HEARTLAND REGIONAL MEDICAL CENTER: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization: HEARTLAND REGIONAL MEDICAL CENTER (EIN 44-0545289)
Tax period: 2017-07-01 to 2018-06-30
Filed: 2019-05-10
IRS object ID: 201921309349303517
Schema version: 2017v2.2
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule H
Schedule I
Schedule J
Schedule K
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2019-05-10T12:30:31-05:00	ReturnTs
Tax Period End	2018-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	420714325	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	RSM US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	201 North Harrison Street Suite 300	AddressLine1Txt
City	Davenport	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	528011999	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2017-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	440545289	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Heartland Regional Medical Center	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	HEAR	BusinessNameControlTxt
Phone	8162717070	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	5325 Faraon Street	AddressLine1Txt
City	St Joseph	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	64506	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Dwain Stilson	PersonNm
Person Title	Officer	PersonTitleTxt
Signature	2019-05-10	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Jenifer L Chase	PreparerPersonNm
PTIN	P01306883	PTIN
Phone	5638884000	PhoneNum

Field	Value	IRS element (for citing)
Tax	2017	TaxYr
Build TS	2019-02-21 02:37:17Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	Mosaic Life Care	BusinessNameLine1Txt

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Dwain Stilson	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	5325 Faraon Street	AddressLine1Txt
City	St Joseph	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	64506	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$959,948,927	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.mymosaiclifecare.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1985	FormationYr
Legal Domicile State	MO	LegalDomicileStateCd
Activity Or Mission	TO IMPROVE POPULATION HEALTH OUTCOMES IN OUR REGION BY PROVIDING THE RIGHT CARE, AT THE RIGHT TIME, PLACE AND COST.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	4392	TotalEmployeeCnt
Total Volunteers	556	TotalVolunteersCnt
Total Gross UBI	$1,845,118	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$580,266	PYContributionsGrantsAmt
CY Contributions Grants	$404,614	CYContributionsGrantsAmt
PY Program Service Revenue	$632,544,479	PYProgramServiceRevenueAmt
CY Program Service Revenue	$619,549,975	CYProgramServiceRevenueAmt
PY Investment Income	$24,962,821	PYInvestmentIncomeAmt
CY Investment Income	$22,782,479	CYInvestmentIncomeAmt
PY Other Revenue	$22,569,155	PYOtherRevenueAmt
CY Other Revenue	$26,609,496	CYOtherRevenueAmt
PY Total Revenue	$680,656,721	PYTotalRevenueAmt
CY Total Revenue	$669,346,564	CYTotalRevenueAmt
PY Grants And Similar Paid	$2,954,095	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$3,751,749	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$343,111,274	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$350,501,825	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$283,544	CYTotalFundraisingExpenseAmt
PY Other Expenses	$303,790,632	PYOtherExpensesAmt
CY Other Expenses	$289,902,137	CYOtherExpensesAmt
PY Total Expenses	$649,856,001	PYTotalExpensesAmt
CY Total Expenses	$644,155,711	CYTotalExpensesAmt
PY Revenues Less Expenses	$30,800,720	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$25,190,853	CYRevenuesLessExpensesAmt
Total Assets BOY	$900,919,281	TotalAssetsBOYAmt
Total Assets EOY	$935,224,619	TotalAssetsEOYAmt
Total Liabilities BOY	$373,385,281	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$343,474,048	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$527,534,000	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$591,750,571	NetAssetsOrFundBalancesEOYAmt
Mission	TO IMPROVE POPULATION HEALTH OUTCOMES IN OUR REGION BY PROVIDING THE RIGHT CARE, AT THE RIGHT TIME, PLACE AND COST.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$581,698,541	ExpenseAmt
Grant	$3,751,749	GrantAmt
Revenue	$643,996,319	RevenueAmt
Desc	HEARTLAND REGIONAL MEDICAL CENTER IS A 352-BED MEDICAL SURGICAL HOSPITAL LOCATED IN ST JOSEPH, MISSOURI. IT SERVES A COMMUNITY OF 77,000 RESIDENTS. BECAUSE ST JOSEPH IS A BORDER CITY, IT ALSO PROVIDES SERVICES TO THOSE LIVING IN THE ADJACENT STATES OF KANSAS, NEBRASKA AND IOWA. THE ECONOMY OF THE REGION IS BASED ON AGRICULTURE, MINOR MANUFACTURING AND SMALL BUSINESSES RESULTING IN A PAYOR MIX FOR THE MEDICAL CENTER OF APPROXIMATELY 68.87% GOVERNMENTAL OR NO-PAY PATIENTS. 19.9% OF THE POPULATION HAVE INCOME THAT IS BELOW THE FEDERAL POVERTY LEVEL. THE HOSPITAL PROVIDES A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES INCLUDING CARDIO-THORACIC, VASCULAR, ORTHOPEDIC AND GENERAL SURGERIES, MENTAL HEALTH SERVICES, ALONG WITH A FULL ARRAY OF DIAGNOSTIC AND THERAPEUTIC SERVICES. IT OPERATES A 24-HOUR EMERGENCY ROOM DESIGNATED AS A TRAUMA II CENTER BY THE STATE OF MISSOURI. THE HOSPITAL'S OBSTETRICS DEPARTMENT PROVIDES 18 LABOR/DELIVERY/RECOVERY/POST-PARTUM BEDS WHICH ARE ALSO DESIGNATED AS A LEVEL II CENTER. THE HOSPITAL PROVIDES RADIATION ONCOLOGY SERVICES, HOME HEALTH VISITS AND HOSPICE CARE. THE ORGANIZATION IS A MEMBER OF THE MAYO NETWORK FOR CLINICAL CONSULTATIONS. DURING THE YEAR, APPROXIMATELY 17,000 PATIENTS WERE ADMITTED TO THE HOSPITAL RESULTING IN APPROXIMATELY 72,000 PATIENT DAYS. A TOTAL OF APPROXIMATELY 10,000 SURGERIES WERE PERFORMED, THE EMERGENCY ROOM SERVED APPROXIMATELY 58,000 PATIENTS AND APPROXIMATELY 181,000 VISITS WERE GENERATED BY OUTPATIENTS. THE MEDICAL CENTER EMPLOYS APPROXIMATELY 4,200 FULL-TIME EQUIVALENT CARE GIVERS. THE MEDICAL STAFF INCLUDES APPROXIMATELY 250 PROVIDERS COVERING PRIMARY CARE AND SPECIALTY CLINICS FOR APPROXIMATELY 45 LOCATIONS THROUGHOUT THE REGION. THERE WERE APPROXIMATELY 1,050,000 PATIENT VISITS DURING THE YEAR. ACO: Effective July 1, 2012, the Medical Center began participating in the Medicare Shared Savings Program (MSSP). Effective January 1, 2017, the Medical Center discontinued participation in MSSP. During the year ended June 30, 2018, the Medical Center received a shared savings payment totaling $2,867 related to program results related to the calendar year ended December 31, 2016. The Medical Center did not participate in MSSP after December 31, 2016. OTHER PROGRAM SERVICES: THE MEDICAL CENTER HAS A 340B DESIGNATION FROM HRSA (FEDERAL GOVERNMENT). THIS ALLOWS THE MEDICAL CENTER TO RECEIVE OUTPATIENT DRUGS AT REDUCED PRICES FROM THE DRUG MANUFACTURERS. THE 340B PROGRAM ENABLES COVERED ENTITIES TO STRETCH SCARCE FEDERAL RESOURCES AS FAR AS POSSIBLE, REACHING MORE ELIGIBLE PATIENTS AND PROVIDING MORE COMPREHENSIVE SERVICES. THE PROGRAM IS AVAILABLE TO HOSPITALS THAT PROVIDE CARE FOR A DISPROPORTIONATE NUMBER OF PATIENTS THAT RANGE FROM NO INCOME TO LOW INCOME.	Desc
Total Program Service Expenses	$581,698,541	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	Yes (true)	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	Yes (true)	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	261	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	4392	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	Yes (true)	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Form1098 C Filed	false	Form1098CFiledInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	8	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MO	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NC	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Dwain Stilson	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	8162717070	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	5325 Faraon Street	AddressLine1Txt
City	St Joseph	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	64506	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Mark Laney MD
Director/President/Heartland Health CEO	32.0	8.0	Yes (X)	Yes (X)	$2,474,270	$0	$26,709
Adam Stein
Director	1.0	1.0	Yes (X)		$2,500	$0	$0
Brenda Sharpe
Director	1.0	1.0	Yes (X)		$2,500	$0	$0
Brian Bradley
Director	1.0	1.0	Yes (X)		$2,500	$0	$0
Chris Looney MD
Director/Vice Chair	1.0	1.0	Yes (X)		$52,231	$0	$0
Daniel Heckman
Director	1.0	1.0	Yes (X)		$2,500	$0	$0
Dennis Dobyan MD
Director (Until 12/2017)	1.0	9.0	Yes (X)		$2,500	$60,225	$0
Gary Frazer
Director (As of 01/2018)	1.0	1.0	Yes (X)		$0	$0	$0
Lucinda Hayden MD
Director (As of 01/2017)	39.0	1.0	Yes (X)		$659,309	$0	$26,465
Ophelia Lavell Rucker
Director	1.0	1.0	Yes (X)		$2,500	$0	$0
Matt Lukens MD
Director (As of 01/2018)	39.0	1.0	Yes (X)		$667,322	$0	$37,557
Michael Lane
Director (Until 12/2017)	1.0	1.0	Yes (X)		$2,500	$0	$0
Serena Naylor
Director	1.0	3.0	Yes (X)		$2,500	$0	$0
Sterett Schanze
Director (as of 01/2017)	1.0	1.0	Yes (X)		$2,500	$0	$0
Barbara Wurtzler
Director/Chair/Vice Chair	1.0	1.0	Yes (X)		$2,500	$0	$0
Dwain Stilson
CFO/Treasurer	32.0	8.0		Yes (X)	$571,182	$0	$88,465
Fang Xia
Assistant Treasurer (until 06/2018)	38.0	2.0		Yes (X)	$123,910	$0	$12,127
Karen Dittemore
Assistant Secretary	38.0	2.0		Yes (X)	$73,307	$0	$12,516
Michael Pulido
COO/Secretary	32.0	8.0		Yes (X)	$686,163	$0	$143,576
Julee Thompson
Chief Nursing Executive	40.0	0			$304,682	$0	$25,365	Yes (X)
Brady D Dubois
President	39.0	1.0			$416,825	$0	$85,028	Yes (X)
Brennan Lehman
Chief Information Officer	37.0	3.0			$393,577	$0	$64,956	Yes (X)
Davin Turner MD
President	38.0	2.0			$563,165	$0	$79,988	Yes (X)
Hemant K Sheth MD
Staff Physician	40.0	0			$1,134,573	$45,620	$29,827		Yes (X)
John Barclay MD
Staff Physician	40.0	0			$978,094	$0	$35,288		Yes (X)
Mohan R Hindupur MD
Staff Physician	40.0	0			$965,533	$0	$23,758		Yes (X)
Robert Grant DO
Staff Physician	40.0	0			$952,437	$0	$32,388		Yes (X)
Rony M Abou-Jawde MD
Staff Physician	40.0	0			$997,457	$0	$35,288		Yes (X)
Carolyn S Paden
Administrator	40.0	0			$264,533	$0	$14,738			Yes (X)
Curt Kretzinger
COO (until 1/2017)	40.0	0.0			$1,676,258	$0	$17,154			Yes (X)
Jodie Roettger
Assistant Treasurer (until 02/2017)	40.0	0.0			$164,050	$0	$14,936			Yes (X)
John Olson MD
Director/Physician (until 12/2016)	40.0	0			$653,896	$0	$35,788			Yes (X)
John P Wilson
Secretary/Treasurer (until 01/2017)	40.0	0.0			$1,546,312	$0	$5,230			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$16,344,084	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$105,845	TotReportableCompRltdOrgAmt
Total Other Compensation	$847,144	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	464	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Quest Diagnostics
PO Box 14730	St Louis	MO	63150	Medical Services	$1,636,765
Bartimus Frickleton and Robertson
11150 Overbrook Road Suite 200	Leawood	KS	66210	Attorney services	$1,500,000
BHG Structured Settlements Inc
1314 Douglas Street Suite 1400	Omaha	NE	68102	Attorney Services	$1,210,533
Xtend Healthcare LLC
90 Volunteer Drive Suite 150	Hendersonville	TN	37075	Financial services	$1,145,243
Polsinelli Shughart PC
3103 Fredrick Avenue	St Joseph	MO	64506	Attorney Services	$1,139,078

