2013-08-15T08:48:52-05:00 2012-09-30 GRANT THORNTON LLP 8300 THORN DRIVE SUITE 300 WICHITA KS 672262708 990 2011-10-01 481172107 Via Christi Health Inc % JEFF SEIRER VIAC 3168584900 8200 E THORN DRIVE WICHITA KS 67226 DAVID HADLEY 2013-08-01 true Kimberly Temple 3162653231 2011 2016-02-24 21:20:13Z JEFF KORSMO 8200 E THORN DRIVE Suite 300 WICHITA KS 67226 130320649 false 0928 X WWW.VIA-CHRISTI.ORG X 1995 KS AS PART OF A CATHOLIC HEALTH SYSTEM, WE SERVE AS A healing presence WITH SPECIAL CONCERN FOR OUR NEIGHBORS WHO ARE VULNERABLE. 12 11 719 0 267532 0 0 86429044 110358708 29012915 17987885 4593554 1905680 120035513 130252273 0 0 0 0 45470952 52627559 0 0 0 60354576 61482610 105825528 114110169 14209985 16142104 612537640 647402342 430910878 447413361 181626762 199988981 X AS A PART OF 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, INC.'S HISTORY EXTENDS BACK OVER 100 YEARS AND TODAY, ALONG WITH OUR SPONSORING CONGREGATIONS - THE SISTERS OF THE SORROWFUL MOTHER, CONGREGATION OF ST. JOSEPH, SISTERS OF ST. JOSEPH OF CARONDOLET AND THE DAUGHTERS OF CHARITY - WE CONTINUE TO RESPOND TO COMMUNITY NEEDS IN KANSAS AND NORTHEASTERN OKLAHOMA. false false 80926945 111996856 VIA CHRISTI HEALTH, INC., AS A CATHOLIC HEALTH CARE SYSTEM, 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. IN ADDITION TO TYPICAL INPATIENT AND OUTPATIENT SERVICES, VIA CHRISTI HEALTH, INC. OPERATES PRIMARY CARE CLINICS, A LOW INCOME NEIGHBORHOOD OUTREACH CLINIC, SPECIALTY HOSPITALS AND CENTERS, HOME MEDICAL SERVICES, THERAPY CENTERS, AND LONG-TERM CARE VILLAGES. SPECIFIC EXEMPT PURPOSE ACHIEVEMENTS INCLUDE: * MANAGEMENT OF ACUTE CARE FACILITIES THROUGHOUT KANSAS THAT INCLUDE HOSPITAL FACILITIES HOUSING OVER 1,300 BEDS; A REHABILITATION CENTER THAT IS THE HUB FOR 12 OUTPATIENT REHABILITATION CLINICS, AN OCCUPATIONAL AND ENVIRONMENTAL MEDICINE PROGRAM AND A SPORTS MEDICINE PROGRAM; A RESEARCH PROGRAM; A HOME HEALTH PROGRAM; AND 17 FAMILY MEDICINE CLINICS. * MANAGEMENT OF SENIOR CARE FACILITIES THAT SERVE MORE THAN 1,300 RESIDENTS IN ITS 12 SENIOR COMMUNITIES AND PROGRAMS IN KANSAS AND OKLAHOMA. * MANAGEMENT OF AN OUTPATIENT AND RETAIL DIVISION THAT INCLUDES A PORTFOLIO OF COMPANIES PROVIDING AMBULATORY SURGERY, DIAGNOSTIC IMAGING, DURABLE MEDICAL EQUIPMENT, AND REAL ESTATE HOLDINGS. THIS DIVISION ALSO INCLUDES OUTPATIENT CARE SERVICES THAT ARE DELIVERED THROUGH JOINT VENTURES WITH LOCAL PHYSICIANS. 80926945 true false false true false false false false false false true false false true true true false true false false false false false false false false false false false true true false false false false false false false false false true false false false false true true true true false false true 83 0 true 719 true true true true CJ VQ false false false false false false false false X 12 11 false false false false true true true true true false true true true true true true true true true true false X JEFF SEIRER 3168584900 8200 E THORN DRIVE SUITE 300 Wichita KS 672262708 X B Anthony Isaac 1.0 X 0 0 0 David L Strohm 1.0 X X 0 0 0 Donald Wilson 1.0 X 0 0 0 Gerald Aaron 1.0 X X 0 0 0 James C Patton 1.0 X 0 0 0 Jeffrey Korsmo 50.0 X X 318111 0 2070 Jon D Rahman MD 1.0 X 0 0 0 Lois O'Malley 1.0 X 0 0 0 Sr M Jeanine Retzer 1.0 X 0 0 0 Sr M Therese Gottschalk 1.0 X 0 0 0 Msgr Robert E Hemberger 1.0 X 0 0 0 Robert Henkel 1.0 X 0 0 