2017-05-08T15:33:27-05:00 2016-06-30 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2015-07-01 440661018 TRUMAN MEDICAL CENTER INCORPORATED % ALLEN JOHNSON TRUM 8164041000 2301 HOLMES STREET KANSAS CITY MO 64108 CHARLIE SHIELDS PRESIDENT/CEO 8164043528 2017-05-15 true Kevin Ensminger CPA P01310558 8162216300 2015 2021-01-29 14:40:06Z ALLEN JOHNSON 2310 HOLMES KANSAS CITY MO 64108 542818370 false X WWW.TMCMED.ORG X 1976 MO TRUMAN MEDICAL CENTER IS AN ACADEMIC HEALTH CENTER PROVIDING ACCESSIBLE, STATE-OF-THE-ART QUALITY HEALTHCARE TO OUR COMMUNITY REGARDLESS OF ABILITY TO PAY. 29 26 4810 852 0 0 12506820 11333494 529483404 492095736 275210 3901535 32075008 33319928 574340442 540650693 896957 1209250 0 0 253624678 253902890 0 0 0 253172352 261354636 507693987 516466776 66646455 24183917 266958533 275850513 243399346 256798256 23559187 19052257 X 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. false false 189221296 933697 215420422 OUTPATIENT DEPARTMENT- SEE SCHEDULE O 193836450 0 220674579 INPATIENT CARE- SEE SCHEDULE O 78457611 0 89320663 EMERGENCY DEPARTMENT- SEE SCHEDULE O 461515357 true true false true false false false false false true true false false true true false false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true true true false false true 289 0 true 4810 true false false false false false false false false false false X 29 26 false false false false false true false true true false true true false true true true true true true true false MO X ALLEN JOHNSON 8164043528 2310 HOLMES KANSAS CITY MO 64108 CHARLES W SHIELDS PRESIDENT/CEO/DIRECTOR 40.0 0.0 X X 623729 0 110011 PEGGY J DUNN CHAIR/DIRECTOR 1.0 0.0 X X 0 0 0 PAUL M BLACK PAST CHAIR/DIRECTOR 1.0 0.0 X X 0 0 0 RITA M CORTES VICE CHAIR/DIRECTOR 1.0 0.0 X X 0 0 0 PHILIP J SANDERS TREASURER/DIRECTOR 1.0 0.0 X X 0 0 0 DRED D SCOTT PHD VICE CHAIR/DIRECTOR 1.0 0.0 X X 0 0 0 DAVID W THOMPSON SECRETARY/DIRECTOR 1.0 0.0 X X 0 0 0 KAREN ZECY VICE CHAIR/DIRECTOR 1.0 0.0 X X 0 0 0 DAVE BARBER DIRECTOR 1.0 0.0 X 0 0 0 FORESTINE BEASLEY DIRECTOR 1.0 0.0 X 0 0 0 SARAH R CHAVEZ DIRECTOR 1.0 0.0 X 0 0 0 JAMES CORWIN DIRECTOR 1.0 0.0 X 0 0 0 MICHELLE DESILVA DIRECTOR 1.0 0.0 X 0 0 0 MIKE ENOS DIRECTOR 1.0 0.0 X 0 0 0 PAUL P HOLEWINSKI DIRECTOR 1.0 0.0 X 0 0 0 JOLIE JUSTUS DIRECTOR 1.0 0.0 X 0 0 0 STEVEN L KANTER MD DIRECTOR 1.0 0.0 X 0 0 0 STELLA M LEDOUX DIRECTOR/TMC EMPLOYEE 40.0 0.0 X 82361 0 9656 PETER S LEVI DIRECTOR 1.0 0.0 X 0 0 0 TRACEY LEWIS DIRECTOR 1.0 0.0 X 0 0 0 MARVIN LYMAN DIRECTOR 1.0 0.0 X 0 0 0 MARIA MATINEZ DIRECTOR 1.0 0.0 X 0 0 0 LEO MORTON DIRECTOR 1.0 0.0 X 0 0 0 DENNIS S O'LEARY DIRECTOR 1.0 0.0 X 0 0 0 JUAN M RANGEL JR DIRECTOR 1.0 0.0 X 0 0 0 ESMAT SADEDDIN DIRECTOR 1.0 0.0 X 0 0 0 KARA SETTLES MD DIRECTOR 1.0 0.0 X 0 0 0 MARK T STEELE MD DIRECTOR 10.0 1.0 X 106100 0 0 MAHNAZ SHABBIR DIRECTOR 1.0 0.0 X 0 0 0 WILLIAM H COLBY ASSISTANT SECRETARY 40.0 2.0 X 408150 0 91127 ALLEN M JOHNSON ASSISTANT TREASURER 40.0 0.0 X 342668 0 106446 MARK S MCPHEE EVP CLINIC COOR/RETIRED 05/15 40.0 0.0 X 534722 0 47285 JOHN GIANINO NEUROSURGEON 40.0 1.0 X 589816 0 139445 STEPHEN JARVIS ACMO/CLINICAL CHAIR PSYCHIATRY 40.0 0.0 X 290608 0 52805 MANUEL E MORALES PSYCHIATRIST 40.0 0.0 X 365211 0 43258 MARSHA L MORGAN COO - BEHAVIORAL HEALTH 40.0 0.0 X 356385 0 38197 JOHN W BLUFORD PRESIDENT/CEO RETIRED 07/2014 0.0 0.0 X 524084 0 0 4223834 0 638230 217 true true false UNIVERSITY OF MISSOURI-KANSAS CITY PO BOX 805111 KANSAS CITY MO 64180 MEDICAL SERVICES 15202119 UNIVERSITY PHYSICIAN ASSOCIATES 2310 HOLMES SUITE 800 KANSAS CITY MO 64108 PHYSICIAN SERVICES 11298906 CERNER CORPORATION PO BOX 412702 KANSAS CITY MO 64141 IT SERVICES 9359086 MEDICAL IMAGING INC 2001 NE PARVIN ROAD STE 200 KANSAS CITY MO 64116 MEDICAL SERVICES 5285746 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 FOOD SERVICE 5054371 36 6218785 5114709 11333494 NET PATIENT SERVICE REVENUE 621110 313627548 313627548 EXPENSE REIMBURSEMENT 621110 1956640 1956640 MEDICAID ENHANCEMENTS 621110 140635300 140635300 LOCAL GOVERNMENT SUBSIDY 900099 35876248 35876248 492095736 1069212 1069212 0 0 0 0 0 5000000 2167677 2832323 2832323 2832323 0 0 0 340B REVENUE 900099 26792903 26792903 EHR MEANINGFUL USE 900099 1955461 1955461 LABORATORY 900099 1137322 1137322 3434242 3434242 33319928 540650693 525415664 3901535 1209250 1209250 0 0 0 1890456 1890456 0 206630698 183327226 23303472 3240431 2996718 243713 28019296 24752427 3266869 14122009 12431443 1690566 0 715221 715221 185207 185207 105072 105072 0 0 0 0 131309162 109814114 21495048 0 0 11026696 9736573 