HEARTLAND REGIONAL MEDICAL CENTER: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: HEARTLAND REGIONAL MEDICAL CENTER (EIN 44-0545289)
Tax period: 2015-07-01 to 2016-06-30
Filed: 2017-05-15
IRS object ID: 201711359349302366
Schema version: 2015v3.0
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 H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-05-15T09:04:58-05:00	ReturnTs
Tax Period End	2016-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	1201 Walnut Suite 1700	AddressLine1Txt
City	Kansas City	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	641062246	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-07-01	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)
In Care Of	% DWAIN STILSON	InCareOfNm
Business Name Control	HEAR	BusinessNameControlTxt
Phone	8162717070	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	5325 FARAON ST	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	CFO	PersonTitleTxt
Phone	8162717070	PhoneNum
Signature	2017-05-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Michael J Engle	PreparerPersonNm
PTIN	P00482834	PTIN
Phone	8162216300	PhoneNum

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	MOSAIC LIFE CARE	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	DWAIN STILSON	PrincipalOfficerNm

US Address USAddress

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

Field	Value	IRS element (for citing)
Gross Receipts	$884,498,953	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	9	VotingMembersIndependentCnt
Total Employee	4727	TotalEmployeeCnt
Total Volunteers	473	TotalVolunteersCnt
Total Gross UBI	$1,569,674	TotalGrossUBIAmt
PY Contributions Grants	$1,684,519	PYContributionsGrantsAmt
CY Contributions Grants	$645,354	CYContributionsGrantsAmt
PY Program Service Revenue	$591,360,504	PYProgramServiceRevenueAmt
CY Program Service Revenue	$564,223,618	CYProgramServiceRevenueAmt
PY Investment Income	$26,654,887	PYInvestmentIncomeAmt
CY Investment Income	$50,235,912	CYInvestmentIncomeAmt
PY Other Revenue	$29,329,312	PYOtherRevenueAmt
CY Other Revenue	$23,848,502	CYOtherRevenueAmt
PY Total Revenue	$649,029,222	PYTotalRevenueAmt
CY Total Revenue	$638,953,386	CYTotalRevenueAmt
PY Grants And Similar Paid	$2,181,013	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$2,785,232	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$311,994,292	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$321,468,642	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$230,230	CYTotalFundraisingExpenseAmt
PY Other Expenses	$292,940,427	PYOtherExpensesAmt
CY Other Expenses	$274,368,439	CYOtherExpensesAmt
PY Total Expenses	$607,115,732	PYTotalExpensesAmt
CY Total Expenses	$598,622,313	CYTotalExpensesAmt
PY Revenues Less Expenses	$41,913,490	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$40,331,073	CYRevenuesLessExpensesAmt
Total Assets BOY	$830,946,761	TotalAssetsBOYAmt
Total Assets EOY	$859,768,385	TotalAssetsEOYAmt
Total Liabilities BOY	$324,267,134	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$359,153,351	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$506,679,627	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$500,615,034	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
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	$544,161,283	ExpenseAmt
Grant	$2,785,232	GrantAmt
Revenue	$587,240,890	RevenueAmt
Desc	SEE SCHEDULE O	Desc
Total Program Service Expenses	$544,161,283	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
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	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	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	false	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	Yes (true)	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	268	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	4727	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	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	Yes (true)	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	false	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

Field	Value	IRS element (for citing)
Person	DWAIN STILSON	PersonNm
Phone	8162717070	PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
DAVE HOWERY
DIRECTOR	1.0	0.0	Yes (X)	$2,500	$0	$0
DAN HECKMAN
DIRECTOR	1.0	0.0	Yes (X)	$2,500	$0	$0
DR JOHN OLSON
DIRECTOR/STAFF PHYSICIAN	39.0	1.0	Yes (X)	$708,479	$0	$34,779
STEVE SCHRAM
DIRECTOR/CHAIR	1.0	0.0	Yes (X)	$2,500	$0	$0	Yes (X)
BARBARA WURTZLER
DIRECTOR/VICE CHAIR	1.0	0.0	Yes (X)	$2,500	$0	$0	Yes (X)
DR MARK LANEY
DIRECTOR/PRESIDENT/CEO	34.0	6.0	Yes (X)	$1,101,121	$0	$33,016	Yes (X)
DR DENNIS DOBYAN
DIRECTOR	1.0	0.0	Yes (X)	$16,214	$65,244	$0
ADAM STEIN
DIRECTOR	1.0	0.0	Yes (X)	$2,500	$0	$0
BRAD MCANALLY
DIRECTOR	1.0	0.0	Yes (X)	$2,500	$0	$0
SERENA NAYLOR
DIRECTOR	1.0	0.0	Yes (X)	$2,500	$0	$0
DR CHRIS LOONEY
DIRECTOR	1.0	0.0	Yes (X)	$87,554	$0	$0
BRENDA SHARPE
DIRECTOR	1.0	0.0	Yes (X)	$2,500	$0	$0
BRIAN BRADLEY
DIRECTOR	1.0	0.0	Yes (X)	$2,500	$0	$0
OPHELIA LAVELL RUCKER
DIRECTOR	1.0	0.0	Yes (X)	$0	$0	$0
CAROL ROEVER
DIRECTOR	1.0	0.0	Yes (X)	$2,360	$0	$0
CURT KRETZINGER
CHIEF OPERATING OFFICER	33.0	7.0		$722,503	$0	$82,286	Yes (X)
JOHN WILSON
CHIEF TREASURY OFFICER	32.0	8.0		$683,337	$0	$56,241	Yes (X)
DWAIN STILSON
CFO/TREASURER	35.0	5.0		$216,114	$0	$38,598	Yes (X)
KAREN DITTEMORE
SECRETARY	38.0	2.0		$69,689	$0	$12,809	Yes (X)
CAROLYN PADEN
ADMINISTRATOR	40.0	0.0		$252,441	$0	$16,576		Yes (X)
DR DAVIN TURNER
ADMINISTRATOR	40.0	0.0		$431,787	$0	$77,973		Yes (X)
R S KOELLIKER
ADMINISTRATOR	40.0	0.0		$409,538	$0	$28,568		Yes (X)
MICHAEL C PULIDO
CHIEF ADMINISTRATIVE OFFICER	38.0	2.0		$446,612	$0	$92,483		Yes (X)
DR BONNIE GOINS
STAFF PHYSICIAN	40.0	0.0		$1,087,812	$0	$25,676			Yes (X)
DR MOHAN R HINDUPUR
STAFF PHYSICIAN	40.0	0.0		$985,731	$0	$27,882			Yes (X)
DR ROBERT GRANT
STAFF PHYSICIAN	40.0	0.0		$971,628	$0	$36,379			Yes (X)
DR ARVIND K SHARMA
STAFF PHYSICIAN	40.0	0.0		$911,570	$0	$36,048			Yes (X)
DR CODY HARLAN
STAFF PHYSICIAN	40.0	0.0		$823,471	$0	$75,692			Yes (X)
DR MICHAEL NELLESTEIN
STAFF PHYSICIAN	0.0	0.0		$104,138	$0	$0				Yes (X)
DR MAUREEN MANGANARO
STAFF PHYSICIAN	0.0	0.0		$518,509	$0	$32,884				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$10,573,108	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$65,244	TotReportableCompRltdOrgAmt
Total Other Compensation	$707,890	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	382	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
ST JOSEPH ONCOLOGY INC
902 N RIVERSIDE RD STE 200	ST JOSEPH	MO	64507	ONCOLOGY	$2,435,473
CAPITAL PERFORMANCE
11709 ROE D236	LEAWOOD	KS	66211	CONSTRUCTION MGMT	$1,149,991
ACTION ELECTRIC CORP
923 SOUTH 9TH	ST JOSEPH	MO	64503	ELECTRICIAN	$1,149,356
POLSINELLI SHUGHART PC
3101 FREDERICK AVE	ST JOSEPH	MO	64506	LEGAL	$1,115,084
POBLOCKI SIGN COMPANY LLC
922 S 70TH STREET	WEST ALLIS	WI	53214	SIGNAGE	$1,051,659

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	37	CntrctRcvdGreaterThan100KCnt
Related Organizations	$5,787	RelatedOrganizationsAmt
All Other Contributions	$639,567	AllOtherContributionsAmt
Noncash Contributions	$225,000	NoncashContributionsAmt
Total Contributions	$645,354	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE	621110	$536,153,817	$536,153,817
340B PHARMACY REVENUE	621110	$27,438,741	$27,438,741
MEANINGFUL USE PAYMENTS	621110	$631,060	$631,060

Field	Value	IRS element (for citing)
Total Program Service Revenue	$564,223,618	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,534,821	TotalRevenueColumnAmt
Exclusion	$11,534,821	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$831,230	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$831,230	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$831,230	TotalRevenueColumnAmt
Exclusion	$831,230	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$284,036,802	SecuritiesAmt
Other	$37,399	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$245,340,164	SecuritiesAmt
Other	$32,946	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$38,696,638	SecuritiesAmt
Other	$4,453	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$38,701,091	TotalRevenueColumnAmt
Exclusion	$38,701,091	ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$122,261	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$172,457	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$50,196	TotalRevenueColumnAmt
Unrelated Business Revenue	-$50,196	UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
Cafeteria	722514	$2,207,127	$2,207,127
Refferal Lab	111000	$5,967,121	$5,905,597	$61,524
Copying Revenue	541380	$545,211	$545,211

