TY 2021 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/1099-NEC)
(1) Paul D Kempinski MS FACHE...................................................................... Director; President & CEO	40.00 ................. 1.00	X	X	1,565,976	42,657
(2) Douglas Swanson MD...................................................................... Director	40.00 ................. 0.00	X		237,193	20,364
(3) Elizabeth Braham...................................................................... Chair	2.00 ................. 1.00	X	X	0	0
(4) Bill Krueger...................................................................... Vice Chair	1.50 ................. 0.00	X	X	0	0
(5) Vince Clark...................................................................... Treasurer	1.50 ................. 0.00	X	X	0	0
(6) Andrew Teigen...................................................................... Secretary	1.50 ................. 0.00	X	X	0	0
(7) Kevin Barth...................................................................... Director	1.00 ................. 0.00	X		0	0
(8) Jean-Paul Chaurand...................................................................... Director	1.50 ................. 0.00	X		0	0
(9) Jeff Gehab...................................................................... Treasurer	1.00 ................. 0.00	X		0	0
(10) Carolyn Davis MD...................................................................... Director	1.50 ................. 0.00	X		0	0
(11) Terry Matlack...................................................................... Director	1.50 ................. 0.00	X		0	0
(12) Paul McLaughlin...................................................................... Director	1.50 ................. 0.00	X		0	0
(13) Walter Porter...................................................................... Director	1.00 ................. 0.00	X		0	0
(14) Diane Gallagher...................................................................... Director	1.00 ................. 0.00	X		0	0
(15) Olga Koper...................................................................... Director	1.00 ................. 0.00	X		0	0
(16) David Cauble...................................................................... EVP & CFO; End 2/18/22	40.00 ................. 0.00		X	839,156	39,594
(17) Robin Foster JD...................................................................... EVP, General Counsel	40.00 ................. 0.00		X	765,437	46,344

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Robert Steele MD........................................................................ EVP & Chief Strategy/Innovation Off.	40.00 .......................0.00	X			769,907	32,161
(19) Jodi Coombs MBA BSN RN........................................................................ EVP & COO	40.00 .......................0.00	X			763,296	22,305
(20) Robert Lane MD........................................................................ EVP & Physician-in-Chief	40.00 .......................0.00	X			795,117	28,944
(21) Alex Daneshmand DO MBA........................................................................ EVP & Chief Quality Officer	40.00 .......................0.00	X			568,792	18,956
(22) Thomas Wright........................................................................ EVP & Chief HR Officer	40.00 .......................0.00	X			506,153	16,090
(23) Jennifer Kingry........................................................................ Interim CFO; Start 2/19/22	40.00 .......................0.00	X			388,234	39,058
(24) Shawn St Peter MD........................................................................ SVP/Surgeon-in-Chief;ChairDeptOfSurg	40.00 .......................0.00		X		968,656	41,994
(25) Thomas Curran PhD........................................................................ SVP, CSO, Executive Director-CMRI	40.00 .......................0.00		X		894,441	33,293
(26) James O'Brien Jr MD........................................................................ Physician	40.00 .......................0.00			X	1,553,432	46,326
(27) William Douglas MD........................................................................ Physician	40.00 .......................0.00			X	1,502,302	41,994
(28) Chad Mills........................................................................ Sr VP, CIO; End 10/23/21	40.00 .......................0.00			X	1,016,053	31,533
(29) Charles Snyder MD........................................................................ Physician	40.00 .......................0.00			X	804,369	40,044
(30) John Gatti MD........................................................................ Physician	40.00 .......................0.00			X	797,311	46,344

(A) Name and business address	(B) Description of services	(C) Compensation
Anesthesia Associates 8717 West 110th Street Overland Park,KS66210	Anesthesiologists	23,031,177
Turner Construction Company 1220 Washington St Suite 100 Kansas City,MO64105	Construction	13,149,424
McCown Gordon Construction LLC 850 Main Street Kansas City,MO64105	Construction	9,864,275
Cerner Health Connections Inc 2800 Rockcreek Parkway Kansas City,MO64117	Professional Services	8,977,138
Morrison Management Specialists Inc 400 Northridge Rd Suite 600 Sandy Springs,GA30350	Food Service	7,771,723
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 490

- TIN:

SCHEDULE A
(Form 990)

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.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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 12, 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).)

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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% 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 33 1/3% 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 on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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) 2021

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 5 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 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. 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—2020. 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—2021. 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—2020. 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) 2021

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 on 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 5 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 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. 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—2020. 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) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) .

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

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 on 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 on 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) 2021

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 on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2021

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 (explain in Part VI). 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 0.015 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 0.035	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) 2021

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

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. Don't 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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization The Children's Mercy Hospital

Part I Contributors	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) (2021)

Schedule B (Form 990) (2021)

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) (2021)

Schedule B (Form 990) (2021)

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) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990) 2021

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) ......................	0
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................	476,094
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................	476,094
d	Other exempt purpose expenditures ...............................................................................	1,297,857,097
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................	1,298,333,191
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) 2018	(b) 2019	(c) 2020	(d) 2021	(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	488,841	595,374	531,724	476,094	2,092,033

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) 2021

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|No

(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

Schedule C (Form 990) 2021

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.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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 7/25/06, 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 FASB 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 FASB 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 FASB 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) 2021

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 ....	116,845,965	79,934,240	73,663,733	69,788,763	61,620,527
b	Contributions ...	7,032,370	14,256,948	6,974,083	3,003,013	6,774,013
c	Net investment earnings, gains, and losses	-11,449,850	24,331,407	1,066,434	3,300,499	3,517,083
d	Grants or scholarships ...	2,173,533	1,676,630	1,770,010	2,428,542	2,122,860
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	110,254,952	116,845,965	79,934,240	73,663,733	69,788,763

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

80.150 %

Term endowment SchDMd Bullet

19.850 %

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 .....	24,549,276		24,549,276
b	Buildings ....	1,002,253,270	379,891,426	622,361,844
c	Leasehold improvements
d	Equipment ....	543,214,194	433,514,313	109,699,881
e	Other .....	30,467,358		30,467,358
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				787,078,359

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other 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

Investments - Program 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				62,083,733
(2)Income Beneficiary and Charitable Remainder Trusts				46,274,799
(3)Restricted Investments				115,887,973
(4)Right of Use Asset				31,954,750
(5)Due from other funds				5,333
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				256,206,588

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
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	151,716,293
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) 2021

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:

At June 30, 2022 and 2021, there were no uncertain tax positions.

Schedule D (Form 990) 2021

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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" on 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 the region	(d) Activities conducted in region (by type) (such as, 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 the region	(f) Total expenditures for and investments in the region
	Europe (Including Iceland & Greenland) - Albania, Andorra, Austria, Belgium	0	0	Program Services	Travel for healthcare-related education and information sharing	34,789
	North America - Canada and Mexico, but not the United States	0	0	Program Services	Travel for healthcare-related education and information sharing	8,194
	Sub-Saharan Africa - Angola, Benin, Botswana, Burkina Faso,	0	0	Program Services	Travel for healthcare-related education and information sharing	28,665
	Middle East and North Africa	0	0	Program Services	Travel for healthcare-related education and information sharing	4,358
	Central America and the Caribbean	0	0	Program Services	Travel for healthcare-related education and information sharing	9,870
	North America	0	0	Grantmaking		111,783
	Sub-Saharan Africa	0	0	Grantmaking		35,166










3a	Sub-total ....	0	0			232,825
b	Total from continuation sheets to Part I ...	0	0			0
c	Totals (add lines 3a and 3b)	0	0			232,825

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2021

Schedule F (Form 990) 2021

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on 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.

(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of noncash assistance	(i) Method of valuation (book, FMV, appraisal, other)
North America - Canada and Mexico, but not the United States	Research	27,012	Check	0	FMV
North America - Canada and Mexico, but not the United States	Research	84,771	Check	0	FMV
Sub-Saharan Africa - Angola, Benin, Botswana, Burkina Faso,	Research	24,795	Check	0	FMV
Sub-Saharan Africa - Angola, Benin, Botswana, Burkina Faso,	Research	10,371	Check	0	FMV

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
3	Enter total number of other organizations or entities .......................	1

Schedule F (Form 990) 2021

Schedule F (Form 990) 2021Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on 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 noncash assistance	(g) Description of noncash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2021

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2021

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 2:	Subrecipients sign an agreement which details the subrecipient's plan and budget as well as allowable expenditures of the Federal Awards. The agreement is also approved/signed by the Children's Mercy Hospital (CMH) signing official. Each subrecipient is required to submit periodic invoices (not more than monthly) to CMH for reimbursement. All expenditures on the invoice must be according to the subrecipient's budget that was developed during the application process. Invoices received from subrecipients are certified as complete and accurate by the subrecipient and reviewed and approved by the Principal Investigator or appropriate level of authorization, who forwards them to accounts payable for processing. In addition, Research and Grants (R&G) Accounting monitors these invoices to ensure proper coding to the correct award. The R&G accounting staff captures the amount on the budget-to-actual report to monitor the total amount spent by the subrecipient. Based on the amount budgeted to subrecipients and normal invoiced activity, the R&G accounting staff questions unreasonable invoice amounts with the subrecipient. In addition, any subrecipient that received more than $750,000 in Federal funds during the fiscal year is required to obtain an Uniformed Guidance (formerly A-133) audit and send a copy of the audit report to CMH's accounting department for review. The Post Award Manager is responsible for making sure that for all subrecipients that are required submit Uniform Guidance audits and that CMH has received an audit report. CMH maintains a subrecipient monitoring spreadsheet to track Uniform Guidance audit status, DUNS number, year-to-date spending, etc. for all subrecipients.
Part I, line 3:	Method Used to Account for Expenditures: Actual expenses for international travel and international grants.
Part III Accounting Method:
Schedule F, Part II, Line 1	Method Used to Account for Cash Grants and Noncash Assistance on the Organization's Financial Statement: Accrual.

