2024-05-08T14:48:13+00:00 2023-06-30 420714325 RSM US LLP 4650 East 53rd Street Davenport IA 52807 990 2022-07-01 261972987 Heartland Long Term Acute Care Hospital HEAR 8162717070 5325 Faraon Street St Joseph MO 64506 Drew Keesbury Officer 8162717070 2024-05-08 true Drew Keesbury 999009999 Jenifer L Chase P01306883 5638884000 2022 2023-04-26 12:10:37Z Long Term Acute Care Hospital Drew Keesbury 5325 Faraon Street St Joseph MO 64506 11380937 false X https://www.mymlc.com/General/Long-Term-Acute-Care-Hospital/ X 2007 MO TO PROVIDE THE BEST HEALTH CARE AND TO IMPROVE THE LIVES OF THOSE IN THE COMMUNITY. 5 4 158 5 0 0 192859 0 12147405 11380937 0 9993 0 12350257 11380937 0 0 5788327 5827862 0 0 8144045 8004964 13932372 13832826 -1582115 -2451889 2747212 4870869 14498876 19074422 -11751664 -14203553 THE MISSION OF THE HEARTLAND LONG TERM ACUTE CARE HOSPITAL IS TO PROVIDE COMPREHENSIVE, AFFORDABLE CARE TO PATIENTS IN NEED OF LONG TERM ACUTE CARE SERVICES. false false 12827666 11380937 See Notes on Schedule O. 12827666 true false false true false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 3 0 true 158 true false false false false false false false false false false false X 5 4 true false false false true true true true true false false true true true true true true false false false X Drew Keesbury 8162717070 5325 Faraon Street St Joseph MO 64506 Dennis Rosonke Director/Vice Chair 1.0 0 X X 0 0 0 Gene A Claycomb President/Director/Chair 1.0 37.0 X X 0 443355 46562 Ecy Bullock Director 1.0 0 X 0 0 0 Jody Barker Director 1.0 0 X 0 0 0 Linda Judah Director 1.0 0 X 0 0 0 Drew Keesbury CFO/Treasurer 1.0 36.0 X 0 0 0 Michael R Rinard Secretary 1.0 37.0 X 0 273849 41666 Thomas Bieterman Former CFO/Treasurer 1.0 36.0 X 0 167017 2972 Dana L Anderson LTACH Administrator 40.0 0 X 228351 0 39605 Courtney Laipple Respiratory Therapist 40.0 0.0 X 108221 738 23850 Mary E Carden Inpatient RN 40.0 0.0 X 118471 37727 4991 Rachel A James Inpatient RN 40.0 0 X 101243 0 24087 Shana R Larkin Respiratory Therapist 40.0 0 X 111786 389 21654 Tischa Curtin Inpatient RN-LTACH Nursing 40.0 0 X 127033 0 12050 Davin Turner DO Former President/Director/Chair 0.0 38.0 X 0 393638 20954 Dwain Stilson Former CFO/Treasurer 0.0 0.0 X 0 157969 5073 Michael Pulido Former Secretary 0.0 0.0 X 0 1258302 34631 795105 2732984 278095 8 true true false 0 0 NET PATIENT SERVICE REVENUE 621990 11380937 11380937 0 0 0 0 11380937 0 0 0 0 0 0 0 0 0 11380937 11380937 0 0 X 271368 27137 244231 0 4539371 4370075 169296 118505 112551 5954 552211 505045 47166 346407 322438 23969 5414 5414 8338 8338 4122098 3845393 276705 0 280625 194284 86341 38614 38614 681789 672880 8909 351 280 71 350 350 478278 439825 38453 145551 127183 18368 33331 33331 Medical Supplies 1436202 1436202 FRA Tax 738960 738960 Dues and Subscriptions 35063 35063 0 0 0 0 13832826 12827666 1005160 0 0 0 2058714 3816461 0 0 0 0 11738 7872 16919 19721 3636305 2609490 659841 1026815 0 0 0 0 2747212 4870869 4067678 2577219 0 0 10431198 16497203 14498876 19074422 X -11751664 -14203553 -11751664 -14203553 2747212 4870869 -2451889 0 X false true X true false X false false false false false false false false true 8338 8338 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY PORTION OF DUES PAID TO HOSPITAL ASSOCIATIONS THAT ARE USED FOR LOBBYING PURPOSES BY THE HOSPITAL ASSOCIATIONS. 36.00% of the membership dues paid to the Missouri Hospital Association are used for lobbying activities. 27.29% of the membership dues paid to the American Hospital Association are used for lobbying activities. 11.69% of the membership dues paid to the National Association of Long Term Hospitals are used for lobbying activities. 339718 240245 99473 1364051 1159991 204060 1445255 1209254 236001 487281 487281 1026815 DUE TO AFFILIATES 16497203 Checks in Excess of Cash 16497203 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote MOSAIC HEALTH SYSTEM, HEARTLAND REGIONAL MEDICAL CENTER (MOSAIC-ST. JOSEPH), MOSAIC MEDICAL CENTER-MARYVILLE (MOSAIC-MARYVILLE), NORTHWEST MEDICAL CENTER ASSOCIATION, INC. (MOSAIC-ALBANY), HEARTLAND LONG-TERM ACUTE CARE HOSPITAL (HLTACH), MOSAIC LIFE CARE FOUNDATION, AND NORTHWEST MEDICAL CENTER FOUNDATION (MOSAIC-ALBANY) ARE NONPROFIT CORPORATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. HOWEVER, THEY ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. MIDWESTERN AND HHS PROPERTIES, INC. ARE SUBJECT TO INCOME TAXATION. WITH A FEW EXCEPTIONS, Mosaic's tax returns are generally subject to U.S. federal examinations by tax authorities for a period up to three years from the extended due date of return. AT JUNE 30, 2023, NET OPERATING LOSS CARRYFORWARDS GENERATED IN FISCAL YEARS ENDING JUNE 30, 2018 AND PRIOR ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME FOR THESE ENTITIES AGGREGATED APPROXIMATELY $10.6M AND EXPIRE THROUGH 2038. FOR NET OPERATING LOSS CARRYFORWARDS GENERATED IN FISCAL YEAR-ENDED JUNE 30, 2019 AND FORWARD WILL BE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME FOR THESE ENTITIES IN THE AMOUNT OF $1.5M AND ARE CARRIED FORWARD INDEFINITELY. SEPARATE RETURN LIMITATION RESTRICTIONS APPLY TO A PORTION OF THESE NET OPERATING LOSS CARRYFORWARDS. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNCERTAIN TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEET ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AS OF JUNE 30, 2023 AND 2022, THERE WERE NO UNCERTAIN TAX POSITIONS IDENTIFIED AND RECORDED AS A LIABILITY. true true X true X true X true true true false false 22500 22500 0.0016 3370504 3074012 296492 0.0214 0 0.0 0 0 3393004 3074012 318992 0.0231 0 0.0 0 0.0 0 0 0.0 0 0 0.0 0 0 0.0 0 0 0 0 0 0.0 0 0 3393004 3074012 318992 0.0231 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 252738 0 5001935 7871560 -2869625 X true true 1 1 HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH) 5325 FARAON STREET ST JOSEPH MO 64506 www.mymlc.com/GENERAL/LONG-TERM-ACUTE-CARE-HOSPITAL/ 513-14 X LONG TERM ACUTE CARE FACILITY HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH) 1 false false true X X X X X X X X X 21 true true false true X https://www.mymlc.com/General/Community-Health-Needs-Assessment/ X true 21 true https://www.mymlc.com/General/Community-Health-Needs-Assessment/ false true X 200.0 300.0 X true true X X X X true X SEE SCHEDULE O X SEE SCHEDULE O X SEE SCHEDULE O X X X X X X true X false X X X X X true X false false Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY ARE A PRIORITIZED DESCRIPTION OF VARIOUS FACTORS INCLUDING: - MENTAL HEALTH/SUBSTANCE ABUSE; - ACCESS AND COST OF HEALTH CARE; - OBESITY: AND - IMPORTANT HEALTH ISSUES THESE SIGNIFICANT HEALTH NEEDS ARE IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH). The Community Health Needs Assessment (CHNA) was jointly prepared by Heartland Regional Medical Center (Mosaic-St. Joseph) and HLTACH. THE CHNA WAS CONDUCTED DURING TAX YEAR 2021 TO DETERMINE SERVICES NEEDED BY THE MEDICALLY UNDERSERVED. The following three needs were chosen to be addressed over the next three years: - Mental Health/Substance Abuse, - Access to and Cost of Health Care, - Obesity TO ENSURE INPUT WAS TAKEN INTO ACCOUNT FROM PERSONS WHO REPRESENT THE COMMUNITY, Mosaic-St. Joseph and HLTACH UTILIZED AN INDEPENDENT CONSULTING FIRM NAMED CROWE, LLP. THIS FIRM helped CONDUCT key stakeholder interviews and a community survey. Key Stakeholder Interviews: Community input was obtained through key stakeholder interviews performed with leaders from twenty-three community organizations representing public health, public schools, social service organizations and government agencies. To assure the medically underserved were represented in this CHNA, interviews were conducted with representatives from the following organizations; BIG BROTHERS BIG SISTERS, BUCHANAN COUNTY SHERIFF'S DEPARTMENT, COMMUNITY ACTION PARTNERSHIP, COMMUNITY MISSIONS CORPORATION, CATHOLIC CHARITIES, FAMILY GUIDANCE CENTER, INTERSERV, MIDLAND EMPIRE RESOURCES FOR INDEPENDENT LIVING, NORTHWEST HEALTH SERVICES, PIVOTAL POINT TRANSITIONAL HOUSING, PROGRESSIVE COMMUNITY SERVICES, SECOND HARVEST COMMUNITY FOOD BANK, SOCIAL WELFARE BOARD, ST. JOSEPH HABITAT FOR HUMANITY, ST. JOSEPH HEALTH DEPARTMENT, ST. JOSEPH POLICE DEPARTMENT, ST. JOSEPH SCHOOL DISTRICT, ST. JOSEPH UNITED WAY, ST. JOSEPH YOUTH ALLIANCE, ST. JOSEPH YMCA, ST. JOSEPH YWCA, UNTITED CEREBRAL PALSY, VOICES OF COURAGE CHILD ADVOCACY CENTER. These key stakeholder interviews were conducted between October 25th and 27th, 2021. To assure that medically underserved were included in this CHNA, interviews were conducted with agencies serving neighborhoods where median household incomes are very low or unemployed, as well as agencies providing services related to mental health, persons who are homeless, victims of domestic violence, elderly and persons with disabilities. Community Health Survey: In order to develop a broad understanding of community health needs, Mosaic-St. Joseph and HLTACH conducted a community survey in January 2022. A link to the survey was distributed via e-mail, social media and word of mouth to the community at-large. A total of 258 surveys were completed. The majority of respondents were White/Caucasian (96%), 1% of the respondents identified as Black or African American and 1% identified as Hispanic or Latino. The remaining 2% identified with other racial or ethnic identities. THE SAMPLE INCLUDED MEN AND WOMEN, 18 AND OVER. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Heartland Regional Medical Center (Mosaic-St. Joseph). Heartland Long Term Acute Care Hospital (HLTACH) conducted a community health needs assessment and adopted an implementation strategy with Heartland Regional Medical Center (Mosaic-St. Joseph), a related organization. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH). THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED AND AN IMPLEMENTATION PLAN FOR ADDRESSING THE IDENTIFIED NEEDS WAS ADOPTED IN THE 2021 TAX YEAR. THE TOP THREE SIGNIFICANT NEEDS IDENTIFIED WERE: 1) Mental Health/Substance Abuse; 2) Access and Cost of Health Care; AND 3) Obesity. HLTACH's IS A FULLY ENGAGED COMMUNITY PARTNER STRIVING TO ADDRESS THE UNIQUE HEALTH AND SOCIAL ISSUES THAT CHALLENGE THE REGION. MANAGEMENT RECOGNIZES THAT THE COMMUNITY'S MAJOR HEALTH PROBLEMS STEM, IN LARGE PART, FROM SOCIAL DETERMINANTS OF HEALTH. SOCIAL DETERMINANTS THAT AFFECT ACCESS TO HEALTH CARE (HEALTHY PEOPLE 2020 FRAMEWORK) INCLUDE: ECONOMIC STABILITY, POVERTY, EMPLOYMENT, FOOD SECURITY, HOUSING STABILITY, EDUCATION, HIGH SCHOOL GRADUATION, ENROLLMENT IN HIGHER EDUCATION, LANGUAGE AND LITERACY, EARLY CHILDHOOD, NEIGHBORHOOD AND BUILT ENVIRONMENT, ACCESS TO HEALTHY FOOD, QUALITY OF HOUSING, CRIME AND VIOLENCE, ENVIRONMENTAL CONDITIONS, CIVIC PARTICIPATION, PERCEPTIONS OF DISCRIMINATION/EQUITY, AND INCARCERATION/INSTITUTIONALIZATION. TO FULLY MEET THE NEEDS IDENTIFIED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT, Mosaic-St. Joseph and HLTACH IMPLEMENTED A THREE-YEAR ACTION PLAN FOR TAX YEARS 2022, 2023 AND 2024 COMPRISED OF THE FOLLOWING COMPONENTS. SIGNIFICANT NEED #1: Mental Health/Substance Abuse: A) CONTINUE WORK OF BEHAVIORAL HEALTH ALLIANCE. B) CONTINUE TO FINANCIALLY SUPPORT AGENCIES THAT PROVIDE MENTAL HEALTH SERVICES. C) CONTINUE AND EXPAND THE MOSAIC ART EXPERIENCE. D) PROVIDE THE 4TH GRADE CHALLENGE IN ELEMENTARY SCHOOLS WITH EMPHASIS ON MENTAL HEALTH. E) THE ORGANIZATION'S SPIRITUAL HEALTH DEPARTMENT WILL PROVIDE ONGOING EDUCATION ON TRAUMA TO THE COMMUNITY. " THIS EVENT WILL BE PRESENTED YEARLY AND IS OPEN TO THE PUBLIC. MOSAIC CHAPLAINS ALSO PROVIDE ADVANCED DIRECTIVE AND DURABLE POWER OF ATTORNEY EDUCATION FOR ANYONE IN THE HOSPITAL, AND TO CHURCHES AN OTHER COMMUNITY GROUPS WHEN THEY REQUEST. IN ADDITION, SPIRITUAL HEALTH PROVIDES A PULPIT SUPPLY