GOVERNMENTAL ETHICS COMMISSION

RECEIPTS AND EXPENDITURES REPORT OF A POLITICAL OR PARTY COMMITTEE RECEIVED January 10,2020 JAN 13 2020

FILE WITH SECRETARY OF STATE KS Governmental Ethics Comm ssion SEE REVERSE SIDE FOR INSTRUCTIONS

'tt Kansas Hospital Association Political Action Committee A. N arne 0 f C OIIlDll ee: _

Address: 215 SE 8th Street

C1'ty an d Z'Ip C 0 de: Topeka, 66601 _

This is a (check one): __Party Committee " Political Committee

B. Check only ifappropriate: __ Amended Filing __Termination Report

C. Summary (covering the period from January 1, 2019 through December 31, 2019) 1. Cash on hand at beginning ofperiod .. 49,766.89

2. Total Contributions and Other Receipts (Use Schedule A) .. 72,222.58

3. Cash available this period (Add Lines 1 and 2) . 121,989.47

4. Total Expenditures and Other Disbursements (Use Schedule C) .. 51,043.16

5. Cash on hand at close ofperiod (Subtract Line 4 from 3) .. 70,946.31 6. In-Kind Contributions (Use Schedule B) .. 4,714.04

7. Other Transactions (Use Schedule D) . 0.00

D. "I declare that this report, including any accompanying schedules and statements, has been examined by me and to the best ofmy knowledge and belief is true, correct and complete. I understand that the intentional failure to file this document or intentionall filing a false document is a class A misdemeanor."

Date

GEe Form Rev, 2017 SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association Political Action Committee (Name of Party Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cash Cbctk Loao E funds Oth.r Receipt

Ms. Tara Ramlochan Chief Executive Officer 175.00 Meade District Hospital 112/2019

Mr. Dennis L George Chief Executive Officer, APS 501.00 3959 Hwy 59 Kansas Hospital Association 11912019 Ottawa, KS 66067-8345 .;

Mary Jo Taylor for 250.00 114 N. Union 1/9/2019 Void - Mary Jo royfor Stafford, KS 67578 .; for Kansas Senate

Steve Alford for Kansas House 250.00 4179 East Road 19 2/6/2019 Ulysses, KS 67880 .;

Mr. Chad R. Austin Sr. Vice President, Government 76.92 6518 SW 26th Court Relations 2/6f2019 Topeka, KS 66614-4305 Kansas Hospital Association

Mr. Chad R. Austin Sr. Vice President, Government 76.92 6518 SW 26th Court Relations 216/2019 Topeka, KS 66614-4305 Kansas Hospital Association

Ms. Audrey Dunkel Director of Financial Advocacy 36.46 2/6/2019 215 SE 8th Street Kansas Hospital Association Topeka, KS 66603-3906

Ms. Vallerle L Gleason President and Chief Executive 75.40 2/6/2019 609 Autumn Glen Cl. Officer Newton, KS 67114-9007 Newton Medical Center

Mr. Leonard Hernandez Chief Executive Officer 350.00 2/6/2019 220 Apache SI. Coffey County Hospital New Strawn, KS 66839-8801

Shane Hudson 263.49 2/612019 2547 Aberdeen Ln. Central Kansas Foundation Salina, KS 67401-7126

Mr. Randall Peterson President and Chief Executive 100.00 21612019 1500 SW Tenth Avenue Officer Topeka, KS 66604-1301 Stormont Vail Health

2, 157.19

Page --1 of-- 27 SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospl1al Association Political Action Committee (Name ofParly Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 LoaD or Other Cash Checl< Loan E fund. Other Receipt

Ms. Melissa Atkins CPA Chief Executive Officer 260.00 304 West Prout Street Graham County Hospital 2112/2019 Hill City, KS 67642-1435

Mr. Chad R. Austin Sr. Vice President, Govemment 76.92 6518 SW 26th Court Relations 2/15/2019 Topeka, KS 66614-4305 Kansas Hospital Association .f

Ms. Audrey Dunkel Director of Financial Advocacy 38.46 215 SE 8th Stree! Kansas Hospital Association 211512019 Topeka, KS 66603-3906 .f

Mrs. Jennifer A. Findley VP Education/Special Projects 20.00 3517 SW Ashworth Cl. Kansas Hospital Association 2115/2019 Topeka, KS 66614-4590 t/

Mrs. Cindy Leah Samuelson Vice Preslden! 1924 1107 NE 54th St Kansas Hospital Association 2115/2019 Topeka, KS 66617-4505

Brooke Bollman 250.00 601 South Osage Street Sumner County Hospital District 1 3/20/2019 Caldwell, KS 67022-1654

Dr. Lynn Fisher MD Chief of Staff 100.00 3/27/2019 POBox 389 Rooks County Health Center Plainville, KS 67663-{)389

Ms. Tracl Hoopingarner RN Chief Nursing Officer 50.00 312712019 20048 Linwood Rd. LMH Health Linwood, KS 66052-4341 .f

Ms. Karan Orr Chief Nursing Officer 950.00 4/212019 18053 Linwood Rd. Providence Medical Center Linwood, KS 66052-4521 .f

Ms. Judy Corzine Administrative Director and Chief 775.00 4/3/2019 3621 SW Woodvalley Place Information Offi Topeka, KS 66614-3536 Stormont Vail Health .f

Interim CEO 100.00 4/4/2019 Stormont Vail Health t/

2,629.62

Page --2 of-- 27 SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association Political Action Committee (Name of Party Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than .$150 Loan or Other Cash Check Loan K fund. Other Receipt

Thyra Strate 100.00 1521 M Road Edwards County Medical Center 4/412019 Lewis, KS 67552-5226 I

Mr. Russell W. Johnson President and Chief Executive 1,000.00 325 Maine Slreet Officer 41512019 Lawrence, KS 66044-1360 LMH Health I

Mary J. Martell Director 100.00 2922 SW 20th SI. Stormont Vail Health 4/5/2019 Topeka, KS 66604-3209 I

Associated Purchasing Services APS GPO 4,000.00 215 South East Eighth APS 4/8/2019 Topeka, KS 66603 I

Mr. Chad R. Austin Sr. Vice President, Govemment 115.38 6518 SW 26th Court Relations 4/8/2019 Topeka, KS 66614-4305 Kansas Hospital Association I

Mr. Robert C Copple FACHE, PE Senior Administrator 500.00 Ascension Via Christi Hospital, 4/8/2019 5739 Tuttle Cove Road Manhattan, KS 66503-8444 Manhattan

Mrs. Sheryle A. D'Amico VP 200.00 4/8/2019 737 N. 1550 Rd. LMH Health Lawrence, KS 66049-9198 I

Ms. Audray Dunkel Director of Financial Advocacy Sl.69 4/8/2019 215 SE 8th Street Kansas Hospital Association Topeka, KS 66603-3906 I

Mrs. Jennifer A. Findley VP Education/Special Projects 30.00 41812019 3517 SW Ashworth Ct. Kansas Hospital Association Topeka, KS 66614-4590 I

Mr. Doyle L McKimmy FACHE Chief Executive Officer 250.00 4/8/2019 100 Crestvue Jewell County Hospital Mankato, KS 66956-2407 I

r. Michael Ramirez Director of PT/OT/SLP 100.00 4/8/2019 25 Sliver Rain Road Stormont Vail Health Lawrence, KS 66049-5034 I

6,453.07

Page --3 of-- 27 SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association Political Action Committee (Name of Party Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Checl{, Date of Contributor Than $150 Loan or Other C••h Check Loan E funds Ofher Receipt

Ronald Robinson MD 202.60 519 Rugged Rock Rd. Goodland Regional Medical 4/8/2019 Loveland, CO 80537-8357 Center

Mr. Ronald Robln6on MD Chief Executive Officer 202.60 519 Rugged Rock Rd. Rawlins County Health Center 4/8/2019 Loveland, CO 80537-8357 ~

Mrs. Cindy Leah Samuelson Vice President 28.86 1107 NE 54th SI Kansas Hospital Association 4/8/2019 Topeka, KS 66617-4505 ~

Ms. Roxanne R. Schottel 260.00 304 E. Third SI. Washington County Hospital 4/812019 Washington, KS 66968-2098

Nlchole Charnley 100.00 214 E. 5th SI. Stormont Vail Health 4/15/2019 Onaga, KS 66521-9792

Ms. Angela Gamber Director of Post-Surgical/Ortho 100.00 Services 4/1512019 210 NW Valencia Rd. Topeka, KS 66615-9267 Stormont Vall Health ~

Michael J Kongs Director Financial Management 100.00 4/15/2019 7261 SW Fountalndale Stormont Vail Health Topeka, KS 66614-4629 ~

Ms. Tracy O'Rourke Chief Strategy Officer 500.00 4/15/2019 1500 SW Tenth Avenue Stormont Vall Health Topeka, KS 66604-1301 {

Kevin Steck 100.00 4/15/2019 9523 East 109th Street Stormont Vail Health Tulsa, OK 74133-7187 ~

Thomas Baker 100.00 4/1612019 1605 SW 27th Stonnont Vail Health Topeka, KS66611-1638 ~

s. Carol Perry RN, BSN, MSM Vlce President and Chief Nursing 600.00 4/16/2019 1500 SW Tenth Avenue Officer opeka, KS 66604-1301 Stormont Vail Health ~

2,164.06

Page _4__ of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association Political Action Committee (Name ofParty Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cash Checl' LoBn EfJrnda Other Receipt

Salena Gillam 100.00 2928 Fenwick Rd. Stormont Vail Health 4/17/2019 Lawrence, KS 66046-5476

Ms. Amy Kincade Adm. Director, Contlnlum of Care 100.00 2516 SW Chauncey Dr. Stormon1 Vail Health 4/17/2019 Topeka, KS 66614-4952 .f

Mr. Harold Courtois Chief Executive Officer 550.00 515 Elise Heights SI. Memorial Health System 4119/2019 Abilene, KS 67410

Mr. Jeremy Ensey Chief Executive Officer 58.00 535 South Freebom SI. Luke Hospital and living 4/19/2019 Marian, KS 66861-1256 Center

