Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2011 and ending 06-30-2012
BCheck if applicable:
CName of organization
Heartland Regional Medical Center
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
5325 FARAON
 
Room/suite
City or town, state or country, and ZIP + 4
ST JOSEPH, MO64506
D Employer identification number

44-0545289
E Telephone number

G Gross receipts $ 601,745,811
F Name and address of principal officer:
JOHN P WILSON
5325 FARAON
ST JOSEPH,MO64506
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.HEARTLAND-HEALTH.COM
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1985
M State of legal domicile: MO
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE THE BEST HEALTH CARE AND TO IMPROVE THE LIVES OF THOSE IN THE COMMUNITY.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 13
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 10
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 3,956
6 Total number of volunteers (estimate if necessary) .... 6 632
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 1,106,067
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b -1,452,272
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 194,597 440,211
9 Program service revenue (Part VIII, line 2g) ......... 497,961,978 535,301,968
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 14,660,677 7,569,764
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 12,470,717 24,450,689
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 525,287,969 567,762,632
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 3,399,946 2,225,116
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 253,054,219 277,928,007
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 223,099,240 246,690,846
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 479,553,405 526,843,969
19 Revenue less expenses. Subtract line 18 from line 12....... 45,734,564 40,918,663
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 623,105,290 671,179,321
21 Total liabilities (Part X, line 26)............. 286,772,368 323,359,830
22 Net assets or fund balances. Subtract line 21 from line 20..... 336,332,922 347,819,491
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III .........
1
Briefly describe the organization’s mission: SEE SCHEDULE O
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 484,253,539 including grants of $ 1,645,345 ) (Revenue $ 559,264,023 )
SEE SCHEDULE O
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 484,253,539
Form 990 (2011)
Form 990 (2011)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part IIIClick to see attachment........................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment....................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II.. Click to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III.. Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements. Click to see list of attachments
20b
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II......................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V .........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
248
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
3,956
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2011)
Form 990 (2011)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI .........
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
13
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
10
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ..........
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
CA , IL , MO , NC
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
JOHN P WILSON
5325 FARAON
ST JOSEPH,MO64506
(816) 271-6611
Form 990 (2011)
Form 990 (2011)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII .........
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) MARK LANEY MD
DIRECTOR, OFFICER
 54.0 X   X       833,954 0 144,469
(2) FRANK LEONE
DIRECTOR
 1.0 X           0 0 0
(3) AL PURCELL
DIRECTOR
 1.0 X           0 0 0
(4) CAROL ROEVER
DIRECTOR
 1.0 X           0 0 0
(5) STEVE SCHRAM
DIRECTOR
 1.0 X           0 0 0
(6) BARBARA WURTZLER
DIRECTOR
 1.0 X           0 0 0
(7) DAVID CATHCART DO
DIRECTOR, STAFF PHYSICIAN
 59.0 X           267,654 0 14,785
(8) JOHN OLSON MD
DIRECTOR, STAFF PHYSICIAN
 59.0 X           785,379 0 28,739
(9) KAREN BAKER
DIRECTOR
 1.0 X           0 0 0
(10) BRIAN BRADLEY
DIRECTOR
 1.0 X           0 0 0
(11) DENNIS DOBYAN MD
DIRECTOR
 1.0 X           0 50,417 0
(12) JAMES GRAVES
DIRECTOR
 1.0 X           0 0 0
(13) DAN HEGEMAN
DIRECTOR
 1.0 X           0 0 0
(14) DAVE HOWERY
DIRECTOR
 1.0 X           0 0 0
(15) JOHN JARRETT
DIRECTOR
 1.0 X           0 0 0
(16) ANDREW MCCREA
DIRECTOR
 1.0 X           0 0 0
(17) MAUREEN BOYLE MD
DIRECTOR, STAFF PHYSICIAN
 60.0 X           453,213 0 35,335
Form 990 (2011)
Form 990 (2011)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) MICHAEL NELLESTEIN MD
DIRECTOR, STAFF PHYSICIAN
 60.0 X           744,122 0 33,052
(19) CURT KRETZINGER
OFFICER
 52.0     X       594,407 0 104,619
(20) JOHN P WILSON
OFFICER
 50.0     X       540,435 0 85,973
(21) DOUGLAS BRANDT
OFFICER, CONTROLLER
 50.0     X       274,400 0 74,175
(22) KAREN DITTEMORE
OFFICER, ADMIN ASST
 50.0     X       64,942 0 12,228
(23) JOE BOYCE MD
OFFICER
 59.0     X       372,016 0 71,142
(24) DIRCK CLARK
OFFICER
 57.0     X       299,137 0 60,215
(25) MICHAEL PULIDO
OFFICER
 60.0     X       304,305 0 75,201
(26) LYNN THUENTE
OFFICER
 60.0     X       139,769 0 12,421
(27) BARBIE SQUIRES
OFFICER
 60.0     X       80,971 0 4,110
(28) TAMA WAGNER
OFFICER
 60.0     X       196,712 0 64,757
(29) LISA MICHAELIS
MEDICAL CENTER ADMINISTRATOR
 59.0       X     371,640 0 67,124
(30) SCOTT KOELLIKER
HEARTLAND CLINIC ADMINISTRATOR
 59.0       X     284,014 0 81,295
(31) REBECCA PRESTON MD
PHYSICIAN ADMINISTRATOR
 60.0       X     0 0 0
(32) MOHAN HINDUPUR MD
STAFF PHYSICIAN
 60.0         X   1,041,073 0 24,852
(33) ROBERT GRANT MD
STAFF PHYSICIAN
 60.0         X   935,846 0 32,739
(34) ARVIND SHARMA MD
STAFF PHYSICIAN
 60.0         X   901,077 0 30,835
(35) FRANCISCO LAMMOGLIA MD
STAFF PHYSICIAN
 60.0         X   882,728 0 32,239
(36) ALA ABABNEH MD
STAFF PHYSICIAN
 60.0         X   797,652 0 29,231
(37) ED KAMMERER MD
DIRECTOR, STAFF PHYSICIAN
 60.0           X 359,973 0 29,835
(38) PADMAVATHI VELIGATI MD
DIRECTOR, STAFF PHYSICIAN
 60.0           X 448,878 0 9,800
(39) HELEN THOMPSON
OFFICER
 0.0           X 244,558 0 20,325
(40) RUDY WACKER
OFFICER
 0.0           X 592,270 0 0
(41) ROBERT PERMUT MD
OFFICER
 0.0           X 171,567 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 12,982,692 50,417 1,179,496
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet318
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
CERNER CORP
 
  		SOFTWARE SYSTEMS 6,867,895
ST JOSEPH ONCOLOGY INC
 
  		PHYSICIAN COVERAGE 4,835,542
KELLY CONST GROUP INC
 
  		CONSTRUCTION 5,577,189
LAWHON CONSTRUCTION CO
 
  		CONSTRUCTION 2,157,653
LEHR CONSTRUCTION CO INC
 
  		CONSTRUCTION 3,606,448
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet106
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 15,301
e Government grants (contributions)1e 170,185
f All other contributions, gifts, grants, and
similar amounts not included above1f 		254,725
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 440,211
Program Service Revenue Business Code
2a NET PATIENT SERVICE REVENUE 621,110 535,301,968 535,301,968    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 535,301,968
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 5,577,279     5,577,279
4 Income from investment of tax-exempt bond proceeds..MediumBullet 720,647     720,647
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 488,634  
b Less: rental expenses    
c Rental income or (loss) 488,634  
d Net rental income or (loss).......MediumBullet 488,634     488,634
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 35,103,018 8,167
b Less: cost or other basis and sales expenses 33,829,575 9,772
c Gain or (loss) 1,273,443 -1,605
d Net gain or (loss)..........MediumBullet 1,271,838     1,271,838
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a 171,009
b Less: cost of goods sold ..b 143,832
c Net income or (loss) from sales of inventory..MediumBullet 27,177   27,177  
Miscellaneous Revenue Business Code
11a Cafeteria 722,210 2,096,953 2,096,953    
b Refferal Lab 111,000 1,637,335 1,518,754 118,581  
c MEDICAL RECORD COPYING REVENUE 541,380 400,932 400,932    
d All other revenue .... 19,799,658 18,839,349 960,309  
e Total. Add lines 11a–11d ......MediumBullet 23,934,878
12 Total revenue. See Instructions....MediumBullet 567,762,632 558,157,956 1,106,067 8,058,398
Form 990 (2011)
Form 990 (2011)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 2,225,116 2,225,116
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 8,326,393 4,416,615 3,909,778  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 386,825 386,825    
7 Other salaries and wages 218,151,598 204,878,768 13,272,830  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 7,997,178 7,721,093 276,085  
9 Other employee benefits ....... 30,314,602 27,631,822 2,682,780  
10 Payroll taxes ........... 12,751,411 11,720,237 1,031,174  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 1,324,840 623,322 701,518  
c Accounting ........... 139,500   139,500  
d Lobbying ........... 145,358   145,358  
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 624,299   624,299  
g Other .......... 31,796,250 24,558,025 7,238,225  
12 Advertising and promotion .... 3,342,825 3,337,718 5,107  
13 Office expenses ....... 25,944,561 23,824,863 2,119,698  
14 Information technology ...... 452,452 452,452    
15 Royalties .. 0      
16 Occupancy ........... 10,852,531 9,792,407 1,060,124  
17 Travel ............ 905,964 869,972 35,992  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 2,277,467 1,727,820 549,647  
20 Interest ........... 2,484,040 2,442,754 41,286  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 26,580,753 23,731,022 2,849,731  
23 Insurance .............. 6,805,598 6,805,472 126  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a REPAIRS AND MAINTENANCE 14,606,892 9,923,436 4,683,456  
b PROVISION FOR UNCOLLECTIBLE 42,112,706 42,083,155 29,551  
c FRA TAX 15,363,718 15,363,718    
d MEDICAL SUPPLIES 59,132,798 59,132,798    
e
f All other expenses 1,798,294 604,129 1,194,165  
25 Total functional expenses. Add lines 1 through 24f 526,843,969 484,253,539 42,590,430 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 11,208,512 1 16,812,886
2 Savings and temporary cash investments ....... 0 2 0
3 Pledges and grants receivable, net ......... 0 3 0
4 Accounts receivable, net ......... 48,844,760 4 64,676,384
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L .......... 0 5 0
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L .......... 0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 6,916,808 8 8,730,387
9 Prepaid expenses and deferred charges ............ 6,179,267 9 5,213,554
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 514,008,246
b Less: accumulated depreciation. ..... 10b 282,325,572 210,569,793 10c 231,682,674
11 Investments—publicly traded securities .......... 282,618,583 11 282,342,788
12 Investments—other securities. See Part IV, line 11 ...... 36,506,458 12 38,953,298
13 Investments—program-related. See Part IV, line 11 .. 3,064,298 13 3,191,976
14 Intangible assets ......... 0 14 0
15 Other assets. See Part IV, line 11 ........... 17,196,811 15 19,575,374
16 Total assets. Add lines 1 through 15 (must equal line 34)... 623,105,290 16 671,179,321
Liabilities 17 Accounts payable and accrued expenses . 76,538,064 17 116,705,273
18 Grants payable .......... 0 18 0
19 Deferred revenue .......... 27,151 19 53,758
20 Tax-exempt bond liabilities .......... 192,630,000 20 185,700,000
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 4,690,042 23 3,896,839
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D..... 12,887,111 25 17,003,960
26 Total liabilities. Add lines 17 through 25..... 286,772,368 26 323,359,830
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 336,332,922 27 347,819,491
28 Temporarily restricted net assets ..... 0 28 0
29 Permanently restricted net assets ..... 0 29 0
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 336,332,922 33 347,819,491
34 Total liabilities and net assets/fund balances ..... 623,105,290 34 671,179,321
Form 990 (2011)
Form 990 (2011)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI .........
1
Total revenue (must equal Part VIII, column (A), line 12) ...
1
567,762,632
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
526,843,969
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
40,918,663
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
336,332,922
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
-29,432,094
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....
6
347,819,491
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII .........
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?....
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2011)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
Heartland Regional Medical Center
 
