Attach to Form 990 or Form 990-EZ.
See separate instructions.| (i) Name of supported organization |
(ii) EIN |
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) |
(iv) Is the organization in col. (i) listed in your governing document? |
(v) Did you notify the organization in col. (i) of your support? |
(vi) Is the organization in col. (i) organized in the U.S.? |
(vii) Amount of support? |
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| Yes | No | Yes | No | Yes | No | ||||
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| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
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| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3.. | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public Support. Subtract line 5 from line 4. | ||||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets.. | ||||||
| 11 | Total support (Add lines 7 through 10). | ||||||






| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public Support (Subtract line 7c from line 6.) | ||||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
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| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | ||||||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | ||||||




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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
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| Statement of Program Services | Part III, Question 4a | Via Christi Hospitals Wichita, Inc. (VCHW) 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'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) 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 VCHW 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, 2012 --------------------------------------------------------------- Community Benefit (VCHW, Inc. and Subsidiaries): 1. Charity care, at cost $34.2 million 2. Government sponsored health care, net expense $ 6.9 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 $19.1 million Health Professions Education (physicians, nurses, other) $15.0 million Subsidized Health Services (including behavioral health) $ 2.5 million Other Community Services (Donations, in-kind, research) $ 1.6 million 4. Total Quantifiable Community Benefit $60.2 million Listed below are just a few of the community benefit programs offered by VCHW. This is not a complete listing, but a sampling of how the hospital gives back to the Wichita/Sedgwick County area while meeting current needs. VCHW 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. VCHW 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 VCHW. 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. Open Medical Staff - The medical staff is open with over 1,100 physicians having medical privileges at Via Christi Hospitals Wichita. Approximately 300 of these physicians are employed through Via Christi Clinics. Primary care physicians collaborate with Coventry to provide medical home services to Medicare patients, especially those with multiple chronic diseases. Community Boards/Committees/Coalitions - VCHW staff participates in the community on boards of other not-for-profit organizations, government entities, foundations, area colleges and university committees, state-wide coalitions, etc. In FY 2012, VCH had leadership staff participate on 92 outside organization boards (e.g. American Cancer Society, American Heart Association, Center for Health and Wellness, Central Plains Regional Health care Foundation, Grace Med Clinic, Guadalupe Clinic, Harry Hynes Hospice, Kansas Alzheimers Association, Kansas Mental Health Coalition, Kansas Task Force on Emergency Medicine, Ronald McDonald House, Senior Services, Sedgwick County Health Access Project, United Way of the Plains, Wichita Center for Graduate Medical Education and many more). Health Profession Education - Having the only Burn Unit in the State of Kansas, VCHW routinely trains first responders, as well as outlying hospitals how to clinically prepare burn victims for medical transport to Wichita for emergency care. |
| Tax Exempt Bonds | PART IV, QUESTION 24A | Via Christi Hospitals Wichita, Inc. (VCHW) along with Via Christi Health, Inc. (VCH) and other Health System hospitals (the 'Obligated Group'), entered into a master trust indenture and an obligated group a Via Christi Health, Inc. agreement whereby they were jointly and severally liable for all amounts due under any and all notes and guarantees issued pursuant to the master trust indenture. The Obligated Group consists of Via Christi Health, Inc., Via Christi Hospitals Wichita, Inc., Via Christi Rehabilitation Hospital, Inc., Via Christi Hospital Pittsburg, Inc. and Via Christi Hospital Wichita St. Teresa, Inc. All bond debt is reported on the books of VCH with intercompany debt reported on the respective hospital ministries. |