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	41	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
All Other Contributions	$404,614	AllOtherContributionsAmt
Total Contributions	$404,614	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Service Revenue	621110	$612,938,990	$612,938,990
340B Pharmacy Revenue	621110	$38,444,788	$38,444,788
Meaningful Use Payments	621110	$32,965	$32,965
Provision for Uncollectable		-$31,866,768	-$31,866,768

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$619,549,975	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$13,095,524	TotalRevenueColumnAmt
Exclusion	$13,095,524	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$392,373	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$392,373	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$392,373	TotalRevenueColumnAmt
Unrelated Business Revenue	$74,339	UnrelatedBusinessRevenueAmt
Exclusion	$318,034	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$300,099,000	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$290,412,045	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$9,686,955	SecuritiesAmt
Other	$0	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$9,686,955	TotalRevenueColumnAmt
Exclusion	$9,686,955	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$111,282	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$190,318	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$79,036	TotalRevenueColumnAmt
Unrelated Business Revenue	-$79,036	UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
Referral Lab	111000	$6,921,623	$6,868,041	$53,582
Cafeteria	722514	$2,582,516	$2,582,516
Copying Revenue	541380	$610,624	$610,624

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$16,181,396	TotalRevenueColumnAmt
Related Or Exempt Func Income	$14,385,163	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,796,233	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$26,296,159	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$669,346,564	TotalRevenueColumnAmt
Related Or Exempt Func Income	$643,996,319	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,845,118	UnrelatedBusinessRevenueAmt
Exclusion	$23,100,513	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$3,751,749	TotalAmt
Program Services	$3,751,749	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$7,331,094	TotalAmt
Program Services	$2,465,099	ProgramServicesAmt
Management And General	$4,865,995	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$163,597	TotalAmt
Program Services	$163,597	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$275,274,845	TotalAmt
Program Services	$258,395,793	ProgramServicesAmt
Management And General	$16,802,801	ManagementAndGeneralAmt
Fundraising	$76,251	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$8,859,094	TotalAmt
Program Services	$7,733,703	ProgramServicesAmt
Management And General	$1,122,443	ManagementAndGeneralAmt
Fundraising	$2,948	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$42,295,001	TotalAmt
Program Services	$35,975,862	ProgramServicesAmt
Management And General	$6,298,326	ManagementAndGeneralAmt
Fundraising	$20,813	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$16,578,194	TotalAmt
Program Services	$15,362,100	ProgramServicesAmt
Management And General	$1,210,943	ManagementAndGeneralAmt
Fundraising	$5,151	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$27,237	TotalAmt
Program Services	$27,237	ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$1,127,243	TotalAmt
Management And General	$1,127,243	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$464,625	TotalAmt
Management And General	$464,625	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$99,750	TotalAmt
Program Services	$99,750	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$47,202,538	TotalAmt
Program Services	$40,270,469	ProgramServicesAmt
Management And General	$6,932,001	ManagementAndGeneralAmt
Fundraising	$68	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$2,662,391	TotalAmt
Program Services	$15,699	ProgramServicesAmt
Management And General	$2,646,692	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$20,432,140	TotalAmt
Program Services	$16,442,887	ProgramServicesAmt
Management And General	$3,889,097	ManagementAndGeneralAmt
Fundraising	$100,156	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$9,225,943	TotalAmt
Program Services	$9,127,531	ProgramServicesAmt
Management And General	$59,985	ManagementAndGeneralAmt
Fundraising	$38,427	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$11,468,683	TotalAmt
Program Services	$10,044,299	ProgramServicesAmt
Management And General	$1,424,384	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$572,225	TotalAmt
Program Services	$516,293	ProgramServicesAmt
Management And General	$33,858	ManagementAndGeneralAmt
Fundraising	$22,074	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$1,117,076	TotalAmt
Program Services	$902,858	ProgramServicesAmt
Management And General	$208,937	ManagementAndGeneralAmt
Fundraising	$5,281	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$6,817,735	TotalAmt
Program Services	$127,875	ProgramServicesAmt
Management And General	$6,689,860	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$23,698,099	TotalAmt
Program Services	$18,974,505	ProgramServicesAmt
Management And General	$4,723,594	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$10,594,125	TotalAmt
Program Services	$10,359,033	ProgramServicesAmt
Management And General	$235,092	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	FundraisingFundraisingAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies/Includes 340B	$101,782,039	$101,778,309	$3,730
FRA Taxes	$22,684,782	$22,684,782
Dues & Subscriptions	$2,487,506	$1,420,037	$417	$1,067,052
Loss on Pension	$27,438,000	$25,059,074	$8,228	$2,370,698

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$644,155,711	TotalAmt
Program Services	$581,698,541	ProgramServicesAmt
Management And General	$62,173,626	ManagementAndGeneralAmt
Fundraising	$283,544	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$24,279,275	BOYAmt
EOY	$22,237,498	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$74,402,014	BOYAmt
EOY	$67,001,634	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
EOY	$7,108,391	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$8,120,167	BOYAmt
EOY	$7,556,500	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$19,780,020	BOYAmt
EOY	$18,617,583	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$568,502,197	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$393,075,654	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$207,113,345	BOYAmt
EOY	$175,426,543	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$527,244,126	BOYAmt
EOY	$596,253,501	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$7,306,483	BOYAmt
EOY	$7,326,969	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$32,673,851	BOYAmt
EOY	$33,696,000	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$900,919,281	BOYAmt
EOY	$935,224,619	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$155,383,775	BOYAmt
EOY	$138,050,617	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$209,693,134	BOYAmt
EOY	$201,901,083	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$2,130,598	BOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$6,177,774	BOYAmt
EOY	$3,522,348	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$373,385,281	BOYAmt
EOY	$343,474,048	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$526,938,349	BOYAmt
EOY	$591,135,833	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$595,651	BOYAmt
EOY	$614,738	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$527,534,000	BOYAmt
EOY	$591,750,571	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$900,919,281	BOYAmt
EOY	$935,224,619	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$25,190,853	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$15,399,463	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$23,626,255	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$128,844	OtherActivitiesAmt
Total Lobbying Expenditures	$128,844	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY

PORTION OF DUES PAID TO HOSPITAL ASSOCIATIONS THAT ARE USED FOR LOBBYING PURPOSES BY THE HOSPITAL ASSOCIATIONS. 24.2% of the membership dues paid to the Missouri Hospital Association are used for lobbying activities. 22.98% of the membership dues paid to the American Hospital Association are used for lobbying activities. In addition, HRMC CONTRACTS WITH VARIOUS PARTIES FOR LEGISLATIVE LOBBYING IN SUPPORT OF HOSPITAL REIMBURSEMENT AND COMMUNITY SUPPORT.

Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$14,758,476	OtherCostOrOtherBasisAmt
Book Value	$14,758,476	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$289,920,923	OtherCostOrOtherBasisAmt
Depreciation	$173,363,926	DepreciationAmt
Book Value	$116,556,997	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$20,825,462	OtherCostOrOtherBasisAmt
Depreciation	$14,440,384	DepreciationAmt
Book Value	$6,385,078	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$237,828,680	OtherCostOrOtherBasisAmt
Depreciation	$205,271,344	DepreciationAmt
Book Value	$32,557,336	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,168,656	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$5,168,656	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$175,426,543	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
Derivative Instruments	$3,522,348
Minority Interest	$0

Field	Value	IRS element (for citing)
Total Liability	$3,522,348	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	FormAndLineReferenceDesc
Explanation	Heartland Health, Heartland Regional Medical Center, Heartland Foundation, Heartland Long Term Acute Care Hospital, Northwest Medical Center Association, Inc., and Northwest Medical Center Foundation are nonprofit corporations described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Internal Revenue Code. However, they are subject to federal income tax on any unrelated business taxable income. CHPIC, Midwestern Health Management, Inc. and HHS Properties, Inc. are subject to income taxation. Heartland Business Plaza, LLC and Village of Burlington Creek Office, LLC are limited liability companies that are taxed as partnerships. With a few exceptions, Heartland is no longer subject to U.S. federal, state and local income tax examinations by tax authorities for years before 2014. At June 30, 2018, net operating loss carryforwards available to offset future taxable income for these entities aggregated approximately $16,591 and expire through 2035. Separate return limitation restrictions apply to a portion of these net operating loss carryforwards. Tax positions are not offset or aggregated with other positions. Tax positions that meet the more-likely-than-not recognition threshold are measured as the largest amount of tax benefit that is more than 50 percent likely to realized on settlement with the applicable taxing authority. The portion of the benefits associated with tax positions take that exceeds the amount measured as described above is reflected as a liability for uncertain tax benefits in the accompanying balance sheet along with any associated interest and penalties that would be payable to the taxing authorities upon examination. As of June 30, 2018 and 2017, there were no uncertain tax positions identified and recorded as a liability.	ExplanationTxt

Schedule F IRS990ScheduleF

Field	Value	IRS element (for citing)
Grant Records Maintained	false	GrantRecordsMaintainedInd

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	Central America and the Caribbean	RegionTxt
Specific Services Provided	Investments	SpecificServicesProvidedTxt
Region Total Expenditures	$14,887,768	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continuation Total Office	0	ContinuationTotalOfficeCnt
Continuation Total Employee	0	ContinuationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$14,887,768	SubtotalSpentAmt
Continuation Spent	$0	ContinuationSpentAmt
Total Spent	$14,887,768	TotalSpentAmt
Transfer To Foreign Corp	false	TransferToForeignCorpInd
Interest In Foreign Trust	false	InterestInForeignTrustInd
Foreign Corp Ownership	false	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	false	PassiveForeignInvestmestCoInd
Foreign Partnership	false	ForeignPartnershipInd
Boycott Countries	false	BoycottCountriesInd

