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0 7070983 7226668 5214067 6718945 616945506 371538093 257350258 245407413 375628988 448837797 35282752 7722147 2412529 1230219 0 0 14482852 19500600 802370520 830946761 76549982 91228402 0 0 0 0 225227168 220393323 0 0 0 0 3494996 2895501 0 0 11126099 9749908 316398245 324267134 X 485972275 506288328 0 391299 0 0 485972275 506679627 802370520 830946761 X 41913490 -11097685 -10108453 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 56856 false false true 83167 140023 false 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. 19043491 19043491 295917560 138741873 157175687 36240891 20505150 15735741 207034622 165659934 41374688 58708942 46631136 12077806 245407413 0 DERIVATIVE INSTRUMENTS 8664501 MINORITY INTEREST 1085407 9749908 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 Central America and the Caribbean Investments 0 0 0 false false true true false false SCHEDULE F, PART I, LINE 1 THE ORGANIZATION DISPOSED OF ALL THE FOREIGN INVESTMENTS THAT IT HELD DURING THE YEAR ENDING JUNE 30, 2015. true true X true X true X true true false true true 15498242 15498242 0.02830 107275172 89457082 17818090 0.03260 122773414 89457082 33316332 0.06090 3487962 384910 3103052 0.00570 359872 39600 320272 0.00060 2804995 2804995 0.00510 6652829 424510 6228319 0.01140 129426243 89881592 39544651 0.07230 118147 118147 0.00020 121809 121809 0.00020 134908 134908 0.00020 140053 140053 0.00030 514917 514917 0.00090 false 30737257 5298132 149070158 156336086 -7265928 X true true NONE 1 1 HEARTLAND REGIONAL MEDICAL CENTER 5325 FARAON ST ST JOSEPH MO 64506 WWW.MYMOSAICLIFECARE.ORG 426-19 X X X PHARMICIST INTERN PROGRAM HEARTLAND REGIONAL MEDICAL CENTER 1 false false true X X X X X X X X X 12 true false false true X WWW.MYMOSAICLIFECARE.ORG X true 12 true WWW.MYMOSAICLIFECARE.ORG false false true X 200. 300. X true true X true X WWW.MYMOSAICLIFECARE.ORG X WWW.MYMOSAICLIFECARE.ORG X X X X true X false X X X X true X false false SCHDULE H, PART V, LINE 5 A COMMUNITY SURVEY WAS CONDUCTED BY AMERICAN VIEWPOINT, ONE OF THE MOST WIDELY-RESPECTED PUBLIC OPINION RESEARCH AND STRATEGIC MESSAGE CONSULTING FIRMS IN THE UNITED STATES. INTERVIEWS WERE CONDUCTED WITH 500 RESIDENTS ACROSS THE SERVICE AREA. APPROXIMATELY 25 PERCENT OF INTERVIEWS WERE CONDUCTED WITH CELL PHONE ONLY HOUSEHOLDS. THE SAMPLE INCLUDED MEN AND WOMEN BETWEEN THE AGES OF 18 TO MORE THAN 65 WITH HOUSEHOLD INCOMES RANGING FROM BELOW $20K TO ABOVE $50k. AMONG THE RESPONDENTS WERE THOSE WHO HAD LIVED IN ST. JOSEPH FOR LESS THAN FIVE YEARS TO THOSE WHO HAD LIVED IN THE COMMUNITY ALL THEIR LIVES. THE COMMUNITY SURVEY WAS ALSO INTRODUCED TO SIX FOCUS GROUPS COMPRISED OF COMMUNITY MEMBERS, INCLUDING THOSE WITH BROAD INTERESTS AND THOSE WITH SPECIAL KNOWLEDGE OF THE SUBJECT. THE GROUPS REPRESENTED PHYSICIANS, COMMUNITY MEMBERS, CLINICAL STAFF (REGISTERED NURSES AND CARE MANAGERS), HOSPITAL LEADERSHIP AND COMMUNITY HEALTH LEADERS. ADDITIONALLY, OTHER HEALTH DATA ALREADY GATHERED THROUGH OUR OWN POPULATION HEALTH DATABASE, ALONG WITH HEALTH DATA FROM LOCAL, STATE AND NATIONAL SOURCES WAS INCORPORATED INTO A SCORECARD TO MONITOR THE OUR SUCCESS IN IMPROVING THE HEALTH OF OUR COMMUNITY. THOSE OUTSIDE RESOURCES WERE AGENCY FOR HEALTHCARE RESEARCH AND QUALITY (AHRQ) PQI (PREVENT QUALITY INDICATORS), MISSOURI DEPARTMENT OF HEALTH, LOCAL BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) (STJOEHEALTHINFOR.ORG), STATE BRFSS, MISSOURI HOSPITAL ASSOCIATION (MHA) REPORT: ASSESSING THE HEALTH OF OUR COMMUNITIES, COUNTY HEALTH RANKINGS, UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE, ST. JOSEPH HEALTH DEPARTMENT, AMERICAN COMMUNITY SURVEY (ACS), MISSOURI ECONOMIC RESEARCH AND INFORMATION CENTER (MERIC), SUCCESS BY SIX/UNITED WAY, AND HEAD START. SCHEDULE H, PART V, LINE 11 THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN THE 2012 TAX YEAR AND AN IMPLEMENTATION PLAN FOR ADDRESSING THE IDENTIFIED NEEDS ADOPTED FOR THE 2013 TAX YEAR. THE TOP THREE ISSUES DETERMINED FROM THE ASSESSMENT WERE: AVAILABILITY OF MENTAL HEALTH SERVICES; ADULT AND CHILDHOOD OBESITY; AND, EDUCATION ON HEALTH AND HEALTH RESOURCES. IN THE FIRST YEAR OF IMPLEMENTATION, CHARITABLE GIVING WAS BETTER ALIGNED WITH PROGRAMS THAT SUPPORTED COMMUNITY HEALTH SERVICES, COMMUNITY HEALTH NEEDS AND COMMUNITY BUILDING. COLLABORATIVE DISCUSSIONS WITH COMMUNITY AGENCIES INVOLVED WITH MENTAL HEALTH SERVICES HAD BEEN HELD TO