CATHOLIC CARE CENTER INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
CATHOLIC CARE CENTER INC (EIN 48-1067110)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-15
IRS object ID
201122279349303952
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-08-15T15:12:25-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1GRANT THORNTON LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line18300 THORN DRIVE SUITE 300AddressLine1
CityWICHITACity
StateKSState
ZIP Code672262708ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN481067110EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CATHOLIC CARE CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCATHNameControl
Phone3167442020Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line16700 EAST 45TH STREET NORTHAddressLine1
CityBEL AIRECity
StateKSState
ZIP Code67226ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJERRY CARLEYName
TitleTREASURERTitle
Phone3169465215Phone
Date Signed2011-08-11DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone3162653231Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTHOMAS CHURCHNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line16700 EAST 47TH STREET NORTHAddressLine1
CityWICHITACity
StateKSState
ZIP Code67226ZIPCode
FieldValueIRS element (for citing)
Gross Receipts20166661GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number8050GroupExemptionNumber
Organization501cXOrganization501c
Web SiteWWW.VIA-CHRISTI.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1988YearFormation
State Legal DomicileKSStateLegalDomicile
Activity Or Mission DescriptionPROVIDE HEALTH CARE AND HOUSING TO THE ELDERLY PEOPLE OF WICHITA AND THE SURROUNDING COMMUNITIES.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees565TotalNbrEmployees
Total Nbr Volunteers100TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year32937ContributionsGrantsPriorYear
Contributions Grants Current Year26466ContributionsGrantsCurrentYear
Program Service Revenue Prior Year19228203ProgramServiceRevenuePriorYear
Program Service Revenue CY19994007ProgramServiceRevenueCY
Investment Income Prior Year200770InvestmentIncomePriorYear
Investment Income Current Year130930InvestmentIncomeCurrentYear
Other Revenue Prior Year204813OtherRevenuePriorYear
Other Revenue Current Year13036OtherRevenueCurrentYear
Total Revenue Prior Year19666723TotalRevenuePriorYear
Total Revenue Current Year20164439TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year10624645SalariesEtcPriorYear
Salaries Etc Current Year10613806SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year7054193OtherExpensePriorYear
Other Expenses Current Year8033290OtherExpensesCurrentYear
Total Expenses Prior Year17678838TotalExpensesPriorYear
Total Expenses Current Year18647096TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1987885RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1517343RevenuesLessExpensesCY
Total Assets BOY35132519TotalAssetsBOY
Total Assets EOY36083361TotalAssetsEOY
Total Liabilities BOY21919955TotalLiabilitiesBOY
Total Liabilities EOY21043381TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY13212564NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY15039980NetAssetsOrFundBalancesEOY
Mission DescriptionAS 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 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. CATHOLICMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense16006231Expense
Revenue19994007Revenue
DescriptionCATHOLIC CARE CENTER, INC. IS A NURSING AND ASSISTED LIVING FACILITY. THE CENTER CONSISTS OF A 178-BED NURSING FACILITY AND A 100-UNIT ASSISTED LIVING FACILITY LOCATED IN WICHITA, KANSAS. Catholic Care Center, Inc. serves people in the Wichita area. The primary counties include Sedgwick and Butler. A trend of significance in the community is the growing elderly population. To address this trend, Catholic Care Center, Inc. is collaborating with other community organizations, including but not limited to: Meals on Wheels, Alzheimer's Association, and nursing education organizations to provide services and education to the elderly. Financial surpluses are used to fulfill our charitable purpose. The board of directors includes members of the local community. Our organization offers discounted care to persons without adequate financial means to pay for such services. This includes the participation in Medicaid, Medicare, CHAMPUS, Tricare, and/or other government-sponsored health care programs.Description
Total Program Service Expense16006231TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109634NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees565NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonBILL SLATERNamePerson
Telephone Number3169465215TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12622 W CENTRAL SUITE 100AddressLine1
CityWICHITACity
StateKSState
ZIP Code67203ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
LAUREL ALKIRE
TRUSTEE1.0X000
MONSIGNOR ROBERT HEMBERGER
CHAIR1.0X000X
THOMAS CHURCH
PRESIDENT/CEO40.0X012268850249X
GERARD BRUNGARDT MD
TRUSTEE1.0X000
JOAN FELTS PHD
TRUSTEE1.0X000
MARILYN B PAULY
VICE CHAIR1.0X000X
LYNNETTE RAUVOLABOUTA
TRUSTEE1.0X024460746850
SISTER PAM YOUNG
TRUSTEE1.0X000
JERRY CARLEY
TREASURER1.0X025243347594X
DAN LOUGHMAN
TRUSTEE1.0X000
JAMES BARBER
TRUSTEE1.0X020688437978
KATRINA BUSS
SECRETARY1.0000X
VICKY MENDEZ
ASSISTANT ADMINISTRATOR40.009354028186X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs920152TotalReportableCompFrmRltdOrgs
Total Other Compensation210857TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CATHOLIC LIFE CENTER
424 N BROADWAYWICHITAKS67202LANDSCAPING102834
SUNDANCE REHABILITATION
6549 PAYSPHERE CIRCLECHICAGOIL60674THERAPY SERVICES1196156
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
All Other Contributions26466AllOtherContributions
Total Contributions26466TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
RESIDENT ROOM,CARE6230001989586419895864
REIMBURSEMENT REVENUE6230009814398143
