PARKVIEW WABASH HOSPITAL INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- PARKVIEW WABASH HOSPITAL INC (EIN 47-1753440)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-12
- IRS object ID
- 201723169349300122
- Schema version
- 2016v3.0
- 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 K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-12T15:17:44-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | 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 HORWATH 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 | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 471753440 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PARKVIEW WABASH HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PARK | BusinessNameControlTxt |
| Phone | 2603738429 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 710 N EAST STREET | AddressLine1Txt |
| City | WABASH | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46992 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEANNE' WICKENS | PersonNm |
| Person Title | PH CFO | PersonTitleTxt |
| Phone | 2603738407 | PhoneNum |
| Signature | 2017-11-12 | 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 |
| Self Employed | Yes (X) | SelfEmployedInd |
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 | 2017-11-12 | IPDt |
| IP Tm | 16:04:17 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | BD78C0151F32BCCEC501E79B474C54CD1328F117 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | BD78C0151F32BCCEC501E79B474C54CD1328F117 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | 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 | $37,275,889 | 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 | 2014 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | PARKVIEW WABASH HOSPITAL, INC. WORKS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND PROVIDES QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 226 | TotalEmployeeCnt |
| Total Volunteers | 62 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $44,474,227 | PYContributionsGrantsAmt |
| CY Contributions Grants | $21,552 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $37,382,228 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $36,885,118 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,271 | CYInvestmentIncomeAmt |
| PY Other Revenue | $382,768 | PYOtherRevenueAmt |
| CY Other Revenue | $296,403 | CYOtherRevenueAmt |
| PY Total Revenue | $82,239,223 | PYTotalRevenueAmt |
| CY Total Revenue | $37,205,344 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $3,115,017 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $174,991 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,285,901 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,189,108 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $26,567,773 | PYOtherExpensesAmt |
| CY Other Expenses | $32,328,640 | CYOtherExpensesAmt |
| PY Total Expenses | $41,968,691 | PYTotalExpensesAmt |
| CY Total Expenses | $44,692,739 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $40,270,532 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$7,487,395 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $27,772,217 | TotalAssetsBOYAmt |
| Total Assets EOY | $50,740,298 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $21,093,064 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $51,484,189 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,679,153 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$743,891 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PARKVIEW WABASH HOSPITAL, INC. WORKS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND PROVIDES QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $37,172,463 | ExpenseAmt |
| Grant | $174,991 | GrantAmt |
| Revenue | $37,069,842 | RevenueAmt |
| Desc | PARKVIEW WABASH HOSPITAL, INC. IS A NOT-FOR-PROFIT, 25-BED CRITICAL ACCESS FACILITY. PARKVIEW WABASH HOSPITAL, INC. IS FULLY ACCREDITED BY THE JOINT COMMISSION. BOTH A MEDICAL-SURGICAL UNIT AND A CONSTANT CARE UNIT ARE AVAILABLE, AS WELL AS LAB, IMAGING, SURGICAL AND EMERGENCY SERVICES, ONCOLOGY, CARDIAC REHAB, PHYSICAL THERAPY, SENIOR BEHAVIORAL HEALTH AND AN IN-HOUSE SLEEP LAB. PATIENTS HAVE ACCESS TO 14 PARKVIEW PHYSICIANS GROUP PRIMARY CARE AND SPECIALTY PROVIDERS AND MORE THAN 20 VISITING SPECIALISTS. MORE THAN SIXTY MEN AND WOMEN MAKE UP AN ACTIVE VOLUNTEER PROGRAM AT PARKVIEW WABASH HOSPITAL, INC. THEY WELCOME VISITORS AT BOTH THE MAIN (SEE SCHEDULE O FOR CONTINUATION)ENTRANCE AND EMERGENCY ROOM ENTRANCE, TAKE PEOPLE TO THEIR DESTINATIONS, SERVE AS SURGERY HOSTS, HELP WITH OFFICE WORK, ACT AS CHAPLAIN ASSISTANTS AND RUN OUR GIFT SHOP.FINANCIAL ASSISTANCE:PARKVIEW WABASH HOSPITAL, INC. IS COMMITTED TO MAKING MEDICALLY NECESSARY HEALTHCARE ACCESSIBLE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. PATIENTS WHOSE FAMILY INCOME DOES NOT EXCEED TWICE THE FEDERAL POVERTY GUIDELINES MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. A FINANCIAL COUNSELOR IS AVAILABLE TO HELP PATIENTS NAVIGATING THIS PROCESS.COMMUNITY OUTREACH:PARKVIEW WABASH HOSPITAL, INC. IS ONE OF THE LARGEST EMPLOYERS IN WABASH COUNTY AND BELIEVES STRONGLY IN GIVING BACK TO THE COMMUNITY IT SERVES. THE HOSPITAL NOT ONLY SPONSORS ITS OWN EVENTS AND OUTREACH PROGRAMS EACH YEAR, BUT ALSO TAKES AN ACTIVE ROLE IN NUMEROUS OTHER HEALTH FAIRS, FESTIVALS, EDUCATION, PARADES, AND COMMUNITY EVENTS. THE MANAGEMENT AND CO-WORKERS OF PARKVIEW WABASH HOSPITAL, INC. PARTICIPATE IN NUMEROUS VOLUNTEER ACTIVITIES THROUGHOUT THE YEAR TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY.WITH OUR COMMUNITY HEALTH PARTNERS PROGRAM, PARKVIEW WABASH HOSPITAL, INC. INVESTS IN KEY ORGANIZATIONS THAT PROMOTE THE HEALTHY LIFESTYLE CHOICES AND WELL-BEING OF INDIVIDUALS, CHILDREN, AND FAMILIES OF WABASH. IN THE CALENDAR YEAR 2016, THE HOSPITAL SELECTED 8 COMMUNITY AGENCIES OR ORGANIZATIONS TO SUPPORT AND COLLABORATE IN ADDRESSING OUR FOCUS AREAS OF SMOKING CESSATION AND OBESITY. SAMPLINGS OF THOSE PROJECTS INCLUDE:-NEIGHBORS WALK-A-THON - PARKVIEW WABASH HOSPITAL, INC. PROVIDED THE WATER STATION AND A SNACK FOR MORE THAN 500 KIDS IN GRADES K-4 DURING THEIR ANNUAL WALK AT PARADISE SPRING PARK.-THE HOSPITAL SPONSORED THE YMCA'S WATER SAFETY INITIATIVE PROGRAM. THE FOUR-WEEK PROGRAM TEACHES WATER SAFETY AND SWIM SKILLS FOR 3RD, 4TH AND 5TH GRADES.-PARKVIEW WABASH HOSPITAL, INC. PROVIDES A BOOTH AT KINDERGARTEN ROUND-UP, TEACHING PROPER HAND HYGIENE SKILLS.PRIMARY HEALTH CARE ACCESS:PARKVIEW WABASH HOSPITAL, INC. PROVIDES SUPPORT TO 85 HOPE, WABASH COUNTY'S FREE HEALTH CLINIC, BY OFFERING GENEROUS DISCOUNTS ON LAB AND IMAGING SERVICES FOR THEIR UNINSURED ADULT PATIENTS. | Desc |
| Total Program Service Expenses | $37,172,463 | 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 | Yes (1) | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | 27 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 226 | 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| 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 (21 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 |
|---|---|---|---|---|---|---|---|---|---|
| MARILYN CUSTER-MITCHELL | |||||||||
| DIRECTOR/WBHOS PRESIDENT | 40.00 | 1.00 | Yes (X) | Yes (X) | $288,490 | $0 | $81,162 | ||
| MICHAEL PACKNETT | |||||||||
| DIRECTOR/PH PRESIDENT & CEO | 1.00 | 56.00 | Yes (X) | Yes (X) | $0 | $2,067,010 | $712,544 | ||
