2020-11-06T12:12:23-06:00 2019-12-31 350921680 CROWE LLP 330 E JEFFERSON BLVD PO BOX 7 SOUTH BEND IN 466240007 990 2019-01-01 352064353 PARKVIEW OCCUPATIONAL HEALTH CENTERS INC PARK 2603738429 10501 CORPORATE DRIVE FORT WAYNE IN 46845 JEANNE' WICKENS PH CFO 2602669313 2020-11-03 1 BRITTNEY KOCAJ P01320603 5742323992 204.58.171.16 2020-11-03 14:43:55 ES P B38744F01C9F8B49338464F7361C640636AC5E7B B38744F01C9F8B49338464F7361C640636AC5E7B 2019 2021-01-29 14:40:06Z MICHAEL J PACKNETT 10501 CORPORATE DRIVE FORT WAYNE IN 46845 14676514 0 X WWW.PARKVIEW.COM X 1998 IN DELIVER OCCUPATIONAL HEALTH CARE SERVICES AND PROMOTE GENERAL HEALTH OF COMMUNITY. 3 2 194 0 0 0 20000 3980 14509972 14672534 -7792 -368 0 0 14522180 14676146 0 0 0 0 10370443 10940847 0 0 0 6714577 7249808 17085020 18190655 -2562840 -3514509 2212552 3153759 1615810 6071526 596742 -2917767 X DELIVER OCCUPATIONAL HEALTH CARE SERVICES IN A TIMELY, EFFICIENT, COST-EFFECTIVE MANNER AND PROMOTE THE GENERAL HEALTH OF THE COMMUNITY BY PROVIDING EDUCATIONAL AND WELLNESS PROGRAMS TO EMPLOYEE PATIENTS AND EMPLOYER CLIENTS. 0 0 15745428 14672534 PARKVIEW OCCUPATIONAL HEALTH CENTERS, INC. (POHCI) PROVIDES A FULL RANGE OF OCCUPATIONAL HEALTH SERVICES IN PREVENTION, TREATMENT, AND REHABILITATION. THESE SERVICES ARE DELIVERED WITH AN EMPHASIS ON COST CONTAINMENT THROUGH EARLY INTERVENTION AND EXPERT CASE MANAGEMENT. EMPLOYEE ASSISTANCE PROGRAMS (EAP) AND WORKSITE WELLNESS SERVICES ARE ALSO AVAILABLE.POHCI PERFORMS A WIDE VARIETY OF PRE-PLACEMENT PHYSICAL EXAMINATIONS FOR A WIDE CROSS SECTION OF THE NORTHEAST INDIANA AREA BUSINESS COMMUNITY. THESE EXAMINATIONS ARE SPECIFIC TO THE JOB FOR WHICH THE INDIVIDUAL IS BEING CONSIDERED, AND WITH THE ADVENT OF THE AMERICANS(SEE SCHEDULE O FOR CONTINUATION)WITH DISABILITIES ACT (ADA), ARE MATCHING POTENTIAL JOB APPLICANTS WITH THE ESSENTIAL FUNCTIONS OF THEIR JOBS. THIS ASSISTANCE IS CRITICAL TO EMPLOYERS AS THEY COMPLY WITH ADA. THE ORGANIZATION ALSO OFFERS A NATIONALLY CERTIFIED DRUG SCREEN PROGRAM, WHICH IS OPERATED IN COMPLIANCE WITH GUIDELINES ESTABLISHED BY THE NATIONAL INSTITUTE FOR DRUG ABUSE. FURTHER, THE ORGANIZATION PROVIDES ON-SITE MEDICAL MONITORING EXAMINATION PROTOCOL DEVELOPMENT, E. G., ASSISTING COMPANIES WITH THEIR COMPLIANCE UNDER OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION GUIDELINES, ERGONOMIC COMPLIANCE ASSISTANCE, AND ASSISTANCE IN COMPLIANCE WITH THE AMERICANS WITH DISABILITIES ACT REASONABLE ACCOMMODATION GUIDELINES. ADDITIONALLY, THE ORGANIZATION PROVIDES INDUSTRIAL HYGIENE SERVICES TO ASSIST IN ANALYZING NOISE LEVELS, INDOOR AIR QUALITY, AND OTHER MANDATED SURVEILLANCE PROGRAMS UNDER THE AUTHORIZATION OF THE OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION.POHCI'S CLINICS ARE EQUIPPED TO CONDUCT INJURY CARE, PHYSICAL EXAMINATIONS, AND THE FOLLOWING ANCILLARY SERVICES: X-RAY, COLLECTION OF SPECIMENS FOR LABORATORY ANALYSIS, PULMONARY FUNCTION TESTING, AUDIOMETRY, ELECTROCARDIOGRAMS (EKG), AND VISION SCREENING.POHCI SPECIALIZES IN THE TREATMENT OF WORKERS' COMPENSATION INJURIES AND OFFERS PHYSICIAN REFERRALS COMPLIMENTARY TO THE SPECIALIZED TREATMENT OF AN INJURY, SUCH AS HAND SURGERY, NEUROLOGY, AND OPHTHALMOLOGY, AS WELL AS IN-HOUSE PHARMACY SERVICES. THE CONCEPT OF THE ORGANIZATION'S TREATMENT PLAN