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$14,348,009	TotalRevenueColumnAmt
Related Or Exempt Func Income	$12,789,663	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,558,346	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$23,067,468	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$638,953,386	TotalRevenueColumnAmt
Related Or Exempt Func Income	$585,671,216	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,569,674	UnrelatedBusinessRevenueAmt
Exclusion	$51,067,142	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$2,785,232	TotalAmt
Program Services	$2,785,232	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$6,007,029	TotalAmt
Program Services	$2,452,220	ProgramServicesAmt
Management And General	$3,554,809	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$549,247	TotalAmt
Program Services	$549,247	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$250,841,909	TotalAmt
Program Services	$232,703,316	ProgramServicesAmt
Management And General	$18,058,542	ManagementAndGeneralAmt
Fundraising	$80,051	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$10,420,104	TotalAmt
Program Services	$9,203,532	ProgramServicesAmt
Management And General	$1,213,717	ManagementAndGeneralAmt
Fundraising	$2,855	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$38,443,587	TotalAmt
Program Services	$34,446,573	ProgramServicesAmt
Management And General	$3,951,090	ManagementAndGeneralAmt
Fundraising	$45,924	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$15,206,766	TotalAmt
Program Services	$13,919,826	ProgramServicesAmt
Management And General	$1,280,806	ManagementAndGeneralAmt
Fundraising	$6,134	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$1,582,523	TotalAmt
Management And General	$1,582,523	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$698,155	TotalAmt
Management And General	$698,155	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$115,125	TotalAmt
Management And General	$115,125	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$34,343,573	TotalAmt
Program Services	$33,258,259	ProgramServicesAmt
Management And General	$1,063,588	ManagementAndGeneralAmt
Fundraising	$21,726	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$3,503,478	TotalAmt
Program Services	$79,195	ProgramServicesAmt
Management And General	$3,424,283	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$28,638,885	TotalAmt
Program Services	$25,224,706	ProgramServicesAmt
Management And General	$3,390,353	ManagementAndGeneralAmt
Fundraising	$23,826	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$3,082,118	TotalAmt
Program Services	$2,914,287	ProgramServicesAmt
Management And General	$165,965	ManagementAndGeneralAmt
Fundraising	$1,866	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$14,586,180	TotalAmt
Program Services	$11,714,958	ProgramServicesAmt
Management And General	$2,871,222	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,037,606	TotalAmt
Program Services	$984,802	ProgramServicesAmt
Management And General	$52,327	ManagementAndGeneralAmt
Fundraising	$477	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$2,477,507	TotalAmt
Program Services	$2,027,282	ProgramServicesAmt
Management And General	$449,657	ManagementAndGeneralAmt
Fundraising	$568	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$6,329,282	TotalAmt
Program Services	$27,438	ProgramServicesAmt
Management And General	$6,301,844	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$29,495,102	TotalAmt
Program Services	$25,004,769	ProgramServicesAmt
Management And General	$4,444,909	ManagementAndGeneralAmt
Fundraising	$45,424	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$7,160,059	TotalAmt
Program Services	$6,520,636	ProgramServicesAmt
Management And General	$639,423	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
PROVISION FOR UNCOLLECTIBLE	$22,792,622	$22,792,622
FRA TAX	$26,450,624	$26,450,624
MEDICAL SUPPLIES	$89,655,423	$89,643,644	$11,779
DUES & SUBSCRIPTIONS	$2,420,177	$1,458,115	$960,683	$1,379

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$598,622,313	TotalAmt
Program Services	$544,161,283	ProgramServicesAmt
Management And General	$54,230,800	ManagementAndGeneralAmt
Fundraising	$230,230	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$30,537,646	BOYAmt
EOY	$26,904,573	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

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

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$63,765,326	BOYAmt
EOY	$72,432,584	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)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$7,226,668	BOYAmt
EOY	$7,757,338	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$6,718,945	BOYAmt
EOY	$7,577,204	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$637,526,841	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$400,405,078	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$245,407,413	BOYAmt
EOY	$237,121,763	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$448,837,797	BOYAmt
EOY	$476,258,585	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$7,722,147	BOYAmt
EOY	$7,478,444	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$1,230,219	BOYAmt
EOY	$8,180,362	EOYAmt

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$19,500,600	BOYAmt
EOY	$16,057,532	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$830,946,761	BOYAmt
EOY	$859,768,385	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$91,228,402	BOYAmt
EOY	$130,076,130	EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$220,393,323	BOYAmt
EOY	$215,724,479	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$2,895,501	BOYAmt
EOY	$2,483,921	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$9,749,908	BOYAmt
EOY	$10,868,821	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$324,267,134	BOYAmt
EOY	$359,153,351	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$506,288,328	BOYAmt
EOY	$500,223,735	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$391,299	BOYAmt
EOY	$391,299	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$506,679,627	BOYAmt
EOY	$500,615,034	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$830,946,761	BOYAmt
EOY	$859,768,385	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$40,331,073	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$41,799,284	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$4,596,382	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

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
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	Yes (true)	GrantsOtherOrganizationsInd
Grants Other Organizations	$36,225	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$115,125	OtherActivitiesAmt
Total Lobbying Expenditures	$151,350	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE C, PART II-B, LINE 1F	PORTION OF DUES PAID TO HOSPITAL ASSOCIATIONS THAT ARE USED FOR LOBBYING PURPOSES BY THE HOSPITAL ASSOCIATIONS.
SCHEDULE C, PART II-B, LINE 1I	CONTRACTED WITH VARIOUS PARTIES FOR LEGISLATIVE LOBBYING IN SUPPORT OF HOSPITAL REIMBURSEMENT AND COMMUNITY SUPPORT.

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$19,043,491	OtherCostOrOtherBasisAmt
Book Value	$19,043,491	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$309,596,510	OtherCostOrOtherBasisAmt
Depreciation	$150,582,512	DepreciationAmt
Book Value	$159,013,998	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$37,378,172	OtherCostOrOtherBasisAmt
Depreciation	$22,436,771	DepreciationAmt
Book Value	$14,941,401	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$214,266,616	OtherCostOrOtherBasisAmt
Depreciation	$178,127,334	DepreciationAmt
Book Value	$36,139,282	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$57,242,052	OtherCostOrOtherBasisAmt
Depreciation	$49,258,461	DepreciationAmt
Book Value	$7,983,591	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$237,121,763	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
DERIVATIVE INSTRUMENTS	$9,836,671
MINORITY INTEREST	$1,032,150

Field	Value	IRS element (for citing)
Total Liability	$10,868,821	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE D, PART X, LINE 2	FormAndLineReferenceDesc
Explanation	MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS	ExplanationTxt

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	$27,885,322	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$27,885,322	NetCommunityBenefitExpnsAmt
Total Expense	0.04840	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$106,412,373	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$64,833,210	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$41,579,163	NetCommunityBenefitExpnsAmt
Total Expense	0.07220	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$134,297,695	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$64,833,210	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$69,464,485	NetCommunityBenefitExpnsAmt
Total Expense	0.12060	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,333,310	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$423,495	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,909,815	NetCommunityBenefitExpnsAmt
Total Expense	0.00680	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$521,991	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$56,802	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$465,189	NetCommunityBenefitExpnsAmt
Total Expense	0.00080	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,047,548	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,047,548	NetCommunityBenefitExpnsAmt
Total Expense	0.00360	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,902,849	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$480,297	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,422,552	NetCommunityBenefitExpnsAmt
Total Expense	0.01120	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$141,200,544	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$65,313,507	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$75,887,037	NetCommunityBenefitExpnsAmt
Total Expense	0.13180	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$117,939	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$117,939	NetCommunityBenefitExpnsAmt
Total Expense	0.00200	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$141,608	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$141,608	NetCommunityBenefitExpnsAmt
Total Expense	0.00250	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$168,849	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$168,849	NetCommunityBenefitExpnsAmt
Total Expense	0.00290	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$115,125	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$115,125	NetCommunityBenefitExpnsAmt
Total Expense	0.00200	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$543,521	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$543,521	NetCommunityBenefitExpnsAmt
Total Expense	0.00940	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$11,254,997	BadDebtExpenseAmt
Bad Debt Expense Attributable	$5,142,030	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$129,188,404	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$151,726,509	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$22,538,105	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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

Field	Value	IRS element (for citing)
Business Name Line1	NONE	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
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 ST	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	PHARMICIST 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
Information Gaps	Yes (X)	InformationGapsInd
Other	Yes (X)	OtherInd
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	SEE PART V, SECTION C	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	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Strategy Attached	false	StrategyAttachedInd
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.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.	FPGFamilyIncmLmtDscntCarePct
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	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
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Medicare Rates	Yes (X)	MedicareRatesInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 3J	COMMUNITY PARTNERS INCLUDING THE ST JOSEPH SCHOOL DISTRICT AND MISSOURI WESTERN STATE UNIVERSITY.
SCHEDULE H, PART V, SECTION B, LINE 5	TO ENSURE INPUT WAS TAKEN INTO ACCOUNT FROM PERSONS WHO REPRESENT THE COMMUNITY, THE MEDICAL CENTER UTILITIZED AN INDEPENDENT CONSULTING FIRM NAMED LAN RESOURCES, LLC. THIS FIRM CONDUCTED A TELEPHONE SURVEY AND SIX FOCUS GROUPS TO DETERMINE HEALTH PRIORITIES BASED ON THE OPINIONS OF COMMUNITY MEMBERS. THE TELEPHONE SURVEY INVOLVED 381 RESIDENTS FROM THE MEDICAL SYSTEMS SERVICE AREA AND WAS DESIGNED TO OBTAIN FEEDBACK AT A 95% CONFIDENCE INTERVAL. THE SAMPLE INCLUDED MEN AND WOMEN FROM 18 TO OVER 65 WITH HOUSEHOLD INCOMES RANGING FROM LESS THAN $10K TO OVER $75K. TO COMPLETE THE QUALITATIVE ASPECT OF DATA GATHERING ASSOCIATED WITH COMMUNITY HEALTH NEEDS, SIX FOCUS GROUPS WERE CONVENED 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, COMMUNITY MEMBERS AT-LARGE, CLINICAL STAFF (NURSES, CARE MANAGERS AND SOCIAL WORKERS), AND COMMUNITY LEADERS. TWO OF THE FOCUS GROUPS WERE COMPRISED SOLELY OF COMMUNITY MEMBERS AT-LARGE.
SCHEDULE H, PART V, SECTION B, LINE 6A	HEARTLAND LONG TERM ACUTE CARE HOSPITAL
SCHEDULE H, PART V, SECTION B, LINE 7A	THE COMPLETE CHNA CAN BE FOUND AT: HTTPS://WWW.MYMOSAICLIFECARE.ORG/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT /ST-JOSEPH-CHNA/
SCHEDULE H, PART V, SECTION B, LINE 10A	THE IMPLEMENTATION STRATEGY CAN BE FOUND AT: HTTPS://WWW.MYMOSAICLIFECARE.ORG/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT /ST-JOSEPH-CHNA/
SCHEDULE H, PART V, SECTION B, LINE 11	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 ISSUES IDENTIFIED WERE: 1) ACCESS TO AFFORDABLE HEALTH CARE AND MEDICATION; 2) ADULT AND CHILDHOOD OBESITY; AND 3) MENTAL HEALTH SERVICES. THE MEDICAL CENTERS 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 COMMMNITYS 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 FY2016FY2019 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 SUCCESFUL MODEL LED BY CHILDRENS MERCY HOSPITAL, 4TH GRADE CHALLENGE, ETC. B) SUPPORT COMMUNITY CONNECT PROGRAMS THAT ADDRESS OBESITY PREVENTION 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 THE COMPLETE CHNA WITH IMPLEMENTATION STRATEGY CAN BE FOUND AT: HTTPS://WWW.MYMOSAICLIFECARE.ORG/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT /ST-JOSEPH-CHNA/
SCHEDULE H, PART V, SECTION B, LINE 16A	THE FAP CAN BE FOUND AT: https://www.mymosaiclifecare.org/globalassets/mosaic-fap-06232016_final_pu blic-reduced-size.pdf
SCHEDULE H, PART V, SECTION B, LINE 16B	THE FAP APPLICATION CAN BE FOUND AT: https://www.mymosaiclifecare.org/Main/Location/st-joseph-mo/mosaic-life-ca re-at-st.-joseph/Medical-Center/HRMC-Financial-and-Insurance-Information/m yfinancial-options/how-to-apply-for-financial-assistance/
SCHEDULE H, PART V, SECTION B, LINE 16C	THE PLAIN LANGUAGE SUMMARY CAN BE FOUND AT: https://www.mymosaiclifecare.org/Main/Location/st-joseph-mo/mosaic-life-ca re-at-st.-joseph/Medical-Center/HRMC-Financial-and-Insurance-Information/F inancial-Assistance-Guidelines/
SCHEDULE H, PART V, SECTION B, LINE 20E	FINANCIAL COUNSELORS ARE AVAILABLE ONSITE TO EXPLAIN AND HELP PATIENTS AND RESPONSIBLE PARTIES WITH THE FINANCIAL ASSISTANCE POLICY.

