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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 33982858 33982858 33982858 false false true true false false true true true X true X true true true false true false 14445419 0 14445419 0.02740 85837550 72734564 13102986 0.02490 100282969 72734564 27548405 0.05230 7377477 7377477 0.01400 1190483 1190483 0.00230 1068065 249524 818541 0.00100 402531 365463 0.00070 2225116 2225116 0.00420 12263672 249524 11977080 0.02220 112546641 72984088 39525485 0.07450 250981 250981 0.00050 528191 528191 0.00100 466669 466669 0.00090 734071 734071 0.00140 349175 349175 0.00070 766571 766571 0.00150 16715 16715 3112373 3112373 0.00600 false 20073665 0 155227738 179877934 -24650196 X true true SEE PART VI 1 1 HEARTLAND REGIONAL MEDICAL CENTER

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X X X PHARMICIST INTERN PROGRAM HEARTLAND REGIONAL MEDICAL CENTER 1 true true 200. true 300. true X true true X true false true X false false 34 HEARTLAND CLINIC

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SPECIALTY CLINIC HEARTLAND CLINIC

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SPECIALTY CLINIC HEARTLAND CLINIC

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SPECIALTY CLINIC HEARTLAND CLINIC

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SPECIALTY CLINIC HANDS OF HOPE HOSPICE

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HOSPICE SERVICES 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 $42,112,706 SUBTRACTED FOR THE PURPOSE OF CALCULATING THE PERCENTAGE. SCHEDULE H, PART I, LINE 7G PHYSICIAN CLINIC COST $1,068,065 COMMUNITY BUILDING ACTIVITIES SCHEDULE H, PART II FUNDING BY THE ORGANIZATION MAKES THE FOLLOWING COUNCILS AND PROGRAMS POSSIBLE: HEALTHY COMMUNITIES INVESTOR COUNCIL; P-20 BUSINESS AND EDUCATION COUNCIL; THE EMPOWER PLANT; THE REGIONAL TECHNOLOGY INFRASTRUCTURE TEAM; POUND PLUNGE, YOUTH HEALTH PARTNERSHIP, SENIOR HEALTH, PROJECT FIT, WOMEN'S WELLNESS INITIATIVE, HEART WALK, DIABETES EXPO, PROJECT YOUTH!, 4TH GRADE CHALLENGE, PATEE DENTAL CLINIC, HEALTH EXPRESS, CORPORATE CHALLENGE, HEALTH RISK ASSESSMENTS FOR LOCAL BUSINESSES, WELLNESS AMBASSADORS; ENVIRONMENTAL ASSESSMENTS; INCREASED AWARENESS OF THE NEED FOR PHILANTHROPIC EFFORTS AND VOLUNTEERISM TO SUPPORT PROGRAMS SUCH AS SUCCESS BY SIX, SOCIAL WELFARE BOARD, INTERFAITH COMMUNITY SERVICES, NATURE CENTER, NURSING SCHOLARSHIP PROGRAMS, SUPPORT OF AMERICAN RED CROSS PROGRAMS, SUPPORT OF LOCAL ARTS AND CULTURAL ACTIVITIES. BAD DEBT EXPENSE SCHEDULE H, PART III, LINE 4 PATIENT ACCOUNTS RECEIVABLE: FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE MEDICAL CENTER'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS INCREASED FROM 80% OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2011, TO 91% OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2012. IN ADDITION, THE MEDICAL CENTER'S WRITE-OFFS INCREASED APPROXIMATELY $6,300,000 FROM APPROXIMATELY $61,700,000 FOR THE YEAR ENDED JUNE 30, 2011, TO APPROXIMATELY $68,000,000 FOR THE YEAR ENDED JUNE 30, 2012. BOTH INCREASES WERE THE RESULT OF NEGATIVE TRENDS EXPERIENCED IN THE COLLECTION OF AMOUNTS FROM SELF-PAY PATIENTS IN FISCAL YEAR 2012. COST TO PROVIDE BAD DEBT CARE IS BASED UPON THE SCHEDULE H COST TO CHARGE CALCULATION OF 47.63%. SERVICES WERE PROVIDED IN GOOD FAITH BY THE ORGANIZATION. THOSE WHO CHOOSE NOT TO PAY, WHO ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE, CAUSE A DECREASE IN ASSETS OF THE ORGANIZATION, WHICH DECREASES THE ORGANIZATION'S ABILITY TO OFFER COMPENSATION THAT ATTRACTS HIGHLY-TRAINED STAFF OR DECREASES THE ORGANIZATION'S ABILITY TO INVEST IN MEDICAL TECHNOLOGY. THOSE COSTS ARE A NECESSITY IF THE ORGANIZATION IS TO SURVIVE. THOSE WHO CHOOSE NOT TO PAY PUSH THE BURDEN TO THOSE WHO WILL PAY. IN THE END, IT IS THE COMMUNITY THAT PAYS FOR THOSE WHO WILL NOT PAY. MEDICARE SHORTFALL 