2020-05-12T17:01:17-05:00 2019-06-30 420714325 RSM US LLP 4650 East 53rd Street Davenport IA 52807 990 2018-07-01 440545289 Heartland Regional Medical Center HEAR 8162717070 5325 Faraon Street St Joseph MO 64506 Dwain Stilson Officer 2020-05-12 true Jenifer L Chase P01306883 5638884000 2018 2020-09-23 17:36:50Z Mosaic Life Care Dwain Stilson 5325 Faraon Street St Joseph MO 64506 950296386 false X https://www.mymlc.com/Main/Location/st-joseph-mo/mosaic-medical-center-st.-joseph/ X 1985 MO TO IMPROVE POPULATION HEALTH OUTCOMES IN OUR REGION BY PROVIDING THE RIGHT CARE, AT THE RIGHT TIME, PLACE AND COST. 13 7 4357 425 238022 0 404614 355545 619549975 633150002 22782479 23797245 26609496 11529345 669346564 668832137 4896749 53842112 0 0 350501825 327681503 0 0 268893 289902137 260502677 645300711 642026292 24045853 26805845 935224619 1073189130 343474048 442957247 591750571 630231883 TO IMPROVE POPULATION HEALTH OUTCOMES IN OUR REGION BY PROVIDING THE RIGHT CARE, AT THE RIGHT TIME, PLACE AND COST. false false 593047858 53842112 644174605 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. 593047858 true true false true false false false false false true false false false true true false true false false true false false false false false true true true false true true true false false false false false false false true false false false false false true true true true false false true 279 0 true 4357 true true true false false false false false true false false false true X 13 7 true false false false true true true true true false false true true true true true true true true true true CA X Dwain Stilson 8162717070 5325 Faraon Street St Joseph MO 64506 Mark Laney MD Director/President/Mosaic Health System CEO 32.0 4.0 X X 1485460 0 25971 Brian Bradley Director (Until 12/2018) 1.0 1.0 X 2500 0 0 Gary Frazer Director (As of 01/2018) 1.0 1.0 X 2500 0 0 Lucinda Hayden MD Director (As of 1/2017)(Until 12/2019) 39.0 1.0 X 574661 0 25777 Matt Baker Director (As of 6/2019) 1.0 3.0 X 0 0 0 Daniel Heckman Director 1.0 1.0 X 2500 0 0 Chris Looney MD Director/Chair (As of 1/2003) 1.0 1.0 X 45029 0 0 Matt Lukens MD Director (As of 01/2018) 39.0 1.0 X 655793 0 35067 Serena Naylor Director/Vice Chair 1.0 4.0 X 2500 0 0 Thomas Richmond Director (As of 1/2019) 1.0 2.0 X 0 0 0 Ophelia Lavell Rucker Director 1.0 1.0 X 2500 0 0 Sterett Schanze Director (As of 01/2017) 1.0 1.0 X 2500 0 0 Brenda Sharpe Director (Until 12/2018) 1.0 1.0 X 2500 0 0 Melody Smith Director (As of 1/2019) 1.0 1.0 X 0 0 0 Adam Stein Director 1.0 1.0 X 2500 0 0 Barbara Wurtzler Director/Chair/Vice Chair (Until 12/2018) 1.0 1.0 X 2500 0 0 Karen Dittemore Assistant Secretary 38.0 2.0 X 73108 0 12104 Michael Pulido COO/Secretary 32.0 4.0 X 685830 0 147227 Dwain Stilson CFO/Treasurer 32.0 5.0 X 661558 0 36467 Brady D Dubois President of Mosaic Hospitals 37.0 3.0 X 399104 0 85346 Brennan Lehman Chief Information Officer 38.0 0 X 399693 0 65888 Julee Thompson Chief Nursing Executive 40.0 0 X 361498 0 22846 Davin Turner DO Clinic President 38.0 2.0 X 544411 0 81597 Rony M Abou-Jawde MD Staff Physician 40.0 0 X 1182895 0 34197 Joshua Nelson MD Staff Physician 40.0 0 X 1367820 0 13690 Robert Grant DO Staff Physician 40.0 0 X 978192 0 37897 Bonnie Goins MD Staff Physician 40.0 0 X 1094493 0 23000 Hemant K Sheth MD Staff Physician 40.0 0.0 X 1033554 52421 29900 Curt Kretzinger Former COO (Until 01/2017) 40.0 0.0 X 512184 0 16015 John P Wilson Former Secretary/Treasurer (until 01/2017) 40.0 0.0 X 352360 0 0 John Olson MD Former Director/Physician (Until 12/2016) 40.0 0.0 