2020-11-06T12:12:23-06:00 2019-12-31 350921680 CROWE LLP 330 E JEFFERSON BLVD P O BOX 7 SOUTH BEND IN 466240007 990 2019-01-01 471753440 PARKVIEW WABASH HOSPITAL INC PARK 2603738429 10 JOHN KISSINGER DRIVE WABASH IN 46992 JEANNE' WICKENS PH CFO 2602669313 2020-11-03 1 BRITTNEY KOCAJ P01320603 5742323992 204.58.171.16 2020-11-03 14:51:20 ES P B38744F01C9F8B49338464F7361C640636AC5E7B B38744F01C9F8B49338464F7361C640636AC5E7B 2019 2021-01-29 14:40:06Z MICHAEL J PACKNETT 10501 CORPORATE DRIVE FORT WAYNE IN 46845 55828442 0 X WWW.PARKVIEW.COM X 2014 IN PARKVIEW WABASH HOSPITAL, INC. WORKS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND PROVIDES QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US. 12 8 223 52 0 0 645327 322676 45500182 55243146 3503 5710 317335 255290 46466347 55826822 135219 66111 0 0 13210573 15907057 0 0 215900 41173821 43891119 54519613 59864287 -8053266 -4037465 52925711 52040954 69032064 72085909 -16106353 -20044955 X PARKVIEW WABASH HOSPITAL, INC. WORKS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND PROVIDES QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US. 0 0 51027160 66111 55243146 PARKVIEW WABASH HOSPITAL, INC. IS A NOT-FOR-PROFIT, CRITICAL ACCESS FACILITY. PARKVIEW WABASH HOSPITAL, INC. IS FULLY ACCREDITED BY THE JOINT COMMISSION. BOTH A MEDICAL-SURGICAL UNIT AND A CONSTANT CARE UNIT ARE AVAILABLE, AS WELL AS LAB, IMAGING, SURGICAL AND EMERGENCY SERVICES, ONCOLOGY, CARDIAC REHAB, PHYSICAL THERAPY, SENIOR BEHAVIORAL HEALTH AND AN IN-HOUSE SLEEP LAB. PATIENTS HAVE ACCESS TO 10 PARKVIEW PHYSICIANS GROUP PRIMARY CARE AND SPECIALTY PROVIDERS AND MORE THAN 20 VISITING SPECIALISTS. MORE THAN 45 MEN AND WOMEN MAKE UP AN ACTIVE VOLUNTEER PROGRAM AT PARKVIEW WABASH HOSPITAL, INC. THEY WELCOME VISITORS AT BOTH THE MAIN(SEE SCHEDULE O FOR CONTINUATION)ENTRANCE, EMERGENCY ROOM ENTRANCE, AND MEDICAL OFFICE BUILDING ENTRANCE. THE VOLUNTEERS TAKE PEOPLE TO THEIR DESTINATIONS, SERVE AS SURGERY HOSTS, ASSIST ON THE INPATIENT UNIT, HELP WITH OFFICE WORK, ACT AS CHAPLAIN ASSISTANTS AND RUN OUR GIFT SHOP.FINANCIAL ASSISTANCE:PARKVIEW WABASH HOSPITAL, INC. IS COMMITTED TO MAKING MEDICALLY NECESSARY HEALTHCARE ACCESSIBLE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. PATIENTS WHOSE FAMILY INCOME DOES NOT EXCEED TWICE THE FEDERAL POVERTY GUIDELINES MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. A FINANCIAL COUNSELOR IS AVAILABLE TO HELP PATIENTS NAVIGATING THIS PROCESS.COMMUNITY OUTREACH:PARKVIEW WABASH HOSPITAL, INC. IS ONE OF THE LARGEST EMPLOYERS IN WABASH COUNTY AND BELIEVES STRONGLY IN GIVING BACK TO THE COMMUNITY IT SERVES. THE HOSPITAL NOT ONLY SPONSORS ITS OWN EVENTS AND OUTREACH PROGRAMS EACH YEAR, BUT ALSO TAKES AN ACTIVE ROLE IN NUMEROUS OTHER HEALTH FAIRS, FESTIVALS, EDUCATION, PARADES, AND COMMUNITY EVENTS. THE MANAGEMENT AND CO-WORKERS OF PARKVIEW WABASH HOSPITAL, INC. PARTICIPATE IN VOLUNTEER ACTIVITIES THROUGHOUT THE YEAR TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY.WITH OUR COMMUNITY HEALTH PARTNERS PROGRAM, PARKVIEW WABASH HOSPITAL, INC. INVESTS IN KEY ORGANIZATIONS THAT PROMOTE THE HEALTHY LIFESTYLE CHOICES AND WELL-BEING OF INDIVIDUALS, CHILDREN, AND FAMILIES OF WABASH. IN THE CALENDAR YEAR 2019, THE HOSPITAL SELECTED SIX COMMUNITY AGENCIES OR ORGANIZATIONS TO SUPPORT AND COLLABORATE IN ADDRESSING OUR FOCUS AREAS OF OBESITY AND MATERNAL CHILD HEALTH. SAMPLINGS OF THOSE PROJECTS INCLUDE:LIKING FOR BIKING - THIS HOUR-LONG BIKE RIDE OFFERED EVERY SATURDAY FROM MAY THROUGH EARLY SEPTEMBER IS LED BY THE ROCK CITY BIKE CLUB AND VISIT WABASH COUNTY. IT IS FOR ALL AGES AND ABILITIES OF BIKE RIDERS AND MEANT TO ENCOURAGE PHYSICAL ACTIVITY IN ALL. RIDERS CAN RIDE FOR AS LONG AS THEY LIKE AND AT THEIR OWN PACE, WITH THE END GOAL BEING TO INCREASE BOTH BY THE END OF THE EVENT. IN 2019, AVERAGE ATTENDANCE EACH SATURDAY WAS 25.BABY & ME TOBACCO FREE - THE PERCENT OF WABASH COUNTY WOMEN WHO SMOKE WHILE PREGNANT IS ONE OF THE HIGHEST IN THE STATE AT 26.3%. PARKVIEW WABASH HOSPITAL, INC. CHOSE TO PARTNER WITH THE LOCAL TOBACCO FREE COALITION TO OFFER THE NATIONAL BABY & ME TOBACCO FREE PROGRAM. IN 2019, THERE WERE 40 REFERRALS TO THE PROGRAM THAT RESULTED IN NINE ACTIVE PARTICIPANTS.BLESSINGS IN A BACKPACK -- THIS PROGRAM PROVIDED STUDENTS KINDERGARTEN THROUGH 6TH GRADE WITH FOOD ITEMS TO HELP THEM AND THEIR FAMILIES OVER THE WEEKENDS. TO QUALIFY, STUDENTS MUST BE ON FREE OR REDUCED LUNCH.COACHING PROGRAM - THE WABASH COUNTY YMCA PROVIDES A ROBUST COACHING PROGRAM TO THEIR MEMBERS. WITH THE ASSISTANCE OF A COMMUNITY HEALTH PARTNERSHIP WITH PWB, THEY ARE ABLE TO OFFER THE PROGRAM TO THEIR LOW-INCOME MEMBERS AT NO COST. IN 2019, 40 MEMBERS TOOK ADVANTAGE OF THE OPPORTUNITY. OF THOSE PARTICIPANTS, 17% LOWERED THEIR BLOOD PRESSURE, 10% LOWERED THEIR BLOOD GLUCOSE AND 50% LOWERED THEIR BMI BY TWO POINTS OR MORE. ALL REPORTED AN IMPROVEMENT IN THEIR OVERALL WELL-BEING.PRIMARY HEALTH CARE ACCESS: PARKVIEW WABASH HOSPITAL, INC. PROVIDES SUPPORT TO 85 HOPE, WABASH COUNTY'S FREE HEALTH CLINIC, BY OFFERING 100% CHARITY TO ALL OF THEIR PATIENTS. 51027160 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 27 0 1 223 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 8 1 0 0 0 1 1 1 1 1 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 DIRECTOR/PH PRESIDENT & CEO 1.00 56.00 X X 0 3051353 2893212 JEANNE' WICKENS PH CHIEF FINANCIAL OFFICER 1.00 56.00 X 0 843129 327919 DOUGLAS SPARKS DIRECTOR/PH PHYSICIAN 2.00 39.00 X 25239 483537 60861 MARILYN CUSTER-MITCHELL DIRECTOR/WBHOS PRESIDENT 40.00 1.00 X X 289515 0 95354 CATHY WOLFE WBHOS VP PATIENT CARE 40.00 X 176891 0 45221 TRENTON SHODA WBHOS MGR PHARMACY 37.00 3.00 X 143517 10876 30895 SHERRY SCHOENING WBHOS MGR REHAB 40.00 X 131508 0 48207 LISA KROH WBHOS PHARMACIST 41.00 X 149737 0 18759 REBECCA MEREDITH WBHOS PHARMACIST 40.00 X 128865 0 30619 GRACE STANLEY WBHOS NURSE PRACTITIONER 41.00 X 116123 0 20972 WILLIAM RAUH DIRECTOR 1.00 X 11000 0 0 HOWARD HALDERMAN DIRECTOR/CHAIR 1.00 1.00 X 6060 3859 0 ROGER CROMER DIRECTOR 1.00 1.00 X 5000 750 0 KEVIN BOWMAN DIRECTOR 1.00 X 4750 0 0 JASON CALLAHAN DIRECTOR/VICE CHAIR 1.00 X 4750 0 0 PATTY GRANT DIRECTOR 1.00 X 4750 0 0 KENT TERRILL DIRECTOR 1.00 X 4500 0 0 ROBERT PEARSON DIRECTOR 1.00 