2015-05-15T13:53:20-05:00 2014-06-30 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2013-07-01 440545289 HEARTLAND REGIONAL MEDICAL CENTER % JOHN P WILSON HEAR 8162716611 5325 FARAON Suite ST JOSEPH MO 64506 JOHN P WILSON CHIEF FINANCIAL OFFICER 8162716611 2015-05-15 true Michael J Engle P00482834 8162716611 2013 2016-04-25 22:37:26Z MOSAIC LIFE CARE JOHN P WILSON 5325 FARAON ST JOSEPH MO 64506 651903899 false X WWW.MYMOSAICLIFECARE.ORG X 1985 MO TO IMPROVE THE HEALTH OF THE COMMUNITIES LOCATED IN THE REGION & PROVIDE THE RIGHT CARE, AT THE RIGHT TIME, IN THE RIGHT PLACE, AT THE RIGHT COST WITH OUTCOMES SECOND TO NONE. 13 7 4192 472 1358930 -385043 390968 665559 548726273 570328832 18591991 32652613 37268409 22852423 604977641 626499427 1203243 889395 0 0 290835839 304153644 0 0 452608 268127286 276254901 560166368 581297940 44811273 45201487 756242652 802370520 336261843 316398245 419980809 485972275 X To improve the health of individuals and communities located in the 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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 29600528 29600528 29600528 true false true true false false true true true X true X true true false true true 17062925 17062925 0.03200 99944169 85778968 14165201 0.02660 117007094 85778968 31228126 0.05860 9699292 9699292 0.01820 175463 175463 0.00030 987032 67759 919273 0.00170 328422 35951 292471 0.00050 1045990 1045990 0.00200 12236199 103710 12132489 0.02270 129243293 85882678 43360615 0.08130 130367 130367 0.00020 313281 7580 0.00060 247925 247925 0.00050 133748 133748 0.00030 25037 25037 850358 544657 0.00160 false 24906135 4356355 140409375 147253162 -6843787 X true true NONE 1 1 HEARTLAND REGIONAL MEDICAL CENTER 5325 FARAON ST JOSEPH MO 64506 WWW.MYMOSAICLIFECARE.ORG 426-18 X X X PHARMICIST INTERN PROGRAM HEARTLAND REGIONAL MEDICAL CENTER 1 true X X X X X X X X X 12 true false true X WWW.MYMOSAICLIFECARE.ORG X X X X X X X X false false true true 200. true 300. true X X true true X X X true false X X X X true X false false SCHEDULE H, PART V, LINE 3 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), SUCCES SIX/UNITED WAY, AND HEAD START. SCHEDULE H, PART V, LINE 7 IN CONDUCTING THE SURVEY, RESPONDENTS WERE PRESENTED WITH A LIST OF TEN HEALTH ISSUES AND ASKED TO CHOOSE THE TWO BIGGEST HEALTH CHALLENGES IN THE COMMUNITY. OF THE RESPONSES, INTER-RELATED ISSUES OF MENTAL HEALTH/ILLEGAL DRUG USE AND ADULT/CHILD OBESITY/DIABETES MADE UP 64% OF THE RESPONSES. WHILE THE IMPROVEMENT PLAN FOCUSES ON THESE ISSUES, A THIRD NEED IDENTIFIED WILL FOCUS ON EDUCATION ON HEALTH AND HEALTH RESOURCES IN AN EFFORT TO EFFECT CHANGE IN THE REMAINING CHALLENGES OF HEART DISEASE, SMOKING, BREAST CANCER, LUNG CANCER AND DENTAL CARE. THE HOSPITAL IS A FULLY ENGAGED COMMUNITY PARTNER IN ADDRESSING THE HEALTH AND SOCIAL ISSUES IN OUR REGION. IT BELIEVES THAT MAJOR HEALTH PROBLEMS ARE BASED IN HUMAN BEHAVIORS, WHICH IN TURN HAVE THEIR ROOT IN BASIC HUMAN CONDITIONS. THROUGH EDUCATION, THE HOSPITAL BELIEVES THAT IT CAN BEGIN TO RESOLVE SOME OF THE REMAINING ISSUES. SCHEDULE H, PART V, LINE 14G FINANCIAL COUNSELORS CONSULT WITH PATIENTS PRIOR TO DISCHARGE. SCHEDULE H, PART V, LINE 18E FINANCIAL COUNSELORS ARE AVAILABLE ONSITE TO EXPLAIN THE FAP PROCESS AT ANY TIME DURING THE PATIENT'S VISIT. 