DETERMINE BEST SOLUTIONS FOR INCREASING THE AVAILABILITY IN THE CORRECT SETTING. THE TAXPAYER HAD CONTINUED ITS SUPPORT OF PROGRAMS LIKE THE POUND PLUNGE AND THE 4TH GRADE CHALLENGE. A COMPREHENSIVE WEB-BASED INFORMATION CALENDAR OF HEALTH EDUCATION OPPORTUNITIES WAS MADE AVAILABLE TO THE PUBLIC. IN THE SECOND YEAR OF THE THREE-YEAR CYCLE, THE TAXPAYER HAS FURTHER ADDRESSED MENTAL HEALTH ISSUES BY PLACING BEHAVIORAL HEALTH MANAGERS IN ALL PRIMARY CARE CLINICS TO HELP PATIENTS WITH NAVIGATION TO THE MENTAL HEALTH RESOURCES THAT THEY NEED, PROVIDED FINANCIAL SUPPORT TO ORGANIZATIONS PROVIDING MENTAL HEALTH SUPPORT TO THE COMMUNITY AND PARTNERING WITH A COMMUNITY GROUP TO ADDRESS THE MENTAL HEALTH NEEDS OF CHILDREN AND ADOLESCENTS. THE OBESITY ISSUE HAS BEEN ADDRESSED BY CONTINUING SUPPORT OF THE POUND PLUNGE AND THE 4TH GRADE CHALLENGE, DEVELOPED A FIT-TASTIC PROGAM TO PREVENT OBESITY AND LIVE A HEALTHIER LIFESTYLE, DEVELOPED INTERNAL CLINICAL PROTOCOLS TO ADDRESS CHILDHOOD OBESITY, SUPPORTED SCHOOL AND COMMUNITY GARDEN PROJECTS, EXPANDED THE PROGRAM OF HEALTHY COOKING CLASSES FOR KIDS, AGAIN SUPPORTED THE SECOND HARVEST COMMUNITY FOOD BANK AND FURTHER ALIGNED SPONSORSHIPS AND CHARITABLE GIVING WITH THE ESTABLISHED PRIORITIES OF THE CHNA. THE WEB-BASED COMMUNITY CALENDAR CONTINUES TO BE A CENTRALIZED CLEARINGHOUSE TO PROVIDE HEALTH EDUCATION INCLUDING EXERCISE, SCREENINGS, HEALTH FAIRS, MENTAL HEALTH EVENTS, PROVIDER PRESENTATIONS. IMPLEMENTATION STRATEGY CAN BE FOUND AT: https://www.mymosaiclifecare.org/General/Community-Health-Needs-Assessment /St-Joseph-CHNA/ SCHEDULE H, PART V, LINE 20E FINANCIAL COUNSELORS ARE AVAILABLE ONSITE TO EXPLAIN THE FINANCIAL ASSISTANCE POLICY PROCESS AT ANY TIME DURING THE PATIENT'S VISIT. 68 Heartland Clinic 901 Heartland Road Ste 4840 St Joseph MO 64506 Infectious Disease Heartland Clinic 902 Riverside Road Ste 201 St Joseph MO 64507 Rad Oncology Heartland Clinic 902 North Riverside Road St Joseph MO 64507 Specialty Pediatrics Heartland Clinic 5514 Corporate Dr Ste 150 St Joseph MO 64507 Cardiovascular Heartland Clinic 5210 North Belt Highway Ste B St Joseph MO 64506 Family Practice Heartland Clinic 5301 Faraon ST Ste 210A St Joseph MO 64506 Pulmonology Heartland Clinic 105 Far West Drive Ste 100 St Joseph MO 64506 Internal, Peds, Family Heartland Clinic 5514 Corporate Dr Ste 120 St Joseph MO 64506 Internal Heartland Clinic 1115 N Belt Highway St Joseph MO 64506 Urgent Care Spa at Briarcliff 4133 North Mulberry Dr Kansas City MO 64116 MEDICAL SPA Heartland Clinic 9784 N Ash Avenue Kansas City MO 64157 Family/Specialty Heartland Clinic 3715 Beck Road Bldg F St Joseph MO 64506 Internal Medicine Heartland Clinic 5301 Faraon ST Ste 200 St Joseph MO 64506 Occupational Medicine Outpatient Imaging 3620 Frederick Ave St Joseph MO 64506 Imaging Heartland Clinic 711 North 36th Street St Joseph MO 64506 Family Heartland Clinic 105 Far West Drive Ste 201 St Joseph MO 64506 NEUROLOGY Heartland Clinic 902 N Riverside Ste 200 St Joseph MO 64506 Specialty Med Oncology Heartland Clinic 215 S Walnut St Cameron MO 64429 Family Practice Heartland Clinic 207 So Main Troy KS 66087 Family Practice Heartland Outpatient 3107 Frederick Lower Level St Joseph MO 64506 Outpatient Therapy Heartland Counseling 137 N Belt Highway St Joseph MO 64506 Counseling Heartland Clinic 105 Far West Drive Ste 202 St Joseph MO 64506 Psychiatry Heartland Clinic 300 Utah Hiawatha KS 66434 Specialty Heartland Clinic 5210 North Belt Highway Ste C St Joseph MO 64506 Family Practice Heartland Outpatient 902 N Riverside St Joseph MO 64507 Cancer Center Heartland Clinic 901 Heartland Road Suite 3800 St Joseph MO 64506 Specialty Heartland Clinic 2024 S Main Maryville MO 64424 Specialty Heartland Clinic 2600 Miller Bethany MO 64424 Specialty Heartland Clinic 810 Ravenhill Drive Ste 103 Atchison KS 66002 Specialty Heartland Outpatient 3007 N Belt Highway Suite L St Joseph MO 64506 Outpatient Therapy Heartland Clinic 5202 Faraon ST Ste A St Joseph MO 64506 Podiatry Heartland Clinic 705 N College Albany MO 64402 Specialty Clinic Heartland Clinic 104 N 6th Street Ste 15 Atchison KS 66002 Medical Oncology Heartland Clinic 5210 North Belt Highway Ste C St Joseph MO 64506 Specialty Womens Heartland Clinic 8880 NE 82nd Terrace Kansas City MO 64158 Family, Specialty, Imaging Heartland Clinic 8860 NE 82nd Terrace Kansas City MO 64158 Ambulatory Surgery Heartland Clinic 425 W Washington Street Kearney MO 64060 