2017-11-08T16:25:18-06:00 2017-06-30 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2016-07-01 113669999 MOSAIC MOSA 4028963884 4980 S 118TH ST LIND CENTER NO A OMAHA NE 68137 SCOTT HOFFMAN CHIEF FINANCIAL OFFICER 4028963884 2017-11-07 1 WENDY R COOLEY P01523804 4023302660 209.34.201.180 2017-11-07 11:26:42 CS P 63D81CB8106D627D5DFEC195ABD46CB6BD09E3D2 FCEDDD786A52D146CD6D5AF04BB3D8B974087028 2016 2018-03-14 21:41:22Z SCOTT HOFFMAN 4980 S 118TH ST LIND CENTER NO A OMAHA NE 68137 233409337 0 X WWW.MOSAICINFO.ORG X 2003 NE EMBRACING GOD'S CALL TO SERVE IN THE WORLD, MOSAIC ADVOCATES FOR PEOPLE WITH INTELLECTUAL DISABILITIES AND PROVIDES OPPORTUNITIES FOR THEM TO ENJOY A FULL LIFE. 13 13 6901 271 79978 0 3652262 6775651 231521830 223485812 1899556 772514 1278059 1237786 238351707 232271763 87283 179172 0 0 161199064 153608255 0 0 0 73691849 77130909 234978196 230918336 3373511 1353427 103392526 101940358 38179103 35390561 65213423 66549797 X EMBRACING GOD'S CALL TO SERVE IN THE WORLD, MOSAIC ADVOCATES FOR PEOPLE WITH INTELLECTUAL DISABILITIES AND PROVIDES OPPORTUNITIES FOR THEM TO ENJOY A FULL LIFE. 0 0 108211190 118967829 COMMUNITY BASED SERVICES PROVIDED TO PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES ARE SERVICES THAT CAN EITHER BE ON-GOING OR INTERMITTENT SUCH AS RESPITE, FAMILY SUPPORT, FOSTER CARE, PHYSICAL THERAPIES, TRANSPORTATION, AND SUPPORTED EMPLOYMENT. MOSAIC SERVES APPROXIMATELY 2,947 INDIVIDUALS ACROSS THE UNITED STATES UNDER THIS SERVICE CATEGORY. 61193040 67275880 INTERMEDIATE CARE FACILITIES (ICF)--ICF SERVICES PROVIDE 24/7 SUPPORT FOR VERY MEDICALLY FRAGILE INDIVIDUALS WITH INTELLECTUAL OR DEVELOPMENTAL DISABILITIES. MOSAIC SERVES APPROXIMATELY 684 INDIVIDUALS ACROSS THE UNITED STATES UNDER THIS SERVICE CATEGORY. 20404488 22432779 DAY AND VOCATIONAL SERVICES ARE PROVIDED TO INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES IN A VARIETY OF WAYS INCLUDING SUPPORTED EMPLOYMENT, WORK ENCLAVES, VOCATIONAL TRAINING AND SOME SHELTERED WORKSHOPS. MOSAIC SERVES APPROXIMATELY 1,430 INDIVIDUALS ACROSS THE UNITED STATES UNDER THIS SERVICE CATEGORY. 14440413 179172 15875850 MISCELLANEOUS SERVICES PROVIDED TO INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. 14440413 179172 15875850 204249131 1 1 0 1 0 0 1 0 1 1 1 1 0 1 1 1 0 1 0 0 0 1 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 726 0 1 6901 1 1 1 1 BD 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CO X X SCOTT HOFFMAN 4028963884 4980 SOUTH 118TH STREET OMAHA NE 68137 LISA NEGSTAD CHAIRPERSON 1.50 0.10 X X 0 0 0 KATHY PATRICK VICE CHAIRPERSON 1.50 0.00 X X 0 0 0 CONRAD T SWANSON SECOND VICE CHAIRPERSON 1.50 0.00 X X 0 0 0 THE REV KEITH HOHLY SECRETARY 1.50 0.00 X X 0 0 0 EDWARD L BARKER DIRECTOR 1.50 0.00 X 0 0 0 JAMES S BOWEN DIRECTOR 1.50 0.00 X 0 0 0 LINDA K BURT DIRECTOR 1.50 0.00 X 0 0 0 THE REV DANIEL FOREHAND