2026-05-11T13:12:32+00:00 2025-06-30 420714325 RSM US LLP 4650 East 53rd Street Davenport IA 52807 990 2024-07-01 440545289 Heartland Regional Medical Center HEAR 8162717070 5325 Faraon Street St Joseph MO 64506 Drew Keesbury Officer 8162717070 2026-05-11 true Jenifer L Chase P01306883 5638884000 2026-05-11 2024 2025-03-06 01:10:19Z Mosaic Life Care Drew Keesbury 5325 Faraon Street St Joseph MO 64506 883842748 false X https://www.mymlc.com/Main/Location/st-joseph-mo/mosaic-life-care-at-st.-joseph-medical-center X 1985 MO To put the needs of the patient first by empowering a culture where caregivers bring their best, ensuring a healthier future for generations to come. 13 6 4157 89 148598 0 935062 296374 764924060 865537952 276943 1502857 16016330 16070587 782152395 883407770 1686663 2773892 0 353033798 372936753 0 0 408302192 449875272 763022653 825585917 19129742 57821853 495357037 582352118 65724024 94895728 429633013 487456390 To put the needs of the patient first by empowering a culture where caregivers bring their best, ensuring a healthier future for generations to come. false false 718348700 2773892 881249206 HEARTLAND REGIONAL MEDICAL CENTER (Mosaic-St. Joseph) IS A 348-BED MEDICAL SURGICAL HOSPITAL LOCATED IN ST. JOSEPH, MISSOURI. IT SERVES A COMMUNITY OF 105,000 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 71.45% GOVERNMENTAL OR Self-PAY PATIENTS. 10.9% 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 15,000 PATIENTS WERE ADMITTED TO THE HOSPITAL RESULTING IN APPROXIMATELY 68,900 PATIENT DAYS. A TOTAL OF APPROXIMATELY 10,000 SURGERIES WERE PERFORMED, THE EMERGENCY ROOM SERVED APPROXIMATELY 53,300 PATIENTS AND APPROXIMATELY 192,300 VISITS WERE GENERATED BY OUTPATIENTS. In FY2025, the outpatient visits methodology was revised to only include clinic provider visits within a specified CPT range. MOSAIC-ST. JOSEPH EMPLOYS APPROXIMATELY 4,200 FULL-TIME EQUIVALENT CARE GIVERS. THE MEDICAL STAFF INCLUDES APPROXIMATELY 334 PROVIDERS COVERING PRIMARY CARE AND SPECIALTY CLINICS FOR APPROXIMATELY 23 LOCATIONS THROUGHOUT THE REGION. THERE WERE APPROXIMATELY 389,000 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. 718348700 true true false true false false false false false false true false false true true true false true false false false false false false false false true true true true true false false false false false false false false true false false false false false true true true true false false true 134 0 true 4157 true true true false false false false false false false false false false X 13 6 true false false false true true true true true false false false true true true true true true false false true true X Drew Keesbury 8162717070 5325 Faraon Street St Joseph MO 64506 John M Poore Director/President/CEO 1.0 37.0 X X 0 1396868 238073 Adam Stein Former Director/Vice Chair 1.0 1.0 X 0 2500 0 Angelia Martin MD Director 1.0 39.0 X 0 279216 39908 Dennis Rosonke Director 1.0 2.0 X 0 0 0 Elizabeth Kennedy PHD Director 1.0 2.0 X 0 2500 0 Emily Larson DO Director 39.0 1.0 X 447639 2500 49683 Gary Frazer Director/Chair 1.0 1.0 X 0 2500 0 Mary Anne Jackson MD Director 1.0 1.0 X 0 2500 0 Matt Baker Director/Vice Chair 1.0 3.0 X 0 2500 0 Matt Lukens MD Director 39.0 1.0 X 709213 2500 39441 Melody Smith Director 1.0 1.0 X 0 2500 0 Ophelia Lavell Rucker Former Director 1.0 1.0 X 0 2500 0 Serena Naylor Director 1.0 4.0 X 0 2500 0 Thomas Richmond Director 1.0 1.0 X 0 2500 0 William Burns Director 1.0 1.0 X 0 0 0 Davin J Turner DO Chief Administrative Officer 1.0 37.0 X 0 849212 130671 Drew M Keesbury CFO/Treasurer 1.0 36.0 X 0 740821 97485 Michael R Rinard Secretary 1.0 36.0 X 0 368476 81231 Renea Schott Assistant Secretary 1.0 39.0 X 0 73983 26905 Gene A Claycomb President of Mosaic Medical Center 35.0 3.0 X 512714 0 96390 Arvind K Sharma MD Staff Physician 40.0 0 X 1247026 0 39691 Jonathan Amspacher MD Staff Physician 40.0 0 X 1735603 0 46968 Michael Lunski Staff Physician 40.0 0 X 1273903 0 22094 Robert Grant MD Staff Physician 40.0 0 X 1269868 0 49669 Rony M Abou-Jawde MD Staff Physician 40.0 0 X 2184385 0 46983 Mark Laney MD Former Director/President/CEO 0.0 0.0 X 0 220393 0 Michael Pulido Former COO/Secretary 0.0 0.0 X 0 268884 0 9380351 4225353 1005192 577 true true false Quest Diagnostics PO Box 14730 St Louis MO 63150 Medical Services 2406166 Montee Law Firm PC PO Box 127 St Joseph MO 64502 Legal Services 1450000 Hayes Locums LLC PO Box 844543 Dallas TX 752844543 Agency Services 1386976 Capital Performance Management 11709 Roe Ave D236 Leawood KS 662112607 Capital Management 1199771 Radiology Specialists of St Joseph PC 3906 Oakland Avenue St Joseph MO 