Schedule F (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990)

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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 10 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)		(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
			Yes	No
	TrueSense 502 Keystone Dr Warrendale, PA15086	Consult/develop an annual fund and giving program		No	1,408,248	562,275	845,973









Total . . . . . . . . . . . . . . . . . . . .					1,408,248	562,275	845,973

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.

AL, AK, AZ, AR, CA, CO, CT, FL, ID, IN, KS, LA, ME, MI, MT, NE, NV, NC, OH, OK, OR, PA, RI, SC, SD, TX, UT, VT, VA, DE, HI, IA, MD, MO, WA, WV, WI, WY

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

Cat. No. 50083H

Schedule G (Form 990) 2021

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)	(c) Other events 1 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	2,163,101	3,011,626	287,053	5,461,780
2	Less: Contributions . . . .	1,865,997	2,754,638	286,883	4,907,518
3	Gross income (line 1 minus line 2) . . . . . .	297,104	256,988	170	554,262

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .
7	Food and beverages . . .	251,054	74,788		325,842
8	Entertainment . . . .
9	Other direct expenses . . .	282,135	406,771	1,559	690,465
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				1,016,307
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				-462,045

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 . . .

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) 2021

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 provide any additional information. See instructions.

Return Reference	Explanation
Schedule G, Part I, Line 2b, Column (v)	Payments to TrueSense during FY22 totaled $663,399. This amount includes $562,275 for consulting services and $101,124 of fundraising expenses. The agreement distinguishes consulting costs separate from any expense payments of reimbursements.

Schedule G (Form 990) 2021

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

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2021

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? . . . . . .

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	2	105,823	46,881,098	689,607	46,191,491	2.730 %
b	Medicaid (from Worksheet 3, column a) . . . . .	9	277,866	784,940,065	722,002,858	62,937,207	3.720 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	11	383,689	831,821,163	722,692,465	109,128,698	6.450 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	39	338,077	19,193,111	4,098,287	15,094,824	0.890 %
f	Health professions education (from Worksheet 5) . . .	9	11,277	38,332,042	19,138,629	19,193,413	1.130 %
g	Subsidized health services (from Worksheet 6) . . . .	19	115,268	69,802,087	29,954,967	39,847,120	2.350 %
h	Research (from Worksheet 7) .	477		47,869,107	31,298,025	16,571,082	0.980 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	5	29,787	2,013,782	34,766	1,979,016	0.120 %
j	Total. Other Benefits . .	549	494,409	177,210,129	84,524,674	92,685,455	5.470 %
k	Total. Add lines 7d and 7j .	560	878,098	1,009,031,292	807,217,139	201,814,153	11.920 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

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	4	203	176,286	9,000	167,286	0.010 %
2	Economic development	6	6	303,611	0	303,611	0.020 %
3	Community support
4	Environmental improvements
5	Leadership development and training for community members	2	17	1,848	0	1,848	0 %
6	Coalition building	1	900	184,741	190,060	0	0 %
7	Community health improvement advocacy	4	4	89,609	0	89,609	0.010 %
8	Workforce development	15	1,045	409,727	38,135	371,592	0.020 %
9	Other
10	Total	32	2,175	1,165,822	237,195	933,946	0.060 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare 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. ......

208,602

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).....

2,481,792

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

4,194,561

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

-1,712,769

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) 2021

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?2Name, 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) 2021

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

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): www.childrensmercy.org/communityneeds

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 22

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

Yes

If "Yes" (list url): www.childrensmercy.org/communityneeds

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) 2021

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)

Was widely publicized 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):

www.childrensmercy.org/financialcounseling/

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

Same as 16a

A plain language summary of the FAP was widely available on a website (list url):
Same as 16a

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)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	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 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 nonpayment?..................................

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

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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

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

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

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)

Schedule H (Form 990) 2021

Page 7

Part VFacility Information (continued)

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

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

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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) 2021

