TY 2015 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) Charles Schellhorn...................................................................... Chairman	1.00 .................	X	X	0	0
(2) Debbie Sosland-Edelman...................................................................... Vice Chairman	1.00 .................	X	X	0	0
(3) Elizabeth Braham...................................................................... Treasurer	1.00 .................	X	X	0	0
(4) David Goebel...................................................................... Secretary	1.00 .................	X	X	0	0
(5) Bill Krueger...................................................................... Director	1.00 .................	X		0	0
(6) Dr Carolyn Davis...................................................................... Director	1.00 .................	X		0	0
(7) Paul McLaughlin...................................................................... Director	1.00 .................	X		0	0
(8) Andrew Teigen...................................................................... Director	1.00 .................	X		0	0
(9) Jonathan Baum...................................................................... Director	1.00 .................	X		0	0
(10) Kathy Perryman MD...................................................................... Director	1.00 .................	X		0	0
(11) John Ovel...................................................................... Director	1.00 .................	X		0	0
(12) Tom Weir...................................................................... Director	1.00 .................	X		0	0
(13) Gerald Woods MD...................................................................... Director	40.00 .................	X		339,917	39,564
(14) Randall L O'Donnell PhD...................................................................... Director; President & CEO	40.00 .................	X	X	1,502,633	99,006
(15) Charles Roberts MD...................................................................... EVP & Exec.Medical Director	40.00 .................		X	766,971	31,932
(16) Sandra AJ Lawrence...................................................................... Executive VP & CAO	40.00 .................		X	713,654	35,589
(17) Karen S Cox RN PhD FAAN...................................................................... Executive VP & Co-COO	40.00 .................		X	705,924	34,758

(A) Name and business address	(B) Description of services	(C) Compensation
Anesthesia Associates 8717 West 110th Street Overland Park,KS66210	Anesthesiologists	29,659,855
Lytle Construction Inc 1100 SW Hamblen Rd Lees Summit,MO64081	Construction	13,560,636
Sodexho Marriott Services Inc 4880 Paysphere Circle Chicago,IL80674	Food Services	9,021,479
BSA Lifestructures Inc 9365 Counselors Row Indianapolis,IN46240	Construction	3,261,192
University Physician Associate 2310 Holmes Street Kansas City,MO64108	Physicians	3,095,970
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 417

- 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.
right arrow

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

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

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

The Children's Mercy Hospital

Employer identification number

44-0605373

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 (Form 990 or 990-EZ))

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 in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

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

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 VI.)..
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 section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. 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—2014. 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—2015. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. 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 VI 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) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 VI.) ..
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 section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. 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—2014. 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) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

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

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

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

2015

Name of the organization

The Children's Mercy Hospital

Employer identification number

44-0605373

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, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) 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), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions 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 an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 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 an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled 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 totaling $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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization The Children's Mercy Hospital

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	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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization The Children's Mercy Hospital		Employer identification number 44-0605373

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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization The Children's Mercy Hospital			Employer identification number 44-0605373
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ 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) (2015)

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

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

OMB No. 1545-0047

2015

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

The Children's Mercy Hospital

Employer identification number

44-0605373

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

$ 3,145

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

$ 315

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-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

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).
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) ...............................................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...........................................	374,689
c	Total lobbying expenditures (add lines 1a and 1b) .......................................................................	374,689
d	Other exempt purpose expenditures .........................................................................................	989,094,184
e	Total exempt purpose expenditures (add lines 1c and 1d) ....................................................................	989,468,873
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.	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
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ..........................................................................	0
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ...........................................................................	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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2012	(b) 2013	(c) 2014	(d) 2015	(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	431,136	615,259	382,374	374,689	1,803,458

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

Schedule C (Form 990 or 990-EZ) 2015

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 on 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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Part I-A, Line 1:	The Hospital remains neutral in political affairs and in no way endorses or opposes any candidate. However, payments were made to other organizations, which, unbeknownst to the Hospital, included funds directed toward political campaign activity. No organizational managers were aware such payments were going to be used towards political expenditures. We are appropriately reporting such payments, and paying the imposed 4955 excise tax. There was no intention to direct funds to support political activities, and this error involved very small amounts which are minor in relation to the Hospital's exempt purpose activities.
Part I-B, Line 4a:	As soon as the error was uncovered internally, safeguards were immediately established, including implementing specific procedures to prevent future unintentional diversion of funds for political expenditures. We have corrected the activity, including efforts to recover the expenditures to the extent possible.

Return Reference

Explanation

Part I-A, Line 1:

The Hospital remains neutral in political affairs and in no way endorses or opposes any candidate. However, payments were made to other organizations, which, unbeknownst to the Hospital, included funds directed toward political campaign activity. No organizational managers were aware such payments were going to be used towards political expenditures. We are appropriately reporting such payments, and paying the imposed 4955 excise tax. There was no intention to direct funds to support political activities, and this error involved very small amounts which are minor in relation to the Hospital's exempt purpose activities.

Part I-B, Line 4a:

As soon as the error was uncovered internally, safeguards were immediately established, including implementing specific procedures to prevent future unintentional diversion of funds for political expenditures. We have corrected the activity, including efforts to recover the expenditures to the extent possible.

Schedule C (Form 990 or 990EZ) 2015

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

The Children's Mercy Hospital

Employer identification number

44-0605373

Part I

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

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of 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" on 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on 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)

Revenue included on 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:

Revenue included on 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) 2015

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
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, for escrow or custodial account liability?

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" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	48,208,836	48,018,417	41,996,791	38,607,709	41,124,198
b	Contributions ...	5,953,303	2,780,952	1,926,665	961,835	755,549
c	Net investment earnings, gains, and losses	-1,112,327	-916,648	5,685,649	4,052,039	-1,440,270
d	Grants or scholarships ...	1,737,990	1,673,885	1,590,688	1,624,792	1,831,768
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	51,311,822	48,208,836	48,018,417	41,996,791	38,607,709

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 on 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)

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

3a(ii)

Yes

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

Yes

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' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	21,300,491		21,300,491
b	Buildings	581,932,129	221,800,009	360,132,120
c	Leasehold improvements
d	Equipment ...	436,812,583	338,399,549	98,413,034
e	Other ...	44,830,538		44,830,538
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				524,676,183

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on 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
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

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

(a) Description				(b) Book value
(1) Other Assets				39,286,344
(2) Income Beneficiary and Charitable Remainder Trusts				39,738,358
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				79,024,702

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
Reserve for Prof. Liability Claims	49,537,301
Deferred Lease Incentive	766,865
Postretirement Medical Liability	35,862,746
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	86,166,912
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) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) 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
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
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
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
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
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
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
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

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

Part V, Line 4:

Endowment funds are held by The Children's Mercy Hospital and The Children's Mercy Hospital Foundation, a supporting organization of The Children's Mercy Hospital. The endowment funds are intended to provide a permanent source of funding for designated activities carried out by The Children's Mercy Hospital, the funds for which are provided from the earnings and principal of these endowment funds.

Part X, Line 2:

FIN 48 Footnote: The Hospital and its affiliates follow ASC Subtopic 740-10, Income Taxes - Overall. ASC Subtopic 740-10 provides specific guidance on how to address uncertainty in accounting for income tax assets and liabilities, prescribing recognition thresholds and measurement attributes. At June 30, 2016 and 2015, there were no uncertain tax positions.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

See separate instructions. Right pointing arrow large image

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization
The Children's Mercy Hospital

Employer identification number

44-0605373

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.