82 Heartland Clinic 901 Heartland Road Ste 4840 St Joseph MO 64506 Specialty Clinic Heartland Clinic 902 Riverside Road St Joseph MO 64507 Specialty Clinic Heartland Clinic 802 N Riverside Ste 100 St Joseph MO 64507 Specialty Clinic Heartland Clinic 5514 Corporate Dr Ste 150 St Joseph MO 64507 Specialty Clinic Heartland Clinic 5210 North Belt Highway St Joseph MO 64506 Specialty Clinic Heartland Clinic 5301 Faraon Ste 210 St Joseph MO 64506 Specialty Clinic Heartland Clinic 105 Far West Drive Ste 100 St Joseph MO 64506 Specialty Clinic Heartland Clinic 5514 Corporate Dr Ste 120 St Joseph MO 64506 Specialty Clinic Heartland Clinic 1115 N Belt Highway St Joseph MO 64506 Urgent Care Spa at Briarcliff 4133 North Mulberry Dr Kansas City MO 64116 Spa Heartland Clinic 2703 Running Horse Rd Platte City MO 64079 Specialty Clinic Heartland Clinic 3715 Beck Road St Joseph MO 64506 Internal Medicine Heartland Clinic 401 Illinois St Joseph MO 64504 Occupational Medicine Advanced Diagnostic Imaging 3620 Frederick Ave St Joseph MO 64506 Imaging Heartland Clinic 1314 N 36th St St Joseph MO 64506 Specialty Heartland Clinic 105 Far West Drive Ste 201 St Joseph MO 64506 Specialty Heartland Clinic 4201 North Belt Highway St Joseph MO 64506 Specialty Clinic Heartland Clinic 215 S Walnut St Cameron MO 64429 Family Practice Heartland Clinic 207 So Main Troy KS 66087 Family Practice Heartland Outpatient Therapy-Midwest 3107 Frederick 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 Specialty Heartland Clinic 300 Utah Hiawatha KS 66434 Family Practice Hands of Hope Hospice 307 Pineview Street Stanberry MO 64489 Hospice Services Heartland Clinic 711 N 36th St St Joseph MO 64506 Specialy Clinic Heartland Clinic 1015 West Fourth Cameron MO 64429 Specialy Clinic Heartland Clinic 2024 S Main Maryville MO 64424 Specialy Clinic Heartland Clinic 2600 Miller Bethany MO 64424 Specialy Clinic Heartland Clinic 2812 St Joseph Ave St Joseph MO 64505 Specialy Clinic Heartland Clinic 3007 N Belt Highway St Joseph MO 64506 Outpatient Therapy Heartland Clinic 5302 Faraon St Joseph MO 64506 Specialty Clinic Heartland Clinic 705 N College Albany MO 64402 Specialty Clinic Heartland Clinic 100 Central St Chillicothe MO 64601 Specialty Clinic Heartland Clinic 5204 North Belt Highway St Joseph MO 64506 Specialty Clinic Heartland Clinic 8860 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 Heartland Clinic 137 N Belt Highway St Joseph MO 64506 Specialty CAH AMBULATORY SURGERY Heartland Clinic 1600 East Evergreen Cameron MO 64429 Specialty Heartland Clinic 1600 East Evergreen Ste B Cameron MO 64429 Specialty Heartland