LESTER E COX MEDICAL CENTER: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization: LESTER E COX MEDICAL CENTER (EIN 44-0577118)
Tax period: 2017-10-01 to 2018-09-30
Filed: 2019-08-09
IRS object ID: 201902219349300120
Schema version: 2017v2.3
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	2019-08-09T11:33:21-05:00	ReturnTs
Tax Period End	2018-09-30	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	2017-10-01	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	SR VP AND CFO	PersonTitleTxt
Phone	4172698811	PhoneNum
Signature	2019-08-08	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	43032920192215000010	FederalOriginalSubmissionId
Federal Original Submission Id	2019-08-09	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	1268FF691D31AAA4923DEFBD1CC270529A8C0F8D	AtSubmissionCreationDeviceId
At Submission Filing Device Id	39CBA67CBDC84C24964593991C1F330368A3BFFE	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2017	TaxYr
Build TS	2019-02-21 02:37:17Z	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	$1,555,167,660	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	14	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	10842	TotalEmployeeCnt
Total Volunteers	15	TotalVolunteersCnt
Total Gross UBI	$663,457	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$270,834	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$3,508,450	PYContributionsGrantsAmt
CY Contributions Grants	$3,707,224	CYContributionsGrantsAmt
PY Program Service Revenue	$1,143,802,388	PYProgramServiceRevenueAmt
CY Program Service Revenue	$1,198,109,827	CYProgramServiceRevenueAmt
PY Investment Income	$29,394,027	PYInvestmentIncomeAmt
CY Investment Income	$19,931,522	CYInvestmentIncomeAmt
PY Other Revenue	$12,020,785	PYOtherRevenueAmt
CY Other Revenue	$17,836,092	CYOtherRevenueAmt
PY Total Revenue	$1,188,725,650	PYTotalRevenueAmt
CY Total Revenue	$1,239,584,665	CYTotalRevenueAmt
PY Grants And Similar Paid	$1,649,320	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,188,060	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$430,204,990	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$438,017,467	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$575,901	CYTotalFundraisingExpenseAmt
PY Other Expenses	$695,156,566	PYOtherExpensesAmt
CY Other Expenses	$735,504,839	CYOtherExpensesAmt
PY Total Expenses	$1,127,010,876	PYTotalExpensesAmt
CY Total Expenses	$1,174,710,366	CYTotalExpensesAmt
PY Revenues Less Expenses	$61,714,774	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$64,874,299	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,562,280,731	TotalAssetsBOYAmt
Total Assets EOY	$1,621,399,974	TotalAssetsEOYAmt
Total Liabilities BOY	$747,084,033	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$711,853,525	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$815,196,698	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$909,546,449	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	$794,279,627	ExpenseAmt
Revenue	$880,888,828	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 $200,759,990 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	$223,893,634	ExpenseAmt
Revenue	$172,789,102	RevenueAmt
Desc	PHYSICIAN CARE: EMPLOYED PHYSICIANS AT LESTER E. COX MEDICAL CENTERS 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 35.8 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	$33,681,686	ExpenseAmt
Revenue	$31,258,665	RevenueAmt
Desc	HOME CARE: LESTER E. COX MEDICAL CENTERS' HOME CARE SERVICES ARE PROVIDED BY OXFORD HEALTHCARE HOME CARE AND HOSPICE AND COX HOME SUPPORT DURABLE MEDICAL EQUIPMENT. OXFORD 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	$37,585,643	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant	$1,188,060	TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue	$113,173,232	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$1,089,440,590	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	Yes (true)	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	508	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	10842	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
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	14	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 (31 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 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)		$356,659	$0	$40,154
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	40.0	1.0	Yes (X)		$0	$1,033,961	$15,118
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
STACI NIEMOTH MD
BOARD MEMBER	1.0	40.0	Yes (X)		$0	$604,930	$15,118
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
STEVE EDWARDS
PRESIDENT AND CEO COXHEALTH	5.0	40.0		Yes (X)	$0	$1,639,010	$293,841
JACOB MCWAY
SR VP & CFO COXHEALTH	5.0	40.0		Yes (X)	$0	$829,516	$156,627
VICKIE NELSON
SECRETARY TO THE BOARD	5.0	40.0		Yes (X)	$0	$63,284	$10,100
RON PRENGER
SR VP, CHIEF HOSPITAL OFFICER	40.0	0.0			$476,143	$0	$45,010	Yes (X)
ROBERT FERGUSON
VP FERRELL DUNCAN CLINIC	40.0	0.0			$307,281	$0	$24,035	Yes (X)
KAREN KRAMER
VP, CHIEF NURSING OFFICER	40.0	0.0			$295,800	$0	$37,228	Yes (X)
MAX BUETOW
VP REGIONAL SERVICES	40.0	0.0			$224,524	$0	$26,922	Yes (X)
JEFF HAWKINS
VP CLINICAL SERVICES	40.0	0.0			$189,386	$0	$17,067	Yes (X)
AMANDA HEDGPETH
VP CLINICAL SERVICES	40.0	0.0			$181,481	$0	$20,233	Yes (X)
GENICE MAROC
VP CLINICAL SERVICES	40.0	0.0			$219,242	$0	$18,859	Yes (X)
FRANK ROMERO
VP MEDICAL AFFAIRS	40.0	0.0			$461,787	$0	$28,733	Yes (X)
DAVID STRONG
VP HOSPITAL REVENUE & CFO CMCB	20.0	20.0			$170,050	$170,051	$56,033	Yes (X)
GREGORY STAMPS MD
PHYSICIAN	40.0	0.0			$734,138	$0	$46,733		Yes (X)
ARMIN KAMYAB MD
PHYSICIAN	40.0	0.0			$845,872	$0	$38,313		Yes (X)
PAUL KIDDER DO
PHYSICIAN	40.0	0.0			$491,714	$0	$46,144		Yes (X)
ARJIT CHOWDHURY MD
PHYSICIAN	40.0	0.0			$531,965	$0	$27,337		Yes (X)
LOUIS KRENN MD
PHYSICIAN	40.0	0.0			$627,652	$0	$28,209		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$6,113,694	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$4,340,752	TotReportableCompRltdOrgAmt
Total Other Compensation	$991,814	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	489	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	$15,123,882
OZARK ANESTHESIA ASSOCIATES
1000 E PRIMROSE ST 520	SPRINGFIELD	MO	65807	ANESTHESIA SERVICES	$8,898,596
SHIFTWISE
500 W MAIN ST STE 14	ST PAUL	MN	55170	STAFFING MGMT	$7,443,075
360 DEGREE MEDICINE
108 SUNNY LANE	BRANSON WEST	MO	65737	PHYSICIAN SERVICES	$6,364,020
FERRELL DUNCAN BUILDING CO
1001 E PRIMROSE AVE	SPRINGFIELD	MO	65807	RENTAL SPACE	$3,427,383