DIRECTOR 1.50 0.00 X 0 0 0 JAMES J OLMSTED DIRECTOR 1.50 0.00 X 0 0 0 SANDRA SCOTT DIRECTOR 1.50 0.00 X 0 0 0 PAMELA SPADARO DIRECTOR 1.50 0.10 X 0 0 0 JAMES P TOTSCH DIRECTOR 1.50 0.00 X 0 0 0 JOSEPH TURKOWSKI DIRECTOR 1.50 0.00 X 0 0 0 LINDA TIMMONS PRESIDENT AND CEO 39.70 0.30 X 503675 0 138532 SCOTT HOFFMAN TREASURER AND CFO 39.70 0.30 X 238671 0 36409 RAUL SALDIVAR SVP OF OPERATIONS 40.00 0.00 X 310267 0 52450 KEITH SCHMODE SVP MISSION OPPORTUNITIES 40.00 0.00 X 268018 0 46536 SUE LOERTS SVP OF HUMAN RESOURCES 40.00 0.00 X 228253 0 39012 RENEE COUGHLIN SVP OF MISSION ADVANCEMENT 40.00 0.00 X 182568 0 46301 MARVA WEAVER VP OF OPERATIONS THRU 5/14/16 40.00 0.00 X 217290 0 10982 DONNA WERNER SVP OF ADVOCACY 40.00 0.00 X 188942 0 33780 JOSEPH LYONS GENERAL COUNSEL 40.00 0.00 X 195840 0 23002 WANDA WINFREE CHIEF INTEGRITY OFFICER 40.00 0.00 X 169499 0 39145 MARLIN WILKERSON VICE PRESIDENT OF OPERATIONS 40.00 0.00 X 163170 0 32852 NANCY DAVIS VICE PRESIDENT OF OPERATIONS 40.00 0.00 X 153789 0 29699 TAMMY WESTFALL VICE PRESIDENT OF OPERATIONS 40.00 0.00 X 157463 0 25780 STACY MORTON VP OF FINANCIAL OPERATIONS 40.00 0.00 X 162376 0 15908 KATIE GIVENS VP OF INFORMATION TECHNOLOGY 40.00 0.00 X 145621 0 31952 KRISTIN ROSSOW VICE PRESIDENT OF ACCOUNTING 27.40 12.60 X 144118 0 25894 MOLLY KENNIS VICE PRESIDENT OF OPERATIONS 40.00 0.00 X 149254 0 16045 ANDREA FERRUCCI VICE PRESIDENT OF OPERATIONS 40.00 0.00 X 142586 0 21194 DOLORES BANGERT VP FIXED ASSET DEVEL. THRU 6/09/16 27.50 12.50 X 141293 0 15640 CINDY SCHROEDER FORMER SENIOR VICE PRESIDENT 30.00 0.00 X 129273 0 5914 3991966 0 687027 41 1 1 0 EPIC CONSTRUCTION 12455 WOODCREST DR OMAHA NE 68137 CONSTRUCTION 514181 PJW NURSING CONSULTANTS LLC 28 CUMBERLAND ROAD WEST HARTFORD CT 06119 NURSING 459138 RICOH PO BOX 534777 ATLANTA GA 303534777 OFFICE STAFF, EQUIPMENT, AND MAINTENANCE 241637 WALKER BROTHERS ROOFING 3281 FAYETTE AVE SLOAN IA 51055 ROOFING 222360 ANTHONY AND STEPHANIE CAMPANA 1318 GARFIELD STREET HOLDREGE NE 68949 HOST HOME 217365 36 6531645 244006 6775651 MEDICARE/MEDICAID PMTS 624100 214607794 214607794 PROGRAM SERVICE REV. 624100 4246005 4246005 CONSULTING INCOME 541610 2887950 2887950 MANAGEMENT FEES 541610 1035913 1035913 RENTAL INCOME 532000 708150 708150 223485812 114670 79978 34692 10531 10531 230310 69581 160729 160729 160729 1725837 1067993 657844 657844 657844 INSURANCE PROCEEDS 900099 405594 405594 PURCHASING CARD REBATE 900099 175220 175220 485712 485712 1066526 232271763 224552338 79978 863796 X 10000 10000 169172 169172 3710211 3710211 121079812 109866689 11213123 470048 458049 11999 19387551 18286089 1101462 8960633 8033579 927054 164050 15470 148580 284788 26856 257932 36483142 34179148 2303994 14287316 13067613 1219703 9445820 9001918 443902 3175609 1882620 1292989 73592 11 73581 1198521 807167 391354 4805727 3595806 1209921 2173406 2109037 64369 BAD