2021-05-07T13:57:00-05:00 2020-06-30 135565207 KPMG LLP 191 W Nationwide Blvd Suite 500 Columbus OH 43215 990 2019-07-01 440605373 The Children's Mercy Hospital CHIL 8162343000 2401 Gillham Road Kansas City MO 64108 David Cauble Executive VP & CFO 8162343000 2021-05-07 1 Mollie P Longhouse P00294881 6142492300 2019 2022-09-23 18:48:47Z David Cauble 2401 Gillham Road Kansas City MO 64108 1634293177 0 X www.childrensmercy.org X 1901 MO Excellence in healthcare for children 15 12 9965 1203 4227688 117665 62229421 78650301 1452144593 1478886544 62846609 39078917 18333669 36991514 1595554292 1633607276 47092567 59717011 0 0 818332794 860789103 186376 359542 6947088 554268668 588095765 1419880405 1508961421 175673887 124645855 2111702017 2254485183 556087441 612438487 1555614576 1642046696 X Children's Mercy is a leading independent children's health organization dedicated to holistic care, translational research, breakthrough innovation, and educating the next generation of caregivers. Together, we transform the health, well-being and potential of children, with unwavering compassion for those most vulnerable. 1 0 1054234005 56109944 1511859121 All expenses for program services relate to providing healthcare. There were a total of 367 licensed beds and 92,694 patient days during the year from 14,644 admissions. Interim stays totaled 4,260 and 545,033 outpatient encounters, including ED and Urgent Care. Telemedicine visits totaled 35,404. There were a total of 17,915 surgical cases for both inpatient (4,255) and outpatient (13,660). Children's Mercy radiology procedures totaled 177,713 procedures for FY20. The Children's Mercy Hospital (the Hospital) consists of a 314-bed teaching hospital for children located in Kansas City, Missouri, and a 53-bed hospital for children located in Overland Park, Kansas. Children's Mercy Hospital provides the highest level of medical care, technology, services, equipment, and facilities promoting the health and well-being of children in the region, from birth through adolescence. Patients and their families are treated with compassion in a family-centered environment that recognizes their physical, emotional, financial, social, and spiritual needs. The comprehensive healthcare environment provided by the Hospital includes clinical services, research, and teaching efforts, which are designed to serve today's and tomorrow's children, and the community in which they live. The Hospital's services are available to all regardless of ability to pay. 64515106 3607067 0 Children's Mercy Hospital (CMH) is dedicated to becoming a leader in pediatric translational research. A strategic planning initiative established the Children's Mercy Research Institute (CMRI) to focus on research and research infrastructure. Through the generosity of two philanthropic gifts totaling $150 million, the hospital has built a nine story, 375,000 square foot facility enabling research scientists to gain access to state-of-the-art research technology as well as dry lab and wet lab space to support that research. The CMRI building opened in the fall of 2020. The building includes an auditorium for presentations to train medical school students and inform the public about pediatric healthcare innovations that are being developed and created by research scientists and physicians here in collaboration with others throughout the nation and world. In addition these generous gifts will help support funding for scientific programs and recruitment. Research conducted today at CMH includes basic science and clinical research in numerous areas including pharmacology, cancer, cardiology, genetic diseases and health outcomes. Areas of research strength include Precision Therapeutics, Genomics Medicine, Population Health and Innovations in Health Care Delivery. During the year ended June 30, 2020 there were more than 495 active sponsored research projects. The Children's Research Institute occupies about 4% of the space on the main campus and is 4% of the total annual operating budget. Children's Mercy spent $59.6 million in the year ended June 30, 2020 on research and per information from the NIH Reporter received more than $7.75 Million in NIH funding in this same time period. More than 900+ publications were accepted and/or published. The Children's Research Institute provides seed funding to Investigators with internal competitive grant programs such as the Midwest Cancer Alliance and the Katherine Berry Richardson (KBR) Fund, with expectations that this funding will lead to applications for externally funded grant programs in the future. 1118749111 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 1 1 0 1 1 0 1 1 1 1 1 1 1 0 0 0 0 0 0 1 1 0 1 0 0 0 1 1 1 1 0 0 1 535 0 1 9965 1 1 1 0 0 0 0 1 1 0 0 0 0 0 1 0 X 15 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X David Cauble Executive VP & CFO 8162343000 2401 Gillham Road Kansas City MO 64108 Paul D Kempinski MS FACHE Director; President & CEO 40.00 1.00 X X 1428571 0 19224 Randall L O'Donnell PhD Former President & CEO; End 9/1/18 0.00 0.00 X 1411373 0 0 James O'Brien Jr MD Physician 40.00 0.00 X 1194003 0 44388 William Douglas MD Physician 40.00 0.00 X 1204822 0 32403 James D Saint Louis MD Physician 40.00 0.00 X 1202215 0 18626 Jo Stueve EVP & COO; End 9/27/19 40.00 0.00 X 1111075 0 35094 Charles Roberts MD EVP & Exec.Med Director; End 8/17/19 40.00 0.00 X 962649 0 33960 Walter Andrews MD Physician 40.00 0.00 X 800950 0 44424 Shawn St Peter MD SVP/Surgeon-in-Chief;ChairDeptOfSurg 40.00 0.00 X 799319 0 40224 Charles Snyder MD Physician 40.00 0.00 X 800097 0 38448 David Cauble EVP & CFO 40.00 0.00 X 705159 0 37424 Thomas Curran PhD SVP, CSO, Executive Director-CMRI 40.00 0.00 X 698847 0 29004 Sandra AJ Lawrence Former EVP & CAO; End 2/14/19 40.00 0.00 X 713245 0 14220 Robin Foster JD Senior VP, General Counsel 40.00 0.00 X 666840 0 40224 Laura Fitzmaurice MD Director 40.00 0.00 X 463330 0 44424 Robert Steele MD EVP&Chief Strat/InnovOff;Strt10/7/19 40.00 0.00 X 343857 0 4055 Jodi Coombs MBA BSN RN EVP & COO; Start 10/1/19 40.00 0.00 X 127473 0 1691 Paul McLaughlin Chair 2.00 1.00 X X 0 0 0 Elizabeth Braham Vice Chair 2.00 0.00 X X 0 0 0 Andrew Teigen Treasurer 1.50 0.00 X X 0 0 0 Bill Krueger Secretary 1.50 0.00 X X 0 0 0 Kevin Barth Director 1.00 0.00 X 0 0 0 Jean-Paul Chaurand Director 1.50 0.00 X 0 0 0 Vince Clark Director 1.00 0.00 X 0 0 0 Carolyn Davis MD Director 1.00 0.00 X 0 0 0 Terry Matlack Director 1.00 0.00 X 0 0 0 Charles Schellhorn Director 1.00 4.00 X 0 0 0 Debbie Sosland-Edelman Director 1.50 0.00 X 0 0 0 Edna Talboy Director 1.00 0.00 X 0 0 0 Tom Weir Director 1.50 0.00 X 0 0 0 Robert Lane MD EVP&Physician-in-Chief;Start 1/20/20 40.00 0.00 X 0 0 0 14633825 0 477833 1572 1 1 0 McCown Gordon Construction LLC 850 Main Street Kansas City MO 64105 Construction 81093407 Anesthesia Associates 8717 West 110th Street Overland Park KS 66210 Anesthesiologists 35555399 Accenture LLP 161 North Clark Street Chicago IL 60601 Consulting 25600720 Cerner Health Connections Inc 2800 Rockcreek Parkway Kansas City MO 64117 Professional Services 9506084 Sodexo Inc 9801 Washingtonian Blvd Gaithersburg MD 20878 Food Service 8153027 462 524783 4054104 7871154 42191976 24008284 1589002 78650301 Net Patient Services 621110 1478886544 1478886544 1478886544 39078917 39078917 477150 4054104 685901 -208751 -208751 Contract Revenue 900099 22414826 22414826 Transport 621910 2443630 2443630 Gift Shop 453220 1384651 1384651 10957158 6729470 4227688 37200265 1633607276 1511859121 4227688 38870166 X 3546692 3546692 55886111 55886111 284208 284208 8398676 2125160 6273516 696646411 565167372 127398757 4080282 36005651 28969561 6827725 208365 73127757 58531238 14164261 432258 46610608 37502137 8838735 269736 3630947 207176 3423771 615940 19700 596240 595374 595374 359542 359542 167266068 70051388 96666612 548068 6698311 272606 6398485 27220 4518865 122525 4328581 67759 20293404 8469100 11153350 670954 6107170 4473283 1619164 14723 7380571 6478126 902445 64815566 24359153 40407616 48797 24342295 20256968 4085327 Medical Supplies 178265578 163577692 14560752 127134 State Medicaid Taxes 56316996 56316996 Dues & Subscriptions 7270779 3120800 4064016 85963 Inventory- Food Service 5064763 2569888 2491706 3169 34913138 6441231 28468789 3118 1508961421 1118749111 383265222 6947088 