Form ~990~ ~ Return of Organization Exempt From Income...

39
2001 Under section S07(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation) Department of the Treasury Internal Ray~e SeMce I III The organization may have to use a copy of this return to satisfy state reporting requirements calendar ear or tax ear be g innin g 2007 and enc Pima C Name of organization -IRS TRpt9\N MEDICAL CENTER INCORPORATED pbl or print or Number and street (or P O box d mail rs not delivered to street address) Room/suite tYV . 2301 HOLAgS STREET Specift Home- City or town, state or country, and 21P + 4 Uena swvaa .. ..True vn wino Cash X Accrual H ant I are not appbcable to Section 527 orgariumfions H(e) Is this a group return for affiliates? F1 Y"FZ No H(b) It "Yes "enter number of affiliates l~ X(c) Are ell affiliates included? Q Yes D No (II "No, atlncha I¢t SK instructans ) H(a) b this a ropanh mmm read by an F___l a Section 601(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A (Farm 990 or 990-F_Z) G Web J Organization type (check only one) 1~X 501(c) 1 03 1 " (insert no ) 4947(e)(1) or 577 K Check here 1 it the organi7alan's gross receipts are normally not more than $25 000 The organization need not file a velum with the 0i5, bid if the organization received a Form 990 Package in tie mail, it should file a return without financial data Some sibs require a complete return M Check 1 u if the organization m not required to altach Sch B (Form 990 990-EZ or 990-PFD Revenue Ex enses and Chan ges In Net Assets or Fund Balances See Sp ecific Instructions 1 Contributions, gifts, grants, and similar amounts mewed SgTl 1 a Direct public support , , , , , , , , . , , 7 a 1 , 676 , 529 b Indirect public support , , , , , , , , , , , , , , 1 b c Government contributions (grants) , , , , , , , , 7 c 43 , 819 , 479 d Tompaalines 7 .through tcl(oani 44,897,256 nonoani 598,752 ) 2 Program service revenue including government fees and contracts (from Part VII, line 93) , , , , 7 Membership dues and assessments , , , , , , , , , , , , , , , , , , 4 Interest on savings and temporary cash investments , , , , , , , , , , , , , , , , , 5 Dividends and interest from secunties , , , , , , 6 a Gloss rents , , , . 6a b Less rental expenses , , , , , , , 6 b e Net rental income or (loss) (subtract line 6b from line 6a) , , , , , , , , 7 Other investment income (describe STMT 3 p ; 8 a Gross amount from sales of assets other IA1 Sen,r,ues (B) Dow Y than inventory 8a 33 , 384 . b Less cost or other basis and sales expenses 8 b 6 , 297 c Gain or (loss) (attach schedule) , , , _ Bc 27 , 087 d Net gain or (loss) (combine line Be, columns (A) and (B)) Q 9 Special events and activities (attach schedule) a Gross revenue (not including $ . . . . . . of . contributions reported on line 1a) LLJ ~+ b Less direct expenses other than fundraising expenses 9 b c Net income or (loss) from special events (subtract line 9b from fine gal 10a Gross sales of inventory, less returns and ailrnrances 0a ass cost of goods sold , , , , , , , , , , " ob c ~ sales of inventory (attach schedule) (subtract line 10b from line 1Qa) , 1 Part I, line 703) Total revenue add 16) 1d 2 3 4 5 6c 7 Bd 9c 10c and 11 J M~g4r~e~p( 44~ column (B)) . . . . . . . . . . . . . . . . 6YVJ Management ana la- from line 44, column (C)) r 1 ndw~rLo Yr~~ olumn (D)) , , ~m~Tts'lo Milach schedule) _ , , , , , , , 7 7 Total Total Total ex enses s 16 and 44 column A 18 Excess or (deficit) for the year (subtract line 17 from line 12) " , , , , , _ , , , , Y 7 9 Net assets or fund balances at beginning of year (from line 73, column (A)) a 20 Other changes in net assets or fund balances (attach explanation) S,0!'l q , , $~T Y = 21 Net assets or fund balances at end of r (combine hoes 18 19 and 20 For Paperwork Reduction Act Notice, see the separate Instructions jSk 7E70102000 05NOG1 R922 03/15/2003 15 32 :11 V01-7 51385 Farm990 (2001) 3 Form ~990~ ~ Return of Organization Exempt From Income Talc A For the 201 cn,oYU-peleeY Adam . Mme WnP imi~i nem wm fJ Mum Mok " ~bn o " ~a D Employer IEanCRCaCOn number E Telephone number

Transcript of Form ~990~ ~ Return of Organization Exempt From Income...

Page 1: Form ~990~ ~ Return of Organization Exempt From Income ...990s.foundationcenter.org/990_pdf_archive/440/440661018/440661018... · 37 Accounting fees , , , , , , , , 71 72 ... Joint

2001 Under section S07(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

Department of the Treasury Internal Ray~e SeMce I III The organization may have to use a copy of this return to satisfy state reporting requirements

calendar ear or tax ear beg inning 2007 and enc

Pima C Name of organization -IRS TRpt9\N MEDICAL CENTER INCORPORATED pbl or print or Number and street (or P O box d mail rs not delivered to street address) Room/suite

tYV.

2301 HOLAgS STREET Specift Home- City or town, state or country, and 21P + 4 Uena swvaa .. ..True vn wino

Cash X Accrual

H ant I are not appbcable to Section 527 orgariumfions

H(e) Is this a group return for affiliates? F1 Y"FZ No

H(b) It "Yes "enter number of affiliates l~

X(c) Are ell affiliates included? Q Yes D No (II "No, atlncha I¢t SK instructans )

H(a) b this a ropanh mmm read by an F___l

a Section 601(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A (Farm 990 or 990-F_Z)

G Web

J Organization type (check only one) 1~X 501(c) 1 0 3 1 " (insert no ) 4947(e)(1) or 577

K Check here 1 it the organi7alan's gross receipts are normally not more than $25 000 The

organization need not file a velum with the 0i5, bid if the organization received a Form 990 Package

in tie mail, it should file a return without financial data Some sibs require a complete return

M Check 1 u if the organization m not required to altach Sch B (Form 990 990-EZ or 990-PFD

Revenue Ex enses and Changes In Net Assets or Fund Balances See Sp ecific Instructions

1 Contributions, gifts, grants, and similar amounts mewed SgTl 1

a Direct public support , , , , , , , , . , , 7 a 1 , 676, 529

b Indirect public support , , , , , , , , , , , , , , 1 b

c Government contributions (grants) , , , , , , , , 7 c 43 , 819, 479

d Tompaalines 7 .through tcl(oani 44,897,256 nonoani 598,752 )

2 Program service revenue including government fees and contracts (from Part VII, line 93) , , , ,

7 Membership dues and assessments , , , , , , , , , , , , , , , , , ,

4 Interest on savings and temporary cash investments , , , , , , , , , , , , , , , , ,

5 Dividends and interest from secunties , , , , , ,

6 a Gloss rents , , ,

.

6a

b Less rental expenses , , , , , , , 6 b

e Net rental income or (loss) (subtract line 6b from line 6a) , , , , , , , ,

7 Other investment income (describe STMT 3

p; 8 a Gross amount from sales of assets other IA1 Sen,r,ues (B) Dow Y

than inventory 8a 33 , 384 .

b Less cost or other basis and sales expenses 8 b 6, 297

c Gain or (loss) (attach schedule) , , , _ Bc 27 , 087

d Net gain or (loss) (combine line Be, columns (A) and (B))

Q 9 Special events and activities (attach schedule)

a Gross revenue (not including $ . . . . . . of .

contributions reported on line 1a) LLJ ~+ b Less direct expenses other than fundraising expenses 9 b

c Net income or (loss) from special events (subtract line 9b from fine gal

10a Gross sales of inventory, less returns and ailrnrances 0a

ass cost of goods sold , , , , , , , , , , " ob

c ~ sales of inventory (attach schedule) (subtract line 10b from line 1Qa) ,

1 Part I, line 703)

Total revenue add 16) 1d 2 3 4 5 6c 7 Bd 9c 10c and 11

J M~g4r~e~p( 44~ column (B)) . . . . . . . . . . . . . . . . 6YVJ

Management ana

la-

from line 44, column (C))

r 1 ndw~rLo Yr~~ olumn (D)) , ,

~m~Tts'lo Milach schedule) _ , , , , , , ,

7 7 Total Total Total ex enses s 16 and 44 column A

18 Excess or (deficit) for the year (subtract line 17 from line 12) " , , , , , _ , , , , Y

7 9 Net assets or fund balances at beginning of year (from line 73, column (A))

a 20 Other changes in net assets or fund balances (attach explanation) S,0!'l q , , $~T Y = 21 Net assets or fund balances at end of r (combine hoes 18 19 and 20

For Paperwork Reduction Act Notice, see the separate Instructions jSk 7E70102000

05NOG1 R922 03/15/2003 15 32 :11 V01-7 51385

Farm990 (2001)

3

Form ~990~ ~ Return of Organization Exempt From Income Talc

A For the 201 cn,oYU-peleeY

Adam.