64508 Medical Services 1089258 27 296374 296374 Net Patient Service Revenue 621110 804903334 804903334 340B Pharmacy Revenue 621110 60634618 60634618 0 0 0 0 865537952 305666 305666 412742 202007 210735 0 210735 210735 1430162 232971 0 1197191 1197191 1197191 All Other Revenue 900099 11879275 11879275 Cafeteria 722514 4201317 4201317 Referral Lab 621511 -220740 -369338 148598 0 0 0 0 15859852 883407770 881249206 148598 1713592 2773892 2773892 1925944 1305472 620472 0 78365 78365 311488360 308926612 2561748 6956395 6893482 62913 33810387 33281848 528539 18677302 18476586 200716 43786 43786 145238 99000 46238 47411825 46988304 423521 0 7233 7233 20686054 19390596 1295458 6857348 6846487 10861 5429728 4768274 661454 413270 411715 1555 157038 151501 5537 66969 66969 27574603 26502150 1072453 7972005 6935556 1036449 Medical Supplies/Includes 340B 175830042 175830042 Corporate Allocations From Mosaic Health System 133208231 34634140 98574091 FRA Taxes 22697688 22697688 Dues & Subscriptions 1374214 1282788 91426 0 0 0 0 825585917 718348700 107237217 0 24354 44303 101340402 96753325 0 0 0 0 225000 200000 12259959 14082157 9108118 15915664 685147759 437939268 237897003 247208491 0 0 0 4891469 4113749 129610732 204034429 495357037 582352118 53525439 78634026 0 0 12198585 16261702 65724024 94895728 X 429633013 487446390 0 10000 429633013 487456390 495357037 582352118 X 57821853 1524 X false true true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 145238 145238 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. 28.80% of the membership dues paid to the Missouri Hospital Association are used for lobbying activities. 39.00% 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. 17321803 17321803 418509076 251175247 167333829 18651939 17189994 1461945 213880405 169574027 44306378 16784536 16784536 247208491 Due from Affiliates 178344345 Long Term Investments 25690084 204034429 Federal Income Taxes Leases & Other Less Current Portion 7555613 Due to Affiliates 6594548 Current Portion - Long Term Debt 2107702 Interest Payable 3839 16261702 X 0 0 0 0 0 0 0 0 0 0 0 0 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, 2025, 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 $6.3M 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 $1.9M 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, 2025 AND 2024, THERE WERE NO UNCERTAIN TAX POSITIONS IDENTIFIED AND RECORDED AS A LIABILITY. true true X true X true X 13624978 13624978 0.01650 120137727 101286859 18850868 0.02283 0 0.0 0 0 133762705 101286859 32475846 0.03934 8847376 1089743 7757633 0.00940 393248 875 392373 0.00048 45082958 36447124 8635834 0.01046 705444 69212 636232 0.00077 1856933 1856933 0.00225 0 0 56885959 37606954 19279005 0.02335 0 0 190648664 138893813 51754851 0.06269 36748 36748 0.00004 115000 115000 0.00014 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 151748 0 151748 0.00018 false 31345979 0 178299440 219891563 -41592123 X true true 1 1 Heartland Regional Medical Center 5325 Faraon Street St Joseph MO 64506 www.mymlc.com/Main/Location/st-joseph-mo/mosaic-medical-center-st.-joseph/ 426-28 X X X X Pharmacist Intern Program Heartland Regional Medical Center 1 false false true X X X X X X X X X 24 true true false true X https://www.mymlc.com/General/Community-Health-Needs-Assessment/St-Joseph-CHNA/ X true 24 true https://www.mymlc.com/General/Community-Health-Needs-Assessment/St-Joseph-CHNA/ 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; - POVERTY/SOCIAL DETERMINANTS OF HEALTH; - DISEASE PREVENTION EDUCATION 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 HEARTLAND REGIONAL MEDICAL CENTER (MOSAIC-ST. JOSEPH) AND Heartland Long-Term Acute Care Hospital (HLTACH). THE CHNA WAS CONDUCTED DURING TAX YEAR 2024 TO DETERMINE SERVICES NEEDED BY THE MEDICALLY UNDERSERVED, LOW INCOME OR MINORITY POPULATIONS. THE FOLLOWING THREE NEEDS WERE CHOSEN TO BE ADDRESSED OVER THE NEXT THREE YEARS: - MENTAL HEALTH - POVERTY/SOCIAL DETERMINANTS OF HEALTH - DISEASE PREVENTION EDUCATION MOSAIC-ST. JOSEPH AND HLTACH UTILIZED AN INDEPENDENT CONSULTING FIRM NAMED CROWE, LLP TO GATHER INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY BY CONDUCTING KEY STAKEHOLDER INTERVIEWS AND A COMMUNITY SURVEY. KEY STAKEHOLDER INTERVIEWS: MOSAIC-ST, JOSEPH AND HLTACH OBTAINED INPUT FROM COMMUNITY LEADERS REPRESENTING TWENTY-FIVE ORGANIZATIONS INCLUDING PUBLIC HEALTH, PUBLIC SCHOOLS, LOCAL GOVERNMENT OFFICIALS, SOCIAL SERVICES AND VARIOUS NON-PROFIT ORGANIZATIONS THROUGH KEY STAKEHOLDER INTERVIEWS. IN ADDITION, 72 PARTICIPANTS REPRESENTING MOSAIC-ST, JOSEPH'S HEALTH CARE PROVIDERS AND SENIOR LEADERS PARTICIPATED IN TWO FOCUS