For grantmakers.Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in region	(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in region	(f) Total expenditures for and investments in region
	North America			Program Services	Travel for healthcare-related education and information sharing	60,907
	Central America & the Caribbean			Program Services	Travel for healthcare-related education and information sharing	33,395
	Europe			Program Services	Travel for healthcare-related education and information sharing	80,856
	East Asia & the Pacific			Program Services	Travel for healthcare-related education and information sharing	32,983
	Middle East & North Africa			Program Services	Travel for healthcare-related education and information sharing	3,493
	South Asia			Program ServicesProgram Services	Travel for healthcare-related education and information sharing	1,766
	Sub-Saharan Africa			Program Services	Travel for healthcare-related education and information sharing	44,161
	South America			Program Services	Travel for healthcare-related education and information sharing	3,611









3a	Sub-total .....	0	0			261,172
b	Total from continuation sheets to Part I ...	0	0			0
c	Totals (add lines 3a and 3b)	0	0			261,172

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2015

Schedule F (Form 990) 2015

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(a)(c) Region	(b)(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2015

Schedule F (Form 990) 2015Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

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

Schedule F (Form 990) 2015

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2015

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

ReturnReference	Explanation
Part I, line 3:	Method Used to Account for Expenditures: Actual expenses for international travel

Schedule F (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

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

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization
The Children's Mercy Hospital

Employer identification number

44-0605373

Part I

Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










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

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

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

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2015

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 Gala/Auction (event type)	(b) Event #2 Event/Auction (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	1,786,602	1,722,083	3,508,685
2	Less: Contributions . . . .	1,411,477	1,395,324	2,806,801
3	Gross income (line 1 minus line 2) . . . . . .	375,125	326,759	701,884

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .	145,160	3,503	148,663
7	Food and beverages . . .	172,111	38,157	210,268
8	Entertainment . . . .	4,314		4,314
9	Other direct expenses . . .	83,131	141,320	224,451
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .			587,696
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .			114,188

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .	83,131	141,320	224,451

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2015

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2015

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" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

The Children's Mercy Hospital

Employer identification number

44-0605373

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 30000.0000000000 %

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 50000.0000000000 %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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? . . . . . .

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		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(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) . . .	322	5,779	15,061,894	941,120	14,120,774	1.200 %
b	Medicaid (from Worksheet 3, column a) . . . . .	363	364,198	556,065,793	430,888,370	125,177,423	10.660 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	315	38,526	42,710,874	23,758,199	18,952,675	1.610 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	1,000	408,503	613,838,561	455,587,689	158,250,872	13.470 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	30	108,183	8,724,302	1,022,077	7,702,225	0.660 %
f	Health professions education (from Worksheet 5) . . .	48	10,419	42,717,729	15,447,119	27,270,610	2.320 %
g	Subsidized health services (from Worksheet 6) . . . .	133	140,892	78,682,094	64,787,905	13,894,189	1.180 %
h	Research (from Worksheet 7) .	353	0	14,423,310	8,377,327	6,045,983	0.520 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	6	2,881	584,986	1,000	583,986	0.050 %
j	Total. Other Benefits . .	570	262,375	145,132,421	89,635,428	55,496,993	4.730 %
k	Total. Add lines 7d and 7j .	1,570	670,878	758,970,982	545,223,117	213,747,865	18.200 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

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.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	2	0	74,688		74,688	0.010 %
2	Economic development
3	Community support
4	Environmental improvements	6	393	112,715		112,715	0.010 %
5	Leadership development and training for community members	1	450	4,285		4,285	0 %
6	Coalition building	4	0	376,504	195,828	180,676	0.020 %
7	Community health improvement advocacy	7	100	296,862	100,318	196,544	0.020 %
8	Workforce development	13	1,143	1,456,900	16,800	1,440,100	0.120 %
9	Other
10	Total	33	2,086	2,321,954	312,946	2,009,008	0.180 %

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. ......

29,960,538

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. ......

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).....

4,385,958

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

4,653,801

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

-267,843

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) 2015

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 (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)								Other (Describe)	Facility reporting group
1	The Children's Mercy Hospital 2401 Gillham Road Kansas City,MO64108 http://www.childrensmercy.org/ 39-54	X	X	X	X	X	X	Specialty Clinics; Primary Care Clinics	A
2	Children's Mercy Kansas 5808 W 110th Overland Park,KS66211 http://www.childrensmercy.org/ H-046-008	X	X	X	X		X	Specialty Clinics	A

Schedule H (Form 990) 2015

Page 4

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)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

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 12......................

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 significant 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 Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

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

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

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): See Part V, Section C

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): See Part V, Section C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

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)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, 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) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Yes

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 included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 300.000000000000% and FPG family income limit for eligibility for discounted care of 500.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

See Part V, Section C

The FAP application form was widely available on a website (list url):

See Part V, Section C

A plain language summary of the FAP was widely available on a website (list url):
See Part V, Section C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

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 all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized 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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (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)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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 Section C)

Other (describe in Section C)

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 Section C)

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 Section C.

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 Section C.

