2020-08-17T08:51:39-05:00 2019-09-30 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2018-10-01 480543789 STORMONT-VAIL HEALTHCARE INC % ROBERT LANGLAND STOR 7853546000 1500 SW 10TH AVENUE TOPEKA KS 66604 ROBERT LANGLAND SR VP AND CFO 7853546000 2020-08-15 true Michael J Engle P00482834 8162216300 2020-08-15 167.68.126.162 43372220202305000006 2020-08-17 P 4FF701660D093BB059534A9D2307DE1523344BB3 355CC2E4B6E27E32DAADC48E1CA8D97843AD7DA8 2018 2020-09-23 17:36:50Z ROBERT KENAGY 1500 SW 10TH AVENUE TOPEKA KS 66604 768362871 false X WWW.STORMONTVAIL.ORG X 1894 KS WORKING TOGETHER TO IMPROVE THE HEALTHCARE OF OUR COMMUNITY BY PROVIDING QUALITY SERVICES REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY 15 12 5944 500 136296 8983 737840 732057 766348331 754374713 48893893 4794185 6951226 8109675 822931290 768010630 656844 943489 0 0 438054113 447273608 0 0 0 296363271 285774858 735074228 733991955 87857062 34018675 822944546 834176342 327499987 367307784 495444559 466868558 X WORKING TOGETHER TO IMPROVE THE HEALTH CARE OF OUR COMMUNITY BY PROVIDING QUALITY SERVICES REGARDLESS OF RACE, CREED, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. false false 637751030 943489 754238417 SEE SCHEDULE O 637751030 true true false true false false false false true true true false false true false false true false false true false false false false false true true true false true true true false false false false false false false true false false false false false true true true true false false true 216 0 true 5944 true true true false false false false false false false false false false false X 15 12 false false false false false false false true true false false true true true true true true true true true true X ROBERT LANGLAND 7853546000 1500 SW 10TH AVENUE TOPEKA KS 66604 X PAMELA JOHNSON-BETTS DIRECTOR 3.0 0.0 X 0 0 0 DEBRA CLAYTON DIRECTOR 3.0 0.0 X 0 0 0 BRENDA SUE MILLS DIRECTOR 3.0 0.0 X 0 0 0 JAMES PARRISH DIRECTOR/SECRETARY 3.0 0.0 X X 0 0 0 JAMES R SCHMANK DIRECTOR/VICE CHAIR 3.0 0.0 X X 0 0 0 SUEANN V SCHULTZ DIRECTOR 3.0 0.0 X 0 0 0 RICK WIENCKOWSKI DIRECTOR/CHAIRMAN 3.0 0.0 X X 0 0 0 ROBERT KENAGY PRESIDENT CEO 50.0 1.0 X X 648166 0 115421 RANDALL PETERSON PRESIDENT CEO (Retired 3/2019) 50.0 1.0 X X 945425 0 170952 MARK KNACKENDOFFEL DIRECTOR 3.0 0.0 X 0 0 0 ROBERT ST PETER DIRECTOR 3.0 0.0 X 0 0 0 ALONZO HARRISON DIRECTOR 3.0 0.0 X 0 0 0 AILEEN MCCARTHY DIRECTOR/PHYSICIAN 50.0 0.0 X 264302 0 24876 MARSHA POPE DIRECTOR 3.0 0.0 X 0 0 0 MARK RUELLE DIRECTOR 3.0 0.0 X 0 0 0 KEVIN DISHMAN DIRECTOR 50.0 0.0 X 902166 0 66867 ROBERT O LANGLAND VICE PRESIDENT/CFO 50.0 1.0 X 370710 0 59035 JUDY CORZINE VP & CHIEF INFORMATION OFFICER 50.0 0.0 X 330289 0 34306 DAVID CUNNINGHAM VP & FACILITIES OFFICER 50.0 1.0 X 279170 0 76834 SRIDEVI DONEPUDI SVP & CHIEF MEDICAL QUUALITY O 50.0 0.0 X 305024 0 63011 CLIFTON JONES VP & PHYSICIAN 50.0 0.0 X 346181 0 60605 AMY KINCADE VP POPULATION HEALTH 50.0 0.0 X 211453 0 43217 MICHAEL KONGS DIRECTOR FINANCIAL MANAGEMENT 50.0 1.0 X 213086 0 41124 SALAH NAJM VP ACUTE CARE & PHYSICIAN 50.0 0.0 X 946386 0 43712 TRACY O'ROURKE SVP & CHIEF ADMINISTRATIVE OFF 50.0 0.0 X 324386 0 82538 CAROL PERRY SVP & CHIEF NURSING OFFICER 50.0 0.0 X 358946 0 73912 WILLIAM SACHS VP SURGICAL SERVICES & PHYSICI 50.0 0.0 X 960386 0 73795 JANET STANEK SR VP RETIRED 50.0 1.0 X 479552 0 98072 DARLENE STONE SVP & CHIEF EXPERIENCE OFFICER 50.0 1.0 X 305055 0 81261 ERIC VOTH VP PRIMARY CARE & PHYSICIAN 50.0 0.0 X 435196 0 89544 DEBRA YOCUM VP CLINIC OPERATIONS 50.0 0.0 X 346131 0 69644 MATTHEW WILLS PHYSICIAN 50.0 0.0 X 1324531 0 37413 PETER TUTUSKA PHYSICIAN 50.0 0.0 X 1151419 0 34863 NASON LUI PHYSICIAN 50.0 0.0 X 1147185 0 44527 BENJAMIN BOUDREAUX PHYSICIAN 50.0 0.0 X 1189338 0 50362 TEWODROS ADDISSE PHYSICIAN 50.0 0.0 X 1229842 0 22810 KEVIN HAN VP RETIRED 0.0 0.0 X 303313 0 11067 DOUGLAS ROSE VP RETIRED 0.0 0.0 X 820670 0 3153 16138308 0 1572921 613 true true false SODEXO INC AFFILIATES PO BOX 360170 PITTSBURG PA 152516170 DIETARY SERVICES 2590199 ANESTHESIA ASSOCIATES 823 SW MULVANE SUITE 2A TOPEKA KS 66606 PHYSICIAN SERVICES 2538073 MCELROYS INC PO BOX 5188 TOPEKA KS 66605 BUILDING CONTRACTORS 1859183 RADIOLOGY NUCLEAR MEDICINE LLC PO BOX 2312 WICHITA KS 67201 PHYSICIAN SERVICES 1418450 LABORATORY CORP OF AMERICA PO BOX 12140 BURLINGTON NC 27216 LABORATORY SERVICES 1386760 61 599857 132200 125414 732057 NET PATIENT SERVICE REVENUE 621300 747440249 747440249 PHARMACY 621910 1817108 1680812 136296 NUTRITIONAL SERVICES 621300 1800647 1800647 EDUCATION SERVICES/SCHOOL OF NURS 621300 2275126 2275126 OTHER SERVICE REVENUE 621300 1041583 1041583 754374713 3102642 3102642 0 0 493851 493851 0 493851 493851 2043784 352241 2043784 -352241 1691543 1691543 0 0 0 0 0 0 0 0 0 EARNINGS - 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DIRECT ACTIVITIES ENTAIL THE CEO'S OCCASIONAL INTERACTION WITH LEGISLATORS REGARDING BILLS THAT WOULD AFFECT THE ORGANIZATION OR HEALTHCARE INDUSTRY. 