HEARTLAND REGIONAL MEDICAL CENTER: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: HEARTLAND REGIONAL MEDICAL CENTER (EIN 44-0545289)
Tax period: 2018-07-01 to 2019-06-30
Filed: 2020-05-12
IRS object ID: 202031339349302728
Schema version: 2018v3.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-05-12T17:01:17-05:00	ReturnTs
Tax Period End	2019-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	420714325	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	RSM US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	4650 East 53rd Street	AddressLine1Txt
City	Davenport	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	52807	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	440545289	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Heartland Regional Medical Center	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	HEAR	BusinessNameControlTxt
Phone	8162717070	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	5325 Faraon Street	AddressLine1Txt
City	St Joseph	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	64506	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Dwain Stilson	PersonNm
Person Title	Officer	PersonTitleTxt
Signature	2020-05-12	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Jenifer L Chase	PreparerPersonNm
PTIN	P01306883	PTIN
Phone	5638884000	PhoneNum

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-09-23 17:36:50Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	Mosaic Life Care	BusinessNameLine1Txt

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Dwain Stilson	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	5325 Faraon Street	AddressLine1Txt
City	St Joseph	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	64506	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$950,296,386	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	https://www.mymlc.com/Main/Location/st-joseph-mo/mosaic-medical-center-st.-joseph/	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1985	FormationYr
Legal Domicile State	MO	LegalDomicileStateCd
Activity Or Mission	TO IMPROVE POPULATION HEALTH OUTCOMES IN OUR REGION BY PROVIDING THE RIGHT CARE, AT THE RIGHT TIME, PLACE AND COST.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	4357	TotalEmployeeCnt
Total Volunteers	425	TotalVolunteersCnt
Total Gross UBI	$238,022	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$404,614	PYContributionsGrantsAmt
CY Contributions Grants	$355,545	CYContributionsGrantsAmt
PY Program Service Revenue	$619,549,975	PYProgramServiceRevenueAmt
CY Program Service Revenue	$633,150,002	CYProgramServiceRevenueAmt
PY Investment Income	$22,782,479	PYInvestmentIncomeAmt
CY Investment Income	$23,797,245	CYInvestmentIncomeAmt
PY Other Revenue	$26,609,496	PYOtherRevenueAmt
CY Other Revenue	$11,529,345	CYOtherRevenueAmt
PY Total Revenue	$669,346,564	PYTotalRevenueAmt
CY Total Revenue	$668,832,137	CYTotalRevenueAmt
PY Grants And Similar Paid	$4,896,749	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$53,842,112	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$350,501,825	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$327,681,503	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$268,893	CYTotalFundraisingExpenseAmt
PY Other Expenses	$289,902,137	PYOtherExpensesAmt
CY Other Expenses	$260,502,677	CYOtherExpensesAmt
PY Total Expenses	$645,300,711	PYTotalExpensesAmt
CY Total Expenses	$642,026,292	CYTotalExpensesAmt
PY Revenues Less Expenses	$24,045,853	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$26,805,845	CYRevenuesLessExpensesAmt
Total Assets BOY	$935,224,619	TotalAssetsBOYAmt
Total Assets EOY	$1,073,189,130	TotalAssetsEOYAmt
Total Liabilities BOY	$343,474,048	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$442,957,247	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$591,750,571	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$630,231,883	NetAssetsOrFundBalancesEOYAmt
Mission	TO IMPROVE POPULATION HEALTH OUTCOMES IN OUR REGION BY PROVIDING THE RIGHT CARE, AT THE RIGHT TIME, PLACE AND COST.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$593,047,858	ExpenseAmt
Grant	$53,842,112	GrantAmt
Revenue	$644,174,605	RevenueAmt
Desc	HEARTLAND REGIONAL MEDICAL CENTER (Mosaic-St. Joseph) IS A 352-BED MEDICAL SURGICAL HOSPITAL LOCATED IN ST. JOSEPH, MISSOURI. IT SERVES A COMMUNITY OF 77,000 RESIDENTS. BECAUSE ST. JOSEPH 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-ST. JOSEPH APPROXIMATELY 70.79% GOVERNMENTAL OR Self-PAY PATIENTS. 18.9% OF THE POPULATION HAVE INCOME THAT IS BELOW THE FEDERAL POVERTY LEVEL. MOSAIC-ST. JOSEPH PROVIDES A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES INCLUDING CARDIO-THORACIC, VASCULAR, ORTHOPEDIC AND GENERAL SURGERIES, MENTAL HEALTH SERVICES, ALONG WITH A FULL ARRAY OF DIAGNOSTIC AND THERAPEUTIC SERVICES. IT OPERATES A 24-HOUR EMERGENCY ROOM DESIGNATED AS A TRAUMA II CENTER BY THE STATE OF MISSOURI. MOSAIC-ST. JOSEPH'S OBSTETRICS DEPARTMENT PROVIDES 18 LABOR, DELIVERY, RECOVERY AND POST-PARTUM BEDS WHICH ARE ALSO DESIGNATED AS A LEVEL II CENTER. THE HOSPITAL PROVIDES RADIATION ONCOLOGY SERVICES, HOME HEALTH VISITS AND HOSPICE CARE. THE ORGANIZATION IS A MEMBER OF THE MAYO NETWORK FOR CLINICAL CONSULTATIONS. DURING THE YEAR, APPROXIMATELY 16,500 PATIENTS WERE ADMITTED TO THE HOSPITAL RESULTING IN APPROXIMATELY 70,000 PATIENT DAYS. A TOTAL OF APPROXIMATELY 10,500 SURGERIES WERE PERFORMED, THE EMERGENCY ROOM SERVED APPROXIMATELY 54,000 PATIENTS AND APPROXIMATELY 139,500 VISITS WERE GENERATED BY OUTPATIENTS. MOSAIC-ST. JOSEPH EMPLOYS APPROXIMATELY 4,400 FULL-TIME EQUIVALENT CARE GIVERS. THE MEDICAL STAFF INCLUDES APPROXIMATELY 270 PROVIDERS COVERING PRIMARY CARE AND SPECIALTY CLINICS FOR APPROXIMATELY 33 LOCATIONS THROUGHOUT THE REGION. THERE WERE APPROXIMATELY 590,000 CLINIC PATIENT VISITS DURING THE YEAR. OTHER PROGRAM SERVICES: MOSAIC-ST. JOSEPH HAS A 340B DESIGNATION FROM HEALTH RESOURCES AND SERVICES ADMINISTRATION (FEDERAL GOVERNMENT). THIS ALLOWS THE MEDICAL CENTER 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.	Desc
Total Program Service Expenses	$593,047,858	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	Yes (true)	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	Yes (true)	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	279	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	4357	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	Yes (true)	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Form1098 C Filed	false	Form1098CFiledInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	Yes (true)	SubjToTaxRmnrtnExPrchtPymtInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Dwain Stilson	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	8162717070	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	5325 Faraon Street	AddressLine1Txt
City	St Joseph	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	64506	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Mark Laney MD
Director/President/Mosaic Health System CEO	32.0	4.0	Yes (X)	Yes (X)	$1,485,460	$0	$25,971
Brian Bradley
Director (Until 12/2018)	1.0	1.0	Yes (X)		$2,500	$0	$0
Gary Frazer
Director (As of 01/2018)	1.0	1.0	Yes (X)		$2,500	$0	$0
Lucinda Hayden MD
Director (As of 1/2017)(Until 12/2019)	39.0	1.0	Yes (X)		$574,661	$0	$25,777
Matt Baker
Director (As of 6/2019)	1.0	3.0	Yes (X)		$0	$0	$0
Daniel Heckman
Director	1.0	1.0	Yes (X)		$2,500	$0	$0
Chris Looney MD
Director/Chair (As of 1/2003)	1.0	1.0	Yes (X)		$45,029	$0	$0
Matt Lukens MD
Director (As of 01/2018)	39.0	1.0	Yes (X)		$655,793	$0	$35,067
Serena Naylor
Director/Vice Chair	1.0	4.0	Yes (X)		$2,500	$0	$0
Thomas Richmond
Director (As of 1/2019)	1.0	2.0	Yes (X)		$0	$0	$0
Ophelia Lavell Rucker
Director	1.0	1.0	Yes (X)		$2,500	$0	$0
Sterett Schanze
Director (As of 01/2017)	1.0	1.0	Yes (X)		$2,500	$0	$0
Brenda Sharpe
Director (Until 12/2018)	1.0	1.0	Yes (X)		$2,500	$0	$0
Melody Smith
Director (As of 1/2019)	1.0	1.0	Yes (X)		$0	$0	$0
Adam Stein
Director	1.0	1.0	Yes (X)		$2,500	$0	$0
Barbara Wurtzler
Director/Chair/Vice Chair (Until 12/2018)	1.0	1.0	Yes (X)		$2,500	$0	$0
Karen Dittemore
Assistant Secretary	38.0	2.0		Yes (X)	$73,108	$0	$12,104
Michael Pulido
COO/Secretary	32.0	4.0		Yes (X)	$685,830	$0	$147,227
Dwain Stilson
CFO/Treasurer	32.0	5.0		Yes (X)	$661,558	$0	$36,467
Brady D Dubois
President of Mosaic Hospitals	37.0	3.0			$399,104	$0	$85,346	Yes (X)
Brennan Lehman
Chief Information Officer	38.0	0			$399,693	$0	$65,888	Yes (X)
Julee Thompson
Chief Nursing Executive	40.0	0			$361,498	$0	$22,846	Yes (X)
Davin Turner DO
Clinic President	38.0	2.0			$544,411	$0	$81,597	Yes (X)
Rony M Abou-Jawde MD
Staff Physician	40.0	0			$1,182,895	$0	$34,197		Yes (X)
Joshua Nelson MD
Staff Physician	40.0	0			$1,367,820	$0	$13,690		Yes (X)
Robert Grant DO
Staff Physician	40.0	0			$978,192	$0	$37,897		Yes (X)
Bonnie Goins MD
Staff Physician	40.0	0			$1,094,493	$0	$23,000		Yes (X)
Hemant K Sheth MD
Staff Physician	40.0	0.0			$1,033,554	$52,421	$29,900		Yes (X)
Curt Kretzinger
Former COO (Until 01/2017)	40.0	0.0			$512,184	$0	$16,015			Yes (X)
John P Wilson
Former Secretary/Treasurer (until 01/2017)	40.0	0.0			$352,360	$0	$0			Yes (X)
John Olson MD
Former Director/Physician (Until 12/2016)	40.0	0.0			$606,717	$0	$34,618			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$13,036,860	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$52,421	TotReportableCompRltdOrgAmt
Total Other Compensation	$727,605	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	418	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Quest Diagnostics
PO Box 14730	St Louis	MO	63150	Medical Services	$1,531,544
Capital Performance Management
11709 Roe Ave D236	Leawood	KS	662112607	Capital Management	$1,287,236
Bird Law Firm PC
1212 Frederick Avenue	St Joseph	MO	64501	Attorney services	$1,150,000
Kaufman Hall & Associates LLC
8610 Solution Center	Chicago	IL	60677	capital advisory services	$1,050,502
POLSINELLI SHUGHART PC
3103 FREDRICK AVENUE	St Joseph	MO	64506	ATTORNEY SERVICES	$770,871