Mme WnP

imi~i nem

wm

fJ

Mum Mok " ~bn o "~a

D Employer IEanCRCaCOn number

E Telephone number

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What is the organizations primary exempt purposed " STMT B Program Senservice

All organizations must describe then exempt purpose achievements in a dear and concise manner State the number (Required for501(c)(3)ana of clients served, publications issued, etc Discuss achievements that are not measurable (Section 501(c)(3) and (4) (4)orgs amass >(a)(1)

trusts, but optional M organizations and 4947(a)(1) nonexempt charitable trusts must also enter the amount of proms and allocations to others ) others ) a THE-MEDICAL CENTER_PROVIDES SHORT AND LONG -TERM-CARE- TO THEGENERAI- PUBLIC OF RAN3AS_CITY_AtiD JACKSON COfINTYi-MO__________---_____ CARE-IS PROVIDED WITHOUT REGARD_TO ABILITY TO PAY__________________---___-

Grants and allocations $ 239 , 557 , 002 b TO SUPPORT THE CONSTRUCTION OF A NEW BUILDING -FOR- THE- KANSAS CITY MO HEALTH DEPAR1SgNT AND-TFIE_OYERATION OF THE_DEPAAT_________---____ MENT_Iti ORDER TO ENHANCE COtMfONITY_}iEALTH SERVICES,______----____________-

(Grants and allocations $ 4 , 571 , 482) 4 1 571A82 . c

--------------------------------------------------------------------------- ---------------------------------------------------------------------------

(Grants and alloca4ons $ ) d

--------------------------------------------------------------------------- ---------------------------------------------------------------------------

Grants and allocations $ e Other program services attach schedule Grants and allocations $ f Total of Program Service Expenses (should equal line 44 column (B) Program services) . . ~ 244 , 128 , 484

±E ozozooo Form 990 (2001) 05NOG1 8922 03/15/2003 15 32-11 V01-7 51385 4

harm 990 (Zwi) 44-0661018 Page 2 Statement of All organizations must complete column (A) Columns (B), (C), end (D) ere required for section 501 (c)(3) end (4) organizations Functional Expenses end section <947(a)(1) nonexempt charitable trusts but optional for others (See Specific Instructions on page 21 )

Do not include amourKS reported on line ~ (B) Program (c) Manapunent 66,86,86,f06,ori6 ofPaR1 "`~' (p)

Total seivices and general

22 Grants and allocations (attach schedule) M ~.MONQ''~Q (vans < .571 .482 noncuns ) 22 4 , 571 , 482 . 4 , 571- , 48-2-

2S Specific 27 assIntsncerou~dmEuals (attach schedule

) 24 Benefits paid toortarmembe~s ( attach Y4 +w0 .~xR�~~u~1 " 25 Compensation of officers, directors, etc 25 1 , 160, 544 1 , 160, 544 26 Other salaries and wages , , , , , 28 116 081 065 . 92 613 211 . 23 , 467 , 854 27 Pension plan contributions , , , , , 27 6 , 355 , 579 4 , 985 , 222 1 , 370 , 357 28 Other employee benefits , , , , , , 28 8 , 095 , 009 6 , 710 , 499 . 1 , 364 , 510 . 29 Payroll taxes , , , , , , , , , , 29 8 , 169 , 951 . 6 , 534 , 123 . 1 , 635 , 828 30 Professional fundraising fees , , , , , 30 37 Accounting fees , , , , , , , , 71 72 Legal fees , . , , , , 32 37 Supplies , , , , , , , . , , 33 3 , 204 , 349 3 , 204 , 34 9 34 Telephone , , , , 34 35 Postage and shipping , , , , , , 75 36 Occupancy , , , , , , , 76 37 Equipment rental and maintenance . 37 38 Printing and publications , 38 39 Travel 39 40 Conferences, conventions, and meetings 40 41 Interest , , , , , , , , , 41 1 076 036 1 , 076 . 03 6 42 Depreciation depkuon etc (attach schedule) 42 12 , 990 . 533 12 , 990 , 533 43 omsre,wvunnmcaem .oon(tem~e)STMT 7 7a 125 656 156 . 110 282 , 48S . 15 373 671

Sb c

3d 3e

44 Total functional expenses pee fries 71 mmupn 47)

Joint Costs Check " Lf if you are following SOP 9&2 Are any,lomt costs from a combined educational campaign and fundralsinp solicitation reported m (B) Program services? , " M Yes X No If "Yes; enter (i) the aggregate amount of these point costs $ , (n) the amount allocated to Program sernces "f

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Forme40 (70011 44-0661018 pap 3

Balance Sheets (See Specific Instructions on page 24 )

(g) End of year

60 Accounts payable and accrued expenses , , , , , , , , , , 61 Grants payable , , , , , , , , , , , , , , , , , , , , , 62 Deterred revenue , , . . , , . . , , . . . . . , . , . , , sTmT 10 . 63 Loans from officers, directors, trustees, and key employees (attach

schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . m 64a Tax-exempt bond liabilities (attach schedule) . . . , , , . , , , , , . .

b Mortgages and other notes payable (attach schedule) 65 Other liabilities (describe ji~ STMT 11

Organizations that follow SFAS 117, check here " U and complete lines 67 through 69 and lines 73 and 74

d 67 Unrestricted 68 Temporarily restricted , . . , . , . , , .

q 69 Permanently restricted . . . . . . . . . . . . . . . m

Organizations that do not follow SFAS 177, check here t Eland complete lines 70 through 74 u

0 70 Capital stock, trust principal, or current funds 71 Paid-in or capital surplus, or land, budding, and equipment fund , ,

,n 72 Retained earnings, endowment, accumulated income, or other funds a 73 Total net assets or fund balances (add lines 67 through 69 OR lines

70 through 72, column (A) must equal line 1 9, and column (B) must equal line 21 ). ,

7

05NOG1 8922 03/15/2003 15 32 :11 V01-7 51385

Note . Where required, attached schedules and amounts within the description (A) column should be /or end-of-year emounts only Beginning of year

45 Cash - non-interest-beanng . . . . . . . . . . . . . . . . . , . . 4 , 670 , 320 '46 Savings and temporary cash investments . . . .

47a Accounts receivable , , , 47a 81 , 050 , 713 . b Less allowance for doubtful accounts , , , 47b 23 , 486 , 179 34 , 579 , 89 !

48a Pledges receivable , , , , , , , , , , 48a b Less allowance for doubtful account , , , , , , 486

49 Grants receivable 50 Recervables from officers, directors, trustees, and key employees

(attach schedule) , , , , , , , , , , , , , , , , , , , , 51a Other notes and loans receivable (attach

schedule) , , , , , , , , , , 51a 4 . 922 . 141 u b Less allowance for doubtful accounts 51 b . .

52 Inventories for sale or use 53 Prepaid expenses and deferred charges . . . . . . . . 54 Investments - securities (attach schedule) , , , , , , " N Cost .O FMV 55a Investments - land, buildings, and

equipment basis , , , , , , , , , , , , , 55a b Less accumulated depreciation (attach

55b schedule) � � � � � � , 56 Investments - other (attach schedule) . . , , ,

" . . , . ,

57a Land, buildings, and equipment basis , , 57a 247 , 678 , 702 b Less accumulated depreciation (attach

schedule) , , , , , , , , , , , , , , , , 57b 129 , 644 , 605 58 Other assets (descnbe " STMT 9 )

Form 990 is available for public inspection and, for some people, serves as the primary or sole source of information about a particular organization How the public perceives an organization in such cases may be determined by the information presented on its return Therefore, please make sure the return is complete and accurate and fully describes, in Part III, the organization's programs and accomplishments

ISAk 1E10]03000

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44-0661018 Reconciliation of Expenses per Audited Financial Statements with Expenses per Rnfi'm

Reconciliation of Revenue per Auanea Financial Statements with Revenue per Return (See Specific Instructions . oaae 26

Add amounts on linen (7) through (4) " b c Line a minus line b , , , " c 284 . 00 ! d Amounts included on line 17,

Form 990 but not on line a . (1 ) Investment expenses

not included on line 6b, Form 990

(2) Other (specify)

Sai'P 14 S 3,354,805 . Add amounts on lines (1) and (2) l o- 1 3 , 35,

e Total expenses per line 17, Form 990 line c plus line d

. ~ ~ " a 287 , 361

oyees (List each one even if not compensated, see Specific

Sa!'P 13 f 3 .174 . 129 Add amounts on lines (1) and (2) " d

e Total revenue per line 12, Form 990 fros t plus line d . " e

List of Officers, Directors, Trus

75 did any officer, director, trustee, or key employee receive aggregate compensation of more wan $100,O00 from your organization and ail related organizations, of which more than E10,000 was provided by the related organizations? " O Yes ~X No If 'Yes,' attach schedule - see Specific Instructions on gape 27

