2013-08-09T10:58:30-05:00 2012-09-30 GRANT THORNTON LLP 8300 THORN DRIVE SUITE 300 WICHITA KS 672262708 990 2011-10-01 480543778 Via Christi Hospital Pittsburg Inc % MIKE JOY VIAC 6202316100 1 Mt Carmel Way Pittsburg KS 66762 Mike Joy 2013-08-01 true Kimberly Temple 3162653231 2011 2016-02-24 21:20:13Z Randall Cason 1 Mt Carmel Way Pittsburg KS 66762 91025814 false 0928 X www.via-christi.org X 1903 KS Inspired by the Gospel and our Catholic tradition, we serve as a healing presence with special concern for our neighbors who are vulnerable. 12 10 952 109 295593 99038 166641 182308 87055068 87021247 1633130 1689366 2181871 1955389 91036710 90848310 0 0 0 0 44715790 46268228 0 0 0 35908636 39223893 80624426 85492121 10412284 5356189 88963055 116130505 11142992 26369656 77820063 89760849 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. false false 68785802 87967873 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. An expanded description of the organization's program services can be found on Schedule O. 68785802 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 false false true false false false false false false false false false false false false false true true true false false true 92 0 true 952 true true true false false false false false false false false false X 12 10 false false false false true true true true true false false true true true true true true true true true false X MIKE JOY 6202320109 1 MT CARMEL WAY Pittsburg KS 66762 X John Mitchelson 1.0 X X 0 0 0 Randall Cason 50.0 X 0 335849 47127 Tammy Battaglia MD 1.0 X 0 0 0 Marty Beezley 1.0 X 0 0 0 Susanne Daniels 1.0 X 0 0 0 Chuck Hosman 1.0 X 0 0 0 Sr Marie Veronica Janousek 1.0 X 0 15132 0 Rodney Odgers MD 1.0 X 0 0 0 Richard Oler 1.0 X 0 0 0 Steve Scott 1.0 X 0 0 0 Vince VanBecelaere 1.0 X 0 0 0 Wendell Wilkinson 1.0 X 0 0 0 Randall Peterson 1.0 X 0 640820 135270 Drew Talbott 50.0 X 149888 0 31521 Debra Cartwright 50.0 X 205085 0 31845 Bill Aquino 50.0 X 166950 0 29706 Riaz Baqir 50.0 X 456902 0 25909 Ali Hammad 50.0 X 902583 0 32056 Bashar Marji 50.0 X 930591 0 28749 Boban Mathew 50.0 X 647415 0 33993 Danny Reveal 50.0 X 557662 0 28736 Connie McCune 0.0 X 194640 0 1179 4211716 991801 426091 31 true true false Rehabcare Group Inc PO Box 502096 ST LOUIS MO 63150 Staffing 687881 Pittsburg Emergency Physicians LLC 8717 W 110th St Ste 500 OVERLAND PARK KS 66210 Staffing 509993 DeWitt and Associates Inc PO Box 3378 GS SPRINGFIELD MO 65808 Construction 3935126 Regional Medical Laboratory of SEK 2401 S Tucker Suite 5 PITTSBURG KS 63150 Staffing 462217 HMN Architects Inc 7400 W 110th Street Suite 200 OVERLAND PARK KS 66210 Construction 447529 12 175205 7103 182308 PATIENT SERVICE REVENUE 621110 85060396 85060396 LABORATORY SERVICES 621500 260851 144932 115919 MEANINGFUL USE REVENUE 621110 1700000 1700000 87021247 956463 956463 0 0 205611 134343 71268 71268 71268 774133 1931 43161 774133 -41230 732903 732903 0 0 0 CAFETERIA 900099 434718 434718 CATERING 722320 139794 40560 99234 DURABLE MEDICAL EQUIPMENT 621610 50716 50716 1258893 991277 88398 179218 1884121 90848310 87896605 295593 2473804 0 0 0 0 775374 775374 0 36385312 33317577 3067735 774915 665725 109190 5968222 5258686 709536 2364405 2094458 269947 1196989 57985 1139004 4101 4101 0 0 0 0 9198265 6455247 2743018 359289 5083 354206 15922052 15410850 511202 5016192 971 5015221 0 1076280 1069524 6756 227393 161761 65632 0 55782 42176 13606 519475 519475 0 3906478 3700413 206065 728899 196294 532605 MEMBERSHIP DUES 405524 129449 276075 SOCIAL EVENTS 116280 34871 81409 VEHICLE FUEL & MAINTENANCE 105066 48001 57065 INCOME TAX EXPENSE 55746 55746 330082 80985 249097 85492121 68785802 16706319 0 18824000 5959773 22803154 37644556 0 0 10033207 12891873 0 0 0 0 0 0 1957745 2195332 333627 184608 86517390 48767183 33674501 37750207 0 0 0 0 0 0 0 0 1336821 19504156 88963055 116130505 11036349 7145573 0 0 0 5915 0 0 0 0 0 0 0 0 0 0 106643 19218168 11142992 26369656 X 77820063 89760849 0 0 0 0 77820063 89760849 88963055 116130505 X 5356189 6584597 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 10224 10224 false Lobbying Activities Part II-B, Question 1i Via Christi Hospital Pittsburg, Inc. pays dues to the Kansas Hospital Association (KHA), the American Heart Association (AHA), the Catholic Health Association (CHA), and the Pittsburg Chamber of Commerce (Chamber) who are involved in lobbying activities. For fiscal 2012 it was determined that 15.0% (KHA), 24.42% (AHA), 3.0% (CHA), and 5.0% (Chamber) of the dues were used for lobbying activites. Dues % Lobbying Total AHA 14,137 24.42% 3,452 KHA 41,467 15.00% 6,220 CHA 17,919 3.00% 538 Chamber 288 5.00% 14 ------ ----- 73,811 10,224 168788 168788 43447785 15977916 27469869 41033241 32154203 8879038 1867576 635064 1232512 37750207 MEDICAID/MEDICARE SETTLEMENT 115247 SETTLEMENT RECEIVABLE 1725428 RELATED PARTY RECEIVABLES 16553279 OTHER CURRENT ASSETS 965619 INVESTMENT IN RML OF SEK 144583 19504156 0 ASSET RETIREMENT OBLIGATION 116964 VCHS NOTE PAYABLE 18000000 PENSION DEPOSITS PAYABLE 1101204 19218168 FIN 48 (ASC 740) Footnote Part X, Question 2 The organization follows the FIN 48 policy of Via Christi Health, Inc. (VCH) and the policy is provided in the VCH consolidated audited financial statements. 