DEBT EXPENSE 1497280 1144639 352641 DUES & MEMBERSHIPS 917537 275369 642168 CFR EXPENSE 670943 105335 565608 UNRELATED BUS. INC TAX 20648 20648 1932530 1214564 717966 230918336 204249131 26669205 0 10718585 9997563 1007926 1013307 25341392 23623694 1636732 1678317 116139049 72425931 46515861 43713118 7189155 9224624 5929149 5922776 5053726 6766959 103392526 101940358 17636251 16413719 327382 317936 17680716 15244752 2534754 3414154 38179103 35390561 X 64326496 65668466 886927 881331 65213423 66549797 103392526 101940358 X 1353427 -10650 -6403 X X 0 1 X 1 1 1 X 7504201 6660703 5901972 3652262 6775651 30494789 200856466 206114000 224467717 231521830 223485812 1086445825 208360667 212774703 230369689 235174092 230261463 1116940614 3536 2385 1337 1965 3317 12540 0 3536 2385 1337 1965 3317 12540 1116928074 135576 166630 157311 249898 275533 984948 67279 76224 137592 139683 79978 500756 202855 242854 294903 389581 355511 1485704 3800424 3720044 540645 787697 1066526 9915336 212363946 216737601 231205237 236351370 231683500 1128341654 0.98990 0.98660 0.00130 0.00130 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 1 21759 0 0 1 2413 1 1 4784 28956 0 PART II-B, LINE 1: DURING THE PAST YEAR, MOSAIC ENGAGED IN VARIOUS NON-PARTISAN ACTIVITIES TO INFLUENCE SPECIFIC LEGISLATION IMPACTING THE ORGANIZATION. MOSAIC ENGAGED ADVOCATES ON SOCIAL MEDIA ABOUT ISSUES IMPACTING THE ORGANIZATION, INCLUDING PROVIDING A LINK FOR ADVOCATES TO CONTACT THEIR MEMBERS OF CONGRESS. MOSAIC DID ADVERTISE ON SOCIAL MEDIA IN 2017. MOSAIC ALSO SENT POSTCARDS TO PEOPLE AFFILIATED WITH THE ORGANIZATION INFORMING THEM ABOUT PREVAILING PUBLIC POLICY ISSUES IMPACTING THE ORGANIZATION AND PROVIDING CONTACT INFORMATION FOR MEMBERS OF CONGRESS. MOSAIC ALSO INCLUDED IN ITS SEMI-ANNUAL PUBLICATION A POSTCARD FOR ADVOCATES TO SEND DIRECTLY TO THEIR MEMBERS OF CONGRESS. MOSAIC AS AN ORGANIZATION ENGAGED ITS MEMBERS OF CONGRESS THROUGH LETTERS, EMAILS, AND OFFICE VISITS. MOSAIC ALSO WORKED WITH ITS STAFF TO PLACE LETTERS TO THE EDITOR PIECES IN LOCAL NEWSPAPERS AND SENT A VARIETY OF ACTION ALERTS TO ITS ADVOCACY NETWORK. X X X 1 80.00 0 1 0 100.00 0 1 1672430 19473832 19372189 1774073 0 36914107 1341962 4036488 4982443 37310114 35685382 1635155 502714 909144 36914107 36531798 833105 830838 2510359 35685382 34313920 2487529 4868779 5138430 36531798 34764985 2848409 3247117 6546591 34313920 0.83970 0.14020 0.02010 0 1 1 4964519 4964519 88047036 53685072 34361964 1789293 1428865 360428 11228113 9865266 1362847 10110088 7446728 2663360 43713118 110000 C CSV OF LIFE INSURANCE 483851 F BOND RESERVES 100000 F INVESTMENT IN BICO 8530773 C 9224624 AFFILIATE RECEIVABLES 4598191 MISCELLANEOUS RECEIVABLES 787768 INTERUNIT RECEIVABLE 476000 INVESTMENT IN PROPERTY 905000 6766959 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS- MEDICAID 1301091 REFUNDABLE FEES 22583 CRATS