGED IN A COMMUNITY BREASTFEEDING COALITION WITH THE GOAL OF STRATEGICALLY ALIGNING EFFORTS TO HELP MOVE THE CHIP INITIATIVE FORWARD. -IN ADDITION TO EDUCATION PRESENTED IN OUR GENERAL PRENATAL CLASSES, THE COXHEALTH LACTATION CONSULTANTS FACILITATE A MONTHLY BREAST FEEDING SUPPORT GROUP CALLED THE LACTATION CLUB. -THE ANNUAL COXHEALTH BABY FAIR IS A FREE EVENT THAT FEATURES VENDOR DISPLAYS, DEMONSTRATIONS, DOOR PRIZES, AND CLASSES WITH A VARIETY OF TOPICS INCLUDING BREASTFEEDING. 6. INCREASE DETECTION AND TREATMENT OF THE EARLIEST STAGES OF LUNG CANCER NODULES -COXHEALTH OFFERS LOW-DOSE CT SCANS AS A DIAGNOSTIC SCREENING FOR LUNG CANCER. LOW-DOSE CT SCANS USE LOWER AMOUNTS OF RADIATION TO HELP IDENTIFY LUNG NODULES IN THE EARLIEST STAGES OF LUNG CANCER WHEN IT IS MOST TREATABLE. STUDIES HAVE SHOWN THAT PATIENTS WHO PARTICIPATE IN A LOW-DOSE CT LUNG CANCER PROGRAM ARE 20% LESS LIKELY TO DIE FROM LUNG CANCER THAN THOSE WHO WERE NOT SCREENED WHEN APPROPRIATE. -SINCE THE PROGRAM BEGAN, THE NUMBER OF INDIVIDUALS WHO HAD A LOW-DOSE CT SCAN COMPLETED HAS CONTINUED TO INCREASE. 7. INCREASE REFERRALS TO COMMUNITY ORAL HEALTH RESOURCES FOR PATIENTS PRESENTING TO THE ED FOR DENTAL ISSUES -COMMUNITY PARTNERSHIPS WITH LOCAL RESOURCES HAVE BEEN STRENGTHENED AND REFINED TO ENSURE STAFF FEEL EMPOWERED TO REFER PATIENTS TO FACILITIES LIKE THE JORDAN VALLEY COMMUNITY HEALTH CENTER (JVCHC) FOR THE APPROPRIATE LEVEL OF CARE FOR ORAL HEALTH ISSUES. -WHEN EVALUATING THE CHIEF COMPLAINTS OF PATIENTS THAT PRESENTED TO THE EMERGENCY DEPARTMENT (ED) FIVE OR MORE TIMES IN A 12-MONTH PERIOD FOR NON-EMERGENT CARE, DENTAL COMPLAINTS RANKED AMONG THE HIGHEST. -PROTOCOLS WERE DEVELOPED FOR PATIENTS THAT PRESENT WITH TOOTH PAIN IN THE ED. AFTER THE MEDICAL SCREENING EXAM COMPLETION, THE PATIENT IS TRANSITIONED TO JVCHC FOR IMMEDIATE DENTAL CARE. -COXHEALTH WORKED IN COLLABORATION WITH JVCHC TO APPLY FOR A GRANT THAT ALLOWED FOR THE HIRE OF ADDITIONAL DENTISTS. TO ENSURE SAME-DAY OR NEXT DAY APPOINTMENTS, THE DENTAL CLINIC EXPANDED TO ADD SATURDAY HOURS. -QUICK ACCESS TO THE DENTAL CLINIC ALLOWED COXHEALTH ED PHYSICIANS TO DISCONTINUE PRESCRIBING NARCOTICS TO PATIENTS WHO PRESENTED WITH TOOTH PAIN.
SCHEDULE H, PART V, SECTION B, LINE 13A	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 V, SECTION B, LINE 13H	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 16A	FINANCIAL ASSISTANCE POLICY WEBSITE: HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/
SCHEDULE H, PART V, SECTION B, LINE 16B	FINANCIAL ASSISTANCE POLICY APPLICATION WEBSITE: HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/
SCHEDULE H, PART V, SECTION B, LINE 16C	PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.COXHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/
SCHEDULE H, PART V, SECTION B, LINE 16J	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.