IS CENTERED AROUND THE EARLY INTERVENTION/EARLY TO WORK CONCEPT. THROUGH EARLY INTERVENTION AND A VARIETY OF TREATMENT AND REHABILITATIVE MODALITIES, PATIENTS ARE ASSURED THE MOST EXPEDITIOUS RETURN TO WORK, THUS SAVING THE EMPLOYERS TREMENDOUS EXPENSE IN LOST PRODUCTIVITY, OVERTIME, TRAINING COSTS, ETC.POHCI PROVIDES PHYSICAL THERAPY ON-SITE AT THE CENTRAL, NORTH AND SOUTH LOCATIONS. POHCI HAS PARTNERED WITH THE PARKVIEW HOSPITAL PHYSICAL THERAPY DEPARTMENTS IN OTHER AREAS OF THE REGION. THE THERAPISTS ARE TRAINED IN REHABILITATION OF WORK RELATED INJURIES AND ARE SUPERVISED BY THE ORGANIZATION'S OCCUPATIONAL HEALTH PHYSICIANS. THE FOCUS OF THE THERAPIST IS TO RETURN THE INJURED WORKER TO THE JOB. DURING PHYSICAL THERAPY REHABILITATION, THE INJURED WORKER IS TAUGHT PROPER LIFTING TECHNIQUES TO AVOID RE-INJURY. THE OCCUPATIONAL THERAPY DEPARTMENT SPECIALIZES IN HAND REHABILITATION, UTILIZING VARIOUS EXERCISES AND SPLINTS THAT ASSIST IN EXPEDITING THE RECOVERY PROCESS.POHCI ALSO PROVIDES A COMPREHENSIVE WORK CONDITIONING PROGRAM, WHICH OPERATES WITHIN A WORK SIMULATION ENVIRONMENT, THUS ASSISTING THE INDIVIDUAL WITH BUILDING A PHYSICAL TOLERANCE LEVEL IN ORDER TO RETURN TO WORK IN A FULLY REHABILITATED CONDITION, IF AT ALL POSSIBLE.POHCI IS COMMITTED TO COST CONTAINMENT FOR ITS EMPLOYER CLIENTS AND/OR THEIR INSURANCE CARRIERS. SINCE THE ORGANIZATION SPECIALIZES IN OCCUPATIONAL HEALTH, APPROXIMATELY NINETY-NINE PERCENT (99%) OF THE FEES FOR ALL CASES ARE PAID EITHER THROUGH THE EMPLOYERS' WORKERS' COMPENSATION INSURANCE OR DIRECTLY BY THE EMPLOYERS. 15745428 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 X 16 0 1 194 1 0 0 0 0 0 0 0 0 0 0 0 0 X 3 2 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 IN X JEANNE' WICKENS 2602669313 10501 CORPORATE DRIVE FORT WAYNE IN 46845 MICHAEL PACKNETT PH PRESIDENT & CEO 1.00 56.00 X 0 3051353 2893212 JEANNE' WICKENS PH CHIEF FINANCIAL OFFICER 1.00 56.00 X 0 843129 327919 MICHAEL KNIPP POHCI PHYSICIAN 39.00 X 252926 0 45697 OMOTAYO FAWIBE POHCI PHYSICIAN 39.00 X 243876 0 43099 LISA SCHANBACHER DIRECTOR/POHCI VP 20.00 20.00 X 127648 87180 51753 CARIN FOSS POHCI OCC HEALTH NP 40.00 X 140226 0 43029 DIANE CASEY POHCI DIR OCC HEALTH 40.00 X 135262 0 33706 FELICIA COLCLESSER POHCI OCC HEALTH NP 38.00 X 138072 0 18482 MARJORIE HINER DIRECTOR/CHAIR 1.00 1.00 X 500 0 0 DENISE LEMMON DIRECTOR/SECRETARY/TREASUR 1.00 1.00 X 500 0 0 1039010 3981662 3456897 19 0 1 0 PARKVIEW PROFESSIONAL PROGRAMS INC 10501 CORPORATE DRIVE FORT WAYNE IN 46845 LABORATORY SERVICES 631112 QUEST DIAGNOSTICS PO BOX 740709 ATLANTA GA 30374 LABORATORY SERVICES 568221 COMPHEALTH PO BOX 972651 DALLAS TX 753972651 PHYSICIANS 220260 MIDWEST COMMUNITY HEALTH ASSOCIATES INC 442 WEST HIGH STREET BRYAN OH 43506 PHYSICIANS 142318 4 3980 3980 PATIENT SERVICE 621400 14672534 14672534 14672534 368 -368 -368 -368 14676146 14672534 0 -368 X 159399 159399 63315 63315 8188494 8188494 2529639 2529639 1982070 1812220 169850 6067 6067 374766 245991 128775 694452 670086 24366 743760 743612 148 150072 135127 14945 37431 33137 4294 188441 156779 31662 113445 97551 15894 CORPORATE SERVICE ALLOC 1892532 1892532 MEDICAL SUPPLIES 873862 873862 BAD DEBT 148475 148475 DUES & SUBSCRIPTIONS 19545 18386 1159 24890 22687 2203 18190655 15745428 2445227 