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	53	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
All Other Contributions	$355,545	AllOtherContributionsAmt
Total Contributions	$355,545	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Service Revenue	621110	$586,100,000	$586,100,000
340B Pharmacy Revenue	621110	$47,050,002	$47,050,002

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$633,150,002	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$14,927,245	TotalRevenueColumnAmt
Exclusion	$14,927,245	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$786,076	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$390,393	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$395,683	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$395,683	TotalRevenueColumnAmt
Unrelated Business Revenue	$128,963	UnrelatedBusinessRevenueAmt
Exclusion	$266,720	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$289,943,856	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$281,073,856	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$8,870,000	SecuritiesAmt
Other	$0	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,870,000	TotalRevenueColumnAmt
Exclusion	$8,870,000	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
Referral Lab	621511	$5,202,168	$5,137,910	$64,258
Cafeteria	722514	$2,868,431	$2,868,431
Copying Revenue	561439	$489,736	$489,736

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,573,327	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,528,526	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$44,801	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$11,133,662	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$668,832,137	TotalRevenueColumnAmt
Related Or Exempt Func Income	$644,174,605	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$238,022	UnrelatedBusinessRevenueAmt
Exclusion	$24,063,965	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$53,842,112	TotalAmt
Program Services	$53,842,112	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$6,065,210	TotalAmt
Program Services	$2,720,639	ProgramServicesAmt
Management And General	$3,344,571	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$261,553	TotalAmt
Program Services	$261,553	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$262,965,206	TotalAmt
Program Services	$246,344,541	ProgramServicesAmt
Management And General	$16,564,504	ManagementAndGeneralAmt
Fundraising	$56,161	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$7,586,164	TotalAmt
Program Services	$6,169,132	ProgramServicesAmt
Management And General	$1,415,403	ManagementAndGeneralAmt
Fundraising	$1,629	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$34,690,522	TotalAmt
Program Services	$33,848,859	ProgramServicesAmt
Management And General	$827,680	ManagementAndGeneralAmt
Fundraising	$13,983	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$16,112,848	TotalAmt
Program Services	$14,904,973	ProgramServicesAmt
Management And General	$1,204,044	ManagementAndGeneralAmt
Fundraising	$3,831	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$27,787	TotalAmt
Program Services	$27,787	ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$1,290,022	TotalAmt
Management And General	$1,290,022	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$285,646	TotalAmt
Management And General	$285,646	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$106,500	TotalAmt
Program Services	$106,500	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$39,568,451	TotalAmt
Program Services	$34,118,016	ProgramServicesAmt
Management And General	$5,450,019	ManagementAndGeneralAmt
Fundraising	$416	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,639,840	TotalAmt
Program Services	$174,423	ProgramServicesAmt
Management And General	$1,465,417	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$21,505,344	TotalAmt
Program Services	$16,590,436	ProgramServicesAmt
Management And General	$4,785,272	ManagementAndGeneralAmt
Fundraising	$129,636	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$12,675,023	TotalAmt
Program Services	$11,814,380	ProgramServicesAmt
Management And General	$848,771	ManagementAndGeneralAmt
Fundraising	$11,872	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$10,103,199	TotalAmt
Program Services	$8,029,414	ProgramServicesAmt
Management And General	$2,044,430	ManagementAndGeneralAmt
Fundraising	$29,355	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$568,682	TotalAmt
Program Services	$492,730	ProgramServicesAmt
Management And General	$54,469	ManagementAndGeneralAmt
Fundraising	$21,483	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$1,059,563	TotalAmt
Program Services	$857,294	ProgramServicesAmt
Management And General	$202,269	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$6,534,181	TotalAmt
Program Services	$96,776	ProgramServicesAmt
Management And General	$6,437,405	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$23,514,116	TotalAmt
Program Services	$22,195,917	ProgramServicesAmt
Management And General	$1,318,199	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$5,898,994	TotalAmt
Program Services	$5,670,310	ProgramServicesAmt
Management And General	$228,684	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	FundraisingFundraisingAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies/Includes 340B	$110,255,235	$110,254,848	$387
FRA Taxes	$22,863,480	$22,863,480
Dues & Subscriptions	$2,606,614	$1,663,738	$140	$942,736

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$642,026,292	TotalAmt
Program Services	$593,047,858	ProgramServicesAmt
Management And General	$48,709,541	ManagementAndGeneralAmt
Fundraising	$268,893	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$22,237,498	BOYAmt
EOY	$18,630,714	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$67,001,634	BOYAmt
EOY	$70,509,499	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$7,108,391	BOYAmt
EOY	$7,119,066	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$7,556,500	BOYAmt
EOY	$8,209,765	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$18,617,583	BOYAmt
EOY	$26,149,940	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$628,188,547	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$410,230,823	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$175,426,543	BOYAmt
EOY	$217,957,724	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$596,253,501	BOYAmt
EOY	$663,420,570	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$7,326,969	BOYAmt
EOY	$7,365,960	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
EOY	$1,693,373	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$33,696,000	BOYAmt
EOY	$52,132,519	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$935,224,619	BOYAmt
EOY	$1,073,189,130	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$138,050,617	BOYAmt
EOY	$136,973,414	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$201,901,083	BOYAmt
EOY	$297,204,774	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$3,522,348	BOYAmt
EOY	$8,779,059	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$343,474,048	BOYAmt
EOY	$442,957,247	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$591,135,833	BOYAmt
EOY	$629,232,793	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$614,738	BOYAmt
EOY	$999,090	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$591,750,571	BOYAmt
EOY	$630,231,883	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$935,224,619	BOYAmt
EOY	$1,073,189,130	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$26,805,845	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$12,876,134	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$1,200,667	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$141,033	OtherActivitiesAmt
Total Lobbying Expenditures	$141,033	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	FormAndLineReferenceDesc
Explanation	PORTION OF DUES PAID TO HOSPITAL ASSOCIATIONS THAT ARE USED FOR LOBBYING PURPOSES BY THE HOSPITAL ASSOCIATIONS. 29.10% of the membership dues paid to the Missouri Hospital Association are used for lobbying activities. 22.73% of the membership dues paid to the American Hospital Association are used for lobbying activities. In addition, Heartland Regional Medical Center (Mosaic St. Joseph) CONTRACTS WITH VARIOUS PARTIES FOR LEGISLATIVE LOBBYING IN SUPPORT OF HOSPITAL REIMBURSEMENT AND COMMUNITY SUPPORT.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$14,478,727	OtherCostOrOtherBasisAmt
Book Value	$14,478,727	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$327,273,177	OtherCostOrOtherBasisAmt
Depreciation	$184,512,959	DepreciationAmt
Book Value	$142,760,218	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$20,775,886	OtherCostOrOtherBasisAmt
Depreciation	$14,804,615	DepreciationAmt
Book Value	$5,971,271	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$252,224,337	OtherCostOrOtherBasisAmt
Depreciation	$210,913,249	DepreciationAmt
Book Value	$41,311,088	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$13,436,420	OtherCostOrOtherBasisAmt
Book Value	$13,436,420	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$217,957,724	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
Derivative Instruments	$0
Other Liabilities	$8,779,059

