TRUMAN MEDICAL CENTER INCORPORATED: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: TRUMAN MEDICAL CENTER INCORPORATED (EIN 44-0661018)
Tax period: 2019-07-01 to 2020-06-30
Filed: 2021-05-03
IRS object ID: 202141239349301524
Schema version: 2019v5.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule O
Schedule R
Affiliated Group Schedule

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2021-05-03T13:06:02-05:00	ReturnTs
Tax Period End	2020-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	1201 Walnut Suite 1700	AddressLine1Txt
City	Kansas City	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	641062246	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2019-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	440661018	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	TRUMAN MEDICAL CENTER INCORPORATED	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% MARGA HOELSCHER	InCareOfNm
Business Name Control	TRUM	BusinessNameControlTxt
Phone	8164041000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2301 HOLMES STREET	AddressLine1Txt
City	KANSAS CITY	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	64108	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	CHARLES W SHIELDS	PersonNm
Person Title	PRESIDENT/CEO	PersonTitleTxt
Phone	8164043528	PhoneNum
Signature	2021-05-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Michael J Engle	PreparerPersonNm
PTIN	P00482834	PTIN
Phone	8162216300	PhoneNum

Field	Value	IRS element (for citing)
Tax	2019	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	MARGA HOELSCHER	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2301 HOLMES	AddressLine1Txt
City	KANSAS CITY	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	64108	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$635,238,767	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.TMCMED.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1976	FormationYr
Legal Domicile State	MO	LegalDomicileStateCd
Activity Or Mission	TRUMAN MEDICAL CENTER IS AN ACADEMIC HEALTH CENTER PROVIDING ACCESSIBLE, STATE-OF-THE-ART QUALITY HEALTHCARE TO OUR COMMUNITY REGARDLESS OF ABILITY TO PAY.	ActivityOrMissionDesc
Voting Members Governing Body	32	VotingMembersGoverningBodyCnt
Voting Members Independent	30	VotingMembersIndependentCnt
Total Employee	5244	TotalEmployeeCnt
Total Volunteers	113	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$11,873,856	PYContributionsGrantsAmt
CY Contributions Grants	$11,391,051	CYContributionsGrantsAmt
PY Program Service Revenue	$554,283,627	PYProgramServiceRevenueAmt
CY Program Service Revenue	$577,623,640	CYProgramServiceRevenueAmt
PY Investment Income	$407,366	PYInvestmentIncomeAmt
CY Investment Income	-$159,956	CYInvestmentIncomeAmt
PY Other Revenue	$42,307,682	PYOtherRevenueAmt
CY Other Revenue	$45,640,429	CYOtherRevenueAmt
PY Total Revenue	$608,872,531	PYTotalRevenueAmt
CY Total Revenue	$634,495,164	CYTotalRevenueAmt
PY Grants And Similar Paid	$789,194	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$19,000	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$301,045,794	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$324,803,169	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$300,795,702	PYOtherExpensesAmt
CY Other Expenses	$302,341,194	CYOtherExpensesAmt
PY Total Expenses	$602,630,690	PYTotalExpensesAmt
CY Total Expenses	$627,163,363	CYTotalExpensesAmt
PY Revenues Less Expenses	$6,241,841	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$7,331,801	CYRevenuesLessExpensesAmt
Total Assets BOY	$392,721,691	TotalAssetsBOYAmt
Total Assets EOY	$444,243,623	TotalAssetsEOYAmt
Total Liabilities BOY	$300,778,194	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$371,542,204	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$91,943,497	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$72,701,419	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	TRUMAN MEDICAL CENTER IS AN ACADEMIC HEALTH CENTER PROVIDING ACCESSIBLE, STATE-OF-THE-ART QUALITY HEALTHCARE TO OUR COMMUNITY REGARDLESS OF THE ABILITY TO PAY.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$257,295,942	ExpenseAmt
Grant	$19,000	GrantAmt
Revenue	$289,817,792	RevenueAmt
Desc	OUTPATIENT DEPARTMENT- SEE SCHEDULE O	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$220,776,518	ExpenseAmt
Revenue	$248,682,364	RevenueAmt
Desc	INPATIENT CARE- SEE SCHEDULE O	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$75,252,147	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$84,763,913	RevenueAmt
Desc	EMERGENCY DEPARTMENT- SEE SCHEDULE O	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$553,324,607	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (true)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	Yes (true)	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	337	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	5244	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	Yes (true)	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	32	GoverningBodyVotingMembersCnt
Independent Voting Member	30	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	false	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	MO	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	MARGA HOELSCHER	PersonNm
Phone	8164043540	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2301 HOLMES	AddressLine1Txt
City	KANSAS CITY	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	64108	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (41 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
CHARLES W SHIELDS
PRESIDENT/CEO/DIRECTOR	40.0	0.0	Yes (X)	Yes (X)	$1,113,121	$0	$432,567
ALLEN M JOHNSON
ASSISTANT TREASURER	40.0	0.0		Yes (X)	$884,961	$0	$47,763
WILLIAM H COLBY
ASSISTANT SECRETARY	40.0	2.0		Yes (X)	$862,488	$0	$56,148
JOHN GIANINO
NEUROSURGEON	40.0	1.0			$624,618	$0	$113,575	Yes (X)
MITZI CARDENAS
EXECUTIVE CHIEF ADMIN OFFICER	40.0	0.0			$551,922	$0	$50,374	Yes (X)
DOUG BRANDT
ASSOC CFO	40.0	0.0			$552,453	$0	$28,533	Yes (X)
LYNETTE WHEELER
COO - LW	40.0	0.0			$505,933	$0	$40,348	Yes (X)
MARK T STEELE MD
DIRECTOR	20.0	1.0	Yes (X)		$435,952	$0	$0
RUTH PULLINS
CHIEF HR OFFICER	40.0	0.0			$356,667	$0	$69,726	Yes (X)
PEGGY J DUNN
PAST CHAIR/DIRECTOR	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
DAVE BARBER
VICE CHAIR/DIRECTOR	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
PHILIP J SANDERS
CHAIR/DIRECTOR	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
DRED D SCOTT PHD
VICE CHAIR/DIRECTOR	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
TIMOTHY A WURST
SECRETARY/VICE CHAIR/DIRECTOR	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
FORESTINE BEASLEY
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
ZANE M BURKE
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
DOUGLAS M BURGESS MD
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
JAMES CORWIN
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
SEN KIKI CURLS
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
JOLIE L JUSTUS
VICE CHAIR/DIRECTOR	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
TRACEY LEWIS
TREASURER/DIRECTOR	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
MARVIN LYMAN
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
JON OTTO
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
MAHNAZ SHABBIR
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
ZULEMA BASSHAM
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
MICHAEL COLLINS
VICE CHAIR/DIRECTOR	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
CARLOS GOMEZ
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
KAMANI M LANKACHANDRA MD
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
ALISE MARTINY
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
MELISSA ROBINSON
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
MAULI AGRAWAL
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
JEFFREY A METZNER MD
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
PAT CONTRERAS
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
SEAN GRATTON MD
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
STEVE HAWN
VICE CHAIR/DIRECTOR	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
MARY ANNE JACKSON MD
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
JAMES TERRANCE JR
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
GLEN TALBOY MD
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
MUDASSAR ZIA MD
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
LATOSHA ELIGON
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
EILEEN WEIR
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$5,888,115	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$839,034	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	302	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	Yes (true)	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
UNIVERSITY HEALTH PHYSICIANS
2310 HOLMES SUITE 800	KANSAS CITY	MO	64108	PHYSICIAN SERVICES	$20,619,280
CERNER CORPORATION
PO BOX 412702	KANSAS CITY	MO	64141	IT SERVICES	$19,409,898
UNIVERSITY OF MISSOURI-KANSAS CITY
PO BOX 805111	KANSAS CITY	MO	64180	MEDICAL SERVICES	$16,977,283
MEDICAL IMAGING PA
127 W 10TH STREET SUITE 202	KANSAS CITY	MO	64105	MEDICAL SERVICES	$5,497,041
UNION HILL ANESTHESIA PC
5512 ABERDEEN RD	FAIRWAY	KS	66205	MEDICAL SERVICES	$6,784,326

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	37	CntrctRcvdGreaterThan100KCnt
Government Grants	$7,418,920	GovernmentGrantsAmt
All Other Contributions	$3,972,131	AllOtherContributionsAmt
Total Contributions	$11,391,051	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE	621110	$347,614,645	$347,614,645
EXPENSE REIMBURSEMENT	621110	$1,865,077	$1,865,077
MEDICAID ENHANCEMENTS	621110	$174,282,361	$174,282,361
LOCAL GOVERNMENT SUBSIDY	900099	$36,264,324	$36,264,324
PROVIDER RELIEF FUNDS	900099	$17,597,233	$17,597,233

Field	Value	IRS element (for citing)
Total Program Service Revenue	$577,623,640	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$328,647	TotalRevenueColumnAmt
Exclusion	$328,647	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$255,000	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$699,771	SecuritiesAmt
Other	$43,832	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$699,771	SecuritiesAmt
Other	$211,168	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$488,603	TotalRevenueColumnAmt
Exclusion	-$488,603	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
340B REVENUE	900099	$34,936,356	$34,936,356
EHR MEANINGFUL USE	900099	$314,035	$314,035
LAB	900099	$2,372,729	$2,372,729

