Civic Intelligence

Lester E Cox Medical Centers

990 • Fiscal year 2018 • EIN 44-0577118

Oct 01, 2017 to Sep 30, 2018 • Filed on Aug 08, 2019

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

62nd percentile

0.44x

Higher debt load relative to assets than 62% of similar nonprofits.

2018 filings • 501(c)3 • $1B+ nonprofits • Source year 2018

Liabilities / Revenue

42nd percentile

0.57x

Higher debt load relative to revenue than 42% of similar nonprofits.

2018 filings • 501(c)3 • $1B+ nonprofits • Source year 2018

Net Margin

39th percentile

5.2%

Higher net margin than 39% of similar nonprofits.

2018 filings • 501(c)3 • $1B+ nonprofits • Source year 2018

Top Officer Pay

54th percentile

$1,932,851

Higher top officer pay than 54% of similar nonprofits.

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

2018 filings • 501(c)3 • $1B+ nonprofits • Source year 2018

Asset Growth

41st percentile

3.8%

Faster asset growth than 41% of similar nonprofits.

2018 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2017 to 2018

Revenue Growth

36th percentile

4.3%

Faster revenue growth than 36% of similar nonprofits.

2018 filings • 501(c)3 • $1B+ nonprofits • Annualized from 2017 to 2018

Assets

Up

$1,621,399,974

Up $59,119,243 (+3.8%) from 2017

Net Assets

Up

$909,546,449

Up $94,349,751 (+12%) from 2017

Liabilities

Down

$711,853,525

Down $35,230,508 (-4.7%) from 2017

Revenue

Up

$1,239,584,665

Up $50,859,015 (+4.3%) from 2017

Expenses

Up

$1,174,710,366

Up $47,699,490 (+4.2%) from 2017

Net Income

Up

$64,874,299

Up $3,159,525 (+5.1%) from 2017

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

2018

Assets$1,621,399,974
Liabilities$711,853,525
Net Assets$909,546,449

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

2018

Revenue$1,239,584,665
Expenses$1,174,710,366
Net Income$64,874,299
Jump To
Filing Snapshot
Filing Period
Oct 1, 2017 to Sep 30, 2018
Signed
Aug 8, 2019
Return Version
2017v2.3
Gross Receipts
$1,555,167,660
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$491,860,610$512,489,951▲ $20,629,341
Land, Buildings, and Equipment, Net$437,779,446$436,420,088▼ $1,359,358
Investments Program Related$207,720,383$248,352,878▲ $40,632,495
Savings and Temporary Cash Investments$182,532,177$180,125,784▼ $2,406,393
Accounts Receivable$144,714,568$150,412,515▲ $5,697,947
Intangible Assets$25,263,742$25,263,742→ $0
Inventories for Sale or Use$12,489,817$13,736,953▲ $1,247,136
Prepaid Expenses and Deferred Charges$11,587,046$11,733,114▲ $146,068
Other Notes and Loans Receivable, Net$5,975,650$10,019,995▲ $4,044,345
Cash and Non-Interest-Bearing Accounts$1,549,715$5,847,089▲ $4,297,374
Investments Other Securities$23,519,148$2,333,846▼ $21,185,302
Receivables From Officers Etc$0$726,662▲ $726,662
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Loans From Officers Directors$0$0→ $0
Total Assets$1,562,280,731$1,621,399,974▲ $59,119,243
Other Assets Total$17,288,429$23,937,357▲ $6,648,928
Liabilities
Tax Exempt Bond Liabilities$454,589,924$447,791,927▼ $6,797,997
Accounts Payable and Accrued Expenses$208,617,977$180,320,066▼ $28,297,911
Other Liabilities$59,628,720$56,470,041▼ $3,158,679
Mortgage Notes Payable Secured by Investment Property$13,303,246$15,346,290▲ $2,043,044
Unsecured Notes Loans Payable$7,589,337$7,455,266▼ $134,071
Deferred Revenue$3,354,829$4,469,935▲ $1,115,106
Grants Payable$0$0→ $0
Escrow Account Liability$0$0→ $0
Total Liabilities$747,084,033$711,853,525▼ $35,230,508
Net Assets / Fund Balance
Unrestricted Net Assets$774,690,863$866,288,448▲ $91,597,585
Temporarily Rstr Net Assets$20,632,685$22,758,349▲ $2,125,664
Permanently Rstr Net Assets$19,873,150$20,499,652▲ $626,502
Total Net Assets Fund Balance$815,196,698$909,546,449▲ $94,349,751
Total Liabilities and Net Assets / Fund Balance$1,562,280,731$1,621,399,974▲ $59,119,243

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$194,459,295$494,534,527$688,993,822
Buildings$195,025,688$198,935,777$393,961,465
Other Land Buildings$19,234,939$13,568,323$32,803,262
Land$27,046,709-$27,046,709
Leasehold Improvements$653,457$4,116,549$4,770,006
Investment Program Related Org$248,352,878--

Endowment Activity

PeriodBeginningContrib.Gain/LossOther UsesEnd
2017$4,044,690$418,547▲ $101,204$338,500$4,225,941
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
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
Armin Kamyab MdPhysicianFT$845,632$38,553$884,185
Gregory Stamps MdPhysicianFT$733,448$47,423$780,871
Louis Krenn MdPhysicianFT$627,352$28,509$655,861
Arjit Chowdhury MdPhysicianFT$531,665$27,637$559,302
Paul Kidder DoPhysicianFT$491,444$46,414$537,858
Ron PrengerSr VP, Chief Hospital OfficerFT$423,068$98,085$521,153
Frank RomeroVP Medical AffairsFT$461,097$29,423$490,520
Patricia Dix MdBoard MemberFT$353,816$42,997$396,813
Karen KramerVP, Chief Nursing OfficerFT$274,898$58,130$333,028
Robert FergusonVP Ferrell Duncan ClinicFT$286,605$44,711$331,316
Max BuetowVP Regional ServicesFT$210,014$41,432$251,446
Genice MarocVP Clinical ServicesFT$203,248$34,853$238,101
Jeff HawkinsVP Clinical ServicesFT$175,800$30,653$206,453
Amanda HedgpethVP Clinical ServicesFT$170,209$31,505$201,714
David StrongVP Hospital Revenue & CFO CmcbPT$133,044$65,022$198,066
Vickie NelsonSecretary to the BoardPT-$73,384$73,384

Board Members and Trustees

NameTitle
Dennis HeimChair of the Board
Steve EdwardsPresident and CEO Coxhealth
Charles Chalender1st Vice Chair
Robert Fulp2nd Vice Chair of the Board
Hal Higdon3rd Vice Chair
Brian JaredBoard Member
David Zolfaghari MdBoard Member
Jack PrimBoard Member
James HutchesonBoard Member
Jan BaumgartnerBoard Member
Janice HarrisBoard Member
Joseph TurnerBoard Member
Robert McdowellBoard Member
Staci Niemoth MdBoard Member
Jacob McwaySr VP & CFO Coxhealth

Highest Paid Contractors

ContractorServicesLocationCompensation
Springfield Neurological InstitutePhys Remuneration3801 S NATIONAL AVE, Springfield, MO 65804$15,123,882
Ozark Anesthesia AssociatesAnesthesia Services1000 E PRIMROSE ST 520, Springfield, MO 65807$8,898,596
ShiftwiseStaffing Mgmt500 W MAIN ST STE 14, St Paul, MN 55170$7,443,075
360 Degree MedicinePhysician Services108 SUNNY LANE, Branson West, MO 65737$6,364,020
Ferrell Duncan Building CoRental Space1001 E PRIMROSE AVE, Springfield, MO 65807$3,427,383
Revenue and Support