| RICK HENVEY | |||||||||
| DIRECTOR/PH CHIEF OPERATING OFFICER | 1.00 | 40.00 | Yes (X) | $0 | $853,904 | $141,214 | |||
| DOUGLAS SPARKS | |||||||||
| DIRECTOR/PH PHYSICIAN | 1.00 | 41.00 | Yes (X) | $21,353 | $521,003 | $57,518 | |||
| JAMES BAIN | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $12,000 | $0 | $0 | |||
| KEVIN BOWMAN | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $4,750 | $0 | $0 | |||
| JASON CALLAHAN | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $4,250 | $0 | $0 | |||
| ROGER CROMER | |||||||||
| DIRECTOR/CHAIR | 1.00 | 2.00 | Yes (X) | $6,500 | $2,750 | $0 | |||
| PATTY GRANT | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $5,750 | $0 | $0 | |||
| HOWARD HALDERMAN | |||||||||
| DIRECTOR/VICE CHAIR | 1.00 | 0.00 | Yes (X) | $4,500 | $0 | $0 | |||
| ROBERT PEARSON | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $4,250 | $0 | $0 | |||
| KELLY STOUFFER | |||||||||
| DIRECTOR/SECRETARY/TREASURER | 1.00 | 0.00 | Yes (X) | $4,500 | $0 | $0 | |||
| KENT TERRILL | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $4,250 | $0 | $0 | |||
| JEANNE' WICKENS | |||||||||
| PH CHIEF FINANCIAL OFFICER | 1.00 | 56.00 | Yes (X) | $0 | $372,369 | $79,329 | |||
| STANTON RISSER | |||||||||
| INTERIM PH CFO - PARTIAL YEAR/PH VP | 1.00 | 56.00 | Yes (X) | $0 | $318,160 | $67,612 | |||
| CATHY WOLFE | |||||||||
| WBHOS VP PATIENT CARE | 40.00 | 0.00 | $163,602 | $0 | $46,288 | Yes (X) | |||
| SHERRY SCHOENING | |||||||||
| WBHOS MGR REHAB | 40.00 | 0.00 | $132,631 | $0 | $40,919 | Yes (X) | |||
| LISA KROH | |||||||||
| WBHOS PHARMACIST | 46.00 | 0.00 | $126,334 | $0 | $15,458 | Yes (X) | |||
| MARLA CUMMINS | |||||||||
| WBHOS MGR CLINIC HOME HEALTH | 40.00 | 0.00 | $111,285 | $0 | $29,187 | Yes (X) | |||
| JOSE ANGELITO SIMPAO | |||||||||
| WBHOS PHYSICAL THERAPIST | 44.00 | 0.00 | $106,757 | $0 | $20,797 | Yes (X) | |||
| TONIA RICHARDS | |||||||||
| WBHOS PHYSICAL THERAPIST | 40.00 | 1.00 | $103,451 | $1,941 | $21,645 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,104,653 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,137,137 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,313,673 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PROFESSIONAL EMERGENCY PHYSICIANS INC | |||||
| 3640 NEW VISION DR STE A | FORT WAYNE | IN | 46845 | PHYSICIANS | $1,666,047 |
| PARKVIEW HOSPITAL INC | |||||
| 11109 PARKVIEW PLAZA DRIVE | FORT WAYNE | IN | 46845 | LABORATORY SERVICES | $1,308,912 |
| NORTHEAST INTERNAL MEDICINE ASSOC INC | |||||
| 2500 N DETROIT ST | LAGRANGE | IN | 46761 | HOSPITALISTS | $331,921 |
| CROSS COUNTRY STAFFING | |||||
| PO BOX 404674 | ATLANTA | GA | 303844674 | NURSES | $182,520 |
| MED SOLUTIONS TEMP STAFFING | |||||
| 1010 N 102ND ST SUITE 300 | OMAHA | NE | 68114 | NURSES | $174,535 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $21,552 | RelatedOrganizationsAmt |
| Total Contributions | $21,552 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE | 622000 | $36,275,426 | $36,275,426 |
| PHARMACY | 446110 | $366,752 | $366,752 |
| PULMONARY REHAB | 621990 | $129,106 | $129,106 |
| INTERUNIT RENT | 531120 | $60,249 | $60,249 |
| HOME BOUND MEALS | 900099 | $35,323 | $35,323 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,262 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,262 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $36,885,118 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $17,664 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $70,545 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$52,881 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$52,881 | TotalRevenueColumnAmt |
| Exclusion | -$52,881 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,271 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,271 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,271 | TotalRevenueColumnAmt |
| Exclusion | $2,271 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| WABASH MRI LLC | 532000 | $184,724 | $184,724 | |
| CAFETERIA SALES | 722210 | $157,868 | $157,868 | |
| FITNESS CENTER - EMPLOYEE | 713940 | $6,692 | $6,692 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $349,284 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,205,344 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $37,069,842 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $113,950 | 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 | $174,991 | TotalAmt |
| Program Services | $174,991 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $653,927 | TotalAmt |
| Management And General | $653,927 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,637,321 | TotalAmt |
| Program Services | $8,637,321 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,897,860 | TotalAmt |
| Program Services | $2,897,860 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,336,375 | TotalAmt |
| Program Services | $4,678,325 | ProgramServicesAmt |
| Management And General | $658,050 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,458,160 | TotalAmt |
| Program Services | $1,308,250 | ProgramServicesAmt |
| Management And General | $149,910 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $882,595 | TotalAmt |
| Program Services | $864,644 | ProgramServicesAmt |
| Management And General | $17,951 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,130 | TotalAmt |
| Program Services | $108,773 | ProgramServicesAmt |
| Management And General | $11,357 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,638 | TotalAmt |
| Program Services | $22,540 | ProgramServicesAmt |
| Management And General | $4,098 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $310,214 | TotalAmt |
| Program Services | $310,214 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,031,624 | TotalAmt |
| Program Services | $4,992,975 | ProgramServicesAmt |
| Management And General | $38,649 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,698 | TotalAmt |
| Program Services | $42,369 | ProgramServicesAmt |
| Management And General | $36,329 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| CORP SERVICE ALLOCATION | $5,884,000 | $5,884,000 | |
| PH SUBSIDY | $5,753,846 | $5,753,846 | |
| MEDICAL SUPPLIES | $3,701,934 | $3,701,934 | |
| BAD DEBT | $3,594,891 | $3,594,891 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,535 | TotalAmt |
| Program Services | $83,530 | ProgramServicesAmt |
| Management And General | $66,005 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,692,739 | TotalAmt |
| Program Services | $37,172,463 | ProgramServicesAmt |
| Management And General | $7,520,276 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,955 | BOYAmt |
| EOY | $1,904 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $441,601 | BOYAmt |
| EOY | $1,638,561 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,689,561 | BOYAmt |
| EOY | $5,116,915 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $379,758 | BOYAmt |
| EOY | $271,190 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $84,763 | BOYAmt |
| EOY | $54,115 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $30,059,852 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,954,023 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,564,916 | BOYAmt |
| EOY | $20,105,829 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $23,536,873 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$270,967 | BOYAmt |