1290123 172118 172118 0 593554 593554 2889353 2889353 0 21365197 21365197 2136962 2136962 BAD DEBT EXPENSE 25120136 25120136 MEDICAL STAFF EXPENSES 135144 135144 MEDICAL SUPPLIES 32452434 32452434 PHARMACEUTICALS 33148380 33148380 516466776 461515357 54951419 0 8296184 22601031 27483 30270 1118147 660406 55968850 51146382 0 0 0 0 0 0 5833183 7009355 4766824 5335691 497080676 336036247 162504116 161044429 0 0 0 0 0 0 0 0 28443746 28022949 266958533 275850513 150713603 174401231 0 0 0 0 63705872 56396463 0 0 0 0 20151188 18886208 0 0 8828683 7114354 243399346 256798256 X 10825729 6398775 9540360 9460384 3193098 3193098 23559187 19052257 266958533 275850513 X 24183917 -28690847 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 57854 57854 47218 47218 105072 105072 516361704 516361704 516466776 516466776 1000000 1000000 250000 250000 1000000 1000000 1000000 1000000 4000000 6000000 97731 75808 115716 105072 394327 250000 250000 250000 250000 1000000 1500000 38170 30138 59402 57854 185564 3173107 0 -82203 0 102557 0 2988347 3244340 0 42279 0 113512 0 3173107 3173837 200 172581 0 102278 0 3244340 3077353 200 189940 0 93656 0 3173837 2981134 125200 70859 0 99840 0 3077353 1.00000 true false 3709661 3709661 306616182 190055273 116560909 180721863 145980974 34740889 6032970 6032970 161044429 ASSETS FOR CAPITAL ACQUISITION 2998129 ASSETS EXTERNALLY RESTRICTED 537110 INTEREST IN ASSETS OF TMCCF 12116338 OTHER RECEIVABLES 8855708 OTHER ASSETS 3515664 28022949 0 457F PLAN LIABILITY 2998447 UNAMORTIZED PREMIUM 1603382 OTHER LIABILITIES 2512525 7114354 515981805 3857625 3857625 512124180 28526513 28526513 540650693 495624598 5910025 5910025 489714573 26752203 26752203 516466776 SCHEDULE D, PART V, LINE 4 THE INVESTMENTS ARE TO BE HELD IN PERPETUITY AT TRUMAN MEDICAL CENTER CHARITABLE FOUNDATION; THE INCOME IS PRIMARILY RESTRICTED FOR THE PURPOSE OF FUNDING DEPARTMENT CHAIRMAN POSITIONS AT THE UNIVERSITY OF MISSOURI-KANSAS CITY SCHOOL OF MEDICINE. (THE MEDICAL CENTER IS THE TEACHING FACILITY FOR THE UMKC SCHOOL OF MEDICINE.) 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 375,250 RELATED ORGANIZATION REVENUE 3,482,375 ----------- TOTAL $ 3,857,625 SCHEDULE D, PART XI, LINE 4B MEDICAL STAFF REVENUE 163,769 TEMPORARILY RESTRICTED CONTRIBUTIONS 412,872 CONTRIBUTION USED FOR ASSET ACQUISITION 1,332,813 ELIMINATIONS 1,496,923 BAD DEBT EXPENSE 25,120,136 ----------- TOTAL $ 28,526,513 SCHEDULE D, PART XII, LINE 2D RELATED ORGANIZATION EXPENSES $ 5,910,025 SCHEDULE D, PART XII, LINE 4B ELIMINATIONS 1,496,923 MEDICAL STAFF EXPENSES 135,144 BAD DEBT EXPENSE 25,120,136 ------------ TOTAL $ 26,752,203 true true X true X false true true true false true true 96723147 87353105 9370042 0.01910 151440372 164775309 248163519 252128414 9370042 0.01910 501680 155756 345924 0.00070 39663327 34921345 4741982 0.00970 8046626 2966604 5080021 0.01030 450000 450000 0.00090 48661633 38043705 10617927 0.02160 296825152 290172119 19987969 0.04070 true 25120136 18840102 62082526 88315094 -26232568 X true true 2 1 TRUMAN MEDICAL CENTER - HOSPITAL HILL 2301 HOLMES KANSAS CITY MO 64108 WWW.TRUMED.ORG 285-39 X X X X 2 TRUMAN MEDICAL CENTER - LAKEWOOD 7900 LEES SUMMIT ROAD KANSAS CITY MO 64139 WWW.TRUMED.ORG 195-54 X X X X TRUMAN MEDICAL CENTER - HOSPITAL HILL 1 false false true X X X X X X X X 15 true true false true X SEE PART V, SECTION C X true 15 true SEE PART V, SECTION C false true X 200. 0. X X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X true X false X X X X true X false false TRUMAN MEDICAL CENTER - LAKEWOOD 2 false false true X X X X X X X X X 15 true true false true X SEE PART V, SECTION C X true 15 true SEE PART V, SECTION C false true X 200. 0. X X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 - BOTH FACILITIES TMC CONDUCTED THREE STAKEHOLDER MEETINGS, AS WELL AS AN ELECTRONIC SURVEY, TO ENGAGE COMMUNITY MEMBERS IN THE ASSESSMENT PROCESS. STAKEHOLDER MEETINGS INCLUDED THE TMC LAKEWOOD PATIENT ADVISORY COUNCIL, A MEETING AT THE INDEPENDENCE SCHOOL DISTRICT, AND A MEETING AT THE LUCILE BLUFORD LIBRARY THAT INCLUDED INDIVIDUALS ENGAGED IN THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAMS. A COMMON SET OF QUESTIONS WAS POSED TO EACH GROUP, AND RESPONSES COLLECTED AND SUMMARIZED BY GROUP AND AS A COLLECTIVE. APPROXIMATELY 70 INDIVIDUALS PARTICIPATED IN THESE GROUP MEETINGS. FOLLOWING ARE THE QUESTIONS THAT WERE PRESENTED TO EACH GROUP: - WHAT DO YOU BELIEVE ARE MOST IMPORTANT CHARACTERISTICS OF A HEALTHY COMMUNITY? - WHAT DO YOU BELIEVE ARE THE MOST IMPORTANT ISSUES THAT MUST BE DEALT WITH IF WE WANT TO IMPROVE HEALTH AND QUALITY OF LIFE IN THE COMMUNITY? - WHAT DO YOU THINK IS THE BIGGEST HEALTH-RELATED PROBLEM IN THE COMMUNITY? - WHAT IS THE MOST IMPORTANT SERVICE THAT TRUMAN MEDICAL CENTERS OFFERS? - ARE THERE ANY SERVICES THAT YOU THINK TRUMAN MEDICAL CENTERS SHOULD PROVIDE THAT THEY CURRENTLY DO NOT? IN ADDITION, OVER 100 COMMUNITY MEMBERS, INCLUDING BOTH INDIVIDUALS AS WELL AS REPRESENTATIVES OF COMMUNITY ORGANIZATIONS, COMPLETED AN ELECTRONIC SURVEY THAT ESTABLISHED THE INITIAL 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. 