2013-08-08T21:53:02-05:00 2012-09-30 GRANT THORNTON LLP 8300 THORN DRIVE SUITE 300 WICHITA KS 672262708 990 2011-10-01 202828680 St John's Inc % BILL SLATER STJO 7856283241 2225 Canterbury HAYS KS 67601 Jerry Carley 2013-08-01 true Kimberly Temple 3162653231 2011 2016-02-24 21:20:13Z X DAVID KARLIN 2225 CANTERBURY HAYS KS 67601 8032694 false 0928 X www.via-christi.org X 2005 KS PROVIDE NURSING CARE AND ASSISTED LIVING SERVICES TO ELDERLY AND DISABLED PERSONS REGARDLESS OF AGE, RACE, COLOR, RELIGION, SEX, OR NATIONAL ORIGIN. 7 4 322 28 0 15097 5995 8537695 7658263 2969 -138698 290567 263660 8846328 7789220 0 0 0 0 5088787 5334994 0 0 0 3000338 2497853 8089125 7832847 757203 -43627 8765484 16005944 6945824 13985037 1819660 2020907 X AS A PART OF VIA CHRISTI HEALTH, A CATHOLIC HEALTH SYSTEM, WE SHARE THIS MISSION: "INSPIRED BY THE GOSPEL AND OUR CATHOLIC TRADITION, WE SERVE AS A HEALING PRESENCE WITH SPECIAL CONCERN FOR OUR NEIGHBORS WHO ARE VULNERABLE." VIA CHRISTI HEALTH SYSTEM'S HISTORY EXTENDS BACK OVER 100 YEARS AND TODAY, ALONG WITH OUR SPONSORING CONGREGATIONS - THE SISTERS OF THE SORROWFUL MOTHER, CONGREGATION OF ST. JOSEPH, SISTERS OF ST. JOSEPH OF CARONDOLET AND THE DAUGHTERS OF CHARITY - WE CONTINUE TO RESPOND TO COMMUNITY NEEDS IN KANSAS AND NORTHEASTERN OKLAHOMA. THE OBLIGATION TO REACH OUT TO THOSE IN NEED AND IMPROVE COMMUNITY HEALTH FLOWS DIRECTLY FROM OUR IDENTITY AS A FAITH-BASED HEALING MINISTRY. AS A MISSION-DRIVEN ORGANIZATION, WE PROVIDE COMMUNITY BENEFIT BECAUSE WE ARE COMMITTED TO OUR CORE VALUES OF: HUMAN DIGNITY - WE RECOGNIZE AND RESPECT THE SACREDNESS OF EACH PERSON; STEWARDSHIP - WE RESPONSIBLY CARE FOR ALL RESOURCES ENTRUSTED TO US; EXCELLENCE - WE EXTEND OURSELVES IN OUTSTANDING SERVI false false 5667018 7658263 PROVIDE SKILLED NURSING SERVICES AND ASSISTED LIVING SERVICE TO ELDERLY AND DISABLED INDIVIDUALS. THE NURSING HOME CARE CONSISTS OF A 130 BED LONG-TERM CARE FACILITY FOR THE ELDERLY AND PHYSICALLY HANDICAPPED. THE ASSISTED LIVING COMPLEX HOUSES 44 INDEPENDENT AND ASSISTED LIVING APARTMENT UNITS FOR THE ELDERLY AND PHYSICALLY HANDICAPPED. St. John's, Inc. serves people in the Hays area. The primary counties include Ellis and Russell. A trend of significance in the community is the growing elderly population. To address this trend St. John's, Inc. is collaborating with other community organizations, including but not limited to: Meals on Wheels and nursing education organizations to provide services and education to the elderly. Financial surpluses are used to fulfill our charitable purpose. The board of directors includes members of the local community. Our organization offers discounted care to persons without adequate financial means to pay for such services. This includes the participation in Medicaid, Medicare, CHAMPUS, Tricare, and/or other government-sponsored health care programs. 5667018 true false false true false false false false false false true false false false true true false true false false false false false false false false false false false true true false false false false false false false false false false false false false false false true false false false false true 7 0 true 322 true false false false false false false false false false false X 7 4 false false false false true true true true true false false true true true true true true true true false X BILL SLATER 3169465215 2622 W CENTRAL SUITE 100 Wichita KS 67203 X David Karlin 40.0 X X 0 89669 6531 Jerry Carley 1.0 X X 0 282325 45746 James Brull MD 1.0 X 0 0 0 Joseph Hess 1.0 X X 0 0 0 Kraig Gross 1.0 X 0 0 0 Lynnette RauvolaBouta 1.0 X 0 307336 45175 Sister Margaret Nugent 1.0 X 0 0 0 0 679330 97452 0 false true false Simpson Associates 1831 S Anna WICHITA KS 67277 Construction 5801528 