2018-11-07T08:42:27-06:00 2018-06-30 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2017-07-01 113669999 MOSAIC MOSA 4028963884 4980 S 118TH ST LIND CENTER NO A OMAHA NE 68137 SCOTT HOFFMAN CHIEF FINANCIAL OFFICER 4028963884 2018-11-05 1 WENDY R COOLEY P01523804 4023302660 209.34.201.180 2018-11-05 20:06:52 CS P E6709256AE62C187106D7B5701549848FE3370C4 5D066E2939FE45487034BD10C4A0DC94BE27FEF9 2017 2019-02-21 02:37:17Z SCOTT HOFFMAN 4980 S 118TH ST LIND CENTER NO A OMAHA NE 68137 231195953 0 X WWW.MOSAICINFO.ORG X 2003 NE EMBRACING GOD'S CALL TO SERVE IN THE WORLD, MOSAIC ADVOCATES FOR PEOPLE WITH INTELLECTUAL DISABILITIES AND PROVIDES OPPORTUNITIES FOR THEM TO ENJOY A FULL LIFE. 12 12 6522 179 92943 0 6775651 7166036 223485812 221852846 772514 694091 1237786 941806 232271763 230654779 179172 184659 0 0 153608255 146867209 0 0 0 77130909 80380302 230918336 227432170 1353427 3222609 101940358 110613492 35390561 40886082 66549797 69727410 X EMBRACING GOD'S CALL TO SERVE IN THE WORLD, MOSAIC ADVOCATES FOR PEOPLE WITH INTELLECTUAL DISABILITIES AND PROVIDES OPPORTUNITIES FOR THEM TO ENJOY A FULL LIFE. 0 0 108939933 120242628 COMMUNITY BASED SERVICES PROVIDED TO PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES ARE SERVICES THAT CAN EITHER BE ON-GOING OR INTERMITTENT SUCH AS RESPITE, FAMILY SUPPORT, FOSTER CARE, PHYSICAL THERAPIES, TRANSPORTATION, AND SUPPORTED EMPLOYMENT. MOSAIC SERVES APPROXIMATELY 2,598 INDIVIDUALS ACROSS THE UNITED STATES UNDER THIS SERVICE CATEGORY. 62262857 68722730 INTERMEDIATE CARE FACILITIES (ICF)--ICF SERVICES PROVIDE 24/7 SUPPORT FOR VERY MEDICALLY FRAGILE INDIVIDUALS WITH INTELLECTUAL OR DEVELOPMENTAL DISABILITIES. MOSAIC SERVES APPROXIMATELY 627 INDIVIDUALS ACROSS THE UNITED STATES UNDER THIS SERVICE CATEGORY. 17916124 19774951 DAY AND VOCATIONAL SERVICES ARE PROVIDED TO INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES IN A VARIETY OF WAYS INCLUDING SUPPORTED EMPLOYMENT, WORK ENCLAVES, VOCATIONAL TRAINING AND SOME SHELTERED WORKSHOPS. MOSAIC SERVES APPROXIMATELY 1,620 INDIVIDUALS ACROSS THE UNITED STATES UNDER THIS SERVICE CATEGORY. 12616476 184659 13925456 MISCELLANEOUS SERVICES PROVIDED TO INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. 12616476 184659 13925456 201735390 1 1 0 1 0 0 1 0 1 1 1 1 0 0 1 1 0 1 0 0 0 1 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 733 0 1 6522 1 1 1 1 BD 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CO X X SCOTT HOFFMAN 4028963884 4980 SOUTH 118TH STREET OMAHA NE 68137 CONRAD T SWANSON CHAIRPERSON 1.50 0.00 X X 0 0 0 LISA NEGSTAD CHAIRPERSON THRU 10/17 1.50 0.10 X X 0 0 0 JAMES J OLMSTED VICE CHAIRPERSON 1.50 0.00 X X 0 0 0 LINDA K BURT SECOND VICE CHAIRPERSON 1.50 0.00 X X 0 0 0 THE REV KEITH HOHLY SECRETARY 1.50 0.00 X X 0 0 0 EDWARD L BARKER DIRECTOR 1.50 0.00 X 0 0 0 