19873775 98309413 80163168 75106323 236235301 219007550 14261595 15778184 25000745 24475230 1458173285 697993309 686772977 760179976 793624486 778622503 5565259 5337331 250204711 277668673 2111702017 2254485183 143890683 135969285 320815446 315960864 91381312 160508338 556087441 612438487 X 1314609285 1396871262 241005291 245175434 1555614576 1642046696 2111702017 2254485183 X 124645855 6235724 -44449459 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 595374 595374 1118153737 1118749111 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 421071 492239 488841 595374 1997525 250000 250000 250000 250000 1000000 1500000 73663733 6974083 1066434 1770010 79934240 69788763 3003013 3300499 2428542 73663733 61620527 6774013 3517083 2122860 69788763 51311822 7334271 5017500 2043066 61620527 48208836 5953303 -1112327 1737990 51311822 0.85330 0.14670 0 1 1 24549276 24549276 721293590 314580262 406713328 508349719 383413047 124936672 203980700 203980700 760179976 Other Assets 62008281 Income Beneficiary and Charitable Remainder Trusts 45694706 Restricted Investments 125818556 Right of Use Asset 44147130 277668673 Reserve for Prof. Liability Claims 41898165 Postretirement Medical Liability 49516326 Other Liabilities 21797109 Unearned Premiums 2733233 Lease Liability 44563505 160508338 X Part V, Line 4: Endowment funds are held by The Children's Mercy Hospital and The Children's Mercy Hospital Foundation, a supporting organization of The Children's Mercy Hospital. The endowment funds are intended to provide a permanent source of funding for designated activities carried out by The Children's Mercy Hospital, the funds for which are provided from the earnings and principal of these endowment funds. Part X, Line 2: At June 30, 2020 and 2019, there were no uncertain tax positions. 1 North America 0 0 Program Services Travel for healthcare-related education and information sharing 21464 Central America & the Caribbean 0 0 Program Services Travel for healthcare-related education and information sharing 18770 Europe 0 0 Program Services Travel for healthcare-related education and information sharing 66286 East Asia & the Pacific 0 0 Program Services Travel for healthcare-related education and information sharing 31443 South America 0 0 Program Services Travel for healthcare-related education and information sharing 1921 South Asia 0 0 Program ServicesProgram Services Travel for healthcare-related education and information sharing 1225 Sub-Saharan Africa 0 0 Program Services Travel for healthcare-related education and information sharing 15849 Middle East and North Africa 0 0 Program Services Travel for healthcare-related education and information sharing 798 Russia and Neighboring States 0 0 Program Services 492 North America 0 0 Grantmaking 69407 Sub-Saharan Africa 0 0 Grantmaking 214801 0 0 0 0 0 0 157756 284700 442456 North America - Canada and Mexico, but not the United States Research 10500 Check 0 FMV North America - Canada and Mexico, but not the United States Research 58907 Check 0 FMV Sub-Saharan Africa - Angola, Benin, Botswana, Burkina Faso, Research 214801 Check 0 FMV 2 1 0 0 0 0 0 0 Part I, Line 2: Subrecipients sign an agreement which details the subrecipient's plan and budget as well as allowable expenditures of the Federal Awards. The agreement is also approved/signed by the Children's Mercy Hospital (CMH) signing official. Each subrecipient is required to submit periodic invoices (not more than monthly) to CMH for reimbursement. All expenditures on the invoice must be according to the subrecipient's budget that was developed during the application process. Invoices received from subrecipients are certified as complete and accurate by the subrecipient and reviewed and approved by the Principal Investigator or appropriate level of authorization, who forwards them to accounts payable for processing. In addition, Research and Grants (R&G) Accounting monitors these invoices to ensure proper coding to the correct award. The R&G accounting staff captures the amount on the budget-to-actual report to monitor the total amount spent by the subrecipient. Based on the amount budgeted to subrecipients and normal invoiced activity, the R&G accounting staff questions unreasonable invoice amounts with the subrecipient. In addition, any subrecipient that received more than $750,000 in Federal funds during the fiscal year is required to obtain an Uniformed Guidance (formerly A-133) audit and send a copy of the audit report to CMH's accounting department for review. The Post Award Manager is responsible for making sure that for all subrecipients that are required submit Uniform Guidance audits and that CMH has received an audit report. CMH maintains a subrecipient monitoring spreadsheet to track Uniform Guidance audit status, DUNS number, year-to-date spending, etc. for all subrecipients. Part I, line 3: Method Used to Account for Expenditures: Actual expenses for international travel and international grants. Part III Accounting Method: Schedule F, Part II, Line 1 Method Used to Account for Cash Grants and Noncash Assistance on the Organization's Financial Statement: Accrual. X X X X X 1 TrueSense 502 Keystone Dr Warrendale PA 15086 Consult/develop an annual fund and giving program 0 592451 353654 238797 Rachael Steele 2401 Gillham Rd Kansas City MO 64108 Consult & advise on capital campaign 0 0 5888 -5888 592451 359542 232909 KS MO AK AL AR CA CO CT DC FL GA HI IL KY MA MD ME MI MN MS NC ND NH NJ NM NV NY OH OK OR PA RI SC TN UT VA WA WI WV Gala/Auction 2419353 2074080 345273 345230 140292 7663 Event/Auction 1946980 1838608 108372 100996 60016 17964 4 164921 141416 23505 13701 39 4531254 4054104 477150 459927 200308 25666 685901 -208751 Schedule G, Part I, Line 2b, Column (v) Payments to TrueSense during FY20 totaled $401,036. This amount includes $353,654 for consulting services and $47,382 of fundraising expenses. The agreement distinguishes consulting costs separate from any expense payments of reimbursements. 1 1 X 1 X 300.000000000000 1 X 500.000000000000 1 1 1 0 1 1 2 35142 24883078 952259 23930819 0.01590 9 297393 705512491 624756561 80755930 0.05350 11 332535 730395569 625708820 104686749 0.06940 42 384615 18608727 2538173 16070554 0.01070 9 12647 33616870 16446465 17170405 0.01140 18 123799 64300657 5378518 58922139 0.03900 495 0 43408477 22505585 20902892 0.01390 4 0 822131 858 821273 0.00050 568 521061 160756862 46869599 113887263 0.07550 579 853596 891152431 672578419 218574012 0.14490 2 2 78322 0 78322 0.00010 3 0 11500 0 11500 0.00000 2 80 2629 0 2629 0.00000 0 0 0 0 2 0 6423 0 6423 0.00000 8 158 404002 5000 399002 0.00030 11 8 107185 0 107185 0.00010 15 619 454404 266 454138 0.00030 0 0 43 867 1064465 5266 1059199 0.00080 1 75275 0 2555571 3413873 -858302 X 1 1 2 1 The Children's Mercy Hospital 2401 Gillham Road Kansas City MO 64108 http://www.childrensmercy.org/ 39-54 X X X X X X Specialty Clinics; Primary Care Clinics A 2 Children's Mercy Kansas 5808 W 110th Overland Park KS 66211 http://www.childrensmercy.org/ H-046-008 X X X X X Specialty Clinics A Facility Reporting Group - A 0 0 1 X X X X X X X X X 18 1 0 0 1 X www.childrensmercy.org/communityneeds X 1 18 1 www.childrensmercy.org/communityneeds 0 1 X 300.000000000000 500.000000000000 X X X X X X X 1 1 X X X 1 X www.childrensmercy.org/financialcounseling/ X www.childrensmercy.org/financialcounseling/ X www.childrensmercy.org/financialcounseling/ X X X X X X 1 X 0 X X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: The Children's Mercy Hospital, - Facility 2: Children's Mercy Kansas Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 5: The most recent CHNA included input from persons who represent the broad interest of the community. From October of 2018 through April 2019 Children's Mercy held activities and meetings to solicit input and feedback from community voices. The activities included: seven community meetings (130 community, neighborhood and parent residents); a telephone survey of 1000 randomly selected parents/caregivers of children under the age of 18 years; a Key Informant Online Survey sent to 299 elected officials, physicians, public health leaders, other health professionals, social service providers, and business, neighborhood, housing and community leaders (36% response) and a Children's Health Summit (held April 1, 