Schedule H (Form 990) 2015

Page 7

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Part V, Section B	Facility Reporting Group A
Facility Reporting Group A consists of:	- Facility 1: The Children's Mercy Hospital, - Facility 2: Children's Mercy Kansas
Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 5:	As part of the CHNA, five focus groups were conducted over the first week of August 2015. The focus groups were constructed to focus on each of the four counties. Fourty-six individuals representing physicians, other health professionals, social service providers, business leaders, and other community leaders participated. In addition, a Key Informant Online Survey was sent to 99 elected officials, physicians, other health professionals, social service providers, and business, neighborhood, housing and community leaders. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work as well as the community overall. Over 230 representatives from area public health, health care, social services, governmental, community, neighborhood and housing organizations were invited to a Children's Health Summit on March 11, 2016. From this group, 168 attended (45 from Children's Mercy) and participated in a process to rate the priority health issues for the region. Organizations that participated in the all three events included: Mother & Child Health Coalition; Olathe Public Schools; Shawnee Mission Public Schools; Local Initiatives Support Corporation of Greater Kansas City; Rosedale Development Association; New Bethel Community Development Corporation; Truman Lakewood; Tri-County Mental Health; Turner House Children's Clinic; Unified Government of Wyandotte County Public Health Department; University of Missouri-Kansas City School of Nursing; Clay County Health Department; Johnson County (KS) Health Department; Missouri Department of Health and Human Services; Samuel U. Rodgers Health Center; Ewing Marion Kauffman Foundation; Jackson County Health Department; Kansas Department of Health and Environment; Urban Neighborhood Initiative; The Children's Place; Kansas Children's Service League; Kids TLC; Mid America Headstart. A complete list of all organizations and specifics about the process is provided in the community health needs assessment provided on the Children's Mercy website.
Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 7d:	The CHNA reports for both facilities in Facility Reporting Group A are located on the Hospital website: http://www.childrensmercy.org/About_Us/Community_Benefit/Community_Health_Needs_Assessment/
Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 11:	The implementation strategy plan was approved on October 11, 2016 and made available to the public within the IRS required 4 1/2 months after year end associated with the conducted and approved CHNA completed during the 2015 tax year. The most recently adopted implementation stragegy plan can be found on the hospital website:http://www.childrensmercy.org/About_Us/Community_Benefit/Community_Health_Needs_Assessment/Access with emphasis on Medical Home; Injury and Safety; and Weight, Nutrition and Physical Activity were the three priorities identified in the 2013 CHNA. Over the past three years progress has been made in each of these areas. The following are some of the accomplishments in the Access area: Children's Mercy continues to work with area pediatric practices to support their transition to a medical home; CMH adopted new scheduling practices that provide easier availability to appointments and launched Saturday specialty clinics in the summer of 2015. The Pediatric Fellow program expanded to 36 programs. In the Injury and Safety area the Promise 1000 collaboration between all the home visiting programs in the Kansas City area includes over 12 home visiting programs in the area and supports referrals, coordination of technical assistance, data collection and evaluation services. In addition, Children's Mercy serves as a partner agency in the Trauma Matters community program. In the Weight, Nutrition and Physical Activity area, CMH serves as the leader for a community collaboration called Weighing In that brings together a number of area groups to work on healthy eating and active lifestyle activities. From the 2016 CHNA, the community identified the following priorities: Access to Health Services; Mental and Behavioral Health; Infant Mortality; Obesity; Food Insecurity; Parent Support, Early Education, Housing, Violence, Employment and Poverty (in no particular order). Over 300 staff members at Children's Mercy were presented the community priorities and identified three of the priorities to focus on through 2019: Access to Health Services; Mental and Behavioral Health and Infant Mortality. Children's Mercy adopted an implementation strategy and action plan to address the 2016 priority health needs.For more details, please visit http://www.childrensmercy.org/About_Us/Community_Benefit/Community_Health_Needs_Assessment/
Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 13b:	To determine financial assistance eligibility for discounted care, we review financial assistance denials that have been appealed through a multi-disciplinary committee that uses a point system rubric using indicators such as FPG, total balance due as a percentage of annual income, out of pocket responsibility for upcoming year as a percentage of annual income, annual frequency of visits for ongoing care, financial hardship indicators such as recent bankruptcy/foreclosure, and medical complexity due to health condition. Each factor, if applicable, is reviewed and assigned point value based on a preset scale, that serves as a tool for the discounted care scale.
Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 13h:	Patients seeking care at organization with out of network insurance plans are not eligible for charity care.
Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 16i:	The FAP, FAP application form and plain language summary were widely available on the hospital website:http://www.childrensmercy.org/financialcounseling/
Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 22d:	Patients receiving charity care for emergency or medically necessary care are not charged more than amounts generally billed (AGB) to insured patients. AGB is determined using a cost to charge ratio from the most recently audited financial statements to determine discounts for patients receiving financial assistance.
Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 5:	As part of the CHNA, five focus groups were conducted over the first week of August 2015. The focus groups were constructed to focus on each of the four counties. Fourty-six individuals representing physicians, other health professionals, social service providers, business leaders, and other community leaders participated. In addition, a Key Informant Online Survey was sent to 99 elected officials, physicians, other health professionals, social service providers, and business, neighborhood, housing and community leaders. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work as well as the community overall. Over 230 representatives from area public health, health care, social services, governmental, community, neighborhood and housing organizations were invited to a Children's Health Summit on March 11, 2016. From this group, 168 attended (45 from Children's Mercy) and participated in a process to rate the priority health issues for the region. Organizations that participated in the all three events included: Mother & Child Health Coalition; Olathe Public Schools; Shawnee Mission Public Schools; Local Initiatives Support Corporation of Greater Kansas City; Rosedale Development Association; New Bethel Community Development Corporation; Truman Lakewood; Tri-County Mental Health; Turner House Children's Clinic; Unified Government of Wyandotte County Public Health Department; University of Missouri-Kansas City School of Nursing; Clay County Health Department; Johnson County (KS) Health Department; Missouri Department of Health and Human Services; Samuel U. Rodgers Health Center; Ewing Marion Kauffman Foundation; Jackson County Health Department; Kansas Department of Health and Environment; Urban Neighborhood Initiative; The Children's Place; Kansas Children's Service League; Kids TLC; Mid America Headstart. A complete list of all organizations and specifics about the process is provided in the community health needs assessment provided on the Children's Mercy website.
Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 7d:	The CHNA reports for both facilities in Facility Reporting Group A are located on the Hospital website: http://www.childrensmercy.org/About_Us/Community_Benefit/Community_Health_Needs_Assessment/
Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 11:	The implementation strategy plan was approved on October 11, 2016 and made available to the public within the IRS required 4 1/2 months after year end associated with the conducted and approved CHNA completed during the 2015 tax year. The most recently adopted implementation strategy plan can be found on the hospital website:http://www.childrensmercy.org/About_Us/Community_Benefit/Community_Health_Needs_Assessment/Access with emphasis on Medical Home; Injury and Safety; and Weight, Nutrition and Physical Activity were the three priorities identified in the 2013 CHNA. Over the past three years progress has been made in each of these areas. The following are some of the accomplishments in the Access area: Children's Mercy continues to work with area pediatric practices to support their transition to a medical home; CMH adopted new scheduling practices that provide easier availability to appointments and launched Saturday specialty clinics in the summer of 2015. The Pediatric Fellow program expanded to 36 programs. In the Injury and Safety area the Promise 1000 collaboration between all the home visiting programs in the Kansas City area includes over 12 home visiting programs in the area and supports referrals, coordination of technical assistance, data collection and evaluation services. In addition, Children's Mercy serves as a partner agency in the Trauma Matters community program. In the Weight, Nutrition and Physical Activity area, CMH serves as the leader for a community collaboration called Weighing In that brings together a number of area groups to work on healthy eating and active lifestyle activities. From the 2016 CHNA, the community identified the following priorities: Access to Health Services; Mental and Behavioral Health; Infant Mortality; Obesity; Food Insecurity; Parent Support, Early Education, Housing, Violence, Employment and Poverty (in no particular order). Over 300 staff members at Children's Mercy were presented the community priorities and identified three of the priorities to focus on through 2019: Access to Health Services; Mental and Behavioral Health and Infant Mortality. Children's Mercy adopted an implementation strategy and action plan to address the 2016 priority health needs.For more details, please visit http://www.childrensmercy.org/About_Us/Community_Benefit/Community_Health_Needs_Assessment/
Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 13b:	To determine financial assistance eligibility for discounted care, we review financial assistance denials that have been appealed through a multi-disciplinary committee that uses a point system rubric using indicators such as FPG, total balance due as a percentage of annual income, out of pocket responsibility for upcoming year as a percentage of annual income, annual frequency of visits for ongoing care, financial hardship indicators such as recent bankruptcy/foreclosure, and medical complexity due to health condition. Each factor, if applicable, is reviewed and assigned point value based on a preset scale, that serves as a tool for the discounted care scale.
Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 13h:	Patients seeking care at organization with out of network insurance plans are not eligible for charity care.
Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 16i:	The FAP, FAP application form and plain language summary were widely available on the hospital website:http://www.childrensmercy.org/Patients_and_Families/Financial_Matters/Financial_Counseling/
Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 22d:	Patients receiving charity care for emergency or medically necessary care are not charged more than amounts generally billed (AGB) to insured patients. AGB is determined using a cost to charge ratio from the most recently audited financial statements to determine discounts for patients receiving financial assistance.

