Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 10-01-2022 , and ending 09-30-2023
BCheck if applicable:
CName of organization
Stormont-Vail Heathcare Inc
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1500 SW 10TH AVENUE
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
TOPEKA, KS66604
D Employer identification number

48-0543789
E Telephone number

G Gross receipts $ 1,008,939,878
F Name and address of principal officer:
ROBERT KENAGY
1500 SW 10TH AVENUE
TOPEKA,KS66604
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
http://www.stormontvail.org/
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1894
M State of legal domicile: KS
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: WORKING TOGETHER TO IMPROVE THE HEALTH-CARE OF OUR COMMUNITY BY PROVIDING QUALITY SERVICES REGARDLESS OF RACE, CREED, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 18
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 14
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 6,487
6 Total number of volunteers (estimate if necessary) ............. 6 347
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 89,247
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 60,709
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,002,749 17,823,122
9 Program service revenue (Part VIII, line 2g) ......... 841,139,202 969,234,666
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 6,382,573 21,143,565
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 514,893 738,525
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 849,039,417 1,008,939,878
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 998,151 522,000
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 536,513,071 574,749,307
16a Professional fundraising fees (Part IX, column (A), line 11e) .....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 304,989,743 373,867,701
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 842,500,965 949,139,008
19 Revenue less expenses. Subtract line 18 from line 12....... 6,538,452 59,800,870
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,006,157,074 1,101,675,780
21 Total liabilities (Part X, line 26)............. 332,764,844 338,379,646
22 Net assets or fund balances. Subtract line 21 from line 20..... 673,392,230 763,296,134
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: WORKING TOGETHER TO IMPROVE THE HEALTH-CARE OF OUR COMMUNITY BY PROVIDING QUALITY SERVICES REGARDLESS OF RACE, CREED, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 820,117,480 including grants of $ 522,000 ) (Revenue $ 969,230,786 )
See Schedule O
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet820,117,480
Form 990 (2021)
Form 990 (2021)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment
List of Attached Documents:
// Content
...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment
List of Attached Documents:
// Content
.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part III..
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part III..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment
List of Attached Documents:
// Content
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment
List of Attached Documents:
// Content
.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment
List of Attached Documents:
// Content
............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part X
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
List of Attached Documents:
// Content
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
List of Attached Documents:
// Content
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
List of Attached Documents:
// Content
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
List of Attached Documents:
// Content
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
List of Attached Documents:
// Content
21
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
List of Attached Documents:
// Content
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see list of attachments
List of Attached Documents:
// Content
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
List of Attached Documents:
// Content
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
List of Attached Documents:
// Content
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
List of Attached Documents:
// Content
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
173
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
6,487
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
Yes
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
18
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
14
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletSTACIE MASON1500 SW 10TH AVE   TOPEKA,KS66604 (785) 354-6000
Form 990 (2021)
Form 990 (2021)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) BRENDA SUE MILLS
 
DIRECTOR/CHAIR
 3.0
.................
0.0 		X   X       0 0 0
(2) DEBRA CLAYTON
 
DIRECTOR/SECRETARY
 3.0
.................
0.0 		X   X       0 0 0
(3) MARK RUELLE
 
DIRECTOR/VICE CHAIR
 3.0
.................
0.0 		X   X       0 0 0
(4) PEGGY BURNETTE
 
VICE PRES/CFO TREASURER - ended 02/23
 47.0
.................
3.0 		X   X       669,642 0 97,831
(5) ROBERT KENAGY
 
PRESIDENT CEO
 47.0
.................
3.0 		X   X       1,638,170 0 47,474
(6) Stacie Mason
 
Vice President/CFO Treasurer - Started 02/23
 47.0
.................
3.0 		X   X       0 0 0
(7) AILEEN MCCARTHY
 
DIRECTOR/PHYSICIAN
 50.0
.................
0.0 		X           363,298 0 32,909
(8) ALONZO HARRISON
 
DIRECTOR
 3.0
.................
0.0 		X           0 0 0
(9) CYNTHIA HORNBERGER
 
DIRECTOR
 3.0
.................
0.0 		X           0 0 0
(10) JAMES R SCHMANK
 
DIRECTOR
 3.0
.................
0.0 		X           0 0 0
(11) KEVIN DISHMAN
 
DIRECTOR/PHYSICIAN
 47.0
.................
3.0 		X           841,578 0 110,722
(12) MARK KNACKENDOFFEL
 
DIRECTOR
 3.0
.................
0.0 		X           0 0 0
(13) MARSHA POPE
 
DIRECTOR
 3.0
.................
0.0 		X           0 0 0
(14) MICHEL' PHILIPP COLE
 
DIRECTOR
 3.0
.................
0.0 		X           0 0 0
(15) PAMELA JOHNSON-BETTS
 
DIRECTOR
 3.0
.................
0.0 		X           0 0 0
(16) RICK WIENCKOWSKI
 
DIRECTOR
 3.0
.................
0.0 		X           0 0 0
(17) ROBERT ST PETER
 
DIRECTOR
 3.0
.................
0.0 		X           0 0 0
Form 990 (2021)
Form 990 (2021)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) SUEANN V SCHULTZ
 
DIRECTOR
 3.0
.......................0.0 		X           0 0 0
(19) THOMAS BELL
 
DIRECTOR
 3.0
.......................0.0 		X           0 0 0
(20) CAROL PERRY
 
SVP AND CHIEF NURSING OFFICER
 47.0
.......................3.0 		      X     606,123 0 39,563
(21) DEBRA YOCUM
 
VP CLINIC OPERATIONS
 30.0
.......................20.0 		      X     529,170 0 39,358
(22) TRACY O'ROURKE
 
SVP AND CHIEF ADMIN OFFICER
 47.0
.......................3.0 		      X     668,268 0 114,423
(23) JACOB DEISTER
 
PHYSICIAN
 50.0
.......................0.0 		        X   1,326,000 0 43,102
(24) JOHN MA
 
PHYSICIAN
 50.0
.......................0.0 		        X   1,844,335 0 43,942
(25) MATTHEW WILLS
 
PHYSICIAN
 50.0
.......................0.0 		        X   1,401,784 0 35,394
(26) MICHAEL TILLEY
 
PHYSICIAN
 50.0
.......................0.0 		        X   1,545,131 0 40,912
(27) TEWODROS ADDISSE
 
PHYSICIAN
 50.0
.......................0.0 		        X   1,351,027 0 22,789






1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 12,784,526 0 668,419
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet822
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
KENDALL CONSTRUCTION INC

2551 NW BUTTON RD
TOPEKA,KS66618 		CONSTRUCTION 20,595,174
TRIMEDX INC

PO BOX 636129
CINCINNATI,OH45623 		EQUIP MAINTENANCE 7,638,154
ANESTHESIA ASSOCIATES

823 SW MULVANE ST
TOPEKA,KS66606 		ANESTHESIA PHYS SVC 6,324,670
SENNE & COMPANY INC

2001 NW HIGHWAY 24
TOPEKA,KS66618 		CONSTRUCTION 5,385,876
SODEXO INC & AFFILIATES

PO BOX 360170
PITTSBURGH,PA152516170 		SUPPORT SVCS MGT 5,247,259
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet91
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 311,146
e Government grants (contributions)1e 17,379,176
f All other contributions, gifts, grants, and similar amounts not included above1f 132,800
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 17,823,122
Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUE 621300 908,281,500 908,281,500    
b PHARMACY 621910 34,858,330 34,854,450 3,880  
c NUTRITIONAL SERVICES 621300 2,268,802 2,268,802    
d EDUCATION SERVICES/SCHOOL OF NURSING 621300 1,860,584 1,860,584    
e RESEARCH 621300 4,056,283 4,056,283    
f All other program service revenue. 17,909,167 17,909,167 0 0
g Total. Add lines 2a–2f .....MediumBullet 969,234,666
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 12,340,066     12,340,066
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents 5,856 647,302 6a
b Less: rental expenses     6b
c Rental income or (loss) 5,856 647,302 6c
d Net rental income or (loss).......MediumBullet 653,158     653,158
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 64,575 8,738,924 7a
b Less: cost or other basis and sales expenses     7b
c Gain or (loss) 64,575 8,738,924 7c
d Net gain or (loss).........MediumBullet 8,803,499     8,803,499
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a INVESTMENTS IN PARTNERSHIPS 901101 85,367   85,367  
b -   0   0  
c -   0   0  
d All other revenue .... 0 0 0 0
e Total. Add lines 11a–11d ...... MediumBullet 85,367
12 Total revenue. See instructions.....MediumBullet 1,008,939,878 969,230,786 89,247 21,796,723
Form 990 (2021)
Form 990 (2021)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 522,000 522,000
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 5,033,220 4,064,601 968,619  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........ 478,531,993 418,031,753 60,500,240  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 16,938,842 14,022,670 2,916,172  
9 Other employee benefits ....... 44,785,845 37,962,689 6,823,156  
10 Payroll taxes ........... 29,459,407 25,360,541 4,098,866  
11 Fees for services (non-employees):        
a Management ...... 2,130,959   2,130,959  
b Legal ......... 415,030   415,030  
c Accounting ........... 280,120   280,120  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 1,031,032   1,031,032  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 47,050,846 37,837,102 9,213,744 0
12 Advertising and promotion .... 245,068 27,719 217,349  
13 Office expenses ....... 5,901,967 4,754,945 1,147,022  
14 Information technology ...... 21,412,460 14,024,741 7,387,719  
15 Royalties ..        
16 Occupancy ........... 13,237,840 11,006,324 2,231,516  
17 Travel ............ 619,736 424,606 195,130  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 410,403 215,998 194,405  
20 Interest ........... 3,615,539 2,982,298 633,241  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 28,947,656 25,348,959 3,598,697  
23 Insurance ... 4,009,753 3,307,468 702,285  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 196,106,812 194,811,546 1,295,266  
b Other 26,912,554 5,956,664 20,955,890  
c REPAIRS & MAINTENANCE 13,540,453 12,378,550 1,161,903  
d BAD DEBT 4,610,971 4,610,971    
e All other expenses 3,388,502 2,465,335 923,167 0
25 Total functional expenses. Add lines 1 through 24e 949,139,008 820,117,480 129,021,528 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 15,747 1 15,694
2 Savings and temporary cash investments ......... 87,293,763 2 72,461,950
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 116,052,379 4 127,217,978
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
0 6 0
7 Notes and loans receivable, net ...........   7  
8 Inventories for sale or use ............ 13,352,047 8 16,879,513
9 Prepaid expenses and deferred charges ...... 11,633,552 9 11,150,625
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 660,154,973
b Less: accumulated depreciation 10b 365,386,998 267,625,202 10c 294,767,975
11 Investments—publicly traded securities . 211,736,057 11 205,537,826
12 Investments—other securities. See Part IV, line 11 ..... 227,614,543 12 275,463,069
13 Investments—program-related. See Part IV, line 11 .. 23,605,462 13 29,625,689
14 Intangible assets ............... 1,687,500 14 1,437,500
15 Other assets. See Part IV, line 11 ........... 45,540,822 15 67,117,961
16 Total assets. Add lines 1 through 15 (must equal line 33)... 1,006,157,074 16 1,101,675,780
Liabilities 17 Accounts payable and accrued expenses ..... 138,551,713 17 113,070,972
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities ......... 185,057,678 20 173,884,250
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 1,300,000 23 222,034
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 7,855,453 25 51,202,390
26 Total liabilities. Add lines 17 through 25.. 332,764,844 26 338,379,646
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 673,032,632 27 762,892,092
28 Net assets with donor restrictions ........... 359,598 28 404,042
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 673,392,230 32 763,296,134
33 Total liabilities and net assets/fund balances ........ 1,006,157,074 33 1,101,675,780
Form 990 (2021)
Form 990 (2021)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,008,939,878
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
949,139,008
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
59,800,870
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
673,392,230
5
Net unrealized gains (losses) on investments ...............
5
20,581,352
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
9,521,682
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
763,296,134
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2021)
Form 990 (2021)
Additional Data


