HEARTLAND REGIONAL MEDICAL CENTER: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: HEARTLAND REGIONAL MEDICAL CENTER (EIN 44-0545289)
Tax period: 2016-07-01 to 2017-06-30
Filed: 2018-05-14
IRS object ID: 201801349349303655
Schema version: 2016v3.0
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 H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-05-14T10:57:00-05:00	ReturnTs
Tax Period End	2017-06-30	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	1 S WACKER DRIVE STE 800	AddressLine1Txt
City	CHICAGO	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	60606	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-07-01	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
Phone	8162717070	PhoneNum
Signature	2018-05-11	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	WAYNE HARDER	PreparerPersonNm
PTIN	P00294296	PTIN
Phone	3126343400	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	108.171.131.187	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2018-05-11	IPDt
IP Tm	11:08:13	IPTm
IP Timezone	CD	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	4B8E1423B9F197D509CCF13AB357181C17C415CB	AtSubmissionCreationDeviceId
At Submission Filing Device Id	4EC0B96C62AE7F3F798FFAAE8A06701F68EED858	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	MOSAIC LIFE CARE	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	DWAIN STILSON	PrincipalOfficerNm

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	$887,829,506	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.MYMOSAICLIFECARE.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1985	FormationYr
Legal Domicile State	MO	LegalDomicileStateCd
Activity Or Mission	SEE SCHEDULE O 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	9	VotingMembersIndependentCnt
Total Employee	4627	TotalEmployeeCnt
Total Volunteers	459	TotalVolunteersCnt
Total Gross UBI	$1,575,463	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$645,354	PYContributionsGrantsAmt
CY Contributions Grants	$580,266	CYContributionsGrantsAmt
PY Program Service Revenue	$564,223,618	PYProgramServiceRevenueAmt
CY Program Service Revenue	$632,544,479	CYProgramServiceRevenueAmt
PY Investment Income	$50,235,912	PYInvestmentIncomeAmt
CY Investment Income	$24,962,821	CYInvestmentIncomeAmt
PY Other Revenue	$23,848,502	PYOtherRevenueAmt
CY Other Revenue	$22,569,155	CYOtherRevenueAmt
PY Total Revenue	$638,953,386	PYTotalRevenueAmt
CY Total Revenue	$680,656,721	CYTotalRevenueAmt
PY Grants And Similar Paid	$2,785,232	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$2,954,095	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$321,468,642	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$343,111,274	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$153,058	CYTotalFundraisingExpenseAmt
PY Other Expenses	$274,368,439	PYOtherExpensesAmt
CY Other Expenses	$303,790,632	CYOtherExpensesAmt
PY Total Expenses	$598,622,313	PYTotalExpensesAmt
CY Total Expenses	$649,856,001	CYTotalExpensesAmt
PY Revenues Less Expenses	$40,331,073	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$30,800,720	CYRevenuesLessExpensesAmt
Total Assets BOY	$859,768,385	TotalAssetsBOYAmt
Total Assets EOY	$900,919,281	TotalAssetsEOYAmt
Total Liabilities BOY	$359,153,351	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$373,385,281	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$500,615,034	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$527,534,000	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
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	0	SignificantNewProgramSrvcInd
Significant Change	Yes (1)	SignificantChangeInd
Expense	$590,094,205	ExpenseAmt
Grant	$2,954,095	GrantAmt
Revenue	$652,821,802	RevenueAmt
Desc	SEE SCHEDULE O	Desc
Total Program Service Expenses	$590,094,205	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	272	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	4627	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MO	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NC	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	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
DAN HECKMAN
DIRECTOR	1.00	1.00	Yes (X)	$2,500	$0	$0
DR JOHN OLSON
DIRECTOR/PHYSICIAN(UNTIL 12/2016)	1.00	39.00	Yes (X)	$696,848	$0	$35,272
STEVE SCHRAM
DIRECTOR/CHAIR(UNTIL 12/2016)	1.00	1.00	Yes (X)	$2,500	$0	$0	Yes (X)
BARBARA WURTZLER
DIRECTOR/CHAIR/VICE CHAIR	1.00	1.00	Yes (X)	$2,500	$0	$0	Yes (X)
DR MARK LANEY
DIRECTOR/PRESIDENT/CEO	34.00	3.00	Yes (X)	$1,075,453	$0	$28,769	Yes (X)
DR DENNIS DOBYAN
DIRECTOR	1.00	1.00	Yes (X)	$2,500	$74,416	$0
ADAM STEIN
DIRECTOR	1.00	1.00	Yes (X)	$2,500	$0	$0
BRAD MCANALLY
DIRECTOR(UNTIL 12/2016)	1.00	1.00	Yes (X)	$2,500	$0	$0
SERENA NAYLOR
DIRECTOR	1.00	3.00	Yes (X)	$2,500	$18,000	$0
DR CHRIS LOONEY
DIRECTOR/VICE CHAIR	1.00	1.00	Yes (X)	$60,640	$0	$0
BRENDA SHARPE
DIRECTOR	1.00	1.00	Yes (X)	$2,500	$0	$0
BRIAN BRADLEY
DIRECTOR	1.00	1.00	Yes (X)	$2,500	$0	$0
OPHELIA LAVELL RUCKER
DIRECTOR	1.00	1.00	Yes (X)	$2,500	$0	$0
MICHAEL LANE
DIRECTOR (AS OF 01/2017)	1.00	1.00	Yes (X)	$0	$0	$0
DR LUCINDA HAYDEN
DIRECTOR (AS OF 01/2017)	1.00	39.00	Yes (X)	$505,292	$0	$26,126
STET SCHANZE
DIRECTOR (AS OF 01/2017)	1.00	1.00	Yes (X)	$0	$0	$0
CURT KRETZINGER
COO (UNTIL 01/2017)	33.00	7.00		$739,075	$0	$81,923	Yes (X)
MICHAEL PULIDO
CHIEF OPERATING OFFICER/SECRETARY	34.00	6.00		$481,420	$0	$107,602	Yes (X)
JOHN WILSON
SECRETARY/TREASURER(UNTIL 01/2017)	33.00	7.00		$600,461	$0	$13,667	Yes (X)
DWAIN STILSON
CFO/TREASURER	33.00	7.00		$359,407	$0	$74,958	Yes (X)
KAREN DITTEMORE
ASSISTANT SECRETARY	39.00	2.00		$68,170	$0	$12,958	Yes (X)
JODIE ROETTGER
ASSISTANT TREASURER	39.00	2.00		$182,214	$0	$23,389	Yes (X)
DR DAVIN TURNER
PRESIDENT	40.00	0.00		$426,186	$0	$80,381		Yes (X)
BRADY D DUBOIS
PRESIDENT	40.00	0.00		$356,190	$0	$81,942		Yes (X)
CAROLYN S PADEN
ADMINISTRATOR	40.00	0.00		$222,926	$0	$17,219		Yes (X)
BRENNAN LEHMAN
CHIEF INFORMATION OFFICER	40.00	0.00		$312,648	$0	$62,293		Yes (X)
DR RONY M ABOU-JAWDE
STAFF PHYSICIAN	40.00	0.00		$995,534	$0	$34,873			Yes (X)
DR MOHAN R HINDUPUR
STAFF PHYSICIAN	40.00	0.00		$1,046,888	$0	$28,719			Yes (X)
DR ROBERT GRANT
STAFF PHYSICIAN	40.00	0.00		$950,349	$0	$37,373			Yes (X)
DR ARVIND K SHARMA
STAFF PHYSICIAN	40.00	0.00		$960,436	$0	$34,542			Yes (X)
DR RAJAGOPAL RANGINENI
STAFF PHYSICIAN	40.00	0.00		$958,567	$0	$28,819			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$11,023,704	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$92,416	TotReportableCompRltdOrgAmt
Total Other Compensation	$810,825	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	412	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	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	$1,636,978
POLSINELLI SHUGHART PC
3103 FREDERICK AVENUE	ST JOSEPH	MO	64506	ATTORNEY SERVICES	$1,344,784
CAPITAL PERFORMANCE MANAGEMENT
11709 ROE AVENUE SUITE D236	LEAWOOD	KS	66211	CONSTRUCTION MANAGEMENT	$937,302
BKD LLP
1201 WALNUT STREET SUITE 1700	KANSAS CITY	MO	64106	FINANCIAL SERVICES	$679,045
KEMBERTON HEALTHCARE SERV LLC
501 CORPORATE CENTRE DRIVE SUITE 6	FRANKLIN	TN	37067	HEALTHCARE SERVICES	$651,794

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	34	CntrctRcvdGreaterThan100KCnt
All Other Contributions	$580,266	AllOtherContributionsAmt
Total Contributions	$580,266	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE	621110	$601,465,862	$601,465,862
340B PHARMACY REVENUE	621110	$30,802,835	$30,802,835
MEANINGFUL USE PAYMENTS	621110	$275,782	$275,782

Field	Value	IRS element (for citing)
Total Program Service Revenue	$632,544,479	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$10,946,821	TotalRevenueColumnAmt
Exclusion	$10,946,821	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$818,722	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$818,722	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$818,722	TotalRevenueColumnAmt
Unrelated Business Revenue	$102,353	UnrelatedBusinessRevenueAmt
Exclusion	$716,369	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$220,946,000	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$206,930,000	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$14,016,000	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$14,016,000	TotalRevenueColumnAmt
Exclusion	$14,016,000	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$127,660	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$242,785	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$115,125	TotalRevenueColumnAmt
Unrelated Business Revenue	-$115,125	UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
REFERRAL LAB	111000	$7,089,535	$7,023,670	$65,865
CAFETERIA	722514	$2,347,238	$2,347,238
COPYING REVENUE	541380	$567,642	$567,642

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,861,143	TotalRevenueColumnAmt
Related Or Exempt Func Income	$10,338,773	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,522,370	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$21,865,558	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$680,656,721	TotalRevenueColumnAmt
Related Or Exempt Func Income	$652,821,802	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,575,463	UnrelatedBusinessRevenueAmt
Exclusion	$25,679,190	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$2,954,095	TotalAmt
Program Services	$2,954,095	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$6,297,849	TotalAmt
Program Services	$2,448,383	ProgramServicesAmt
Management And General	$3,849,466	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$636,947	TotalAmt
Program Services	$636,947	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$267,363,097	TotalAmt
Program Services	$253,241,130	ProgramServicesAmt
Management And General	$14,059,617	ManagementAndGeneralAmt
Fundraising	$62,350	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$8,208,534	TotalAmt
Program Services	$7,829,073	ProgramServicesAmt
Management And General	$377,054	ManagementAndGeneralAmt
Fundraising	$2,407	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$43,905,124	TotalAmt
Program Services	$37,299,941	ProgramServicesAmt
Management And General	$6,587,989	ManagementAndGeneralAmt
Fundraising	$17,194	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$16,699,723	TotalAmt
Program Services	$15,291,938	ProgramServicesAmt
Management And General	$1,403,426	ManagementAndGeneralAmt
Fundraising	$4,359	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$2,761,264	TotalAmt
Management And General	$2,761,264	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$317,406	TotalAmt
Management And General	$317,406	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$102,750	TotalAmt
Management And General	$102,750	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$43,437,521	TotalAmt
Program Services	$35,963,061	ProgramServicesAmt
Management And General	$7,471,952	ManagementAndGeneralAmt
Fundraising	$2,508	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$3,068,554	TotalAmt
Program Services	$168,897	ProgramServicesAmt
Management And General	$2,899,657	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$24,899,357	TotalAmt
Program Services	$20,638,172	ProgramServicesAmt
Management And General	$4,249,547	ManagementAndGeneralAmt
Fundraising	$11,638	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$3,003,131	TotalAmt
Program Services	$2,670,619	ProgramServicesAmt
Management And General	$309,051	ManagementAndGeneralAmt
Fundraising	$23,461	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$13,877,597	TotalAmt
Program Services	$12,315,972	ProgramServicesAmt
Management And General	$1,561,625	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$924,783	TotalAmt
Program Services	$852,789	ProgramServicesAmt
Management And General	$71,856	ManagementAndGeneralAmt
Fundraising	$138	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$2,174,343	TotalAmt
Program Services	$1,734,875	ProgramServicesAmt
Management And General	$430,711	ManagementAndGeneralAmt
Fundraising	$8,757	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$6,445,932	TotalAmt
Program Services	$29,957	ProgramServicesAmt
Management And General	$6,415,975	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$27,897,956	TotalAmt
Program Services	$23,053,739	ProgramServicesAmt
Management And General	$4,825,038	ManagementAndGeneralAmt
Fundraising	$19,179	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$10,608,703	TotalAmt
Program Services	$9,883,319	ProgramServicesAmt
Management And General	$725,384	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES	$92,379,193	$92,379,193
PROVISION FOR UNCOLLECT	$43,681,877	$43,681,877
FRA TAX	$25,824,000	$25,824,000
DUES & SUBSCRIPTIONS	$2,386,265	$1,196,228	$1,188,970	$1,067

