2016-05-16T17:06:04-05:00 2015-06-30 861065772 DELOITTE TAX LLP 250 EAST FIFTH STREET SUITE 1900 CINCINNATI OH 45202 990 2014-07-01 481172107 Via Christi Health Inc VIAC 3168584900 8200 E Thorn Drive Wichita KS 67226 Carol Karp Chief Financial Officer 2016-05-16 true REBECCA LYONS P01487105 5137847100 2014 2016-08-17 19:52:53Z Jeff Korsmo 8200 E Thorn Drive Wichita KS 67226 150282155 false 0928 X https://www.viachristi.org/ X 1995 KS We serve as a healing presence with special concern for our neighbors who are vulnerable. 10 9 925 694 2209884 -8412 1878727 3170408 113624346 134148509 15198455 8941719 850167 3339059 131551695 149599695 2566377 2108598 0 0 62920563 59636294 0 0 618446 89543252 118807373 155030192 180552265 -23478497 -30952570 575749845 555701448 519906126 415573233 55843719 140128215 Via Christi Health, Inc., a Catholic Health System, shares 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 151712804 2108598 134771838 Via Christi Health, Inc., a Catholic health system, shares 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'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. 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: 1) Service of the Poor - Generosity of spirit, especially for persons most in need; 2) Reverence - Respect and compassion for the dignity and diversity of life; 3) Integrity - Inspiring trust through personal leadership; 4) Wisdom - Integrating excellence and stewardship; 5) Creativity - Courageous innovation; and 6) Dedication - Affirming the hope and joy of our ministry. The primary location of Via Christi Health, Inc. is Wichita, Sedgwick County, Kansas. The 2014 estimated population was 508,803. Wichita is the largest city within Sedgwick County and the State of Kansas. The population is 81% white, 9.5% Black, 1.4% American Indian and 4.4% Asian. 3.6% of the population identified themselves as being biracial and 13.9% identified themselves as Hispanic or Latino. Nearly 14% of the population speak a foreign language, other than English, in their homes. 88.6% of adults 25 and older identified themselves as having a high school education and nearly 29% identified themselves as having Bachelor of Arts/Bachelor of Science degrees. Median household income is $49,865, which is less than the rest of the State at $51,332. The land area is nearly 1,000 square miles with approximately 500 persons per square mile when compared to 35 per square mile for all of Kansas. VCH works with the communities they serve in addressing their needs with their limited resources. Here are some of the ways in which VCH helps. Employees assist with: 1) Fundraising for other area not-for-profits through the annual One Community Campaign (in partnership with United Way), 2) Protecting the environment through a recycling program, 3) Saving lives through sponsoring blood drives in partnership with the American Red Cross, 4) Cash donations to organizations and programs that are health related, 5) In-kind donations of time for United Way Ambassadors, Jefferson Elementary, American Heart Association, Ronald McDonald House, community food drives, Children's Miracle Network and more. The financial information in this report was prepared in accordance with the Catholic Health Association's Community Benefit reporting guidelines. These guidelines recommend the following: 1) Report Charity Care at cost, not charges, 2) Do not include bad debt, contractual allowances and quick pay discounts as part of the Charity Care expense, 3) Do not count Medicare shortfall as a community benefit, and 4) Report the net expense for community benefit services (e.g. the total community benefit expense minus any associated revenue from patients, payers and other external sources.) For Fiscal Year Ended June 30, 2015: Community Benefit - VCH provided the following net benefit: Financial & In-Kind Donations = $969,525; Community Benefit Operations = $196,998; Community Health Improvement = $266,809; Research = $57,579; Community Building = $13,608 Total of Quantifiable Community Benefit of $1,480,911. In addition, in the category of Community Building, Via Christi Health, Inc. expended a total of $13,608 for a Grand Total of $1,504,519. One of the restricted donations of $100,000 was awarded to GraceMed Health Clinic, Inc., a FQHC that, in partnership with VCH and the YMCA, has opened up a clinic in South Wichita where there was a health care desert. Land was donated by the YMCA and VCH cash went toward the first year of operational costs in order to increase access to healthcare for low income populations living in the area who are in need of a medical home. For the Fiscal Year Ended June 30, 2015, Community Benefit - VCH Consolidated provided the following net benefit: 1. Charity Care (at cost) - $46,122,579 2. Government sponsored health care (net expense at cost) - $15,593,880 3. Community benefit programs (net expense) - $20,770,525 Community Health Improvement Services: a. Community Health Improvement Services and Community Benefit Operations - $1,883,263 b. Health Professions Education - $16,586,827 c. Subsidized Health Services - $430,802 d. Research - $281,626 e. Financial and in-kind donations - $1,481,902 f. Community building activities - $106,105 Total quantifiable community benefit expense - $82,470,525 102603 0 54770 VIA CHRISTI HEALTH, INC. CORPORATE OFFICE COMMUNITY BENEFIT - COMMUNITY HEALTH IMPROVEMENT SERVICES, RESEARCH, FINANCIAL AND IN-KIND CONTRIBUTIONS, COMMUNITY BUILDING ACTIVITIES, AND COMMUNITY BENEFIT OPERATIONS. 151815407 true true false true false false false false false true true false true true true true false true false false false false false false true false false true true true false false false false false false false true false false false false false true true true true false true 254 0 true 925 true true true false false false false true true false false false false X 10 9 true false false false true true true true true false true true true true true true true true true true false X Judy Davis 3168584931 8200 E Thorn Drive Suite 300 Wichita KS 672262708 JEFFREY O KORSMO PRESIDENT & CEO 50.00 0 X X 1234574 0 67812 SR M THERESE GOTTSCHALK TRUSTEE 1.00 5.70 X 0 0 0 GERALD T AARON TRUSTEE 1.00 0 X 0 0 0 B ANTHONY ISAAC TRUSTEE 1.00 0 X 0 0 0 THOMAS R KRUSE TRUSTEE 1.00 0 X 0 0 0 JON RAHMAN TRUSTEE 1.00 0 X 0 0 0 SR MARY JOAN WALSH TRUSTEE 1.00 0 X 0 0 0 LYNDON O WELLS TRUSTEE 1.00 0 X 0 0 0 CAROLINE A WILLIAMS TRUSTEE 1.00 0 X 0 0 0 DONALD A WILSON TRUSTEE 1.00 0 X 0 0 0 SR M JEANINE RETZER TRUSTEE (END 4/15) 1.00 0 X 0 0 0 ROBERTA JOHNSON ASSISTANT SECRETARY 36.00 14.00 X 280071 0 51357 GARY KNIGHT SECRETARY 50.00 1.00 X 435018 0 128044 JEFF SEIRER ASSISTANT TREASURER 46.00 7.00 X 345950 0 67759 CAROL KARP TREASURER (START 8/14) 49.00 5.00 X 158602 0 9132 ABDUL BENGALI CHIEF INFORMATION OFFICER 50.00 0 X 519534 0 12274 JUDITH ESPINOZA CHIEF HUMAN RESOURCES OFFICER 50.00 0 X 329378 0 69962 CLAUDIO J FERRARO SR. ADMINISTRATOR CLIN SVC LN 45.00 5.00 X 356329 0 63975 DAVID A GAMBINO CHIEF STRATEGY & REG ADM OFFICER 44.00 11.00 X 563471 0 121219 LINDA GOODWIN CHIEF NURSING OFFICER 1.00 49.00 X 141380 192839 70658 SHERRY HAUSMANN CHIEF HOSPITAL ADMIN OFFICER 2.00 48.00 X 511373 0 85924 JOHN SHELLITO MD CHIEF CLINICAL PHYSICIAN OFFICER 48.00 2.00 X 595306 0 115931 MARGARET TICHACEK CHIEF PLANNING & MKT 50.00 0 X 367698 0 57774 KARL J ULRICH MD CHIEF OPERATING OFFICER (START 2/14) 50.00 0 X 714879 0 107184 DARRELL YOUNGMAN DO CHIEF MEDICAL OFFICER 2.00 48.00 X 422084 20204 63389 STEVE NESBITT CHIEF