Clinic 2016 S Main Street Maryville MO 64468 Specialty Heartland Clinic 2703 Running Horse Rd Platte City MO 64079 Specialty Heartland Outpatient Therapy-Platte 2703 Running Horse Rd SteB Platte City MO 64079 Outpatient Therapy Heartland Clinic 3007 N Belt Highway St Joseph MO 64506 Specialty Heartland Hearing Services 3620 Frederick Ave St Joseph MO 64506 Hearing Services Heartland Clinic 5301 Faraon Ste 210B St Joseph MO 64506 Specialty Clinic Heartland Wound Center 5301 Faraon Ste 250 St Joseph MO 64506 Wound Care Heartland Clinic 5301 Faraon Ste 160 St Joseph MO 64506 Specialty Heartland Clinic 5301 Faraon Ste 220 St Joseph MO 64506 Specialty Heartland Clinic 711 N 36th St Ste A St Joseph MO 64506 Specialty Heartland Clinic 802 N Riverside Ste 130 St Joseph MO 64507 Specialty Heartland Clinic 802 N Riverside Ste 150 St Joseph MO 64507 Specialty Heartland Clinic 802 N Riverside Ste 150 St Joseph MO 64507 Specialty Heartland Clinic 802 N Riverside Ste 150 St Joseph MO 64507 Specialty Heartland Clinic 802 N Riverside Ste 160 St Joseph MO 64507 Specialty Heartland Clinic 802 N Riverside Ste 190 St Joseph MO 64507 Specialty Heartland Clinic 802 N Riverside Ste 200 St Joseph MO 64507 Specialty Heartland Clinic 802 N Riverside Ste 210 St Joseph MO 64507 Specialty Heartland Clinic 802 N Riverside Ste 220 St Joseph MO 64507 Specialty Heartland Clinic 802 N Riverside Ste 225 St Joseph MO 64507 Specialty Heartland Clinic 802 N Riverside Ste G50 St Joseph MO 64507 Specialty Heartland Clinic 802 N Riverside Ste G60 St Joseph MO 64507 Specialty Heartland Clinic 802 N Riverside Ste G70 St Joseph MO 64507 Specialty Heartland Clinic 802 N Riverside Suite 100 St Joseph MO 64507 Specialty Heartland Clinic 802 N Riverside Suite 140 St Joseph MO 64507 Specialty Heartland Clinic 802 N Riverside Suite 220 St Joseph MO 64507 Specialty Diabetes Center 901 Heartland Road St Joseph MO 64506 Outpatient Services Heartland Clinic 901 Heartland Road Ste 4810 St Joseph MO 64506 Specialty Heartland Clinic 901 Heartland Road Ste 2800 St Joseph MO 64506 Specialty Weight Management Center 901 Heartland Road Suite 1810 St Joseph MO 64506 Weight Management Center Heartland Clinic 902 N Riverside Ste 200 St Joseph MO 64506 Specialty Heartland Clinic 901 Heartland Road Suite 3800 St Joseph MO 64506 Specialty Cancer Center 902 N Riverside St Joseph MO 64507 Cancer Center Heartland Clinic 902 N Riverside Rd Lower Level St Joseph MO 64507 Specialty Heartland Clinic 8020 Raven Hill Drive Ste 103 Atchison KS 66002 Specialty Heartland Clinic 8020 Raven Hill Drive Ste 109 Atchison KS 66002 Specialty Heartland Clinic 9784 N Ash Avenue Kansas City MO 64157 Specialty Heartland Clinic 6301 N Lucerne Kansas City MO 64151 Family, Specialty, Imaging, Ambulatory Surgery 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 $48,616,311 SUBTRACTED FOR THE PURPOSE OF CALCULATING THE PERCENTAGE. SCHEDULE H, PART I, LINE 7G DENTAL CLINIC $ 2,740 UROLOGY CLINIC 101,451 ------------ $ 104,191 ============ 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 8 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 THE ORGANIZATION HAS ESTABLISHED STANDARDS LD6014 (PFS-COLLECTION GUIDELINES FOR MEDICAL CENTER), LD6503 (PFS OFFICE-PAYMENT ARRANGEMENTS: AFM AND PFM) AND LD6465 (MEDICAL CENTER, HEARTLAND PARAMEDICS, HEARTLAND CLINIC AND LONG TERM ACUTE CARE HOSPITAL FINANCIAL ASSISTANCE) WHICH GOVERN COLLECTION PRACTICES FOR ALL TYPES OF PAYERS FROM THE CREATION OF THE PATIENT'S ACCOUNT DURING REGISTRATION TO THE FINAL ARRANGEMENTS NECESSARY TO BRING THE BALANCE TO ZERO. SCHEDULE H, PART VI, LINE 2 A COMMUNITY SURVEY WAS CONDUCTED TO DETERMINE THE HEALTH NEED PRIORITIES, ACCORDING TO THE OPINION OF INDIVIDUALS IN THE ORGANIZATION'S SERVICE AREA. THE 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. BY COMBINING THE DATA FROM THE COMMUNITY SURVEY, ADDING EXTERNAL DATA FROM PRE-ESTABLISHED REPUTABLE SOURCES AND THE RESULTS FROM THE SIX COMMUNITY FOCUS GROUPS, THE TOP THREE COMMUNITY HEALTH NEEDS WERE DETERMINED: MENTAL HEALTH SERVICES; ADULT AND CHILDHOOD OBESITY; AND, EDUCATION ON HEALTH AND HEALTH RESOURCES. THE ORGANIZATION HAS DEVELOPED A THREE-YEAR ACTION PLAN TO ADDRESS THESE ISSUES. THE IMPLEMENTATION STRATEGY CAN BE FOUND AT: https://www.mymosaiclifecare.org/General/Community-Health-Needs-Assessment /St-Joseph-CHNA/ OUR PROGRESS WITHIN THE FIRST YEAR OF THE PROCESS IS TO BETTER ALIGN OUR CHARITABLE GIVING WITH PROGRAMS THAT SUPPORT COMMUNITY HEALTH SERVICES, COMMUNITY HEALTH NEEDS AND COMMUNITY BUILDING. WE HAVE MET WITH COMMUNITY AGENCIES WHO ARE INVOLVED WITH MENTAL HEALTH SERVICES, TO DISCUSS COLLABORATION. WE HAVE CONTINUED THE POUND PLUNGE ADULT WEIGHT LOSS PROGRAM AND THE 4TH GRADE CHALLENGE CHILD FITNESS PROGRAM AND HAVE PLANS TO EXPAND THE 4TH GRADE CHALLENGE TO PRIVATE SCHOOLS AND OTHER REGIONAL AREA SCHOOLS. WE HAVE ENCOURAGED MOSAIC CAREGIVERS TO REGISTER WITH THE LIVE WELL CREW IN ORDER TO VOLUNTEER THEIR TIME TO ASSIST WITH THE 4TH GRADE CHALLENGE AND THE POUND PLUNGE ACTIVITIES. WE HAVE BEGUN PLANS FOR A COMMUNITY COALITION TO ADDRESS THE ISSUE OF CHILDHOOD OBESITY. WE HAVE COMPILED A COMPREHENSIVE WEB-BASED INFORMATION CALENDAR FOR EASY REFERENCE AND PLANNING OF ALL HEALTH EDUCATION OPPORTUNITIES IN OUR AREA. 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 61.2% MEDICARE AND MEDICAID, 32.2% COMMERCIAL AND 6.6% 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 NINE YEARS, THE ORGANIZATION HAS SPONSORED THE POUND PLUNGE, A THREE-MONTH LONG EVENT TO ENCOURAGE WEIGHT LOSS, EXERCISE AND HEALTHY EATING. MORE THAN 15,000 PEOPLE HAVE PARTICIPATED AND OVER 103,000 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, THE PROGRAM HAS BEEN EXPANDED TO 10 ADDITIONAL SCHOOLS, AND NOW INCLUDES SCHOOL GARDENS AND HEALTHY COOKING CLASSES AT SIX TITLE ONE SCHOOLS. THE PROGRAM COMPLETED ITS SIXTH YEAR IN APRIL, 2014. 