PARK CENTER INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- PARK CENTER INC (EIN 35-1135451)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-07
- IRS object ID
- 202103119349300610
- Schema version
- 2020v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-07T10:46:53-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | 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 EAST JEFFERSON BLVD PO 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 | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351135451 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PARK CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PARK | BusinessNameControlTxt |
| Phone | 2603738429 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 909 EAST STATE BLVD | AddressLine1Txt |
| City | FORT WAYNE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46805 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEANNE' WICKENS | PersonNm |
| Person Title | PH CFO | PersonTitleTxt |
| Phone | 2602669313 | PhoneNum |
| Signature | 2021-11-05 | 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 | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| 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 | 46808 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $31,207,340 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PARKCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1967 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | PARK CENTER, INC.'S MISSION IS TO RESTORE LIVES. BY PARTNERING WITH CONSUMERS, WE STRIVE TO SUPPORT AND FACILITATE THEIR JOURNEY TOWARD HEALTH. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 692 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $9,665,765 | PYContributionsGrantsAmt |
| CY Contributions Grants | $13,010,942 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,665,152 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $18,177,115 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,529 | PYInvestmentIncomeAmt |
| CY Investment Income | $19,283 | CYInvestmentIncomeAmt |
| PY Other Revenue | $232,667 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $20,572,113 | PYTotalRevenueAmt |
| CY Total Revenue | $31,207,340 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $14,552,324 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $26,806,585 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,259,617 | PYOtherExpensesAmt |
| CY Other Expenses | $12,763,374 | CYOtherExpensesAmt |
| PY Total Expenses | $19,811,941 | PYTotalExpensesAmt |
| CY Total Expenses | $39,569,959 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $760,172 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$8,362,619 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $19,793,479 | TotalAssetsBOYAmt |
| Total Assets EOY | $24,892,621 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,432,724 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $16,664,273 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $12,360,755 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,228,348 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PARK CENTER, INC.'S MISSION IS TO RESTORE LIVES. BY PARTNERING WITH CONSUMERS, WE STRIVE TO SUPPORT AND FACILITATE THEIR JOURNEY TOWARD HEALTH.PARK CENTER'S VISION IS A COMMUNITY WHERE:- BEHAVIORAL HEALTH CHALLENGES ARE NO LONGER IN THE SHADOWS,- PEOPLE WHO EXPERIENCE THE PAIN OF A BEHAVIORAL HEALTH ISSUE HAVE EASY ACCESS TO EFFECTIVE CARE,- THE BURDEN OF UNADDRESSED BEHAVIORAL HEALTH CHALLENGES NO LONGER REDUCE THE PRODUCTIVITY AND VIBRANCY OF OUR COMMUNITY, AND- PARK CENTER IS RECOGNIZED AS A VITAL CONTRIBUTOR TO THIS NEW REALITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $37,248,378 | ExpenseAmt |
| Revenue | $18,177,115 | RevenueAmt |
| Desc | PARK CENTER, INC. IS A COMMUNITY MENTAL HEALTH CENTER WITH OFFICES IN ALLEN, ADAMS, WELLS AND WHITLEY COUNTIES. OUR GOAL IS TO PROVIDE QUALITY CARE AND SUPPORT TO PROMOTE WELLNESS AND HEALING FOR CLIENTS OF ALL AGES AND AT EVERY STAGE OF RECOVERY. AT PARK CENTER, WE OFFER A COMPREHENSIVE SELECTION OF SERVICES IN THE PROFESSIONAL SETTING YOU EXPECT, WHILE TAILORING TREATMENTS TO ACHIEVE THE PERSONAL CARE YOU DESERVE.DURING 2020, PARK CENTER, INC. PROVIDED OVER 200,000 SERVICES TO MORE THAN 14,161 INDIVIDUALS. EIGHTY-SEVEN PERCENT OF THE INDIVIDUALS REPORT AN ANNUAL INCOME BELOW $10,400. (SEE SCHEDULE O FOR CONTINUATION) PARK CENTER, INC. OFFERS CLINIC BASED SERVICES IN OUR OFFICES LOCATED IN ALLEN, ADAMS, WELLS AND WHITLEY COUNTIES. OUR TEAM OF LICENSED SOCIAL WORKERS, MENTAL HEALTH