F«m990 (2001)

1E70403000 05NOG1 8922 03/15/2003 15 .32 11 V01-7 51385 6

a Total revenue, gains, and other support per audited financial statements , ,

b ' Amounts included on line a but not on line 12, Form 990

(1) Net unrealized gains on Investments , , $ -453,306

(Z) Donated services and use of facilities S

(3) Recoveries of prior year grants , , , 2

(4) Other (specify)

Sa!'P 12 L 3,359 .805 . Add amounts on lines (1) through (4)

e Line a minus line b " e d Amounts included on line 12,

Form 990 but not on line a : (1) Investment expenses

not included on line 6b, Form 990 t

(2) Other (specify)

a Total expenses and losses per 34 , 22 4 4B8 audited financial statements , , , " a 2B4 0015 .81919

b Amounts included on line a but not --- ' on line 77, Form 990

(1) Donated services and use of facilities $

(z) Prior year adjustments reported on line 20,

' , Form 990 . . . . t (3) Losses reported on ,

line 20, Form 990 $ (4) Other (specify)

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OSNOG1 R922 03/15/2003 15 32 :11 V01-7 51385 7

78 Did the organization engage In any activity not previously reported to the IRS? If 'Yes," attach a detailed description of each activity , , 76 X 77 Were any changes made In the organizing or governing documents but not reported to the IRS? , , , , , , , , , , , , , , , , , , , 77 X

I( "Yes," attach e conformed copy of the changes 78a Did the orpanjzadon have unrelated business prose Income of E1,000 or more during the year covered by this return? , , , , , , , , , 7Ba X

b If "Yes," has It filed a tax return on Form 990 "7 (or this yea(! , , , , , , , , 786 X 79 Was there a liquidation, dissolution, termination, or substantial contraction during we year? If 'Yes.' attach a statement , , , , , , , , 79 X 80a Is the organization related (other than by association with a statewide or nationwide organization) through common

membership, governing bodies, trustees, officers, etc , to arty other exempt or nonexempt organization? , , , , , , , , , $gj'P, 3.45 80a X b If "Yea," enter the name of the organization 1

and cheek whether h Is X exempt OR nonexempt 81a Enter direct or Indirect political expenditure See line 81 mstrucGons , , , , , , , , , , , , , , , B7a NO

bDldlheorganization file Form 7720-POL(orthis yea(t , , , , , , , , , , , , , , , , , , , , , , , , 87b X

82a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge

or of substantially less than fair rental value? , , , , , , , , , , , , , , , , , , , , , , , , , , 82a X b II "Yes," you may Indicate the value of these items here Do not include this amount as revenue in Part I or as an expense In Part II (See Instructions m Part III ) , , , , , , Bob '

83a Did the organization comply with the public inspection requirements for returns and exemption applications? , , , , , 83a X b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? , , , , Bib X

84a Did the organization solicit any contributions or gifts that were not tax deductible? , , , , , , , , , , , , , , , , 84a X b If 'Yes," did the organization Include with every solicitation an express statement that such contributions

orgifts were nottaxdeduchble'!, , , , , , , , , , , , , , , , , , , 846 N 86 501(c)(4), (S), w(6) organizations a Were substantially all dues nondeductible by members , , , , , , , , , , , , , , , , , , 86a N

b Did the organization make only in-house lobbying expenditures of E2,000 or less? , , , , , , , , , , , , , , , BSb N If 'Yes" was answered to either 85a or 85b, do not complete BSc through SSh below unless the organization received a waiver for proxy tax owed for we prior year

c Dues, assessments, and similar amounts from member , , , , , , , , 86c N/A d Section 162(e) lobbying and political expenditures , , , , , , , , , 86d

" " N/A

e Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices , , , , , , , , , , , BSe N/A .. 1 Taxable amount of lobbying and political expenditures (line BSd less 85e) , , , , , , , , , , 861 N/A g Does the organization elect to pay the section 6033(e) tax on the amount in 85f7 , , , , , , , , , , 86' " N , h II section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount in 85f to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax yeai'7 , , , , , , , , , , 86h N

86 501(e)(7) ags Enter a Initiation face and capital contributions included on line 2 N/A b Gross receipts, Included on line 12, for public use of club facilities , , , , , , , , , , , , , , , 86b N A - ,

87 501(c)(f2) orgs Enter a Gross Income from members or shareholders , , , , , , , , , , , , 87a N/A b Grass income from other sources (Do not net amounts due or paid to other sources against amounts due or rtterved from them , , , , , 876 N/A

88 At any time during the year, did the organization own a 50°b or greater interest in a taxable corporation or partnership, or an entity disregarded as separate from we organization under Regulations sections 307 7701 .2 and 301 770737 If 'Yes; complete Part IX , , , , , , , , , , , , , , , , , , , , , , , , 88

89a 501(c)(3) organizations. Enter Amount of lax imposed on the organization during the year under section 4911 jo. NONE , section 4972 " NONE , section 4955 106 NONE

b 501(c)(3) end 501(c)(4) wgs Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefd transaction from a prior year? II "Yes; attach a statement explaining each transaction , , , . . . . , , , , , , , , , , , , , , . . . , . . , , , , , 89b X

c Enter Amount of lax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 . . . . . . . . . . .

" . . " NONE

d Enter Amount of tax on line 89c, above, reimbursed by the organ¢ation , , . , , , , , , , , ~ NONE 90a List the states with which a copy of this return is (led ji~ NONE

b Number of employees employed in the pay period that Includes March 12, 2001 (See instructions) , , , , , , , , , , , 190b 13098 91 The books are in care o1 " AL JOHNSON Telephone no " 816-556-3150

Located at ii~ 2310 HOI.t4ES, KANSAS CITY, MO LP " 4 ji~ 64108 9 2 Section 4947(a)( 1) nonexempt charitable trusts filing Form 990 m lieu of Form 1041 -Check here 1~u

and enter the amount of tax-exempt interest reserved or accrued during the tax veer . "" 19T 1 " N/A

Fortn990 (2001)

JSA 1E7041 1000

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512 513 or 514 (E) p Related or

Amount exempt (unction

Note Enter moss amounts unless otherwise Unrelated business inc

indicated (A) (B) 93 Program service revenue rode

Amount

a PATIENT FEES

b CONTRACTUAL ALLOW. c CHARITY CARE d EXPENSE REIbfBURSE

e

f Medicare/Medicaid payments , , ,

g Fees and contracts from government agencies

94 Membership dues and assessments .

95 intereatanvW~vaanatemporary oahlmmunant+

96 Dividends and interest from secunGes .

97 Net rental income or (loss) from real estate

a debt-financed properly . . . . . . .

b not debt-financed property . . . . .

98 Not rental Income or (loa)from peronal property .

99 Other investment income . . . . . 100 Gain or(IOa) from aleaols:vbomerNanlnvmrory " 101 Net income or (loss) from special events

102 Gross profit or (ton) from sales of inventory

103 Other revenue a

b CAFETERIA SALES

c 6IISCELLANEOUS

d

e ---~--~~

104 Subtotal (add columns (B), (D), and (E)) . ~ I

106 Total (add line 104, columns (B), (D), and (E)) . . . . . . Note One 105 plus line 1d, Part l, should equal the amount on line 12, Part I

. . . 1 239,001,110

Line No I Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment of the oraanizahon's exempt ourooses (other than by orohdina funds for such purposes)

(B) (C)

(D) Erw' (ear Nature of activities Total income assets

Name address, and EIN of corporation

Yes I x I No

JSA 1 E 10501000

05NOGI R922 03/15/2003 15'32 11 V01-7

(a) Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? (b) Did the organization, Burin the year, pay premiums, directly d r al benefi t c

Note If "Yes" to !6) . file FormlB870 an71 EGTrm 4 720 (see instruct,

Please Sign 1 ' Signa e olRcer Here '

Type or prim name and tRle

Preparefs' A A L Paid signature

PRF1aRt'5 Firms name (or yours Use Only R self-employed) ' 12

address and ZIP49

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MARK LIPAAI

ant Contractors for Professional Services Individuals or firms) If there are none, enter "None '~

(E) Type of service I (c) Compensation

MEDICAL- IMGING-,_ ING

Total number of others receiving oval 550,000 for professional winces "

I

1 9

For Paperwork Reduction Act Notice, see the Instructions for Farm 990 and Forth 990-EZ

J5Ok 1517107 WO

05NOG1 R922 03/15/2003 15 :32 .11 V01-7 51385 9

SCHEDULER Organization Exempt Under Section 501(c)(3) OMB NO 15450

(Foam 990 or 990-EZ) (Except Private Foundation) and Section 601(e), 6010, fi0'I(k), 601(n), or Section 4947(a)(1) Nonexempt Charitable Trust O

