2019-05-01T17:53:26-05:00 2018-06-30 135565207 KPMG LLP 1000 Walnut St 1000 Kansas City MO 64106 990 2017-07-01 440605373 The Children's Mercy Hospital CHIL 8162343000 2401 Gillham Road Kansas City MO 64108 David Cauble Executive VP & CFO 8162343000 2019-05-01 1 Justin T Keller P01419781 8168025200 199.242.168.195 2019-05-01 15:41:07 CD P BCF02EA18EFDC5BC0678815518EEAE43C22D81AE BCF02EA18EFDC5BC0678815518EEAE43C22D81AE 2017 2019-02-21 02:37:17Z David Cauble 2401 Gillham Road Kansas City MO 64108 1655988401 0 X www.childrensmercy.org X 1901 MO Excellence in healthcare for children 15 12 11238 1412 4929419 1407800 48842788 182970176 1332048694 1405128243 20278506 34457449 2086919 32547035 1403256907 1655102903 33158421 47080340 0 0 767446337 784919231 0 143077 4600825 552414356 556128606 1353019114 1388271254 50237793 266831649 1528633645 1965698928 419022112 579024567 1109611533 1386674361 X To improve the health and well being of children by providing comprehensive, family-centered health care and committing to the highest level of clinical and psychosocial care, and to research, academic and service excellence. 1 0 1001621310 45663092 1433076168 All expenses for program services relate to providing healthcare. There were a total of 367 licensed beds and 89,446 patient days during the year from 15,198 admissions. Interim stays totaled 6,576 and outpatient encounters, including ED and Urgent Care, were 610,691. There were a total of 20,144 surgical cases which includes 4,322 inpatient and 15,822 outpatient cases. Diagnostic procedures, tests and treatments totaled 1,234,020 and outpatient prescriptions totaled 167,387 Children's Mercy critical care transports totaled 5,725 in fiscal year 2018.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. 57542684 1417248 Children's Mercy Hospital (CMH) is dedicated to becoming a leader in pediatric translational research. A recent strategic planning initiative established the Children's Research Institute to focus on research and research infrastructure. CMH initiated a planning process in preparation for making a commitment of a nearly $200M to the construction of a new research building. This commitment will lead to breakthroughs in treating, diagnosing and preventing complex childhood diseases. 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 Clinical Pharmacology and Therapeutic Innovation, Genomics Medicine, Health Services and Outcomes and Innovations in Health Care Delivery. During the year ended June 30, 2018 there were more than 375 active sponsored research projects. The Children's Research Institute occupies about 3% of the space on the main campus and is 3% of the total annual operating budget. Children's Mercy spent $51 million in the year ended June 30, 2018 on research and per information from the NIH Reporter received more than $5.8 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. 1059163994 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 0 0 1 1 0 0 0 1 1 1 1 0 0 1 527 0 1 11238 1 1 1 0 0 0 0 1 1 0 0 0 0 X 15 12 0 0 1 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 Debbie Sosland-Edelman Chairman 1.00 X X 0 0 0 Paul McLaughlin Vice Chairman 1.00 X X 0 0 0 Elizabeth Braham Treasurer 1.00 X X 0 0 0 Andrew Teigen Secretary 1.00 X X 0 0 0 Jonathan Baum Director 1.00 X 0 0 0 Jean-Paul Chaurand Director 1.00 X 0 0 0 Carolyn Davis MD Director 1.00 X 0 0 0 Dave Goebel Director 1.00 X 0 0 0 Bill Krueger Director 1.00 X 0 0 0 Charles Schellhorn Director 1.00 X 0 0 0 Edna Talboy Director 1.00 X 0 0 0 Robert Weatherly MD Director 40.00 X 528672 0 38298 Tom Weir Director 1.00 X 0 0 0 Gerald Woods MD Director 40.00 X 355383 0 42366 Randall L O'Donnell PhD Director; President & CEO 40.00 X X 1516840 0 283385 Charles Roberts MD EVP & Exec.Medical Director 40.00 X 720286 0 36780 Sandra AJ Lawrence Executive VP & CAO 40.00 X 705508 0 42366 Karen S Cox RN PhD FAAN Executive VP & Co-COO 40.00 X 731210 0 36792 Jo Stueve Executive VP & Co-COO 40.00 X 727084 0 36792 David Cauble Executive VP & CFO 40.00 X 595858 0 18066 Michael Artman MD Chairman-Dept of Pediatrics 40.00 X 625075 0 36780 Shawn St Peter MD Chairman-Dept of Surgery 40.00 X 784925 0 35616 Thomas Curran PhD Exec Director & CSO, CRI 40.00 X 667519 0 7506 Robin Foster JD Senior VP, General Counsel 40.00 X 617559 0 38316 James O'Brien Jr MD Physician 40.00 X 1193976 0 38298 James D Saint Louis MD Physician 40.00 X 1197352 0 26964 Paul Grabb MD Physician 40.00 X 803348 0 33338 Walter S Andrews MD Physician 40.00 X 788443 0 42366 George Holcomb III MD Physician 40.00 X 787319 0 40440 13346357 0 834469 2317 0 1 0 Anesthesia Associates 8717 West 110th Street Overland Park KS 66210 Anesthesiologists 32393074 Turner Construction Inc 1220 Washington St Suite 100 Kansas City MO 64105 Construction 22268605 Sodexho Marriott Services Inc 9801 Washingtonian Boulevard Gaithersburg MD 20878 Food Services 8993514 BSA Lifestructures Inc 9365 Counselors Row Indianapolis IN 46240 Construction 8419649 Cerner Health Connections Inc 2800 Rockcreek Parkway Kansas City MO 64117 Professional Services 7544268 428 741596 3683042 8231891 10106633 160207014 398736 182970176 Net Patient Services 621110 1405128243 1405128243 1405128243 34457449 34457449 555189 3683042 885498 -330309 -330309 Contract Revenue 900099 15305306 15305306 Cafeteria 722514 3050470 3050470 Transport 621910 2982862 2982862 11538706 6609287 4929419 32877344 1655102903 1433076168 4929419 34127140 X 1270673 1270673 45412273 45412273 397394 397394 13388189 7341284 6046905 626349955 518206966 105700507 2442482 31145246 25585983 5440352 118911 69528083 57117686 12144943 265454 44507758 36563357 7774473 169928 5661239 150164 5511075 493924 36000 457924 492239 492239 143077 143077 149978908 