2019) that invited 350 (198 attended). Children's Health Summit participants reviewed the initial CHNA findings and participated in a process to identify and rate priority health issues. Organizations participating in the CHNA surveys and events included: El Centro; Restart; The Family Conservancy; Urban Neighborhood Initiative; Advent Health; Bike Walk KC; Catholic Charities of Kansas City-St. Joseph; Child Care Aware of Kansas; Child Protection Center; Children of Incarcerated Parents; Clay County Public Health Center; Communities In Schools; Comprehensive Community Development; Cornerstones of Care; Eitas; First Hand Foundation; Food Equality Initiative; Greater Kansas City Community Foundation; Guadalupe Centers; Happy Bottoms; Harvesters- The Community Food Network; Health Care Collaborative of Rural Missouri; Health Forward Foundation; Healthy Families America; Jackson County Community Children's Service Fund; Johnson County Department of Health Environment; Kansas Children's Service League; Kansas City Health Department; Kansas City Healthy Start; Kansas City Public Schools; KC Healthy Kids; Kids TLC; Project Eagle; KVC Hospitals of Kansas City; Legal Aid of Western Missouri; Lincoln College Preparatory Academy; Jackson County Health Department; Mid-America Regional Council; Mattie Rhodes Center; Nurture KC; Mid America Head Start; Mid-America Regional Council; Missouri Primary Care Association; No Kid Hungry Missouri; North Kansas City Hospital; North Kansas City Schools; Operation Breakthrough; PACES; Phoenix Family; Platte County Health Department; REACH Healthcare Foundation; Samuel U Rodgers Health Center; Sleepyhead Beds; Sunflower Health Plan; Swope Health Services; Synergy Services Inc.; The Children's Place; The Health Care Collaborative of Rural Missouri; Truman Medical Centers; Turn The Page KC; UMKC Health Sciences District; United Community Services of Johnson County; United Way of Greater Kansas City; Wyandotte County Health Department; Wyandotte Health Foundation; YMCA of Greater Kansas City; and representatives from private pediatric offices. The CHNA provides a list of all organizations and specifics on the CHNA data collection process. Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 11: The implementation strategy plan was approved on October 15, 2019 and made available to the public within the IRS required 4 1/2 months after year end associated with the conducted and approved CHNA completed during the 2018 tax year. The most recently adopted implementation strategy plan can be found on the hospital website:http://www.childrensmercy.org/communityneedsData collection for the 2018 CHNA began in June 2018 and ended December 2018. On April 1, 2019, Children's Mercy hosted the Children's Health Summit bringing together close to 200 community representatives to review CHNA data and identify critical health needs. Needs identified are (listed in priority order): mental/behavioral health; access to health services; infant health; nutrition/physical activity/weight; injury and violence; tobacco/alcohol/substance abuse; and asthma. The community also recognized that in order to address the identified priorities, three overarching population level topics must be considered-addressing social determinants of health, focusing on equitable outcomes, and keeping children safe. From April 2, 2019 through May 15, 2019, over 180 Children's Mercy employees and senior leadership were presented the community-identified health needs and themes and selected three as Priority Health Needs (Access to Health Services with a focus on Asthma, Mental and Behavioral Health, and Infant Health), based on the issue's importance to children's health, potential measurable impact if issue addressed, and Children's Mercy's ability to address issue with resources and personnel. The Children's Mercy Board of Directors approved the Priority Health Needs on June 18, 2019. The Priority Health Needs will receive heightened attention and support while the other community identified needs (Significant Health Needs) will continue to be addressed through programming, but not receive accelerated attention. Examples of programs Children's Mercy supports to address Priority and Significant health needs and preliminary program results include: a community-based support group for antepartum and postpartum mothers (mental/behavioral health and infant health) where six mothers participated with 100% responding that the group was beneficial; supported the revision and improvement of safe sleep programs and practices at largest public delivery hospital (infant health); prescription drug management and disposal videos developed (mental/behavioral health); Power of Play program with two refugee-service agency staff trained on the importance of play and strategies to support play, 18 families participated (mental/behavioral health); Red Card: Call It When You See It anti-bullying campaign in conjunction with Sporting KC the local MLS Soccer team (mental/behavioral health) reaching over 10,000 students in over 35 area schools; 119,007 system-wide suicide prevention screenings completed and over 250 families received suicide prevention education (mental/behavioral health); Stop the Bleed training (access to care) to 272 community members; 5,691 flu vaccines provided through the Family and Friends Flu Events (access to care); the Circulation transportation program provided 1,255 rides to primary care appointments (access to care); 482.5 pounds of produce harvested in the community garden and over 9,000 kids received free meals through the Kids Eat Free summer food program (nutrition/physical activity/weight); and the provision of over 300 medication lock boxes and 1,000 gun locks to support the safe storage of medications and firearms (injury and violence). Organizations receiving Community Benefit Grants include: the Black Health Care Coalition to support Community Baby Showers; the Community Health Council of Wyandotte County to support access to health, expand Every Baby to One to additional churches and Cradle Kansas City a community infant health collaborative; Uzazi Village to support outreach to pregnant and parenting African American women; Sleepyhead Beds to expand porta-crib distribution to community agencies; and Zero Reasons Why a community mobilization suicide prevention campaign. With the onset of the COVID-19 pandemic, new program models were developed to continue to safely reach children and families. Examples of the approaches: curbside Emergency Meal Program (5,200 meals provided); drive-thru community baby showers; over 3,000 individuals received COVID-19 education; open-air provision of sports physicals; telemedicine visits; and virtual health education sessions. Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 13b: The written financial assistance policy explains criteria beyond FPG to include residency requirements, available payors to applicant, asset levels, and in-network insurance status. Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 13h: Patients seeking care at organization with out of network insurance plans are not eligible for charity care. Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, Line 20a: Because the Hospital is not exercising any extraordinary collection actions in the event of nonpayment, it has no occasion to provide written notice about upcoming ECAs. Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 5: The most recent CHNA included input from persons who represent the broad interest of the community. From October of 2018 through April 2019 Children's Mercy held activities and meetings to solicit input and feedback from community voices. The activities included: seven community meetings (130 community, neighborhood and parent residents); a telephone survey of 1000 randomly selected parents/caregivers of children under the age of 18 years; a Key Informant Online Survey sent to 299 elected officials, physicians, public health leaders, other health professionals, social service providers, and business, neighborhood, housing and community leaders (36% response) and a Children's Health Summit (held April 1, 2019) that invited 350 (198 attended). Children's Health Summit participants reviewed the initial CHNA findings and participated in a process to identify and rate priority health issues. Organizations participating in the CHNA surveys and events included: El Centro; Restart; The Family Conservancy; Urban Neighborhood Initiative; Advent Health; Bike Walk KC; Catholic Charities of Kansas City-St. Joseph; Child Care Aware of Kansas; Child Protection Center; Children of Incarcerated Parents; Clay County Public Health Center; Communities In Schools; Comprehensive Community Development; Cornerstones of Care; Eitas; First Hand Foundation; Food Equality Initiative; Greater Kansas City Community Foundation; Guadalupe Centers; Happy Bottoms; Harvesters- The Community Food Network; Health Care Collaborative of Rural Missouri; Health Forward Foundation; Healthy Families America; Jackson County Community Children's Service Fund; Johnson County Department of Health Environment; Kansas Children's Service League; Kansas City Health Department; Kansas City Healthy Start; Kansas City Public Schools; KC Healthy Kids; Kids TLC; Project Eagle; KVC Hospitals of Kansas City; Legal Aid of Western Missouri; Lincoln College Preparatory Academy; Jackson County Health Department; Mid-America Regional Council; Mattie Rhodes Center; Nurture KC; Mid America Head Start; Mid-America Regional Council; Missouri Primary Care Association; No Kid Hungry Missouri; North Kansas City Hospital; North Kansas City Schools; Operation Breakthrough; PACES; Phoenix Family; Platte County Health Department; REACH Healthcare Foundation; Samuel U Rodgers Health Center; Sleepyhead Beds; Sunflower Health Plan; Swope Health Services; Synergy Services Inc.; The Children's Place; The Health Care Collaborative of Rural Missouri; Truman Medical Centers; Turn The Page KC; UMKC Health Sciences District; United Community Services of Johnson County; United Way of Greater Kansas City; Wyandotte County Health Department; Wyandotte Health Foundation; YMCA of Greater Kansas City; and representatives from private pediatric offices. The CHNA provides a list of all organizations and specifics on the CHNA data collection process. Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 11: The implementation strategy plan was approved on October 15, 2019 and made available to the public within the IRS required 4 1/2 months after year end associated with the conducted and approved CHNA completed during the 2018 tax year. The most recently adopted implementation strategy plan can be found on the hospital website:http://www.childrensmercy.org/communityneedsData collection for the 2018 CHNA began in June 2018 and ended December 2018. On April 1, 2019, Children's Mercy hosted the Children's Health Summit bringing together close to 200 community representatives to review CHNA data and identify critical health needs. Needs identified are (listed in priority order): mental/behavioral health; access to health services; infant health; nutrition/physical activity/weight; injury and violence; tobacco/alcohol/substance abuse; and asthma. The community also recognized that in order to address the identified priorities, three overarching population level topics must be considered-addressing social determinants of health, focusing on equitable outcomes, and keeping children safe. From April 2, 2019 through May 15, 2019, over 180 Children's Mercy employees and senior leadership were presented the community-identified health needs and themes and selected three as Priority Health Needs (Access to Health Services with a focus on Asthma, Mental and Behavioral Health, and Infant Health), based on the issue's importance to children's health, potential measurable impact if issue addressed, and Children's Mercy's ability to address issue with resources and personnel. The Children's Mercy Board of Directors approved the Priority Health Needs on June 18, 2019. The Priority Health Needs will receive heightened attention and support while the other community identified needs (Significant Health Needs) will continue to be addressed through programming, but not receive accelerated attention. Examples of programs Children's Mercy supports to address Priority and Significant health needs and preliminary program results include: a community-based support group for antepartum and postpartum mothers (mental/behavioral health and infant health) where six mothers participated with 100% responding that the group was beneficial; supported the revision and improvement of safe sleep programs and practices at largest public delivery hospital (infant health); prescription drug management and disposal videos developed (mental/behavioral health); Power of Play program with two refugee-service agency staff trained on the importance of play and strategies to support play, 18 families participated (mental/behavioral health); Red Card: Call It When You See It anti-bullying campaign in conjunction with Sporting KC the local MLS Soccer team (mental/behavioral health) reaching over 10,000 students in over 35 area schools; 119,007 system-wide suicide prevention screenings completed and over 250 families received suicide prevention education (mental/behavioral health); Stop the Bleed training (access to care) to 272 community members; 5,691 flu vaccines provided through the Family and Friends Flu Events (access to care); the Circulation transportation program provided 1,255 rides to primary care appointments (access to care); 482.5 pounds of produce harvested in the community garden and over 9,000 kids received free meals through the Kids Eat Free summer food program (nutrition/physical activity/weight); and the provision of over 300 medication lock boxes and 1,000 gun locks to support the safe storage of medications and firearms (injury and violence). Organizations receiving Community Benefit Grants include: the Black Health Care Coalition to support Community Baby Showers; the Community Health Council of Wyandotte County to support access to health, expand Every Baby to One to additional churches and Cradle Kansas City a community infant health collaborative; Uzazi Village to support outreach to pregnant and parenting African American women; Sleepyhead Beds to expand porta-crib distribution to community agencies; and Zero Reasons Why a community mobilization suicide prevention campaign. With the onset of the COVID-19 pandemic, new program models were developed to continue to safely reach children and families. Examples of the approaches: curbside Emergency Meal Program (5,200 meals provided); drive-thru community baby showers; over 3,000 individuals received COVID-19 education; open-air provision of sports physicals; telemedicine visits; and virtual health education sessions. Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 13b: The written financial assistance policy explains criteria beyond FPG to include residency requirements, available payors to applicant, asset levels, and in-network insurance status. Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 13h: Patients seeking care at organization with out of network insurance plans are not eligible for charity care. Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, Line 20a: Because the Hospital is not exercising any extraordinary collection actions in the event of nonpayment, it has no occasion to provide written notice about upcoming ECAs. 14 1 - Children's Mercy West 4313 State Ave Kansas City KS 66102 Outpatient Clinics 2 - Children's Mercy Wichita Clinic 3243 E Murdock Suite 201 Wichita KS 67208 Outpatient Clinics 3 - Children's Mercy Sports Medicine Center 1801 N 98th Street Kansas City KS 66109 Rehabilitation 4 - Children's Mercy Pediatric Eye Care 4820 College Blvd Leawood KS 66211 Practice Use 5 - Children's Mercy Joplin Clinic 3333 McIntosh Circle Suite 6 Joplin MO 64804 Outpatient Clinics 6 - Children's Mercy Olathe 20333 W 151st St Olathe KS 66061 Outpatient Clinics 7 - Children's Mercy Heartland Clinic 802 N Riverside Rd Suite 105 St Joseph MO 64502 Outpatient Clinics 8 - Children's Mercy Outreach Junction City 361 Grant Ave Junction City KS 66441 Outreach Clinic 9 - Children's Mercy Outreach Garden City 311 E Spruce St Garden City KS 67846 Outreach Clinic 10 - Children's Mercy Outreach Great Bend 1021 Einsenhower Ave Great Bend KS 65730 Outreach Clinic 11 - Children's Mercy Outreach Springfield 1000 E Primrose Suite 300 Springfield MO 65807 Outreach Clinic 12 - Children's Mercy Outreach Parsons 1902 S US Hwy 59 BLDG E Ste 200 Parsons KS 67357 Outreach Clinic 13 - Children's Mercy Outreach Salina 737 E Crawford Salina KS 67401 Outreach Clinic 14 - Children's Mercy at KU Hospital 2000 Olathe Boulevard Kansas City KS 66103 Outreach Clinic Part I, Line 3c: Free care eligibility is based on FPG and other factors such as residency and exhausting other available payor sources. For discounted care, if a financial assistance application was denied and the decision then appealed, the case is reviewed through a multi-disciplinary committee that uses a point system rubric using indicators such as FPG, total balance due as a percentage of annual income, out of pocket responsibility for upcoming year as a percentage of annual income, annual frequency of visits for ongoing care, financial hardship indicators such as recent bankruptcy/foreclosure, and medical complexity due to health condition. Each factor, if applicable, is reviewed and assigned point value based on a preset scale, that serves as a tool for the discounted care scale. Part I, Line 7: The cost-to-charge ratio derived from Worksheet 2 was used for Lines 7a and 7b. Cost-to-charge ratios derived from the Medicare Cost Report were used for Lines 7f and 7g. Part I, Line 7g: In FY20, over 123,799 children were reached through clinical services classified as Subsidized Health Services. Subsidized health services included pediatric primary care clinics at Children's Mercy Broadway and West as well as community-based clinics located at Synergy Services (youth-serving agency), Operation Breakthrough (early childhood center) and at University Academy (K-12 charter school). Other subsidized health services include: dialysis; developmental and behavioral sciences; neonatology; hematology/oncology; genetics; pain management; home health services; the fetal health center; transport; ophthalmology; and child abuse and neglect. The services are provided at a financial loss to Children's Mercy after removing Charity Care, unreimbursed Medicaid, private insurance shortages and contract, grants and gifts. All subsidized health services meet an identified community need and a shortage of available services would exist in the community if Children's Mercy did not provide the service. Part I, Line 7A: Financial assistance cost reported on this line is derived from Worksheet 1 which takes gross charges for patients who have been awarded financial assistance and then multiplies those charges by a cost-to-charge ratio derived from Worksheet 2 to arrive at cost of providing financial assistance. Part I, Line 7h: Children's Mercy researchers strive to find better ways to prevent, treat and eliminate pediatric disease and to improve community-based health outcomes. In FY20, over 495 studies met Community Benefit criteria. The Children's Research Institute is creating an integrated research environment where no boundaries exist between science and medicine. The hospital's leadership in pediatric genomic medicine and clinical pharmacology is driving research and innovation in nephrology, cardiology, cancer treatment and other subspecialties to provide answers for the most difficult cases and challenging pediatric conditions. In addition, we are building a dedicated, state-of-art biorepository that can advance diagnostic discovery and health outcomes. Part II, Community Building Activities: The Children's Mercy community building activities address identified community health needs such as physical activity, early education, poverty, access to health services, infant mortality, mental and behavioral health, and employment. The activities include programs and/or resources intended to make physical improvements, provide community support, advocate for community health improvements, and address community-wide workforce issues through numerous workforce development outreach initiatives. Examples include the maintenance of the Hospital Hill Park and the Sylvia Nutter Playground, the management of a community garden, advocacy activities, participation on Chamber of Commerce committees related to health improvement, and healthcare workforce development for high school students and community members. Part III, Line 4: Audited Financial Statements Footnote M, Page 13. Part III, Line 8: Cost to charge ratio Part III, Line 9b: Collection attempts are discontinued once charges are determined to be eligible for charity care or financial assistance; insurance collection attempts continue as appropriate. Part VI, Line 2: The hospital has an initiative development process that brings forward new initiatives around strategic, operational, community health, and innovation based on community/market trends and needs and through consultation with community-based organizations. On a routine basis, the Strategic Planning Department monitors demographic and service trends of the region and compares this data to national benchmarks. The hospital strategic planning process also takes into account all of the qualitative and quantitative market data to define strategies and tactics that address the community need. In addition, Trauma Services maintains a Trauma Registry and the Promise 1000 centralizes the data collection on the health services and needs of children (0 - 3 years of age) who receive home visiting services. Part VI, Line 3: Flyers and financial counselor business cards and copies of the Financial Assistance Plain Language Summary are available at all access points within the Hospital. Efforts are made by the financial counselors to contact self pay patients and families, either in person, or through phone call or letters to inform/assist families with charity care and Medicaid or state program eligibility. Self pay or underinsured patients can also be referred to a financial counselor by an Access Representative, Patient Care Services, Social Work, Patient Financial Services, or other staff members for screening and assistance. All billing statements refer patients to financial counseling resources and the financial assistance policy posted on the hospital website. Part VI, Line 4: Children's Mercy serves over 233,106 children from across the states of Kansas and Missouri. In Kansas 102 counties and in Missouri, 114 counties have federally designated primary care HPSA areas. Across the two states, Children's Mercy identifies 43 counties as the Outreach Service Area, 50 counties as the Secondary Service Area; and 18 counties as the Primary Service Area. Within the Primary Service Area are six counties called the Metro Service Area. Each of the service areas include urban, suburban and rural counties. The Outreach Service Area includes more rural counties than the other service areas. The Metro Service Area includes more urban and suburban areas than rural. Within the Metro Service Area are the four counties (Jackson and Clay counties located in Missouri and Johnson and Wyandotte counties located in Kansas) that comprise the Children's Mercy CHNA service area. Johnson, Wyandotte and Jackson counties have primary care HPSA areas. Children's Mercy is the only children's hospital in the region. Limited pediatric services are available at the Kansas University Medical Center, St. Luke's Health System, Centerpoint, Liberty Hospital, North Kansas City, Research Medical Center, Shawnee Mission Medical Center and Overland Park hospitals. During the fiscal year in which Children's Mercy initiated the CHNA, residents of these counties contribute over 61.5 percent of the encounters at Children's Mercy. The four counties serve as the location of our physical facilities (e.g., Children's Mercy Adele Hall Campus, Children's Mercy Hospital Kansas, Children's Mercy West, Children's Mercy Northland, Children's Mercy Broadway, Children's Mercy College Boulevard, Children's Mercy Olathe, Children's Mercy Blue Valley, Children's Mercy at The University of Kansas Hospital, Children's Mercy Sports Medicine at Village West, and Children's Mercy East) and the source of a majority of our patient encounters. The four counties house a total population of 1,747,030 ; of these 422,989 or 24 percent are children. Within this region, Wyandotte County has the greatest proportion of children under 18 and Jackson County has the smallest proportion, but largest in absolute number. The overall population of children in these