274250 18160 292410 276921 -2671 274250 276224 697 276921 266314 9910 276224 258083 8231 266314 1.00000 false false 21105670 21105670 306481117 127601602 178879515 182044762 155903089 26141673 4381461 4381461 230508319 25925102 F ALTERNATIVE INVESTMENTS 166790939 F 192716041 0 Accrued Pension Obligation 104601831 Due to Related Parties 2290142 2016 Bonds Interest Payable 445159 107337132 770603173 6406638 24867340 31273978 739329195 693377 27988058 28681435 768010630 725488082 20177563 20177563 705310519 693377 27988059 28681436 733991955 SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS ARE USED IN ACCORDANCE WITH THE DIRECTION OF THE APPLICABLE DONOR GIFT INSTRUMENT AT THE TIME THE GIFT IS ADDED TO THE FUND. SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D RELATED ORGANIZATION REVENUE $ 31,305,273 ELIMINATIONS (6,437,933) ------------- $ 24,867,340 SCHEDULE D, PART XI, LINE 4B BAD DEBT EXPENSE $27,988,058 SCHEDULE D, PART XII, LINE 2D RELATED ORGANIZATION EXPENSES $ 23,942,703 ELIMINATIONS (3,765,140) ------------- $ 20,177,563 SCHEDULE D, PART XII, LINE 4B BAD DEBT EXPENSE $27,988,058 false Central America and the Caribbean Investments 604160 604160 604160 true false true false false false PART I, LINE 3 COLUMN F THE ACCRUAL METHOD OF ACCOUNTING IS USED TO REPORT THE AMOUNT OF THE PASSIVE FOREIGN INVESTMENTS IN COLUMN F. true true X true X true X true true true false false 18440021 18440021 0.02610 76315638 51447690 24867948 0.03520 94755659 51447690 43307969 0.06130 1232330 177571 1054759 0.00150 4035023 2311163 1723860 0.00240 4674548 2142814 2531734 0.00360 8800 8800 0.00000 9950701 4631548 5319153 0.00750 104706360 56079238 48627122 0.06880 false 27988058 256182038 331541470 -75359432 X true true 1 1 STORMONT VAIL HEALTHCARE INC 1500 SW 10TH AVE TOPEKA KS 66604 WWW.STORMONTVAIL.ORG H-089-003 X X X STORMONT VAIL HEALTHCARE INC 1 false false true X X X X X X X X X X 18 true true true true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 18 true SEE PART V, SECTION C false true X 150. 400. X X X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 3J THE SHAWNEE COUNTY HEALTH NEEDS ASSESSMENT IDENTIFIED 14 HEALTH ISSUES THE HEALTHCARE COMMUNITY SHOULD ADDRESS. THE FINAL REPORT HAS A DETAILED ANALYSIS OF EACH ISSUE THAT INCLUDES: DATA SOURCES, SHAWNEE COUNTY'S CURRENT PERFORMANCE, DISCUSSION OF THE ISSUE AND BARRIERS TO OVERCOME AND HEALTHY PEOPLE 2020 TARGETS. SCHEDULE H, PART V, SECTION B, LINE 5 SINCE THE DEVELOPMENT OF THE 2015 COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP), HEARTLAND HEALTHY NEIGHBORHOODS (HHN) HAS LED THE CHIP EFFORTS FOR TOPEKA AND SHAWNEE COUNTY. THE CHIP STEERING COMMITTEE, CONSISTING OF HHN'S CURRENT CHAIR, VICE-CHAIR, IMMEDIATE PAST CHAIR, SHAWNEE COUNTY HEALTH DEPARTMENT'S COMMUNITY HEALTH PLANNER AND THE DIRECTOR OF STRATEGY AND BUSINESS DEVELOPMENT FOR STORMONT VAIL HEALTH, HAS SPEARHEADED THE DEVELOPMENT PROCESS OF THIS MOST RECENT CHIP WITH ASSISTANCE FROM HHN WORKGROUPS, COMMUNITY ORGANIZATIONS, AND TWO CONSULTANTS FROM THE KANSAS HEALTH INSTITUTE. FOR THE CURRENT ROUND OF COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT PLANNING, A CONSULTANT (VVV CONSULTANTS LLC), WAS HIRED BY STORMONT VAIL HEALTH TO CONDUCT THE CHNA. THE CHNA PROCESS CONSISTED OF: 1) A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) COMMUNITY SURVEY, WHICH WAS DISTRIBUTED IN THE SUMMER OF 2018. 2) COMPILATION OF SECONDARY DATA OF HEALTH OUTCOMES AND HEALTHCARE DELIVERY SERVICES IN THE COUNTY, INCLUDING COUNTY HEALTH RANKINGS AND OTHER MEASURES OF MORBIDITY AND MORTALITY. AS OF APRIL 2019, SHAWNEE COUNTY IS RANKED 59TH FOR HEALTH FACTORS, AND 79TH FOR HEALTH OUTCOMES OUT OF 102 RANKED COUNTIES IN KANSAS. YEARS OF POTENTIAL LIFE LOST (YPLL) FROM MORTALITY DUE TO CHRONIC DISEASES, DRUG OVERDOSES AND SUICIDE, IS A MEASURE FROM THE COUNTY HEALTH RANKINGS THAT CONTRIBUTES MOST TO LOWERING SHAWNEE COUNTY'S RANKING. 3) TOWN HALL MEETINGS ACROSS THE COUNTY TO PRESENT AND DISCUSS THE SURVEY AND DATA. DURING THE TOWN HALLS, PARTICIPANTS WERE GIVEN THE CHANCE TO PROVIDE INPUT ON WHAT THEY PERCEIVED TO BE THE TOP HEALTH ISSUES FOR SHAWNEE COUNTY. THAT LIST OF ISSUES IS WHAT WAS USED FOR CHIP PRIORITIZATION. A LIST OF THE TOP ISSUES FROM THE CHNA COMMUNITY SURVEY AND THE LIST OF TOP ISSUES FROM THE TOWN HALL MEETINGS WERE COMBINED AND USED FOR PRIORITIZATION OF ISSUES FOR THE CHIP. THE TOP ISSUES FROM THE CHNA SURVEY AND CHNA TOWN HALL MEETINGS WERE EVALUATED AGAINST THE FOLLOWING CRITERIA: - SERIOUSNESS - HOW MUCH OF AN IMPACT DOES THE POTENTIAL PRIORITY AREA HAVE ON THE MORBIDITY, MORTALITY AND QUALITY OF LIFE IN THE COMMUNITY? - FEASIBILITY - HOW LIKELY IS IT THAT THE CHIP CAN HAVE AN IMPACT ON THE POTENTIAL PRIORITY AREA? - ALIGNMENT - HOW WELL DOES THE POTENTIAL PRIORITY AREA SUPPORT OTHER EFFORTS IN THE COMMUNITY? - MEASURABILITY - IS IT POSSIBLE TO MEASURE PROGRESS IN THE POTENTIAL PRIORITY AREA? - CONCERN - WHAT IS THE LEVEL OF CONCERN IN THE COMMUNITY REGARDING THE POTENTIAL PRIORITY AREA? PARTICIPANTS AT TWO COMMUNITY MEETINGS, HELD ON MARCH 29, 2019, AND APRIL 8, 2019, REPRESENTING OVER 100 COMMUNITY VOICES, COMPLETED THE PRIORITIZATION PROCESS. FOR EACH ISSUE IN THE LIST, THEY WERE INSTRUCTED TO JUDGE THE ISSUE AGAINST THE FIVE CRITERIA AND RATE THE ISSUE FROM 1 (LOWEST) TO 5 (HIGHEST) FOR EACH OF THE CRITERIA. USING THE RESULTS FROM THE PRIORITIZATION PROCESS, FOUR ISSUES ROSE TO THE TOP AS PRIORITIES TO FOCUS ON DURING THE CHIP PROCESS. THE CHIP STEERING COMMITTEE SUMMARIZED THESE TOP PRIORITIES INTO THE FOLLOWING FOUR PRIORITY AREAS: 1. BEHAVIORAL HEALTH 2. ACCESS TO FOOD 3. SUBSTANCE USE 4. HEALTH EQUITY CHIP WORKGROUPS FOR EACH PRIORITY AREA WERE CREATED FROM EXISTING AND NEWLY-FORMED HHN WORKGROUPS, COMMUNITY ORGANIZATIONS, AND OTHER STAKEHOLDERS. A SCHEMATIC DIAGRAM OF THE WORKGROUPSINVOLVED IN EACH PRIORITY AREA CAN BE FOUND IN APPENDIX E. THIS CHIP AIMS TO INCREASE COMMUNITY CAPACITY BY REMOVING BARRIERS FOR COLLABORATION. BY COLLABORATING WITH EXISTING ORGANIZATIONS, HHN LEADERSHIP ALSO AIMS TO BUILD COMMUNITY CAPACITY AND SUSTAINABILITY OF CHIP EFFORTS. THE CHIP