2012-08-12T19:19:40-05:00 2011-09-30 GRANT THORNTON LLP 8300 THORN DRIVE SUITE 300 WICHITA KS 672262708 990 2010-10-01 480543778 VIA CHRISTI HOSPITAL PITTSBURG INC VIAC 6202316100 1 MT CARMEL WAY PITTSBURG KS 66762 DEBRA BAINBRIDGE 6202316100 2012-08-01 true Kimberly Temple 3162653231 2010 2016-02-24 21:20:13Z RANDY CASON 1 MT CARMEL WAY PITTSBURG KS 66762 91063186 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. 15 10 932 169 351905 145031 376416 166641 83374501 87055068 1423804 1633130 1935598 2181871 87110319 91036710 19067 0 0 0 43943625 44715790 0 0 0 38800751 35908636 82763443 80624426 4346876 10412284 81526770 88963055 11395591 11142992 70131179 77820063 X VIA CHRISTI HOSPITAL PITTSBURG, INC. SHARES THE SAME MISSION AS VIA CHRISTI HEALTH, INC. 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 63750625 88015279 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. 63750625 true true false true false false false false false true false false false 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 57 0 true 932 true true true false false false false false false false false false X 15 10 false false false false true true true true true false false true true true true true true true true true false KS X DEBRA BAINBRIDGE 6202320109 1 MT CARMEL WAY PITTSBURG KS 66762 X RODNEY ODGERS MD 1.0 X 0 0 0 WENDELL WILKINSON 1.0 X 0 0 0 TAMMY BATTAGLIA MD 1.0 X 0 0 0 SR SUSANNE DANIELS 1.0 X 0 0 0 RANDALL PETERSON 1.0 X 0 537324 159950 SR MARIE VERONICA JANOUSEK 1.0 X 0 21937 3624 CHUCK HOSMAN 1.0 X 0 0 0 DEBRA BAINBRIDGE 50.0 X X 207771 0 31304 DREW TALBOTT 50.0 X X 152802 0 30770 RICHARD OLER 1.0 X 0 0 0 JOHN MITCHELSON 1.0 X X 0 0 0 STEVE SCOTT 1.0 X 0 0 0 MARTY BEEZLEY 1.0 X 0 0 0 RANDY CASON 50.0 X X 0 232712 42242 VINCE VAN BECELAERE 1.0 X 0 0 0 CONNIE MCCUNE 50.0 X 143726 0 26742 BILL AQUINO 50.0 X 168930 0 26807 JULIANNA RIESCHICK 50.0 X 118031 0 16311 ALI HAMMAD MD 50.0 X 891579 0 31017 DANNY REVEAL MD 50.0 X 603566 0 26434 BASHAR MARJI MD 50.0 X 942562 0 26803 BOBAN MATHEW MD 50.0 X 505494 0 33271 JACOB TARABOLOUS DO 50.0 X 397527 0 25951 JONATHAN DAVIS 0.0 X 0 78356 0 4131988 870329 481226 32 true true false Pittsburg Emergency Physicians LLC 12 Corporate Woods Suite 250 OVERLAND PARK KS 66210 STAFFING 127692 DMS Health Technologies PO Box 86 MINNEAPOLIS MN 55486 PET IMAGING 122891 JE Dunn Construction Co 929 Holmes KANSAS CITY MO 64106 CONSTRUCTION 121939 Rehabcare Group Inc PO Box 502096 ST LOUIS MO 63150 STAFFING 109358 Regional Medical Laboratory of SEK 2401 S Tucker Suite 5 PITTSBURG KS 66762 LABORATORY 103799 6 151982 14659 166641 PATIENT SERVICES 621110 87055068 87055068 87055068 626611 626611 0 0 180494 26476 154018 154018 154018 989049 17470 0 0 989049 17470 1006519 1006519 0 0 0 CAFETERIA 900099 408891 408891 PASS-THROUGH 900003 251581 114543 120796 16242 CATERING-INHOUSE 722320 159859 39745 120114 1207522 960211 191364 55947 2027853 91036710 88129822 351905 2388342 0 0 0 0 1556297 158276 1398021 0 34496006 30779986 3716020 1690241 1451284 238957 4564494 3350540 1213954 2408752 2043503 365249 2544026 17978 2526048 30462 30462 0 0 0 0 8196229 6455061 1741168 415141 7693 407448 14435155 13951174 483981 2935724 3677 2932047 0 1145852 1144128 1724 158195 99143 59052 0 13343 9330 4013 23211 23211 0 4043057 3788819 254238 833918 253895 580023 MEMBERSHIP DUES 341683 112755 228928 SOCIAL EVENTS 140504 38879 101625 VEHICLE FUEL & MAINTENANCE 100812 43529 57283 PHYSICIAN LOAN FORGIVENESS 150663 150663 INCOME TAX 143682 143682 256979 40975 216004 80624426 63750625 16873801 0 10904452 18824000 24243758 22803154 9526098 10033207 1833763 1957745 665665 333627 78702061 45027560 33875949 33674501 477085 1336821 81526770 88963055 10383948 