STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

LEWIS AND CLARK INFORMATION EXCHANGE: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
LEWIS AND CLARK INFORMATION EXCHANGE (EIN 32-0290671)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-15
IRS object ID
201331359349305833
Schema version
2011v1.5
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)
Timestamp2013-05-15T13:22:47-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

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 Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN320290671EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LEWIS AND CLARK INFORMATION EXCHANGEBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% JOHN P WILSONInCareOfName
Name ControlLEWINameControl
Phone8162716611Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line15325 FARAON STREETAddressLine1
CityST JOSEPHCity
StateMOState
ZIP Code64506ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN P WILSONName
TitleCHIEF FINANCIAL OFFICERTitle
Date Signed2013-05-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMichael J EngleName
Phone8162216300Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOE BOYCE MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line15325 FARAON STREETAddressLine1
CityST JOSEPHCity
StateMOState
ZIP Code64506ZIPCode
FieldValueIRS element (for citing)
Gross Receipts196352GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HEARTLAND-HEALTH.COMWebSite
Year Formation2009YearFormation
State Legal DomicileMOStateLegalDomicile
Activity Or Mission DescriptionCOORDINATION OF HEALTH INFORMATION SHARING FOR BETTER UNDERSTANDING OF THE PATIENT'S MEDICAL HISTORY.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers8TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year359949ProgramServiceRevenuePriorYear
Program Service Revenue CY196352ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year359949TotalRevenuePriorYear
Total Revenue Current Year196352TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year466655SalariesEtcPriorYear
Salaries Etc Current Year537347SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year230613OtherExpensePriorYear
Other Expenses Current Year302082OtherExpensesCurrentYear
Total Expenses Prior Year697268TotalExpensesPriorYear
Total Expenses Current Year839429TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-337319RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-643077RevenuesLessExpensesCY
Total Assets BOY25701TotalAssetsBOY
Total Assets EOY1717TotalAssetsEOY
Total Liabilities BOY344558TotalLiabilitiesBOY
Total Liabilities EOY963651TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-318857NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-961934NetAssetsOrFundBalancesEOY
Mission DescriptionCOORDINATION OF HEALTH INFORMATION SHARING FOR BETTER UNDERSTANDING OF THE PATIENT'S MEDICAL HISTORY.MissionDescription
Expense781496Expense
Grants0Grants
Revenue196352Revenue
DescriptionCOORDINATION OF HEALTH INFORMATION SHARING FOR BETTER UNDERSTANDING OF THE PATIENT'S MEDICAL HISTORY.Description
Total Program Service Expense781496TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
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 LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
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
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
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
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
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 CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
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 FARAON STREETAddressLine1
CityST JOSEPHCity
StateMOState
ZIP Code64506ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationFormerFormer
DIRCK CLARK
DIRECTOR/OFFICER1.0XX029913760215
LINDA BAHRKE
DIRECTOR1.0X027197664679
BEN ERNST
DIRECTOR1.0X000
JOE BOYCE MD
DIRECTOR/PRESIDENT/COO1.0XX037201671142
BRIAN BRADLEY
DIRECTOR1.0X000
JON DOOLITTLE
DIRECTOR1.0X000
LAURA FITZMAURICE MD
DIRECTOR1.0X000
DEBE GASH
DIRECTOR1.0X000
HAROLD JOHNSON
DIRECTOR1.0X000
CLAY PATTERSON
DIRECTOR1.0X000
MARLA TOBIN MD
DIRECTOR1.0X000
SAM TURNER
DIRECTOR1.0X000
JOHN P WILSON
SEC'Y/TREAS/CFO1.0X054043585973
DOUGLAS BRANDT
ASSISTANT TREASURER1.0X027440074175
KAREN DITTEMORE
ASSISTANT SECRETARY1.0X06494212228
JEFFREY BLOEMKER
EXECUTIVE DIRECTOR60.0X136390024238
HELEN THOMPSON
FORMER OFFICER024455820325X
FieldValueIRS element (for citing)
Total Reportable Comp From Org136390TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2067464TotalReportableCompFrmRltdOrgs
Total Other Compensation412975TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

