COMMUNITY HOSPITAL OF NOBLE COUNTY INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: COMMUNITY HOSPITAL OF NOBLE COUNTY INC (EIN 35-2087092)
Tax period: 2021-01-01 to 2021-12-31
Filed: 2022-11-02
IRS object ID: 202223069349302892
Schema version: 2021v4.2
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 B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-11-02T17:35:31-05:00	ReturnTs
Tax Period End	2021-12-31	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	330 E JEFFERSON BLVD P O BOX 7	AddressLine1Txt
City	SOUTH BEND	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	466240007	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	352087092	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY HOSPITAL OF NOBLE COUNTY INC	BusinessNameLine1Txt

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	401 N SAWYER RD	AddressLine1Txt
City	KENDALLVILLE	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	467552568	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JEANNE' WICKENS	PersonNm
Person Title	PH CFO	PersonTitleTxt
Phone	2602669313	PhoneNum
Signature	2022-11-02	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

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	BRITTNEY KOCAJ	PreparerPersonNm
PTIN	P01320603	PTIN
Phone	5742323992	PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	3	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	PARKVIEW NOBLE HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	MICHAEL J PACKNETT	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	$71,773,323	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	1999	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	11	VotingMembersGoverningBodyCnt
Voting Members Independent	6	VotingMembersIndependentCnt
Total Employee	307	TotalEmployeeCnt
Total Volunteers	34	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$5,699,734	PYContributionsGrantsAmt
CY Contributions Grants	$2,235,532	CYContributionsGrantsAmt
PY Program Service Revenue	$62,467,796	PYProgramServiceRevenueAmt
CY Program Service Revenue	$69,166,385	CYProgramServiceRevenueAmt
PY Investment Income	-$5,652	PYInvestmentIncomeAmt
CY Investment Income	-$776,974	CYInvestmentIncomeAmt
PY Other Revenue	$72,981	PYOtherRevenueAmt
CY Other Revenue	$231,314	CYOtherRevenueAmt
PY Total Revenue	$68,234,859	PYTotalRevenueAmt
CY Total Revenue	$70,856,257	CYTotalRevenueAmt
PY Grants And Similar Paid	$109,589	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$83,402	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$19,601,545	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$20,889,010	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$68,371	CYTotalFundraisingExpenseAmt
PY Other Expenses	$38,895,388	PYOtherExpensesAmt
CY Other Expenses	$35,779,664	CYOtherExpensesAmt
PY Total Expenses	$58,606,522	PYTotalExpensesAmt
CY Total Expenses	$56,752,076	CYTotalExpensesAmt
PY Revenues Less Expenses	$9,628,337	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$14,104,181	CYRevenuesLessExpensesAmt
Total Assets BOY	$39,986,763	TotalAssetsBOYAmt
Total Assets EOY	$52,459,659	TotalAssetsEOYAmt
Total Liabilities BOY	$10,799,109	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$9,192,432	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$29,187,654	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$43,267,227	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	COMMUNITY HOSPITAL OF NOBLE 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	$45,952,213	ExpenseAmt
Grant	$83,402	GrantAmt
Revenue	$69,166,385	RevenueAmt
Desc	COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. COMMUNITY HEALTH IMPROVEMENT:AS A NOT-FOR-PROFIT HOSPITAL, WE FOCUS ON OUR MISSION TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE AND TO PROVIDE A PERSONALIZED WELLNESS JOURNEY. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. EXISTS FOR ONE PURPOSE - TO IMPROVE THE HEALTH OF OUR COMMUNITIES. COMMUNITY HOSPITAL OF NOBLE 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. PARKVIEW CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT ON A REGULAR BASIS TO IDENTIFY HEALTH(SEE SCHEDULE O FOR CONTINUATION)NEEDS WITHIN NORTHEAST INDIANA, PARTICULARLY, IN THE FIVE COUNTIES IN WHICH OUR HOSPITALS EXIST. THE FOLLOWING ARE SOME OF THE WAYS COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. IS REACHING OUT TO MAKE OUR NEIGHBORHOODS AND COMMUNITIES HEALTHIER:-FINANCIAL ASSISTANCE-COMMUNITY HEALTH IMPROVEMENT INITIATIVES-PRIMARY HEALTH CARE /ACCESS-HEALTH SCREENINGS AND PREVENTION-DISEASE MANAGEMENT-HEALTH EDUCATIONFINANCIAL ASSISTANCE:COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.'S MISSION INCLUDES CARING FOR PEOPLE WHO DO NOT HAVE THE MEANS TO MEET THEIR FINANCIAL OBLIGATIONS. THE HOSPITAL PLACES ITS PRIORITY ON PROVIDING THE NECESSARY CARE, NOT ON THE PATIENT'S ABILITY TO PAY FOR THEIR MEDICAL EXPENSES.COMMUNITY HEALTH IMPROVEMENT INITIATIVES:THE PURPOSE OF COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.'S COMMUNITY HEALTH IMPROVEMENT PROGRAM IS TO FUND COMMUNITY HEALTH IMPROVEMENT EFFORTS WITHIN THE SERVICE AREA OF COMMUNITY HOSPITAL OF NOBLE 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.CENTER FOR HEALTHY LIVING SUPPORTED BY THE COMMUNITY HEALTH IMPROVEMENT MANAGER: COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. OFFERS A WELLNESS FACILITY WHERE THE COMMUNITY CAN ACCESS COOKING DEMONSTRATIONS, DIABETES EDUCATION, HEALTH BEHAVIOR CHANGE PROGRAMS, REDUCED COST BLOOD DRAWS, AND PROFESSIONAL LECTURES ON HEALTH/WELLNESS. THE COMMUNITY HEALTH IMPROVEMENT MANAGER IS INSTRUMENTAL IN THE IMPLEMENTATION OF KEY STRATEGIES AS IDENTIFIED BY OUR COMMUNITY HEALTH NEEDS ASSESSMENT - OBESITY, MENTAL HEALTH, AND DRUG ABUSE AT THE PARKVIEW NOBLE CENTER FOR HEALTHY LIVING - COMMUNITY LEARNING CENTER LOCATION. ALL PROGRAMS AND SERVICES ARE OFFERED FREE, AT LOWER COST, OR SCHOLARSHIPS ARE PROVIDED; NO ONE IS TURNED AWAY FOR INABILITY TO PAY. MANY OF THE PROGRAMS TARGETED OBESITY AND OVERALL WELLNESS. THE MANAGER CONTINUES TO PROMOTE AND MANAGE THE MY BEST HEALTH PROGRAM WHICH HAS THE GOAL TO PREVENT, ARREST AND REVERSE CHRONIC DISEASE. AS THE COVID-19 PANDEMIC CONTINUED THROUGH 2021, THE CENTER FOR HEALTHY LIVING OFFERED A MIX OF IN-PERSON AND VIRTUAL PROGRAM OPTIONS. COMMUNITY HEALTH IMPROVEMENT MANAGER: COMMUNITY HOSPITAL OF NOBLE 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 LEARNING CENTER LEADERSHIP MEETINGS. THESE LEADERSHIP MEETINGS BRING VARIOUS LEADERS ACROSS THE 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 ISSUE. THE COMMUNITY HEALTH IMPROVEMENT MANAGER IS ALSO INVOLVED IN VARIOUS OTHER COALITIONS AND COMMUNITY PARTNERSHIPS SUCH AS THRIVE BY 5, WORKING TOWARDS INCREASING CHILDCARE SPACES IN NOBLE COUNTY; ACTIVATE NOBLE COUNTY, WORKING TO INCREASE ACCESS