Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 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 | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) .... | ||||||
| 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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) |
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| 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 2015 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-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 4A | ORGANIZATION'S MISSION: OMC'S MISSION IS TO PROVIDE EXCEPTIONAL, COMPASSIONATE CARE TO ALL WE SERVE. ORGANIZATION'S VISION: AT OMC, OUR VISION IS TO CHANGE LIVES BY NURTURING HOPE, IMPROVING HEALTH AND ENCOURAGING WELLNESS - EVERY PERSON, EVERY TIME. OUR CORE VALUES: RESPECT, COMPASSION, INTEGRITY, SUPERIOR SERVICE, TEAMWORK, ENTHUSIASM, AND ACCOUNTABILITY. |
| FORM 990, PART III, LINE 4 | Program Service Accomplishments: OMC is committed to the community and as part of that commitment, hosts a number of outreach services and programs each year. In 2015, OMC provided community benefit expense and charity care to assist the uninsured and underinsured, and to provide other assistance based on need. OMC also provided activities for community members of all ages. 2015 YEAR IN REVIEW: QUALITY: JCAHO accredited. Level 2 state stroke certification. Began work towards being a Missouri Quality Award winning hospital. OMC Wound Care Services was recognized with a national award for clinical excellence. In 2015, OMC performed 221 coronary interventions with a door-to-balloon time of 74 minutes, substantially better than the national standard set by the American Heart Association of 90 minutes. Door-to-balloon time is a quality measure indicating the amount of time between a heart attack patients arrival at the emergency room to the time that the patients blocked artery is reopened in the cardiac catheterization lab. Intensive Care Unit had zero central line infections, zero catheter associated infections, and zero ventilator pneumonia infections. OMC received a grant to focus on improving transitions of care, reducing hospital readmission rates, and reducing the unnecessary usage of the emergency department, each of which has been recognized by the Centers for Medicare and Medicaid Services as critically important to health care reform initiatives. COMMUNITY SUPPORT AND BENEFIT: *Health fairs: 625 participated in health fairs and 200 in free screenings hosted by OMC in various communities. *Educational dinners with speakers on health topics: 280 attendees *Educational presentations to area employers. *Other educational presentations: 330 attendees *Support of community Biggest Loser challenge: 232 enrolled and 138 completed challenge *Breathe Easy Coalition promoting smoke-free environments including campaign for smoke-free public areas and education on dangers of second-hand smoke. *Support of organizations such as Boys and Girls Club, Community Foundation Buddy Walk, and Future Farmers of America. *Athletic Physicals 411 local student athletes received free athletic physicals during an event at OMC. Free screenings were also offered at rural health clinics. *458 individuals participated in the OMC Superhero Fun Run, raising funds to help OMC patients who are in need and undergoing cancer