Software ID: 22016089
Software Version: 2022v5.0
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public
Inspection
Name of the organization
Stormont-Vail Heathcare Inc
 
Employer identification number

48-0543789
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
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.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
33 1/3% support test—2022. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization .......................right arrow
b
33 1/3% support test—2021. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow
17a
10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
b
10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (f) Total
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 on 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 VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
33 1/3% support tests-2022. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow
b
33 1/3% support tests—2021. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow
20
Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by 0.035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity 		2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions 		8  
9 Distributable amount for 2022 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2022 		(iii)
Distributable
Amount for 2022
1 Distributable amount for 2022 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2022:
a From 2017.......  
b From 2018.......  
c From 2019.......  
d From 2020.......  
e From 2021.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2022 distributable amount  
i Carryover from 2017 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2022 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2022 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2022, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions. 		 
6 Remaining underdistributions for 2022. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions. 		 
7 Excess distributions carryover to 2023. Add lines
3j and 4c. 		 
8 Breakdown of line 7:
a Excess from 2018.....  
b Excess from 2019.....  
c Excess from 2020.....  
d Excess from 2021.....  
e Excess from 2022.....  
Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990) 2022


Additional Data


Software ID: 22016089
Software Version: 2022v5.0
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2022
Name of the organization
Stormont-Vail Heathcare Inc
 
Employer identification number

48-0543789
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990) (2022)
Schedule B (Form 990) (2022) Page 2
Name of organization
Stormont-Vail Heathcare Inc
  		Employer identification number
48-0543789
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2022)
Schedule B (Form 990) (2022)
Page 3
Name of organization
Stormont-Vail Heathcare Inc
  		Employer identification number

48-0543789
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I 		(b)
Description of noncash property given 		(c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I 		(b)
Description of noncash property given 		(c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I 		(b)
Description of noncash property given 		(c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I 		(b)
Description of noncash property given 		(c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I 		(b)
Description of noncash property given 		(c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I 		(b)
Description of noncash property given 		(c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
Schedule B (Form 990) (2022)
Schedule B (Form 990) (2022)
Page 4
Name of organization
Stormont-Vail Heathcare Inc
  		Employer identification number

48-0543789
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990) (2022)
Additional Data


Software ID: 22016089
Software Version: 2022v5.0
SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Stormont-Vail Heathcare Inc
 
Employer identification number

48-0543789
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990) 2021


Schedule C (Form 990) 2021
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
Yes
 
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
Yes
 
22,967
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
7,144
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
 
No
 
j
Total. Add lines 1c through 1i ....................................................................................................
30,111
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures. See Instructions .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE GRANTS TO ORGANIZATIONS FOR LOBBYING REPRESENTS THE PORTION OF HOSPITAL ASSOCIATION DUES WHICH ARE ATTRIBUTED TO LOBBYING AND ADVOCACY ACTIVITIES. DIRECT ACTIVITIES ENTAIL THE CEO or CFO'S OCCASIONAL INTERACTION WITH LEGISLATORS REGARDING BILLS THAT WOULD AFFECT THE ORGANIZATION OR HEALTHCARE INDUSTRY.
Schedule C (Form 990) 2021


Additional Data


Software ID: 22016089
Software Version: 2022v5.0

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Stormont-Vail Heathcare Inc
 
Employer identification number

48-0543789
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
 
(ii) Related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment) 		(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   26,156,758 26,156,758
b Buildings ....   377,289,621 194,845,935 182,443,686
c Leasehold improvements        
d Equipment ....   244,164,165 169,577,804 74,586,361
e Other .....   12,544,429 963,259 11,581,170
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 294,767,975
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 3
Part VII
Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3) Other
(A) ALTERNATIVE INVESTMENTS		 275,463,069 F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 275,463,069
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)OTHER RECEIVABLES 21,231,472
(2)DUE FROM AFFILIATES 42,144,799
(3)LEASE ROU ASSETS 3,741,690
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 67,117,961
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 51,202,390
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Schedule D, Part V, Line 4 ENDOWMENT FUNDS ARE USED IN ACCORDANCE WITH THE DIRECTION OF THE APPLICABLE DONOR GIFT INSTRUMENT AT THE TIME THE GIFT IS ADDED TO THE FUND.
Schedule D, Part X, Line 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
Schedule D (Form 990) 2021


Additional Data


Software ID: 22016089
Software Version: 2022v5.0




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
Stormont-Vail Heathcare Inc
 
Employer identification number

48-0543789
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in the region (d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in the region		 (f) Total expenditures
for and investments
in the region
Central America and the Caribbean 0 0 Investments   38,311,632
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .... 0 0 38,311,632
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 0 38,311,632
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2022
Schedule F (Form 990) 2022
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of noncash
assistance 		(h) Description
of noncash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
 
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2022
Schedule F (Form 990) 2022Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
noncash
assistance 		(g) Description
of noncash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2022
Schedule F (Form 990) 2022
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2022
Schedule F (Form 990) 2022
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
ReturnReference Explanation
Schedule F, Part I, Line 3 Method used to account for expenditures on org's financial statements CENTRAL AMERICA AND THE CARIBBEAN-Accrual
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2022
Additional Data


Software ID: 22016089
Software Version: 2022v5.0



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
Stormont-Vail Heathcare Inc
 
Employer identification number

48-0543789
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
 
No
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
 
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    22,225,692   22,225,692 2.35 %
b Medicaid (from Worksheet 3, column a) . . . . .     117,530,253 87,673,335 29,856,918 3.16 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .         0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 139,755,945 87,673,335 52,082,610 5.51 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     2,271,736 304,148 1,967,588 0.21 %
f Health professions education (from Worksheet 5) . . .     3,278,362 2,473,938 804,424 0.09 %
g Subsidized health services (from Worksheet 6) . . . .     38,381,426 24,942,601 13,438,825 1.42 %
h Research (from Worksheet 7) .     4,473,268 4,061,583 411,685 0.04 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     223,190 145,000 78,190 0.01 %
j Total. Other Benefits . . 0 0 48,627,982 31,927,270 16,700,712 1.77 %
k Total. Add lines 7d and 7j . 0 0 188,383,927 119,600,605 68,783,322 7.28 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing         0 0 %
2 Economic development         0 0 %
3 Community support     6,910   6,910 0 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members		         0 0 %
6 Coalition building         0 0 %
7 Community health improvement advocacy         0 0 %
8 Workforce development         0 0 %
9 Other         0 0 %
10 Total 0 0 6,910 0 6,910 0 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
4,610,971
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
299,881,367
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
383,536,947
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-83,655,580
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1MANHATTAN SURGICAL
  		SURGERY CENTER 0.49 %   0.4 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?2Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 STORMONT VAIL HEALTHCARE INC
1500 SW 10TH AVE
TOPEKA,KS66604
http://www.stormontvail.org/
H-089-003 		X X         X     A
2 Stormont Vail Health Flint Hills LLC
1102 St Marys Road
Junction City,KS664414139
H-031-001-2 		X X         X     B
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
A
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 21
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): THE IMPLEMENTATION STRATEGY CAN BE FOUND AT: HTTPS://WWW.STORMONTVAIL.ORG/WE-ARE-STORMONT/COMMUNITY-
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
WWW.STORMONTVAIL.ORG/PATIENT-RESOURCES/FINANCIAL-SERVICES/ FINANCIAL-ASSISTANCE/
b
WWW.STORMONTVAIL.ORG/PATIENT-RESOURCES/FINANCIAL-SERVICES/ FINANCIAL-ASSISTANCE/
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 6
Part VFacility Information (continued)

Billing and Collections
A
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
A
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
B
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1 Yes  
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2 Yes  
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3   No
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20  
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5    
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a    
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b    
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7    
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8    
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
B
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
WWW.STORMONTVAIL.ORG/PATIENT-RESOURCES/FINANCIAL-SERVICES/ FINANCIAL-ASSISTANCE/
b
WWW.STORMONTVAIL.ORG/PATIENT-RESOURCES/FINANCIAL-SERVICES/ FINANCIAL-ASSISTANCE/
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 6
Part VFacility Information (continued)