FieldValueIRS element (for citing)
Total Program Service Revenue19994007TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column130930TotalRevenueColumn
Exclusion$130,930ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Fundraising Events4547GrossIncomeFundraisingEvents
Fundraising Direct Expenses2222FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column2325TotalRevenueColumn
Exclusion$2,325ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
BEAUTY & BARBER81290098956$98,956
VENDING MACHINE9000992993$2,993
GIFT SHOP45322034389$34,389

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column-125627TotalRevenueColumn
Exclusion-$125,627ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue10711TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column20164439TotalRevenueColumn
Related Or Exempt Function Income19994007RelatedOrExemptFunctionIncome
Exclusion$143,966ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total8888678Total
Program Services8029106ProgramServices
Management And General859572ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1046506Total
Program Services945309ProgramServices
Management And General101197ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total678622Total
Program Services612999ProgramServices
Management And General65623ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1058829Total
Management And General1058829ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1214Total
Management And General1214ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total21450Total
Management And General21450ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1524002Total
Program Services1421176ProgramServices
Management And General102826ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total43819Total
Management And General43819ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1908953Total
Program Services1778780ProgramServices
Management And General130173ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total818429Total
Program Services818161ProgramServices
Management And General268ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total5701Total
Program Services2265ProgramServices
Management And General3436ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total17631Total
Program Services11022ProgramServices
Management And General6609ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total806547Total
Program Services806547ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1413540Total
Program Services1413540ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total65356Total
Management And General65356ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
MAINTENANCE - SOFTWARE124695124695
BAD DEBT9112891128
RESIDENT TRANSPORTATION4228542285
RELIGIOUS2740427404
GIFT SHOP1948919489

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total42818Total
Program Services14424ProgramServices
Management And General28394ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total18647096Total
Program Services16006231ProgramServices
Management And General2640865ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY5097323BOY
EOY5489403EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3640087BOY
EOY4099373EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1829163BOY
EOY2186895EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY72352BOY
EOY61570EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY39955BOY
EOY48150EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis34523519LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec10407387LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY24293463BOY
EOY24116132EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY160176BOY
EOY81838EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY35132519BOY
EOY36083361EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1673844BOY
EOY1549818EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY3648264BOY
EOY3095934EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY16534847BOY
EOY16340129EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY63000BOY
EOY57500EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY21919955BOY
EOY21043381EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY13118632BOY
EOY14938344EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY93932BOY
EOY101636EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY13212564BOY
EOY15039980EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY35132519BOY
EOY36083361EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years42006CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years47124CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years25059CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year32937CurrentTaxYearMinus1Year
Current Tax Year26466CurrentTaxYear
Total173592Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years14455391CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years16458280CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years18055244CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year19228203CurrentTaxYearMinus1Year
Current Tax Year19994007CurrentTaxYear
Total88191125Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years14497397CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years16505404CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years18080303CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year19261140CurrentTaxYearMinus1Year
Current Tax Year20020473CurrentTaxYear
Total88364717Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years71187CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years77257CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years81178CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year81470CurrentTaxYearMinus1Year
Current Tax Year82765CurrentTaxYear
Total393857Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years71187CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years77257CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years81178CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year81470CurrentTaxYearMinus1Year