Schedule H (Form 990) 2015

Page 8

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?32
Name and address		Type of Facility (describe)
1	1 - Children's Mercy Clinics on Broadway 3101 Broadway Kansas City,MO64111	Outpatient Clinics
2	2 - Children's Mercy Northland 501 NW Barry Rd Kansas City,MO64155	Outpatient Clinics
3	3 - Children's Mercy East 20300 East Valley View Parkway Independence,MO66102	Outpatient Clinics
4	4 - Children's Mercy College Boulevard 5520 College Boulevard Overland Park,KS66211	Outpatient Clinics
5	5 - Children's Mercy Blue Valley 6750 West 135th Street Overland Park,KS66223	Outpatient Clinics
6	6 - Children's Mercy West 4313 State Ave Kansas City,KS66201	Outpatient Clinics
7	7 - Children's Mercy Wichita 3243 E Murdock Wichita,KS67208	Outpatient Clinics
8	8 - CMH- Joplin Freeman Health System 3333 McIntosh Circle Dr Suite 6 Joplin,MO64804	Outpatient Clinics
9	9 - Children's Mercy St Joseph 802 North Riverside Road Suite 105 St Joseph,MO64501	Outpatient Clinics
10	10 - CMH Nephrology - Wichita 818 N Emporia Suite 310 Wichita,KS67214	Outreach Clinic
11	11 - CMH Endocrinology - Springfield 1000 E Primrose Springfield,MO65807	Outreach Clinic
12	12 - CMH Speech & Language 1330 E Linwood Blvd Kansas City,MO64109	Specialty Clinic
13	13 - CMH Cardiology - Junction City 1106 St Marys Rd Suite 303 Junction City,KS66441	Outreach Clinic
14	14 - CMH Gastroeneterolgy - Wichita 6837 W 37th Street North Bldg 1 Wichita,KS67205	Outreach Clinic
15	15 - CMH Cardiology- Garden City 311 E Spruce St Garden City,KS67846	Outreach Clinic
16	16 - CMH Endocrinology - Junction City 361 Grant Ave Junction City,KS66441	Outreach Clinic
17	17 - CMH Urology - Wichita 6837 W 37th St North Bldg 1 Wichita,KS67205	Outreach Clinic
18	18 - CMH Endocrinology - Great Bend 3515 Broadway Ave Great Bend,KS67530	Outreach Clinic
19	19 - CMH Endocrinology - Pittsburg 3011 N Michigan Pittsburg,KS66762	Outreach Clinic
20	20 - CMH Endocrinology - Parsons 1902 S US Highway 59 Parsons,KS67357	Outreach Clinic
21	21 - CMH Orthopaedic Surgery - Salina 520 S Santa Fe Ave Salina,KS67401	Outreach Clinic
22	22 - CMH Gastroeneterolgy - Salina 400 S Santa Fe Ave Salina,KS67401	Outreach Clinic
23	23 - CMH Orthopaedic Surgery - Wichita 2778 N Webb Rd Wichita,KS67226	Outreach Clinic
24	24 - CMH Rehab Medicine- Wichita 929 N St Francis Wichita,KS67214	Outreach Clinic
25	25 - CMH Endocrinology - Salina 737 E Crawford Salina,KS67401	Outreach Clinic
26	26 - CMH Hematology - Dodge City 2020 Central Dodge City,KS67801	Outreach Clinic
27	27 - Pediatric Eye Care PA 4820 College Blvd Overland Park,KS66211	Pratice Use
28	28 - CMH- DevelopmentalBehavioral Medicine 211 Cherry Ave Oakley,KS67748	Outreach Clinic
29	29 - CMH HematologyOncology - Springfield 2115 S Fremont Ave Suite 2200 Springfield,MO65804	Outreach Clinic
30	30 - CMH Rehab Medicine- Bethany 6800 NW 39th Expressway Bethany,OK73008	Outreach Clinic
31	31 - CMH Telemedicine- Garden City 311 E Spruce St Garden City,KS67846	Outreach Clinic
32	32 - CMH HematologyOncology - Wichita 9211 E 21st St N Wichita,KS67206	Outreach Clinic

Schedule H (Form 990) 2015

Page 9

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 I, Line 3c:	To determine financial assistance eligibility for discounted care, we review financial assistance denials that have been appealed through a multi-disciplinary committee that uses a point system rubric using indicators such as FPG, total balance due as a percentage of annual income, out of pocket responsibility for upcoming year as a percentage of annual income, annual frequency of visits for ongoing care, financial hardship indicators such as recent bankruptcy/foreclosure, and medical complexity due to health condition. Each factor, if applicable, is reviewed and assigned point value based on a preset scale, that serves as a tool for the discounted care scale.
Part I, Line 7:	Cost-to-charge ratios were calculated as appropriate and applied to charges.
Part I, Line 7g:	Children's Mercy operates subsidized health services that span across primary care clinics, in-patient units, specialty care clinics, and in the community. Over 218,000 children received subsidized health services in FY16. The organization operate a clinic at a 1,000 student K-12 charter school in Kansas City, MO. Subsidized health services also include the Developmental and Behavioral Sciences (over 8,000 children across the system), a Home Care program (636 children) and clinics for children with conditions such as Hemophilia, Downs Syndrome, Endocrine Disorders, and Burns. Additionally, Children's Mercy physicians and nurses provide outreach specialty clinics in communities throughout our region, making this specialized care more easily accessible to families so they don't have to travel long distances to receive care in Kansas City. In an attempt to further improve access, Children's Mercy provides telemedicine services that will allow the organization to reach a broader patient population.
Part I, Ln 7 Col(f):	The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), which is subtracted for purposes of calculating the percentage in this column, is $29,960,538.
Part II, Community Building Activities:	Children's Mercy conducts a variety of community building activities that allow the organization to connect with the community and promote healthy living. In addition to several longstanding programs such as Weighing In Coalition that works to bring together community organizations to change policy and environments to support healthy lifestyles and active living, Children's Mercy also offers community oriented programs and/or resources intended to make physical improvements, provide community support, build coalitions, advocate for community health improvements and address community-wide workforce issues. Some examples include the maintenance of the Hospital Hill Park and the Sylvia Nutter Playground, Environmental Health Community Trainings and housing assessments, Equity and Diversity programs, and numerous advocacy activities including a Healthy Lifestyles Youth Advocacy Program.
Part III, Line 2:	The provision for bad debt is based upon management's assessment of expected net collections on aged accounts and patient responsibility balances. For receivables associated with services provided to patients who have third party coverage, the Hospital provides a provision for bad debt for balances greater than 365 days or patient responsibility balances that have met criteria for bad debt prior to 365 days. For receivables associated with self-pay patients, the Hospital records a provision of bad debt in the period of service on the basis of its past experience at an amount that approximates cost. Patient responsibiltiy balances (after insurance processing and application of contractual discounts) as well as self pay amounts (less the applicable discount) for patients with no payor source are utilized to determine bad debt expense, less any patient payments.
Part III, Line 4:	Refer to footnote '(o) Net Patient Service Revenue and Other Revenue' on page 10 of the attached audited financial statements. This footnote discusses both bad debt expense as well as the allowance for doubtful accounts.
Part III, Line 8:	The Children's Mercy Hospital follows the regulations governing the preparation of the Medicare Cost Report. In doing so, the Medicare allowable costs are based on the Hospital's audited financial statement amounts adjusted for those costs not allowable, such as costs related to physician and nurse practitioner services, marketing, and physician referrals. Other revenue sources such as for the cafeteria, vending machines, medical records fees, and various miscellaneous operating revenues are offset from total costs to determine allowable costs. Total costs per functional area, or Cost Report line/category, are divided by charges to determine cost-to-charge ratios for each area.
Part III, Line 9b:	Collection attempts are discontinued once charges are determined to be eligible for charity care or financial assistance; insurance collection attempts continue as appropriate.
Part VI, Line 2:	In FY2016, The Children's Mercy completed a child and adolescent Community Health Needs Assessment (CHNA) of the Children's Mercy service area (Jackson and Clay counties in Missouri and Johnson and Wyandotte counties in Kansas). This service area represents over 72% encounters during a fiscal year. Children's Mercy hired the firm, Professional Research Consultants, Inc. based in Omaha, NE., to support qualitative and quantitative data collection and analysis. The CHNA added an exploration of social determinants of health. Quantitative data sources include primary research (the 2015-6 PRC Child and Adolescent Health Survey-surveyed 1000 families across the region) and secondary data (vital statistics and health-related data from local, state and national sources). Qualitative data included input from five focus groups and an on-line Key Informant survey. Participants in the focus groups and in the Key Informant survey included representatives from community health care providers, public health professionals, social service representatives, and community leaders. The CHNA results were presented to over 220 representatives from across the community who participated in a day-long session (March 11, 2016) to identify key priorities for the region. The identified priorities were then presented to over 300 Children's Mercy staff members who rated the community identified priorities as to their importance, ability to measure outcomes, and Children's Mercy's ability to impact. The final top priorities that were then approved by the Children's Mercy Board of Directors in 2016 were 1.) Access to Health Services, 2.) Mental and Behavioral Health, and 3.) Infant Mortality.
Part VI, Line 3:	Flyers and business cards are available at all access points within the Hospital. Efforts are made by the financial counselors to contact self pay patients and families, either in person, or through phone call or letters. Self pay or underinsured patients can also be referred to a financial counselor by an Access Representative, Patient Care Services, Social Work, Patient Financial Services, or other staff members for screening and assistance. All billing statements refer patients to Financial Counseling resources; hospital website posts the financial assistance policy.
Part VI, Line 4:	The Children's Mercy service area for the CHNA is comprised of 4 counties located in both Missouri (Jackson and Clay counties) and Kansas (Johnson and Wyandotte Counties). During the fiscal year in which Children's Mercy initiated the CHNA, residents of these counties contribute over 72% of the encounters at Children's Mercy. The four counties serve as the location of our physical facilities (e.g. Main Campus, Children's Mercy South, Children's Mercy West, Children's Mercy Northland, Children's Mercy Broadway Clinics and Children's Mercy East) and the source of a majority of our patient encounters. The four counties house a total population of 1,652,781; of these 411,888 or 25.9 percent are children. Within this region, Wyandotte County has the greatest proportion of children under 18 and Jackson County has the smallest proportion, but largest in absolute number. The overall population of children in these four counties increased between 1980 and 2013 and the overall make-up of the population shifted as well. In 1980, black, Hispanic or other ethnicities comprised 21 percent of the four counties under 18 years of age population and in 2013 36 percent of the region's under 18 population made up these groups. According to the U.S. Census, the median family income was $68,993. In 2014, across the region, 19 percent of all children live in poverty; 37.6 percent of children in Wyandotte County live in poverty. Of all Kansas City area families led by a single mother, 29.2 percent are living in poverty. Jackson County and especially Wyandotte County have considerably more families led by a single mother living below the federal poverty level.
Part VI, Line 5:	The Children's Mercy Hospital is a nonprofit hospital operated to serve a public rather than a private interest and meeting the requirements of Revenue Ruling 69-545. Control of the Hospital rests with its Board, which is primarily composed of members of the community, in addition to a few select employees of the Hospital. The Hospital accepts patients paying with Medicaid and Medicare, and operates an active and generally accessible emergency room open to all children without regard to ability to pay. The Hospital uses any surplus funds to improve the quality of patient care, expand its facilities, and advance its medical training, education, and research programs.Children's Mercy promotes children's health in the Kansas City region in numerous ways. Highlights of these programs include providing direct funding support to community organizations with like missions (i.e. Reach Out and Read, the Ronald McDonald House), training community members on assessing and managing child abuse (i.e. SCAN Outreach Services), the coordination of a community-wide strategy to organize home visiting, participating in community health fairs, serving on key community commitities (i.e., Infant and Child Mortality review boards, health department planning committees) and providing training and education for families with children at-risk for obesity or diabetes (i.e. Zoom to Health, PHIT Kids, etc.).
Part VI, Line 6:	The Children's Mercy Hospital is not part of an affiliated health care system.