11036349 905000 0 106643 106643 11395591 11142992 X 70131179 77820063 70131179 77820063 81526770 88963055 X 10412284 -2723400 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 10787 10787 false LOBBYING ACTIVITIES SCHEDULE C, PART II-B, QUESTION 1I VIA CHRISTI HOSPITAL PITTSBURG, INC. (VCH-P) pays dues to the Kansas Hospital Association (KHA), THE AMERICAN HEART ASSOCIATION (AHA), THE CATHOLIC HEALTH ASSOCIATION (CHA), and Pittsburg Area Chamber of Commerce (Chamber) who are involved in lobbying activities. For FY 2011 it was determined that 15.0% OF KHA, 24.60% OF AHA, 5.15% OF CHA and 5% OF THE Chamber dues were used for lobbying activites. VCH-P DOES NOT HAVE AN ACTIVE 501(H) ELECTION. KHA LOBBYING: $ 6,096 AHA LOBBYING: $ 3,798 CHA LOBBYING: $ 817 CHAMBER LOBBYING: $ 76 ------- $10,787 168788 168788 36756770 14398502 22358268 38392530 30059652 8332878 3383973 569406 2814567 33674501 0 ASSET RETIREMENT OBLIGATION 106643 106643 FIN 48 SCHEDULE D, PART X 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 ENTITIES, ALL OF THE ENTITIES IN THE HEALTH SYSTEM ARE ORGANIZATIONS DESCRIBED IN 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. 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 CARRYFORWARD. INCOME TAX EXPENSE OR BENEFIT IS INCLUDED IN OTHER NON-OPERATING GAINS AND LOSSES IN THE CONSOLIDATED STATEMENTS OF OPERATION 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 6847000 0 6847000 0.08490 10060000 13899000 -3839000 0.04760 16907000 13899000 3008000 0.03730 246867 4578 242289 0.00300 83702 0 83702 0.00100 60250 25165 35085 0.00040 1962 0 1962 166430 0 166430 0.00210 559211 29743 529468 0.00650 17466211 13928743 3537468 0.04380 281 0 281 388 0 388 549 0 549 58 0 58 672 0 672 1948 0 1948 true 635623 0 29507623 31133809 -1626186 X true true RML of SEK Medical Laboratory 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 ANNUAL COMMUNITY BENEFIT REPORT PART I, LINE 6A Annually, a community benefit report is prepared and printed in the Via Christi Health's annual report which is released in various formats to the public and which is also available from the Via Christi Health webpage at www.viachristi.org. In addition, Via Christi Hospitals and their ministries are happy to make public presentations when requested on the findings of the health needs assessment. COMMUNITY BENEFIT PROGRAMS PART I, LINE 7 For examples of some of the community benefit programs provided by Via Christi Hospital Pittsburg 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 the smaller role proportionately. A report in the Journal of American Medical Association and the Center for Disease Control suggests that the factors impacting health are as follows: lifestyle and behaviors, 50 percent; environment, 20 percent; genetics and human biology, 20 percent and health care, 10 percent. Community building activities help to address the other indicators outside of the role traditionally played by health care organizations. These activities are almost exclusively done in some form of partnership in which the community or other organizations are better suited to address identified community needs. Via Christi Health, Inc. (VCH) 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. Donations such as staff time and expertise for trainings or presentations to Chamber, Rotary or other service groups, special population outreach efforts for at-risk children in need of mentoring, assistance in building homes for the homeless or domestic violence victims, donating outdated equipment to free clinics, or other durable goods provided to area shelters and other organizations are all ways to maximize those agencies' resources so they can provide more program services. Pittsburg, KS