TY 2013 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) JOHN W BLUFORD........................................................................ PRESIDENT/CEO/DIRECTOR	40.0 .......................1.0	X	X	1,107,114	207,094
(2) PAUL M BLACK........................................................................ PAST CHAIRPERSON/DIRECTOR	1.0 .......................1.0	X	X	0	0
(3) PHILIP J SANDERS........................................................................ TREASURER/DIRECTOR	1.0 .......................	X	X	0	0
(4) SARAH RUIZ CHAVEZ........................................................................ DIRECTOR	1.0 .......................	X		0	0
(5) DAVID W THOMPSON........................................................................ DIRECTOR	1.0 .......................	X		0	0
(6) JAMES CORWIN........................................................................ DIRECTOR	1.0 .......................	X		0	0
(7) DOUGLAS Y CURRAN........................................................................ DIRECTOR	1.0 .......................1.0	X		0	0
(8) JUAN M RANGEL JR........................................................................ SECRETARY/DIRECTOR	1.0 .......................	X	X	0	0
(9) NEIL T DOUTHAT........................................................................ VICE-CHAIR/DIRECTOR	1.0 .......................	X	X	0	0
(10) BETTY M DREES MD........................................................................ DIRECTOR	1.0 .......................	X		0	0
(11) PEGGY DUNN........................................................................ BOARD CHAIR/DIRECTOR	1.0 .......................1.0	X	X	0	0
(12) MATTHEW C GRATTON MD........................................................................ DIRECTOR	1.0 .......................	X		0	0
(13) PAUL P HOLEWINSKI........................................................................ DIRECTOR	1.0 .......................	X		0	0
(14) PETER S LEVI........................................................................ VICE-CHAIR/DIRECTOR	1.0 .......................	X	X	0	0
(15) LEO MORTON........................................................................ DIRECTOR	1.0 .......................	X		0	0
(16) DENNIS S O'LEARY MD........................................................................ VICE-CHAIR/DIRECTOR	1.0 .......................	X	X	0	0
(17) MARIA MARTINEZ........................................................................ DIRECTOR	1.0 .......................	X		0	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(18) MARK T STEELE MD........................................................................ DIRECTOR	1.0 .......................1.0	X			106,100	0
(19) TIMOTHY A WURST........................................................................ DIRECTOR	1.0 .......................	X			0	0
(20) JEAN ROTH JACOBS........................................................................ DIRECTOR	1.0 .......................	X			0	0
(21) REVEREND ERIC D WILLIAMS........................................................................ DIRECTOR	1.0 .......................	X			0	0
(22) MICHAEL OFOKANSI........................................................................ DIRECTOR/TMC EMPLOYEE	40.0 .......................	X			98,978	12,592
(23) MAHNAZ SHABBIR........................................................................ DIRECTOR	1.0 .......................	X			0	0
(24) MICHELLE CHOLLET........................................................................ DIRECTOR	1.0 .......................	X			0	0
(25) CINDY CIRCO........................................................................ DIRECTOR	1.0 .......................	X			0	0
(26) RITA CORTES........................................................................ DIRECTOR	1.0 .......................	X			0	0
(27) MARK DONOVAN........................................................................ DIRECTOR	1.0 .......................	X			0	0
(28) MIKE ENOS........................................................................ DIRECTOR	1.0 .......................	X			0	0
(29) MARVIN LYMAN........................................................................ DIRECTOR	1.0 .......................	X			0	0
(30) DRED SCOTT........................................................................ DIRECTOR	1.0 .......................	X			0	0
(31) KARA L SETTLES MD........................................................................ DIRECTOR	1.0 .......................	X			0	0
(32) TRACEY LEWIS........................................................................ DIRECTOR	1.0 .......................	X			0	0
(33) KAREN ZECY........................................................................ DIRECTOR	1.0 .......................	X			0	0
(34) EDWARD DULLENTY........................................................................ DIRECTOR/TMC EMPLOYEE	40.0 .......................	X			50,003	3,921
(35) AL JOHNSON........................................................................ ASSISTANT TREASURER	40.0 .......................		X		324,722	108,668
(36) WILLIAM COLBY........................................................................ ASSISTANT SECRETARY	40.0 .......................2.0		X		303,696	77,909
(37) JOHN GIANINO........................................................................ NEUROSURGEON	40.0 .......................			X	448,101	136,411
(38) GANDHIVARMA SUBRAMANIAM........................................................................ NEUROSURGEON	40.0 .......................			X	375,933	109,080
(39) MARK MCPHEE........................................................................ EVP CLINICAL COORDINATION	40.0 .......................			X	341,098	81,173
(40) MUHAMMAD FARHAN........................................................................ PYSCHIATRIST	40.0 .......................			X	270,815	47,016
(41) STEPHEN JARVIS........................................................................ ACMO/CLINICAL CHAIR PSYCHIATRY	40.0 .......................			X	266,249	59,258

(A) Name and business address	(B) Description of services	(C) Compensation
CERNER CORPORATION,	SOFTWARE SYSTEMS	15,899,176
UNIVERSITY OF MISSOURI-KANSAS CITY,	MEDICAL SERVICES	15,055,996
UNIVERSITY PHYSICIAN ASSOCIATES,	MEDICAL SERVICES	12,031,312
MEDICAL IMAGING INC,	MEDICAL SERVICES	5,212,186
CHILDREN'S MERCY HOSPITAL,	MEDICAL SERVICES	4,513,086
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 22

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21	4,460,660	4,460,660
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	2,790,877		2,790,877
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	203,341,863	179,915,945	23,425,918
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,868,891	3,615,168	253,723
9	Other employee benefits .......	27,915,105	24,535,319	3,379,786
10	Payroll taxes ...........	14,463,033	12,648,424	1,814,609
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	1,344,058		1,344,058
c	Accounting ...........	169,500		169,500
d	Lobbying ...........	75,808		75,808
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	0
12	Advertising and promotion ....	0
13	Office expenses .......	121,669,784	99,967,274	21,702,510
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	9,552,503	7,151,956	2,400,547
17	Travel ............	151,917		151,917
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	583,977		583,977
20	Interest ...........	3,238,327	3,238,327
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	25,216,533	25,216,533
23	Insurance ..............	1,734,159	1,734,159
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	BAD DEBT EXPENSE	22,769,172	22,769,172
b	MEDICAL STAFF EXPENSES	129,501	129,501
c	MEDICAL SUPPLIES	28,556,987	28,556,987
d	PHARMACEUTICALS	24,849,292	24,849,292
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	496,881,947	438,788,717	58,093,230	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	190,997	1	2,448,222
2	Savings and temporary cash investments .........	25,913	2	29,382
3	Pledges and grants receivable, net ...........	1,244,999	3	1,669,572
4	Accounts receivable, net .............	72,065,821	4	58,373,241
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
		0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	4,904,508	8	5,671,996
9	Prepaid expenses and deferred charges ..........	3,515,824	9	7,244,999
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	479,619,730
b	Less: accumulated depreciation .....	10b	297,363,261	180,131,186	10c	182,256,469
11	Investments—publicly traded securities ..........	0	11	0
12	Investments—other securities. See Part IV, line 11 .....	0	12	0
13	Investments—program-related. See Part IV, line 11 .....	0	13	0
14	Intangible assets ...............	0	14	0
15	Other assets. See Part IV, line 11 ...........	36,766,406	15	33,749,336
16	Total assets. Add lines 1 through 15 (must equal line 34)......	298,845,654	16	291,443,217
	17	Accounts payable and accrued expenses .........	125,978,280	17	204,038,887
18	Grants payable .................	0	18	0
19	Deferred revenue ................	0	19	0
20	Tax-exempt bond liabilities .............	62,292,595	20	70,955,623
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	31,402,075	23	27,110,591
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	7,178,174	25	10,966,707
26	Total liabilities. Add lines 17 through 25.........	226,851,124	26	313,071,808
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	53,991,424	27	-32,624,147
28	Temporarily restricted net assets ...........	14,810,008	28	7,802,458
29	Permanently restricted net assets ...........	3,193,098	29	3,193,098
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	71,994,530	33	-21,628,591
34	Total liabilities and net assets/fund balances ........	298,845,654	34	291,443,217

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

Truman Medical Center Incorporated

Employer identification number

44-0661018

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the supported organization? ................

11g(i)

(ii) A family member of a person described in (i) above? ......................

11g(ii)

(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of monetary support
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2013

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2012 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2013. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2012. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2012. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2013

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2012 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2012 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2013. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ........ right arrow

33 1/3% support tests—2012. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2013

Page 4

Part IV

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Name of the organization

Truman Medical Center Incorporated

Employer identification number

44-0661018

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year ......................... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 2

Name of organization Truman Medical Center Incorporated

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTEDRESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 3

Name of organization Truman Medical Center Incorporated

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 4

Name of organization
Truman Medical Center Incorporated

Employer identification number

44-0661018

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed.

