2018-01-24T16:56:39-06:00 2017-06-30 300038643 VARNEY & ASSOCIATES CPAS LLC 120 NORTH JULIETTE MANHATTAN KS 665026092 990 2016-07-01 481152279 MERCY COMMUNITY HEALTH FOUNDATION INC MERC 7855875462 PO BOX 13 MANHATTAN KS 665050013 DR DAVID PAULS PRESIDENT 7855875462 2018-01-24 1 TAMMY M BRYANT P00733332 7855372202 70.184.233.175 2018-01-24 13:16:19 CS P 1A735CD3651B28D620A1BC4BAB67BA1DD16B13BC 1A735CD3651B28D620A1BC4BAB67BA1DD16B13BC 2016 2021-01-29 14:40:06Z DR DAVID PAULS PO BOX 13 MANHATTAN KS 665050013 417327 0 X WWW.VIA-CHRISTI.ORG/MERCYFOUNDATION X 1994 KS TO RAISE FUNDS IN SUPPORT OF VIA CHRISTI HOSPITAL IN MANHATTAN, KANSAS AND ITS PROGRAMS. 19 18 0 60 0 0 280610 148501 0 0 24348 176008 -88773 33642 216185 358151 40996 80514 0 0 0 0 0 0 0 50544 40894 91540 121408 124645 236743 4454760 4752155 1262 363 4453498 4751792 X TO PROMOTE HEALTH IN THE MANHATTAN, KANSAS COMMUNITY AND THE SURROUNDING AREAS IN A MANNER NOT INCONSISTENT WITH THE MISSION OF VIA CHRISTI HOSPITAL OF MANHATTAN, KANSAS BYDEVELOPING AND MAINTAINING INITIATIVES IN PRIVATE FUNDRAISING, FINANCIAL MANAGEMENT, ANDVOLUNTEERISM. 0 0 89871 80514 SINCE 2001, THE MERCY FOUNDATION HAS RECEIVED NEARLY 62,000 GIFTS AND RAISED MORE THAN $0.3 MILLION TO SUPPORT COMMUNITY HEALTH CARE AT VIA CHRISTI HOSPITAL, INCLUDING:- $5 MILLION FOR THE CAPITAL CAMPAIGN. THIS MONEY HAS HELPED FUND THE EXPANSION AND MODERNIZATION OF VIA CHRISTI HOSPITAL, INCLUDING FACILITIES AND EQUIPMENT,- MORE THAN $1,254,000 FOR THE CARDIAC INITIATIVE. THIS MONEY HAS HELPED FUND A STATE-OF-THE-ART CATHETERIZATION LAB AND A CARDIOLOGY PICTURE ARCHIVING COMPUTER SYSTEM (PACS), PURCHASE A 64-SLICE CT SCANNER, RECRUIT TWO INTERVENTIONAL CARDIOLOGISTS, AND ESTABLISH THE HEART INSTITUTE AT VIA CHRISTI. 89871 1 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 19 18 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X KRISTIN COTTAM 7855875462 1823 COLLEGE AVE MANHATTAN KS 66502 DAVID PAULS MD CHAIR 0.25 X X 0 0 0 RICH JANKOVICH SECRETARY/TREASURER 0.25 2.00 X X 0 0 0 RANDALL ANDERES VICE CHAIR 0.25 X X 0 0 0 RICHARD BAKER MD TRUSTEE 0.25 X 0 0 0 TOM BARTH DDS TRUSTEE 0.25 X 0 0 0 MARYE MEEKER TRUSTEE 0.25 X 0 0 0 MARK DUFF TRUSTEE 0.25 X 0 0 0 RUTH DYER PHD TRUSTEE 0.25 X 0 0 0 MARK GROS MD TRUSTEE 0.25 X 0 0 0 EILEEN HINKIN TRUSTEE 0.25 X 0 0 0 MARK HUNGERFORD DDS TRUSTEE 0.25 X 0 0 0 PEGGY LYONS TRUSTEE 0.25 X 0 0 0 DAN MESSELT TRUSTEE 0.25 X 0 0 0 WARD MORGAN TRUSTEE 0.25 X 0 0 0 RAWLEY PHILPOTT DDS TRUSTEE 0.25 X 0 0 0 MONICA COEN FOUNDATION ADVISOR 0.25 X 0 