GROUPS. INTERVIEWS WERE CONDUCTED WITH REPRESENTATIVES FROM THE FOLLOWING ORGANIZATIONS: AFL CIO, BARTLETT CENTER, BIG BROTHERS BIG SISTERS, BUCHANAN COUNTY SHERIFF'S DEPARTMENT, CATHOLIC CHARITIES, COMMUNITY ACTION PARTNERSHIP, COMMUNITY MISSIONS CORPORATION, FAMILY GUIDANCE CENTER, GIRL SCOUTS OF NORTHEAST KANSAS AND NORTHWEST MISSOURI, INTERSERV, MERIL, MIDCITY EXCELLENCE CENTER, NORTHWEST HEALTH SERVICES, SECOND HARVEST COMMUNITY FOOD BANK, SOCIAL WELFARE BOARD, ST. JOSEPH HABITAT FOR HUMANITY, ST. JOSEPH HEALTH DEPARTMENT, ST. JOSEPH SCHOOL DISTRICT, ST. JOSEPH TRANSIT, ST. JOSEPH UNITED WAY, ST. JOSEPH YMCA, ST. JOSEPH YOUTH ALLIANCE, ST. JOSEPH YWCA, UNITED CEREBRAL PALSY, VOICES OF COURAGE-CHILD ADVOCACY CENTER. THE KEY STAKEHOLDER INTERVIEWS WERE CONDUCTED THROUGHOUT OCTOBER OF 2024 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 DURING FEBRUARY AND MARCH OF 2025. A LINK TO THE SURVEY WAS DISTRIBUTED VIA E-MAIL, SOCIAL MEDIA AND WORD OF MOUTH TO THE COMMUNITY AT-LARGE. A TOTAL OF 78 SURVEYS WERE COMPLETED. THE MAJORITY OF RESPONDENTS WERE WHITE/CAUCASIAN 85.4%, HISPANIC OR LATINO 6.0%, NONHISPANIC BLACK 5.0%, NON-HISPANIC MULTIPLE RACES 5.7% AND 2.8% NON-HISPANIC SOME OTHER RACE. 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 TAX-EXEMPT ORGANIZATION. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - HEARTLAND REGIONAL MEDICAL CENTER (Mosaic-St. Joseph):. THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED AND AN IMPLEMENTATION PLAN FOR ADDRESSING THE IDENTIFIED NEEDS WAS ADOPTED IN THE 2024 TAX YEAR. THE TOP THREE SIGNIFICANT NEEDS IDENTIFIED WERE: 1) Mental Health; 2) Poverty/Social Determinants of Health; AND 3) Disease Prevention Education. Mosaic-St. Joseph is a fully engaged community partner striving to address the unique health and social issues that challenge the region. The primary barriers to improving health and quality of life in the community include economic instability and high poverty rates, which affect access to healthcare, housing, and nutritious food. The community struggles with a lack of affordable and reliable transportation, making it difficult for residents to access healthcare services and other essential resources. There is a significant uninsured population, and many individuals face challenges navigating the healthcare system, particularly in obtaining insurance and accessing Medicaid. The shortage of primary care providers and pediatricians further limits healthcare access. Cultural and language barriers, especially among the immigrant population, contribute to distrust in the healthcare system. Education and literacy issues hinder individuals' ability to access and utilize available resources effectively. Mental health and drug addiction are prevalent, with many using substances to self-medicate due to inadequate mental health services. The community also faces challenges related to housing, with a lack of affordable, clean housing options and no 24/7 shelter available. There is also a lack of motivation and engagement among residents to participate in health-promoting activities. TO FULLY MEET THE NEEDS IDENTIFIED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT, Mosaic-St. Joseph and HLTACH IMPLEMENTED A THREE-YEAR ACTION PLAN FOR TAX YEARS 2025, 2026 AND 2027 COMPRISED OF THE FOLLOWING COMPONENTS. SIGNIFICANT NEED #1: Mental Health: A) Continue work of Community Behavioral Health Alliance. B) Continue to financially support agencies that provide services. C) Collaboration with ACES, Youth Alliance, Big Brothers/Big Sisters. D) Continue to have mental health workers in Mosaic's Emergency Department from Family Guidance Center. E) Physical expansion of mental health service areas. F) Continue to recruit mental health providers. G) Continue to focus on mental health education in the 4th Grade Challenge. H) MOSAIC-ST, JOSEPH's Spiritual Health Department will provide ongoing education on trauma. SIGNIFICANT NEED #2: Poverty/Social Determinants of Health: A) Continue to financially support organizations that provide services to those in poverty. B) Provide financial support for the development of a 24/7 year-round homeless shelter. C) Continue to provide Medicaid enrollment assistance. SIGNIFICANT NEED #3: Disease Prevention Education: A) Continue to provide the 4th Grade Challenge healthy habits program to all public and private elementary schools. B) Continue to offer Kids in the Kitchen healthy cooking classes to elementary school students. C) Develop a healthy cooking class for adults. D) Continue Healthy Lifestyles program pilot for cancer survivors. E) Continue to be involved in the Opioid Task Force. F) Continue to support organizations that provide healthy lifestyle education, such as St. Joseph Youth Alliance and Mid-City Excellence. G) Financial support for the building of an aquatic center that our arthritis patients can use. 