Via Christi Hospital Pittsburg, Inc. (VCH-P) is a standing member of the Crawford County Community Coalition which is a collaborative effort of county agencies whose mission is to improve the lives of children and families living within county boundaries. VCH-P clinical staff supports high school students who are discerning a health profession career choice by allowing the students to shadow them for a day and/or by clinical staff giving presentations to high school student classes to expose them to the possibilities of the wide variety of health career choices available. These outreach efforts by VCH-P help to ensure that families with children and high school students are aware of health care services available in the community and will feel comfortable in accessing them when needed or in joining them as a career choice when finished with their formal training. BAD DEBT EXPENSE PART III, LINE 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 debts 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 Medicare shortfall. VCH follows the guidance from CHA and does not consider bad debt as a community benefit. MEDICARE SHORTFALL PART III, LINE 8 VCH-P follows the CHA guidelines regarding Medicare and does not include it as community benefit. The methodology described in the instructions to Schedule H, Part III, Section B, Line 7 for reporting Medicare shortfall does not take into account all costs incurred by the Hospital and does not represent the total Medicare shortfall. The Medicare shortfall reported on Schedule H, Part III, Section B, Line 7 was determined using information from the organizations Medicare cost report (using the Medicare Cost report step-down methodology of allocating costs). However, utilizing an internal cost accounting system actually results in a Medicare shortfall of $3,106,000. The most common reason for a difference between the Medicare shortfall reported on Schedule H and the actual shortfall reported above include inclusion of Medicare Advantage revenue and expenses; inclusion of Medicare Part B Revenue and Expenses; inclusion of other fee schedule revenue, other timing issues, and costs that are considered unallowable on the Medicare cost report that are, in fact, related to Medicare patient care DEBT COLLECTION POLICY PART III, LINE 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. NEEDS ASSESSMENT PART VI, LINE 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 KS, United Way and others) and in 2010 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 were used to conduct the MRHC and WCH assessments. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3 VCH financial assistance staff is trained on how to qualify patients for Medicaid, SCHIP and other income-based programs. During the patient's registration, admissions and discharge processes, VCH attempts to identify patients who may be eligible for charity or discounted care through the charity care policy. In addition, VCH uses a percentage of the Federal Poverty Guidelines (FPG) to determine free and discounted care. COMMUNITY INFORMATION PART VI, LINE 4 The primary counties for the Pittsburg ministries includes; Crawford and Cherokee Counties. Crawford County has a land area of 593 square miles and Cherokee County has a land area of 587 square miles. Crawford County has a population of 39,134 compared to Cherokee County's 21,603 in 2010. The population demographics for Crawford County include: 91.2% white; 2.0% Black; 0.9% American Indian; 1.2% Asian; and 4.5% persons of Hispanic or Latino origin. Cherokee County has 90.3% white; 0.5% Black; 4.1% American Indian; 0.3% Asian; and 2.0% persons of Hispanic or Latino origin. 