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	89	CntrctRcvdGreaterThan100KCnt
Fundraising	$45,602	FundraisingAmt
Related Organizations	$642,026	RelatedOrganizationsAmt
All Other Contributions	$3,019,596	AllOtherContributionsAmt
Total Contributions	$3,707,224	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	$1,174,840,794	$1,174,840,794
NET PATIENT SERVICE - UNRELATED LAB	621500	$514,085		$514,085
NET PATIENT SERVICE - UNRELATED RETAIL DME	446199	$233,334		$233,334
CAFETERIA, MEALS & VENDING	722514	$5,292,816	$5,292,816
FITNESS CENTERS	713940	$3,071,978	$3,071,978

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$14,156,820	TotalRevenueColumnAmt
Related Or Exempt Func Income	$14,156,820	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$1,198,109,827	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$9,333,262	TotalRevenueColumnAmt
Exclusion	$9,333,262	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$1,879,904	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$1,311,572	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$568,332	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$568,332	TotalRevenueColumnAmt
Exclusion	$568,332	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$324,735,795	SecuritiesAmt
Other	$108,177	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$314,066,487	SecuritiesAmt
Other	$179,225	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$10,669,308	SecuritiesAmt
Other	-$71,048	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$10,598,260	TotalRevenueColumnAmt
Exclusion	$10,598,260	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$20,642	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$45,602	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$25,711	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$5,069	TotalRevenueColumnAmt
Exclusion	-$5,069	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	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
LOSS ON INVESTMENT IN EQUITY INVESTEE	900099	-$73,171	-$83,962	$10,791
CHANGE IN INTEREST IN NET ASSETS OF SUBS	900099	$17,346,000		$17,346,000

Field	Value	IRS element (for citing)
Other Revenue Total	$17,272,829	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,239,584,665	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,197,362,408	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$663,457	UnrelatedBusinessRevenueAmt
Exclusion	$37,851,576	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	$134,977	TotalAmt
Program Services	$134,977	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$1,053,083	TotalAmt
Program Services	$1,053,083	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	$3,168,610	TotalAmt
Program Services	$1,866,629	ProgramServicesAmt
Management And General	$1,301,981	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$779,163	TotalAmt
Program Services	$428,630	ProgramServicesAmt
Management And General	$350,533	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$348,751,064	TotalAmt
Program Services	$327,172,561	ProgramServicesAmt
Management And General	$21,363,026	ManagementAndGeneralAmt
Fundraising	$215,477	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$16,722,183	TotalAmt
Program Services	$15,707,364	ProgramServicesAmt
Management And General	$1,006,621	ManagementAndGeneralAmt
Fundraising	$8,198	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$44,242,515	TotalAmt
Program Services	$41,393,701	ProgramServicesAmt
Management And General	$2,833,566	ManagementAndGeneralAmt
Fundraising	$15,248	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$24,353,932	TotalAmt
Program Services	$22,771,920	ProgramServicesAmt
Management And General	$1,582,012	ManagementAndGeneralAmt

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	$19,922	TotalAmt
Management And General	$19,922	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$188,973	TotalAmt
Management And General	$188,973	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$132,505	TotalAmt
Management And General	$132,505	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	$1,035,673	TotalAmt
Management And General	$1,035,673	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$305,124,726	TotalAmt
Program Services	$260,960,149	ProgramServicesAmt
Management And General	$44,156,033	ManagementAndGeneralAmt
Fundraising	$8,544	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$255,895	TotalAmt
Program Services	$218,767	ProgramServicesAmt
Management And General	$37,128	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$16,787,768	TotalAmt
Program Services	$14,316,706	ProgramServicesAmt
Management And General	$2,429,108	ManagementAndGeneralAmt
Fundraising	$41,954	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$6,241,153	TotalAmt
Program Services	$5,335,624	ProgramServicesAmt
Management And General	$905,529	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$20,431,932	TotalAmt
Program Services	$19,805,004	ProgramServicesAmt
Management And General	$593,045	ManagementAndGeneralAmt
Fundraising	$33,883	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$2,095,220	TotalAmt
Program Services	$1,791,224	ProgramServicesAmt
Management And General	$303,996	ManagementAndGeneralAmt

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	$2,544,615	TotalAmt
Program Services	$2,175,417	ProgramServicesAmt
Management And General	$369,198	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$18,644,629	TotalAmt
Program Services	$17,008,908	ProgramServicesAmt
Management And General	$1,635,721	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$36,088,095	TotalAmt
Program Services	$32,921,256	ProgramServicesAmt
Management And General	$3,165,987	ManagementAndGeneralAmt
Fundraising	$852	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$2,500,865	TotalAmt
Program Services	$2,281,460	ProgramServicesAmt
Management And General	$219,405	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS	$176,100,959	$176,100,959
BAD DEBT	$97,966,344	$97,966,344
STATE PROVIDER TAX	$42,839,837	$42,839,837
LICENSES, DUES, SUBSCRIPTIONS	$1,379,534	$1,179,377	$200,157

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,126,194	TotalAmt
Program Services	$4,010,693	ProgramServicesAmt
Management And General	$863,756	ManagementAndGeneralAmt
Fundraising	$251,745	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,174,710,366	TotalAmt
Program Services	$1,089,440,590	ProgramServicesAmt
Management And General	$84,693,875	ManagementAndGeneralAmt
Fundraising	$575,901	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,549,715	BOYAmt
EOY	$5,847,089	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$182,532,177	BOYAmt
EOY	$180,125,784	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	$144,714,568	BOYAmt
EOY	$150,412,515	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$726,662	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	$5,975,650	BOYAmt
EOY	$10,019,995	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$12,489,817	BOYAmt
EOY	$13,736,953	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$11,587,046	BOYAmt
EOY	$11,733,114	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$1,147,575,264	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$711,155,176	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$437,779,446	BOYAmt
EOY	$436,420,088	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$491,860,610	BOYAmt
EOY	$512,489,951	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$23,519,148	BOYAmt
EOY	$2,333,846	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$207,720,383	BOYAmt
EOY	$248,352,878	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	$17,288,429	BOYAmt
EOY	$23,937,357	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,562,280,731	BOYAmt
EOY	$1,621,399,974	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$208,617,977	BOYAmt
EOY	$180,320,066	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	$3,354,829	BOYAmt
EOY	$4,469,935	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$454,589,924	BOYAmt
EOY	$447,791,927	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	$13,303,246	BOYAmt
EOY	$15,346,290	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$7,589,337	BOYAmt
EOY	$7,455,266	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$59,628,720	BOYAmt
EOY	$56,470,041	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$747,084,033	BOYAmt
EOY	$711,853,525	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$774,690,863	BOYAmt
EOY	$866,288,448	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$20,632,685	BOYAmt
EOY	$22,758,349	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$19,873,150	BOYAmt
EOY	$20,499,652	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$815,196,698	BOYAmt
EOY	$909,546,449	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,562,280,731	BOYAmt
EOY	$1,621,399,974	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$64,874,299	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$8,076,886	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$21,398,566	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