0 David Hadley 49.0 X 558974 0 85163 Gary Knight 49.0 X 362847 0 56480 Jeff Seirer 50.0 X 290945 0 52313 Roberta Johnson 49.0 X 251694 0 38383 Randall Peterson 49.0 X 640820 0 135270 David Gambino 49.0 X 521595 0 71696 Jerry Carley 49.0 X 282325 0 45746 John Shellito 50.0 X 323349 0 61717 Lynnette Rauvolabouta 49.0 X 307336 0 45175 Robert Kenagy 50.0 X 387876 0 79893 Martin Ekrem 50.0 X 399482 0 52032 Diane Hilburn 50.0 X 359610 0 702 Janelle Moerer 50.0 X 349625 0 55031 John Broberg 50.0 X 344539 0 51931 Randy Cason 50.0 X 335849 0 47127 Kevin Conlin 0.0 X 299488 0 720 Richard Allen 0.0 X 242295 0 0 Scott Nygaard MD 0.0 X 283065 0 0 Sherrie String 0.0 X 216835 0 17624 Michalene Maringer 0.0 X 415153 0 0 7491813 0 899073 65 true true false Navigant Consulting 4511 Paysphere Circle CHICAGO IL 60674 Consulting 1498115 MedAssets 100 North Point Center East Suite ALPHARETTA GA 30022 Consulting 1429252 PriceWaterhouseCoopers LLC One North Wacker CHICAGO IL 60606 External Audit 772043 Advisory Board PO Box 79461 BALTIMORE MD 21279 Consulting 543162 CHAN 231 S Bemiston Avenue Suite 300 CLAYTON MO 63105 Internal Audit 1338929 29 0 MANAGEMENT FEES 561000 16792436 16627436 165000 SERVICE CENTER 561000 2358054 2358054 REIMBURSEMENTS 561000 21312050 21312050 HR SERVICE CENTER 561000 6278100 6278100 IT SERVICE CENTER 561000 50570141 50570141 13047927 13047927 110358708 15024589 15024589 0 0 146292 43760 102532 102532 102532 2987862 50 24616 2987862 -24566 2963296 2963296 0 0 0 MISCELLANEOUS 900099 1246694 1246694 PURCHASE DISCOUNTS 900099 162783 162783 POOLED INVESTMENT MGMT FEES 900099 393671 393671 1803148 130252273 111996856 267532 17987885 0 0 0 0 5483793 5483793 0 36931402 23788209 13143193 3058574 1877160 1181414 4210330 2865556 1344774 2943460 1675182 1268278 0 0 1063013 1063013 0 0 0 4879338 2086915 2792423 657158 7043 650115 2365885 2122237 243648 0 0 1432007 47735 1384272 630174 374214 255960 0 624530 432730 191800 11883722 11875295 8427 0 11262616 10167990 1094626 168246 25071 143175 MAINTENANCE CONTRACTS 15162507 14705854 456653 PURCHASED SERVICES 3530009 2811997 718012 UTILITIES 2598108 2514425 83683 COLLECTION FEES 1150453 1150453 4074844 2398879 1675965 114110169 80926945 33183224 0 11445056 50093 172831965 156147660 0 0 0 0 0 0 0 0 236972616 257671132 0 0 7572658 8349454 41642683 10124192 13428086 31518491 0 0 0 0 0 0 15627262 15122121 154659997 178543391 612537640 647402342 13603301 25048609 0 0 0 0 404724952 392673441 0 0 0 0 0 0 0 0 12582625 29691311 430910878 447413361 X 181626762 199988981 0 0 0 0 181626762 199988981 612537640 647402342 X 16142104 2220115 X false true true X true true X X X X false false false SISTERS OF THE SORROWFUL MOTHER 731215174 01 true true true 0 DAUGHTERS OF CHARITY 430887104 01 true true true 0 CONGREGATION OF THE SISTERS OF ST JOSEPH 830481134 01 true true true 0 SISTERS OF ST JOSEPH OF CARONDELET 431227406 01 true true true 0 4 0 false true false false false false true 260065 false false 260065 false LOBBYING PART II-B, Questions 1b & 1g 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 relate to carrying out health care programs. Via Christi Health, Inc. does not participate in activities supporting a political candidate. 