Billing and Collections
B
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
B
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - STORMONT VAIL HEALTHCARE, INC.. SINCE THE DEVELOPMENT OF THE 2015 COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP), HEARTLAND HEALTHY NEIGHBORHOODS (HHN) HAS LED THE CHIP EFFORTS FOR TOPEKA AND SHAWNEE COUNTY. THE CHIP STEERING COMMITTEE, CONSISTING OF HHN'S CURRENT CHAIR, VICE-CHAIR, STORMONT VAIL HEALTHCARE DIRECTOR OF COMMUNITY ENGAGEMENT, UNITED WAY VICE PRESIDEN COMMUNITY IMPACT, SHAWNEE COUNTY HEALTH DEPARTMENT DIVISION MANAGER AND THE DIRECTOR OF STRATEGY AND BUSINESS DEVELOPMENT FOR STORMONT VAIL HEALTH, HAS SPEARHEADED THE DEVELOPMENT PROCESS OF THIS MOST RECENT CHIP WITH ASSISTANCE FROM HHN WORKGROUPS AND COMMUNITY ORGANIZATIONS. FOR THE CURRENT ROUND OF COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT PLANNING, A LEADERSHIP TEAM LED BY STORMONT VAIL HEALTH, SHAWNEE COUNTY HEALTH DEPARTMENT AND HHN CONDUCTED THE CHNA. THE CHNA PROCESS CONSISTED OF: 1) A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) COMMUNITY SURVEY, WHICH WAS DISTRIBUTED IN THE SPRING OF 2021. 2) COMPILATION OF SECONDARY DATA OF HEALTH OUTCOMES AND HEALTHCARE DELIVERY SERVICES IN THE COUNTY, INCLUDING COUNTY HEALTH RANKINGS AND OTHER MEASURES OF MORBIDITY AND MORTALITY. AS OF APRIL 2021, SHAWNEE COUNTY IS RANKED 47TH FOR HEALTH FACTORS, AND 64TH FOR HEALTH OUTCOMES OUT OF 102 RANKED COUNTIES IN KANSAS. YEARS OF POTENTIAL LIFE LOST (YPLL) FROM MORTALITY DUE TO CHRONIC DISEASES, DRUG OVERDOSES AND SUICIDE, IS A MEASURE FROM THE COUNTY HEALTH RANKINGS THAT CONTRIBUTES MOST TO LOWERING SHAWNEE COUNTY'S RANKING. 3) A VIRTUAL TOWN HALL MEETING ACROSS THE COUNTY TO PRESENT AND DISCUSS THE SURVEY AND DATA. DURING THE TOWN HALL, PARTICIPANTS WERE GIVEN THE CHANCE TO PROVIDE INPUT ON WHAT THEY PERCEIVED TO BE THE TOP HEALTH ISSUES FOR SHAWNEE COUNTY. THAT LIST OF ISSUES IS WHAT WAS USED FOR CHIP PRIORITIZATION. A LIST OF THE TOP ISSUES FROM THE CHNA COMMUNITY SURVEY AND THE LIST OF TOP ISSUES FROM THE TOWN HALL MEETINGS WERE COMBINED AND USED FOR PRIORITIZATION OF ISSUES FOR THE CHIP. THE TOP ISSUES FROM THE CHNA SURVEY AND CHNA TOWN HALL MEETINGS WERE EVALUATED AGAINST THE FOLLOWING CRITERIA: - SERIOUSNESS - HOW MUCH OF AN IMPACT DOES THE POTENTIAL PRIORITY AREA HAVE ON THE MORBIDITY, MORTALITY AND QUALITY OF LIFE IN THE COMMUNITY? - FEASIBILITY - HOW LIKELY IS IT THAT THE CHIP CAN HAVE AN IMPACT ON THE POTENTIAL PRIORITY AREA? - ALIGNMENT - HOW WELL DOES THE POTENTIAL PRIORITY AREA SUPPORT OTHER EFFORTS IN THE COMMUNITY? - MEASURABILITY - IS IT POSSIBLE TO MEASURE PROGRESS IN THE POTENTIAL PRIORITY AREA? - CONCERN - WHAT IS THE LEVEL OF CONCERN IN THE COMMUNITY REGARDING THE POTENTIAL PRIORITY AREA? PARTICIPANTS AT THE VIRTUAL TOWN HALL, HELD ON MARCH 10, 2021, REPRESENTING OVER 95 COMMUNITY VOICES AND 45 DIFERENT ORGANIZATIONS, COMPLETED THE PRIORITIZATION PROCESS. FOR EACH ISSUE IN THE LIST, THEY WERE INSTRUCTED TO JUDGE THE ISSUE AGAINST THE FIVE CRITERIA AND RATE THE ISSUE FROM 1 (LOWEST) TO 5 (HIGHEST) FOR EACH OF THE CRITERIA. USING THE RESULTS FROM THE PRIORITIZATION PROCESS, FOUR ISSUES ROSE TO THE TOP AS PRIORITIES TO FOCUS ON DURING THE CHIP PROCESS. THE CHIP STEERING COMMITTEE SUMMARIZED THESE TOP PRIORITIES INTO THE FOLLOWING FOUR PRIORITY AREAS: 1. BEHAVIORAL HEALTH 2. ACCESS TO FOOD 3. SUBSTANCE USE 4. HEALTH EQUITY CHIP WORKGROUPS FOR EACH PRIORITY AREA WERE CREATED FROM EXISTING AND NEWLY FORMED HHN WORKGROUPS, COMMUNITY ORGANIZATIONS, AND OTHER STAKEHOLDERS. A SCHEMATIC DIAGRAM OF THE WORKGROUPS PRIORITY AREA CAN BE FOUND IN APPENDIX E. THIS CHIP AIMS TO INCREASE COMMUNITY CAPACITY BY REMOVING BARRIERS FOR COLLABORATION. BY COLLABORATING WITH EXISTING ORGANIZATIONS, HHN LEADERSHIP ALSO AIMS TO BUILD COMMUNITY CAPACITY AND SUSTAINABILITY OF CHIP EFFORTS. THE CHIP STEERING COMMITTEE DEVELOPED THE GOALS UNDER EACH PRIORITY AREA AND SOUGHT FEEDBACK FROM THE HHN WORKGROUPS AND OTHER COMMUNITY PARTNERS ON THE CONTENT OF THESE PRIORITY AREAS AND GOALS. OBJECTIVES FOR EACH PRIORITY AREA WERE DRAFTED BY THE CHIP STEERING COMMITTEE AND REFINED BY COLLABORATING WITH EXISTING ORGANIZATIONS, HHN LEADERSHIP ALSO AIMS TO BUILD COMMUNITY CAPACITY AND SUSTAINABILITY OF CHIP EFFORTS. THE CHIP STEERING COMMITTEE DEVELOPED THE GOALS UNDER EACH PRIORITY AREA AND SOUGHT FEEDBACK FROM THE HHN WORKGROUPS AND OTHER COMMUNITY PARTNERS ON THE CONTENT OF THESE PRIORITY AREA AND GOALS. OBJECTIVES FOR EACH PRIORITY AREA WERE DRAFTED BY THE CHIP STEERING COMMITTEE AND REFINED BY COLLABORATING WITH EXISTING ORGANIZATION, HHN LEADERSHIP ALSO AIMS TO BUILD ON COMMUNITY CAPACITY AND SUSTAINABILITY OF CHIP EFFORTS. THE CHIP STEERING COMMITTE DEVELOPED THE GOALS UNDER EACH PRIORITY AREA AND SOUGHT FEEDBACK FROM THE HHN WORKGROUPS AND OTHER COMMUNITY PARTNERS ON THE CONTENT OF THESE PRIORITY AREAS AND GOALS. OBJECTIVES FOR EACH PRIORITY AREA WERE DRAFTED BY THE CHIP STEERING COMMITTEE AND REFINED BASED ON FEEDBACK FROM THE CHIP WORKGROUPS AND PARTNERING COMMUNITY. THE CHIP STEERING COMMITTEE EXAMINED SHAWNEE COUNTY DATA TRENDS OVER TIME IN ORDER TO CREATE FEASIBLE OUTCOME OBJECTIVES WITHIN THE GIVEN TIMEFRAME. THE DEGREE OF CHANGE FROM YEAR-TO-YEAR WAS USED TO ESTABLISH A REASONABLE MEASURE OF CHANGE BY THE YEAR 2025. ADDITIONALLY, THE GROUP CONSIDERED THAT HEALTHY PEOPLE 2030 OBJECTIVES TYPICALLY AIM FOR A 10 PERCENT IMPROVEMENT OVER THE COURSE OF 10 YEARS. BECAUSE THIS CHIP COVERED A SPAN OF THREE YEARS EXPECTATIONS WERE ADJUSTED ACCORDINGLY. THE BENCHMARKING AGAINST HEALTHY PEOPLE 2030 TARGETS PROVIDED A GENERAL ESTIMATE, WHILE THE TREND ANALYSIS (IF AVAILABLE) PROVIDED MORE SPECIFICITY TO THE LOCAL MEASURES. FINALIZED INTERVENTIONS AND ACTIVITIES TO BE UNDERTAKEN WERE DEVELOPED BY THE WORKGROUPS AND PARTNERING ORGANIZATIONS FOR EACH PRIORITY AREA CHOSEN TO ACHIEVE THE OBJECTIVES IN THE CHIP ADDRESS AREAS OF BOTH MIDSTREAM AND UPSTREAM HEALTH AND WILL CONTINUE TO EVOLVE AND EMERGE IN ACCORDANCE WITH THE COMMUNITY CONTEXT IN PREPARATION FOR THE CHIP'S IMPLEMENTATION. ADDITIONALLY, THE CHIP INCLUDES INTERVENTIONS THAT ADDRESS BOTH INDIVIDUAL SOCIAL NEEDS AS WELL AS IMPROVING COMMUNITY CONDITIONS THAT WILL SUPPORT HEALTHIER LIVES FOR ALL SHAWNEE COUNTY RESIDENTS. THROUGHOUT THE DEVELOPMENT OF THE CHIP, THE STEERING COMMITTEE CONSIDERED UPSTREAM SOLUTIONS THAT ADDRESSED THE SOCIAL DETERMINANTS OF HEALTH AND FOCUSED ON POLICIES, SYSTEM AND ENVIRONMENTAL CHANGES IN EACH OF THE PRIORITY AREAS.
Schedule H, Part V, Section B, Line 6b Facility A, 1 Facility A, 1 - STORMONT VAIL HEALTHCARE, INC.. ORGANIZATIONS LEADING THE CHNA: STORMONT VAIL HEALTH SHAWNEE COUNTY HEALTH DEPARTMENT HEARTLAND HEALTHY NEIGHBORHOODS THE HEARTLAND HEALTHY NEIGHBORHOOD LEADERSHIP COMMITTEE IS THE LEAD COMMITTEE FOR HEARTLAND HEALTHY NEIGHBORHOODS. A COMMUNITY HEALTH PLANNER, A DIRECTOR & PATHWAYS COORDINATOR AS WELL AS A CHNA/CHIP STEERING COMMITTEE ALL REPORT TO THE LEADERSHIP COMMITTEE. THERE ARE CHAIR, VICE CHAIR AND PAST CHAIR POSITIONS WITHIN THE LEADERSHIP COMMITTEE. EACH OF THE IDENTIFIED PRIORITIES HAVE COALITIONS OR TASK FORCES THAT REPORT TO THE LEADERSHIP COMMITTEE. THE CURRENT LIST OF PRIORITIES INCLUDE THESE COALITIONS OR TASK FORCES: PARTNER GROUP: SUICIDE PREVENTION COALITION SUBSTANCE MISUSE TASK FORCE ACTIVE ENVIRONMENT HEALTHY BABIES HEALTHY EATING BEHAVIORAL HEALTH COLLABORATIVE STI COLLABORATIVE EACH GROUP HAS A CHAIR ASSIGNED TO LEAD THE PRIORITIZED EFFORTS. SEVERAL OF THE GROUPS HAVE PARTNER GROUPS INCLUDING: ACTIVE ENVIRONMENT - COMPLETE STREETS ADVISORY COUNCIL HEALTH BABIES - FETAL INFANT MORTALITY REVIEW BOARD HEALTH EATING - SHAWNEE COUNTY FARM & FOOD ADVISORY COUNCIL BEHAVIORAL HEALTH COLLABORATIVE - COMMUNITIES OF CARE THE FOLLOWING IS A LIST OF ORGANIZATIONS REPRESENTED IN THE COMMUNITY PRIORITIZATION MEETINGS: ADVISORS EXCEL ARDENT HEALTH SYSTEM AUBURN-WASHBURN PUBLIC SCHOOLS - USD 437 BAKER SCHOOL OF NURSING BARTLETT AND WEST BLUE CROSS AND BLUE SHIELD OF KANSAS BREADBASKET FARMERS' MARKET CAPITOL FEDERAL SAVINGS BANK CENTRAL TOPEKA GROCERY OASIS CHILD CARE AWARE OF EASTERN KANSAS CITY OF TOPEKA CITY OF TOPEKA FIRE DEPARTMENT CITY OF TOPEKA POLICE DEPARTMENT CITY OF TOPEKA - CITIZEN'S ADVISORY COUNCIL COMMUNITY ACTION, INC. COMMUNITY MEMBERS CORE FIRST BANK & TRUST COX COMMUNICATIONS EAST TOPEKA SENIOR CENTER EL CENTRO OF TOPEKA EVERGY PLAZA FAMILY SERVICE AND GUIDANCE CENTER FELLOWSHIP HI-CREST FLORENCE CRITTENTON SERVICES OF TOPEKA GRACEMED GREATER TOPEKA PARTNERSHIP HARVESTERS HISTORIC OLD TOWN NIA IBEW LOCAL 304 JAYHAWK AREA AGENCY ON AGING K-STATE RESEARCH AND EXTENSION KANSAS ASSOCIATION FOR THE MEDICALLY UNDERSERVED KANSAS BUREAU OF INVESTIGATION KANSAS CHILDREN'S SERVICE LEAGUE KANSAS DEPARTMENT FOR AGING DISABILITY SERVICES KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES KANSAS DEPARTMENT OF REVENUE KANSAS HEALTH INSTITUTE KANSAS STATE UNIVERSITY MIDLAND CARE NEW DAWN WELLNESS AND RECOVERY OMNI CIRCLE GROUP PARENTS AS TEACHERS - USD 501 PREVENTION AND RESILIENCY SERVICES (PARS) SEAMAN PUBLIC SCHOOLS - USD 345 SECURITY BENEFIT SHAWNEE COUNTY BOARD OF COUNTY COMMISSIONERS SHAWNEE COUNTY DEPARTMENT OF CORRECTIONS SHAWNEE COUNTY HEALTH DEPARTMENT SHAWNEE COUNTY PARKS AND RECREATION SHAWNEE HEIGHTS HIGH SCHOOL STORMONT VAIL HEALTH SUCCESSFUL CONNECTIONS THE VILLAGES INC. TOPEKA & SHAWNEE COUNTY PUBLIC LIBRARY TOPEKA CAPITAL-JOURNAL TOPEKA COMMUNITY FOUNDATION TOPEKA HABITAT FOR HUMANITY TOPEKA HOUSING AUTHORITY TOPEKA JUMP TOPEKA METRO TOPEKA PUBLIC SCHOOLS - USD 501 TOPEKA RESCUE MISSION UNITE US UNITED HEALTHCARE UNITED WAY OF KAW VALLEY U.S. BANK VALEO BEHAVIORAL HEALTH CARE WASHBURN UNIVERSITY WESTAR ENERGY WIBW YWCA OF NORTHEAST KANSAS
Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - STORMONT VAIL HEALTHCARE, INC.. IN THE FISCAL YEAR 2022 STRATEGIC PLANNING EFFORT, STORMONT VAIL CONTINUED TO FOCUS ON OUR COMMUNITY HEALTH PILLAR TO OUR PLAN. THIS ADDITION CODIFIES THE IMPORTANT ROLE STORMONT VAIL HEALTH PLAYS IN SHAWNEE COUNTY AS THE LARGEST EMPLOYER AND HEALTH CARE SYSTEM OF CHOICE IN IMPROVING THE HEALTH OF OUR COMMUNITY. THIS STRATEGIC FOCUS IS BASED UPON THE INPUT WE GATHERED DURING THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT AND 2022 COMMUNITY HEALTH IMPROVEMENT PLANS. OUR COMMUNITY PILLAR IS BROKEN DOWN INTO FIVE AREAS OF FOCUS, AS INDICATED BELOW: FOOD SECURITY 1.) EVALUATE FURTHER CHANGES TO STORMONT VAIL FOOD OFFERINGS TO PROMOTE HEALTHY EATING 2.) PARTNER WITH SCFFAC, HD AND KHI TO DETERMINE PRIORITIES AND STRATEGIES THAT INCREASE ACCESS TO AND AFFORDABILITY OF FOOD 3.) DEVELOP SUSTAINABILITY AND GROWTH PLAN FOR PRESCRIPTIVE FOOD PANTRY EDUCATION AND LITERACY 1.) FOCUS EFFORTS AT SECONDARY SCHOOLS TO: A.) EDUCATE AND PROMOTE CAREER IN HEALTHCARE, AT SVH B.) PROVIDE GENERAL HEALTH EDUCATION (PREVENTATIVE CARE)/PROMOTE SVH ECONOMIC VITALITY 1.) INCREASE NUMBER OF TCALC INTERNS THAT TRANSITION TO EMPLOYMENT WITH SVH HEALTH EQUITY 1.) CONVENE HISPANIC COMMUNITY HEALTH MEETINGS TO FURTHER GAIN INSIGHT INTO HEALTH CARE DISPARITIES WITHIN THE HISPANIC COMMUNITY 2.) ADVANCE DATA COLLECTION TO HAVE EQUALITY OF CARE: A.) IDENTIFY PLAN TO CREATE "EQUITY DASHBOARD" DESIGNED TO IDENTIFY AREAS OF HEALTH CARE DISPARITIES 3.) OPERATIONALIZE THE STORMONT VAIL MOBILE CLINIC WITHIN NORTH TOPEKA, EAST TOPKEA AND OAKLAND AND PARTNER WITH MAP TO COORDINATE WITHIN COMMUNITY 4.) GROW ENROLLEE VOLUME IN THE LINK PROGRAM 5.) ENGAGE IN SHAWNEE COUNTY BEHAVORIAL COLALBORATIVE COMMUNITY LEADERSHIP 1.) DEVELOP STORMONT VAIL VOLUNTEERISM INITIATIVES 2.) IMPLEMENT COMMUNITY COMMITTEE OF SVH BOARD TO ASSIST, INFORM, PROVIDE OVERSIGHT AND RECOMMEND ACTIONS TO SVH BOARD TO IMPROVE THE HEALTH OF OUR COMMUNITY 3.) DEVELOP CHNA STRATEGIES SPECIFIC FOR RILEY COUNTY WITH SUPPORT OF REGIONAL ADMINISTRATOR