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. PART V, SECTION B, LINE 7A - BOTH FACILITIES THE COMPLETE CHNA FOR TMC-HOSPITAL HILL CAN BE FOUND AT: http://www.trumed.org/files/chna/HH-Community-Health-Needs-Assessment-2016 .pdf THE COMPLETE CHNA FOR TMC-LAKEWOOD CAN BE FOUND AT: http://www.trumed.org/files/chna/LW-Community-Health-Needs-Assessment-2016 .pdf PART V, SECTION B, LINE 10A - BOTH FACILITIES THE IMPLEMENTATION STRATEGY FOR TMC-HOSPITAL HILL CAN BE FOUND AT: http://www.trumed.org/files/chna/HH-Community-Health-Needs-Assessment-2016 .pdf THE IMPLEMENTATION STRATEGY FOR TMC-LAKEWOOD CAN BE FOUND AT: http://www.trumed.org/files/chna/LW-Community-Health-Needs-Assessment-2016 .pdf PART V, SECTION B, LINE 11 - BOTH FACILITIES TMC'S CHNA IDENTIFIED NEEDS THAT EXTEND BEYOND A 12-MONTH TIME-FRAME. EACH NEED/PRIORITY IS LISTED BELOW, WITH A BRIEF STATEMENT OF PROGRESS. EACH PRIORITY REMAINS ACTIVE, AND THE COMMUNITY NEED IN EACH AREA IS CURRENT. TMC REVIEWS PROGRESS AS PART OF ITS BUDGETING AND RESOURCE DEVELOPMENT PROCESSES TO ASSURE THAT RESOURCES ARE BEING ALLOCATED AND/OR SOUGHT TO ADDRESS EACH PRIORITY. STRENGTHEN THE QUALITY NET THE FOCUS OF THIS PRIORITY NEED IS CONTINUED DEVELOPMENT OF THE PRIMARY CARE INFRASTRUCTURE TO MEET THE NEEDS OF COMMUNITY MEMBERS, AND TO IMPLEMENT TEAM-BASED CARE ACROSS THE SYSTEM. TMC WILL CONTINUE TO ADDRESS THIS PRIORITY NEED. IN 2013, TMC EXPANDED ITS SCHOOL-BASED PROGRAM THROUGH DEPLOYMENT OF MOBILE SERVICES TO THE INDEPENDENCE SCHOOL DISTRICT. TEAM-BASED CARE STRATEGIES WERE EXPANDED TO ADDITIONAL INPATIENT SETTINGS, AND CARE TRANSITION PLANS WERE IMPLEMENTED TO IMPROVE HANDOFFS BETWEEN THE INPATIENT AND OUTPATIENT SETTING. BEHAVIORAL HEALTH THE STRATEGY FOR BEHAVIORAL HEALTH IS TO INTEGRATE IT INTO THE PRIMARY CARE SETTING. DURING THE REPORTING YEAR, TMC HAS LED THE COMMUNITY IN TRAINING FOR TRAUMA-INFORMED CARE; IMPLEMENTED REGULAR SCREENING AND TRACKING FOR AT-RISK POPULATIONS TO IDENTIFY BEHAVIORAL HEALTH PATIENTS MUCH EARLIER; IMPLEMENTED WIDESPREAD TRAINING FOR ALL SUPPORT STAFF ON CARING FOR BEHAVIORAL HEALTH PATIENTS OF VARYING SEVERITY, AND CONTINUED TO FULLY IMPLEMENT BEHAVIORAL HEALTH SUPPORT IN THE PRIMARY CARE SETTING. CHRONIC DISEASE THE PRIORITY NEED IS INCREASING ACCESS TO INTEGRATED CARE. PROGRESS IN THIS AREA IS LINKED TO THE "STRENGTHENING THE QUALITY NET" PRIORITY. MATERNAL & INFANT HEALTH THE PRIORITY NEED IS TO INCREASE ACCESS TO PRENATAL CARE. TMC WAS DESIGNATED AS A BABY FRIENDLY HOSPITAL. A MULTI-DISCIPLINARY TEAM HAS BEEN FORMED TO EXECUTE THE PROGRAM WITH THE GOAL OF OBTAINING THE DESIGNATION IN FISCAL YEAR 2015. DENTAL CARE/ORAL HEALTH THE PRIORITY NEED IS TO INCREASE ACCESS TO ORAL HEALTH SERVICES. IN 2016, TMC PROVIDED 3,321 NUTRITIONAL COUNSELING VISITS AND 3,932 ORAL HYGIENE INSTRUCTION VISITS TO STUDENTS IN THE ELEMENTARY AND MIDDLE SCHOOLS DURING THE COURSE OF THIS YEAR FOR A TOTAL OF 7,253 INTERACTIONS THAT INCREASED THE KNOWLEDGE AND HOME CARE OF THE STUDENTS. TMC PROVIDED 342 DENTAL RESTORATIONS AND PLACED 766 SEALANTS AS PART OF OUR EFFORT TO IMPROVE ACTUAL DENTAL HEALTH OF THE ELEMENTARY AND MIDDLE SCHOOL STUDENTS. PART V, SECTION B, LINE 16A - BOTH FACILITIES THE FAP CAN BE FOUND AT: http://www.trumed.org/files/financial-counseling/financial-assistance-poli cy.pdf PART V, SECTION B, LINE 16B - BOTH FACILITIES THE FAP APPLICATION CAN BE FOUND AT: http://www.trumed.org/files/financial-counseling/discount-application-elig ibility-statement.pdf 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 PART V, SECTION B, LINE 20E - BOTH FACILITIES OTHER NOTIFICATIONS OF FINANCIAL ASSISTANCE OPTIONS INCLUDE MAILING A LETTER INFORMING THE PATIENT OF OPTIONS IF A PATIENT IS DISCHARGED BEFORE BEING SEEN BY A FINANCIAL ADVISOR. 