JAMES S BOWEN DIRECTOR 1.50 0.00 X 0 0 0 THE REV DANIEL FOREHAND DIRECTOR 1.50 0.00 X 0 0 0 MEGAN GUSTAFSON DIRECTOR 1.50 0.00 X 0 0 0 SANDRA SCOTT DIRECTOR 1.50 0.00 X 0 0 0 PAMELA SPADARO DIRECTOR 1.50 0.10 X 0 0 0 JAMES P TOTSCH DIRECTOR 1.50 0.00 X 0 0 0 KATHY PATRICK DIRECTOR 1.50 0.00 X 0 0 0 JOSEPH TURKOWSKI DIRECTOR THUR 10/17 1.50 0.00 X 0 0 0 LINDA TIMMONS PRESIDENT AND CEO 39.70 0.30 X 546100 0 42152 SCOTT HOFFMAN TREASURER AND CFO 39.70 0.30 X 279454 0 39052 RAUL SALDIVAR SVP OF OPERATIONS 40.00 0.00 X 344214 0 -9500 SUE LOERTS SVP OF HUMAN RESOURCES 40.00 0.00 X 248500 0 44805 RENEE COUGHLIN SVP OF MISSION ADVANCEMENT 40.00 0.00 X 219051 0 50998 KEITH SCHMODE SVP MISSION FULFILLMENT 40.00 0.00 X 284589 0 47055 JOSEPH LYONS GENERAL COUNSEL 40.00 0.00 X 225247 0 41348 KNUTE ROTTO CHIEF OPERATING OFFICER 40.00 0.00 X 423214 0 29124 MARLIN WILKERSON VP OF OPERATIONS 40.00 0.00 X 174723 0 36220 NANCY DAVIS VP OF OPERATIONS 40.00 0.00 X 186612 0 15411 TAMMY WESTFALL VP OF OPERATIONS 40.00 0.00 X 161226 0 19988 STACY MORTON VP OF FINANCIAL OPERATIONS 40.00 0.00 X 168938 0 22958 KATIE GIVENS VP OF INFORMATION TECHNOLOGY 40.00 0.00 X 155851 0 29666 WANDA WINFREE CHIEF INTEGRITY OFFICER 40.00 0.00 X 155146 0 10854 MOLLY KENNIS VP OF OPERATIONS 40.00 0.00 X 153382 0 18920 KRISTIN ROSSOW VP OF ACCOUNTING 37.50 2.50 X 153319 0 26144 STEVEN ROBERTS VP OF OPERATIONS 40.00 0.00 X 152850 0 31087 PAULA BURTON VP OF HUMAN RESOURCES 40.00 0.00 X 136486 0 22110 KELLI JORGENSEN VP OF HR SOLUTIONS 40.00 0.00 X 140784 0 22010 JASON DAVIS VP OF BUSINESS INTELLIGENCE 40.00 0.00 X 142485 0 15580 ANDREA FERRUCCI VP OF OPERATIONS 40.00 0.00 X 147135 0 20920 MATTHEW SHEFFIELD SENIOR DEVELOPMENT OFFICER 40.00 0.00 X 137868 0 31615 4737174 0 608517 47 0 1 0 PJW NURSING CONSULTANTS LLC 150 TRUMBELL ST STE 3C HARTFORD CT 06103 NURSING 463946 RTG MEDICAL 1005 E 23RD ST SUITE 200 FREMONT NE 68025 STAFFING SERVICES 233548 ESSENTIAL PERSONNEL 1828 N WEBB RD STE 1 GRAND ISLAND NE 68803 STAFFING SERVICES 216100 RICOH PO BOX 534777 ATLANTA GA 303534777 MANAGED SERVICES 172465 MAXIM HEALTHCARE SERVICES INC 12558 COLLETIONS CENTER DR CHICAGO IL 60693 STAFFING SERVICES 163528 33 7166036 7166036 MEDICARE/MEDICAID PMTS 624100 213819097 213819097 PROGRAM SERVICE REV. 624100 3708034 3708034 CONSULTING INCOME 541610 2700950 2700950 MANAGEMENT FEES 541610 960053 960053 RENTAL INCOME 532000 664712 664712 221852846 202172 92943 109229 10909 10909 194337 76359 117978 117978 117978 53 956681 0 464815 53 491866 491919 491919 INSURANCE PROCEEDS 900099 529051 529051 PURCHASING CARD REBATE 900099 138807 138807 145061 145061 812919 230654779 222665765 92943 730035 X 57667 57667 126992 126992 4528698 4528698 116973016 106745080 10227936 424735 424735 16407838 15550226 857612 8532922 7592468 940454 116700 9398 107302 354305 