Civic Intelligence

Lester E Cox Medical Centers

990 • Fiscal year 2017 • EIN 44-0577118

Oct 01, 2016 to Sep 30, 2017 • Filed on Jan 19, 2018

1423 N Jefferson StSpringfield, MO 65802

(417) 269-3000

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

65th percentile

0.48x

Higher debt load relative to assets than 65% of similar nonprofits.

2017 filings • 501(c)3 • $1B+ nonprofits • Source year 2017

Liabilities / Revenue

43rd percentile

0.63x

Higher debt load relative to revenue than 43% of similar nonprofits.

2017 filings • 501(c)3 • $1B+ nonprofits • Source year 2017

Net Margin

42nd percentile

5.2%

Higher net margin than 42% of similar nonprofits.

2017 filings • 501(c)3 • $1B+ nonprofits • Source year 2017

Top Officer Pay

51st percentile

$1,809,435

Higher top officer pay than 51% of similar nonprofits.

Top officer pay equals 0.2% of source-year revenue.

2017 filings • 501(c)3 • $1B+ nonprofits • Source year 2017

Asset Growth

43rd percentile

6.8%

Faster asset growth than 43% of similar nonprofits.

2017 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2016 to 2017

Revenue Growth

37th percentile

5.3%

Faster revenue growth than 37% of similar nonprofits.

2017 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2016 to 2017

Assets

Up

$1,562,280,731

Up $99,131,508 (+6.8%) from 2016

Net Assets

Up

$815,196,698

Up $102,437,889 (+14%) from 2016

Liabilities

Down

$747,084,033

Down $3,306,381 (-0.4%) from 2016

Revenue

Up

$1,188,725,650

Up $59,931,711 (+5.3%) from 2016

Expenses

Up

$1,127,010,876

Up $59,902,719 (+5.6%) from 2016

Net Income

Up

$61,714,774

Up $28,992 (+0.0%) from 2016

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$3.0B$2.0B$1.0B$0Assets 2010: $1,009,995,091Liabilities 2010: $543,627,435Net Assets 2010: $466,367,6562010Assets 2011: $1,009,866,577Liabilities 2011: $569,514,135Net Assets 2011: $440,352,4422011Assets 2012: $1,079,342,042Liabilities 2012: $594,762,251Net Assets 2012: $484,579,7912012Assets 2013: $1,345,753,808Liabilities 2013: $685,529,161Net Assets 2013: $660,224,6472013Assets 2014: $1,403,872,850Liabilities 2014: $729,411,456Net Assets 2014: $674,461,3942014Assets 2015: $1,420,537,175Liabilities 2015: $756,535,309Net Assets 2015: $664,001,8662015Assets 2016: $1,463,149,223Liabilities 2016: $750,390,414Net Assets 2016: $712,758,8092016Assets 2017: $1,562,280,731Liabilities 2017: $747,084,033Net Assets 2017: $815,196,6982017Assets 2018: $1,621,399,974Liabilities 2018: $711,853,525Net Assets 2018: $909,546,4492018Assets 2019: $1,753,434,894Liabilities 2019: $803,578,470Net Assets 2019: $949,856,4242019Assets 2020: $1,734,890,340Liabilities 2020: $970,097,000Net Assets 2020: $764,793,3402020Assets 2021: $1,947,973,281Liabilities 2021: $925,591,859Net Assets 2021: $1,022,381,4222021Assets 2022: $1,842,947,814Liabilities 2022: $796,226,092Net Assets 2022: $1,046,721,7222022Assets 2023: $1,932,352,204Liabilities 2023: $758,239,286Net Assets 2023: $1,174,112,9182023Assets 2024: $2,055,262,059Liabilities 2024: $803,779,952Net Assets 2024: $1,251,482,1072024