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	$90,400	DirectContactLegislatorsAmt
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$42,105	OtherActivitiesAmt
Total Lobbying Expenditures	$132,505	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 PENMAN & WINTON CONSULTING 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 2018, THE AMOUNT ATTRIBUTABLE TO LOBBYING WAS $28,117 FOR MHA AND $13,988 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	$4,044,690	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 Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,452,776	BeginningYearBalanceAmt
Contributions	$513,875	ContributionsAmt
Investment Earnings Or Losses	$154,886	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$27,000	GrantsOrScholarshipsAmt
Other Expenditures	$294,102	OtherExpendituresAmt
End Year Balance	$4,800,435	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.41410	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.58590	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	$27,046,709	OtherCostOrOtherBasisAmt
Book Value	$27,046,709	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$393,961,465	OtherCostOrOtherBasisAmt
Depreciation	$198,935,777	DepreciationAmt
Book Value	$195,025,688	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,770,006	OtherCostOrOtherBasisAmt
Depreciation	$4,116,549	DepreciationAmt
Book Value	$653,457	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$688,993,822	OtherCostOrOtherBasisAmt
Depreciation	$494,534,527	DepreciationAmt
Book Value	$194,459,295	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$32,803,262	OtherCostOrOtherBasisAmt
Depreciation	$13,568,323	DepreciationAmt
Book Value	$19,234,939	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$436,420,088	TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

Field	Value	IRS element (for citing)
Desc	INT IN NA OF TAX EXEMPT SUBS	Desc
Book Value	$248,352,878	BookValueAmt
Method Valuation	C	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Program Rltd	$248,352,878	TotalBookValueProgramRltdAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
EST AMT DUE TO 3RD PARTIES	$5,476,573
DUE TO AFFILIATES	$16,522,506
SELF INSURANCE CLAIMS PAYABLE	$34,470,962

Field	Value	IRS element (for citing)
Total Liability	$56,470,041	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	$1,085,995
Central America and the Caribbean	0	0	Investments		$99,162,247

