Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 07-01-2022 , and ending 06-30-2023
BCheck if applicable:
CName of organization
Heartland Regional Medical Center
 
 
Doing business as
Mosaic Life Care
 
Number and street (or P.O. box if mail is not delivered to street address)
5325 Faraon Street
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
St Joseph, MO64506
D Employer identification number

44-0545289
E Telephone number

G Gross receipts $ 728,108,069
F Name and address of principal officer:
Drew Keesbury
5325 Faraon Street
St Joseph,MO64506
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
https://www.mymlc.com/Main/Location/st-joseph-mo/mosaic-medical-center-st.-joseph/
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
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 IMPROVE POPULATION HEALTH OUTCOMES IN OUR REGION BY PROVIDING THE RIGHT CARE, AT THE RIGHT TIME, PLACE AND COST.
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 7
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 3,891
6 Total number of volunteers (estimate if necessary) ............. 6 105
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 82,249
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 5,802,961 3,208,632
9 Program service revenue (Part VIII, line 2g) ......... 691,329,049 709,145,991
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 179,998 470,625
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 13,048,847 14,992,573
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 710,360,855 727,817,821
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,338,498 1,072,664
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 313,457,121 335,115,065
16a Professional fundraising fees (Part IX, column (A), line 11e) .....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 379,572,911 387,612,801
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 694,368,530 723,800,530
19 Revenue less expenses. Subtract line 18 from line 12....... 15,992,325 4,017,291
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 462,827,700 462,032,495
21 Total liabilities (Part X, line 26)............. 56,029,973 51,217,477
22 Net assets or fund balances. Subtract line 21 from line 20..... 406,797,727 410,815,018
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 MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: TO IMPROVE POPULATION HEALTH OUTCOMES IN OUR REGION BY PROVIDING THE RIGHT CARE, AT THE RIGHT TIME, PLACE AND COST.
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 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 $ 651,353,114 including grants of $ 1,072,664 ) (Revenue $ 723,875,645 )
HEARTLAND REGIONAL MEDICAL CENTER (Mosaic-St. Joseph) IS A 352-BED MEDICAL SURGICAL HOSPITAL LOCATED IN ST. JOSEPH, MISSOURI. IT SERVES A COMMUNITY OF 79,000 RESIDENTS. BECAUSE ST. JOSEPH IS A BORDER CITY, IT ALSO PROVIDES SERVICES TO THOSE LIVING IN THE ADJACENT STATES OF KANSAS, NEBRASKA AND IOWA. THE ECONOMY OF THE REGION IS BASED ON AGRICULTURE, MINOR MANUFACTURING AND SMALL BUSINESSES RESULTING IN A PAYOR MIX FOR MOSAIC-ST. JOSEPH APPROXIMATELY 73.30% GOVERNMENTAL OR Self-PAY PATIENTS. 14.8% OF THE POPULATION HAVE INCOME THAT IS BELOW THE FEDERAL POVERTY LEVEL. MOSAIC-ST. JOSEPH 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. MOSAIC-ST. JOSEPH'S OBSTETRICS DEPARTMENT PROVIDES 18 LABOR, DELIVERY, RECOVERY AND POST-PARTUM BEDS WHICH ARE ALSO DESIGNATED AS A LEVEL II CENTER. THE HOSPITAL PROVIDES RADIATION ONCOLOGY SERVICES, HOME HEALTH VISITS AND HOSPICE CARE. THE ORGANIZATION IS A MEMBER OF THE MAYO NETWORK FOR CLINICAL CONSULTATIONS. DURING THE YEAR, APPROXIMATELY 13,400 PATIENTS WERE ADMITTED TO THE HOSPITAL RESULTING IN APPROXIMATELY 66,400 PATIENT DAYS. A TOTAL OF APPROXIMATELY 9,800 SURGERIES WERE PERFORMED, THE EMERGENCY ROOM SERVED APPROXIMATELY 49,200 PATIENTS AND APPROXIMATELY 178,300 VISITS WERE GENERATED BY OUTPATIENTS. MOSAIC-ST. JOSEPH EMPLOYS APPROXIMATELY 3,900 FULL-TIME EQUIVALENT CARE GIVERS. THE MEDICAL STAFF INCLUDES APPROXIMATELY 295 PROVIDERS COVERING PRIMARY CARE AND SPECIALTY CLINICS FOR APPROXIMATELY 25 LOCATIONS THROUGHOUT THE REGION. THERE WERE APPROXIMATELY 633,200 CLINIC PATIENT VISITS DURING THE YEAR. OTHER PROGRAM SERVICES: MOSAIC-ST. JOSEPH HAS A 340B DESIGNATION FROM HEALTH RESOURCES AND SERVICES ADMINISTRATION (FEDERAL GOVERNMENT). THIS ALLOWS THE MEDICAL CENTER TO RECEIVE OUTPATIENT DRUGS AT REDUCED PRICES FROM THE DRUG MANUFACTURERS. THE 340B PROGRAM ENABLES COVERED ENTITIES TO STRETCH SCARCE FEDERAL RESOURCES AS FAR AS POSSIBLE, REACHING MORE ELIGIBLE PATIENTS AND PROVIDING MORE COMPREHENSIVE SERVICES. THE PROGRAM IS AVAILABLE TO HOSPITALS THAT PROVIDE CARE FOR A DISPROPORTIONATE NUMBER OF PATIENTS THAT RANGE FROM NO INCOME TO LOW INCOME.
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 expensesMediumBullet651,353,114
Form 990 (2021)
Form 990 (2021)
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
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment
List of Attached Documents:
// Content
...
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 I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment
List of Attached Documents:
// Content
.........
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 Rev. Proc. 98-19? If "Yes," complete Schedule C, Part III..
5
 
 
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 I.........................
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 II....
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..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; 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 IV..............
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 V......
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, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment
List of Attached Documents:
// Content
...................
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.......
11b
 
No
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.......
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 IXClick to see attachment
List of Attached Documents:
// Content
............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
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 XClick to see attachment
List of Attached Documents:
// Content
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII......................
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 and XII is optional Click to see attachment
List of Attached Documents:
// Content
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, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
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. See instructions. ....
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 hospital facilities? If "Yes," complete Schedule H....Click to see attachment
List of Attached Documents:
// Content
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
List of Attached Documents:
// Content
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
List of Attached Documents:
// Content
21
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
List of Attached Documents:
// Content
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 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
List of Attached Documents:
// Content
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 lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
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
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
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.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
List of Attached Documents:
// Content
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
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
List of Attached Documents:
// Content
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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.............
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 VI
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
154
b
Enter the number of Forms W-2G included on 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
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
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
3,891
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” to line 3b, 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, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
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 as charitable contributions? ...
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. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring 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. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the 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 amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
 
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
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 or note to any line 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
1a
13
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
7
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
 
No
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
Yes
 
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 on Schedule O the process, if any, used by the organization to review this 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 on 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
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, describe the process on 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
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 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, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletDrew Keesbury5325 Faraon Street   St Joseph,MO64506 (816) 271-7070
Form 990 (2021)
Form 990 (2021)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line 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. 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 the 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, Form 1099-MISC, and/or box 1 of Form 1099-NEC) 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.

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(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/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) John M Poore
 
Director/President/CEO
 1.0
.................
37.0 		X   X       0 646,385 15,112
(2) Adam Stein
 
Director/Chair
 1.0
.................
1.0 		X           0 2,500 0
(3) Angelia Martin MD
 
Director
 1.0
.................
39.0 		X           0 274,056 37,851
(4) Daniel Heckman
 
Director
 1.0
.................
1.0 		X           0 2,500 0
(5) Elizabeth Kennedy PHD
 
Director
 1.0
.................
2.0 		X           0 2,500 0
(6) Emily Larson DO
 
Director
 39.0
.................
1.0 		X           378,887 2,500 44,874
(7) Gary Frazer
 
Director/Vice Chair
 1.0
.................
1.0 		X           0 2,500 0
(8) Matt Baker
 
Director
 1.0
.................
3.0 		X           0 2,500 0
(9) Matt Lukens MD
 
Director
 39.0
.................
1.0 		X           641,633 2,500 35,894
(10) Melody Smith
 
Director
 1.0
.................
1.0 		X           0 2,500 0
(11) Ophelia Lavell Rucker
 
Director
 1.0
.................
1.0 		X           0 2,500 0
(12) Serena Naylor
 
Director
 1.0
.................
4.0 		X           0 2,500 0
(13) Thomas Richmond
 
Director
 1.0
.................
1.0 		X           0 2,500 0
(14) Davin Turner DO
 
Chief Administrative Officer
 1.0
.................
37.0 		    X       232,604 161,034 20,954
(15) Drew Keesbury
 
CFO/Treasurer
 1.0
.................
36.0 		    X       0 0 0
(16) Michael R Rinard
 
Secretary
 1.0
.................
37.0 		    X       0 273,849 41,666
(17) Renea Schott
 
Assistant Secretary
 1.0
.................
39.0 		    X       0 68,687 23,921
Form 990 (2021)
Form 990 (2021)
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 (list any hours for related organizations below dotted line) 		(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/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Thomas Bieterman
 
Former CFO/Treasurer
 1.0
.......................36.0 		    X       0 167,017 2,972
(19) Gene A Claycomb
 
President of Mosaic Medical Center
 35.0
.......................3.0 		      X     443,355 0 46,562
(20) Andrew Walker MD
 
Staff Physician
 40.0
.......................0 		        X   1,068,264 0 39,770
(21) Gopichand Pendurti MD
 
Staff Physician
 40.0
.......................0 		        X   1,102,045 0 47,632
(22) Jonathan Amspacher MD
 
Staff Physician
 40.0
.......................0 		        X   1,116,111 0 40,162
(23) Mohan R Hindupur MD
 
Staff Physician
 40.0
.......................0 		        X   1,228,304 0 33,786
(24) Rony M Abou-Jawde MD
 
Staff Physician
 40.0
.......................0 		        X   1,850,182 0 40,474
(25) Dwain Stilson
 
Former CFO/Treasurer
 0.0
.......................0.0 		          X 0 157,969 5,073
(26) Karen S Miller
 
Former CFO/Treasurer
 0.0
.......................0.0 		          X 0 179,091 12,749
(27) Mark Laney MD
 
Former Director/President/CEO
 0.0
.......................0.0 		          X 0 3,032,113 27,536
(28) Michael Pulido
 
Former COO/Secretary
 0.0
.......................0.0 		          X 0 1,258,302 34,631




1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 8,061,385 6,246,003 551,619
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet520
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
Quest Diagnostics

PO Box 14730
St Louis,MO63150 		Medical Services 3,481,091
Capital Performance Management