Sundance Rehabilitation 6549 Paysphere Circle CHICAGO IL 60674 Therapy 401980 SYSCO PO BOX 40 OLATHE KS 66051 Dietary 365244 3 5995 5995 RESIDENT SERVICE REVENUE 623000 7658263 7658263 7658263 19215 19215 0 0 15524 70037 0 243474 15524 -173437 -157913 -157913 0 0 0 EMPLOYEE MEALS 722210 12293 12293 GUEST UNIT RENTALS 531390 8326 8326 GUEST MEALS 722210 6961 6961 236080 236080 263660 7789220 7658263 124962 0 0 0 0 0 0 4566579 4100473 466106 0 478917 6493 472424 289498 10631 278867 648434 30716 617718 0 13281 3668 9613 0 0 0 48809 37632 11177 29940 2136 27804 737411 692385 45026 95625 10800 84825 0 325984 320538 5446 11744 5061 6683 0 7338 6957 381 149978 149978 0 268659 268659 27049 27049 BUSINESS START-UP COSTS 71496 71496 RELIGIOUS 21386 21386 VEHICLE FUEL & MAINTENANCE 15985 15985 MEMBERSHIP DUES 8171 375 7796 16563 4531 12032 7832847 5667018 2165829 0 1150 1075 1621867 1549630 0 0 378586 502019 0 0 0 0 0 0 3346 20376 36152 26033 13934243 435432 6724383 13498811 0 0 0 0 0 0 0 0 0 408000 8765484 16005944 680259 590625 0 0 0 0 0 13000000 0 0 0 0 0 0 0 0 6265565 394412 6945824 13985037 X 1819660 2020907 0 0 0 0 1819660 2020907 8765484 16005944 X -43627 244874 X false true true X false X 57955 42872 56919 15097 5995 178838 7095664 7759988 7573280 8537695 7658263 38624890 7153619 7802860 7630199 8552792 7664258 38803728 10985 16485 43997 49093 48734 169294 10985 16485 43997 49093 48734 169294 38634434 16083 11845 9281 14544 19215 70968 16083 11845 9281 14544 19215 70968 205737 208859 248826 290567 263660 1217649 7375439 8023564 7888306 8857903 7947133 40092345 0.96364 0.96589 0.00177 0.00229 X false false false false false false false false true 517 517 false Lobbying Expenditures Part II-B, Question 1i St. John's, Inc. pays dues to KAHSA. 10% of the dues paid were used for lobbying activities. 44914 44914 12327387 275762 12051625 0 0 0 1535828 151925 1383903 26114 7745 18369 13498811 0 RELATED PARTY NOTE PAYABLE 383407 SECURITY DEPOSITS 11005 394412 FIN 48 (ASC 740) PART X, Question 2 The organization follows the FIN 48 policy of Via Christi Health, Inc. (VCH) and the policy is provided in the VCH consolidated audited financial statements. With the exception of certain subsidiaries, all of the entities in the Health System are organizations under Section 501(c)(3) of the Internal Revenue Code and are generally exempt from payment of income taxes on related income pursuant to Section 501(a) of the Internal Revenue Code. Subsidiaries which are for-profit organizations are subject to federal and state income taxes. Accounting principles generally accepted in the United States of America require the Health System's management to evaluate tax positions taken by the Health System and its subsidiaries and recognize a tax liability (or asset) if an uncertain position has been taken that more likely than not would not be sustained upon examination by the Internal Revenue Service. Management has analyzed the tax positions by the Health System and its subsidiaries, and has concluded that as of September 30, 2012 and 2011, there were no uncertain tax positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements. Tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases and operating loss and tax credit carryforwards. Income tax expense or benefit is included in other nonoperating gains and losses in the consolidated statements of operations and changes in net assets. Deferred tax assets and liabilities are measured using enacted tax rates expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. X X X X false true false false false false false false false Jerry Carley 0 225240 0 51128 0 5957 0 34742 0 11004 0 328071 0 0 Lynnette RauvolaBouta 0 247386 0 54715 0 5235 0 36436 0 8739 0 352511 0 0 Supplemental