Supplementary Information - (See separate instructions .) ~o0 1 Department of the 71Ca9urJ Internal Revenue service " MUST be completed b the above or anizations and attached to their Form 990 or 990F2 Name of the organization Em ployer ICentMCaCOn numl

Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (See page 1 of the instructions List each one If there are none, enter "None"

(e) Name and address a rack employee paid more (b) Title and average (d) Contributions to (a) Expenx

than 150,000 fours per week (c) Compensation employee benefit plans 8 account and other

EavnMrf to mcnnn deferred mmoertsn4on allewanrc

JTMEAHOLT LOT Y-7, LAKE LOTAWANA r.rr. ~ c crne.`rm rm aenii;a

STEPHEN JARVIS CHAIR OP

2211 CHARLOTTE

KANSAS CITY , MD 64108 40

t91RY NESTHUES RN NURSE

5490 NE NEDGEWOOD CT rvsIc erMirm un GanGd A

CHERYL PILSL 13700 E 53RD TERRACE LEE'S SO[MIIT . MO 60133 Total number of other employees paid over

(See page 2 of the instructions List each one (wh

(a) Name and address of each independent contractor paid more than $50,000

HOSPITAL- HILL- HEALTH- SERVICES- CORP.

CERNER CORPORATION

SIEFgNS MEDICAL SOLUTIONS USA

DELOZTTE CONSULTING

9chedule A (Form 990 or 990E ]001

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Statements About Activities (See page 2 of the instructions )

1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on legislative matter or referendum? If Yes; enter the total expenses paid or incurred in connection with the lobbying activities " E (Must equal amount on line 38, Part VI-A, or line I w Part VI-B ) Orpanizahons that made an election under section 501(h) by filing Form 5768 must complete Part VI-A Other organizations checking 'Yes ;' must complete Part VI-B AND attach a statement giving a detailed description of the lobbying activities

2 During the year, has the organization, either directly or indirectly, engaged in any of the following acts with any substanLal contributors, trustees, directors, officers, creators, key employees, or members of then families, or with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary? (N the answer to arty queshm it 'Yes,' attach a detailed statement explaining the transactions )

a Sale, exchange, or leasing of property! , , , , , , , , , , , , , , , , , , , , ,

No

b Lending of money or other extension of credit? , , , , ,

3 Does the organization make grants for scholarships, fellowships, student loans, etc 7 (See Note below ) 4 Do you have a section 403(6) annuity plan for your employees? . . . . . . . . . . . . . . . . . . . . . Mote Attach e statement to explain how the arganrsatron dafermmes that ma'rvMuek a organrzatrons reeemng gram's S12S1 19

(a) Name(s) of supported organeahon(s) I (b) Line number

from above

74 F-1 An oraanizahon organized and operated to test for public safety Section 509(a)(4) (See pace 6 of the instructions I Schedule A (Forth 990 or 990.EZ) 2007

JSA tEt77020D0

OSNOGI R922 03/15/2003 15 :32 :11 VO1-7 10 51385

c Furnishing of goods, services, or facilities? , . , . , , . . . , , , . . STMT 18

d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)7 . . , . . . . , , ,

e Transfer o1 any part of its income or assets'! , , , , , , , , . . , , . . . , ,

Reason for Non-Private Foundation Status (See pages 3 through 6 of the instructions )

The or anization is not a private foundation because it is (Please check only ONE applicable box ) 6 A church, convention of churches, or association of churches Section 170(b)(1)(A)(i) 6 A school Section 170(b)(1)(A)(n) (Also complete Part V ) 7 X A hospital or a cooperative hospital service organization Section 170(b)(1)(A)(nQ 8 ~ A Federal, state, or local government or governmental unit Section 170(b)(1)(A)(v) 9 A medical research organization operated in conjunction with a hospital Section 170(b)(1)(A)(n) Enter the hospAal's name, city,

and state 1 10 El An organization operated for the benefit o1 a college or university owned or operated by a gwemmeMal unit Section 170(b)(1)(A)(1v)

(Also complete the Support Schedule in Part IV-A )

11 a a An organization that normally receives a substantial part of its support from a governmental unit or from the general public Section 170(b)(1)(A)(vi) (Also complete the Support Schedule in Part IV-A )

11115H A community trust Section 170(b)(1)(A)(h) (Also complete the Support Schedule m Part IV-A ) 12 An organization that normally receives (1) more than 33 7/3% 01 its support from contributions, membership fees, and gross

receipts from activities related to its charitable, etc , functions -subject to certain exceptions, and (Z) no more than 33 1l3!L of

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

by the organization after June 30, 1975 See section 509(a)(2) (Also complete the Support Schedule in Part IV-A )

13 F_]

An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in (1) lines 5 through 12 above, or (2) section 501(c)(4), (5), or (6), it they meet the test of section 509(a)(2) (See section 509(a)(3) )

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Galenaar year for nswi year oeginmng ml

16 Gifts, grants, and contributions received (Do aee nne co I

public without charge " " 22 Other income Attach a schedule Do not

include pain or (loss) from sale of capital assets

23 Total of lines 15 throw h 22

24 Line 23 minus line 17

25 Enter 1% of line 23 26 Organizations described on lines 10 or 71 a Enter 2 % 01 amount in column (e), line 24 A7QT, jV$I,XCi%Z17 .F , ,

b Prepare a list for your records to show the name of and amount contributed by each person (other than a

governmental unit or publicly supported organization) whose total gifts for 1997 through 2000 exceeded the

amount shown m line 26a Do not file this list with your return Enter the total of all these excess amounts ,

c Total support for section 509(a)(1) test Enter line 24, column (e) . . . . . . , ,

d Add Amounts from column (e) for lines 18 19

22 26b

e Public support (line 26c minus line 26d total)

(2000) ___------_-_____(1999) _____________--__-_ (1998) --_NO_T_AFPLICABLE _(1997) -_-____--_____ b For any amount included in line 17 that was received from each person (other than "disqualified persons'), prepare a list for your records to

show the name of, and amount received for each year, that was more than the larger of (1) the amount on line 25 for the year or (Z) $5,000 (Include in the list organizations described in lines 5 through 11, as well as individuals) Do not file this list with your return After computing the difference between the amount received and the larger amount described in (7) or (2), enter the sum of these differences (the excess amounts) (or each year (2000) ________________1999) ___________________ (1998) ___________________(1997)_______________

c Add Amounts from column (e) for lines 15 16 17 20 21 . . .

d Add Line 27a total and line 27b total . , . . . . .

e Public support (line 27c total minus line 27d total) " 1110,

f Total support for section 509(a)(2) test Enter amount on line 23, column (e) . . . . "1 Y71 I

g Public support percentage (line 27e (numerator) divided byline ]7l (denominator)) . . . . . 10.

any unusual grants during 1997 through 2000, the date and amount of the prom, and a brief

J~ tE7731 3 00O

05NOG1 A922 03/15/2003 15 32 11 V01-7 11 51385

ScheduleA ~-arm990or990fI 2001 44-0661018 e3 " SUPport Schedule (Complete only If you checked a box online 10, 11, or 12 ) Use cash method of eccoUnCng. NOT APPLICABLE

17 Grass receipts from admissions, merchandise sold or services performed, or furnishing of facilities m any activity that is related to the

78 Gross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired oy me organization aver rune vu, roio

. 19 Net income from unrelated business activities not included in line 18

20 Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf . . . . . . . .

21 me value of services or facilities furnished to the organization by a governmental unit without charge Do not include the value of services or facilities generally furnished to the

27 organizations described on line 12 a For amounts included in lines 15, 16, and 17 that were received from a "disqualified person," prepare a list for your records to show the name of, and total amounts received in each year from, each "disqualified person' Do not file this list with your return Enter the sum of such amounts for each year

Grants For an organization described m line 11U, 11, or 12 th~ a list for your records to show, for each year, the name of the on of the nature of the Grant Do not file this list with Your return

or

Page 10: Form ~990~ ~ Return of Organization Exempt From Income ...990s.foundationcenter.org/990_pdf_archive/440/440661018/440661018... · 37 Accounting fees , , , , , , , , 71 72 ... Joint

74a Does the organization receive any financial aid or assistance from a governmental agency . . . . . . . 34a

b Has the organization's right to such aid ever been revoked or suspended , . . . . . . . 34b If you answered "Yes" to either 34a or b, please explain using an attached statement

75 Does the organization certify that it has complied with the applicable requirements of sections 4 01 through 4 OS

J5A tE1t30 Z 000

05NOG1 A922 03/15/2003 15'32 :11 V01-7 51385 12

aa-ossioie

Schedule A (Form 890 a 990-EZ) 2001 NOT APPLICABLE Page 4 Private School Questionnaire (See page 7 of the Instructions ) (To be completed ONLY by schools that checked the box on line 6 in Part IV)

29 Does we organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, Yes No other governing instrument, or in a resolution of its governing body? . . . . 29

30 Does the organization include a statement of its racially nondiscriminatory policy toward students in all ms brochures, catalogues, and other written communications with the public dealing with student admissions, programs, and scholarships , , , . . , , '70

31 Has the organization publicized its raaally nondiscriminatory policy through newspaper or broadcast media during the period of solicitation for students, or during the registration period d it has no solicitation program, in a way that makes the policy known to all parts of the general community R serves . , , 31 , If "Yes," please describe, d "No," please explain (If you need more space, attach a separate statement )

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -----------------------------------------------------------------------------

J2 Does the organization maintain the following a Records indicating the meal composition of the student body, faculty, and administrative staff's . . 32a b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory

bass? 12b e Copies of all catalogues, brochures, announcements, and other written communications to the public dealing

with student admissions, programs, and scholarships . . . . . . 32c d Copses of all material used by the organization or on its behalf to solicit contributions? 32d

If you answered "No" to any of the above, please explain (If you need more space, attach a separate statement) --

----------------------------------------------------------------------------- -----------------------------------------------------------------------------

33 Does the organization discriminate by race in any way with respell to , �

a Students' rights or privileges? . . . . . . . . . . . . . . . . . , . . . , . . ,

b Admissions policies?

c Employment of faculty or administrative staff's , . , , , . , . , , . . , , , , ,

d Scholarships or other financial assistance?

e Educational policies?

I Use of facilities?

g Athletic programs . . , . , . , , , , , . , . . , , , , , , . . , . . . . ,

h Other extracurricular activities?

If you answered "Yes" to any of the above, please explain (If you need more space, attach a separate statement) ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- -----------------------------------------------------------------------------

Schedule q (Form 990 or BBUFZ) 2001

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DRUMM Lobbying Expenditures by Electing Public Charities (See page 9 of the mst

o be completed ONLY by an eligible organization that filed Form 5768 N

Check fl~ a if the organization belongs to an affiliated group

Check " b d you checked "a" and "limited control" provisions apply

Limits on Lobbying Expenditures

(The term "expenditures" means amounts paid or incurred )

38 Total lobbying expenditures to influence public opinion (grassroots lobbying) . 38

37 Total lobbying expenditures to influence a legislative body (direct lobbying) . 77

38 Total lobbying expenditures (add lines 36 and 37), , . , , , 38

79 Other exempt purpose expenditures , , , , , , , , , , , , , . . 39

40 Total exempt purpose expenditures (add lines 38 and 39) . . . . 40

41 Lobbying nontaxable amount Enter the amount from the following table -

If the amount on line 40 Is - The lobbying nontaxable amount Is -

Not over $500,000 , , , , 2016 0l the amount m One 40 , , , , , ,

Over 5500 000 but not over $1 000,000 , , $700,000 plus 15% of the excess over 2500,000

Over $1 000,000 but not over 51,500,000 . , $775 000 plus 70% of the excess over 51 000,000 47

Over $1,500,000 but not over 517,000,000 , $275,000 plus 5% of the excess over $1 500 000

Over $17,000,000 $1 000 000 . ~ ~ , , , , ,

42 Grassroots nontaxable amount (enter 25°h of tine 41) . . ~

, , 42

43 Subtract line 42 from line 36 Enter -0- if line 42 is more than line 36 43 44 Subtract line 41 from line 38 Enter -0- if line 47 is more than line 38 , . . 44

ated group To be completed totals I for ALL electing

organizations

Lobbying Expenditures During 4-Year Averaging Period

(e) (b) I (c) 000 1999

(d)

Grassroots lobbying

05NOG1 A922 03/15/2003 15 :32 11 V01-7 51385 13

on* 11 !here is an amount on either line 43 orline 44, you must file Form 4720 I I L 4-Year Averaging Period Under Section 501(h)

(Some organizations that made a section 501(h) election do not have to complete all of the five columns below See the instructions for lines 45 through 50 on page 11 of the instructions )

Calendar year (or fiscal (a) year beginning In) " 200 Lobbying nontaxable amount Lobbying ceiling amount

Grassroots nontaxable

Grassroots ceiling amount

Lobbying Actively by Nonelectmg Public Charities NOT APPLICABLE For reporting only b or anizahons that did not com plete Part VI-A See a e 12 of the instructions

During the year, did the organization attempt to influence national, state or local legislation, including any Yes No Amount attempt to influence public opinion on a legislative matter or referendum, through the use of

a Volunteers X � -~ � b Paid staff or management (include compensation in expenses reported on tines c through h ) , X

c Media advertisements X

d Mailings to members, legislators, or the public , , , , , , , X

e Publications, or published or broadcast statements , , , , , , X

T Grants to other organizations for lobbying purposes , , , , ~

, , , X

g Direct contact with legislators, their staffs, government officials, or a legislative body X h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means X

I Total lobbying expenditures (add lines e through h ), , , , , , If "Yes" to any of the above also attach a statement giving a detailed description of the lobbrna acWihes

Schedule A (Foam 990 or 990.Qj MO7

J5A fE1t407000

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Exempt Organizations (See page 12 of the Instructions ) 51 Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section

501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations? a Transfers from the reporting organization to a nonchantable exempt organization of Yes No

(I) Cash , . , (II) Other assets a(II) X

b Other transactions (1) Sales or exchanges of assets with e nonchantable exempt organization . , , , , , , . . . , , , (II) Purchases of assets from a noncharRable exempt organization . . . . . ,

(III) Rental of facilities, equipment or other assets . , . . . . . . . . . . . . . . . , . , (iv) Reimbursement arrangements (v) Loans or loan guarantees . , (v1) Performance of services or membership or fundraising solicitations , , . , . . . , , , I NO)

e Sharing of facilities, equipment, mailing lists, other assets, or paid employees . , , , , , , , , d II the answer to any of the above is "Yes; complete the following schedule Column (b) should always show the fair market value of the

goods, other assets, or services peen by the reporting organization If the organ¢atlon received less wan fair market value in any

52a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527 " o yes ~X No

Schedule A (Form 990 or 990-EZ) 2007 1 E 12M 3 000

05NOG1 R922 03/15/2003 15 :32 :11 V01-7 51385 14

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Signature and Verification Under peeurttes W Perjury I declare mat I Rave examined INS form including accompanying sfJhedJes and statements and to t he best of my knowledge and belief it is Vue ca,ecC and cy0ltWand thalo 3a6aWw"e0 to prepare tlss lam

R wn belo

~CEIV p w w they due

'~i~yel~r ~e LUUL~Q

an exlension.p(t J~

Date

Alternate Mailing Address- Enter the address d you want the returned to an address different than the one entered above

ATTN TAX DEPT Type or n BKD, LLP print ]20 w 12th ST , SUITE 1200

C KANSAS CITY, MO 64105-1936

Form 8868 I12 2000)

~wm 87e8 132 700fp Page 2

* If you are filing for anAddiuonal (not automatic) 3-Month Extension, complete only Part Itind check this box 111- 0

Note Only complete Part 11 i( you have already been granted an automatic 3-month extension an a previously filed Form 8868 & I( You are filing for anAutomanc 3-Month Extension, complete only Part qon page 7)

Type or Name of Exempt Organization Employer identification number

pant TRUMAN MEDICAL CENTER INCORPORATED 44 ' 0661018 File the Number sweet and room or sure no II a P O box see instructions For IRS use only extended 2301 Holmes Street due date for r" "re City town or post office state and ZIP code Fix a foreign address see msvuciiais - '

Check type of return to be filed(Fde a separate application for each return) form 990 D form 990-EZ 0 Form 990-T (sec 401(a) or 408(a) trust) El Form 1047-A 0 Form 5227 El Form 8870 Form 990 BL 0 Form 990-PF 0 Form 990-T (trust other than above) El Form 4120 1 :1 Form 6069

STOP Do not complete Part II d you were not already granted an automatic 3-month extension on a previously filed Form 8868

" If the organization does not have an office or place of business in the United Slates, check [his box 1~ 0 " I( this is for a Group Return, enter the

o83 nizauorfs tour digit Group Exemption Number (GEN) If this is

for the whole group, check this box " I! it is (or part o! the group check this box " D and attach a list with the

4 bequest an additional 3-month extension of time until _ rlHttl.n 1 / U

5 For calendar year _ . . . , or other tax year beginning Ms1}t _ .1 . . . . . . . 20 and ending- APL_ .__ 30 Zp06 II this [ax year is for less than 12 months, check reason o Initial return 0 Final re[urrO Change in accounting period