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	1	SubtotalEmployeesCnt
Total Office	0	TotalOfficeCnt
Total Employee	1	TotalEmployeeCnt
Subtotal Spent	$100,248,242	SubtotalSpentAmt
Total Spent	$100,248,242	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	$40,510	GrossReceiptsEvent1Amt
Charitable Contri Event1	$25,183	CharitableContriEvent1Amt
Gross Revenue Event1	$15,327	GrossRevenueEvent1Amt
Cash Prizes Event1	$1,875	CashPrizesEvent1Amt
Rent Facility Costs Event1	$16,240	RentFacilityCostsEvent1Amt
Other Direct Expenses Event1	$550	OtherDirectExpensesEvent1Amt
Event2	WRAP IT UP	Event2Nm
Gross Receipts Event2	$25,734	GrossReceiptsEvent2Amt
Charitable Contri Event2	$20,419	CharitableContriEvent2Amt
Gross Revenue Event2	$5,315	GrossRevenueEvent2Amt
Cash Prizes Event2	$150	CashPrizesEvent2Amt
Rent Facility Costs Event2	$5,037	RentFacilityCostsEvent2Amt
Food And Beverage Event2	$127	FoodAndBeverageEvent2Amt
Entertainment Event2	$175	EntertainmentEvent2Amt
Other Direct Expenses Event2	$1,557	OtherDirectExpensesEvent2Amt
Other Events Total	0	OtherEventsTotalCnt
Gross Receipts Total	$66,244	GrossReceiptsTotalAmt
Charitable Contributions Tot	$45,602	CharitableContributionsTotAmt
Gross Revenue Total Events	$20,642	GrossRevenueTotalEventsAmt
Cash Prizes Total Events	$2,025	CashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$21,277	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$127	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$175	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$2,107	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$25,711	DirectExpenseSummaryEventsAmt
Net Income Summary	-$5,069	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	$37,253,035	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$37,253,035	NetCommunityBenefitExpnsAmt
Total Expense	0.03460	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$154,564,195	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$131,689,457	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$22,874,738	NetCommunityBenefitExpnsAmt
Total Expense	0.02120	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$191,817,230	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$131,689,457	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$60,127,773	NetCommunityBenefitExpnsAmt
Total Expense	0.05580	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$192,252	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$192,252	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,903,960	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,374,160	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,529,800	NetCommunityBenefitExpnsAmt
Total Expense	0.00330	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,476,003	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,094,544	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,381,459	NetCommunityBenefitExpnsAmt
Total Expense	0.00500	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,142,616	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,142,616	NetCommunityBenefitExpnsAmt
Total Expense	0.00200	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$20,714,831	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,468,704	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$11,246,127	NetCommunityBenefitExpnsAmt
Total Expense	0.01050	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$212,532,061	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$141,158,161	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$71,373,900	NetCommunityBenefitExpnsAmt
Total Expense	0.06630	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$97,966,344	BadDebtExpenseAmt
Bad Debt Expense Attributable	$14,631,192	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$383,292,493	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$468,121,955	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$84,829,462	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	15	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	15	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: A COMMITTEE WAS FORMED TO CREATE AND IMPLEMENT THE SURVEY USED IN THE ASSESSMENT. THE COMMITTEE BEGAN MEETING IN JUNE 2015 AND WAS COMPRISED OF HOSPITAL, ACADEMIC AND PUBLIC HEALTH PARTNERS. THE COMMITTEE CREATED A SURVEY AND THE FOCUS OF THIS SURVEY WAS TO GARNER FEEDBACK FROM RESIDENTS IN THE REGION ON PRIORITIZING ISSUES THAT ARE BARRIERS TO IMPROVED HEALTH. IN ADDITION, THE COMMITTEE DETERMINED THAT THERE WAS SIGNIFICANT VALUE IN OBTAINING PERSPECTIVES ON HEALTH FROM BOTH INDIVIDUALS AND ORGANIZATIONS THAT PROVIDE SERVICES TO THE COMMUNITY. AS A RESULT, AN ADDITIONAL SURVEY THAT HAD MINOR ADJUSTMENTS MADE FOR THE ORGANIZATIONAL PERSPECTIVE WAS ALSO ADMINISTERED. AFTER THE SURVEY WAS DEVELOPED, IT WAS APPROVED THROUGH THE INSTITUTIONAL REVIEW BOARD THROUGH THE OFFICE OF RESEARCH ADMINISTRATION AT MISSOURI STATE UNIVERSITY AND TRANSLATED INTO SPANISH. THE FULL SURVEY CAN BE FOUND IN THE APPENDIX J OF THE REPORT. SURVEY MONKEY WAS USED TO STREAMLINE THE DATA COLLECTION, COMPILATION AND ANALYSIS. THE SURVEY INCLUDED FOUR POTENTIAL PATHS BASED ON 2 LINKS (ENGLISH AND SPANISH) AND THE FIRST QUESTION (INDIVIDUAL OR ORGANIZATION). THE ANNOUNCEMENT OF THE SURVEY WAS MADE THROUGH A JOINT EFFORT OF ALL PARTICIPATING PARTNERS WITH A COORDINATED PRESS RELEASE. INDIVIDUAL ORGANIZATIONS PROMOTED THE COMPLETION OF THE SURVEY THROUGH EMAIL, NETWORKING, SOCIAL MEDIA AND PROMOTION AT POINT OF SERVICE WITHIN FACILITIES. INCENTIVES WERE NOT OFFERED TO PARTICIPANTS AT ANY POINT OF SURVEY COLLECTION. TO MAXIMIZE THE RESPONSE RATE, THE SURVEY WAS KEPT OPEN AND PROMOTED FROM AUGUST 2015 UNTIL DECEMBER 2015. PRELIMINARY RESULTS WERE COLLECTED AT THE BEGINNING OF NOVEMBER 2015 TO INFORM THE LINE OF QUESTIONING DEVELOPED FOR THE FOCUS GROUPS. FINAL RESULTS WERE THEN TABULATED IN DECEMBER 2015 AND JANUARY 2016. FOCUS GROUPS WERE ALSO USED TARGETING UNDERSERVED, CHRONICALLY ILL AND LOW-POPULATIONS IN EACH COMMUNITY. A RESEARCHER FROM MISSOURI STATE UNIVERSITY'S SOCIOLOGY DEPARTMENT WAS CONTRACTED TO COMPLETE THE FOCUS GROUPS. THE RESEARCHER HAS EXPERIENCE WITH HEALTHCARE AND FOCUS GROUPS. THE RESEARCHER ALSO SERVED ON THE