2025-05-12T10:13:28+00:00 2024-06-30 420714325 RSM US LLP 4650 East 53rd Street Davenport IA 52807 990 2023-07-01 832249459 Mosaic Medical Center Maryville MOSA 8162717070 5325 Faraon Street Saint Joseph MO 64506 Drew Keesbury Officer 8162717070 2025-05-12 true true Jenifer L Chase P01306883 5638884000 2025-05-12 2023 2025-03-06 01:10:19Z Drew Keesbury 5325 Faraon Street Saint Joseph MO 64506 87961037 false X https://www.mymlc.com/Main/Location/maryville-mo/mosaic-medical-center-maryville/ X 2018 MO TO IMPROVE POPULATION HEALTH OUTCOMES IN OUR REGION BY PROVIDING THE RIGHT CARE, AT THE RIGHT TIME, PLACE AND COST. 5 2 521 56 35806 25264 10288013 2734756 79942543 84291018 -22110 18103 1537757 866062 91746203 87909939 41105 54106 0 42932698 45273046 0 0 48460108 47291642 91433911 92618794 312292 -4708855 51033011 49419939 25238028 27589318 25794983 21830621 TO IMPROVE POPULATION HEALTH OUTCOMES IN OUR REGION BY PROVIDING THE RIGHT CARE, AT THE RIGHT TIME, PLACE AND COST. false false 75798038 54106 85121274 MOSAIC MEDICAL CENTER-MARYVILLE (MOSAIC-MARYVILLE) IS A 35-BED MEDICAL SURGICAL HOSPITAL LOCATED IN MARYVILLE, MISSOURI. IT SERVES A COMMUNITY OF 10,300 RESIDENTS. BECAUSE MARYVILLE 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-MARYVILLE OF APPROXIMATELY 67.47% GOVERNMENTAL OR NO-PAY PATIENTS. MOSAIC-MARYVILLE PROVIDES A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES INCLUDING VASCULAR, ORTHOPEDIC AND GENERAL SURGERIES, AND MENTAL HEALTH SERVICES. IT OPERATES A 24-HOUR EMERGENCY ROOM, AND AN OBSTETRICS DEPARTMENT PROVIDES 4 LABOR/DELIVERY/RECOVERY/POST-PARTUM BEDS. MOSAIC-MARYVILLE reduced the bed count from 81 to 35 in anticipation of obtaining a CRITICAL ACCESS HOSPITAL designation in FY2025. DURING FY24, APPROXIMATELY 1,400 PATIENTS WERE ADMITTED TO MOSAIC-MARYVILLE RESULTING IN APPROXIMATELY 6,750 PATIENT DAYS. A TOTAL OF APPROXIMATELY 1,900 SURGERIES WERE PERFORMED, THE EMERGENCY ROOM SERVED APPROXIMATELY 8,039 PATIENTS AND APPROXIMATELY 90,000 VISITS WERE GENERATED BY OUTPATIENTS. THERE WERE APPROXIMATELY 101,200 PATIENT VISITS DURING THE YEAR. OTHER PROGRAM SERVICES: THE MOSAIC MEDICAL CENTER-MARYVILLE HAS A 340B DESIGNATION FROM HEALTH RESOURCES AND SERVICES ADMINISTRATION (FEDERAL GOVERNMENT). THIS ALLOWS MOSAIC-MARYVILLE 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. 75798038 true true false true false false false false false true false true true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true 53 0 true 521 true true true false false false false false false false false false false X 5 2 true false false false true true true true true false false true true true true true true false false false X Drew Keesbury 8162717070 5325 Faraon Street St Joseph MO 64506 John M Poore Director/Chair 1.0 37.0 X X 0 1136919 39911 Davin Turner DO Director/Vice Chair 1.0 37.0 X 0 645499 43162 Gene A Claycomb Director/Vice Chair 1.0 38.0 X 0 418503 44902 Matt Baker Director 1.0 3.0 X 0 2500 0 Serena Naylor Director 1.0 4.0 X 0 2500 0 Drew Keesbury CFO/Treasurer 1.0 36.0 X 0 459172 17432 Michael R Rinard Secretary 1.0 36.0 X 0 281508 44915 Nathan Blackford President 40.0 0 X 336218 0 71455 Benjamin Kinderknecht DO Staff Physician 40.0 0 X 472520 0 42311 John T Symonds DO Staff Physician 40.0 0 X 525072 0 36534 Lorraine Dodson MD Staff Physician 40.0 0 X 521271 0 21946 Timothy J Monahan MD Staff Physician 40.0 0 X 716215 0 47011 William J Kinderknecht DO Staff Physician 40.0 0 X 616192 0 42311 Mark Laney MD Former Director/CEO 0.0 0.0 X 0 1061154 0 Michael Pulido Former Secretary/Director/Chair 0.0 0.0 X 0 590338 20738 Thomas Bieterman Former CFO/Treasurer 0.0 0.0 X 0 185860 12817 3187488 4783953 485445 52 true true false PATRICK CASADY DBA CASADY CONTRACTING 27811 275th St Maryville MO 64468 