Field	Value	IRS element (for citing)
Facility	77	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (77 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
SPRINGFIELD INPATIENT PHYSICIANS
3801 S NATIONAL AVE 5TH FL	SPRINGFIELD	MO	65807	MEDICAL OFFICES
ADULT MEDICINE AND ENDOCRINOLOGY SPECLST
960 E WALNUT LAWN SUITE 201	SPRINGFIELD	MO	65807	CLINIC
FAMILY MEDICAL CARE CENTER
1423 N JEFFERSON ST B-100	SPRINGFIELD	MO	65802	CLINIC
PHYSICIANS FOR WOMEN
3850 S NATIONAL AVE 400	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH CENTER STEEPLECHASE
1530 E REPUBLIC RD	SPRINGFIELD	MO	65804	CLINIC
PEDIATRIC CENTER
3443 S NATIONAL AVE	SPRINGFIELD	MO	65807	CLINIC
REGIONAL PERINATAL CENTER
1000 E PRIMROSE 360	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH CENTER NIXA
411 N MCCROSKEY	NIXA	MO	65714	CLINIC
NORTHSIDE PEDIATRICS AND ADOLESCENTS
1443 N ROBBERSON 200	SPRINGFIELD	MO	65802	CLINIC
COXHEALTH NEWBORN MEDICINE SPECIALISTS
3801 S NATIONAL AVE	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH CENTER WILLOW SPRINGS
816 E MAIN	WILLOW SPRINGS	MO	65793	CLINIC
SUN RIVER ORTHOPAEDICS
3800 S NATIONAL AVE 700	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH CENTER ELFINDALE
1429 W SUNSHINE	SPRINGFIELD	MO	65807	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 STE B	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH CENTER WILLARD
304 E JACKSON 5H	WILLARD	MO	65781	CLINIC
COXHEALTH CENTER MOUNTAIN GROVE
1602-A N MAIN ST	MOUNTAIN GROVE	MO	65711	CLINIC
COX SENIOR HEALTH CENTER
1423 N JEFFERSON ST	SPRINGFIELD	MO	65802	CLINIC
COX SENIOR HEALTH CENTER SOUTH
3525 S NATIONAL 207	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH CENTER MARSHFIELD
1245 BANNING ST	MARSHFIELD	MO	65706	CLINIC
COXHEALTH CENTER OZARK
5548 N FARMER BRANCH RD	OZARK	MO	65721	CLINIC
COXHEALTH CENTER REPUBLIC
820 ILLINOIS AVE	REPUBLIC	MO	65738	CLINIC
COXHEALTH SURGERY MONETT
801 N LINCOLN	MONETT	MO	65708	CLINIC
COXHEALTH CENTER AVA
806 SW COLLINS AVE	AVA	MO	65608	CLINIC
COXHEALTH INPATIENT PSYCHIATRY
1423 N JEFFERSON ST	SPRINGFIELD	MO	65802	CLINIC
COXHEALTH CENTER BUFFALO
119 N ASH	BUFFALO	MO	65622	CLINIC
COXHEALTH CENTER ROGERSVILLE
151 JOHNSTOWN DR	ROGERSVILLE	MO	65742	CLINIC
COXHEALTH CENTER FOR ADDICTIONS
1423 N JEFFERSON ST	SPRINGFIELD	MO	65802	CLINIC
THE CLINIC AT WALMART #0444
3315 S CAMPBELL	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH PEDIATRIC SPECIALTIES TURNER
1000 E PRIMROSE 200	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH CENTER SEYMOUR
202 COMMERCIAL	SEYMOUR	MO	65746	CLINIC
THE CLINIC AT WALMART #0379
2004 W MARLER LANE	OZARK	MO	65721	CLINIC
THE CLINIC AT WALMART #2221
2021 E INDEPENDENCE	SPRINGFIELD	MO	65804	CLINIC
THE CLINIC AT WALMART #1009
1150 US HWY 60 EAST	REPUBLIC	MO	65738	CLINIC
COXHEALTH CENTER CAMPBELL
2750 S CAMPBELL	SPRINGFIELD	MO	65807	CLINIC
PEDIATRIC HOSPITAL AFFILIATES
3801 S NATIONAL AVE 7TH FL	SPRINGFIELD	MO	65807	CLINIC
SPRINGFIELD NEUROLOGICAL AND SPINE
3801 S NATIONAL	SPRINGFIELD	MO	65804	CLINIC
COXHEALTH PSYCHOLOGICAL SERVICES
3800 S NATIONAL 770	SPRINGFIELD	MO	65807	CLINIC
MARTIN CENTER
3901 S FREMONT	SPRINGFIELD	MO	65807	CLINIC
OZARK HEALTH VENTURES
3550 S NATIONAL AVE	SPRINGFIELD	MO	65807	CLINIC
BONE AND JOINT CENTER
3555 S NATIONAL AVE	SPRINGFIELD	MO	65807	CLINIC
FERRELL-DUNCAN CLINIC
1000 E PRIMROSE	SPRINGFIELD	MO	65807	MEDICAL OFFICES
MEYER CENTER FITNESS AND REHAB
3545 S NATIONAL AVE	SPRINGFIELD	MO	65807	FITNESS AND REHAB CENTER
COX HYPERBARIC MEDICINE AND WOUND CARE
3525 S NATIONAL AVE 101	SPRINGFIELD	MO	65807	CLINIC
MEDICAL OFFICE BUILDING-COX WALNUT LAWN
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
COXHEALTH INFECTIOUS DISEASES SPECIALTY
3800 S NATIONAL LL100	SPRINGFIELD	MO	65807	CLINIC
COX CARE MOBILE
3525 S NATIONAL AVE 105	SPRINGFIELD	MO	65807	CLINIC
THE CLINIC AT WALMART #86
2825 N KANSAS EXPWAY	SPRINGFIELD	MO	65803	CLINIC
SENIOR ADVANTAGE
1000 E WALNUT LAWN	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH SPECIALTY CLINIC
1001 E PRIMROSE STREET	SPRINGFIELD	MO	65807	CLINIC
PANTHER CLINIC OPERATED BY COXHEALTH
900 N BENTON AVENUE	SPRINGFIELD	MO	65802	CLINIC
COXHEALTH ADULT & PEDIATRIC URGENT CARE
1000 E PRIMROSE	SPRINGFIELD	MO	65807	URGENT CARE CLINIC
COXHEALTH VIRTUAL VISITS
1423 N JEFFERSON	SPRINGFIELD	MO	65802	CLINIC
COXHEALTH NEUROPSYCHOLOGY
3801 S NATIONAL AVE SUITE 900	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH OCCUPATIONAL MEDICINE
1499 N ROBBERSON	SPRINGFIELD	MO	65802	CLINIC
COXHEALTH PEDIATRIC PLACE
3800 S NATIONAL AVE SUITE 730	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH PEDIATRIC SURGICAL SPECIALTIES
1000 E PRIMROSE SUITE 300	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH PRIMROSE OBGYN
1000 E PRIMROSE SUITE 270	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH QUICK CARE HYVEE
1720 W BATTLEFIELD	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH SKIN CARE
1925 CHESTERFIELD BLVD	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH WELCOME CLINIC
2900 S NATIONAL BLDG A	SPRINGFIELD	MO	65804	CLINIC
COXHEALTH CENTER OZARK
5548 N FARNER BRANCH RD	OZARK	MO	65721	CLINIC
PALLIATIVE CARE
3801 S NATIONAL AVE	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH OZARK PEDIATRICS
1741 SOUTH 15TH ST	OZARK	MO	65721	CLINIC
COXHEALTH MEDICAL MILE CLINIC
2900 S NATIONAL AVE	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH CENTER SOUTHERN HILLS
2702 E SUNSHINE	SPRINGFIELD	MO	65804	CLINIC
COXHEALTH CONSULTING SERV AND AVIATION M
3555 S NATIONAL AVE SUITE 104	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH INTEGRATED BEHAVIORAL HEALTHCA
3800 S NATIONAL LL100	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH OBSTETRICS AND GYNECOLOGY
3525 S NATIONAL AVE 210	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH PEDIATRIC SPECIALTIES MED SOUT
3525 S NATIONAL AVE SUITE 210	SPRINGFIELD	MO	65807	CLINIC
GLYCEMIC MANAGEMENT SERVICES
3801 S NATIONAL AVE	SPRINGFIELD	MO	65807	CLINIC
COXHEALTH CENTER BRANSON
890 HWY 248	BRANSON	MO	65616	CLINIC