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, A MEDICAL TRANSPORT PROVIDER, 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 MEDICAL TRANSPORT PROVIDER IS THE SOLE AMBULANCE PROVIDER IN THE COUNTY, NOT SUPPORTED BY ANY ALTERNATIVE GOVERNMENT FUNDING. 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) 242000 SUPPORT HEARTLAND FOUNDATION 5325 FARAON ST JOSEPH MO 64506 431262768 501(C)(3) 543260 SUPPORT COMMUNITY ALLIANCE 3033 FREDERICK ST JOSEPH MO 64506 440419460 501(C)(6) 35100 SUPPORT MO W STATE UNIV FOUNDATI 5425 DOWNS DRIVE ST JOSEPH MO 64507 237035423 501(C)(3) 23696 SUPPORT MHA CENTER FOR EDUCATION PO BOX 60 JEFFERSON CITY MO 65102 430898947 501(C)(3) 78110 SUPPORT AMERICAN HEART ASSOCIATION 6800 W 93RD STREET OVERLAND PARK KS 66212 135613797 501(C)(3) 20000 SUPPORT ALLIED ARTS COUNCIL 118 S EIGHTH ST JOSEPH MO 64501 430810827 501(C)(3) 8500 SUPPORT PONY EXPRESS BASEBALL INC PO BOX 1588 ST JOSEPH MO 64502 274437372 501(C)(3) 9000 SUPPORT ROBIDOUX RESIDENT THEATER 124 S 8TH ST JOSEPH MO 64501 431257970 501(C)(3) 11000 SUPPORT SECOND HARVEST COMMUNITY FOOD BANK 915 DOUGLAS ST JOSEPH MO 64505 431268319 501(C)(3) 65500 SUPPORT SMITHVILLE SCHOOL DISTRICT 655 S COMMERCIAL AVE SMITHVILLE MO 64089 431906203 GOVERNMENT 5300 SUPPORT ST JOSEPH AREA CHAMBER OF COMMERCE 3003 FREDERICK AVENUE ST JOSEPH MO 64506 440419460 501(C)(6) 34925 SUPPORT FRIENDS OF THE PARK 1920 GRAND AVE ST JOSEPH MO 64505 208175921 501(C)(3) 5888 SUPPORT YOUNG WOMEN'S CHRISTIAN ASSOCIATION 3014 NORTH 8TH STREET ST JOSEPH MO 64501 440552219 501(C)(3) 5850 SUPPORT NORTHLAND REGIONAL CHAMBER OF COMMERCE 634 NW ENGLEWOOD ROAD ST JOSEPH MO 64118 431279100 501(C)(6) 7100 SUPPORT PLATTE COUNTY ECONOMIC DEVELOPMENT COUNCIL 11724 NW PLAZA CIRCLE STE 400 KANSAS CITY MO 64153 431484127 501(C)(3) 6000 SUPPORT 13 3 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 MARK LANEY MD DIRECTOR,CEO 693111 0 380000 0 49128 0 10200 0 22850 0 1155289 0 0 0 DR JOHN OLSON DIRECTOR/STAFF PHYSICIAN 569248 0 95081 0 4246 0 10200 0 23762 0 702537 0 0 0 CURT KRETZINGER OFFICER 431424 0 135078 0 39680 0 67580 0 10270 0 684032 0 0 0 JOHN P WILSON OFFICER 412989 0 122778 0 20435 0 53615 0 0 0 609817 0 0 0 MICHAEL PULIDO OFFICER 277066 0 69328 0 7680 0 61841 0 25042 0 440957 0 0 0 DR JOE BOYCE OFFICER 330676 0 89988 0 4705 0 61287 0 17120 0 503776 0 0 0 LISA MICHAELIS OFFICER 280485 0 60000 0 26269 0 41505 0 14609 0 422868 0 0 0 SCOTT KOELLIKER ADMINISTRATOR 273803 0 60116 0 3023 0 71004 0 25367 0 433313 0 0 0 CAROLYN PADEN ASSIST ADMINISTRATOR, SURGICAL 191807 0 21344 0 6449 0 0 0 16309 0 235909 0 0 0 DR DAVIN TURNER ADMINISTRATOR,STAFF PHYSICIAN 324400 0 117067 0 1970 0 52632 0 22542 0 518611 0 0 0 DR ROBERT GRANT STAFF PHYSICIAN 850933 0 18959 0 1970 0 10200 0 25367 0 907429 0 0 0 DR MOHAN HINDUPUR STAFF PHYSICIAN 934444 0 7033 0 23691 0 10200 0 17120 0 992488 0 0 0 DR ROBERT JOHNSON STAFF PHYSICIAN 751431 0 153698 0 20116 0 10200 0 15207 0 950652 0 0 0 DR JOHN BARCLAY STAFF PHYSICIAN 400054 0 463693 0 1391 0 