Field	Value	IRS element (for citing)
Total Liability	$8,779,059	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	FormAndLineReferenceDesc
Explanation	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), Heartland Foundation, and Northwest Medical Center Foundation (NMC Foundation) 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. Village at Burlington Creek Office, LLC is a limited liability company that is taxed as a partnership. 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 2015. At June 30, 2019, net operating loss carryforwards available to offset future taxable income for these entities aggregated approximately $15,900 and expire through 2038. 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, 2019 and 2018, there were no uncertain tax positions identified and recorded as a liability.	ExplanationTxt

Schedule F IRS990ScheduleF

Field	Value	IRS element (for citing)
Grant Records Maintained	false	GrantRecordsMaintainedInd

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	Central America and the Caribbean	RegionTxt
Specific Services Provided	Investments	SpecificServicesProvidedTxt
Region Total Expenditures	$29,595,921	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continuation Total Office	0	ContinuationTotalOfficeCnt
Continuation Total Employee	0	ContinuationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$29,595,921	SubtotalSpentAmt
Continuation Spent	$0	ContinuationSpentAmt
Total Spent	$29,595,921	TotalSpentAmt
Transfer To Foreign Corp	Yes (true)	TransferToForeignCorpInd
Interest In Foreign Trust	false	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (true)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	false	PassiveForeignInvestmestCoInd
Foreign Partnership	Yes (true)	ForeignPartnershipInd
Boycott Countries	false	BoycottCountriesInd

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	false	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$33,635,736	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$33,635,736	NetCommunityBenefitExpnsAmt
Total Expense	0.0568	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$87,648,031	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$66,337,784	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$21,310,247	NetCommunityBenefitExpnsAmt
Total Expense	0.0360	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$121,283,767	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$66,337,784	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$54,945,983	NetCommunityBenefitExpnsAmt
Total Expense	0.0927	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$4,813,167	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$362,506	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,450,661	NetCommunityBenefitExpnsAmt
Total Expense	0.0075	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$122,033	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$122,033	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$247,971	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$247,971	NetCommunityBenefitExpnsAmt
Total Expense	0.0004	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$707,711	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$54,446	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$653,265	NetCommunityBenefitExpnsAmt
Total Expense	0.0011	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$2,418,884	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,418,884	NetCommunityBenefitExpnsAmt
Total Expense	0.0041	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$8,309,766	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$416,952	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,892,814	NetCommunityBenefitExpnsAmt
Total Expense	0.0133	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$129,593,533	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$66,754,736	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$62,838,797	NetCommunityBenefitExpnsAmt
Total Expense	0.1060	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$26,268	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$26,268	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$128,825	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$128,825	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$341,529	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$341,529	NetCommunityBenefitExpnsAmt
Total Expense	0.0006	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$496,622	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$496,622	NetCommunityBenefitExpnsAmt
Total Expense	0.0008	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$18,846,983	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$152,836,943	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$189,047,750	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$36,210,807	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Heartland Regional Medical Center	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	5325 Faraon Street	AddressLine1Txt
City	St Joseph	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	64506	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.mymlc.com/Main/Location/st-joseph-mo/mosaic-medical-center-st.-joseph/	WebsiteAddressTxt
State License	426-23	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Other	Pharmacist Intern Program	OtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Heartland Regional Medical Center	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	18	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	https://www.mymlc.com/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ST-JOSEPH-CHNA/	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	18	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	https://www.mymlc.com/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ST-JOSEPH-CHNA/	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.0	FPGFamilyIncmLmtDscntCarePct
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	See Schedule O	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	See Schedule O	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	See Schedule O	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3E	The significant health needs of the community are a prioritized description of various factors including: - health and quality of life; - barriers to improving community health; - health disparities: and - important health issues. 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 - HEARTLAND REGIONAL MEDICAL CENTER (Mosaic-St. Joseph). The Community Health Needs Assessment (CHNA) was jointly prepared by Mosaic-St. Joseph and Heartland Long Term Acute Care Hospital (HLTACH). THE CHNA WAS CONDUCTED During tax year 2018 TO DETERMINE SERVICES NEEDED BY THE MEDICALLY UNDERSERVED. The following three needs were chosen to be addressed over the next three years: - Mental/Behavioral Health, - Substance Use, - Access to Care for Uninsured and Low-Income Persons TO ENSURE INPUT WAS TAKEN INTO ACCOUNT FROM PERSONS WHO REPRESENT THE COMMUNITY, Mosaic-St. Joseph UTILIZED AN INDEPENDENT CONSULTING FIRM NAMED CROWE, LLP. THIS FIRM helped CONDUCT key stakeholder interviews, provider focus groups and a community survey. Key Stakeholder Interviews: Community input was obtained through key stakeholder interviews performed with leaders from twenty-four community organizations representing public health, public schools, social service organizations and government agencies. To assure the medically underserved were represented in this CHNA, interviews were conducted with representatives from the following organizations; BARTLETT CENTER, BIG BROTHERS/BIG SISTERS, Buchanan County SHERIFF'S DEPARTMENT, COMMUNITY ACTION PARTNERSHIP, Community Missions Corporation, CATHOLIC CHARITIES, FAMILY GUIDANCE CENTER, Girls Scouts of Northeast Kansas and Northwest Missouri, INTERSERV, MERIL, MidCity Excellence Center, NORTHWEST HEALTH SERVICES, SECOND HARVEST Community Food Bank, SOCIAL WELFARE BOARD, St Joseph HABITAT FOR HUMANITY, ST JOSEPH HEALTH DEPARTMENT, ST JOSEPH SCHOOL DISTRICT, ST JOSEPH TRANSIT, St Joseph UNITED WAY, St Joseph YOUTH ALLIANCE, St Joseph YMCA, St Joseph YWCA, United Cerebral Palsy and Voices of Courage-Child Advocacy Center. These key stakeholder interviews were conducted between October 17th and 19th, 2018. To assure that medically underserved were included in this CHNA, interviews were conducted with agencies serving neighborhoods where median household incomes are very low or unemployed, as well as agencies providing services related to mental health, persons who are homeless, victims of domestic violence, elderly and persons with disabilities. Provider Focus Groups: Three focus groups were conducted between October 17th and 19th, 2018, to obtain input from Mosaic-St. Joseph's and HLTACH's leadership team as well as physicians and other clinical providers employed by the organizations. One focus group was comprised of members from the organization's leadership. Additionally, two focus groups were conducted with clinical providers employed by the organizations including physicians, registered nurses, counselors and other medical providers. In total, 49 individuals participated in the three focus group sessions. Focus groups explored four areas to identify significant health needs of the community as well as potential ways to address identified needs. The areas included 1.) health and quality of life; 2.) barriers to improving community health; 3.) health disparities: and 4.) significant health issues. Community Health Survey: In order to develop a broad understanding of community health needs, Mosaic-St. Joseph and HLTACH conducted a community survey in November 2018. A link to the survey was distributed via e-mail, social media and word of mouth to the community at-large. A total of 681 surveys were completed. The majority of respondents were White/Caucasian (97%), 1% of the respondents identified as Black or African American and 1% identified as Hispanic or Latino. 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 6a Facility , 1	Facility , 1 - Heartland Long Term Acute Care Hospital (HLTACH). Heartland Regional Medical Center (Mosaic-St. Joseph) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT AND ADOPTED AN IMPLEMENTATION STRATEGY WITH Heartland Long Term Acute Care Hospital (HLTACH), A RELATED ORGANIZATION.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - HEARTLAND REGIONAL MEDICAL CENTER (Mosaic-St. Joseph):. THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED AND AN IMPLEMENTATION PLAN FOR ADDRESSING THE IDENTIFIED NEEDS WAS ADOPTED IN THE 2018 TAX YEAR. THE TOP THREE SIGNIFICANT NEEDS IDENTIFIED WERE: 1) Mental/Behavioral Health; 2) Substance Use; AND 3) Access to Care for Uninsured and Low-Income Persons. Mosaic-St. Joseph'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-St. Joseph created THE COMMUNITY CONNECT PROGRAM FOR POPULATION HEALTH. COMMUNITY CONNECT IS A REQUEST FOR PROPOSAL (RFP) PROCESS IN WHICH NONPROFIT COMMUNITY ORGANIZATIONS MAY APPLY FOR FUNDING TO IMPLEMENT INNOVATIVE PROGRAMS THAT ADDRESS ONE OR MORE OF THE THREE PRIMARY HEALTH NEEDS AS DETERMINED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT. COMMUNITY CONNECT IS AN IMPORTANT PART OF THE FY2020-FY2023 CHNA ACTION PLAN. TO FULLY MEET THE NEEDS IDENTIFIED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT, Mosaic-St. Joseph IMPLEMENTED A THREE-YEAR ACTION PLAN COMPRISED OF THE FOLLOWING COMPONENTS. SIGNIFICANT NEED #1: Mental Health PLAN: A) Mosaic will provide financial support to organizations providing mental health support to the homeless community, through the Urban Mission Collaborative Project. B) Mosaic will partner financially with the St. Joseph School District to implement an anti-bullying campaign. C) The 4th Grade Challenge will incorporate a mental health education session. D) Mosaic Life Care's Spiritual Health Department will provide ongoing education on trauma to the community. The initial presentation was "IMPACT OF TRAUMA ON THE HUMAN SPIRIT." This event will be presented yearly and is open to the public. SIGNIFICANT NEED #2: Substance Abuse PLAN: A) Mosaic will provide financial support to organizations providing substance abuse counseling and treatment to the community through the Urban Mission Collaborative Project. SIGNIFICANT NEED #3: Access to Care for Uninsured and Low- Income Persons PLAN: A) Mosaic will provide financial support to organizations that are part of the Urban Mission Collaborative Project, which is providing access support to the homeless community. B) Mosaic will operate and provide all financial support for a school-based clinic in a Title 1 school. To increase access to care for children, The Community Clinic at Carden Park opened on October 23, 2017, providing well-child exams for children at school. This School Based Health Clinic is the result of the partnership between the St. Joseph School District and Mosaic Life Care. The Mosaic team has seen over 300 patients since opening, has made numerous referrals for further treatment and has helped students break down barriers to attendance. Although based out of the school nurse's office at Carden Park, this clinic serves all SJSD students. In addition to providing well child examinations and seeing children who are sick, The Mosaic team has fulfilled stringent requirements needed for the clinic to became VFC certified. They can now administer immunizations to students throughout the District. The Community Clinic at Carden Park is one of only a handful in the state of Missouri. DURING FY19, THE COMMUNITY CONNECT ALLOCATIONS COMMITTEE AWARDED FUNDING OF $950 THOUSAND TO 12 NON-PROFIT COMMUNITY ORGANIZATIONS WHICH ADDRESSES ONE OR MORE OF THE PRIMARY HEALTH NEEDS FROM THE MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT. THE COMPLETE CHNA WITH IMPLEMENTATION STRATEGY CAN BE FOUND AT: https://www.mymlc.com/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ST-JOSEPH-CHNA/
Schedule H, Part V, Section B, Line 20 Facility , 1	Facility , 1 - Heartland Regional Medical Center (Mosaic-St. Joseph):. 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.