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,017,309	TotalRevenueColumnAmt
Related Or Exempt Func Income	$8,017,309	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$45,640,429	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$634,495,164	TotalRevenueColumnAmt
Related Or Exempt Func Income	$623,264,069	RelatedOrExemptFuncIncomeAmt
Exclusion	-$159,956	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$19,000	TotalAmt
Program Services	$19,000	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$3,229,450	TotalAmt
Management And General	$3,229,450	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$264,711,947	TotalAmt
Program Services	$231,877,654	ProgramServicesAmt
Management And General	$32,834,293	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$4,246,530	TotalAmt
Program Services	$3,874,394	ProgramServicesAmt
Management And General	$372,136	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$35,020,351	TotalAmt
Program Services	$30,400,924	ProgramServicesAmt
Management And General	$4,619,427	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$17,594,891	TotalAmt
Program Services	$15,242,026	ProgramServicesAmt
Management And General	$2,352,865	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$889,907	TotalAmt
Management And General	$889,907	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$254,356	TotalAmt
Management And General	$254,356	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$127,770	TotalAmt
Management And General	$127,770	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$48,014,829	TotalAmt
Program Services	$43,213,346	ProgramServicesAmt
Management And General	$4,801,483	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$837,667	TotalAmt
Program Services	$628,250	ProgramServicesAmt
Management And General	$209,417	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$104,657,137	TotalAmt
Program Services	$89,411,831	ProgramServicesAmt
Management And General	$15,245,306	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$16,310,051	TotalAmt
Program Services	$12,232,538	ProgramServicesAmt
Management And General	$4,077,513	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$12,955,263	TotalAmt
Program Services	$11,439,497	ProgramServicesAmt
Management And General	$1,515,766	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$177,979	TotalAmt
Program Services	$157,155	ProgramServicesAmt
Management And General	$20,824	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$512,399	TotalAmt
Program Services	$452,448	ProgramServicesAmt
Management And General	$59,951	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,870,428	TotalAmt
Program Services	$1,683,385	ProgramServicesAmt
Management And General	$187,043	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$21,604,893	TotalAmt
Program Services	$18,796,257	ProgramServicesAmt
Management And General	$2,808,636	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,700,208	TotalAmt
Program Services	$1,467,595	ProgramServicesAmt
Management And General	$232,613	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
MEDICAL STAFF EXPENSES	$134,943	$134,943
MEDICAL SUPPLIES	$44,180,607	$44,180,607
PHARMACEUTICALS	$48,112,757	$48,112,757

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$627,163,363	TotalAmt
Program Services	$553,324,607	ProgramServicesAmt
Management And General	$73,838,756	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$10,837,850	BOYAmt
EOY	$51,066,237	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$163,025	BOYAmt
EOY	$2,115,412	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$719,123	BOYAmt
EOY	$566,940	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$74,519,059	BOYAmt
EOY	$65,022,036	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$7,741,455	BOYAmt
EOY	$8,477,804	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$3,673,043	BOYAmt
EOY	$7,687,101	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$638,042,773	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$401,426,514	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$179,441,768	BOYAmt
EOY	$236,616,259	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$7,350,834	BOYAmt
EOY	$7,514,650	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$108,275,534	BOYAmt
EOY	$65,177,184	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$392,721,691	BOYAmt
EOY	$444,243,623	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$156,391,616	BOYAmt
EOY	$197,647,544	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$102,692,985	BOYAmt
EOY	$97,555,900	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$29,460,438	BOYAmt
EOY	$25,752,722	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$12,233,155	BOYAmt
EOY	$50,586,038	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$300,778,194	BOYAmt
EOY	$371,542,204	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$68,409,124	BOYAmt
EOY	$47,178,523	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$23,534,373	BOYAmt
EOY	$25,522,896	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$91,943,497	BOYAmt
EOY	$72,701,419	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$392,721,691	BOYAmt
EOY	$444,243,623	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$7,331,801	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$77,801	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$26,496,078	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Organization Belongs Afflt Grp	Yes (X)	OrganizationBelongsAffltGrpInd

Total Grassroots Lobbying TotalGrassrootsLobbyingGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$59,922	FilingOrganizationsTotalAmt
Affiliated Group Total	$59,922	AffiliatedGroupTotalAmt

Total Direct Lobbying TotalDirectLobbyingGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$67,848	FilingOrganizationsTotalAmt
Affiliated Group Total	$67,848	AffiliatedGroupTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$127,770	FilingOrganizationsTotalAmt
Affiliated Group Total	$127,770	AffiliatedGroupTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$627,035,593	FilingOrganizationsTotalAmt
Affiliated Group Total	$627,035,593	AffiliatedGroupTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$627,163,363	FilingOrganizationsTotalAmt
Affiliated Group Total	$627,163,363	AffiliatedGroupTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,000,000	FilingOrganizationsTotalAmt
Affiliated Group Total	$1,000,000	AffiliatedGroupTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$250,000	FilingOrganizationsTotalAmt
Affiliated Group Total	$250,000	AffiliatedGroupTotalAmt

Field	Value	IRS element (for citing)
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$1,000,000	CurrentYearMinus3Amt
Current Year Minus2	$1,000,000	CurrentYearMinus2Amt
Current Year Minus1	$1,000,000	CurrentYearMinus1Amt
Current Year	$1,000,000	CurrentYearAmt
Total	$4,000,000	TotalAmt

Field	Value	IRS element (for citing)
Lobbying Ceiling	$6,000,000	LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$115,773	CurrentYearMinus3Amt
Current Year Minus2	$104,992	CurrentYearMinus2Amt
Current Year Minus1	$110,791	CurrentYearMinus1Amt
Current Year	$127,770	CurrentYearAmt
Total	$459,326	TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$250,000	CurrentYearMinus3Amt
Current Year Minus2	$250,000	CurrentYearMinus2Amt
Current Year Minus1	$250,000	CurrentYearMinus1Amt
Current Year	$250,000	CurrentYearAmt
Total	$1,000,000	TotalAmt

Field	Value	IRS element (for citing)
Grassroots Ceiling	$1,500,000	GrassrootsCeilingAmt

Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$47,766	CurrentYearMinus3Amt
Current Year Minus2	$42,789	CurrentYearMinus2Amt
Current Year Minus1	$44,175	CurrentYearMinus1Amt
Current Year	$59,922	CurrentYearAmt
Total	$194,652	TotalAmt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,658,405	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	$26,539	InvestmentEarningsOrLossesAmt
Other Expenditures	$129,274	OtherExpendituresAmt
End Year Balance	$3,555,670	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,511,267	BeginningYearBalanceAmt
Contributions	$5,000	ContributionsAmt
Investment Earnings Or Losses	$151,452	InvestmentEarningsOrLossesAmt
Other Expenditures	$9,314	OtherExpendituresAmt
End Year Balance	$3,658,405	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,355,388	BeginningYearBalanceAmt
Contributions	$5,000	ContributionsAmt
Investment Earnings Or Losses	$286,306	InvestmentEarningsOrLossesAmt
Other Expenditures	$135,427	OtherExpendituresAmt
End Year Balance	$3,511,267	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,130,017	BeginningYearBalanceAmt
Contributions	$944	ContributionsAmt
Investment Earnings Or Losses	$366,243	InvestmentEarningsOrLossesAmt
Other Expenditures	$141,816	OtherExpendituresAmt
End Year Balance	$3,355,388	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,173,107	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	-$82,203	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$102,557	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$2,988,347	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.91800	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.08200	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	Yes (true)	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,909,661	OtherCostOrOtherBasisAmt
Book Value	$4,909,661	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$337,591,689	OtherCostOrOtherBasisAmt
Depreciation	$231,786,760	DepreciationAmt
Book Value	$105,804,929	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$215,028,480	OtherCostOrOtherBasisAmt
Depreciation	$169,639,754	DepreciationAmt
Book Value	$45,388,726	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$80,512,943	OtherCostOrOtherBasisAmt
Book Value	$80,512,943	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$236,616,259	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDesc	Book ValueBookValueAmt
ASSETS FOR CAPITAL ACQUISITION	$3,641,684
ASSETS EXTERNALLY RESTRICTED	$1,236,328
INTEREST IN ASSETS OF TMCCF	$24,286,570
ASSETS HELD BY BOND TRUSTEE	$26,598,017
OTHER RECEIVABLES	$9,414,585

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$65,177,184	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
457F PLAN LIABILITY	$3,641,684
UNAMORTIZED PREMIUM	$1,041,613
OTHER LIABILITIES	$45,902,741