COUNSELORS, MARRIAGE AND FAMILY THERAPISTS, ADDICTION COUNSELORS, PSYCHIATRISTS, PHYSICIAN ASSISTANTS, ADVANCED NURSES, AND PSYCHOLOGISTS ARE UNIQUELY SKILLED TO ADDRESS YOUR BEHAVIORAL HEALTH NEEDS. PARK CENTER, INC. OFFERS SPECIALIZED SERVICES IN EARLY CHILDHOOD MENTAL HEALTH, DIALECTAL BEHAVIORAL THERAPY (DBT), MEDICALLY ASSISTED TREATMENT (MAT), AND EARLY BREAK PSYCHOSIS. SERVICES ARE AVAILABLE TO BOTH THE CHILD AND ADULT POPULATION.PARK CENTER, INC. OFFERS COMMUNITY-BASED SERVICES IN ALLEN, ADAMS, AND WELLS COUNTIES. THESE SERVICES ARE AVAILABLE BASED UPON AN ASSESSMENT OF NEED. OUR TEAM OF THERAPISTS AND CASEWORKERS WORK ALONGSIDE OF INDIVIDUALS IN THEIR HOME, SCHOOL, AND COMMUNITY ENVIRONMENTS. PARK CENTER, INC. HAS A 16 BED ACUTE PSYCHIATRIC HOSPITAL FOR ADULTS LOCATED IN ALLEN COUNTY. THIS UNIT PROVIDES SHORT-TERM STABILIZATION, ASSESSMENT, MEDICATION REVIEW, AND TREATMENT PLANNING. PRIOR TO DISCHARGE CLIENTS ARE ASSISTED WITH CREATING PLANS FOR SAFETY MANAGEMENT AND LINKING TO OTHER LESS INTENSIVE SERVICES.PARK CENTER, INC. HAS A NUMBER OF ADULT GROUP HOMES IN WHICH WE SERVE CLIENTS WITH MENTAL HEALTH AND CHEMICAL DEPENDENCY NEEDS. PARK CENTER ALSO HAS A RESIDENTIAL ADDICTIONS PROGRAM FOR INDIVIDUALS REFERRED BY THE COURT SYSTEM.PARK CENTER, INC. HAS A 16 BED RESIDENTIAL FACILITY FOR ADOLESCENT MALES WHO ARE DISPLAYING UNHEALTHY SEXUAL BEHAVIORS THAT REQUIRE OUT OF HOME TREATMENT. THIS SERVICE STRUCTURE ALSO HAS 2 GROUP HOMES THAT PROVIDE A LESS INTENSE LEVEL OF CARE TO THIS SAME POPULATION.PARK CENTER, INC. OFFERS A NUMBER OF SERVICES GEARED AT HELPING CLIENTS REHABILITATE BACK INTO THEIR LIVES AND FIND MEANINGFUL WORK OPPORTUNITIES. THROUGH ON THE JOB TRAINING AND SUPPORT, MANY INDIVIDUALS ARE ABLE TO FIND AND MAINTAIN STABLE EMPLOYMENT. PARK CENTER, INC.'S CARRIAGE HOUSE IS A MEMBER OF CLUB HOUSE INTERNATIONAL. THIS PROGRAM FOLLOWS THE SOCIAL REHABILITATION MODEL. IT PLACES EMPHASIS UPON RESPECT, INDEPENDENCE AND PERSONAL RESPONSIBILITY.PARK CENTER, INC. UTILIZES A HOSPITAL LIAISON AND A COURT LIAISON TO ASSIST CONSUMERS WITH HIGHER NEEDS. THE HOSPITAL LIAISON PROVIDES SUPPORT SERVICES TO INDIVIDUALS AT STATE OR LOCAL PSYCHIATRIC HOSPITALS. THE COURT LIAISON WORKS WITH CONSUMERS, FAMILIES, AND THE COURT SYSTEM WHEN THE SEVERITY OF SYMPTOMS REQUIRES EMERGENCY DETENTION, INVOLUNTARY COMMITMENTS, AND GUARDIANSHIP. | Desc |
| Total Program Service Expenses | $37,248,378 | 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 | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | 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 | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | 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 | 0 | RelatedOrganizationCtrlEntInd |
| 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 | 39 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 692 | 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | 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 | 46808 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| GREG JOHNSON | ||||||||
| DIRECTOR/PH CCIA | 0.00 | 40.00 | Yes (X) | $0 | $694,718 | $154,899 | ||
| CHARLES CLARK | ||||||||
| DIRECTOR/BHI PRESIDENT | 0.00 | 40.00 | Yes (X) | $0 | $347,548 | $94,178 | ||
| GARY ZWIERZYNSKI | ||||||||
| DIRECTOR/SECRETARY/TREASURER/PVHOS SVP GME | 0.00 | 40.00 | Yes (X) | $0 | $309,473 | $74,413 | Yes (X) | |
| CLYDE NIX | ||||||||
| DIRECTOR/PC PRESIDENT | 40.00 | 0.00 | Yes (X) | $185,992 | $0 | $35,819 | Yes (X) | |
| BETH LOCK | ||||||||
| DIRECTOR/PH DIR GOVT & LEGAL AFFAIRS | 0.00 | 40.00 | Yes (X) | $0 | $74,439 | $12,403 | ||
| RICHARD ROBINSON | ||||||||
| DIRECTOR/VICE CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $4,750 | $0 | Yes (X) | |
| CAROLYN BRODY | ||||||||
| DIRECTOR/CHAIR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JAIMIE FERREN | ||||||||
| DIRECTOR-PARTIAL YEAR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TRAVIS FRIEND | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| TIM GALL | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JODI LEAS | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JAN NESS | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| WYLIE SIRK | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ANGELA STEWART-MARTIN | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JASMINE KAUR | ||||||||
| PC PHYSICIAN | 40.00 | 0.00 | $321,323 | $0 | $13,277 | Yes (X) | ||
| ANDREA NAAUM | ||||||||
| PC PHYSICIAN | 40.00 | 0.00 | $298,548 | $0 | $24,896 | Yes (X) | ||
| SYED MUMTAZ | ||||||||
| PC PHYSICIAN | 40.00 | 0.00 | $290,524 | $0 | $38,951 | Yes (X) | ||