7 State in detail why you need the extension . . . . . . .__ . . . . . . . . . . . . . . . . . . . . . . . ------ . . . . . ------ _ ----- __ ______ Addi.txox~a~__ .t_i.me._z.s. -require d_.ta accumulate --the _xnf_ox-maci_on ._, _______ _

_.necessasy .tn._file . .a__cflmpler_e .and .accurate._ratuz'b. . . . . . . . . . . . . . . . . ., . . . . . . . . __ Ba If this application is for Form 990-BL, 990-PF, 990-T 4720, or 6069, enter the tentative tax, less any

nonrefundable credits See instructions _ t

b 7f this application is for Form 990-PF 990-T 4720 or 6069, enter any refundable credits and estimated tax payments made Include any prior year overpayment allowed as a credit and any amount paid previously with Form 8868 _

c Balance Due Subtract line 8b from line Ba Include your payment with this form or, d required, deposit with FTD coupon or, d required by using EFTPS (Electronic Federal Tax Payment System) See instructions

5~g,a e ~ "0' ~ rme ll~ CPA Date Notice to Applicant-To Be Completed by the IRS

We have approved this application Please attach this loan to the wganaauoh return we have not approved this application However we have granted a 10-day grace period from the later of the la't dale of the organRanods return (including any prior extensions) This grace penod is considered to be a valid ex

tR otherwise required to be made on a timely return Please attach this form to the organ¢atida return

('

We have not approved this application After considering the reasons staled in item 7 we cannot grant your revue to file We are nod granting a 10-day grace period

We cannot consider this application because it was fled alter the due date of the return for which an eatensw,ii,

O Other - - -- - --- - - --- - - --- -- -- --- --- EXTakSIGN ar?Rr '~1c!) ----- -- 1

Y

12-16-02

3-month extension

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Form 8868 Application for Extension of Time To File an (December 2000) Exempt Organization Return OMB NO 7545.1709 Department M the Treasury Internal Ramie service " File a separate ep06rahon for each return

If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box , . , , ~ x If you are filing tar an Additional (not automatic) 3-Month Extension, complete only Part II (on page 2 of this form) .

Note: Do not complete Part U unless you have already been granted an automatic 3-month extension on a previously filed Forth 8868

Automatic 3-Month Extension of Time - Only submit onginal (no copies needed) Note: Form 99aTcorpola0ons requesting an automatic 6-month extension - cheat this box and complete Part 1 only All other corporations (including Form 990-C filers) must use Form 7004 to request an extension of time to file income tax returns Partnershi s, REMICs and trusts must use Forth 8736 to request an extension of time to file Form 1065, 1066, or 1041 Type Or Name of Exempt Organization Employer Identification number print TRUMAN MEDICAL CENTER, INCORPORATED 44-0661018 Foe by the due Number, street, and room n suite no If a P O boX sec instructions date ror Airio 2301 Holmes Street your '°6'm S°° Instructions City, twin or post office. slate, and ZIP code For a foreign address, see instructions

Kansas City, MO 64108 Check type of return to 6e filed (file a se orate application (or each return) X Form 990 Form 990-T (corporation)

Form 990-81 Form 990-T(sec. 401(e) a 408(a) trust) Form 990-EZ Form 990-T (trust other than above) Form 990-Pf Form 1041 "A

Form 4720 ~I Forth 5227 e Forth 6069

Forth 8870

JSA ovens, 2 000

" If the organization aces not have an office or place of business in the United States, cheat this box , , , . . . . , ~

. . , , " If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) If this is for the whole group, check this box " If it is for part of the group, check this box " and attach a list with the names and EINs of all members the extension will cover 7 I request an automatic 3-month (6-month, for 990-T corporation) extension of lime until DECEMBER 16 . 2002

to file the exempt organization return for the organization named above The extension is for the organv2tion's return for calendar year or

x8 110, tax year beginning May 1, , 2001 , and ending April 30 . 2002

2 It this tax year is for less than 12 months, cheat reason E] Initial return El Final return O Change in accounting period

3a If this application is for Forth 990-BL, 99dPF, 990-T, 4720, or 6069, enter the tentative tax less any nonrefundable credits See Instructions $

b If this application is for Form 990.PF or 990-T, enter any refundable treads and estimated tax payments made Include any prior year overpayment allowed as a credit , _ , . . , . , $

c Balance Due Subtract line 3b from line 3a Include your payment with this for ,m, or, if required, deposit with FTD coupon or, d required, by using EFfPS (Electronic Federal Tax Payment System) See instructions . . . , . . . . . , . . . . . . . , . . , $

Under penalties of perjury I declare that I haw exnmmad this lam including accompanying schedules end statements end to the beat of my knoWedge and belief R n hue correct one Compl I em e fn pee this honn

Signature " /6dfl~~~y,~ Title " CPA Dale " 9-16-02

For Paperwork Reduction Act Notice, see Instruction Form 8868 (i2-zaoo)

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22 05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385

Truman Medical Center, Incorporated

FORM 990, PART I - OTHER INVESTMENT INCOME

DESCRIPTION

FAMILY HEALTH PARTNERS MISCELLANEOUS

TOTAL

44-0661018

AMOUNT

462,368 . 286,711 .

749,079 .

STATEMENT 3

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4~4-0661018

TOTAL

23 05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385

Truman Medical Center, Incorporated

FORM 990, PART I - OTHER INCREASES IN FUND BALANCES

DESCRIPTION

NET ASSETS RELEASED FROM RESTRICTIONS USED FOR THE PURCHASE OF PROPERTY 6 EQUIPMENT

CHANGE IN INTEREST OF ASSETS OF TRUMAN MEDICAL CENTER CHARITABLE FOUNDATION

OTHER CHANGES TO NET ASSETS EQUITY IN MEDICAL STAFF

AMOUNT

3,354,805 .

2,381,908 . 453,334 . 106,724 .

------------6,296,771 .

STATEMENT 4

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4'4-0681018

AMOUNT DESCRIPTION

05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385 24

Truman Medical Center, Incorporated

FORM 990, PART I - OTHER DECREASES IN FUND BALANCES

UNREALIZED LOSS ON INVESTMENTS 453,306 . ------------

TOTAL 453,306 .

STATEMENT 5

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------------

TOTAL CONTRIBUTIONS PAID 4,571,482

25 STATEMENT 6 05NOG1 K922 03/15/2003 15 32 11 V01-7 51385

TRUHAIt MEDICAL CENTER, INCORPORATED

FORM 990, PART II - GRANTS AND ALLOCATIONS PAID DURING SHE YEAR

RELATIONSHIP TO SUBSTANTIAL CONTRIBUTOR

AND

RECIPIENT NAME AND ADDRESS FOUNDATION STATUS OF RECIPIENT -------------------------- ------------------------------

GAAHT9 PAID

CITY HEALTH DEPARTIENT

d4-0661018

PURPOSE OP GRANT OR CONTRIBUTION AMOUNT

-------------------------------- ------

0,571,482

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MEDICAL PROFESSIONAL FEES 54199183 . 54199183 . GENERAL SERVICES 9,441,082 . 9,441,082 . ADMINISTRATIVE SERVICES 15373671 . 15373671 . RESEARCH EXPENDITURES 4,219,025 . 4,219,025 . INSURANCE 10786400 . 10786400 . SAD DEBTS 29096758 . 29096758 . MISCELLANEOUS 2,540,037 . 2,540,037 .

---------- ---------- ---------- TOTALS 125656156 . 110282485 . 15373671 .

05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385 26 STATEMENT 7

TRUMAN MEDICAL CENTER, INCORPORATED 44-0661018

FORM 990, PART II - OTHER EXPENSES

PROGRAM MANAGEMENT DESCRIPTION TOTAL SERVICES AND GENERAL ----------- ----- -------- -----------

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TO PROVIDE SHORT AND LONG TERM MEDICAL CARE TO THE RESIDENTS OF JACKSON COUNTY, MISSOURI WITHOUT REGARD TO ABILITY TO PAY .

STATEMENT 8

05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385 27

TRUMAN MEDICAL CENTER, INCORPORATED

FOAM 990, PART III - ORGANIZATION'S PRIMARY EXEMPT PURPOSE

4'4-0661018

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STATEMENT 9

05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385 28

TRUMAN MEDICAL CENTER, INCORPORATED 4d-0661018

FORM 990, PART IV - OTHER ASSETS

BEGINNING ENDING DESCRIPTION BOOK VALUE BOOK VALUE ----------- ---------- ----------

SH-TERM ASSETS LIMITED IN USE 4,495,000 . 7,520,658 . DESIGNATED ASSETS FOR SELF

INSURANCE LOSSES 10,826,253 . 7,856,110 . DESIGNATED ASSETS FOR CAPITAL ACQUISITIONS S OTHER USES 13,733,133 . 3,484,807 .

DESIGNATED ASSETS EXTERNALLY RESTRICTED BY DONORS 1,019,916 . 839,240 .