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$25,864,201	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$25,864,201	NetCommunityBenefitExpnsAmt
Total Expense	0.0422	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$91,547,092	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$73,770,654	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,776,438	NetCommunityBenefitExpnsAmt
Total Expense	0.0290	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$117,411,293	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$73,770,654	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$43,640,639	NetCommunityBenefitExpnsAmt
Total Expense	0.0713	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,073,446	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$316,401	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,757,045	NetCommunityBenefitExpnsAmt
Total Expense	0.0061	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$141,481	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$141,481	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$317,815	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$591	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$317,224	NetCommunityBenefitExpnsAmt
Total Expense	0.0005	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$546,214	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$42,097	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$504,117	NetCommunityBenefitExpnsAmt
Total Expense	0.0008	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,272,954	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,272,954	NetCommunityBenefitExpnsAmt
Total Expense	0.0037	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$7,351,910	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$359,089	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,992,821	NetCommunityBenefitExpnsAmt
Total Expense	0.0114	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$124,763,203	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$74,129,743	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$50,633,460	NetCommunityBenefitExpnsAmt
Total Expense	0.0827	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,583	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,583	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$110,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$110,000	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$307,996	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$307,996	NetCommunityBenefitExpnsAmt
Total Expense	0.0005	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$420,579	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$420,579	NetCommunityBenefitExpnsAmt
Total Expense	0.0007	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$31,866,770	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$152,412,147	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$179,359,105	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$26,946,958	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Heartland Regional Medical Center	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	5325 Faraon Street	AddressLine1Txt
City	St Joseph	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	64506	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.mymosaiclifecare.org	WebsiteAddressTxt
State License	426-19	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Other	Pharmacist Intern Program	OtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Heartland Regional Medical Center	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	https://www.mymosaiclifecare.org/General/Community-Health-Needs-Assessment/	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	https://www.mymosaiclifecare.org/General/Community-Health-Needs-Assessment/St-Joseph-CHNA/	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.0	FPGFamilyIncmLmtDscntCarePct
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	See Schedule O .	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	See Schedule O	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	See Schedule O	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3E	The health needs are a prioritized description of the significant health needs of the community and identified through the CHNA.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - HEARTLAND REGIONAL MEDICAL CENTER:. THE MEDICAL CENTER CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT TO DETERMINE SERVICES NEEDED BY THE MEDICALLY UNDERSERVED, LOW INCOME OR MINORITY POPULATIONS. TO ENSURE INPUT WAS TAKEN INTO ACCOUNT FROM PERSONS WHO REPRESENT THE COMMUNITY, THE MEDICAL CENTER UTILIZED AN INDEPENDENT CONSULTING FIRM NAMED LAN RESOURCES, LLC. THIS FIRM CONDUCTED A TELEPHONE SURVEY AND DIRECTED SIX FOCUS GROUPS TO DETERMINE HEALTH PRIORITIES BASED ON THE OPINIONS OF COMMUNITY MEMBERS. THE TELEPHONE SURVEY WAS CONDUCTED IN APRIL AND MAY OF 2015 AND INVOLVED 381 RESIDENTS FROM THE MEDICAL SYSTEM'S SERVICE AREA AND WAS DESIGNED TO OBTAIN FEEDBACK AT A 95% CONFIDENCE INTERVAL. THE SAMPLE INCLUDED MEN AND WOMEN, 18 AND OVER WITH DIVERSE HOUSEHOLD INCOMES INCLUDING THOSE WITH INCOMES LESS THAN $10K. TO COMPLETE THE QUALITATIVE ASPECT OF DATA GATHERING ASSOCIATED WITH COMMUNITY HEALTH NEEDS, SIX FOCUS GROUPS WERE CONVENED IN THE WEEK OF JUNE 14TH THROUGH JUNE 20TH OF 2015, THAT INCLUDED COMMUNITY REPRESENTATIVES WITH BROAD INTERESTS AND THOSE WITH SPECIAL KNOWLEDGE OF THE SUBJECT. THE ORGANIZATION RECRUITED INTERNAL PARTICIPANTS, WHILE THE CONSULTING FIRM RECRUITED ALL EXTERNAL PARTICIPANTS AND MODERATED EACH FOCUS GROUP. THE SIX FOCUS GROUPS CONSISTED OF PHYSICIANS (24 MOSAIC PHYSICIANS), TWO DIFFERENT COMMUNITY MEMBERS AT-LARGE (ONE GROUP HAD 22 AND THE OTHER GROUP HAD 26 INDIVIDUALS), CLINICAL STAFF (44 PARTICIPANTS WERE MOSAIC NURSES, CARE MANAGERS AND SOCIAL WORKERS), AND COMMUNITY LEADERS. THIS WAS MADE UP OF REPRESENTATIVES FROM; SOCIAL WELFARE BOARD, SECOND HARVEST, YMCA, CATHOLIC CHARITIES, INTERSERV, ST JOSEPH POLICE DEPARTMENT, ST JOSEPH HEALTH DEPARTMENT, NORTHWEST HEALTH SERVICES, COMMUNITY ACTION PARTNERSHIP, BARTLETT CENTER, ST JOSEPH SHERIFF'S DEPARTMENT, ST JOSEPH SCHOOL DISTRICT, YOUTH ALLIANCE, ST JOSEPH TRANSIT, HABITAT FOR HUMANITY, BIG BROTHERS/BIG SISTERS, UNITED WAY, FAMILY GUIDANCE CENTER AND MERIL.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - Heartland Long Term Acute Care Hospital. The Medical Center prepares its CHNA in conjunction with Heartland Long Term Acute Care Hospital.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - HEARTLAND REGIONAL MEDICAL CENTER:. THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED AND AN IMPLEMENTATION PLAN FOR ADDRESSING THE IDENTIFIED NEEDS WAS ADOPTED IN THE 2015 TAX YEAR. THE TOP THREE SIGNIFICANT NEEDS IDENTIFIED WERE: 1) ACCESS TO AFFORDABLE HEALTH CARE AND MEDICATION; 2) ADULT AND CHILDHOOD OBESITY; AND 3) MENTAL HEALTH SERVICES. THE MEDICAL CENTER'S ROLE IS MUCH MORE THAN BEING A HOSPITAL. IT IS A FULLY ENGAGED COMMUNITY PARTNER STRIVING TO ADDRESS THE UNIQUE HEALTH AND SOCIAL ISSUES THAT CHALLENGE THE REGION. MANAGEMENT RECOGNIZES THAT THE COMMUNITY'S MAJOR HEALTH PROBLEMS STEM, IN LARGE PART, FROM SOCIAL DETERMINANTS OF HEALTH. SOCIAL DETERMINANTS THAT AFFECT ACCESS TO HEALTH CARE (HEALTHY PEOPLE 2020 FRAMEWORK) INCLUDE: ECONOMIC STABILITY, POVERTY, EMPLOYMENT, FOOD SECURITY, HOUSING STABILITY, EDUCATION, HIGH SCHOOL GRADUATION, ENROLLMENT IN HIGHER EDUCATION, LANGUAGE AND LITERACY, EARLY CHILDHOOD, NEIGHBORHOOD AND BUILT ENVIRONMENT, ACCESS TO HEALTHY FOOD, QUALITY OF HOUSING, CRIME AND VIOLENCE, ENVIRONMENTAL CONDITIONS, CIVIC PARTICIPATION, PERCEPTIONS OF DISCRIMINATION/EQUITY, AND INCARCERATION/INSTITUTIONALIZATION. TO POSITIVELY IMPACT THE SOCIAL DETERMINANTS OF HEALTH, THE MEDICAL CENTER INTRODUCED THE COMMUNITY CONNECT PROGRAM FOR POPULATION HEALTH. COMMUNITY CONNECT IS A REQUEST FOR PROPOSAL (RFP) PROCESS IN WHICH NONPROFIT COMMUNITY ORGANIZATIONS MAY APPLY FOR FUNDING TO IMPLEMENT INNOVATIVE PROGRAMS THAT ADDRESS ONE OR MORE OF THE THREE PRIMARY HEALTH NEEDS AS DETERMINED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT. COMMUNITY CONNECT IS AN IMPORTANT PART OF THE FY2016-FY2019 CHNA ACTION PLAN. TO FULLY MEET THE NEEDS IDENTIFIED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE MEDICAL CENTER IMPLEMENTED A THREE-YEAR ACTION PLAN COMPRISED OF THE FOLLOWING COMPONENTS. SIGNIFICANT NEED #1: ACCESS TO AFFORDABLE HEALTH CARE AND MEDICATION PLAN: A) SUPPORT COMMUNITY CONNECT PROGRAMS THAT ADDRESS ACCESS TO CARE B) PROVIDE A CLINIC WITH ENHANCED SERVICES FOR OUR MOST VULNERABLE POPULATIONS. SIGNIFICANT NEED #2: ADULT AND CHILDHOOD OBESITY PLAN: A) CONTINUE AND EXPAND CURRENT HEALTH IMPROVEMENT PROGRAMS SUCH AS POUND PLUNGE,1-2-3-4-5 FIT-TASTIC BASED ON A SUCCESSFUL MODEL LED BY CHILDREN'S MERCY HOSPITAL, 4TH GRADE CHALLENGE, ETC. SIGNIFICANT NEED #3: MENTAL HEALTH SERVICES PLAN: A) SUPPORT COMMUNITY CONNECT PROGRAMS THAT ADDRESS MENTAL HEALTH NEEDS. B) CONTINUE TO PROVIDE FINANCIAL SUPPORT TO ORGANIZATIONS PROVIDING MENTAL HEALTH SUPPORT TO THE COMMUNITY SUCH AS THE CENTER, HEALTH GROUP AND HILLCREST TRANSITIONAL HOUSING AND BIG BROTHERS BIG SISTERS WHICH PROVIDES COUNSELING SERVICES TO CHILDREN. DURING FY18, THE COMMUNITY CONNECT ALLOCATIONS COMMITTEE AWARDED FUNDING OF $1.2 MILLION TO 14 NON-PROFIT COMMUNITY ORGANIZATIONS WHICH ADDRESSED ONE OR MORE OF THE PRIMARY HEALTH NEEDS FROM THE MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT. THE COMPLETE CHNA WITH IMPLEMENTATION STRATEGY CAN BE FOUND AT: https://www.mymosaiclifecare.org/contentassets/560700dc2aa34098b640da6faad6bdb2/chna.pdf
Schedule H, Part V, Section B, Line 20 Facility , 1	Facility , 1 - Heartland Regional Medical Center. FINANCIAL COUNSELORS ARE AVAILABLE ONSITE TO EXPLAIN AND HELP PATIENTS AND GUARANTORS WITH THE FINANCIAL ASSISTANCE POLICY. SEE FINANCIAL ASSISTANCE POLICY FOR A COMPLETE DESCRIPTION OF EFFORTS MADE BEFORE INITIATING COLLECTION ACTIONS.