Family Practice Heartland Clinic 6185 Jefferson Ave Parkville MO 64152 Family Practice Heartland Clinic 6420 N Prospect Ave Gladstone MO 64119 Family Practice Heartland Clinic 1103 S US Highway 169 Smithville MO 64089 Family Practice Heartland Clinic 2370 Vintage Court Excelsior Springs MO 64024 Family Practice Outpatient Services 901 Heartland Road Ste 4870 St Joseph MO 64506 Sleep Disorders AMBULATORY SURGERY Heartland Clinic 1600 East Evergreen Cameron MO 64429 Specialty Heartland Clinic 1610 East Evergreen Ste B Cameron MO 64429 Medical Oncology Heartland Clinic 2016 S Main Street Maryville MO 64468 Medical Oncology Heartland Clinic 2703 Running Horse Rd Platte City MO 64079 Family, Specialty Heartland Outpatient 2703 Running Horse Rd SteB Platte City MO 64079 Outpatient Therapy Heartland Clinic 3007 N Belt Highway St Joseph MO 64506 Specialty Heartland Clinic 6301 N Lucerne Kansas City MO 64151 Family, Specialty, Imaging Heartland Clinic 5301 Faraon ST Ste 210B St Joseph MO 64506 Pulmonology Heartland Outpatient 901 Heartland Road Ste 1810 St Joseph MO 64506 Wound Care Heartland Clinic 5301 Faraon ST Ste 160 St Joseph MO 64506 ENT Heartland Clinic 901 Heartland Road Ste 4860 St Joseph MO 64506 Caregiver Quick Clinic Heartland Clinic 1701 East 9th Street Trenton MO 64683 Family Heartland Clinic 802 N Riverside Ste 130 St Joseph MO 64507 Rehab Heartland Clinic 802 N Riverside Ste 150 St Joseph MO 64507 Specialty Heartland Clinic 802 N Riverside Ste 150 St Joseph MO 64507 Spine Heartland Clinic 802 N Riverside Suite 100 St Joseph MO 64507 Pain Mgmt Heartland Clinic 802 N Riverside Suite 140 St Joseph MO 64507 Arthritis Heartland Clinic 802 N Riverside Ste G60 St Joseph MO 64507 Breast Care Heartland Clinic 802 N Riverside Ste 200 St Joseph MO 64507 Vascular Heartland Clinic 802 N Riverside Ste 210 St Joseph MO 64507 Cardiothoracic Heartland Clinic 802 N Riverside Ste 220 St Joseph MO 64507 Bariatric Care Heartland Clinic 802 N Riverside Ste 225 St Joseph MO 64507 Vein Care Heartland Clinic 802 N Riverside Ste G50 St Joseph MO 64507 General Surgery Heartland Clinic 5204 North Belt Highway Ste A St Joseph MO 64506 Plastic, Dermatology Heartland Clinic 901 Heartland Road Ste 4810 St Joseph MO 64506 Endocrinology Heartland Clinic 901 Heartland Road Ste 2800 St Joseph MO 64506 Womens SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATED THE AMOUNTS REPORTED IN THE TABLE WAS THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2. SCHEDULE H, PART I, LINE 7, COLUMN F COST IS FROM FORM 990, PART IX, LINE 25 COLUMN (A) WITH BAD DEBT OF $59,926,027 SUBTRACTED FOR THE PURPOSE OF CALCULATING THE PERCENTAGE. SCHEDULE H, PART II FUNDING BY THE ORGANIZATION PROVIDES ECONOMIC SUPPORT TO THE DOWNTOWN COMMUNITY AS WELL AS COMMUNITY SUPPORT OF DISASTER READINESS, COORDINATION, AND RELIEF AMONGST OTHER COMMUNITY BUILDING ACTIVITIES. SCHEDULE H, PART III, LINE 2 BAD DEBT WRITEOFFS OF SELF PAY PORTIONS OF ACCOUNTS RECEIVABLE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE ARE USED TO DETERMINE HISTORICAL PERCENTAGES WHICH ARE THEN APPLIED TO CURRENT SELF PAY ACCOUNTS RECEIVABLE TO DETERMINE THE AMOUNT OF BAD DEBT RESERVE NEEDED FOR FUTURE BAD DEBT WRITEOFFS. ANY ADJUSTMENTS TO THE RESERVE ARE BOOKED AS BAD DEBT EXPENSE. FOR THE CALCULATION IN #2, THOSE ADJUSTMENTS ARE MULTIPLIED BY THE COST TO CHARGE PERCENTAGE DETERMINED BY THESE SCHEDULE H WORKSHEETS. SCHEDULE H, PART III, LINE 4 THE BAD DEBT EXPENSE FOOTNOTE IS ON PAGE 9 OF THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, 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 ORGANIZATION'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 WILL HAVE TO BE COVERED BY THOSE WHO PAY. THE BURDEN FALLS ON THE COMMUNITY. SCHEDULE H, PART III, LINE 9B HEARTLAND'S STANDARD LD6465 (MEDICAL CENTER, CLINIC, AND LONG-TERM ACUTE CARE HOSPITAL FINANCIAL ASSISTANCE) CONTAINS PROVISIONS ON COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. ACCORDING TO THIS POLICY, ENTERPRISE FINANCIAL COUNSELORS AND PRE ACCESS SERVICES REPRESENTATIVES ARE RESPONSIBLE FOR DETERMINING IF A PATIENT IS ELIGIBLE FOR DISCOUNTED MEDICAL SERVICES. THE GUIDELINES ARE BASED ON RESIDENCY, GROSS INCOME AND FAMILY SIZE. FREE CARE IS GIVEN TO PATIENTS WHOSE INCOME IS LESS THAN 200% OF FEDERAL POVERTY GUIDELINES. A 50% DISCOUNT IS GIVEN TO PATIENTS WHOSE INCOME IS BETWEEN 201% AND 300% OF FEDERAL POVERTY GUIDELINES. CERTAIN PRESUMPTIVE GUIDELINES MAY QUALIFY A PATIENT FOR THE FINANCIAL ASSISTANCE POLICY. IT IS THE PATIENT'S RESPONSIBILITY TO PRESENT REQUIRED DOCUMENTATION TO SUBSTANTIATE A DISCOUNT. FOR CLINIC, A 100% DISCOUNT IS APPLIED AFTER COPAY FOR ELIGIBLE PATIENTS BASED ON 100% OF THE FEDERAL POVERTY GUIDELINES. DEPENDING ON THE PATIENT'S INSURANCE COVERAGE A COPAYMENT OF UP TO $80 WILL BE DUE FROM THE PATIENT FOR A CLINIC VISIT, WHICH IS EXCLUDED FROM FINANCIAL ASSISTANCE. 