| MAHROKH SHAYANPOUR | ||||||||
| PC PHYSICIAN | 40.00 | 0.00 | $247,682 | $0 | $19,843 | Yes (X) | ||
| RONALD PANCNER | ||||||||
| PC PHYSICIAN | 40.00 | 0.00 | $219,570 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,563,639 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,430,928 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $468,679 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | 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 DRIVE | FORT WAYNE | IN | 46845 | MEDICAL PERSONNEL SERVICES | $661,110 |
| CROSSROAD CHILD & FAMILY SERVICES | |||||
| 1825 BEACON STREET | FORT WAYNE | IN | 46805 | TREATMENT SERVICES | $456,854 |
| ARAMARK | |||||
| 25259 NETWORK PLACE | CHICAGO | IL | 60673 | LAUNDRY SERVICES | $266,073 |
| CLAIMAID | |||||
| 8141 ZIONVILLE ROAD | INDIANAPOLIS | IN | 46268 | MEDICAID ENROLLMENT SERVICES | $210,540 |
| FOCUSONE SOLUTIONS LLC | |||||
| 13609 CALIFORNIA STREET | OMAHA | NE | 68154 | MEDICAL PERSONNEL SERVICES | $185,504 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $12,509,694 | GovernmentGrantsAmt |
| All Other Contributions | $501,248 | AllOtherContributionsAmt |
| Total Contributions | $13,010,942 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621300 | $17,870,677 | $17,870,677 |
| APPLE SPICE SALES | 722320 | $306,438 | $306,438 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $18,177,115 | TotalProgramServiceRevenueAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $19,283 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $19,283 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,283 | TotalRevenueColumnAmt |
| Exclusion | $19,283 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,207,340 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,177,115 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $19,283 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $221,811 | TotalAmt |
| Management And General | $221,811 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,183,503 | TotalAmt |
| Program Services | $20,183,503 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $771,747 | TotalAmt |
| Program Services | $771,747 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,141,750 | TotalAmt |
| Program Services | $4,141,750 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,487,774 | TotalAmt |
| Program Services | $1,474,189 | ProgramServicesAmt |
| Management And General | $13,585 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,954 | TotalAmt |
| Management And General | $44,954 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,902 | TotalAmt |
| Management And General | $113,902 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,497,293 | TotalAmt |
| Program Services | $4,465,230 | ProgramServicesAmt |
| Management And General | $32,063 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,126 | TotalAmt |
| Program Services | $37,894 | ProgramServicesAmt |
| Management And General | $232 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,896,447 | TotalAmt |
| Program Services | $1,860,853 | ProgramServicesAmt |
| Management And General | $35,594 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,575 | TotalAmt |
| Program Services | $40,575 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,727,746 | TotalAmt |
| Program Services | $1,714,349 | ProgramServicesAmt |
| Management And General | $13,397 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,370 | TotalAmt |
| Program Services | $66,731 | ProgramServicesAmt |
| Management And General | $2,639 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,958 | TotalAmt |
| Program Services | $19,980 | ProgramServicesAmt |
| Management And General | $978 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,436 | TotalAmt |
| Program Services | $104,436 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,175,995 | TotalAmt |
| Program Services | $1,166,487 | ProgramServicesAmt |
| Management And General | $9,508 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $326,130 | TotalAmt |
| Program Services | $316,040 | ProgramServicesAmt |
| Management And General | $10,090 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| CORPORATE SERVICE ALLOC | $1,752,674 | $1,752,674 | |
| HOSPITAL ASSESSMENT FEE | $451,159 | $451,159 | |
| MEDICAL SUPPLIES | $230,307 | $230,307 | |
| DUES & SUBSCRIPTIONS | $133,783 | $49,085 | $84,698 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,519 | TotalAmt |
| Program Services | $118,450 | ProgramServicesAmt |
| Management And General | $21,069 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,569,959 | TotalAmt |