Field	Value	IRS element (for citing)
Facility	42	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (42 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt	Address Line2USAddress/AddressLine2Txt
Cameron Mosaic Life Care
215 South Walnut Street Suite A	Cameron	MO	64429	Family Care
Mosaic Life Care Clinics
902 North Riverside Road	St Joseph	MO	64507	Medical Oncology, Radiation Oncology & Pediatrics
Mosaic Life Care Clinics
705 North College	Albany	MO	64402	Cardiovascular, General Surgery, Neurology, Podiatry, Vascular Surgery & Women's Health
Mosaic Life Care Clinics
2600 Miller Street	Bethany	MO	64424	Cardiology, Neurology & Rheumatology
Mosaic Life Care Clinics
901 Heartland Road	St Joseph	MO	64506	Infectious Disease, Diabetes, Endocrinology, Internal Medicine, Sleep Disorder & Women's Health
Mosaic Life Care Clinics
5301 Faraon Street Suites XXX-XX-XXXX	St Joseph	MO	64506	Ears Nose & Throat, Pulmonary & Critical Care	A210B
Excelsior Springs Mosaic Life Care Clinics
2370 Vintage Court	Excelsior Springs	MO	64024	Family Care
Mosaic Life Care Clinics
711 North 36th Street Suite 100 Low	St Joseph	MO	64506	Family Care, Home Health, Hospice & Care at Home	er Level
Mosaic Life Care Clinics
5210 North Belt Highway Entrance B	St Joseph	MO	64506	Family Care & Women's Health
Mosaic Life Care Clinics
2701 Running Horse Road	Platte City	MO	64079	Family Care, Outpatient Therapy & Sports Medicine
Mosaic Life Care Clinics
9784 North Ash Avenue	Kansas City	MO	64157	Family Care
Internal Medicine Beck Rd St Joseph
3715 Beck Road Building F	St Joseph	MO	64506	Internal Medicine
Mosaic Life Care Clinics
5514 Corporate Drive Suites 120 150	St Joseph	MO	64507	Cardiovascular & Internal Medicine
Mosaic Life Care Clinics
105 Far West Drive Suites 100 201	St Joseph	MO	64506	Internal Medicine, Pediatrics, Family Care, Neurology & Outpatient Behavior Health
Kearney Mosaic Life Care
425 West Mosaic Life Care Way	Kearney	MO	64060	Family Care
Mosaic Life Care Clinics
802 North Riverside Road	St Joseph	MO	64506	Bariatric, Breast, CardioThoracic Surgery, General Surgery,Pain Management,Physical Medicine & Rehab
Medical Oncology Mosaic Life Care
1610 East Evergreen Suite B	Cameron	MO	64429	Medical Oncology
Mosaic Life Care Clinics
2016 South Main	Maryville	MO	64468	Medical Oncology & Neuro Surgery
Mosaic Life Care Burlington Creek Clinic
6301 North Lucerne	Kansas City	MO	64151	Imaging, Orthopedic, Specialty Clinics, Physical Medicine & Rehabilitation
Mosaic Life Care Shoal Creek Clinic
8880 NE 82nd Terrace	Kansas City	MO	64158	Family Care, Urgent Care, Specialty Clinics, Physical Medicine & Rehabilitation
Mosaic Life Care Hospice at Stanberry
307 Pineview Pine View Manor Rm 507	Stanberry	MO	64489	Hospice
Mosaic Life Care Surgery Center Shoal
8860 Northeast 82nd Terrace	Kansas City	MO	64158	Outpatient Surgery
Northwest Medical Center Home Health
1607 East US Highway 136	Albany	MO	64402	Home Health
Mosaic Life Care Clinics
3620 Fredrick Avenue	St Joseph	MO	64506	Outpatient Imaging & Counseling Care
OP Therapy Frederick Ave St Joseph
3107 Frederick Avenue Lower Level	St Joseph	MO	64506	Outpatient Therapy
Mosaic Life Care Clinics
3007 North Belt Highway	St Joseph	MO	64506	Outpatient Therapy & Chiropractic Care
Pain Management Mosaic Life Care
100 Central Street	Chillicothe	MO	64601	Pain Management
Plastic Surgery & Dermatology Mosaic
5204 North Belt Highway Suite A2016	St Joseph	MO	64506	Plastic Surgery & Dermatology
Parkville Commons Mosaic Life Care
6301 North Lucerne	Kansas City	MO	64151	Family Care & Specialties
Podiatry St Joseph Mosaic Life Care
5202 Faraon Street Suite A	St Joseph	MO	64506	Podiatry
Mosaic Life Care Clinics
1600 East Evergreen PO Box 557	Cameron	MO	64429	Rheumatology, Pulmonary & Critical Care
Mosaic Life Care Clinics
2024 South Main Street	Maryville	MO	64468	Ear Nose & Throat, Neurology, Podiatry, Pulmonary & Critical Care
Smithville Mosaic Life Care
1103 South US Highway 169	Smithville	MO	64089	Family Care
Mosaic Life Care Clinics
1701 East 9th Street	Trenton	MO	64683	Family Care & Neurology
Urgent Care St Joseph Mosaic Life Care
1115 North Belt Highway	St Joseph	MO	64506	Urgent Care
Mosaic Life Care Clinics
810 Ravenhill Drive Suite 103	Atchison	KS	66002	Specialties
Mosaic Life Care Clinics
104 North 6th	Atchison	KS	66002	Medical Oncology
Hiawatha Mosaic Life Care
300 Utah	Hiawatha	KS	66434	Family Care
Troy Mosaic Life Care
207 South Main	Troy	KS	66087	Family Care
Endocrinology Mosaic Life Care
220 Essie Davison Drive	Clarinda	IA	51632	Endocrinology
Mosaic Life Care Clinics
1301 North 3rd	Atchison	KS	66002	Specialties
Endocrinology Mosaic Life Care
820 Raven Hill Drive	Atchison	KS	66002	Endocrinology