313645 0 SHON ROBBEN TRUSTEE 0.25 X 0 0 0 DAVID ROGERS TRUSTEE 0.25 X 0 0 0 JEFF SMITH TRUSTEE 0.25 X 0 0 0 KRISTIN COTTAM FOUNDATION DIRECTOR 40.00 X 0 0 0 0 313645 0 0 0 1 0 0 15879 50025 82597 15879 148501 110672 110672 65336 0 65336 65336 65336 92818 15879 59176 33642 33642 358151 65336 0 144314 62354 62354 18160 18160 18400 18400 13137 13137 550 550 314 314 1660 1660 2500 2500 EMERGENCY SERVICES 2030 2030 ONE COMMUNITY 992 992 DONOR APPRECIATION 901 901 MEMBERSHIP DUES 338 338 72 72 121408 89871 31537 0 78395 161669 676 676 4375689 4589810 4454760 4752155 135 1127 363 1262 363 X 235405 254969 2896149 3174768 1321944 1322055 4453498 4751792 4454760 4752155 236743 61551 0 X 0 0 0 X 66696 289925 273296 280610 148501 1059028 66696 289925 273296 280610 148501 1059028 1059028 86392 113303 122529 123413 176008 621645 1680673 0.63010 0.71140 X 909575 89275 2838 996012 922775 -662 9850 2688 909575 935415 5582 15441 2781 922775 849197 101240 12164 2858 935415 778935 4825 67040 1603 849197 0 0 0 4589810 F 4589810 GIFT ANNUITY 363 363 PART V, LINE 4: THE FUNDS ARE USED FOR SCHOLARSHIP DISTRIBUTIONS. GALA (RED DRESS) 76904 11821 65083 9095 2500 15833 GOLF TOURNAMENT 31793 4058 27735 25913 455 5380 108697 15879 92818 25913 9550 2500 21213 59176 33642 0 VIA CHRISTI HEALTH INC 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 481172107 62354 PURCHASE OF CRIBS FOR BABY & WOMENS AND BABY HARNESS KIDS/SEATS EMPLOYEES EDUCATION ASSISTANCE, SCHOLARSHIPS, AND ASSISTANCE WITH PATIENT EXPENSES 3000 18160 PART I, LINE 2: MERCY COMMUNITY HEALTH FOUNDATION, INC. DOES NOT SOLICIT GRANT APPLICATIONS FROM ORGANIZATIONS TO WHICH IT PROVIDES ASSISTANCE. THE FOUNDATION PROVIDES ASSISTANCE TO CERTAIN ORGANIZATIONS LISTED IN SCHEDULE I BASED ON EMPLOYEE PAYROLL CONTRIBUTIONS; THE INDIVIDUAL CONTRIBUTIONS ARE FORWARDED TO THE ORGANIZATION AS SOON AS THE FUNDS ARE RECEIVED. 0 1 0 0 0 0 0 0 0 MONICA COEN FOUNDATION ADVISOR 0 290746 0 0 0 22899 0 0 0 0 0 313645 0 0 PART I, LINE 3 THE ORGANIZATION DOES NOT COMPENSATE THE TOP MANAGEMENT OFFICIAL FOR THEIR ROLE AS SENIOR ADMINISTRATOR OF THE ORGANIZATION. HOWEVER, IF THEY DID, THIS PERSON'S SALARY WOULD BE SET USING THE FOLLOWING POLICIES ESTABLISHED BY VIA CHRISTI HEALTH, INC., A RELATED ORGANIZATION: - COMPENSATION COMMITTEE, - INDEPENDENT COMPENSATION CONSULTANT, - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B ELIGIBLE EXECUTIVES PARTICIPATE IN A PROGRAM THAT PROVIDES FOR SUPPLEMENTAL RETIREMENT BENEFITS. THE PAYMENT OF BENEFITS UNDER THE PROGRAM, IF ANY, IS ENTIRELY