Community Benefit Insight - Tax-exempt hospital

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Truman Medical Center Incorporated

2301 Holmes Street

Kansas City, MO 64108

EIN: 440661018

The hospital that you have selected is part of a multi-facility organization that reports community benefit expenditures in the aggregate and not by individual hospital. The data shown below are for the multi-facility organization. We encourage you to contact the individual hospital directly if you would like community benefit information on the hospital.Learn more

Individual Facility Details: University Health Lakewood Med Ctr

7900 Lees Summit Road
Kansas City, MO 64139

2 hospitals in organization:
(click a facility name to update Individual Facility Details panel)

University Health Truman Med Center

University Health Lakewood Med Ctr

Bed count	304	Medicare provider number	260102	Member of the Council of Teaching Hospitals	YES	Children's hospital	NO

Truman Medical Center IncorporatedDisplay data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

11.6%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 22,836,259 3.20 %
Medicaid as % of operating expenses	$ 47,006,212 6.58 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 9,122,058 1.28 %
Subsidized health services as % of operating expenses	$ 2,631,952 0.37 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 942,878 0.13 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 384,411 0.05 %
Community building* as % of operating expenses	$ 0 0 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	Not available
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 0 0 %
Physical improvements and housing as % of community building expenses	$ 0
Economic development as % of community building expenses	$ 0
Community support as % of community building expenses	$ 0
Environmental improvements as % of community building expenses	$ 0
Leadership development and training for community members as % of community building expenses	$ 0
Coalition building as % of community building expenses	$ 0
Community health improvement advocacy as % of community building expenses	$ 0
Workforce development as % of community building expenses	$ 0
Other as % of community building expenses	$ 0
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2021

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 52,095,670 7.29 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 39,071,753 75.00 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2021

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2021

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 356795577 including grants of $ 185148) (Revenue $ 385741009)
OUTPATIENT DEPARTMENT- SEE SCHEDULE O

4B (Expenses $ 240449193 including grants of $ 0) (Revenue $ 259955897)
INPATIENT CARE- SEE SCHEDULE O

4C (Expenses $ 49124029 including grants of $ 0) (Revenue $ 53109269)
EMERGENCY DEPARTMENT- SEE SCHEDULE O

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

SCHEDULE H, PART V, SECTION B, LINE 5 - BOTH FACILITIES
UNIVERSITY HEALTH DEVELOPED AN ELECTRONIC SURVEY TO ENGAGE COMMUNITY PARTNERS IN THE ASSESSMENT PROCESS. A COMMON SET OF QUESTIONS WAS POSED, AND RESPONSES COLLECTED ELECTRONICALLY AND VIA PAPER SURVEYS AND SUMMARIZED. TWENTY-THREE PARTNER ORGANIZATIONS PARTICIPATED IN THE SURVEY. THIS SURVEY ESTABLISHED THE SET OF ISSUES OF MOST INTEREST TO THE COMMUNITY. RESPONDENTS WERE ASKED TO SELECT ISSUES, AND ALSO TO CONSIDER SERVICES THEY BELIEVED COULD BE STRENGTHENED IN TERMS OF ACCESS, AVAILABILITY AND/OR QUALITY. RESPONSES WERE SUMMARIZED TO PROVIDE A CONSENSUS REPORT. 1792 COMPLETED SURVEYS WERE COLLECTED AND THE RESULTS AGGREGATED AND ANALYZED TO IDENTIFY THE MOST IMPORTANT ISSUES THE COMMUNITY BELIEVES UH NEEDS TO ADDRESS BASED ON THEIR KNOWLEDGE OF ISSUES FACING PATIENTS AND THE COMMUNITY. TWO SURVEYS WERE CONDUCTED - ONE FOR EACH UH FACILITY - IN ORDER TO ESTABLISH UNIQUE PRIORITIES FOR EACH ENTITY.

SCHEDULE H, PART V, SECTION B, LINE 6A
UH COMPLETED CHNA REPORTS FOR TWO FACILITIES, UNIVERSITY HEALTH - TRUMAN MEDICAL CENTER AND UNIVERSITY HEALTH - LAKEWOOD MEDICAL CENTER, AS REQUIRED BY THE IRS, EACH FACILITY HAS A SEPARATE REPORT, WITH FACILITY-SPECIFIC PRIORITIES.