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. 24 Cameron Mosaic Life Care 923 North Walnut Street Cameron MO 64429 Family Care, Neurology, and Endocrinology Mosaic Life Care Clinics 902 North Riverside Road St Joseph MO 64507 Medical and Radiation Oncology, Outpatient Infusion, Cardiovascular and Continued Care Mosaic Life Care Clinics 2600 Miller Street Bethany MO 64424 Cardiology and Endocrinology Mosaic Life Care Clinics 901 Heartland Road St Joseph MO 64506 Infectious, Endocrinology, Internal Medicine, Wound, Sleep Disorder, Women's Health and Menopause Mosaic Life Care Clinics 5301 Faraon Street Suites XXX-XX-XXXX 210B St Joseph MO 64506 Ears Nose and Throat, Pulmonary and Critical Care, Physical Medicine and Rehabilitation, Sports Med Mosaic Life Care Clinics 711 North 36th Street Suite 100 Low er Level St Joseph MO 64506 Family Care & Outpatient Therapy Mosaic Life Care Clinics 5210 North Belt Highway Entrance B C St Joseph MO 64506 Family Care Mosaic Life Care Clinics 5514 Corporate Drive Suites 120 150 St Joseph MO 64507 Internal Medicine and Pediatrics Mosaic Life Care Clinics 105 Far West Drive Suites 100 201 2 02 St Joseph MO 64506 Internal Medicine, Pediatrics, Family Care, Neurology, Outpat Infusion, & Outpatient Behavior Health Mosaic Life Care Clinics 802 North Riverside Road St Joseph MO 64506 Bariatric, Breast, Cardio Thoracic & General Surgery, Pain Mgmt, Rheumatology, Vein Care & etc. Medical Oncology Mosaic Life Care 1610 East Evergreen Suite B Cameron MO 64429 Cancer Care Mosaic Life Care Clinics 2016 South Main Maryville MO 64468 Medical Oncology, Neuro Surgery, Maternity, Imaging, Cancer Care, Cardiology, Cardiopulmonary Rehab Mosaic Life Care Hospice at Stanberry 307 Pineview Pine View Manor Rm 507 Stanberry MO 64489 Hospice Mosaic Life Care Clinics 3620 Fredrick Avenue St Joseph MO 64506 Outpatient Imaging, Counseling Care, & Radiology Mosaic Life Care Clinics 3007 North Belt Highway St Joseph MO 64506 Outpatient Therapy & Chiropractic Care Plastic Surgery & Dermatology Mosaic 5204 North Belt Highway Suite A St Joseph MO 64506 Plastic Surgery & Dermatology Mosaic Life Care Clinics 1600 East Evergreen PO Box 557 Cameron MO 64429 Pulmonary, Cardiology, & Vascular Mosaic Life Care Clinics 1707 East 9th Street Trenton MO 64683 Family Care, Cardiology Urgent Care St Joseph Mosaic Life Care 1115 North Belt Highway St Joseph MO 64506 Urgent Care Mosaic Life Care Clinics 104 North 6th Atchison KS 66002 Cancer Care Troy Mosaic Life Care 207 South Main Troy KS 66087 Family Care Endocrinology Mosaic Life Care 820 Raven Hill Drive Atchison KS 66002 Endocrinology, Nephrology, & Vascular Mosaic Life Care at St Joseph Nephrology 1009 West St Maarten Drive St Joseph MO 64506 Nephrology Mosaic Life Care 5506 Corporate Drive St Joseph MO 64507 Home Health, Hospice, Care at Home 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 I, Line 3c In FY2024, Heartland Regional Medical Center (Mosaic-St. Joseph) 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-St. Joseph for free or discounted care. Schedule H, Part I, Line 6a Not applicable Schedule H, Part I, Line 7b DURING THE YEAR-ENDED 06/30/2025, Heartland Regional Medical Center (Mosaic-St Joseph) reduced the estimated FEDERAL REIMBURSEMENT ALLOWANCE program liability related to prior program years by approximately $9,442,000, 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, 2025. RECORDED ESTIMATES MAY CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM AS THEY ARE INHERENTLY SUBJECTIVE DUE TO THE LACK OF HISTORICAL PRECEDENCE WITH RESPECT TO HOW THE STATE ADMINISTERS THE PROGRAM. Schedule H, Part VI, Line 7 NOT APPLICABLE Schedule H, Part I, Line 7h HEARTLAND REGIONAL MEDICAL CENTER (MOSAIC-ST. JOSEPH) 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-ST. JOSEPH 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 I, Line 7a Column e During fiscal year 2025 (tax year 2024), Heartland Regional Medical Center (Mosaic-St. Joseph) experienced changes in presumptive charity and operations that temporarily reduced reported charity care expenses. To continue meeting community needs, Mosaic-St. Joseph provided additional sponsorships near the end of the fiscal year. In fiscal year 2026, Mosaic-St. Joseph implemented targeted process improvements to strengthen eligibility screening and financial assistance workflows, ensuring patients receive appropriate support. These efforts include enhanced initiatives to proactively identify and assist patients who may qualify for Medicaid. 