11709 Roe Ave D236
Leawood,KS662112607 		Capital Management 1,396,288
McIntosh Law Firm PC Trust Acc

920 West 47th Street
Kansas City,MO64112 		Legal Services 1,000,000
Radiology Specialists of St Joseph PC

3906 Oakland Avenue
St Joseph,MO64508 		Medical Services 931,652
Kempton & Russell LLC

114 East Fifth Street
Sedalia,MO65301 		Legal Services 867,304
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet26
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 2,618,876
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f 589,756
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 3,208,632
Program Service RevenueAmt Business Code
2a Net Patient Service Revenue 621110 679,278,359 679,278,359    
b 340B Pharmacy Revenue 621110 29,867,632 29,867,632    
c
d
e
f All other program service revenue. 0 0 0 0
g Total. Add lines 2a–2f .....MediumBullet 709,145,991
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 415,719     415,719
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   405,352 6a
b Less: rental expenses   224,682 6b
c Rental income or (loss) 0 180,670 6c
d Net rental income or (loss).......MediumBullet 180,670     180,670
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 120,472   7a
b Less: cost or other basis and sales expenses 65,566   7b
c Gain or (loss) 54,906 0 7c
d Net gain or (loss).........MediumBullet 54,906     54,906
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a Referral Lab 621511 5,122,847 5,040,598 82,249  
b Cafeteria 722514 3,517,682 3,517,682    
c Copying Revenue 561439 21,082 21,082    
d All other revenue .... 6,150,292 6,150,292 0 0
e Total. Add lines 11a–11d ...... MediumBullet 14,811,903
12 Total revenue. See instructions.....MediumBullet 727,817,821 723,875,645 82,249 651,295
Form 990 (2021)
Form 990 (2021)
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).Check if Schedule O contains a response or note to any line 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 domestic organizations and domestic governments. See Part IV, line 21 .... 1,052,664 1,052,664
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 20,000 20,000
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 2,106,917 1,580,616 526,301 0
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 19,169 19,169    
7 Other salaries and wages........ 280,992,913 278,813,925 2,178,988  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 6,346,134 6,291,219 54,915  
9 Other employee benefits ....... 28,465,959 28,009,024 456,935  
10 Payroll taxes ........... 17,183,973 16,989,315 194,658  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 28,654   28,654  
c Accounting ...........        
d Lobbying ........... 170,253 127,250 43,003  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 45,756,977 45,497,423 259,554 0
12 Advertising and promotion .... 6,999 6,999    
13 Office expenses ....... 18,917,350 18,236,132 681,218  
14 Information technology ...... 6,822,095 6,812,678 9,417  
15 Royalties ..        
16 Occupancy ........... 5,268,933 4,776,937 491,996  
17 Travel ............ 370,933 370,342 591  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 215,419 211,479 3,940  
20 Interest ........... 1,694,341 1,694,341    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 26,503,031 25,325,227 1,177,804  
23 Insurance ... 4,317,928 4,317,928    
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a Medical Supplies/Includes 340B 139,165,142 139,165,142    
b Corporate Allocations From Mosaic Health System 108,751,140 42,412,945 66,338,195  
c FRA Taxes 28,580,952 28,580,952    
d Dues & Subscriptions 1,042,654 1,041,407 1,247  
e All other expenses 0 0 0 0
25 Total functional expenses. Add lines 1 through 24e 723,800,530 651,353,114 72,447,416 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 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 284,763 1 336,292
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 78,944,456 4 105,031,825
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
0 6 0
7 Notes and loans receivable, net ........... 6,892,735 7 75,000
8 Inventories for sale or use ............ 11,925,165 8 11,448,807
9 Prepaid expenses and deferred charges ...... 8,754,108 9 11,461,396
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 647,972,045
b Less: accumulated depreciation 10b 410,608,226 231,403,068 10c 237,363,819
11 Investments—publicly traded securities . 975,027 11 0
12 Investments—other securities. See Part IV, line 11 ..... 0 12  
13 Investments—program-related. See Part IV, line 11 .. 0 13  
14 Intangible assets ............... 6,745,515 14 4,817,998
15 Other assets. See Part IV, line 11 ........... 116,902,863 15 91,497,358
16 Total assets. Add lines 1 through 15 (must equal line 33)... 462,827,700 16 462,032,495
Liabilities 17 Accounts payable and accrued expenses ..... 43,208,046 17 39,721,872
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities .........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
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 12,821,927 25 11,495,605
26 Total liabilities. Add lines 17 through 25.. 56,029,973 26 51,217,477
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 406,485,893 27 410,503,184
28 Net assets with donor restrictions ........... 311,834 28 311,834
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 406,797,727 32 410,815,018
33 Total liabilities and net assets/fund balances ........ 462,827,700 33 462,032,495
Form 990 (2021)
Form 990 (2021)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
727,817,821
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
723,800,530
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
4,017,291
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
406,797,727
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
0
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
410,815,018
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line 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 on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 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?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
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 (2021)
Form 990 (2021)
Additional Data


Software ID: 22016089
Software Version: 2022v5.0
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
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 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 2
Part II
Support Schedule for Organizations Described in Sections 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 failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
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) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
33 1/3% support test—2022. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization .......................right arrow
b
33 1/3% support test—2021. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow
17a
10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
b
10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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 on 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 VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
33 1/3% support tests-2022. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow
b
33 1/3% support tests—2021. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow
20
Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by 0.035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity 		2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions 		8  
9 Distributable amount for 2022 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2022 		(iii)
Distributable
Amount for 2022
1 Distributable amount for 2022 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2022:
a From 2017.......  
b From 2018.......  
c From 2019.......  
d From 2020.......  
e From 2021.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2022 distributable amount  
i Carryover from 2017 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2022 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2022 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2022, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions. 		 
6 Remaining underdistributions for 2022. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions. 		 
7 Excess distributions carryover to 2023. Add lines
3j and 4c. 		 
8 Breakdown of line 7:
a Excess from 2018.....  
b Excess from 2019.....  
c Excess from 2020.....  
d Excess from 2021.....  
e Excess from 2022.....  
Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990) 2022


Additional Data


Software ID: 22016089
Software Version: 2022v5.0
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2022
Name of the 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 isn't covered by the General Rule and/or the Special Rules doesn't 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 its Form 990PF, Part I, line 2, to certify that it doesn't 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) (2022)
Schedule B (Form 990) (2022) Page 2
Name of organization
Heartland Regional Medical Center
  		Employer identification number
44-0545289
Part I
Contributors
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


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

$  


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

$  


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

$  


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

$  


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

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2022)
Schedule B (Form 990) (2022)
Page 3
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) (2022)
Schedule B (Form 990) (2022)
Page 4
Name of organization
Heartland Regional Medical Center
  		Employer identification number

44-0545289
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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) (2022)
Additional Data


Software ID: 22016089
Software Version: 2022v5.0
SCHEDULE C
(Form 990)

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 BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), 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. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

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-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
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 SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) Total
2a Lobbying nontaxable 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) 2021


Schedule C (Form 990) 2021
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 on 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? ..........................................................
 
No
 
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? ...................................................................................................................
Yes
 
160,253
j
Total. Add lines 1c through 1i ....................................................................................................
160,253
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
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY PORTION OF DUES PAID TO HOSPITAL ASSOCIATIONS THAT ARE USED FOR LOBBYING PURPOSES BY THE HOSPITAL ASSOCIATIONS. 36.00% of the membership dues paid to the Missouri Hospital Association are used for lobbying activities. 27.29% of the membership dues paid to the American Hospital Association are used for lobbying activities. In addition, Heartland Regional Medical Center (Mosaic St. Joseph) CONTRACTS WITH VARIOUS PARTIES FOR LEGISLATIVE LOBBYING IN SUPPORT OF HOSPITAL REIMBURSEMENT AND COMMUNITY SUPPORT.
Schedule C (Form 990) 2021


Additional Data


Software ID: 22016089
Software Version: 2022v5.0

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on 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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
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" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of 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" on 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 7/25/06, 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, 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 section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, 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" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB 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 XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB 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)
Revenue included on 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 FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, 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 XIII.
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" on 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 XIII 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, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on 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 current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on 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" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. 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 .....   17,243,794 17,243,794
b Buildings ....   409,694,906 234,667,289 175,027,617
c Leasehold improvements   18,075,713 16,315,318 1,760,395
d Equipment ....   195,840,203 159,625,619 36,214,584
e Other .....   7,117,429   7,117,429
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 237,363,819
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 3
Part VII
Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. 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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)Other Assets 91,497,358
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 91,497,358
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 11,495,605
2. Liability for uncertain tax positions. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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 (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 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 XIII.) ........... 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 XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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 XIII.) ............ 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 XIII.) ............ 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 XIII
Supplemental Information
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote MOSAIC HEALTH SYSTEM, HEARTLAND REGIONAL MEDICAL CENTER (MOSAIC-ST. JOSEPH), MOSAIC MEDICAL CENTER-MARYVILLE (MOSAIC-MARYVILLE), NORTHWEST MEDICAL CENTER ASSOCIATION, INC. (MOSAIC-ALBANY), HEARTLAND LONG-TERM ACUTE CARE HOSPITAL (HLTACH), MOSAIC LIFE CARE FOUNDATION, AND NORTHWEST MEDICAL CENTER FOUNDATION (MOSAIC-ALBANY) ARE NONPROFIT CORPORATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. HOWEVER, THEY ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. MIDWESTERN AND HHS PROPERTIES, INC. ARE SUBJECT TO INCOME TAXATION. WITH A FEW EXCEPTIONS, Mosaic's tax returns are generally subject to U.S. federal examinations by tax authorities for a period up to three years from the extended due date of return. AT JUNE 30, 2023, NET OPERATING LOSS CARRYFORWARDS GENERATED IN FISCAL YEARS ENDING JUNE 30, 2018 AND PRIOR ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME FOR THESE ENTITIES AGGREGATED APPROXIMATELY $10.6M AND EXPIRE THROUGH 2038. FOR NET OPERATING LOSS CARRYFORWARDS GENERATED IN FISCAL YEAR-ENDED JUNE 30, 2019 AND FORWARD WILL BE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME FOR THESE ENTITIES IN THE AMOUNT OF $1.5M AND ARE CARRIED FORWARD INDEFINITELY. SEPARATE RETURN LIMITATION RESTRICTIONS APPLY TO A PORTION OF THESE NET OPERATING LOSS CARRYFORWARDS. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNCERTAIN TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEET ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AS OF JUNE 30, 2023 AND 2022, THERE WERE NO UNCERTAIN TAX POSITIONS IDENTIFIED AND RECORDED AS A LIABILITY.
Schedule D (Form 990) 2021


Additional Data


Software ID: 22016089
Software Version: 2022v5.0




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
Heartland Regional Medical Center
 
Employer identification number

44-0545289
Part I
Financial Assistance 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) as a factor in determining 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 as a factor in determining 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 used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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, as a factor in determining 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
Yes
 
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) . . . 		    17,840,181   17,840,181 2.46 %
b Medicaid (from Worksheet 3, column a) . . . . .     124,776,747 84,994,033 39,782,714 5.49 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .         0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 142,616,928 84,994,033 57,622,895 7.95 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     6,130,674 543,593 5,587,081 0.77 %
f Health professions education (from Worksheet 5) . . .     368,668   368,668 0.05 %
g Subsidized health services (from Worksheet 6) . . . .     1,958,079 0 1,958,079 0.27 %
h Research (from Worksheet 7) .     646,018 125,398 520,620 0.07 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     472,950   472,950 0.07 %
j Total. Other Benefits . . 0 0 9,576,389 668,991 8,907,398 1.23 %
k Total. Add lines 7d and 7j . 0 0 152,193,317 85,663,024 66,530,293 9.18 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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     34,927   34,927 0 %
2 Economic development     115,000   115,000 0.02 %
3 Community support         0 0 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members		         0 0 %
6 Coalition building         0 0 %
7 Community health improvement advocacy         0 0 %
8 Workforce development         0 0 %
9 Other         0 0 %
10 Total 0 0 149,927 0 149,927 0.02 %
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 Healthcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
26,589,817
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
135,749,644
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
184,206,294
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-48,456,650
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(owned 10% or more by officers, directors, trustees, key employees, and physicians—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 %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Heartland Regional Medical Center
5325 Faraon Street
St Joseph,MO64506
www.mymlc.com/Main/Location/st-joseph-mo/mosaic-medical-center-st.-joseph/
426-26 		X X         X   Pharmacist Intern Program  
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Heartland Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 21
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://www.mymlc.com/General/Community-Health-Needs-Assessment/St-Joseph-CHNA/
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Heartland Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SCHEDULE O
b
SEE SCHEDULE O
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 6
Part VFacility Information (continued)