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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, COLUMN F	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 $4,175,994. 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 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 III, SECTION A, LINE 2	BAD DEBT EXPENSE: 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, 2019. 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, SECTION A, LINE 3	BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: 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 2014-2018, APPROXIMATELY 15.5 PERCENT OF GREENE COUNTY WAS CONSIDERED TO LIVE IN POVERTY.
SCHEDULE H, PART III, SECTION A, LINE 4	BAD DEBT EXPENSE FOOTNOTE: THE AUDIT FOOTNOTE ADDRESSING BAD DEBT EXPENSE AND PATIENT ACCOUNTS RECEIVABLE IS FOUND ON PAGE 11 OF THE AUDITED FINANCIAL STATEMENTS UNDER NOTE 1, SUBTITLED "PATIENT ACCOUNTS RECEIVABLE."
SCHEDULE H, PART III, SECTION B, LINE 8	COMMUNITY BENEFIT: 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, SECTION C, LINE 9B	COLLECTION POLICY: 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 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 EARLY 2016. A PUBLIC PERCEPTION STUDY OF AREA HEADS OF HOUSEHOLDS IS CONDUCTED ANNUALLY. THE MOST RECENT STUDY SURVEYED 876 HOUSEHOLDS IN OUR SERVICE AREA TO DETERMINE WHAT SERVICES ARE NEEDED. WE ALSO PERFORM A PUBLIC HEALTH SURVEY, WHICH ASKS COMMUNITY LEADERS AND HEALTH PROFESSIONALS WHAT THEIR PRIORITIES ARE AND WHAT HEALTH SERVICES ARE LACKING IN THEIR COMMUNITY. THE PUBLIC HEALTH SURVEY IS SENT TO COUNTY PUBLIC HEALTH DEPARTMENTS, LOCAL AGENCIES, REGIONAL SERVICES CLINICS, MENTAL HEALTH FACILITIES, AND PUBLIC SCHOOLS THROUGHOUT THE TOTAL SERVICE AREA. LESTER E. COX MEDICAL CENTERS REFERENCES UNITED HEALTH FOUNDATION STATE-BY-STATE HEALTH RANKINGS AS WELL AS ROBERT WOOD JOHNSON AND UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE COUNTY HEALTH RANK FOR HEALTH OUTCOMES AND HEALTH FACTORS. COXHEALTH ALSO REFERENCES "ASSESSING THE HEALTH OF THE COMMUNITY", WHICH IS AN ANALYSIS OF BEHAVIORS AND OUTCOMES FOR THE SPECIFIC COUNTIES OF THE SERVICE AREA BY THE MISSOURI HOSPITAL ASSOCIATION. DEMOGRAPHIC AND ECONOMIC ANALYSIS IS PERFORMED FOR THE 22-COUNTY SERVICE AREA. NIELSEN CLARITAS DEMOGRAPHIC ESTIMATES AND PROJECTIONS ARE USED TO EVALUATE THE CHANGE IN POPULATION CHARACTERISTICS. UNEMPLOYMENT, HOME FORECLOSURE, AND INPATIENT PAYER DATA IS ALSO ASSESSED. IN 2016, COXHEALTH PERFORMED A COMMUNITY HEALTH NEEDS ASSESSMENT AS PART OF A COLLABORATIVE EFFORT, CONSISTING OF A VARIETY OF ORGANIZATIONS ACROSS THE OZARKS, TO BETTER UNDERSTAND THE HEALTH STATUS, BEHAVIORS, AND NEEDS OF THE POPULATIONS WE SERVE. UNDER THE UMBRELLA OF THE LOCAL OZARKS HEALTH COMMISSION, THIS FIRST-TIME COLLABORATION WAS THE LARGEST IN THE REGION SPANNING FOUR STATES-MISSOURI, OKLAHOMA, ARKANSAS AND KANSAS-29 COUNTIES AND THREE HOSPITAL SYSTEMS. THE WORKING GROUP SAW THE VALUE OF USING A SYSTEMATIC, DATA-DRIVEN ASSESSMENT TO INFORM DECISIONS AND GUIDE EFFORTS TO IMPROVE COMMUNITY HEALTH AND WELLNESS ON A REGIONAL LEVEL. THIS LARGER, CONCERTED APPROACH WILL LEVERAGE COMMON STRENGTHS AND STRATEGIES TO MOVE IN THE SAME DIRECTION ON SIGNIFICANT HEALTH CONCERNS. THE 2019 ASSESSMENT PROCESS BUILDS ON THE METHODOLOGY DEVELOPED DURING THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT. IT INCLUDES MORE THAN 140 HOSPITAL AND COMMUNITY DATA INDICATORS. THIS DATA WAS COMPARED TO THE NATION AND PAST PERFORMANCE AND USED TO IDENTIFY THE SIX ASSESSED HEALTH ISSUES (AHI): CANCER, LUNG DISEASE, CARDIOVASCULAR DISEASE, MENTAL HEALTH, DIABETES, AND ORAL HEALTH. LOCAL STAKEHOLDERS UTILIZED A COMBINATION OF PUBLIC HEALTH AND HOSPITAL DATA, ALONG WITH A COMMUNITY SURVEY DATA, TO PRIORITIZE THE AHI BASED ON FEASIBILITY AND COMMUNITY READINESS. THIS PRIORITIZATION PROCESS RESULTED IN THREE PRIORITIES FOR THE SPRINGFIELD COMMUNITY: LUNG DISEASE, CARDIOVASCULAR DISEASE AND MENTAL HEALTH. ALTHOUGH OTHER AHI WERE IDENTIFIED AS HEALTH ISSUES FOR THE SPRINGFIELD COMMUNITY, RESOURCES WOULD BE DILUTED IN AN EFFORT TO ADDRESS SEVERAL HEALTH ISSUES, THUS MINIMIZING THE ABILITY TO CREATE MEANINGFUL IMPACT. BY PRIORITIZING THE AHI BY FEASIBILITY AND COMMUNITY READINESS, THE COMMUNITY WILL BE ABLE TO HAVE A GREATER IMPACT ON OVERALL COMMUNITY HEALTH THROUGH EFFICIENT AND EFFECTIVE RESOURCE ALLOCATION.
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 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. TO COMPLETE THE TRANSACTION, COXHEALTH FORMED TWO ENTITIES, COX BARTON COUNTY HOSPITAL, A MISSOURI NONPROFIT CORPORTATION, AND CBCH, LLC, A MISSOURI LIMITED LIABILITY COMPANY. BOTH ENTITIES HAVE THE SAME CORPORATE PARENT, COXHEALTH, WHICH IS A MISSOURI NONPROFIT CORPORATION. THE OPERATION AND ASSETS OF THE HOSPITAL HAVE BEEN HELD BY CBCH, LLC SINCE JANUARY 1, 2018 AND WILL BE TRANSFERRED TO COX BARTON COUNTY HOSPITAL EFFECTIVE OCTOBER 1, 2019.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
MHA CENTER FOR EDUCATION
PO BOX 60	JEFFERSON CITY	MO	65102	430898947	501(C)(3)	$93,312	COMM BENEFIT
COXHEALTH
COXHEALTH	SPRINGFIELD	MO	65802	471087427	501(C)(3)	$47,599	COMM BENEFIT
COXHEALTH FOUNDATION
3525 S NATIONAL STE 204	SPRINGFIELD	MO	65807	436810485	501(C)(3)	$9,693	COMM BENEFIT

