2024-03-01T13:50:06-06:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2022-01-01 431834356 OZARKS MEDICAL CENTER FOUNDATION OZAR 4178535700 12 PARKWAY CENTER WEST PLAINS MO 65775 JOSH REEVES VP OF DEVELOPMENT 4178535700 2024-02-10 1 JOSH REEVES XXX-XX-XXXX 0 AMBER ROGNAN-HAMILTON P01251012 3149254300 2024-02-10 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z X THOMAS KELLER 12 PARKWAY CENTER WEST PLAINS MO 65775 2228906 0 X OZARKSHEALTHCARE.COM/SUPPORT-US/FOUNDATION/ X 1998 MO THE ORGANIZATION SUPPORTS OZARKS MEDICAL CENTER HEALTH CARE SYSTEM, ENSURING A PLACE CLOSE TO HOME TO MEET ALL MEDICAL NEEDS. OMC FOUNDATION HELPS OMC TO HELP YOU. 8 7 25 26 0 0 407734 990049 0 0 140641 130266 540176 456037 1088551 1576352 100366 1246869 0 0 259734 172035 0 0 129551 216451 129457 576551 1548361 512000 27991 3835307 3520010 0 0 3835307 3520010 TO SUPPORT OZARKS MEDICAL CENTER IN PROVIDING HIGH QUALITY, COMPASSIONATE HEALTHCARE AND PROMOTE WELLNESS IN THE COMMUNITIES WE SERVE. 0 0 1246869 1246869 0 DEVELOPMENT AND USE OF FUNDS FOR: 1) NEW MEDICAL TECHNOLOGY AND EQUIPMENT, 2) COMMUNITY WELLNESS, PREVENTION AND OTHER OUT-OF-HOSPITAL SERVICES TO PROMOTE QUALITY OF LIFE, AND 3) RENOVATION AND NEW FACILITIES. OZARKS HEALTHCARE FOUNDATION HAS LAUNCHED A FUNDRAISING INITIATIVE FOR MAMMOGRAPHY, EQUIPMENT AND COMMUNITY BENEFIT FOR MAMMOGRAPHY. 1246869 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 3 0 25 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 8 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X JOSH REEVES 4178535700 12 PARKWAY CENTER WEST PLAINS MO 65775 X THOMAS WILLIAM KELLER CEO 1.00 55.00 X X 0 647307 29721 NEWT BRILL BOARD MEMBER 1.00 0.00 X 0 0 0 NANCY SHAW VICE CHAIR 1.00 0.00 X X 0 0 0 BOB ECKMAN SECRETARY/TREASURER 1.00 0.00 X X 0 0 0 ROBIN MORGAN BOARD MEMBER 1.00 0.00 X 0 0 0 KENNETH JOPLIN CHAIRMAN 1.00 0.00 X X 0 0 0 KEVIN GLEGHORN BOARD MEMBER 1.00 2.00 X 0 0 0 SHAWN MARHEFKA BOARD MEMBER 1.00 1.00 X 0 0 0 JOSHUA REEVES VP OF DEVELOPMENT 18.00 37.00 X 0 132865 17201 0 780172 46922 0 0 1 0 0 296398 380000 313651 57948 990049 130266 130266 149030 296398 13927 135103 135103 959561 638627 320934 320934 1576352 0 0 586303 1246869 1246869 46137 46137 98433 98330 103 27465 27445 20 28768 28768 2956 29 2927 50083 50083 42127 42127 2749 2749 434 434 DUES & SUBSCRIPTIONS 2340 2340 1548361 1246869 171941 129551 204208 87941 130838 789681 156534 134374 7 212 51150 44836 1411 6314 3329885 2378433 12424 123055 3835307 3520010 0 0 X 2086273 2561238 1749034 958772 3835307 3520010 3835307 3520010 27991 -343288 0 X X 0 1 X 1 0 X 298893 657050 135806 407734 990049 2489532 298893 657050 135806 407734 990049 2489532 332107 2157425 84284 139450 54338 140641 130266 548979 3038511 4141784 0.71000 0.69970 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3202971 -3202971 2922387 1001270 388025 1075378 33333 3202971 2867144 362651 -139793 138502 29113 2922387 0.00000 0.00000 0.00000 1 28394 28394 0 22756 16442 6314 6314 INTEREST IN ASSETS OF COUMMUNITY FOUNDATION OF OZARKS 2378433 F 2378433 PART V, LINE 4: THE CONSOLIDATED FINANCIALS DID NOT REPORT ANY ENDOWMENTS OR RELATED ACTIVITY. PRIOR YEAR TOTALS REPRESENTED THEIR INTEREST IN THE ASSETS HELD AT THE COMMUNITY FOUNDATION AT THE OZARKS. AS SUCH, THE ENDOWMENT FUND BALANCE HAS BEEN ADJUSTED TO