70119308 79475579 384021 6803897 248923 6554934 40 4214170 135508 4034249 44413 19798568 9920373 9571878 306317 7974094 6145449 1590447 238198 11540305 11540305 62030586 28003861 34023532 3193 13617286 10388082 3229204 Medical Supplies 154335706 143781202 10177451 377053 State Medicaid Taxes 48618958 48618958 0 0 Bad Debt 27680522 27680522 0 0 Dues & Subscriptions 7140277 3275478 3768682 96117 35747927 7224245 28512061 11621 1388271254 1059163994 324506435 4600825 77465637 141948242 3025 0 9075998 118037496 186339631 231257514 13665606 13425700 15881509 23665860 1233502139 617224313 568839462 616277826 564674191 578888106 5038984 5874244 87649602 236323940 1528633645 1965698928 115147553 144942092 220413868 338069643 83460691 96012832 419022112 579024567 X 1032131130 1163213731 77480403 223460630 1109611533 1386674361 1528633645 1965698928 X 266831649 1783448 8447731 X 0 1 X 1 1 1 X 0 492239 492239 1058671755 1059163994 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 382374 374689 421071 492239 1670373 250000 250000 250000 250000 1000000 1500000 61620527 6774013 3517083 2122860 69788763 51311822 7334271 5017500 2043066 61620527 48208836 5953303 -1112327 1737990 51311822 48018417 2780952 -916648 1673885 48208836 41996791 1926665 5685649 1590688 48018417 0.83590 0.16410 0 1 1 26339744 26339744 677987936 259308622 418679314 465729519 357915691 107813828 63444940 63444940 616277826 Other Assets 46417958 Income Beneficiary and Charitable Remainder Trusts 46912208 Restricted Investments 59247547 Unexpended Proceeds of Debt Issuance 83746227 236323940 Reserve for Prof. Liability Claims 48206853 Deferred Lease Incentive 196232 Postretirement Medical Liability 42168461 Other Liabilities 5441286 96012832 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, 2018 and 2017, there were no uncertain tax positions. 1 North America 0 0 Program Services Travel for healthcare-related education and information sharing 201658 Central America & the Caribbean 0 0 Program Services Travel for healthcare-related education and information sharing 11740 Europe 0 0 Program Services Travel for healthcare-related education and information sharing 83917 East Asia & the Pacific 0 0 Program Services Travel for healthcare-related education and information sharing 14896 South America 0 0 Program Services Travel for healthcare-related education and information sharing 2277 South Asia 0 0 Program ServicesProgram Services Travel for healthcare-related education and information sharing 3120 Sub-Saharan Africa 0 0 Program Services Travel for healthcare-related education and information sharing 45607 North America 0 0 Grantmaking 153976 Sub-Saharan Africa 0 0 Grantmaking 223026 Europe 0 0 Grantmaking 20392 0 0 0 0 0 0 517191 243418 760609 North America Research 51028 Check FMV North America Research 102948 Check FMV Sub-Saharan Africa Research 220599 Check FMV Europe (Including Iceland & Greenland) Research 20392 Check FMV 2 2 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 $500,000 in Federal funds during the fiscal year is required to obtain an 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 A-133 audits and that CMH has received an audit report. CMH maintains a subrecipient monitoring spreadsheet to track A-133 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. 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 Schultz & Williams 1617 JFK BlvdSte 1700 Philadelphia PA 19103 Consult/develop an annual fund and mid-level giving program 0 439358 56452 382906 Rachael Steele 2401 Gillham Rd Kansas City MO 64108 Consult & advise on capital campaign 0 0 86625 -86625 439358 143077 296281 KS MO Gala/Auction 2019687 1712135 307552 354983 13304 2880 28291 Event/Auction 2218544 1970907 247637 217796 93444 1424 173376 4238231 3683042 555189 572779 106748 4304 201667 885498 -330309 Schedule G, Part I, Line 2b, Column (v) Payments to Schultz & Williams during FY18 totaled $256,982. This amount includes $56,452 for consulting fees and $200,530 of fundraising expenses. The agreement distinguishes consulting costs separate from any expense payments or reimbursements. 1 1 X 1 X 300.000000000000 1 X 500.000000000000 1 1 0 1 1 2 44499 18537927 920623 17617304 0.01290 9 434672 636766604 562892444 73874160 0.05430 11 479171 655304531 563813067 91491464 0.06720 36 230972 12744149 1910546 10833603 0.00800 25 12245 35208904 17250399 17958505 0.01320 28 130756 76391175 42110622 34280553 0.02520 234 34751486 12608779 22142707 0.01630 5 756487 22779 733708 0.00050 328 373973 159852201 73903125 85949076 0.06320 339 853144 815156732 637716192 177440540 0.13040 3 1 92157 92157 0.00010 2 360 2852 2852 0.00000 6 1 71218 1000 70218 0.00010 16 965 719606 27020 692586 0.00050 27 1327 885833 28020 857813 0.00070 1 27680522 0 2556027 3764991 -1208964 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 15 1 0 0 1 X www.childrensmercy.org/communityneeds X 1 15 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: As part of the CHNA, five focus groups were conducted the first week of August 2016. Fourty-six individuals representing physicians, public health leaders, other health professionals, social service providers, business leaders, and other community leaders participated. In addition, a Key Informant Online Survey was sent to 99 elected officials, physicians, public health leaders, other health professionals, social service providers, and business, neighborhood, housing and community leaders. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work as well as the community overall. Over 230 representatives from area public health, health care, social services, governmental, community, neighborhood and housing organizations were invited to a Children's Health Summit on March 11, 2016. From this group, 168 attended (45 from Children's Mercy) and participated in a process to rate the priority health issues for the region. Organizations that participated in the all three events included: Mother & Child Health Coalition; Olathe Public Schools; Shawnee Mission Public Schools; Local Initiatives Support Corporation of Greater Kansas City; Rosedale Development Association; New Bethel Community Development Corporation; Truman Lakewood; Tri-County Mental Health; Turner House Children's Clinic; Unified Government of Wyandotte County Public Health Department; University of Missouri-Kansas City School of Nursing; Clay County Health Department; Johnson County (KS) Health Department; Missouri Department of Health and Human Services; Samuel U. Rodgers Health Center; Ewing Marion Kauffman Foundation; Jackson County Health Department; Kansas Department of Health and Environment; Urban Neighborhood Initiative; The Children's Place; Kansas Children's Service League; Kids TLC; Mid America Headstart. A complete list of all organizations and specifics on the process is provided in the community health needs assessment provided on the Children's Mercy website. Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 11: The implementation strategy plan was approved on October 11, 2016 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 2015 tax year. The most recently adopted implementation stragegy plan can be found on the hospital website:www.childrensmercy.org/communityneedsThrough 2016 CHNA data, the community identified the following health needs: Access to Health Services; Mental and Behavioral Health; Infant Mortality; Obesity; Food Insecurity; Parent Support, Early Education, Housing, Violence, Employment and Poverty (in no particular order). Over 300 Children's Mercy employees and senior leadership were presented the community health needs and selected three (Access to Health Services; Mental and Behavioral Health and Infant Mortality) as "Priority Health Needs", based on the need's importance and Children's Mercy's ability to make an impact. The Priority Health Needs will receive heightened attention and support. The remaining community identified needs were noted as "Significant Health Needs." Programs addressing the Significant Health Needs will continue, but not receive accelerated attention or resources. The Children's Mercy Board of Directors adopted the CHNA and the Priority and Significant Health Needs on June 14, 2016. An implementation strategy and action plan to address the Priority Health Needs was developed by the Children's Mercy Community Benefit/CHNA Advisory Group (CB/CHNA) in consultation with staff from various community agencies and programs such as, the Wyandotte Health Department, the Wyandotte Fetal Infant Mortality Review, the Black Health Care Coalition, and Live Well Community Health Centers. The Children's Mercy Board of Directors adopted the implementation plan and strategy on October 11, 2016. The CB/CHNA Advisory Group completed a comprehensive inventory of current Children's Mercy programs that address the priority and significant health needs. As part of this exercise, a list of current and potential community partners was created and areas of opportunity and key indicators identified. The creation of an internal community benefit support program and an externally focused Community Benefit Grant program help to support existing and new programs and services targeted at the priority and significant health needs strategies. The internal community benefit support program provides additional dollars for internal Children's Mercy programs that are addressing a priority and/or significant health need. The Community Benefit Grant program is to support outside organization that are addressing a Priority Health Need. Over the past year, internal support dollars were provided to support the distribution of gun locks (violence), supplying porta-cribs to births at Truman Medical Center newborns (infant mortality), development of early intervention program (mental health and infant mortality), Adolescent access to care (access to care), distribution of medication lock boxes (mental health, violence), development of a community garden (food insecurity/obesity), and the support of summer lunch program (food insecurity/obesity). A Community Benefit Grant awards were made to address the Priority Health Area- Infant Mortality to the Black Health Care Coalition (to support Community Baby Showers), the New Bethel Development Corporation (to develop a faith-based infant mortality reduction initiative), to the Mother and Child Health Coalition of Greater Kansas City (to produce a data report on Infant Mortality and to conduct an infant mortality conference), Uzzazi Village (to support outreach to pregnant and parenting African American women) and to SleepyHead Beds (to support a centralized distribution system of port-a-cribs). A number of initiatives are under development including a transportation initiative (access to care) that will launch in January of 2019 and an anti-bullying campaign in conjunction with the local MLS Soccer team, Sporting KC. 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 2 -- Children's Mercy Kansas Part V, Section B, line 5: As part of the CHNA, five focus groups were conducted the first week of August 2016. Fourty-six individuals representing physicians, public health leaders, other health professionals, social service providers, business leaders, and other community leaders participated. In addition, a Key Informant Online Survey was sent to 99 elected officials, physicians, public health leaders, other health professionals, social service providers, and business, neighborhood, housing and community leaders. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work as well as the community overall. Over 230 representatives from area public health, health care, social services, governmental, community, neighborhood and housing organizations were invited to a Children's Health Summit on March 11, 2016. From this group, 168 attended (45 from Children's Mercy) and participated in a process to rate the priority health issues for the region. Organizations that participated in the all three events included: Mother & Child Health Coalition; Olathe Public Schools; Shawnee Mission Public Schools; Local Initiatives Support Corporation of Greater Kansas City; Rosedale Development Association; New Bethel Community Development Corporation; Truman Lakewood; Tri-County Mental Health; Turner House Children's Clinic; Unified Government of Wyandotte County Public Health Department; University of Missouri-Kansas City School of Nursing; Clay County Health Department; Johnson County (KS) Health Department; Missouri Department of Health and Human Services; Samuel U. Rodgers Health Center; Ewing Marion Kauffman Foundation; Jackson County Health Department; Kansas Department of Health and Environment; Urban Neighborhood Initiative; The Children's Place; Kansas Children's Service League; Kids TLC; Mid America Headstart. A complete list of all organizations and specifics on the process is provided in the community health needs assessment provided on the Children's Mercy website. Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 11: The implementation strategy plan was approved on October 11, 2016 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 2015 tax year. The most recently adopted implementation stragegy plan can be found on the hospital website:www.childrensmercy.org/communityneedsThrough 2016 CHNA data, the community identified the following health needs: Access to Health Services; Mental and Behavioral Health; Infant Mortality; Obesity; Food Insecurity; Parent Support, Early Education, Housing, Violence, Employment and Poverty (in no particular order). Over 300 Children's Mercy employees and senior leadership were presented the community health needs and selected three (Access to Health Services; Mental and Behavioral Health and Infant Mortality) as "Priority Health Needs", based on the need's importance and Children's Mercy's ability to make an impact. The Priority Health Needs will receive heightened attention and support. The remaining community identified needs were noted as "Significant Health Needs." Programs addressing the Significant Health Needs will continue, but not receive accelerated attention or resources. The Children's Mercy Board of Directors adopted the CHNA and the Priority and Significant Health Needs on June 14, 2016. An implementation strategy and action plan to address the Priority Health Needs was developed by the Children's Mercy Community Benefit/CHNA Advisory Group (CB/CHNA) in consultation with staff from various community agencies and programs such as, the Wyandotte Health Department, the Wyandotte Fetal Infant Mortality Review, the Black Health Care Coalition, and Live Well Community Health Centers. The Children's Mercy Board of Directors adopted the implementation plan and strategy on October 11, 2016. The CB/CHNA Advisory Group completed a comprehensive inventory of current Children's Mercy programs that address the priority and significant health needs. As part of this exercise, a list of current and potential community partners was created and areas of opportunity and key indicators identified. The creation of an internal community benefit support program and an externally focused Community Benefit Grant program help to support existing and new programs and services targeted at the priority and significant health needs strategies. The internal community benefit support program provides additional dollars for internal Children's Mercy programs that are addressing a priority and/or significant health need. The Community Benefit Grant program is to support outside organization that are addressing a Priority Health Need. Over the past year, internal support dollars were provided to support the distribution of gun locks (violence), supplying porta-cribs to births at Truman Medical Center newborns (infant mortality), development of early intervention program (mental health and infant mortality), Adolescent access to care (access to care), distribution of medication lock boxes (mental health, violence), development of a community garden (food insecurity/obesity), and the support of summer lunch program (food insecurity/obesity). A Community Benefit Grant awards were made to address the Priority Health Area- Infant Mortality to the Black Health Care Coalition (to support Community Baby Showers), the New Bethel Development Corporation (to develop a faith-based infant mortality reduction initiative), to the Mother and Child Health Coalition of Greater Kansas City (to produce a data report on Infant Mortality and to conduct an infant mortality conference), Uzzazi Village (to support outreach to pregnant and parenting African American women) and to SleepyHead Beds (to support a centralized distribution system of port-a-cribs). A number of initiatives are under development including a transportation initiative (access to care) that will launch in January of 2019 and an anti-bullying campaign in conjunction with the local MLS Soccer team, Sporting KC. 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. 