PAYABLE 884054 LIABILITY FOR PENSION BENEFITS 1206426 3414154 X 253077106 -27053 20832396 20805343 232271763 0 232271763 251740732 20832396 20832396 230908336 10000 10000 230918336 PART II, LINE 9: THE FINANCIAL STATEMENTS FOR MOSAIC AND ITS AFFILIATES DO NOT CONTAIN ANY INFORMATION REGARDING THE CONSERVATION EASEMENT. PART IV, LINE 1B: MOSAIC IS THE REPRESENTATIVE-PAYEE FOR THE PERSONAL FUNDS OF A NUMBER OF INDIVIDUALS IN SERVICE. MOSAIC DOES NOT OWN THE ACCOUNTS. IN PREVIOUS YEARS, THE ACCOUNTING FOR SUCH ACTIVITIES OCCURRED AT THE AGENCY LEVEL AND AN AGGREGATE ACCOUNTING OF SUCH SERVICES WAS NOT POSSIBLE. MOSAIC IS NOW ABLE TO TRACK ALL ACCOUNT ACTIVITIES, AND THE NUMBERS LISTED ON PART IV, LINES 1C - 1F ACCURATELY REFLECT THE AGGREGATE BALANCE OF THESE ACCOUNTS. PART V, LINE 4: THE ENDOWMENT FUNDS ARE INTENDED FOR SUPPORT OF MOSAIC'S LONG TERM COMMITMENT TO ITS MISSION AND FOR CAPITAL IMPROVEMENTS AND GENERAL OPERATIONS. THE ENDOWMENT FUNDS ARE HELD BY THE MOSAIC FOUNDATION. PART X, LINE 2: ALL CONSOLIDATED AFFILIATED ENTITIES, EXCEPT FOR MOSAIC HOUSING CORP V, INC., EASE-E MEDICAL, INC. AND BICO, LTD. ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OR 501(C)(2) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN MOSAIC'S TAX EXEMPT STATUS. MOSAIC RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. SUCH TAX POSITIONS, WHICH ARE MORE THAN 50% LIKELY OF BEING REALIZED, ARE MEASURED AT THEIR HIGHEST VALUE. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. DURING 2017 AND 2016, MANAGEMENT DETERMINED THAT THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS OTHER THAN DESCRIBED PREVIOUSLY. PART XI, LINE 2D - OTHER ADJUSTMENTS: ELIMINATION OF INTERNAL MANAGEMENT FEES 20,762,815. RECLASSIFICATION OF RENTAL INCOME AND EXPENSES 69,581. PART XII, LINE 2D - OTHER ADJUSTMENTS: ELIMINATION OF INTERNAL MANAGEMENT FEES 20,762,815. RECLASSIFICATION OF RENTAL INCOME AND EXPENSES 69,581. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT TO MOSAIC HOUSING CORPORATIONS 18 & 19 10,000. 1 0 0 0 0 0 0 0 0 0 EUROPE SUPPORT DEVELOPMENT OF SERVICES FOR PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. 35000 WIRE TRANSFER 0 SUB-SAHARAN AFRICA SUPPORT DEVELOPMENT OF SERVICES FOR PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. CENTER-BASED AND IN-HOME SUPPORT FOR CHILDREN WITH DISABILITIES AND THEIR CAREGIVERS. 134172 WIRE TRANSFER 0 2 0 0 0 1 0 0 0 1 MOSAIC HOUSING CORPORATION XVIII 4980 S 118 ST OMAHA NE 68137 261710184 501(C)(3) 5000 0 THE GRANT PROVIDED IS TO THE RELATED ORGANIZATION TO FURTHER ITS TAX EXEMPT FUNCTION. MOSAIC HOUSING CORPORATION XIX 4980 S 118 ST OMAHA NE 68137 261710259 501(C)(3) 5000 0 THE GRANT PROVIDED IS TO THE RELATED ORGANIZATION TO FURTHER ITS TAX EXEMPT FUNCTION. 