Schedule H, Part V, Section B, Line 2 STORMONT-VAIL HEALTHCARE INC FORMED A NEW SINGLE MEMBER LLC, STORMONT-VAIL HEALTH FLINT HILLS, LLC, WHICH OBTAINED ITS KANSAS STATE HOSPITAL LICENSE IN JUNE 2023 TO OPERATE A HOSPITAL IN GEARY COUNTY KANSAS.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?41
Name and address Type of Facility (describe)
1 COTTON O'NEIL HEART CENTER
909 SW MULVAN E ST
TOPEKA,KS66606 		PHYSICIAN OFFICE
2 COTTON O'NEIL CANCER CENTER
1414 SW 8TH ST
TOPEKA,KS66606 		CANCER CENTER
3 STORMONT VAIL OUTPATIENT SURGERY CENTER
2660 SW 3RD ST
TOPEKA,KS66606 		SURGERY CENTER
4 COTTON O'NEIL KANZA PARK
2660 SW 3RD ST
TOPEKA,KS66606 		PHYSICIAN OFFICE
5 COTTON O'NEIL MULVANE
823 SW MULVANE ST
TOPEKA,KS66606 		PHYSICIAN OFFICE
6 COTTON O'NEIL DIGESTIVE HEALTH CLINIC
720 SW LANE ST
TOPEKA,KS66606 		PHYSICIAN OFFICE
7 STORMONT VAIL ENT SURGERY CENTER
920 SW LANE
TOPEKA,KS66606 		SURGERY CENTER
8 STORMONT VAIL IMAGING CENTER
731 SW MULVANE ST
TOPEKA,KS66606 		IMAGING CENTER
9 COTTON O'NEIL MANHATTAN
1133 COLLEGE ST SUITE E-110
MANHATTAN,KS66502 		PHYSICIAN OFFICE
10 COTTON O'NEIL GARFIELD
901 SW GARFIELD ST
TOPEKA,KS66606 		PHYSICIAN OFFICE
11 STORMONT VAIL BEHAVIORAL HEALTH
3707 SW 6TH ST
TOPEKA,KS66606 		PSYCHIATRIC SERVICES
12 STORMONT VAIL PAIN MANAGEMENT CENTER
823 SW MULVANE ST
TOPEKA,KS66606 		PHYSICIAN OFFICE
13 COTTON O'NEIL ASBURY DRIVE CLINIC
2902 SW ASBURY DR
TOPEKA,KS66614 		PHYSICIAN OFFICE
14 COTTON O'NEIL EMPORIA CLINIC
1301 SW 12TH ST
EMPORIA,KS66801 		PHYSICIAN OFFICE
15 COTTON O'NEIL NORTH
4505 NW FIELDING ROAD
TOPEKA,KS66618 		PHYSICIAN OFFICE
16 COTTON O'NEIL PEDIATRIC
4100 SW 15TH ST
TOPEKA,KS66604 		OFFICE
17 COTTON O'NEIL DERMATOLOGY CLINIC
6650 SW MISSION VALLEY DRIVE
TOPEKA,KS66614 		PHYSICIAN OFFICE
18 COTTON O'NEIL DIABETESENDOCRINOLOGY CTR
3520 SW 6TH AVE
TOPEKA,KS66606 		PHYSICIAN OFFICE
19 STORMONT VAIL SLEEP CENTER
1615 SW 8TH AVE
TOPEKA,KS66606 		SLEEP CENTER
20 COTTON O'NEIL URISH CLINIC
6725 SW 29TH ST
TOPEKA,KS66614 		PHYSICIAN OFFICE
21 COTTON O'NEIL CROCO CLINIC
2909 SE WALNUT DR
TOPEKA,KS66605 		PHYSICIAN OFFICE
22 COTTON O'NEIL DIGESTIVE HEALTH POYNTZ
1014 POINTZ AVE SUITE B
MANHATTAN,KS66502 		PHYSICIAN OFFICE
23 STORMONT VAIL INFUSION CENTER
909 SW MULVANE ST LOWER LEVEL
TOPEKA,KS66606 		INFUSION CENTER
24 COTTON O'NEIL EXPRESS CARE MIDTOWN
909 SW MULVAN E ST
TOPEKA,KS66606 		PHYSICIAN CLINIC
25 COTTON O'NEIL FOOT AND ANKLE CLINIC
1315 SW 6TH AVE SUITE A
TOPEKA,KS66606 		PHYSICIAN OFFICE
26 COTTON O'NEIL CORPORATE VIEW CLINIC
601 CORPORATE VIEW ROAD
TOPEKA,KS66615 		PHYSICIAN OFFICE
27 COTTON O'NEIL DIGESTIVE HEALTH HYLTON
1213 HYLTON HEIGHTS ROAD SUITE 101
MANHATTAN,KS66502 		PHYSICIAN OFFICE
28 COTTON O'NEIL WAMEGO CLINIC
1704 COMMERCIAL CIRCLE
WAMEGO,KS66547 		PHYSICIAN OFFICE
29 COTTON O'NEIL OSAGE CITY CLINIC
131 WEST MARKET ST
OSAGE CITY,KS66523 		PHYSICIAN OFFICE
30 COTTON O'NEIL CARDIAC THORACIC SURGEON
830 SW MULVANE
TOPEKA,KS66606 		PHYSICIAN OFFICE
31 COTTON O'NEIL DIGESTIVE HEALTH WESTPORT
1419 WESTPO RT LANDING PLACE
MANHATTAN,KS66502 		PHYSICIAN OFFICE
32 COTTON O'NEIL SEUROS PINE CLINIC
2660 SW 3RD ST
TOPEKA,KS66606 		PHYSICIAN OFFICE
33 COTTON O'NEIL OSKALOOSA CLINIC
209 W JEFFERSON ST
OSKALOOSA,KS66066 		PHYSICIAN OFFICE
34 STORMONT VAIL WORK CARE
1516 SW 6TH AVE1516 SW 6TH AVE
TOPEKA,KS66606 		PHYSICIAN OFFICE
35 COTTON O'NEIL CARBONDALE CLINIC
211 EAST MAIN ST
TOPEKA,KS66523 		PHYSICIAN OFFICE
36 COTTON O'NEIL NETAWAKA CLINIC
200 WHITE WAY
NETAWAKA,KS66516 		PHYSICIAN OFFICE
37 COTTON O'NEIL MERIDEN CLINIC
407 EAST WYANDOTTE
MERIDEN,KS66512 		PHYSICIAN OFFICE
38 COTTON O'NEIL ROSSVILLE CLINIC
423 MAIN ST
ROSSVILLE,KS66533 		PHYSICIAN OFFICE
39 COTTON O'NEIL LAWRENCE CLINIC
330 ARKANSAS
LAWRENCE,KS66044 		PHYSICIAN OFFICE
40 COTTON O'NEIL PEDIATRICS MISSION WOODS
2860 SW MISSION WOODS DR
TOPEKA,KS66614 		PHYSICIAN OFFICE
41 COTTON O'NEIL LEBO CLINIC
118 W 4TH ST
LEBO,KS66856 		PHYSICIAN OFFICE
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
Schedule H, Part I, Line 7g STORMONT VAIL PROVIDES MATERNAL FETAL MEDICINE SERVICES, BREASTFEEDING CLINIC, TRAUMA PROGRAM, CARE CLINIC AND A MOBILE CLINIC TO THE COMMUNITY. THE ORGANIZATION CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 4610971
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance COST TO CHARGE RATIO
Schedule H, Part II Community Building Activities Supporting community organizations by participating in fundraising events and communities attempting to grow the community.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE BAD DEBT EXPENSE AMOUNT IS CALCULATED BY DETERMINING THE AMOUNT OF THE ACCOUNTS THAT WERE WRITTEN OFF AS BAD DEBT NET OF ANY RECOVERIES. A COST TO CHARGE RATIO WAS APPLIED TO THE NET BAD DEBT AMOUNT IN ORDER TO DETERMINE COST. THE AMOUNT WRITTEN OFF AS BAD DEBT HAS BEEN REDUCED BY ANY APPLICABLE DISCOUNTS.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology WE ARE NOT AWARE OF ANY PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE THAT WERE CONSIDERED TO BE BAD DEBT.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE FINANCIAL STATEMENT FOOTNOTE ADDRESSING BAD DEBT EXPENSE IS ON PAGE 11 OF THE ATTACHED FINANCIAL STATEMENTS.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs STORMONT VAIL HEALTHCARE BELIEVES THAT SOME PORTION OF THE MEDICARE SHORTFALL SHOULD BE CONSIDERED TO BE A COMMUNITY BENEFIT. STORMONT VAIL PROVIDES MEDICAL CARE TO THE MEMBERS OF THE COMMUNITY, INCLUDING MEDICARE PATIENTS, EVEN IF THE COSTS OF THAT CARE ARE NOT COMPLETELY REIMBURSED. THE HEALTH OF THE COMMUNITY WOULD SUFFER IF STORMONT VAIL DID NOT PROVIDE THESE SERVICES.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance AN ESSENTIAL ELEMENT OF THE MISSION OF STORMONT VAIL HEALTHCARE IS TO BE GOOD FINANCIAL STEWARDS AS WE STRIVE TO IMPROVE THE HEALTHCARE OF OUR COMMUNITY. AS PART OF THAT STEWARDSHIP, WE MUST DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH PATIENTS CAN AFFORD TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WE WORK VERY HARD TO MAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TO THOSE WHO NEED IT MOST AND TO ENSURE THAT WE MANAGE OUR RESOURCES SO THAT WE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. THE ORGANIZATION NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND IN COMMUNICATION REGARDING PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. OUR REPRESENTATIVES WORK WITH PATIENTS TO TRY TO REACH THE MOST EQUITABLE SOLUTION IN ORDER TO RESOLVE A PATIENT BILL. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED.
Schedule H, Part V, Section B, Line 16a FAP website A - STORMONT VAIL HEALTHCARE, INC.: Line 16a URL: WWW.STORMONTVAIL.ORG/PATIENT-RESOURCES/FINANCIAL-SERVICES/ FINANCIAL-ASSISTANCE/; B - Stormont Vail Health Flint Hills, LLC: Line 16a URL: WWW.STORMONTVAIL.ORG/PATIENT-RESOURCES/FINANCIAL-SERVICES/ FINANCIAL-ASSISTANCE/;
Schedule H, Part V, Section B, Line 16b FAP Application website A - STORMONT VAIL HEALTHCARE, INC.: Line 16b URL: WWW.STORMONTVAIL.ORG/PATIENT-RESOURCES/FINANCIAL-SERVICES/ FINANCIAL-ASSISTANCE/; B - Stormont Vail Health Flint Hills, LLC: Line 16b URL: WWW.STORMONTVAIL.ORG/PATIENT-RESOURCES/FINANCIAL-SERVICES/ FINANCIAL-ASSISTANCE/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - STORMONT VAIL HEALTHCARE, INC.: Line 16c URL: WWW.STORMONTVAIL.ORG/PATIENT-RESOURCES/FINANCIAL-SERVICES/ FINANCIAL-ASSISTANCE/; B - Stormont Vail Health Flint Hills, LLC: Line 16c URL: WWW.STORMONTVAIL.ORG/PATIENT-RESOURCES/FINANCIAL-SERVICES/ FINANCIAL-ASSISTANCE/;
Schedule H, Part VI, Line 2 Needs assessment IN ADDITION TO THE CHNA, STORMONT VAIL AND STAFF ARE ACTIVE IN THE COMMUNITY. BY DOING SO, STORMONT VAIL IS ABLE TO LEARN ABOUT ISSUES IMPACTING THE COMMUNITY AND CITIZENS.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance STORMONT VAIL WIDELY PUBLICIZES THE FINANCIAL ASSISTANCE PROGRAM BY POSTING INFORMATION ON THE STORMONT VAIL WEBSITE, NOTIFYING AND DISTRIBUTING INFORMATION TO PATIENTS AT ALL REGISTRATION AREAS WHEN THEY PRESENT FOR SERVICE, MAKING INFORMATION AVAILABLE IN REGISTRATION WAITING ROOMS, INCLUDING INFORMATION ON PATIENT BILLING STATEMENTS, MENTIONING THE FAP WHEN DISCUSSING AN INDIVIDUAL'S BILL OVER THE TELEPHONE AND BY PUBLICIZING THE FAP TO COMMUNITY HEALTH CENTERS AND SOCIAL SERVICE AGENCIES. STORMONT VAIL ALSO ASSISTS PATIENTS IN OBTAINING COVERAGE THROUGH GOVERNMENTAL PROGRAMS.
Schedule H, Part VI, Line 4 Community information TOPEKA IS THE MAJOR URBAN CENTER IN SHAWNEE COUNTY WITH A POPULATION OF 178,909 (US CENSUS BUREAU 2020). SHAWNEE COUNTY IS THE THIRD LARGEST COUNTY IN THE STATE. SHAWNEE COUNTY HAS A SLIGHTLY GREATER RACIAL AND ETHNIC DIVERSITY THAN THE STATE OF KANSAS OVERALL. OVER 27% OF THE COUNTY AND 25% OF TOPEKA ARE NON-WHITE. THE AFRICAN AMERICAN POPULATION IN SHAWNEE COUNTY IS 8.5% VERSUS 6.2% STATEWIDE. HISPANIC OR LATINO IN SHAWNEE COUNTY IS 13.4% VERSUS 12.7% STATEWIDE. MEDIAN AND PER CAPITA INCOME ARE SLIGHTLY LOWER FOR SHAWNEE COUNTY THAN FOR THE STATE. THE COUNTY'S POVERTY RATE IS 10.5%, AND THE STATE'S RATE IS 10.6% PERCENT. THE PERCENTAGE OF SHAWNEE COUNTY CHILDREN LIVING IN POVERTY IS 13% - THE SAME AS THE STATE, AND 23% OF CHILDREN LIVE IN SINGLE-PARENT HOUSEHOLDS COMPARED TO 21% STATEWIDE.
Schedule H, Part VI, Line 5 Promotion of community health STORMONT VAIL IS A NON-PROFIT CORPORATION SO ANY SURPLUS FUNDS ARE RE-INVESTED BACK INTO THE ORGANIZATION AND NOT PAID TO INVESTORS. THE HEALTH SYSTEM IS MANAGED BY A LOCAL BOARD OF DIRECTORS WHO ARE COMMUNITY LEADERS. STORMONT VAIL ACCEPTS ALL PATIENTS REGARDLESS OF INSURANCE COVERAGE SO THAT CARE IS PROVIDED TO ALL WHO NEED CARE.
Schedule H, Part VI, Line 7 State filing of community benefit report KS
Schedule H (Form 990) 2022
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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2022
Open to Public
Inspection
Name of the organization
Stormont-Vail Heathcare Inc
 