3245162 944649 2300513 494854 330021 164833 37719662 8728415 28991247 183005 121107 61898 31518491 INTEREST RECEIVABLE 233788 ASSETS LIMITED AS TO USE 47185229 INVESTMENTS IN AFFILIATES 89855961 CAPITAL ISSUANCE COSTS 3212376 INVESTMENT IN RELATED ORGS. 34202815 OTHER NONCURRENT ASSETS 1876450 OTHER MISC. RECEIVABLES 1976772 178543391 0 PENSION DEPOSITS PAYABLE 1603305 WORKER'S COMP RESERVE 8883926 PROFESSIONAL LIABILITY TAIL ACCRUAL 2909227 RELATED PARTY ACCOUNTS PAYABLE 16294853 29691311 FIN 48 (ASC 740) Footnote PART X, Question 2 With the exception of certain subsidiaries, all of the entities in the Health System are organizations under Section 501(c)(3) of the Internal Revenue Code and are generally exempt from payment of income taxes on related income pursuant to Section 501(a) of the Internal Revenue Code. Subsidiaries which are for-profit organizations are subject to federal and state income taxes. Accounting principles generally accepted in the United States of America require the Health Systems management to evaluate tax positions taken by the Health System and its subsidiaries and recognize a tax liability (or asset) if an uncertain position has been taken that more likely than not would not be sustained upon examination by the Internal Revenue Service. Management has analyzed the tax positions by the Health System and its subsidiaries, and has concluded that as of September 30, 2012 and 2011, there were no uncertain tax positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements. Tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases and operating loss and tax credit carryforwards. Income tax expense or benefit is included in other nonoperating gains and losses in the consolidated statements of operations and changes in net assets. Deferred tax assets and liabilities are measured using enacted tax rates expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. X true true X X X X X true true false false false false false false false David Hadley 441316 0 107317 0 10341 0 73443 0 11720 0 644137 0 0 0 Gary Knight 293708 0 61151 0 7988 0 45256 0 11224 0 419327 0 0 0 Jeff Seirer 246953 0 39375 0 4617 0 41225 0 11088 0 343258 0 0 0 Jeffrey Korsmo 224808 0 0 0 93303 0 0 0 2070 0 320181 0 0 0 Roberta Johnson 211023 0 32782 0 7889 0 33564 0 4819 0 290077 0 0 0 Randall Peterson 502186 0 124597 0 14037 0 125809 0 9461 0 776090 0 0 0 David Gambino 414410 0 95511 0 11674 0 62769 0 8927 0 593291 0 0 0 Jerry Carley 225240 0 51128 0 5957 0 34742 0 11004 0 328071 0 0 0 John Shellito 315515 0 0 0 7834 0 50825 0 10892 0 385066 0 0 0 Lynnette Rauvolabouta 247386 0 54715 0 5235 0 36436 0 8739 0 352511 0 0 0 Robert Kenagy 376233 0 0 0 11643 0 68825 0 11068 0 467769 0 0 0 Martin Ekrem 320221 0 67709 0 11552 0 43038 0 8994 0 451514 0 0 0 Diane Hilburn 11386 0 62169 0 286055 0 622 0 80 0 360312 0 0 0 Janelle Moerer 282518 0 59230 0 7877 0 43840 0 11191 0 404656 0 0 0 John Broberg 265055 0 72373 0 7111 0 40794 0 11137 0 396470 0 0 0 Randy Cason 263363 0 67645 0 4841 0 36004 0 11123 0 382976 0 0 0 Kevin Conlin 31023 0 268192 0 273 0 310 0 410 0 300208 0 0 0 Richard Allen 0 0 0 0 242295 0 0 0 0 0 242295 0 0 0 Scott Nygaard MD 0 0 0 0 283065 0 0 0 0 0 283065 0 0 0 Sherrie String 152190 0 61750 0 2895 0 13217 0 4407 0 234459 0 0 0 Michalene Maringer 1053 0 0 0 414100 0 0 0 0 0 415153 0 0 0 SEVERANCE PAYMENTS PART I, QUESTION 4A Michalene Maringer $414,099.65 Scott Nygaard $283,064.28 Diane Hilburn $284,655.50 SUPPLEMENTAL NON-QUALIFED RETIREMENT