28533 325772 41369473 39368689 2000784 13298713 12290994 1007719 9966799 9488665 478134 3290631 2121964 1168667 45139 45139 603600 525129 78471 4651534 3476123 1175411 1981323 1895755 85568 DUES & MEMBERSHIPS 1071836 252393 819443 BAD DEBT EXPENSE 769279 11316 757963 CFR EXPENSE 594267 82401 511866 2266703 1686862 579841 227432170 201735390 25696780 0 9997563 18356194 1013307 1173973 23623694 23349853 1678317 2036656 111140386 69230085 43713118 41910301 9224624 10778346 5922776 7602425 6766959 5405744 101940358 110613492 16413719 20528648 317936 431407 15244752 12005373 4421735 3414154 3498919 35390561 40886082 X 65668466 68866905 881331 860505 66549797 69727410 101940358 110613492 X 3222609 -5518 -153322 113844 X X 0 1 X 1 1 1 X 6660703 5901972 3652262 6775651 7166036 30156624 206114000 224467717 231521830 223485812 221852846 1107442205 212774703 230369689 235174092 230261463 229018882 1137598829 2385 1337 1965 3317 864 9868 0 2385 1337 1965 3317 864 9868 1137588961 166630 157311 249898 275533 314475 1163847 76224 137592 139683 79978 92943 526420 242854 294903 389581 355511 407418 1690267 3720044 540645 787697 1066526 812919 6927831 216737601 231205237 236351370 231683500 230239219 1146216927 0.99250 0.98990 0.00150 0.00130 X 1 1 0 1 390 0 0 1 31177 1 0 31567 0 PART II-B, LINE 1: DURING THE PAST YEAR, MOSAIC ENGAGED IN VARIOUS NON-PARTISAN ACTIVITIES TO INFLUENCE SPECIFIC LEGISLATION IMPACTING THE ORGANIZATION. MOSAIC ENGAGED ADVOCATES ON SOCIAL MEDIA ABOUT ISSUES IMPACTING THE ORGANIZATION, INCLUDING PROVIDING A LINK FOR ADVOCATES TO CONTACT THEIR MEMBERS OF CONGRESS. MOSAIC ADVERTISED ON SOCIAL MEDIA IN 2018. MOSAIC ALSO SENT CORRESPONDENCE TO PEOPLE AFFILIATED WITH THE ORGANIZATION INFORMING THEM ABOUT PREVAILING PUBLIC POLICY ISSUES IMPACTING THE ORGANIZATION AND PROVIDING CONTACT INFORMATION FOR MEMBERS OF CONGRESS. MOSAIC AS AN ORGANIZATION ENGAGED ITS MEMBERS OF CONGRESS THROUGH LETTERS, EMAILS, AND OFFICE VISITS. MOSAIC ALSO SENT A VARIETY OF ACTION ALERTS TO ITS ADVOCACY NETWORK. X X X 1 80.00 0 1 0 100.00 0 1 1774073 20327626 20491112 1610587 0 36379971 1618196 2591357 4277441 36312083 35983964 1341962 4036488 4982443 36379971 35685382 1635155 502714 1839287 35983964 36531798 833105 830838 2510359 35685382 34313920 2487529 4868779 5138430 36531798 0.83480 0.14460 0.02060 0 1 1 4868682 4868682 84674332 52555498 32118834 1442660 1135390 307270 10010008 8248934 1761074 10144704 7290263 2854441 41910301 110000 C CSV OF LIFE INSURANCE 521651 F BOND RESERVES 100000 F INVESTMENT IN BICO 10046695 C 10778346 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS- MEDICAID 1750198 REFUNDABLE FEES 19270 CRATS PAYABLE 597054 LIABILITY FOR PENSION BENEFITS 1132397 3498919 X PART II, LINE 9: THE FINANCIAL STATEMENTS FOR MOSAIC AND ITS AFFILIATES DO NOT CONTAIN ANY INFORMATION