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PARKVIEW WABASH HOSPITAL INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
PARKVIEW WABASH HOSPITAL INC (EIN 47-1753440)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-10
IRS object ID
202313149349304516
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-11-10T14:15:41-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN350921680PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CROWE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1401 E LAS OLAS BLVD SUITE 1100AddressLine1Txt
CityFORT LAUDERDALECityNm
State AbbreviationFLStateAbbreviationCd
ZIP33301ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN471753440EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PARKVIEW WABASH HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPARKBusinessNameControlTxt
Phone2603738429PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110 JOHN KISSINGER DRAddressLine1Txt
CityWABASHCityNm
State AbbreviationINStateAbbreviationCd
ZIP469921648ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJEANNE' WICKENSPersonNm
Person TitlePH CFOPersonTitleTxt
Phone2602669313PhoneNum
Signature2023-11-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJEANNEPersonFirstNm
Person LastWICKENSPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRITTNEY KOCAJPreparerPersonNm
PTINP01320603PTIN
Phone9542028600PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRICK HENVEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11450 PRODUCTION RDAddressLine1Txt
CityFORT WAYNECityNm
State AbbreviationINStateAbbreviationCd
ZIP468081167ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$62,161,167GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PARKVIEW.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2014FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionIMPROVE HEALTH & PROVIDE QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee245TotalEmployeeCnt
Total Volunteers25TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,988,183PYContributionsGrantsAmt
CY Contributions Grants$469,372CYContributionsGrantsAmt
PY Program Service Revenue$64,104,929PYProgramServiceRevenueAmt
CY Program Service Revenue$61,325,792CYProgramServiceRevenueAmt
PY Investment Income-$49,994PYInvestmentIncomeAmt
CY Investment Income$2,387CYInvestmentIncomeAmt
PY Other Revenue$247,379PYOtherRevenueAmt
CY Other Revenue$270,083CYOtherRevenueAmt
PY Total Revenue$66,290,497PYTotalRevenueAmt
CY Total Revenue$62,067,634CYTotalRevenueAmt
PY Grants And Similar Paid$76,540PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$23,310CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$17,024,363PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$18,795,664CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$64,409CYTotalFundraisingExpenseAmt
PY Other Expenses$39,344,613PYOtherExpensesAmt
CY Other Expenses$42,779,448CYOtherExpensesAmt
PY Total Expenses$56,445,516PYTotalExpensesAmt
CY Total Expenses$61,598,422CYTotalExpensesAmt
PY Revenues Less Expenses$9,844,981PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$469,212CYRevenuesLessExpensesAmt
Total Assets BOY$48,953,118TotalAssetsBOYAmt
Total Assets EOY$43,274,746TotalAssetsEOYAmt
Total Liabilities BOY$57,952,497TotalLiabilitiesBOYAmt
Total Liabilities EOY$51,731,175TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$8,999,379NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$8,456,429NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionPARKVIEW WABASH HOSPITAL, INC. WORKS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND PROVIDES QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$50,983,315ExpenseAmt
Grant$23,310GrantAmt
Revenue$61,325,792RevenueAmt
DescPARKVIEW WABASH HOSPITAL, INC. IS A MEMBER OF PARKVIEW HEALTH. WE ARE DEDICATED TO IMPROVING AND INSPIRING THE HEALTH OF THE COMMUNITIES WE SERVE. WE ACCOMPLISH THIS THROUGH DELIVERING WORLD-CLASS TEAMWORK AND EXCELLENT CARE. WE PARTNER WITH PATIENTS AND OTHER COMMUNITY ORGANIZATIONS TO TAILOR PERSONALIZED HEALTH JOURNEYS. EXCELLENCE, INNOVATION AND VALUE ARE IMPORTANT TO OUR PATIENTS AND TO US. OUR CARE IS DELIVERED WHILE ALWAYS KEEPING IN MIND CONVENIENCE, COMPASSION AND EXCELLENCE BOTH IN COST AND QUALITY. WE DEVELOP AND VALUE RELATIONSHIPS WITH OUR PATIENTS AND OUR COMMUNITY.PARKVIEW WABASH HOSPITAL, INC. IS A MAGNET DESIGNATED HOSPITAL. AS A (SEE SCHEDULE O FOR CONTINUATION)CRITICAL ACCESS HOSPITAL, PARKVIEW WABASH HOSPITAL, INC., IS ONE OF THE SMALLEST HOSPITALS IN THE UNITED STATES TO ACHIEVE THIS DESIGNATION. WIDELY CONSIDERED THE HIGHEST RECOGNITION FOR NURSING EXCELLENCE, MAGNET DESIGNATION RECOGNIZES MEASURABLE, POSITIVE PATIENT OUTCOMES AND HIGH SATISFACTION LEVELS. MAGNET DESIGNATION IS GRANTED BY THE AMERICAN NURSES CREDENTIALING CENTER'S (ANCC) MAGNET RECOGNITION PROGRAM, WHICH ENSURES THAT RIGOROUS STANDARDS FOR NURSING EXCELLENCE ARE MET. TO MAINTAIN MAGNET RECOGNITION, A HOSPITAL MUST CONTINUE TO MEET THE HIGH STANDARDS SET BY THE ANCC. ACCORDING TO THE ANCC, MAGNET DESIGNATION INDICATES AN ORGANIZATION PROVIDES A CULTURE IN WHICH NURSES CAN FLOURISH AS PROFESSIONALS. THESE SELECT ENTITIES PLACE AN EMPHASIS ON PROVIDING THEIR NURSING TEAMS WITH THE PROFESSIONAL AUTONOMY TO MAKE CLINICAL DECISIONS AT PATIENT BEDSIDES. THEY ALSO INVOLVE NURSES IN DECISIONS REGARDING THE PATIENT CARE ENVIRONMENT, AS WELL AS ENABLE MORE INTERDISCIPLINARY COLLABORATIONS WITH OTHER TEAM MEMBERS.IN 2022, PARKVIEW WABASH HOSPITAL, INC., WAS RECOGNIZED BY THE CHARTIS CENTER FOR RURAL HEALTH WITH A PERFORMANCE LEADERSHIP AWARD IN THE QUALITY, OUTCOMES AND PATIENT PERSPECTIVE CATEGORIES, HAVING ACHIEVED TOP QUARTILE PERFORMANCE IN ALL AREAS.HOSPITAL SERVICES INCLUDE:- FULL-SERVICE, 24-HOUR EMERGENCY DEPARTMENT WITH SEVEN TREATMENT ROOMS, ONE TRAUMA BAY AND A "SAFE ROOM" FOR PATIENTS WHO MAY BE EXPERIENCING A BEHAVIORAL HEALTH CRISIS- TWO SURGICAL SUITES, ONE ENDOSCOPY ROOM, SIX PRE-/POST-OP ROOMS AND TWO RECOVERY ROOMS- MEDICAL INFUSION UNIT PROVIDING OUTPATIENT MEDICATIONS, INFUSIONS, TRANSFUSIONS AND CENTRAL LINE CARE UNDER THE SUPERVISION OF DEDICATED NURSES WHO ARE ONCOLOGY CERTIFIED.- REHABILITATION AND WELLNESS SERVICES INCLUDING ADULT AND PEDIATRIC PHYSICAL AND OCCUPATIONAL THERAPY, SPEECH THERAPY, DIABETES EDUCATION, MEDICAL NUTRITION THERAPY, AND CARDIAC AND PULMONARY REHAB- FULL-SERVICE LAB AND PHARMACY, INCLUDING AN ATU CLINIC FOR PATIENTS TAKING BLOOD THINNERS- A SLEEP DISORDERS LAB OFFERING TWO PATIENT ROOMS FOR OVERNIGHT, ON-SITE SLEEP STUDIES AND INSTRUCTION FOR PATIENTS RECEIVING HOME SLEEP STUDIES- DIAGNOSTIC IMAGING SERVICES: 3D MAMMOGRAPHY, 3D AND 4D ULTRASOUND, CT SCAN, MRI, NUCLEAR MEDICINE, DEXA SCAN, EKG, EEG AND CARDIOPULMONARY PROCEDURES AND VASCULAR SCREENING- PARKVIEW PHYSICIANS GROUP SPECIALTY AND PRIMARY CARE OFFICES ARE LOCATED ON SITE IN MEDICAL OFFICE SPACE ADJOINING THE HOSPITALTHE PATIENT AND FAMILY ADVISORY COUNCIL (PFAC) IS A FORUM THAT ENABLES PATIENTS AND/OR FAMILY MEMBERS OF A PATIENT TO HAVE DIRECT INPUT AND INFLUENCE ON PROGRAMS AND PRACTICES OF PARKVIEW WABASH HOSPITAL, INC. THE COUNCIL INCLUDES COMMUNITY MEMBERS FROM WABASH COUNTY AND HELPS THE HOSPITAL LEADERS TO UNDERSTAND THE PULSE OF THE COMMUNITY AND GUIDE DECISIONS THAT ENSURE COMMUNITY MEMBERS' PERSPECTIVES AND IDEAS ARE REPRESENTED. A GROUP OF MEN AND WOMEN MAKE UP AN ACTIVE VOLUNTEER PROGRAM AT PARKVIEW WABASH HOSPITAL, INC. THEY WELCOME VISITORS AT BOTH THE MAIN ENTRANCE AND EMERGENCY ROOM ENTRANCE, AS WELL AS OPERATE THE HOSPITAL GIFT SHOP. THE VOLUNTEERS TAKE PEOPLE TO THEIR DESTINATIONS, GREET VISITORS AND PATIENTS, ANSWER QUESTIONS, AND ASSIST OUR CO-WORKERS WITH SMALL TASKS. THEY GENEROUSLY GAVE MORE THAN 2,100 VOLUNTEER HOURS IN 2022.PARKVIEW WABASH HOSPITAL, INC., WAS PLEASED TO BEGIN A PART-TIME CHAPLAINCY PROGRAM IN 2022. THE PROGRAM PROVIDES SPIRITUAL SUPPORT FOR PATIENTS AND THEIR FAMILIES. THE CHAPLAIN WORKS 20 HOURS PER WEEK AND IS ALSO AVAILABLE BY REQUEST IN TIMES OF PATIENT NEED OR TO COMFORT FAMILIES DURING DIFFICULT HEALTHCARE DECISIONS AND OUTCOMES. THE SUPPORT PROVIDED IS BENEFICIAL TO THE STAFF AS WELL FROM BOTH THE PERSONAL AND CAREGIVER PERSPECTIVE.DEPARTMENT MANAGERS WORK WITH LOCAL HIGH SCHOOLS TO PROVIDE STUDENT INTERNSHIPS IN A VARIETY OF SETTINGS, ALLOWING THEM TO EXPLORE CAREERS IN CLINICAL AND NON-CLINICAL HOSPITAL ENVIRONMENTS DURING THE SCHOOL YEAR. COLLEGE INTERNS ARE WELCOMED EACH SUMMER AS WELL TO GAIN EXPERIENCE IN THEIR CHOSEN AREA OF STUDY.COMMUNITY HEALTH IMPROVEMENT INITIATIVES:THE PURPOSE OF PARKVIEW WABASH HOSPITAL, INC.'S COMMUNITY HEALTH IMPROVEMENT PROGRAM IS TO FUND COMMUNITY HEALTH IMPROVEMENT EFFORTS WITHIN THE HOSPITAL'S SERVICE AREA. THE HOSPITAL SETS ASIDE FUNDS ANNUALLY TO SUPPORT PROGRAMS OF SELECTED COMMUNITY HEALTH PARTNERS WHOSE WORK ALIGNS WITH HEALTH PRIORITIES IDENTIFIED PERIODICALLY BY THE COMMUNITY HEALTH NEEDS ASSESSMENT.WITH ITS COMMUNITY HEALTH PARTNERS PROGRAM, PARKVIEW WABASH HOSPITAL, INC., INVESTS IN PROGRAMMING BY KEY ORGANIZATIONS THAT PROMOTE THE HEALTHY LIFESTYLE CHOICES AND WELL-BEING OF INDIVIDUALS, CHILDREN, AND FAMILIES OF WABASH COUNTY. IN CALENDAR YEAR 2022, THE HOSPITAL SELECTED FIVE COMMUNITY AGENCIES OR ORGANIZATIONS WITH WHICH TO COLLABORATE IN ADDRESSING FOCUS AREAS: SUBSTANCE USE DISORDER/MENTAL HEALTH AND OBESITY.FINANCIAL ASSISTANCE:PARKVIEW WABASH HOSPITAL, INC.'S MISSION INCLUDES CARING FOR PEOPLE WHO DO NOT HAVE THE MEANS TO MEET THEIR FINANCIAL OBLIGATIONS. A FINANCIAL COUNSELOR IS AVAILABLE TO ASSIST PATIENTS IN NAVIGATING THIS PROCESS. THE HOSPITAL PRIORITIZES OUR RESPONSIBILITY TO DELIVER EXCELLENT, NECESSARY CARE TO THE PATIENT, NOT THE PATIENT'S ABILITY TO PAY FOR HIS/HER MEDICAL EXPENSES. PRIMARY HEALTHCARE/ACCESS:PARKVIEW WABASH HOSPITAL, INC., COLLABORATES WITH PARKVIEW PHYSICIANS GROUP (PPG) TO PROVIDE THE MEDICAL COVERAGE NEEDED FOR THE COMMUNITY. IF AN INDIVIDUAL DOES NOT HAVE A LOCAL PRIMARY CARE PHYSICIAN, THEY ARE ADVISED TO VIEW THE ONLINE PROVIDER DIRECTORY. PPG OFFICES AND THE HOSPITAL CAN REFER PEOPLE WHO DO NOT HAVE HEALTH INSURANCE TO MATTHEW 25 HEALTH AND CARE BASED IN FORT WAYNE OR THOSE WHO ARE UNDERINSURED TO 85 HOPE, WABASH COUNTY'S FREE CLINIC.IN ADDITION, THE HOSPITAL PROVIDES SUPPORT FOR THE WABASH MEDICATION ASSISTANCE PROGRAM, WHICH ASSISTS THOSE WHO QUALIFY IN OBTAINING MEDICAL SUPPLIES AND PRESCRIPTION MEDICATIONS AT NO OR LOW COST. THE PROGRAM ALSO HELPS PATIENTS ENROLL IN PHARMACEUTICAL ASSISTANCE PROGRAMS.HEALTH SCREENING AND PREVENTION:PARKVIEW WABASH HOSPITAL, INC., WAS ABLE TO COLLABORATE WITH PARKVIEW CENTER FOR HEALTHY LIVING TO SAFELY PROVIDE TWO SOCIALLY DISTANCED "CHECK-UP DAY" EVENTS TO PROVIDE REDUCED-COST LABORATORY WORK TO AREA RESIDENTS.COMMUNITY OUTREACH:PARKVIEW WABASH HOSPITAL, INC. IS ONE OF THE LARGEST EMPLOYERS IN WABASH COUNTY AND BELIEVES STRONGLY IN GIVING BACK TO THE COMMUNITY IT SERVES. TYPICALLY, THE HOSPITAL WILL SPONSOR A VARIETY OF ITS OWN EVENTS AND OUTREACH PROGRAMS THROUGHOUT THE YEAR, AS WELL AS TAKE AN ACTIVE ROLE IN NUMEROUS OTHER HEALTH FAIRS, FESTIVALS, EDUCATION, PARADES, AND COMMUNITY EVENTS. THE MANAGEMENT AND CO-WORKERS OF PARKVIEW WABASH HOSPITAL, INC. WERE ABLE TO PARTICIPATE IN SEVERAL VOLUNTEER ACTIVITIES DURING THE YEAR TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY. THOSE INCLUDED SUCH THINGS AS THE DAM-TO-DAM CENTURY BIKE RIDE, LIKING FOR BIKING, BLESSINGS IN A BACKPACK MEAL PACKING, WABASH MIDDLE SCHOOL 5K, FOUNDER'S FESTIVAL FIRST AID BOOTH, AND BLOOD DRIVES, JUST TO NAME A FEW.Desc