Employer identification number

44-0545289
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2011
Name of organization
Heartland Regional Medical Center
 
Employer identification number

44-0545289
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
Heartland Regional Medical Center
  		Employer identification number

44-0545289
Part I
Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
Heartland Regional Medical Center
  		Employer identification number

44-0545289
Part II
Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
Heartland Regional Medical Center
  		Employer identification number

44-0545289
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
Use duplicate copies of Part III if additional space is needed
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Heartland Regional Medical Center
 
Employer identification number

44-0545289
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2011

Schedule C (Form 990 or 990-EZ) 2011
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check expenses, and share of excess lobbying expenditures).
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots nontaxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2011


Schedule C (Form 990 or 990-EZ) 2011
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
145,358
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
 
No
 
j
Total. Add lines 1c through 1i ...............................
145,358
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
Schedule C (Form 990 or 990EZ) 2011

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
Heartland Regional Medical Center
 
Employer identification number

44-0545289
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958), relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....        
b Contributions ........        
c Net investment earnings, gains, and losses ...        
d Grants or scholarships .....        
e Other expenditures for facilities
and programs ........ 		       
f Administrative expenses ....        
g End of year balance ......        
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   15,317,168 15,317,168
b Buildings ................   233,998,983 106,696,843 127,302,140
c Leasehold improvements ............   24,170,163 13,953,010 10,217,153
d Equipment ................   169,747,104 122,831,384 46,915,720
e Other .................   70,774,828 38,844,335 31,930,493
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 231,682,674
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) INVESTMENT IN LLC'S 		4,970,440 C

(B) PRIVATE INVESTMENT FUNDS 		33,982,858 F







Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 38,953,298
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes 0
DERIVATIVE INSTRUMENTS 16,032,250
MINORITY INTEREST 971,710







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 17,038,200
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8  
9 Total adjustments (net). Add lines 4 through 8 ......................... 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
UNCERTAIN TAX POSITIONS DISCLOSURE SCHEDULE D, PART X, LINE 2 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
Schedule D (Form 990) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
Heartland Regional Medical Center
 
Employer identification number

44-0545289
Part I
General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants
and other assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? ..............................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other
assistance outside the United States.
3
Activites per Region. (Use Part V if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees or agents in region or independent contractors (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total
expenditures for region/investments
in region
Central America and the Caribbean     Investments   33,982,858
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....     33,982,858
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     33,982,858
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990,
Part IV, line 15, for any recipient who received more than $5,000. Check this box if no one recipient received more than $5,000 ........ MediumBullet
Use Part V if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2
Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .....MediumBullet
 
3
Enter total number of other organizations or entities ........................MediumBullet
 
Schedule F (Form 990) 2011
Schedule F (Form 990) 2011Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Use Part V if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926 (see instructions for Form 926).................
2 Did the organization have an interest in a foreign trust during the tax year? If " Yes," the organization may be required to file Form 3520 and/or Form 3520-A. (see instructions for Forms 3520 and 3520-A)..........
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with respect to Certain Foreign Corporations. (see instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with respect to Certain Foreign Partnerships. (see instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see instructions for Form 5713)................................................
Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
Page 5
Part V
Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
Identifier ReturnReference Explanation
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2011
Additional Data


Software ID:  
Software Version:  



SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
Heartland Regional Medical Center
 
Employer identification number

44-0545289
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the
following was the family income limit for eligibility for discounted care: ............
3b
Yes
 
c
If the organization did not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year?...........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ...............
6b
 
No
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance
and Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    14,445,419 0 14,445,419 2.740 %
b Medicaid (from Worksheet 3, column a) .....     85,837,550 72,734,564 13,102,986 2.490 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .            
dTotal Financial Assistance and
Means-Tested Government Programs ..... 		    100,282,969 72,734,564 27,548,405 5.230 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    7,377,477   7,377,477 1.400 %
f Health professions education
(from Worksheet 5) .. 		    1,190,483   1,190,483 0.230 %
g Subsidized health services
(from Worksheet 6) .. 		    1,068,065 249,524 818,541 0.100 %
h Research (from Worksheet 7)     402,531   365,463 0.070 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....     2,225,116   2,225,116 0.420 %
jTotal Other Benefits ...     12,263,672 249,524 11,977,080 2.220 %
kTotal. Add lines 7d and 7j. ..     112,546,641 72,984,088 39,525,485 7.450 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     250,981   250,981 0.050 %
2 Economic development     528,191   528,191 0.100 %
3 Community support     466,669   466,669 0.090 %
4 Environmental improvements            
5 Leadership development and training for community members     734,071   734,071 0.140 %
6 Coalition building     349,175   349,175 0.070 %
7 Community health improvement advocacy     766,571   766,571 0.150 %
8 Workforce development     16,715   16,715  
9 Other            
10 Total     3,112,373   3,112,373 0.600 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense........
2
20,073,665
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....
3
0
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
155,227,738
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
179,877,934
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-24,650,196
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures
(see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1SEE PART VI
  		       