Schedule H (Form 990) 2015

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," on 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

2015

Open to Public
Inspection

Name of the organization
The Children's Mercy Hospital

Employer identification number
44-0605373

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 Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on 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 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) American Heart Association 6800 W 93rd Street Overland Park,KS66212	13-5613797	501(c)3	48,500	Mission is to foster appropriate cardiac care in an effort to reduce disability and deaths caused by cardiovascular disease and stroke.
(2) Boys & Girls Club of Greater Kansas City 2405 Elmwood Ave Kansas City,MO64127	43-6072065	501(c)3	14,300	Promote development of self-esteem, values, and skills for boys and girls, ages 5-18, with special emphasis on youth from disadvantaged circumstances.
(3) DeLaSalle Education Center 3737 Troost Ave Kansas City,MO64109	43-0971728	501(c)3	14,625	A tuition-free charter high school that gives students a chance to improve their learning and life skills, stimulate their potential, and fulfill their promise.
(4) Charlie's House 6324 N Chatham Ste 223 Kansas City,MO64151	06-1830922	501(c)3	26,000	Participates in and sponsors community-wide events to provide home safety information.
(5) JDRF- Juvenile Diabetes Research Foundation 920 Main St Ste 280 Kansas City,MO64105	23-1907729	501(c)3	8,800	Support diabetes research and research-related education.
(6) Leukemia and Lymphoma Society 6811 Shawnee Mission Pkwy Ste 202 Shawnee Mission,KS66202	13-5644916	501(c)3	5,900	Mission is to cure leukemia, lymphoma, Hodgkin's disease and myeloma, and improve the quality of life of patients and their families.
(7) March of Dimes 4400 College Ste 180 Overland Park,KS66211	13-1846366	501(c)3	15,000	Support programs that improve the health of mothers and babies.
(8) Jackson County CASA 2544 Holmes Kansas City,MO64108	43-1401328	501(c)3	9,000	CASA's mission is to be a child's voice in court (recruit, train and support lay volunteers who act as advocates on behalf of the best interest of abused and neglected children).
(9) Ronald McDonald House Charities 2502 Cherry St Kansas City,MO64108	43-1190760	501(c)3	42,495	Provide comfort and care for families seeking life-saving medical treatment for their children.
(10) National Kidney Foundation 6405 Metcalf Ave Ste 204 Overland Park,KS66202	13-1673104	501(c)3	9,860	Dedicated to preventing kidney and urinary tract diseases, improving the health and well-being of individuals and families affected by kidney disease and increasing the availability of all organs for transplantation.
(11) Kansas City Friends of Alvin Ailey 1714 E 18th St Kansas City,MO64108	43-1412078	501(c)3	9,250	Making dance accessible to all people, teaching young people critical life skills through dance, and modeling interracial and multi-cultural community partnerships.
(12) Kansas University Endowment (Reach Out and Read) 3901 Rainbow Blvd MS 1051 Kansas City,KS66106	48-0547734	501(c)3	45,560	Prepares Kansas City's youngest children to succeed in school by partnering with doctors and nurses to prescribe books and encourage families to read together.

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) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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

(1) Patient Financial Assistance	5779	15,061,895	Cost	Charity Care
(1)
(2)
(3)
(4)
(5)
(6)
(7)

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

Part I, Line 2:

Grants generally go to nonprofit organizations and agencies with which The Children's Mercy Hospital shares a common mission. These are agencies that generally support the health and well-being of children and families. The Children's Mercy Hospital documents the appropriate use of our funds by attending annual events to collaborate with agency board members and their executive leaders about issues related to the achievement of the agency's mission; reviewing web-based annual reports; and requesting and receiving a report from the agency grant recipient confirming the portion of grant dollars that go directly to the agency's mission-critical enterprise.

Schedule I (Form 990) 2015

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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

The Children's Mercy Hospital

Employer identification number

44-0605373

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 on 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 .........

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? ..

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 on 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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on 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," on line 5a or 5b, describe in Part III.

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

The organization?

