Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | CURT KRETZINGER, JOHN WILSON, AND DOUGLAS BRANDT HAVE A BUSINESS RELATIONSHIP. THEY ARE OFFICERS OR DIRECTORS OF MIDWESTERN HEALTH MANAGEMENT, INC., HHS PROPERTIES, INC. OR COMMUNITY HEALTH PLAN INSURANCE COMPANY. CURT KRETZINGER, JOHN WILSON, MICHAEL PULIDO, DOUGLAS BRANDT, REBECCA PRESTON, MD, HAVE A BUSINESSS RELATIONSHIP. THEY ARE ALL OFFICERS AND EMPLOYEES OF HEARTLAND REGIONAL MEDICAL CENTER. CURT KRETZINGER, JOHN WILSON AND DOUGLAS BRANDT HAVE A BUSINESS RELATIONSHIP. THEY ARE OFFICERS OF HEARTLAND LONG TERM ACUTE CARE HOSPITAL AND REGIONAL EMERGENCY MEDICAL SERVICES AUTHORITY. JOHN WILSON AND DOUGLAS BRANDT HAVE A BUSINESS RELATIONSHIP. THEY ARE OFFICERS OF HEARTLAND FOUNDATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | HEARTLAND HEALTH, A RELATED TAX EXEMPT ORGANIZATION, HAS THE POWER TO APPOINT TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 7B | HEARTLAND HEALTH, A RELATED TAX EXEMPT ORGANIZATION, BOARD OF DIRECTORS HAS THE POWER TO TERMINATE THE TRUST. |
| FORM 990, PART VI, SECTION B, LINE 11B | AN INDEPENDENT ACCOUNTING FIRM PREPARES THE RETURN. IT IS THEN REVIEWED BY THE TRUSTEES. AFTER REVISIONS, IF NECESSARY, THE TRUSTEES AGAIN REVIEW THE FINAL RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL TRUSTEES RECEIVE A COPY OF THE CONFLICT OF INTEREST POLICY AND THE APPLICABLE CONFLICT OF INTEREST DISCLOSURE FORM AND QUESTIONNAIRE, WHICH IS COMPLETED TO IDENTIFY ANY RELATIONSHIPS, POSITIONS OR CIRCUMSTANCES WITH RESPECT TO WHICH IT IS BELIEVED A CONFLICT MAY ARISE. EACH TRUSTEE IS ASKED TO DISCLOSE FULLY AND FRANKLY ANY AND ALL ACTUAL OR POTENTIAL CONFLICTS OR DUALITY OF INTEREST OR RESPONSIBILITY, WHETHER PERSONAL, INDIVIDUAL OR BUSINESS, WHICH MAY EXIST OR APPEAR TO EXIST. A DUALITY OF INTEREST BECOMES A CONFLICT OF INTEREST ONLY IF THE DISINTERESTED TRUSTEES DECIDE THAT A CONFLICT OF INTEREST EXISTS BECAUSE THE DUALITY OF INTEREST IS SO SUBSTANTIAL THAT IT COULD COMPROMISE OBJECTIVE DECISION-MAKING OR COULD OTHERWISE BE DETRIMENTAL TO THE EXEMPT STATUS OR FINANCIAL WELL-BEING OF THE PLAN. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PLAN DOCUMENTS ARE PROVIDED TO ALL EMPLOYEE PARTICIPANTS. |
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