2019-05-13T13:25:26-05:00 2018-06-30 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2017-07-01 440661018 TRUMAN MEDICAL CENTER INCORPORATED % ALLEN JOHNSON TRUM 8164041000 2301 HOLMES STREET KANSAS CITY MO 64108 CHARLIE SHIELDS PRESIDENT/CEO 8164043528 2019-05-15 true Kevin R Ensminger CPA P01310558 8162216300 167.68.126.162 43372220191335000017 2019-05-13 P 67F1221570CB0498B58445783EEBE74F47EF6DD1 67F1221570CB0498B58445783EEBE74F47EF6DD1 2017 2019-02-21 02:37:17Z ALLEN JOHNSON 2301 HOLMES KANSAS CITY MO 64108 591177950 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. 30 27 4871 888 0 104874 11404906 11097006 509392873 541734321 1521607 371505 34405814 37946468 556725200 591149300 385562 546552 0 0 275704657 289059432 0 0 0 271398445 292721271 547488664 582327255 9236536 8822045 297682605 356565389 231609289 267326358 66073316 89239031 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163309 PEGGY J DUNN PAST CHAIR/DIRECTOR 1.0 0.0 X X 0 0 0 DAVE BARBER VICE CHAIR/DIRECTOR 1.0 0.0 X X 0 0 0 PHILIP J SANDERS CHAIR/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 TIMOTHY A WURST SECRETARY/VICE CHAIR/DIRECTOR 1.0 0.0 X X 0 0 0 KAREN ZECY TREASURER/DIRECTOR 1.0 0.0 X X 0 0 0 FORESTINE BEASLEY DIRECTOR 1.0 0.0 X 0 0 0 ZANE M BURKE DIRECTOR 1.0 0.0 X 0 0 0 ANN H CARY PHD DIRECTOR 1.0 0.0 X 0 0 0 JAMES CORWIN DIRECTOR 1.0 0.0 X 0 0 0 SEN KIKI CURLS DIRECTOR 1.0 0.0 X 0 0 0 DAVID EMBRY DIRECTOR 1.0 0.0 X 0 0 0 PAUL P HOLEWINSKI DIRECTOR 1.0 0.0 X 0 0 0 STEPHEN JARVIS MD DIRECTOR 40.0 0.0 X 268132 0 48846 JOLIE L JUSTUS VICE CHAIR/DIRECTOR 1.0 0.0 X X 0 0 0 STEVEN L KANTER 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 JON OTTO DIRECTOR 1.0 0.0 X 0 0 0 MAHNAZ SHABBIR DIRECTOR 1.0 0.0 X 0 0 0 MARK T STEELE MD DIRECTOR 20.0 1.0 X 308364 0 0 REV ERIC D WILLIAMS DIRECTOR 1.0 0.0 X 0 0 0 ADAM ALGREN MD DIRECTOR 1.0 0.0 X 0 0 0 BARBARA A BICHELMEYER DIRECTOR 1.0 0.0 X 0 0 0 MICHAEL COLLINS DIRECTOR 1.0 0.0 X 0 0 0 CARLOS GOMEZ DIRECTOR 1.0 0.0 X 0 0 0 JIM HEETER DIRECTOR 1.0 0.0 X 0 0 0 ALISE MARTINY DIRECTOR 1.0 0.0 X 0 0 0 MELISSA ROBINSON DIRECTOR 1.0 0.0 X 0 0 0 WILLIAM H COLBY ASSISTANT SECRETARY 40.0 2.0 X 481504 0 109866 ALLEN M JOHNSON ASSISTANT TREASURER 40.0 0.0 X 521948 0 124402 JOHN GIANINO NEUROSURGEON 40.0 1.0 X 600137 0 105688 MITZI CARDENAS SR VP CHIEF STRATEGY INFO OFF. 40.0 0.0 X 350046 0 75472 LYNDA DONEGAN VP PROFESSIONAL HEALTH SERVICE 40.0 0.0 X 324449 0 15814 GERARD GRIMALDI VP HEALTH POLICY & GOVT RELATI 40.0 0.0 X 307513 0 79712 DOUG BRANDT ASSOCIATE CFO 40.0 1.0 X 300627 0 91192 4190521 0 814301 244 false true false CERNER CORPORATION PO BOX 412702 KANSAS CITY MO 64141 IT SERVICES 18176833 UNIVERSITY OF MISSOURI-KANSAS CITY PO BOX 805111 KANSAS CITY MO 64180 MEDICAL SERVICES 16205927 UNIVERSITY PHYSICIAN ASSOCIATES 2310 HOLMES SUITE 800 KANSAS CITY MO 64108 PHYSICIAN SERVICES 14204798 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 FOOD SERVICE 5703369 MEDICAL IMAGING INC 2001 NE PARVIN ROAD STE 200 KANSAS CITY MO 64116 MEDICAL SERVICES 5255369 35 6679236 4417770 11097006 NET PATIENT SERVICE REVENUE 621110 356856659 356856659 EXPENSE REIMBURSEMENT 621110 2579688 2579688 MEDICAID ENHANCEMENTS 621110 146013090 146013090 LOCAL GOVERNMENT SUBSIDY 900099 36284884 36284884 541734321 344552 344552 0 0 0 0 0 55603 28650 26953 26953 26953 0 0 0 0 0 0 0 0 0 340B REVENUE 900099 31902680 31902680 EHR MEANINGFUL USE 900099 435235 435235 LAB 900099 2007099 2007099 3601454 3601454 37946468 591149300 579680789 371505 546552 546552 0 0 0 3257292 355583 2901709 0 232375732 205103623 27272109 3940973 3719920 221053 33814673 29597262 4217411 15670762 13686770 1983992 0 810283 810283 168980 168980 104992 104992 0 0 0 0 149112609 124530127 24582482 0 0 13548606 11963419 1585187 221675 195739 25936 0 600680 530400 70280 2081639 1873476 