Cleaning Services 288299 OSHS CONSTRUCTION 8 BELMONT RD ST JOSEPH MO 64505 BUILDING SERVICES 257045 MOBILE SURGICAL SOLUTIONS LLC 5202 Faraon St St Joseph MO 64506 Medical Services 126000 3 2314378 18051 402327 2734756 Net Patient Service Revenue 621110 80796608 80796608 340B Pharmacy Revenue 621110 3494410 3494410 0 0 0 0 84291018 21481 21481 54945 54945 0 54945 54945 47720 51098 0 -3378 -3378 -3378 Other Misc Revenue 900099 448741 448741 Cafeteria Revenue 722514 324469 324469 Referral Lab Revenue 621511 37907 2101 35806 0 0 0 0 811117 87909939 85121274 35806 18103 54106 54106 421640 0 421640 0 36668392 35432336 1236056 907497 880791 26706 5065660 4710653 355007 2209857 2102708 107149 15061 15061 4447539 3995551 451988 0 9236 6136 3100 2767530 2117795 649735 951375 920039 31336 1168517 130238 1038279 105179 91163 14016 61903 45868 16035 619411 3204 616207 2771088 1796295 974793 1141956 1141956 Corporate Allocations From Mosaic Health System 15437021 4631107 10805914 Medical Supplies/Includes 340B 15238485 15238485 FRA Tax 2486064 2486064 Dues and Subscriptions 71277 13543 57734 0 0 0 0 92618794 75798038 16820756 0 24918 29191 14789529 11967234 0 0 0 0 1832251 1898223 852771 741232 32543530 9843566 22190508 22699964 0 7648472 8392965 1459667 1046224 2234895 2644906 51033011 49419939 4624336 5100667 0 0 20613692 22488651 25238028 27589318 X 18146511 13437655 7648472 8392966 25794983 21830621 51033011 49419939 X -4708855 1095347 -350854 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 15061 15061 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY PORTION OF DUES PAID TO HOSPITAL ASSOCIATIONS THAT ARE USED FOR LOBBYING PURPOSES BY THE HOSPITAL ASSOCIATIONS. 32.40% of the membership dues paid to the Missouri Hospital Association are used for lobbying activities. 32.00% of the membership dues paid to the American Hospital Association are used for lobbying activities. 600000 600000 18969696 3246103 15723593 518259 70753 447506 9777933 5325009 4452924 2677642 1201701 1475941 22699964 St Francis Foundation Investments 8392965 F 8392965 Long Term Investments 2644906 2644906 Due To Affiliates 22488651 22488651 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote MOSAIC HEALTH SYSTEM, HEARTLAND REGIONAL MEDICAL CENTER (MOSAIC-ST. JOSEPH), MOSAIC MEDICAL CENTER-MARYVILLE (MOSAIC-MARYVILLE), NORTHWEST MEDICAL CENTER ASSOCIATION, INC. (MOSAIC-ALBANY), HEARTLAND LONG-TERM ACUTE CARE HOSPITAL (HLTACH), MOSAIC LIFE CARE FOUNDATION, AND NORTHWEST MEDICAL CENTER FOUNDATION (ALBANY FOUNDATION) 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, 2024, 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 $7.2M 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 $1.8M 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, 2024 AND 2023, THERE WERE NO UNCERTAIN TAX POSITIONS IDENTIFIED AND RECORDED AS A LIABILITY. true true X true X true X true true true false false 2464262 2464262 0.0266 13505305 11738697 1766608 0.0191 0 0.0 0 0 15969567 11738697 4230870 0.0457 144672 1890 142782 0.0015 22187 22187 0.0002 0 0.0 0 0.0 139097 139097 0.0015 0 0 305956 1890 304066 0.0033 0 0 16275523 11740587 4534936 0.0489 0 0.0 0 0.0 211844 6354 205490 0.0022 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 211844 6354 205490 0.0022 false 4661288 0 14887035 18649896 -3762861 X true true 1 1 Mosaic Medical Center-Maryville 2016 South Main Maryville MO 64468 www.mymlc.com/Main/Location/maryville-mo/mosaic-medical-center-maryville/ 559-4 X X X X Mosaic Medical Center-Maryville 1 false false true X X X X X X X X X 21 true false false true X https://www.mymlc.com/General/Community-Health-Needs-Assessment/maryville-community-health-needs-ass X true 21 true https://www.mymlc.com/General/Community-Health-Needs-Assessment/maryville-community-health-needs-ass