Mr. Elgin Glanzer Chief Rnanclal Officer 300.00 1602 Park Place Cl Memorial Health System 4/1912019 Abilene, KS 67410-2153

Ms. Vallerie L Gleason President and Chief Executive 82.94 Officer 4/19/2019 609 Autumn Glen Cl. Newton, KS 67114-9007 Newton Medical Center .f

Betty Greer 726.70 4/19/2019 2802 Road M Kearny County Hospital Deerfield, KS 67838-3833

Mrs. Lara Key Chief Executive Officer 250.00 4/19/2019 2380 V Rd Sabetha Community Hospital Sabetha, KS 66534-2595 .f

Ms. Laurie Labarca 200.00 4/1912019 1149 N. Glenmoor Dr. Ascension VIa Christl S1. Francis Wichita, KS 67206-4131 .f

Mr. Thomas Macaronas Chief Financial Officer 60.00 4/19/2019 1902 South U S Highway 59 Labette Health Parsons, KS 67357-4948 .f

s. Kathi J. McKinney RN eNG/Risk 6(1.00 4/19/2019 16 E 5th Labette Health rie, KS 66733-1604 {

2,487.64

Page _5__ of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association PolltJeal Action Committee (Name of Party Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cash Check Loan E fund> Othar Receipt

Mrs. Carrie L. Sala BSN, MSM Chief Executive Officer 37,12 8553 11 OTh Rd Holton Community Hospital 4/1912019 Delia, KS 66418-9536

Terry J Siek Chief Nursing Officer 100.00 300 W. 21st Hays Medical Center 4119/2019 Hays, KS 67601-3004 .f

Mr. Doug Stacy Chief Information OffIcer 100.00 3325 Crown Drive Labette Health 4/1912019 Independence, KS 67301-1517 .f

Ms. Chrls1lna Sykes CHHR Director Human Resources 60.00 1902 South U S Highway 59 LabeUe Health 4119/2019 Parsons, KS 67357-4948 .f

Anthony Vaughan 60.00 307 E. Wingard Rd. Labette Health 4/19/2019 Independence, KS 67301-7504

Mr. Eric A. Voth MD Physician 400.00 Stormont Vall Health 4/19/2019 411 Woodbury Court Topeka, KS 66606-2192

Mr. Brian A Williams Chief Executive Officer 2(J0.00 4/1912019 1307 Partridge Ave. LabeUe Health Parsons, KS 67357-5000

Allsha Herrmann 100.00 4/26/2019 670 70th Ave. Edwards County Medical Center Kinsley, KS 67547-4820

Mr. Kristopher Mathews 100.00 4/26/2019 963 CC5 Ln. Decatur Health Systems Oberlin, KS 67749-5122 .f

Ms. Mary Sweet Administrator 250.00 4/2612019 721 West Kansas Avenue Kiowa County Memorlal Hospital Greensburg, KS 67054-1633 .f

HR Director 100.00 4/27/2019 New10n Medical Center .f

1.507.12

Page _6__ of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECElPTS

Kansas Hospital Association Political Action Commit1ee (Name ofParty Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cash Ch

Ms. Shannan Flach Chief Executive Officer 250.00 21749 Plowboy Rd. Kingman Community Hospital 512/2019 Paxico. KS 66526-9256 t/

Ms. Genette Nicholas Vice President Government 360.00 1001 West 58tf1 Street Relations 5/2/2019 Kansas City, MO 64113-1232 Children's Mercy Hospital Kansas City t/

Mr. Michael Ruggiero Interim Chief Executive Officer 100.00 250 North Rock Road, Suite 160 Ashland Health Center 5/8/2019 Wichita, KS 67206-2241 t/

Mr. Chad R. Austin Sr. Vice President, Government 76.92 6518 SW 26th Court Relations 5/13/2019 Topeka, KS 66614-4305 Kansas Hospital Association

Diana Brosa 100.00 6234 SW Ward Rd. Stormont Vall Health 5/13/2019 Tecumseh, KS 66542

Ms. Christena Crawford Dir., Birthplace, Breaslfeeding 100.00 2600 Staffordshire Rd Clinic 511312019 Topeka, KS 66614-4366 Stonmont Vail Health

Ms. Audrey Dunkel Director of Financial Advocacy 38.46 5/13f2019 215 SE 8th Street Kansas Hospital Association Topeka, KS 66603-3906

Mrs. Jennifer A. Findley VP Education/Special Projects 20.00 5/13/2019 3517 SW Ashworth Cl. Kansas Hospital Association Topeka, KS 66614-4590 t/

Organization of Nurse Leaders Kansas Nursing Professional Association 250.00 5/1312019 215 SE Eighth KONL Topeka, KS 66603-3906 t/

Dr. Rob Kenagy MD President and Chief Executive 1,000.00 5113/2019 720 S. Kansas Ave. Apt. 300 Officer Topeka, KS 66603-3885 Stonmont Vail Health t/

Director, Library Services 100.00 5/13/2019 Stonmont Vall Health t/

2,385.38

Page _7__ of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association Political Action Committee (Name ofParty Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cosh Chede Loan E rands Other Receipt

Larry W. Lane Director 100.00 2821 NW Halfday PI. Stormont Vall Health 5/13/2019 Topeka, KS 66618-1649

Mr. Robert Langland Senior Vice President and Chief 500.00 4417 SE Oak Bend Dr. financial Officer 5/13/2019 Topeka, KS 66609-9508 Stormont Vall Health .f

Vicky McGrath 100.00 211W.11th Stormont Vall Health 5/13/2019 Auburn, KS 66402-9477 .f

Beverly J Rice DIrector, Volunteer Services 100.00 6323 SW Valencla Rd. Stormont Vail Health 5/13/2019 ubum, KS 66402-9562

Mrs. Cindy Leah Samuelson VIce President 19.24 1107 NE 54th St Kansas Hospital Association 5/13/2019 Topeka, KS 66617-4505

Ms. Darlene Stone SVP & CHRO 100.00 5714 Longleaf Dr. Stormont Vail Health 5/13/2019 Lawrence, KS 66049-5802

Ms. Jill R. Straub Health Information Management 100.00 5/13/2019 5200 NW 44th SI. Director Topeka, KS 66618-3405 Stormont Vall Health

Mr. Curt Thomas Administrator 250.00 5/13/2019 312 Custer Street Ness County Hospital District No Ness City, KS 67560-1654 .f

Ms. Debra L. Yocum Vice President, Clinical Services 35

Chris Croft for Kansas House 250.00 5121/2019 8909 W. 148th Terr. Overland Park, KS 66221 Void - for .f Kansas Hause

President and Chief Executive 600.00 512412019 Officer Newton Medical Center .f

2,469.24

Page _8__ of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association Political Action Committee (Name ofParty Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cash Che<:k Loan E fund. Other Receipt

Mr. J. Ben Quinton MHA Administrator 75.00 7711 S. Greenwich Road William Newton Hospital 5/24/2019 Derby. KS 67037-9550 .f

Mr. Michael Ruggiero Interlm Chief Executive Officer 100.00 250 North Rock Road, Suite 160 Ashland Health Center 5/2412019 Wichita, KS 67206-2241 .f

Mr. Jeremy Ensey Chief ExecutIVe Officer 63.45 535 South Freeborn SI. Luke Hospital and Living 6/3/201 g Marlon, KS 66861·1256 Center

Mrs. Carrie L. Sala BSN, MSM Chief Executive Officer 200.00 8553 11 OTh Rd Holton Communfty Hospital 6/5/2019 Della, KS 66418-9536 .f

Mr. Jeremy Clingenpeel Administrator 250.00 POBox 159 Satanta District Hospital and Long 6/17/2019 Satanta, KS 67870.{)159 Term Care

Mr. Curt Colson Regional VP Operations 256.73 605 N. Main SI. Great Plains Health Alliance, Inc. 6/17/2019 Hoisington, KS 67544-2150 .f

Mr. Sam D. Huenergardt Chief Executive Officer 1.000.00 6/17/2019 9395 Crown Crest Boulevard AdvenlHeallh Shawnee Mission Parker, CO 80138-8573 .f

Mr. Kim Moore 100.00 8/17/2019 810 Loch Lammond Dr. Hutchinson Regional Medical Hutchinson. KS 67502-2045 Center .f

Mr. Steven B. Poage VIce PresldentlCFO 500.00 6/17/2019 3401 SW Alameda Kansas HospItal Association Topeka, KS 66614-5109 .f

Stephanie Saucedo Business Office Manager 100.00 6/17/2019 605 E. Vine SI. Meade District Hospital Meade, KS 67864-0755

r. Jennifer Scot1 Koontz Physician 100.00 6/21/2019 1800 Firebox Newton Medical Center ewton, KS 67114-5526

2.745.18

Pao-e0 9 of 27_ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Assoc!atlon Polltlcal Actlon Commlltee (Name of Party Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Ca.h Check Loan E (WId. Other Receipt

Mr. Michael Ruggiero Interim Chief Executlve Officer 100.00 250 North Rock Road, Suite 160 Ashland Health Center 6/24/2019 Wichita, KS 67206-2241

Mr. Michael Ruggiero Interim Chief Executive Officer 100.00 250 North Rock Road, Suite 160 Ashland Health Center 6/2412019 Wichita, KS 67206-2241 .f

Ms. Kiley Floyd Chief Executlve Officer 200.00 1600 Community Drive Nemaha Valley Community 6/27/2019 Seneca, KS 66538-9739 Hospital .;

Mrs. Robin Rollins Harrold Senior VIce President 150.00 7303 Hauser Drive AdventHeallh Shawnee Mission 6127/2019 Shawnee, KS 66216-4156

Mr. David M. Robinson Trustee 350.00 810 S. Denman Neosho Memorial Regional 6/27/2019 Chanute, KS 66720-2536 Medical Center

Mr. Chad R. Austin Sr. VIce President, Government 163.84 6518 SW 26th Court Relations 6128/2019 Topeka, KS 66614-4305 Kansas Hospital Association