INTEREST IN NET ASSETS OF TRUMAN MEDICAL CENTER CHARITABLE FOUNDATION 15,355,595, 17,737,503 .

HELD BY TRUSTEE NONE 22,115,347 . MEDICAL STAFF BANK ACCOUNTS NONE 106,724 .

--------------- --------------- TOTALS 45,929,897 . 59,660,389 .

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DESCRIPTION

ACCRUED PENSION COST 4,595,382 . ---------------

4,595,382 . TOTALS

29 05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385

TRUMAN MEDICAL CENTER, INCORPORATED

FORM 990, PART IV - DEFERRED REVENUE

BEGINNING BOOK VALUE

4a-0661018

ENDING BOOK VALUE

5,158,154 . ---------------

5,158,154 .

STATEMENT 10

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DESCRIPTION

11,648,357 . NONE

211,143 . ---------------

11,859,500 . TOTALS

05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385 30

TRUMAN MEDICAL CENTER, INCORPORATED

FORM 990, PART IV - OTHER LIABILITIES

SELF-INSURED ACCRUED LOSSES DUE TO CITY OF KC, MO OTHER

BEGINNING BOOK VALUE

4'4-0661018

ENDING BOOK VALUE

15,766,286 . 208,068 . 295,429 .

---------------16,269,783 .

STATEMENT 11

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NET ASSETS RELEASED FROM RESTRICTIONS 3,354,805 .

--------------- TOTAL 3,354,805

05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385 31

TRUMAN MEDICAL CENTER, INCORPORATED 4.4-06E1018

FORM 990, PART IV-A - OTHER REVENUE ON BOOKS BUT NOT ON RETURN

DESCRIPTION AMOUNT ----------- ------

STATEMENT 12

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4.4-0681018

FORM 990, PART IV-A - OTHER REVENUE ON RETURN BUT NOT ON BOOKS

05NOG1 K922 03/15/2003 15 :32 :11 VO1-7 51385 32

TRUMAN MEDICAL CENTER, INCORPORATED

DESCRIPTION

TEMPORARILY RESTRICTED REVENUE

TOTAL

AMOUNT

3,174,129 . ---------------

3,174,129

STATEMENT 13

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05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385 33

TRUMAN MEDICAL CENTER, INCORPORATED Q4-0661018

FORM 990, PART IV-B - OTHER EXPENSES ON RETURN BUT NOT ON BOOKS

DESCRIPTION AMOUNT ----------- ------

ASSETS RELEASED FROM RESTRICT 3,354,805 . ---------------

TOTAL 3,354,805 .

STATEMENT 14

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TRUMAN MEDICAL CENTER, INCORPORATED 44-0661018

FORM 990, PART V - LIST OF OFFICERS, DIRECTORS, AND TRUSTEES

CONTRIBUTIONS EXPENSE ACCT TO EMPLOYEE AND OTHER

BENEFIT PLANS ALLOWANCES ------------- ----------

NONE 2,405 .

TITLE AND TIME DEVOTED TO POSITION COMPENSATION ------------------- ------------

CEO 358,000 . 40 HRS

JOHN BLUFORD 4425 NE HOIT DRIVE LEE'S SUMMIT, MO 64064

CATHERINE DISCH 190 POINTS DRIVE GLADSTONE, MO 64116

ALLEN JOHNSON 7150 LACKMAN ROAD #1008 SHAWNEE, KS 66217

LEWIS POPPER 6908 VALLEY ROAD KANSAS CITY, MO 64113

MARJORIE SMELSTOR 5143 W . 75TH STREET PRAIRIE VILLAGE, KS 66208

SEE ATTACHED LIST DIRECTOR AS REQ .

GRAND TOTALS 1,160,544 . NONE

34 05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385 STATEMENT 15

NAME AND ADDRESS ----------------

COO, DEPUTY EXEC DIR 40 HRS

CFO 40 HRS

GENERAL COUNSEL 40 HRS

CAO 40 HRS

233,684 .

187,200 .

211,050 .

170,610 .

NONE

NONE

NONE

NONE

NONE

NONE

1,950 .

1,950 .

1,950 .

1,950 .

NONE

10,205 .

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COORDINATED PROFESSIONAL SERVICES TRUMAN MEDICAL CENTER CHARITABLE FOUNDATION UNIVERSITY PHYSICIANS ASSOCIATES

FORMERLY HOSPITAL HILL HEALTH SERVICES CORP . TRUMAN MEDICAL CENTER AUXILLARY TRUMAN MEDICAL CENTER EAST AUXILLARY

STATEMENT 16

05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385 35

TRUMAN MEDICAL CENTER, INCORPORATED

FORM 990, PART VI - NAMES OF RELATED ORGANIZATIONS

44-ossioie

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TRUMAN MEDICAL CENTER, INCORPORATED 44-0661018

FORM 990, PART IX - INFORMATION REGARDING TAXABLE SUBSIDIARIES

PERCENTAGE NATURE OF NAME AND ADDRESS OWNERSHIP BUSINESS TOTAL ENDING EMPLOYER IDENTIFICATION NUMBER INTEREST ACTIVITIES INCOME ASSETS ------------------------------ -------- ---------- ------ ------

FAMILY HEALTH PARTNERS 0 .500000 HEALTH SERV 462,368 . NONE 215 WEST PERSHING KANSAS CITY, MO 64108 43-1726517

------------ ------------

TOTAL INCOME 462,368 . NONE

05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385 36 STATEMENT 17

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SEE FORM 990, PART V

STATEMENT 18

05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385 37

TRUMAN MEDICAL CENTER, INCORPORATED

SCHEDULE A, PART III - EXPLANATION FOR LINE 2D

4U-0661018

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05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385 38

TRUMAN MEDICAL CENTER, INCORPORATED 4'4-0661018

SCHEDULE A, PART III - EXPLANATION FOR LINE 4

TRUMAN MEDICAL CENTER HAS CONTRIBUTED FUNDS TO THE CITY OF KANSAS CITY, MISSOURI FOR USE BY THE KANSAS CITY DEPARTMENT OF HEALTH IN THE DEVELOPMENT AND CONSTRUCTION OF A NEW BUILDING AND ITS OPERATIONS . TRUMAN MEDICAL CENTER CONSIDERS IT IMPORTANT TO LINK PATIENT PREVENTION SERVICES WITH ACUTE CARE SERVICES AND ALSO HAS THE DESIRE TO ENHANCE COMMUNITY HEALTH SERVICES .

STATEMENT 19

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PART IV, LINE 57 b PART II, LINE 42 COST

LAND $ 995,174 BUILDINGS 6 IMPROVE . 157,031,615 EQUIPMENT 80,874,185 CONSTRUC . IN PROCESS 8,777,728

-------------TOTAL $247,678,702 $129,644,605

39 05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385

Truman Medical Center, Incorporated

FEDERAL FOOTNOTES

A/D $ NONE 79,096,178 50,548,427

NONE

44-0661018

DEPRECIATION $ NONE 6,086,460 6,904,073

NONE

12,990,533

STATEMENT 1

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05NOG1 K922 03/15/2003 15 :32 :11 V01-7 51385 40

Truman Medical Center, Incorporated 4$-0661018

FEDERAL FOOTNOTES

FORM 990, PART I, QUESTION 7 OTHER INVESTMENT INCOME -----------------------TRUMAN MEDICAL CENTER WAS A 50/50 PARTNER IN FAMILY HEALTH PARTNERS WITH CHILDREN'S MERCY HOSPITAL . FAMILY HEALTH PARTNERS IS A HMO WHICH WAS FOUNDED TO PROVIDE HEALTH CARE SERVICES TO ITS MEMBERS . THE TRUMAN MEDICAL CENTER RECORD THE INVESTMENT ON THE EQUITY BASIS, REPORTING ITS SHARE OF FAMILY HEALTH PARTNER'S NET INCOME (LOSS) FOR THE YEAR . TRUMAN MEDICAL CENTER WITHDREW FROM THE PARTNERSHIP IN 2002 .