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135435 3801067 3130017 944 366243 141816 3355388 3173107 0 -82203 0 102557 0 2988347 3244340 0 42279 0 113512 0 3173107 3173837 200 172581 0 102278 0 3244340 0.81320 0.18680 true false 4909661 4909661 327897735 209751886 118145849 190274260 155372150 34902110 4989545 4989545 162947165 ASSETS FOR CAPITAL ACQUISITION 3372917 ASSETS EXTERNALLY RESTRICTED 718702 INTEREST IN ASSETS OF TMCCF 13302733 ASSETS HELD BY BOND TRUSTEE 63932649 OTHER RECEIVABLES 11819504 OTHER ASSETS 1658553 94805058 0 457F PLAN LIABILITY 3372917 UNAMORTIZED PREMIUM 1322498 OTHER LIABILITIES 8145946 12841361 563657969 -283035 3403472 3120437 560537532 30611768 30611768 591149300 556371111 3572003 3572003 552799108 29528147 29528147 582327255 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 440,064 RELATED ORGANIZATION REVENUE 2,963,408 ----------- TOTAL $ 3,403,472 SCHEDULE D, PART XI, LINE 4B MEDICAL STAFF REVENUE 155,319 TEMPORARILY RESTRICTED CONTRIBUTIONS 577,198 CONTRIBUTION USED FOR ASSET ACQUISITION 492,684 ELIMINATIONS 784,006 BAD DEBT EXPENSE 28,602,561 ----------- TOTAL $ 30,611,768 SCHEDULE D, PART XII, LINE 2D RELATED ORGANIZATION EXPENSES $ 3,572,003 SCHEDULE D, PART XII, LINE 4B ELIMINATIONS 784,006 MEDICAL STAFF EXPENSES 141,580 BAD DEBT EXPENSE 28,602,561 ------------ TOTAL $ 29,528,147 true true X true X false true true true false false 116098797 101057952 15040845 0.02720 177790547 184634378 293889344 285692330 15040845 0.02720 954323 178489 775834 0.00140 34229613 25009697 9219916 0.01670 5771765 2616059 3155706 0.00570 1095575 1095575 0.00200 42051276 27804245 14247031 0.02580 335940620 313496575 29287876 0.05300 true 28602561 21451921 64052878 69940796 -5887918 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 true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X 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 true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 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. SCHEDULE H, PART V, SECTION B, LINE 7A THE COMPLETE CHNA FOR TMC-HOSPITAL HILL CAN BE FOUND AT: https://www.trumed.org/files/chna/HH-Community-Health-Needs-Assessment-Sum mary-Full-2016.pdf THE COMPLETE CHNA FOR TMC-LAKEWOOD CAN BE FOUND AT: https://www.trumed.org/files/chna/LW-Community-Health-Needs-Assessment-Ful l-2016.pdf PART V, SECTION B, LINE 10A - BOTH FACILITIES THE IMPLEMENTATION STRATEGY FOR TMC-HOSPITAL HILL CAN BE FOUND AT: https://www.trumed.org/files/chna/HH-Community-Health-Needs-Assessment-Sum mary-Full-2016.pdf THE IMPLEMENTATION STRATEGY FOR TMC-LAKEWOOD CAN BE FOUND AT: https://www.trumed.org/files/chna/LW-Community-Health-Needs-Assessment-Ful l-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: https://www.trumed.org/files/financial-counseling/financial-assistance-pol icy-fap.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 1 TMC BEHAVIOR HEALTH 300 WEST 19TH TERRACE KANSAS CITY MO 64108 MENTAL HEALTH FACILITY PART I, LINE 3C ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS AND RESIDENCY ARE OTHER FACTORS USED IN THE ELIGIBILITY CRITERIA EXPLAINED IN THE FAP FOR PROVIDING FREE CARE. 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 $28,602,561. 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: https://www.trumed.org/files/chna/HH-Community-Health-Needs-Assessment-Sum mary-Full-2016.pdf https://www.trumed.org/files/chna/LW-Community-Health-Needs-Assessment-Ful l-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) 500000 Friends of Psychiatry CITY OF KANSAS CITY MISSOURI 414 E 12TH ST KANSAS CITY MO 64106 CITY OF KCMO 46552 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 false true false false false true false false false CHARLES W SHIELDS PRESIDENT/CEO/DIRECTOR 620371 0 98400 0 9030 0 137705 0 25604 0 891110 0 0 0 STEPHEN JARVIS MD DIRECTOR 244743 