| EOY | -$22,339 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $880,630 | BOYAmt |
| EOY | $37,250 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,772,217 | BOYAmt |
| EOY | $50,740,298 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $739,546 | BOYAmt |
| EOY | $3,481,747 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $25,036,995 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $242,633 | BOYAmt |
| EOY | $240,943 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,110,885 | BOYAmt |
| EOY | $22,724,504 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,093,064 | BOYAmt |
| EOY | $51,484,189 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,679,153 | BOYAmt |
| EOY | -$743,891 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,679,153 | BOYAmt |
| EOY | -$743,891 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,772,217 | BOYAmt |
| EOY | $50,740,298 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$7,487,395 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $447 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $63,904 | 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
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,426 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,426 | 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 AND AMERICAN HOSPITAL ASSOCIATION USED FOR LOBBYING ACTIVITIES | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $695,012 | BeginningYearBalanceAmt |
| Contributions | $1,000 | ContributionsAmt |
| Investment Earnings Or Losses | $12,689 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $708,701 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $615,245 | BeginningYearBalanceAmt |
| Contributions | $17,427 | ContributionsAmt |
| Investment Earnings Or Losses | $62,340 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $695,012 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $985,290 | OtherCostOrOtherBasisAmt |
| Book Value | $985,290 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,662,929 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,265,707 | DepreciationAmt |
| Book Value | $12,397,222 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,085,074 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,688,316 | DepreciationAmt |
| Book Value | $1,396,758 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,326,559 | OtherCostOrOtherBasisAmt |
| Book Value | $5,326,559 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $20,105,829 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO/FROM INTERUNIT | $21,756,549 |
| EST MEDICARE/MEDICAID SETTLEMENTS | $967,955 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $22,724,504 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | ENDOWMENT FUNDS ARE USED FOR THE ORGANIZATION'S PROGRAMS AND OPERATIONS RELATED TO PATIENT-FOCUSED CARE. |
| PART X, LINE 2: | PARKVIEW HEALTH SYSTEM, INC. AND SUBSIDIARIES - NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES THE LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): PAGE 16 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, 2016 AND 2015, 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 2012 AND PRIOR. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | 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 | $849,734 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $849,734 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02070 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,354,565 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,154,498 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,200,067 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02920 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,648,962 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,492,477 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,156,485 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02810 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,853,261 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,646,975 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,206,286 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07800 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $246,929 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,231 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $239,698 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00580 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $83,893 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $83,893 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $330,822 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,231 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $323,591 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00780 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,184,083 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,654,206 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,529,877 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08580 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,594,891 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $35,113 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $10,373,386 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,362,572 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,010,814 | 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 |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 WABASH MRI LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | EQUIPMENT LEASING | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.75000 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0.01670 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.23330 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | PARKVIEW WABASH HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 710 N EAST STREET | AddressLine1Txt |
| City | WABASH | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46992 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PARKVIEW.COM | WebsiteAddressTxt |
| State License | 16-005094-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PARKVIEW WABASH 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 | WWW.PARKVIEW.COM | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.PARKVIEW.COM | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.PARKVIEW.COM | 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 |
|---|---|
| PARKVIEW WABASH HOSPITAL, INC. | PART V, SECTION B, LINE 5: THE RESEARCH TEAM WORKED TO ENSURE THAT THE NEEDS OF THE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS WERE TAKEN INTO ACCOUNT DURING THE COURSE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE SURVEY SAMPLE WAS STRATIFIED TO ENSURE THAT POPULATION SUBSETS WERE REPRESENTED ACCURATELY. SURVEYING OF PUBLIC HEALTH OFFICIALS, OTHER HEALTHCARE PROFESSIONALS AND VARIOUS SOCIAL SERVICE ORGANIZATIONS THAT SPECIALIZE IN AIDING VULNERABLE POPULATIONS IN THE SEVEN-COUNTY AREA WAS ALSO CONDUCTED. ADDITIONALLY, THE ASSESSMENT TEAM CONDUCTED TARGETED FOCUS GROUPS WITH POTENTIALLY VULNERABLE POPULATIONS, INCLUDING THE HISPANIC/LATINO AND AFRICAN AMERICAN POPULATIONS. THE AMISH POPULATION WAS RANDOMLY SURVEYED THROUGH A WRITTEN SURVEY. INFORMATION GAINED THROUGH FOCUS GROUPS AND WRITTEN SURVEYS HELPED TO GAIN INSIGHT INTO THE HEALTH NEEDS AND PERCEPTIONS OF THESE SUB-POPULATION GROUPS TO BETTER UNDERSTAND KEY PUBLIC HEALTH AND HEALTHCARE ISSUES. |
