COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC (EIN 20-2401676)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-09
- IRS object ID
- 202333139349305268
- 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
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-09T16:27:26-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 E LAS OLAS BLVD SUITE 1100 | AddressLine1Txt |
| City | FORT LAUDERDALE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 202401676 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL OF LAGRANGE COUNTY | BusinessNameLine1Txt |
| Business Name Line2 | INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 2603738429 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 207 N TOWNLINE RD | AddressLine1Txt |
| City | LAGRANGE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 467611325 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEANNE' WICKENS | PersonNm |
| Person Title | PH CFO | PersonTitleTxt |
| Phone | 2602669313 | PhoneNum |
| Signature | 2023-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JEANNE | PersonFirstNm |
| Person Last | WICKENS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BRITTNEY KOCAJ | PreparerPersonNm |
| PTIN | P01320603 | PTIN |
| Phone | 9542028600 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PARKVIEW LAGRANGE HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RICK HENVEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1450 PRODUCTION RD | AddressLine1Txt |
| City | FORT WAYNE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 468081167 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $42,693,641 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PARKVIEW.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2005 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | IMPROVE HEALTH & PROVIDE QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 170 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,170,811 | PYContributionsGrantsAmt |
| CY Contributions Grants | $137,175 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $41,164,589 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $42,242,017 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$6,820 | PYInvestmentIncomeAmt |
| CY Investment Income | $2 | CYInvestmentIncomeAmt |
| PY Other Revenue | $263,625 | PYOtherRevenueAmt |
| CY Other Revenue | $300,103 | CYOtherRevenueAmt |
| PY Total Revenue | $42,592,205 | PYTotalRevenueAmt |
| CY Total Revenue | $42,679,297 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $59,971 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $39,082 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $14,682,536 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,902,286 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $12,707 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $22,770,303 | PYOtherExpensesAmt |
| CY Other Expenses | $24,644,343 | CYOtherExpensesAmt |
| PY Total Expenses | $37,512,810 | PYTotalExpensesAmt |
| CY Total Expenses | $39,585,711 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,079,395 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,093,586 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $31,981,138 | TotalAssetsBOYAmt |
| Total Assets EOY | $31,300,442 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $20,059,687 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $16,544,351 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,921,451 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $14,756,091 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | COMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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 Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $31,592,879 | ExpenseAmt |
| Grant | $39,082 | GrantAmt |
| Revenue | $42,242,017 | RevenueAmt |
| Desc | AS A COMMUNITY-OWNED, NOT FOR PROFIT ORGANIZATION, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IS DEDICATED TO IMPROVING THE HEALTH AND INSPIRING THE WELL-BEING IN THE COMMUNITIES WE SERVE. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. GIVES BACK TO THE COMMUNITY IN THE FORM OF IMPROVED FACILITIES, FREE AND DISCOUNTED CARE, EDUCATION AND OUTREACH PROGRAMS, VOLUNTEERISM AND MUCH MORE. USING INFORMATION FROM THE TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. ALIGNS ITS OUTREACH PROGRAMS TO PRIORITIZE AND ADDRESS THE COMMUNITY'S NEEDS. (SEE SCHEDULE O FOR CONTINUATION)FOLLOWING ARE SOME OF THE WAYS COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IS REACHING OUT TO MAKE OUR NEIGHBORHOODS AND COMMUNITIES HEALTHIER:-FINANCIAL ASSISTANCE-COMMUNITY HEALTH IMPROVEMENT INITIATIVES-PRIMARY HEALTH CARE /ACCESS -MEDICATION ASSISTANCE PROGRAM (MAP)-HEALTH SCREENINGS AND PREVENTION-DISEASE MANAGEMENT-CONTRIBUTIONS TOWARD AND PARTICIPATION IN ECONOMIC DEVELOPMENT ACTIVITIESFINANCIAL ASSISTANCE:COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.'S MISSION INCLUDES CARING FOR PATIENTS WHO DO NOT HAVE THE MEANS TO MEET THEIR FINANCIAL OBLIGATIONS. THE HOSPITAL PLACES ITS PRIORITY ON PROVIDING THE NECESSARY CARE FOR EACH PATIENT, NOT ON THE PATIENT'S FINANCIAL ABILITY TO PAY FOR THEIR MEDICAL SERVICES.COMMUNITY HEALTH IMPROVEMENT INITIATIVES:THE PURPOSE OF COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.'S COMMUNITY HEALTH IMPROVEMENT PROGRAM IS TO FUND COMMUNITY HEALTH IMPROVEMENT EFFORTS WITHIN THE SERVICE AREA OF COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. THE HOSPITAL SETS ASIDE A PORTION OF ITS NET INCOME ANNUALLY TO FUND COMMUNITY HEALTH INITIATIVES AND PARTNERS WITH COMMUNITY ORGANIZATIONS TO ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF NORTHEAST INDIANA. SOME OF THESE INITIATIVES AND PROGRAMS ARE HIGHLIGHTED BELOW.COMMUNITY HEALTH IMPROVEMENT MANAGER: THE COMMUNITY HEALTH IMPROVEMENT MANAGER IS INSTRUMENTAL IN THE IMPLEMENTATION OF KEY STRATEGIES AS IDENTIFIED BY OUR HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT - MENTAL HEALTH, SUBSTANCE USE/ABUSE, SUICIDE, OBESITY AND CHILD ABUSE AND NEGLECT. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.'S COMMUNITY HEALTH IMPROVEMENT MANAGER PARTNERS WITH VARIOUS COMMUNITY ORGANIZATIONS AND NON-PROFITS TO BENEFIT THE OVERALL COMMUNITY. THE COMMUNITY HEALTH IMPROVEMENT MANAGER IS INVOLVED WITH MONTHLY COMMUNITY LEADERSHIP MEETINGS. THESE LEADERSHIP MEETINGS BRING COMMUNITY PARTNERS AND STAKEHOLDERS FROM ACROSS LAGRANGE COUNTY TOGETHER TO COLLABORATE ON COMMUNITY NEEDS INCLUDING BUT NOT LIMITED TO OVERALL HEALTH, EDUCATION AND ECONOMY. THE GROUP COLLABORATES TO MEET COMMUNITY NEEDS TOGETHER AND ELIMINATES EACH ORGANIZATION WORKING ON THEIR OWN TOWARDS THE SAME ISSUES. THE COMMUNITY HEALTH IMPROVEMENT MANAGER IS ALSO INVOLVED IN VARIOUS OTHER COALITIONS AND COMMUNITY PARTNERSHIPS SUCH AS COUNCIL FOR A DRUG FREE LAGRANGE, FOCUS LAGRANGE, LAGRANGE COUNTY CHAMBER OF COMMERCE, LAGRANGE COUNTY TOGETHER, AND NORTHEAST INDIANA FARM TO SCHOOL. THE COMMUNITY HEALTH IMPROVEMENT MANAGER IDENTIFIES, DEVELOPS, IMPLEMENTS, AND EVALUATES ALL COMMUNITY HEALTH PROGRAMS OFFERED THROUGH THE HOSPITAL. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IS ONE OF THE LARGEST EMPLOYERS IN LAGRANGE COUNTY AND BELIEVES STRONGLY IN GIVING BACK TO THE COMMUNITY IT SERVES. THE HOSPITAL NOT ONLY SPONSORS ITS OWN EVENTS AND OUTREACH PROGRAMS EACH YEAR, BUT ALSO TAKES AN ACTIVE ROLE IN NUMEROUS OTHER LOCALLY SPONSORED HEALTH EVENTS, EDUCATION, AND COMMUNITY EVENTS. THE MANAGEMENT AND CO-WORKERS PARTICIPATE IN VOLUNTEER ACTIVITIES THROUGHOUT THE YEAR TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY.TO ASSIST IN HEALTH EDUCATION IN OUR SCHOOL DISTRICTS, FUNDS ARE PROVIDED TO MCMILLEN HEALTH TO PROVIDE EVIDENCE-BASED EDUCATION AROUND THE TOP HEALTH PRIORITIES IDENTIFIED IN THE TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH ARE MENTAL HEALTH, SUBSTANCE USE/ABUSE, SUICIDE, OBESITY AND CHILD ABUSE AND NEGLECT.BOOMERANG BACKPACK / BLESSINGS IN A BACKPACK: FUNDING IS PROVIDED TO THE LAGRANGE COUNTY CHAMBER OF COMMERCE TO SUPPORT STUDENTS IN OUR COUNTY SCHOOL DISTRICTS WHO NEED ACCESS TO FOOD OVER THE WEEKENDS WHEN SCHOOL IS NOT IN SESSION. STUDENTS ARE IDENTIFIED THROUGH THE SCHOOLS AS AT RISK OF HUNGER. PRIMARY HEALTH CARE / ACCESS:COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. PROVIDES CLINICAL STAFF AND SUPPORT TO TARGETED POPULATIONS WITHIN LAGRANGE COUNTY, INCLUDING:-A PART-TIME PLAIN CHURCH COORDINATOR WHO SERVES AS A RESOURCE FOR AMISH, MENNONITE AND OTHER PLAIN CHURCH MEMBERS TO ADDRESS QUESTIONS RELATED TO HEALTHCARE SERVICES AVAILABLE WITHIN THE PARKVIEW HEALTH SYSTEM, DETERMINING THE APPROXIMATE COST OF A PROCEDURE, SCHEDULING OF A DIAGNOSTIC TEST, OR A BILLING QUESTION. THE PLAIN CHURCH COORDINATOR ASSISTS INDIVIDUALS AND FAMILIES BY OBTAINING AN ANSWER TO THE QUESTIONS THIS COMMUNITY HAS RELATED TO SEEKING HEALTHCARE FROM PARKVIEW.IN 2022, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC., AFFORDED 39 EXPECTANT PARENTS THE OPPORTUNITY TO ATTEND BIRTH PLANNING CLASSES BY A REGISTERED NURSE WHO IS A CERTIFIED LACTATION CONSULTANT. THE CLASSES PROVIDE ANSWERS TO ANY QUESTIONS AN EXPECTANT MOTHER MAY HAVE; IN ADDITION, OTHER RESOURCES ARE AVAILABLE AT APPOINTMENTS WITH THE HOSPITAL'S BIRTH PLANNER. PRENATAL CLASSES WERE PROVIDED TO 66 INDIVIDUALS. ADDITIONAL SUPPORT ONCE A BABY IS BORN INCLUDES BREASTFEEDING, WHICH WAS PROVIDED TO 86 INDIVIDUALS, AND SAFE SLEEP CLASSES, WHICH WAS PROVIDED TO SEVEN PEOPLE. MEDICATION ASSISTANCE PROGRAMS (MAP):COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. MAINTAINS A MEDICATION ASSISTANCE PROGRAM FOR LAGRANGE COUNTY RESIDENTS. MAP PARTNERS WITH PATIENTS, PHYSICIANS, PHARMACEUTICAL COMPANIES, AND DONORS TO PROVIDE MEDICATION ASSISTANCE AT LITTLE OR NO COST FOR QUALIFIED INDIVIDUALS. FOR ACUTE MEDICATION NEEDS, MEDICATIONS ARE PROVIDED BY PARKVIEW PHARMACY AT NO COST TO THE PATIENT. LONG-TERM MEDICATION HELP IS PROVIDED THROUGH CONNECTING CLIENTS WITH PHARMACEUTICAL ASSISTANCE PROGRAMS (PAP) AND COPAY ASSISTANCE PROGRAMS. HEALTH SCREENING, PREVENTION, AND DISEASE MANAGEMENT: COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. PROVIDES FREE AND LOW-COST SERVICES, HEALTH SCREENINGS AND EDUCATION TO DIVERSE POPULATIONS IN OUR SERVICE AREA. THESE INCLUDE: -COMMUNITY CHECK-UP DAYS. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. PROVIDED LOW-COST BLOOD TESTS TO THE COMMUNITY SERVING 47 PEOPLE. -VOUCHERS REDEEMABLE FOR NINE MONTHS OF PRENATAL VITAMINS. THESE ARE MADE AVAILABLE TO WOMEN THROUGH THE HOSPITAL BIRTH PLANNER, LAGRANGE COUNTY PRIMARY CARE PHYSICIANS AND OBSTETRICIANS, THE LAGRANGE COUNTY HEALTH DEPARTMENT, AND WIC. VOUCHERS ARE REDEEMABLE AT LOCAL PHARMACIES WHO THEN SUBMIT THEM TO THE HOSPITAL FOR REIMBURSEMENT THROUGH COMMUNITY HEALTH IMPROVEMENT FUNDS.-QPR TRAINING IS OFFERED MONTHLY TO CO-WORKERS OF COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. AND TO LAGRANGE COUNTY COMMUNITY MEMBERS. THIS SUICIDE PREVENTION TRAINING PREPARES ATTENDEES TO IDENTIFY WARNING SIGNS AND INTERVENE IN HOPES OF PREVENTING SUICIDE COMPLETION. IN 2022 THE HOSPITAL WAS ABLE TO PROVIDE TRAINING TO 157 PEOPLE. ECONOMIC DEVELOPMENT:ECONOMIC DEVELOPMENT CORPORATION - COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. PROVIDES FUNDING TO THE LAGRANGE COUNTY ECONOMIC DEVELOPMENT CORPORATION (EDC) TO SUPPORT THEIR EFFORTS IN DEVELOPING BUSINESS RETENTION AND EXPANSION, BUSINESS ATTRACTION, ENTREPRENEURIAL DEVELOPMENT, AND TO ENCOURAGE HIGHER PAYING JOBS AND ECONOMIC IMPROVEMENT IN OVERALL QUALITY OF LIFE. THE EDC CONTRIBUTES TO FURTHERING ACCESS IN OUR COUNTY BY INVESTING IN AREAS THAT CONTRIBUTE TO A THRIVING COMMUNITY, SUCH AS HOUSING AND AIDING BUSINESSES IN IDENTIFYING BUILDING SITES. THE EDC ALSO INVESTS IN AREAS THAT IMPACT OBESITY AND MATERNAL/INFANT/CHILD HEALTH BY SUPPORTING THE LAUNCH LAGRANGE STUDENT ENTREPRENEURIAL COMPETITION AND LAGRANGE COUNTY TRAILS. IN ADDITION, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IS PART OF THE LAGRANGE COUNTY EARLY LEARNING COALITION. LAGRANGE COUNTY IS CONSIDERED A CHILDCARE DESERT BECAUSE THERE ARE NOT ENOUGH CERTIFIED CHILDCARE PROVIDERS BASED ON OUR COUNTY'S POPULATION. REPRESENTATIVES FROM THE HOSPITAL COLLABORATE WITH KEY STAKEHOLDERS AND HR REPRESENTATIVES FROM COUNTY BUSINESSES TO WORK TOGETHER TOWARDS INCREASING THE NUMBER OF CERTIFIED CHILDCARE PROVIDERS FOR LAGRANGE COUNTY. | Desc |
| Total Program Service Expenses | $31,592,879 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 36 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 170 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEANNE' WICKENS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2602669313 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1450 PRODUCTION RD | AddressLine1Txt |
| City | FORT WAYNE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 468081167 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MICHAEL PACKNETT | ||||||||
| DIRECTOR/PH PRESIDENT & CEO | 0.00 | 40.00 | Yes (X) | Yes (X) | $0 | $2,602,841 | $338,299 | |
| LISA BOOTH | ||||||||
| DIRECTOR/PH PHYSICIAN | 0.00 | 40.00 | Yes (X) | $17,120 | $527,885 | $49,722 | ||
| RHONDA SHARP | ||||||||
| DIRECTOR/PH PHYSICIAN | 16.00 | 24.00 | Yes (X) | $158,806 | $201,812 | $38,233 | ||
| JORDI DISLER | ||||||||
| DIRECTOR/LGHOS PRESIDENT | 40.00 | 0.00 | Yes (X) | Yes (X) | $308,629 | $0 | $97,612 | |
| TODD KLINEDINST | ||||||||
| DIRECTOR/LGHOS VP PATIENT CARE SVCS | 40.00 | 0.00 | Yes (X) | $213,263 | $0 | $13,447 | ||
| STEVEN CHRISTNER | ||||||||
| DIRECTOR/VICE CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $4,750 | $0 | $0 | |
| DARYL HERSHBERGER | ||||||||
| DIRECTOR/CONTRACTED PHYSICIAN | 1.00 | 0.00 | Yes (X) | $134,924 | $0 | $0 | ||
| MARK LEU | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $4,750 | $0 | $0 | ||
| MICHAEL MELLINGER | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $4,500 | $0 | $0 | ||
| TREVOR THAIN | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $3,250 | $0 | $0 | ||
| BETH THORNBURG | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $4,750 | $0 | $0 | ||
| JOE URBANSKI | ||||||||
| DIRECTOR/CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $6,250 | $2,000 | $0 | |
| ROBERT BOND | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $4,500 | $0 | $0 | ||
| PAUL YODER | ||||||||
| DIRECTOR/SECRETARY/TREASURER | 1.00 | 0.00 | Yes (X) | Yes (X) | $4,500 | $0 | $0 | |
| JEANNE' WICKENS | ||||||||
| PH CHIEF FINANCIAL OFFICER | 0.00 | 40.00 | Yes (X) | $0 | $1,264,400 | $357,767 | ||
| BRENDA ARMENTROUT | ||||||||
| LGHOS MGR PHARMACY | 40.00 | 0.00 | $217,221 | $0 | $36,055 | Yes (X) | ||
| MARY LOU WRIGHT | ||||||||
| LGHOS RN | 25.00 | 15.00 | $88,458 | $82,692 | $27,008 | Yes (X) | ||
| ROBERT BLOOMFIELD | ||||||||
| LGHOS MGR SUPPORT SERVICE | 40.00 | 0.00 | $150,451 | $0 | $40,645 | Yes (X) | ||
| TREVOR FRY | ||||||||
| LGHOS MGR ER | 40.00 | 0.00 | $141,840 | $0 | $40,949 | Yes (X) | ||
| EMILY PLANT | ||||||||
| LGHOS MGR IP | 40.00 | 0.00 | $138,578 | $0 | $34,161 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,606,540 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,681,630 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,073,898 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 21 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PROFESSIONAL EMERGENCY PHYSICIANS INC | |||||
| PO BOX 12949 | FORT WAYNE | IN | 46866 | PHYSICIANS | $1,971,000 |
| PARKVIEW HOSPITAL INC | |||||
| 11109 PARKVIEW PLAZA DR | FORT WAYNE | IN | 468451701 | LABORATORY SERVICES | $1,251,499 |
| CLINICAL COLLEAGUES INC | |||||
| PO BOX 824246 | PHILADELPHIA | PA | 19182 | ANESTHESIOLOGISTS | $916,489 |
| FOCUSONE SOLUTIONS LLC | |||||