Non-qualified Retirement Plan Paid by a Related Organization Part I, Question 4b Jerry Carley 19,597.32 Lynnette Rauvolabouta 17,558.72 City of Hays Kansas 486011465 000421052 2012-09-20 13000000 Healthcare facility in Hays, KS false false false 0 0 13026000 0 0 0 286000 0 0 12740000 0 0 2032 false false true true false false false false 0.00000 0.00000 0.00000 true false true false 0 false 0 false false X Members Part VI, Section A, Questions 6, 7a & 7b THE TERM MEMBERS SHALL BE INTERPRETED TO MEAN THOSE PERSONS WHO HAVE BEEN APPOINTED AS MEMBERS OF THE BOARD OF TRUSTEES OF VIA CHRISTI VILLAGES, INC. SECTION 2, PARAGRAPH 6 OF THE BYLAWS PROVIDE THE MEMBER WITH THE FOLLOWING POWERS: *CHANGES IN THE CORPORATION'S PURPOSES OR PHILOSOPHY, AMENDMENTS OF ITS ARTICLES OF INCORPORATION OR BYLAWS; *ISSUANCE OF NOTES, BONDS, OR OTHER EVIDENCE OF INDEBTEDNESS IN EXCESS OF $20,000; *PURCHASE, SALE, ALIENATION, ENCUMBRANCE, OR LEASE OF REAL PROPERTY HAVING A VALUE IN EXCESS OF $50,000; *APPOINTMENT AND REMOVAL OF TRUSTEES; AND *REVIEW AND APPROVAL OF THE CORPORATION'S OPERATING AND CAPITAL BUDGETS, AND UNBUDGETED EXPENDITURES IN EXCESS OF $20,000. 990 Review Part VI, Section B, Question 11b A COPY OF FORM 990 IS PROVIDED TO THE BOARD OF TRUSTEES VIA A SECURE EMAIL PRIOR TO FILING WITH THE IRS. Conflict of Interest Policy Part VI, Section B, Question 12c THE ORGANIZATION'S POLICY IS MONITORED AS PART OF THE SYSTEM-WIDE PROCEDURES AND NOT AT THE ORGANIZATIONAL LEVEL. THE SYSTEM-WIDE PROCEDURES ARE AS FOLLOWS: 1) AT TIME OF APPOINTMENT AND ANNUALLY THEREAFTER, ALL INTERESTED PERSONS, INCLUDING BOARD AND COMMITTEE MEMBERS, COMPLETE A DISCLOSURE STATEMENT WHICH ADDRESSES ACTUAL OR POTENTIAL CONFLICTS OF INTEREST; 2) THE DISCLOSURE STATEMENT IS DONE ELECTRONICALLY AND THE RETURN OF THE COMPLETED STATEMENT IS A CONDITION OF CONTINUED APPOINTMENT, EMPLOYMENT, OR PARTICIPATION WITH THE ORGANIZATION; 3) ALL ACTUAL OR POTENTIAL CONFLICTS ARE REVIEWED, INVESTIGATED, AND RESOLVED BY THE CHIEF GOVERNANCE OFFICER AND THE CORPORATE RESPONSIBILITY OFFICER, WITH THE RESULTS SHARED WITH THE CHIEF EXECUTIVE OF THE ORGANIZATION; and 4) PERIODIC REVIEWS ARE CONDUCTED BY GOVERNANCE, COMPLIANCE, AND INTERNAL AUDIT TO ENSURE THE ORGANIZATION IS OPERATING CONSISTENT WITH THE POLICY AND ENFORCING THE POLICY'S TERMS. Compensation Review Part VI, Section B, Questions 15a & 15b ST. JOHN'S, Inc. uses the policies established by Via Christi Health, Inc. (VCH). VCH has established a common philosophy, strategy, and processes for executive compensation. Through the oversight of the VCH Executive Compensation Committee, executive compensation is competitively positioned at its stated market position when compared to the compensation paid by relevant organizations (comparably-sized health systems, hospitals, and long-term care providers). VCH recognizes its responsibility to ensure that its executive compensation program is appropriate in view of its mission and tax-exempt status and that its compensation levels and expenditures are reasonable and not excessive. To ensure these ends, the VCH Executive Compensation Committee has established and approved the executive compensation philosophy for VCH and all related entities. It will also approve all changes in the compensation package for VCH executives in advance. On an annual basis, the Committee conducts a comprehensive review of total compensation for all executives. It also reviews and approves "off-cycle" compensation transactions as needed. In their review, the Committee considers the following factors: * Market data from independent compensation surveys and sources that reflect comparable positions in organizations of similar size and scope; * Difficulties in recruiting and retaining