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. true true X true X true X true true true false true true 7147000 0 7147000 0.08360 10980000 10370000 610000 0.00710 18127000 10370000 7757000 0.09070 293399 2588 290811 0.00340 14711 14711 0.00020 63623 27945 35678 0.00040 12834 12834 0.00020 99601 99601 0.00120 484168 30533 453635 0.00540 18611168 10400533 8210635 0.09610 400 400 3919 3919 116 116 104 104 819 819 5358 5358 true 2245803 28424669 30128782 -1704113 X true true RML of SEK Laboratory Services 0.50000 1 1 Via Christi Hospital Pittsburg Inc

1 Mt Carmel Way Pittsburg KS 66762

X X X Level III Trauma Ctr Cancer Center Heart Center Via Christi Hospital Pittsburg Inc 1 true true 200. true 400. true X X X X X X X true true X X X true false true X false false ANNUAL COMMUNITY BENEFIT REPORT PART I, Question 6b A community benefit update that includes data from Via Christi Hospital Pittsburg, Inc. (VCH-P) is printed in Via Christi Health's annual report. This annual report is released in various formats to the public and is available at the Via Christi Health website at www.viachristi.org/about-us or upon request. In addition, VCH-P makes public presentations, when invited, on the findings of the latest health needs assessment. COMMUNITY BENEFIT PROGRAMS PART I, Question 7 For examples of some of the community benefit programs provided by Via Christi Hospital Pittsburg, Inc. see the Schedule O footnote for Part III, Statement of Program Services. COMMUNITY BUILDING ACTIVITIES PART II Community building activities are essential roles for health care organizations in that they address many of the underlying determinants of health. Research has consistently shown that when the socioeconomic factors influencing health are explored, health care actually plays a smaller role proportionately. A report in the Journal of American Medical Association and the Center for Disease Control suggests that the determinants impacting health are as follows: lifestyle and behaviors, 50%; environment, 20%; genetics and human biology, 20%; and health care, 10%. Community building activities help to address the other determinants outside of the role traditionally played by health care organizations. The hospital provides timely and specific resources to help community organizations through donations to fulfill their missions of improving the well-being of the community and contributing to its overall health status in ways that may differ from direct clinical services provided by the hospital. These activities are almost exclusively done in partnership with other community organizations, which are better suited to address identified community needs. Listed below are just a few of the Community Building activities reported by our hospital during FY2012. This is not a complete listing but a sampling of how the hospital participates in the health of the community through its Community Building activities. Chamber of Commerce - Via Christi Hospital Pittsburg, Inc. (VCH-P) hosts an annual chamber coffee to update chamber members on health challenges in the area, community needs that have been addressed by the hospital during the last year, new health services that have come into town, or services that may have relocated. This event gives chamber members, especially those who are employers, new information to share with their employees to increase service awareness or introduce services to people who have moved into the area. VCH-P involvement improves awareness of health related services and gives them an opportunity to collect additional data on possible gaps that can be incorporated into future health assessments. Crawford County Leadership Program - Staff participated and graduated from this leadership program. The purpose is to network with community leaders to get a better understanding of area needs and how their participation can assist in addressing those needs. Participants look at time, talent, and resources they or