Field	Value	IRS element (for citing)
Total Liability	$50,586,038	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$693,909,565	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$77,801	NetUnrealizedGainsInvstAmt
Other Revenue	$129,670,428	OtherRevenueAmt
Revenue Not Reported	$129,592,627	RevenueNotReportedAmt
Revenue Subtotal	$564,316,938	RevenueSubtotalAmt
Other Revenues Not Included	$70,178,226	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$70,178,226	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$634,495,164	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$687,540,703	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$129,494,498	OtherExpensesIncludedAmt
Expenses Not Reported	$129,494,498	ExpensesNotReportedAmt
Expenses Subtotal	$558,046,205	ExpensesSubtotalAmt
Other Expenses Not Included	$69,117,158	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$69,117,158	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$627,163,363	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4	THE INVESTMENTS ARE TO BE HELD IN PERPETUITY AT TRUMAN MEDICAL CENTER CHARITABLE FOUNDATION. THE FOUNDATION'S ENDOWMENT CONSISTS OF SIX INDIVIDUAL DONOR-RESTRICTED FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THESE INTENTIONS INCLUDE: SUPPORTING INFECTIOUS DISEASE EDUCATION AT TMC, INC. SUPPORTING THE WOMEN'S HEALTH DEPARTMENT AT TMC, INC. SUPPORTING THE TRAUMA DEPARTMENT AT TMC, INC. PROVIDING PROGRAM SUPPORT TO BEHAVIORAL HEALTH AT TMC, INC. SUPPORTING THE UNRESTRICTED NEEDS OF TMC, INC. SUPPORTING ALZHEIMER UNIT AT TMC, INC. THE FOUNDATION HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS AND OTHER ITEMS SUPPORTED BY ITS ENDOWMENT. UNDER THE FOUNDATION'S POLICIES, ENDOWMENT ASSETS ARE INVESTED IN A MANNER THAT IS INTENDED TO PRESERVE AND PROTECT ASSETS BY EARNING A TOTAL RETURN FOR EACH ENDOWMENT APPROPRIATE TO EACH FUND'S TIME HORIZON, LIQUIDITY NEEDS AND RISK TOLERANCE. THE FOUNDATION HAS A POLICY (THE SPENDING POLICY) OF APPROPRIATING FOR EXPENDITURE EACH YEAR THE LESSER OF 5% OF ITS ENDOWMENT FUND'S FAIR VALUE OR THE FUND'S NET INCOME THROUGH THE YEAR END PRECEDING THE YEAR IN WHICH EXPENDITURE IS PLANNED.
SCHEDULE D, PART X, LINE 2	MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
SCHEDULE D, PART XI, LINE 2D	Net Assets Released From Restrictions $ 302,345 Related Organization Revenue 129,368,083 ----------- $ 129,670,428
SCHEDULE D, PART XI, LINE 4B	Medical Staff Revenue $ 212,882 Temporarily Restricted Contributions 550,449 Contribution used for Asset Acquisition 451,680 Eliminations 68,963,215 Bad Debt Expense ----------- $ 70,178,226
SCHEDULE D, PART XII, LINE 2D	Related Organization Expenses $ 129,494,498
SCHEDULE D, PART XII, LINE 4B	Eliminations $ 68,963,215 Medical Staff Expenses 153,943 ----------- Total $ 69,117,158

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	false	FPGReferenceDiscountedCareInd
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$133,119,113	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$107,236,010	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$25,883,103	NetCommunityBenefitExpnsAmt
Total Expense	0.04130	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$207,304,421	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$175,257,848	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$32,046,573	NetCommunityBenefitExpnsAmt
Total Expense	0.05110	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$340,423,534	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$282,493,858	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$57,929,676	NetCommunityBenefitExpnsAmt
Total Expense	0.09240	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,040,887	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$313,556	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$727,331	NetCommunityBenefitExpnsAmt
Total Expense	0.00120	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$41,197,189	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$36,400,308	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,796,881	NetCommunityBenefitExpnsAmt
Total Expense	0.00760	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,940,144	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,792,789	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,147,355	NetCommunityBenefitExpnsAmt
Total Expense	0.00500	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$430,085	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$430,085	NetCommunityBenefitExpnsAmt
Total Expense	0.00070	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$48,608,305	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$39,506,653	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,101,652	NetCommunityBenefitExpnsAmt
Total Expense	0.01450	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$389,031,839	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$322,000,511	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$67,031,328	NetCommunityBenefitExpnsAmt
Total Expense	0.10690	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$31,693,236	BadDebtExpenseAmt
Bad Debt Expense Attributable	$23,769,927	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$72,446,891	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$60,797,576	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$11,649,315	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Teaching HospitalTeachingHospitalInd	Research FacilityResearchFacilityInd	Facility Reporting GroupFacilityReportingGroupCd
TRUMAN MEDICAL CENTER - HOSPITAL HILL
1	2301 HOLMES	KANSAS CITY	MO	64108	WWW.TRUMED.ORG	285-39	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
TRUMAN MEDICAL CENTER - LAKEWOOD
2	7900 LEES SUMMIT ROAD	KANSAS CITY	MO	64139	WWW.TRUMED.ORG	195-54	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	A	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	18	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	X	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	18	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	0.	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5 - BOTH FACILITIES	TMC CONDUCTED AN ELECTRONIC SURVEY TO ENGAGE COMMUNITY PARTNERS IN THE ASSESSMENT PROCESS. A COMMON SET OF QUESTIONS WAS POSED, AND RESPONSES COLLECTED AND SUMMARIZED. TWENTY-THREE PARTNER ORGANIZATIONS PARTICIPATED IN THE SURVEY. THIS ELECTRONIC SURVEY ESTABLISHED THE SET OF ISSUES OF MOST INTEREST TO THE COMMUNITY. RESPONDENTS WERE ASKED TO SELECT ISSUES, AND ALSO TO CONSIDER SERVICES THEY BELIEVED COULD BE STRENGTHENED IN TERMS OF ACCESS, AVAILABILITY AND/OR QUALITY. RESPONSES WERE SUMMARIZED TO PROVIDE A CONSENSUS REPORT. IN ADDITION, 395 TMC TEAM MEMBERS PARTICIPATED IN AN ELECTRONIC SURVEY IN WHICH THEY IDENTIFIED THE MOST IMPORTANT ISSUES THEY BELIEVE TMC NEEDS TO ADDRESS BASED ON THEIR KNOWLEDGE OF ISSUES FACING PATIENTS AND THE COMMUNITY. TWO SURVEYS WERE CONDUCTED - ONE FOR EACH TMC FACILITY - IN ORDER TO ESTABLISH UNIQUE PRIORITIES FOR EACH ENTITY.
SCHEDULE H, PART V, SECTION B, LINE 6A	TMC COMPLETED CHNA REPORTS FOR TWO FACILITIES, TMC-HOSPITAL HILL AND TMC-LAKEWOOD. AS REQUIRED BY THE IRS, EACH FACILITY HAS A SEPARATE REPORT, WITH FACILITY-SPECIFIC PRIORITIES.
SCHEDULE H, PART V, SECTION B, LINE 7A - BOTH FACILITIES	THE COMPLETE CHNA FOR TMC-HOSPITAL HILL AND TMC-LAKEWOOD CAN BE FOUND AT: https://www.trumed.org/about-us/publications/
SCHEDULE H, PART V, SECTION B, LINE 10 - BOTH FACILITIES	THE IMPLEMENTATION STRATEGY FOR TMC-HOSPITAL HILL AND TMC-LAKEWOOD CAN BE FOUND AT: https://www.trumed.org/about-us/publications/
SCHEDULE H, PART V, SECTION B, LINE 11 - BOTH FACILITIES	Assessing the needs of the community is an integral part of TMCs day-to-day operations. As a safety net provider with a significant population of uninsured patients, it is critical to TMCs survival to assure provision of care that meets community need and keeps the costs of care as reasonable as possible. A formal community health needs assessment process was initiated in the fall of 2012, in the fall of 2015, and again in 2019. This process included the following steps: Define Community. As part of this phase, TMC examined the current patient data file and other documentation of defined geographic service area for Hospital Hill and Lakewood facilities. This included: - Define geographic service area - Define specific target populations with broader reach than the geographic service area Identify Partners. TMC has many partners. As part of its ongoing work in meeting community need, TMC engages these organizations in strategic planning and in helping identify organizational priorities. During this phase, TMC completed the following: - Established an inventory of TMC involvement in community-based partnerships - Identified consumers and engaged them through focus groups and surveys Secondary Data: TMC assembled a broad set of data to measure and evaluate health status, health statistics and the incidence rates of disease, illness and accidents using secondary data sources. This phase of the assessment focused on not only on health outcomes, but also on factors that influence future health, such as health and wellness habits, experiences accessing care and attitudes that influence healthy behavior. Primary Data: This effort to measure and evaluate health status, health statistics and the incidence rates of disease, illness and accidents uses Truman Medical Centers data. The primary data collection effort focused on health outcomes and factors that influence health, such as homelessness, insurance coverage and health care system utilization for specific conditions; specific to the TMC patient experience. Aggregated Data: TMC assimilated Secondary and Primary data sets into a combined comprehensive report and overview of the TMC service areas and patients. The aggregated data report is reflected throughout this report. Identify & Prioritize Issues. This phase engaged the board, organizational leadership, key constituents and community partners to identify and prioritize community health issues; using the results of the data analysis. Multiple surveys were utilized during this process, with delineation of responses between TMC staff/leadership and the community overall. After analysis of responses, and considering the unique focus of TMC as an academic medical center and safety net health system, the following issues emerged: Access to Integrated Care; Chronic Disease; Behavioral Health; Maternal & Infant Health; and Violence Prevention. Integrated Care Access is an overarching theme in TMCs CHNA. As an Essential Hospital, TMC is the safety net health system for the greater Kansas City region. In this capacity, TMC has a continual focus on assuring access; access to outpatient clinical care, access to specific target populations, and access to services needed by the community at large. With the community continuing to experience a shortage of primary care providers, TMC remains committed to working with the regions Federally Qualified Health Centers to assure access to specialty care. Through a variety of mechanisms, TMC will continue its efforts to increase access to all types of care, for all community members. Using a health equity approach, which recognizes the impact of socio-ecological factors on a persons ability to access health care, TMC continues to identify locations for direct outreach, including community-based clinics and community-based health education. This approach is an underlying theme to everything TMC undertakes; with staff members educated in cultural competence and trauma-informed care. This approach was designed to create an atmosphere of welcome for all who interact with TMC. Because of this focus, TMC will continue its goal of being the provider of choice for key health conditions which include Sickle Cell disease, HIV and other chronic conditions that disproportionately impact minority populations in the greater Kansas City region. Chronic Care Because chronic diseases impact a significant number of TMCs patients, and their prevalence in the community is high, the focus in this area is on continuous improvement of programs and services across all initiatives. Community need, and patient demand, will continue to be monitored with services tailored to meet need. Chronic disease self-management programs will be delivered in neighborhood settings to encourage participation, and patients with significant, and co-occurring conditions will be encouraged to enroll in specialty programs for assistance with medication management, self-care and other supportive services. Behavioral Health The opioid crisis has become predominant in the community. TMC will continue to model integrated primary care and intensive mental health/substance abuse services, including development of a clinic designed specifically to assist patients with medication-assisted therapy to address their addiction. Maternal & Infant Health TMCs primary focus relative to the CHNA is to expand its community outreach and education efforts to bring more pregnant women into care earlier in their pregnancies. Furthering this approach, efforts under the Access area will place clinical points of care in neighborhoods throughout the service area offering more immediate access to providers. Violence Prevention Under this area, TMC will participate in the Aim for Peace initiative. This intervention model is designed specifically to reduce retaliatory violence. As a Level 1 Trauma Center, TMC experiences a significant volume of gang-related emergency department visits. As a result, staff are trained to identify potentially violent situations and engage the Aim for Peace model to diffuse situations.
SCHEDULE H, PART V, SECTION B, LINE 16A - BOTH FACILITIES	THE FAP CAN BE FOUND AT: https://www.trumed.org/patients-visitors/billing-information/financial-ass istance/
SCHEDULE H, PART V, SECTION B, LINE 16B - BOTH FACILITIES	THE FAP APPLICATION CAN BE FOUND AT: https://www.trumed.org/patients-visitors/billing-information/financial-ass istance/
SCHEDULE H, PART V, SECTION B, LINE 16C - BOTH FACILITIES	THE PLAIN LANGUAGE SUMMARY CAN BE FOUND AT: https://www.trumed.org/patients-visitors/financial-services/financial-coun seling