Highlighted filing

2017

Assets$1,562,280,731
Liabilities$747,084,033
Net Assets$815,196,698

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$2.0B$1.5B$1.0B$500M$0Expenses 2010: $887,512,5332010Expenses 2011: $910,557,3842011Expenses 2012: $934,248,1672012Expenses 2013: $997,971,3682013Revenue 2014: $1,083,992,905Expenses 2014: $1,021,023,955Net Income 2014: $62,968,9502014Revenue 2015: $1,053,603,679Expenses 2015: $1,024,249,172Net Income 2015: $29,354,5072015Revenue 2016: $1,128,793,939Expenses 2016: $1,067,108,157Net Income 2016: $61,685,7822016Revenue 2017: $1,188,725,650Expenses 2017: $1,127,010,876Net Income 2017: $61,714,7742017Revenue 2018: $1,239,584,665Expenses 2018: $1,174,710,366Net Income 2018: $64,874,2992018Revenue 2019: $1,233,130,712Expenses 2019: $1,155,222,365Net Income 2019: $77,908,3472019Revenue 2020: $1,242,454,411Expenses 2020: $1,200,307,528Net Income 2020: $42,146,8832020Revenue 2021: $1,458,642,232Expenses 2021: $1,362,990,040Net Income 2021: $95,652,1922021Revenue 2022: $1,579,841,659Expenses 2022: $1,491,924,122Net Income 2022: $87,917,5372022Revenue 2023: $1,639,754,736Expenses 2023: $1,611,918,444Net Income 2023: $27,836,2922023Revenue 2024: $1,830,394,766Expenses 2024: $1,770,434,588Net Income 2024: $59,960,1782024

Highlighted filing

2017

Revenue$1,188,725,650
Expenses$1,127,010,876
Net Income$61,714,774
Jump To
Filing Snapshot
Filing Period
Oct 1, 2016 to Sep 30, 2017
Signed
Jan 19, 2018
Return Version
2016v3.1
Gross Receipts
$1,425,255,420
Mission and Program Overview

Mission

Mission: to improve the health of the communities we serve through quality health care, education and research.

The organization provides quality health care, education and research in order to improve the health of the communities it serves.

Balance Sheet Detail
LineBeginningEndChange
Assets
Investments in Publicly Traded Securities$480,356,289$491,860,610▲ $11,504,321
Land, Buildings, and Equipment, Net$434,846,443$437,779,446▲ $2,933,003
Investments Program Related$185,628,527$207,720,383▲ $22,091,856
Savings and Temporary Cash Investments$127,184,521$182,532,177▲ $55,347,656
Accounts Receivable$133,044,837$144,714,568▲ $11,669,731
Intangible Assets$25,283,894$25,263,742▼ $20,152
Investments Other Securities$31,875,038$23,519,148▼ $8,355,890
Inventories for Sale or Use$12,336,468$12,489,817▲ $153,349
Prepaid Expenses and Deferred Charges$11,432,646$11,587,046▲ $154,400
Other Notes and Loans Receivable, Net$5,965,653$5,975,650▲ $9,997
Cash and Non-Interest-Bearing Accounts$1,248,042$1,549,715▲ $301,673
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Loans From Officers Directors$0$0→ $0
Total Assets$1,463,149,223$1,562,280,731▲ $99,131,508
Other Assets Total$13,946,865$17,288,429▲ $3,341,564
Liabilities
Tax Exempt Bond Liabilities$464,349,573$454,589,924▼ $9,759,649
Accounts Payable and Accrued Expenses$223,035,917$208,617,977▼ $14,417,940
Other Liabilities$43,451,027$59,628,720▲ $16,177,693
Mortgage Notes Payable Secured by Investment Property$9,138,723$13,303,246▲ $4,164,523
Unsecured Notes Loans Payable$7,699,099$7,589,337▼ $109,762
Deferred Revenue$2,716,075$3,354,829▲ $638,754
Grants Payable$0$0→ $0
Escrow Account Liability$0$0→ $0
Total Liabilities$750,390,414$747,084,033▼ $3,306,381
Net Assets / Fund Balance
Unrestricted Net Assets$674,416,276$774,690,863▲ $100,274,587
Temporarily Rstr Net Assets$19,562,781$20,632,685▲ $1,069,904
Permanently Rstr Net Assets$18,779,752$19,873,150▲ $1,093,398
Total Net Assets Fund Balance$712,758,809$815,196,698▲ $102,437,889
Total Liabilities and Net Assets / Fund Balance$1,463,149,223$1,562,280,731▲ $99,131,508

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$185,405,278$467,545,288$652,950,566
Buildings$202,672,851$188,921,691$391,594,542
Other Land Buildings$21,911,824$12,786,355$34,698,179
Land$27,046,709-$27,046,709
Leasehold Improvements$742,784$3,972,822$4,715,606
Investment Program Related Org$207,720,383--