false true X 200.0 300.0 X true true X X X X true X SEE SCHEDULE O X SEE SCHEDULE O X SEE SCHEDULE O X X X X X X true X false X X X X X true X false false Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY ARE A PRIORITIZED DESCRIPTION OF VARIOUS FACTORS INCLUDING: - MENTAL HEALTH; AND - ADULT AND CHILDHOOD OBESITY 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 - MOSAIC MEDICAL CENTER MARYVILLE (MOSAIC-MARYVILLE). Mosaic Medical Center - Maryville (MOSAIC-MARYVILLE) offers both inpatient and outpatient services including Emergency Care, plus convenient clinics and specialty care services. We seek to improve the health of area individuals and communities and to provide the right care, at the right time, in the right place, at the right cost with outcomes second to none. THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS PREPARED BY MOSAIC-MARYVILLE. THE CHNA WAS CONDUCTED DURING TAX YEAR 2021, TO DETERMINE SERVICES NEEDED BY THE MEDICALLY UNDERSERVED. THE FOLLOWING TWO NEEDS WERE CHOSEN TO BE ADDRESSED OVER THE NEXT THREE YEARS: - MENTAL HEALTH, - ADULT AND CHILDHOOD OBESITY TO ENSURE INPUT WAS TAKEN INTO ACCOUNT FROM PERSONS WHO REPRESENT THE COMMUNITY, MOSAIC-MARYVILLE UTILIZED AN INDEPENDENT CONSULTING FIRM NAMED CROWE, LLP. THIS FIRM HELPED CONDUCT KEY STAKEHOLDER INTERVIEWS AND A COMMUNITY HEALTH SURVEY. KEY STAKEHOLDER INTERVIEWS: COMMUNITY INPUT WAS OBTAINED THROUGH KEY STAKEHOLDER INTERVIEWS PERFORMED WITH LEADERS FROM NINE COMMUNITY ORGANIZATIONS REPRESENTING PUBLIC HEALTH, PUBLIC SCHOOLS, LOCAL GOVERNMENT OFFICIALS, SOCIAL SERVICE ORGANIZATIONS AND NON-PROFIT ORGANIZATIONS. TO ASSURE THE MEDICALLY UNDERSERVED WERE REPRESENTED IN THIS CHNA, INTERVIEWS WERE CONDUCTED WITH REPRESENTATIVES FROM THE FOLLOWING ORGANIZATIONS: 1ST UNITED METHODIST CHURCH, BIG BROTHERS/BIG SISTERS OF NODAWAY COUNTY, COMMUNITY SERVICES INC., MARYVILLE R-II SCHOOL DISTRICT, NODAWAY COUNTY ECONOMIC DEVELOPMENT, NODAWAY COUNTY HEALTH DEPARTMENT, NODAWAY COUNTY SENIOR CENTER, NORTHWEST MISSOURI REGIONAL COUNCIL OF GOVERNMENTS, AND NORTHWEST MISSOURI STATE UNIVERSITY. THESE KEY STAKEHOLDER INTERVIEWS WERE CONDUCTED BETWEEN October 2021 to February 2022. TO ASSURE THAT MEDICALLY UNDERSERVED WERE INCLUDED IN THIS CHNA, INTERVIEWS WERE CONDUCTED WITH AGENCIES SERVING PERSONS WHO ARE HOMELESS, DISABLED, VICTIMS OF DOMESTIC VIOLENCE, UNEMPLOYED AND/OR PERSONS WITH LOW INCOME. COMMUNITY HEALTH SURVEY: MOSAIC-MARYVILLE's most recent CHNA was conducted during its fiscal year ending June 30, 2022 to be on the same CHNA cycle as the other related hospitals in Mosaic Life Care. The majority of respondents were White/Caucasian (99%). The remaining 1% identified with other racial or ethnic identities. THE SAMPLE INCLUDED MEN AND WOMEN, 18 AND OVER. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - MOSAIC MEDICAL CENTER-MARYVILLE (MOSAIC-MARYVILLE). 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 TWO SIGNIFICANT NEEDS IDENTIFIED WERE: 1) MENTAL HEALTH; AND 2) ADULT AND CHILDHOOD OBESITY MOSAIC-MARYVILLE'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 POSITIVELY IMPACT THE SOCIAL DETERMINANTS OF HEALTH, MOSAIC-MARYVILLE CREATED THE FOLLOWING ACTION PLAN FOR POPULATION HEALTH: SIGNIFICANT NEED #1: MENTAL HEALTH PLAN: A) THE ORGANIZATION WILL EXPAND AND CONTINUE CLINIC BEHAVIORAL HEALTH OFFERINGS. B) THE ORGANIZATION WILL CONTINE TO provide support to organizations providing mental health programs to the community. C) THE ORGANIZATION will enhance relationship with Northwest Missouri State University's wellness center regarding behavioral/mental health concerns D) THE ORGANIZATION will work with area schools to raise awareness and provide resources for child and adolescent mental health. E) THE