2 0 PART I, LINE 2: GRANTS ARE PROVIDED TO RELATED ORGANIZATIONS TO FURTHER THEIR TAX EXEMPT FUNCTIONS. X 1 1 X X X X X X 1 0 0 0 0 0 0 0 0 LINDA TIMMONS PRESIDENT AND CEO 467632 0 28280 0 7763 0 106744 0 31788 0 642207 0 0 0 SCOTT HOFFMAN TREASURER AND CFO 225818 0 9580 0 3273 0 14233 0 22176 0 275080 0 0 0 RAUL SALDIVAR SVP OF OPERATIONS 308346 0 0 0 1921 0 23914 0 28536 0 362717 0 0 0 KEITH SCHMODE SVP MISSION OPPORTUNITIES 253620 0 11104 0 3294 0 18000 0 28536 0 314554 0 0 0 SUE LOERTS SVP OF HUMAN RESOURCES 217716 0 9426 0 1111 0 14010 0 25002 0 267265 0 0 0 RENEE COUGHLIN SVP OF MISSION ADVANCEMENT 174031 0 7877 0 660 0 11663 0 34638 0 228869 0 0 0 MARVA WEAVER VP OF OPERATIONS THRU 5/14/16 75943 0 0 0 141347 0 1760 0 9222 0 228272 0 0 0 DONNA WERNER SVP OF ADVOCACY 185588 0 2656 0 698 0 11604 0 22176 0 222722 0 0 0 JOSEPH LYONS GENERAL COUNSEL 187671 0 7650 0 519 0 11506 0 11496 0 218842 0 0 0 WANDA WINFREE CHIEF INTEGRITY OFFICER 163920 0 4800 0 779 0 10609 0 28536 0 208644 0 0 0 MARLIN WILKERSON VICE PRESIDENT OF OPERATIONS 145905 0 16525 0 740 0 4390 0 28462 0 196022 0 0 0 NANCY DAVIS VICE PRESIDENT OF OPERATIONS 151254 0 1525 0 1010 0 4433 0 25266 0 183488 0 0 0 TAMMY WESTFALL VICE PRESIDENT OF OPERATIONS 155322 0 1525 0 616 0 4354 0 21426 0 183243 0 0 0 STACY MORTON VP OF FINANCIAL OPERATIONS 158731 0 3025 0 620 0 4412 0 11496 0 178284 0 0 0 KATIE GIVENS VP OF INFORMATION TECHNOLOGY 143408 0 1525 0 688 0 0 0 31952 0 177573 0 0 0 KRISTIN ROSSOW VICE PRESIDENT OF ACCOUNTING 142090 0 1525 0 503 0 4078 0 21816 0 170012 0 0 0 MOLLY KENNIS VICE PRESIDENT OF OPERATIONS 147157 0 1525 0 572 0 1639 0 14406 0 165299 0 0 0 ANDREA FERRUCCI VICE PRESIDENT OF OPERATIONS 140506 0 1525 0 555 0 0 0 21194 0 163780 0 0 0 DOLORES BANGERT VP FIXED ASSET DEVEL. THRU 6/09/16 75357 0 0 0 65936 0 1965 0 13675 0 156933 0 0 0 CINDY SCHROEDER FORMER SENIOR VICE PRESIDENT 129273 0 0 0 0 0 5914 0 0 0 135187 0 0 0 PART I, LINE 1A EVERY EMPLOYEE CAN BE REIMBURSED UP TO $25 PER MONTH FOR HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES. THIS BENEFIT IS TREATED AS TAXABLE COMPENSATION TO THE EMPLOYEE. PART I, LINE 4A MARVA WEAVER RECEIVED SEVERANCE PAYMENTS OF $140,816. DOLORES BANGERT RECEIVED SEVERANCE PAYMENTS OF $65,499. SCHEDULE J, PART II, COLUMN C: MOSAIC EVALUATES THE LIABILITY RELATED TO THEIR POSTRETIREMENT BENEFITS (SALARY AND HEALTH INSURANCE CONTINUATION) THROUGH AN ACTUARIAL REVIEW. THE ADJUSTMENT IS INCLUDED IN RETIREMENT AND OTHER DEFERRED COMPENSATION. A PUBLIC FINANCE AUTHORITY 273866124 000000000 2017-06-29 12188750 REFUND PRIOR ISSUES (1/28/03, 6/1/05, 3/12/10, 3/31/10, 4/14/10, 4/30/12). 