Employer identification number
48-0543789
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) STORMONT VAIL FOUNDATION
1500 SW 10TH AVE
TOPEKA,KS66604 		48-0980926 501(C)(3) 522,000       SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
1
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2022

Schedule I (Form 990) 2022
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
Schedule I, Part I, Line 2 GRANTS ARE HISTORICALLY ONLY MADE TO THE STORMONT-VAIL FOUNDATION, A RELATED 501(C)(3) ORGANIZATION. DUE TO THE CLOSE WORKING RELATIONSHIP BETWEEN THE ORGANIZATIONS, NO MONITORING OF THE USAGE OF FUNDS AFTER THE FACT IS DEEMED NECESSARY.
Schedule I (Form 990) 2022



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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
Stormont-Vail Heathcare Inc
 
Employer identification number

48-0543789
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
Yes
 
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2022

Schedule J (Form 990) 2022
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1ROBERT KENAGY
 
PRESIDENT CEO 		(i)

(ii)		 963,907
-------------
0 		514,419
-------------
0 		159,844
-------------
0 		14,800
-------------
0 		32,674
-------------
0 		1,685,644
-------------
0 		146,250
-------------
0
2PEGGY BURNETTE
 
VICE PRES/CFO TREASURER - ended 02/23 		(i)

(ii)		 563,233
-------------
0 		102,658
-------------
0 		3,751
-------------
0 		82,347
-------------
0 		15,484
-------------
0 		767,473
-------------
0 		0
-------------
0
3KEVIN DISHMAN
 
DIRECTOR/PHYSICIAN 		(i)