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 Pediatric Eye Care 4820 College Blvd Leawood KS 66211 Practice Use 4 - Children's Mercy Sports Medicine Center 1801 N 98th Street Kansas City KS 66109 Rehabilitation 5 - Children's Mercy Joplin Clinic 3333 McIntosh Circle Suite 6 Joplin MO 64804 Outpatient Clinics 6 - Children's Mercy Heartland Clinic 802 N Riverside Rd Suite 105 St Joseph MO 64502 Outpatient Clinics 7 - Children's Mercy Outreach Junction City 361 Grant Ave Junction City KS 66441 Outreach Clinic 8 - Children's Mercy Olathe 20333 W 151st St Olathe KS 66061 Outpatient Clinics 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 Outreach Pittsburg 3011 N Michigan Pittsburg KS 66762 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 FY18, over 130,000 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 medicine, neonatology, hematology/oncology, genetics, pain management, the fetal health center, 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, Ln 7 Col(f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), which is subtracted for purposes of calculating the percentage in this column, is $27,680,522. 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 FY18, over 234 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, heart care, 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: Children's Mercy conducts a variety of community building activities which addresses identified health needs such as physical activity, behavioral and mental health, access to health services, 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. Some examples include the maintenance of the Hospital Hill Park and the Sylvia Nutter Playground, the development of a community garden, advocacy activities related to mental and behavioral health and access to health services and healthcare workforce development targeted at high school students. Part III, Line 2: The amount of bad debt reported on Part III, Line 2 comes from the Bad Debt Expense reported on the CMH Audited Financial Statements. Bad debt is written off based on the remaining receivable balance after all other payments and adjustments for patients who do not qualify for financial assistance. Part III, Line 4: Audited Financial Statements- Note l, Page 12: Uncollectible amounts from patients who do not qualify for charity care under CMH's charity care policy are included as a reduction of patient service revenue in the provision for bad debt. Receivables for the related revenue are recorded for the full amount and are offset by the allowance for contractual adjustments and doubtful accounts and appropriately reflected at the net realizable value. The decrease in the provision for bad debt as of June 30, 2018 compared to June 30, 2017 is due to a significant revision of estimates for allowances for bad debt in FY2017 as well as the implementation of presumptive charity in mid-FY2017, which moved significant deductions to charity in FY2018 as compared to FY2017. 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; financial assistance policy posted on the hospital website. Part VI, Line 4: Children's Mercy serves over 242,000 children from across the states of Kansas and Missouri. In Kansas 96 counties have federally-designated primary care HPSA areas and in Missouri 117 counties have federally-designated primary care HPSA areas. Within these two states we identify 43 counties as Outreach areas; 50 counties as the secondary service area; and 18 counties as the primary service area. Each of these areas is comprised of urban, suburban and rural regions. The Outreach service area includes more rural counties than the other listed service areas. The Metro service area (6 counties) includes more urban and suburban areas than rural. Within the Metro service area is the Children's Mercy service area for the CHNA. This includes 4 counties located in both Missouri (Jackson and Clay counties) and Kansas (Johnson and Wyandotte Counties). 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 70% 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 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, and Children's Mercy East) and the source of a majority of our patient encounters. The 4 counties house a total population of 1,652,781; of these 411,888 or 25.9% 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 4 counties increased between 1980 and 2013 and the overall make-up of the population shifted as well. In 1980, black, Hispanic or other ethnicities comprised 21% of the 4 counties under 18 years of age population and in 2013 36% of the region's under 18 population made up these groups. According to the U.S. Census, the median family income was $68,993. In 2014, across the region, 19% of all children live in poverty; 37.6% of children in Wyandotte County live in poverty. Of all Kansas City area families led by a single mother, 29.2% are living in poverty. Jackson County and especially Wyandotte County have considerably more families led by a single mother living below the federal poverty level. 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 promotes children's health in the Kansas City region in numerous ways. Highlights include providing direct funding support to community organizations engaged in important work to address the CHNA priorities (Infant Mortality reduction, Access to Health and Access to Behavioral and Mental Health). Organizations include: Reach Out and Read; the Ronald McDonald House; The March of Dimes; the Black Health Care Coalition; Happy Bottoms; the Greater Kansas City Maternal and Child Health Coalition, the Community Health Council of Wyandotte County; New Bethel Neighborhood Development Corporation; and Uzazi Village. Programs working to improve outcomes for children are strengthened through a community-wide strategy to organize home visiting, participation in community health fairs, 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, etc.). 