Ms. Audrey Dunkel Director of Financial Advocacy 76.92 6128/2019 215 SE 8th Street Kansas Hospital AssocIation Topeka, KS 66603-3906

Mrs. Jennifer A. Findley VP Education/Special Projects 40.00 6/28/2019 3517 SW Ashworth CL Kansas Hospital Association Topeka, KS 66614-4590

Ms. Sally Othmer Director of Data Services 15.40 6/28/2019 1725 NW Grove Kansas Hospital Association Topeka, KS 66606-1237 .;

Mrs. Cindy Leah Samuelson Vice President 38.48 6128/2019 1107 NE 54th St Kansas Hospital Association Topeka, KS 66617-4505 .f

r. Bryant McNally Division VP of Membership 175.00 7/3/2019 02 Russell Boulevard Services olumbla, MO 65203-1720 Missouri Hospital Association

1,399.64

Page 10 of 27 -- -- SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association PolIUcal Actlon Committee (Name of Party Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cas" C1teck Loan E funds Other Receipt

Molly Haase Director of Advocacy 260.00 32 W. 70th Terrace AdventHealth Shawnee Mission 7/12/2019 Kansas City, MO 64113-2564

Mr. John Broberg Chief Executive Officer 250.00 15621 Pawnee SI. Hiawatha Community Hospital 7/18/2019 Overland Park, KS 66224-3884 .f

Mr. Jesse Mock Chief Executive Officer 260.00 P.O. Box 989 University of Kansas Health 7/18/2019 Great Bend, KS 67530-0989 System Great Bend Camp .f

Christiane Cole 250.00 1110 Evergreen Dr. Phillips County Hospital 711912019 Phillipsburg, KS 67661-7061

Sunflower Chapter HFMA Professional Association 500.00 PO Box 2196 Sunflower Chapter HFMA 711912019 Wichita, KS 67201-2196

Mr. Robert L Mullen FACHE 100.00 1704 Sheffield Circle Kansas Hospital Association 7/19/2019 Manhattan, KS 66503-2220

Mr. Dallas A Polen Chief of Public Policy Strategy 350.00 7/23/2019 5401 West 101th Terrace Children's Mercy Hospital Kansas Overland Park, KS 66207-3127 City

Mr. Kevin Myers Director Information Technology 100.00 7125/2019 PO Box 360 WIlson Medical Center Neodesha, KS 66757-D360

Mr. Chad R. Austin Sr. Vice President, Government 76.92 713012019 6518 SW 26th Court Relations Topeka, KS 66614-4305 Kansas Hospital Association .f

Ms. Audrey Dunkel Director of Financial Advocacy 38M 7/3012019 215 SE 8th Street Kansas Hospital Association Topeka, KS 66603-3906 .f

VP EducatlonlSpecial Projects 20.00 7/30/2019 Kansas Hospital Association .f

2,185.38

Page _1_1_ of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association Pollt1cal Action Committee (Name of PaIty Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate &x Cash, Cbeck, Date of Contributor Than $150 Loan or Other Cash Check Loon Efonds Oth.,. Receipt

Mrs. Terri Gehring Vice President Operations 100.00 1993 Arrowhead Road McPherson Hospital 7130/2019 Moundridge, KS 67107-7498 I

Ms. Sally Othmer Director of Data Services 7.70 1725 NW Grove Kansas Hospital Association 713012019 Topeka, KS 66608-1237 I

Mrs. Cindy Leah Samuelson Vice President 19.24 1107 NE 54th St Kansas Hospital Association 7130/2019 Topeka, KS 66617-4505 I

Ms. Coleen Tummons Chief Executive Officer 300.00 200 Castle Rock Street Gove County Medical Center 7130/2019 Quinter, KS 67752-9777

Mrs. Beth Worden Director Nursing Services 100.00 2149 Hwy 58 McPherson Hospital 7/30/2019 Galva, KS 67443

Ms. Kelly McDermeit Director Outreach and Support 75.00 10390 SW Lakeview Drive Services 8/1/2019 Pratt, KS 67124-8209 Pratt Regional Medical Center

Ms. Kiley Floyd Chief Executive Officer 100.00 8/5/2019 1600 Community Drive Nemaha Valley Community Seneca, KS 66538-9739 Hospital

Ms. Nancy Zimmerman RN Administrator 100.00 81712019 HC 65, Box 8A Comanche County Hospital Coldwater, KS 67029-9500

Andrew Bair 170.00 8/13/2019 509 N. Douglas Ave. Ellsworth County Medical Center Ellsworth, KS 67439-3221 I

Ms. Laraine Gengler Chief Financial Officer 100.00 8/13/2019 401 Cedar Circle Lindsborg Community Hospital LIndsborg, KS 67456-2328 I

s. Cheri Hunt RN, BSN, MHA Vice President Patient Care 100.00 8/13/2019 13506 W. 53rd Terrace Services and Chief Nur hawnee, KS 66216-5165 Children's Mercy Hospital Kansas I Ity

1,171.94

Page 12 of 27 -- --- SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association Political Action Committee (Name ofParty Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cash Check LoIU1 E fund. Other Receipt

KHHRA Hospital HR Professional 1,000.00 215 SE Eighth Association 8/13/2019 Topeka, KS 66603-3906 KHHRA

RJsk & Quality Mgt KS Assoc of Risk & Quality Management 500.00 C-O Kansas Hospital Association Association 8/13/2019 215 SE Eighth Ave. .; Topeka, KS 66603-3906 Ms. Susan M Page President and Chief Executive 360.00 1410 Maple Street Officer 8/13/2019 Pratt, KS 67124-2903 Pratt Regional Medical Center .;

Dr. Shawn St. Peter Chief of Surgery 100.00 11713 Overbrook Road Children's Mercy Hospital Kansas 8/13/2019 Leawood, KS 66211-2225 City

Dr. James Stanford 100.00 206 S. Chicago Comanche County Hospital 8/13/2019 Coldwater, KS 67029-2948

Ms. Deborah Frey Stem RN, JD Clinical Services/Legal Counsel 100.00 3338 SW Alameda Dr. Kansas Hospital Association 8/13/2019 Topeka, KS 66604-2660

Mr. Larry VanDerWege Administrator 560.00 8/13/2019 743 Diamond Or. Lindsborg Community Hospital Lindsborg, KS 67456-2328

Ms. Karen Braman SVP Healthcare Strategy & 600.00 8/1412019 911 N. 1464 Rd. Planning Lawrence, KS 66049-9184 Kansas Hospital Association .;

Mr. Jeremy Armstron9 FACHE Chief Executive Officer 201.00 8/16/2019 POBox 399 Mitchell County Hospital Health Beloit, KS 67420-0399 Systems .;

Mr. PaulO. Kempinski Chief Executive Officer 500.00 8116/2019 4813 W. 148th Street Children's Mercy Hospital Kansas Leawood, KS 66224-9411 City .;

r. Eldon Koepke Chief Financial Officer 100.00 8/16/2019 898290 Rd Mitchell County Hospital Health Beloit, KS 67420-0399 Systems I

4,101.00

Page _1_3_ of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association Political Action Committee (Name ofParty Committee or Political Committee)

Occupation & Industry of Check Amonnt of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cosh Check Loon E I\mds Other Receipt

Mr. Thomas L Bell President and ChieF Executive 1,250.00 215 Southeast 8th Avenue Officer 8/20/2019 Topeka, KS 66603-3906 Kansas Hospital Association

Mr. William Ermann President and ChieF Executive 1,720,00 Box 1340 Officer 8/20/2019 Liberal, KS 67905-1340 Southwest Medical Center t/

Mrs. Jenny Niblock Chief Clinical Officer 100.00 1880 County Road 0 Citizens Medical Center 8/20/2019 Colby, KS 67701-9173 t/

Kansas Healthcare Environmenta Services Professional Association 250.00 Association 8/20/2019 215 SE EIghth Ave. Topeka, KS 66603-3906

Mr. Scott M. Smith Chief Executive Officer 300.00 3001 Ave. A Western Plains Medical Complex 8/20/2019 Dodge City, KS 67801-2270

Mr. Ryan Slover Chief Financial Officer 100.00 Citizens Medical Center 8120/2019 707 Valley Vis1a Norton, KS 67654-0250

Mr. Chris Tinsley Vice Chair, Board of Trustees 100.00 8/20/2019 PO Box 187 WIlson Medical Center Neodesha, KS 66757..Q187

Mr, Greg Unruh Chief Executive Officer 350.00 8/2012019 865 N. Thompson Citizens Medical Center Colby. KS 67701-3702

Ms. Ruth Duling Chief Executive Officer 100,00 812212019 2604 Carline Girard Medical Center Girard, KS 66743-2213 t/

Mr. Jeffery Perry President and Chief Executive 250.00 8123/2019 800 Raven Hili Drive Officer Atchison, KS 66002-9204 Atchison Hospital t/

hem Vaughn MD 130.00 8123/2019 1216 Waverly Dr. LMH Health awrence, KS 66049-5016 t/

4,660.00

Page --14 of-- 27 SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association Political Action Committee (Name of Party Committee or Political Committee)

Occnpation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cash Check Loan E funds Other Receipt

Mr. George Harms Chief Financial Officer 100.00 4508 Vista Dr. Hays Medical Center 8/27/2019 Hays, KS 67601-1860

Mr. Bruce Witt Director, Government Relations 200.00 820 Carriage Rd. Via Christi Health 8/27/2019 Maize, KS 67101-9697 .;

Mr. Bryce A Young Chief Operating Officer 100.00 1001 West 38th Hays Medical Center 8/27/2019 Hays, KS 67601-1516 .;

Ms. Joannah Applequist Corporate Compliance Officer 100.00 3802 Butterfield Road Hays Medical Center 8/30/2019 Hays, KS 67601-8100

Mr. Jeremy Armstrong FACHE Chief Executlve Officer 100.00 POBox 399 Mitchell County Hospital Health 8/30/2019 Beloit, KS 67420-0399 Systems

Quality Heallhcare Committee for Parent Organization 600.00 PO Box 144 8/30/2019 Jefferson City, MO 65102-0144

Quality Healthcare Committee for Parent Organization 250.00 8/30/2019 PO Box 144 Jefferson City, MO 65102-0144