PLAN PART I, QUESTION 4B Lynnette Rauvolabouta $ 17,558.72 David Gambino $ 44,393.63 David Hadley $ 57,517.71 Gary Knight $ 23,819.73 Janelle Moerer $ 23,014.95 Jeff Seirer $ 20,399.97 Jerry Carley $ 19,597.32 John Broberg $ 21,695.48 John Shellito $ 30,000.00 Martin Ekrem $ 26,309.72 Randall Peterson $105,226.91 Randy Cason $ 21,348.92 Robert Kenagy $ 48,000.00 Roberta Johnson $ 12,738.14 Gross-Up Payments Part I, Question 1a Jeff Korsmo received a gross-up payment of $52,514 for relocation expenses. Executives also received gross-up payments for long term disability premiums as follows: David Hadley: $2,655 Gary Knight: $2,655 Jeff Seirer: $2,655 Roberta Johnson: $2,125 Randall Peterson: $1,430 David Gambino: $2,655 Jerry Carley: $2,311 John Shellito: $2,655 Robert Kenagy: $1,532 Martin Ekrem: $2,655 Janelle Moerer: $1,736 John Broberg: $2,655 Randy Cason: $2,499 Gross-up payments are fully taxable to the recipient. City of Wichita 486000653 967250TP6 2009-09-24 158093162 Acquire,Construct,&Equip St. Teres false false false City of Wichita 486000653 967250TP6 2009-12-16 90670941 Refunding of Series 1999 Bonds iss false false false City of Wichita 486000653 967250UZ2 2011-09-27 192391340 Remodel/Construct Projects; Refund false false false 26685000 0 158168124 0 0 0 1615345 81026 0 106875884 49595869 0 2011 true false true true 0 0 90670973 0 0 0 812150 0 0 0 89864746 0 2001 true false true true 0 0 192399174 0 0 0 1409624 0 0 1313802 163156419 26518733 true false false true false false false false 0 true 0 false false false false 0 true false true false 0 false 0 false true false false false 0 false 0 false true false true false 0 false 0 false true David Strohm Director 72406 Insurance Policy Commissions false Form 990 Review PART VI, Section B, QUESTION 11B A COPY OF FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS VIA A SECURE EMAIL PRIOR TO FILING WITH THE IRS. Conflict of Interest Policy PART VI, SECTION B, QUESTION 12C 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. 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. Compensation Review PART VI, SECTION B, QUESTIONs 15a & 15b Via Christi Health, Inc. (VCH) has established a common philosophy, strategy, and processes 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. Governing Documents PART VI, SECTION C, QUESTION 19 VIA CHRISTI HEALTH, INC.'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. Community Benefit Report Part III 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 congregations - The Sisters of the Sorrowful Mother, Congregation of St Joseph, Sisters of St Joseph of Carondolet and the Daughters of Charity - 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 Via Christi Health, Inc. (VCH) provides free or reduced health care services for those individuals who meet the financial guidelines. Discounts are based on established definitions of the Federal Poverty Guidelines, and when patients are eligible to receive government assistance they are strongly encouraged to register for this type of financial assistance. VCH provides health care services to all Medicaid recipients regardless of their ability to pay. This amount represents the cost of the amount of care that was given to Medicaid recipients by VCH providers but was not reimbursed by the government. 