X 606717 0 34618 13036860 52421 727605 418 true true false Quest Diagnostics PO Box 14730 St Louis MO 63150 Medical Services 1531544 Capital Performance Management 11709 Roe Ave D236 Leawood KS 662112607 Capital Management 1287236 Bird Law Firm PC 1212 Frederick Avenue St Joseph MO 64501 Attorney services 1150000 Kaufman Hall & Associates LLC 8610 Solution Center Chicago IL 60677 capital advisory services 1050502 POLSINELLI SHUGHART PC 3103 FREDRICK AVENUE St Joseph MO 64506 ATTORNEY SERVICES 770871 53 X 355545 355545 Net Patient Service Revenue 621110 586100000 586100000 340B Pharmacy Revenue 621110 47050002 47050002 0 0 0 0 633150002 14927245 14927245 786076 390393 395683 0 395683 128963 266720 289943856 281073856 8870000 0 8870000 8870000 Referral Lab 621511 5202168 5137910 64258 Cafeteria 722514 2868431 2868431 Copying Revenue 561439 489736 489736 2573327 2528526 44801 0 11133662 668832137 644174605 238022 24063965 53842112 53842112 6065210 2720639 3344571 0 261553 261553 262965206 246344541 16564504 56161 7586164 6169132 1415403 1629 34690522 33848859 827680 13983 16112848 14904973 1204044 3831 27787 27787 1290022 1290022 285646 285646 106500 106500 39568451 34118016 5450019 416 1639840 174423 1465417 21505344 16590436 4785272 129636 12675023 11814380 848771 11872 10103199 8029414 2044430 29355 568682 492730 54469 21483 1059563 857294 202269 6534181 96776 6437405 23514116 22195917 1318199 5898994 5670310 228684 Medical Supplies/Includes 340B 110255235 110254848 387 FRA Taxes 22863480 22863480 Dues & Subscriptions 2606614 1663738 942736 140 0 0 0 0 642026292 593047858 48709541 268893 22237498 18630714 67001634 70509499 0 0 0 7108391 7119066 7556500 8209765 18617583 26149940 628188547 410230823 175426543 217957724 596253501 663420570 0 7326969 7365960 1693373 33696000 52132519 935224619 1073189130 138050617 136973414 201901083 297204774 0 3522348 8779059 343474048 442957247 X 591135833 629232793 614738 999090 591750571 630231883 935224619 1073189130 X 26805845 12876134 -1200667 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 141033 141033 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY PORTION OF DUES PAID TO HOSPITAL ASSOCIATIONS THAT ARE USED FOR LOBBYING PURPOSES BY THE HOSPITAL ASSOCIATIONS. 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. 14478727 14478727 327273177 184512959 142760218 20775886 14804615 5971271 252224337 210913249 41311088 13436420 13436420 217957724 Derivative Instruments 0 Other Liabilities 8779059 8779059 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote Mosaic Health System, Heartland Regional Medical Center (Mosaic-St. Joseph), Mosaic Medical Center-Maryville (Mosaic-Maryville), Northwest Medical Center Association, Inc. (Mosaic-Albany), Heartland Long-Term Acute Care Hospital (HLTACH), 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. false Central America and the Caribbean Investments 29595921 0 0 0 0 0 0 29595921 0 29595921 true false true false true false true true X true X true X true true true false false 0 0 33635736 0 33635736 0.0568 0 0 87648031 66337784 21310247 0.0360 0 0 0 0 0 0.0 0 0 121283767 66337784 54945983 0.0927 0 0 4813167 362506 4450661 0.0075 0 0 122033 0 122033 0.0002 0 0 247971 0 247971 0.0004 0 0 707711 54446 653265 0.0011 0 0 2418884 0 2418884 0.0041 0 0 8309766 416952 7892814 0.0133 0 0 129593533 66754736 62838797 0.1060 0 0 26268 0 26268 0.0000 0 0 128825 0 128825 0.0002 0 0 341529 0 341529 0.0006 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 496622 0 496622 0.0008 false 18846983 0 152836943 189047750 -36210807 X true true 1 1 Heartland Regional Medical Center 5325 Faraon Street St Joseph MO 64506 www.mymlc.com/Main/Location/st-joseph-mo/mosaic-medical-center-st.