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$649,856,001	TotalAmt
Program Services	$590,094,205	ProgramServicesAmt
Management And General	$59,608,738	ManagementAndGeneralAmt
Fundraising	$153,058	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$26,904,573	BOYAmt
EOY	$24,279,275	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$72,432,584	BOYAmt
EOY	$74,402,014	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$7,757,338	BOYAmt
EOY	$8,120,167	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$7,577,204	BOYAmt
EOY	$19,780,020	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$601,678,289	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$394,564,944	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$237,121,763	BOYAmt
EOY	$207,113,345	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$476,258,585	BOYAmt
EOY	$527,244,126	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$7,478,444	BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$8,180,362	BOYAmt
EOY	$7,306,483	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$16,057,532	BOYAmt
EOY	$32,673,851	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$859,768,385	BOYAmt
EOY	$900,919,281	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$130,076,130	BOYAmt
EOY	$155,383,775	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$215,724,479	BOYAmt
EOY	$209,693,134	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$2,483,921	BOYAmt
EOY	$2,130,598	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$10,868,821	BOYAmt
EOY	$6,177,774	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$359,153,351	BOYAmt
EOY	$373,385,281	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$500,223,735	BOYAmt
EOY	$526,938,349	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$391,299	BOYAmt
EOY	$595,651	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$500,615,034	BOYAmt
EOY	$527,534,000	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$859,768,385	BOYAmt
EOY	$900,919,281	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$30,800,720	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$34,281,148	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$38,162,902	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	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 (1)	AuditCommitteeInd
Federal Grant Audit Required	0	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	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (1)	GrantsOtherOrganizationsInd
Grants Other Organizations	$34,120	GrantsOtherOrganizationsAmt
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$102,750	OtherActivitiesAmt
Total Lobbying Expenditures	$136,870	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE C, PART II-B, LINE 1F	PORTION OF DUES PAID TO HOSPITAL ASSOCIATIONS THAT ARE USED FOR LOBBYING PURPOSES BY THE HOSPITAL ASSOCIATIONS.
SCHEDULE C, PART II-B, LINE 1I	CONTRACTED WITH VARIOUS PARTIES FOR LEGISLATIVE LOBBYING IN SUPPORT OF HOSPITAL REIMBURSEMENT AND COMMUNITY SUPPORT.

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$23,444,059	OtherCostOrOtherBasisAmt
Book Value	$23,444,059	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$297,016,559	OtherCostOrOtherBasisAmt
Depreciation	$157,275,415	DepreciationAmt
Book Value	$139,741,144	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$22,685,257	OtherCostOrOtherBasisAmt
Depreciation	$14,138,702	DepreciationAmt
Book Value	$8,546,555	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$197,109,028	OtherCostOrOtherBasisAmt
Depreciation	$164,478,191	DepreciationAmt
Book Value	$32,630,837	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$61,423,386	OtherCostOrOtherBasisAmt
Depreciation	$58,672,636	DepreciationAmt
Book Value	$2,750,750	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$207,113,345	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
DERIVATIVE INSTRUMENTS	$6,117,774
MINORITY INTEREST	$60,000

Field	Value	IRS element (for citing)
Total Liability	$6,177,774	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	THE MEDICAL CENTER IS A NONPROFIT CORPORATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PRUSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. HOWEVER, THE MEDICAL CENTER IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. WITH A FEW EXCEPTIONS, THE MEDICAL CENTER IS NO LONGER SUBJECT TO U.S. FEDERAL, STATE, AND LOCAL INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES BEFORE 2013. 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 PERCENT 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 LIABLITY 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, 2017 AND 2016, THERE WERE NO UNCERTAIN TAX POSITIONS IDENTIFIED AND RECORDED AS A LIABILITY.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	300.000000000000	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	0	FPGReferenceDiscountedCareInd
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$22,411,362	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$22,411,362	NetCommunityBenefitExpnsAmt
Total Expense	0.03450	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$98,205,168	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$74,369,697	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$23,835,471	NetCommunityBenefitExpnsAmt
Total Expense	0.03670	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$120,616,530	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$74,369,697	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$46,246,833	NetCommunityBenefitExpnsAmt
Total Expense	0.07120	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,049,149	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$297,412	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,751,737	NetCommunityBenefitExpnsAmt
Total Expense	0.00580	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$390,057	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$52,218	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$337,839	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,025,603	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,025,603	NetCommunityBenefitExpnsAmt
Total Expense	0.00310	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,464,809	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$349,630	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,115,179	NetCommunityBenefitExpnsAmt
Total Expense	0.00940	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$127,081,339	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$74,719,327	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$52,362,012	NetCommunityBenefitExpnsAmt
Total Expense	0.08060	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$112,118	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$112,118	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$111,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$111,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$260,473	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,080	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$247,393	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$483,591	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,080	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$470,511	NetCommunityBenefitExpnsAmt
Total Expense	0.00080	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReportedInd
Bad Debt Expense	$18,636,327	BadDebtExpenseAmt
Bad Debt Expense Attributable	$10,378,653	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$137,476,771	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$180,008,062	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$42,531,291	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 (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	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 ST	AddressLine1Txt
City	ST JOSEPH	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	64506	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.MYMOSAICLIFECARE.ORG	WebsiteAddressTxt
State License	426-19	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Other	PHARMICIST 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	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	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
Other	Yes (X)	OtherInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	300.000000000000	FPGFamilyIncmLmtFreeCarePct
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	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 (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SEC C	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
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	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 (1)	NondisEmergencyCarePolicyInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
HEARTLAND REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 3J: COMMUNITY PARTNERS INCLUDING THE ST JOSEPH SCHOOL DISTRICT AND MISSOURI WESTERN STATE UNIVERSITY.
HEARTLAND REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 5: TO ENSURE INPUT WAS TAKEN INTO ACCOUNT FROM PERSONS WHO REPRESENT THE COMMUNITY, THE MEDICAL CENTER UTILITIZED AN INDEPENDENT CONSULTING FIRM NAMED LAN RESOURCES, LLC. THIS FIRM CONDUCTED A TELEPHONE SURVEY AND SIX FOCUS GROUPS TO DETERMINE HEALTH PRIORITIES BASED ON THE OPINIONS OF COMMUNITY MEMBERS. THE TELEPHONE SURVEY INVOLVED 381 RESIDENTS FROM THE MEDICAL SYSTEM'S SERVICE AREA AND WAS DESIGNED TO OBTAIN FEEDBACK AT A 95% CONFIDENCE INTERVAL. THE SAMPLE INCLUDED MEN AND WOMEN FROM 18 TO OVER 65 WITH HOUSEHOLD INCOMES RANGING FROM LESS THAN $10K TO OVER $75K. TO COMPLETE THE QUALITATIVE ASPECT OF DATA GATHERING ASSOCIATED WITH COMMUNITY HEALTH NEEDS, SIX FOCUS GROUPS WERE CONVENED THAT INCLUDED COMMUNITY REPRESENTATIVES WITH BROAD INTERESTS AND THOSE WITH SPECIAL KNOWLEDGE OF THE SUBJECT. THE ORGANIZATION RECRUITED INTERNAL PARTICIPANTS, WHILE THE CONSULTING FIRM RECRUITED ALL EXTERNAL PARTICIPANTS AND MODERATED EACH FOCUS GROUP. THE SIX FOCUS GROUPS CONSISTED OF PHYSICIANS, COMMUNITY MEMBERS AT-LARGE, CLINICAL STAFF (NURSES, CARE MANAGERS AND SOCIAL WORKERS), AND COMMUNITY LEADERS. TWO OF THE FOCUS GROUPS WERE COMPRISED SOLELY OF COMMUNITY MEMBERS AT-LARGE.
HEARTLAND REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 6A: HEARTLAND LONG TERM ACUTE CARE HOSPITAL.PART V, SECTION B, LINE 7A:HTTPS://WWW.MYMOSAICLIFECARE.ORG/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPART V, SECTION B, LINE 10:HTTPS://WWW.MYMOSAICLIFECARE.ORG/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
HEARTLAND REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED AND AN IMPLEMENTATION PLAN FOR ADDRESSING THE IDENTIFIED NEEDS WAS ADOPTED IN THE 2015 TAX YEAR. THE TOP THREE SIGNIFICANT NEEDS IDENTIFIED WERE: 1) ACCESS TO AFFORDABLE HEALTH CARE AND MEDICATION; 2) ADULT AND CHILDHOOD OBESITY; AND 3) MENTAL HEALTH SERVICES. THE MEDICAL CENTER'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, THE MEDICAL CENTER INTRODUCED 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 FY2016 FY2019 CHNA ACTION PLAN.TO FULLY MEET THE NEEDS IDENTIFIED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE MEDICAL CENTER IMPLEMENTED A THREE-YEAR ACTION PLAN COMPRISED OF THE FOLLOWING COMPONENTS. SIGNIFICANT NEED #1: ACCESS TO AFFORDABLE HEALTH CARE AND MEDICATION PLAN: A) SUPPORT COMMUNITY CONNECT PROGRAMS THAT ADDRESS ACCESS TO CARE B) PROVIDE A CLINIC WITH ENHANCED SERVICES FOR OUR MOST VULNERABLE POPULATIONS.SIGNIFICANT NEED #2: ADULT AND CHILDHOOD OBESITY PLAN: A) CONTINUE AND EXPAND CURRENT HEALTH IMPROVEMENT PROGRAMS SUCH AS POUND PLUNGE,1-2-3-4-5 FIT-TASTIC BASED ON SUCCESFUL MODEL LED BY CHILDREN'S MERCY HOSPITAL, 4TH GRADE CHALLENGE, ETC. B) SUPPORT COMMUNITY CONNECT PROGRAMS THAT ADDRESS OBESITY PREVENTIONSIGNIFICANT NEED #3: MENTAL HEALTH SERVICES PLAN: A) SUPPORT COMMUNITY CONNECT PROGRAMS THAT ADDRESS MENTAL HEALTH NEEDS. B) CONTINUE TO PROVIDE FINANCIAL SUPPORT TO ORGANIZATIONS PROVIDING MENTAL HEALTH SUPPORT TO THE COMMUNITY SUCH AS THE CENTER, HEALTH GROUP AND HILLCREST TRANSITIONAL HOUSING AND BIG BROTHERS BIG SISTERS WHICH PROVIDES COUNSELING SERVICES TO CHILDREN.DURING FY17, THE COMMUNITY CONNECT ALLOCATIONS COMMITTEE AWARDED FUNDING OF $1.2 MILLION TO 10 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.MYMOSAICLIFECARE.ORG/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ST-JOSEPH-CHNA/PART V, SECTION B, LINE 16A, FAP WEBSITE:HTTPS://WWW.MYMOSAICLIFECARE.ORG/GLOBALASSETS/FAP-05222017-REDUCED-SIZE.PDFPART V, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.MYMOSAICLIFECARE.ORG/GLOBALASSETS/FINANCIAL-ASSISTANCE-APPLICATION-WITH-1557-REDUCED-SIZE.PDFPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.MYMOSAICLIFECARE.ORG/MAIN/LOCATION/ST-JOSEPH-MO/MOSAIC-LIFE-CARE-AT-ST.-JOSEPH/MEDICAL-CENTER/HRMC-FINANCIAL-AND-INSURANCE-INFORMATION/FINANCIAL-ASSISTANCE-GUIDELINES/
HEARTLAND REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 20E: FINANCIAL COUNSELORS ARE AVAILABLE ONSITE TO EXPLAIN AND HELP PATIENTS AND RESPONSIBLE PARTIES WITH THE FINANCIAL ASSISTANCE POLICY.