Field	Value	IRS element (for citing)
Facility	33	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (33 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt	Address Line2USAddress/AddressLine2Txt
Cameron Mosaic Life Care
215 South Walnut Street Suite A	Cameron	MO	64429	Family Care
Mosaic Life Care Clinics
902 North Riverside Road	St Joseph	MO	64507	Medical Oncology, Radiation Oncology & Pediatrics
Mosaic Life Care Clinics
705 North College	Albany	MO	64402	Cardiovascular, General Surgery, Neurology, Podiatry, Vascular Surgery & Women's Health
Mosaic Life Care Clinics
2600 Miller Street	Bethany	MO	64424	Cardiology, Neurology & Rheumatology
Mosaic Life Care Clinics
901 Heartland Road	St Joseph	MO	64506	Infectious, Diabetes, Endocrinology, Internal Medicine, Wound, Sleep Disorder & Women's Health
Mosaic Life Care Clinics
5301 Faraon Street Suites XXX-XX-XXXX	St Joseph	MO	64506	Ears Nose & Throat, Pulmonary & Critical Care, Physical Medicine & Rehabilitation	210B
Mosaic Life Care Clinics
711 North 36th Street Suite 100 Low	St Joseph	MO	64506	Family Care, Home Health, Hospice & Care at Home	er Level
Mosaic Life Care Clinics
5210 North Belt Highway Entrance B	St Joseph	MO	64506	Family Care & Women's Health	C
Internal Medicine Beck Rd St Joseph
3715 Beck Road Building F	St Joseph	MO	64506	Internal Medicine
Mosaic Life Care Clinics
5514 Corporate Drive Suites 120 150	St Joseph	MO	64507	Cardiovascular & Internal Medicine
Mosaic Life Care Clinics
105 Far West Drive Suites 100 201 2	St Joseph	MO	64506	Internal Medicine, Pediatrics, Family Care, Neurology & Outpatient Behavior Health	02
Mosaic Life Care Clinics
802 North Riverside Road	St Joseph	MO	64506	Bariatric, Breast, CardioThoracic Surgery, General Surgery,Pain Management,Physical Medicine & Rehab
Medical Oncology Mosaic Life Care
1610 East Evergreen Suite B	Cameron	MO	64429	Medical Oncology
Mosaic Life Care Clinics
2016 South Main	Maryville	MO	64468	Medical Oncology & Neuro Surgery
Mosaic Life Care Hospice at Stanberry
307 Pineview Pine View Manor Rm 507	Stanberry	MO	64489	Hospice
Mosaic Family Care - Albany
1607 East US Highway 136	Albany	MO	64402	Family Care
Mosaic Life Care Clinics
3620 Fredrick Avenue	St Joseph	MO	64506	Outpatient Imaging & Counseling Care
OP Therapy Frederick Ave St Joseph
3107 Frederick Avenue Lower Level	St Joseph	MO	64506	Outpatient Therapy
Mosaic Life Care Clinics
3007 North Belt Highway	St Joseph	MO	64506	Outpatient Therapy & Chiropractic Care
Plastic Surgery & Dermatology Mosaic
5204 North Belt Highway Suite A	St Joseph	MO	64506	Plastic Surgery & Dermatology
Podiatry St Joseph Mosaic Life Care
5202 Faraon Street Suite A	St Joseph	MO	64506	Podiatry
Mosaic Life Care Clinics
1600 East Evergreen PO Box 557	Cameron	MO	64429	Rheumatology, Pulmonary & Critical Care
Mosaic Life Care Clinics
2024 South Main Street	Maryville	MO	64468	Ear Nose & Throat, Neurology, Podiatry, Pulmonary & Critical Care
Mosaic Life Care Clinics
1701 East 9th Street	Trenton	MO	64683	Family Care
Urgent Care St Joseph Mosaic Life Care
1115 North Belt Highway	St Joseph	MO	64506	Urgent Care
Mosaic Life Care Clinics
810 Ravenhill Drive Suite 103	Atchison	KS	66002	Specialties
Mosaic Life Care Clinics
104 North 6th	Atchison	KS	66002	Medical Oncology
Hiawatha Mosaic Life Care
300 Utah	Hiawatha	KS	66434	Family Care
Troy Mosaic Life Care
207 South Main	Troy	KS	66087	Family Care
Endocrinology Mosaic Life Care
220 Essie Davison Drive	Clarinda	IA	51632	Endocrinology
Mosaic Life Care Clinics
1301 North 3rd	Atchison	KS	66002	Specialties
Endocrinology Mosaic Life Care
820 Raven Hill Drive	Atchison	KS	66002	Endocrinology
Mosaic Life Care at St Joseph Nephrology
1009 West St Maarten Drive	St Joseph	MO	64506	Nephrology