1 TMC BEHAVIOR HEALTH 300 WEST 19TH TERRACE KANSAS CITY MO 64108 MENTAL HEALTH FACILITY PART I, LINE 3C SEE PART VI, SECTION B, LINE 13 FOR THE LIST OF OTHER FACTORS USED IN THE ELIGIBILITY CRITERIA EXPLAINED IN THE FAP FOR PROVIDING FREE CARE. PART I, LINE 7 THE COST METHOD USED TO CALCULATE THE AMOUNTS IN THIS TABLE IS A COST TO CHARGE RATIO. PART I, LINE 7, COLUMN F THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 COLUMN (A), SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $25,120,136. PART I, LINE 7G THE ORGANIZATION DEDUCTION INCLUDES $2,344,295 OF COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES. PART III, SECTION A, LINE 2 THE COST OF BAD DEBTS IS DETERMINED BY USING THE COST TO CHARGE RATIO. BAD DEBTS DO REPRESENT FREE OR UNCOMPENSATED SERVICES PROVIDED TO PATIENTS IN WHICH THERE WAS AN EXPECTATION OF PAYMENT AT TIME OF SERVICE. HOWEVER, MANY TIMES AFTER PURSUING COLLECTION IT IS DISCOVERED THE PATIENT DID NOT HAVE THE ABILITY TO PAY. PART III, SECTION A, LINE 3 TMC HAS DISCOVERED ABOUT 75% OF BAD DEBTS RESULT FROM PATIENTS WHO ARE INDIGENT OR DO NOT QUALIFY FOR MEDICAID. 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 8 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, SECTION B, LINE 8 TMC BELIEVES THAT MEDICARE SHORTFALLS SHOULD QUALIFY AS A COMMUNITY BENEFIT COST IF THE MEDICARE BENEFICIARY IS INDIGENT. APPROXIMATELY 75% OF THE TMC MEDICARE SHORTFALL IS RELATED TO THE COST OF TREATING THE MEDICARE INDIGENT (MEDICARE/MEDICAID ELIGIBLE) POPULATION. PART III, SECTION C, LINE 9B TMC DOES NOT PURSUE COLLECTION FOR UNPAID DISCOUNTED AMOUNTS FOR INDIVIDUALS WITHIN THE CATCHMENT AREA. PART VI, LINE 2 - NEEDS ASSESSMENT A TMC COMMUNITY PARTNER, THE MID-AMERICA REGIONAL COUNCIL LAUNCHED A BI-STATE (MO-KS) HEALTH CARE INITIATIVE TO IMPROVE ACCESS TO HEALTH CARE FOR THE UNINSURED AND UNDER SERVED IN GREATER KANSAS CITY. THE INITIATIVE INCLUDED A SURVEY AND CREATION OF SEVERAL SUBGROUPS TO ADDRESS HEALTHCARE AND MENTAL HEALTH NEEDS OF THE UNINSURED AND UNDER INSURED IN THE KANSAS CITY AREA AND SYSTEMS NEEDED TO PROVIDE THAT CARE. TMC IS AN ACTIVE MEMBER OF THE SAFETY NET COLLABORATIVE SUB-GROUP. TMC'S STRATEGIC OBJECTIVES AND THE COMPLETED CHNA REPORTS FOR THE TWO TMC FACILITIES, TMC-HOSPITAL HILL AND TMC-LAKEWOOD, CAN BE FOUND AT: http://www.trumed.org/files/chna/HH-Community-Health-Needs-Assessment-2016 .pdf http://www.trumed.org/files/chna/LW-Community-Health-Needs-Assessment-2016 .pdf 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. PART VI, LINE 4 - COMMUNITY INFORMATION TMC SERVES THE POPULATION OF JACKSON COUNTY AND KANSAS CITY, MISSOURI. JACKSON COUNTY ENCOMPASSES APPROXIMATELY 618 SQUARE MILES AND SERVES A POPULATION OF 675,000. THE DEMOGRAPHICS ARE 70% CAUCASIAN AND 23% AFRICAN AMERICAN. TMC HOSPITAL HILL DEMOGRAPHICS ARE 48% AFRICAN AMERICAN AND 39% CAUCASIAN. TMC-LAKEWOOD DEMOGRAPHICS ARE 17% AFRICAN AMERICAN AND 73% CAUCASIAN. MORE THAN 70% OF TMC PATIENTS HAVE COMMERCIAL OR GOVERNMENT INSURANCE COVERAGE. 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. FOR ADDITIONAL INFORMATION ON COMMUNITY BENEFIT ACTIVITIES, PLEASE SEE TMC'S 2014-2015 COMMUNITY BENEFIT REPORT AT: https://www.trumed.org/files/publications/Community_Benefit_Report_2014-15 _FINAL_for_web(1).pdf true UNIVERSITY OF MISSOURI-KANSAS CITY 5100 ROCKHILL ROAD KANSAS CITY MO 64110 436003859 501(C)(3) 900000 OPERATIONS CITY OF KANSAS CITY MISSOURI 414 E 12TH ST KANSAS CITY MO 64106 GOVERNMENT 309250 OPERATIONS 2 SCHEDULE I, PART I, LINE 2 THE GRANTS PROVIDED WERE MADE TO OTHER PUBLIC ORGANIZATIONS WHO HAVE A CLOSE WORKING RELATIONSHIP WITH TRUMAN MEDICAL CENTER. THESE ORGANIZATIONS STRIVE TO FURTHER SUPPORT THE HOSPITAL OPERATIONS OF TRUMAN MEDICAL CENTER, INC. THEREFORE, THE USE OF THE GRANTED FUNDS IS MONITORED THROUGH THE CLOSE WORKING RELATIONSHIPS WITH THESE ORGANIZATIONS. X X X X X X true true false false false false false false false CHARLES W SHIELDS PRESIDENT/CEO/DIRECTOR 531927 0 88300 0 3502 0 59827 0 50184 0 733740 0 0 0 WILLIAM H COLBY ASSISTANT SECRETARY 381857 0 0 0 26293 0 40968 0 50159 0 499277 0 0 0 ALLEN M JOHNSON ASSISTANT TREASURER 340424 0 0 0 2244 0 76261 0 30185 0 449114 0 0 0 JOHN W BLUFORD PRESIDENT/CEO RETIRED 07/2014 0 0 0 0 524084 0 0 0 0 0 524084 0 0 0 MARK S MCPHEE EVP CLINIC COOR/RETIRED 05/15 144765 0 0 0 389957 0 11066 0 36219 0 582007 0 0 0 JOHN GIANINO NEUROSURGEON 481839 0 0 0 107977 0 101802 0 37643 0 729261 0 0 0 STEPHEN JARVIS ACMO/CLINICAL CHAIR PSYCHIATRY 275547 0 0 0 15061 0 25145 0 27660 0 343413 0 0 0 MANUEL E MORALES PSYCHIATRIST 209606 0 0 0 155605 0 13539 0 29719 0 408469 0 0 0 MARSHA L MORGAN COO - BEHAVIORAL HEALTH 181864 0 0 0 174521 0 22480 0 15717 0 394582 0 0 0 SCHEDULE J, PART I, LINE 4A MARK MCPHEE $ 220,122 SCHEDULE J, PART