SURVEY COMMITTEE AND WAS AN INTEGRAL PART OF THE PROCESS. AFTER THE TOPICS OF FOCUS WERE IDENTIFIED IN AUGUST 2015, THE RESEARCHER DEVELOPED THE FOCUS GROUP QUESTIONS AND SUBMITTED THEM TO THE SURVEY COMMITTEE AND THE STEERING COMMITTEE TO REVIEW AND PROVIDE FEEDBACK. THE SURVEY COMMITTEE ALSO HELPED DETERMINE THE NUMBER OF FOCUS GROUPS AND THE TARGET AUDIENCE FOR THE FOCUS GROUPS. THE COMMITTEE DETERMINED THAT RESIDENTS WERE THE MOST IMPORTANT GROUP FROM WHICH TO RECEIVE IN-DEPTH FEEDBACK. ADDITIONALLY, THE COMMITTEE DETERMINED THAT IT WAS NECESSARY TO CONDUCT FOCUS GROUPS IN EACH OF THE NINE COMMUNITIES DUE TO VARIANCES IN LOCAL PERCEPTIONS AND BARRIERS. FOCUS GROUP FACILITATOR TRAININGS WERE CONDUCTED IN SEPTEMBER AND OCTOBER 2015, WITH FOCUS GROUPS OCCURRING IN NOVEMBER AND DECEMBER 2015. IN ADDITION, SECONDARY DATA WAS COLLECTED FROM COMMUNITYCOMMONS.ORG AND OTHER SOURCES AND EMERGENCY DEPARTMENT DATA WAS OBTAINED FROM HOSPITAL PARTNERS.
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 CITIZENS MEMORIAL HEALTHCARE, FREEMAN HEALTH SYSTEM, AND MERCY. THE CHNA WAS ALSO CONDUCTED WITH RELATED ORGANIZATIONS COX MEDICAL CENTER BRANSON 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: -BURRELL BEHAVIORAL HEALTH -JASPER COUNTY HEALTH DEPARTMENT -JOPLIN HEALTH DEPARTMENT -POLK COUNTY HEALTH CENTER -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 HTTP://WWW.CITIZENSMEMORIAL.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, NUTRITION SERVICES, AND ADVANCED CARE PLANNING. THEY PROVIDE TOOLS DESIGNED TO INCREASE SELF-MANAGEMENT OF CHRONIC CONDITIONS INCLUDING DIABETES, LUNG DISEASE, CHRONIC PAIN, 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 IS REFINING THE SCOPE OF OFFERINGS TO AN EVIDENCE-BASED, TARGETED PROGRAM SUITE THAT FOCUSES HEAVILY ON IMPROVING CHRONIC CONDITION MANAGEMENT OF PATIENTS. THIS REORGANIZATION AND RESTRUCTURE REMAINS IN PROCESS WITH PLANS FOR FULL IMPLEMENTATION IN THE NEAR FUTURE. -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. -AS A RESULT OF THIS INTERVENTION, TIGR VIDEO VIEWS INCREASED FROM 1,618 VIEWS IN JUNE 2017, TO 4,694 VIEWS IN MAY 2018. 2. REDUCE AVOIDABLE HOSPITAL READMISSIONS -IN FEBRUARY 2017, COXHEALTH IMPLEMENTED A PATIENT READMISSION INTERVIEW FORM. WHEN A PATIENT IS READMITTED WITHIN THIRTY DAYS, A CASE MANAGER MEETS WITH THE PATIENT TO DISCUSS THE READMISSION. TO INCREASE THE NUMBER OF PATIENTS INTERVIEWED, COXHEALTH NURSING ADMINISTRATION BEGAN TRAINING NURSES ON LIGHT DUTY TO COMPLETE THE INTERVIEWS IN 2018. 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 PATIENT'S 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 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 SYSTEM'S CURRENT TOBACCO TREATMENT OFFERINGS WAS CONDUCTED EARLIER THIS YEAR. RECOMMENDATIONS FROM THAT ASSESSMENT INCLUDE CREATION AND IMPLEMENTATION OF A CLEARLY OUTLINED REFERRAL PROCESS AND DEFINED RESOURCES; PROMOTION OF THE ASK, ADVISE, ACT/REFER MODEL TO INITIATE INTERVENTION; DEVELOPMENT AND IMPLEMENTATION OF PREOPERATIVE PROTOCOL TO PROMOTE TOBACCO CESSATION 12 HOURS PRE- AND POST-SURGERY. -EARLIER THIS YEAR, WE PROVIDED TRAINING TO 12 KEY COXHEALTH STAFF MEMBERS AND 3 COMMUNITY EDUCATORS. COMPLETION OF THE UMASS EDUCATION CURRICULUM, REQUIRED EXAMS, AND PRACTICE HOURS MAKE CLASS PARTICIPANTS ELIGIBLE FOR CERTIFICATION AS TOBACCO TREATMENT SPECIALISTS. AS A RESULT OF THIS EDUCATION, THERE WILL BE A LARGE INCREASE IN THE AMOUNT OF CESSATION RESOURCES AVAILABLE WITHIN THE SYSTEM. -THE QUIT RATE FOR OUR MFH STONE AND TANEY COUNTIES TOBACCO CESSATION GRANT HAS STEADILY INCREASED SINCE ITS INCEPTION IN 2013, WITH THE CURRENT QUIT RATE FOR 2018 TO DATE AT 75%. AVERAGING ACROSS THE HISTORY OF THE PROGRAM, THE AGGREGATED QUIT RATE IS 53%. -DUE TO THE SUCCESS OF THIS PROGRAM, FOLLOWING THE GRANT'S END ON MAY 31, 2018, WE WERE ABLE TO HIRE A FULL TIME TOBACCO CESSATION COORDINATOR WHO WILL BE 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. -PLANS ARE IN PLACE TO FURTHER INTEGRATE THE TWO PROGRAMS TO PROVIDE A COHESIVE UNIT AND BETTER UTILIZE RESOURCES TO SERVE AT-RISK COMMUNITIES. 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 BREASTFEEDING 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 INCREASED NEARLY THREE-FOLD. AS A RESULT, 354 PEOPLE HAVE BEEN SCREENED FOR EARLY STAGE LUNG CANCER USING LOW-DOSE CT SCAN TECHNOLOGY. -THE GOAL OF DEVELOPING A REFERRAL PATHWAY BETWEEN THE CLINIC AND SYSTEM TOBACCO CESSATION RESOURCES IS UNDERWAY. 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. IN 2017, 2,098 INDIVIDUALS WHO PRESENTED TO THE SPRINGFIELD ED WITH NON-EMERGENT DENTAL PAIN WERE REFERRED TO JORDAN VALLEY FOR TREATMENT. OF THOSE INDIVIDUALS, 1,061 (50.5%) RECEIVED TREATMENT. -FOLLOWING A JOINT EFFORT BETWEEN PROGRAM ADMINISTRATORS AT COXHEALTH AND JORDAN VALLEY TO IMPROVE COMMUNICATION AND DATA REPORTING, THE MONTHLY REFERRAL COMPLETION RATE TO DATE HAS INCREASED EXPONENTIALLY TO 91.0%. -IN 2017, OF THE 612 INDIVIDUALS WHO PRESENTED TO COX BRANSON ED WITH DENTAL PAIN, 426 WERE REFERRED TO APPROPRIATE DENTAL CARE. OF THOSE REFERRAL PATIENTS WHO COULD BE REACHED FOR FOLLOW-UP, 31.5% HAD FULFILLED THEIR REFERRAL APPOINTMENT. THE LOW COMPLETION RATE CAN BE COR
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 & 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 & 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 & 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 & JOINT CENTER
3555 S NATIONAL AVE	SPRINGFIELD	MO	65807	CLINIC
FERRELL-DUNCAN CLINIC
1000 E PRIMROSE	SPRINGFIELD	MO	65807	MEDICAL OFFICES
MEYER CENTER FITNESS & REHAB
3545 S NATIONAL AVE	SPRINGFIELD	MO	65807	FITNESS AND REHAB CENTER
COX HYPERBARIC MEDICINE & 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 & CHILDREN'S CENTER
1000 E PRIMROSE	SPRINGFIELD	MO	65807	MEDICAL OFFICES
WHEELER HEART & 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	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 ADULT & PEDIATRIC URGENT CARE
1000 E PRIMROSE SUITE 170	SPRINGFIELD	MO	65807	URGENT CARE CLINIC
COXHEALTH CENTER SOUTHERN HILLS
2702 E SUNSHINE	SPRINGFIELD	MO	65804	CLINIC
COXHEALTH CONSULTING SERV & AVIATION MED
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