REGARDING THE CONSERVATION EASEMENT. PART IV, LINE 1B: MOSAIC IS THE REPRESENTATIVE-PAYEE FOR THE PERSONAL FUNDS OF A NUMBER OF INDIVIDUALS IN SERVICE. MOSAIC DOES NOT OWN THE ACCOUNTS. IN PREVIOUS YEARS, THE ACCOUNTING FOR SUCH ACTIVITIES OCCURRED AT THE AGENCY LEVEL AND AN AGGREGATE ACCOUNTING OF SUCH SERVICES WAS NOT POSSIBLE. MOSAIC IS NOW ABLE TO TRACK ALL ACCOUNT ACTIVITIES, AND THE NUMBERS LISTED ON PART IV, LINES 1C - 1F ACCURATELY REFLECT THE AGGREGATE BALANCE OF THESE ACCOUNTS. PART V, LINE 4: THE ENDOWMENT FUNDS ARE INTENDED FOR SUPPORT OF MOSAIC'S LONG TERM COMMITMENT TO ITS MISSION AND FOR CAPITAL IMPROVEMENTS AND GENERAL OPERATIONS. THE ENDOWMENT FUNDS ARE HELD BY THE MOSAIC FOUNDATION. PART X, LINE 2: ALL CONSOLIDATED AFFILIATED ENTITIES, EXCEPT FOR MOSAIC HOUSING CORP V, INC., EASE-E MEDICAL, INC. AND BICO, LTD. ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OR 501(C)(2) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN MOSAIC'S TAX EXEMPT STATUS. MOSAIC RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. SUCH TAX POSITIONS, WHICH ARE MORE THAN 50% LIKELY OF BEING REALIZED, ARE MEASURED AT THEIR HIGHEST VALUE. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. DURING 2018 AND 2017, MANAGEMENT DETERMINED THAT THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS OTHER THAN DESCRIBED PREVIOUSLY. 1 0 0 0 0 0 0 0 0 0 SUB-SAHARAN AFRICA SUPPORT DEVELOPMENT OF SERVICES FOR PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. CENTER-BASED AND IN-HOME SUPPORT FOR CHILDREN WITH DISABILITIES AND THEIR CAREGIVERS. 126992 WIRE TRANSFER 0 1 0 0 0 1 0 0 0 1 MOSAIC HOUSING CORPORATION XVIII 4980 S 118TH ST OMAHA NE 68137 261710184 501(C)(3) 8000 THE GRANT PROVIDED IS TO THE RELATED ORGANIZATION TO FURTHER ITS TAX EXEMPT FUNCTION. MOSAIC HOUSING CORPORATION II 4980 S 118TH ST OMAHA NE 68137 470773689 501(C)(3) 10000 THE GRANT PROVIDED IS TO THE RELATED ORGANIZATION TO FURTHER ITS TAX EXEMPT FUNCTION. MOSAIC HOUSING CORPORATION XIV 4980 S 118TH ST OMAHA NE 68137 204417891 501(C)(3) 39667 THE GRANT PROVIDED IS TO THE RELATED ORGANIZATION TO FURTHER ITS TAX EXEMPT FUNCTION. 3 0 PART I, LINE 2: GRANTS ARE PROVIDED TO RELATED ORGANIZATIONS TO FURTHER THEIR TAX EXEMPT FUNCTIONS. X 1 1 X X X X X X 1 0 0 0 0 0 0 0 0 LINDA TIMMONS PRESIDENT AND CEO 485632 0 55005 0 5463 0 10271 0 31881 0 588252 0 0 0 SCOTT HOFFMAN TREASURER AND CFO 239511 0 36470 0 3473 0 16942 0 22110 0 318506 0 0 0 RAUL SALDIVAR SVP OF OPERATIONS 69150 0 0 0 275064 0 -9986 0 486 0 334714 0 0 0 SUE LOERTS SVP OF HUMAN RESOURCES 225482 0 21882 0 1136 0 15501 0 29304 0 293305 0 0 0 RENEE COUGHLIN SVP OF MISSION ADVANCEMENT 181905 0 36470 0 676 0 14194 0 36804 0 270049 0 0 0 KEITH SCHMODE SVP MISSION FULFILLMENT 262091 0 21882 0 616 0 17793 0 29262 0 331644 0 0 0 JOSEPH LYONS GENERAL COUNSEL 