| 13609 CALIFORNIA ST | OMAHA | NE | 68154 | MEDICAL PERSONNEL | $790,138 |
| NORTHEAST INTERNAL MEDICINE ASSOC INC | |||||
| 2500 N DETROIT ST | LAGRANGE | IN | 46761 | HOSPITALISTS | $432,438 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $755 | RelatedOrganizationsAmt |
| Government Grants | $136,420 | GovernmentGrantsAmt |
| Noncash Contributions | $240 | NoncashContributionsAmt |
| Total Contributions | $137,175 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE | 622110 | $42,134,931 | $42,134,931 |
| INTERUNIT RENT | 531120 | $51,508 | $51,508 |
| PHARMACY | 456110 | $29,414 | $29,414 |
| SPEECH THERAPY | 621300 | $22,371 | $22,371 |
| MEALS ON WHEELS | 624210 | $2,212 | $2,212 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,581 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,581 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $42,242,017 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,914 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $14,344 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$10,430 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$10,430 | TotalRevenueColumnAmt |
| Exclusion | -$10,430 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2 | TotalRevenueColumnAmt |
| Exclusion | $2 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA REVENUE | 722514 | $288,701 | $288,701 |
| GIFT SHOP REVENUE | 459420 | $21,832 | $21,832 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $310,533 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $42,679,297 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $42,242,017 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $300,105 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,082 | TotalAmt |
| Program Services | $39,082 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $884,325 | TotalAmt |
| Management And General | $884,325 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $279,674 | TotalAmt |
| Program Services | $279,674 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,181,176 | TotalAmt |
| Program Services | $10,181,176 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,557,111 | TotalAmt |
| Program Services | $3,557,111 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,191,429 | TotalAmt |
| Program Services | $5,492,792 | ProgramServicesAmt |
| Management And General | $698,637 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $416 | TotalAmt |
| Program Services | $416 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $830,590 | TotalAmt |
| Program Services | $800,612 | ProgramServicesAmt |
| Management And General | $29,978 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,944 | TotalAmt |
| Program Services | $3,786 | ProgramServicesAmt |
| Management And General | $158 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $748,051 | TotalAmt |
| Program Services | $739,308 | ProgramServicesAmt |
| Management And General | $8,743 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,629 | TotalAmt |
| Program Services | $10,493 | ProgramServicesAmt |
| Management And General | $1,136 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,371 | TotalAmt |
| Program Services | $5,674 | ProgramServicesAmt |
| Management And General | $5,697 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $248,784 | TotalAmt |
| Program Services | $248,784 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,519,566 | TotalAmt |
| Program Services | $1,493,666 | ProgramServicesAmt |
| Management And General | $25,900 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,954 | TotalAmt |
| Program Services | $91,954 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| CORP SERVICE ALLOCATION | $6,277,377 | $6,277,377 | |
| PH CLINICAL SUPPORT | $3,522,689 | $3,522,689 | |
| MEDICAL SUPPLIES | $2,749,014 | $2,749,014 | |
| HOSPITAL ASSESSMENT FEE | $2,336,852 | $2,336,852 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,677 | TotalAmt |
| Program Services | $39,796 | ProgramServicesAmt |
| Management And General | $48,174 | ManagementAndGeneralAmt |
| Fundraising | $12,707 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,585,711 | TotalAmt |
| Program Services | $31,592,879 | ProgramServicesAmt |
| Management And General | $7,980,125 | ManagementAndGeneralAmt |
| Fundraising | $12,707 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,757 | BOYAmt |
| EOY | $1,757 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $252,916 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,281,458 | BOYAmt |
| EOY | $6,844,664 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $395,706 | BOYAmt |
| EOY | $389,198 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,417 | BOYAmt |
| EOY | $4,926 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $34,732,907 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $22,584,410 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,031,916 | BOYAmt |
| EOY | $12,148,497 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,011,241 | BOYAmt |
| EOY | $5,011,241 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,997,727 | BOYAmt |
| EOY | $6,900,159 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,981,138 | BOYAmt |
| EOY | $31,300,442 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,980,329 | BOYAmt |
| EOY | $1,665,888 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,467,613 | BOYAmt |
| EOY | $192,423 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,186,769 | BOYAmt |
| EOY | $13,160,114 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,424,976 | BOYAmt |
| EOY | $1,525,926 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,059,687 | BOYAmt |
| EOY | $16,544,351 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,921,451 | BOYAmt |
| EOY | $14,756,091 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,921,451 | BOYAmt |
| EOY | $14,756,091 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,981,138 | BOYAmt |
| EOY | $31,300,442 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,093,586 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$258,946 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $4,175 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,175 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | REPRESENTS THE PORTION OF THE DUES PAID TO INDIANA HOSPITAL AND HEALTH ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION AND NATIONAL RURAL HEALTH ASSOCIATION USED FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $320,702 | OtherCostOrOtherBasisAmt |
| Book Value | $320,702 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,256,634 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,444,355 | DepreciationAmt |
| Book Value | $7,812,279 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,320 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,320 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,128,597 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,658,627 | DepreciationAmt |
| Book Value | $3,469,970 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,011,654 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,466,108 | DepreciationAmt |
| Book Value | $545,546 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,148,497 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE TO/FROM INTERUNIT | $6,525,012 |
| RIGHT OF USE ASSETS | $375,147 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $6,900,159 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| LEASE LIABILITY | $377,228 |
| EST MEDICARE/MEDICAID SETTLEMENTS | $686,449 |
| EST 3RD PARTY SETTLEMENTS | $462,249 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,525,926 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $641,388 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $641,388 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01780 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,729,932 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,869,982 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,859,950 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05160 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,189,233 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,707,636 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,481,597 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04110 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,560,553 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,577,618 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,982,935 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11050 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $194,024 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,560 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $192,464 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00530 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,228 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $15,228 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,062,737 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,273,067 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $789,670 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02190 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $48,658 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $48,658 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,320,647 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,274,627 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,046,020 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02890 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,881,200 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,852,245 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,028,955 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13940 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $0 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $6,556,052 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,441,268 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,114,784 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL OF LAGRANGE COUNTY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 207 N TOWNLINE RD | AddressLine1Txt |
| City | LAGRANGE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46761 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PARKVIEW.COM | WebsiteAddressTxt |
| State License | 14-005085-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL OF LAGRANGE COUNTY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.PARKVIEW.COM/LOCALHEALTHNEEDS | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.PARKVIEW.COM/LOCALHEALTHNEEDS | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, LINES 16A B & C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, LINES 16A B & C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, LINES 16A B & C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| COMMUNITY HOSPITAL OF LAGRANGE COUNTY | 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 LAGRANGE COUNTY, 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 LAGRANGE 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 LAGRANGE COUNTY, THIS INCLUDED HISPANIC, AMISH, 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 LAGRANGE COUNTY, IN-PERSON TEAMS OF RESEARCH ASSISTANTS CONDUCTED COMMUNITY SURVEY OUTREACH AT THE LOCAL PUBLIC LIBRARY, TOPEKA PHARMACY (A HIGHLY TRUSTED BUSINESS IN THE AMISH COMMUNITY), AND LAGRANGE COUNTY THRIFT STORE. REGARDING VULNERABLE POPULATIONS SURVEYED IN LAGRANGE COUNTY, 18.1% OF RESPONDENTS REPORTED AN INCOME OF < $35,000, 3.2% OF RESPONDENTS IDENTIFIED AS HISPANIC/LATINO, AND 17.6% WERE AMISH. ADDITIONALLY, RESPONDENTS 65 YEARS AND OLDER WERE WELL-REPRESENTED (31.4%). THE PROVIDER SURVEY INCLUDED RESPONSES FROM PHYSICIANS, REGISTERED NURSES, MENTAL/BEHAVIORAL HEALTH PROVIDERS, COMMUNITY/SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH/COMMUNITY HEALTH WORKERS, SOCIAL WORKERS/CASE MANAGERS, PUBLIC SECTOR WORKERS, AND EDUCATORS. IN ADDITION TO DATA COLLECTION, PARKVIEW LAGRANGE HOSPITAL, INC. COLLABORATED WITH THE COMMUNITY AND PARTNERING ORGANIZATIONS TO SELECT AND PRIORITIZE LAGRANGE 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 LAGRANGE HOSPITAL, INC. HELD A COMMUNITY MEETING ON SEPTEMBER 6, 2022, TO ENGAGE LAGRANGE COUNTY COMMUNITY MEMBERS TO SELECT TWO HEALTH PRIORITIES IN ADDITION TO THE SHARED MENTAL HEALTH PRIORITY THAT WAS SET FOR THE PARKVIEW HEALTH REGION FOR THE NEXT THREE YEARS. THIS GROUP OF 39 STAKEHOLDERS CONDUCTED A THOUGHTFUL REVIEW OF THE 2022 CHNA DATA AND ENGAGED IN A PRIORITIZATION GRID EXERCISE, WHICH INVOLVED EXAMINING THE RANK OF THE TOP 10 HEALTH PRIORITIES PROVIDED BY THE COMMUNITY, AMISH RESPONDENTS, AND PROVIDERS. PARTICIPANTS WERE THEN ASKED TO RATE SIGNIFICANCE, SEVERITY, SUITABILITY, AND HEALTH DISPARITY RELATED TO SOCIAL DETERMINANTS OF HEALTH, FOR EACH OF THE 10 PRIORITIES. FOLLOWING THIS, PARTICIPANTS WERE ASKED TO VOTE ON THEIR TOP TWO RECOMMENDATIONS. FROM THIS VOTING, THE FOLLOWING HEALTH PRIORITIES WERE RECOMMENDED AS BEING TOP AREAS TO ADDRESS IMPROVEMENT EFFORTS: SUBSTANCE USE/ABUSE, OBESITY, AND CHILD ABUSE. THIS INFORMATION WAS TAKEN TO THE LAGRANGE COUNTY MENTAL HEALTH/SUBSTANCE USE COLLABORATIVE ON SEPTEMBER 15, 2022, TO DETERMINE IF THE GROUP WANTED TO CONTINUE TO FOCUS ON MENTAL HEALTH AND SUBSTANCE USE/ABUSE COLLECTIVELY OR ESTABLISH TWO SEPARATE GROUPS TO WORK ON IMPROVEMENT EFFORTS IN THESE HEALTH PRIORITIES. THE COLLABORATIVE ELECTED TO CONTINUE WORKING ON SUBSTANCE USE/ABUSE AND MENTAL HEALTH COLLECTIVELY. AS A RESULT, BASED ON THE RECOMMENDATION OF LAGRANGE COUNTY COMMUNITY PARTNERS, THE FOLLOWING HEALTH PRIORITIES HAVE BEEN ADOPTED FROM THE 2022 CHNA: #1 MENTAL HEALTH/SUBSTANCE USE AND ABUSE/SUICIDE, #2 OBESITY, AND #3 CHILD ABUSE. THESE RECOMMENDATIONS WERE TAKEN BEFORE PARKVIEW LAGRANGE HOSPITAL BOARD QUALITY ON SEPTEMBER 16, 2022, AND BOARD PLANNING ON SEPTEMBER 23, 2022. BOTH GOVERNING BODIES ADOPTED THE ABOVE HEALTH PRIORITY RECOMMENDATIONS AT THOSE RESPECTIVE MEETINGS.PRIORITIZATION SESSION ATTENDEES REPRESENTED SEVERAL ORGANIZATIONS IN LAGRANGE COUNTY: PARKVIEW LAGRANGE ADMIN, PARKVIEW LAGRANGE BOARD, LAKELAND SCHOOL CORPORATION, BRIGHTPOINT, SCAN, INDIANA AEYC, PARKVIEW BEHAVIORAL HEALTH INSTITUTE ADMIN, COLE CENTER FAMILY YMCA, PARKVIEW EMS, TOPEKA PHARMACY, BOWEN CENTER, THE COMMUNITY HEALTH CLINIC, LAGRANGE TRAILS, LAGRANGE COUNTY PARKS DEPARTMENT, WESTVIEW SCHOOLS CORPORATION, LAGRANGE COUNTY HEALTH DEPARTMENT, CHILDREN FIRST CENTER, PLAIN CHURCH GROUP MINISTRY, WESTVIEW POLICE DEPARTMENT, LAGRANGE STANDARD, AND LAGRANGE CHURCH OF GOD. |
| COMMUNITY HOSPITAL OF LAGRANGE COUNTY | 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 NOBLE COUNTY, INC. (EIN 35-2087092); HUNTINGTON MEMORIAL HOSPITAL, INC. (EIN 35-1970706); WHITLEY MEMORIAL HOSPITAL, INC. (EIN 35-1967665); PARKVIEW WABASH HOSPITAL, INC. (EIN 47-1753440); PARK CENTER, INC. (EIN 35-1135451) AND ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH, LLC (EIN 26-0143823). |
| COMMUNITY HOSPITAL OF LAGRANGE COUNTY | 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. |
| COMMUNITY HOSPITAL OF LAGRANGE COUNTY | 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:A COLLABORATIVE GROUP WAS FORMED IN 2019 TO BRING KEY STAKEHOLDERS AND COMMUNITY PARTNERS FROM THE LAGRANGE COUNTY COMMUNITY TOGETHER TO ADDRESS MENTAL HEALTH, SUBSTANCE USE/ABUSE, AND SUICIDE. THIS WAS IDENTIFIED AS THE TOP NEED IN OUR REGION BASED ON RESULTS FROM THE 2019 AND 2022 COMMUNITY HEALTH NEEDS ASSESSMENT, MEASURING THE PERCENT OF THE POPULATION WITH FREQUENT MENTAL DISTRESS. THE MENTAL HEALTH/SUBSTANCE USE COLLABORATIVE MADE PROGRESS IN THE FOLLOWING AREAS:-YEAR-ROUND DRUG TAKEBACK EDUCATION: DISSEMINATED DRUG DISPOSAL BAGS TO INDIVIDUALS AND ORGANIZATIONS THROUGHOUT LAGRANGE COUNTY. THESE BAGS CAN SAFELY BE USED TO DEACTIVATE PILLS, LIQUID, OR PATCHES AND HELP TO REDUCE THE LIKELIHOOD OF PRESCRIPTION DRUG ABUSE. DISTRIBUTED FLYERS THROUGHOUT LAGRANGE COUNTY THAT IDENTIFY THE DRUG DISPOSAL BINS LOCATIONS AND HOW TO SAFELY DISPOSE OF NEEDLES. -PARTNERED WITH MCMILLEN HEALTH TO PROVIDE EDUCATION TO YOUTH IN LAGRANGE COUNTY SCHOOLS AROUND PEER PRESSURE, TEACHING REFUSAL SKILLS, EDUCATION ON OPIOIDS AND EFFECTS ON THE NERVOUS SYSTEM, THE BRAIN AND THE BODY.WITH ASSISTANCE FROM PARKVIEW BEHAVIORAL HEALTH INSTITUTE, AN EVIDENCE-BASED SUICIDE PREVENTION STRATEGY KNOWN AS QUESTION, PERSUADE AND REFER (QPR) IS OFFERED AS A FREE TRAINING PROGRAM TO EQUIP PARTICIPANTS TO RECOGNIZE THE WARNING SIGNS OF SUICIDE AND HOW TO TAKE STEPS TO INTERVENE. SINCE BEING IMPLEMENTED IN 2017, OVER 1,500 PEOPLE HAVE RECEIVED THIS EDUCATION, WITH 157 PEOPLE BEING TRAINED IN 2022. THE GOAL OF THIS PROGRAM IS TO REDUCE THE NUMBER OF SUICIDE ATTEMPTS AND DEATH BY SUICIDE IN LAGRANGE COUNTY.-UTILIZED IHA SHIP FUNDING TO HAVE ADDITIONAL STAFF TRAINED ON QPR TO HELP TEACH SUICIDE PREVENTION CURRICULUM. PARKVIEW BEHAVIORAL HEALTH IS INVOLVED IN THE LAGRANGE COUNTY COMMUNITY TO PROVIDE THERAPY AND RESOURCES FOR THOSE WITH IMMEDIATE MENTAL HEALTH NEEDS. 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. SINCE ITS INCEPTION IN 2014 AT COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC., THE PROGRAM HAS PROVIDED OVER 15,000 HOURS OF DIRECT COUNSELING SERVICES TO INDIVIDUALS IN LAGRANGE, STEUBEN AND NOBLE COUNTIES, WITH 2,262 HOURS BEING PROVIDED TO 48 PATIENTS IN 2022. IN ADDITION, 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.THE LAGRANGE COUNTY MENTAL HEALTH/SUBSTANCE USE COLLABORATIVE SPENT SEVERAL HOURS IN 2022 PLANNING FOR CRISIS INTERVENTION TEAM TRAINING THAT WILL BE OFFERED TO LAW ENFORCEMENT, SCHOOL RESOURCE OFFICERS, AND FIRST RESPONDERS. OVER 30 COMMUNITY PARTNERS ARE INVOLVED WITH DEVELOPING THIS ANNUAL TRAINING PROGRAM. THE GOALS OF THIS TRAINING ARE TO ENSURE THE SAFETY OF OFFICERS, FIRST RESPONDERS, AND CIVILIANS, INCREASE UNDERSTANDING OF MENTAL ILLNESS, AND TO IMPROVE RELATIONSHIPS WITH THE COMMUNITY, MENTAL HEALTH PROFESSIONALS, PEOPLE WITH MENTAL ILLNESS AND FAMILY MEMBERS.OBESITY: A COLLABORATIVE GROUP WAS FORMED IN 2019 TO BRING KEY STAKEHOLDERS AND COMMUNITY PARTNERS FROM THE LAGRANGE COUNTY COMMUNITY TOGETHER TO ADDRESS OBESITY. THIS WAS IDENTIFIED AS A TOP NEED IN OUR COUNTY BASED ON RESULTS FROM THE 2019 AND 2022 COMMUNITY HEALTH NEEDS ASSESSMENT, MEASURING THE PERCENT OF THE POPULATION WITH A SEDENTARY LIFESTYLE, AND THOSE WITH A BODY MASS INDEX GREATER THAN OR EQUAL TO 30 KG/M2, AND ACCESS TO EXERCISE OPPORTUNITIES AND HEALTHY FOODS. THE OBESITY COLLABORATIVE MADE PROGRESS IN THE FOLLOWING AREAS:-LAGRANGE COUNTY COMMUNITY MEMBERS WERE ENCOURAGED TO PARTICIPATE IN THE GREAT APPLE CRUNCH FOR THE MONTH OF OCTOBER 2022 BY TAKING PHOTOS OF THEMSELVES BITING INTO AN APPLE AND POSTING IT ON SOCIAL MEDIA. THE INTENT WAS TO RAISE AWARENESS TO THE BENEFITS OF MAKING HEALTHIER FOOD CHOICES. BECAUSE LAGRANGE COUNTY HAS A SIGNIFICANT PLAIN CHURCH/AMISH POPULATION THAT DOES NOT USE SOCIAL MEDIA OR INTERNET, A CHALLENGE WAS PUT OUT TO AMISH SCHOOLS TO SUBMIT AN ORIGINAL RECIPE OR ESSAY THAT INCLUDED AN APPLE. STUDENTS IN GRADES K - 8 SUBMITTED 42 ENTRIES. FOUR RANDOM WINNERS WERE SELECTED TO RECEIVE WELLNESS BUNDLES FOR THEIR SCHOOL CLASSROOM. -THE HOSPITAL PARTNERS WITH THE COLE CENTER FAMILY YMCA TO INCREASE PHYSICAL ACTIVITY BY OFFERING GROUP EXERCISE CLASSES IN LAGRANGE COUNTY. THESE GROUP CLASSES ALSO OFFER A CLOSE-KNIT COMMUNITY TO PARTICIPANTS AS THEY DEVELOP FRIENDSHIPS THROUGH REGULAR ATTENDANCE, WHICH POSITIVELY IMPACTS THEIR MENTAL HEALTH AND WELL-BEING. IN 2022, APPROXIMATELY 110 PEOPLE PARTICIPATED IN THESE CLASSES. -PARTNERED WITH MCMILLEN HEALTH TO PROVIDE EDUCATION TO YOUTH IN LAGRANGE COUNTY SCHOOLS ON THE FOLLOWING TOPICS: MEDIA INFLUENCE ON JUNK FOOD CONSUMPTION, HARMFUL EFFECTS OF FAD DIETS, ANOREXIA, BULIMIA, OBESITY, EDUCATION ON BASIC FOOD GUIDELINES, INCLUDING READING FOOD LABELS, UNDERSTANDING FITNESS FACTS AND LEARNING ABOUT PREVENTATIVE HEALTH CHOICES.PARTNERED WITH PARKVIEW WELL-BEING TEAM AND NORTHEAST INDIANA FARM-TO-SCHOOL TO PROVIDE HARVEST OF THE MONTH TASTE TESTS TO 5,892 STUDENTS THROUGH THE LAGRANGE COUNTY SCHOOLS. KIDS WERE INVITED TO TRY FRUITS AND VEGETABLES THEY WOULD NOT HAVE OTHERWISE, AND ALSO HAD EDUCATION ON THE PRODUCE TIED INTO THE TEACHER'S EDUCATION CURRICULUM SPECIFIC TO THE SUBJECT THEY WERE TEACHING. CHILD ABUSE & NEGLECT:A COLLABORATIVE GROUP WAS FORMED IN 2019 TO BRING KEY STAKEHOLDERS AND COMMUNITY PARTNERS FROM THE LAGRANGE COUNTY COMMUNITY TOGETHER TO ADDRESS CHILD ABUSE & NEGLECT. THIS WAS IDENTIFIED AS A TOP NEED IN OUR COUNTY BASED ON RESULTS FROM THE 2019 AND 2022 COMMUNITY HEALTH NEEDS ASSESSMENT, MEASURING THE PERCENT OF CHILD ABUSE & NEGLECT RATES, AND % OF CHILDREN IN NEED OF SERVICES. IN 2022, THE CHILD ABUSE & NEGLECT COLLABORATIVE MADE PROGRESS IN THE FOLLOWING AREAS: -PARTNERED WITH MCMILLEN HEALTH TO PROVIDE EDUCATION TO YOUTH IN LAGRANGE COUNTY SCHOOLS ON THE FOLLOWING TOPICS: SOCIAL AND EMOTIONAL SKILLS, BEING THE BOSS OF THEIR BODY, HOW TO IDENTIFY A TRUSTED ADULT, INAPPROPRIATE TOUCH, BULLYING, STAYING SAFE ONLINE, WARNING SIGNS OF SUICIDE AND HOW TO IDENTIFY AN ABUSIVE RELATIONSHIP WHILE DATING.CHILD ABUSE & NEGLECT PANEL PRESENTATIONS PUT ON BY A GROUP OF COMMUNITY PARTNERS INVOLVING DCS, SCAN, CHILDRENS 1ST, BOWEN CENTER, NORTHEASTERN CENTER, AND PARKVIEW LAGRANGE HOSPITAL. EDUCATION WAS PROVIDED ON HOW AND WHEN TO REFER TO DCS AND WHEN IT'S NOT APPROPRIATE TO REFER TO OTHER COMMUNITY PARTNERS. IN 2022, PANEL PRESENTATIONS WERE GIVEN TO OVER 183 INDIVIDUALS IN LOCAL SCHOOL SYSTEMS, THE COURT SYSTEM, MINISTERIAL ASSOCIATION, HOSPITAL STAFF AND THE GENERAL PUBLIC. OTHER HEALTH NEEDS NOT BEING ADDRESSED:HEALTH NEEDS IDENTIFIED AND WHY THE HOSPITAL DOES NOT INTEND TO ADDRESS THESE AS PART OF THE IMPLEMENTATION STRATEGY:-ALZHEIMER'S DISEASE / DEMENTIA - HOSPITAL DOES NOT HAVE EXPERTISE TO EFFECTIVELY ADDRESS THE NEED. THIS NEED IS BEING ADDRESSED BY OTHERS WITHIN THE PARKVIEW HEALTH SYSTEM.-ASTHMA - INDIVIDUALS' INPATIENT AND OUTPATIENT MEDICAL PROVIDERS ADDRESS THE NEEDS OF THOSE WITH ASTHMA.-CANCER - HOSPITAL DOES NOT HAVE EXPERTISE TO EFFECTIVELY ADDRESS THE NEED. THIS NEED IS BEING ADDRESSED BY PARKVIEW CANCER INSTITUTE. -CARDIOVASCULAR DISEASE - WHILE WE ARE NOT ADDRESSING CARDIOVASCULAR DISEASE AND DIABETES SPECIFICALLY, WE WILL BE ADDRESSING OBESITY. MANY OF OUR OUTREACH INITIATIVES TO ADDRESS OR PREVENT OBESITY WILL IMPACT BOTH AREAS IN THAT INTERVENTIONS ARE SIMILAR FOR THESE HEALTH ISSUES.-CHRONIC OBSTRUCTIVE PULMONARY DISEASE - HOSPITAL DOES NOT HAVE EXPERTISE TO EFFECTIVELY ADDRESS THE NEED. THIS NEED IS BEING ADDRESSED BY OTHERS WITHIN PARKVIEW HEALTH.-KIDNEY DISEASE - HOSPITAL DOES NOT HAVE EXPERTISE TO EFFECTIVELY ADDRESS THE NEED. THIS NEED IS BEING ADDRESSED BY OTHERS WITHIN THE PARKVIEW HEALTH SYSTEM. -TOBACCO USE - COMMUNITY PARTNER AGENCIES IN LAGRANGE COUNTY OFFER ONGOING CESSATION CLASSES TO COMMUNITY MEMBERS. PARKVIEW LAGRANGE HOSPITAL OPERATES A TOBACCO FREE CAMPUS. |
| PART V, LINES 16A, 16B AND 16C | HTTPS://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)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
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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 7BCOMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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 7CCOMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. ACCEPTS ALL 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, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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 EXPENSECOMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. EXCLUDED $3,522,689 OF PH CLINICAL SUPPORT EXPENSE. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | DESCRIBE HOW THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES, AS REPORTED, PROMOTES THE HEALTH OF THE COMMUNITIES THE ORGANIZATION SERVES.COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. HAS A STRONG COMMITMENT TO SUPPORTING AND ENHANCING THE VITALITY OF OUR COMMUNITY, AND AS SUCH INVESTS IN PROJECTS THAT HELP TO IMPROVE THE HEALTH AND INSPIRE THE WELL-BEING OF THE COMMUNITY. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. PARTNERS WITH THE LAGRANGE COUNTY ECONOMIC DEVELOPMENT CORPORATION (LCEDC) TO CONTINUE TO SUPPORT LAGRANGE COUNTY AS A TOP PLACE TO LIVE, WORK AND PLAY. A FEW EXAMPLES OF PARTNERSHIP WITH LCEDC INCLUDE WORKING WITH A NEWLY FOUNDED COALITION CALLED THE LAGRANGE COUNTY EARLY LEARNING COALITION TO INCREASE ACCESS TO QUALITY EARLY LEARNING /CHILDCARE PROGRAMS IN LAGRANGE COUNTY. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IS ALSO A FINANCIAL SPONSOR FOR EDC INFRASTRUCTURE, HOUSING DEVELOPMENT, AND QUALITY OF LIFE/GROWTH IN THE COUNTY. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. HAS ACTIVE REPRESENTATION BY LEADERSHIP ON THE BOARDS OF NEARLY 30 COMMUNITY NON-PROFIT AND CIVIC AGENCIES THROUGHOUT LAGRANGE COUNTY AND THE SURROUNDING AREA. |
| 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. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. HAS TAKEN THE POSITION NOT TO INCLUDE THE MEDICARE SHORTFALLS OR SURPLUSES AS PART OF COMMUNITY BENEFIT. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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.COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC., PRIMARILY SERVES THE LAGRANGE COUNTY COMMUNITIES OF HOWE, LAGRANGE, SHIPSHEWANA, STROH, TOPEKA, AND WOLCOTTVILLE INDIANA. AS THE ONLY HOSPITAL IN THIS COUNTY, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC., ALSO SERVES, TO A LIMITED EXTENT, SURROUNDING COMMUNITIES IN THE EASTERN PORTION OF ELKHART COUNTY, INDIANA, THE WESTERN PORTION OF STEUBEN COUNTY, INDIANA, AND SOME OF THE SOUTHERN PORTIONS OF CASS, ST. JOSEPH, AND BRANCH COUNTIES IN MICHIGAN.ACCORDING TO CONDUENT HEALTHY COMMUNITIES INSTITUTE (HCI), LAGRANGE COUNTY IS A RURAL AREA WITHIN THE HEALTH SYSTEM'S SERVICE AREA WITH A POPULATION OF 40,524 (2021). IN ADDITION, HCI REPORTS THE MEDIAN HOUSEHOLD INCOME OF LAGRANGE COUNTY RESIDENTS IS APPROXIMATELY $75,624 WITH 5.3% LIVING BELOW THE FEDERAL POVERTY LEVEL (2017-2021). APPROXIMATELY 71.4% OF LAGRANGE COUNTY RESIDENTS HAVE HEALTH INSURANCE (2020), AND THIS OUTLIER IS LIKELY DUE TO THE AMISH POPULATION LOCATED WITHIN THIS COUNTY. ACCORDING TO THE INDIANA HOSPITAL ASSOCIATION DIMENSIONS DATABASE (2022), COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. HAD 14.5% OF INPATIENT DISCHARGES THAT WERE MEDICAID PATIENTS AND 3.3% WERE SELF-PAY. FOR OUTPATIENT PROCEDURES, 17.2% WERE MEDICAID PATIENTS, AND 4.95% 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:1) DISCIPLINE: MENTAL HEALTHHSPA ID: 7186175063HPSA NAME: NORTHEASTERN CATCHMENT AREA 18DESIGNATION TYPE: GEOGRAPHIC HPSACOUNTY NAME: DEKALB, LAGRANGE, NOBLE, AND STEUBEN COUNTIESHPSA SCORE:17 STATUS: DESIGNATEDRURAL STATUS: RURAL2) DISCIPLINE: PRIMARY CAREHSPA ID: 1183947553HPSA NAME: LAGRANGE COUNTYDESIGNATION TYPE: GEOGRAPHIC HPSACOUNTY NAME: LAGRANGE COUNTYHPSA SCORE:11 STATUS: DESIGNATEDRURAL STATUS: 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 (E.G. OPEN MEDICAL STAFF, COMMUNITY BOARD, USE OF SURPLUS FUNDS, ETC.).THE MAJORITY OF THE COMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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 THROUGHOUT THE COMMUNITY CAN COUNT ON COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. TO BE STANDING BY WITH EMERGENCY CARE 24 HOURS A DAY, 365 DAYS A YEAR. THE EMERGENCY DEPARTMENT IS STAFFED WITH BOARD-CERTIFIED PHYSICIANS AND A NURSING STAFF THAT IS TRAINED AND CERTIFIED IN EMERGENCY CARE. FURTHERMORE, NO PATIENT IS EVER DENIED TREATMENT, REGARDLESS OF THEIR ABILITY TO PAY AND COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. AND ITS AFFILIATES CONTINUE TO ADAPT TO MEET THE NEEDS OF THE COMMUNITY.COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. GIVES BACK TO THE COMMUNITY IN THE FORM OF IMPROVED FACILITIES, EDUCATION AND OUTREACH PROGRAMS, FREE AND DISCOUNTED CARE, VOLUNTEERISM AND MUCH MORE. THE FOLLOWING ARE SOME OF THE WAYS COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IS REACHING OUT TO MAKE OUR NEIGHBORHOODS AND COMMUNITIES HEALTHIER:-EDUCATION: COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IS TAKING THE LEAD IN PARTNERING WITH SCHOOLS FOR HEALTH OCCUPATION EDUCATION PROGRAMS, CAREER PATHWAYS PROGRAMS, PREVENTIVE EDUCATION, AND SCREENINGS FOR STUDENTS.COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. PARTNERED WITH TOPEKA PHARMACY AND SUPERSHOT TO PROVIDE FREE FLU AND COVID-19 VACCINES AND BOOSTERS TO OVER 178 PEOPLE. -MEDICATION ASSISTANCE PROGRAM (MAP): COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. MAINTAINS A MEDICATION ASSISTANCE PROGRAM FOR LAGRANGE COUNTY RESIDENTS. MAP PARTNERS WITH PATIENTS, PHYSICIANS, PHARMACEUTICAL COMPANIES, AND DONORS TO PROVIDE MEDICATION ASSISTANCE AT LITTLE OR NO COST FOR QUALIFIED INDIVIDUALS. FOR ACUTE MEDICATION NEEDS, MEDICATIONS ARE PROVIDED BY PARKVIEW PHARMACY AT NO COST TO THE PATIENT. LONG-TERM MEDICATION HELP IS PROVIDED THROUGH CONNECTING CLIENTS WITH PHARMACEUTICAL ASSISTANCE PROGRAMS (PAP) AND COPAY ASSISTANCE PROGRAMS. IN 2022, 244 PATIENTS WERE SERVED THROUGH THIS PROGRAM, OF WHICH 89 WERE NEW REFERRALS. THERE WERE 18 PHARMACY FILLS PROVIDED AND $984 OF PRESCRIPTION COSTS COVERED.-COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. TEAM MEMBERS SERVED OVER 340 HOURS ON PROJECTS AND ADVISORY BODIES FOR THE FOLLOWING: DISTRICT 3 HOSPITAL COALITION, EMA ADVISORY BOARD, FARMERS STATE BANK BOARD, JUNIOR ACHIEVEMENT, JUVENILE DETENTION ALTERNATIVES INITIATIVE, LAGRANGE COUNTY CORONER'S OFFICE, LAGRANGE COUNTY FAIRGROUNDS BOARD, COUNCIL FOR A DRUG FREE LAGRANGE, LAGRANGE COUNTY CHAMBER OF COMMERCE, LAGRANGE COUNTY EARLY LEARNING COALITION, LAGRANGE COUNTY ECONOMIC DEVELOPMENT CORPORATION, LAGRANGE COUNTY HEALTH DEPARTMENT, LAGRANGE COUNTY HOUSING PROJECT, LAGRANGE PARTNERS, MANCHESTER PHARMACY EXPERIENTIAL ADVISORY COUNCIL, NORTHEAST INDIANA FARM TO SCHOOL, NORTHEAST INDIANA STIGMA FREE, PURDUE EXTENSION YOUTH DEVELOPMENT COMMITTEE, SEXUAL ASSAULT RESPONSE TEAM, ST. MARY'S SCHOOL BOARD, AND TOPEKA 4-H.THE COMMUNITY HEALTH IMPROVEMENT COMMITTEE (CHIC) OF COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IS A PROGRAM THAT PROVIDES GRANT SUPPORT FOR COMMUNITY HEALTH INITIATIVES DELIVERED BY NOT-FOR-PROFIT COMMUNITY ORGANIZATIONS THAT SHARE THE HOSPITAL'S MISSION TO ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF LAGRANGE COUNTY AND PROVIDE SERVICES THAT ARE NOT AVAILABLE THROUGH THE HOSPITAL. FUNDS ARE AWARDED BASED ON THE TOP NEEDS THAT WERE IDENTIFIED FOR LAGRANGE COUNTY THROUGH THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. THE FOLLOWING CHIC INITIATIVES WERE SUPPORTED THROUGH HEALTH PARTNERS WHO ALIGN WITH THE TOP COMMUNITY HEALTH NEEDS IDENTIFIED FOR LAGRANGE COUNTY AND NORTHEAST INDIANA. FUNDED PROGRAMS PROVIDING SUPPORT TO LAGRANGE COUNTY PATIENTS IN 2022 INCLUDED:-BRIGHTPOINT - SUPPORT WAS PROVIDED TO ASSIST WITH OBTAINING HEALTHCARE COVERAGE FOR CHILDREN AND THEIR FAMILIES. -CANCER SERVICES OF NORTHEAST INDIANA - SUPPORT WAS PROVIDED TO ASSIST PATIENTS WITH HEALTHCARE SUPPLIES NOT COVERED BY INSURANCE, AND FOR EDUCATION RELATED TO WELLNESS AND HEALTHY LIFESTYLE PRACTICES.-LAGRANGE COUNTY ECONOMIC DEVELOPMENT CORPORATION - SUPPORT WAS PROVIDED TO ASSIST WITH EFFORTS AROUND ACCESS TO HOUSING AND INCREASING CAPACITY FOR CERTIFIED EARLY LEARNING/CHILDCARE PROGRAMS.-MCMILLEN HEALTH - SUPPORT WAS PROVIDED TO BRING EDUCATION AND PROGRAMMING ON MENTAL HEALTH/SUBSTANCE USE, OBESITY AND WELLNESS, AND CHILD ABUSE & NEGLECT TO STUDENTS AT THE THREE PUBLIC SCHOOL SYSTEMS IN LAGRANGE COUNTY.-LAGRANGE COUNTY SHERIFF'S DEPARTMENT - SUPPLIES WERE PROVIDED FOR 4TH GRADE SAFETY CAMPS. -LAGRANGE COUNTY PARKS DEPARTMENT - AN AED WAS PURCHASED FOR THEIR PARK RANGER. FUNDING WAS AWARDED IN SUPPORT OF THE DALLAS LAKE PARK FITNESS TRAIL SIGNS, AND THE DELT CHURCH PARK DISC GOLF. -LAGRANGE COUNTY MENTAL HEALTH / SUBSTANCE USE COLLABORATIVE - FUNDING WAS PROVIDED TO BRING DAVID PARNELL IN TO SPEAK ABOUT DRUGS AND SUICIDE IN ALL THREE LAGRANGE COUNTY SCHOOLS JUNIOR AND SENIOR CLASSES, AT THE LAGRANGE SHERIFF'S DEPARTMENT, AND TO THE GENERAL PUBLIC. OVER 325 PEOPLE HEARD HIS TALK. OVER 160 COPIES OF HIS BOOK, FACING THE DRAGON, WERE DISTRIBUTED TO THE PUBLIC AND LAGRANGE COUNTY READS BOOK CLUBS WERE HOSTED IN PARTNERSHIP WITH THE LAGRANGE PUBLIC LIBRARY LOCATIONS. -LAGRANGE COMMUNITIES YOUTH CENTERS - FUNDING WAS PROVIDED TO TEACH BABYSITTING CLASSES TO STUDENTS IN 5TH - 8TH GRADE HOW TO OPERATE AS A BUSINESS, BASIC FIRST AID & CPR, CARING FOR INFANTS AND YOUTH, AND OTHER ASPECTS OF STARTING TO BABYSIT.-PLAIN CHURCH GROUP MINISTRY - FUNDING WAS PROVIDED TO PLAN FOR INCREASING PARTICIPATION FROM THE AMISH COMMUNITY TO RECEIVE IMMUNIZATIONS.-PRAIRIE HEIGHTS ELEMENTARY SCHOOL - FUNDING WAS PROVIDED FOR RED RIBBON WEEK ACTIVITIES RELATED TO DRUG AND ALCOHOL PREVENTION AWARENESS AND EDUCATION.-COMMUNITY HEALTH CLINIC - FUNDING WAS PROVIDED IN SUPPORT OF THEIR GENETIC CARE CLINIC.-LAGRANGE VOLUNTEER FIRE DEPARTMENT - FUNDING WAS PROVIDED IN SUPPORT OF SAFETY MATERIALS BEING DISTRIBUTED TO ELDERLY AND YOUTH.-LAGRANGE COUNTY CHAMBER OF COMMERCE - FUNDING WAS PROVIDED IN SUPPORT OF THE BLESSINGS IN A BACKPACK & BOOMERANG BACKPACK PROGRAM.-LAGRANGE COUNTY OBESITY COLLABORATIVE - FUNDING WAS PROVIDED IN SUPPORT OF THE GREAT APPLE CRUNCH AMISH SCHOOL CHALLENGE.-CRUSHED BUT NOT BROKEN - FUNDING WAS PROVIDED IN SUPPORT OF DOMESTIC VIOLENCE PROGRAMMING AND SERVICES.-INSPIRATION MINISTRIES - FUNDING WAS PROVIDED IN SUPPORT OF RECOVERY HOUSING.-ST. MARTINS HEALTHCARE - FUNDING WAS PROVIDED IN SUPPORT OF IMPLEMENTATION OF THEIR MOBILE HEALTH CLINIC.-LAGRANGE CHURCH OF GOD - FUNDING WAS PROVIDED IN SUPPORT OF COMMUNITY AID AND RESOURCES.PATIENT & FAMILY ADVISORY COUNCIL (PFAC): IN 2022, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. CONTINUED ITS PARTNERSHIP WITH PATIENTS AND PATIENT FAMILY MEMBERS THROUGH THE HOSPITAL'S PFAC. THE PFAC MEMBERS PROVIDED FEEDBACK ABOUT PROCESSES AND COMMUNICATION OPPORTUNITIES THAT WOULD IMPROVE QUALITY AND THE PATIENT EXPERIENCE. AREAS IMPACTED BY THE PFAC'S INVOLVEMENT DURING 2022 WERE: SAFE DRUG DISPOSAL, MENTAL HEALTH CRISIS INTERVENTION, 2022 COMMUNITY HEALTH NEEDS ASSESSMENT FEEDBACK COLLECTION, COVID POLICIES & PROCEDURES, MAGNET SURVEY PROCESS, SWING BED REBRANDING, SIGNAGE EVALUATION AND RURAL COMMUNITIES' OPIOID RESPONSE PROGRAM. |
| PART VI, LINE 6: | IF THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM, DESCRIBE THE RESPECTIVE ROLES OF THE ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED.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 STATES | IN |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| HAROLD W MCMILLEN CENTER FOR HEALTH EDUCATION INC | ||||||||
| 600 JIM KELLEY BLVD | FORT WAYNE | IN | 46816 | 351186994 | 501(C)(3) | $10,000 | $0 | PROVIDE VITAL & EFFECTIVE HEALTH EDUCATION THAT PROMOTES PHYSICAL, EMOTIONAL & SOCIAL WELL-BEING |
| INSPIRATION MINISTRIES INC | ||||||||
| 138 E 7TH STREET | AUBURN | IN | 46706 | 800798094 | 501(C)(3) | $6,000 | $0 | PROGRAMS TO HELP PEOPLE TRANSFORM THEIR LIVES IN TIMES OF TRANSITION |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | COMMUNITY 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp 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 |
| LISA BOOTH | ||||||||||||||
| DIRECTOR/PH PHYSICIAN | $17,120 | $410,512 | $0 | $84,991 | $0 | $32,382 | $1,054 | $32,496 | $508 | $15,664 | $18,682 | $576,045 | $0 | $0 |
| JORDI DISLER | ||||||||||||||
| DIRECTOR/LGHOS PRESIDENT | $207,367 | $0 | $78,305 | $0 | $22,957 | $0 | $70,059 | $0 | $27,553 | $0 | $406,241 | $0 | $21,333 | $0 |
| RHONDA SHARP | ||||||||||||||
| DIRECTOR/PH PHYSICIAN | $158,806 | $163,350 | $0 | $32,124 | $0 | $6,338 | $14,774 | $18,776 | $2,062 | $2,621 | $175,642 | $223,209 | $0 | $0 |
| BRENDA ARMENTROUT | ||||||||||||||
| LGHOS MGR PHARMACY | $185,261 | $0 | $28,150 | $0 | $3,810 | $0 | $23,568 | $0 | $12,487 | $0 | $253,276 | $0 | $0 | $0 |
| TODD KLINEDINST | ||||||||||||||
| DIRECTOR/LGHOS VP PATIENT CARE SVCS | $163,552 | $0 | $48,494 | $0 | $1,217 | $0 | $10,602 | $0 | $2,845 | $0 | $226,710 | $0 | $0 | $0 |
| MARY LOU WRIGHT | ||||||||||||||
| LGHOS RN | $87,417 | $77,434 | $750 | $5,000 | $291 | $258 | $8,003 | $7,481 | $5,956 | $5,568 | $102,417 | $95,741 | $0 | $0 |
| ROBERT BLOOMFIELD | ||||||||||||||
| LGHOS MGR SUPPORT SERVICE | $128,492 | $0 | $20,278 | $0 | $1,681 | $0 | $16,904 | $0 | $23,741 | $0 | $191,096 | $0 | $0 | $0 |
| TREVOR FRY | ||||||||||||||
| LGHOS MGR ER | $121,963 | $0 | $19,511 | $0 | $366 | $0 | $16,031 | $0 | $24,918 | $0 | $182,789 | $0 | $0 | $0 |
| EMILY PLANT | ||||||||||||||
| LGHOS MGR IP | $118,986 | $0 | $19,233 | $0 | $359 | $0 | $8,152 | $0 | $26,009 | $0 | $172,739 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF COMMUNITY HOSPITAL LAGRANGE COUNTY, 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 4B | SUPPLEMENTAL 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): JORDI DISLER $21,333; 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: JORDI DISLER $35,158; MICHAEL PACKNETT $268,732; JEANNE' WICKENS $303,865 |
| PART I, LINE 7 | MANAGEMENT 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANA HEALTH AND EDUCATIONAL FACILITY FINANCING AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 351611409 | BondIssuerEIN |
| CUSIP | 45479RCF2 | CUSIPNum |
| Bond Issued | 2007-03-15 | BondIssuedDt |
| Issue Price | $24,930,000 | IssuePriceAmt |
| Purpose | SEE PART VI | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $11,725,000 | RetiredAmt |
| Total Proceeds | $25,930,446 | TotalProceedsAmt |
| Capitalized Interest | $1,074,006 | CapitalizedInterestAmt |
| Issuance Costs From Proceeds | $208,535 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $154,519 | CreditEnhancementAmt |
| Capital Expenditures | $24,493,386 | CapitalExpendituresAmt |
| Substantial Completion | 2008 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | Yes (1) | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (1) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | Yes (1) | EngageBondCounselContractsInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | Yes (1) | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE K, PART I, COLUMN F, LINE A: | CONSTRUCTION OF NEW HOSPITAL FACILITY FOR COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IN LAGRANGE, INDIANA |
| SCHEDULE K, PART II, COLUMN A, LINE 3: | THIS AMOUNT INCLUDES INTEREST OF $1,000,446. EARNED ON PROJECT, COST OF ISSUANCE AND CAPITALIZED INTEREST FUNDS. |
| SCHEDULE K, PART III, COLUMN A, LINES 4-6: | AS PART OF OUR EFFORTS TO MONITOR AND ENSURE THAT THERE IS NO PRIVATE USE AT OUR BOND FINANCED FACILITIES, WE CONTRIBUTE EQUITY TO FINANCE A PORTION OF OUR NEW MONEY PROJECTS. |
| 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 COMPUTATION PERFORMED ON APRIL 13, 2010. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| LYNNELLE MILLER | |||
| FAMILY MEMBER OF DIRECTOR LISA BOOTH | $164,550 | EMPLOYEE LYNNELLE MILLER RECEIVED COMPENSATION (INCLUDING TAXABLE AND NONTAXABLE FRINGE BENEFITS TREATED AS COMPENSATION) FROM COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. | 0 |
| REDI-CARE INC PC | |||
| ENTITY OF WHICH DIRECTOR DARYL HERSHBERGER OWNED A 35% OR GREATER INTEREST | $134,924 | VENDOR ARRANGEMENT - TRANSACTIONS WERE ENTERED INTO AT ARM'S LENGTH. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC., EIN 20-2401676. 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 COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. WAS 36 AND 170 RESPECTIVELY. |
| FORM 990, PART VI, SECTION A, LINE 1A | THE 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 2 | DIRECTORS/OFFICERS JORDI DISLER AND JOE URBANSKI HAVE A BUSINESS RELATIONSHIP. DIRECTOR/OFFICER MICHAEL PACKNETT AND OFFICER JEANNE' WICKENS HAVE BUSINESS RELATIONSHIPS AS OFFICERS OF RELATED ENTITIES. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE 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 COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. WITH CERTAIN RESERVED POWERS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE 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 7B | SEE SCHEDULE O EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A |
| FORM 990, PART VI, SECTION B, LINE 11B | PURSUANT 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. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IS A SUBSIDIARY CORPORATION OF PARKVIEW HEALTH SYSTEM, INC. AN ELECTRONIC COPY OF THE ORGANIZATION'S FINAL FORM 990 (INCLUDING REQUIRED SCHEDULES) WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY, 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 12C | AS 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 15 | LINES 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 19 | COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER: PROGRAM SERVICE EXPENSES 481,145. MANAGEMENT AND GENERAL EXPENSES 59,522. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 540,667. MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 3,760,148. MANAGEMENT AND GENERAL EXPENSES 407,053. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,167,201. LAB SERVICES: PROGRAM SERVICE EXPENSES 1,251,499. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,251,499. COLLECTION EXPENSE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 232,062. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 232,062. |
| 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 -258,946. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (24 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| PARKVIEW HEALTH SYSTEM INC | |||||||||||
| 1450 PRODUCTION RD | FORT WAYNE | IN | 468081167 | 351972384 | HEALTH CARE | IN | 501(C)(3) | LINE 12C, III-FI | N/A | 0 | |
| PARKVIEW HOSPITAL INC | |||||||||||
| 11109 PARKVIEW PLAZA DR | FORT WAYNE | IN | 468451701 | 350868085 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| PARKVIEW FOUNDATION INC | |||||||||||
| 3844 NEW VISION DR | FORT WAYNE | IN | 468451724 | 237220589 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | PARKVIEW HOSPITAL INC | |
| DEKALB MEMORIAL HOSPITAL INC | |||||||||||
| 1316 E 7TH ST | AUBURN | IN | 467062515 | 351064295 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| PARKVIEW DEKALB HOSPITAL FOUNDATION INC | |||||||||||
| 1316 E 7TH ST | AUBURN | IN | 467062515 | 351064295 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | DEKALB MEMORIAL HOSPITAL INC | |
| HUNTINGTON MEMORIAL HOSPITAL INC | |||||||||||
| 2001 STULTS RD | HUNTINGTON | IN | 467501291 | 351970706 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| PARKVIEW HUNTINGTON HOSPITAL FOUNDATION INC | |||||||||||
| 2001 STULTS RD | HUNTINGTON | IN | 467501291 | 320012095 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | HUNTINGTON MEMORIAL HOSPITAL INC | |
| PARKVIEW LAGRANGE HOSPITAL FOUNDATION INC | |||||||||||
| 207 N TOWNLINE RD | LAGRANGE | IN | 467611325 | 833347115 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | Yes (1) | COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC | |
| COMMUNITY HOSPITAL OF NOBLE COUNTY INC | |||||||||||
| 401 N SAWYER RD | KENDALLVILLE | IN | 467552568 | 352087092 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| COMMUNITY HOSPITAL OF NOBLE COUNTY FOUNDATION INC | |||||||||||
| 401 N SAWYER RD | KENDALLVILLE | IN | 467552568 | 352089183 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | COMMUNITY HOSPITAL OF NOBLE COUNTY INC | |
| PARKVIEW WABASH HOSPITAL INC | |||||||||||
| 10 JOHN KISSINGER DR | WABASH | IN | 469921648 | 471753440 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| PARKVIEW WABASH HOSPITAL FOUNDATION INC | |||||||||||
| 10 JOHN KISSINGER DR | WABASH | IN | 469921648 | 351921445 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | PARKVIEW WABASH HOSPITAL INC | |
| WHITLEY MEMORIAL HOSPITAL INC | |||||||||||
| 1260 E STATE ROAD 205 | COLUMBIA CITY | IN | 467259492 | 351967665 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| WHITLEY MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 1260 E STATE ROAD 205 | COLUMBIA CITY | IN | 467259492 | 311190239 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | WHITLEY MEMORIAL HOSPITAL INC | |
| MIDWEST COMMUNITY HEALTH ASSOCIATES INC | |||||||||||
| 442 W HIGH ST | BRYAN | OH | 435061681 | 341045870 | PHYSICIANS | OH | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| PARKVIEW OCCUPATIONAL HEALTH CENTERS INC | |||||||||||
| 1450 PRODUCTION RD | FORT WAYNE | IN | 468081167 | 352064353 | OCCUPATIONAL HEALTH | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| PARK CENTER INC | |||||||||||
| 909 E STATE BLVD | FORT WAYNE | IN | 468053404 | 351135451 | COMPREHENSIVE MENTAL HEALTH CENTER | IN | 501(C)(3) | LINE 10 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| OUABACHE VILLAGE INC | |||||||||||
| 909 E STATE BLVD | FORT WAYNE | IN | 468053404 | 020731922 | PROVIDE HOUSING TO HANDICAPPED INDIVIDUALS | IN | 501(C)(3) | LINE 10 | 0 | PARK CENTER INC | |
| RICHARDVILLE APARTMENTS INC | |||||||||||
| 909 E STATE BLVD | FORT WAYNE | IN | 468053404 | 050543940 | PROVIDE HOUSING TO HANDICAPPED INDIVIDUALS | IN | 501(C)(3) | LINE 10 | 0 | PARK CENTER INC | |
| RICHARDVILLE APARTMENTS II INC | |||||||||||
| 909 E STATE BLVD | FORT WAYNE | IN | 468053404 | 861077255 | PROVIDE HOUSING TO HANDICAPPED INDIVIDUALS | IN | 501(C)(3) | LINE 10 | 0 | PARK CENTER INC | |
| SEDDLEMEYER APARTMENTS INC | |||||||||||
| 909 E STATE BLVD | FORT WAYNE | IN | 468053404 | 352067590 | PROVIDE HOUSING TO HANDICAPPED INDIVIDUALS | IN | 501(C)(3) | LINE 10 | 0 | PARK CENTER INC | |
| WAYNEDALE APARTMENTS INC | |||||||||||
| 909 E STATE BLVD | FORT WAYNE | IN | 468053404 | 351972197 | PROVIDE HOUSING TO HANDICAPPED INDIVIDUALS | IN | 501(C)(3) | LINE 10 | 0 | PARK CENTER INC | |
| WAYNEDALE II APARTMENTS INC | |||||||||||
| 909 E STATE BLVD | FORT WAYNE | IN | 468053404 | 223972135 | PROVIDE HOUSING TO HANDICAPPED INDIVIDUALS | IN | 501(C)(3) | LINE 10 | 0 | PARK CENTER INC | |
| WOODSIDE APARTMENTS INC | |||||||||||
| 909 E STATE BLVD | FORT WAYNE | IN | 468053404 | 351937426 | PROVIDE HOUSING TO HANDICAPPED INDIVIDUALS | IN | 501(C)(3) | LINE 10 | 0 | PARK CENTER INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH LLC | ||||||||||
| 1450 PRODUCTION RD | FORT WAYNE | IN | 468081167 | 260143823 | ORTHOPAEDIC HOSPITAL | IN | N/A | N/A | 0 | 0 |
| MANAGED CARE SERVICES LLC | ||||||||||
| 1450 PRODUCTION RD | FORT WAYNE | IN | 468081167 | 351996535 | HEALTH PLAN ADMINISTRATION | IN | N/A | N/A | 0 | 0 |
| FOUNDATION SURGERY AFFILIATE OF FORT WAYNE LLC | ||||||||||
| 1450 PRODUCTION RD | FORT WAYNE | ID | 468081167 | 201394120 | SURGICAL SERVICES | IN | N/A | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| PARKVIEW PROFESSIONAL PROGRAMS INC | |||||||||
| 1450 PRODUCTION RD | FORT WAYNE | IN | 468081167 | 351668888 | REFERENCE LAB | IN | N/A | C | 0 |
| WOODLAND PLAZA MEDICAL PARK CONDO ASSOC INC | |||||||||
| 202 W BERRY ST | FORT WAYNE | IN | 468022273 | 352058340 | PROPERTY OWNERS ASSOCIATION | IN | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |