2022-05-11T09:32:12-05:00 2021-06-30 420714325 RSM US LLP 4650 East 53rd Street Davenport IA 52807 990 2020-07-01 832249459 Mosaic Medical Center Maryville MOSA 8162717374 5325 Faraon Street Saint Joseph MO 64506 Karen S Miller Officer 2022-05-11 true Karen S Miller 999009999 Jenifer L Chase P01306883 5638884000 2020 2022-09-23 18:48:47Z Karen S Miller 5325 Faraon Street Saint Joseph MO 64506 87440620 false X https://www.mymlc.com/Main/Location/maryville-mo/mosaic-medical-center-maryville/ X 2018 MO TO IMPROVE POPULATION HEALTH OUTCOMES IN OUR REGION BY PROVIDING THE RIGHT CARE, AT THE RIGHT TIME, PLACE AND COST. 5 2 552 28 140293 51409 13055224 12446016 58859673 72581182 0 2269161 2413422 74184058 87440620 231399 110825 0 37544596 39209304 0 0 44436686 45007545 82212681 84327674 -8028623 3112946 31593665 38239596 18221395 21754380 13372270 16485216 TO IMPROVE POPULATION HEALTH OUTCOMES IN OUR REGION BY PROVIDING THE RIGHT CARE, AT THE RIGHT TIME, PLACE AND COST. false false 70526948 110825 74854311 MOSAIC MEDICAL CENTER-MARYVILLE (MOSAIC-MARYVILLE) IS A 81-BED MEDICAL SURGICAL HOSPITAL LOCATED IN MARYVILLE, MISSOURI. IT SERVES A COMMUNITY OF 12,000 RESIDENTS. BECAUSE MARYVILLE IS A BORDER CITY, IT ALSO PROVIDES SERVICES TO THOSE LIVING IN THE ADJACENT STATES OF KANSAS, NEBRASKA AND IOWA. THE ECONOMY OF THE REGION IS BASED ON AGRICULTURE, MINOR MANUFACTURING AND SMALL BUSINESSES RESULTING IN A PAYOR MIX FOR MOSAIC-MARYVILLE OF APPROXIMATELY 60.94% GOVERNMENTAL OR NO-PAY PATIENTS. MOSAIC-MARYVILLE PROVIDES A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES INCLUDING VASCULAR, ORTHOPEDIC AND GENERAL SURGERIES, AND MENTAL HEALTH SERVICES. IT OPERATES A 24-HOUR EMERGENCY ROOM, AND AN OBSTETRICS DEPARTMENT PROVIDES 9 LABOR/DELIVERY/RECOVERY/POST-PARTUM BEDS. DURING FY21, APPROXIMATELY 1,400 PATIENTS WERE ADMITTED TO MOSAIC-MARYVILLE RESULTING IN APPROXIMATELY 6,100 PATIENT DAYS. A TOTAL OF APPROXIMATELY 1,500 SURGERIES WERE PERFORMED, THE EMERGENCY ROOM SERVED APPROXIMATELY 7,400 PATIENTS AND APPROXIMATELY 90,100 VISITS WERE GENERATED BY OUTPATIENTS. THERE WERE APPROXIMATELY 100,100 PATIENT VISITS DURING THE YEAR. OTHER PROGRAM SERVICES: THE MOSAIC MEDICAL CENTER-MARYVILLE HAS A 340B DESIGNATION FROM HEALTH RESOURCES AND SERVICES ADMINISTRATION (FEDERAL GOVERNMENT). THIS ALLOWS MOSAIC-MARYVILLE TO RECEIVE OUTPATIENT DRUGS AT REDUCED PRICES FROM THE DRUG MANUFACTURERS. THE 340B PROGRAM ENABLES COVERED ENTITIES TO STRETCH SCARCE FEDERAL RESOURCES AS FAR AS POSSIBLE, REACHING MORE ELIGIBLE PATIENTS AND PROVIDING MORE COMPREHENSIVE SERVICES. THE PROGRAM IS AVAILABLE TO HOSPITALS THAT PROVIDE CARE FOR A DISPROPORTIONATE NUMBER OF PATIENTS THAT RANGE FROM NO INCOME TO LOW INCOME. 70526948 true true false true false false false false false true false false false true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true 48 0 true 552 true true true false false false false false false false false false false X 5 2 true false false false true true true true true false false true true true true true true false false false X Karen S Miller 8162717374 5325 Faraon Street St Joseph MO 64506 Michael Pulido COO/Secretary/Director/Chair 1.0 35.0 X X 0 771238 179962 Davin Turner DO Director/Vice Chair 1.0 38.0 X 0 678787 110974 Mark Laney MD Director/CEO 1.0 36.0 X 0 2352409 29716 Matt Baker Director 1.0 3.0 X 0 2500 0 Serena Naylor Director 1.0 4.0 X 0 2500 0 Dwain Stilson CFO/Treasurer 1.0 36.0 X 0 741217 42234 Nathan Blackford President 40.0 0 X 278691 0 62222 Amrit Singh MD Staff Physician 40.0 0 X 368659 0 19245 Benjamin Kinderknecht DO Staff Physician 40.0 0 X 422613 0 36063 Jack Forest DO Staff Physician 40.0 0 X 427569 0 42184 Shirley Harris MD Staff Physician 40.0 0 X 471102 0 11400 William Humphreys MD Staff Physician 40.0 0 X 434445 0 28982 2403079 4548651 562982 47 false true false Wapiti Medical Staffing 107 Flynn Drive Suite 600 Milbank SD 57252 Medical Services 947124 Medicus Hospitalists LLC 22 Roulston Road Windham NH 03087 Medical Services 810121 Nuclear Imaging of Omaha Inc 7515 South 46 Ave Omaha NE 68157 Medical Services 550159 Barton & Associates Inc PO Box 417844 Boston ME 022417844 Medical Services 527088 Eagle Telemedicine 280 Interstate North Circle Suite 150 Atlanta GA 30339 Medical Services 245174 6 6427528 5706068 312420 19975 12446016 Net Patient Service Revenue 621110 68057471 68057471 340B Pharmacy Revenue 621110 4523711 4523711 0 0 0 0 72581182 143101 143101 0 143101 143101 0 0 Referral Lab Revenue 621511 1893689 1814486 79203 Daycare Revenue 624410 61090 61090 Cafeteria Revenue 722514 227193 227193 88349 88349 0 0 2270321 87440620 74854311 140293 0 110825 110825 301955 0 301955 0 31885386 29721550 2163836 314365 313884 481 4869392 4335820 533572 1838206 1748395 89811 788 788 12735 12735 6498062 6389095 108967 0 2427 2427 2789350 2121981 667369 640866 605171 35695 1145246 115482 1029764 56767 52473 4294 28851 28593 258 766541 766541 2236367 1485289 751078 717737 714199 3538 Corporate Allocations From Mosaic Health System 12165111 4889793 7275318 Medical Supplies/Includes 340B 14789362 14789362 FRA Tax 2967048 2967048 Dues and Subscriptions 101267 46541 54726 89020 89020 0 0 84327674 70526948 13800726 0 13364 297858 8149160 9478200 0 0 0 0 1287366 1901812 752401 680036 25740746 3356592 19485988 22384154 0 0 1905386 1938607 0 1558929 31593665 38239596 2492579 3291590 0 0 15728816 18462790 18221395 21754380 X 13372270 16179297 305919 13372270 16485216 31593665 38239596 3112946 0 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 12735 12735 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY PORTION OF DUES PAID TO HOSPITAL ASSOCIATIONS THAT ARE USED FOR LOBBYING PURPOSES BY THE HOSPITAL ASSOCIATIONS. 32.40% of the membership dues paid to the Missouri Hospital Association are used for lobbying activities. 25.56% of the membership dues paid to the American Hospital Association are used for lobbying activities. 