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

See separate instructions. SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Truman Medical Center Incorporated

Employer identification number

44-0661018

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2013

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures). Click to see attachment

B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(a) Filing organization's totals	(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......	30,138	30,138
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......	45,670	45,670
c	Total lobbying expenditures (add lines 1a and 1b) ...................	75,808	75,808
d	Other exempt purpose expenditures ........................	496,806,139	496,806,139
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............	496,881,947	496,881,947
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.	1,000,000	1,000,000
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................	250,000	250,000
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................		Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) Total

2a	Lobbying nontaxable amount	1,000,000	1,000,000	1,000,000	1,000,000	4,000,000

b	Lobbying ceiling amount (150% of line 2a, column(e))					6,000,000

c	Total lobbying expenditures	88,789	80,305	97,731	75,808	342,633

d	Grassroots nontaxable amount	250,000	250,000	250,000	250,000	1,000,000

e	Grassroots ceiling amount (150% of line 2d, column (e))					1,500,000

f	Grassroots lobbying expenditures	35,205	36,360	38,170	30,138	139,873

Schedule C (Form 990 or 990-EZ) 2013

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Total. Add lines 1c through 1i ...............................

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation

Schedule C (Form 990 or 990EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions. SchDMd Bullet

Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Truman Medical Center Incorporated

Employer identification number

44-0661018

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) .....
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2013

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....	3,173,837	3,077,353	2,981,134	2,781,031	2,747,603
b	Contributions ........	200	200	125,200	5,200	1,100
c	Net investment earnings, gains, and losses	172,581	189,940	70,859	291,700	140,396
d	Grants or scholarships .....	0	0	0	0	0
e	Other expenditures for facilities and programs ........	102,278	93,656	99,840	96,797	108,068
f	Administrative expenses ....	0	0	0	0	0
g	End of year balance ......	3,244,340	3,173,837	3,077,353	2,981,134	2,781,031

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

Yes

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	3,161,527		3,161,527
b	Buildings ................	304,266,088	171,852,670	132,413,418
c	Leasehold improvements ............
d	Equipment ................	162,199,388	125,510,591	36,688,797
e	Other .................	9,992,727		9,992,727
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				182,256,469

Schedule D (Form 990) 2013

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) ASSETS FOR CAPITAL ACQUISITION				2,811,282
(2) ASSETS EXTERNALLY RESTRICTED				305,925
(3) INTEREST IN ASSETS OF TMCCF				10,689,633
(4) DEFERRED FINANCING COST				826,913
(5) OTHER RECEIVABLES				18,474,310
(6) HELD BY BOND TRUSTEE				641,273



Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				33,749,336

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes		0
457F PLAN LIABILITY		2,811,282
UNAMORTIZED PREMIUM		1,884,268
OTHER LIABILITIES		6,271,157






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		10,966,707
2. Liability for uncertain tax positions In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................

Schedule D (Form 990) 2013

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	388,657,210
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	5,993,014
e	Add lines 2a through 2d .....................			2e	5,993,014
3	Subtract line 2e from line 1.....................			3	382,664,196
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b	36,007,092
c	Add lines 4a and 4b.......................			4c	36,007,092
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	418,671,288

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	476,145,759
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d	3,321,344
e	Add lines 2a through 2d......................			2e	3,321,344
3	Subtract line 2e from line 1.....................			3	472,824,415
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b	24,057,532
c	Add lines 4a and 4b.......................			4c	24,057,532
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	496,881,947

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
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 487,606 RELATED ORGANIZATION REVENUE 5,505,408 ----------- TOTAL $ 5,993,014
SCHEDULE D, PART XI, LINE 4B	MEDICAL STAFF REVENUE 153,096 CONTRIBUTION USED FOR ASSET ACQUISITION 11,925,965 ELIMINATIONS 1,158,859 BAD DEBT EXPENSE 22,769,172 ----------- TOTAL $ 36,007,092
SCHEDULE D, PART XII, LINE 2D	RELATED ORGANIZATION EXPENSES $ 3,321,344
SCHEDULE D, PART XII, LINE 4B	ELIMINATIONS 1,158,859 MEDICAL STAFF EXPENSES 129,501 BAD DEBT EXPENSE 22,769,172 ------------ TOTAL $ 24,057,532

Schedule D (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Truman Medical Center Incorporated

Employer identification number

44-0661018

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..	129,053,483	86,998,101	42,055,382	8.750 %
b	Medicaid (from Worksheet 3, column a) ....	156,546,040	123,727,093	32,818,947	6.830 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	285,599,523	210,725,194	74,874,329	15.580 %
Other Benefits		1,188,353	537,225	651,128	0.140 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	1,188,353	537,225	651,128	0.140 %
f	Health professions education (from Worksheet 5) ..	36,966,732	24,783,658	12,183,074	2.540 %
g	Subsidized health services (from Worksheet 6) ..	7,743,897	1,898,869	5,845,028	1.220 %
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	5,205,332		5,205,332	1.080 %
j	Total. Other Benefits ..	51,104,314	27,219,752	23,884,562	4.980 %
k	Total. Add lines 7d and 7j .	336,703,837	237,944,946	98,758,891	20.560 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013

Schedule H (Form 990) 2013

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	800,000	800,000
9	Other
10	Total	800,000	800,000

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

22,769,172

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

17,076,879

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

70,390,538

Enter Medicare allowable costs of care relating to payments on line 5.....

90,327,879

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-19,937,341

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2013

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?2 Name, address, primary website address, and state license number
1	TRUMAN MEDICAL CENTER - HOSPITAL HILL 2301 HOLMES KANSAS CITY,MO64108 WWW.TRUMED.ORG	X	X	X	X
2	TRUMAN MEDICAL CENTER - LAKEWOOD 7900 LEES SUMMIT ROAD KANSAS CITY,MO64139 WWW.TRUMED.ORG	X	X	X	X

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	TRUMAN MEDICAN CENTER - HOSPITAL HILL
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ....................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): WWW.TRUMED.ORG

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	If "Yes," indicate the factors used in determining such amounts (check all that apply):
a	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?..........	17		No
	If "Yes," check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	TRUMAN MEDICAL CENTER - LAKEWOOD
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): WWW.TRUMED.ORG

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	If "Yes," indicate the factors used in determining such amounts (check all that apply):
a	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?..........	17		No
	If "Yes," check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference	Explanation
PART V, SECTION B, LINE 3	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.
PART V, SECTION B, LINE 4	TMC COMPLETED CHNA REPORTS FOR TWO FACILITIES, TMC-HOSPITAL HILL AND TMC-LAKEWOOD. AS REQUIRED BY THE IRS, EACH FACILITY HAS A SEPARATE REPORT, WITH FACILITY-SPECIFIC PRIORITIES.
PART V, SECTION B, LINE 7	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. IN ADDITION, TMC IS PROGRESSING IN THE ESTABLISHMENT OF AN AFFORDABLE COMMUNITY GROCERY STORE. THE ANTICIPATED COMPLETION DATE FOR THIS PROJECT IS FALL, 2015. MATERNAL & INFANT HEALTH THE PRIORITY NEED IS TO INCREASE ACCESS TO PRENATAL CARE. TMC IS PURSUING DESIGNATION 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 2013, TMC EXPANDED ITS SCHOOL-BASED PROGRAM THROUGH DEPLOYMENT OF MOBILE SERVICES TO THE INDEPENDENCE SCHOOL DISTRICT. THIS MOBILE PROGRAM SCREENED ALMOST 3,500 STUDENTS AND PERFORMED MORE THAN 7,600 PROCEDURES IN 2013.
PART V, SECTION B, LINE 12I	TMC FINANCIAL COUNSELING STAFF ARE RESPONSIBLE FOR DETERMINING IF A PATIENT IS A RESIDENT OF KANSAS CITY OR JACKSON COUNTY AND THEREFORE MAY BE ELIGIBLE FOR DISCOUNTED OR FREE MEDICAL SERVICES. THE GUIDELINES ARE BASED ON RESIDENCY, INCOME, AND FAMILY SIZE. THE DISCOUNT IS GRANTED FOR INCOMES UP TO 400% OF FEDERAL POVERTY GUIDELINES WITH FREE CARE UP TO 200% OF FPG. TMC USES A VERIFICATION TOOL CALLED TRANSUNION REVENUE MANAGER TO VERIFY RESIDENCY, INCOME, ASSETS AND FAMILY UNIT.
PART V, SECTION B, LINE 18E	OTHER NOTIFICATIONS OF FINANCIAL ASSISTANCE OPTIONS INCLUDE MAILING A LETTER INFORMING THE PATIENT OF OPTIONS IF A PATIENT IS DISCHARGED BEFORE BEING SEEN BY A FINANCIAL ADVISOR.
PART V, SECTION B, LINE 20D	PATIENT RESPONSIBILITY FOR EMERGENCY SERVICES APPROXIMATES TMC COST FOR PROVIDING SERVICE.