SCHEDULE H, PART V, SECTION B, LINE 7A - BOTH FACILITIES
THE COMPLETE CHNA REPORTS FOR UNIVERSITY HEALTH -TRUMAN MEDICAL CENTER AND UNIVERSITY HEALTH - LAKEWOOD MEDICAL CENTER CAN BE FOUND AT: https://www.universityhealthkc.org/about-us/publications/community-health- needs-assessment/

SCHEDULE H, PART V, SECTION B, LINE 10 - BOTH FACILITIES
THE IMPLEMENTATION STRATEGY FOR UNIVERSITY HEALTH - TRUMAN MEDICAL CENTER AND UNIVERSITY HEALTH - LAKEWOOD MEDICAL CENTER CAN BE FOUND AT: https://www.universityhealthkc.org/about-us/publications/community-health- needs-assessment/

SCHEDULE H, PART V, SECTION B, LINE 11 - BOTH FACILITIES
ASSESSING THE NEEDS OF THE COMMUNITY IS AN INTEGRAL PART OF UH'S DAY-TO-DAY OPERATIONS. AS A SAFETY NET PROVIDER WITH A SIGNIFICANT POPULATION OF UNINSURED PATIENTS, IT IS CRITICAL TO UH'S SURVIVAL TO ASSURE PROVISION OF CARE THAT MEETS COMMUNITY NEED AND KEEPS THE COSTS OF CARE AS REASONABLE AS POSSIBLE. A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS WAS INITIATED IN THE FALL OF 2012, IN THE FALL OF 2015, IN THE FALL OF 2019, AND AGAIN IN 2022. THIS PROCESS INCLUDED THE FOLLOWING STEPS: DEFINE COMMUNITY. AS PART OF THIS PHASE, UH EXAMINED THE CURRENT PATIENT DATA FILE AND OTHER DOCUMENTATION OF DEFINED GEOGRAPHIC SERVICE AREA FOR HOSPITAL HILL AND LAKEWOOD FACILITIES. THIS INCLUDED: - DEFINE GEOGRAPHIC SERVICE AREA - DEFINE SPECIFIC TARGET POPULATIONS WITH BROADER REACH THAN THE GEOGRAPHIC SERVICE AREA IDENTIFY PARTNERS. UH HAS MANY PARTNERS. AS PART OF ITS ONGOING WORK IN MEETING COMMUNITY NEED, UH ENGAGES THESE ORGANIZATIONS IN STRATEGIC PLANNING AND IN HELPING IDENTIFY ORGANIZATIONAL PRIORITIES. DURING THIS PHASE, UH COMPLETED THE FOLLOWING: - ESTABLISHED AN INVENTORY OF UH INVOLVEMENT IN COMMUNITY-BASED PARTNERSHIPS - IDENTIFIED CONSUMERS AND ENGAGED THEM THROUGH FOCUS GROUPS AND SURVEYS SECONDARY DATA: UH ASSEMBLED A BROAD SET OF DATA TO MEASURE AND EVALUATE HEALTH STATUS, HEALTH STATISTICS AND THE INCIDENCE RATES OF DISEASE, ILLNESS AND ACCIDENTS USING SECONDARY DATA SOURCES. THIS PHASE OF THE ASSESSMENT FOCUSED ON NOT ONLY ON HEALTH OUTCOMES, BUT ALSO ON FACTORS THAT INFLUENCE FUTURE HEALTH, SUCH AS HEALTH AND WELLNESS HABITS, EXPERIENCES ACCESSING CARE AND ATTITUDES THAT INFLUENCE HEALTHY BEHAVIOR. PRIMARY DATA: THIS EFFORT TO MEASURE AND EVALUATE HEALTH STATUS, HEALTH STATISTICS AND THE INCIDENCE RATES OF DISEASE, ILLNESS AND ACCIDENTS USES TRUMAN MEDICAL CENTERS DATA. THE PRIMARY DATA COLLECTION EFFORT FOCUSED ON HEALTH OUTCOMES AND FACTORS THAT INFLUENCE HEALTH, SUCH AS HOMELESSNESS, INSURANCE COVERAGE AND HEALTH CARE SYSTEM UTILIZATION FOR SPECIFIC CONDITIONS; SPECIFIC TO THE UH PATIENT EXPERIENCE. AGGREGATED DATA: UH ASSIMILATED SECONDARY AND PRIMARY DATA SETS INTO A COMBINED COMPREHENSIVE REPORT AND OVERVIEW OF THE UH SERVICE AREAS