QUALITY OFFICER (END 11/14) 0.00 50.00 X 247477 201732 34573 DANIEL PENNINGTON CHIEF PHILANTHROPY OFFICER (END 10/14) 50.00 1.00 X 288619 0 19865 JOHN R BROBERG SR. ADMINSTRATOR 46.00 4.00 X 371296 0 58655 RANDALL R CASON SR. ADMINISTRATOR 48.00 2.00 X 358017 0 56605 EDWARD J HETT MEDICAL DIRECTOR 50.00 0 X 309264 0 49634 ART HUBER SR. ADMIN 4.00 46.00 X 274578 0 49053 LISA CARRUTHERS SR ADMIN REV CYCLE 50.00 0 X 338287 0 67351 DIANA KIDD FORMER KEY EMPLOYEE 0.00 1.00 X 100547 0 10141 CARLETON RIDER FORMER KEY EMPLOYEE (END 6/14) 0.00 1.00 X 306391 0 27171 RANDALL PETERSON FORMER KEY EMPLOYEE (END 4/12) 0.00 0 X 645257 0 0 JERRY CARLEY FORMER KEY EMPLOYEE (END 12/13) 0.00 0.00 X 207533 0 0 LORI GRUBS FORMER KEY EMPLOYEE-CHRO (END 11/12) 0.00 0 X 126985 0 0 10549898 414775 1465442 88 true true false American Consultants 9359 West 75th Street Overland Park KS 66204 Services 5198649 ARX 800 Crescent Centre Drive Suite 500 Franklin TN 37067 Services 2900708 HIMS Consulting Group Inc 2155 Resort Drive Suite 220 Steamboat Springs CO 80487 Services 1330340 AGFA Healthcare Corporation 10 South Academy Street Greenville SC 29601 Services 816499 Medical Information Technology Inc Meditech Circle Westwood MA 02090 Software Management Support 631510 47 X 125141 781658 70334 2193275 3170408 IT Service Center 561000 73002972 73002972 Reimbursements 561000 37347036 37347036 Management Fees 561000 16690505 14480621 2209884 HR Service Center 561000 7107996 7107996 0 0 0 0 134148509 8994041 8994041 0 0 92542 0 0 144864 92542 -144864 -52322 -52322 148185 125141 89335 58850 58850 840487 448261 392226 392226 Soarian Early Termination Fee 900099 1732275 1732275 POOLED INVESTMENT MANAGEMENT 900099 118372 118372 Vending MACHINE/Other 900099 35417 35417 1001919 1001919 0 0 2887983 149599695 134826608 2209884 9392795 1224331 1224331 884267 884267 9088070 9088070 1424025 1424025 37607599 30421684 6820482 365433 -1568715 -991828 -463217 -113670 9673395 6292792 3313782 66821 3411920 2272959 1112887 26074 34209 26626 7583 1855753 9770 1845983 0 259826 259826 0 0 0 0 820600 641376 15130 164094 6222385 5489374 733011 31033192 30552086 481106 2688804 2620007 68797 1217501 1040447 177054 268361 160187 108174 12113480 12113480 22524419 21907791 616628 -428455 7181 -435636 Purchased Services 9666726 8451574 1207938 7214 Service Fees 13951031 13059762 823829 67440 Equip mgt/TriMedx Exp 9155422 9155422 Collection Services 4705941 4705941 2718178 1510352 1172786 35040 180552265 151815407 28118412 618446 13163660 17117634 366953 429751 0 0 0 281416626 217365348 261869 216966 8132086 6015198 28358993 -3622223 41526577 31981216 0 80432991 86341008 61464334 58205235 88984749 138029092 575749845 555701448 50559021 33616630 0 0 469347105 381956603 519906126 415573233 X 41023697 124989232 8894681 9213642 5925341 5925341 55843719 140128215 575749845 555701448 X -30952570 -1239579 116476645 X false true X true true true X X X 11 VIA CHRISTI HOSPITAL PITTSBURG INC 480543778 3 true 0 0 VIA CHRISTI HOSPITAL WICHITA ST TERESA INC 271965272 3 true 812032 0 VIA CHRISTI HOSPITALS WICHITA INC 481172106 3 true 0 0 GERARD HOUSE INC 481049532 9 true 207869 0 VIA CHRISTI REHABILITATION HOSPITAL INC 481158274 3 true 0 0 VIA CHRISTI HEALTH PARTNERS INC 480958974 9 true 0 0 VIA CHRISTI HOSPITAL MANHATTAN INC 481186704 3 true 0 0 MERCY COMMUNITY HEALTH FOUNDATION INC 481152279 9 true 0 0 WAMEGO HOSPITAL ASSOCIATION INC 721526400 3 true 0 0 MERCY REGIONAL HOME MEDICAL SERVICES LLC 432024491 9 true 0 0 SALINA REGIONAL HOME MEDICAL SERVICES LLC 431948057 9 true 0 0 11 1019901 0 false false false false false false false false false false false false false false false true true true X false true Schedule A, Part IV, Line 3a Even though each Via Christi entity chooses their own board members, there is oversight from the VCH board. There is a historic and continuing relationship between VCH and Via Christi entities and the VCH board has final decision over major decisions for all Via Christi entities. Schedule A, Part IV, Section A, Line 1 Supported Orgs Listed By Name VCH sets the overall policies for all Via Christi entities to follow and communicates the policies to each entity. Even though each Via Christi entity chooses their own board members, there is oversight from the VCH board. There is a historic and continuing relationship between VCH and Via Christi entities and the VCH board has final decision over major decisions for all Via Christi entities. Schedule A, Part IV, Section D, Line 3 Supp. Org. Have Significant Voice In Investment Policies The Ascension Sponsor, through its control of the Ascension board, controls the system integrated strategic operational financial plan, annual targets, and initiatives. Within this operational framework, certain expenditures of funds, capital investments, issuances of debt, etc. are subject to Ascension-level approval. Schedule A, Part IV, Section E, Line 3b Substantial Direction Over Policies/Programs/Activities VCH sets the overall policies for all Via Christi entities to follow and communicates the policies to each entity. Even though each Via Christi entity chooses their own board members, there is oversight from the VCH board. There is a historic and continuing relationship between VCH and Via Christi entities and the VCH board has final decision over major decisions for all Via Christi entities. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 259826 false false 259826 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY The Director of Public Policy/Advocacy and the Director of Government Relations set up meetings with government officials or legislators to discuss Via Christi Health, Inc.'s positions on issues. Lobbying issues related to positions on issues related to carrying out healthcare programs. Via Christi Health, 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. 14820023 2823903 52589 815367 1389866 352299 15138983 14143938 1842184 953821 659430 1031195 429295 14820023 13703596 2750395 167725 520396 1604370 353012 14143938 13098590 2849747 1014728 689873 2172326 397270 13703596 12824717 3198552 33188 561157 1960981 435729 13098590 0.0 0.3914 0.6086 false false -3663784 -6552931 2889147 -464391 -892458 428067 31431837 3933776 27498061 1055331 -110610 1165941 31981216 Investment in Salina Regional Health Center 86341008 C 86341008 Investment in Related Organizations 26034421 Prepaid Pension 3673624 Other Noncurrent Assets 3614703 Other Miscellaneous Receivables 2764117 Interest Receivable 173797 Cash Value Life Insurance 16922 Interest in Investments Held by Ascension Health Alliance 101751508 138029092 INTERCOMPANY DEBT WITH ASCENSION HEALTH ALLIANCE 367383014 VALUATION RESERVE 6577807 WORKERS COMP RESERVE 4354529 PROFESSIONAL LIABILITY TAIL ACCRUAL 3286957 DEFERRED COMP - KEYSOP 354296 381956603 Schedule D, Part X, Line 2 FIN 48 (ASC 740) FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE AND ITS MEMBER ORGANIZATIONS ("THE SYSTEM"), WHICH INCLUDE THE ACTIVITY OF VIA CHRISTI HEALTH, 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. Schedule D, Part V, Line 4 Intended uses of endowment funds These funds are used to provide financial support for various medical related projects and causes within Via Christi Health System. They also provide support for non-medical related issues such as employee and patient assistance. Permanently restricted funds are retained and only the earnings are released for purposes approved by the Board of Trustees. Charity Classic 145930 61235 84695 42696 5199 Gala Dinner 127396 63906 63490 24927 16513 0 273326 125141 148185 67623 21712 89335 58850 true Via Christi Hospitals Wichita Inc 929 N St Francis Wichita KS 67214 481172106 501(c)(3) 812032 Operating Expenses/Equipment & Education Gerard House Inc 3144 N Hood Wichita KS 67204 481049532 501(c)(3) 207869 Operating Expenses GraceMed Health Clinic Inc 1122 N Topeka Wichita KS 67218 481159633 501(c)(3) 61168 General Assistance for Patients Greater Wichita YMCA 402 N Market St Wichita KS 67202 480554440 501(c)(3) 10000 Medical Equipment & Low Income Family Memberships Wichita Metro Chamber of Commerce Inc 350 West Douglas Avenue Wichita KS 67202 480477290 501(c)(6) 25000 Economic Development Partnership Ronald McDonald House Charities of Wichita Inc 1110 N Emporia Wichita KS 67214 480918101 501(c)(3) 5500 Benefit Golf Tournament 5 1 Via Christi Employee Assistance 62 21458 VCH-W Patient Assistance 2726 78552 VCH-W Student Scholarships 54 49099 Local Community Scholarships 320 735158 Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant Funds All grants and assistance are reviewed and approved by a grant committee consisting of members of the Board of Trustees. Grant expenses are reviewed by the accounting department, and detailed grant reports are requested from all grantees. Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. All grants and assistance are reviewed and approved by a grant committee consisting of members of the Board of Trustees. Grant expenses are reviewed by the accounting department, and detailed grant reports are requested from all grantees. X true true X X X X true true false false false false false false false JEFFREY O KORSMO PRESIDENT & CEO 819900 0 396914 0 17760 0 48300 0 19512 0 1302386 0 0 0 JERRY CARLEY FORMER KEY EMPLOYEE (END 12/13) 1 0 0 0 207532 0 0 0 0 0 207533 0 0 0 LORI GRUBS FORMER KEY EMPLOYEE-CHRO (END 11/12) 0 0 0 0 126985 0 0 0 0 0 126985 0 0 0 ROBERTA JOHNSON ASSISTANT SECRETARY 215175 0 57129 0 7767 0 42318 0 9039 0 331428 0 19367 0 GARY KNIGHT SECRETARY 427173 0 0 0 7845 0 113321 0 14723 0 563062 0 0 0 JEFF SEIRER ASSISTANT TREASURER 276864 0 62485 0 6601 0 48628 0 19131 0 413709 0 0 0 CAROL KARP TREASURER (START 8/14) 119270 0 0 0 39332 0 5054 0 4078 0 167734 0 0 0 DIANA KIDD FORMER KEY EMPLOYEE 99131 0 0 0 1416 0 7889 0 2252 0 110688 0 0 0 CARLETON RIDER FORMER KEY EMPLOYEE (END 6/14) 247130 0 0 0 59261 0 26085 0 1086 0 333562 0 0 0 RANDALL PETERSON FORMER KEY EMPLOYEE (END 4/12) 645257 0 0 0 0 0 0 0 0 0 645257 0 0 0 ABDUL BENGALI CHIEF INFORMATION OFFICER 406230 0 104709 0 8595 0 10400 0 1874 0 531808 0 0 0 JUDITH ESPINOZA CHIEF HUMAN RESOURCES OFFICER 256319 0 68372 0 4687 0 52281 0 17681 0 399340 0 0 0 CLAUDIO J FERRARO SR. ADMINISTRATOR CLIN SVC LN 280316 0 71821 0 4192 0 46545 0 17430 0 420304 0 0 0 DAVID A GAMBINO CHIEF STRATEGY & REG ADM OFFICER 438370 0 116184 0 8917 0 105040 0 16179 0 684690 0 0 0 LINDA GOODWIN CHIEF NURSING OFFICER 136880 121194 0 67233 4500 4412 9160 40239 11345 9914 161885 242992 0 0 SHERRY HAUSMANN CHIEF HOSPITAL ADMIN OFFICER 400463 0 106084 0 4826 0 68686 0 17238 0 597297 0 0 0 JOHN SHELLITO MD CHIEF CLINICAL PHYSICIAN OFFICER 443308 0 131676 0 20322 0 96436 0 19495 0 711237 0 0 0 MARGARET TICHACEK CHIEF PLANNING & MKT 280976 0 80025 0 6697 0 48623 0 9151 0 425472 0 2534 0 KARL J ULRICH MD CHIEF OPERATING OFFICER (START 2/14) 419815 0 111376 0 183688 0 96200 0 10984 0 822063 0 41930 0 DARRELL YOUNGMAN DO CHIEF MEDICAL OFFICER 409927 20204 0 0 12157 0 43058 0 20331 0 485473 20204 0 0 STEVE NESBITT CHIEF QUALITY OFFICER (END 11/14) 146901 195914 95737 0 4839 5818 3988 12912 7361 10312 258826 224956 0 0 DANIEL PENNINGTON CHIEF PHILANTHROPY OFFICER (END 10/14) 225131 0 51120 0 12368 0 5786 0 14079 0 308484 0 93 0 JOHN R BROBERG SR. ADMINSTRATOR 275321 0 86690 0 9285 0 49403 0 9252 0 429951 0 0 0 RANDALL R CASON SR. ADMINISTRATOR 270229 0 82864 0 4924 0 39220 0 17385 0 414622 0 0 0 EDWARD J HETT MEDICAL DIRECTOR 270748 0 31641 0 6875 0 34531 0 15103 0 358898 0 0 0 ART HUBER SR. ADMIN 216426 0 52594 0 5558 0 32193 0 16860 0 323631 0 0 0 LISA CARRUTHERS SR ADMIN REV CYCLE 275493 0 59056 0 3738 0 45633 0 21718 0 405638 0 0 0 Schedule J, Part I, Line 1a First-class or charter travel Midwest Corporate Aviation , 1/28/15, $2,654, Project Tumbleweed--Passengers Jeff Seirer, Jeff Korsmo, Gary Knight, Sherry Hausmann, Dave Gambino. Not taxable compensation. Schedule J, Part I, Line 4a Severance or change-of-control payment The following Former Key Employees received severance payments from the organization or a related organization during calendar year 2014: Lori Grubs - $123,200 Jerry Carley - $205,526 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. The following individual received a distribution from a supplemental non-qualified retirement plan in the amount listed below: Karl Ulrich - $41,930 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: Roberta Johnson - $19,367 Margaret Tichacek - $2,534 Daniel Pennington - $93 INTRUST BANK BOARD MEMBER (LYNDON WELLS) IS A BOARD MEMBER OF INTRUST BANK 199635 BANK FEES PAID TO INTRUST BANK BY VIA CHRISTI HEALTH, INC. false 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 Health, Inc. (VCH) has established a common philosophy, strategy, and process for executive compensation to be used throughout the Health System. 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 Health, Inc. has a single corporate member, Ascension Health. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Via Christi Health, Inc. has a single corporate member, Ascension Health, who has the ability to elect members to the governing body of Via Christi Health, Inc. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Ascension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluations; debt limits; strategic & financial plans; assets; and system policies & procedures. These areas are subject to certain levels of approval by Ascension Health per the system authority matrix. 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 Member's questions. Form 990, Part VI, Line 12c Conflict of interest policy The organization monitors and enforces the Conflict of Interest Policy 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 Health, 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 P-Card Rev - Total Revenue: 160876, Related or Exempt Function Revenue: 160876, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Misc Op Rev - Total Revenue: 841043, Related or Exempt Function Revenue: 841043, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Transfer to Via Christi Entities - XXX-XX-XXXX; Transfer from Ascension Entities - -40555186; Market Value/Fund Balance - -XXX-XX-XXXX; FMV Non-controlling interest - other Activity - 1239276; Change in Pension and Other Changes - -1237058; Foundation Capital Transfers to Via Christi Entities - -84227; Transfer of Market value co 0101 to 0100 - 9080606; Beneficial interest - 35828238; Transfers to Affiliates - 23452350; Other Unrestricted Net Asset Activity - 12444; Net Assets Released from Restriction - 350599; 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 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 VIA CHRISTI HOSPITALS WICHITA INC 929 N SAINT FRANCIS WICHITA KS 67214 481172106 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 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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 Via Christi Health Inc C Corporation 19333326 10152359 true INTEGRATED HEALTHCARE SYSTEMS INC 3311 EAST MURDOCK 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