600000 600000 16318053 1052051 15266002 20302 5183 15119 6793728 1858050 4935678 2008663 441308 1567355 22384154 Due To Affiliates 18462790 18462790 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote Mosaic Health System, Heartland Regional Medical Center (Mosaic-St. Joseph), Mosaic Medical Center-Maryville (Mosaic-Maryville), Northwest Medical Center Association, Inc. (Mosaic-Albany), Heartland Long-Term Acute Care Hospital (HLTACH), Mosaic Life Care Foundation, and Northwest Medical Center Foundation (Mosaic-Albany) are nonprofit corporations described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Internal Revenue Code. However, they are subject to federal income tax on any unrelated business taxable income. Midwestern Health Management, Inc. (Midwestern) and HHS Properties, Inc. are subject to income taxation. With a few exceptions, Mosaic is no longer subject to U.S. federal, state and local income tax examinations by tax authorities for years before 2017. At June 30, 2021, net operating loss carryforwards generated in fiscal years ending June 30, 2018 and prior are available to offset future taxable income for these entities aggregated approximately $15,800 and expire through 2038. For net operating loss carryforwards generated in fiscal year-ended June 30, 2019 and forward will be available to offset future taxable income for these entities in the amount of $1,000 and carried forward indefinitely. Separate return limitation restrictions apply to a portion of these net operating loss carryforwards. Tax positions are not offset or aggregated with other positions. Tax positions that meet the more-likely-than-not recognition threshold are measured as the largest amount of tax benefit that is more than 50% likely to be realized on settlement with the applicable taxing authority. The portion of the benefits associated with tax positions taken that exceeds the amount measured as described above is reflected as a liability for uncertain tax benefits in the accompanying balance sheet along with any associated interest and penalties that would be payable to the taxing authorities upon examination. As of June 30, 2021 and 2020, there were no uncertain tax positions identified and recorded as a liability. true true X true X true X true true true false false 0 0 4262989 0 4262989 0.0507 0 0 9165436 6389483 2775953 0.0330 0 0 0 0 0 0.0 0 0 13428425 6389483 7038942 0.0837 0 0 36474 510 35964 0.0004 0 0 708 0 708 0.0000 0 0 1813782 877281 936501 0.0111 0 0 0 0 0 0.0 0 0 187797 0 187797 0.0022 0 0 2038761 877791 1160970 0.0138 0 0 15467186 7267274 8199912 0.0975 0 0 0 0 0 0.0 0 0 3855 0 3855 0.0000 0 0 94467 200 94267 0.0011 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 98322 200 98122 0.0012 false 2229292 0 13528874 17255758 -3726884 X true true 1 1 Mosaic Medical Center-Maryville 2016 South Main Maryville MO 64468 www.mymlc.com/Main/Location/maryville-mo/mosaic-medical-center-maryville/ 559-2 X X X Mosaic Medical Center-Maryville 1 false false true X X X X X X X X X 20 true false false true X https://www.mymlc.com/General/Community-Health-Needs-Assessment/maryville-community-health-needs-ass X true 20 true https://www.mymlc.com/General/Community-Health-Needs-Assessment/maryville-community-health-needs-ass false true X 200.0 300.0 X true true X X X X true X SEE SCHEDULE O X SEE SCHEDULE O X SEE SCHEDULE O X X X X X X true X false X X X X X true X false false Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY ARE A PRIORITIZED DESCRIPTION OF VARIOUS FACTORS INCLUDING: - SUBSTANCE ABUSE AND MENTAL HEALTH; - EXERCISE OPTIONS, HEALTHY EATING AND WELLNESS; AND - LACK OF TRANSPORTATION THESE SIGNIFICANT HEALTH NEEDS ARE IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - MOSAIC MEDICAL CENTER MARYVILLE (MOSAIC-MARYVILLE). Mosaic Medical Center - Maryville (MOSAIC-MARYVILLE), previously SSM Health St. Francis Hospital, joined the Mosaic HEALTH SYSTEM network effective April 1, 2019. MOSAIC-MARYVILLE offers both inpatient and outpatient services including Emergency Care, plus convenient clinics and specialty care services. We seek to improve the health of area individuals and communities and to provide the right care, at the right time, in the right place, at the right cost with outcomes second to none. THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS PREPARED BY MOSAIC-MARYVILLE. THE CHNA WAS CONDUCTED DURING TAX YEAR 2020, TO DETERMINE SERVICES NEEDED BY THE MEDICALLY UNDERSERVED. THE FOLLOWING TWO NEEDS WERE CHOSEN TO BE ADDRESSED OVER THE NEXT THREE YEARS: - MENTAL HEALTH, - ADULT AND CHILDHOOD OBESITY TO ENSURE INPUT WAS TAKEN INTO ACCOUNT FROM PERSONS WHO REPRESENT THE COMMUNITY, MOSAIC-MARYVILLE UTILIZED AN INDEPENDENT CONSULTING FIRM NAMED CROWE, LLP. THIS FIRM HELPED CONDUCT KEY STAKEHOLDER INTERVIEWS AND A COMMUNITY HEALTH SURVEY. KEY STAKEHOLDER INTERVIEWS: COMMUNITY INPUT WAS OBTAINED THROUGH KEY STAKEHOLDER INTERVIEWS PERFORMED WITH LEADERS FROM NINE COMMUNITY ORGANIZATIONS REPRESENTING PUBLIC HEALTH, PUBLIC SCHOOLS, LOCAL GOVERNMENT OFFICIALS, SOCIAL SERVICE ORGANIZATIONS AND NON-PROFIT ORGANIZATIONS. TO ASSURE THE MEDICALLY UNDERSERVED WERE REPRESENTED IN THIS CHNA, INTERVIEWS WERE CONDUCTED WITH REPRESENTATIVES FROM THE FOLLOWING ORGANIZATIONS: 1ST UNITED METHODIST CHURCH, BIG BROTHERS/BIG SISTERS OF NODAWAY COUNTY, COMMUNITY SERVICES INC., COMMUNITY SERVICES INC., MARYVILLE R-II SCHOOL DISTRICT, NODAWAY COUNTY ECONOMIC DEVELOPMENT, NODAWAY COUNTY HEALTH DEPARTMENT, NODAWAY COUNTY SENIOR CENTER, NORTHWEST MISSOURI REGIONAL COUNCIL OF GOVERNMENTS, AND NORTHWEST MISSOURI STATE UNIVERSITY. THESE KEY STAKEHOLDER INTERVIEWS WERE CONDUCTED BETWEEN JANUARY 12TH AND 15TH, 2021. TO ASSURE THAT MEDICALLY UNDERSERVED WERE INCLUDED IN THIS CHNA, INTERVIEWS WERE CONDUCTED WITH AGENCIES SERVING PERSONS WHO ARE HOMELESS, DISABLED, VICTIMS OF DOMESTIC VIOLENCE, UNEMPLOYED AND/OR PERSONS WITH LOW INCOME. COMMUNITY HEALTH SURVEY: In order to develop a broad understanding of community health needs, Mosaic -Maryville conducted a community survey in February 2021. A link to the survey was distributed via e-mail, social media and word of mouth to the community at-large. A total of 559 surveys were completed. The majority of respondents were White/Caucasian (99%). The remaining 1% identified with other racial or ethnic identities. THE SAMPLE INCLUDED MEN AND WOMEN, 18 AND OVER. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - MOSAIC MEDICAL CENTER-MARYVILLE (MOSAIC-MARYVILLE). THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED AND AN IMPLEMENTATION PLAN FOR ADDRESSING THE IDENTIFIED NEEDS WAS ADOPTED IN THE 2020 TAX YEAR. THE TOP TWO SIGNIFICANT NEEDS IDENTIFIED WERE: 1) MENTAL HEALTH; AND 2) ADULT AND CHILDHOOD OBESITY MOSAIC-MARYVILLE'S ROLE IS MUCH MORE THAN BEING A HOSPITAL. IT IS A FULLY ENGAGED COMMUNITY PARTNER STRIVING TO ADDRESS THE UNIQUE HEALTH AND SOCIAL ISSUES THAT CHALLENGE THE REGION. MANAGEMENT RECOGNIZES THAT THE COMMUNITY'S MAJOR HEALTH PROBLEMS STEM, IN LARGE PART, FROM SOCIAL DETERMINANTS OF HEALTH. SOCIAL DETERMINANTS THAT AFFECT ACCESS TO HEALTH CARE (HEALTHY PEOPLE 2020 FRAMEWORK) INCLUDE: ECONOMIC STABILITY, POVERTY, EMPLOYMENT, FOOD SECURITY, HOUSING STABILITY, EDUCATION, HIGH SCHOOL GRADUATION, ENROLLMENT IN HIGHER EDUCATION, LANGUAGE AND LITERACY, EARLY CHILDHOOD, NEIGHBORHOOD AND BUILT ENVIRONMENT, ACCESS TO HEALTHY FOOD, QUALITY OF HOUSING, CRIME AND VIOLENCE, ENVIRONMENTAL CONDITIONS, CIVIC PARTICIPATION, PERCEPTIONS OF DISCRIMINATION/EQUITY, AND INCARCERATION/INSTITUTIONALIZATION. TO POSITIVELY IMPACT THE SOCIAL DETERMINANTS OF HEALTH, MOSAIC-MARYVILLE CREATED THE FOLLOWING ACTION PLAN FOR POPULATION HEALTH: SIGNIFICANT NEED #1: MENTAL HEALTH PLAN: A) MOSAIC-Maryville WILL EXPAND AND CONTINUE CLINIC BEHAVIORAL HEALTH OFFERINGS. B) MOSAIC-Maryville WILL CONTINE TO provide support to organizations providing mental health programs to the community. C) Mosaic-Maryville will enhance relationship with Northwest Missouri State University's wellness center regarding behavioral/mental health concerns D) MOSAIC-Maryville will work with area schools to raise awareness and provide resources for child and adolescent mental health. E) Mosaic-Maryville will work with area mental health providers and collaborators to identify ways to reduce the stigma of mental illness. F) Mosaic-Maryville will identify and work together with funding sources to support mental health initiatives. SIGNIFICANT NEED #2: ADULT AND CHILDHOOD OBESITY: A) MOSAIC-Maryville will continue Healthy Lifestyles and Commit to Be Fit. B) MOSAIC-Maryville will continue diabetes education programs and support group. C) MOSAIC-Maryville will expand and continue the 4th Grade Challenge programs into all county schools and encourage caregivers to volunteer to participate in this program. D) MOSAIC-Maryville will continue health screenings. E) Mosaic-Maryville will increase community education regarding obesity. THE COMPLETE CHNA WITH IMPLEMENTATION STRATEGY CAN BE FOUND AT: HTTPS://www.mymlc.com/General/Community-Health-Needs-Assessment/maryville-community-health-needs-assessment/ Schedule H, Part V, Section B, Line 20 Facility , 1 Facility , 1 - Mosaic Medical Center - Maryville (Mosaic-Maryville). FINANCIAL COUNSELORS ARE AVAILABLE ONSITE TO EXPLAIN AND HELP PATIENTS AND GUARANTORS WITH THE FINANCIAL ASSISTANCE POLICY. SEE FINANCIAL ASSISTANCE POLICY FOR A COMPLETE DESCRIPTION OF EFFORTS MADE BEFORE INITIATING COLLECTION ACTIONS. 5 Mosaic Specialty Care - East 114 East South Hills Drive Maryville MO 64468 Behavioral Health & Walk-in Clinic Mosaic Medical Building - Maryville 2024 South Main Street Maryville MO 64468 ENT, Neurology, Wound Care, Gastroenterology, Pulmonary, Vascular Surgery, Home Health & Hospice Mosaic Family Care - Bedford 408 Dodge St Bedford IA 50833 Family Care Mosaic Family Care - Savannah 301 E Price Street Savannah MO 64485 Family Care Mosaic Outpatient Therapy - Maryville 409 West South Hills Drive Maryville MO 64468 Outpatient Therapy Schedule H, Part I, Line 3c Not Applicable Schedule H, Part I, Line 6a Not Applicable Schedule H, Part I, Line 7f Mosaic Medical Center Maryville (Mosaic-Maryville) did not report bad debt expense as part of operating expenses for Health Professions Education for year ended 06/30/21. NO BAD DEBT EXPENSE IS REPORTED ON FORM 990, PART IX, LINE 25, AS IT IS REPORTED ON FORM 990, PART VIII, LINE 2A IN NET PATIENT SERVICE REVENUE. THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE (SCHEDULE H, PART I, LINE 7, COLUMN (C)) AS A PERCENTAGE OF TOTAL EXPENSES IS 18.38%, AND THE PERCENTAGE INCREASES TO 38.89% IF MEDICARE ALLOWABLE COSTS (SCHEDULE H, PART III, SECTION B, LINE 6) ARE INCLUDED IN TOTAL COMMUNITY BENEFIT EXPENSE. Schedule H, Part I, Line 7g On March 11, 2020, the World Health Organization (WHO) declared the novel coronavirus disease (COVID-19) a pandemic. The Center for Disease Control (CDC) confirmed its spread to the United States and it was declared a national public health emergency, followed by state of emergency declarations (including by the Governor of Missouri), and the Centers for Medicare and Medicaid Services (CMS) issuing guidance regarding elective procedures. The COVID-19 pandemic has caused significant disruption to the national economy as well as Mosaic's operations. In 2021, the COVID-19 pandemic continued to impact Mosaic's business as well as patients, communities and employees. With the COVID-19 pandemic Mosaic-Maryville has incurred an increase in expenses related to the following items: 1. Personal Protective Equipment (PPE) 2. Pharmacy Expenses 3. Labor Costs 4. Supplies and various other expenses During FY21, Mosaic-Maryville experienced a net increase of $937,000 in Covid-19 expenses, which is reflected in Part I, Line 7g. Schedule H, Part I, Line 7g Subsidized Health Services CERTAIN COVID-19 COSTS WERE SUBSIDIZED WITH PROVIDER RELIEF FUNDS. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 0 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WAS THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2. FINANCIAL ASSISTANCE AT COST WAS $4,263,000 and $5,133,000 FOR YEARS ENDED 6/30/21 AND 6/30/20, RESPECTIVELY. MEDICAID NET COMMUNITY BENEFIT EXPENSE WAS $2,776,000 AND $3.458,000 FOR THE YEARS ENDED 6/30/21 AND 6/30/20, RESPECTIVELY. MOSAIC MEDICAL-MARYVILLE RECEIVES REIMBURSEMENT FROM THE MEDICAID PROGRAM IN RELATION TO THE PERCENTAGE OF MEDICAID AND INDIGENT POPULATION THEY SERVE. Schedule H, Part II Community Building Activities MOSAIC MEDICAL CENTER-Maryville (MOSAIC-Maryville) COMMUNITY BUILDING ACTIVITIES PROMOTED THE HEALTH OF THE COMMUNITIES SERVED BY PROVIDING quality child care SUPPORT in THE GREATER Maryville AREA through operation of a child care center. As a result of the Coronavirus Pandemic and other factors, the child care center closed in August of 2020. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Mosaic Medical Center-Maryville (Mosaic-Maryville) calculates bad debt expense at the established rate as reported in patient service revenue in the audited financial statements. Discounts provided by third-party payors on patient accounts are written off as contractual allowances. Payments received on an account previously written off to bad debt expense are credited to a bad debt recovery account. Schedule H, Part III, Line 3 Bad Debt Expense Methodology Mosaic Medical Center-Maryville (Mosaic-Maryville) used a charity care assessment system during the tax year-ended June 30, 2020 that assists the organization in identifying patients who are eligible for financial assistance under the organization's financial assistance policy (FAP). As a result, Mosaic-Maryville reported zero dollars for the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's FAP. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Please see THE ACCOUNTS RECEIVABLE FOOTNOTE ON PAGE 11 and the Patient Service revenue Footnote regarding implicit price concessions on page 18 OF The ATTACHED AUDITED FINANCIAL STATEMENTS. SEE ALSO THE PARAGRAPH IN THE CHARITY CARE FOOTNOTE ON PAGE 19. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO DIRECTLY FROM THE MEDICARE COST REPORT WHICH RESULTS IN A SHORTFALL of covering the hospital's cost of treating Medicare patients. This shortfall, IN ADDITION TO NON-PAYMENT BY MEDICARE RECIPIENTS FOR THEIR DEDUCTIBLE AND COINSURANCE AMOUNT INCREASES FINANCIAL ASSISTANCE AND BAD DEBT. Mosaic Medical Center - Maryville (Mosaic-Maryville) PROVIDES SERVICES TO ALL MEDICARE PATIENTS WITH THE KNOWLEDGE THAT THE COST OF PROVIDING CARE TO THEM MAY EXCEED THE REIMBURSEMENT FROM MEDICARE FOR THE SERVICES PROVIDED. THE SHORTFALL OF COSTS, FINANCIAL ASSISTANCE AND BAD DEBT IS CONSIDERED TO BE A COMMUNITY BENEFIT BECAUSE THE Mosaic-Maryville IS ABSORBING THE ADDITIONAL COST OF PROVIDING CARE TO THE ELDERLY AND DISABLED IN THE COMMUNITY. IN ADDITION, THIS COINCIDES WITH THE IRS REVENUE RULING 69-545, WHICH provides general requirements for tax exemption, along with section 501(c)(3). Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Mosaic Medical Center-Maryville is committed to continuing the rich 125 year tradition of serving Maryville and surrounding communities. Maintaining continuity with Franciscan Sisters of Mary and the SSM St. Francis organization, Mosaic Medical Center-Maryville is pleased to continue supporting vulnerable community member needs with a generous charity policy. THE FINANCIAL ASSISTANCE POLICY CONTAINS PROVISIONS ON COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ONLY. ACCORDING TO THIS POLICY, FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA ARE BASED ON RESIDENCY, GROSS HOUSEHOLD INCOME & HOUSEHOLD SIZE. APPLYING FOR FINANCIAL ASSISTANCE Patients will be informed of Mosaic Medical Center-Maryville's (Mosaic-Maryville) Financial Assistance Policy and the process for submitting an application. to determine if the patient or guarantor is eligible for financial assistance, Mosaic-Maryville asks for the necessary information and documents to prove household size, income, and residency. A completed application for financial assistance should be submitted within 240 days from the date of the first post-discharge billing statement. Mosaic-Maryville will make reasonable efforts to explain the Medicaid benefits, the health insurance exchange and coverage, and other public and private coverage that may apply. Mosaic-Maryville will also provide the details of these programs and offer to help patients and guarantors apply for them as well as, private programs and COBRA coverage. Once the patient or guarantor is screened to be potentially eligible for any of these programs, public or private, Mosaic-Maryville expects him or her to apply. If a patient or guarantor chooses not to apply, he or she may be denied financial assistance. If the patient or guarantor is potentially eligible for any third-party coverage, he or she must provide documentation of approval or denial of that third-party coverage before a Mosaic-Maryville financial assistance application will be accepted. Information on the Mosaic-Maryville Financial Assistance Policy will be communicated to patients in a culturally appropriate language. Information about the policy will be translated in the most prevalent languages in the Mosaic-Maryville primary service area. COLLECTION ACTIONS TAKEN IN EVENT OF NON-PAYMENT No account will be subject to collection actions within 120 days of issuing the first post-discharge statement and without first making reasonable efforts to determine whether the patient is eligible for financial assistance. No extraordinary collection actions will be pursued against a patient if the patient or guarantor has provided documentation showing that an application has been submitted for Medicaid or other publicly sponsored health programs, and that an eligibility determination is still pending. If a statement is sent to a patient or guarantor, and mail is returned as undeliverable, Mosaic-Maryville will attempt to find a correct address. If the correct address cannot be found, Mosaic-Maryville will attempt to contact the patient or guarantor by telephone at the number listed by the patient or guarantor. If efforts to communicate with the patient or guarantor fail, accounts will be sent to a collection agency. Reasonable efforts to inform patient of financial assistance Prior to sending an account to a