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 HEARTLAND REGIONAL MEDICAL CENTER
5325 FARAON
ST JOSEPH,MO64506 		X X         X   PHARMICIST INTERN PROGRAM
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
HEARTLAND REGIONAL MEDICAL CENTER
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet the community health needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Participation in the development of a community-wide community benefit plan
d Participation in the execution of a community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?34
Name and address Type of Facility (describe)
1 HEARTLAND CLINIC
901 HEARTLAND ROAD
ST JOSEPH,MO64506 		SPECIALTY CLINIC
2 HEARTLAND CLINIC
902 RIVERSIDE ROAD
ST JOSEPH,MO64507 		SPECIALTY CLINIC
3 HEARTLAND CLINIC
802 N RIVERSIDE
ST JOSEPH,MO64507 		SPECIALTY CLINIC
4 HEARTLAND CLINIC
5514 CORPORATE DR
ST JOSEPH,MO64507 		SPECIALTY CLINIC
5 HEARTLAND CLINIC
5210 NORTH BELT HIGHWAY
ST JOSEPH,MO64506 		FAMILY PRACTICE
6 HEARTLAND CLINIC
5301 FARAON
ST JOSEPH,MO64506 		SPECIALTY CLINIC
7 HEARTLAND CLINIC
105 FAR WEST DRIVE
ST JOSEPH,MO64506 		SPECIALTY CLINIC
8 HEARTLAND CLINIC
5325 FARAON
ST JOSEPH,MO64506 		SPECIALTY CLINIC
9 HEARTLAND CLINIC
1115 N BELT HIGHWAY
ST JOSEPH,MO64506 		URGENT CARE
10 SPA AT BRIARCLIFF
4133 NORTH MULBERRY DRIVE
KANSAS CITY,MO64116 		SPA
11 HEARTLAND CLINIC
2703 RUNNING HORSE RD
PLATTE CITY,MO64079 		SPECIALTY CLINIC
12 HEARTLAND CLINIC
3715 BECK ROAD
ST JOSEPH,MO64506 		INTERNAL MEDICINE
13 HEARTLAND CLINIC
401 ILLINOIS
ST JOSEPH,MO64504 		OCCUPATIONAL MEDICINE
14 ADVANCED DIAGNOSTIC IMAGING
3620 FREDERICK AVENUE
ST JOSEPH,MO64506 		IMAGING
15 HEARTLAND CLINIC
1314 N 36TH ST
ST JOSEPH,MO64506 		SPECIALTY
16 HEARTLAND CLINIC
400 N FULLERTON
PRINCETON,MO64673 		FAMILY PRACTICE
17 HEARTLAND CLINIC
4201 NORTH BELT HIGHWAY
ST JOSEPH,MO64506 		SPECIALTY CLINIC
18 HEARTLAND CLINIC
215 S WALNUT ST
CAMERON,MO64429 		FAMILY PRACTICE
19 HEARTLAND CLINIC
207 SO MAIN
TROY,KS66087 		FAMILY PRACTICE
20 HEARTLAND OUTPATIENT THERAPY-MIDWEST
3107 FREDERICK
ST JOSEPH,MO64506 		OUTPATIENT THERAPY
21 HEARTLAND COUNSELING
137 N BELT HIGHWAY
ST JOSEPH,MO64506 		COUNSELING
22 PATEE DENTAL CLINIC
904 SOUTH 10TH
ST JOSEPH,MO64501 		DENTAL SERVICES
23 HEARTLAND CLINIC
300 UTAH
HIAWATHA,KS66434 		FAMILY PRACTICE
24 HEARTLAND CLINIC
1236 N JESSE JAMES RD
EXCELSIOR SPRINGS,MO64024 		FAMILY PRACTICE
25 HEARTLAND CLINIC
711 N 36TH ST
ST JOSEPH,MO64506 		SPECIALTY CLINIC
26 HEARTLAND CLINIC
1015 WEST FOURTH
CAMERON,MO64429 		SPECIALTY CLINIC
27 HEARTLAND CLINIC
2024 S MAIN
MARYVILLE,MO64468 		SPECIALTY CLINIC
28 HEARTLAND CLINIC
2600 MILLER
BETHANY,MO64424 		SPECIALTY CLINIC
29 HEARTLANC CLINIC
2812 ST JOSEPH AVENUE
ST JOSEPH,MO64505 		SPECIALTY CLINIC
30 HEARTLAND SPORTS ACCELERATION
3007 N BELT HIGHWAY
ST JOSEPH,MO64506 		OUTPATIENT THERAPY
31 HEARTLAND CLINIC
5302 FARAON
ST JOSEPH,MO64506 		SPECIALTY CLINIC
32 HEARTLAND CLINIC
705 N COLLEGE
ALBANY,MO64402 		SPECIALTY CLINIC
33 HEARTLAND CLINIC
100 CENTRAL ST
CHILLICOTHE,MO64601 		SPECIALTY CLINIC
34 HANDS OF HOPE HOSPICE
307 PINEVIEW ST
STANBERRY,MO64489 		HOSPICE SERVICES
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
SCHEDULE H, PART I, LINE 7   THE COSTING METHODOLOGY USED TO CALCULATED THE AMOUNTS REPORTED IN THE TABLE WAS THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2.
SCHEDULE H, PART I, LINE 7, COLUMN F   COST IS FROM FORM 990, PART IX, LINE 25 COLUMN (A) WITH BAD DEBT OF $42,112,706 SUBTRACTED FOR THE PURPOSE OF CALCULATING THE PERCENTAGE.
SCHEDULE H, PART I, LINE 7G   PHYSICIAN CLINIC COST $1,068,065
COMMUNITY BUILDING ACTIVITIES SCHEDULE H, PART II FUNDING BY THE ORGANIZATION MAKES THE FOLLOWING COUNCILS AND PROGRAMS POSSIBLE: HEALTHY COMMUNITIES INVESTOR COUNCIL; P-20 BUSINESS AND EDUCATION COUNCIL; THE EMPOWER PLANT; THE REGIONAL TECHNOLOGY INFRASTRUCTURE TEAM; POUND PLUNGE, YOUTH HEALTH PARTNERSHIP, SENIOR HEALTH, PROJECT FIT, WOMEN'S WELLNESS INITIATIVE, HEART WALK, DIABETES EXPO, PROJECT YOUTH!, 4TH GRADE CHALLENGE, PATEE DENTAL CLINIC, HEALTH EXPRESS, CORPORATE CHALLENGE, HEALTH RISK ASSESSMENTS FOR LOCAL BUSINESSES, WELLNESS AMBASSADORS; ENVIRONMENTAL ASSESSMENTS; INCREASED AWARENESS OF THE NEED FOR PHILANTHROPIC EFFORTS AND VOLUNTEERISM TO SUPPORT PROGRAMS SUCH AS SUCCESS BY SIX, SOCIAL WELFARE BOARD, INTERFAITH COMMUNITY SERVICES, NATURE CENTER, NURSING SCHOLARSHIP PROGRAMS, SUPPORT OF AMERICAN RED CROSS PROGRAMS, SUPPORT OF LOCAL ARTS AND CULTURAL ACTIVITIES.
BAD DEBT EXPENSE SCHEDULE H, PART III, LINE 4 PATIENT ACCOUNTS RECEIVABLE: FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE MEDICAL CENTER'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS INCREASED FROM 80% OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2011, TO 91% OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2012. IN ADDITION, THE MEDICAL CENTER'S WRITE-OFFS INCREASED APPROXIMATELY $6,300,000 FROM APPROXIMATELY $61,700,000 FOR THE YEAR ENDED JUNE 30, 2011, TO APPROXIMATELY $68,000,000 FOR THE YEAR ENDED JUNE 30, 2012. BOTH INCREASES WERE THE RESULT OF NEGATIVE TRENDS EXPERIENCED IN THE COLLECTION OF AMOUNTS FROM SELF-PAY PATIENTS IN FISCAL YEAR 2012. COST TO PROVIDE BAD DEBT CARE IS BASED UPON THE SCHEDULE H COST TO CHARGE CALCULATION OF 47.63%. SERVICES WERE PROVIDED IN GOOD FAITH BY THE ORGANIZATION. THOSE WHO CHOOSE NOT TO PAY, WHO ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE, CAUSE A DECREASE IN ASSETS OF THE ORGANIZATION, WHICH DECREASES THE ORGANIZATION'S ABILITY TO OFFER COMPENSATION THAT ATTRACTS HIGHLY-TRAINED STAFF OR DECREASES THE ORGANIZATION'S ABILITY TO INVEST IN MEDICAL TECHNOLOGY. THOSE COSTS ARE A NECESSITY IF THE ORGANIZATION IS TO SURVIVE. THOSE WHO CHOOSE NOT TO PAY PUSH THE BURDEN TO THOSE WHO WILL PAY. IN THE END, IT IS THE COMMUNITY THAT PAYS FOR THOSE WHO WILL NOT PAY.
MEDICARE SHORTFALL SCHEDULE H, PART III, LINE 8 THE MEDICARE ALLOWABLE FAILS TO COVER COST. NON-PAYMENT BY MEDICARE RECIPIENTS FOR THEIR DEDUCTIBLE AND COINSURANCE AMOUNTS INCREASES FINANCIAL ASSISTANCE AND BAD DEBT. THESE SHORTFALLS DECREASE THE ORGANIZATION'S POOL OF ASSETS AND IT'S ABILITY TO SUCCESSFULLY ATTRACT HIGHLY-TRAINED STAFF AND INVEST IN MEDICAL TECHNOLOGY. IF SERVICES ARE TO BE MAINTAINED, THEN THE COSTS WILL HAVE TO BE COVERED BY THOSE WHO PAY. THE BURDEN FALLS ON THE COMMUNITY.
COLLECTION PRACTICES SCHEDULE H, PART III, LINE 9B THE ORGANIZATION HAS ESTABLISHED STANDARDS LD6014 PFS-COLLECTION GUIDELINES FOR MEDICAL CENTER), LD6503 (PFS OFFICE-PAYMENT ARRANGEMENTS: AFM AND PFM) AND LD6465 (MEDICAL CENTER, HEARTLAND PARAMEDICS, HEARTLAND CLINIC AND LONG TERM ACUTE CARE HOSPITAL FINANCIAL ASSISTANCE) WHICH GOVERN COLLECTION PRACTICES FOR ALL TYPES OF PAYERS FROM THE CREATION OF THE PATIENT'S ACCOUNT DURING REGISTRATION TO THE FINAL ARRANGEMENTS NECESSARY TO BRING THE BALANCE TO ZERO.
MANAGEMENT COMPANIES & JOINT VENTURES SCHEDULE H, PART IV 1. (A) MERCURY SURGERY CENTER (B) INVESTMENT IN SURGERY CENTER (C) 15% (D) 0% (E) 85% 2. (A) ST. JOSEPH BUSINESS PARK LENDERS, LLC (B) DEVELOPMENT (C) 26% (D) 0% (E) 0% 3. (A) PREMIER PURCHASING PARTNERS, LP (B) GROUP BUYING POWER (C) .34% (D) 0% (E) 0% 4. (A) HEARTLAND HEALTH BUSINESS PLAZA, LLC (B) BUILDING LEASE (C) 21% (D) 0% (E) 79% 5. (A) BRIARCLIFF TUILERIES, LLC (B) BUILDING LEASE (C) 58.7% (D) 0% (E) 0%
CHARGES FOR MEDICAL CARE SCHEDULE H, PART V, LINE 19 IF AN INDIVIDUAL MEETS THE GUIDELINES FOR 100% WRITEOFF, THEN THEY ARE NOT CHARGED ANY AMOUNT. IF THEY ARE ELIGIBLE FOR A 50% WRITEOFF, THEN THEY ARE ONLY CHARGED FOR 50% OF THE CHARGES, WHICH IS LOWER THAN THE AVERAGE OF THE 3 LOWEST NEGOTIATED COMMERICAL INSURANCE RATES.
NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 1 ASSESSMENTS WERE CONDUCTED THROUGH SURVEYS OF INDIVIDUALS AND GROUPS. ADDITIONAL INFORMATION WAS PROVIDED THROUGH COMMUNITY GROUPS AND GOVERNMENT AGENCIES IN THE VICINITY. A COLLABORATIVE THINK TANK OF LOCAL EDUCATION HEADS, STATE, COUNTY AND CITY GOVERNMENT LEADERS, LOCAL BUSINESS LEADERS AND AFFILIATED HOSPITAL AND FOUNDATION LEADERSHIP HAVE TARGETED SEVERAL CRITICAL AREAS: PREPARING TODAY'S STUDENTS TO BE TOMORROW'S WORKFORCE; OBESITY IN BOTH CHILDREN AND ADULTS; ENVIRONMENTAL PROTECTION; BUILDING PHILANTHROPY AND VOLUNTEERISM; REINFORCING THE MORAL OBLIGATION THAT COMPANIES AND INDIVIDUALS HAVE TO IMPROVE THEIR COMMUNITY.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 2 AS PART OF THE PRE-REGISTRATION PROCESS, INSURANCE COVERAGE INFORMATION IS REQUESTED. IF A CLIENT INDICATES INABILITY TO PAY, THEN THE CLIENT IS SCREENED FOR MEDICAID ELIGIBILITY AND ASSISTED IN THE APPLICATION PROCESS. IF NO OTHER PAYMENT RESOURCES ARE AVAILABLE, THE CLIENT IS ADVISED OF THE FINANCIAL ASSISTANCE PROGRAM AND ENCOURAGED TO PROVIDE THE NECESSARY FINANCIAL DOCUMENTATION TO PROVE ELIGIBILITY. CLIENTS WHO WERE NOT SCREENED BY PRE-REGISTRATION AND THEREFORE MISSED THE SCREENING PROCESS, HAVE THE ABILITY TO LEARN OF THE MEDICAID ELIGIBILITY AND FINANCIAL ASSISTANCE SERVICES BY CONTACTING THE BILLING DEPARTMENT UPON RECEIPT OF AN ACCOUNT STATEMENT. FINANCIAL DOCUMENTATION IS STILL NECESSARY TO PROVE QUALIFICATION FOR THE FINANCIAL ASSISTANCE SERVICE.
COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 3 THE ORGANIZATION'S SERVICE AREA IS A 21 COUNTY URBAN/RURAL AREA LOCATED NEAR THE INTERSECTION OF A FOUR-STATE AREA. THE POPULATION IS ELDERLY AND UNDER-INSURED. THE LOCAL ECONOMY IS MADE UP OF AGRICULTURAL, SMALL MANUFACTURING AND SELF-EMPLOYED BUSINESSES, PRIMARILY BLUE COLLAR WORKERS. THE ORGANIZATION SUPPORTS A PAYOR MIX OF 49% MEDICARE, 14% MEDICAID, 31% COMMERCIAL AND 6% SELF PAY. 17.8% OF RESIDENTS LIVE BELOW THE NATIONAL POVERTY LEVEL AND 14.8% ARE UNINSURED. 27.9% ARE SMOKERS, 10% HAVE DIABETES AND 23.6% HAVE A BODY MASS INDEX GREATER THAN 30. ONLY 21% OF THE RESIDENTS HAVE A COLLEGE DEGREE AND NEARLY 61% OF STUDENTS RECEIVE FREE OR REDUCED-COST LUNCH.
PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 4 THE ORGANIZATION RECOGNIZES THAT THE MAJOR HEALTH PROBLEMS OF OUR COMMUNITY ARE BASED IN HUMAN BEHAVIORS, WHICH IN TURN HAVE THEIR ROOT IN BASIC HUMAN CONDITIONS. OUR EFFORTS ADDRESS ALL LEVELS OF WHAT WE CALL THE HEALTH PYRAMID, THE ACTUAL PHYSICAL CONDITIONS FORMING ONLY THE TIP. WE HAVE PROGRAMS IN PLACE TO ADDRESS A WIDE VARIETY OF HUMAN BEHAVIORS THAT INFLUENCE HEALTH. COMMUNITY OUTREACH HEALTH IMPROVEMENT INITIATIVES HELP THOSE IN OUR COMMUNITY CHANGE THE HUMAN BEHAVIORS THAT PUT THEIR HEALTH AT RISK. TO REACH THE ROOT CAUSES, OUR AFFILIATED FOUNDATION ASSUMES A ROLE TO ADDRESS THE HUMAN CONDITIONS THAT AFFECT HEALTH. FUNDING BY THE ORGANIZATION MAKES THE FOLLOWING COUNCILS AND PROGRAMS POSSIBLE: HEALTHY COMMUNITIES INVESTOR COUNCIL P-20 BUSINESS AND EDUCATION COUNCIL; THE EMPOWER PLANT; THE REGIONAL TECHNOLOGY INFRASTRUCTURE TEAM; POUND PLUNGE, YOUTH HEALTH PARTNERSHIP, SENIOR HEALTH, PROJECT FIT, WOMEN'S WELLNESS INITIATIVE, HEART WALK, DIABETES EXPO, PROJECT YOUTH!, 4TH GRADE CHALLENGE, PATEE DENTAL CLINIC, HEALTH EXPRESS, CORPORATE CHALLENGE, HEALTH RISK ASSESSMENTS FOR LOCAL BUSINESSES, WELLNESS AMBASSADORS; ENVIRONMENTAL ASSESSMENTS; INCREASED AWARENESS OF THE NEED FOR PHILANTHROPIC EFFORTS AND VOLUNTEERISM TO SUPPORT PROGRAMS SUCH AS SUCCESS BY SIX, SOCIAL WELFARE BOARD, INTERFAITH COMMUNITY SERVICES, NATURE CENTER, NURSING SCHOLARSHIP PROGRAMS, SUPPORT OF AMERICAN RED CROSS PROGRAMS, SUPPORT OF LOCAL ARTS AND CULTURAL ACTIVITIES.
AFFILIATED HEALTH CARE SYSTEM SCHEDULE H, PART VI, LINE 5 THE ORGANIZATION IS AFFILIATED, THROUGH A PARENT BOARD, WITH A FOUNDATION, AN ACUTE LONG TERM CARE HOSPITAL, A MEDICAL TRANSPORT PROVIDER, A COMMUNITY HEALTH IMPROVEMENT SOLUTIONS SERVICE AND A HEALTH INFORMATION EXCHANGE, ALL OF WHICH COLLABORATE WITH EDUCATIONAL, GOVERNMENTAL AND LOCAL BUSINESS LEADERS TO IMPLEMENT PROGRAMS THAT WILL HELP TO ALLEVIATE THOSE ISSUES WHICH LEAD TO POOR HEALTH HABITS AND THE ULTIMATE NEED FOR MEDICAL CARE. THE PARENT BOARD IS FILLED WITH LEADERS FROM THE COMMUNITY WHO REPRESENT THE EDUCATIONAL, MEDICAL, GOVERNMENTAL AND BUSINESS SECTORS IN THE COMMUNITY. THE FOUNDATION HAS DIRECT OVERSIGHT FOR MANY OF THE PROGRAMS AND COUNCILS THAT ARE WORKING TO ELIMINATE THE FACTORS THAT LEAD TO THE NEED FOR MEDICARE CARE. THE ACUTE LONG TERM CARE HOSPITAL IS A FACILITY DEDICATED TO THE CARE OF THOSE PATIENTS WHOSE CHRONIC ILLNESS REQUIRES A GREATER LENGTH OF STAY THAN THE NORM FOR ROUTINE ACUTE PATIENTS. THE MEDICAL TRANSPORT PROVIDER IS THE SOLE AMBULANCE PROVIDER IN THE COUNTY, NOT SUPPORTED BY ANY ALTERNATIVE GOVERNMENT FUNDING. THE COMMUNITY HEALTH IMPROVEMENT SOLUTIONS SERVICE WORKS WITH OTHER EMPLOYERS IN THE COMMUNITY TO EFFECT HEALTHY CHANGES IN THEIR WORKFORCES. THE HEALTH INFORMATION EXCHANGE IS AN EFFORT TO MAKE ALL MEDICAL RECORD INFORMATION FOR A PATIENT ACCESSIBLE BY ANY PROVIDER AT ANY LOCATION.
Schedule H (Form 990) 2011
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
Heartland Regional Medical Center
 