STEERING COMMITTEE DEVELOPED THE GOALS UNDER EACH PRIORITY AREA AND SOUGHT FEEDBACK FROM THE HHN WORKGROUPS AND OTHER COMMUNITY PARTNERS ON THE CONTENT OF THESE PRIORITY AREAS AND GOALS. OBJECTIVES FOR EACH PRIORITY AREA WERE DRAFTED BY THE CHIP STEERING COMMITTEE AND REFINED BASED ON FEEDBACK FROM THE CHIP WORKGROUPS AND PARTNERING COMMUNITY ORGANIZATIONS. TARGETS FOR THE OUTCOMEOBJECTIVES WERE DETERMINED BY EXAMINING SHAWNEE COUNTY DATA TRENDS OVER TIME IN ORDER TO CREATE FEASIBLE OUTCOME OBJECTIVES WITHIN THE GIVEN TIMEFRAME. THE DEGREE OF CHANGE FROM YEAR-TO-YEAR WAS USED TO ESTABLISH A REASONABLE MEASURE OF CHANGE BY THE YEAR 2022. ADDITIONALLY, THE GROUP CONSIDERED THAT HEALTHY PEOPLE 2020 (HP 2020) OBJECTIVES TYPICALLY AIM FOR A 10 PERCENT IMPROVEMENT OVER THE COURSE OF 10 YEARS. BECAUSE THIS CHIP COVERS A SPAN OF THREE YEARS, EXPECTATIONS WERE ADJUSTED ACCORDINGLY. THE BENCHMARKING AGAINST HP 2020 TARGETS PROVIDED A GENERAL ESTIMATE, WHILE THE TREND ANALYSIS (IF AVAILABLE) PROVIDED MORE SPECIFICITY TO THE LOCAL MEASURES AND CHANGES OVER TIME.ONCE THE PRIORITY AREAS, GOALS AND OBJECTIVES WERE FINALIZED, INTERVENTIONS AND ACTIVITIES TO BE UNDERTAKEN WERE DEVELOPED BY THE WORKGROUPS AND PARTNERING ORGANIZATIONS FOR EACH PRIORITY AREA, INCONSULTATION WITH THE CHIP STEERING COMMITTEE. THE INTERVENTIONS CHOSEN TO ACHIEVE THE OBJECTIVES IN THIS CHIP ADDRESS AREAS OF BOTH MIDSTREAM AND UPSTREAM HEALTH, AND WILL CONTINUE TO EVOLVE AND EMERGE IN ACCORDANCE WITH THE COMMUNITY CONTEXT IN PREPARATION FOR THE CHIPS IMPLEMENTATION. ADDITIONALLY, THE CHIP INCLUDES INTERVENTIONS THAT ADDRESS BOTH INDIVIDUAL SOCIAL NEEDS, AS WELL AS IMPROVING COMMUNITY CONDITIONS THAT WILL SUPPORT HEALTHIER LIVES FOR ALL SHAWNEE COUNTY RESIDENTS. THROUGHOUT THE DEVELOPMENT OF THE CHIP, THE STEERING COMMITTEE CONSIDERED UPSTREAM SOLUTIONS THAT ADDRESSED THE SOCIAL DETERMINANTS OF HEALTH AND FOCUSED ON POLICIES, SYSTEMS, AND ENVIRONMENT CHANGES IN EACH OF THE PRIORITY AREAS. SCHEDULE H, PART V, SECTION B, LINE 6A UNIVERSITY OF KANSAS HOSPITAL SYSTEM - ST. FRANCIS CAMPUS SCHEDULE H, PART V, SECTION B, LINE 6B THE FOLLOWING IS A LIST OF PARTNERS AND COMMUNITY ORGANIZATIONS INVOLVED WITH HHN: ADVENTURE DENTAL AND VISION ALDERSGATE VILLAGE AMERICAN HEART ASSOCIATION ANGELS CARE HOME HEALTH AUBURN WASHBURN - USD 437 BAJILLION AGENCY BAKER UNIVERSITY SCHOOL OF NURSING BLUE CROSS AND BLUE SHIELD OF KANSAS BOYS & GIRLS CLUB OF TOPEKA BREAKTHROUGH HOUSE, INC. BREWSTER PLACE CAREGIVERS HOME HEALTH CHILDCARE AWARE OF EASTERN KANSAS CITY OF TOPEKA COMMUNITY ACTION HEAD START COMMUNITY ACTION, INC. COMMUNITY RESOURCES COUNCIL COMMUNITY VOLUNTEERS EL CENTRO OF TOPEKA FAMILY SERVICE & GUIDANCE CENTER FIRST LUTHERAN CHURCH FLORENCE CRITTENTON SERVICES OF TOPEKA, INC. GRACEMED GREATER TOPEKA PARTNERSHIP HARVESTERS HARVESTERS COMMUNITY FOOD NETWORK HEALTHACCESS INTERIM HEALTH CARE J AYHAWK AREA AGENCY ON AGING K-STATE RESEARCH AND EXTENSION KANSAS BREASTFEEDING COALITION, INC. KANSAS CHILDREN'S SERVICE LEAGUE KANSAS DEPARTMENT OF CHILDREN AND FAMILIES KANSAS FOUNDATION FOR MEDICAL CARE, INC. KANSAS HEALTH INSTITUTE KANSAS REHABILITATION HOSPITAL LINCOLN CENTER MIDLAND CARE MIDWEST HEALTH NAMI TOPEKA NEW DAWN WELLNESS AND RECOVERY ONE HEART PROJECT ORAL HEALTH KANSAS POSITIVE CONNECTIONS PREVENTION AND RECOVERY SERVICES, INC. SAFE STREETS SEAMAN USD 345 SHAWNEE COUNTY COMMISSION SHAWNEE COUNTY HEALTH DEPARTMENT SHAWNEE COUNTY PARKS AND RECREATION STORMONT VAIL HEALTH TANGLEWOOD HEALTH & REHABILITATION TARC, INC. TOPEKA AND SHAWNEE COUNTY PUBLIC LIBRARY TOPEKA CHAPTER OF THE LINKS, INC. TOPEKA COMMON GROUND TOPEKA COMMUNITY CYCLE PROJECT TOPEKA COMMUNITY FOUNDATION TOPEKA DOULA PROJECT TOPEKA HOUSING AUTHORITY TOPEKA JUMP TOPEKA KANSAS BLACK NURSES ASSOCIATION TOPEKA METRO TOPEKA METROPOLITAN TRANSIT AUTHORITY TOPEKA POLICE DEPARTMENT TOPEKA PUBLIC SCHOOLS PARENTS AS TEACHERS TOPEKA PUBLIC SCHOOLS USD 501 UNITED WAY OF GREATER TOPEKA VALEO BEHAVIORAL HEALTH CARE WASHBURN UNIVERSITY THE FOLLOWING IS A LIST OF ORGANIZATIONS REPRESENTED IN THE COMMUNITY PRIORITIZATION MEETINGS: ADVISORS EXCEL BAKER SCHOOL OF NURSING BARTLETT AND WEST BLUE CROSS AND BLUE SHIELD OF KANSAS CAPITOL FEDERAL SAVINGS BANK CENTRAL NATIONAL BANK CHAOS LIMITED CIRCLES OF GREATER TOPEKA CITY OF TOPEKA CITY OF TOPEKA POLICE DEPARTMENT CLAYTON WEALTH PARTNERS COMMUNITY ACTION, INC. COMMUNITY MEMBERS CORE FIRST BANK & TRUST COX COMMUNICATIONS EAST TOPEKA SENIOR CENTER EL CENTRO OF TOPEKA FAMILY SERVICE AND GUIDANCE CENTER FLORENCE CRITTENTON SERVICES OF TOPEKA GLASS ASSOCIATION OF NORTH AMERICA GOODELL, STRATTON, EDMONDS & PALMER, LLP GRACEMED GREATER TOPEKA CHAMBER OF COMMERCE GREATER TOPEKA PARTNERSHIP HARVESTERS HEARTLAND VISIONING JOHN B. TURNEY CHARTERED K-STATE RESEARCH AND EXTENSION KANSAS ASSOCIATION FOR THE MEDICALLY UNDERSERVED KANSAS BUREAU OF INVESTIGATION KANSAS CHILDREN'S SERVICE LEAGUE KANSAS DEPARTMENT FOR AGING DISABILITY SERVICES KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES KANSAS DEPARTMENT OF REVENUE KANSAS HEALTH INSTITUTE KANSAS INDEPENDENT COLLEGE ASSOCIATION KANSAS STATE UNIVERSITY KEARNEY AND ASSOCIATES KUJIMA COLLECTIVE MCPHERSON CONTRACTORS, INC. MIDLAND CARE NEW DAWN WELLNESS AND RECOVERY PARENTS AS TEACHERS PREVENTION AND RECOVERY SERVICES (PARS) SEAMAN USD 345 SECURITY BENEFIT SHAWNEE COUNTY BOARD OF COUNTY COMMISSIONERS SHAWNEE COUNTY DEPARTMENT OF CORRECTIONS SHAWNEE COUNTY HEALTH DEPARTMENT SHAWNEE COUNTY PARKS AND RECREATION SHAWNEE HEIGHTS HIGH SCHOOL SOWARDS GLASS STORMONT VAIL HEALTH