Total Program Service Expenses$50,983,315TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document34IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee245EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JEANNE' WICKENSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2602669313PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11450 PRODUCTION RDAddressLine1Txt
CityFORT WAYNECityNm
State AbbreviationINStateAbbreviationCd
ZIP468081167ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
MICHAEL PACKNETT
DIRECTOR/PH PRESIDENT & CEO0.0040.00Yes (X)Yes (X)$0$2,602,841$338,299
DOUGLAS SPARKS
DIRECTOR/PH PHYSICIAN0.0040.00Yes (X)$23,437$494,391$72,858
DEBRA POTEMPA
DIRECTOR/WBHOS PRESIDENT40.000.00Yes (X)Yes (X)$164,949$52,904$38,301
MARILYN CUSTER-MITCHELL
DIRECTOR-PARTIAL YR/WBHOS PRESIDENT40.000.00Yes (X)Yes (X)$200,680$0$17,610
WILLIAM RAUH
DIRECTOR1.000.00Yes (X)$12,000$0$0
HOWARD HALDERMAN
DIRECTOR/CHAIR1.001.00Yes (X)Yes (X)$7,000$3,500$0
KEVIN BOWMAN
DIRECTOR/SECRETARY/TREASURER1.000.00Yes (X)Yes (X)$4,750$0$0
KELLY STOUFFER
DIRECTOR/VICE CHAIR1.000.00Yes (X)Yes (X)$5,000$0$0
KENT TERRILL
DIRECTOR1.000.00Yes (X)$4,500$0$0
ROGER CROMER
DIRECTOR1.001.00Yes (X)$4,500$0$0
PATTY GRANT
DIRECTOR1.000.00Yes (X)$5,000$0$0
PARKER BEAUCHAMP
DIRECTOR-PARTIAL YR1.000.00Yes (X)$3,750$0$0
BENJAMIN VANDERPOOL
DIRECTOR1.000.00Yes (X)$3,250$0$0
JEANNE' WICKENS
PH CHIEF FINANCIAL OFFICER0.0040.00Yes (X)$0$1,264,400$357,767
CATHY WOLFE
WBHOS VP PATIENT CARE SVCS40.000.00$214,527$0$43,436Yes (X)
PAULA OPHEIM
WBHOS MGR PHARMACY40.000.00$179,785$0$29,748Yes (X)
JAMI METZGER
WBHOS NURSE PRACTITIONER40.000.00$177,590$0$48,916Yes (X)
LISA KROH
WBHOS PHARMACIST40.000.00$155,685$0$18,167Yes (X)
GRACE STANLEY
WBHOS NURSE PRACTITIONER40.000.00$148,922$0$25,762Yes (X)
MELANIE ZOLMAN
WBHOS NURSE PRACTITIONER40.000.00$148,304$591$22,830Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,463,629TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$4,418,627TotReportableCompRltdOrgAmt
Total Other Compensation$1,013,694TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K30IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PARKVIEW HEALTH SYSTEM INC
1450 PRODUCTION RDFORT WAYNEIN46808RHC OPERATIONS$7,849,940
PARKVIEW HOSPITAL INC
11109 PARKVIEW PLAZA DRFORT WAYNEIN46845LABORATORY SERVICES$2,205,282
FOCUSONE SOLUTIONS LLC
13609 CALIFORNIA STOMAHANE68154MEDICAL PERSONNEL$1,139,428
PROFESSIONAL EMERGENCY PHYSICIANS INC
3640 NEW VISION DR SUITE AFORT WAYNEIN46845PHYSICIANS$562,061
NORTHEAST INTERNAL MEDICINE ASSOC INC
2500 N DETROIT STLAGRANGEIN46761HOSPITALISTS$422,453
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Related Organizations$10,275RelatedOrganizationsAmt
Government Grants$459,097GovernmentGrantsAmt
Total Contributions$469,372TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE622110$61,154,005$61,154,005
INTERUNIT RENT531120$100,179$100,179
PHARMACY456110$52,422$52,422
MEALS ON WHEELS624210$19,186$19,186
FieldValueIRS element (for citing)
Total Program Service Revenue$61,325,792TotalProgramServiceRevenueAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$43,201RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$93,533RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$50,332RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$50,332TotalRevenueColumnAmt
Exclusion-$50,332ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$2,387OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$2,387OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,387TotalRevenueColumnAmt
Exclusion$2,387ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA SALES722514$313,948$313,948
GIFT SHOP459420$6,467$6,467
FieldValueIRS element (for citing)
Other Revenue Total$320,415OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$62,067,634TotalRevenueColumnAmt
Related Or Exempt Func Income$61,325,792RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$272,470ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$23,310TotalAmt
Program Services$23,310ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$746,686TotalAmt
Management And General$746,686ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$13,465,147TotalAmt
Program Services$13,465,147ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,583,831TotalAmt
Program Services$4,583,831ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$13,187,952TotalAmt
Program Services$12,424,852ProgramServicesAmt
Management And General$763,100ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$617TotalAmt
Program Services$617ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,022,636TotalAmt
Program Services$881,618ProgramServicesAmt
Management And General$141,018ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,950,623TotalAmt
Program Services$1,928,591ProgramServicesAmt
Management And General$22,032ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$31,684TotalAmt
Program Services$27,422ProgramServicesAmt
Management And General$4,262ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$5,132TotalAmt
Program Services$2,626ProgramServicesAmt
Management And General$2,506ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$707,270TotalAmt
Program Services$707,270ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,561,024TotalAmt
Program Services$3,554,169ProgramServicesAmt
Management And General$6,855ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$113,656TotalAmt
Program Services$56,241ProgramServicesAmt
Management And General$57,415ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
CORP SERVICE ALLOCATION$8,734,830$8,734,830
MEDICAL SUPPLIES$6,770,707$6,770,707
HOSPITAL ASSESSMENT FEE$3,267,827$3,267,827
PH CLINICAL SUPPORT$3,224,974$3,224,974

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$200,516TotalAmt
Program Services$64,113ProgramServicesAmt
Management And General$71,994ManagementAndGeneralAmt
Fundraising$64,409FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$61,598,422TotalAmt
Program Services$50,983,315ProgramServicesAmt
Management And General$10,550,698ManagementAndGeneralAmt
Fundraising$64,409FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,350BOYAmt
EOY$1,350EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$252,916BOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$11,325,975BOYAmt
EOY$9,425,061EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$903,764BOYAmt
EOY$1,034,532EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$63,090BOYAmt
EOY$22,559EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$48,509,452LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$16,850,741LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$34,686,631BOYAmt
EOY$31,658,711EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,719,392BOYAmt
EOY$1,132,533EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$48,953,118BOYAmt
EOY$43,274,746EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,424,813BOYAmt
EOY$2,294,155EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$3,475,488BOYAmt
EOY$326,382EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$21,969,171BOYAmt
EOY$21,174,945EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$30,083,025BOYAmt
EOY$27,935,693EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$57,952,497BOYAmt
EOY$51,731,175EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$8,999,379BOYAmt
EOY-$8,456,429EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$8,999,379BOYAmt
EOY-$8,456,429EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$48,953,118BOYAmt
EOY$43,274,746EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$469,212ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$73,738OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$4,950OtherActivitiesAmt
Total Lobbying Expenditures$4,950TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationOTHER ACTIVITIES - REPRESENTS THE PORTION OF THE DUES PAID TO INDIANA HOSPITAL AND HEALTH ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION, NATIONAL RURAL HEALTH ASSOCIATION, AND NATIONAL ASSOCIATION OF RURAL HEALTH CLINICS USED FOR LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,406,260BeginningYearBalanceAmt
Investment Earnings Or Losses-$134,295InvestmentEarningsOrLossesAmt
Administrative Expenses$10,686AdministrativeExpensesAmt
End Year Balance$1,261,279EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,199,665BeginningYearBalanceAmt
Investment Earnings Or Losses$218,314InvestmentEarningsOrLossesAmt
Administrative Expenses$11,719AdministrativeExpensesAmt
End Year Balance$1,406,260EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,154,580BeginningYearBalanceAmt
Investment Earnings Or Losses$54,264InvestmentEarningsOrLossesAmt
Administrative Expenses$9,179AdministrativeExpensesAmt
End Year Balance$1,199,665EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$747,680BeginningYearBalanceAmt
Contributions$340,000ContributionsAmt
Investment Earnings Or Losses$79,352InvestmentEarningsOrLossesAmt
Administrative Expenses$12,452AdministrativeExpensesAmt
End Year Balance$1,154,580EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$704,414BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$53,424InvestmentEarningsOrLossesAmt
Grants Or Scholarships$502GrantsOrScholarshipsAmt
Administrative Expenses$9,656AdministrativeExpensesAmt
End Year Balance$747,680EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.75320PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.24680TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,208,757OtherCostOrOtherBasisAmt
Book Value$1,208,757BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$31,518,742OtherCostOrOtherBasisAmt
Depreciation$7,122,819DepreciationAmt
Book Value$24,395,923BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,873,581OtherCostOrOtherBasisAmt
Depreciation$8,796,473DepreciationAmt
Book Value$5,077,108BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,908,372OtherCostOrOtherBasisAmt
Depreciation$931,449DepreciationAmt
Book Value$976,923BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$31,658,711TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
LEASE LIABILITY$1,157,028
DUE TO/FROM INTERUNIT$21,577,725
EST MEDICARE/MEDICAID SETTLEMENTS$3,538,493
EST 3RD PARTY SETTLEMENTS$987,399
RHC SETTLEMENTS$675,048
FieldValueIRS element (for citing)
Total Liability$27,935,693TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:ENDOWMENT FUNDS ARE USED FOR THE ORGANIZATION'S PROGRAMS AND OPERATIONS RELATED TO PATIENT-FOCUSED CARE.