their employers can bring to bear on the identified needs. VCH-P involvement improves awareness of health related services to those involved in leadership position and also gives them another informal way of collecting data on possible gaps for future health assessments. Conference Room Usage by Non-Health Related Organizations - VCH-P offers a conference room for civic groups who are engaged in supporting community efforts or whose mission is to advance the quality of life for others (e.g. Kiwanis, Rotary, etc). These groups meet for free at the hospital thus saving their resources to address community needs. By offering this donated space, VCH-P ensures that these groups have more money to carry on their mission of promoting economic development of the area or a better quality of life for those who live in the Pittsburg area. High School Students Shadowing and In-Class Presentations - VCH-P organized a shadowing experience for high school students interested in the Cancer Center. These high school students were interested in learning more about careers that are available to work with cancer patients. By hosting these experiences, VCH-P is hopeful that students will be challenged to enter health care careers. Research has shown that when youth have direct exposure to professionals who serve in their areas of interest, they are more likely to succeed with current studies. In addition, staff has gone out to area schools to give presentations on specific health professions during career days. These presentations are useful in promoting awareness about health careers and allow students to ask questions on educational requirements and potential employment opportunities. Youth Leadership Program - In partnership with Pittsburg's Chamber of Commerce, VCH-P staff partnered with sixth graders in the five county area elementary schools. Staff worked with students through activities and discussions on various aspects of leadership. The involvement of VCH-P's staff time is to ensure young children know the importance of leadership and how they can use these skills to enrich the lives of others (e.g. reduce the effects of bullying or improve healthier choices through peer examples). Participation on the State's Trauma Registry Subcommittee - Staff participate on the State's subcommittee. The trauma registry provides the mechanism to collect data and evaluate trauma care and allows researchers the ability to analyze patient data for quality improvement, injury control, and resource utilization of local, state, and national level. While hospitals are required to maintain a trauma registry, there is no requirement that staff serve on State level committees. By participating at this level, VCH-P saves the State additional staffing money plus ensures that quality data is being collected through their involvement of monitoring patient outcomes. BAD DEBT EXPENSE PART III, LINE 3 The organization has no suitable basis for estimating bad debt expense that would be attributable to patients eligible under the organization's charity care policy. Audit Note on Bad Debt Expense Part III, Section A, Question 4 The provision for bad debt expense is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payer category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for bad debt expense to establish an appropriate allowance for uncollectible accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, The Health System follows established guidelines for placing certain past-due patient balances with collection agencies, subject to terms of certain restrictions on collection efforts as determined by the Health System. Accounts receivable are written off after collections efforts have been followed in accordance with the Health System's policies. VCH-P reports bad debt in accordance with generally accepted accounting principles (GAAP). Healthcare Financial Management Statement 15 is followed to the extent that it aligns with the guidelines set forth by GAAP. Bad debt expense at cost is determined using the same cost-to-charge ratio that is used for charity care and Medicaid shortfall. VCH-P follows the guidance from CHA and does not consider bad debt as a community benefit. Medicare Shortfall PART III, Section B, Question 8 VCH-P follows the CHA guidelines regarding Medicare and does not include it as community benefit. Debt Collection Policy Part III, Section C, Question 9b It is the policy of VCH-P to promote socially just practices for billing and collections for all patients receiving care. The policy is intended to further the VCH-P 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-P