2017-11-14T13:43:11-06:00 2016-12-31 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2016-01-01 431286484 HEARTLAND HEALTH CARE PLAN TRUST FUND % DWAIN STILSON HEAR 8162717070 5325 FARAON ST ST JOSEPH MO 64506 DWAIN STILSON TRUSTEE 8162717070 2017-11-15 true Michael J Engle P00482834 8162216300 167.68.126.162 43372220173185000007 2017-11-14 P B5412E4DADBE3B1CA033AE4565498248AC6850D5 355CC2E4B6E27E32DAADC48E1CA8D97843AD7DA8 2016 2017-02-10 21:41:12Z X DWAIN STILSON 5325 FARAON ST ST JOSEPH MO 64506 37226009 false X N/A X 1978 MO THE PLAN OPERATES TO PROVIDE MEDICAL AND DENTAL BENEFITS TO ALL OF ITS MEMBERS. X 6 0 0 6 0 0 0 40571295 37084964 84878 141045 0 0 40656173 37226009 0 0 37300683 40650142 0 0 0 0 0 2339894 2339019 39640577 42989161 1015596 -5763152 6672801 0 1127399 0 5545402 0 X THE PLAN OPERATES TO PROVIDE MEDICAL AND DENTAL BENEFITS TO ALL OF ITS MEMBERS. false true THE SOLE PURPOSE OF THE FUND IS TO PROVIDE HEALTH CARE BENEFITS, INCLUDING HOSPITALIZATION, MEDICAL, DENTAL AND VISION CARE AND TO PAY ADMINISTRATIVE COSTS OF THE PLAN FOR ELIGIBLE EMPLOYEES OF ALL AFFILIATES. false false false false false false false false false false false false false false false true false false false false false false false false false false false false true false false false false false false false false true false false true true true false true 0 0 0 false false false false false false X 6 0 true false true false false true true true true false false true true true true true true false false false X DWAIN STILSON 8162717070 5325 FARAON ST ST JOSEPH MO 64506 CURT KRETZINGER TRUSTEE 1.0 39.0 X 0 739075 81822 JOHN P WILSON TRUSTEE 1.0 39.0 X 0 600461 13667 MICHAEL PULIDO TRUSTEE 1.0 39.0 X 0 481420 107102 EDWARD KAMMERER MD TRUSTEE/STAFF PHYSICIAN 1.0 39.0 X 0 547408 34292 WILLIAM F RIPPE MD TRUSTEE/STAFF PHYSICIAN 1.0 39.0 X 0 478699 24073 DWAIN STILSON TRUSTEE 1.0 39.0 X 0 359407 73958 MOHAN HINDUPUR MD TRUSTEE/STAFF PHYSICIAN 1.0 39.0 X 0 1046888 29319 0 4253358 364233 0 true true false BLUE CROSS BLUE SHIELD 2301 MAIN KANSAS CITY MO 64141 PLAN ADMIN FEES 1398141 DELTA DENTAL OF MISSOURI 5325 FARAON ST JOSEPH MO 64506 DENTAL NETWORK 132120 NUESYNERGY 5325 FARAON ST JOSEPH MO 64506 CONTRACT ADMIN 137043 LOCKTON BENEFIT SERVICES 5325 FARAON ST JOSEPH MO 64506 CONSULTING 123283 4 0 EMPLOYER CONTRIBUTION 525100 33026461 33026461 EMPLOYEE CONTRIBUTION 525100 4058503 4058503 37084964 141045 141045 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37226009 37084964 141045 0 0 0 40650142 0 0 0 0 0 0 0 0 0 0 0 0 2339019 0 0 0 0 0 0 0 0 0 0 0 0 42989161 0 0 4163512 0 0 0 3867 0 0 0 0 0 0 0 0 0 0 0 0 0 2505422 0 0 0 0 0 0 0 0 0 6672801 0 1127399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1127399 0 X 0 0 0 0 5545402 0 5545402 0 6672801 0 -5763152 217750 X false true X true false false false 37443759 217750 217750 37226009 37226009 42989161 42989161 42989161 SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. false true false CURT KRETZINGER TRUSTEE 0 608353 0 92148 0 38574 0 67794 0 14028 0 820897 0 127926 JOHN P WILSON TRUSTEE 0 575075 0 6947 0 18439 0 13667 0 0 0 614128 0 118524 MICHAEL PULIDO TRUSTEE 0 409347 0 57142 0 14931 0 81110 0 25992 0 588522 0 59263 MOHAN HINDUPUR MD