IN AREA CHURCHES WHEN NEEDED AND GIVE PRESENTATIONS ON THE ROLE OF THE CHAPLAIN IN HEALTH CARE. SIGNIFICANT NEED #2: ACCESS TO AND COST OF CARE: A) The organization will provide financial support to organizations providing ACCESS SUPPORT TO THE COMMUNITY, SUCH AS FAITH IN ACTION TRANSPORTATION MINISTRY B) THE ORGANIZATION WILL CONTINUE TO SUPPORT SOCIAL WELFARE BOARD Free Clinic. SIGNIFICANT NEED #3: OBESITY: A) THE ORGANIZATION WILL AGAIN OFFER 4TH GRADE CHALLENGE IN ELEMENTARY SCHOOLS, PROVIDING PHYSICAL ACTIVITY AND EDUCATION ON HEALTHY EATING AND EXERCISE. B) THE ORGANIZATION WILL ONCE AGAIN PROVIDE KIDS IN THE KITCHEN HEALTHY COOKING CLASS. C) THE ORGANIZATION WILL PROVIDE AN ADULT HEALTHY LIFESYTLE PROGRAM. D) THE ORGANIZATION WILL ALSO SUPPORT SECOND HARVEST COMMUNITY FOOD BANK IN PROVIDING HEALTHY FOOD CHOICES. THE COMPLETE CHNA WITH IMPLEMENTATION STRATEGY CAN BE FOUND AT: HTTPS://WWW.MYMLC.COM/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ST-JOSEPH-CHNA/ Schedule H, Part V, Section B, Line 20 Facility , 1 Facility , 1 - Heartland Long Term Acute Care Hospital (HLTACH). FINANCIAL COUNSELORS ARE AVAILABLE ONSITE TO EXPLAIN AND HELP PATIENTS AND RESPONSIBLE PARTIES WITH THE FINANCIAL ASSISTANCE POLICY. SEE FINANCIAL ASSISTANCE POLICY FOR COMPLETE DESCRIPTION OF EFFORTS MADE BEFORE INITIATING COLLECTION ACTIONS. 0 Schedule H, Part I, Line 3c Not applicable Schedule H, Part I, Line 6a Not Applicable Schedule H, Part I, Line 7f HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH) DID NOT REPORT BAD DEBT EXPENSE AS PART OF OPERATING EXPENSES FOR HEALTH PROFESSIONS EDUCATION FOR YEAR ENDED 06/30/23. NO BAD DEBT EXPENSE IS REPORTED ON FORM 990, PART IX, LINE 25, AS IT IS REPORTED ON FORM 990, PART VIII, LINE 2A IN NET PATIENT SERVICE REVENUE. THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE (SCHEDULE H, PART I, LINE 7, COLUMN (C)) AS A PERCENTAGE OF TOTAL EXPENSES IS 24.53%, AND THE PERCENTAGE INCREASES TO 81.43% IF MEDICARE ALLOWABLE COSTS (SCHEDULE H, PART III, SECTION B, LINE 6) ARE INCLUDED IN TOTAL COMMUNITY BENEFIT EXPENSE. Schedule H, Part III, Line 2 Explanation of Change in Bad Debt HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH) REPORTED THERE WERE NO SIGNIFICANT CHANGES IN BAD DEBT EXPENSE FOR FISCAL YEAR-ENDED JUNE 30, 2023 AND FOR FISCAL YEAR-ENDED JUNE 30, 2022. THESE ARE REPORTED IN ACCORDANCE WITH GAAP. Schedule H, Part VI, Line 7 NOT APPLICABLE Schedule H, Part I, Line 7b DURING THE YEAR-ENDED 06/30/2023, Heartland Long Term Acute Care Hospital (HLTACH)reduced the estimated FEDERAL REIMBURSEMENT ALLOWANCE program liability related to prior program years by approximately $1,976,000 thereby increasing patient service revenue by the same amount. This change in estimate was the result of the state of Missouri providing HLTACH final settlement notifications during the year ended June 30, 2023. Due to the subjectivity involved in making these estimates due to the lack of historical precedence with respect to how the state administers the program, there is at least a reasonable possibility that recorded estimates will change by a material amount in the near term. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WAS THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2. FINANCIAL ASSISTANCE AT COST WAS $22,500 AND $87,000 FOR YEARS ENDED 6/30/23 AND 6/30/22, RESPECTIVELY. MEDICAID NET COMMUNITY BENEFIT LOSS WAS $296,000 AND $269,000 FOR YEARS ENDED 6/30/23 AND 6/30/22, RESPECTIVELY. THE HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH) RECEIVES REIMBURSEMENT FROM THE MEDICAID PROGRAM IN RELATION TO THE PERCENTAGE OF MEDICAID AND INDIGENT POPULATION THEY SERVE. Schedule H, Part II Community Building Activities Not Applicable Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Heartland Long Term Acute Care Hospital (HLTACH) calculates bad debt expense at the established rate as reported in patient service revenue in the audited financial statements. Discounts provided by third-party payors on patient accounts are written off as contractual allowances. Payments received on an account previously written off to bad debt expense are credited to a bad debt recovery account. Schedule H, Part III, Line 3 Bad Debt Expense Methodology Heartland Long Term Acute Care Hospital (HLTACH) uses a third party to electronically review a patient or the patient's Guarantor information to assess financial need. This review utilizes a healthcare industry-recognized, predictive model that is based on public record databases and does not access the patient or guarantor's credit file. The model's rule set is designed to assess each patient based upon the same standards and is calibrated against historical Financial Assistance approvals by the organization. This enables the organization to assess whether a patient is characteristic of other patients who have historically qualified for Financial Assistance under the traditional application process. When the model is utilized, it will be deployed prior to bad debt assignment or after all other eligibility and payment sources have been exhausted. This allows the organization to screen all patients for Financial Assistance prior to pursuing any extraordinary collection actions. As a result, HLTACH reported zero dollars for the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's Financial Assistance Policy. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Please see THE ACCOUNTS RECEIVABLE FOOTNOTE ON PAGE 10 and 11 and the Patient Service revenue Footnote regarding implicit price concessions on page 18 OF The ATTACHED AUDITED FINANCIAL STATEMENTS. SEE ALSO THE PARAGRAPH IN THE CHARITY CARE FOOTNOTE ON PAGE 19. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO DIRECTLY FROM THE MEDICARE COST REPORT WHICH RESULTS IN A SHORTFALL OF COVERING THE HOSPITAL'S COST OF TREATING MEDICARE PATIENTS. THIS SHORTFALL, IN ADDITION TO NON-PAYMENT BY MEDICARE RECIPIENTS FOR THEIR DEDUCTIBLE AND COINSURANCE AMOUNT INCREASES FINANCIAL ASSISTANCE AND BAD DEBT. THE HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH) PROVIDES SERVICES TO ALL MEDICARE PATIENTS WITH THE KNOWLEDGE THAT THE COST OF PROVIDING CARE TO THEM MAY EXCEED THE REIMBURSEMENT FROM MEDICARE FOR THE SERVICES PROVIDED. THE SHORTFALL OF COSTS, FINANCIAL ASSISTANCE AND BAD DEBT IS CONSIDERED TO BE A COMMUNITY BENEFIT BECAUSE THE HLTACH IS ABSORBING THE ADDITIONAL COST OF PROVIDING CARE TO THE ELDERLY AND DISABLED IN THE COMMUNITY. IN ADDITION, THIS COINCIDES WITH THE IRS REVENUE RULING 69-545, WHICH provides general requirements for tax exemption, along with section 501(c)(3). Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance THE FINANCIAL ASSISTANCE POLICY CONTAINS PROVISIONS ON COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ONLY. ACCORDING TO THIS POLICY, FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA ARE BASED ON RESIDENCY, GROSS HOUSEHOLD INCOME & HOUSEHOLD SIZE. APPLYING FOR FINANCIAL ASSISTANCE Patients will be informed of Heartland Long Term Acute Care Hospital's (HLTACH) Financial Assistance Policy and the process for submitting an application. to determine if the patient or guarantor is eligible for financial assistance, HLTACH asks for the necessary information and documents to prove household size, income, and residency. A completed application for financial assistance should be submitted within 240 days from the date of the first post-discharge billing statement. HLTACH will make reasonable efforts to explain the Medicaid benefits, the health insurance exchange and coverage, and other public and private coverage that may apply. HLTACH will also provide the details of these programs and offer to help patients and guarantors apply for them as well as, private programs and COBRA coverage. Once the patient or guarantor is screened to be potentially eligible for any of these programs, public or private, HLTACH expects him or her to apply. If a patient or guarantor chooses not to apply, he or she may be denied financial assistance. If the patient or guarantor is potentially eligible for any third-party coverage, he or she must provide documentation of approval or denial of that third-party coverage before a HLTACH financial assistance application will be accepted. Information on the HLTACH Financial Assistance Policy will be communicated to patients in a culturally appropriate language. Information about the policy will be translated in the most prevalent languages in the HLTACH primary service area. COLLECTION ACTIONS TAKEN IN EVENT OF NON-PAYMENT No account will be subject to collection actions within 120 days of issuing the first post-discharge statement and without first making reasonable efforts to determine whether the patient is eligible for financial assistance. No extraordinary collection actions will be pursued against a patient if the patient or guarantor has provided documentation showing that an application has been submitted for Medicaid or other publicly sponsored health programs, and that an eligibility determination is still pending. If a statement is sent to a patient or guarantor, and mail is returned as undeliverable, HLTACH will attempt to find a correct address. If the correct address cannot be found, HLTACH will attempt to contact the patient or guarantor by telephone at the number listed by the patient or guarantor. If efforts to communicate with the patient or guarantor fail, accounts will be sent to a collection agency. Reasonable efforts to inform patient of financial assistance Prior to sending an account to a collection agency, the patient or guarantor will generally receive a minimum of four written statements (includes the first post-discharge statement and three subsequent statements). These statements will include a telephone number for information on paying patient balances and a notice about financial assistance. If an agreement has not been made to resolve the account, the fourth and final statement will be sent to the patient or guarantor. This statement acts as a notice to the account owner of the amount owed to HLTACH and that the account will be placed with a third-party collection agency in 30 days. This statement will include a plain language summary and will outline any collection actions that may be taken if a plan is not put in place to settle the account. There are other times when accounts may be placed in collections including when: 1. The patient or guarantor has not made timely payments according to the agreed-upon payment plan 2. The patient or guarantor has received a financial assistance discount but is no longer working with HLTACH in good faith to pay off the remaining amount owed. Extraordinary collection activities Once an account is with the collection agency, the following actions may be taken to make sure debt for services and care is paid. They are "Extraordinary Collection Activities:" 1. Seizing the patient's or guarantor's bank account 2. Civil actions 3. Property liens 4. Garnishing of wages 5. Reporting adverse information to credit bureaus Before "Extraordinary Collection Activities" can begin, the account must be reviewed, and approval must be given by Patient Billing Leadership. When one of these actions is to be taken against a patient or guarantor, the patient or guarantor will be given a 30-day written notice of the action to be taken. The patient or guarantor will also be informed of the Financial Assistance Policy and how to apply for it. A plain language summary of the Financial Assistance Policy will be included with the notice. ENFORCEMENT HLATCH staff are expected to uphold the highest ethical standards. All business must be conducted in the name of the caller or HLTACH. Everything a staff member says must be true and correct using a professional approach. The