(ii)		 602,446
-------------
0 		235,298
-------------
0 		3,834
-------------
0 		87,542
-------------
0 		23,180
-------------
0 		952,300
-------------
0 		0
-------------
0
4AILEEN MCCARTHY
 
DIRECTOR/PHYSICIAN 		(i)

(ii)		 320,287
-------------
0 		36,839
-------------
0 		6,172
-------------
0 		14,230
-------------
0 		18,679
-------------
0 		396,207
-------------
0 		0
-------------
0
5TRACY O'ROURKE
 
SVP AND CHIEF ADMIN OFFICER 		(i)

(ii)		 492,140
-------------
0 		174,865
-------------
0 		1,263
-------------
0 		75,282
-------------
0 		39,141
-------------
0 		782,691
-------------
0 		0
-------------
0
6CAROL PERRY
 
SVP AND CHIEF NURSING OFFICER 		(i)

(ii)		 392,572
-------------
0 		161,338
-------------
0 		52,213
-------------
0 		14,800
-------------
0 		24,763
-------------
0 		645,686
-------------
0 		47,865
-------------
0
7DEBRA YOCUM
 
VP CLINIC OPERATIONS 		(i)

(ii)		 356,333
-------------
0 		132,445
-------------
0 		40,392
-------------
0 		14,800
-------------
0 		24,558
-------------
0 		568,528
-------------
0 		36,456
-------------
0
8JOHN MA
 
PHYSICIAN 		(i)

(ii)		 1,753,860
-------------
0 		64,252
-------------
0 		26,223
-------------
0 		14,800
-------------
0 		29,142
-------------
0 		1,888,277
-------------
0 		0
-------------
0
9MICHAEL TILLEY
 
PHYSICIAN 		(i)

(ii)		 1,477,483
-------------
0 		32,016
-------------
0 		35,632
-------------
0 		14,800
-------------
0 		26,112
-------------
0 		1,586,043
-------------
0 		0
-------------
0
10MATTHEW WILLS
 
PHYSICIAN 		(i)

(ii)		 1,338,932
-------------
0 		59,240
-------------
0 		3,612
-------------
0 		8,700
-------------
0 		26,694
-------------
0 		1,437,178
-------------
0 		0
-------------
0
11TEWODROS ADDISSE
 
PHYSICIAN 		(i)

(ii)		 1,300,021
-------------
0 		49,074
-------------
0 		1,932
-------------
0 		14,800
-------------
0 		7,989
-------------
0 		1,373,816
-------------
0 		0
-------------
0
12JACOB DEISTER
 
PHYSICIAN 		(i)

(ii)		 1,277,815
-------------
0 		46,925
-------------
0 		1,260
-------------
0 		13,850
-------------
0 		29,252
-------------
0 		1,369,102
-------------
0 		0
-------------
0
Schedule J (Form 990) 2022

Schedule J (Form 990) 2022
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
Schedule J, Part I, Line 5a Compensation contingent on revenues of the organization EMPLOYED PHYSICIANS MAY EARN ADDITIONAL COMPENSATION IF THE RELATIVE VALUE UNITS THAT ARE GENERATED FROM THEIR PRACTICE EXCEED CERTAIN LEVELS.
Schedule J, Part I, Line 4b 457(F) ANNUAL CONTRIBUTIONS MADE AS PERCENT OF BASE SALARY IN DECEMBER. IF OVER AGE 60 CONTRIBUTIONS ARE VESTED AND TAXES ARE WITHHELD. IF LESS THAN 60 CONTRIBUTIONS DO NOT VEST UNTIL EARLIER OF 5 ANNUAL CONTRIBUTIONS OR AGE 60. ACCOUNT IS NOT DISTRIBUTED UNTIL TERMINATION. THE FOLLOWING PARTICIPATED IN THE 457(F) PLAN: PEGGY BURNETTE KEVIN DISHMAN ROBERT KENAGY TRACY O'ROURKE CAROL PERRY DEBRA YOCUM
Schedule J, Part II, Column (F) COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS VESTED OR PAID TO THE INDIVIDUAL.
Schedule J (Form 990) 2022

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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Stormont-Vail Heathcare Inc
 
Employer identification number
48-0543789
Part Ⅰ
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer		 (i) Pool
financing
Yes No Yes No Yes No
A KANSAS DEVELOPMENT FINANCE AUTHORITY
  		48-1066589   12-15-2016 70,350,000 HEALTH FACILITIES, REFUND 2007I BONDS (08/29/07), 2008F BONDS (04/02/08) & 2012I BONDS (08/14/07).   X   X   X
B KANSAS DEVELOPMENT FINANCE AUTHORITY
  		48-1066589   08-21-2017 31,870,000 REFUND 2016 TAXABLE NOTE   X   X   X
C KANSAS DEVELOPMENT FINANCE AUTHORITY
  		48-1066589   08-19-2019 36,265,000 REFUND PORTION 2011 BONDS   X   X   X
D KANSAS DEVELOPMENT FINANCE AUTHORITY
  		48-1066589   05-20-2021 35,390,000 HEALTH FACILITIES   X   X   X
KANSAS DEVELOPMENT FINANCING AUTHORITY
  		48-1066589   08-17-2022 40,145,000 REFUND REMAINDER 2013 BONDS   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 10,005,000 19,580,000 5,880,000 1,445,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 70,709,937 31,870,000 36,265,000 35,617,871
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds ............. 15,110      
6 Proceeds in refunding escrows ............... 0      
7 Issuance costs from proceeds ............... 684,718   365,041 364,928
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 20,165,265     33,772,040
11 Other spent proceeds ............. 49,844,844 31,870,000 35,899,959  
12 Other unspent proceeds ............. 1,460     1,480,903
13 Year of substantial completion ............. 2020 2001 2013
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2020, a current refunding issue)? ........ 		X   X   X     X
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........ 		X   X     X   X
16 Has the final allocation of proceeds been made? .......... X   X   X     X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 2
Part Ⅲ
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X       X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X       X   X
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X       X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X       X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X         X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X          
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet        
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet        
6 Total of lines 4 and 5 ............. 0 % 0 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........ 		X   X   X   X  
Part Ⅳ
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? ....... X       X   X  
b Exception to rebate? ........                
c No rebate due? ......... X   X          
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X     X X  
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 3
Part Ⅳ
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part Ⅴ
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part Ⅵ
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Schedule K, Part II, Line 3 COLUMNS A AND D AMOUNT IS NOT EQUAL TO ISSUE PRICE DUE TO INVESTMENT EARNINGS EARNED DURING THE PROJECT PERIOD.
Schedule K, Part II, Line 11 COLUMNS A AND B THIS AMOUNT OF BOND PROCEEDS WAS DEPOSITED INTO THE REFUNDING ACCOUNT OR ESCROW FUND AND WAS USED TO REFUND THE PRIOR OBLIGATION(S).
Schedule K, Part II, Line 13 COLUMN B THE PROJECT FINANCED BY THE REFUNDED BONDS HAD AN ORIGINAL PROJECT COMPLETION DATE THAT OCCURRED IN 2001.
Schedule K, Part IV, Line 2c COLUMN A Issuer name: KANSAS DEVELOPMENT FINANCE AUTHORITY The calculation for computing no rebate due was performed on 11/15/2021
Schedule K, Part IV, Line 2c COLUMN B Issuer name: KANSAS DEVELOPMENT FINANCE AUTHORITY The calculation for computing no rebate due was performed on 10/18/2021
Schedule K (Form 990) 2021

Additional Data


Software ID: 22016089
Software Version: 2022v5.0


Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Stormont-Vail Heathcare Inc
 
Employer identification number
48-0543789
Part Ⅰ
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer		 (i) Pool
financing
Yes No Yes No Yes No
A KANSAS DEVELOPMENT FINANCE AUTHORITY
  		48-1066589   12-15-2016 70,350,000 HEALTH FACILITIES, REFUND 2007I BONDS (08/29/07), 2008F BONDS (04/02/08) & 2012I BONDS (08/14/07).   X   X   X
B KANSAS DEVELOPMENT FINANCE AUTHORITY
  		48-1066589   08-21-2017 31,870,000 REFUND 2016 TAXABLE NOTE   X   X   X
C KANSAS DEVELOPMENT FINANCE AUTHORITY
  		48-1066589   08-19-2019 36,265,000 REFUND PORTION 2011 BONDS   X   X   X
D KANSAS DEVELOPMENT FINANCE AUTHORITY
  		48-1066589   05-20-2021 35,390,000 HEALTH FACILITIES   X   X   X
KANSAS DEVELOPMENT FINANCING AUTHORITY
  		48-1066589   08-17-2022 40,145,000 REFUND REMAINDER 2013 BONDS   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 10,005,000 19,580,000 5,880,000 1,445,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 70,709,937 31,870,000 36,265,000 35,617,871
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds ............. 15,110      
6 Proceeds in refunding escrows ............... 0      
7 Issuance costs from proceeds ............... 684,718   365,041 364,928
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 20,165,265     33,772,040
11 Other spent proceeds ............. 49,844,844 31,870,000 35,899,959  
12 Other unspent proceeds ............. 1,460     1,480,903
13 Year of substantial completion ............. 2020 2001 2013
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2020, a current refunding issue)? ........ 		X   X   X     X
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........ 		X   X     X   X
16 Has the final allocation of proceeds been made? .......... X   X   X     X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 2
Part Ⅲ
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X       X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X       X   X
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X       X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X       X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X         X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X          
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet        
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet        
6 Total of lines 4 and 5 ............. 0 % 0 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........ 		X   X   X   X  
Part Ⅳ
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? ....... X       X   X  
b Exception to rebate? ........                
c No rebate due? ......... X   X          
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X     X X  
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 3
Part Ⅳ
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part Ⅴ
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part Ⅵ
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Schedule K, Part II, Line 3 COLUMNS A AND D AMOUNT IS NOT EQUAL TO ISSUE PRICE DUE TO INVESTMENT EARNINGS EARNED DURING THE PROJECT PERIOD.
Schedule K, Part II, Line 11 COLUMNS A AND B THIS AMOUNT OF BOND PROCEEDS WAS DEPOSITED INTO THE REFUNDING ACCOUNT OR ESCROW FUND AND WAS USED TO REFUND THE PRIOR OBLIGATION(S).
Schedule K, Part II, Line 13 COLUMN B THE PROJECT FINANCED BY THE REFUNDED BONDS HAD AN ORIGINAL PROJECT COMPLETION DATE THAT OCCURRED IN 2001.
Schedule K, Part IV, Line 2c COLUMN A Issuer name: KANSAS DEVELOPMENT FINANCE AUTHORITY The calculation for computing no rebate due was performed on 11/15/2021
Schedule K, Part IV, Line 2c COLUMN B Issuer name: KANSAS DEVELOPMENT FINANCE AUTHORITY The calculation for computing no rebate due was performed on 10/18/2021
Schedule K (Form 990) 2021