FieldValueIRS element (for citing)
Name PersonCERNER CORPORATIONNamePerson
FieldValueIRS element (for citing)
Address Of ContractorAddressOfContractor
Description Of ServicesSOFTWARE SYSTEMSDescriptionOfServices
Compensation120493Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REVENUEDescription
Total Revenue Column196352TotalRevenueColumn
Related Or Exempt Function Income196352RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue196352TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

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 Column196352TotalRevenueColumn
Related Or Exempt Function Income196352RelatedOrExemptFunctionIncome

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)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total164591Total
Program Services164591ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total286346Total
Program Services258310ProgramServices
Management And General28036ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1256Total
Program Services1256ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total54649Total
Program Services46682ProgramServices
Management And General7967ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total30505Total
Program Services25468ProgramServices
Management And General5037ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total22241Total
Program Services22241ProgramServices

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)
Total206590Total
Program Services190297ProgramServices
Management And General16293ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total359Total
Program Services359ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total22259Total
Program Services22259ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total35299Total
Program Services35299ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total8990Total
Program Services8990ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total3344Total
Program Services3344ProgramServices

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)
DescriptionOTHERDescription
Total3000Total
Program Services2400ProgramServices
Management And General600ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total839429Total
Program Services781496ProgramServices
Management And General57933ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY25701BOY
EOY1717EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

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)
BOY0BOY
EOY0EOY

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)
BOY25701BOY
EOY1717EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY34964BOY
EOY49972EOY

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)
BOY309594BOY
EOY913679EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY344558BOY
EOY963651EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-318857BOY
EOY-961934EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-318857BOY
EOY-961934EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY25701BOY
EOY1717EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-643077ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years327213CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year359949CurrentTaxYearMinus1Year
Current Tax Year196352CurrentTaxYear
Total883514Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years327213CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year359949CurrentTaxYearMinus1Year
Current Tax Year196352CurrentTaxYear
Total883514Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years317213CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year337239CurrentTaxYearMinus1Year
Current Tax Year170452CurrentTaxYear
Total824904Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years317213CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year337239CurrentTaxYearMinus1Year
Current Tax Year170452CurrentTaxYear
Total824904Total
FieldValueIRS element (for citing)
Public Support Total50958610PublicSupportTotal509

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years327213CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year359949CurrentTaxYearMinus1Year
Current Tax Year196352CurrentTaxYear
Total883514Total
FieldValueIRS element (for citing)
First5 Years509XFirst5Years509

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment
Other Land BuildingsOtherLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO AFFILIATEDescription
Amount$913,679Amount
FieldValueIRS element (for citing)
Total Of Amounts913679TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

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 PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base 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 OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
HELEN THOMPSON
0868460001577120000024455800
JOHN P WILSON
039993401201010204000850270946062640800
DIRCK CLARK
0228305050639020193042276017939035935200
DOUGLAS BRANDT
0203433047154023813056140018035034857500
LINDA BAHRKE
0214722045863011391044898019781033665500
JOE BOYCE MD
029517807381303025056558014584044315800
JEFFREY BLOEMKER
1198800157390771045130197250160628000

