2018-05-15T19:05:17-05:00 2017-06-30 990 2016-07-01 480543778 Via Christi Hospital Pittsburg inc VIAC 3147338000 1 Mt Carmel Way Pittsburg KS 66762 Tonya Mershon Tax Officer 2017-11-10 2016 2021-01-29 14:40:06Z Randall Cason 1 Mt Carmel Way Pittsburg KS 66762 86037031 false 0928 X https://www.viachristi.org/locations/hospitals/via-christi-hospital-pittsburg X 1903 KS Rooted in the loving ministry of Jesus as healer, we commit ourselves to serving all persons with special attention to those who are poor and vulnerable. Our Catholic health ministry is dedicated to spiritually centered, holistic care which sustains and improves the health of individuals and communities. We are advocates for a compassionate and just society through our actions and our words. 13 11 680 145 283300 173349 129454 633916 87265518 83968148 -319213 78986 1428260 1238344 88504019 85919394 69730 1000 0 41243254 38787907 0 0 0 46234212 53862144 87547196 92651051 956823 -6731657 85697667 80388934 32983568 18112590 52714099 62276344 Our Mission as part of a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve. false false 73538682 1000 84332392 VIA CHRISTI HOSPITAL PITTSBURG, INC. (VCH-P) AND ITS AFFILIATES ENRICH THE COMMUNITIES IN WHICH THEY OPERATE AS WELL AS THE BROADER COMMUNITY, IMPROVE MEDICINE THROUGH RESEARCH, EDUCATING NURSES/NURSING STUDENTS AND OTHER HEALTH CARE PROVIDERS, PARTNER WITH THE LOCAL FQHC BY PROVIDING CARDIAC SPECIALTY CARE IN PITTSBURG AND SURROUNDING COMMUNITIES, AND PROVIDE CARE AND SUPPORT TO PEOPLE IN NEED. VCH-P FURTHER SUPPORTS THIS MISSION WITH A COMMUNITY BOARD, OPEN MEDICAL STAFF, AND AN EMERGENCY ROOM AVAILABLE TO PATIENTS REGARDLESS OF ABILITY TO PAY. 73538682 true true false true false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 120 0 true 680 true true true false false false false false false false false false X 13 11 false false false false true true true true true false false false true true true true true false false true true X Darla Larkin 3167193240 8200 E Thorn Drive Wichita KS 67226 TODD A CONKLIN EX-OFFICIO, COO 1.0 53.0 X X 0 786543 33995 ANGELA SHAW MD EX-OFFICIO, MEDICAL STAFF PRESIDENT (END 12/2016) 40.0 0 X X 268606 0 37196 RANDALL R CASON SR ADMINISTRATOR/PRESIDENT 50.0 0.0 X X 123850 235825 36461 JIM MCDANIEL MD EX-OFFICIO, MEDICAL STAFF PRESIDENT (START 1/2017) 1.0 0 X X 0 0 0 ELIAS TAWIL MD CHAIR 1.0 1.0 X X 0 0 0 MARK WERNER VICE CHAIR 1.0 0 X X 0 0 0 JOHN CLARK SECRETARY 1.0 0 X X 0 0 0 KATHLEEN SANDNESS MD TREASURER 1.0 0 X X 0 0 0 JASON MARIETTA TRUSTEE 1.0 0 X 0 0 0 RICHARD OLER TRUSTEE 1.0 0 X 0 0 0 STEVE SCOTT MD TRUSTEE 1.0 0 X 0 0 0 SISTER SUSANNE DANIELS TRUSTEE (END 7/2016) 1.0 0 X 0 0 0 SISTER MARIE VERONICA JANOUSEK TRUSTEE (END DATE 8/2016) 1.0 0 X 0 0 0 SUZANNE DEXTRAS MD TRUSTEE (START 11/2016) 1.0 0 X 0 0 0 BLAKE BENSON TRUSTEE (START 7/2016) 1.0 0 X 0 0 0 DARON HALL TRUSTEE (START 7/2016) 1.0 0 X 0 0 0 MIKE JOY ADMINISTRATOR FINANCE (END 1/2017) 50.0 0 X 132374 0 13171 DREW K TALBOTT VP OF OPERATIONS (START 1/2017) 50.0 0 X 188213 0 28047 CAROL KARP ASSISTANT TREASURER/CFO (END 3/2017) 1.0 56.0 X 0 513212 29379 GARY KNIGHT ASSISTANT SECRETARY 1.0 56.0 X 0 531167 34459 CARLA J YOST CHIEF NURSING OFFICER-VCH 5.0 45.0 X 0 368010 35216 ALI HAMMAD MD PHYSICIAN 40.0 0 X 1008970 0 39327 BASHAR MARJI MD PHYSICIAN 40.0 0 X 1011959 0 38436 BOBAN N MATHEW MD PHYSICIAN 40.0 0 X 512292 0 42841 MARY K REED MD PHYSICIAN 40.0 0 X 460760 0 30355 ANDREW J WHITE MD PHYSICIAN 40.0 0 X 536730 0 33287 ROBERTA JOHNSON FORMER OFFICER (END 6/2016) 0.0 40.0 X 0 334289 24139 JEFF N SEIRER FORMER OFFICER (END 8/2014) 0.0 50.0 X 0 341902 41328 DAVID HADLEY FORMER OFFICER (END 1/2014) 0.0 0.0 X 0 498310 0 4243754 3609258 497637 40 true true false REHABCARE GROUP SRS DIV 680 SOUTH FOURTH ST LOUISVILLE KY 40202 MANAGEMENT FEES 520708 PITTSBURG EMERGENCY PHYSICIANS LLC 8717 W 110TH ST STE 500 14 CORPORATE WOODS OVERLAND PARK KS 66210 PHYSICIAN SERVICES 468760 ACCELECARE WOUND CENTERS INC P O BOX 671242 DALLAS TX 75267 MEDICAL SERVICES 365852 REGIONAL MEDICAL LABORATORY DEPARTMENT 2821 TULSA OK 74182 LABORATORY SERVICES 354969 ORTHO SPECIALISTS OF THE FOUR STATES 444 FOUR STATES DR STE 1 GALENA KS 66739 MEDICAL SERVICES 249888 9 X 146170 487746 633916 NET PATIENT SERVICE REVENUE 621990 83181136 83181136 340B PHARMACY REVENUE 621990 642714 642714 LABORATORY SERVICES 621500 98252 53946 44306 Meaningful Use Revenue 621110 82803 82803 joint venture loss - operating 621990 -36757 -210577 173820 0 0 0 0 83968148 66128 66128 189337 69258 120079 0 120079 120079 61237 48379 0 12858 12858 12858 34489 34489 34489 Occupational Health 621990 436453 436453 Cafeteria 722514 318536 318536 Catering 722320 97395 24825 72570 231392 145917 40349 45126 1083776 85919394 84332392 283300 669786 X 1000 1000 796363 305802 490561 0 30963695 28509173 2454522 567999 519097 48902 4406843 4377927 28916 2053007 1842843 210164 96180 0 96180 24672 24672 11646 11646 10823881 10503317 320564 0 346428 638 345790 366868 261728 105140 26834 12374 14460 1769741 1700611 69130 61861 33023 28838 85678 62756 22922 5812704 3348865 2463839 539376 539376 Supplies 16457840 16448023 9817 Management Fees 15388645 3814594 11574051 Cost of Goods Sold 807099 807099 Medicaid State Assessment 565454 565454 0 677237 424358 252879 0 92651051 73538682 19112369 0 477298 276031 176020 179316 14251307 13234056 0 0 0 2880503 2664465 2321128 2685192 74783146 19117666 59257016 55665480 0 0 694643 847143 122980 124306 5516772 4712945 85697667 80388934 6440327 6390819 20000 28138 0 26523241 11693633 32983568 18112590 X 52178338 61681323 535761 595021 52714099 62276344 85697667 80388934 X -6731657 16293902 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 11646 11646 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent the portion of dues paid to national and state hospital associations that are specifically allocable to lobbying. Via Christi Hospital Pittsburg, Inc. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent the portion of dues paid to national and state hospital associations that are specifically allocable to lobbying. Via Christi Hospital Pittsburg, Inc. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 2100000 2100000 51331038 7530283 43800755 20521108 11355327 9165781 831000 232056 598944 55665480 Other Current Assets Physician Guarantee LT Assets 136000 Intra/Intercompany AR 164551 Estimated Settlements from Third-Party Payor 1741150 Other Receivables 2369305 Security Deposits 301939 4712945 -23134 VCHS Note Payable Self-Insurance Liability Related Party Payables 7278238 Physician Guarantee Liability 9054 Estimated Settlement to Third-Party Payor 2685499 Asset Retirement Obligation Liability 87492 Recovery Tail Liability 1656484 11693633 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2017. true true X true X 250 true X true true true false true true 8496549 8496549 0.0917 43726060 38844908 4881152 0.0527 0 0.0 0 0 52222609 38844908 13377701 0.1444 229043 26067 202976 0.0022 88408 0 88408 0.0010 0 0 0 0.0 0 0 0 0.0 55757 0 55757 0.0006 0 0 373208 26067 347141 0.0037 0 0 52595817 38870975 13724842 0.1481 0 0 0 0.0 94 0 94 0.0000 10574 0 10574 0.0001 0 0 0 0.0 82 0 82 0.0000 0 0 0 0.0 0 0 0 0.0 358 0 358 0.0000 0 0 0 0.0 0 0 11108 0 11108 0.0001 false 1873251 0 23861816 29763878 -5902062 X true true 1 1 VIA CHRISTI HOSPITAL PITTSBURG INC 1 Mt CARMEL WAY PITTSBURG KS 66762 https://www.viachristi.org/locations/hospitals/via-christi-hospital-pittsburg KANSAS H-019-002 X X X LEVEL III TRAUMA CENTER, CANCER CENTER AND HEART VIA CHRISTI HOSPITAL PITTSBURG INC 1 false false true X X X X X X X X 15 true false true true X https://www.viachristi.org/about-via-christi/mission/community-benefit X http://www.crawfordcountykansas.org/uploads/6/2/7/8/62784259/master_crawford_county_cha_2017.pdf X true 15 false true false true X 250.0 400.0 X X true true X X X X true X https://www.viachristi.org/patients-and-visitors/billing-and-finance/financial-assistance X https://www.viachristi.org/patients-and-visitors/billing-and-finance/financial-assistance X https://www.viachristi.org/patients-and-visitors/billing-and-finance/financial-assistance X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Via Christi Hospitals, Pittsburg, Inc.. The Lower 6 Southeast Kansas Counties (Elk, Neosho, Crawford, Chautauqua, Montgomery and Cherokee Counties) participated in one community health needs assessment during Fall 2016. The organizations that assisted with this effort and served on the core team included: County Boards of Health, Via Christi Hospital in Pittsburg, Pittsburg State University Irene Ransom Bradley School of Nursing and Mid America Nazarene University. The four major areas of concern identified by the regional work group were: mental health, cancers, heart disease and stroke as the most important health problems in this area. The model adopted for this CHNA was developed by the National Association of City/County Health Officials and the Centers for Disease Control and Prevention. The mobilizing for action through planning and partnerships (MAPP) Model consists of six phases: organization, visioning, the four assessments, identifying strategic issues, formulating goals and strategies and action cycle. A total of 1,608 surveys were completed. The respondents were comprised of the following ethnic groups: 89.1% white, 4.4% American Indian / Alaskan Native, 3.5% Hispanic, 1.8% African-American, and 1.2% Other. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Via Christi Hospitals, Pittsburg, Inc.. The Crawford County Health Department mission is to strives to provide optimal community health services throughout the lifespan with special emphasis on the prevention of disease and the education of persons in our care. Their direct health staffing includes registered nurses, dietitian, lab technician and nurse practitioners. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Via Christi Hospital Pittsburg, Inc.. Goals being addressed post CHNA 1) Chronic disease support - VCH-P continues offering various health education classes as well to support patients and their families in their desire to understand their chronic conditions and how best to manage them for healthier outcomes. Specific VCH-P programs are CHF Self-Management, Smoking Cessation, Diabetes Self-Management and Monthly Lunch and Learn sessions. 