0 0 0 A 12188750 2293743 187009 9707998 2012 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 1 0 1 0 0 0 0 A 0 FORM 990, PART VI, SECTION A, LINE 7A THE EVANGELICAL LUTHERAN CHURCH IN AMERICA APPOINTS THREE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B MOSAIC BOARD OF DIRECTORS MAY MAKE ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION WITHOUT OTHER APPROVAL WITH THE EXCEPTION OF SECTIONS 8 AND 10. AMENDMENTS TO SECTIONS 8 AND 10 OF THE ARTICLES OF INCORPORATION REQUIRE PRIOR WRITTEN CONSENT OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. SECTION 8 OF THE ARTICLES OF INCORPRATION SPECIFIES WHERE ASSETS WOULD BE TRANSFERRED UPON THE LIQUIDATION OF MOSAIC, AND SECTION 10 COVERS MOSAIC'S AFFILIATION WITH THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. FORM 990, PART VI, SECTION B, LINE 11B EACH DECEMBER, THE SENIOR VICE PRESIDENT FOR HUMAN RESOURCES AND CHIEF INTEGRITY OFFICER IDENTIFY THE DISQUALIFIED PERSONS BASED ON INFORMATION FILED IN EACH KEY EMPLOYEE'S ANNUAL CONFLICT OF INTEREST FORM. THE VP OF HR SOLUTIONS AND VP OF ACCOUNTING REVIEW THE SALARY AND BENEFIT INFORMATION REQUIRED FOR ALL DIRECTORS, OFFICERS, KEY EMPLOYEES AND DISQUALIFIED PERSONS AND PREPARE A SCHEDULE FOR REVIEW BY THE SVP OF HUMAN RESOURCES AND SENIOR VICE PRESIDENT AND CHIEF FINANCIAL OFFICER. A REVIEW OF ALL INTERNATIONAL, LOBBYING AND UNRELATED BUSINESS ACTIVITIES IS COMPLETED BY THE CHIEF FINANCIAL OFFICER AND VP OF ACCOUNTING WITH RELEVANT STAFF. FORM 990 IS PREPARED BY THE ORGANIZATION'S OUTSIDE ACCOUNTING FIRM. THE CHIEF FINANCIAL OFFICER, THE ORGANIZATION'S OUTSIDE ACCOUNTING FIRM, AND THE CHIEF EXECUTIVE OFFICER REVIEW THE RETURN. THE FINANCE AND AUDIT COMMITTEE AND THE BOARD OF DIRECTORS ARE PROVIDED A COPY OF THE RETURN PRIOR TO FILING FORM 990. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS EACH BOARD DIRECTOR COMPLETES A CONFLICT OF INTEREST FORM AND SUBMITS IT TO THE CHAIRPERSON OF THE BOARD INTEGRITY COMMITTEE. ANY FINANCIAL CONFLICTS OF INTEREST ARE REPORTED TO THE CHIEF FINANCIAL OFFICER FOR REPORTING ON THE FORM 990. ON AN ANNUAL BASIS ALL STAFF COMPLETE A CONFLICT OF INTEREST FORM IN CONJUNCTION WITH THEIR ANNUAL EVALUATION. ALL CONFLICTS OF INTEREST ARE REVIEWED BY HUMAN RESOURCES. ANY CONFLICTS OF INTEREST OF THE CHIEF EXECUTIVE OFFICER ARE REPORTED TO THE BOARD OF DIRECTORS. CONFLICTS OF INTEREST OF SENIOR STAFF ARE REVIEWED BY THE SENIOR VICE PRESIDENT FOR HUMAN RESOURCES AND CHIEF INTEGRITY OFFICER AND REPORTED TO THE CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER FOR REPORTING ON THE FORM 990. ANY NEW CONFLICTS OF INTEREST THAT ARISE DURING THE YEAR ARE REQUIRED TO BE REPORTED AT THAT TIME. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS ESTABLISHED AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE IS RESPONSIBLE FOR: CONTRACTING WITH AN INDEPENDENT CONSULTANT TO DOCUMENT COMPARABLE COMPENSATION LEVELS PAID TO EXECUTIVES WITH SIMILAR POSITIONS AND RESPONSIBILITIES IN SIMILAR ORGANIZATIONS, HELPING THE COMMITTEE APPLY MOSAIC'S COMPENSATION PHILOSOPHY TO THE MARKET SURVEY DATA TO IDENTIFY SUPPORTABLE COMPENSATION LEVELS AND COMPENSATION RANGES, AND OPINING IN ADVANCE THAT RESULTING COMPENSATION