5% of the Crawford County residents and 2.5% of the Cherokee County residents reported using a language other than English in their homes. High school graduation rates, for the years 2005 - 2009, were 88.2% in Crawford County and 84.5% in Cherokee County. A bachelor's degree or higher was reported by 25.3% of Crawford County residents and 14.2% for Cherokee County residents. Median household income for Crawford County residents in 2008 was $34,753 compared to $35,201 for Cherokee County. Median value of owner-occupied housing units was $81,500 for Crawford County and $63,300 for Cherokee County. According to Quick Facts, from the US Census, 19.5% of Crawford County lived below the poverty level in 2009. This is higher than the 13.2% identified for the State of Kansas. Cherokee County is also above the State of Kansas' level as 18.4% of their residents suggest that they live below the poverty level. VCH-P is the only hospital facility in the City of Pittsburg. Other hospitals are in neighboring communities but 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. PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 VCH and its affiliates enrich the communities in which they operate as well as the broader community, improving medicine through research, educating physicians and other healthcare 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 Crawford County and has overall responsibility for the charitable mission of the organization as set forth in its Articles of Incorporation and By Laws. These 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 healthcare, 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. Open Medical Staff - The medical staff of VCH-P is an open medical staff and is composed of physicians, dentists and podiatrists licensed to practice medicine in the State of Kansas. VCH-P staff also participates in the community on boards of other not-for-profit organizations, government entities, foundations, area colleges and university committees, state-wide coalitions, etc. AFFILIATED HEALTH CARE SYSTEM PART VI, LINE 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, LINE 7 Kansas does not require hospitals to file community benefit reports but Via Christi Health distributes our community benefit totals and activities annually in press releases as well as in our annual report. X X X X false true false false false false false false false JONATHAN DAVIS 0 0 0 78356 0 0 0 0 0 0 0 78356 0 0 RANDALL PETERSON 0 443357 0 81238 0 12729 0 151362 0 8588 0 697274 0 0 DEBRA BAINBRIDGE 170856 0 34020 0 2895 0 23524 0 7780 0 239075 0 0 0 DREW TALBOTT 124088 0 25689 0 3025 0 20847 0 9923 0 183572 0 0 0 CONNIE MCCUNE 113707 0 23478 0 6541 0 18926 0 7816 0 170468 0 0 0 BILL AQUINO 137133 0 28409 0 3388 0 18947 0 7860 0 195737 0 0 0 ALI HAMMAD MD 744723 0 121354 0 25502 0 18375 0 12642 0 922596 0 0 0 DANNY REVEAL MD 530613 0 11050 0 61903 0 14140 0 12294 0 630000 0 0 0 BASHAR MARJI MD 649413 0 290965 0 2184 0 14254 0 12549 0 969365 0 0 0 BOBAN MATHEW MD 503142 0 0 0 2352 0 20825 0 12446 0 538765 0 0 0 RANDY CASON 0 228732 0 0 0 3980 0 33530 0 8712 0 274954 0 0 JACOB TARABOLOUS DO 369119 0 0 0 28408 0 15925 0 10026 0 423478 0 0 0 SUPPLEMENTAL NON-QUALIFIED PLAN PAID BY A RELATED ORGANIZATION PART I, QUESTION 4B RANDALL PETERSON $132,987.12 RANDY CASON $ 20,795.76 BILL AQUINO $ 8,673.03 DEBRA BAINBRIDGE $ 10,393.51 CONNIE MCCUNE $ 7,103.00 JULIANNA RIESCHICK $ 6,500.99 DREW TALBOTT $ 7,829.27 COMMUNITY BENEFIT REPORT Part III Via Christi Hospital Pittsburg, Inc. (VCH-P) is a member of Via Christi Health, Inc. (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: - Promoting and defending human dignity - Caring for persons living in poverty and other vulnerable populations - Promoting the common good - Stewarding resources responsibly According to the VCH's 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 below. 