Field	Value	IRS element (for citing)
Total501c3 Org	3	Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (7 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt
CHILDREN'S MIRACLE NETWORK -SPECIAL NEEDS GRANT	2341	$188,223
CHILDREN'S MIRACLE NETWORK -FAMILY CARE GRANTS	78	$182,675
CHILDREN'S MIRACLE NETWORK -COMMUNITY OUTREACH GRA	38063	$59,610
CHILDREN'S MIRACLE NETWORK -LESTER E COX MC GRANTS	63524	$525,581
CHILDREN'S MIRACLE NETWORK -OTHER GRANTS	18912	$434,902
TUITION ASSISTANCE PROGRAMS	10	$97,710
CAR SEAT/SLEEP SACK	3729	$24,359

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S.: 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 2019, NEARLY 123,000 CHILDREN WERE SERVED: SPECIAL NEEDS FUND - $188,223 - DIRECT FINANCIAL ASSISTANCE TO FAMILIES, WHICH INCLUDES: KIDS CHECKS - $90,639 MEAL TRAYS - $61,072 MEAL VOUCHERS - $3,872 GIFT CARDS - $32,640 FAMILY CARE GRANTS - $182,675 - DIRECT FINANCIAL ASSISTANCE TO FAMILIES, WHICH INCLUDES: SPEECH, OCCUPATIONAL AND PHYSICAL THERAPY BILLS, HOSPITAL BILLS, ETC. COMMUNITY GUARANTEED GRANTS - $59,610 TOTAL CARDIAC PROGRAM (A PORTION TO COX- MONETT HOSPITAL, INC.) - $26,610 "NEVER SHAKE A BABY" PROGRAM - $15,000 BICYCLE SAFETY PROGRAM - $ 7,000 WASTED PROGRAM - $3,000 WATER SAFETY PROGRAM - $2,000 CAR SEAT SAFETY PROGRAM - $6,000 LESTER E. COX MEDICAL CENTERS GUARANTEED GRANTS - $525,581 TOTAL CHILD LIFE PROGRAM - $147,210 C.A.R.E. MOBILE - $378,371 DISCRETIONARY AND OPEN FUNDS - $434,902 - 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: SURGICAL SERVICES - $22,109 MONETT L & D - $15,167 LABOR & DELIVERY - $41,187 RESPIRATORY CARE - $77,332 PEDIATRICS/PICU - $4,982 BRANSON PEDIATRICS - $20,605 BRANSON MATERNITY - $15,977 BRANSON THERAPY SERVICES - $5,000 CHILD/ADOLESCENT PSYCH - $22,495 WOMEN/NEWBORN - $20,521 CASE MANAGEMENT - $5,998 OP NEURO-THERAPY - $7,690 ACUTE CARE THERAPY - $21,900 REHAB THERAPY MORH - $5,203 LABORATORY SERVICES - $4,962 BARTON COUNTY ER - $23,774 *GI ENDOSCOPE & TOWER - $120,000 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.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
First Class Or Charter Travel	Yes (X)	FirstClassOrCharterTravelInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	Yes (true)	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (20 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
PATRICIA DIX MD
BOARD MEMBER	$360,417	$0	$0	$0	$2,843	$0	$26,750	$0	$14,746	$0	$404,756	$0	$0	$0
DAVID ZOLFAGHARI MD
BOARD MEMBER	$0	$1,125,716	$0	$0	$0	$0	$0	$0	$0	$16,320	$0	$1,142,036	$0	$0
STEVE EDWARDS
PRESIDENT AND CEO COXHEALTH	$0	$1,113,707	$0	$377,807	$0	$10,359	$0	$269,727	$0	$25,566	$0	$1,797,166	$0	$0
JACOB MCWAY
SR VP AND CFO COXHEALTH	$0	$605,649	$0	$148,486	$0	$137,806	$0	$144,963	$0	$23,216	$0	$1,060,120	$0	$126,919
IBRAHIM ABE ABDALLA MD
BOARD MEMBER	$0	$983,315	$0	$0	$0	$0	$0	$0	$0	$16,320	$0	$999,635	$0	$0
LOUIS KRENN MD
PHYSICIAN	$633,410	$0	$0	$0	$300	$0	$13,365	$0	$16,370	$0	$663,445	$0	$0	$0
ARMIN KAMYAB MD
PHYSICIAN	$1,127,076	$0	$0	$0	$270	$0	$31,865	$0	$7,823	$0	$1,167,034	$0	$0	$0
NAGIB CHOWDHURY MD
PHYSICIAN	$533,604	$0	$0	$0	$270	$0	$31,865	$0	$7,823	$0	$573,562	$0	$0	$0
GREGORY STAMPS MD
PHYSICIAN	$670,684	$0	$0	$0	$690	$0	$32,250	$0	$16,435	$0	$720,059	$0	$0	$0
ARJIT CHOWDHURY MD
PHYSICIAN	$592,902	$0	$0	$0	$300	$0	$13,365	$0	$16,370	$0	$622,937	$0	$0	$0
DAVID STRONG
VP HOSPITAL REVENUE & CFO CMCB	$139,122	$139,123	$19,251	$19,251	$20,824	$20,825	$21,175	$21,175	$8,267	$8,268	$208,639	$208,642	$17,179	$17,180
RON PRENGER
SR VP, CHIEF HOSPITAL OFFICER	$409,424	$0	$54,885	$0	$1,980	$0	$31,750	$0	$14,602	$0	$512,641	$0	$0	$0
GENICE MAROC
VP CLINICAL SERVICES	$203,657	$0	$12,922	$0	$1,980	$0	$7,107	$0	$8,231	$0	$233,897	$0	$0	$0
MAX BUETOW
VP REGIONAL SERVICES	$218,301	$0	$15,501	$0	$690	$0	$13,750	$0	$16,467	$0	$264,709	$0	$0	$0
JEFF HAWKINS
VP CLINICAL SERVICES	$180,008	$0	$11,048	$0	$1,290	$0	$9,749	$0	$8,032	$0	$210,127	$0	$0	$0
FRANK ROMERO
VP MEDICAL AFFAIRS	$412,948	$0	$22,403	$0	$1,980	$0	$13,750	$0	$16,650	$0	$467,731	$0	$0	$0
ROBERT FERGUSON
VP FERRELL DUNCAN CLINIC	$292,839	$0	$19,524	$0	$1,980	$0	$13,750	$0	$11,482	$0	$339,575	$0	$0	$0
KAREN KRAMER
VP, CHIEF NURSING OFFICER	$281,120	$0	$18,318	$0	$1,290	$0	$31,742	$0	$14,487	$0	$346,957	$0	$0	$0
AMANDA HEDGPETH
VP CLINICAL SERVICES	$177,541	$0	$10,460	$0	$270	$0	$9,555	$0	$7,748	$0	$205,574	$0	$0	$0
STACI NIEMOTH MD
BOARD MEMBER	$0	$571,029	$0	$0	$0	$0	$0	$0	$0	$16,320	$0	$587,349	$0	$0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1A	INFORMATION REGARDING BENEFITS PROVIDED: MONTHLY SOCIAL CLUB DUES ARE INCLUDED IN THE TAXABLE COMPENSATION OF STEVE EDWARDS, CEO. CHARTER TRAVEL IS PROVIDED FOR STEVE EDWARDS, JACOB MCWAY AND DENNIS HEIM FOR TRAVEL TO COLLABORATIVE MEETINGS REPRESENTING COXHEALTH FOR EXPEDIENCY. AS THERE WAS NO PERSONAL USE PORTION OF THIS BENEFIT, NONE WAS INCLUDED IN TAXABLE WAGES.
SCHEDULE J, PART I, LINE 4B	SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: STEVE EDWARDS AND JACOB MCWAY PARTICIPATE IN A 457(F) NONQUALIFIED RETIREMENT PLAN WITH LESTER E. COX MEDICAL CENTERS: - STEVE EDWARDS RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $255,977. - JACOB MCWAY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $113,098. - JACOB MCWAY RECEIVED A 457(F) DISTRIBUTION OF $126,919, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - DAVID STRONG RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $28,600. - DAVID STRONG RECEIVED A 457(F) DISTRIBUTION OF $34,359, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990.
SCHEDULE J, PART I, LINE 6A	COMPENSATION CONTINGENT ON THE 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 MARTIN JONES, ARIJIT CHOWDHURY, CARY MARQUIS, TOMMY TRENT, AND BOYD CROCKETT. 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 II; AND FORM 990, PART VII	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.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
HEALTH & EDUCATIONAL FACILITIES AUTH - STATE OF MO
A	431178966	60637AEA6	2013-04-17	$215,764,775	NEW INFRASTRUCTURE/CURRENT REFUND	false	false	false
HEALTH & EDUCATIONAL FACILITIES AUTH - STATE OF MO
B	431178966		2008-10-15	$70,000,000	NEW INFRASTRUCTURE & EQUIPMENT	false	false	false
HEALTH & EDUCATIONAL FACILITIES AUTH - STATE OF MO
C	431178966	60635R427	2008-09-25	$157,078,759	'97 & '02 REFUND & NEW INFRSTRCTRE	Yes (true)	false	false
HEALTH & EDUCATIONAL FACILITIES AUTH - STATE OF MO
D	431178966		2008-10-15	$35,000,000	NEW INFRASTRUCTURE & EQUIPMENT	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$3,515,000	$0	$216,278,348	$0	$16,377,190	$0	$2,222,341	$0	$0	$167,958,089	$29,720,728	$0	2015	Yes (true)	false	Yes (true)	Yes (true)
B	$0	$0	$70,469,521	$0	$783,050	$0	$501,052	$2,121,540	$0	$67,063,879	$0	$0	2012	false	false	Yes (true)	Yes (true)
C	$24,530,872	$130,000,000	$158,302,381	$3,102,979	$1,387,574	$0	$1,448,413	$0	$0	$66,262,892	$73,174,648	$0	2012	Yes (true)	false	Yes (true)	Yes (true)
D	$560,000	$0	$35,028,548	$0	$421,299	$0	$271,929	$803,381	$0	$33,531,939	$0	$0	2012	false	false	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd	Total Private Business UseTotalPrivateBusinessUsePct
A	false	Yes (true)	false	false	0	false	false	false	Yes (true)
B	false	false	false	false	0.00830	false	false	false	Yes (true)	0.00830
C	false	Yes (true)	false	false	0.00930	false	false	false	Yes (true)	0.00930
D	false	false	false	false	0.00830	false	false	false	Yes (true)	0.00830