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 7g	No costs attributable to a physician clinic are included in subsidized health services.
Schedule H, Part I, Line 7f	The medical center did not report bad debt expense as part of operating expenses for year ended 06/30/18.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	0
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WAS THE COST TO CHARGE RATIO DERIVED FROM THE CALCULATIONS FROM WORKSHEET 2. FINANCIAL ASSISTANCE AT COST WAS $22,400,000 AND $25,900,000 FOR YEARS ENDED 6/30/17 AND 6/30/18, RESPECTIVELY. MEDICAID NET COMMUNITY BENEFIT EXPENSE WAS $23,800,000 AND $17,800,000 FOR YEARS ENDED 6/30/17 AND 6/30/18, RESPECTIVELY. THE MEDICAL CENTER RECEIVES REIMBURSEMENT FROM THE MEDICAID PROGRAM IN RELATION TO THE PERCENTAGE OF MEDICAID AND INDIGENT POPULATION THEY SERVE.
Schedule H, Part II Community Building Activities	THE MEDICAL CENTER'S COMMUNITY BUILDING ACTIVITIES PROMOTED THE HEALTH OF THE COMMUNITIES SERVED BY PROVIDING ECONOMIC SUPPORT TO HELP RE-VITALIZE THE DOWNTOWN ST JOSEPH AREA AND FACILITATE JOB GROWTH THROUGHOUT THE GREATER ST JOSEPH AREA. AMONG OTHER COMMUNITY BUILDING ACTIVITIES, THE MEDICAL CENTER FUNDS AND MAINTAINS A TEAM FOCUSED ON DISASTER READINESS, COORDINATION AND RELIEF.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	THE AMOUNT OF BAD DEBT REPORTED ON PART III, LINE 2 COMES FROM THE BAD DEBT EXPENSE REPORTED IN THE HEARTLAND REGIONAL MEDICAL CENTER AUDIT REPORT ON PAGE 39.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	The Medical Center is transitioning to a new charity assessment system to help direct appropriate patients to financial assistance. As a result, management anticipates a reduction in line 3 bad debt expense attributable to patients eligible under the organization's financial assistance policy.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	THE BAD DEBT EXPENSE FOOTNOTE IS ON PAGE 11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. SEE ALSO THE PARAGRAPH IN THE CHARITY CARE FOOTNOTE ON THE TOP OF PAGE 17.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	THE MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO DIRECTLY FROM THE MEDICARE COST REPORT WHICH RESULTS IN A SHORTFALL OF COVERING THE HOSPITAL'S COST OF TREATING MEDICARE PATIENTS. THIS SHORTFALL, IN ADDITION TO NON-PAYMENT BY MEDICARE RECIPIENTS FOR THEIR DEDUCTIBLE AND COINSURANCE AMOUNT INCREASES FINANCIAL ASSISTANCE AND BAD DEBT. THE MEDICAL CENTER PROVIDES SERVICES TO ALL MEDICARE PATIENTS WITH THE KNOWLEDGE THAT THE COST OF PROVIDING CARE TO THEM MAY EXCEED THE REIMBURSEMENT FROM MEDICARE FOR THE SERVICES PROVIDED. THE SHORTFALL OF COSTS, FINANCIAL ASSISTANCE AND BAD DEBT IS CONSIDERED TO BE A COMMUNITY BENEFIT BECAUSE THE HOSPITAL IS ABSORBING THE COST OF PROVIDING CARE TO THE ELDERLY AND DISABLED IN THE COMMUNITY. IN ADDITION, THIS COINCIDES WITH THE IRS REVENUE RULING 69-545, WHICH provides general requirements for tax exemption, along with section 501(c)(3).
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY CONTAINS PROVISIONS ON COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ONLY. ACCORDING TO THIS POLICY, FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA ARE BASED ON RESIDENCY, GROSS HOUSEHOLD INCOME & HOUSEHOLD SIZE. APPLYING FOR FINANCIAL ASSISTANCE Patients will be informed of the Mosaic Life Care Financial Assistance Policy and the process for submitting an application. to determine if the patient or guarantor is eligible for financial assistance, Mosaic Life Care asks for the necessary information and documents to prove household size, income, and residency. A completed application for financial assistance should be submitted within 240 days from the date of the first post-discharge billing statement. Mosaic Life Care will make reasonable efforts to explain the Medicaid benefits, the health insurance exchange and coverage, and other public and private coverage that may apply. Mosaic Life Care will also provide the details of these programs and offer to help patients and guarantors apply for them as well as, private programs and COBRA coverage. Once the patient or guarantor is screened to be potentially eligible for any of these programs, public or private, Mosaic Life Care expects him or her to apply. If a patient or guarantor chooses not to apply, he or she may be denied financial assistance. If the patient or guarantor is potentially eligible for any third-party coverage, he or she must provide documentation of approval or denial of that third-party coverage before a Mosaic Life Care financial assistance application will be accepted. Information on the Mosaic Life Care Financial Assistance Policy will be communicated to patients in a culturally appropriate language. Information about the policy will be translated in the most prevalent languages in the Mosaic Life Care primary service area. COLLECTION ACTIONS TAKEN IN EVENT OF NON-PAYMENT No account will be subject to collection actions within 120 days of issuing the first post-discharge statement and without first making reasonable efforts to determine whether the patient is eligible for financial assistance. No extraordinary collection actions will be pursued against a patient if the patient or guarantor has provided documentation showing that an application has been submitted for Medicaid or other publicly sponsored health programs, and that an eligibility determination is still pending. If a statement is sent to a patient or guarantor, and mail is returned as undelivered, Mosaic Life Care will attempt to find a correct address. If the correct address cannot be found, Mosaic Life Care will attempt to contact the patient or guarantor by telephone at the number listed by the patient or guarantor. If efforts to communicate with the patient or guarantor fail, accounts will be sent to a collection agency. Reasonable efforts to inform patient of financial assistance Prior to sending an account to a collection agency, the patient or guarantor will generally receive a minimum of four written statements (includes the first post-discharge statement and three subsequent statements). These statements will include a telephone number for information on paying patient balances and a notice about financial assistance. If an agreement has not been made to resolve the account, the fourth and final statement will be sent to the patient or guarantor. This statement acts as a notice to the account owner of the amount owed to Mosaic Life Care and that the account will be placed with a third-party collection agency in 30 days. This statement will include a plain language summary and will outline any collection actions that may be taken if a plan is not put in place to settle the account. There are other times when accounts may be placed in collections including when: 1. The patient or guarantor has not made timely payments according to the agreed-upon payment plan 2. The patient or guarantor has received a financial assistance discount but is no longer working with Mosaic Life Care in good faith to pay off the remaining amount owed. Extraordinary collection activities Once an account is with the collection agency, the following actions may be taken to make sure debt for services and care is paid. They are "Extraordinary Collection Activities:" 1. Seizing the patient's or guarantor's bank account 2. Civil actions 3. Property liens 4. Garnishing of wages 5. Reporting adverse information to credit bureaus Before "Extraordinary Collection Activities" can begin, the account must be reviewed, and approval must be given by Mosaic Life Care Patient Billing Leadership. When one of these actions is to be taken against a patient or guarantor, the patient or guarantor will be given a 30-day written notice of the action to be taken. The patient or guarantor will also be informed of the Mosaic Life Care Financial Assistance Policy and how to apply for it. A plain language summary of the Financial Assistance Policy will be included with the notice. ENFORCEMENT Mosaic Life Care staff are expected to uphold the highest ethical standards. All business must be conducted in the name of the caller or mosaic life care. Everything a staff member says must be true and correct using a professional approach. The staff as well as, all third-party vendors working on behalf of Mosaic life care, will uphold and adhere to the Fair Debt Collection Practices Act.
Schedule H, Part V, Section B, Line 16a FAP website	- Heartland Regional Medical Center: Line 16a URL: See Schedule O .;
Schedule H, Part V, Section B, Line 16b FAP Application website	- Heartland Regional Medical Center: Line 16b URL: See Schedule O;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- Heartland Regional Medical Center: Line 16c URL: See Schedule O;
Schedule H, Part VI, Line 2 Needs assessment	HEARTLAND REGIONAL MEDICAL CENTER HAS A ROBUST APPROACH FOR ASSESSING THE NEEDS OF THE COMMUNITIES IT SERVES. THIS ONGOING COMMITMENT INCLUDES COLLABORATING WITH LOCAL GROUPS, SCHOOL DISTRICTS AND CITY AND COUNTY AGENCIES TO IDENTIFY NEEDS, PROMOTE HEALTHY LIVING, ASSURE THAT AFFORDABLE MEDICAL SERVICES ARE AVAILABLE, DEVELOP STRATEGIES FOR IMPROVING EDUCATION AND ECONOMIC STRENGTH, AND PROVIDING ONGOING SUPPORT.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	THE MEDICAL CENTER INFORMS AND EDUCATES PATIENTS AND GUARANTORS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEGINNING AT THE REGISTRATION DESK AND CONTINUING WITH FINANCIAL ASSISTANCE INFORMATION BEING INCLUDED ON EVERY BILLING STATEMENT A PATIENT OR GUARANTOR RECEIVES FROM THE MEDICAL CENTER. GUIDELINES FOR THE PROGRAM ARE AVAILABLE AT EACH REGISTRATION DESK AND ARE INCLUDED IN ALL ADMISSION PACKETS. PATIENTS ARE CONTACTED IF THE PATIENT IS EXPECTED TO HAVE A FINANCIAL RESPONSIBILITY FOR THE VISIT. A FINANCIAL COUNSELOR ATTEMPTS TO VISIT THE ROOM OF EVERY UNINSURED PATIENT THAT IS ADMITTED TO OUR FACILITY FOR OBSERVATION OR INPATIENT CARE. THE COUNSELOR DISCUSSES PAYMENT OPTIONS WITH THE PATIENT AND CAN ASSIST THEM WITH VARIOUS OPTIONS THAT INCLUDE, BUT ARE NOT LIMITED TO, MEDICAID APPLICATION, HEALTH CARE EXCHANGE ELIGIBILITY AND ELIGIBILITY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. COUNSELORS ALSO WORK WITH OUR CARE MANAGEMENT STAFF TO SUPPORT THE DISCHARGE PROCESSES SO THAT FINANCIAL HARDSHIP DOES NOT KEEP THE PATIENT FROM RECEIVING THE APPROPRIATE FOLLOW-UP CARE. THIS ASSISTANCE INCLUDES INSTRUCTIONS FOR SCHEDULING AN APPOINTMENT WITH A FINANCIAL COUNSELOR WHO CAN ASSIST THEM IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION.
Schedule H, Part VI, Line 4 Community information	THE ORGANIZATION'S PRIMARY AND SECONDARY SERVICE AREA IS A 18 COUNTY URBAN/RURAL REGION LOCATED IN NORTHWEST MISSOURI AND NORTHEAST KANSAS. THE POPULATION IS ELDERLY AND UNDER-INSURED. THE LOCAL ECONOMY CONSISTS OF AGRICULTURAL, SMALL MANUFACTURING AND SELF-EMPLOYED BUSINESSES, PRIMARILY BLUE COLLAR WORKERS. THE ORGANIZATION SUPPORTS A PAYOR MIX OF APPROXIMATELY 68.87% GOVERNMENTAL OR NO-PAY PATIENTS. 19.9% OF THE POPULATION IS BELOW THE POVERTY LEVEL; 18.7 % OF THE POPULATION SMOKES; AND 35.9 % HAVE A BODY MASS INDEX GREATER THAN 30. MORE THAN 64.5% OF THE ELEMENTARY AGE STUDENTS RECEIVE FREE OR REDUCED-COST LUNCHES.
Schedule H, Part VI, Line 5 Promotion of community health	Heartland Regional Medical Center is a nonprofit hospital operating to serve a public rather than a private interest and meeting the requirements of Revenue Ruling 69-545. Control of the Medical Center rests with its Board, which is primarily composed of members of the community, in addition to a few select employees of the Medical Center. The Medical Center accepts patients paying with Medicaid and Medicare and operates an active and generally accessible emergency room open to all patients without regard to ability to pay. The Medical Center uses surplus funds to improve the quality of patient care, maintain and improve equipment and facilities, extend service offerings to new areas and provide support to the communities it serves. The Medical Center promotes health in the St. Joseph region in numerous ways. Highlighted below are examples in which the Medical Center provided direct funding support to the community organizations with like missions. THE ORGANIZATION OFFERS MANY EDUCATIONAL PROGRAMS THROUGHOUT THE YEAR TO HELP MAINTAIN A HEALTHY LIFESTYLE. THESE ARE WELL-ADVERTISED AND MOST OF THEM ARE FREE OF CHARGE. ONE SUCH PROGRAM IS THE POUND PLUNGE. FOR THE PAST TWELVE YEARS, THE ORGANIZATION HAS SPONSORED THIS THREE-MONTH LONG EVENT TO ENCOURAGE WEIGHT LOSS, EXERCISE AND HEALTHY EATING. MORE THAN 22,000 PEOPLE HAVE PARTICIPATED AND OVER 149,000 POUNDS HAVE BEEN LOST. AT THE END OF THE PROGRAM IN 2018, 96% OF RESPONDENTS TO THE SURVEY AGREED THAT THE POUND PLUNGE WAS BENEFICIAL TO OUR COMMUNITY, AND 88% AGREED THAT THEY ARE CURRENTLY CONTINUING A HEALTHY LIFESTYLE AS A RESULT OF THE POUND PLUNGE. ANOTHER AREA OF FOCUS HAS BEEN IN PREVENTING CHILDHOOD OBESITY. SEVERAL YEARS AGO THE ORGANIZATION'S INTERNAL CLINICAL PROTOCOLS ADDRESSING CHILDHOOD OBESITY WERE FOUND TO BE LACKING. THIS HAS BEEN RECTIFIED. APPROPRIATE PROTOCOLS ARE NOW FULLY ESTABLISHED AND HAVE BEEN GIVEN THE APPROVAL OF THE EVIDENCED-BASED PRACTICE GROUP AND ARE EMBEDDED IN THE ELECTRONIC MEDICAL RECORD. ACCOMPANYING THESE ESTABLISHED PROTOCOLS IS A THOROUGH PROVIDER EDUCATION PLAN TO ASSURE THAT THE NEW PROTOCOLS ARE UNDERSTOOD AND USED. EDUCATION ON THE 1-2-3-4-5 FIT-TASTIC! GUIDELINES HAVE BEEN PROVIDED TO ALL CLINICS TO ASSURE A CONSISTENT PATIENT EXPERIENCE. IN PARTNERSHIP WITH THE ST. JOSEPH SCHOOL DISTRICT, THE ORGANIZATION HAS CONTINUED AND EXPANDED THE 4TH GRADE CHALLENGE, WHICH HAS BEEN PROVIDED IN 24 ELEMENTARY SCHOOLS FOR 10 YEARS. PRE AND POST PROGRAM SURVEYING OF STUDENTS SHOWED AT LEAST A 49.75% INCREASE IN KNOWLEDGE OF THE FIT-TASTIC GUIDELINES AFTER COMPLETING THE PROGRAM. 91.7% OF SCHOOL COACHES AGREED THAT THE 4TH GRADE CHALLENGE IS AN EFFECTIVE PROGRAM THAT TEACHES STUDENTS ABOUT HEALTH, EXERCISE AND NUTRITION, AND 83% OF SCHOOL COACHES AGREED THAT THE 4TH GRADE CHALLENGE IS A GREAT HEALTH PROGRAM THAT HELPS FIGHT CHILDHOOD OBESITY. IN 2018, THE NUMBER OF SCHOOL AND COMMUNITY GARDENS WAS ACTIVE IN 8 ELEMENTARY SCHOOLS. THE GARDENS PRODUCED MORE THAN 28,000 POUNDS OF FRESH PRODUCE OVER THE PAST SIX YEARS, ENOUGH TO PROVIDE 22,181 MEALS PROVIDED AT NO COST TO THE COMMUNITY MEMBERS. FOR SOME ECONOMICALLY DISADVANTAGED AREAS, THE GARDENS SUPPLY FRUITS AND VEGETABLES TO FAMILIES WHO WOULD NOT HAVE ACCESS TO THEM OTHERWISE. IN ADDITION, A PROGRAM CALLED HANDS-ONLY CPR HAS PROVIDED EDUCATION ON LIFE SAVING SKILLS IN PARTNERSHIP WITH BUCHANAN COUNTY EMS TO ALL 5TH GRADERS AT 24 SCHOOLS AND TO APPROXIMATELY 1,500 STUDENTS. IN FY18, THE MEDICAL CENTER MAINTAINED A POST NATAL PROGRAM IN WHICH A NURSE PREFORMED A CHECK UP ON MOTHER AND BABY AT THEIR RESIDENCE TWO WEEKS AFTER DELIVERY. THIS IS DONE AT NO EXPENSE TO THE PATIENT AND IS A NON-BILLABLE SERVICE THAT IS PROVIDED AS A COMMUNITY BENEFIT. THE 340B DRUG PRICING PROGRAM ("340B PROGRAM") ENABLES SAFETY NET HEALTHCARE ORGANIZATIONS SERVING UNINSURED, VULNERABLE AND INDIGENT POPULATIONS TO PURCHASE OUTPATIENT PRESCRIPTION DRUGS AT A DISCOUNT. THE MEDICAL CENTER HAS PARTICIPATED IN THIS PROGRAM SINCE 2011. THIS PARTICIPATION HAS GENERATED REVENUE FROM THE CONTRACTED RETAIL PHARMACY RELATIONSHIPS ($66M LTD), CURRENTLY THREATENED BY REGULATION CHALLENGES. THE MEDICAL CENTER HAS RECOGNIZED REDUCED DRUG PRICING FOR OUTPATIENT MEDICATIONS ($56M LTD), CURRENTLY THREATENED BY LEGISLATIVE CHALLENGES. IN FY18 THE 340B PROGRAM RESULTED IN COMMUNITY SAVINGS OF $25 MILLION AS WELL AS ALLOWED THE MEDICAL CENTER TO SUPPORT $26 MILLION WORTH OF COMMUNITY PROGRAMS.
Schedule H, Part VI, Line 6 Affiliated health care system	THE ORGANIZATION IS AFFILIATED, THROUGH A PARENT BOARD, WITH A COMMUNITY FOUNDATION, AN LONG TERM ACUTE CARE HOSPITAL, A CRITICAL ACCESS RURAL HOSPITAL, A RURAL COMMUNITY FOUNDATION AND A COMMUNITY HEALTH IMPROVEMENT SOLUTIONS SERVICE, ALL OF WHICH COLLABORATE WITH EDUCATIONAL, GOVERNMENTAL AND LOCAL BUSINESS LEADERS TO IMPLEMENT PROGRAMS TO HELP IMPROVE HEALTH HABITS AND, IN THE LONG-TERM, THE HEALTH OF THE COMMUNITIES SERVED BY THE MEDICAL CENTER. THE PARENT BOARD IS COMPRISED OF COMMUNITY LEADERS WHO REPRESENT THE EDUCATIONAL, MEDICAL, GOVERNMENTAL AND BUSINESS SECTORS IN THE COMMUNITY. THE ORGANIZATION PROVIDES ACUTE, EMERGENT AND OUTPATIENT CLINIC CARE FOR ALL, REGARDLESS OF THEIR ABILITY TO PAY. THE ORGANIZATION MAINTAINS AN ONGOING COMMITMENT TO PROVIDE SUPPORT FOR THE BETTERMENT OF THE COMMUNITY. THE COMMUNITY FOUNDATION OVERSEES A NUMBER OF PROGRAMS WORKING TO IMPROVE HEALTH IN THE COMMUNITY. THE LONG TERM ACUTE CARE HOSPITAL IS A FACILITY DEDICATED TO THE CARE OF PATIENTS WHO HAVE CHRONIC CONDITIONS REQUIRING A LONGER LENGTH OF STAY THAN IS NORMALLY PROVIDED IN AN ACUTE CARE HOSPITAL. THE CRITICAL ACCESS RURAL HOSPITAL PROVIDES ACUTE, EMERGENT AND OUTPATIENT CLINIC CARE FOR THOSE IN THE RURAL COMMUNITY AREA. THE RURAL COMMUNITY FOUNDATION SUPPORTS THE CRITICAL ACCESS RURAL HOSPITAL. THE COMMUNITY HEALTH IMPROVEMENT SOLUTIONS SERVICE WORKS WITH EMPLOYERS IN THE COMMUNITY TO EFFECT HEALTHY CHANGES IN THEIR WORK FORCES.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (29 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt	Address Line2USAddress/AddressLine2Txt
Heartland Foundation
5325 Faraon Street	St Joseph	MO	64506	431262768	501c3	$851,535	Support
Social Welfare Board
904 S 10th St	St Joseph	MO	64503	446000455	501c3	$309,500	Support	Suite A
MWSU Foundation Inc
5425 DOWNS DRIVE	St Joseph	MO	64507	237035423	501C3	$307,950	Sponsorship
Community Missions Corporation
700 Olive Street	St Joseph	MO	64501	900180479	501C3	$200,000	Support
United Way of Greater St Joseph
118 S 5TH STREET	St Joseph	MO	64501	440547802	501C3	$182,269	Support
Second Harvest Community Food Bank
915 DOUGLAS STREET	St Joseph	MO	64505	431268319	501C3	$150,500	Support
Habitat for Humanity
PO Box 6528	St Joseph	MO	64506	431733608	501C3	$125,000	Support
YWCA
304 N 8TH STREET	ST JOSEPH	MO	64501	440552219	501C3	$107,000	Support
Legal Aid of Western Missouri
1125 Grand Blvd	Kansas City	MO	64106	430824638	501C3	$91,000	Support	Ste 1900
Catholic Charities of KC
1302 Faraon Street	St Joseph	MO	64501	430887779	501C3	$60,000	Support
BBBS of Greater St Joseph
1202 S 28th Street	St Joseph	MO	64507	440666362	501C3	$55,000	Support
MidCity Excellence Community Learning Center
2400 Frederick Avenue Suite 506	St Joseph	MO	64506	431934077	501C3	$50,000	Support
Family Guidance Center for Behavioral Healthcare
724 N 22ND ST	ST JOSEPH	MO	64506	440666362	501C3	$50,000	Support
Hillcrest Transitional Housing
4510 Belleview Suite 300	Kansas City	MO	64111	271481997	501C3	$50,000	Sponsorship
The Center
902 Edmond St Suite 203	St Joseph	MO	64501	431615018	501C3	$40,000	Support
Bartlett Center Youth Programs
409 South 18th Street	St Joseph	MO	64501	237116216	501C3	$30,000	Support
Community Alliance
3003 Frederick Avenue	St Joseph	MO	64506	050587096	501C3	$24,083	Support
Faith in Action
2711 Ashland Ave	St Joseph	MO	64506	440653008	501c3	$20,000	Support
American Red Cross of Northwest Missouri
401 N 12th	St Joseph	MO	64501	530196605	501C3	$19,000	Sponsorship
St Joseph Area Chamber of Commerce
3003 Frederick Avenue	St Joseph	MO	64506	440419460	501c6	$14,430	Sponsorship
Big Brothers Big Sisters of Greater Kansas City
1709 Walnut St	Kansas City	MO	64108	436068464	501C3	$12,500	Sponsorship
Northwest Missouri Childrens Advocacy Center
1807 Woodbine Rd	St Joseph	MO	64506	431910148	501C3	$12,000	Support
Innovation Stockyard
4221 Mitchell Avenue	St Joseph	MO	64507	201215246	501c3	$10,000	Sponsorship
Platte County Economic Development Council Inc
11724 NW Plaza Circle	Kansas City	MO	64153	431484127	501C3	$8,300	Support
Missouri Physicians Health Program
680 Craig Rd 308	St Louis	MO	63141	431572458	501C3	$7,500	Sponsorship
American Heart Association
104 Corporate Lake Dr	Columbia	MO	65203	135613797	501C6	$6,500	Sponsorship
Albrecht-Kemper Museum of Art Foundations
2818 FREDERICK	St Joseph	MO	64506	431855334	501C3	$5,800	Support
Northland Regional Chamber of Commerce
634 NW ENGLEWOOD ROAD	Kansas City	MO	64118	431279100	501C6	$5,410	Sponsorship
Greater Kansas City Chamber of Commerce
30 West Pershing Rd Ste 301	Kansas City	MO	641082423	440196840	501C6	$5,000	Sponsorship