Endowment Activity

PeriodBeginningContrib.Gain/LossOther UsesEnd
2016$3,820,777$426,535▲ $107,185$309,807$4,044,690
2015$5,111,030$653,117▲ $107,994$2,051,364$3,820,777
2014$4,800,435$486,859▲ $149,724$303,188$5,111,030
2013$4,452,776$513,875▲ $154,886$294,102$4,800,435
2012$4,159,597$695,884▲ $162,212$550,317$4,452,776
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
Gregory StampsPhysicianFT$676,386$46,857$723,243
Armin KamyabPhyisicanFT$613,252$20,359$633,611
Tommy Trent DoPhysicianFT$503,990$28,137$532,127
Arijit Chowdhury MdPhysicianFT$497,520$28,102$525,622
Frank RomeroVP Medical AffairsFT$462,416$28,312$490,728
Louis KrennPhysicianFT$451,905$28,137$480,042
Ron PrengerSr VP, Chief Hospital AdminFT$353,943$118,904$472,847
Patricia Dix MdBoard MemberFT$342,860$42,594$385,454
Karen KramerVP, CNOFT$277,285$62,147$339,432
Robert FergusonVP Ferrell Duncan ClinicFT$279,618$47,830$327,448
Max BuetowVP Regional ServicesFT$203,179$25,594$228,773
Genice MarocVP Clinical ServicesFT$194,076$24,908$218,984
Jeff HawkinsVP Clinical ServicesFT$171,011$28,337$199,348
Amanda HedgpethVP Clinical ServicesFT$163,900$29,015$192,915
Vickie NelsonBoard Secretary Beg 8/2017--$79,485$79,485
Kathy RiggerBoard Secretary Ending 8/2017--$64,225$64,225

Board Members and Trustees

NameTitle
Joseph TurnerChairman
Steve EdwardsPresident and CEO
Grant Haden1st Vice Chair Ending 11/2016
Dennis Heim2nd Vice Chair
Charles Chalender3rd Vice Chair
David Zolfaghari MdBoard Member
Jack PrimBoard Member
James HutchesonBoard Member
Janice HarrisBoard Member
Pierre Clothiaux MdBoard Member
Robert FulpBoard Member
Robert McdowellBoard Member
Brian JaredBoard Member Beginning 10/2016
Hal HigdonBoard Member Beginning 10/2016
Jan BaumgartnerBoard Member Beginning 10/2016
Jerry JaredBoard Member Ending 10/2016
Jacob McwaySr VP and CFO

Highest Paid Contractors

ContractorServicesLocationCompensation
Emergency Physicians OfPhys RemunerationSPFD, Springfield, MO 65810$18,077,382
Spfd NeurologicalPhys RemunerationINSTITUTE, Springfield, MO 65804$14,510,769
Ozark AnesthesiaAnesthesia ServicesASSOCIATES, Springfield, MO 65807$8,761,985
ShiftwiseStaffing Mgmt500 W MAIN ST STE 14, St Paul, MN 55170$7,280,878
XtendAccount CollectionsHEALTHCARE, Hendersonville, TN 37075$4,675,095
Revenue and Support

Revenue Composition

Contributions and Grants
$3,508,450
Program Service Revenue
$1,143,802,388
Investment Income
$29,394,027
Other Revenue
$12,020,785
All Other Contributions
$2,435,984
Change in Net Assets
$61,714,774
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$695,156,566
Salaries, Compensation, and Employee Benefits$430,204,990
Grants and Similar Amounts Paid$1,649,320
Total Fundraising Expense$580,275
Professional Fundraising Fees$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$315,343,794$23,614,901$232,437$339,191,132
Fees for Services Other$243,582,606$30,946,695$8,836$274,538,137
Other Employee Benefits$55,004,219$4,251,468$16,194$59,271,881
Depreciation Depletion$32,866,251$3,160,697$442$36,027,390
Payroll Taxes$23,486,590$1,835,937-$25,322,527
Occupancy$19,945,505$631,394$33,346$20,610,245
Office Expenses$16,434,192$2,099,559$36,292$18,570,043
Interest$16,454,616$1,582,415-$18,037,031
Information Technology$5,964,613$761,549-$6,726,162
All Other Expenses$5,245,219$818,132$244,954$6,308,305
Insurance$3,107,891$298,881-$3,406,772
Pension Plan Contributions$2,739,688$168,250$7,774$2,915,712
Current Officers, Directors, Trustees, and Key Employees$1,826,861$1,029,068-$2,855,929
Conferences and Meetings$2,092,922$267,220-$2,360,142
Travel$1,953,317$249,395-$2,202,712
Other Expenses$1,523,912$194,570-$1,718,482
Grants to Domestic Individuals$1,124,120--$1,124,120
Fees for Service Investment Mgmnt Fees-$1,052,435-$1,052,435
Comp Disqual Persons$375,240$272,569-$647,809
Grants to Domestic Orgs$525,200--$525,200
Advertising$392,298$50,088-$442,386
Fees for Services Accounting-$247,413-$247,413
Fees for Services Lobbying-$153,411-$153,411
Fees for Services Legal-$138,757-$138,757
Total Functional Expenses$1,052,605,797$73,824,804$580,275$1,127,010,876
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
University of Missouri Endowment FundColumbia, MO501(c)(3)Comm Benefit$500,000
Cox-monett Hospital IncMonett, MO501(c)(3)Comm Benefit$24,450