SUCCESSFUL CONNECTION (CHILD CARE AWARE) SUPREME COURT OF KANSAS LAW LIBRARY THE VILLAGES INC. TOPEKA AND SHAWNEE COUNTY PUBLIC LIBRARY TOPEKA CAPITAL-JOURNAL TOPEKA COMMUNITY FOUNDATION TOPEKA FIRE DEPARTMENT TOPEKA HOUSING AUTHORITY TOPEKA POLICE DEPARTMENT TOPEKA PUBLIC SCHOOLS UNITED STATES AIR FORCE AIR NATIONAL GUARD 190TH UNITED WAY OF GREATER TOPEKA U.S. BANK VALEO WASHBURN UNIVERSITY WESTAR ENERGY WIBW SCHEDULE H, PART V, SECTION B, LINE 7A & 7B 7A - WWW.STORMONTVAIL.ORG/WP-CONTENT/UPLOADS/2019/10/2020-2022-SNCO-CHIP-9 -30-19.PDF 7B - HTTP://WWW.KANSASHEALTHMATTERS.ORG/RESOURCELIBRARY/INDEX/VIEW?ID=XXX-XX-XXXX SCHEDULE H, PART V, SECTION B, LINE 16A, 16B & 16C THE FINANCIAL ASSISTANCE APPLICATION FORM, INSTRUCTIONS AND A PLAIN LANGUAGE SUMMARY CAN BE LOCATED AT: https://www.stormontvail.org/financial-assistance 35 COTTON O'NEIL HEART CENTER 929 SW MULVANE ST TOPEKA KS 66606 PHYSICIAN OFFICE COTTON O'NEIL CANCER CENTER 1414 SW 8TH STREET TOPEKA KS 66606 CANCER CENTER COTTON O'NEIL GARFIELD 901 SW GARFIELD ST TOPEKA KS 66606 PHYSICIAN OFFICES COTTON O'NEIL MULVANE 823 SW MULVANE ST TOPEKA KS 66606 PHYSICIAN OFFICES STORMONT VAIL BEHAVIORAL HEALTH 3707 SW 6TH ST TOPEKA KS 66606 PSYCHIATRIC SERVICES COTTON O'NEIL KANZA PARK 2660 SW 3RD ST TOPEKA KS 66606 PHYSICIAN OFFICE STORMONT VAIL SURGERY CENTER 920 SW LANE TOPEKA KS 66606 SURGERY CENTER COTTON O'NEIL DIGESTIVE HEALTH CLINIC 720 SW LANE ST TOPEKA KS 66606 PHYSICIAN OFFICE STORMONT VAIL OP SURGERY CENTER 2660 SW 3RD ST TOPEKA KS 66606 SURGERY CENTER COTTON O'NEIL EMPORIA CLINIC 1301 SW 12TH ST EMPORIA KS 66801 PHYSICIAN OFFICE COTTON O'NEIL MANHATTAN 1133 COLLEGE ST SUITE E-110 MANHATTAN KS 66502 PHYSICIAN OFFICE COTTON O'NEIL DERMATOLOGY CLINIC 6650 SW MISSION VALLEY DRIVE TOPEKA KS 66614 PHYSICIAN OFFICE COTTON O'NEIL DIABETESENDOCRINOLOGY CTR 3520 SW 6TH AVE TOPEKA KS 66606 PHYSICIAN OFFICE COTTON O'NEIL NORTH 4505 NW FIELDING ROAD TOPEKA KS 66618 PHYSICIAN OFFICE COTTON O'NEIL URISH CLINIC 6725 SW 29TH TOPEKA KS 66614 PHYSICIAN OFFICE COTTON O'NEIL PEDIATRIC 4100 SW 15TH ST TOPEKA KS 66604 PHYSICIAN CLINIC COTTON O'NEIL CROCO CLINIC 2909 SW WALNUT DR TOPEKA KS 66605 PHYSICIAN OFFICE STORMONT VAIL SLEEP CENTER 920 SW WASHBURN ST TOPEKA KS 66610 SLEEP CENTER CLINIC COTTON O'NEIL CORPORATE VIEW CLINIC 601 CORPORATE VIEW ROAD TOPEKA KS 66615 PHYSICIAN OFFICE STORMONT VAIL MRI CENTER 830 SW MULVANE ST TOPEKA KS 66606 IMAGING CENTER COTTON O'NEIL WAMEGO CLINIC 1704 COMMERCIAL CIRCLE WAMEGO KS 66547 PHYSICIAN OFFICE COTTON O'NEIL NEUROSPINE CLINIC 2660 SW 3RD ST TOPEKA KS 66606 PHYSICIAN OFFICE COTTON O'NEIL CARBONDALE CLINIC 211 EAST MAIN ST CARBONDALE KS 66614 PHYSICIAN OFFICE COTTON O'NEIL OSAGE CITY CLINIC 131 WEST MARKET ST OSAGE CITY KS 66523 PHYSICIAN CLINIC COTTON O'NEIL CARDIAC THORACIC SURGEONS 830 SW MULVANE TOPEKA KS 66606 PHYSICIAN OFFICE COTTON O'NEIL GENERAL SURGERY 1516 SW 6TH AVE TOPEKA KS 66606 PHYSICIAN OFFICE COTTON O'NEIL OSKALOOSA CLINIC 209 W JEFFERSON ST OSKALOOSA KS 66066 PHYSICIAN OFFICE COTTON O'NEIL NOTO CLINIC 1130 N KANSAS AVE TOPEKA KS 66608 PHYSICIAN CLINIC COTTON O'NEIL EXPRESS CARE MIDTOWN 909 SW MULVANE ST TOPEKA KS 66604 PHYSICIAN CLINIC STORMONT VAIL WORK CARE 1504 SW 8TH ST TOPEKA KS 66606 PHYSICIAN OFFICE STORMONT VAIL PAIN MANAGEMENT CENTER 823 SW MULVANE ST TOPEKA KS 66606 PHYSICIAN OFFICE COTTON O'NEIL LEBO CLINIC 118 W 4TH ST LEBO KS 66856 PHYSICIAN OFFICE COTTON O'NEIL MERIDEN CLINIC 407 E WYANDOTTE MERIDEN KS 66512 PHYSICIAN CLINIC COTTON O'NEIL ROSSVILLE CLINIC 423 MAIN ST ROSSVILLE KS 66533 PHYSICIAN CLINIC COTTON O'NEIL LAWRENCE CLINIC 330 ARKANSAS LAWRENCE KS 66044 PHYSICIAN OFFICE SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST TO CHARGE RATIO. SCHEDULE H, PART I, LINE 7F THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES FOR CALCULATING THE NET COMMUNITY BENEFIT EXPENSE PERCENTAGE WAS $21,317,341 SCHEDULE H, PART I, LINE 7G STORMONT VAIL PROVIDES INTERNAL FETAL MEDICINE SERVICES TO THE COMMUNITY. THE ORGANIZATION CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED. SCHEDULE H, PART III, SECTION A, LINE 2 THE BAD DEBT EXPENSE AMOUNT IS CALCULATED BY DETERMINING THE AMOUNT OF THE ACCOUNTS THAT WERE WRITTEN OFF AS BAD DEBT NET OF ANY RECOVERIES. A COST TO CHARGE RATIO WAS APPLIED TO THE NET BAD DEBT AMOUNT IN ORDER TO DETERMINE COST. THE AMOUNT WRITTEN OFF AS BAD DEBT HAS BEEN REDUCED BY ANY APPLICABLE DISCOUNTS. SCHEDULE H, PART III, SECTION A, LINE 3 WE ARE NOT AWARE OF ANY PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE THAT WERE CONSIDERED TO BE BAD DEBT. SCHEDULE H, PART III, SECTION A, LINE 4 THE FINANCIAL STATEMENT FOOTNOTE ADDRESSING BAD DEBT EXPENSE IS ON PAGE 11 OF THE ATTACHED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION B, LINE 8 STORMONT VAIL HEALTHCARE BELIEVES THAT SOME PORTION OF THE MEDICARE SHORTFALL SHOULD BE CONSIDERED TO BE A COMMUNITY BENEFIT. STORMONT VAIL PROVIDES MEDICAL CARE TO THE MEMBERS OF THE COMMUNITY, INCLUDING MEDICARE PATIENTS, EVEN IF THE COSTS OF THAT CARE ARE NOT COMPLETELY REIMBURSED. THE HEALTH OF THE COMMUNITY WOULD SUFFER IF STORMONT VAIL DID NOT PROVIDE THESE SERVICES. SCHEDULE H, PART III, SECTION C, LINE 9B AN ESSENTIAL ELEMENT OF THE MISSION OF STORMONT VAIL HEALTHCARE IS TO BE GOOD FINANCIAL STEWARDS AS WE STRIVE TO IMPROVE THE HEALTHCARE OF OUR COMMUNITY. AS PART OF THAT STEWARDSHIP, WE MUST DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH PATIENTS CAN AFFORD TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WE WORK VERY HARD TO MAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TO THOSE WHO NEED IT MOST AND TO ENSURE THAT WE MANAGE OUR RESOURCES SO THAT WE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. THE ORGANIZATION NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND IN COMMUNICATION REGARDING PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. OUR REPRESENTATIVES WORK WITH PATIENTS TO TRY TO REACH THE MOST EQUITABLE SOLUTION IN ORDER TO RESOLVE A PATIENT BILL. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED. SCHEDULE H, PART VI, LINE 2 IN ADDITION TO THE CHNA, STORMONT VAIL AND STAFF ARE ACTIVE IN THE COMMUNITY. BY DOING SO, STORMONT VAIL IS ABLE TO LEARN ABOUT ISSUES IMPACTING THE COMMUNITY AND CITIZENS. SCHEDULE H, PART VI, LINE 3 STORMONT VAIL WIDELY PUBLICIZES THE FINANCIAL ASSISTANCE PROGRAM BY POSTING INFORMATION ON THE STORMONT VAIL WEBSITE, NOTIFYING AND DISTRIBUTING INFORMATION TO PATIENTS AT ALL REGISTRATION AREAS WHEN THEY PRESENT FOR SERVICE, MAKING INFORMATION AVAILABLE IN REGISTRATION WAITING ROOMS, INCLUDING INFORMATION ON PATIENT BILLING STATEMENTS, MENTIONING THE FAP WHEN DISCUSSING AN INDIVIDUAL'S BILL OVER THE TELEPHONE AND BY PUBLICIZING THE FAP TO COMMUNITY HEALTH CENTERS AND SOCIAL SERVICE AGENCIES. STORMONT VAIL ALSO ASSISTS PATIENTS IN OBTAINING COVERAGE THROUGH GOVERNMENTAL PROGRAMS. SCHEDULE H, PART VI, LINE 4 TOPEKA IS THE MAJOR URBAN CENTER IN SHAWNEE COUNTY. WITH A POPULATION OF 178,406, SHAWNEE COUNTY IS THE THIRD LARGEST COUNTY IN THE STATE. IT IS ONE OF THE FEW URBAN COUNTIES IN KANSAS. THEREFORE, IT IS MORE RACIALLY DIVERSE AND HAS A HIGHER RATE OF POVERTY THAN MOST OF THE STATE. AFRICAN AMERICAN POPULATION IN SHAWNEE COUNTY IS 8.8% VERSUS 6.3% STATEWIDE. HISPANIC OR LATINO IN SHAWNEE COUNTY IS 11.6% VERSUS 11.4% STATEWIDE. PERSONS IN POVERTY IN SHAWNEE COUNTY IS 15.0% WHILE IN THE STATE, 13.6% LIVE IN POVERTY. PERSONS WITHOUT HEALTH INSURANCE IN SHAWNEE COUNTY IS 13.9% AND 11.8% IN KANSAS. SCHEDULE H, PART VI, LINE 5 STORMONT VAIL IS A NON-PROFIT CORPORATION SO ANY SURPLUS FUNDS ARE RE-INVESTED BACK INTO THE ORGANIZATION AND NOT PAID TO INVESTORS. THE HEALTH SYSTEM IS MANAGED BY A LOCAL BOARD OF DIRECTORS WHO ARE COMMUNITY LEADERS. STORMONT VAIL ACCEPTS ALL PATIENTS REGARDLESS OF INSURANCE COVERAGE SO THAT CARE IS PROVIDED TO ALL WHO NEED CARE. SCHEDULE H, PART VI, LINE 6 NONE SCHEDULE H, PART VI, LINE 7 KS true GRACEMED 1122 N TOPEKA ST WICHITA KS 67214 480980926 501 (C) (3) 8800 SUPPORT STORMONT VAIL FOUNDATION 1500 SW 10TH AVENUE TOPEKA KS 66604 480980926 501 (C) (3) 943849 2 SCHEDULE I, PART I, LINE 2 GRANTS ARE HISTORICALLY ONLY MADE TO THE STORMONT-VAIL FOUNDATION, A RELATED 501(C)(3) ORGANIZATION. DUE TO OVERLAP OF OFFICERS/DIRECTORS BETWEEN THE ORGANIZATIONS, NO MONITORING OF THE USAGE OF FUNDS AFTER THE FACT IS DEEMED NECESSARY. X X X X X true true false true false false false false false ROBERT KENAGY PRESIDENT CEO 624122 0 0 0 24044 0 82847 0 32574 0 763587 0 34565 RANDALL PETERSON PRESIDENT CEO (Retired 3/2019) 921281 0 100 0 24044 0 136001 0 34951 0 1116377 0 122401 ROBERT O LANGLAND VICE PRESIDENT/CFO 349599 0 0 0 21111 0 37001 0 22034 0 429745 0 AILEEN MCCARTHY DIRECTOR/PHYSICIAN 228744 0 14436 0 21122 0 12543 0 12333 0 289178 0 KEVIN DISHMAN DIRECTOR 881734 0 0 0 20432 0 33749 0 33118 0 969033 0 MATTHEW WILLS PHYSICIAN 1321122 0 1477 0 1932 0 8100 0 29313 0 1361944 0 PETER TUTUSKA PHYSICIAN 1027375 0 100000 0 24044 0 13600 0 21263 0 1186282 0 NASON LUI PHYSICIAN 1092264 0 20000 0 34921 0 13600 0 30927 0 1191712 0 BENJAMIN BOUDREAUX PHYSICIAN 1168014 0 2068 0 19256 0 13600 0 36762 0 1239700 0 TEWODROS ADDISSE PHYSICIAN 1209410 0 0 0 20432 0 13600 0 9210 0 1252652 0 JUDY CORZINE VP & CHIEF INFORMATION OFFICER 311914 0 0 0 18375 0 13600 0 20706 0 364595 0 DAVID CUNNINGHAM VP & FACILITIES OFFICER 277227 0 0 0 1943 0 42056 0 34778 0 356004 0 SRIDEVI DONEPUDI SVP & CHIEF MEDICAL QUUALITY O 286051 0 0 0 18973 0 35875 0 27136 0 368035 0 KEVIN HAN VP RETIRED 0 0 0 0 303313 0 0 0 11067 0 314380 0 CLIFTON JONES VP & PHYSICIAN 341136 0 0 0 5045 0 35638 0 24967 0 406786 0 22038 AMY KINCADE VP POPULATION HEALTH 199163 0 0 0 12290 0 31183 0 12034 0 254670 0 MICHAEL KONGS DIRECTOR FINANCIAL MANAGEMENT 211671 0 0 0 1415 0 10930 0 30194 0 254210 0 SALAH NAJM VP ACUTE CARE & PHYSICIAN 927030 0 100 0 19256 0 13600 0 30112 0 990098 0 TRACY O'ROURKE SVP & CHIEF ADMINISTRATIVE OFF 305650 0 0 0 18736 0 53409 0 29129 0 406924 0 CAROL PERRY SVP & CHIEF NURSING OFFICER 327862 0 0 0 31084 0 48704 0 25208 0 432858 0 DOUGLAS ROSE VP RETIRED 78907 0 0 0 741763 0 1656 0 1497 0 823823 0 672810 WILLIAM SACHS VP SURGICAL SERVICES & PHYSICI 941126 0 0 0 19260 0 41717 0 32078 0 1034181 0 JANET STANEK SR VP RETIRED 457623 0 0 0 21929 0 70768 0 27304 0 577624 0 DARLENE STONE SVP & CHIEF EXPERIENCE OFFICER 303904 0 0 0 1151 0 46123 0 35138 0 386316 0 ERIC VOTH VP PRIMARY CARE & PHYSICIAN 430862 0 0 0 4334 0 53422 0 36122 0 524740 0 39822 DEBRA YOCUM VP CLINIC OPERATIONS 331778 0 0 0 14353 0 46961 0 22683 0 415775 0 SCHEDULE J, PART I, LINE 4A Kevin Han $201,947 SCHEDULE J, PART I, LINE 4B VESTED ACCRUED ---------- ----------- CLIFTON JONES $ 22,038 $ - ROBERT KENAGY $ 34,565 $ - RANDALL PERTERSON $ 122,401 $ - ERIC VOTH $ 39,822 $ - DAVID CUNNINGHAM $ - $ 28,456 KEVIN DISHMAN $ - $ 20,149 SRIDEVI DONEPUDI $ - $ 23,734 AMY KINCADE $ - $ 20,500 ROBERT LANGLAND $ - $ 37,001 TRACY O'ROURKE $ - $ 39,809 CAROL PERRY $ - $ 35,104 DOUGLAS ROSE $ 672,810 $ - WILLIAM SACHS $ - $ 28,117 JANET STANEK $ - $ 57,168 DARLENE STONE $ - $ 37,293 DEBRA YOCUM $ - $ 33,361 SCHEDULE