2016-05-16T16:33:25-05:00 2015-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 CINCINNATI OH 45202 990 2014-07-01 481172106 Via Christi Hospitals Wichita Inc VIAC 3162685000 929 N Saint Francis Wichita KS 67214 CAROL KARP CHIEF FINANCIAL OFFICER 2016-05-16 true REBECCA LYONS P01487105 5137847100 2014 2016-08-17 19:52:53Z SHERRY HAUSMANN 929 N Saint Francis Wichita KS 67214 567911778 false 0928 X https://www.viachristi.org/locations/hospitals X 1995 KS We serve as a healing presence with special concern for our neighbors who are vulnerable. 15 12 6243 605 10515656 4119288 4377957 3384182 534837472 535499863 17410454 12766820 16132112 16159727 572757995 567810592 48812 87750 0 0 251594646 241643777 0 0 0 255327391 279327972 506970849 521059499 65787146 46751093 825167931 728063678 173172385 160764335 651995546 567299343 As part of Via Christi Health, Inc., a Catholic Health System, 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." Via Christi Health System's history extends back over 100 years and today, along with our sponsoring organization, Ascension Health, we continue to respond to community needs in Kansas and Northeastern Oklahoma. false false 392451745 87750 537709886 PROVIDE OUTPATIENT AND INPATIENT SERVICES FOR THE BENEFIT, CARE, AND TREATMENT OF SICK, INJURED, AGED, AND DISABLED PATIENTS OF SOUTH CENTRAL KANSAS AND SURROUNDING AREAS. 392451745 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 true true true false false false false false false false false false false false false true true true true false false true 265 0 true 6243 true true true false false false false false false false false false X 15 12 true false false false true true true true true false false true true true true true true false true true true X JUDY DAVIS 3168584931 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 NOREEN CARROCCI MD CHAIR 1.00 1.00 X X 0 0 0 CHRIS SHANK VICE CHAIR 1.00 1.00 X X 0 0 0 MICHAEL BUKATY SECRETARY 1.00 1.00 X X 0 0 0 DALE BAALMAN TREASURER 1.00 1.00 X X 0 0 0 SHERRY HAUSMANN CHIEF HOSPITAL ADMIN OFFICER 48.00 2.00 X X 0 511373 85924 SHERYL BEARD MD MEDICAL STAFF PRESIDENT (END 12/14) 40.00 0 X 185338 0 31330 SR M FELICIDAD CHAVEZ TRUSTEE 1.00 1.20 X 0 0 0 SR LORETTA MARIE HALL TRUSTEE 1.00 1.20 X 0 0 0 WILLIAM HANNA TRUSTEE 1.00 1.00 X 0 0 0 BRENT LANCASTER MEDICAL STAFF PRESIDENT (START 1/15) 1.00 0 X 0 0 0 SISTER DIANE LEARY TRUSTEE 1.00 1.00 X 0 0 0 DONALD SEERY MD TRUSTEE/PHYSICIAN 40.00 1.00 X 210004 0 31546 JOHN SHELLITO MD TRUSTEE/CMO CLINIC 1.00 49.00 X 0 595306 115931 ROBERT SIMPSON TRUSTEE 1.00 1.00 X 0 0 0 DAVID YOUNG TRUSTEE 1.00 1.00 X 0 0 0 SR PAMELA YOUNG TRUSTEE 1.00 2.00 X 0 0 0 ROBERTA JOHNSON ASSISTANT SECRETARY 1.00 49.00 X 0 280071 51357 CAROL KARP ASSISTANT TREASURER (START 8/14) 1.00 53.00 X 0 158602 9132 JEFF SEIRER ASSISTANT TREASURER 1.00 52.00 X 0 345950 67759 CLAUDIO J FERRARO SR. ADMINISTRATOR-CLINC SVC LN. 5.00 45.00 X 0 356329 63975 LINDA GOODWIN CHIEF NURSING OFFICER 48.00 2.00 X 192839 141380 70658 ART HUBER SR. ADMINISTRATOR FACILITIES 46.00 4.00 X 0 274578 49053 LAURIE LABARCA ADMIN. HOSPITAL OPS 47.00 1.00 X 423100 0 64188 CYNTHIA LAFLEUR SR. ADMIN. POST ACUTE 25.00 25.00 X 0 229753 37203 KEVIN STRECKER SR. ADMINISTRATOR-HOSPITAL 15.00 35.00 X 0 274377 58255 CARLA YOST SR. ADMIN QUAL IMPROVEMENT 48.00 2.00 X 0 238495 45334 RYAN KELLY ADMINSTRATOR SURGICAL SVCS. 40.00 0 X 242547 0 57377 DARRELL YOUNGMAN DO CHIEF MED OFFICER (END 3/15) 48.00 2.00 X 20204 422084 63389 STEVE NESBITT CHIEF MEDICAL OFFICER 50.00 0.00 X 201732 247477 34573 JON C ANDERS MD PHYSICIAN 50.00 0 X 815488 0 49118 DAVID BRYANT MD PHYSICIAN 50.00 0 X 874033 0 55650 ROBERT D STANGL MD PHYSICIAN 50.00 0 X 564537 0 78797 DANIEL R BAKER MD PHYSICIAN 50.00 0 X 498532 0 77397 MATTHEW S TURNER MD PHYSICIAN 50.00 0 X 481026 0 70084 GARY KNIGHT FORMER OFFICER (END 6/13) 0.00 51.00 X 0 435018 128044 CARLETON RIDER CHIEF ADMIN OFFICER 0.00 1.00 X 0 306391 27171 4709380 4817184 1423245 203 true true false ANESTHESIA CONSULTING SERVICES PA PO BOX 356 WICHITA KS 67201 ANESTHESIA SERVICES 5189660 KS PROFESSIONAL ANESTHESIA & PAIN MGMT PO BOX 1761 WICHITA KS 67201 ANESTHESIA SERVICES 2770000 WICHITA SURGICAL SPECIALISTS PA 818 N EMPORIA WICHITA KS 67214 PHYSICIAN COVERAGE 2390307 SHIFTWISE INC CM-9705 PO BOX 70870 ST PAUL MN 55170 CONTRACT LABOR SERVICES 2253412 RENAL TREATMENT CENTERS - WEST INC PO BOX 8500-1607 PHILADELPHIA PA 19178 DIALYSIS SERVICES & SUPPLIES 1499292 73 X 3159258 224924 3384182 Patient Service Revenue 621400 526209312 524207092 2002220 340B Pharmacy Revenue 446110 6441433 6441433 Meaningful Use 621400 2663709 2663709 Continuing Education 611600 185409 185409 0 0 0 0 535499863 12868006 2787108 10080898 1755625 0 1755625 0 1755625 242849 1512776 0 101186 0 -101186 -101186 -101186 Cafeteria/Vending 722320 4834491 126111 4708380 Laboratory Fees 621500 3231049 242547 2988502 Child Development Center 624410 1158482 1158482 5180080 2811214 2368866 0 14404102 567810592 537709886 10515656 16200868 X 39000 39000 48750 48750 1733582 1307121 426461 196349270 177532974 18816296 -10018785 -8206036 -1812749 39421561 33483855 5937706 14158149 12428949 1729200 7031052 0 7031052 240253 0 240253 27890 178 27712 27280 0 27280 120543570 39765205 80778365 0 833288 59184 774104 16635221 13803104 2832117 707856 250690 457166 8784592 8268688 515904 650146 471525 178621 126697 56350 70347 3454798 0 3454798 27401886 26138302 1263584 4374599 424127 3950472 MEDICAL SUPPLIES 80324622 80324622 0 Medicaid State Assessment 7052134 7052134 0 Income Tax Expense 912046 0 912046 Books & Subscriptions 631474 98139 533335 -431432 -895116 463684 0 521059499 392451745 128607754 0 8246351 6180036 64763671 80886041 0 0 0 48469 109753 13796482 13148348 984001 908950 269269925 50622635 210324794 218647290 0 0 977753 429617 526026410 407753643 825167931 728063678 54734231 43909255 140020 297845 0 33914 23091 118264220 116534144 173172385 160764335 X 651995546 567299343 651995546 567299343 825167931 728063678 X 46751093 -15361218 -116086078 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 29548 29548 false Schedule C, Part II-B, Line 1 Lobbying Activities Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Via Christi Hospitals Wichita, 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. 