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	TMC BEHAVIORAL HEALTH	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	300 WEST 19TH TERRACE	AddressLine1Txt
City	KANSAS CITY	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	64108	ZIPCd

Field	Value	IRS element (for citing)
Facility	MENTAL HEALTH FACILITY	FacilityTxt

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 3C	ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS AND RESIDENCY ARE OTHER FACTORS USED IN THE ELIGIBILITY CRITERIA EXPLAINED IN THE FAP FOR PROVIDING FREE CARE. SCHEDULE H, PART I, LINE 7 THE COST METHOD USED TO CALCULATE THE AMOUNTS IN THIS TABLE IS A COST TO CHARGE RATIO
SCHEDULE H, PART III, SECTION A, LINE 2	THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2020. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.
SCHEDULE H, PART III, SECTION A, LINE 4	THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE IS IN AUDIT NOTE 1 ON PAGE 9 OF THE ATTACHED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, SECTION B, LINE 3	TMC HAS DISCOVERED ABOUT 75% OF BAD DEBTS RESULT FROM PATIENTS WHO ARE INDIGENT OR DO NOT QUALIFY FOR MEDICAID.
SCHEDULE H, PART III, SECTION C, LINE 9B	TMC DOES NOT PURSUE COLLECTION FOR UNPAID DISCOUNTED AMOUNTS FOR INDIVIDUALS WITHIN THE CATCHMENT AREA.
SCHEDULE H, PART VI, LINE 2	TMC CONDUCTED AN ELECTRONIC SURVEY TO ENGAGE COMMUNITY PARTNERS IN THE ASSESSMENT PROCESS. A COMMON SET OF QUESTIONS WAS POSED, AND RESPONSES COLLECTED AND SUMMARIZED. TWENTY-THREE PARTNER ORGANIZATIONS PARTICIPATED IN THE SURVEY. THIS ELECTRONIC SURVEY ESTABLISHED THE SET OF ISSUES OF MOST INTEREST TO THE COMMUNITY. RESPONDENTS WERE ASKED TO SELECT ISSUES, AND ALSO TO CONSIDER SERVICES THEY BELIEVED COULD BE STRENGTHENED IN TERMS OF ACCESS, AVAILABILITY AND/OR QUALITY. RESPONSES WERE SUMMARIZED TO PROVIDE A CONSENSUS REPORT. IN ADDITION, 395 TMC TEAM MEMBERS PARTICIPATED IN AN ELECTRONIC SURVEY IN WHICH THEY IDENTIFIED THE MOST IMPORTANT ISSUES THEY BELIEVE TMC NEEDS TO ADDRESS BASED ON THEIR KNOWLEDGE OF ISSUES FACING PATIENTS AND THE COMMUNITY. TWO SURVEYS WERE CONDUCTED - ONE FOR EACH TMC FACILITY - IN ORDER TO ESTABLISH UNIQUE PRIORITIES FOR EACH ENTITY.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE. IF A PATIENT IS UNINSURED, TMC'S FINANCIAL COUNSELING STAFF WORKS TO BECOME A PATIENT ADVOCATE. THEY ASSIST THE PATIENT IN APPLYING FOR MEDICARE, MEDICAID OR TMC'S CHARITY CARE PROGRAM. TMC POSTS ITS CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES THROUGHOUT THE HOSPITAL.
SCHEDULE H, PART VI, LINE 4 - COMMUNITY INFORMATION	The racial composition of TMCs Health Sciences District service area includes two primary categories: White and African American. These two categories comprise 90.06% of the customers within the Health Sciences District area. Racially, the TMC Health Sciences District service area reflects the greater Jackson County, Missouri racial mix, with 67.31% White, 22.75% African American, 2.06 % Asian, 0.46% Native American/Alaskan Native, 0.29% Native Hawaiian/Pacific Islander, 4.0% reporting some other race, and 3.13% reporting multiple races. The racial composition of TMCs Lakewood service area includes two primary categories: White and African American. These two categories comprise 90.17% of the customers within the Lakewood area. Racially, the TMC Lakewood service area reflects the greater Jackson County, Missouri racial mix, with 68.57% White, 21.6% African American, 2.04% Asian, 0.45% Native American/Alaskan Native, 0.29% Native Hawaiian/Pacific Islander, 3.91% reporting some other race, and 3.13% reporting multiple races.
SCHEDULE H, PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT	TMC has filed an annual community benefit report with the state of Missouri since 2005.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	TRUMAN MEDICAL CENTER CHARITABLE FOUNDATION	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2310 HOLMES STREET STE 735	AddressLine1Txt
City	KANSAS CITY	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	64108	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	431194064	RecipientEIN
IRC Section	501(C)(3)	IRCSectionDesc
Cash Grant	$10,000	CashGrantAmt
Purpose Of Grant	OPERATIONS	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	THE GRANT PROVIDED WAS MADE TO A PUBLIC ORGANIZATION WHO HAS A CLOSE WORKING RELATIONSHIP WITH TRUMAN MEDICAL CENTER. THIS ORGANIZATION STRIVES TO FURTHER SUPPORT THE HOSPITAL OPERATIONS OF TRUMAN MEDICAL CENTER, INC. THEREFORE, THE USE OF THE GRANTED FUNDS IS MONITORED THROUGH THE CLOSE WORKING RELATIONSHIP WITH THIS ORGANIZATION.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	Yes (true)	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
CHARLES W SHIELDS
PRESIDENT/CEO/DIRECTOR	$741,971	$0	$322,980	$0	$48,170	$0	$402,361	$0	$30,206	$0	$1,545,688	$0	$215,954	$0
MARK T STEELE MD
DIRECTOR	$409,048	$0	$26,904	$0	$0	$0	$0	$0	$0	$0	$435,952	$0	$0	$0
WILLIAM H COLBY
ASSISTANT SECRETARY	$508,388	$0	$43,430	$0	$310,670	$0	$24,772	$0	$31,376	$0	$918,636	$0	$211,956	$0
ALLEN M JOHNSON
ASSISTANT TREASURER	$442,205	$0	$37,744	$0	$405,012	$0	$28,687	$0	$19,076	$0	$932,724	$0	$332,955	$0
JOHN GIANINO
NEUROSURGEON	$500,657	$0	$722	$0	$123,239	$0	$78,019	$0	$35,556	$0	$738,193	$0	$117,894	$0
MITZI CARDENAS
EXECUTIVE CHIEF ADMIN OFFICER	$394,960	$0	$31,022	$0	$125,940	$0	$40,825	$0	$9,549	$0	$602,296	$0	$101,669	$0
DOUG BRANDT
ASSOC CFO	$66,958	$0	$0	$0	$485,495	$0	$25,984	$0	$2,549	$0	$580,986	$0	$172,108	$0
LYNETTE WHEELER
COO - LW	$284,018	$0	$49,859	$0	$172,056	$0	$11,200	$0	$29,148	$0	$546,281	$0	$117,214	$0
RUTH PULLINS
CHIEF HR OFFICER	$287,345	$0	$24,287	$0	$45,035	$0	$46,773	$0	$22,953	$0	$426,393	$0	$36,790	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 4A	DOUG BRANDT - $285,963
SCHEDULE J, PART I, LINE 4B	2019 2019 2019 ACCRUAL DISTRIBUTION TOTAL CHARLES SHIELDS $ 122,161 34,046 $ 156,207 WILLIAM COLBY $ -0- 211,956 $ 211,956 ALLEN JOHNSON $ -0- 332,955 $ 332,955 JOHN GIANINO $ 47,819 117,894 $ 165,713 MITZI CARDENAS $ 29,625 101,669 $ 131,295 LYNETTE WHEELER $ -0- 117,214 $ 117,214 DOUG BRANDT $ 19,267 172,108 $ 191,375 RUTH PULLINS $ 35,573 36,790 $ 72,363
SCHEDULE J, PART I, LINE 6A	CERTAIN EMPLOYEES ARE ELIGIBLE FOR A SMALL BONUS RELATED TO MEETING OR EXCEEDING BUDGET.
PART VII, LINE 5 AND SCH J, PART II	TRUMAN MEDICAL CENTER, INC. (TMC) REIMBURSED UNIVERSITY HEALTH PHYSICIANS $435,952 FOR THE TIME MARK STEELE, M.D. SPENT ASSISTING TMC, INC. AS THE MEDICAL DIRECTOR.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd	CUSIPCUSIPNum
MO HEALTH AND EDUCATION FACILITIES AUTH
A	431178966	2017-12-22	$70,000,000	BUILDING, EQUIPMENT AND REFUNDING	false	false	false
JACKSON COUNTY MISSOURI
B	446000524	2012-09-04	$41,180,485	REFUNDING BOND	false	false	false	467578GJ3
JACKSON COUNTY MISSOURI
C	446000524	2011-05-17	$24,674,279	CONSTRUCTION AND EQUIPMENT	false	false	false	467578FS4