DEPENDENT UPON THE FACTS AND CIRCUMSTANCES UNDER WHICH THE EXECUTIVE TERMINATES EMPLOYMENT WITH THE ORGANIZATION. BENEFITS UNDER THE PROGRAM ARE FUNDED ANNUALLY BASED ON PARTICIPATION AND ARE NOT VESTED UNTIL THE 5 YEAR SERVICE REQUIREMENT IS REACHED. DUE TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, THERE IS NO GUARANTEE THAT THESE EXECUTIVES WILL EVER RECEIVE ANY BENEFIT UNDER THE PROGRAM. THE AMOUNT FUNDED ANNUALLY UNDER THE PROGRAM TO THE EXECUTIVES IS REPORTED AS COMPENSATION ON FORM 990 SCHEDULE J, PART II, COLUMN B IN THE YEAR FUNDED, THE AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO EXECUTIVES IS REPORTED ON FORM 990 SCHEDULE J, PART II, COLUMN F. THERE WERE NO DISTRIBUTIONS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE YEAR. FORM 990, PART VI, SECTION A, LINE 2 MANY OF THE PERSONS LISTED ON PART VII HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON RELATED VIA CHRISTI HEALTH, INC. ENTITY BOARDS. - BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 6 MERCY COMMUNITY HEALTH FOUNDATION, INC. HAS A SINGLE CORPORATE MEMBER, VIA CHRISTI HOSPITAL MANHATTAN, INC. FORM 990, PART VI, SECTION A, LINE 7A MERCY COMMUNITY HEALTH FOUNDATION, INC. HAS A SINGLE CORPORATE MEMBER, VIA CHRISTI HOSPITAL MANHATTAN, INC,, WHO HAS THE RESERVE POWER TO APPROVE TWO OF THE NOMINEES AND REMOVE THESE TWO MEMBERS OF THE BOARD OF TRUSTEES OF MERCY COMMUNITY HEALTH FOUNDATION, INC. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT, INCLUDING CERTAIN OFFICERS, WORK DILIGENTLY TO COMPLETE THE FORM 990 AND ATTACHED SCHEDULES IN THROUGH MANNER, PRIOR TO FILING THE RETURN, ALL BOARD MEMBERS ARE PROVIDED THE FORM 990 AND MANAGEMENT TEAM MEMBERS ARE AVAILABLE TO ANSWER ANY BOARD MEMBERS' QUESTIONS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS MONITORED AS PART OF THE SYSTEM-WIDE PROCEDURES OF VIA CHRISTI HEALTH, INC. AND NOT AT THE ORGANIZATIONAL LEVEL. THE SYSTEM-WIDE PROCEDURES ARE AS FOLLOWS: 1 - AT TIME OF APPOINTMENT AND ANNUALLY THEREAFTER, ALL INTERESTED PERSONS, INCLUDING BOARD AND COMMITTEE MEMBERS, COMPLETE A DISCLOSURE STATEMENT WHICH ADDRESSES ACTUAL OR POTENTIAL CONFLICTS OF INTEREST; 2 - THE DISCLOSURE STATEMENT IS DONE ELECTRONICALLY AND THE RETURN OF THE COMPLETED STATEMENT IS A CONDITION OF CONTINUED APPOINTMENT, EMPLOYMENT, OR PARTICIPATION WITH THE ORGANIZATION; 3 - ALL ACTUAL OR POTENTIAL CONFLICTS ARE REVIEWED, INVESTIGATED, AND RESOLVED BY THE CHIEF GOVERNANCE OFFICER AND THE CORPORATE RESPONSIBILITY OFFICER, WITH THE RESULTS SHARED WITH THE CHIEF