PART X, LINE 2:PARKVIEW HEALTH SYSTEM, INC. AND SUBSIDIARIES - NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES THE LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): INCOME TAXES: THE INTERNAL REVENUE SERVICE HAS DETERMINED THAT THE CORPORATION AND CERTAIN AFFILIATED ENTITIES ARE TAX-EXEMPT ORGANIZATIONS AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CERTAIN SUBSIDIARIES OF THE CORPORATION ARE TAXABLE ENTITIES, THE TAX EXPENSE AND LIABILITIES OF WHICH ARE NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION AND ITS TAX-EXEMPT AFFILIATED ENTITIES EACH FILE A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THESE RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH SYSTEMS INCLUDE SUCH MATTERS AS THE TAX-EXEMPT STATUS OF EACH ENTITY, THE CONTINUED TAX-EXEMPT STATUS OF BONDS, THE NATURE, CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME, AND VARIOUS POSITIONS RELATING TO POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (REPORTED ON FORM 990T). AS OF DECEMBER 31, 2022 AND 2021, THERE ARE NO UNRECOGNIZED TAX BENEFITS RESULTING FROM UNCERTAIN TAX POSITIONS. FORMS 990 AND 990T FILED BY THE CORPORATION AND ITS TAX-EXEMPT AFFILIATED ENTITIES ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. FORMS 990 AND 990T FILED BY THE CORPORATION AND ITS TAX-EXEMPT AFFILIATED ENTITIES ARE GENERALLY NO LONGER SUBJECT TO EXAMINATION FOR THE YEAR 2018 AND PRIOR.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent250Yes (X)Percent250Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,033,205TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,033,205NetCommunityBenefitExpnsAmt
Total Expense0.01770TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,435,190TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,424,801DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,010,389NetCommunityBenefitExpnsAmt
Total Expense0.03440TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,262,717TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,529,816DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,732,901NetCommunityBenefitExpnsAmt
Total Expense0.04680TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,731,112TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,954,617DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,776,495NetCommunityBenefitExpnsAmt
Total Expense0.09890TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$60,029TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,251DirectOffsettingRevenueAmt
Net Community Benefit Expns$46,778NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$75,661TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$75,661NetCommunityBenefitExpnsAmt
Total Expense0.00130TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,173,477TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,187,009DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,986,468NetCommunityBenefitExpnsAmt
Total Expense0.03400TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$23,920TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$23,920NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,333,087TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,200,260DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,132,827NetCommunityBenefitExpnsAmt
Total Expense0.03650TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$21,064,199TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,154,877DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,909,322NetCommunityBenefitExpnsAmt
Total Expense0.13540TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,000NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,000NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$0BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$10,435,280ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$13,385,132CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$2,949,852MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PARKVIEW WABASH HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line110 JOHN KISSINGER DRIVEAddressLine1Txt
CityWABASHCityNm
State AbbreviationINStateAbbreviationCd
ZIP46992ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.PARKVIEW.COMWebsiteAddressTxt
State License16-005094-1StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PARKVIEW WABASH HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted22CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTPS://WWW.PARKVIEW.COM/LOCALHEALTHNEEDSOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLHTTPS://WWW.PARKVIEW.COM/LOCALHEALTHNEEDSStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care250.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, LINES 16A B & CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, LINES 16A B & CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, LINES 16A B & CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PARKVIEW WABASH HOSPITAL, INC.PART V, SECTION B, LINE 5: DESCRIBE HOW THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY, AND IDENTIFY THE PERSONS THE HOSPITAL FACILITY CONSULTED:WHEN CONDUCTING ITS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), PARKVIEW HEALTH SYSTEM, INC., INCLUDING THE COMMUNITY HOSPITAL OF PARKVIEW WABASH HOSPITAL, INC., WERE DILIGENT IN ENSURING INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY WAS INCLUDED, WHILE ALSO FOCUSING ON THE NEEDS OF VULNERABLE POPULATIONS IN NORTHEAST INDIANA. IN GATHERING COMMUNITY INPUT, PARKVIEW HEALTH SYSTEM, INC., INCLUDING PARKVIEW WABASH HOSPITAL, INC., OBTAINED THE FOLLOWING: 1) PRIMARY DATA COLLECTED THROUGH A COMMUNITY SURVEY OF RESIDENTS IN EACH PARKVIEW HEALTH COUNTY, 2) PRIMARY DATA COLLECTED THROUGH AN ONLINE SURVEY OF HEALTHCARE AND SOCIAL SERVICE PROVIDERS IN EACH COUNTY THAT PROVIDE SERVICES DIRECTLY TO THE UNDERSERVED IN OUR COMMUNITIES (E.G., PHYSICIANS, NURSES, SOCIAL WORKERS, ETC.), AND 3) SECONDARY DATA COLLECTED FROM CONDUENT'S HEALTHY COMMUNITIES INSTITUTE (HCI) DATABASE AND OTHER LOCAL AND NATIONAL AGENCIES (E.G., COUNTY HEALTH RANKINGS, INDIANA STATE DEPARTMENT OF HEALTH, ETC.). COMMUNITY MEMBER AND PROVIDER INPUT WAS GATHERED FROM MARCH THROUGH MAY 2022 VIA MULTIPLE RECRUITMENT AND DATA COLLECTION METHODS: 1) E-MAIL TO HEALTHCARE AND SOCIAL SERVICE PROVIDERS WITH AN EMBEDDED ONLINE SURVEY LINK; 2) MAILED PAPER AND E-MAILED ONLINE SURVEYS TO COMMUNITY MEMBERS; 3) PAPER SURVEYS DISTRIBUTED TO INDIVIDUALS, CLINICS OR ORGANIZATIONS SERVING HISPANIC, AMISH, OR PEOPLE OF BURMA POPULATIONS; 4) IN-PERSON RECRUITMENT AT LOCATIONS PROVIDING SERVICES TO LOW-INCOME POPULATIONS IN EACH PARKVIEW HEALTH COUNTY; AND 5) PRESS RELEASE AND SOCIAL MEDIA NOTIFICATIONS WITH A SURVEY LINK. THE SURVEY WAS MADE AVAILABLE IN ENGLISH, SPANISH, AND BURMESE.HISPANIC, AMISH, PEOPLE OF BURMA, AND LOW-INCOME POPULATIONS WERE IDENTIFIED AS VULNERABLE POPULATIONS IN PARKVIEW HEALTH COUNTIES, AND THEREFORE SURVEY DISTRIBUTION AND DATA COLLECTION STRATEGIES INCLUDED FOCUSED EFFORTS TO OBTAIN COMMUNITY INPUT FROM THESE POPULATIONS. IN WABASH COUNTY, THIS INCLUDED HISPANIC AND LOW-INCOME POPULATIONS. THE RESEARCH TEAM COORDINATED WITH COMMUNITY HEALTH WORKERS, LOCAL HEALTH DEPARTMENTS, AND KNOWN CONTACTS IN EACH COUNTY TO IDENTIFY LOCATIONS TO SURVEY UNDERREPRESENTED OR VULNERABLE POPULATIONS. IN WABASH COUNTY, IN-PERSON TEAMS OF RESEARCH ASSISTANTS CONDUCTED COMMUNITY SURVEY OUTREACH AT THE LOCAL YMCA, THRIFT STORE AND COFFEE SHOP. REGARDING VULNERABLE POPULATIONS SURVEYED IN WABASH COUNTY, 22.1% OF RESPONDENTS REPORTED AN INCOME OF < $35,000 AND 1.1% OF RESPONDENTS IDENTIFIED AS HISPANIC/LATINO. ADDITIONALLY, RESPONDENTS 65 YEARS AND OLDER WERE WELL-REPRESENTED (45.5%). THE PROVIDER SURVEY INCLUDED RESPONSES FROM PHYSICIANS, NURSE PRACTITIONERS, REGISTERED NURSES, OTHER HEALTHCARE PROVIDERS, COMMUNITY/SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH/COMMUNITY HEALTH WORKERS, AND SOCIAL WORKERS/CASE MANAGERS. IN ADDITION TO DATA COLLECTION, PARKVIEW WABASH HOSPITAL, INC. COLLABORATED WITH THE COMMUNITY AND PARTNERING ORGANIZATIONS TO SELECT AND PRIORITIZE WABASH COUNTY'S HEALTH NEEDS. IN DOING SO, A MODIFIED HANLON METHOD WAS EMPLOYED TO PRIORITIZE HEALTH CONCERNS FOR PARKVIEW HEALTH HOSPITAL COMMUNITIES. THIS METHOD, ALSO KNOWN AS THE BASIC PRIORITY RATING SYSTEM (BPRS) 2.0, IS RECOMMENDED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO) FOR PRIORITIZING COMMUNITY HEALTH NEEDS (GUIDE-TO-PRIORITIZATION-TECHNIQUES.PDF, N.D.). THIS METHOD IS PARTICULARLY USEFUL WHEN THE DESIRED OUTCOME IS AN OBJECTIVELY SELECTED LIST. EXPLICIT IDENTIFICATION OF FACTORS MUST BE CONSIDERED TO SET PRIORITIES, WHICH ENABLES A TRANSPARENT AND REPLICABLE PROCESS. PRIORITY SCORES ARE CALCULATED BASED ON THE SIZE OF THE HEALTH PROBLEM, SERIOUSNESS OF THE HEALTH PROBLEM AND THE AVAILABILITY OF EFFECTIVE HEALTH INTERVENTIONS.AS A CONTINUATION OF THE PRIORITIZATION PROCESS, PARKVIEW WABASH HOSPITAL, INC. HELD A COMMUNITY MEETING ON SEPTEMBER 12, 2022, TO ENGAGE WABASH COUNTY COMMUNITY LEADERS IN HELPING DETERMINE TWO HEALTH PRIORITIES FOR THE COUNTY IN ADDITION TO THE HEALTH PRIORITY OF MENTAL HEALTH THAT WAS SET FOR ALL HOSPITALS IN THE PARKVIEW HEALTH SYSTEM OVER THE NEXT THREE YEARS. THE AREAS OF EDUCATION, GOVERNMENT, SOCIAL SERVICE AGENCIES AND RECREATION WERE ALL REPRESENTED IN THE MEETING, ALONG WITH MEMBERS OF THE PARKVIEW WABASH HOSPITAL ADMINISTRATIVE TEAM. THE GROUP OF STAKEHOLDERS CONDUCTED A THOUGHTFUL REVIEW OF THE 2022 CHNA DATA AND ENGAGED IN A PRIORITIZATION GRID EXERCISE, WHICH INVOLVED EXAMINING THE TOP 10 HEALTH PRIORITIES IDENTIFIED IN THE SURVEY OF THE COMMUNITY AND LOCAL PROVIDERS. THE FINDINGS WERE SUMMARIZED IN THE CHNA. PARTICIPANTS WERE THEN ASKED TO RATE SIGNIFICANCE, SEVERITY, SUITABILITY, AND SOCIAL DETERMINANTS OF HEALTH FOR EACH OF THE 10 PRIORITIES. FOLLOWING THIS, THE STAKEHOLDERS WERE ASKED TO VOTE ON THEIR TOP TWO RECOMMENDATIONS FOR THE TWO ADDITIONAL HEALTH PRIORITIES. GREAT DISCUSSION ENSUED BEFORE VOTING BEGAN. FROM THIS DISCUSSION, IT WAS UNANIMOUSLY AGREED UPON THAT A VOTE WAS NOT NECESSARY. ALL CONCURRED THAT THE FOLLOWING SHOULD BE THE HEALTH PRIORITIES FOR WABASH COUNTY: SUBSTANCE ABUSE/USE AND OBESITY. THE RECOMMENDATIONS OF THE COMMITTEE WERE PRESENTED TO THE PARKVIEW WABASH HOSPITAL BOARD EXECUTIVE PLANNING COMMITTEE ON SEPTEMBER 30, 2022. THEY VOTED UNANIMOUSLY TO ADOPT SUBSTANCE ABUSE/USE AND OBESITY AS ADDITIONAL PRIORITIES. PRIORITIZATION SESSION ATTENDEES REPRESENTED SEVERAL ORGANIZATIONS IN WABASH COUNTY: WABASH CITY GOVERNMENT, WABASH COMMUNITY FOUNDATION, PARKVIEW ADMINISTRATION, WABASH CITY SCHOOLS, MANCHESTER COMMUNITY SCHOOLS, METROPOLITAN SCHOOL DISTRICT OF WABASH COUNTY, WAYPOINT WOMEN'S RECOVERY HOME, AND WABASH YMCA.