12758 0 7406 0 885302 0 0 0 DR HEMANT SHETH STAFF PHYSICIAN 924793 0 109567 0 21788 0 10200 0 17120 0 1083468 0 0 0 DR MAUREEN BOYLE MANGANARO STAFF PHYSICIAN 411494 0 63670 0 19470 0 10200 0 23167 0 528001 0 0 0 DR ED KAMMERER STAFF PHYSICIAN 238601 0 210072 0 1513 0 10200 0 25042 0 485428 0 0 0 DR MICHAEL NELLESTEIN STAFF PHYSICIAN 432102 0 3325 0 18017 0 10200 0 24867 0 488511 0 0 0 DR DAVID CATHCART STAFF PHYSICIAN 97091 0 0 0 1424 0 4059 0 3917 0 106491 0 0 0 SCHEDULE J, PART I, LINE 1A Travel for companions may be paid initially but is then reimbursed after the event. SCHEDULE J, PART I, LINE 4B ACCRUED 6/30/2014 ---------- CURT KRETZINGER 57,380 JOHN P. WILSON 43,415 JOE BOYCE, M.D. 51,034 SCOTT KOELLIKER 60,232 DAVIN TURNER, DO 42,432 MICHAEL PULIDO 51,180 LISA MICHAELIS 31,790 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 79075LAA5 2003-05-22 32225000 REFUND 2001C BONDS ISSUED 11/29/01 false false false B SEE PART VI 431203910 79075LAB3 2009-02-26 70000000 SEE PART VI false false false C SEE PART VI 431203910 79075LAD9 2011-09-30 25250000 SEE PART VI false false false D SEE PART VI 431178966 60637ACP5 2012-10-03 51489534 SEE PART VI false false false A 30825000 0 32225000 0 0 0 0 0 0 0 32225000 0 1993 true false true true B 770000 0 70956418 0 0 0 0 0 0 70956418 0 0 2014 false false true true C 5190000 0 25250000 0 0 0 0 0 0 0 25250000 0 2005 true false true true D 0 0 51535780 0 0 0 708053 0 0 50827727 1 0 2014 false false false true A 0 true B false false false false 0 false false false true C 0 true D 0 true A false true false true SEE PART VI 11.5 true false false 0 false true B false true true false 0 false 0 false true C false true false false 0 false 0 false true D false true false false 0 false 0 false true A true B true C true D true SCHEDULE K, PART I, COLUMN A, LINE A, LINE B, AND LINE C THE INDUSTRIAL DEVELOPMENT AUTHORITY OF ST. JOSEPH, MISSOURI SCHEDULE K, PART I, COLUMN A, LINE D HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI SCHEDULE K, PART I, COLUMN F, LINE B Finance the construction and equipping of certain healthcare facilities. SCHEDULE K, PART I, COLUMN F, LINE C 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 D To acquire, construct, remodel, renovate and equip certain healthcare facilities. SCHEDULE K, PART II, COLUMN B, LINE 3 Amount does not equal to issue price listed in Part I, Column (e) due to investment earnings. SCHEDULE K, PART II, COLUMN D, LINE 3 Amount does not equal to issue price listed in Part I, Column (e) due to investment earnings. SCHEDULE K, PART II, COLUMN D, LINE 16 The organization is currently in the process of preparing a final written allocation for the 2012 Bonds. SCHEDULE K, PART III, COLUMN D 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 prepared as of 5/22/2008 and Form 8038-T was filed in connection. The most recent Arbitrage Rebate Analysis was prepared as of 3/1/2012 and Form 8038-R was filed. SCHEDULE K, PART IV, COLUMN