0 13333 0 10056 0 21382 0 27464 0 316978 0 0 0 MARK T STEELE MD DIRECTOR 308364 0 0 0 0 0 0 0 0 0 308364 0 0 0 WILLIAM H COLBY ASSISTANT SECRETARY 413232 0 33620 0 34652 0 84683 0 25183 0 591370 0 0 0 ALLEN M JOHNSON ASSISTANT TREASURER 410965 0 33396 0 77587 0 98749 0 25653 0 646350 0 0 0 JOHN GIANINO NEUROSURGEON 474739 0 413 0 124985 0 77496 0 28192 0 705825 0 0 0 MITZI CARDENAS SR VP CHIEF STRATEGY INFO OFF. 291614 0 23482 0 34950 0 68340 0 7132 0 425518 0 0 0 LYNDA DONEGAN VP PROFESSIONAL HEALTH SERVICE 287182 0 9139 0 28128 0 7240 0 8574 0 340263 0 0 0 GERARD GRIMALDI VP HEALTH POLICY & GOVT RELATI 235510 0 19589 0 52414 0 57412 0 22300 0 387225 0 0 0 DOUG BRANDT ASSOCIATE CFO 286028 0 10805 0 3794 0 69302 0 21890 0 391819 0 0 0 SCHEDULE J, PART I, LINE 4B & PART II 2017 2017 2017 ACCRUAL DISTRIBUTION TOTAL CHARLES SHIELDS $ 107,705 -0- $ 107,705 WILLIAM COLBY $ 74,698 21,069 $ 95,767 ALLEN JOHNSON $ 69,209 71,342 $ 140,551 JOHN GIANINO $ 47,956 119,282 $ 167,238 MITZI CARDENAS $ 58,217 27,151 $ 85,368 LYNDA DONEGAN $ -0- 19,599 $ 19,599 GERARD GRIMALDI $ 40,821 32,828 $ 73,103 DOUG BRANDT $ 42,843 -0- $ 42,843 PART VII, LINE 5 AND SCH J, PART II TRUMAN MEDICAL CENTER, INC. (TMC) REIMBURSED UNIVERSITY PHYSICIANS ASSOCIATES $308,364 FOR THE TIME MARK STEELE, M.D. SPENT ASSISTING TMC, INC. AS THE MEDICAL DIRECTOR. SCHEDULE J, PART I, LINE 6A CERTAIN EMPLOYEES ARE ELIGIBLE FOR A SMALL ANNUAL BONUS RELATED TO MEETING OR EXCEEDING BUDGET. A HEALTH AND EDUCATION FACILITIES AUTH OF MO 431178966 2006-11-09 12000000 CONSTRUCTION AND EQUIPMENT false false false B JACKSON COUNTY MISSOURI 446000524 467578GJ3 2012-09-04 41180185 REFUNDING BOND false false false C JACKSON COUNTY MISSOURI 446000524 46757BFS4 2011-05-17 24674279 CONSTRUCTION AND EQUIPMENT false false false D HEALTH AND EDUCATION FACILITIES AUTH OF MO 431178966 2017-12-22 70000000 BUILDING,EQUIPMENT &REFUNDING BOND false false false A 11692811 0 11959500 0 0 0 40500 0 0 11959500 0 0 2008 false true true true B 14343230 0 37597509 0 0 0 451929 0 0 0 37145579 0 2012 true false true true C 7485000 0 24674279 0 0 0 289279 0 0 24385000 0 0 2011 false false true true D 830000 0 64745495 0 1172590 0 500000 0 0 0 4754505 63918261 true false false true A false false true true false 0 false false false true B false false true true false 0 false false false true C false false false false 0 false false false true D false false false false 0 false false false true A false true false false 0 false 0 false true B false true false false 0 false 0 false true C false true false false 0 false 0 false true D false true false false 0 false 0 false true A false B false C false D false PART IV, LINE 2C, COLUMN A THE ARBITRAGE REBATE ANALYSIS WAS PERFORMED 2-19-16. PART IV, LINE 2C, COLUMN B THE ARBITRAGE REBATE ANALYSIS WAS PERFORMED 2-19-16. PART IV, LINE 2C, COLUMN C THE ARBITRAGE REBATE ANALYSIS WAS PERFORMED 2-19-16. PART IV, LINE 2C, COLUMN D THE ARBITRAGE REBATE ANALYSIS WAS PERFORMED 12-22-2017. FORM 990, PART III, LINE 4A One of Truman Medical Centers (TMC) greatest strengths is the ability to provide high quality, state-of-the-art healthcare to all our patients regardless of their ability to pay. TMC offers more than 50 primary, specialty and mental health care clinics at TMC Health Sciences District and TMC Lakewood. TMC also has a number of community-based primary and behavioral health clinics. TMCs person-first approach puts the health needs of the patient above profit. The medical centers are nationally recognized for programs in asthma, diabetes, sickle cell, orthopaedics, womens health and emergency/trauma services. In addition, TMC offers services that include ophthalmology, cardiology, gastroenterology, oral surgery and community-based behavioral health services. In 2018, TMC provided 490,864 outpatient care appointments, with