202846 0 21882 0 519 0 14323 0 27025 0 266595 0 0 0 KNUTE ROTTO CHIEF OPERATING OFFICER 260123 0 0 0 163091 0 14400 0 14724 0 452338 0 0 0 MARLIN WILKERSON VP OF OPERATIONS 155608 0 18500 0 615 0 4716 0 31504 0 210943 0 0 0 NANCY DAVIS VP OF OPERATIONS 110234 0 0 0 76378 0 2631 0 12780 0 202023 0 0 0 TAMMY WESTFALL VP OF OPERATIONS 159178 0 1500 0 548 0 4042 0 15946 0 181214 0 0 0 STACY MORTON VP OF FINANCIAL OPERATIONS 163318 0 5000 0 620 0 4718 0 18240 0 191896 0 0 0 KATIE GIVENS VP OF INFORMATION TECHNOLOGY 153779 0 1500 0 572 0 0 0 29666 0 185517 0 0 0 WANDA WINFREE CHIEF INTEGRITY OFFICER 67740 0 3932 0 83474 0 3342 0 7512 0 166000 0 0 0 MOLLY KENNIS VP OF OPERATIONS 151796 0 1000 0 586 0 4346 0 14574 0 172302 0 0 0 KRISTIN ROSSOW VP OF ACCOUNTING 151274 0 1500 0 545 0 4394 0 21750 0 179463 0 0 0 STEVEN ROBERTS VP OF OPERATIONS 152850 0 0 0 0 0 4375 0 26712 0 183937 0 0 0 PAULA BURTON VP OF HUMAN RESOURCES 135958 0 0 0 528 0 3750 0 18360 0 158596 0 0 0 KELLI JORGENSEN VP OF HR SOLUTIONS 139912 0 0 0 872 0 1820 0 20190 0 162794 0 0 0 JASON DAVIS VP OF BUSINESS INTELLIGENCE 142010 0 0 0 475 0 3916 0 11664 0 158065 0 0 0 ANDREA FERRUCCI VP OF OPERATIONS 145580 0 1000 0 555 0 0 0 20920 0 168055 0 0 0 MATTHEW SHEFFIELD SENIOR DEVELOPMENT OFFICER 131967 0 5000 0 901 0 4057 0 27558 0 169483 0 0 0 PART I, LINE 1A EVERY EMPLOYEE CAN BE REIMBURSED UP TO $25 PER MONTH FOR HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES. THIS BENEFIT IS TREATED AS TAXABLE COMPENSATION TO THE EMPLOYEE. PART I, LINE 4A KNUTE ROTTO RECEIVED SEVERANCE PAYMENTS OF $160,004 RAUL SALDIVAR RECEIVED SEVERANCE PAYMENTS OF $275,000 NANCY DAVIS RECEIVED SEVERANCE PAYMENTS OF $75,993 WANDA WINFREE RECEIVED SEVERANCE PAYMENTS OF $83,210 SCHEDULE J, PART II, COLUMN C: MOSAIC EVALUATES THE LIABILITY RELATED TO THEIR POSTRETIREMENT BENEFITS (SALARY AND HEALTH INSURANCE CONTINUATION) THROUGH AN ACTUARIAL REVIEW. THE ADJUSTMENT IS INCLUDED IN RETIREMENT AND OTHER DEFERRED COMPENSATION. A PUBLIC FINANCE AUTHORITY 273866124 000000000 2017-06-29 12188750 REFUND PRIOR ISSUES (1/28/03, 6/1/05, 3/12/10, 3/31/10, 4/14/10, 4/30/12). 0 0 0 B PUBLIC FINANCE AUTHORITY 273866124 000000000 2017-11-01 6740000 REFUND PRIOR TAXABLE ISSUE (6/26/17). 0 0 0 A 1039937 12188750 187009 12001741 2012 1 0 1 1 B 1156621 1021634 134987 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 1 0 1 0 0 0 0 B 0 1 1 0 1 0 0 0 0 A 0 B 0 SCHEDULE K PART II, COLUMN B, LINE 3: DIFFERENCES BETWEEN PART I, COLUMN (E) AND PART II, LINE 3 - THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) AS THIS DEBT WAS ISSUED ON A DRAW-DOWN BASIS AND THE TOTAL PRINCIPAL AVAILABLE HAS NOT YET BEEN DRAWN. FORM 990, PART VI, SECTION A, LINE 7A THE EVANGELICAL LUTHERAN CHURCH IN AMERICA APPOINTS THREE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B