5701378 5701378 155643827 19421727 136222100 9534 2864 6670 88935725 30652442 58283283 18979461 545602 18433859 218647290 DUE TO RELATED PARTIES 37377758 MISC. ACCOUNTS RECEIVABLES 3202474 PREPAID PENSION - LONG TERM 25696435 PY & CY Settlement - Medicare/Medicaid 4943744 CSI RECIEVABLES 1161584 DEFERRED COMPENSATION INVESTMENT 297845 INTEREST IN INVESTMENTS HELD BY ASCENSION HEALTH ALLIANCE 322957392 LIFE INSURNACE - CASH VALUE 100079 INVESTMENT IN SUBSIDIARIES 12016332 407753643 NOTES PAYABLE VCHS CURRENT 1398635 NOTES PAYABLE VCHS LONG TERM 112594945 RETIREMENT BENEFITS PAYABLE 100080 FROZEN SICK PAYABLE 215241 ASSET RETIREMENT OBLIGATION 2225243 116534144 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote From the consolidated audited financial statements of Ascension Health Alliance and its member organizations ("The System"), which include the activity of Via Christi Hospitals Wichita, Inc.: 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, 2015. true true X true X true X true true true false true true 35647998 0 35647998 0.0684 80660058 78223196 2436862 0.0047 0 0 0 0.0 0 0 116308056 78223196 38084860 0.0731 651165 67302 583863 0.0011 26594942 10761344 15833598 0.0304 1810868 1380066 430802 0.0008 212648 0 212648 0.0004 195987 0 195987 0.0004 0 0 29465610 12208712 17256898 0.0331 0 0 145773666 90431908 55341758 0.1062 4233 4233 0.0000 163 163 0.0000 4585 4585 0.0000 1396 1396 0.0000 0 0.0 0 0.0 0 0.0 17655 17655 0.0000 0 0.0 0 0 28032 0 28032 0.0001 false 39753325 0 155514138 168993600 -13479462 X true true KANSAS HEART HOSPITAL LLC CARDIAC ACUTE CARE HOSPITAL 0.49 0.51 3 1 Via Christi Hospitals Wichita Inc https://www.viachristi.org/locations/hospitals Kansas H-087-001 X X X X X A 2 Via Christi Hospitals Wichita Inc https://www.viachristi.org/locations/hospitals Kansas H-087-001 X X X X X A 3 Via Christi Behavioral Health Center https://www.viachristi.org/locations/hospitals Kansas H-087-001 X X IP and OP Psych A A false false true X X X X X X X X X 13 true true true true X https://www.viachristi.org/sites/default/files/pdf/about_us/2013_Community_Needs%20Assessment_Vol.%2 X https://www.viachristi.org/about-via-christi/mission/community-benefit X true 14 false true false true X 2.0 4.0 X X true true X X X X true X HTTPS://WWW.VIACHRISTI.ORG/SITES/DEFAULT/FILES/PDF/BILLING/FAA%20PROP OSED%2010-29-14.PDF X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - Via Christi Hospitals Wichita, Inc. - Francis. A random sample of 7,300 Sedgwick, Butler, Harvey, Reno and Sumner County households was selected. Pre-survey postcards were mailed via first class mail on January 7, 2013, informing potential respondents about the CHNA, asking them to watch for and complete their surveys and giving them the opportunity to request the survey in Spanish or Vietnamese, if preferred. In addition, in an effort to draw upon the recognition and reputation of individuals in Sedgwick, Butler, Harvey, Reno and Sumner counties, community leaders were identified by nonprofit health and human services agencies by asking each executive director to identify up to ten community leaders they believed should be surveyed to gauge the community's pulse as it pertains to the area's health and human service needs. All community leaders identified by at least two agency executive directors were included in the survey research. They included nonprofit health and human services agencies executive directors, as well as presidents/chief executive officers of the area's largest employers, local elected and appointed government officials, public school district superintendents and board presidents were invited to participate. Surveys were mailed out to 511 community leaders and the response rate was 28.1 percent. To get a feeling of real community needs that are being addressed by local not-for-profit and government agencies, using the United Way of the Plains 2-1-1 database, United Way of Reno County contact list and the membership list of the Coalition of Community Health Clinics for Wichita-Sedgwick County, 262 executive directors of programs dealing with poor and/or vulnerable populations were asked to participate in the survey effort. The response rate from this target group was 32.6 percent. Schedule H, Part V, Section B, Line 5 Facility A, 2 Facility A, 2 - Via Christi Hospitals Wichita, Inc. - Harry. A random sample of 7,300 Sedgwick, Butler, Harvey, Reno and Sumner County households was selected. Pre-survey postcards were mailed via first class mail on January 7, 2013, informing potential respondents about the CHNA, asking them to watch for and complete their surveys and giving them the opportunity to request the survey in Spanish or Vietnamese, if preferred. In addition, in an effort to draw upon the recognition and reputation of individuals in Sedgwick, Butler, Harvey, Reno and Sumner counties, community leaders were identified by nonprofit health and human services agencies by asking each executive director to identify up to ten community leaders they believed should be surveyed to gauge the community's pulse as it pertains to the area's health and human service needs. All community leaders identified by at least two agency executive directors were included in the survey research. They included nonprofit health and human services agencies executive directors, as well as presidents/chief executive officers of the area's largest employers, local elected and appointed government officials, public school district superintendents and board presidents were invited to participate. Surveys were mailed out to 511 community leaders and the response rate was 28.1 percent. To get a feeling of real community needs that are being addressed by local not-for-profit and government agencies, using the United Way of the Plains 2-1-1 database, United Way of Reno County contact list and the membership list of the Coalition of Community Health Clinics for Wichita-Sedgwick County, 262 executive directors of programs dealing with poor and/or vulnerable populations were asked to participate in the survey effort. The response rate from this target group was 32.6 percent. Schedule H, Part V, Section B, Line 5 Facility A, 3 Facility A, 3 - Via Christi Behavioral Health Center. A random sample of 7,300 Sedgwick, Butler, Harvey, Reno and Sumner County households was selected. Pre-survey postcards were mailed via first class mail on January 7, 2013, informing potential respondents about the CHNA, asking them to watch for and complete their surveys and giving them the opportunity to request the survey in Spanish or Vietnamese, if preferred. In addition, in an effort to draw upon the recognition and reputation of individuals in Sedgwick, Butler, Harvey, Reno and Sumner counties, community leaders were identified by nonprofit health and human services agencies by asking each executive director to identify up to ten community leaders they believed should be surveyed to gauge the community's pulse as it pertains to the area's health and human service needs. All community leaders identified by at least two agency executive directors were included in the survey research. They included nonprofit health and human services agencies executive directors, as well as presidents/chief executive officers of the area's largest employers, local elected and appointed government officials, public school district superintendents and board presidents were invited to participate. Surveys were mailed out to 511 community leaders and the response rate was 28.1 percent. To get a feeling of real community needs that are being addressed by local not-for-profit and government agencies, using the United Way of the Plains 2-1-1 database, United Way of Reno County contact list and the membership list of the Coalition of Community Health Clinics for Wichita-Sedgwick County, 262 executive directors of programs dealing with poor and/or vulnerable populations were asked to participate in the survey effort. The response rate from this target group was 32.6 percent. Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - Via Christi Hospitals Wichita, Inc.. The 2013 CHNA was conducted in partnership with Via Christi Hospital Wichita St. Teresa, Inc., and Via Christi Rehabilitation Hospital, Inc. Schedule H, Part V, Section B, Line 6a Facility A, 2 Facility A, 2 - Via Christi Hospital Wichita St. Teresa, Inc.. VCH-ST is located on the west side of Wichita, Sedgwick County on a 120-acre campus. The 144,000 square-foot hospital features: - 68 private patient suites - 24/7 emergency room - 6 state-of-the-art operating rooms - Diagnostic imaging and laboratory services - Inpatient pharmacy - Critical care unit - Orthopedics and inpatient rehab - Cardiovascular care Schedule H, Part V, Section B, Line 6a Facility A, 3 Facility A, 3 - Via Christi Rehabilitation Hospital, Inc.. VCRH serves patients in regaining their functional independence following a major illness, trauma or surgery. The specialized facility offers comprehensive inpatient and outpatient therapy for children, including toddlers, and adults, and provides rehabilitation treatment for stroke, spinal cord injuries, limb loss, orthopedic issues and brain injuries. Individualized therapy programs consisting of at least three hours of therapy per day are offered. A comprehensive range of medical services are provided, including full-time physician supervision. Schedule H, Part V, Section B, Line 6b Facility A, 1 Facility A, 1 - The United Way of the Plains. The three focus areas of The United Way of the Plains is education, income and health. They have been conducting community needs assessments since 1985 and are seen as the leader in assessments in the South Central Kansas area. It seemed like a natural choice to join forces with them and the Sedgwick County Health Department in conducting our CHNA. Schedule H, Part V, Section B, Line 6b Facility A, 2 Facility A, 2 - Sedgwick County Department of Health. In 2009, Sedgwick County Health Department started an annual data book and health priorities report looking at access to health care, obesity and diabetes, mental health, oral health and health disparities. Instead of having three separate reports, colleagues got together to establish one CHNA for the area. Sedgwick County Health Department only focuses on Sedgwick County whereas, the CHNA covers multiple counties in and around Wichita, Kansas. Schedule H, Part V, Section B, Line 6b Facility A, 3 Facility A, 3 - Via Christi Health, Inc.. Via Christi Health, Inc.'s rich history of serving the people of Kansas and the surrounding region dates back more than 100 years to the healing ministries of our founding congregations. Today, Via Christi Health, Inc. is the largest provider of healthcare services in Kansas. We serve Kansas and northeast Oklahoma through our doctors, hospitals, and health services. Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - Via Christi Hospitals Wichita, Inc. - Francis. 1) Health insurance - VCH-W provides treatment to all people who come in needing assistance, regardless of their ability to pay. However, once in the door, a case manager will work with each patient to see if they qualify for traditional charity care and/or a government program. If they do, the patient is signed up immediately and strongly encouraged to find a medical home if they do not currently have one. 2) Basic medical care for low-income - VCH-W, like all VCH Hospitals, work with the patient and/or their family to make sure they receive treatment when presenting at the hospital. Prior to discharge, a case manager identifies basic medical care options with the patient/caregiver and provides them with application forms and contact numbers. In addition, if the patient needs assistance filling out the forms or is wanting more information, our case managers willing assist them to ensure a smooth transition, including patient call back to see if recommendations have been followed. 3) Treatment for life-threatening diseases - VCH-W works with each patient, their caregiver and primary physician to develop a treatment plan prior to being discharged from the hospital. If the patient does not have a primary care physician, a case manager works with the patient in finding one prior to their dismissal. Case navigators are being assigned to patients who have multiple chronic diseases so their healthcare can be better monitored to avoid hospitalization. In one case, an indigent patient who had to be transported to a specialty hospital out of state for a life-saving surgery cost Via Christi over $172,000. 4) Assistance with prescriptions for low-income - Via Christi is a part of the Dispensary of Hope Program in which Via Christi's Pharmacy pays an annual fee to access prescription drugs at a discount, and those that qualify through household income can qualify for free or reduced costs. 5) Counseling/mental health services - VCH-W staff works closely with Via Christi Behavioral Health staff and COMCARE in getting referrals to patients who present themselves to the Emergency Room in crisis. Patients who are in need of hospitalization are stabilized in the Emergency Room and are then transferred to Via Christi Behavioral Health Center or elsewhere for further treatment when required. In addition, VCH-W staff participate on numerous community boards (e.g. Grace Med Health, Guadalupe Clinic, Independent Living Resource Center and others) to ensure that people who are medically vulnerable or are indigent can get access to health care. 6) Preparing young people for the workforce - VCH-W, besides offering volunteer opportunities for young adults who are interested in learning more about health care careers, also participate in high school career fairs to promote various health care occupations and the importance of staying in school to get their diplomas. St. Gianna's Academy is an on-site partnership between VCH-W and the Catholic Diocese in Wichita in which junior and senior high school students from Bishop Carroll and Kapaun/Mt. Carmel compete for positions in this pre-med major academy for high school science credits. The number of St. Gianna's Academy graduates who enter college is nearly 100% and, equally impressive is the number of these graduates who go on to become health care practitioners. It's one way that VCH-W is growing it's own workforce through partnering with the Catholic high schools in town. 7) Juvenile delinquency/gang prevention - Via Christi Behavioral Health Center staff have become involved with various school districts by offering educational classes to teachers on dealing with "bullies." This anti-bullying campaign has come about through the increase of social media bullying and an uptick in teen suicides. While not directly related to gang violence, research has shown that bullies tend to hang in groups and victimize youth who are vulnerable in size, demeanor or social class. Schedule H, Part V, Section B, Line 11 Facility A, 2 Facility A, 2 - Via Christi Hospitals Wichita, Inc. - Harry. 