more than 163,000 of those being outpatient behavioral health care service visits. TMCs Medical Pavilions at Health Sciences District 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 Asthma At TMC, our goal is to provide superior and consistent care for the patient with asthma whether it is in the Emergency Department, inpatient unit or clinic setting. TMC has a comprehensive asthma program that provides asthma education to outpatients and inpatients. In an effort to provide a consistent continuum of care, patients are treated in the Emergency Department using a standardized protocol based on national guidelines for the management of asthma and are referred for follow-up care to 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 9,600 patients each year for the treatment and care of asthma. Diabetes In 2009, TMC Health Sciences District opened a spacious new state-of-the-art Diabetes Center to better serve the needs of patients. The new space includes a patient resource center with computer access, diabetes education classroom and consultation rooms, a comfortable waiting area; and expanded exam rooms with advanced technology to support the electronic health record progression. The TMC Diabetes Center provides quality care for 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 2018, TMC treated 15,849 patients for diabetes. Sickle Cell TMC Health Sciences District is 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 providers treat their pain quickly, many times bypassing the Emergency Department. In 2018, 501 patients considered TMC 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 empower patients and caregivers to make healthy decisions. 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 121,310 visits in 2018. WIC provides healthy foods, nutrition education and referrals for women, infants, and children up to the age of five, who are at nutritional risk and meet program guidelines. Cardiology Services The TMC Cardiology Center offers patients a complete range of cardiac services for prevention, early diagnosis, treatment and recovery in a patient-centered environment. TMCs Cardiology Center specializes in interventional cardiology, which refers to non-surgical treatments for heart conditions. Providers rely on cardiac interventions to diagnose and treat coronary artery disease, valvular heart disease, heart failure and congenital heart disease. The Cardiology Center features a sophisticated cardiac catheterization laboratory, nine additional clinic rooms, increased echocardiography testing capabilities and a cardiac rehabilitation service to help prevent repeat heart problems. In 2018, the Cardiology Center provided more than 7,000 outpatient clinic appointments, performed 723 diagnostic catheterization procedures, completed nearly 900 total catheterization laboratory procedures and placed 168 patient required cardiovascular stents. Gastroenterology Services Truman Medical Centers Gastroenterology (GI) Center at the Health Sciences District provides care for patients with all gastrointestinal diseases including but not limited to abdominal pain, constipation, reflux, Irritable Bowel Syndrome, Crohns Disease, and liver diseases. It offers procedures such as: colon cancer screening, upper endoscopy, endoscopic ultrasound, ERCP- which is used to diagnosis diseases of the bile ducts and pancreas, motility studies, and paracentesis. The Center features three procedure rooms, a dedicated prep and recovery area, patient monitoring equipment, including additional cardiac monitoring capabilities with a central monitor at the nursing station. The clinic has six exams rooms, a dedicated triage room, a large education classroom, and a spacious waiting room. The center provides "one-stop shopping" for patients, with registration/check-in and