Field	Value	IRS element (for citing)
Facility	43	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (43 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
CAMERON MOSAIC LIFE CARE
215 South Walnut Street Suite A	CAMERON	MO	64429	CAMERON CLINIC
Heartland Clinic
902 N Riverside	St Joseph	MO	64507	CANCER, MEDICAL ONCOLOGY PEDIATRICS, RADIATION ONCOLOGY
CARDIOVASCULAR CARE MOSAIC LIFE CARE
705 N COLLEGE	ALBANY	MO	64402	CARDIOVASCULAR, GEN SURGERY, NEUROLOGY, PODIATRY, VASCULAR SURGERY AND WOMENS HEALTH CLIN
Heartland Clinic
2600 MILLER ST	BETHANY	MO	64424	CARDIOLOGY, NEUROLOGY AND RHEUMATOLOGY
CARE AT HOME MOSAIC LIFE CARE
137 North Belt Highway	St Joseph	MO	64506	HOME CARE, COUNSELING, HOME HEALTH AND HOSPICE CARE
Heartland Clinic
901 HEARTLAND ROAD	St Joseph	MO	64506	ADULT INFECTIOUS DISEASE, DIABETES, ENDO, IM, EE CLINIC, SLEEP DISORDERS, WOMEN, WOUND
ENT ST JOSEPH MOSAIC LIFE CARE
5301 FARAON SUITE 160	St Joseph	MO	64506	ENT, OCCUPATIONAL MEDICINE PULMONARY AND CRITICAL CARE
EXCELSIOR SPRINGS MOSAIC LIFE CARE
2370 VINTAGE COURT	EXCELSIOR SPRINGS	MO	64024	EXCELSIOR
FAMILY CARE N 36TH ST JOSEPH MOSAIC LIFE
711 N 36TH STREET SUITE 100	St Joseph	MO	64506	FAMILY
FAMILY CARE N POINTE B ST JOSEPH MOSAIC
5210 NORTH BELT HIGHWAY ENTRANCE B	ST JOSEPH	MO	64506	FAMILY MEDICINE AND WOMENS HEALTH
FAMILY CARE PLATTE CITY MOSAIC LIFE CARE
2703 RUNNING HORSE ROAD	PLATTE CITY	MO	64079	FAMILY MEDICINE, OP THERAPY AND SPORTS MEDICINE
GASTROENTEROLOGY HIGHLAND PLAZA MOSAIC
9784 N ASH AVENUE	KANSAS CITY	MO	64157	GASTROENTEROLOGY
INTERNAL MED BECK RD ST JOE MOSAIC LIFE
3715 BECK ROAD BUILDING F	St Joseph	MO	64506	INTERNAL MEDICINE
HEARTLAND CLINIC
5514 CORPORATE DRIVE SUITE 120	St Joseph	MO	64507	CARDIOVASCULAR AND INTERNAL MEDICINE
INTERNAL MED PED & FAMILY ST JOE MOSAIC
105 FAR WEST DRIVE SUITE 100	St Joseph	MO	64506	INTERNAL MEDICINE, NEUROLOGY AND OP BEHAVIORAL
KEARNEY MOSAIC LIFE CARE
425 WEST WASHINGTON STREET	KEARNEY	MO	64060	KEARNEY CLINIC
Heartland Clinic
802 NORTH RIVERSIDE	St Joseph	MO	64507	BARIATRIC, BREAST, CARDIOTHORA GEN SURGERY, MAMMOGRAPHY, ARTH PHY MED & REHAB, NEU, PAIN, RH
MEDICAL ONCOLOGY MOSAIC LIFE CARE
1610 E EVERGREEN SUITE B	Cameron	MO	64429	MEDICAL ONCOLOGY
MEDICAL ONCOLOGY MOSAIC LIFE CARE
2016 S MAIN	MARYVILLE	MO	64468	MEDICAL ONCOLOGY
MOSAIC LIFE CARE BURLINGTON CRK PHY MED
6301 N LUCERNE	KANSAS CITY	MO	64151	PHYSICAL MEDICINE & REHAB, IMAGING, OCCUPATIONAL MED, ORTHO & SPECIALITY CLINICS
MOSAIC LIFE CARE SHOAL CREEK PHY MED REH
8880 NE 82ND TERRACE	KANSAS CITY	MO	64158	PHYSICAL MEDICINE AND REHAB, FAMILY MED, IMAGING, OCC MED, URGENT CARE & SPECIALITY CLIN
MOSAIC LIFE CARE HOSPICE AT STANBERRY
PINE VIEW MANORRM 507 307 PINEVIE	STANBERRY	MO	64489	HOSPICE
MOSAIC LIFE CARE-SURGERY CENTER SHOAL CR
8860 NE 82ND TERRACE	KANSAS CITY	KS	64158	SURGERY CENTER
NEUROSURGERY MOSAIC LIFE CARE
MARYVILLE SPECIALITY CLINIC 2016 S	MARYVILLE	MO	64468	NEUROSURGERY
NORTHWEST MEDICAL CENTER HOME HEALTH AGE
1607 E US HIGHWAY 136	ALBANY	MO	64402	NORTHWEST
OP IMAGING ST JOSEPH MOSAIC LIFE CARE
3620 FREDERICK AVENUE	St Joseph	MO	64506	OP IMAGING
OP THERAPHY FREDERICK AVE ST JOE MOSAIC
3107 FREDERICK LOWER LEVEL	ST JOSEPH	MO	64506	OP THERAPY
OP THERAPY N BELT ST JOSEPH MOSAIC LIFE
3007 NORTH BELT HIGHWAY	STJOSEPH	MO	64506	OUTPATIENT THERAPY & CHIROPRACTIC & OP THERAPY
PAIN MANAGEMENT MOSAIC LIFE CARE
100 CENTRAL ST	CHILLICOTHE	MO	64601	PAIN MANAGEMENT
PARKVILLE COMMONS MOSAIC LIFE CARE
6185 JEFFERSON AVENUE	PARKVILLE	MO	64152	PARKVILLE CLINIC
PLASTIC SURGERY & DERMATOLOGY MOSAIC
5204 NORTH BELT HIGHWAY SUITE A	ST JOSEPH	MO	64506	PLASTIC SURGERY AND DETMATOLOGY
PODIATRY ST JOSEPH MOSAIC LIFE CARE
5202 FARAON SUITE A	ST JOSEPH	MO	64506	PODIATRY
PULMONARY & CRITICAL CARE MOSAIC LIFE
1600 E EVERGREE PO BOX 557	CAMERON	MO	64429	PULMONARY AND CRITICAL CARE AND RHEUMATOLOGY
PULMONARY & CRITICAL CARE MOSAIC LIFE
MARYVILLE SPECIALITY CLINIC 2024 S	MARYVILLE	MO	64468	ENT, PULMONARY & CRITICAL CARE NEUROLOGY AND PODIATRY
SMITHVILLE MOSAIC LIFE CARE
1103 SOUTH US HIGHEWAY 169	SMITHVILLE	MO	64089	SMITHVILLE CLINIC
TRENTON NEUROLOGY MOSAIC LIFE CARE
1701 EAST 9TH STREET	TRENTON	MO	64683	TRENTON NEUROLOGY
TRENTON OCCUPATIONAL MED MOSAIC LIFE
1707 EAST 9TH STREET	TRENTON	MO	64683	TRENTON OCCUPATIONAL MEDICINE
URGENT CARE ST JOSEPH MOSAIC LIFE CARE
1115 NORTH BELT HIGHWAY	ST JOSEPH	MO	64506	URGENT CARE AND OCCUPATIONAL MEDICINE
MOSAIC LIFE CARE AT ATCHISON-SPECIALITY
810 RAVENHILL DR SUITE 103	ATCHISON	KS	66002	SPECIALITY CLINIC
MOSAIC LIFE CARE ATCHISON-MED ONCOLOGY
104 N 6TH	ATCHISON	KS	66002	MEDICAL ONCOLOGY
HIAWATHA MOSAIC LIFE CARE-FAMILY MED
300 UTAH	HIAWATHA	KS	66434	FAMILY MEDICINE
TROY MOSAIC LIFE CARE-FAMILY MEDICINE
207 SOUTH MAIN	TROY	KS	66087	FAMILY MEDICINE
ENDOCRINOLOGY MOSAIC LIFE CARE
220 ESSIE DAVISON DRIVE	CLARINDA	IA	51632	ENDOCRINOLOGY

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 3C	SEE PART VI, SECTION B, LINE 13 FOR THE LIST OF FACTORS USED IN THE ELIGIBILITY CRITERIA EXPLAINED IN THE FAP FOR PROVIDING FREE AND DISCOUNT CARE.
SCHEDULE H, PART I, LINE 7	THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WAS THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2. SCHEDULE H, PART I, LINES 7A & 7B FINANCIAL ASSISTANCE AT COST WAS $15,498,000 AND 27,840,000 FOR YEARS ENDED 6/30/2015 AND 6/30/2016, RESPECTIVELY. THE PRINCIPAL REASON FOR THE INCREASE WAS THE RECLASSIFICATION OF BAD DEBT EXPENSE TO FINANCIAL ASSISTANCE AS THE RESULT OF A MEDICAL DEBT GRACE PERIOD PROVIDED BY THE MEDICAL CENTER DURING THE 2016 FISCAL YEAR UNDER THE CURRENT FINANCIAL ASSISTANCE POLICY. MEDICAID NET COMMUNITY BENEFIT EXPENSE WAS 17,818,000 AND $41,450,000 FOR YEARS ENDED 6/30/2015 AND 6/30/2016, RESPECTIVELY. THE MEDICAL CENTER RECEIVES REIMBURSEMENT FROM THE MEDICAID PROGRAM IN RELATION TO THE PERCENTAGE OF MEDICAID AND INDIGENT POPULATION THEY SERVE. FUNDING RECEIVED IN EXCESS OF COSTS TO PROVIDE THESE SERVICES MAY BE REFUNDED TO THE STATE. DURING 2016, THROUGH MANAGEMENTS CONTINUED REVIEW OF PROGRAM RESULTS, ADDITIONAL INFORMATION FROM IMPROVEMENTS IN THE REPORTING PROCESS AND REVISIONS TO THE CURRENT ESTIMATION PROCESS, THE MEDICAL CENTER RECORDED AN ADDITIONAL ESTIMATED LIABILITY FOR PROGRAM YEARS 2013, 2014 AND 2015 OF APPROXIMATELY $24,650,000 AND APPROXIMATELY $14,075,000 FOR PROGRAM YEAR 2016 BASED ON ACTUAL AND ESTIMATED FUNDING RECEIVED IN EXCESS OF COSTS.
SCHEDULE H, PART I, LINE 7 COLUMN F	THE TOTAL EXPENSE USED AS THE DENOMINATOR IN CALCULATING THE PERCENT OF TOTAL EXPENSE IS THE TOTAL FUNCTIONAL EXPENSE FOUND ON FORM 990, PART IX, LINE 25 COLUMN (A) NET OF THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS OF $22,816,142 FOUND ON FORM 990, PART IX, LINE 24.A COLUMN (A).
SCHEDULE H, PART II	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, SECTION A, LINE 2	THE FOLLOWING EXPLANATION OF THE DETERMINATION OF BAD DEBT EXPENSE APPLIES TO ACCOUNTS RECEIVABLE THAT ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE MEDICAL CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND BAD DEBT EXPENSE. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE MEDICAL CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS (BAD DEBT EXPENSE), IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS (BAD DEBT EXPENSE) IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE MEDICAL CENTERS ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS DECREASED FROM 97% OF GROSS SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2015, TO 95% OF GROSS SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2016. IN ADDITION, THE MEDICAL CENTERS WRITE-OFFS DECREASED APPROXIMATELY $25,000,000 FROM APPROXIMATELY $78,000,000 FOR THE YEAR ENDED JUNE 30, 2015, TO APPROXIMATELY $53,000,000 FOR THE YEAR ENDED JUNE 30, 2016 PRIMARILY DUE TO A TIMING CHANGE IN THE COLLECTIONS PROCESS. DURING 2016, THE MEDICAL CENTER IMPLEMENTED AN AMNESTY PERIOD FOR PATIENT ACCOUNTS PREVIOUSLY WRITTEN OFF TO BAD DEBTS. TO QUALIFY FOR THE AMNESTY, THE PATIENTS WERE REQUIRED TO FILE AN APPLICATION FOR CHARITY CARE DURING 2016. AS A RESULT OF THIS AMNESTY PERIOD, THE MEDICAL CENTER QUALIFIED AS CHARITY CARE APPROXIMATELY $24,500,000 OF GROSS CHARGES ON ACCOUNTS PREVIOUSLY RECORDED TO BAD DEBTS. BAD DEBT EXPENSE REPORTED IN PART III ON LINE 2 IS SHOWN AT COST. THE AMOUNT WAS DETERMINED BY MULTIPLYING THE ORGANIZATION'S TOTAL BAD DEBT EXPENSE BY THE COST TO CHARGE PERCENTAGE.
SCHEDULE H, PART III, SECTION A, LINE 3	IF DOCUMENTATION REQUIRED TO MAKE A DETERMINATION HAD BEEN PROVIDED, IT IS ESTIMATED THAT ADDITIONAL BAD DEBT EXPENSE WOULD HAVE QUALIFIED FOR CHARITY CARE UNDER THE MEDICAL CENTERS FINANCIAL ASSISTANCE POLICY. THE METHODOLOGY TO FORMULATE THIS ESTIMATE INVOLVED USING U.S. CENSUS BUREAU, 2011-2015 AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES DATA FOR INCOME TO POVERTY LEVELS AT OR BELOW 200% AND 300%, RESPECTIVELY. IN ACCORDANCE WITH THE MEDICAL CENTERS FINANCIAL ASSISTANCE POLICY, PATIENTS WHOSE INCOME DOES NOT EXCEED 200% OF THE FEDERAL POVERTY GUIDELINES RECEIVE FREE MEDICAL CARE. THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN THIS CALCULATION FOR THESE PATIENTS WAS DETERMINED BY MULTIPLYING THE PERCENT OF THE POPULATION WHOSE INCOME DID NOT EXCEED 200% OF THE PROVERTY LEVEL BY 100%. HOWEVER, PATIENTS WHOSE INCOME WAS BETWEEN 200% AND 300% OF THE FEDERAL POVERTY GUIDELINES WOULD HAVE RECEIVED A 50% DISCOUNT. ACCORDINGLY, THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN THIS CALCULATION FOR THESE PATIENTS WAS DETERMINED BY MULTIPLYING THE PERCENT OF THE POPULATION WHOSE INCOME FELL BETWEEN 200% AND 300% BY 50%. THE RESULTING EFFECTIVE CHARITY DISCOUNT PERCENTAGES WERE THEN MULTIPLIED BY THE MEDICAL CENTERS TOTAL BAD DEBT EXPENSE. THE CALCULATED BAD DEBT AT THE 200% AND 300% LEVELS WERE THEN ADDED AND MULTIPLED BY THE COST TO CHARGE RATIO TO OBTAIN THE BAD DEBT EXPENSE TO BE INCLUDED IN SCHEDULE H, PART III, LINE 3.
SCHEDULE H, PART III, LINE 4	THE BAD DEBT EXPENSE FOOTNOTE IS ON PAGE 9 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. SEE ALSO THE PARAGRAPH IN THE CHARITY CARE FOOTNOTE ON THE TOP OF PAGE 18 THAT REFERENCES THE 2016 AMNESTY PERIOD RELATED TO BAD DEBT EXPENSE.
SCHEDULE H, PART III, SECTION B, LINE 8	THE MEDICARE ALLOWABLE FAILS TO COVER COST. NON-PAYMENT BY MEDICARE RECIPIENTS FOR THEIR DEDUCTIBLE AND COINSURANCE AMOUNTS INCREASES FINANCIAL ASSISTANCE AND BAD DEBT. THESE SHORTFALLS DECREASE THE ORGANIZATION'S POOL OF ASSETS AND IT'S ABILITY TO SUCCESSFULLY ATTRACT HIGHLY-TRAINED STAFF AND INVEST IN MEDICAL TECHNOLOGY. IF SERVICES ARE TO BE MAINTAINED, THEN THE COSTS HAVE TO BE COVERED BY THOSE WHO PAY. THE BURDEN FALLS ON THE COMMUNITY.
SCHEDULE H, PART III, SECTION C, LINE 9B	THE MEDICAL CENTERS FINANCIAL ASSISTANCE POLICY CONTAINS PROVISIONS ON COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. ACCORDING TO THIS POLICY, FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA ARE BASED ON RESIDENCY, GROSS HOUSEHOLD INCOME AND HOUSEHOLD SIZE. RESIDENCY: TO BE ELIGIBLE TO RECEIVE FINANCIAL ASSISTANCE, THE PERSON APPLYING FOR ASSISTANCE MUST BE A PERMANENT RESIDENT IN THE MEDICAL CENTER SERVICE AREA (PRIMARY, SECONDARY OR TERTIARY). A STUDENT ATTENDING SCHOOL IN THE PRIMARY OR SECONDARY SERVICE AREA AT THE TIME CARE WAS GIVEN, IS ELIGIBLE TO APPLY FOR ASSISTANCE. A STUDENT WHO IS NOT CLAIMED AS A DEPENDENT ON HIS OR HER PARENTS TAX RETURN IS EVALUATED BASED ON THE STUDENTS INCOME. IF THE STUDENT IS CLAIMED AS A DEPENDENT, THE PARENTS OR PARENTS HOUSEHOLD INCOME IS USED TO DETERMINE IF HE OR SHE IS ELIGIBLE FOR FINANCIAL ASSISTANCE. GROSS INCOME AND HOUSEHOLD SIZE: > FREE CARE IS GRANTED TO ELIGIBLE PATIENTS WITH A HOUSEHOLD INCOME UP TO 200% OF FEDERAL POVERTY GUIDELINES. > A 50% DISCOUNT IS GIVEN TO PATIENTS OR GUARANTORS WHOSE HOUSEHOLD INCOME IS GREATER THAN 200% BUT LESS THAN 300% OF FEDERAL POVERTY GUIDELINES. EMERGENCY MEDICAL SERVICES THE MEDICAL CENTER PROVIDES EMERGENCY CARE IN ACCORDANCE WITH FEDERAL EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA) REGULATIONS. ALL PATIENTS ARE SEEN AND GIVEN CARE PRIOR TO BEING SCREENED FOR FINANCIAL ASSISTANCE AND/OR PAYMENT ABILITY IN AN EMERGENCY. CARE IS PROVIDED AT AN EQUAL LEVEL FOR ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. FINANCIAL ASSISTANCE: FINANCIAL ASSISTANCE MAY BE GIVEN TO PATIENTS, OR THEIR GUARANTORS, WHO MEET THE GUIDELINES FOR WHAT IS REQUIRED IN TERMS OF RESIDENCY AND INCOME LEVELS UNDER THE POLICY. PATIENTS OR GUARANTORS ARE EXPECTED TO COOPERATE BY APPLYING FOR ASSISTANCE OR OTHER PUBLIC PROGRAMS IDENTIFIED AS SOURCES OF HELP TO COVER THE COST OF SERVICES AND CARE. PATIENTS OR GUARANTORS WHO CHOOSE NOT TO COOPERATE MAY BE DENIED FINANCIAL ASSISTANCE. ELIGIBLE APPLICANTS QUALIFY FOR ONE OF THE FOLLOWING: FULL FREE CARE: THE FULL AMOUNT OF CHARGES, FOR ELIGIBLE SERVICES GIVEN AT THE MEDICAL CENTER ARE WAIVED AND COVERED FOR THE PATIENT, OR GUARANTOR, IF THE FOLLOWING GUIDELINES ARE MET: 1. THE APPLICANT MEETS ELIGIBILITY CRITERIA AND HAS A YEARLY HOUSEHOLD INCOME THAT DOES NOT EXCEED 200% OF FEDERAL POVERTY GUIDELINES, AND 2. ALL OTHER PAYMENT SOURCES HAVE BEEN EXPLORED AND APPLIED FOR INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF FINANCIAL ASSISTANCE OFFERED BY THIRD PARTIES. FOR ELIGIBLE SERVICES PROVIDED AT CLINICS OWNED BY MEDICAL CENTER, ALL AMOUNTS DUE FROM THE PATIENT, WITH THE EXCEPTION OF CO-PAYS, ARE WAIVED IF THE FOLLOWING GUIDELINES ARE MET: 1. THE APPLICANT MEETS ELIGIBILITY CRITERIA AND HAS A YEARLY HOUSEHOLD INCOME THAT DOES NOT EXCEED 100 PERCENT OF THE FEDERAL POVERTY GUIDELINES, AND 2. ALL OTHER PAYMENT SOURCES HAVE BEEN EXPLORED AND APPLIED FOR INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES. DISCOUNTED CARE: FOR ELIGIBLE SERVICES RECEIVED AT THE MEDICAL CENTER, A 50 PERCENT DISCOUNT OFF OF GROSS CHARGES WILL APPLY FOR PATIENTS OR GUARANTORS, IF THE FOLLOWING GUIDELINES ARE MET: 1. THE APPLICANT MEETS ELIGIBILITY CRITERIA AND HAS A YEARLY HOUSEHOLD INCOME BETWEEN 200 300 PERCENT OF THE FEDERAL POVERTY GUIDELINES, AND 2. ALL OTHER PAYMENT SOURCES HAVE BEEN EXPLORED AND APPLIED FOR INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES. PRESUMPTIVE ELIGIBILITY: SOME PATIENTS OR GUARANTORS ARE PRESUMED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON INDIVIDUAL LIFE CIRCUMSTANCES, FOR EXAMPLE, THOSE WHO ARE HOMELESS OR HAVE QUALIFIED FOR NEEDS-BASED ASSISTANCE PROGRAMS. THIS IS CALLED PRESUMPTIVE ELIGIBILITY. THESE PATIENTS OR GUARANTORS DO NOT NEED TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION IF THEY PROVIDE PROOF THAT THEY QUALIFY FOR CERTAIN PROGRAMS THAT EXIST TO BENEFIT PEOPLE WHO DO NOT HAVE ENOUGH RESOURCES TO PAY FOR SERVICES AND CARE. PRESUMPTIVE ELIGIBILITY IS USED TO GIVE A 100 PERCENT DISCOUNT TO PATIENTS WHO ARE ELIGIBLE BECAUSE THEY MEET THE RESIDENCY AND ONE OF THE PRESUMPTIVE ELIGIBILITY CRITERIA LISTED IN THE MEDICAL CENTERS FINANCIAL ASSISTANCE POLICY. AMOUNTS BILLED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE: BASIS FOR CALCULATING AMOUNTS GENERALLY BILLED: FOLLOWING A DETERMINATION OF FINANCIAL-ASSISTANCE ELIGIBILITY, AN INDIVIDUAL IS NOT CHARGED MORE THAN THE AMOUNTS GENERALLY BILLED (AGB) INDIVIDUALS WITH INSURANCE COVERING THE SAME CARE FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THE AGB IS CALCULATED, OR DETERMINED, USING THE LOOK-BACK METHOD AS FOLLOWS: 1. MOSAIC LIFE CARE REVIEWS ALL PAST CLAIMS THAT HAVE BEEN ALLOWED BY MEDICARE FEE-FOR-SERVICE AND ALL PRIVATE HEALTH INSURERS PAYING CLAIMS TO MOSAIC LIFE CARE FOR MEDICALLY NECESSARY CARE BY THE HOSPITAL IN THE PRIOR CALENDAR YEAR. THE TOTAL AMOUNT INCLUDES COPAYMENTS, DEDUCTIBLES AND COINSURANCE. 