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HEARTLAND HEALTH CARE PLAN TRUST FUND: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
HEARTLAND HEALTH CARE PLAN TRUST FUND (EIN 43-1286484)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201303199349303250
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-15T09:33:15-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11201 Walnut Suite 1700AddressLine1
CityKansas CityCity
StateMOState
ZIP Code641062246ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN431286484EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Heartland Health Care Plan Trust FundBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% JOHN P WILSONInCareOfName
Name ControlHEARNameControl
Phone8162716611Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line15325 FARAONAddressLine1
Address Line2SuiteAddressLine2
CityST JOSEPHCity
StateMOState
ZIP Code64506ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN P WILSONName
TitleTRUSTEETitle
Phone8162716611Phone
Date Signed2013-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMichael J EngleName
Phone8162216300Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOHN P WILSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line15323 FARAONAddressLine1
CityST JOSEPHCity
StateMOState
ZIP Code64506ZIPCode
FieldValueIRS element (for citing)
Gross Receipts34330929GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1978YearFormation
State Legal DomicileMOStateLegalDomicile
Activity Or Mission DescriptionTHE PLAN OPERATES TO PROVIDE MEDICAL AND DENTAL BENEFITS TO ALL OF ITS MEMBERS.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year32319751ProgramServiceRevenuePriorYear
Program Service Revenue CY34294134ProgramServiceRevenueCY
Investment Income Prior Year17744InvestmentIncomePriorYear
Investment Income Current Year36795InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year32337495TotalRevenuePriorYear
Total Revenue Current Year34330929TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year28505296BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY30161891BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1701961OtherExpensePriorYear
Other Expenses Current Year2066931OtherExpensesCurrentYear
Total Expenses Prior Year30207257TotalExpensesPriorYear
Total Expenses Current Year32228822TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2130238RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2102107RevenuesLessExpensesCY
Total Assets BOY3773844TotalAssetsBOY
Total Assets EOY5894156TotalAssetsEOY
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3773844NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5894156NetAssetsOrFundBalancesEOY
Mission DescriptionTHE PLAN OPERATES TO PROVIDE MEDICAL AND DENTAL BENEFITS TO ALL OF ITS MEMBERS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Grants32288822Grants
DescriptionTHE 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.Description
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJOHN P WILSONNamePerson
Telephone Number8162716611TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15325 FARAONAddressLine1
CityST JOSEPHCity
StateMOState
ZIP Code64506ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (6 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationFormerFormer
CURT KRETZINGER
TRUSTEE1.059.0X0720914109187
JOHN P WILSON
TRUSTEE1.059.0X066748088988
MICHAEL PULIDO
TRUSTEE1.059.0X032186277647
DOUGLAS BRANDT
TRUSTEE1.059.0X026427077509
REBECCA PRESTON MD
TRUSTEE1.059.0X024710159703
MOHAN HINDUPUR MD
TRUSTEE1.059.00100952726331X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3231154TotalReportableCompFrmRltdOrgs
Total Other Compensation439365TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Description Of ServicesDescriptionOfServicesCompensationCompensation
MIDWESTERN HEALTH MANAGEMENT
ANALYSIS & LIAISON312000
AETNA LIFE INSURANCE COMPANY
CONTRACT ADMIN1629120
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTION5251002981252729812527
EMPLOYEE CONTRIBUTION52510044816074481607
FieldValueIRS element (for citing)
Total Program Service Revenue34294134TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column36795TotalRevenueColumn
Exclusion$36,795ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column34330929TotalRevenueColumn
Related Or Exempt Function Income34294134RelatedOrExemptFunctionIncome