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Business Name Line1GICProviderName/BusinessNameLine1Txt	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
A	false	false	false	Yes (true)	false	false	false	0	false	Yes (true)
0
B	false	false	false	Yes (true)	Yes (true)	false	false	0	false	Yes (true)
0
C	false	false	false	Yes (true)	false	false	false	0	false	Yes (true)
0
D	false	false	false	Yes (true)	Yes (true)	false	false	0	false	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)
C	Yes (true)
D	Yes (true)

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE K, GROUP 1, PART II, LINE 3, COLUMNS A, B, C, D	TOTAL PROCEEDS OF ISSUE: THE TOTAL PROCEEDS OF THE ISSUE EXCEEDED THE ISSUE PRICE BY THE INVESTMENT EARNINGS AS OF 09/30/2019.
SCHEDULE K, GROUP 1, PART II, LINE 11, COLUMNS A, C	OTHER PROCEEDS SPENT: THE OTHER SPENT PROCEEDS RELATE TO THE CURRENT REFUNDING PROCEEDS OF THE ISSUE.
SCHEDULE K, GROUP 1, PART IV, LINE 2C, COLUMNS A, B, C, D	DATE REBATE COMPUTATION WAS PERFORMED: REBATE CALCULATION/ANALYSIS WERE COMPLETED AS FOLLOWS: -BOND SERIES ISSUE A ON 03/20/2018 -BOND SERIES ISSUE B ON 11/19/2018 -BOND SERIES ISSUE C ON 10/17/2018 -BOND SERIES ISSUE D ON 11/20/2018

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd	CUSIPCUSIPNum
HEALTH & EDUCATIONAL FACILITIES AUTH - STATE OF MO
A	431178966	2017-08-29	$4,692,000	CAPITAL EQUIPMENT FINANCING	false	false	false
HEALTH & EDUCATIONAL FACILITIES AUTH - STATE OF MO
B	431178966	2015-04-22	$142,209,927	REFINANCE 80% 2008A	false	false	false
HEALTH & EDUCATIONAL FACILITIES AUTH - STATE OF MO
C	431178966	2019-04-17	$120,260,000	NEW INFRASTRUCURE & EQUIPMENT	false	false	false	60637ANY4

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$1,274,240	$0	$4,692,000	$0	$0	$0	$90,350	$0	$0	$4,601,650	$0	$0	2017	false	false	Yes (true)	Yes (true)
B	$0	$0	$142,215,222	$0	$0	$0	$1,326,793	$0	$0	$140,826,285	$62,144	$0	2015	false	Yes (true)	false	Yes (true)
C	$0	$0	$120,308,278	$0	$0	$0	$716,079	$0	$0	$28,984,699	$0	$90,607,500		false	false	false	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	false	false	false	false	false	false	Yes (true)
B	false	false	false	false	false	false	false	Yes (true)
C	false	false	false	false	false	false	false	false

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Business Name Line1GICProviderName/BusinessNameLine1Txt	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
A	false	Yes (true)	false	false	false	false	false	0	false	Yes (true)
0
B	false	Yes (true)	false	false	false	false	false	0	false	Yes (true)
0
C	false	Yes (true)	false	false	false	false	false	0	false	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)
C	Yes (true)

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE K, GROUP 2, PART II, LINE 3, COLUMN B	TOTAL PROCEEDS OF ISSUE: THE TOTAL PROCEEDS OF THE ISSUE EXCEEDED THE ISSUE PRICE BY THE INVESTMENT EARNINGS AS OF 09/30/2019.
SCHEDULE K, GROUP 2, PART II, LINE 11, COLUMN B	OTHER PROCEEDS SPENT: THE OTHER SPENT PROCEEDS RELATE TO THE ADVANCE REFUNDING PROCEEDS OF THE ISSUE.