1) Health insurance - VCH-W provides treatment to all people who come in needing assistance, regardless of their ability to pay. However, once in the door, a case manager will work with each patient to see if they qualify for traditional charity care and/or a government program. If they do, the patient is signed up immediately and strongly encouraged to find a medical home if they do not currently have one. 2) Basic medical care for low-income - VCH-W, like all VCH Hospitals, work with the patient and/or their family to make sure they receive treatment when presenting at the hospital. Prior to discharge, a case manager identifies basic medical care options with the patient/caregiver and provides them with application forms and contact numbers. In addition, if the patient needs assistance filling out the forms or is wanting more information, our case managers willing assist them to ensure a smooth transition, including patient call back to see if recommendations have been followed. 3) Treatment for life-threatening diseases - VCH-W works with each patient, their caregiver and primary physician to develop a treatment plan prior to being discharged from the hospital. If the patient does not have a primary care physician, a case manager works with the patient in finding one prior to their dismissal. Case navigators are being assigned to patients who have multiple chronic diseases so their healthcare can be better monitored to avoid hospitalization. In one case, an indigent patient who had to be transported to a specialty hospital out of state for a life-saving surgery cost Via Christi over $172,000. 4) Assistance with prescriptions for low-income - Via Christi is a part of the Dispensary of Hope Program in which Via Christi's Pharmacy pays an annual fee to access prescription drugs at a discount, and those that qualify through household income can qualify for free or reduced costs. 5) Counseling/mental health services - VCH-W staff works closely with Via Christi Behavioral Health staff and COMCARE in getting referrals to patients who present themselves to the Emergency Room in crisis. Patients who are in need of hospitalization are stabilized in the Emergency Room and are then transferred to Via Christi Behavioral Health Center or elsewhere for further treatment when required. In addition, VCH-W staff participate on numerous community boards (e.g. Grace Med Health, Guadalupe Clinic, Independent Living Resource Center and others) to ensure that people who are medically vulnerable or are indigent can get access to health care. 6) Preparing young people for the workforce - VCH-W, besides offering volunteer opportunities for young adults who are interested in learning more about health care careers, also participate in high school career fairs to promote various health care occupations and the importance of staying in school to get their diplomas. St. Gianna's Academy is an on-site partnership between VCH-W and the Catholic Diocese in Wichita in which junior and senior high school students from Bishop Carroll and Kapaun/Mt. Carmel compete for positions in this pre-med major academy for high school science credits. The number of St. Gianna's Academy graduates who enter college is nearly 100% and, equally impressive is the number of these graduates who go on to become health care practitioners. It's one way that VCH-W is growing it's own workforce through partnering with the Catholic high schools in town. 7) Juvenile delinquency/gang prevention - Via Christi Behavioral Health Center staff have become involved with various school districts by offering educational classes to teachers on dealing with "bullies." This anti-bullying campaign has come about through the increase of social media bullying and an uptick in teen suicides. While not directly related to gang violence, research has shown that bullies tend to hang in groups and victimize youth who are vulnerable in size, demeanor or social class. Schedule H, Part V, Section B, Line 11 Facility A, 3 Facility A, 3 - Via Christi Behavioral Health Center. 1) Health insurance - VCH-W provides treatment to all people who come in needing assistance, regardless of their ability to pay. However, once in the door, a case manager will work with each patient to see if they qualify for traditional charity care and/or a government program. If they do, the patient is signed up immediately and strongly encouraged to find a medical home if they do not currently have one. 2) Basic medical care for low-income - VCH-W, like all VCH Hospitals, work with the patient and/or their family to make sure they receive treatment when presenting at the hospital. Prior to discharge, a case manager identifies basic medical care options with the patient/caregiver and provides them with application forms and contact numbers. In addition, if the patient needs assistance filling out the forms or is wanting more information, our case managers willing assist them to ensure a smooth transition, including patient call back to see if recommendations have been followed. 3) Treatment for life-threatening diseases - VCH-W works with each patient, their caregiver and primary physician to develop a treatment plan prior to being discharged from the hospital. If the patient does not have a primary care physician, a case manager works with the patient in finding one prior to their dismissal. Case navigators are being assigned to patients who have multiple chronic diseases so their healthcare can be better monitored to avoid hospitalization. In one case, an indigent patient who had to be transported to a specialty hospital out of state for a life-saving surgery cost Via Christi over $172,000. 4) Assistance with prescriptions for low-income - Via Christi is a part of the Dispensary of Hope Program in which Via Christi's Pharmacy pays an annual fee to access prescription drugs at a discount, and those that qualify through household income can qualify for free or reduced costs. 