EXECUTIVE OF THE ORGANIZATION; AND 4 - PERIODIC REVIEWS ARE CONDUCTED BY GOVERNANCE, COMPLIANCE, AND INTERNAL AUDIT TO ENSURE THE ORGANIZATION IS OPERATING CONSISTENT WITH THE POLICY AND ENFORCING THE POLICY'S TERMS. FORM 990, PART VI, SECTION B, LINE 15 MERCY COMMUNITY HEALTH FOUNDATION USES THE POLICIES ESTABLISHED BY VIA CHRISTI HEALTH, INC. (VCH). VCH HAS ESTABLISHED A COMMON PHILOSOPHY, STRATEGY, AND PROCESSES FOR EXECUTIVE COMPENSATION. THROUGH THE OVERSIGHT OF THE VCH EXECUTIVE COMPENSATION COMMITTEE, EXECUTIVE COMPENSATION IS COMPETITIVELY POSITIONED AT ITS STATED MARKET POSITION WHEN COMPARED TO THE COMPENSATION PAID BY RELEVANT ORGANIZATIONS (COMPARABLY-SIZED HEALTH SYSTEMS, OSPITALS, AND LONG-TERM CARE PROVIDERS). VCH RECOGNIZES ITS RESPONSIBILITY TO ENSURE THAT ITS EXECUTIVE COMPENSATION PROGRAM IS APPROPRIATE IN VIEW OF ITS MISSION AND TAX EXEMPT STATUS AND THAT ITS COMPENSATION LEVELS AND EXPENDITURES ARE REASONABLE AND NOT EXCESSIVE. TO ENSURE THESE ENDS, THE VCH EXECUTIVE COMPENSATION COMMITTEE HAS ESTABLISHED AND APPROVED THE EXECUTIVE COMPENSATION PHILOSOPHY FOR VCH AND ALL RELATED ENTITIES. IT WILL ALSO APPROVE ALL CHANGES IN THE COMPENSATION PACKAGE FOR VCH EXECUTIVES IN ADVANCE. ON AN ANNUAL BASIS, THE COMMITTEE CONDUCTS A COMPREHENSIVE REVIEW OF TOTAL COMPENSATION FOR ALL EXECUTIVES. IT ALSO REVIEWS AND APPROVES "OFF-CYCLE" COMPENSATION TRANSACTIONS AS NEEDED. IN THEIR REVIEW, THE COMMITTEE CONSIDERS THE FOLLOWING FACTORS: - MARKET DATA FROM INDEPENDENT COMPENSATION SURVEYS AND SOURCES THAT REFLECT COMPARABLE POSITIONS IN ORGANIZATIONS OF SIMILAR SIZE AND SCOPE; - DIFFICULTIES IN RECRUITING AND RETAINING EXECUTIVES; - SKILLS, EXPERIENCE AND PERFORMANCE HISTORY OF INDIVIDUAL EXECUTIVES; - CRITICAL BUSINESS OR STRATEGIC ISSUES THAT THE ORGANIZATION MAY FACE; AND - MARKET POSITION FOR TOTAL COMPENSATION. THE ADEQUACY, COMPETITIVENESS, AND COST OF THE VCH TOTAL EXECUTIVE COMPENSATION PROGRAM ARE REVIEWED ON AN ONGOING BASIS AND CHANGES ARE MADE AS THE COMMITTEE DETERMINES APPROPRIATE. THE EXECUTIVE COMPENSATION PROGRAM WILL HE MAINTAINED SUCH THAT IT WILL FALL WITHIN THE SAFE HARBOR GUIDELINES ESTABLISHED BY THE INTERMEDIATE SANCTIONS REGULATIONS. THE COMMITTEE ALSO EMPLOYS THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTANT TO PREPARE MARKET ANALYSIS TO AID AND SUPPORT THE COMMITTEE'S ACTIONS, PROVIDE DOCUMENTATION OF MARKET TRENDS FOR BUDGET SETTING PURPOSES, REVIEW ANNUAL COMPENSATION CHANGES TO ENSURE "REASONABLENESS AND PROVIDE ATTESTATION, AND PROVIDE CONSULTATION