Supplemental Information Detail SupplementalInformationDetail (20 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 7f	Heartland Regional Medical Center (Mosaic-St. Joseph) did not report bad debt expense as part of operating expenses for health professions education for year ended 06/30/19.
Schedule H, Part I, Line 3c	Not Applicable
Schedule H, Part I, Line 6a	Not applicable
Schedule H, Part I, Line 7g Subsidized Health Services	NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC ARE INCLUDED IN SUBSIDIZED HEALTH SERVICES.
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 THE CALCULATIONS FROM WORKSHEET 2. FINANCIAL ASSISTANCE AT COST WAS $33,600,000 AND $25,900,000 FOR YEARS ENDED 6/30/19 AND 6/30/18, RESPECTIVELY. MEDICAID NET COMMUNITY BENEFIT EXPENSE WAS $21,400,000 AND $17,800,000 FOR YEARS ENDED 6/30/19 AND 6/30/18, RESPECTIVELY. THE MEDICAL CENTER 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	Heartland Regional Medical Center (Mosaic-St. Joseph) COMMUNITY BUILDING ACTIVITIES PROMOTED THE HEALTH OF THE COMMUNITIES SERVED BY PROVIDING ECONOMIC SUPPORT TO HELP RE-VITALIZE THE DOWNTOWN ST JOSEPH AREA AND FACILITATE JOB GROWTH THROUGHOUT THE GREATER ST JOSEPH AREA. AMONG OTHER COMMUNITY BUILDING ACTIVITIES, Mosaic-St. Joseph FUNDS AND MAINTAINS A TEAM FOCUSED ON DISASTER READINESS, COORDINATION AND RELIEF.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Heartland Regional Medical Center (Mosaic-St. Joseph) 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	Heartland Regional Medical Center (Mosaic-St. Joseph) adopted a new charity care assessment system during the tax year-ended June 30, 2019 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-St. Joseph 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	THE BAD DEBT EXPENSE FOOTNOTE IS ON PAGE 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. SEE ALSO THE PARAGRAPH IN THE CHARITY CARE FOOTNOTE ON PAGE 16.
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-St. Joseph 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 HOSPITAL IS ABSORBING THE 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	Heartland Regional Medical Center's (Mosaic-St. Joseph) 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 the Mosaic Life Care Financial Assistance Policy and the process for submitting an application. to determine if the patient or guarantor is eligible for financial assistance, Mosaic Life Care 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 Life Care 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 Life Care 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 Life Care 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 Life Care financial assistance application will be accepted. Information on the Mosaic Life Care 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 Life Care 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 undelivered, Mosaic Life Care will attempt to find a correct address. If the correct address cannot be found, Mosaic Life Care 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 Life Care 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 Life Care 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 Mosaic Life Care 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 Mosaic Life Care 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 Life Care staff are expected to uphold the highest ethical standards. All business must be conducted in the name of the caller or mosaic life care. 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 life care, will uphold and adhere to the Fair Debt Collection Practices Act.
Schedule H, Part V, Section B, Line 16a FAP website	- Heartland Regional Medical Center: Line 16a URL: See Schedule O;
Schedule H, Part V, Section B, Line 16b FAP Application website	- Heartland Regional Medical Center: Line 16b URL: See Schedule O;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- Heartland Regional Medical Center: Line 16c URL: See Schedule O;
Schedule H, Part VI, Line 2 Needs assessment	Heartland Regional Medical Center (Mosaic-St. Joseph) 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	Heartland Regional Medical Center (Mosaic-St. Joseph) INFORMS AND EDUCATES PATIENTS AND GUARANTORS 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 Mosaic-St. Joseph. 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	THE ORGANIZATION'S PRIMARY AND SECONDARY SERVICE AREA IS AN 18 COUNTY URBAN/RURAL REGION LOCATED IN NORTHWEST MISSOURI AND NORTHEAST KANSAS. THE POPULATION IS ELDERLY AND UNDER-INSURED. THE LOCAL ECONOMY CONSISTS OF AGRICULTURAL, SMALL MANUFACTURING AND SELF-EMPLOYED BUSINESSES, PRIMARILY BLUE COLLAR WORKERS. THE ORGANIZATION SUPPORTS A PAYOR MIX OF APPROXIMATELY 70.76% GOVERNMENTAL OR SELF-PAY PATIENTS. 18.9% OF THE POPULATION IS BELOW THE POVERTY LEVEL; 18.7% OF THE POPULATION SMOKES; AND 35.9% HAVE A BODY MASS INDEX GREATER THAN 30. MORE THAN 67.8% OF THE ELEMENTARY AGE STUDENTS RECEIVE FREE OR REDUCED-COST LUNCHES.
Schedule H, Part VI, Line 5 Promotion of community health	Heartland Regional Medical Center (Mosaic-St. Joseph) 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 Mosaic-St. Joseph rests with its Board, which is primarily composed of members of the community, in addition to a few select employees of Mosaic-St. Joseph. Mosaic-St. Joseph 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-St. Joseph 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 serves. Mosaic-St. Joseph promotes health in the St. Joseph region in numerous ways. Highlighted below are examples in which Mosaic-St. Joseph provided direct funding support to the community organizations with like missions. THE ORGANIZATION OFFERS MANY EDUCATIONAL PROGRAMS THROUGHOUT THE YEAR TO HELP MAINTAIN A HEALTHY LIFESTYLE. THESE ARE WELL-ADVERTISED AND MOST OF THEM ARE FREE OF CHARGE. ONE SUCH PROGRAM IS THE POUND PLUNGE. FOR THE PAST THIRTEEN YEARS, THE ORGANIZATION HAS SPONSORED THIS THREE-MONTH LONG EVENT TO ENCOURAGE WEIGHT LOSS, EXERCISE AND HEALTHY EATING. MORE THAN 27,000 PEOPLE HAVE PARTICIPATED AND OVER 157,000 POUNDS HAVE BEEN LOST. AT THE END OF THE PROGRAM IN 2019, 93% OF RESPONDENTS TO THE SURVEY AGREED THAT THE POUND PLUNGE WAS BENEFICIAL TO OUR COMMUNITY, AND 81% AGREED THAT THEY ARE CURRENTLY CONTINUING A HEALTHY LIFESTYLE AS A RESULT OF THE POUND PLUNGE. ANOTHER AREA OF FOCUS HAS BEEN IN PREVENTING CHILDHOOD OBESITY. SEVERAL YEARS AGO THE ORGANIZATION'S INTERNAL CLINICAL PROTOCOLS ADDRESSING CHILDHOOD OBESITY WERE FOUND TO BE LACKING. THIS HAS BEEN RECTIFIED. APPROPRIATE PROTOCOLS ARE NOW FULLY ESTABLISHED AND HAVE BEEN GIVEN THE APPROVAL OF THE EVIDENCED-BASED PRACTICE GROUP AND ARE EMBEDDED IN THE ELECTRONIC MEDICAL RECORD. ACCOMPANYING THESE ESTABLISHED PROTOCOLS IS A THOROUGH PROVIDER EDUCATION PLAN TO ASSURE THAT THE NEW PROTOCOLS ARE UNDERSTOOD AND USED. EDUCATION ON THE 1-2-3-4-5 FIT-TASTIC! GUIDELINES HAVE BEEN PROVIDED TO ALL CLINICS TO ASSURE A CONSISTENT PATIENT EXPERIENCE. IN PARTNERSHIP WITH THE ST. JOSEPH SCHOOL DISTRICT, THE ORGANIZATION HAS CONTINUED AND EXPANDED THE 4TH GRADE CHALLENGE, WHICH HAS BEEN PROVIDED IN 24 ELEMENTARY SCHOOLS FOR 11 YEARS. PRE AND POST PROGRAM SURVEYING OF STUDENTS SHOWED AT LEAST A 51% INCREASE IN KNOWLEDGE OF THE FIT-TASTIC GUIDELINES AFTER COMPLETING THE PROGRAM. 90% OF SCHOOL COACHES AGREED THAT THE 4TH GRADE CHALLENGE IS AN EFFECTIVE PROGRAM THAT TEACHES STUDENTS ABOUT HEALTH, EXERCISE AND NUTRITION, AND 81% OF SCHOOL COACHES AGREED THAT THE 4TH GRADE CHALLENGE IS A GREAT HEALTH PROGRAM THAT HELPS FIGHT CHILDHOOD OBESITY. IN 2019, THE NUMBER OF SCHOOL AND COMMUNITY GARDENS WAS ACTIVE IN 6 ELEMENTARY SCHOOLS. THE GARDENS PRODUCED MORE THAN 31,000 POUNDS OF FRESH PRODUCE OVER THE PAST SEVEN YEARS, ENOUGH TO PROVIDE 23,214 MEALS PROVIDED AT NO COST TO THE COMMUNITY MEMBERS. FOR SOME ECONOMICALLY DISADVANTAGED AREAS, THE GARDENS SUPPLY FRUITS AND VEGETABLES TO FAMILIES WHO WOULD NOT HAVE ACCESS TO THEM OTHERWISE. IN ADDITION, A PROGRAM CALLED HANDS-ONLY CPR HAS PROVIDED EDUCATION ON LIFE SAVING SKILLS IN PARTNERSHIP WITH BUCHANAN COUNTY EMS TO ALL 5TH GRADERS AT 24 SCHOOLS AND TO APPROXIMATELY 1,500 STUDENTS. IN FY19, Mosaic-St. Joseph MAINTAINED A POST NATAL PROGRAM IN WHICH A NURSE PREFORMED A CHECK UP ON MOTHER AND BABY AT Mosaic-St. Joseph TWO TO THREE DAYS AFTER DELIVERY. In addition, the nurse will make follow up phone calls for every patient to arrange follow up care for the babies and setup car seat checks for each infant if desired. Lastly, this department provides two hours of support to the breastfeeding group twice a week. THIS IS DONE AT NO EXPENSE TO THE PATIENT AND IS A NON-BILLABLE SERVICE THAT IS PROVIDED AS A COMMUNITY BENEFIT. 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-St. Joseph HAS PARTICIPATED IN THIS PROGRAM SINCE 2011. THIS PARTICIPATION HAS GENERATED REVENUE FROM THE CONTRACTED RETAIL PHARMACY RELATIONSHIPS ($85M LTD), CURRENTLY THREATENED BY REGULATION CHALLENGES. Mosaic-St. Joseph HAS RECOGNIZED REDUCED DRUG PRICING FOR OUTPATIENT MEDICATIONS ($69M LTD), 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.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (29 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt	Address Line2USAddress/AddressLine2Txt
Heartland Foundation
5325 Faraon Street	St Joseph	MO	64506	431262768	501c3	$597,922	General Support
MWSU Foundation
5425 DOWNS DRIVE	St Joseph	MO	64507	237035423	501c3	$469,950	Sponsorship
Community Missions Corporation
700 Olive Street	St Joseph	MO	64501	900180479	501C3	$200,000	General Support
United Way of Greater St Joseph
118 South 5TH STREET	St Joseph	MO	64501	440547802	501C3	$182,410	General Support
The Crossing Outreach
701 South 8th Street	St Joseph	MO	64501	464195177	501C3	$152,000	General Support
Second Harvest Community Food Bank
915 DOUGLAS Street	St Joseph	MO	64505	431268319	501C3	$150,500	General Support
Habitat for Humanity
PO Box 6528	St Joseph	MO	64506	431733608	501C3	$125,500	General Support
Young Women's Christian Association
304 North 8TH Street	St Joseph	MO	64501	440552219	501C3	$108,500	General Support
Legal Aid of Western Missouri
1125 Grand Blvd	Kansas City	MO	64106	430824638	501C3	$91,000	General Support
Catholic Charities of KC
1302 Faraon Street	St Joseph	MO	64501	430887779	501C3	$60,000	General Support
BBBS of Greater St Joseph
1202 South 28th Street	St Joseph	MO	64507	440666362	501C3	$59,000	General Support
Pivotal Point
3000 Parkway A	St Joseph	MO	64507	271481997	501C3	$50,750	General Support
Family Guidance Center for Behavioral Healthcare
724 North 22ND Street	St Joseph	MO	64506	440666362	501C3	$50,000	General Support
Samaritan Counseling Center Inc
902 Edmond Street	St Joseph	MO	64501	431615018	501C3	$40,000	General Support	Suite 203
Bartlett Center Youth Programs
409 South 18th Street	St Joseph	MO	64501	237116216	501C3	$30,000	General Support
St Joseph Area Chamber of Commerce
3003 Frederick Avenue	St Joseph	MO	64506	440419460	501c6	$29,425	Sponsorship
Faith in Action
2711 Ashland Avenue	St Joseph	MO	64506	440653008	501C3	$20,000	General Support
Northwest Missouri Childrens Advocacy Center
1807 Woodbine Road	St Joseph	MO	64506	431910148	501C3	$13,100	General Support
Albrecht-Kemper Museum of Art Foundations
2818 FREDERICK	St Joseph	MO	64506	431855334	501C3	$10,000	General Support
YMCA of St Joseph Missouri
315 South 6th Street	St Joseph	MO	64501	440552491	501C3	$5,482	General Support
Northwest Missouri United Labor Community Services Agency
1203 North 6th Street	St Joseph	MO	64501	431496809	501C3	$5,000	Sponsorship
Robidoux Resident Theatre
615 South 10th Street	St Joseph	MO	64501	431257970	501C3	$5,000	Sponsorship
St Joseph Museums Inc
PO Box 8096	St Joseph	MO	64508	436038202	501C3	$5,000	Sponsorship
Pony Express Baseball Inc
PO Box 1588	St Joseph	MO	64502	274437372	501C3	$5,000	Sponsorship
Pony Exprss Museum Inc
914 Penn Street	St Joseph	MO	64503	431567246	501C3	$5,000	Sponsorship
Westminister Free Clinic
5560 Napoleon Avenue	Oak Park	CA	91377	770563241	501C3	$5,000	Sponsorship
Mosaic Medical Center-Maryville
5325 Faraon Street	St Joseph	MO	64506	832249459	501(C)3	$26,402,888	General Support
Mosaic Health System
5325 Faraon Street	St Joseph	MO	64506	431283316	501(c)(3)	$17,727,964	General Support
Northwest Medical Center Association Inc
705 North College Street	Albany	MO	64402	440580870	501(c)(3)	$6,659,481	General Support