ZERO. MOBILE MAMMOGRAPHY 381592 292620 88972 350 540 5400 AUCTION 57932 3778 54154 439524 296398 143126 350 540 5400 6290 136836 1 OZARKS MEDICAL CENTER PO BOX 1100 WEST PLAINS MO 65775 446005758 501(C)(3) 1246869 0 SUPPORT FOR HOSPITAL EXPANSION AND GENERAL OPERATING SUPPORT 1 PART I, LINE 2: OZARKS MEDICAL CENTER FOUNDATION AND OZARKS MEDICAL CENTER ARE CLOSELY RELATED ORGANIZATIONS WITH CONSOLIDATED FINANCIAL STATEMENTS. AS A RESULT, THE FOUNDATION HAS ACCESS TO THE HOSPITAL'S FINANCIAL INFORMATION AND IS ABLE TO MONITOR THE USE OF GRANT FUNDS. 0 0 0 0 0 0 0 0 0 THOMAS WILLIAM KELLER CEO 0 604932 0 42375 0 0 0 6056 0 23665 0 677028 0 0 JOSHUA REEVES VP OF DEVELOPMENT 0 132865 0 0 0 0 0 650 0 16551 0 150066 0 0 PART I, LINE 3 OZARKS MEDICAL CENTER, A RELATED PARTY, ESTABLISHES THE COMPENSATION OF THE CEO USING A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. X 3 39650 FMV X EQUIPMENT 7 18298 FMV 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B 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. THE FORM 990 IS REVIEWED INTERNALLY BY MANAGEMENT. A COPY OF THE RETURN IS THEN PROVIDED TO THE FOUNDATION BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE WITH CONFLICT OF INTEREST POLICY: ALL BOARD MEMBERS AND KEY EMPLOYEES ARE COVERED UNDER THE POLICY AND CONFLICT STATEMENTS ARE REVIEWED ANNUALLY BY THE BOARD TO DETERMINE IF NEW ITEMS ARE DISCLOSED AND DETERMINE IF CONFLICTS HAVE NOT BEEN DISCLOSED. ANY CONFLICTS THAT ARE NOT DISCLOSED ARE REQUESTED FROM THE BOARD MEMBER. IF A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER WITH THE CONFLICT IS REQUIRED TO ABSTAIN FROM DISCUSSION AND WILL NOT VOTE ON THE ISSUE. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS OF OZARKS MEDICAL CENTER ENGAGED INTEGRATED HEALTH STRATEGIES (AN EXECUTIVE COMPENSATION CONSULTING PRACTICE) TO DO MARKET STUDIES AND ANALYSIS OF EXECUTIVE COMPENSATION. THE MARKET IS REVIEWED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO VIEW UPON WRITTEN REQUEST AT THE ADMINISTRATIVE OFFICE OF THE HOSPITAL DURING REGULAR BUSINESS HOURS. FORM 990, PAGE 7, PART VII AMENDED RETURN IS BEING FILED TO REMOVE NICHOLE COOK FROM PG 7 OF THE 990 AS SHE DOES NOT INTERACT WITH THE FOUNDATION IN HER ROLE AS CFO OF THE HOSPITAL. JOSHUA REEVES IS CONSIDERED TO BE THE TOP FINANCIAL OFFICER FOR THE FOUNDATION AND HAS BEEN ADDED TO THE OFFICERS LIST ON PAGE 7 ALONG WITH HIS COMPENSATION. THIS ALSO CHANGED THE NUMBER OF BOARD MEMBERS TO 8 AND JOSH'S COMPENSATION WAS ADDED TO PAGE 10 LINE 5 ACCORDINGLY. FORM 990 IS ALSO BEING AMENDED TO PROPERLY REPORT RECEIPT OF GOVERNMENT GRANT FROM THE STATE OF MISSOURI ON PART VIII, LINE 1E AND SCHEDULE B. FORM 990, PAGE 12, PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART V, LINE 2A AND PART IX, LINE 7 OZARKS MEDICAL CENTER, A RELATED ORGANIZATION, PROCESSES PAYROLL AND FILES W-2'S FOR THE ORGANIZATIONS. COMPENSATION IS REIMBURSED BY THE FOUNDATION FOR THE AMOUNTS THAT REPRESENT WORK PERFORMED FOR THEM. THE AMOUNT REPORTED ON PART IX INCLUDES ONLY THOSE AMOUNTS ALLOCATED FOR WORK PERFORMED DIRECTLY FOR THE ORGANIZATION, BUT WHO WERE ACTUALLY ISSUED W-2'S BY OZARKS MEDICAL CENTER. OZARKS MEDICAL CENTER 1100 KENTUCKY AVE WEST PLAINS MO 65775 446005758 HOSPITAL MO 501(C)(3) LINE 3 N/A 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0