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
COMPENSATION FROM RELATED ORGANZATIONSCHEDULE J, PART I, LINE 3THE COMPENSATION PROVIDED BY HEARTLAND REGIONAL MEDICAL CENTER FOR JOHN P. WILSON, DIRCK CLARK, HELEN THOMPSON, DOUGLAS BRANDT, KAREN DITTEMORE, AND JOE BOYCE, MD, IS 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, THESE AMOUNTS MAY NEVER BE PAID. TO ESTABLISH COMPENSATION HEARTLAND USED A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD.
SEVERENCE PAYMENT OR CHANGE-OF-CONTROL PAYMENTSCHEDULE J, PART I, LINE 4AHELEN THOMPSON $157,712
SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANSCHEDULE J, PART I, LINE 4BACCRUED 6/30/12 --------------- JOHN WILSON 75,227 DOUGLAS BRANDT 46,152 DIRCK CLARK 32,467 JOE BOYCE, MD 46,178 LINDA BAHRKE 34,626 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 AGREEMENT NULL AND VOID
COMPENSATION OF CHIEF OPERATING OFFICERFORM 990, PART VII & SCHEDULE J, PART IIHelen Thompson was employed as CIO for Heartland Regional Medical Center and terminated in January 2011. Her severance package included compensation through June 2012. As a part of her duties as CIO, she also served as Director and CEO of LACIE; no additional compensation was earned.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (15 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
GOVERNING BODY AND MANAGEMENTFORM 990, PART VI, SECTION A, LINE 1BDr Joe Boyce, Dirck Clark are both employees of Heartland Regional Medical Center, a related corporation and Linda Bahrke is an employee of Midwestern Health Management, Inc., a related corporation.
BUSINESS RELATIONSHIPFORM 990, PART VI, SECTION A, LINE 2JOHN P. WILSON, DOUG BRANDT, DIRCK CLARK, KAREN DITTEMORE, JOE BOYCE, MD ARE ALL EMPLOYEES OF AN AFFILIATE, HEARTLAND REGIONAL MEDICAL CENTER. LINDA BAHRKE IS AN EMPLOYEE OF AN AFFILIATE, MIDWESTERN HEALTH MANAGEMENT, INC.
MEMBERS OR STOCKHOLDERSFORM 990, PART VI, SECTION A, LINE 6HEARTLAND HEALTH, A MISSOURI NONPROFIT CORPORATION, IS THE SOLE MEMBER OF LEWIS AND CLARK INFORMATION EXCHANGE. HEARTLAND HEALTH HAS THE RIGHT TO ELECT THE BOARD OF TRUSTEES OF LEWIS AND CLARK INFORMATION EXCHANGE. HEARTLAND HEALTH IS NOT ENTITLED TO RECEIVE A SHARE OF LEWIS AND CLARK INFORMATION EXCHANGE'S PROFITS, EXCESS DUES, OR ASSETS UPON DISSOLUTION.
MEMBERS OR STOCKHOLDERS MAY ELECT GOVERNING BODYFORM 990, PART VI, SECTION A, LINE 7AHEARTLAND HEALTH BEING THE SOLE MEMBER OF LEWIS AND CLARK INFORMATION EXCHANGE HAS THE RIGHT TO ELECT ALL THE BOARD OF TRUSTEES.
GOVERNING BOARD DECISIONS SUBJECT TO APPROVAL OF MEMBERS OR STOCKHOLDERSFORM 990, PART VI, SECTION A, LINE 7BTHE CORPORATE BYLAWS OF LEWIS AND CLARK INFORMATION EXCHANGE IDENTIFY CERTAIN RIGHTS AND POWERS WHICH ARE RESERVED TO HEARTLAND HEALTH, THE SOLE MEMBER. IN EACH INSTANCE, THE RIGHTS AND POWERS RESERVED TO THE SOLE MEMBER MAY BE SUMMARIZED AS FOLLOWS: A. OVERALL STRATEGIC DIRECTION B. ELECTION OF BOARD MEMBERS C. APPOINTMENT OF THE PRESIDENT, OTHER SENIOR OFFICERS, AUDITORS, AND LEGAL COUNSEL D. ESTABLISHMENT OF BANKING RELATIONSHIPS E. MANAGEMENT OF CASH AND OTHER ASSETS F. APPROVAL OF CHANGES TO THE ARTICLES OF INCORPORATION AND BYLAWS G. LONG-RANGE PLANNING H. ADOPTION OF ANNUAL OPERATING BUDGETS
FORM 990 REVIEW PROCESSFORM 990, PART VI, SECTION A, LINE 11BRETURNS ARE PREPARED BY AN INDEPENDENT ACCOUNTING FIRM, REVIEWED BY THE TREASURER AND ASSISTANT TREASURER AND THEN POSTED TO A WEBSITE FOR REVIEW BY DIRECTORS PRIOR TO FILING.
MONITORING OF CONFLICT OF INTEREST POLICYFORM 990, PART VI, SECTION B, LINE 12CUPON 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. ALL DISMISSALS AND ABSTENTIONS ARE RECORDED IN THE MINUTES OF THE BOARD MEETING. ANNUALLY, 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.
COMPENSATION REVIEWFORM 990, PART VI, SECTION B, LINES 15A & 15BANNUAL REVIEW--PERFORMED DURING FISCAL YEAR 2012. MARKET DATA IS PROVIDED BY INTEGRATED HEALTHCARE STRATEGIES (IHS). A COMPENSATION COMMITTEE COMPRISED OF THE HEARTLAND HEALTH BOARD CHAIR, HEARTLAND HEALTH BOARD VICE-CHAIR AND THREE ADDITIONAL HEARTLAND HEALTH BOARD MEMBERS AND INDEPENDENT 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--IHS) THAT SPECIALIZES IN RESEARCH MARKET SALARY DATA. OUR FACILITY SIZE, OUR 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.
AVAILABILITY OF DOCUMENTSFORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DIRCK CLARK TITLE:DIRECTOR/OFFICER HOURS:59
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:LINDA BAHRKE TITLE:DIRECTOR HOURS:59
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JOE BOYCE, MD TITLE:DIRECTOR/PRESIDENT/COO HOURS:59
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JOHN P. WILSON TITLE:SEC'Y/TREAS/CFO HOURS:59
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DOUGLAS BRANDT TITLE:ASSISTANT TREASURER HOURS:59
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:KAREN DITTEMORE TITLE:ASSISTANT SECRETARY HOURS:59