Additional Data


Software ID: 22016089
Software Version: 2022v5.0

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Stormont-Vail Heathcare Inc
 
Employer identification number

48-0543789
Return Reference Explanation
Form 990, Part III, Line 4a STORMONT-VAIL HEALTHCARE, INC. PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. FOR THE YEAR ENDED SEPTEMBER 30, 2023, 18,537 INPATIENTS, 55,834 EMERGENCY ROOM PATIENTS, 1,517 NEWBORNS, AND 358 NEONATAL INTENSIVE CARE BABIES WERE SERVED. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THE STORMONT VAIL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. STORMONT VAIL'S MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTH CARE SERVICES AND HEALTH CARE EDUCATION REGARDLESS OF ABILITY TO PAY. AS PART OF THIS MISSION, STORMONT VAIL PROVIDES CARE TO PERSONS COVERED BY MEDICARE AND MEDICAID. FOLLOWING ARE SOME OF THE BENEFITS PROVIDED AT REDUCED RATES FOR THE FISCAL YEAR: IN ADDITION TO THE CHARITY CARE PROVIDED, STORMONT VAIL ALSO PROVIDED SERVICE TO PATIENTS THAT RESULTED IN UNCOLLECTIBLE AMOUNTS AS FOLLOWS: BAD DEBT EXPENSE AT COST $ 10,884,749 SHORTFALL OF MEDICARE PAYMENTS AT COST $ 83,655,581 SHORTFALL OF MEDICAID PAYMENTS AT COST $ 29,856,918 STORMONT VAIL ALSO PROVIDES OTHER HEATH CARE SERVICES AND PROGRAMS FOR THE BENEFIT OF THE COMMUNITY, FREE OR AT REDUCED RATES. EXAMPLES OF THESE INCLUDE: 1. SUBSIDY OF NURSING EDUCATION, MEDICAL EDUCATION, AND ALLIED HEALTH EDUCATION 2. OPERATING THE REGIONS ONLY LEVEL III NEONATAL INTENSIVE CARE UNIT (NICU) SERVING A HIGH PERCENTAGE OF MEDICALLY INDIGENT PATIENTS 3. OPERATING A LEVEL II TRAUMA CENTER SERVING NORTHEAST KANSAS 4. ORGANIZED SUPPORT GROUPS FOR A VARIETY OF TOPICS INCLUDING CANCER SUPPORT GROUP, DIABETES ADULT SUPPORT GROUP AND THE PREGNANCY AND INFANT LOSS SUPPORT GROUP 5. VOLUNTEER TIME WAS DONATED TO STORMONT VAIL HELPING TO REDUCE THE COST OF PROVIDING HEALTH CARE 6. Stormont Vail employees support the Care Line, which is an emergency fund for patients in financial distress, providing services and supplies on a short-term basis 7. USE OF POZEZ EDUCATION CENTER FACILITIES FOR A VARIETY OF COMMUNITY GROUPS AND PROGRAMS 8. PARTICIPATED IN NUMEROUS CLINICAL RESEARCH TRIALS THROUGH THE CLINICAL RESEARCH DEPARTMENT 9. OPERATED A PALLIATIVE CARE PROGRAM TO PROVIDE COMFORT CARE TO PATIENTS WITH CHRONIC CONDITIONS 10. PROVIDED SUPPORT AND EDUCATION FOR PATIENTS WITH DIABETES THROUGH THE DIABETES LEARNING CENTER 11. STORMONT-VAIL IS A REGIONAL NETWORK OF 30+ LOCATIONS IN 11 COMMUNITIES IN OUR REGION IMPROVING ACCESS TO MEDICAL CARE IN SEVERAL CITIES THAT OTHERWISE WOULD NOT HAVE ACCESS, PARTICULARLY ON WEEKENDS 12. MATERNAL FETAL MEDICINE PROGRAM PROVIDED CARE AND ACCESS TO SCREENINGS AND GENETIC COUNSELING FOR WOMEN WITH AT-RISK PREGNANCIES 13. OFFERED VARIOUS PARENTING AND CHILDBIRTH PREPARATION PROGRAMS THROUGH STORMONT-VAIL'S WEB SITE 14. THE HEALTH CONNECTION PROGRAM, WHICH PROVIDES PHYSICIAN REFERRAL AND AFTER-HOUR ACCESS TO A NURSE 15. PARTNERED WITH BUILDING BLOCKS TO PROVIDE CHILDCARE SERVICES TO STAFF 16. CONNECTED WITH THE COMMUNITY THROUGH THE ORGANIZATION WEBSITE, WWW.STORMONTVAIL.ORG 17. PARTNERED WITH HEALTH INNOVATION NETWORK OF KANSAS, A COALITION OF 15 HOSPITALS SHARING INFORMATION, EDUCATION AND OTHER NEEDED SERVICES 18. STORMONT VAIL AND ITS EMPLOYEES DONATED FUNDS AND STAFF TIME TO THE MEALS ON WHEELS PROGRAM INCLUDING SPONSORING A MEALS ON WHEELS ROUTE 19. STORMONT VAIL AND ITS EMPLOYEES DONATED FUNDS AND STAFF TIME TO THE UNITED WAY 20. OPERATED THE PATIENT CENTER MEDICAL HOME CONCEPT TO IMPROVE CARE WITH THE FOCUS ON PREVENTION AND WELLNESS 21. WORK WITH OTHERS IN THE COMMUNITY TO IMPROVE SAFETY NET SERVICES FOR UNDER INSURED AND UNINSURED 22. PROVIDED STAFF TO SERVE ON THE BOARD OF DIRECTORS FOR THE UNITED WAY OF TOPEKA, TOPEKA COMMUNITY FOUNDATION, GO TOPEKA, AND OTHERS 23. PROVIDED TRANSPORTATION TO PATIENTS WHO ARE UNABLE TO GET TO THEIR HEALTH CARE APPOINTMENTS OR NEED TRANSPORTATION TO RETURN HOME 24. PROVIDED SCREENING AND COORDINATION FOR PARTICIPANTS FOR A DRUG PROGRAM BENEFIT TO HELP PATIENTS OBTAIN NEEDED MEDICATION 25. PROVIDED COMMUNITY LEADERSHIP THROUGH HEARTLAND HEALTHY NEIGHBORHOODS AND ASSOCIATED WORKGROUP PARTICIPATION 26. DONATED OFFICE SPACE, JANITORIAL SERVICES, SHREDDING, AND PHONES TO HOUSE THE SHAWNEE COUNTY MEDICAL SOCIETY HEALTHACCESS PROGRAM THAT HELPS COORDINATE DONATED CARE FOR LOW-INCOME UNINSURED ON BEHALF OF THE ENTIRE MEDICAL COMMUNITY 27. PARTNERED WITH UNITED WAY 211 SO THAT INDIVIDUALS CAN DIAL 211 FROM ANY PHONE TO SPEAK WITH A REFERRAL SPECIALIST. AVAILABLE IN BOTH ENGLISH AND SPANISH 28. PROVIDED RESOURCE INFORMATION FOR FINANCIAL ASSISTANCE TO INDIVIDUALS 29. PARTNERED WITH SEVERAL ORGANIZATIONS TO PROVIDE MENTAL HEALTH ASSISTANCE 30. FOOD ASSISTANCE RESOURCES WERE PROVIDED IN COLLABORATION WITH SEVERAL ORGANIZATIONS 31. PROVIDED RESOURCE INFORMATION ON HOUSING ASSISTANCE FOR INDIVIDUALS THAT ARE HAVING FINANCIAL DIFFICULTIES OR HAVE BEEN EVICTED 32. Provided health & wellness resources 33. Coordinate two Welcome Baby Jubilee events each year to assist pregnant individuals and their support systems to community resources through booths and a panel presentation. 34. Offer monthly Walk With a Doc events for community members to hear a short presentation by a physician and enjoy a walk at a community location 35. Donate staff time to teach CNA and Phlebotomy classes at a local school district 36. Staff and operate a mobile clinic providing primary care in community parking lots and with the Mobile Access Partnership providing care to individuals who are homeless 37. Provide trauma prevention education for the community including Stop the Bleed, car seat and senior safety check lanes, and fall prevention
Form 990, Part III, Line 4a Continued IN ADDITION TO THESE COMMUNITY CONTRIBUTIONS, STORMONT-VAIL PROVIDED SUPERVISED CLINICAL EXPERIENCE FOR 1,259 STUDENTS TO THE FOLLOWING ENTITIES: NAME/LOCATION-----------------------------------------------TYPE OF STUDENTS 190TH ARW-------------------------------------------------------UNDERGRAD RN OR LPN (21) ATCHISON HOSPITAL-----------------------------------------REGIONAL STAFF STUDENT (1) BAKER UNIVERSITY-------------------------------------------UNDERGRAD RN OR LPN (183) BARTON CO COMMUNITY COLLEGE--------------------MEDICAL TECHNOLOGY STUDENTS (3) BENEDICTINE COLLEGE-------------------------------------UNDERGRAD RN OR LPN (9) BRENAU UNIVERSITY-----------------------------------------INPATIENT OT STUDENT (1) CHAMBERLAIN UNIVERSITY--------------------------------NURSE PRACTITIONER STUDENT (1) CLOUD COUNTY COMMUNITY COLLEGE--------------UNDERGRAD RN OR LPN (3) COFFEY HEALTH SYSTEM----------------------------------REGIONAL STAFF STUDENT (1) CREIGHTON UNIVERSITY-----------------------------------INPATIENT OT STUDENTS (5) EMPORIA STATE UNIVERSITY-----------------------------UNDERGRAD RN OR LPN (2) FORT HAYS ------------------------------------------------------IP SPEECH LANGUAGE PATHOLOGY STUENT (1) FORT HAYS-------------------------------------------------------UNDERGRAD RN OR LPN (1) GRACE UNIVERSITY-------------------------------------------NURSE PRACTITIONER STUDENTS (6) GRAND CANYON UNIVERSITY-----------------------------NURSE PRACTITIONER STUDENT (1) GRAND CANYON UNIVERSISTY---------------------------UNDERGRAD RN OR LPN (3) HIGHLAND COMMUNITY COLLEGE----------------------UNDERGRAD RN OR LPN (27) HUTCHINSON COMMUNITY COLLEGE------------------UNDERGRAD RN OR LPN (3) IHM ACADEMY OF EMS---------------------------------------EMT STUDENTS (2) JUNCTION CITY FIRE DEPARTMENT---------------------REGIONAL STAFF STUDENTS (2) KANSAS STATE UNIVERSITY-------------------------------DIETICIAN STUDENT (1) KANSAS STATE UNIVERSITY-------------------------------PHYSICIAN ASSISTANT STUDENTS (74) MANHATTAN TECHNICAL COLLEGE---------------------MEDICAL TECHNOLOGY STUDENTS (3) MARYVILLE UNIVERSITY-------------------------------------NURSE PRACTITIONER STUDENTS (11) MID AMERICAN NAZARENE UNIVERSITY---------------NURSE PRACTITIONER STUDENT (1) NEMAHA VALLEY COMMUNITY HOSPITAL-------------REGIONAL STAFF STUDENTS (4) NEOSHO COMMUNITY COLLEGE--------------------------UNDERGRAD RN OR LPN (21) NIGHTINGALE COLLEGE--------------------------------------UNDERGRAD RN OR LPN (1) NON-AFFILIATED OBSERVERS-----------------------------OBSERVERS (152) NON-AFFILIATED OBSERVERS-----------------------------CLINIC (1) ROCKHURST UNIVERSITY------------------------------------INPATIENT PT STUDENT (1) ROCKHURST UNIVERSITY------------------------------------NURSE PRACTIONER STUDENTS (2) ROCKHURST UNIVERSITY------------------------------------UNDERGRAD RN OR LPN (21) SABETHA HOSPITAL--------------------------------------------REGIONAL STAFF STUDENTS (9) SEAMAN HIGH SCHOOL---------------------------------------HS WORK PROGRAM (9) TCALC----------------------------------------------------------------PHLEBOTOMY STUDENTS (6) TEXAS WESLEYAN UNIVERSITY----------------------------NURSE ANESTHESIA STUDENTS (6) UNIVERSITY OF MISSOURI-KC------------------------------NURSE PRACTITIONER STUDENTS (5) UNIVERSITY OF CENTRAL MISSOURI---------------------NURSE PRACTITIONER STUDENTS (3) UNIVERSITY OF KANSAS--------------------------------------MEDICAL STUDENT (1) UNIVERSITY OF KANSAS--------------------------------------NURSE PRACTITIONER STUDENTS (7) UNIVERSITY OF KANSAS--------------------------------------PHARMACY STUDENTS (10) UNIVERSITY OF KANSAS--------------------------------------SOCIAL WORK STUDENTS (2) UNIVERSITY OF KANSAS MEDICAL CENTER-----------INPATIENT OT STUDENTS (2) UNIVERSITY OF KANSAS MEDICAL CENTER-----------IP SPEECH LANGUAGE PATH STUDENTS (2) UNIVERSITY OF KANSAS MEDICAL CENTER-----------MEDICAL TECHNOLOGY STUDENT (1) UNIVERSITY OF KANSAS MEDICAL CENTER-----------NURSE ANESTHESIA STUDENTS (4) UNIVERSITY OF KANSAS MEDICAL CENTER-----------NURSE PRACTITIONER STUDENTS (3) UNIVERSITY OF KANSAS MEDICAL CENTER-----------OUTPATIENT PT STUDENT (1) UNIVERSITY OF KANSAS MEDICAL CENTER-----------UNDERGRAD RN OR LPN (1) UNIVERSITY OF NEBRASKA MEDICAL CENTER-------PHYSICIAN ASSISTANT STUDENT (1) UNIVERSITY OF SAINT MARY--------------------------------INPATIENT OT STUDENT (1) UNIVERSITY OF SAINT MARY--------------------------------INPATIENT PT STUDENT (1) UNIVERSITY OF SAINT MARY--------------------------------OUTPATIENT PT STUDENTS (4) WASHBURN INSTITUTE OF TECHNOLOGY--------------PHLEBOTOMY STUDENTS (12) WASHBURN INSTITUTE OF TECHNOLOGY--------------SURGICAL TECH (11) WASHBURN INSTITUTE OF TECHNOLOGY--------------UNDERGRAD RN OR LPN (95) WASHBURN UNIVERSITY--------------------------------------HIM STUDENT (1) WASHBURN UNIVERSITY--------------------------------------INPATIENT OT STUDENTS (4) WASHBURN UNIVERSITY------------------------------------- INPATIENT OTA STUDENT (1) WASHBURN UNIVERSITY--------------------------------------INPATIENT PTA STUDENTS (2) WASHBURN UNIVERSITY--------------------------------------KINESIOLOGY STUDENTS (7) WASHBURN UNIVERSITY--------------------------------------MEDICAL TECHNOLOGY STUDENTS (2) WASHBURN UNIVERSITY--------------------------------------NURSE PRACTITIONER STUDENTS (22) WASHBURN UNIVERSITY--------------------------------------OUTPATIENT PT STUDENTS (5) WASHBURN UNIVERSITY--------------------------------------RAD TECH/MRI/CT STUDENTS (17) WASHBURN UNIVERSITY--------------------------------------RADIATION THERAPY STUDENT (1) WASHBURN UNIVERSITY--------------------------------------RESPIRATORY THERAPY STUDENTS (43) WASHBURN UNIVERSITY--------------------------------------SOCIAL WORK STUDENTS (2) WASHBURN UNIVERSITY--------------------------------------UNDERGRAD RN OR LPN (329) WESTERN GOVERNORS UNIVERSITY--------------------UNDERGRAD RN OR LPN (1) WICHITA STATE UNIVERSITY---------------------------------NURSE PRACTITIONER STUDENTS (2) WICHITA STATE UNIVERSITY---------------------------------PHYSICIAN ASSISTANT STUDENTS (11) WICHITA STATE UNIVERSITY---------------------------------UNDERGRAD RN OR LPN (42)
Form 990, Part III, Line 2 New program services STORMONT-VAIL HEALTHCARE INC FORMED A NEW SINGLE MEMBER LLC, STORMONT-VAIL HEALTH FLINT HILLS, LLC, WHICH OBTAINED ITS KANSAS STATE HOSPITAL LICENSE IN JUNE 2023 TO OPERATE A HOSPITAL IN GEARY COUNTY KANSAS.
Form 990, Part VI, Line 15a & 15b THE BOARD OF DIRECTORS HAS ESTABLISHED AN EXECUTIVE COMPENSATION COMMITTEE THAT IS CHARGED WITH THE OVERSIGHT AND REVIEW OF ALL EXECUTIVE COMPENSATION AND BENEFITS FOR THE CEO, SENIOR VICE PRESIDENTS, AND VICE PRESIDENTS OF THE HEALTH SYSTEM. THE COMPENSATION IS REVIEWED ANNUALLY BY AN EXTERNAL INDEPENDENT CONSULTANT, GALLAGHER. GALLAGHER REVIEWS BASE COMPENSATION, INCENTIVE PROGRAMS AND TOTAL CASH COMPENSATION THAT ARE OFFERED ON AN ANNUAL BASIS TO ENSURE IT ALIGNS WITH FAIR MARKET VALUE AND COMPLIES WITH OUR ESTABLISHED COMPENSATION PHILOSOPHY. IN ADDITION, GALLAGHER ON A REGULAR BASIS REVIEWS THE EXECUTIVE BENEFIT PROGRAM TO ALSO ENSURE IT IS APPROPRIATE AND REASONABLE. GALLAGHER CONDUCTED A REVIEW IN 2023.
Form 990, Part VI, Line 11b Review of form 990 by governing body AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S FINANCE AND AUDIT COMMITTEES. ANY QUESTIONS AND CONCERNS THE ORGANIZATION'S FINANCE AND AUDIT COMITTEES HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990.
Form 990, Part VI, Line 12c Conflict of interest policy THE OFFICERS, DIRECTORS AND KEY EMPLOYEES SUBMIT CONFLICT OF INTEREST STATEMENTS TO THE CHAIRMAN OF THE AUDIT COMMITTEE OF STORMONT VAIL HEALTHCARE EACH YEAR. THE CHAIRMAN REVIEWS THE RESPONSES AND REPORTS TO THE AUDIT COMMITTEE FOR THEIR REVIEW AND DETERMINATION OF ANY APPROPRIATE ACTION TO BE TAKEN. THE CHAIRMAN ALSO THEN REPORTS THE RESULTS TO THE FULL BOARD OF DIRECTORS.
Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STTEMENTS ARE AVAILABLE UPON REQUEST. THE ORGANIZATION DOES NOT MAKE THEIR CONFLICT-OF-INTEREST POLICY AVAILABLE TO THE PUBLIC.
Form 990, Part VIII, Line 2f Other Program Service Revenue - Total Revenue: 17909167, Related or Exempt Function Revenue: 17909167, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances CHANGE IN PENSION OBLIGATION - XXX-XX-XXXX; POST RETIREMENT COSTS - -XXX-XX-XXXX; OTHER CHANGES IN NET ASSETS - 534847; EARNINGS EQUITY INVESTMENTS - 3156839; INVESTMENT IN PARTNERSHIPS - -85367;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