2. THE AGB PERCENTAGES ARE CALCULATED ANNUALLY BY DIVIDING THE SUM OF CLAIMS ALLOWED BY MEDICARE FEE-FOR-SERVICE TOGETHER WITH ALL PRIVATE HEALTH INSURERS TO MOSAIC LIFE CARE BY THE SUM OF THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS. 3. THE PERCENTAGES ARE APPLIED BY THE 120TH DAY AFTER THE END OF THE CALENDAR YEAR MOSAIC LIFE CARE USES TO CALCULATE THE AGB PERCENTAGE(S). COLLECTION ACTIONS TAKEN IN EVENT OF NON-PAYMENT: COLLECTION ACTIONS: NO ACCOUNT IS SUBJECT TO COLLECTION ACTIONS WITHIN 180 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 ARE 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. THE 180-DAY TIMEFRAME MAY BE SHORTENED IF A DECISION HAS BEEN MADE ON FINANCIAL ASSISTANCE, OR WHEN A PAYMENT PLAN HAS BEEN ESTABLISHED AND AGREED TO, BUT THE PATIENT OR GUARANTOR IS NO LONGER MAKING THE REQUIRED PAYMENTS. IF A STATEMENT IS SENT TO A PATIENT OR GUARANTOR, AND MAIL IS RETURNED AS UNDELIVERABLE, THE MEDICAL CENTER ATTEMPTS TO FIND A CORRECT ADDRESS. IF THE CORRECT ADDRESS CANNOT BE FOUND, THE MEDICAL CENTER ATTEMPTS 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, THE ACCOUNT IS 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 GENERALLY RECEIVES A MINIMUM OF SIX WRITTEN STATEMENTS INCLUDING THE FIRST POST-DISCHARGE STATEMENT AND FIVE SUBSEQUENT STATEMENTS. THESE STATEMENTS 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, A SEVENTH AND FINAL STATEMENT IS SENT TO THE PATIENT OR GUARANTOR. THIS STATEMENT ACTS AS A NOTICE TO THE ACCOUNT OWNER OF THE AMOUNT OWED TO THE MEDICAL CENTER AND THAT THE ACCOUNT WILL BE PLACED WITH A THIRDPARTY COLLECTION AGENCY IN 30 DAYS. THIS STATEMENT INCLUDES A PLAIN LANGUAGE SUMMARY AND OUTLINES ANY COLLECTION ACTIONS THAT MAY BE TAKEN IF A PLAN IS NOT PUT IN PLACE TO SETTLE THE ACCOUNT. ORAL NOTIFICATION WILL BE ATTEMPTED AT THIS TIME AS WELL TO ENSURE THE PATIENT OR GUARANTOR IS AWARE OF MOSAIC LIFE CARES FINANCIAL ASSISTANCE POLICY AND THE DEBT THEY OWE. 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 AGREEDUPON PAYMENT PLAN. 2. THE PATIENT OR GUARANTOR HAS RECEIVED A FINANCIAL ASSISTANCE DISCOUNT, BUT IS NO LONGER WORKING WITH THE MEDICAL CENTER 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 PATIENTS OR GUARANTORS BANK ACCOUNT 2. CIVIL ACTIONS 3. PROPERTY LIENS 4. PROPERTY FORECLOSURES 5. GARNISHING OF WAGES 6. REPORTING ADVERSE INFORMATION TO CREDIT BUREAUS BEFORE EXTRAORDINARY COLLECTION ACTIVITIES CAN BEGIN, THE ACCOUNT MUST BE REVIEWED AND APPROVAL MUST BE GIVEN BY THE MEDICAL CENTERS PATIENT BILLING LEADERSHIP. WHEN ONE OF THESE ACTIONS IS TO BE TAKEN AGAINST A PATIENT OR GUARANTOR, THE PATIENT OR GUARANTOR IS GIVEN A 30DAY WRITTEN NOTICE OF THE ACTION TO BE TAKEN. THE PATIENT OR GUARANTOR IS ALSO INFORMED OF THE MEDICAL CENTERS FINANCIAL ASSISTANCE POLICY AND HOW TO APPLY FOR IT. A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL
SCHEDULE H, PART VI, LINE 2	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	THE MEDICAL CENTER INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGBILITY FOR FINANCIAL ASSISTANCE BEGINNING AT THE REGISTRATION DESK AND CONTINUING WITH FINANCIAL ASSISTANCE INFORMATION BEING INCLUDED ON EVERY BILLING STATEMENT A PATIENT RECEIVES FROM THE MEDICAL CENTER. GUIDELINES FOR THE PROGRAM ARE AVAILABLE AT EACH REGISTRATION DESK AND ARE INCLUDED IN ALL ADMISSION PACKETS FOR UNINSURED PATIENTS. 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 ORGANIZATIONS 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 AND APPOINTMENT WITH A FINANCIAL COUNSELOR WHO CAN ASSIST THEM IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION.
SCHEDULE H, PART VI, LINE 4	THE ORGANIZATION'S PRIMARY AND SECONDARY SERVICE AREA IS A 23 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 60% MEDICARE AND MEDICAID, 34% COMMERCIAL AND 6% SELF PAY. 18% OF THE POPULATION IS BELOW THE POVERTY LEVEL; 19% OF POPULATION SMOKE; AND 36% HAVE A BODY MASS INDEX GREATER THAN 30. MORE THAN 60 PERCENT OF THE ELEMENTARY AGE STUDENTS RECEIVE FREE OR REDUCED-COST LUNCHES.
SCHEDULE H, PART VI, LINE 5	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 ELEVEN YEARS, THE ORGANIZATION HAS SPONSORED THIS THREE-MONTH LONG EVENT TO ENCOURAGE WEIGHT LOSS, EXERCISE AND HEALTHY EATING. MORE THAN 19,500 PEOPLE HAVE PARTICIPATED AND OVER 125,000 POUNDS HAVE BEEN LOST. AT THE END OF THE PROGRAM IN 2016, 93.7 PERCENT OF RESPONDENTS TO THE SURVEY AGREED THAT THE POUND PLUNGE WAS BENEFICIAL TO OUR COMMUNITY, AND 90.6 PERCENT 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 WILL BE 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 WILL BE 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 26 ELEMENTARY SCHOOLS FOR EIGHT YEARS. PRE AND POST PROGRAM SURVEYING OF STUDENTS SHOWED AT LEAST A 40 PERCENT INCREASE IN KNOWLEDGE OF THE FIT-TASTIC GUIDELINES AFTER COMPLETING THE PROGRAM. 96 PERCENT OF SCHOOL COACHES AGREED THAT THE 4TH GRADE CHALLENGE IS AN EFFECTIVE PROGRAM THAT TEACHES STUDENTS ABOUT HEALTH, EXERCISE AND NUTRITION, AND 93 PERCENT OF SCHOOL COACHES AGREED THAT THE 4TH GRADE CHALLENGE IS A GREAT HEALTH PROGRAM THAT HELPS FIGHT CHILDHOOD OBESITY. IN 2015 THE NUMBER OF SCHOOL AND COMMUNITY GARDENS WAS EXPANDED FROM SIX TO EIGHT ELEMENTARY SCHOOLS. MORE THAN 16,825 LBS. OF FRESH PRODUCE HAS BEEN GROWN SINCE 2012, AND IS FREE FOR COMMUNITY MEMBERS TO HARVEST AND USE FOR MEALS. FOR SOME ECONOMICALLY DISADVANTAGED AREAS, THE GARDENS SUPPLY FRUITS AND VEGETABLES TO FAMILIES WHO WOULD NOT HAVE ACCESS TO THEM OTHERWISE.
SCHEDULE H, PART VI, LINE 6	THE ORGANIZATION IS AFFILIATED, THROUGH A PARENT BOARD, WITH A FOUNDATION, AN ACUTE LONG TERM CARE HOSPITAL, A CRITICAL ACCESS RURAL HOSPITAL 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 FOUNDATION OVERSEES A NUMBER OF PROGRAMS WORKING TO IMPROVE HEALTH IN THE COMMUNITY. THE ACUTE LONG TERM 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 COMMUNITY HEALTH IMPROVEMENT SOLUTIONS SERVICE WORKS WITH EMPLOYERS IN THE COMMUNITY TO EFFECT HEALTHY CHANGES IN THEIR WORKFORCES.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (18 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
UNITED WAY OF GREATER ST JOSEPH
118 S 5TH STREET	ST JOSEPH	MO	64501	440547802	501(C)(3)	$175,312	SUPPORT
HEARTLAND FOUNDATION
5325 FARAON STREET	ST JOSEPH	MO	64506	431262768	501(C)(3)	$773,793	SUPPORT
MO WESTERN STATE UNIVERSITY FOUNDATION
5425 DOWNS DRIVE	ST JOSEPH	MO	64507	237035423	501(C)(3)	$333,950	SPONSORSHIP
ALLIED ARTS COUNCIL OF ST JOESEPH MO
118 S EIGHTH STREET	ST JOSEPH	MO	64501	430810827	501(C)(3)	$26,500	SPONSORSHIP
SECOND HARVEST COMMUNITY FOOD BANK
915 DOUGLAS STREET	ST JOSEPH	MO	64505	431268319	501(C)(3)	$32,500	SUPPORT	$6,675	FMV	FOOD
ST JOSEPH AREA CHAMBER OF COMMERCE
3003 FREDERICK AVENUE	ST JOSEPH	MO	64506	440419460	501(C)(6)	$14,550	SPONSORSHIP
NORTHLAND REGIONAL CHAMBER OF COMMERCE
634 NW ENGLEWOOD ROAD	ST JOSEPH	MO	64118	431279100	501(C)(6)	$14,139	SPONSORSHIP
ALBRECHT-KEMPER MUSEUM OF ART FOUNDATION
2818 FREDERICK	ST JOSEPH	MO	64506	431855334	501(C)(3)	$10,827	SUPPORT
THE CENTER
902 EDMOND STREET STE 203	ST JOSEPH	MO	64501	431615018	501(C)(3)	$25,500	SUPPORT
LADIES UNION BENEVOLENT ASSOCATION
801 N NOYES BLVD	ST JOSEPH	MO	64506	440563788	501(C)(3)	$16,691	SUPPORT
NORTHWEST HEALTH SERVICES INC
2303 VILLAGE DRIVE	ST JOSEPH	MO	64506	431323669	501(C)(3)	$20,000	SUPPORT
ST JOSEPH PARKS REC AND CIVIC FACILITIES
1920 GRAND AVE	ST JOSEPH	MO	64505	446000256	MUNICIPAL GOV'T	$5,250	SUPPORT
CITY OF ST JOSEPH
1100 FREDERICK AVENUE	ST JOSEPH	MO	64501	446000256	MUNICIPAL GOV'T		SUPPORT	$1,120,712	FMV	BUILDING
INNOVATION STOCKYARD
4221 MITCHELL AVENUE	ST JOSEPH	MO	64507	201215246	501(C)(3)	$30,000	SPONSORSHIP
COMMUNITY ALLIANCE
3003 FREDERICK AVENUE	ST JOSEPH	MO	64506	050587096	501(C)(3)	$22,058	SUPPORT
HILLCREST TRANSITIONAL HOUSING
4510 BELLEVIEW SUITE 300	KANSAS CITY	MO	64111	271481997	501(C)(3)	$14,000	SPONSORSHIP
AMERICAN HEART ASSOCIATION
104 CORPORATE LAKE DRIVE	COLUMBIA	MO	65203	135613797	501(C)(6)	$13,000	SPONSORSHIP
ST JOSEPH YOUTH ALLIANCE
5223 MITCHELL AVE	ST JOSEPH	MO	64507	431680758	501(C)(3)	$10,350	SUPPORT