| Program Services | $37,248,378 | ProgramServicesAmt |
| Management And General | $2,321,581 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,362,055 | BOYAmt |
| EOY | $3,342,498 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,318 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,085,018 | BOYAmt |
| EOY | $323,752 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,965,083 | BOYAmt |
| EOY | $3,937,491 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,245 | BOYAmt |
| EOY | $86,155 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,342 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $400,217 | BOYAmt |
| EOY | $258,642 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $20,665,176 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,024,374 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,277,730 | BOYAmt |
| EOY | $15,640,802 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,916 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,526,555 | BOYAmt |
| EOY | $1,303,281 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,793,479 | BOYAmt |
| EOY | $24,892,621 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,159,532 | BOYAmt |
| EOY | $3,304,938 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,000 | BOYAmt |
| EOY | $233,802 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $259,030 | BOYAmt |
| EOY | $360,800 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,528,420 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,335,742 | BOYAmt |
| EOY | $12,764,733 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,432,724 | BOYAmt |
| EOY | $16,664,273 | 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 | $12,360,755 | BOYAmt |
| EOY | $8,228,348 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,360,755 | BOYAmt |
| EOY | $8,228,348 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,793,479 | BOYAmt |
| EOY | $24,892,621 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$8,362,619 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $4,230,212 | 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) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $12,350,514 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,729,835 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,214,304 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,665,765 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,010,942 | CurrentTaxYearAmt |
| Total | $59,971,360 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,154,279 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $21,164,868 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $24,248,791 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,665,152 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $22,055,401 | CurrentTaxYearAmt |
| Total | $97,288,491 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $31,504,793 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $32,894,703 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $37,463,095 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $20,330,917 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $35,066,343 | CurrentTaxYearAmt |
| Total | $157,259,851 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $157,259,851 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,726 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $18,992 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,487 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,760 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $74,965 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,726 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $18,992 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,487 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,760 | CurrentTaxYearMinus1YearAmt |
| Total | $74,965 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $177,782 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $174,434 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $66,346 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $224,186 | CurrentTaxYearMinus1YearAmt |
| Total | $642,748 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $31,702,301 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $33,088,129 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $37,555,928 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $20,564,863 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $35,066,343 | CurrentTaxYearAmt |