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?1
Name and address		Type of Facility (describe)
1	TMC BEHAVIOR HEALTH 300 WEST 19TH TERRACE KANSAS CITY,MO64108	MENTAL HEALTH FACILITY
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2013

Page

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART V, SECTION B, LINE 3	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.
PART V, SECTION B, LINE 4	TMC COMPLETED CHNA REPORTS FOR TWO FACILITIES, TMC-HOSPITAL HILL AND TMC-LAKEWOOD. AS REQUIRED BY THE IRS, EACH FACILITY HAS A SEPARATE REPORT, WITH FACILITY-SPECIFIC PRIORITIES.
PART V, SECTION B, LINE 7	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. IN ADDITION, TMC IS PROGRESSING IN THE ESTABLISHMENT OF AN AFFORDABLE COMMUNITY GROCERY STORE. THE ANTICIPATED COMPLETION DATE FOR THIS PROJECT IS FALL, 2015. MATERNAL & INFANT HEALTH THE PRIORITY NEED IS TO INCREASE ACCESS TO PRENATAL CARE. TMC IS PURSUING DESIGNATION 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 2013, TMC EXPANDED ITS SCHOOL-BASED PROGRAM THROUGH DEPLOYMENT OF MOBILE SERVICES TO THE INDEPENDENCE SCHOOL DISTRICT. THIS MOBILE PROGRAM SCREENED ALMOST 3,500 STUDENTS AND PERFORMED MORE THAN 7,600 PROCEDURES IN 2013.
PART V, SECTION B, LINE 12I	TMC FINANCIAL COUNSELING STAFF ARE RESPONSIBLE FOR DETERMINING IF A PATIENT IS A RESIDENT OF KANSAS CITY OR JACKSON COUNTY AND THEREFORE MAY BE ELIGIBLE FOR DISCOUNTED OR FREE MEDICAL SERVICES. THE GUIDELINES ARE BASED ON RESIDENCY, INCOME, AND FAMILY SIZE. THE DISCOUNT IS GRANTED FOR INCOMES UP TO 400% OF FEDERAL POVERTY GUIDELINES WITH FREE CARE UP TO 200% OF FPG. TMC USES A VERIFICATION TOOL CALLED TRANSUNION REVENUE MANAGER TO VERIFY RESIDENCY, INCOME, ASSETS AND FAMILY UNIT.
PART V, SECTION B, LINE 18E	OTHER NOTIFICATIONS OF FINANCIAL ASSISTANCE OPTIONS INCLUDE MAILING A LETTER INFORMING THE PATIENT OF OPTIONS IF A PATIENT IS DISCHARGED BEFORE BEING SEEN BY A FINANCIAL ADVISOR.
PART V, SECTION B, LINE 20D	PATIENT RESPONSIBILITY FOR EMERGENCY SERVICES APPROXIMATES TMC COST FOR PROVIDING SERVICE.

Schedule H (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
Truman Medical Center Incorporated

Employer identification number
44-0661018

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance
(1) UNIVERSITY OF MISSOURI-KANSAS CITY 5100 Rockhill Road KANSAS CITY,MO64110	43-6003859	501(c)(3)	500,000				Friends of Psychiatry
(2) JACKSON COUNTY MISSOURI 415 EAST 12TH STREET KANSAS CITY,MO64106		Government		3,960,660	FMV	BUILDING	DONATION OF BUILDING

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2013

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference	Explanation
SCHEDULE I, PART I, LINE 2	THE GRANTS PROVIDED WERE MADE TO OTHER PUBLIC CHARITIES WHO HAVE A CLOSE WORKING RELATIONSHIP WITH TRUMAN MEDICAL CENTER. THESE ORGANIZATIONS STRIVE TO FURTHER SUPPORT THE HOSPITAL OPPERATIONS OF TRUMAN MEDICAL CENTER, INC. THEREFORE, THE USE OF THE GRANTED FUNDS IS MONITORED THROUGH THE CLOSE WORKING RELATIONSHIPS WITH THESE ORGANIZATIONS.

Schedule I (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Truman Medical Center Incorporated

Employer identification number

44-0661018

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2013

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)JOHN W BLUFORDPRESIDENT/CEO/DIRECTOR	(i) (ii)	695,902 0	405,695 0	5,517 0	155,368 0	51,726 0	1,314,208 0
(2)AL JOHNSONASSISTANT TREASURER	(i) (ii)	321,307 0	2,000 0	1,415 0	73,933 0	34,735 0	433,390 0
(3)WILLIAM COLBYASSISTANT SECRETARY	(i) (ii)	300,412 0	2,000 0	1,284 0	28,267 0	49,642 0	381,605 0
(4)JOHN GIANINONEUROSURGEON	(i) (ii)	447,410 0	0 0	691 0	98,317 0	38,094 0	584,512 0
(5)GANDHIVARMA SUBRAMANIAMNEUROSURGEON	(i) (ii)	375,541 0	0 0	392 0	99,460 0	9,620 0	485,013 0
(6)MARK MCPHEEEVP CLINICAL COORDINATION	(i) (ii)	338,768 0	0 0	2,330 0	21,515 0	59,658 0	422,271 0
(7)MUHAMMAD FARHANPYSCHIATRIST	(i) (ii)	270,668 0	0 0	147 0	30,364 0	16,653 0	317,832 0
(8)STEPHEN JARVISACMO/CLINICAL CHAIR PSYCHIATRY	(i) (ii)	265,259 0	0 0	990 0	18,658 0	40,601 0	325,508 0

Schedule J (Form 990) 2013

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE J, PART I, LINE 1A	TRUMAN MEDICAL CENTER INC. PROVIDED A HEALTH CLUB MEMBERSHIP AND LEGAL SERVICES TO JOHN W. BLUFORD, PRESIDENT AND CEO. THE VALUE OF THE MEMBERSHIP AND LEGAL SERVICES WERE INCLUDED IN HIS W-2 AS TAXABLE INCOME.
SCHEDULE J, PART I, LINE 3	TRUMAN MEDICAL CENTER, INC. UTILIZES AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN CONTRACT, FORM 990 OF COMPARABLE ORGANIZATIONS AND COMPENSATION SURVEYS TO ESTABLISH FAIR MARKET VALUE SALARIES AND BENEFITS FOR TRUMAN MEDICAL CENTER, INC. AND ITS AFFILIATES' OFFICERS AND DIRECTORS.
SCHEDULE J, PART I, LINE 4B & PART II	2013 2013 2013 ACCRUAL DISTRIBUTION TOTAL JOHN BLUFORD $ 132,183 -0- $ 132,183 JOHN GIANINO $ 77,407 -0- $ 77,407 AL JOHNSON $ 51,839 -0- $ 51,839 WILLIAM COLBY $ 27,361 -0- $ 27,361 STEPHEN JARVIS $ 16,892 -0- $ 16,892 G. SUBRAMANIAM $ 79,689 -0- $ 79,689 MARK MCPHEE $ 21,109 -0- $ 21,109 G. SUBRAMANIAM $ 79,689 -0- $ 79,689 MUHAMMAD FARHAN $ 28,374 -0- $ 28,374
PART VII, LINE 5 AND SCH J, PART II	TRUMAN MEDICAL CENTER, INC. (TMC) REIMBURSED UNIVERSITY PHYSICIANS ASSOCIATES $106,100 FOR THE TIME MARK STEELE, M.D. SPENT ASSISTING TMC, INC. AS THE MEDICAL DIRECTOR.

Schedule J (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
Truman Medical Center Incorporated

Employer identification number
44-0661018

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	JACKSON COUNTY MISSOURI PUBLIC BUILDING CORP	43-1772348	46737ECH3	05-18-2006	20,236,825	CONSTRUCTION		X		X		X
B	JACKSON COUNTY MISSOURI	44-6000524	467578FS4	05-17-2011	24,674,279	CONSTRUCTION & EQUIPMENT		X		X		X
C	JACKSON COUNTY MISSOURI	44-6000524	46757BGJ3	09-04-2012	37,597,509	SPECIAL OBLIGATION REFUNDING		X		X		X
D	HEALTH & EDUCATIONAL FACILITIES AUTH OF MO	43-1178966		07-03-2013	12,000,000	CONSTRUCTION & EQUIPMENT		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	7,495,000		2,325,000		2,204,895		1,427,090
2 Amount of bonds legally defeased . . . . . . . . . . .	0		0		0		0
3 Total proceeds of issue . . . . . . . . . . . . . .	9,820,851		24,674,279		37,597,509		12,000,000
4 Gross proceeds in reserve funds . . . . . . . . . . . .	0		0		0		0
5 Capitalized interest from proceeds . . . . . . . . . . .	0		0		0		0
6 Proceeds in refunding escrows . . . . . . . . . . . .	0		0		0		0
7 Issuance costs from proceeds . . . . . . . . . . . .	50,581		289,279		451,929		199,950
8 Credit enhancement from proceeds . . . . . . . . . . .	139,000		0		0		0
9 Working capital expenditures from proceeds . . . . . . . . .	0		0		0		0
10 Capital expenditures from proceeds . . . . . . . . . . .	2,600,000		24,385,000		0		11,800,050
11 Other spent proceeds . . . . . . . . . . . . . .	7,170,000		0		37,145,579		0
12 Other unspent proceeds . . . . . . . . . . . . . .	0		0		0		0
13 Year of substantial completion . . . . . . . . . . . .	2006		2011		2012		2013
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .		X		X		X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X		X	X			X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2013

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X			X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .
6 Total of lines 4 and 5 . . . . . . . . . . . . .
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X		X
b Exception to rebate? . . . . . . . .		X		X		X		X
c No rebate due? . . . . . . . .		X		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .		X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider . . . . . . . . .	0		0		0
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was the hedge terminated? . . . . . .