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. THE FOLLOWING DOCUMENTS ARE AVAILABLE. I. FINANCIAL ASSISTANCE POLICY - PROVIDES AN IN-DEPTH EXPLANATION OF THE FINANCIAL ASSISTANCE PROGRAM INCLUDING DETAILS ABOUT INCOME, RESIDENCE, AND ELIGIBILITY GUIDELINES. THE PROCESS FOR APPLYING FOR FINANCIAL ASSISTANCE AND MOSAIC LIFE CARE'S BILLING PRACTICES ARE ALSO EXPLAINED IN THIS DOCUMENT. II. FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY - A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY THAT IS ALSO AVAILABLE THROUGHOUT THE ORGANIZATION TO BE PROVIDED TO THE PATIENT UPON REQUEST. THIS DOCUMENT CONTAINS THE INCOME CATEGORIES IN DETAIL BASED ON. THE FEDERAL POVERTY GUIDELINES. THE FEDERAL POVERTY GUIDELINES ARE UPDATED ANNUALLY IN CONJUNCTION WITH THE UPDATES FROM THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. III. FINANCIAL ASSISTANCE APPLICATION - THE APPLICATION IS AVAILABLE ONLINE IN ORDER TO ALLOW AN APPLICANT TO VIEW THE CRITERIA AND ALSO COMPLETE THE APPLICATION PRIOR TO MEETING WITH A FINANCIAL COUNSELOR. THE MEDICAL CENTER ADOPTED THE FOLLOWING COLLECTION POLICY PROCEDURES EFFECTIVE OCTOBER 1, 2015. NO PATIENT ACCOUNT WILL BE SUBJECT TO COLLECTION ACTIONS WITHIN 240 DAYS OF ISSUING THE FIRST POST-DISCHARGE STATEMENT AND WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE. NO EXTRAORDINARY COLLECTION ACTIONS WILL BE PURSUED AGAINST A PATIENT IF THE PATIENT OR GUARANTOR HAS PROVIDED DOCUMENTATION SHOWING THAT AN APPLICATION HAS BEEN SUBMITTED FOR MEDICAID OR OTHER PUBLICLY SPONSORED HEALTH PROGRAMS, AND THAT AN ELIGIBILITY DETERMINATION IS STILL PENDING. THIS 240-DAY TIMEFRAME MAY BE SHORTENED IF A DECISION HAS BEEN MADE ON FINANCIAL ASSISTANCE, OR WHEN A PAYMENT PLAN HAS BEEN ESTABLISHED AND AGREED TO, BUT THE PATIENT OR GUARANTOR IS NO LONGER MAKING THE REQUIRED PAYMENTS. IF A STATEMENT IS SENT TO A PATIENT OR GUARANTOR, AND MAIL IS RETURNED AS UNDELIVERABLE, THE MEDICAL CENTER WILL ATTEMPT TO FIND A CORRECT ADDRESS. IF THE CORRECT ADDRESS CANNOT BE FOUND, THE MEDICAL CENTER 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: AS OF JULY 1, 2015, PRIOR TO SENDING AN ACCOUNT TO A COLLECTION AGENCY, THE PATIENT OR GUARANTOR WILL GENERALLY RECEIVE A MINIMUM OF SEVEN WRITTEN STATEMENTS INCLUDING THE FIRST POST-DISCHARGE STATEMENT AND SIX SUBSEQUENT STATEMENTS. THESE STATEMENTS WILL INCLUDE A TELEPHONE NUMBER FOR INFORMATION ON PAYING PATIENT BALANCES AND A CONSPICUOUS NOTICE ABOUT FINANCIAL ASSISTANCE. IF THE PATIENT DOES NOT CALL AND SETUP A FORMAL PAYMENT PLAN, BUT DOES MAKE ACCEPTABLE PAYMENTS, STATEMENTS WILL CONTINUE UNTIL BALANCE IS PAID IN FULL. WHEN A PATIENT CALLS THE MEDICAL CENTER'S FINANCIAL SERVICES AREA STATING HE OR SHE IS UNABLE TO PAY THE BALANCE, THE FOLLOWING STEPS PROCEED. 1) FINANCIAL COUNSELING IS PROVIDED TO DETERMINE IF PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE. 2) A FORMAL PAYMENT PLAN IS DISCUSSED. PRIOR TO OCTOBER 2015, THE FORMAL PAYMENT PLANS COULD ONLY BE FOR A MAXIMUM OF 18 MONTHS. AS OF OCTOBER 2015, PAYMENT PLANS MAY BE FOR A MAXIMUM OF 36 MONTHS. 3) PRIOR TO OCTOBER 2015, SPECIAL CONTRACTS WERE USED IF THE PATIENT COULD NOT PAY BALANCE WITHIN 18 MONTHS AND WERE REVIEWED TO BE WITH OR WITHOUT INTEREST. AS OF OCTOBER 2015, SPECIAL CONTRACTS ARE WITHOUT INTEREST AND ARE ONLY USED IF PATIENT CANNOT PAY BALANCE WITHIN 36 MONTHS. IF AN AGREEMENT HAS NOT BEEN MADE TO RESOLVE THE ACCOUNT, AN EIGHTH 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 THE MEDICAL CENTER 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. ORAL NOTIFICATION WILL BE ATTEMPTED AT THIS TIME AS WELL TO ENSURE THE PATIENT OR GUARANTOR IS AWARE OF MOSAIC LIFE CARE'S FINANCIAL ASSISTANCE POLICY AND THE DEBT THEY OWE. 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 HEARTLAND IN GOOD FAITH TO PAY OFF THE REMAINING AMOUNT OWED. SCHEDULE H, 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. SCHEDULE H, PART VI, LINE 3 THIS COMPREHENSIVE EXPOSURE BEGINS WITH INFORMATION AT THE REGISTRATION DESK AND CONCLUDES WITH FINANCIAL ASSISTANCE INFORMATION BEING INCLUDED ON EVERY BILLING STATEMENT A PATIENT RECEIVES FROM MOSAIC LIFE CARE. GUIDELINES FOR THE PROGRAM ARE AVAILABLE AT EACH REGISTRATION DESK AND 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 CHARITY CARE. 