| Total | $157,977,564 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99550 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99360 | PublicSupportPY509Pct |
| Investment Income CY | 0.00050 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00060 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME - 2016 AMOUNT: $ 104,324. 2017 AMOUNT: $ 111,794. 2018 AMOUNT: $ 66,346. 2019 AMOUNT: $ 13,908. 2020 AMOUNT: $ 0. DSH FEDERAL FUNDS - 2016 AMOUNT: $ 73,458. 2017 AMOUNT: $ 62,640. 2018 AMOUNT: $ 0. 2019 AMOUNT: $ 210,278. 2020 AMOUNT: $ 0. | ExplanationTxt |
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 | $2,295 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,295 | 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 | OTHER ACTIVITIES - REPRESENTS THE PORTION OF THE DUES PAID TO VARIOUS PROFESSIONAL ASSOCIATIONS USED FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,414,734 | OtherCostOrOtherBasisAmt |
| Book Value | $1,414,734 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,418,500 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,437,174 | DepreciationAmt |
| Book Value | $12,981,326 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,616,340 | OtherCostOrOtherBasisAmt |
| Depreciation | $585,676 | DepreciationAmt |
| Book Value | $1,030,664 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $215,602 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,524 | DepreciationAmt |
| Book Value | $214,078 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $15,640,802 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| RESTRICTED FUND - RESIDENCES | $360,800 |
| RIGHT OF USE ASSETS | $942,481 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,303,281 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| LEASE LIABILITY | $942,874 |
| EST 3RD PARTY SETTLEMENTS | $449,594 |
| NOTE PAYABLE TO RELATED PARTY | $1,863,666 |
| NOTE PAYABLE TO PH | $2,285,552 |
| DUE TO/FROM INTERUNIT | $7,223,047 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $12,764,733 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $31,408,378 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $201,038 | OtherRevenueAmt |
| Revenue Not Reported | $201,038 | RevenueNotReportedAmt |
| Revenue Subtotal | $31,207,340 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $31,207,340 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $39,770,997 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $201,038 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $201,038 | ExpensesNotReportedAmt |
| Expenses Subtotal | $39,569,959 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $39,569,959 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | THE ORGANIZATION IS AN AGENT FOR HELD FUNDS FOR PATIENTS' REPRESENTATIVE PAYEE ACCOUNTS. |
| PART X, LINE 2: | 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 CENTER IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS SUCH, THE CENTER IS GENERALLY EXEMPT FROM INCOME TAXES. HOWEVER, THE CENTER IS REQUIRED TO FILE FEDERAL FORM 990 RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, WHICH IS AN INFORMATIONAL RETURN ONLY. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CENTER AND RECOGNIZE A TAX LIABILITY IF THE CENTER HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2020, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE CENTER FILED ITS FEDERAL AND STATE INCOME TAX RETURNS FOR PERIODS THROUGH DECEMBER 31, 2019. THESE INCOME TAX RETURNS ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE LATER OF THE DATE THE RETURN WAS FILED OR ITS DUE DATE (INCLUDING APPROVED EXTENSIONS). |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | ELIMINATION OF INTERUNIT RENT REVENUE 201,038. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | ELIMINATION OF INTERUNIT RENT EXPENSE 201,038. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GREG JOHNSON | ||||||||||||||
| DIRECTOR/PH CCIA | $0 | $522,781 | $0 | $151,837 | $0 | $20,100 | $0 | $116,541 | $0 | $38,358 | $0 | $849,617 | $0 | $15,198 |
| CHARLES CLARK | ||||||||||||||
| DIRECTOR/BHI PRESIDENT | $0 | $230,277 | $0 | $61,899 | $0 | $55,372 | $0 | $69,872 | $0 | $24,306 | $0 | $441,726 | $0 | $50,244 |
| GARY ZWIERZYNSKI | ||||||||||||||
| DIRECTOR/SECRETARY/TREASURER/PVHOS S | $0 | $249,546 | $0 | $56,693 | $0 | $3,234 | $0 | $50,225 | $0 | $24,188 | $0 | $383,886 | $0 | $0 |
| JASMINE KAUR | ||||||||||||||
| PC PHYSICIAN | $295,865 | $0 | $25,000 | $0 | $458 | $0 | $1,872 | $0 | $11,405 | $0 | $334,600 | $0 | $0 | $0 |
| SYED MUMTAZ | ||||||||||||||
| PC PHYSICIAN | $265,282 | $0 | $21,458 | $0 | $3,784 | $0 | $13,177 | $0 | $25,774 | $0 | $329,475 | $0 | $0 | $0 |