will perform a reasonable review of each account to verify that the patient/guarantor is not potentially eligible for any government assistance program (e.g., Medicaid, Medicare, etc.) and would likely not qualify for charity care. VCH-P 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'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. Financial Assistance Policy Part V, Question 13g The full policy is not posted in each of these areas; however, reference to the policy is posted and the policy is immediately available to anyone who requests it. Needs Assessment Part VI, Question 2 Ministry representatives are involved with numerous coalitions that periodically assess community needs (e.g. Early Childhood Development Taskforce, Family Resource Center, Personal Action Toward Health Coalition for Seniors, Pittsburg Area Community Outreach, Project Warmth, Community Health Center of Southeast Kansas, United Way, and others) and in FY2011 conducted their own health assessment. Secondary data, other community assessments, and one-on-one interviews with community leaders, social service providers, health care providers, and government representatives are used to conduct the assessment. Patient Education of Eligibility for Financial Assistance Part VI, Question 3 The VCH-P financial assistance staff is trained on how to qualify patients for Medicaid, SCHIP, and other such income-based programs. During the patient's registration, admissions, and discharge processes, VCH-P staff attempt to identify patients who may be eligible for charity or discounted care through the charity care policy. In addition, VCH-P uses a percentage of the Federal Poverty Guidelines (FPG) to determine free and discounted care. Community Information PART VI, Question 4 The primary counties for Pittsburg ministries include Crawford and Cherokee Counties. Crawford County has a land area of 590 square miles and Cherokee County has a land area of 588 square miles. Crawford County has an estimated 2011 population of 39,220 compared to Cherokee County's 21,385. The population demographics for Crawford County include: 92.6% white; 2.3% Black; 1.0% American Indian; 1.4% Asian; and 4.7% persons of Hispanic or Latino origin. Cherokee County demographics include: 90.7% white; 0.8% Black; 3.9% American Indian; 0.4% Asian; and 2.2% persons of Hispanic or Latino origin. Approximately 5.8% of the Crawford County residents and 2.6% of the Cherokee County residents reported using a language other than English in their homes. High school graduation rates, for the years 2007-2011, were 88.7% in Crawford County and 85.8% in Cherokee County. A bachelor's degree or higher was reported by 27.8% of Crawford County residents and 13.4% for Cherokee County residents. Median household income for Crawford County residents for the years 2007-2011 was $36,043 compared to $41,513 for Cherokee County. Median value of owner-occupied housing units for the same time period was $85,200 for Crawford County and $71,400 for Cherokee County. According to Quick Facts from the US Census, 19.1% of Crawford County lived below the poverty level between the years 2007-2011. This is higher than the 12.6% identified for the State of Kansas. Cherokee County is also above the State of Kansas' level as 15.4% of their residents suggest that they live below the poverty level. VCH-P is the only hospital facility in the City of Pittsburg. There are other hospitals in neighboring communities, but they offer fewer services. In order to find a similar medical facility, patients would need to travel to Joplin, Missouri or Tulsa, Oklahoma for emergency care. Kansas reported in 2011 that 13.3% of all residents were persons 65 years of age and older. This compares to 14.0% for Crawford and 16.1% for Cherokee Counties. Thus services for a growing aging population need to be monitored in future assessments. Promotion of Community Health PART VI, Question 5 VCH-P and its affiliates enrich the communities in which they operate as well as the broader community, improving medicine through research, educating physicians and other health care providers, and providing care and support to people in need. VCH-P further supports this mission with a community board, open medical staff, and an emergency room available to patients regardless of ability to pay. Community representation on the Governing Body - The Board of Trustees is the governing body of VCH-P. The majority of its members are external members comprised of persons who reside in or around Sedgwick County. The board has overall responsibility for the