Additional Data


Software ID: 22016089
Software Version: 2022v5.0
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Stormont-Vail Heathcare Inc
 
Employer identification number

48-0543789
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity
(1) COTTON O'NEIL ACO LLC
1500 SW 10TH AVE
TOPEKA,KS66604
46-5542929 		SHARED SAVING KS 0 15,694 SVHC
 
(2) STORMONT VAIL HEALTH FLINT HILLS LLC
100 SW 10TH AVE
TOPEKA,KS66604
88-3089376 		HOSPITAL KS 34,171,197 23,163,913 SVHC
 
(3) STORMONT VAIL RETAIL PHARMACY
1500 SWE 10TH AVE
TOPEKA,KS66604
92-0577641 		PHARMACY KS 33,720,870 14,591,111 svch
 






Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)STORMONT-VAIL FOUNDATION
1500 SW 10TH AVE

TOPEKA,KS66604
48-0980926 		FUNDRAISING KS 501(c)(3) 7 SVHC
 
Yes
 
(2)STORMONT VAIL HEALTHCARE AUXILIARY
1500 SW 10TH AVE

TOPEKA,KS66604
48-6140517 		FUNDRAISING KS 501(c)(3) Type III-FI SVHC
 
Yes
 
(3)BUILDING BLOCKS OF TOPEKA INC
620 SW LANE

TOPEKA,KS66606
48-1121628 		CHILD DAYCARE KS 501(c)(3) 10 SVHC
 
Yes
 








For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) URISH MEDICAL PLAZA LLC

1500 SW 10TH AVENUE
TOPEKA,KS66614
 REAL ESTATE KS SVI
  		N/A                
(2) MANHATTAN SURGICAL HOSPITAL LLC

1829 COLLEGE AVE
MANHATTAN,KS66502
48-1202466 		SURGERY KS SVHC
  		Related 3,727,040 5,017,203   No     No 92.13 %










Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) STORMONT VAIL INC

1500 SW 10TH AVE
TOPEKA,KS66604
48-0782848 		MEDICAL SPA KS SVHC
  		C Corporation 942,156 5,766,691 100.00 % Yes  
(2) CENTURY HEALTH SOLUTIONS INC

2951 SW WOODSIDE DR
TOPEKA,KS66614
48-1206397 		INSURANCE ADM KS SVHC
  		C Corporation 38,945 44,275 100.00 % Yes  










Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
Yes
 
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
Yes
 
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) STORMONT VAIL FOUNDATION

 B 522,000 FMV
(2) STORMONT VAIL FOUNDATION

 C 261,146 FMV
(3) MANHATTAN SURGICAL HOSPITAL LLC

 C 2,701,917 FMV
(4) STORMONT VAIL INC

 F 3,309,972 FMV
(5) STORMONT VAIL INC

 H 392,214 FMV
(6) STORMONT VAIL INC

 O 942,156 FMV
(7) STORMONT VAIL FOUNDATION

 O 574,827 FMV
(8) BUILDING BLOCKS OF TOPEKA

 O 2,277,515 FMV
(9) BUILDING BLOCKS OF TOPEKA

 Q 1,461,660 FMV
(10) STORMONT VAIL FOUNDATIOIN

 S 100,000 FMV
(11) STORMONT VAIL INC

 S 964,564 FMV
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
Schedule R (Form 990) 2021

Additional Data


Software ID: 22016089
Software Version: 2022v5.0