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 THE CALCULATIONS FROM WORKSHEET 2. FOR THE YEAR ENDED 6/30/2025, THE CALCULATION IN WORKSHEET 2 WAS MODIFIED TO BETTER ALIGN WITH IRS INSTRUCTIONS SPECIFICALLY RELATED TO THE COST OF NONPATIENT CARE ACTIVITIES, REFLECTING A MORE ACCURATE ALLOCATION OF PATIENT CARE COSTS AT COST. Schedule H, Part II Community Building Activities HEARTLAND REGIONAL MEDICAL CENTER (MOSAIC-ST. JOSEPH) COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES SERVED BY PROVIDING SEVERAL EDUCATIONAL PROGRAMS TO HELP MAINTAIN A HEALTHY LIFESTYLE. THE PROGRAMS ARE WELL-ADVERTISED, AND MOST OF THEM ARE FREE OF CHARGE. FOR EXAMPLE, MOSAIC-ST. JOSEPH'S ADULT HEALTHY LIFESTYLES AND KIDS IN THE KITCHEN HEALTHY COOKING CLASSES HELP REDUCE ADULT AND CHILDHOOD OBESITY. THE 4TH GRADE HEALTH CHALLENGE, WHICH MOSAIC-ST. JOSEPH COORDINATES WITH LOCAL ELEMENTARY SCHOOLS, TARGETS REDUCING OBESITY WITH AN EMPHASIS ON MENTAL HEALTH. MOSAIC-ST. JOSEPH COMMUNITY BUILDING ACTIVITIES PROVIDE THE COMMUNITY WITH MENTAL HEALTH SUPPORT BY COLLABORATING WITH THE COMMUNITY BEHAVIORAL HEALTH ALLIANCE AND MOSAIC-ST. JOSEPH SPIRITUAL HEALTH DEPARTMENT. MOSAIC-ST. JOSEPH ALSO CONTINUES TO PROVIDE FINANCIAL SUPPORT TO AGENCIES THAT PROVIDE MENTAL HEALTH SERVICES. MOSAIC-ST. JOSEPH PROVIDES ECONOMIC SUPPORT TO RE-VITALIZE THE DOWNTOWN ST. JOSEPH AREA AND FACILITATE JOB GROWTH THROUGHOUT THE GREATER ST. JOSEPH AREA. 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. The presumptive charity and operational changes experienced in FY25 not only reduced charity care expense but also contributed to an increase in bad debt expense during the same period. As process improvements were implemented in FY26, earlier intervention helped ensure that eligible patients were reviewed for charity care or Medicaid coverage, reducing bad debt expense. 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'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-St. Joseph. This enables Mosaic-St. Joseph 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. Joseph 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 ITS BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER ITS 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 and 19 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 Heartland Regional Medical Center's (Mosaic-St. Joseph) 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. Mosaic-St. Joseph's net community benefit expense (Schedule H, Part i, line 7, column (e)) as a percentage is 6.27%, and the percentage increases to 11.31% 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 HEARTLAND REGIONAL MEDICAL CENTER (HRMC) FINANCIAL ASSISTANCE POLICY CONTAINS THE ACTIONS HRMC MAY TAKE IN THE EVENT OF A PATIENT'S NON-PAYMENT, INCLUDING COLLECTION ACTIONS AND REPORTING TO CREDIT AGENCIES. THESE ACTIONS APPLY BROADLY TO HRMC PATIENTS, INCLUDING THOSE PATIENTS HRMC KNOWS QUALIFY FOR FINANCIAL ASSISTANCE UNDER ITS FINANCIAL ASSISTANCE POLICY (FAP). UNDER HRMC'S 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, HRMC 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 HRMC, THE PATIENT ACCOUNT WILL BE TURNED OVER TO A THIRD-PARTY COLLECTION AGENCY. 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 Heartland Regional Medical Center's (Mosaic-St. Joseph) 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. Mosaic-St Joseph SUPPORTS A PAYOR MIX OF APPROXIMATELY 71.45% GOVERNMENTAL OR SELF-PAY PATIENTS. 14.7% OF THE POPULATION IS BELOW THE POVERTY LEVEL; 19.2% OF THE POPULATION SMOKES; AND 33.5% HAVE A BODY MASS INDEX GREATER THAN 30. MORE THAN 59.2% 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. Mosaic-St. Joseph extends medical staff privileges to all qualified physicians in its community for some or all of its departments or specialties. HIGHLIGHTED BELOW ARE EXAMPLES IN WHICH MOSAIC-ST. JOSEPH PROVIDED DIRECT FUNDING SUPPORT TO THE COMMUNITY ORGANIZATIONS WITH LIKE MISSIONS. IN FY25, 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 FY25, THESE COMMUNITY HEALTH IMPROVEMENT PROGRAMS WERE ALSO 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. In FY25, Mosaic-St. Joseph announced the development of Plaza 4, a new three-story, 90,000-square-foot medical office facility adjacent to its main campus in St. Joseph, Missouri. Scheduled to open in spring 2026, this project represents a significant investment in improving access to care and enhancing the patient experience for the region. The Plaza 4 medical office building is designed to consolidate and expand