5) Counseling/mental health services - VCH-W staff works closely with Via Christi Behavioral Health staff and COMCARE in getting referrals to patients who present themselves to the Emergency Room in crisis. Patients who are in need of hospitalization are stabilized in the Emergency Room and are then transferred to Via Christi Behavioral Health Center or elsewhere for further treatment when required. In addition, VCH-W staff participate on numerous community boards (e.g. Grace Med Health, Guadalupe Clinic, Independent Living Resource Center and others) to ensure that people who are medically vulnerable or are indigent can get access to health care. 6) Preparing young people for the workforce - VCH-W, besides offering volunteer opportunities for young adults who are interested in learning more about health care careers, also participate in high school career fairs to promote various health care occupations and the importance of staying in school to get their diplomas. St. Gianna's Academy is an on-site partnership between VCH-W and the Catholic Diocese in Wichita in which junior and senior high school students from Bishop Carroll and Kapaun/Mt. Carmel compete for positions in this pre-med major academy for high school science credits. The number of St. Gianna's Academy graduates who enter college is nearly 100% and, equally impressive is the number of these graduates who go on to become health care practitioners. It's one way that VCH-W is growing it's own workforce through partnering with the Catholic high schools in town. 7) Juvenile delinquency/gang prevention - Via Christi Behavioral Health Center staff have become involved with various school districts by offering educational classes to teachers on dealing with "bullies." This anti-bullying campaign has come about through the increase of social media bullying and an uptick in teen suicides. While not directly related to gang violence, research has shown that bullies tend to hang in groups and victimize youth who are vulnerable in size, demeanor or social class. 8 Via Christi Cancer Center 817 N Emporia Wichita KS 67214 Cancer Center Via Christi Cyberknife Center 825 N Emporia Wichita KS 67214 Cyberknife Cancer Treatment Via Christi Wound Center 825 N Emporia WICHITA KS 67214 Wound Center Solutions for Life 6100 E Central WICHITA KS 67208 Medical Research Via Christi Research 1100 N st Francis Wichita KS 67214 Medical Research Via Christi Family Medicine CENTER 707 N Emporia WICHITA KS 67214 Family Practice Clinic Via Christi Family Medicine 1121 s Clifton Wichita KS 67218 Family Practice Clinic Dr Anthony Johnstone 1230 E 6th Winfield KS 67156 Family Practice Clinic Schedule H, Part III, Line 1 BAD DEBT IN ACCORDANCE WITH STATEMENT NO. 15 VCH-W 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 I, Line 6a NAME OF RELATED ORGANIZATIONS THAT PREPARED THE COMMUNITY BENEFIT REPORT 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 Wichita area. Community Benefit Report: Via Christi Hospitals Wichita, Inc. ("VCH-W") is a member of Via Christi Health, Inc. ("VCH"). As a Catholic health system, VCH-W 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-W 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 (2012). 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-W'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, 2015 Community Benefit: 1. Charity Care, at cost: $46.2 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): $15.5 million 3. Community Benefit programs, net expense: $20.8 million 4. Total Quantifiable Community Benefit: $82.5 million Schedule H, Part I, Line 7g Subsidized Health Services Subsidized health services - Net losses by the VCH-W Family Practice and Specialty Clinics are reported here. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost of providing charity care, means tested government programs, and 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 certain categories in the table, this was a cost accounting system; in other categories, such as Financial Assistance and Medicaid, a specific cost-to-charge ratio was calculated and applied. Schedule H, Part II Community Building Activities As active members of the chamber and other networking coalitions, staff is in position to assist in the recruitment of new health care providers wanting to move into the geographic area resulting in more access to healthcare providers for all residents. In addition, engaging in community building organizations that increase economic development in the area, provide community support, provide leadership development and training for community members and promote workforce development, also helps to encourage young professionals to look at the variety of health care career options available to them through area colleges and technical schools. Via Christi Hospitals Wichita, Inc. offer high school youth a specific program - St. Gianna's Academy, which allows pre-med science majors an opportunity to see first hand the various health care career choices they can make once they graduate from high school. Involvement in this program has resulted in over 75% of the students becoming health care professionals (doctors, nurses, physical therapists, pharmacists, etc.). 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-W 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 VCH-W has a very robust financial assistance program; 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 Hospitals Wichita, 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-W's bad debt deduction was $39,753,325 at charges and $8,798,842 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-W 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, and Line 7 for reporting Medicare shortfall does not take into account all costs incurred by VCH-W and does not represent the total Medicare shortfall. The Medicare shortfall reported on Schedule H, Part III, Section B, and 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 $11,275,327. 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-W to promote socially just practices for billing and collections for all patients receiving care. The policy is intended to further VCH-W's mission by requiring ethical conduct in billing and collecting self-pay balances from patient/guarantor's 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-W 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-W 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-W'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 A - Via Christi Behavioral Health Center: 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 A - Via Christi Hospitals Wichita, Inc.: Line 16b URL: HTTPS://WWW.VIACHRISTI.ORG/SITES/DEFAULT/FILES/PDF/BILLING/FAA%20PROP OSED%2010-29-14.PDF; A - Via Christi Behavioral Health Center: Line 16b URL: HTTPS://WWW.VIACHRISTI.ORG/SITES/DEFAULT/FILES/PDF/BILLING/FAA%20PROPOSED%2010-29-14.PDF; Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - Via Christi Behavioral Health Center: Line 16c URL: HTTPS://WWW.VIACHRISTI.