Quality Healthcare Committee for Parent Organization 250.00 8/30/2019 PO Box 144 Jefferson City, MO 65102-0144

Ms. Marianna Harris Administrator 120.00 8/30/2019 118 S. 6th Street Osborne County Memorial Osborne. KS 67473-2322 Hospital

Mr. Edward Hemman RN, MBAHCM. President and Chief Executive 1,000.00 8/30/2019 FACHE Officer 3717 Fairway Dr. Hays Medical Center Hays, KS 67601-1588 rs. Judllh Ann Hodgson Chief Nursing Officer 100.00 8/30/2019 240 28th Rd Hospital District No 1 of Rice IIUe River, KS 67457-9004 County

2.920.00

Page~of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Assoclatlon Political Actlon Committee (Name ofParty Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cash Checl, Loan El'und.t Othor Receipt

Mr. Terry Pound Chief Financial Officer 100.00 420 S Pioneer Hospital District No 1 of Rice 8/30/2019 Lyons, KS 67554-2613 County

Janice Reese 100.00 604 Walnut Wilson Medical Centar 8/30/2019 Neodesha, KS 66757-1268 t/

Mr. Richard Shank External Affairs Representative 200.00 1701 East 23rd Avanue Hutchinson Regional Medical 8/30/2019 Hutchinson, KS 67502-1105 Center t/

Mr. George M Stover Chief Executive Officer 150.00 PO Box 828 Hospital Dlsbict No 1 of Rice 8/3012019 Lyons, KS 67554-0828 County t/

Mr. Shae C. Veach VP Regional Operations 100.00 4107 Smoky Hili Drive Hays Medical Center 8/30/2019 Hays, KS 67601-4713

Mr Kenny Wllk Vice Chair 65.48 14123 Belrive Cir. University of Kansas Hospital, The 8/30/2019 Basehor, KS 66007-5268

Mr. Chad R Austin Sr. Vice President, Government 115.36 9/3/2019 6518 SW 26th Court Relations Topeka, KS 66614-4305 Kansas Hospital Association

Ms. AUdrey Dunkel Director of Financial Advocacy 57.69 913/2019 215 SE 8th Street Kansas Hospital Association Topeka, KS 66603-3906

Mrs. Jennifer A. Findley VP Education/Special Projects 30.00 91312019 3517 SW Ashworth Ct. Kansas Hospital Association Topeka, KS 66614-4590 t/

Mrs. Letllfa A. Hollingsworth Director of Reimbursement 100.00 9/3/2019 2635 SW Santa Fe Dr. Kansas Hospital Association Topeka, KS 66614-4956 t/

5. Sally Othmer Director of Data Services 11.55 9/3/2019 1725 NW Grove Kansas Hospital Association opeka, KS 66606-1237 t/

1,033.10

Page _1_6_ of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospftal Association Political Action Committee (Name ofParty Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Co.sb Checlt Loon E funds Other Reeeipt

Mrs. Cindy Leah Samuelson Vice President 28.86 1107 NE 54th 5t Kansas Hospital Association 9/3/2019 Topeka, KS 66617-4505

Ms. Sandra Dickerson Chief Executive Officer 130.00 325 MissIon Road Greenwood County Hospital 9/4/2019 Eureka, KS 67045-2119 .;

Ms. Deborah Bruner Chief Executive Officer and 200.00 POBox 127 Administrator 9/5/2019 Minneola, KS 67865-0127 Minneola District Hospital .;

Ms. Teresa Clark Chief Executive Officer and 200.00 211 East Earl Street Administrator 9/5/2019 Leoti, KS 67861-9620 Wichita County Health Center

Ms. Niceta Farber Chief Executive Officer 125.00 POBox 167 Sheridan County Health Complex 9/5/2019 HOXie, KS 67740-0167

Ms. Sarah A Gideon 100.00 9/5/2019 616 PennsylvanIa Stormont Vall Health Holton, KS 66436-8824

Mr Kenny W1lk Vice Chair 500.00 9/5/2019 14123 Belrive Cir. University of Kansas Hospital, The Basehor, KS 66007-5268

Mr. John Brober9 Chief Executive Officer 400.00 9/6/2019 15621 Pawnee SI. Hiawatha Community Hospital Overland Park, KS 66224-3884 .;

Mr. EI91n Glanzer Chief Financial Officer 225.00 9/6/2019 1602 Park Place CI. Memorlal Health System Abilene, KS 67410-2153 .;

Rhonda Goddard 530.00 9/6/2019 2869 HOth Ave. Graham County Hospital Penokee, KS 67659-2023 .;

Barb Grecian 175.00 9/612019 1133 A. 350th Ave. Graham County Hospital alco, KS 67657-9637 .;

2,613.88

Paae0 17 of 27_ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association Political Action Committee (Name of Party Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cash Check Loan E f'unds Other Receipt

Ms. Linda Murphy Chief Financial Officer 475.00 POBox 70 Osborne County Memorial 9/6/2019 Osborne, KS 67473-0070 Hospital

Mr. Scali J Taylor President and Chief Executive 100.00 1617 Crestway Dr. Officer 9/9/2019 Garden City, KS 67840-5679 SI. Catherlne Hospital

Mr. Harold Courtois Chief Executive Officer 275.00 515 Elise Heights SI. Memorlal Health System 9/12/2019 Abilene, KS 67410

Robert Gibbs MD 450.00 611 Quail Creek Rd. Labelle Health 9/1212019 Parsons, KS 67357-2257

Betty Greer 240.00 2802 Road AA Kearny County Hospital 9/1212019 Deerfield, KS 67838-3833 ~

Kansas Hospital Attorneys !

Mr. Greg Lundstrom Director of Hospital Relations 100.00 9/1212019 605 West Lincoln Street Kansas Hospital Association Lindsborg, KS 67456-2328

Michael O'Dell 125.00 9/12/2019 1901 Sheridan Ave. Sheridan County Health Complex Hox.le, KS 67740-9602

Mr. Meldon L Snow Chief Executive Officer 250.00 9/1212019 211 Cherry 51. Logan County Hospital Oakley, KS 67748-1218 ~

Mr. Todd WIllert Chief Execut1ve Officer 350.00 9/1212019 900 Western SI. Community HealthGare System Onaga, KS 66521-8100 t/

Trustee 100.00 9/1212019 Graham County Hospital ~

2,965.00

Page _1_8_ of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association Political Aclion Committee

(Name of Party Committee OT Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cash Check Loan :E (und. Other Receipt

Ms. Jenea Oliver VP Philanthropy 100.00 14610 Tillman Road Children's Mercy Hospital Kansas 9/13/2019 Smithville, MO 64089-8961 City

Mr. Scott J Taylor President and Chief Executive 500.00 1617 Crestway Dr. Officer 9/13/2019 Garden City, KS 67846-5679 SI. Catherine Hospital

Mr. Randall R. Cason FACHE Senior Administrator 350.67 905 Cedar Lane Ascension Via Christi Hospital 911712019 Pittsburg, KS 66762-6643

Mr. David-Paul Cavazos MBA Chief Executive Officer 250.00 215 South Buckeye Street Republic County Hospital 9/1712019 lola, KS 66749-3301

Mrs. Brenda Legleiter BSN, RN Chief Executive Officer 250.00 POBox 520 Rush County Memorial Hospital 9/17/2019 La Crosse, KS 675~-o520

Ms. Dee Dee Dewell Director, CAH Networks 100.00 2120 Farmstead Ascension Via Chrfstl Sl Francis 10/2/2019 Wichita, KS 67208-1867

Katie Seay 100.00 10/3/2019 4109 Eagle Valley Dr. Ascension Via Christi Hospital, Manhattan. KS 66502-1581 Manhattan

Mr. Chad R. Austln Sr. Vice President, Government 76.92 10/9/2019 6518 SW 26th Court Relations Topeka, KS 66614-4305 Kansas Hospital Association

Andrew Balr 65.84 10/9/2019 509 N. Douglas Ave. Ellsworth County Medical Centar Ellsworth, KS 67439-3221 ~

Mr. Harold Courtois Chief Executive Officer 137.00 10/912019 515 Elise Heights St. Memorial Health System ilene, KS 67410 ~

s. Reagan Cusslmanlo JD Government Relations Manager 500.00 10/9/2019 17181 W. 159th Sl University of Kansas Hospital. The lathe, KS 66062-3917 ~

2,450.43

Page _1_9_ of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital AssociaUon Political Action Committee (Name ofParty Committee or Political Committee)

Occupation & Industry of Checl. Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cash Check Loan E fund. Other Receipt

Ms. Audrey Dunkel Director of Financial Advocacy 38.46 215 SE 8th Street Kansas Hospital Association 101912019 Topeka, KS 66603-3906

Mr. Jeremy Ensey Chief Executive Officer 75.40 535 South Freebom SI. Luke Hospital and Uvlng 10/912019 Marion, KS 66861-1256 Center .f

Mrs. Jennifer A. Findley VP Education/Special Projects 20.00 3517 SW Ashworth Cl Kansas Hospital Assoclatlon 10/9/2019 Topeka, KS 66614-4590 .f

Ms. Vallerie L Gleason President and Chief Executive 37.00 609 Autumn Glen Cl. Officer 10/9/2019 Newton, KS 67114-9007 Newlon Medical Center

Willis Heck 100.00 609 Quail Dr. Newton Medical Center 1019/2019 Newton, KS 67114-5614

KAHVRP 100.00 10/9/2019 215 SE Eighth Topeka, KS 66603-3906

Ms. Sally Othmer Director of Data Servfces 7.70 10/9/2019 1725 NW Grove Kansas Hospital Association Topeka, KS 66606-1237 .f

Mrs. Carrie L. Sala BSN, MSM Chief Executive Officer 100.00 10/912019 8553 110Th Rd Holton Community Hospital Della, KS 66418-9536 .f

Mrs. Cindy Leah Samuelson Vice President 19.24 10/9/2019 1107 NE 54th St Kansas Hospital Association Topeka, KS 66617-4505 .f