outpatient services, creating a convenient and efficient environment for patients and visitors. The new facility will feature: * Outpatient Imaging and Laboratory Services - Providing advanced diagnostic capabilities in a streamlined setting. * Retail and Specialty Pharmacy - Offering on-site medication access and specialty pharmaceutical support. * Eight Outpatient Clinic Service Lines - Including primary care and specialty practices to meet diverse health needs. Beyond clinical services, the building incorporates modern design principles focused on energy efficiency and accessibility. Mosaic-St. Joseph partnered with a national team of architects and engineers to ensure the facility supports a high standard of care and operational excellence. This investment underscores Mosaic- St Joseph's commitment to expanding health care services, improving community health outcomes, and supporting economic growth in the region. During FY25, Mosaic-St. Joseph expanded its clinical capabilities by adding new providers across multiple specialties. This strategic growth initiative was designed to enhance patient access, broaden the range of available services, and support the hospital's long term commitment to meeting community healthcare needs. The addition of these providers strengthened service lines, increased capacity, and positioned the organization to better serve patients throughout the region. Mosaic-St. Joseph advanced community health by developing a new interventional neurology and neuroendovascular program designed to elevate the region's stroke care to a top-tier level. As part of this initiative, experienced staff participated in specialized training at nationally recognized medical centers. This training improved readiness to deliver advanced stroke interventions locally. This program allows community members to receive time sensitive, life saving treatments such as thrombectomies, cerebral and spinal angiography, aneurysm and AVM procedures, and vascular stenting without needing to travel outside the region. Early implementation includes support for rural patients, who will increasingly be transferred to the hospital for high level stroke interventions, thereby improving equitable access to specialized neurological care. These advancements directly contribute to improving community health outcomes, reducing disability from stroke, increasing local access to cutting edge medical procedures, and supporting the hospital's mission to enhance the well being of the population it serves. Mosaic-St. Joseph plays a vital role in expanding access to quality health care in St. Joseph and the surrounding rural communities. Through its partnership with the UMKC School of Medicine, Mosaic-St. Joseph helps create a direct pipeline of future physicians who are specifically trained in and committed to serving rural populations. This collaboration ensures that local residents benefit from more consistent, community based medical care and helps address long standing provider shortages in northwest Missouri. By offering hands on clinical training, innovation, and real world rural health experience, Mosaic-St. Joseph strengthens the region's health care workforce and supports a sustainable model for delivering care to underserved communities. 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 provides inpatient, outpatient and emergency care services as a critical access hospital with 35 licensed beds and employees both primary and specialty physicians. Mosaic-Maryville licenses decreased from 81 to 35 beds as a result of converting to a critical access hospital during fiscal year 2025. The Parent is the sole corporate member of Mosaic-Maryville. The Parent also has ownership interest in the following related organizations: Northwest Medical Center Association, Inc. dba Mosaic Medical Center-Albany (Mosaic-Albany) is a Missouri nonprofit corporation located in Albany, Missouri, that provides inpatient, outpatient and emergency care services as a critical access hospital with 21 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 30 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 that operates 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 Heartland Foundation 5325 Faraon Street St Joseph MO 64506 431262768 501c3 421116 General Support YMCA of St Joseph Missouri 315 South 6th Street St Joseph MO 64501 440552491 501C3 255000 General Support Samaritan Counseling Center Inc 902 Edmond Street St Joseph MO 64501 431615018 501C3 210000 General Support United Way of Greater St Joseph 118 South 5TH STREET St Joseph MO 64501 440547802 501C3 152380 General Support Second Harvest Community