staff as well as, all third-party vendors working on behalf of HLTACH, will uphold and adhere to the Fair Debt Collection Practices Act. Schedule H, Part V, Section B, Line 16a FAP website - HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH): Line 16a URL: SEE SCHEDULE O; Schedule H, Part V, Section B, Line 16b FAP Application website - HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH): Line 16b URL: SEE SCHEDULE O; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH): Line 16c URL: SEE SCHEDULE O; Schedule H, Part VI, Line 2 Needs assessment Heartland Long Term Acute Care Hospital (HLTACH) HAS A ROBUST APPROACH FOR ASSESSING THE NEEDS OF THE COMMUNITIES IT SERVES. THIS ONGOING COMMITMENT INCLUDES COLLABORATING WITH LOCAL GROUPS, SCHOOL DISTRICTS AND CITY AND COUNTY AGENCIES TO IDENTIFY NEEDS, PROMOTE HEALTHY LIVING, ASSURE THAT AFFORDABLE MEDICAL SERVICES ARE AVAILABLE, DEVELOP STRATEGIES FOR IMPROVING EDUCATION AND ECONOMIC STRENGTH, AND PROVIDING ONGOING SUPPORT. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEGINNING AT THE REGISTRATION DESK AND CONTINUING WITH FINANCIAL ASSISTANCE INFORMATION BEING INCLUDED ON EVERY BILLING STATEMENT A PATIENT OR GUARANTOR RECEIVES FROM THE MEDICAL CENTER. GUIDELINES FOR THE PROGRAM ARE AVAILABLE AT EACH REGISTRATION DESK AND ARE INCLUDED IN ALL ADMISSION PACKETS. PATIENTS ARE CONTACTED IF THE PATIENT IS EXPECTED TO HAVE A FINANCIAL RESPONSIBILITY FOR THE VISIT. A FINANCIAL COUNSELOR ATTEMPTS TO VISIT THE ROOM OF EVERY UNINSURED PATIENT THAT IS ADMITTED TO OUR FACILITY FOR OBSERVATION OR INPATIENT CARE. THE COUNSELOR DISCUSSES PAYMENT OPTIONS WITH THE PATIENT AND CAN ASSIST THEM WITH VARIOUS OPTIONS THAT INCLUDE, BUT ARE NOT LIMITED TO, MEDICAID APPLICATION, HEALTH CARE EXCHANGE ELIGIBILITY AND ELIGIBILITY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. COUNSELORS ALSO WORK WITH OUR CARE MANAGEMENT STAFF TO SUPPORT THE DISCHARGE PROCESSES SO THAT FINANCIAL HARDSHIP DOES NOT KEEP THE PATIENT FROM RECEIVING THE APPROPRIATE FOLLOW-UP CARE. THIS ASSISTANCE INCLUDES INSTRUCTIONS FOR SCHEDULING AN APPOINTMENT WITH A FINANCIAL COUNSELOR WHO CAN ASSIST THEM IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION. Schedule H, Part VI, Line 4 Community information THE ORGANIZATION'S PRIMARY AND SECONDARY SERVICE AREA IS AN 18 COUNTY URBAN/RURAL REGION LOCATED IN NORTHWEST MISSOURI AND NORTHEAST KANSAS. THE POPULATION IS ELDERLY AND UNDER-INSURED. THE LOCAL ECONOMY CONSISTS OF AGRICULTURAL, SMALL MANUFACTURING AND SELF-EMPLOYED BUSINESSES, PRIMARILY BLUE-COLLAR WORKERS. THE ORGANIZATION SUPPORTS A PAYOR MIX OF APPROXIMATELY 97.67% GOVERNMENTAL OR SELF-PAY PATIENTS. 15.5% OF THE POPULATION IS BELOW THE POVERTY LEVEL; 24.3% OF THE POPULATION SMOKES; AND 29% HAVE A BODY MASS INDEX GREATER THAN 30. MORE THAN 69% OF THE ELEMENTARY AGE STUDENTS RECEIVE FREE OR REDUCED-COST LUNCHES. Schedule H, Part VI, Line 5 Promotion of community health Heartland Long Term Acute Care Hospital (HLTACH) is a nonprofit corporation that is operating to serve a public rather than a private interest and meeting the requirements of Revenue Ruling 69-545. Control of the HLTACH rests with its Board, which is primarily composed of members of the community, in addition to a few select employees of the HLTACH. HLTACH accepts patients paying with Medicaid and Medicare and is accessible to all patients without regard to ability to pay. HLTACH uses any surplus funds to improve the quality of patient care, maintain and improve equipment and facilities, extend service offerings to new areas and provide support to the communities it serves. IN FY23, RECOVERED FROM THE EFFECTS OF THE COVID 19 PANDEMIC THESE COMMUNITY HEALTH IMPROVEMENT PROGRAMS WERE OFFERED: 1. 4TH GRADE HEALTH CHALLENGE IN ELEMENTARY SCHOOLS 2. ADULT HEALTHY LIFESTYLE PROGRAM (REPLACED POUND PLUNGE) PILOTED WITH CANCER SURVIVORS 3. KIDS IN THE KITCHEN HEALTHY COOKING CLASSES IN ELEMENTARY SCHOOLS Schedule H, Part VI, Line 6 Affiliated health care system THE ORGANIZATION IS AFFILIATED, THROUGH A PARENT BOARD, WITH A REGIONAL MEDICAL CENTER HOSPITAL, A COMMUNITY FOUNDATION, A LONG-TERM ACUTE CARE HOSPITAL, A CRITICAL ACCESS RURAL HOSPITAL, A RURAL COMMUNITY FOUNDATION AND A GENERAL MEDICAL AND SURGICAL HOSPITAL. 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 ORGANIZATION. THESE AFFILIATIONS INCLUDE THE HOSPITAL REPORTED ON THIS TAX RETURN. THE PARENT BOARD IS COMPRISED OF COMMUNITY LEADERS WHO REPRESENT THE EDUCATIONAL, MEDICAL, GOVERNMENTAL AND BUSINESS SECTORS IN THE COMMUNITY. THE COMMUNITY FOUNDATION OVERSEES A NUMBER OF PROGRAMS WORKING TO IMPROVE HEALTH AND EDUCATIONAL NEEDS IN THE COMMUNITY. THE REGIONAL MEDICAL CENTER HOSPITAL PROVIDES GENERAL MEDICAL AND SURGICAL NEEDS TO PATIENTS AND PROVIDES BOTH PRIMARY AND SPECIALTY PHYSICIANS, IN ADDITION TO PROVIDING EMERGENT AND OUTPATIENT CLINIC CARE FOR ALL. THE LONG-TERM ACUTE CARE HOSPITAL IS A FACILITY DEDICATED TO THE CARE OF PATIENTS WHO HAVE CHRONIC CONDITIONS REQUIRING A LONGER LENGTH OF STAY THAN IS NORMALLY PROVIDED IN AN ACUTE CARE HOSPITAL. THE GENERAL MEDICAL AND SURGICAL CARE HOSPITAL PROVIDES ACUTE, EMERGENT AND OUTPATIENT CLINIC CARE FOR ALL. THE CRITICAL ACCESS RURAL HOSPITAL PROVIDES ACUTE, EMERGENT AND OUTPATIENT CLINICS ARE FOR THOSE IN THE RURAL COMMUNITY AREA. THE RURAL COMMUNITY FOUNDATION SUPPORTS THE CRITICAL ACCESS RURAL HOSPITAL. ALL HOSPITAL FACILITIES PROVIDE CARE FOR ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. ALL THE HOSPITAL ORGANIZATIONS MAINTAIN AN ONGOING COMMITMENT TO PROVIDE SUPPORT FOR THE BETTERMENT OF THE COMMUNITY. true true false false false false false false false Davin Turner DO Former President/Director/Chair 0 354867 0 35973 0 2798 0 8299 0 12655 0 414592 0 63730 Gene A Claycomb President/Director/Chair 0 344147 0 94682 0 4526 0 10588 0 35974 0 489917 0 0 Michael Pulido Former Secretary 0 1255487 0 0 0 2815 0 8102 0 26529 0 1292933 0 519516 Dwain Stilson Former CFO/Treasurer 0 157169 0 550 0 250 0 0 0 5073 0 163042 0 74404 Michael R Rinard Secretary 0 213676 0 58812 0 1361 0 9254 0 32412 0 315515 0 0 Thomas Bieterman Former CFO/Treasurer 0 166756 0 261 0 0 0 0 0 2972 0 169989 0 0 Dana L Anderson LTACH Administrator 178908 0 48561 0 882 0 7581 0 32024 0 267956 0 0 0 Mary E Carden Inpatient RN 117967 37701 0 0 504 26 3789 1202 0 0 122260 38929 0 0 Schedule J, Part I, Line 4a Severance or change-of-control payment Mosaic Health System, a related organization, paid Michael Pulido, COO, severance payments during calendar year 2022. This is reported on Form 990, Part VII and Schedule J, Part II as other reportable compensation. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan GENE CLAYCOMB - VESTED $0; ACCRUED $50,400 MICHAEL RINARD - VESTED $0; ACCRUED $31,360 DANA ANDERSON - VESTED $0; ACCRUED $18,900 THOSE LISTED ABOVE HAVE SIGNED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN WHICH RECOGNIZES THE VALUE OF THE INDIVIDUAL AND THE MUTUAL BENEFIT OF CONTINUED EMPLOYMENT FOR AN EXTENDED PERIOD OF TIME BY ESTABLISHING A 457F PLAN. THE FOLLOWING ARE THE GENERAL STIPULATIONS OF THE AGREEMENT: 1. THE PLAN IS FUNDED YEARLY AS THE RESULT OF A CALCULATION DESCRIBED IN THE AGREEMENT, WHICH WILL REWARD THE INDIVIDUAL WITH 100% VESTING BASED ON A 5-YEAR CLIFF VESTING SCHEDULE. 2. FOR SERP PARTICIPANTS PRIOR TO 2019, DISTRIBUTION WILL OCCUR UPON DEATH OR UPON SEPARATION FROM SERVICE DUE TO DISABILITY OR UPON INVOLUNTARY SEPARATION FROM SERVICE WITHOUT CAUSE. THEN A LUMP SUM PAYMENT WILL BE DISBURSED WITHIN 90 DAYS OF EACH SITUATION TAKING INTO CONSIDERATION A NON-COMPETE COVENANT. 3. FOR SERP PARTICIPANTES AFTER 2019, DISTRIBUTION WILL OCCUR UPON DEATH OR UPON SEPARATION FROM SERVICE DUE TO DISABILITY OR UPON INVOLUNTARY SEPARATION FROM SERVICE WITHOUT CAUSE. THEN A LUMP SUM PAYMENT DISTRIBUTES WITHIN 60 DAYS AND DOESN'T TAKE INTO ACCOUNT NON-COMPETE COVENANT. 4. SEPARATION WITH CAUSE MAKES THE SUPPLEMENTAL EXECUTIVE RETIREMENT AGREEMENT NULL AND VOID. Schedule J, Part I, Line 3 Compensation Plan COMPENSATION IS ESTABLISHED BY MOSAIC HEALTH SYSTEM, A RELATED ENTITY USING THE FOLLOWING: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. COMPENSATION SURVEY OR STUDY 4. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE Form 990, Part III, Line 4 THE LONG TERM ACUTE CARE HOSPITAL OFFERS THE COMMUNITY AND SERVICE AREA OF NORTHWEST MISSOURI A SPECIALIZED LEVEL OF INPATIENT CARE FOR THE MEDICALLY COMPLEX PATIENT WHO REQUIRES EXTENDED HOSPITALIZATION. THE 41-BED HOSPITAL-WITHIN-A-HOSPITAL IS CO-LOCATED WITHIN HEARTLAND REGIONAL MEDICAL CENTER MOSAIC LIFE CARE AT ST. JOSEPH. THE FILING ORGANIZATION PROVIDES CARE TO THE MEDICALLY COMPLEX PATIENT AND ALSO OFFERS A CLOSE OBSERVATION UNIT CONSISTING OF 8 BEDS FOR PATIENTS WHO REQUIRE INCREASED NURSING-TO-PATIENT RATIOS AND TECHNICAL SUPPORT FOR MORE CRITICAL CARE NEEDS SUCH AS VENTILATOR WEANING AND TELEMETRIC MONITORING. PATIENTS HAVE AN AVERAGE LENGTH OF STAY OF LONGER THAN 25 DAYS. PATIENTS REQUIRE DAILY PHYSICIAN VISITS, ROUND-THE-CLOCK NURSING CARE AS WELL AS SUCH MULTIDISCIPLINARY SERVICES AS RESPIRATORY THERAPISTS, DIETITIANS, DIALYSIS TECHNICIANS AND PHYSICAL, OCCUPATIONAL, AND SPEECH PATHOLOGISTS DUE TO THEIR MEDICAL COMPLICATIONS AND NEEDS. CARE FOR PATIENTS IS PROVIDED IN A SMALL, PERSONALIZED ENVIRONMENT THAT OFFERS A LARGE ARRAY OF RESOURCES, PRIVATE ROOMS AND AMENITIES FOR PATIENT'S FAMILIES. PATIENTS ARE TYPICALLY REFERRED TO HEARTLAND LONG TERM ACUTE CARE HOSPITAL AFTER RECEIVING CARE IN A HOSPITAL-BASED INTENSIVE CARE UNIT OR MEDICAL-SURGICAL UNIT. CARE WAS PROVIDED TO 167 PATIENTS WHO GENERATED 7,277 PATIENT DAYS. THE ORGANIZATION SUPPORTS A PAYOR MIX OF APPROXIMATELY 97.67% GOVERNMENTAL AND NO-PAY PATIENTS. FINANCIAL ASSISTANCE WAS PROVIDED AT A COST OF $22,500. Form 990, Part VI, Line 15 COMPENSATION IS ESTABLISHED BY MOSAIC HEALTH SYSTEM, A RELATED ENTITY. AN ANNUAL REVIEW WAS PERFORMED DURING THE PRIOR FISCAL YEAR. MARKET DATA WAS PROVIDED BY A THIRD PARTY COMPENSATION CONSULTANT THAT SPECIALIZES IN MARKET SALARY DATA. A COMPENSATION COMMITTEE COMPRISED OF MOSAIC HEALTH SYSTEM BOARD CHAIR, MOSAIC HEALTH SYSTEM BOARD VICE-CHAIR AND THREE ADDITIONAL MOSAIC HEALTH SYSTEM BOARD MEMBERS AND INDEPENDENT LEGAL COUNSEL, AS SCRIBE, OVERSAW AN ANNUAL SALARY REVIEW PROCESS FOR OFFICERS AND ADMINISTRATORS. FOR EACH POSITION TO BE REVIEWED, THE FULL SCOPE OF DUTIES AND RESPONSIBILITIES, NUMBERS OF STAFF MANAGED, PROCESSES MANAGED, APPROXIMATE REVENUE, EXPENSE, OR CAPITAL DOLLARS MANAGED WERE PROVIDED TO THE THIRD PARTY CONSULTANT. FACILITY SIZE, NOT-FOR-PROFIT STATUS AND THE SCOPE OF EACH JOB POSITION WERE COMPARED TO LIKE FACILITIES TO DETERMINE BASE COMPENSATION AND INCENTIVE COMPENSATION FOR EACH POSITION. THE DATA GATHERED BY THE THIRD PARTY CONSULTANT WAS REVIEWED BY THE COMPENSATION COMMITTEE, OUTLIER ISSUES WERE RESOLVED AND, BASED UPON PRESENT FINANCIAL INDICATORS, THE COMMITTEE MADE ITS DETERMINATION OF COMPENSATION LEVELS FOR THE NEXT PAY YEAR. Form 990, Part VI, Line 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS GENE A CLAYCOMB, DREW KEESBURY AND MICHAEL RINARD HAVE A BUSINESS RELATIONSHIP. Form 990, Part VI, Line 6 Classes of members or stockholders MOSAIC HEALTH SYSTEM, A MISSOURI NONPROFIT CORPORATION, IS THE SOLE MEMBER OF HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH). Form 990, Part VI, Line 7a Members or stockholders electing members of governing body MOSAIC HEALTH SYSTEM, AS THE SOLE MEMBER OF HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH), HAS THE RIGHT TO ELECT ALL MEMBERS OF THE BOARD OF DIRECTORS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders THE CORPORATE BYLAWS OF HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH) IDENTIFY CERTAIN RIGHTS AND POWERS WHICH ARE RESERVED TO MOSAIC HEALTH