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. COLLECTION PRACTICES 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. MANAGEMENT COMPANIES & JOINT VENTURES SCHEDULE H, PART IV 1. (A) MERCURY SURGERY CENTER (B) INVESTMENT IN SURGERY CENTER (C) 15% (D) 0% (E) 85% 2. (A) ST. JOSEPH BUSINESS PARK LENDERS, LLC (B) DEVELOPMENT (C) 26% (D) 0% (E) 0% 3. (A) PREMIER PURCHASING PARTNERS, LP (B) GROUP BUYING POWER (C) .34% (D) 0% (E) 0% 4. (A) HEARTLAND HEALTH BUSINESS PLAZA, LLC (B) BUILDING LEASE (C) 21% (D) 0% (E) 79% 5. (A) BRIARCLIFF TUILERIES, LLC (B) BUILDING LEASE (C) 58.7% (D) 0% (E) 0% CHARGES FOR MEDICAL CARE SCHEDULE H, PART V, LINE 19 IF AN INDIVIDUAL MEETS THE GUIDELINES FOR 100% WRITEOFF, THEN THEY ARE NOT CHARGED ANY AMOUNT. IF THEY ARE ELIGIBLE FOR A 50% WRITEOFF, THEN THEY ARE ONLY CHARGED FOR 50% OF THE CHARGES, WHICH IS LOWER THAN THE AVERAGE OF THE 3 LOWEST NEGOTIATED COMMERICAL INSURANCE RATES. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 1 ASSESSMENTS WERE CONDUCTED THROUGH SURVEYS OF INDIVIDUALS AND GROUPS. ADDITIONAL INFORMATION WAS PROVIDED THROUGH COMMUNITY GROUPS AND GOVERNMENT AGENCIES IN THE VICINITY. A COLLABORATIVE THINK TANK OF LOCAL EDUCATION HEADS, STATE, COUNTY AND CITY GOVERNMENT LEADERS, LOCAL BUSINESS LEADERS AND AFFILIATED HOSPITAL AND FOUNDATION LEADERSHIP HAVE TARGETED SEVERAL CRITICAL AREAS: PREPARING TODAY'S STUDENTS TO BE TOMORROW'S WORKFORCE; OBESITY IN BOTH CHILDREN AND ADULTS; ENVIRONMENTAL PROTECTION; BUILDING PHILANTHROPY AND VOLUNTEERISM; REINFORCING THE MORAL OBLIGATION THAT COMPANIES AND INDIVIDUALS HAVE TO IMPROVE THEIR COMMUNITY. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 2 AS PART OF THE PRE-REGISTRATION PROCESS, INSURANCE COVERAGE INFORMATION IS REQUESTED. IF A CLIENT INDICATES INABILITY TO PAY, THEN THE CLIENT IS SCREENED FOR MEDICAID ELIGIBILITY AND ASSISTED IN THE APPLICATION PROCESS. IF NO OTHER PAYMENT RESOURCES ARE AVAILABLE, THE CLIENT IS ADVISED OF THE FINANCIAL ASSISTANCE PROGRAM AND ENCOURAGED TO PROVIDE THE NECESSARY FINANCIAL DOCUMENTATION TO PROVE ELIGIBILITY. CLIENTS WHO WERE NOT SCREENED BY PRE-REGISTRATION AND THEREFORE MISSED THE SCREENING PROCESS, HAVE THE ABILITY TO LEARN OF THE MEDICAID ELIGIBILITY AND FINANCIAL ASSISTANCE SERVICES BY CONTACTING THE BILLING DEPARTMENT UPON RECEIPT OF AN ACCOUNT STATEMENT. FINANCIAL DOCUMENTATION IS STILL NECESSARY TO PROVE QUALIFICATION FOR THE FINANCIAL ASSISTANCE SERVICE. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 3 THE ORGANIZATION'S SERVICE AREA IS A 21 COUNTY URBAN/RURAL AREA LOCATED NEAR THE INTERSECTION OF A FOUR-STATE AREA. THE POPULATION IS ELDERLY AND UNDER-INSURED. THE LOCAL ECONOMY IS MADE UP OF AGRICULTURAL, SMALL MANUFACTURING AND SELF-EMPLOYED BUSINESSES, PRIMARILY BLUE COLLAR WORKERS. THE ORGANIZATION SUPPORTS A PAYOR MIX OF 49% MEDICARE, 14% MEDICAID, 31% COMMERCIAL AND 6% SELF PAY. 17.8% OF RESIDENTS LIVE BELOW THE NATIONAL POVERTY LEVEL AND 14.8% ARE UNINSURED. 27.9% ARE SMOKERS, 10% HAVE DIABETES AND 23.6% HAVE A BODY MASS INDEX GREATER THAN 30. ONLY 21% OF THE RESIDENTS HAVE A COLLEGE DEGREE AND NEARLY 61% OF STUDENTS RECEIVE FREE OR REDUCED-COST LUNCH. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 4 THE ORGANIZATION RECOGNIZES THAT THE MAJOR HEALTH PROBLEMS OF OUR COMMUNITY ARE BASED IN HUMAN BEHAVIORS, WHICH IN TURN HAVE THEIR ROOT IN BASIC HUMAN CONDITIONS. OUR EFFORTS ADDRESS ALL LEVELS OF WHAT WE CALL THE HEALTH PYRAMID, THE ACTUAL PHYSICAL CONDITIONS FORMING ONLY THE TIP. WE HAVE PROGRAMS IN PLACE TO ADDRESS A WIDE VARIETY OF HUMAN BEHAVIORS THAT INFLUENCE HEALTH. COMMUNITY OUTREACH HEALTH IMPROVEMENT INITIATIVES HELP THOSE IN OUR COMMUNITY CHANGE THE HUMAN BEHAVIORS THAT PUT THEIR HEALTH AT RISK. TO REACH THE ROOT CAUSES, OUR AFFILIATED FOUNDATION ASSUMES A ROLE TO ADDRESS THE HUMAN CONDITIONS THAT AFFECT HEALTH. FUNDING BY THE ORGANIZATION MAKES THE FOLLOWING COUNCILS AND PROGRAMS POSSIBLE: HEALTHY