collection agency, the patient or guarantor will generally receive a minimum of four written statements (includes the first post-discharge statement and three subsequent statements). These statements will include a telephone number for information on paying patient balances and a notice about financial assistance. If an agreement has not been made to resolve the account, the fourth and final statement will be sent to the patient or guarantor. This statement acts as a notice to the account owner of the amount owed to Mosaic-Maryville and that the account will be placed with a third-party collection agency in 30 days. This statement will include a plain language summary and will outline any collection actions that may be taken if a plan is not put in place to settle the account. There are other times when accounts may be placed in collections including when: 1. The patient or guarantor has not made timely payments according to the agreed-upon payment plan 2. The patient or guarantor has received a financial assistance discount but is no longer working with Mosaic-Maryville in good faith to pay off the remaining amount owed. Extraordinary collection activities Once an account is with the collection agency, the following actions may be taken to make sure debt for services and care is paid. They are "Extraordinary Collection Activities:" 1. Seizing the patient's or guarantor's bank account 2. Civil actions 3. Property liens 4. Garnishing of wages 5. Reporting adverse information to credit bureaus Before "Extraordinary Collection Activities" can begin, the account must be reviewed, and approval must be given by Patient Billing Leadership. When one of these actions is to be taken against a patient or guarantor, the patient or guarantor will be given a 30-day written notice of the action to be taken. The patient or guarantor will also be informed of the Financial Assistance Policy and how to apply for it. A plain language summary of the Financial Assistance Policy will be included with the notice. ENFORCEMENT Mosaic-Maryville staff are expected to uphold the highest ethical standards. All business must be conducted in the name of the caller or Mosaic-Maryville. Everything a staff member says must be true and correct using a professional approach. The staff as well as, all third-party vendors working on behalf of Mosaic-Maryville, will uphold and adhere to the Fair Debt Collection Practices Act. Schedule H, Part V, Section B, Line 16a FAP website - Mosaic Medical Center-Maryville: Line 16a URL: SEE SCHEDULE O; Schedule H, Part V, Section B, Line 16b FAP Application website - Mosaic Medical Center-Maryville: Line 16b URL: SEE SCHEDULE O; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Mosaic Medical Center-Maryville: Line 16c URL: SEE SCHEDULE O; Schedule H, Part VI, Line 2 Needs assessment MOSAIC MEDICAL CENTER-Maryville (MOSAIC-Maryville) HAS A ROBUST APPROACH FOR ASSESSING THE NEEDS OF THE COMMUNITIES IT SERVES. THIS ONGOING COMMITMENT INCLUDES COLLABORATING WITH LOCAL GROUPS, SCHOOL DISTRICTS AND CITY AND COUNTY AGENCIES TO IDENTIFY NEEDS, PROMOTE HEALTHY LIVING, ASSURE THAT AFFORDABLE MEDICAL SERVICES ARE AVAILABLE, DEVELOP STRATEGIES FOR IMPROVING EDUCATION AND ECONOMIC STRENGTH, AND PROVIDING ONGOING SUPPORT. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Mosaic Medical Center-Maryville (Mosaic-Maryville) INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEGINNING AT THE REGISTRATION DESK AND CONTINUING WITH FINANCIAL ASSISTANCE INFORMATION BEING INCLUDED ON EVERY BILLING STATEMENT A PATIENT OR GUARANTOR RECEIVES FROM THE Mosaic-Maryville. GUIDELINES FOR THE PROGRAM ARE AVAILABLE AT EACH REGISTRATION DESK AND ARE INCLUDED IN ALL ADMISSION PACKETS. PATIENTS ARE CONTACTED IF THE PATIENT IS EXPECTED TO HAVE A FINANCIAL RESPONSIBILITY FOR THE VISIT. A FINANCIAL COUNSELOR ATTEMPTS TO VISIT THE ROOM OF EVERY UNINSURED PATIENT THAT IS ADMITTED TO OUR FACILITY FOR OBSERVATION OR INPATIENT CARE. THE COUNSELOR DISCUSSES PAYMENT OPTIONS WITH THE PATIENT AND CAN ASSIST THEM WITH VARIOUS OPTIONS THAT INCLUDE, BUT ARE NOT LIMITED TO, MEDICAID APPLICATION, HEALTH CARE EXCHANGE ELIGIBILITY AND ELIGIBILITY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. COUNSELORS ALSO WORK WITH OUR CARE MANAGEMENT STAFF TO SUPPORT THE DISCHARGE PROCESSES SO THAT FINANCIAL HARDSHIP DOES NOT KEEP THE PATIENT FROM RECEIVING THE APPROPRIATE FOLLOW-UP CARE. THIS ASSISTANCE INCLUDES INSTRUCTIONS FOR SCHEDULING AN APPOINTMENT WITH A FINANCIAL COUNSELOR WHO CAN ASSIST THEM IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION. Schedule H, Part VI, Line 4 Community information Mosaic Medical Center - Maryville (Mosaic - Maryville) IS A not-for-profit hospital LOCATED IN Maryville, MISSOURI, AND OPERATES CLINICS IN Maryville, Savannah AND Bedford, IA. ITS PRIMARY SERVICE AREA IS PRIMARILY RURAL AND INCLUDES Nodaway COUNTY LOCATED IN NORTHWEST MISSOURI. ACCORDING TO THE 2019 U.S. CENSUS ESTIMATES, THE POPULATION IN THE NODAWAY COUNTY SERVICE AREA IS APPROXIMATELY 19,355, WHICH INCLUDES A HIGH PERCENTAGE OF LOW INCOME FAMILIES. THE ORGANIZATION SUPPORTS A PAYOR MIX OF APPROXIMATELY 60.94% GOVERNMENTAL OR SELF-PAY PATIENTS. Schedule H, Part VI, Line 5 Promotion of community health Mosaic MEDICAL CENTER - Maryville (MOSAIC-Maryville) IS A NONPROFIT HOSPITAL OPERATING TO SERVE A PUBLIC RATHER THAN A PRIVATE INTEREST AND MEETING THE REQUIREMENTS OF REVENUE RULING 69-545. CONTROL OF THE MOSAIC-Maryville RESTS WITH ITS BOARD, WHICH IS PRIMARILY COMPOSED OF MEMBERS OF THE COMMUNITY, IN ADDITION TO A FEW SELECT EMPLOYEES OF MOSAIC-Maryville. MOSAIC-Maryville ACCEPTS PATIENTS PAYING WITH MEDICAID AND MEDICARE AND OPERATES AN ACTIVE AND GENERALLY ACCESSIBLE EMERGENCY ROOM OPEN TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. MOSAIC-Maryville USES SURPLUS FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE, MAINTAIN AND IMPROVE EQUIPMENT AND FACILITIES, EXTEND SERVICE OFFERINGS TO NEW AREAS AND PROVIDE SUPPORT TO THE COMMUNITIES IT SERVICES. MOSAIC-Maryville PROMOTES HEALTH IN THE Maryville REGION IN NUMEROUS