-joseph/ 426-23 X X X Pharmacist Intern Program Heartland Regional Medical Center 1 false false true X X X X X X X X X 18 true true false true X https://www.mymlc.com/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ST-JOSEPH-CHNA/ X true 18 true https://www.mymlc.com/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ST-JOSEPH-CHNA/ false true X 200.0 300.0 X true true X X X X true X See Schedule O X See Schedule O X See Schedule O X X X X X X true X false X X X X X true X false false Schedule H, Part V, Section B, Line 3E The significant health needs of the community are a prioritized description of various factors including: - 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. 33 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 210B St Joseph MO 64506 Ears Nose & Throat, Pulmonary & Critical Care, Physical Medicine & Rehabilitation Mosaic Life Care Clinics 711 North 36th Street Suite 100 Low er Level St Joseph MO 64506 Family Care, Home Health, Hospice & Care at Home Mosaic Life Care Clinics 5210 North Belt Highway Entrance B C St Joseph MO 64506 Family Care & Women's Health 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 02 St Joseph MO 64506 Internal Medicine, Pediatrics, Family Care, Neurology & Outpatient Behavior Health 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 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. true Heartland Foundation 5325 Faraon Street St Joseph MO 64506 431262768 501c3 597922 General Support MWSU Foundation 5425 DOWNS DRIVE St Joseph MO 64507 237035423 501c3 469950 Sponsorship Community Missions Corporation 700 Olive Street St Joseph MO 64501 900180479 501C3 200000 General Support United Way of Greater St Joseph 118 South 5TH STREET St Joseph MO 64501 440547802 501C3 182410 General Support The Crossing Outreach 701 South 8th Street St Joseph MO 64501 464195177 501C3 152000 General Support Second Harvest Community Food Bank 915 DOUGLAS Street St Joseph MO 64505 431268319 501C3 150500 General Support Habitat for Humanity PO Box 6528 St Joseph MO 64506 431733608 501C3 125500 General Support Young Women's Christian Association 304 North 8TH Street St Joseph MO 64501 440552219 501C3 108500 General Support Legal Aid of Western Missouri 1125 Grand Blvd Kansas City MO 64106 430824638 501C3 91000 General Support Catholic Charities of KC 1302 Faraon Street St Joseph MO 64501 430887779 501C3 60000 General Support BBBS of Greater St Joseph 1202 South 28th Street St Joseph MO 64507 440666362 501C3 59000 General Support Pivotal Point 3000 Parkway A St Joseph MO 64507 271481997 501C3 50750 General Support Family Guidance Center for Behavioral Healthcare 724 North 22ND Street St Joseph MO 64506 440666362 501C3 50000 General Support Samaritan Counseling Center Inc 902 Edmond Street Suite 203 St Joseph MO 64501 431615018 501C3 40000 General Support Bartlett Center Youth Programs 409 South 18th Street St Joseph MO 64501 237116216 501C3 30000 General Support St Joseph Area Chamber of Commerce 3003 Frederick Avenue St Joseph MO 64506 440419460 501c6 29425 Sponsorship Faith in Action 2711 Ashland Avenue St Joseph MO 64506 440653008 501C3 20000 General Support Northwest Missouri Childrens Advocacy Center 1807 Woodbine Road St Joseph MO 64506 431910148 501C3 13100 General Support Albrecht-Kemper Museum of Art Foundations 2818 FREDERICK St Joseph MO 64506 431855334 501C3 10000 General Support YMCA of St Joseph Missouri 315 South 6th Street St Joseph MO 64501 440552491 501C3 5482 General Support Northwest Missouri United Labor Community Services Agency 1203 North 6th Street St Joseph MO 64501 431496809 501C3 5000 Sponsorship Robidoux Resident Theatre 615 South 10th Street St Joseph MO 64501 431257970 501C3 5000 Sponsorship St Joseph Museums Inc PO Box 8096 St Joseph MO 64508 436038202 501C3 5000 Sponsorship Pony Express Baseball Inc PO Box 1588 St Joseph MO 64502 274437372 501C3 5000 Sponsorship Pony Exprss Museum Inc 914 Penn Street St Joseph MO 64503 431567246 501C3 5000 Sponsorship Westminister Free Clinic 5560 Napoleon Avenue Oak Park CA 91377 770563241 501C3 5000 Sponsorship Mosaic Medical Center-Maryville 5325 Faraon Street St Joseph MO 64506 832249459 501(C)3 26402888 General Support Mosaic Health System 5325 Faraon Street St Joseph MO 64506 431283316 501(c)(3) 17727964 General Support Northwest Medical Center Association Inc 705 North College Street Albany MO 64402 440580870 501(c)(3) 6659481 General Support 28 1 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. X true true X X X X true true false false false false false false false Mark Laney MD Director/President/Mosaic Health System CEO 881882 0 403217 0 200361 0 11000 0 14971 0 1511430 0 0 0 John Olson MD Former Director/Physician (Until 12/2016) 545345 0 43556 0 17815 0 11000 0 23618 0 641334 0 0 0 Lucinda Hayden MD Director (As of 1/2017)(Until 12/2019) 429977 0 104991 0 39694 0 11000 0 14777 0 600438 0 0 0 Matt Lukens MD Director (As of 01/2018) 575008 0 54667 0 26118 0 11000 0 24067 0 690860 0 0 0 Curt Kretzinger Former COO (Until 01/2017) 0 0 106963 0 405220 0 0 0 16015 0 528199 0 0 0 John P Wilson Former Secretary/Treasurer (until 01/2017) 0 0 0 0 352360 0 0 0 0 0 352360 0 0 0 Michael Pulido COO/Secretary 544266 0 138876 0 2688 0 124030 0 23197 0 833057 0 67482 0 Dwain Stilson CFO/Treasurer 435892 0 224712 0 955 0 11000 0 25467 0 698025 0 0 0 Brady D Dubois President of Mosaic Hospitals 321009 0 76588 0 1507 0 62149 0 23197 0 484451 0 0 0 Brennan Lehman Chief Information Officer 318191 0 79990 0 1512 0 43021 0 22867 0 465581 0 0 0 Julee Thompson Chief Nursing Executive 283170 0 75592 0 2736 0 9177 0 13669 0 384344 0 0 0 Davin Turner DO Clinic President 425351 0 115922 0 3138 0 58730 0 22867 0 626008 0 58786 0 Rony M Abou-Jawde MD Staff Physician 937761 0 210588 0 34547 0 11000 0 23197 0 1217092 0 0 0 Joshua Nelson MD Staff Physician 300980 0 1066374 0 465 0 6700 0 6990 0 1381509 0 0 0 Robert Grant DO Staff Physician 839498 0 66276 0 72418 0 11000 0 26897 0 1016089 0 0 0 Bonnie Goins MD Staff Physician 938243 0 129250 0 27000 0 8223 0 14777 0 1117493 0 0 0 Hemant K Sheth MD Staff Physician 693335 52421 281172 0 59047 0 7523 0 21223 1154 1062300 53575 0 0 Schedule J, Part I, Line 3 Compensation Plan COMPENSATION IS ESTABLISHED BY MOSAIC HEALTH SYSTEM, A RELATED ENTITY, USING THE FOLLOWING: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. COMPENSATION SURVEYS OR STUDIES 4. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE Schedule J, Part I, Line 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. A HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI 431178966 60637ACP5 2012-10-03 51489534 See Part VI false false false B HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI 431178966 60637ACP5 2018-04-30 44936461 See Part VI false false false C HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI 431178966 60637APX4 2019-05-30 251996936 See Part VI false false false A 0 0 51535780 0 0 0 708053 0 0 50827726 1 0 2014 false false true true B 