TO EXERCISE OPPORTUNITIES AND REDUCE FOOD INSECURITY; AND VARIOUS OTHERS. THE COMMUNITY HEALTH IMPROVEMENT MANAGER ALSO IDENTIFIES, DEVELOPS, IMPLEMENTS, AND EVALUATES ALL COMMUNITY PROGRAMS OFFERED THROUGH THE CENTER FOR HEALTHY LIVING, INCLUDING NUTRITION EDUCATION, HEALTH SCREENINGS AND VARIOUS OTHER ACTIVITIES. COMMUNITY PARTNERSHIPS: COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. INVESTS IN KEY ORGANIZATIONS (HEALTH PARTNERS) THAT ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF NOBLE COUNTY AND NORTHEAST INDIANA. WE PARTNER WITH THE COLE FAMILY CENTER YMCA ON MULTIPLE PROJECTS TO ENCOURAGE HEALTHIER LIFESTYLES INCLUDING SCHOLARSHIPS TO THE YMCA AND A BLOOD PRESSURE SELF-MONITORING PROGRAM. TO ASSIST THOSE LESS FORTUNATE, WE SUPPORT ST. MARTIN'S HEALTHCARE AND NOBLE HOUSE MINISTRIES. WE ALSO PARTNER WITH THE NOBLE COUNTY HEALTH DEPARTMENT TO PROVIDE IMMUNIZATIONS TO CHILDREN WHO OTHERWISE COULD NOT ACCESS THEM. TO ENCOURAGE HIGHER PAYING JOBS AND ECONOMIC IMPROVEMENT, WE PARTNER WITH THE NOBLE COUNTY ECONOMIC DEVELOPMENT CORPORATION. TO ASSIST IN HEALTH EDUCATION IN OUR SCHOOL DISTRICTS, FUNDS ARE PROVIDED TO MCMILLEN HEALTH TO PROVIDE EVIDENCE-BASED EDUCATION OVER OBESITY, TOBACCO USE, DRUG USE, AND MENTAL HEALTH TO AREA SCHOOLS. OTHER PARTNERS ACTIVE IN ADDRESSING MEDICAL ISSUES INCLUDE ACTIVATE NOBLE COUNTY AND THE COMMUNITY LEARNING CENTER. DURING THE COVID-19 PANDEMIC, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.'S HEALTH PARTNERS ADAPTED PROGRAMS TO BE OFFERED VIRTUALLY OR THROUGH E-LEARNING. ACTIVATE NOBLE COUNTY: THIS ORGANIZATION IS A TRUE COMMUNITY PARTNERSHIP WITH MANY ORGANIZATIONS INCLUDING COMMUNITY HOSPITAL OF NOBLE COUNTY, INC., THE COLE FAMILY CENTER YMCA, COMMUNITY LEARNING CENTER, PARKS AND RECREATION AND LOCAL GOVERNMENT. THE MISSION IS "TO IMPROVE THE HEALTH AND WELLNESS OF NOBLE COUNTY BY INCREASING OPPORTUNITIES FOR HEALTHY EATING AND ACTIVE LIVING." THE GROUP HAS BEEN THE CENTRAL PARTNERSHIP TO ESTABLISH COMMUNITY GOALS AROUND THE COMMUNITY HEALTH NEEDS ESTABLISHED FROM OUR ASSESSMENT: MENTAL HEALTH/DRUG ABUSE AND OBESITY. THE GROUP MEETS MONTHLY WORKING COLLABORATIVELY TO ESTABLISH PROGRAMS, GUIDELINES AND TO MAKE IMPROVEMENTS TO KEY METRICS FROM THE ASSESSMENT PLAN AND HAS ESTABLISHED SOCIAL MEDIA PLATFORMS TO INCREASE ENGAGEMENT AND ACTION AMONG THE COMMUNITY. THE GROUP CONTINUED TO MEET VIRTUALLY THROUGH THE COVID-19 PANDEMIC. ACTIVATE NOBLE COUNTY ALSO IS AN INSTRUMENTAL PART IN POLICY CHANGE IN NOBLE COUNTY. THE GROUP HAS STARTED CONVERSATION AND GAINED MOMENTUM AROUND WALKABILITY AND BIKE ABILITY IN NOBLE COUNTY. THE GROUP LED THE EFFORT FOR BOTH PARKLETS AND WAYFINDING SIGNS TO BE INSTALLED IN ONE OF NOBLE COUNTY'S DOWNTOWNS TO PROVIDE A DESTINATION THAT ENCOURAGES WALKING. THE GROUP ALSO GROWS AND MAINTAINS A COMMUNITY GARDEN TO HELP INCREASE ACCESS TO FRESH, AFFORDABLE PRODUCE. THROUGH THE COVID-19 PANDEMIC, THE GROUP CONTINUED TO MAINTAIN A COMMUNITY GARDEN FOR COMMUNITY MEMBERS TO ACCESS FRESH, AFFORDABLE PRODUCE. PRIMARY HEALTH CARE/ACCESS:MEDICATION ASSISTANCE PROGRAM (MAP): COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. MAINTAINS A MEDICATION ASSISTANCE PROGRAM FOR NOBLE 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. THE MAP WAS OFFERED THROUGH COVID-19 VIRTUALLY. HEALTH SCREENING AND DISEASE PREVENTION AND MANAGEMENT:HEALTH SCREENINGS AND SUPPORT GROUPS: COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. OFFERS NUMEROUS HEALTH SCREENINGS THROUGHOUT THE YEAR THAT ARE DESIGNED TO PROVIDE HEALTH SCREENINGS FOR DISEASE PREVENTION AT A REDUCED COST AND THE PROMOTION OF HEALTHY LIFESTYLES. THE HOSPITAL ALSO PROVIDES SUPPORT GROUPS FOR INDIVIDUALS WHO EXPERIENCE DIABETES, PARKINSONS AND STROKE TO ASSIST PATIENTS AND FAMILIES IN MANAGING DISEASE.	Desc
Total Program Service Expenses	$45,952,213	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	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	Yes (1)	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	0	TaxExemptBondsInd
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	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	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	Yes (1)	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	31	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	307	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	11	GoverningBodyVotingMembersCnt
Independent Voting Member	6	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 (19 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	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
MICHAEL PACKNETT
DIRECTOR/PH PRESIDENT & CEO	0.00	40.00	Yes (X)	Yes (X)	$0	$2,037,606	$326,073
MYCAL MANSFIELD
DIRECTOR/PH PHYSICIAN	0.00	40.00	Yes (X)		$6,409	$449,207	$62,030
LISA LANE
DIRECTOR/PH PHYSICIAN	0.00	40.00	Yes (X)		$18,560	$350,858	$64,852
GARY ADKINS
DIRECTOR/NBHOS PRESIDENT	40.00	0.00	Yes (X)	Yes (X)	$318,856	$0	$82,285
DOUGLAS SCOTT
DIRECTOR	1.00	0.00	Yes (X)		$12,700	$0	$0
THOMAS LEEDY
DIRECTOR	1.00	1.00	Yes (X)		$4,750	$750	$0
GEORGE BENNETT
DIRECTOR/CHAIR	1.00	1.00	Yes (X)	Yes (X)	$6,000	$2,250	$0
ROBERT KIRSCH
DIRECTOR/VICE CHAIR	1.00	0.00	Yes (X)	Yes (X)	$4,500	$0	$0
BETH MUNK
DIRECTOR-PARTIAL YR/SECRETARY	1.00	0.00	Yes (X)	Yes (X)	$3,500	$0	$0
JARROD RAMER
DIRECTOR/SECRETARY	1.00	0.00	Yes (X)	Yes (X)	$4,250	$0	$0
GARY GATMAN
DIRECTOR/TREASURER	1.00	0.00	Yes (X)	Yes (X)	$4,250	$0	$0
KARA WARRENER
DIRECTOR	1.00	0.00	Yes (X)		$4,500	$0	$0
JEANNE' WICKENS
PH CHIEF FINANCIAL OFFICER	0.00	40.00		Yes (X)	$0	$1,059,636	$349,980
ERIN GOLDSBERRY
NBHOS VP PATIENT CARE	40.00	0.00			$172,881	$3,742	$33,326	Yes (X)
KELLY BALYEAT
NBHOS MGR PHARMACY	40.00	0.00			$177,827	$0	$40,594		Yes (X)
RICHARD LARIMORE
NBHOS MGR SUPPORT SVCS	40.00	0.00			$133,011	$0	$20,464		Yes (X)
JULIE DESPER
NBHOS MGR REHAB	36.00	4.00			$116,943	$12,054	$37,316		Yes (X)
JENNIFER PERKINS
NBHOS HOUSE SPV	40.00	0.00			$143,452	$0	$47,810		Yes (X)
GARY HEIMAN
NBHOS PARAMEDIC	32.00	8.00			$117,068	$14,658	$20,422		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,249,457	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$3,930,761	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,085,152	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	23	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
PARKVIEW HOSPITAL INC
11109 PARKVIEW PLAZA DR	FORT WAYNE	IN	46845	LABORATORY SERVICES	$2,757,336
CLINICAL COLLEAGUES INC
PO BOX 824246	PHILADELPHIA	PA	19182	ANESTHESIOLOGISTS	$1,121,803
NORTHEAST INTERNAL MEDICINE ASSOC INC
2500 N DETROIT ST	LAGRANGE	IN	46761	HOSPITALISTS	$411,985
PROLINK HEALTHCARE
4600 MONTGOMERY ROAD SUITE 300	CINCINNATI	OH	45212	MEDICAL PERSONNEL	$285,783
FOCUSONE SOLUTIONS LLC
13609 CALIFORNIA ST	OMAHA	NE	68154	MEDICAL PERSONNEL	$238,270