Field	Value	IRS element (for citing)
Total501c3 Org	16	Total501c3OrgCnt
Total Other Org	3	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION IS COMMITTED TO THE DEVELOPMENT OF A HEALTHY COMMUNITY WHICH INCLUDES THE HEALTH OF INDIVIDUALS, AN ADEQUATE NUMBER OF JOBS FOR THE WORKFORCE AND SUCCESSFUL BUSINESSES TO BOOST THE LOCAL ECONOMY. GRANTS ARE PROVIDED TO LOCAL GROUPS THAT ACHIEVE THESE OBJECTIVES. GENERALLY OUR OFFICERS, DIRECTORS OR EMPLOYEES ARE IN A VOLUNTEER POSITION OR ARE A BOARD MEMBER OF THE RECIPIENT ORGANIZATION.	ExplanationTxt

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
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
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 (16 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
DR JOHN OLSON
DIRECTOR/STAFF PHYSICIAN	$557,229	$0	$144,409	$0	$6,841	$0	$10,600	$0	$24,179	$0	$743,258	$0	$0	$0
DR MARK LANEY
DIRECTOR/PRESIDENT/CEO	$769,329	$0	$327,087	$0	$4,705	$0	$10,600	$0	$22,416	$0	$1,134,137	$0	$0	$0
DR MICHAEL NELLESTEIN
STAFF PHYSICIAN	$0	$0	$0	$0	$104,138	$0	$0	$0	$0	$0	$104,138	$0	$0	$0
DR MAUREEN MANGANARO
STAFF PHYSICIAN	$445,089	$0	$71,431	$0	$1,989	$0	$10,600	$0	$22,284	$0	$551,393	$0	$0	$0
CURT KRETZINGER
CHIEF OPERATING OFFICER	$475,549	$0	$101,923	$0	$145,031	$0	$71,955	$0	$10,331	$0	$804,789	$0	$121,672	$0
JOHN WILSON
CHIEF TREASURY OFFICER	$444,078	$0	$103,100	$0	$136,159	$0	$56,241	$0	$0	$0	$739,578	$0	$112,348	$0
DWAIN STILSON
CFO/TREASURER	$191,320	$0	$24,091	$0	$703	$0	$8,150	$0	$30,448	$0	$254,712	$0	$0	$0
CAROLYN PADEN
ADMINISTRATOR	$219,353	$0	$25,913	$0	$7,175	$0	$0	$0	$16,576	$0	$269,017	$0	$0	$0
DR DAVIN TURNER
ADMINISTRATOR	$337,189	$0	$91,573	$0	$3,025	$0	$55,025	$0	$22,948	$0	$509,760	$0	$0	$0
R S KOELLIKER
ADMINISTRATOR	$310,921	$0	$46,045	$0	$52,572	$0	$7,560	$0	$21,008	$0	$438,106	$0	$50,129	$0
MICHAEL C PULIDO
CHIEF ADMINISTRATIVE OFFICER	$311,782	$0	$62,593	$0	$72,237	$0	$67,035	$0	$25,448	$0	$539,095	$0	$57,211	$0
DR BONNIE GOINS
STAFF PHYSICIAN	$562,679	$0	$520,792	$0	$4,341	$0	$10,600	$0	$15,076	$0	$1,113,488	$0	$0	$0
DR MOHAN R HINDUPUR
STAFF PHYSICIAN	$894,750	$0	$79,584	$0	$11,397	$0	$10,600	$0	$17,282	$0	$1,013,613	$0	$0	$0
DR ROBERT GRANT
STAFF PHYSICIAN	$835,777	$0	$133,190	$0	$2,661	$0	$10,600	$0	$25,779	$0	$1,008,007	$0	$0	$0
DR ARVIND K SHARMA
STAFF PHYSICIAN	$826,983	$0	$81,926	$0	$2,661	$0	$10,600	$0	$25,448	$0	$947,618	$0	$0	$0
DR CODY HARLAN
STAFF PHYSICIAN	$820,439	$0	$1,463	$0	$1,569	$0	$10,600	$0	$65,092	$0	$899,163	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1A	TRAVEL FOR COMPANIONS WAS NOT INCLUDED AS TAXABLE COMPENSATION AS IT WAS 100% FOR BUSINESS PURPOSES.
SCHEDULE J, PART I, LINE 4A	DR. MICHAEL NELLESTEIN $ 104,138
SCHEDULE J, PART I, LINE 4B	VESTED ACCRUED 6/30/2016 6/30/2016 --------- --------- MICHAEL C. PULIDO $ 57,211 $ 56,469 JOHN WILSON $ 112,348 $ 45,641 CURT KRETZINGER $ 121,672 $ 61,355 DR. DAVIN TURNER $ 0 $ 44,544 R S KOELLIKER $ 50,129 $ 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
SEE PART VI
A	431203910	79075LAB3	2009-02-26	$70,000,000	SEE PART VI	false	false	false
SEE PART VI
B	431203910	79075LAD9	2011-09-30	$25,250,000	SEE PART VI	false	false	false
SEE PART VI
C	431178966	60637ACP5	2012-10-03	$51,489,534	SEE PART VI	false	false	false
SEE PART VI
D	431203910		2015-11-18	$81,225,000	SEE PART VI	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	$1,180,000	$0	$70,956,418	$0	$0	$0	$0	$0	$0	$70,956,418	$0	$0	2014	false	false	Yes (true)	Yes (true)
B	$10,840,000	$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	$50,827,727	$0	$0	2014	false	false	Yes (true)	Yes (true)
D	$0	$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	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd	Total Private Business UseTotalPrivateBusinessUsePct
A	false	false	false	false	0	false	false	false	Yes (true)
B					0
C	false	Yes (true)	false	false	0.06730	false	false	false	Yes (true)	0.06730
D					0