four counties increased between 1980 and 2015 and the overall make-up of the population shifted as well. In 1980, black, Hispanic or other ethnicities comprised 21 percent of the four counties under 18 years of age population and in 2015 36.4 percent of the region's under 18 population made up these groups. According to the 2019 U.S. Census, the median family income for the four counties was $64,745. The highest percentage of children living in poverty is in Wyandotte County (26.5%), followed by Jackson County (19.0%), Clay County (8.7%) and Johnson County (6.0%). Part VI, Line 5: The Children's Mercy Hospital is a nonprofit hospital operated to serve a public rather than a private interest and meeting the requirements of Revenue Ruling 69-545. Control of the Hospital rests with its Board, which is primarily composed of members of the community, in addition to a few select employees of the Hospital. The Hospital accepts patients paying with Medicaid and Medicare, and operates an active and generally accessible emergency room open to all children without regard to ability to pay. The Hospital uses any surplus funds to improve the quality of patient care, expand its facilities, and advance its medical training, education, and research programs.Children's Mercy provides funding to community organizations to support programs addressing the CHNA priority health needs. Organizations include: Black Health Care Coalition; Happy Bottoms; Nurture KC; the Community Health Council of Wyandotte County; New Bethel Neighborhood Development Corporation; Northland Health Alliance; Sleepyhead Beds, El Centro; Restart; Urban Neighborhood Initiative; Uzazi Village; Boys and Girls Clubs of Greater KC; Down Syndrome Guild; Reach Out and Read KC; and Ronald McDonald House Charities of Kansas City. Programs working to improve outcomes for children are strengthened through a community-wide strategy to organize home visiting, participation in community health fairs, support for healthy housing, decrease violence; support the mental health of children; service on key community committees (i.e. Infant and Child Mortality review boards, health department planning committees) and through the provision of training and education for families with children at-risk for obesity or diabetes (i.e. Zoom to Health, PHIT Kids). Part VI, Line 6: The Children's Mercy Hospital is not part of an affiliated health care system. 1 American Heart Association 6800 W 93rd St Overland Park KS 66212 135613797 501(c)3 50000 0 To support education, prevention education and research into heart disease. Black Health Care Coalition 6400 Independence Ave Kansas City MO 64125 431515095 501(c)3 7500 0 To support health care access and the reduction of infant mortality in the African-American population. Charlie's House Inc 2425 Campbell St Kansas City MO 64108 061830922 501(c)3 8333 0 To support injury prevention education across the Kansas City community. Community Health Council of Wyandotte County 803 Armstrong Ave Kansas City KS 66101 010674969 501(c)3 7500 0 To support access to health care and infant health initiatives to Wyandotte County residents. Kansas University Endowment (Reach Out and Read) 3901 Rainbow Blvd MS 1039 Kansas City KS 66106 480547734 501(c)3 20000 0 To provide early education reading program to children attending health care appointments. Leukemia & Lymphoma Society 6811 Shawnee Mission Pkwy 202 Shawnee Mission KS 66202 135644916 501(c)3 17500 0 To cure leukemia, lymphoma, Hodgkin's disease and myeloma, and improve the quality of life for children and their families. Ronald McDonald House Charities 2502 Cherry St Kansas City MO 64108 431190760 501(c)3 98000 0 Provide comfort and care for children and their families who are seeking life-saving pediatric medical treatment. Sleepyhead Beds 4741 Central 244 Kansas City MO 64112 273677974 501(c)3 7500 0 To support the provision of portable cribs to families in need. Uzazi Village 4232 Troost Kansas City MO 64110 460589830 501(c)3 7500 0 To provide education and support programs to African American pregnant and parenting families. Medical College of Wisconsin 8701 Watertown Plank Rd Milwaukee WI 53226 390806261 501(c)3 47015 0 Research Oregon Health & Science 3181 SW Sam Jackson Park Rd AD201 Portland OR 97201 931176109 GOVT 38724 0 Research Seattle Children's Hospital 4800 Sand Point Way NE Seattle WA 98105 910564748 501(c)3 29971 0 Research Regents UCSF PO Box 748872 Los Angeles CA 90074 946036493 501(c)3 12589 0 Research University of California 9500 Gilman Dr La Jolla CA 92093 330833316 GOVT 44962 0 Research Regents University of Michigan 1500 East Medical Center Dr Ann Arbor MI 48109 386006309 GOVT 35603 0 Research University of New Mexico 1 University of New Mexico Albuquerque NM 87131 856000642 GOVT 41266 0 Research Cincinnati Children's Hospital 3333 Burnet Avenue Suite 330 Cincinnati OH 45229 310833936 501(c)3 122332 0 Research Stanford Junior University 3145 Porter Dr Palo Alto CA 94304 941156365 501(c)3 296440 0 Research KU Center for Research KUCR 2385 Irving Hill Road Lawrence KS 66045 480680117 501(c)3 94364 0 Research University of Wisconsin 465 Henry Mall Madison WI 53706 391805963 501(c)3 18242 0 Research Vanderbilt Medical Center Dept AT 40379 Atlanta GA 31192 352528741 501(c)3 17595 0 Research KUMC Research Institute Inc 3901 Rainbow Blvd MS 1039 Kansas City KS 66160 481108830 501(c)3 258960 0 Research University of Missouri UMKC KCUR 118 University Hall Columbia MO 65211 436003859 GOVT 195526 0 Research Cleveland Clinic 9500 Euclid Avenue NA-4 Cleveland OH 44195 340714585 501(c)3 12574 Research NACHRI NACH Children's Hospital 600 13th Street NW Suite 500 Washington DC 20005 510120256 501(c)3 52801 0 Research California Los Angeles UCLA 10921 Wilshire Blvd 5th Floor Los Angeles CA 90024 956006143 501(c)3 16234 0 Research Duke University PO Box 104132 Durham NC 27708 560532129 501(c)3 52934 0 Research H Lee Moffitt Cancer Center 12902 Magnolia Dr Tampa FL 33612 592451713 501(c)3 33509 0 Research Midwest Biomedical Research PO Box 300662 Kansas City MO 64130 431496422 183322 0 Research Joslin Diabetes Center Inc One Joslin Place Boston MA 02215 042203836 501(c)3 342024 0 Research Illumisoft LLC 1111 Main Street Kansas City MO 64105 823165111 191114 0 Research CYFT Incorporated 222 Third Street Suite 1130 Cambridge MA 02142 473547678 746270 0 Research Emory University 103 B Jones Center Atlanta GA 30322 580566256 501(c)3 65319 Research Phoenix Childrens Hospital 1919 East Thomas Rd Pheonix AZ 85016 860422559 501(c)3 24390 Research University of Alabama 701 20th Street S Birmingham AL 35294 636005396 501(c)3 14823 0 Research Washington University 700 Rosedale Avenue Saint Louis MO 63112 430653611 501(c)3 13741 0 Research University of Colorado PO Box 910238 Denver CO 80291 846000555 GOVT 13352 0 Research Children's Hospital Boston 300 Longwood Ave Boston MA 02115 042774441 501(c)3 13343 0 Research UCSF Medical Center 500 Parnassus Ave San Francisco CA 94117 943281657 19538 0 Research Kaiser Foundation Research Institute 1800 Harrison St 16th Floor Oakland CA 94612 941105628 64425 0 Research Albert Einstein College of Medicine 1300 Morris Park Ave Bronx NY 10461 830621846 39203 0 Research University of North Carolina at Chapel Hill PO Box 402420 Atlanta GA 30384 566001393 501(c)3 84997 0 Research San Diego State University Foundation 5250 Campanile Drive San Diego CA 92182 956042721 71857 0 Research Research Foundation for the State University of New York PO Box 9 Albany NY 12201 141368361 501(c)3 13500 0 Research 37 7 Patient Financial Assistance 35142 0 55886111 Cost Charity Care Part I, Line 2: Children's Mercy provides charitable contributions to nonprofit organizations which share a common mission to improve the health and well-being of children. The contributions are restricted to meet a community identified need and community benefit requirements. Children's Mercy documents the appropriate use of our funds by sending a restricted contribution letter; attending annual events; reviewing web-based annual reports; and meeting with agency grant recipient to ascertain the outcomes of their work. Subrecipients sign an agreement which details the subrecipient's plan and budget as well as allowable expenditures of the Federal Awards. The agreement is also approved/signed by