Schedule L IRS990ScheduleL

Field	Value	IRS element (for citing)
Total Balance Due	$0	TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (11 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
VICKI HOCKENSMITH
S EDWARDS - SEE PART V	$112,718	WAGES AND BENEFITS	false
TERRY HAMMER
S EDWARDS - SEE PART V	$110,997	WAGES AND BENEFITS	false
LISA ESPY
K KRAMER - SEE PART V	$38,490	WAGES	false
JASON PRENGER
R PRENGER - SEE PART V	$24,727	WAGES AND BENEFITS	false
BETTY EDWARDS
S EDWARDS - SEE PART V	$23,953	RETIREMENT BENEFITS	false
CONNIE ROMERO
F ROMERO - SEE PART V	$105,520	WAGES AND BENEFITS	false
ANDREW HEDGPETH
A HEDGPETH - SEE PART V	$253,420	WAGES AND BENEFITS	false
JEFF HAWKINS
A HEDGPETH - SEE PART V	$202,096	WAGES AND BENEFITS	false
AMANDA HEDGPETH
J HAWKINS - SEE PART V	$197,826	WAGES AND BENEFITS	false
LISA HEDGPETH
A HEDGPETH - SEE PART V	$30,375	WAGES AND BENEFITS	false
SCOTT ROGERS
S NIEMOTH - SEE PART V	$114,254	WAGES AND BENEFITS	false