2) Mental Health - VCH-P Behavioral Health provides behavioral health services for children, adolescents, adults, seniors and families. Also, Chaplains and Social Workers have been trained in "Mental Health First Aid" in accordance with the Crawford County Health Improvement Plan to provide a more timely response to mental health crises. 3) Drugs and alcohol - VCH-P hosts ACOA group on site. In accordance with the Crawford County Health Improvement Plan, a Chaplain has been trained in "Screening, Brief Intervention, Referral to Treatment (SBIRT)" to intervene and triage alcohol and drug abuse. 4) Obesity - VCH-P is collaborating with Crawford County Live Well to encourage residents to make healthy choices through education, motivation and support. All identified health needs above are being addressed. 14 Physical Therapy 1 Med Center Circle Ste B Pittsburg KS 66762 Outpatient physical therapy, speech therapy, sports therapy, and occupational therapy services. Home Medical 202 E Centennial Ste 15 Pittsburg KS 66762 Outpatient durable medical equipment Cardiology 1011 Mt Carmel Place Pittsburg KS 66762 Outpatient Cardiology Services Sleep Lab 3 Medical Center Circle Pittsburg KS 66762 Sleep Lab Services Cardiology 2711 S Rouse Ste C/D Pittsburg KS 66762 Outpatient Cardiology Services Behavioral Health 200 E Centennial Ste 13 Pittsburg KS 66762 Outpatient behavioral health clinic Pediatric Clinic 2711 S Rouse Ste E Pittsburg KS 66762 Outpatient Pediatric Care Surgery Clinic 1 Med Center Circle Ste C Pittsburg KS 66762 Outpatient Surgical Services Pulmonology Clinic 2711 S Rouse Ste C/D Pittsburg KS 66762 Outpatient Pulmonary services Surgery Clinic 2701 S Rouse Ste A Pittsburg KS 66762 Outpatient Surgical Services Pain Management 1 Med Center Circle Ste A Pittsburg KS 66762 Outpatient Pain Management services Cancer Center - Parsons 1509 Main Parsons KS 67357 Outpatient oncology clinic Cancer Center - Ft Scott 1621 S Main Fort Scott KS 66701 Outpatient oncology clinic Schedule H, Part VI, Line 7 States with which the organization files a community benefit report The state of Kansas does not require hospitals to file community benefit reports; but VCH distributes our community benefit totals and activities annually in press releases as well as in our annual report. Schedule H, Part I, Line 6a NAME OF RELATED ORGANIZATION Via Christi Health, Inc. produces a consolidated annual report for all ministries in their periodical magazine called "Via Christi Life". Within the report, several pages describe the Community Benefit activities that have taken place over the last year and the monetary value to the Pittsburg area. Community Benefit Report: Via Christi Hospital Pittsburg, Inc. ("VCH-P") is a member of Via Christi Health, Inc. ("VCH"). As a Catholic health system, VCH-P has its origins in faith-based responses to health needs of our communities, with a particular concern for those living in poverty and who are vulnerable. The obligation to reach out to those in need and improve community health flows directly from our identity as a faith-based healing ministry. As a mission-driven organization, we provide community benefit because we are committed to our core values of: - Service of the Poor - Generosity of spirit, especially for persons most in need. - Reverence - Respect and compassion for the dignity and diversity of life. - Integrity - Inspiring trust through personal leadership. - Wisdom - Integrating excellence and stewardship. -Creativity - Courageous innovation. - Dedication - Affirming the hope and joy of our ministry. According to the VCH-P mission statement, "As a part of Via Christi Health, Inc., we share this mission: Inspired by the Gospel and our Catholic tradition, we serve as a healing presence with special concern for our neighbors who are vulnerable." The financial information in this report was prepared in accordance with the Catholic Health Association's (CHA) A Guide for Planning and Reporting Community Benefit Guidelines (2015). Per these guidelines, we report the net expense for community benefit services (e.g. the total community benefit expense minus any associated revenue from patients, residents, payers and other external sources). The CHA guidelines reflect a conservative approach to reporting quantifiable community benefit. The goal of the guidelines is to produce community benefit financial reports that reflect true costs and that describe community benefit activities that increase access to health care and improve community health for all. The following are VCH's definitions for quantifiable community benefits reports. Charity Care - free or discounted health services provided to persons who cannot afford to pay and who meet VCH's criteria for financial assistance. Charity care is reported in terms of costs, not charges. Charity care does not include bad debt. Government Sponsored Means-Tested Health Care - includes unpaid costs of public programs for low-income persons. The shortfall created when VCH receives payments that are less than the cost of caring for public program beneficiaries. This payment shortfall is not the same as a contractual allowance, which is the full difference between charges and government