Yes

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

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

For persons listed on 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 on 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" on 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) 2015

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 on 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 in column(B) reported as deferred on 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)
1Gerald Woods MDDirector	(i) (ii)	315,058 ------------- 0	14,779 ------------- 0	10,080 ------------- 0	23,850 ------------- 0	15,956 ------------- 0	379,723 ------------- 0	0 ------------- 0
2Randall L O'Donnell PhDDirector; President & CEO	(i) (ii)	1,156,591 ------------- 0	304,511 ------------- 0	41,531 ------------- 0	84,932 ------------- 0	14,429 ------------- 0	1,601,994 ------------- 0	0 ------------- 0
3Charles Roberts MDEVP & Exec.Medical Director	(i) (ii)	601,608 ------------- 0	138,606 ------------- 0	26,757 ------------- 0	23,850 ------------- 0	8,437 ------------- 0	799,258 ------------- 0	0 ------------- 0
4Sandra AJ LawrenceExecutive VP & CAO	(i) (ii)	558,495 ------------- 0	132,938 ------------- 0	22,221 ------------- 0	19,875 ------------- 0	16,069 ------------- 0	749,598 ------------- 0	0 ------------- 0
5Karen S Cox RN PhD FAANExecutive VP & Co-COO	(i) (ii)	537,932 ------------- 0	123,964 ------------- 0	44,028 ------------- 0	23,850 ------------- 0	12,322 ------------- 0	742,096 ------------- 0	0 ------------- 0
6Jo StueveExecutive VP & Co-COO	(i) (ii)	537,933 ------------- 0	122,626 ------------- 0	26,757 ------------- 0	23,950 ------------- 0	11,263 ------------- 0	722,529 ------------- 0	0 ------------- 0
7Michael Artman MDChairman- Dept of Pediatrics	(i) (ii)	557,731 ------------- 0	0 ------------- 0	22,404 ------------- 0	19,875 ------------- 0	17,128 ------------- 0	617,138 ------------- 0	0 ------------- 0
8James O'Brien Jr MDPhysician	(i) (ii)	1,178,291 ------------- 0	0 ------------- 0	21,141 ------------- 0	19,875 ------------- 0	16,069 ------------- 0	1,235,376 ------------- 0	0 ------------- 0
9James D Saint Louis MDPhysician	(i) (ii)	1,191,757 ------------- 0	0 ------------- 0	3,141 ------------- 0	0 ------------- 0	16,069 ------------- 0	1,210,967 ------------- 0	0 ------------- 0
10Peter Pastuszko MDPhysician	(i) (ii)	951,405 ------------- 0	0 ------------- 0	27,617 ------------- 0	13,921 ------------- 0	12,166 ------------- 0	1,005,109 ------------- 0	0 ------------- 0
11Charles Snyder MDPhysician	(i) (ii)	755,280 ------------- 0	0 ------------- 0	21,381 ------------- 0	23,850 ------------- 0	16,069 ------------- 0	816,580 ------------- 0	0 ------------- 0
12Walter S Andrews MDPhysician	(i) (ii)	753,260 ------------- 0	0 ------------- 0	23,463 ------------- 0	23,850 ------------- 0	16,069 ------------- 0	816,642 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2015

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
Part I, Line 6	A portion of the total cash compensation paid to the President/CEO and all Executive Vice Presidents is determined by a performance based plan approved by the Compensation Committee of the Board of Directors. The plan includes Hospital and individual performance goals, one component of which is based in part on net earnings.
Part I, Line 4b and Part II, Line 2, Column (C)	$61,082 of deferred severance compensation was accrued for Randall O'Donnell that may or may not be paid in the future.

Schedule J (Form 990) 2015

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

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

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
The Children's Mercy Hospital

Employer identification number
44-0605373

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	Health and Educational Facilities Authority of the State of Missouri	43-1178966	60635HH85	11-15-2009	178,852,416	See Part VI		X		X		X
B	Health and Educational Facilities Authority of the State of Missouri	43-1178966		12-21-2010	71,550,000	See Part VI		X		X		X
C	Health and Educational Facilities Authority of the State of Missouri	43-1178966		11-14-2014	18,775,000	See Part VI		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	14,525,000		66,655,000		3,700,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	179,112,696		71,550,000		18,775,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	80,262,696
11 Other spent proceeds .............	98,850,000		71,550,000		18,775,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2013
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X		X		X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	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
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2015

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
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		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	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?	X		X		X
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 %
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 .........	0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		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
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? .............
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

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X
b Exception to rebate? ........		X	X		X
c No rebate due? .........		X		X		X
If "Yes" to 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
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X	X		X
b Name of provider ..........			UBS AG		UBS AG
c Term of hedge .........			3090.0000000000 %		2090.0000000000 %
d Was the hedge superintegrated? ......				X		X
e Was the hedge terminated? ........				X		X

Schedule K (Form 990) 2015

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
b Name of provider ..........
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
7 Has the organization established written procedures to monitor the requirements of section 148? ...	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

Part VI

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

Return Reference	Explanation
Schedule K, Part I, Row A, Column (f)	The Series 2009 Bonds were issued for the following purposes: (i) refinance a bank loan, which was incurred to refinance the Series 2007AB Bonds (issued June 26, 2007) and (ii) finance hospital facilities (new tower on Main Campus and new hospital location).
Schedule K, Part I, Row B, Column (f)	In 2008, the Organization restructed some of its existing debt. The Series 2002 Bonds (June 19, 2002) were remarketed as the Series 2008A Bonds, and the Series 2003 Bonds (June 5, 2003) were remarketed as the Series 2008B Bonds. Then, in December 2010, the Series 2008A/B Bonds were modified in a manner that resulted in a "reissuance" for tax purposes.
Schedule K, Part I, Row C, Column (f)	In 2008, the Organization restructured some of its existing debt. The Series 2002 Bonds (June 19, 2002) were remarketed as the Series 2008A Bonds, and the Series 2003 Bonds (June 5, 2003) were remarketed as the Series 2008B bonds. Then, in December 2010, the Series 2008AB Bonds were modified in a manner that resulted in a "reissuance" for tax purposes. Later, in November 2011, the Series 2008B Bonds were modified in a manner that resulted in a "reissuance" for tax purposes.
Schedule K, Part II, Line 11, Column A	$98,850,000 of Bond proceeds were used to pay off the bank loan that was incurred to refinance the Series 2007AB Bonds.
Schedule K, Part II, Line 11, Column B	$71,550,000 of Bond proceeds were treated as used to refinance the Series 2008AB Bonds as a result of the "reissuance" of the Series 2008AB Bonds.
Schedule K, Part II, Line 11, Column C	$18,775,000 of Bond proceeds was treated as used to refinance the Series 2008B Bonds as a result of the "reissuance" of the Series 2008B Bonds.
Schedule K, Part II, Line 13, Column B	The Series 2008AB Bonds were treated as "reissued" on December 21, 2010, and therefore, there were no "new-money" projects financed by the "reissued" Series 2008AB Bonds.
Schedule K, Part II, Line 13, Column C	The Series 2008B Bonds were treated as "reissued" on November 14,2014, and therefore, there were no "new-money" projects financed by the "reissued" Series 2008B Bonds.

Schedule K (Form 990) 2015

Additional Data

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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

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

The Children's Mercy Hospital

Employer identification number

44-0605373

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) 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 Benefiting 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) 2015

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	(b) Relationship between interested person and the organization	(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) Kathy Perryman Pediatric Anesthesi	Anesthesia Associates of Kansas City, Member for the organization	29,773,326	Medical		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2015

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

2015

Open to Public Inspection

Name of the organization

The Children's Mercy Hospital

Employer identification number

44-0605373

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 ....	X	15	120,850	FMV
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..	X		20,246	FMV
5 Clothing and household goods .......	X		231,039	FMV
6 Cars and other vehicles ..	X	1	8,124
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	17	199,807	FMV
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 ..
17 Real estate—Other ...
18 Collectibles .....	X	16	10,133	FMV
19 Food inventory ...	X	33	75,034	FMV
20 Drugs and medical supplies .	X	16	20,100	FMV
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( Toys )	X	628	242,087	FMV
26 Other ( Trips & Experiences )	X	60	168,456	FMV
27 Other ( Miscellaneous )	X	43	100,883	FMV
28 Other ( Jewelry )	X	6	20,629	FMV

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) (2015)

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
Part I, Column (b):	The amounts in Part I, Column (b) represent the number of contributions received during the taxable year.
Part I, Line 33:	Books and clothing were received and utilized by patients and families; not resold.