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 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 FOUNDATION
5325 FARAONST JOSEPHMO64506431262768SUPPORTMO501(C)(3)9HHtrue
HEARTLAND LONG TERM ACUTE CARE HOSPITAL
5325 FARAONST JOSEPHMO64506261972987HEALTH CAREMO501(C)(3)3HHtrue
HEARTLAND REGIONAL MEDICAL CENTER
5325 FARAONST JOSEPHMO64506440545289HEALTH CAREMO501(C)(3)3HHtrue
REGIONAL EMERGENCY MEDICAL SERVICE
5325 FARAONST JOSEPHMO64506273923442AMBULANCE SVCMO501(C)(3)9HHtrue

Form990 Schedule R Part IV Form990ScheduleRPartIV (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
MIDWESTERN HEALTH MANAGEMENT INC
5325 FARAONST JOSEPHMO64506431264358HEALTH CAREMOHHC - CORPORATION000.00000
COMMUNITY HEALTH PLAN
5325 FARAONST JOSEPHMO64506431690582INSURANCEMOHHC - CORPORATION000.00000
COMMUNITY HEALTH PLAN INSURANCE COMPANY
5325 FARAONST JOSEPHMO64506431210152INSURANCEMOHHC - CORPORATION00
HHS PROPERTIES INC
5325 FARAONST JOSEPHMO64506431593799DEVELOPMENTMOHHC - CORPORATION000.00000
UPTOWN HOUSING INC
5325 FARAONST JOSEPHMO64506261416252DEVELOPMENTMOHHC - CORPORATION000.00000
UPTOWN ST JOSEPH REDEVELOPMENT
5325 FARAONST JOSEPHMO64506201742813DEVELOPMENTMOHHC - CORPORATION000.00000
HEALTH CARE BENEFIT TRUST
5325 FARAONST JOSEPHMO64506431286484HEALTH CAREMOHHTRUST000.00000
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 OrgtrueLoansOrGuaranteesFromOtherOrg
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 OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
HEARTLAND REGIONAL MEDICAL CENTER
E604085FMV
HEARTLAND REGIONAL MEDICAL CENTER
L87557FMV
HEARTLAND REGIONAL MEDICAL CENTER
O737924FMV