| ANDREA NAAUM | ||||||||||||||
| PC PHYSICIAN | $283,119 | $0 | $15,000 | $0 | $429 | $0 | $12,880 | $0 | $12,016 | $0 | $323,444 | $0 | $0 | $0 |
| MAHROKH SHAYANPOUR | ||||||||||||||
| PC PHYSICIAN | $247,200 | $0 | $0 | $0 | $482 | $0 | $9,231 | $0 | $10,612 | $0 | $267,525 | $0 | $0 | $0 |
| CLYDE NIX | ||||||||||||||
| DIRECTOR/PC PRESIDENT | $184,254 | $0 | $0 | $0 | $1,738 | $0 | $9,719 | $0 | $26,100 | $0 | $221,811 | $0 | $0 | $0 |
| RONALD PANCNER | ||||||||||||||
| PC PHYSICIAN | $219,570 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $219,570 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | 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): CHARLES CLARK $50,244; GREG JOHNSON $15,198; 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 $50,244 REPORTED AS REQUIRED FOR MR. CLARK WAS A RESULT OF THE VESTING OF SUCH AMOUNT UNDER THE TERMS OF THE RESPECTIVE PLANS. HOWEVER, THESE AMOUNTS WERE PREVIOUSLY REPORTED IN MR. CLARKS'S DEFERRED COMPENSATION 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: CHARLES CLARK $38,522; GREG JOHNSON $85,191; GARY ZWIERZYNSKI $37,400 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 1A: | PARKVIEW HEALTH SYSTEM, INC. (PH), EIN 35-1972384, IS THE COMMON PAYING AGENT FOR THE FILING ORGANIZATION, PARK CENTER, INC., EIN 35-1135451. THEREFORE, ALL APPLICABLE IRS TAX FILINGS, INCLUDING FORMS 1099 AND 1096 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, 2020 WAS 738. FOR PURPOSES OF COMPLETING FORM 990, PART V, LINE 1A THE NUMBER REPORTED FOR THE PARK CENTER, INC. WAS 39. |
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE SHALL BE SUCH ODD NUMBER OF DIRECTORS AS MAY FROM TIME-TO-TIME BE APPOINTED BY THE BOARD, WITH THE NUMBER OF CLASS A DIRECTORS APPOINTED TO THE EXECUTIVE COMMITTEE TO BE ONE (1) GREATER THAN THE NUMBER OF CLASS B DIRECTOR(S) APPOINTED TO THE EXECUTIVE COMMITTEE. THE RESPONSIBILITIES AND FUNCTIONS OF THE EXECUTIVE COMMITTEE AS DELEGATED TO SUCH COMMITTEE BY THE BOARD OF DIRECTORS ARE AS FOLLOWS: (1) TRANSACT ALL EMERGENCY BUSINESS BETWEEN REGULAR MEETINGS OF THE BOARD OF DIRECTORS; (2) ASSIST THE BOARD OF DIRECTORS BY SERVING AS A FORUM WHERE STRATEGIC AND OTHER CRITICAL ISSUES MAY BE SUBSTANTIALLY DEVELOPED BEFORE GOING TO THE BOARD OF DIRECTORS FOR DISCUSSION AND CONSIDERATION; (3) SERVE AS THE EVALUATION COMMITTEE TO ANNUALLY EVALUATE THE PERFORMANCE OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER AND REPORT SUCH EVALUATION TO THE BOARD OF DIRECTORS; (4) OVERSEE THE PLANNING OF THE ANNUAL MEETING OF THE BOARD; (5) REVIEW PERSONNEL TRENDS, PROVIDE OVERSIGHT FOR ALL PERSONNEL FUNCTIONS OF THE CORPORATION TO INCLUDE, BUT NOT LIMITED TO: ANNUAL REVIEW OF SALARY SCHEDULES AND BENEFIT PROGRAMS; ANNUAL STAFFING PLAN; AFFIRMATIVE ACTION PLANS; AND SUCCESSION PLANS; (6) PERFORM SUCH OTHER TASKS OR PROJECTS AS MAY BE DELEGATED BY THE BOARD OF DIRECTORS; AND (7) MONITOR CONTRACTS FOR SERVICES DIRECTLY RELATED TO PATIENT CARE. |
| 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 PARK CENTER, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE CORPORATE MEMBER, PARKVIEW HEALTH SYSTEM, INC. EIN 35-1972384, SHALL HAVE THE FOLLOWING RESERVED POWERS AS STATED IN PARK CENTER, INC.'S BYLAWS UNDER ARTICLE IV - POWERS AND RESPONSIBILITIES, SECTION 4.3 - POWERS OF THE MEMBER: THE FOLLOWING POWERS AND RESPONSIBILITIES SHALL BE RESERVED TO THE MEMBER, ACTING BY A MEMBER OF ITS SENIOR LEADERSHIP TEAM, AND THE MEMBER OR THE BOARD OF DIRECTORS SHALL ACT TO CARRY OUT THE MEMBER'S DIRECTIONS WITH RESPECT TO: A. APPOINTING CLASS A DIRECTORS (INCLUDING APPOINTMENTS TO FILL VACANCIES) AND INITIATING THE REMOVAL OF, AND REMOVING, ANY CLASS A DIRECTOR OF THE CORPORATION; B. APPROVING APPOINTMENTS OF CLASS B DIRECTORS (INCLUDING APPOINTMENTS TO FILL VACANCIES) AND INITIATING THE REMOVAL OF, AND REMOVING, WITH CAUSE, ANY CLASS B DIRECTOR; C. APPOINTING (INCLUDING APPOINTMENTS TO FILL A VACANCY) AND INITIATING THE REMOVAL OF, AND REMOVING, THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE CORPORATION, WITH OR WITHOUT CAUSE, PROVIDED CONSIDERATION IS GIVEN TO RECOMMENDATIONS OF THE BOARD REGARDING SUCH APPOINTMENT OR REMOVAL, IF ANY ARE SO MADE; D. APPROVING AND ADOPTING THE STRATEGIC PLAN, AND ANY AMENDMENTS THERETO, FOR THE CORPORATION AND ITS AFFILIATES, INCLUDING ANY INDIVIDUAL INITIATIVES OR ARRANGEMENTS, SUCH AS A NEW SERVICE OR CONTRACTUAL ARRANGEMENT, DEEMED BY THE MEMBER TO BE OF STRATEGIC IMPORTANCE TO THE CORPORATION OR ITS AFFILIATES AND DIRECT AND MONITOR COMPLIANCE WITH SUCH PLANS, INITIATIVES AND ARRANGEMENTS; E. APPROVING