PARKVIEW WABASH HOSPITAL, INC.PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY'S CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES:PARKVIEW HOSPITAL, INC. (EIN 35-0868085); DEKALB MEMORIAL HOSPITAL, INC. (EIN 35-1064295); COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. (EIN 20-2401676); COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. (EIN 35-2087092); HUNTINGTON MEMORIAL HOSPITAL, INC. (EIN 35-1970706); WHITLEY MEMORIAL HOSPITAL, INC. (EIN 35-1967665); PARK CENTER, INC. (EIN 35-1135451)AND ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH, LLC (EIN 26-0143823).
PARKVIEW WABASH HOSPITAL, INC.PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY'S CHNA WAS ALSO CONDUCTED WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES:PARKVIEW HEALTH SYSTEM, INC. (EIN 35-1972384), THROUGH PARKVIEW'S HEALTH SERVICES AND INFORMATICS RESEARCH (HSIR) GROUP, DESIGNED AND CONDUCTED BOTH PRIMARY AND SECONDARY DATA COLLECTION AND ANALYSIS ACTIVITIES FOR THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). HSIR EMPLOYS MULTIPLE RESEARCH STAFF, WHICH INCLUDES PHD PREPARED SCIENTISTS, USER EXPERIENCE SPECIALISTS AND PROJECT MANAGERS. AS A RESEARCH UNIT EMBEDDED IN PARKVIEW, HSIR HAS DEDICATED TIME TO SUPPORT INITIATIVES THAT REQUIRE RESEARCH SKILLS, SUCH AS THE CHNA.
PARKVIEW WABASH HOSPITAL, INC.PART V, SECTION B, LINE 11: DESCRIBE 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:SIGNIFICANT HEALTH NEEDS BEING ADDRESSED:MENTAL HEALTH AND SUBSTANCE ABUSE --PARKVIEW WABASH HOSPITAL, INC., IS BOLSTERING ITS EFFORTS IN AREAS DEEMED TO BE HIGHEST IMPACT FOR MENTAL HEALTH AND DRUG ABUSE IN THE FOLLOWING WAYS:- THROUGH OUR BEHAVIORAL HEALTH PROGRAM, WHICH OPENED IN LATE 2020, PARKVIEW WABASH HOSPITAL, INC., OFFERS OUTPATIENT ALCOHOL AND OPIOID DEPENDENCY MEDICATION TREATMENT. INTENSIVE OUTPATIENT GROUP TREATMENT OFFERS THREE PHASES OF GROUP SESSIONS FOR TREATMENT, ENABLING PATIENTS TO ENGAGE IN DAILY ROUTINES AND CONTINUE LIVING AT HOME.- THE LIFEBRIDGE SENIOR INTENSIVE OUTPATIENT PROGRAM IS A SPECIALTY MENTAL/BEHAVIORAL PROGRAM DESIGNED TO MEET THE NEEDS OF OLDER ADULTS FOCUSING ON PROVIDING INTENSIVE INDIVIDUAL, FAMILY AND/OR GROUP SERVICES. EACH OF THE INDIVIDUALS ENROLLED IN THE LIFEBRIDGE PROGRAM ATTEND MONTHLY APPOINTMENTS WITH THE MEDICAL DIRECTOR/PSYCHIATRIST FOR MEDICATION MANAGEMENT AND TREATMENT PLANNING. AT EACH VISIT, INDIVIDUALS ARE SCREENED BY NURSING STAFF FOR VITALS, MEDICATION RECONCILIATION AND ANY MEDICAL CONCERNS ARE IMMEDIATELY COMMUNICATED TO THE INDIVIDUAL'S PRIMARY CARE PHYSICIAN. FAMILY AND SIGNIFICANT OTHERS ARE ENCOURAGED TO PARTICIPATE IN THE TREATMENT PROCESS. LIFEBRIDGE PROVIDES A COHESIVE TREATMENT TEAM TO INCREASE INDIVIDUAL'S MENTAL HEALTH AND PHYSICAL WELL-BEING.- SUPPORT OF WAYPOINT, A TRANSITIONAL RECOVERY HOME FOR WOMEN, CONTINUED IN 2022. WOMEN WHO ARE RELEASED FROM JAIL OR A REHABILITATION FACILITY, WHO ARE SOBER, AND WHO WISH TO ABSTAIN FROM RETURNING TO PRIOR HABITS, CAN COME TO THE HOME FOR SUPPORT AND GUIDANCE AS THEY WORK TO RE-ENTER THE WORKFORCE AND REBUILD THEIR LIVES AND RELATIONSHIPS OF OTHERS. PARKVIEW WABASH HOSPITAL, INC., PROVIDES FUNDING FOR DRUG AND ALCOHOL TEST KITS. OUR MANAGERS ALSO INVESTED THEIR PERSONAL TIME TO CLEAN, PAINT AND PREPARE THE HOUSE FOR ITS 2022 OPENING.- PARKVIEW WABASH HOSPITAL, INC., PARTNERS CLOSELY WITH THE WABASH COUNTY TOBACCO FREE COALITION ON SEVERAL INITIATIVES. WE PROVIDE FUNDING FOR NICOTINE REPLACEMENT THERAPY, DON'T START SMOKING EDUCATION FOR ALL 2ND AND 5TH GRADERS IN WABASH COUNTY AND PRENATAL CESSATION CLASSES.OBESITY -- PARKVIEW WABASH HOSPITAL, INC., SUPPORTS PROGRAMS ESTABLISHED TO ADDRESS OBESITY IN WABASH COUNTY. ACTIONS TO ADDRESS THE ISSUE OF OBESITY CENTER AROUND PROGRAMS THAT ENGAGE CHILDREN AND FAMILIES AND INCLUDE THE FOLLOWING PROGRAMS:- WITH FUNDING PROVIDED BY THE PARKVIEW WABASH HOSPITAL, INC., FOUNDATION, A FIVE-SPACE PARKING LOT WAS BUILT ADJACENT TO THE HOSPITAL'S HALF-MILE WALKING PATH TO ENCOURAGE GREATER COMMUNITY USAGE OF THE PATH.- THE HOSPITAL PARTNERS WITH VISIT WABASH COUNTY AND THE SPIKES AND BIKES CLUB TO OFFER "LIKING FOR BIKING," A WEEKLY 60-MINUTE BIKE RIDE FOR PEOPLE OF ALL AGES AND FITNESS LEVELS. THE GOAL IS TO ENCOURAGE PHYSICAL ACTIVITY IN A CASUAL, FUN, GROUP SETTING. THERE ARE 17 RIDES FROM MAY THROUGH AUGUST. THIRTY-SIX PEOPLE RODE AT LEAST ONE WEEK, WITH 13 PEOPLE RIDING 10 OR MORE WEEKS. TWO PEOPLE REPORTED LOSING WEIGHT FROM THE START OF THE PROGRAM.- BLESSINGS IN A BACKPACK WORKS TO COMBAT FOOD INSECURITY BY FEEDING, ON AVERAGE, 600 ELEMENTARY STUDENTS WEEKLY THROUGHOUT 2022. ONE STUDENT WROTE "I LIKE GETTING THE BLESSINGS BAG BECAUSE MY MOM SAYS IT HELPS A LOT."- THE HOSPITAL'S "MYWELL-BEING" COMMITTEE PROVIDES RESOURCES FOR CO-WORKERS TO ENABLE THEM TO BE GOOD EXAMPLES FOR THE REST OF THE COMMUNITY.- PARKVIEW WABASH HOSPITAL, INC., PARTNERED WITH HAWKINS FAMILY FARM IN 2022 TO PARTICIPATE IN THEIR FARM SHARE PROGRAM. CO-WORKERS COULD SIGN UP FOR THE PROGRAM AND HAVE FRESH, LOCALLY GROWN VEGETABLES AND FRUITS OF THEIR CHOICE DELIVERED TO THE HOSPITAL FOR PICK UP. APPROXIMATELY 50 PEOPLE PARTICIPATED AT SOME LEVEL DURING THE SIX- MONTH SEASON.MATERNAL/CHILD HEALTH --- PARKVIEW WABASH HOSPITAL, INC., OFFERS A MOMS GROUP, SAFE SLEEP AND LACTATION VISITS TO THE COMMUNITY. THE PROGRAMS WERE DESIGNED TO REDUCE RISKS AND INCREASE HEALTHY BEHAVIORS AMONG NEWBORNS, AS WELL AS OFFERING SUPPORT TO BOTH FIRST-TIME AND EXPERIENCED MOTHERS. ALL CLASSES ARE OPEN TO THE PUBLIC, REGARDLESS OF WHERE MOM DELIVERED.- THE HOSPITAL PARTNERED WITH THE INDIANA STATE DEPARTMENT OF HEALTH TO OFFER A BOOSTER BASH IN SEPTEMBER. LED BY STAFF CERTIFIED IN CAR SEAT SAFETY, CO-WORKERS CHECKED BOOSTER SEATS FOR PROPER INSTALLATION, FIT AND SAFETY. FREE BOOSTER SEATS WERE PROVIDED IF SEATS WERE EXPIRED OR THE WRONG SIZE.OTHER HEALTH NEEDS NOT BEING ADDRESSED:KIDNEY DISEASE - THIS IS NOT AN AREA OF PRIORITY AS THERE ARE LIMITED RESOURCES TO ADDRESS THE NEED. THERE ARE RESOURCES ELSEWHERE IN THE PARKVIEW HEALTH SYSTEM.ASTHMA - THIS ISSUE WAS NOT A PRIORITY OF COMMUNITY MEMBERS, AND THEREFORE, WOULD NOT RECEIVE SUFFICIENT SUPPORT TO SUCCEED. INDIVIDUALS' PRIMARY CARE PROVIDERS ADDRESS THESE NEEDS. CANCER - THIS IS NOT LIKELY TO BE RESOLVED AT THIS TIME. WHILE WE DID NOT CHOOSE CANCER AS A PRIMARY NEED, PARKVIEW WABASH HOSPITAL, INC., OFFERS AN ONCOLOGIST ON-SITE TWO DAYS A WEEK, AS WELL AS AN ONCOLOGY-CERTIFIED NURSE PRACTITIONER THREE DAYS EACH WEEK. WE OFFER CHEMOTHERAPY FOUR DAYS PER WEEK.DIABETES - WHILE PARKVIEW WABASH HOSPITAL, INC., DID NOT SELECT DIABETES AS A TOP HEALTH PRIORITY, WE DO UNDERSTAND ITS PREVALENCE IN OUR COMMUNITY. OUR REGISTERED DIETITIANS WORK WITH PATIENTS ON A ONE-ON-ONE BASIS THROUGH PHYSICIAN REFERRAL AND INPATIENT CONSULTS. WE ALSO BELIEVE OUR CONTINUED EFFORTS TO FOCUS ON OBESITY AS A PRIORITY WILL POSITIVELY IMPACT DIABETES.CARDIOVASCULAR DISEASE - AS WITH DIABETES, WE BELIEVE OUR EMPHASIS ON OBESITY WILL SERVE TO MITIGATE THE RISK OF CARDIOVASCULAR DISEASE. PARKVIEW WABASH HOSPITAL, INC., BOASTS A STRONG CARDIOPULMONARY REHABILITATION PROGRAM THAT DATES BACK TO 1983. IT WAS ONE OF THE FIRST PROGRAMS OF ITS KIND IN A RURAL COMMUNITY. CHILD ABUSE AND NEGLECT - THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS THIS ISSUE. WE WILL CONTINUE TO MONITOR AND REPORT ALL SUSPECTED CONCERNS OBSERVED TO CHILD PROTECTIVE SERVICES.