Field	Value	IRS element (for citing)
Total501c3 Org	25	Total501c3OrgCnt
Total Other Org	4	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule I, Part II Line 2	Missouri Western State University Foundation
Schedule I, Part II Line 8	Young Women's Christian Association
Schedule I, Part II Line 11	Big Brothers Big Sisters of Greater St. Joseph
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.	The organization is committed to the development of a healthy community. 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. The recipients are required to submit quarterly reports to Heartland Regional Medical Center detailing the program's expenditures and progress toward the stated goals. Heartland Regional Medical Center's Advocacy department monitors the progress.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	Yes (X)	TravelForCompanionsInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Mark Laney MD
Director/President/Heartland Health CEO	$2,161,776	$0	$311,738	$0	$756	$0	$10,800	$0	$15,909	$0	$2,500,979	$0	$0	$0
John Olson MD
Director/Physician (until 12/2016)	$566,137	$0	$87,255	$0	$504	$0	$10,800	$0	$24,988	$0	$689,684	$0	$0	$0
Lucinda Hayden MD
Director (As of 01/2017)	$470,543	$0	$188,261	$0	$504	$0	$10,800	$0	$15,665	$0	$685,773	$0	$0	$0
Matt Lukens MD
Director (As of 01/2018)	$593,112	$0	$73,706	$0	$504	$0	$10,800	$0	$26,757	$0	$704,879	$0	$0	$0
Curt Kretzinger
COO (until 1/2017)	$1,176,462	$0	$0	$0	$499,796	$0	$1,856	$0	$15,298	$0	$1,693,411	$0	$989,930	$0
Jodie Roettger
Assistant Treasurer (until 02/2017)	$32,374	$0	$0	$0	$131,676	$0	$1,393	$0	$13,543	$0	$178,986	$0	$0	$0
John P Wilson
Secretary/Treasurer (until 01/2017)	$1,111,896	$0	$0	$0	$434,416	$0	$5,230	$0	$0	$0	$1,551,542	$0	$984,929	$0
Dwain Stilson
CFO/Treasurer	$431,539	$0	$139,139	$0	$504	$0	$61,808	$0	$26,657	$0	$659,647	$0	$0	$0
Michael Pulido
COO/Secretary	$567,519	$0	$117,889	$0	$756	$0	$116,488	$0	$27,088	$0	$829,739	$0	$59,623	$0
Carolyn S Paden
Administrator	$122,433	$0	$0	$0	$142,100	$0	$0	$0	$14,738	$0	$279,271	$0	$0	$0
Julee Thompson
Chief Nursing Executive	$245,835	$0	$58,847	$0	$0	$0	$10,800	$0	$14,565	$0	$330,046	$0	$0	$0
Brady D Dubois
President	$349,969	$0	$66,100	$0	$756	$0	$60,540	$0	$24,488	$0	$501,853	$0	$0	$0
Brennan Lehman
Chief Information Officer	$326,459	$0	$66,362	$0	$756	$0	$41,296	$0	$23,660	$0	$458,532	$0	$0	$0
Davin Turner MD
President	$465,814	$0	$96,596	$0	$756	$0	$55,831	$0	$24,157	$0	$643,153	$0	$14,027	$0
Hemant K Sheth MD
Staff Physician	$763,120	$45,620	$370,949	$0	$504	$0	$10,800	$734	$18,294	$0	$1,163,666	$46,354	$0	$0
John Barclay MD
Staff Physician	$400,181	$0	$577,409	$0	$504	$0	$10,800	$0	$24,488	$0	$1,013,382	$0	$0	$0
Mohan R Hindupur MD
Staff Physician	$902,508	$0	$62,521	$0	$504	$0	$5,400	$0	$18,358	$0	$989,292	$0	$0	$0
Robert Grant DO
Staff Physician	$874,357	$0	$77,576	$0	$504	$0	$5,400	$0	$26,988	$0	$984,825	$0	$0	$0
Rony M Abou-Jawde MD
Staff Physician	$977,162	$0	$19,791	$0	$504	$0	$10,800	$0	$24,488	$0	$1,032,745	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 3 Compensation Plan	COMPENSATION IS ESTABLISHED BY HEARTLAND HEALTH, A RELATED ENTITY, USING THE FOLLOWING: A. COMPENSATION COMMITTEE B. INDEPENDENT COMPENSATION CONSULTANT D. COMPENSATION SURVEYS OR STUDIES E. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
Schedule J, Part I, Line 1a Travel for companions	TRAVEL FOR COMPANIONS WAS NOT INCLUDED AS TAXABLE COMPENSATION AS IT WAS 100% FOR BUSINESS PURPOSES.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation	SENIOR EXECUTIVES HAVE A WRITTEN EMPLOYMENT CONTRACT.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	DAVIN TURNER, DO - VESTED $14,026.90 ; ACCRUED $45,031 BRENNAN LEHMAN - VESTED $0 ; ACCRUED $30,496 BRADY DUBOIS - VESTED $0 ; ACCRUED $49,920 CURT KRETZINGER - VESTED $989,930 ; ACCRUED $0 DWAIN STILSON - VESTED $0 ; ACCRUED $51,008 MICHAEL PULIDO - VESTED $59,263 ; ACCRUED $105,688 JOHN WILSON - VESTED $984,929 ; ACCRUED $0 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 BASED ON A 5-YEAR CLIFF VESTING SCHEDULE AND AT NORMAL RETIREMENT AGE OR UPON DEATH OR UPON SEPARATION FROM SERVICE DUE TO DISABILITY OR UPON INVOLUNTARY SEPARATION FROM SERVICE WITHOUT CAUSE, WITH LUMP SUM PAYMENT WITHIN 90 DAYS OF EACH SITUATION TAKING INTO CONSIDERATION A NON-COMPETE COVENANT SEPARATION WITH CAUSE MAKES SUPPLEMENTAL EXECUTIVE RETIREMENT AGREEMENTS NULL AND VOID.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
THE INDUSTRIAL DEVELOPMENT AUTHORITY OF ST JOSEPH MISSOURI
A	431203910	79075LAB3	2009-02-26	$70,000,000	FINANCE THE CONSTRUCTION AND EQUIPPING OF CERTAIN HEALTHCARE FACILITIES.	false	false	false
THE INDUSTRIAL DEVELOPMENT AUTHORITY OF ST JOSEPH MISSOURI
B	431203910	79075LAD9	2011-09-30	$25,250,000	REFUND 2001AB BONDS ISSUED 11/29/2001, 2001D BONDS ISSUED 11/29/2001 & 2003E BONDS ISSUED 5/22/2003.	false	false	false
HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI
C	431178966	60637ACP5	2012-10-03	$51,489,534	TO ACQUIRE, CONSTRUCT, REMODEL, RENOVATE AND EQUIP CERTAIN HEALTHCARE FACILITIES.	false	false	false
THE INDUSTRIAL DEVELOPMENT AUTHORITY OF ST JOSEPH MISSOURI
D	431203910		2015-11-18	$81,225,000	REFUND 2001AB AND 2001D BONDS ISSUED ON 11/29/2001.	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$1,635,000	$0	$70,956,418	$0	$0	$0	$0	$0	$0	$70,956,418	$0	$0	2014	false	false	Yes (true)	Yes (true)
B	$13,450,000	$0	$25,250,000	$0	$0	$0	$0	$0	$0	$0	$25,250,000	$0	2005	Yes (true)	false	Yes (true)	Yes (true)
C	$0	$0	$51,535,780	$0	$0	$0	$708,053	$0	$0	$50,827,726	$1	$0	2014	false	false	Yes (true)	Yes (true)
D	$9,100,000	$0	$81,225,000	$0	$0	$0	$362,060	$0	$0	$0	$80,862,940	$0	2005	Yes (true)	false	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Private Bus Concerning UBIPrivateBusConcerningUBIPct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropPct	Remedial Action TakenRemedialActionTakenInd
A	false	false	false	false	0.0	0.0	false	false	Yes (true)
B
C	false	false	false	false	0.0	0.0	false	Yes (true)	Yes (true)	0.0087	Yes (true)
D