RANGES ARE REASONABLE COMPENSATION. THE COMPENSATION CONSULTANT WILL ALSO ADVISE AND OPINE ON BENEFIT DESIGN, BENEFIT OPTIONS, AND REASONABLENESS OF BENEFIT AMOUNTS AS ELEMENTS OF COMPENSATION. THE EXECUTIVE COMMITTEE WILL ADOPT A COMPENSATION PHILOSOPHY FOR OFFICERS AND KEY EMPLOYEES GUIDED BY THE CONSULTANT'S INFORMATION AND USE THE COMPENSATION PHILOSOPHY TO APPROVE THE COMPENSATION OF THE CEO, APPROVE THE COMPENSATION RANGES FOR OTHER OFFICERS AND KEY EMPLOYEES, AND REPORT ITS ACTIONS TO THE FULL BOARD. THE CEO, WORKING WITHIN SALARY RANGES APPROVED BY THE EXECUTIVE COMMITTEE, SETS THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. MINUTES, DOCUMENTATION OF INDEPENDENT CONSULTANT COMPARABILITY DATA AND RECOMMENDATIONS ARE MAINTAINED AS PART OF THE RECORD OF THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 INDIVIDUALS MAY REQUEST MOSAIC'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS THROUGH AN EMAIL REQUEST FORM AVAILABLE ON MOSAIC'S PUBLIC WEBSITE (WWW.MOSAICINFO.ORG). FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 4,261,875. MANAGEMENT AND GENERAL EXPENSES 1,619,683. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,881,558. DAY/HOST SERVICES: PROGRAM SERVICE EXPENSES 28,166,784. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,166,784. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 1,750,489. MANAGEMENT AND GENERAL EXPENSES 684,311. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,434,800. FORM 990, PART XI, LINE 9: POSTRETIREMENT BENEFIT RELATED CHANGES OTHER THAN NET PERIODIC COST -16,403. GRANT TO MOSAIC HOUSING CORPORATIONS 18 & 19 10,000. FORM 990, PART XII, LINE 2C: THE FINANCE AND AUDIT COMMITEE OVERSEES THE AUDIT & SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MOSAIC FOUNDATION 4980 S 118 ST OMAHA NE 68137 363837360 FUNDRAISING AND INVESTMENT ASSET MANAGEMENT NE 501(C)(3) LINE 12A, I MOSAIC 1 THE OAKS OF DUNN COUNTY 4980 S 118 ST OMAHA NE 68137 391913323 SENIOR LIVING SERVICES WI 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION I 4980 S 118 ST OMAHA NE 68137 363756911 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION II 4980 S 118 ST OMAHA NE 68137 470773689 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION III 4980 S 118 ST OMAHA NE 68137 470788396 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION IV 4980 S 118 ST OMAHA NE 68137 911823422 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION VII 4980 S 118 ST OMAHA NE 68137 470828015 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION VIII 4980 S 118 ST OMAHA NE 68137 470828012 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION IX 4980 S 118 ST OMAHA NE 68137 742838413 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION X 4980 S 118 ST OMAHA NE 68137 742908789 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XI 4980 S 118 ST OMAHA NE 68137 311706640 