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: * Report charity care at cost, not charges; * Do not include bad debt, contractual allowances, and quick pay discounts as part of charity care expense; * Do not count Medicare shortfall as a community benefit; and * 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 SEPTEMBER 30, 2012 COMMUNITY BENEFIT - CORPORATE OFFICE ONLY $375,313 COMMUNITY BENEFIT - VIA CHRISTI HEALTH, INC. Consolidated 1) CHARITY CARE - AT COST $46.8 million 2) GOVERNMENT SPONSORED HEALTH CARE - NET EXPENSE $21.7 million (Includes UNPAID COST OF PUBLIC INDIGENT CARE PROGRAMS (MEDICAID, SCHIP, OTHER SAFETY NET PROGRAMS); DOES NOT INCLUDE MEDICARE SHORTFALL) 3) COMMUNITY BENEFIT PROGRAMS - NET EXPENSE $22.0 million Includes: SUBSIDIZED HEALTH SERVICES, INCLUDING BEHAVIORAL HEALTH $15.4 million FINANCIAL AND IN-KIND DONATIONS $ 2.5 million COMMUNITY HEALTH IMPROVEMENT SERVICES $ 1.9 million COMMUNITY BENEFIT OPERATIONS $ 0.2 million Other COMMUNITY Benefit $ 0.6 million TOTAL QUANTIFIABLE COMMUNITY BENEFIT $90.5 million Members PART VI, Section A, QUESTIONs 6, 7a, & 7b THE SPONSORS HAVE DELEGATED THE GOVERNANCE RESPONSIBILITIES OF VIA CHRISTI HEALTH, INC. (VCH) TO THE MARIAN HEALTH SYSTEM INC., A DELAWARE NOT-FOR- PROFIT CORPORATION AND ASCENSION HEALTH, A MISSOURI NOT-FOR-PROFIT CORPORATION (COLLECTIVELY REFERRED TO AS "MEMBERS"). THE MEMBERS HAVE THE RIGHT TO APPROVE OR TAKE ACTION UPON THE RECOMMENDATION OF THE VIA CHRISTI HEALTH, INC., BOARD ON CERTAIN ACTIONS BEFORE THEY BECOME FINAL OR BINDING ON THE CORPORATION. THE FOLLOWING POWERS ARE RESERVED TO THE MEMBERS OR THEIR DELEGATED REPRESENTATIVES: * DEFINE, APPROVE, CHANGE OR INTERPRET THE MISSION, VALUES, PURPOSE, AND PHILOSOPHY OF THE CORPORATION. * APPROVE THE ARTICLES OF INCORPORATION, THE BYLAWS, AND ANY AMENDMENTS THERETO OF THE CORPORATION. * APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS OF VCH. * APPOINT AND REMOVE THE PRESIDENT AND CEO OF VIA CHRISTI HEALTH, INC. (VCH). * SUBJECT TO CANONICAL REQUIREMENTS, ESTABLISHE THE OVERALL DEBT LIMIT FOR VCH AND APPROVE THE INCURRENCE OF DEBT IN EXCESS OF THAT LIMIT. * APPROVE THE DISSOLUTION, MERGER, CONSOLIDATION, OR SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF VCH. * APPROVE AND REMOVE, WITH OR WITHOUT CAUSE, THE INDEPENDENT AUDITING FIRM FOR VCH. * RECEIVE AND APPROVE OPERATING AND CAPITAL BUDGETS AND FINANCIAL REPORTS OF VCH. * APPROVE FINANCING THROUGH PARTICIPATION IN OBLIGATED GROUPS OF ASCENSION HEALTH OR MARIAN HEALTH SYSTEM. * REVIEW AND APPROVE REAL AND PERSONAL PROPERTY TRANSACTIONS CONSISTENT WITH PROVISION OF CANON LAW. NET ASSET RECONCILIATION PART XI, Question 5 Unrealized Gain 17,272,807 Sponsorship Fee ( 634,781) Change in OCI - Pension 2,593,341 Equity Transfer to Related (25,000,000) Beneficial Interest in Subsidiary 10,031,893 Change in Temporarily Restricted Assets ( 2,118,145) Other (includes rounding) 75,000 ------------ TOTAL 2,220,115 Schedule K Supplemental Information Schedule K, Parts I, II, III, & V DESCRIPTION OF PURPOSE SCHEDULE K, PART I, COLUMN F, ROWS A, B, & C ROW A - ACQUIRING, CONSTRUCTING, AND EQUIPPING NEW HEALTH CARE FACILITY; CURRENT REFUNDING OF SERIES 1992 BONDS ISSUED 2/1/1992. ROW B - CURRENT REFUNDING OF SERIES 1999 BONDS ISSUED 10/1/1999. Row C - Acquiring, constructing, and equipping certain hospital improvements; CURRENT refunding of series 2001 