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$4,170,000	$0	$70,000,000	$39,915,417	$6,750,626	$0	$485,984	$0	$0	$24,844,094	$4,754,505	$0	2020	Yes (true)	false	false	Yes (true)
B	$18,008,925	$0	$37,597,509	$0	$0	$0	$451,929	$0	$0	$0	$37,145,580	$0	2012	Yes (true)	false	Yes (true)	Yes (true)
C	$10,380,000	$0	$24,674,279	$0	$0	$0	$289,279	$0	$0	$24,385,000	$0	$0	2011	false	false	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd
A	false	false	false	false	false	false	false	Yes (true)
B	false	false	Yes (true)	false	false	false	false	Yes (true)	Yes (true)
C	false	false	false	false	false	false	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Business Name Line1GICProviderName/BusinessNameLine1Txt	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd	No Rebate DueNoRebateDueInd
0
A	false	Yes (true)	false	false	false	0	false	Yes (true)
0
B	false		false	false	false	0	false	Yes (true)	Yes (true)
0
C	false		false	false	false	0	Yes (true)	Yes (true)	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	false
B	false
C	false

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART IV, LINE 2C, COLUMN B	THE ARBITRAGE REBATE ANALYSIS WAS PERFORMED 9-24-2017
PART IV, LINE 2C, COLUMN C	THE ARBITRAGE REBATE ANALYSIS WAS PERFORMED 5-7-2016