charitable mission of the organization as set forth in its Articles of Incorporation and Bylaws. Trustees are selected based on their expertise, experience, and other criteria established by the nominating committee of the Board of Trustees. Areas of expertise and experience include such areas as health care, 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. Targeted Population Health Fairs and Screenings are conducted annually for children, seniors, and the broader community. Screenings include blood pressure checks, eye exams, hearing tests, feet exams, sport physicals, bone density, BMI, pre-concussion testing, and recommendations for establishing a medical home. During FY 2012, VCH-P Staff held or participated in health fairs given at government offices, local businesses, area churches, Pittsburg State University Family Day, area high schools, senior villages, and at the Aging Expo. In addition, the Cancer Center staff held a skin cancer screening and was involved in circulating hemocult kits for colorectal cancer screenings. The Sports Medicine staff provided high school wellness/sports medicine physicals at a discounted rate of $10 per student. Community Boards/Committees/Coalitions - VCH-P staff serve on various not-for-profit boards, committees, and coalitions to keep informed about community needs and to share resources and expertise with various groups as they work to achieve their missions. In FY 2012, VCH-P served with the following: Pittsburg State University School of Nursing Advisory Board; Local Emergency Preparedness Committee; Live Well Health and Wellness Committee of Crawford County; Elm Acres Foundation Board; Crawford County Community Coalition; Angels Among Us, and Pittsburg Ministerial Alliance Association. CareVan, a popular transportation program owned and operated by VCH-P, provides non-emergency medical transportation assistance to elderly and handicap individuals. In FY 2012, VCH-P's CareVan provided 8,876 trips at a cost of $222,802. Health Profession Education of area physicians, nurses, physician assistants, nursing students and other health care professionals who are either looking for continuing education credits, wanting more hands-on training, or are in need of field practicum placements, etc. are welcomed at VCH-P for additional training opportunities. Over 180 students spent time at VCH-P getting hands-on experience in a learning environment during FY 2012. In-Kind Donations through staff assistance of other not-for-profit organizations in meeting their missions and/or sharing of hospital space to conduct health related not-for-profit business are other ways that VCH-P gives back to the community. In FY 2012, VCH-P participated with a number of groups like American Red Cross On-Site Blood Drive, Pittsburg Corporate Challenge, Community Foundation of Southeast Kansas, and various civic groups. In addition, VCH-P partnered with the Salvation Army and Wesley House to collect food and clothing donations from area residents; prepare ready-to-eat pies for the Lion's Club chili feed; provide assistance with purchasing medications for indigent patients when other resources aren't available; prepare 225 servings of ready-to-eat potato soup for Project Warmth; provide athletic training to St Mary's High School trainers and during games; and provide sharps disposal container for the public. Community Education - VCH-P staff prepared and provided educational opportunities for the community on a variety of topics. During FY 2012, presentations were made on child car seat installations; pain management for people with arthritis; breast cancer awareness; skin cancer, colorectal cancer; childbirth preparation classes; rural trauma team class; women heart health; and smoking cessation and/or smoking prevention. Overall, VCH-P's combined community benefit programs (not counting unpaid reimbursement of Medicare or bad debt) accounted for $8.2 million to the geographical area of Pittsburg, Kansas for FY 2012. Affiliated Health Care System Part VI, Question 6 VCH-P is an affiliate of Via Christi Health, Inc. (VCH). 