bonds issued 7/19/2001. ------------------------------------------------------------------- PROCEEDS OF ISSUE SCHEDULE K, PART II, LINE 3, COLUMNS A, B, & C Part II, Line 3 for Columns A, B, and C differ from the issuance price in Part I, Column E by the following: Column A: $74,962 Investment Income Columm B: $ 32 Investment Income Column C: $ 7,834 Investment Income ------------------------------------------------------------------- REFUNDING PRE-2003 ISSUES SCHEDULE K, PART III, COLUMN B VIA CHRISTI HEALTH, INC. IS FOLLOWING THE SPECIAL RULE FOR REFUNDING OF PRE-2003 ISSUES DESCRIBED IN THE SCHEDULE K INSTRUCTIONS. THE SPECIAL RULE EXEMPTS ISSUES REFUNDING PRE-2003 BONDS FROM COMPLETING PART III. ------------------------------------------------------------------- PROCEDURES TO UNDERTAKE CORRECTIVE ACTION SCHEDULE K, PART V During tax year 2011, Via Christi Health, Inc., did not have written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations. As of 04/01/2013, Via Christi Health, Inc. became a full member of Ascension Health. As of that date, Via Christi Health, Inc. will follow the written procedures of Ascension Health for all outstanding bond issues. ------------------------------------------------------------------- REPORTING RELATED ORGANIZATIONS SCHEDULE K VIA CHRISTI HOSPITALS WICHITA, INC. (VCHW) ALONG WITH VIA CHRISTI HEALTH, INC. (VCH) AND OTHER HEALTH SYSTEM HOSPITALS (THE "OBLIGATED GROUP"), ENTERED INTO A MASTER TRUST INDENTURE AND AN OBLIGATED GROUP AGREEMENT WHEREBY THEY WERE JOINTLY AND SEVERALLY LIABLE FOR ALL AMOUNTS DUE UNDER ANY AND ALL NOTES AND GUARANTEES ISSUED PURSUANT TO THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP CONSISTS OF THE VIA CHRISTI HEALTH, INC., VIA CHRISTI HOSPITALS WICHITA, INC., VIA CHRISTI REHABILITATION HOSPITAL, INC., VIA CHRISTI HOSPITAL PITTSBURG, INC., AND VIA CHRISTI HOSPITAL WICHITA ST. TERESA, INC. ALL BOND DEBT IS REPORTED ON THE BOOKS OF VIA CHRISTI HEALTH, INC. WITH INTERCOMPANY DEBT REPORTED ON THE RESPECTIVE HOSPITAL MINISTRIES. Executive Committee Part VI, Section A, Question 1a The organization's bylaws provide for an executive committee. This Committee shall consist of the Chairperson, the President and two other directors. The Committee shall have the power to transact all regular business of the Board during the period between meetings of the Board, subject to any prior limitations imposed by the Board. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:David Hadley TITLE:CFO/Treasurer HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Gary Knight TITLE:Secretary HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Roberta Johnson TITLE:Assistant Secretary HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Randall Peterson TITLE:SVP Hospitals; Term. 4/20/12 HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:David Gambino TITLE:SVP Strategy HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jerry Carley TITLE:SVP Via Christi Villages HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Lynnette Rauvolabouta TITLE:SVP Mission Integration HOURS:1 Via Christi Clinical Services LLC 8200 E Thorn Drive Suite 300 Wichita KS 67226 204399092 Health Care KS 2372426 197156 VCH Ascension Health PO Box 45998 St Louis MO 63145 311662309 Hlth Sys Gov MO 501(c)(3) 11-I NA false Catholic Care Center Inc 6700 E 45th St N Wichita