executives; * Skills, experience and performance history of individual executives; * Critical business or strategic issues that the organization may face; and * Market position for total compensation. The adequacy, competitiveness, and cost of the VCH total executive compensation program are reviewed on an ongoing basis and changes are made as the Committee determines appropriate. The executive compensation program will be maintained such that it will fall within the safe harbor guidelines established by the Intermediate Sanctions regulations. The Committee also employs the services of an independent compensation consultant to prepare market analysis to aid and support the Committee's actions, provide documentation of market trends for budget setting purposes, review annual compensation changes to ensure "reasonableness" and provide attestation, and provide consultation on all executive compensation issues. The Committee also relies on third-party validation of performance measures used in the determination of compensation. Governing Documents Part VI, Section C, Question 19 ST. JOHN'S, INC.'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. Reconciliation of Net Assets Part XI, Question 5 Unrealized Gain 57,761 Sponsorship Fee (13,672) Donations transferred from Via Christi Foundation, Inc. 200,785 -------- TOTAL 244,874 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jerry Carley TITLE:Secretary/Treasurer HOURS:49 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Lynnette RauvolaBouta TITLE:Trustee HOURS:49 Ascension Health PO Box 45998 St Louis MO 63145 311662309 Hlth Sys Gov MO 501(c)(3) 11-I NA false Catholic Care Center Inc 6700 E 45th St N Wichita KS 67226 481067110 Rtrmnt Home KS 501(c)(3) 09 NA false Cornerstone Assisted Living Inc 3636 N Ridge Road Wichita KS 67205 481241079 Rtrmnt Home KS 501(c)(3) 09 NA false Gerard House Inc 3144 N Hood Wichita KS 67204 481049532 Shelter KS 501(c)(3) 07 NA false Marian Health System Inc 1923 South Utica Avenue Tulsa OK 74104 363659989 Hospital Supp DE 501(c)(3) 11-I NA false Mercy Community Health Foundation Inc 1823 College Avenue Manhattan KS 66502 481152279 Foundation KS 501(c)(3) 09 NA false Mercy Regional Health Center Inc 1823 College Avenue Manhattan KS 66502 481186704 Hospital KS 501(c)(3) 03 NA false Mercy Regional Home Medical Services LLC 2439 Claflin Road Manhattan KS 66502 432024491 Home Medical KS 501(c)(3) 11-III O NA false Mount Carmel Foundation Inc 1102 E Centennial Drive Pittsburg KS 66762 480961283 Foundation KS 501(c)(3) 11-I NA false Salina Regional Home Medical Services 520 S Santa Fe Ave Ste 140 Salina KS 67401 431948057 Home Medical KS 501(c)(3) 11-III O NA false Via Christi Clinic Services 8200 E Thorn Drive Suite 300 Wichita KS 67226 273984287 Med Clinic KS 501(c)(3) 11-I NA false Via Christi Foundation Inc 723 N McLean Blvd Wichita KS 67203 481173588 Foundation KS 501(c)(3) 11-III FI NA false Via Christi Health Partners Inc 8200 E Thorn Drive Suite 300 Wichita KS 67226 480958974 Mgmt Co KS 501(c)(3) 09 NA false Via Christi Health Inc 8200 E Thorn Drive Suite 300 Wichita KS 67226 481172107 Hospital Supp KS 501(c)(3) 09 NA false Via Christi Healthcare Outreach Program 2622 W Central Suite 100 Wichita KS 67203 481236589 Pace Communit KS 501(c)(3) 09 NA false Via Christi Home Health Wichita Inc 555 S Washington Wichita KS 67211 481046371 Home Health KS 501(c)(3) 09 NA false Via Christi Hospital Pittsburg Inc 1102 E Centennial Drive Pittsburg KS 66762 480543778 Hospital KS 501(c)(3) 03 NA false Via Christi Hospital Wichita St Teresa 14800 W St Teresa Wichita KS 67235 271965272 Hospital KS 501(c)(3) 03 NA false Via Christi Hospitals Wichita Inc 929 N St Francis Wichita KS 67214 481172106 Hospital KS 501(c)(3) 03 NA false VC Immediate