Field	Value	IRS element (for citing)
Facility	43	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (43 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt	Address Line2USAddress/AddressLine2Txt
1 - CAMERON MOSAIC LIFE CARE
215 SOUTH WALNUT STREET SUITE A	CAMERON	MO	64429	FAMILY CARE
2 - MOSAIC LIFE CARE CLINICS
902 N RIVERSIDE	SAINT JOSEPH	MO	64507	MEDICAL ONCOL, RADIATION ONCOL,PEDIATRICS
3 - MOSAIC LIFE CARE CLINICS
705 N COLLEGE	ALBANY	MO	64402	CARDIOVASC, GEN SURG, NEUROL, PODIATRY, VASC SURG, WOMENS HEALTH
4 - MOSAIC LIFE CARE CLINICS
2600 MILLER ST	BETHANY	MO	64424	CARDIOLOGY, NEUROL, RHEUMATOLOGY
5 - MOSAIC LIFE CARE CLINICS
901 HEARTLAND ROAD	SAINT JOSEPH	MO	64506	INFECT DISEASE, DIABETES, ENDO, INTRNL MED, CAREGIVER, SLEEP DISORDER, WOMEN
6 - MOSAIC LIFE CARE CLINICS
5301 FARAON SUITES 160 200 210 210B	SAINT JOSEPH	MO	64506	ENT, OCCUPA MED, PULM & CRIT CARE
7 - EXCELSIOR SPRINGS MOSAIC LIFE CARE
2370 VINTAGE COURT	EXCELSIOR SPRINGS	MO	64024	FAMILY CARE
8 - MOSAIC LIFE CARE CLINICS
711 N 36TH STREET SUITE 100 LOWER	SAINT JOSEPH	MO	64506	FAMILY CARE, HOME HEALTH, HOSPICE, CARE AT HOME	LVL
9 - MOSAIC LIFE CARE CLINICS
5210 NORTH BELT HIGHWAY ENTRANCES B	SAINT JOSEPH	MO	64506	FAMILY CARE, WOMENS HEALTH	C
10 - MOSAIC LIFE CARE CLINICS
2701 RUNNING HORSE ROAD	PLATTE CITY	MO	64079	FAMILY CARE, OUTPT THER, SPORTS MEDICINE
11 - MOSAIC LIFE CARE CLINICS
9784 N ASH AVENUE	KANSAS CITY	MO	64157	FAMILY CARE, GASTRO
12 - INTERNAL MEDICINE BECK RD ST JOSEPH MOSA
3715 BECK ROAD BUILDING F	SAINT JOSEPH	MO	64506	INTERNAL MEDICINE
13 - MOSAIC LIFE CARE CLINICS
5514 CORPORATE DRIVE SUITE 120 150	SAINT JOSEPH	MO	64507	CARDIOVASC, INTERNAL MEDICINE
14 - MOSAIC LIFE CARE CLINICS
105 FAR WEST DRIVE SUITE 100 201	SAINT JOSEPH	MO	64506	INTRNL MED, PEDIATRICS, FAMILY CARE, NEUROL, OUTPT BEHAV HEALTH	202
15 - KEARNEY MOSAIC LIFE CARE
425 WEST MOSAIC LIFE CARE WAY	KEARNEY	MO	64060	FAMILY CARE
16 - MOSAIC LIFE CARE CLINICS
802 NORTH RIVERSIDE	SAINT JOSEPH	MO	64506	BARIATRIC, BREAST, CARDIOTHORACIC SURG, GEN SURG, PHYS MED & REHAB, PAIN MGM
17 - MEDICAL ONCOLOGY MOSAIC LIFE CARE
1610 E EVERGREEN SUITE B	CAMERON	MO	64429	MEDICAL ONCOLOGY
18 - MOSAIC LIFE CARE CLINICS
2016 S MAIN	MARYVILLE	MO	64468	MEDICAL ONCOLOGY, NEUROSURG
19 - MOSAIC LIFE CARE BURLINGTON CREEK CLINIC
6301 N LUCERNE	KANSAS CITY	MO	64151	PHYS MED & REHA, IMAGING, OCCUP MED, ORTHO, SPECIALTY CLINICS
20 - MOSAIC LIFE CARE SHOAL CREEK CLINIC
8880 NE 82ND TERRACE	KANSAS CITY	MO	64158	PHYS MED & REHAB, FAMILY CARE, IMAGING, OCCUP MED, URGENT CARE, SPECIALTIES
21 - MOSAIC LIFE CARE HOSPICE AT STANBERRY
PINE VIEW MANOR RM 507 307 PINEVIEW	STANBERRY	MO	64489	HOSPICE	ST
22 - MOSAIC LIFE CARE SURGERY CENTER SHOAL CR
8860 NE 82ND TERRACE	KANSAS CITY	MO	64158	OUTPATIENT SURGERY
23 - NORTHWEST MEDICAL CENTER HOME HEALTH AGE
1607 E US HIGHWAY 136	ALBANY	MO	64402	HOME HEALTH
24 - MOSAIC LIFE CARE CLINICS
3620 FREDERICK AVENUE	SAINT JOSEPH	MO	64506	OUTPT IMAGING, COUNSELING CARE
25 - OP THERAPY FREDERICK AVE ST JOSEPH MOSAI
3107 FREDERICK AVE LOWER LEVEL	SAINT JOSEPH	MO	64506	OUTPT THERAPY
26 - MOSAIC LIFE CARE CLINICS
3007 NORTH BELT HIGHWAY	SAINT JOSEPH	MO	64506	OUTPT THERAPY, CHIROPRACTIC CARE
27 - PAIN MANAGEMENT MOSAIC LIFE CARE
100 CENTRAL ST	CHILLICOTHE	MO	64601	PAIN MANAGEMENT
28 - PLASTIC SURGERY & DERMATOLOGY MOSAIC LIF
5204 NORTH BELT HIGHWAY SUITE A2016	SAINT JOSEPH	MO	64506	PLASTIC SURG, DERMATOLOGY	S
29 - PARKVILLE COMMONS MOSAIC LIFE CARE
6301 N LUCERNE	KANSAS CITY	MO	64151	FAMILY CARE, SPECIALTIES
30 - PODIATRY ST JOSEPH MOSAIC LIFE CARE
5202 FARAON SUITE A	SAINT JOSEPH	MO	64506	PODIATRY
31 - MOSAIC LIFE CARE CLINICS
1600 E EVERGREEN PO BOX 557	CAMERON	MO	64429	PULMONARY & CRIT CARE, RHEUMATOLOGY
32 - MOSAIC LIFE CARE CLINICS
MARYVILLE SPECIALTY CLINIC 2024 S	MARYVILLE	MO	64468	ENT, PULM & CRIT CARE, NEUROLOGY, PODIATRY	MAIN
33 - SMITHVILLE MOSAIC LIFE CARE
1103 SOUTH US HIGHWAY 169	SMITHVILLE	MO	64089	FAMILY CARE
34 - MOSAIC LIFE CARE CLINICS
1701 EAST 9TH STREET	TRENTON	MO	64683	FAMILY CARE, NEUROLOGY
35 - TRENTON OCCUPATIONAL MEDICINE MOSAIC LIF
1707 EAST 9TH STREET	TRENTON	MO	64683	OCCUPATIONAL MEDICINE
36 - URGENT CARE ST JOSEPH MOSAIC LIFE CARE
1115 NORTH BELT HIGHWAY	SAINT JOSEPH	MO	64506	URGENT CARE
37 - MOSAIC LIFE CARE CLINIC
810 RAVENHILL DR SUITE 103	ATCHISON	KS	66002	SPECIALTIES
38 - MOSAIC LIFE CARE CLINIC
104 N 6TH	ATCHISON	KS	66002	MEDICAL ONCOLOGY
39 - HIAWATHA MOSAIC LIFE CARE
300 UTAH	HIAWATHA	KS	66434	FAMILY CARE
40 - TROY MOSAIC LIFE CARE
207 SOUTH MAIN	TROY	KS	66087	FAMILY CARE
41 - ENDOCRINOLOGY MOSAIC LIFE CARE
220 ESSIE DAVISON DRIVE	CLARINDA	IA	51632	ENDOCRINOLOGY
42 - MOSAIC LIFE CARE CLINICS
1301 NORTH 3RD	ATCHISON	KS	66002	SPECIALTIES
43 - ENDOCRINOLOGY MOSAIC LIFE CARE
820 RAVEN HILL DRIVE	ATCHISON	KS	66002	ENDOCRINOLOGY

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	SEE PART I, LINE 3B - DURING FY17 THE ORGANIZATION DID NOT OFFER DISCOUNTED CARE, HOWEVER STARTING IN FY18 THE ORGANIZATION NOW OFFERS DISCOUNTED CARE.SEE PART VI, SECTION B, LINE 13 FOR THE LIST OF FACTORS USED IN THE ELIGIBILITY CRITERIA EXPLAINED IN THE FAP FOR PROVIDING FREE AND DISCOUNT CARE.
PART I, LINE 7:	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.PART I, LINES 7A AND 7B:FINANCIAL ASSISTANCE AT COST WAS 27,840,000 AND 25,290,000 FOR YEARS ENDED 6/30/16 AND 6/30/2017, RESPECTIVELY. DURING FISCAL YEAR 2016, A MEDICAL DEBT GRACE PERIOD WAS PROVIDED BY THE MEDICAL CENTER WHICH RESULTED IN HIGHER COSTS. DURING FISCAL YEAR 2017, THE FINANCIAL ASSISTANCE POLICY WAS EXPANDED TO 300% OF THE FEDERAL POVERTY GUIDELINES WHICH RESULTED IN INCREASED COSTS. MEDICAID NET COMMUNITY BENEFIT EXPENSE WAS 41,450,000 AND 33,141,000 FOR YEARS ENDED 6/30/16 AND 6/30/17, RESPECTIVELY. THE MEDICAL CENTER RECEIVES REIMBURSEMENT FROM THE MEDICAID PROGRAM IN RELATION TO THE PERCENTAGE OF MEDICAID AND INDIGENT POPULATION THEY SERVE. FUNDING RECEIVED IN EXCESS OF COSTS TO PROVIDE THESE SERVICES MAY BE REFUNDED TO THE STATE. DURING 2016, THROUGH MANAGEMENT'S CONTINUED REVIEW OF PROGRAM RESULTS, ADDITIONAL INFORMATION FROM IMPROVEMENTS IN THE REPORTING PROCESS AND REVISIONS TO THE CURRENT ESTIMATION PROCESS, THE MEDICAL CENTER RECORDED AN ADDITIONAL ESTIMATED LIABILITY FOR PROGRAM YEARS 2013, 2014 AND 2015 OF APPROXIMATELY 24,650,000 AND APPROXIMATELY 14,075,000 FOR PROGRAM YEAR 2016 BASED ON ACTUAL AND ESTIMATED FUNDING RECEIVED IN EXCESS OF COSTS. DUE TO THE SUBJECTIVITY INVOLVED IN MAKING THESE ESTIMATES AND THE LACK OF HISTORICAL PRECEDENCE WITH RESPECT TO HOW THE STATE ADMINISTERS THE PROGRAM, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES SILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM.PART I, LINE 7 COLUMN (F):THE TOTAL EXPENSE USED AS THE DENOMINATOR IN CALCULATING THE PERCENT OF TOTAL EXPENSE IS THE TOTAL FUNCTIONAL EXPENSE FOUND ON FORM 990, PART IX, LINE 25, COLUMN (A) NET OF THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS OF 43,881,000 FOUND ON FORM 990, PART IX, LINE 24A, COLUMN A.
PART II, COMMUNITY BUILDING ACTIVITIES:	THE MEDICAL CENTER'S 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, THE MEDICAL CENTER FUNDS AND MAINTAINS A TEAM FOCUSED ON DISASTER READINESS, COORDINATION AND RELIEF.
PART III, LINE 2:	THE FOLLOWING EXPLANATION OF THE DETERMINATION OF BAD DEBT EXPENSE APPLIES TO ACCOUNTS RECEIVABLE THAT ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE.IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE MEDICAL CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS.MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND BAD DEBT EXPENSE.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE MEDICAL CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS (BAD DEBT EXPENSE), IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY).FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS (BAD DEBT EXPENSE) IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE MEDICAL CENTER'S ALLOWANCE OF DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS DECREASED FROM 95% OF GROSS SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2016 TO 93% OF GROSS SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2017. IN ADDITION, THE MEDICAL CENTER'S WRITE-OFFS INCREASED APPROXIMATELY $3,635,000 FROM APPROXIMATELY $53,000,000 FOR THE YEAR ENDED JUNE 30, 2016 TO APPROXIMATELY $56,635,000 FOR THE YEAR ENDED JUNE 30, 2017 PRIMARILY DUE TO A TIMING CHANGE IN THE COLLECTIONS PROCESS.DURING 2016, THE MEDICAL CENTER IMPLEMENTED AN AMNESTY PERIOD FOR PATIENT ACCOUNTS PREVIOUSLY WRITTEN OFF TO BAD DEBTS. TO QUALIFY FOR THE AMNESTY, THE PATIENTS WERE REQUIRED TO FILE AN APPLICATION FOR CHARITY CARE DURING 2016. AS A RESULT OF THIS AMNESTY PERIOD, THE MEDICAL CENTER QUALIFIED AS CHARITY CARE APPROXIMATELY $24,5000,000 OF GROSS CHARGES ON ACCOUNTS PREVIOUSLY RECORDED TO BAD DEBTS.BAD DEBT EXPENSE REPORTED IN PART III ON LINE 2 IS SHOWN AT COST. THE AMOUNT WAS DETERMINED BY MULTIPLYING THE ORGANIZATION'S TOTAL BAD DEBT EXPENSE BY THE COST TO CHARGE PERCENTAGE.
PART III, LINE 3:	IT IS ESTIMATED THAT ADDITIONAL BAD DEBT EXPENSE WOULD HAVE QUALIFIED FOR CHARITY CARE UNDER THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY. THE METHODOLOGY TO FORMULATE THIS ESTIMATE INVOLVED USING U.S. CENSUS BUREAU, 2012-2016 AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES DATA FOR INCOME POVERTY LEVELS AT OR BELOW 300%. IN ACCORDANCE WITH THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY, PATIENTS WHOSE INCOME DOES NOT EXCEED 300% OF FEDERAL POVERTY GUIDELINES RECEIVE FREE MEDICAL CARE. THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN THIS CALCULATION FOR THESE PATIENTS WAS DETERMINED BY MULTIPLYING THE PERCENT OF THE POPULATION WHOSE INCOME DID NOT EXCEED 300% OF THE POVERTY LEVEL BY 100%. THE RESULTING EFFECTIVE CHARITY DISCOUNT PERCENTAGES WERE THEN MULTIPLIED BY THE MEDICAL CENTERS TOTAL BAD DEBT EXPENSE. THE CALCULATED BAD DEBT AT THE 300% LEVEL WAS THEN MULTIPLIED BY THE COST TO CHARGE RATIO TO OBTAIN THE BAD DEBT EXPENSE TO BE INCLUDED IN SCHEDULE H, PART III, LINE 3.
PART III, LINE 4:	THE BAD DEBT EXPENSE FOOTNOTE IS ON PAGE 11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. SEE ALSO THE PARAGRAPH IN THE CHARITY CARE FOOTNOTE ON THE TOP OF PAGE 17 THAT REFERENCES THE 2016 AMNESTY PERIOD RELATED TO BAD DEBT EXPENSE.
PART III, LINE 8:	THE MEDICARE ALLOWABLE FAILS TO COVER COST. NON-PAYMENT BY MEDICARE RECIPIENTS FOR THEIR DEDUCTIBLE AND COINSURANCE AMOUNTS INCREASES FINANCIAL ASSISTANCE AND BAD DEBT. THESE SHORTFALLS DECREASE THE ORGANIZATIONS'S POOL OF ASSETS AND IT'S ABILITY TO SUCCESSFULLY ATTRACT HIGHLY-TRAINED STAFF AND INVEST IN MEDICAL TECHNOLOGY. IF SERVICES ARE TO BE MAINTAINED, THEN THE COSTS HAVE TO BE COVERED BY THOSE WHO PAY. THE BURDEN FALLS ON THE COMMUNITY.
PART III, LINE 9B:	THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY CONTAINS PROVISIONS ON COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. ACCORDING TO THIS POLICY, FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA ARE BASED ON RESIDENCY, GROSS HOUSEHOLD INCOME AND HOUSEHOLD SIZE.RESIDENCY: TO BE ELIGIBLE TO RECEIVE FINANCIAL ASSISTANCE, THE PERSON APPLYING FOR ASSISTANCE MUST BE A RESIDENT IN THE MOSAIC LIFE CARE SERVICE AREA AS LISTED ON ATTACHMENT B (PRIMARY, SECONDARY, TERTIARY, AND EXPANSION AREA). A STUDENT ATTENDING SCHOOL IN THE PRIMARY, SECONDARY, TERRITORY, OR EXPANSION SERVICE AREA AT THE TIME CARE WAS GIVEN, IS ELIGIBLE TO APPLY FOR ASSISTANCE. A STUDENT WHO IS NOT CLAIMED AS A DEPENDENT ON HIS OR HER PARENT'S OR PARENTS' TAX RETURN WILL BE EVALUATED BASED ON THE STUDENT'S INCOME. IF THE STUDENT IS CLAIMED AS A DEPENDENT, THE PARENT'S OR PARENTS' HOUSEHOLD INCOME WILL BE USED TO DETERMINE IF HE OR SHE IS ELIGIBLE FOR FINANCIAL ASSISTANCE. GROSS INCOME AND HOUSEHOLD SIZE:FREE CARE IS GRANTED TO ELIGIBLE PATIENTS WITH A HOUSEHOLD INCOME UP TO 300 PERCENT OF FEDERAL POVERTY GUIDELINES. EMERGENCY MEDICAL SERVICES - MOSAIC LIFE CARE WILL PROVIDE EMERGENCY CARE IN ACCORDANCE WITH FEDERAL EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA) REGULATIONS. ALL PATIENTS ARE SEEN AND GIVEN CARE PRIOR TO BEING SCREENED FOR FINANCIAL ASSISTANCE AND/OR PAYMENT ABILITY IN AN EMERGENCY. CARE WILL BE PROVIDED AT AN EQUAL LEVEL FOR ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. FINANCIAL ASSISTANCE: FINANCIAL ASSISTANCE MAY BE GIVEN TO PATIENTS, OR THEIR GUARANTORS, WHO MEET THE GUIDELINES FOR WHAT IS REQUIRED IN TERMS OF RESIDENCY AND INCOME LEVELS UNDER THIS POLICY. MOSAIC LIFE CARE EXPECTS PATIENTS OR GUARANTORS TO COOPERATE BY APPLYING FOR ASSISTANCE OR OTHER PUBLIC PROGRAMS WE IDENTIFY AS SOURCES OF HELP TO COVER THE COST OF SERVICES AND CARE. PATIENTS OR GUARANTORS WHO CHOOSE NOT TO COOPERATE MAY BE DENIED FINANCIAL ASSISTANCE.ELIGIBLE APPLICANTS QUALIFY FOR ONE OF THE FOLLOWING:FULL FREE CARE: THE FULL AMOUNT OF CHARGES, FOR ELIGIBLE SERVICES GIVEN AT THE MEDICAL CENTER ARE WAIVED AND COVERED FOR THE PATIENT, OR GUARANTOR, IF THE FOLLOWING GUIDELINES ARE MET: 1. THE APPLICANT MEETS ELIGIBILITY CRITERIA AND HAS A YEARLY HOUSEHOLD INCOME THAT DOES NOT EXCEED 300 PERCENT OF FEDERAL POVERTY GUIDELINES, AND 2. ALL OTHER PAYMENT SOURCES HAVE BEEN EXPLORED AND APPLIED FOR INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF FINANCIAL ASSISTANCE OFFERED BY THIRD PARTIES.FOR ELIGIBLE SERVICES PROVIDED AT CLINICS OWNED BY MEDICAL CENTER, ALL AMOUNTS DUE FROM THE PATIENT, WITH THE EXCEPTION OF CO-PAYS, ARE WAIVED IF THE FOLLOWING GUIDELINES ARE MET: 1. THE APPLICANT MEETS ELIGIBILITY CRITERIA AND HAS A YEARLY HOUSEHOLD INCOME THAT DOES NOT EXCEED 300 PERCENT OF THE FEDERAL POVERTY GUIDELINES, AND 2. ALL OTHER PAYMENT SOURCES HAVE BEEN EXPLORED AND APPLIED FOR INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES.PRESUMPTIVE ELIGIBILITY: SOME PATIENTS OR GUARANTORS ARE PRESUMED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON INDIVIDUAL LIFE CIRCUMSTANCES, FOR EXAMPLE, THOSE WHO ARE HOMELESS OR HAVE QUALIFIED FOR NEEDS-BASED ASSISTANCE PROGRAMS. THIS IS CALLED PRESUMPTIVE ELIGIBILITY. THESE PATIENTS OR GUARANTORS DO NOT NEED TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION IF THEY PROVIDE PROOF THAT THEY QUALIFY FOR CERTAIN PROGRAMS THAT EXIST TO BENEFIT PEOPLE WHO DO NOT HAVE ENOUGH