Page 8

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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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:	Children's Mercy developed the most recent CHNA with input from persons who represent broad interests within the community. Data collection for the CHNA occurred between November 2021 and May 2022. During this time, Children's Mercy held activities and hosted meetings to solicit input and feedback from the community. Activities included: two community meetings with 21 neighborhood residents representing low income and vulnerable populations; a telephone survey of 1,250 randomly selected parents/caregivers of children under the age of 18 years old living in the Children's Mercy service area; a Key Informant Online Survey sent to 300 elected officials, physicians, public health leaders, health professionals, social service providers, and business, neighborhood, housing, and community leaders (26% response rate); a Children's Health Summit held April 28, 2022 that invited community representatives to review CHNA data and identify critical health needs (140 attended). Organizations participating in the CHNA surveys and events included: Ability KC; American Lung Association; Amethyst Place; Arvest Bank; B-C Education Consultant Services; Belton School District; BikeWalkKC; Black Health Care Coalition; Blue Springs Pediatrics; Calvary Community Outreach Network; CASA of Johnson and Wyandotte Counties; Catholic Charities of Kansas City-St. Joseph; CDC Foundation - MoDHSS; Center for Neighborhoods; Cerner Corporation; Child Protection Center; City of Kansas City, Missouri; Clay County Children's Services Fund; Clay County Public Health Center; Community Health Council of Wyandotte County; CMC, Cockerall and McIntosh Pediatrics; Commerce Bank; Comprehensive Mental Health; Communities in Schools; Community Health Council of Wyandotte County; Community LINC; Core Changing Concepts; Cornerstones of Care; Cradle Kansas City; Cradle Thru College Care Pediatrics, Inc.; Crittenton Children's Center; Cross-Lines Community Outreach, Inc.; DeBruce Foundation; DHSS - Office of the Assistant Secretary for Health; El Centro; Fore the Kids Foundation; Front Porch Alliance; Girl Scouts of NE Kansas NW Missouri; Greater Kansas City Coalition to End Homelessness; Green Acres Urban Farm and Research Project; Growing Futures; Harvesters - The Community Food Network; Health Resources and Services Administration; Health Forward Foundation; Health Partnership of Johnson County; H&R Block Foundation and Bloch Family Foundation; Ivanhoe Neighborhood Council; Jackson County Community Mental Health Fund; Jackson County Court; JE Dunn Construction; Johnson County Department of Health and Environment; Kansas City Area Transit Authority; Kansas City Indian Center; Kansas City, Kansas Community College; Kansas City, Missouri Health Department; Kansas City, Missouri Health Commission; Kansas City, Missouri Public Schools; Kansas Department of Health and Environment; KC Common Good; KC Healthy Kids; Kids Win Missouri; Latino Health for All Coalition; Lee's Summit School District; Lee's Summit Pediatrics; Liberty Public Schools; March of Dimes; Marion and Henry Bloch Family Foundation; Mattie Rhodes Center; Mid-America Head Start; Mid-America Regional Council; Mid-Continent Public Library; Missouri Department of Health and Senior Services; MOCSA; Northland Neighborhoods, Inc.; Parent Leadership Training Institute; Pediatric Associates; Pediatric Care North; Phoenix Family; Planet Play; Platform Civic Strategies; Platte County Health Department; Platte County Prevention Coalition; Preferred Pediatrics; Public Progress; Project Eagle Early Head Start; REACH Healthcare Foundation; Samuel U. Rodgers Health Center; Sleepyhead Beds; Start at Zero, Stone County Health Department; Swope Health Services; Synergy Services, Inc.; The Family Conservancy; Tri-County Mental Health Services; Nurture KC; ReDiscover; Rose Brooks; SchoolSmart KC; University of Missouri - Kansas City School of Urban Planning & Design; City of Kansas City, Missouri LGBTQ Commission; Unified Government Public Health Department of Wyandotte County; United Community Services of Johnson County; United Way of Greater Kansas City; University Health; University of Kansas Medical Center; Uzazi Village; Sierra Club of Greater Kansas City; Sophic Solutions; Urban Neighborhood Initiatives; Webster County Health Department; Westside Housing Organization; Wyandotte Economic Development Council; Wyandotte Health Foundation; Wyandotte Mental Health; YMCA of Greater Kansas City; Youth Ambassadors, Inc. The CHNA provides a comprehensive list of all organizations and specifics on the data collection process. The priority needs identified were: child and youth mental health; access to health services; violence prevention; housing and neighborhood conditions. Priority health needs were selected based on the issue's importance to children's health, potential measurable impact if addressed, and Children's Mercy's ability to mitigate the issue with resources and personnel. The Children's Mercy Board of Directors approved the Priority Health Needs on June 15, 2022. The Priority Health Needs will receive heightened attention and support from Children's Mercy. Children's Mercy's 2022-2025 Implementation Plan was adopted by the Children's Mercy Board of Directors on November 7, 2022. For the tax year ended June 30, 2022, which is the time period reported in this Form 990, Children's Mercy addressed the significant health needs that were identified in its 2018 CHNA and in which the implementation strategy was adopted for fiscal years 2020, 2021 and 2022.
Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 11:	The implementation strategy plan that covers the time period reported on this tax return was approved on October 15, 2019 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 2018 tax year. The most recently adopted implementation strategy plan can be found on the hospital website:http://www.childrensmercy.org/communityneedsFrom 2021 to 2022, Children's Mercy continued to support program and efforts that addressed the 2019 CHNA identified priority health needs: Access to Care with a focus on Asthma; Improving Infant Health; Improving Mental/Behavioral Health; Addressing Nutrition/Physical Activity and Weight; Increasing Injury and Violence Prevention activities, Reducing Tobacco, Alcohol and Substance Abuse. The following highlights key programs and activities that address the priority health needs. Access to care with a focus on asthma key activities and programs: launched a school-based asthma telemedicine support program to better serve high-risk children living with asthma in three Kansas City schools; created online training modules for school nurses addressing school-based care for children living with asthma and diabetes; added asthma screening to community-based health fair events, reaching over 60 individuals; maintained an online daily pollen and spore count accessed by 17,500 unique visitors; launched COVID-19 testing program in the Kansas City, Missouri Public School District; Expanded Circulation transportation program to all clinical service at Children's Mercy Broadway and Operation Breakthrough locations, providing 2,179 rides between 2021 - 2022; Provided Project Adam education and training to create heart safe schools; Increased social determinants of health screenings and referral programs through the launch of the Lift Up KC community referral platform; expanded Athletic Training and support services to serve 10 schools and reaching 5,340 student athletes; expanded primary care services for children offered at Vibrant Health, a FQHC located in Wyandotte County, Kansas; supported the Community Health Council of Wyandotte County to expand health insurance coverage and the availability of community health workers; provided health services at clinics located at Synergy Services, University Academy, and Operation Breakthrough; participated in back-to-school events providing health assessments and referrals to needed resources. Mental and behavioral health: developed a mental and behavioral health strategic plan to create greater access, developed new partnerships, and expanded mental and behavioral health services for children in the region; provided education to 230 parents and caregivers of children who have experienced stressful or traumatic events in their lives; continued the Red Card: Call It When You See It anti-bullying campaign in partnership with local MLS soccer Team, Sporting Kansas City, reaching 21,766 students, parents, teachers, and community members; offered acute mental health screening in emergency department; expanded the Prepped & Ready parenting video education series to reach 371 parents and caregivers; hired community outreach staff to develop new partnerships and strengthen community-based mental health services. Infant health: Continued support to Promise 1000 and TIES home visiting services reaching 509 parents and children; participated in community baby shower events in partnership with the Kansas City Black Healthcare Coalition; provided financial support to efforts led by community-based organizations including Uzazi Village, Nurture KC, Every Baby to One, and Cradle KC to expand outreach, services, and education to pregnant and parenting families; expanded availability of safe sleep education and portable cribs to area agencies. Nutrition, physical activity, and weight: convened and partnered with community-based organizations through the Kansas City Physical Activity Plan; continued support of the Kids Eat Free summer foods program; established a food pantry at Children's Mercy Broadway; established a Girls on the Run program; continued maintenance of the Children's Mercy Community Garden, serving 200 community members; facilitated a weight management evening group reaching 841 parents and children; established the Fruits and veggie Connect program. Injury and violence prevention: continue to serve as a leader with the Safe Kids Greater Kansas City Coalition; established the Community Outreach & Violence Response (COVER) program in the emergency department to serve as an intervention and support resource for families impacted by violence, reaching over 71 families between 2021 - 2022; continued to distribute gun locks; provided financial support to the Ad Hoc Group Against Crime, Mothers in Charge, Grandparents Against Gun Violence, and Charlie's House to support community-based initiatives to reduce injury and violence; distributed car seats and booster seats to 2,082 families and provided car seat consultations to 2,090 families; supported community-based bike rodeos and distributed bike helmets to promote injury prevention. Tobacco, Alcohol, and Substance Abuse: participated in national drug take-back days; provided community-based educational presentations on vaping and tobacco use; provided smoking cessation support for parents of children hospitalized at Children's Mercy. Children's Mercy's website provides a link that allows community organizations to submit requests for Children's Mercy to provide resources, program support and/or expertise to address identified community needs. Between 2021-2022, Children's Mercy received 67 requests that included 50 community/school events/health fairs and over 17 technical assistance/presentations/workshops/training services. Organizations receiving financial support from Children's Mercy include: Ability KC; AIDS Service Foundation of Greater Kansas City; American Heart Association; Angel Flight Central, Inc.; Big Brothers Big Sisters of Greater Kansas City; Bionexus KC; Black Health Care Coalition of Greater Kansas City; Boys and Girls Club of America; Children's Place; Children's Center for the Visually Impaired; Chrons and Colitis Foundation; Community Assistance Council; Community Services League; Child Protection Center; Friends of Johnson County Mental Health, Inc.; Front Porch Alliance; Giving Hope and Help, Inc.; Grandparents for Gun Safety; HappyBottoms; Head for the Cure Foundation; Jackson County CASA; Junior League of Kansas City, Missouri; Kansas City Friends of Alvin Ailey; Kansas City Public Schools; Kansas City Hospice Foundation; Lead to Read, Inc.; Local Initiatives Support Corporation; Metropolitan Organization to Counter Sexual Assault; Missouri KidsFirst Child Advocacy Centers, Inc.; Newhouse, Inc.; Operation Breakthrough, Inc.; Ronald McDonald Charities; Rose Brooks Center; SAVE, Inc.; Sherwood Autism Center; Sunflower House, Inc.; Teach for America; Truman Heartland Community Foundation; Wichita's Little Heroes.
Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 13b:	The written financial assistance policy explains criteria beyond FPG to include residency requirements, available payors to applicant, asset levels, and in-network insurance status.
Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, line 13h:	Patients seeking care at organization with out of network insurance plans are not eligible for charity care.
Group A-Facility 1 -- The Children's Mercy Hospital Part V, Section B, Line 20a:	Because the Hospital is not exercising any extraordinary collection actions in the event of nonpayment, it has no occasion to provide a written notice about upcoming ECAs.
Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 5:	Children's Mercy developed the most recent CHNA with input from persons who represent broad interests within the community. Data collection for the CHNA occurred between November 2021 and May 2022. During this time, Children's Mercy held activities and hosted meetings to solicit input and feedback from the community. Activities included: two community meetings with 21 neighborhood residents representing low income and vulnerable populations; a telephone survey of 1,250 randomly selected parents/caregivers of children under the age of 18 years old living in the Children's Mercy service area; a Key Informant Online Survey sent to 300 elected officials, physicians, public health leaders, health professionals, social service providers, and business, neighborhood, housing, and community leaders (26% response rate); a Children's Health Summit held April 28, 2022 that invited community representatives to review CHNA data and identify critical health needs (140 attended). Organizations participating in the CHNA surveys and events included: Ability KC; American Lung Association; Amethyst Place; Arvest Bank; B-C Education Consultant Services; Belton School District; BikeWalkKC; Black Health Care Coalition; Blue Springs Pediatrics; Calvary Community Outreach Network; CASA of Johnson and Wyandotte Counties; Catholic Charities of Kansas City-St. Joseph; CDC Foundation - MoDHSS; Center for Neighborhoods; Cerner Corporation; Child Protection Center; City of Kansas City, Missouri; Clay County Children's Services Fund; Clay County Public Health Center; Community Health Council of Wyandotte County; CMC, Cockerall and McIntosh Pediatrics; Commerce Bank; Comprehensive Mental Health; Communities in Schools; Community Health Council of Wyandotte County; Community LINC; Core Changing Concepts; Cornerstones of Care; Cradle Kansas City; Cradle Thru College Care Pediatrics, Inc.; Crittenton Children's Center; Cross-Lines Community Outreach, Inc.; DeBruce Foundation; DHSS - Office of the Assistant Secretary for Health; El Centro; Fore the Kids Foundation; Front Porch Alliance; Girl Scouts of NE Kansas NW Missouri; Greater Kansas City Coalition to End Homelessness; Green Acres Urban Farm and Research Project; Growing Futures; Harvesters - The Community Food Network; Health Resources and Services Administration; Health Forward Foundation; Health Partnership of Johnson County; H&R Block Foundation and Bloch Family Foundation; Ivanhoe Neighborhood Council; Jackson County Community Mental Health Fund; Jackson County Court; JE Dunn Construction; Johnson County Department of Health and Environment; Kansas City Area Transit Authority; Kansas City Indian Center; Kansas City, Kansas Community College; Kansas City, Missouri Health Department; Kansas City, Missouri Health Commission; Kansas City, Missouri Public Schools; Kansas Department of Health and Environment; KC Common Good; KC Healthy Kids; Kids Win Missouri; Latino Health for All Coalition; Lee's Summit School District; Lee's Summit Pediatrics; Liberty Public Schools; March of Dimes; Marion and Henry Bloch Family Foundation; Mattie Rhodes Center; Mid-America Head Start; Mid-America Regional Council; Mid-Continent Public Library; Missouri Department of Health and Senior Services; MOCSA; Northland Neighborhoods, Inc.; Parent Leadership Training Institute; Pediatric Associates; Pediatric Care North; Phoenix Family; Planet Play; Platform Civic Strategies; Platte County Health Department; Platte County Prevention Coalition; Preferred Pediatrics; Public Progress; Project Eagle Early Head Start; REACH Healthcare Foundation; Samuel U. Rodgers Health Center; Sleepyhead Beds; Start at Zero, Stone County Health Department; Swope Health Services; Synergy Services, Inc.; The Family Conservancy; Tri-County Mental Health Services; Nurture KC; ReDiscover; Rose Brooks; SchoolSmart KC; University of Missouri - Kansas City School of Urban Planning & Design; City of Kansas City, Missouri LGBTQ Commission; Unified Government Public Health Department of Wyandotte County; United Community Services of Johnson County; United Way of Greater Kansas City; University Health; University of Kansas Medical Center; Uzazi Village; Sierra Club of Greater Kansas City; Sophic Solutions; Urban Neighborhood Initiatives; Webster County Health Department; Westside Housing Organization; Wyandotte Economic Development Council; Wyandotte Health Foundation; Wyandotte Mental Health; YMCA of Greater Kansas City; Youth Ambassadors, Inc. The CHNA provides a comprehensive list of all organizations and specifics on the data collection process. The priority needs identified were: child and youth mental health; access to health services; violence prevention; housing and neighborhood conditions. Priority health needs were selected based on the issue's importance to children's health, potential measurable impact if addressed, and Children's Mercy's ability to mitigate the issue with resources and personnel. The Children's Mercy Board of Directors approved the Priority Health Needs on June 15, 2022. The Priority Health Needs will receive heightened attention and support from Children's Mercy. Children's Mercy's 2022-2025 Implementation Plan was adopted by the Children's Mercy Board of Directors on November 7, 2022. For the tax year ended June 30, 2022, which is the time period reported in this Form 990, Children's Mercy addressed the significant health needs that were identified in its 2018 CHNA and in which the implementation strategy was adopted for fiscal years 2020, 2021 and 2022.
Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 11:	The implementation strategy plan that covers the time period reported on this tax return was approved on October 15, 2019 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 2018 tax year. The most recently adopted implementation strategy plan can be found on the hospital website:http://www.childrensmercy.org/communityneedsFrom 2021 to 2022, Children's Mercy continued to support program and efforts that addressed the 2019 CHNA identified priority health needs: Access to Care with a focus on Asthma; Improving Infant Health; Improving Mental/Behavioral Health; Addressing Nutrition/Physical Activity and Weight; Increasing Injury and Violence Prevention activities, Reducing Tobacco, Alcohol and Substance Abuse. The following highlights key programs and activities that address the priority health needs. Access to care with a focus on asthma key activities and programs: launched a school-based asthma telemedicine support program to better serve high-risk children living with asthma in three Kansas City schools; created online training modules for school nurses addressing school-based care for children living with asthma and diabetes; added asthma screening to community-based health fair events, reaching over 60 individuals; maintained an online daily pollen and spore count accessed by 17,500 unique visitors; launched COVID-19 testing program in the Kansas City, Missouri Public School District; Expanded Circulation transportation program to all clinical service at Children's Mercy Broadway and Operation Breakthrough locations, providing 2,179 rides between 2021 - 2022; Provided Project Adam education and training to create heart safe schools; Increased social determinants of health screenings and referral programs through the launch of the Lift Up KC community referral platform; expanded Athletic Training and support services to serve 10 schools and reaching 5,340 student athletes; expanded primary care services for children offered at Vibrant Health, a FQHC located in Wyandotte County, Kansas; supported the Community Health Council of Wyandotte County to expand health insurance coverage and the availability of community health workers; provided health services at clinics located at Synergy Services, University Academy, and Operation Breakthrough; participated in back-to-school events providing health assessments and referrals to needed resources. Mental and behavioral health: developed a mental and behavioral health strategic plan to create greater access, developed new partnerships, and expanded mental and behavioral health services for children in the region; provided education to 230 parents and caregivers of children who have experienced stressful or traumatic events in their lives; continued the Red Card: Call It When You See It anti-bullying campaign in partnership with local MLS soccer Team, Sporting Kansas City, reaching 21,766 students, parents, teachers, and community members; offered acute mental health screening in emergency department; expanded the Prepped & Ready parenting video education series to reach 371 parents and caregivers; hired community outreach staff to develop new partnerships and strengthen community-based mental health services. Infant health: Continued support to Promise 1000 and TIES home visiting services reaching 509 parents and children; participated in community baby shower events in partnership with the Kansas City Black Healthcare Coalition; provided financial support to efforts led by community-based organizations including Uzazi Village, Nurture KC, Every Baby to One, and Cradle KC to expand outreach, services, and education to pregnant and parenting families; expanded availability of safe sleep education and portable cribs to area agencies. Nutrition, physical activity, and weight: convened and partnered with community-based organizations through the Kansas City Physical Activity Plan; continued support of the Kids Eat Free summer foods program; established a food pantry at Children's Mercy Broadway; established a Girls on the Run program; continued maintenance of the Children's Mercy Community Garden, serving 200 community members; facilitated a weight management evening group reaching 841 parents and children; established the Fruits and veggie Connect program. Injury and violence prevention: continue to serve as a leader with the Safe Kids Greater Kansas City Coalition; established the Community Outreach & Violence Response (COVER) program in the emergency department to serve as an intervention and support resource for families impacted by violence, reaching over 71 families between 2021 - 2022; continued to distribute gun locks; provided financial support to the Ad Hoc Group Against Crime, Mothers in Charge, Grandparents Against Gun Violence, and Charlie's House to support community-based initiatives to reduce injury and violence; distributed car seats and booster seats to 2,082 families and provided car seat consultations to 2,090 families; supported community-based bike rodeos and distributed bike helmets to promote injury prevention. Tobacco, Alcohol, and Substance Abuse: participated in national drug take-back days; provided community-based educational presentations on vaping and tobacco use; provided smoking cessation support for parents of children hospitalized at Children's Mercy. Children's Mercy's website provides a link that allows community organizations to submit requests for Children's Mercy to provide resources, program support and/or expertise to address identified community needs. Between 2021-2022, Children's Mercy received 67 requests that included 50 community/school events/health fairs and over 17 technical assistance/presentations/workshops/training services. Organizations receiving financial support from Children's Mercy include: Ability KC; AIDS Service Foundation of Greater Kansas City; American Heart Association; Angel Flight Central, Inc.; Big Brothers Big Sisters of Greater Kansas City; Bionexus KC; Black Health Care Coalition of Greater Kansas City; Boys and Girls Club of America; Children's Place; Children's Center for the Visually Impaired; Chrons and Colitis Foundation; Community Assistance Council; Community Services League; Child Protection Center; Friends of Johnson County Mental Health, Inc.; Front Porch Alliance; Giving Hope and Help, Inc.; Grandparents for Gun Safety; HappyBottoms; Head for the Cure Foundation; Jackson County CASA; Junior League of Kansas City, Missouri; Kansas City Friends of Alvin Ailey; Kansas City Public Schools; Kansas City Hospice Foundation; Lead to Read, Inc.; Local Initiatives Support Corporation; Metropolitan Organization to Counter Sexual Assault; Missouri KidsFirst Child Advocacy Centers, Inc.; Newhouse, Inc.; Operation Breakthrough, Inc.; Ronald McDonald Charities; Rose Brooks Center; SAVE, Inc.; Sherwood Autism Center; Sunflower House, Inc.; Teach for America; Truman Heartland Community Foundation; Wichita's Little Heroes.
Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 13b:	The written financial assistance policy explains criteria beyond FPG to include residency requirements, available payors to applicant, asset levels, and in-network insurance status.
Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, line 13h:	Patients seeking care at organization with out of network insurance plans are not eligible for charity care.
Group A-Facility 2 -- Children's Mercy Kansas Part V, Section B, Line 20a:	Because the Hospital is not exercising any extraordinary collection actions in the event of nonpayment, it has no occasion to provide a written notice about upcoming ECAs.