I, LINE 4B & PART II 2015 2015 2015 ACCRUAL DISTRIBUTION TOTAL ALLEN JOHNSON $ 54,948 -0- $ 54,948 WILLIAM COLBY $ 39,940 23,798 $ 63,738 CHARLES SHIELDS $ 56,514 -0- $ 56,514 JOHN GIANINO $ 80,490 106,885 $ 187,375 MARK MCPHEE $ 11,066 62,760 $ 73,826 STEPHEN JARVIS $ -0- 14,034 $ 14,034 MANUEL MORALES $ 13,539 63,125 $ 76,664 MARSHA MORGAN $ 18,270 36,795 $ 55,065 PART VII, LINE 5 AND SCH J, PART II TRUMAN MEDICAL CENTER, INC. (TMC) REIMBURSED UNIVERSITY PHYSICIANS ASSOCIATES $106,100 FOR THE TIME MARK STEELE, M.D. SPENT ASSISTING TMC, INC. AS THE MEDICAL DIRECTOR. A JACKSON COUNTY MISSOURI PUBLIC BUILDING CORP 431772348 46737ECH3 2006-05-18 20236825 CONSTRUCTION AND EQUIPMENT false false false B JACKSON COUNTY MISSOURI 446000524 46757BFS4 2011-05-17 24674279 CONSTRUCTION AND EQUIPMENT false false false C JACKSON COUNTY MISSOURI 446000524 467578GJ3 2012-09-04 41180185 REFUNDING BOND false false false D HEALTH & EDUCATIONAL FACILITIES AUTH OF MO 431178966 2013-07-03 12000000 CONSTRUCTION AND EQUIPMENT false false false A 9005000 0 9820851 0 0 0 50581 139000 0 2600000 7170000 0 2006 false true true true B 4825000 0 24674279 0 0 0 289279 0 0 24385000 0 0 2011 false false true true C 8468075 0 37597509 0 0 0 451929 0 0 0 37145579 0 2012 true false true true D 4681576 0 11800050 0 0 0 199950 0 0 11800050 0 0 2014 false false true true A false false true true false 0 false false false true B false false false false 0 false false false true C false false false false 0 false false false true D false false true true false 0 false false false true A false false false true false false 0 false 0 false true B false false false true false false 0 false 0 false true C false false false true false false 0 false 0 false true D false false false true false false 0 false 0 false true A false B false C false D false PART IV, LINE 2C, COLUMN A - TAX-EXEMPT BONDS #1 THE ARBITRAGE REBATE ANALYSIS WAS PERFORMED IN 2011. PART IV, LINE 2C, COLUMN B - TAX-EXEMPT BONDS #1 THE ARBITRAGE REBATE ANALYSIS WAS PERFORMED 2-19-16. PART IV, LINE 2C, COLUMN C - TAX-EXEMPT BONDS #1 THE ARBITRAGE REBATE ANALYSIS WAS PERFORMED 2-19-16. PART IV, LINE 2C, COLUMN D - TAX-EXEMPT BONDS #1 THE ARBITRAGE REBATE ANALYSIS WAS PERFORMED 2-19-16. A HEALTH & EDUCATION FACILITIES AUTH OR MO 431178966 2006-11-09 12000000 CONSTRUCTION AND EQUIPMENT false false false A 10543712 0 11959500 0 0 0 40500 0 0 11959500 0 0 2008 false true true true A false false true true false 0 false false false true A false false false true false false 0 false 0 false true A false PART IV, LINE 2C, COLUMN A - TAX-EXEMPT BONDS #2 THE ARBITRAGE REBATE ANALYSIS WAS PERFORMED IN 2011. FORM 990, PART III, LINE 4A One of Truman Medical Centers (TMC) strengths is the ability to provide high quality, state-of-the-art healthcare to all our patients regardless of their ability to pay, offering more than 50 primary, specialty and mental health care clinics at TMC Hospital Hill and TMC Lakewood. TMC also has a number of community-based primary and mental health clinics, TMCs person-first approach puts the health needs of the patient above profit. We are nationally recognized for our programs in asthma, diabetes, sickle cell, orthopaedics, womens health and emergency/trauma services. However, we offer many more services, including ophthalmology, cardiology, gastroenterology, oral surgery and community based mental health services. In 2016, TMC provided 714,382 outpatient care visits, with 377,033 of those being outpatient mental health care service visits. TMCs Medical Pavilions at Hospital Hill and Lakewood provide high-quality outpatient primary care, whether a patients needs include a general physical exam or help with a specific complaint. TMCs internal medicine physicians treat high cholesterol, osteoporosis, diabetes, high blood pressure, womens health services, surgical consultations and skin disorders, among others. Chronic Disease Management At TMC, treatment of asthma is broad and includes striving for excellence in all areas where patients with asthma are encountered. Our goal is to provide superior and consistent care for the patient with asthma whether it is in the emergency department, inpatient unit, clinic setting, research or the community. Several years ago, TMC instituted 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 our outpatient pulmonary clinic to help break the cycle of emergent care. This program has resulted in a substantial reduction in admissions for asthma sufferers. TMC sees more than 12,000 patients each year for the treatment