| PARKVIEW WABASH HOSPITAL, INC. | PART V, SECTION B, LINE 6A: PARKVIEW HOSPITAL, INC. (EIN 35-0868085); COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. (EIN 20-2401676); COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. (EIN 35-2087092); HUNTINGTON MEMORIAL HOSPITAL, INC. (EIN 35-1970706); WHITLEY MEMORIAL HOSPITAL, INC. (EIN 35-1967665) AND ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH, LLC (EIN 26-0143823). |
| PARKVIEW WABASH HOSPITAL, INC. | PART V, SECTION B, LINE 6B: PARKVIEW HEALTH, INC. (EIN 35-1972384); INDIANA PARTNERSHIP FOR HEALTHY COMMUNITIES (A PARTNERSHIP BETWEEN THE INDIANA UNIVERSITY RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH AND THE POLIS CENTER AT IUPUI) AND CONDUENT HEALTHY COMMUNITIES INSTITUTE. |
| PARKVIEW WABASH HOSPITAL, INC. | PART V, SECTION B, LINE 11: SIGNIFICANT HEALTH NEEDS BEING ADDRESSED:OBESITY -- PARKVIEW WABASH HOSPITAL WILL CONTINUE PROGRAMS ESTABLISHED FROM 2014 THROUGH 2016 TO ADDRESS OBESITY IN WABASH COUNTY. ACTIONS TO ADDRESS THE ISSUE OF OBESITY CENTER AROUND PROGRAMS THAT ENGAGE CHILDREN AND FAMILIES AND INCLUDE THE FOLLOWING PROGRAMS:-MID-WEEK FARMERS MARKET-OJ NEIGHBORS ELEMENTARY FIT CLUB-COMMUNITY-BASED DIABETES EDUCATION PROGRAM-DIABETES CLASSESMATERNAL/CHILD HEALTH -- PARKVIEW WABASH HOSPITAL CLOSED ITS OBSTETRICS UNIT IN 2004. THE UNIT WILL BE REOPENED IN THE REPLACEMENT FACILITY IN JUNE 2018. STRATEGIES INCLUDE THE FOLLOWING:-HIRING A BIRTH PLANNER/LACTATION CONSULTANT IN 2017 TO BEGIN PROGRAMS FOR NEW AND EXPECTANT MOMS IN WABASH COUNTY-IMPLEMENTING PROGRAMS DESIGNED TO REDUCE RISKS AND INCREASE HEALTHY BEHAVIORS AMONG PREGNANT WOMEN-PROMOTING THE SERVICES OF CATHERINE REESE, MD, AND SHELLEY BOONE, NP, TO IMPROVE ACCESS TO PRENATAL CARE-INCREASING EFFORTS TO RAISE AWARENESS AND BUILD RELATIONSHIPS WITH COMMUNITY PARTNERSOTHER HEALTH NEEDS NOT BEING ADDRESSED: TOBACCO USE - THE WABASH COUNTY TOBACCO FREE COALITION IS THE LEAD ORGANIZATION IN WABASH COUNTY RELATED TO TOBACCO FREE EFFORTS. THE COALITION PROVIDES INFORMATION ON RESOURCES ABOUT LOCAL SMOKING CESSATION PROGRAMS AND ADVOCATES FOR NO-SMOKING PUBLIC POLICY. PARKVIEW WABASH HOSPITAL IS REPRESENTED ON THEIR BOARD OF DIRECTORS AND ALSO FUNDS THEIR "DON'T START SMOKING" PROGRAM FOR ALL 2ND AND 5TH GRADERS IN THE COUNTY THROUGH A CHI GRANT. THE HOSPITAL IS ALSO A TOBACCO FREE CAMPUS. DIABETES, CARDIOVASCULAR DISEASE AND CANCER - WHILE PARKVIEW WABASH HOSPITAL DID NOT SELECT THESE CHRONIC DISEASES AS TOP HEALTH PRIORITIES, OUR REGISTERED DIETITIAN IS ALSO A CERTIFIED DIABETIC EDUCATOR. SHE WORKS WITH PATIENTS ON A ONE-ON-ONE BASIS THROUGH PHYSICIAN REFERRAL AND INPATIENT CONSULTS. ADDITIONALLY, SHE PARTNERS WITH 85 HOPE AND MANCHESTER UNIVERSITY TO PROVIDE 3-4 PROGRAMS PER YEAR ON DIABETES EDUCATION AND PREVENTION. DRUGS/ALCOHOL ABUSE AND ADDICTION - ALTHOUGH PARKVIEW WABASH HOSPITAL DID NOT SELECT THIS AS A TOP PRIORITY, WE DO RECOGNIZE IT AS AN ISSUE THAT NEEDS ATTENTION. PWB PRESIDENT MARILYN CUSTER-MITCHELL WILL CONVENE A MEETING OF COMMUNITY STAKEHOLDERS IN JUNE/JULY WITH THE GOAL OF SHARING INFORMATION AND DATA ON THE CURRENT SITUATION IN WABASH COUNTY. THE INTENDED OUTCOME IS AN ONGOING TASK FORCE THAT WILL FORM AND FOCUS EFFORTS ON THE ISSUE. SEXUALLY TRANSMITTED DISEASES (STDS) - THE WABASH COUNTY HEALTH DEPARTMENT IS THE MAIN RESOURCE IN OUR COUNTY FOR INDIVIDUALS WITH THESE NEEDS. CHRONIC KIDNEY DISEASE - PARKVIEW WABASH HOSPITAL HAS DONE RESEARCH OVER THE YEARS ON THE NEED FOR ADDITIONAL RESOURCES IN THIS AREA. FOR INSTANCE, ALL THREE NATIONAL COMPANIES WHO PROVIDE DIALYSIS HAVE CONDUCTED EVALUATIONS OF THE NEED WITHIN WABASH COUNTY AND DETERMINED IT WAS NOT BENEFICIAL TO BRING DIALYSIS TO WABASH COUNTY. THERE ARE COMPANIES THAT PROVIDE THE SERVICE IN THE COUNTIES NEIGHBORING WABASH. PARKVIEW WABASH HOSPITAL MET WITH THE LOCAL PUBLIC TRANSIT PROVIDER AND THEY AGREED TO RELAX THEIR "IN-COUNTY" RULE TO TRANSPORT RESIDENTS IN NEED OF MEDICAL CARE IN A NEIGHBORING COUNTY. ASTHMA - WHILE ASTHMA WAS NOT SELECTED AS A TOP HEALTH PRIORITY, 85 HOPE, THE LOCAL FREE CLINIC, PROVIDES ASTHMA EDUCATION TO ITS PATIENTS. THE PROGRAM INCLUDES EDUCATION, INFORMATION, AND STRATEGIES FOR FOLLOW-UP CARE THAT ARE BOTH INEXPENSIVE AND EFFECTIVE. AGING - WABASH COUNTY OFFERS A VIBRANT AND ACTIVE SENIOR CENTER. THE DALLAS WINCHESTER SENIOR CENTER OFFERS MEALS MONDAY THROUGH FRIDAY, PRESCRIPTION ASSISTANCE, A FOOD PANTRY, PUBLIC TRANSPORTATION, SOCIAL EVENTS, PHYSICAL ACTIVITIES AND CONNECTIONS TO RESOURCES THAT BENEFIT SENIORS IN OUR COMMUNITY. MENTAL HEALTH - AREA RESIDENTS HAVE ACCESS TO A NUMBER OF RESOURCES IN THE COMMUNITY. THE BOWEN CENTER, FRIENDS COUNSELING CENTER AND MENTAL HEALTH AMERICA OF WABASH COUNTY EACH SERVE PEOPLE OF ALL AGES. PARKVIEW WABASH HOSPITAL ALSO PARTNERS WITH MHA OF WABASH COUNTY TO FUND THEIR MENTAL HEALTH FIRST AID COURSES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 7 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - THE REHAB PLACE | ||||
| 500 S CASS STREET | WABASH | IN | 46992 | PHYSICAL THERAPY |
| 2 - WABASH-MIAMI HOME HEALTH CARE & HOSPICE | ||||
| 400 ASH STREET | WABASH | IN | 46992 | OFFICES FOR HOME HEALTH CARE & HOSPICE |
| 3 - AUTUMN RIDGE REHABILITATION CENTRE | ||||
| 600 WABASH AVENUE | WABASH | IN | 46992 | LAB DRAW SITE |
| 4 - WELLBROOKE OF WABASH | ||||
| V20 JOHN KISSINGER DRIVE | WABASH | IN | 46992 | LAB DRAW SITE |
| 5 - MILLERS EAST | ||||
| 1900 ALBER STREET | WABASH | IN | 46992 | LAB DRAW SITE |
| 6 - MILLERS WEST | ||||
| 1720 ALBER STREET | WABASH | IN | 46992 | LAB DRAW SITE |
| 7 - VERNON MANOR | ||||
| 1955 VERNON STREET | WABASH | IN | 46992 | LAB DRAW SITE |
Supplemental Information Detail SupplementalInformationDetail (14 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 7: | PART I, LINE 7APARKVIEW WABASH HOSPITAL, INC. IS COMMITTED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS UNABLE TO MEET THEIR FINANCIAL OBLIGATIONS. IT IS FURTHERMORE THE POLICY OF PARKVIEW WABASH HOSPITAL, INC. NOT TO WITHHOLD OR DENY ANY REQUIRED MEDICAL CARE AS A RESULT OF A PATIENT'S FINANCIAL INABILITY TO PAY HIS/HER MEDICAL EXPENSES.THE FINANCIAL ASSISTANCE COST REPORTED ON LINE 7A IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE FINANCIAL ASSISTANCE CHARGES FOREGONE ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF SERVICES RENDERED.PART I, LINE 7BPARKVIEW WABASH HOSPITAL, INC. ACCEPTS ALL MEDICAID, MEDICAID MANAGED CARE, AND OUT-OF-STATE MEDICAID PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEDICAID PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING MEDICAID, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE UNREIMBURSED MEDICAID COST REPORTED ON LINE 7B IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE MEDICAID CHARGES ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF MEDICAID SERVICES RENDERED. THEN, THE COST OF MEDICAID SERVICES RENDERED IS DEDUCTED FROM THE REIMBURSEMENT RECEIVED FOR MEDICAID PATIENTS TO ARRIVE AT A GAIN/(LOSS) RELATIVE TO THESE PATIENTS.PART I, LINE 7CPARKVIEW WABASH HOSPITAL, INC. ACCEPTS ALL CERTAIN MEANS-TESTED PATIENTS FROM THE HEALTHY INDIANA PLAN (HIP) WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEANS-TESTED PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING HIP, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE UNREIMBURSED HIP COST REPORTED ON LINE 7C IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE HIP CHARGES ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF HIP SERVICES RENDERED. THEN, THE COST OF HIP SERVICES RENDERED IS DEDUCTED FROM THE REIMBURSEMENT RECEIVED FOR HIP PATIENTS TO ARRIVE AT A GAIN/(LOSS) RELATIVE TO THESE PATIENTS.PART I, LINE 7EAMOUNTS PRESENTED ARE BASED ON ACTUAL SPEND FOR THOSE SERVICES AND BENEFITS PROVIDED DEEMED TO IMPROVE THE HEALTH OF THE COMMUNITIES IN WHICH WE SERVE AND CONFORM WITH THE MISSION OF OUR EXEMPT PURPOSE.PART I, LINE 7IIN KEEPING WITH OUR MISSION AND COMMITMENT TO THE COMMUNITIES IN WHICH WE SERVE, PARKVIEW WABASH HOSPITAL, INC. CONTINUES ITS TRADITION OF CONTRIBUTING TO NUMEROUS ORGANIZATIONS ON BOTH AN AS-NEEDED BASIS AND NEGOTIATED BASIS. AMOUNTS PRESENTED REPRESENT ACTUAL SPEND TO ORGANIZATIONS THROUGHOUT OUR COMMUNITIES. |
