2023-11-09T16:27:26-06:00 2022-12-31 350921680 CROWE LLP 401 E LAS OLAS BLVD SUITE 1100 FORT LAUDERDALE FL 33301 990 2022-01-01 351064295 DEKALB MEMORIAL HOSPITAL INC DEKA 2603738429 1316 E 7TH ST AUBURN IN 467062515 JEANNE' WICKENS PH CFO 2602669313 2023-11-09 1 JEANNE WICKENS 999009999 1 BRITTNEY KOCAJ P01320603 9542028600 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z PARKVIEW DEKALB HOSPITAL RICK HENVEY 1450 PRODUCTION RD FORT WAYNE IN 468081167 124530392 0 X WWW.PARKVIEW.COM X 1964 IN IMPROVE HEALTH & PROVIDE QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US. 11 7 413 25 1647197 0 2211343 258327 73430673 73855983 1692292 272972 322540 422701 77656848 74809983 29104 25694 0 0 23610380 26522840 0 0 6324 42295374 51023879 65934858 77572413 11721990 -2762430 71850103 61926781 9059668 3822960 62790435 58103821 X DEKALB MEMORIAL HOSPITAL, INC. WORKS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND PROVIDES QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US. 0 0 64095403 25694 72208786 AS A NOT-FOR-PROFIT HOSPITAL, DEKALB MEMORIAL HOSPITAL, INC. FOCUSES ON OUR MISSION TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE AND PROVIDING A PERSONALIZED WELLNESS JOURNEY. DEKALB MEMORIAL HOSPITAL, INC. EXISTS FOR ONE PURPOSE - TO IMPROVE THE HEALTH OF OUR COMMUNITIES. DEKALB MEMORIAL HOSPITAL, INC. GIVES BACK TO THE COMMUNITY IN THE FORM OF IMPROVED FACILITIES, EDUCATION AND OUTREACH PROGRAMS, FREE AND DISCOUNTED CARE, VOLUNTEERISM AND MUCH MORE. THE FOLLOWING ARE SOME OF THE WAYS DEKALB MEMORIAL HOSPITAL, INC. IS REACHING OUT TO MAKE OUR NEIGHBORHOODS AND COMMUNITIES HEALTHIER:(SEE SCHEDULE O FOR CONTINUATION)-FINANCIAL ASSISTANCE-COMMUNITY HEALTH IMPROVEMENT INITIATIVES-PRIMARY HEALTHCARE /ACCESSFINANCIAL ASSISTANCE:DEKALB MEMORIAL HOSPITAL, INC.'S MISSION INCLUDES CARING FOR PEOPLE WHO DO NOT HAVE THE MEANS TO MEET THEIR FINANCIAL OBLIGATIONS. THE HOSPITAL PLACES ITS PRIORITY ON PROVIDING THE NECESSARY CARE, NOT ON THE PATIENT'S ABILITY TO PAY FOR THEIR MEDICAL EXPENSES.COMMUNITY HEALTH IMPROVEMENT INITIATIVES:THE PURPOSE OF DEKALB MEMORIAL HOSPITAL, INC.'S COMMUNITY HEALTH IMPROVEMENT PROGRAM IS TO FUND COMMUNITY HEALTH IMPROVEMENT EFFORTS WITHIN THE SERVICE AREA OF DEKALB MEMORIAL HOSPITAL, INC. THE HOSPITAL SETS ASIDE A PORTION OF ITS NET INCOME ANNUALLY TO FUND COMMUNITY HEALTH INITIATIVES AND PARTNERS WITH COMMUNITY ORGANIZATIONS TO ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF NORTHEAST INDIANA. SOME OF THESE INITIATIVES AND PROGRAMS ARE HIGHLIGHTED BELOW.COMMUNITY HEALTH IMPROVEMENT MANAGER: DEKALB MEMORIAL HOSPITAL, INC.'S COMMUNITY HEALTH IMPROVEMENT MANAGER PARTNERS WITH VARIOUS COMMUNITY ORGANIZATIONS AND NON-PROFITS TO BENEFIT THE OVERALL COMMUNITY. THE COMMUNITY HEALTH IMPROVEMENT MANAGER PARTICIPATES IN VARIOUS COALITIONS AND COMMUNITY PARTNERSHIPS INCLUDING LEADING THE DEKALB COUNTY MENTAL HEALTH COLLABORATIVE. THIS COLLABORATIVE IS WORKING TO SET BOTH LONG-TERM AND SHORT-TERM GOALS AROUND IMPROVING QUALITY OF LIFE AND REDUCING BARRIERS TO ACCESS CARE IN DEKALB COUNTY. THIS COLLABORATIVE IS ALSO EXPLORING THE OPPORTUNITY TO BECOME A CERTIFIED CRISIS INTERVENTION TEAM AND IDENTIFYING OPPORTUNITIES TO BETTER SERVE OUR COMMUNITY ACROSS MULTIPLE INTERCEPTS OF CRIMINAL JUSTICE SYSTEMS AND HEALTHCARE. THE COMMUNITY HEALTH IMPROVEMENT MANAGER IDENTIFIES, DEVELOPS, IMPLEMENTS AND EVALUATES ALL COMMUNITY PROGRAMS