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 and state level. State Filing of Community Benefit Report Part VI, Question 7 Kansas does not require hospitals to file community benefit reports but Via Christi Health, Inc. distributes our community benefit totals and activities annually in press releases as well as in our annual report. X X X X true true false false false false false false false Drew Talbott 126392 0 20374 0 3122 0 20827 0 10694 0 181409 0 0 0 Debra Cartwright 174581 0 27046 0 3458 0 23617 0 8228 0 236930 0 0 0 Randall Cason 0 263363 0 67645 0 4841 0 36004 0 11123 0 382976 0 0 Randall Peterson 0 502186 0 124597 0 14037 0 125809 0 9461 0 776090 0 0 Bill Aquino 139956 0 22476 0 4518 0 21302 0 8404 0 196656 0 0 0 Riaz Baqir 443933 0 0 0 12969 0 0 0 25909 0 482811 0 0 0 Ali Hammad 745462 0 133371 0 23750 0 0 0 32056 0 934639 0 0 0 Bashar Marji 656810 0 271476 0 2305 0 0 0 28749 0 959340 0 0 0 Boban Mathew 504321 0 0 0 143094 0 0 0 33993 0 681408 0 0 0 Danny Reveal 540668 0 0 0 16994 0 0 0 28736 0 586398 0 0 0 Connie McCune 60864 0 18484 0 115292 0 139 0 1040 0 195819 0 0 0 Severance Paid by the Filing Organization PART I, QUESTION 4a Connie McCune $106,608.68 Supplemental Non-Qualified Retirement Plan PART I, QUESTION 4B Paid by the Filing Organization: Bill Aquino $ 8,818.41 Debra Cartwright $ 10,622.16 Drew Talbott $ 7,985.83 Paid by a Related Organization: Randall Peterson $105,226.91 Randall Cason $ 21,348.92 Statement of Program Services Part III Via Christi Hospital Pittsburg, Inc. (VCH-P) is a member of Via Christi Health (VCH). As a Catholic health system, VCH 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, VCH operates primary care clinics, a low income neighborhood outreach clinic, specialty hospitals and centers, home medical services, therapy centers, and long-term care villages. The obligation to reach out to those in need and to improve community health flows directly from VCH's identity as a faith-based healing ministry. VCH continues its tradition in providing community benefit because we are committed to: o Promoting and defending human dignity o Caring for persons living in poverty and other vulnerable populations o Promoting the common good o Stewarding resources responsibly According to the VCH mission statement, "As a part of Via Christi Health, 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. Per these Guidelines, we report the net expense for community benefit services (i.e. 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-P 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. Health Professions Education - Helping to prepare future health care professionals is a distinguishing characteristic of not-for-profit health care and constitutes a significant community benefit. This category includes programs and financial assistance for physicians and medical students, nurses and nursing students, interns, and other health professionals. For fiscal year ended September 30, 2012 -------------------------------------------------------------- Community Benefit (VCH-P and Subsidiaries): 1. Charity care, at cost $7.1 million 2. Government sponsored health care, net expense $0.6 million Unpaid cost of public indigent care programs (includes Medicaid, SCHIP, other safety net programs; does not include Medicare shortfall) 3. Community Benefit Programs, net expense $0.5 million 4. Total Quantifiable Community Benefit $8.2 million Listed below are just a few of the community benefit programs offered by VCH-P. This is not a complete listing but a sampling of how the hospital gives back to the community while meeting current needs. VCH-P and its affiliates enrich the communities in which they operate as well as the broader community, improving medicine through research, educating physicians and other health care providers, and providing care and support to people in need. VCH-P further supports this mission with a community board, open medical staff, and an emergency room available to patients regardless of ability to pay. Community representation on the Governing Body - The Board of Trustees is the governing body of VCH-P. The majority of its members are external members comprised of persons who reside in or around Sedgwick County. The board has overall responsibility for the charitable mission of the organization as set forth in its Articles of Incorporation and Bylaws. Trustees are selected based on their expertise, experience, and other criteria established by the nominating committee of the Board of Trustees. Areas of expertise and experience include such areas as health care, 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. Targeted Population Health Fairs and Screenings are conducted annually for children, seniors, and the broader community. Screenings include blood pressure checks, eye exams, hearing tests, feet exams, sport physicals, bone density, BMI, pre-concussion testing, and recommendations for establishing a medical home. During FY 2012, VCH-P Staff held or participated in health fairs given at government offices, local businesses, area churches, Pittsburg State University