Billing and Collections
Heartland Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
17 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 all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Heartland Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
22 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
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Schedule H, Part V, Section B, Line 3E The significant health needs of the community are a prioritized description of various factors including: - Mental Health/Substance Abuse: - Access and Cost of Health Care; - Obesity: and - important health issues. These significant health needs are identified through The Community Health Needs Assessment (CHNA).
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - HEARTLAND REGIONAL MEDICAL CENTER (Mosaic-St. Joseph). The Community Health Needs Assessment (CHNA) was jointly prepared by Mosaic-St. Joseph and Heartland Long Term Acute Care Hospital. THE CHNA WAS CONDUCTED DURING TAX YEAR 2021 TO DETERMINE SERVICES NEEDED BY THE MEDICALLY UNDERSERVED. The following three needs were chosen to be addressed over the next three years: - Mental Health/Substance Abuse, - Access to and Cost of Health Care, - Obesity TO ENSURE INPUT WAS TAKEN INTO ACCOUNT FROM PERSONS WHO REPRESENT THE COMMUNITY, Mosaic-St. Joseph and HLTACH UTILIZED AN INDEPENDENT CONSULTING FIRM NAMED CROWE, LLP. THIS FIRM helped CONDUCT key stakeholder interviews and a community survey. Key Stakeholder Interviews: COMMUNITY INPUT WAS OBTAINED THROUGH KEY STAKEHOLDER INTERVIEWS PERFORMED WITH LEADERS FROM TWENTY-THREE COMMUNITY ORGANIZATIONS REPRESENTING PUBLIC HEALTH, PUBLIC SCHOOLS, SOCIAL SERVICE ORGANIZATIONS AND GOVERNMENT AGENCIES. TO ASSURE THE MEDICALLY UNDERSERVED WERE REPRESENTED IN THIS CHNA, INTERVIEWS WERE CONDUCTED WITH REPRESENTATIVES FROM THE FOLLOWING ORGANIZATIONS; BIG BROTHERS BIG SISTERS, BUCHANAN COUNTY SHERIFF'S DEPARTMENT, COMMUNITY ACTION PARTNERSHIP, COMMUNITY MISSIONS CORPORATION, CATHOLIC CHARITIES, FAMILY GUIDANCE CENTER, INTERSERV, MIDLAND EMPIRE RESOURCES FOR INDEPENDENT LIVING, NORTHWEST HEALTH SERVICES, PIVOTAL POINT TRANSITIONAL HOUSING, PROGRESSIVE COMMUNITY SERVICES, SECOND HARVEST COMMUNITY FOOD BANK, SOCIAL WELFARE BOARD, ST. JOSEPH HABITAT FOR HUMANITY, ST. JOSEPH HEALTH DEPARTMENT, ST. JOSEPH POLICE DEPARTMENT, ST. JOSEPH SCHOOL DISTRICT, ST. JOSEPH UNITED WAY, ST. JOSEPH YOUTH ALLIANCE, ST. JOSEPH YMCA, ST. JOSEPH YWCA, UNTITED CEREBRAL PALSY, VOICES OF COURAGE CHILD ADVOCACY CENTER. These key stakeholder interviews were conducted between October 25th and 27th, 2021. To assure that medically underserved were included in this CHNA, interviews were conducted with agencies serving neighborhoods where median household incomes are very low or unemployed, as well as agencies providing services related to mental health, persons who are homeless, victims of domestic violence, elderly and persons with disabilities. Community Health Survey: In order to develop a broad understanding of community health needs, Mosaic-St. Joseph and HLTACH conducted a community survey in January 2022. A link to the survey was distributed via e-mail, social media and word of mouth to the community at-large. A total of 258 surveys were completed. The majority of respondents were White/Caucasian (96%), 1% of the respondents identified as Black or African American and 1% identified as Hispanic or Latino. The remaining 2% identified with other racial or ethnic identities. THE SAMPLE INCLUDED MEN AND WOMEN, 18 AND OVER.
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Heartland Long Term Acute Care Hospital (HLTACH). Heartland Regional Medical Center (Mosaic-St. Joseph) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT AND ADOPTED AN IMPLEMENTATION STRATEGY WITH Heartland Long Term Acute Care Hospital (HLTACH), A RELATED ORGANIZATION.
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - HEARTLAND REGIONAL MEDICAL CENTER (Mosaic-St. Joseph):. FACILITY NAME: HEARTLAND REGIONAL MEDICAL CENTER (MOSAIC-ST. JOSEPH): DESCRIPTION: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED AND AN IMPLEMENTATION PLAN FOR ADDRESSING THE IDENTIFIED NEEDS WAS ADOPTED IN THE 2021 TAX YEAR. THE TOP THREE SIGNIFICANT NEEDS IDENTIFIED WERE: 1) MENTAL HEATLTH/SUBSTANCE ABUSE; 2) ACCESS AND COST OF HEALTH CARE; AND 3) OBESITY. MOSAIC-ST. JOSEPH'S ROLE IS MUCH MORE THAN BEING A HOSPITAL. IT IS A FULLY ENGAGED COMMUNITY PARTNER STRIVING TO ADDRESS THE UNIQUE HEALTH AND SOCIAL ISSUES THAT CHALLENGE THE REGION. MANAGEMENT RECOGNIZES THAT THE COMMUNITY'S MAJOR HEALTH PROBLEMS STEM, IN LARGE PART, FROM SOCIAL DETERMINANTS OF HEALTH. SOCIAL DETERMINANTS THAT AFFECT ACCESS TO HEALTH CARE (HEALTHY PEOPLE 2020 FRAMEWORK) INCLUDE: ECONOMIC STABILITY, POVERTY, EMPLOYMENT, FOOD SECURITY, HOUSING STABILITY, EDUCATION, HIGH SCHOOL GRADUATION, ENROLLMENT IN HIGHER EDUCATION, LANGUAGE AND LITERACY, EARLY CHILDHOOD, NEIGHBORHOOD AND BUILT ENVIRONMENT, ACCESS TO HEALTHY FOOD, QUALITY OF HOUSING, CRIME AND VIOLENCE, ENVIRONMENTAL CONDITIONS, CIVIC PARTICIPATION, PERCEPTIONS OF DISCRIMINATION/EQUITY, AND INCARCERATION/INSTITUTIONALIZATION. TO FULLY MEET THE NEEDS IDENTIFIED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT, MOSAIC-ST. JOSEPH IMPLEMENTED A THREE-YEAR ACTION PLAN FOR THE TAX YEARS 2022, 2023, AND 2024 COMPRISED OF THE FOLLOWING COMPONENTS. SIGNIFICANT NEED #1: MENTAL HEALTH/SUBSTANCE ABUSE: A)CONTINUE WORK OF BEHAVIORAL HEALTH ALLIANCE. B)CONTINUE TO FINANCIALLY SUPPORT AGENCIES THAT PROVIDE MENTAL HEALTH SERVICES. C)CONTINUE AND EXPAND THE MOSAIC ART EXPERIENCE. D)PROVIDE THE 4TH GRADE CHALLENGE IN ELEMENTARY SCHOOLS WITH EMPHASIS ON MENTAL HEALTH. E) THE ORGANIZATION'S SPIRITUAL HEALTH DEPARTMENT WILL PROVIDE ONGOING EDUCATION ON TRAUMA TO THE COMMUNITY. THIS EVENT WILL BE PRESENTED YEARLY AND IS OPEN TO THE PUBLIC. MOSAIC CHAPLAINS ALSO PROVIDE ADVANCED DIRECTIVE AND DURABLE POWER OF ATTORNEY EDUCATION FOR ANYONE IN THE HOSPITAL, AND TO CHURCHES AN OTHER COMMUNITY GROUPS WHEN THEY REQUEST. IN ADDITION, SPIRITUAL HEALTH PROVIDES A PULPIT SUPPLY IN AREA CHURCHES WHEN NEEDED AND GIVE PRESENTATIONS ON THE ROLE OF THE CHAPLAIN IN HEALTH CARE. SIGNIFICANT NEED #2: ACCESS TO AND COST OF CARE: A) THE ORGANIZATION WILL PROVIDE FINANCIAL SUPPORT TO ORGANIZATIONS PROVIDING ACCESS SUPPORT TO THE COMMUNITY, SUCH AS FAITH IN ACTION TRANSPORTATION MINISTRY B) THE ORGANIZATION WILL CONTINUE TO SUPPORT SOCIAL WELFARE BOARD. SIGNIFICANT NEED #3: OBESITY: A) THE ORGANIZATION WILL AGAIN OFFER 4TH GRADE CHALLENGE IN ELEMENTARY SCHOOLS, PROVIDING PHYSICAL ACTIVITY AND EDUCATION ON HEALTHY EATING AND EXERCISE. B) THE ORGANIZATION WILL ONCE AGAIN PROVIDE KIDS IN THE KITCHEN HEALTHY COOKING CLASS. C) THE ORGANIZATION WILL PROVIDE AN ADULT HEALTHY LIFESYTLE PROGRAM. D) THE ORGANIZATION WILL ALSO SUPPORT SECOND HARVEST COMMUNITY FOOD BANK IN PROVIDING HEALTHY FOOD CHOICES. THE COMPLETE CHNA WITH IMPLEMENTATION STRATEGY CAN BE FOUND AT: HTTPS://WWW.MYMLC.COM/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ST-JOSEPH-CHNA/
Schedule H, Part V, Section B, Line 20 Facility , 1 Facility , 1 - Heartland Regional Medical Center (Mosaic-St. Joseph):. FINANCIAL COUNSELORS ARE AVAILABLE ONSITE TO EXPLAIN AND HELP PATIENTS AND GUARANTORS WITH THE FINANCIAL ASSISTANCE POLICY. SEE FINANCIAL ASSISTANCE POLICY FOR A COMPLETE DESCRIPTION OF EFFORTS MADE BEFORE INITIATING COLLECTION ACTIONS.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 9
Part VFacility Information (continued)