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 WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990 WAS REDUCED BY BAD DEBT EXPENSE OF $97,966,344.
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 $5,381,459. 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 BAD DEBT EXPENSE LISTED ON LINE 2 IS THE BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS.
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 2013-2017, APPROXIMATELY 16.2 PERCENT OF GREENE COUNTY WAS CONSIDERED TO LIVE IN POVERTY.
SCHEDULE H, PART III, SECTION A, LINE 4	BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HEALTH SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HEALTH SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HEALTH SYSTEM RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
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 2012 AND 2015. THE ENVIRONMENTAL SCAN AND THE COMMUNITY HEALTH NEEDS ASSESSMENT ARE VERY SIMILAR IN THAT SOME OF THE SAME ELEMENTS ARE PRESENT IN BOTH DOCUMENTS. 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 2015, 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-51 COUNTIES AND FOUR 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. THIS ASSESSMENT, ALONG WITH THE RESULTING ACTION PLAN, WILL ALLOW COXHEALTH TO HAVE A MORE HOLISTIC AND UP-TO-DATE PICTURE WITH WHICH TO STRATEGICALLY ADDRESS COMMUNITY HEALTH CONCERNS.
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: BAXTER - AR, BOONE - AR, CARROLL - AR, CEDAR, DADE, DALLAS, DOUGLAS, HICKORY, HOWELL, LACLEDE, MARION - AR, OREGON, OZARK, POLK, PULASKI, TEXAS, AND WRIGHT (ALL SSA COUNTIES ARE LOCATED IN MISSOURI EXCEPT BAXTER, BOONE, CARROLL, AND MARION COUNTIES IN ARKANSAS). THE TOTAL POPULATION IN THE SERVICE AREA IS APPROACHING THE ONE MILLION AND APPROXIMATELY 59% OF THE TOTAL 24-COUNTY POPULATION IS IN THE SEVEN COUNTY PRIMARY SERVICE AREA. SLIGHTLY MORE THAN 50% OF THE MARKET IS FEMALE AND ALMOST NEARLY 18% OF THE SERVICE AREA IS FEMALE BETWEEN THE AGES OF 15 AND 44. THE SEGMENT OF THE POPULATION OVER THE AGE OF 65 IS ALMOST 19% OF THE TOTAL POPULATION AND IS PROJECTED TO INCREASE 12% BETWEEN 2018 AND 2023. THE AVERAGE HOUSEHOLD INCOME IS $58,561 IN THE TOTAL 24-COUNTY SERVICE AREA COMPARED WITH $73,505 FOR THE STATE OF MISSOURI. DIVERSITY IS VERY LOW IN THE 24-COUNTY SERVICE AREA AS 90% 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 OXFORD HEALTHCARE, HOME PARENTERAL SERVICES (INFUSION THERAPY) AND HOME SUPPORT (DURABLE MEDICAL EQUIPMENT). OXFORD HEALTHCARE SUPPORTED THE COMMUNITY THROUGH MONTHLY NUTRITION AND FALL PREVENTION SEMINARS AT 20 AREA SENIOR CENTERS THROUGHOUT SOUTHWEST MISSOURI. OXFORD ALSO PROVIDED FREE BONE DENSITY SCREENINGS AT 34 COMMUNITY EVENTS, AND VITAL SIGN SCREENINGS AT MANY MORE. THROUGH AN ANNUAL FAN DRIVE, OXFORD COLLECTED AND DISTRIBUTED MORE THAN 700 BOX FANS TO SENIORS AND THE DISABLED WHO LACK ADEQUATE ACCESS TO COOLING DURING THE SUMMER MONTHS. HOME PARENTERAL SERVICES RECEIVED A SECOND GRANT AWARD FROM THE MISSOURI FOUNDATION FOR HEALTH ORGANIZATION. THIS GRANT ALLOWS HPS TO SERVE PATIENTS THAT FALL THROUGH THE CRACKS DUE TO HAVING NO REIMBURSEMENT OF ANY KIND, SERVING PATIENTS THROUGHOUT SOUTHERN MISSOURI. COXHEALTH HOME CARE SERVICES OF THE MIDWEST SUPPORTS THE COMMUNITY BY PROVIDING IN-HOME PRIVATE DUTY SERVICES, HOME HEALTHCARE AND THERAPY SUPPORT SERVICES, 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, 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. COXHEALTH AUXILIARY SUPPORTS THE COMMUNITY THROUGH FINANCIAL AND NON-FINANCIAL MEANS. THE ORGANIZATION PROVIDES SCHOLARSHIPS TO NURSING AND MEDICAL TECHNOLOGY STUDENTS AT COX COLLEGE. IN ADDITION, THE AUXILIARY PROVIDES SLEEP SACKS TO ALL NEWBORNS BORN AT LESTER E. COX MEDICAL CENTERS AND CAR SEATS TO THOSE IN NEED TO ENSURE THE SAFETY OF ANY NEWBORN LEAVING LESTER E. COX MEDICAL CENTERS. IN JANUARY 2013, SKAGGS COMMUNITY HOSPITAL ASSOCIATION D/B/A COX MEDICAL CENTER BRANSON (CMCB) BECAME A PART OF THE COXHEALTH NETWORK. UNDER THE AGREEMENT, A MEMBER SUBSTITUTION MODEL, CMCB CONTINUES TO MAINTAIN ITS OWN HOSPITAL BOARD WHILE BECOMING A SUBSIDIARY OF COXHEALTH. COXHEALTH, AS THE PARENT COMPANY, ASSUMES THE RESPONSIBILITIES PREVIOUSLY HELD BY THE CMCB BOARD OF TRUSTEES. THE CMCB BOARD WILL HAVE REPRESENTATION ON THE COXHEALTH BOARD. THIS ALLOWS BOTH PARTIES TO ACT TOGETHER AS ONE ENTITY FOR THE PURPOSES OF CONTRACTING, RECRUITMENT AND GROWTH. 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 HOSPTIAL (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)	$84,354	COMM BENEFIT
COXHEALTH
1423 N JEFFERSON	SPRINGFIELD	MO	65802	471087427	501(C)(3)	$33,139	COMM BENEFIT
COX-MONETT HOSPITAL INC
801 N LINCOLN AVE	MONETT	MO	65708	431656689	501(C)(3)	$6,794	COMM BENEFIT