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XII 4980 S 118 ST OMAHA NE 68137 481297244 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XIII 4980 S 118 ST OMAHA NE 68137 421626679 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XIV 4980 S 118 ST OMAHA NE 68137 204417891 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XV 4980 S 118 ST OMAHA NE 68137 205765691 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XVI 4980 S 118 ST OMAHA NE 68137 205765731 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XVII 4980 S 118 ST OMAHA NE 68137 261710013 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XVIII 4980 S 118 ST OMAHA NE 68137 261710184 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XIX 4980 S 118 ST OMAHA NE 68137 261710259 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XX 4980 S 118 ST OMAHA NE 68137 264555206 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING 1 4980 S 118 ST OMAHA NE 68137 202997161 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING 2 4980 S 118 ST OMAHA NE 68137 204417645 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING OF MACOMB 1 4980 S 118 ST OMAHA NE 68137 204841909 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING OF ROCKFORD 1 4980 S 118 ST OMAHA NE 68137 204841856 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XXI 4980 S 118 ST OMAHA NE 68137 264555313 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XXII 4980 S 118 ST OMAHA NE 68137 273483415 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XXIII 4980 S 118 ST OMAHA NE 68137 710875364 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC VEBA 4980 S 118 ST OMAHA NE 68137 363831874 EMPLOYEE WELFARE BENEFIT PLAN NE 501(C)(9) N/A MOSAIC 1 MOSAIC RESIDENTIAL SERVICES OF NEBRASKA LLC 4980 S 118 ST OMAHA NE 68137 271695051 LOW INCOME HOUSING NE N/A EASE-E MEDICAL INC 731 SOUTH 8TH STREET CANON CITY CO 81212 470842353 SALE OF MEDICAL EQUIPMENT AND SUPPLIES NE MOSAIC C 4519755 1027556 1.00000 1 MOSAIC HOUSING CORPORATION V 4980 S 118 ST OMAHA NE 68137 470805545 LOW INCOME HOUSING NE MOSAIC C 797217 1.00000 1 BICO 4980 S 118 ST OMAHA NE 68137 CAPTIVE INSURANCE BD MOSAIC C 18096112 1.00000 1 CHARITABLE REMAINDER TRUSTS (4) INVESTMENT MANAGEMENT NE N/A T 1 CHARITABLE REMAINDER TRUST (1) INVESTMENT MANAGEMENT FL N/A T 1 1 1 1 1 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 EASE-E MEDICAL EQUIPMENT A 79978 CASH TRANSFERRED EQUALS FMV THE MOSAIC FOUNDATION C 6531645 CASH TRANSFERRED EQUALS FMV EASE-E MEDICAL EQUIPMENT S 111112 CASH TRANSFERRED EQUALS FMV THE MOSAIC FOUNDATION L 2062000 CASH TRANSFERRED EQUALS FMV BICO L 825000 CASH TRANSFERRED EQUALS FMV MOSAIC VEBA L 369996 CASH TRANSFERRED EQUALS FMV EASE-E MEDICAL EQUIPMENT L 477302 CASH TRANSFERRED EQUALS FMV THE MOSAIC FOUNDATION D 222301 CASH TRANSFERRED EQUALS FMV MOSAIC VEBA D 170182 CASH TRANSFERRED EQUALS FMV