Exclusion$36,795ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total30161891Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionADMINISTRATIVE FEESDescription
Total2066931Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total32228822Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2839016BOY
EOY5096119EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2473BOY
EOY2473EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY0BOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY932355BOY
EOY795564EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3773844BOY
EOY5894156EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY3773844BOY
EOY5894156EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3773844BOY
EOY5894156EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3773844BOY
EOY5894156EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses2102107ReconcilationRevenueExpenses
Reconciliation Unrealized Invest18205ReconciliationUnrealizedInvest
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment
Other Land BuildingsOtherLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability
Total Of Amounts0TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt34349134TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments18205NetUnrealizedGainsInvestments
Revenue Not Rptd F99018205RevenueNotRptdF990
Revenue Subtotal34330929RevenueSubtotal
Total Revenue Per Form99034330929TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt32228822TotExpensesEtcAuditedFinclStmt
Expenses Subtotal32228822ExpensesSubtotal
Total Expenses Per Form99032228822TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierUNCERTAIN TAX POSITIONS DISCLOSUREIdentifier
Return ReferenceSCHEDULE D, PART X, LINE 2ReturnReference
ExplanationMANAGEMENT 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.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgs
CURT KRETZINGER
TRUSTEE054439401385700379500100786084010830101
JOHN P WILSON
TRUSTEE05218540124620021006088988000756468
MICHAEL PULIDO
TRUSTEE0257303061680028790566530209940399509
DOUGLAS BRANDT
TRUSTEE02057900351970232830583150191940341779
REBECCA PRESTON MD
TRUSTEE023150201500005990453950143080306804
MOHAN HINDUPUR MD
TRUSTEE093305705574102072901000001633101035858

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
METHODS USED TO ESTABLISH COMPENSATIONSCHEDULE J, PART I, LINE 3COMPENSATION 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 COMMMITTEE
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANSCHEDULE J, PART I, LINE 4BCURT KRETZINGER $ 90,786 JOHN P WILSON $ 78,988 MICHAEL PULIDO $ 46,464 DOUGLAS BRANDT $ 48,459 REBECCA PRESTON, MD $ 37,532
COMPENSATION PAID BY A RELATED ORGANIZATIONFORM 990, PART VII, & SCHEDULE J, PART IIFOR CURT KRETZINGER, JOHN P. WILSON, MICHAEL PULIDO, DOUGLAS BRANDT AND REBECCA PRESTON, 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.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonSEE SCHEDULE L PART VNamePerson

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierTRANSACTIONS WITH INTERESTED PERSONSIdentifier
Return ReferenceSCHEDULE L, PART IVReturnReference
Explanation(A) MIDWESTERN HEALTH MANAGEMENT, INC. (B) JOHN WILSON, CURT KRETZINGER, DOUGLAS BRANDT ARE OFFICERS OF MIDWESTERN HEALTH MANAGEMENT, INC. (C) $312,000 (D) CONTRACT ADMINISTRATOR (E) NOExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
BUSINESS RELATIONSHIPSFORM 990, PART VI, SECTION A, LINE 2CURT KRETZINGER, JOHN WILSON, DOUGLAS BRANDT, MICHAEL PULIDO AND REBECCA PRESTON, MD HAVE A BUSINESS RELATIONSHIP. THEY ARE ALL OFFICERS AND/OR DIRECTORS OF HEARTLAND REGIONAL MEDICAL CENTER, HEARTLAND HEATLH, HEARTLAND FOUNDATION, REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY, LEWIS AND CLARK INFORMATION INTERCHANGE, MIDWESTERN HEALTH MANAGEMENT, INC., HHS PROPERTIES, INC.,OR COMMUNITY HEALTH PLAN INSURANCE COMPANY.
APPOINTMENT OF THE BOARD OF TRUSTEESFORM 990, PART VI, SECTION A, LINE 7AHEARTLAND HEALTH, A RELATED TAX EXEMPT ORGANIZATION, HAS THE POWER TO APPOINT TRUSTEES.
GOVERNANCE DECISIONS SUBJECT TO APPROVALFORM 990, PART VI, SECTION A, LINE 7BHEARTLAND HEALTH'S, A RELATED TAX EXEMPT ORGANIZATION, BOARD OF DIRECTORS HAS THE POWER TO TERMINATE THE TRUST.
REVIEW PROCESS OF FORM 990FORM 990, PART VI, SECTION B, LINE 11BAN INDEPENDENT ACCOUNTING FIRM PREPARES THE RETURN. IT IS THEN REVIEWED BY THE TRUSTEES. AFTER REVISIONS, IF NECESSARY, THE TRUSTEES AGAIN REVIEW THE FINAL RETURN.