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	9	CntrctRcvdGreaterThan100KCnt
Related Organizations	$129,434	RelatedOrganizationsAmt
Government Grants	$2,106,098	GovernmentGrantsAmt
Total Contributions	$2,235,532	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE	622000	$68,681,023	$68,681,023
EMS SUBSIDY	621910	$282,790	$282,790
INTERUNIT RENT	531120	$118,611	$118,611
PHARMACY	446110	$39,814	$39,814
HEALTH FAIR	621990	$36,925	$36,925

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$7,222	TotalRevenueColumnAmt
Related Or Exempt Func Income	$7,222	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$69,166,385	TotalProgramServiceRevenueAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$22,446	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$45,092	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	-$22,646	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$22,646	TotalRevenueColumnAmt
Exclusion	-$22,646	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$95,000	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$871,974	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$776,974	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$776,974	TotalRevenueColumnAmt
Exclusion	-$776,974	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
CAFETERIA SALES	722514	$233,896	$233,896
GIFT SHOP	453220	$20,064	$20,064

Field	Value	IRS element (for citing)
Other Revenue Total	$253,960	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$70,856,257	TotalRevenueColumnAmt
Related Or Exempt Func Income	$69,166,385	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	-$545,660	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	$83,402	TotalAmt
Program Services	$83,402	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$680,192	TotalAmt
Management And General	$680,192	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$15,504,873	TotalAmt
Program Services	$15,504,873	ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$4,703,945	TotalAmt
Program Services	$4,703,945	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$6,728,301	TotalAmt
Program Services	$5,883,341	ProgramServicesAmt
Management And General	$844,960	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,393	TotalAmt
Management And General	$1,393	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,048,650	TotalAmt
Program Services	$927,391	ProgramServicesAmt
Management And General	$121,259	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$6,615	TotalAmt
Program Services	$6,615	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,208,158	TotalAmt
Program Services	$2,206,641	ProgramServicesAmt
Management And General	$1,517	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$5,992	TotalAmt
Program Services	$5,743	ProgramServicesAmt
Management And General	$249	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$25,424	TotalAmt
Program Services	$25,424	ProgramServicesAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,748	TotalAmt
Program Services	$1,748	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$1,424,635	TotalAmt
Program Services	$1,414,060	ProgramServicesAmt
Management And General	$10,575	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$123,616	TotalAmt
Program Services	$123,616	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Management And GeneralManagementAndGeneralAmt	Program ServicesProgramServicesAmt
CORP SERVICE ALLOCATION	$9,019,567	$9,019,567
MEDICAL SUPPLIES	$6,124,479		$6,124,479
PH CLINICAL SUPPORT	$6,062,935		$6,062,935
HOSPITAL ASSESSMENT FEE	$2,801,412		$2,801,412

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$196,739	TotalAmt
Program Services	$76,588	ProgramServicesAmt
Management And General	$51,780	ManagementAndGeneralAmt
Fundraising	$68,371	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$56,752,076	TotalAmt
Program Services	$45,952,213	ProgramServicesAmt
Management And General	$10,731,492	ManagementAndGeneralAmt
Fundraising	$68,371	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$10,440	BOYAmt
EOY	$19,563	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
EOY	$252,916	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$9,535,105	BOYAmt
EOY	$11,934,957	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$425,412	BOYAmt
EOY	$360,886	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$15,850	BOYAmt
EOY	$17,170	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$16,840,079	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$12,207,134	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$5,668,134	BOYAmt
EOY	$4,632,945	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$5,000	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$840,505	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$23,486,317	BOYAmt
EOY	$35,241,222	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$39,986,763	BOYAmt
EOY	$52,459,659	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$2,598,085	BOYAmt
EOY	$2,094,188	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$4,841,386	BOYAmt
EOY	$3,177,783	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$3,359,638	BOYAmt
EOY	$3,920,461	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$10,799,109	BOYAmt
EOY	$9,192,432	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	$29,187,654	BOYAmt
EOY	$43,267,227	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$29,187,654	BOYAmt
EOY	$43,267,227	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$39,986,763	BOYAmt
EOY	$52,459,659	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$14,104,181	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$24,608	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 B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

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	$5,054	OtherActivitiesAmt
Total Lobbying Expenditures	$5,054	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 VARIOUS PROFESSIONAL ASSOCIATIONS USED FOR LOBBYING ACTIVITIES.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$135,936	BeginningYearBalanceAmt
Investment Earnings Or Losses	$9,303	InvestmentEarningsOrLossesAmt
End Year Balance	$145,239	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$130,151	BeginningYearBalanceAmt
Investment Earnings Or Losses	$5,785	InvestmentEarningsOrLossesAmt
End Year Balance	$135,936	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$126,071	BeginningYearBalanceAmt
Investment Earnings Or Losses	$4,080	InvestmentEarningsOrLossesAmt
End Year Balance	$130,151	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$122,487	BeginningYearBalanceAmt
Investment Earnings Or Losses	$3,584	InvestmentEarningsOrLossesAmt
End Year Balance	$126,071	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$113,496	BeginningYearBalanceAmt
Investment Earnings Or Losses	$8,991	InvestmentEarningsOrLossesAmt
End Year Balance	$122,487	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	1.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.00000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.00000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,912,444	OtherCostOrOtherBasisAmt
Depreciation	$2,201,432	DepreciationAmt
Book Value	$1,711,012	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$7,379	OtherCostOrOtherBasisAmt
Depreciation	$7,379	DepreciationAmt
Book Value	$0	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$12,164,864	OtherCostOrOtherBasisAmt
Depreciation	$9,379,345	DepreciationAmt
Book Value	$2,785,519	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$755,392	OtherCostOrOtherBasisAmt
Depreciation	$618,978	DepreciationAmt
Book Value	$136,414	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$4,632,945	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDesc	Book ValueBookValueAmt
DUE TO/FROM INTERUNIT	$34,914,497
RIGHT OF USE ASSETS	$326,725

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$35,241,222	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
EST 3RD PARTY SETTLEMENTS	$1,052,124
EST MEDICARE/MEDICAID SETTLEMENTS	$2,540,670
LEASE LIABILITY	$327,667

Field	Value	IRS element (for citing)
Total Liability	$3,920,461	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART V, LINE 4:

TO SUPPORT HOSPITAL BUILDING NEEDS FOR COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.