Employer identification number
44-0545289
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) UNITED WAY OF ST JOSEPH118 SOUTH 5TH STREET
ST JOESPH,MO64501 		44-0547802 501(c)(3) 192,375       SUPPORT
(2) HEARTLAND FOUNDATION5325 FARAON
ST JOSEPH,MO64506 		43-1262768 501(C)(3) 1,778,857       SUPPORT
(3) ST JOSEPH MUSEUMS INCPO BOX 8096
ST JOSEPH,MO64508 		43-6038202 501(C)(3) 6,000       SUPPORT
(4) CITY OF ST JOSEPH1920 GRAND AVE
ST JOSEPH,MO64505 		GOVERNMENT 5,540       SUPPORT
(5) YWCA OF ST JOSEPH304 N 8TH
ST JOSEPH,MO64501 		44-0552219 501(C)(3) 7,750       SUPPORT
(6) INTER-SERVE1412 N 3RD
ST JOSEPH,MO64505 		75-3197631 501(C)(3) 17,610       SUPPORT
(7) MISSOURI WESTERN STATE5425 DOWNS DRIVE
ST JOSEPH,MO64507 		23-7035423 GOVERNMENT 23,700       SUPPORT










2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
7
3
Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image
0
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2011

Schedule I (Form 990) 2011
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS SCHEDULE I, PART I, LINE 2 THE ORGANIZATION IS COMMITTED TO THE DEVELOPMENT OF A HEALTHY COMMUNITY WHICH INCLUDES THE HEALTH OF INDIVIDUALS, AN ADEQUATE NUMBER OF JOBS FOR THE WORKFORCE AND SUCCESSFUL BUSINESSES TO BOOST THE LOCAL ECONOMY. GRANTS ARE PROVIDED TO LOCAL GROUPS THAT ACHIEVE THESE OBJECTIVES. GENERALLY OUR OFFICERS, DIRECTORS OR EMPLOYEES ARE IN A VOLUNTEER POSITION OR ARE A BOARD MEMBER OF THE RECIPIENT ORGANIZATION.
Schedule I (Form 990) 2011


Additional Data


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Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
Heartland Regional Medical Center
 
Employer identification number

44-0545289
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) MARK LANEY MD (i)
(ii)		 581,821
0 		232,000
0 		20,133
0 		126,434
0 		18,035
0 		978,423
0 		0
0
(2) DAVID CATHCART DO (i)
(ii)		 256,730
0 		7,500
0 		3,424
0 		8,009
0 		6,776
0 		282,439
0 		0
0
(3) JOHN OLSON MD (i)
(ii)		 589,188
0 		193,815
0 		2,376
0 		9,800
0 		18,939
0 		814,118
0 		0
0
(4) MAUREEN BOYLE MD (i)
(ii)		 411,417
0 		23,352
0 		18,444
0 		9,800
0 		25,535
0 		488,548
0 		0
0
(5) MICHAEL NELLESTEIN MD (i)
(ii)		 716,913
0 		8,333
0 		18,876
0 		9,800
0 		23,252
0 		777,174
0 		0
0
(6) ED KAMMERER MD (i)
(ii)		 238,580
0 		119,719
0 		1,674
0 		9,800
0 		20,035
0 		389,808
0 		0
0
(7) PADMAVATHI VELIGATI MD (i)
(ii)		 406,650
0 		23,352
0 		18,876
0 		9,800
0 		0
0 		458,678
0 		0
0
(8) CURT KRETZINGER (i)
(ii)		 424,258
0 		132,900
0 		37,249
0 		96,263
0 		8,356
0 		699,026
0 		0
0
(9) JOHN P WILSON (i)
(ii)		 399,934
0 		120,101
0 		20,400
0 		85,027
0 		946
0 		626,408
0 		0
0
(10) DOUGLAS BRANDT (i)
(ii)		 203,433
0 		47,154
0 		23,813
0 		56,140
0 		18,035
0 		348,575
0 		0
0
(11) JOE BOYCE MD (i)
(ii)		 295,178
0 		73,813
0 		3,025
0 		56,558
0 		14,584
0 		443,158
0 		0
0
(12) DIRCK CLARK (i)
(ii)		 228,305
0 		50,639
0 		20,193
0 		42,276
0 		17,939
0 		359,352
0 		0
0
(13) MICHAEL PULIDO (i)
(ii)		 241,071
0 		60,500
0 		2,734
0 		54,966
0 		20,235
0 		379,506
0 		0
0
(14) LYNN THUENTE (i)
(ii)		 123,308
0 		10,444
0 		6,017
0 		5,545
0 		6,876
0 		152,190
0 		0
0
(15) TAMA WAGNER (i)
(ii)		 157,729
0 		34,320
0 		4,663
0 		46,168
0 		18,589
0 		261,469
0 		0
0
(16) HELEN THOMPSON (i)
(ii)		 86,846
0 		 
0 		157,712
0 		9,219
0 		11,106
0 		264,883
0 		0
0
(17) RUDY WACKER (i)
(ii)		 592,270
0 		0
0 		0
0 		0
0 		0
0 		592,270
0 		0
0
(18) ROBERT PERMUT MD (i)
(ii)		 171,567
0 		0
0 		0
0 		0
0 		0
0 		171,567
0 		0
0
(19) LISA MICHAELIS (i)
(ii)		 278,261
0 		62,456
0 		30,923
0 		55,104
0 		12,020
0 		438,764
0 		0
0
(20) SCOTT KOELLIKER (i)
(ii)		 224,043
0 		47,475
0 		12,496
0 		60,260
0 		21,035
0 		365,309
0 		0
0
(21) MOHAN HINDUPUR MD (i)
(ii)		 949,622
0 		70,253
0 		21,198
0 		9,800
0 		15,052
0 		1,065,925
0 		0
0
(22) ROBERT GRANT MD (i)
(ii)		 863,649
0 		70,253
0 		1,944
0 		9,800
0 		22,939
0 		968,585
0 		0
0
(23) ARVIND SHARMA MD (i)
(ii)		 812,380
0 		70,253
0 		18,444
0 		9,800
0 		21,035
0 		931,912
0 		0
0
(24) FRANCISCO LAMMOGLIA MD (i)
(ii)		 811,349
0 		69,003
0 		2,376
0 		9,800
0 		22,439
0 		914,967
0 		0
0
(25) ALA ABABNEH MD (i)
(ii)		 627,631
0 		168,077
0 		1,944
0 		7,350
0 		21,881
0 		826,883
0 		0
0
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
OTHER COMPENSATION SCHEDULE J, PART I, LINE 1A MARK LANEY, M.D., DIRCK CLARK, SCOTT KOELLIKER HAVE SOCIAL CLUB MEMBERSHIPS THAT ARE 100% BUSINESS. ANY FACILITY USAGE CHARGES ABOVE THE MEMBERSHIP FEES, PERTAINING TO PERSONAL USE, ARE PAID DIRECTLY TO THE CLUB BY THE EMPLOYEE, THEREFORE THE AMOUNTS WERE NOT INCLUDED IN THEIR W-2.
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B ACCRUED 6/30/2012 --------- CURT KRETZINGER 86,463 JOHN P. WILSON 75,227 DOUGLAS BRANDT 46,152 MARK LANEY, M.D. 116,634 DIRCK CLARK 32,467 MICHAEL PULIDO 44,242 LISA MICHAELIS 44,811 TAMA WAGNER 38,843 JOE BOYCE, M.D. 46,178 SCOTT KOELLIKER 49,656 THOSE LISTED ABOVE HAVE SIGNED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS WHICH RECOGNIZE THE VALUE OF THE INDIVIDUAL AND THE MUTUAL BENEFIT OF CONTINUED EMPLOYMENT FOR AN EXTENDED PERIOD OF TIME BY ESTABLISHING A 457f PLAN. THE PLAN IS FUNDED YEARLY AS THE RESULT OF A CALCULATION DESCRIBED IN THE AGREEMENT WHICH WILL REWARD THE INDIVIDUALS WITH 100% VESTING AT NORMAL RETIREMENT AGE OR UPON DEATH OR UPON SEPARATION FROM SERVICE DUE TO DISABILITY OR UPON INVOLUNTARY SEPARATION FROM SERVICE WITHOUT CAUSE, WITH LUMP SUM PAYMENT WITHIN 90 DAYS OF EACH SITUATION TAKING INTO CONSIDERATION A NON-COMPETE COVENANT. SEPARATION WITH CAUSE MAKES SUPPLEMENTAL EXECUTIVE RETIREMENT AGREEMENT NULL AND VOID.
COMPENSATION PAID BY HEARTLAND REGIONAL MEDICAL CENTER SCHEDULE J, PART II THE COMPENSATION PROVIDED BY HEARTLAND REGIONAL MEDICAL CENTER FOR CURT KRETZINGER, JOHN P. WILSON, DIRCK CLARK, DR. MARK LANEY, DOUGLAS BRANDT, KAREN DITTEMORE, JOE BOYCE, MD, MICHAEL PULIDO, TAMA WAGNER AND LISA MICHAELIS IS FOR SERVICES TO ALL HEARTLAND ENTITIES. INCLUDED IN THE DEFERRED COMPENSATION ARE EMPLOYER CONTRIBUTIONS INTO QUALIFIED PLANS AND NON-QUALIFIED DEFERRED COMPENSATION PLANS THAT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE AND SEVERANCE THAT IS PROVIDED WITHIN THE EXECUTIVE'S EMPLOYMENT AGREEMENT. THEREFORE, THESE AMOUNTS MAY NEVER BE PAID.
Schedule J (Form 990) 2011

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
Heartland Regional Medical Center
 
Employer identification number
44-0545289
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A THE INDUSTRIAL DEVELOPMENT AUTHORITY OF ST JOE
  		43-1203910 79075LAA5 05-17-2003 32,225,000 REFUND THE SERIES 2001(C) BONDS   X   X   X
B THE INDUSTRIAL DEVELOPMENT AUTHORITY OF ST JOE
  		43-1203910 79075la09 09-30-2011 25,250,000 SERIES 2011 FIXED RATE   X   X   X
C THE INDUSTRIAL DEVELOPMENT AUTHORITY OF ST JOE
  		43-1203910 79075LAB3 02-13-2009 70,000,000 SERIES 2009A VARIABLE RATE REV   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . 0 0 0  
2 Amount of bonds legally defeased . . . . . . . . . . 0 0 0  
3 Total proceeds of issue . . . . . . . . . . . . . 32,225,000 25,250,000 70,000,000  
4 Gross proceeds in reserve funds . . . . . . . . 0 0 0  
5 Capitalized interest from proceeds . . . . . . . . . . 0 0 0  
6 Proceeds in refunding escrows . . . . . . . . . . . 0 0 0  
7 Issuance costs from proceeds . . . . . . . . . . . 260,055 216,452 1,026,303  
8 Credit enhancement from proceeds . . . . . . . . . . 0 0 0  
9 Working capital expenditures from proceeds . . . . . . . 0 0 0  
10 Capital expenditures from proceeds . . . . . . . . . . 0 0 49,139,726  
11 Other spent proceeds . . . . . . . . . . . 0 0 0  
12 Other unspent proceeds . . . . . . . . . . . 0 0 19,833,971  
13 Year of substantial completion . . . . . . . . . . . 2003 2012 2013
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . X   X     X    
15 Were the bonds issued as part of an advance refunding issue? . . . .   X   X   X    
16 Has the final allocation of proceeds been made? . . . . . . X   X     X    
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . X   X   X      
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X    
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2011
Schedule K (Form 990) 2011
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X    
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . .                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . .   X   X   X    
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.00000% 0.00000% 0.00000%   %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.00000% 0.00000% 0.00000%   %
6 Total of lines 4 and 5 . . .. . . . . . . . . 0.00000% 0.00000% 0.00000%   %
7 Does the bond issue meet the private security or payment test? . . . X   X   X      
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
X   X   X      
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X    
2 Is the bond issue a variable rate issue? X     X X      
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X    
b Name of provider . . . . . . . . CITIGROUP INC
  		0
  		0
  		 
 
c Term of hedge . . . . . . . . 2.5      
d Was the hedge superintegrated? . . . .                
e Was a hedge terminated? . . . . .                
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . .   X   X   X    
b Name of provider . . . . . . 0
  		0
  		0
  		 
 
c Term of GIC . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . .                
5 Were any gross proceeds invested beyond an available temporary period? . . . . . .   X   X   X    
6 Did the bond issue qualify for an exception to rebate? .   X   X   X    
7 Has the organization established written procedures to monitor the requirements of section 148? . . .   X   X   X    
Schedule K (Form 990) 2011

Schedule K (Form 990) 2011
Page 3
Part V
Procedures To Undertake Corrective Action
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . .
Part VI
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
B: (I) FINANCE THE COSTS OF THE CONSTRUCTION AND EQUIPPING OF CERTAIN 0  
HEALTHCARE FACILITIES 0  
(II)PAY CERTAIN COSTS OF THE ISSUANCE OF BONDS 0  
(III)REFUND REVENUE BONDS 0  
Schedule K (Form 990) 2011

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
Heartland Regional Medical Center
 
Employer identification number

44-0545289
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2011
Schedule L (Form 990 or 990-EZ) 2011
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) SEE PART IV          
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
BUSINESS TRANSACTIONS WITH INTERESTED PERSONS SCHEDULE L, PART IV (A) DONNA WILSON (B) DONNA WILSON IS THE YOUTH HEALTH DIRECTOR FOR HEARTLAND REGIONAL MEDICAL CENTER AND IS THE WIFE OF JOHN WILSON, WHO IS THE CHIEF FINANCIAL OFFICER OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 98,182 (D) SALARY FOR YOUTH HEALTH DIRECTOR SERVICES (E) NO (A) CORINNE KOELLIKER (B) CORINNE KOELLIKER IS A LASER TECHNICIAN FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE SISTER OF SCOTT KOELLIKER, WHO IS A KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 31,544 (D) SALARY FOR LASER TECHNICIAN SERVICES (E) NO (A) JON KOELLIKER (B) JON KOELLIKER IS A TS APPLICATIONS ANALYST FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE BROTHER OF SCOTT KOELLIKER, WHO IS A KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 104,814 (D) SALARY FOR TS APPLICATIONS ANALYST SERVICES (E) NO (A) MARINA KOELLIKER (B) MARINA KOELLIKER IS A REGISTERED NURSE FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE WIFE OF SCOTT KOELLIKER, WHO IS A KEY EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 89,644 (D) SALARY FOR REGISTERED NURSE SERVICES (E) NO (A) TRACY HOWERY (B) TRACY HOWERY IS AN ADVANCED PRACTICE REGISTERED NURSE FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE DAUGHTER-IN-LAW OF DAVE HOWERY, WHO IS A DIRECTOR OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 30,679 (D) SALARY FOR REGISTERED NURSE SERVICES (E) NO (A) JAMUNA HINDUPUR (B) JAMUNA HINDUPUR IS A CLINICAL TECHNICIAN FOR HEARTLAND REGIONAL MEDICAL CENTER, AND IS THE WIFE OF MOHAN HINDUPUR, WHO IS A HIGHLY COMPENSATED EMPLOYEE OF HEARTLAND REGIONAL MEDICAL CENTER. (C) $ 30,679 (D) SALARY FOR CLINICAL TECHNICIAN SERVICES (E) NO
Schedule L (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
Heartland Regional Medical Center
 