Family Day, area high schools, senior villages, and at the Aging Expo. In addition, the Cancer Center staff held a skin cancer screening and was involved in circulating hemocult kits for colorectal cancer screenings. The Sports Medicine staff provided high school wellness/sports medicine physicals at a discounted rate of $10 per student. Community Boards/Committees/Coalitions - VCH-P staff serve on various not-for-profit boards, committees, and coalitions to keep informed about community needs and to share resources and expertise with various groups as they work to achieve their missions. In FY 2012, VCH-P served with the following: Pittsburg State University School of Nursing Advisory Board; Local Emergency Preparedness Committee; Live Well Health and Wellness Committee of Crawford County; Elm Acres Foundation Board; Crawford County Community Coalition; Angels Among Us, and Pittsburg Ministerial Alliance Association. CareVan, a popular transportation program owned and operated by VCH-P, provides non-emergency medical transportation assistance to elderly and handicap individuals. In FY 2012, VCH-P's CareVan provided 8,876 trips at a cost of $222,802. Health Profession Education of area physicians, nurses, physician assistants, nursing students and other health care professionals who are either looking for continuing education credits, wanting more hands-on training, or are in need of field practicum placements, etc. are welcomed at VCH-P for additional training opportunities. Over 180 students spent time at VCH-P getting hands-on experience in a learning environment during FY 2012. In-Kind Donations through staff assistance of other not-for-profit organizations in meeting their missions and/or sharing of hospital space to conduct health related not-for-profit business are other ways that VCH-P gives back to the community. In FY 2012, VCH-P participated with a number of groups like American Red Cross On-Site Blood Drive, Pittsburg Corporate Challenge, Community Foundation of Southeast Kansas, and various civic groups. In addition, VCH-P partnered with the Salvation Army and Wesley House to collect food and clothing donations from area residents; prepare ready-to-eat pies for the Lion's Club chili feed; provide assistance with purchasing medications for indigent patients when other resources aren't available; prepare 225 servings of ready-to-eat potato soup for Project Warmth; provide athletic training to St Mary's High School trainers and during games; and provide sharps disposal containers for the public. Community Education - VCH-P staff prepared and provided educational opportunities for the community on a variety of topics. During FY 2012, presentations were made on child car seat installations; pain management for people with arthritis; breast cancer awareness; skin cancer, colorectal cancer; childbirth preparation classes; rural trauma team class; women heart health; and smoking cessation and/or smoking prevention. FORM 990 REVIEW PART VI, SECTION B, QUESTION 11B A COPY OF FORM 990 IS PROVIDED TO THE BOARD OF TRUSTEES VIA A SECURE EMAIL PRIOR TO FILING WITH THE IRS. CONFLICT OF INTEREST POLICY PART VI, SECTION B, QUESTION 12C THE CONFLICT OF INTEREST POLICY IS MONITORED/ENFORCED AS PART OF THE SYSTEM-WIDE PROCEDURES AND IS NOT HANDLED AT THE ORGANIZATION 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 COMPLETED 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. COMPENSATION REVIEW PART VI, SECTION B, QUESTIONs 15A & 15B Via Christi Hospital Pittsburg, 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 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 HOSPITAL PITTSBURG, INC.'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. MEMBERS PART VI, SECTION A, Questions 6, 7a, & 7b VIA CHRISTI HEALTH, INC. IS THE SOLE MEMBER. THE MEMBER MAY APPROVE AND REMOVE INDIVIDUALS ON THE BOARD OF TRUSTEES. ARTICLE 2 OF THE BYLAWS PROVIDE THE MEMBER WITH THE FOLLOWING POWERS: *DEFINE, APPROVE, CHANGE, OR INTERPRET THE MISSION, VALUES, PURPOSE, AND PHILOSPHY 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 TRUSTEES OF THE CORPORATION; *APPOINT AND REMOVE THE PRESIDENT AND CEO OF THE CORPORATION; *SUBJECT TO CANONICAL REQURIEMENTS, ESTABLISH THE OVERALL DEBT LIMIT FOR THE CORPORATION 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 VIA CHRISTI HOSPITAL PITTSBURG, INC.; *APPROVE AND REMOVE, WITH OR WITHOUT CAUSE, THE INDEPENDENT AUDITING FIRM FOR VIA CHRISTI HOSPITAL PITTSBURG, INC.; *RECEIVE AND APPROVE OPERATING AND CAPITAL BUDGETS AND FINANCIAL REPORTS OF VIA CHRISTI HOSPITAL PITTSBURG, INC.; *APPROVE FINANCING THROUGH