AND PATIENTS. THE AGGREGATED DATA REPORT IS REFLECTED THROUGHOUT THIS REPORT. IDENTIFY & PRIORITIZE ISSUES. THIS PHASE ENGAGED THE BOARD, ORGANIZATIONAL LEADERSHIP, KEY CONSTITUENTS AND COMMUNITY PARTNERS TO IDENTIFY AND PRIORITIZE COMMUNITY HEALTH ISSUES; USING THE RESULTS OF THE DATA ANALYSIS. MULTIPLE SURVEYS WERE UTILIZED DURING THIS PROCESS, WITH DELINEATION OF RESPONSES BETWEEN UH STAFF/LEADERSHIP AND THE COMMUNITY OVERALL. AFTER ANALYSIS OF RESPONSES, AND CONSIDERING THE UNIQUE FOCUS OF UH AS AN ACADEMIC MEDICAL CENTER AND SAFETY NET HEALTH SYSTEM, THE FOLLOWING ISSUES EMERGED: SOCIAL DETERMINANTS OF HEALTH (POVERTY AND HOMELESSNESS); MENTAL HEALTH, BEHAVIORAL HEALTH, SUBSTANCE ABUSE AND SUICIDE; RACISM AND DISCRIMINITORY CARE; MATERNAL & CHILD HEALTH. SOCIAL DETERMINANTS OF HEALTH PARTICIPANTS OF THE FOCUS GROUP IDENTIFIED THE IMPACT OF SOCIAL DETERMINANTS OF HEALTH (SDOH) AS A PRIORITY OF THEIR COMMUNITY. THE IMPACT OF POVERTY AND HOMELESSNESS CONTINUES TO BE THE GREATEST BARRIER TO INVIDUALS' HEALTH IN JACKSON COUNTY. ACCORDING TO THE HEALTH EQUITY DASHBOARDS AT MISSOURI HOSPITAL ASSOCIATIONS, THERE IS A HIGHER DISPARITY FACTOR FOR HOUSING AMONG BLACK/AFRICAN AMERICANS COMPARED TO THEIR WHITE COUNTERPARTS. ATTENDEES OF THE COMMUNITY UNANIMOUSLY AGREED THAT POVERTY IS ONE OF THE MOST IMPORTANT ISSUES THAT, WHEN ADDRESSED, CAN HELP ALLEVIATE THE OTHER UNDERLYING SDOHS. ACCORDING TO THE 2022 COUNTY HEALTH RANKINGS AND ROADMAP, JACKSON COUNTY HAS CONSISTENTLY RECORDED A HIGHER PERCENTAGE OF CHILDREN IN POVERTY COMPARED TO THE STATE AND NATIONAL TRENDS. THERE IS A STRONG AND GROWING EVIDENCE BASE LINKING STABLE AND AFFORDABLE HOUSING TO HEALTH. THROUGH A VARIETY OF MECHANISMS, UH WILL CONTINUE ITS EFFORTS TO PARTNER WITH COMMUNITY SERVICES AND PARTNERS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH FOR ALL COMMUNITY MEMBERS. USING A HEALTH EQUITY APPROACH, WHICH RECOGNIZES THE IMPACT OF SOCIO-ECOLOGICAL FACTORS ON A PERSONS' OVERALL HEALTH, UH CONTINUES TO IDENTIFY LOCATIONS FOR DIRECT OUTREACH, INCLUDING COMMUNITY-BASED CLINICS AND COMMUNITY-BASED HEALTH EDUCATION. THIS APPROACH IS AN UNDERLYING THEME TO EVERYTHING UH UNDERTAKES; WITH STAFF MEMBERS EDUCATED IN CULTURAL COMPETENCE AND TRAUMA-INFORMED CARE. THIS APPROACH WAS DESIGNED TO CREATE AN ATMOSPHERE OF WELCOME FOR ALL WHO INTERACT WITH UH. BECAUSE OF THIS FOCUS, UH WILL CONTINUE ITS GOAL OF BEING THE PROVIDER OF CHOICE FOR ALL CONDITIONS THAT DISPROPORTIONATELY IMPACT MINORITY POPULATIONS IN THE GREATER KANSAS CITY REGION. MENTAL HEALTH, BEHAVIORAL HEALTH, SUBSTANCE USE AND SUICIDE OF THE 1,792 RESPONDENTS TO THE 2022 SURVEY, 1,009 REPORTED BEHAVIORAL HEALTH AS AN ONGOING PROBLEM IN THE COMMUNITY WHILE 669 CITED SUBSTANCE ABUSE. A REVIEW OF THE 2022 COUNTY HEALTH RANKINGS AND ROADMAPS REVEALS THAT JACKSON