Schedule H (Form 990) 2021

Page 9

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?10
Name and address		Type of Facility (describe)
1	1 - Children's Mercy Wichita Clinic 3243 E Murdock Suite 201 Wichita,KS67208	Outpatient Clinics
2	2 - Children's Mercy Village West 1801 N 98th Street Kansas City,KS66109	Rehabilitation
3	3 - Children's Mercy at KU Hospital 2000 Olathe Boulevard Kansas City,KS66103	Outreach Clinic
4	4 - Children's Mercy Joplin Clinic 3333 McIntosh Circle Suite 6 Joplin,MO64804	Outpatient Clinics
5	5 - Children's Mercy St Joseph 802 N Riverside Rd Suite 105 St Joseph,MO64502	Outpatient Clinics
6	6 - Children's Mercy Outreach Garden City 311 E Spruce St Garden City,KS67846	Outreach Clinic
7	7 - Children's Mercy Outreach Junction City 361 Grant Ave Junction City,KS66441	Outreach Clinic
8	8 - Children's Mercy Olathe 20333 W 151st St Olathe,KS66061	Outpatient Clinics
9	9 - Children's Mercy Outreach Great Bend 1021 Einsenhower Ave Great Bend,KS65730	Outreach Clinic
10	10 - Children's Mercy Outreach Springfield 1000 E Primrose Suite 300 Springfield,MO65807	Outreach Clinic