RESOURCES TO PAY FOR SERVICES AND CARE. PRESUMPTIVE ELIGIBILITY IS USED TO GIVE A 100 PERCENT DISCOUNT TO PATIENTS WHO ARE ELIGIBLE BECAUSE THEY MEET THE RESIDENCY AND ONE OF THE PRESUMPTIVE ELIGIBILITY CRITERIA LISTED IN THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY.AMOUNTS BILLED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE:BASIS FOR CALCULATING AMOUNTS GENERALLY BILLED: FOLLOWING A DETERMINATION OF FINANCIAL-ASSISTANCE ELIGIBILITY, AN INDIVIDUAL IS NOT CHARGED MORE THAN THE AMOUNTS GENERALLY BILLED (AGB) INDIVIDUALS WITH INSURANCE COVERING THE SAME CARE FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THE AGB IS CALCULATED, OR DETERMINED, USING THE PROSPECTIVE MEDICARE METHOD.COLLECTION ACTIONS: NO ACCOUNT WILL BE SUBJECT TO COLLECTION ACTIONS WITHIN 120 DAYS OF ISSUING THE FIRST POSTDISCHARGE STATEMENT AND WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE. NO EXTRAORDINARY COLLECTION ACTIONS WILL BE PURSUED AGAINST A PATIENT IF THE PATIENT OR GUARANTOR HAS PROVIDED DOCUMENTATION SHOWING THAT AN APPLICATION HAS BEEN SUBMITTED FOR MEDICAID OR OTHER PUBLICLY SPONSORED HEALTH PROGRAMS, AND THAT AN ELIGIBILITY DETERMINATION IS STILL PENDING. IF A STATEMENT IS SENT TO A PATIENT OR GUARANTOR, AND MAIL IS RETURNED AS UNDELIVERABLE, MOSAIC 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 INCLUDING 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. THE MEDICAL CENTER COMPLIES WITH ALL FEDERAL, STATE AND LOCAL LAWS, RULES AND REGULATIONS AS WELL AS REPORTING NEEDS THAT MAY APPLY TO THE WORK AND ACTIONS DONE AS A RESULT OF OUR FINANCIAL ASSISTANCE POLICY.THE ORGANIZATION MAKES ITS FINANCIAL ASSISTANCE POLICY AND OTHER RELATED DOCUMENTS AVAILABLE TO PATIENTS ON ITS WEBSITE AT: HTTPS://MYMOSAICLIFECARE.ORG/FINANCIAL-AND-INSURANCE-INFORMATION.(PLEASE NOTE THAT THIS POLICY WAS REVISED EFFECTIVE JULY 1, 2017, AND SOME OF THE PROVISIONS DESCRIBED HEREIN WERE UPDATED IN THE CURRENT ONLINE VERSION OF THE POLICY.)
PART VI, LINE 2:	HEARTLAND REGIONAL MEDICAL CENTER 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.
PART VI, LINE 3:	THE MEDICAL CENTER INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEGINNING AT THE REGISTRATION DESK AND CONTINUING WITH FINANCIAL ASSISTANCE INFORMATION BEING INCLUDED ON EVERY BILLING STATEMENT A PATIENT RECEIVES FROM THE MEDICAL CENTER. GUIDELINES FOR THE PROGRAM ARE AVAILABLE AT EACH REGISTRATION DESK AND ARE INCLUDED IN ALL ADMISSION PACKETS FOR UNINSURED PATIENTS. 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.
PART VI, LINE 4:	THE ORGANIZATION'S PRIMARY AND SECONDARY SERVICE AREA IS A 20 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 60.9% MEDICARE AND MEDICAID, 33.3% COMMERCIAL AND 5.8% SELF PAY. 19.9% 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 63.1% OF THE ELEMENTARY AGE STUDENTS RECEIVE FREE OR REDUCED-COST LUNCHES.
PART VI, LINE 5:	THE ORGANIZATION OFFERS MANY EDUCATION 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 ELEVEN YEARS, THE ORGANIZATION HAS SPONSORED THIS THREE-MONTH LONG EVENT TO ENCOURAGE WEIGHT LOSS, EXERCISE AND HEALTHY EATING. MORE THAN 21,000 PEOPLE HAVE PARTICIPATED AND OVER 136,000 POUNDS HAVE BEEN LOST. AT THE END OF THE PROGRAM IN 2017, 88% OF RESPONDENTS TO THE SURVEY AGREED THAT THE POUND PLUNGE WAS BENEFICIAL TO OUR COMMUNITY, AND 79% 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 26 ELEMENTARY SCHOOLS FOR 9 YEARS. PRE AND POST PROGRAM SURVEYING OF STUDENTS SHOWED AT LEAST A 44.75% INCREASE IN KNOWLEDGE OF THE FIT-TASTIC GUIDELINES AFTER COMPLETING THE PROGRAM. 100% OF SCHOOL COACHES AGREED THAT THE 4TH GRADE CHALLENGE IS AN EFFECTIVE PROGRAM THAT TEACHES STUDENTS ABOUT HEALTH, EXERCISE AND NUTRITION, AND 93.4% OF SCHOOL COACHES AGREED THAT THE 4TH GRADE CHALLENGE IS A GREAT HEALTH PROGRAM THAT HELPS FIGHT CHILDHOOD OBESITY.IN 2017, THE NUMBER OF SCHOOL AND COMMUNITY GARDENS WAS EXPANDED TO 9 ELEMENTARY SCHOOLS. MORE THAN 26,000 POUNDS OF FRESH PRODUCE HAS BEEN GROWN SINCE 2012, AND IS FREE FOR THE COMMUNITY MEMBERS TO HARVEST AND USE FOR MEALS. FOR SOME ECONOMICALLY DISADVANTAGED AREAS, THE GARDENS SUPPLY FRUITS AND VEGETABLES TO FAMILIES WHO WOULD NOT HAVE ACCESS TO THEM OTHERWISE.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. THE MEDICAL CENTER HAS PARTICIPATED IN THIS PROGRAM SINCE 2011. THIS PARTICIPATION HAS GENERATED REVENUE FROM THE CONTRACTED RETAIL PHARMACY RELATIONSHIPS ($56M LTD), CURRENTLY THREATENED BY REGULATION CHALLENGES. THE MEDICAL CENTER HAS RECOGNIZED REDUCED DRUG PRICING FOR OUTPATIENT MEDICATIONS ($42M LTD), CURRENTLY THREATENED BY LEGISLATIVE CHALLENGES. BECAUSE OF THE MEDICAL CENTER'S 340B PROGRAM OUR LOCAL PATIENTS HAVE BENEFITED FROM SAVINGS BY ACCESSING 340B CASH PRICING FOR THEIR MEDICATIONS AT CONTRACTED LOCAL RETAIL PHARMACIES ($65M LTD*). THE COMMUNITY SAVINGS OUT OF POCKET IS CALCULATED BASED ON WHAT THE PATIENT WOULD HAVE PAID IN CASH (NON 340B) VERSUS WHAT THEY DID PAY ON THE 340B CASH PROGRAM. IN FY17 THE 340B PROGRAM RESULTED IN COMMUNITY SAVINGS OF $32 MILLION AS WELL AS ALLOWED THE MEDICAL CENTER TO SUPPORT $25 MILLION WORTH OF COMMUNITY PROGRAMS.
PART VI, LINE 6:	THE ORGANIZATION IS AFFILIATED, THROUGH A PARENT BOARD, WITH A COMMUNITY FOUNDATION, AN ACUTE LONG TERM CARE HOSPITAL, A CRITICAL ACCESS RURAL HOSPITAL, A RURAL COMMUNITY FOUNDATION AND A COMMUNITY HEALTH IMPROVEMENT SOLUTIONS SERVICE, 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 MEDICAL CENTER.THE PARENT BOARD IS COMPRISED OF COMMUNITY LEADERS WHO REPRESENT THE EDUCATIONAL, MEDICAL, GOVERNMENTAL AND BUSINESS SECTORS IN THE COMMUNITY. THE ORGANIZATION PROVIDES ACUTE, EMERGENT AND OUTPATIENT CLINIC CARE FOR ALL, REGARDLESS OF THEIR ABILITY TO PAY. THE ORGANIZATION MAINTAINS AN ONGOING COMMITMENT TO PROVIDE SUPPORT FOR THE BETTERMENT OF THE COMMUNITY.THE COMMUNITY FOUNDATION OVERSEES A NUMBER OF PROGRAMS WORKING TO IMPROVE HEALTH IN THE COMMUNITY. THE ACUTE LONG TERM CARE HOSPITAL IS A FACILITY DEDICATED TO THE CARE OF PATIENTS WHO HAVE CHRONIC CONDITIONS REQUIRING A LONGER LENGTH OF STAY THAN IS NORMALLY PORVIDED IN AN ACUTE CARE HOSPITAL.THE CRITICAL ACCESS RURAL HOSPITAL PROVIDES ACUTE, EMERGENT AND OUTPATIENT CLINIC ARE FOR THOSE IN THE RURAL COMMUNITY AREA. THE RURAL COMMUNITY FOUNDATION SUPPORTS THE CRITICAL ACCESS RURAL HOSPITAL. THE COMMUNITY HEALTH IMPROVEMENT SOLUTIONS SERVICE WORKS WITH EMPLOYERS IN THE COMMUNITY TO EFFECT HEALTHY CHANGES IN THEIR WORKFORCES.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (25 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Purpose Of GrantPurposeOfGrantTxt
HEARTLAND FOUNDATION
5325 FARAON STREET	ST JOSEPH	MO	64506	431262768	501(C)3	$848,925	$117,468	FMV	SUPPORT; EQUIPMENT CONTRIBUTED TO EMPOWER U
MISSOURI WESTERN STATE UNIVERSITY FOUNDATION INC
5425 DOWNS DRIVE	ST JOSEPH	MO	64507	237035423	501(C)3	$307,400		FMV	SPONSORSHIP
SECOND HARVEST COMMUNITY FOOD BANK
915 DOUGLAS STREET	ST JOSEPH	MO	64505	431268319	501(C)3	$187,750		FMV	SUPPORT
SOCIAL WELFARE BOARD
904 S 10TH STREET SUITE A	ST JOSEPH	MO	64503	446000455	501(C)3	$187,000		FMV	SUPPORT
UNITED WAY OF GREATER ST JOSEPH
118 S 5TH STREET	ST JOSEPH	MO	64501	440547802	501(C)3	$183,760		FMV	SUPPORT
COMMUNITY MISSIONS CORPORATION
700 OLIVE STREET	ST JOSEPH	MO	64501	900180479	501(C)3	$175,000		FMV	SUPPORT
CATHOLIC CHARITIES OF KC
1302 FARAON STREET	ST JOSEPH	MO	64501	430887779	501(C)3	$125,000		FMV	SUPPORT
HABITAT FOR HUMANITY
PO BOX 6528	ST JOSEPH	MO	64506	431733608	501(C)3	$100,000		FMV	SUPPORT
LEGAL AID OF WESTERN MISSOURI
1125 GRAND BLVD SUITE 1900	KANSAS CITY	MO	64106	430824638	501(C)3	$91,000		FMV	SUPPORT
NORTHWEST MISSOURI CHILDRENS ADVOCACY CENTER
1807 WOODBINE ROAD	ST JOSEPH	MO	64506	431910148	501(C)3	$60,506		FMV	SUPPORT
FAMILY GUIDANCE CENTER FOR BEHAVIORAL HEALTHCARE
724 N 22ND STREET	ST JOSEPH	MO	64506	440666362	501(C)3	$50,000		FMV	SUPPORT
BIG BROTHERS BIG SISTERS OF GREATER ST JOSEPH
1202 S 28TH STREET	ST JOSEPH	MO	64507		501(C)3	$45,000		FMV	SUPPORT
THE CENTER
902 EDMOND STREET SUITE 203	ST JOSEPH	MO	64501	431615018	501(C)3	$40,500		FMV	SUPPORT
COMMUNITY ALLIANCE
3003 FREDERICK AVENUE	ST JOSEPH	MO	64506	050587096	501(C)3	$20,490		FMV	SUPPORT
ST JOSEPH AREA CHAMBER OF COMMERCE
3003 FREDERICK AVENUE	ST JOSEPH	MO	64506	440419460	501(C)6	$16,350		FMV	SPONSORSHIP
GREATER KANSAS CITY CHAMBER OF COMMERCE
30 W PERSHING ROAD SUITE 301	KANSAS CITY	MO	64108	440196840	501(C)6	$13,700		FMV	SPONSORSHIP
BIG BROTHERS BIG SISTERS OF GREATER KANSAS CITY
1709 WALNUT STREET	KANSAS CITY	MO	64108	436068464	501(C)3	$12,500		FMV	SPONSORSHIP
AMERICAN RED CROSS OF NORTHWEST MISSOURI
401 N 12TH STREET	ST JOSEPH	MO	64501	530196605	501(C)3	$12,500		FMV	SPONSORSHIP
SYNERGY SERVICES INC
400 E 6TH STREET	PARKVILLE	MO	64152	430970674	501(C)3	$10,000		FMV	SPONSORSHIP
ST JOSEPH MUSEUMS INC
PO BOX 8096	ST JOSEPH	MO	64508	436038202	501(C)3	$10,000		FMV	SPONSORSHIP
LADIES UNION BENEVOLENT ASSOCIATION DBA NOYES HOME FOR CHILDREN
801 N NOYES BOULEVARD	ST JOSEPH	MO	64506	440563788	501(C)3	$10,000		FMV	SUPPORT
NORTHLAND REGIONAL CHAMBER OF COMMERCE
634 NW ENGLEWOOD ROAD	KANSAS CITY	MO	64118	431279100	501(C)6	$6,200		FMV	SPONSORSHIP
ALBRECHT-KEMPER MUSEUM OF ART FOUNDATIONS
2818 FREDERICK AVENUE	ST JOSEPH	MO	64506	431855334	501(C)3	$5,750		FMV	SUPPORT
SALVATION ARMY
602 MESSANIE STREET	ST JOSEPH	MO	64502	440545998	501(C)3	$5,540		FMV	SPONSORSHIP
PLATTE COUNTY ECONOMIC DEVELOPMENT COUNCIL INC
11724 NW PLAZA CIRCLE SUITE 200	KANSAS CITY	MO	64153	431484127	501(C)3	$5,025		FMV	SUPPORT

