Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
LE COX MED CTR |
440577118 | 3 | Yes | 719,044 | 0 | |
|
Total 1
|
719,044 | 0 | ||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2019 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART I, LINE 12G, COLUMN A | THE FULL NAME OF THE SUPPORTED ORGANIZATION IS LESTER E COX MEDICAL CENTERS. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART I, LINE 1 | ORGANIZATION'S MISSION AND MOST SIGNIFICANT ACTIVITY: ADDITIONALLY, COXHEALTH FOUNDATION RAISES FUNDS TO SUPPORT THE MISSION OF COXHEALTH THROUGH SUPPORT OF HEALTH EDUCATION, FACILITIES, TECHNOLOGIES AND THOSE PROGRAMS AND SERVICES WHICH IMPACT THE HEALTH OF OUR OZARKS COMMUNITY. EACH CONTRIBUTION TO THE FOUNDATION CREATES THE FOLLOWING BENEFITS: -SUPPORTS SERVICES FOR THE INDIGENT AND UNINSURED BY PROVIDING FINANCIAL ASSISTANCE THROUGH THE BETHLEHEM FUND FOR HIGH-RISK MOTHERS, THE GOOD SAMARITAN FUND AND OTHER PATIENT CARE FUNDS. AT COXHEALTH, HEALTH CARE IS PROVIDED WITHOUT PREJUDICE AND REGARDLESS OF THE PATIENT'S ABILITY TO PAY. -PROVIDES EDUCATIONAL TRAINING TO RESIDENT PHYSICIANS AND TO FUTURE NURSES THROUGH THE FAMILY PRACTICE RESIDENCY PROGRAM AND COX COLLEGE SCHOLARSHIP AND ENDOWMENT FUNDS. -ASSISTS THE COMMUNITY BY PROVIDING PROGRAMS LIKE CPR TRAINING AND SMOKING CESSATION CLASSES, AS WELL AS THE EMERGENCY CARDIOVASCULAR CARE COMMUNITY TRAINING CENTER AND THE WOMEN AND HEART - KNOW YOUR FIGURES AWARENESS CAMPAIGN. -BUILDS NEW, EXPANDED FACILITIES WITH GIFTS TO SUPPORT STATE-OF-THE-ART EQUIPMENT TO CONTINUE MEDICAL RESEARCH AND OFFER INNOVATIVE CLINICAL TREATMENTS AND PROCEDURES IN AREAS SUCH AS CANCER, HEART DISEASE, REHABILITATION AND MUCH MORE. |
| FORM 990, PART III, LINE 4D | EXEMPT PURPOSE ACHIEVEMENTS - OTHER: THE COXHEALTH FOUNDATION WRITES FEDERAL, STATE AND PRIVATE FUNDER REQUESTS FOR PROGRAMS AND SERVICES NEEDED WITHIN COXHEALTH TO BETTER SERVE OUR PATIENTS AND COMMUNITY. GRANTS IN THIS FISCAL YEAR INCLUDED THOSE FOR TELEMEDICINE FOR PATIENT CARE AND FOR STUDENTS IN SCHOOLS, QUALITY IMPROVEMENTS IN HEALTHCARE, SCHOLARSHIPS FOR HEALTH PROFESSIONS, SUPPORT FOR TRAUMA SERVICES AMONGST OTHERS. |
| FORM 990, PART VI, SECTION A, LINE 2 | BUSINESS RELATIONSHIPS: BOARD MEMBERS WHO RECEIVE COMPENSATION AND OFFICERS ARE EMPLOYED BY COXHEALTH AND ITS AFFILIATES AND THEREFORE SHARE A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINES 6, 7A, AND 7B | MEMBERS OR STOCKHOLDERS: COXHEALTH FOUNDATION SHALL HAVE ONE MEMBER WHICH SHALL BE LESTER E. COX MEDICAL CENTERS (MEMBER), WHICH IS A CONTROLLED SUBSIDIARY OF A PARENT CORPORATION KNOWN AS COXHEALTH (PARENT). THE MEMBER AND PARENT SHALL EXERCISE THEIR POWERS AND FULFILL THEIR