Schedule M (Form 990) (2015)

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 990-EZ 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

2015

Open to Public
Inspection

Name of the organization

The Children's Mercy Hospital

Employer identification number

44-0605373

Return Reference	Explanation
Form 990, Part III, line 2	Children's Research Institute Children's Mercy established the Children's Mercy Research Institute to align and focus our research efforts more effectively so CMH can improve the health and well-being of children and advance pediatric health. Center for Pediatric Innovation Opened and staffed this facility, which concentrates on inspiring and supporting innovative healthcare providers and hospital staff to invent, test, and eject into the marketplace new or improved healthcare programs and processes to serve the vulnerable pediatric population in our community and beyond. Canine Therapy Program Created and staffed this program (including two highly trained therapy dogs), which evidence shows helps hospitalized patients recover their health from procedures in a more timely manner, thus enabling an earlier discharge from the hospital and lower costs. East Imaging Center An assessment of the population in the Eastern region of our Metropolitan service area uncovered barriers making it difficult for patients to gain timely access to diagnostic imaging services needed as a prerequisite to the prompt identification and execution of a treatment plan. Supported by a Certificate of Need from the State of Missouri, the center opened at Children's Mercy East, removing the access barriers that were inhibiting the delivery of timely service. Centralized Biorepository With the advent of this new program, previously decentralized tissue samples used for diagnosis, treatment and academic research are now combined and catalogued in a centralized unit, thus enabling researchers to gain access to a fully scaled source of robust data to conduct more sophisticated and reliable research to find cures for extraordinary diseases and conditions often unique to the pediatric population. Expansion of Wichita, Kansas Regional Center Supported by research to discover unmet needs of the pediatric patient population in Wichita and western Kansas, the center expanded and now supports the employment of full-time, locally residing medical subspecialists who treat Kansas patients requiring support from doctors in cardiology, endocrinology and nephrology. Pediatric Healthcare Summit Conducted in March 2016, the community's first ever pediatric healthcare summit gathered nearly 200 leaders representing partnering agencies to review the results of the area's only pediatric Community Health Needs Assessment and identify ways where partnership among attending organizations could lead to the more efficient and effective delivery of healthcare to the vulnerable population served by those participating in the program. STAT-Seq This proprietary, unique test enables prompt discovery of a patient's genetic anomalies - the source of medical conditions that prior to the use of this test would have taken months, if not years to diagnose. As a result, lives are now being saved and deteriorating health conditions now reversed because diagnostic conundrums are being solved, enabling prompter treatment of patients who gain better healthcare outcomes and oftentimes radically reduced healthcare costs.
Form 990, Part VI, Section B, line 11	The final Form 990, including all required schedules, was provided to each voting member of the Board of Directors prior to its filing with the IRS.
Form 990, Part VI, Section B, line 12c	Each employee is required to complete an Outside Professional and Commercial Interests Form (Conflict of Interest Form) at the time of employment, at the time of their annual evaluation, and any time their financial interests change. Board members are required to complete a Conflict of Interest Questionnaire at the time of their appointment, at least one time annually, and are required to update their information any time their financial interests change. All Outside Professional and Commercial Interests Forms and Conflict of Interest Questionnaires are reviewed by the Corporate Compliance Manager.
Form 990, Part VI, Section B, line 15	The Compensation Committee of the Board of Directors is responsible for approving the compensation of the CEO, which they document in an Employment Agreement between the Board of Directors and the CEO. The Compensation Committee also approves the compensation of the EVP/CAO, the EVP/Chief Medical Officer, two persons with the title EVP/co-Chief Operating Officer, all officers of the Hospital, and the Chair of the Department of Pediatrics, who is a key employee. The Compensation Committee is composed of independent outside directors who receive no compensation for their participation on the Board. The Compensation Committee engages an outside consulting firm, whose practice includes the analysis of compensation for not-for-profit hospitals, to advise the Committee with regard to market data and analysis, which was used to establish compensation. A letter from the compensation consultant opining on the reasonableness of the compensation was provided to the Committee and documentation of the Committee's deliberations and decision are in existence.
Form 990, Part VI, Section C, line 19	The organization's governing documents, conflict of interest policy, and audited financial statements are available upon request.
Form 990, Part XI, line 9:	Change in benefit obligation 203,025. Tax reversal of unrealized gain -8,679,975. Net unrealized change in income beneficiary and charitable remainder trusts 2,585,011. Intercompany Transfer -6,965,001.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

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

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

The Children's Mercy Hospital

Employer identification number

44-0605373

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
(1) CMH Insurance Company LLC 2401 Gillham Road Kansas City,MO64108	Insurance for The Children's Mercy Hospital	MO	95,842	10,785,858	The Children's Mercy Hospital
(2) Physician Business Partners LLC 2401 Gillham Road Kansas City,MO64108	Physician network for education and purchasing	MO	0	0	The Children's Mercy Hospital
(3) Children's Research Institute LLC 2401 Gillham Road Kansas City,MO64108	Supports research activities of The Children's Mercy Hospital	MO	0	0	The Children's Mercy Hospital

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)Children's Mercy Hospital Foundation 2401 Gillham Road Kansas City,MO64108 43-1564302	Investment management to benefit Children's Mercy Hospital	MO	501(C)(3)	line 11, III-NFI	N/A		No
(2)Children's Mercy's Family Health Partners Inc 2420 Pershing Kansas City,MO64108 43-1726517	Integrated health insurance benefits care system	MO	501(C)(3)	line 9	The Children's Mercy Hospital	Yes
(3)Children's Mercy Hospital Self-Insurance Trust Commerce Trust Co PO Box 419248 Kansas City,MO64141 43-6231807	Providing funds for malpractice claims against CMH & employees	MO	501(C)(3)	line 11, I	The Children's Mercy Hospital	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2015

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	(h) Percentage ownership	(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
(1) Children's Mercy Integrated Care Solutions Inc 2401 Gillham Road Kansas City,MO64108 45-3741386	Coordinates medical care of pediatric patients	KS	The Children's Mercy Hospital	C	-8,367,713	8,766,792	100.000 %	Yes
(2) Income Beneficiary Trusts (6)	Trust	MO	N/A	T					No

Schedule R (Form 990) 2015

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) ............................

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

Yes

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) .......................

Yes

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) .....................

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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) Children's Mercy Integrated Care Solutions	O	4,362,939	Book
(2) Children's Mercy Integrated Care Solutions	J	187,351	Book
(3) Children's Mercy Integrated Care Solutions	L	1,642,707	Book
(4) Children's Mercy Integrated Care Solutions	B	7,100,000	Book
(5) Children's Mercy Family Health Partners	C	135,000	Book
(6) Children's Mercy Integrated Care Solutions	P	318,795	Book
(7) Children's Mercy Integrated Care Solutions	Q	101,689	Book
(8) Children's Mercy Integrated Care Solutions	S	122,416,595	Book

Schedule R (Form 990) 2015

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) 2015

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) 2015

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: Excellence in healthcare for children
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	8,263
6	Total number of volunteers (estimate if necessary) .............	6	954
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	3,829,051
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	327,369

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	27,846,619	37,060,901
9	Program service revenue (Part VIII, line 2g) .........	1,133,871,342	1,194,702,474
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	25,966,780	26,016,482
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	15,822,736	19,816,681
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,203,507,477	1,277,596,538
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	13,288,387	15,463,964
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)	637,512,335	714,820,574
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 3,800,938
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	441,744,372	473,424,006
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,092,545,094	1,203,708,544
19	Revenue less expenses. Subtract line 18 from line 12.......	110,962,383	73,887,994
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,386,129,346	1,420,276,296
21	Total liabilities (Part X, line 26).............	414,190,620	403,103,989
22	Net assets or fund balances. Subtract line 21 from line 20.....	971,938,726	1,017,172,307

