2016-05-05T09:23:53-05:00 2015-09-30 481066439 BERBERICH TRAHAN & CO PA 3630 SW BURLINGAME ROAD TOPEKA KS 666112050 990 2014-10-01 480980926 STORMONT-VAIL FOUNDATION CO CORPORATE FINANCE STOR 7853545623 1500 SW 10TH AVENUE TOPEKA KS 66604 KENNETH L STONE TREASURER 7853545623 2016-05-04 1 CHERYL G HAYWARD P00016097 7852343427 2014 2016-08-17 19:52:53Z JANE MACKEY 1500 SW 10TH AVENUE TOPEKA KS 66604 13164134 0 X WWW.STORMONTVAIL.ORG X 1984 KS SEE CONTINUATION ON SCHEDULE O: TO PROVIDE VOLUNTARY GIFT SUPPORT FOR STORMONT-VAIL HEALTHCARE, INC. PATIENT CARE SERVICES AND COMMUNITY HEALTH EDUCATION PROGRAMS, IN SUPPORT OF HEALTHCARE'S MISSION OF "WORKING TOGETHER TO IMPROVE THE HEALTH OF OUR COMMUNITY." 26 22 0 22 0 0 2270513 1794478 0 0 644252 1851026 133385 144365 3048150 3789869 267125 409297 0 0 416745 435270 0 0 252968 616998 1235073 1300868 2079640 1747282 1710229 18743945 19392135 135387 152791 18608558 19239344 X TO PROVIDE VOLUNTARY GIFT SUPPORT FOR STORMONT-VAIL HEALTHCARE, INC. PATIENT CARE SERVICES AND COMMUNITY HEALTH EDUCATION PROGRAMS, IN SUPPORT OF HEALTHCARE'S MISSION OF "WORKING TOGETHER TO IMPROVE THE HEALTH OF OUR COMMUNITY." 0 0 811462 FACILITIES:CONSISTENT WITH ITS MISSION, THE FOUNDATION PROVIDES STORMONT-VAIL HEALTHCARE WITH FUNDING FOR MEDICAL FACILITIES AND EQUIPMENT NEEDED TO IMPROVE THE HEALTH OF THE COMMUNITY. 287249 PATIENT CARE AND OTHER:A MAJORITY OF PROGRAM SERVICE EXPENDITURES IN THIS CATEGORY IS FOR DISCHARGE ASSISTANCE TO STORMONT-VAIL HEALTHCARE PATIENTS WHO HAVE CRITICAL NEEDS AT THE TIME OF DISCHARGE FROM THE HOSPITAL OR TREATMENT IN OUR CLINICS. TIMELY FUNDING IS PROVIDED FOR ITEMS SUCH AS CLOTHING, PRESCRIPTION DRUGS, TRANSPORTATION NEEDS, ETC. WHERE THE PATIENTS HAVE NO OTHER SOURCES OF FUNDING. 140850 140850 SCHOLARSHIPS:IN COOPERATION WITH BAKER UNIVERSITY, THE FOUNDATION PROVIDES SCHOLARSHIPS TO DESERVING NURSING STUDENTS ATTENDING THE BAKER UNIVERSITY SCHOOL OF NURSING AT STORMONT-VAIL. IN ADDITION TO BAKER UNIVERSITY, SCHOLARSHIPS ARE PROVIDED TO STUDENTS ATTENDING SOME OTHER POST SECONDARY ALLIED HEALTH EDUCATION PROGRAMS. OTHER SCHOLARSHIPS ARE ALSO PROVIDED TO KU, KSU, AND WU. 53676 EDUCATION:THE FOUNDATION COOPERATES WITH STORMONT-VAIL HEALTHCARE TO FUND EMPLOYEES' ATTENDANCE AT SELECT CONFERENCES, WORKSHOPS AND PROGRAMS IN ORDER TO GAIN KNOWLEDGE AND SKILLS, AND TO SHARE THAT KNOWLEDGE WITH PEERS,FURTHER ENHANCING PATIENT CARE AND IMPROVING THE HEALTH OF OUR COMMUNITY 268447 268447 OTHER COMMUNITY SUPPORT:THE FOUNDATION MAKES GRANTS/SPONSORSHIPS TO OTHER COMMUNITY CHARITIES ON BEHALF OF THE STORMONT-VAIL HEALTHCARE SYSTEM. 