Field	Value	IRS element (for citing)
Total501c3 Org	22	Total501c3OrgCnt
Total Other Org	3	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION IS COMMITTED TO THE DEVELOPMENT OF A HEALTHY COMMUNITY WHICH INCLUDES THE HEALTH OF INDIVIDUALS, AN ADEQUATE NUMBER OF JOBS FOR THE WORKFORCE AND SUCCESSFUL BUSINESSES TO BOOST THE LOCAL ECONOMY. 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.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	Yes (X)	TravelForCompanionsInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	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 (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	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
DR JOHN OLSON
DIRECTOR/PHYSICIAN(UNTIL 12/2016)	$555,432	$0	$137,075	$0	$4,341	$0	$10,600	$0	$24,672	$0	$732,120	$0	$0	$0
DR MARK LANEY
DIRECTOR/PRESIDENT/CEO	$832,348	$0	$238,400	$0	$4,705	$0	$10,600	$0	$18,169	$0	$1,104,222	$0	$0	$0
DR LUCINDA HAYDEN
DIRECTOR (AS OF 01/2017)	$464,918	$0	$39,114	$0	$1,260	$0	$10,600	$0	$15,526	$0	$531,418	$0	$0	$0
CURT KRETZINGER
COO (UNTIL 01/2017)	$514,296	$0	$92,148	$0	$132,631	$0	$67,794	$0	$14,129	$0	$820,998	$0	$127,926	$0
MICHAEL PULIDO
CHIEF OPERATING OFFICER/SECRETARY	$361,990	$0	$57,142	$0	$62,288	$0	$81,110	$0	$26,492	$0	$589,022	$0	$59,263	$0
JOHN WILSON
SECRETARY/TREASURER(UNTIL 01/2017)	$468,353	$0	$6,947	$0	$125,161	$0	$13,667	$0	$0	$0	$614,128	$0	$118,524	$0
DWAIN STILSON
CFO/TREASURER	$301,830	$0	$56,848	$0	$729	$0	$48,516	$0	$26,442	$0	$434,365	$0	$0	$0
JODIE ROETTGER
ASSISTANT TREASURER	$171,482	$0	$9,027	$0	$1,705	$0	$6,745	$0	$16,644	$0	$205,603	$0	$0	$0
DR DAVIN TURNER
PRESIDENT	$348,585	$0	$74,576	$0	$3,025	$0	$56,439	$0	$23,942	$0	$506,567	$0	$0	$0
BRADY D DUBOIS
PRESIDENT	$300,630	$0	$53,999	$0	$1,561	$0	$57,913	$0	$24,029	$0	$438,132	$0	$0	$0
CAROLYN S PADEN
ADMINISTRATOR	$52,329	$0	$0	$0	$170,597	$0	$0	$0	$17,219	$0	$240,145	$0	$0	$0
BRENNAN LEHMAN
CHIEF INFORMATION OFFICER	$265,616	$0	$45,482	$0	$1,550	$0	$38,836	$0	$23,457	$0	$374,941	$0	$0	$0
DR RONY M ABOU-JAWDE
STAFF PHYSICIAN	$981,104	$0	$12,861	$0	$1,569	$0	$10,600	$0	$24,273	$0	$1,030,407	$0	$0	$0
DR MOHAN R HINDUPUR
STAFF PHYSICIAN	$906,849	$0	$128,642	$0	$11,397	$0	$10,600	$0	$18,119	$0	$1,075,607	$0	$0	$0
DR ROBERT GRANT
STAFF PHYSICIAN	$850,990	$0	$96,698	$0	$2,661	$0	$10,600	$0	$26,773	$0	$987,722	$0	$0	$0
DR ARVIND K SHARMA
STAFF PHYSICIAN	$829,133	$0	$128,642	$0	$2,661	$0	$10,600	$0	$23,942	$0	$994,978	$0	$0	$0
DR RAJAGOPAL RANGINENI
STAFF PHYSICIAN	$947,170	$0	$0	$0	$11,397	$0	$10,600	$0	$18,219	$0	$987,386	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	TRAVEL FOR COMPANIONS WAS NOT INCLUDED AS TAXABLE COMPENSATION AS IT WAS 100% FOR BUSINESS PURPOSES.
PART I, LINE 3	SENIOR EXECUTIVES HAVE A WRITTEN EMPLOYMENT CONTRACT.
PART I, LINES 4A-B	PER THE TERMS OF SEVERANCE AGREEEMNT BETWEEN CAROLYN PADEN AND THE ORGANIZATION SHE RECIEVED $168,084 OF SEVERANCE THAT WAS TREATED AS TAXABLE IN 2016 AND IS INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III).
SCHEDULE J, PART I, LINE 4B	DAVIN TURNER, DO - VESTED $0 ; ACCRUED $45,720 BRADY DUBOIS - VESTED $0 ; ACCRUED $47,739 CURT KRETZINGER - VESTED $127,926 ; ACCRUED $57,194 DWAIN STILSON - VESTED $0 ; ACCRUED $36,850 MICHAEL PULIDO - VESTED $59,263 ; ACCRUED $69,899 JOHN WILSON - VESTED $118,524 ; ACCRUED $3,067 THOSE LISTED ABOVE HAVE SIGNED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS WHICH RECOGNIZE THE VALUE OF THE INDIVIDUAL AND THE MUTUAL BENEFIT OF CONTINUED EMPLOYMENT FOR AN EXTENDED PERIOD OF TIME BY ESTABLISHING A 457F PLAN THE PLAN IS FUNDED YEARLY AS THE RESULT OF A CALCULATION DESCRIBED IN THE AGREEMENT WHICH WILL REWARD THE INDIVIDUALS WITH 100% VESTING BASED ON A 5-YEAR CLIFF VESTING SCHEDULE AND AT NORMAL RETIREMENT AGE OR UPON DEATH OR UPON SEPARATION FROM SERVICE DUE TO DISABILITY OR UPON INVOLUNTARY SEPARATION FROM SERVICE WITHOUT CAUSE, WITH LUMP SUM PAYMENT WITHIN 90 DAYS OF EACH SITUATION TAKING INTO CONSIDERATION A NON-COMPETE COVENANT SEPARATION WITH CAUSE MAKES SUPPLEMENTAL EXECUTIVE RETIREMENT AGREEMENTS NULL AND VOID.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
SEE PART VI
A	431203910	79075LAB3	2009-02-26	$70,000,000	SEE PART VI	0	0	0
SEE PART VI
B	431203910	79075LAD9	2011-09-30	$25,250,000	SEE PART VI	0	0	0
SEE PART VI
C	431178966	60637ACP5	2012-10-03	$51,489,534	SEE PART VI	0	0	0
SEE PART VI
D	431203910		2015-11-18	$81,225,000	SEE PART VI	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Other Spent ProceedsOtherSpentProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt
A	$1,390,000	$70,956,418	$70,956,418	2014	0	Yes (1)	Yes (1)
B	$12,490,000	$25,250,000		2005	Yes (1)	Yes (1)	Yes (1)	$25,250,000
C		$51,535,780	$50,827,726	2014	0	Yes (1)	Yes (1)	$1	$708,053
D	$4,112,500	$81,225,000		2005	Yes (1)	Yes (1)	Yes (1)	$80,862,940	$362,060