0 0 25232246 0 0 0 0 0 0 4151819 0 21080427 true false false true C 0 0 252004873 0 0 0 2176364 0 0 47660358 149768930 52399222 true false false true A false false false false 0.0 0.0 0.0 false true 0.8727 true true B false 0.0 false false true C false true true true false 0.0 0.0 0.0 false false true A false true false false false false true B false true false false false true true C false true false false false false true A true B true C true 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. Donna Wilson DONNA WILSON IS THE WIFE OF JOHN WILSON. 94851 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. 74542 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 92160 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. 556992 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 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. 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 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 true Heartland Long Term Acute Care Hospital 5325 Faraon Street St Joseph MO 64506 261972987 Healthcare MO 501(c)(3) 3 Mosaic Health System true Northwest Medical Center Association Inc 705 North College Street Albany MO 64402 440580870 Healthcare MO 501(c)(3) 3 Mosaic Health System 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 true Mosaic Medical Center-Maryville 5325 Faraon Street St Joseph MO 64506 832249459 Healthcare MO 501(c)(3) 3 Mosaic Health System true ST JOSEPH DOWNTOWN DEVELOPMENT LLC 5325 FARAON STREET ST JOSEPH MO 64506 474317460 DEVELOPMENT OF DOWNTOWN ST. JOSEPH MO NA N/A Midwestern Health Management Inc 5325 Faraon Street St Joseph MO 64506 431264358 Healthcare MO NA C Corporation true HHS Properties Inc 5325 Faraon Street St Joseph MO 64506 431593799 Investment MO NA C Corporation true Uptown Housing Inc 5325 Faraon Street St Joseph MO 64506 261416252 Redevelopment MO HRMC C Corporation 1 true Uptown St Joseph Redevelopment Corp 5325 Faraon Street St Joseph MO 64506 201742813 Redevelopment MO HRMC C Corporation 1 true true true true true false false false false false true true true true true true true true true true Heartland Long Term Acute Care Hospital (HLTACH) A 472795 FMV Heartland Long Term Acute Care Hospital (HLTACH) J 584520 FMV Heartland Long Term Acute Care Hospital (HLTACH) L 2806944 FMV Heartland Long Term Acute Care Hospital (HLTACH) Q 2941698 FMV Northwest Medical Center Association Inc (Mosaic-Albany) L 2392410 FMV Northwest Medical Center Association Inc (Mosaic-Albany) Q 8485482 FMV Northwest Medical Center Association Inc (Mosaic-Albany) S 122636 FMV Heartland Foundation B 597922 FMV Heartland Foundation Q 1986488 FMV Midwestern Health Management Inc (Midwestern) L 1895247 FMV Midwestern Health Management Inc (Midwestern) Q 2713016 FMV St Joseph Downtown Development LLC (905 owned by MHM) L 382933 FMV St Joseph Downtown Development LLC (905 owned by MHM) Q 337057 FMV HHS Properties Inc L 213220 FMV HHS Properties Inc K 262182 FMV HHS Properties Inc Q 1208925 FMV Ascend Development LLC (disregarded entity wholly owned by MHM) Q 104098 FMV Ascend Development LLC (disregarded entity wholly owned by MHM) L 1811804 FMV Mosaic Health System B 17727964 FMV German American Master Tenant LLC Q 53737 FMV St Joseph Downtown Development LLC (905 owned by MHM) R 262208 FMV Mosaic Medical Center-Maryville (Mosaic-Maryville) L 4310375 FMV Mosaic Medical Center-Maryville (Mosaic-Maryville) Q 1013301 FMV Mosaic Medical Center-Maryville (Mosaic-Maryville) B 26402888 FMV Northwest Medical Center Association Inc (Mosaic-Albany) B 6659481 FMV