0 25834 19631 1281113 1438309 29432 0 161057 33789 62672 3121545 1649455 842384 1472090 2212552 3153759 491300 461691 1124510 5609835 1615810 6071526 X 596742 -2917767 596742 -2917767 2212552 3153759 -3514509 0 X 0 1 X 1 0 X FORM 990, SCHEDULE A, PART 1, LINE 3: EXPLANATION OF CHARITY STATUS PURSUANT TO THE IRS DETERMINATION LETTER DATED SEPTEMBER 1, 1999, THE ORGANIZATION IS RECOGNIZED AS EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION IS DESCRIBED IN SECTION(S) 509(A)(1) AND 170(B(1)(A)(III) AS A HOSPITAL OR A COOPERATIVE HOSPITAL SERVICE ORGANIZATION. PARKVIEW OCCUPATIONAL HEALTH CENTER, INC.'S ORIGINAL APPLICATION FOR RECOGNITION OF EXEMPTION (FORM 1023) STATES THE FOLLOWING: "THE CORPORATION WILL NOT BE A HOSPITAL BUT WILL OPERATE OUTPATIENT CLINICS. THE CORPORATION OPERATES FOR THE PURPOSE OF TREATING WORKERS' COMPENSATION INJURIES AND ILLNESSES IN THE FORT WAYNE METROPOLITAN AREA. IT WILL NOT BE AN EMERGENCY ROOM AS FORMALLY DEFINED. IT WILL BE DESIGNED TO TREAT MINOR EMERGENCIES THAT OCCUR IN THE WORK PLACE THAT ARE COVERED UNDER WORKERS' COMPENSATION LAWS. AS AN AFFILIATE OF PARKVIEW HEALTH SYSTEMS, INC., ALL CHARITY PATIENTS WILL BE REFERRED AND TREATED WITHIN THE PARKVIEW SYSTEM IF SUCH PATIENTS SO CHOOSE." 0 0 0 0 0 0 0 0 1 233 233 0 PART II-B, LINE 1: OTHER ACTIVITIES - REPRESENTS THE PORTION OF THE DUES PAID TO VARIOUS PROFESSIONAL ASSOCIATIONS USED FOR LOBBYING ACTIVITIES. 603226 257006 346220 902213 427739 474474 1585142 945553 639589 30964 19157 11807 1472090 DUE TO/FROM INTERUNIT 5492329 OPERATING LEASES 117506 5609835 X 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, 2019 AND 2018, 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 NO LONGER SUBJECT TO EXAMINATION FOR THE YEAR 2015 AND PRIOR. X X 1 1 0 1 0 0 0 0 0 1 0 MICHAEL PACKNETT PH PRESIDENT & CEO 0 1115831 0 248595 0 1686927 0 2854466 0 38746 0 5944565 0 1637768 JEANNE' WICKENS PH CHIEF FINANCIAL OFFICER 0 689476 0 131971 0 21682 0 295719 0 32200 0 1171048 0 0 MICHAEL KNIPP POHCI PHYSICIAN 252266 0 0 0 660 0 12926 0 32771 0 298623 0 0 0 OMOTAYO FAWIBE POHCI PHYSICIAN 193423 0 0 0 50453 0 10873 0 32226 0 286975 0 0 0 LISA SCHANBACHER DIRECTOR/POHCI VP 87180 87180 29389 0 11079 0 14935 10200 15816 10802 158399 108182 8547 0 CARIN FOSS POHCI OCC HEALTH NP 131522 0 7466 0 1238 0 10224 0 32805 0 183255 0 0 0 DIANE CASEY POHCI DIR OCC HEALTH 121799 0 11911 0 1552 0 8173 0 25533 0 168968 0 0 0 FELICIA COLCLESSER POHCI OCC HEALTH NP 127826 0 6024 0 4222 0 5112 0 13370 0 156554 0 0 0 PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - TAX ON TAXABLE GIFT: OMOTAYO FAWIBE $10 DISCRETIONARY SPENDING ACCOUNT - TAXABLE: FELICIA COLCLESSER $1,000; CARIN FOSS $800 PART I, LINE 3 RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF PARKVIEW OCCUPATIONAL HEALTH CENTERS, 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 TAXABLE - LISA SCHANBACHER $8,547; MICHAEL PACKNETT $1,637,768 PARTICIPANTS DEFERRED - 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. BENEFITS EARNED UNDER THE PLANS WILL FUND THE EMPLOYEES' EVENTUAL RETIREMENT BENEFIT. THESE BENEFITS ARE PROVIDED IN EXCHANGE FOR ALL OF THE EMPLOYEES' YEARS OF SERVICE TO THE ORGANIZATION, AND THE COST OF THE BENEFITS MAY VARY FROM YEAR TO YEAR. 