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, 2011 ---------------------------------------- Community Benefit (VCH-P and Subsidiaries): 1)Charity care - at cost $6.8 million 2)Government sponsored health care - net expense $(3.8) 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 $3.5 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. Targeted Population Health Fairs & Screenings are conducted annually for children, seniors, and the broader community. During FY2011, over 1,872 people were served for a cost of nearly $6,377 by having their blood pressure checked, eyes examed, hearing tested, feet examined, sport physicals and labs drawn, or given recommendations for establishing a medical home with either a physician and/or the area FQHC clinic. Support Groups & Educational Presentations are hosted (e.g. cancer, stroke, breast cancer, rehab services, etc) and numerous educational presentations (e.g. arthritis exercise class, smoking prevention, personal actions toward health, stroke, etc) were given in the Pittsburg area. In FY2011, over 1,550 attendees participated in these events at a cost of over $15,000. Transportation is a real concern for rural communities, and Cherokee and Crawford Counties are no exceptions. Having affordable and reliable transportation for medical appointments is critical, especially for elderly patients who may be unable to drive or who have no other alternatives. CareVan, a popular transportation program owned and operated by VCH-P provided transportation assistance over 10,265 times in FY2011 at a cost of $216,141. 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 100 health care professionals and/or students hoping to enter the health care field were offered training opportunities through the various programs offered by VCH-P at a cost of nearly $84,000. Response to Joplin Tornado - In partnership with Pittsburg State University and Catholic Charities of Southwest Missouri, VCH-P provided volunteer assistance with Case Management and help set up a Comprehensive Service Center. In addition, the hospital took in many of the injured patients due to the total destruction of St. John's Hospital in Joplin and assisted with the various needs of displaced families who had loved ones admitted to the hospital. In-Kind Donations - Service on community boards that are health related (e.g. Prescription Assistance Liaison Program, Project Warmth, etc), and/or sharing of hospital space to conduct health related not-for-profit business is another area in which VCH-P gives back to the community. In fiscal year 2011, VCH-P contributed just over $166,430 through financial and in-kind contributions. Community Benefit Operations - Community benefit staff uses and trains others to use the Community Benefit Inventory Social Accountability (CBISA) software, developed by Lyon Software and used by over 1,700 hospitals throughout the country. CBISA software follows the reporting guidelines adopted by Catholic Health Association and does not include bad debt or unpaid Medicare reimbursements as community benefit. Overall, VCH-P combined community benefit programs (not counting traditional charity care and/or unpaid reimbursement of Medicaid) accounted for $531,416 contributed to the geographical area of Pittsburg, Kansas during FY2011. FORM 990 REVIEW PART VI, SECTION B, QUESTION 11B THE AUDIT COMMITTEE REVIEWS AND APPROVES THE FORM 990 PRIOR TO THE DATE OF FILING. THE AUDIT COMMITTEE REPORTS ON THE REVIEW TO THE BOARD OF TRUSTEES AND ASSURES THAT THE BOARD HAS THE OPPORTUNITY TO REVIEW THE FINAL FORM 990 AS FILED. 