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE L, PART IV	FormAndLineReferenceDesc
Explanation	BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (1,2,5)STEVE EDWARDS, CEO, HAS THREE FAMILY MEMBERS WHO WORK FOR OR RECEIVE RETIREMENT BENEFITS FROM LESTER E. COX MEDICAL CENTERS. VICKI HOCKENSMITH IS HIS SISTER, TERRY HAMMER IS HIS BROTHER-IN-LAW, AND BETTY B. EDWARDS IS HIS MOTHER. (3)KAREN KRAMER'S SISTER, LISA ESPY, IS AN EMPLOYEE AT LESTER E. COX MEDICAL CENTERS, AND KAREN IS VICE PRESIDENT AND CHIEF NURSING OFFICER. (4)RON PRENGER'S SON, JASON PRENGER, IS AN EMPLOYEE AT LESTER E. COX MEDICAL CENTERS, AND RON IS A SENIOR VICE PRESIDENT AND CHIEF HOSPITAL OFFICER. (6)FRANK ROMERO'S WIFE, CONNIE ROMERO, IS AN EMPLOYEE OF LESTER E. COX MEDICAL CENTERS AND FRANK IS VICE PRESIDENT OF MEDICAL AFFAIRS. (7,8,9,10) ANDREW HEDGPETH IS AN EMPLOYEE OF LESTER E. COX MEDICAL CENTERS AND AMANDA HEDGPETH IS AN EMPLOYEE OF LESTER E. COX MEDICAL CENTERS AND ARE MARRIED. THERE ARE TWO ADDITIONAL FAMILY MEMBERS WHO ARE EMPLOYEES OF LESTER E. COX MEDICAL CENTERS. JEFF HAWKINS, VICE PRESIDENT OF CLINICAL SERVICES, IS AMANDA HEDGPETH'S UNCLE. LISA HEDGPETH, AN EMPLOYEE OF LESTER E. COX MEDICAL CENTERS, IS ANDREW HEDGPETH'S MOTHER. (11) STACI NIEMOTH'S HUSBAND, SCOTT ROGERS, IS AN EMPLOYEE OF LESTER E. COX MEDICAL CENTERS AND STACI IS JOC CHAIR OF MEDICAL AFFAIRS.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (29 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 4B	ADDITIONAL INFORMATION ABOUT PHYSICIAN CARE: AFFORDABLE, CONVENIENT CARE IS ALSO PROVIDED IN OUR RETAIL CLINICS. LESTER E. COX MEDICAL CENTERS CONTINUES TO PARTNER WITH WAL-MART AND HYVEE AND CURRENTLY HAS 6 PARTNERSHIP CLINICS. COXHEALTH HAS ALSO INVESTED IN TELEMEDICINE INFRASTRUCTURE TO FURTHER EXPAND ITS ABILITY TO OFFER COST EFFECTIVE AND CONVENIENT CARE TO OUR COMMUNITY.
FORM 990, PART III, LINE 4C	EXEMPT PURPOSE ACHIEVEMENTS - ADDITIONAL INFORMATION ABOUT HOME CARE: OXFORD SUPPORTS THE COMMUNITY THROUGH THEIR ASSOCIATION SUPPORT (I.E. ALZHEIMER'S ASSOCIATION, DIABETES ASSOCIATION, HEART ASSOCIATION, ETC,) THEY WORK DILIGENTLY TO RAISE FUNDS FOR PATIENTS THROUGH DONATIONS FROM THEIR EMPLOYEES AND A COMMUNITY WIDE FAN DRIVE FOR PATIENTS WITHOUT AIR CONDITIONING. HOME SUPPORT HAS PROVIDED DURABLE MEDICAL EQUIPMENT AND SERVICES TO PATIENTS IN SOUTHWEST MISSOURI FOR OVER 30 YEARS AND AS THE COMPANY HAS GROWN IT HAS STEADILY BECOME MORE INVOLVED IN AN EFFORT TO BETTER MEET THE NEEDS OF THE COMMUNITY AS A WHOLE. THE STAFF SUPPORT THEIR PATIENTS AND FAMILIES IN MANY WAYS BY CONTACTING HOME HEALTH CARE AGENCIES, DIVISION OF AGING AND OTHER LOCAL CHARITIES. THEY REGULARLY DONATE MEDICAL EQUIPMENT TO CONVOY OF HOPE AND OTHER AGENCIES THAT SUPPORT DISASTER AND RELIEF EFFORTS BOTH LOCALLY AND ABROAD. COMMUNITY BENEFIT ACTIVITIES INCLUDE DONATED EMPLOYEE TIME AND PARTS TO INSTALL AN OVERHEAD LIFT FOR AN ORGANIZATION CALLED "HORSES OF HOPE" THAT AIDS IN HELPING DISABLED PATIENTS RIDE HORSES.
FORM 990, PART III, LINES 4A-4D	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-FOR-PROFIT 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. COX MEDICAL CENTERS DOES THIS THROUGH INITIATIVES LIKE KOHL'S 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 $ 202,640,317 CMC $ 232,818,665 SYSTEM-WIDE THIS FIGURE INCLUDES THE ESTIMATED UNPAID COSTS OF PROVIDING CARE 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 $ 284,811 CMC $ 300,760 SYSTEM-WIDE INCLUDES ACTIVITIES CARRIED OUT TO IMPROVE COMMUNITY HEALTH AND SERVICES THAT ARE SUBSIDIZED BECAUSE THEY ARE NEEDED IN THE COMMUNITY. EXAMPLES ARE COMMUNITY EDUCATION, HEALTH SCREENINGS, SUPPORT GROUPS, IMMUNIZATIONS, COALITION BUILDING AND SUBSIDY OF HEALTH CARE SERVICES. HEALTH PROFESSIONALS EDUCATION AND RESEARCH $ 4,409,860 CMC $ 5,639,606 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 $ 2,046,727 CMC $ 2,217,966 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: $ 209,381,715 CMC $ 240,976,997 SYSTEM-WIDE ECONOMIC IMPACT REAL ESTATE AND PROPERTY TAXES $ 967,646 CMC $ 1,308,834 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 $ 63,630,558 CMC $ 90,110,325 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 $ 475,149,361 CMC $ 818,309,350 SYSTEM-WIDE THE COXHEALTH SYSTEM IS ONE OF THE LARGEST EMPLOYERS IN SOUTHWEST MISSOURI. IN CALENDAR YEAR 2015, LESTER E. COX MEDICAL CENTERS ALONE EMPLOYED NEARLY 9,400 PEOPLE, AND THE REMAINING COXHEALTH SYSTEM AFFILIATES CARRY THE TOTAL EMPLOYED FIGURE TO OVER 10,000 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: $ 544,560,492 CMC $ 915,324,430 SYSTEM-WIDE TOTAL CONTRIBUTIONS TO THE COMMUNITY: $ 753,942,207 CMC $ 1,156,301,427 SYSTEM-WIDE
FORM 990, PART VI, SECTION A, LINE 2	BUSINESS RELATIONSHIPS: BOARD MEMBERS JAN BAUMGARTNER AND ROBERT FULP HAVE A BUSINESS RELATIONSHIP. BOARD MEMBERS WHO RECEIVE COMPENSATION, OFFICERS, AND KEY EMPLOYEES ARE EMPLOYED BY COXHEALTH AND ITS AFFILIATES AND THEREFORE SHARE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6, 7A & 7B	MEMBERS, STOCKHOLDERS, OR OTHER PERSONS: 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 AND CEO 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 OVERRIDE AND REVERSE ANY DECISION MADE OR ACTION AUTHORIZED BY THE CMC BOARD TO THE EXTENT THAT SUCH DECISION OR ACTION CONFLICTS WITH A DECISION MADE OR ACTION AUTHORIZED BY THE JOINT OPERATIONS COMMITTEE OF THE MEMBER; (W) 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.
FORM 990, PART VI, SECTION B, LINE 11B	990 REVIEW POLICY: 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, SECTION B, LINE 12C	MONITORING COMPLIANCE WITH 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. FOR VENDORS, THE POLICY IS DISTRIBUTED WITH THEIR INITIAL CONTRACT WITH LESTER E. COX MEDICAL CENTERS.
FORM 990, PART VI, SECTION B, LINES 15A & 15B	COMPENSATION REVIEW POLICY: 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, SECTION C, LINE 19	DOCUMENT DISCLOSURE: 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 VII, SECTION A	BOARD MEMBER COMPENSATION: DRS. DIX, NIEMOTH, ZOLFAGHARI, AND ABDALLA ARE RECEIVING COMPENSATION RELATED TO THEIR ROLES AS EMPLOYEES UNDER COXHEALTH AND RELATED AFFILIATES. NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS BOARD MEMBERS.
FORM 990, PART XI, LINE 9	OTHER CHANGES TO NET ASSETS: $ (49,603,336) DEFINED BENEFIT PENSION PLAN LOSS & SETTLEMENT (13,398) CHANGE IN BENEFICIAL INTEREST IN TRUST 2,516,324 TRANSFER FROM AFFILIATES 661,589 TRANSFER OF COXHEALTH AUXILIARY NET ASSETS ------------- $ (46,438,821)
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED AFFILIATE SERVICES TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G	DESCRIPTION:PHYSICAL REMUNERATION TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACT LABOR TOTAL FEES:9752028
FORM 990 PART IX LINE 11G	DESCRIPTION:ANESTHESIA SERVICES TOTAL FEES:8504500
FORM 990 PART IX LINE 11G	DESCRIPTION:REPAIRS & MAINTENANCE TOTAL FEES:6957396
FORM 990 PART IX LINE 11G	DESCRIPTION:BILLING/COLLECTIONS SERVICES TOTAL FEES:6068549
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED LAB SERVICES TOTAL FEES:5891147
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:5130474
FORM 990 PART IX LINE 11G	DESCRIPTION:CONSULTING TOTAL FEES:3027427
FORM 990 PART IX LINE 11G	DESCRIPTION:HOUSEKEEPING/LAUNDRY TOTAL FEES:2438542
FORM 990 PART IX LINE 11G	DESCRIPTION:MEDICAL DIRECTOR TOTAL FEES:1714896
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED MANAGEMENT SERVICES TOTAL FEES:730875
FORM 990 PART IX LINE 11G	DESCRIPTION:PHARMACY FEES TOTAL FEES:688239
FORM 990 PART IX LINE 11G	DESCRIPTION:OCCUPATIONAL THERAPY TOTAL FEES:366757
FORM 990 PART IX LINE 11G	DESCRIPTION:COURIER SERVICES TOTAL FEES:357663
FORM 990 PART IX LINE 11G	DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:346368
FORM 990 PART IX LINE 11G	DESCRIPTION:SPECIAL SERVICES TOTAL FEES:114919
FORM 990 PART IX LINE 11G	DESCRIPTION:RADIOLOGY TOTAL FEES:91198