STATEMENT 2

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BOARD MEMBER Donald H Alexander Board of Alexander & Associates, Inc Governor 408 Miami Avenue Kansas City , KS 66105 Suzanne E Allen Board of 2808 West 66'" Governor Shawnee Mission, KS 66208 Dr Rex Archer City Director of Health Director Kansas City Health Department 2400 Troost Kansas City , MO 64708 Councilman Evert Ashes, III City 414 East 12'" Street Director 24'" Floor, City Hall Kansas City , MO 64106 Steven Ballard, Ph D University Provost & Vice Chancellor for Director Academic Affairs UMKC 300 G Administrative Center 5100 Rockhdl Road Kansas City, MO 64110-2499

Paul Black Public Chief Sales Officer & Executive VP Director Carrier Corporation 2800 Rockcreek Parkway Kansas City , MO 64117 John W Bluford Executive CEO/Executive Director Director Truman Medical Center 2301 Holmes Kansas City , MO 64108 Nona Rolling Board of 4550 Warwick Governor Kansas City, MO 64111

John P. Borden - Immediate Past Chair Board of 4444 West 131° Terrace Director Leawood, KS 66209

Robert A Brooks, III Rep First Commercial Real Estate Services, Inc Director One Ward Parkway, Suite 305 Kansas City , MO 64112 Troy Brown Public 6662 Oakwood Drive Director Odessa, MO 64076 William L Bruning - President Public 4818 Jarboe Director Kansas City , MO 64112 Rose Bryent - Secretary Public 11701 Wyandotte Director Kansas City, MO 64114

F Edwin Cockrell Board of Tension Envelope Corporation Governor 819 East 19°' Street Kansas City , MO 64108

August 19, 2002

TMC BOARD OF DIRECTORS & GOVERNORS 2001-2002

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BOARD MEMBER James L. Cole Board of Country Club Bank Governor P O Box 410889 Kansas City, MO 64141-0889 Joanne Collins Board of 4030 Bellefontaine Governor Kansas City, MO 64130 Charles Curran Board of 4550 Warwick Blvd , Box 65 Governor Kansas City, MO 64111 Arthur A Davis, III Public 2629 Northwest Bent Tree Circle Director Lee's Summit, MO 64081 Suellen Dice City 6815 Edgevale Road Director Kansas City, MO 64173

Betty M Drees, MD University Interim Dean Director UMKC School of Medicine 2411 Holmes Kansas City, MO 64108

Karl F Eaton Board of 13740 Pembroke Circle Governor Leawood, KS 66224

Councilman Charles A Eddy City 414 East 12'" Street Director 24' Floor, City Hall Kansas City, MO 64106

Stanley Edlavitch, PhD, MA Board of 206 West 94°' Street Governor Kansas City , MO 64114 E Frank Ellis Board of First Guard Health Plan Governor 3801 Blue Parkway Kansas City, MO 64130 Randall C Ferguson, Jr Public IBM Director 2345 Grand Avenue Kansas City, MO 64108 Gerald Finke, D 0 Public Clinical Chief, Radiology Director Truman Medical Center 2301 Holmes Kansas City, MO 64108 Michael Fleschman County Cecil Williams Law Firm Director 1125 Grand Avenue, Suite 707 Kansas City, MO 64106 Frances Foerschler Public 4418 Northeast Carolane Director Kansas City, MO 64116-1525 Tresia A Franklin Board of Benefits Director Governor Hallmark Cards Mail Drop 185 P O Box 419580 Kansas City , MO 64179 Carmen S Glenn Board of P 0 Box 25151 Governor Dallas, TX 75225-1751

August 19, 2002 2

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BOARD MEMBER Michael Golden Board of Golden & Company Governor 1102 Grand Avenue Suite 1111 Kansas City, MO 64106

Bayard M Grant Board of 1011 Central Street Governor Kansas City, MO 64105

Judge Jon R Gray Public Circuit Court, Jackson County Director Jackson County Courthouse - Division 18 415 East 12'" Street Kansas City, MO 64106 R Stephen Griffith, M D Public Chairman Director Community & Family Medicine Truman Medical Center Lakewood 7900 Lee's Summit Road Kansas City, MO 64139 Robert M Hernandez, Sr Board of 4720 Genessee Governor Kansas City , MO 64111 Walter Hiersteiner Board of Tension Envelope Corporation Governor 819 East 19' Street Kansas City, MO 64108

Christopher T Hinken Public 604 West 67' Terrace Director Kansas City, MO 64113

Laura R Hockaday Board of 121 Ward Parkway, Apt 302 Governor Kansas City, MO 64112 E J Holland, Jr Board of 3674 Belleview Avenue Governor Kansas City, MO 64111

Sarah Ingram-Eiser Public 4605 Holmes Director Kansas City, MO 64110

Barbara Lebedun Board of H&R Block Foundation Governor Suite 500 4435 Main Kansas City, MO 64111 Bettye Long Board of 1233 South Pleasant Governor Independence, MO 64055 John Mescal Board of 16080 Mona Lane Governor Platte City, MO 64079

Byron McCallum Board of Commerce Bank Metro Department Governor P O Box 419248 IKCMT-1) Kansas City . MO 64106

Richard McEachen Board of Ferree, Bunn, O'Grady & Rundberg, Governor Chartered

August 19, 2002 3

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T~BOARD MEMBER 9300 Metcalf Suite 300 Overland Park, KS 66212 Nancy Mills University Dean, UMKGSchool of Nursing Director 2220 Holmes Kansas City, MO 64108 Thomas Mills Board of Criminal Investigation Bureau, Room 507 Governor State Office Budding 615 East 13'" Street Kansas City , MO 64106 Graham Morris County Director of Finance Director Jackson County Courthouse 415 East 12'" Street Kansas City, MO 64106 Beverly Nix Board of 2207 Red Bridge Terrace Governor Kansas City, MO 64131 Lloyd C Olson, MD Represent The Children's Mercy Hospital Director 2401 Gillham Road Kansas City , MO 64108 Javier A Palomarez Board of 14100 Granada Governor Leawood, KS 66224

Joel Pelotsky Board of US Trustee Governor 400 East Ninth Street Room 3440 Kansas City, MO 64106

Philip Gary Pettett, MD Represent The Children's Mercy Hospital Director 2401 Gillham Road Kansas City, MO 64108

Benjamin F Pettus, Jr Represent Samuel Rodgers Health Center Director 825 Euclid Kansas City, MO 64124-2322

Robert Piepho, Ph D University Dean Director UMKC School of Pharmacy 5005 Rockhill Road Kansas City , MO 64110 Barbara Potts Public 78508 E 30°' Terrace Director Independence, MO 64057 Robert Redmond Board of 6315 Brookside Plaza Governor Suite 104 Kansas City, MO 64113 Michael Reed, BIDS, Ph D University Dean Director UMKC School of Dentistry 650 East 25°` Street Kansas City, MO 64108-2784 Ronald C Reamer Represent 2601 Verona Road Director Mission Hills, KS 66208-1267

August 19, 2002 4

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BOARD MEMBER

George R Reisz, MD Public Chairman, Internal Medicine Director Truman Medical Center 2301 Holmes Kansas City, MO 64108 Philip Richter Board of Senior Vice President Governor LIMB Bank, Investment Banking Division 18 P O Box 419226 Kansas City, MO 64131.6226 Frederick H Riesmeyer, II - Chair Public Spradley & Riesmeyer Director 4700 Belleview Suite 210 Kansas City , MO 64112 Kevin Riper City Director of Finance Director 414 E 120 Street 3'° Floor, City Hall Kansas City, MO 64106 John A Rios Board of Deputy Director Governor Excelsior Springs Job Corps Center 701 St Lows Avenue Excelsior Springs, MO 64024 Edward B Rucker County 3654 Campbell Director Kansas City, MO 64106 Joan C Runnion Public 1260 West 64'" Street Director Kansas City, MO 64113

Felix N Satiates, M D Board of Chairman, Department of Ophthalmology Governor UMKC School of Medians & Truman Medical Center 2300 Holmes Kansas City, MO 64108 Theodore Seligson Board of Foss, Seligson, La(ferty-Architects Governor 106 West 14" Street Kansas City, MO 64105

Kara L Settles, MD Public Truman Medical Center Director Depart of Anesthesiology 2301 Holmes Kansas City, MO 64108

Alicia Smith, RN Public 10827 Fremont Director Kansas City, MO 64134

Margo C Soule' Represent Sonnenschein, Nath & Rosenthal Director 4520 Main Kansas City , MO 64111 Aggie Stackhaus Public 3530 Walnut Director Kansas City, MO 64111

John Thigpen Crty

August 19, 2002 5

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6 August 19, 2002

`BOARD MEMBER Director of Human Resources Director 12'" Floor, City Hall 414 East 12'" Street Kansas City, MO 64106

Mark Thomhill - President Elect Public Spencer, Fame . Bntt & Browne Director 1400 Commerce Bank Building 1000 Walnut Kansas City, MO 64105 Jerome S . Tilzer, CPA - Treasurer Represent 10212 Mohawk Lane Director Leawood,KS 66206-2437

Donald H Tranin Board of 1215 West 63'" Street Directors Kansas City, MO 64113 Fiita Valenciano Board of AVANCE Kansas City Governor P O Box 171063 Kansas City, KS 66117 James B Wilson County 4545 East 53'° Street Director Kansas City, MO 64130 John Wood Board of 400 Duke Gibson Drive Governor Kansas City, MO 64145 John C Wurst Board of Henry Wurst, Incorporated Governor 1331 Saline North Kansas City , MO 64116 Terry Young County Jackson County Legislature Director 200 S Main Independence, MO 64050