PART V, LINES 16A, 16B AND 16CHTTPS://WWW.PARKVIEW.COM/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE
PART V, SECTION B, LINE 3E:THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.

Supplemental Information Detail SupplementalInformationDetail (15 entries)

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PART I, LINE 6A:THE RELATED ENTITIES OF PARKVIEW HEALTH SYSTEM, INC. (EIN 35-1972384); PARKVIEW HOSPITAL, INC. (EIN 35-0868085); COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. (EIN 20-2401676); COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. (EIN 35-2087092); HUNTINGTON MEMORIAL HOSPITAL, INC. (EIN 35-1970706); WHITLEY MEMORIAL HOSPITAL, INC. (EIN 35-1967665); DEKALB MEMORIAL HOSPITAL, INC. (EIN 35-1064295; PARK CENTER, INC. (EIN 35-1135451); AND PARKVIEW WABASH HOSPITAL, INC. (EIN 47-1753440) PREPARED A COMBINED REPORT TO THE COMMUNITY DETAILING COMMUNITY BENEFIT PROGRAMS AND SERVICES.
PART I, LINE 7:PART I, LINE 7ATHE FINANCIAL ASSISTANCE COST REPORTED ON LINE 7A IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE FINANCIAL ASSISTANCE CHARGES FOREGONE ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF SERVICES RENDERED.PART I, LINE 7BPARKVIEW WABASH HOSPITAL, INC. ACCEPTS ALL MEDICAID, MEDICAID MANAGED CARE, AND OUT-OF-STATE MEDICAID PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEDICAID PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING MEDICAID, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE UNREIMBURSED MEDICAID COST REPORTED ON LINE 7B IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE MEDICAID CHARGES ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF MEDICAID SERVICES RENDERED. THEN, THE COST OF MEDICAID SERVICES RENDERED IS DEDUCTED FROM THE REIMBURSEMENT RECEIVED FOR MEDICAID PATIENTS TO ARRIVE AT A GAIN/(LOSS) RELATIVE TO THESE PATIENTS.PART I, LINE 7CPARKVIEW WABASH HOSPITAL, INC. ACCEPTS ALL CERTAIN MEANS-TESTED PATIENTS FROM THE HEALTHY INDIANA PLAN (HIP) WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEANS-TESTED PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING HIP, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE UNREIMBURSED HIP COST REPORTED ON LINE 7C IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE HIP CHARGES ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF HIP SERVICES RENDERED. THEN, THE COST OF HIP SERVICES RENDERED IS DEDUCTED FROM THE REIMBURSEMENT RECEIVED FOR HIP PATIENTS TO ARRIVE AT A GAIN/(LOSS) RELATIVE TO THESE PATIENTS.PART I, LINE 7EAMOUNTS PRESENTED ARE BASED ON ACTUAL SPEND FOR THOSE SERVICES AND BENEFITS PROVIDED DEEMED TO IMPROVE THE HEALTH OF THE COMMUNITIES IN WHICH WE SERVE AND CONFORM WITH THE MISSION OF OUR EXEMPT PURPOSE.PART I, LINE 7FAMOUNTS PRESENTED ARE BASED UPON ACTUAL SPEND AND ARE IN CONFORMITY WITH AGREED UPON COMMITMENTS WITH THE VARIOUS EDUCATIONAL PROGRAMS.PART I, LINE 7GAMOUNTS PRESENTED DO NOT INCLUDE ANY COSTS ASSOCIATED WITH PHYSICIAN CLINICS.PART I, LINE 7IIN KEEPING WITH OUR MISSION AND COMMITMENT TO THE COMMUNITIES IN WHICH WE SERVE, PARKVIEW WABASH HOSPITAL, INC. CONTINUES ITS TRADITION OF CONTRIBUTING TO NUMEROUS ORGANIZATIONS ON BOTH AN AS-NEEDED BASIS AND NEGOTIATED BASIS. AMOUNTS PRESENTED REPRESENT ACTUAL SPEND TO ORGANIZATIONS THROUGHOUT OUR COMMUNITIES.
PART I, LN 7 COL(F):PERCENT OF TOTAL EXPENSEPARKVIEW WABASH HOSPITAL, INC. EXCLUDED $3,224,974 OF PH CLINICAL SUPPORT EXPENSE.
PART II, COMMUNITY BUILDING ACTIVITIES:DESCRIBE HOW THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES, AS REPORTED, PROMOTE THE HEALTH OF THE COMMUNITIES THE ORGANIZATION SERVES.PARKVIEW WABASH HOSPITAL, INC. PROVIDES SUPPORT FOR LOCAL ECONOMIC DEVELOPMENT PROGRAMS AND WORKS CLOSELY WITH GROW WABASH COUNTY, THE COUNTY'S ECONOMIC DEVELOPMENT ORGANIZATION AND THE CITY OF WABASH. PROMOTION OF ECONOMIC DEVELOPMENT IN WABASH COUNTY IS A PART OF A COLLECTIVE PLAN TO IMPROVE THE QUALITY OF LIFE AND ULTIMATELY THE OVERALL HEALTH AND WELL-BEING OF THE COMMUNITY.
PART III, LINE 2:FOR FINANCIAL STATEMENT PURPOSES, THE ORGANIZATION HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE.
PART III, LINE 4:BAD DEBT EXPENSE - PARKVIEW HEALTH SYSTEM, INC. AND SUBSIDIARIES - NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTSTEXT 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:PAGES 12 AND 23 - 27 OF ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8:COMMUNITY BENEFIT & METHODOLOGY FOR DETERMINING MEDICARE COSTSSUBSTANTIAL SHORTFALLS TYPICALLY ARISE FROM PAYMENTS THAT ARE LESS THAN THE COST TO PROVIDE THE CARE OR SERVICES AND DO NOT INCLUDE ANY AMOUNTS RELATING TO INEFFICIENT OR POOR MANAGEMENT. PARKVIEW WABASH HOSPITAL, INC. ACCEPTS ALL MEDICARE PATIENTS, AS REFLECTED ON THE YEAR-END MEDICARE COST REPORT, WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. HOWEVER, MEDICARE PAYMENTS REPRESENT A PROXY OF COST CALLED THE "UPPER PAYMENT LIMIT." IT HAS HISTORICALLY BEEN ASSUMED THAT UPPER PAYMENT LIMIT PAYMENTS DO NOT GENERATE A SHORTFALL. AS A RESULT, PARKVIEW WABASH HOSPITAL, INC. HAS TAKEN THE POSITION NOT TO INCLUDE THE MEDICARE SHORTFALLS OR SURPLUSES AS PART OF COMMUNITY BENEFIT. PARKVIEW WABASH HOSPITAL, INC. RECOGNIZES THAT THE SHORTFALL OR SURPLUS FROM MEDICARE DOES NOT INCLUDE THE COSTS AND REVENUES ASSOCIATED WITH MEDICARE ADVANTAGE PATIENTS. AS SUCH, THE TOTAL SHORTFALL OR SURPLUS OF MEDICARE IS UNDERSTATED DUE TO THE COSTS AND REVENUES ASSOCIATED WITH MEDICARE ADVANTAGE PATIENTS NOT BEING INCLUDED IN THE COMMUNITY BENEFIT DETERMINATION.
PART III, LINE 9B:A PATIENT'S FAILURE TO MAKE PAYMENT ARRANGEMENTS THROUGH VARIOUS AVAILABLE PAYMENT OPTIONS OR FAILURE TO APPLY FOR AND RECEIVE APPROVAL UNDER THE FINANCIAL ASSISTANCE POLICY MAY RESULT IN THE ACCOUNT BEING REFERRED TO A COLLECTION AGENCY DUE TO NON-PAYMENT. THE COLLECTION AGENCY MAY REPORT THE ACCOUNT TO ONE OR ALL THREE CREDIT REPORTING AGENCIES, WHICH MAY ADVERSELY AFFECT THE PATIENT'S CREDIT SCORE.A PATIENT MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE APPLICATION PERIOD, EVEN IF THE ACCOUNT HAS BEEN PLACED WITH A COLLECTION AGENCY. IF AN INDIVIDUAL SUBMITS A COMPLETE FINANCIAL ASSISTANCE APPLICATION DURING THE APPLICATION PERIOD, AND PARKVIEW HEALTH DETERMINES THE INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THEN PARKVIEW HEALTH WILL TAKE ALL REASONABLE AVAILABLE MEASURES TO REVERSE ANY EXTRAORDINARY COLLECTION ACTION (EXCEPT FOR A SALE OF DEBT) TAKEN AGAINST THE INDIVIDUAL TO OBTAIN PAYMENT FOR THE CARE. ALSO, IF AN INDIVIDUAL SUBMITS AN INCOMPLETE FINANCIAL ASSISTANCE APPLICATION DURING THE APPLICATION PERIOD, PARKVIEW WILL SUSPEND ANY EXTRAORDINARY COLLECTION ACTIONS AGAINST THE INDIVIDUAL (WITH RESPECT TO CHARGES TO WHICH THE FINANCIAL ASSISTANCE APPLICATION UNDER REVIEW RELATES) UNTIL THE FINANCIAL ASSISTANCE APPLICATION HAS BEEN PROCESSED AND AN ELIGIBILITY DECISION RENDERED.
PART VI, LINE 2: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.IN ADDITION TO COMPLETING A COMMUNITY HEALTH NEEDS ASSESSMENT ON A TRIENNIAL BASIS, PARKVIEW WABASH HOSPITAL , INC. ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY IT SERVES THROUGH PRIMARY AND SECONDARY DATA ANALYSIS, WORKING WITH THE ORGANIZATION'S COMMUNITY PARTNERS AND FRONTLINE STAFF. PARKVIEW WABASH HOSPITAL, INC. IDENTIFIES AND VERIFIES COMMUNITY HEALTH NEEDS THROUGH THE FOLLOWING:1. HEALTHY COMMUNITIES INSTITUTE (HCI) SECONDARY DATA ANALYSIS2. OBSERVATIONS AND DATA COLLECTED FROM FRONTLINE STAFF WORKING WITH VULNERABLE POPULATIONS (I.E., COMMUNITY NURSES AND COMMUNITY HEALTH WORKERS)3. REVIEW OF COMMUNITY NEEDS ASSESSMENTS CONDUCTED BY LOCAL ORGANIZATIONS (I.E., UNITED WAY, BRIGHTPOINT, ETC.) 4. PARKVIEW LEADERS SERVING ON HEALTH-RELATED AND SOCIAL SERVICE BOARDS OF DIRECTORS IN THE COMMUNITY5. OTHER PUBLIC HEALTH DATABASES (E.G. COMMUNITY COMMONS, COUNTY HEALTH RANKINGS) KEY HOSPITAL REPRESENTATIVES MAINTAIN ON-GOING RELATIONSHIPS THROUGHOUT THE COMMUNITY AND MEET REGULARLY WITH ORGANIZATIONS THAT SHARE THE MISSION OF IMPROVING THE HEALTH AND INSPIRING THE WELL-BEING OF THE COMMUNITY WE SERVE.
PART VI, LINE 3: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.SIGNAGE AND BROCHURES ARE POSTED AND AVAILABLE AT ALL HOSPITAL POINTS OF REGISTRATION AND IN THE EMERGENCY DEPARTMENT. PATIENTS ARE OFFERED PLAIN LANGUAGE SUMMARIES OF THE FINANCIAL ASSISTANCE POLICY DURING THE REGISTRATION PROCESS AND IN EACH FOLLOW UP STATEMENT SENT TO THE PATIENT. PATIENT STATEMENTS WILL INDICATE HOW A PATIENT CAN OBTAIN FINANCIAL ASSISTANCE APPLICATIONS AND WHO THEY CAN CONTACT FOR ASSISTANCE.