Section D. 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?23
Name and address Type of Facility (describe)
1 Cameron Mosaic Life Care
923 North Walnut Street
Cameron,MO64429 		Family Care and Endocrinology
2 Mosaic Life Care Clinics
902 North Riverside Road
St Joseph,MO64507 		Medical Oncology, CARDIOVASULAR CARE, and Radiation Oncology
3 Mosaic Life Care Clinics
2600 Miller Street
Bethany,MO64424 		Cardiology and Endocrinology
4 Mosaic Life Care Clinics
901 Heartland Road
St Joseph,MO64506 		Infectious, Endocrinology, Internal Medicine, Wound, Sleep Disorder and Women's Health and Menopause
5 Mosaic Life Care Clinics
5301 Faraon Street Suites XXX-XX-XXXX
210B
St Joseph,MO64506 		Ears Nose and Throat, Pulmonary and Critical Care, and Physical Medicine and Rehabilitation
6 Mosaic Life Care Clinics
711 North 36th Street Suite 100 Low
er Level
St Joseph,MO64506 		Family Care & Outpatient Therapy
7 Mosaic Life Care Clinics
5210 North Belt Highway Entrance B
C
St Joseph,MO64506 		Family Care
8 Mosaic Life Care Clinics
5514 Corporate Drive Suites 120 150
St Joseph,MO64507 		Internal Medicine and Pediatrics
9 Mosaic Life Care Clinics
105 Far West Drive Suites 100 201 2
02
St Joseph,MO64506 		Internal Medicine, Pediatrics, Family Care, Neurology & Outpatient Behavior Health
10 Mosaic Life Care Clinics
802 North Riverside Road
St Joseph,MO64506 		Bariatric, Breast, CardioThoracic & General Surgery, Pain Management, Rheumatology, Vein Care & etc.
11 Medical Oncology Mosaic Life Care
1610 East Evergreen Suite B
Cameron,MO64429 		Cancer Care
12 Mosaic Life Care Clinics
2016 South Main
Maryville,MO64468 		Medical Oncology, Neuro Surgery, Maternity, Imaging, Cancer Care, Cardiology, Cardiopulmonary Rehab
13 Mosaic Life Care Hospice at Stanberry
307 Pineview Pine View Manor Rm 507
Stanberry,MO64489 		Hospice
14 Mosaic Life Care Clinics
3620 Fredrick Avenue
St Joseph,MO64506 		Outpatient Imaging, Counseling Care, & Radiology
15 Mosaic Life Care Clinics
3007 North Belt Highway
St Joseph,MO64506 		Outpatient Therapy & Chiropractic Care
16 Plastic Surgery & Dermatology Mosaic
5204 North Belt Highway Suite A
St Joseph,MO64506 		Plastic Surgery & Dermatology
17 Mosaic Life Care Clinics
1600 East Evergreen PO Box 557
Cameron,MO64429 		Pulmonary, Cardiology, Neurology, & Vascular
18 Mosaic Life Care Clinics
1707 East 9th Street
Trenton,MO64683 		Family Care
19 Urgent Care St Joseph Mosaic Life Care
1115 North Belt Highway
St Joseph,MO64506 		Urgent Care
20 Mosaic Life Care Clinics
104 North 6th
Atchison,KS66002 		Cancer Care
21 Troy Mosaic Life Care
207 South Main
Troy,KS66087 		Family Care
22 Endocrinology Mosaic Life Care
820 Raven Hill Drive
Atchison,KS66002 		Endocrinology & Vascular
23 Mosaic Life Care at St Joseph Nephrology
1009 West St Maarten Drive
St Joseph,MO64506 		Nephrology
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
Schedule H, Part I, Line 7f Heartland Regional Medical Center (Mosaic-St. Joseph) did not report bad debt expense as part of operating expenses for health professions education for year ended 06/30/23. NO BAD DEBT EXPENSE IS REPORTED ON FORM 990, PART IX, LINE 25, AS IT IS REPORTED ON FORM 990, PART VIII, LINE 2A IN NET PATIENT SERVICE REVENUE. THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE (SCHEDULE H, PART I, LINE 7, COLUMN (C)) AS A PERCENTAGE OF TOTAL EXPENSES IS 21.01%, AND THE PERCENTAGE INCREASES TO 46.43% IF MEDICARE ALLOWABLE COSTS (SCHEDULE H, PART III, SECTION B, LINE 6) ARE INCLUDED IN TOTAL COMMUNITY BENEFIT EXPENSE.
Schedule H, Part I, Line 3c Not Applicable
Schedule H, Part I, Line 6a Not applicable
Schedule H, Part I, Line 7b DURING THE YEAR-ENDED 06/30/2023, Heartland Regional Medical Center (Mosaic-St Joseph) reduced the estimated FEDERAL REIMBURSEMENT ALLOWANCE program liability related to prior program years by approximately $7,568,000 thereby increasing patient service revenue by the same amount. This change in estimate was the result of the state of Missouri providing Mosaic-St Joseph final settlement notifications during the year ended June 30, 2023. Due to the subjectivity involved in making these estimates due to the lack of historical precedence with respect to how the state administers the program, there is at least a reasonable possibility that recorded estimates will change by a material amount in the near term.
Schedule H, Part I, Line 7g On March 11, 2020, the World Health Organization (WHO) declared the novel coronavirus disease (COVID-19) a pandemic. The Center for Disease Control (CDC) confirmed its spread to the United States and it was declared a national public health emergency, followed by state of emergency declarations (including by the Governor of Missouri), and the Centers for Medicare and Medicaid Services (CMS) issuing guidance regarding elective procedures. The COVID-19 pandemic has caused significant disruption to the national economy as well as Mosaic's operations. In 2023, the COVID-19 pandemic continued to impact Mosaic's business as well as patients, communities and employees. With the COVID-19 pandemic Mosaic-St Joseph has incurred expenses related to the following items: 1. Personal Protective Equipment (PPE) 2. Pharmacy Expenses 3. Temporary Testing Sites 4. Temporary Vaccination Clinics 5. Labor Costs 6. Supplies and various other expenses During FY23, Heartland Regional Medical Center (Mosaic-St Joseph) experienced a net increase of $1,960,000 in Covid-19 expenses, which is reflected in Part I, Line 7g.
Schedule H, Part III, Line 2 Adoption of Charity Care Assessment System Heartland Regional Medical Center (Mosaic-St. Joseph) reported a slight increase in bad debt expense, from $23,614,137 for fiscal year-ended June 30, 2022 to $26,589,817 for fiscal year-ended June 30, 2023.
Schedule H, Part VI, Line 7 NOT APPLICABLE
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WAS THE COST TO CHARGE RATIO DERIVED FROM THE CALCULATIONS FROM WORKSHEET 2. FINANCIAL ASSISTANCE AT COST WAS $17,840,000 AND $22,081,000 FOR YEARS ENDED 6/30/23 AND 6/30/22. MEDICAID NET COMMUNITY BENEFIT EXPENSE WAS $39,783,000 FOR THE YEAR ENDED 6/30/23 WHILE MEDICAID NET COMMUNITY BENEFIT EXPENSE WAS $20,254,000 FOR YEAR ENDED 6/30/22, RESPECTIVELY. THE HEARTLAND REGIONAL MEDICAL CENTER (MOSAIC-ST. JOSEPH) RECEIVES REIMBURSEMENT FROM THE MEDICAID PROGRAM IN RELATION TO THE PERCENTAGE OF MEDICAID AND INDIGENT POPULATION THEY SERVE.
Schedule H, Part II Community Building Activities Heartland Regional Medical Center (Mosaic-St. Joseph) COMMUNITY BUILDING ACTIVITIES PROMOTED THE HEALTH OF THE COMMUNITIES SERVED BY PROVIDING ECONOMIC SUPPORT TO HELP RE-VITALIZE THE DOWNTOWN ST JOSEPH AREA AND FACILITATE JOB GROWTH THROUGHOUT THE GREATER ST JOSEPH AREA. AMONG OTHER COMMUNITY BUILDING ACTIVITIES, Mosaic-St. Joseph FUNDS AND MAINTAINS A TEAM FOCUSED ON DISASTER READINESS, COORDINATION AND RELIEF.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Heartland Regional Medical Center (Mosaic-St. Joseph) calculates bad debt expense at the established rate as reported in patient service revenue in the audited financial statements. Discounts provided by third-party payors on patient accounts are written off as contractual allowances. Payments received on an account previously written off to bad debt expense are credited to a bad debt recovery account.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology HEARTLAND REGIONAL MEDICAL CENTER (MOSAIC-ST. JOSEPH) uses a third party to electronically review a patient or the patient's Guarantor information to assess financial need. This review utilizes a healthcare industry-recognized, predictive model that is based on public record databases and does not access the patient or guarantor's credit file. The model's rule set is designed to assess each patient based upon the same standards and is calibrated against historical Financial Assistance approvals by Mosaic-St. Joesph. This enables Mosaic-St. Joesph to assess whether a patient is characteristic of other patients who have historically qualified for Financial Assistance under the traditional application process. When the model is utilized, it will be deployed prior to bad debt assignment or after all other eligibility and payment sources have been exhausted. This allows Mosaic-St. Joesph to screen all patients for Financial Assistance prior to pursuing any extraordinary collection actions. AS A RESULT, MOSAIC-ST. JOSEPH REPORTED ZERO DOLLARS FOR THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S Financial Assistance Policy.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Please see THE ACCOUNTS RECEIVABLE FOOTNOTE ON PAGE 10 and 11 and the Patient Service revenue Footnote regarding implicit price concessions on page 18 OF The ATTACHED AUDITED FINANCIAL STATEMENTS. SEE ALSO THE PARAGRAPH IN THE CHARITY CARE FOOTNOTE ON PAGE 19.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO DIRECTLY FROM THE MEDICARE COST REPORT WHICH RESULTS IN A SHORTFALL OF COVERING THE HOSPITAL'S COST OF TREATING MEDICARE PATIENTS. THIS SHORTFALL, IN ADDITION TO NON-PAYMENT BY MEDICARE RECIPIENTS FOR THEIR DEDUCTIBLE AND COINSURANCE AMOUNT INCREASES FINANCIAL ASSISTANCE AND BAD DEBT. Mosaic-St. Joseph PROVIDES SERVICES TO ALL MEDICARE PATIENTS WITH THE KNOWLEDGE THAT THE COST OF PROVIDING CARE TO THEM MAY EXCEED THE REIMBURSEMENT FROM MEDICARE FOR THE SERVICES PROVIDED. THE SHORTFALL OF COSTS, FINANCIAL ASSISTANCE AND BAD DEBT IS CONSIDERED TO BE A COMMUNITY BENEFIT BECAUSE THE HOSPITAL IS ABSORBING THE COST OF PROVIDING CARE TO THE ELDERLY AND DISABLED IN THE COMMUNITY. IN ADDITION, THIS COINCIDES WITH THE IRS REVENUE RULING 69-545, WHICH provides general requirements for tax exemption, along with section 501(c)(3).