| PART I, LN 7 COL(F): | PERCENT OF TOTAL EXPENSEPARKVIEW WABASH HOSPITAL, INC. EXCLUDED $3,594,891 OF BAD DEBT EXPENSE. |
| 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 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 14 OF ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | COMMUNITY BENEFIT & METHODOLOGY FOR DETERMINING MEDICARE COSTSSUBSTANTIAL SHORTFALLS TYPICALLY ARISE FROM PAYMENTS THAT ARE LESS THAN THE COST TO PROVIDE THE CARE OR SERVICES AND DO NOT INCLUDE ANY AMOUNTS RELATING TO INEFFICIENT OR POOR MANAGEMENT. PARKVIEW WABASH HOSPITAL, INC. ACCEPTS ALL MEDICARE PATIENTS, AS REFLECTED ON THE YEAR-END MEDICARE COST REPORT, WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. HOWEVER, MEDICARE PAYMENTS REPRESENT A PROXY OF COST CALLED THE "UPPER PAYMENT LIMIT." IT HAS HISTORICALLY BEEN ASSUMED THAT UPPER PAYMENT LIMIT PAYMENTS DO NOT GENERATE A SHORTFALL. AS A RESULT, PARKVIEW WABASH HOSPITAL, INC. HAS TAKEN THE POSITION NOT TO INCLUDE THE MEDICARE SHORTFALLS OR SURPLUSES AS PART OF COMMUNITY BENEFIT. PARKVIEW WABASH HOSPITAL, INC. RECOGNIZES THAT THE SHORTFALL OR SURPLUS FROM MEDICARE DOES NOT INCLUDE THE COSTS AND REVENUES ASSOCIATED WITH MEDICARE ADVANTAGE PATIENTS. AS SUCH, THE TOTAL SHORTFALL OR SURPLUS OF MEDICARE IS UNDERSTATED DUE TO THE COSTS AND REVENUES ASSOCIATED WITH MEDICARE ADVANTAGE PATIENTS NOT BEING INCLUDED IN THE COMMUNITY BENEFIT DETERMINATION. |
| PART III, LINE 9B: | IF THE PATIENT CANNOT PAY IN FULL, THE OPTION OF A LOW INTEREST LOAN IS AVAILABLE WITH THE SAME DISCOUNT OFFERED FOR CASH PAYMENTS AS LONG AS THE LOAN IS ARRANGED WITHIN 30 DAYS OF THE FIRST GUARANTOR STATEMENT. IF THE PATIENT DEFAULTS ON THE LOAN, THE DISCOUNT WILL BE REVERSED AND THE PATIENT'S ACCOUNT WILL BE PLACED IN A COLLECTION AGENCY.INTEREST-FREE PAYMENTS WITH PAY-OUT NOT TO EXCEED 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 260.373.7770 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.PARKVIEW HEALTH SYSTEM, INC. INCLUDING COMMUNITY HOSPITAL OF WABASH COUNTY, INC. CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE SEVEN COUNTIES (ALLEN, HUNTINGTON, KOSCIUSKO, LAGRANGE, NOBLE, WABASH AND WHITLEY) WHERE PARKVIEW HAS HOSPITALS. ADDITIONALLY, PARKVIEW HEALTH SYSTEM, INC. PARTNERED WITH THE INDIANA PARTNERSHIP FOR HEALTHY COMMUNITIES (IPHC) TO COMPLETE MUCH OF THE FIELD WORK. IPHC CONDUCTED THE RANDOMLY SELECTED COMMUNITY MEMBER SURVEY TO OBTAIN PRIMARY DATA. THE SURVEY INSTRUMENT USED FOR THIS STUDY WAS LARGELY BASED ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM. OUR SURVEY INCLUDED CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO NATIONAL HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. IPHC ASSISTED WITH SURVEYING PUBLIC HEALTH, OTHER HEALTHCARE PROFESSIONALS, SOCIAL SERVICE AGENCIES AND OTHER COMMUNITY GROUP REPRESENTATIVES. THEY ALSO CONDUCTED SECONDARY DATA RESEARCH, DATA ANALYSIS AND FACILITATED PRIORITIZATION OF IDENTIFIED HEALTH ISSUES. A COLLECTIVE SECONDARY DATA BASE PROVIDED BY CONDUENT HEALTHY COMMUNITIES INSTITUTE WAS ALSO USED TO DETERMINE HEALTH ISSUES FOR EACH COUNTY IN THE SEVEN-COUNTY AREA. OTHER STATE AND NATIONAL SECONDARY SOURCES INCLUDED 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 US CENSUS BUREAU. CHNA REPORTS WERE PRESENTED TO AND ADOPTED BY THEIR RESPECTIVE HOSPITAL BOARD OF DIRECTORS IN 2016. COMMUNITY HOSPITAL OF WABASH COUNTY, INC. REPRESENTATIVES MAINTAIN ON-GOING RELATIONSHIPS THROUGHOUT OUR COMMUNITIES AND MEET REGULARLY WITH ORGANIZATIONS THAT SHARE THE MISSION OF IMPROVING THE HEALTH AND INSPIRING THE WELL-BEING OF OUR COMMUNITIES. HEALTH ISSUES IDENTIFIED IN THE SURVEY INCLUDED: OBESITY, TOBACCO USE, MATERNAL/CHILD HEALTH, DIABETES, CARDIOVASCULAR DISEASE, DRUG/ALCOHOL USE, CANCER, STDS, HEALTHCARE ACCESS, MENTAL HEALTH, ASTHMA, AGING AND CHRONIC KIDNEY DISEASE.THE PRIORITIZATION OF HEALTH ISSUES WAS CONDUCTED USING A MODIFIED HANLON METHOD WHICH TAKES INTO ACCOUNT THE SIZE OF THE HEALTH PROBLEM, SERIOUSNESS OF THE HEALTH PROBLEM AND THE EFFECTIVENESS OF INTERVENTIONS. THIS METHOD, CALLED THE BASIC PRIORITY RATING SYSTEM (BPRS) IS RECOMMENDED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO) FOR THE PURPOSE OF PRIORITIZING COMMUNITY HEALTH NEEDS. FROM THE LIST OF HEALTH ISSUES IDENTIFIED, THREE TOP HEALTH PRIORITIES WERE SELECTED THROUGH APPLYING THE PEARL TEST WHICH IS DESIGNED TO SCREEN OUT IMPRACTICAL OR IMPRACTICABLE INTERVENTIONS BASE ON KEY FEASIBILITY FACTORS. THESE PRIORITIES ARE: 1) OBESITY/HEALTHY LIFESTYLES; 2) MATERNAL/CHILD HEALTH.OTHER WAYS THAT COMMUNITY HOSPITAL OF WABASH COUNTY, INC. IDENTIFIES OR VERIFIES COMMUNITY HEALTH NEEDS: -OTHER COMMUNITY NEEDS ASSESSMENTS CONDUCTED BY LOCAL ORGANIZATIONS -OBSERVATIONS BY HEALTHCARE PROFESSIONALS WHO WORK WITH VULNERABLE POPULATIONS-SPECIFIC REQUESTS PROMPTED BY OBSERVATION BY OTHER PROFESSIONALS IN THE COMMUNITY |
| PART VI, LINE 3: | DESCRIBE HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.SIGNAGE AND BROCHURES ARE POSTED AND AVAILABLE AT ALL HOSPITAL POINTS OF REGISTRATION AND IN THE EMERGENCY DEPARTMENT. PATIENTS ARE OFFERED PLAIN LANGUAGE SUMMARIES OF THE FINANCIAL ASSISTANCE POLICY DURING THE REGISTRATION PROCESS AND IN EACH FOLLOW UP STATEMENT SENT TO THE PATIENT. PATIENT STATEMENTS WILL INDICATE HOW A PATIENT CAN OBTAIN FINANCIAL ASSISTANCE APPLICATIONS AND WHO THEY CAN CONTACT FOR ASSISTANCE. |
| PART VI, LINE 4: | DESCRIBE THE COMMUNITY THE ORGANIZATION SERVES, TAKING INTO ACCOUNT THE GEOGRAPHIC AREA AND DEMOGRAPHIC CONSTITUENTS IT SERVES.THE ONLY HOSPITAL IN WABASH COUNTY, PARKVIEW WABASH HOSPITAL, INC., PRIMARILY SERVES THE COMMUNITIES OF WABASH, NORTH MANCHESTER, ROANN, URBANA, LAGRO, AND LAFONTAINE. TO A LESSER EXTENT, THE HOSPITAL ALSO SERVES COMMUNITIES IN SURROUNDING COUNTIES.WABASH COUNTY HAS APPROXIMATELY 32,138 RESIDENTS, WITH 96.8% BEING CAUCASIAN AND 19.8% 65 AND OLDER. THE COUNTY'S UNEMPLOYMENT RATE IS 4.2%. THE MEDIAN HOUSEHOLD INCOME IN WABASH COUNTY IS $45,151, WITH A POVERTY RATE OF 15.2%.PARKVIEW WABASH HOSPITAL, INC., IS THE 5TH LARGEST EMPLOYER IN THE COUNTY. THE MAKE-UP OF EMPLOYERS IN THE COUNTY IS LARGELY MANUFACTURING, FOLLOWED BY EDUCATION AND HEALTHCARE. |