financial counseling all in same area. In FY 2018, the TMC GI Center provided more than 8,600 outpatient visits and performed more than 7,500 procedures. Ophthalmology The Ophthalmology Clinics at TMC are full-service facilities for the medical and surgical treatment of eye diseases. Services range from prescribing glasses and fitting contact lenses to the treatment of complex ocular disorders. Providers perform outpatient surgery and laser treatment, including refractive laser surgery. In 2018, the Ophthalmology Department provided care in more than 21,000 outpatient visits. Dentistry and Oral Surgery Services Oral & Maxillofacial surgeons practice a wide scope of care with expertise ranging from corrective jaw surgery to wisdom tooth removal. They also diagnose and treat facial injuries and perform a full range of dental implant procedures. The facial pain/temporomandibular joint syndrome (TMJ) clinic also offers diagnosis and treatment of facial pain and TMJ. Providers cared for more than 23,000 dental patients at the TMC Lakewood Dental Clinic. Outpatient Behavioral Health Services In 2018, TMC Behavioral Health provided 163,138 outpatient visits to 9,611 patients. These services are aimed at assisting clients in managing the symptoms of their illness, and improving their day-to-day lives. The services include case management, crisis and outreach services, mental health assessments, employment services, occupational therapies, peer support groups, medication management, rehabilitation, substance abuse treatment and therapy and counseling for children, adolescents, adults and families. Jackson County Health Department TMC contracts with the Jackson County, Missouri government to manage the Jackson County Health Department (JACOHD). In 2018, the JACOHD provided nearly 125,167 community based encounters including vaccinations, community health education and adult traumatic brain injury case management. The JACOHD is dedicated to the prevention of disease and the maintenance of a high level of health in the family and community through education, immunization, inspection, and supportive care. FORM 990, PART III, LINE 4B Truman Medical Centers (TMC) includes TMC Health Sciences District, TMC Lakewood and TMC Behavioral Health. It 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 in 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, orthopedics and plastic surgery. TMC cares for more than 117,000 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 2018 (July 1, 2017- June 30, 2018), TMC had 22,608 inpatient admissions and provided 93,063 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 patients and clients have multiple chronic diseases such as diabetes, asthma, heart failure and hypertension. In FY 2018, 60% of TMC patients suffered from at least one or more of these chronic diseases. Due to some social disparities, such as lack of transportation, or a language barrier, patients ability to manage their condition with proper medication and follow-up care is difficult and many times, providers end up admitting patients for their condition. TMC works diligently to overcome these ethnic, social and racial barriers when patients receive their care. TMC has specialized language interpreters on staff at both Health Sciences District and Lakewood locations to help ensure that patients with limited English proficiency or deaf patients receive high quality, individualized care with communication assistance. TMC is one of the few hospitals to have on staff interpreters available around the clock to assist patients with paperwork and communicating with medical professionals. TMC interpreter services has approximately 28 language interpreters on staff that provide face-to-face interpreting in three major languages: Spanish, Somali and Arabic. Additionally, over the phone