ON ALL EXECUTIVE COMPENSATION ISSUES. THE COMMITTEE ALSO RELIES ON THIRD-PARTY VALIDATION OF PERFORMANCE MEASURES USED IN THE DETERMINATION OF COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 63145 453358926 NATIONAL HEALTH SYSTEM MO 501(C)(3) LINE 12A, I N/A 0 ASCENSION HEALTH PO BOX 45998 ST LOUIS MO 63145 311662309 NATIONAL HEALTH SYSTEM MO 501(C)(3) LINE 12A, I ASCENSION HEALTH ALLIANCE 0 VIA CHRISTI HEALTH INC 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 481172107 HEALTH SYSTEM PARENT KS 501(C)(3) LINE 12C, III-FI ASCENSION HEALTH ALLIANCE 0 VIA CHRISTI VILLAGES INC 2622 W CENTRAL SUITE 100 WICHITA KS 67203 480559086 MANAGEMENT COMPANY KS 501(C)(3) LINE 12C, III-FI VIA CHRISTI HEALTH INC 0 VIA CHRISTI VILLAGE HAYS INC 2225 CANTERBURY DRIVE HAYW KS 67601 202828680 RETIREMENT HOME KS 501(C)(3) LINE 10 VIA CHRISTI VILLAGES INC 1 VIA CHRISTI CARE AT HOME INC 2622 W CENTRAL SUITE 100 WICHITA KS 67203 271889960 HEALTH AGENCY KS 501(C)(3) LINE 10 VIA CHRISTI VILLAGES INC 1 VIA CHRISTI HEALTHCARE OUTREACH PROGRAM FOR ELDERS INC 2622 W CENTRAL SUITE 100 WICHITA KS 67203 481236589 PAGE COMMUNITY PROGRAMS KS 501(C)(3) LINE 10 VIA CHRISTI VILLAGES INC 1 VIA CHRISTI VILLAGE GEORGETOWN INC 165 S GEORGETOWN WICHITA KS 67218 481129325 RETIREMENT HOME KS 501(C)(3) LINE 10 VIA CHRISTI VILLAGES INC 1 VIA CHRISTI VILLAGE MANHATTAN INC 2800 WILLOW GROVE ROAD MANHATTAN KS 66502 481078862 RETIREMENT HOME KS 501(C)(3) LINE 10 VIA CHRISTI VILLAGES INC 1 VIA CHRISTI VILLAGE MCLEAN INC 777 N MCLEAN BLVD WICHITA KS 67203 481247723 RETIREMENT HOME KS 501(C)(3) LINE 10 VIA CHRISTI VILLAGES INC 1 VIA CHRISTI VILLAGE PITTSBURG INC 1502 E CENTENNIAL DRIVE PITTSBURG KS 66762 743070971 RETIREMENT HOME KS 501(C)(3) LINE 10 VIA CHRISTI VILLAGES INC 1 VIA CHRISTI VILLAGE PONCA CITY INC 1601 ACADEMY ROAD PONCA CITY OK 74604 731153337 RETIREMENT HOME OK 501(C)(3) LINE 10 VIA CHRISTI VILLAGES INC 1 VIA CHRISTI HOSPITAL PITTSBURG INC 1 MT CARMEL WAY PITTSBURG KS 66762 480543778 HOSPITAL KS 501(C)(3) LINE 3 VIA CHRISTI HEALTH INC 0 MOUNT CARMEL FOUNDATION INC 1 MT CARMEL WAY PITTSBURG KS 66762 480961283 FOUNDATION KS 501(C)(3) LINE 12A, I VIA CHRISTI HOSPITAL PITTSBURG INC 0 VIA CHRISTI HEALTH ALLIANCE IN ACCOUNTABLE CARE INC 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 462872857 ACO KS 501(C)(3) VIA CHRISTI HEALTH INC 0 VIA CHRISTI HOSPITAL WICHITA ST TERESA INC 14800 W ST TERESA WICHITA KS 67235 271965272 HOSPITAL KS 501(C)(3) LINE 3 VIA CHRISTI HEALTH INC 0 VIA CHRISTI HOSPITALS WICHITA INC 929 N SAINT