and care of asthma. Diabetes In 2009, TMC Hospital Hill opened a spacious new state-of-the-art Diabetes Center to better serve the needs of our patients. The new space includes a patient resource center with computer access, diabetes education classroom and consultation rooms, a comfortable, attractive waiting area; and expanded exam rooms with advanced technology to support the electronic health record progression. The TMC Diabetes Center provides quality care for our patients with diabetes, helping to manage diabetes on a planned, rather than episodic basis. The comprehensive "team approach" connects patients with specially-trained physicians and nursing staff. The team also helps coordinate care with other specialty service providers, such as ophthalmology, cardiology, podiatry, and other referrals as needed. In fiscal year 2016, TMC had 17,661 patients treated for diabetes. Sickle Cell TMC Hospital Hill is also one of the top providers of sickle cell care in the region, with Kansas Citys only adult Sickle Cell Center. The center provides a variety of medical inpatient and outpatient treatments, including annual exams, nutritional counseling, physical therapy, lab and x-ray evaluations and pain management counseling. Patients in sickle cell crisis find a healing environment where their pain is treated quickly, many times bypassing the emergency department, in a soothing setting offering calming colors and soft lighting. In 2016, 536 patients considered TMC as their medical home for sickle cell care. Womens Health Services As a national center of excellence in Womens Health, TMC seeks to connect women to the best resources available in health care services; education and community outreach, and empower the caregiver to make healthy decisions for themselves and others. With these objectives as the focus, TMC offers a continuum of health care services, including 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. TMC provides diagnostic breast health services, streamlining the patient experience by making virtually all of the components of a breast evaluation available in one campus location. TMC offers 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. TMC is also one of the largest providers of women, infants and children (WIC) services in the state of Missouri with 138,200 visits in 2016. WIC provides healthy foods, nutrition education and referrals for women, infants, and children up to the age of 5, 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. TMCs Cardiology Center specializes in interventional cardiology, which refers to non-surgical treatments for heart conditions. Cardiac interventions are used 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 2016, the Cardiology Center provided 8,197 outpatient clinic visits, performed 544 diagnostic catheterization procedures, placed 208 patient required cardiovascular stents and completed 627 total catheterization laboratory procedures. Gastroenterology Services Truman Medical Centers Gastroenterology (GI) Center on Hospital Hill has a full service procedural area offering 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 also 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 - all with a computer in each room, a dedicated triage room, a large education classroom, and a spacious waiting room area. The center provides "one-stop shopping" for patients, with registration/check-in and financial counseling all in same area. The clinic provides care for patients with all gastrointestinal diseases including but not limited to abdominal pain, constipation, reflux, Irritable Bowel Syndrome, Crohns Disease, and liver diseases. In FY 2016, the TMC GI Center provided more than 5,500 outpatient visits and performed more than 6,500 procedures. Ophthalmology Ophthalmology services the Ophthalmology Clinics at TMC are full-service facilities for the medical and surgical treatment of eye diseases. Services range from prescribing of glasses and fitting of contact lenses to the treatment of complex ocular disorders. Outpatient surgery and laser treatment, including refractive laser surgery, are also performed. In 2016, the Ophthalmology Department provided care in more than 14,650 outpatient visits. Dentistry and Oral Surgery Services Oral & Maxillofacial surgeons manage a wide variety of problems relating to the mouth, teeth and facial regions, practicing a wide scope of care with expertise ranging from corrective jaw surgery to wisdom tooth removal. They also diagnose and treat facial injuries and temporomandibular