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	Business Name Line1GICProviderName/BusinessNameLine1Txt	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd	Rebate Not Due YetRebateNotDueYetInd	Term Of HedgeTermOfHedgePct	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd
0
A	false	Yes (true)	Yes (true)	false	false	0	Yes (true)	Yes (true)
0
B	Yes (true)		false	false	false	0	false	Yes (true)
0
C	false	Yes (true)	false	false	false	0	false	Yes (true)
WELLS FARGO BANK
D	false		Yes (true)	Yes (true)	false	0	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 I, COLUMN A, LINE A, LINE B, AND LINE D	THE INDUSTRIAL DEVELOPMENT AUTHORITY OF ST. JOSEPH, MISSOURI
SCHEDULE K, PART I, COLUMN A, LINE C	HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI
SCHEDULE K, PART I, COLUMN F, LINE A	Finance the construction and equipping of certain healthcare facilities.
SCHEDULE K, PART I, COLUMN F, LINE B	Refund 2001AB Bonds issued on 11/29/2001, 2001D Bonds issued on 11/29/2001 and 2003E Bonds issued on 5/22/2003.
SCHEDULE K, PART I, COLUMN F, LINE C	To acquire, construct, remodel, renovate and equip certain healthcare facilities.
SCHEDULE K, PART I, COLUMN F, LINE D	Refund 2001AB and 2001D Bonds issued on 11/29/2001.
SCHEDULE K, PART II, COLUMN A, LINE 3	Amount does not equal to issue price listed in Part I, Column (e) due to investment earnings.
SCHEDULE K, PART II, COLUMN C, LINE 3	Amount does not equal to issue price listed in Part I, Column (e) due to investment earnings.
SCHEDULE K, PART III, 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, 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 IV, COLUMN A, LINE 2C	The Arbitrage Rebate Analysis was performed as of 2/1/2014.
SCHEDULE K, PART IV, COLUMN C, LINE 2C	The Arbitrage Rebate Analysis was performed as of 9/1/2014.
SCHEDULE K, PART IV, COLUMN A, LINE 6	THE PROJECT FUND WAS INVESTED BEYOND THE THREE YEAR TEMPORARY PERIOD BUT NO EXCESS YIELD LIABILITY WAS GENERATED.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	SEE PART V	PersonNm

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE L, PART IV	FormAndLineReferenceDesc
Explanation	TRANSACTION #1 (A) DONNA WILSON (B) DONNA WILSON IS THE SERVICE LEADER FOR YOUTH AND ADULT PARTNERSHIPS FOR HEARTLAND REGIONAL MEDICAL CENTER AND IS THE WIFE OF JOHN WILSON, WHO IS THE CHIEF TREASURY OFFICER OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 126,742 (D) SALARY AND OTHER COMPENSATION FOR SERVICE LEADER SERVICES (E) NO TRANSACTION #2 (A) CORINNE KOELLIKER (B) CORINNE KOELLIKER IS A LASER TECHNICIAN FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE SISTER OF SCOTT KOELLIKER, WHO IS A KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 34,601 (D) SALARY AND OTHER COMPENSATION FOR LASER TECHNICIAN SERVICES (E) NO TRANSACTION #3 (A) JON KOELLIKER (B) JON KOELLIKER IS A TS APPLICATIONS ANALYST FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE BROTHER OF SCOTT KOELLIKER, WHO IS A KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 108,039 (D) SALARY AND OTHER COMPENSATION FOR TS APPLICATIONS ANALYST SERVICES (E) NO TRANSACTION #4 (A) MARINA KOELLIKER (B) MARINA KOELLIKER IS A REGISTERED NURSE FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE WIFE OF SCOTT KOELLIKER, WHO IS A KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 74,863 (D) SALARY FOR REGISTERED NURSE SERVICES (E) NO TRANSACTION #5 (A) TRACY HOWERY (B) TRACY HOWERY IS AN ADVANCED PRACTICE REGISTERED NURSE FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE DAUGHTER-IN-LAW OF DAVE HOWERY, WHO IS A DIRECTOR OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 120,734 (D) SALARY FOR ADVANCED PRACTICE REGISTERED NURSE SERVICES (E) NO TRANSACTION #6 (A) JILLIAN KOELLIKER (B) JILLIAN KOELLIKER IS A STAFF NURSE FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE DAUGHTER OF SCOTT KOELLIKER, WHO IS A KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 54,322 (D) SALARY FOR STAFF NURSE (E) NO TRANSACTION #7 (A) MARY KOELLIKER (B) MARY KOELLIKER IS A THERAPY DEPARTMENT EMPLOYEE FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE SISTER-IN-LAW OF SCOTT KOELLIKER, WHO IS A KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 29,946 (D) SALARY FOR THERAPY DEPARTMENT SERVICES (E) NO	ExplanationTxt

Schedule M IRS990ScheduleM

Field	Value	IRS element (for citing)
Works Of Art		WorksOfArtGrp
Art Historical Treasures		ArtHistoricalTreasuresGrp
Art Fractional Interest		ArtFractionalInterestGrp
Books And Publications		BooksAndPublicationsGrp
Clothing And Household Goods		ClothingAndHouseholdGoodsGrp
Cars And Other Vehicles		CarsAndOtherVehiclesGrp
Boats And Planes		BoatsAndPlanesGrp
Intellectual Property		IntellectualPropertyGrp
Securities Publicly Traded		SecuritiesPubliclyTradedGrp
Securities Closely Held Stock		SecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust Intrsts		SecurPrtnrshpTrustIntrstsGrp
Securities Miscellaneous		SecuritiesMiscellaneousGrp
Qualified Contrib Hist Struct		QualifiedContribHistStructGrp
Qualified Contrib Other		QualifiedContribOtherGrp
Real Estate Residential		RealEstateResidentialGrp