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 AND APPOINTMENT WITH A FINANCIAL COUNSELOR WHO CAN ASSIST THEM IN COMPLETING THE APPLICATION FOR FREE OR DISCOUNTED CARE. SCHEDULE H, PART VI, LINE 4 THE ORGANIZATION'S SERVICE AREA IS A 23 COUNTY URBAN/RURAL AREA LOCATED NEAR THE INTERSECTION OF A FOUR-STATE AREA. 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 62% MEDICARE AND MEDICAID, 32% COMMERCIAL AND 6% SELF PAY. A LARGE PERCENT OF THE REGION'S POPULATION ARE BELOW THE NATIONAL POVERTY LEVEL AND ARE UNINSURED OR UNDER-INSURED. NEARLY A QUARTER OF THE POPULATION SMOKE, HAVE DIABETES OR HAVE A BODY MASS INDEX GREATER THAN 30. MORE THAN 60 PERCENT OF THE ELEMENTARY AGE STUDENTS RECEIVE FREE OR REDUCED-COST LUNCHES. SCHEDULE H, PART VI, LINE 5 THE ORGANIZATION OFFERS NEARLY 50 EDUCATIONAL PROGRAMS THROUGHOUT THE YEAR TO HELP MAINTAIN A HEALTHY LIFESTYLE. THESE ARE WELL-ADVERTISED AND MOST OF THEM ARE FREE OF CHARGE. FOR THE PAST TEN YEARS, THE ORGANIZATION HAS SPONSORED THE POUND PLUNGE, A THREE-MONTH LONG EVENT TO ENCOURAGE WEIGHT LOSS, EXERCISE AND HEALTHY EATING. MORE THAN 18,000 PEOPLE HAVE PARTICIPATED AND OVER 115,000 POUNDS HAVE BEEN LOST. THE 4TH GRADE CHALLENGE IS A PROGRAM CREATED FOR CHILDREN WHO ARE AT THE AGE WHEN THEY CAN BEGIN TO MAKE CHOICES FOR THEMSELVES. THE OBJECTIVE OF THE PROGRAM IS TO IMPROVE THESE STUDENTS' HEALTH BY PROVIDING AN EIGHT WEEK CURRICULUM WITH FUN, HANDS-ON ACTIVITIES DESIGNED TO ENCOURAGE HEALTHY EATING HABITS, EXERCISE AND MAKING WISE LIFESTYLE CHOICES. DURING THE CHNA PROCESS, TWENTY SIX SCHOOLS PARTICIPATE IN THE PROGRAM, WHICH ALSO INCLUDES SCHOOL GARDENS AND HEALTHY COOKING CLASSES AT SIX TITLE ONE SCHOOLS. THE PROGRAM COMPLETED ITS SEVENTH YEAR IN APRIL, 2015. THE ORGANIZATION HAS ADOPTED THE 1-2-3-4-5 FITTASTIC MESSAGING, WHICH WAS DEVELOPED BY CHILDRENS MERCY HOSPITAL, TO BE THE EVIDENCED BASED GUIDELINES FOR ALL THE CHILD OBESITY PREVENTION PROGRAMS. THE ORGANIZATION HAS ALSO DEVELOPED UNIFORM PROVIDER PROTOCOLS FOR DIAGNOSING AND TREATING CHILDHOOD OBESITY. THE ORGANIZATION HAS CONTRIBUTED SIGNIFICANT FINANCIAL SUPPORT TO ORGANIZATIONS DEDICATED TO MENTAL HEALTH SERVICES, POVERTY AND HOMELESSNESS. tHE ORGANIZATION, IN RESPONSE TO COMMUNITY REQUEST, HAS DEVELOPED A COMPREHENSIVE COMMUNITY CALENDAR FOR HEALTH EVENTS AND HEALTH EDUCATION. THIS IS LOCATED ON THE ORGANIZATIONAL WEBSITE. THE ORGANIZATION IS A FUNDING PARTNER OF A COMMUNITY ALLIANCE PROJECT GEARED TO SHARE AND COORDINATE THE EXISTENCE OF COMMUNITY HEALTH AND WELFARE PROJECTS. SCHEDULE H, PART VI, LINE 6 THE ORGANIZATION IS AFFILIATED, THROUGH A PARENT BOARD, WITH A FOUNDATION, AN ACUTE LONG TERM CARE HOSPITAL, AND A COMMUNITY HEALTH IMPROVEMENT SOLUTIONS SERVICE, ALL OF WHICH COLLABORATE WITH EDUCATIONAL, GOVERNMENTAL AND LOCAL BUSINESS LEADERS TO IMPLEMENT PROGRAMS THAT WILL HELP TO ALLEVIATE THOSE ISSUES WHICH LEAD TO POOR HEALTH HABITS AND THE ULTIMATE NEED FOR MEDICAL CARE. THE PARENT BOARD IS COMPRISED OF COMMUNITY LEADERS WHO REPRESENT THE EDUCATIONAL, MEDICAL, GOVERNMENTAL AND BUSINESS SECTORS IN THE COMMUNITY. THE FOUNDATION HAS DIRECT OVERSIGHT FOR MANY OF THE PROGRAMS AND COUNCILS THAT ARE WORKING TO ELIMINATE THE FACTORS THAT LEAD TO THE NEED FOR MEDICAL CARE. THE ACUTE LONG TERM CARE HOSPITAL IS A FACILITY DEDICATED TO THE CARE OF THOSE PATIENTS WHOSE CHRONIC ILLNESS REQUIRES A GREATER LENGTH OF STAY THAN THE NORM FOR ROUTINE ACUTE PATIENTS. THE COMMUNITY HEALTH IMPROVEMENT SOLUTIONS SERVICE WORKS WITH OTHER EMPLOYERS IN THE COMMUNITY TO EFFECT HEALTHY CHANGES IN THEIR WORKFORCES. true UNITED WAY OF ST JOE 118 S 5TH STREET ST JOSEPH MO 64501 440547802 501(C)(3) 175089 SUPPORT HEARTLAND FOUNDATION 5325 FARAON ST ST JOSEPH MO 64506 431262768 501(C)(3) 708676 SUPPORT MO W STATE UNIV FOUNDATI 5425 DOWNS DRIVE ST JOSEPH MO 64507 237035423 501(C)(3) 335580 SUPPORT ALLIED ARTS COUNCIL 118 S EIGHTH ST JOSEPH MO 64501 430810827 501(C)(3) 10000 SUPPORT SECOND HARVEST COMMUNITY FOOD BANK 915 DOUGLAS ST JOSEPH MO 64505 431268319 501(C)(3) 65000 SUPPORT SMITHVILLE SCHOOL DISTRICT 655 S COMMERCIAL AVE SMITHVILLE MO 64089 431906203 GOVERNMENT 6340 SUPPORT ST JOSEPH AREA CHAMBER OF COMMERCE 3003 