PART VI, LINE 4:DESCRIBE THE COMMUNITY THE ORGANIZATION SERVES, TAKING INTO ACCOUNT THE GEOGRAPHIC AREA AND DEMOGRAPHIC CONSTITUENTS IT SERVES.PARKVIEW WABASH HOSPITAL, INC., IS LOCATED IN WABASH COUNTY, AND IS THE ONLY FULL-SERVICE HOSPITAL IN WABASH COUNTY. PARKVIEW WABASH HOSPITAL, INC., PRIMARILY SERVES THE COMMUNITIES OF WABASH, NORTH MANCHESTER, ROANN, URBANA, LAGRO AND LAFOUNTAINE. TO A LESSER EXTENT, THE HOSPITAL SERVES COMMUNITIES IN SURROUNDING COUNTIES, TO INCLUDE MIAMI COUNTY, SOUTHERN KOSCIUSKO COUNTY AND NORTHERN GRANT COUNTY. ACCORDING TO CONDUENT HEALTHY COMMUNITIES INSTITUTE (HCI), WABASH COUNTY, IS A RURAL AREA WITHIN THE HEALTH SYSTEM'S SERVICE AREA WITH A POPULATION OF 30,816 (2021). IN ADDITION, HCI REPORTS THE MEDIAN HOUSEHOLD INCOME OF WABASH COUNTY RESIDENTS IS APPROXIMATELY $59,611 WITH 12.4% LIVING BELOW THE FEDERAL POVERTY LEVEL (2017-2021). APPROXIMATELY 90.8% OF WABASH COUNTY RESIDENTS HAVE HEALTH INSURANCE (2020). ACCORDING TO THE INDIANA HOSPITAL ASSOCIATION DIMENSIONS DATABASE (2022), PARKVIEW WABASH HOSPITAL, INC. HAD 13.5% OF INPATIENT DISCHARGES THAT WERE MEDICAID PATIENTS AND 1.9% WERE SELF-PAY. FOR OUTPATIENT PROCEDURES, 19.5% WERE MEDICAID PATIENTS, AND 2.4% PERCENT WERE SELF-PAY. HEALTH RESOURCES & SERVICES ADMINISTRATION (HRSA), AN AGENCY OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, DEVELOPS SHORTAGE DESIGNATION CRITERIA INTENDED TO IDENTIFY A GEOGRAPHIC AREA, POPULATION GROUP OR FACILITY AS A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) OR A MEDICALLY UNDERSERVED AREA OR POPULATION (MUA/P). HEALTH RESOURCES & SERVICES ADMINISTRATION (HRSA) HAS DESIGNATED/IDENTIFIED THE FOLLOWING MEDICALLY UNDERSERVED AREAS/POPULATIONS AND HEALTH PROFESSIONAL SHORTAGE AREAS:WABASH COUNTY:1) DISCIPLINE: PRIMARY CAREMUA/P ID: 1181155511SERVICE AREA NAME: LOW INCOME - WABASH COUNTYDESIGNATION TYPE: MUP LOW INCOMEINDEX OF MEDICAL UNDERSERVICE SCORE: 57.7 STATUS: DESIGNATEDRURAL STATUS: RURAL2) DISCIPLINE: MENTAL HEALTHHSPA ID: 7186918305HPSA NAME: MENTAL HEALTH CATCHMENT AREA 28 - WARSAWDESIGNATION TYPE: GEOGRAPHIC HPSACOUNTY NAME: HUNTINGTON, KOSCIUSKO, MARSHALL, WABASH, AND WHITLEY COUNTIESHPSA SCORE:17 STATUS: DESIGNATEDRURAL STATUS: PARTIALLY RURAL
PART VI, LINE 5: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 (EG OPEN MEDICAL STAFF, COMMUNITY BOARD, USE OF SURPLUS FUNDS, ETC.)THE MAJORITY OF THE PARKVIEW WABASH HOSPITAL, INC. BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY MEMBERS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THE HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.PEOPLE IN OUR SERVICE AREA HAVE ACCESS TO CARE 24 HOURS A DAY, 365 DAYS A YEAR THROUGH PARKVIEW WABASH HOSPITAL, INC.'S EMERGENCY DEPARTMENT (ED). THE ED IS STAFFED WITH BOARD-CERTIFIED EMERGENCY CARE PHYSICIANS, PHYSICIAN ASSISTANTS AND A NURSING STAFF THAT IS TRAINED AND EXPERIENCED IN EMERGENCY CARE. ADDITIONALLY, THE HOSPITAL OFFERS FIRST CARE, A WALK-IN CLINIC OPEN FROM 8 A.M. TO 8 P.M. MONDAY THROUGH FRIDAY AND 8 A.M. TO 2 P.M. ON SATURDAY AND SUNDAY.FURTHERMORE, NO PATIENT IS EVER DENIED TREATMENT, REGARDLESS OF THEIR ABILITY TO PAY, AND PARKVIEW WABASH HOSPITAL, INC. AND ITS AFFILIATES CONTINUE TO ADAPT TO MEET THE NEEDS OF THE COMMUNITY.OUR CARE IS NOT LIMITED TO THE WALLS OF OUR BUILDING. PARKVIEW WABASH HOSPITAL, INC., IS ACTIVE IN THE COMMUNITY IN A VARIETY OF WAYS.A FEW HIGHLIGHTS INCLUDE:--ONCOLOGY - THE PARKVIEW WABASH HOSPITAL, INC.'S, ONCOLOGY PROGRAM OFFERS CANCER PATIENTS ADVANCED CHEMOTHERAPY TREATMENT CLOSE TO HOME. ADDITIONALLY, THE DEPARTMENT ENCOURAGES SUPPORT BEYOND TREATMENT BY PROVIDING FREE SCREENINGS AND CLINICAL TRIALS. --MEALS ON WHEELS - THE HOSPITAL'S NUTRITION CARE SERVICES DEPARTMENT PACKAGES PREPARED MEALS EACH WEEK FOR ABOUT 20 LOW-INCOME RESIDENTS. COMMUNITY VOLUNTEERS DELIVER THOSE MEALS TO THEIR HOMES.--BLESSINGS IN A BACKPACK - ONE EVENING EACH MONTH DURING THE SCHOOL YEAR, PARKVIEW WABASH HOSPITAL, INC., MANAGERS VOLUNTEER AN EVENING PACKING ABOUT 600 BAGS OF FOOD FOR AREA CHILDREN IN NEED, GRADES KINDERGARTEN THROUGH SIXTH. THE FOOD BAGS ARE INTENDED TO HELP THE FAMILIES GET THROUGH THE WEEKEND.--HOT DOG MINISTRY - PARKVIEW WABASH HOSPITAL, INC., LEADERS SERVE LOW INCOME FAMILIES A MEAL EVERY TUESDAY DURING THE SUMMER AND TWICE A MONTH DURING THE WINTER. IT IS A PROGRAM RUN BY FIRST UNITED METHODIST CHURCH AND OUR TEAM IS HAPPY TO HELP APPROXIMATELY 85 PEOPLE EACH WEEK IN THE SUMMER AND ABOUT 20 EACH WEEK IN THE WINTER.--SCHOOL EDUCATION - THE HOSPITAL PROVIDES A WEEKLY 45-MINUTE EDUCATION SESSION TO ANY HIGH SCHOOL OR MIDDLE SCHOOL STUDENT WHO SELF-IDENTIFIES AS WANTING TO QUIT VAPING. IT IS LEAD BY A LICENSED MENTAL HEALTH COUNSELOR. THEY DISCUSS TRIGGERS, TOOLS TO QUIT AND THE DANGERS OF VAPING. IN 2022, SIX STUDENTS ATTENDED SESSIONS, WITH ONE SUCCESSFULLY QUITTING.--BRIANNA'S HOPE - THE SECOND THURSDAY OF EVERY MONTH, A TEAM OF PARKVIEW WABASH HOSPITAL, INC., MANAGERS AND STAFF SUPPLY A MEAL FOR AN ADDICTION RECOVERY SUPPORT GROUP. THEY SERVE APPROXIMATELY 20 PEOPLE.EVERY MEMBER OF THE PARKVIEW WABASH HOSPITAL, INC., HEALTHCARE TEAM, REGARDLESS OF THEIR DEPARTMENT, IS RESPONSIBLE FOR NURTURING AN ENVIRONMENT OF EXCELLENCE AS THE PLACE PATIENTS WANT TO RECEIVE CARE, PHYSICIANS WANT TO PRACTICE, AND CO-WORKERS WANT TO WORK. WE UNDERSTAND THAT BY PROVIDING EXCELLENCE IN ALL WE DO, WE NOT ONLY ENSURE THE SUCCESS OF PARKVIEW WABASH HOSPITAL, INC., BUT ALSO FOR THE COMMUNITY WE SERVE.
PART VI, LINE 6:IF THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM, DESCRIBE THE RESPECTVE ROLES OF THE ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED.PARKVIEW HEALTH SYSTEM, INC. (PARKVIEW), A HEALTHCARE SYSTEM SERVING NORTHEAST INDIANA AND NORTHWEST OHIO THROUGH OUR HOSPITALS AND PHYSICIAN CLINICS, INCLUDES THE NOT-FOR-PROFIT HOSPITALS OF PARKVIEW HOSPITAL, INC.; COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.; COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.; DEKALB MEMORIAL HOSPITAL, INC.; HUNTINGTON MEMORIAL HOSPITAL, INC.; PARK CENTER, INC.; PARKVIEW WABASH HOSPITAL, INC.; WHITLEY MEMORIAL HOSPITAL, INC.; AS WELL AS 60 PERCENT OWNERSHIP IN THE JOINT VENTURE OF ORTHOPEDIC HOSPITAL AT PARKVIEW NORTH, LLC.EACH HOSPITAL ENTITY ENGAGES IN COMMUNITY OUTREACH ACTIVITIES CUSTOMIZED TO MEET THE UNIQUE HEALTH NEEDS OF THEIR RESPECTIVE COMMUNITIES. AFFILIATE HOSPITALS ALSO WORK TOGETHER AND SHARE PROGRAMMING AND MESSAGING WHERE COMMON COMMUNITY HEALTH ISSUES ARE IDENTIFIED. FROM THE LIST OF HEALTH ISSUES IDENTIFIED IN NORTHEAST INDIANA AS PART OF THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT, THE HEALTH PRIORITY OF MENTAL HEALTH WAS SELECTED BY ALL AFFILIATE HOSPITALS.AFFILIATE HOSPITALS EACH HAVE A LOCAL BOARD OF DIRECTORS. PARKVIEW HEALTH SYSTEM, INC. ALSO ENGAGES WITH A BOARD OF DIRECTORS THAT CONSISTS OF REPRESENTATION FROM EACH OF THE AFFILIATE HOSPITAL BOARDS AND UP TO 15 AT-LARGE PHYSICIANS OR COMMUNITY LEADERS. MOST OF THE BOARD OF DIRECTORS SHALL ALWAYS BE INDEPENDENT AS DEFINED BY THE INTERNAL REVENUE SERVICE (IRS). PARKVIEW CONTRIBUTES TO THE OVERALL SUCCESS OF THE REGION THROUGH SIGNIFICANT INVOLVEMENT IN THE COMMUNITIES WE SERVE. BY DEVELOPING VARIOUS PARTNERSHIPS AND ALIGNMENTS WITH DIFFERENT SECTORS AND ORGANIZATIONS, PARKVIEW HELPS TO BENEFIT THE ECONOMY, QUALITY OF LIFE, AND HEALTH AND WELL-BEING ACROSS THE REGION. WITH A CONSISTENT FOCUS ON OUR MISSION AND VISION, WE WORK TO PROVIDE EXCELLENT CARE TO EVERY PERSON, EVERY DAY WITHIN OUR FACILITIES WHILE SERVING AS GOOD STEWARDS OF SURPLUS FUNDS TO POSITIVELY IMPACT COMMUNITY HEALTH STATUS.