RESPONSIBILITIES AS SPECIFIED IN THE ARTICLES OF INCORPORATION AND THE BYLAWS. THE FOLLOWING RESERVED POWERS MAY BE EXERCISED BY THE PARENT WITHOUT PRIOR ACTION BY THE BOARD. SAID RESERVED POWERS ARE: (A) TO ESTABLISH AND CHANGE THE BUSINESS PURPOSES, MISSION, VISION OR VALUES OF COXHEALTH FOUNDATION; (B) APPROVE THE ADOPTION, OR PERMIT THE ADOPTION OF, ANY NEW, OR ANY CHANGES TO ANY EXISTING, LONG-TERM OR MASTER INSTITUTIONAL PLANS OF THE COXHEALTH FOUNDATION; (C) APPROVE THE ADOPTION OF THE ANNUAL OPERATING BUDGET OF THE COXHEALTH FOUNDATION; (D) TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF COXHEALTH FOUNDATION AS PROVIDED THEREIN; (E) TO APPROVE AMENDMENTS TO THE BYLAWS; (F) TO APPROVE THE ADOPTION OF AND ANY REVISION TO THE CHARTERS FOR ALL COMMITTEES ESTABLISHED BY THE BOARD; (G) TO APPOINT AND REMOVE THE DIRECTORS OR HONORARY DIRECTORS OF COXHEALTH FOUNDATION, SUBJECT TO THE REQUIREMENTS OF ARTICLE FIVE, AND TO APPOINT AND REMOVE THE OFFICERS OF THE BOARD AND COXHEALTH FOUNDATION; (H) TO APPROVE THE APPOINTMENT AND REMOVAL OF THE PRESIDENT OF COXHEALTH FOUNDATION; (I) TO APPOINT THE AUDITOR AND THE CORPORATE COUNSEL FOR COXHEALTH FOUNDATION AND ITS CONTROLLED SUBSIDIARIES OR REMOTELY CONTROLLED SUBSIDIARIES; (J) 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 COXHEALTH FOUNDATION IN SUCH PROGRAMS; AND TO AUTHORIZE THE OPENING AND CLOSING OF BANK ACCOUNTS AND INVESTMENT ACCOUNTS IN THE NAME OF COXHEALTH FOUNDATION; (K) AUTHORIZE OR PERMIT THE COXHEALTH FOUNDATION TO ENGAGE IN, OR ENTER INTO, ANY TRANSACTION PROVIDING FOR THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE, CREATION OF A SECURITY INTEREST IN OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF ITS ASSETS; (L) APPROVE, OR PERMIT THE APPROVAL OF, ANY CONTRIBUTIONS OR GRANTS BY THE COXHEALTH FOUNDATION TO ANY AFFILIATE OR SUBSIDIARY OF MEMBER; (M) AUTHORIZE OR PERMIT THE COXHEALTH FOUNDATION TO ENTER INTO OR PERFORM ANY CONTRACT OR ENGAGE IN ANY TRANSACTION NOT SPECIFIED ABOVE WHICH INVOLVES THE EXPENDITURE OF A SUM GREATER THAN TWENTY-FIVE THOUSAND AND NO/100 DOLLARS ($25,000.00); (N) APPROVE OR PERMIT THE BORROWING OF MONEY BY THE COXHEALTH FOUNDATION; (O) TO APPROVE THE ACQUISITION OR DISPOSITION BY COXHEALTH FOUNDATION OF ANOTHER LEGAL ENTITY OR AN INTEREST IN ANOTHER LEGAL ENTITY; (P) APPROVE THE ADOPTION, OR PERMIT THE ADOPTION OF, A PLAN OF DISSOLUTION OF THE COXHEALTH FOUNDATION; (Q) APPROVE THE ADOPTION, OR PERMIT THE ADOPTION OF, A PLAN OF MERGER OR CONSOLIDATION OF THE COXHEALTH FOUNDATION WITH ANOTHER LEGALLY DEFINED NON-PROFIT COXHEALTH FOUNDATION; (R) TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF COXHEALTH FOUNDATION OR THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF COXHEALTH FOUNDATION; (S) TO APPROVE THE ORGANIZATION, ACQUISITION, FORMATION OF A CONTROLLED SUBSIDIARY, REMOTELY CONTROLLED SUBSIDIARY, AFFILIATE, OR LEGALLY DEFINED NON-PROFIT ORGANIZATION; (T) TO DETERMINE THE EXTENT TO WHICH AND THE MANNER IN WHICH THE POWERS DESCRIBED IN THIS SECTION WHICH ARE RESERVED TO THE PARENT WITH RESPECT TO COXHEALTH FOUNDATION 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. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW PROCESS: 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, THE FORM 990 IS FIRST REVIEWED BY MEMBERS OF TOP MANAGEMENT. ONCE THEY HAVE APPROVED THE DRAFT, A FINAL COPY IS PROVIDED TO THE BOARD OF DIRECTORS VIA EMAIL. |
| 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 CORPORATE COMPLIANCE POLICY, SET FORTH BELOW. IN ADDITION, THE LESTER E. COX MEDICAL CENTERS BYLAWS CONTAIN A CONFLICT OF INTEREST PROVISION TO ENSURE 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 A SUB-COMMITTEE OF THE BOARD WITH THE ASSISTANCE OF THE EXECUTIVE OFFICE AND IS DEFINED IN THE BOARD BYLAWS. 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 AT THEIR FIRST CONTRACT WITH LESTER E. COX MEDICAL CENTERS. |
| FORM 990, PART VI, SECTION B, LINE 15A | COMPENSATION REVIEW POLICY: THE PRESIDENT'S COMPENSATION IS PERIODICALLY REVIEWED BY AN INDEPENDENT CONSULTANT USING COMPARABILITY DATA. THE CONSULTANT'S RECOMMENDATIONS ARE PRESENTED TO AND DISCUSSED WITH THE BOARD OF DIRECTORS. THIS REVIEW IS DOCUMENTED IN BOARD MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE: ORGANIZATION DOCUMENTS WILL BE MADE AVAILABLE UPON WRITTEN REQUEST FOR A LEGITIMATE BUSINESS OR FUNDRAISING PURPOSE (AS DETERMINED BY TOP MANAGEMENT). DOCUMENTS MAY BE VIEWED AT THE FOUNDATION'S OFFICE. |
| FORM 990, PART VII, SECTION A | BOARD MEMBER COMPENSATION: RUSSELL DETTEN, M.D., JOSE DOMINGUEZ, M.D., AND CHARLES WOODALL, III, M.D., ARE EMPLOYEES OF LESTER E. COX MEDICAL CENTERS, A RELATED ORGANIZATION. THEIR COMPENSATION IS RELATED TO THIER ROLES AS EMPLOYEES. NO BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR DUTIES AS BOARD MEMBERS. COXHEALTH FOUNDATION PRESIDENT LISA ALEXANDER RECEIVES HER COMPENSATION FROM LESTER E. COX MEDICAL CENTERS, BUT HER TIME SPENT IS RELATED TO COXHEALTH FOUNDATION. COXHEALTH FOUNDATION FILES NO W-2S AND ANY EMPLOYEES OR INDEPENDENT CONTRACTORS PROVIDING SERVICES TO COXHEALTH FOUNDATION ARE REPORTED BY LESTER E. COX MEDICAL CENTERS. |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS: $ (6,363,477) TRANSFERS TO AFFILIATES 1,048 CHANGE IN BENEFICIAL INTEREST IN TRUST ------------- $ (6,362,429) |
| Software ID: | |
| Software Version: |