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

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (5 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt
CHILDREN'S MIRACLE NETWORK -SPECIAL NEEDS GRANTS	2000	$166,562
CHILDREN'S MIRACLE NETWORK -FAMILY CARE GRANTS	86	$166,190
CHILDREN'S MIRACLE NETWORK -COMMUNITY OUTREACH GRA	46532	$56,338
CHILDREN'S MIRACLE NETWORK -LESTER E COX MC GRANTS	66867	$433,493
CHILDREN'S MIRACLE NETWORK -OTHER GRANTS	500	$230,500

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 2018, APPROXIMATELY 203,218 CHILDREN WERE SERVED: SPECIAL NEEDS FUND - $166,562 - DIRECT FINANCIAL ASSISTANCE TO FAMILIES, WHICH INCLUDES: KIDS CHECKS - $74,294 MEAL TRAYS - $54,105 MEAL VOUCHERS - $4,223 GIFT CARDS - $33,940 FAMILY CARE GRANTS - $166,190 - DIRECT FINANCIAL ASSISTANCE TO FAMILIES, WHICH INCLUDES: SPEECH, OCCUPATIONAL AND PHYSICAL THERAPY BILLS, HOSPITAL BILLS, ETC. COMMUNITY GUARANTEED GRANTS - $56,338 TOTAL CARDIAC PROGRAM (A PORTION TO COX- MONETT HOSPITAL, INC.) - $23,338 "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 - $433,493 TOTAL CHILD LIFE PROGRAM - $145,000 C.A.R.E. MOBILE - $288,493 DISCRETIONARY AND OPEN FUNDS - $230,500 - 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: - $5,055 NORTH ER: - $21,831 LABOR & DELIVERY: - $20,337 COX AIR CARE: - $3,960 RESPIRATORY CARE: - $62,926 PEDIATRICS/PICU: - $8,962 BRANSON PEDIATRICS: - $787 CHILD/ADOLESCENT PSYCH: - $2,485 WOMEN/NEWBORN: - $2,764 NICU: - $42,865 CASE MANAGEMENT: - $4,994 BRANSON MATERNITY: - $16,405 BRANSON L&D: - $780 BRANSON FAMILY MED & OB: - $1,130 OUTPATIENT REHAB: - $31,627 URGENT CARE MORH: - $3,592 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 (19 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	$353,816	$0	$0	$0	$2,843	$0	$26,500	$0	$13,654	$0	$396,813	$0	$0	$0
DAVID ZOLFAGHARI MD
BOARD MEMBER	$0	$1,033,961	$0	$0	$0	$0	$0	$0	$0	$15,118	$0	$1,049,079	$0	$0
STACI NIEMOTH MD
BOARD MEMBER	$0	$604,930	$0	$0	$0	$0	$0	$0	$0	$15,118	$0	$620,048	$0	$0
STEVE EDWARDS
PRESIDENT AND CEO COXHEALTH	$0	$1,046,683	$0	$354,990	$0	$237,337	$0	$269,477	$0	$24,364	$0	$1,932,851	$0	$226,957
JACOB MCWAY
SR VP & CFO COXHEALTH	$0	$563,540	$0	$150,695	$0	$115,281	$0	$134,613	$0	$22,014	$0	$986,143	$0	$104,612
GREGORY STAMPS MD
PHYSICIAN	$733,448	$0	$0	$0	$690	$0	$31,500	$0	$15,233	$0	$780,871	$0	$0	$0
ARMIN KAMYAB MD
PHYSICIAN	$845,632	$0	$0	$0	$240	$0	$31,041	$0	$7,272	$0	$884,185	$0	$0	$0
PAUL KIDDER DO
PHYSICIAN	$491,444	$0	$0	$0	$270	$0	$30,981	$0	$15,163	$0	$537,858	$0	$0	$0
ARJIT CHOWDHURY MD
PHYSICIAN	$531,665	$0	$0	$0	$300	$0	$13,041	$0	$14,296	$0	$559,302	$0	$0	$0
LOUIS KRENN MD
PHYSICIAN	$627,352	$0	$0	$0	$300	$0	$13,041	$0	$15,168	$0	$655,861	$0	$0	$0
RON PRENGER
SR VP, CHIEF HOSPITAL OFFICER	$423,068	$0	$51,096	$0	$1,979	$0	$31,500	$0	$13,510	$0	$521,153	$0	$0	$0
ROBERT FERGUSON
VP FERRELL DUNCAN CLINIC	$286,605	$0	$19,386	$0	$1,290	$0	$13,500	$0	$10,535	$0	$331,316	$0	$0	$0
KAREN KRAMER
VP, CHIEF NURSING OFFICER	$274,898	$0	$19,612	$0	$1,290	$0	$23,830	$0	$13,398	$0	$333,028	$0	$0	$0
MAX BUETOW
VP REGIONAL SERVICES	$210,014	$0	$14,240	$0	$270	$0	$11,744	$0	$15,178	$0	$251,446	$0	$0	$0
JEFF HAWKINS
VP CLINICAL SERVICES	$175,800	$0	$12,296	$0	$1,290	$0	$9,594	$0	$7,473	$0	$206,453	$0	$0	$0
AMANDA HEDGPETH
VP CLINICAL SERVICES	$170,209	$0	$11,032	$0	$240	$0	$9,310	$0	$10,923	$0	$201,714	$0	$0	$0
GENICE MAROC
VP CLINICAL SERVICES	$203,248	$0	$14,015	$0	$1,979	$0	$11,176	$0	$7,683	$0	$238,101	$0	$0	$0
FRANK ROMERO
VP MEDICAL AFFAIRS	$461,097	$0	$0	$0	$690	$0	$13,500	$0	$15,233	$0	$490,520	$0	$0	$0
DAVID STRONG
VP HOSPITAL REVENUE & CFO CMCB	$133,044	$133,044	$19,437	$19,437	$17,569	$17,570	$20,350	$20,350	$7,666	$7,667	$198,066	$198,068	$13,924	$13,925

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, JACOB MCWAY AND DAVID STRONG PARTICIPATE IN A 457(F) NONQUALIFIED RETIREMENT PLAN WITH LESTER E. COX MEDICAL CENTERS. - STEVE EDWARDS RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $255,977. - STEVE EDWARDS RECEIVED A 457(F) DISTRIBUTION OF $226,957, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - JACOB MCWAY RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $103,113. - JACOB MCWAY RECEIVED A 457(F) DISTRIBUTION OF $104,612, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. - DAVID STRONG RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $27,200. - DAVID STRONG RECEIVED A 457(F) DISTRIBUTION OF $27,849, 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 ARIJIT CHOWDHURY, GREGORY STAMPS, LOUIS KRENN, TOMMY TRENT, AND ARMIN KAMYAB. 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	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$2,065,000	$0	$216,274,809	$0	$16,377,190	$0	$2,222,341	$0	$0	$167,958,089	$29,717,189	$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	$18,398,154	$130,000,000	$158,279,909	$3,102,979	$1,387,574	$0	$1,448,413	$0	$0	$66,262,892	$73,152,176	$0	2012	Yes (true)	false	Yes (true)	Yes (true)
D	$460,000	$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	false	false	false	0	false	false	false	Yes (true)
B	false	false	false	false	0	false	false	false	Yes (true)
C	false	Yes (true)	false	false	0.00080	false	false	false	Yes (true)	0.00080
D	false	false	false	false	0	false	false	false	Yes (true)

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 09/30/2018.
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 (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
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

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 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	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$630,612	$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	$142,213,429	$0	$0	$0	$1,326,793	$0	$0	$140,824,492	$62,144	$0	2015	false	Yes (true)	false	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 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	false	false	false	0	false	false	false	Yes (true)
B	false	Yes (true)	false	false	0.00090	false	false	false	Yes (true)	0.00090

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 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)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	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 09/30/2018.
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

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

Field	Value	IRS element (for citing)
Person	ROBERT BEZANSON	PersonNm
Relationship With Org	FORMER CEO	RelationshipWithOrgTxt
Loan Purpose	LIFE INSURANCE REFIN	LoanPurposeTxt
Loan From Organization	Yes (X)	LoanFromOrganizationInd
Original Principal	$726,662	OriginalPrincipalAmt
Balance Due	$726,662	BalanceDueAmt
Default	false	DefaultInd
Board Or Committee Approval	Yes (true)	BoardOrCommitteeApprovalInd
Written Agreement	Yes (true)	WrittenAgreementInd