| Executive Committee | PART VI, SECTION A, QUESTION 1A | The organization's bylaws establish an executive committee. This committee shall consist of the Chairperson, the President, and two other directors. The Committee shall have the power to transact all regular business of the Board during the period between meetings of the Board, subject to any prior limitations imposed by the Board. |
| Changes to Organizational Documents | PART VI, SECTION A, QUESTION 4 | The organization's bylaws were revised primarily to simplify and bring consistency to the language. Additional changes include: 1) The amended bylaws refer to board members as "directors" rather than "trustees"; 2) The synchronization of the annual meeting was changed; 3) The list of standing committees was modified; 4) The composition of the Executive Committee was changed to increase flexibility; and 5) Section 3.17 and Article 11 were added to strengthen the articulation of commitment to acting always in a manner which is in keeping with the requirements of Section 501(c)(3) of the Internal Revenue Code. |
| Members | PART VI, section A, QUESTIONs 6, 7a, &7b | VIA CHRISTI HEALTH, INC. IS THE SOLE CORPORATE MEMBER. THE MEMBER HAS THE FOLLOWING SPECIFIC RIGHTS AND RESPONSIBILITIES: * APPROVE, BEFORE THEY MAY BECOME EFFECTIVE, ALL MISSION, PHILOSOPHY AND VALUE STATEMENTS OF THE MEDICAL CENTER AND ALL AMENDMENTS THERETO. * MONITOR COMPLIANCE WITH THE MISSION AND PHILOSOPHY OF THE MEMBER AND SPONSORS THROUGH RECEIPT OF ANNUAL REPORTS, FINANCIAL STATEMENTS AND OTHER PERTINENT INFORMATION. * ENACT OR AMEND ARTICLES OF INCORPORATION FOR THE CORPORATION IN ITS SOLE DISCRETION AND APPROVE ALL AMENDMENTS THERETO. * ENACT CORPORATE BYLAWS FOR THE CORPORATION IN ITS SOLE DISCRETION AND APPROVE ALL AMENDMENTS THERETO. * APPOINT OR REMOVE THE TRUSTEES OF THE MEDICAL CENTER. * APPOINT OR REMOVE THE PRESIDENT OF THE MEDICAL CENTER. * APPROVE, BEFORE IT MAY BECOME EFFECTIVE, THE DISSOLUTION, MERGER OR CONSOLIDATION OR SALE OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION. * APPROVE ALL DONATIONS, TRANSFERS, LEASES, ENCUMBRANCES OR OTHER CONVEYANCES OF THE PROPERTY OF ALL ASSETS OF THE MEDICAL CENTER IN EXCESS OF THE LESSER OF THE CANONICAL ALIENATION THRESHOLD OR THE AMOUNT SPECIFIED FROM TIME TO TIME BY THE MEMBER. * APPROVE, BEFORE IT MAY BECOME EFFECTIVE, THE CREATION OF ANY TAXABLE OR TAX-EXEMPT SUBSIDIARY ORGANIZATION TO THE MEDICAL CENTER. * RECEIVE AND APPROVE ALL OPERATING AND CAPITAL BUDGETS OF THE MEDICAL CENTER. * APPROVE ALL UNBUDGETED EXPENSE IN EXCESS OF $200,000 OR THE AMOUNT SPECIFIED IN WRITING FROM TIME TO TIME BY THE MEMBER. * APPROVE THE ISSUANCE OF ANY DEBT BY THE MEDICAL CENTER IN EXCESS OF THE LESSER OF THE CANONICAL ALIENATION THRESHOLD OR THE AMOUNT SPECIFIED IN WRITING FROM TIME TO TIME BY THE MEMBER. |
| 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 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; and 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 Review | Part VI, Section B, Questions 15a & 15b | Via Christi Hospitals Wichita, 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 HOSPITALs WICHITA, INC.'s GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Reconciliation of Net Assets | Part XI, Question 5 | Unrealized Gain 25,276,028 Change in Net Assets of Joint Ventures (214,662) Restricted Funds released 766,243 Annual Sponsorship Fee (1,383,469) Change in OCI - Pension 33,709,042 Equity Transfers to/from Related 2,290,362 Beneficial Interest in Subsidiary 961,871 Foundation Funds Released 606,905 Miscellaneous Other changes (3,310) ----------- TOTAL 62,009,010 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Randall Peterson TITLE:Director; Term. 4/20/12 HOURS:49 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Gary Knight TITLE:Assistant Secretary HOURS:49 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Michael Wegner TITLE:CFO HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Cynthia LaFleur TITLE:President Post Acute HOURS:25 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Linda Goodwin TITLE:VP Clinical Svc. & CNO HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Sr. Sherri Marie Kuhn TITLE:SVP Mission Integration HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Art Huber TITLE:VP Facilities HOURS:4 |
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