payments. For Fiscal Year Ended June 30, 2017 Community Benefit for VCH-P by category was: 1. Charity Care, at cost: $8.50 million 2. Government Sponsored Health Care, net expense: Unpaid cost of public indigent care programs (includes Medicaid, SCHIP and other safety net programs; does not include Medicare shortfall): $4.88 million 3. Community Benefit programs, net expense: $358.25 thousand 4. Total Quantifiable Community Benefit: $13.738 million Schedule H, Part III, Line 1 BAD DEBT IN ACCORDANCE WITH STATEMENT NO. 15 VCH-P reports bad debt in accordance with generally accepted accounting principles (GAAP). Healthcare Financial Management Statement No. 15 is followed to the extent that it aligns with the guidelines set forth by GAAP. Schedule H, Part V, Section B, Line 17 Billing and Collection Policy During tax year 2017, the organization learned via verbal comments of IRS agents at public events that the IRS intends that the "readily obtainable" standard in the 501(r) regulations for the AGB calculation and billing and collection policy is only met if those items are posted to the organization's web site. The organization had interpreted that web posting standard to be a safe harbor after consulting with external counsel and tax advisors, and timely took other steps to make the information readily obtainable. Consequently, the organization does not believe its decision to not post these documents to its web site rises to the level of a failure, nor does it believe the circumstances were either willful or egregious, having otherwise timely taken the steps necessary to attain and continue to maintain compliance with the other requirements related to the billing and collection policy and the AGB, as part of its policies and procedures for ensuring compliance with all aspects of 501(r). However, the organization is making this voluntary disclosure in order to communicate to the IRS the changes it is undertaking in response to the recent IRS informal guidance on this specific point concerning the "readily obtainable" standard, and the fact that the organization has started the work necessary to post its AGB information and billing and collection policy to its web site and will complete those additional postings as soon as reasonably possible. The other web postings required under 501(r) (i.e., those related to the community health needs assessment and the financial assistance policy) were timely completed and continue to remain in place as required. The organization believes its safeguards worked as intended in this case (i.e., the organization has regular communications with a number of external law firms and tax consultants and the timely attention to the recent guidance was supported by the framework of regular access to subject matter experts). These changes are in the process of being incorporated into corporate policies and procedures that apply to the organization. Schedule H, Part I, Line 6a Community benefit report prepared by related organization Via Christi Health, Inc. EIN: 48-1172107 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost of providing charity care, means-tested government programs, and other community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied. Schedule H, Part II Community Building Activities Staff participate on the Southeast Kansas (SEKS) Healthcare Coalition which deals with disaster preparedness. In addition, a staff person also serves on the executive committee of this coalition representing faith based groups and volunteers. The purpose of this group is to ensure that the community organizations are prepared and ready to respond to any natural disasters that may occur in the area such as tornadoes, floods, major snowstorms, fires, etc. and be able to immediately address the spiritual, mental, physical, emotional and financial stresses these disasters may cause. Networking with other social service providers, as well as healthcare organizations, ensures a comprehensive and efficient approach to dealing with the issues presented. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Bad debt expense at cost is determined using the same cost-to-charge ratio that is used for charity care and Medicaid shortfall. VCH-P follows the guidance from CHA and does not consider bad debt as a community benefit. Schedule H, Part III, Line 3 Bad Debt Expense Methodology Via Christi Hospital Pittsburg, Inc. has a very robust financial assistance policy; therefore, no estimate is made for bad debt attributed to financial assistance eligible patients. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote From the audited financial statements of Ascension Health Alliance (which include the activity of Via Christi Hospital PIttsburg, Inc.): The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the System follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by the System. Accounts receivable are written off after collection efforts have been followed in accordance with the System's policies. The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year. VCH-P's bad debt deduction was $1,873,251 at charges and $601,842 at cost (after the cost to charge ratio was applied to the amount of charges). Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs VCH-P follows the CHA guidelines regarding Medicare and does not include it as community benefit. However, the methodology described in the instructions to Schedule H, Part III, Section B, Line 7 for reporting Medicare shortfall does not take into account all costs incurred by VCH-P and does not represent the total Medicare shortfall. The Medicare shortfall reported on Schedule H, Part III, Section E, Line 7 was determined using information from the organization's Medicare cost report (using the Medicare cost report step-down methodology of allocating costs). However, utilizing an internal cost accounting system actually results in a Medicare shortfall of $7,379,821. The most common reason for a difference between the Medicare shortfall reported on schedule h and the actual shortfall reported above include: inclusion of Medicare advantage revenue and expenses, inclusion of Medicare Part B revenue and expenses, inclusion of other fee schedule revenue, other timing issues, and costs that are considered unallowable on the Medicare cost report that are, in fact, related to Medicare Patient care. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance It is the policy of VCH-P to promote socially just practices for billing and collections for all patients receiving care. The policy is intended to further the VCH-P mission by requiring ethical conduct in billing and collecting self-pay balances from patients/guarantors regardless of ability to pay. The policy ensures that prior to turning an account over to a third party collection agent (agent) for collection activity, VCH-P will perform a reasonable review of each account to verify that the patient/guarantor is not potentially eligible for any government assistance programs (e.g. Medicaid, Medicare, etc.) and would likely not qualify for charity care. VCH-P will direct its staff and agents to periodically assess each patient/guarantor's ability to pay or to determine eligibility for charity care. The review and assessment should include but may not be limited to the following: A. Ensure the patient/guarantor has been notified of VCH's financial assistance policy; B. Ensure the patient/guarantor was offered a financial assistance application; C. Ensure documentation of any known extraordinary financial circumstances of the patient/guarantor or if they are medically indigent. Schedule H, Part V, Section B, Line 16a FAP website - VIA CHRISTI HOSPITAL PITTSBURG, INC.: Line 16a URL: https://www.viachristi.org/patients-and-visitors/billing-and-finance/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - VIA CHRISTI HOSPITAL PITTSBURG, INC.: Line 16b URL: https://www.viachristi.org/patients-and-visitors/billing-and-finance/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - VIA CHRISTI HOSPITAL PITTSBURG, INC.: Line 16c URL: https://www.viachristi.org/patients-and-visitors/billing-and-finance/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment In the fall of 2016 VCH-P reached out to the Crawford County Health Department to begin a community health assessment. The SE KS Health Committee made a special effort to invite agencies within the region to become partners in our CHNA journey. Crawford Co Health Department and VCH-P assumed the lead of the SE KS Health Committee. A timeline was made, a key leadership team was developed and a CHNA model for the Lower 8 counties was adopted using the MAPP method. Numerous not-for-profit agencies participated and a survey developed and distributed throughout the region. Surveys were available in English and Spanish. Media was also engaged to promote the availability of the survey, as well as the electronic link where it could be taken online. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance The VCH-P financial assistance staff is trained on how to qualify patients for Medicaid, SCHIP, and other such income-based programs. During the patient's registration, admissions, and discharge processes, VCH-P staff attempt to identify patients who may be eligible for charity or discounted care through the charity care policy. In addition, VCH-P uses a percentage of the federal poverty guidelines (FPG) to determine free and discounted care. Schedule H, Part VI, Line 4 Community information While VCH-P serves the general southeast region of the State of Kansas, the primary county for VCH-P is Crawford. Crawford County has a land area of 590 square miles. Crawford County has an estimated 2016 population of 39,134 with the following population demographics: 91.6% white, 2.4% Black, 1.1% American Indian, 1.8% Asian, and 5.3% persons of Hispanic or Latino origin. Approximately 5.8% of the Crawford County residents reported using a language other than English in their homes. High school graduation rates, for the years 2012-2016, were 90.1% in Crawford County. A bachelor's degree or higher was reported by 28.4% of Crawford County residents. Median household income for Crawford County residents for the years 2012-2016 was $37,607 compared to $55,322 for Kansans in general. Median value of owner-occupied housing units for the same time period was $85,100 