MOSAIC BOARD OF DIRECTORS MAY MAKE ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION WITHOUT OTHER APPROVAL WITH THE EXCEPTION OF SECTIONS 8 AND 10. AMENDMENTS TO SECTIONS 8 AND 10 OF THE ARTICLES OF INCORPORATION REQUIRE PRIOR WRITTEN CONSENT OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. SECTION 8 OF THE ARTICLES OF INCORPORATION SPECIFIES WHERE ASSETS WOULD BE TRANSFERRED UPON THE LIQUIDATION OF MOSAIC, AND SECTION 10 COVERS MOSAIC'S AFFILIATION WITH THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. FORM 990, PART VI, SECTION B, LINE 11B EACH DECEMBER, THE SENIOR VICE PRESIDENT FOR HUMAN RESOURCES AND CHIEF INTEGRITY OFFICER IDENTIFY THE DISQUALIFIED PERSONS BASED ON INFORMATION FILED IN EACH KEY EMPLOYEE'S ANNUAL CONFLICT OF INTEREST FORM. THE VP OF HR SOLUTIONS AND VP OF ACCOUNTING REVIEW THE SALARY AND BENEFIT INFORMATION REQUIRED FOR ALL DIRECTORS, OFFICERS, KEY EMPLOYEES AND DISQUALIFIED PERSONS AND PREPARE A SCHEDULE FOR REVIEW BY THE SVP OF HUMAN RESOURCES AND SENIOR VICE PRESIDENT AND CHIEF FINANCIAL OFFICER. A REVIEW OF ALL INTERNATIONAL, LOBBYING AND UNRELATED BUSINESS ACTIVITIES IS COMPLETED BY THE CHIEF FINANCIAL OFFICER AND VP OF ACCOUNTING WITH RELEVANT STAFF. FORM 990 IS PREPARED BY THE ORGANIZATION'S OUTSIDE ACCOUNTING FIRM. THE CHIEF FINANCIAL OFFICER, THE ORGANIZATION'S OUTSIDE ACCOUNTING FIRM, AND THE CHIEF EXECUTIVE OFFICER REVIEW THE RETURN. THE FINANCE AND AUDIT COMMITTEE AND THE BOARD OF DIRECTORS ARE PROVIDED A COPY OF THE RETURN PRIOR TO FILING FORM 990. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, EACH BOARD DIRECTOR COMPLETES A CONFLICT OF INTEREST FORM AND SUBMITS IT TO THE CHAIRPERSON OF THE BOARD INTEGRITY COMMITTEE. ANY FINANCIAL CONFLICTS OF INTEREST ARE REPORTED TO THE CHIEF FINANCIAL OFFICER FOR REPORTING ON THE FORM 990. ON AN ANNUAL BASIS ALL STAFF COMPLETE A CONFLICT OF INTEREST FORM IN CONJUNCTION WITH THEIR ANNUAL EVALUATION. ALL CONFLICTS OF INTEREST ARE REVIEWED BY HUMAN RESOURCES. ANY CONFLICTS OF INTEREST OF THE CHIEF EXECUTIVE OFFICER ARE REPORTED TO THE BOARD OF DIRECTORS. CONFLICTS OF INTEREST OF SENIOR STAFF ARE REVIEWED BY THE SENIOR VICE PRESIDENT FOR HUMAN RESOURCES AND CHIEF INTEGRITY OFFICER AND REPORTED TO THE CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER FOR REPORTING ON THE FORM 990. ANY NEW CONFLICTS OF INTEREST THAT ARISE DURING THE YEAR ARE REQUIRED TO BE REPORTED AT THAT TIME. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS ESTABLISHED AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE IS RESPONSIBLE FOR: CONTRACTING WITH AN INDEPENDENT CONSULTANT TO DOCUMENT COMPARABLE COMPENSATION LEVELS PAID TO EXECUTIVES WITH SIMILAR POSITIONS AND RESPONSIBILITIES IN SIMILAR ORGANIZATIONS, HELPING THE COMMITTEE APPLY MOSAIC'S COMPENSATION PHILOSOPHY TO THE MARKET SURVEY DATA TO IDENTIFY SUPPORTABLE COMPENSATION LEVELS AND COMPENSATION RANGES, AND OPINING IN ADVANCE THAT RESULTING COMPENSATION RANGES ARE REASONABLE COMPENSATION. THE COMPENSATION CONSULTANT WILL ALSO ADVISE AND OPINE ON BENEFIT DESIGN, BENEFIT OPTIONS, AND REASONABLENESS OF BENEFIT AMOUNTS AS ELEMENTS OF COMPENSATION. THE EXECUTIVE COMMITTEE WILL ADOPT A COMPENSATION PHILOSOPHY FOR OFFICERS AND KEY EMPLOYEES GUIDED BY THE CONSULTANT'S INFORMATION AND USE THE COMPENSATION PHILOSOPHY TO APPROVE THE COMPENSATION OF THE CEO, APPROVE THE COMPENSATION RANGES FOR OTHER OFFICERS AND KEY EMPLOYEES, AND REPORT ITS ACTIONS TO THE FULL BOARD. THE CEO, WORKING WITHIN SALARY RANGES APPROVED BY THE EXECUTIVE COMMITTEE, SETS THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. MINUTES, DOCUMENTATION OF INDEPENDENT CONSULTANT COMPARABILITY DATA AND RECOMMENDATIONS ARE MAINTAINED AS PART OF THE RECORD OF THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 INDIVIDUALS MAY REQUEST MOSAIC'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS THROUGH AN EMAIL REQUEST FORM AVAILABLE ON MOSAIC'S PUBLIC WEBSITE (WWW.MOSAICINFO.ORG). FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 2,290,725. MANAGEMENT AND GENERAL EXPENSES 1,395,300. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,686,025. DAY/HOST SERVICES: PROGRAM SERVICE EXPENSES 34,830,167. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,830,167. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 2,247,797. MANAGEMENT AND GENERAL EXPENSES 605,484. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,853,281. FORM 990, PART XI, LINE 9: POSTRETIREMENT BENEFIT RELATED CHANGES OTHER THAN NET PERIODIC COST 113,844. FORM 990, PART XII, LINE 2C: THE FINANCE AND AUDIT COMMITEE OVERSEES THE AUDIT & SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MOSAIC FOUNDATION 4980 S 118 ST OMAHA NE 68137 363837360 FUNDRAISING AND INVESTMENT ASSET MANAGEMENT NE 501(C)(3) LINE 12A, I MOSAIC 1 THE OAKS OF DUNN COUNTY 4980 S 118 ST OMAHA NE 68137 391913323 SENIOR LIVING SERVICES WI 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION I 4980 S 118 ST OMAHA NE 68137 363756911 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION II 4980 S 118 ST OMAHA NE 68137 470773689 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION IV 4980 S 118 ST OMAHA NE 68137 911823422 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION VII 4980 S 118 ST OMAHA NE 68137 470828015 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION VIII 4980 S 118 ST OMAHA NE 68137 470828012 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION IX 4980 S 118 ST OMAHA NE 68137 742838413 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION X 4980 S 118 ST OMAHA NE 68137 742908789 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XI 4980 S 118 ST