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd	Exception To RebateExceptionToRebateInd	Term Of HedgeTermOfHedgePct	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd
(no name)
A	false	Yes (true)	Yes (true)	false	false	Yes (true)	Yes (true)
(no name)
B	Yes (true)		false	false	false	false	Yes (true)
(no name)
C	false	Yes (true)	false	false	false	false	Yes (true)
Wells Fargo Bank NA
D	false		Yes (true)	Yes (true)	false	false	Yes (true)	Yes (true)	11.1	false	false

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)
C	Yes (true)
D	Yes (true)

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule K, Part III, Line 1 Column B	PART III FOR 2011 BONDS HAS NOT BEEN COMPLETED. THE 2011 BONDS WERE USED TO REFINANCE PROJECTS ORIGINALLY FINANCED WITH BONDS ISSUED PRIOR TO JANUARY 1, 2003.
Schedule K, Part III, Line 1 Column D	PART III FOR 2015AB BONDS HAS NOT BEEN COMPLETED. THE 2015AB BONDS WERE USED TO REFINANCE PROJECTS ORIGINALLY FINANCED WITH BONDS ISSUED PRIOR TO JANUARY 1, 2003.
Schedule K, Part I Line C	A PORTION OF THE SERIES 2012 BONDS WAS TREATED AS REISSUED ON 4/30/2018 IN CONNECTION WITH A REMEDIAL ACTION UNDER TREASURY REGULATIONS § 1.141-12(e).
Schedule K, Part II, Line 3 Column A	AMOUNT DOES NOT EQUAL TO ISSUE PRICE LISTED IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS.
Schedule K, Part II, Line 3 Column C	AMOUNT DOES NOT EQUAL TO ISSUE PRICE LISTED IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS.
Schedule K, Part IV, Line 2c Column A	THE ARBITRAGE REBATE ANALYSIS WAS PERFORMED AS OF 2/1/2014.
Schedule K, Part IV, Line 2c Column C	THE ARBITRAGE REBATE ANALYSIS WAS PERFORMED AS OF 9/1/2014.
Schedule K, Part IV, Line 6 Column A	THE PROJECT FUND WAS INVESTED BEYOND THE THREE YEAR TEMPORARY PERIOD BUT NO EXCESS YIELD LIABILITY WAS GENERATED.
Schedule K, Part I, Column (a) & Part II, Column A, Line 3 (On the second form)	A PORTION OF THE SERIES 2012 BONDS IN THE AMOUNT OF $44,936,460.60 WAS TREATED AS REISSUED IN CONNECTION WITH A REMEDIAL ACTION UNDER TREASURY REGULATIONS § 1.141-12(E). TOTAL PROCEEDS EQUAL TO $24,794,467.92.
Schedule K, Part II, Line 13 Column A (On the second form)	THE SUBSTITUTE PROJECT HAS NOT BEEN COMPLETED AS OF THE FISCAL YEAR END.
Schedule K, Part II, Line 14 Column A (On the second form)	A PORTION OF THE SERIES 2012 BONDS WAS TREATED AS REISSUED ON 4/30/2018 IN CONNECTION WITH A REMEDIAL ACTION UNDER TREASURY REGULATIONS § 1.141-12(E). PROCEEDS RECEIVED FROM THE REISSUANCE WILL BE USED TO FINANCE A SUBSTITUTE PROJECT.
Schedule K, Part III Column A (On the second form)	PART III FOR 2012 REISSUED BONDS HAS NOT BEEN COMPLETED. THE SUBSTITUTE PROJECT HAS NOT BEEN COMPLETED AS OF THE FISCAL YEAR END.
Schedule K, Part IV, Line 6 Column A (On the second form)	DISPOSITION PROCEEDS ARE INVESTED AFTER THE 30-DAY TEMPORARY PERIOD.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	431178966	BondIssuerEIN
CUSIP	60637ACP5	CUSIPNum
Bond Issued	2018-04-30	BondIssuedDt
Issue Price	$44,936,461	IssuePriceAmt
Purpose	TO ACQUIRE, CONSTRUCT, REMODEL, RENOVATE AND EQUIP CERTAIN HEALTHCARE FACILITIES.	PurposeDesc
Defeased	false	DefeasedInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Pool Financing	false	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$0	RetiredAmt
Bond Defeased	$0	BondDefeasedAmt
Total Proceeds	$24,818,312	TotalProceedsAmt
In Reserve Fund	$0	InReserveFundAmt
Capitalized Interest	$0	CapitalizedInterestAmt
Refunding Escrow	$0	RefundingEscrowAmt
Issuance Costs From Proceeds	$0	IssuanceCostsFromProceedsAmt
Credit Enhancement	$0	CreditEnhancementAmt
Working Capital Expenditures	$0	WorkingCapitalExpendituresAmt
Capital Expenditures	$0	CapitalExpendituresAmt
Other Spent Proceeds	$0	OtherSpentProceedsAmt
Unspent	$24,818,312	UnspentAmt
Current Refunding	Yes (true)	CurrentRefundingInd
Advance Refunding	false	AdvanceRefundingInd
Final Allocation Made	false	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (true)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Total Private Business Use	0.0	TotalPrivateBusinessUsePct

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiledInd
Rebate Not Due Yet	Yes (true)	RebateNotDueYetInd
Variable Rate Issue	false	VariableRateIssueInd
Hedge Identified In Bks And Rec	false	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	Yes (true)	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (true)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (true)	ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Donna Wilson
DONNA WILSON is THE WIFE OF JOHN WILSON.	$96,148	DONNA WILSON IS THE SERVICE LEADER FOR YOUTH AND ADULT PARTNERSHIPS FOR HEARTLAND REGIONAL MEDICAL CENTER AND IS THE WIFE OF JOHN WILSON, WHO WAS THE CHIEF TREASURY OFFICER OF HEARTLAND REGIONAL MEDICAL CENTER. COMPENSATION IS WITHIN FAIR MARKET VALUE RANGE. THIS AMOUNT INCLUDES SALARY & OTHER COMPENSATION FOR SERVICE LEADER SERVICES.	false
Nikki Lehman
NIKKI LEHMAN IS THE WIFE OF BRENNAN LEHMAN.	$70,110	NIKKI LEHMAN IS A REVENUE CYCLE ANALYST AT HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE SPOUSE OF BRENNAN LEHMAN, WHO IS THE CHIEF INFORMATION OFFICER OF HEARTLAND REGIONAL MEDICAL CENTER. COMPENSATION IS WITHIN FAIR MARKET VALUE RANGE. THIS AMOUNT INCLUDES SALARY AND OTHER COMPENSATION FOR REVENUE CYCLE ANALYST SERVICES.	false
Jim Summers
Jim Summers is the Father-in-Law of Adam Stein.	$1,000,260	JIM SUMMERS IS THE FATHER-IN-LAW OF ADAM STEIN, WHO IS A DIRECTOR ON THE HEARTLAND REGIONAL MEDICAL CENTER BOARD. ADAM STEIN, BROKERED THE SALE OF A BUILDING TO HRMC AT FAIR MARKET VALUE BASED ON APPRAISAL. HRMC DID NOT PAY A COMMISSION FEE, ONLY THE PURCHASE PRICE OF THE PROPERTY.	false