Schedule K (Form 990) 2013

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X		X		X
b Name of provider . . . . . . . . .	0		0		0		0
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?		X		X		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation

Schedule K (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Truman Medical Center Incorporated

Employer identification number

44-0661018

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ...... $

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2013

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) SEE PART V

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
SCHEDULE L, PART VI, LINES 1 & 2	LINE 1: (A) JE DUNN CONSTRUCTION (B) PEGGY DUNN IS A DIRECTOR OF TMC AND IS ALSO A DIRECTOR OF JE DUNN CONSTRUCTION. (C) $2,519,341 (D) CONSTRUCTION SERVICES (E) NO

Schedule L (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Information about Schedule M (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Truman Medical Center Incorporated

Employer identification number

44-0661018

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..	X	1	3,300,000	MKT VALUE APPRAISAL
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that

it must hold for at least three years from the date of the initial contribution, and which is not required to be used

for exempt purposes for the entire holding period? ..................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2013)

Page 2

Part II

Supplemental Information. Provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE M, PART I, COLUMN B	THE INFORMATION PRESENTED IN COLUMN B IS THE NUMBER OF CONTRIBUTIONS.

Schedule M (Form 990) (2013)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

Truman Medical Center Incorporated

Employer identification number

44-0661018

Return Reference	Explanation
FORM 990, PART III, LINE 4A	ONE OF TRUMAN MEDICAL CENTERS (TMC) STRENGTHS IS THE ABILITY TO PROVIDE HIGH QUALITY, STATE-OF-THE-ART HEALTHCARE TO ALL OUR PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, OFFERING MORE THAN 50 PRIMARY, SPECIALTY AND MENTAL HEALTH CARE CLINICS AT TMC HOSPITAL HILL AND TMC LAKEWOOD. TMC ALSO HAS A NUMBER OF COMMUNITY-BASED PRIMARY AND MENTAL HEALTH CLINICS, TMCS PERSON-FIRST APPROACH PUTS THE HEALTH NEEDS OF THE PATIENT ABOVE PROFIT. WE ARE NATIONALLY RECOGNIZED FOR OUR PROGRAMS IN ASTHMA, DIABETES, SICKLE CELL, ORTHOPAEDICS, WOMENS HEALTH AND EMERGENCY/TRAUMA SERVICES. HOWEVER, WE OFFER MANY MORE SERVICES,INCLUDING OPHTHALMOLOGY, CARDIOLOGY, GASTROENTEROLOGY, ORAL SURGERY AND COMMUNITY BASED MENTAL HEALTH SERVICES. IN 2014, TMC PROVIDED OUTPATIENT CARE FOR 524,112 PATIENTS, WITH 201,725 OF THOSE BEING OUTPATIENT MENTAL HEALTH CARE SERVICES. TMCS MEDICAL PAVILIONS AT HOSPITAL HILL AND LAKEWOOD PROVIDE HIGH-QUALITY OUTPATIENT PRIMARY CARE, WHETHER A PATIENTS NEEDS INCLUDE A GENERAL PHYSICAL EXAM OR HELP WITH A SPECIFIC COMPLAINT. TMCS INTERNAL MEDICINE PHYSICIANS TREAT HIGH CHOLESTEROL, OSTEOPOROSIS, DIABETES, HIGH BLOOD PRESSURE, WOMENS HEALTH SERVICES, SURGICAL CONSULTATIONS AND SKIN DISORDERS, AMONG OTHERS. CHRONIC DISEASE MANAGEMENT AT TMC, TREATMENT OF ASTHMA IS BROAD AND INCLUDES STRIVING FOR EXCELLENCE IN ALL AREAS WHERE PATIENTS WITH ASTHMA ARE ENCOUNTERED. OUR GOAL IS TO PROVIDE SUPERIOR AND CONSISTENT CARE FOR THE PATIENT WITH ASTHMA WHETHER IT IS IN THE EMERGENCY DEPARTMENT, INPATIENT UNIT, CLINIC SETTING, RESEARCH OR THE COMMUNITY. TMC HOSPITAL HILL IS HOME TO THE AREAS AMERICAN LUNG ASSOCIATION ASTHMA CLINICAL RESEARCH CENTER (ACRC), AN ELITE NETWORK OF 18 NOT-FOR-PROFIT CLINICAL RESEARCH CENTERS DEDICATED TO ASTHMA TREATMENT RESEARCH, ATTRACTING SOME OF THE BEST ASTHMA INVESTIGATORS WORLDWIDE. THE ACRC NETWORK CONDUCTS LARGE CLINICAL TRIALS THAT WILL HAVE A DIRECT IMPACT ON PATIENT CARE AND ASTHMA TREATMENT. SEVERAL YEARS AGO, TMC INSTITUTED A COMPREHENSIVE ASTHMA PROGRAM THAT PROVIDES ASTHMA EDUCATION TO OUTPATIENTS AND INPATIENTS. IN AN EFFORT TO PROVIDE A CONSISTENT CONTINUUM OF CARE, PATIENTS ARE TREATED IN THE EMERGENCY DEPARTMENT USING A STANDARDIZED PROTOCOL BASED ON NATIONAL GUIDELINES FOR THE MANAGEMENT OF ASTHMA AND ARE REFERRED FOR FOLLOW-UP CARE TO OUR OUTPATIENT PULMONARY CLINIC TO HELP BREAK THE CYCLE OF EMERGENT CARE. THIS PROGRAM HAS RESULTED IN A SUBSTANTIAL REDUCTION IN ADMISSIONS FOR ASTHMA SUFFERERS. TMC SEES MORE NEARLY 10,000 PATIENTS EACH YEAR FOR THE TREATMENT AND CARE OF ASTHMA. DIABETES FIVE YEARS AGO, TMC HOSPITAL HILL OPENED A SPACIOUS NEW STATE-OF-THE-ART DIABETES CENTER TO BETTER SERVE THE NEEDS OF OUR PATIENTS. THE NEW SPACE INCLUDES A PATIENT RESOURCE CENTER WITH COMPUTER ACCESS, DIABETES EDUCATION CLASSROOM AND CONSULTATION ROOMS, A COMFORTABLE, ATTRACTIVE WAITING AREA; AND EXPANDED EXAM ROOMS WITH ADVANCED TECHNOLOGY TO SUPPORT THE ELECTRONIC HEALTH RECORD PROGRESSION. THE TMC DIABETES CENTER PROVIDES QUALITY CARE FOR OUR PATIENTS WITH DIABETES, HELPING TO MANAGE DIABETES ON A PLANNED, RATHER THAN EPISODIC BASIS. THE COMPREHENSIVE "TEAM APPROACH" CONNECTS PATIENTS WITH SPECIALLY-TRAINED PHYSICIANS AND NURSING STAFF. THE TEAM ALSO HELPS COORDINATE CARE WITH OTHER SPECIALTY SERVICE PROVIDERS, SUCH AS OPHTHALMOLOGY, CARDIOLOGY, PODIATRY, AND OTHER REFERRALS AS NEEDED. IN FISCAL YEAR 2014, TMC TREATED MORE THAN 14,000 PATIENTS FOR DIABETES. SICKLE CELL TMC HOSPITAL HILL IS ALSO ONE OF THE TOP PROVIDERS OF SICKLE CELL CARE IN THE REGION, WITH KANSAS CITYS ONLY ADULT SICKLE CELL CENTER. THE CENTER PROVIDES A VARIETY OF MEDICAL INPATIENT AND OUTPATIENT TREATMENTS, INCLUDING ANNUAL EXAMS, NUTRITIONAL COUNSELING, PHYSICAL THERAPY, LAB AND X-RAY EVALUATIONS AND PAIN MANAGEMENT COUNSELING. PATIENTS IN SICKLE CELL CRISIS FIND A HEALING ENVIRONMENT WHERE THEIR PAIN IS TREATED QUICKLY, MANY TIMES BYPASSING THE EMERGENCY DEPARTMENT, IN A SOOTHING SETTING OFFERING CALMING COLORS AND SOFT LIGHTING. IN 2014, 629 PATIENTS CONSIDER TMC AS THEIR MEDICAL HOME FOR SICKLE CELL CARE. WOMENS HEALTH SERVICES AS A NATIONAL CENTER OF EXCELLENCE IN WOMENS HEALTH, TMC SEEKS TO CONNECT WOMEN TO THE BEST RESOURCES AVAILABLE IN HEALTH CARE SERVICES; EDUCATION AND COMMUNITY OUTREACH, AND EMPOWER THE CAREGIVER TO MAKE HEALTHY DECISIONS FOR THEMSELVES AND OTHERS. WITH THESE OBJECTIVES AS THE FOCUS, TMC OFFERS A CONTINUUM OF HEALTH CARE