CONFLICT OF INTEREST POLICYFORM 990, PART VI, SECTION B, LINE 12CALL TRUSTEES RECEIVE A COPY OF THE CONFLICT OF INTEREST POLICY AND THE APPLICABLE CONFLICT OF INTEREST DISCLOSURE FORM AND QUESTIONNAIRE, WHICH IS COMPLETED TO IDENTIFY ANY RELATIONSHIPS, POSITIONS OR CIRCUMSTANCES WITH RESPECT TO WHICH IT IS BELIEVED A CONFLICT MAY ARISE. EACH TRUSTEE IS ASKED TO DISCLOSE FULLY AND FRANKLY ANY AND ALL ACTUAL OR POTENTIAL CONFLICTS OR DUALITY OF INTEREST OR RESPONSIBILITY, WHETHER PERSONAL, INDIVIDUAL OR BUSINESS, WHICH MAY EXIST OR APPEAR TO EXIST. A DUALITY OF INTEREST BECOMES A CONFLICT OF INTEREST ONLY IF THE DISINTERESTED TRUSTEES DECIDE THAT A CONFLICT OF INTEREST EXISTS BECAUSE THE DUALITY OF INTEREST IS SO SUBSTANTIAL THAT IT COULD COMPROMISE OBJECTIVE DECISION-MAKING OR COULD OTHERWISE BE DETRIMENTAL TO THE EXEMPT STATUS OR FINANCIAL WELL-BEING OF THE PLAN.
GOVERNING DOCUMENTSFORM 990, PART VI, SECTION C, LINE 19THE 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.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
HEARTLAND HEALTH
5325 FARAONST JOSEPHMO64506431283316HEALTH CAREMO501(C)(3)11ANAfalse
HEARTLAND REGIONAL MEDICAL CENTER
5325 FARAONST JOSEPHMO64506440545289HEALTH CAREMO501(C)(3)3HHtrue
HEARTLAND FOUNDATION
5325 FARAONST JOSEPHMO64506431262768COMM BENEFITMO501(C)(3)7HHtrue
HEARTLAND LONG TERM ACUTE CARE HOSPITAL
5325 FARAONST JOSEPHMO64506261972987HEALTH CAREMO501(C)(3)3HHtrue
LEWIS AND CLARK INFORMATION EXCHANGE
5325 FARAON STREETST JOSEPHMO64506320290671MEDICAL DATAMO501(C)(3)9HHtrue
REGIONAL EMERGENCY MEDICAL SERVICES
5325 FARAON STREETST JOESEPHMO64506273923442AMBULANCEMO501(C)(3)7HHtrue

Form990 Schedule R Part IV Form990ScheduleRPartIV (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrg
MIDWESTERN HEALTH MANAGEMENT INC
5325 FARAONST JOSEPHMO64506431264358HEALTH SVCSMOHHC CORPORATIONtrue
COMMUNITY HEALTH PLAN
5325 FARAONST JOSEPHMO64506431690582INSURANCEMOHHC CORPORATIONtrue
COMMUNITY HEALTH PLAN INSURANCE COMPANY
5325 FARAONST JOSEPHMO64506431210152INSURANCEMOHHC CORPORATIONtrue
HHS PROPERTIES INC
5325 FARAONST JOSEPHMO64506431593799PROPERTY MGMTMOHHC CORPORATIONtrue
UPTOWN HOUSING INC
5325 FARAONST JOSEPHMO64506261416252REVITALIZATIOMOHHC CORPORATIONtrue
UPTOWN ST JOSEPH REDEVELOPMENT
5325 FARAONST JOSEPHMO64506201742813REDEVELOPMENTMOHHC CORPORATIONtrue
SHOAL CREEK FAMILY MEDICINE AND ALLERGY
5325 FARAONST JOSEPHMO64506010754265HEALTH SVCSMOHHC CORPORATIONtrue
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
HEARTLAND REGIONAL MEDICAL CENTER
L29298982FMV
HEARTLAND LONG TERM ACUTE CARE HOSPITAL
L513545FMV
HEARTLAND REGIONAL MEDICAL CENTER
M20000000FMV
MIDWESTERN HEALTH MANAGEMENT INC
M312000FMV