Ms. Isabel Schmedemann Chief Executive Officer and 137.48 10/9/2019 819 North CSt. Administrator Herington, KS 67449-1606 Herington Municipal Hospital .f

s. Isabel Schmedemann Chief Executive Officer and 112.52 10/9/2019 19 North C SI. Administrator erington, KS 67449-1606 Hering10n Municipal Hospital .;

747.80

Page~of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association Political Action Committee (Name of Party Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cash Check Loan E funds Other Receipt

Mr. Brian A Williams Chief Executive Officer 172.84 1307 Partridge Ave. Labette Health 10/9/2019 Parsons, KS 67357-5000

Mr. Dennis R Shelby Chief Executive Officer 21)0,00 POBox 360 Wilson Medical Center 10/11/2019 Neodesha, KS 66757-0360

Wesley Hoyt 250.00 200 Buckskin Road Hutchinson Regional Medical 10/1212019 Hutchinson, KS 67502-4407 Center .;

Ms. Margaret Grismer Interim Chief Executlve Officer 250.00 5310 S. Emblem St. Hillsboro Community Hospital 10/15/2019 Derby, KS 67037-9313 .;

Mr. Kevin Laaper Chief Executive Officer 250.00 1067 US Hwy 56 Morris County Hospital 1012212019 Council Grove, KS 66846-8775

Mr. Austin M Gillard MHA Chief Executive Officer 250.00 Clay County Medical Center 10/23/2019 1604 1st Street Clay Center, KS 67432-0512

Ms. Peg Tlchacak Chief Mission Integration Officer 200.00 10/30/2019 8938 E. Bradford CL Via Christi Health Wichita, KS 67206-4047

Ms. Deborah Bruner Chief Executive Officer and 40.00 11/6/2019 POBox 127 Administrator Minneola, KS 67865-0127 Minneola District Hospital

Ms. Deborah Bruner Chief Executive Officer and 40.00 11/6/2019 POBox 127 Administrator Minneola, KS 67865-0127 Minneola District Hospital

Mr. Chad R. Austin Sr. Vice President, Govemment 76.92 11/812019 6518 SW 26th Court Relations Topeka, KS 66614-4305 Kansas Hospital Association .;

Ms. Reagan Cussimanlo JD Government Relations Manager 86.02 11/8/2019 17181 W. 159th SI. University of Kansas Hospital, The lathe, KS 66062-3917 .;

1,815.78

Page _2_1_ of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Assoclallon Political Act10n Committee (Name ofParty Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cash Ched< Loan E fund. Other Receipt

Ms. Audrey Dunkel Director of Financial Advocacy 38,46 215 SE 8th Street Kansas Hospital Assocfatlon 11/8/2019 Topeka, KS 66603-3906

Mr. Jeremy Er>sey Chief Executive Offlcer 64.98 535 South Freebom 51. Luke Hospital and Living 11/8/2019 Marion, KS 86861-1256 Center .f

Mrs. Jennifer A. Findley VP Education/Speclal Projects 20.00 3517 SW Ashworth Cl. Kansas Hospital Association 11/8/2019 Topeka,KS 66614-4590 .f

Ms. Kiley Floyd Chief Executive Officer 87.00 1600 Community Drive Nemaha Valley Community 11/8/2019 Seneca, KS 66538-9739 Hospital

Ms. Gina Frack Chief Executive Officer 250.00 7622 Hwy 383 Norton County Hospital 11/8/2019 Norton, KS 67654-5687

Ms. Sarah A Gideon 34.80 Stonnont Vail Health 11/812019 616 Pennsylvania Holton, KS 66436-8824

Service Corporallon Kansas Health 750.00 11/8/2019 215 SE Eighth Kansas Hospital Association Topeka, KS 66603-3906

Pat Myers 100.00 11/8/2019 744 Campbell SI. Kiowa District Healthcare Kiowa, KS 67070-1326 .f

Ms. Sally Othmer Director of Data Services 7.70 11/8/2019 1725 NW Grove Kansas Hospital Association Topeka, KS 66606-1237 .f

Mrs. Cindy Leah Samuelson Vice President 19.24 11/8/2019 1107 NE 54th St Kansas Hospital Association Topeka, KS 66617-4505 .f

s. Peggy R. Tuxhom Chief Quality Officer 204.16 11/8/2019 503 Rambler Rd. Hutchinson Regional Medical utchinson, KS 67502-5133 Center

1,576.34

Page~of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association Political Action Committee (Name of Party Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cash Checl. Loan E funds Other Receipt

Mr. Bruce Wilt Director, Governmen1 Relations 155.44 820 Carriage Rd. Via Christi Health 11/8/2019 Maize, KS 67101-9697

Ms. Aimee Zimmerman RN Chief Operations Officer 336.40 211 Cherry Street Logan County Hospital 11/812019 Oakley, KS 6774&-1218 .f

Mr. Claudio .r Ferraro Senior Administrator 260.00 1100 N. Saint Francis Ascension Via Christi Hospital on 11/11/2019 Suite 400 SI. Teresa WIchita, KS 67214-2884 .f

Kansas Association of Health Care Professional Association 250.00 Communicators 11/11/2019 215 SE 8th Avenue Topeka, KS 66603-3906

Mr. Ken Johnson President and Chief Executive 100.00 4403 Spyglass Dr. Officer 11/11/2019 Hutchinson, KS 67502-8071 Hutchinson Regional Medical Center

Shane Kannarr DO 100.00 Ascension Via Christi Hospital 11/11/2019 2521 N. Broadway Pittsburg, KS 66762-2620

Mr. Richard Shank Extemal Affairs Representative 50.00 11/11/2019 1701 Easl23rd Avenue Hutchinson Regional Medical Hutchinson, KS 67502-1105 Center

Ms. Peggy R. Tuxhorn Chief Quality Officer 100.00 11/11/2019 2503 Rambler Rd. Hutchinson Regional Medical Hutchinson, KS 67502-5133 Center

Mrs. Jenny Niblock Chief Clinical Officer 473.60 11/13/2019 1880 County Road a Citizens Medical Center Colby, KS 67701-9173

Barbara Bollier for Kansas Senate 250.00 11/21/2019 6910 Overhill Rd. Void· Barbara Bonier Mission Hills, KS 66208 for Kansas Senate

roy L. Waymaster for Kansas House 250.00 11/21/2019 12 N Fairview Ave Void - Troy L uray, KS 67649 Waymastar for Kansas House

2,315.44

Page 23 of 27 -- -- SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital AssociaUon Political Action Committee (Name ofParty Committee or Political Committee)

Occupation & Industry of Check Am.ount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other C.sh Check Loan E fnnds Other Receipt

Rul Xu for Kansas House 250,00 4724 Belinder Ave. Void - RlJ Xu for 11/21/2019 Westwood, KS 66205 .f Kansas House

Mr. Thomas L Bell President and Chief Executive 1,250.00 215 Southeast 8th Avenue Officer 11/2212019 Topeka, KS 66603-3906 Kansas Hospital Association .;

Mr. Doug Gaston Senior Vice President and Chief 200,00 4000 Cambridge Street Financial Officer 11/26/2019 Kansas City, KS 66160-8501 University of Kansas Health System, The .f

Lyndon Wells 250.00 2916 N. Cypress Sl. Via Christi Health 11/26/2019 Wichita, KS 67226-2132

Mr, Jeffrey Novorr Vice President 150,00 3544 W. 153rd Terrace University of Kansas Hospital, The 11/27/2019 Leawood, KS 66224-9556

Mr. Anthony Thomas Chief Executive Officer 150.00 Rooks County Health Center 11/27/2019 POBox 389 PlainVille, KS 67663-0389

Mr. Dan Peters General Counsel 500.00 121212019 3901 Rainbow Boulevard University of Kansas Hospital, The Kansas City, KS 66160-8500

Terry Rusconi 100.00 1212/2019 4800 NE Pebble Beach Sl University of Kansas Hospital. The Lees Summit, MO 64064-1323

Mr. Jeremy Armstrong FACHE Chief Executive Officer 75.40 121412019 POBox 399 Mitchell County Hospital Health Beloit, KS 67420-0399 Systems .f

Mr. Chad R. Austin Sr. Vice President, Government 153.88 1214/2019 6518 SW 26th Court Relations Topeka, KS 66614-4305 Kansas Hospital Association .;

r. Curt Colson Regional VP Operations 214.60 1214/2019 05 N. Main Sl. Great Plains Health Alliance, Inc. olslngton, KS 67544-2150 .;

3,293.88

Page~of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association PoilU cal Action Committee (Name ofParty Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Checlc, Date of Contributor Than $150 Loan or Other Cash Checl< Loan E fWId. Olber Receipt

Ms. Audrey Dunkel Director of Financial Advocacy 76.94 215 SE 8th Street Kansas Hospital Association 12/4/2019 Topeka, KS 66603-3906

Mrs. Jennifer A. Findley VP EducaUon/Speclal Projects 40.00 3517 SW Ashworth Ct. Kansas Hospital Association 12/4/2019 Topeka, KS 66614-4590 .;

Ms. Vallerie L Gleason President and Chief Executive n.72 609 Autumn Glen Ct. Officer 12/4/2019 Newton, KS 67114-9007 Newton Medical Center .;

Betty Greer 40.00 2802 RoadAA Kearny County Hospital 12/4/2019 Deerfield, KS 67838-3833

Kansas Good Government Fund HCA State PAC to PAC transfer 350.00 215 SE 8th HCA Kansas Good Government 12/4/2019 Topeka, KS 66603-3906 Fund

Kansas Good Government Fund HCA Slate PAC to PAC transfer 500.00 215 SE 8th HCA Kansas Good Government 12/4/2019 Topeka, KS 66603-3906 Fund

Kansas Good Government Fund HCA State PAC to PAC transfer 2,150.00 12/4/2019 215 SE 8th HCA Kansas Good Govemmant Topeka, KS 66603-3906 Fund

Kansas Good Govemment Fund HCA Slate PAC to PAC transfer 1,000.00 12/412019 215 SE 8th HCA Kansas Good Govemment Topeka, KS 66603-3906 Fund t/