| PART VI, LINE 5: | PROVIDE ANY OTHER INFORMATION IMPORTANT TO DESCRIBING HOW THE ORGANIZATION'S HOSPITAL FACILITIES OR OTHER HEALTH CARE FACILITIES FURTHER ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY (EG OPEN MEDICAL STAFF, COMMUNITY BOARD, USE OF SURPLUS FUNDS, ETC.)PARKVIEW WABASH HOSPITAL, INC.'S, BOARD OF DIRECTORS IS COMPRISED PRIMARILY OF INDEPENDENT COMMUNITY MEMBERS WHO RESIDE AND WORK IN WABASH COUNTY. THE HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.PEOPLE IN OUR SERVICE AREA COMMUNITY HAVE ACCESS TO CARE 24 HOURS A DAY, 365 DAYS A YEAR THROUGH PARKVIEW WABASH HOSPITAL'S EMERGENCY DEPARTMENT (ED). THE ED IS STAFFED WITH BOARD-CERTIFIED EMERGENCY CARE PHYSICIANS AND A NURSING STAFF THAT IS TRAINED AND EXPERIENCES IN EMERGENCY CARE. ADDITIONALLY, THE HOSPITAL OFFERS FIRST CARE, A WALK-IN CLINIC OPEN FROM 8 A.M. TO 8 P.M. MONDAY THROUGH FRIDAY AND 8 A.M. TO 2 P.M. ON SATURDAYS.OUR CARE IS NOT LIMITED TO THE WALLS OF OUR BUILDING. PARKVIEW WABASH HOSPITAL, INC., OFFERS A WIDE BREADTH OF SERVICES TO ITS RURAL COMMUNITY. A FEW HIGHLIGHTS INCLUDE:ONCOLOGY: THE PARKVIEW WABASH HOSPITAL, INC.'S, ONCOLOGY PROGRAM OFFERS CANCER PATIENTS ADVANCED CHEMOTHERAPY TREATMENT CLOSE TO HOME. LAST YEAR, WE TREATED OVER 75 PATIENTS AND ADMINISTERED MORE THAN 1,000 CHEMOTHERAPY TREATMENTS. ADDITIONALLY, THE DEPARTMENT ENCOURAGES SUPPORT BEYOND TREATMENT BY PROVIDING FREE SCREENINGS, CLINICAL TRIALS AND AN ANNUAL SURVIVOR'S DAY BANQUET VIA H.O.P.E., THEIR INDEPENDENT FOUNDATION. H.O.P.E. CAN ALSO PROVIDE FINANCIAL ASSISTANCE WITH TRANSPORTATION, WIGS AND SOME MEDICATION.SURGERY: OUR MEDICAL STAFF OFFERS NOTHING LESS THAN INNOVATIVE AND INDIVIDUALIZED SURGERY OPTIONS THAT ARE RESPONSIVE TO OUR PATIENTS' NEEDS. AT PARKVIEW WABASH HOSPITAL, INC., WE'RE PROUD TO OFFER AN INCREASING NUMBER OF MINIMALLY INVASIVE OPTIONS, WHICH TYPICALLY RESULT IN LESS PAIN, A SHORTER HOSPITAL STAY AND FASTER RECOVERY. OUR SURGICAL SPECIALTIES INCLUDE: GENERAL SURGERY, UROLOGY, GYNECOLOGY, AND PODIATRY.PHYSICAL, OCCUPATIONAL, SPEECH AND SPORTS MEDICINE: THE REHAB PLACE OF PARKVIEW WABASH HOSPITAL, INC., IS AN EXCELLENT RESOURCE FOR REHABILITATION, INCLUDING PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY. WE HAVE A TEAM OF WELL-EDUCATED HEALTHCARE PROFESSIONALS WHO ARE COMMITTED TO EXCELLENCE AND SERVICE. WE HAVE THE BENEFIT OF EXPERIENCE AND EQUIPMENT WHICH RIVALS ANY FACILITY IN THE STATE TO INCLUDE AQUATIC THERAPY.PARKVIEW WABASH HOSPITAL, INC., IS ACTIVE IN THE COMMUNITY WITH A VARIETY OF PARTNERSHIPS TO INCLUDE:BE WELL WABASH COUNTY: BE WELL IS A PARTNERSHIP OF A VARIETY OF WABASH COUNTY LEADERS - HEALTHCARE, BUSINESS, INDUSTRY, EDUCATION, SOCIAL SERVICE, GOVERNMENT - WHO ARE ALL INTERESTED IN IMPROVING HEALTH COUNTY WIDE. THE MISSION IS TO MOVE WABASH COUNTY TOWARD BETTER WELL-BEING BY PROMOTING LIFE BALANCE IN THE AREAS OF COMMUNITY, PURPOSE, MIND AND BODY. UNINSURED ASSISTANCE: PARKVIEW WABASH HOSPITAL, INC., ASSISTS THOSE LESS FORTUNATE BY SUPPORTING 85 HOPE, THE COUNTY'S FREE CLINIC. EDUCATION: THE SCHOOLS ARE A KEY PARTNER FOR PARKVIEW WABASH HOSPITAL, INC. EACH YEAR WE ARE THE LEAD AGENCY IN HELPING TO PROVIDE IHSAA SPORTS PHYSICALS TO COUNTY ATHLETES. PARKVIEW WABASH HOSPITAL, INC., ALSO SPONSORS THE YMCA'S WATER SAFETY INITIATIVE PROGRAM, WHICH TEACHES COUNTY 3RD, 4TH AND 5TH GRADERS WATER SAFETY AND SWIM SKILLS. IN ADDITION, THE HOSPITAL PARTICIPATES IN CAREER PATHWAYS PROGRAMS, HOSTS STUDENT INTERNS AND PARTICIPATES IN A VARIETY OF SCHOOL EVENTS SUCH AS WALK-A-THONS, FAMILY READING NIGHTS AND 5K CHALLENGES.ATHLETIC TRAINERS: PARKVIEW WABASH HOSPITAL, INC., EMPLOYS THREE ATHLETIC TRAINERS TO WORK IN THREE WABASH COUNTY HIGH SCHOOLS. THESE TRAINERS SPEND HOURS AT A WIDE VARIETY OF ATHLETIC EVENTS TO ASSIST IF A STUDENT ATHLETE IS INJURED DURING PLAY. THEY ARE ALSO AVAILABLE DURING AND AFTER SCHOOL HOURS FOR ICING, TAPING AND STRETCHING OF ATHLETES IN NEED.HEALTH FAIRS AND SCREENINGS: PARKVIEW WABASH HOSPITAL, INC., SPONSORS AN ANNUAL HEALTH FAIR EACH OCTOBER. MORE THAN 600 PEOPLE ATTEND AND RECEIVE A WIDE VARIETY OF FREE AND DISCOUNTED HEALTH SCREENINGS AND AN ABUNDANCE OF FREE INFORMATION ON THE PROMOTION OF HEALTHY LIFESTYLES, DISEASE PREVENTION, LOCAL RESOURCES AND MORE. THE HOSPITAL ALSO PARTICIPATES IN NUMEROUS HEALTH FAIRS AND ACTIVITIES THROUGHOUT THE YEAR SPONSORED BY LOCAL BUSINESS, INDUSTRY AND SCHOOLS. EVERY MEMBER OF THE PARKVIEW WABASH HOSPITAL, INC., HEALTHCARE TEAM, REGARDLESS OF THEIR DEPARTMENT, IS RESPONSIBLE FOR NURTURING AN ENVIRONMENT OF EXCELLENCE AS THE PLACE PATIENTS WANT TO RECEIVE CARE, PHYSICIANS WANT TO PRACTICE, AND CO-WORKERS WANT TO WORK. WE UNDERSTAND THAT BY PROVIDING EXCELLENCE IN ALL WE DO, WE NOT ONLY INSURE THE SUCCESS OF PARKVIEW WABASH HOSPITAL, INC., BUT ALSO FOR THE COMMUNITY WE SERVE. |
| PART VI, LINE 6: | IF THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM, DESCRIBE THE RESPECTVE ROLES OF THE ORGANIZATION AND TIS 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. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| PARKVIEW WABASH HOSPITAL FOUNDATION INC | |||||||
| 710 N EAST STREET | WABASH | IN | 46992 | 351921445 | 501 (C) 3 | $90,000 | OPERATIONS |
| COMMUNITY FOUNDATION OF WABASH COUNTY INC | |||||||
| 2018 E MAIN STREET | N MANCHESTER | IN | 46962 | 356019016 | 501 (C) 3 | $25,000 | INCLUSIVE PARK PROJECT |
| WABASH COUNTY YMCA | |||||||
| 500 S CASS STREET | WABASH | IN | 46992 | 350733765 | 501 (C) 3 | $10,525 | YOUTH PROGRAMS & BODY COMPOSITION EQUIPMENT CAMPAIGN |
| LIVING WELL IN WABASH COUNTY | |||||||
| PO BOX 447 | WABASH | IN | 46992 | 351514343 | 501 (C) 3 | $6,500 | COUNTY TRANSIT PROGRAM |
| WABASH MARKETPLACE | |||||||
| 99 W CANAL STREET | WABASH | IN | 46992 | 351524022 | 501 (C) 3 | $5,400 | RIVERFRONT DEVELOPMENT PROJECT, WALKING PROGRAMS AND FARMER'S MARKET |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 5 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | COMMUNITY HEALTH IMPROVEMENT FUNDING PARTNER ORGANIZATIONS ARE REQUIRED TO SUBMIT AN ANNUAL PROGRESS REPORT RELATED TO PROGRAM FUNDING. PARTNER ORGANIZATIONS ARE REQUIRED TO RE-APPLY FOR FUNDING ON AN ANNUAL BASIS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARILYN CUSTER-MITCHELL | ||||||||||||||
| DIRECTOR/WBHOS PRESIDENT | $189,886 | $0 | $77,584 | $0 | $21,020 | $0 | $53,721 | $0 | $27,441 | $0 | $369,652 | $0 | $0 | $0 |
| MICHAEL PACKNETT | ||||||||||||||
| DIRECTOR/PH PRESIDENT & CEO | $0 | $999,068 | $0 | $525,000 | $0 | $542,942 | $0 | $669,350 | $0 | $43,194 | $0 | $2,779,554 | $0 | $419,516 |
| RICK HENVEY | ||||||||||||||
| DIRECTOR/PH CHIEF OPERATING OFFICER | $0 | $594,524 | $0 | $204,825 | $0 | $54,555 | $0 | $103,454 | $0 | $37,760 | $0 | $995,118 | $0 | $15,031 |
| DOUGLAS SPARKS | ||||||||||||||
| DIRECTOR/PH PHYSICIAN | $21,353 | $454,312 | $0 | $37,151 | $0 | $29,540 | $946 | $22,904 | $1,336 | $32,332 | $23,635 | $576,239 | $0 | $0 |
| JEANNE' WICKENS | ||||||||||||||
| PH CHIEF FINANCIAL OFFICER | $0 | $329,339 | $0 | $15,000 | $0 | $28,030 | $0 | $60,171 | $0 | $19,158 | $0 | $451,698 | $0 | $0 |
| STANTON RISSER | ||||||||||||||
| INTERIM PH CFO - PARTIAL YEAR/PH VP | $0 | $193,037 | $0 | $116,196 | $0 | $8,927 | $0 | $40,555 | $0 | $27,057 | $0 | $385,772 | $0 | $6,041 |
| CATHY WOLFE | ||||||||||||||
| WBHOS VP PATIENT CARE | $124,315 | $0 | $37,562 | $0 | $1,725 | $0 | $21,278 | $0 | $25,010 | $0 | $209,890 | $0 | $0 | $0 |
| SHERRY SCHOENING | ||||||||||||||