AND ADOPTING THE CAPITAL AND OPERATING BUDGETS AND FINANCIAL PLANS, AND ANY AMENDMENTS THERETO, OF THE CORPORATION AND ITS AFFILIATES; APPROVING THE INCURRENCE OF ANY DEBT PROPOSED BY THE CORPORATION, INCLUDING THE ISSUANCE OF BONDS BY THE CORPORATION AND ITS AFFILIATES, AND REQUIRING THE INCURRENCE OF DEBT BY THE CORPORATION AND ITS AFFILIATES; G. APPROVING THE TRANSFER OF ASSETS BY THE CORPORATION AND ITS AFFILIATES, INCLUDING TRANSFERS OF REAL PROPERTY, PERSONAL PROPERTY, CASH, STOCK OR OTHER TANGIBLE OR INTANGIBLE ASSETS, UNLESS OTHERWISE IDENTIFIED IN PREVIOUSLY APPROVED STRATEGIC PLANS, INITIATIVES, ARRANGEMENTS OR BUDGETS; H. REQUIRING AND DIRECTING THE TRANSFER OF ASSETS BY THE CORPORATION OR ITS AFFILIATES, PROVIDED THAT APPROVAL OF THE BOARD IS ALSO REQUIRED IF THE TRANSFER INVOLVES A TRANSFER OR SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR WOULD PREVENT THE CORPORATION FROM OPERATING A PSYCHIATRIC HOSPITAL IN THE COMMUNITY. FOR PURPOSES OF THIS SECTION, BOARD APPROVAL SHALL NOT BE REQUIRED FOR PARTICIPATION IN A MASTER TRUST INDENTURE, POOLED FINANCING OR ANY OTHER KIND OF DEBT INSTRUMENT,BORROWING OR GUARANTY OBLIGATING CORPORATION ASSETS; I. APPROVING PARTICIPATION (INCLUDING THE EXERCISE OF RENEWAL OPTIONS) BY THE CORPORATION AND ITS AFFILIATES IN NETWORKS, AFFILIATIONS, JOINT VENTURES, PARTNERSHIPS, MERGERS, DISSOLUTIONS OR ACQUISITIONS AND REQUIRING AND DIRECTING PARTICIPATION BY THE CORPORATION AND ITS AFFILIATES IN SUCH ARRANGEMENTS; J. EXCEPT AS OTHERWISE DIRECTED BY THE MEMBER, APPROVING DECISIONS OF THE CORPORATION AND ITS AFFILIATES TO PARTICIPATE IN ANY NOVEL, QUALITATIVELY OR QUANTITATIVELY UNIQUE MANAGED CARE OR OTHER HEALTH CARE SERVICE PURCHASING ARRANGEMENTS AND REQUIRE PARTICIPATION BY THE CORPORATION AND ITS AFFILIATES IN SUCH HEALTH CARE SERVICE PURCHASING ARRANGEMENTS, OTHER THAN (I) APPLICATIONS FOR FUNDING FROM THE DIVISION OF MENTAL HEALTH AND ADDICTIONS (OR ANY SUCCESSOR AGENCY), OR (II) ALLOCATIONS OF PUBLIC SUBSIDIES, OR ANY SIMILAR ARRANGEMENTS TO THE EXTENT THEY ARE IN THE ORDINARY COURSE OF THE CORPORATION'S EXISTING MANAGED CARE OR PURCHASING RELATIONSHIPS (E.G., MEDICAID MANAGED CARE AGREEMENTS, ETC.); K. DEVELOPING AND REQUIRING ADOPTION OF MINIMUM MEDICAL STAFF QUALITY ASSURANCE AND UTILIZATION REVIEW STANDARDS, CRITERIA AND PROCEDURES FOR THE CORPORATION AND ITS AFFILIATES IN CONSULTATION WITH THE CORPORATION; L. APPROVING ANY ACTION OF THE CORPORATION OR AN AFFILIATE TO CHANGE THE HOSPITAL FROM A PSYCHIATRIC HOSPITAL OR TO CLOSE THE HOSPITAL; AND M. APPROVING OR REQUIRING AND DIRECTING ANY AMENDMENT TO THE BYLAWS OR ARTICLES OF INCORPORATION OF THE CORPORATION OR AN AFFILIATE THEN IN EFFECT, AND THE ARTICLES OF INCORPORATION AND BYLAWS OR SIMILAR GOVERNING DOCUMENTS OF ANY NEWLY CREATED AFFILIATE, INCLUDING AS NECESSARY OR ADVISABLE TO RESOLVE SIGNIFICANT ETHICAL ISSUES, TO MAINTAIN THE JOINT COMMISSION ACCREDITATION, TAX-EXEMPT STATUS, PARTICIPATION IN MEDICARE/MEDICAID OR TO PREVENT SIGNIFICANT ADVERSE LEGAL OR FINANCIAL EFFECTS TO THE CORPORATION OR THE MEMBER; PROVIDED, THAT THERE CAN BE NO AMENDMENT TO THE RESERVED POWERS LISTED IN THIS SECTION 4.3 WITHOUT THE CONSENT OF MEMBER, AND NO AMENDMENT TO THE CLASS B DIRECTOR APPOINTMENT POWERS LISTED IN SECTION 3.2 PRIOR TO OCTOBER 1, 2023 WITHOUT THE CONSENT OF PARK CENTER HOLDINGS, INC. |
| 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 | PARK CENTER, 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 PARK CENTER, INC.'S GOVERNING BODY, PRIOR TO FILING WITH THE IRS. ON OCTOBER 27, 2021, THE AUDIT COMMITTEE OF PARKVIEW HEALTH SYSTEM, INC. 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 | THE BOARD REVIEWS THE CONFLICTS OF INTEREST POLICY EACH YEAR AND EACH MEMBER SIGNS A FORM, DOCUMENTING THEIR UNDERSTANDING OF THE POLICY AND HOW IT RELATES TO THEM. STAFF REVIEW AND SIGN THE CODE OF ETHICS EACH YEAR DURING THEIR PERFORMANCE EVALUATION. POTENTIAL CONFLICTS ARE DISCUSSED EITHER WITH THE BOARD OR WITH THE CO-WORKER'S SUPERVISOR. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO'S COMPENSATION IS REVIEWED EACH YEAR BY THE EXECUTIVE COMMITTEE OF THE BOARD. THE EXECUTIVE COMMITTEE REVIEWS COMPENSATION SURVEYS TO BECOME AWARE OF THE COMPENSATION OF COMPARABLE POSITIONS. FOR THE OTHER KEY EMPLOYEES OF THE ORGANIZATION, SALARY SURVEYS ARE EXAMINED EACH YEAR TO COMPARE COMPENSATION. |