Schedule H (Form 990) 2021

Page 10

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:	Free care eligibility is based on FPG and other factors such as residency and exhausting other available payor sources. For discounted care, if a financial assistance application was denied and the decision then appealed, the case is reviewed through a multi-disciplinary committee that uses a point system rubric using indicators such as FPG, total balance due as a percentage of annual income, out of pocket responsibility for upcoming year as a percentage of annual income, annual frequency of visits for ongoing care, financial hardship indicators such as recent bankruptcy/foreclosure, and medical complexity due to health condition. Each factor, if applicable, is reviewed and assigned point value based on a preset scale, that serves as a tool for the discounted care scale.
Part I, Line 7:	The cost-to-charge ratio derived from Worksheet 2 was used for Lines 7a and 7b. Cost from the Medicare Cost Report was used for Lines 7f (Health Professions Education). Cost from our decision support system was used for 7g (Subsidized Health Services).
Part I, Line 7g:	In FY22, over 115,000 children were reached through clinical services classified as Subsidized Health Services. Subsidized health services included pediatric primary care clinics at Children's Mercy Broadway as well as community-based clinics located at Synergy Services (youth-serving agency), Operation Breakthrough (early childhood center) and at University Academy (K-12 charter school). Other subsidized health services include: adolescent medicine; burn unit outpatient; child adversity & resilience; child & family mental health services; Center for Healthy Lifestyles and Nutrition; developmental & behavioral medicine; general pediatrics; genetics; hematology/oncology; home health; neonatology follow up; ophthalmology; pain management; palliative care outpatient; sexual assault nursing education program; teen clinic; critical care transport services. The services are provided at a financial loss to Children's Mercy after removing Charity Care, unreimbursed Medicaid, private insurance shortages and contract, grants and gifts. All subsidized health services meet an identified community need and a shortage of available services would exist in the community if Children's Mercy did not provide the service.
Part I, Line 7A:	Financial assistance cost reported on this line is derived from Worksheet 1 which takes gross charges for patients who have been awarded financial assistance and then multiplies those charges by a cost-to-charge ratio derived from Worksheet 2 to arrive at cost of providing financial assistance.
Part I, Line 7H:	Children's Mercy researchers strive to find better ways to prevent, treat and eliminate pediatric disease and to improve community-based health outcomes. In FY22, over 477 studies met Community Benefit criteria. The Children's Research Institute is creating an integrated research environment where no boundaries exist between science and medicine. The hospital's leadership in pediatric genomic medicine and clinical pharmacology is driving research and innovation in nephrology, cardiology, cancer treatment and other subspecialties to provide answers for the most difficult cases and challenging pediatric conditions. In addition, a dedicated, state-of-art biorepository that can advance diagnostic discovery and health outcomes is available for use by all researchers.
Part II, Community Building Activities:	The Children's Mercy community building activities address identified community health needs such as physical activity, poverty, access to health services, mental and behavioral health, and employment. The activities include programs and/or resources intended to make physical improvements, provide community support, advocate for community health improvements, and address community-wide workforce issues through numerous workforce development outreach initiatives. Examples include the maintenance of the Hospital Hill Park and the Sylvia Nutter Playground, facilitation of the UMKC Health Sciences District, establishment of the Health Sciences District Community Improvement District (CID), the management of a community garden, advocacy activities, participation on Chamber of Commerce committees related to health improvement, health careers exploration activities for elementary students through support of Junior Achievement BizTown, and healthcare workforce development for high school students and community members.
Part III, Line 4:	Audited Financial Statements Footnote M, Page 13.
Part III, Line 8:	Cost to charge ratio
Part III, Line 9b:	Collection attempts are discontinued once charges are determined to be eligible for charity care or financial assistance; insurance collection attempts continue as appropriate.
Part VI, Line 2:	The hospital has an initiative development process that brings forward new initiatives around strategic, operational, community health, and innovation based on community/market trends and needs and through consultation with community-based organizations. On a routine basis, the Strategic Planning Department monitors demographic and service trends of the region and compares this data to national benchmarks. The hospital strategic planning process also takes into account all of the qualitative and quantitative market data to define strategies and tactics that address the community need. In addition, Trauma Services maintains a Trauma Registry and the Promise 1000 centralizes the data collection on the health services and needs of children (0 - 3 years of age) who receive home visiting services.
Part VI, Line 3:	Flyers and financial counselor business cards and copies of the Financial Assistance Plain Language Summary are available at all access points within the Hospital. Efforts are made by the financial counselors to contact self pay patients and families, either in person, or through phone call or letters to inform/assist families with charity care and Medicaid or state program eligibility. Self pay or underinsured patients can also be referred to a financial counselor by an Access Representative, Patient Care Services, Social Work, Patient Financial Services, or other staff members for screening and assistance. All billing statements refer patients to financial counseling resources and the financial assistance policy posted on the hospital website.
Part VI, Line 4:	Children's Mercy serves over 230,000 children from across the states of Kansas and Missouri. In Kansas 102 counties and in Missouri 114 counties have federally designated primary care HPSA areas. Across the two states, Children's Mercy identifies 43 counties as the Outreach Service Area, 50 counties as the Secondary Service Area, and 18 counties as the Primary Service Area. Within the Primary Service Area are six counties called the Metro Service Area. Each of the service areas include urban, suburban and rural counties. The Outreach Service Area includes more rural counties than the other service areas. The Metro Service Area includes more urban and suburban areas than rural. Within the Metro Service Area are the five counties (Jackson, Clay, and Platte counties located in Missouri and Johnson and Wyandotte counties located in Kansas) that comprise the Children's Mercy CHNA service area. All five counties have primary care HPSA designations. Children's Mercy is the only children's hospital in the region. Limited pediatric services are available at the Kansas University Medical Center, St. Luke's Health System, Centerpoint, Liberty Hospital, North Kansas City, Research Medical Center, Shawnee Mission Medical Center and Overland Park hospitals. During the fiscal year in which Children's Mercy initiated the CHNA, residents of Jackson, Clay, Platte, Wyandotte, and Johnson Counties contribute over 72 percent of the encounters at Children's Mercy. The Children's Mercy CHNA service area serve as the location of our physical facilities (e.g., Children's Mercy Adele Hall Campus, Children's Mercy Hospital Kansas, Children's Mercy West, Children's Mercy Northland, Children's Mercy Broadway, Children's Mercy College Boulevard, Children's Mercy Olathe, Children's Mercy Blue Valley, Children's Mercy at The University of Kansas Hospital, Children's Mercy Sports Medicine at Village West, and Children's Mercy East) and the source of a majority of our patient encounters. The five counties house a total population of 1,861,214. Of these, 440,392 or 24 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 five counties increased between 1980 and 2020 and the overall make-up of the population shifted as well. In 1980, black, Hispanic or other ethnicities comprised 21 percent of the five counties under 18 years of age population. In 2020 36.4 percent of the region's under 18 population made up these groups. A higher percentage of children under age 18 years live in poverty than the population as a whole. The percentage of children under age 18 who live in poverty has grown in four of the five counties from 2015 to 2020. The highest percentage of children living in poverty is in Wyandotte County (26.7%), followed by Jackson County (20.2%), Clay County (11.5%), Platte County (5.9%), and Johnson County (5.4%).
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 provides funding and partnership to over 75 community organizations and efforts that support programs addressing the CHNA priority health needs. Organizations include: Operation Breakthrough; Reach Out and Read; Black Health Care Coalition; Happy Bottoms; Community Health Council of Wyandotte County; Northland Health Alliance; Uzazi Village; Boys and Girls Clubs of Greater KC; Teach for America; Local Initiatives Support Corporation; Front Porch Alliance; Big Brothers Big Sisters of Greater Kansas City; AIDS Service Foundation of Greater Kansas City; Vibrant Health Services; Greenline Foundation; and Ronald McDonald House Charities of Kansas City. Through the Kansas City Physical Activity Plan, Children's Mercy convened with organizations across the community to improve physical infrastructures to promote healthy living and eating. Programs working to improve outcomes for children are strengthened through a community-wide strategy to organize home visiting; participation in community health fairs; support for healthy housing;support the mental health of children; service on key community committees (i.e. Infant and Child Mortality review boards). Children's Mercy works closely with area school districts to support education, risk mitigation practices, testing and vaccination.
Part VI, Line 6:	The Children's Mercy Hospital is not part of an affiliated health care system.

Schedule H (Form 990) 2021

Additional Data

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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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

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	(h) Purpose of grant or assistance
(1) American Heart Association 7272 Greenville Avenue Dallas,TX75231	13-5613797	501(c)3	21,540	To support vaping prevention, healthy living and physical activity activities and education for children and youth in Wichita and Kansas City region.
(2) Vibrant Health- Turner Health Clinic 12 North 12th Street Suite 300 Kansas City,KS66102	48-1151382	501(c)3	893,716	To support access to care.
(3) Community Health Council of Wyandotte County 803 Armstrong Ave Kansas City,KS66101	01-0674969	501(c)3	17,500	To support efforts to improve access to care for Wyandotte County residents.
(4) Kansas University Endowment PO Box 928 Lawrence,KS66044	48-0547734	501(c)3	5,500	Support annual health equity conference and Medical Student Association.
(5) Greenline Foundation 3230 Benton Boulevard Kansas City,MO64128	85-2704983	501(c)3	200,000	To support housing options for families living in central Kansas City.
(6) Ronald McDonald House Charities 2502 Cherry St Kansas City,MO64108	43-1190760	501(c)3	103,620	To increase access to care by providing housing for families.
(7) RareKC Foundation 10708 West 129th Street Overland Park,KS66213	82-3511792	501(c)3	25,000	To support education, awareness, and research on rare diseases.
(8) Camps for Kids 5913 Woodson Road Mission,KS66202	43-1244326	501(c)3	19,315	o support summer camp for children, includes Camp Systole and Camp ChiMer.
(9) Boys and Girls Clubs of Greater Kansas City 4001 Dr Martin Luther King Jr Blvd Kansas City,MO64130	43-6072065	501(c)3	18,500	To support physical activity and social emotional health programs for children.
(10) Operation Breakthrough 3039 Troost Kansas City,MO64109	43-0971560	501(c)3	12,174	To support programs for children.
(11) Amethyst Place 2735A Troost Kansas City,MO64109	43-1887442	501(c)3	10,000	To support the development of a playground.
(12) Black Health Care Coalition 6400 Independence Ave Kansas City,MO64125	43-1515095	501(c)3	10,000	To support outreach to pregnant women and new parents.
(13) Burns Recovered Support Group 6220 South Lindberg BoulevardSuite 203 St Louis,MO63123	43-1412215	501(c)3	10,000	To support summer camp opportunities for children.
(14) Food Equality Initiative 300 East 39th Street Kansas City,MO64111	47-2377396	501(c)3	10,000	To address food insecurity.
(15) Uzazi Village 4232 Troost Kansas City,MO64110	46-0589830	501(c)3	10,000	To support black women in achieving healthy birth outcomes.
(16) Arthritis Foundation 1355 Peachtree St NE Suite 600 Atlanta,GA30309	58-1341679	501(c)3	8,500	To support Camp Joint Adventure and education and awareness.
(17) UMKC Foundation 5115 Oak Street Kansas City,MO64112	26-0840496	501(c)3	8,250	To support medical school education.
(18) March of Dimes Foundation 1550 Crystal Drive Suite 1300 Arlington,VA22202	13-1846366	501(c)3	7,500	To support pregnant women and infants.
(19) Midwest Hemophilia Association 1471 West South Street Suite F Ozark,MO64134	43-1595395	501(c)3	7,500	To support summer camp opportunities for children.
(20) Community Assistance council 10901 Blue Ridge Boulevard Kansas City,MO64134	23-7439079	501(c)3	7,000	o support agency in addressing SDOH
(21) Community Services League 404 North Noland Road Independence,MO64050	43-0976396	501(c)3	7,000	To support agency in addressing SDOH.
(22) Duke University PO Box 104132 Durham,NC27708	56-0532129	501(c)3	164,464	Research
(23) H Lee Moffitt Cancer Center 12902 Magnolia Dr Tampa,FL33612	59-2451713	501(c)3	9,540	Research
(24) Midwest Biomedical Research PO Box 300662 Kansas City,MO64130	43-1496422		181,413	Research
(25) Illumisoft LLC 1111 Main Street Kansas City,MO64105	82-3165111		21,987	Research
(26) CYFT Incorporated 222 Third Street Suite 1130 Cambridge,MA02142	47-3547678		1,176,250	Research
(27) University of Alabama 701 20th Street S Birmingham,AL35294	63-6005396	501(c)3	8,358	Research
(28) Washington University 700 Rosedale Avenue Saint Louis,MO63112	43-0653611	501(c)3	6,827	Research
(29) Kansas University Endowment Association PO Box 928 Lawrence,KS66044	48-0547734	501(c)3	240,000	Research
(30) Albert Einstein College of Medicine 1300 Morris Park Ave Bronx,NY10461	83-0621846		88,953	Research
(31) University of North Carolina at Chapel Hill PO Box 402420 Atlanta,GA30384	56-6001393	501(c)3	113,390	Research
(32) San Diego State University Foundation 5250 Campanile Drive San Diego,CA92182	95-6042721		108,672	Research
(33) KU Hospital Authority 3901 Rainbow Blvd Kansas City,KS66160	48-1202402	GOVT	35,000	Research
(34) University of Miami PO Box 248106 Coral Gables,FL33124	59-0624458	501(c)3	242,527	Research
(35) University of Illinois 506 South Wright Street Urbana,IL61801	37-6000511	501(c)3	52,688	Research
(36) CHOP Children's Hospital of Philadelphia 3401 Civic Center Blvd Philadelphia,PA19104	23-1352166	501(c)3	144,466	Research
(37) EMORY Genetics Medical Research Pediatrics 1760 Haygood Drive NE Suite W440C Atlanta,GA30322	58-0566256	501(c)3	25,597	Research
(38) University of Chicago 5801 South Ellis Ave Chicago,IL60637	36-2177139	501(c)3	270,588	Research
(39) University of Pittsburgh 500 Ross Street Pittsburg,PA15262	25-0965591	501(c)3	13,906	Research
(40) University of Wisconsin 465 Henry Mall Madison,WI53706	39-1805963	501(c)3	13,457	Research
(41) Dupont Hospital for Children Nemours Foundation 1600 Rockland Rd Wilmington,DE19803	59-0634433	501(c)3	58,369	Research
(42) State of Kansas KUMC 3901 Rainbow Blvd Kansas City,KS66160	48-1124839	GOVT	23,759	Research
(43) Oxford University Press 2001 Evans Road Cary,NC27513	98-6001062		176,628	Research
(44) Children's Hospital Boston 300 Longwood Ave Boston,MA02115	04-2774441	501(c)3	6,828	Research
(45) Huntsman Cancer Institute University of Utah 2000 Circle of Hope Salt Lake City,UT84112	87-6000525	501(c)3	13,658	Research
(46) Adventhealth Centra Care 2600 Westhall Lane Maitland,FL32751	48-0637731	501(c)3	49,503	Research
(47) University of Nebraska Medical Center 985045 Nebraska Medical Center Omaha,NE68198	47-0049123	GOVT	250,480	Research
(48) Joslin Diabetes Center Inc One Joslin Place Boston,MA02215	04-2203836		119,735	Research
(49) Wright State University 3640 Colonel Glen Highway Dayton,OH45435	31-0732831	GOVT	28,588	Research
(50) Arkansas Children's Research Institute 13 Childrens Way Little Rock,AR72202	71-0694931	501(c)3	12,000	Research
(51) Children's Research Institute 111 Michigan Ave NW Suite 5400 Washington,DC20010	52-1654453	501(c)3	42,180	Research
(52) Medical College of Wisconsin 8701 Watertown Plank Rd Milwaukee,WI53226	39-0806261	501(c)3	19,925	Research
(53) Oregon Health & Science 3181 SW Sam Jackson Park Rd AD201 Portland,OR97239	93-1176109	GOVT	18,458	Research
(54) Seattle Children's Hospital 4800 Sand Point Way NE Seattle,WA98105	91-0564748	501(c)3	38,741	Research
(55) Regents UCSF 1955 Folsom Street San Francisco,CA94143	94-6036493	501(c)3	12,200	Research
(56) University of California 9500 Gilman Dr La Jolla,CA92093	33-0833316	501(c)3	22,511	Research
(57) University of New Mexico 1 University of New Mexico Albuquerque,NM87131	85-6000642	GOVT	22,318	Research
(58) Cincinnati Children's Hospital 3333 Burnet Avenue Suite 330 Cincinnati,OH45229	31-0833936	501(c)3	55,131	Research
(59) Stanford Junior University 3145 Porter Dr Palo Alto,CA94304	94-1156365	501(c)3	6,593	Research
(60) KU Center for Research KUCR 2385 Irving Hill Road Lawrence,KS66045	48-0680117	501(c)3	77,471	Research
(61) Vanderbilt Medical Center Dept AT 40379 Atlanta,GA31192	35-2528741	501(c)3	18,635	Research
(62) KUMC Research Institute Inc 3901 Rainbow Blvd Kansas City,MO66160	48-1108830	501(c)3	459,989	Research
(63) University of Missouri UMKC KCUR 118 University Hall Columbia,MO65211	43-6003859	GOVT	253,175	Research
(64) Cleveland Clinic 9500 Euclid Avenue NA-4 Cleveland,OH44195	34-0714585	501(c)3	11,751	Research
(65) Research Institute at Nationwide Children's Hospital 700 Childrens Drive Columbus,OH43205	31-6056230	501(c)3	7,000	Research