PART X, LINE 2:

PARKVIEW HEALTH SYSTEM, INC. AND SUBSIDIARIES - NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES THE LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): INCOME TAXES: THE INTERNAL REVENUE SERVICE HAS DETERMINED THAT THE CORPORATION AND CERTAIN AFFILIATED ENTITIES ARE TAX-EXEMPT ORGANIZATIONS AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CERTAIN SUBSIDIARIES OF THE CORPORATION ARE TAXABLE ENTITIES, THE TAX EXPENSE AND LIABILITIES OF WHICH ARE NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION AND ITS TAX-EXEMPT AFFILIATED ENTITIES EACH FILE A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THESE RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH SYSTEMS INCLUDE SUCH MATTERS AS THE TAX-EXEMPT STATUS OF EACH ENTITY, THE CONTINUED TAX-EXEMPT STATUS OF BONDS, THE NATURE, CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME, AND VARIOUS POSITIONS RELATING TO POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (REPORTED ON FORM 990T). AS OF DECEMBER 31, 2021 AND 2020, 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 2017 AND PRIOR.

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	$1,098,084	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,098,084	NetCommunityBenefitExpnsAmt
Total Expense	0.02170	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,354,769	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,202,252	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,152,517	NetCommunityBenefitExpnsAmt
Total Expense	0.02270	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,134,312	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,850,893	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,283,419	NetCommunityBenefitExpnsAmt
Total Expense	0.02530	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$13,587,165	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,053,145	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,534,020	NetCommunityBenefitExpnsAmt
Total Expense	0.06970	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$155,378	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$155,378	NetCommunityBenefitExpnsAmt
Total Expense	0.00310	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$9,368	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$9,368	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,826,550	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,482,800	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,343,750	NetCommunityBenefitExpnsAmt
Total Expense	0.04620	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$73,409	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$73,409	NetCommunityBenefitExpnsAmt
Total Expense	0.00140	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,064,705	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,482,800	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,581,905	NetCommunityBenefitExpnsAmt
Total Expense	0.05090	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$20,651,870	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$14,535,945	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,115,925	NetCommunityBenefitExpnsAmt
Total Expense	0.12060	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$10,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$10,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	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	$11,377,686	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$9,020,804	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$2,356,882	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 NOBLE COUNTY INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	401 SAWYER RD	AddressLine1Txt
City	KENDALLVILLE	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46755	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.PARKVIEW.COM	WebsiteAddressTxt
State License	14-002434-1	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
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 NOBLE COUNTY INC	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	19	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	19	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	HTTPS://WWW.PARKVIEW.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	HTTPS://WWW.PARKVIEW.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	HTTPS://WWW.PARKVIEW.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE	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 (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.	PART V, SECTION B, LINE 5: DESCRIBE HOW THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY, AND IDENTIFY THE PERSONS THE HOSPITAL FACILITY CONSULTED:WHEN CONDUCTING ITS 2019 CHNA, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. AND THE INDIANA PARTNERSHIP FOR HEALTHY COMMUNITIES (IN-PHC) RESEARCH TEAM WERE DILIGENT IN ENSURING THE INPUT FROM PERSONS REPRESENTING THE BROADER INTERESTS OF THE COMMUNITY'S VULNERABLE POPULATIONS WERE CONSIDERED.IN GATHERING QUALITATIVE COMMUNITY INPUT, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. AND ITS RESEARCH PARTNERS OBTAINED THE FOLLOWING: 1) PRIMARY DATA COLLECTED VIA AN ONLINE SURVEY OF PARKVIEW HEALTH SYSTEM, INC. HEALTHCARE PROVIDERS (E.G., PHYSICIANS, NURSES, SOCIAL WORKERS, ETC.). ADDITIONALLY, THE HEALTH SYSTEM'S CHNA RESEARCH PARTNERS CONDUCTED A SURVEY OF THE COMMUNITY RESIDENTS IN EACH PARKVIEW HEALTH COUNTY. 2) SECONDARY DATA WAS GATHERED FROM CONDUENT'S HEALTHY COMMUNITIES INSTITUTE (HCI) DATABASE AND OTHER LOCAL AND NATIONAL AGENCIES.IN ADDITION TO DATA COLLECTION, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. TURNED TO THE COMMUNITY AND PARTNERING ORGANIZATIONS WHEN SELECTING AND PRIORITIZING NOBLE COUNTY'S HEALTH NEEDS. IN DOING SO, A MODIFIED HANLON METHOD PRIORITIZED 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.). ALTHOUGH COMPLEX TO IMPLEMENT, IT IS 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.THE INDIANA PARTNERSHIP FOR HEALTHY COMMUNITIES PRESENTED AN OVERVIEW OF THE REGIONAL CHNA FINDINGS ON JULY 16, 2019, TO ATTENDEES REPRESENTING THE PARKVIEW HEALTH SYSTEM. IN TOTAL OVER 60 INDIVIDUALS PARTICIPATED IN THE PRIORITIZATION PROCESS, INCLUDING REPRESENTATIVES FROM HOSPITAL SERVICE LINES, COMMUNITY HOSPITALS, HEALTHCARE PROVIDERS/PHYSICIANS, EXECUTIVE LEADERSHIP TEAM, COMMUNITY HEALTH AND HOSPITAL BOARD OF DIRECTORS. AFTER A THOROUGH REVIEW OF THE DATA AND CONSIDERABLE DISCUSSION, THE GROUP USED AN ELECTRONIC VOTING SYSTEM TO RANK THE VARIOUS HEALTH NEEDS IDENTIFIED IN THE CHNA. ULTIMATELY, THE GROUP VOTED ON SUBSTANCE USE DISORDER/MENTAL HEALTH, AS THE SHARED HEALTH PRIORITY ACROSS THE HEALTH SYSTEM.AS A CONTINUATION OF THE PRIORITIZATION PROCESS, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC FORMED AN INTERNAL, MULTI-DISCIPLINARY ADVISORY COUNCIL TO SELECT ADDITIONAL HEALTH PRIORITIES FOR COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. THIS GROUP OF STAKEHOLDERS MET AND DISCUSSED THE RESULTS OF THE CHNA. AFTER A THOUGHTFUL REVIEW OF THE DATA AND EXTENSIVE DISCUSSION, THE ADVISORY COMMITTEE SELECTED OBESITY AS OUR SECOND PRIORITY.COMMUNITY HOSPITAL OF NOBLE COUNTY ALSO HELD A COMMUNITY SESSION TO SHARE THE NOBLE COUNTY CHNA RESULTS AND TO GATHER FEEDBACK FROM LOCAL NON-PROFIT AND PUBLIC HEALTH ORGANIZATIONS. ADDITIONALLY, THE TOP TWO HEALTH PRIORITIES WERE PRESENTED TO AND ADOPTED BY COMMUNITY HOSPITAL OF NOBLE COUNTY, INC'S HOSPITAL BOARD OF DIRECTORS.
COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.	PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY'S CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES:PARKVIEW HOSPITAL, INC. (EIN 35-0868085); COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. (EIN 20-2401676); HUNTINGTON MEMORIAL HOSPITAL, INC. (EIN 35-1970706); WHITLEY MEMORIAL HOSPITAL, INC. (EIN 35-1967665); PARKVIEW WABASH HOSPITAL, INC. (EIN 47-1753440) AND ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH, LLC (EIN 26-0143823).
COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.	PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY'S CHNA WAS ALSO CONDUCTED WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES:PARKVIEW HEALTH, INC. (EIN 35-1972384); INDIANA PARTNERSHIP FOR HEALTHY COMMUNITIES (A PARTNERSHIP BETWEEN THE INDIANA UNIVERSITY RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH AND THE POLIS CENTER AT IUPUI) AND CONDUENT HEALTHY COMMUNITIES INSTITUTE.
COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.	PART V, SECTION B, LINE 11: DESCRIBE HOW THE HOSPITAL FACILITY IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA AND ANY SUCH NEEDS THAT ARE NOT BEING ADDRESSED TOGETHER WITH THE REASONS WHY SUCH NEEDS ARE NOT BEING ADDRESSED:SIGNIFICANT HEALTH NEEDS BEING ADDRESSED:OBESITY:COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. IS BOLSTERING ITS EFFORTS IN AREAS DEEMED TO BE THE HIGHEST IMPACT FOR OBESITY PREVENTION. THESE INCLUDE THE FOLLOWING: 1) WORKING TO INCREASE ACCESS TO FRESH, AFFORDABLE, AND LOCALLY GROWN (WHEN POSSIBLE) FOOD; 2) INCREASING CONSUMPTION OF FRESH PRODUCE; 3) OFFERING CURRICULUM TO ELEMENTARY SCHOOLS FOR PHYSICAL ACTIVITY AND NUTRITION; AND 4) PROVIDER DIRECTED WELLNESS RESOURCES INCLUDING REFERRALS TO MY BEST HEALTH, HEALTH BEHAVIOR CHANGE PROGRAM. ACTIONS TO ADDRESS THE ISSUE OF OBESITY CENTER AROUND AND INCLUDE THE FOLLOWING PROGRAMS: 1) MY BEST HEALTH, HEALTH BEHAVIOR CHANGE PROGRAM2) ACTIVATE NOBLE COUNTY AND COMMUNITY LEARNING CENTER GARDEN ACTIVATE NOBLE COUNTY MAINTAINED A GARDEN IN THE SUMMER GROWING MONTHS AND ALLOWED COMMUNITY MEMBERS TO ACCESS FRESH, AFFORDABLE PRODUCE DURING THE SUMMER MONTHS WHILE PRACTICING OUTDOOR SOCIAL DISTANCING. THE GARDEN IS LOCATED ON THE COMMUNITY LEARNING CENTER GROUNDS WHICH IS INSIDE A USDA FOOD DESERT. 3)DIABETES SUPPORT -DIABETES SUPPORT GROUPS WERE RUN FREE OF CHARGE TO THE COMMUNITY. THEY WERE OFFERED WITH A HYBRID APPROACH GIVING PARTICIPANTS THE OPTION TO JOIN IN PERSON OR VIRTUALLY. 4)COOKING DEMONSTRATIONS -COOKING DEMOS WERE OFFERED VIRTUALLY TO THE COMMUNITY VIA ZOOM. 5)PROVIDE EDUCATION TO SCHOOLS-PARTNERING WITH MCMILLEN HEALTH -MCMILLEN HEALTH PROVIDED BOTH IN PERSON AND VIRTUAL OPTIONS TO LOCAL SCHOOL DISTRICTS TO PROVIDE EDUCATION AROUND PHYSICAL ACTIVITY, NUTRITION, AND HEALTHY CHOICES. MENTAL HEALTH & DRUG ABUSE: COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. IS BOLSTERING ITS EFFORTS IN AREAS DEEMED TO BE HIGHEST IMPACT FOR MENTAL HEALTH & DRUG ABUSE IN THE FOLLOWING WAYS: TOBACCO USE: 1) PROVIDE EDUCATION IN THE SCHOOL SYSTEMS FOR PREVENTION OF TOBACCO USE IN PARTNERSHIP WITH MCMILLEN HEALTH. MCMILLEN HEALTH PROVIDED BOTH IN PERSON AND VIRTUAL OPTIONS TO LOCAL SCHOOL DISTRICTS TO PROVIDE EDUCATION.2) PARTNER WITH COMMUNITY HOSPITAL OF NOBLE COUNTY INC.'S RESPIRATORY CARE DEPARTMENT.COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.'S RESPIRATORY CARE DEPARTMENT INITIATED EDUCATION ON SMOKING CESSATION AND OFFERS HOSPITAL INPATIENTS PAMPHLETS AROUND CENTER FOR HEALTHY LIVING FREEDOM FROM SMOKING PROGRAM. PATIENTS HAVE THE OPTION WHILE IN THE HOSPITAL TO BE REFERRED TO THE CENTER FOR HEALTHY LIVING TO REGISTER FOR A FREEDOM FROM SMOKING CLASS WHILE STILL IN THE HOSPITAL, THUS ELIMINATING ONE MORE THING TO REMEMBER AFTER DISCHARGE. 3) OFFER FREEDOM FROM SMOKING (TOBACCO CESSATION PROGRAM) AT NO COST TO ALL PARTICIPANTS THROUGH PARKVIEW CENTER FOR HEALTHY LIVING VIRTUALLY. DRUG USE: COMMUNITY HOSPITAL OF NOBLE COUNTY PARTNERS WITH VARIOUS COMMUNITY PARTNERS TO PROVIDE EDUCATION IN OUR SCHOOL SYSTEMS. MENTAL HEALTH: 1) THE CENTER FOR HEALTHY LIVING PARTNERS WITH THE COMMUNITY LEARNING CENTER TO OFFER CLASSES FOR STRESS REDUCTION AS WELL AS A HEALING ARTS SERIES. 2) PARKVIEW BEHAVIORAL HEALTH IS INVOLVED IN THE NOBLE COUNTY COMMUNITY TO BRIEFLY PROVIDE THERAPY AND RESOURCES FOR THOSE WITH IMMEDIATE MENTAL HEALTH NEEDS. 3) SUPPORTING LOCAL PARTNERS SUCH AS NOBLE HOUSE MINISTRIES.4) EDUCATION TO LOCAL SCHOOLS FOR PREVENTION OF DRUG USE AND MENTAL HEALTH STIGMA REDUCTION. OTHER HEALTH NEEDS NOT BEING ADDRESSED:-DIABETES - COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. CURRENTLY ALREADY HAS A DIABETES EDUCATOR ON STAFF AND SUPPORT GROUPS OFFERED TO THE COMMUNITY. REGISTERED DIETICIANS ARE ON STAFF TO PROVIDE CONSULTATIONS FOR THOSE DIAGNOSED WITH DIABETES. SUPPORT GROUPS AND WORKSHOPS WERE AFFECTED BY THE COVID-19 PANDEMIC, BUT EDUCATION WAS STILL PROVIDED TO PATIENTS THROUGH THE DIABETES EDUCATOR VIRTUALLY. -MATERNAL/INFANT/CHILD HEALTH - A BIRTH PLANNER ON STAFF TEACHES SAFE SLEEP CLASSES FOR EXPECTING PARENTS AND LIFE AND FAMILY SERVICES & HEALTHIER MOMS AND BABIES ALREADY OFFER WORKSHOPS AND EDUCATION FOR THE UNDERSERVED POPULATIONS IN NOBLE COUNTY. THE BIRTH PLANNER, OB SUPERVISORS, AND LIFE AND FAMILY SERVICES ALSO PARTNER TO OFFER A MOM-TO-BE SUPPORT GROUP TO INSPIRE AND ENCOURAGE ALL MOMS, ESPECIALLY YOUNG MOMS ACROSS THE COUNTY. THESE PROGRAMS WERE ADAPTED THROUGH THE COVID-19 PANDEMIC TO BE ABLE TO BE OFFERED VIRTUALLY. -CARDIOVASCULAR DISEASE - THE SIZE OF THE HEALTH PROBLEM WAS LOWER IN RANKING THAN THE THREE HEALTH NEEDS IDENTIFIED. -CANCER - THE SIZE OF THE HEALTH PROBLEM WAS LOWER IN RANKING THAN THE THREE HEALTH NEEDS IDENTIFIED. -HEALTH CARE ACCESS - COST AND QUALITY - COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. CURRENTLY OFFERS MEDICATION ASSISTANCE, CHARITY CARE, AND FINANCIAL ASSISTANCE WITH HOSPITAL BILLS. -ASTHMA - THIS NEED RANKED TOO LOW OVERALL ON THE HANLON SCORES BY INDICATOR AND WAS NOT CHOSEN. -AGING - THIS NEED RANKED TOO LOW OVERALL ON THE HANLON SCORES BY INDICATOR AND WAS NOT CHOSEN.