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 4A	One of the greatest strength of Truman Medical Centers (TMC) is its ability to provide high quality, state-of-the-art healthcare to all its patients, regardless of patients' ability to pay. TMC offers more than 50 primary, specialty, and mental health care clinics at its Health Sciences District and Lakewood campuses. TMC also has a number of community-based primary and behavioral health clinics. TMC person-first approach puts the health needs of the patient above profit. The medical center is nationally recognized for programs in asthma, diabetes, sickle cell, orthopaedics, women's health and emergency/trauma services. In addition, TMC offers services that include ophthalmology, cardiology, gastroenterology, oral surgery and community-based behavioral health services. In fiscal year 2020, TMC provided more than a half a million (508,343 to be exact) outpatient care appointments, with more than 173,000 of those being outpatient behavioral health care visits. TMC's Medical Pavilions at Health Sciences District and Lakewood provide high-quality outpatient primary care, whether a patient's needs include a general physical exam or help with a specific complaint. Nearly 70,000 TMC patients are living with at least one chronic disease. Internal medicine physicians are experts in chronic disease management, specifically: high cholesterol, osteoporosis, diabetes, high blood pressure, obesity, and sickle cell disease. COVID-19 On February 26, 2020 Emergency Management leaders at TMC declared a Code Delta Level 1 in response to the spread of COVID-19. It was escalated on March 12, 2020 to Level 2. For 111 days- from March 12 to June 30th- the incident command team worked together to prepare for, and respond to, the changes brought on by the ensuing pandemic. Staffing, securing adequate personal protective equipment (PPE) and sanitizing supplies, plus communication of key safety messages were some of the challenges the command center team faced. Communicating evidence-based information about prevention, symptoms and treatment of COVID-19 was a priority for both patients of TMC and the community. The medical center's communications team worked with Interpreter Services and key community partners, such as members of the faith community, to ensure that members of Kansas City's Black and Brown communities had the same access to accurate COVID-19 information. In March administrators arranged for drive-thru COVID-19 testing at both of the TMC campuses. From the start date until the end of FY 20, providers administered more than 17,500 COVID-19 tests that were processed by TMC laboratories. The pandemic spurred the use of telemedicine at TMC. Before the spread of COVID-19, five providers offered telehealth services. By June 2020, nearly 300 providers were using telehealth to see patients and behavioral health clients. On December 14, 2020 Truman Medical Centers began to administer the COVID-19 vaccine. More information about the efforts to vaccinate all eligible Missourians will be included in FY21 filing. Chronic Disease Management Asthma At TMC, it is the providers' goal to provide superior and consistent care for the patient with asthma, whether it is in the Emergency Department, inpatient unit, or clinic setting. TMC has a comprehensive asthma program that provides asthma education to outpatients and inpatients. In an effort to provide a consistent continuum of care, patients are treated in the Emergency Department using a standardized protocol based on national guidelines for the management of asthma and are referred for follow-up care to an outpatient pulmonary clinic to help break the cycle of emergent care. This program has resulted in a substantial reduction in admissions for asthma sufferers. Last year, its providers treated 8,052 patients for the treatment and care of asthma. Diabetes At TMC, providers know that a diabetes diagnosis can be devastating. More than 15,000 TMC patients have a diabetes diagnosis. In FY 20, there were nearly 9,600 visits to the Diabetes Center, where specialized providers are well equipped to handle all aspects of the disease. The Diabetes Center offers a state-of-the-art facility to better serve patients' needs. TMC providers believe in helping patients manage their diabetes on a planned, rather than episodic basis. The comprehensive team-approach connects patients with specially trained physicians and nursing staff. The team coordinates care with other specialty service providers, such as ophthalmology, cardiology, podiatry, and other referrals as needed. The Diabetes Center includes: A. A patient resource center with computer access B. A diabetes education classroom C. Large consultation rooms for group or individual related to disease and nutrition D. A patient waiting area designed for comfort E. Expanded exam rooms with advanced technology with access to Electronic Health Records Sickle Cell At TMC, providers strive to empower patients with Sickle Cell Disease to live life to the fullest. Providers provide a healing environment, individual attention, and a strong support system for our patients, with a quality of care based on current treatment guidelines and benchmarks of care. In FY20, 473 TMC patients had a diagnosis of Sickle Cell Disease. During a crisis state, unlike an emergency department, the TMC Sickle Cell Center is able to treat patients' pain more efficiently in a quiet, soothing environment with the goal of initiating pain treatment within 30 minutes of arrival. Providers, aware of individuals' medical history, create a custom treatment plan for each patient, including a holistic approach to encompass long-term goals. The Sickle Cell Center team sees the importance of providing chronic disease management and strategies to modify the individual's disease with the goal of decreasing acute pain episodes and supporting healthier outcomes. The center also provides primary care for other routine health needs such as sore throat, hypertension or diabetes management to not only the person with sickle cell but also their adult family member. Women's Health Services Obstetrics & Gynecology At Truman Medical Centers, providers offer a wide variety of services and specialized care just for women, through all stages of their lives. Services include family planning, mid-life services, breast health, the specialized treatment of vulvar and pelvic pain diseases, obstetrics, hysteroscopic surgery, and alternatives to hysterectomy, adolescent gynecology, and well-woman exams. Patients can receive OB/GYN services and primary care, all in one location. High Risk Pregnancy As a regional referral center for high-risk pregnancies, and an academic medical center, TMC Health Sciences District offers specialized care to pregnant women. Maternal-Fetal Medicine (or perinatology) is a unique specialty of obstetrics that involves the diagnosis, evaluation and management of problems that may affect a mother or her unborn child. Families facing a fetal abnormality can come to TMC with confidence knowing it will provide expert care for their every need - maternal expertise for care of the pregnant woman, fetal expertise for care of their unborn baby, and pediatric expertise for care of their newborn. Patients have access to level III neonatal intensive care unit (NICU) staffed by pediatricians from Children's Mercy Hospital. In addition, they have immediate access (via a bridge, just steps away) to adjacent level IV NICU at Children's Mercy Hospital - the highest level of care available for premature and critically-ill newborns, including ECMO (extracorporeal membrane oxygenation) life support technology. The Birthplace At the TMC Birthplace, the focus is on providing a safe, comfortable, and positive birth experience for families. TMC is proud to have delivered 3,482 babies in FY20, making it the medical center where nearly half of all babies in Kansas City, Missouri are born. A Neonatal Intensive Care Unit nurse attends all deliveries, and if needed, its Level III Newborn Intensive Care Unit for infants with special needs is just steps away. Our staff also provides care to mothers who deliver at Children's Mercy Hospital for emergency and critical care maternal fetal medicine issues. A bridge connects the two facilities for easy access between the hospitals.
WOMEN'S CARE BREAST CENTER	TMC provides diagnostic breast health services to women in the greater Kansas City area. The Women's Care Breast Center streamlines services by making virtually all of the components of a breast evaluation available in one campus location-and patients can usually receive a diagnosis the same day. Providers offer clinical breast exams, mammograms, breast ultrasounds, fine-needle aspirations, and an imaging-assisted breast biopsy technique that is less invasive than a typical surgical breast biopsy. Patients have access to a dedicated breast nurse navigator who will guide them through their journey. A diverse and highly qualified dedicated breast team, including a fellowship-trained breast surgeon, plastic and reconstructive surgeon, gynecologist, and fellowship trained breast radiologist staff The Breast Center. Every patient who might be at risk will also receive comprehensive lymphedema education and preoperative assessment by our certified lymphedema specialist, referral to our high-risk prevention clinic, or genetic counselling as necessary. WIC TMC is also one of the largest providers of Women, Infants and Children (WIC) Services in the state of Missouri with 111,994 visits in FY20. WIC provides healthy foods, nutrition education and referrals for women, infants, and children up to the age of five, who are at nutritional risk, and meet program guidelines. Cardiology Services The TMC Cardiology Center offers patients a complete range of cardiac services for prevention, early diagnosis, treatment, and recovery in a patient-centered environment. TMC's Cardiology Center specializes in interventional cardiology, which refers to non-surgical treatments for heart conditions. Providers rely on cardiac interventions to diagnose and treat coronary artery disease, valvular heart disease, heart failure, and congenital heart disease. The Cardiology Center features a sophisticated cardiac catheterization laboratory, nine additional clinic rooms, increased echocardiography testing capabilities and a cardiac rehabilitation service to help prevent repeat heart problems. In FY 20, the Cardiology Center provided more than 7,600 outpatient clinic appointments, performed 483 diagnostic catheterization procedures, completed 707 total catheterization laboratory procedures and placed 153 patient required cardiovascular stents. Gastroenterology Services Truman Medical Centers/University Health' Gastroenterology (GI) Center at the Health Sciences District provides care for patients with all gastrointestinal diseases including but not limited to abdominal pain, constipation, reflux, Irritable Bowel Syndrome, Crohn's Disease, and liver diseases. It offers procedures such as: colon cancer screening, upper endoscopy, endoscopic ultrasound, ERCP-which is used to diagnosis diseases of the bile ducts and pancreas, motility studies, and paracentesis. The Center features three procedure rooms, a dedicated prep and recovery area, patient monitoring equipment, including additional cardiac monitoring capabilities with a central monitor at the nursing station. The clinic has six exams rooms, a dedicated triage room, a large education classroom, and a spacious waiting room. The center provides "one-stop shopping" for patients, with registration/check-in and financial counseling all in same area. In FY 2020, the TMC GI Center provided more than 10,200 outpatient visits and performed more than 7,100 procedures. Ophthalmology The Ophthalmology Clinics at TMC are full-service facilities for the medical and surgical treatment of eye diseases. Services range from prescribing glasses and fitting contact lenses to the treatment of complex ocular disorders. Providers perform outpatient surgery and laser treatment, including refractive laser surgery. In FY 20, the Ophthalmology Department provided care in 20,250 visits. Dentistry and Oral Surgery Services Oral & Maxillofacial surgeons practice a wide scope of care with expertise ranging from corrective jaw surgery to wisdom tooth removal. Providers also diagnose and treat facial injuries and perform a full range of dental implant procedures. The facial pain/temporomandibular joint syndrome (TMJ) clinic also offers diagnosis and treatment of facial pain and TMJ. Nine thousand two hundred patients received oral surgical services at TMC in FY20 and treated 15,761 dental patients at the TMC Lakewood Dental Clinic. Outpatient Behavioral Health Services In FY 20, TMC Behavioral Health provided 173,018 outpatient visits to 9,623 patients. These services are aimed at assisting clients in managing the symptoms of their illness, and improving their day-to-day lives. The services include case management, crisis and outreach services, mental health assessments, employment services, occupational therapies, peer support groups, medication management, rehabilitation, substance abuse treatment and therapy and counseling for children, adolescents, adults and families. Jackson County Health Department TMC contracts with the Jackson County, Missouri government to manage the Jackson County Health Department (JACOHD). In FY 20, the JACOHD provided nearly 138,284 community based encounters including vaccinations, community health education, and adult traumatic brain injury case management. The JACOHD is dedicated to the prevention of disease and the maintenance of a high level of health in the family and community through education, immunization, inspection, and supportive care.
FORM 990, PART III, LINE 4B	Truman Medical Centers (TMC), an academic medical center, that includes the campuses of TMC Health Sciences District, TMC Lakewood, and TMC Behavioral Health. TMC is the core educational partner for the University of Missouri-Kansas City Schools of Medicine, Nursing, Dentistry and Pharmacy. THE NEWEST ADDITION TO TMC IS UNIVERSITY HEALTH WHICH OPENED IN in 2015. UNIVERSITY HEALTH IS Kansas City's only downtown surgical center and an outpatient clinic powered by Truman Medical Centers. Clinics at University Health: audiology, the breast center, dermatology, ear, nose, throat, ophthalmology, oral and maxillofacial surgery, pain management, orthopedics and plastic surgery. TMC providers cared for more than 117,000 individual patients in fiscal year 2020. Regardless of their financial situation or ability to pay, these patients receive quality, state-of-the-art inpatient, outpatient and emergency care that encompass both physical and mental health care. TMC is licensed for 359 inpatient acute care (including 19 NICU) and 188 long-term care beds. In fiscal year 2020 (July 1, 2019- June 30, 2020), TMC had 21,542 inpatient admissions and provided 87,317 days of inpatient care and more than 61,000 days of long-term patient care. As the primary safety net hospital in the Kansas City, Missouri metropolitan area, TMC treats a vulnerable patient population with a high degree of health care disparity. These disparities cut across economic, racial and ethnic boundaries. Many of TMC's patients and clients have multiple chronic diseases such as diabetes, asthma, heart failure and hypertension. In FY 2020, nearly 70,000 of TMC patients suffered from at least one or more of these chronic diseases. Due to some social disparities, such as lack of transportation, or a language barrier, patients' ability to manage their condition with proper medication and follow-up care is difficult and many times, providers end up admitting patients for their condition. TMC works diligently to overcome these ethnic, social and racial barriers when patients receive their care. TMC has specialized language interpreters on staff at both Health Sciences District and Lakewood locations to help ensure that patients with limited English proficiency or deaf patients receive high quality, individualized care with communication assistance. TMC is one of the few hospitals to have on staff interpreters available around the clock to assist patients with paperwork and communicating with medical professionals. TMC interpreter services has approximately 28 