interpreters in 150 languages are available via dual handset telephonic interpreting units. In Fiscal Year 2018, TMC language access provided 145,664 interpreted encounters for patients. Behavioral Health Behavioral Health is essential to well-being and can affect self-image, relationships, sleep, eating, and even physical health. Many times, patients with chronic diseases also suffer from mental illness and/or substance abuse and addiction problems. Gaining access to quality, behavioral health care services is often difficult and expensive. In many communities, inpatient mental health facilities do not exist or are at capacity nearly 100 percent of the time. TMC is one of only a few health systems that provides both inpatient medical and mental health care beds. TMC Behavioral Health offers a comprehensive array of mental health and substance abuse treatment services at both the TMC Health Sciences District and TMC Lakewood Counseling. All mental health services are aimed at assisting clients in managing the symptoms of their illnesses and in improving their day-to-day lives. TMC services also provide the support many people with mental illness need to regain a sense of meaning and purpose in life. TMC Behavioral Health has 66 inpatient mental health beds including a specialized geriatric inpatient unit at TMC Lakewood. In FY 2018, TMC Behavioral Health treated 6,911 patients, with 2,288 patients admitted for inpatient mental health care at a TMC facility. Womens Health TMC offers full Womens Health Services and is the birthplace to nearly half of all babies born in Jackson County, Missouri. TMC Health Sciences District specializes in high-risk pregnancies and births. It is home to a 19-bed, Level III neonatal intensive care unit (NICU), one of the largest in the area. In 2011, TMC Lakewood opened a renovated and expanded labor and delivery unit serving the people of eastern Jackson County. This unit also includes a Level II NICU. In fiscal year 2018, TMC delivered 3,428 babies. FORM 990, PART III, LINE 4C Truman Medical Centers Emergency Departments provided care to 86,828 patients in 2018, with more than 59,000 of those visits at TMC Health Sciences District, making it one of the busiest adult emergency departments in the Kansas City metro area. The TMC Health Sciences District Emergency Department (ED) is a designated Level 1 Trauma Center. It consists of a team of nearly 25 physicians and more than 125 nurses specially trained in treating trauma and critical care injuries. Trauma surgeons and other members of the trauma team are in the hospital 24-hours a day, seven days a week. The TMC Lakewood Emergency Department has a staff of ten board certified emergency medicine physicians and 36 nurses providing immediate, compassionate, quality care to residents of eastern Jackson County, Missouri each year. Aim4Peace As an academic safety-net hospital in Kansas City, Missouri, TMC receives a significant amount of intentional trauma. Aim4Peace, a local organization that works to prevent violence is focused on the reduction of intentional gunshot incidents. As the only hospital in association with Aim4Peace, TMC helps affect a culture shift in what is accepted as the norm among the perpetrators of violent crime while reducing recidivism in the emergency department. TMC is listed in the national directory of hospital-based violence intervention and prevention programs. Sexual Abuse Nurse Examiner (SANE) The TMC Health Sciences District Emergency Department (ED) has a Sexual Abuse Nurse Examiner (SANE) on site to provide a thorough forensic examination of women who report being a victim of sexual assault. When a woman enters the Emergency Department reporting a sexual assault or rape, she is sent to a SANE and taken to a private room for examination. The Kansas City SANE