322123 268447 1561684 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 3 0 1 0 0 0 0 0 0 0 0 0 0 0 X 26 22 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 KS X KENNETH L STONE 7853545623 1500 SW 10TH AVENUE TOPEKA KS 66604 KEN STONE SVF TREAS./DIR CORP ACCTG 4.00 X X 0 143025 33117 JUDY MOLER IMMEDIATE PAST CHAIRPERSON 1.00 X X 0 0 0 JARED HOLROYD TRUSTEE 1.00 X 0 0 0 BEN ARTILES TRUSTEE 1.00 X 0 0 0 RICK JACKSON TRUSTEE 1.00 X 0 0 0 OLGA SMITH TRUSTEE 1.00 X 0 0 0 TOM MCBRIDE TRUSTEE 1.00 X 0 0 0 BETTY CLICK TRUSTEE 1.00 X 0 0 0 KENT CORNISH TRUSTEE 1.00 X 0 0 0 STEVE TYLER CHAIRPERSON 1.00 X X 0 0 0 JANE MACKEY PRESIDENT 40.00 X X 0 167005 23403 DAN RICHARDSON TRUSTEE 1.00 X 0 0 0 MIKE WORSWICK TRUSTEE 1.00 X 0 0 0 MARY ANN DURALL TRUSTEE 1.00 X 0 0 0 RICHARD ROSS TRUSTEE 1.00 X 0 0 0 KEVIN HAN VICE PRESIDENT & CFO 1.00 X X 0 409390 121475 RANDY PETERSON PRESIDENT & CEO STORMONT 1.00 X 0 900336 200126 MAYNARD OLIVERIUS FORMER PRES.& CEO STORMONT 1.00 X 0 145031 0 ROSALIND JENNINGS TRUSTEE 1.00 X 0 0 0 MARK RUELLE TRUSTEE 1.00 X 0 0 0 MIRANDA CARMONA SECRETARY 1.00 X X 0 0 0 JIM PARRISH TRUSTEE 1.00 X 0 0 0 GLEN SCOTT TRUSTEE 1.00 X 0 0 0 DOUG WOLFF TRUSTEE 1.00 X 0 0 0 KEVIN HAHN VICE-CHAIRPERSON 1.00 X X 0 0 0 ANNE WILSON TRUSTEE 1.00 X 0 0 0 0 1764787 378121 0 0 1 0 0 702327 1092151 1794478 890562 890562 10276924 9316460 960464 960464 960464 202170 57805 144365 144365 3789869 960464 0 1034927 409297 409297 435270 38859 184132 212279 10586 10586 23523 23523 13179 13179 46456 3524 21632 21300 9645 9645 688 688 2284 2246 38 2825 2825 DESIGNATED DISBURSEMENT 1042019 1042019 EDUCATION 54861 53676 1185 MISCELLANEOUS 11660 480 5008 6172 SVHC EMPLOYEE RECOGNITI 11626 11626 5721 2203 3518 2079640 1561684 264988 252968 445603 1001 150006 407349 1024559 728387 8136 12740 45059 34415 12323 10644 8704687 9458085 8398631 8773929 18743945 19392135 97718 96212 37669 56579 135387 152791 X 1405285 1293555 3979870 4149206 13223403 13796583 18608558 19239344 18743945 19392135 X 1710229 -1454335 374892 X X 0 1 X 1 0 X 751039 1311397 1193816 2270513 1794478 7321243 751039 1311397 1193816 2270513 1794478 7321243 620824 6700419 419219 498607 582990 656888 890562 3048266 10369509 275106 0.64620 0.59530 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8136401 402037 -223447 141165 8173826 6850620 869030 527689 110938 8136401 6010736 396574 526228 82918 6850620 5070422 453835 712526 226047 6010736 5086119 228603 -102103 142197 5070422 0.13270 0.70870 0.15860 0 0 45059 34415 10644 10644 ACCRUED INVESTMENT INCOME 15199 CHARITABLE REMAINDER TRUST 755000 BENEFICIAL INTEREST IN TRUST 8003730 8773929 DUE TO SVHC 51979 CHARITABLE GIFT ANNUNITIES 4600 56579 X 4141819 375473 375473 3766346 23523 23523 3789869 3511033 1454916 1454916 2056117 23523 23523 2079640 PART V, LINE 4: ENDOWMENT FUNDS ARE USED IN ACCORDANCE WITH THE DIRECTION OF THE APPLICABLE DONOR GIFT INSTRUMENT AT THE TIME THE GIFT IS ADDED TO THE FUND. ALL ENDOWMENTS ACCEPTED SUPPORT THE MISSION OF THE STORMONT-VAIL FOUNDATION. PART X, LINE 2: THE FOUNDATION'S POLICY IS TO EVALUATE UNCERTAIN TAX POSITIONS ANNUALLY. MANAGEMENT EVALUATED THE FOUNDATION'S TAX POSITIONS AND CONCLUDED THAT THE FOUNDATION HAD TAKEN NO UNCERTAIN TAX POSITION THAT REQUIRED ADJUSTMENT TO THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS 374,892. FUNDRAISING EXPENSES 581. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 581. UNREALIZED LOSSES FROM INVESTMENTS 1,454,335. BIG HEARTS GOLF TOURNAMENT 202170 202170 25708 13840 17005 1252 202170 202170 25708 13840 17005 1252 57805 144365 1 BAKER UNIVERSITY PO BOX 65 BALDWIN CITY KS 66006 480543766 501(C)(3) 131850 FUND NURSING SCHOLARSHIPS AMERICAN CANCER SOCIETY 1315 SW ARROWHEAD RD TOPEKA KS 66604 131788491 501(C)(3) 13000 COMMUNITY CHARITABLE SUPPORT ON BEHALF OF STORMONT-VAIL HEALTHCARE AMERICAN HEART ASSOCIATION 5375 SW 7TH ST TOPEKA KS 66606 135613797 501(C)(3) 55000 COMMUNITY CHARITABLE SUPPORT ON BEHALF OF STORMONT-VAIL HEALTHCARE ARTHRITIS FOUNDATION 1900 W 75TH STREET PRARIE VILLAGE KS 66208 581341679 501(C)(3) 8750 COMMUNITY CHARITABLE SUPPORT ON BEHALF OF STORMONT-VAIL HEALTHCARE MARCH OF DIMES FOUNDATION 1133 SW GAGE BLVD TOPEKA KS 66604 131846366 501(C)(3) 15000 COMMUNITY CHARITABLE SUPPORT ON BEHALF OF STORMONT-VAIL HEALTHCARE MEALS ON WHEELS OF SHAWNEE AND JEFFERSON COUNTIES 2701 SW EAST CIRCLE DRIVE SOUTH TOPEKA KS 66606 480792685 501(C)(3) 10000 COMMUNITY CHARITABLE SUPPORT ON BEHALF OF STORMONT-VAIL HEALTHCARE RACE AGAINST BREAST CANCER INC PO BOX 4458 TOPEKA KS 66604 481154057 501(C)(3) 10000 COMMUNITY CHARITABLE SUPPORT ON BEHALF OF STORMONT-VAIL HEALTHCARE YWCA OF TOPEKA 225 SW 12TH ST TOPEKA KS 66612 480556758 501(C)(3) 10375 COMMUNITY CHARITABLE SUPPORT ON BEHALF OF STORMONT-VAIL HEALTHCARE JUNIOR ACHIEVEMENT OF KANSAS 3735 SW WANAMAKER RD TOPEKA KS 66610 841267604 501(C)(3) 15000 COMMUNITY CHARITABLE SUPPORT ON BEHALF OF STORMONT-VAIL HEALTHCARE KANSAS LEGAL SERVICES 712 S KANSAS AVE TOPEKA KS 66603 480872528 501(C)(3) 8000 COMMUNITY CHARITABLE SUPPORT ON BEHALF OF STORMONT-VAIL HEALTHCARE MAKE-A-WISH FOUNDATION OF KS 125 S WASHINGTON STE 100 WICHITA KS 67202 480984820 501(C)(3) 15000 COMMUNITY CHARITABLE SUPPORT ON BEHALF OF STORMONT-VAIL HEALTHCARE WASHBURN UNIVERSITY OF TOPEKA 1700 SW COLLEGE AVE TOPEKA KS 66621 486030115 170(C)(1) 37122 COMMUNITY CHARITABLE SUPPORT ON BEHALF OF STORMONT-VAIL HEALTHCARE PART I, LINE 2: FOR SCHOLARSHIPS REPORTED IN PART II OF THIS SCHEDULE, THE FOUNDATION PROVIDES SCHOLARSHIP FUNDING TO BAKER UNIVERSITY FOR SCHOLARSHIPS GRANTED TO STUDENTS OF THE SCHOOL OF NURSING PROGRAM WHICH OFFERS A BACHELOR OF SCIENCE IN NURSING DEGREE. THE SCHOOL OF NURSING IS OWNED BY STORMONT-VAIL HEALTHCARE, INC. BAKER UNIVERSITY CONFERS DEGREES AND MANAGES ADMISSIONS, SCHOLARSHIPS, AND ACADEMIC AFFAIRS. THE FOUNDATION RECEIVED DETAILED REPORTS LISTING SCHOLARSHIP RECIPIENTS. X X 0 1 0 0 0 0 0 0 0 KEN STONE SVF TREAS./DIR CORP ACCTG 0 137875 0 4268 0 882 0 9269 0 23848 0 176142 0 0 JANE MACKEY PRESIDENT 0 141284 0 24372 0 1349 0 9690 0 13713 0 190408 0 0 KEVIN HAN VICE PRESIDENT & CFO 0 343004 0 62745 0 3641 0 113385 0 8090 0 530865 0 0 RANDY