J, PART I, LINE 4C 457F - ANNUAL CONTRIBUTIONS MADE AS PERCENT OF BASE SALARY IN DECEMBER. IF OVER AGE 60 CONTRIBUTIONS ARE VESTED AND TAXES ARE WITHHELD. IF LESS THAN 60 CONTRIBUTIONS DO NOT VEST UNTIL EARLIER OF 5 ANNUAL CONTRIBUTIONS OR AGE 60. ACCOUNT IS NOT DISTRIBUTED UNTIL TERMINATION. DOUGLAS ROSE WAS 457F DISTRIBUTION WAS UNDER PREVIOUS 457F PLAN DESIGN. VESTING AND DISTRIBUTION DID NOT OCCUR UNTIL AFTER TERMINATION. SCHEDULE J, PART I, LINE 5A EMPLOYED PHYSICIANS MAY EARN ADDITIONAL COMPENSATION IF THE RELATIVE VALUE UNITS THAT ARE GENERATED FROM THEIR PRACTICE EXCEEDS CERTAIN LEVELS. SCHEDULE J, PART II, COLUMN F COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS VESTED OR PAID TO THE INDIVIDUAL. A KANSAS DEVELOPMENT FINANCE AUTHORITY 481066589 48543BMW5 2011-08-31 61193487 SEE PART IV true false false B KANSAS DEVELOPMENT FINANCE AUTHORITY 481066589 485438PD4 2013-11-21 39321250 HEALTH FACILITIES false false false C KANSAS DEVELOPMENT FINANCE AUTHORITY 481066589 2016-12-15 70350000 SEE PART IV false false false D KANSAS DEVELOPMENT FINANCE AUTHORITY 481066589 2017-08-21 31870000 REFUND 2016O TAXABLE NOTE false false false A 14790000 35455000 61196914 0 32263 0 830826 0 0 10008295 50325531 0 2013 true false true true B 530000 0 39327332 0 0 0 670848 0 0 38656483 0 0 2017 false false true true C 2425000 0 70704999 0 15110 0 684718 0 0 18514625 49844844 1645702 true true false true D 7515000 0 31870000 0 0 0 0 0 0 0 31870000 0 2001 true true true true A false false true true false 0.00000 0.00000 0.00000 false false false true B false false true true false 0.00000 0.00000 0.00000 false false false true C false false true true true true 0.00000 0.00000 0.00000 false false false true D 0.00000 0.00000 0.00000 A false true false false 0 false 0 false true B false true false false 0 false 0 true true C false true true false 0 false 0 false true D false true true false 0 false 0 false true A true B true C true D true SCHEDULE K, PART I, LINE A, COLUMN F HEALTH FACILITIES, REFUND 2001K BONDS (05/15/2001), AND REFUND 2008E BONDS (04/02/2008). SCHEDULE K, PART I, LINE C, COLUMN F HEALTH FACILITIES, REFUND 2007I BONDS (08/29/2007), REFUND 2008F BONDS (04/02/2008) AND REFUND 2012I BONDS (8/14/2012). SCHEDULE K, PART II, LINE 3, COLUMN A, B & C AMOUNT IS NOT EQUAL TO ISSUE PRICE DUE TO INVESTMENT EARNINGS EARNED DURING THE PROJECT PERIOD. SCHEDULE K, PART II, LINE 11, COLUMN A, B & c THIS IS THE AMOUNT OF BOND PROCEEDS THAT HAVE BEEN USED AS OF THE FISCAL YEAR END TO REFUND PRIOR BONDS. SCHEDULE K, PART II, LINE 13, COLUMN D THE PROJECT FINANCED BY THE REFUNDED BONDS HAD AN ORIGINAL PROJECT COMPLETION DATE THAT OCCURRED IN 2001. SCHEDULE K, PART II, LINE 13 & 16, COLUMN C PROJECT HAS NOT BEEN COMPLETED SCHEDULE K, PART III, COLUMN D NOT REPORTED ON BECAUSE NEW MONEY PROJECT WAS PLACED IN SERVICE PRIOR TO 1/1/2003 SCHEDULE K, PART IV, LINE 2A, COLUMN A THE REBATE CALCULATION WAS PERFORMED ON 8/1/2013 SCHEDULE K, PART IV, LINE 2C, COLUMN B THE REBATE CALCULATION WAS COMPLETED AS OF 11/15/2018 SCHEDULE K, PART IV, LINE 6, COLUMN C THE PROJECT FUND WAS INVESTED FOR 6 MONTHS BEYOND THE 3-YEAR TEMPORARY PERIOD. THE YIELD ON THE INVESTMENTS HELD AFTER THE 3-YEAR TEMPORARY PERIOD WAS BELOW THE BOND YIELD. A KANSAS DEVELOPMENT FINANCE AUTHORITY 481066589 2019-08-19 36265000 REFUND PORTION OF 2011 BONDS false false false A 0 0 36265000 0 0 35898209 365041 0 0 0 0 1750 2013 true false true true A false false true true false 0.00000 0.00000 0.00000 false false false true A false true true false 0 false 0 false true A true KEEGAN HAN SON OF RETIRED CFO 56301 WAGES false SCHEDULE L, PART IV LINE (1) A) KEEGAN J HAN B) HAS A FAMILY RELATIONSHIP WITH KEVIN HAN, WHO IS A FORMER OFFICER OF STORMONT VAIL HEALTHCARE, INC. C) $56,301 D) EMPLOYEE COMPENSATION E) NO FORM 990, PART II, LINE 4A Stormont-Vail HealthCare, Inc. provides quality medical health care regardless of race, creed, sex, national origin, handicap, age, or ability to pay. For the year ended September 30, 2019, 23,902 inpatients, 62,570 emergency room patients, 1,722 newborns, and 373 neonatal intensive care babies were served. Although reimbursement for services rendered is critical to the operation and stability of the Stormont Vail, it is recognized that not all individuals possess the ability to purchase essential medical services. Stormont Vail's mission is to serve the community with respect to providing health care services and health care education regardless of ability to pay. As part of this mission, the Stormont Vail provides care to persons covered by Medicare and Medicaid patients. Following are some of the benefits provided at reduced rates for the fiscal year: In addition to the charity care provideStormont-Vail Healthcare also provided service to patients that resulted in uncollectible amounts as follows: Bad Debt Expense at Cost $ 21,317,341 Shortfall of Medicare Payments at Cost $ 75,359,432 Shortfall of Medicaid Payments at Cost $ 24,867,948 Stormont Vail also provides other health care services and programs for the benefit of the community, free or at reduced rates. Examples of these include: 1. Subsidyof nursing education, medical education, and allied health education 2. Operating the regions only Level III Neonatal Intensive Care Unit (NICU) serving a high percentage of medically indigent patients 3. Operating a Level II Trauma Center serving northeast Kansas 4. Provided donations of healthcare equipment and materials to regional hospitals and charitable organizations. 