WAYS. MOSAIC-Maryville PROVIDED DIRECT FUNDING SUPPORT TO THE COMMUNITY ORGANIZATIONS WITH LIKE MISSIONS INCLUDING COMMUNITY EVENTS AND ACTIVITIES OF LOCAL SCHOOLS AND NURSING HOMES. THE ORGANIZATION OFFERS MANY EDUCATIONAL PROGRAMS TO HELP MAINTAIN A HEALTHY LIFESTYLE. THESE ARE WELL-ADVERTISED AND MOST OF THEM ARE FREE OF CHARGE. In regards to the mental health services provided to the community, Mosaic-Maryville works with Northwest Missouri State University's wellness center to provide assistance and education with behavioral/mental health concerns. In addition, the organization works with area schools to raise awareness and provide resources for child and adolescent mental health. Mosaic-Maryville has programs like Healthy Lifestyles and Commit to be Fit to help reduce adult and childhood obesity. Another program is Health 4 Life which participates with local schools to help reduce obesity. THE 340B DRUG PRICING PROGRAM ("340B PROGRAM") ENABLES SAFETY NET HEALTHCARE ORGANIZATIONS SERVING UNINSURED, VULNERABLE AND INDIGENT POPULATIONS TO PURCHASE OUTPATIENT PRESCRIPTION DRUGS AT A DISCOUNT. Mosaic-Maryville HAS PARTICIPATED IN THIS PROGRAM SINCE 2019. THIS PARTICIPATION HAS GENERATED REVENUE FROM THE CONTRACTED RETAIL PHARMACY RELATIONSHIPS AND HAS REDUCED DRUG PRICING FOR OUTPATIENT MEDICATIONS. THE PROGRAM IS CURRENTLY THREATENED BY LEGISLATIVE CHALLENGES. Schedule H, Part VI, Line 6 Affiliated health care system THE ORGANIZATION IS AFFILIATED, THROUGH A PARENT BOARD, WITH A REGIONAL Medical CENTER Hospital, A COMMUNITY FOUNDATION, A LONG-TERM ACUTE CARE HOSPITAL, A CRITICAL ACCESS RURAL HOSPITAL, A RURAL COMMUNITY FOUNDATION AND A GENERAL MEDICAL AND Surgical HOSPITAL. ALL OF WHICH COLLABORATE WITH EDUCATIONAL, GOVERNMENTAL AND LOCAL BUSINESS LEADERS TO IMPLEMENT PROGRAMS TO HELP IMPROVE HEALTH HABITS AND, IN THE LONG-TERM, THE HEALTH OF THE COMMUNITIES SERVED BY THE ORGANIZATION. These affiliations include the hospital reported on this tax return. THE PARENT BOARD IS COMPRISED OF COMMUNITY LEADERS WHO REPRESENT THE EDUCATIONAL, MEDICAL, GOVERNMENTAL AND BUSINESS SECTORS IN THE COMMUNITY. THE COMMUNITY FOUNDATION OVERSEES A NUMBER OF PROGRAMS WORKING TO IMPROVE HEALTH and Educational needs IN THE COMMUNITY. The Regional Medical center hospital provides general medical and surgical needs to patients and provides both primary and specialty physicians, in addition to providing emergent and outpatient clinic care for all. The Long-term acute care hospital IS A FACILITY DEDICATED TO THE CARE OF PATIENTS WHO HAVE CHRONIC CONDITIONS REQUIRING A LONGER LENGTH OF STAY THAN IS NORMALLY PROVIDED IN AN ACUTE CARE HOSPITAL. THE GENERAL MEDICAL and Surgical CARE HOSPITAL PROVIDES ACUTE, EMERGENT AND OUTPATIENT CLINIC CARE FOR ALL. THE CRITICAL ACCESS RURAL HOSPITAL PROVIDES ACUTE, EMERGENT AND OUTPATIENT CLINICS ARE FOR THOSE IN THE RURAL COMMUNITY AREA. THE RURAL COMMUNITY FOUNDATION SUPPORTS THE CRITICAL ACCESS RURAL HOSPITAL. ALL HOSPITAL FACILITIES PROVIDE CARE FOR ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. ALL THE HOSPITAL Organizations MAINTAIN AN ONGOING COMMITMENT TO PROVIDE SUPPORT FOR THE BETTERMENT OF THE COMMUNITY. true Northwest Foundation Inc 800 University Drive Maryville MO 64468 237165025 501(c)(3) 100000 General Support 1 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. The organization is committed to the development of a healthy community. Grants are provided to local groups that achieve these objectives. Generally Mosaic Medical Center - Maryville (Mosaic-Maryville) officers, directors or employees are in a volunteer position or are a board member of the recipient organization. The recipients are required to submit applications to Mosaic Medical Center-Maryville (MOSAIC-MARYVILLE) detailing the program's expenditures and progress toward the stated goals. false true false false false false false false false Michael Pulido COO/Secretary/Director/Chair 0 580634 0 185086 0 5518 0 149128 0 30834 0 951200 0 80837 Mark Laney MD Director/CEO 0 873001 0 1471285 0 8123 0 11400 0 18316 0 2382125 0 0 Davin Turner DO Director/Vice Chair 0 517876 0 154693 0 6218 0 83220 0 27754 0 789761 0 69482 Dwain Stilson CFO/Treasurer 0 485577 0 253973 0 1667 0 11400 0 30834 0 783451 0 0 Nathan Blackford President 218745 0 59070 0 876 0 33768 0 28454 0 340913 0 0 0 William Humphreys MD Staff Physician 426322 0 0 0 8123 0 11400 0 17582 0 463427 0 0 0 Shirley Harris MD Staff Physician 393736 0 61064 0 16302 0 11400 0 0 0 482502 0 0 0 Jack Forest DO Staff Physician 419446 0 0 0 8123 0 11400 0 30784 0 469753 0 0 0 Amrit Singh MD Staff Physician 240021 0 107520 0 21118 0 1423 0 17822 0 387904 0 0 0 Benjamin Kinderknecht DO Staff Physician 420946 0 0 0 1667 0 6779 0 29284 0 458676 0 0 0 Schedule J, Part I, Line 3 Compensation Plan COMPENSATION IS ESTABLISHED BY MOSAIC HEALTH SYSTEM, A RELATED ENTITY, USING THE FOLLOWING: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. COMPENSATION SURVEYS OR STUDIES 4. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan NATE BLACKFORD - VESTED $0 ; ACCRUED $25,400 DAVIN TURNER - VESTED $69,482; ACCRUED $71,820 MICHAEL PULIDO - VESTED $80,837; ACCRUED $137,728 THOSE LISTED ABOVE HAVE SIGNED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN WHICH RECOGNIZES THE VALUE OF THE INDIVIDUAL AND THE MUTUAL BENEFIT OF CONTINUED EMPLOYMENT FOR AN EXTENDED PERIOD OF TIME BY ESTABLISHING A 457F PLAN. THE FOLLOWING ARE THE GENERAL STIPULATIONS OF THE AGREEMENT: 1. THE PLAN IS FUNDED YEARLY AS THE RESULT OF A CALCULATION DESCRIBED IN THE AGREEMENT, WHICH WILL REWARD THE INDIVIDUAL WITH 100% VESTING BASED ON A 5-YEAR CLIFF VESTING SCHEDULE. 2. DISTRIBUTION WILL OCCUR AT NORMAL RETIREMENT AGE OR UPON DEATH OR UPON SEPARATION FROM SERVICE DUE TO DISABILITY OR UPON INVOLUNTARY SEPARATION FROM SERVICE WITHOUT CAUSE. THEN A LUMP SUM PAYMENT WILL BE DISBURSED WITHIN 90 DAYS OF EACH SITUATION TAKING INTO CONSIDERATION A NON-COMPETE COVENANT. 