Current Tax Year82765CurrentTaxYear
Total393857Total
FieldValueIRS element (for citing)
Public Support Total50987970860PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years253788CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years299672CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years284252CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year199528CurrentTaxYearMinus1Year
Current Tax Year130930CurrentTaxYear
Total1168170Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years253788CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years299672CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years284252CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year199528CurrentTaxYearMinus1Year
Current Tax Year130930CurrentTaxYear
Total1168170Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years226246CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years279789CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years210222CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year204318CurrentTaxYearMinus1Year
Current Tax Year249852CurrentTaxYear
Total1170427Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years14977431CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years17084865CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years18574777CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year19664986CurrentTaxYearMinus1Year
Current Tax Year20401255CurrentTaxYear
Total90703314Total
FieldValueIRS element (for citing)
Public Support Percentage5090.96988PublicSupportPercentage509
Prior Year Support Percentage0.96844PriorYearSupportPercentage
Investment Income Percentage0.01288InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01405PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$2,036OtherActivitiesAmount
Total Lobbying Expenditures IIB2036TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLOBBYINGIdentifier
Return ReferenceSCHEDULE C, PART II-BReturnReference
ExplanationCATHOLIC CARE CENTER, INC. PAYS DUES TO KAHSA. 10% OF THE DUES PAID ARE FOR LOBBYING. THE DUES WERE USED FOR LOBBYING ISSUES RELATED TO CARRYING OUT HEALTHCARE PROGRAMS AND DO NOT PARTICIPATE IN ACTIVITIES SUPPORTING A POLITICAL CANDIDATE.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1201416OtherCostOrOtherBasis
Book Value1201416BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis20429891OtherCostOrOtherBasis
Depreciation5825409Depreciation
Book Value14604482BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis9721068OtherCostOrOtherBasis
Depreciation3665475Depreciation
Book Value6055593BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3171144OtherCostOrOtherBasis
Depreciation916503Depreciation
Book Value2254641BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings24116132TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionREFUNDABLE SECURITY DEPOSITSDescription
Amount$57,500Amount
FieldValueIRS element (for citing)
Total Of Amounts57500TotalOfAmounts
Total Revenue20164439TotalRevenue
Total Expenses18647096TotalExpenses
Excess Or Deficit For Year1517343ExcessOrDeficitForYear
Net Unrealized GL On Investments310073NetUnrealizedGLOnInvestments
Total Adjustments310073TotalAdjustments
Excess Or Deficit Per FS1827416ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt20474512TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments310073NetUnrealizedGainsInvestments
Revenue Not Rptd F990310073RevenueNotRptdF990
Revenue Subtotal20164439RevenueSubtotal
Total Revenue Per Form99020164439TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt18647096TotExpensesEtcAuditedFinclStmt
Expenses Subtotal18647096ExpensesSubtotal
Total Expenses Per Form99018647096TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierFIN 48Identifier
Return ReferenceSCHEDULE D, PART XReturnReference
ExplanationTHE COMPANY IS A TAX-EXEMPT ORGANIZATION UNDER THE INTERNAL REVENUE CODE. IN ADDITION, THE COMPANY HAS MAINTAINED ITS TAX EXEMPT STATUS BY CONDUCTING ACTIVITIES WITHIN THE SCOPE OF ITS EXEMPTION GRANTED BY THE INTERNAL REVENUE SERVICE.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Written Policy Re T And E ExpensesfalseWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
THOMAS CHURCH
09452501320301496009027041222017293700
LYNNETTE RAUVOLABOUTA
02021800383040412303752509325029145700
JERRY CARLEY
021516203195505316035753011841030002700
JAMES BARBER
018016602346503253026283011695024486200

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN PAID BY A RELATED ORGANIZATIONPART I, QUESTION 4BLynnette RauvolaBouta 21,425.39 Jerry Carley 20,923.92
GROSS UP PAYMENTS PAID BY A RELATED ORGANIZATIONPART I, QUESTION 1Lynnette RauvolaBouta 599.34 PART I, QUESTION 1B Via Christi Health does not have a written policy regarding the items listed in Schedule J, Part 1, Question 1b, the Via Christi Health Executive Compensation Committee has oversight for any compensation paid to Via Christi Health executives. Payment of health and/or social club dues payments were discontinued in calendar year 2009. Gross-up payment are made in specific circumstances and on a limited basis.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1SEDGWICK COUNTYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN486000798IssuerEIN
CUSIP Number815331DF7CUSIPNumber
Date Issued2010-08-01DateIssued
Issue Price16860000IssuePrice
Description Of PurposeREFUNDING 2001 & 2003 BOND ISSUESDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds16860000TotalProceeds
Issuance Costs From Proceeds335000IssuanceCostsFromProceeds
Year Of Subst Completion2003YearOfSubstCompletion
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Bond Counsel Routinely EngagedfalseBondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FORM 990 REVIEWPART VI, SECTION A, QUESTION 11A COPY OF FORM 990 IS PROVIDED TO THE BOARD OF TRUSTEES VIA A SECURE EMAIL PRIOR TO FILING WITH THE IRS.