language interpreters on staff that provide face-to-face interpreting in three major languages: Spanish, Somali and Arabic. Additionally, over the phone interpreters in 150 languages are available via dual handset telephonic interpreting units. In Fiscal Year 2020, TMC language access provided 189,757 interpreted encounters for patients. COVID-19 On February 26, 2020 Emergency Management leaders at TMC declared a Code Delta Level 1 in response to the spread of COVID-19. It was escalated on March 12, 2020 to Level 2. For 111 days- from March 12 to June 30th- the incident command team worked together to prepare for, and respond to, the changes brought on by the ensuing pandemic. Staffing, securing adequate personal protective equipment (PPE) and sanitizing supplies, plus communication of key safety messages were some of the challenges the command center team faced. Communicating evidence-based information about prevention, symptoms and treatment of COVID-19 was a priority for both patients of TMC and the community. The medical center's communications team worked with Interpreter Services and key community partners, such as members of the faith community, to ensure that members of Kansas City's Black and Brown communities had the same access to accurate COVID-19 information. In March administrators arranged for drive-thru COVID-19 testing at both of the TMC campuses. From the start date until the end of FY 20, providers administered more than 17,500 COVID-19 tests that were processed by TMC laboratories. The pandemic spurred the use of telemedicine at TMC. Before the spread of COVID-19, five providers offered telehealth services. By June 2020, nearly 300 providers were using telehealth to see patients and behavioral health clients. On December 14, Truman Medical Centers/University Health began to administer the COVID-19 vaccine. More information about the efforts to vaccinate all eligible Missourians will be included in FY21 filing. Behavioral Health Behavioral Health is essential to well-being and can affect self-image, relationships, sleep, eating, and even physical health. Many times, patients with chronic diseases also suffer from mental illness and/or substance abuse and addiction problems. Gaining access to quality, behavioral health care services is often difficult and expensive. In many communities, inpatient mental health facilities do not exist or are at capacity nearly 100 percent of the time. TMC is one of only a few health systems that provides both inpatient medical and mental health care beds. TMC Behavioral Health offers a comprehensive array of mental health and substance abuse treatment services at both the TMC Health Sciences District and TMC Lakewood Counseling. All mental health services are aimed at assisting clients in managing the symptoms of their illnesses and in improving their day-to-day lives. TMC services also provide the support many people with mental illness need to regain a sense of meaning and purpose in life. TMC Behavioral Health has 66 inpatient mental health beds including a specialized geriatric inpatient unit at TMC Lakewood. In FY 20, TMC Behavioral Health treated 9,623 patients, with 2,231 patients admitted for inpatient mental health care at a TMC facility. Women's Health TMC offers full Women's Health Services and is the birthplace to nearly half of all babies born in Jackson County, Missouri. TMC Health Sciences District specializes in high-risk pregnancies and births. It is home to a 19-bed, Level III neonatal intensive care unit (NICU), one of the largest in the area. In 2011, TMC Lakewood opened a renovated and expanded labor and delivery unit serving the people of eastern Jackson County. This unit also includes a Level II NICU. In fiscal year 2020, TMC proudly delivered 3,482 babies, which is nearly half of the number of all babies born in Kansas City, Missouri.
FORM 990, PART III, LINE 4C	Truman Medical Center's Emergency Departments provided care to 87,567 patients in fiscal year 2020, with more than 60,000 of those visits at TMC Health Sciences District, making it one of the busiest adult emergency departments in the Kansas City metro area. The TMC Health Sciences District Emergency Department (ED) is a state designated Level 1 Trauma Center. It consists of a team of nearly 25 physicians and more than 125 nurses specially trained in treating trauma and critical care injuries. Trauma surgeons and other members of the trauma team are in the hospital 24-hours a day, seven days a week. The TMC Lakewood Emergency Department has a staff of ten board certified emergency medicine physicians and 36 nurses providing immediate, compassionate, quality care to residents of eastern Jackson County, Missouri each year. Aim4Peace As an academic safety-net hospital in Kansas City, Missouri, TMC receives a significant amount of intentional trauma. Aim4Peace, a local organization that works to prevent violence is focused on the reduction of intentional gunshot incidents. As the primary hospital in association with Aim4Peace, TMC helps affect a culture shift in what is accepted as the norm among the perpetrators of violent crime while reducing recidivism in the emergency department. TMC is listed in the national directory of hospital-based violence intervention and prevention programs. Sexual Abuse Nurse Examiner (SANE) The TMC Health Sciences District Emergency Department (ED) has a Sexual Abuse Nurse Examiner (SANE) on site to provide a thorough forensic examination of women who report being a victim of sexual assault. When a woman enters the Emergency Department reporting a sexual assault or rape, she is sent to a SANE and taken to a private room for examination. The Kansas City SANE program has made a profound difference in the quality of care provided to sexual assault victims. SANEs offer victims prompt, compassionate care and comprehensive forensic evidence collection. In addition to helping preserve the victim's dignity and reduce psychological trauma, SANEs enhance evidence collection for more effective investigations and better prosecutions. TMC's SANE program has also helped to provide leadership in the community by educating and training other potential SANEs. Each year, the TMC SANE cares for and examines nearly 100 women in the Health Sciences District Emergency Department. Trauma Research The Trauma Research Team is currently conducting several exciting research projects including grant-funded research and original projects. All projects are designed with the objective of optimizing care of the traumatically injured patient. Research projects in progress during fiscal 2020 include: Investigator Initiated Projects . Measuring Immediate Responders' Knowledge Gained Through "Stop the Bleed" Education and Training. Teresa Lienhop, PI . Effect of Aim4Peace Community-Based Violence Prevention Program on Recidivism Rates in Trauma Patients in Kansas City Missouri. Michael Moncure, PI . Does procedural simulation training improve resident training and ability on the da Vinci surgical system compared to basic simulation training? Brook Nelson, PI . The role of surgical reality fluid in providing a superior experience in dissections. Michael Moncure, PI . The utility of a viscoelastic hemostatic assay in guiding the administration of antifibrinolytics and blood products (ROTEM). Michael Moncure, Nhi Nguyen Co-PIs . Comparing the outcomes of the usage of enhanced recovery guidelines with open, laparoscopic and robotic colon resections. Michael Moncure, PI . Multidisciplinary strategy to implement trauma informed care and prevent burnout in surgical residents. Michael Moncure, PI . Assessing the difference in patient safety between verbal handoffs and more visual bedside handoffs in surgical residency as residents perceive it. Michael Moncure, PI . Does the RISE program improve screening and follow-up of traumatically injured patients with PTSD. Michael Moncure, PI . Using a Delphi consensus for decision making in the treatment of radial head fractures. Akin Cil, PI . Serial Bladder pressure Measurements to Determine the Incidence of Abdominal Compartment Syndrome in Death by Neurological Criteria Organ Donors. Michael Moncure, PI . Creating CT images from MRI scans using artificial intelligence/machine learning algorithms. Akin Cil, PI . Safety comparison of heparin and enoxaparin for venous thrombosis prophylaxis in traumatic brain injury. Michael Moncure, PI . Comparing Fibroscan to Biopsy Results in determining liver transplantability and function. Michael Moncure, PI . The Follow-up of Incidental Findings in Trauma Patients. Michael Moncure, PI . Tabletop Simulation to enhance team preparedness to execute the "Allocation of Scarce Critical Care Resources During a Public Health Emergency" Policy and Procedures. Emily Hillman, PI . Does the STAHR (Students in Training, in Academia, Health and Research) program impact the recruitment and retention of students typically underrepresented in medicine. Michael Moncure, PI . Incidental Positive COVID-19 Results in Trauma Patients. Michael Moncure, PI . 3D Printed N95 Equivalent for PPE Shortages: The Kansas City Mask. Michael Moncure, PI . Does wound vac training improve nursing performance when using wound vacs? Michael Moncure, PI . Perioperative Treatment of Patients with positive drug screens after orthopaedic surgery procedures. Amelia Sorensen, PI Performance Improvement Patient Safety Program (PIPS) The Performance Improvement Patient Safety (PIPS) is an important part of the trauma program at TMC Health Sciences District. PIPS works toward implementing a system of patient care delivery that focuses on the identification of critical issues and achievement of outcomes within effective time frames and with appropriate use of resources. The areas of monitoring and improving include pre-hospital care, emergency department, inpatient stay, and rehabilitation. The primary focus is on the promptness, documentation, and appropriateness of care along with patient outcomes. Advanced Trauma Care for Nurses Continuing medical education is not just a requirement it is a necessity to enhance the knowledge and abilities of the medical professional. Truman Medical Center in the Health Sciences District was the first hospital to bring Advanced Trauma Care for Nurses (ATCN) to the Kansas City metropolitan area. The course is geared toward nursing staff in the Emergency Department and Intensive Care Units. When nurses complete the ATCN class and work alongside trauma physicians certified in Advanced Trauma Life Support (ATLS), they find that their thought processes and actions are more aligned with the physician's approach, which simultaneously addresses the care of the trauma patient in a patient-centered and logical sequence. ATCN encourages a team approach to trauma care and is taught concurrently with ATLS, so both nurse ATCN and physician ATLS students attend the same lectures. Lectures are followed by a series of hands-on skills stations that include extensive training on initial patient assessment and management of airway, breathing, hemorrhagic shock, musculoskeletal, spinal, head and pediatric trauma.
FORM 990, PART VI, SECTION A, LINE 7A	ALL DIRECTORS ARE ELECTED BY THE SITTING TMC BOARD. SEVERAL DIRECTORS ARE DESIGNATED BY THE CHIEF EXECUTIVE OFFICERS OF VARIOUS REPRESENTED ENTITIES, INCLUDING THREE EACH FROM THE CITY OF KANSAS CITY, MISSOURI AND JACKSON COUNTY, MISSOURI, ONE FROM THE TMC MEDICAL STAFF AND FIVE FROM UNIVERSITY HEALTH PHYSICIANS, AND TWO EMPLOYEES OF TMC WHO REPRESENT NON-MANAGEMENT STAFF. IN ADDITION, THE MEDICAL SCHOOL DEAN AND CHANCELLOR OF THE UNIVERSITY OF MISSOURI-KANSAS CITY AND THE BOARD CHAIR OF THE TMC CHARITABLE FOUNDATION ARE NOMINATED EACH YEAR FOR BOARD ELECTION.
FORM 990, PART VI, SECTION B, LINE 11B	INFORMATION FOR THE FORM 990 IS GATHERED AND INDEPENDENTLY PREPARED BY THE DIRECTOR OF CORPORATE ACCOUNTING AND REVIEWED BY THE CFO BEFORE SUBMITTING TO AN INDEPENDENT ACCOUNTING FIRM. THE FORM 990 IS THEN PREPARED AND REVIEWED BY THE INDEPENDENT ACCOUNTING FIRM USING THE INFORMATION GATHERED. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S ACCOUNTING PERSONNEL, CFO AND CEO AND ANY QUESTIONS AND CONCERNS THE ORGANIZATION'S ACCOUNTING PERSONNEL, CFO AND CEO HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. DUE TO THE SIZE OF THE TMC, INC. BOARD, FINAL COPIES OF THE FORM 990 ARE NOT PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990.
FORM 990, PART VI, SECTION B, LINE 12C	THE TMC POLICY IS NO TMC EXECUTIVE WILL DISADVANTAGE TRUMAN MEDICAL CENTER'S, INCORPORATED (TMC'S) INTEREST AS A RESULT OF A PRIVATE INTEREST. THIS POLICY APPLIES TO TMC EMPLOYEES FROM THE LEVEL OF ASSOCIATE ADMINISTRATOR UP TO PRESIDENT, AND TO TMC-EMPLOYED PHYSICIANS (HEREINAFTER, COLLECTIVELY EXECUTIVES). THE PURPOSE OF THE POLICY AND PROCEDURE IS TO PROTECT THE INTEREST OF TMC, WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF A TMC EXECUTIVE. EXECUTIVES HAVE THE FIDUCIARY DUTY TO ACT IN GOOD FAITH WITH DUE REGARD FOR THE BEST INTERESTS OF THE INSTITUTION. WHENEVER AN EXECUTIVE FIRST BECOMES AWARE OF A PROPOSED OR ACTUAL TRANSACTION TO WHICH THE EXECUTIVE OR FAMILY MEMBER IS A PARTY, REGARDLESS OF THE DOLLAR AMOUNT OF THE TRANSACTION, THE EXECUTIVE SHALL MAKE A PROMPT, FULL AND FRANK DISCLOSURE TO THE CONFLICT OF INTEREST PANEL (VIA THE DIRECTOR OF INTERNAL AUDIT) OF ALL MATERIAL FACTS OF THE TRANSACTION AND THE EXECUTIVE'S INTEREST. THIS DISCLOSURE SHALL BE MADE BEFORE TMC ENTERS INTO OR APPROVES THE TRANSACTION AND THE EXECUTIVE SHALL NOT PARTICIPATE IN OR BE PRESENT DURING THE CONSIDERATION OF THE PROPOSED TRANSACTION, EXCEPT THAT THE EXECUTIVE MAY STATE A POSITION ON THE MATTER AND MAY ANSWER PERTINENT QUESTIONS. THE PANEL, WITH THE SUPPORT OF THE APPROPRIATE TMC MANAGERS OTHER THAN THE CONFLICTED EXECUTIVE, SHALL DETERMINE WHETHER TMC COULD OBTAIN A MORE ADVANTAGEOUS TRANSACTION WITH REASONABLE EFFORT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. EACH EXECUTIVE SHALL ANNUALLY DISCLOSE THE NATURE OF PERSONAL INTERESTS OF THE EXECUTIVE OR FAMILY MEMBERS IN EACH ORGANIZATION WITH WHICH TMC HAS DONE BUSINESS IN THE PAST YEAR OR MAY DO BUSINESS IN THE COMING YEAR. THE DIRECTOR OF INTERNAL AUDIT SHALL RECEIVE, COMPILE, AND ANALYZE THE DISCLOSURES WITHIN 90 DAYS OF DISTRIBUTING THE ANNUAL DISCLOSURE STATEMENTS TO EXECUTIVES, AND SHALL IDENTIFY ANY POTENTIAL ISSUES. THE PANEL COLLECTIVELY IS RESPONSIBLE FOR ENSURING THAT EACH EXECUTIVE COMPLIES WITH THE POLICY AND WITH APPLICABLE RELATED POLICIES AND PROCEDURES. IF THE PANEL DETERMINES THAT AN EXECUTIVE HAS VIOLATED OR MAY VIOLATE SUCH A POLICY, THE PANEL SHALL NOTIFY THE EXECUTIVE OF THE STEPS TO BE TAKEN TO RECTIFY THE SITUATION. IF THE PANEL IS UNABLE TO EFFECT AN ADJUSTMENT OF THE MATTER TO ITS SATISFACTION, IT SHALL REPORT THE MATTER TO THE EXECUTIVE'S SUPERVISOR OR OTHER APPROPRIATE SUPERVISORY AUTHORITY WITH A RECOMMENDATION FOR REMEDY OR SANCTION. ADDITIONALLY, EXECUTIVES REMAIN SUBJECT TO THE RELATED POLICIES THAT APPLY TO ALL TMC EMPLOYEES, INCLUDING CONFLICT OF INTEREST POLICY, CORPORATE CODE OF CONDUCT AND EMPLOYEE HANDBOOK.
FORM 990, PART VI, SECTION B, LINE 15A & 15B	THE EXECUTIVE COMPENSATION COMMITTEE (ECC) IS A SEPARATE COMMITTEE OF THE BOARD OF DIRECTORS. THE ECC REVIEWS AND APPROVES THE COMPENSATION FOR ALL SENIOR EXECUTIVES ANNUALLY. THE ECC REVIEWS THE EMPLOYMENT AGREEMENT FOR THE CEO AND THAT PROPOSED COMPENSATION INCREASES MEET IRS GUIDELINES. ECC HIRES AN INDEPENDENT CONSULTANT COMPANY TO SUPPORT THE ECC ANALYSIS. 2020 WAS THE MOST RECENT REVIEW.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AS APPROVED BY THE CFO OR LEGAL DEPARTMENT.
FORM 990, PART XI, LINE 9	CHANGE IN NET ASSETS OF TMC FOUNDATION $ 1,740,419 CHANGE IN DEFINED BENEFIT PENSION PLAN (30,186,496) TRANSFER FOR AFFILIATE 2,000,000 OTHER RECONCILING ITEMS (50,001) ------------- TOTAL $(26,496,078)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
AUXILIARY TO TRUMAN MEDICAL CENTER
2301 HOLMES	KANSAS CITY	MO	64108	436099279	SUPPORT	MO	501(C)(3)	10	NA	false
TMC PROF AND GEN LIABILITY SELF INS TRUS
2301 HOLMES	KANSAS CITY	MO	64108	431946384	LIABILITY INS	MO	501(C)(3)	12B	NA	false
TMC FINANCE SUPPORT CORPORATION
2301 HOLMES	KANSAS CITY	MO	64108	271994129	SUPPORT	MO	501(C)(3)	12A	TMC	Yes (true)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Affiliated Group Schedule AffiliatedGroupSchedule