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	Midwestern Health Management, Inc. and HHS Properties, Inc. - Business relationship, Curt Kretzinger - Business relationship, Mark Laney, M.D. - Business relationship, Michael Pulido - Business relationship, Dwain Stilson - Business relationship, John P. Wilson - Business relationship, Community Health Plan Insurance Company - Business relationship, Curt Kretzinger - Business relationship, Mark Laney, M.D. - Business relationship, Dwain Stilson - Business relationship, Brennan Lehman - Business relationship, Davin Turner, D.O. - Business relationship, John Wilson - Business relationship, Michael Pulido - Business relationship, Uptown Housing, Inc. - Business relationship, Curt Kretzinger - Business relationship, Dwain Stilson - Business relationship, John Wilson - Business relationship
Form 990, Part VI, Line 6 Classes of members or stockholders	HEARTLAND HEALTH, A MISSOURI NONPROFIT CORPORATION, IS THE SOLE MEMBER OF HEARTLAND REGIONAL MEDICAL CENTER.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	Heartland Regional Medical Center Board members are identical to the Heartland Health board, and Heartland Health is the sole member of Heartland Regional Medical Center. This gives the board members the ability to select the board.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	THE SOLE MEMBER (HEARTLAND HEALTH) SHALL HAVE THE FOLLOWING POWERS: OVERALL STRATEGIC DIRECTION (EXCLUDING MATTERS RELATED PRIMARILY TO THE ACCOUNTABLE CARE ORGANIZATION (ACO) OPERATED BY THE HOSPITAL, INCLUDING SPECIFICALLY ANY MEDICARE SHARED SAVINGS PROGRAM CREATED UNDER THE AFFORDABLE CARE ACT), APPOINTMENT OF AUDITORS AND LEGAL COUNSEL, ESTABLISHMENT OF BANKING RELATIONSHIPS AND MANAGEMENT OF CASH AND OTHER ASSETS (EXCLUDING ACO SHARED SAVINGS DISTRIBUTIONS AND REPAYMENT OF SHARED LOSSES), LONG-RANGE PLANNING, ADOPTION OF ANNUAL OPERATING PLANS AND APPLICATION FOR CERTIFICATES OF NEED.
Form 990, Part VI, Line 11b Review of form 990 by governing body	AN INDEPENDENT ACCOUNTING FIRM REVIEWS THE FORM 990 WITH INFORMATION PROVIDED FROM HEARTLAND REGIONAL MEDICAL CENTER'S ACCOUNTING STAFF. THE INDEPENDENT ACCOUNTING FIRM REVIEWS A DRAFT OF THE FORM 990 WITH THE INTERNAL TAX DEPARTMENT OF HEARTLAND REGIONAL MEDICAL CENTER. THE DRAFT FORM 990 IS REVISED FOR ANY CORRECTIONS OR CLARIFICATIONS BASED ON THE REVIEW. THE INDEPENDENT ACCOUNTING FIRM THEN CONDUCTS A REVIEW OF THE FORM 990 WITH THE CONTROLLER AND CHIEF FINANCIAL OFFICER OF HEARTLAND REGIONAL MEDICAL CENTER. AFTER ANY NECESSARY CORRECTIONS OR CLARIFICATIONS ARE MADE TO THE FORM 990, A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO ALL VOTING MEMBERS OF THE HEARTLAND REGIONAL MEDICAL CENTER BOARD OF DIRECTORS PRIOR TO ELECTRONICALLY FILING THE RETURN.
Form 990, Part VI, Line 12c Conflict of interest policy	UPON AGREEING TO FILL A BOARD POSITION, THE PROSPECTIVE MEMBER IS REQUIRED TO SIGN A CONFLICT OF INTEREST DOCUMENT WHICH DISCLOSES FAMILY AND BUSINESS RELATIONSHIPS THAT COULD BE CONSIDERED IN CONFLICT WITH HIS/HER POSITION ON THE BOARD. IN THIS DOCUMENT, THE MEMBER AGREES TO DISCLOSE ANY ACTIVITIES IN WHICH HE/SHE MAY NOT BE INDEPENDENT IN REGARDS TO A TRANSACTION. THIS DOCUMENT IS DISTRIBUTED AND HELD BY THE CORPORATE COMPLIANCE OFFICE AND LEGAL COUNSEL. THE NEW MEMBER ALSO SIGNS HEARTLAND'S CODE OF CONDUCT DOCUMENT IN WHICH THE MEMBER AGREES TO COMPLY WITH THE ORGANIZATION'S ETHICAL STANDARDS AND CONFIDENTIALITY POLICIES. THIS DOCUMENT IS HELD BY THE CORPORATE COMPLIANCE OFFICE. ANNUALLY, THE CORPORATE COMPLIANCE OFFICER DISTRIBUTES A SURVEY TO EACH BOARD MEMBER TO FACILITATE DISCLOSURE OF ANY REPORTABLE ACTIVITIES. DURING THE COURSE OF BOARD MEETINGS, BOARD MEMBERS WILL DISMISS THEMSELVES FROM MEETINGS AND/OR ABSTAIN FROM VOTING DURING DISCUSSIONS OF ISSUES THAT RELATE TO THOSE SPECIFIC MEMBERS OR THE COMPANIES THAT THEY REPRESENT. FOR EXAMPLE, PHYSICIAN BOARD MEMBERS ABSTAIN FROM VOTING ON THEIR OWN RE-CREDENTIALING; UNIVERSITY BOARD MEMBERS ARE DISMISSED DURING DISCUSSIONS OF UNIVERSITY-RELATED ACTIVITIES; AND LEGAL COUNSEL IS DISMISSED DURING DISCUSSION AND VOTING ON LEGAL COUNSEL REVIEW AND SELECTION. ALL DISMISSALS AND ABSTENTIONS ARE RECORDED IN THE MINUTES OF THE BOARD MEETING. ANNUALLY, THE BOARD MEMBERS ALONG WITH OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO RE-SIGN THE CODE OF CONDUCT DOCUMENT IN WHICH THEY AGREE TO COMPLY WITH THE ORGANIZATION'S ETHICAL STANDARDS AND CONFIDENTIALITY POLICIES. THEY ALSO RECEIVE A QUESTIONNAIRE WHICH FACILITATES THE DISCLOSURE OF ANY REPORTABLE ACTIVITIES TO THE CORPORATE COMPLIANCE OFFICER.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	COMPENSATION IS ESTABLISHED BY HEARTLAND REGIONAL MEDICAL CENTER (HRMC). AN ANNUAL REVIEW WAS PERFORMED DURING THE PRIOR FISCAL YEAR FOR THE CURRENT YEAR'S COMPENSATION. MARKET DATA IS PROVIDED BY AN INDEPENDENT COMPENSATION CONSULTANT. A COMPENSATION COMMITTEE COMPRISED OF THE HRMC BOARD CHAIR, HRMC VICE-CHAIR AND THREE ADDITIONAL HRMC BOARD MEMBERS AND LEGAL COUNSEL, AS SCRIBE, OVERSEE AN ANNUAL SALARY REVIEW PROCESS FOR OFFICERS, ADMINISTRATORS AND KEY EMPLOYEES. FOR EACH POSITION TO BE REVIEWED, THE FULL SCOPE OF DUTIES AND RESPONSIBILITIES, NUMBERS OF STAFF MANAGED, PROCESSES MANAGED, APPROXIMATE REVENUE, EXPENSE, OR CAPITAL DOLLARS MANAGED ARE PROVIDED BY A THIRD PARTY CONSULTANT THAT SPECIALIZES IN RESEARCH MARKET SALARY DATA. FACILITY SIZE, NOT-FOR-PROFIT STATUS AND THE SCOPE OF EACH JOB POSITION IS COMPARED TO SIMILAR FACILITIES TO DETERMINE BASE COMPENSATION AND INCENTIVE COMPENSATION FOR EACH POSITION. THE DATA GATHERED BY THE MARKET RESEARCH FIRM IS REVIEWED BY THE COMPENSATION COMMITTEE, OUTLIER ISSUES ARE RESOLVED AND BASED UPON PRESENT FINANCIAL INDICATORS, THE COMMITTEE MAKES THEIR DETERMINATION OF COMPENSATION LEVELS FOR THE NEXT PAY YEAR.
Form 990, Part VI, Line 19 Required documents available to the public	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	All Other Revenue - Total Revenue: 16181396, Related or Exempt Function Revenue: 14385163, Unrelated Business Revenue: 1796233, Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Change in fair value of derivative instruments - 2242702; Change in fair value of cash flow hedging derivatives - 353000; Change in defined benefit pension plan - 25238000; Net asset transfers - -330000; Asset impairment/Restructuring - -3528432; Pension interest and amortization of actual loss - -228015; Net assets released from restrictions used for operations - -121000;
Schedule H Part II Line 7h	Mosaic Life Care's Clinical Research Program provides alternative treatment options when standard of care has failed. These patients may not have access to other treatments. Clinical Research coordinators seamlessly provide care for patients outside of normal treatment options. Clinical research is an important part of any medical care because it helps advance the sciences developed to treat and ultimately lead to management, and a possible cure, for multiple diagnosis. The clinical research department at Mosaic Life Care provides education to the community on the types of clinical research we can provide which includes pharmaceuticals, medical devices, case studies, retrospective chart reviews, prospective trials, humanitarian device trials, compassionate use trials, emergency use trials and much more. The Research team will assist the patients in proper screening and determine eligibility.
Form 990, Part XII, Line 2C Financial Statements and Reporting	The results of the consolidated audit are reviewed by the Heartland Health Board, the parent corporation.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION IS ESTABLISHED BY HEARTLAND HEALTH, A RELATED ENTITY. AN ANNUAL REVIEW WAS PERFORMED DURING THE PRIOR FISCAL YEAR. MARKET DATA WAS PROVIDED BY A THIRD PARTY COMPENSATION CONSULTANT THAT SPECIALIZES IN MARKET SALARY DATA. A COMPENSATION COMMITTEE COMPRISED OF HEARTLAND HEALTH BOARD CHAIR, HEARTLAND HEALTH BOARD VICE-CHAIR AND THREE ADDITIONAL HEARTLAND HEALTH BOARD MEMBERS AND INDEPENDENT LEGAL COUNSEL, AS SCRIBE, OVERSAW AN ANNUAL SALARY REVIEW PROCESS FOR OFFICERS AND ADMINISTRATORS. 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 WERE PROVIDED TO THE THIRD PARTY CONSULTANT. FACILITY SIZE, NOT-FOR-PROFIT STATUS AND THE SCOPE OF EACH JOB POSITION WERE COMPARED TO LIKE FACILITIES TO DETERMINE BASE COMPENSATION AND INCENTIVE COMPENSATION FOR EACH POSITION. THE DATA GATHERED BY THE THIRD PARTY CONSULTANT WAS REVIEWED BY THE COMPENSATION COMMITTEE, OUTLIER ISSUES WERE RESOLVED AND, BASED UPON PRESENT FINANCIAL INDICATORS, THE COMMITTEE MADE ITS DETERMINATION OF COMPENSATION LEVELS FOR THE NEXT PAY YEAR.
Schedule H Section B Part V Line 16a FAP Website URL	https://www.mymosaiclifecare.org/Main/Location/st-joseph-mo/mosaic-life-care-at-st.-joseph/Medical-Center/medical-bills-made-easy/financial-assistance/
Schedule H Section B Part V Line 16b FAP application form	https://www.mymosaiclifecare.org/Main/Location/st-joseph-mo/mosaic-life-care-at-st.-joseph/Medical-Center/medical-bills-made-easy/financial-assistance/
Schedule H Section B Part V Line 16c FAP Plain Language Summary	https://www.mymosaiclifecare.org/Main/Location/st-joseph-mo/mosaic-life-care-at-st.-joseph/Medical-Center/medical-bills-made-easy/financial-assistance/

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Northland Expansion LLC
5325 Faraon Street	St Joseph	MO	64506	Development	MO	$0	$0	HRMC
Urgent Care Properties LLC
5325 Faraon Street	St Joseph	MO	64506	Development	MO	$0	$0	HRMC

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
Heartland Health
5325 Faraon Street	St Joseph	MO	64506	431283316	Healthcare	MO	501(c)(3)	Type I	NA	false
Heartland Foundation
5325 Faraon Street	St Joseph	MO	64506	431262768	Support	MO	501(c)(3)	7	Heartland Health	Yes (true)
Heartland Long Term Acute Care Hospital
5325 Faraon Street	St Joseph	MO	64506	261972987	Healthcare	MO	501(c)(3)	3	Heartland Health	Yes (true)
Northwest Medical Center Association Inc
705 North College Street	Albany	MO	64402	440580870	Healthcare	MO	501(c)(3)	3	Heartland Health	Yes (true)
Northwest Medical Center Foundation Inc
705 North College Street	Albany	MO	64402	473694893	Support	MO	501(c)(3)	7	Northwest Medical Center Association Inc	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	ST JOSEPH DOWNTOWN DEVELOPMENT LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	5325 FARAON STREET	AddressLine1Txt
City	ST JOSEPH	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	64506	ZIPCd

Field	Value	IRS element (for citing)
EIN	474317460	EIN
Primary Activities	DEVELOPMENT OF DOWNTOWN ST. JOSEPH	PrimaryActivitiesTxt
Legal Domicile State	MO	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Predominant Income Type	N/A	PredominantIncomeTypeTxt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	OwnershipOwnershipPct
Midwestern Health Management Inc
5323 Faraon Street	St Joseph	MO	64506	431264358	Healthcare	MO	NA	C Corporation	Yes (true)
Community Health Plan Insurance Company
5323 Faraon Street	St Joseph	MO	64506	431210152	Insurance	MO	NA	C Corporation	Yes (true)
HHS Properties Inc
5323 Faraon Street	St Joseph	MO	64506	431593799	Investment	MO	NA	C Corporation	Yes (true)
Uptown Housing Inc
5323 Faraon Street	St Joseph	MO	64506	261416252	Redevelopment	MO	HRMC	C Corporation	Yes (true)	1
Uptown St Joseph Redevelopment Corp
5323 Faraon Street	St Joseph	MO	64506	201742813	Redevelopment	MO	HRMC	C Corporation	Yes (true)	1

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (23 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Heartland Long Term Acute Care Hospital
A	$521,447	FMV
Heartland Long Term Acute Care Hospital
J	$577,200	FMV
Heartland Long Term Acute Care Hospital
L	$2,773,199	FMV
Heartland Long Term Acute Care Hospital
Q	$2,941,698	FMV
Northwest Medical Center Association Inc
L	$7,279,471	FMV
Northwest Medical Center Association Inc
Q	$4,540,635	FMV
Northwest Medical Center Association Inc
S	$147,659	FMV
Heartland Foundation
B	$851,535	FMV
Heartland Foundation
Q	$2,018,641	FMV
Midwestern Health Management Inc
B	$1,540,000	FMV
Midwestern Health Management Inc
L	$2,135,660	FMV
Midwestern Health Management Inc
Q	$2,490,989	FMV
Midwestern Health Management Inc
I	$86,958	FMV
St Joseph Downtown Development LLC (905 owned by MHM)
L	$75,491	FMV
St Joseph Downtown Development LLC (905 owned by MHM)
Q	$54,285	FMV
HHS Properties Inc
L	$945,324	FMV
HHS Properties Inc
K	$259,119	FMV
HHS Properties Inc
Q	$820,000	FMV
Aspire LLC (disregarded entity for HHS Properties is member)
L	$51,319	FMV
Aspire LLC (disregarded entity for whom HHS Properties is memeber)
Q	$720,000	FMV
Community Health Plan Insurance Company
S	$1,225,273	FMV
Ascend Development LLC (disregarded entity wholly owned by MHM)
Q	$249,770	FMV
Ascend Development LLC (disregarded entity wholly owned by MHM)
L	$6,840,139	FMV