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
FERRELL DUNCAN CLINIC
1001 E PRIMROSE	SPRINGFIELD	MO	65807	542183221	PHYSICIANS	MO	$0	$0	LESTER E COX
REGIONAL SERVICES
3800 S NATIONAL SUITE 540	SPRINGFIELD	MO	65807	542183222	HEALTHCARE	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
COXHEALTH HOME SUPPORT SYSTEMS
2224 W SUNSET	SPRINGFIELD	MO	65807	542183216	HOME HEALTH	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 INNOVATIONS LLC
3850 S NATIONAL	SPRINGFIELD	MO	65807	271117213	MANAGEMENT	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	65806		REAL ESTATE	MO	$0	$0	COXHLTH INNV

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (17 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
COX ALTERNATIVE CARE OF THE OZARKS INC
PO BOX 10939	SPRINGFIELD	MO	65808	431641925	HOME HEALTH	MO	501(C)(3)	10	LESTER E COX	Yes (true)
COXHEALTH FOUNDATION
3525 S NATIONAL SUITE 204	SPRINGFIELD	MO	65807	436810485	FUNDRAISING	MO	501(C)(3)	12A I	LESTER E COX	Yes (true)
COXHEALTH HOME CARE SVCS OF THE MIDWEST
PO BOX 10939	SPRINGFIELD	MO	65808	264781194	HOME HEALTH	MO	501(C)(3)	10	LESTER E COX	Yes (true)
COX HPS OF THE OZARKS INC
2220 W SUNSET	SPRINGFIELD	MO	65807	431641927	HOME HEALTH	MO	501(C)(3)	10	LESTER E COX	Yes (true)
COX-MONETT HOSPITAL INC
801 N LINCOLN	MONETT	MO	65708	431656689	HOSPITAL	MO	501(C)(3)	3	LESTER E COX	Yes (true)
HEALTH ENRICHMENT SERVICES INC
3801 S NATIONAL	SPRINGFIELD	MO	65807	363263313	MED SERVICES	MO	501(C)(3)	7	LESTER E COX	Yes (true)
HEALTHCARE SERVICES OF THE OZARKS INC
PO BOX 10939	SPRINGFIELD	MO	65808	431641928	HOME HEALTH	MO	501(C)(3)	10	LESTER E COX	Yes (true)
PRIMROSE PLACE INC
1115 E PRIMROSE	SPRINGFIELD	MO	65807	431183783	SUPPORT	MO	501(C)(3)	12A I	LESTER E COX	Yes (true)
LESTER E COX MED CTRPROF LIAB LOSS FUND
1423 N JEFFERSON	SPRINGFIELD	MO	65802	366668576	SELF INSURANC	MO	501(C)(3)	12A I	LESTER E COX	Yes (true)
COXHEALTH
1423 N JEFFERSON	SPRINGFIELD	MO	65802	471087427	HOLDING CO	MO	501(C)(3)	12 B II	NA	false
COX MEDICAL GROUP
1423 N JEFFERSON	SPRINGFIELD	MO	65802	471087566	PHYSICIANS	MO	501(C)(3)	10	COXHEALTH	false
SKAGGS COMM HOSP ASSOC (COX MC BRANSON)
525 BRANSON LANDING BOULEVARD	BRANSON	MO	65616	440584290	HOSPITAL	MO	501(C)(3)	3	LESTER E COX	Yes (true)
COXHEALTH SYSTEMS HMO INC
PO BOX 5750	SPRINGFIELD	MO	658015750	431757075	HMO	MO	501(C)(4)		LESTER E COX	Yes (true)
COX COLLEGE
1423 N JEFFERSON	SPRINGFIELD	MO	65802	475148345	EDUCATION	MO	501(C)(3)	2	LESTER E COX	Yes (true)
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	Yes (true)
COX BARTON COUNTY HOSPITAL
1423 N JEFFERSON	SPRINGFIELD	MO	65802	823300758	HOSPITAL	MO	501(C)(3)	3	COXHEALTH	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
MEDICAL DEVELOPMENTS INC
1423 N JEFFERSON	SPRINGFIELD	MO	65802	431622182	PHARMACY	MO	LESTER E COX	C CORP	$3,361,540	$6,051,476	1.00000	Yes (true)
COX TAXABLE CLOSE CORPORATION
1423 N JEFFERSON AVE	SPRINGFIELD	MO	65802	472573263	MEDICAL CLINIC	MO	COX MED GROUP	C CORP	$0	$0		false
FERRELL-DUNCAN CLINIC INC
1001 E PRIMROSE	SPRINGFIELD	MO	65808	430991578	PHYSICIANS	MO	CTCC	C CORP	$0	$0		false
INSURANCE CO OF SPRINGFIELD INC
					CAPTIVE INSURANCE		LESTER E COX	C CORP	$1,138,370	$582,460	1.00000	Yes (true)	GRAND PAVILLION CORPORATE CENTRE	KY GRAND CAYMAN	CJ	GRAND CAYMAN	CJ

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (26 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
SKAGGS COMM HOSP ASSOC DBA COX MED CTR BRNSN
A/J	$7,230	COST
COXHEALTH FOUNDATION
C	$2,769,003	COST
COX COLLEGE
K	$533,457	COST
COX-MONETT HOSPITAL INC
K	$154,536	COST
MEDICAL DEVELOPMENTS INC
K	$183,059	COST
COX HPS OF THE OZARKS INC
K	$220,920	COST
SKAGGS COMM HOSP ASSOC DBA COX MED CTR BRNSN
P	$3,089,467	COST
COX COLLEGE
P	$144,008	COST
COX-MONETT HOSPITAL INC
P	$755,096	COST
COX HPS OF THE OZARKS INC
P	$658,665	COST
COXHEALTH SYSTEMS HMO INC
P	$3,316,619	COST
SKAGGS COMM HOSP ASSOC DBA COX MED CTR BRNSN
Q	$84,608,687	COST
COX COLLEGE
Q	$10,824,367	COST
COX-MONETT HOSPITAL INC
Q	$22,697,659	COST
MEDICAL DEVELOPMENTS INC
Q	$2,757,085	COST
COX BARTON COUNTY HOSPITAL
Q	$6,637,510	COST
COX HPS OF THE OZARKS INC
Q	$2,891,191	COST
HEALTHCARE SERVICES OF THE OZARKS INC
Q	$932,535	COST
COXHEALTH SYSTEMS HMO INC
Q	$5,671,194	COST
COX MEDICAL GROUP
Q	$354,308	COST
FERRELL-DUNCAN CLINIC INC
Q	$6,401,888	COST
SKAGGS COMM HOSP ASSOC DBA COX MED CTR BRNSN
R	$362,667	COST
COX-MONETT HOSPITAL INC
R	$55,084	COST
MEDICAL DEVELOPMENTS INC
R	$298,681	COST
SKAGGS COMM HOSP ASSOC DBA MED CTR BRNSN
S	$183,450	COST
MEDICAL DEVELOPMENTS INC
S	$8,334,215	COST