SERVICES, INCLUDING FAMILY PLANNING, MID-LIFE SERVICES, BREAST HEALTH, THE SPECIALIZED TREATMENT OF VULVAR AND PELVIC PAIN DISEASES, OBSTETRICS, HYSTEROSCOPIC SURGERY AND ALTERNATIVES TO HYSTERECTOMY, ADOLESCENT GYNECOLOGY, AND WELL-WOMAN EXAMS. PATIENTS CAN RECEIVE OB/GYN SERVICES AND PRIMARY CARE, ALL IN ONE LOCATION. TMC PROVIDES DIAGNOSTIC BREAST HEALTH SERVICES, STREAMLINING THE PATIENT EXPERIENCE BY MAKING VIRTUALLY ALL OF THE COMPONENTS OF A BREAST EVALUATION AVAILABLE IN ONE CAMPUS LOCATION. TMC OFFERS CLINICAL BREAST EXAMS, MAMMOGRAMS, BREAST ULTRASOUNDS, FINE-NEEDLE ASPIRATIONS, AND AN IMAGING-ASSISTED BREAST BIOPSY TECHNIQUE THAT IS LESS INVASIVE THAN A TYPICAL SURGICAL BREAST BIOPSY. TMC IS ALSO ONE OF THE LARGEST PROVIDERS OF WOMEN, INFANTS AND CHILDREN (WIC) SERVICES IN THE STATE OF MISSOURI WITH 158,789 VISITS IN 2014. WIC PROVIDES HEALTHY FOODS, NUTRITION EDUCATION AND REFERRALS FOR WOMEN, INFANTS, AND CHILDREN UP TO THE AGE OF 5, WHO ARE AT NUTRITIONAL RISK AND MEET PROGRAM GUIDELINES. CARDIOLOGY SERVICES THE TMC CARDIOLOGY CENTER OFFERS PATIENTS A COMPLETE RANGE OF CARDIAC SERVICES FOR PREVENTION, EARLY DIAGNOSIS, TREATMENT AND RECOVERY IN A PATIENT-CENTERED ENVIRONMENT. TMCS CARDIOLOGY CENTER SPECIALIZES IN INTERVENTIONAL CARDIOLOGY, WHICH REFERS TO NON-SURGICAL TREATMENTS FOR HEART CONDITIONS. CARDIAC INTERVENTIONS ARE USED TO DIAGNOSE AND TREAT CORONARY ARTERY DISEASE, VALVULAR HEART DISEASE, HEART FAILURE AND CONGENITAL HEART DISEASE. THE CARDIOLOGY CENTER FEATURES A SOPHISTICATED CARDIAC CATHETERIZATION LAB, FOUR ADDITIONAL CLINIC ROOMS, INCREASED ECHOCARDIOGRAPHY TESTING CAPABILITIES AND A CARDIAC REHABILITATION SERVICE TO HELP PREVENT REPEAT HEART PROBLEMS. IN 2014, THE CARDIOLOGY CENTER PROVIDED MORE THAN 9,300 OUTPATIENT CLINIC VISITS, PERFORMED 914 CATHETERIZATION PROCEDURES, WHICH INCLUDED 601 HEART CATHETERIZATIONS (239 OF WHICH WERE STENT PLACEMENTS). GASTROENTEROLOGY SERVICES TMC'S GASTROENTEROLOGY (GI) CENTER ON HOSPITAL HILL WAS EXPANDED TO INCLUDE ENDOSCOPIC ULTRASOUND EQUIPMENT, ONE OF ONLY A FEW SUCH UNITS IN THE KANSAS CITY AREA, PROVIDING TMC PATIENTS ANOTHER METHOD FOR EARLY DETECTION OF CANCER. THE CENTER ALSO FEATURES THREE PROCEDURE ROOMS, A DEDICATED PREP AND RECOVERY AREA, IMPROVED PATIENT MONITORING EQUIPMENT, INCLUDING ADDITIONAL CARDIAC MONITORING CAPABILITIES WITH A CENTRAL MONITOR AT THE NURSING STATION, SIX EXAMS ROOMS - ALL WITH NEW EQUIPMENT INCLUDING A COMPUTER IN EACH ROOM, A DEDICATED TRIAGE ROOM, A LARGE EDUCATION CLASSROOM, AND A SPACIOUS NEW WAITING ROOM AREA. THE CENTER PROVIDES "ONE-STOP SHOPPING" FOR PATIENTS, WITH REGISTRATION/CHECK-IN AND FINANCIAL COUNSELING ALL IN SAME AREA. IN 2014, THE TMC GI CENTER TREATED MORE THAN 6,300 PATIENTS IN MORE THAN 13,000 PATIENT VISITS AND PERFORMED MORE THAN 6,900 PROCEDURES. OPHTHALMOLOGY SERVICES THE OPHTHALMOLOGY CLINICS AT TMC ARE FULL-SERVICE FACILITIES FOR THE MEDICAL AND SURGICAL TREATMENT OF EYE DISEASES. SERVICES RANGE FROM PRESCRIBING OF GLASSES AND FITTING OF CONTACT LENSES TO THE TREATMENT OF COMPLEX OCULAR DISORDERS. OUTPATIENT SURGERY AND LASER TREATMENT, INCLUDING REFRACTIVE LASER SURGERY, ARE ALSO PERFORMED. IN 2014, THE OPHTHALMOLOGY DEPARTMENT TREATED MORE THAN 18,389 PATIENTS. DENTISTRY AND ORAL SURGERY SERVICES ORAL & MAXILLOFACIAL SURGEONS MANAGE A WIDE VARIETY OF PROBLEMS RELATING TO THE MOUTH, TEETH AND FACIAL REGIONS, PRACTICING A WIDE SCOPE OF CARE WITH EXPERTISE RANGING FROM CORRECTIVE JAW SURGERY TO WISDOM TOOTH REMOVAL. THEY ALSO DIAGNOSE AND TREAT FACIAL INJURIES AND TEMPOROMANDIBULAR JOINT SYNDROME (TMJ) DISORDERS, AND PERFORM A FULL RANGE OF DENTAL IMPLANT PROCEDURES. TMC PROVIDES DIAGNOSIS AND TREATMENT OF ORAL AND FACIAL EMERGENCIES, BROKEN FACIAL BONES, AND PLACEMENT OF DENTAL IMPLANTS. THE FACIAL PAIN/TMJ CLINIC ALSO OFFERS DIAGNOSIS AND TREATMENT OF FACIAL PAIN AND (TMJ). MORE THAN 9,300 PATIENTS RECEIVED ORAL SURGICAL SERVICES AT TMC IN 2014 AND TREATED NEARLY 18,000 DENTAL PATIENTS AT THE TMC LAKEWOOD DENTAL CLINIC. OUTPATIENT MENTAL HEALTH SERVICES IN ADDITION TO OUTPATIENT PHYSICAL MEDICAL CARE SERVICES, TMC PROVIDES COMPREHENSIVE OUTPATIENT MENTAL HEALTH SERVICES. IN 2014, TMC BEHAVIORAL HEALTH PROVIDED 201,725 OUTPATIENT VISITS TO MORE THAN 18,000 PATIENTS. THESE SERVICES ARE AIMED AT ASSISTING CLIENTS IN MANAGING THE SYMPTOMS OF THEIR ILLNESS AND IN IMPROVING FUNCTIONING IN THEIR DAY-TO-DAY LIVES AND INCLUDE CASE MANAGEMENT, CRISIS AND OUTREACH SERVICES, MENTAL HEALTH ASSESSMENTS, EMPLOYMENT SERVICES, OCCUPATIONAL THERAPIES, PEER SUPPORT GROUPS, MEDI
FORM 990, PART III, LINE 4B	THE TRUMAN MEDICAL CENTERS (TMC) INCLUDES TMC HOSPITAL HILL, TMC LAKEWOOD AND TMC BEHAVIORAL HEALTH AND IS THE PRIMARY TEACHING HOSPITAL FOR THE UNIVERSITY OF MISSOURI-KANSAS CITY SCHOOLS OF MEDICINE, NURSING, DENTISTRY AND PHARMACY. TMC CARES FOR MORE THAN 112,000 INDIVIDUAL PATIENTS EACH YEAR. THESE PATIENTS RECEIVE, REGARDLESS OF THEIR FINANCIAL SITUATION OR ABILITY TO PAY, QUALITY, STATE-OF-THE-ART INPATIENT, OUTPATIENT AND EMERGENCY CARE THAT ENCOMPASS BOTH PHYSICAL AND MENTAL HEALTH CARE. TMC IS LICENSED FOR 353 INPATIENT ACUTE CARE (INCLUDING 19 NICU) AND 188 LONG-TERM CARE BEDS. IN FISCAL YEAR 2014 (JULY 1, 2013-JUNE 30, 2014), TMC HAD 19,017 INPATIENT ADMISSIONS AND PROVIDED 87,833 PATIENT DAYS OF CARE. AS THE PRIMARY SAFETY NET HOSPITAL IN THE KANSAS CITY, MISSOURI METROPOLITAN AREA, TMC TREATS A VULNERABLE PATIENT POPULATION WITH A HIGH DEGREE OF HEALTH CARE DISPARITY. THESE DISPARITIES CUT ACROSS ECONOMIC, RACIAL AND ETHNIC BOUNDARIES. MANY OF TMCS CLIENTELE HAVE MULTIPLE, POORLY MANAGED CHRONIC DISEASES SUCH AS DIABETES, ASTHMA, HEART FAILURE AND HYPERTENSION. THEY ARE FREQUENTLY ADMITTED TO A TMC HOSPITAL BECAUSE OF THESE CHRONIC ILLNESSES AND DUE TO SOME SOCIAL DISPARITIES, SUCH AS LACK OF TRANSPORTATION, OR A LANGUAGE BARRIER, THEIR ABILITY TO MANAGE THEIR CONDITION WITH PROPER MEDICATION AND FOLLOW-UP CARE IS DIFFICULT AND MANY TIMES, THEY END UP READMITTED FOR THEIR CONDITION. TMC WORKS DILIGENTLY TO OVERCOME THESE ETHNIC, SOCIAL AND RACIAL BARRIERS WHEN PATIENTS RECEIVE THEIR CARE. TMC HAS SPECIALIZED LANGUAGE INTERPRETERS ON STAFF AT BOTH HOSPITAL HILL AND LAKEWOOD LOCATIONS TO HELP ENSURE THAT PATIENTS WITH LIMITED PROFICIENCY IN ENGLISH OR DEAFNESS RECEIVE HIGH