joint syndrome (TMJ) disorders, and perform a full range of dental implant procedures. TMC provides diagnosis and treatment of oral and facial emergencies, broken facial bones, and placement of dental implants. The facial pain/TMJ clinic also offers diagnosis and treatment of facial pain and TMJ. More than 8,703 patients received oral surgical services at TMC in 2016 and treated more than 19,950 dental patients at the TMC Lakewood Dental Clinic. Outpatient Mental Health Services In addition to outpatient physical medical care services, TMC provides comprehensive outpatient mental health services. In 2016, TMC Behavioral Health provided 272,751 outpatient visits to 10,905 patients. These services are aimed at assisting clients in managing the symptoms of their illness and in improving functioning in their day-to-day lives and 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 2016, the JACOHD provided nearly 122,719 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 The Truman Medical Centers (TMC) includes TMC Hospital Hill, TMC Lakewood and TMC Behavioral Health and is the primary teaching hospital for the University of Missouri-Kansas City Schools of Medicine, Nursing, Dentistry and Pharmacy. The newest addition to TMC is University Health, which opened its doors October 2015. University Health is Kansas Citys outpatient clinic powered by Truman Medical Centers. Clinics at University Health include: audiology, the breast center, dermatology, ear, nose, throat, ophthalmology, OB/GYN, oral and maxiofacial surgery, pain management, orthopeadics, pain management and plastic surgery. TMC cares for more than 108,000 individual patients each year. 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 2016 (July 1, 2015- June 30, 2016), TMC had 19,657 inpatient admissions and provided 91,366 patient days of 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 TMCs clientele have multiple, poorly managed chronic diseases such as diabetes, asthma, heart failure and hypertension. In FY 2016, more than 71,000 patients suffering from at least one chronic disease were treated at TMC. They are frequently admitted to a TMC hospital because of these chronic illnesses and due to some social disparities, such as lack of transportation, or a language barrier, their ability to manage their condition with proper medication and follow-up care is difficult and many times, they end up readmitted 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 Hospital Hill 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 few hospitals to have on staff interpreters available around the clock to assist patients with paperwork and communicating, in their native language, 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 2016, TMC language access provided 133,046 interpreted encounters for patients. Mental 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, mental health care services is often difficult and expensive. In many communities, inpatient mental health facilities do not exist and/or are at capacity nearly 100 percent of the time. TMC is one of only a few health systems that provide 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 Hospital Hill 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 persons 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, and a mental health emergency department at TMC Hospital Hill. In FY 2016, TMC behavioral health treated 10,905 patients, with 2,855 patients admitted for inpatient mental health care at a TMC facility. Womens Health TMC offers full Womens Health Services and is the birthplace to more than half of all babies born in Jackson County, Missouri. TMC Hospital Hill specializes in high-risk pregnancies and births and is home to a 19-bed, level iii neonatal intensive care unit (NICU), one of the largest in the area, that provides compassionate care to the most ill of newborns. In fiscal year 2016, TMC delivered 3,963 babies. In 2011, TMC Lakewood opened a renovated and expanded labor and delivery unit serving the people of eastern Jackson County. This new unit also includes a level II NICU. FORM 990, PART III, LINE 4C Truman Medical Centers Emergency Departments provided care to 85,339 patients in 2016, with more than 57,700 of those visits at TMC Hospital Hill, making it one of the busiest adult emergency departments in the Kansas City metro area. The TMC Lakewood Emergency Department has a staff of ten board certified emergency medicine physicians and 36 nurses providing immediate, compassionate, quality care to more than 30,000 