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 Street Overland Park KS 66212 135613797 501(c)3 8018 Mission is to foster appropriate cardiac care in an effort to reduce disability and deaths caused by cardiovascular disease and stroke. Boys & Girls Club of Greater Kansas City 2405 Elmwood Ave Kansas City MO 64127 436072065 501(c)3 14250 Promote development of self-esteem, values, and skills for boys and girls, ages 5-18, with special emphasis on youth from disadvantaged circumstances. JDRF- Juvenile Diabetes Research Foundation 920 Main St Ste 280 Kansas City MO 64105 231907729 501(c)3 8700 Support diabetes research and research-related education. Leukemia and Lymphoma Society 6811 Shawnee Mission Pkwy Ste 202 Shawnee Mission KS 66202 135644916 501(c)3 18720 Mission is to cure leukemia, lymphoma, Hodgkin's disease and myeloma, and improve the quality of life of patients and their families. Ronald McDonald House Charities 2502 Cherry St Kansas City MO 64108 431190760 501(c)3 73615 Provide comfort and care for families seeking life-saving medical treatment for their children. Kansas University Endowment (Reach Out and Read) 3901 Rainbow Blvd MS 1051 Kansas City KS 66106 480547734 501(c)3 65560 Prepares Kansas City's youngest children to succeed in school by partnering with doctors and nurses to prescribe books and encourage families to read together. Arthritis Foundation 1900 W 75th Street Suite 200 Prairie Village KS 66208 581341679 501(c)3 9300 Help conquer everday battles with arthritis through life-changing information and resources, access to optimal care, and advancements in science and community connections. Center for Practical Bioethics 1111 Main St Ste 500 Kansas City MO 64105 480985815 501(c)3 7500 Initiatives in Aging in Community, addressing under-treatment of cronic pain, certificate program in clinical ethics and health policy. DeLaSalle Education Center 3737 Troost Ave Kansas City MO 64109 430971728 501(c)3 14750 DeLaSalle Education Center is the only alternative charter high school in Missouri dedicated to serving at-promise urban core students. Duke University Health System PO Box 104132 Durham NC 27708 562070036 501(c)3 11716 Research Emory Genetics Medical Research 103 B Jones Center Atlanta GA 30322 580566256 501(c)3 38180 Research Medical College of Wisconsin 8701 Watertown Plank Rd Milwaukee WI 53226 390806261 501(c)3 25701 Research Oregon Health & Science 3181 SW Sam Jackson Park Rd AD201 Portland OR 97201 931176109 GOVT 7082 Research Seattle Children's Hospital 4800 Sand Point Way NE Seattle WA 98105 910564748 501(c)3 18406 Research University of Alabama UAB 701 20th St S Birmingham AL 35294 636005396 501(c)3 16283 Research University of California 9500 Gilman Dr La Jolla CA 92093 330833316 102298 Research Regents University of Michigan 1500 East Medical Center Dr Ann Arbor MI 48109 386006309 GOVT 23354 Research University of New Mexico 1 University of New Mexico Albuquerque NM 87131 856000642 GOVT 31630 Research Cincinnati Children's Hospital 3333 Burnet Avenue Suite 330 Cincinnati OH 45229 310833936 501(c)3 97563 Research Stanford Junior University 3145 Porter Dr Palo Alto CA 94304 941156365 501(c)3 8750 Research OUHSC Oklahoma PO Box 26901 Oklahoma City OK 73126 736017987 GVOT 7615 Research University of Kansas City Missouri 414 East 12th St Kansas City MO 64106 446000201 GOVT 12500 Research Vanderbilt Medical Center Dept AT 40379 Atlanta GA 31192 352528741 501(c)3 25290 Research KUMC Research Institute Inc 3901 Rainbow Blvd MS 1039 Kansas City KS 66160 481108830 501(c)3 19661 Research University of Missouri UMKC KCUR 118 University Hall Columbia MO 65211 436003859 GOVT 215694 Research Cleveland Clinic 9500 Euclid Avenue NA-4 Cleveland OH 44195 340714585 501(c)3 20120 Research Children's Hospital Boston 300 Longwood Avenue Boston MA 02115 042774441 501(c)3 13594 Research California Los Angeles UCLA 10921 Wilshire Blvd 5th Floor Los Angeles CA 90024 956006143 501(c)3 20799 Research STFM Teachers Family Medicine 11400 Tomahawk Creek Pkwy Ste 240 Leawood KS 66211 431026492 501(c)6 66855 Research Duke University PO Box 104132 Durham NC 27708 560532129 501(c)3 7898 Research H Lee Moffitt Cancer Center 12902 Magnolia Dr Tampa FL 33612 592451713 501(c)3 190239 Research Youth Ambassadors Inc 7309 High Dr Prairie Village KS 66208 455220294 501(c)3 25000 Research 30 2 Patient Financial Assistance 44499 45412273 Cost Charity Care Part I, Line 2: Grants generally go to nonprofit organizations and agencies with which The Children's Mercy Hospital shares a common mission. These are agencies that generally support the health and well-being of children and families. The Children's Mercy Hospital documents the appropriate use of our funds by attending annual events to collaborate with agency board members and their executive leaders about issues related to the achievement of the agency's mission; reviewing web-based annual reports; and requesting and receiving a report from the agency grant recipient confirming the portion of grant dollars that go directly to the agency's mission-critical enterprise. 