3. SEPARATION WITH CAUSE MAKES THE SUPPLEMENTAL EXECUTIVE RETIREMENT AGREEMENT NULL AND VOID. Form 990, Part VI, Line 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS MARK LANEY, M.D., MICHAEL PULIDO, AND DWAIN STILSON HAVE A BUSINESS RELATIONSHIP. Form 990, Part VI, Line 6 Classes of members or stockholders MOSAIC HEALTH SYSTEM, A MISSOURI NONPROFIT CORPORATION, IS THE SOLE MEMBER OF Mosaic Medical Center-Maryville (Mosaic-Maryville). Form 990, Part VI, Line 7a Members or stockholders electing members of governing body MOSAIC HEALTH SYSTEM, AS THE SOLE MEMBER OF Mosaic Medical Center-Maryville (Mosaic-Maryville) HAS THE RIGHT TO ELECT ALL THE BOARD OF DIRECTORS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders MOSAIC HEALTH SYSTEM, AS THE SOLE MEMBER SHALL HAVE THE FOLLOWING POWERS: OVERALL STRATEGIC DIRECTION, NUMBER AND ELECTION OF BOARD MEMBERS, APPOINTMENT OF AUDITORS AND LEGAL COUNSEL, ESTABLISHMENT OF BANKING RELATIONSHIPS AND MANAGEMENT OF CASH AND OTHER ASSETS, APPROVAL OF CHANGES TO THE ARTICLES OF INCORPORATION AND BYLAWS, LONG-RANGE PLANNING, ADOPTION OF ANNUAL OPERATING PLANS AND APPLICATION FOR CERTIFICATES OF NEED. Form 990, Part VI, Line 11b Review of form 990 by governing body THE ACCOUNTING STAFF OF THE ORGANIZATION PREPARES THE FORM 990 AND SUBMITS A DRAFT TO AN INDEPENDENT ACCOUNTING FIRM. THE INDEPENDENT ACCOUNTING FIRM REVIEWS THE FORM 990 WITH INFORMATION PROVIDED FROM THE ORGANIZATION'S ACCOUNTING STAFF. THE DRAFT FORM 990 IS REVISED FOR ANY CORRECTIONS OR CLARIFICATIONS BASED ON THE REVIEW BY THE INDEPENDENT ACCOUNTING FIRM. THEN THE FORM 990 IS REVIEWED BY THE ORGANIZATIONS LEADERSHIP FOR ANY QUESTIONS AND CONCERNS. AFTER RESOLVING QUESTIONS AND CONCERNS WITH LEADERSHIP AND THE ACCOUNTING FIRM, THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN PRESENTED TO BOARD FOR APPROVAL. ONCE APPROVED THEN THE 990 TAX RETURN IS ELECTRONICALLY FILED. Form 990, Part VI, Line 12c Conflict of interest policy THIS CONFLICTS OF INTEREST AND DOCUMENTATION POLICY ("POLICY") APPLIES TO ALL DIRECTORS AND OFFICERS OF THE ORGANIZATION AND ANY OTHER PERSON WHO IS IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE DECISIONS AND AFFAIRS OF THE ORGANIZATION (COLLECTIVELY, "COVERED PERSONS"). DUTY TO DISCLOSE IF AN INTERESTED PERSON HAS A POSITION OR FINANCIAL INTEREST IN ANY BUSINESS OR OTHER ENTITY WITH WHICH THE ORGANIZATION IS CONSIDERING ENTERING INTO AN ARRANGEMENT OR TRANSACTION, THE INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER POSITION OR FINANCIAL INTEREST AND ALL MATERIAL FACTS RELATED THERETO TO THE ORGANIZATION'S BOARD OF DIRECTORS (THE "BOARD") OR EXECUTIVE COMMITTEE AS SOON AS THE INTERESTED PERSON HAS KNOWLEDGE OF THE POTENTIAL ARRANGEMENT OR TRANSACTION, AND WHENEVER REQUESTED BY THE BOARD OR THE EXECUTIVE COMMITTEE. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS AFTER DISCLOSURE OF A POSITION OR A FINANCIAL INTEREST BY AN INTERESTED PERSON, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE INTERESTED PERSON (INCLUDING THOSE INTERESTED PERSONS WHO ARE MEMBERS OF THE BOARD OR EXECUTIVE COMMITTEE) WILL LEAVE THE BOARD MEETING WHILE THE DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS IN CONNECTION WITH THE PROPOSED TRANSACTION IS DISCUSSED BY THE BOARD OR THE EXECUTIVE COMMITTEE AND VOTED UPON. A POSITION OR A FINANCIAL INTEREST WILL BE CONSIDERED A CONFLICT OF INTEREST ONLY IF THE BOARD OR THE EXECUTIVE COMMITTEE MAKES SUCH DETERMINATION. AN INTERESTED PERSON IS CONSIDERED TO HAVE A CONFLICT OF INTEREST WITH RESPECT TO HIS OR HER COMPENSATION IF THE PERSON RECEIVES COMPENSATION FROM THE ORGANIZATION AND THE PERSON'S COMPENSATION IS BEING DISCUSSED OR REVIEWED BY THE BOARD OR ANY COMMITTEE THEREOF. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST *BEFORE ANY DISCUSSION AND VOTE ON WHETHER A CONFLICT OF INTEREST EXISTS, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OR THE EXECUTIVE COMMITTEE REGARDING THE INTERESTED PERSON'S POSITION OR FINANCIAL INTEREST. AFTER SUCH PRESENTATION, THE INTERESTED PERSON WILL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE PROPOSED TRANSACTION. *THE BOARD OR THE EXECUTIVE COMMITTEE WILL UNDERTAKE APPROPRIATE DUE DILIGENCE AND INFORM ITSELF OF ALL MATERIAL INFORMATION REASONABLY AVAILABLE TO IT AND EXPLORE ALL REASONABLE ALTERNATIVES TO THE PROPOSED TRANSACTION THAT WOULD NOT INVOLVE THE CONFLICT OF INTEREST. *IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OR THE EXECUTIVE COMMITTEE WILL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE PROPOSED TRANSACTION IS (I) IN THE ORGANIZATION'S BEST INTEREST, (II) FOR THE ORGANIZATION'S OWN BENEFIT, AND (III) FAIR AND REASONABLE TO THE ORGANIZATION. IN CONFORMITY WITH THIS DETERMINATION, THE BOARD WILL MAKE ITS DECISION AS TO WHETHER THE ORGANIZATION MAY ENTER INTO THE PROPOSED TRANSACTION. QUORUM FOR BOARD OR EXECUTIVE COMMITTEE ACTION FOR PURPOSES OF THE BOARD OR EXECUTIVE COMMITTEE ACTIONS TO BE TAKEN UNDER THESE PROCEDURES, INCLUDING THE DETERMINATION WHETHER A CONFLICT OF INTEREST EXISTS, A MAJORITY OF THE DISINTERESTED DIRECTORS ON THE BOARD OR THE EXECUTIVE COMMITTEE WILL CONSTITUTE A QUORUM. HOWEVER, IN NO CASE WILL A SINGLE DISINTERESTED DIRECTOR TAKE ANY SUCH ACTION. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY IF THE BOARD OR THE EXECUTIVE COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO DISCLOSE A POSITION OR A FINANCIAL INTEREST, IT WILL INFORM THE COVERED PERSON OF THE BASIS FOR SUCH BELIEF AND AFFORD THE COVERED PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE COVERED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED UNDER THE CIRCUMSTANCES, THE BOARD OR THE EXECUTIVE COMMITTEE DETERMINES THAT THE COVERED PERSON HAS IN FACT FAILED TO DISCLOSE A POSITION OR A FINANCIAL INTEREST, THE BOARD OR THE EXECUTIVE COMMITTEE WILL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. DOCUMENTATION IN MINUTES THE MINUTES OF THE BOARD OR THE EXECUTIVE COMMITTEE WILL CONTAIN: *WITH RESPECT TO THE DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS, THE NAME OF THE INTERESTED PERSON WHO DISCLOSED OR WAS OTHERWISE FOUND TO HAVE A POSITION OR FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST; THE NATURE OF THE