QUALITY, INDIVIDUALIZED CARE WITH COMMUNICATION ASSISTANCE. TMC IS ONE OF FEW HOSPITALS TO HAVE ON STAFF INTERPRETERS AVAILABLE AROUND THE CLOCK TO ASSIST PATIENTS WITH PAPERWORK AND COMMUNICATING, IN THEIR NATIVE LANGUAGE, WITH MEDICAL PROFESSIONALS. TMC INTERPRETER SERVICES HAS APPROXIMATELY 20 LANGUAGE INTERPRETERS ON STAFF THAT PROVIDES DIRECT TRANSLATIONS IN THREE MAJOR LANGUAGES, SPANISH, SOMALI AND ARABIC. ADDITIONALLY, 150 LANGUAGE INTERPRETATIONS ARE AVAILABLE VIA DUAL HANDSET TELEPHONIC INTERPRETING UNITS. IN FISCAL YEAR 2014, TMC LANGUAGE ACCESS PROVIDED 144,178 INTERPRETED ENCOUNTERS FOR PATIENTS. MENTAL HEALTH IS ESSENTIAL TO WELL-BEING AND CAN AFFECT SELF-IMAGE, RELATIONSHIPS, SLEEP, EATING, AND EVEN PHYSICAL HEALTH. MANY TIMES PATIENTS WITH CHRONIC DISEASES ALSO SUFFER FROM MENTAL ILLNESS AND/OR SUBSTANCE ABUSE AND ADDICTION PROBLEMS. GAINING ACCESS TO QUALITY, MENTAL HEALTH CARE SERVICES IS OFTEN DIFFICULT AND EXPENSIVE. IN MANY COMMUNITIES, INPATIENT MENTAL HEALTH FACILITIES DO NOT EXIST AND/OR ARE AT CAPACITY NEARLY 100 PERCENT OF THE TIME. TMC IS ONE OF ONLY A FEW HEALTH SYSTEMS THAT PROVIDE BOTH INPATIENT MEDICAL AND MENTAL HEALTH CARE BEDS. TMC BEHAVIORAL HEALTH OFFERS A COMPREHENSIVE ARRAY OF MENTAL HEALTH AND SUBSTANCE ABUSE TREATMENT SERVICES AT BOTH THE TMC HOSPITAL HILL AND TMC LAKEWOOD COUNSELING. ALL MENTAL HEALTH SERVICES ARE AIMED AT ASSISTING CLIENTS IN MANAGING THE SYMPTOMS OF THEIR ILLNESSES AND IN IMPROVING THEIR DAY-TO-DAY LIVES. TMC SERVICES ALSO PROVIDE THE SUPPORT MANY PERSONS WITH MENTAL ILLNESS NEED TO REGAIN A SENSE OF MEANING AND PURPOSE IN LIFE. TMC BEHAVIORAL HEALTH HAS 66 INPATIENT MENTAL HEALTH BEDS INCLUDING A SPECIALIZED GERIATRIC INPATIENT UNIT AT TMC LAKEWOOD, AND A MENTAL HEALTH EMERGENCY DEPARTMENT AT TMC HOSPITAL HILL. IN FY 2014, TMC BEHAVIORAL HEALTH TREATEDMORE THAN 18,023 PATIENTS, WITH 2,266 PATIENTS ADMITTED FOR INPATIENT MENTAL HEALTH CARE AT A TMC FACILITY. WOMENS HEALTH TMC OFFERS FULL WOMENS HEALTH SERVICES AND IS THE BIRTHPLACE TO MORE THAN ONE-THIRD OF ALL BABIES BORN IN JACKSON COUNTY, MISSOURI. TMC HOSPITAL HILL SPECIALIZES IN HIGH-RISK PREGNANCIES AND BIRTHS AND IS HOME TO A 19-BED, LEVEL III NEONATAL INTENSIVE CARE UNIT (NICU), ONE OF THE LARGEST IN THE AREA, THAT PROVIDES COMPASSIONATE CARE TO THE MOST ILL OF NEWBORNS. IN FISCAL YEAR 2014, TMC DELIVERED 3,483 BABIES. A LITTLE UNDER FOUR YEARS AGO, TMC LAKEWOOD OPENED A RENOVATED AND EXPANDED LABOR AND DELIVERY UNIT SERVING THE PEOPLE OF EASTERN JACKSON COUNTY. THIS NEW UNIT ALSO INCLUDES A LEVEL II NICU. THE LAKEWOOD FAMILY BIRTHPLACE HAS HAD A NEARLY 88 PERCENT INCREASE IN BIRTHS SINCE OPENING AT THE END OF 2011.
FORM 990, PART III, LINE 4C	TRUMAN MEDICAL CENTERS EMERGENCY DEPARTMENTS PROVIDED CARE TO MORE THAN 101,000 PATIENTS IN 2014, WITH MORE THAN 71,000 OF THOSE VISITS AT TMC HOSPITAL HILL, MAKING IT ONE OF THE BUSIEST ADULT EMERGENCY DEPARTMENTS IN THE KANSAS CITY METRO AREA. THE TMC LAKEWOOD EMERGENCY DEPARTMENT HAS A STAFF OF TEN BOARD CERTIFIED EMERGENCY MEDICINE PHYSICIANS AND 36 NURSES PROVIDING IMMEDIATE, COMPASSIONATE, QUALITY CARE TO MORE THAN 30,000 RESIDENTS OF EASTERN JACKSON COUNTY, MISSOURI EACH YEAR. AS A DESIGNATED LEVEL 1 TRAUMA CENTER, ONE OF ONLY FIVE IN THE REGION, THE TMC HOSPITAL HILL EMERGENCY DEPARTMENT (ED) CONSISTS OF A TEAM OF NEARLY 25 PHYSICIANS AND MORE THAN 125 NURSES SPECIALLY TRAINED IN TREATING TRAUMA AND CRITICAL CARE INJURIES. TRAUMA SURGEONS AND OTHER MEMBERS OF THE TRAUMA TEAM ARE IN THE HOSPITAL 24-HOURS A DAY, SEVEN DAYS A WEEK. AIM 4 PEACE AS AN ACADEMIC SAFETY NET HOSPITAL IN KANSAS CITY, MISSOURI, TMC RECEIVES A SIGNIFICANT AMOUNT OF PENETRATING TRAUMA. AIM 4 PEACE, AS THE VIOLENCE AND INJURY PREVENTION PROGRAM, IS FOCUSED ON THE REDUCTION OF INTENTIONAL GUNSHOT INCIDENTS AND ESTABLISHES A MECHANISM TO FACILITATE COLLABORATIVE EFFORTS BETWEEN THE TWO IN ENGAGING AND ASSISTING THE CITIZENS OF KANSAS CITY TO MANAGE PROBLEMS IN A MORE CONSTRUCTIVE MANNER. AS THE ONLY HOSPITAL IN ASSOCIATION WITH AIM 4 PEACE, TMC HAS THE UNIQUE OPPORTUNITY TO INTERVENE, IN CONCERT WITH THE INTERVENTION SPECIALIST, TO AFFECT A CULTURE SHIFT IN WHAT IS ACCEPTED AS THE NORM AMONG THE PERPETRATORS OF VIOLENT CRIME WHILE REDUCING RECIDIVISM IN THE EMERGENCY DEPARTMENT. TMC IS LISTED IN THE NATIONAL DIRECTORY OF HOSPITAL-BASED VIOLENCE INTERVENTION AND PREVENTION PROGRAMS. SINCE INCEPTION OF PROGRAM GUN-RELATED VIOLENCE HAS DECREASED IN THE FOUR TARGETED "GROUND ZERO ZONES." AGGRAVATED ASSAULT IN THE EAST PATROL DIVISION DROPPED 5% AND HOMICIDES EXPERIENCED A 20% REDUCTION FROM 2006 THROUGH 2012. THE AIM 4 PEACE PUBLIC HEALTH MODEL USES AN EVIDENCE BASED APPROACH AND HAS CREATED HEALTH CARE AND LAW ENFORCEMENT SAVINGS THROUGH GANG RELATED MEDIATION. NO QUANTITATIVE UPDATES RELATED TO COST SAVINGS HAVE BEEN RELEASED SINCE 2010. REORGANIZATION OF THE PROGRAM THROUGH THE KANSAS CITY HEALTH DEPARTMENT IS IN PROGRESS. SEXUAL ABUSE NURSE EXAMINER (SANE) THE TMC HOSPITAL HILL EMERGENCY DEPARTMENT HAS A SEXUAL ABUSE NURSE EXAMINER (SANE) ON SITE TO PROVIDE A THOROUGH FORENSIC EXAMINATION OF WOMEN WHO HAVE BEEN THE VICTIMS OF RAPE. WHEN A WOMAN ENTERS THE EMERGENCY DEPARTMENT CLAIMING A SEXUAL ASSAULT OR RAPE, SHE IS SENT TO A SANE AND TAKEN TO A PRIVATE ROOM FOR EXAMINATION. THE KANSAS CITY SANE PROGRAM HAS MADE A PROFOUND DIFFERENCE IN THE QUALITY OF CARE PROVIDED TO SEXUAL ASSAULT VICTIMS. SANES OFFER VICTIMS PROMPT, COMPASSIONATE CARE AND COMPREHENSIVE FORENSIC EVIDENCE COLLECTION. IN ADDITION TO HELPING PRESERVE THE VICTIM'S DIGNITY AND REDUCE PSYCHOLOGICAL TRAUMA, SANES ENHANCE EVIDENCE COLLECTION FOR MORE EFFECTIVE INVESTIGATIONS AND BETTER PROSECUTIONS. PARTICULARLY IN NONSTRANGER SEXUAL ASSAULT CASES, THOROUGH DOCUMENTATION OF EVIDENCE CORROBORATING A VICTIM'S ACCOUNT OF AN ASSAULT BY ESTABLISHING LACK OF CONSENT LEADS TO MORE PROSECUTIONS THAT ARE SUCCESSFUL. TMCS SANE HAS ALSO HELPED TO PROVIDE LEADERSHIP IN THE COMMUNITY BY EDUCATING AND TRAINING OTHER POTENTIAL SANES. EACH YEAR NEARLY 100 WOMEN ARE CARED FOR AND EXAMINED BY THE TMC SANE IN THE HOSPITAL HILL EMERGENCY DEPARTMENT. TRAUMA RESEARCH IN ADDITION TO PATIENT CARE, LEVEL ONE TRAUMA CENTERS CONDUCT RESEARCH PROGRAMS, HEALTHCARE PROVIDER EDUCATION, COMMUNITY OUTREACH PROGRAMS, AND IS A REFERRAL RESOURCE FOR