FRANCES WICHITA KS 67214 481172106 HOSPITAL KS 501(C)(3) LINE 3 VIA CHRISTI HEALTH INC 0 VIA CHRISTI REHABILITATION HOSPITAL INC 1151 N ROCK ROAD WICHITA KS 67206 481158274 REHABILITATION HOSPITAL KS 501(C)(3) LINE 3 VIA CHRISTI HOSPITALS WICHITA INC 0 VIA CHRISTI PROPERTY SERVICES INC 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 480948571 PROPERTY MANAGEMENT KS 501(C)(4) VIA CHRISTI HOSPITALS WICHITA INC 0 VIA CHRISTI HEALTH PARTNERS INC 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 480958974 MANAGEMENT COMPANY KS 501(C)(3) LINE 10 VIA CHRISTI HEALTH INC 0 VIA CHRISTI HOSPITAL MANHATTAN INC 1823 COLLEGE AVENUE MANHATTAN KS 66502 481186704 HOSPITAL KS 501(C)(3) LINE 3 VIA CHRISTI HEALTH INC 0 WAMEGO HOSPITAL ASSOCIATION INC 711 GENN DRIVE WAMEGO KS 66547 721526400 HOSPITAL KS 501(C)(3) LINE 3 VIA CHRISTI HOSPITAL MANHATTAN INC 0 SALINA REGIONAL HOME MEDICAL SERVICES LLC 520 SOUTH SANTA FE AVE SALINA KS 67401 431948057 MEDICAL EQUIPMENT KS 501(C)(3) LINE 10 SALINA REGIONAL HEALTH CENTER INC 0 CORNERSTONE ASSISTED LIVING INC 2622 W CENTRAL SUITE 100 WICHITA KS 67203 481241079 RETIREMENT HOME KS 501(C)(3) LINE 10 VIA CHRISTI VILLAGES INC 0 GERARD HOUSE INC 929 N SAINT FRANCES WICHITA KS 67214 481172106 HOSPITAL KS 501(C)(3) LINE 3 VIA CHRISTI HEALTH INC 0 AMBULATORY SURGERY CENTER LP 8200 THORN DRIVE SUITE 300 WICHITA KS 67226 481114690 SURGERY CENTER KS N/A 0 0 AMS DIAGNOSTICS LLC 8200 THORN DRIVE SUITE 300 WICHITA KS 67226 481223653 RADIOLOGY SERVICES KS N/A 0 0 KANSAS SURGERY AND RECOVERY CENTER LLC 2770 NORTH WEBB ROAD WICHITA KS 67226 481148580 SURGERY CENTER KS N/A 0 0 MERCY IMAGING LLC 1823 COLLEGE AVENUE MANHATTAN KS 66502 481251984 RADIOLOGY SERVICES KS N/A 0 0 AFFILIATED MEDICAL SERVICES LABORATORY INC 2916 E CENTRAL WICHITA KS 67214 481239522 MEDICAL LABORATORY KS N/A C 0 INTEGRATED HEALTHCARE SYSTEMS INC 3311 EAST MURDOCK WICHITA KS 67208 480941549 CLINIC SERVICES KS N/A C 0 VCH IOWA PC TRUST 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 276937322 BENEFICIARY TRUST IA N/A T 0 VCH IOWA PC TRUST 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 273983977 PROFESSIONAL ASSOCIATION IA N/A C 0 VIA CHRISTI CLINIC PA 3311 EAST MURDOCK WICHITA KS 67208 480993446 PROFESSIONAL ASSOCIATION KS N/A C 0 VIA CHRISTI CLINIC SERVICES INC 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 273984287 CLINIC SERVICES KS N/A C 0 SUNFLOWER ASSURANCE LTD PO BOX 1085 GRAND CAYMAN CJ KY1-1102 980223159 INSURANCE COMPANY CJ N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0