Field	Value	IRS element (for citing)
Total501c3 Org	28	Total501c3OrgCnt
Total Other Org	1	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule I, Part II Line 2	Missouri Western State University Foundation
Schedule I, Part II Line 11	Big Brothers Big Sisters of Greater St. Joseph
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 our officers, directors or employees are in a volunteer position or are a board member of the recipient organization. The recipients are required to submit quarterly reports to Heartland Regional Medical Center detailing the program's expenditures and progress toward the stated goals. Heartland Regional Medical Center's Advocacy department monitors the progress.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	Yes (X)	TravelForCompanionsInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Mark Laney MD
Director/President/Mosaic Health System CEO	$881,882	$0	$403,217	$0	$200,361	$0	$11,000	$0	$14,971	$0	$1,511,430	$0	$0	$0
John Olson MD
Former Director/Physician (Until 12/2016)	$545,345	$0	$43,556	$0	$17,815	$0	$11,000	$0	$23,618	$0	$641,334	$0	$0	$0
Lucinda Hayden MD
Director (As of 1/2017)(Until 12/2019)	$429,977	$0	$104,991	$0	$39,694	$0	$11,000	$0	$14,777	$0	$600,438	$0	$0	$0
Matt Lukens MD
Director (As of 01/2018)	$575,008	$0	$54,667	$0	$26,118	$0	$11,000	$0	$24,067	$0	$690,860	$0	$0	$0
Curt Kretzinger
Former COO (Until 01/2017)	$0	$0	$106,963	$0	$405,220	$0	$0	$0	$16,015	$0	$528,199	$0	$0	$0
John P Wilson
Former Secretary/Treasurer (until 01/2017)	$0	$0	$0	$0	$352,360	$0	$0	$0	$0	$0	$352,360	$0	$0	$0
Michael Pulido
COO/Secretary	$544,266	$0	$138,876	$0	$2,688	$0	$124,030	$0	$23,197	$0	$833,057	$0	$67,482	$0
Dwain Stilson
CFO/Treasurer	$435,892	$0	$224,712	$0	$955	$0	$11,000	$0	$25,467	$0	$698,025	$0	$0	$0
Brady D Dubois
President of Mosaic Hospitals	$321,009	$0	$76,588	$0	$1,507	$0	$62,149	$0	$23,197	$0	$484,451	$0	$0	$0
Brennan Lehman
Chief Information Officer	$318,191	$0	$79,990	$0	$1,512	$0	$43,021	$0	$22,867	$0	$465,581	$0	$0	$0
Julee Thompson
Chief Nursing Executive	$283,170	$0	$75,592	$0	$2,736	$0	$9,177	$0	$13,669	$0	$384,344	$0	$0	$0
Davin Turner DO
Clinic President	$425,351	$0	$115,922	$0	$3,138	$0	$58,730	$0	$22,867	$0	$626,008	$0	$58,786	$0
Rony M Abou-Jawde MD
Staff Physician	$937,761	$0	$210,588	$0	$34,547	$0	$11,000	$0	$23,197	$0	$1,217,092	$0	$0	$0
Joshua Nelson MD
Staff Physician	$300,980	$0	$1,066,374	$0	$465	$0	$6,700	$0	$6,990	$0	$1,381,509	$0	$0	$0
Robert Grant DO
Staff Physician	$839,498	$0	$66,276	$0	$72,418	$0	$11,000	$0	$26,897	$0	$1,016,089	$0	$0	$0
Bonnie Goins MD
Staff Physician	$938,243	$0	$129,250	$0	$27,000	$0	$8,223	$0	$14,777	$0	$1,117,493	$0	$0	$0
Hemant K Sheth MD
Staff Physician	$693,335	$52,421	$281,172	$0	$59,047	$0	$7,523	$0	$21,223	$1,154	$1,062,300	$53,575	$0	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 1a Travel for companions	TRAVEL FOR COMPANIONS IS PAID BY THE Heartland Regional MEDICAL CENTER (Mosaic-St. Joseph) BUT IS REIMBURSED TO Mosaic-St. Joseph THROUGH BEING DEDUCTED FROM THE BOARD MEMBERS STIPENDS EACH YEAR. THE TOTAL AMOUNT OF THE STIPEND IS REFLECTED ON THE BOARD MEMBERS 1099 THAT THEY RECEIVE FOR EACH CALENDAR YEAR.
Schedule J, Part I, Line 4a Severance or change-of-control payment	Due to the confidentiality agreements between the former employees and the organizations, the names and amounts are not disclosed.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	DAVIN TURNER, DO - VESTED $58,786 ; ACCRUED $47,730 BRENNAN LEHMAN - VESTED $0 ; ACCRUED $32,021 BRADY DUBOIS - VESTED $0 ; ACCRUED $51,149 MICHAEL PULIDO - VESTED $67,482 ; ACCRUED $113,030 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.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI
A	431178966	60637ACP5	2012-10-03	$51,489,534	See Part VI	false	false	false
HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI
B	431178966	60637ACP5	2018-04-30	$44,936,461	See Part VI	false	false	false
HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI
C	431178966	60637APX4	2019-05-30	$251,996,936	See Part VI	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$0	$0	$51,535,780	$0	$0	$0	$708,053	$0	$0	$50,827,726	$1	$0	2014	false	false	Yes (true)	Yes (true)
B	$0	$0	$25,232,246	$0	$0	$0	$0	$0	$0	$4,151,819	$0	$21,080,427		Yes (true)	false	false	Yes (true)
C	$0	$0	$252,004,873	$0	$0	$0	$2,176,364	$0	$0	$47,660,358	$149,768,930	$52,399,222		Yes (true)	false	false	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Private Bus Concerning UBIPrivateBusConcerningUBIPct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropPct	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd
A	false	false	false	false	0.0	0.0	false	Yes (true)	0.8727	Yes (true)	Yes (true)
B	false						false	false			Yes (true)
C	false	Yes (true)	Yes (true)	false	0.0	0.0	false	false			Yes (true)	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd	Rebate Not Due YetRebateNotDueYetInd
A	false	Yes (true)	false	false	false	false	Yes (true)
B	false		false	false	false	Yes (true)	Yes (true)	Yes (true)
C	false		false	false	false	false	Yes (true)	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)
C	Yes (true)