Field	Value	IRS element (for citing)
Total Balance Due	$726,662	TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (10 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
VICKI HOCKENSMITH
S EDWARDS - SEE PART V	$107,973	WAGES AND BENEFITS	false
TERRY HAMMER
S EDWARDS - SEE PART V	$109,467	WAGES AND BENEFITS	false
LISA ESPY
K KRAMER - SEE PART V	$43,636	WAGES	false
JASON PRENGER
R PRENGER - SEE PART V	$22,848	WAGES AND BENEFITS	false
BETTY EDWARDS
S EDWARDS - SEE PART V	$23,953	RETIREMENT BENEFITS	false
CONNIE ROMERO
F ROMERO - SEE PART V	$102,033	WAGES AND BENEFITS	false
ANDREW HEDGPETH
A HEDGPETH - SEE PART V	$248,500	WAGES AND BENEFITS	false
JEFF HAWKINS
A HEDGPETH - SEE PART V	$198,980	WAGES AND BENEFITS	false
AMANDA HEDGPETH
J HAWKINS - SEE PART V	$190,791	WAGES AND BENEFITS	false
LISA HEDGPETH
A HEDGPETH - SEE PART V	$48,388	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.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (30 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 $ 165,411,175 CMC $ 194,895,277 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 $ 280,853 CMC $ 305,689 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 $ 3,280,401 CMC $ 3,370,795 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 $ 2,054,015 CMC $ 2,188,228 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: $ 171,026,444 CMC $ 200,759,990 SYSTEM-WIDE ECONOMIC IMPACT REAL ESTATE AND PROPERTY TAXES $ 916,509 CMC $ 1,168,716 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 $ 67,876,383 CMC $ 77,516,141 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 $ 440,361,589 CMC $ 579,345,633 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: $ 509,154,481 CMC $ 661,645,394 SYSTEM-WIDE TOTAL CONTRIBUTIONS TO THE COMMUNITY: $ 680,180,925 CMC $ 862,405,384 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, LINE 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, AND ZOLFAGHARI 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: $ (4,000) RETURN OF CAPITAL 20,988,472 DEFINED BENEFIT PENSION PLAN LOSS & SETTLEMENT 396,000 TRANSFER FROM AFFILIATES 18,094 CHANGE IN BENEFICIAL INTEREST IN TRUST ------------- $ 21,398,566
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:9797088
FORM 990 PART IX LINE 11G	DESCRIPTION:ANESTHESIA SERVICES TOTAL FEES:8287767
FORM 990 PART IX LINE 11G	DESCRIPTION:REPAIRS & MAINTENANCE TOTAL FEES:6672587
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED LAB SERVICES TOTAL FEES:6004857
FORM 990 PART IX LINE 11G	DESCRIPTION:BILLING/COLLECTIONS SERVICES TOTAL FEES:5909341
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:5514068
FORM 990 PART IX LINE 11G	DESCRIPTION:CONSULTING TOTAL FEES:3198247
FORM 990 PART IX LINE 11G	DESCRIPTION:HOUSEKEEPING/LAUNDRY TOTAL FEES:2016917
FORM 990 PART IX LINE 11G	DESCRIPTION:MEDICAL DIRECTOR TOTAL FEES:1840168
FORM 990 PART IX LINE 11G	DESCRIPTION:PHARMACY FEES TOTAL FEES:792353
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED MANAGEMENT SERVICES TOTAL FEES:714729
FORM 990 PART IX LINE 11G	DESCRIPTION:COURIER SERVICES TOTAL FEES:350960
FORM 990 PART IX LINE 11G	DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:266445
FORM 990 PART IX LINE 11G	DESCRIPTION:OCCUPATIONAL THERAPY TOTAL FEES:184646
FORM 990 PART IX LINE 11G	DESCRIPTION:SPECIAL SERVICES TOTAL FEES:105036
FORM 990 PART IX LINE 11G	DESCRIPTION:RADIOLOGY TOTAL FEES:48514
FORM 990 PART IX LINE 11G	DESCRIPTION:MEDICAL TRANSCRIPTION TOTAL FEES:44800

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (10 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	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
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
TITAN CF LP
				364781057	INVESTMENT		$0	$0	LESTER E COX	UBS FUND SVC CAYMAN LTD	GRAND CAYMAN	CJ	CJ
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 (19 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)
COX-MONETT HOSPITAL AUXILIARY
801 N LINCOLE AVE	MONETT	MO	65708	431852817	FUNDRAISING	MO	501(C)(3)	10	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)
COXHEALTH AUXILIARY
3801 S NATIONAL	SPRINGFIELD	MO	65807	431090590	SUPPORT	MO	501(C)(3)	10	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	$3,927,395	$5,411,606	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	$1,087,042	$545,979	1.00000	Yes (true)	GRAND PAVILLION CORPORATE CENTRE	GRAND CAYMAN	CJ	KY1-110	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 (27 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
SKAGGS COMM HOSP ASSOC DBA COX MED CTR BRNSN
A/J	$3,967	COST
COXHEALTH FOUNDATION
C	$614,526	COST
COX COLLEGE
K	$526,979	COST
COX-MONETT HOSPITAL INC
K	$69,208	COST
MEDICAL DEVELOPMENTS INC
K	$179,995	COST
COX HPS OF THE OZARKS INC
K	$220,920	COST
SKAGGS COMM HOSP ASSOC DBA COX MED CTR BRNSN
P	$4,136,652	COST
COX-MONETT HOSPITAL INC
P	$1,850,047	COST
COX HPS OF THE OZARKS INC
P	$662,944	COST
COXHEALTH SYSTEMS HMO INC
P	$3,282,881	COST
COXHEALTH
P	$161,199,782	COST
COX HPS OF THE OZARKS INC
Q	$2,954,422	COST
HEALTHCARE SERVICES OF THE OZARKS INC
Q	$1,013,982	COST
COXHEALTH SYSTEMS HMO INC
Q	$14,335,920	COST
COX MEDICAL GROUP
Q	$343,547	COST
FERRELL-DUNCAN CLINIC INC
Q	$3,241,246	COST
COXHEALTH
Q	$171,727,121	COST
SKAGGS COMM HOSP ASSOC DBA MED CTR BRNSN
Q	$79,197,864	COST
COX COLLEGE
Q	$9,659,645	COST
COX-MONETT HOSPITAL INC
Q	$21,293,277	COST
MEDICAL DEVELOPMENTS INC
Q	$2,468,659	COST
SKAGGS COMM HOSP ASSOC DBA MED CTR BRNSN
R	$551,720	COST
COX-MONETT HOSPITAL INC
R	$126,380	COST
MEDICAL DEVELOPMENTS INC
R	$716,970	COST
COXHEALTH
R	$520,176	COST
SKAGGS COMM HOSP ASSOC DBA MED CTR BRNSN
S	$81,393	COST
MEDICAL DEVELOPMENTS INC
S	$6,864,178	COST