COUNTY HAD A HIGHER SUICIDE RATE COMPARED TO THE STATE. SUICIDE IS SIGNIFICANTLY HIGHER AMONG WHITES, FOLLOWED BY BLACK/AFRICAN AMERICANS AND HISPANICS RESPECTIVELY. ACCORDING TO THE 2021 STATUS REPORT ON MISSOURI'S SUBSTANCE USE AND MENTAL HEALTH, JACKSON COUNTY EXPERIENCED AN INCREASE IN THE NUMBER OF INDIVIDUALS WHO RECEVIED PSYCHIATRIC SERVICES FOR ANXIETY AND FEAR DISORDERS, DEPRESSIVE MOOD DISORDER, DEVELOPMENT AND AGE-RELATED DISORDERS, IMPULSE CONTROL AND CONDUCT DISORDER, PERSONALITY DISORDERS, SCHIZOPHRENIA AND PSYCHOTIC DISORDERS, TRAUMA AND STRESS RELATED DISORDERS. THE OPIOID CRISIS CONTINUES TO BE PREDOMINANT IN THE COMMUNITY. UH WILL CONTINUE TO MODEL INTEGRATED PRIMARY CARE AND INTENSIVE MENTAL HEALTH/SUBSTANCE ABUSE SERVICES, INCLUDING OUR CLINIC DESIGNED SPECIFICALLY TO ASSIST PATIENTS WITH MEDICATION-ASSISTED THERAPY TO ADDRESS THEIR ADDICTION. RACISM AND DISCRIMINITORY CARE A REVIEW OF RACIAL DIVERSITY TO MEASURE THE SPECIAL DISTRIBUTION OR EVENESS OF POPULATION DEMOGRAPHIC GROUPS REVEALED THAT JACKSON COUNTY HAS HIGH SEGREGATION. A REVIEW OF KEY HEALTH OUTCOME INDICATORS REVEALED THAT MINORITY POPULATIONS HAVE SIGNIFICANT HEALTH DISPARITIES IN KEY AREAS. IT IS IMPORTANT TO NOTE THAT WHILE THERE MAY BE OTHER CONFOUNDING FACTORS CONTRIBUTING TO THESE DISPARITIES, RACISM AND DISCRIMINITORY CARE IS A MAJOR ISSUE PER THE INFORMATION GATHERED DURING THE COMMUNITY FORUM. LIFE EXPECTANCY BY CENSUS TRACT SEPARATED BY THREE MILES IN JACKSON COUNTY RESULTS IN A DIFFERENCE OF 21.6 YEARS. AFTER A DROP IN LIFE EXPECTANCY IN RECENT YEARS, SIGNS INDICATE THE OVERALL TREND MAY BE LEVELING OFF. NOT ALL GROUPS OF PEOPLE, EVERYWHERE, HAVE EXPERIENCED THE SAME LENGTH OF LIFE TRENDS. RACIAL OPPORTUNITY GAP PERSISTS. MODEST GAINS IN UNEMPLOYMENTS RATES HAVE NOT TRANSLATED INTO HOUSEHOLD INCOMES WITH LOWER INCOMES TO MAKE ENDS MEET AND BE HEALTHY. ADDRESSING THIS ISSUE IN JACKSON COUNTY BY ENGAGING THE RIGHT PARTNERS WILL BE KEY IN STRATEGIZING ON WAYS TO ENSURE THAT EVERYONE HAS A FAIR CHANCE OF LIVING A HEALTHY LIFESTYLE. MATERNAL & INFANT HEALTH ADDRESSING THE COMPLEX HEALTH CONSIDERATIONS RELATING TO MATERNAL AND CHILD HEALTH IS IMPORTANT BECAUSE IT PROVIDES AN OPPORTUNITY TO END PREVENTABLE DEATHS AMONG ALL WOMEN, INFANTS, CHILDREN AND ADOLSCENTS, WHILE GREATLY IMPROVING THEIR HEALTH AND WELL-BEING. INFANT MORTALITY REPRESENTS THE HEALTH OF A VULNERABLE AGE GROUP AND CAN PROVIDE CONTEXT TO SUPPORT INTERPRETATION OF THE YEARS OF POTENTIAL LIFE LOST IN A COUNTY. IT IS ALSO COMMONLY USED TO EXAMINE GLOBAL HEALTH DIFFERENCES AS WELL AS TO UNDERSTAND HISTORIC RACIAL INEQUALITIES IN THE UNITED STATES. ADDRESSING THIS PRIORITY ISSUE IN JACKSON COUNTY WILL REQUIRE PARTNERSHIPS AND COLLABORATIONS BETWEEN HOSPITALS AND COMMUNITY-BASED ORGANIZATIONS TO HELP ADDRESS THE UNDERLYING ISSUES.