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule K, Part I Column (C), Line B	A PORTION OF THE SERIES 2012 BONDS WAS TREATED AS REISSUED ON 4/30/2018 IN CONNECTION WITH A REMEDIAL ACTION UNDER TREASURY REGULATIONS § 1.141-12(e).
Schedule K, Part II Column A, Line 3	AMOUNT DOES NOT EQUAL TO ISSUE PRICE LISTED IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS.
Schedule K, Part II Column C, Line 3	AMOUNT DOES NOT EQUAL TO ISSUE PRICE LISTED IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS.
Schedule K, Part IV Column A, Line 2C	THE ARBITRAGE REBATE ANALYSIS WAS PERFORMED AS OF 9/1/2014.
Schedule K, Part II Column B, Line 3	A PORTION OF THE SERIES 2012 BONDS IN THE AMOUNT OF $44,936,460.60 WAS TREATED AS REISSUED IN CONNECTION WITH A REMEDIAL ACTION UNDER TREASURY REGULATIONS § 1.141-12(E). THE AMOUNT SHOWN ON LINE 3 OF $25,232,246 DOES NOT MATCH THE TOTAL OF THE DEEMED REISSUANCE OF $24,794,467.92 DUE TO INVESTMENT EARNINGS.
Schedule K, Part III Column B	CERTAIN PORTIONS OF PART III FOR THE SERIES 2012 REISSUED BONDS HAVE NOT BEEN COMPLETED BECAUSE THE SUBSTITUTE PROJECT HAS NOT BEEN COMPLETED AS OF THE FISCAL YEAR END.
Schedule K, Part IV Column B, Line 6	DISPOSITION PROCEEDS ARE INVESTED AFTER THE 30-DAY TEMPORARY PERIOD.
Schedule K, Part II Column C, Line 11	$3,642,800 OF THIS AMOUNT REPRESENTS BOND PROCEEDS USED FOR AN EXTRAORDINARY SWAP TERMINATION PAYMENT.
Schedule K, Part III Column C	PART III ITEM C IS ONLY COMPLETED FOR THE PORTION OF THE SERIES 2019A BONDS ALLOCATED TO REFUNDING THE SERIES 2009A BONDS. THE RESPONSES IN PART III DO NOT COVER THE ASSETS FINANCED OR REFINANCED WITH THE PORTION OF THE SERIES 2019A BONDS ALLOCATED TO REFUNDING THE SERIES 2011 BONDS AND SERIES 2015AB BONDS BECAUSE THE SERIES 2011 BONDS AND SERIES 2015AB BONDS WERE USED TO REFINANCE PROJECTS ORIGINALLY FINANCED WITH BONDS ISSUED PRIOR TO JANUARY 1, 2003. IN ADDITION, THE RESPONSES IN PART III DO NO COVER ASSETS FINANCED WITH PROCEEDS OF THE NEW MONEY PORTION OF THE SERIES 2019A BONDS BECAUSE THE NEW MONEY PROJECT HAS NOT BEEN COMPLETED AS OF THE FISCAL YEAR END.
Schedule K, Part I, Column (f) Line A	TO ACQUIRE, CONSTRUCT, REMODEL, RENOVATE AND EQUIP CERTAIN HEALTHCARE FACILITIES.
Schedule K, Part I, Column (f) Line B	TO ACQUIRE, CONSTRUCT, REMODEL, RENOVATE AND EQUIP CERTAIN HEALTHCARE FACILITIES.
Schedule K, Part I, Column (f) Line C	To acquire, construct, reconstruct, repair, alter, improve and extend of the health facilities and to refund 2009A Bonds issued on 2/26/2009, 2011 Bonds issued on 9/30/2011 and 2015AB Bonds issued on 11/18/2015.
Schedule K, Part II Column B, Line 14	A PORTION OF THE SERIES 2012 BONDS WAS TREATED AS REISSUED ON 4/30/2018 IN CONNECTION WITH A REMEDIAL ACTION UNDER TREASURY REGULATIONS § 1.141-12(E). DISPOSITION PROCEEDS WILL BE USED TO FINANCE A SUBSTITUTE PROJECT.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Donna Wilson
DONNA WILSON IS THE WIFE OF JOHN WILSON.	$94,851	DONNA WILSON IS THE SERVICE LEADER FOR YOUTH AND ADULT PARTNERSHIPS FOR HEARTLAND REGIONAL MEDICAL CENTER AND IS THE WIFE OF JOHN WILSON, WHO WAS THE CHIEF TREASURY OFFICER OF HEARTLAND REGIONAL MEDICAL CENTER. COMPENSATION IS WITHIN FAIR MARKET VALUE RANGE. THIS AMOUNT INCLUDES SALARY & OTHER COMPENSATION FOR SERVICE LEADER SERVICES.	false
Nikki Lehman
NIKKI LEHMAN IS THE WIFE OF BRENNAN LEHMAN.	$74,542	NIKKI LEHMAN IS A SENIOR REVENUE CYCLE ANALYST AT HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE SPOUSE OF BRENNAN LEHMAN, WHO IS THE CHIEF INFORMATION OFFICER OF HEARTLAND REGIONAL MEDICAL CENTER. COMPENSATION IS WITHIN FAIR MARKET VALUE RANGE. THIS AMOUNT INCLUDES SALARY AND OTHER COMPENSATION FOR REVENUE CYCLE ANALYST SERVICES.	false
Kathryn Richmond
Kathryn Richmond is the daughter-in-law of Thomas Richmond	$92,160	Kathryn Richmond is the Property Management at Heartland Regional Medical Center, and is the daughter-in-law of Thomas Richmond, who is a board member for the Heartland Foundation. COMPENSATION IS WITHIN FAIR MARKET VALUE RANGE. THIS AMOUNT INCLUDES SALARY AND OTHER COMPENSATION FOR PROPERTY MANAGER.	false
Raymond Sisson
Raymond Sisson an employee of Adam Stein.	$556,992	RAYMOND SISSON IS AN EMPLOYEE OF ADAM STEIN, WHO IS A DIRECTOR ON THE HEARTLAND REGIONAL MEDICAL CENTER BOARD. ADAM STEIN BROKERED THE SALE OF LAND FOR MOSAIC-ST. JOSEPH AT FAIR MARKET VALUE BASED ON APPRAISAL.	false