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) 2021

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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) Patient Financial Assistance	105823	0	111,404,525	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:

Children's Mercy provides charitable contributions to nonprofit organizations which share a common mission to improve the health and well-being of children. The contributions are restricted to meet a community identified need and community benefit requirements. Children's Mercy documents the appropriate use of our funds by sending a restricted contribution letter; attending annual events; reviewing web-based annual reports; and meeting with agency grant recipient to ascertain the outcomes of their work. Subrecipients sign an agreement which details the subrecipient's plan and budget as well as allowable expenditures of the Federal Awards. The agreement is also approved/signed by the Children's Mercy Hospital (CMH) signing official. Each subrecipient is required to submit periodic invoices (not more than monthly) to CMH for reimbursement. All expenditures on the invoice must be according to the subrecipient's budget that was developed during the application process. Invoices received from subrecipients are certified as complete and accurate by the subrecipient and reviewed and approved by the Principal Investigator or appropriate level of authorization, who forwards them to accounts payable for processing. In addition, Research and Grants (R&G) Accounting monitors these invoices to ensure proper coding to the correct award. The R&G accounting staff captures the amount on the budget-to-actual report to monitor the total amount spent by the subrecipient. Based on the amount budgeted to subrecipients and normal invoiced activity, the R&G accounting staff questions unreasonable invoice amounts with the subrecipient. In addition, any subrecipient that received more than $750,000 in Federal funds during the fiscal year is required to obtain a Uniformed Guidance (formerly A-133) audit and send a copy of the audit report to CMH's accounting department for review. The Post Award Manager is responsible for making sure that for all subrecipients that are required submit Uniform Guidance audits and that CMH has received an audit report. CMH maintains a subrecipient monitoring spreadsheet to track Uniform Guidance audit status, DUNS number, year-to-date spending, etc. for all subrecipients.

Schedule I (Form 990) 2021

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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 on 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 on 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? .............

Yes

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

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? ..................

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 nonfixed
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) 2021

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, 1099-MISC compensation, and/or 1099-NEC			(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)
1Paul D Kempinski MS FACHE Director; President & CEO	(i) (ii)	1,115,317 ------------- 0	426,440 ------------- 0	24,219 ------------- 0	21,750 ------------- 0	21,192 ------------- 0	1,608,918 ------------- 0	0 ------------- 0
2James O'Brien Jr MD Physician	(i) (ii)	1,530,430 ------------- 0	0 ------------- 0	23,002 ------------- 0	26,100 ------------- 0	20,511 ------------- 0	1,600,043 ------------- 0	0 ------------- 0
3William Douglas MD Physician	(i) (ii)	1,479,300 ------------- 0	0 ------------- 0	23,002 ------------- 0	21,750 ------------- 0	20,529 ------------- 0	1,544,581 ------------- 0	0 ------------- 0
4Chad Mills Sr VP, CIO; End 10/23/21	(i) (ii)	410,126 ------------- 0	116,119 ------------- 0	489,808 ------------- 0	14,705 ------------- 0	17,945 ------------- 0	1,048,703 ------------- 0	0 ------------- 0
5Shawn St Peter MD SVP/Surgeon-in-Chief;ChairDeptOfSurg	(i) (ii)	866,216 ------------- 0	82,105 ------------- 0	20,335 ------------- 0	21,750 ------------- 0	21,684 ------------- 0	1,012,090 ------------- 0	0 ------------- 0
6Thomas Curran PhD SVP, CSO, Executive Director-CMRI	(i) (ii)	734,418 ------------- 0	132,510 ------------- 0	27,513 ------------- 0	24,875 ------------- 0	8,703 ------------- 0	928,019 ------------- 0	0 ------------- 0
7David Cauble EVP & CFO; End 2/18/22	(i) (ii)	612,787 ------------- 0	205,627 ------------- 0	20,742 ------------- 0	18,850 ------------- 0	22,184 ------------- 0	880,190 ------------- 0	0 ------------- 0
8John Gatti MD Physician	(i) (ii)	775,464 ------------- 0	0 ------------- 0	21,847 ------------- 0	26,100 ------------- 0	21,684 ------------- 0	845,095 ------------- 0	0 ------------- 0
9Charles Snyder MD Physician	(i) (ii)	780,125 ------------- 0	0 ------------- 0	24,244 ------------- 0	26,100 ------------- 0	14,229 ------------- 0	844,698 ------------- 0	0 ------------- 0
10Robert Lane MD EVP & Physician-in-Chief	(i) (ii)	576,309 ------------- 0	195,831 ------------- 0	22,977 ------------- 0	8,700 ------------- 0	20,529 ------------- 0	824,346 ------------- 0	0 ------------- 0
11Robin Foster JD EVP, General Counsel	(i) (ii)	568,821 ------------- 0	170,258 ------------- 0	26,358 ------------- 0	26,100 ------------- 0	21,684 ------------- 0	813,221 ------------- 0	0 ------------- 0
12Robert Steele MD EVP & Chief Strategy/Innovation Off.	(i) (ii)	559,865 ------------- 0	189,300 ------------- 0	20,742 ------------- 0	11,917 ------------- 0	21,684 ------------- 0	803,508 ------------- 0	0 ------------- 0
13Jodi Coombs MBA BSN RN EVP & COO	(i) (ii)	556,203 ------------- 0	186,351 ------------- 0	20,742 ------------- 0	13,875 ------------- 0	9,870 ------------- 0	787,041 ------------- 0	0 ------------- 0
14Alex Daneshmand DO MBA EVP & Chief Quality Officer	(i) (ii)	342,273 ------------- 0	154,173 ------------- 0	72,346 ------------- 0	6,231 ------------- 0	13,623 ------------- 0	588,646 ------------- 0	0 ------------- 0
15Thomas Wright EVP & Chief HR Officer	(i) (ii)	404,660 ------------- 0	76,697 ------------- 0	24,796 ------------- 0	8,700 ------------- 0	8,678 ------------- 0	523,531 ------------- 0	0 ------------- 0
16Jennifer Kingry Interim CFO; Start 2/19/22	(i) (ii)	295,591 ------------- 0	73,695 ------------- 0	18,948 ------------- 0	18,850 ------------- 0	21,556 ------------- 0	428,640 ------------- 0	0 ------------- 0
17Douglas Swanson MD Director	(i) (ii)	208,323 ------------- 0	8,365 ------------- 0	20,505 ------------- 0	20,250 ------------- 0	1,137 ------------- 0	258,580 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2021

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 4a	Included in the compensation of Chad Mills is $489,228 of severance following termination of employment.

Schedule J (Form 990) 2021

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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 Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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	60637ALX8	10-13-2016	148,207,195	see Part VI		X		X		X
B	Health and Educational Facilities Authority of the State of Missouri	43-1178966	60637AMM1	12-20-2017	131,226,503	see Part VI		X		X		X
C	Health and Educational Facilities Authority of the State of Missouri	43-1178966	000000000	02-28-2019	17,940,000	see Part VI		X		X		X
D	Health and Educational Facilities Authority of the State of Missouri	43-1178966	000000000	02-28-2019	24,750,000	see Part VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	8,690,000				11,191,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	148,207,195		133,764,094		17,940,000		24,750,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	638,217		1,224,610
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............			132,404,922
11 Other spent proceeds .............	147,568,978		134,562		17,940,000		24,750,000
12 Other unspent proceeds .............
13 Year of substantial completion .............
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X		X	X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........	X			X		X		X
16 Has the final allocation of proceeds been made? ..........	X			X	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

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

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X		X		X		X
b Exception to rebate? ........		X		X	X		X
c No rebate due? .........	X		X		X		X
If "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		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		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		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation
Schedule K, Part I, Line A, Column (f)	Description of Purpose- The Series 2016 Bonds were issued to refinance a portion of the outstanding Series 2009 Bonds (issued Nov. 19, 2009).
Schedule K, Part I, Line B, Column (f)	Description of Purpose- The Series 2017A Bonds were issued to construct and equip a professional office building and a research institute for the Corporation.
Schedule K, Part I, Line C, Column (f)	Description of Purpose- The Series 2019A Bonds were issued to refinance 2008A/B Bonds and remaining portion of 2009 Bonds.
Schedule K, Part I, Line D, Column (f)	Description of Purpose- The Series 2019B Bonds were issued to refinance 2008A/B Bonds and remaining portion of 2009 Bonds.
Schedule K, Part II, Line 3, Column B	Total Proceeds- Difference between issue price and total proceeds of the Series 2017A Bonds represent $2,537,591 of investment proceeds.
Schedule K, Part II, Line 11, Column A	Other Spent Proceeds- $147,568,978 of Bond proceeds was used to establish a refunding escrow to refinance a portion of the outstanding Series 2009 Bonds.
Schedule K, Part II, Line 11, Column C	Other Spent Proceeds- $17,940,000 of Bond proceeds were used to refund the series 2008A/B and 2009 Bonds.
Schedule K, Part II, Line 11, Column D	Other Spent Proceeds- $24,750,000 of Bond proceeds was used to refund the series 2008A/B and 2009 Bonds.
Schedule K, Part II, Line 13, Column A	Date of Substantial Completion- The Series 2016 Bonds were issued to refinance the Series 2009 Bonds, and therefore, there were no "new-money" projects financed by the Series 2016 Bonds.
Schedule K, Part II, Line 13, Column B	Date of Substantial Completion- The projects financed by the Series 2017A Bonds have not yet been completed.
Schedule K, Part II, Line 13, Column C	Date of Substantial Completion- The Series 2019A Bonds were issued to refinance the Series 2008A/B and 2009 Bonds, and therefore, there were no "new-money" projects financed by the Series 2019A Bonds.
Schedule K, Part II, Line 13, Column D	Date of Substantial Completion- The Series 2019B Bonds were issued to refinance the Series 2008A/B and 2009 Bonds, and therefore, there were no "new-money" projects financed by the Series 2019B Bonds.

Schedule K (Form 990) 2021

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Schedule L
(Form 990)

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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 section 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 the 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) 2021

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) John Barth	Son of Director Kevin Barth	57,737	Employment		No
(2) Francesca Barth	Daughter-in-law of Director Kevin Barth	61,813	Employment		No
(3) Chandra Swanson	Daughter of Director Douglas Swanson	84,304	Employment		No
(4)			Payment for FMV of Services Provided		No
(5) Substantial Contributor	Substantial Contributor	1,161,488	Payment for FMV of Services Provided		No
(6) Substantial Contributor	Substantial Contributor	155,889	Payment for FMV of Services Provided		No
(7) Substantial Contributor	Substantial Contributor	1,006,125	Payment for FMV of Services Provided		No
(8) Substantial Contributor	Substantial Contributor	1,109,563	Payment for FMV of Services Provided		No
(9) Substantial Contributor	Substantial Contributor	664,157	Payment for FMV of Services Provided		No
(10) Substantial Contributor	Substantial Contributor	1,028,194	Payment for FMV of Services Provided		No
(11) Substantial Contributor	Substantial Contributor	5,598,452	Payment for FMV of Services Provided		No
(12) Substantial Contributor	Substantial Contributor	865,353	Payment for FMV of Services Provided		No
(13) Substantial Contributor	Substantial Contributor	1,201,888	Payment for FMV of Services Provided		No
(14) Substantial Contributor	Substantial Contributor	5,424,060	Payment for FMV of Services Provided		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990) 2021

Additional Data

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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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

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	6	5,809	FMV
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......	X		3,709
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	28	405,099	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 .....
19 Food inventory ...	X	23	115,896	FMV
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( Miscellaneous )	X	21	27,514	FMV
26 Other ( Jewelry )	X	3	8,510	FMV
27 Other ( )
28 Other ( )

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

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't 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 nonstandard 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 didn't 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) (2021)

Page 2

Part IISupplemental 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.

Schedule M (Form 990) (2021)

Additional Data

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SCHEDULE O
(Form 990)

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

The Children's Mercy Hospital

Employer identification number

44-0605373

Return Reference	Explanation
Form 990, Part VI, Section B, line 11b	The final Form 990, including all required schedules, was provided to each voting member of the Board of Directors prior to its filing with the IRS.
Form 990, Part VI, Section B, line 12c	Corporate compliance reviews all potential conflicts disclosed, and reviews and approves completion of the related management plan.
Form 990, Part VI, Section B, line 15	The People and Compensation Committee of the Board of Directors (the "Committee") is responsible for approving the compensation of the CEO and, based on the CEO's recommendation, the compensation of the Executive Vice Presidents ("EVPs"). The Committee's deliberations and approvals of such compensation are documented in the minutes of the Committee's meetings. The Committee is composed of independent directors who receive no compensation for their service on the Board of Directors. The Committee engages an independent consulting firm, with expertise and experience in analysis of compensation of not-for-profit hospital executives (including review and application of market data), to advise the Committee with regard to compensation of the CEO and the EVPs. The consulting firm provides an opinion to the Committee regarding the reasonableness of such compensation, which is maintained in the Committee's records.
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 252,559. Change in interest rate swap valuation 3,729,247. Net Unrealized Change in Income Beneficiary and Charitable Remainder Trusts -8,689,506. Unrealized Loss on Equity Investments -241,164,697.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

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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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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	-4,680	10,407,939	The Children's Mercy Hospital
(2) Physician Business Partners LLC 2401 Gillham Road Kansas City,MO64108	Physician network for education and purchasing	MO			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			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) 2021

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?		(k) Percentage ownership
(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	(k) Percentage ownership

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	(h) Percentage ownership	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	10,254,953	77,011,806	100.000 %	Yes
(2) Children's Mercy- Pediatric Associates Inc 4400 Broadway Suite 206 Kansas City,MO64111 81-4659989	Medical Practice	KS	The Children's Mercy Hospital	C	640	3,157,165	100.000 %	Yes
(3) Children's Mercy- Pediatric Care Specialists Inc 12541 Foster St Suite 260 Overland Park,KS66213 81-4753049	Medical Practice	KS	The Children's Mercy Hospital	C	-4,856	1,506,007	100.000 %	Yes
(4) Children's Mercy- Pediatric Care North Inc 8781 N Platte Purchase Drive Kansas City,MO64155 81-5020009	Medical Practice	KS	The Children's Mercy Hospital	C	-17,831	1,460,864	100.000 %	Yes
(5) Children's Mercy- Johnson County Pediatrics Inc 8800 West 75th St Suite 220 Shawnee Mission,KS66204 32-0505028	Medical Practice	KS	The Children's Mercy Hospital	C	3,261	819,256	100.000 %	Yes
(6) Children's Mercy- Preferred Pediatrics Inc 241 NW McNary Ct Lees Summit,MO64081 82-1130197	Medical Practice	KS	The Children's Mercy Hospital	C	66,384	635,100	100.000 %	Yes
(7) Children's Mercy- Cass County Pediatrics and Adolescents Inc 503 N Scott Belton,MO64012 82-0881485	Medical Practice	KS	The Children's Mercy Hospital	C	2,353	190,380	100.000 %	Yes
(8) Children's Mercy- Cradle Thru College Care Inc 1004 Carondelet Dr Suite 30 Kansas City,MO64114 82-2804086	Medical Practice	KS	The Children's Mercy Hospital	C	57,948	338,978	100.000 %	Yes
(9) Children's Mercy- Redwood Pediatrics Inc 9151 NE 81st Ter Suite 240 Kansas City,MO64158 82-2564241	Medical Practice	KS	The Children's Mercy Hospital	C	66,728	541,113	100.000 %	Yes
(10) Children's Mercy- Summit Pediatrics and Adolescent Medicine Inc 3171 E Carnegie Dr ST A Lees Summit,MO64064 82-4082519	Medical Practice	KS	The Children's Mercy Hospital	C	1,818	1,012,079	100.000 %	Yes
(11) Children's Mercy- Shawnee Mission Pediatrics Inc 7450 Kessler St Suite 105 Merriam,KS66204 84-1836624	Medical Practice	KS	The Children's Mercy Hospital	C	22,186	1,960,684	100.000 %	Yes
(12) Children's Mercy- Health Care for Children Inc 9051 NE 81st Terrace Suite 100 Kansas City,MO64158 84-1845668	Medical Practice	KS	The Children's Mercy Hospital	C	102,295	403,722	100.000 %	Yes
(13) Children's Mercy- Leawood Pediatrics Inc 5401 College Blvd Suite 101 Leawood,KS66211 84-2411195	Medical Practice	KS	The Children's Mercy Hospital	C	-5,308	1,055,386	100.000 %	Yes
(14) Children's Mercy- Cockerell and McIntosh Pediatrics Inc 1203 SW State Route 7 Blue Springs,MO64014 84-4455782	Medical Practice	KS	The Children's Mercy Hospital	C	33,788	1,411,151	100.000 %	Yes
(15) Children's Mercy- Community Choice Pediatrics Inc 1425 NW Blue Parkway Lees Summit,MO64086 85-1139290	Medical Practice	KS	The Children's Mercy Hospital	C	-3,188	2,306,610	100.000 %	Yes
(16) Income Beneficiary Trusts(5)	Trust	MO	N/A	T					No