CONFLICT OF INTEREST POLICYPART VI, SECTION B, QUESTION 12CTHE ORGANIZATION'S POLICY IS MONITORED AS PART OF THE SYSTEM-WIDE PROCEDURES AND NOT AT THE ORGANIZATIONAL LEVEL. THE SYSTEM-WIDE PROCEDURES ARE 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 ORGANZIATION IS OPERATING CONSISTENT WITH THE POLICY AND ENFORCING THE POLICY'S TERMS.
COMPENSATION REVIEWPART VI, SECTION B, QUESTION 15Catholic Care Center, Inc. uses the policies established by Via Christi Health, Inc. (VCH). VCH has established a common philosophy, strategy, and processes for executive compensation 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 DOCUMENTSPART VI, SECTION C, QUESTION 19CATHOLIC CARE CENTER, INC.'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
MEMBERSPART VI, SECTION A, Q6, 7A, AND 7BTHE TERM MEMBERS SHALL BE INTERPRETED TO MEAN THE ROMAN CATHOLIC BISHOP OF THE WICHITA DIOCESE AND VIA CHRISTI VILLAGES, INC. SECTION IV, PARAGRAPH 13 OF THE BYLAWS PROVIDE THE MEMBER WITH THE FOLLOWING POWERS: *CHANGES IN THE CORPORATION'S PURPOSES OR PHILOSOPHY, AMENDMENTS OF ITS ARTICLES OF INCORPORATION OR BYLAWS, OR RESTRUCTURING OF THE CORPORATION WITH OTHER ENTITIES; *ISSUANCE OF NOTES, BONDS OR OTHER EVIDENCE OF INDEBTEDNESS IN EXCESS OF $100,000 FOR CAPITAL NEEDS; *PURCHASE, SALE, ALIENATION, ENCUMBRANCE OR LEASE OR REAL PROPERTY HAVING A VALUE IN EXCESS OF $100,000; *APPOINTMENT OF DIRECTORS AND THE CHIEF EXECUTIVE OFFICER; AND *REVIEW AND APPROVAL OF THE CORPORATION'S BUDGETS, AND UNDBUDGETED EXPENDITURES IN EXCESS OF $100,000.
RELATED TAX-EXEMPT ORGANIZATIONSSCHEDULE R, PART IICATHOLIC CARE CENTER, INC. is INDIRECTLY 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.
CONSOLIDATED C-CORP INFORMATIONSCHEDULE R, PART IVPREFERRED HEALTH SYSTEMS, INC. IS THE PARENT COMPANY OF THE FOLLOWING WHOLLY-OWNED SUBSIDIARIES: --PREFERRED PLUS OF KANSAS, INC. --PREFERRED HEALTH CARE, INC. --KANSAS HEALTH PLAN, INC. --PREFERRED HEALTH SYSTEMS, INC. INSURANCE CO. --PREFERRED BENEFITS ADMINISTRATOR, INC. THE SCHEDULE R, PART IV DISCLOSURE OF PREFERRED HEALTH SYSTEMS, INC. CONSISTS OF CONSOLIDATED INFORMATION FOR THE YEAR ENDED DECEMBER 31, 2009. PREFERRED HEALTH SYSTEMS, INC. WAS SOLD DURING THE FISCAL YEAR. THE SALE WAS ANNOUNCED OCTOBER 2009 AND FINALIZED FEBRUARY 2010. PREFERRED HEALTH SYSTEMS, INC. WAS NOT A RELATED ORGANIZATION AT THE END OF THE FISCAL YEAR ENDING 09/30/2010.