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 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, QUESTION 15A AND 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 to be used throughout the Via Christi Health System. VCH's philosophy, strategy, and process for executive compensation are described next. 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 * 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, Q6, 7A, AND 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 REQUIREMENTS, 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. *REVIEW AND APPROVE REAL AND PERSONAL PROPERTY TRANSACTIONS CONSISTENT WITH PROVISION OF CANON LAW. RELATED TAX-EXEMPT ORGANIZATIONS SCHEDULE R, 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. RECONCILIATION OF NET ASSETS PART XI, QUESTION 5 Unrealized Loss (1,605,829) Partnership Adj 44,592 ------------ (2,723,400) Bad Debt Expense Parts VIII and IX In July 2011, the FASB issued ASU 2011-07, Health Care Entities (Topic 954): Presentation and Disclosure of Patient Services Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities. ASU 2011-07 includes amendments to FASB's ASC Topic 954, Health Care Entities. The objective of the update is to provide financial statement users with greater transparency about a health care entity's net patient service revenue and the related allowance for doubtful accounts. The amendments requires health care entities that recognize significant amounts of patient service revenue at the time services are rendered, even though they do not immediately assess the patients' ability to pay, to present the provision for bad debts related to patient service revenue as a deduction from patient service revenue (net of contractual allowances and discounts) on their statement of operations. The Heath System elected to adopt this standard as of September 30, 2011, which did not have a significant impact on the consolidated financial statements. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RANDALL PETERSON TITLE:EX-OFFICIO HOURS:49 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SR. MARIE VERONICA JANOUSEK TITLE:TRUSTEE HOURS:19 Catholic Care Center Inc 6700 E 45th St N Wichita KS 67226 481067110 Rtrmnt Home KS 501(c)(3) 9 na CIBOR INC 9229 E 27TH ST N SUITE 200 Wichita KS 67226 270564463 Research KS 501(c)(3) 7 na Cornerstone Assisted Living Inc 3636 N Ridge Road Wichita KS 67205 481241079 Rtrmnt Home KS 501(c)(3) 9 na Gerard House Inc 3144 N Hood Wichita KS 67204 481049532 Shelter KS 501(c)(3) 7 na Marian Health System Inc 1923 South Utica Avenue Tulsa OK 74104 363659989 Hospital Supp DE 501(c)(3) 11 na Mercy Community Health Foundation Inc 1823 College Ave Manhattan KS 66502 481152279 Foundation KS 501(c)(3) 11 na Mercy Regional Health Center Inc 1823 College Ave Manhattan KS 66502 481186704 Hospital KS 501(c)(3) 3 na Mercy Regional Home Medical Services 2439 Claflin Road Manhattan KS 66502 432024491 Home Medical KS 501(c)(3) 11 na Mount Carmel Foundation Inc 1102 E Centennial Dr Pittsburg KS 66762 480961283 Foundation KS 501(c)(3) 11 na Salina Regional Home Medical Services 520 S Santa Fe Ave Ste 140 Salina KS 67401 431948057 Home Medical KS 501(c)(3) 11 na St John's Inc 2225 Cantebury Dr Hays KS 67601 202828680 Rtrmnt Home KS 501(c)(3) 9 na Via Christi Foundation Inc 723 N McLean Blvd Wichita KS 67203 481173588 Foundation KS 501(c)(3) 11 na Via Christi Health Partners Inc 8200 E Thorn Dr SUITE 300 Wichita KS 67226 480958974 Mgmnt Co. KS 501(c)(3) 9 na Via Christi Health Inc 8200 E Thorn Dr SUITE 300 Wichita KS 67226 481172107 Hospital Supp KS 501(c)(3) 9 na Via Christi Healthcare Outreach Program 2622 W Central