for Crawford County and $184,700 for Kansas. According to Quick Facts from the US Census, 22.3% of Crawford County lived below the poverty level between the years 2012-2016. This is higher than the 12.7% identified for the State of Kansas. VCH-P is the only hospital facility in the City of Pittsburg. Other hospitals are in neighboring communities but offer fewer services. In order to find a similar medical facility, patients would need to travel to Joplin, Missouri or Tulsa, Oklahoma for emergency care. Kansas reported in 2016 that 15.2% of all residents were persons 65 years of age and older. This compares to 15.1% for Crawford. Thus services for a growing aging population need to be monitored in future assessments. Schedule H, Part VI, Line 5 Promotion of community health VCH-P enriches Crawford County as well as the broader community by improving medicine through educating clinical providers and providing care and support to people in need. VCH-P further supports this mission with a community board, open medical staff, and an emergency room available 24/7 to patients regardless of ability to pay. The majority of its Governing Board are external members comprised of persons who reside in or around Crawford County and have overall responsibility for the charitable mission of the organization as set forth in its Articles of Incorporation and Bylaws. These directors are selected based on their expertise, experience, and other criteria established by the nominating committee of the Board of Directors. Areas of expertise and experience include such areas as healthcare, finance, education, and local government. The Board actively debates and sets policy and strategic direction for the ministry but does not get involved in issues related to daily operations. The Board takes a balanced approach when addressing community and business/financial concerns. The Board is also the primary group for determining the use of surplus funds generated by the organization which are reinvested in the ministry in order to allow the ministry to sustain its mission and prepare for the future. -The medical staff of VCH-P is open and is composed of physicians licensed to practice medicine in the State of Kansas. -VCH-P staff participates on boards of not-for-profit organizations (e.g. Veterans Leadership Advisory Committee- a program to provide vision and advocacy, innovation and leadership development to veterans and their families) -In Pittsburg, Kansas, VCH-P participated in monthly car seat installations and safety checks where staff educated those in attendance on how to properly install and adjust infant and child car seats and if needed gave free seats to those who could not afford one. Periodic health fairs were held at various locations around town to promote healthy living and good nutrition practices (e.g. YMCA PATH, KOAM health & wellness expo at the Pittsburg State University Plaster Center, and City of Pittsburg employee health fair and at the Wesley House). Staff also presented and/or hosted public presentations on behavioral health, diabetes heart health, fall prevention, stroke awareness, yoga for wellness, human trafficking and several other learning opportunities. They also provided smoking cessation classes for the general public, provided free prostate and skin cancer screenings, and concussion education for youth, their coaches and families. -Civic groups are also invited in to VCH-P to use conference rooms for their meetings to allow their limited resources to be used for programs that enhance the quality of life in the community. -Staff assist with fundraising efforts for other not-for-profit organizations (Project Warmth, and United Way) -Staff also assist with coordinating and participating in periodic American Red Cross blood drives. -VCH-P provides a monthly meal subsidy for the Family Resource Center to ensure children get healthy meals while at the daycare center. -VCH-P also provides free medication for indigent patients who are in need of financial assistance. -VCH-P hosts monthly support groups for those with breast cancer and those who may have other types of cancer as well. -VCH-P has additional support groups and/or educational classes for those who have had strokes or have been diagnosed with arthritis. -VCH-P also operates a transport CareVan for those without transportation to get to and from their health care appointments. The van not only covers the City of Pittsburg but also goes into the rural areas of the county. In 2016, VCH-P provided 6,934 passenger trips for medical care at a cost of $127,235. -VCH-P also serves as a training site for nursing students, lab technicians, pharmacy students, cardiac rehab, ultrasound and radiology and others who must complete a field practicum before earning their diplomas and/or degrees. -A monthly discount is given to the Family Resource Center on their food expenses in order to provide healthy meals to children who are served through the FRC's daily programs. In 2016, VCH-P provided the Family Resource Center with $42,000 to assist with their monthly food cost for their daycare center students. Schedule H, Part VI, Line 6 Affiliated health care system VCH-P