X 4250 0 0 KELLY STOUFFER DIRECTOR/SECRETARY/TREASURER 1.00 X 4250 0 0 1210705 4393504 3572019 16 0 1 0 PARKVIEW HEALTH SYSTEM INC 10501 CORPORATE DRIVE FORT WAYNE IN 46845 RHC OPERATIONS 5209553 PROFESSIONAL EMERGENCY PHYSICIANS INC 3640 NEW VISION DRIVE SUITE A FORT WAYNE IN 46845 PHYSICIANS 1981584 PARKVIEW HOSPITAL INC 11109 PARKVIEW PLAZA DRIVE FORT WAYNE IN 46845 LABORATORY SERVICES 1815797 FOCUSONE SOLUTIONS LLC 13609 CALIFORNIA STREET OMAHA NE 68154 NURSES 1321348 AMOR EXCAVATING INC 2191 WEST PARK DRIVE HUNTINGTON IN 46750 DEMOLITION WORK 918251 11 322676 322676 NET PATIENT SERVICE 622000 54994248 54994248 INTERUNIT RENT 531120 139957 139957 PHARMACY 446110 91513 91513 HOME BOUND MEALS 900099 17140 17140 DIAGNOSTIC RADIOLOGY 621990 280 280 8 8 55243146 6648 6648 290 682 -392 -392 -392 938 -938 -938 -938 CAFETERIA SALES 722210 240480 240480 GIFT SHOP 453220 15202 15202 255682 55826822 55243146 0 261000 X 66111 66111 684549 684549 11176056 11176056 4046452 4046452 13894538 13206055 688483 644 113 531 1119407 979385 140022 1598740 1589079 9661 66741 39108 27633 16164 15193 971 797483 797483 3764732 3757877 6855 96273 52211 44062 CORP SERVICE ALLOCATION 6929388 6929388 MEDICAL SUPPLIES 6769115 6769115 BAD DEBT 4597727 4597727 PH CLINICAL SUPPORT 3864682 3864682 375485 70513 89072 215900 59864287 51027160 8621227 215900 2579 2330 867701 576573 7308100 8645219 778933 880988 56776 48223 70239502 28372234 43593522 41867268 318100 0 0 20353 52925711 52040954 2419448 1839559 24340424 23613740 470666 1803180 41801526 44829430 69032064 72085909 X -16106353 -20044955 -16106353 -20044955 52925711 52040954 X -4037465 2714 96149 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4082 4082 0 PART II-B, LINE 1: OTHER ACTIVITIES - REPRESENTS THE PORTION OF THE DUES PAID TO INDIANA HOSPITAL AND HEALTH ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION, INDIANA RURAL HEALTH ASSOCIATION AND VARIOUS PROFESSIONAL ASSOCIATIONS USED FOR LOBBYING ACTIVITIES. 846506 300560 87363 1096 12452 1220881 805494 165 51005 502 9656 846506 621519 101080 90165 7270 805494 603064 21841 3385 621519 617156 6827 -14095 6824 603064 0.05060 0.77810 0.17130 1 1 1 1208757 1208757 52247830 23120904 29126926 14907858 4929557 9978301 1875057 321773 1553284 41867268 DUE TO/FROM INTERUNIT 41691225 EST MEDICARE/MEDICAID SETTLEMENTS 3138205 44829430 X PART V, LINE 4: ENDOWMENT FUNDS ARE USED FOR THE ORGANIZATION'S PROGRAMS AND OPERATIONS RELATED TO PATIENT-FOCUSED CARE. PART X, LINE 2: PARKVIEW HEALTH SYSTEM, INC. AND SUBSIDIARIES - NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES THE LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): INCOME TAXES: THE INTERNAL REVENUE SERVICE HAS DETERMINED THAT THE CORPORATION AND CERTAIN AFFILIATED ENTITIES ARE TAX-EXEMPT ORGANIZATIONS AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CERTAIN SUBSIDIARIES OF THE CORPORATION ARE TAXABLE ENTITIES, THE TAX EXPENSE AND LIABILITIES OF WHICH ARE NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION AND ITS TAX-EXEMPT AFFILIATED ENTITIES EACH FILE A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THESE RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH SYSTEMS INCLUDE SUCH MATTERS AS THE TAX-EXEMPT STATUS OF EACH ENTITY, THE CONTINUED TAX-EXEMPT STATUS OF BONDS, THE NATURE, CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME, AND VARIOUS POSITIONS RELATING TO POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (REPORTED ON FORM 990T). AS OF DECEMBER 31, 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. 1 1 X 1 X 0 1 1 1 0 1 1 1282170 0 1282170 0.02320 4243481 1989750 2253731 0.04080 4718897 3008663 1710234 0.03090 10244548 4998413 5246135 0.09490 81541 0 81541 0.00150 51821 0 51821 0.00090 133362 133362 0.00240 10377910 4998413 5379497 0.09730 25000 25000 0.00050 28888 28888 0.00050 53888 53888 0.00100 1 4597727 26513 13009367 13793863 -784496 X 1 1 1 1 PARKVIEW WABASH HOSPITAL INC 10 JOHN KISSINGER DRIVE WABASH IN 46992 WWW.PARKVIEW.COM 16-005094-1 X X X X PARKVIEW WABASH HOSPITAL INC 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X HTTPS://WWW.PARKVIEW.COM/LOCALHEALTHNEEDS X 1 19 1 HTTPS://WWW.PARKVIEW.COM/LOCALHEALTHNEEDS 0 1 X 200.000000000000 X X X X X 1 1 X X X 1 X HTTPS://WWW.PARKVIEW.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X HTTPS://WWW.PARKVIEW.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X HTTPS://WWW.PARKVIEW.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 PARKVIEW WABASH HOSPITAL, INC. PART V, SECTION B, LINE 5: DESCRIBE HOW THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY, AND IDENTIFY THE PERSONS THE HOSPITAL FACILITY CONSULTED:PARKVIEW HEALTH SYSTEM, INC. INCLUDING PARKVIEW WABASH HOSPITAL, INC., CONDUCTED ITS LAST COMMUNITY HEALTH NEEDS ASSESSMENT IN 2019. OVER THE COURSE OF ADMINISTERING THIS COMMUNITY HEALTH NEEDS ASSESSMENT, THE INDIANA PARTNERSHIP FOR HEALTH COMMUNITIES (IN-PHC) RESEARCH TEAM WORKED TO ENSURE THAT THE NEEDS OF THE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS WERE TAKEN INTO ACCOUNT.THE INDIANA PARTNERSHIP FOR HEALTHY COMMUNITIES (IN-PHC) IS A COLLABORATION BETWEEN THE POLIS CENTER AT IUPUI (POLIS) AND THE INDIANA UNIVERSITY RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH (FSPH). FORMED WITH SUPPORT FROM THE INDIANA CLINICAL AND TRANSLATIONAL SCIENCES INSTITUTE (I-CTSI), ITS MISSION IS TO HELP BUILD THE CAPACITY OF HOSPITALS, LOCAL HEALTH DEPARTMENTS, AND COMMUNITY-BASED ORGANIZATIONS TO IMPROVE THE HEALTH OF INDIANA COMMUNITIES. IN-PHC DOES THIS BY TRANSLATING KNOWLEDGE GENERATED BY THE ACADEMY AND BY COMMUNITIES INTO IMPROVED AND SUSTAINABLE PROCESSES FOR UNDERSTANDING AND EFFECTING COMMUNITY HEALTH. THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT USED THREE SOURCES OF PRIMARY DATA: 1) A PHONE SURVEY OF THE COMMUNITY CONDUCTED ON BEHALF OF PARKVIEW WABASH HOSPITAL, INC., BY THE IN-PHC COMPLETED IN MARCH 2019; 2) AN ONLINE SURVEY DEVELOPED BY THE IN-PHC AND DISTRIBUTED BY THE HOSPITAL TO AREA PROVIDERS INCLUDING PUBLIC HEALTH OFFICIALS, OTHER HEALTHCARE PROFESSIONALS AND VARIOUS SOCIAL SERVICE ORGANIZATIONS THAT SPECIALIZE IN AIDING VULNERABLE POPULATIONS COMPLETED IN JUNE 2019; AND 3) A WRITTEN SURVEY, FOR THE AMISH COMMUNITY IN LAGRANGE COUNTY, WAS DISTRIBUTED THROUGH COMMUNITY LEADERS, AND WAS COMPLETED IN THE SUMMER OF 2019.THE PARKVIEW HEALTH COMMUNITY DASHBOARD DEVELOPED BY HEALTHY COMMUNITIES INSTITUTE WAS USED AS A PRIMARY SOURCE OF SECONDARY DATA. THIS DASHBOARD INCLUDES DATA FROM THE INDIANA HOSPITAL ASSOCIATION AS WELL AS THE INDIANA STATE DEPARTMENT OF HEALTH, NATIONAL CANCER INSTITUTE, CENTERS FOR DISEASE CONTROL AND PREVENTION, CENTERS FOR MEDICAID AND MEDICARE SERVICES, THE NATIONAL CENTER FOR HIV/AIDS, VIRAL HEPATITIS, STD AND TB PREVENTION, INSTITUTE FOR HEALTH METRICS AND EVALUATION, COUNTY HEALTH RANKINGS WEBSITE, US CENSUS BUREAU, US DEPARTMENT OF AGRICULTURE, AND OTHER SOURCES. ADDITIONAL STATE AND NATIONAL SECONDARY DATA SOURCES WERE ACCESSED BY THE CHNA TEAM FOR MORE RECENT AND GEOGRAPHICALLY SPECIFIC INFORMATION, INCLUDING THE FOLLOWING:-AMERICAN COMMUNITY SURVEY: THE AMERICAN COMMUNITY SURVEY (ACS) HELPS LOCAL OFFICIALS, COMMUNITY LEADERS, AND BUSINESSES UNDERSTAND THE CHANGES TAKING PLACE IN THEIR COMMUNITIES. IT IS THE PREMIER SOURCE FOR DETAILED POPULATION AND HOUSING INFORMATION ABOUT OUR NATION.-ANNIE E. CASEY FOUNDATION: THE ANNIE E. CASEY FOUNDATION IS A PRIVATE PHILANTHROPIC ORGANIZATION THAT WORKS TO BUILD A BRIGHTER FUTURE FOR DISADVANTAGED CHILDREN IN THE UNITED STATES. THE KIDS COUNT DATA BOOK OFFERS A NATIONAL LOOK AT THE WELL-BEING OF AMERICA'S CHILDREN AND FAMILIES BY EXPLORING HOW STATES ARE PERFORMING ON KEY DATA INDICATORS. -CENTER FOR DISEASE CONTROL AND PREVENTION: AS A FEDERALLY FUNDED AGENCY, CDC SERVES AS A GREAT RESOURCE FOR MORTALITY AND MORBIDITY DATA FOR ALL THE INFECTIOUS AND CHRONIC DISEASES AND OTHER CONDITIONS.-COUNTY HEALTH RANKINGS: A ROBERT WOOD JOHNSON FOUNDATION PROGRAM IMPLEMENTED BY THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE THAT RELEASES NEW ESTIMATES ANNUALLY MEASURING HEALTH ACROSS ALL US COUNTIES. THESE DATA ARE COMPILED FROM A VARIETY OF PROVIDERS AND TYPICALLY COMBINES DATA ACROSS MULTIPLE YEARS TO RELEASE ESTIMATES FOR AREAS WITH SMALL POPULATIONS, SUCH AS RURAL COUNTIES.-CENTERS FOR MEDICARE & MEDICAID SERVICES: THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) PROVIDES HEALTH COVERAGE TO MORE THAN 100 MILLION PEOPLE THROUGH MEDICARE, MEDICAID, AND THE CHILDREN'S HEALTH INSURANCE PROGRAM, AND THE HEALTH INSURANCE MARKETPLACE. THE CMS SEEKS TO STRENGTHEN AND MODERNIZE THE NATION'S HEALTH CARE SYSTEM TO PROVIDE ACCESS TO HIGH QUALITY CARE AND IMPROVED HEALTH AT LOWER COSTS.-FEEDING AMERICA: A NONPROFIT ORGANIZATION WORKING TO FEED AMERICA'S HUNGRY THROUGH FOOD BANKS. DATA ARE COMPILED FROM THE CURRENT POPULATION SURVEY, AMERICAN COMMUNITY SURVEY, AND BUREAU OF LABOR STATISTICS TO PRODUCE FOOD-INSECURITY REPORTS.-INDIANA INDICATORS: A FREE DATA RESOURCE PROVIDING CURRENT INDIANA HEALTH-RELATED DATA AT THE STATE AND COUNTY LEVELS AND DEVELOPED BY THE INDIANA STATE DEPARTMENT OF HEALTH, INDIANA HOSPITAL ASSOCIATION, AND INDIANA BUSINESS RESEARCH CENTER.-INDIANA STATE DEPARTMENT OF HEALTH (ISDH): THE ISDH'S ANNUAL NATALITY REPORT INCLUDES INFORMATION ON LIVE BIRTHS IN INDIANA AS WELL AS A MORTALITY REPORT COMPILING INFORMATION ON THE DEATHS OF INDIANA RESIDENTS.-NATIONAL CANCER INSTITUTE: THE NATIONAL CANCER INSTITUTE (NCI) IS THE FEDERAL GOVERNMENT'S PRINCIPAL AGENCY FOR CANCER RESEARCH AND TRAINING. NCI MAINTAIN LARGE REGISTRIES OF INFORMATION ABOUT PEOPLE DIAGNOSED WITH CANCER TO HELP IDENTIFY IMPORTANT ISSUES THAT AFFECT CANCER PATIENTS AND SURVIVORS.-NATIONAL CENTER FOR HIV/AIDS, VIRAL HEPATITIS, STD, AND TB PREVENTION: THE NATIONAL CENTER FOR HIV/AIDS, VIRAL HEPATITIS, STD, AND TB PREVENTION IS ONE OF THE LARGER CENTERS AT CDC AND A FEDERAL SOURCE OF DATA ABOUT SEXUALLY TRANSMITTED INFECTIONS AND DISEASES.-THE NATIONAL ENVIRONMENTAL PUBLIC HEALTH TRACKING NETWORK: THE TRACKING NETWORK BRINGS TOGETHER HEALTH DATA AND ENVIRONMENT DATA FROM NATIONAL, STATE, AND CITY SOURCES AND PROVIDES SUPPORTING INFORMATION TO MAKE THE DATA EASIER TO UNDERSTAND. -US CENSUS BUREAU: A LEADING SOURCE OF DATA ON THE PEOPLE AND ECONOMY OF THE US.-2018 INDIANA ASSOCIATION OF ADULT DAY SERVICES (IAADS) SURVEY: THE 5TH ANNUAL INDIANA ADULT DAY CENTER SURVEY WAS CONDUCTED DURING THE SUMMER OF 2018 BY THE MEMBER RELATIONS COMMITTEE OF THE IAADS BOARD OF DIRECTORS. FOR THE FIRST TIME, CENTERS WERE GIVEN THE OPTION TO COMPLETE THE SURVEY ONLINE AS WELL AS BY TELEPHONE. SEVENTY-SEVEN PERCENT OF THOSE RESPONDING USED THE ONLINE OPTION. RESULTS WERE TABULATED BASED ON INDIVIDUAL SURVEY DATA. PARKVIEW WABASH HOSPITAL, INC. PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY'S CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES:PARKVIEW HOSPITAL, INC. (EIN 35-0868085); 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); AND ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH, LLC (EIN 26-0143823). PARKVIEW WABASH HOSPITAL, INC. PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY'S CHNA WAS ALSO CONDUCTED WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES:PARKVIEW HEALTH, 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. PARKVIEW WABASH HOSPITAL, INC. PART V, SECTION B, LINE 11: DESCRIBE HOW THE HOSPITAL FACILITY IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA AND ANY SUCH NEEDS THAT ARE NOT BEING ADDRESSED TOGETHER WITH THE REASONS WHY SUCH NEEDS ARE NOT BEING ADDRESSED:SIGNIFICANT HEALTH NEEDS BEING ADDRESSED:OBESITY -- PARKVIEW WABASH HOSPITAL WILL CONTINUE PROGRAMS ESTABLISHED TO ADDRESS OBESITY IN WABASH COUNTY. ACTIONS TO ADDRESS THE ISSUE OF OBESITY CENTER AROUND PROGRAMS THAT ENGAGE CHILDREN AND FAMILIES AND INCLUDE THE FOLLOWING PROGRAMS:-INCORPORATED A NEARLY HALF MILE WALKING PATH AROUND THE POND ON OUR NEW CAMPUS TO PROMOTE PHYSICAL ACTIVITY. PARTNERED WITH THE CITY OF WABASH TO CREATE SIDEWALKS ON WABASH STREET THAT LEAD TO THE WALKING PATH AND IMPROVE THE WALKABILITY OF THE NORTH END OF TOWN.-IN PARTNERSHIP WITH THE CITY OF WABASH AND INGUARD HEALTH, INVESTED IN AN OUTDOOR FITNESS COURT, LOCATED IN DOWNTOWN WABASH. THE FITNESS COURT, WHICH IS ADJACENT TO THE PAVED RIVERWALK WALKING PATH, PROMOTES AN EASY, 7-MINUTE STRENGTH AND CARDIO WORKOUT. IT IS FREE AND OPEN TO THE PUBLIC.MATERNAL/CHILD HEALTH -- -CONTINUE TO PROMOTE PROGRAMS DESIGNED TO REDUCE RISKS AND INCREASE HEALTHY BEHAVIORS AMONG PREGNANT WOMEN VIA A PART-TIME LACTATION CONSULTANT AND BIRTH PLANNER-SPONSORED A HAND-WASHING BOOTH AT THE ANNUAL KINDERGARTEN ROUND-UP. TAUGHT MORE THAN 150 CHILDREN AND THEIR FAMILIES THE PROPER WAY TO WASH THEIR HANDS.-INCREASED EFFORTS TO RAISE AWARENESS AND BUILD RELATIONSHIPS WITH COMMUNITY PARTNERSOTHER HEALTH NEEDS NOT BEING ADDRESSED: TOBACCO USE - THE TOBACCO FREE COALITION IS THE LEAD ORGANIZATION IN WABASH COUNTY RELATED TO TOBACCO FREE EFFORTS. THE COALITION PROVIDES INFORMATION ON RESOURCES ABOUT LOCAL SMOKING CESSATION PROGRAMS AND ADVOCATES FOR NO-SMOKING PUBLIC POLICY. PARKVIEW WABASH HOSPITAL IS REPRESENTED ON THEIR COALITION BOARD AND ALSO FUNDS THEIR "DON'T START SMOKING" PROGRAM FOR ALL 2ND AND 5TH GRADERS IN THE COUNTY AND THEIR BABY AND ME TOBACCO FREE PROGRAM THROUGH A CHI GRANT. THE HOSPITAL IS ALSO A TOBACCO FREE CAMPUS. DIABETES, CARDIOVASCULAR DISEASE AND CANCER - WHILE PARKVIEW WABASH HOSPITAL DID NOT SELECT THESE CHRONIC DISEASES AS TOP HEALTH PRIORITIES, OUR REGISTERED DIETITIAN IS ALSO A CERTIFIED DIABETIC EDUCATOR. SHE WORKS WITH PATIENTS ON A ONE-ON-ONE BASIS THROUGH PHYSICIAN REFERRAL AND INPATIENT CONSULTS. DRUGS/ALCOHOL ABUSE AND ADDICTION - ALTHOUGH PARKVIEW WABASH HOSPITAL DID NOT SELECT THIS AS A TOP PRIORITY; WE DO RECOGNIZE IT AS AN ISSUE THAT NEEDS ATTENTION. WABASH COUNTY FORMED A DRUG STEERING COMMITEE IN JULY 2017. PWB PRESIDENT MARILYN CUSTER-MITCHELL HELPS TO FACILITATE THE MONTHLY MEETINGS. ACCOMPLISHMENTS OF THE STEERING COMMITTEE INCLUDE:-WORKED WITH SCHOOLS TO PROVIDE EDUCATION; ELEMENTARY STUDENTS RECEIVED A PRESENTATION FROM THE YOUTH SERVICES BUREAU OF HUNTINGTON COUNTY; WABASH COUNTY DEPARTMENT OF CHILD SERVICES CREATED AND ORGANIZED THE ADDICTIONS IMPACT PANEL (LOCAL PEOPLE) WHO PRESENTED TO SECONDARY STUDENTS IN WABASH COUNTY.-BEGAN A PROGRAM TO OFFER MEDICATION ASSISTED TREATMENT (MAT) TO JAIL INMATES. -HELD A SEMINAR OF SECOND CHANCE EMPLOYERS. SEXUALLY TRANSMITTED DISEASES (STDS) - THE WABASH COUNTY HEALTH DEPARTMENT IS THE MAIN RESOURCE IN OUR COUNTY FOR INDIVIDUALS WITH THESE NEEDS.CHRONIC KIDNEY DISEASE - PARKVIEW WABASH HOSPITAL HAS DONE RESEARCH OVER THE YEARS ON THE NEED FOR ADDITIONAL RESOURCES IN THIS AREA. FOR INSTANCE, ALL THREE NATIONAL COMPANIES WHO PROVIDE DIALYSIS HAVE CONDUCTED EVALUATIONS OF THE NEED WITHIN WABASH COUNTY AND DETERMINED IT WAS NOT BENEFICIAL TO BRING DIALYSIS TO WABASH COUNTY. THERE ARE COMPANIES THAT PROVIDE THE SERVICE IN THE COUNTIES NEIGHBORING WABASH. PARKVIEW WABASH HOSPITAL MET WITH THE LOCAL PUBLIC TRANSIT PROVIDER AND THEY AGREED TO RELAX THEIR "IN-COUNTY" RULE TO TRANSPORT RESIDENTS IN NEED OF MEDICAL CARE IN A NEIGHBORING COUNTY. ASTHMA - WHILE ASTHMA WAS NOT SELECTED AS A TOP HEALTH PRIORITY, 85 HOPE, THE LOCAL FREE CLINIC, PROVIDES ASTHMA EDUCATION TO ITS PATIENTS. THE PROGRAM INCLUDES EDUCATION, INFORMATION, AND STRATEGIES FOR FOLLOW-UP CARE THAT ARE BOTH INEXPENSIVE AND EFFECTIVE. AGING - WABASH COUNTY OFFERS A VIBRANT AND ACTIVE SENIOR CENTER. THE DALLAS WINCHESTER SENIOR CENTER OFFERS MEALS MONDAY THROUGH FRIDAY, PRESCRIPTION ASSISTANCE, A FOOD PANTRY, PUBLIC TRANSPORTATION, SOCIAL EVENTS, PHYSICAL ACTIVITIES AND CONNECTIONS TO RESOURCES THAT BENEFIT SENIORS IN OUR COMMUNITY. MENTAL HEALTH - AREA RESIDENTS HAVE ACCESS TO A NUMBER OF RESOURCES IN THE COMMUNITY. THE BOWEN CENTER, FRIENDS COUNSELING CENTER AND MENTAL HEALTH AMERICA OF WABASH COUNTY EACH SERVE PEOPLE OF ALL AGES.-THE LIFEBRIDGE SENIOR INTENSIVE OUTPATIENT PROGRAM IS A SPECIALTY MENTAL/BEHAVIORAL PROGRAM DESIGNED TO MEET THE NEEDS OF OLDER ADULTS FOCUSING ON PROVIDING INTENSIVE INDIVIDUAL, FAMILY AND /OR GROUP SERVICES. EACH OF THE INDIVIDUALS ENROLLED IN THE LIFEBRIDGE PROGRAM ATTEND MONTHLY APPOINTMENTS WITH MEDICAL DIRECTOR/PSYCHIATRIST FOR MEDICATION MANAGEMENT AND TREATMENT PLANNING. AT EACH VISIT, INDIVIDUALS ARE SCREENED BY NURSING STAFF FOR VITALS, MEDICATION RECONCILIATION AND ANY MEDICAL CONCERNS ARE IMMEDIATELY COMMUNICATED TO THE INDIVIDUAL'S PRIMARY CARE PHYSICIAN. FAMILY AND SIGNIFICANT OTHERS ARE ENCOURAGED TO PARTICIPATE IN THE TREATMENT PROCESS. LIFEBRIDGE PROVIDES A COHESIVE TREATMENT TEAM TO INCREASE INDIVIDUAL'S MENTAL HEALTH AND PHYSICAL WELL-BEING. 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. 5 1 - AUTUMN RIDGE REHABILITATION CENTRE 600 WABASH AVENUE WABASH IN 46992 LAB DRAW SITE 2 - WELLBROOKE OF WABASH V20 JOHN KISSINGER DRIVE WABASH IN 46992 LAB DRAW SITE 3 - MILLERS EAST 1900 ALBER STREET WABASH IN 46992 LAB DRAW SITE 4 - MILLERS WEST 1720 ALBER STREET WABASH IN 46992 LAB DRAW SITE 5 - VERNON MANOR 1955 VERNON STREET WABASH IN 46992 LAB DRAW SITE 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) AND PARKVIEW WABASH HOSPITAL, INC. (EIN 47-1753440) PREPARED A COMBINED REPORT TO THE COMMUNITY DETAILING COMMUNITY BENEFIT PROGRAMS AND SERVICES. PART I, LINE 7: PART I, LINE 7ATHE FINANCIAL ASSISTANCE COST REPORTED ON LINE 7A IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE FINANCIAL ASSISTANCE CHARGES FOREGONE ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF SERVICES RENDERED.PART I, LINE 7BPARKVIEW WABASH HOSPITAL, INC. ACCEPTS ALL MEDICAID, MEDICAID MANAGED CARE, AND OUT-OF-STATE MEDICAID PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEDICAID PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING MEDICAID, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE UNREIMBURSED MEDICAID COST REPORTED ON LINE 7B IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE MEDICAID CHARGES ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF MEDICAID SERVICES RENDERED. THEN, THE COST OF MEDICAID SERVICES RENDERED IS DEDUCTED FROM THE REIMBURSEMENT RECEIVED FOR MEDICAID PATIENTS TO ARRIVE AT A GAIN/(LOSS) RELATIVE TO THESE PATIENTS.PART I, LINE 7CPARKVIEW WABASH HOSPITAL, INC. ACCEPTS ALL CERTAIN MEANS-TESTED PATIENTS FROM THE HEALTHY INDIANA PLAN (HIP) WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEANS-TESTED PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING HIP, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE UNREIMBURSED HIP COST REPORTED ON LINE 7C IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE HIP CHARGES ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF HIP SERVICES RENDERED. THEN, THE COST OF HIP SERVICES RENDERED IS DEDUCTED FROM THE REIMBURSEMENT RECEIVED FOR HIP PATIENTS TO ARRIVE AT A GAIN/(LOSS) RELATIVE TO THESE PATIENTS.PART I, LINE 7EAMOUNTS PRESENTED ARE BASED ON ACTUAL SPEND FOR THOSE SERVICES AND BENEFITS PROVIDED DEEMED TO IMPROVE THE HEALTH OF THE COMMUNITIES IN WHICH WE SERVE AND CONFORM WITH THE MISSION OF OUR EXEMPT PURPOSE.PART I, LINE 7IIN KEEPING WITH OUR MISSION AND COMMITMENT TO THE COMMUNITIES IN WHICH WE SERVE, PARKVIEW WABASH HOSPITAL, INC. CONTINUES ITS TRADITION OF CONTRIBUTING TO NUMEROUS ORGANIZATIONS ON BOTH AN AS-NEEDED BASIS AND NEGOTIATED BASIS. AMOUNTS PRESENTED REPRESENT ACTUAL SPEND TO ORGANIZATIONS THROUGHOUT OUR COMMUNITIES. PART I, LN 7 COL(F): PERCENT OF TOTAL EXPENSEPARKVIEW WABASH HOSPITAL, INC. EXCLUDED $4,597,727 OF BAD DEBT EXPENSE. PART II, COMMUNITY BUILDING ACTIVITIES: DESCRIBE HOW THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES, AS REPORTED, PROMOTE THE HEALTH OF THE COMMUNITIES THE ORGANIZATION SERVES.PARKVIEW WABASH HOSPITAL, INC. PROVIDES SUPPORT FOR LOCAL ECONOMIC DEVELOPMENT PROGRAMS. THESE EFFORTS ARE ALIGNED WITH OF THE HEALTH SYSTEM'S STRATEGIC INVOLVEMENT IN THE NORTHEAST INDIANA REGIONAL PARTNERSHIP'S VISION 2020, A REGIONAL INITIATIVE DESIGNED TO TRANSFORM NORTHEAST INDIANA INTO A TOP GLOBAL COMPETITOR BY FOCUSING ON A COMMON MISSION TO DEVELOP, ATTRACT AND RETAIN TALENT. VISION 2020'S REGIONAL PRIORITIES ARE TIED TO EDUCATION/WORKFORCE, BUSINESS CLIMATE, ENTREPRENEURSHIP, INFRASTRUCTURE AND QUALITY OF LIFE FOR THE ELEVEN-COUNTY REGION IN NORTHEAST INDIANA. PROMOTION OF ECONOMIC DEVELOPMENT IN WABASH COUNTY IS A PART OF A COLLECTIVE PLAN TO IMPROVE THE QUALITY OF LIFE AND ULTIMATELY THE OVERALL HEALTH AND WELL-BEING OF THE COMMUNITY.PARKVIEW WABASH HOSPITAL, INC. WORKS CLOSELY WITH GROW WABASH COUNTY, THE COUNTY'S ECONOMIC DEVELOPMENT ORGANIZATION AND THE CITY OF WABASH. PWB PRESIDENT SERVES ON THE BOARD FOR GROW WABASH COUNTY AND IS INVOLVED IN COMMUNITY MEETINGS THAT DISCUSS THE OUTLOOK, FUTURE AND PLAN FOR A VIBRANT CITY.PARKVIEW WABASH HOSPITAL, INC. ALSO SUPPORTS PHYSICIAN RECRUITMENT ACTIVITIES TO ASSIST IN TIMELY RESPONSE TO PATIENT CARE NEEDS IN THE COMMUNITY. THESE RECRUITMENT ACTIVITIES ARE BASED ON RESULTS OF A PERIODIC PHYSICIAN NEEDS ASSESSMENT. PARKVIEW WABASH HOSPITAL, INC. DEVELOPED A PHYSICIAN RECRUITMENT PLAN TO ADDRESS POTENTIAL GAPS IN PATIENT COVERAGE. PARKVIEW WABASH HOSPITAL, INC. STRIVES TO BRING THE BEST INTEGRATED, QUALITY, AND COST-EFFECTIVE CARE AND INNOVATIVE TECHNOLOGY TO OUR COMMUNITIES. IN DOING SO, WE FOCUS OUR EFFORTS ON RECRUITING AN EXCEPTIONAL TEAM OF PHYSICIANS. EVERY MEMBER OF PARKVIEW WABASH HOSPITAL, INC.'S HEALTHCARE TEAM IS RESPONSIBLE FOR NURTURING AN ENVIRONMENT OF EXCELLENCE AS THE BEST PLACE FOR CO-WORKERS TO WORK, PHYSICIANS TO PRACTICE MEDICINE, AND PATIENTS TO RECEIVE CARE. WE ARE COMMITTED TO PROVIDING AN EXCELLENT EXPERIENCE TO ALL PEOPLE. WE KNOW HOW IMPORTANT CLINICAL, SERVICE AND OPERATIONAL EXCELLENCE IS TO THE SUCCESS OF PARKVIEW WABASH HOSPITAL, INC., AND WE RECOGNIZE HOW IMPORTANT OUR SUCCESS IS TO THE COMMUNITY. PART III, LINE 2: BAD DEBT ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS UNDER GENERALLY ACCEPTED ACCOUNTING STANDARDS IS REPORTED IN ACCORDANCE WITH ASU 2014-09 AND HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15. TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES ACCOUNTING FOR BAD DEBT EXPENSE IS CONTAINED IN THE ATTACHED FINANCIAL STATEMENTS AT PAGES 13 AND 25 - 29. PART III, LINE 3: COSTING METHODOLOGY USED:UNCOLLECTIBLE PATIENT ACCOUNTS ARE CHARGED AGAINST THE PROVISION FOR BAD DEBT IN ACCORDANCE WITH THE POLICIES OF PARKVIEW WABASH HOSPITAL, INC. HOWEVER, DURING THE COLLECTION PROCESS THERE IS A CONTINUOUS EFFORT TO DETERMINE IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. THEREFORE, ONCE AN UNCOLLECTIBLE ACCOUNT HAS BEEN CHARGED OFF AND IT IS DETERMINED THROUGH THE COLLECTION PROCESS THAT THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THE UNCOLLECTIBLE ACCOUNT IS RECLASSIFIED TO CHARITY CARE AND ALL COLLECTION EFFORTS CEASE. PATIENTS ARE ELIGIBLE TO APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME, INCLUDING PATIENTS WHOSE ACCOUNTS HAVE BEEN PLACED IN A BAD DEBT AGENCY. THE AMOUNT REFLECTED ON LINE 3 WAS CALCULATED BY TOTALING THE ACCOUNTS PREVIOUSLY WRITTEN OFF TO BAD DEBT AND PLACED WITH A COLLECTION AGENCY, BUT SUBSEQUENTLY RECLASSIFIED AS CHARITY CARE DURING THE TAX YEAR. THE ACCOUNTS WERE RECLASSIFIED AS CHARITY CARE DUE TO THE FACT THAT PATIENTS APPLIED FOR, AND WERE APPROVED FOR, FINANCIAL ASSISTANCE AFTER THE ACCOUNTS WERE PLACED WITH A BAD DEBT AGENCY. 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 13 AND 25 - 29 OF ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: COMMUNITY BENEFIT & METHODOLOGY FOR DETERMINING MEDICARE COSTSSUBSTANTIAL SHORTFALLS TYPICALLY ARISE FROM PAYMENTS THAT ARE LESS THAN THE COST TO PROVIDE THE CARE OR SERVICES AND DO NOT INCLUDE ANY AMOUNTS RELATING TO INEFFICIENT OR POOR MANAGEMENT. PARKVIEW WABASH HOSPITAL, INC. ACCEPTS ALL MEDICARE PATIENTS, AS REFLECTED ON THE YEAR-END MEDICARE COST REPORT, WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. HOWEVER, MEDICARE PAYMENTS REPRESENT A PROXY OF COST CALLED THE "UPPER PAYMENT LIMIT." IT HAS HISTORICALLY BEEN ASSUMED THAT UPPER PAYMENT LIMIT PAYMENTS DO NOT GENERATE A SHORTFALL. AS A RESULT, PARKVIEW WABASH HOSPITAL, INC. HAS TAKEN THE POSITION NOT TO INCLUDE THE MEDICARE SHORTFALLS OR SURPLUSES AS PART OF COMMUNITY BENEFIT. PARKVIEW WABASH HOSPITAL, INC. RECOGNIZES THAT THE SHORTFALL OR SURPLUS FROM MEDICARE DOES NOT INCLUDE THE COSTS AND REVENUES ASSOCIATED WITH MEDICARE ADVANTAGE PATIENTS. AS SUCH, THE TOTAL SHORTFALL OR SURPLUS OF MEDICARE IS UNDERSTATED DUE TO THE COSTS AND REVENUES ASSOCIATED WITH MEDICARE ADVANTAGE PATIENTS NOT BEING INCLUDED IN THE COMMUNITY BENEFIT DETERMINATION. PART III, LINE 9B: IF THE PATIENT CANNOT PAY IN FULL, THE OPTION OF A LOW INTEREST LOAN IS AVAILABLE WITH THE SAME DISCOUNT OFFERED FOR CASH PAYMENTS AS LONG AS THE LOAN IS ARRANGED WITHIN 30 DAYS OF THE FIRST GUARANTOR STATEMENT. IF THE PATIENT DEFAULTS ON THE LOAN, THE DISCOUNT WILL BE