Suite 100 Wichita KS 67203 481236589 PACE Communit KS 501(c)(3) 9 na Via Christi Home Health Wichita Inc 555 S Washington Wichita KS 67211 481046371 Home Health KS 501(c)(3) 9 na Via Christi Hospital Wichita St Teresa 14800 W St Teresa Wichita KS 67235 271965272 Hospital KS 501(c)(3) 3 na Via Christi Hospitals Wichita Inc 929 N St Francis Wichita KS 67214 481172106 Hospital KS 501(c)(3) 3 na VC Immediate Care MOTHER MARY ANNE INC 929 N St Francis Wichita KS 67214 208374099 Med. Clinic KS 501(c)(3) 9 na Via Christi Property Services Inc 1100 N St Francis Suite 240 Wichita KS 67214 480948571 Property Mgmt KS 501(c)(4) N/A na Via Christi Rehabilitation Hospital Inc 1151 N Rock Road Wichita KS 67206 481158274 Rehab. KS 501(c)(3) 3 na Via Christi Village Georgetown Inc 1655 S Georgetown Wichita KS 67218 481129325 Rtrmnt Home KS 501(c)(3) 9 na Via Christi Village Manhattan Inc 2800 Willowgrove Rd Manhattan KS 66502 481078862 Rtrmnt Home KS 501(c)(3) 9 na Via Christi Village McLean Inc 777 N McLean Blvd Wichita KS 67203 481247723 Rtrmnt Home KS 501(c)(3) 9 na Via Christi Village Ponca City Inc 1601 Academy Rd Ponca City OK 74604 731153337 Rtrmnt Home OK 501(c)(3) 9 na Via Christi Village Pittsburg Inc 1502 E Centennial Dr Pittsburg KS 66762 743070971 Rtrmnt Home KS 501(c)(3) 9 na Via Christi Villages Inc 2622 W Central Suite 100 Wichita KS 67203 480559086 Mgmnt Co. KS 501(c)(3) 11 na Wamego Hospital Association 711 Genn Dr Wamego KS 66547 721526400 Hospital KS 501(c)(3) 3 na ASCENSION HEALTH PO BOX 45998 ST LOUIS MO 63145 311662309 HLTH SYS GOV MO 501(c)(3) 11 NA VIA CHRISTI INMYHOME INC 2622 W Central Suite 100 WICHITA KS 67203 271889960 HLTH AGENCY KS 501(c)(3) 9 nA Via Christi Clinic Services Inc 8200 Thorn Drive Suite 300 Wichita KS 67226 273984284 Med Clinic KS 501(c)(3) 11 na PFI LLC 8200 THORN DRIVE SUITE 300 WICHITA KS 67226 721557076 MED CHEM MFG KS NA N/A 0 0 0 0.00000 Ambulatory Surgery Center LP 8200 E THORN DR SUITE 300 WICHITA KS 67226 481114690 SURGERY CTR KS NA N/A 0 0 0 0.00000 AMS Diagnostics LLC 8200 E THORN DR SUITE 300 WICHITA KS 67226 481223653 DIAGNOSTIC IM KS NA n/a 0 0 0 0.00000 KS Surgery and Recovery Ctr LLC 2770 NORTH WEBB ROAD WICHITA KS 67226 481148580 MEDICAL SVC KS NA N/A 0 0 0 0.00000 Mercy Imaging LLC 1823 COLLEGE AVENUE MANHATTAN KS 66502 481251984 DIAGNOSTIC IM KS NA N/A 0 0 0 0.00000 MR Imaging Center LLC dba Anatomi Ima 8200 E THORN DR SUITE 300 WICHITA KS 67226 481000538 RADIOLOGY SVC KS NA N/A 0 0 0 0.00000 Preferred PET Imaging of KS LLC 8200 E THORN DR SUITE 300 WICHITA KS 67226 481250123 DIAGNOSTIC IM KS NA n/a 0 0 0 0.00000 Via Christi Cyberknife LLC 8200 E THORN DR SUITE 300 WICHITA KS 67226 354588711 RADIOLOGY SVC KS NA n/a 0 0 0 0.00000 St Joseph MRI LLC 8200 E THORN DR SUITE 300 WICHITA KS 67226 481007220 MEDICAL SVCS KS NA N/A 0 0 0 0.00000 AFFILIATED MEDICAL SERVICES 2916 E CENTRAL WICHITA KS 67214 481239522 MEDICAL LAB KS VC HEALTH C CORP 12321597 7892802 1.00000 SUNFLOWER ASSURANCE LTD PO BOX 1085 GRAND CAYMAN CAYMAN ISLANDS CJ KY1-1102 980223159 INSURANCE CO. CJ NA FOREIGN CORP 3651768 38500707 1.00000 Integrated Healthcare Systems Inc 3311 East Murdock Wichita KS 67208 480941549 Clinic Services KS NA C CORP 58758618 41790046 1.00000 VCH Iowa PC Trust 8200 Thorn Drive Suite 300 Wichita KS 67226 276937322 Beneficiary Trust IA NA TRUST 0 0 1.00000 VCH Iowa PC 8200 Thorn Drive Suite 300 Wichita KS 67226 273983977 Prof. Corp IA na C CORP 0 0 1.00000 Via Christi Clinic PA 3311 East Murdock Wichita KS 67208 480993446 Prof. Association KS NA C CORP 116439508 24067602 1.00000 false false true false false false false false false false false false false false false true false false Mount Carmel Foundation c 135000