Affiliated Schedule AffiliatedScheduleGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Electing OrganizationElectingOrganizationInd	Total Grassroots LobbyTotalGrassrootsLobbyAmt	Total Direct LobbyTotalDirectLobbyAmt	Total Lobby ExpenditureTotalLobbyExpenditureAmt	Other Exempt Purpose ExpendOtherExemptPurposeExpendAmt	Total Exempt Purpose ExpendTotalExemptPurposeExpendAmt	Lobby NontxLobbyNontxAmt	Grassroots NontxGrassrootsNontxAmt	Total Lobby Grssroot Mns NontxTotalLobbyGrssrootMnsNontxAmt	Tot Lbby Expend Mns Lobby NontxTotLbbyExpendMnsLobbyNontxAmt	Share Excess Lobby ExpendShareExcessLobbyExpendAmt
TRUMAN MEDICAL CENTER INCOR
2301 HOLMES STREET	KANSAS CITY	MO	64108	440661018	Yes (X)	$59,922	$67,848	$127,770	$626,941,572	$627,069,342	$1,000,000	$250,000	$0	$0	$0
TMC FINANCE SUPPORT CORPORAT
2301 HOLMES STREET	KANSAS CITY	MO	64108	271994129		$0	$0	$0	$0	$0	$0	$0	$0	$0	$0