PETERSON PRESIDENT & CEO STORMONT 0 713039 0 181753 0 5544 0 170842 0 29284 0 1100462 0 0 FORM 990, PART VI, SECTION A, LINE 6 STORMONT-VAIL HEALTHCARE, INC. IS THE SOLE VOTING MEMBER OF THE STORMONT-VAIL FOUNDATION. STORMONT-VAIL HEALTHCARE, INC. IS A 501(C)(3) EXEMPT NON-PROFIT HEALTH CARE PROVIDER WITH NUMEROUS LOCATIONS IN AND THROUGHOUT TOPEKA AND NORTHEAST KANSAS. FORM 990, PART VI, SECTION A, LINE 7A THE TRUSTEES ARE ELECTED BY THE VOTING MEMBER OF THE FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11 THE PRESIDENT AND THE TREASURER FURNISH A DRAFT OF FORM 990 TO THE FOUNDATION'S FINANCE COMMITTEE FOR A MEETING AT WHICH THE REPORT IS DISCUSSED. THE FINANCE COMMITTEE'S FEEDBACK IS CONSIDERED AND FURTHER DISCUSSED WITH THE PAID PREPARER AS THE BASIS OF MODIFICATIONS, AS APPROPRIATE, IN THE FINAL VERSION OF FORM 990 FOR FILING. THE FINAL, FILED VERSION IS MADE AVAILABLE TO THE BOARD OF TRUSTEES PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE BOARD'S FOUNDATION RELATIONS COMMITTEE REVIEWS CONFLICTS OF INTEREST AND CONFIDENTIALITY STATEMENTS, AND CODE OF CONDUCT CERTIFICATIONS FOR ALL BOARD MEMBERS AND OFFICERS. FORM 990, PART VI, SECTION B, LINE 15 ALTHOUGH THE PRESIDENT AND EXECUTIVE DIRECTOR OF THE STORMONT-VAIL FOUNDATION IS NOT AN EMPLOYEE OF THE STORMONT-VAIL FOUNDATION, THE COMPENSATION OF THAT POSITION IS DETERMINED AS FOLLOWS: THE COMPENSATION COMMITTEE OF STORMONT-VAIL HEALTHCARE (COMPRISED OF THE TWO SENIOR VICE PRESIDENTS, ALL THE VICE PRESIDENTS, AND THE DIRECTORS OF COMPENSATION/BENEFITS AND FINANCE) REVIEW NATIONAL SURVEY DATA FOR THIS POSITION AND PROPOSE A PAY RANGE FOR THE POSITION. THE PRESIDENT AND CEO OF STORMONT-VAIL ALONG WITH THE CHAIR OF THE STORMONT-VAIL FOUNDATION BOARD REVIEWS THE FOUNDATION PRESIDENT AND EXECUTIVE DIRECTOR'S PERFORMANCE AND COMPENSATION IS DETERMINED BY THAT REVIEW. COMPENSATION FOR OTHER PERSONS, WHOSE COMPENSATION IS DISCLOSED IN THIS FORM 990 AND SCHEDULE J, IS DETERMINED BY STORMONT-VAIL HEALTHCARE, INC. BOARD OF DIRECTORS, OFFICERS, MANAGEMENT AND/OR IN ACCORDANCE WITH ESTABLISHED POLICIES AND PRACTICES OF HEALTHCARE. ADDITIONAL INFORMATION MAY BE AVAILABLE ON SCHEDULE O FOR STORMONT-VAIL HEALTHCARE, INC.'S FORM 990. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. THE FOUNDATION INCLUDES A COPY OF ITS AUDITED FINANCIAL STATEMENTS WITH ITS ANNUAL FORM SC FILED WITH THE KANSAS SECRETARY OF STATE. A CONDENSED BALANCE SHEET AND REVENUE AND EXPENSE STATEMENT IS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS 374,892. FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR YEAR. STORMONT-VAIL HEALTHCARE INC 1500 SW 10TH ST TOPEKA KS 666041353 480543789 PROVIDES HEALTH AND MEDICAL SERVICES KS 501(C)(3) 170(B)(1)(A)(III) STORMONT-VAIL HEALTHCARE 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 STORMONT-VAIL HEALTHCARE INC C 702327 STORMONT-VAIL HEALTHCARE INC O 435270 STORMONT-VAIL HEALTHCARE INC R 757559