5. Organized support groups for a variety of topics including Cancer Support Group, Diabetes Adult Support Group and the Pregnancy and Infant Loss Support Group 6. Approximately 50,000 hours of volunteer time were donated to the Stormont Vail helping to reduce the cost of providing health care 7. Maintaining the Health Sciences Library that is made available to the public free of charge as a medical resource 8. Stormont Vail employees support the Care Line, which is an emergency fund for patients in financial distress, providing services and supplies on a short-term basis 9. Use of Pozez Education Center facilities for a variety of community groups and programs 10. Participated in numerous clinical research trials through the Clinical Research Department 11. Stormont-Vail West Behavioral Health Services operates a substance abuse program 12. Operated a Palliative Care program to provide comfort care to patients witchronic conditions 13. Provide support and education for patients with diabetes through the Diabetes Learning Center. 14. Stormont-Vail is a regional network of 36 locations in northeast Kansas access to medical care in several cities that otherwise would not have access, particularly on weekends 15. Maternal Fetal Medicine program provided care and access to screenings and genetic counseling for women with at-risk pregnancies. 16. Offered various parenting and childbirth preparation programs through Stormont-Vail's web site 17. The Health Connection program, which provides physician referral and after-hour access to a nurse, received 580,293 calls 18. Partnered with Building Blocks to provide childcare services to staff and the community 19. A skin screening clinic for the community was held at the Cotton- O'Neil Cancer Center 20. Connect with the community through the organization website, www.stormontvail.org 21. Partnered with Health Innovation Network of Kansas, a coalition that has 17 hospitals sharing information, education and other needed services 22. The Boy to Man and Girl to Woman communication education programs facilitate conversation between adults and pre-teens about future physical and emotional changes 23. Stormont Vail and its employees donated funds and staff time to the Meals on Wheels program including sponsoring a Meals on Wheels route. 24. Stormont Vail and its employees donated funds and staff time to the United Way 25. Implemented the Patient Center Medical Home concept to improve care with the focus on prevention and wellness 26. Work with others in the community to improve safety net services for under insured and uninsured 27. Provided staff to serve on the Board of Directors for the United Way of Topeka, Topeka Community Foundation Go Topeka, Harvesters and others. 28. Provided education and material at various employee health fairs in the region. 29. Participated in community events providing health and wellness information conducting blood pressure screenings and handing out health related items (sunscreen, lip balm, hand sanitizer, etc.) 30. The HealthWise program provides health and wellness information as well as clinics such as blood pressure, vaccinations, etc. 31. Provided transportation to patients who are unable to get to their health care appointments or need transportation to return home. 32. Provide screening and coordination for participants for a drug program benefit to help patients obtain needed medication 33. Provides several programs to prevent or treat injuries such as Stepping On, ThinkFirst National Injury Prevention, Safe Kids Shawnee County, CarFit and Stop the Bleed. 34. SponWellpower program events such as community health fairs, children's play area at West Ridge Mall, and Healthy Steps. IN ADDITION TO THESE COMMUNITY CONTRIBUTIONS, STORMONT-VAIL provided supervised clinical experience for 1,226 students and 240,407 hours to the following entities: Name/Location Students Dept/Division ------------------------------ ---------- ------------------ Baker University Nursing Multiple BARTON COUNTY CC PHLEBOTOMY LABORATORY BUTLER UNIVERSITY PHYS. ASSISTANT Multiple Clarkson College Phys. Assistant Pediatric Care Coffey Health System Nursing Multiple Colby Community College PT Rehab Services Creighton University Nursing Patient Care Services Creighton University OT Occupational Therapy Des Moines University Phys Assistant Patient Care Services Emporia State University Nursing Medical Arts Clinic Flint Hills Technical College LPN Medical Arts Clinic Fort Hays Nursing Nursing Multiple Fort Hays Speech Therapy Speech Therapy Rehab Services Frontier School of Midwifery Nursing The Birthplace Graceland University Nursing Patient Care Services Grand Canyon University Nursing Multiple Hiawatha Community Hospital Nursing Patient Care Services Highland Community College Nursing Patient Care Services Hutchinson Community College Nursing Patient Care Services Hutchinson Community College Nursing Patient Care Services University of Kansas Nursing Patient Care Services University of Kansas Pharmacy Pharmacy University of Kansas Psychology Behavioral Health University of Kansas Social Work Behavioral Health Kansas University Med Center Medical Students Clinic Manhattan Technical College MLT students Laboratory Maryville University Nursing Patient Care Services Massachusetts College Phys Assistant Clinic MidAmerica Nazarene Uni. Nursing Patient Care Services University of Missouri KC Nursing Cotton ONeil Clinics University of Missouri KC PA Students Cotton ONeil Clinics Nebraska Medical Center/WU Medical Tech Laboratory