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 (17 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	EQUITY IN A HOME OTHER THAN THE PATIENT OR GUARANTOR'S PRIMARY RESIDENCE.
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 NOBLE 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 NOBLE COUNTY, INC. ACCEPTS ALL CERTAIN MEANS-TESTED PATIENTS FROM THE HEALTHY INDIANA PLAN (HIP) WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEANS-TESTED PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING HIP, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE UNREIMBURSED HIP COST REPORTED ON LINE 7C IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE HIP CHARGES ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF HIP SERVICES RENDERED. THEN, THE COST OF HIP SERVICES RENDERED IS DEDUCTED FROM THE REIMBURSEMENT RECEIVED FOR HIP PATIENTS TO ARRIVE AT A GAIN/(LOSS) RELATIVE TO THESE PATIENTS.PART I, LINE 7EAMOUNTS PRESENTED ARE BASED ON ACTUAL SPEND FOR THOSE SERVICES AND BENEFITS PROVIDED DEEMED TO IMPROVE THE HEALTH OF THE COMMUNITIES IN WHICH WE SERVE AND CONFORM WITH THE MISSION OF OUR EXEMPT PURPOSE.PART I, LINE 7FAMOUNTS PRESENTED ARE BASED UPON ACTUAL SPEND AND ARE IN CONFORMITY WITH AGREED UPON COMMITMENTS WITH THE VARIOUS EDUCATIONAL PROGRAMS.PART I, LINE 7GAMOUNTS PRESENTED DO NOT INCLUDE ANY COSTS ASSOCIATED WITH PHYSICIAN CLINICS.PART I, LINE 7IIN KEEPING WITH OUR MISSION AND COMMITMENT TO THE COMMUNITIES IN WHICH WE SERVE, COMMUNITY HOSPITAL OF NOBLE 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 NOBLE COUNTY, INC. EXCLUDED $6,062,935 OF PH CLINICAL SUPPORT EXPENSE.
PART II, COMMUNITY BUILDING ACTIVITIES:	DESCRIBE HOW THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES, AS REPORTED, PROMOTE THE HEALTH OF THE COMMUNITIES THE ORGANIZATION SERVES.COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. HAS A STRONG COMMITMENT TO SUPPORTING AND ENHANCING THE VITALITY OF OUR COMMUNITY, AND INVESTS IN PROJECTS THAT HELP TO IMPROVE THE HEALTH AND INSPIRE THE WELL-BEING OF THE COMMUNITY. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. PARTNERS WITH NOBLE COUNTY ECONOMIC DEVELOPMENT TO CONTINUE TO SUPPORT NOBLE COUNTY AS A TOP PLACE TO LIVE, WORK AND PLAY. A FEW EXAMPLES OF PARTNERSHIP WITH NOBLE COUNTY ECONOMIC DEVELOPMENT CORPORATION INCLUDE WORKING WITH A NEWLY FOUNDED COALITION CALLED THRIVE BY FIVE TO INCREASE QUALITY CHILDCARE AND PRE-K SEATS IN NOBLE COUNTY. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. IS ALSO IN THE INITIAL STAGES OF WORKING WITH LOCAL AND STATE LEADERS TO INCREASE ACCESS TO BROADBAND INTERNET IN OUR COMMUNITY.
PART III, LINE 2:	FOR FINANCIAL STATEMENT PURPOSES, THE ORGANIZATION HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE.
PART III, LINE 4:	BAD DEBT EXPENSE - PARKVIEW HEALTH SYSTEM, INC. AND SUBSIDIARIES - NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTSTEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE OR THE PAGE NUMBER ON WHICH THIS FOOTNOTE IS CONTAINED IN THE ATTACHED FINANCIAL STATEMENTS:PAGES 12 AND 23 - 26 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 NOBLE 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 NOBLE COUNTY, INC. HAS TAKEN THE POSITION NOT TO INCLUDE THE MEDICARE SHORTFALLS OR SURPLUSES AS PART OF COMMUNITY BENEFIT. COMMUNITY HOSPITAL OF NOBLE 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 NOBLE COUNTY, INC. ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES THROUGH PRIMARY AND SECONDARY DATA ANALYSIS, WORKING WITH THE ORGANIZATION'S COMMUNITY PARTNERS, AND ITS FRONTLINE STAFF. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. IDENTIFIES AND VERIFIES COMMUNITY HEALTH NEEDS THROUGH THE FOLLOWING:- HEALTHY COMMUNITIES INSTITUTE (HCI) SECONDARY DATA ANALYSIS- OBSERVATIONS FROM FRONTLINE STAFF WORKING WITH VULNERABLE POPULATIONS (I.E., COMMUNITY NURSES AND COMMUNITY HEALTH WORKERS)- REVIEW OF COMMUNITY NEEDS ASSESSMENTS CONDUCTED BY LOCAL ORGANIZATIONS (I.E., UNITED WAY, BRIGHTPOINT, ETC.)- PARKVIEW LEADERSHIP'S SERVICE ON HEALTH-RELATED AND SOCIAL SERVICE COMMUNITY BOARDSKEY 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 NOBLE COUNTY, INC. PRIMARILY SERVES THE NOBLE COUNTY COMMUNITIES OF KENDALLVILLE, LIGONIER, AVILLA, ALBION, ROME CITY, CROMWELL AND WOLCOTTVILLE. AS THE ONLY HOSPITAL IN THIS COUNTY, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. ALSO SERVES, TO A LIMITED EXTENT, OTHER SURROUNDING COMMUNITIES. ACCORDING TO CONDUENT HEALTHY COMMUNITIES INSTITUTE (2019), NOBLE COUNTY HAS APPROXIMATELY 47,774 RESIDENTS, PRIMARILY CAUCASIAN. HISPANICS OR LATINOS MAKE UP APPROXIMATELY 10.5% OF NOBLE COUNTY RESIDENTS. THE MEDIAN INCOME IN NOBLE COUNTY IS $58,947 AND THE PROPORTION OF THOSE LIVING BELOW THE POVERTY LEVEL IS 7.8% (2016-2020). THE MAKEUP OF EMPLOYMENT IS HEAVILY MANUFACTURING, FOLLOWED BY HEALTHCARE AND SOCIAL ASSISTANCE JOBS. ACCORDING TO COUNTY HEALTH RANKINGS (2019), NOBLE COUNTY'S UNINSURED RATE IS 11%, AND THE UNEMPLOYMENT RATE IS 3.1%. ACCORDING TO THE INDIANA HOSPITAL ASSOCIATION DIMENSIONS DATABASE, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. FACILITIES HAD 21.7% OF INPATIENT DISCHARGES THAT WERE MEDICAID PATIENTS AND 3.1% WERE SELF-PAY. FOR OUTPATIENT PROCEDURES, 18.7% WERE MEDICAID PATIENTS, AND 3.6% PERCENT WERE SELF-PAY (2021). HEALTH RESOURCES AND 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). HRSA HAS DESIGNATED THE FOLLOWING:1) COUNTIES: DEKALB, LAGRANGE, NOBLE AND STEUBEN COUNTYDISCIPLINE: MENTAL HEALTHHPSA ID: 7186175063HPSA NAME: NORTHEASTERN CATCHMENT AREA 18DESIGNATION TYPE: GEOGRAPHIC HPSAHPSA FTE SHORT: 7.03HPSA SCORE: 17STATUS: 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 NOBLE COUNTY, INC. BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY MEMBERS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. PEOPLE THROUGHOUT THE COMMUNITY CAN COUNT ON COMMUNITY HOSPITAL OF NOBLE 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 EMERGENCY CARE PHYSICIANS AND A NURSING STAFF THAT IS TRAINED AND EXPERIENCED IN EMERGENCY CARE. IN ADDITION, AN AFTER-HOURS CLINIC IS STAFFED BY LOCAL PHYSICIANS AFTER HOURS AND ON THE WEEKENDS.FURTHERMORE, NO PATIENT IS EVER DENIED TREATMENT, REGARDLESS OF THEIR ABILITY TO PAY, AND COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. AND ITS AFFILIATES CONTINUE TO ADAPT TO MEET THE NEEDS OF THE COMMUNITY. ADDITIONALLY, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. ANNUALLY FUNDS COMMUNITY HEALTH IMPROVEMENT INITIATIVES AND PARTNERS WITH COMMUNITY ORGANIZATIONS TO ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF NORTHEAST INDIANA. KEY PROJECTS AND AREAS OF FOCUS FUNDED THROUGH THE COMMUNITY HEALTH IMPROVEMENT INITIATIVE AND OTHER HOSPITAL FUNDS INCLUDE: -EDUCATION: COMMUNITY HOSPITAL OF NOBLE 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 PARTNERSHIPS: COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. INVESTS IN KEY ORGANIZATIONS (HEALTH PARTNERS) THAT ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF NOBLE COUNTY AND NORTHEAST INDIANA. WE PARTNER WITH THE COLE FAMILY CENTER YMCA ON MULTIPLE PROJECTS TO ENCOURAGE HEALTHIER LIFESTYLES SUCH AS SCHOLARSHIPS TO ACCESS THE YMCA AND A HYPERTENSION SELF-MONITORING PROGRAM. TO ASSIST THOSE LESS FORTUNATE, WE SUPPORT NOBLE HOUSE AND ST. MARTIN'S HEALTHCARE. TO ENCOURAGE HIGHER PAYING JOBS AND ECONOMIC IMPROVEMENT, WE PARTNER WITH THE NOBLE COUNTY ECONOMIC DEVELOPMENT CORPORATION. WE PARTNER WITH THE NOBLE COUNTY HEALTH DEPARTMENT TO PROVIDE IMMUNIZATIONS TO CHILDREN WHO COULD OTHERWISE NOT ACCESS THEM. OTHER PARTNERS ACTIVE IN ADDRESSING MEDICAL ISSUES INCLUDE THE COMMUNITY LEARNING CENTER, ACTIVATE NOBLE COUNTY, AND MCMILLEN HEALTH. -ACTIVATE NOBLE COUNTY: A TRUE COMMUNITY PARTNERSHIP BETWEEN COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. AND MANY AREA ORGANIZATIONS, INCLUDING THE LOCAL YMCA. THE MISSION IS "TO IMPROVE THE HEALTH AND WELLNESS OF NOBLE COUNTY BY INCREASING OPPORTUNITIES FOR HEALTHY EATING AND ACTIVE LIVING." THE GROUP HAS BEEN THE CENTRAL PARTNERSHIP TO ESTABLISH COMMUNITY GOALS AROUND THE COMMUNITY HEALTH NEEDS ESTABLISHED FROM OUR ASSESSMENT: OBESITY. THE GROUP MEETS MONTHLY WORKING COLLABORATIVELY TO ESTABLISH PROGRAMS, GUIDELINES AND MAKE IMPROVEMENTS TO KEY METRICS FROM THE ASSESSMENT PLAN. THROUGH COVID-19, THE GROUP CONTINUED TO MEET VIRTUALLY AND OFFER A COMMUNITY GARDEN FOR THOSE IN NEED IN THE COMMUNITY. -MEDICATION ASSISTANCE PROGRAM (MAP): COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. MAINTAINS A MEDICATION ASSISTANCE PROGRAM FOR NOBLE 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. THE MAP WAS OFFERED THROUGH COVID-19 VIRTUALLY. -HEALTH SCREENINGS & SUPPORT: COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. PUTS ON NUMEROUS HEALTH SCREENINGS THROUGHOUT THE YEAR THAT ARE DESIGNED TO PROVIDE HEALTH SCREENINGS FOR DISEASE PREVENTION AT A REDUCED COST AND THE PROMOTION OF HEALTHY LIFESTYLES. THE HOSPITAL ALSO PROVIDES SUPPORT GROUPS TO ASSIST PATIENTS AND FAMILIES IN MANAGING DISEASE.
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.; PARKVIEW WABASH HOSPITAL, INC.; WHITLEY MEMORIAL HOSPITAL, INC.; HUNTINGTON MEMORIAL HOSPITAL, INC.; DEKALB MEMORIAL HOSPITAL, INC.; PARK CENTER, INC.; AS WELL AS 60 PERCENT OWNERSHIP IN THE JOINT VENTURE OF ORTHOPEDIC HOSPITAL AT PARKVIEW NORTH, LLC.THE CORPORATE MISSION AND VISION IS AS FOLLOWS: AS A COMMUNITY OWNED, NOT-FOR-PROFIT ORGANIZATION, PARKVIEW HEALTH IS DEDICATED TO IMPROVING YOUR HEALTH AND INSPIRING YOUR WELL-BEING BY: 1) TAILORING A PERSONALIZED HEALTH JOURNEY TO ACHIEVE YOUR UNIQUE GOALS, 2) DEMONSTRATING WORLD-CLASS TEAMWORK AS WE PARTNER WITH YOU ALONG THAT JOURNEY 3) PROVIDING THE EXCELLENCE, INNOVATION AND VALUE YOU SEEK IN TERMS OF CONVENIENCE, COMPASSION, SERVICE, COST AND QUALITY.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 THE SEVEN-COUNTY AREA, THE HEALTH PRIORITY OF SUBSTANCE USE DISORDER/MENTAL HEALTH PROMOTION 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.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/WELL-BEING ACROSS THE REGION. WITH A CONSISTENT FOCUS ON OUR MISSION AND VISION, WE WORK TO PROVIDE THE BEST CARE TO EVERY PERSON, EVERY DAY WITHIN OUR FACILITIES WHILE SERVING AS GOOD STEWARDS OF SURPLUS FUNDS IN OUR EFFORTS 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.
PART V, SECTION B, LINE 19:	DISCLOSURE STATEMENT FOR CORRECTION SECTION 501(R) OMISSIONS, ERRORS AND OTHER FAILURES PURSUANT TO INTERNAL REVENUE SERVICE REVENUE PROCEDURE 2015-21. IN JANUARY AND FEBRUARY 2021, THE ORGANIZATION'S INTERNAL AUDIT DEPARTMENT PERFORMED A COMPREHENSIVE REVIEW OF ALL APPLICABLE POLICIES AND PRACTICES UNDER SECTION 501(R) OF THE INTERNAL REVENUE CODE AND THE TREASURY REGULATIONS ISSUED THEREUNDER. THE AUDIT PERIOD WAS AUGUST 1, 2020, THROUGH DECEMBER 31, 2020. AS A RESULT OF THE AUDIT, MINOR POLICY CHANGES WERE MADE, AND MINOR PROCEDURAL CHANGES RELATED TO SECTION 501(R) COMPLIANCE WERE IMPLEMENTED.ALSO, IT WAS DETERMINED THAT 135 PATIENT ACCOUNTS WERE PRESUMPTIVELY DETERMINED TO BE ELIGIBLE FOR LESS-THAN-100% FINANCIAL ASSISTANCE, WERE NOT NOTIFIED REGARDING THE WAY TO APPLY FOR MORE GENEROUS ASSISTANCE UNDER THE FAP AND WERE INADVERTENTLY SUBJECT TO ADVERSE CREDIT REPORTING. THE ADVERSE CREDIT REPORTING, HOWEVER, WAS IMMEDIATELY REMOVED IN MAY 2021. IN ADDITION TO THE FINANCIAL ASSISTANCE NOTIFICATION ON ALL PATIENT STATEMENTS, THE HOSPITAL FACILITY INSTITUTED PROCEDURES TO PROVIDE WRITTEN NOTICE TO PATIENTS WHO RECEIVE PARTIAL PRESUMPTIVE FINANCIAL ASSISTANCE THAT INFORMS THE INDIVIDUAL REGARDING THE BASIS FOR THE PRESUMPTIVE FAP ELIGIBILITY DETERMINATION AND THE WAY TO APPLY FOR MORE GENEROUS ASSISTANCE DURING THE APPLICATION PERIOD.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Purpose Of GrantPurposeOfGrantTxt
COLE CENTER FAMILY YMCA
P O BOX 233	KENDALLVILLE	IN	46755	237077600	501(C)(3)	$27,000	$0	HEALTH AND WELLNESS PROGRAMS
HAROLD W MCMILLEN CENTER FOR HEALTH EDUCATION INC
600 JIM KELLEY BLVD	FORT WAYNE	IN	46816	351186994	501(C)(3)	$25,000	$0	PROVIDE VITAL & EFFECTIVE HEALTH EDUCATION THAT PROMOTES PHYSICAL, EMOTIONAL & SOCIAL WELL-BEING
THE COMMUNITY LEARNING CENTER INC
P O BOX 98 401 E DIAMOND ST	KENDALLVILLE	IN	46755	834223782	501(C)(3)	$10,000	$0	PROGRAMS TO FOSTER AND ENHANCE ECONOMIC AND COMMUNITY DEVELOPMENT
NOBLE COUNTY HEALTH DEPARTMENT
2090 N STATE ROAD 9 SUITE C	ALBION	IN	46701		GOVT ORG	$7,336	$0	PURCHASE OF INJECTABLE FLU VACCINE FOR SCHOOL BASED CLINICS
NOBLE HOUSE INC
205 E HIGHLAND ST	ALBION	IN	46701	351883761	501(C)(3)	$6,600	$0	EMERGENCY ASSISTANCE AND REFERRALS TO FAMILIES

Field	Value	IRS element (for citing)
Total501c3 Org	5	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	$1,220,966	$0	$259,085	$0	$557,555	$0	$292,805	$0	$33,268	$0	$2,363,679	$0	$507,042
JEANNE' WICKENS
PH CHIEF FINANCIAL OFFICER	$0	$770,820	$0	$142,288	$0	$146,528	$0	$320,169	$0	$29,811	$0	$1,409,616	$0	$124,406
MYCAL MANSFIELD
DIRECTOR/PH PHYSICIAN	$6,409	$380,640	$0	$44,907	$0	$23,660	$367	$25,733	$505	$35,425	$7,281	$510,365	$0	$0
LISA LANE
DIRECTOR/PH PHYSICIAN	$18,560	$292,766	$0	$33,574	$0	$24,518	$1,603	$30,297	$1,656	$31,296	$21,819	$412,451	$0	$0
GARY ADKINS
DIRECTOR/NBHOS PRESIDENT	$216,064	$0	$34,115	$0	$68,677	$0	$55,185	$0	$27,100	$0	$401,141	$0	$65,497	$0
KELLY BALYEAT
NBHOS MGR PHARMACY	$162,079	$0	$11,258	$0	$4,490	$0	$13,019	$0	$27,575	$0	$218,421	$0	$0	$0
ERIN GOLDSBERRY
NBHOS VP PATIENT CARE	$152,353	$3,730	$20,029	$0	$499	$12	$9,980	$216	$22,640	$490	$205,501	$4,448	$0	$0
JENNIFER PERKINS
NBHOS HOUSE SPV	$128,287	$0	$8,350	$0	$6,815	$0	$18,122	$0	$29,688	$0	$191,262	$0	$0	$0
JULIE DESPER
NBHOS MGR REHAB	$108,170	$12,019	$8,456	$0	$317	$35	$14,275	$1,471	$19,554	$2,016	$150,772	$15,541	$0	$0
RICHARD LARIMORE
NBHOS MGR SUPPORT SVCS	$121,461	$0	$8,441	$0	$3,109	$0	$9,275	$0	$11,189	$0	$153,475	$0	$0	$0
GARY HEIMAN
NBHOS PARAMEDIC	$107,769	$14,658	$3,250	$0	$6,049	$0	$5,134	$643	$13,015	$1,630	$135,217	$16,931	$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 OF NOBLE 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): GARY ADKINS $65,497; MICHAEL PACKNETT $507,042; JEANNE' WICKENS $124,406 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 $507,042 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: GARY ADKINS $37,247; MICHAEL PACKNETT $260,905; JEANNE' WICKENS $299,869
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 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 NOBLE COUNTY, INC., EIN 35-2087092. 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, 2021 WAS 593. THE TOTAL NUMBER OF EMPLOYEES REPORTED ON FORM W-3 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2021 WAS 16,240. FOR PURPOSES OF COMPLETING FORM 990, PART V, LINE 1A AND 2A, THE NUMBER REPORTED FOR THE COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. WAS 31 AND 307 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	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 NOBLE 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 NOBLE 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 26, 2022, 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 VICE PRESIDENT OR ABOVE, THE COMPENSATION COMMITTEE OF RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., DETERMINES THE COMPENSATION OF THE CEO, OFFICERS, AND KEY EMPLOYEES.
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 1,348,765. MANAGEMENT AND GENERAL EXPENSES 141,756. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,490,521. MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,777,240. MANAGEMENT AND GENERAL EXPENSES 404,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,181,240. COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 299,204. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 299,204. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 2,757,336. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,757,336.
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 -24,608.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (25 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
COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC
207 N TOWNLINE RD	LAGRANGE	IN	467611325	202401676	HOSPITAL CARE	IN	501(C)(3)	LINE 3		0	PARKVIEW HEALTH SYSTEM INC
PARKVIEW LAGRANGE HOSPITAL FOUNDATION INC
207 N TOWNLINE RD	LAGRANGE	IN	467611325	833347115	FUND MGMT	IN	501(C)(3)	LINE 12A, I		0	COMMUNITY HOSPITAL OF LAGRANGE COUNTY 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		Yes (1)	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
PARK CENTER HOLDINGS INC
909 E STATE BLVD	FORT WAYNE	IN	468053404	843684074	TO SUPPORT PARK CENTER INC	IN	501(C)(3)	LINE 12D, III-O		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 (2 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

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

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
COMMUNITY HOSPITAL OF NOBLE COUNTY FOUNDATION INC
C	$129,434	PART VII SUPPLEMENTAL INFORMATION
COMMUNITY HOSPITAL OF NOBLE COUNTY FOUNDATION INC
M	$68,371	PART VII SUPPLEMENTAL INFORMATION

Supplemental Information Detail SupplementalInformationDetail

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