PARTICIPATION IN THE OBLIGATED GROUP OF VIA CHRISTI HEALTH SYSTEM; AND *REVIEW AND APPROVE REAL AND PERSONAL PROPERTY TRANSACTIONS CONSISTENT WITH PROVISION OF CANON LAW. RECONCILIATION OF NET ASSETS PART XI, QUESTION 5 Unrealized Gain 2,403,108 Pension Adjustment 4,036,868 Partnership Adjustment (101,803) Sponsorship Fee (163,576) Transfer from Mt. Carmel 410,000 ----------- Total 6,584,597 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Randall Peterson TITLE:Trustee; Term. 4/20/12 HOURS:49 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 NA false Cornerstone Assisted Living Inc 2622 W Central Suite 100 Wichita KS 67203 481241079 Rtrmnt Home KS 501(c)(3) 09 NA false Gerard House Inc 3144 N Hood Wichita KS 67204 481049532 Shelter KS 501(c)(3) 07 NA false 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 false Mercy Regional Health Center Inc 1823 College Avenue Manhattan KS 66502 481186704 Hospital KS 501(c)(3) 03 NA false Mercy Regional Home Medical Services LLC 2439 Claflin Road Manhattan KS 66502 432024491 Home Medical KS 501(c)(3) 11-III FI NA false Mount Carmel Foundation Inc 1102 E Centennial Drive Pittsburg KS 66762 480961283 Foundation KS 501(c)(3) 11-I VCH-Pitt true Salina Regional Home Medical Services 520 S Santa Fe Ave Suite 140 Salina KS 67401 431948057 Home Medical KS 501(c)(3) 11-III O NA false St Johns Inc 2225 Canterbury Drive Hays KS 67601 202828680 Rtrmnt Home KS 501(c)(3) 09 NA false Via Christi Clinic Services 8200 E Thorn Drive Suite 300 Wichita KS 67226 273984287 Med Clinic KS 501(c)(3) 11-I NA false Via Christi Foundation Inc 723 N McLean Blvd Wichita KS 67203 481173588 Foundation KS 501(c)(3) 11-III FI NA false Via Christi Health Partners Inc 8200 E Thorn Drive Suite 300 Wichita KS 67226 480958974 Mgmt Co KS 501(c)(3) 09 NA false Via Christi Health Inc 8200 E Thorn Drive Suite 300 Wichita KS 67226 481172107 Hospital Supp KS 501(c)(3) 09 NA false Via Christi Healthcare Outreach Program 2622 W Central Suite 100 Wichita KS 67203 481236589 Pace Communit KS 501(c)(3) 09 NA false Via Christi Home Health Wichita Inc 555 S Washington Wichita KS 67211 481046371 Home Health KS 501(c)(3) 09 NA false Via Christi Hospital Wichita St Teresa 14800 W St Teresa Wichita KS 67235 271965272 Hospital KS 501(c)(3) 03 NA false Via Christi Hospitals Wichita Inc 929 N St Francis Wichita KS 67214 481172106 Hospital KS 501(c)(3) 03 NA false VC Immediate Care Mother Mary Anne Inc 929 N St Francis Wichita KS 67214 208374099 Med Clinic KS 501(c)(3) 09 NA false Via Christi InMyHome Inc 2622 W Central Suite 100 Wichita KS 67203 271889960 Hlth Agency KS 501(c)(3) 09 NA false Via Christi Property Services Inc 1100 N St Francis Suite 240 Wichita KS 67214 480948571 Property Mgmt KS 501(c)(4) N/A NA false Via Christi Rehabilitation Hospital Inc 1151 N Rock Road Wichita KS 67206 481158274 Rehab KS 501(c)(3) 03 NA false Via Christi Village Georgetown Inc 1655 S Georgetown Wichita KS 67218 481129325 Rtrmnt Home KS 501(c)(3) 09 NA false Via Christi Village Manhattan Inc 2800 Willowgrove Rd Manhattan KS 66502 481078862 Rtrmnt Home KS 501(c)(3) 09 NA false Via Christi Village McLean Inc 777 N McLean Blvd Wichita KS 67203 481247723 Rtrmnt Home KS 501(c)(3) 09 NA false Via Christi Village Ponca City Inc 1601 Academy Road Ponca City OK 74604 731153337 Rtrmnt Home OK 501(c)(3) 09 NA false Via Christi Village Pittsburg Inc 1502 E Centennial Dr Pittsburg KS 66762 743070971 Rtrmnt Home KS 501(c)(3) 09 NA false Via Christi Villages Inc 2622 W Central Suite 100 Wichita KS 67206 480559086 Mgmt Co KS 501(c)(3) 11-III FI NA false Wamego Hospital Association 711 Genn Drive Wichita KS 66547 721526400 Hospital KS 501(c)(3) 03 MRHC false 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 na 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 Related 66008 13173 false 0 false 0.03165 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 0 0 0.00000 Integrated Healthcare Systems Inc 3311 East Murdock Wichita KS 67208 480941549 Clinic Svcs KS NA C Corp 0 0 0.00000 Sunflower Assurance LTD PO Box 1085 Grand Cayman CJ KY1-1102 980223159 Insurance Co CJ NA Foreign Corp 0 0 0.00000 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 0 0.00000 VCH Iowa PC Trust 8200 E Thorn Drive Suite 300 Wichita KS 67226 276937322 Ben Trust IA NA Trust 0 0 0.00000 false false false false true false false false true false false false false true false true false true Mount Carmel Foundation r 400000 FMV Related Tax Exempt Organizations Part II VIA CHRISTI HOSPITAL PITTSBURG, INC. IS CONTROLLED BY VIA CHRISTI HEALTH, INC. 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.