International Summary

Employees
1
Spending
$157,161,809

International Compliance

Activity in boycott countries
No
Foreign corporation ownership
Yes
Foreign partnership interest
No
Interest in foreign trust
No
Passive foreign investment company interest
Yes
Transfers to foreign corporations
Yes

International Activities

RegionActivityServicesOfficesEmployeesSpending
Central America and the CaribbeanInvestments---$156,073,276
Central America and the CaribbeanInvestmentsCaptive Insurance-1$1,088,533
Fundraising, Events, and Gaming
Fundraising activities
Yes
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$38,443
Fundraising Gross Income$35,519
Gaming Direct Expenses$0
Gaming Gross Income$0
Professional Fundraising Fees$0

Fundraising Events

EventGross ReceiptsGross RevenueDirect ExpensesNet Income
Golf Tourney$35,639$16,603-$16,603
Medical Mile$29,198$13,167$3,132$10,035
Total Events$85,476$35,519$38,443$-2,924
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
Yes
Subject to proxy tax
No
Insider Transactions and Loans

Interested-Person Transactions

Interested PartyRelationshipDescriptionShared RevenueAmount
Andrew HedgpethA Hedgpeth - See Part VWages and BenefitsNo$194,292
Jeff HawkinsA Hedgpeth - See Part VWages and BenefitsNo$192,021
Amanda HedgpethJ Hawkins - See Part VWages and BenefitsNo$182,264
Terry HammerS Edwards - See Part VWages and BenefitsNo$107,191
Vicki HockensmithS Edwards - See Part VWages and BenefitsNo$105,660
Connie RomeroF Romero - See Part VWages and BenefitsNo$78,277
Lisa HedgpethA Hedgpeth - See Part VWages and BenefitsNo$46,106
Lisa EspyK Kramer - See Part VWagesNo$40,264
Betty EdwardsS Edwards - See Part VRetirement BenefitsNo$23,953
Jason PrengerR Prenger - See Part VWages and BenefitsNo$21,787
Constance BuetowM Buetow - Seet Part VWages and BenefitsNo$18,886
Erica SamuelD Heim - See Part VWages and BenefitsNo$11,382

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Self Insurance Claims Payable$37,721,035
Due to Affiliates$16,077,857
Est Amt Due to 3rd Parties$5,829,828

Bond Issues

BondIssuerIssuedIssue PricePurpose
AHealth & Educational Facilities Auth - State of Mo2013-04-17$215,764,775New infrastructure/current refund
CHealth & Educational Facilities Auth - State of Mo2008-09-25$157,078,75997 & 02 refund, new infrastructure
BHealth & Educational Facilities Auth - State of Mo2015-04-22$142,209,927REFINANCE 80% 2008A
BHealth & Educational Facilities Auth - State of Mo2008-10-15$70,000,000New infrastructure & equipment
DHealth & Educational Facilities Auth - State of Mo2008-10-15$35,000,000New infrastructure & equipment
AHealth & Educational Facilities Auth - State of Mo2017-08-29$4,692,000Capital equipment financing

Bond Proceeds

BondTotal ProceedsSpentRetiredIssuance Costs
A$216,270,777$29,708,339$538,720$2,222,341
C$158,223,345$72,482,407$0$1,448,413
B$142,201,343$0$0$1,326,793
B$70,469,521$0$0$501,052
D$35,028,548$0$855,000$271,929
A$4,692,000$0$0$9,350