COMMUNITIES IN NEARBY REGIONS. THE TRAUMA RESEARCH TEAM IS CURRENTLY CONDUCTING SEVERAL EXCITING RESEARCH PROJECTS INCLUDING PHARMACEUTICAL-SPONSORED TRIALS, GRANT-FUNDED RESEARCH AND ORIGINAL PROJECTS. ALL PROJECTS ARE DESIGNED WITH THE OBJECTIVE OF OPTIMIZING CARE OF THE TRAUMATICALLY INJURED PATIENT. RESEARCH PROJECTS IN PROGRESS DURING FISCAL 2014 INCLUDE: A) ACUTE SPINAL CORD INJURY STUDY: THE GOAL OF THIS STUDY IS TO IDENTIFY THE SAFETY AND EFFECTIVENESS OF A STUDY DRUG, SUN 13837 INJECTION, WHEN COMPARED TO A PLACEBO IN ADULT SUBJECTS WITH ACUTE CERVICAL SPINAL CORD INJURIES. THIS STUDY IS SPONSORED BY ASUBIO PHARMACEUTICALS, INC. B) HEMORRHAGIC SHOCK STUDY: INVESTIGATING THE MECHANISMS OF CELL INJURY FOLLOWING HEMORRHAGIC SHOCK, AND SPECIFICALLY HOW THE DEVELOPMENT OF SHOCK LEADS TO THE DEPLETION OF CELLULAR ENERGY STORES AND CELL DEATH. THE GOAL OF THIS RESEARCH PROGRAM IS TO DEVELOP NEW TREATMENTS FOR HEMORRHAGIC SHOCK WHICH CAN BE ADMINISTERED BEFORE OR DURING INITIAL RESUSCITATION. C) SEPTIC SHOCK STUDY: INVESTIGATING THE CYTOKINE RESPONSE OF SEPTIC PATIENTS VERSUS THAT OF HEALTHY VOLUNTEERS. THE RESULTS OF THIS RESEARCH ARE EXPECTED TO PROVIDE NEW INFORMATION ON CELLULAR MECHANISMS OF THE SYSTEMIC INFLAMMATORY RESPONSES. D) INDIRECT CALORIMETRY STUDY: EVALUATING THE ACCURACY OF THE QUARK RMR MACHINE FOR INDIRECT CALORIMETRY IN PATIENTS ON VENTILATORS AS COMPARED TO A METHOD USING GAS COLLECTION AND ANALYSIS. E) VITAMIN D STUDY: RETROSPECTIVE CHART REVIEW LOOKING AT INCIDENCE OF VITAMIN D DEFICIENCY IN PATIENTS ADMITTED TO A MIDWEST URBAN HOSPITAL. F) ANATOMIC RECONSTRUCTION VERSUS HOOK PLATE RECONSTRUCTION IN PATIENTS WITH TYPE III AND TYPE V ACRONMIOCLAVICULAR (AC) JOINT SEPARATIONS: A COMPARION, INVESTIGATOR INITIATED. INCIDENCE OF PRIMARY CARE IN THE INJURED PATIENT. INVESTIGATOR INITIATED. PERFORMANCE IMPROVEMENT PATIENT SAFETY (PIPS) THE PERFORMANCE IMPROVEMENT PATIENT SAFETY (PIPS) IS AN IMPORTANT PART OF THE TRAUMA PROGRAM AT TMC HOSPITAL HILL. THE PERFORMANCE IMPROVEMENT AND PATIENT SAFETY PROGRAM WORKS TOWARD IMPLEMENTING A SYSTEM OF PATIENT CARE DELIVERY THAT FOCUSES ON THE ACHIEVEMENT OF OUTCOMES WITHIN EFFECTIVE TIME FRAMES AND WITH APPROPRIATE USE OF RESOURCES. THE AREAS OF MONITORING AND IMPROVING INCLUDE PRE-HOSPITAL CARE, EMERGENCY DEPARTMENT, AND INPATIENT STAY, TO REHABILITATION. THE PRIMARY FOCUS IS ON THE PROMPTNESS, DOCUMENTATION, AND APPROPRIATENESS OF CARE ALONG WITH PATIENT OUTCOMES. ADVANCED TRAUMA CARE FOR NURSES CONTINUING MEDICAL EDUCATION IS NOT JUST A REQUIREMENT IT IS A NECESSITY TO ENHANCE THE KNOWLEDGE AND ABILITIES OF THE MEDICAL PROFESSIONAL. TRUMAN MEDICAL CENTER HOSPITAL HILL WAS THE FIRST HOSPITAL TO BRING ADVANCED TRAUMA CARE FOR NURSES (ATCN) TO THE KANSAS CITY METROPOLITAN AREA. THE COURSE IS GEARED TOWARD NURSING STAFF IN THE EMERGENCY DEPARTMENT AND INTENSIVE CARE UNITS. WHEN NURSES COMPLETE THE ATCN CLASS AND WORK ALONG SIDE 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 SENIOR DIRECTOR OF BUDGET AND DECISION SUPPORT 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, THE AUDIT COMMITTEE (A SUB-COMMITTEE OF THE BOARD) REVIEWS THE 990 BEFORE IT IS FILED. FINAL COPIES OF THE 990 ARE AVAILABLE TO ALL BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 12C	THE TMC POLICY IS NO TMC EXECUTIVE WILL DISADVANTAGE TRUMAN MEDICAL CENTER'S, INCORPORATED (TMC'S) INTEREST AS A RESULT OF A PRIVATE INTEREST. THIS POLICY APPLIES TO TMC EMPLOYEES FROM THE LEVEL OF ASSOCIATE ADMINISTRATOR UP TO PRESIDENT, AND TO TMC-EMPLOYED PHYSICIANS (HEREINAFTER, COLLECTIVELY "EXECUTIVES"). THE PURPOSE OF THE POLICY AND PROCEDURE IS TO PROTECT THE INTEREST OF TMC, WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF A TMC EXECUTIVE. EXECUTIVES HAVE THE FIDUCIARY DUTY TO ACT IN GOOD FAITH WITH DUE REGARD FOR THE BEST INTERESTS OF THE INSTITUTION. WHENEVER AN EXECUTIVE FIRST BECOMES AWARE OF A PROPOSED OR ACTUAL TRANSACTION TO WHICH THE EXECUTIVE OR FAMILY MEMBER IS A PARTY, REGARDLESS OF THE DOLLAR AMOUNT OF THE TRANSACTION, THE EXECUTIVE SHALL MAKE A PROMPT, FULL AND FRANK DISCLOSURE TO THE CONFLICT OF INTEREST PANEL (VIA THE DIRECTOR OF INTERNAL AUDIT) OF ALL MATERIAL FACTS OF THE TRANSACTION AND THE EXECUTIVE'S INTEREST. THIS DISCLOSURE SHALL BE MADE BEFORE TMC ENTERS INTO OR APPROVES THE TRANSACTION AND THE EXECUTIVE SHALL NOT PARTICIPATE IN OR BE PRESENT DURING THE CONSIDERATION OF THE PROPOSED TRANSACTION, EXCEPT THAT THE EXECUTIVE MAY STATE A POSITION ON THE MATTER AND MAY ANSWER PERTINENT QUESTIONS. THE PANEL, WITH THE SUPPORT OF THE APPROPRIATE TMC MANAGERS OTHER THAN THE CONFLICTED EXECUTIVE, SHALL DETERMINE WHETHER TMC COULD OBTAIN A MORE ADVANTAGEOUS TRANSACTION WITH REASONABLE EFFORT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. EACH EXECUTIVE SHALL ANNUALLY DISCLOSE THE NATURE OF PERSONAL INTERESTS OF THE EXECUTIVE OR FAMILY MEMBERS IN EACH ORGANIZATION WITH WHICH TMC HAS DONE BUSINESS IN THE PAST YEAR OR MAY DO BUSINESS IN THE COMING YEAR. THE DIRECTOR OF INTERNAL AUDIT SHALL RECEIVE, COMPILE, AND ANALYZE THE DISCLOSURES WITHIN 90 DAYS OF DISTRIBUTING THE ANNUAL DISCLOSURE STATEMENTS TO EXECUTIVES, AND SHALL IDENTIFY ANY POTENTIAL ISSUES. THE PANEL COLLECTIVELY IS RESPONSIBLE FOR ENSURING THAT EACH EXECUTIVE COMPLIES WITH THE POLICY AND WITH APPLICABLE RELATED POLICIES AND PROCEDURES. IF THE PANEL DETERMINES THAT AN EXECUTIVE HAS VIOLATED OR MAY VIOLATE SUCH A POLICY, THE PANEL SHALL NOTIFY THE EXECUTIVE OF THE STEPS TO BE TAKEN TO RECTIFY THE SITUATION. IF THE PANEL IS UNABLE TO EFFECT AN ADJUSTMENT OF THE MATTER TO ITS SATISFACTION, IT SHALL REPORT THE MATTER TO THE EXECUTIVE'S SUPERVISOR OR OTHER APPROPRIATE SUPERVISORY AUTHORITY WITH A RECOMMENDATION FOR REMEDY OR SANCTION. ADDITIONALLY, EXECUTIVES REMAIN SUBJECT TO THE RELATED POLICIES THAT APPLY TO ALL TMC EMPLOYEES, INCLUDING CONFLICT OF INTEREST POLICY, CORPORATE CODE OF CONDUCT AND EMPLOYEE HANDBOOK.
FORM 990, PART VI, SECTION B, LINES 15A & 15B	THE EXECUTIVE COMPENSATION COMMITTEE (ECC) IS A SEPARATE COMMITTEE OF THE BOARD OF DIRECTORS. THE ECC REVIEWS 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.
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 $ (6,527,647) TRANSFER TO AFFILIATE 115,365 CHANGE IN DEFINED BENEFIT PENSION PLAN (9,000,450) ----------- TOTAL ($ 15,412,462)