program has made a profound difference in the quality of care provided to sexual assault victims. SANEs offer victims prompt, compassionate care and comprehensive forensic evidence collection. In addition to helping preserve the victim's dignity and reduce psychological trauma, SANEs enhance evidence collection for more effective investigations and better prosecutions. TMCs SANE program has also helped to provide leadership in the community by educating and training other potential SANEs. Each year, the TMC SANE cares for and examines nearly 100 women in the Health Sciences District Emergency Department. Trauma Research The Trauma Research Team is currently conducting several exciting research projects including grant-funded research and original projects. All projects are designed with the objective of optimizing care of the traumatically injured patient. Research projects in progress during fiscal 2018 include: A) Investigator Initiated: Thorn in My Side Chest Tube Management; Dr. Geehan, PI B) Investigator Initiated: Fundamentals of Critical Care Support (Attitudinal Survey); Dr. Moncure, PI C) Investigator Initiated: Amendment to continue enrollment using additional indicators: Incidence of Primary Care in the Injured Patient; Dr. Geehan, PI. D) Measuring Immediate Responders Knowledge Gained Through "Stop the Bleed" Education and Training - Amendment approved to continue study in the lay public as a comparison; Teresa Lienhop, PI E) Millennium Pharmaceutical: TAKEDA: Enteral Feeding in Critical Care; Dr. Moncure, PI Performance Improvement Patient Safety Program (PIPS) The Performance Improvement Patient Safety (PIPS) is an important part of the trauma program at TMC Health Sciences District. PIPS works toward implementing a system of patient care delivery that focuses on the achievement of outcomes within effective time frames and with appropriate use of resources. The areas of monitoring and improving include pre-hospital care, emergency department, inpatient stay, and rehabilitation. The primary focus is on the promptness, documentation, and appropriateness of care along with patient outcomes. Advanced Trauma Care for Nurses Continuing medical education is not just a requirement it is a necessity to enhance the knowledge and abilities of the medical professional. Truman Medical Center Health Sciences District was the first hospital to bring Advanced Trauma Care for Nurses (ATCN) to the Kansas City metropolitan area. The course is geared toward nursing staff in the Emergency Department and Intensive Care Units. When nurses complete the ATCN class and work alongside trauma physicians certified in Advanced Trauma Life Support (ATLS), they find that their thought processes and actions are more aligned with the 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 NOT 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. 2018 WAS THE MOST RECENT REVIEW. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AS APPROVED BY THE CFO OR LEGAL DEPARTMENT. FORM 990, PART XI, LINE 9 CHANGE IN NET ASSETS OF TMC FOUNDATION $ 1,048,555 CHANGE IN DEFINED BENEFIT PENSION PLAN 13,680,063 CHANGE IN PERMANENTLY RESTRICTED NET ASSETS (101,913) ---------- TOTAL $ 14,626,705 AUXILIARY TO TRUMAN MEDICAL CENTER 2301 HOLMES KANSAS CITY MO 64108 436099279 SUPPORT MO 501(C)(3) 10 NA false TMC PROF AND GEN LIABILITY SELF INS TRUS 2301 HOLMES KANSAS CITY MO 64108 431946384 LIABILITY INS MO 501(C)(3) 12B NA false TMC FINANCE SUPPORT CORPORATION 2301 HOLMES KANSAS CITY MO 64108 271994129 SUPPORT MO 501(C)(3) 12A TMC true false false false false false false false false false false false false true true true false true true true TRUMAN MEDICAL CENTER INCOR 2301 HOLMES STREET KANSAS CITY MO 64108 440661018 X 42789 62203 104992 582222263 582327255 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