SYSTEM, THE SOLE MEMBER. IN EACH INSTANCE, THE RIGHTS AND POWERS RESERVED TO THE SOLE MEMBER MAY BE SUMMARIZED AS FOLLOWS: 1. ANY FUNDAMENTAL CHANGE IN THE MISSION, PURPOSE OR PHILOSOPHY OF THE HOSPITAL 2. ANY CHANGE AFFECTING OR THREATENING HOST HOSPITAL'S COMPLIANCE AND REQUIRED QUALIFICATIONS AS A SOLE COMMUNITY PROVIDER, PARTICULARLY DURING THE FIRST SIX (6) MONTHS OF REQUISITE DATA COLLECTION UNDER CLASSIFICATION AS A SHORT TERM ACUTE CARE HOSPITAL, OR IN THE EVENT THE HOSPITAL REVERTS TO ITS INITIAL CMS CERTIFICATION AS A SHORT-TERM ACUTE CARE HOSPITAL 3. THE INCURRENCE OF DEBT, INCLUDING WITHOUT LIMITATION, BORROWINGS, GUARANTEES, LOANS, ENCUMBRANCES, OPERATING LEASES, PURCHASE OR LEASE OF REAL ESTATE, AND CAPITAL LEASES, IN EXCESS OF FIVE HUNDRED THOUSAND DOLLARS ($500,000), MEASURED IN AN ANNUAL AGGREGATE 4. ANY MERGER OR CONSOLIDATION TO WHICH THE HOSPITAL IS A PARTY. THE SALE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE HOSPITAL 5. POLICIES PERTAINING TO CHARITY CARE 6. ANY RELEASE OR CANCELLATION OF INDIVIDUAL CLAIMS IN EXCESS OF $75,000 7. ANY CAPITAL EXPENDITURES WHICH IN THE AGGREGATE EXCEED $250,000 ANNUALLY 8. APPOINTMENT AND REMOVAL OF THE CORPORATE DIRECTOR 9. THE DEFENSE, SETTLEMENT OR RESOLUTION OF ANY DISPUTE INVOLVING THE HOSPITAL IN WHICH THE AMOUNT IN CONTROVERSY IS IN EXCESS OF $250,000 10. THE DEFENSE, SETTLEMENT OR RESOLUTION OF ANY REGULATORY CHALLENGES TO THE LEGAL STRUCTURE OF THE HOSPITAL, ALLEGED OVERPAYMENTS FROM ANY GOVERNMENTAL AGENCY OR ANY ALLEGATIONS FROM A GOVERNMENTAL AGENCY OF FRAUD AND ABUSE 11. APPROVE THE STRATEGIC PLAN OF THE HOSPITAL Form 990, Part VI, Line 11b Review of form 990 by governing body THE ACCOUNTING STAFF OF THE ORGANIZATION PREPARES THE FORM 990 AND SUBMITS A DRAFT TO AN INDEPENDENT ACCOUNTING FIRM. THE INDEPENDENT ACCOUNTING FIRM REVIEWS THE FORM 990 WITH INFORMATION PROVIDED FROM THE ORGANIZATION'S ACCOUNTING STAFF. THE DRAFT FORM 990 IS REVISED FOR ANY CORRECTIONS OR CLARIFICATIONS BASED ON THE REVIEW BY THE INDEPENDENT ACCOUNTING FIRM. THEN THE FORM 990 IS REVIEWED BY THE ORGANIZATIONS LEADERSHIP FOR ANY QUESTIONS AND CONCERNS. AFTER RESOLVING QUESTIONS AND CONCERNS WITH LEADERSHIP AND THE ACCOUNTING FIRM, THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN PRESENTED TO BOARD FOR APPROVAL. ONCE APPROVED THEN THE 990 TAX RETURN IS ELECTRONICALLY FILED. Form 990, Part VI, Line 12c Conflict of interest policy THIS CONFLICTS OF INTEREST AND DOCUMENTATION POLICY ("POLICY") APPLIES TO ALL DIRECTORS AND OFFICERS OF THE ORGANIZATION AND ANY OTHER PERSON WHO IS IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE DECISIONS AND AFFAIRS OF THE ORGANIZATION (COLLECTIVELY, "COVERED PERSONS"). DUTY TO DISCLOSE IF AN INTERESTED PERSON HAS A POSITION OR FINANCIAL INTEREST IN ANY BUSINESS OR OTHER ENTITY WITH WHICH THE ORGANIZATION IS CONSIDERING ENTERING INTO AN ARRANGEMENT OR TRANSACTION, THE INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER POSITION OR FINANCIAL INTEREST AND ALL MATERIAL FACTS RELATED THERETO TO THE ORGANIZATION'S BOARD OF DIRECTORS (THE "BOARD") OR EXECUTIVE COMMITTEE AS SOON AS THE INTERESTED PERSON HAS KNOWLEDGE OF THE POTENTIAL ARRANGEMENT OR TRANSACTION, AND WHENEVER REQUESTED BY THE BOARD OR THE EXECUTIVE COMMITTEE. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS AFTER DISCLOSURE OF A POSITION OR A FINANCIAL INTEREST BY AN INTERESTED PERSON, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE INTERESTED PERSON (INCLUDING THOSE INTERESTED PERSONS WHO ARE MEMBERS OF THE BOARD OR EXECUTIVE COMMITTEE) WILL LEAVE THE BOARD MEETING WHILE THE DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS IN CONNECTION WITH THE PROPOSED TRANSACTION IS DISCUSSED BY THE BOARD OR THE EXECUTIVE COMMITTEE AND VOTED UPON. A POSITION OR A FINANCIAL INTEREST WILL BE CONSIDERED A CONFLICT OF INTEREST ONLY IF THE BOARD OR THE EXECUTIVE COMMITTEE MAKES SUCH DETERMINATION. AN INTERESTED PERSON IS CONSIDERED TO HAVE A CONFLICT OF INTEREST WITH RESPECT TO HIS OR HER COMPENSATION IF THE PERSON RECEIVES COMPENSATION FROM THE ORGANIZATION AND THE PERSON'S COMPENSATION IS BEING DISCUSSED OR REVIEWED BY THE BOARD OR ANY COMMITTEE THEREOF. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST *BEFORE ANY DISCUSSION AND VOTE ON WHETHER A CONFLICT OF INTEREST EXISTS, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OR THE EXECUTIVE COMMITTEE REGARDING THE INTERESTED PERSON'S POSITION OR FINANCIAL INTEREST. AFTER SUCH PRESENTATION, THE INTERESTED PERSON WILL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE PROPOSED TRANSACTION. *THE BOARD OR THE EXECUTIVE COMMITTEE WILL UNDERTAKE APPROPRIATE DUE DILIGENCE AND INFORM ITSELF OF ALL MATERIAL INFORMATION REASONABLY AVAILABLE TO IT AND EXPLORE ALL REASONABLE ALTERNATIVES TO THE PROPOSED TRANSACTION THAT WOULD NOT INVOLVE THE CONFLICT OF INTEREST. *IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OR THE EXECUTIVE COMMITTEE WILL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE PROPOSED TRANSACTION IS (I) IN THE ORGANIZATION'S BEST INTEREST, (II) FOR THE ORGANIZATION'S OWN BENEFIT, AND (III) FAIR AND REASONABLE TO THE ORGANIZATION. IN CONFORMITY WITH THIS DETERMINATION, THE BOARD WILL MAKE ITS DECISION AS TO WHETHER THE ORGANIZATION MAY ENTER INTO THE PROPOSED TRANSACTION. QUORUM FOR BOARD OR EXECUTIVE COMMITTEE ACTION FOR PURPOSES OF THE BOARD OR EXECUTIVE COMMITTEE ACTIONS TO BE TAKEN UNDER THESE PROCEDURES, INCLUDING THE DETERMINATION WHETHER A CONFLICT OF INTEREST EXISTS, A MAJORITY OF THE DISINTERESTED DIRECTORS ON THE BOARD OR THE EXECUTIVE COMMITTEE WILL CONSTITUTE A QUORUM. HOWEVER, IN NO CASE WILL A SINGLE DISINTERESTED DIRECTOR TAKE ANY SUCH ACTION. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY IF THE BOARD OR THE EXECUTIVE COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO DISCLOSE A POSITION OR A FINANCIAL INTEREST, IT WILL INFORM THE COVERED PERSON OF THE BASIS FOR SUCH BELIEF AND AFFORD THE COVERED PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE COVERED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED UNDER THE CIRCUMSTANCES, THE BOARD OR THE EXECUTIVE COMMITTEE DETERMINES THAT THE COVERED PERSON HAS IN FACT FAILED TO DISCLOSE A POSITION OR A FINANCIAL INTEREST, THE BOARD OR THE EXECUTIVE COMMITTEE WILL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. DOCUMENTATION IN MINUTES THE MINUTES OF THE BOARD OR THE EXECUTIVE COMMITTEE WILL CONTAIN: *WITH RESPECT TO THE DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS, THE NAME OF THE INTERESTED PERSON WHO DISCLOSED OR WAS OTHERWISE FOUND TO HAVE A POSITION OR FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST; THE NATURE OF THE POSITION OR FINANCIAL INTEREST; ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT; AND THE BOARD OR THE EXECUTIVE COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED. *WITH RESPECT TO WHETHER OR NOT THE CONFLICT OF INTEREST TRANSACTION IS APPROVED, THE NAMES OF THE PERSONS PRESENT FOR THE DISCUSSIONS AND VOTE RELATED TO THE PROPOSED TRANSACTION; THE CONTENT OF THE DISCUSSION; WHETHER ALTERNATIVES WERE DISCUSSED THAT DID NOT INVOLVE A CONFLICT OF INTEREST; THE BASIS FOR THE DETERMINATION THAT THE PROPOSED TRANSACTION WAS (I) IN THE ORGANIZATION'S BEST INTEREST, (II) FOR THE ORGANIZATION'S OWN BENEFIT, AND (III) FAIR AND REASONABLE TO THE ORGANIZATION; AND THE RECORD OF THE VOTE TAKEN IN CONNECTION WITH THE PROCEEDINGS. ANNUAL STATEMENTS EACH COVERED PERSON WILL ANNUALLY SIGN A STATEMENT THAT AFFIRMS SUCH PERSON: *HAS RECEIVED A COPY OF THIS POLICY; *HAS READ AND UNDERSTANDS THE POLICY; *HAS AGREED TO COMPLY WITH THE POLICY; AND *UNDERSTANDS THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX AND TO MAINTAIN ITS FEDERAL TAX EXEMPTION THE ORGANIZATION MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IN ADDITION, EACH COVERED PERSON WILL ANNUALLY COMPLETE, SIGN AND PROMPTLY RETURN TO THE BOARD A QUESTIONNAIRE AND DISCLOSURE STATEMENT SUBSTANTIALLY IN THE FORM ATTACHED HERETO. A COVERED PERSON NEED NOT DISCLOSE COMPENSATION PAID TO THE COVERED PERSON BY ORGANIZATION PURSUANT TO A RESOLUTION OF THE BOARD. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. ALL OF THESE DOCUMENTS ARE LOCATED IN ADMINISTRATION. Form 990, Part IX, Line 11g Other Fees ANCILLARY MEDICAL - Total Expense: 2399236, Program Service Expense: 2397566, Management and General Expenses: 1670, Fundraising Expenses: ; MEDICAL DIRECTOR FEES - Total Expense: 60225, Program Service Expense: 60225, Management and General Expenses: 0, Fundraising Expenses: ; PURCHASED AGENCY STAFF - Total Expense: 8927, Program Service Expense: 8927, Management and General Expenses: , Fundraising Expenses: ; PURCHASED DIALYSIS - Total Expense: 339778, Program Service Expense: 339778, Management and General Expenses: , Fundraising Expenses: ; CORPORATE SUPPORT SERVICES ALLOCATION - Total Expense: 964672, Program Service Expense: 689637, Management and General Expenses: 275035, Fundraising Expenses: ; TECHNOLOGY SERVICES ALLOCATION - Total Expense: 349260, Program Service Expense: 349260, Management and General Expenses: , Fundraising Expenses: ; Form 990, Part XII, Line 2c The results of the consolidated audit are reviewed by the Mosaic Health System Board, the sole member of Heartland Long Term Acute Care Hospital (HLTACH). Schedule H, Part V, Section B, Line 16a FAP Website URL https://www.mymlc.com/Main/Location/st-joseph-mo/mosaic-life-care-at-st.-joseph-medical-center/main-medical-center/medical-bills-made-easy/financial-assistance/ Schedule H, Part V, Section B, Line 16b FAP Application Form https://www.mymlc.com/Main/Location/st-joseph-mo/mosaic-life-care-at-st.-joseph-medical-center/main-medical-center/medical-bills-made-easy/financial-assistance/ Schedule H, Part V, Section B, Line 16c FAP Plain Language Summary https://www.mymlc.com/Main/Location/st-joseph-mo/mosaic-life-care-at-st.-joseph-medical-center/main-medical-center/medical-bills-made-easy/financial-assistance/ Mosaic Health System (MHS) 5325 Faraon Street St Joseph MO 64506 431283316 Healthcare MO 501(c)(3) Type II NA false Heartland Regional Medical Center (Mosaic-St Joseph) 5325 Faraon Street St Joseph MO 64506 440545289 Healthcare MO 501(c)(3) 3 Mosaic Health System true Heartland Foundation (Mosaic Life Care Foundation) 5325 Faraon Street St Joseph MO 64506 431262768 Support MO 501(c)(3) 7 Mosaic Health System true Northwest Medical Center Association Inc (Mosaic-Albany) 705 N College Street Albany MO 64402 440580870 Healthcare MO 501(c)(3) 3 Mosaic Health System true Northwest Medical Center Foundation Inc (NMC Foundation) 705 N College Street Albany MO 64402 473694893 Support MO 501(c)(3) Type I Northwest Medical Center Association Inc true Mosaic Medical Center-Maryville (Mosaic-Maryville) 5325 Faraon Street St Joseph MO 64506 832249459 Healthcare MO 501(c)(3) 3 Mosaic Health System true St Joseph Downtown Development LLC 5325 Faraon Street St Joseph MO 64506 474317460 Development MO NA N/A Midwestern Health Management Inc 5325 Faraon Street St Joseph MO 64506 431264358 Healthcare MO NA C Corporation true HHS Properties Inc 5325 Faraon Street St Joseph MO 64506 431593799 Investment MO NA C Corporation true Uptown Housing Inc 5325 Faraon Street St Joseph MO 64506 261416252 Redevelopment MO NA C Corporation true Uptown St Joseph Redevelopment Corp 5325 Faraon Street St Joseph MO 64506 201742813 Redevelopment MO NA C Corporation true false false false false true false false false false true true false true true true true false true false HEARTLAND REGIONAL MEDICAL CENTER (MOSAIC-ST JOSEPH) K 672880 FMV HEARTLAND REGIONAL MEDICAL CENTER (MOSAIC-ST JOSEPH) M 2969188 FMV Mosaic Health System (MHS) M 680013 FMV Mosaic Health System (MHS) P 4645186 FMV HEARTLAND REGIONAL MEDICAL CENTER (MOSAIC-ST JOSEPH) P 1759187 FMV