Employer identification number

44-0545289
Identifier Return Reference Explanation
ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 THE MISSION OF THE HEARTLAND REGIONAL MEDICAL CENTER IS TO ESTABLISH AND OPERATE A DIVERSIFIED HEALTH CARE DELIVERY SYSTEM THAT PROVIDES THE RIGHT CARE, AT THE RIGHT TIME, IN THE RIGHT PLACE, AT THE RIGHT COST WITH OUTCOMES SECOND TO NONE FOR THE PEOPLE LIVING IN NORTHWEST MISSOURI AND ADJACENT AREAS IN KANSAS, IOWA, AND NEBRASKA, REGARDLESS OF ABILITY TO PAY, WHILE ALSO STRIVING TO IMPROVE THE LIVES OF THOSE INDIVIDUALS BY FOCUSING ON PREVENTIVE HEALTH INITIATIVES SUCH AS EDUCATION, WELLNESS PROGRAMS, HEALTH-RELATED ACTIVITIES AND COMMUNITY BENEFIT PROGRAMS.
PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A HEARTLAND REGIONAL MEDICAL CENTER IS 352-BED MEDICAL SURGICAL HOSPITAL LOCATED IN ST JOSEPH, MISSOURI. IT SERVES A COMMUNITY OF 70,000 RESIDENTS. BECAUSE ST JOSEPH IS A BORDER TOWN, IT ALSO PROVIDES SERVICES TO THOSE LIVING IN THE ADJACENT STATES OF KANSAS, NEBRASKA AND IOWA. THE ECONOMY OF THE REGION IS BASED ON AGRICULTURE, MINOR MANUFACTURING AND SMALL BUSINESSES RESULTING IN A PAYOR MIX FOR THE HOSPITAL OF 63% GOVERNMENTAL, 31% COMMERCIAL AND 6% UNINSURED. THE HOSPITAL PROVIDES A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES INCLUDING CARDIO-THORACIC, VASCULAR, ORTHOPEDIC AND GENERAL SURGERIES, MENTAL HEALTH SERVICES, ALONG WITH A FULL ARRAY OF DIAGNOSTIC AND THERAPEUTIC SERVICES. IT OPERATES A 24-HOUR EMERGENCY ROOM DESIGNATED AS A TRAUMA II CENTER BY THE STATE OF MISSOURI. THE HOSPITAL'S OBSTETRICS DEPARTMENT PROVIDES 18 LABOR/DELIVERY/RECOVERY/POST-PARTUM BEDS WHICH ARE ALSO DESIGNATED AS A LEVEL II CENTER. THE HOSPITAL PROVIDES RADIATION ONCOLOGY SERVICES, HOME HEALTH VISITS AND HOSPICE CARE. DURING THE YEAR, 17,718 PATIENTS WERE ADMITTED TO THE HOSPITAL RESULTING IN 76,207 PATIENT DAYS. A TOTAL OF 10,800 SURGERIES WERE PERFORMED, THE EMERGENCY ROOM SERVED 58,047 PATIENTS AND 233,254 VISITS WERE GENERATED BY OUTPATIENTS. THE HOSPITAL EMPLOYS 4,232 PEOPLE AND HAS A TOTAL OF 239 ACTIVE AND ASSOCIATE MEDICAL STAFF. THE EMPLOYED MEDICAL STAFF INCLUDES 213 PHYSICIANS, 2 DENTISTS, 1 CHIROPRACTOR AND 88 NURSE PRACTITIONERS/PHYSICIAN EXTENDERS COVERING 42 FAMILY MEDICINE AND SPECIALTY CLINICS IN ADDITION TO NUMEROUS SATELLITE CLINICS THROUGHOUT THE REGION RESULTING IN APPROXIMATELY 600,850 PATIENT VISITS DURING THE YEAR.
BUSINESS/FAMILY RELATIONSHIPS FORM 990, PART VI, SECTION A, LINE 2 BRIAN BRADLEY, JOHN P. WILSON, JOE BOYCE, MD, DIRCK CLARK, DOUGLAS BRANDT, KAREN DITTEMORE HAVE A BUSINESS RELATIONSHIP. THEY ARE EITHER OFFICERS AND/OR DIRECTORS OF LEWIS AND CLARK INFORMATION EXCHANGE, A RELATED NOT-FOR-PROFIT CORPORATION. KAREN BAKER, CAROL ROEVER, JOHN P. WILSON, CURT KRETZINGER, DOUGLAS BRANDT, KAREN DITTEMORE HAVE A BUSINESS RELATIONSHIP. THEY ARE EITHER OFFICERS AND/OR DIRECTORS OF REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY, A RELATED NOT-FOR-PROFIT CORPORATION. JOHN P. WILSON, CURT KRETZINGER, DIRCK CLARK, DOUGLAS BRANDT, KAREN DITTEMORE, MARK LANEY, M.D., SCOTT KOELLIKER, LISA MICHAELIS HAVE A BUSINESS RELATIONSHIP. THEY ARE EITHER OFFICERS AND/OR DIRECTORS OF MIDWESTERN HEALTH MANAGMENT, INC., COMMUNITY HEALTH PLAN, INC., COMMUNITY HEALTH PLAN INSURANCE COMPANY, HHS PROPERTIES, INC., UPTOWN HOUSING, INC., UPTOWN ST. JOSEPH REDEVELOPMENT CORPORATION WHICH ARE RELATED FOR PROFIT CORPORATIONS.
CHANGES TO ORGANIZATIONAL DOCUMENTS FORM 990, PART VI, SECTION A, LINE 4 THE SOLE MEMBER (HEARTLAND HEALTH) SHALL HAVE THE FOLLOWING POWERS: OVERALL STRATEGIC DIRECTION (EXCLUDING MATTERS RELATED PRIMARILY TO THE ACCOUNTABLE CARE ORGANIZATION (ACO) OPERATED BY THE HOSPITAL, INCLUDING SPECIFICALLY ANY MEDICARE SHARED SAVINGS PROGRAM CREATED UNDER THE AFFORDABLE CARE ACT), APPOINTMENT OF AUDITORS AND LEGAL COUNSEL, ESTABLISHMENT OF BANKING RELATIONSHIPS AND MANAGEMENT OF CASH AND OTHER ASSETS (EXCLUDING ACO SHARED SAVINGS DISTRIBUTIONS AND REPAYMENT OF SHARED LOSSES), LONG-RANGE PLANNING, ADOPTION OF ANNUAL OPERATING PLANS AND APPLICATION FOR CERTIFICATES OF NEED. IN ADDITION TO EXISTING POWERS, THE BOARD OF DIRECTORS SHALL HAVE THE FOLLOWING POWERS AND AUTHORITY RELATED TO THE OVERSIGHT AND OPERATION OF THE ACO: RECEIVING AND DISTRIBUTING SHARED SAVINGS; REPAYING SHARED LOSSES, IF APPLICABLE; ESTABLISHING, REPORTING, AND ENSURING ACO PARTICIPANT AND ACO PROVIDERS/SUPPLIERS COMPLIANCE WITH ACO PROGRAM REQUIREMENTS, INCLUDING THE QUALITY PERFORMANCE STANDARDS; FULFILLING ANY OTHER ACO FUNCTIONS AS REQUIRED UNDER APPLICABLE ACO REGULATIONS, STATUTES, OR CONTRACT TERMS; OVERSIGHT AND STRATEGIC DIRECTION OF THE ACO; HOLDING ACO MANAGEMENT (HOSPITAL PRESIDENT AND OTHER OFFICERS) ACCOUNTABLE FOR THE ACO'S ACTIVITIES. THE CHIEF EXECUTIVE OFFICER OF THE HOSPITAL SHALL BE A DIRECTOR BY VIRTUE OF HIS OFFICE. THE REMAINDER OF THE BOARD OF DIRECTORS SHALL BE A SELF-PERPETUATING BOARD, AND ANY VACANCIES OCCURIING THERIN MAY BE FILLED AT ANY REGULAR OR SPECIAL MEETING OF THE BOARD OF DIRECTORS BY AN AFFIRMATIVE VOTE OF A MAJORITY OF THE REMAINING DIRECTORS. WITH THE EXCEPTION OF DIRECTORS WHO ARE DIRECTORS BY VIRTUE OF THEIR OFFICE, A DIRECTOR MAY BE REMOVED, WITH OR WITHOUT CAUSE, BY A VOTE OF TWO-THIRDS OF THE ENTIRE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS SHALL FILL ANY VACANCY IN THE BOARD OF DIRECTORS. DIRECTORS MAY PARTICIPATE IN A REGULAR OR SPECIAL MEETING OF THE BOARD OF DIRECTORS BY ANY MEANS OF COMMUNICATION BY WHICH DIRECTORS PARTICIPATING MAY SIMULTANEOUSLY HEAR EACH OTHER DURING THE MEETING, OR BY ANY OTHER MEANS RECOGNIZED UNDER MISSOURI LAW. A DIRECTOR PARTICIPATING IN A MEETING BY THIS MEANS IS DEEMED TO BE PRESENT IN PERSON AT THE MEETING. THE CHAIRMAN OF THE BOARD OF DIRECTORS AND THE PRESIDENT SHALL SERVE AS MEMBERS OF THE EXECUTIVE COMMITTEE BY VIRTUE OF THEIR OFFICES. THE REMAINING MEMBERS OF THE EXECUTIVE COMMITTE SHALL BE ELECTED BY A MAJORITY VOTE OF THE BOARD OF DIRECTORS. AN ADDED DUTY OF THE FINANCE COMMITTEE IS TO REVIEW AND MAKE RECOMMENDATIONS ON THE RECEIPT AND DISTRIBUTION OF ANY ACO SHARED SAVINGS AND THE REPAYMENT OF ANY ACO SHARED LOSSES. AN ADDED DUTY OF THE SERVICE/QUALITY COMMITTEE IS TO REVIEW AND MAKE RECOMMENDATIONS REGARDING THE ACO'S QUALITY ASSURANCE AND IMPROVEMENT PROGRAM. COMMITTEE MEMBERS MAY PARTICIPATE IN A COMMITTEE MEETING BY ANY MEANS OF COMMUNICATION BY WHICH ALL MEMBERS PARTICIPATING MAY SIMULTANEOUSLY HEAR EACH OTHER DURING THE MEETING, OR BY ANY OTHER MEANS RECOGNIZED UNDER MISSOURI LAW. A COMMITTEE MEMBER PARTICIPATING IN A MEETING BY THIS MEANS IS DEEMED TO BE PRESENT IN PERSON AT THE MEETING. THE OFFICERS OF THE CORPORATION SHALL BE THE PRESIDENT (CHIEF EXECUTIVE OFFICER), A CHIEF OPERATING OFFICER, A SECRETARY AND A CHIEF FINANCIAL OFFICER (TREASURER), AND SUCH OTHER OFFICERS AND ASSISTANT OFFICERS AS MAY BE DEEMED NECESSARY BY THE BOARD OF DIRECTORS OR THE PRESIDENT. THE PRESIDENT, SECRETARY AND CHIEF FINANCIAL OFFICER SHALL BE ELECTED BY THE BOARD OF DIRECTORS AND SHALL HOLD OFFICE FOR A TERM OF ONE YEAR, OR UNTIL HIS SUCCESSOR IS DULY ELECTED AND QUALIFIED, UNLESS SOONER REMOVED BY THE BOARD OF DIRECTORS. THE CHIEF OPERATING OFFICER AND OTHER OFFICERS SHALL BE SELECTED BY THE PRESIDENT AND SHALL HOLD OFFICE UNTIL REMOVED BY THE PRESIDENT OR THE BOARD OF DIRECTORS. ANY OFFICER MAY BE REMOVED OR DISCHARGED BY THE BOARD OF DIRECTORS. VACANCIES IN THE OFFICE OF PRESIDENT, SECRETARY AND CHIEF FINANCIAL OFFICER SHALL BE FILLED BY THE BOARD OF DIRECTORS. THE PRESIDENT SHALL BE THE CHIEF EXECUTIVE OFFICER OF THE HOSPITAL AND SHALL HAVE THE AUTHORITY TO DIRECT AND ADMINISTER ALL THE ACTIVITIES AND DEPARTMENTS OF THE HOSPITAL, SUBJECT TO SUCH POLICIES AS MAY BE ADOPTED BY THE BOARD OF DIRECTORS, OR ANY COMMITTEES TO WHICH THE BOARD OF DIRECTORS HAS DELEGATED POWER FOR SUCH ACTION. IN ADDITION TO OTHER DUTIES, THE PRESIDENT SHALL BE RESPONSIBLE FOR THE IMPLEMENTATION OF ALL POLICIES ESTABLISHED BY THE BOARD OF DIRECTORS. ADDITIONALLY, THE PRESIDENT SHALL MANAGE THE OPERATIONS OF THE ACO. THE MEDICAL STAFF SHALL DEVELOP AND ADOPT THE MEDICAL STAFF BYLAWS AND STANDARDS, WHICH SHALL BECOME EFFECTIVE WHEN APPROVED BY THE BOARD OF DIRECTORS. NEITHER THE BOARD OF DIRECTORS NOR THE MEDCAL STAFF MAY UNILATERALLY AMEND THE MEDICAL STAFF BYLAWS OR STANDARDS, EXCEPT AS SET FORTH BELOW. THE BOARD OF DIRECTORS SHALL MAINTAIN COMPLETE AND ULTIMATE RESPONSIBILITY AND AUTHORITY OVER THE HOSPITAL AND THE MEDICAL STAFF. ACCORDINGLY, IF AN AMENDMENT TO THE MEDICAL STAFF BYLAWS OR STANDARDS IS URGENTLY NEEDED IN ORDER TO ADDRESS AN ISSUE OF QUALITY, PATIENT SAFETY, LIABILITY, REGULATORY COMPLIANCE, LEGAL COMPLIANCE, OR OTHER CRITICAL OBLIGATIONS OF THE HOSPITAL, AND THE MEDICAL STAFF AND THE MEDICAL STAFF EXECUTIVE COMMITTEE ARE INCAPABLE OF, OR REFUSE TO MAKE THE NECESSARY AMENDMENT TO THE MEDICAL STAFF BYLAWS OR STANDARDS, THE BOARD OF DIRECTORS MAY EXERCISE ITS AUTHORITY TO UNILATERALLY AMEND THE MEDICAL STAFF