Revenue Composition

Contributions and Grants
$3,707,224
Program Service Revenue
$1,198,109,827
Investment Income
$19,931,522
Other Revenue
$17,836,092
All Other Contributions
$3,019,596
Change in Net Assets
$64,874,299
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$735,504,839
Salaries, Compensation, and Employee Benefits$438,017,467
Grants and Similar Amounts Paid$1,188,060
Total Fundraising Expense$575,901
Professional Fundraising Fees$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$327,172,561$21,363,026$215,477$348,751,064
Fees for Services Other$260,960,149$44,156,033$8,544$305,124,726
Other Employee Benefits$41,393,701$2,833,566$15,248$44,242,515
Depreciation Depletion$32,921,256$3,165,987$852$36,088,095
Payroll Taxes$22,771,920$1,582,012-$24,353,932
Occupancy$19,805,004$593,045$33,883$20,431,932
Interest$17,008,908$1,635,721-$18,644,629
Office Expenses$14,316,706$2,429,108$41,954$16,787,768
Pension Plan Contributions$15,707,364$1,006,621$8,198$16,722,183
Information Technology$5,335,624$905,529-$6,241,153
All Other Expenses$4,010,693$863,756$251,745$5,126,194
Current Officers, Directors, Trustees, and Key Employees$1,866,629$1,301,981-$3,168,610
Conferences and Meetings$2,175,417$369,198-$2,544,615
Insurance$2,281,460$219,405-$2,500,865
Travel$1,791,224$303,996-$2,095,220
Other Expenses$1,179,377$200,157-$1,379,534
Grants to Domestic Individuals$1,053,083--$1,053,083
Fees for Service Investment Mgmnt Fees-$1,035,673-$1,035,673
Comp Disqual Persons$428,630$350,533-$779,163
Advertising$218,767$37,128-$255,895
Fees for Services Accounting-$188,973-$188,973
Grants to Domestic Orgs$134,977--$134,977
Fees for Services Lobbying-$132,505-$132,505
Fees for Services Legal-$19,922-$19,922
Total Functional Expenses$1,089,440,590$84,693,875$575,901$1,174,710,366
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Mha Center for EducationJefferson City, MO501(c)(3)Comm Benefit$84,354
CoxhealthSpringfield, MO501(c)(3)Comm Benefit$33,139
Cox-monett Hospital IncMonett, MO501(c)(3)Comm Benefit$6,794

International Summary

Offices
0
Employees
1
Spending
$100,248,242

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-00$99,162,247
Central America and the CaribbeanInvestmentsCaptive Insurance01$1,085,995
Fundraising, Events, and Gaming
Fundraising activities
Yes
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$25,711
Fundraising Gross Income$20,642
Gaming Direct Expenses$0
Gaming Gross Income$0
Professional Fundraising Fees$0

Fundraising Events

EventGross ReceiptsGross RevenueDirect ExpensesNet Income
Scramble for Mi$40,510$15,327$550$14,777
Wrap It Up$25,734$5,315$1,557$3,758
Total Events$66,244$20,642$25,711$-5,069
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$248,500
Jeff HawkinsA Hedgpeth - See Part VWages and BenefitsNo$198,980
Amanda HedgpethJ Hawkins - See Part VWages and BenefitsNo$190,791
Terry HammerS Edwards - See Part VWages and BenefitsNo$109,467
Vicki HockensmithS Edwards - See Part VWages and BenefitsNo$107,973
Connie RomeroF Romero - See Part VWages and BenefitsNo$102,033
Lisa HedgpethA Hedgpeth - See Part VWages and BenefitsNo$48,388
Lisa EspyK Kramer - See Part VWagesNo$43,636
Betty EdwardsS Edwards - See Part VRetirement BenefitsNo$23,953
Jason PrengerR Prenger - See Part VWages and BenefitsNo$22,848

Loans and Receivables

Line ItemBeginningEndChange
Receivables from Officers, Directors, Trustees, and Key Employees$0$726,662▲ $726,662
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Self Insurance Claims Payable$34,470,962
Due to Affiliates$16,522,506
Est Amt Due to 3rd Parties$5,476,573

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$157,078,759'97 & '02 refund & new infrstrctre
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$216,274,809$29,717,189$2,065,000$2,222,341
C$158,279,909$73,152,176$18,398,154$1,448,413
B$142,213,429$62,144$0$1,326,793
B$70,469,521$0$0$501,052
D$35,028,548$0$460,000$271,929
A$4,692,000$0$630,612$90,350

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 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, 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.

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
Phone
4172698811
Signed
2019-08-08
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Steve Edwards
Formed
1923
Legal Domicile
Mo
Voting Board Members
14
Independent Board Members
11
Employees
10,842
Volunteers
15

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 $ 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 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

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 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.