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCE/FINANCIAL-ASSISTANCE; Schedule H, Part VI, Line 2 Needs assessment In addition to the CHNAs conducted every 3 years by the hospital, VCH-W makes use of other research conducted in the community (e.g. Sedgwick County Health Department's annual plan, the United Way's Environmental Scan, up-to-date downloads from the Census Bureau, as well as Kansas University's Institute for Policy and Social Research). Specific research may be conducted when applying for grants and targeted research focusing on patients who come into our Emergency Rooms and/or other departments are useful in looking at population health trends. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance All patients registered at Via Christi Hospitals Wichita, Inc. receive a Patient Admissions Brochure which includes information on the financial assistance policy and how to contact a financial counselor. Signage is also posted in each registration area. Financial assistance information is also provided on the Via Christi website. The information included in the brochure is: "At Via Christi Hospital, patients receive necessary medical care regardless of their ability to pay. Services are provided without regard to culture, age, gender, race, color, national origin, sexual orientation, spiritual beliefs socioeconomic status, language or disability. Trained financial counselors are available to discuss individual needs. We will review your eligibility for financial assistance and assist you in making payment arrangements". Schedule H, Part VI, Line 4 Community information The primary counties for Via Christi Hospitals Wichita, Inc. include Sedgwick and Butler Counties. Sedgwick County has a land area of 998 square miles with an estimated 2014 population of 508,803. Butler County has a land area of 1,430 square miles with an estimated 2014 population of 66,227. Sedgwick County's racial breakout includes 81.0% white, 9.5% Black, 1.4% American Indian, 4.4% Asian and 13.9% persons of Hispanic or Latino origin. The diversity of the population in Sedgwick County is greater than for either Butler County or the State of Kansas as a whole. Racial breakout for Butler County include: 93.6% white, 1.9% Black, 1.1% American Indian, 1.0% Asian persons, and 4.5% persons of Hispanic or Latino origin. It was reported by 13.6% of Sedgwick County and 3.2% of Butler County residents that a language other than English is spoken at home. When it comes to education, 88.6% of Sedgwick County residents completed high school and 28.7% had a bachelor's degrees or higher. This compares to 92.8% for high school graduates and 26.7% bachelor's degrees or higher for Butler County. Median household income for Sedgwick County residents between the years of 2009-2013 was $49,865 compared to $56,454 for Butler County. The median value of owner- occupied housing units, during the same time period in Sedgwick County, was $124,000 compared to $127,800 for Butler County residents. Sedgwick County reports 15.3% of its residents are below poverty level compared to 8.4% for Butler County. The Statewide poverty level is around 13.7%. Schedule H, Part VI, Line 5 Promotion of community health VCH-W enriches the Wichita area through a community board, open medical staff, and taking care of patients regardless of their ability to pay. Community representation of the Governing Body - where the majority of its members are external members comprised of persons who reside in or around Sedgwick County and has overall responsibility for the charitable mission of the organization as set forth in its Articles of Incorporation and Bylaws, These trustees represent areas of expertise in areas of 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. Open Medical Staff - The medical staff is open with over 1,100 physicians having medical privileges at Via Christi Hospitals in Wichita, including VCH-W. Approximately 300 of these physicians are employed through Via Christi Clinics. Primary care physicians are providing medical home services to Medicare and Medicaid patients, especially those with multiple chronic diseases. Community Boards/Committees/Coalitions - VCH-W staff participates in the community on boards and committees of other not-for-profit organizations, government entities, foundations, area colleges and university committees, state-wide coalitions and national healthcare related not-for-profit organizations. Via Christi Hospitals Wichita, Inc. has representatives who regularly serve in some capacity to fulfill the missions of the following organizations located in Sedgwick County: Safe Kids Wichita Area Coalition, South Central Regional Trauma Council, Drowning Prevention Coalition, American Heart Association, StepStone and Dear Neighbor Board, Butler Community College Nursing Advisory Council, Central Plains Regional Healthcare Foundation, Kansas High School Athletic Association Sports Medicine Advisory Committee, YMCA Board, American Lung Association/COPD Committee, Family Life/Natural Family Planning Committee, Grace Med Clinic, Guadalupe Clinic, Wichita Center for Graduate Medical Education, Independent Living Resource Center and more. VCH-W encourages participation of outside non-profit groups to use their ministries to promote their missions, such as Newman University and Wichita State University nursing students, employees of the State's Medicaid enrollment program, University of Kansas Psychiatry clerkship, American Red Cross blood donation program and others. In addition, VCH-W provides rent subsidies for Sedgwick County's EMS vehicles, GraceMed Clinic (FQHC), Ronald McDonald House, St. Gianna's Academy and other not-for-profit groups needing space to hold their meetings, trainings and/or routine work. VCH-W staff present numerous educational talks during the course of the year on various topics dealing with health related issues for news media wanting to inform the public about specific illnesses, breastfeeding clinics for new moms or newborns who are having difficulty in grasping the nursing technique, critical access hospitals and first responders who have to deal with burn victims, the general public on health prevention and wellness activities, students from grade school to college age on avoiding the spreading of the common cold, car seat check clinics, bicycle safety, appropriate touching, bullying, human trafficking, and workforce careers. VCH-W was presented with a Community Service Award by U.S. Attorney Barry Grissom for VCH-W staff training to help identify and help victims of human trafficking and for its groundbreaking work with health care providers and partnership with law enforcement. For review of VCH-W on this topic, go to http: www.viachristi.org/about-via-christi/mission/human-trafficking-initiative. Schedule H, Part VI, Line 6 Affiliated health care system VCH-W 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, durable medical equipment and senior facilities). 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 and research. The organizations work together to serve their communities at the local regional, state and national level. Ascension Health Alliance, d/b/a Ascension (Ascension), is a Missouri nonprofit corporations 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 23 States and the District of Columbia. Ascension is sponsored by Ascension Sponsor, a Public Juridic Person. The Participating 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. true Central Plains Health Care Partnership Inc 1102 South Hillside Wichita KS 67211 481200868 501(c)3 35000 Project Access 1 0 SCHOLARSHIPS 57 48750 Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant Funds Scholarships are given to both employees and non-employees who are accepted into an approved degree program in the last year to two years before graduation. Scholarships are monitored through the education department staff. Scholarships are renewable each semester. To renew the scholarship, students must submit a completed renewal application, a copy of their pre-registration schedule for the upcoming semester, and a copy of their current course grades upon completion of each semester. Students must maintain a 3.0 GPA and be a resident of Kansas and a citizen or national of the United States. Students who choose not to renew their scholarship or are ineligible to renew their scholarship must continue to submit their pre-registration schedule for the upcoming semester and a copy of their current course grades upon completion of each semester to ensure they are continuing in their course of study. If students drop out of a program, all scholarship monies are immediately due and payable back to the Hospital. Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. Scholarships are given to both employees and non-employees who are accepted into an approved degree program in the last year to two years before graduation. Scholarships are monitored through the education department staff. Scholarships are renewable each semester. To renew the scholarship, students must submit a completed renewal application, a copy of their pre-registration schedule for the upcoming semester, and a copy of their current course grades upon completion of each semester. Students must maintain a 3.0 GPA and be a resident of Kansas and a citizen or national of the United States. Students who choose not to renew their scholarship or are ineligible to renew their scholarship must continue to submit their pre-registration schedule for the upcoming semester and a copy of their current course grades upon completion of each semester to ensure they are continuing in their course of study. If students drop out of a program, all scholarship monies are immediately due and payable back to the Hospital. false true false false false false false false false CARLETON RIDER CHIEF ADMIN OFFICER 0 247130 0 0 0 59261 0 26085 0 1086 0 333562 0 0 SHERRY HAUSMANN CHIEF HOSPITAL ADMIN OFFICER 0 400463 0 106084 0 4826 0 68686 0 17238 0 597297 0 0 SHERYL BEARD MD MEDICAL STAFF PRESIDENT (END 12/14) 184925 0 0 0 413 0 16754 0 14576 0 216668 0 0 0 DONALD SEERY MD TRUSTEE/PHYSICIAN 207099 0 0 0 2905 0 22052 0 9494 0 241550 0 0 0 JOHN SHELLITO MD TRUSTEE/CMO CLINIC 0 443308 0 131676 0 20322 0 96436 0 19495 0 711237 0 0 GARY KNIGHT FORMER OFFICER (END 6/13) 0 427173 0 0 0 7845 0 113321 0 14723 0 563062 0 0 ROBERTA JOHNSON ASSISTANT SECRETARY 0 215175 0 57129 0 7767 0 42318 0 9039 0 331428 0 19367 CAROL KARP ASSISTANT TREASURER (START 8/14) 0 119270 0 0 0 39332 0 5054 0 4078 0 167734 0 0 JEFF SEIRER ASSISTANT TREASURER 0 276864 0 62485 0 6601 0 48628 0 19131 0 413709 0 0 CLAUDIO J FERRARO SR. ADMINISTRATOR-CLINC SVC LN. 0 280316 0 71821 0 4192 0 46545 0 17430 0 420304 0 0 LINDA GOODWIN CHIEF NURSING OFFICER 121194 136880 67233 0 4412 4500 40239 9160 9914 11345 242992 161885 0 0 ART HUBER SR. ADMINISTRATOR FACILITIES 0 216426 0 52594 0 5558 0 32193 0 16860 0 323631 0 0 LAURIE LABARCA ADMIN. HOSPITAL OPS 339669 0 77938 0 5493 0 50128 0 14060 0 487288 0 676 0 CYNTHIA LAFLEUR SR. ADMIN. POST ACUTE 0 185650 0 39387 0 4716 0 30133 0 7070 0 266956 0 0 KEVIN STRECKER SR. ADMINISTRATOR-HOSPITAL 0 223057 0 48271 0 3049 0 39286 0 18969 0 332632 0 0 CARLA YOST SR. ADMIN QUAL IMPROVEMENT 0 187573 0 47490 0 3432 0 29000 0 16334 0 283829 0 0 RYAN KELLY ADMINSTRATOR SURGICAL SVCS. 201596 0 38243 0 2708 0 37911 0 19466 0 299924 0 0 0 DARRELL YOUNGMAN DO CHIEF MED OFFICER (END 3/15) 20204 409927 0 0 0 12157 0 43058 0 20331 20204 485473 0 0 STEVE NESBITT CHIEF MEDICAL OFFICER 195914 146901 0 95737 5818 4839 12912 3988 10312 7361 224956 258826 0 0 JON C ANDERS MD PHYSICIAN 467732 0 346154 0 1602 0 33892 0 15226 0 864606 0 0 0 DAVID BRYANT MD PHYSICIAN 526277 0 346154 0 1602 0 33563 0 22087 0 929683 0 0 0 ROBERT D STANGL MD PHYSICIAN 522237 0 35703 0 6597 0 24307 0 54490 0 643334 0 0 0 DANIEL R BAKER MD PHYSICIAN 469390 0 28246 0 896 0 28906 0 48491 0 575929 0 0 0 MATTHEW S TURNER MD PHYSICIAN 453687 0 26443 0 896 0 17985 0 52099 0 551110 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 HOSPITALS WICHITA, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S SENIOR ADMINISTRATOR: - 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 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. No distributions from the supplemental nonqualified retirement plan were made during the year. Keysop plan-frozen: Eligible executives participated in a frozen supplemental option benefit program that provides for supplemental retirement benefits that was limited to Via Christi Hospital St. Francis Preferred Medical Associate Physicians, Mount Carmel Regional Medical Center and Via Christi Health system executives. The payment of benefits under the program, if any, was linked to the exercise date for the options or to earned dividends on the options. Executives were vested in full when the options were granted. The amount ultimately paid under the program to executives receiving net option value is reported on Form 990, Schedule J, Part II, Column F. The following individuals received a distribution from the Keysop plan in the amount listed below: Laurie Labarca - $572 Roberta Johnson - $19,367 Form 990, Part IV, Line 20b