the Children's Mercy Hospital (CMH) signing official. Each subrecipient is required to submit periodic invoices (not more than monthly) to CMH for reimbursement. All expenditures on the invoice must be according to the subrecipient's budget that was developed during the application process. Invoices received from subrecipients are certified as complete and accurate by the subrecipient and reviewed and approved by the Principal Investigator or appropriate level of authorization, who forwards them to accounts payable for processing. In addition, Research and Grants (R&G) Accounting monitors these invoices to ensure proper coding to the correct award. The R&G accounting staff captures the amount on the budget-to-actual report to monitor the total amount spent by the subrecipient. Based on the amount budgeted to subrecipients and normal invoiced activity, the R&G accounting staff questions unreasonable invoice amounts with the subrecipient. In addition, any subrecipient that received more than $750,000 in Federal funds during the fiscal year is required to obtain an Uniformed Guidance (formerly A-133) audit and send a copy of the audit report to CMH's accounting department for review. The Post Award Manager is responsible for making sure that for all subrecipients that are required submit Uniform Guidance audits and that CMH has received an audit report. CMH maintains a subrecipient monitoring spreadsheet to track Uniform Guidance audit status, DUNS number, year-to-date spending, etc. for all subrecipients. X 1 1 X X X X X 1 1 0 0 0 1 0 0 0 Paul D Kempinski MS FACHE Director; President & CEO 1078880 0 293333 0 56358 0 0 0 19509 0 1448080 0 0 0 Randall L O'Donnell PhD Former President & CEO; End 9/1/18 0 0 0 0 1411373 0 0 0 0 0 1411373 0 1411373 0 James O'Brien Jr MD Physician 1171526 0 0 0 22477 0 25200 0 19473 0 1238676 0 0 0 William Douglas MD Physician 1172994 0 0 0 31828 0 13179 0 20664 0 1238665 0 0 0 James D Saint Louis MD Physician 1179738 0 0 0 22477 0 18200 0 711 0 1221126 0 0 0 Jo Stueve EVP & COO; End 9/27/19 509559 0 499410 0 102106 0 25200 0 10072 0 1146347 0 0 0 Charles Roberts MD EVP & Exec.Med Director; End 8/17/19 534881 0 105133 0 322635 0 25200 0 9658 0 997507 0 0 0 Walter Andrews MD Physician 773937 0 0 0 27013 0 25200 0 19509 0 845659 0 0 0 Shawn St Peter MD SVP/Surgeon-in-Chief;ChairDeptOfSurg 779076 0 0 0 20243 0 21000 0 20664 0 840983 0 0 0 Charles Snyder MD Physician 776003 0 0 0 24094 0 25200 0 13533 0 838830 0 0 0 David Cauble EVP & CFO 566046 0 118430 0 20683 0 18200 0 20664 0 744023 0 0 0 Thomas Curran PhD SVP, CSO, Executive Director-CMRI 675128 0 0 0 23719 0 21000 0 8289 0 728136 0 0 0 Sandra AJ Lawrence Former EVP & CAO; End 2/14/19 134525 0 0 0 578720 0 11056 0 3198 0 727499 0 0 0 Robin Foster JD Senior VP, General Counsel 536649 0 103359 0 26832 0 21000 0 20664 0 708504 0 0 0 Laura Fitzmaurice MD Director 459117 0 0 0 4213 0 25200 0 19476 0 508006 0 0 0 Robert Steele MD EVP&Chief Strat/InnovOff;Strt10/7/19 121322 0 147444 0 75091 0 0 0 4362 0 348219 0 0 0 Part I, Line 1a Gross-up payments were provided to three officers. These payments were treated as taxable income to the listed persons. Part I, Lines 4a-b Included in the compensation of Charles Roberts is $254,275 of severance following termination of employment. Included in the compensation of Sandra Lawrence is $574,383 of severance following termination of employment. Included in the compensation of Randall O'Donnell is $1,411,373 of severance, which was accrued and reported as deferred compensation in prior years. The amount is a payment from the Plan representing the value no longer subject to substantial risk of forfeiture. Part I, Line 6 A portion of the total cash compensation paid to the President/CEO and all Executive Vice Presidents is determined by a performance based plan approved by the Compensation Committee of the Board of Directors. The plan includes Hospital and individual performance goals, one component of which is based in part on net earnings. A Health and Educational Facilities Authority of the State of Missouri 431178966 60637ALX8 2016-10-13 148207195 see Part VI 0 0 0 B Health and Educational Facilities Authority of the State of Missouri 431178966 60637AMM1 2017-12-20 131226503 see Part VI 0 0 0 C Health and Educational Facilities Authority of the State of Missouri 431178966 000000000 2019-02-28 17940000 see Part VI 0 0 0 D Health and Educational Facilities Authority of the State of Missouri 431178966 000000000 2019-02-28 24750000 see Part VI 0 0 0 A 2760000 148207192 638217 147568975 0 1 1 1 B 133764130 1224064 132404922 135144 0 0 0 1 C 5164300 17940000 17940000 1 0 1 1 D 24750000 24750000 1 0 1 1 A 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 C 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 D 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 1 0 0 0 0 1 B 0 1 0 1 0 0 0 0 1 C 0 1 1 1 1 0 0 0 1 D 0 1 1 1 1 0 0 0 1 A 1 B 1 C 1 D 1 Schedule K, Part I, Line A, Column (f) Description of Purpose- The Series 2016 Bonds were issued to refinance a portion of the outstanding Series 2009 Bonds (issued Nov. 19, 2009). Schedule K, Part I, Line B, Column (f) Description of Purpose- The Series 2017A Bonds were issued to construct and equip a professional office building and a research institute for the Corporation. Schedule K, Part I, Line C, Column (f) Description of Purpose- The Series 2019A Bonds were issued to refinance 2008A/B Bonds and remaining portion of 2009 Bonds. Schedule K, Part I, Line D, Column (f) Description of Purpose- The Series 2019B Bonds were issued to refinance 2008A/B Bonds and remaining portion of 2009 Bonds. Schedule K, Part II, Line 3, Column B Total Proceeds- Difference between issue price and total proceeds of the Series 2017A Bonds represent $2,160,658 of investment proceeds. Schedule K, Part II, Line 11, Column A Other Spent Proceeds- $147,568,978 of Bond proceeds was used to establish a refunding escrow to refinance a portion of the outstanding Series 2009 Bonds. Schedule K, Part II, Line 11, Column C Other Spent Proceeds- $17,940,000 of Bond proceeds were used to refund the series 2008A/B and 2009 Bonds. Schedule K, Part II, Line 11, Column D Other Spent Proceeds- $24,750,000 of Bond proceeds was used to refund the series 2008A/B and 2009 Bonds. Schedule K, Part II, Line 13, Column A Date of Substantial Completion- The Series 2016 Bonds were issued to refinance the Series 2009 Bonds, and therefore, there were no "new-money" projects financed by the Series 2016 Bonds. Schedule K, Part II, Line 13, Column B Date of Substantial Completion- The projects financed by the Series 2017A Bonds have not yet been completed. Schedule K, Part II, Line 13, Column C Date of Substantial Completion- The Series 2019A Bonds were issued to refinance the Series 2008A/B and 2009 Bonds, and therefore, there were no "new-money" projects financed by the Series 2019A Bonds. Schedule K, Part II, Line 13, Column D Date of Substantial Completion- The Series 2019B Bonds were issued to refinance the Series 2008A/B and 2009 Bonds, and therefore, there were no "new-money" projects financed by the Series 2019B Bonds. John Barth Son of Director Kevin Barth 66575 Employment 0 Francesca Barth Daughter-in-law of Director Kevin Barth 69238 Employment 0 Substantial Contributor Substantial Contributor 1292243 Payment for FMV of Services Provided 0 Substantial Contributor Substantial Contributor 1359072 Payment for FMV of Services Provided 0 Substantial Contributor Substantial Contributor 4105205 Payment for FMV of Services Provided 0 Substantial Contributor Substantial Contributor 2292465 Payment for FMV of Services Provided 0 Substantial Contributor Substantial Contributor 6399184 Payment for FMV of Services Provided 0 Substantial Contributor Substantial Contributor 3069111 Payment for FMV of Services Provided 0 Substantial Contributor Substantial Contributor 291140 Payment for FMV of Services Provided 0 Substantial Contributor Substantial Contributor 3586488 Payment for FMV of Services Provided 0 Substantial Contributor Substantial Contributor 347831 Payment for FMV of Services Provided 0 Substantial Contributor Substantial Contributor 135206 Payment for FMV of Services Provided 0 Substantial Contributor Substantial Contributor 285465 Payment for FMV of Services Provided 0 Substantial