SCHEDULE H, PART V, SECTION B, LINE 16A - BOTH FACILITIES
THE FAP CAN BE FOUND AT: https://www.universityhealthkc.org/patients-visitors/billing-information/ financial-assistance/

SCHEDULE H, PART V, SECTION B, LINE 16B - BOTH FACILITIES
THE FAP APPLICATION CAN BE FOUND AT: https://www.universityhealthkc.org/patients-visitors/billing-information/ financial-assistance/

SCHEDULE H, PART V, SECTION B, LINE 16C - BOTH FACILITIES
THE PLAIN LANGUAGE SUMMARY CAN BE FOUND AT: https://www.universityhealthkc.org/patients-visitors/billing-information/ financial-assistance/

Supplemental Information

Schedule H (Form 990) Part VI

SCHEDULE H, PART I, LINE 3C
ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS AND RESIDENCY ARE OTHER FACTORS USED IN THE ELIGIBILITY CRITERIA EXPLAINED IN THE FAP FOR PROVIDING FREE CARE. SCHEDULE H, PART I, LINE 7 THE COST METHOD USED TO CALCULATE THE AMOUNTS IN THIS TABLE IS A COST TO CHARGE RATIO. SCHEDULE H, PART I, LINE 7G NO PHYSICIAN CLINIC COSTS ARE INCLUDED IN THE SUBSIDIZED HEALTH SERVICES COMMUNITY BENEFIT EXPENSES.

SCHEDULE H, PART III, SECTION A, LINE 2
THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2022. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.

SCHEDULE H, PART III, SECTION A, LINE 4
THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE IS IN AUDIT NOTE 1 ON PAGE 9 OF THE ATTACHED FINANCIAL STATEMENTS.

SCHEDULE H, PART III, SECTION B, LINE 3
UH HAS DISCOVERED ABOUT 75% OF BAD DEBTS RESULT FROM PATIENTS WHO ARE INDIGENT OR DO NOT QUALIFY FOR MEDICAID.

SCHEDULE H, PART III, SECTION C, LINE 9B
UH DOES NOT PURSUE COLLECTION FOR UNPAID DISCOUNTED AMOUNTS FOR INDIVIDUALS WITHIN THE CATCHMENT AREA.