BYLAWS OR STANDARDS AS NECESSARY. IN SUCH A SITUATION, THE BOARD OF DIRECTORS' AMENDMENT SHALL BE FINAL, AND ALL VOTING MEMBERS OF THE MEDICAL STAFF SHALL BE NOTIFIED OF THE AMENDMENT WITHIN TEN (10) DAYS OF THE AMENDMENT BECOMING FINAL. ALL ASPECTS OF MEMBERSHIP STATUS AND SPECIFIC CLINICAL PRIVILEGES SHALL BE GRANTED OR WITHHELD TO A PRACTITIONER ON THE BASIS OF CRITERA RELATED TO GOOD PATIENT CARE AT THE HOSPITAL, TO PROFESSIONAL ABILITY AND JUDGMENT, OR TO COMMUNITY OR HOSPITAL NEEDS, AND NOT ON THE BASIS OF SEX, RACE, AGE, SEXUAL ORIENTATION, HANDICAP OR DISABLED, CREED, COLOR, NATIONAL ORIGIN, RELIGION, ANCESTRY, GENETIC HISTORY, MARITAL STATUS OR MILITARY/VETERAN STATUS. IN THE EVENT OF A CONFLICT BETWEEN THE MEDICAL STAFF EXECUTIVE COMMITTEE AND THE MEDICAL STAFF, A PROCESS IS OUTLINED IN THE BYLAWS FOR CONFLICT MANAGEMENT. THE BOARD OF DIRECTORS SHALL, AFTER CONSIDERING THE RECOMMENDATIONS OF THE MEDICAL STAFF, THE HEARTLAND CLINIC AND OTHER INDEPENDENT HEALTH PRACTITIONERS PROVIDING PATIENT CARE SERVICES, SPECIFY REVIEW AND EVALUATION ACTIVITIES TO ASSESS, PRESERVE AND IMPROVE THE OVERALL QUALITY AND EFFICIENCY OF PATIENT CARE. ACKNOWLEDGING ITS RESPONSIBILTY FOR CARE WHICH IS TO BE PROVIDED TO PATIENTS, THE BOARD OF DIRECTORS SHALL REQUIRE THAT THE MEDICAL STAFF, THE HEARTLAND CLINIC AND OTHER HEALTH CARE PROFESSIONALS PROVIDING PATIENT CARE SERVICES CONDUCT ACTIVITIES THAT CONTRIBUTE TO THE PRESERVATION AND IMPROVEMENT OF THE QUALITY AND EFFICIENCY OF PATIENT CARE. ADDITIONALLY INCLUDED IS ON-GOING MONITORING AND EVALUATION OF PATIENT CARE PRACTICE THROUGH DEFINED FUNCTIONS OF THE MEDICAL STAFF, THE HEARTLAND CLINIC, OTHER PROFESSIONAL SERVICES AND THE HOSPITAL ADMINISTRATION; MANAGMENT OF CLINICAL AFFAIRS, INCLUDING ENFORCEMENT OF MEDICAL STAFF STANDARDS AND CLINICAL POLICIES AND CONSULTATION REQUIREMENTS, INITIATION OF DISCILPLINARY ACTIONS, SURVEILLANCE OVER REQUIREMENTS FOR MONITORING THE EXERCISE OF CLINICAL PRIVILEGES; SUCH OTHER MEASURES AS THE BOARD OF DIRECTORS MAY, AFTER RECEIVING AND CONSIDERING THE ADVICE OF THE MEDICAL STAFF, THE OTHER PROFESSIONAL SERVICE, THE HEARTLAND CLINIC AND/OR THE HOSPITAL ADMINISTRATION, DEEM NECESSARY FOR THE PRESERVATION AND IMPROVEMENT OF THE QUALITY AND EFFICIENCY OF PATIENT CARE. THE BOARD OF DIRECTORS SHALL, UPON RECOMMENDATION OF THE SERVICE/QUALITY COMMITTEE, ADOPT AND IMPLEMENT A QUALITY ASSURANCE AND IMPROVEMENT PROGRAM FOR THE THE ACO. SUCH PROGRAM SHALL PROMOTE EVIDENCE-BASED MEDICINE AND PROMOTE PATIENT ENGAGEMENT, INCLUDING COMPLIANCE WITH PATIENT EXPERIENCE OF CARE SURVEY REQUIREMENTS, COMPLIANCE WITH BENEFICIARY REPRESENTATIVE REQUIREMENTS, PROCESS FOR EVALUATING THE HEALTH NEEDS OF ACO'S POPULATION, COMMUNICAITON OF CLINICAL KNOWLEDGE/EVIDENCE-BASED MEDICINE TO BENEFICIARIES IN A WAY THAT IS UNDERSTANDABLE TO THEM, BENEFICIARY ENGAGEMENT AND SHARED DECISION-MAKING THAT TAKES INTO ACCOUNT THE BENEFICIARIES' UNIQUE NEEDS, PREFEREENCES, VALUES, AND PRIORITIES, WRITTEN STANDARDS IN PLACE FOR BENEFICIARY ACCESS AND COMMUNICATION, AND A PROCESS IN PLACE FOR BENEFICIARIES TO ACCESS THEIR MEDICAL RECORD. THE REFERENCE TO VOLUNTEERS IS NOW TERMED AS VOLUNTEER AMBASSADORS. THE BYLAWS MAY BE AMENDED, ALTERED, ABRIDGED, ADDED TO OR REPEALED AT ANY MEETING OF THE BOARD OF DIRECTORS BY AN AFFIRMATIVE VOTE OF TWO-THIRDS OF THE ENTIRE BOARD OF DIRECTORS.
MEMBERS OR STOCKHOLDERS FORM 990, PART VI, SECTION A, LINE 6 HEARTLAND HEALTH, A MISSOURI NONPROFIT CORPORATION, IS THE SOLE MEMBER OF HEARTLAND REGIONAL MEDICAL CENTER.
GOVERNING BOARD DECISIONS SUBJECT TO APPROVAL OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER (HEARTLAND HEALTH) SHALL HAVE THE FOLLOWING POWERS: OVERALL STRATEGIC DIRECTION (EXCLUDING MATTERS RELATED PRIMARILY TO THE ACCOUNTABLE CARE ORGANIZATION (ACO) OPERATED BY THE HOSPITAL, INCLUDING SPECIFICALLY ANY MEDICARE SHARED SAVINGS PROGRAM CREATED UNDER THE AFFORDABLE CARE ACT), APPOINTMENT OF AUDITORS AND LEGAL COUNSEL, ESTABLISHMENT OF BANKING RELATIONSHIPS AND MANAGEMENT OF CASH AND OTHER ASSETS (EXCLUDING ACO SHARED SAVINGS DISTRIBUTIONS AND REPAYMENT OF SHARED LOSSES), LONG-RANGE PLANNING, ADOPTION OF ANNUAL OPERATING PLANS AND APPLICATION FOR CERTIFICATES OF NEED.
FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION A, LINE 11B AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE TREASURER AND ASSISTANT TREASURER OF HEARTLAND REGIONAL MEDICAL CENTER REVIEW THE 990. THE 990 IS THEN POSTED TO A WEBSITE FOR ALL VOTING MEMBERS TO ACCESS BEFORE IT IS FILED.
MONITORING OF CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C UPON AGREEING TO FILL A BOARD POSITION, THE PROSPECTIVE MEMBER IS REQUIRED TO SIGN A CONFLICT OF INTEREST DOCUMENT WHICH DISCLOSES FAMILY AND BUSINESS RELATIONSHIPS THAT COULD BE CONSIDERED IN CONFLICT WITH THEIR POSITION ON THE BOARD. IN THIS DOCUMENT, THEY AGREE THAT THEY WILL DISCLOSE ANY ACTIVITIES IN WHICH THEY MAY NOT BE INDEPENDENT IN REGARDS TO A TRANSACTION. THIS DOCUMENT IS DISTRIBUTED AND HELD BY LEGAL COUNSEL. THE MEMBER ALSO SIGNS HEARTLAND'S CODE OF CONDUCT DOCUMENT IN WHICH THEY AGREE TO ETHICAL BEHAVIOR AND ADHERING TO CONFIDENTIALITY POLICIES. THIS DOCUMENT IS HELD BY THE CORPORATE COMPLIANCE OFFICE. ANNUALLY, THE CORPORATE COMPLIANCE OFFICER DISTRIBUTES A SURVEY TO EACH BOARD MEMBER TO FACILITATE DISCLOSURE OF ANY REPORTABLE ACTIVITIES. DURING THE COURSE OF BOARD MEETINGS, BOARD MEMBERS WILL DISMISS THEMSELVES FROM MEETINGS AND/OR ABSTAIN FROM VOTING DURING DISCUSSIONS OF ISSUES THAT RELATE TO THOSE SPECIFIC MEMBERS OR THE COMPANIES THAT THEY REPRESENT. FOR EXAMPLE, PHYSICIAN BOARD MEMBERS ABSTAIN FROM VOTING ON THEIR OWN RE-CREDENTIALING, UNIVERSITY BOARD MEMBERS ARE DISMISSED DURING DISCUSSIONS OF UNIVERSITY-RELATED ACTIVITIES AND LEGAL COUNSEL IS DISMISSED DURING DISCUSSION AND VOTING ON LEGAL COUNSEL REVIEW AND SELECTION. ALL DISMISSALS AND ABSTENTIONS ARE RECORDED IN THE MINUTES OF THE BOARD MEETING. ANNUALLY, THE OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO SIGN A CODE OF CONDUCT DOCUMENT IN WHICH THEY AGREE TO ETHICAL BEHAVIOR AND ADHERING TO CONFIDENTIALITY POLICIES. THEY ALSO RECIEVE A QUESTIONNAIRE WHICH FACILITATES THE DISCLOSURE OF ANY REPORTABLE ACTIVITIES TO THE CORPORATE COMPLIANCE OFFICER.
COMPENSATION REVIEW FORM 990, PART VI, SECTION B, LINES 15A & 15B ANNUAL REVIEW--PERFORMED DURING FISCAL YEAR 2011 FOR THE FOLLOWING FISCAL YEAR. MARKET DATA IS PROVIDED BY INTEGRATED HEALTHCARE STRATEGIES (IHS). A COMPENSATION COMMITTEE COMPRISED OF THE HEARTLAND HEALTH BOARD CHAIR, HEARTLAND HEALTH BOARD VICE-CHAIR AND THREE ADDITIONAL HEARTLAND HEALTH BOARD MEMBERS AND INDEPENDENT LEGAL COUNSEL, AS SCRIBE, OVERSEE AN ANNUAL SALARY REVIEW PROCESS FOR OFFICERS, ADMINISTRATORS AND KEY EMPLOYEES. FOR EACH POSITION TO BE REVIEWED, THE FULL SCOPE OF DUTIES AND RESPONSIBILITIES, NUMBERS OF STAFF MANAGED, PROCESSES MANAGED, APPROXIMATE REVENUE, EXPENSE, OR CAPITAL DOLLARS MANAGED ARE PROVIDED TO A THIRD PARTY CONSULTANT (FOR THIS PERIOD--IHS) THAT SPECIALIZES IN RESEARCH MARKET SALARY DATA. FACILITY SIZE, NOT-FOR-PROFIT STATUS AND THE SCOPE OF EACH JOB POSITION IS COMPARED TO LIKE FACILITIES TO DETERMINE BASE COMPENSATION AND INCENTIVE COMPENSATION FOR EACH POSITION. THE DATA GATHERED BY THE MARKET RESEARCH FIRM IS REVIEWED BY THE COMPENSATION COMMITTEE, OUTLIER ISSUES ARE RESOLVED AND BASED UPON PRESENT FINANCIAL INDICATORS, THE COMMITTEE MAKES THEIR DETERMINATION OF COMPENSATION LEVELS FOR THE NEXT PAY YEAR.
AVAILABILITY OF DOCUMENTS FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
RECONCILIATION OF NET ASSETS FORM 990, PART XI, LINE 5 UNREALIZED GAINS(LOSSES) ON INVESTMENTS $ (1,324,588) NET ASSET TRANSFER $ (1,520,000) CHANGE IN FAIR VALUE $ (5,014,930) CHANGES IN MIN PENS. LIAB. $(21,572,578) ------------- $(29,432,096)
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARK LANEY, MD TITLE:DIRECTOR, OFFICER HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DAVID CATHCART, DO TITLE:DIRECTOR, STAFF PHYSICIAN HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN OLSON, MD TITLE:DIRECTOR, STAFF PHYSICIAN HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DENNIS DOBYAN, MD TITLE:DIRECTOR HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CURT KRETZINGER TITLE:OFFICER HOURS:8
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN P WILSON TITLE:OFFICER HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DOUGLAS BRANDT TITLE:OFFICER, CONTROLLER HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KAREN DITTEMORE TITLE:OFFICER, ADMIN ASST HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOE BOYCE, MD TITLE:OFFICER HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DIRCK CLARK TITLE:OFFICER HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:LISA MICHAELIS TITLE:MEDICAL CENTER ADMINISTRATOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SCOTT KOELLIKER TITLE:HEARTLAND CLINIC ADMINISTRATOR HOURS:1
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