Schedule R (Form 990) 2021

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 .....................

Yes

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

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

Yes

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

Yes

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

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	7,057,362	Book
(2) Children's Mercy Integrated Care Solutions	J	303,554	Book
(3) Children's Mercy Integrated Care Solutions	L	1,062,000	Book
(4) Children's Mercy Integrated Care Solutions	P	409,842	Book
(5) Children's Mercy Integrated Care Solutions	Q	16,332	Book
(6) Children's Mercy Integrated Care Solutions	S	216,040,410	Book
(7) Children's Mercy- Cockerell & McIntosh Pediatrics Inc	D	100,000	Book
(8)			Book
(9) Children's Mercy- Pediatric Associates Inc	A	1,612	Book
(10) Children's Mercy- Cass County Pediatrics and Adolescents Inc	A	4,056	Book
(11) Children's Mercy- Cradle thru College Care Inc	A	1,058	Book
(12) Children's Mercy- Health Care for Children Inc	A	54	Book
(13) Children's Mercy- Leawood Pediatrics Inc	A	5,317	Book
(14) Children's Mercy- Cockerell & McIntosh Pediatrics Inc	A	111	Book
(15) Children's Mercy- Community Choice Pediatrics Inc	A	23,626	Book

Schedule R (Form 990) 2021

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2021

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) 2021

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	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	10,017
6	Total number of volunteers (estimate if necessary) .............	6	672
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	4,034,116
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	212,158

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	114,304,051	81,660,446
9	Program service revenue (Part VIII, line 2g) .........	1,573,848,853	1,775,671,734
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	30,623,543	147,978,049
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	35,334,390	47,520,859
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,754,110,837	2,052,831,088
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	67,683,788	117,687,798
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)	919,618,342	979,999,070
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	621,411	562,275
b	Total fundraising expenses (Part IX, column (D), line 25) 6,387,235
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	590,480,382	595,790,797
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,578,403,923	1,694,039,940
19	Revenue less expenses. Subtract line 18 from line 12.......	175,706,914	358,791,148
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,689,363,915	2,741,802,615
21	Total liabilities (Part X, line 26).............	671,608,552	643,743,229
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,017,755,363	2,098,059,386

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,212,018,510 including grants of $ 112,817,140 ) (Revenue $ 1,819,620,522 )
	All expenses for program services relate to providing healthcare. There was a total of 390 licensed beds and 195,172 adjusted patient days during the year from 14,345 admissions. Outpatient encounters totaled 585,521 which includes 47,282 primary care visits, 99,939 urgent care visits, 102,557 emergency department visits and 335,743 specialty clinic visits. Telemedicine visits totaled 72,642 which includes both synchronous and asynchronous visits. There was a total of 19,469 surgical cases which includes 4,165 inpatient cases and 15,304 outpatient cases. Children's Mercy's Adele Hall Campus consists of a 338-bed teaching hospital for children located in Kansas City, Missouri, and a 52-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 $ 86,314,681 including grants of $ 4,870,658 ) (Revenue $ 0 )
	Children's Mercy Hospital (CMH) is dedicated to becoming a leader in pediatric translational research. A strategic planning initiative established the Children's Mercy Research Institute (CMRI) to focus on research and research infrastructure. Through the generosity of two philanthropic gifts totaling $150 million, the Hospital has built a nine story, 375,000 square foot facility enabling research scientists to gain access to state-of-the-art research technology as well as dry lab and wet lab space to support that research. The CMRI building opened in the fall of 2020. The building includes an auditorium for presentations to train medical school students and inform the public about pediatric healthcare innovations that are being developed and created by research scientists and physicians here in collaboration with others throughout the nation and world. In addition these generous gifts will help support funding for scientific programs and recruitment. 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 Precision Therapeutics, Genomics Medicine, Population Health, Emerging Infections and Health Care Innovation. During the year ended June 30, 2022 there were more than 477 active sponsored research projects. The Children's Mercy Research Institute occupies about 18% of the space on the main campus and 7% of the total annual operating budget. Children's Mercy spent $86 million in the year ended June 30, 2022 on research and per information from the NIH Reporter received more than $8.2 Million in NIH funding in this same time period. More than 900+ publications were accepted and/or published. The Children's Mercy 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 expenses1,298,333,191

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	14,735,825	0	588,001

1a	Federated campaigns..		1a	206,512
b	Membership dues..		1b
c	Fundraising events..		1c	4,907,518
d	Related organizations		1d	8,128,884
e	Government grants (contributions)		1e	20,818,033

f	All other contributions, gifts, grants, and similar amounts not included above		1f	47,599,499

g	Noncash contributions included in lines 1a - 1f:$		1g	566,537

h Total. Add lines 1a-1f.......		81,660,446

		Business Code
2a	Net Patient Services	621110	1,775,671,734	1,775,671,734
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		1,775,671,734

3 Investment income (including dividends, interest, and othersimilar amounts) ......			147,978,049			147,978,049
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)			7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ 4,907,518of contributions reported on line 1c). See Part IV, line 18 ....
			8a	554,262
b	Less: direct expenses ...		8b	1,016,307
c	Net income or (loss) from fundraising events..			-462,045			-462,045
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	Contract Revenue		900099	27,601,560	27,601,560
b	Transport		621910	2,887,746	2,887,746
c	Gift Shop		453220	1,383,931	1,383,931
d	All other revenue ....			16,109,667	12,075,551	4,034,116
e	Total. Add lines 11a–11d ......			47,982,904
12	Total revenue. See instructions.....			2,052,831,088	1,819,620,522	4,034,116	147,516,004

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	6,136,324	6,136,324
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	111,404,525	111,404,525
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	146,949	146,949
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	9,341,804	2,175,265	7,166,539
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........	793,558,864	621,622,170	167,617,332	4,319,362
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	44,700,764	34,729,354	9,730,933	240,477
9	Other employee benefits .......	79,040,591	62,108,870	16,523,385	408,336
10	Payroll taxes ...........	53,357,047	41,454,678	11,615,324	287,045
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	1,825,788	19,530	1,806,258
c	Accounting ...........	499,845		499,845
d	Lobbying ...........	476,094		476,094
e	Professional fundraising services. See Part IV, line 17	562,275			562,275
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)	157,127,173	63,620,681	93,335,857	170,635
12	Advertising and promotion ....	6,133,294	27,499	6,105,795
13	Office expenses .......	3,869,666	89,370	3,773,985	6,311
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	18,557,244	8,337,885	9,902,266	317,093
17	Travel ............	4,788,721	3,118,889	1,644,292	25,540
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	10,726,550	9,479,951	1,246,599
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	75,711,644	40,290,297	35,371,593	49,754
23	Insurance ...	24,821,068	19,498,885	5,322,183
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	194,459,367	190,626,704	3,832,663	0
b	State Medicaid Taxes	64,033,533	64,033,533	0	0
c	Dues & Subscriptions	8,042,444	3,087,989	4,954,455	0
d	Inventory- Food Service	6,823,855	6,350,472	473,383	0
e	All other expenses	17,894,511	9,973,371	7,920,733	407
25	Total functional expenses. Add lines 1 through 24e	1,694,039,940	1,298,333,191	389,319,514	6,387,235
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 ........			69,008,187	1	178,115,608
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......			36,363,988	3	41,641,177
4	Accounts receivable, net .............			237,316,739	4	274,093,148
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			17,422,487	8	18,556,240
9	Prepaid expenses and deferred charges ......			30,823,421	9	28,665,792
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,600,484,098
b	Less: accumulated depreciation	10b	813,405,739	801,737,291	10c	787,078,359
11	Investments—publicly traded securities .			1,226,047,938	11	1,149,774,668
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			6,483,027	13	7,671,035
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			264,160,837	15	256,206,588
16	Total assets. Add lines 1 through 15 (must equal line 33)...			2,689,363,915	16	2,741,802,615

17	Accounts payable and accrued expenses .....	190,279,556	17	197,277,888
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	305,923,732	20	294,749,048
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			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	175,405,264	25	151,716,293
26	Total liabilities. Add lines 17 through 25..	671,608,552	26	643,743,229

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	1,831,370,960	27	1,894,759,441
28	Net assets with donor restrictions ...........	186,384,403	28	203,299,945
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	2,017,755,363	32	2,098,059,386
33	Total liabilities and net assets/fund balances ........	2,689,363,915	33	2,741,802,615

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; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	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; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No