TAX EXEMPT BONDSSCHEDULE K GENERAL INFORMATIONTHE SEDGWICK COUNTY HEALTH CARE FACILITIES REFUNDING REVENUE BONDS WERE ISSUED TO REDEEM THE CENTER'S HEALTH CARE FACILITIES REVENUE BONDS SERIES 2001 AND SERIES 2003. IN CONNECTION WITH THE ISSUANCE OF THE BONDS, THE CENTER AND SEDGWICK COUNTY, KANSAS HAVE ENTERED INTO A LEASE AGREEMENT WHEREBY THE CENTER AGRESS TO MAKE PAYMENTS DIRECTLY TO A TRUSTEE SUFFICIENT TO RETIRE THE BONDS AND PAY ALL INTEREST EXPENSE INCURRED. THE BONDS ARE COLLATERALIZED BY SUBSTANTIALLY ALL OF THE CENTER'S PROPERTY AND EQUIPMENT. ADDITIONALLY, THE 2010 BONDS ARE COLLATERALIZED BY A WRITTEN GUARANTY AGREEMENT WITH VIA CHRISTI AND THE WICHITA DIOCESE.
HOURS WORKED BY OFFICERS/TRUSTEES FOR A RELATED ORGANIZATIONPART VII, COLUMN ATHE FOLLOWING INDIVIDUALS WORKED 40 HOURS PER WEEK FOR A RELATED ORGANIZATION: LYNNETTE RAUVOLABOUTA, THOMAS CHURCH, JERRY CARLEY AND JAMES BARBER

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (30 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
CIBOR INC
9229 E 27TH ST N SUITE 200WichitaKS67226270564463ResearchKS501(c)(3)7NA
Cornerstone Assisted Living Inc
3636 N Ridge RoadWichitaKS67205481241079Rtrmnt HomeKS501(c)(3)9NA
Gerard House Inc
3144 N HoodWichitaKS67204481049532ShelterKS501(c)(3)7NA
Marian Health System Inc
1923 South Utica AvenueTulsaOK74104363659989Hospital SuppDE501(c)(3)11NA
Mercy Community Health Foundation Inc
1823 College AveManhattanKS66502481152279FoundationKS501(c)(3)11NA
Mercy Regional Health Center Inc
1823 College AveManhattanKS66502481186704HospitalKS501(c)(3)3NA
Mercy Regional Home Medical Services LL
2439 Claflin RoadManhattanKS66502432024491Home MedicalKS501(c)(3)11NA
Mount Carmel Foundation Inc
1102 E Centennial DrPittsburgKS66762480961283FoundationKS501(c)(3)11NA
Salina Regional Home Medical Services L
520 S Santa Fe Ave Ste 140SalinaKS67401431948057Home MedicalKS501(c)(3)11NA
St John's Inc
2225 Cantebury DrHaysKS67601202828680Rtrmnt HomeKS501(c)(3)9NA
Via Christi Foundation Inc
723 N McLean BlvdWichitaKS67203481173588FoundationKS501(c)(3)11NA
Via Christi Health Partners Inc
8200 E Thorn DR SUITE 300WichitaKS67226480958974Mgmnt Co.KS501(c)(3)9NA
Via Christi Health Inc
8200 E Thorn Dr SUITE 300WichitaKS67226481172107Hospital SuppKS501(c)(3)9NA
Via Christi Healthcare Outreach Program
2622 W Central Suite 100WichitaKS67203481236589PACE CommunitKS501(c)(3)9NA
Via Christi Home Health Wichita Inc
555 S WashingtonWichitaKS67211481046371Home HealthKS501(c)(3)9NA
Via Christi Hospital Pittsburg Inc
1102 E Centennial DrPittsburgKS66762480543778HospitalKS501(c)(3)3NA
Via Christi Hospital Wichita St Teresa
14800 W St TeresaWichitaKS67235271965272HospitalKS501(c)(3)3NA
Via Christi Hospitals Wichita Inc