Real Estate Commercial RealEstateCommercialGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	1	ContributionCnt
Noncash Contributions Rpt F990	$225,000	NoncashContributionsRptF990Amt
Method Of Determining Revenues	APPRAISAL	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Real Estate Other		RealEstateOtherGrp
Collectibles		CollectiblesGrp
Food Inventory		FoodInventoryGrp
Drugs And Medical Supplies		DrugsAndMedicalSuppliesGrp
Taxidermy		TaxidermyGrp
Historical Artifacts		HistoricalArtifactsGrp
Scientific Specimens		ScientificSpecimensGrp
Archaeological Artifacts		ArchaeologicalArtifactsGrp
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	false	ReviewProcessUnusualNCGiftsInd
Third Parties Used	false	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE M, PART I, COLUMN B	FormAndLineReferenceDesc
Explanation	THE INFORMATION PRESENTED IN COLUMN B IS THE NUMBER OF CONTRIBUTIONS.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 4A	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 70% GOVERNMENTAL GOVERNMENTAL AND UNINSURED. 18% 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 15,400 PATIENTS WERE ADMITTED TO THE HOSPITAL RESULTING IN APPROXIMATELY 65,700 PATIENT DAYS. A TOTAL OF APPROXIMATELY 10,000 SURGERIES WERE PERFORMED, THE EMERGENCY ROOM SERVED APPROXIMATELY 62,000 PATIENTS AND APPROXIMATELY 191,000 VISITS WERE GENERATED BY OUTPATIENTS. THE MEDICAL CENTER EMPLOYS APPROXIMATELY 4,300 FULL-TIME EQUIVALENT CARE GIVERS. THE MEDICAL STAFF INCLUDES APPROXIMATELY 300 PROVIDERS COVERING PRIMARY CARE AND SPECIALTY CLINICS AT 43 LOCATIONS THROUGHOUT THE REGION. THERE WERE APPROXIMATELY 851,000 PATIENT VISITS DURING THE YEAR. FINANCIAL AMNESTY PERIOD OFFERED: IN ORDER TO ASSIST ITS PATIENTS AND IN ACCORDANCE WITH ITS TAX-EXEMPT PURPOSE, THE MEDICAL CENTER OFFERRED A THREE MONTH FINANCIAL AMNESTY PERIOD DURING 2015-2016 FOR PATIENTS WHOSE ACCOUNTS WERE PREVIOUSLY WRITTEN OFF TO BAD DEBT. TO QUALIFY FOR THE AMNESTY, THE PATIENTS WERE REQUIRED TO FILE AN APPLICATION FOR CHARITY CARE DURING THE THREE-MONTH PERIOD. AS A RESULT OF THIS AMNESTY PERIOD, THE MEDICAL CENTER QUALIFIED AS CHARITY CARE APPROXIMATELY $24,500,000 OF GROSS CHARGES ON ACCOUNTS PREVIOUSLY RECORDED TO BAD DEBTS. ACO: 2016 IS THE FOURTH YEAR THAT MOSAIC LIFE CARE HAS BEEN AN ACCOUNTABLE CARE ORGANIZATION (ACO). AN ACO IS A GROUP OF DOCTORS AND OTHER HEALTH-CARE PROVIDERS WHO AGREE TO VOLUNTARILY WORK TOGETHER WITH MEDICARE TO PROVIDE HIGH-QUALITY MEDICAL CARE AND SERVICE AT THE RIGHT TIME AND IN THE RIGHT SETTING. THE ACO PROGRAM ENCOMPASSES QUALITY METRICS. PROVIDING EXCEPTIONAL HEALTH CARE AT LOWER COSTS THROUGH THE ACO MODEL FURTHERS MOSAIC'S TAX EXEMPT MISSION. MOSAIC PARTICIPATES IN THE MEDICARE SHARED SAVINGS ACO PROGRAM AND WORKS CLOSELY WITH NON-MOSAIC DOCTORS AND OTHER HEALTH-CARE PROVIDERS TO PROVIDE CARE FOR BENEFICIARIES WHO HAVE TRADITIONAL MEDICARE. BENEFICIARIES BENEFIT BECAUSE THEIR DOCTORS ARE PART OF A TEAM THAT FOCUSES ON THE COORDINATION AND QUALITY OF THEIR MEDICAL CARE. FOR CALENDAR YEAR 2015, MOSAIC ACHIEVED A 96.11% QUALITY SCORE. IN 2016, THE MEDICAL CENTER EARNED BACK-TO-BACK FIVE-STAR RATINGS FROM CMS AND IS THE ONLY HOSPITAL IN MISSOURI TO HAVE EARNED FIVE STARS. IN THE MOST RECENT RELEASE, JUST 83 INSITUTIONS OUT OF 3,629 HOSPITALS, OR 2.2 PERCENT, EARNED FIVE STARS NATIONWIDE. MOSAIC ALSO PARTICIPATES IN AN ACO WITH BLUE CROSS BLUE SHIELD OF KANSAS CITY (BCBSKC). FOR CALENDAR YEAR 2015, MOSAIC REALIZED EARNED SAVINGS RELATIVE TO BCBSKC TARGETS FOR THE THIRD YEAR IN A ROW. 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.
FORM 990, PART VI, SECTION A, LINE 2	ALL BOARD MEMBERS ALSO SERVE ON THE BOARD OF THE SOLE MEMBER, HEARTLAND HEALTH. CURT KRETZINGER, JOHN P. WILSON AND DWAIN STILSON HAVE A BUSINESS RELATIONSHIP WITH HEARTLAND LONG-TERM ACUTE CARE HOSPITAL, A RELATED NOT-FOR-PROFIT CORPORATION. THEY SERVE AS EITHER A DIRECTOR OR OFFICER OF HEARTLAND LONG TERM ACUTE CARE HOSPITAL. JOHN P. WILSON, CURT KRETZINGER, MARK LANEY, M.D., DWAIN STILSON, SERENA NAYLOR AND MICHAEL PULIDO HAVE A BUSINESS RELATIONSHIP WITH NORTHWEST MEDICAL CENTER ASSOCIATION, INC. THEY SERVE AS EITHER OFFICERS AND/OR DIRECTORS FOR NORTHWEST MEDICAL CENTER ASSOCIATION, INC., WHICH IS A RELATED NOT-FOR-PROFIT CORPORATION. JOHN P. WILSON, CURT KRETZINGER, MARK LANEY, M.D., AND DWAIN STILSON HAVE A BUSINESS RELATIONSHIP WITH MIDWESTERN HEALTH MANAGEMENT, INC. AND HHS PROPERTIES, INC. THEY SERVE AS EITHER OFFICERS AND/OR DIRECTORS OF MIDWESTERN HEALTH MANAGMENT, INC. AND HHS PROPERTIES, INC., WHICH ARE RELATED FOR-PROFIT CORPORATIONS. JOHN P. WILSON, CURT KRETZINGER, MARK LANEY, M.D., DWAIN STILSON, DAVIN TURNER, D.O., LISA MICHAELIS, JAREN PIPPITT, BRENNAN LEHMAN AND MICHAEL PULIDO HAVE A BUSINESS RELATIONSHIP WITH COMMUNITY HEALTH PLAN INSURANCE COMPANY. THEY SERVE AS EITHER OFFICERS AND/OR DIRECTORS FOR COMMUNITY HEALTH PLAN INSURANCE COMPANY, WHICH IS A RELATED FOR-PROFIT CORPORATION. JOHN P. WILSON, CURT KRETZINGER, AND DWAIN STILSON HAVE A BUSINESS RELATIONSHIP WITH UPTOWN HOUSING, INC., AND SHOAL CREEK FAMILY MEDICINE & ALLERGY, INC. THEY SERVE AS EITHER OFFICERS AND/OR DIRECTORS OF UPTOWN HOUSING, INC. AND SHOAL CREEK FAMILY MEDICINE & ALLERGY, INC., WHICH ARE RELATED FOR-PROFIT CORPORATIONS.
FORM 990, PART VI, SECTION A, LINE 4	Heartland Regional Medical Center adopted amended bylaws on October 28, 2015. These bylaws provide that the Board of Directors shall have authority, by resolution, to fix the compensation, if any, of the Directors serving as directors of the Hospital and may provide for reimbursement of expense incurred by the Directors on behalf of the Hospital. The previous bylaws stated that Directors shall not receive any compensation for their services as Directors but may receive reimbursement for expenses incurred on bahalf of the Hospital.
FORM 990, PART VI, SECTION A, LINE 6	HEARTLAND HEALTH, A MISSOURI NONPROFIT CORPORATION, IS THE SOLE MEMBER OF HEARTLAND REGIONAL MEDICAL CENTER.
FORM 990, PART VI, SECTION B, LINE 7B	THE SOLE MEMBER (HEARTLAND HEALTH) SHALL HAVE THE FOLLOWING POWERS: OVERALL STRATEGIC DIRECTION (EXCLUDING MATTERS RELATED PRIMARILY TO THE ACCOUNTABLE CARE ORGANIZATION (ACO) OPERATED BY THE HOSPITAL, INCLUDING SPECIFICALLY ANY MEDICARE SHARED SAVINGS PROGRAM CREATED UNDER THE AFFORDABLE CARE ACT), APPOINTMENT OF AUDITORS AND LEGAL COUNSEL, ESTABLISHMENT OF BANKING RELATIONSHIPS AND MANAGEMENT OF CASH AND OTHER ASSETS (EXCLUDING ACO SHARED SAVINGS DISTRIBUTIONS AND REPAYMENT OF SHARED LOSSES), LONG-RANGE PLANNING, ADOPTION OF ANNUAL OPERATING PLANS AND APPLICATION FOR CERTIFICATES OF NEED.
FORM 990, PART VI, SECTION B, LINE 11B	AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE FORM 990 WITH INFORMATION PROVIDED FROM HEARTLAND REGIONAL MEDICAL CENTERS 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, SECTION B, LINE 12C	UPON AGREEING TO FILL A BOARD POSITION, THE PROSPECTIVE MEMBER IS REQUIRED TO SIGN A CONFLICT OF INTEREST DOCUMENT WHICH DISCLOSES FAMILY AND BUSINESS RELATIONSHIPS THAT COULD BE CONSIDERED IN CONFLICT WITH 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 ORGANIZATIONS 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 HEARTLANDS 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, SECTION B, LINE 15A & 15B	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 HEARTLAND HEALTH BOARD CHAIR, HEARTLAND HEALTH BOARD VICE-CHAIR AND THREE ADDITIONAL HEARTLAND HEALTH 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 TO 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, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST.
FORM 990, PART XI, LINE 9	NET ASSET TRANSFER $ (4,143,244) CHANGE IN FAIR VALUE OF CASH FLOW HEDGING DERIVATES 352,724 CHANGE IN DEFINED BENEFIT PENSION PLAN LIABILITY (227,297) DECONSOLIDATION OF AFFILIATES (578,565) ------------- $ (4,596,382) =============

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
NORTHLAND EXPANSION LLC
5325 FARAON ST	ST JOSEPH	MO	64506	DEVELOPMENT	MO	$0	HRMC
URGENT CARE PROPERTIES LLC
5325 FARAON ST	ST JOSEPH	MO	64506	DEVELOPMENT	MO	$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 ST	ST JOSEPH	MO	64506	431283316	HEALTHCARE	MO	501(C)(3)	11B	NA	false
HEARTLAND FOUNDATION
5325 FARAON ST	ST JOSEPH	MO	64506	431262768	SUPPORT	MO	501(C)(3)	7	HH	Yes (true)
HEARTLAND LONG TERM ACUTE CARE HOSPITAL
5325 FARAON ST	ST JOSEPH	MO	64506	261972987	HEALTHCARE	MO	501(C)(3)	3	HH	Yes (true)
HEARTLAND HEALTH CARE PLAN TRUST FUND
5325 FARAON ST	ST JOSEPH	MO	64506	431286484	VEBA	MO	501(C)(9)		HH	Yes (true)
NORTHWEST MEDICAL CENTER ASSOCATION INC
705 N COLLEGE ST	ALBANY	MO	64402	440580870	HEALTHCARE	MO	501(C)(3)	3	HH	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	MPACT HEALTH LLC	BusinessNameLine1Txt

US Address USAddress

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

Field	Value	IRS element (for citing)
EIN	812138259	EIN
Primary Activities	HEALTHCARE	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	EXCLUDED	PredominantIncomeTypeTxt
Share Of Total Income	-$270,632	ShareOfTotalIncomeAmt
Share Of EOY Assets	$60,208	ShareOfEOYAssetsAmt
Disproportionate Allocations	false	DisproportionateAllocationsInd
UBI Code V	$0	UBICodeVAmt
General Or Managing Partner	false	GeneralOrManagingPartnerInd
Ownership	0.33000	OwnershipPct

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	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Controlled OrganizationControlledOrganizationInd
MIDWESTERN HEALTH MANAGEMENT INC
5325 FARAON ST	ST JOSEPH	MO	64506	431264358	HEALTHCARE	MO	HH	C CORP	$0	$0	Yes (true)
COMMUNITY HEALTH PLAN INSURANCE COMPANY
5325 FARAON ST	ST JOSEPH	MO	64506	431210152	INSURANCE	MO	HH	C CORP	$0	$0	Yes (true)
HHS PROPERTIES INC
5325 FARAON ST	ST JOSEPH	MO	64506	431593799	INVESTMENT	MO	HH	C CORP	$0	$0	Yes (true)
UPTOWN HOUSING INC
5325 FARAON ST	ST JOSEPH	MO	64506	261416252	REDEVELOPMENT	MO	HH	C CORP	$0	$0	Yes (true)
UPTOWN ST JOSEPH REDEVELOPMENT CORP
5325 FARAON ST	ST JOSEPH	MO	64506	201742813	REDEVELOPMENT	MO	HH	C CORP	$0	$0	Yes (true)

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 (19 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
MIDWESTERN HEALTH MANAGEMENT INC
B	$3,779,850	FMV
MIDWESTERN HEALTH MANAGEMENT INC
L	$722,361	FMV
MIDWESTERN HEALTH MANAGEMENT INC
Q	$5,001,628	FMV
HHS PROPERTIES INC
B	$147,984	FMV
HHS PROPERTIES INC
K	$258,507	FMV
HHS PROPERTIES INC
L	$325,000	FMV
HHS PROPERTIES INC
Q	$197,219	FMV
HEARTLAND HEALTH BUSINESS PLAZA LLC
K	$1,045,153	FMV
HEARTLAND LONG TERM ACUTE CARE HOSPITAL
A	$1,092,127	FMV
HEARTLAND LONG TERM ACUTE CARE HOSPITAL
L	$5,217,821	FMV
HEARTLAND LONG TERM ACUTE CARE HOSPITAL
Q	$7,018,169	FMV
HEARTLAND FOUNDATION
Q	$1,547,371	FMV
COMMUNITY HEALTH PLAN INSURANCE COMPANY
Q	$95,325	FMV
NORTHWEST MEDICAL CENTER ASSOCIATION INC
A	$48,920	FMV
NORTHWEST MEDICAL CENTER ASSOCIATION INC
L	$1,000,000	FMV
NORTHWEST MEDICAL CENTER ASSOCIATION INC
Q	$20,655,318	FMV
SHOAL CREEK FAMILY MEDICINE & ALLERGY INC
Q	$141,951	FMV
SHOAL CREEK FAMILY MEDICINE & ALLERGY INC
S	$555,568	FMV
MPACT HEALTH LLC
B	$319,867	FMV