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 956,816,427 including grants of $ 15,463,964 ) (Revenue $ 1,194,702,474 )
	All expenses for program services relate to providing healthcare. There were a total of 354 licensed beds and 86,233 patient days during the year from 14,190 admissions. Interim stays totaled 10,403 and outpatient encounters, including ED and Urgent Care, were 777,573 from 224,867 individual patients. There were a total of 20,118 surgical cases which includes 4,230 inpatient and 15,888 outpatient cases. Diagnostic procedures, tests and treatments totaled 1,429,902 and outpatient prescriptions totaled 156,549. Children's Mercy critical care transports totaled 5,329 in fiscal year 2016.The Children's Mercy Hospital (the Hospital) consists of a 301-bed teaching hospital for children located in Kansas City, Missouri, and a 53-bed hospital for children located in Overland Park, Kansas. Children's Mercy Hospital provides the highest level of medical care, technology, services, equipment, and facilities promoting the health and well-being of children in the region, from birth through adolescence. Patients and their families are treated with compassion in a family-centered environment that recognizes their physical, emotional, financial, social, and spiritual needs. The comprehensive healthcare environment provided by the Hospital includes clinical services, research, and teaching efforts, which are designed to serve today's and tomorrow's children, and the community in which they live.The Hospital's services are available to all regardless of ability to pay.

4b	(Code: ) (Expenses $ 32,652,446 including grants of $ ) (Revenue $ )
	Children's Mercy Hospital (CMH) is dedicated to becoming a leader in pediatric translational research. A recent strategic planning initiative established the Children's Research Institute to focus on research and research infrastructure. This commitment will lead to breakthroughs in treating, diagnosing and preventing complex childhood diseases. Research conducted today at CMH includes basic science and clinical research in numerous areas including pharmacology, cancer, cardiology, genetic diseases and health outcomes. Areas of research strength include Clinical Pharmacology and Therapeutic Innovation, Genomics Medicine, Health Services and Outcomes and Innovations in Health Care Delivery. During the year ended June 30, 2016 there were more than 390 active sponsored research projects. The Children's Research Institute occupies about 3% of the space on the main campus and is 3% of the total annual operating budget. Children's Mercy spent $32.7 million in the year ended June 30, 2016 on research and per information from the NIH Reporter received more than $4 Million in NIH funding in this same time period. More than 700 publications were accepted and/or published. The Children's Research Institute provides seed funding to Investigators with internal competitive grant programs such as the Midwest Cancer Alliance and the Katherine Berry Richardson (KBR) Fund, with expectations that this funding will lead to applications for externally funded grant programs in the future.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses989,468,873

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)				(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) Jo Stueve........................................................................ Executive VP & Co-COO	40.00 .......................	X			687,316	0	34,858
(19) David Cauble........................................................................ Senior VP & CFO	40.00 .......................	X			0	0	0
(20) Michael Artman MD........................................................................ Chairman- Dept of Pediatrics	40.00 .......................		X		580,135	0	35,589
(21) James O'Brien Jr MD........................................................................ Physician	40.00 .......................			X	1,199,432	0	35,589
(22) James D Saint Louis MD........................................................................ Physician	40.00 .......................			X	1,194,898	0	15,714
(23) Peter Pastuszko MD........................................................................ Physician	40.00 .......................			X	979,022	0	24,673
(24) Charles Snyder MD........................................................................ Physician	40.00 .......................			X	776,661	0	39,564
(25) Walter S Andrews MD........................................................................ Physician	40.00 .......................			X	776,723	0	39,564

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	10,223,286	0	466,400

1a	Federated campaigns..		1a	849,480
b	Membership dues..		1b
c	Fundraising events..		1c	2,806,801
d	Related organizations		1d	8,124,915
e	Government grants (contributions)		1e	9,241,418

f	All other contributions, gifts, grants, and similar amounts not included above		1f	16,038,287

g	Noncash contributions included in lines 1a-1f:$ 1,217,388
h Total.Add lines 1a-1f.......		37,060,901

			Business Code
2a	Net Patient Services	621110	1,194,702,474	1,194,702,474
b
c
d
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			1,194,702,474

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			26,016,482			26,016,482
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
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).....
8a	Gross income from fundraising events (not including $ 2,806,801of contributions reported on line 1c). See Part IV, line 18 ....
	a		701,884
b	Less: direct expenses ...b		587,696
c	Net income or (loss) from fundraising events..			114,188			114,188
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..
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..
Business Code			Miscellaneous Revenue
11a	Cafeteria		722210	4,682,871	4,682,871
b	Transport		621910	2,185,830	2,185,830
c	Gift Shop		453220	1,199,080	1,199,080
d	All other revenue ....			11,634,712	7,805,661	3,829,051
e	Total. Add lines 11a–11d ......			19,702,493
12	Total revenue. See Instructions......			1,277,596,538	1,210,575,916	3,829,051	26,130,670

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	402,069	402,069
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	15,061,895	15,061,895
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	10,078,285	6,240,724	3,837,561
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	566,974,734	487,709,215	77,288,456	1,977,063
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	26,674,501	22,833,029	3,750,082	91,390
9	Other employee benefits .......	73,408,245	62,836,510	10,320,228	251,507
10	Payroll taxes ...........	37,684,809	32,257,711	5,297,985	129,113
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	3,022,721		3,022,721
c	Accounting ...........	345,234		345,234
d	Lobbying ...........	374,689		374,689
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	94,062,478	75,543,233	18,185,272	333,973
12	Advertising and promotion ....
13	Office expenses .......	4,650,817	782,747	3,798,362	69,708
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	16,751,562	5,876,763	10,798,216	76,583
17	Travel ............	7,850,754	6,246,245	1,372,313	232,196
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	13,184,392	13,184,392
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	56,152,892	30,021,854	25,906,132	224,906
23	Insurance ...	10,846,378	8,947,444	1,898,934
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	Medical Supplies	130,373,533	127,184,285	2,802,450	386,798
b	State Medicaid Taxes	45,652,965	45,652,965
c	Equipment Rental and Ma	31,511,224	5,943,528	25,567,696
d	Bad Debt	29,960,538	29,960,538
e	All other expenses	28,683,829	12,783,726	15,872,402	27,701
25	Total functional expenses. Add lines 1 through 24e	1,203,708,544	989,468,873	210,438,733	3,800,938
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).

1	Cash–non-interest-bearing ........			101,870,465	1	64,941,368
2	Savings and temporary cash investments .........			3,004	2	3,011
3	Pledges and grants receivable, net ......			6,102,724	3	5,852,768
4	Accounts receivable, net .............			179,661,471	4	200,133,023
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
					5
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
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........			11,291,222	8	12,638,569
9	Prepaid expenses and deferred charges ......			12,478,727	9	14,242,332
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,084,875,741
b	Less: accumulated depreciation	10b	560,199,558	499,417,003	10c	524,676,183
11	Investments—publicly traded securities .			491,609,137	11	510,911,294
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			9,950,474	13	7,853,046
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			73,745,119	15	79,024,702
16	Total assets. Add lines 1 through 15 (must equal line 34)...			1,386,129,346	16	1,420,276,296

17	Accounts payable and accrued expenses .....	144,827,592	17	133,332,588
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	189,528,649	20	183,604,489
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
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..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
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	79,834,379	25	86,166,912
26	Total liabilities. Add lines 17 through 25..	414,190,620	26	403,103,989

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	914,007,638	27	951,043,568
28	Temporarily restricted net assets ...........	57,931,088	28	66,128,739
29	Permanently restricted net assets		29
	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 ...........	971,938,726	33	1,017,172,307
34	Total liabilities and net assets/fund balances ........	1,386,129,346	34	1,420,276,296

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No