Bond Financing Compliance

No rebate due
Yes
Rebate not yet due
No
Form 8038-T filed
No
Gross proceeds invested
No
Gross proceeds invested in GIC
No
Exception to rebate
No
Corrective action procedures
Yes
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Backup withholding compliance
Yes
Business relationship with family members
Yes
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 2

Business relationships: board members jerry jared, joseph turner, and grant haden have a business relationship. Board members jerry jared and brian jared have a family relationship, although they did not serve on the board at the same time. 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

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, clothiaux, 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.

Filing and Contact Details

Filer

Filer Name
Lester E Cox Medical Centers
EIN
44-0577118
In Care Of
% JACOB M MCWAY
Phone
4172693000
Address
1423 N JEFFERSON ST, SPRINGFIELD, MO 65802

Signing Officer

Name
Jake Mcway
Title
Sr VP and CFO
Signed
2018-01-19
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Steve Edwards
Formed
1923
Legal Domicile
Mo
Voting Board Members
14
Independent Board Members
10
Employees
10,513
Volunteers
16

Preparer

Firm
Bkd Llp
Address
910 E ST LOUIS 200/PO BOX 1190, SPRINGFIELD, MO 65806-2523
Preparer
Brian D Todd
Phone
4178658701
Supplemental Narrative

Additional Explanations

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 $ 135,739,103 cmc $ 166,318,469 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 $ 1,339,704 cmc $ 1,397,339 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 $ 1,331,350 cmc $ 1,341,561 system-wide this figure is the cost of providing clinical placements for physicians and other health professionals plus the un-reimbursed cost of cox family medicine residency and schools of allied health professions. It includes the un-reimbursed expense of studies on therapeutic protocols and research. Foundation grants, financial contributions and in-kind donations $ 1,956,291 cmc $ 2,082,643 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: $ 140,366,448 cmc $ 171,140,012 system-wide economic impact real estate and property taxes $ 988,634 cmc $ 1,142,099 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 $ 72,451,278 cmc $ 92,064,669 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 $ 432,318,574 cmc $ 704,173,538 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: $ 505,758,486 cmc $ 800,410,618 system-wide total contributions to the community: $ 646,124,934 cmc $ 971,550,630 system-wide

Form 990, Part IX, Line 11G

Other fees for services: $ 116,430,381 purchased affiliate services 108,194,283 physical remuneration 9,669,314 contract labor 7,825,000 anesthesia services 6,798,322 billing/collection services 6,335,662 purchased lab services 5,429,616 other purchased services 4,558,320 contracted repairs & maintenance 2,479,764 consulting 2,330,576 housekeeping/laundry 1,905,752 medical director 928,908 pharmacy fees 791,709 purchased management services 373,669 courier services 304,728 professional fees 71,980 occupational therapy services 44,421 medical transcription 40,818 special services 24,914 radiology services ------------- $ 274,538,137

Form 990, Part XI, Line 9

Other changes to net assets: $ 22,313,000 defined benefit pension plan gain 1,292,000 transfer from affiliates 41,480 change in beneficial interest in trust (6,000) return of capital ------------- $ 23,640,480

Financial Statement Notes

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 b 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.