COMMUNITIES INVESTOR COUNCIL P-20 BUSINESS AND EDUCATION COUNCIL; THE EMPOWER PLANT; THE REGIONAL TECHNOLOGY INFRASTRUCTURE TEAM; POUND PLUNGE, YOUTH HEALTH PARTNERSHIP, SENIOR HEALTH, PROJECT FIT, WOMEN'S WELLNESS INITIATIVE, HEART WALK, DIABETES EXPO, PROJECT YOUTH!, 4TH GRADE CHALLENGE, PATEE DENTAL CLINIC, HEALTH EXPRESS, CORPORATE CHALLENGE, HEALTH RISK ASSESSMENTS FOR LOCAL BUSINESSES, WELLNESS AMBASSADORS; ENVIRONMENTAL ASSESSMENTS; INCREASED AWARENESS OF THE NEED FOR PHILANTHROPIC EFFORTS AND VOLUNTEERISM TO SUPPORT PROGRAMS SUCH AS SUCCESS BY SIX, SOCIAL WELFARE BOARD, INTERFAITH COMMUNITY SERVICES, NATURE CENTER, NURSING SCHOLARSHIP PROGRAMS, SUPPORT OF AMERICAN RED CROSS PROGRAMS, SUPPORT OF LOCAL ARTS AND CULTURAL ACTIVITIES. AFFILIATED HEALTH CARE SYSTEM SCHEDULE H, PART VI, LINE 5 THE ORGANIZATION IS AFFILIATED, THROUGH A PARENT BOARD, WITH A FOUNDATION, AN ACUTE LONG TERM CARE HOSPITAL, A MEDICAL TRANSPORT PROVIDER, A COMMUNITY HEALTH IMPROVEMENT SOLUTIONS SERVICE AND A HEALTH INFORMATION EXCHANGE, 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 FILLED WITH LEADERS FROM THE COMMUNITY 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 MEDICARE 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. THE HEALTH INFORMATION EXCHANGE IS AN EFFORT TO MAKE ALL MEDICAL RECORD INFORMATION FOR A PATIENT ACCESSIBLE BY ANY PROVIDER AT ANY LOCATION. true UNITED WAY OF ST JOSEPH 118 SOUTH 5TH STREET ST JOESPH MO 64501 440547802 501(c)(3) 192375 SUPPORT HEARTLAND FOUNDATION 5325 FARAON ST JOSEPH MO 64506 431262768 501(C)(3) 1778857 SUPPORT ST JOSEPH MUSEUMS INC PO BOX 8096 ST JOSEPH MO 64508 436038202 501(C)(3) 6000 SUPPORT CITY OF ST JOSEPH 1920 GRAND AVE ST JOSEPH MO 64505 GOVERNMENT 5540 SUPPORT YWCA OF ST JOSEPH 304 N 8TH ST JOSEPH MO 64501 440552219 501(C)(3) 7750 SUPPORT INTER-SERVE 1412 N 3RD ST JOSEPH MO 64505 753197631 501(C)(3) 17610 SUPPORT MISSOURI WESTERN STATE 5425 DOWNS DRIVE ST JOSEPH MO 64507 237035423 GOVERNMENT 23700 SUPPORT 7 0 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS SCHEDULE I, 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 X true true X X X X X true true false false false false false false false MARK LANEY MD 581821 0 232000 0 20133 0 126434 0 18035 0 978423 0 0 0 DAVID CATHCART DO 256730 0 7500 0 3424 0 8009 0 6776 0 282439 0 0 0 JOHN OLSON MD 589188 0 193815 0 2376 0 9800 0 18939 0 814118 0 0 0 MAUREEN BOYLE MD 411417 0 23352 0 18444 0 9800 0 25535 0 488548 0 0 0 MICHAEL NELLESTEIN MD 716913 0 8333 0 18876 0 9800 0 23252 0 777174 0 0 0 ED KAMMERER MD 238580 0 119719 0 1674 0 9800 0 20035 0 389808 0 0 0 PADMAVATHI VELIGATI MD 406650 0 23352 0 18876 0 9800 0 0 0 458678 0 0 0 CURT KRETZINGER 424258 0 132900 0 37249 0 96263 0 8356 0 699026 0 0 0 JOHN P WILSON 399934 0 120101 0 20400 0 85027 0 946 0 626408 0 0 0 DOUGLAS BRANDT 203433 0 47154 0 23813 0 56140 0 18035 0 348575 0 0 0 JOE BOYCE MD 295178 0 73813 0 3025 0 56558 0 14584 0 443158 0 0 0 DIRCK CLARK 228305 0 50639 0 20193 0 42276 0 17939 0 359352 0 0 0 MICHAEL PULIDO 241071 0 60500 0 2734 0 54966 0 20235 0 379506 0 0 0 LYNN THUENTE 123308 0 10444 0 6017 0 5545 0 6876 0 152190 0 0 0 TAMA WAGNER 157729 0 34320 0 4663 0 46168 0 18589 0 261469 0 0 0 HELEN THOMPSON 86846 0 0 157712 0 9219 0 11106 0 264883 0 0 0 RUDY WACKER 592270 0 0 0 0 0 0 0 0 0 592270 0 0 0 ROBERT PERMUT MD 171567 0 0 0 0 0 0 0 0 0 171567 0 0 0 LISA MICHAELIS 278261 0 62456 0 30923 0 55104 0 12020 0 438764 0 0 0 SCOTT KOELLIKER 224043 0 47475 0 12496 0 60260 0 21035 0 365309 0 0 0 MOHAN HINDUPUR MD 949622 0 70253 0 21198 0 9800 0 15052 0 1065925 0 0 0 ROBERT GRANT MD 863649 0 70253 0 1944 0 9800 0 22939 0 968585 0 0 0 ARVIND SHARMA MD 812380 0 70253 0 18444 0 9800 0 21035 0 931912 0 0 0 FRANCISCO LAMMOGLIA MD 811349 0 69003 0 2376 0 9800 0 22439 0 914967 0 0 0 ALA ABABNEH MD 627631 0 168077 0 1944 0 7350 0 21881 0 826883 0 0 0 OTHER COMPENSATION SCHEDULE J, PART I, LINE 1A MARK LANEY, M.D., DIRCK CLARK, SCOTT KOELLIKER HAVE SOCIAL CLUB MEMBERSHIPS THAT ARE 100% BUSINESS. ANY FACILITY USAGE CHARGES ABOVE THE MEMBERSHIP FEES, PERTAINING TO PERSONAL USE, ARE PAID DIRECTLY TO THE CLUB BY THE EMPLOYEE, THEREFORE THE AMOUNTS WERE NOT INCLUDED IN THEIR W-2. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B ACCRUED 6/30/2012 --------- CURT KRETZINGER 86,463 JOHN P. WILSON 75,227 DOUGLAS BRANDT 46,152 MARK LANEY, M.D. 116,634 DIRCK CLARK 32,467 MICHAEL PULIDO 44,242 LISA MICHAELIS 44,811 TAMA WAGNER 38,843 JOE BOYCE, M.D. 46,178 SCOTT KOELLIKER 49,656 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 PAID BY HEARTLAND REGIONAL MEDICAL CENTER SCHEDULE J, PART II THE COMPENSATION PROVIDED BY HEARTLAND REGIONAL MEDICAL CENTER FOR CURT KRETZINGER, JOHN P. WILSON, DIRCK CLARK, DR. MARK LANEY, DOUGLAS BRANDT, KAREN DITTEMORE, JOE BOYCE, MD, MICHAEL PULIDO, TAMA WAGNER AND LISA MICHAELIS 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. THE INDUSTRIAL DEVELOPMENT AUTHORITY OF ST JOE 431203910 79075LAA5 2003-05-17 32225000 REFUND THE SERIES 2001(C) BONDS false false false THE INDUSTRIAL DEVELOPMENT AUTHORITY OF ST JOE 431203910 79075la09 2011-09-30 25250000 SERIES 2011 FIXED RATE false false false THE INDUSTRIAL DEVELOPMENT AUTHORITY OF ST JOE 431203910 79075LAB3 2009-02-13 70000000 SERIES 2009A VARIABLE RATE REV false false false 0 0 32225000 0 0 0 260055 0 0 0 0 0 2003 true false true true 0 0 25250000 0 0 0 216452 0 0 0 0 0 2012 true false true true 0 0 70000000 0 0 0 1026303 0 0 49139726 0 19833971 2013 false false false true false false false false 0.00000 0.00000 0.00000 true false false false false 0.00000 0.00000 0.00000 true false false false false 0.00000 0.00000 0.00000 true true true CITIGROUP INC 2.5 false 0 false false false false false 0 false 0 false false false true false 0 false 0 false false X B: (I) FINANCE THE COSTS OF THE CONSTRUCTION AND EQUIPPING OF CERTAIN 0 HEALTHCARE FACILITIES 0 (II)PAY CERTAIN COSTS OF THE ISSUANCE OF BONDS 0 (III)REFUND REVENUE BONDS 0 SEE PART IV BUSINESS TRANSACTIONS WITH INTERESTED PERSONS SCHEDULE L, PART IV (A) DONNA WILSON (B) DONNA WILSON IS THE YOUTH HEALTH DIRECTOR FOR HEARTLAND REGIONAL MEDICAL CENTER AND IS THE WIFE OF JOHN WILSON, WHO IS THE CHIEF FINANCIAL OFFICER OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 98,182 (D) SALARY FOR YOUTH HEALTH DIRECTOR 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) $ 31,544 (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) $ 104,814 (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) $ 89,644 (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) $ 30,679 (D) SALARY FOR REGISTERED NURSE SERVICES (E) NO (A) JAMUNA HINDUPUR (B) JAMUNA HINDUPUR IS A CLINICAL TECHNICIAN FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE WIFE OF MOHAN HINDUPUR, WHO IS A HIGHLY COMPENSATED EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 30,679 (D) SALARY FOR CLINICAL TECHNICIAN SERVICES (E) NO ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 THE MISSION OF THE HEARTLAND REGIONAL MEDICAL CENTER IS TO ESTABLISH AND OPERATE A DIVERSIFIED HEALTH CARE DELIVERY SYSTEM THAT PROVIDES THE RIGHT CARE, AT THE RIGHT TIME, IN THE RIGHT PLACE, AT THE RIGHT COST WITH OUTCOMES SECOND TO NONE FOR THE PEOPLE LIVING IN NORTHWEST MISSOURI AND ADJACENT AREAS IN KANSAS, IOWA, AND NEBRASKA, REGARDLESS OF ABILITY TO PAY, WHILE ALSO STRIVING TO IMPROVE THE LIVES OF THOSE INDIVIDUALS BY FOCUSING ON PREVENTIVE HEALTH INITIATIVES SUCH AS EDUCATION, WELLNESS PROGRAMS, HEALTH-RELATED ACTIVITIES AND COMMUNITY BENEFIT PROGRAMS. PROGRAM SERVICE ACCOMPLISHMENTS 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 63% GOVERNMENTAL, 31% COMMERCIAL AND 6% UNINSURED. THE HOSPITAL PROVIDES A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES INCLUDING CARDIO-THORACIC, VASCULAR, ORTHOPEDIC AND GENERAL SURGERIES, MENTAL HEALTH SERVICES, ALONG WITH A FULL ARRAY OF DIAGNOSTIC AND THERAPEUTIC SERVICES. IT OPERATES A 24-HOUR EMERGENCY ROOM DESIGNATED AS A TRAUMA II CENTER BY THE STATE OF MISSOURI. THE HOSPITAL'S OBSTETRICS DEPARTMENT PROVIDES 18 LABOR/DELIVERY/RECOVERY/POST-PARTUM BEDS WHICH ARE ALSO DESIGNATED AS A LEVEL II CENTER. THE HOSPITAL PROVIDES RADIATION ONCOLOGY SERVICES, HOME HEALTH VISITS AND HOSPICE CARE. DURING THE YEAR, 17,718 PATIENTS WERE ADMITTED TO THE HOSPITAL RESULTING IN 76,207 PATIENT DAYS. A TOTAL OF 10,800 SURGERIES WERE PERFORMED, THE EMERGENCY ROOM SERVED 58,047 PATIENTS AND 233,254 VISITS WERE GENERATED BY OUTPATIENTS. THE HOSPITAL EMPLOYS 4,232 PEOPLE AND HAS A TOTAL OF 239 ACTIVE AND ASSOCIATE MEDICAL STAFF. THE EMPLOYED MEDICAL STAFF INCLUDES 213 PHYSICIANS, 2 DENTISTS, 1 CHIROPRACTOR AND 88 NURSE PRACTITIONERS/PHYSICIAN EXTENDERS COVERING 42 FAMILY MEDICINE AND SPECIALTY CLINICS IN ADDITION TO NUMEROUS SATELLITE CLINICS THROUGHOUT THE REGION RESULTING IN APPROXIMATELY 600,850 PATIENT VISITS DURING THE YEAR. BUSINESS/FAMILY RELATIONSHIPS FORM 990, PART VI, SECTION A, LINE 2 BRIAN BRADLEY, JOHN P. WILSON, JOE BOYCE, MD, DIRCK CLARK, DOUGLAS BRANDT, KAREN DITTEMORE HAVE A BUSINESS RELATIONSHIP. THEY ARE EITHER OFFICERS AND/OR DIRECTORS OF LEWIS AND CLARK INFORMATION EXCHANGE, A RELATED NOT-FOR-PROFIT CORPORATION. KAREN BAKER, CAROL ROEVER, JOHN P. WILSON, CURT KRETZINGER, DOUGLAS BRANDT, KAREN DITTEMORE HAVE A BUSINESS RELATIONSHIP. THEY ARE EITHER OFFICERS AND/OR DIRECTORS OF REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY, A RELATED NOT-FOR-PROFIT CORPORATION. JOHN P. WILSON, CURT KRETZINGER, DIRCK CLARK, DOUGLAS BRANDT, KAREN DITTEMORE, 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, INC., COMMUNITY HEALTH PLAN INSURANCE COMPANY, HHS PROPERTIES, INC., UPTOWN HOUSING, INC., UPTOWN ST. JOSEPH REDEVELOPMENT CORPORATION WHICH ARE RELATED FOR PROFIT CORPORATIONS. CHANGES TO ORGANIZATIONAL DOCUMENTS FORM 990, PART VI, SECTION A, LINE 4 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. IN ADDITION TO EXISTING POWERS, THE BOARD OF DIRECTORS SHALL HAVE THE FOLLOWING POWERS AND AUTHORITY RELATED TO THE OVERSIGHT AND OPERATION OF THE ACO: RECEIVING AND DISTRIBUTING SHARED SAVINGS; REPAYING SHARED LOSSES, IF APPLICABLE; ESTABLISHING, REPORTING, AND ENSURING ACO PARTICIPANT AND ACO PROVIDERS/SUPPLIERS COMPLIANCE WITH ACO PROGRAM REQUIREMENTS, INCLUDING THE QUALITY PERFORMANCE STANDARDS; FULFILLING ANY OTHER ACO FUNCTIONS AS REQUIRED UNDER APPLICABLE ACO REGULATIONS, STATUTES, OR CONTRACT TERMS; OVERSIGHT AND STRATEGIC DIRECTION OF THE ACO; HOLDING ACO MANAGEMENT (HOSPITAL PRESIDENT AND OTHER OFFICERS) ACCOUNTABLE FOR THE ACO'S ACTIVITIES. THE CHIEF EXECUTIVE OFFICER OF THE HOSPITAL SHALL BE A DIRECTOR BY VIRTUE OF HIS OFFICE. THE REMAINDER OF THE BOARD OF DIRECTORS SHALL BE A SELF-PERPETUATING BOARD, AND ANY VACANCIES OCCURIING THERIN MAY BE FILLED AT ANY REGULAR OR SPECIAL MEETING OF THE BOARD OF DIRECTORS BY AN AFFIRMATIVE VOTE OF A MAJORITY OF THE REMAINING DIRECTORS. WITH THE EXCEPTION OF DIRECTORS WHO ARE DIRECTORS BY VIRTUE OF THEIR OFFICE, A DIRECTOR MAY BE REMOVED, WITH OR WITHOUT CAUSE, BY A VOTE OF TWO-THIRDS OF THE ENTIRE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS SHALL FILL ANY VACANCY IN THE BOARD OF DIRECTORS. DIRECTORS MAY PARTICIPATE IN A REGULAR OR SPECIAL MEETING OF THE BOARD OF DIRECTORS BY ANY MEANS OF COMMUNICATION BY WHICH DIRECTORS PARTICIPATING MAY SIMULTANEOUSLY HEAR EACH OTHER DURING THE MEETING, OR BY ANY OTHER MEANS RECOGNIZED UNDER MISSOURI LAW. A DIRECTOR PARTICIPATING IN A MEETING BY THIS MEANS IS DEEMED TO BE PRESENT IN PERSON AT THE MEETING. THE CHAIRMAN OF THE BOARD OF DIRECTORS AND THE PRESIDENT SHALL SERVE AS MEMBERS OF THE EXECUTIVE COMMITTEE BY VIRTUE OF THEIR OFFICES. THE REMAINING MEMBERS OF THE EXECUTIVE COMMITTE SHALL BE ELECTED BY A MAJORITY VOTE OF THE BOARD OF DIRECTORS. AN ADDED DUTY OF THE FINANCE COMMITTEE IS TO REVIEW AND MAKE RECOMMENDATIONS ON THE RECEIPT AND DISTRIBUTION OF ANY ACO SHARED SAVINGS AND THE REPAYMENT OF ANY ACO SHARED LOSSES. AN ADDED DUTY OF THE SERVICE/QUALITY COMMITTEE IS TO REVIEW AND MAKE RECOMMENDATIONS REGARDING THE ACO'S QUALITY ASSURANCE AND IMPROVEMENT PROGRAM. COMMITTEE MEMBERS MAY PARTICIPATE IN A COMMITTEE MEETING BY ANY MEANS OF COMMUNICATION BY WHICH ALL MEMBERS PARTICIPATING MAY SIMULTANEOUSLY HEAR EACH OTHER DURING THE MEETING, OR BY ANY OTHER MEANS RECOGNIZED UNDER MISSOURI LAW. A COMMITTEE MEMBER PARTICIPATING IN A MEETING BY THIS MEANS IS DEEMED TO BE PRESENT IN PERSON AT THE MEETING. THE OFFICERS OF THE CORPORATION SHALL BE THE PRESIDENT (CHIEF EXECUTIVE OFFICER), A CHIEF OPERATING OFFICER, A SECRETARY AND A CHIEF FINANCIAL OFFICER (TREASURER), AND SUCH OTHER OFFICERS AND ASSISTANT OFFICERS AS MAY BE DEEMED NECESSARY BY THE BOARD OF DIRECTORS OR THE PRESIDENT. THE PRESIDENT, SECRETARY AND CHIEF FINANCIAL OFFICER SHALL BE ELECTED BY THE BOARD OF DIRECTORS AND SHALL HOLD OFFICE FOR A TERM OF ONE YEAR, OR UNTIL HIS SUCCESSOR IS DULY ELECTED AND QUALIFIED, UNLESS SOONER REMOVED BY THE BOARD OF DIRECTORS. THE CHIEF OPERATING OFFICER AND OTHER OFFICERS SHALL BE SELECTED BY THE PRESIDENT AND SHALL HOLD OFFICE UNTIL REMOVED BY THE PRESIDENT OR THE BOARD OF DIRECTORS. ANY OFFICER MAY BE REMOVED OR DISCHARGED BY THE BOARD OF DIRECTORS. VACANCIES IN THE OFFICE OF PRESIDENT, SECRETARY AND CHIEF FINANCIAL OFFICER SHALL BE FILLED BY THE BOARD OF DIRECTORS. THE PRESIDENT SHALL BE THE CHIEF EXECUTIVE OFFICER OF THE HOSPITAL AND SHALL HAVE THE AUTHORITY TO DIRECT AND ADMINISTER ALL THE ACTIVITIES AND DEPARTMENTS OF THE HOSPITAL, SUBJECT TO SUCH POLICIES AS MAY BE ADOPTED BY THE BOARD OF DIRECTORS, OR ANY COMMITTEES TO WHICH THE BOARD OF DIRECTORS HAS DELEGATED POWER FOR SUCH ACTION. IN ADDITION TO OTHER DUTIES, THE PRESIDENT SHALL BE RESPONSIBLE FOR THE IMPLEMENTATION OF ALL POLICIES ESTABLISHED BY THE BOARD OF DIRECTORS. ADDITIONALLY, THE PRESIDENT SHALL MANAGE THE OPERATIONS OF THE ACO. THE MEDICAL STAFF SHALL DEVELOP AND ADOPT THE MEDICAL STAFF BYLAWS AND STANDARDS, WHICH SHALL BECOME EFFECTIVE WHEN APPROVED BY THE BOARD OF DIRECTORS. NEITHER THE BOARD OF DIRECTORS NOR THE MEDCAL STAFF MAY UNILATERALLY AMEND THE MEDICAL STAFF BYLAWS OR STANDARDS, EXCEPT AS SET FORTH BELOW. THE BOARD OF DIRECTORS SHALL MAINTAIN COMPLETE AND ULTIMATE RESPONSIBILITY AND AUTHORITY OVER THE HOSPITAL AND THE MEDICAL STAFF. ACCORDINGLY, IF AN AMENDMENT TO THE MEDICAL STAFF BYLAWS OR STANDARDS IS URGENTLY NEEDED IN ORDER TO ADDRESS AN ISSUE OF QUALITY, PATIENT SAFETY, LIABILITY, REGULATORY COMPLIANCE, LEGAL COMPLIANCE, OR OTHER CRITICAL OBLIGATIONS OF THE HOSPITAL, AND THE MEDICAL STAFF AND THE MEDICAL STAFF EXECUTIVE COMMITTEE ARE INCAPABLE OF, OR REFUSE TO MAKE THE NECESSARY AMENDMENT TO THE MEDICAL STAFF BYLAWS OR STANDARDS, THE BOARD OF DIRECTORS MAY EXERCISE ITS AUTHORITY TO UNILATERALLY AMEND THE MEDICAL STAFF BYLAWS OR STANDARDS AS NECESSARY. IN SUCH A SITUATION, THE BOARD OF DIRECTORS' AMENDMENT SHALL BE FINAL, AND ALL VOTING MEMBERS OF THE MEDICAL STAFF SHALL BE NOTIFIED OF THE AMENDMENT WITHIN TEN (10) DAYS OF THE AMENDMENT BECOMING FINAL. ALL ASPECTS OF MEMBERSHIP STATUS AND SPECIFIC CLINICAL PRIVILEGES SHALL BE GRANTED OR WITHHELD TO A PRACTITIONER ON THE BASIS OF CRITERA RELATED TO GOOD PATIENT CARE AT THE HOSPITAL, TO PROFESSIONAL ABILITY AND JUDGMENT, OR TO COMMUNITY OR HOSPITAL NEEDS, AND NOT ON THE BASIS OF SEX, RACE, AGE, SEXUAL ORIENTATION, HANDICAP OR DISABLED, CREED, COLOR, NATIONAL ORIGIN, RELIGION, ANCESTRY, GENETIC HISTORY, MARITAL STATUS OR MILITARY/VETERAN STATUS. IN THE EVENT OF A CONFLICT BETWEEN THE MEDICAL STAFF EXECUTIVE COMMITTEE AND THE MEDICAL STAFF, A PROCESS IS OUTLINED IN THE BYLAWS FOR CONFLICT MANAGEMENT. THE BOARD OF DIRECTORS SHALL, AFTER CONSIDERING THE RECOMMENDATIONS OF THE MEDICAL STAFF, THE HEARTLAND CLINIC AND OTHER INDEPENDENT HEALTH PRACTITIONERS PROVIDING PATIENT CARE SERVICES, SPECIFY REVIEW AND EVALUATION ACTIVITIES TO ASSESS, PRESERVE AND IMPROVE THE OVERALL QUALITY AND EFFICIENCY OF PATIENT CARE. ACKNOWLEDGING ITS RESPONSIBILTY FOR CARE WHICH IS TO BE PROVIDED TO PATIENTS, THE BOARD OF DIRECTORS SHALL REQUIRE THAT THE MEDICAL STAFF, THE HEARTLAND CLINIC AND OTHER HEALTH CARE PROFESSIONALS PROVIDING PATIENT CARE SERVICES CONDUCT ACTIVITIES THAT CONTRIBUTE TO THE PRESERVATION AND IMPROVEMENT OF THE QUALITY AND EFFICIENCY OF PATIENT CARE. ADDITIONALLY INCLUDED IS ON-GOING MONITORING AND EVALUATION OF PATIENT CARE PRACTICE THROUGH DEFINED FUNCTIONS OF THE MEDICAL STAFF, THE HEARTLAND CLINIC, OTHER PROFESSIONAL SERVICES AND THE HOSPITAL ADMINISTRATION; MANAGMENT OF CLINICAL AFFAIRS, INCLUDING ENFORCEMENT OF MEDICAL STAFF STANDARDS AND CLINICAL POLICIES AND CONSULTATION REQUIREMENTS, INITIATION OF DISCILPLINARY ACTIONS, SURVEILLANCE OVER REQUIREMENTS FOR MONITORING THE EXERCISE OF CLINICAL PRIVILEGES; SUCH OTHER MEASURES AS THE BOARD OF DIRECTORS MAY, AFTER RECEIVING AND CONSIDERING THE ADVICE OF THE MEDICAL STAFF, THE OTHER PROFESSIONAL SERVICE, THE HEARTLAND CLINIC AND/OR THE HOSPITAL ADMINISTRATION, DEEM NECESSARY FOR THE PRESERVATION AND IMPROVEMENT OF THE QUALITY AND EFFICIENCY OF PATIENT CARE. THE BOARD OF DIRECTORS SHALL, UPON RECOMMENDATION OF THE SERVICE/QUALITY COMMITTEE, ADOPT AND IMPLEMENT A QUALITY ASSURANCE AND IMPROVEMENT PROGRAM FOR THE THE ACO. SUCH PROGRAM SHALL PROMOTE EVIDENCE-BASED MEDICINE AND PROMOTE PATIENT ENGAGEMENT, INCLUDING COMPLIANCE WITH PATIENT EXPERIENCE OF CARE SURVEY REQUIREMENTS, COMPLIANCE WITH BENEFICIARY REPRESENTATIVE REQUIREMENTS, PROCESS FOR EVALUATING THE HEALTH NEEDS OF ACO'S POPULATION, COMMUNICAITON OF CLINICAL KNOWLEDGE/EVIDENCE-BASED MEDICINE TO BENEFICIARIES IN A WAY THAT IS UNDERSTANDABLE TO THEM, BENEFICIARY ENGAGEMENT AND SHARED DECISION-MAKING THAT TAKES INTO ACCOUNT THE BENEFICIARIES' UNIQUE NEEDS, PREFEREENCES, VALUES, AND PRIORITIES, WRITTEN STANDARDS IN PLACE FOR BENEFICIARY ACCESS AND COMMUNICATION, AND A PROCESS IN PLACE FOR BENEFICIARIES TO ACCESS THEIR MEDICAL RECORD. THE REFERENCE TO VOLUNTEERS IS NOW TERMED AS VOLUNTEER AMBASSADORS. THE BYLAWS MAY BE AMENDED, ALTERED, ABRIDGED, ADDED TO OR REPEALED AT ANY MEETING OF THE BOARD OF DIRECTORS BY AN AFFIRMATIVE VOTE OF TWO-THIRDS OF THE ENTIRE BOARD OF DIRECTORS. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, SECTION A, LINE 6 HEARTLAND HEALTH, A MISSOURI NONPROFIT CORPORATION, IS THE SOLE MEMBER OF HEARTLAND REGIONAL MEDICAL CENTER. GOVERNING BOARD DECISIONS SUBJECT TO APPROVAL OF MEMBERS OR STOCKHOLDERS 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 REVIEW PROCESS FORM 990, PART VI, SECTION A, LINE 11B AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE TREASURER AND ASSISTANT TREASURER OF HEARTLAND REGIONAL MEDICAL CENTER REVIEW THE 990. THE 990 IS THEN POSTED TO A WEBSITE FOR ALL VOTING MEMBERS TO ACCESS BEFORE IT IS FILED. MONITORING OF CONFLICT OF INTEREST POLICY 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 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 REVIEW FORM 990, PART VI, SECTION B, LINES 15A & 15B ANNUAL REVIEW--PERFORMED DURING FISCAL YEAR 2011 FOR THE FOLLOWING FISCAL YEAR. 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. 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. AVAILABILITY OF DOCUMENTS FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. RECONCILIATION OF NET ASSETS FORM 990, PART XI, LINE 5 UNREALIZED GAINS(LOSSES) ON INVESTMENTS $ (1,324,588) NET ASSET TRANSFER $ (1,520,000) CHANGE IN FAIR VALUE $ (5,014,930) CHANGES IN MIN PENS. LIAB. $(21,572,578) ------------- $(29,432,096) HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARK LANEY, MD TITLE:DIRECTOR, OFFICER HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DAVID CATHCART, DO TITLE:DIRECTOR, STAFF PHYSICIAN HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN OLSON, MD TITLE:DIRECTOR, STAFF PHYSICIAN HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DENNIS DOBYAN, MD TITLE:DIRECTOR HOURS:10 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CURT KRETZINGER TITLE:OFFICER HOURS:8 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN P WILSON TITLE:OFFICER HOURS:10 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DOUGLAS BRANDT TITLE:OFFICER, CONTROLLER HOURS:10 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KAREN DITTEMORE TITLE:OFFICER, ADMIN ASST HOURS:10 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOE BOYCE, MD TITLE:OFFICER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DIRCK CLARK TITLE:OFFICER HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:LISA MICHAELIS TITLE:MEDICAL CENTER ADMINISTRATOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SCOTT KOELLIKER TITLE:HEARTLAND CLINIC ADMINISTRATOR HOURS:1 NORTHLAND EXPANSION LLC 5323 FARAON ST JOSEPH MO 64506 DEVELOPMENT MO 0 4000 HRMC HEARTLAND HEALTH 5325 FARAON ST JOSEPH MO 64506 431283316 HEALTHCARE MO 501(C)(3) 11A NA false HEARTLAND FOUNDATION 5325 FARAON ST JOSEPH MO 64506 431262768 SUPPORT MO 501(C)(3) 9 HH true HEARTLAND LONG TERM ACUTE CARE HOSPITAL 5325 FARAON ST JOSEPH MO 64506 261972987 HEALTH` MO 501(C)(3) 3 HH true LEWIS AND CLARK INFORMATION EXCHANGE 5325 FARAON ST JOSEPH MO 64506 320290671 DATA SHARING MO 501(C)(3) 9 HH true REGIONAL EMERGENCY MEDICAL SERVICES AUTH 5325 FARAON ST JOSEPH MO 64506 273923442 AMBULANCE SVC MO 501(C)(3) 9 HH true BRIARCLIFF TUILERIES OFFICE LLC 6300 N REVERE SUITE 225 KANSAS CITY MO 64151 453338381 DEVELOPMENT MO HRMC RENTAL INCOME -25091 794254 false false 0.58727 MIDWESTERN HEALTH MANAGEMENT INC 5325 FARAON ST JOSEPH MO 64506 431264358 HEALTHCARE MO HH C CORP 0 0 0.00000 COMMUNITY HEALTH PLAN INC 5325 FARAON ST JOSEPH MO 64506 431690582 INSURANCE MO HH C CORP 0 0 0.00000 COMMUNITY HEALTH PLAN INSURANCE COMPANY 5325 FARAON ST JOSEPH MO 64506 431210152 INSURANCE MO HH C CORP 0 0 0.00000 HHS PROPERTIES INC 5325 FARAON ST JOSEPH MO 64506 431593799 INVESTMENT MO HH C CORP 0 0 0.00000 UPTOWN HOUSING INC 5325 FARAON ST JOSEPH MO 64506 261416252 REDEVELOPMENT MO HH C CORP 0 0 0.00000 UPTOWN ST JOSEPH REDEVELOPMENT CORP 5325 FARAON ST JOSEPH MO 64506 201742813 REDEVELOPMENT MO HH C CORP 0 0 0.00000 HEALTH CARE BENEFIT TRUST 5325 FARAON ST JOSEPH MO 64506 431286484 HEALTH CARE MO HH TRUST 0 0 0.00000 false true false true true true false false true true true true false false false true false true COMMUNITY HEALTH PLAN INSURANCE COMPANY P 112666 FMV COMMUNITY HEALTH PLAN P 403787 FMV MIDWESTERN HEALTH MANAGEMENT INC B 700000 FMV MIDWESTERN HEALTH MANAGEMENT INC E 117979 FMV MIDWESTERN HEALTH MANAGEMENT INC I 237470 FMV MIDWESTERN HEALTH MANAGEMENT INC K 1281789 FMV MIDWESTERN HEALTH MANAGEMENT INC L 906433 FMV MIDWESTERN HEALTH MANAGEMENT INC P 11914774 FMV HHS PROPERTIES INC B 300000 FMV HHS PROPERTIES INC J 176197 FMV LEWIS AND CLARK INFORMATION EXCHANGE D 604085 FMV LEWIS AND CLARK INFORMATION EXCHANGE K 87557 FMV LEWIS AND CLARK INFORMATION EXCHANGE P 737924 FMV NORTHLAND EXPANSION LLC D 1420555 FMV REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY D 3934597 FMV REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY F 839405 FMV REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY K 805722 FMV REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY L 100139 FMV REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY P 3639147 FMV HEARTLAND LONG TERM ACUTE CARE HOSPITAL D 8860365 FMV HEARTLAND LONG TERM ACUTE CARE HOSPITAL I 520000 FMV HEARTLAND LONG TERM ACUTE CARE HOSPITAL K 4129353 FMV HEARTLAND LONG TERM ACUTE CARE HOSPITAL P 6458337 FMV HEARTLAND FOUNDATION D 68751 FMV HEARTLAND FOUNDATION P 1267124 FMV HEARTLAND FOUNDATION B 1778857 FMV