| WBHOS MGR REHAB | $114,686 | $0 | $17,531 | $0 | $414 | $0 | $15,235 | $0 | $25,684 | $0 | $173,550 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - TAX ON TAXABLE GIFT CERTIFICATE PAID TO: MARLA CUMMINS $95 |
| PART I, LINE 3 | RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF PARKVIEW HOSPITAL, INC.'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. INDEPENDENT COMPENSATION CONSULTANT 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 - RICK HENVEY $15,031; MICHAEL PACKNETT $419,516; STANTON RISSER $6,041 PARTICIPANTS DEFERRED - THE FOLLOWING INDIVIDUALS HAVE AN AMOUNT INCLUDED IN SCHEDULE J, PART II, COLUMN (C) FOR AN AMOUNT EARNED BUT NOT YET VESTED UNDER ONE OF PARKVIEW'S DEFERRED COMPENSATION PLANS. BENEFITS EARNED UNDER THE PLANS WILL FUND THE EMPLOYEES' EVENTUAL RETIREMENT BENEFIT. THESE BENEFITS ARE PROVIDED IN EXCHANGE FOR ALL OF THE EMPLOYEES' YEARS OF SERVICE TO THE ORGANIZATION, AND THE COST OF THE BENEFITS MAY VARY FROM YEAR TO YEAR. THE AMOUNTS ARE AT RISK AND WILL NOT BE PAID UNLESS AND UNTIL EACH EMPLOYEE HAS PROVIDED SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION. BENEFITS UNDER THE PLANS VEST AT THE TIME SET FORTH IN THE PLAN DOCUMENTS AND ARE FORFEITED IF THE EMPLOYEES TERMINATE EMPLOYMENT BEFORE SATISFYING THOSE PLAN CONDITIONS. MARILYN CUSTER-MITCHELL $35,171; RICK HENVEY $92,854; MICHAEL PACKNETT $645,500; STANTON RISSER $22,005; JEANNE' WICKENS $57,021; CATHY WOLFE $14,774 |
| 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 K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANA FINANCE AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 351602316 | BondIssuerEIN |
| CUSIP | NONEAVAIL | CUSIPNum |
| Bond Issued | 2016-08-17 | BondIssuedDt |
| Issue Price | $25,000,000 | IssuePriceAmt |
| Purpose | SEE PART VI | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $25,047,142 | TotalProceedsAmt |
| Capital Expenditures | $1,510,269 | CapitalExpendituresAmt |
| Unspent | $23,536,873 | UnspentAmt |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | 0 | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | Yes (1) | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (1) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | Yes (1) | EngageBondCounselContractsInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | Yes (1) | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE K, PART I,A,F: | CONSTRUCTION OF NEW HOSPITAL FACILITY FOR PARKVIEW WABASH HOSPITAL, INC. IN WABASH, INDIANA |
| SCHEDULE K, PART II,3,A: | THIS AMOUNT INCLUDES INTEREST OF $47,142. EARNED ON PROJECT FUND. |
| SCHEDULE K, PART III, LINES 4-6: | AS PART OF OUR EFFORTS TO MONITOR AND ENSURE THAT THERE IS NO PRIVATE USE AT OUR BOND FINANCED FACILITIES, WE CONTRIBUTE EQUITY TO FINANCE A PORTION OF OUR NEW MONEY PROJECTS. |
| SCHEDULE K, PART III, LINE 7: | THE BOND IS NOT A PRIVATE ACTIVITY BOND BECAUSE IT DOES NOT MEET THE PRIVATE BUSINESS USE TEST. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINES 1A AND 2A: | PARKVIEW HEALTH SYSTEM, INC. (PH), EIN 35-1972384, IS THE COMMON PAYING AGENT FOR THE FILING ORGANIZATION, PARKVIEW WABASH HOSPITAL, INC., EIN 47-1753440. THEREFORE, ALL APPLICABLE IRS TAX FILINGS, INCLUDING FORMS 1099, 1096, W-2 AND W-3 ARE REPORTED AND FILED BY PH. THE TOTAL NUMBER REPORTED IN BOX 3 OF FORM 1096 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2016 WAS 573. THE TOTAL NUMBER OF EMPLOYEES REPORTED ON FORM W-3 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2016 WAS 12,046. FOR PURPOSES OF COMPLETING FORM 990, PART V, LINE 1A AND 2A, THE NUMBER REPORTED FOR THE PARKVIEW WABASH HOSPITAL, INC. WAS 27 AND 226 RESPECTIVELY. |
| FORM 990, PART VI, SECTION A, LINE 2 | DIRECTORS MARILYN CUSTER-MITCHELL AND DOUGLAS SPARKS HAVE A BUSINESS RELATIONSHIP AS DIRECTORS ON THE BOARD OF A RELATED ENTITY. OFFICER JEANNE' WICKENS AND DIRECTOR RICK HENVEY HAVE A BUSINESS RELATIONSHIP AS DIRECTORS ON THE BOARD OF A RELATED ENTITY. OFFICER STANTON RISSER AND DIRECTOR RICK HENVEY HAVE A BUSINESS RELATIONSHIP AS DIRECTORS ON THE BOARD OF A RELATED ENTITY. DIRECTORS ROGER CROMER AND ROBERT PEARSON HAVE A BUSINESS RELATIONSHIP AS DIRECTORS ON THE BOARD OF AN UNRELATED ENTITY. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION IS ORGANIZED AS A NOT-FOR-PROFIT CORPORATION. PURSUANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, PARKVIEW HEALTH SYSTEM, INC. EIN 35-1972384 IS THE SOLE MEMBER OF PARKVIEW WABASH HOSPITAL, INC. WITH CERTAIN RESERVED POWERS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE CORPORATE MEMBER, PARKVIEW HEALTH SYSTEM, INC. EIN 35-1972384, SHALL HAVE THE FOLLOWING RESERVED POWERS: (I) APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, MEMBERS OF THE BOARD SUBJECT TO THE COMPOSITION REQUIREMENTS REGARDING COMMUNITY AND PHYSICIAN REPRESENTATION SET FORTH IN ARTICLE V, SECTION 2; (II) APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE CHAIR AND VICE CHAIR OF THE BOARD AND THE PRESIDENT OF THE CORPORATION; (III) APPROVE AND/OR REQUIRE THE ADOPTION OF AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (IV) APPROVE AND/OR REQUIRE THE ESTABLISHMENT, ACQUISITION, DIVESTITURE, DISSOLUTION, CLOSURE, MERGER, CONSOLIDATION, CHANGE IN CORPORATE MEMBERSHIP, AFFILIATION OR CORPORATE REORGANIZATION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (V) APPROVE AND ADOPT THE STRATEGIC PLAN AND ANY AMENDMENTS THERETO FOR THE CORPORATION AND ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (VI) APPROVE AND/OR REQUIRE THE INCURRENCE OF ANY DEBT, INCLUDING THE ISSUANCE OF ANY BONDS, PROPOSED BY THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION IN EXCESS OF LIMITS SPECIFIED IN THE POLICY OF THE CORPORATE MEMBER; (VII) APPROVE AND/OR REQUIRE THE APPROVAL OF CONTRACTS OR LOANS OBLIGATING THE CORPORATION TO EXPEND OR REPAY AN AMOUNT IN EXCESS OF LIMITS SPECIFIED IN THE POLICY OF THE CORPORATE MEMBER; (VIII) APPROVE AND/OR REQUIRE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE, TRANSFER, ENCUMBRANCE OR OTHER DISPOSITION OF PROPERTY AND ASSETS OF THE CORPORATION IN EXCESS OF LIMITS SPECIFIED IN THE POLICY OF THE CORPORATE MEMBER; (IX) APPROVE AND ADOPT THE CAPITAL BUDGET, OPERATING BUDGET, FINANCIAL PLANS AND ANY AMENDMENTS THERETO FOR THE CORPORATION AND ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (X) APPROVE AND/OR REQUIRE THE ADOPTION OF A MANAGED CARE POLICY FOR THE CORPORATION AND ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION, INCLUDING NETWORK PARTICIPATION, PARTICIPATION IN ANY MANAGED CARE AGREEMENT AND PARTICIPATION IN ANY OTHER HEALTH CARE SERVICE ARRANGEMENTS; (XI) APPOINT AND REMOVE AUDITORS, ATTORNEYS AND OTHER PROFESSIONAL ADVISORS FOR THE CORPORATION AND ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (XII) DEVELOP, APPROVE AND/OR REQUIRE THE ADOPTION OF MEDICAL STAFF QUALITY ASSURANCE STANDARDS, UTILIZATION REVIEW STANDARDS, CRITERIA, POLICIES AND PROCEDURES FOR THE CORPORATION AND ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (XIII) APPROVE AND/OR REQUIRE THE ADOPTION OF ANY ACTION TO CHANGE THE CORPORATION FROM A GENERAL, ACUTE CARE COMMUNITY HOSPITAL OR TO CLOSE THE CORPORATION'S CURRENT LOCATION; (XIV) APPROVE EACH ANNUAL LIST OF PROPOSED DONORS AND AMOUNTS OF DONATIONS OR GRANTS NOT INCLUDED IN THE ANNUAL BUDGET, AND MAKE PROPOSALS TO DEVIATE THEREFROM THROUGHOUT EACH YEAR IN EXCESS OF LIMITS SPECIFIED IN THE POLICY OF THE CORPORATE MEMBER; AND (XV) APPROVE AND/OR REQUIRE THE ADOPTION OF ANY ACTION THAT IS INCONSISTENT WITH THE POLICY OF THE CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7B | SEE SCHEDULE O EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A |