OMAHA NE 68137 311706640 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XII 4980 S 118 ST OMAHA NE 68137 481297244 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XIII 4980 S 118 ST OMAHA NE 68137 421626679 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XIV 4980 S 118 ST OMAHA NE 68137 204417891 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XV 4980 S 118 ST OMAHA NE 68137 205765691 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XVI 4980 S 118 ST OMAHA NE 68137 205765731 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XVII 4980 S 118 ST OMAHA NE 68137 261710013 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XVIII 4980 S 118 ST OMAHA NE 68137 261710184 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XIX 4980 S 118 ST OMAHA NE 68137 261710259 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XX 4980 S 118 ST OMAHA NE 68137 264555206 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING 1 4980 S 118 ST OMAHA NE 68137 202997161 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING 2 4980 S 118 ST OMAHA NE 68137 204417645 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING OF MACOMB 1 4980 S 118 ST OMAHA NE 68137 204841909 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING OF ROCKFORD 1 4980 S 118 ST OMAHA NE 68137 204841856 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XXI 4980 S 118 ST OMAHA NE 68137 264555313 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XXII 4980 S 118 ST OMAHA NE 68137 273483415 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XXIII 4980 S 118 ST OMAHA NE 68137 710875364 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC VEBA 4980 S 118 ST OMAHA NE 68137 363831874 EMPLOYEE WELFARE BENEFIT PLAN NE 501(C)(9) N/A MOSAIC 1 MOSAIC RESIDENTIAL SERVICES OF NEBRASKA LLC 4980 S 118 ST OMAHA NE 68137 271695051 LOW INCOME HOUSING NE N/A EASE-E MEDICAL INC 731 SOUTH 8TH STREET CANON CITY CO 81212 470842353 SALE OF MEDICAL EQUIPMENT AND SUPPLIES NE MOSAIC C 4746985 802870 1.00000 1 MOSAIC HOUSING CORPORATION V 4980 S 118 ST OMAHA NE 68137 470805545 LOW INCOME HOUSING NE MOSAIC C 915017 1.00000 1 BICO 4980 S 118 ST OMAHA NE 68137 CAPTIVE INSURANCE BD MOSAIC C 19661284 1.00000 1 CHARITABLE REMAINDER TRUSTS (5) INVESTMENT MANAGEMENT NE N/A T 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 EASE-E MEDICAL EQUIPMENT A 92943 CASH TRANSFERRED EQUALS FMV THE MOSAIC FOUNDATION C 7166036 CASH TRANSFERRED EQUALS FMV EASE-E MEDICAL EQUIPMENT S 357114 CASH TRANSFERRED EQUALS FMV THE MOSAIC FOUNDATION L 1775000 CASH TRANSFERRED EQUALS FMV BICO L 925000 CASH TRANSFERRED EQUALS FMV MOSAIC VEBA L 369996 CASH TRANSFERRED EQUALS FMV EASE-E MEDICAL EQUIPMENT L 536196 CASH TRANSFERRED EQUALS FMV THE MOSAIC FOUNDATION R 281005 CASH TRANSFERRED EQUALS FMV MOSAIC VEBA S 71806 CASH TRANSFERRED EQUALS FMV