Nebraska Medical Center Medical Clinic Nemaha Vally Com. Hospital Nursing Patient Care Services Neosho Community College Nursing Patient Care Services Rasmussen College Nursing Students Multiple Research College of Nursing Nursing Multiple Rockhurst University PT OT Rehab Services Sabetha Hospital Nursing Patient Care Services Saint Louis University Nursing Patient Care Services Saint Lukes College of Health NP Multiple University of Saint Mary PT Students Rehabilitation Seaman High School H.S. Students Multiple South University Nursing Patient Care Services Texas Wesleyan University CRNA Surgical Services USD #501 High School Multiple Walden University Nursing Patient Care Services Washburn University Kinesiology Heart Center Washburn University Health Inform. Health Inform. Mgmt. Washburn University Nursing Multiple Washburn University OT Rehab Services Washburn University PT Assistants Rehab Services Washburn University Imaging Medical Imaging Washburn University Phlebotomy Laboratory Washburn University Psychology Behavioral Health Washburn University Radiologic Cert. CT Washburn University Radiation Therapy Cancer Center Washburn University Resp. Therapy Pulmonary Care Washburn University Social Work SV Behavioral Health Washburn University Ultrasound-Cardio Med. Services Division Washburn University Ultrasound-General Radiology/Ultrasound Washburn Institute of Tech. LPNs Multiple Washburn Institute of Tech. Surg Techs Surgical Services/TSDS Washburn Institute of Tech. EMT Patient Care Services Washington University PT Assistants Rehab Services Wichita State University Phys Assistant Multiple Wichita State University Medical Tech. Laboratory Wichita State University Phys Assistant Multiple FORM 990, PART VI, SECTION B, LINE 11B STORMONT VAIL HEALTHCARE STAFF AND AN INDEPENDENT ACCOUNTING FIRM PREPARES AND THE ACCOUNTING FIRM REVIEWS THE 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S STRATEGY AND FINANCE COMMITTEE. ANY QUESTIONS AND CONCERNS THE ORGANIZATION'S STRATEGY AND FINANCE COMMITTEE HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990. FORM 990, PART VI, SECTION B, LINE 12C THE OFFICERS, DIRECTORS AND KEY EMPLOYEES SUBMIT CONFLICT OF INTEREST STATEMENTS TO THE CHAIRMAN OF THE AUDIT COMMITTEE OF STORMONT VAIL HEALTHCARE EACH YEAR. THE CHAIRMAN REVIEWS THE RESPONSES AND REPORTS TO THE AUDIT COMMITTEE FOR THEIR REVIEW AND DETERMINATION OF ANY APPROPRIATE ACTION TO BE TAKEN. THE CHAIRMAN ALSO THEN REPORTS THE RESULTS TO THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS HAS ESTABLISHED AN EXECUTIVE COMPENSATION COMMITTEE THAT IS CHARGED WITH THE OVERSIGHT AND REVIEW OF ALL EXECUTIVE COMPENSATION AND BENEFITS FOR THE CEO, SENIOR VICE PRESIDENTS AND VICE PRESIDENTS OF THE HEALTH SYSTEM. THE COMPENSATION IS REVIEWED ANNUALLY BY AN EXTERNAL INDEPENDENT CONSULTANT, GALLAGHER. GALLAGHER REVIEWS BASE COMPENSATION, INCENTIVE PROGRAMS AND TOTAL CASH COMPENSATION THAT ARE OFFERED ON AN ANNUAL BASIS TO ENSURE IT ALIGNS WITH FAIR MARKET VALUE AND COMPLIES WITH OUR ESTABLISHED COMPENSATION PHILOSOPHY. IN ADDITION, GALLAGHER ON A REGULAR BASIS REVIEWS THE EXECUTIVE BENEFIT PROGRAM TO ALSO ENSURE IT IS APPROPRIATE AND REASONABLE. FORM 990, PART VI, SECTION B, LINE 15B GALLAGHER CONDUCTED A REVIEW IN 2019 FORM 990, PART VI, SECTION C, LINE 19 STORMONT VAIL HEALTHCARE MAKES THEIR FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION AS PART OF THE FORM 990 INFORMATION RETURN. ANY CHANGES TO THE GOVERNING DOCUMENTS ARE INCLUDED WITH THE FORM 990 RETURN. AT THIS TIME, THE HEALTH CENTER DOES NOT MAKE THEIR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9 CHANGE IN UNRECOGNIZED FUNDED STATUS OF PENSION PLAN - $ 62,218,078 NET ASSET TRANSFER - $ 6,783,237 ---------------- - $ 69,001,315 COTTON-O-NEIL ACO LLC 1500 SW 10TH AVENUE TOPEKA KS 66604 465542929 SHARED SAVING KS 0 15747 SVHC STORMONT-VAIL FOUNDATION 1500 SW 10TH AVENUE TOPEKA KS 66604 480980926 FUNDRAISING KS 501(C)(3) 7 SVHC true STORMONT-VAIL HEALTHCARE AUXILIARY 1500 SW 10TH AVENUE TOPEKA KS 66604 486140517 FUNDRAISING KS 501(C)(3) 12A SVHC true TOPEKA AIR AMBULANCE INC 1500 SW 10TH AVENUE TOPEKA KS 66604 480930553 AIR AMBULANCE KS 501(C)(3) 3 SVHC true BUILDING BLOCKS OF TOPEKA INC 620 SW LANE TOPEKA KS 66606 481121628 CHILD DAYCARE KS 501(C)(3) 9 SVHC true URISH MEDICAL PLAZA LLC 1500 SW 10TH AVENUE TOPEKA KS 66604 480782848 REAL ESTATE KS SVI N/A SVHC RADIATION ONCOLOGY LLC 1500 SW 10TH AVENUE TOPEKA KS 66604 814646356 ONCOLOGY SERVICES KS SVHC RELATED 6024453 3180496 false true 0.74000 STORMONT VAIL INC 901 GARFIELD TOPEKA KS 66606 480782848 RETAIL PHARMACY KS SVHC C-CORP 15818450 7195112 1.00000 true CENTURY HEALTH SOLUTIONS INC 2951 SW WOODSIDE DR TOPEKA KS 66614 481206397 INSURANCE ADMIN KS SVHC C-CORP 529400 107220 1.00000 true TENTH STREET PROPERTY INC 1500 SW 10TH ST TOPEKA KS 66604 480788844 REAL ESTATE KS SVHC C-CORP 0 0 1.00000 true false true true false false true false false false false false false false true true false true false true STORMONT VAIL FOUNDATION B 943849 FMV STORMONT VAIL FOUNDATION C 574073 FMV STORMONT VAIL AUXILIARY C 239326 FMV SVHC RADIATION ONCOLOGY LLC F 5732711 FMV URISH MEDICAL PLAZA LLC F 134557 FMV STORMONT VAIL INC F 750000 FMV CENTURY HEALTH SOLUTIONS INC F 310000 FMV STORMONT VAIL INC O 1253204 FMV STORMONT VAIL FOUNDATION O 507431 FMV SVHC RADIATION ONCOLOGY LLC O 1468706 FMV CENTURY HEALTH SOLUTIONS INC O 177360 FMV STORMONT VAIL AUXILIARY Q 414850 FMV BUILDING BLOCKS OF TOPEKA Q 942373 FMV BUILDING BLOCKS OF TOPEKA S 450000 FMV