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Heartland Regional Medical Center's (Mosaic-St. Joseph) FINANCIAL ASSISTANCE POLICY CONTAINS PROVISIONS ON COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ONLY. ACCORDING TO THIS POLICY, FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA ARE BASED ON RESIDENCY, GROSS HOUSEHOLD INCOME & HOUSEHOLD SIZE. APPLYING FOR FINANCIAL ASSISTANCE Patients will be informed of the Mosaic-St. Joseph Financial Assistance Policy and the process for submitting an application to determine if the patient or guarantor is eligible for financial assistance, Mosaic-St. Joseph asks for the necessary information and documents to prove household size, income, and residency. A completed application for financial assistance should be submitted within 240 days from the date of the first post-discharge billing statement. Mosaic-St. Joseph will make reasonable efforts to explain the Medicaid benefits, the health insurance exchange and coverage, and other public and private coverage that may apply. Mosaic-St. Joseph will also provide the details of these programs and offer to help patients and guarantors apply for them as well as, private programs and COBRA coverage. Once the patient or guarantor is screened to be potentially eligible for any of these programs, public or private, Mosaic-St. Joseph expects him or her to apply. If a patient or guarantor chooses not to apply, he or she may be denied financial assistance. If the patient or guarantor is potentially eligible for any third-party coverage, he or she must provide documentation of approval or denial of that third-party coverage before a Mosaic-St. Joseph financial assistance application will be accepted. Information on the Mosaic-St. Joseph Financial Assistance Policy will be communicated to patients in a culturally appropriate language. Information about the policy will be translated in the most prevalent languages in the Mosaic-St. Joseph primary service area. COLLECTION ACTIONS TAKEN IN EVENT OF NON-PAYMENT No account will be subject to collection actions within 120 days of issuing the first post-discharge statement and without first making reasonable efforts to determine whether the patient is eligible for financial assistance. No extraordinary collection actions will be pursued against a patient if the patient or guarantor has provided documentation showing that an application has been submitted for Medicaid or other publicly sponsored health programs, and that an eligibility determination is still pending. If a statement is sent to a patient or guarantor, and mail is returned as undeliverable, Mosaic-St. Joseph will attempt to find a correct address. If the correct address cannot be found, Mosaic-St. Joseph will attempt to contact the patient or guarantor by telephone at the number listed by the patient or guarantor. If efforts to communicate with the patient or guarantor fail, accounts will be sent to a collection agency. Reasonable efforts to inform patient of financial assistance Prior to sending an account to a collection agency, the patient or guarantor will generally receive a minimum of four written statements (includes the first post-discharge statement and three subsequent statements). These statements will include a telephone number for information on paying patient balances and a notice about financial assistance. If an agreement has not been made to resolve the account, the fourth and final statement will be sent to the patient or guarantor. This statement acts as a notice to the account owner of the amount owed to Mosaic-St. Joseph and that the account will be placed with a third-party collection agency in 30 days. This statement will include a plain language summary and will outline any collection actions that may be taken if a plan is not put in place to settle the account. There are other times when accounts may be placed in collections including when: 1. The patient or guarantor has not made timely payments according to the agreed-upon payment plan 2. The patient or guarantor has received a financial assistance discount but is no longer working with Mosaic-St. Joseph in good faith to pay off the remaining amount owed. Extraordinary collection activities Once an account is with the collection agency, the following actions may be taken to make sure debt for services and care is paid. They are "Extraordinary Collection Activities:" 1. Seizing the patient's or guarantor's bank account 2. Civil actions 3. Property liens 4. Garnishing of wages 5. Reporting adverse information to credit bureaus Before "Extraordinary Collection Activities" can begin, the account must be reviewed, and approval must be given by Mosaic-St. Joseph Patient Billing Leadership. When one of these actions is to be taken against a patient or guarantor, the patient or guarantor will be given a 30-day written notice of the action to be taken. The patient or guarantor will also be informed of the Mosaic-St. Joseph Financial Assistance Policy and how to apply for it. A plain language summary of the Financial Assistance Policy will be included with the notice. ENFORCEMENT Mosaic-St. Joseph staff are expected to uphold the highest ethical standards. All business must be conducted in the name of the caller or Mosaic-St. Joseph. Everything a staff member says must be true and correct using a professional approach. The staff as well as, all third-party vendors working on behalf of Mosaic-St. Joseph, will uphold and adhere to the Fair Debt Collection Practices Act.
Schedule H, Part V, Section B, Line 16a FAP website - Heartland Regional Medical Center: Line 16a URL: SEE SCHEDULE O;
Schedule H, Part V, Section B, Line 16b FAP Application website - Heartland Regional Medical Center: Line 16b URL: SEE SCHEDULE O;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Heartland Regional Medical Center: Line 16c URL: SEE SCHEDULE O;
Schedule H, Part VI, Line 2 Needs assessment Heartland Regional Medical Center (Mosaic-St. Joseph) HAS A ROBUST APPROACH FOR ASSESSING THE NEEDS OF THE COMMUNITIES IT SERVES. THIS ONGOING COMMITMENT INCLUDES COLLABORATING WITH LOCAL GROUPS, SCHOOL DISTRICTS AND CITY AND COUNTY AGENCIES TO IDENTIFY NEEDS, PROMOTE HEALTHY LIVING, ASSURE THAT AFFORDABLE MEDICAL SERVICES ARE AVAILABLE, DEVELOP STRATEGIES FOR IMPROVING EDUCATION AND ECONOMIC STRENGTH, AND PROVIDING ONGOING SUPPORT.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Heartland Regional Medical Center (Mosaic-St. Joseph) INFORMS AND EDUCATES PATIENTS AND GUARANTORS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEGINNING AT THE REGISTRATION DESK AND CONTINUING WITH FINANCIAL ASSISTANCE INFORMATION BEING INCLUDED ON EVERY BILLING STATEMENT A PATIENT OR GUARANTOR RECEIVES FROM Mosaic-St. Joseph. GUIDELINES FOR THE PROGRAM ARE AVAILABLE AT EACH REGISTRATION DESK AND ARE INCLUDED IN ALL ADMISSION PACKETS. PATIENTS ARE CONTACTED IF THE PATIENT IS EXPECTED TO HAVE A FINANCIAL RESPONSIBILITY FOR THE VISIT. A FINANCIAL COUNSELOR ATTEMPTS TO VISIT THE ROOM OF EVERY UNINSURED PATIENT THAT IS ADMITTED TO OUR FACILITY FOR OBSERVATION OR INPATIENT CARE. THE COUNSELOR DISCUSSES PAYMENT OPTIONS WITH THE PATIENT AND CAN ASSIST THEM WITH VARIOUS OPTIONS THAT INCLUDE, BUT ARE NOT LIMITED TO, MEDICAID APPLICATION, HEALTH CARE EXCHANGE ELIGIBILITY AND ELIGIBILITY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. COUNSELORS ALSO WORK WITH OUR CARE MANAGEMENT STAFF TO SUPPORT THE DISCHARGE PROCESSES SO THAT FINANCIAL HARDSHIP DOES NOT KEEP THE PATIENT FROM RECEIVING THE APPROPRIATE FOLLOW-UP CARE. THIS ASSISTANCE INCLUDES INSTRUCTIONS FOR SCHEDULING AN APPOINTMENT WITH A FINANCIAL COUNSELOR WHO CAN ASSIST THEM IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION.
Schedule H, Part VI, Line 4 Community information THE ORGANIZATION'S PRIMARY AND SECONDARY SERVICE AREA IS AN 18 COUNTY URBAN/RURAL REGION LOCATED IN NORTHWEST MISSOURI AND NORTHEAST KANSAS. THE POPULATION IS ELDERLY AND UNDERINSURED. THE LOCAL ECONOMY CONSISTS OF AGRICULTURAL, SMALL MANUFACTURING AND SELFEMPLOYED BUSINESSES, PRIMARILY BLUE-COLLAR WORKERS. THE ORGANIZATION SUPPORTS A PAYOR MIX OF APPROXIMATELY 73.30% GOVERNMENTAL OR SELF-PAY PATIENTS. 15.5% OF THE POPULATION IS BELOW THE POVERTY LEVEL; 24.3% OF THE POPULATION SMOKES; AND 29% HAVE A BODY MASS INDEX GREATER THAN 30. MORE THAN 69% OF THE ELEMENTARY AGE STUDENTS RECEIVE FREE OR REDUCED-COST LUNCHES.
Schedule H, Part VI, Line 5 Promotion of community health HEARTLAND REGIONAL MEDICAL CENTER (MOSAIC-ST. JOSEPH) IS A NONPROFIT HOSPITAL OPERATING TO SERVE A PUBLIC RATHER THAN A PRIVATE INTEREST AND MEETING THE REQUIREMENTS OF REVENUE RULING 69-545. CONTROL OF MOSAIC-ST. JOSEPH RESTS WITH ITS BOARD, WHICH IS PRIMARILY COMPOSED OF MEMBERS OF THE COMMUNITY, IN ADDITION TO A FEW SELECT EMPLOYEES OF MOSAIC-ST. JOSEPH. MOSAIC-ST. JOSEPH ACCEPTS PATIENTS PAYING WITH MEDICAID AND MEDICARE AND OPERATES AN ACTIVE AND GENERALLY ACCESSIBLE EMERGENCY ROOM OPEN TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. MOSAIC-ST. JOSEPH USES SURPLUS FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE, MAINTAIN AND IMPROVE EQUIPMENT AND FACILITIES, EXTEND SERVICE OFFERINGS TO NEW AREAS AND PROVIDE SUPPORT TO THE COMMUNITIES IT SERVES. MOSAIC-ST. JOSEPH PROMOTES HEALTH IN THE ST. JOSEPH REGION IN NUMEROUS WAYS. HIGHLIGHTED BELOW ARE EXAMPLES IN WHICH MOSAIC-ST. JOSEPH PROVIDED DIRECT FUNDING SUPPORT TO THE COMMUNITY ORGANIZATIONS WITH LIKE MISSIONS. IN FY23, MOSAIC-ST. JOSEPH MAINTAINED A POST NATAL PROGRAM IN WHICH A NURSE WILL MAKE FOLLOW UP PHONE CALLS FOR EVERY PATIENT TO ARRANGE FOLLOW UP CARE FOR THE BABIES AND SETUP CAR SEAT CHECKS FOR EACH INFANT IF DESIRED. IN ADDITION, THIS DEPARTMENT PROVIDES TWO HOURS OF SUPPORT TO THE BREASTFEEDING GROUP TWICE A WEEK. THIS IS DONE AT NO EXPENSE TO THE PATIENT AND IS A NON-BILLABLE SERVICE THAT IS PROVIDED AS A COMMUNITY BENEFIT. IN FY23, RECOVERED FROM THE EFFECTS OF THE COVID 19 PANDEMIC THESE COMMUNITY HEALTH IMPROVEMENT PROGRAMS WERE OFFERED: 1. 4TH GRADE HEALTH CHALLENGE IN ELEMENTARY SCHOOLS 2. ADULT HEALTHY LIFESTYLE PROGRAM (REPLACED POUND PLUNGE) PILOTED WITH CANCER SURVIVORS 3. KIDS IN THE KITCHEN HEALTHY COOKING CLASSES IN ELEMENTARY SCHOOLS THE 340B DRUG PRICING PROGRAM ("340B PROGRAM") ENABLES SAFETY NET HEALTHCARE ORGANIZATIONS SERVING UNINSURED, VULNERABLE AND INDIGENT POPULATIONS TO PURCHASE OUTPATIENT PRESCRIPTION DRUGS AT A DISCOUNT. MOSAIC-ST. JOSEPH HAS PARTICIPATED IN THIS PROGRAM SINCE 2011. THIS PARTICIPATION HAS GENERATED REVENUE FROM THE CONTRACTED RETAIL PHARMACY RELATIONSHIPS AND HAS REDUCED DRUG PRICING FOR OUTPATIENT MEDICATIONS. THE PROGRAM IS CURRENTLY THREATENED BY LEGISLATIVE CHALLENGES.
Schedule H, Part VI, Line 6 Affiliated health care system THE ORGANIZATION IS AFFILIATED, THROUGH A PARENT BOARD, WITH A REGIONAL Medical CENTER Hospital, A COMMUNITY FOUNDATION, A LONG-TERM ACUTE CARE HOSPITAL, A CRITICAL ACCESS RURAL HOSPITAL, A RURAL COMMUNITY FOUNDATION AND A GENERAL MEDICAL AND Surgical HOSPITAL. ALL OF WHICH COLLABORATE WITH EDUCATIONAL, GOVERNMENTAL AND LOCAL BUSINESS LEADERS TO IMPLEMENT PROGRAMS TO HELP IMPROVE HEALTH HABITS AND, IN THE LONG-TERM, THE HEALTH OF THE COMMUNITIES SERVED BY THE ORGANIZATION. These affiliations include the hospital reported on this tax return. THE PARENT BOARD IS COMPRISED OF COMMUNITY LEADERS WHO REPRESENT THE EDUCATIONAL, MEDICAL, GOVERNMENTAL AND BUSINESS SECTORS IN THE COMMUNITY. THE COMMUNITY FOUNDATION OVERSEES A NUMBER OF PROGRAMS WORKING TO IMPROVE HEALTH and Educational needs IN THE COMMUNITY. The Regional Medical center hospital provides general medical and surgical needs to patients and provides both primary and specialty physicians, in addition to providing emergent and outpatient clinic care for all. The Long-term acute care hospital IS A FACILITY DEDICATED TO THE CARE OF PATIENTS WHO HAVE CHRONIC CONDITIONS REQUIRING A LONGER LENGTH OF STAY THAN IS NORMALLY PROVIDED IN AN ACUTE CARE HOSPITAL. THE GENERAL MEDICAL and Surgical CARE HOSPITAL PROVIDES ACUTE, EMERGENT AND OUTPATIENT CLINIC CARE FOR ALL. THE CRITICAL ACCESS RURAL HOSPITAL PROVIDES ACUTE, EMERGENT AND OUTPATIENT CLINICS ARE FOR THOSE IN THE RURAL COMMUNITY AREA. THE RURAL COMMUNITY FOUNDATION SUPPORTS THE CRITICAL ACCESS RURAL HOSPITAL. ALL HOSPITAL FACILITIES PROVIDE CARE FOR ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. ALL THE HOSPITAL Organizations MAINTAIN AN ONGOING COMMITMENT TO PROVIDE SUPPORT FOR THE BETTERMENT OF THE COMMUNITY.
Schedule H (Form 990) 2022
Additional Data