Kansas Good Government Fund HCA Stale PAC to PAC transfer 1,000.00 12/4/2019 215 SE 8th HCA Kansas Good Government Topeka, KS 66603-3906 Fund ~

Sean Kumer 100.00 12/4/2019 5942 Reinhardt Drive University of Kansas Health Fairway, KS 66205-3329 System, The t/

rs. Brittnl Oehmke Administrator 146.16 12/4/2019 05 S. Hanover Hanover Hospital Hanover, KS 66945-8924 t/

5,480.82

Page~of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association Politlcal ActJon Committee (Name ofParty Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cash Check Loan E funds Olb"" Receipt

Ms. Sally Olhmer Director of Data Services 15.30 1725 NW Grove Kansas Hospital Association 1214/2019 Topeka, KS 66606-1237

Mrs, Cindy Leah Samuelson Vice President 38,36 1107 NE 54th St Kansas Hospital Assoclation 1214/2019 Topeka, KS 66617-4505 .f

Mr. Larry VanDerWege Administrator 156.60 743 Diamond Dr. Lindsborg Community Hospital 1214/2019 Lindsborg, KS 67456-2328 .f

Michael Knecht 200.00 9753 Saddletop SI. AdventHealth Shawnee Mission 12/11/2019 Lenexa, KS 66227-7345

MIchael McCullough 400.00 8200 E. Thom Dr. Via Christi Health 1211212019 Wichita, KS 67226-2709

Mark Duff 500.00 Ascension Via Christl Hospital, 12116/2019 2016 Estella Drive Manhattan, KS 66503-7568 Manhattan

Mr. Harold Courtois Chief Executive Officer 38.00 12118/2019 515 Elise Heights St Memorial Health System Abilene, KS 67410

Brenda Dykstra 500.00 12118/2019 14157 W. 141st Street University of Kansas Hospital, The Olathe. KS 66062-5376

Edwerd J. Hett MD President, PMA 250.00 12118/2019 1401 W. River Blvd. Apt 5E Via Christl Health Wichita, KS 67203-3300 .f

Health Care Executives Kansas Association Professional Association 250.00 12118/2019 of Kansas Association of Health Car 215 SE 8th 51. .f Topeka, KS 66603-3906

killed Care Professionals Kansas 100.00 rganlzatlon of 15 SE Eighth .f opeka, KS 66603-3906

2,448.26

Page~of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Hospital Association Political Action Committee (Name ofParty Committee or Political Committee)

Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cas!, Check Loan E fund. Other Receipt

Mr. Bob Page President and Chief Executive 1,000.00 3510 W. 92nd St Officer 12120/2019 Leawood, KS 66206-1768 University of Kansas Health System, The .f

Ms. Tammy Peterman RN, MS Executive Vice President, Chief 500.00 5101 W. 81st Street Operating Officer 12120/2019 Prairie Village, KS 66208-4920 University of Kansas Health .f System, The

Ms. Jodi A. Schmidt 100.00 6023 102nd Terr. University of Kansas Health 12/27/2019 Overland Park, KS 66207-3842 System, The .f

1.600.00

Complete if last page of Schedule A

Totalltemized Receipts for Period 69,787.17

Total Unitemized Contributions ($50 or less) 2,435.41

Sale ofPolitical Materials (Unitemized) 0.00

Total Contributions When Contributor Not Known 0.00

72,222.58

Page ~ of..1Z..­ SCHEDULEB IN-KIND CONTRIBUTIONS

Kansas Hospital Association PoHtlcal Action Committee (Narne of Party Committee or Political Committee)

List Occupation & Value of Date Name and Address Industry for Those Giving Description of In-Kind In-Kind of Contributor an In-Kind of More Than Contribution Contribution $150

Kansas Hospital Association Qulk Print - Print PAC Brochures 1/25/2019 215 SE Eighth 1,931.96 Topeka, KS 66603

Kansas Hospital Association Dobies Healthcare Group ­ 2/1/2019 215 SE Eighth Update PAC Broctlure 468.75 Topeka, KS 066Q3

Kansas Hospital Association Premier Global- Steering 215 SE Eighth Committee Chairs 2/28/2019 19.25 Topeka, KS 66603

Kansas HospKal AssocIation Premier Global - Steering 215 SE Eighth Commi!lee 111.02 2/28/2019 Topeka, KS 66603

Kansas Hospital Association Fed Ex - Check to AHA PAC 215 SE Eighth 31712019 Topeka, KS 66603 40.45

Kansas Hospital Association Fed Ex - Check to AHA PAC 215 SE Eighth 51712019 Topeka, KS 66603 41.11

Kansas Hospital Association KS Govt Ethics - PAC Registration 215 SE Eighth 6/512019 Topeka, KS 66603 300:00

Kansas HospKal Association Fed Ex - Check to AHA PAC 215 SE Eighth 6/30/2019 Topeka, KS 66603 41.02

Kansas Hospllal Association Fed Ex - Check to AHA PAC 215 SE Eighth 71212019 Topeka, KS 66603 40.73

2,994.29

Complete if last page of Schedule B

Total Itemized (over $100) In-Killd Contributions

Total Ullitemized ($100 or Jess) In-Kind Contributions

Page _,__ oC3__ SCBEDULEB IN-KIND CONTRIBUTIONS

Kansas Hospital Association Political Action Committee (Name of Party Committee or Political Committee)

List Occupation & Value of Date Name and Address Industry for Those Giving Description ofIn-Klnd In-Kind of Contributor an In-Kind of More Than Contribution Contribution $150

Kansas Hospital Association Fed Ex - Check to AHA PAC 8/31/2019 215 SE Eighth 40.83 Topeka, KS 66603

Kansas Hospital Assoclation Fed Ex - Check to AHA PAC 8/31/2019 215 SE Eighth 40.64 Topeka, KS 66603

Kansas Hospital Association Premier Global - Steering 215 SE Eighth Committee 8/31/2019 97,06 Topeka, KS 66603

Kansas Hospital Association Chair Massage - KHA Convention 215 SE EIghth 90.00 9/3/2019 Topeka, KS 66603

Kansas Hospital Association Chair Massage - KHA Convention 215 SE Eighth 9/3/2019 Topeka, KS 66603 112.50

Kansas Hospital Association Cindy Samuelson - PAC Table 215 SE Eighth Decorations 9/13/2019 Topeka, KS 66603 72.04

Kansas Hospital Association Fed Ex - Check to AHA PAC 215 SE Eighth 912312019 Topeka. KS 66603 25.95

Kansas Hospital Association Office Depot 215 SE Eighth 9/2412019 Topeka, KS 66603 600,00

Kansas Hospital Association Sigle Photography - KHA 215 SE Eighth Convention 11114/2019 Topeka, KS 66603 800.00

1,879.02

Complete iflast page of Schedule B

Total Itemized (over $100) In-Kind Contributions

Total Unitemized ($100 or less) ill-Kind Contributions ==-:======""...,.,.,====~.""",.,I------l ,·:~Qi@1!{.;m~~;:

Page _2__ of_3__ SCHEDULEB IN-KIND CONTRIBUTIONS

Kansas Hospital Association PolitIcal Action Commillee (Name of Party Co=ittee or Political Co=ittee)

List Occupation & Value of Date Name and Address Industry for Those Giving Description ofIn-Kind In-Kind of Contributor an In-Kind of More Than Contribution Contribution $150

Kansas Hospital Association Fed Ex - Check to AHA PAC 12/5/2019 215 SE Eighth 40.73 Topeka, KS 66603

40.73

Complete if last page of Schedule B

Total Itemized (over $100) In-Kind Contributions 4,714.04

Total Unitemized ($100 or less) In-Kind Contributions 0.00 •.~~1w~!~ml~~.~~~~mmlf~1~ 4,714.04

Page _3__ of_3__ SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS

Kansas Hospital Assoclallon Political Action Committee (Name of Party Committee or Political Committee)

Purpose of Expenditure Name and Address Amount Date To Whom Expenditure is Made Ifindependent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address

CoreFirst Bank & Trust December Credit Card Fees 3035 SW Topeka Blvd 49.06 119/2019 Topeka, KS 66611

CoreFirst Bank & Trust January Credit Card Fees 3035 SW Topeka Blvd 37.00 214/2019 Topeka, KS 66611

CoreFlrst Bank & Trust January Credi1 Card Fees 3035 SW Topeka Blvd 49.06 2/11/2019 Topeka, KS 66611

AHAPAC·Amerlcan Hospital Association FEDERAL 1,013.68 2120/2019 800 10lh Street, NW Two City Center, Suite 400

CoreFirst Bank & Trust Bank Fees for Credit Card 3035 SW Topeka Blvd 36.37 3/4/2019 Topeka, KS 66611

Kansas Senate Democrats Annual Steak Fry P.O. Box 1611 3/4/2019 1,000.00 Topeka, KS 66611

CoreFlrst Bank & Trust Bank Fees for Credit Card 3/11/2019 3035 SW Topeka Blvd 49.06 Topeka, KS 66611

CoreFirst Bank & Trust Bank Fees for Credit Card 4/212019 3035 SW Topeka Blvd 61.82 Topeka, KS 66611

CoreFlrst Bank & Trust Bank Fees for Credit Card 4/9/2019 3035 SW Topeka Blvd 49.06 Topeka, KS 66611

AHAPAC-Amerlcan Hospital Association 4/2912019 FEDERAL 2,618.10 800 10th Street, NW Two City Center, Suite 400

4,963.21

Page_1_of~ SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS

Kansas Hospital Association Political Action Committee (Name ofParty Committee or Political Committee)

Purpose ofExpenditure Name and Address Amount Date To Whom Expenditure is Made Ifindependent or in~kind expenditure in excess of$300 is made for a candidate, list candidate name & address

CoreFirst Bank & Trust Bank Fee for Credit Card 3035 SW Topeka Blvd 161.51 5f2f2019 Topeka, KS 66611

CoreFlrst Bank & Trust Bank Fee for Credit Card 3035 SW Topeka Blvd 49.06 5f9f2019 Topeka, KS 66611