Food Bank 915 DOUGLAS Street St Joseph MO 64505 431268319 501C3 150500 5134 Other Meals donated General Support Social Welfare Board 904 South 10th Street Suite A St Joseph MO 64503 133412408 150000 General Support YWCA of St Joseph Missouri 304 N 8th Street St Joseph MO 64501 440552219 501C3 102400 General Support North Central Missouri College Foundation 1301 Main Street Trenton MO 646831824 431423040 501C3 100000 General Support St Joseph Area Chamber of Commerce 3003 Frederick Avenue St Joseph MO 64506 440419460 501c6 97075 Sponsorship Community Missions Corporation 700 Olive Street St Joseph MO 64501 900180479 501C3 61715 General Support Albrecht-Kemper Museum of Art Foundations 2818 FREDERICK St Joseph MO 64506 431855334 501C3 60500 General Support Ashland United Methodist Church 2211 Ashland Ave St Joseph MO 64506 440653008 501C3 58300 General Support Northwest Missouri Childrens Advocacy Center 1807 Woodbine Road St Joseph MO 64506 431910148 501C3 56500 General Support Habitat for Humanity 3131 Frederick Ave St Joseph MO 64506 431733608 501C3 53000 General Support Pivotal Point 3000 Parkway A St Joseph MO 64507 271481997 501C3 50000 General Support St Joseph Housing Corp 2902 S36th Street Pl St Joseph MO 64503 994689938 501C3 50000 General Support St Joseph Mustangs 4707 College Blvd Suite 204 Leawood KS 66211 261723796 40000 General Support Ladies Union Benevolent Association dba Noyes Home for Children 801 N Noyes Blvd St Joseph MO 64506 440563788 501C3 35000 General Support Community Foundation of Northwest Missouri 1010 W St Maartens Dr Suite C St Joseph MO 64506 270436182 501C3 30500 General Support Main Street St Joseph 224 N 7th Street St Joseph MO 64501 871903139 501C3 25300 General Support Community Alliance 3003 Frederick Avenue St Joseph MO 64506 050587096 501C3 24286 General Support MidCity Excellence 1802A Union Street St Joseph MO 64501 431934077 501C3 20000 General Support Northwest Foundation Inc 800 University Drive Maryville MO 64468 446000301 501C3 18150 Sponsorship Sisters of Solace 3024 Frederick Ave St Joseph MO 64506 831624357 501C3 16350 General Support MWSU Foundation Inc 5425 DOWNS DRIVE St Joseph MO 64507 237035423 501C3 15100 General Support Faith in Action 2711 Ashland Avenue St Joseph MO 64506 440653008 501C3 10000 General Support Friends of St Joseph School District PO Box 8511 St Joseph MO 64506 833499451 10000 General Support City of St Joseph Health Department 904 S 10th St Suite E St Joseph MO 64503 446000256 CITY OF ST JOSEPH 7800 General Support Outside 45 3907 Seneca Street St Joseph MO 64507 993612907 501C3 6000 General Support The Crossing Outreach 701 South 8th Street St Joseph MO 64501 464195177 501C3 5000 General Support Northwest Missouri Law Enforcement Foundation 5005 Frederick Blvd St Joseph MO 64506 883303443 501C3 5000 General Support St Joseph School District 1415 N 26th Street St Joseph MO 64506 386000681 City of St Joseph 5000 General Support Project Cure 8800 NE Underground Drive Pillar 373 Kansas City MO 64161 841568566 501C3 5000 General Support Pony Express Baseball PO Bos 1588 St Joseph MO 64502 274437372 501C3 5000 General Support Big Brothers Big Sisters 625 Francis Street St Joseph MO 64501 440666362 501C3 5000 General Support Youth Alliance 5223 Mitchell Avenue St Joseph MO 64507 431680758 501C3 56721 Other Meals donated General Support 32 4 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds 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. Mosaic-St. Joseph is committed to the development of a healthy community. Grants are provided to local groups that achieve these objectives. The recipients are required to submit quarterly reports to Mosaic-St. Joseph detailing the program's expenditures and progress toward the stated goals. Mosaic-St. Joseph 's Advocacy department monitors the progress. true true false false false false false false false John M Poore Director/President/CEO 0 1039449 0 352085 0 5334 0 213800 0 24273 0 1634941 0 0 Matt Lukens MD Director 686337 2500 0 0 22876 0 13800 0 25641 0 748654 2500 0 0 Emily Larson DO Director 345606 2500 65800 0 36233 0 11500 0 38183 0 497322 2500 0 0 Angelia Martin MD Director 0 268785 0 7860 0 2571 0 5725 0 34183 0 319124 0 0 Michael Pulido Former COO/Secretary 0 0 0 0 0 268884 0 0 0 0 0 268884 0 0 Mark Laney MD Former Director/President/CEO 0 0 0 0 0 220393 0 0 0 0 0 220393 0 0 Davin J Turner DO Chief Administrative Officer 0 681882 0 161996 0 5334 0 97800 0 32871 0 979883 0 0 Drew M Keesbury CFO/Treasurer 0 585390 0 153973 0 1458 0 65167 0 32318 0 838306 0 0 Michael R Rinard Secretary 0 296959 0 69131 0 2386 0 45160 0 36071 0 449707 0 0 Gene A Claycomb President of Mosaic Medical Center 399971 0 105921 0 6822 0 60107 0 36283 0 609104 0 0 0 Rony M Abou-Jawde MD Staff Physician 946808 0 1213710 0 23867 0 13800 0 33183 0 2231368 0 0 0 Jonathan Amspacher MD Staff Physician 1069953 0 641172 0 24478 0 13800 0 33168 0 1782571 0 0 0 Robert Grant MD Staff Physician 984904 0 200000 0 84964 0 13736 0 35933 0 1319537 0 0 0 Michael Lunski Staff Physician 754105 0 518340 0 1458 0 11500 0 10594 0 1295997 0 0 0 Arvind K Sharma MD Staff Physician 985905 0 200000 0 61121 0 13800 0 25891 0 1286717 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 2024. 