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IRS990/Form990PartVIISectionAGrp/PersonNm8DAVID ZOLFAGHARI MD
IRS990/Form990PartVIISectionAGrp/PersonNm9ROBERT FULP
IRS990/Form990PartVIISectionAGrp/PersonNm10JANICE HARRIS
IRS990/Form990PartVIISectionAGrp/PersonNm11STACI NIEMOTH MD
IRS990/Form990PartVIISectionAGrp/PersonNm12JACK PRIM
IRS990/Form990PartVIISectionAGrp/PersonNm13JOSEPH TURNER
IRS990/Form990PartVIISectionAGrp/PersonNm14STEVE EDWARDS
IRS990/Form990PartVIISectionAGrp/PersonNm15JACOB MCWAY
IRS990/Form990PartVIISectionAGrp/PersonNm16VICKIE NELSON
IRS990/Form990PartVIISectionAGrp/PersonNm17RON PRENGER
IRS990/Form990PartVIISectionAGrp/PersonNm18ROBERT FERGUSON
IRS990/Form990PartVIISectionAGrp/PersonNm19KAREN KRAMER
IRS990/Form990PartVIISectionAGrp/PersonNm20MAX BUETOW
IRS990/Form990PartVIISectionAGrp/PersonNm21JEFF HAWKINS
IRS990/Form990PartVIISectionAGrp/PersonNm22AMANDA HEDGPETH
IRS990/Form990PartVIISectionAGrp/PersonNm23GENICE MAROC
IRS990/Form990PartVIISectionAGrp/PersonNm24FRANK ROMERO
IRS990/Form990PartVIISectionAGrp/PersonNm25DAVID STRONG
IRS990/Form990PartVIISectionAGrp/PersonNm26GREGORY STAMPS MD
IRS990/Form990PartVIISectionAGrp/PersonNm27ARMIN KAMYAB MD
IRS990/Form990PartVIISectionAGrp/PersonNm28PAUL KIDDER DO
IRS990/Form990PartVIISectionAGrp/PersonNm29ARJIT CHOWDHURY MD
IRS990/Form990PartVIISectionAGrp/PersonNm30LOUIS KRENN MD
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IRS990/Form990PartVIISectionAGrp/TitleTxt01ST VICE CHAIR
IRS990/Form990PartVIISectionAGrp/TitleTxt1BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt2CHAIR OF THE BOARD
IRS990/Form990PartVIISectionAGrp/TitleTxt3BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt4BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt53RD VICE CHAIR
IRS990/Form990PartVIISectionAGrp/TitleTxt6BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt7BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt8BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt92ND VICE CHAIR OF THE BOARD
IRS990/Form990PartVIISectionAGrp/TitleTxt10BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt11BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt12BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt13BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt14PRESIDENT AND CEO COXHEALTH
IRS990/Form990PartVIISectionAGrp/TitleTxt15SR VP & CFO COXHEALTH
IRS990/Form990PartVIISectionAGrp/TitleTxt16SECRETARY TO THE BOARD
IRS990/Form990PartVIISectionAGrp/TitleTxt17SR VP, CHIEF HOSPITAL OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt18VP FERRELL DUNCAN CLINIC
IRS990/Form990PartVIISectionAGrp/TitleTxt19VP, CHIEF NURSING OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt20VP REGIONAL SERVICES
IRS990/Form990PartVIISectionAGrp/TitleTxt21VP CLINICAL SERVICES
IRS990/Form990PartVIISectionAGrp/TitleTxt22VP CLINICAL SERVICES
IRS990/Form990PartVIISectionAGrp/TitleTxt23VP CLINICAL SERVICES
IRS990/Form990PartVIISectionAGrp/TitleTxt24VP MEDICAL AFFAIRS
IRS990/Form990PartVIISectionAGrp/TitleTxt25VP HOSPITAL REVENUE & CFO CMCB
IRS990/Form990PartVIISectionAGrp/TitleTxt26PHYSICIAN
IRS990/Form990PartVIISectionAGrp/TitleTxt27PHYSICIAN
IRS990/Form990PartVIISectionAGrp/TitleTxt28PHYSICIAN
IRS990/Form990PartVIISectionAGrp/TitleTxt29PHYSICIAN
IRS990/Form990PartVIISectionAGrp/TitleTxt30PHYSICIAN
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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
2018Detailed filing. Detailed filing data is available for this year.$1,621$712$910$1,240$1,175$64.9
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$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

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