residents of eastern Jackson County, Missouri each year. As a designated level 1 Trauma Center, one of three level one centers in Kansas City, MO., the TMC Hospital Hill Emergency Department (ED) 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. Aim 4 Peace As an academic safety net hospital in Kansas City, Missouri, TMC receives a significant amount of penetrating trauma. Aim 4 Peace, as the violence and injury prevention program, is focused on the reduction of intentional gunshot incidents and establishes a mechanism to facilitate collaborative efforts between the two in engaging and assisting the citizens of Kansas City to manage problems in a more constructive manner. As the only hospital in association with Aim 4 Peace, TMC has the unique opportunity to intervene, in concert with the intervention specialist, to 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 Hospital Hill Emergency Department has a Sexual Abuse Nurse Examiner (SANE) on site to provide a thorough forensic examination of women who have been the victims of rape. When a woman enters the Emergency Department claiming 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. Particularly in non-stranger sexual assault cases, thorough documentation of evidence corroborating a victim's account of an assault by establishing lack of consent leads to more prosecutions that are successful. TMCs SANE has also helped to provide leadership in the community by educating and training other potential SANEs. Each year nearly 100 women are cared for and examined by the TMC SANE in the Hospital Hill Emergency Department. Trauma Research In addition to patient care, Level One Trauma Centers conduct research programs, healthcare provider education, community outreach programs, and is a referral resource for communities in nearby regions. The Trauma Research Team is currently conducting several exciting research projects including pharmaceutical-sponsored trials, 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 2016 include: A) "Anatomic reconstruction versus hook plate reconstruction in patients with type III and type V acromioclavicular (AC) joint separations: a comparison." Investigator initiated: Dr. Akin Cil, Principal Investigator. B) "Incidence of primary care in the injured patient." Investigator initiated: Dr. Douglas Geehan, Principal Investigator. C) "A Prospective, Randomized, Controlled Study to Evaluate the Effectiveness and Safety of CELSTAT as an Adjunct to Hemostasis for Tissue Bleeding in Cardiothoracic, General and Vascular Surgery." Pharmaceutical-sponsored trial: Baxter Healthcare Corporation. Performance Improvement Patient Safety (PIPS) The Performance Improvement Patient Safety (PIPS) is an important part of the trauma program at TMC Hospital Hill. The performance improvement and patient safety program works toward implementing a system of patient care delivery that focuses on the 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, and inpatient stay, to 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 Hospital Hill 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 physicians 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 EACH FROM THE TMC MEDICAL STAFF AND UNIVERSITY PHYSICIAN ASSOCIATES, 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 ASSOCIATE CFO AND 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 DRAFT IS THEN SENT TO THE CFO WHO REVIEWS AND DISTRIBUTES TO THE CHAIR OF THE TMC, INC. AUDIT COMMITTEE. DUE TO THE SIZE OF THE TMC, INC. BOARD, FINAL COPIES OF THE 990 ARE AVAILABLE TO ALL BOARD MEMBERS. 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, LINES 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. 2016 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 $ (117,598) TRANSFER TO AFFILIATE 115,794 CHANGE IN DEFINED BENEFIT PENSION PLAN (28,689,043) ----------- TOTAL $ (28,690,847) AUXILIARY TO TRUMAN MEDICAL CENTER 2301 HOLMES KANSAS CITY MO 64108 436099279 SUPPORT MO 501(C)(3) 11C NA false TMC PROF & GEN LIABILITY SELF INS TRUST 2301 HOLMES KANSAS CITY MO 64108 431946384 LIABILITY INS MO 501(C)(3) 11B NA false TMC FINANCE SUPPORT CORPORATION 2301 HOLMES KANSAS CITY MO 64108 271994129 SUPPORT MO 501(C)(3) 11A TMC true false false false false false false false false false false false false true true true false true true true TMC FINANCE SUPPORT CORPORATION R 115794 COST TRUMAN MEDICAL CENTER INCOR 2301 HOLMES STREET KANSAS CITY MO 64108 440661018 X 0 47218 47218 516419558 516466776 1000000 250000 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