2015-05-14T17:43:20-05:00 2014-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2013-07-01 481067110 Catholic Care Center Inc CATH 3167442020 6700 East 45th Street North Bel Aire KS 67226 Erik Hatten AHSC CEO 3167442020 2015-05-14 1 Rebecca Lyons P01487105 5137847100 2013 2016-02-25 16:41:14Z Markus Meyer 6700 East 45th Street North Bel Aire KS 67226 21805823 0 0928 X www.viachristi.org/locations/seniors X 1988 KS Provide health care & housing to the elderly people of Wichita & the surrounding communities. 8 6 566 60 0 0 33715 22472 15622319 21324874 107018 167894 149258 239836 15912310 21755076 0 0 0 0 8094668 10951090 0 0 0 6493180 9237658 14587848 20188748 1324462 1566328 41372988 45456345 22737954 25205924 18635034 20250421 X As a part of Via Christi Health, 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'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:Human Dignity - We recognize and respect the sacredness of each person;Stewardship - We responsibly care for all resources entrusted to us;Excellence - We extend ourselves in outstanding service. 0 0 16683705 21335927 Catholic Care Center, Inc. is a nursing and assisted living facility. The Center consists of a 178-bed nursing facility and a 100-unit assisted living facility located in Wichita, Kansas. Catholic Care Center, Inc. serves people in the Wichita area. The primary counties include Sedgwick and Butler. A trend of significance in the community is the growing elderly population. To address this trend, Catholic Care Center, Inc. is collaborating with other community organizations, including but not limited to: Meals on Wheels, Alzheimer's Association, and nursing education organizations to provide services and education to the elderly.Financial surpluses are used to fulfill our charitable purpose. The Board of Directors included members of the local community. Our organization offers discounted care to persons without adequate financial means to pay for such services. This includes the participation in Medicaid, Medicare, Champus, Tricare, and/or other government-sponsored health care programs. 16683705 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 32 0 1 566 1 0 0 0 0 0 1 1 0 0 0 0 X 8 6 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X Brenda DeHass 3169465216 2622 W Central Suite 100 Wichita KS 67203 X Monsignor Robert Hemberger Chair 1.00 0.00 X X 0 0 0 Dan Loughman Vice Chair 1.00 0.00 X X 0 0 0 Jerry Carley end 1213 Treasurer 1.00 49.00 X X 0 266485 69523 David Gambino start 0214 Treasurer 1.00 49.00 X X 0 429376 96728 James Barber end 0913 Trustee 1.00 49.00 X 0 215182 22758 Joan Melzer Trustee 1.00 0.00 X 0 0 0 Lynette RauvolaBouta Trustee (end 02/14) 1.00 49.00 X 0 263295 73196 Fr Michael Simone Trustee 1.00 0.00 X 0 0 0 Julie Stremel Trustee 1.00 0.00 X 0 0 0 Sister Pam Young Trustee 1.00 0.00 X 0 0 0 Thomas Church end 1113 President/CEO 50.00 0.00 X X 0 128620 22459 Markus Meyer start 1213 President/CEO 50.00 0.00 X X 0 26111 3259 Katrina Davis Secretary 1.00 40.00 X 0 52912 16559 0 1381981 304482 0 0 1 0 Simpson & Associates 1831 South Anna PO Box 771088 Wichita KS 67209 Construction (Sch O) 2871283 Robl Commercial Construction 5842 West 21st Street North Wichita KS 67205 Construction (Sch O) 2462728 Via Christi Villages Inc 2622 West Central Wichita KS 67203 Management Services 1739661 Genesis Eldercare Rehabilitation Service PO Box 7247-6521 Philadelphia PA 19170 Therapy Services 1173430 FF&E Specialty Group 5750 West 95th St 225 Overland Park KS 66207 Furnishings-New Construction (Sch O) 166214 7 8596 13876 22472 Resident Room Care 623000 21220927 21220927 Reimbursement Revenue 623000 103947 103947 21324874 190852 190852 22958 -22958 -22958 -22958 13025 8596 8081 4944 4944 24521 19708 4813 4813 Beauty & Barber 812900 112802 112802 Guest Meals 722210 24094 24094 Equipment Rental 532420 11053 11053 82130 82130 230079 21755076 21335927 0 396677 9259278 8332301 926977 1056327 781898 274429 635485 587921 47564 5081 5081 46036 46036 1625824 1521239 104585 47319 47319 2138097 2023293 114804 157387 23679 133708 962213 962213 10412 1109 9303 21154 13047 8107 683572 683572 1552668 1552668 1667367 1667367 122886 122886 Resident Transportation 70078 70078 Membership Dues 26982 196 26786 Religious 26710 26710 Vehicle Fuel & Maint. 7475 7475 66397 8317 58080 20188748 16683705 3505043 0 9197658 10398321 4654463 4897430 1577702 1566151 84506 90584 8313 171414 43795173 15499698 25829320 28295475 21026 36970 41372988 45456345 1168547 2874888 21569407 22331036 22737954 25205924 X 18635034 20200967 49454 18635034 20250421 41372988 45456345 X 1566328 49454 -395 X 0 1 X 1 0 X 26466 52395 14222 27783 22472 143338 19994007 20956109 21035071 15622319 21324874 98932380 24521 24521 20020473 21008504 21049293 15650102 21371867 99100239 82765 88545 91554 262864 0 82765 88545 91554 262864 98837375 130930 126995 141502 90358 190852 680637 130930 126995 141502 90358 190852 680637 249852 224444 226786 151956 229682 1082720 20401255 21359943 21417581 15892416 21792401 100863596 0.97990 0.97880 0.00670 0.00700 X Schedule A, Part III, Line 12, Explanation of Other Income: Beauty Barber Guest Meals Equipment Rental Miscellaneous Revenue Schedule A, Part III: Effective April 1, 2013, Via Christi Health, the parent of the filing organization, was acquired by Ascension Health. Ascension Health is a subsidiary of Ascension Health Alliance. As part of the acquisition, the organization changed its tax year to June 30 in order to align with the tax year of Ascension Health. Amounts reported on Schedule A, Part III for the 2012 tax year represent the short period October 1, 2012 through June 30, 2013. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2316 2316 0 Part II-B, Line 1: Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Catholic Care Center, Inc. does not participate in or intervene in (including the publishing or distributing or statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 1348007 1348007 31357000 11371639 19985361 3954313 2586452 1367861 7135853 1541607 5594246 28295475 Due to Related Party 274764 Non-Refundable Use Fees 1077751 Refundable Use Fees 6059515 Note Payable VCHS Long-Term 14850000 Residency Funds 63486 Resident Restricted Fund 5520 22331036 X 21796817 49454 49454 21747363 7713 7713 21755076 20208456 19708 19708 20188748 0 20188748 Part X, Line 2: The Center has been recognized as exempt from federal income taxes under section 501(c)(3) of the Internal Revenue Code and a similar provision of state law. The Center recognizes the financial statement benefit of a tax position only after determining that the relevant tax authority would more likely than not sustain the position following an audit. Part XI, Line 4b - Other Adjustments: Inventory - Cost of Goods Sold -19,708. Contributions 22,472. Fundraising Activity Profit 4,944. Rounding 5. Part XII, Line 2d - Other Adjustments: Inventory - Cost of Goods Sold 19,708. Parkinson's Fundraising 21621 5996 15625 1415 1243 2409 3014 1 2600 -2600 21621 8596 13025 1415 1243 2409 3014 8081 4944 1 1 0 0 0 0 0 0 0 Jerry Carley end 1213 Treasurer 0 254530 0 8511 0 3444 0 51432 0 18091 0 336008 0 0 David Gambino start 0214 Treasurer 0 395610 0 22500 0 11266 0 81140 0 15588 0 526104 0 0 James Barber end 0913 Trustee 0 163265 0 5461 0 46456 0 10309 0 12449 0 237940 0 0 Lynette RauvolaBouta Trustee (end 02/14) 0 250568 0 8148 0 4579 0 60038 0 13158 0 336491 0 0 Thomas Church end 1113 President/CEO 0 119892 0 2240 0 6488 0 11587 0 10872 0 151079 0 0 Part I, Line 3 Via Christi Health, Inc., a related organization of Catholic Care Center, Inc., uses the following to establish the compensation of the organization's President/CEO: - Compensation Committee, - Independent Compensation Consultant, - Compensation Survey or Study, and - Approval by the Board or Compensation Committee. Part I, Line 4a: Severance Payment: James Barber - $43615 Part I, Line 4b: Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are funded annually based on participation and are not vested until the 5 year service requirement is reached. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. The amount funded annually under the program to the executives is reported as compensation on Form 990 Schedule J, Part II, Column B in the year funded. The amount ultimately paid under the program to executives is reported on Form 990 Schedule J, Part II, Column F. There were no distributions to a supplemental nonqualified retirement plan during the year. Form 990, Part VI, Section A, line 2 Many of the persons listed on Part VII have a "business relationship" with each other by virtue of employment by related Via Christi Health, Inc. related entities. Form 990, Part VI, Section A, line 6 Catholic Care Center, Inc. has two corporate members, Via Christi Villages, Inc. and Catholic Diocese of Wichita. Form 990, Part VI, Section A, line 7a Catholic Care Center, Inc. has two corporate members, Via Christi Villages, Inc. and the Catholic Diocese of Wichita, who have the ability to elect members to the governing body of Catholic Care Center, Inc. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Catholic Care Center, Inc.'s financial information or corporation as a whole are subject to approval by its corporate members, Via Christi Villages, Inc. and the Catholic Diocese of Wichita. Form 990, Part VI, Section B, line 11 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, Section B, line 12c The Organization's Conflict of Interest Policy is monitored/enforced as part of the system-wide procedures of Via Christi Health, Inc. and not 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, Section B, line 15 Catholic Care Center, Inc. uses the policies established by Via Christi Health, Inc. (VCH). VCH has established a common philosophy, strategy, and processes for executive compensation. Through the oversight of the VCH Executive Compensation Committee, executive compensation is competitively positioned at its stated market position when compared to the compensation paid by relevant organizations (comparably-sized health systems, 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 transaction 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, Section C, line 19 Catholic Care Center, Inc.'s governing documents and Conflict of Interest Policy are available to the public upon request. Form 990, Part VII, Section B: Payments to Simpson & Associates, Robl Commercial Construction, FF&E Specialty Group and Viztum Commercial Flooring represent payments for both materials and services. These amounts cannot be separated. Form 990, Part XI, line 9: Miscellaneous Audit Adjustment -395.