POSITION OR FINANCIAL INTEREST; ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT; AND THE BOARD OR THE EXECUTIVE COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED. *WITH RESPECT TO WHETHER OR NOT THE CONFLICT OF INTEREST TRANSACTION IS APPROVED, THE NAMES OF THE PERSONS PRESENT FOR THE DISCUSSIONS AND VOTE RELATED TO THE PROPOSED TRANSACTION; THE CONTENT OF THE DISCUSSION; WHETHER ALTERNATIVES WERE DISCUSSED THAT DID NOT INVOLVE A CONFLICT OF INTEREST; THE BASIS FOR THE DETERMINATION THAT THE PROPOSED TRANSACTION WAS (I) IN THE ORGANIZATION'S BEST INTEREST, (II) FOR THE ORGANIZATION'S OWN BENEFIT, AND (III) FAIR AND REASONABLE TO THE ORGANIZATION; AND THE RECORD OF THE VOTE TAKEN IN CONNECTION WITH THE PROCEEDINGS. ANNUAL STATEMENTS EACH COVERED PERSON WILL ANNUALLY SIGN A STATEMENT THAT AFFIRMS SUCH PERSON: *HAS RECEIVED A COPY OF THIS POLICY; *HAS READ AND UNDERSTANDS THE POLICY; *HAS AGREED TO COMPLY WITH THE POLICY; AND *UNDERSTANDS THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX AND TO MAINTAIN ITS FEDERAL TAX EXEMPTION THE ORGANIZATION MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IN ADDITION, EACH COVERED PERSON WILL ANNUALLY COMPLETE, SIGN AND PROMPTLY RETURN TO THE BOARD A QUESTIONNAIRE AND DISCLOSURE STATEMENT SUBSTANTIALLY IN THE FORM ATTACHED HERETO. A COVERED PERSON NEED NOT DISCLOSE COMPENSATION PAID TO THE COVERED PERSON BY ORGANIZATION PURSUANT TO A RESOLUTION OF THE BOARD. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. ALL OF THESE DOCUMENTS ARE LOCATED IN ADMINISTRATION. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue All Other Revenue - Total Revenue: 88349, Related or Exempt Function Revenue: 88349, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part XII, Line 2c Mosaic Health System the sole member of Mosaic Medical Center-Maryville (Mosaic-Maryville), filed a consolidated audited financial statement for year ending 6/30/21. These financial statements were audited by RSM US LLP. Upon completion of the audit, RSM US LLP provided an opinion that the FY21 financial statements fairly presented, in all material respects, the financial position of Mosaic Health System and related organizations. RSM presented the audited financial statements and the Board of Directors reviewed and approved the FY21 audited financial statements. Schedule H, Part V, Section B, Line 16a https://www.mymlc.com/Main/Location/st-joseph-mo/mosaic-medical-center-st.-joseph/main-medical-center/medical-bills-made-easy/financial-assistance/ Schedule H, Part V, Section B, Line 16b https://www.mymlc.com/Main/Location/st-joseph-mo/mosaic-medical-center-st.-joseph/main-medical-center/medical-bills-made-easy/financial-assistance/ Schedule H, Part V, Section B, Line 16c https://www.mymlc.com/Main/Location/st-joseph-mo/mosaic-medical-center-st.-joseph/main-medical-center/medical-bills-made-easy/financial-assistance/ Form 990, Part XII, Line 2C Financial Statements and Reporting The results of the consolidated audit are reviewed by the Mosaic Health System Board, the parent corporation. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS ESTABLISHED BY MOSAIC HEALTH SYSTEM, A RELATED ENTITY. AN ANNUAL REVIEW WAS PERFORMED DURING THE PRIOR FISCAL YEAR. MARKET DATA WAS PROVIDED BY A THIRD PARTY COMPENSATION CONSULTANT THAT SPECIALIZES IN MARKET SALARY DATA. A COMPENSATION COMMITTEE COMPRISED OF MOSAIC HEALTH SYSTEM BOARD CHAIR, MOSAIC HEALTH SYSTEM BOARD VICE-CHAIR AND THREE ADDITIONAL MOSAIC HEALTH SYSTEM BOARD MEMBERS AND INDEPENDENT LEGAL COUNSEL, AS SCRIBE, OVERSAW AN ANNUAL SALARY REVIEW PROCESS FOR OFFICERS AND ADMINISTRATORS. FOR EACH POSITION TO BE REVIEWED, THE FULL SCOPE OF DUTIES AND RESPONSIBILITIES, NUMBERS OF STAFF MANAGED, PROCESSES MANAGED, APPROXIMATE REVENUE, EXPENSE, OR CAPITAL DOLLARS MANAGED WERE PROVIDED TO THE THIRD PARTY CONSULTANT. FACILITY SIZE, NOT-FOR-PROFIT STATUS AND THE SCOPE OF EACH JOB POSITION WERE COMPARED TO LIKE FACILITIES TO DETERMINE BASE COMPENSATION AND INCENTIVE COMPENSATION FOR EACH POSITION. THE DATA GATHERED BY THE THIRD PARTY CONSULTANT WAS REVIEWED BY THE COMPENSATION COMMITTEE, OUTLIER ISSUES WERE RESOLVED AND, BASED UPON PRESENT FINANCIAL INDICATORS, THE COMMITTEE MADE ITS DETERMINATION OF COMPENSATION LEVELS FOR THE NEXT PAY YEAR. Mosaic Health System (MHS) 5325 Faraon Street St Joseph MO 64506 431283316 Healthcare MO 501(c)(3) Type II NA false Heartland Foundation (MOSAIC LIFE CARE FOUNDATION) 5325 Faraon Street St Joseph MO 64506 431262768 Support MO 501(c)(3) 7 Mosaic Health System true Heartland Long Term Acute Care Hospital (HLTACH) 5325 Faraon Street St Joseph MO 64506 261972987 Healthcare MO 501(c)(3) 3 Mosaic Health System true Heartland Regional Medical Center (MOSAIC-ST JOSEPH) 5325 Faraon Street St Joseph MO 64506 440545289 Healthcare MO 501(c)(3) 3 Mosaic Health System true Northwest Medical Center Association Inc (MOSAIC-ALBANY) 705 North College Street Albany MO 64402 440580870 Healthcare MO 501(c)(3) 3 Mosaic Health System true Northwest Medical Center Foundation Inc (NMC FOUNDATION) 705 North College Street Albany MO 64402 473694893 Support MO 501(c)(3) Type I Northwest Medical Center Association Inc true ST JOSEPH DOWNTOWN DEVELOPMENT LLC 5325 Faraon Street St Joseph MO 64506 474317460 DEVELOPMENT OF DOWNTOWN ST. JOSEPH MO NA N/A Midwestern Health Management Inc 5325 Faraon Street St Joseph MO 64506 431264358 Healthcare MO NA C Corporation true HHS Properties Inc 5325 Faraon Street St Joseph MO 64506 431593799 Investment MO NA C Corporation true Uptown Housing Inc 5325 Faraon Street St Joseph MO 64506 261416252 Redevelopment MO NA C Corporation true Uptown St Joseph Redevelopment Corp 5325 Faraon Street St Joseph MO 64506 201742813 Redevelopment MO NA C Corporation true false false true false false false false false false true true false true true true true false true false Mosaic Health System (MHS) C 6407553 FMV Heartland Regional Medical Center (Mosaic-St Joseph) P 4152321 FMV Mosaic Health System (MHS) M 11468831 FMV Mosaic Health System (MHS) P 10629320 FMV Mosaic Health System (MHS) R 766486 FMV