PART VI, LINE 7, REPORTS FILED WITH STATESIN
PART VI, LINE 7 CONT'D:A COPY OF FORM 990, SCHEDULE H IS FILED WITH THE INDIANA STATE DEPARTMENT OF HEALTH.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
OTIS R BOWEN CENTER FOR HUMAN SERVICES INC
2621 EAST JEFFERSON STWARSAWIN46581351057889501(C)(3)$8,000$0WABASH COUNTY TOBACCO FREE COALITION PROGRAMS
BLESSINGS IN A BACK PACK
4121 SHELBYVILLE ROADLOUISVILLEKY40207261964620501(C)(3)$6,000$0RESOURCES TO PROVIDE FOOD FOR ELEMENTARY SCHOOL CHILDREN WHO MIGHT OTHERWISE GO HUNGRY
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationCOMMUNITY HEALTH IMPROVEMENT FUNDING PARTNER ORGANIZATIONS ARE REQUIRED TO SUBMIT AN ANNUAL PROGRESS REPORT RELATED TO PROGRAM FUNDING. PARTNER ORGANIZATIONS ARE REQUIRED TO RE-APPLY FOR FUNDING ON AN ANNUAL BASIS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Discretionary Spending AcctYes (X)DiscretionarySpendingAcctInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MICHAEL PACKNETT
DIRECTOR/PH PRESIDENT & CEO$0$1,330,197$0$664,677$0$607,967$0$302,282$0$36,017$0$2,941,140$0$577,374
JEANNE' WICKENS
PH CHIEF FINANCIAL OFFICER$0$804,432$0$363,922$0$96,046$0$325,215$0$32,552$0$1,622,167$0$70,644
DOUGLAS SPARKS
DIRECTOR/PH PHYSICIAN$23,437$423,139$0$42,896$0$28,356$1,518$32,032$1,779$37,529$26,734$563,952$0$0
CATHY WOLFE
WBHOS VP PATIENT CARE SVCS$161,304$0$49,637$0$3,586$0$15,198$0$28,238$0$257,963$0$0$0
DEBRA POTEMPA
DIRECTOR/WBHOS PRESIDENT$164,199$0$750$25,000$0$27,904$21,024$6,743$7,976$2,558$193,949$62,205$0$0
JAMI METZGER
WBHOS NURSE PRACTITIONER$158,887$0$17,533$0$1,170$0$16,314$0$32,602$0$226,506$0$0$0
MARILYN CUSTER-MITCHELL
DIRECTOR-PARTIAL YR/WBHOS PRESIDENT$64,475$0$92,640$0$43,565$0$5,298$0$12,312$0$218,290$0$23,937$0
PAULA OPHEIM
WBHOS MGR PHARMACY$155,595$0$23,920$0$270$0$12,691$0$17,057$0$209,533$0$0$0
GRACE STANLEY
WBHOS NURSE PRACTITIONER$134,396$0$12,386$0$2,140$0$13,307$0$12,455$0$174,684$0$0$0
LISA KROH
WBHOS PHARMACIST$154,161$0$750$0$774$0$17,040$0$1,127$0$173,852$0$0$0
MELANIE ZOLMAN
WBHOS NURSE PRACTITIONER$128,326$591$12,117$0$7,861$0$10,380$41$12,360$49$171,044$681$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ADISCRETIONARY SPENDING ACCOUNT - TAXABLE DISCRETIONARY SPENDING ACCOUNT PAID TO: JAMI METZGER $900; GRACE STANLEY $1,000; MELANIE ZOLMAN $908
PART I, LINE 3RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF PARKVIEW WASBASH HOSPITAL, INC.'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. INDEPENDENT COMPENSATION CONSULTANT FORM 990 OF OTHER ORGANIZATIONS COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC.
PART I, LINE 4BSUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS THE FOLLOWING INDIVIDUALS PARTICIPATE IN SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLANS. BENEFITS EARNED UNDER THE PLANS WILL FUND THE EMPLOYEES' EVENTUAL RETIREMENT BENEFIT. THESE BENEFITS ARE PROVIDED IN EXCHANGE FOR THE EMPLOYEES' YEARS OF SERVICE TO THE ORGANIZATION AND THE AMOUNT OF THE BENEFITS MAY VARY FROM YEAR TO YEAR. THE FOLLOWING INDIVIDUALS VESTED IN A PORTION OF THEIR DEFERRED COMPENSATION PLANS, WHICH IS TREATED AS TAXABLE INCOME TO THE INDIVIDUALS AT THE TIME OF VESTING. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III): MARILYN CUSTER-MITCHELL $23,937; MICHAEL PACKNETT $577,374; JEANNE' WICKENS $70,644 AMOUNTS LISTED ABOVE THAT HAVE BEEN REPORTED AS DEFERRED COMPENSATION ON PRIOR FORM 990 WILL ALSO BE REFLECTED IN SCHEDULE J, PART II, COLUMN (F). FOR EXAMPLE, THE AMOUNT OF $577,374 REPORTED AS REQUIRED FOR MR. PACKNETT WAS A RESULT OF THE VESTING OF SUCH AMOUNT UNDER THE TERMS OF THE RESPECTIVE PLANS. HOWEVER, THESE AMOUNTS WERE PREVIOUSLY REPORTED IN MR. PACKNETT'S DEFERRED COMPENSATION OVER MORE THAN 10 YEARS AS THE AMOUNTS WERE DEFERRED UNDER THE PLANS. AS SUCH, THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN (F) IS AN INDICATION OF AMOUNTS THAT HAVE BEEN REPORTED TWICE, ONCE AS A DEFERRAL AND ONCE AS VESTED. THE FOLLOWING INDIVIDUALS HAVE AN AMOUNT INCLUDED IN SCHEDULE J, PART II, COLUMN (C) FOR AN AMOUNT EARNED BUT NOT YET VESTED UNDER ONE OF PARKVIEW'S DEFERRED COMPENSATION PLANS. THE AMOUNTS ARE AT RISK AND WILL NOT BE PAID UNLESS AND UNTIL EACH EMPLOYEE HAS PROVIDED SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION. BENEFITS UNDER THE PLANS VEST AT THE TIME SET FORTH IN THE PLAN DOCUMENTS AND ARE FORFEITED IF THE EMPLOYEES TERMINATE EMPLOYMENT BEFORE SATISFYING THOSE PLAN CONDITIONS. DEFERRALS REPORTED IN SCHEDULE J, PART II, COLUMN (C) INCLUDE: MICHAEL PACKNETT $268,732; DEBRA POTEMPA $27,767; JEANNE' WICKENS $303,865
PART I, LINE 7MANAGEMENT INCENTIVE COMPENSATION PLAN (MICP) AND PHYSICIAN AND PROVIDER INCENTIVE COMPENSATION PLAN (PICP) ARE ANNUAL INCENTIVE PROGRAMS. SYSTEM GOALS ARE APPROVED BY THE BOARD. AT CONCLUSION OF THE PLAN YEAR, RESULTS ARE SHARED WITH THE BOARD AND THE EXECUTIVE COMMITTEE OF THE BOARD APPROVES FINAL PAYMENT.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1INDIANA FINANCE AUTHORITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN351602316BondIssuerEIN
CUSIPNONEAVAILCUSIPNum
Bond Issued2016-08-17BondIssuedDt
Issue Price$25,000,000IssuePriceAmt
PurposeSEE PART VIPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$3,675,000RetiredAmt
Total Proceeds$25,247,064TotalProceedsAmt
Capital Expenditures$25,247,064CapitalExpendituresAmt
Substantial Completion2018SubstantialCompletionYr
Refunding Tax Exempt Bonds0RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease ArrangementsYes (1)AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate DueYes (1)NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE K, PART I, COLUMN F, LINE A:CONSTRUCTION OF NEW HOSPITAL FACILITY FOR PARKVIEW WABASH HOSPITAL, INC. IN WABASH, INDIANA
SCHEDULE K, PART II, COLUMN A, LINE 3:THIS AMOUNT INCLUDES INTEREST OF $247,064. EARNED ON PROJECT FUND.
SCHEDULE K, PART III, COLUMN A, LINE 7:BECAUSE PARKVIEW MONITORS THE PRIVATE BUSINESS USE PERCENTAGE FOR EACH BOND ISSUE, TO ENSURE THAT THE PRIVATE BUSINESS USE LIMIT IS NOT EXCEEDED, PARKVIEW DOES NOT CALCULATE THE AMOUNT OF PRIVATE PAYMENTS.
SCHEDULE K, PART IV, COLUMN A, LINE 2C:REBATE CALCULATION PERFORMED ON JANUARY 23, 2019.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINES 1A AND 2A:PARKVIEW HEALTH SYSTEM, INC. (PH), EIN 35-1972384, IS THE COMMON PAYING AGENT FOR THE FILING ORGANIZATION, PARKVIEW WABASH HOSPITAL, INC., EIN 47-1753440. THEREFORE, ALL APPLICABLE IRS TAX FILINGS, INCLUDING FORMS 1099, 1096, W-2 AND W-3 ARE REPORTED AND FILED BY PH. THE TOTAL NUMBER REPORTED IN BOX 3 OF FORM 1096 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2022 WAS 627. THE TOTAL NUMBER OF EMPLOYEES REPORTED ON FORM W-3 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2022 WAS 17,284. FOR PURPOSES OF COMPLETING FORM 990, PART V, LINE 1A AND 2A, THE NUMBER REPORTED FOR THE PARKVIEW WABASH HOSPITAL, INC. WAS 34 AND 245 RESPECTIVELY.
FORM 990, PART VI, SECTION A, LINE 1ATHE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE OFFICERS OF THE BOARD, THE PRESIDENT OF THE CORPORATION, THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATE MEMBER OR HIS/HER DESIGNEE, THE CURRENT PRESIDENT OF THE MEDICAL STAFF AND SUCH OTHER PERSONS AS IDENTIFIED BY THE CHAIR OF THE BOARD, EACH OF WHOM SHALL BE ENTITLED TO VOTE. IN NO EVENT SHALL THE MEMBERS OF THE EXECUTIVE COMMITTEE EXCEED EIGHT (8) PEOPLE. THE EXECUTIVE COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION IN ANY MATTER WHEN THE BOARD IS NOT IN SESSION, REPORTING TO THE BOARD FOR ITS RATIFICATION OF ITS ACTION. THE CHAIR OF THE BOARD SHALL SERVE AS CHAIR OF THE EXECUTIVE COMMITTEE. MEETINGS OF THE EXECUTIVE COMMITTEE MAY BE CALLED BY THE CHAIR OR BY THREE (3) MEMBERS.
FORM 990, PART VI, SECTION A, LINE 2DIRECTOR/OFFICER HOWARD HALDERMAN AND DIRECTOR PARKER BEAUCHAMP HAVE A BUSINESS RELATIONSHIP AS DIRECTORS ON THE BOARD OF AN UNRELATED ENTITY. DIRECTOR/OFFICER MICHAEL PACKNETT AND OFFICER JEANNE' WICKENS HAVE BUSINESS RELATIONSHIPS AS OFFICERS OF RELATED ENTITIES.
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION IS ORGANIZED AS A NOT-FOR-PROFIT CORPORATION. PURSUANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, PARKVIEW HEALTH SYSTEM, INC. EIN 35-1972384 IS THE SOLE MEMBER OF PARKVIEW WABASH HOSPITAL, INC. WITH CERTAIN RESERVED POWERS.