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 $500,000 in Federal funds during the fiscal year is required to obtain an 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 A-133 audits and that CMH has received an audit report. CMH maintains a subrecipient monitoring spreadsheet to track A-133 audit status, DUNS number, year-to-date spending, etc. for all subrecipients. X X X X X 0 1 0 0 0 1 0 0 0 Robert Weatherly MD Director 507195 0 0 0 21477 0 20250 0 18333 0 567255 0 0 0 Gerald Woods MD Director 313702 0 17624 0 24057 0 24300 0 18270 0 397953 0 0 0 Randall L O'Donnell PhD Director; President & CEO 1229242 0 238197 0 49401 0 270893 0 12777 0 1800510 0 0 0 Charles Roberts MD EVP & Exec.Medical Director 605395 0 86387 0 28504 0 24300 0 12765 0 757351 0 0 0 Sandra AJ Lawrence Executive VP & CAO 586966 0 95382 0 23160 0 24300 0 18351 0 748159 0 0 0 Karen S Cox RN PhD FAAN Executive VP & Co-COO 589759 0 96093 0 45358 0 24300 0 13932 0 769442 0 0 0 Jo Stueve Executive VP & Co-COO 589467 0 99444 0 38173 0 24300 0 12777 0 764161 0 0 0 David Cauble Executive VP & CFO 479074 0 68378 0 48406 0 0 0 19503 0 615361 0 0 0 Michael Artman MD Chairman-Dept of Pediatrics 599776 0 0 0 25299 0 24300 0 13920 0 663295 0 0 0 Shawn St Peter MD Chairman-Dept of Surgery 766115 0 0 0 18810 0 17550 0 19506 0 821981 0 0 0 Thomas Curran PhD Exec Director & CSO, CRI 648963 0 0 0 18556 0 0 0 7791 0 675310 0 0 0 Robin Foster JD Senior VP, General Counsel 517266 0 78288 0 22005 0 20250 0 19506 0 657315 0 0 0 James O'Brien Jr MD Physician 1173138 0 0 0 20838 0 20250 0 18333 0 1232559 0 0 0 James D Saint Louis MD Physician 1176514 0 0 0 20838 0 17550 0 9699 0 1224601 0 0 0 Paul Grabb MD Physician 783633 0 0 0 19715 0 15272 0 18351 0 836971 0 0 0 Walter S Andrews MD Physician 761989 0 0 0 26454 0 24300 0 18351 0 831094 0 0 0 George Holcomb III MD Physician 764659 0 0 0 22660 0 24300 0 17580 0 829199 0 0 0 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. Part I, Line 4b and Part II, Line 2, Column (C) $246,593 of deferred severance compensation was accrued for Randall O'Donnell that may or may not be paid in the future. A Health and Educational Facilities Authority of the State of Missouri 431178966 60635HH77 2009-11-19 178852416 See Part VI 1 0 0 B Health and Educational Facilities Authority of the State of Missouri 431178966 2010-12-21 71550000 See Part VI 0 0 0 C Health and Educational Facilities Authority of the State of Missouri 431178966 2014-11-14 18775000 See Part VI 0 0 0 D Health and Educational Facilities Authority of the State of Missouri 431178966 60637ALX8 2016-10-13 148207195 see Part VI 0 0 0 A 20145000 131440000 179112696 80262696 98850000 2013 1 0 1 1 B 66905000 71550000 71550000 1 0 1 1 C 7650000 18775000 18775000 1 0 1 1 D 148207195 638217 147568975 0 1 1 1 A 0 0 1 1 1 1 0 0 1 B 0 0 1 1 1 1 0 0 1 C 0 0 1 1 1 1 0 0 1 D 0 0 1 1 1 1 0 0 1 A 0 0 0 1 0 0 0 1 1 B 0 0 1 1 1 1 UBS AG 30.900000000000 0 0 0 0 1 C 0 0 1 1 1 1 UBS AG 20.900000000000 0 0 0 0 1 D 0 1 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 Schedule K, Part I, Row A, Column (f) The Series 2009 Bonds were issued for the following purposes: (i) refinance a bank loan, which was incurred to refinance the Series 2007AB Bonds (issued June 26, 2007) and (ii) finance hospital facilities (new tower on Main Campus and new hospital location). Schedule K, Part I, Row B, Column (f) In 2008, the Organization restructed some of its existing debt. The Series 2002 Bonds (June 19, 2002) were remarketed as the Series 2008A Bonds, and the Series 2003 Bonds (June 5, 2003) were remarketed as the Series 2008B Bonds. Then, in December 2010, the Series 2008A/B Bonds were modified in a manner that resulted in a "reissuance" for tax purposes. Schedule K, Part I, Row C, Column (f) In 2008, the Organization restructured some of its existing debt. The Series 2002 Bonds (June 19, 2002) were remarketed as the Series 2008A Bonds, and the Series 2003 Bonds (June 5, 2003) were remarketed as the Series 2008B bonds. Then, in December 2010, the Series 2008AB Bonds were modified in a manner that resulted in a "reissuance" for tax purposes. Later, in November 2011, the Series 2008B Bonds were modified in a manner that resulted in a "reissuance" for tax purposes. Schedule K, Part I, Row D, Column (f) The Series 2016 Bonds were issued to refinance a portion of the outstanding Series 2009 Bonds (issued Nov. 19, 2009). Schedule K, Part II, Line 3, Column A Difference between issue price and total proceeds of the Series 2009 Bonds represents $260,280 of investment proceeds. Schedule K, Part II, Line 11, Column A $98,850,000 of Bond proceeds were used to pay off the bank loan that was incurred to refinance the Series 2007AB Bonds. Schedule K, Part II, Line 11, Column B $71,550,000 of Bond proceeds were treated as used to refinance the Series 2008AB Bonds as a result of the "reissuance" of the Series 2008AB Bonds. Schedule K, Part II, Line 11, Column C $18,775,000 of Bond proceeds was treated as used to refinance the Series 2008B Bonds as a result of the "reissuance" of the Series 2008B Bonds. Schedule K, Part II, Line 11, Column D $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 13, Column B The Series 2008AB Bonds were treated as "reissued" on December 21, 2010, and therefore, there were no "new-money" projects financed by the "reissued" Series 2008AB Bonds. Schedule K, Part II, Line 13, Column C The Series 2008B Bonds were treated as "reissued" on November 14,2014, and therefore, there were no "new-money" projects financed by the "reissued" Series 2008B Bonds. Schedule K, Part II, Line 13, Column D 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 IV, Line 2c, Column A The Arbitrage Rebate Analysis was performed as of November 1, 2012. Schedule K, Part I, Row A, Column (f) The Series 2017A Bonds were issued to contruct and equip a professional office building and a research institute for the Corporation. Schedule K, Part II, Line 3, Column A Difference between issue price and total proceeds of the Series 2017A Bonds represents $308,626 of investment proceeds. Schedule K, Part II, Line 13, Column A The projects financed by the Series 2017A have not yet been completed. A Health and Educational Facilities Authority of the State of Missouri 431178966 60637AMM1 2017-12-20 131226503 see Part VI 0 0 0 A 131535129 1224064 46265058 2082 84043925 0 0 0 1 A 0 0 1 1 1 