KS 67226 481067110 Rtrmnt Home KS 501(c)(3) 09 VCV true Cornerstone Assisted Living Inc 2622 W Central Suite 100 Wichita KS 67203 481241079 Rtrmnt Home KS 501(c)(3) 09 VCV true Gerard House Inc 3144 N Hood Wichita KS 67204 481049532 Shelter KS 501(c)(3) 07 VCHW true Marian Health System Inc 1923 South Utica Avenue Tulsa OK 74104 363659989 Hospital Supp DE 501(c)(3) 11-I NA false Mercy Community Health Foundation Inc 1823 College Avenue Manhattan KS 66502 481152279 Foundation KS 501(c)(3) 09 MRHC true Mercy Regional Health Center Inc 1823 College Avenue Manhattan KS 66502 481186704 Hospital KS 501(c)(3) 03 VCH true Mercy Regional Home Medical Services LLC 2439 Claflin Road Manhattan KS 66502 432024491 Home Medical KS 501(c)(3) 11-III FI MRHC true Mount Carmel Foundation Inc 1102 E Centennial Drive Pittsburg KS 66762 480961283 Foundation KS 501(c)(3) 11-I VCH-P true Salina Regional Home Medical Services 520 S Santa Fe Ave Ste 140 Salina KS 67401 431948057 Home Medical KS 501(c)(3) 11-III O VCHP true St Johns Inc 2225 Canterbury Drive Hays KS 67601 202828680 Rtrmnt Home KS 501(c)(3) 09 VCV true Via Christi Clinic Services 8200 E Thorn Drive Suite 300 Wichita KS 67226 273984287 Med Clinic KS 501(c)(3) 11-I VCH true Via Christi Foundation Inc 723 N McLean Blvd Wichita KS 67203 481173588 Foundation KS 501(c)(3) 11-III FI VCHW true Via Christi Health Partners Inc 8200 E Thorn Drive Suite 300 Wichita KS 67226 480958974 Mgmt Co KS 501(c)(3) 09 VCHW true Via Christi Healthcare Outreach Program 2622 W Central Suite 100 Wichita KS 67203 481236589 Pace Communit KS 501(c)(3) 09 VCV true Via Christi Home Health Wichita Inc 555 S Washington Wichita KS 67211 481046371 Home Health KS 501(c)(3) 09 VCVW true Via Christi Hospital Pittsburg Inc 1102 E Centennial Drive Pittsburg KS 66762 480543778 Hospital KS 501(c)(3) 03 VCH true Via Christi Hospital Wichita St Teresa 14800 W St Teresa Wichita KS 67235 271965272 Hospital KS 501(c)(3) 03 VCHW true Via Christi Hospitals Wichita Inc 929 N St Francis Wichita KS 67214 481172106 Hospital KS 501(c)(3) 03 VCH true VC Immediate Care Mother Mary Anne Inc 929 N St Francis Wichita KS 67214 208374099 Med Clinic KS 501(c)(3) 09 VCHW true Via Christi InMyHome Inc 2622 W Central Suite 100 Wichita KS 67203 271889960 Hlth Agency KS 501(c)(3) 09 VCV true Via Christi Property Services Inc 1100 N St Francis Suite 240 Wichita KS 67214 480948571 Property Mgmt KS 501(c)(4) n/a VCHP true Via Christi Rehabilitation Hospital Inc 1151 N Rock Road Wichita KS 67206 481158274 Rehab KS 501(c)(3) 03 VCHW true Via Christi Village Georgetown Inc 1655 S Georgetown Wichita KS 67218 481129325 Rtrmnt Home KS 501(c)(3) 09 VCV true Via Christi Village Manhattan Inc 2800 Willowgrove Rd Manhattan KS 66502 481078862 Rtrmnt Home KS 501(c)(3) 09 VCV true Via Christi Village McLean Inc 777 N McLean Blvd Wichita KS 67203 481247723 Rtrmnt Home KS 501(c)(3) 09 VCV true Via Christi Village Ponca City Inc 1601 Academy Road Ponca City OK 74604 731153337 Rtrmnt Home OK 501(c)(3) 09 VCV true Via Christi Village Pittsburg Inc 1502 E Centennial Dr Pittsburg KS 66762 743070971 Rtrmnt Home KS 501(c)(3) 09 VCV true Via Christi Villages Inc 2622 W Central Suite 100 Wichita KS 67206 480559086 Mgmt Co KS 501(c)(3) 11-III FI VCH true Wamego Hospital Association 711 Genn Drive Wamego KS 66547 721526400 Hospital KS 501(c)(3) 03 MRHC