FORM 990, PART VI, SECTION A, LINE 7ATHE CORPORATE MEMBER, PARKVIEW HEALTH SYSTEM, INC. EIN 35-1972384, SHALL HAVE THE FOLLOWING RESERVED POWERS: (I) APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, MEMBERS OF THE BOARD SUBJECT TO THE COMPOSITION REQUIREMENTS REGARDING COMMUNITY AND PHYSICIAN REPRESENTATION SET FORTH IN ARTICLE V, SECTION 2; (II) APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE CHAIR AND VICE CHAIR OF THE BOARD AND THE PRESIDENT OF THE CORPORATION; (III) APPROVE AND/OR REQUIRE THE ADOPTION OF AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (IV) APPROVE AND/OR REQUIRE THE ESTABLISHMENT, ACQUISITION, DIVESTITURE, DISSOLUTION, CLOSURE, MERGER, CONSOLIDATION, CHANGE IN CORPORATE MEMBERSHIP, AFFILIATION OR CORPORATE REORGANIZATION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (V) APPROVE AND ADOPT THE STRATEGIC PLAN AND ANY AMENDMENTS THERETO FOR THE CORPORATION AND ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (VI) APPROVE AND/OR REQUIRE THE INCURRENCE OF ANY DEBT, INCLUDING THE ISSUANCE OF ANY BONDS, PROPOSED BY THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION IN EXCESS OF LIMITS SPECIFIED IN THE POLICY OF THE CORPORATE MEMBER; (VII) APPROVE AND/OR REQUIRE THE APPROVAL OF CONTRACTS OR LOANS OBLIGATING THE CORPORATION TO EXPEND OR REPAY AN AMOUNT IN EXCESS OF LIMITS SPECIFIED IN THE POLICY OF THE CORPORATE MEMBER; (VIII) APPROVE AND/OR REQUIRE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE, TRANSFER, ENCUMBRANCE OR OTHER DISPOSITION OF PROPERTY AND ASSETS OF THE CORPORATION IN EXCESS OF LIMITS SPECIFIED IN THE POLICY OF THE CORPORATE MEMBER; (IX) APPROVE AND ADOPT THE CAPITAL BUDGET, OPERATING BUDGET, FINANCIAL PLANS AND ANY AMENDMENTS THERETO FOR THE CORPORATION AND ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (X) APPROVE AND/OR REQUIRE THE ADOPTION OF A MANAGED CARE POLICY FOR THE CORPORATION AND ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION, INCLUDING NETWORK PARTICIPATION, PARTICIPATION IN ANY MANAGED CARE AGREEMENT AND PARTICIPATION IN ANY OTHER HEALTH CARE SERVICE ARRANGEMENTS; (XI) APPOINT AND REMOVE AUDITORS, ATTORNEYS AND OTHER PROFESSIONAL ADVISORS FOR THE CORPORATION AND ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (XII) DEVELOP, APPROVE AND/OR REQUIRE THE ADOPTION OF MEDICAL STAFF QUALITY ASSURANCE STANDARDS, UTILIZATION REVIEW STANDARDS, CRITERIA, POLICIES AND PROCEDURES FOR THE CORPORATION AND ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (XIII) APPROVE AND/OR REQUIRE THE ADOPTION OF ANY ACTION TO CHANGE THE CORPORATION FROM A GENERAL, ACUTE CARE COMMUNITY HOSPITAL OR TO CLOSE THE CORPORATION'S CURRENT LOCATION; (XIV) APPROVE EACH ANNUAL LIST OF PROPOSED DONORS AND AMOUNTS OF DONATIONS OR GRANTS NOT INCLUDED IN THE ANNUAL BUDGET, AND MAKE PROPOSALS TO DEVIATE THEREFROM THROUGHOUT EACH YEAR IN EXCESS OF LIMITS SPECIFIED IN THE POLICY OF THE CORPORATE MEMBER; AND (XV) APPROVE AND/OR REQUIRE THE ADOPTION OF ANY ACTION THAT IS INCONSISTENT WITH THE POLICY OF THE CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7BSEE SCHEDULE O EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A
FORM 990, PART VI, SECTION B, LINE 11BPURSUANT TO PARKVIEW HEALTH SYSTEM INC.'S BYLAWS, THE SYSTEM AUDIT COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION TO PROVIDE REVIEW OF THE CORPORATION AND ITS SUBSIDIARY CORPORATIONS' FORM 990 FILINGS. PARKVIEW WABASH HOSPITAL, INC. IS A SUBSIDIARY CORPORATION OF PARKVIEW HEALTH SYSTEM, INC. AN ELECTRONIC COPY OF THE ORGANIZATION'S FINAL FORM 990 (INCLUDING SUPPLEMENTAL SCHEDULES) WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY AND THE SYSTEM AUDIT COMMITTEE, PRIOR TO FILING WITH THE IRS. ON OCTOBER 24, 2023, THE SYSTEM AUDIT COMMITTEE REVIEWED THE FORM 990 AS ULTIMATELY FILED WITH THE IRS. THIS REVIEW INCLUDED A PRESENTATION BY THE ORGANIZATION'S TAX PREPARER TO HIGHLIGHT THE SIGNIFICANT AREAS ON THE FORM 990 AND SUPPLEMENTAL SCHEDULES.
FORM 990, PART VI, SECTION B, LINE 12CAS DESCRIBED IN ARTICLE IX SECTION 6, OF THE PARKVIEW HEALTH SYSTEM, INC. (PH) BYLAWS, PH ADOPTED PH'S COMPLIANCE POLICY FOR THE ORGANIZATION AND ITS NOT-FOR-PROFIT RELATED ORGANIZATIONS (AND AS LIKEWISE NOTED IN THEIR BYLAWS) WHEN ADDRESSING CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. THIS COMPLIANCE POLICY (COMPLIANCE POLICY #14) REQUIRES THAT EACH BOARD MEMBER, BOARD COMMITTEE MEMBER, AND KEY MANAGEMENT PERSONNEL MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST FORM. THIS INFORMATION IS PROVIDED TO THE CHAIRMAN OF THE BOARD (FOR BOARD AND BOARD COMMITTEE MEMBERS) AND TO SENIOR MANAGEMENT (FOR KEY MANAGEMENT PERSONNEL). IN ADDITION, AS TO THE CONDUCT OF BOARD MEETINGS, THE FOLLOWING PROCESS IS FOLLOWED: "WHENEVER A PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE IS CONSIDERING A TRANSACTION OR ARRANGEMENT WITH AN ORGANIZATION, ENTITY OR INDIVIDUAL IN WHICH A PERSON COVERED BY THIS POLICY HAS A FINANCIAL OR CONFLICTING INTEREST, THE FOLLOWING SHALL OCCUR: 1. THE INTERESTED PERSON MUST DISCLOSE THE FINANCIAL OR CONFLICTING INTEREST AND ALL MATERIAL FACTS TO THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE; 2. THE INTERESTED PERSON WITH THAT FINANCIAL OR CONFLICTING INTEREST MAY MAKE A PRESENTATION AT THE BOARD OR BOARD COMMITTEE MEETING REGARDING THE TRANSACTION OR ARRANGEMENT HOWEVER, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE FINANCIAL OR CONFLICTING INTEREST; AND 3. THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE MUST APPROVE THE TRANSACTION OR ARRANGEMENT BY A MAJORITY VOTE OF THE BOARD MEMBERS PRESENT AT A MEETING THAT HAS A QUORUM, NOT INCLUDING THE VOTE OF THE INTERESTED PERSON. THE INTERESTED PERSON MAY NOT VOTE ON THE MATTER. A. UPON THE REQUEST OF PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE, THE MATTER MAY BE DELEGATED TO THE PH COMPLIANCE COMMITTEE FOR EVALUATION, RECOMMENDATION AND/OR DETERMINATION. 4. WHENEVER A FINANCIAL OR CONFLICTING INTEREST IS ADDRESSED BY A PH OR PH AFFILIATE BOARD, NOTICE SHALL BE GIVEN TO THE PH COMPLIANCE OFFICER / GENERAL COUNSEL."
FORM 990, PART VI, SECTION B, LINE 15LINES 15A AND 15B ARE ANSWERED NO IN ACCORDANCE WITH THE IRS INSTRUCTIONS. TO THE EXTENT THAT THE ORGANIZATION HAS A VICE PRESIDENT OR ABOVE, THE RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., HAS A PROCESS IN PLACE FOR DETERMINING COMPENSATION OF THE CEO, OFFICERS, AND KEY EMPLOYEES. THE PROCESS INCLUDES CONSULTATIONS WITH AN INDEPENDENT COMPENSATION ADVISOR AND THE REVIEW OF APPROPRIATE COMPARABILITY DATA; REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE OF THE GOVERNING BODY CONSISTING OF MEMBERS WHO DO NOT HAVE A CONFLICT OF INTEREST CONCERNING THE COMPENSATION; AND CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. IN 2022, THE COMPENSATION COMMITTEE OF PARKVIEW HEALTH SYSTEM, INC. REVIEWED AND APPROVED ALL EXECUTIVE COMPENSATION, BENEFITS, AND PERQUISITES FOR THE 2022 COMPENSATION PACKAGE, PURSUANT TO THE PARKVIEW HEALTH BYLAWS. THE COMPENSATION PACKAGE WAS APPROVED BY A MAJORITY OF INDEPENDENT COMPENSATION COMMITTEE MEMBERS. PARKVIEW'S INDEPENDENT CONSULTANT PREPARES A COMPETITIVE COMPENSATION ANALYSIS USING DATA FROM MULTIPLE PUBLISHED SURVEYS PREPARED BY INDEPENDENT FIRMS FOR POSITIONS THAT ARE FUNCTIONALLY COMPARABLE IN SIMILAR-SIZED HEALTH SYSTEMS AND HOSPITAL ORGANIZATIONS ON BOTH A REGIONAL AND NATIONAL BASIS. THE INDEPENDENT CONSULTANT PROVIDES A STATEMENT OF REASONABLENESS OF THE COMPENSATION PROVIDED TO THE CEO AS WELL AS ALL EXECUTIVES AT THE VICE PRESIDENT LEVEL AND ABOVE. ALL DATA IS SHARED WITH THE BOARD OF DIRECTORS. THE BOARD APPROVES ANY CHANGES IN COMPENSATION FOR THE CEO AND THEIR DIRECT REPORTS. APPROVAL IS ALSO PROVIDED FOR THE SALARY BUDGET FOR THE ENTIRE ORGANIZATION. THE BOARD REVIEWS AND APPROVES THE PLAN DOCUMENTS FOR THE MANAGEMENT INCENTIVE COMPENSATION PLAN (MICP) AND THE PHYSICIAN AND PROVIDER INCENTIVE COMPENSATION PLAN (PICP).
FORM 990, PART VI, SECTION C, LINE 19COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GOTHER: PROGRAM SERVICE EXPENSES 1,034,946. MANAGEMENT AND GENERAL EXPENSES 102,083. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,137,029. RHC OPERATIONS: PROGRAM SERVICE EXPENSES 7,849,940. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,849,940. MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,334,684. MANAGEMENT AND GENERAL EXPENSES 404,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,738,684. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 2,205,282. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,205,282. COLLECTIONS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 257,017. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 257,017.
FORM 990, PART IX, LINES 5-10:PARKVIEW HEALTH SYSTEM, INC., EIN 35-1972384, SERVES AS THE COMMON PAYING AGENT FOR ALL TAX-EXEMPT ORGANIZATIONS OF THE SYSTEM. SALARIES AND WAGES OF EMPLOYEES WORKING FOR THESE ORGANIZATIONS ARE CHARGED DIRECTLY TO THE ORGANIZATIONS IN WHICH THEY WORK. THE ACTUAL EXPENSES FOR PAYROLL TAXES, EMPLOYEE BENEFITS, AND PENSION PLAN CONTRIBUTIONS ARE REFLECTED ON THE BOOKS OF PARKVIEW HEALTH SYSTEM, INC. FOR FINANCIAL REPORTING PURPOSES. TO ACCOUNT FOR BENEFIT COSTS ON THE BOOKS OF THE OTHER TAX EXEMPT ORGANIZATIONS, AN ALLOCATION METHODOLOGY IS UTILIZED TO CHARGE THESE ORGANIZATIONS WITH AN ESTIMATE OF THE OVERALL COSTS, REFERRED TO AS A "BENEFIT ALLOCATION" FROM PARKVIEW HEALTH SYSTEM, INC. THE ALLOCATION DOES NOT DISTINGUISH BETWEEN THE COSTS OF THE VARIOUS COMPONENTS (I.E. PAYROLL TAXES, EMPLOYEE BENEFITS, AND PENSION PLAN CONTRIBUTIONS). THEREFORE, FOR PURPOSES OF THE FORM 990, PART IX, THE TOTAL BENEFIT ALLOCATION FOR THE EMPLOYEES' SALARIES AND WAGES REPORTED ON LINE 7 IS REFLECTED ON LINE 9 AND NOT ALLOCATED BETWEEN LINES 8 OR 10. FOR PURPOSES OF THE FORM 990, PART IX, LINES 5 AND 6 REFLECT COMPENSATION AND BENEFIT AMOUNTS REPORTED IN PART VII.
FORM 990, PART XI, LINE 9:ASSET TRANSFERS/ADJUSTMENTS 73,738.

Schedule R IRS990ScheduleR

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Transactions Related Org TransactionsRelatedOrgGrp

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FieldValueIRS element (for citing)
Business Name Line1PARKVIEW WABASH HOSPITAL FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeMTransactionTypeTxt
Involved$64,409InvolvedAmt
Method Of Amount DeterminationPART VII SUPPLEMENTAL INFORMATIONMethodOfAmountDeterminationTxt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART V, LINE 2, COLUMN (C):FormAndLineReferenceDesc
ExplanationTHE AMOUNTS REPORTED AS TRANSACTIONS WITH RELATED ORGANIZATIONS ARE CONSISTENT WITH THE AMOUNTS REPORTED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS UNDER THE GENERALLY ACCEPTED ACCOUNTING STANDARDS DEPENDING ON THE TYPE OF TRANSACTION INVOLVED.ExplanationTxt