ORGANIZATION will work with area mental health providers and collaborators to identify ways to reduce the stigma of mental illness. F) THE ORGANIZATION will identify and work together with funding sources to support mental health initiatives. SIGNIFICANT NEED #2: ADULT AND CHILDHOOD OBESITY: A) THE ORGANIZATION will continue Healthy Lifestyles and Commit to Be Fit. B) THE ORGANIZATION will continue diabetes education programs and support group. C) THE ORGANIZATION will expand and continue the 4th Grade Challenge programs into all county schools and encourage caregivers to volunteer to participate in this program. D) THE ORGANIZATION will continue health screenings. E) THE ORGANIZATION will increase community education regarding obesity. THE COMPLETE CHNA WITH IMPLEMENTATION STRATEGY CAN BE FOUND AT: HTTPS://www.mymlc.com/General/Community-Health-Needs-Assessment/maryville-community-health-needs-assessment/ Schedule H, Part V, Section B, Line 20 Facility , 1 Facility , 1 - Mosaic Medical Center - Maryville (Mosaic-Maryville). 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. 5 Mosaic Specialty Care - East 114 East South Hills Drive Maryville MO 64468 Behavioral Health and Walk-in Clinic Mosaic Medical Building - Maryville 2024 South Main Street Maryville MO 64468 ENT, Neurology, Wound Care, Gastroenterology, Pulmonary, Vascular Surgery, Home Health, Hospice, etc Mosaic Family Care - Bedford 408 Dodge St Bedford IA 50833 Family Care Mosaic Family Care - Savannah 301 E Price Street Savannah MO 64485 Family Care Mosaic Outpatient Therapy - Maryville 409 West South Hills Drive Maryville MO 64468 Outpatient Therapy & Diabetes Care Schedule H, Part I, Line 3c In FY2024, Mosaic Medical Center-Maryville (Mosaic-Maryville) modified the Financial Assistance Policy (FAP) eligibility criteria to include an asset test. Includable assets, which are assets identified in the FAP, are combined with gross household income and compared to the Federal Poverty Guidelines threshold previously established by Mosaic-Maryville for free or discounted care. Schedule H, Part I, Line 6a Not Applicable Schedule H, Part I, Line 7 Column F 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. Schedule H, Part VI, Line 7 NOT APPLICABLE Schedule H, Part I, Line 7b DURING THE YEAR-ENDED 06/30/2024, MOSAIC MEDICAL CENTER MARYVILLE (MOSAIC-MARYVILLE) increased the estimated FEDERAL REIMBURSEMENT ALLOWANCE program liability related to prior program years by approximately $561,000 thereby decreasing patient service revenue by the same amount. This change in estimate was the result of the state of Missouri providing Mosaic-Maryville final settlement notifications during the year ended June 30, 2024. 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 Subsidized Health Services 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 WORKSHEET 2. Schedule H, Part II Community Building Activities MOSAIC MEDICAL CENTER-MARYVILLE (MOSAIC-MARYVILLE) COMMUNITY BUILDING ACTIVITIES PROMOTED THE HEALTH OF THE COMMUNITIES SERVED BY PROVIDING MANY EDUCATIONAL PROGRAMS TO HELP MAINTAIN A HEALTHY LIFESTYLE. THESE ARE WELL-ADVERTISED AND MOST OF THEM ARE FREE OF CHARGE. IN REGARDS TO THE MENTAL HEALTH SERVICES PROVIDED TO THE COMMUNITY, MOSAIC-MARYVILLE WORKS WITH NORTHWEST MISSOURI STATE UNIVERSITY'S WELLNESS CENTER TO PROVIDE ASSISTANCE AND EDUCATION WITH BEHAVIORAL/MENTAL HEALTH CONCERNS. IN ADDITION, THE ORGANIZATION WORKS WITH AREA SCHOOLS TO RAISE AWARENESS AND PROVIDE RESOURCES FOR CHILD AND ADOLESCENT MENTAL HEALTH. MOSAIC-MARYVILLE HAS PROGRAMS LIKE HEALTHY LIFESTYLES AND COMMIT TO BE FIT TO HELP REDUCE ADULT AND CHILDHOOD OBESITY. ANOTHER PROGRAM IS HEALTH 4 LIFE WHICH PARTICIPATES WITH LOCAL SCHOOLS TO HELP REDUCE OBESITY. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Mosaic Medical Center-Maryville (Mosaic-Maryville) 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 MOSAIC MEDICAL CENTER-MARYVILLE (MOSAIC-MARYVILLE) uses a third party to electronically review a patient's or the guarantor's 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's 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-Maryville. This enables Mosaic-Maryville 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-Maryville to screen all patients for Financial Assistance prior to pursuing any extraordinary collection actions. AS A RESULT, MOSAIC-MARYVILLE 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 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 Mosaic-Maryville'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 Medical Center - Maryville (Mosaic-Maryville) 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 Mosaic-Maryville IS ABSORBING THE ADDITIONAL COST OF PROVIDING CARE TO THE ELDERLY AND DISABLED IN THE COMMUNITY. Mosaic-Maryville's net community benefit expense (Schedule H, Part I, line 7, column (e)) as a percentage is 4.89%, and the percentage increases to 8.96% if Medicare shortfalls (SCHEDULE H, PART III, SECTION B, LINE 7) are included in net community benefit expense. IN ADDITION, THIS COINCIDES WITH THE IRS REVENUE RULING 69-545, WHICH provides general requirements for tax exemption, along with section 501(c)(3) and 501(r). Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Mosaic Medical Center-Maryville (Mosaic-Maryville) FINANCIAL ASSISTANCE POLICY CONTAINS THE ACTIONS Mosaic-Maryville MAY TAKE IN THE EVENT OF A PATIENT'S NON-PAYMENT, INCLUDING COLLECTION ACTIONS AND REPORTING TO CREDIT AGENCIES. THESE ACTIONS APPLY BROADLY TO Mosaic-Maryville PATIENTS, INCLUDING THOSE PATIENTS Mosaic-Maryville KNOWS QUALIFY FOR FINANCIAL ASSISTANCE UNDER ITS FINANCIAL ASSISTANCE POLICY (FAP). UNDER Mosaic-Maryville FAP, PATIENTS MAY RECEIVE FREE OR DISCOUNTED CARE, DEPENDING ON THEIR FINANCIAL QUALIFICATIONS. FOR FAP-ELIGIBLE PATIENTS WITH BALANCES REMAINING AFTER DISCOUNTS, COLLECTION ACTIONS WILL NOT BE TAKEN WITHIN 120 DAYS OF ISSUING THE FIRST POST-DISCHARGE STATEMENT(S). DURING THIS 120-DAY PERIOD, PATIENTS WILL RECEIVE FOUR WRITTEN STATEMENTS. IF FOR SOME REASON A MONTHLY STATEMENT IS RETURNED AS UNDELIVERABLE, Mosaic-Maryville WILL ATTEMPT TO OBTAIN A CORRECT ADDRESS OR REACH THE PATIENT BY TELEPHONE. IF, AFTER 120 DAYS, THE PATIENT HAS NOT REMITTED PAYMENT OR AGREED TO A PAYMENT PLAN WITH Mosaic-Maryville, THE PATIENT ACCOUNT WILL BE TURNED OVER TO A THIRD-PARTY COLLECTION AGENCY. Schedule H, Part V, Section B, Line 16a FAP website - Mosaic Medical Center-Maryville: Line 16a URL: SEE SCHEDULE O; Schedule H, Part V, Section B, Line 16b FAP Application website - Mosaic Medical Center-Maryville: Line 16b URL: SEE SCHEDULE O; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Mosaic Medical Center-Maryville: Line 16c URL: SEE SCHEDULE O; Schedule H, Part VI, Line 2 Needs assessment MOSAIC MEDICAL CENTER-Maryville (MOSAIC-Maryville) 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 Mosaic Medical Center-Maryville (Mosaic-Maryville) INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEGINNING AT THE REGISTRATION DESK AND CONTINUING WITH FINANCIAL ASSISTANCE INFORMATION BEING INCLUDED ON EVERY BILLING STATEMENT A PATIENT OR GUARANTOR RECEIVES FROM THE Mosaic-Maryville. 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 Mosaic Medical Center - Maryville (Mosaic - Maryville) IS A not-for-profit hospital LOCATED IN Maryville, MISSOURI, AND OPERATES CLINICS IN Maryville, Savannah AND Bedford, IA. ITS PRIMARY SERVICE AREA IS PRIMARILY RURAL AND INCLUDES Nodaway COUNTY LOCATED IN NORTHWEST MISSOURI. ACCORDING TO THE 2023 U.S. CENSUS ESTIMATES, THE POPULATION IN THE NODAWAY COUNTY SERVICE AREA IS APPROXIMATELY 20,695, WHICH INCLUDES A HIGH PERCENTAGE OF LOW INCOME FAMILIES. THE ORGANIZATION SUPPORTS A PAYOR MIX OF APPROXIMATELY 67.47% GOVERNMENTAL OR SELF-PAY PATIENTS. Schedule H, Part VI, Line 5 Promotion of community health Mosaic MEDICAL CENTER - Maryville (MOSAIC-Maryville) 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 THE MOSAIC-Maryville RESTS WITH ITS BOARD, WHICH IS PRIMARILY COMPOSED OF MEMBERS OF THE COMMUNITY, IN ADDITION TO A FEW SELECT EMPLOYEES OF MOSAIC-Maryville. MOSAIC-Maryville 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-Maryville 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 SERVICES. MOSAIC-Maryville PROMOTES HEALTH IN THE Maryville REGION IN NUMEROUS WAYS. MOSAIC-Maryville PROVIDED DIRECT FUNDING SUPPORT TO THE COMMUNITY ORGANIZATIONS WITH LIKE MISSIONS INCLUDING COMMUNITY EVENTS AND ACTIVITIES OF LOCAL SCHOOLS AND NURSING HOMES. MOSAIC-Maryville EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. THE ORGANIZATION OFFERS MANY EDUCATIONAL PROGRAMS TO HELP MAINTAIN A HEALTHY LIFESTYLE. THESE ARE WELL-ADVERTISED AND MOST OF THEM ARE FREE OF CHARGE. In regards to the mental health services provided to the community, Mosaic-Maryville works with Northwest Missouri State University's wellness center to provide assistance and education with behavioral/mental health concerns. In addition, the organization works with area schools to raise awareness and provide resources for child and adolescent mental health. Mosaic-Maryville has programs like Healthy Lifestyles and Commit to be Fit to help reduce adult and childhood obesity. Another program is Health 4 Life which participates with local schools to help reduce obesity. 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-Maryville HAS PARTICIPATED IN THIS PROGRAM SINCE 2019. 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 MOSAIC HEALTH SYSTEM (PARENT) IS A MISSOURI NONPROFIT CORPORATION LOCATED IN ST. JOSEPH, MISSOURI, THAT PROVIDES, THROUGH ITS VARIOUS SUBSIDIARIES AND AFFILIATES, AN INTEGRATED HEALTH CARE DELIVERY SYSTEM, INCLUDING INPATIENT AND OUTPATIENT CARE AND PHYSICIAN SERVICES TO RESIDENTS OF NORTHWEST MISSOURI AND ADJACENT AREAS IN IOWA, KANSAS AND NEBRASKA. AS THE SYSTEM MANAGER, THE PARENT'S MISSION IS TO MANAGE THE EXEMPT PUBLIC CHARITIES IN ITS HEALTH CARE SYSTEM AS A "SUPPORTING ORGANIZATION" WITHIN THE MEANING OF SECTIONS 501(C)(3) AND 509(A)(3) OF THE INTERNAL REVENUE CODE (IRC). THE PARENT HAS OWNERSHIP INTEREST IN THE FOLLOWING RELATED ORGANIZATIONS: HEARTLAND REGIONAL MEDICAL CENTER DBA MOSAIC LIFE CARE (MOSAIC-ST. JOSEPH) IS A MISSOURI NONPROFIT CORPORATION LOCATED IN ST. JOSEPH, MISSOURI, THAT OPERATES A GENERAL MEDICAL AND SURGICAL HOSPITAL WITH 348 LICENSED BEDS AND EMPLOYS BOTH PRIMARY AND SPECIALTY PHYSICIANS. THE PARENT IS THE SOLE CORPORATE MEMBER OF MOSAIC-ST. JOSEPH. MOSAIC MEDICAL CENTER-MARYVILLE (MOSAIC-MARYVILLE) IS A MISSOURI NONPROFIT CORPORATION LOCATED IN MARYVILLE, MISSOURI, THAT OPERATES A GENERAL MEDICAL AND SURGICAL HOSPITAL WITH 81 LICENSED BEDS AND EMPLOYS BOTH PRIMARY AND SPECIALTY PHYSICIANS. THE PARENT IS THE SOLE CORPORATE MEMBER OF MOSAIC-MARYVILLE. OBLIGATED GROUP: THE PARENT, MOSAIC-ST. JOSEPH AND MOSAIC-MARYVILLE ARE MEMBERS OF THE OBLIGATED GROUP, WHICH IS LIABLE FOR CERTAIN LONG-TERM DEBT OUTSTANDING UNDER A MASTER TRUST INDENTURE (SEE NOTE 5). THE PARENT ALSO HAS OWNERSHIP INTEREST IN THE FOLLOWING RELATED ORGANIZATIONS: NORTHWEST MEDICAL CENTER ASSOCIATION, INC. DBA MOSAIC MEDICAL CENTER-ALBANY (MOSAICALBANY) IS A MISSOURI NONPROFIT CORPORATION LOCATED IN ALBANY, MISSOURI, THAT PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES AS A CRITICAL ACCESS HOSPITAL WITH 25 LICENSED BEDS. THE PARENT IS THE SOLE CORPORATE MEMBER OF MOSAIC-ALBANY. HEARTLAND LONG-TERM ACUTE CARE HOSPITAL (LTACH) IS A MISSOURI NONPROFIT CORPORATION THAT OPERATES A LONG-TERM ACUTE CARE HOSPITAL WITH 41 LICENSED BEDS IN SPACE LEASED FROM MOSAIC-ST. JOSEPH. THE PARENT IS THE SOLE CORPORATE MEMBER OF LTACH. HEARTLAND FOUNDATION DBA MOSAIC LIFE CARE FOUNDATION IS A MISSOURI NONPROFIT CORPORATION WHOSE MISSION AND PRINCIPAL ACTIVITIES ARE TO EMPOWER CHILDREN AND ADULTS TO BUILD HEALTHIER, MORE LIVABLE COMMUNITIES, PRIMARILY IN NORTHWEST MISSOURI AND NEIGHBORING COUNTIES IN IOWA, KANSAS AND NEBRASKA. THE PARENT IS THE SOLE CORPORATE MEMBER OF MOSAIC LIFE CARE FOUNDATION. NORTHWEST MEDICAL CENTER FOUNDATION (ALBANY FOUNDATION) IS A MISSOURI NONPROFIT CORPORATION OPERATED TO PERFORM THE FUNCTIONS OF, AND/OR TO CARRY OUT THE PURPOSES OF MOSAIC-ALBANY AND OTHER CHARITABLE HEALTH CARE ORGANIZATIONS LOCATED IN MOSAIC-ALBANY'S SERVICE AREA. ALBANY FOUNDATION'S PURPOSES SHALL INCLUDE, BUT NOT BE LIMITED TO, OWNING PROPERTY, FUNDRAISING AND MAKING GRANTS FROM ITS FUNDS FOR THE BENEFIT OF THE MOSAIC-ALBANY AND THE OTHER ORGANIZATIONS IT SUPPORTS. MOSAIC-ALBANY IS THE SOLE CORPORATE MEMBER OF ALBANY FOUNDATION. true Northwest Missouri State University 800 University Drive Maryville MO 64468 446000301 501C3 14250 General Support 1 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. Mosaic Medical Center - Maryville IS COMMITTED TO THE DEVELOPMENT OF A HEALTHY COMMUNITY. GRANTS ARE PROVIDED TO LOCAL GROUPS THAT ACHIEVE THESE OBJECTIVES. GENERALLY MOSAIC MEDICAL CENTER - MARYVILLE 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 MOSAIC MEDICAL CENTER - MARYVILLE DETAILING THE PROGRAM'S EXPENDITURES AND PROGRESS TOWARD THE STATED GOALS. MOSAIC MEDICAL CENTER - MARYVILLE'S ADVOCACY DEPARTMENT MONITORS THE PROGRESS. true true false false false false false false false John M Poore Director/Chair 0 995932 0 135653 0 5334 0 13200 0 26711 0 1176830 0 0 Davin Turner DO Director/Vice Chair 0 594549 0 45616 0 5334 0 12413 0 30749 0 688661 0 0 Gene A Claycomb Director/Vice Chair 0 376783 0 35458 0 6262 0 10991 0 33911 0 463405 0 0 Mark Laney MD Former Director/CEO 0 0 0 0 0 1061154 0 0 0 0 0 1061154 0 0 Michael Pulido Former Secretary/Director/Chair 0 0 0 0 0 590338 0 0 0 20738 0 611076 0 0 Thomas Bieterman Former CFO/Treasurer 0 185573 0 287 0 0 0 2890 0 9927 0 198677 0 0 Drew Keesbury CFO/Treasurer 0 445072 0 13200 0 900 0 0 0 17432 0 476604 0 0 Nathan Blackford President 302351 0 32985 0 882 0 40006 0 31449 0 407673 0 0 0 Michael R Rinard Secretary 0 255214 0 24256 0 2038 0 11666 0 33249 0 326423 0 0 Timothy J Monahan MD Staff Physician 711056 0 0 0 5159 0 13200 0 33811 0 763226 0 0 0 William J Kinderknecht DO Staff Physician 431609 0 171419 0 13164 0 11250 0 31061 0 658503 0 0 0 John T Symonds DO Staff Physician 437735 0 67995 0 19342 0 13200 0 23334 0 561606 0 0 0 Lorraine Dodson MD Staff Physician 459881 0 44389 0 17001 0 12025 0 9921 0 543217 0 0 0 Benjamin Kinderknecht DO Staff Physician 470948 0 0 0 1572 0 11250 0 31061 0 514831 0 0 0 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 TAX-EXEMPT ORGANIZATION, 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 tax-exempt organization, paid Samuel Mark Laney, CEO, severance payments during calendar year 2023. This is reported on Form 990, Part VII and Schedule J, Part II as other reportable compensation. Mosaic Health System, a related tax-exempt organization, paid Michael Pulido, COO, severance payments during calendar year 2023. 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 NATHAN BLACKFORD - VESTED $28,756; ACCRUED $31,200 GENE A CLAYCOMB - VESTED $0; ACCRUED $54,431 DAVIN TURNER, DO - VESTED $0; ACCRUED $84,000 MICHAEL R RINARD - VESTED $0; ACCRUED $31,360 JOHN M POORE - VESTED $0; ACCRUED $200,000 DREW KEESBURY - VESTED $0; ACCRUED $53,667 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. Form 990, Part VI, Line 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS MICHAEL R RINARD, DREW KEESBURY, DAVIN TURNER,DO, AND JOHN M. POORE HAVE A BUSINESS RELATIONSHIP. Form 990, Part VI, Line 6 Classes of members or stockholders MOSAIC HEALTH SYSTEM, A related tax-exempt organization, IS THE SOLE MEMBER OF Mosaic Medical Center-Maryville (Mosaic-Maryville). Form 990, Part VI, Line 7a Members or stockholders electing members of governing body As the sole member of Mosaic Medical Center-Maryville (Mosaic-Maryville), Mosaic Health System, a related tax-exempt organization, has the right to elect all members of the board of directors. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Mosaic Health System, a related tax-exempt organization and the sole member, shall have the following powers: overall strategic direction, number and election of board members, appointment of auditors and legal counsel, establishment of banking relationships and management of cash and other assets, approval of changes to the articles of incorporation and bylaws, 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 XI, Line 9 Other changes in net assets or fund balances NET ASSETS RELEASED FROM RESTRICTIONS - -350854; Schedule H, Part V, Section B, Line 16a 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 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 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 XII, Line 2C Financial Statements and Reporting The results of the consolidated audit are reviewed by the Mosaic Health System Board, a related tax-exempt organization. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS ESTABLISHED BY MOSAIC HEALTH SYSTEM, A RELATED tax-exempt organization. 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 Presidents. For each position to be reviewed, the full scope of duties and responsibilities, 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 on 9/19/2023 as documented in the meeting minutes. Mosaic Health System (MHS) 5325 Faraon Street St Joseph MO 64506 431283316 Healthcare MO 501(c)(3) Type II NA false Heartland Foundation (MOSAIC LIFE CARE FOUNDATION) 5325 Faraon Street St Joseph MO 64506 431262768 Support MO 501(c)(3) 7 Mosaic Health System true Heartland Long Term Acute Care Hospital (HLTACH) 5325 Faraon Street St Joseph MO 64506 261972987 Healthcare MO 501(c)(3) 3 Mosaic Health System true Heartland Regional Medical Center (MOSAIC-ST JOSEPH) 5325 Faraon Street St Joseph MO 64506 440545289 Healthcare MO 501(c)(3) 3 Mosaic Health System true Northwest Medical Center Association Inc (MOSAIC-ALBANY) 705 North College Street Albany MO 64402 440580870 Healthcare MO 501(c)(3) 3 Mosaic Health System true Northwest Medical Center Foundation Inc (NMC FOUNDATION) 705 North College Street Albany MO 64402 473694893 Support MO 501(c)(3) Type I Northwest Medical Center Association Inc true Midwestern Health Management Inc 5325 Faraon Street St Joseph MO 64506 431264358 Healthcare MO NA C Corporation true HHS Properties Inc 5325 Faraon Street St Joseph MO 64506 431593799 Investment MO NA C Corporation true Uptown Housing Inc 5325 Faraon Street St Joseph MO 64506 261416252 Redevelopment MO NA C Corporation true Uptown St Joseph Redevelopment Corp 5325 Faraon Street St Joseph MO 64506 201742813 Redevelopment MO NA C Corporation true false false true false false false false false false true true false true true true true true true false HEARTLAND REGIONAL MEDICAL CENTER (MOSAIC-ST JOSEPH) P 4535196 FMV MOSAIC HEALTH SYSTEM (MHS) C 2314378 FMV MOSAIC HEALTH SYSTEM (MHS) M 15437021 FMV MOSAIC HEALTH SYSTEM (MHS) Q 2331867 FMV MOSAIC HEALTH SYSTEM (MHS) R 627183 FMV