true Ambulatory Surgery Center LP 8200 E Thorn Drive Suite 300 Wichita KS 67226 481007220 Surgery Ctr KS NA n/a 0 0 false 0 false 0.00000 AMS Diagnostics LLC 8200 E Thorn Drive Suite 300 Wichita KS 67226 481223653 Radiology Svc KS NA n/a 0 0 false 0 false 0.00000 Kansas Surgery and Recovery Ctr 8200 E Thorn Drive Suite 300 Wichita KS 67226 481148580 Surgery Ctr KS NA n/a 0 0 false 0 false 0.00000 Mercy Imaging LLC 8200 E Thorn Drive Suite 300 Wichita KS 67226 481251984 Diagnostic Im KS MRHC n/a 0 0 false 0 false 0.00000 MR Imaging Center LLC 8200 E Thorn Drive Suite 300 Wichita KS 67226 481000538 Radiology Svc KS NA n/a 0 0 false 0 false 0.00000 PFI LLC 8200 E Thorn Drive Suite 300 Wichita KS 67226 721557076 Med Chem Mfg KS NA n/a 0 0 false 0 false 0.00000 Preferred PET Imaging of KS LLC 8200 E Thorn Drive Suite 300 Wichita KS 67226 481250123 Diagnostic Im KS NA n/a 0 0 false 0 false 0.00000 St Joseph MRI LLC 8200 E Thorn Drive Suite 300 Wichita KS 67226 481007220 Medical Svcs KS NA n/a 0 0 false 0 false 0.00000 Via Christi Cyberknife LLC 8200 E Thorn Drive Suite 300 Wichita KS 67226 354588711 Radiology Svc KS na n/a 0 0 false 0 false 0.00000 Affiliated Medical Services Lab Inc 2916 E Central Wichita KS 67214 481239522 Medical Lab KS NA C Corp 1.00000 Integrated Healthcare Systems Inc 3311 East Murdock Wichita KS 67208 480941549 Clinic Svcs KS NA C Corp 84727641 41028592 1.00000 Sunflower Assurance LTD PO Box 1085 Grand Cayman CJ KY1-1102 980223159 Insurance Co CJ NA C Corp 1.00000 Via Christi Clinic PA 3311 East Murdock Wichita KS 67208 480993446 Prof Assoc KS NA C Corp 0 0 0.00000 VCH Iowa PC 8200 E Thorn Drive Suite 300 Wichita KS 67226 273983977 Holding Co IA NA Trust 0 48710195 1.00000 VCH Iowa PC Trust 8200 E Thorn Drive Suite 300 Wichita KS 67226 276937322 Ben Trust IA na Trust 0 0 1.00000 true false false true false false false false true false false false false true true true true true Via Christi Hospitals Wichita Inc a 3861120 Cost Mercy Regional Health Center Inc a 391077 Cost Via Christi Villages Inc a 329635 Cost Via Christi Clinic PA a 154475 Cost Via Christi Hospitals Wichita Inc d 121507450 Cost Mercy Regional Health Center Inc d 5715158 Cost Via Christi Villages Inc d 4799210 Cost Via Christi Hospitals Wichita Inc n 975192 Cost Via Christi Villages Inc n 330993 Cost Via Christi Hospital Pittsburg Inc n 382747 Cost Mercy Regional Health Center Inc n 344473 Cost Via Christi Clinic PA n 1736420 Cost Via Christi Hospital Wichita Inc r 7386996 Cost Mercy Regional Health Center Inc r 2033748 Cost Via Christi Villages Inc r 959004 Cost Via Christi Hospital Pittsburg Inc r 1139004 COST Via Christi Hospitals Wichita Inc o 22619836 COST Mercy Regional Health Center Inc o 6923589 COST Via Christi Villages Inc o 2272734 cost Via Christi Hospital Pittsburg Inc o 7339223 cost Related Tax Exempt Entities Part II VIA CHRISTI HEALTH, INC. IS JOINTLY SPONSORED AND CONTROLLED BY ASCENSION HEALTH AND MARIAN HEALTH SYSTEM, WHICH IN TURN ARE SPONSORED BY THE SISTERS OF THE SORROWFUL MOTHER, FOUR PROVINCES OF THE DAUGHTERS OF CHARITY, THE CONGREGATION OF ST. JOSEPH, AND THE SISTERS OF ST. JOSEPH OF CARONDELET. DUE TO SUCH SPONSORSHIP AND CONTROL, AND IN THE INTEREST OF INCREASED CLARITY AND TRANSPARENCY, BOTH ASCENSION HEALTH AND MARIAN HEALTH SYSTEM ARE BEING LISTED AS RELATED ORGANIZATIONS ON SCHEDULE R.