treatment. *OMCs Education Services conducted 163 classes that were attended by 1,058 participants. Classes included First Aid, Heartsaver CPR/AED, Basic Life Support, Advanced Cardiac Life Support, Pediatric Advanced Life Support, Non-Violent Crisis Intervention, Basic Cardiac Dysrhythmia, 12 Lead, and Trauma Nursing Core Course. *MASH Camp 21 students in grades 10 through 12 participated in OMCs M*A*S*H (Medical and Science Health) Camp. The camp offers hands on experience for those interested in health care careers. *REACH and other tours or presentations to students about healthcare careers: 112 attendees *Collaboration with Missouri State University-West Plains to provide nursing program. *Job shadow and internship opportunities to develop future healthcare and business workforce. *Scholarships for healthcare programs and employee tuition reimbursement. In 2015, OMC paid over $63.5 million in annual wages to more than 1,100 employees. 180 volunteers contributed 28,413 hours to OMC. SERVICES: At Ozarks Medical Center, we are neighbors serving neighbors. Our system of eight rural health care clinics ensures that residents in our 8-county service area have access to the quality care they need. OMC Statistics: 114 beds 8-county service area serving a market of 160,000 people More than 100 physicians on medical staff Admissions 5,685 Births 641 Emergency Department Visits 26,077 Inpatient and Outpatient Surgeries 2,607 Rehabilitation Services Procedures 109,268 Rehabilitation Contracted Services 37,659 Home health, Hospice and Support 86,482 Allergy/Immunology Behavioral Healthcare Cancer Treatment Center Heart Care Services Nephrology Lung Care Services Internal medicine clinic Neurosciences Center Orthopedic Clinic Ozark Works/Occupational Medicine Pain Management Pulmonology Rheumatology Surgical Specialists Clinic Wound Care Services Womens Health Care Clinic West Plains Imaging Rehabilitation Services Sleep Center Family Care Clinics in nine communities Heart of the Ozarks Medical Equipment (H.O.M.E.) OMC offered x-ray, lab services, physical therapy, occupational therapy, speech-language pathology and counseling services in its outlying clinics, saving travel for many people living throughout the 8-county area served by OMC. area served by OMC. |
| FORM 990, PART VI, SECTION A, LINE 2 | BUSINESS AND FAMILY RELATIONSHIPS: GREG BEYKIRCH, ROGER SHAW III, MARJORIE SLAYTON, AND TRAVIS MORRISON SHARE A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINES 6, 7A, & 7B | MEMBERS/STOCKHOLDERS: OZARKS MEDICAL CENTER HAS ONE CLASS OF MEMBERSHIP. ALL INTERESTED PARTIES ARE ELIGIBLE FOR MEMBERSHIP UPON PAYMENT OF THE MEMBERSHIP FEES SET BY THE BOARD OF DIRECTORS. MEMBERSHIP IS NOT TRANSFERABLE OR ASSIGNABLE. MEMBERS, AFTER BEING A MEMBER FOR AT LEAST THIRTY DAYS, SHALL BE ELIGIBLE TO VOTE ON ANY BUSINESS OF THE CORPORATION. EACH MEMBER IS ENTITLED TO ONE VOTE. THE BOARD OF DIRECTORS CONSISTS OF 15 DIRECTORS. TEN OF THE CORPORATION'S BOARD MEMBERS, ELECTED FROM OZARKS MEDICAL CENTER'S SERVICE AREA, ARE ELECTED BY THE MEMBERS OF THE CORPORATION. ANY DIRECTOR PREVIOUSLY ELECTED BY THE MEMBERS MAY BE REMOVED FROM OFFICE BY THE MEMBERS AT AN ANNUAL MEETING OR ANY PROPERLY CALLED SPECIAL MEETING, BY THE VOTE OF TWO-THIRDS OF THE MEMBERS PRESENT, IN WHICH EVENT THE MEMBERS PRESENT WILL ELECT A SUCCEEDING DIRECTOR