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 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	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	0	0	0	0	0.00000	0.00000	0.00000	0	0	Yes (1)
C	0	Yes (1)	0	0	0.03370	0.00000	0.03370	0	0	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	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	Business Name Line2HedgeProviderName/BusinessNameLine2Txt	Term Of HedgeTermOfHedgePct	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd
(no name)
A	0	0	0	Yes (1)	Yes (1)	0	0	Yes (1)	Yes (1)
(no name)
B	Yes (1)				0	0	0	0	Yes (1)
(no name)
C	0	0	0	Yes (1)	0	0	0	0	Yes (1)
WELLS FARGO BANK
D	0	0	Yes (1)	0	Yes (1)	Yes (1)	0	0	Yes (1)	NA	11.100000000000	0	0

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)
D	Yes (1)

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, COLUMN A, LINE A, LINE B, AND LINE D	THE INDUSTRIAL DEVELOPMENT AUTHORITY OF ST. JOSEPH, MISSOURI
PART IV, COLUMN A, LINE 2C	THE ARBITRAGE REBATE ANALYSIS WAS PERFORMED AS OF 2/1/2014
PART IV, COLUMN C, LINE 2C	THE ARBITRAGE REBATE ANALYSIS WAS PERFORMED AS OF 9/1/2014
PART IV, COLUMN A, LINE 6	THE PROJECT FUND WAS INVESTED BEYOND THE THREE YEAR TEMPORARY PERIOD BUT NO EXCESS YIELD LIABILITY WAS GENERATED
PART I, COLUMN A, LINE C	HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI
PART I, COLUMN F, LINE A	FINANCE THE CONSTRUCTION AND EQUIPPING OF CERTAIN HEALTHCARE FACILITIES
PART I, COLUMN F, LINE B	REFUND 2001 AB BONDS ISSUED ON 11/29/2001, 2001 D BONDS ISSUES ON 11/29/2001 AND 2003 E BONDS ISSUED ON 5/22/2003
PART I, COLUMN F, LINE C	TO ACQUIRE, CONSTRUCT, REMODEL, RENOVATE AND EQUIP CERTAIN HEALTHCARE FACILITIES
PART I, COLUMN F, LINE D	REFUND 2001 AB AND 2001 D BONDS ISSUED ON 11/29/2001
PART II, COLUMN A, LINE 3	AMOUNT DOES NOT EQUAL TO ISSUE PRICE LISTED IN PART I COLUMN (E) DUE TO INVESTMENT EARNINGS
PART II, COLUMN C, LINE 3	AMOUNT DOES NOT EQUAL TO ISSUE PRICE LISTED IN PART I COLUMN (E) DUE TO INVESTMENT EARNINGS
PART III, COLUMN B	PART III FOR 2011 BONDS HAS NOT BEEN COMPLETED. THE 2011 BONDS WERE USED TO REFINANCE PROJECTS ORIGINALLY FINANCED WITH BONDS ISSUED PRIOR TO JANUARY 1, 2003.
PART III, COLUMN D	PART III FOR 2015 AB BONDS HAS NOT BEEN COMPLETED. THE 2015 AB BONDS WERE USED TO REFINANCE PROJECTS ORIGINALLY FINANCED WITH BONDS ISSUED PRIOR TO JANUARY 1, 2003

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (8 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
DONNA WILSON
SEE PART V	$106,856	SEE PART V	0
CORINNE KOELLIKER
SEE PART V	$33,986	SEE PART V	0
JON KOELLIKER
SEE PART V	$109,256	SEE PART V	0
MARINA KOELLIKER
SEE PART V	$108,957	SEE PART V	0
TRACY HOWERY
SEE PART V	$124,698	SEE PART V	0
JILLIAN KOELLIKER
SEE PART V	$43,419	SEE PART V	0
MARY KOELLIKER
SEE PART V	$34,718	SEE PART V	0
NIKKI LEHMAN
SEE PART V	$61,004	SEE PART V	0

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE L, PART IV, LINE 1, COLUMN B	DONNA WILSON IS THE SERVICE LEADER FOR YOUTH AND ADULT PARTNERSHIPS FOR HEARTLAND REGIONAL MEDICAL CENTER AND IS THE WIFE OF JOHN WILSON, WHO IS THE CHIEF TREASURY OFFICER OF HEARTLAND REGIONAL MEDICAL CENTER.
SCHEDULE L, PART IV, LINE 1, COLUMN D	SALARY AND OTHER COMPENSATION FOR SERVICE LEADER SERVICES
SCHEDULE L, PART IV, LINE 2, COLUMN B	CORINNE KOELLIKER IS A LASER TECHNICIAN FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE SISTER OF SCOTT KOELLIKER, WHO IS A FORMER KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER.
SCHEDULE L, PART IV, LINE 2, COLUMN D	SALARY AND OTHER COMPENSATION FOR LASER TECHNICIAN SERVICES
SCHEDULE L, PART IV, LINE 3, COLUMN B	JON KOELLIKER IS A TS APPLICATIONS ANALYST FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE BROTHER OF SCOTT KOELLIKER, WHO IS A FORMER KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER.
SCHEDULE L, PART IV, LINE 3, COLUMN D	SALARY AND OTHER COMPENSATION FOR TS APPLICATIONS ANALYST SERVICES
SCHEDULE L, PART IV, LINE 4, COLUMN B	MARINA KOELLIKER IS A REGISTERED NURSE FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE WIFE OF SCOTT KOELLIKER, WHO IS A FORMER KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER.
SCHEDULE L, PART IV, LINE 4, COLUMN D	SALARY FOR REGISTERED NURSE SERVICES
SCHEDULE L, PART IV, LINE 5, COLUMN B	TRACY HOWERY IS AN ADVANCED PRACTICE REGISTERED NURSE FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE DAUGHTER-IN-LAW OF DAVE HOWERY, WHO IS A FORMER DIRECTOR OF HEARTLAND REGIONAL MEDICAL CENTER.
SCHEDULE L, PART IV, LINE 5, COLUMN D	SALARY FOR ADVANCED PRACTICE REGISTERED NURSE SERVICES
SCHEDULE L, PART IV, LINE 6, COLUMN B	JILLIAN KOELLIKER IS A STAFF NURSE FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE DAUGHTER OF SCOTT KOELLIKER, WHO IS A FORMER KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER.
SCHEDULE L, PART IV, LINE 6, COLUMN D	SALARY FOR STAFF NURSE
SCHEDULE L, PART IV, LINE 7, COLUMN B	MARY KOELLIKER IS A THERAPY DEPARTMENT EMPLOYEE FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE SISTER-IN-LAW OF SCOTT KOELLIKER, WHO IS A FORMER KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER.
SCHEDULE L, PART IV, LINE 7, COLUMN D	SALARY FOR THERAPY DEPARTMENT SERVICES
SCHEDULE L, PART IV, LINE 8, COLUMN B	NIKKI LEHMAN IS A 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.
SCHEDULE L, PART IV, LINE 8, COLUMN D	SALARY AND OTHER COMPENSATION FOR REVENUE CYCLE ANALYST SERVICES