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part I, Line 4 & Form 990, Part VI, Section A, Line 1B	THE FOLLOWING HEALTH REGIONAL MEDICAL CENTER DIRECTORS ARE NOT INDEPENDENT DUE TO TRANSACTIONS DISCLOSED ON THE FORM 990, SCHEDULE L: THOMAS RICHMOND AND ADAM STEIN.
Form 990, Part I, Line 13	IN FY2019, THE REPORTING ORGANIZATION HAS DETERMINED IT WOULD BE MORE APPROPRIATE THAT NET ASSET TRANSFERS BETWEEN RELATED ORGANIZATIONS THAT IT IN PRIOR YEARS WAS REPORTED IN FORM 990, PART XI, RECONCILIATION OF NET ASSETS AS AN "OTHER CHANGE IN NET ASSETS" NOW BE REPORTED AS CONTRIBUTION REVENUE (OR GRANTS MADE). FOR COMPARATIVE PURPOSES, THE REPORTING ORGANIZATION HAS ALSO REFLECTED THE EFFECT OF THE CHANGE IN HOW IT REPORTS ITS NET ASSET TRANSFERS IN THE FORM 990, PART I, PRIOR YEAR SUMMARY.
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 AS THEY WERE OFFICERS OF HHS PROPERTIES, INC. AND MIDWESTERN HEALTH MANAGEMENT, INC., BOTH RELATED TAXABLE ORGANIZATIONS, DURING THE TAX YEAR.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	Mark Laney, M.D. - Business relationship, Michael Pulido - Business relationship, Dwain Stilson - 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 HEARTLAND REGIONAL MEDICAL CENTER.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	Heartland Regional Medical Center Board members are identical to the Mosaic Health System board, and Mosaic Health System is the sole member of Heartland Regional Medical Center. This gives the board members the ability to select the board.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	THE SOLE MEMBER (MOSAIC HEALTH SYSTEM) SHALL HAVE THE FOLLOWING POWERS: OVERALL STRATEGIC DIRECTION (EXCLUDING MATTERS RELATED PRIMARILY TO THE ACCOUNTABLE CARE ORGANIZATION (ACO) OPERATED BY THE HOSPITAL, INCLUDING SPECIFICALLY ANY MEDICARE SHARED SAVINGS PROGRAM CREATED UNDER THE AFFORDABLE CARE ACT), APPOINTMENT OF AUDITORS AND LEGAL COUNSEL, ESTABLISHMENT OF BANKING RELATIONSHIPS AND MANAGEMENT OF CASH AND OTHER ASSETS (EXCLUDING ACO SHARED SAVINGS DISTRIBUTIONS AND REPAYMENT OF SHARED LOSSES), 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	Other Revenue - Total Revenue: 2573327, Related or Exempt Function Revenue: 2528526, Unrelated Business Revenue: 44801, Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Change in fair value of derivative instruments - -279000; Change in fair value of cash flow hedging derivatives - 2998000; Asset impairment/Restructuring - -4033000; Net assets released from restrictions used for operations - 113333;
Schedule H, Part V, Section B, Line 16a FAP Website URL	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 FAP Application Form	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 FAP Plain Language Summary	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 II Line 7h	Mosaic Life Care's Clinical Research Program provides alternative treatment options when standard of care has failed. These patients may not have access to other treatments. Clinical Research coordinators seamlessly provide care for patients outside of normal treatment options. Clinical research is an important part of any medical care because it helps advance the sciences developed to treat and ultimately lead to management, and a possible cure, for multiple diagnosis. The clinical research department at Mosaic Life Care provides education to the community on the types of clinical research we can provide which includes pharmaceuticals, medical devices, case studies, retrospective chart reviews, prospective trials, humanitarian device trials, compassionate use trials, emergency use trials and much more. The Research team will assist the patients in proper screening and determine eligibility.
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 15A & 15B	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.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Northland Expansion LLC
5325 Faraon Street	St Joseph	MO	64506	Development	MO	$0	$0	HRMC
Urgent Care Properties LLC
5325 Faraon Street	St Joseph	MO	64506	Development	MO	$0	$0	HRMC

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
Mosaic Health System
5325 Faraon Street	St Joseph	MO	64506	431283316	Healthcare	MO	501(c)(3)	Type II	NA	false
Heartland Foundation
5325 Faraon Street	St Joseph	MO	64506	431262768	Support	MO	501(c)(3)	7	Mosaic Health System	Yes (true)
Heartland Long Term Acute Care Hospital
5325 Faraon Street	St Joseph	MO	64506	261972987	Healthcare	MO	501(c)(3)	3	Mosaic Health System	Yes (true)
Northwest Medical Center Association Inc
705 North College Street	Albany	MO	64402	440580870	Healthcare	MO	501(c)(3)	3	Mosaic Health System	Yes (true)
Northwest Medical Center Foundation Inc
705 North College Street	Albany	MO	64402	473694893	Support	MO	501(c)(3)	Type I	Northwest Medical Center Association Inc	Yes (true)
Mosaic Medical Center-Maryville
5325 Faraon Street	St Joseph	MO	64506	832249459	Healthcare	MO	501(c)(3)	3	Mosaic Health System	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	ST JOSEPH DOWNTOWN DEVELOPMENT LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	5325 FARAON STREET	AddressLine1Txt
City	ST JOSEPH	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	64506	ZIPCd

Field	Value	IRS element (for citing)
EIN	474317460	EIN
Primary Activities	DEVELOPMENT OF DOWNTOWN ST. JOSEPH	PrimaryActivitiesTxt
Legal Domicile State	MO	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Predominant Income Type	N/A	PredominantIncomeTypeTxt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	OwnershipOwnershipPct
Midwestern Health Management Inc
5325 Faraon Street	St Joseph	MO	64506	431264358	Healthcare	MO	NA	C Corporation	Yes (true)
HHS Properties Inc
5325 Faraon Street	St Joseph	MO	64506	431593799	Investment	MO	NA	C Corporation	Yes (true)
Uptown Housing Inc
5325 Faraon Street	St Joseph	MO	64506	261416252	Redevelopment	MO	HRMC	C Corporation	Yes (true)	1
Uptown St Joseph Redevelopment Corp
5325 Faraon Street	St Joseph	MO	64506	201742813	Redevelopment	MO	HRMC	C Corporation	Yes (true)	1

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (25 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Heartland Long Term Acute Care Hospital (HLTACH)
A	$472,795	FMV
Heartland Long Term Acute Care Hospital (HLTACH)
J	$584,520	FMV
Heartland Long Term Acute Care Hospital (HLTACH)
L	$2,806,944	FMV
Heartland Long Term Acute Care Hospital (HLTACH)
Q	$2,941,698	FMV
Northwest Medical Center Association Inc (Mosaic-Albany)
L	$2,392,410	FMV
Northwest Medical Center Association Inc (Mosaic-Albany)
Q	$8,485,482	FMV
Northwest Medical Center Association Inc (Mosaic-Albany)
S	$122,636	FMV
Heartland Foundation
B	$597,922	FMV
Heartland Foundation
Q	$1,986,488	FMV
Midwestern Health Management Inc (Midwestern)
L	$1,895,247	FMV
Midwestern Health Management Inc (Midwestern)
Q	$2,713,016	FMV
St Joseph Downtown Development LLC (905 owned by MHM)
L	$382,933	FMV
St Joseph Downtown Development LLC (905 owned by MHM)
Q	$337,057	FMV
HHS Properties Inc
L	$213,220	FMV
HHS Properties Inc
K	$262,182	FMV
HHS Properties Inc
Q	$1,208,925	FMV
Ascend Development LLC (disregarded entity wholly owned by MHM)
Q	$104,098	FMV
Ascend Development LLC (disregarded entity wholly owned by MHM)
L	$1,811,804	FMV
Mosaic Health System
B	$17,727,964	FMV
German American Master Tenant LLC
Q	$53,737	FMV
St Joseph Downtown Development LLC (905 owned by MHM)
R	$262,208	FMV
Mosaic Medical Center-Maryville (Mosaic-Maryville)
L	$4,310,375	FMV
Mosaic Medical Center-Maryville (Mosaic-Maryville)
Q	$1,013,301	FMV
Mosaic Medical Center-Maryville (Mosaic-Maryville)
B	$26,402,888	FMV
Northwest Medical Center Association Inc (Mosaic-Albany)
B	$6,659,481	FMV