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Truman Medical Center Incorporated

Employer identification number

44-0661018

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) AUXILIARY TO TRUMAN MEDICAL CENTER 2301 HOLMES KANSAS CITY,MO64108 43-6099279	SUPPORT	MO	501(C)(3)	11C	NA		No
(2) TMC PROF & GENERAL LIABILITY SELF-INS 2301 HOLMES KANSAS CITY,MO64108 43-1946384	LIABILITY INS	MO	501(C)(3)	11B	NA		No
(3) TMC FINANCE SUPPORT CORPORATION 2301 HOLMES KANSAS CITY,MO64108 27-1994129	SUPPORT	MO	501(C)(3)	11A	TMC	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2013

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No

Schedule R (Form 990) 2013

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

Yes

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) TMC FINANCE SUPPORT CORPORATION	R	115,635	COST

Schedule R (Form 990) 2013

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V?UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V?UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2013

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

TY 2013 AffiliatedGroupSchedule

Name:

Truman Medical Center Incorporated

EIN: 44-0661018

Affiliated Group Business Name:

TRUMAN MEDICAL CENTER INCOR

Address. Either US or Foreign Type:

2301 HOLMES STREET

KANSAS CITY,

64108

EIN:

44-0661018

Electing Organization Checkbox:

Total Grassroots Lobbying:

30,138

Total Direct Lobbying:

45,670

Total Lobbying Expenditures:

75,808

Other Exempt Purpose Expenditures:

496,806,139

Total Exempt Purpose Expenditures:

496,881,947

Lobbying Nontaxable Amount:

1,000,000

Grassroots Nontaxable Amount:

250,000

Tot Lobbying Grassroot Minus Non Tx:

Tot Lobby Expend Mns Lobbying Non Tx:

Share Of Excess Lobbying:

Affiliated Group Business Name:

TMC FINANCE SUPPORT CORPORAT

Address. Either US or Foreign Type:

2301 HOMES STREET

KANSAS CITY,

64108

EIN:

27-1994129

Electing Organization Checkbox:

Total Grassroots Lobbying:

Total Direct Lobbying:

Total Lobbying Expenditures:

Other Exempt Purpose Expenditures:

Total Exempt Purpose Expenditures:

Lobbying Nontaxable Amount:

Grassroots Nontaxable Amount:

Tot Lobbying Grassroot Minus Non Tx:

Tot Lobby Expend Mns Lobbying Non Tx:

Share Of Excess Lobbying:

1	Briefly describe the organization’s mission or most significant activities: TRUMAN MEDICAL CENTER IS AN ACADEMIC HEALTH CENTER PROVIDING ACCESSIBLE, STATE-OF-THE-ART QUALITY HEALTHCARE TO OUR COMMUNITY REGARDLESS OF ABILITY TO PAY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	33
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	29
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	4,832
6	Total number of volunteers (estimate if necessary) .............	6	773
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	21,692,993	24,120,540
9	Program service revenue (Part VIII, line 2g) .........	451,625,739	365,061,762
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	3,546,486	182,768
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	16,544,843	29,306,218
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	493,410,061	418,671,288
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	34,873	4,460,660
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	253,836,072	252,379,769
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	244,280,761	240,041,518
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	498,151,706	496,881,947
19	Revenue less expenses. Subtract line 18 from line 12.......	-4,741,645	-78,210,659
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	298,845,654	291,443,217
21	Total liabilities (Part X, line 26).............	226,851,124	313,071,808
22	Net assets or fund balances. Subtract line 21 from line 20.....	71,994,530	-21,628,591

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 197,454,923 including grants of $ 4,460,660 ) (Revenue $ 177,465,591 )
	OUTPATIENT DEPARTMENT- SEE SCHEDULE O

4b	(Code: ) (Expenses $ 179,903,374 including grants of $ ) (Revenue $ 161,690,872 )
	INPATIENT CARE- SEE SCHEDULE O

4c	(Code: ) (Expenses $ 61,430,420 including grants of $ ) (Revenue $ 55,211,517 )
	EMERGENCY DEPARTMENT- SEE SCHEDULE O

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses438,788,717

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	3,692,809	0	843,122

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		12,747,734
e	Government grants (contributions)1e		7,305,295

f	All other contributions, gifts, grants, and similar amounts not included above1f		4,067,511

g	Noncash contributions included in lines 1a-1f:$		3,300,000
h	Total. Add lines 1a-1f.......			24,120,540
			Business Code
2a	NET PATIENT SERVICE REVENUE		621110	253,004,933	253,004,933
b	EXPENSE REIMBURSEMENT		621110	2,153,715	2,153,715
c	MEDICAID ENHANCEMENTS		621110	73,634,249	73,634,249
d	LOCAL GOVERNMENT SUBSIDY		900099	36,268,865	36,268,865
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			365,061,762
3	Investment income (including dividends, interest, and other similar amounts).......			182,768			182,768
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss).......			0
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss)..........			0
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a	MEDICAL STAFF REVENUE		900099	152,680	152,680
b	340B REVENUE		900099	18,050,171	18,050,171
c	EHR MEANINGFUL USE		900099	2,656,492	2,656,492
d	All other revenue ....			8,446,875	8,446,875
e	Total. Add lines 11a–11d ......			29,306,218
12	Total revenue. See Instructions......			418,671,288	394,367,980		182,768


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			190,997	1	2,448,222
2	Savings and temporary cash investments .........			25,913	2	29,382
3	Pledges and grants receivable, net ...........			1,244,999	3	1,669,572
4	Accounts receivable, net .............			72,065,821	4	58,373,241
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			4,904,508	8	5,671,996
9	Prepaid expenses and deferred charges ..........			3,515,824	9	7,244,999
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	479,619,730
b	Less: accumulated depreciation .....	10b	297,363,261	180,131,186	10c	182,256,469
11	Investments—publicly traded securities ..........			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 .....			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			36,766,406	15	33,749,336
16	Total assets. Add lines 1 through 15 (must equal line 34)......			298,845,654	16	291,443,217
17	Accounts payable and accrued expenses .........			125,978,280	17	204,038,887
18	Grants payable .................			0	18	0
19	Deferred revenue ................			0	19	0
20	Tax-exempt bond liabilities .............			62,292,595	20	70,955,623
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			31,402,075	23	27,110,591
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			7,178,174	25	10,966,707
26	Total liabilities. Add lines 17 through 25.........			226,851,124	26	313,071,808
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			53,991,424	27	-32,624,147
28	Temporarily restricted net assets ...........			14,810,008	28	7,802,458
29	Permanently restricted net assets ...........			3,193,098	29	3,193,098
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			71,994,530	33	-21,628,591
34	Total liabilities and net assets/fund balances ........			298,845,654	34	291,443,217