Care Mother Mary Anne Inc 929 N St Francis Wichita KS 67214 208374099 Med Clinic KS 501(c)(3) 09 NA false Via Christi InMyHome Inc 2622 W Central Suite 100 Wichita KS 67203 271889960 Hlth Agency KS 501(c)(3) 09 NA false Via Christi Property Services Inc 1100 N St Francis Suite 240 Wichita KS 67214 480948571 Property Mgmt KS 501(c)(4) NA false Via Christi Rehabilitation Hospital Inc 1151 N Rock Road Wichita KS 67206 481158274 Rehab KS 501(c)(3) 03 NA false Via Christi Village Georgetown Inc 1655 S Georgetown Wichita KS 67218 481129325 Rtrmnt Home KS 501(c)(3) 09 NA false Via Christi Village Manhattan Inc 2800 Willowgrove Rd Manhattan KS 66502 481078862 Rtrmnt Home KS 501(c)(3) 09 NA false Via Christi Village McLean Inc 777 N McLean Blvd Wichita KS 67203 481247723 Rtrmnt Home KS 501(c)(3) 09 NA false Via Christi Village Ponca City Inc 1601 Academy Road Ponca City OK 74604 731153337 Rtrmnt Home OK 501(c)(3) 09 NA false Via Christi Village Pittsburg Inc 1502 E Centennial Dr Pittsburg KS 66762 743070971 Rtrmnt Home KS 501(c)(3) 09 NA false Via Christi Villages Inc 2622 W Central Suite 100 Wichita KS 67206 480559086 Mgmt Co KS 501(c)(3) 11-III FI NA false Wamego Hospital Association 711 Genn Drive Wamego KS 66547 721526400 Hospital KS 501(c)(3) 03 NA false Ambulatory Surgery Center LP 8200 E Thorn Drive Suite 300 Wichita KS 67226 481007220 Surgery Ctr KS NA N/A 0 0 false 0 false 0.00000 AMS Diagnostics LLC 8200 E Thorn Drive Suite 300 Wichita KS 67226 481223653 Radiology Svc KS NA N/A 0 0 false 0 false 0.00000 Kansas Surgery and Recovery Ctr 8200 E Thorn Drive Suite 300 Wichita KS 67226 481148580 Surgery Ctr KS NA N/A 0 0 false 0 false 0.00000 Mercy Imaging LLC 8200 E Thorn Drive Suite 300 Wichita KS 67226 481251984 Diagnostic Im KS NA N/A 0 0 false 0 false 0.00000 MR Imaging Center LLC 8200 E Thorn Drive Suite 300 Wichita KS 67226 481000538 Radiology Svc KS NA N/A 0 0 false 0 false 0.00000 PFI LLC 8200 E Thorn Drive Suite 300 Wichita KS 67226 721557076 Med Chem Mfg KS NA N/A 0 0 false 0 false 0.00000 Preferred PET Imaging of KS LLC 8200 E Thorn Drive Suite 300 Wichita KS 67226 481250123 Diagnostic Im KS NA N/A 0 0 false 0 false 0.00000 St Joseph MRI LLC 8200 E Thorn Drive Suite 300 Wichita KS 67226 481007220 Medical Svcs KS NA N/A 0 0 false 0 false 0.00000 Via Christi Cyberknife LLC 8200 E Thorn Drive Suite 300 Wichita KS 67226 354588711 Radiology Svc KS NA N/A 0 0 false 0 false 0.00000 Affiliated Medical Services Lab Inc 2916 E Central Wichita KS 67214 481239522 Medical Lab KS VC Health C Corp 1.00000 Integrated Healthcare Systems Inc 3311 East Murdock Wichita KS 67208 480941549 Clinic Svcs KS NA C Corp 1.00000 Sunflower Assurance LTD PO Box 1085 Grand Cayman CJ KY1-1102 980223159 Insurance Co CJ NA C Corp 1.00000 Via Christi Clinic PA 3311 East Murdock Wichita KS 67208 480993446 Prof Assoc KS NA C Corp 1.00000 VCH Iowa PC 8200 E Thorn Drive Suite 300 Wichita KS 67226 273983977 Holding Co IA NA Trust 1.00000 VCH Iowa PC Trust 8200 E Thorn Drive Suite 300 Wichita KS 67226 276937322 Ben Trust IA NA Trust 1.00000 false true true false false false false false false false false false false true false false false false Related Tax Exempt Organizations Part II ST. JOHN'S, INC. IS INDIRECTLY CONTROLLED BY VIA CHRISTI HEALTH, INC. VIA CHRISTI HEALTH, INC. IS JOINTLY SPONSORED AND CONTROLLED BY ASCENSION HEALTH AND MARIAN HEALTH SYSTEM, WHICH IN TURN ARE SPONSORED BY THE SISTERS OF THE SORROWFUL MOTHER, FOUR PROVINCES OF THE DAUGHTERS OF CHARITY, THE CONGREGATION OF ST. JOSEPH, AND THE SISTERS OF ST. JOSEPH OF CARONDELET. DUE TO SUCH SPONSORSHIP AND CONTROL, AND IN THE INTEREST OF INCREASED CLARITY AND TRANSPARENCY, BOTH ASCENSION HEALTH AND MARIAN HEALTH SYSTEM ARE BEING LISTED AS RELATED ORGANIZATIONS ON SCHEDULE R.