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IRS990/Form990PartVIISectionAGrp/PersonNm13JAN BAUMGARTNER
IRS990/Form990PartVIISectionAGrp/PersonNm14HAL HIGDON
IRS990/Form990PartVIISectionAGrp/PersonNm15BRIAN JARED
IRS990/Form990PartVIISectionAGrp/PersonNm16KATHY RIGGER
IRS990/Form990PartVIISectionAGrp/PersonNm17STEVE EDWARDS
IRS990/Form990PartVIISectionAGrp/PersonNm18JACOB MCWAY
IRS990/Form990PartVIISectionAGrp/PersonNm19VICKIE NELSON
IRS990/Form990PartVIISectionAGrp/PersonNm20RON PRENGER
IRS990/Form990PartVIISectionAGrp/PersonNm21ROBERT FERGUSON
IRS990/Form990PartVIISectionAGrp/PersonNm22KAREN KRAMER
IRS990/Form990PartVIISectionAGrp/PersonNm23JEFF HAWKINS
IRS990/Form990PartVIISectionAGrp/PersonNm24AMANDA HEDGPETH
IRS990/Form990PartVIISectionAGrp/PersonNm25GENICE MAROC
IRS990/Form990PartVIISectionAGrp/PersonNm26FRANK ROMERO
IRS990/Form990PartVIISectionAGrp/PersonNm27MAX BUETOW
IRS990/Form990PartVIISectionAGrp/PersonNm28ARIJIT CHOWDHURY MD
IRS990/Form990PartVIISectionAGrp/PersonNm29TOMMY TRENT DO
IRS990/Form990PartVIISectionAGrp/PersonNm30GREGORY STAMPS
IRS990/Form990PartVIISectionAGrp/PersonNm31ARMIN KAMYAB
IRS990/Form990PartVIISectionAGrp/PersonNm32LOUIS KRENN
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt00
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt10
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt20
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt30
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt40
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt50
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt60
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt70
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt80
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt9345793
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt100
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt110
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt120
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt130
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt140
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt150
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt160
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt170
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt180
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt190
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt20428364
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt21301061
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt22295542
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt23182737
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt24173369
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt25207366
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt26462866
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt27203418
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt28497790
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt29504290
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt30677076
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt31613492
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt32452205
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt00
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt10
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt20
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt30
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt40
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt50
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt60
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt70
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt80
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt90
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt10949903
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt11528833
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt120
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt130
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt140
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt150
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt1656744
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt171532608
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt18794156
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt1961450
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt200
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt210
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt220
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt230
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt240
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt250
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt260
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt270
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt280
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt290
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt300
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt310
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt320
IRS990/Form990PartVIISectionAGrp/TitleTxt0CHAIRMAN
IRS990/Form990PartVIISectionAGrp/TitleTxt11ST VICE CHAIR ENDING 11/2016
IRS990/Form990PartVIISectionAGrp/TitleTxt22ND VICE CHAIR
IRS990/Form990PartVIISectionAGrp/TitleTxt33RD VICE CHAIR
IRS990/Form990PartVIISectionAGrp/TitleTxt4BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt5BOARD MEMBER ENDING 10/2016
IRS990/Form990PartVIISectionAGrp/TitleTxt6BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt7BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt8BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt9BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt10BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt11BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt12BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt13BOARD MEMBER BEGINNING 10/2016
IRS990/Form990PartVIISectionAGrp/TitleTxt14BOARD MEMBER BEGINNING 10/2016
IRS990/Form990PartVIISectionAGrp/TitleTxt15BOARD MEMBER BEGINNING 10/2016
IRS990/Form990PartVIISectionAGrp/TitleTxt16BOARD SECRETARY ENDING 8/2017
IRS990/Form990PartVIISectionAGrp/TitleTxt17PRESIDENT AND CEO
IRS990/Form990PartVIISectionAGrp/TitleTxt18SR VP AND CFO

Document Assets

No mirrored PDF or thumbnail assets are attached yet.

Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Facts available. Structured filing facts are available, but richer extracted sections are limited.$2,055$804$1,251$1,830$1,770$60.0
2023Summary only. Only limited summary data is available for this year.$1,932$758$1,174$1,640$1,612$27.8
2022Facts available. Structured filing facts are available, but richer extracted sections are limited.$1,843$796$1,047$1,580$1,492$87.9
2021XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1,948$926$1,022$1,459$1,363$95.7
2020XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1,735$970$765$1,242$1,200$42.1
2019XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1,753$804$950$1,233$1,155$77.9
2018Facts available. Structured filing facts are available, but richer extracted sections are limited.$1,621$712$910$1,240$1,175$64.9
2017Detailed filing. Detailed filing data is available for this year.$1,562$747$815$1,189$1,127$61.7
2016XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1,463$750$713$1,129$1,067$61.7
2015Detailed filing. Detailed filing data is available for this year.$1,421$757$664$1,054$1,024$29.4
2014Detailed filing. Detailed filing data is available for this year.$1,404$729$674$1,084$1,021$63.0
2013Facts available. Structured filing facts are available, but richer extracted sections are limited.$1,346$686$660$998
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$1,079$595$485$934
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$1,010$570$440$911
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$1,010$544$466$888
Peer Organizations

Similar nonprofits based on the same Siviq industry and scale cohort. 2017 filings • 501(c)3 • $1B+ nonprofits