United Democrats of Kansas PO Box 1582 1,000.00 5f17f2019 Lawrence, KS 66044

CoreFirst Bank &Trust Bank fee for credit card 3035 SW Topeka Blvd 38.04 6/3/2019 Topeka, KS 66611

AHAPAG-Amerlcan Hospital Association FEDERAL 1,304.91 6/412019 800 10th Street, NW Two City Center, Suite 400

CoreFirst Bank & Trust Bank fee for credit card 3035 SW Topeka Blvd 6f11f2019 49.06 Topeke, KS 66611

AHAPAC-Amerlcan Hospital Association 71212019 FEDERAL 1,690.69 800 10th Street, NW Two City Center, Suite 400

CoreFlrst Bank & Trust Bank Fee for Credit Card June 7f2l2019 3035 SW Topeka Blvd 124.42 Topeka, KS 66611

CoreFlrst Bank & Trust Bank Fee for Credit Card June 7/10/2019 3035 SW Topeka Blvd 49.06 Topeka, KS 66611

AHAPAC-Amerlcan HospitaJ Association 8/1/2019 FEDERAL 64991 800 10th Street, NW Two City Genter, Suite 400

5,116.66

Page_2_of~ SCHEDULEC EXPENDITURES AND OTHER DISBURSEM:ENTS

Kansas Hospital Association Political Action Committee (Name ofParty Committee or Political Committee)

Purpose of Expenditure Name and Address Amount Date To Whom Expenditure is Made If' independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address

CoreFirst Bank & Trust Bank Fees for Credit Card 3035 SW Topeka Blvd 55.74 81212019 Topeka, KS 66611

CoreFirst Bank & Trust Bank Fees for Credit Card 3035 SW Topeka Blvd 8/9/2019 Topeka, KS 66611 49.06

AHAPAC-American Hospllal Association FEDERAL 3,716.25 8122/2019 800 10th Street, NW Two City Center, Suite 400

CoreFirst Bank & Trust Bank Fees for Credit Card 3035 SW Topeka Blvd 242.09 9/3/2019 Topeka, KS 66611

Square Up Kenny Wllk

9/5/2019 13.76

Square Up Elgin Glanzer 9/6/2019 6.19

Square Up John Broberg 9/6/2019 11.00

Square Up Linda Murphy 9/6/2019 13.06

Square Up Barb Grecian 9/6/2019 4.81

Square Up Steve Schwarting 9/6/2019 1.38

4,113.34

Page_3_of~ SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS

Kansas Hospital Association Political Action Commlttae (Name of Party Committee or Political Committee)

Purpose of Expenditure Name and Address Amount Date To Whom Expenditure is Made If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address

Square Up Rhonda Goddard 14.58 9/6/2019

CoreFirst Bank & Trust 3035 SW Topeka Blvd 9/10/2019 Topeka, KS 66611 49.06

AHAPAG-American Hospital Association FEDERAL 3,515.61 9/19/2019 800 10th Street, NW Two City Center, Suite 400

CoreFlrst Bank & Trust Bank Fees for CredIt Card 3035 SW Topeka Blvd 37.21 10/2/2019 Topeka, KS 66611

CoreFirst Bank & Trust Bank Fees for Credit Card 3035 SW Topeka Blvd 49.06 10/9/2019 Topeka, KS 66611

Square Up Reagan Cusslmanlo 10/9/2019 13.75

Mike Amyx for Kansas House , STATE HOUSE 45th KS 10/10/2019 501 Lawrence Ave. 250.00 Lawrence, KS 66049

Dave Baker for Kansas House Dave Baker, STATE HOUSE 68th KS 278 Lakeroad 10/10/2019 . 250.00 Councll Grove, KS 66846

Barbara W. Ballard for Kansas House Barbara W. Ballard, STATE HOUSE 44th KS 10/10/2019 1532 Alvamar Drive 250.00 Lawrence, KS 66047

John Barker for Kansas House John Barker, STATE HOUSE 70th KS 10/10/2019 103 Wasslnger Ave 250.00 Abilene, KS 67410

4,679.27

Page_4_of~ SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS

Kansas Hospital Association Political Action Committee (Name ofParty Committee or Political Committee)

Purpose of Expenditure Name and Address Amount Date To Whom Expenditure is Made Ifindependent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address

David Benson for Kansas House David Benson, STATE HOUSE 48th KS 13901 Hemlock SI. 250.00 10/10/2019 Overland Park, KS 66223

Ed Berger for Kansas Senate , STATE SENATE 34th KS 2603 Heather Parkway, Suite B 250.00 10/10/2019 Hutchinson, KS 67502

RJck Billinger for Kansas Senate , STATE SENATE 40th KS PO Box 594 250.00 10/10/2019 Goodland, KS 67135

Elizabeth Bishop for Kansas House Elizabeth Bishop, STATE HOUSE 88th KS 8518 E. Longlake SI. 250.00 10/10/2019 Wichita, KS 67207

Barbara Bollier for Kansas Senate Barbara Bollier, STATE SENATE 7th KS 6910 Overhill Rd, 250.00 10/10/2019 Mission Hills, KS 66208

Elaine S. Bowers for Kansas Senate , STATE SENATE 36th KS 1326 N 150th Rd 10/10/2019 250.00 Concordia, KS 66901

Sydney Carlin for Kansas House , STATE HOUSE 66th KS 10/10/2019 1650 sunnyslope 250.00 Manhattan, KS 66502

Suzi Carlson for Kansas House , STATE HOUSE 64th KS 10/10/2019 1741 Berglund Dr. 250.00 Clay Center, KS 67432

Will Carpenter for Kansas House WIll Carpenter, STATE HOUSE 75th KS 10/10/2019 6965 SW 18th SI. 250.00 EI Dorado, KS 67042

Lonnie Clark for State Representative , STATE HOUSE 65th KS 10/10/2019 824 B S. Madison 250.00 Junction City, KS 66441

2,500.00

Page_5_of~ SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS

Kansas Hospital Association Polilical Action Committee (Name ofParty Committee or Political Committee)

Pnrpose of Expenditure Name and Address Amount Date To Whom Expenditure is Made H independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address

Stephanie Clayton for Kansas House , STATE HOUSE 19th KS 9825 Woodson Dr. 250.00 10/10/2019 Overland Park, KS 66207

Susan L. Concannon for Kansas House , STATE HOUSE 107th KS 921 North Mill 250.00 10/10/2019 Beloit, KS 67420

Diana Dierks for Kansas House , STATE HOUSE 71s1 KS 1221 Sunrlse Dr. 250.00 10/10/2019 Salina, KS 67401

John Doll for Kansas Senate John Doll, STATE SENATE 39th KS 2927 Cliff Place 250.00 10/10/2019 Garden CIty, KS 67846

Ronald Ellis for Kansas House Ronald Ellis, STATE HOUSE 47th KS 9199 K-4 Highway 250.00 10/10/2019 Meriden, KS 66512

John Eplee for Kansas House , STATE HOUSE 63rd KS 163 Deer Run 10/10/2019 250.00 Atchison, KS 66002

Oletha Fausl-Goudeau for Kansas Senate Oletha Faust-Goudeau, STATE SENATE 29th KS 10/10/2019 4158 Regents Lane 250.00 Wichita, KS 67208

Marcl Francisco for Kansas Senate Marcl Francisco, STATE SENATE 2nd KS 10/10/2019 1101 Ohio 250.00 Lawrence, KS 66044

Bruce Givens for Kansas Senate , STATE SENATE 14th KS 10/10/2019 1525 Counlry Club Rd 250.00 EI Dorado, KS 67042

Dan Goddard for Kansas Senale , STATE SENATE 15th KS 10/10/2019 3420 Mosher Rd. Parsons, KS 67357 250.00

2,500.00

Page_6_of~ SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS

Kansas Hospital Association Political Action Committee (Name ofParty Committee or Political Committee)

Purpose of Expenditure Name and Address Amount Date To Whom Expenditure is Made If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address

David Haley for Kansas Senate , STATE SENATE 4th KS 936 Cleveland Ave. 250.00 10/10/2019 Kansas City, KS 66101

Randall Hardy for Kansas Senate , STATE SENATE 24th KS 816 Highland Ave. 10/10/2019 Salina, KS 67401 250.00

Tom Hawk for Kansas Senate , STATE SENATE 22nd KS 2600 Woodhaven Ct. 250.00 10/1012019 Manhattan, KS 66502

Anthony Hensley for Kansas Senate , STATE SENATE 19th KS 2226 SE Virginia 250.00 10/10/2019 Topeka, KS 66605

Don Hineman for Kansas House , STATE HOUSE 118th KS 116 S Longhom Rd 250,00 10/10/2019 Dighton, KS 67839

Tom Holland for Kansas Senate om Holland, STATE SENATE 3rd KS 961 E 1600 Rd 10/10/2019 250.00 Baldwin City, KS 66006

Eileen Hom for Kansas House Elleen Hom, STATE HOUSE 10th KS 2121 Vermont Sl 10/1012019 250.00 Lawrence, KS 66046

J. Russell Jennings for Kansas House J. Russell Jennings, STATE HOUSE 122nd KS 515 Pleasntvlew 10/10/2019 250.00 Lakin, KS 67830

Steven Johnson for Kansas House Steven Johnson, STATE HOUSE 108th KS 10/10/2019 10197 South Hopkins Road 250.00 ssaria, KS 67416

Jim Kar1esklnt for Kansas House Jim Kar1eskint, STATE HOUSE 42nd KS 10/10/2019 24542 Cantrell Road Tonganoxie, KS 66086 250.00

2,500.00

Page_7_of~ SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS

Kansas Hospital Association Polltlcal Action Committee (Name of Party Committee or Political Committee)

Purpose of Expenditure Name and Address Amount Date To Whom Expenditure is Made If independent or in-lUnd expenditure in excess of $300 is made for a candidate, list candidate name & address

Jim Kelly for Kansas House Jim Kelly, STATE HOUSE 12th KS 309 S. 5th 250.00 10/10/2019 Independence, KS 67301

Dan Kerschen for Kansas Senate , STATE SENATE 26th KS 645 South 263 West 250.00 10/10/2019 Garden Plain, KS 67050