| 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 1,823,005. MANAGEMENT AND GENERAL EXPENSES 32,063. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,855,068. MEDICAL PERSONNEL & TREATMENT SERVICES: PROGRAM SERVICE EXPENSES 1,986,643. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,986,643. CLEANING & LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 317,848. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 317,848. MEDICAID ENROLLMENT SERVICES: PROGRAM SERVICE EXPENSES 210,540. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 210,540. LAB SERVICES: PROGRAM SERVICE EXPENSES 127,194. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 127,194. |
| FORM 990, PART XI, LINE 9: | ASSET TRANSFERS/ADJUSTMENTS FROM PRIOR YEAR 4,230,212. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (18 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 | 46808 | 351972384 | HEALTH CARE | IN | 501(C)(3) | LINE 12C, III-FI | N/A | 0 | |
| COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC | |||||||||||
| 207 N TOWNLINE ROAD | LAGRANGE | IN | 46761 | 202401676 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| COMMUNITY HOSPITAL OF NOBLE COUNTY FOUNDATION INC | |||||||||||
| 401 SAWYER ROAD | KENDALLVILLE | IN | 46755 | 352089183 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | COMMUNITY HOSPITAL OF NOBLE COUNTY INC | |
| COMMUNITY HOSPITAL OF NOBLE COUNTY INC | |||||||||||
| 401 SAWYER ROAD | KENDALLVILLE | IN | 46755 | 352087092 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| DEKALB MEMORIAL HOSPITAL INC | |||||||||||
| 1316 EAST SEVENTH STREET | AUBURN | IN | 46706 | 351064295 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| HUNTINGTON MEMORIAL HOSPITAL INC | |||||||||||
| 2001 STULTS ROAD | HUNTINGTON | IN | 46750 | 351970706 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| MIDWEST COMMUNITY HEALTH ASSOCIATES INC | |||||||||||
| 442 W HIGH STREET | BRYAN | OH | 43506 | 341045870 | PHYSICIANS | OH | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| PARK CENTER HOLDINGS INC | |||||||||||
| 909 EAST STATE BLVD | FORT WAYNE | IN | 46805 | 843684074 | TO SUPPORT PARK CENTER, INC. | IN | 501(C)(3) | LINE 12D, III-O | 0 | PARKVIEW HEALTH SYSTEM INC | |
| PARKVIEW DEKALB HOSPITAL FOUNDATION INC | |||||||||||
| 1316 EAST SEVENTH STREET | AUBURN | IN | 46706 | 356047817 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | DEKALB MEMORIAL HOSPITAL INC | |
| PARKVIEW FOUNDATION INC | |||||||||||
| 3844 NEW VISION DR | FORT WAYNE | IN | 46845 | 237220589 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | PARKVIEW HOSPITAL INC | |
| PARKVIEW HOSPITAL INC | |||||||||||
| 11109 PARKVIEW PLAZA DRIVE | FORT WAYNE | IN | 46845 | 350868085 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| PARKVIEW HUNTINGTON HOSPITAL FOUNDATION INC | |||||||||||
| 2001 STULTS ROAD | HUNTINGTON | IN | 46750 | 320012095 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | HUNTINGTON MEMORIAL HOSPITAL INC | |
| PARKVIEW LAGRANGE HOSPITAL FOUNDATION INC | |||||||||||
| 207 N TOWNLINE ROAD | LAGRANGE | IN | 46761 | 833347115 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC | |
| PARKVIEW OCCUPATIONAL HEALTH CENTERS INC | |||||||||||
| 1450 PRODUCTION RD | FORT WAYNE | IN | 46808 | 352064353 | OCCUPATIONAL HEALTH | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| PARKVIEW WABASH HOSPITAL FOUNDATION INC | |||||||||||
| 10 JOHN KISSINGER DRIVE | WABASH | IN | 46992 | 351921445 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | PARKVIEW WABASH HOSPITAL INC | |
| PARKVIEW WABASH HOSPITAL INC | |||||||||||
| 10 JOHN KISSINGER DRIVE | WABASH | IN | 46992 | 471753440 | 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 | 46725 | 311190239 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | WHITLEY MEMORIAL HOSPITAL INC | |
| WHITLEY MEMORIAL HOSPITAL INC | |||||||||||
| 1260 E STATE ROAD 205 | COLUMBIA CITY | IN | 46725 | 351967665 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM 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 | 46808 | 260143823 | ORTHO HOSPITAL | IN | N/A | N/A | 0 | 0 |
| MANAGED CARE SERVICES LLC | ||||||||||
| 1450 PRODUCTION RD | FORT WAYNE | IN | 46808 | 351996535 | HEALTH PLAN ADMIN | IN | N/A | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 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 | 46808 | 351668888 | REFERENCE LAB | IN | N/A | C | 0 |
| MIDWEST COMMUNITY HEALTH ASSOCIATES INC | |||||||||
| 442 W HIGH STREET | BRYAN | OH | 43506 | 341045870 | PHYSICIANS | OH | N/A | C | 0 |
| WOODLAND PLAZA MEDICAL PARK CONDO ASSOC INC | |||||||||
| 202 W BERRY ST SUITE 800 | FORT WAYNE | IN | 46802 | 352058340 | CONDO MANAGEMENT | 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 | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |