WHITLEY MEMORIAL HOSPITAL INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- WHITLEY MEMORIAL HOSPITAL INC (EIN 35-1967665)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-10
- IRS object ID
- 201803149349300925
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-10T16:26:46-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 330 E JEFFERSON BLVD P O BOX 7 | AddressLine1Txt |
| City | SOUTH BEND | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 466240007 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351967665 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WHITLEY MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WHIT | BusinessNameControlTxt |
| Phone | 2603738429 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1260 EAST STATE ROAD 205 | AddressLine1Txt |
| City | COLUMBIA CITY | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46725 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEANNE' WICKENS | PersonNm |
| Person Title | PH CFO | PersonTitleTxt |
| Phone | 2603738407 | PhoneNum |
| Signature | 2018-11-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KENNETH J KEBER | PreparerPersonNm |
| PTIN | P00240883 | PTIN |
| Phone | 5742323992 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 204.58.171.16 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-10 | IPDt |
| IP Tm | 15:51:32 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | B38744F01C9F8B49338464F7361C640636AC5E7B | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B38744F01C9F8B49338464F7361C640636AC5E7B | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | 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 | 10501 CORPORATE DRIVE | AddressLine1Txt |
| City | FORT WAYNE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46845 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $181,399,232 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PARKVIEW.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1995 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | WHITLEY MEMORIAL HOSPITAL, INC. WORKS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND PROVIDES QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 405 | TotalEmployeeCnt |
| Total Volunteers | 31 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $200,319 | PYContributionsGrantsAmt |
| CY Contributions Grants | $46,838 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $72,958,461 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $81,726,476 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,460,514 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,101,707 | CYInvestmentIncomeAmt |
| PY Other Revenue | $73,818 | PYOtherRevenueAmt |
| CY Other Revenue | $81,390 | CYOtherRevenueAmt |
| PY Total Revenue | $74,693,112 | PYTotalRevenueAmt |
| CY Total Revenue | $85,956,411 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $217,613 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $192,339 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $21,637,743 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $22,576,440 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $43,936,143 | PYOtherExpensesAmt |
| CY Other Expenses | $51,103,476 | CYOtherExpensesAmt |
| PY Total Expenses | $65,791,499 | PYTotalExpensesAmt |
| CY Total Expenses | $73,872,255 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $8,901,613 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $12,084,156 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $94,855,104 | TotalAssetsBOYAmt |
| Total Assets EOY | $94,330,725 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,997,465 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $12,548,401 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $81,857,639 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $81,782,324 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WHITLEY MEMORIAL HOSPITAL, INC. WORKS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND PROVIDES QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $61,822,125 | ExpenseAmt |
| Grant | $192,339 | GrantAmt |
| Revenue | $81,726,476 | RevenueAmt |
| Desc | AS A COMMUNITY PARTNER AND NOT-FOR-PROFIT ORGANIZATION, WHITLEY MEMORIAL HOSPITAL, INC. - A MEMBER OF PARKVIEW HEALTH - IS DEDICATED TO IMPROVING YOUR HEALTH AND INSPIRING YOUR WELL-BEING BY TAILORING A PERSONALIZED HEALTH JOURNEY TO ACHIEVE YOUR UNIQUE GOALS. BY DEMONSTRATING WORLD-CLASS TEAMWORK, WE PARTNER WITH YOU ALONG THAT JOURNEY AND PROVIDE THE EXCELLENCE, INNOVATION AND VALUE YOU SEEK IN TERMS OF CONVENIENCE, COMPASSION, SERVICE, COST AND QUALITY. DURING 2017, PARKVIEW HEALTH'S HOSPITALS JOINED THE RANKS OF THE NATION'S MOST ELITE BY ACHIEVING MAGNET RECOGNITION ACROSS THE REGION. MAGNET DESIGNATION IS GRANTED BY THE AMERICAN NURSES CREDENTIALING(SEE SCHEDULE O FOR CONTINUATION) | Desc |
| Total Program Service Expenses | $61,822,125 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 37 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 405 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEANNE' WICKENS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2603738407 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10501 CORPORATE DRIVE | AddressLine1Txt |
| City | FORT WAYNE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46845 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SCOTT GABRIEL | ||||||||||
| DIRECTOR/WMHOS PRESIDENT | 40.00 | 1.00 | Yes (X) | Yes (X) | $277,461 | $0 | $82,865 | |||
| MICHAEL PACKNETT | ||||||||||
| DIRECTOR/PH PRESIDENT & CEO | 1.00 | 56.00 | Yes (X) | Yes (X) | $0 | $1,599,863 | $735,183 | |||
| JAMES STAPEL | ||||||||||
| DIRECTOR/VICE CHAIR/PH MED DIR | 1.00 | 32.00 | Yes (X) | $0 | $284,260 | $87,810 | ||||
| SHAWN ELLIS | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $5,000 | $0 | $0 | ||||
| KATHERINE FLECK | ||||||||||
| DIRECTOR/SECRETARY/TREASURER | 1.00 | 0.00 | Yes (X) | $4,750 | $0 | $0 | ||||
| TIM GRISSOM | ||||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $20,000 | $2,000 | $0 | ||||
| JIM HEUER | ||||||||||
| DIRECTOR/CHAIR | 1.00 | 1.00 | Yes (X) | $6,250 | $2,250 | $0 | ||||
| JOSEPH KESSIE | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $4,750 | $0 | $0 | ||||
| GEORGE SCHRUMPF | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $4,768 | $0 | $0 | ||||
| DAVID SMITH | ||||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $4,750 | $500 | $0 | ||||
| BRAD VOELZ | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $4,750 | $0 | $0 | ||||
| JANE WEAR | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $4,500 | $0 | $0 | ||||
| JEANNE' WICKENS | ||||||||||
| PH CHIEF FINANCIAL OFFICER | 1.00 | 56.00 | Yes (X) | $0 | $701,132 | $135,403 | ||||
| BRIDGET DOLOHANTY-JOHNSON | ||||||||||
| WMHOS VP PATIENT CARE | 40.00 | 0.00 | $206,613 | $0 | $37,641 | Yes (X) | ||||
| JEFFREY ROCKETT | ||||||||||
| WMHOS VP OUTPATIENT SERVICES | 43.00 | 0.00 | $166,706 | $0 | $34,145 | Yes (X) | ||||
| AMANDA KNOWLES | ||||||||||
| WMHOS MGR PHARMACY | 40.00 | 0.00 | $164,078 | $0 | $40,801 | Yes (X) | ||||
| BENJAMIN MAGGARD | ||||||||||
| WMHOS PHARMACIST | 36.00 | 4.00 | $122,172 | $12,809 | $34,828 | Yes (X) | ||||
| CHARLES JINKS | ||||||||||
| WMHOS PHARMACIST | 23.00 | 17.00 | $73,179 | $60,730 | $44,603 | Yes (X) | ||||
| MICHELLE MCNEIL | ||||||||||
| WMHOS CLINICAL SUPERVISOR | 49.00 | 0.00 | $121,463 | $0 | $20,510 | Yes (X) | ||||
| PETER TALATI | ||||||||||
| WMHOS MGR REHAB | 40.00 | 0.00 | $116,653 | $0 | $26,899 | Yes (X) | ||||
| STANTON RISSER | ||||||||||
| FORMER OFFICER/PH VP PARTIAL YEAR | 0.00 | 40.00 | $0 | $157,067 | $17,632 | Yes (X) | ||||
| MICHAEL BROWNING | ||||||||||
| FORMER OFFICER | 0.00 | 0.00 | $0 | $277,686 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,307,843 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,098,297 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,298,320 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | 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 | LABORATORY SERVICES | $2,864,093 |
| PROFESSIONAL EMERGENCY PHYSICIANS | |||||
| PO BOX 12949 | FORT WAYNE | IN | 46866 | PHYSICIANS | $1,191,299 |
| GREAT LAKES ANESTHESIA PC | |||||
| 500 N NAPPANEE ST STE 11-B | ELKHART | IN | 46514 | ANESTHESIOLOGISTS | $726,566 |
| NORTHEAST INTERNAL MEDICINE ASSOC INC | |||||
| 2500 N DETROIT STREET | LAGRANGE | IN | 46761 | HOSPITALISTS | $406,061 |
| FOCUSONE SOLUTIONS LLC | |||||
| 13609 CALIFORNIA STREET | OMAHA | NE | 68154 | NURSES | $383,675 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $33,505 | RelatedOrganizationsAmt |
| Government Grants | $13,333 | GovernmentGrantsAmt |
| Total Contributions | $46,838 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 622000 | $79,507,505 | $79,507,505 |
| PHARMACY | 446110 | $1,064,994 | $1,064,994 |
| INTERUNIT RENT | 531120 | $781,705 | $781,705 |
| EMS SUBSIDY | 621610 | $250,000 | $250,000 |
| REHAB REVENUE | 900099 | $120,643 | $120,643 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,629 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,629 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $81,726,476 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $987,778 | TotalRevenueColumnAmt |
| Exclusion | $987,778 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $66,278 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $230,140 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$163,862 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$163,862 | TotalRevenueColumnAmt |
| Exclusion | -$163,862 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $98,325,752 | SecuritiesAmt |
| Other | $858 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $95,192,264 | SecuritiesAmt |
| Other | $20,417 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,133,488 | SecuritiesAmt |
| Other | -$19,559 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,113,929 | TotalRevenueColumnAmt |
| Exclusion | $3,113,929 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA REVENUE | 722210 | $212,611 | $212,611 |
| GIFT SHOP REVENUE | 453220 | $32,641 | $32,641 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $245,252 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $85,956,411 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $81,726,476 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,183,097 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $192,339 | TotalAmt |
| Program Services | $192,339 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $864,949 | TotalAmt |
| Management And General | $864,949 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,315,872 | TotalAmt |
| Program Services | $16,315,872 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,395,619 | TotalAmt |
| Program Services | $5,395,619 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,500 | TotalAmt |
| Management And General | $60,500 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,956 | TotalAmt |
| Management And General | $148,956 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,839,930 | TotalAmt |
| Program Services | $6,813,556 | ProgramServicesAmt |
| Management And General | $1,026,374 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,297 | TotalAmt |
| Program Services | $16,053 | ProgramServicesAmt |
| Management And General | $10,244 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,364,718 | TotalAmt |
| Program Services | $1,254,616 | ProgramServicesAmt |
| Management And General | $110,102 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,030,950 | TotalAmt |
| Program Services | $4,016,073 | ProgramServicesAmt |
| Management And General | $14,877 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,507 | TotalAmt |
| Program Services | $49,403 | ProgramServicesAmt |
| Management And General | $21,104 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,403 | TotalAmt |
| Management And General | $25,403 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,921 | TotalAmt |
| Program Services | $115,921 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,562,095 | TotalAmt |
| Program Services | $2,560,322 | ProgramServicesAmt |
| Management And General | $1,773 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,707 | TotalAmt |
| Program Services | $122,590 | ProgramServicesAmt |
| Management And General | $36,117 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $10,658,948 | $10,658,948 | |
| CORP SERVICE ALLOCATION | $9,652,000 | $9,652,000 | |
| PH SUBSIDY | $8,954,041 | $8,954,041 | |
| MEDICAL SUPPLIES | $5,281,009 | $5,281,009 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,494 | TotalAmt |
| Program Services | $75,763 | ProgramServicesAmt |
| Management And General | $77,731 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,872,255 | TotalAmt |
| Program Services | $61,822,125 | ProgramServicesAmt |
| Management And General | $12,050,130 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,100 | BOYAmt |
| EOY | $3,100 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $294,332 | BOYAmt |
| EOY | $136,831 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,570,046 | BOYAmt |
| EOY | $9,353,497 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $343,813 | BOYAmt |
| EOY | $399,733 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,216 | BOYAmt |
| EOY | $69,351 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $39,697,349 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $13,427,788 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,816,629 | BOYAmt |
| EOY | $26,269,561 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,038,585 | BOYAmt |
| EOY | $54,327,950 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,750,383 | BOYAmt |
| EOY | $3,770,702 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,855,104 | BOYAmt |
| EOY | $94,330,725 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,001,729 | BOYAmt |
| EOY | $2,223,329 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,043,751 | BOYAmt |
| EOY | $3,228,521 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,951,985 | BOYAmt |
| EOY | $7,096,551 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,997,465 | BOYAmt |
| EOY | $12,548,401 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,857,639 | BOYAmt |
| EOY | $81,782,324 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,857,639 | BOYAmt |
| EOY | $81,782,324 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,855,104 | BOYAmt |
| EOY | $94,330,725 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $12,084,156 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,320,229 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$13,479,700 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $4,095 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,095 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | REPRESENTS THE PORTION OF THE DUES PAID TO INDIANA HOSPITAL AND HEALTH ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION AND VARIOUS PROFESSIONAL ASSOCIATIONS USED FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $260,483 | OtherCostOrOtherBasisAmt |
| Book Value | $260,483 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,608,256 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,492,107 | DepreciationAmt |
| Book Value | $13,116,149 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $48,824 | OtherCostOrOtherBasisAmt |
| Depreciation | $48,824 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,310,335 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,469,229 | DepreciationAmt |
| Book Value | $10,841,106 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,469,451 | OtherCostOrOtherBasisAmt |
| Depreciation | $417,628 | DepreciationAmt |
| Book Value | $2,051,823 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $26,269,561 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| NOTE PAYABLE TO PH | $6,893,500 |
| EST THIRD PARTY PAYABLES | $203,051 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,096,551 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | PARKVIEW HEALTH SYSTEM, INC. AND SUBSIDIARIES - NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES THE LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): PAGE 15 OF ATTACHED FINANCIAL STATEMENTS. 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, 2017 AND 2016, 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 2013 AND PRIOR. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $919,994 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $919,994 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01460 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,091,085 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,937,911 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,153,174 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04990 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,440,924 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,078,862 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,362,062 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02150 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,452,003 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,016,773 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,435,230 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08600 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $117,184 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,211 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $107,973 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $34,819 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $34,819 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $134,798 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $134,798 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $286,801 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,211 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $277,590 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00440 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,738,804 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,025,984 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,712,820 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09040 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,498 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,498 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $34,498 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $34,498 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $10,658,948 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $128,536 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,640,267 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,208,974 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,568,707 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WHITLEY MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1260 E STATE ROAD 205 | AddressLine1Txt |
| City | COLUMBIA CITY | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46725 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PARKVIEW.COM | WebsiteAddressTxt |
| State License | 14-005090-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WHITLEY MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.PARKVIEW.COM/LOCALHEALTHNEEDS | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.PARKVIEW.COM/LOCALHEALTHNEEDS | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.PARKVIEW.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.PARKVIEW.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.PARKVIEW.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| WHITLEY MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 5: PARKVIEW HEALTH SYSTEM, INC. INCLUDING WHITLEY MEMORIAL HOSPITAL, INC. CONDUCTED ITS LAST COMMUNITY HEALTH NEEDS ASSESSMENT IN 2016. 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 2016 COMMUNITY HEALTH NEEDS ASSESSMENT USED THREE SOURCES OF PRIMARY DATA: 1) A PHONE SURVEY OF THE COMMUNITY CONDUCTED ON BEHALF OF WHITLEY MEMORIAL HOSPITAL, INC. AND THE INDIANA PARTNERSHIP FOR HEALTHY COMMUNITIES (IN-PHC) BY THE EAGLETON CENTER FOR PUBLIC INTEREST POLLING (A CENTER OF RUTGERS UNIVERSITY) COMPLETED IN MARCH 2016; 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 2016; AND 3) FOCUS GROUPS WITH SPECIFIC VULNERABLE POPULATIONS, INCLUDING THE HISPANIC/LATINO AND AFRICAN AMERICAN POPULATIONS WERE CONDUCTED BY IN-PHC IN ALLEN, NOBLE AND KOSCIUSKO COUNTIES. FOR THE AMISH COMMUNITY IN LAGRANGE COUNTY, A WRITTEN SURVEY WAS DISTRIBUTED THROUGH COMMUNITY LEADERS. FOCUS GROUP AND WRITTEN SURVEY DATA COLLECTION WAS COMPLETED IN THE SUMMER OF 2016.CONDUENT'S HEALTHY COMMUNITIES INSTITUTE (HCI) DATA BASE WAS USED TO ACCESS SECONDARY DATA FOR THE SEVEN-COUNTY AREA. STATE AND NATIONAL DATA WAS OBTAINED THROUGH THE CENTERS FOR DISEASE CONTROL AND PREVENTION, COUNTY HEALTH RANKINGS, HEALTH INDICATORS WAREHOUSE, INDIANA STATE DEPARTMENT OF HEALTH, INDIANA UNIVERSITY CENTER FOR HEALTH POLICY AND THE U.S. CENSUS BUREAU. |
| WHITLEY MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 6A: PARKVIEW HOSPITAL, INC. (EIN 35-0868085); COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. (EIN 20-2401676); HUNTINGTON MEMORIAL HOSPITAL, INC. (EIN 35-1970706); COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. (EIN 35-2087092); PARKVIEW WABASH HOSPITAL, INC. (EIN 47-1753440) AND ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH, LLC (EIN 26-0143823). |
| WHITLEY MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 6B: 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. |
| WHITLEY MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 11: SIGNIFICANT HEALTH NEEDS BEING ADDRESSED:OBESITY -- PARKVIEW WHITLEY HOSPITAL WILL SERVE AS A COMMUNITY LEADER PARTNERING WITH OTHER KEY COMMUNITY ORGANIZATIONS TO PROMOTE A CULTURE OF HEALTHY DECISIONS THAT INCLUDES ACTIVE LIVING AND HEALTH EATING. PARKVIEW WHITLEY HOSPITAL WILL CONTINUE TO ESTABLISH NEW AND FOSTER EXISTING PROGRAMS AND RELATIONSHIPS WITH OTHER ORGANIZATIONS. WE STRIVE TO PARTNER WITH ORGANIZATIONS THAT SERVE CHILDREN AND OR UNDERSERVED POPULATIONS. WE ALSO FOCUS ON OPPORTUNITIES FOR COMMUNITY MEMBERS TO MONITOR THEIR HEALTH BETTER WITH LOW-COST OR NO-COST EDUCATIONAL AND SCREENING EVENTS.MATERNAL/CHILD HEALTH -- PARKVIEW WHITLEY HOSPITAL WILL SERVE AS A COMMUNITY LEADER PARTNERING WITH OTHER KEY COMMUNITY ORGANIZATIONS TO PROMOTE A CULTURE OF HEALTHY DECISIONS THAT PROMOTE THE SAFETY AND WELL-BEING OF INFANTS AND CHILDREN BEFORE AND AFTER THEIR BIRTH. PARKVIEW WHITLEY HOSPITAL WILL CONTINUE TO ESTABLISH NEW AND FOSTER EXISTING PROGRAMS AND RELATIONSHIPS WITH OTHER ORGANIZATIONS. WE AIM AT PARTNERING WITH ORGANIZATIONS THAT ARE WORKING WITH CHILDREN AND OR UNDERSERVED POPULATIONS.OTHER HEALTH NEEDS NOT BEING ADDRESSED:ACCESS TO CARE -- BRIGHT POINT (FORMERLY CANI- COMMUNITY ACTION OF NORTHEAST INDIANA) HELPS FAMILIES GAIN ACCESS HEALTH INSURANCE COVERAGE FOR THEIR CHILDREN. THE ORGANIZATION UTILIZES SPACE IN ONE OF THE PARKVIEW WHITLEY BUILDINGS IN WHITLEY COUNTY; THE SPACE IS PROVIDED IN-KIND IN ORDER TO HELP THEM WITH THEIR BOTTOM LINE SO THAT THEY CAN FOCUS ON PROVIDING RESOURCES TO THOSE IN NEED. ACCESS TO CARE -- MULTI COUNTY MEDICAL OUTREACH CLINIC --THE FREE CLINIC OPERATES IN SPACE THAT IS PROVIDED TO THIS NON-PROFIT ORGANIZATION IN KIND TO SERVE THE UNDER/UNINSURED RESIDENTS OF THIS AREA. PARKVIEW WHITLEY HOSPITAL PROVIDES FREE LAB SERVICES TO THE PATIENTS THAT HAVE AN ORDER FROM THE CLINIC. PARKVIEW WHITLEY HOSPITAL ALSO HAS STAFF THAT WORK AT THE CLINIC ON A REGULAR BASIS. TOBACCO USE -- THIS IS BEING ADDRESSED IN KOSCIUSKO COUNTY BY COLLABORATING WITH AND PROVIDING FUNDING FOR THE TOBACCO COALITION TO HAVE PROGRAMS IN THE SCHOOLS AND PROGRAMS FOR EXPECTANT MOMS. OUR GOAL IS TO BE ABLE TO REPLICATE SIMILAR PROGRAMS IN WHITLEY COUNTY. DIABETES -- WHILE ADDRESSING OBESITY ISSUES IN OUR COMMUNITIES, WE WILL MOST LIKELY HAVE AN IMPACT ON DIABETES AND DIABETES MANAGEMENT. ALTHOUGH NOT A FOCUS AREA, WE HAVE DIABETES EDUCATION IN BOTH COUNTIES AND PLAN TO CONTINUE THESE PROGRAMS. CANCER -- A LIMITED AMOUNT OF FUNDING HAS BEEN DISTRIBUTED TO CANCER SERVICES IN ALLEN COUNTY, AS THEY SERVE MANY PATIENTS IN WHITLEY COUNTY. CARDIOVASCULAR DISEASE -- WITH AN EMPHASIS ON ADDRESSING OBESITY, WE WILL BE INDIRECTLY IMPACT CARDIOVASCULAR DISEASE. MAINTAINING A PROPER DIET AND REGULAR EXERCISE IS CERTAINLY BENEFICIAL FOR CARDIOVASCULAR HEALTH. OUR QUARTERLY CHECK-UP DAYS HELP PATIENTS TO MONITOR SUCH THINGS AS CHOLESTEROL LEVELS, BLOOD PRESSURE AND OTHER CARDIOVASCULAR FACTORS. OUR REHAB DEPARTMENT HAS AN EXCELLENT CARDIAC REHAB PROGRAM WHICH ALLOWS PATIENTS TO CONTINUE TO UTILIZE THE FACILITY FOR AS LONG AS THEY LIKE AFTER GRADUATION, FOR A SMALL FEE. THIS IS AN ESPECIALLY GOOD OPPORTUNITY FOR THOSE WHO ARE UNABLE TO AFFORD, OR ARE INTIMIDATED BY, LOCAL FITNESS CENTERS. DRUG AND ALCOHOL ABUSE AND ADDICTION -- ALTHOUGH NOT A CHOSEN PRIORITY, DRUG AND ALCOHOL ABUSE IS CERTAINLY AN AREA THAT WE KEEP A WATCHFUL EYE ON, AND WE WILL CONTINUE TO DO SO. IF WE SEE A SIGNIFICANT SHIFT IN THESE ISSUES, WE WILL BE ON BOARD WITH THE COMMUNITY TO ADDRESS THESE NEEDS. MENTAL HEALTH -- MENTAL HEALTH IS OFTEN TIED TO ALCOHOL AND DRUG ABUSE AND WE WORK WITH PARKVIEW BEHAVIORAL HEALTH (PBH) TO MONITOR THE MENTAL HEALTH OF OUR COMMUNITY. MENTAL HEALTH SERVICES IN WHITLEY COUNTY ARE VERY LIMITED AND POSE CHALLENGES IN OUR ABILITY TO PARTNER WITH PROVIDERS. PBH HAS WORKED WITH WHITLEY MEMORIAL HOSPITAL, INC. LEADERSHIP AND OTHER ORGANIZATIONS TO TRAIN LEADERS ON QUESTION, PERSUADE, REFER (QPR), AN EVIDENCE BASED SUICIDE PREVENTION MODEL. THIS A PROGRAM IS BUILT ON A TRAIN-THE-TRAINER MODEL, ENABLING MANY COMMUNITY MEMBERS TO BE PREPARED TO ASSIST OTHERS IN THEIR TIME OF CRISIS. CHRONIC KIDNEY DISEASE -- THE INDICATORS SHOW THIS AS AN AREA OF CONCERN IN KOSCIUSKO COUNTY, BUT NOT IN WHITLEY. IT RANKED 11TH OUT OF THE 12 INDICATORS. THUS, WE ARE NOT PRIORITIZING THIS AT THIS TIME. ASTHMA -- THE INDICATORS SHOW THIS AS AN AREA OF CONCERN IN KOSCIUSKO COUNTY, BUT NOT IN WHITLEY. IT RANKED 12TH OUT OF THE 12 INDICATORS. THUS, WE ARE NOT PRIORITIZING THIS AT THIS TIME. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - PWH EMS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1250 E STATE ROAD 205 | AddressLine1Txt |
| City | COLUMBIA CITY | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46725 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | AMBULANCE SERVICES | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (18 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | EQUITY IN A HOME OTHER THAN THE PATIENT OR GUARANTOR'S PRIMARY RESIDENCE. |
| PART I, LINE 6A: | THE RELATED ENTITIES OF PARKVIEW HEALTH SYSTEM, INC. (EIN 35-1972384); PARKVIEW HOSPITAL, INC. (EIN 35-0868085); COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. (EIN 20-2401676); COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. (EIN 35-2087092); HUNTINGTON MEMORIAL HOSPITAL, INC. (EIN 35-1970706); WHITLEY MEMORIAL HOSPITAL, INC. (EIN 35-1967665) 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 7BWHITLEY MEMORIAL 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 7CWHITLEY MEMORIAL HOSPITAL, INC. ACCEPTS ALL MEANS-TESTED PATIENTS FROM THE HEALTHY INDIANA PLAN (HIP) WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEANS-TESTED PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING HIP, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE UNREIMBURSED HIP COST REPORTED ON LINE 7C IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE HIP CHARGES ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF HIP SERVICES RENDERED. THEN, THE COST OF HIP SERVICES RENDERED IS DEDUCTED FROM THE REIMBURSEMENT RECEIVED FOR HIP PATIENTS TO ARRIVE AT A GAIN/(LOSS) RELATIVE TO THESE PATIENTS.PART I, LINE 7EAMOUNTS PRESENTED ARE BASED ON ACTUAL SPEND FOR THOSE SERVICES AND BENEFITS PROVIDED DEEMED TO IMPROVE THE HEALTH OF THE COMMUNITIES IN WHICH WE SERVE AND CONFORM WITH THE MISSION OF OUR EXEMPT PURPOSE.PART I, LINE 7FAMOUNTS PRESENTED ARE BASED UPON ACTUAL SPEND AND ARE IN CONFORMITY WITH AGREED UPON COMMITMENTS WITH THE VARIOUS EDUCATIONAL PROGRAMS.PART I, LINE 7IIN KEEPING WITH OUR MISSION AND COMMITMENT TO THE COMMUNITIES IN WHICH WE SERVE, WHITLEY MEMORIAL 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 EXPENSEWHITLEY MEMORIAL HOSPITAL, INC. EXCLUDED $10,658,948 OF BAD DEBT EXPENSE. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | DESCRIBE HOW THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES, AS REPORTED, PROMOTES THE HEALTH OF THE COMMUNITIES THE ORGANIZATION SERVES.HEALTH RESOURCES & SERVICES ADMINISTRATION (HRSA), IS AN AGENCY OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. HRSA DEVELOPS SHORTAGE DESIGNATION CRITERIA AND USES THEM TO DECIDE WHETHER OR NOT A GEOGRAPHIC AREA, POPULATION GROUP OR FACILITY IS A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) OR A MEDICALLY UNDERSERVED AREA OR POPULATION (MUA/P). HRSA HAS DESIGNATED THE WARSAW MENTAL HEALTH CATCHMENT AREA 28 IN WHITLEY COUNTY AND KOSCIUSKO COUNTY AS A HPSA IN MENTAL HEALTH. HRSA HAS DESIGNATED THE LOW INCOME - WARSAW SERVICE AREA, WHICH IS LOCATED IN KOSCIUSKO COUNTY, AS A MUP.AS SUCH, WHITLEY MEMORIAL HOSPITAL, INC. PROVIDES SUPPORT FOR LOCAL ECONOMIC DEVELOPMENT PROGRAMS. THESE EFFORTS ARE ALIGNED WITH 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 AND LEADERSHIP DEVELOPMENT IN WHITLEY COUNTY AND KOSCIUSKO 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. WHITLEY MEMORIAL HOSPITAL, INC. SPONSORED THE ANNUAL KOSCIUSKO CHAMBER OF COMMERCE MEETING WHICH FEATURED INDIANA GOVERNOR, ERIC HOLCOMB, AS THE GUEST SPEAKER WHOSE DISCUSSION INCLUDED CHANGES TO HEALTHCARE, THE OPIOID CRISIS, THE ECONOMY, AND OTHER TOPICS THAT HAVE A DIRECT IMPACT ON KOSCIUSKO COUNTY BUSINESSES.WHITLEY MEMORIAL HOSPITAL, INC. ALSO PROVIDED SUPPORT TO THE GLOBAL LEADERSHIP SUMMIT. THIS ANNUAL PROGRAM IS HELD WITH LEADING BUSINESSES IN KOSCIUSKO COUNTY AS A LEADERSHIP SUMMIT FOR MANAGERS. THE GOAL OF THE TWO-DAY SUMMIT, WHICH IS TRANSMITTED VIA SATELLITE AND HELD SIMULTANEOUSLY AT DIFFERENT AREAS ACROSS THE U.S., IS TO HONE AND IMPROVE LEADERSHIP SKILLS AMONG EMPLOYEES. STRONG LEADERS PLAY A KEY ROLE IN BUILDING THRIVING COMMUNITIES. WHITLEY MEMORIAL HOSPITAL, INC. FOCUSED ON COMMUNITY YOUTH AS WELL THROUGH CONTRIBUTION TO KOSCIUSKO YOUTH LEADERSHIP ACADEMY (KYLA). THE INITIATIVE IS AN OFFSHOOT OF AN ADULT PROGRAM GEARED FOR UPCOMING LEADERS IN THE ADULT WORKFORCE IN KOSCIUSKO COUNTY. SIMILAR IN MISSION, KYLA WAS FORMED TO ENCOURAGE THE GROWTH, EDUCATION, TRAINING AND MOTIVATION OF FUTURE LEADERS TO MEET THE CHALLENGES OF DEVELOPMENT AND EXPANSION IN KOSCIUSKO COUNTY. ANOTHER MEANS SUPPORT FOR EDUCATION WAS THROUGH A CONTRIBUTION TO WARSAW CHRISTIAN SCHOOL. THIS SMALL PRIVATE SCHOOL IN WARSAW WAS IN NEED OF FUNDS TO UPGRADE THEIR COMPUTER LAB FOR STUDENTS. THE DONATION WAS MADE TO HELP BUY MONITORS AND NEW PRINTERS FOR THE STUDENTS. WHITLEY MEMORIAL HOSPITAL, INC. JOINED FORCES WITH THE KOSCIUSKO BUILDERS ASSOCIATION AND OTHER LOCAL WARSAW BUSINESSES IN A PHILANTHROPIC ENDEAVOR TO BUILD A NEW HOME FOR A MILITARY VETERAN WHO HAD SUSTAINED SUBSTANTIAL INJURIES DURING HIS SERVICE IN AFGHANISTAN AND WAS UNABLE TO WORK. THE BUSINESSES REVEALED THE SURPRISE TO THE FAMILY AFTER A CONCERT HELD IN THEIR HONOR.WHITLEY MEMORIAL HOSPITAL, INC. PROVIDED SUPPORT TO THE ART IN THE ALLEY PROJECT IN DOWNTOWN WARSAW, INDIANA, WHICH IS A PUBLIC GATHERING SPACE THAT FEATURES TWO-DIMENSIONAL ARTWORK ALONG THE WALLS ALONG WITH SHADED TABLES, A DECORATIVE TILE WALKWAY, BIKE PARKING, WI-FI AND PLANTER BOXES. BUILT AS A MEANS OF INCREASING GREEN SPACE AND TO FACILITATE A SENSE OF COMMUNITY, THE ALLEY SPACE HAS BECOME A POPULAR MEETING DESTINATION FOR COMMUNITY MEMBERS.UNDERSTANDING THE IMPORTANCE OF SOCIAL EVENTS TO COMMUNITIES, WHITLEY MEMORIAL HOSPITAL, INC. CONTRIBUTED TO BUSCO BLOCK DAYS, A FAMILY-FRIENDLY COMMUNITY EVENT HELD ANNUALLY IN DOWNTOWN CHURUBUSCO, INDIANA, WHICH FEATURES A VARIETY OF EVENTS, BOOTHS AND A PARADE FOR MEMBERS OF COMMUNITY.RELATED TO DIRECT HEALTHCARE, WHITLEY MEMORIAL HOSPITAL, INC. 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. WHITLEY MEMORIAL HOSPITAL, INC. DEVELOPS A PHYSICIAN RECRUITMENT PLAN TO ADDRESS POTENTIAL GAPS IN PATIENT COVERAGE AS WELL AS 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 THAT ARE THE RIGHT FIT FOR THE COMMUNITY.EVERY MEMBER OF WHITLEY MEMORIAL 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 EXCELLENT CUSTOMER SERVICE TO ALL PEOPLE. WE KNOW HOW IMPORTANT CLINICAL, SERVICE AND OPERATIONAL EXCELLENCE IS TO THE SUCCESS OF WHITLEY MEMORIAL HOSPITAL, INC., AND WE RECOGNIZE HOW IMPORTANT OUR SUCCESS IS TO THE COMMUNITY. AN EXAMPLE OF OUR DEDICATION TO QUALITY CARE IS USING PRIMARILY EIGHT (8) HOUR SHIFTS FOR INPATIENT NURSING STAFF VS. 12 HOUR SHIFTS THAT ARE COMMON WITHIN THE INDUSTRY. WE ARE ALSO COMMITTED TO PROVIDING OPPORTUNITIES TO OUR NURSING STAFF TO FURTHER THEIR EDUCATION AND ENCOURAGING ALL NURSING STAFF TO PURSUE AT LEAST A BACHELOR'S LEVEL OF NURSING EDUCATION. |
| PART III, LINE 2: | THE AMOUNT REPORTED IS CONSISTENT WITH THE AMOUNT REPORTED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS UNDER THE GENERALLY ACCEPTED ACCOUNTING STANDARDS.DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS (BAD DEBT RECOVERIES) ARE FACTORED INTO THE ALLOWANCE FOR BAD DEBT ESTIMATION PROCESS. |
| PART III, LINE 3: | COSTING METHODOLOGY USED:UNCOLLECTIBLE PATIENT ACCOUNTS ARE CHARGED AGAINST THE PROVISION FOR BAD DEBT IN ACCORDANCE WITH THE POLICIES OF WHITLEY MEMORIAL 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:PAGE 12 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. WHITLEY MEMORIAL 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, WHITLEY MEMORIAL HOSPITAL, INC. HAS TAKEN THE POSITION NOT TO INCLUDE THE MEDICARE SHORTFALLS OR SURPLUSES AS PART OF COMMUNITY BENEFIT. WHITLEY MEMORIAL 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 TWELVE (12) 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 IDENTIFYING HEALTH NEEDS THROUGH THE TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT, WHITLEY MEMORIAL HOSPITAL, INC. IDENTIFIES AND VERIFIES COMMUNITY HEALTH NEEDS THROUGH THE FOLLOWING:- OTHER COMMUNITY NEEDS ASSESSMENTS CONDUCTED BY LOCAL ORGANIZATIONS- USE OF CONDUENT'S HEALTHY COMMUNITIES INSTITUTE SECONDARY DATA PLATFORM- OBSERVATIONS BY HEALTHCARE PROFESSIONALS WHO WORK WITH VULNERABLE POPULATIONS- SPECIFIC REQUESTS PROMPTED BY OTHER PROFESSIONALS IN THE COMMUNITYHOSPITAL 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.WHITLEY MEMORIAL HOSPITAL, INC., A MEMBER OF PARKVIEW HEALTH SYSTEMS, INC., PRIMARILY SERVICES WHITLEY COUNTY INCLUDING THE COMMUNITIES OF COLUMBIA CITY, CHURUBUSCO, LARWILL, AND SOUTH WHITLEY. EXPANSION INTO KOSCIUSKO COUNTY WITH PARKVIEW WARSAW, A FREE-STANDING EMERGENCY DEPARTMENT WITH MULTI-MODALITY IMAGING, LABORATORY AND PHYSICAL REHABILITATION, BROUGHT EXTENSION OF QUALITY SERVICES TO MEET THE NEEDS OF WARSAW AND THE SURROUNDING COMMUNITIES AS WELL. THE WARSAW FACILITY INCLUDES SUITES FOR PRIMARY CARE AND SPECIALTY PHYSICIAN OFFICES AND HAS SHELL SPACE ON THE THIRD FLOOR FOR GROWTH OF SERVICES IN THE FUTURE. PARKVIEW WARSAW OPERATES UNDER THE WHITLEY MEMORIAL HOSPITAL, INC. TAX ID AND PROVIDER NUMBERS.WHITLEY COUNTY HAS APPROXIMATELY 33,756 RESIDENTS, PRIMARILY CAUCASIAN. THE MEDIAN HOUSEHOLD INCOME IS $54,837. THE UNEMPLOYMENT RATE IS 2.7%. THE MAJORITY OF THE EMPLOYMENT IN THE COUNTY IS RELATED TO MANUFACTURING, RETAIL SALES AND HEALTHCARE. KOSCIUSKO COUNTY HAS APPROXIMATELY 79,206 RESIDENTS, PRIMARILY CAUCASIAN, AND APPROXIMATELY 7.9% HISPANIC OR LATINO. THE UNEMPLOYMENT RATE IS 2.4%. MANUFACTURING, HEAVILY WEIGHTED IN THE ORTHOPEDICS INDUSTRY, EDUCATION AND HEALTH SERVICES MAKE UP THE MAJORITY OF EMPLOYMENT IN THE COUNTY. THE MEDIAN HOUSEHOLD INCOME IS $54,482. |
| PART VI, LINE 5: | PROVIDE ANY OTHER INFORMATION IMPORTANT TO DESCRIBING HOW THE ORGANIZATION'S HOSPITAL FACILITIES OR OTHER HEALTH CARE FACILITIES FURTHER ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY (E.G. OPEN MEDICAL STAFF, COMMUNITY BOARD, USE OF SURPLUS FUNDS, ETC.).WHITLEY MEMORIAL HOSPITAL, INC.'S BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY MEMBERS FROM WHITLEY AND KOSCIUSKO COUNTIES ALONG WITH HOSPITAL PRESIDENT AND MEDICAL STAFF PRESIDENT. A MAJORITY OF THE BOARD RESIDES IN WHITLEY MEMORIAL HOSPITAL, INC.'S PRIMARY SERVICE AREA. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. PEOPLE THROUGHOUT THE COMMUNITY CAN COUNT ON WHITLEY MEMORIAL HOSPITAL, INC. TO AVAILABLE WITH EMERGENCY CARE 24 HOURS A DAY, 365 DAYS A YEAR. THE EMERGENCY DEPARTMENTS BOTH IN WHITLEY COUNTY AND KOSCIUSKO COUNTY ARE STAFFED WITH BOARD-CERTIFIED EMERGENCY CARE PHYSICIANS AND A NURSING STAFF THAT IS TRAINED AND EXPERIENCED IN EMERGENCY CARE. FURTHERMORE, NO PATIENT IS EVER DENIED TREATMENT, REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL IN WHITLEY COUNTY FEATURES 30 BEDS WITH ALL PRIVATE ROOMS, IN A 96,000 SQUARE FEET FACILITY LOCATED ON 42 ACRES. PARKVIEW WARSAW IN KOSCIUSKO COUNTY IS A 90,000 SQUARE FEET FACILITY FEATURING 10 EMERGENCY ROOM BEDS INCLUDING 2 THAT ARE EQUIPPED FOR TRAUMA PATIENTS. AS A COMMUNITY PARTNER AND NOT-FOR-PROFIT ORGANIZATION, WHITLEY MEMORIAL HOSPITAL, INC., IS DEDICATED TO IMPROVING YOUR HEALTH AND INSPIRING YOUR WELL-BEING BY TAILORING A PERSONALIZED HEALTH JOURNEY TO ACHIEVE YOUR UNIQUE GOALS. BY DEMONSTRATING WORLD-CLASS TEAMWORK, WE PARTNER WITH YOU ALONG THAT JOURNEY AND PROVIDE THE EXCELLENCE, INNOVATION AND VALUE YOU SEEK IN TERMS OF CONVENIENCE, COMPASSION, SERVICE, COST AND QUALITY. WHITLEY MEMORIAL HOSPITAL, INC. IS CONSISTENTLY RATED HIGHLY IN PUBLICALLY REPORTED MEASURES OF CARE AS WELL AS THE PATIENT PERCEPTION OF CARE.THE FOLLOWING LIST DEMONSTRATES SOME OF THE WAYS WHITLEY MEMORIAL HOSPITAL, INC. REACHES OUT TO MAKE OUR COMMUNITIES HEALTHIER: -FINANCIAL ASSISTANCE-COMMUNITY HEALTH IMPROVEMENT INITIATIVES-PRIMARY HEALTH CARE/ACCESS-MEDICATION ASSISTANCE PROGRAM (MAP)-HEALTH SCREENING/PREVENTION AND DISEASE MANAGEMENT-EDUCATIONAL AND SUPPORT PROGRAMS-SENIOR'S CLUB-EMS SERVICES-SPONSORSHIPSFINANCIAL ASSISTANCE:WHITLEY MEMORIAL HOSPITAL, INC.'S MISSION INCLUDES CARING FOR PEOPLE WHO DO NOT HAVE THE MEANS TO MEET THEIR FINANCIAL OBLIGATIONS. A FINANCIAL COUNSELOR IS AVAILABLE TO ASSIST PATIENTS IN NAVIGATING THIS PROCESS. THE HOSPITAL PLACES ITS PRIORITY ON PROVIDING THE NECESSARY CARE, NOT ON THE PATIENT'S ABILITY TO PAY FOR THEIR MEDICAL EXPENSES. COMMUNITY HEALTH IMPROVEMENT:THE PURPOSE OF WHITLEY MEMORIAL HOSPITAL, INC.'S COMMUNITY HEALTH IMPROVEMENT PROGRAM IS TO FUND COMMUNITY HEALTH IMPROVEMENT EFFORTS WITHIN THE SERVICE AREA OF WHITLEY MEMORIAL HOSPITAL, INC. THE HOSPITAL SETS ASIDE UP TO 10 PERCENT OF ITS NET INCOME ANNUALLY TO FUND COMMUNITY HEALTH INITIATIVES AND PARTNERS WITH COMMUNITY ORGANIZATIONS TO ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF NORTHEAST INDIANA. WHITLEY MEMORIAL HOSPITAL, INC. INVESTS IN KEY ORGANIZATIONS THAT PROMOTE THE HEALTH AND WELLNESS OF FAMILIES, CHILDREN, AND INDIVIDUALS OF WHITLEY AND KOSCIUSKO COUNTIES. KEY PROJECTS AND AREAS OF FOCUS FUNDED THROUGH THE COMMUNITY HEALTH IMPROVEMENT INITIATIVE AND OTHER HOSPITAL FUNDS INCLUDE:-SUPPORT OF B.A.B.E. OF WHITLEY COUNTY, AN INCENTIVE BASED PROGRAM FOR PREGNANT WOMEN AND FAMILIES, IN AN EFFORT TO DETER THE HIGH INCIDENCE OF LOW-BIRTH WEIGHT BABIES AND TO ENSURE THAT THE CHILDREN ARE GIVEN THE BEST POSSIBLE START IN LIFE. -DONATION TO CANCER SERVICES OF NORTHEAST INDIANA PROVIDED EDUCATION, MEDICAL SUPPLIES, NUTRITION COUNSELING, WIGS AND OTHER SERVICES TO 178 WHITLEY COUNTY RESIDENTS WITH A CANCER DIAGNOSIS. -THE GIVING GARDENS OF INDIANA IS A NON-PROFIT ORGANIZATION THAT GROWS STARTER PLANTS FOR LOCAL GARDENERS AND ALSO GROWS PRODUCE FOR LOCAL CITIZENS. THEIR PLANTS AND PRODUCE ARE GIVEN FREE TO ENCOURAGE HEALTHIER EATING HABITS. AN ESTIMATED 500 POUNDS OF PRODUCE WAS DONATED IN 2017.-INTERFAITH MISSION - THE LIGHTHOUSE - IS A MEN'S AND WOMEN'S TRANSITIONAL SHELTER THAT EDUCATES AS WELL AS HOUSES THE HOMELESS TO BE ABLE TO LIVE INDEPENDENTLY. THEY TEACH PARENTING, COOKING NUTRITION, AND COLLABORATION WITH OTHER SERVICES IN THE COMMUNITY FOR THEIR CLIENTS. EIGHTY CLIENTS WERE SERVICED IN 2017.-WHITLEY COUNTY COUNCIL ON AGING PROVIDES A DOOR-TO-DOOR PUBLIC TRANSPORT SERVICE FOR INDIVIDUALS WHO RESIDE IN WHITLEY COUNTY. CLIENTS MAY USE THIS SERVICE FOR MANY DIFFERENT TRANSPORTATION NEEDS, INCLUDING TRIPS TO THE DOCTOR'S OFFICE OR HOSPITAL, THEIR PLACE OF EMPLOYMENT, OR LOCAL EVENTS. TRANSPORTATION IS ALSO AVAILABLE FOR YOUNG SCHOOL AGED CHILDREN TO DAYCARE OR KINDERGARTEN. -MULTI-COUNTY MEDICAL OUTREACH CLINIC IS GIVEN IN-KIND LAB SERVICES THROUGH PARKVIEW WHITLEY HOSPITAL TO SERVE THE NEEDS OF THEIR UNINSURED PATIENTS. THEY ALSO RECEIVE IN-KIND SPACE TO OPERATE THEIR CLINIC. -WHITLEY COUNTY FARMERS MARKET SPONSORS THE DOWNTOWN COLUMBIA CITY SATURDAY MARKETS WHICH PROVIDE LOCALLY GROWN FRESH FRUITS AND VEGETABLES FOR SALE TO THE COMMUNITY EVERY SATURDAY SEASONALLY. THE FARMERS MARKET ACCEPTS SNAP AND WIC, WHICH IS VERY BENEFICIAL TO THE LOW INCOME FAMILIES IN THE COMMUNITY. THE HOSPITAL, ALSO, PARTICIPATED IN THE POWER OF PRODUCE (POP) PROGRAM WHICH GAVE AWAY FRESH PRODUCE OR A FOOD PRODUCING PLANT TO 93 PARTICIPATING CHILDREN AND HOSTS A WEEKLY MARKET ON THEIR CAMPUS THROUGHOUT THE SUMMER MONTHS AS WELL. -SUPPORTED THE KOSCIUSKO YOUTH LEAGUE TO PROVIDE HEALTHY SNACKS AND WATER AFTER BASEBALL GAMES RATHER THAN SUGAR SWEETENED FOODS AND BEVERAGES. -SUPPORTED THE CENTER FOR WHITLEY COUNTY YOUTH, A LOCAL YOUTH DEVELOPMENT ORGANIZATION. THEY PROVIDE POSITIVE ROLE MODELS, SNACKS, MEALS AND ACTIVITIES TO AT RISK TEENS TO IMPROVE THEIR HEALTH AND OPPORTUNITIES FOR SUCCESS IN LIFE. -WHITLEY MEMORIAL HOSPITAL, INC. PROVIDED FUNDING TO THE KOSCIUSKO COUNTY TOBACCO FREE COALITION THRU GRACE SCHOOLS INC. FOCUS IS PLACED ON MOTHER AND CHILD WELL-BEING INCLUDING SMOKING CESSATION PROGRAMS. -WHITLEY MEMORIAL HOSPITAL, INC. PROVIDES LUNCHES FOR TROY CENTER SCHOOL AT NO COST TO ENSURE NUTRITIONAL MEALS ARE AVAILABLE TO EACH STUDENT. TROY CENTER IS AN ACCREDITED INDEPENDENT ALTERNATIVE SCHOOL HELPING STUDENTS TO GAIN AN EDUCATION AND EARN A DIPLOMA AT THEIR OWN PACE, PROVIDING AN OPTION FOR ACHIEVEMENT FOR THOSE WHO HAVE FAILED IN TRADITIONAL SCHOOL SETTINGS.PRIMARY HEALTH CARE ACCESS:WHITLEY MEMORIAL HOSPITAL, INC. FEATURES 30 BEDS WITH ALL PRIVATE ROOMS. EMERGENCY MEDICAL CARE, OBSTETRIC CARE AND MEDICAL-SURGICAL UNITS ARE AVAILABLE AS WELL AS LAB, MULTIPLE MODALITIES OF IMAGING SERVICES, SURGICAL SERVICES, PHYSICAL REHABILITATION AS WELL AS CARDIAC/PULMONARY REHABILITATION. AN ATTACHED MEDICAL OFFICE BUILDING PROVIDES CONVENIENT, EASY ACCESS FOR PATIENTS TO RECEIVE CARE FROM FAMILY AND SPECIALTY PHYSICIANS AS WELL AS LABORATORY AND DIAGNOSTIC X-RAY SERVICES.THE PARKVIEW WARSAW FACILITY IN KOSCIUSKO COUNTY INCLUDES A 10 BED FREE-STANDING EMERGENCY DEPARTMENT, MULTI-MODALITY IMAGING, LABORATORY, PHYSICAL REHABILITATION AND MASSAGE THERAPY AS WELL AS PRIMARY CARE AND SPECIALTY PHYSICIAN OFFICES. EMERGENCY PATIENTS WHO REQUIRE A HIGHER LEVEL OF CARE ARE TRANSPORTED TO WHITLEY MEMORIAL HOSPITAL OR TO TERTIARY CARE FACILITIES IN ALLEN COUNTY.MEDICATION ASSISTANCE PROGRAM (MAP):WHITLEY MEMORIAL HOSPITAL, INC. SUPPORTS A MEDICATION ASSISTANCE PROGRAM THAT BEEN VERY SUCCESSFUL SINCE ITS INCEPTION. MAP PARTNERS WITH PATIENTS, PHYSICIANS, PHARMACEUTICAL COMPANIES, LOCAL PHARMACIES, AND DONORS TO PROVIDE MEDICATION ASSISTANCE AT LITTLE OR NO COST FOR QUALIFIED INDIVIDUALS IN WHITLEY COUNTY. EMERGENCY VOUCHERS FOR ACUTE MEDICATION NEEDS ARE REDEEMED AT LOCAL PHARMACIES. LONG-TERM MEDICATION HELP IS PROVIDED THROUGH CONNECTING PATIENTS WITH PHARMACEUTICAL ASSISTANCE PROGRAMS (PAP).HEALTH SCREENING/PREVENTION AND DISEASE MANAGEMENT:WHITLEY MEMORIAL HOSPITAL, INC. PARTICIPATES IN NUMEROUS HEALTH FAIRS AND ACTIVITIES THROUGHOUT THE YEAR TO PROVIDE HEALTH EDUCATION, HEALTH SCREENINGS FOR DISEASE PREVENTION, AND TO PROMOTE HEALTHY LIFESTYLES. THE HOSPITAL ALSO PROVIDES SUPPORT GROUPS TO ASSIST PATIENTS AND FAMILIES IN MANAGING DISEASE. -WELLNESS CHECK UP DAYS INCLUDED MULTIPLE HEALTH SCREENINGS AND HEALTH AND PREVENTION EDUCATION FOR ADULTS OF THE COMMUNITY. THIS EVENT PROVIDED LABORATORY TESTING FOR 459 COMMUNITY MEMBERS IN 2017. FRANCINE'S FRIENDS MOBILE MAMMOGRAPHY ALSO CONTINUES TO OFFER MAMMOGRAMS.(NARRATIVE CONTINUED AFTER PART VI, LINE 7) |
| PART VI, LINE 6: | IF THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM, DESCRIBE THE RESPECTIVE ROLES OF THE ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED.PARKVIEW HEALTH SYSTEM, INC. (PARKVIEW), A HEALTHCARE SYSTEM SERVING NORTHEAST INDIANA AND NORTHWEST OHIO THROUGH OUR HOSPITALS AND PHYSICIAN CLINICS, INCLUDES THE NOT-FOR-PROFIT HOSPITALS OF PARKVIEW HOSPITAL, INC.; COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.; COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.; PARKVIEW WABASH HOSPITAL, INC.; WHITLEY MEMORIAL HOSPITAL, INC.; HUNTINGTON MEMORIAL HOSPITAL, INC.; 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. |
| PART VI, SUPPLEMENTAL INFORMATION, LINE 5 | CONTINUED FROM ABOVE: PROVIDE ANY OTHER INFORMATION IMPORTANT TO DESCRIBING HOW THE ORGANIZATION'S HOSPITAL FACILITIES OR OTHER HEALTH CARE FACILITIES FURTHER ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY (E.G. OPEN MEDICAL STAFF, COMMUNITY BOARD, USE OF SURPLUS FUNDS, ETC.).-WHITLEY MEMORIAL HOSPITAL, INC. AND THE WHITLEY COUNTY COMMUNITY FOUNDATION PARTNER TOGETHER TO PROVIDE FREE MAMMOGRAPHY SCREENING TO WOMEN WHO ARE UNINSURED OR UNDERINSURED. THROUGH THE WOMEN'S GIVING CIRCLE, A FUND OF THE WHITLEY COUNTY COMMUNITY FOUNDATION, VOUCHERS ARE GIVEN TO WOMEN WHO ARE UNINSURED OR UNDERINSURED AND CAN BE REDEEMED AT THE HOSPITAL FOR MAMMOGRAMS.- WHITLEY MEMORIAL HOSPITAL, INC. PROVIDED SUPPORT FOR JOE'S KIDS, AN ORGANIZATION THAT PROVIDES SPECIALIZED PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY TO CHILDREN TO HELP THEM REACH THEIR MAXIMAL LEVEL OF INDEPENDENCE IN THE AREAS OF GROSS MOTOR SKILLS AND MOBILITY, FINE MOTOR SKILLS, SENSORY PROCESSING, SELF-CARE, FEEDING AND SWALLOWING AND SPEECH AND LANGUAGE.-WHITLEY MEMORIAL HOSPITAL, INC. PARTNERS WITH THE LOCAL YMCA TO PROVIDE NO COST GROUP EXERCISE AND FITNESS CLASSES TO THEIR EMPLOYEES. ADDITIONAL FITNESS EQUIPMENT IS ALSO PROVIDED TO EMPLOYEES WITHIN OUR FACILITY TO PROMOTE THEIR HEALTH AND FITNESS. EDUCATIONAL AND SUPPORT PROGRAMS:NUMEROUS OTHER EDUCATIONAL AND SUPPORT OPPORTUNITIES ARE AVAILABLE FOR THE PUBLIC SUCH AS CARDIO-PULMONARY REHAB SUPPORT, DIABETES SUPPORT, NUTRITION CLASSES, WEIGHT LOSS SUPPORT AND SMOKING CESSATION CLASSES. CO-WORKERS ALSO VOLUNTEER THEIR TIME TO STAFF THE BOOTHS AT THE WHITLEY COUNTY AND KOSCIUSKO COUNTY 4-H FAIRS OFFERING EDUCATIONAL MATERIALS, BLOOD PRESSURE CHECKS AND A PRIVATE LACTATION AREA. WHITLEY MEMORIAL HOSPITAL, INC. WORKS WITH LOCAL HIGH SCHOOLS TO PROVIDE OPPORTUNITIES FOR STUDENTS TO BE INTERNS IN A VARIETY OF SETTINGS, ALLOWING THEM TO EXPLORE CAREERS IN CLINICAL AND NON-CLINICAL HOSPITAL ENVIRONMENTS. A CHAPLAINCY PROGRAM PROVIDES SPIRITUAL SUPPORT FOR PATIENTS AND THEIR FAMILIES.SENIOR CLUB: THE WHITLEY MEMORIAL HOSPITAL, INC. SENIOR CLUB PROVIDES EDUCATIONAL OPPORTUNITIES FOR LOCAL SENIORS TO LEARN MORE ABOUT THEIR HEALTH. MEETINGS FEATURE GUEST SPEAKERS, AND INCLUDE A SIMPLE EXERCISE SEGMENT AND GIVING MEMBERS THE OPPORTUNITY TO CHECK THEIR WEIGHT AND BLOOD PRESSURE. THESE EVENTS ARE HELD 10 TIMES PER YEAR. EMS SERVICES:WHITLEY MEMORIAL HOSPITAL, INC. MANAGES AND OPERATES EMS SERVICES FOR WHITLEY COUNTY WITH DEDICATED AMBULANCES AVAILABLE FOR EMERGENCY DISPATCH 24 HOURS, 7 DAYS PER WEEK. AN ADDITIONAL 12 HOUR/DAY STAFFED AMBULANCE WAS ADDED TO THE FLEET IN 2017 TO HELP ENSURE THE QUICKEST RESPONSE TIME POSSIBLE IN EMERGENCY SITUATIONS AND PROVIDE ADDITIONAL RESOURCES FOR PATIENTS WHO NEED TRANSFERRED TO ANOTHER FACILITY OUTSIDE THE COUNTY. OVERALL, EMS SERVICES FOR WHITLEY ARE AT THE SCENE FOR LIFE THREATENING EMERGENCIES IN UNDER 13 MINUTES 93% OF THE TIME BEATING THE STANDARD TARGET OF 90% OF THE TIME. THERE WERE 1410 EMS RUNS AND 1069 PATIENT TRANSPORTS DURING 2017. STAFFED AMBULANCES ALSO PROVIDE EMERGENCY MEDICAL SERVICES COVERAGE FOR LOCAL FOOTBALL GAMES, THE WHITLEY COUNTY 4-H FAIR AND OTHER AREA COMMUNITY EVENTS. THEY PARTICIPATE IN LOCAL OPERATION PROM EVENTS AND FIRE TRAINING BURNS AS WELL.SPONSORSHIPS:WHITLEY MEMORIAL HOSPITAL, INC. SPONSORS NUMEROUS LOCAL ORGANIZATIONS EACH YEAR THAT HAVE POSITIVE IMPACTS ON THE COMMUNITIES SERVED. THE FUNDING PROVIDED SUPPORTS EVENTS RELATED TO HEALTHY ACTIVITIES SUCH AS TRIATHLONS OR 5K RACES AS WELL AS TO ORGANIZATIONS WHO ARE DEDICATED TO SERVING SPECIFIC INDIVIDUALS IN NEED. THE SPONSORSHIPS FOR 2017 INCLUDED BAKER YOUTH CLUB, THE BEAMAN HOME SHELTER, BIG BROTHERS BIG SISTERS, BOWEN CENTER, CASA OF KOSCIUSKO COUNTY, UNITED WAY, INDIANA CENTER FOR NURSING, IPFW, JUNIOR ACHIEVEMENT, KATE'S KART, KOSCIUSKO CHAMBER OF COMMERCE, KOSCIUSKO COMMUNITY YMCA, KOSCIUSKO LEADERSHIP ACADEMY, MARCH OF DIMES, PASSAGES INC., RONALD MCDONALD HOUSE, SOUTH WHITLEY YOUTH LEAGUE, WAGON WHEEL CENTER FOR THE ARTS, WARSAW CHRISTIAN SCHOOL, WARSAW LITTLE LEAGUE, WAWASEE KIWANIS CLUB TRIATHLON, WHITLEY COUNTY 4-H CLUBS AND WHITLEY COUNTY ECONOMIC DEVELOPMENT CORP. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| WHITLEY MEMORIAL HOSPITAL FOUNDATION INC | |||||||
| 1260 EAST STATE ROAD 205 | COLUMBIA CITY | IN | 46725 | 311190239 | 501 ( C ) 3 | $103,231 | OPERATIONS |
| BABE BEDS AND BRITCHES ETC | |||||||
| 533 N LINE ROAD | COLUMBIA CITY | IN | 46725 | 351130532 | 501 ( C ) 3 | $14,700 | TEEN PARENT CHILDCARE CENTER |
| JOE'S KIDS | |||||||
| 3540 COMMERCE DRIVE | WARSAW | IN | 46580 | 464095781 | 501 ( C ) 3 | $11,000 | REHABILITATION & DISABILITY SERVICES |
| CANCER SERVICES OF NORTHEAST IN | |||||||
| 6316 MUTUAL DRIVE | FORT WAYNE | IN | 46825 | 350965609 | 501 ( C ) 3 | $5,050 | SUPPORT SERVICES FOR WHITLEY COUNTY RESIDENTS WITH A CANCER DIAGNOSIS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 4 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | COMMUNITY HEALTH IMPROVEMENT FUNDING PARTNER ORGANIZATIONS ARE REQUIRED TO SUBMIT AN ANNUAL PROGRESS REPORT RELATED TO PROGRAM FUNDING. PARTNER ORGANIZATIONS ARE REQUIRED TO RE-APPLY FOR FUNDING ON AN ANNUAL BASIS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SCOTT GABRIEL | ||||||||||||||
| DIRECTOR/WMHOS PRESIDENT | $198,230 | $0 | $78,174 | $0 | $1,057 | $0 | $52,931 | $0 | $29,934 | $0 | $360,326 | $0 | $0 | $0 |
| MICHAEL PACKNETT | ||||||||||||||
| DIRECTOR/PH PRESIDENT & CEO | $0 | $1,029,197 | $0 | $337,969 | $0 | $232,697 | $0 | $702,543 | $0 | $32,640 | $0 | $2,335,046 | $0 | $0 |
| JAMES STAPEL | ||||||||||||||
| DIRECTOR/VICE CHAIR/PH MED DIR | $0 | $208,600 | $0 | $55,991 | $0 | $19,669 | $0 | $69,321 | $0 | $18,489 | $0 | $372,070 | $0 | $15,219 |
| JEANNE' WICKENS | ||||||||||||||
| PH CHIEF FINANCIAL OFFICER | $0 | $597,900 | $0 | $82,480 | $0 | $20,752 | $0 | $103,150 | $0 | $32,253 | $0 | $836,535 | $0 | $0 |
| BRIDGET DOLOHANTY-JOHNSON | ||||||||||||||
| WMHOS VP PATIENT CARE | $167,932 | $0 | $35,066 | $0 | $3,615 | $0 | $25,670 | $0 | $11,971 | $0 | $244,254 | $0 | $0 | $0 |
| JEFFREY ROCKETT | ||||||||||||||
| WMHOS VP OUTPATIENT SERVICES | $136,615 | $0 | $20,126 | $0 | $9,965 | $0 | $11,942 | $0 | $22,203 | $0 | $200,851 | $0 | $0 | $0 |
| AMANDA KNOWLES | ||||||||||||||
| WMHOS MGR PHARMACY | $148,094 | $0 | $15,715 | $0 | $269 | $0 | $15,084 | $0 | $25,717 | $0 | $204,879 | $0 | $0 | $0 |
| BENJAMIN MAGGARD | ||||||||||||||
| WMHOS PHARMACIST | $115,798 | $12,795 | $6,250 | $0 | $124 | $14 | $8,784 | $921 | $22,739 | $2,384 | $153,695 | $16,114 | $0 | $0 |
| CHARLES JINKS | ||||||||||||||
| WMHOS PHARMACIST | $72,210 | $60,048 | $750 | $500 | $219 | $182 | $9,180 | $7,618 | $15,195 | $12,610 | $97,554 | $80,958 | $0 | $0 |
| STANTON RISSER | ||||||||||||||
| FORMER OFFICER/PH VP PARTIAL YEAR | $0 | $87,858 | $0 | $37,484 | $0 | $31,725 | $0 | $4,409 | $0 | $13,223 | $0 | $174,699 | $0 | $10,507 |
| MICHAEL BROWNING | ||||||||||||||
| FORMER OFFICER | $0 | $0 | $0 | $0 | $0 | $277,686 | $0 | $0 | $0 | $0 | $0 | $277,686 | $0 | $277,686 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | TRAVEL FOR COMPANIONS - TAXABLE EXPENSE REIMBURSEMENT FOR FAMILY MEMBER PAID TO: SCOTT GABRIEL $41; GEORGE SCHRUMPF $18 |
| PART I, LINE 3 | RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF WHITLEY MEMORIAL 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, LINE 4B | SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS TAXABLE - MICHAEL BROWNING $277,686; STANTON RISSER $10,507; JAMES STAPEL $15,219 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. BRIDGET DOLOHANTY-JOHNSON $19,472; SCOTT GABRIEL $34,031; MICHAEL PACKNETT $678,243; JAMES STAPEL $36,961; JEANNE' WICKENS $97,750 |
| PART I, LINE 7 | MANAGEMENT INCENTIVE COMPENSATION PLAN (MICP) AND PHYSICIAN AND PROVIDER INCENTIVE COMPENSATION PLAN (PICP) ARE ANNUAL INCENTIVE PROGRAMS. SYSTEM GOALS ARE APPROVED BY THE BOARD. AT CONCLUSION OF THE PLAN YEAR, RESULTS ARE SHARED WITH THE BOARD AND THE EXECUTIVE COMMITTEE OF THE BOARD APPROVES FINAL PAYMENT. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A | CENTER'S (ANCC) MAGNET RECOGNITION PROGRAM, WHICH ENSURES THAT RIGOROUS STANDARDS FOR NURSING EXCELLENCE ARE MET. TO ACHIEVE MAGNET RECOGNITION, ORGANIZATIONS MUST PASS A RIGOROUS AND LENGTHY REVIEW PROCESS THAT DEMANDS WIDESPREAD PARTICIPATION FROM CARE PROVIDERS AND CO-WORKERS AT EACH HOSPITAL. ACCORDING TO THE ANCC, MAGNET DESIGNATION INDICATES AN ORGANIZATION IN WHICH NURSES CAN FLOURISH AS PROFESSIONALS. THESE SELECT ENTITIES PLACE AN EMPHASIS ON PROVIDING THEIR NURSING TEAMS WITH THE PROFESSIONAL AUTONOMY TO MAKE CLINICAL DECISIONS AT PATIENT BEDSIDES. THEY ALSO INVOLVE NURSES IN DECISIONS REGARDING THE PATIENT CARE ENVIRONMENT, AS WELL AS ENABLE MORE INTERDISCIPLINARY COLLABORATIONS WITH OTHER TEAM MEMBERS. WHITLEY MEMORIAL HOSPITAL, INC. IS KEEPING PACE WITH THE RAPIDLY CHANGING HEALTHCARE INDUSTRY BY INCORPORATING NEW TECHNOLOGY AND THE LATEST DIAGNOSTIC AND TREATMENT PROCEDURES WHILE CONTINUALLY SEEKING WAYS TO GIVE BACK TO THE COMMUNITY WE SERVE. THIS IS REFLECTED IN OUR NEW TELECARDIOLOGY CAPABILITIES WHICH GIVE CARDIAC PATIENTS IMMEDIATE ACCESS TO CARDIOLOGISTS. THE SPECIALISTS, WHO ARE BASED AT PARKVIEW'S REGIONAL MEDICAL CENTER, ARE ABLE TO MONITOR AND GIVE DIRECTIVES REMOTELY VIA SPECIALIZED EQUIPMENT. OUR CORE VALUES ARE DISPLAYED THROUGH OUR MANY COMMUNITY EDUCATION AND OUTREACH PROGRAMS AS WELL AS OUR CHARITY CARE SERVICES AND THE VOLUNTEERISM OF OUR EMPLOYEES. TO FURTHER ADDRESS THE SPECIFIC NEEDS OF THE COMMUNITY, PARKVIEW HEALTH ROUTINELY SPONSORS A PROFESSIONALLY ADMINISTERED COMMUNITY HEALTH NEEDS ASSESSMENT TO IDENTIFY HEALTH NEEDS WITHIN NORTHEAST INDIANA, PARTICULARLY, THE SEVEN COUNTIES IN WHICH HOSPITALS EXIST. THE FOLLOWING ARE SOME OF THE WAYS WHITLEY MEMORIAL HOSPITAL, INC. IS REACHING OUT TO MAKE OUR NEIGHBORHOODS AND COMMUNITIES HEALTHIER: -FINANCIAL ASSISTANCE -COMMUNITY HEALTH IMPROVEMENT INITIATIVES -PRIMARY HEALTH CARE/ACCESS -MEDICATION ASSISTANCE PROGRAM (MAP) -HEALTH SCREENING/PREVENTION AND DISEASE MANAGEMENT -EDUCATIONAL AND SUPPORT PROGRAMS -SENIOR CLUB -VOLUNTEER PROGRAM/STAFF VOLUNTEERISM -EMS SERVICES -STAFF FITNESS CENTER FINANCIAL ASSISTANCE: WHITLEY MEMORIAL HOSPITAL, INC.'S MISSION INCLUDES CARING FOR PEOPLE WHO DO NOT HAVE THE MEANS TO MEET THEIR FINANCIAL OBLIGATIONS. A FINANCIAL COUNSELOR IS AVAILABLE TO ASSIST PATIENTS IN NAVIGATING THIS PROCESS. THE HOSPITAL'S HIGHEST PRIORITY IS PROVIDING NECESSARY CARE FOR THE PATIENT, NOT THE PATIENT'S ABILITY TO PAY FOR HIS/HER MEDICAL EXPENSES. COMMUNITY HEALTH IMPROVEMENT INITIATIVES: WHITLEY MEMORIAL HOSPITAL, INC.'S COMMUNITY HEALTH IMPROVEMENT PROGRAM WAS ESTABLISHED TO HELP FUND COMMUNITY HEALTH IMPROVEMENT EFFORTS WITHIN WHITLEY MEMORIAL HOSPITAL'S SERVICE AREA. THE HOSPITAL SETS ASIDE UP TO 10 PERCENT OF ITS NET INCOME ANNUALLY TO FUND COMMUNITY HEALTH INITIATIVES. BY PARTNERING WITH COMMUNITY ORGANIZATIONS, THESE FUNDS ARE USED TO ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF WHITLEY COUNTY AND KOSCIUSKO COUNTY WITH A SPECIAL EMPHASIS ON ADDRESSING THE HEALTH ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. WHITLEY MEMORIAL HOSPITAL, INC. INVESTS IN KEY ORGANIZATIONS THAT PROMOTE THE HEALTH AND WELL-BEING OF FAMILIES, CHILDREN, AND INDIVIDUALS OF THE COMMUNITIES SERVED. PRIMARY HEALTH CARE/ACCESS: WHITLEY MEMORIAL HOSPITAL, INC. FEATURES 30 BEDS WITH ALL PRIVATE ROOMS. EMERGENCY MEDICAL CARE, OBSTETRIC CARE AND A MEDICAL-SURGICAL UNIT ARE AVAILABLE AS WELL AS LABORATORY, MULTIPLE MODALITY IMAGING, SURGICAL SERVICES, SLEEP DISORDERS LAB, OUTPATIENT INFUSION CENTER AND PHYSICAL REHABILITATION INCLUDING MASSAGE THERAPY. A NEW FASTER CT SCANNER WAS PURCHASED AND PUT INTO SERVICE IN JANUARY 2017 IN ORDER TO PROVIDE HIGHER QUALITY AND FASTER SCANS FOR PATIENT DIAGNOSTIC SERVICES AS WELL AS A SECOND ULTRASOUND UNIT TO ENABLE DUAL TESTING TO ELIMINATE WAIT TIMES FOR SCHEDULED PROCEDURES OR DELAYS WHEN AN EMERGENCY ROOM NEED ARISES. AN ATTACHED MEDICAL OFFICE BUILDING PROVIDES CONVENIENT, EASY ACCESS FOR PATIENTS TO RECEIVE CARE FROM FAMILY AND SPECIALTY PHYSICIANS AS WELL AS LABORATORY AND IMAGING SERVICES. PARKVIEW WARSAW SERVICES INCLUDE A FREE-STANDING EMERGENCY DEPARTMENT WITH TEN ROOMS, TWO OF WHICH ARE EQUIPPED FOR TRAUMA PATIENTS. THERE IS A FULL SERVICES MULTI-MODALITY IMAGING DEPARTMENT WHICH INCLUDES A 3-D TOMOGRAPHY MAMMOGRAPHY UNIT FOR THE BEST QUALITY SCANS THAT HELP TO REDUCE THE NUMBER OF FOLLOW-UP TESTING REQUIRED. THE FACILITY ALSO INCLUDES LABORATORY, PHYSICAL REHABILITATION AND MASSAGE THERAPY AS WELL AS PRIMARY CARE AND SPECIALTY PHYSICIAN OFFICES. AN ANTICOAGULATION CLINIC OPENED IN FEBRUARY 2017 FOR PATIENTS IN NEED OF ROUTINE TESTING OF BLOOD WHILE TAKING ANTICOAGULANT DRUGS. SHELL SPACE ON THE THIRD FLOOR PROVIDES AREA FOR GROWTH OF SERVICES IN THE FUTURE. MEDICATION ASSISTANCE PROGRAM (MAP): BY PARTNERING WITH, PHYSICIANS, PHARMACEUTICAL COMPANIES, LOCAL PHARMACIES, AND DONORS, WHITLEY MEMORIAL HOSPITAL IS ABLE TO PROVIDE MEDICATION ASSISTANCE AT LITTLE OR NO COST FOR QUALIFIED INDIVIDUALS. EMERGENCY VOUCHERS FOR ACUTE MEDICATION NEEDS ARE REDEEMED AT THE HOSPITAL PHARMACY. LONG-TERM MEDICATION HELP IS PROVIDED TO PATIENTS BY CONNECTING THEM WITH PHARMACEUTICAL ASSISTANCE PROGRAMS (PAP). HEALTH SCREENING/PREVENTION AND DISEASE MANAGEMENT: WHITLEY MEMORIAL HOSPITAL, INC. PARTICIPATES MANY ACTIVITIES THROUGHOUT THE YEAR TO PROVIDE HEALTH EDUCATION, HEALTH SCREENINGS FOR DISEASE PREVENTION AND TO PROMOTE HEALTHY LIFESTYLES AND WELL-BEING. THE HOSPITAL ALSO PROVIDES SUPPORT GROUPS TO ASSIST PATIENTS AND FAMILIES IN MANAGING DISEASE: -CHECK-UP DAYS ARE OFFERED QUARTERLY EITHER ON-SITE AT THE HOSPITAL OR NEARBY AT THE YMCA WITH ASSISTANCE BY STAFF. LOW COST LABORATORY SCREENINGS ARE AVAILABLE AS WELL AS HEALTH AND PREVENTION EDUCATION FOR ADULTS OF THE COMMUNITY. THERE WERE 459 PARTICIPANTS AT THE WHITLEY MEMORIAL HOSPITAL, INC. LOCATION. -WHITLEY MEMORIAL HOSPITAL, INC.'S BIRTH PLANNER AND LACTATION CONSULTANT CONDUCT BREASTFEEDING EDUCATION AND A SUPPORT GROUP FOR NEW MOMS. LAMAZE CLASSES ARE ALSO AVAILABLE TO PARENTS-TO-BE. -WHITLEY MEMORIAL HOSPITAL, INC. AND THE WHITLEY COUNTY COMMUNITY FOUNDATION PARTNER TOGETHER TO PROVIDE FREE MAMMOGRAPHY SCREENING TO WOMEN WHO ARE UNINSURED OR UNDERINSURED. THROUGH THE WOMEN'S GIVING CIRCLE, A FUND OF THE WHITLEY COUNTY COMMUNITY FOUNDATION, VOUCHERS ARE GIVEN TO THOSE WHO QUALIFY AND CAN BE REDEEMED AT THE HOSPITAL FOR MAMMOGRAMS. -WHITLEY MEMORIAL HOSPITAL, INC. PROVIDES FIRST RESPONDER AND ADVANCED EMT COURSES. -THERE WERE 238 HEART SMART CT SCANS PERFORMED IN 2017 BETWEEN WHITLEY AND WARSAW LOCATIONS AT A MINIMAL OUT-OF-POCKET FEE. THE SCAN IS A SIMPLE, NON-INVASIVE TEST THAT CAN DETECT CORONARY ARTERY DISEASE IT ITS EARLY STAGES. LUNG SCANS ARE AVAILABLE AS WELL FOR SMOKERS CONSIDERED TO BE "AT-RISK". SIXTY-SEVEN INDIVIDUALS UTILIZED THAT SERVICE. THE TEST INVOLVES A LOW DOSE CT TO ASSIST IN DIAGNOSING EARLY STAGE LUNG CANCER. -WHITLEY MEMORIAL HOSPITAL, INC. IS DEDICATED TO THE WELL-BEING OF ITS CO-WORKERS ALONG WITH ITS PATIENTS. A FITNESS CENTER IS AVAILABLE 24/7 WITH A VARIETY OF EXERCISE AND STRENGTH TRAINING EQUIPMENT FOR ALL STAFF TO ENJOY. RECUMBENT BIKES ARE AVAILABLE WITHIN SEVERAL DEPARTMENTS AS WELL. EDUCATIONAL AND SUPPORT PROGRAMS: NUMEROUS OTHER EDUCATIONAL AND SUPPORT OPPORTUNITIES ARE AVAILABLE FOR THE PUBLIC SUCH AS CARDIO-PULMONARY REHAB SUPPORT, DIABETES SUPPORT, NUTRITION CLASSES, WEIGHT LOSS SUPPORT, ON-SITE SEASONAL FARMER'S MARKET AND SMOKING CESSATION CLASSES. THE FAMILY BIRTH CENTER ALSO OFFERS A BREASTFEEDING SUPPORT GROUP AS WELL AS A POSTPARTUM DEPRESSION AND ANXIETY SUPPORT GROUP FOR NEW MOTHERS. CO-WORKERS VOLUNTEER THEIR TIME TO STAFF THE BOOTHS AT THE WHITLEY COUNTY AND KOSCIUSKO COUNTY 4-H FAIRS OFFERING EDUCATIONAL MATERIALS, BLOOD PRESSURE CHECKS AND A PRIVATE LACTATION AREA. NURSES ALSO GIVE EDUCATIONAL PRESENTATIONS TO LOCAL ELEMENTARY STUDENTS STRESSING THE IMPORTANCE OF HANDWASHING AS WELL AS WATER SAFETY, BIKE SAFETY AND SUN SAFETY LESSONS. WHITLEY MEMORIAL HOSPITAL, INC. WORKS WITH LOCAL HIGH SCHOOLS TO PROVIDE OPPORTUNITIES FOR STUDENTS TO BE INTERNS IN A VARIETY OF SETTINGS, ALLOWING THEM TO EXPLORE CAREERS IN CLINICAL AND NON-CLINICAL HOSPITAL ENVIRONMENTS. A CHAPLAINCY PROGRAM WAS STARTED IN 2016 TO PROVIDE SPIRITUAL SUPPORT FOR PATIENTS AND THEIR FAMILIES. SENIOR CLUB: THE WHITLEY MEMORIAL HOSPITAL, INC. SENIOR CLUB PROVIDES EDUCATIONAL OPPORTUNITIES FOR LOCAL SENIORS TO LEARN MORE ABOUT THEIR HEALTH. MEETINGS FEATURE GUEST SPEAKERS, AND INCLUDE A SIMPLE EXERCISE SEGMENT, AND OFFER MEMBERS THE OPPORTUNITY TO CHECK THEIR WEIGHT AND BLOOD PRESSURE. THESE EVENTS ARE HELD 10 TIMES PER YEAR. |
| FORM 990, PART III, LINE 4A | VOLUNTEER PROGRAM/STAFF VOLUNTEERISM: THE VOLUNTEER PROGRAM AT WHITLEY MEMORIAL HOSPITAL, INC. HAS APPROXIMATELY 30 VOLUNTEERS WHO FUNCTION TO ASSIST PATIENTS, PROVIDE DIRECTIONS, WORK IN THE GIFT SHOP AND ASSIST STAFF. THE MANAGEMENT AND EMPLOYEES OF PARKVIEW WHITLEY ALSO PARTICIPATE IN NUMEROUS VOLUNTEER ACTIVITIES THROUGHOUT THE COMMUNITY TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY. THESE ACTIVITIES INCLUDE PARTICIPATION IN THE LOCAL DAY OF CARING, THE MULTI COUNTY MEDICAL OUTREACH CLINIC, JUNIOR ACHIEVEMENT PROGRAMS AT LOCAL SCHOOLS AND THE SALVATION ARMY BELL RINGING. EMS SERVICES: WHITLEY MEMORIAL HOSPITAL, INC. MANAGES AND OPERATES EMS SERVICES FOR WHITLEY COUNTY WITH DEDICATED AMBULANCES AVAILABLE FOR EMERGENCY DISPATCH 24 HOURS, 7 DAYS PER WEEK. AN ADDITIONAL 12 HOUR/DAY STAFFED AMBULANCE WAS ADDED TO THE FLEET IN 2017 TO HELP ENSURE THE QUICKEST RESPONSE TIME POSSIBLE IN EMERGENCY SITUATIONS AND PROVIDE ADDITIONAL RESOURCES FOR PATIENTS WHO NEED TRANSFERRED TO ANOTHER FACILITY OUTSIDE THE COUNTY. OVERALL, EMS SERVICES FOR WHITLEY ARE AT THE SCENE FOR LIFE THREATENING EMERGENCIES IN UNDER 13 MINUTES 93% OF THE TIME BEATING THE STANDARD TARGET OF 90% OF THE TIME. THERE WERE 1410 EMS RUNS AND 1069 PATIENT TRANSPORTS DURING 2017. STAFFED AMBULANCES ALSO PROVIDE EMERGENCY MEDICAL SERVICES COVERAGE FOR LOCAL FOOTBALL GAMES, THE WHITLEY COUNTY 4-H FAIR AND OTHER AREA COMMUNITY FAIRS. THEY PARTICIPATE IN LOCAL OPERATION PROM EVENTS AND FIRE TRAINING BURNS AS WELL. TO FURTHER SERVE THE COMMUNITY, PARKVIEW WHITLEY HAS ADDED A NEW AMBULANCE TO ITS FLEET FEATURING A SMALLER, MORE STREAMLINED DESIGN, GIVING MEDICAL PERSONAL EASIER ACCESS TO BOTH THE PATIENT AS WELL AS EQUIPMENT. |
| 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, WHITLEY MEMORIAL HOSPITAL, INC., EIN 35-1967665. 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, 2017 WAS 571. THE TOTAL NUMBER OF EMPLOYEES REPORTED ON FORM W-3 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2017 WAS 12,715. FOR PURPOSES OF COMPLETING FORM 990, PART V, LINE 1A AND 2A, THE NUMBER REPORTED FOR THE WHITLEY MEMORIAL HOSPITAL, INC. WAS 37 AND 405 RESPECTIVELY. |
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE IS COMPRISED OF MEMBERS FROM THE ORGANIZATION'S BOARD OF DIRECTORS AND MAY ACT ON BEHALF OF THE ORGANIZATION IN ANY MATTER WHEN THE BOARD IS NOT IN SESSION, REPORTING TO THE BOARD FOR ITS RATIFICATION OF ITS ACTIONS. USE OF THE EXECUTIVE COMMITTEE IS INFREQUENT AND TYPICALLY MEETS ONLY WHEN IT IS IMPRACTICAL TO GET THE FULL BOARD TOGETHER FOR A SPECIAL BOARD MEETING. |
| 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 WHITLEY MEMORIAL 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 AS DEFINED IN THE NETWORK AGREEMENT: (A) APPOINT DIRECTORS (INCLUDING APPOINTMENTS TO FILL A VACANCY) AND INITIATE THE REMOVAL AND REMOVE ANY DIRECTOR OF THE CORPORATION, WITH CAUSE, PROVIDED CONSIDERATION IS GIVEN TO RECOMMENDATIONS OF THE BOARD REGARDING SUCH APPOINTMENT OR REMOVAL, IF ANY ARE SO MADE; (B) APPOINT (INCLUDING APPOINTMENTS TO FILL A VACANCY) AND INITIATE THE REMOVAL AND REMOVE THE PRESIDENT 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; (C) APPROVE AND ADOPT THE STRATEGIC PLAN FOR THE CORPORATION AND ITS AFFILIATES, INCLUDING ANY INDIVIDUAL INITIATIVES OR ARRANGEMENTS, SUCH AS A NEW SERVICE OR CONTRACTUAL ARRANGEMENT, DEEMED BY THE CORPORATE MEMBER TO BE OF STRATEGIC IMPORTANCE TO THE CORPORATION OR ITS AFFILIATES AND DIRECT AND MONITOR COMPLIANCE WITH SUCH PLANS, INITIATIVES AND ARRANGEMENTS; (D) APPROVE AND ADOPT THE CAPITAL AND OPERATING BUDGETS OF THE CORPORATION AND ITS AFFILIATES; (E) APPROVE THE INCURRENCE OF ANY DEBT PROPOSED BY THE CORPORATION, INCLUDING THE ISSUANCE OF BONDS, BY THE CORPORATION AND ITS AFFILIATES AND REQUIRE THE INCURRENCE OF DEBT BY THE CORPORATION AND ITS AFFILIATES; (F) APPROVE 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. (G) REQUIRE AND DIRECT 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 AN ACUTE CARE 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; (H) APPROVE PARTICIPATION (INCLUDING THE EXERCISE OF RENEWAL OPTIONS) BY THE CORPORATION AND ITS AFFILIATES IN NETWORKS, AFFILIATIONS, JOINT VENTURES, PARTNERSHIPS, MERGERS OR ACQUISITIONS AND REQUIRE PARTICIPATION BY THE CORPORATION AND ITS AFFILIATES IN SUCH ARRANGEMENTS; (I) APPROVE DECISIONS OF THE CORPORATION AND ITS AFFILIATES TO PARTICIPATE (INCLUDING THE EXERCISE OF RENEWAL OPTIONS) IN 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; (J) DEVELOP AND REQUIRE 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; (K) APPROVE ANY ACTION OF THE CORPORATION OR AN AFFILIATE TO CHANGE THE HOSPITAL FROM A GENERAL, ACUTE CARE COMMUNITY HOSPITAL OR TO CLOSE THE HOSPITAL; AND (L) APPROVE ANY AMENDMENT TO THE BYLAWS OR THE ARTICLES OF INCORPORATION OF THE CORPORATION, AND THE ARTICLES AND BYLAWS OF ANY NEWLY CREATED AFFILIATE AND REQUIRE AMENDMENT OF THESE GOVERNING DOCUMENTS AS NECESSARY OR ADVISABLE TO RESOLVE SIGNIFICANT ETHICAL ISSUES; TO MAINTAIN JOINT COMMISSION ACCREDITATION, TAX-EXEMPT STATUS, PARTICIPATION IN MEDICARE/MEDICAID OR TO PREVENT SIGNIFICANT ADVERSE LEGAL OR FINANCIAL EFFECTS TO THE CORPORATION OR SYSTEM, EXCEPT THAT THERE CAN BE NO AMENDMENT TO THE RESERVED POWERS LISTED IN SECTIONS (G) AND (K) OF THIS EXHIBIT A OR THE REQUIREMENT THAT ELECTED DIRECTORS BE REPRESENTATIVES OF WHITLEY COUNTY, AS DESCRIBED IN ARTICLE V, SECTIONS 2 AND 10 OF THESE BYLAWS WITHOUT THE CONSENT OF THE CORPORATION. THE CORPORATE MEMBER SHALL DEVELOP POLICIES FOR THE IMPLEMENTATION OF THE RESERVED POWERS, INCLUDING MATERIALITY POLICIES REGARDING MATTERS SUBJECT TO REVIEW. |
| 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. WHITLEY MEMORIAL 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 10, 2018, THE SYSTEM AUDIT COMMITTEE REVIEWED THE FORM 990 AS ULTIMATELY FILED WITH THE IRS. THIS REVIEW INCLUDED A PRESENTATION BY THE ORGANIZATION'S TAX PREPARER TO HIGHLIGHT THE SIGNIFICANT AREAS ON THE FORM 990 AND SUPPLEMENTAL SCHEDULES. |
| FORM 990, PART VI, SECTION B, LINE 12C | AS DESCRIBED IN ARTICLE IX SECTION 6, OF THE PARKVIEW HEALTH SYSTEM, INC. (PH) BYLAWS, PH ADOPTED PH'S COMPLIANCE POLICY FOR THE ORGANIZATION AND ITS NOT-FOR-PROFIT RELATED ORGANIZATIONS (AND AS LIKEWISE NOTED IN THEIR BYLAWS) WHEN ADDRESSING CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. THIS COMPLIANCE POLICY (COMPLIANCE POLICY #14) REQUIRES THAT EACH BOARD MEMBER, BOARD COMMITTEE MEMBER, AND KEY MANAGEMENT PERSONNEL MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST FORM. THIS INFORMATION IS PROVIDED TO THE CHAIRMAN OF THE BOARD (FOR BOARD AND BOARD COMMITTEE MEMBERS) AND TO SENIOR MANAGEMENT (FOR KEY MANAGEMENT PERSONNEL). IN ADDITION, AS TO THE CONDUCT OF BOARD MEETINGS, THE FOLLOWING PROCESS IS FOLLOWED: "WHENEVER A PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE IS CONSIDERING A TRANSACTION OR ARRANGEMENT WITH AN ORGANIZATION, ENTITY OR INDIVIDUAL IN WHICH A PERSON COVERED BY THIS POLICY HAS A FINANCIAL OR CONFLICTING INTEREST, THE FOLLOWING SHALL OCCUR: 1. THE INTERESTED PERSON MUST DISCLOSE THE FINANCIAL OR CONFLICTING INTEREST AND ALL MATERIAL FACTS TO THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE; 2. THE INTERESTED PERSON WITH THAT FINANCIAL OR CONFLICTING INTEREST MAY MAKE A PRESENTATION AT THE BOARD OR BOARD COMMITTEE MEETING REGARDING THE TRANSACTION OR ARRANGEMENT HOWEVER, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE FINANCIAL OR CONFLICTING INTEREST; AND 3. THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE MUST APPROVE THE TRANSACTION OR ARRANGEMENT BY A MAJORITY VOTE OF THE BOARD MEMBERS PRESENT AT A MEETING THAT HAS A QUORUM, NOT INCLUDING THE VOTE OF THE INTERESTED PERSON. THE INTERESTED PERSON MAY NOT VOTE ON THE MATTER. A. UPON THE REQUEST OF PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE, THE MATTER MAY BE DELEGATED TO THE PH COMPLIANCE COMMITTEE FOR EVALUATION, RECOMMENDATION AND/OR DETERMINATION. 4. WHENEVER A FINANCIAL OR CONFLICTING INTEREST IS ADDRESSED BY A PH OR PH AFFILIATE BOARD, NOTICE SHALL BE GIVEN TO THE PH COMPLIANCE OFFICER / GENERAL COUNSEL." |
| FORM 990, PART VI, SECTION B, LINE 15 | LINES 15A AND 15B ARE ANSWERED NO IN ACCORDANCE WITH THE IRS INSTRUCTIONS. TO THE EXTENT THAT THE ORGANIZATION HAS VICE PRESIDENT OR ABOVE, THE COMPENSATION COMMITTEE OF RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., DETERMINES THE COMPENSATION OF THE CEO, OFFICERS, AND KEY EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER: PROGRAM SERVICE EXPENSES 1,359,733. MANAGEMENT AND GENERAL EXPENSES 134,233. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,493,966. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,053,543. MANAGEMENT AND GENERAL EXPENSES 349,913. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,403,456. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 2,864,093. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,864,093. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 536,187. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 536,187. COLLECTION EXPENSE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 542,228. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 542,228. |
| 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: | CURRENT YEAR EARNINGS TRANSFERRED TO PARENT -13,592,446. ASSET TRANSFERS/ADJUSTMENTS 112,746. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 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 | |||||||||||
| 10501 CORPORATE DRIVE | FORT WAYNE | IN | 46845 | 351972384 | HEALTH CARE | IN | 501(C)(3) | LINE 12C, III-FI | N/A | 0 | |
| WHITLEY MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 1260 E STATE ROAD 205 | COLUMBIA CITY | IN | 46725 | 311190239 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | Yes (1) | WHITLEY MEMORIAL HOSPITAL INC | |
| PARKVIEW OCCUPATIONAL HEALTH CENTERS INC | |||||||||||
| 10501 CORPORATE DRIVE | FORT WAYNE | IN | 46845 | 352064353 | OCCUP HEALTH | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM 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 | |
| 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 | |
| HUNTINGTON MEMORIAL HOSPITAL INC | |||||||||||
| 2001 STULTS ROAD | HUNTINGTON | IN | 46750 | 351970706 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM 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 | |
| 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 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH LLC | ||||||||||
| 10501 CORPORATE DRIVE | FORT WAYNE | IN | 46845 | 260143823 | ORTHO HOSPITAL | IN | N/A | N/A | 0 | 0 |
| FOUNDATION SURGERY AFFILIATE OF FORT WAYNE LLC | ||||||||||
| 8004 CARNEGIE BLVD | FORT WAYNE | IN | 46804 | 201394120 | SURGICAL SERVICES | 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 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| 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 | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| WHITLEY MEMORIAL HOSPITAL FOUNDATION INC | ||
| B | $103,231 | PART VII SUPPLEMENTAL INFORMATION |
| WHITLEY MEMORIAL HOSPITAL FOUNDATION INC | ||
| C | $33,505 | PART VII SUPPLEMENTAL INFORMATION |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART V, LINE 2, COLUMN (C): | FormAndLineReferenceDesc |
| Explanation | THE AMOUNTS REPORTED AS TRANSACTIONS WITH RELATED ORGANIZATIONS ARE CONSISTENT WITH THE AMOUNTS REPORTED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS UNDER THE GENERALLY ACCEPTED ACCOUNTING STANDARDS DEPENDING ON THE TYPE OF TRANSACTION INVOLVED. | ExplanationTxt |