TO SERVE THE UNEXPIRED TERM OF THE REMOVED DIRECTOR. EACH MEMBER HAS ONE VOTE. ANY VACANCY DUE TO DEATH OR RESIGNATION SHALL BE FILLED BY ELECTION BY THE REMAINING MEMBERS OF THE BOARD. TWO DIRECTORS ARE ELECTED BY THE MEDICAL STAFF OF THE ORGANIZATION AND MUST BE A MEDICAL STAFF MEMBER THAT IS ALSO A MEMBER OF THE CORPORATION TO BE ELIGIBLE TO BE ELECTED TO THE BOARD. ANY VACANCIES OF THESE TWO BOARD POSITIONS ARE FILLED BY THE MEDICAL STAFF. THE REMAINING THREE BOARD OF DIRECTORS ARE DESIGNATED BY THEIR POSITION IN THE ORGANIZATION. THE CHIEF OF THE MEDICAL STAFF, THE IMMEDIATE PAST CHIEF OF THE MEDICAL STAFF, AND THE CHIEF ELECT OF THE MEDICAL STAFF ARE ALL BOARD MEMBERS FOR AS LONG AS THEY HOLD THOSE TITLES. THE BYLAWS OF THE CORPORATION MAY BE AMENDED AT AN ANNUAL OR PROPERLY CALLED SPECIAL MEETING OF THE MEMBERS OF THE CORPORATION BY TWO-THIRDS OF THE VOTE CAST OR A MAJORITY OF THE VOTING POWER, WHICHEVER IS LESS. THE BYLAWS MAY ALSO BE AMENDED BY THE BOARD PROVIDED THAT THE AMENDMENT DOES NOT RELATE TO THE NUMBER OF DIRECTORS, THE COMPOSITION OF THE BOARD, THE TERM OF OFFICE OF DIRECTORS, OR THE METHOD OR WAY IN WHICH DIRECTORS ARE ELECTED OR SELECTED, OR PROVIDED THAT THE BASIC PURPOSE OF THE CORPORATION SHALL NOT BE CHANGED OR ALTERED. IF ANY OF THOSE CONDITIONS DOES NOT APPLY, THE AMENDMENT MUST BE VOTED ON BY THE MEMBERS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | REVIEW PROCESS FOR FORM 990: 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 BOARD WILL REVIEW THE FORM AND RECORD IN THE MEETING MINUTES THEIR ACCEPTANCE OF THE DRAFT. |
| FORM 990, PART VI, SECTION B, LINE 12C | COMPLIANCE WITH CONFLICT OF INTEREST POLICY: CONFLICT STATEMENTS ARE REVIEWED ANNUALLY BY THE EXECUTIVE COMMITTEE TO DETERMINE IF NEW ITEMS WERE DISCLOSED. IF A BOARD MEMBER DID HAVE A CONFLICT OF INTEREST, HE/SHE WOULD ABSTAIN FROM VOTING ON ANY TRANSACTIONS RELATED TO THAT CONFLICT. STATEMENTS ARE ALSO OBTAINED FROM EXECUTIVES. |
| FORM 990, PART VI, SECTION B, LINE 15A | CEO COMPENSATION REVIEW: IN LATE 2013, B.E. SMITH (RECRUITMENT FIRM) WAS HIRED. THEY PERFORMED A REGIONAL SEARCH FOR OMC'S NEW CEO. THEY ALSO PROVIDED MARKET INFORMATION THAT INDICATED THE NEED TO INCREASE THE CEO COMPENSATION, WHICH THE COMPENSATION AND BENEFITS COMMITTEE VALIDATED WITH MISSOURI HOSPITAL ASSOCIATION DATA. THE FINAL COMPENSATION PACKAGE THAT WAS PRESENTED AND ACCEPTED BY THE CURRENT CEO WAS FIRST APPROVED AND REVIEWED BY THE COMPENSATION AND BENEFITS COMMITTEE AND BOARD EXECUTIVE COMMITTEE. ALL BOARD MEMBERS INVOLVED WERE INDEPENDENT BOARD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 15B | OTHER OFFICER & KEY EMPLOYEE COMPENSATION REVIEW: COMPENSATION IS DETERMINED USING A COMBINATION OF SOURCES INCLUDING MISSOURI HOSPITAL ASSOCIATION COMPARATIVE DATA, SEARCH FIRM DATA AND RECOMMENDATIONS AND OTHER AVAILABLE MARKET DATA. THIS REVIEW IS PERFORMED BY THE ORGANIZATION'S BOARD. |
| 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, PART VII, SECTION A | BOARD MEMBER COMPENSATION: BOARD MEMBERS CHARLES MORGAN, M.D., JASON SPURLING, M.D., A.K. GEORGE, M.D., AARON MILLS, M.D., AND RODNEY ZIMBELMAN, M.D., RECEIVE COMPENSATION FOR THEIR ROLES AS PHYSICIANS. NO BOARD MEMBERS RECEIVE ANY COMPENSATION FOR THEIR DUTIES AS A MEMBER OF THE BOARD OF DIRECTORS. |
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