Explanation of Financial Statements The activity of Via Christi Hospitals Wichita, Inc. (VCH-W) is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of VCH-W is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of VCH-W. Form 990, Part VI, Line 2 Business/Family Relationships Amongst Interested Persons MANY OF THE PERSONS LISTED ON PART VII HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF EMPLOYMENT BY VIA CHRISTI HEALTH, INC. RELATED ENTITIES. Form 990, Part VI, Line 15 Compensation VIA CHRISTI HOSPITALS WICHITA, INC. USES THE POLICIES ESTABLISHED BY VIA CHRISTI HEALTH, INC. (VCH). VCH HAS ESTABLISHED A COMMON PHILOSOPHY, STRATEGY, AND PROCESS 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, HOSPITALS, 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 BE 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, Line 6 Classes of members or stockholders Via Christi Hospitals Wichita, 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 Hospitals Wichita, Inc. has a single corporate member, Via Christi Health, Inc., who has the ability to elect members to the governing body of Via Christi Hospitals Wichita, Inc. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to Via Christi Hospitals Wichita, Inc. 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 Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough 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, Line 12c Conflict of interest policy The Conflict of Interest Policy is monitored/enforced as part of the system-wide procedures of Via Christi Health, Inc. and is not handled at the organizational level. The policy is monitored and enforced 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, Line 19 Required documents available to the public Via Christi Hospitals Wichita, Inc.'s governing documents and Conflict of Interest Policy are available to the public upon request. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other Revenue - Total Revenue: 5180080, Related or Exempt Function Revenue: 2811214, Unrelated Business Revenue: 2368866, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees Contract Labor - Total Expense: 2557652, Program Service Expense: 1747387, Management and General Expenses: 810265, Fundraising Expenses: ; Program Service - Total Expense: 63057171, Program Service Expense: 0, Management and General Expenses: 63057171, Fundraising Expenses: ; Purchased Services - Total Expense: 15157923, Program Service Expense: 14609096, Management and General Expenses: 548827, Fundraising Expenses: ; Professional Fees - Total Expense: 26495563, Program Service Expense: 20704703, Management and General Expenses: 5790860, Fundraising Expenses: ; Other Expenses - Total Expense: 13275261, Program Service Expense: 2704019, Management and General Expenses: 10571242, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Foundation Released Funds - 811980; Pension - -7076916; Transfer between Entities & Ascension - -XXX-XX-XXXX; VIA CHRISTI EMERGENCY PHYSICIAN SERVICES LLC 929 N SAINT FRANCIS WICHITA KS 67214 450528343 PHYSICIAN SERVICES KS -4616553 2533 VIA CHRISTI HOSPITALS WICHITA INC ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 63145 453358926 NATIONAL HEALTH SYSTEM MO 501(c)(3 Type I NA false ASCENSION HEALTH PO BOX 45998 ST LOUIS MO 63145 311662309 NATIONAL HEALTH SYSTEM MO 501(c)(3 Type I ASCENSION HEALTH ALLIANCE false VIA CHRISTI HEALTH INC 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 481172107 HEALTH SYSTEM PARENT KS 501(c)(3 Type III-FI ASCENSION HEALTH false VIA CHRISTI HOSPITAL PITTSBURG INC 1 MT CARMEL WAY PITTSBURG KS 66762 480543778 HOSPITAL KS 501(c)(3 3 VIA CHRISTI HEALTH INC true MOUNT CARMEL FOUNDATION INC 1 MT CARMEL WAY PITTSBURG KS 66762 480961283 FOUNDATION KS 501(c)(3 Type I VIA CHRISTI HOSPITAL PITTSBURG INC true VIA CHRISTI HOSPITAL WICHITA ST TERESA INC 14800 W ST TERESA WICHITA KS 67235 271965272 HOSPITAL KS 501(c)(3 3 VIA CHRISTI HEALTH INC true GERARD HOUSE INC 3144 N HOOD WICHITA KS 67204 481049532 HOSPITAL SUPPORT KS 501(c)(3 9 VIA CHRISTI HOSPITALS WICHITA INC true VIA CHRISTI REHABILITATION HOSPITAL INC 1151 N ROCK ROAD WICHITA KS 67206 481158274 REHABILITATION HOSPITAL KS 501(c)(3 3 VIA CHRISTI HOSPITALS WICHITA INC true 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 true VIA CHRISTI HEALTH PARTNERS INC 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 480958974 MANAGEMENT COMPANY KS 501(c)(3 9 VIA CHRISTI HEALTH INC true Via Christi Hospital Manhattan Inc 1823 COLLEGE AVENUE MANHATTAN KS 66502 481186704 HOSPITAL KS 501(c)(3 3 VIA CHRISTI HEALTH INC true MERCY COMMUNITY HEALTH FOUNDATION INC PO BOX 13 MANHATTAN KS 66502 481152279 FOUNDATION KS 501(c)(3 9 Via Christi Hospital Manhattan Inc true WAMEGO HOSPITAL ASSOCIATION INC 711 GENN DRIVE WAMEGO KS 66547 721526400 HOSPITAL KS 501(c)(3 3 Via Christi Hospital Manhattan Inc true MERCY REGIONAL HOME MEDICAL SERVICES LLC 2439 CLAFLIN ROAD MANHATTAN KS 66502 432024491 MEDICAL EQUIPMENT KS 501(c)(3 9 Via Christi Hospital Manhattan Inc true SALINA REGIONAL HOME MEDICAL SERVICES LLC 520 SOUTH SANTA FE AVE SALINA KS 67401 431948057 MEDICAL EQUIPMENT KS 501(c)(3 9 SALINA REGIONAL HEALTH CENTER INC true AMBULATORY SURGERY CENTER LP 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 481114690 SURGERY CENTER KS NA N/A AMS DIAGNOSTICS LLC 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 481223653 RADIOLOGY SERVICES KS NA N/A KANSAS SURGERY AND RECOVERY CENTER LLC 2770 NORTH WEBB ROAD WICHITA KS 67226 481148580 SURGERY CENTER KS NA N/A MR IMAGING CENTER LLC 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 481000538 IMAGING CENTER KS NA N/A ST JOSEPH MRI LLC 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 481007220 IMAGING CENTER KS NA N/A Via Christi Imaging LLC (fka Mercy Imaging LLC) 1823 COLLEGE AVENUE MANHATTAN KS 66502 481251984 RADIOLOGY SERVICES KS NA N/A AFFILIATED MEDICAL SERVICES LABORATORY INC 2916 E CENTRAL WICHITA KS 67214 481239522 MEDICAL LABORATORY KS NA C Corporation true INTEGRATED HEALTHCARE SYSTEMS INC 3311 EAST MURDOCK WICHITA KS 67208 480941549 CLINIC SERVICES KS NA C Corporation true VCH IOWA PC TRUST 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 276937322 BENEFICIARY TRUST IA NA Trust true VCH IOWA PC 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 273983977 PROFESSIONAL ASSOCIATION IA NA C Corporation true VIA CHRISTI CLINIC PA 3311 EAST MURDOCK WICHITA KS 67208 480993446 PROFESSIONAL ASSOCIATION KS NA C Corporation true VIA CHRISTI CLINIC SERVICES INC 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 273984287 CLINIC SERVICES KS NA C Corporation true VIA CHRISTI HEALTH ALLIANCE IN ACCOUNTABLE CARE INC 8200 E THORN DRIVE SUITE 300 WICHITA KS 67226 462872857 ACO KS NA C Corporation 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