Jen Kessinger for Kansas House , STATE HOUSE 20th KS 12605 Walmer St. 250.00 10/10/2019 Overland Park, KS 66209

Brenda Landwehr for Kansas House , STATE HOUSE 105th KS 2611 N. Bayside Cl. 250.00 10/10/2019 Wichita, KS 67205

Marty Long for Kansas House Marty Long, STATE HOUSE 124th KS 2221 S. Road P 250.00 10/10/2019 Ulysses, KS 67880

Jeff Longblne for Kansas Senate , STATE SENATE 17th KS PO Box 1903 10/10/2019 250.00 Emporia, KS 66801

Nancy Lusk for Kansas House , STATE HOUSE 22nd KS 10/10/2019 PO Box 35 250.00 Overland Park,

Leonard Mastronl for Kansas House Leonard Mastroni, STATE HOUSE 117th KS 10/10/2019 102 Fairway Drive 250.00 LaCrosse, KS 67548

Carolyn McGinn for Kansas Senate Carolyn McGinn, STATE SENATE 31st KS 10/10/2019 11047 N 87W 250.00 SEDGWICK, KS 67135

J.e. Moore for Kansas House J.C. Moore, STATE HOUSE 93rd KS 10/10/2019 7810 W. 79th Street S 250.00 Clearwater, KS 67206

2,500.00

Page_8_of~ SCHEDULE C EXPENDITURES AND OTHER DISBURSEMENTS

Kansas Hospital Association Political Action Committee (Name ofParty Committee or Political Committee)

Purpose of Expenditure Name and Address Amount Date To Whom Expenditure is Made Ifindependent or in-kind expenditure in excess of $300 is made for a candidate, tist candidate name & address

Kathy Wolfe Moore for Kansas House Kathy Moore, STATE HOUSE 36th KS 3209 N 131st Street 250.00 10/10/2019 Kansas City, KS 66109

Monica Muman for Kansas House , STATE HOUSE 3rd KS 1313 Mallory CI. 250.00 10/10/2019 Pittsburg, KS 66762

Cindy Neighbor for Kansas House , STATE HOUSE 18th KS 10405 West 52nd Terrace 250.00 10/10/2019 Shawnee, KS 66203

Boyd Orr for Kansas House , STATE HOUSE 115th KS 30111 H. Rd. 250.00 10/10/2019 Fowler, KS 67844

Jarred Ousley for State House , STATE HOUSE 24th KS 6800 Farley 250.00 10/10/2019 Merriam, KS 66203

Bill Pannbacker for Kansas House Bill Pannbacker, STATE HOUSE 106th KS 210 East College 10/10/2019 250.00 Washington, KS 66968

Brett Parker for Kansas House , STATE HOUSE 29th KS 10/10/2019 8323 W. 108tlh SI., Apt F 250.00 Overland Park, KS 66210

Fred Patton for Kansas House Fred Palton, STATE HOUSE 50th KS 339 NE46th 10/10/2019 250.00 Topeka, KS 66048

Pat Pettey for Kansas Senate Pat Pelley, STATE SENATE 6th KS 10/10/2019 5316 Lakewood St. 250.00 Kansas City, KS 66106

Tom Phillips for Kensas House Tom Phillips, STATE HOUSE 67th KS 10/10/2019 PO Box 1731 Manhattan, KS 66505-1732 250.00

2,500.00

Page_9_of~ SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS

Kansas Hospital Association Political Action Committee (Name of Party Committee or Political Committee)

Purpose of Expenditure Name and Address Amount Date To Whom Expenditure is Made Ifindependent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address

Probst for Progress , STATE HOUSE 102nd KS PO Box 3262 250.00 10/10/2019 Hutchinson, KS 67504

Richard Proehl for Kansas House , STATE HOUSE 7th KS 510 Pine Ridge Rd 250.00 10/10/2019 Parsons, KS 67357

Bradley Ralph for Kansas House Bradley Ralph, STATE HOUSE 119th KS 2009 Frederick Dr. 250.00 10/10/2019 Dodga City, KS 67801

Susan Ruiz for Kansas House , STATE HOUSE 23rd KS 7306 Bond SI. 250.00 10/10/2019 Shawnee, KS 66203

Ron Ryckman for Kansas House Ron Ryckman, STATE HOUSE 78th KS 14234 W 158th St 250.00 10/10/2019 Olathe, KS 66062

Mark Samsel for Kansas House , STATE HOUSE 5th KS 227 Edgewood Drive 10/10/2019 250.00 Wellsville, KS 66092

Tom Sawyar for Kansas House Tom Sawyer, STATE HOUSE 95th KS 1041 S. Elizabeth St 10/1 0{201 9 250.00 Wichita, 67213

Mark Schreiber for Kansas House Mark Schreiber, STATE HOUSE 60th KS 1722 Yucca Lane 10/10/2019 250.00 Emporia, KS 66801

John Skubal for State Senate , STATE SENATE 11th KS 10/10/2019 6503 W. 134th Terrace 250.00 Overtand Park, KS 66209

Adam Smith for Kansas House Adam Smith, STATE HOUSE 1201h KS 10/10/2019 1970 RD 3 Weskan, KS 6n62 250.00

2,500.00

Page~of~ SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS

Kansas Hospital Association Political ActJon Committee (Name of Party Committee or Political Committee)

Purpose of Expenditure Name and Address Amount Date To Whom Expenditure is Made Ifindependent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address

Gene Sueilentrop for Kansas Senate , STATE SENATE 27th KS 6813 W. Northwind Circle 250.00 10/10/2019 Wichita, KS 67205

Dinah Sykes for Kansas Senate Dinah Sykes, STATE SENATE 21st KS 10227 Thaden Circle 10/10/2019 Lenexa, KS 66212 250.00

Mary Jo Taylor for Kansas Senate Mary Taylor, STATE SENATE 33rd KS 114 N. Union 250.00 10/10/2019 Stafford, KS 67578

Kent Thompson for Kansas House , STATE HOUSE 9th KS PO Box 626 250.00 10/10/2019 lola, KS 66749

Mary Ware for Kansas Senate , STATE SENATE 25th KS 1444 N. Perry 250.00 10/10/2019 Wichita, KS 67203

Troy L Waymasterfor Kansas House , STATE HOUSE 109th KS 112 N FairvIew Ave 10/10/2019 250.00 Luray, KS 67649

John Wheeier for Kansas House John Wheeler, STATE HOUSE 123rd KS 902 Anderson Street 10/10/2019 250.00 Garden City, KS 67846

Wilborn for Senate Richard Wilborn, STATE SENATE 35th KS 1504 Heritage Place 10/10/2019 250.00 McPherson, KS 67460

Brandon Woodard for Kansas House , STATE HOUSE 30th KS 10/10/2019 9051 Renner Blvd. #3002 250.00 Lenexa, KS 66219

Rui Xu for Kansas House , STATE HOUSE 25th KS 10/10/2019 4724 Beilnder Ave. Westwood, KS 66205 250.00

2,500.00

Page _1_1_ of~ SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS

Kansas Hospital AssociatIon Political Action Committee (Name ofParty Committee or Political Committee)

Purpose of Expenditure Name and Address Amount Date To Whom Expenditure is Made If independent or in-lrind expenditure in excess of $300 is made for a candidate, list candidate name & address

Square Up Dennis Shelby 550 10/11/2019

Square Up Margaret Grismer

10/15/2019 6.88

Laura Kelly for Kansas , GOVERNOR KS P.O. Box 2098 2,000.00 10/17/2019 Topeka, KS 66601

CoreFirst Bank & Trust Bank Fees for Credit Card 3035 SW Topeka Blvd 45.61 11/4/2019 Topeka, KS 66611

CoreFlrst Bank & Trust Bank Fees for Credit Card 3035 SW Topeka Blvd 49.06 11/12/2019 Topeka, KS 66611

AHAPAG-American Hospital Association FEDERAL 11/15/2019 3,616.15 800 10th Street, NW Two City Cenler, Suite 400

Kansas Republican Senalorlal Committee PO Box 2663 11/15/2019 1,000.00 Topeka, KS 66601

Square Up Tom Bell 11/2212019 32.60

6,755.80

Page_12_of~ SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS

Kansas Hospl1al Association Political Action Committee (Name ofParty Committee or Political Committee)

Name aDd Address Purpose of Expenditure Date To Whom Expenditure is Made Amount Ifindependent or in-kind expenditure in excess of $300 is made for a candidate, list candidate Dame & address

CoreFirst Bank & Trust Bank Fees for Credit Cards 3035 SW Topeka Blvd 121212019 Topeka, KS 66611 39.35

Square Up Michael McCullough

1215/2019 11.50

Clayton for Kansas Stephanie Clayton, STATE SENATE 7th KS 9625 Woodson Dr. 1216/2019 Overland Park, 66207 1,000.00

Cox for Kansas Tom Cox, STATE SENATE 10th KS 13510 W, 72nd SI. 12/612019 Shawnee, KS 66216 1,000.00

Republican House Campaign Committee 2025 SW Gage Blvd 12/9/2019 Topeka, KS 66603 2,000,00

AHAPAC-American Hospital Association FEDERAL 12/10/2019 600 10th Street, NW 3,260.99 Two City Center, Suite 400

CoreFlrst Bank & Trust Bank Fees for Credit Cards 3035 SW Topeka Blvd 12110/2019 Topeka, KS 66611 49.06

AHAPAC-Amerlcan Hospital Association FEDERAL 12120/2019 600 10th Street, NW 409.50 Two City Center, Suite 400 ~,.,"; ~'1~1~1{i£~ '.<:,:.:' ';:::i}:: 2~""' :.:""""')~";- ... c,.:,,·.; ~?F{::;:~.;;·.:· ~{~;8:4~~,l.0 7,790.40

:,,~,' ;~j~~J~j 1 -.:0:.:' ·;-:2: ','c" .:.;,,,;,,,:':.;~(...::; ". ",;

Complete if last page of Schedule C

Total Itemized Expenditures This Period 50,916.66

124.48

51,043.16

Page_13_of~