TRUSTEE/STAFF PHYSICIAN 0 899517 0 128642 0 18729 0 10600 0 18719 0 1076207 0 0 EDWARD KAMMERER MD TRUSTEE/STAFF PHYSICIAN 0 359872 0 150807 0 36729 0 10600 0 23692 0 581700 0 0 WILLIAM F RIPPE MD TRUSTEE/STAFF PHYSICIAN 0 320232 0 139738 0 18729 0 0 0 24073 0 502772 0 0 DWAIN STILSON TRUSTEE 0 284559 0 56848 0 18000 0 48516 0 25442 0 433365 0 0 SCHEDULE J, PART I, LINE 3 COMPENSATION IS ESTABLISHED BY HEARTLAND HEALTH, A RELATED ENTITY, USING THE FOLLOWING: A. COMPENSATION COMMITTEE B. INDEPENDENT COMPENSATION CONSULTANT C. WRITTEN EMPLOYMENT CONTRACT D. COMPENSATION SURVEYS OR STUDIES E. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, PART I, LINE 4B PAID ACCRUED ----------- ----------- CURT KRETZINGER $ 127,926 $ 57,194 JOHN P WILSON $ 118,527 $ 3,067 MICHAEL PULIDO $ 59,263 $ 69,899 DWAIN STILSON $ 0 $ 36,850 FORM 990, PART VII, & SCHEDULE J, PART II FOR CURT KRETZINGER, JOHN P. WILSON, MICHAEL PULIDO, EDWARD KAMMERER, MD, WILLIAM F. RIPPE, MD, DWAIN STILSON, AND MOHAN HINDUPUR, MD, THE COMPENSATION IS PROVIDED BY HEARTLAND REGIONAL MEDICAL CENTER, A RELATED ENTITY, FOR SERVICES TO ALL HEARTLAND ENTITIES. INCLUDED IN THE DEFERRED COMPENSATION ARE EMPLOYER CONTRIBUTIONS INTO QUALIFIED PLANS AND NON-QUALIFIED DEFERRED COMPENSATION PLANS THAT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE AND SEVERANCE THAT IS PROVIDED WITHIN THE EXECUTIVE'S EMPLOYMENT AGREEMENT. THEREFORE, AMOUNTS MAY NEVER BE PAID. true true false false true false true false SCHEDULE N, PART I THE BOARD OF DIRECTORS OF THE SOLE MEMBER VOTED TO TERMINATE THE TRUST EFFECTIVE DECEMBER 31, 2016 AS ALLOWED BY THE TRUST AGREEMENT. THE HEALTH INSURANCE PLAN WILL REVERT TO THE SPONSORING ORGANIZATION. ALL REMAINING ASSETS OF THE TRUST WERE USED TO PAY ALL OUTSTANDING LIABLITIES AND EXPENSES, THEREFORE NO ASSETS OR LIABILITIES WERE TRANSFERRED TO THE SUCCESSOR ORGANIZATION. SCHEDULE N, PART I, LINE 2a DR. MARK LANEY IS A DIRECTOR AND OFFICER OF HEARTLAND REGIONAL MEDICAL CENTER SCHEDULE N, PART I, LINE 2b CURT KRETZINGER, MICHAEL PULIDO, EDWARD KAMMERER, MD, WILLIAM F. RIPPE, MD, DWAIN STILSON, MOHAN HINDUPUR, MD, AND MARK LANEY, MD ARE CURRENT EMPLOYEES OF HEARTLAND REGIONAL MEDICAL CENTER, A SUCCESSOR ORGANIZATION. FORM 990, PART III, LINE 3 THE BOARD OF DIRECTORS OF THE SOLE MEMBER VOTED TO TERMINATE THE TRUST EFFECTIVE DECEMBER 31, 2016 AS ALLOWED BY THE TRUST AGREEMENT. THE HEALTH INSURANCE PLAN WILL REVERT TO THE SPONSORING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 2 CURT KRETZINGER, JOHN WILSON, DWAIN STILSON AND MICHAEL PULIDO HAVE A BUSINESS RELATIONSHIP. THEY ARE OFFICERS OR DIRECTORS OF MIDWESTERN HEALTH MANAGEMENT, INC., HHS PROPERTIES, INC. OR COMMUNITY HEALTH PLAN INSURANCE COMPANY. CURT KRETZINGER, JOHN WILSON, MICHAEL PULIDO, DWAIN STILSON, EDWARD KAMMERER, MD, AND WILLIAM F. RIPPE, MD HAVE A BUSINESSS RELATIONSHIP. THEY ARE ALL OFFICERS AND/OR EMPLOYEES OF HEARTLAND REGIONAL MEDICAL CENTER. CURT KRETZINGER AND JOHN WILSON HAVE A BUSINESS RELATIONSHIP. THEY SERVE AS EITHER A DIRECTOR OR OFFICER OF HEARTLAND LONG TERM ACUTE CARE HOSPITAL. JOHN WILSON, CURT KRETZINGER AND DWAIN STILSON HAVE A BUSINESS RELATIONSHIP. THEY ARE OFFICERS OF HEARTLAND FOUNDATION. CURT KRETZINGER, MICHAEL