929 N St FrancisWichitaKS67214481172106HospitalKS501(c)(3)3NA
VC IMMEDIATE CARE MOTHER MARY ANNE INC
929 N St FrancisWichitaKS67214208374099Med. ClinicKS501(c)(3)9NA
Via Christi Property Services Inc
1100 N St Francis Suite 240WichitaKS67214480948571Property MgmtKS501(c)(4)N/ANA
Via Christi Rehabilitation Hospital Inc
1151 N Rock RoadWichitaKS67206481158274Rehab.KS501(c)(3)3NA
Via Christi Village Georgetown Inc
1655 S GeorgetownWichitaKS67218481129325Rtrmnt HomeKS501(c)(3)9NA
Via Christi Village Manhattan Inc
2800 Willowgrove RdManhattanKS66502481078862Rtrmnt HomeKS501(c)(3)9NA
Via Christi Village McLean Inc
777 N McLean BlvdWichitaKS67203481247723Rtrmnt HomeKS501(c)(3)9NA
Via Christi Village Ponca City Inc
1601 Academy RdPonca CityOK74604731153337Rtrmnt HomeOK501(c)(3)9NA
Via Christi Village Pittsburg Inc
1502 E Centennial DrPittsburgKS66762743070971Rtrmnt HomeKS501(c)(3)9NA
Via Christi Villages Inc
2622 W Central Suite 100WichitaKS67203480559086Mgmnt Co.KS501(c)(3)11NA
Wamego Hospital Association
711 Genn DrWamegoKS66547721526400HospitalKS501(c)(3)3NA
ASCENSION HEALTH
PO BOX 45998ST LOUISMO63145311662309HLTH SYS GOVMO501(c)(3)11NA
VIA CHRISTI INMYHOME INC
2622 W CENTRAL SUITE 100WICHITAKS67203271889960HLTH AGENCYKS501(c)(3)9NA

Form990 Schedule R Part III Form990ScheduleRPartIII (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsCode VCodeVAmount
ST JOSEPH MRI LLC
8200 E THORN DR SUITE 300WICHITAKS67226481007220MEDICAL SVCSKSNAN/A00$0
AMBULATORY SURGERY CENTER KS
8200 E THORN DR SUITE 300WICHITAKS67226481114690SURGERY CTRKSNAN/A00$0
KANSAS SURGERY AND RECOVERY CTR LLC
8200 E THORN DR SUITE 300WICHITAKS67226481148580SURGERY CTRKSNAN/A00$0
MR IMAGING CENTER LLC
8200 E THORN DR SUITE 300WICHITAKS67226481000538RADIOLOGY SVCKSNAN/A00$0
VIA CHRISTI CYBERKNIFE LLC
8200 E THORN DR SUITE 300WICHITAKS67226354588711RADIOLOGY SVCKSNAN/A00$0
AMS DIAGNOSTICS LLC
8200 E THORN DR SUITE 300WICHITAKS67226481223653RADIOLOGY SVCKSNAN/A00$0
PREFERRED PET IMAGING OF KS LLC
8200 E THORN DR SUITE 300WICHITAKS67226481250123DIAGNOSTIC IMKSNAN/A00$0
PFI LLC
8200 E THORN DR SUITE 300WICHITAKS67226721557076MED CHEM MFGKSNAN/A00$0
MERCY IMAGING LLC
8200 E THORN DR SUITE 300WICHITAKS67226481251984DIAGNOSTIC IMKSNAN/A00$0

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
PREFERRED HEALTH SYSTEMS INC
8535 21ST NORTHWICHITAKS67206481134570INSURANCE HOLDINGKSNAC-CORP4392544851828900461.00000
AFFILIATED MEDICAL SERVICES LAB INC
2916 E CENTRALWICHITAKS67214481235922MEDICAL LABKSNAC-CORP1253700072300001.00000
SUNFLOWER ASSURANCE LTD
980223159INSURANCE CO.NAFOREIGN CORP.4300000296410001.00000PO BOX 1085GRAND CAYMANCAYMAN ISLANDSCJKY1-1102CJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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