1 0 0 1 A 0 1 0 1 0 0 0 0 1 A 1 Substantial Contributor Substantial Contributor 16730220 Sevices and sale of assets 0 Substantial Contributor Substantial Contributor 10790595 Services 0 Substantial Contributor Substantial Contributor 3129465 Services 0 Christine Roberts Spouse of Officer Charles Roberts 25431 Employment 0 Nancy Zirpolo Sister of Officer Karen Cox 95746 Employment 0 Debra Horne Spouse of Key Employee Michael Artman 10758 Employment 0 X 11 23195 FMV X 200 FMV X 3114 FMV X 1 43393 FMV X 24 232427 FMV X 21 7680 FMV X 24 17012 FMV X Events 27 32581 FMV X Experiences 21 19770 FMV X Miscellaneous 13 10441 FMV X Jewelry 6 8923 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. Part I, Line 33: Books and clothing were received and utilized by patients and families; not resold. Form 990, Part III, line 2 Headache Treatment Center First-of-its-kind in the country Headache Treatment Center opened at Children's Mercy Hospital Kansas to provide rapid headache relief to patients age 3 to 21. Headaches will be evaluated by a headache-trained provider and will offer a personalized treatment to reduce or eliminate pain. Maternal Fetal Transport Team Children's Mercy launched Maternal Fetal Transport service, the only one of its kind in western Missouri and all of Kansas where a high-risk obstetrics nurse is an integral member of the transport team. Other team members include a neonatal critical care nurse, respiratory therapist and EMT or Paramedic. Sports Medicine Center at Village West Opening of the state-of-the art facility for youth athletes in joint collaboration with Sporting KC's National Training Center and US Soccer's Coaching Development Center. Children's Mercy App Children's Mercy launched its Children's Mercy App which includes indoor navigation, Save My Spot for Urgent Care Center, Patient Portal, Find a Doctor, and more. Children's Mercy Junction City Children's Mercy opened a regional outreach center in Junction City, KS to better suuport patients in western and central Kansas. Children's Mercy Riverside Children's Mercy expanded its Pharmacy and Home Health services to a new location in Riverside, MO. CHPeds Guide App Launched the first phase of the CMPeds App to help support external providers with clinical decision support in conditions like febrile infants. Form 990, Part VI, Section A, line 4 The bylaws of The Children's Mercy Hospital were updated to add a Research Committee to the list of Standing Committees. The duties and activities of the Research Committee were also added to the bylaws. 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 Each employee is required to complete an Outside Professional and Commercial Interests Form (Conflict of Interest Form) at the time of employment, at the time of their annual evaluation, and any time their financial interests change. Board members are required to complete a Conflict of Interest Questionnaire at the time of their appointment, at least one time annually, and are required to update their information any time their financial interests change. All Outside Professional and Commercial Interests Forms and Conflict of Interest Questionnaires are reviewed by Corporate Compliance. 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/co-Chief Operating Officer, all officers of the Hospital, and the Chair of the Department of Pediatrics, who is a key employee. 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 documentation of the Committee's deliberations and decision are 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 70,119,308. Management and general expenses 79,475,579. Fundraising expenses 384,021. Total expenses 149,978,908. Form 990, Part XI, line 9: Change in benefit obligation 1,099,205. Change in interest rate swap valuation 5,972,318. Net Unrealized Change in Income Beneficiary and Charitable Remainder Trusts 1,306,208. Intercompany Transfer 70,000. CMH Insurance Company LLC 2401 Gillham Road Kansas City MO 64108 Insurance for The Children's Mercy Hospital MO 109702 10065565 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 17269049 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 1737258 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 -3091 1444348 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 1352143 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 -4669 637214 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 -22797 428374 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 -1304 304644 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 -86020 223896 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 -363 169151 1.00000 1 Income Beneficiary Trusts (6) 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 5455722 Book Children's Mercy Integrated Care Solutions J 275809 Book Children's Mercy Integrated Care Solutions L 1121812 Book Children's Mercy Integrated Care Solutions P 359835 Book Children's Mercy Integrated Care Solutions Q 68602 Book Children's Mercy Integrated Care Solutions S 125927973 Book Children's Mercy Hospital Family Health Partners Inc R 70000 Book Children's Mercy- Cass County Pediatrics and Adolescents Inc D 165000 Book Children's Mercy- Preferred Pediatrics Inc D 175000 Book Children's Mercy- Redwood Pediatrics Inc D 75000 Book Children's Mercy- Cradle thru College Care Inc D 200000 Book Children's Mercy- Pediatric Care Specialists Inc A 1573 Book Children's Mercy- Pediatric Associates Inc A 11805 Book Children's Mercy- Pediatric Care North Inc A 3793 Book Children's Mercy- Cass County Pediatrics and Adolescents Inc A 2814 Book Children's Mercy- Preferred Pediatrics Inc A 5246 Book Children's Mercy- Redwood Pediatrics Inc A 2130 Book Children's Mercy- Cradle thru College Care Inc A 3185 Book