Software ID: 22016089
Software Version: 2022v5.0

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2022
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 Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC 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
noncash assistance		 (h) Purpose of grant
or assistance
(1) Heartland Foundation
5325 Faraon Street
St Joseph,MO64506 		43-1262768 501c3 554,013       General Support
(2) St Joseph Area Chamber of Commerce
3003 Frederick Avenue
St Joseph,MO64506 		44-0419460 501c6 98,590       Sponsorship
(3) Samaritan Counseling Center Inc
902 Edmond Street
St Joseph,MO64501 		43-1615018 501C3 50,200       General Support
(4) Pivotal Point
3000 Parkway A
St Joseph,MO64507 		27-1481997 501C3 50,000       General Support
(5) Northwest Foundation Inc
800 University Drive
Maryville,MO64468 		23-7165025 501C3 50,000       General Support
(6) ST Kolbe-Puckett Center for Healing Inc
210 North 7th Street
St Joseph,MO64501 		82-2433712 501C3 30,000       General Support
(7) St Joseph Mustangs
4707 College Blvd Suite 204
Leawood,KS66211 		26-1723796   15,000       General Support
(8) Albrecht-Kemper Museum of Art Foundations
2818 FREDERICK
St Joseph,MO64506 		43-1855334 501C3 10,950       General Support
(9) Second Harvest Community Food Bank
915 DOUGLAS Street
St Joseph,MO64505 		43-1268319 501C3 10,500 7,718 Other Meals donated General Support
(10) Faith in Action
2711 Ashland Avenue
St Joseph,MO64506 		44-0653008 501C3 10,000       General Support
(11) MWSU Foundation Inc
5425 DOWNS DRIVE
St Joseph,MO64507 		23-7035423 501c3 7,000       Sponsorship
(12) The Crossing Outreach
701 South 8th Street
St Joseph,MO64501 		46-4195177 501C3 5,655       General Support
(13) Community Alliance
3003 Frederick Avenue
St Joseph,MO64506 		05-0587096 501C3 5,000       General Support
(14) YMCA of St Joseph Missouri
315 South 6th Street
St Joseph,MO64501 		44-0552491 501C3 5,000       General Support
(15) Big Brothers Big Sisters of Greater St Joseph
1202 South 28th Street
St Joseph,MO64507 		44-0666362 501C3 5,000       General Support
(16) Northwest Missouri Childrens Advocacy Center
1807 Woodbine Road
St Joseph,MO64506 		43-1910148 501C3 5,000       General Support
(17) Ladies Union Benevolent Association dba Noyes Home for Children
801 N Noyes Blvd
St Joseph,MO64506 		44-0563788 501C3 5,000       General Support
(18) The Curators of the University of Missouri
5100 Rockhill Road
Kansas City,MO641102499 		43-6003859   100,000   FMV   General Support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
16
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
2
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2022

Schedule I (Form 990) 2022
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1) Scholarships 24 20,000      
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. The organization is committed to the development of a healthy community. Grants are provided to local groups that achieve these objectives. Generally Heartland Regional Medical Center (Mosaic-St. Joseph) officers, directors or employees are in a volunteer position or are a board member of the recipient organization. The recipients are required to submit quarterly reports to Heartland Regional Medical Center detailing the program's expenditures and progress toward the stated goals. Heartland Regional Medical Center's Advocacy department monitors the progress. In FY2023 through the receipt of the Healthcare Services Group Charitable Foundation contribution, HRMC provided additional support to caregivers that were participating in Tuition Reimbursement through Mosaic per the HSGCF requirement. Leaders gathered names of potential candidates, then verified that the candidates were still pursuing their higher education along with being in good standing with HR. The dollars were divided based on the candidate list and each entity decided how they could assign their entity's portion. The Scholarship candidates are required to provide proof of acceptance to the institution, proof of full-time status as a student, a certified college transcript and two letters of recommendation. This helps to provide evidence the funds are used for the purpose for which it was awarded.
Schedule I (Form 990) 2022



Additional Data


Software ID: 22016089
Software Version: 2022v5.0


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" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
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 on 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 on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
 
 
3
Indicate which, if any, of the following the filing organization used 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 on 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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on 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," on line 5a or 5b, describe in Part III.
6
For persons listed on 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," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on 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" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2022

Schedule J (Form 990) 2022
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 on 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 (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1John M Poore
 
Director/President/CEO 		(i)

(ii)		 0
-------------
630,107 		0
-------------
13,827 		0
-------------
2,451 		0
-------------
0 		0
-------------
15,112 		0
-------------
661,497 		0
-------------
0
2Matt Lukens MD
 
Director 		(i)

(ii)		 621,444
-------------
2,500 		0
-------------
0 		20,189
-------------
0 		12,200
-------------
0 		23,694
-------------
0 		677,527
-------------
2,500 		0
-------------
0
3Emily Larson DO
 
Director 		(i)

(ii)		 290,435
-------------
2,500 		60,000
-------------
0 		28,452
-------------
0 		10,250
-------------
0 		34,624
-------------
0 		423,761
-------------
2,500 		0
-------------
0
4Angelia Martin MD
 
Director 		(i)

(ii)		 0
-------------
271,453 		0
-------------
36 		0
-------------
2,567 		0
-------------
5,627 		0
-------------
32,224 		0
-------------
311,907 		0
-------------
0
5Michael Pulido
 
Former COO/Secretary 		(i)

(ii)		 0
-------------
1,255,487 		0
-------------
0 		0
-------------
2,815 		0
-------------
8,102 		0
-------------
26,529 		0
-------------
1,292,933 		0
-------------
519,516
6Mark Laney MD
 
Former Director/President/CEO 		(i)

(ii)		 0
-------------
3,027,894 		0
-------------
228 		0
-------------
3,991 		0
-------------
8,220 		0
-------------
19,316 		0
-------------
3,059,649 		0
-------------
1,973,799
7Dwain Stilson
 
Former CFO/Treasurer 		(i)

(ii)		 0
-------------
157,169 		0
-------------
550 		0
-------------
250 		0
-------------
0 		0
-------------
5,073 		0
-------------
163,042 		0
-------------
74,404
8Karen S Miller
 
Former CFO/Treasurer 		(i)

(ii)		 0
-------------
178,284 		0
-------------
0 		0
-------------
807 		0
-------------
7,236 		0
-------------
5,513 		0
-------------
191,840 		0
-------------
0
9Davin Turner DO
 
Chief Administrative Officer 		(i)

(ii)		 194,479
-------------
160,388 		35,973
-------------
0 		2,152
-------------
646 		5,866
-------------
2,433 		8,053
-------------
4,602 		246,523
-------------
168,069 		63,730
-------------
0
10Michael R Rinard
 
Secretary 		(i)

(ii)		 0
-------------
213,676 		0
-------------
58,812 		0
-------------
1,361 		0
-------------
9,254 		0
-------------
32,412 		0
-------------
315,515 		0
-------------
0
11Thomas Bieterman
 
Former CFO/Treasurer 		(i)

(ii)		 0
-------------
166,756 		0
-------------
261 		0
-------------
0 		0
-------------
0 		0
-------------
2,972 		0
-------------
169,989 		0
-------------
0
12Gene A Claycomb
 
President of Mosaic Medical Center 		(i)

(ii)		 344,147
-------------
0 		94,682
-------------
0 		4,526
-------------
0 		10,588
-------------
0 		35,974
-------------
0 		489,917
-------------
0 		0
-------------
0
13Mohan R Hindupur MD
 
Staff Physician 		(i)

(ii)		 892,550
-------------
0 		324,198
-------------
0 		11,556
-------------
0 		12,200
-------------
0 		21,586
-------------
0 		1,262,090
-------------
0 		0
-------------
0
14Rony M Abou-Jawde MD
 
Staff Physician 		(i)

(ii)		 950,484
-------------
0 		872,186
-------------
0 		27,512
-------------
0 		10,250
-------------
0 		30,224
-------------
0 		1,890,656
-------------
0 		0
-------------
0
15Jonathan Amspacher MD
 
Staff Physician 		(i)

(ii)		 543,784
-------------
0 		555,594
-------------
0 		16,733
-------------
0 		10,250
-------------
0 		29,912
-------------
0 		1,156,273
-------------
0 		0
-------------
0
16Gopichand Pendurti MD
 
Staff Physician 		(i)

(ii)		 416,102
-------------
0 		684,371
-------------
0 		1,572
-------------
0 		9,758
-------------
0 		37,874
-------------
0 		1,149,677
-------------
0 		0
-------------
0
17Andrew Walker MD
 
Staff Physician 		(i)

(ii)		 879,572
-------------
0 		159,500
-------------
0 		29,192
-------------
0 		10,250
-------------
0 		29,520
-------------
0 		1,108,034
-------------
0 		0
-------------
0
Schedule J (Form 990) 2022

Schedule J (Form 990) 2022
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation COMPENSATION IS ESTABLISHED BY MOSAIC HEALTH SYSTEM, A RELATED ENTITY, USING THE FOLLOWING: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. COMPENSATION SURVEYS OR STUDIES 4. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
Schedule J, Part I, Line 4a Severance or change-of-control payment Mosaic Health System, a related organization, paid Samuel Mark Laney, CEO, severance payments during calendar year 2022. This is reported on Form 990, Part VII and Schedule J, Part II as other reportable compensation. Mosaic Health System, a related organization, paid Michael Pulido, COO, severance payments during calendar year 2022. This is reported on Form 990, Part VII and Schedule J, Part II as other reportable compensation.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan JOHN M POORE - VESTED $0; ACCRUED $116,667 MICHAEL RINARD - VESTED $0; ACCRUED $31,360 DAVIN TURNER - VESTED $0; ACCRUED $21,000 GENE CLAYCOMB - VESTED $0; ACCRUED $50,400 THOSE LISTED ABOVE HAVE SIGNED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN WHICH RECOGNIZES THE VALUE OF THE INDIVIDUAL AND THE MUTUAL BENEFIT OF CONTINUED EMPLOYMENT FOR AN EXTENDED PERIOD OF TIME BY ESTABLISHING A 457F PLAN. THE FOLLOWING ARE THE GENERAL STIPULATIONS OF THE AGREEMENT: 1. THE PLAN IS FUNDED YEARLY AS THE RESULT OF A CALCULATION DESCRIBED IN THE AGREEMENT, WHICH WILL REWARD THE INDIVIDUAL WITH 100% VESTING BASED ON A 5-YEAR CLIFF VESTING SCHEDULE. 2. FOR SERP PARTICIPANTS PRIOR TO 2019, DISTRIBUTION WILL OCCUR UPON DEATH OR UPON SEPARATION FROM SERVICE DUE TO DISABILITY OR UPON INVOLUNTARY SEPARATION FROM SERVICE WITHOUT CAUSE. THEN A LUMP SUM PAYMENT WILL BE DISBURSED WITHIN 90 DAYS OF EACH SITUATION TAKING INTO CONSIDERATION A NON-COMPETE COVENANT. 3. FOR SERP PARTICIPANTES AFTER 2019, DISTRIBUTION WILL OCCUR UPON DEATH OR UPON SEPARATION FROM SERVICE DUE TO DISABILITY OR UPON INVOLUNTARY SEPARATION FROM SERVICE WITHOUT CAUSE. THEN A LUMP SUM PAYMENT DISTRIBUTES WITHIN 60 DAYS AND DOESN'T TAKE INTO ACCOUNT NON-COMPETE COVENANT. 4. SEPARATION WITH CAUSE MAKES THE SUPPLEMENTAL EXECUTIVE RETIREMENT AGREEMENT NULL AND VOID.
Schedule J (Form 990) 2022

Additional Data


Software ID: 22016089
Software Version: 2022v5.0
Schedule L
(Form 990)
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, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
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), section 501(c)(4), and section 501(c)(29) 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) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by 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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting 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 assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990) 2021
Schedule L (Form 990) 2021
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) RYAN FRAZER
  		RYAN FRAZER IS THE SON OF GARY FRAZER 19,169 RYAN FRAZER IS AN ATHLETIC TRAINER AT HEARTLAND REGIONAL MEDICAL CENTER AND IS THE SON OF GARY FRAZER, WHO IS A BOARD MEMBER FOR THE HEARTLAND REGIONAL MEDICAL CENTER. COMPENSATION IS WITHIN FAIR MARKET VALUE RANGE. THIS AMOUNT INCLUDES SALARY AND OTHER COMPENSATION FOR A PATIENT EXPERIENCE COORDINATOR.   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990) 2021


Additional Data


Software ID: 22016089
Software Version: 2022v5.0




SCHEDULE O
(Form 990)

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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Heartland Regional Medical Center
 
Employer identification number

44-0545289
Return Reference Explanation
Form 990, Part I, Line 4 & Form 990, Part VI, Section A, Line 1B THE FOLLOWING HEARTLAND REGIONAL MEDICAL CENTER DIRECTORS ARE NOT INDEPENDENT DUE TO TRANSACTIONS DISCLOSED ON THE FORM 990, SCHEDULE L: GARY FRAZER. THE FOLLOWING HEARTLAND REGIONAL MEDICAL CENTER DIRECTORS ARE NOT INDEPENDENT DUE TO TRANSACTIONS DISCLOSED ON THE MOSAIC HEALTH SYSTEM'S, a related organization, FORM 990, SCHEDULE L: THOMAS RICHMOND.
Form 990, Part I, Line 13 THE REPORTING ORGANIZATION DETERMINED IT WOULD REPORT NET ASSET TRANSFERS BETWEEN RELATED ORGANIZATIONS AS CONTRIBUTION REVENUE (OR GRANT EXPENSE).
Form 990, Part VI, Line 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS MICHAEL RINARD, DREW KEESBURY, DAVIN TURNER, AND JOHN M. POORE HAVE A BUSINESS RELATIONSHIP.
Form 990, Part VI, Line 6 Classes of members or stockholders MOSAIC HEALTH SYSTEM, A MISSOURI NONPROFIT CORPORATION, IS THE SOLE MEMBER OF HEARTLAND REGIONAL MEDICAL CENTER.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Heartland Regional Medical Center Board members are identical to the Mosaic Health System board, and Mosaic Health System is the sole member of Heartland Regional Medical Center. This gives the board members the ability to select the board.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders THE SOLE MEMBER (MOSAIC HEALTH SYSTEM) SHALL HAVE THE FOLLOWING POWERS: OVERALL STRATEGIC DIRECTION (EXCLUDING MATTERS RELATED PRIMARILY TO THE ACCOUNTABLE CARE ORGANIZATION (ACO) OPERATED BY THE HOSPITAL, INCLUDING SPECIFICALLY ANY MEDICARE SHARED SAVINGS PROGRAM CREATED UNDER THE AFFORDABLE CARE ACT), APPOINTMENT OF AUDITORS AND LEGAL COUNSEL, ESTABLISHMENT OF BANKING RELATIONSHIPS AND MANAGEMENT OF CASH AND OTHER ASSETS (EXCLUDING ACO SHARED SAVINGS DISTRIBUTIONS AND REPAYMENT OF SHARED LOSSES), LONG-RANGE PLANNING, ADOPTION OF ANNUAL OPERATING PLANS AND APPLICATION FOR CERTIFICATES OF NEED.
Form 990, Part VI, Line 11b Review of form 990 by governing body THE ACCOUNTING STAFF OF THE ORGANIZATION PREPARES THE FORM 990 AND SUBMITS A DRAFT TO AN INDEPENDENT ACCOUNTING FIRM. THE INDEPENDENT ACCOUNTING FIRM REVIEWS THE FORM 990 WITH INFORMATION PROVIDED FROM THE ORGANIZATION'S ACCOUNTING STAFF. THE DRAFT FORM 990 IS REVISED FOR ANY CORRECTIONS OR CLARIFICATIONS BASED ON THE REVIEW BY THE INDEPENDENT ACCOUNTING FIRM. THEN THE FORM 990 IS REVIEWED BY THE ORGANIZATIONS LEADERSHIP FOR ANY QUESTIONS AND CONCERNS. AFTER RESOLVING QUESTIONS AND CONCERNS WITH LEADERSHIP AND THE ACCOUNTING FIRM, THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN PRESENTED TO BOARD FOR APPROVAL. ONCE APPROVED THEN THE 990 TAX RETURN IS ELECTRONICALLY FILED.
Form 990, Part VI, Line 12c Conflict of interest policy THIS CONFLICTS OF INTEREST AND DOCUMENTATION POLICY ("POLICY") APPLIES TO ALL DIRECTORS AND OFFICERS OF THE ORGANIZATION AND ANY OTHER PERSON WHO IS IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE DECISIONS AND AFFAIRS OF THE ORGANIZATION (COLLECTIVELY, "COVERED PERSONS"). DUTY TO DISCLOSE IF AN INTERESTED PERSON HAS A POSITION OR FINANCIAL INTEREST IN ANY BUSINESS OR OTHER ENTITY WITH WHICH THE ORGANIZATION IS CONSIDERING ENTERING INTO AN ARRANGEMENT OR TRANSACTION, THE INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER POSITION OR FINANCIAL INTEREST AND ALL MATERIAL FACTS RELATED THERETO TO THE ORGANIZATION'S BOARD OF DIRECTORS (THE "BOARD") OR EXECUTIVE COMMITTEE AS SOON AS THE INTERESTED PERSON HAS KNOWLEDGE OF THE POTENTIAL ARRANGEMENT OR TRANSACTION, AND WHENEVER REQUESTED BY THE BOARD OR THE EXECUTIVE COMMITTEE. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS AFTER DISCLOSURE OF A POSITION OR A FINANCIAL INTEREST BY AN INTERESTED PERSON, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE INTERESTED PERSON (INCLUDING THOSE INTERESTED PERSONS WHO ARE MEMBERS OF THE BOARD OR EXECUTIVE COMMITTEE) WILL LEAVE THE BOARD MEETING WHILE THE DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS IN CONNECTION WITH THE PROPOSED TRANSACTION IS DISCUSSED BY THE BOARD OR THE EXECUTIVE COMMITTEE AND VOTED UPON. A POSITION OR A FINANCIAL INTEREST WILL BE CONSIDERED A CONFLICT OF INTEREST ONLY IF THE BOARD OR THE EXECUTIVE COMMITTEE MAKES SUCH DETERMINATION. AN INTERESTED PERSON IS CONSIDERED TO HAVE A CONFLICT OF INTEREST WITH RESPECT TO HIS OR HER COMPENSATION IF THE PERSON RECEIVES COMPENSATION FROM THE ORGANIZATION AND THE PERSON'S COMPENSATION IS BEING DISCUSSED OR REVIEWED BY THE BOARD OR ANY COMMITTEE THEREOF. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST -BEFORE ANY DISCUSSION AND VOTE ON WHETHER A CONFLICT OF INTEREST EXISTS, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OR THE EXECUTIVE COMMITTEE REGARDING THE INTERESTED PERSON'S POSITION OR FINANCIAL INTEREST. AFTER SUCH PRESENTATION, THE INTERESTED PERSON WILL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE PROPOSED TRANSACTION. -THE BOARD OR THE EXECUTIVE COMMITTEE WILL UNDERTAKE APPROPRIATE DUE DILIGENCE AND INFORM ITSELF OF ALL MATERIAL INFORMATION REASONABLY AVAILABLE TO IT AND EXPLORE ALL REASONABLE ALTERNATIVES TO THE PROPOSED TRANSACTION THAT WOULD NOT INVOLVE THE CONFLICT OF INTEREST. -IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OR THE EXECUTIVE COMMITTEE WILL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE PROPOSED TRANSACTION IS (I) IN THE ORGANIZATION'S BEST INTEREST, (II) FOR THE ORGANIZATION'S OWN BENEFIT, AND (III) FAIR AND REASONABLE TO THE ORGANIZATION. IN CONFORMITY WITH THIS DETERMINATION, THE BOARD WILL MAKE ITS DECISION AS TO WHETHER THE ORGANIZATION MAY ENTER INTO THE PROPOSED TRANSACTION. QUORUM FOR BOARD OR EXECUTIVE COMMITTEE ACTION FOR PURPOSES OF THE BOARD OR EXECUTIVE COMMITTEE ACTIONS TO BE TAKEN UNDER THESE PROCEDURES, INCLUDING THE DETERMINATION WHETHER A CONFLICT OF INTEREST EXISTS, A MAJORITY OF THE DISINTERESTED DIRECTORS ON THE BOARD OR THE EXECUTIVE COMMITTEE WILL CONSTITUTE A QUORUM. HOWEVER, IN NO CASE WILL A SINGLE DISINTERESTED DIRECTOR TAKE ANY SUCH ACTION. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY IF THE BOARD OR THE EXECUTIVE COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO DISCLOSE A POSITION OR A FINANCIAL INTEREST, IT WILL INFORM THE COVERED PERSON OF THE BASIS FOR SUCH BELIEF AND AFFORD THE COVERED PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE COVERED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED UNDER THE CIRCUMSTANCES, THE BOARD OR THE EXECUTIVE COMMITTEE DETERMINES THAT THE COVERED PERSON HAS IN FACT FAILED TO DISCLOSE A POSITION OR A FINANCIAL INTEREST, THE BOARD OR THE EXECUTIVE COMMITTEE WILL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. DOCUMENTATION IN MINUTES THE MINUTES OF THE BOARD OR THE EXECUTIVE COMMITTEE WILL CONTAIN: -WITH RESPECT TO THE DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS, THE NAME OF THE INTERESTED PERSON WHO DISCLOSED OR WAS OTHERWISE FOUND TO HAVE A POSITION OR FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST; THE NATURE OF THE POSITION OR FINANCIAL INTEREST; ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT; AND THE BOARD OR THE EXECUTIVE COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED. -WITH RESPECT TO WHETHER OR NOT THE CONFLICT OF INTEREST TRANSACTION IS APPROVED, THE NAMES OF THE PERSONS PRESENT FOR THE DISCUSSIONS AND VOTE RELATED TO THE PROPOSED TRANSACTION; THE CONTENT OF THE DISCUSSION; WHETHER ALTERNATIVES WERE DISCUSSED THAT DID NOT INVOLVE A CONFLICT OF INTEREST; THE BASIS FOR THE DETERMINATION THAT THE PROPOSED TRANSACTION WAS (I) IN THE ORGANIZATION'S BEST INTEREST, (II) FOR THE ORGANIZATION'S OWN BENEFIT, AND (III) FAIR AND REASONABLE TO THE ORGANIZATION; AND THE RECORD OF THE VOTE TAKEN IN CONNECTION WITH THE PROCEEDINGS. ANNUAL STATEMENTS EACH COVERED PERSON WILL ANNUALLY SIGN A STATEMENT THAT AFFIRMS SUCH PERSON: -HAS RECEIVED A COPY OF THIS POLICY; -HAS READ AND UNDERSTANDS THE POLICY; -HAS AGREED TO COMPLY WITH THE POLICY; AND -UNDERSTANDS THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX AND TO MAINTAIN ITS FEDERAL TAX EXEMPTION THE ORGANIZATION MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IN ADDITION, EACH COVERED PERSON WILL ANNUALLY COMPLETE, SIGN AND PROMPTLY RETURN TO THE BOARD A QUESTIONNAIRE AND DISCLOSURE STATEMENT SUBSTANTIALLY IN THE FORM ATTACHED HERETO. A COVERED PERSON NEED NOT DISCLOSE COMPENSATION PAID TO THE COVERED PERSON BY ORGANIZATION PURSUANT TO A RESOLUTION OF THE BOARD.
Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. ALL OF THESE DOCUMENTS ARE LOCATED IN ADMINISTRATION.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other Revenue - Total Revenue: 6150292, Related or Exempt Function Revenue: 6150292, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part X, Column (B) Line 1 and Line 28 IN TAX YEAR 2022, HEARTLAND REGIONAL MEDICAL CENTER (MOSAIC-ST. JOSEPH) DETERMINED THAT IT WAS MORE APPROPRIATE TO INCLUDE IN COLUMN (B) (END OF YEAR) FOR LINE 1 AND LINE 28 (NET ASSETS WITH DONOR RESTRICTIONS) CERTAIN IMMATERIAL ITEMS NOT INCLUDED WITHIN THE FINAL AUDIT REPORT.
Form 990, Part XII, Line 2c Financial Statements and Reporting The results of the consolidated audit are reviewed by the Mosaic Health System Board, the parent corporation.
Schedule H, Part I, Line 7h Mosaic Life Care's Clinical Research Program provides alternative treatment options when standard of care has failed. These patients may not have access to other treatments. Clinical Research coordinators seamlessly provide care for patients outside of normal treatment options. Clinical research is an important part of any medical care because it helps advance the sciences developed to treat and ultimately lead to management, and a possible cure, for multiple diagnosis. The clinical research department at Mosaic Life Care provides education to the community on the types of clinical research we can provide which includes pharmaceuticals, medical devices, case studies, retrospective chart reviews, prospective trials, humanitarian device trials, compassionate use trials, emergency use trials and much more. The Research team will assist the patients in proper screening and determine eligibility.
Schedule H, Part V, Section B, Line 16a FAP Website URL https://www.mymlc.com/Main/Location/st-joseph-mo/mosaic-life-care-at-st.-joseph-medical-center/main-medical-center/medical-bills-made-easy/financial-assistance/
Schedule H, Part V, Section B, Line 16b FAP Application Form https://www.mymlc.com/Main/Location/st-joseph-mo/mosaic-life-care-at-st.-joseph-medical-center/main-medical-center/medical-bills-made-easy/financial-assistance/
Schedule H, Part V, Section B, Line 16c FAP Plain Language Summary https://www.mymlc.com/Main/Location/st-joseph-mo/mosaic-life-care-at-st.-joseph-medical-center/main-medical-center/medical-bills-made-easy/financial-assistance/
FORM 990, PART VI, SECTION B, LINE 15A & 15B COMPENSATION IS ESTABLISHED BY MOSAIC HEALTH SYSTEM, A RELATED ENTITY. AN ANNUAL REVIEW WAS PERFORMED DURING THE PRIOR FISCAL YEAR. MARKET DATA WAS PROVIDED BY A THIRD PARTY COMPENSATION CONSULTANT THAT SPECIALIZES IN MARKET SALARY DATA. A COMPENSATION COMMITTEE COMPRISED OF MOSAIC HEALTH SYSTEM BOARD CHAIR, MOSAIC HEALTH SYSTEM BOARD VICE-CHAIR AND THREE ADDITIONAL MOSAIC HEALTH SYSTEM BOARD MEMBERS AND INDEPENDENT LEGAL COUNSEL, AS SCRIBE, OVERSAW AN ANNUAL SALARY REVIEW PROCESS FOR OFFICERS AND ADMINISTRATORS. FOR EACH POSITION TO BE REVIEWED, THE FULL SCOPE OF DUTIES AND RESPONSIBILITIES, NUMBERS OF STAFF MANAGED, PROCESSES MANAGED, APPROXIMATE REVENUE, EXPENSE, OR CAPITAL DOLLARS MANAGED WERE PROVIDED TO THE THIRD PARTY CONSULTANT. FACILITY SIZE, NOT-FOR-PROFIT STATUS AND THE SCOPE OF EACH JOB POSITION WERE COMPARED TO LIKE FACILITIES TO DETERMINE BASE COMPENSATION AND INCENTIVE COMPENSATION FOR EACH POSITION. THE DATA GATHERED BY THE THIRD PARTY CONSULTANT WAS REVIEWED BY THE COMPENSATION COMMITTEE, OUTLIER ISSUES WERE RESOLVED AND, BASED UPON PRESENT FINANCIAL INDICATORS, THE COMMITTEE MADE ITS DETERMINATION OF COMPENSATION LEVELS FOR THE NEXT PAY YEAR.
Form 990, Part X Effective January 1, 2020, Mosaic Health System (the parent) was assigned and assumed certain assets and liabilities from its subsidiaries. As the system manager, the Parent's mission is to manage the exempt public charities in the health care system as a "supporting organization" within the meaning of Sections 501(c)(3) and 509(a)(3) of the Internal Revenue Code.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


Additional Data


Software ID: 22016089
Software Version: 2022v5.0
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2021
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 (if applicable) 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
5325 Faraon Street
St Joseph,MO64506
 Development MO 0 0 HRMC
 
(2) Urgent Care Properties LLC
5325 Faraon Street
St Joseph,MO64506
 Development MO 0 0 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 entity?
Yes No
(1)Mosaic Health System (MHS)
5325 Faraon Street

St Joseph,MO64506
43-1283316 		Healthcare MO 501(c)(3) Type II NA
 
 
No
(2)Heartland Foundation (MOSAIC LIFE CARE FOUNDATION)
5325 Faraon Street

St Joseph,MO64506
43-1262768 		Support MO 501(c)(3) 7 Mosaic Health System
 
Yes
 
(3)Heartland Long Term Acute Care Hospital (HLTACH)
5325 Faraon Street

St Joseph,MO64506
26-1972987 		Healthcare MO 501(c)(3) 3 Mosaic Health System
 
Yes
 
(4)Northwest Medical Center Association Inc (MOSAIC-ALBANY)
705 North College Street

Albany,MO64402
44-0580870 		Healthcare MO 501(c)(3) 3 Mosaic Health System
 
Yes
 
(5)Northwest Medical Center Foundation Inc (NMC FOUNDATION)
705 North College Street

Albany,MO64402
47-3694893 		Support MO 501(c)(3) Type I Northwest Medical Center Association Inc
 
Yes
 
(6)Mosaic Medical Center-Maryville (MOSAIC-MARYVILLE)
5325 Faraon Street

St Joseph,MO64506
83-2249459 		Healthcare MO 501(c)(3) 3 Mosaic Health System
 
Yes
 


For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) ST JOSEPH DOWNTOWN DEVELOPMENT LLC

5325 FARAON STREET
ST JOSEPH,MO64506
47-4317460 		DEVELOPMENT OF DOWNTOWN ST. JOSEPH MO NA
  		N/A                












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
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) Midwestern Health Management Inc

5325 Faraon Street
St Joseph,MO64506
43-1264358 		Healthcare MO NA
  		C Corporation       Yes  
(2) HHS Properties Inc

5325 Faraon Street
St Joseph,MO64506
43-1593799 		Investment MO NA
  		C Corporation       Yes  
(3) Uptown Housing Inc

5325 Faraon Street
St Joseph,MO64506
26-1416252 		Redevelopment MO HRMC
  		C Corporation     100 % Yes  
(4) Uptown St Joseph Redevelopment Corp

5325 Faraon Street
St Joseph,MO64506
20-1742813 		Redevelopment MO HRMC
  		C Corporation     100 % Yes  






Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
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, or (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
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
Yes
 
h Purchase of assets from related organization(s) ............................
1h
Yes
 
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
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 related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) Mosaic Health System (MHS)

 M 108,751,140 FMV
(2) Mosaic Health System (MHS)

 P 284,481,129 FMV
(3) Heartland Foundation (MLC Foundation)

 B 554,013 FMV
(4) HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH)

 J 672,880 FMV
(5) HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH)

 L 2,969,188 FMV
(6) Northwest Medical Center Association Inc (Mosaic-Albany)

 P 3,265,618 FMV
(7) Heartland Foundation (MLC Foundation)

 Q 467,096 FMV
(8) MOSAIC MEDICAL CENTER-MARYVILLE (MOSAIC-MARYVILLE)

 Q 3,409,305 FMV
(9) HHS Properties Inc

 K 271,432 FMV
(10) HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH)

 Q 1,759,187 FMV
(11) MOSAIC HEALTH SYSTEM (MHS)

 G 695,659 FMV
(12) Heartland Foundation (MLC Foundation)

 C 2,304,557 FMV
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) 2021
Schedule R (Form 990) 2021
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
Schedule R (Form 990) 2021

Additional Data


Software ID: 22016089
Software Version: 2022v5.0