FREDERICK AVENUE ST JOSEPH MO 64506 440419460 501(C)(6) 22025 SUPPORT YOUNG WOMEN'S CHRISTIAN ASSOCIATION 3014 NORTH 8TH STREET ST JOSEPH MO 64501 440552219 501(C)(3) 9500 SUPPORT NORTHLAND REGIONAL CHAMBER OF COMMERCE 634 NW ENGLEWOOD ROAD ST JOSEPH MO 64118 431279100 501(C)(6) 15345 SUPPORT MO W STATE UNIV FOUNDATION 5425 DOWNS DRIVE ST JOSEPH MO 64506 237035423 501(C)(3) 7500 FMV SUPPORT AMERICAN CANCER SOCIETY INC 1100 PENNSYLVANIA AVE KANSAS CITY MO 64102 131788491 501(C)(3) 7000 SUPPORT INSTITUTE FOR INDUSTRIAL & APPLIED LIFE SCIENCES 4221 MITCHELL AVENUE ST JOSEPH MO 64507 201215246 501(C)(3) 20000 SUPPORT UNLIMITED PLAY INC 4140 OLD MILL PARKWAY ST PETERS MO 63376 134252421 501(C)(3) 35000 SUPPORT FAMILY GUIDANCE CENTER FOR BEHAVIORAL HEALTHCARE 724 N 22ND ST ST JOSEPH MO 64506 440666362 501(C)(3) 41000 SUPPORT SAMARITAN COUNSELING CENTER 902 EDMOND ST JOSEPH MO 64501 431615018 501(C)(3) 58000 SUPPORT THE INTERSERV FOUNDATION 200 CHEROKEE STREET ST JOSEPH MO 64504 753197631 501(C)(3) 60000 SUPPORT BUCHANAN COUNTY AGRI-BUSINESS EXP CENTER INC 224 N 7TH ST PO BOX 8384 ST JOSEPH MO 64501 261352588 501(C)(3) 87500 SUPPORT LADIES UNION BENEVOLENT ASSOCATION 801 N NOYES BLVD ST JOSEPH MO 64506 440563788 501(C)(3) 125000 SUPPORT NORTHWEST HEALTH SERVICES INC 2303 VILLAGE DRIVE ST JOSEPH MO 64506 431323669 501(C)(3) 234184 SUPPORT ST JOSEPH PARKS REC AND CIVIC FACILITIES DEPT 1920 GRAND AVE ST JOSEPH MO 64505 446000256 MUNICIPAL GOV'T 6490 SUPPORT 17 2 PART I, LINE 2 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. X true true X X X X X false true false false false false false false false DR JOHN OLSON STAFF PHYSICIAN/BOARD 569935 0 108133 0 15928 0 10400 0 23532 0 727928 0 0 0 DR MAUREEN MANGANARO STAFF PHYSICIAN 447882 0 17810 0 2065 0 10400 0 23632 0 501789 0 0 0 DR MICHAEL NELLESTEIN STAFF PHYSICIAN 257105 0 0 0 2504 0 7800 0 12794 0 280203 0 0 0 DR HEMANT SHETH STAFF PHYSICIAN 930810 0 1663 0 54508 0 7800 0 15111 0 1009892 0 0 0 DR BONNIE GOINS STAFF PHYSICIAN 550991 0 367908 0 45843 0 10400 0 15304 0 990446 0 0 0 DR MOHAN HINDUPUR STAFF PHYSICIAN 930703 0 0 0 19388 0 10400 0 15111 0 975603 0 0 0 DR ROBERT GRANT STAFF PHYSICIAN 825920 0 14028 0 44628 0 10400 0 23632 0 918609 0 0 0 DR ARVIND SHARMA STAFF PHYSICIAN 826251 0 4428 0 27227 0 10400 0 23301 0 891608 0 0 0 CAROLYN S PADEN ADMINISTRATOR 208015 0 15475 0 9186 0 0 0 15304 0 247980 0 0 0 DR DAVIN TURNER ADMINISTRATOR 343380 0 84519 0 2444 0 54954 0 23301 0 508597 0 0 0 R S KOELLIKER ADMINISTRATOR 293403 0 49292 0 14307 0 73703 0 23225 0 453930 0 0 0 MICHAEL C PULIDO CHIEF ADMINISTRATIVE OFFICER 309778 0 58800 0 29465 0 64531 0 23301 0 485875 0 15252 0 CURT KRETZINGER CHIEF OPERATING OFFICER 478592 0 94710 0 124180 0 70649 0 7927 0 776058 0 101255 0 JOHN P WILSON SECRETARY/TREASURER/CFO 448500 0 82797 0 84296 0 55886 0 0 0 671479 0 62660 0 MARK LANEY MD PRESIDENT/CEO 753327 0 316825 0 13609 0 10400 0 23632 0 1117794 0 0 0 SCHEDULE J, PART I, LINE 1A Travel for companions was not included as taxable compensation as it was 100% for business purposes. SCHEDULE J, PART I, LINE 4B ACCRUED VESTED 6/30/2015 6/30/2015 ---------- ----------- CURT KRETZINGER 60,249 101,255 JOHN P. WILSON 45,486 62,660 SCOTT KOELLIKER 63,243 0 DAVIN TURNER, DO 44,554 0 MICHAEL PULIDO 53,739 15,252 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 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. A SEE PART VI 431203910 79075LAB3 2009-02-26 70000000 SEE PART VI false false false B SEE PART VI 431203910 79075LAD9 2011-09-30 25250000 SEE PART VI false false false C SEE PART VI 431178966 60637ACP5 2012-10-03 51489534 SEE PART VI false false false A 980000 0 70956418 0 0 0 0 0 0 70956418 0 0 2014 false false true true B 8335000 0 25250000 0 0 0 0 0 0 0 25250000 0 2005 true false true true C 0 0 51535780 0 0 0 708053 0 0 50827727 0 0 2014 false false true true A false false false false 0 false false false true B 0 true C false false false false 0 false false false true A false true true false 0 false 0 true true B false true false false 0 false 0 false true C false true false false 0 false 0 false true A true B true C true SCHEDULE K, PART I, COLUMN A, LINE A AND LINE B THE INDUSTRIAL DEVELOPMENT AUTHORITY OF ST. JOSEPH, MISSOURI SCHEDULE K, PART I, COLUMN A, LINE C HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI SCHEDULE K, PART I, COLUMN F, LINE A Finance the construction and equipping of certain healthcare facilities. SCHEDULE