PULIDO, JOHN WILSON, AND DWAIN STILSON HAVE A BUSINESS RELATIONSHIP. THEY ARE BOARD MEMBERS OR OFFICERS OF NORTHWEST MEDICAL CENTER ASSOCIATION, INC. JOHN WILSON AND DWAIN STILSON HAVE A BUSINESS RELATIONSHIP. THEY SERVE AS OFFICERS OF HEARTLAND HEALTH. FORM 990, PART VI, SECTION A, LINE 4 RESOLUTION WAS APPROVED TO TERMINATE THE TRUST ACCOUNT. FORM 990, PART VI, SECTION A, LINE 7A HEARTLAND HEALTH, A RELATED TAX EXEMPT ORGANIZATION, HAS THE POWER TO APPOINT TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B HEARTLAND HEALTH, A RELATED TAX EXEMPT ORGANIZATION, BOARD OF DIRECTORS HAS THE POWER TO TERMINATE THE TRUST. FORM 990, PART VI, SECTION B, LINE 11B AN INDEPENDENT ACCOUNTING FIRM PREPARES THE RETURN. IT IS THEN REVIEWED BY THE TRUSTEES. AFTER REVISIONS, IF NECESSARY, THE TRUSTEES AGAIN REVIEW THE FINAL 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 THEIR POSITION ON THE BOARD. IN THIS DOCUMENT, THEY AGREE THAT THEY WILL DISCLOSE ANY ACTIVITIES IN WHICH THEY MAY NOT BE INDEPENDENT IN REGARDS TO A TRANSACTION. THIS DOCUMENT IS DISTRIBUTED AND HELD BY LEGAL COUNSEL. THE MEMBER ALSO SIGNS HEARTLAND'S CODE OF CONDUCT DOCUMENT IN WHICH THEY AGREE TO ETHICAL BEHAVIOR AND ADHERING TO 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. ALL DISMISSALS AND ABSTENTIONS ARE RECORDED IN THE MINUTES OF THE BOARD MEETING. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PLAN DOCUMENTS ARE PROVIDED TO ALL EMPLOYEE PARTICIPANTS. HEARTLAND HEALTH 5325 FARAON ST ST JOSEPH MO 64506 431283316 HEALTH CARE MO 501(C)(3) 12A NA false HEARTLAND REGIONAL MEDICAL CENTER 5325 FARAON ST ST JOSEPH MO 64506 440545289 HEALTH CARE MO 501(C)(3) 3 HH true HEARTLAND FOUNDATION 5325 FARAON ST ST JOSEPH MO 64506 431262768 COMM BENEFIT MO 501(C)(3) 10 HH true HEARTLAND LONG TERM ACUTE CARE HOSPITAL 5325 FARAON ST ST JOSEPH MO 64506 261972987 HEALTH CARE MO 501(C)(3) 3 HH true NORTHWEST MEDICAL CENTER ASSOCIATION 705 COLLEGE ALBANY MO 64402 440580870 HEALTH CARE MO 501(C)(3) 3 HH true NORTHWEST MEDICAL CENTER FOUNDATION INC 705 N COLLEGE STREET ALBANY MO 64402 473694893 SUPPORT MO 501(C)(3) 12A NWMCA true ST JOSEPH DOWNTOWN DEVELOPMENT LLC 5325 FARAON ST ST JOSEPH MO 64506 474317460 REAL ESTAE MO MHM UNRELATED 0 0 false 0 MIDWESTERN HEALTH MANAGEMENT INC 5325 FARAON ST ST JOSEPH MO 64506 431264358 HEALTH SVCS MO HH C CORPORATION true COMMUNITY HEALTH PLAN INSURANCE COMPANY 5325 FARAON ST ST JOSEPH MO 64506 431210152 INSURANCE MO HH C CORPORATION true HHS PROPERTIES INC 5325 FARAON ST ST JOSEPH MO 64506 431593799 PROPERTY MGMT MO HH C CORPORATION true UPTOWN HOUSING INC 5325 FARAON ST ST JOSEPH MO 64506 261416252 REVITALIZATIO MO HH C CORPORATION true UPTOWN ST JOSEPH REDEVELOPMENT 5325 FARAON ST ST JOSEPH MO 64506 201742813 REDEVELOPMENT MO HH C CORPORATION true false false false false false false false false false false false true true false false false false false false HEARTLAND REGIONAL MEDICAL CENTER L 28824817 FMV HEARTLAND LONG TERM ACUTE CARE HOSPITAL L 457573 FMV NORTHWEST MEDICAL CENTER ASSOCIATION INC L 1658466 FMV MIDWESTERN HEALTH MANAGEMENT INC L 334187 FMV HEARTLAND FOUNDATION L 105796 FMV HEARTLAND REGIONAL MEDICAL CENTER M 16594154 FMV NORTHWEST MEDICAL CENTER ASSOCIATION INC M 303482 FMV