| FORM 990, PART VI, SECTION B, LINE 11B | PURSUANT TO PARKVIEW HEALTH SYSTEM INC.'S BYLAWS, THE SYSTEM AUDIT COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION TO PROVIDE REVIEW OF THE CORPORATION AND ITS SUBSIDIARY CORPORATIONS' FORM 990 FILINGS. PARKVIEW WABASH HOSPITAL, INC. IS A SUBSIDIARY CORPORATION OF PARKVIEW HEALTH SYSTEM, INC. AN ELECTRONIC COPY OF THE ORGANIZATION'S FINAL FORM 990 (INCLUDING SUPPLEMENTAL SCHEDULES) WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY AND THE SYSTEM AUDIT COMMITTEE, PRIOR TO FILING WITH THE IRS. ON OCTOBER 25, 2017, 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 | REGARDING LINES 15A AND 15B, TO THE EXTENT THAT THE ORGANIZATION HAS VICE PRESIDENT OR ABOVE, THE ORGANIZATION USED A PROCESS FOR DETERMINING COMPENSATION OF THE CEO, OFFICERS, AND KEY EMPLOYEES. THE PROCESS INCLUDES CONSULTATIONS WITH AN INDEPENDENT COMPENSATION ADVISOR AND THE REVIEW OF APPROPRIATE COMPARABILITY DATA; REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE OF THE GOVERNING BODY CONSISTING OF MEMBERS WHO DO NOT HAVE A CONFLICT OF INTEREST CONCERNING THE COMPENSATION; AND CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. IN 2016, THE BOARD OF PARKVIEW HEALTH SYSTEM, INC. REVIEWED AND APPROVED ALL EXECUTIVE COMPENSATION, BENEFITS AND PERQUISITES FOR THE 2016 COMPENSATION PACKAGE, PURSUANT TO THE PARKVIEW HEALTH BYLAWS. THE COMPENSATION PACKAGE WAS APPROVED BY A MAJORITY OF INDEPENDENT BOARD MEMBERS. PARKVIEW'S INDEPENDENT CONSULTANT PREPARES A COMPETITIVE COMPENSATION ANALYSIS USING DATA FROM MULTIPLE PUBLISHED SURVEYS PREPARED BY INDEPENDENT FIRMS FOR POSITIONS THAT ARE FUNCTIONALLY COMPARABLE IN SIMILAR-SIZED HEALTH SYSTEMS AND HOSPITAL ORGANIZATIONS ON BOTH A REGIONAL AND NATIONAL BASIS. THE INDEPENDENT CONSULTANT PROVIDES A STATEMENT OF REASONABLENESS OF THE COMPENSATION PROVIDED TO THE CEO AS WELL AS ALL EXECUTIVES AT THE VICE PRESIDENT LEVEL AND ABOVE. ALL DATA IS SHARED WITH THE BOARD OF DIRECTORS. THE BOARD APPROVES ANY CHANGES IN COMPENSATION FOR THE CEO AND HIS DIRECT REPORTS. APPROVAL IS ALSO PROVIDED FOR THE SALARY BUDGET FOR THE ENTIRE ORGANIZATION. THE BOARD REVIEWS AND APPROVES THE PLAN DOCUMENTS FOR THE MANAGEMENT INCENTIVE COMPENSATION PLAN (MICP) AND THE PHYSICIAN AND PROVIDER INCENTIVE COMPENSATION PLAN (PICP). OFFICES OR POSITIONS REVIEWED AT THE 2016 MEETING: PRESIDENT AND CHIEF EXECUTIVE OFFICER PARKVIEW HEALTH EXECUTIVE VICE PRESIDENT CHIEF PHYSICIAN EXECUTIVE CHIEF OPERATING OFFICER PARKVIEW HEALTH CHIEF EXPERIENCE OFFICER PHYSICIAN EXECUTIVE OFFICER PARKVIEW PHYSICIANS GROUP PRESIDENT PARKVIEW REGIONAL MEDICAL CENTER AND AFFILIATES CHIEF CLINICAL INTEGRATION OFFICER CHIEF FINANCIAL OFFICER CHIEF INFORMATION OFFICER SENIOR VICE PRESIDENT GENERAL COUNSEL SENIOR VICE PRESIDENT CHIEF OPERATING OFFICER PARKVIEW PHYSICIANS GROUP CHIEF QUALITY AND SAFETY OFFICER SENIOR VICE PRESIDENT REVENUE CYCLE AND PAYOR STRATEGIES CHIEF HUMAN RESOURCES OFFICER CHIEF NURSING EXECUTIVE SENIOR VICE PRESIDENT STRATEGIC INITIATIVES CHIEF ACADEMIC AND RESEARCH OFFICER CHIEF MEDICAL INFORMATICS OFFICER CHIEF MEDICAL OFFICER PARKVIEW PHYSICIANS GROUP MEDICAL DIRECTOR COMMUNITY HOSPITALS MEDICAL DIRECTOR INTEGRATION AND DEVELOPMENT CHIEF OPERATING OFFICER - RANDALLIA CHIEF NURSING OFFICER - PARKVIEW REGIONAL MEDICAL CENTER AND AFFILIATES PRESIDENT - PARKVIEW CANCER CENTER SENIOR VICE PRESIDENT CHIEF OPERATING OFFICER SERVICE LINE LEADER BEHAVIORAL HEALTH SENIOR VICE PRESIDENT CHIEF OPERATING OFFICER SERVICE LINE LEADER ORTHO SENIOR VICE PRESIDENT CHIEF OPERATING OFFICER SERVICE LINE LEADER HEART INSTITUTE SENIOR VICE PRESIDENT CHIEF OPERATING OFFICER SERVICE LINE LEADER CANCER INSTITUTE SENIOR VICE PRESIDENT SERVICE LINE LEADER SENIOR VICE PRESIDENT DELIVERY SYSTEM INTEGRATION SENIOR VICE PRESIDENT FACILITY DESIGN AND OVERSIGHT SENIOR VICE PRESIDENT HEALTH AND WELL-BEING SENIOR VICE PRESIDENT PARKVIEW PHYSICIANS GROUP OPERATIONS DEPLOYMENT SENIOR VICE PRESIDENT SUPPLY AND SUPPORT SERVICES PRESIDENT COMMUNITY HOSPITALS VICE PRESIDENT CLINICAL INTEGRATION VICE PRESIDENT CONSTRUCTION VICE PRESIDENT EMPLOYEE STRATEGIES VICE PRESIDENT FINANCE VICE PRESIDENT MARKETING/COMMUNICATIONS/COMMUNITY RELATIONS VICE PRESIDENT NURSING RANDALLIA VICE PRESIDENT OPERATIONS - CANCER INSTITUTE VICE PRESIDENT PATIENT CARE SERVICES COMMUNITY HOSPITALS VICE PRESIDENT PARKVIEW PHYSICIANS GROUP FINANCE VICE PRESIDENT PARKVIEW PHYSICIANS GROUP PHYSICIAN PRACTICES VICE PRESIDENT STRATEGY AND BUSINESS DEVELOPMENT VICE PRESIDENT SURGICAL SERVICES PARKVIEW REGIONAL MEDICAL CENTER AND AFFILIATES VICE PRESIDENT CLINICAL OPERATIONS - PARKVIEW PHYSICIANS GROUP VICE PRESIDENT INFORMATION SECURITY VICE PRESIDENT INTERNAL AUDIT VICE PRESIDENT TECHNOLOGY VICE PRESIDENT PATIENT CARE SERVICES - COMMUNITY HOSPITALS |
| 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 1,242,667. MANAGEMENT AND GENERAL EXPENSES 658,050. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,900,717. PROFESSSIONAL FEES: PROGRAM SERVICE EXPENSES 2,126,746. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,126,746. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 1,308,912. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,308,912. |
| 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: | BOOK/TAX DIFFERENCE WABASH MRI LLC 63,904. |
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 | |
| WABASH COUNTY HOSPITAL FOUNDATION INC | |||||||||||
| 710 N EAST ST | WABASH | IN | 46992 | 351921445 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | Yes (1) | PARKVIEW WABASH 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 | |
| WHITLEY MEMORIAL HOSPITAL INC | |||||||||||
| 1260 E STATE ROAD 205 | COLUMBIA CITY | IN | 46725 | 351967665 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| 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 | |
| HUNTINGTON MEMORIAL HOSPITAL INC | |||||||||||
| 2001 STULTS ROAD | HUNTINGTON | IN | 46750 | 351970706 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WABASH MRI LLC | ||||||||||||||
| 10501 CORPORATE DRIVE | FORT WAYNE | IN | 46845 | 204352572 | EQUIPMENT LEASING | IN | PARKVIEW WABASH HOSPITAL INC | RELATED | $184,724 | $344,909 | 0 | Yes (1) | 0.75000 | |
| ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH LLC | ||||||||||||||
| 10501 CORPORATE DRIVE | FORT WAYNE | IN | 46845 | 260143823 | ORTHO HOSPITAL | IN | N/A | 0 | 0 | N/A | ||||
| FOUNDATION SURGERY AFFILIATE OF FORT WAYNE LLC | ||||||||||||||
| 8004 CARNEGIE BLVD | FORT WAYNE | IN | 46804 | 201394120 | SURGICAL SERVICES | IN | N/A | 0 | 0 | N/A | ||||
| MANAGED CARE SERVICES LLC | ||||||||||||||
| 10501 CORPORATE DRIVE | FORT WAYNE | IN | 46845 | 351996535 | HEALTH PLAN ADMIN | IN | N/A | 0 | 0 | N/A | ||||
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 | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | 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 | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| WABASH COUNTY HOSPITAL FOUNDATION INC | ||
| B | $90,000 | PART VII SUPPLEMENTAL INFORMATION |
| WABASH COUNTY HOSPITAL FOUNDATION INC | ||
| C | $21,552 | 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 |