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 3	ON JULY 1, 2014, HEARTLAND HEALTH, THE HOLDING COMPANY OF THE HEARTLAND REGIONAL MEDICAL CENTER, TRANSFERRED THE REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY AND ITS OPERATIONS AND ASSETS TO BUCHANAN COUNTY. DURING THE TRANSITION, THE MEDICAL CENTER IS LEASING PERSONNEL AND OPERATING SPACE TO ASSIST WITH OPERATIONS.
FORM 990, PART III, LINE 4A	HEARTLAND REGIONAL MEDICAL CENTER 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 THE MEDICAL CENTER OF 61% GOVERNMENTAL, 33% MANAGED CARE/COMMERCIAL AND 6% UNINSURED. 19.9% OF THE POPULATION HAVE INCOME THAT IS BELOW THE FEDERAL POVERTY LEVEL. THE HOSPITAL 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. THE HOSPITAL'S OBSTETRICS DEPARTMENT PROVIDES 18 LABOR/DELIVERY/RECOVERY/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 16,200 PATIENTS WERE ADMITTED TO THE HOSPITAL RESULTING IN APPROXIMATELY 68,000 PATIENT DAYS. A TOTAL OF APPROXIMATELY 10,000 SURGERIES WERE PERFORMED, THE EMERGENCY ROOM SERVED APPROXIMATELY 61,000 PATIENTS AND APPROXIMATELY 185,000 VISITS WERE GENERATED BY OUTPATIENTS. THE MEDICAL CENTER EMPLOYS APPROXIMATELY 4,300 FULL-TIME EQUIVALENT CARE GIVERS. THE MEDICAL STAFF INCLUDES APPROXIMATELY 300 PROVIDERS COVERING PRIMARY CARE AND SPECIALTY CLINICS AT 58 LOCATIONS THROUGHOUT THE REGION. THERE WERE APPROXIMATELY 901,000 PATIENT VISITS DURING THE YEAR. FINANCIAL AMNESTY PERIOD OFFERED: IN ORDER TO ASSIST ITS PATIENTS AND IN ACCORDANCE WITH ITS TAX-EXEMPT PURPOSE, THE MEDICAL CENTER OFFERRED A THREE MONTH FINANCIAL AMNESTY PERIOD DURING 2015-2016 FOR PATIENTS WHOSE ACCOUNTS WERE PREVIOUSLY WRITTEN OFF TO BAD DEBT. TO QUALIFY FOR THE AMNESTY, THE PATIENTS WERE REQUIRED TO FILE AN APPLICATION FOR CHARITY CARE DURING THE THREE-MONTH PERIOD. AS A RESULT OF THIS AMNESTY PERIOD, THE MEDICAL CENTER QUALIFIED AS CHARITY CARE APPROXIMATELY $24,500,000 OF ACCOUNTS PREVIOUSLY RECORDED TO BAD DEBTS. ACO: 2016 IS THE FOURTH YEAR THAT MOSAIC LIFE CARE HAS BEEN AN ACCOUNTABLE CARE ORGANIZATION (ACO). AN ACO IS A GROUP OF DOCTORS AND OTHER HEALTH-CARE PROVIDERS WHO AGREE TO VOLUNTARILY WORK TOGETHER WITH MEDICARE TO PROVIDE HIGH-QUALITY MEDICAL CARE AND SERVICE AT THE RIGHT TIME AND IN THE RIGHT SETTING. THE ACO PROGRAM ENCOMPASSES QUALITY METRICS. PROVIDING EXCEPTIONAL HEALTH CARE AT LOWER COSTS THROUGH THE ACO MODEL FURTHERS MOSAIC'S TAX EXEMPT MISSION. MOSAIC PARTICIPATES IN THE MEDICARE SHARED SAVINGS ACO PROGRAM AND WORKS CLOSELY WITH NON-MOSAIC DOCTORS AND OTHER HEALTH-CARE PROVIDERS TO PROVIDE CARE FOR BENEFICIARIES WHO HAVE TRADITIONAL MEDICARE. BENEFICIARIES BENEFIT BECAUSE THEIR DOCTORS ARE PART OF A TEAM THAT FOCUSES ON THE COORDINATION AND QUALITY OF THEIR MEDICAL CARE.FOR CALENDAR YEAR 2015, MOSAIC ACHIEVED 96.11% QUALITY SCORE. IN 2016, THE MEDICAL CENTER EARNED BACK-TO-BACK FIVE STAR RATINGS FROM CMS AND IS THE ONLY HOSPITAL IN MISSOURI TO HAVE EARNED FIVE STARS. IN THE MOST RECENT RELEASE, JUST 83 INSITUTIONS OUT OF 3,629 HOSPITALS, OR 2.2 PERCENT, EARNED FIVE STARS NATIONWIDE. FOR CALENDAR 2016, MOSAIC REVIEVED A QUALITY SCORE OF 99.06%. MOSAIC RECEIVED A EARNED PERFORMANCE PAYMENT OF $2.86M. MOSAIC IS NO LONGER PARTICIPATING IN THE MSSP PROGRAM AS OF JULY 31, 2017. MOSAIC ALSO PARTICIPATES IN AN ACO WITH BLUE CROSS BLUE SHIELD OF KANSAS CITY (BCBSKC). FOR CALENDAR YEAR 2015, MOSAIC REALIZED EARNED SAVINGS RELATIVE TO BCBSKC TARGETS FOR THE THIRD YEAR IN A ROW. DURING 2016, MOSAIC DID NOT REALIZE SHARED SHAVINGS. QUALITY MEASURES WERE NOT AVAILABLE FROM BSBCKC. OTHER PROGRAM SERVICES: THE MEDICAL CENTER HAS A 340B DESIGNATION FROM HRSA (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.
FORM 990, PART VI, SECTION A, LINE 2	JOHN P. WILSON, CURT KRETZINGER, MARK LANEY, M.D., MICHAEL PULIDO AND DWAIN STILSON HAVE A BUSINESS RELATIONSHIP WITH MIDWESTERN HEALTH MANAGEMENT, INC. AND HHS PROPERTIES, INC. THEY SERVE AS EITHER OFFICERS AND/OR DIRECTORS OF MIDWESTERN HEALTH MANAGMENT, INC. AND HHS PROPERTIES, INC., WHICH ARE RELATED FOR-PROFIT CORPORATIONS. JOHN P. WILSON, CURT KRETZINGER, MARK LANEY, M.D., DWAIN STILSON, DAVIN TURNER, D.O., MICHAEL PULIDO, AND BRENNAN LEHMAN HAVE A BUSINESS RELATIONSHIP WITH COMMUNITY HEALTH PLAN INSURANCE COMPANY. THEY SERVE AS EITHER OFFICERS AND/OR DIRECTORS FOR COMMUNITY HEALTH PLAN INSURANCE COMPANY, WHICH IS A RELATED FOR-PROFIT CORPORATION. JOHN P. WILSON, CURT KRETZINGER, AND DWAIN STILSON HAVE A BUSINESS RELATIONSHIP WITH UPTOWN HOUSING, INC. THEY SERVE AS EITHER OFFICERS AND/OR DIRECTORS OF UPTOWN HOUSING, INC. WHICH IS A RELATED FOR-PROFIT CORPORATION.
FORM 990, PART VI, SECTION A, LINE 6	HEARTLAND HEALTH, A MISSOURI NONPROFIT CORPORATION, IS THE SOLE MEMBER OF HEARTLAND REGIONAL MEDICAL CENTER.
FORM 990, PART VI, SECTION A, LINE 7B	THE SOLE MEMBER (HEARTLAND HEALTH) 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, SECTION B, LINE 11B	AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE FORM 990 WITH INFORMATION PROVIDED FROM HEARTLAND REGIONAL MEDICAL CENTER'S ACCOUNTING STAFF. THE INDEPENDENT ACCOUNTING FIRM REVIEWS A DRAFT OF THE FORM 990 WITH THE INTERNAL TAX DEPARTMENT OF HEARTLAND REGIONAL MEDICAL CENTER. THE DRAFT FORM 990 IS REVISED FOR ANY CORRECTIONS OR CLARIFICATIONS BASED ON THE REVIEW. THE INDEPENDENT ACCOUNTING FIRM THEN CONDUCTS A REVIEW OF THE FORM 990 WITH THE CONTROLLER AND CHIEF FINANCIAL OFFICER OF HEARTLAND REGIONAL MEDICAL CENTER. AFTER ANY NECESSARY CORRECTIONS OR CLARIFICATIONS ARE MADE TO THE FORM 990, A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO ALL VOTING MEMBERS OF THE HEARTLAND REGIONAL MEDICAL CENTER BOARD OF DIRECTORS PRIOR TO ELECTRONICALLY FILING THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12C	UPON AGREEING TO FILL A BOARD POSITION, THE PROSPECTIVE MEMBER IS REQUIRED TO SIGN A CONFLICT OF INTEREST DOCUMENT WHICH DISCLOSES FAMILY AND BUSINESS RELATIONSHIPS THAT COULD BE CONSIDERED IN CONFLICT WITH HIS/HER POSITION ON THE BOARD. IN THIS DOCUMENT, THE MEMBER AGREES TO DISCLOSE ANY ACTIVITIES IN WHICH HE/SHE MAY NOT BE INDEPENDENT IN REGARDS TO A TRANSACTION. THIS DOCUMENT IS DISTRIBUTED AND HELD BY THE CORPORATE COMPLIANCE OFFICE AND LEGAL COUNSEL. THE NEW MEMBER ALSO SIGNS HEARTLAND'S CODE OF CONDUCT DOCUMENT IN WHICH THE MEMBER AGREES TO COMPLY WITH THE ORGANIZATION'S ETHICAL STANDARDS AND CONFIDENTIALITY POLICIES. THIS DOCUMENT IS HELD BY THE CORPORATE COMPLIANCE OFFICE. ANNUALLY, THE CORPORATE COMPLIANCE OFFICER DISTRIBUTES A SURVEY TO EACH BOARD MEMBER TO FACILITATE DISCLOSURE OF ANY REPORTABLE ACTIVITIES. DURING THE COURSE OF BOARD MEETINGS, BOARD MEMBERS WILL DISMISS THEMSELVES FROM MEETINGS AND/OR ABSTAIN FROM VOTING DURING DISCUSSIONS OF ISSUES THAT RELATE TO THOSE SPECIFIC MEMBERS OR THE COMPANIES THAT THEY REPRESENT. FOR EXAMPLE, PHYSICIAN BOARD MEMBERS ABSTAIN FROM VOTING ON THEIR OWN RE-CREDENTIALING; UNIVERSITY BOARD MEMBERS ARE DISMISSED DURING DISCUSSIONS OF UNIVERSITY-RELATED ACTIVITIES; AND LEGAL COUNSEL IS DISMISSED DURING DISCUSSION AND VOTING ON LEGAL COUNSEL REVIEW AND SELECTION. ALL DISMISSALS AND ABSTENTIONS ARE RECORDED IN THE MINUTES OF THE BOARD MEETING. ANNUALLY, THE BOARD MEMBERS ALONG WITH OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO RE-SIGN THE CODE OF CONDUCT DOCUMENT IN WHICH THEY AGREE TO COMPLY WITH THE ORGANIZATION'S ETHICAL STANDARDS AND CONFIDENTIALITY POLICIES. THEY ALSO RECEIVE A QUESTIONNAIRE WHICH FACILITATES THE DISCLOSURE OF ANY REPORTABLE ACTIVITIES TO THE CORPORATE COMPLIANCE OFFICER.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION IS ESTABLISHED BY HEARTLAND HEALTH, A RELATED ENTITY. AN ANNUAL REVIEW WAS PERFORMED DURING THE PRIOR FISCAL YEAR FOR THE CURRENT YEAR'S COMPENSATION. MARKET DATA IS PROVIDED BY AN INDEPENDENT COMPENSATION CONSULTANT. A COMPENSATION COMMITTEE COMPRISED OF THE HEARTLAND HEALTH BOARD CHAIR, HEARTLAND HEALTH BOARD VICE-CHAIR AND THREE ADDITIONAL HEARTLAND HEALTH BOARD MEMBERS AND LEGAL COUNSEL, AS SCRIBE, OVERSEE AN ANNUAL SALARY REVIEW PROCESS FOR OFFICERS, ADMINISTRATORS AND KEY EMPLOYEES. 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 ARE PROVIDED TO A THIRD PARTY CONSULTANT THAT SPECIALIZES IN RESEARCH MARKET SALARY DATA. FACILITY SIZE, NOT-FOR-PROFIT STATUS AND THE SCOPE OF EACH JOB POSITION IS COMPARED TO SIMILAR FACILITIES TO DETERMINE BASE COMPENSATION AND INCENTIVE COMPENSATION FOR EACH POSITION. THE DATA GATHERED BY THE MARKET RESEARCH FIRM IS REVIEWED BY THE COMPENSATION COMMITTEE, OUTLIER ISSUES ARE RESOLVED AND BASED UPON PRESENT FINANCIAL INDICATORS, THE COMMITTEE MAKES THEIR DETERMINATION OF COMPENSATION LEVELS FOR THE NEXT PAY YEAR.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST.
FORM 990, PART XI, LINE 9:	CHANGE IN FAIR VALUE OF DERIVATIVE INSTRUMENTS 3,366,174. CHANGE IN FAIR VALUE OF CASH FLOW HEDGING DERIVATIVES 352,724. CHANGE IN DEFINED BENEFIT PENSION PLAN -752,071. NET ASSET TRANSFERS -4,296,216. ASSET IMPAIRMENT AND OTHER RESTRUCTURING INCOME -35,281,927. PENSION INTEREST AND AMORTIZATION OF ACTURIAL LOSS -1,551,586.

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	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
NORTHLAND EXPANSION LLC
5325 FARAON STREET	ST JOSEPH	MO	64506	DEVELOPMENT	MO	$0	HRMC
URGENT CARE PROPERTIES LLC
5325 FARAON STREET	ST JOSEPH	MO	64506	DEVELOPMENT	MO	$0	HRMC

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
HEARTLAND HEALTH
5325 FARAON STREET	ST JOSEPH	MO	64506	431283316	HEALTHCARE	MO	501(C)3	LINE 11	N/A	0
HEARTLAND FOUNDATION
5325 FARAON STREET	ST JOSEPH	MO	64506	431262768	SUPPORT	MO	501(C)3	LINE 7		Yes (1)	HH
HEARTLAND LONG TERM ACUTE CARE HOSPITAL
5325 FARAON STREET	ST JOSEPH	MO	64506	261972987	HEALTHCARE	MO	501(C)3	LINE 3		Yes (1)	HH
NORTHWEST MEDICAL CENTER ASSOCIATION INC
705 N COLLEGE STREET	ALBANY	MO	64402	440580870	HEALTHCARE	MO	501(C)3	LINE 3		Yes (1)	HH
NORTHWEST MEDICAL CENTER FOUNDATION INC
705 NORTH COLLEGE STREET	ALBANY	MO	64402	473694893	SUPPORT	MO	501(C)3	LINE 7		0	NWMCA

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 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
MIDWESTERN HEALTH MANAGEMENT INC
5325 FARAON STREET	ST JOSEPH	MO	64506	431264358	HEALTHCARE	MO	HH	C	0
COMMUNITY HEALTH PLAN INSURANCE COMPANY
5325 FARAON STREET	ST JOSEPH	MO	64506	431210152	INSURANCE	MO	HH	C	0
HHS PROPERTIES INC
5325 FARAON STREET	ST JOSEPH	MO	64506	431593799	INVESTMENT	MO	HH	C	0
UPTOWN HOUSING INC
5325 FARAON STREET	ST JOSEPH	MO	64506	261416252	REDEVELOPMENT	MO	HH	C	0
UPTOWN ST JOSEPH REDEVELOPMENT CORP
5325 FARAON STREET	ST JOSEPH	MO	64506	201742813	REDEVELOPMENT	MO	HH	C	0

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (1)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (1)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (19 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
MIDWESTERN HEALTH MANAGEMENT INC
B	$3,965,486	FMV
MIDWESTERN HEALTH MANAGEMENT INC
L	$375,286	FMV
MIDWESTERN HEALTH MANAGEMENT INC
Q	$5,262,023	FMV
ST JOSEPH DOWNTOWN DEVELOPMENT LLC (PARTNERSHIP 905 OWNED BY MHM)
Q	$137,321	FMV
ST JOSEPH DOWNTOWN DEVELOPMENT LLC (PARTNERSHIP 905 OWNED BY MHM)
D	$3,777,351	FMV
HHS PROPERTIES INC
B	$170,000	FMV
HHS PROPERTIES INC
K	$236,965	FMV
HHS PROPERTIES INC
Q	$278,212	FMV
HEARTLAND HEALTH BUSINESS PLAZA LLC
K	$1,045,153	FMV
HEARTLAND LONG TERM ACUTE CARE HOSPITAL
J	$577,200	FMV
HEARTLAND LONG TERM ACUTE CARE HOSPITAL
L	$5,170,492	FMV
HEARTLAND LONG TERM ACUTE CARE HOSPITAL
Q	$7,053,449	FMV
HEARTLAND LONG TERM ACUTE CARE HOSPITAL
A	$514,303	FMV
HEARTLAND FOUNDATION
B	$966,393	FMV
HEARTLAND FOUNDATION
Q	$1,356,645	FMV
COMMUNITY HEALTH PLAN INSURANCE COMPANY
Q	$5,715	FMV
NORTHWEST MEDICAL CENTER ASSOCIATION INC
Q	$18,469,122	FMV
NORTHWEST MEDICAL CENTER ASSOCIATION INC
L	$1,610,866	FMV
NORTHWEST MEDICAL CENTER ASSOCIATION INC
A	$77,061	FMV