Additional Data


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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
Heartland Regional Medical Center
 
Employer identification number

44-0545289
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity







(1) NORTHLAND EXPANSION LLC
5323 FARAON
ST JOSEPH,MO64506
 DEVELOPMENT MO 0 4,000 HRMC
 










Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) HEARTLAND HEALTH

5325 FARAON

ST JOSEPH,MO64506
43-1283316 		HEALTHCARE MO 501(C)(3) 11A NA
 
 
No
(2) HEARTLAND FOUNDATION

5325 FARAON

ST JOSEPH,MO64506
43-1262768 		SUPPORT MO 501(C)(3) 9 HH
 
Yes
 
(3) HEARTLAND LONG TERM ACUTE CARE HOSPITAL

5325 FARAON

ST JOSEPH,MO64506
26-1972987 		HEALTH` MO 501(C)(3) 3 HH
 
Yes
 
(4) LEWIS AND CLARK INFORMATION EXCHANGE

5325 FARAON

ST JOSEPH,MO64506
32-0290671 		DATA SHARING MO 501(C)(3) 9 HH
 
Yes
 
(5) REGIONAL EMERGENCY MEDICAL SERVICES AUTH

5325 FARAON

ST JOSEPH,MO64506
27-3923442 		AMBULANCE SVC MO 501(C)(3) 9 HH
 
Yes
 




For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) BRIARCLIFF TUILERIES OFFICE LLC

6300 N REVERE SUITE 225
KANSAS CITY,MO64151
45-3338381 		DEVELOPMENT MO HRMC
  		RENTAL INCOME -25,091 794,254   No     No 58.727 %












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) MIDWESTERN HEALTH MANAGEMENT INC
5325 FARAON
ST JOSEPH,MO64506
43-1264358 		HEALTHCARE MO HH
  		C CORP 0 0 0 %
(2) COMMUNITY HEALTH PLAN INC
5325 FARAON
ST JOSEPH,MO64506
43-1690582 		INSURANCE MO HH
  		C CORP 0 0 0 %
(3) COMMUNITY HEALTH PLAN INSURANCE COMPANY
5325 FARAON
ST JOSEPH,MO64506
43-1210152 		INSURANCE MO HH
  		C CORP 0 0 0 %
(4) HHS PROPERTIES INC
5325 FARAON
ST JOSEPH,MO64506
43-1593799 		INVESTMENT MO HH
  		C CORP 0 0 0 %
(5) UPTOWN HOUSING INC
5325 FARAON
ST JOSEPH,MO64506
26-1416252 		REDEVELOPMENT MO HH
  		C CORP 0 0 0 %
(6) UPTOWN ST JOSEPH REDEVELOPMENT CORP
5325 FARAON
ST JOSEPH,MO64506
20-1742813 		REDEVELOPMENT MO HH
  		C CORP 0 0 0 %
(7) HEALTH CARE BENEFIT TRUST
5325 FARAON
ST JOSEPH,MO64506
43-1286484 		HEALTH CARE MO HH
  		TRUST 0 0 0 %
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
Yes
 
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) COMMUNITY HEALTH PLAN INSURANCE COMPANY

 P 112,666 FMV
(2) COMMUNITY HEALTH PLAN

 P 403,787 FMV
(3) MIDWESTERN HEALTH MANAGEMENT INC

 B 700,000 FMV
(4) MIDWESTERN HEALTH MANAGEMENT INC

 E 117,979 FMV
(5) MIDWESTERN HEALTH MANAGEMENT INC

 I 237,470 FMV
(6) MIDWESTERN HEALTH MANAGEMENT INC

 K 1,281,789 FMV
(7) MIDWESTERN HEALTH MANAGEMENT INC

 L 906,433 FMV
(8) MIDWESTERN HEALTH MANAGEMENT INC

 P 11,914,774 FMV
(9) HHS PROPERTIES INC

 B 300,000 FMV
(10) HHS PROPERTIES INC

 J 176,197 FMV
(11) LEWIS AND CLARK INFORMATION EXCHANGE

 D 604,085 FMV
(12) LEWIS AND CLARK INFORMATION EXCHANGE

 K 87,557 FMV
(13) LEWIS AND CLARK INFORMATION EXCHANGE

 P 737,924 FMV
(14) NORTHLAND EXPANSION LLC

 D 1,420,555 FMV
(15) REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY

 D 3,934,597 FMV
(16) REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY

 F 839,405 FMV
(17) REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY

 K 805,722 FMV
(18) REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY

 L 100,139 FMV
(19) REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY

 P 3,639,147 FMV
(20) HEARTLAND LONG TERM ACUTE CARE HOSPITAL

 D 8,860,365 FMV
(21) HEARTLAND LONG TERM ACUTE CARE HOSPITAL

 I 520,000 FMV
(22) HEARTLAND LONG TERM ACUTE CARE HOSPITAL

 K 4,129,353 FMV
(23) HEARTLAND LONG TERM ACUTE CARE HOSPITAL

 P 6,458,337 FMV
(24) HEARTLAND FOUNDATION

 D 68,751 FMV
(25) HEARTLAND FOUNDATION

 P 1,267,124 FMV
(26) HEARTLAND FOUNDATION

 B 1,778,857 FMV
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(e)
Are all
partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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