K, PART I, COLUMN F, LINE B Refund 2001AB Bonds issued on 11/29/2001, 2001D Bonds issued on 11/29/2001 and 2003E Bonds issued on 5/22/2003. SCHEDULE K, PART I, COLUMN F, LINE C To acquire, construct, remodel, renovate and equip certain healthcare facilities. SCHEDULE K, PART II, COLUMN A, LINE 3 Amount does not equal to issue price listed in Part I, Column (e) due to investment earnings. SCHEDULE K, PART II, COLUMN C, LINE 3 Amount does not equal to issue price listed in Part I, Column (e) due to investment earnings. SCHEDULE K, PART II, COLUMN C, LINE 16 The organization is currently in the process of preparing a final written allocation for the 2012 Bonds. SCHEDULE K, PART III, COLUMN C The organization is currently in the process of preparing a final written allocation for the 2012 Bonds. SCHEDULE K, PART IV, COLUMN A, LINE 2C The Arbitrage Rebate Analysis was performed as of 2/1/2014. SCHEDULE K, PART IV, COLUMN A, LINE 6 The project fund was invested beyond the three year temporary period but no excess yield liability was generated. SEE PART IV SCHEDULE L, PART IV (A) DONNA WILSON (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 FINANCIAL OFFICER OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 124,304 (D) SALARY AND OTHER COMPENSATION FOR SERVICE LEADER SERVICES (E) NO (A) CORINNE KOELLIKER (B) CORINNE KOELLIKER IS A LASER TECHNICIAN FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE SISTER OF SCOTT KOELLIKER, WHO IS A KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 34,273 (D) SALARY AND OTHER COMPENSATION FOR LASER TECHNICIAN SERVICES (E) NO (A) JON KOELLIKER (B) JON KOELLIKER IS A TS APPLICATIONS ANALYST FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE BROTHER OF SCOTT KOELLIKER, WHO IS A KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 108,891 (D) SALARY AND OTHER COMPENSATION FOR TS APPLICATIONS ANALYST SERVICES (E) NO (A) MARINA KOELLIKER (B) MARINA KOELLIKER IS A REGISTERED NURSE FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE WIFE OF SCOTT KOELLIKER, WHO IS A KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 72,587 (D) SALARY FOR REGISTERED NURSE SERVICES (E) NO (A) TRACY HOWERY (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 DIRECTOR OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 122,244 (D) SALARY FOR ADVANCED PRACTICE REGISTERED NURSE SERVICES (E) NO (A) JILLIAN KOELLIKER (B) JILLIAN KOELLIKER IS A STAFF NURSE FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE DAUGHTER OF SCOTT KOELLIKER, WHO IS A KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 58,816 (D) SALARY FOR STAFF NURSE (E) NO (A) MARY KOELLIKER (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 KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 30,262 (D) SALARY FOR THERAPY DEPARTMENT SERVICES (E) NO FORM 990, PART III, LINE 4A HEARTLAND REGIONAL MEDICAL CENTER IS 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 62% GOVERNMENTAL, 32% COMMERCIAL AND 6% UNINSURED. 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 16,000 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 62,000 PATIENTS AND APPROXIMATELY 183,000 VISITS WERE GENERATED BY OUTPATIENTS. THE HOSPITAL EMPLOYS APPROXIMATELY 4,200 PEOPLE AND HAS A TOTAL OF 250 ACTIVE AND ASSOCIATE MEDICAL STAFF. THE EMPLOYED MEDICAL STAFF INCLUDES APPROXIMATELY 173 PHYSICIANS AND 79 NURSE PRACTITIONERS/PHYSICIAN EXTENDERS COVERING APPROXIMATELY 78 FAMILY MEDICINE AND SPECIALTY CLINICS AT 52 LOCATIONS THROUGHOUT THE REGION. THERE WERE APPROXIMATELY 786,000 PATIENT VISITS DURING THE YEAR. ACO: 2015 IS THE THIRD 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 2014, MOSAIC SAW A 2.8% SAVINGS FROM CMS TARGETS WHILE ACHIEVING A 95.11% QUALITY SCORE WHICH WAS THE SECOND HIGHEST SCORE AMONG ACO ORGANIZATIONS. MOSAIC ALSO PARTICIPATES IN AN ACO WITH BLUE CROSS BLUE SHIELD OF KANSAS CITY (BCBSKC). FOR CALENDAR YEAR 2014, MOSAIC REALIZED A 1.8% SAVINGS RELATIVE TO BCBSKC TARGETS. QUALITY MEASURES WERE NOT AVAILABLE FROM BSBCKC. OTHER PROGRAM SERVICES: MOSAIC 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 ALL BOARD MEMBERS ALSO SERVE ON THE BOARD OF THE SOLE MEMBER, HEARTLAND HEALTH. CURT KRETZINGER AND JOHN P. WILSON HAVE A BUSINESS RELATIONSHIP WITH HEARTLAND LONG-TERM ACUTE CARE HOSPITAL, A RELATED NOT-FOR-PROFIT CORPORATION. THEY SERVE AS EITHER A DIRECTOR OR OFFICER OF HEARTLAND LONG TERM ACUTE CARE HOSPITAL. JOHN P. WILSON, CURT KRETZINGER, MARK LANEY, M.D., DWAIN STILSON, SERENA NAYLOR AND MICHAEL PULIDO HAVE A BUSINESS RELATIONSHIP WITH NORTHWEST MEDICAL CENTER ASSOCIATION, INC. THEY SERVE AS EITHER OFFICERS AND/OR DIRECTORS FOR NORTHWEST MEDICAL CENTER ASSOCIATION, INC., WHICH IS A RELATED NOT-FOR-PROFIT CORPORATION. JOHN P. WILSON, CURT KRETZINGER, MARK LANEY, M.D., 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, DAVID TURNER, D.O., SCOTT KOELLIKER, LISA MICHAELIS, JAREN PIPPITT, AND MICHAEL PULIDO 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., AND SHOAL CREEK FAMILY MEDICINE & ALLERGY, INC. THEY SERVE AS EITHER OFFICERS AND/OR DIRECTORS OF UPTOWN HOUSING, INC. AND SHOAL CREEK FAMILY MEDICINE & ALLERGY, INC., WHICH ARE RELATED FOR-PROFIT CORPORATIONS. 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, DIRECTOR OF ACCOUNTING, AND CONTROLLER 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 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 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 SIGN A CODE OF CONDUCT DOCUMENT IN WHICH THEY AGREE TO COMPLY WITH HEARTLAND'S ETHICAL STANDARDS AND CONFIDENTIALITY POLICIES. THEY ALSO RECEIVE A QUESTIONNAIRE WHICH FACILITATES THE DISCLOSURE OF ANY REPORTABLE ACTIVITIES TO THE CORPORATE COMPLIANCE OFFICER. REPORTABLE ACTIVITIES TO THE CORPORATE COMPLIANCE OFFICER. FORM 990, PART VI, SECTION B, LINES 15A & 15B 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 (FOR THIS PERIOD) THAT SPECIALIZES IN RESEARCH MARKET SALARY DATA. FACILITY SIZE, NOT-FOR-PROFIT STATUS AND THE SCOPE OF EACH JOB POSITION IS COMPARED TO LIKE 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 B, LINE 16B A JOINT VENTURE POLICY WAS DRAFTED DURING THE FISCAL YEAR. THE POLICY IS BEING SUBMITTED FOR FORMAL BOARD APPROVAL AND WILL BE ADOPTED BY NEXT FISCAL 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 NET ASSET TRANSFER $ (655,000) CHANGE IN FAIR VALUE OF CASH FLOW HEDGING DERIVATES 1,027,068 CHANGE IN DEFINED BENEFIT PENSION PLAN LIABILITY 13,717,892 LOSS ON PARTIAL SETTLEMENT OF DEFINED BENEFIT PENSION PLAN (24,198,413) ------------- $(10,108,453) ============= NORTHLAND EXPANSION LLC 5325 FARAON ST ST JOSEPH MO 64506 DEVELOPMENT MO 0 HRMC URGENT CARE PROPERTIES LLC 5325 FARAON ST ST JOSEPH MO 64506 DEVELOPMENT MO 0 HRMC HEARTLAND HEALTH 5325 FARAON ST ST JOSEPH MO 64506 431283316 HEALTHCARE MO 501(C)(3) 11B NA false HEARTLAND FOUNDATION 5325 FARAON ST ST JOSEPH MO 64506 431262768 SUPPORT MO 501(C)(3) 7 HH true HEARTLAND LONG TERM ACUTE CARE HOSPITAL 5325 FARAON ST ST JOSEPH MO 64506 261972987 HEALTHCARE MO 501(C)(3) 3 HH true HEARTLAND HEALTH CARE PLAN TRUST FUND 5325 FARAON ST ST JOSEPH MO 64506 431286484 VEBA MO 501(C)(9) HH true NORTHWEST MEDICAL CENTER ASSOCATION INC 705 N COLLEGE ST ALBANY MO 64402 440580870 HEALTHCARE MO 501(C)(3) 3 HH true MIDWESTERN HEALTH MANAGEMENT INC 5325 FARAON ST ST JOSEPH MO 64506 431264358 HEALTHCARE MO HH C CORP 0 0 true COMMUNITY HEALTH PLAN INSURANCE COMPANY 5325 FARAON ST ST JOSEPH MO 64506 431210152 INSURANCE MO HH C CORP 0 0 true HHS PROPERTIES INC 5325 FARAON ST ST JOSEPH MO 64506 431593799 INVESTMENT MO HH C CORP 0 0 true UPTOWN HOUSING INC 5325 FARAON ST ST JOSEPH MO 64506 261416252 REDEVELOPMENT MO HH C CORP 0 0 true UPTOWN ST JOSEPH REDEVELOPMENT CORP 5325 FARAON ST ST JOSEPH MO 64506 201742813 REDEVELOPMENT MO HH C CORP 0 0 true SHOAL CREEK FAMILY MEDICINE & ALLERGY 5325 FARAON ST ST JOSEPH MO 64506 010754265 HEALTHCARE MO HRMC S CORP 57726 35928 1.00000 true true true true true false false false false false true true true true true true true true true true MIDWESTERN HEALTH MANAGEMENT INC D 1882105 FMV MIDWESTERN HEALTH MANAGEMENT INC L 771778 FMV MIDWESTERN HEALTH MANAGEMENT INC M 156000 FMV MIDWESTERN HEALTH MANAGEMENT INC Q 4613707 FMV MIDWESTERN HEALTH MANAGEMENT INC S 200000 FMV HHS PROPERTIES INC R 340000 FMV HHS PROPERTIES INC K 258507 FMV HHS PROPERTIES INC Q 53566 FMV HHS PROPERTIES INC D 297917 FMV HEARTLAND HEALTH BUSINESS PLAZA LLC K 1045153 FMV HEARTLAND LONG TERM ACUTE CARE HOSPITAL D 10031347 FMV HEARTLAND LONG TERM ACUTE CARE HOSPITAL L 5334164 FMV HEARTLAND LONG TERM ACUTE CARE HOSPITAL Q 4676502 FMV HEARTLAND LONG TERM ACUTE CARE HOSPITAL A 1202829 FMV HEARTLAND FOUNDATION B 708676 FMV HEARTLAND FOUNDATION Q 733866 FMV HEARTLAND FOUNDATION D 1311710 FMV NORTHWEST MEDICAL CENTER ASSOCIATION INC D 1967253 FMV NORTHWEST MEDICAL CENTER ASSOCIATION INC Q 5700000 FMV SHOAL CREEK FAMILY MEDICINE AND ALLERGY INC D 570420 FMV