SCHEDULE H, PART VI, LINE 2
UH DEVELOPED AN ELECTRONIC SURVEY TO ENGAGE COMMUNITY PARTNERS IN THE ASSESSMENT PROCESS. A COMMON SET OF QUESTIONS WAS POSED, AND RESPONSES COLLECTED ELECTRONICALLY AND VIA PAPER SURVEYS AND SUMMARIZED. TWENTY-THREE PARTNER ORGANIZATIONS PARTICIPATED IN THE SURVEY. THIS ELECTRONIC SURVEY ESTABLISHED THE SET OF ISSUES OF MOST INTEREST TO THE COMMUNITY. RESPONDENTS WERE ASKED TO SELECT ISSUES, AND ALSO TO CONSIDER SERVICES THEY BELIEVED COULD BE STRENGTHENED IN TERMS OF ACCESS, AVAILABILITY AND/OR QUALITY. RESPONSES WERE SUMMARIZED TO PROVIDE A CONSENSUS REPORT. 1792 COMPLETED SURVEYS WERE COLLECTED AND THE RESULTS AGGREGATED AND ANALYZED TO IDENTIFY THE MOST IMPORTANT ISSUES THE COMMUNITY BELIEVES UH NEEDS TO ADDRESS BASED ON THEIR KNOWLEDGE OF ISSUES FACING PATIENTS AND THE COMMUNITY. TWO SURVEYS WERE CONDUCTED - ONE FOR EACH UH FACILITY - IN ORDER TO ESTABLISH UNIQUE PRIORITIES FOR EACH ENTITY.

SCHEDULE H, PART VI, LINE 3
IF A PATIENT IS UNINSURED, UH'S FINANCIAL COUNSELING STAFF WORKS TO BECOME A PATIENT ADVOCATE. THEY ASSIST THE PATIENT IN APPLYING FOR MEDICARE, MEDICAID OR UH'S CHARITY CARE PROGRAM. UH POSTS ITS CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES THROUGHOUT THE HOSPITAL.

SCHEDULE H, PART VI, LINE 4
THE RACIAL COMPOSITION OF UH'S HEALTH SCIENCES DISTRICT SERVICE AREA INCLUDES TWO PRIMARY CATEGORIES: WHITE AND AFRICAN AMERICAN. THESE TWO CATEGORIES COMPRISE 90.06% OF THE CUSTOMERS WITHIN THE HEALTH SCIENCES DISTRICT AREA. RACIALLY, THE UH HEALTH SCIENCES DISTRICT SERVICE AREA REFLECTS THE GREATER JACKSON COUNTY, MISSOURI RACIAL MIX, WITH 67.31% WHITE, 22.75% AFRICAN AMERICAN, 2.06 % ASIAN, 0.46% NATIVE AMERICAN/ALASKAN NATIVE, 0.29% NATIVE HAWAIIAN/PACIFIC ISLANDER, 4.0% REPORTING SOME OTHER RACE, AND 3.13% REPORTING MULTIPLE RACES. THE RACIAL COMPOSITION OF UHS LAKEWOOD SERVICE AREA INCLUDES TWO PRIMARY CATEGORIES: WHITE AND AFRICAN AMERICAN. THESE TWO CATEGORIES COMPRISE 90.17% OF THE CUSTOMERS WITHIN THE LAKEWOOD AREA. RACIALLY, THE UH LAKEWOOD SERVICE AREA REFLECTS THE GREATER JACKSON COUNTY, MISSOURI RACIAL MIX, WITH 68.57% WHITE, 21.6% AFRICAN AMERICAN, 2.04% ASIAN, 0.45% NATIVE AMERICAN/ALASKAN NATIVE, 0.29% NATIVE HAWAIIAN/PACIFIC ISLANDER, 3.91% REPORTING SOME OTHER RACE, AND 3.13% REPORTING MULTIPLE RACES.

SCHEDULE H, PART VI, LINE 6
N/A

SCHEDULE H, PART VI, LINE 7
MISSOURI