is an affiliate of Via Christi Health, Inc. (VCH) and Ascension Health. VCH's affiliates are large multi-faceted, integrated, not-for-profit ministries including hospital and non-hospital ministries (physician group practices, hospital organizations, research, home health, and durable medical equipment). These ministries work together to care for patients, joined by common systems and a philosophy of serving as a healing presence with special concern for our neighbors especially those who are vulnerable. This community benefit happens through its focus on patient care, education, research and community outreach. The organizations work together to serve their communities at the local, regional, and state level. Ascension Health Alliance, d/b/a Ascension (Ascension), is a Missouri nonprofit corporation formed on September 13, 2011. Ascension is the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities, or Health Ministries, located in 22 of the United States and the District of Columbia. Ascension is sponsored by Ascension Sponsor, a Public Juridic Person. The Participating ORGANIZATIONS/ENTITIES of Ascension Sponsor are the Daughters of Charity of St. Vincent de Paul, St. Louise Province; the Congregation of St. Joseph; the Congregation of the Sisters of St. Joseph of Carondelet; the Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. - American Province; and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi - US/Caribbean Province. Mission: The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing, and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs: -Traditional charity care includes the cost of services provided to persons who cannot afford healthcare because of inadequate resources and/or who are uninsured or underinsured. -Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and other vulnerable persons. -Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome. -Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings, and medical research. Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and other community benefit programs. The cost of providing care to persons living in poverty and other community benefit programs is estimated by reducing charges forgone by a factor derived from the ratio of each entity's total operating expenses to the entity's billed charges for patient care. Certain costs such as graduate medical education and certain other activities are excluded from total operating expenses for purposes of this computation. false true false false false false false false false TODD A CONKLIN EX-OFFICIO, COO 0 516031 0 210377 0 60135 0 13250 0 20745 0 820538 0 0 ANGELA SHAW MD EX-OFFICIO, MEDICAL STAFF PRESIDENT (END 12/2016) 240346 0 27506 0 754 0 15027 0 22169 0 305802 0 0 0 RANDALL R CASON SR ADMINISTRATOR/PRESIDENT 56710 233920 60346 0 6794 1905 617 13455 4289 18100 128756 267380 0 0 ROBERTA JOHNSON FORMER OFFICER (END 6/2016) 0 227889 0 55368 0 51032 0 16178 0 7961 0 358428 0 0 JEFF N SEIRER FORMER OFFICER (END 8/2014) 0 278985 0 58683 0 4234 0 17225 0 24103 0 383230 0 0 DAVID HADLEY FORMER OFFICER (END 1/2014) 0 0 0 0 0 498310 0 0 0 0 0 498310 0 498310 DREW K TALBOTT VP OF OPERATIONS (START 1/2017) 157599 0 26743 0 3871 0 10353 0 17694 0 216260 0 0 0 CAROL KARP ASSISTANT TREASURER/CFO (END 3/2017) 0 347639 0 131276 0 34297 0 13250 0 16129 0 542591 0 0 GARY KNIGHT ASSISTANT SECRETARY 0 336428 0 136705 0 58034 0 17225 0 17234 0 565626 0 0 CARLA J YOST CHIEF NURSING OFFICER-VCH 0 281782 0 63203 0 23025 0 13962 0 21254 0 403226 0 0 ALI HAMMAD MD PHYSICIAN 897041 0 106933 0 4996 0 15900 0 23427 0 1048297 0 0 0 BASHAR MARJI MD PHYSICIAN 858966 0 151250 0 1743 0 14575 0 23861 0 1050395 0 0 0 BOBAN N MATHEW MD PHYSICIAN 507296 0 0 0 4996 0 17225 0 25616 0 555133 0 0 0 MARY K REED MD PHYSICIAN 444270 0 9588 0 6902 0 6625 0 23730 0 491115 0 0 0 ANDREW J WHITE MD PHYSICIAN 444794 0 91000 0 936 0 10353 0 22934 0 570017 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Via Christi Health, Inc., a related organization of Via Christi Hospital Pittsburg, Inc., uses the following to establish the compensation of the organization's Top Management Official: - Compensation committee - Independent Compensation Consultant - Compensation Survey or Study - Approval by the Board or Compensation Committee Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan 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 unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following individuals received payment from the supplemental nonqualified retirement plan in the amount as noted: DAVID HADLEY - $498,310 Form 990, Part IV, Line 20b Explanation of Financial Statements THE ACTIVITY OF VIA CHRISTI HOSPITAL PITTSBURG, INC. IS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. NO INDIVIDUAL AUDIT OF VIA CHRISTI HOSPITAL PITTSBURG, INC. IS COMPLETED. THEREFORE, THE ATTACHED AUDITED FINANCIAL STATEMENTS ARE OF ASCENSION HEALTH ALLIANCE AND AFFILIATES, WHICH INCLUDE THE ACTIVITY OF VIA CHRISTI HOSPITAL PITTSBURG, INC. Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL In determining the compensation of the Organization's Top Management Official, the process performed by Via Christi Health, Inc., a related organization of Via Christi Hospital Pittsburg, Inc., included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the Top Management Offical was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the Committee minutes. The individual was not present when his compensation was decided. Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS, THE PROCESS PERFORMED BY VIA CHRISTI HEALTH, INC., A RELATED ORGANIZATION OF VIA CHRISTI HOSPITAL PITTSBURG, INC., INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE VIA CHRISTI HEALTH, INC. EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 6 Classes of members or stockholders Via Christi Hospital Pittsburg, Inc. has a single corporate member, Via Christi Health, Inc. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Via Christi Hospital Pittsburg, Inc. has a single corporate member, Via Christi Health, Inc., who has the ability to elect members to the governing body of Via Christi Hospital Pittsburg, Inc. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to Via Christi Hospital Pittsburg, Inc.'s Financial information or corporation as a whole are subject to approval by its sole corporate member, Via Christi Health, Inc. Form 990, Part VI, Line 11b Review of form 990 by governing body DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. Form 990, Part VI, Line 12c Conflict of interest policy The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Line 19 Required documents available to the public The Organization will provide any documents open to public inspection upon request. Form 990, Part VII, Section A Compensation Sister Marie Veronica Janousek receives compensation from Via Christi Hospital Wichita, Inc. Her compensation is not paid directly to her but is paid to her religious order in accordance with her vow of poverty. Sister Susanne Daniels receives compensation from Via Christi Hospital Wichita, Inc. Her compensation is not paid directly to her but is paid to her religious order in accordance with her vow of poverty. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Education Revenue - Total Revenue: 25377, Related or Exempt Function Revenue: 25377, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Durable Medical Equipment - Total Revenue: 38122, Related or Exempt Function Revenue: , Unrelated Business Revenue: 38122, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Medical Records - Total Revenue: 21321, Related or Exempt Function Revenue: 21321, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Meals on Wheels - Total Revenue: 45126, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 45126; Vending - Total Revenue: 6652, Related or Exempt Function Revenue: 6652, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Pharmacy - Total Revenue: 812, Related or Exempt Function Revenue: 500, Unrelated Business Revenue: 312, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Fitness Center (employees only) - Total Revenue: 4504, Related or Exempt Function Revenue: 4504, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Sterilization - Total Revenue: 5163, Related or Exempt Function Revenue: 3248, Unrelated Business Revenue: 1915, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Clinical Care Trials - Total Revenue: 6475, Related or Exempt Function Revenue: 6475, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Scrap Sales - Total Revenue: 988, Related or Exempt Function Revenue: 988, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Sports Therapy - Total Revenue: 22841, Related or Exempt Function Revenue: 22841, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Cardiac Cards - Total Revenue: 3392, Related or Exempt Function Revenue: 3392, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Forensics Revenue - Total Revenue: 7075, Related or Exempt Function Revenue: 7075, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Carevan Revenue - Total Revenue: 563, Related or Exempt Function Revenue: 563, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Unclaimed Exempt Checks - Total Revenue: 19236, Related or Exempt Function Revenue: 19236, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Trimedx Refund - Total Revenue: 22482, Related or Exempt Function Revenue: 22482, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Incentive payments - Total Revenue: 1263, Related or Exempt Function Revenue: 1263, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees Purchased Services - Total Expense: 10750111, Program Service Expense: 10501594, Management and General Expenses: 248517, Fundraising Expenses: ; Other - Total Expense: 73770, Program Service Expense: 1723, Management and General Expenses: 72047, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Transfers to/from Affiliates - 17742683; Mount Carmel Foundation Beneficial Interest - 59258; Transfers to/from Affiliate Intercompany - 5502288; Other Comp Income - Pension - -500935; Net Asset Transfer To/From Alpha - -6509392; Form 990, Part XII, Line 2c oversight of audit or selection of independent accountant Via Christi Hospital Pittsburg, Inc. is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole. 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