Contributor Substantial Contributor 89370897 Payment for FMV of Services Provided 0 Substantial Contributor Substantial Contributor 3441656 Payment for FMV of Services Provided 0 Substantial Contributor Substantial Contributor 1246587 Payment for FMV of Services Provided 0 X 10 10735 FMV X FMV X 1668 FMV X 1 55415 FMV X 32 1488559 FMV X 6 3750 FMV X 27 11608 FMV X Jewelry 12 12779 FMV X Miscellaneous 8 4488 FMV 0 0 1 0 Part I, Column (b): The amounts in Part I, Column (b) represent the number of contributions received during the taxable year. Form 990, Part III, line 2 University of Kansas Hospital and Children's Mercy entered into a pediatric affliation agreement. The University of Kansas Hospital transitioned six pediatric specialty clinic - cardiology, endocrinology, gastroenterology, nephrology, neurology and rheumatology - to Children's Mercy. School Support during COVID-19: Children's Mercy worked with schools to help them create a healthy and safe environment for their staff and students during the COVID pandemic. This included written guidance and protocols, school webinars for teachers and administrators, and a school outreach portal to help schools address their most pressing questions. The Emergency Food Program was started to ensure kids did not go food insecure while schools were shutdown. Starting in March 2020 and going through the end of May 2020, Children's Mercy provided 5,200 free meals to children and their families. The Circulation Transportation program was launched to provide rides to patients and families at risk for missing primary care appointments due to lack of transportation. Rides scheduled to primary care appointments totaled 4,008 and averaged 8.5 rides per day. Form 990, Part VI, Section B, line 11b The final Form 990, including all required schedules, was provided to each voting member of the Board of Directors prior to its filing with the IRS. Form 990, Part VI, Section B, line 12c Corporate compliance reviews all potential conflicts disclosed, and reviews and approves completion of the related management plan. Form 990, Part VI, Section B, line 15 The Compensation Committee of the Board of Directors is responsible for approving the compensation of the CEO, which they document in an Employment Agreement between the Board of Directors and the CEO. The Compensation Committee also approves the compensation of the EVP/CAO, the EVP/Chief Medical Officer, two persons with the title EVP/Chief Operating Officer, all officers of the Hospital, and the Chair of the Department of Pediatrics. The Compensation Committee is composed of independent outside directors who receive no compensation for their participation on the Board. The Compensation Committee engages an outside consulting firm, whose practice includes the analysis of compensation for not-for-profit hospitals, to advise the Committee with regard to market data and analysis, which was used to establish compensation. A letter from the compensation consultant opining on the reasonableness of the compensation was provided to the Committee and there is documentation of the Committee's deliberations and decision in existence. Form 990, Part VI, Section C, line 19 The organization's governing documents, conflict of interest policy, and audited financial statements are available upon request. Form 990, Part IX, line 11g Other Fees: Program service expenses 70,051,388. Management and general expenses 96,666,612. Fundraising expenses 548,068. Total expenses 167,266,068. Form 990, Part XI, line 9: Change in benefit obligation 644,000. Change in interest rate swap valuation -2,328,321. Net Unrealized Change in Income Beneficiary and Charitable Remainder Trusts -944,567. Intercompany Transfer 32,243. Unrealized Loss on Equity Investments -41,852,814. CMH Insurance Company LLC 2401 Gillham Road Kansas City MO 64108 Insurance for The Children's Mercy Hospital MO 134060 12894584 The Children's Mercy Hospital Physician Business Partners LLC 2401 Gillham Road Kansas City MO 64108 Physician network for education and purchasing MO The Children's Mercy Hospital Children's Research Institute LLC 2401 Gillham Road Kansas City MO 64108 Supports research activities of The Children's Mercy Hospital MO The Children's Mercy Hospital Children's Mercy Hospital Foundation 2401 Gillham Road Kansas City MO 64108 431564302 Investment management to benefit Children's Mercy Hospital MO 501(C)(3) line 11, III-NFI N/A 0 Children's Mercy's Family Health Partners Inc 2420 Pershing Kansas City MO 64108 431726517 Integrated health insurance benefits care system MO 501(C)(3) line 9 The Children's Mercy Hospital 1 Children's Mercy Hospital Self-Insurance Trust Commerce Trust Co PO Box 419248 Kansas City MO 64141 436231807 Providing funds for malpractice claims against CMH & employees MO 501(C)(3) line 11, I The Children's Mercy Hospital 1 Children's Mercy Integrated Care Solutions Inc 2401 Gillham Road Kansas City MO 64108 453741386 Coordinates medical care of pediatric patients KS The Children's Mercy Hospital C 38378224 1.00000 1 Children's Mercy- Pediatric Associates Inc 4400 Broadway Suite 206 Kansas City MO 64111 814659989 Medical Practice KS The Children's Mercy Hospital C 1567348 1.00000 1 Children's Mercy- Pediatric Care Specialists Inc 12541 Foster St Suite 260 Overland Park KS 66213 814753049 Medical Practice KS The Children's Mercy Hospital C 8969 1622193 1.00000 1 Children's Mercy- Pediatric Care North Inc 8781 N Platte Purchase Drive Kansas City MO 64155 815020009 Medical Practice KS The Children's Mercy Hospital C 1276010 1.00000 1 Children's Mercy- Johnson County Pediatrics Inc 8800 West 75th St Suite 220 Shawnee Mission KS 66204 320505028 Medical Practice KS The Children's Mercy Hospital C 9544 919528 1.00000 1 Children's Mercy- Preferred Pediatrics Inc 241 NW McNary Ct Lees Summit MO 64081 821130197 Medical Practice KS The Children's Mercy Hospital C 89041 698732 1.00000 1 Children's Mercy- Cass County Pediatrics and Adolescents Inc 503 N Scott Belton MO 64012 820881485 Medical Practice KS The Children's Mercy Hospital C 50321 277655 1.00000 1 Children's Mercy- Cradle Thru College Care Inc 1004 Carondelet Dr Suite 30 Kansas City MO 64114 822804086 Medical Practice KS The Children's Mercy Hospital C 147767 1.00000 1 Children's Mercy- Redwood Pediatrics Inc 9151 NE 81st Ter Suite 240 Kansas City MO 64158 822564241 Medical Practice KS The Children's Mercy Hospital C -2983 223888 1.00000 1 Children's Mercy- Summit Pediatrics and Adolescent Medicine Inc 3171 E Carnegie Dr ST A Lees Summit MO 64064 824082519 Medical Practice KS The Children's Mercy Hospital C -127 954263 1.00000 1 Children's Mercy- Shawnee Mission Pediatrics Inc 7450 Kessler St Suite 105 Merriam KS 66204 841836624 Medical Practice KS The Children's Mercy Hospital C -64683 2139523 1.00000 1 Children's Mercy- Health Care for Children Inc 9051 NE 81st Terrace Suite 100 Kansas City MO 64158 841845668 Medical Practice KS The Children's Mercy Hospital C 77998 524591 1.00000 1 Children's Mercy- Leawood Pediatrics Inc 5401 College Blvd Suite 101 Leawood KS 66211 842411195 Medical Practice KS The Children's Mercy Hospital C -122271 1069466 1.00000 1 Income Beneficiary Trusts (5) Trust MO N/A T 0 1 0 1 1 1 0 0 0 0 1 0 1 0 0 1 1 1 1 1 Children's Mercy Integrated Care Solutions O 5990276 Book Children's Mercy Integrated Care Solutions J 303554 Book Children's Mercy Integrated Care Solutions L 1240431 Book Children's Mercy Integrated Care Solutions P 415310 Book Children's Mercy Integrated Care Solutions Q 62275 Book Children's Mercy Integrated Care Solutions S 141978189 Book Children's Mercy Hospital Family Health Partners Inc R 32243 Book Children's Mercy- Shawnee Mission Pediatrics Inc D 350000 Book Children's Mercy- Health Care for Children Inc D 325000 Book Children's Mercy- Leawood Pediatrics Inc D 250000 Book Children's Mercy- Pediatric Associates Inc A 6194 Book Children's Mercy- Cass County Pediatrics and Adolescents Inc A 3569 Book Children's Mercy- Preferred Pediatrics Inc A 1323 Book Children's Mercy- Cradle thru College Care Inc A 4962 Book Children's Mercy- Summit Pediatrics & Adolescent Medicine Inc A 3242 Book Children's Mercy- Shawnee Mission Pediatrics Inc A 12836 Book Children's Mercy- Health Care for Children Inc A 7785 Book Children's Mercy- Leawood Pediatrics Inc A 7743 Book