REVERSED AND THE PATIENT'S ACCOUNT WILL BE PLACED IN A COLLECTION AGENCY.INTEREST-FREE PAYMENTS WITH PAY-OUT NOT TO EXCEED THIRTY-SIX (36) MONTHS ARE AVAILABLE. THE MINIMUM MONTHLY PAYMENT IS $25.FINANCIAL ASSISTANCE MAY BE AVAILABLE FOR THOSE PATIENTS WHO CANNOT PAY THEIR BILL. THOSE OPTIONS ARE GOVERNMENTAL ASSISTANCE OR FREE CARE THROUGH THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM. THE HEALTH SYSTEM FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON PARKVIEW.COM OR BY VISITING ANY HOSPITAL CASHIER OFFICE OR BY CALLING PATIENT ACCOUNTING AT 260.266.6700 OR TOLL FREE 855.814.0012. A PATIENT MAY APPLY FOR FINANCIAL ASSISTANCE ANYTIME DURING THE APPLICATION PERIOD. FAILURE TO MAKE ARRANGEMENTS AS LISTED ABOVE OR FAILURE TO APPLY FOR AND RECEIVE APPROVAL UNDER THE FINANCIAL ASSISTANCE POLICY MAY RESULT IN THE ACCOUNT BEING PLACED IN A COLLECTION AGENCY DUE TO NON-PAYMENT. THE COLLECTION AGENCY MAY REPORT THE ACCOUNT TO ONE OR ALL THREE CREDIT REPORTING AGENCIES WHICH MAY ULTIMATELY ADVERSELY AFFECT THE PATIENT'S CREDIT SCORE. ADDITIONALLY, THE COLLECTION AGENCY MAY SUE AND OBTAIN A JUDGMENT AGAINST THE PATIENT FOR NON-PAYMENT. THESE ACTIONS WILL NOT OCCUR UNTIL 120 DAYS AFTER THE PATIENT IS SENT THEIR FIRST FOLLOW-UP STATEMENT INDICATING THE AMOUNT THEY OWE.A PATIENT MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE APPLICATION PERIOD, EVEN THOUGH THEY HAVE BEEN PLACED IN A COLLECTION AGENCY. IF THE PATIENT WAS SENT THEIR FIRST NOTICE ON THE ACCOUNT FOR WHICH THEY ARE APPLYING FOR FREE CARE BETWEEN 120 DAYS AND THE END OF THE APPLICATION PERIOD, THE ACTIONS ABOVE WILL BE SUSPENDED UNTIL THE FREE CARE APPLICATION ELIGIBILITY IS DETERMINED. PART VI, LINE 2: DESCRIBE HOW THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES, IN ADDITION TO ANY CHNAS REPORTED IN PART V, SECTION B.IN ADDITION TO COMPLETING A COMMUNITY HEALTH NEEDS ASSESSMENT ON A TRIENNIAL BASIS, PARKVIEW HEALTH SYSTEM, INC. INCLUDING PARKVIEW WABASH HOSPITAL, 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.- DATA COLLECTION FROM COMMUNITY HEALTH WORKERS- HCI SECONDARY DATA- MEETING WITH COMMUNITY PARTNERS- OBSERVATIONS FROM FRONTLINE STAFF WORKING WITH VULNERABLE POPULATIONS- REVIEW OF CHNA CONDUCTED BY LOCAL ORGANIZATIONSHOSPITAL 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.THE ONLY HOSPITAL IN WABASH COUNTY, PARKVIEW WABASH HOSPITAL, INC., PRIMARILY SERVES THE COMMUNITIES OF WABASH, NORTH MANCHESTER, ROANN, URBANA, LAGRO, AND LAFONTAINE. TO A LESSER EXTENT, THE HOSPITAL ALSO SERVES COMMUNITIES IN SURROUNDING COUNTIES.WABASH COUNTY HAS APPROXIMATELY 32,138 RESIDENTS, WITH 96.8% BEING CAUCASIAN AND 19.8% 65 AND OLDER. THE COUNTY'S UNEMPLOYMENT RATE IS 4.8%. THE PER CAPITA PERSONAL INCOME IN WABASH COUNTY IS $39,447.PARKVIEW WABASH HOSPITAL, INC., IS THE 5TH LARGEST EMPLOYER IN THE COUNTY. THE MAKE-UP OF EMPLOYERS IN THE COUNTY IS LARGELY MANUFACTURING, FOLLOWED BY EDUCATION AND HEALTHCARE. PART VI, LINE 5: PROVIDE ANY OTHER INFORMATION IMPORTANT TO DESCRIBING HOW THE ORGANIZATION'S HOSPITAL FACILITIES OR OTHER HEALTH CARE FACILITIES FURTHER ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY (EG OPEN MEDICAL STAFF, COMMUNITY BOARD, USE OF SURPLUS FUNDS, ETC.)THE MAJORITY OF THE PARKVIEW WABASH HOSPITAL, INC. BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY MEMBERS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THE HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.PEOPLE IN OUR SERVICE AREA COMMUNITY HAVE ACCESS TO CARE 24 HOURS A DAY, 365 DAYS A YEAR THROUGH PARKVIEW WABASH HOSPITAL, INC.'S EMERGENCY DEPARTMENT (ED). THE ED IS STAFFED WITH BOARD-CERTIFIED EMERGENCY CARE PHYSICIANS AND A NURSING STAFF THAT IS TRAINED AND EXPERIENCED IN EMERGENCY CARE. ADDITIONALLY, THE HOSPITAL OFFERS FIRSTCARE, A WALK-IN CLINIC OPEN FROM 8 A.M. TO 8 P.M. MONDAY THROUGH FRIDAY AND 8 A.M. TO 2 P.M. ON SATURDAYS AND SUNDAYS.OUR CARE IS NOT LIMITED TO THE WALLS OF OUR BUILDING. PARKVIEW WABASH HOSPITAL, INC., OFFERS A WIDE BREADTH OF SERVICES TO ITS RURAL COMMUNITY. A FEW HIGHLIGHTS INCLUDE:--ONCOLOGY - THE PARKVIEW WABASH HOSPITAL, INC.'S, ONCOLOGY PROGRAM OFFERS CANCER PATIENTS ADVANCED CHEMOTHERAPY TREATMENT CLOSE TO HOME. LAST YEAR, WE ADMINISTERED ROUGHLY 4,000 INFUSION TREATMENTS TO INCLUDE CHEMOTHERAPY, INJECTIONS, IV PUSHES, LEVEL PORT FLUSHES AND COMPLEX REGIMES. ADDITIONALLY, THE DEPARTMENT ENCOURAGES SUPPORT BEYOND TREATMENT BY PROVIDING FREE SCREENINGS AND CLINICAL TRIALS. --SURGERY - OUR MEDICAL STAFF OFFERS NOTHING LESS THAN INNOVATIVE AND INDIVIDUALIZED SURGERY OPTIONS THAT ARE RESPONSIVE TO OUR PATIENTS' NEEDS. AT PARKVIEW WABASH HOSPITAL, INC., WE'RE PROUD TO OFFER AN INCREASING NUMBER OF MINIMALLY INVASIVE OPTIONS, WHICH TYPICALLY RESULT IN LESS PAIN, A SHORTER HOSPITAL STAY AND FASTER RECOVERY. IN 2019, WE HIRED THE FIRST FULL-TIME ORTHOPEDIC SURGEON WE HAD IN MORE THAN A DECADE. THIS ALLOWED OUR COMMUNITY TO STAY CLOSE TO HOME FOR MANY SURGERIES AND PROCEDURES THEY ONCE HAD TO TRAVEL TO RECEIVE. OTHER SURGICAL SPECIALTIES INCLUDE: GENERAL SURGERY, COLO-RECTAL, UROLOGY, GYNECOLOGY, AND PODIATRY.--PHYSICAL, OCCUPATIONAL, SPEECH AND SPORTS MEDICINE - THE REHAB PLACE OF PARKVIEW WABASH HOSPITAL, INC., IS AN EXCELLENT RESOURCE FOR REHABILITATION, INCLUDING PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY. WE HAVE A TEAM OF HIGHLY-SKILLED HEALTHCARE PROFESSIONALS WHO ARE COMMITTED TO EXCELLENCE AND SERVICE. WE HAVE THE BENEFIT OF EXPERIENCE AND EQUIPMENT THAT RIVALS ANY FACILITY IN THE STATE, TO INCLUDE AQUATIC THERAPY. OUR THERAPY DEPARTMENT IS LOCATED AT OUR LOCAL YMCA. THE PROXIMITY TO THE Y IS A GREAT PARTNERSHIP THAT ALLOWS OUR THERAPISTS TO ENCOURAGE PATIENTS TO CONTINUE THEIR EXERCISE ROUTINES ONCE DISCHARGED FROM OUR CARE.PARKVIEW WABASH HOSPITAL, INC., IS ACTIVE IN THE COMMUNITY WITH A VARIETY OF PARTNERSHIPS TO INCLUDE:--CITY OF WABASH LEADERSHIP VISION - IN 2019, THE MAYOR OF THE CITY OF WABASH FORMED A COMMITTEE COMPRISED OF COMMUNITY VOLUNTEERS, SCHOOL ADMINISTRATORS AND BUSINESS LEADERS FROM THROUGHOUT WABASH COUNTY. HOSPITAL ADMINISTRATION IS PART OF THIS GROUP THAT MEETS QUARTERLY. THE GROUP IS DIVIDED INTO DIFFERENT AREAS OF FOCUS - SOCIAL SERVICE, EDUCATION, AND CITY, COMMUNITY AND BUSINESS DEVELOPMENT. THE END GOAL IS TO MAKE WABASH COUNTY A HEALTHY AND VIBRANT COMMUNITY WHERE PEOPLE WANT TO WORK, LIVE AND PLAY.--WABASH COUNTY DRUG STEERING COMMITTEE - COMPRISED OF LOCAL LAW ENFORCEMENT, COURT OFFICIALS, BOWEN CENTER STAFF AND OTHERS, THE DRUG STEERING COMMITTEE WORKS TOGETHER TO ADDRESS THE DRUG PROBLEM IN WABASH COUNTY. PARKVIEW WABASH HOSPITAL PRESIDENT SERVES AS THE CHAIR OF THE COMMITTEE. THE COMMITTEE IS CURRENTLY LOOKING TO OPEN A SOBER WOMEN'S HOME.--UNINSURED ASSISTANCE - PARKVIEW WABASH HOSPITAL, INC., ASSISTS THOSE LESS FORTUNATE BY SUPPORTING 85 HOPE, THE COUNTY'S FREE CLINIC. --EDUCATION - THE SCHOOLS ARE A KEY PARTNER FOR PARKVIEW WABASH HOSPITAL, INC. PARKVIEW WABASH HOSPITAL, INC., ALSO SPONSORS THE YMCA'S WATER SAFETY INITIATIVE PROGRAM, WHICH TEACHES COUNTY 3RD, 4TH AND 5TH GRADERS WATER SAFETY AND SWIM SKILLS. IN ADDITION, THE HOSPITAL PARTICIPATES IN CAREER PATHWAYS PROGRAMS, HOSTS STUDENT INTERNS AND PARTICIPATES IN A VARIETY OF SCHOOL EVENTS SUCH AS WALK-A-THONS, YOUTH TRIATHLONS, AND 5K CHALLENGES.--ATHLETIC TRAINERS - PARKVIEW WABASH HOSPITAL, INC., EMPLOYS THREE ATHLETIC TRAINERS TO WORK IN THREE WABASH COUNTY HIGH SCHOOLS. THESE TRAINERS SPEND HOURS AT A WIDE VARIETY OF ATHLETIC EVENTS TO ASSIST IF A STUDENT ATHLETE IS INJURED DURING PLAY. THEY ARE ALSO AVAILABLE DURING AND AFTER SCHOOL HOURS FOR ATHLETES IN NEED.HEALTH FAIRS AND SCREENINGS: PARKVIEW WABASH HOSPITAL, INC., HOSTED TWO CHECK-UP DAYS IN 2019 - ONE IN THE SUMMER AND ONE IN THE FALL. MORE THAN 100 PEOPLE ATTENDED AND RECEIVED A WIDE VARIETY OF FREE AND DISCOUNTED HEALTH SCREENINGS AND AN ABUNDANCE OF FREE INFORMATION ON THE PROMOTION OF HEALTHY LIFESTYLES, DISEASE PREVENTION, LOCAL RESOURCES AND MORE. THE HOSPITAL ALSO PARTICIPATES IN NUMEROUS HEALTH FAIRS AND ACTIVITIES THROUGHOUT THE YEAR SPONSORED BY LOCAL BUSINESS, INDUSTRY AND SCHOOLS.EVERY MEMBER OF THE PARKVIEW WABASH HOSPITAL, INC., HEALTHCARE TEAM, REGARDLESS OF THEIR DEPARTMENT, IS RESPONSIBLE FOR NURTURING AN ENVIRONMENT OF EXCELLENCE AS THE PLACE PATIENTS WANT TO RECEIVE CARE, PHYSICIANS WANT TO PRACTICE, AND CO-WORKERS WANT TO WORK. WE UNDERSTAND THAT BY PROVIDING EXCELLENCE IN ALL WE DO, WE NOT ONLY INSURE THE SUCCESS OF PARKVIEW WABASH HOSPITAL, INC., BUT ALSO FOR THE COMMUNITY WE SERVE. PART VI, LINE 6: IF THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM, DESCRIBE THE RESPECTVE ROLES OF THE ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED.PARKVIEW HEALTH SYSTEM, INC. (PARKVIEW), A HEALTHCARE SYSTEM SERVING NORTHEAST INDIANA AND NORTHWEST OHIO THROUGH OUR HOSPITALS AND PHYSICIAN CLINICS, INCLUDES THE NOT-FOR-PROFIT HOSPITALS OF PARKVIEW HOSPITAL, INC.; COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.; COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.; PARKVIEW WABASH HOSPITAL, INC.; WHITLEY MEMORIAL HOSPITAL, INC.; HUNTINGTON MEMORIAL HOSPITAL, INC.; DEKALB MEMORIAL HOSPITAL, INC.; AS WELL AS 60 PERCENT OWNERSHIP IN THE JOINT VENTURE OF ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH, LLC. PARKVIEW CONTRIBUTES TO THE SUCCESS OF THE REGION BY EFFECTIVELY MANAGING ITS FACILITIES, EFFICIENTLY PROVIDING AND DELIVERING ITS SERVICES, AND SUPPORTING LOCAL BUSINESSES AND ACTIVITIES. PARKVIEW SEEKS TO CREATE ALIGNMENT OPPORTUNITIES TO DELIVER COMPREHENSIVE HIGH-QUALITY CARE THAT BENEFIT PATIENTS, PHYSICIANS, CO-WORKERS AND COMMUNITIES. EACH HOSPITAL ENTITY ENGAGES IN COMMUNITY OUTREACH CUSTOMIZED TO MEET THE UNIQUE NEEDS OF THEIR RESPECTIVE COMMUNITIES. AFFILIATE HOSPITALS WORK TOGETHER AND SHARE PROGRAMMING AND MESSAGING WHERE COMMON COMMUNITY HEALTH ISSUES ARE IDENTIFIED. FROM THE LIST OF HEALTH ISSUES IN THE SEVEN-COUNTY AREA, THE HEALTH PRIORITY OF OBESITY/HEALTHY LIFESTYLE PROMOTION AND EDUCATION INCLUDING GOOD NUTRITION, ACCESS TO AND CONSUMPTION OF HEALTHY FOODS AND AN ACTIVE LIFESTYLE WAS SELECTED BY ALL AFFILIATE HOSPITALS. PARKVIEW PRIDES ITSELF IN NOT ONLY OFFERING THE HIGHEST LEVEL OF CARE TO ITS PATIENTS, BUT ALSO IN PROVIDING AN EXCELLENT WORKPLACE FOR ITS PHYSICIANS, NURSES AND STAFF. PARKVIEW'S 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. PARKVIEW BELIEVES THAT THE COMMUNITIES IT SERVES SHOULD ALL HAVE THE PEACE OF MIND THAT COMES WITH ACCESS TO COMPASSIONATE, HIGH-QUALITY HEALTHCARE, REGARDLESS OF WHETHER THE CARE IS DELIVERED IN A RURAL OR URBAN SETTING. PART VI, LINE 7, REPORTS FILED WITH STATES IN PART VI, LINE 7: A COPY OF FORM 990, SCHEDULE H IS FILED WITH THE INDIANA STATE DEPARTMENT OF HEALTH. 1 WABASH COUNTY BUSINESS ALLIANCE FOUNDATION INC 214 SOUTH WABASH STREET WABASH IN 46992 351538747 501(C)(3) 25000 PROMOTE ECONOMIC DEVELOPMENT & INDUSTRIAL GROWTH IN WABASH COUNTY WABASH COUNTY YMCA INC 500 SOUTH CASS STREET WABASH IN 46992 350733765 501(C)(3) 10475 YOUTH PROGRAMS & BODY COMPOSITION EQUIPMENT CAMPAIGN OTIS R BOWEN CENTER FOR HUMAN SERVICES INC 2621 EAST JEFFERSON STREET WARSAW IN 46581 351057889 501(C)(3) 9000 WABASH COUNTY TOBACCO FREE COALITION PROGRAMS 3 0 PART I, LINE 2: 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. X X 1 1 1 1 0 0 0 0 0 1 0 MICHAEL PACKNETT DIRECTOR/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 DOUGLAS SPARKS DIRECTOR/PH PHYSICIAN 25239 427539 0 28957 0 27041 1250 23950 1769 33892 28258 541379 0 0 MARILYN CUSTER-MITCHELL DIRECTOR/WBHOS PRESIDENT 207607 0 44085 0 37823 0 63196 0 32158 0 384869 0 15475 0 CATHY WOLFE WBHOS VP PATIENT CARE 137689 0 28232 0 10970 0 12207 0 33014 0 222112 0 7889 0 TRENTON SHODA WBHOS MGR PHARMACY 126075 4781 11182 0 6260 6095 181 14 28537 2163 172235 13053 0 0 SHERRY SCHOENING WBHOS MGR REHAB 120681 0 9816 0 1011 0 15117 0 33090 0 179715 0 0 0 LISA KROH WBHOS PHARMACIST 147898 0 1425 0 414 0 16426 0 2333 0 168496 0 0 0 REBECCA MEREDITH WBHOS PHARMACIST 127041 0 1231 0 593 0 9290 0 21329 0 159484 0 0 0 PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - TAX ON TAXABLE GIFT: TRENTON SHODA $13 DISCRETIONARY SPENDING ACCOUNT - TAXABLE: GRACE STANLEY $1,000 PART I, LINE 3 RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF PARKVIEW HOSPITAL, INC.'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. INDEPENDENT COMPENSATION CONSULTANT FORM 990 OF OTHER ORGANIZATIONS COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. PART I, LINES 4A-B SEVERANCE PAYMENT TRENTON SHODA $6,150 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS TAXABLE - MARILYN CUSTER-MITCHELL $15,475; MICHAEL PACKNETT $1,637,768; CATHY WOLFE $7,889 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. MARILYN CUSTER-MITCHELL $38,433; 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. A INDIANA FINANCE AUTHORITY 351602316 NONEAVAIL 2016-08-17 25000000 SEE PART VI 0 0 0 A 1435000 25247064 25247064 2018 0 0 1 1 A 0 1 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 SCHEDULE K, PART I, COLUMN F, LINE A: CONSTRUCTION OF NEW HOSPITAL FACILITY FOR PARKVIEW WABASH HOSPITAL, INC. IN WABASH, INDIANA SCHEDULE K, PART II, COLUMN A, LINE 3: THIS AMOUNT INCLUDES INTEREST OF $247,064. EARNED ON PROJECT FUND. SCHEDULE K, PART III, COLUMN A, LINE 7: BECAUSE PARKVIEW MONITORS THE PRIVATE BUSINESS USE PERCENTAGE FOR EACH BOND ISSUE, TO ENSURE THAT THE PRIVATE BUSINESS USE LIMIT IS NOT EXCEEDED, PARKVIEW DOES NOT CALCULATE THE AMOUNT OF PRIVATE PAYMENTS. SCHEDULE K, PART IV, COLUMN A, LINE 2C: REBATE CALCULATION PERFORMED ON JANUARY 23, 2019. FORM 990, PART V, LINES 1A AND 2A: PARKVIEW HEALTH SYSTEM, INC. (PH), EIN 35-1972384, IS THE COMMON PAYING AGENT FOR THE FILING ORGANIZATION, PARKVIEW WABASH HOSPITAL, INC., EIN 47-1753440. THEREFORE, ALL APPLICABLE IRS TAX FILINGS, INCLUDING FORMS 1099, 1096, W-2 AND W-3 ARE REPORTED AND FILED BY PH. THE TOTAL NUMBER REPORTED IN BOX 3 OF FORM 1096 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 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 WABASH HOSPITAL, INC. WAS 27 AND 223 RESPECTIVELY. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE OFFICERS OF THE BOARD, THE PRESIDENT OF THE CORPORATION, THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATE MEMBER OR HIS/HER DESIGNEE, THE CURRENT PRESIDENT OF THE MEDICAL STAFF AND SUCH OTHER PERSONS AS IDENTIFIED BY THE CHAIR OF THE BOARD, EACH OF WHOM SHALL BE ENTITLED TO VOTE. IN NO EVENT SHALL THE MEMBERS OF THE EXECUTIVE COMMITTEE EXCEED EIGHT (8) PEOPLE. THE EXECUTIVE COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION IN ANY MATTER WHEN THE BOARD IS NOT IN SESSION, REPORTING TO THE BOARD FOR ITS RATIFICATION OF ITS ACTION. THE CHAIR OF THE BOARD SHALL SERVE AS CHAIR OF THE EXECUTIVE COMMITTEE. MEETINGS OF THE EXECUTIVE COMMITTEE MAY BE CALLED BY THE CHAIR OR BY THREE (3) MEMBERS. FORM 990, PART VI, SECTION A, LINE 2 DIRECTORS ROGER CROMER AND ROBERT PEARSON HAVE A BUSINESS RELATIONSHIP AS DIRECTORS ON THE BOARD OF AN UNRELATED 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 WABASH HOSPITAL, 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. PARKVIEW WABASH HOSPITAL, INC. IS A SUBSIDIARY CORPORATION OF PARKVIEW HEALTH SYSTEM, INC. AN ELECTRONIC COPY OF THE ORGANIZATION'S FINAL FORM 990 (INCLUDING SUPPLEMENTAL SCHEDULES) WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY AND THE SYSTEM AUDIT COMMITTEE, PRIOR TO FILING WITH THE IRS. ON OCTOBER 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 OTHER: PROGRAM SERVICE EXPENSES 2,730,966. MANAGEMENT AND GENERAL EXPENSES 71,589. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,802,555. RHC OPERATIONS: PROGRAM SERVICE EXPENSES 5,209,553. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,209,553. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,240,148. MANAGEMENT AND GENERAL EXPENSES 423,873. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,664,021. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 1,815,797. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,815,797. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 1,209,591. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,209,591. COLLECTIONS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 193,021. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 193,021. 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 -27,332. WABASH MRI, LLC - ENTITY DISSOLUTION 123,481. PARKVIEW HEALTH SYSTEM INC 10501 CORPORATE DRIVE FORT WAYNE IN 46845 351972384 HEALTH CARE IN 501(C)(3) LINE 12C, III-FI N/A 0 PARKVIEW WABASH HOSPITAL FOUNDATION INC 10 JOHN KISSINGER DRIVE WABASH IN 46992 351921445 FUND MGMT IN 501(C)(3) LINE 12A, I PARKVIEW WABASH HOSPITAL INC 1 PARKVIEW OCCUPATIONAL HEALTH CENTERS INC 10501 CORPORATE DRIVE FORT WAYNE IN 46845 352064353 OCCUP HEALTH IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC 0 PARKVIEW HOSPITAL INC 11109 PARKVIEW PLAZA DRIVE FORT WAYNE IN 46845 350868085 HOSPITAL CARE IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC 0 COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC 207 N TOWNLINE ROAD LAGRANGE IN 46761 202401676 HOSPITAL CARE IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC 0 WHITLEY MEMORIAL HOSPITAL INC 1260 E STATE ROAD 205 COLUMBIA CITY IN 46725 351967665 HOSPITAL CARE IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC 0 COMMUNITY HOSPITAL OF NOBLE COUNTY INC 401 SAWYER ROAD KENDALLVILLE IN 46755 352087092 HOSPITAL CARE IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC 0 HUNTINGTON MEMORIAL HOSPITAL INC 2001 STULTS ROAD HUNTINGTON IN 46750 351970706 HOSPITAL CARE IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC 0 PARK CENTER INC 909 EAST STATE BLVD FORT WAYNE IN 46805 351135451 COMPREHENSIVE MENTAL HEALTH CENTER IN 501(C)(3) LINE 10 PARKVIEW HEALTH SYSTEM INC 0 PARK CENTER HOLDINGS INC 909 EAST STATE BLVD FORT WAYNE IN 46805 843684074 TO SUPPORT PARK CENTER, INC. IN 501(C)(3) LINE 12B, II PARKVIEW HEALTH SYSTEM INC 0 DEKALB MEMORIAL HOSPITAL INC 1316 EAST SEVENTH STREET AUBURN IN 46706 351064295 HOSPITAL CARE IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC 0 ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH LLC 10501 CORPORATE DRIVE FORT WAYNE IN 46845 260143823 ORTHO HOSPITAL IN N/A N/A 0 0 MANAGED CARE SERVICES LLC 10501 CORPORATE DRIVE FORT WAYNE IN 46845 351996535 HEALTH PLAN ADMIN IN N/A N/A 0 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 0 1 1 0 0 0 0 0 0 1 1 1 1 1 0 1 1 1 1 PARKVIEW WABASH HOSPITAL FOUNDATION INC C 322676 PART VII SUPPLEMENTAL INFORMATION PARKVIEW WABASH HOSPITAL FOUNDATION INC M 215900 PART VII SUPPLEMENTAL INFORMATION SCHEDULE R, PART V, LINE 2, COLUMN (C): 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.