A, LINE 4B Salomon Brothers Holding Company Inc./Wells Fargo SCHEDULE K, PART IV, COLUMN B, LINE 2C The Arbitrage Rebate Analysis was performed as of 2/1/2014. SCHEDULE K, PART IV, COLUMN B, 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) $ 122,349 (D) SALARY 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) $ 29,649 (D) SALARY 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) $ 107,571 (D) SALARY 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) $ 70,741 (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) $ 120,369 (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) $ 18,690 (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) $ 27,649 (D) SALARY FOR THERAPY DEPARTMENT SERVICES (E) NO (A) RADIOLOGY SPECIALISTS OF ST. JOSEPH, PC (B) DR. CHRIS LOONEY IS THE VICE PRESIDENT OF RADIOLOGY SPECIALISTS OF ST. JOSEPH, PC AND A DIRECTOR OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $180,729 (D) RADIOLOGY INTERPRETATION SERVICES (E) NO (A) US BANK (B) DAN HECKMAN IS AN OFFICER OF US BANK AND A DIRECTOR OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $452,763 (D) INVESTMENT MANAGEMENT FEES FOR US BANK (E) NO (A) MIDWESTERN HEALTH MANAGEMENT, INC. (B) DR. MARK LANEY, CURT KRETZINGER, AND JOHN WILSON ARE OFFICERS AND/OR DIRECTORS OF MIDWESTERN HEALTH MANAGMENT, INC. AND ARE OFFICERS OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $15,804, $312,000, $1,000,000 (D) PURCHASE OF ASSETS, PERFORMANCE OF SERVICES, REIMBURSEMENT OF EXPENSES (E) NO (A) HHS PROPERTIES, INC. (B) DR. MARK LANEY, CURT KRETZINGER, AND JOHN WILSON ARE OFFICERS AND/OR DIRECTORS OF HHS PROPERTIES, INC. AND ARE OFFICERS OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $249,709 (D) LEASE OF FACILITIES (E) NO FORM 990, PART III, LINE 2 ACO: Mosaic Life Care recently became 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. By providing exceptional health care at lower costs Mosaic believes that entering into the ACO model furthers it's tax exempt mission. The ACO's that Mosaic is a part of have certain quality metrics as well as expense reduction targets that must be met. Mosaic has agreed to participate in a Medicare Shared Savings ACO and work closely with the other doctors and health-care providers to coordinate care for Medicare beneficiaries who have traditional Medicare. Beneficiaries benefit because their doctors will be part of a team that focuses on the coordination and quality of their medical care. Mosaic has recently agreed to participate in an ACO with Blue Cross Blue Shield of Kansas City (BCBSKC). Partnering with BCBSKC is bringing the coordination care to commercial beneficiaries to lower costs and improve the quality of their medical care. Mosaic has received reporting from both ACO's for the first program year with positive trending in both lower costs and higher quality. Other Program Services: Mosaic recently received 340b designation from HRSA (Federal government). This allows the hospital 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 III, LINE 4A HEARTLAND REGIONAL MEDICAL CENTER IS 352-BED MEDICAL SURGICAL HOSPITAL LOCATED IN ST JOSEPH, MISSOURI. IT SERVES A COMMUNITY OF 70,000 RESIDENTS. BECAUSE ST JOSEPH IS A BORDER TOWN, 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 HOSPITAL OF 61.2% GOVERNMENTAL, 32.2% COMMERCIAL AND 6.6% 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 17,000 PATIENTS WERE ADMITTED TO THE HOSPITAL RESULTING IN APPROXIMATELY 72,000 PATIENT DAYS. A TOTAL OF APPROXIMATELY 11,000 SURGERIES WERE PERFORMED, THE EMERGENCY ROOM SERVED APPROXIMATELY 55,000 PATIENTS AND APPROXIMATELY 160,000 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 160 PHYSICIANS 75 NURSE PRACTITIONERS/PHYSICIAN EXTENDERS COVERING APPROXIMATELY 80 FAMILY MEDICINE AND SPECIALTY CLINICS AT 50 LOCATIONS THROUGHOUT THE REGION RESULTING IN APPROXIMATELY 740,000 PATIENT VISITS DURING THE YEAR. FORM 990, PART VI, SECTION A, LINE 2 ALL BOARD MEMBERS ALSO SERVE ON THE BOARD OF THE SOLE MEMBER, HEARTLAND HEALTH. CAROL ROEVER, JOHN P. WILSON, CURT KRETZINGER, HAVE A BUSINESS RELATIONSHIP. THEY ARE EITHER OFFICERS AND/OR DIRECTORS OF REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY, A RELATED NOT-FOR-PROFIT CORPORATION. CURT KRETZINGER AND JOHN P. WILSON HAVE A BUSINESS RELATIONSHIP. THEY ARE EITHER A DIRECTOR OR OFFICER OF HEARTLAND LONG TERM ACUTE CARE HOSPITAL, A RELATED NOT-FOR-PROFIT CORPORATION. JOHN P. WILSON, CURT KRETZINGER, MARK LANEY, M.D., SCOTT KOELLIKER, LISA MICHAELIS HAVE A BUSINESS RELATIONSHIP. THEY ARE EITHER OFFICERS AND/OR DIRECTORS OF MIDWESTERN HEALTH MANAGMENT, INC., COMMUNITY HEALTH PLAN INSURANCE COMPANY, HHS PROPERTIES, INC., UPTOWN HOUSING, 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 A, LINE 11B AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE FORM 990 WITH INFORMATION PROVIDED FROM THE ORGANIZATIONS ACCOUNTING STAFF. THE INDEPENDENT ACCOUNTING FIRM REVIEWS A DRAFT OF THE FORM 990 WITH THE INTERNAL TAX DEPARTMENT AND CONTROLLER OF HEARTLAND REGIONAL MEDICAL CENTER. THE DRAFT FORM 990 IS REVISED FOR ANY CORRECTIONS OR CLARIFICATIONS BASED ON THE REVIEW WITH THE TAX DEPARTMENT AND THE CONTROLLER. 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 BOARD VIA EMAIL 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 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 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, THE OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO SIGN A CODE OF CONDUCT DOCUMENT IN WHICH THEY AGREE TO ETHICAL BEHAVIOR AND ADHERING TO CONFIDENTIALITY POLICIES. THEY ALSO RECIEVE A QUESTIONNAIRE WHICH FACILITATES THE DISCLOSURE OF ANY 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 IS CURRENTLY BEING DRAFTED 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 $ (1,162,788) CHANGE IN FAIR VALUE OF CASH FLOW HEDGING DERIVATES 1,032,965 CHANGE IN PENS. 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