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. MICHAEL PACKNETT $2,829,266; JEANNE' WICKENS $281,719 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. ALEXANDRA BRAND FAMILY MEMBER OF DIRECTOR LISA SCHANBACHER 63315 EMPLOYEE ALEXANDRA BRAND RECEIVED COMPENSATION (INCLUDING TAXABLE AND NONTAXABLE FRINGE BENEFITS TREATED AS COMPENSATION) FROM PARKVIEW OCCUPATIONAL HEALTH CENTERS, INC. 0 FORM 990, PART V, LINES 1A AND 2A: PARKVIEW HEALTH SYSTEM, INC. (PH), EIN 35-1972384, IS THE COMMON PAYING AGENT FOR THE FILING ORGANIZATION, PARKVIEW OCCUPATIONAL HEALTH CENTERS, INC., EIN 35-2064353. 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, 2019 WAS 524. THE TOTAL NUMBER OF EMPLOYEES REPORTED ON FORM W-3 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2019 WAS 15,019. FOR PURPOSES OF COMPLETING FORM 990, PART V, LINE 1A AND 2A, THE NUMBER REPORTED FOR THE PARKVIEW OCCUPATIONAL HEALTH CENTERS, INC. WAS 16 AND 194 RESPECTIVELY. FORM 990, PART VI, SECTION A, LINE 2 DIRECTOR LISA SCHANBACHER AND OFFICER JEANNE' WICKENS HAVE A BUSINESS RELATIONSHIP AS DIRECTORS ON THE BOARD OF A RELATED ENTITY. 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 PARKVIEW OCCUPATIONAL HEALTH CENTERS, 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 AS DEFINED IN THE NETWORK AGREEMENT: 1. THE BOARD OF DIRECTORS SHALL BE COMPRISED OF THREE (3) DIRECTORS. EACH DIRECTOR SHALL BE ELECTED BY THE SOLE MEMBER OF THE CORPORATION AT THE ANNUAL MEETING OF THE MEMBERSHIP. 2. THE CONFLICT OF INTEREST POLICY OF THE SOLE MEMBER OF THE CORPORATION, WHICH HAS BEEN APPROVED BY THE SYSTEM-WIDE CORPORATE COMPLIANCE COMMITTEE AND APPROVED BY THE SOLE MEMBER OF THE CORPORATION, SHALL APPLY TO THE CORPORATION. THIS CONFLICT OF INTEREST POLICY CAN ONLY BE AMENDED UPON THE APPROVAL OF THE BOARD OF DIRECTORS OF THE SOLE MEMBER OF THE CORPORATION. 3. IT SHALL BE THE GENERAL RULE THAT THE EMPLOYMENT OF IMMEDIATE FAMILY MEMBERS (MOTHER, FATHER, SISTER, BROTHER, SON, DAUGHTER OR SPOUSE) OF DIRECTORS AND EXECUTIVE MANAGEMENT STAFF SHALL BE PERMITTED AS AUTHORIZED BY THE PERSONNEL POLICIES OF THE CORPORATION AND THE SOLE MEMBER OF THE CORPORATION. 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 A, LINE 8B AT THE CURRENT TIME NO EXECUTIVE COMMITTEE EXISTS. 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. PARKVIEW OCCUPATIONAL HEALTH CENTERS, 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 6, 2020, 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 LAB: PROGRAM SERVICE EXPENSES 1,234,710. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,234,710. CLEANING: PROGRAM SERVICE EXPENSES 35,615. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 35,615. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 75,021. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 75,021. PHYSICIAN PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 408,771. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 408,771. COLLECTION: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 15,603. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,603. OTHER: PROGRAM SERVICE EXPENSES 58,103. MANAGEMENT AND GENERAL EXPENSES 154,247. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 212,350. 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. 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