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 $200,000 MICHAEL R RINARD - VESTED $0; ACCRUED $31,360 DAVIN TURNER, DO - VESTED $0; ACCRUED $84,000 GENE A CLAYCOMB - VESTED $0; ACCRUED $54,431 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. Full vesting in all amounts accrued under the Plan will occur upon attainment of age 65 while employed by Mosaic Health System, death or disability while employed by Mosaic Health System, or involuntary termination of employment with Mosaic Health System without cause. 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 participants 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. 5. If the SERP Participant terminates employment prior to completing the required service period, and such termination occurs before death or disability, the SERP Participant shall forfeit all rights to any portion of the Account that is not vested. RYAN FRAZER RYAN FRAZER IS THE SON OF GARY FRAZER 52936 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 AN Athletic Trainer false Elizabeth Hale Elizabeth Hale IS THE Granddaughter OF Melody Smith 25429 Elizabeth Hale IS AN Inpatient RN in the UCI department AT HEARTLAND REGIONAL MEDICAL CENTER AND IS THE Granddaughter OF Melody Smith, 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 AN Inpatient RN. false 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 and Melody Smith. THE FOLLOWING HEARTLAND REGIONAL MEDICAL CENTER DIRECTORS ARE NOT INDEPENDENT DUE TO TRANSACTIONS DISCLOSED ON THE MOSAIC HEALTH SYSTEM'S, A RELATED TAX-EXEMPT ORGANIZATION, FORM 990, SCHEDULE L: THOMAS RICHMOND. 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 CORPORATION, IS THE SOLE MEMBER OF HEARTLAND REGIONAL MEDICAL CENTER. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body As the sole member of Heartland Regional Medical Center (Mosaic-St. Joseph), 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 (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 XI, Line 9 Other changes in net assets or fund balances Other changes in unrestricted net assets - 1524; Total - 1524; 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. 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 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 10/2/2024 as documented in the meeting minutes. Northland Expansion LLC 5325 Faraon Street St Joseph MO 64506 Development MO 0 0 Heartland Regional Medical Center Urgent Care Properties LLC 5325 Faraon Street St Joseph MO 64506 Development MO 0 0 Heartland Regional Medical Center Mosaic Health System (MHS) 5325 Faraon Street St Joseph MO 64506 431283316 Healthcare MO 501(c)(3) Type III-FI 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 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 Mosaic Medical Center-Maryville (MOSAIC-MARYVILLE) 5325 Faraon Street St Joseph MO 64506 832249459 Healthcare MO 501(c)(3) 3 Mosaic Health System true Midwestern Health Management Inc 5325 Faraon Street St Joseph MO 64506 431264358 Property Mgmt Svcs 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 Heartland Regional Medical Center C Corporation 0 0 1 true Uptown St Joseph Redevelopment Corp 5325 Faraon Street St Joseph MO 64506 201742813 Redevelopment MO Heartland Regional Medical Center C Corporation 0 0 1 true false true false true false false false false false true true true true true true true true true true MOSAIC HEALTH SYSTEM (MHS) M 127074518 FMV MOSAIC HEALTH SYSTEM (MHS) P 399222237 FMV HEARTLAND FOUNDATION (MLC FOUNDATION) B 421116 FMV HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH) J 638337 FMV HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH) Q 54519 FMV NORTHWEST MEDICAL CENTER ASSOCIATION INC (MOSAIC-ALBANY) P 3193930 FMV HEARTLAND FOUNDATION (MLC FOUNDATION) P 273803 FMV MOSAIC MEDICAL CENTER-MARYVILLE (MOSAIC-MARYVILLE) Q 5087368 FMV HHS PROPERTIES INC K 285004 FMV HEARTLAND LONG TERM ACUTE CARE HOSPITAL (HLTACH) L 2557370 FMV MOSAIC MEDICAL CENTER-MARYVILLE (MOSAIC-MARYVILLE) S 86875 FMV NORTHWEST MEDICAL CENTER ASSOCIATION INC (MOSAIC-ALBANY) S 84256 FMV