OFFERED THROUGH DEKALB MEMORIAL HOSPITAL, INC., INCLUDING NUTRITION EDUCATION, HEALTH SCREENINGS AND VARIOUS OTHER ACTIVITIES IN PARTNERSHIP WITH MULTIPLE COMMUNITY PARTNERS.COMMUNITY PARTNERSHIPS: DEKALB MEMORIAL HOSPITAL, INC. INVESTS IN KEY ORGANIZATIONS (HEALTH PARTNERS) THAT ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF DEKALB COUNTY AND NORTHEAST INDIANA. WE PARTNER WITH THE JUDY A. MORRILL RECREATION CENTER TO INCREASE ACCESS TO EXERCISE OPPORTUNITIES IN DEKALB COUNTY. TO ASSIST THOSE LESS FORTUNATE, WE SUPPORT ST. MARTIN'S HEALTHCARE AND THE UNITED WAY OF DEKALB COUNTY. TO ENCOURAGE HIGHER PAYING JOBS AND ECONOMIC IMPROVEMENT, WE PARTNER WITH THE DEKALB COUNTY ECONOMIC DEVELOPMENT CORPORATION. TO SUPPORT THOSE IN RECOVERY, RE-ENTRY AND OFFER RESTORATIVE SERVICES, WE PARTNER WITH INSPIRATION MINISTRIES. INSPIRATION MINISTRIES WORKS TO DEVELOP AND SUSTAIN SERVICES THAT REDUCE ADDICTION, RECIDIVISM AND POVERTY IN NORTHEAST INDIANA. PRIMARY HEALTHCARE/ACCESS: PHARMACARE: DEKALB MEMORIAL HOSPITAL, INC'S PHARMACARE PROGRAM IS A FULL-SERVICE RETAIL PHARMACY FEATURE OVER THE COUNTER ITEMS, VITAMINS AND NATURAL SUPPLEMENTS, ORTHOPEDIC SUPPORTS AND BREASTFEEDING SUPPLIES. PRESCRIPTION COMPOUNDING AND CUSTOMIZED MEDICATIONS ARE ALSO AVAILABLE. THE PHARMACARE PROGRAM ALSO OFFERS MEDICATION PACKAGING TO HELP PATIENTS ADHERE TO THEIR DOSAGE SCHEDULE AND PROVIDE PEACE OF MIND THAT THE RIGHT DOSAGE IS BEING ADMINISTERED AT THE RIGHT TIME. MEDICATION DELIVERY IS ALSO AVAILABLE TO RELIEVE THE TRANSPORTATION BARRIER FOR THOSE WITHOUT ACCESS, THE ELDERLY AND OTHERS WHO MAY NEED MEDICATIONS DELIVERED. MEDICATION ASSISTANCE PROGRAM (MAP): DEKALB MEMORIAL HOSPITAL, INC. MAINTAINS A MEDICATION ASSISTANCE PROGRAM FOR DEKALB COUNTY RESIDENTS. MAP PARTNERS WITH PATIENTS, PHYSICIANS, PHARMACEUTICAL COMPANIES AND DONORS TO PROVIDE MEDICATION ASSISTANCE AT LITTLE OR NO COST FOR QUALIFIED INDIVIDUALS. FOR ACUTE MEDICATION NEEDS, MEDICATIONS ARE PROVIDED BY PARKVIEW PHARMACY AT NO COST TO THE PATIENT. LONG-TERM MEDICATION HELP IS PROVIDED THROUGH CONNECTING CLIENTS WITH PHARMACEUTICAL ASSISTANCE PROGRAMS (PAP) AND COPAY ASSISTANCE PROGRAMS. HEALTH SCREENINGS AND SUPPORT GROUPS: DEKALB MEMORIAL HOSPITAL, INC. IN PARTNERSHIP WITH PARKVIEW CENTER FOR HEALTHY LIVING OFFERS NUMEROUS HEALTH SCREENINGS THROUGHOUT THE YEAR THAT ARE DESIGNED TO PROVIDE HEALTH SCREENINGS FOR DISEASE PREVENTION AT A REDUCED COST AND THE PROMOTION OF HEALTHY LIFESTYLES. 64095403 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 X 33 0 1 413 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 7 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IN X JEANNE' WICKENS 2602669313 1450 PRODUCTION RD FORT WAYNE IN 468081167 MICHAEL PACKNETT DIRECTOR/PH PRESIDENT & CEO 0.00 40.00 X X 0 2602841 338299 THOMAS MASON DIRECTOR/PH PHYSICIAN 0.00 40.00 X 1250 399919 71276 NATASHA EICHER DIRECTOR/DMHOS PRESIDENT 40.00 0.00 X X 342897 0 100409 TRINA CHAPMAN-SMITH DIRECTOR-PARTIAL YR/PH PHYSICIAN 0.00 40.00 X 3000 197824 13005 DOUGLAS MORROW DIRECTOR/CHAIR 1.00 1.00 X X 6250 1250 0 THOMAS HARTMAN DIRECTOR 1.00 0.00 X 4250 0 0 MICHAEL TULLIS DIRECTOR 1.00 1.00 X 4500 0 0 BRYAN NUGEN DIRECTOR/SECRETARY/TREASURER 1.00 0.00 X X 4250 0 0 TRENTON STUCKEY DIRECTOR 1.00 0.00 X 4125 0 0 SCOTT PFLUGHOEFT DIRECTOR/VICE CHAIR 1.00 0.00 X X 4500 0 0 TYLER JOHNSON DIRECTOR 1.00 0.00 X 13600 0 0 CLARAMARY WINEBRENNER DIRECTOR 1.00 1.00 X 4250 0 0 JEANNE' WICKENS PH CHIEF FINANCIAL OFFICER 0.00 40.00 X 0 1264400 357767 KARRA HEGGEN DMHOS VP PATIENT CARE SVCS 40.00 0.00 X 285591 0 36161 LON KEYES DMHOS PHARMACY MGR 40.00 0.00 X 187301 0 23998 JACOB CLENDENEN DMHOS PHARMACIST 40.00 0.00 X 152996 0 41304 ANTHONY STUMP DMHOS MGR REHAB 40.00 0.00 X 149473 0 46170 BETHANY HEILEMAN DMHOS PHARMACIST 40.00 0.00 X 136900 0 47959 JEANNETTE STURGES DMHOS NURSING SERVICES MGR 40.00 0.00 X 132553 0 38547 BRET CLAGHORN FORMER OFFICER/CURRENT PH VP 0.00 40.00 X 0 253943 61155 1437686 4720177 1176050 29 1 1 0 FOCUSONE SOLUTIONS LLC 13609 CALIFORNIA STREET OMAHA NE 68154 MEDICAL PERSONNEL 3829857 PARKVIEW HOSPITAL INC 11109 PARKVIEW PLAZA DR FORT WAYNE IN 46845 LABORATORY SERVICES 3305787 ASSOCIATED ANESTHESIOLOGISTS OF FORT WAY 10315 DAWSON CREEK BLVD SUITE A/B FORT WAYNE IN 46825 ANESTHESIOLOGISTS 830661 NORTHEAST INTERNAL MEDICINE ASSOC INC 2500 N DETROIT STREET LAGRANGE IN 46761 HOSPITALISTS 329452 HOSPITAL LAUNDRY SERVICES INC 3322 CAVALIER DR FORT WAYNE IN 46808 LAUNDRY SERVICES 200372 8 5556 252771 230 258327 NET PATIENT SERVICE REVENUE 622110 65856354 65856354 PHARMACY 456110 6525137 4877940 1647197 INTERUNIT RENT 531120 1213174 1213174 EMS SUBSIDY 621910 250000 250000 HEALTH/DISEASE EDUCATION CLASSES 621990 10246 10246 1072 1072 73855983 278546 278546 219518 212770 6748 6748 6748 49502065 49497866 9773 4199 -9773 -5574 -5574 CAFETERIA REVENUE 722514 415953 415953 415953 74809983 72208786 1647197 695673 X 25694 25694 815033 815033 19159582 19159582 6548225 6548225 43535 43535 9640088 9100849 539239 1114 1114 1663047 1423093 239954 8495 8495 1816280 1809034 7246 7940 7586 354 8021 5565 2456 14649 14649 2232324 2229526 2798 197906 174455 23451 MEDICAL SUPPLIES 11891594 11891594 CORP SERVICE ALLOCATION 11749363 11749363 PH CLINICAL SUPPORT 8698633 8698633 HOSPITAL ASSESSMENT FEE 2880691 2880691 170199 116618 47257 6324 77572413 64095403 13470686 6324 2950 2950 84481 143440 252916 0 11397992 9292554 880016 1145094 52449 31711 38634609 7106993 27617427 31527616 25045603 6516269 19783416 71850103 61926781 3826250 3022963 2867511 146 2365907 799851 9059668 3822960 X 62790435 58103821 62790435 58103821 71850103 61926781 X -2762430 -3932450 2008266 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3714 3714 0 PART II-B, LINE 1: OTHER ACTIVITIES - REPRESENTS THE PORTION OF THE DUES PAID TO INDIANA HOSPITAL AND HEALTH ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION AND VARIOUS PROFESSIONAL ASSOCIATIONS USED FOR LOBBYING ACTIVITIES. 4509748 4509748 24542806 3842731 20700075 9290 8223 1067 7588230 3154292 4433938 1984535 101747 1882788 31527616 DUE TO/FROM INTERUNIT 19071915 EST MEDICARE/MEDICAID SETTLEMENTS 147830 RIGHT OF USE ASSETS 563671 19783416 LEASE LIABILITY 576173 EST 3RD PARTY SETTLEMENTS 223678 799851 X PART X, LINE 2: PARKVIEW HEALTH SYSTEM, INC. AND SUBSIDIARIES - NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES THE LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): INCOME TAXES: THE INTERNAL REVENUE SERVICE HAS DETERMINED THAT THE CORPORATION AND CERTAIN AFFILIATED ENTITIES ARE TAX-EXEMPT ORGANIZATIONS AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CERTAIN SUBSIDIARIES OF THE CORPORATION ARE TAXABLE ENTITIES, THE TAX EXPENSE AND LIABILITIES OF WHICH ARE NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION AND ITS TAX-EXEMPT AFFILIATED ENTITIES EACH FILE A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THESE RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH SYSTEMS INCLUDE SUCH MATTERS AS THE TAX-EXEMPT STATUS OF EACH ENTITY, THE CONTINUED TAX-EXEMPT STATUS OF BONDS, THE NATURE, CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME, AND VARIOUS POSITIONS RELATING TO POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (REPORTED ON FORM 990T). AS OF DECEMBER 31, 2022 AND 2021, 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 GENERALLY NO LONGER SUBJECT TO EXAMINATION FOR THE YEAR 2018 AND PRIOR. 1 1 X 1 X 1 X 1 1 1 0 1 1 702644 702644 0.01020 6471231 4490717 1980514 0.02880 9276297 5837475 3438822 0.04990 16450172 10328192 6121980 0.08890 2296172 2002805 293367 0.00430 148753 148753 0.00220 9122197 5786396 3335801 0.04840 122286 122286 0.00180 11689408 7789201 3900207 0.05670 28139580 18117393 10022187 0.14560 1 0 0 7535563 9948999 -2413436 X 1 1 1 1 DEKALB MEMORIAL HOSPITAL INC 1316 EAST SEVENTH STREET AUBURN IN 46706 WWW.PARKVIEW.COM 20-005041-1 X X X DEKALB MEMORIAL HOSPITAL INC 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X HTTPS://WWW.PARKVIEW.COM/LOCALHEALTHNEEDS X 1 22 1 HTTPS://WWW.PARKVIEW.COM/LOCALHEALTHNEEDS 0 1 X 200.000000000000 250.000000000000 X X X X X 1 1 X X X 1 X SEE PART V, LINES 16A B & C X SEE PART V, LINES 16A B & C X SEE PART V, LINES 16A B & C X X X X X X 1 X 0 X X X X 1 X 0 0 DEKALB MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 5: DESCRIBE HOW THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY, AND IDENTIFY THE PERSONS THE HOSPITAL FACILITY CONSULTED:WHEN CONDUCTING ITS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), PARKVIEW HEALTH SYSTEM, INC., INCLUDING THE COMMUNITY HOSPITAL OF DEKALB MEMORIAL HOSPITAL, INC., WERE DILIGENT IN ENSURING INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY WAS INCLUDED, WHILE ALSO FOCUSING ON THE NEEDS OF VULNERABLE POPULATIONS IN NORTHEAST INDIANA. IN GATHERING COMMUNITY INPUT, PARKVIEW HEALTH SYSTEM, INC., INCLUDING DEKALB MEMORIAL HOSPITAL, INC., OBTAINED THE FOLLOWING: 1) PRIMARY DATA COLLECTED THROUGH A COMMUNITY SURVEY OF RESIDENTS IN EACH PARKVIEW HEALTH COUNTY, 2) PRIMARY DATA COLLECTED THROUGH AN ONLINE SURVEY OF HEALTHCARE AND SOCIAL SERVICE PROVIDERS IN EACH COUNTY THAT PROVIDE SERVICES DIRECTLY TO THE UNDERSERVED IN OUR COMMUNITIES (E.G., PHYSICIANS, NURSES, SOCIAL WORKERS, ETC.), AND 3) SECONDARY DATA COLLECTED FROM CONDUENT'S HEALTHY COMMUNITIES INSTITUTE (HCI) DATABASE AND OTHER LOCAL AND NATIONAL AGENCIES (E.G., COUNTY HEALTH RANKINGS, INDIANA STATE DEPARTMENT OF HEALTH, ETC.). COMMUNITY MEMBER AND PROVIDER INPUT WAS GATHERED FROM MARCH THROUGH MAY 2022 VIA MULTIPLE RECRUITMENT AND DATA COLLECTION METHODS: 1) E-MAIL TO HEALTHCARE AND SOCIAL SERVICE PROVIDERS WITH AN EMBEDDED ONLINE SURVEY LINK; 2) MAILED PAPER AND E-MAILED ONLINE SURVEYS TO COMMUNITY MEMBERS; 3) PAPER SURVEYS DISTRIBUTED TO INDIVIDUALS, CLINICS OR ORGANIZATIONS SERVING HISPANIC, AMISH, OR PEOPLE OF BURMA POPULATIONS; 4) IN-PERSON RECRUITMENT AT LOCATIONS PROVIDING SERVICES TO LOW-INCOME POPULATIONS IN EACH PARKVIEW HEALTH COUNTY; AND 5) PRESS RELEASE AND SOCIAL MEDIA NOTIFICATIONS WITH A SURVEY LINK. THE SURVEY WAS MADE AVAILABLE IN ENGLISH, SPANISH, AND BURMESE.HISPANIC, AMISH, PEOPLE OF BURMA, AND LOW-INCOME POPULATIONS WERE IDENTIFIED AS VULNERABLE POPULATIONS IN PARKVIEW HEALTH COUNTIES, AND THEREFORE SURVEY DISTRIBUTION AND DATA COLLECTION STRATEGIES INCLUDED FOCUSED EFFORTS TO OBTAIN COMMUNITY INPUT FROM THESE POPULATIONS. IN DEKALB COUNTY, THIS INCLUDED HISPANIC AND LOW-INCOME POPULATIONS. THE RESEARCH TEAM COORDINATED WITH COMMUNITY HEALTH WORKERS, LOCAL HEALTH DEPARTMENTS, AND KNOWN CONTACTS IN EACH COUNTY TO IDENTIFY LOCATIONS TO SURVEY UNDERREPRESENTED OR VULNERABLE POPULATIONS. IN DEKALB COUNTY, IN-PERSON TEAMS OF RESEARCH ASSISTANTS CONDUCTED COMMUNITY SURVEY OUTREACH AT THE LOCAL YMCA AND PUBLIC LIBRARY. DEKALB COUNTY HAD THE SECOND HIGHEST RATE OF COMMUNITY MEMBER PARTICIPATION AMONG THE EIGHT COUNTIES SURVEYED. REGARDING VULNERABLE POPULATIONS SURVEYED IN DEKALB COUNTY, 17.1% OF RESPONDENTS REPORTED AN INCOME OF < $35,000 AND 1.7% OF RESPONDENTS IDENTIFIED AS HISPANIC/LATINO. ADDITIONALLY, RESPONDENTS 65 YEARS AND OLDER WERE WELL-REPRESENTED (38.0%). THE PROVIDER SURVEY INCLUDED RESPONSES FROM PHYSICIANS, NURSE PRACTITIONERS, REGISTERED NURSES, MENTAL/BEHAVIORAL HEALTH PROVIDERS, COMMUNITY/SOCIAL SERVICE PROVIDERS, SOCIAL WORKERS/CASE MANAGERS, AND PUBLIC SECTOR WORKERS. IN ADDITION TO DATA COLLECTION, PARKVIEW DEKALB MEMORIAL HOSPITAL, INC. COLLABORATED WITH THE COMMUNITY AND PARTNERING ORGANIZATIONS TO SELECT AND PRIORITIZE DEKALB COUNTY'S HEALTH NEEDS. IN DOING SO, A MODIFIED HANLON METHOD WAS EMPLOYED TO PRIORITIZE HEALTH CONCERNS FOR PARKVIEW HEALTH HOSPITAL COMMUNITIES. THIS METHOD, ALSO KNOWN AS THE BASIC PRIORITY RATING SYSTEM (BPRS) 2.0, IS RECOMMENDED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO) FOR PRIORITIZING COMMUNITY HEALTH NEEDS (GUIDE-TO-PRIORITIZATION-TECHNIQUES.PDF, N.D.). THIS METHOD IS PARTICULARLY USEFUL WHEN THE DESIRED OUTCOME IS AN OBJECTIVELY SELECTED LIST. EXPLICIT IDENTIFICATION OF FACTORS MUST BE CONSIDERED TO SET PRIORITIES, WHICH ENABLES A TRANSPARENT AND REPLICABLE PROCESS. PRIORITY SCORES ARE CALCULATED BASED ON THE SIZE OF THE HEALTH PROBLEM, SERIOUSNESS OF THE HEALTH PROBLEM AND THE AVAILABILITY OF EFFECTIVE HEALTH INTERVENTIONS. ON SEPTEMBER 26, 2022, PARKVIEW DEKALB MEMORIAL HOSPITAL, INC. CONVENED A COMMUNITY MEETING TO PRIORITIZE THE SIGNIFICANT HEALTH ISSUES UNCOVERED IN THE 2022 CHNA REPORT. THE DATA FROM THE 2022 CHNA WAS PRESENTED TO A GROUP OF 38 COMMUNITY MEMBERS. THE GROUP OF COMMUNITY STAKEHOLDERS HAD THOUGHTFUL DISCUSSIONS AROUND THE DATA FROM THE ASSESSMENT AND PRIORITY RANKING SCORES, COMPLETED A PRIORITIZATION GRID EXERCISE TO CONSIDER SIGNIFICANCE, SEVERITY, SUITABILITY, AND HEALTH DISPARITY RELATED TO SOCIAL DETERMINANTS OF HEALTH, AND ELECTRONICALLY VOTED ON WHAT THEY THOUGHT SHOULD BE THE NUMBER 2 AND 3 PRIORITIES FOR DEKALB COUNTY BASED ON THE TOP 10 PRIORITIES IDENTIFIED IN THE CHNA. THE COMMITTEE IDENTIFIED MENTAL HEALTH, SUBSTANCE ABUSE AND OBESITY AS THE TOP THREE PRIORITIES IN DEKALB COUNTY, ADOPTING THE #1 HEALTH PRIORITY OF MENTAL HEALTH THAT WAS SET FOR THE PARKVIEW HEALTH REGION ON AUGUST 22, 2022. PRIORITIZATION SESSION ATTENDEES REPRESENTED SEVERAL ORGANIZATIONS IN DEKALB COUNTY: PARKVIEW DEKALB ADMINISTRATION, WOMEN'S CARE CENTER OF NORTHEAST INDIANA, FORTIFY LIFE DEKALB COUNTY, CHILDREN FIRST OF DEKALB COUNTY, UNITED WAY DEKALB, INSPIRATION MINISTRIES, PARKVIEW BEHAVIORAL HEALTH, WARM HEART MINISTRIES, JUNIOR ACHIEVEMENT OF DEKALB COUNTY, YMCA, SWEITZER FAMILY FOUNDATION, IMAGE OF HOPE RANCH, JAM RECREATION CENTER OF DEKALB COUNTY, AND DEKALB SCHOOL CORPORATION.AS A CONTINUATION OF THE PRIORITIZATION PROCESS, INFORMATION FROM THE CHNA AND THE COMMUNITY SESSION WERE BROUGHT TO THE COMMUNITY HEALTH IMPROVEMENT (CHI) COMMITTEE AT PARKVIEW DEKALB MEMORIAL HOSPITAL, INC. THE COMMITTEE HAD AN IN-DEPTH DISCUSSION AROUND THE DATA AND RESPONSES FROM THE COMMUNITY SESSION. BASED ON THIS DISCUSSION, THE COMMITTEE IDENTIFIED MENTAL HEALTH, SUBSTANCE ABUSE AND OBESITY AS THE TOP 3 PRIORITIES IN DEKALB COUNTY. THE NEEDS ASSESSMENT, COMMUNITY SESSION DATA AND CHI COMMITTEE RECOMMENDATIONS WERE PRESENTED TO THE PARKVIEW DEKALB HOSPITAL BOARD OF DIRECTORS ON OCTOBER 21, 2022. THE BOARD OF DIRECTORS VOTED TO ADOPT THE ABOVE HEALTH PRIORITY RECOMMENDATIONS AT THE BOARD MEETING. DEKALB MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY'S 2022 CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES:PARKVIEW HOSPITAL, INC. (EIN 35-0868085); COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. (EIN 20-2401676); HUNTINGTON MEMORIAL HOSPITAL, INC. (EIN 35-1970706); COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. (EIN 35-2087092); WHITLEY MEMORIAL HOSPITAL, INC. (EIN 35-1967665); PARKVIEW WABASH HOSPITAL, INC. (EIN 47-1753440); PARK CENTER, INC. (EIN 35-1135451); AND ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH, LLC (EIN 26-0143823). DEKALB MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY'S CHNA WAS ALSO CONDUCTED WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES:PARKVIEW HEALTH SYSTEM, INC. (EIN 35-1972384), THROUGH PARKVIEW'S HEALTH SERVICES AND INFORMATICS RESEARCH (HSIR) GROUP, DESIGNED AND CONDUCTED BOTH PRIMARY AND SECONDARY DATA COLLECTION AND ANALYSIS ACTIVITIES FOR THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). HSIR EMPLOYS MULTIPLE RESEARCH STAFF, WHICH INCLUDES PHD PREPARED SCIENTISTS, USER EXPERIENCE SPECIALISTS AND PROJECT MANAGERS. AS A RESEARCH UNIT EMBEDDED IN PARKVIEW, HSIR HAS DEDICATED TIME TO SUPPORT INITIATIVES THAT REQUIRE RESEARCH SKILLS, SUCH AS THE CHNA. DEKALB MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 11: DESCRIBE HOW THE HOSPITAL FACILITY IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA AND ANY SUCH NEEDS THAT ARE NOT BEING ADDRESSED TOGETHER WITH THE REASONS WHY SUCH NEEDS ARE NOT BEING ADDRESSED:SIGNIFICANT HEALTH NEEDS BEING ADDRESSED: BASED ON THE CHNA CONDUCTED IN 2019DEKALB MEMORIAL HOSPITAL, INC. PARTNERED WITH THESE COMMUNITY ORGANIZATIONS TO SUPPORT SAFETY AND HEALTHY LIFESTYLES IN THE COMMUNITY: THE JUDY A. MORRILL RECREATION CENTER (JAM), ST. MARTIN'S HEALTHCARE, UNITED WAY OF DEKALB COUNTY AND INSPIRATION MINISTRIES.ACCESS TO MENTAL HEALTH:THE HOSPITAL SUPPORTS ST. MARTIN'S HEALTHCARE WHO PROVIDES MENTAL HEALTH COUNSELING TO UNINSURED AND UNDERINSURED PATIENTS IN THE COUNTY. THE HOSPITAL HAS ALSO PARTNERED WITH COMMUNITY GROUPS TO COLLABORATE ON WAYS TO SUPPORT COMMUNITY MEMBERS IN A MENTAL HEALTH CRISIS.SUPPORT THE ALICE (ASSET LIMITED CONSTRAINED EMPLOYED) POPULATION:DEKALB MEMORIAL HOSPITAL, INC. CONTINUES TO SUPPORT THE UNITED WAY OF DEKALB COUNTY WHOSE PRIMARY FOCUS IS IN SUPPORT OF THE ALICE POPULATION. BOTH MONETARY AND BOARD MEMBER REPRESENTATION WERE MADE TO THE UNITED WAY. SUPPORT INCLUDES: FUNDING TO PROVIDE PROGRAMMING SUCH AS FOOD PANTRIES, EMERGENCY HOUSING ASSISTANCE AND CONNECTING PEOPLE TO AND ACCESSING RESOURCES THROUGHOUT THE COMMUNITY. ANOTHER WAY DEKALB MEMORIAL HOSPITAL, INC. SUPPORTS THE ALICE POPULATION IS THROUGH THE PHARMACARE RETAIL PHARMACY. ENHANCED SERVICES ARE OFFERED TO RESIDENTS WITHIN DEKALB COUNTY FOR PRESCRIPTION PILL PACKING AND DELIVERY SERVICE. BOTH SERVICES ARE OFFERED FOR NO FEE TO THE RESIDENT. THE GOAL IS TO ENSURE ALL RESIDENTS IN THE COUNTY HAVE ACCESS TO THEIR MEDICATIONS IN A SAFE AND TIMELY MANNER.SUPPORT SUBSTANCE ABUSE DISORDER:DEKALB MEMORIAL HOSPITAL, INC. HAS PARTNERED WITH INSPIRATION MINISTRIES TO SUPPORT THEIR MISSION OF DEVELOPING AND SUSTAINING SERVICES THAT REDUCE ADDICTION, RECIDIVISM, AND POVERTY IN DEKALB COUNTY. THE HOSPITAL PROVIDES MONETARY DONATIONS IN SUPPORT OF THIS VULNERABLE POPULATION. THE HOSPITAL LEADERSHIP ALSO SITS ON COMMUNITY COLLABORATION COMMITTEES NOT ONLY IN SUPPORT OF THESE GROUPS BUT ALSO IN SUPPORT OF MINIMIZING THE STIGMA THESE GROUPS BATTLE.OTHER HEALTH NEEDS NOT BEING ADDRESSED: BASED ON THE CHNA CONDUCTED IN 2022CHRONIC KIDNEY DISEASE - THIS IS NOT AN AREA OF PRIORITY AS THERE ARE LIMITED RESOURCES TO ADDRESS THE NEED. THERE ARE RESOURCES ELSEWHERE IN THE PARKVIEW HEALTH SYSTEM AND INDIVIDUALS' PRIMARY CARE PROVIDERS ADDRESS THIS NEED.CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) - THIS IS NOT AN AREA OF PRIORITY AS THERE ARE LIMITED RESOURCES TO ADDRESS THE NEED. THERE ARE RESOURCES ELSEWHERE IN THE PARKVIEW HEALTH SYSTEM AND INDIVIDUALS' PRIMARY CARE PROVIDERS ADDRESS THIS NEED.ASTHMA - THIS IS NOT AN AREA OF PRIORITY AS THERE ARE LIMITED RESOURCES TO ADDRESS THE NEED. THERE ARE RESOURCES ELSEWHERE IN THE PARKVIEW HEALTH SYSTEM AND INDIVIDUALS' PRIMARY CARE PROVIDERS ADDRESS THIS NEED.CANCER - THIS IS NOT AN AREA OF PRIORITY AS THERE ARE LIMITED RESOURCES TO ADDRESS THE NEED. THERE ARE RESOURCES ELSEWHERE IN THE PARKVIEW HEALTH SYSTEM. CARDIOVASCULAR DISEASE - AS WITH DIABETES, WE BELIEVE OUR EMPHASIS ON OBESITY WILL SERVE TO MITIGATE THE RISK OF CARDIOVASCULAR DISEASE. MOTHERS NOT IN EARLY PRENATAL CARE - THIS NEED WAS NOT A PRIORITY OF COMMUNITY MEMBERS, AND THEREFORE, WOULD NOT RECEIVE SUFFICIENT SUPPORT TO SUCCEED. DIABETES - AS WITH CARDIOVASCULAR DISEASE, WE BELIEVE OUR EMPHASIS ON OBESITY WILL SERVE TO MITIGATE THE RISK OF DIABETES. PART V, LINES 16A, 16B AND 16C HTTPS://WWW.PARKVIEW.COM/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE PART V, SECTION B, LINE 3E: THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. PART I, LINE 6A: THE RELATED ENTITIES OF PARKVIEW HEALTH SYSTEM, INC. (EIN 35-1972384); PARKVIEW HOSPITAL, INC. (EIN 35-0868085); COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. (EIN 20-2401676); COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. (EIN 35-2087092); HUNTINGTON MEMORIAL HOSPITAL, INC. (EIN 35-1970706); WHITLEY MEMORIAL HOSPITAL, INC. (EIN 35-1967665); DEKALB MEMORIAL HOSPITAL, INC. (EIN 35-1064295; PARK CENTER, INC. (EIN 35-1135451); AND PARKVIEW WABASH HOSPITAL, INC. (EIN 47-1753440) PREPARED A COMBINED REPORT TO THE COMMUNITY DETAILING COMMUNITY BENEFIT PROGRAMS AND SERVICES. PART I, LINE 7: PART I, LINE 7ATHE FINANCIAL ASSISTANCE COST REPORTED ON LINE 7A IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE FINANCIAL ASSISTANCE CHARGES FOREGONE ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF SERVICES RENDERED.PART I, LINE 7BDEKALB MEMORIAL HOSPITAL, INC. ACCEPTS ALL MEDICAID, MEDICAID MANAGED CARE, AND OUT-OF-STATE MEDICAID PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEDICAID PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING MEDICAID, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE UNREIMBURSED MEDICAID COST REPORTED ON LINE 7B IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE MEDICAID CHARGES ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF MEDICAID SERVICES RENDERED. THEN, THE COST OF MEDICAID SERVICES RENDERED IS DEDUCTED FROM THE REIMBURSEMENT RECEIVED FOR MEDICAID PATIENTS TO ARRIVE AT A GAIN/(LOSS) RELATIVE TO THESE PATIENTS.PART I, LINE 7CDEKALB MEMORIAL HOSPITAL, INC. ACCEPTS ALL MEANS-TESTED PATIENTS FROM THE HEALTHY INDIANA PLAN (HIP) WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEANS-TESTED PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING HIP, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE UNREIMBURSED HIP COST REPORTED ON LINE 7C IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE HIP CHARGES ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF HIP SERVICES RENDERED. THEN, THE COST OF HIP SERVICES RENDERED IS DEDUCTED FROM THE REIMBURSEMENT RECEIVED FOR HIP PATIENTS TO ARRIVE AT A GAIN/(LOSS) RELATIVE TO THESE PATIENTS.PART I, LINE 7EAMOUNTS PRESENTED ARE BASED ON ACTUAL SPEND FOR THOSE SERVICES AND BENEFITS PROVIDED DEEMED TO IMPROVE THE HEALTH OF THE COMMUNITIES IN WHICH WE SERVE AND CONFORM WITH THE MISSION OF OUR EXEMPT PURPOSE.PART I, LINE 7FAMOUNTS PRESENTED ARE BASED UPON ACTUAL SPEND AND ARE IN CONFORMITY WITH AGREED UPON COMMITMENTS WITH THE VARIOUS EDUCATIONAL PROGRAMS.PART I, LINE 7GAMOUNTS PRESENTED DO NOT INCLUDE ANY COSTS ASSOCIATED WITH PHYSICIAN CLINICS.PART I, LINE 7IIN KEEPING WITH OUR MISSION AND COMMITMENT TO THE COMMUNITIES IN WHICH WE SERVE, DEKALB MEMORIAL HOSPITAL, INC. CONTINUES ITS TRADITION OF CONTRIBUTING TO NUMEROUS ORGANIZATIONS ON BOTH AN AS-NEEDED BASIS AND NEGOTIATED BASIS. AMOUNTS PRESENTED REPRESENT ACTUAL SPEND TO ORGANIZATIONS THROUGHOUT OUR COMMUNITIES. PART I, LN 7 COL(F): PERCENT OF TOTAL EXPENSEDEKALB MEMORIAL HOSPITAL, INC. EXCLUDED $8,698,633 OF PH CLINICAL SUPPORT EXPENSE. PART III, LINE 2: FOR FINANCIAL STATEMENT PURPOSES, THE ORGANIZATION HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE. PART III, LINE 4: BAD DEBT EXPENSE - PARKVIEW HEALTH SYSTEM, INC. AND SUBSIDIARIES - NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTSTEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE OR THE PAGE NUMBER ON WHICH THIS FOOTNOTE IS CONTAINED IN THE ATTACHED FINANCIAL STATEMENTS:PAGES 12 AND 23 - 27 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. DEKALB MEMORIAL HOSPITAL, INC. ACCEPTS ALL MEDICARE PATIENTS, AS REFLECTED ON THE YEAR-END MEDICARE COST REPORT, WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. HOWEVER, MEDICARE PAYMENTS REPRESENT A PROXY OF COST CALLED THE "UPPER PAYMENT LIMIT." IT HAS HISTORICALLY BEEN ASSUMED THAT UPPER PAYMENT LIMIT PAYMENTS DO NOT GENERATE A SHORTFALL. AS A RESULT, DEKALB MEMORIAL HOSPITAL, INC. HAS TAKEN THE POSITION NOT TO INCLUDE THE MEDICARE SHORTFALLS OR SURPLUSES AS PART OF COMMUNITY BENEFIT. DEKALB MEMORIAL HOSPITAL, INC. RECOGNIZES THAT THE SHORTFALL OR SURPLUS FROM MEDICARE DOES NOT INCLUDE THE COSTS AND REVENUES ASSOCIATED WITH MEDICARE ADVANTAGE PATIENTS. AS SUCH, THE TOTAL SHORTFALL OR SURPLUS OF MEDICARE IS UNDERSTATED DUE TO THE COSTS AND REVENUES ASSOCIATED WITH MEDICARE ADVANTAGE PATIENTS NOT BEING INCLUDED IN THE COMMUNITY BENEFIT DETERMINATION. PART III, LINE 9B: A PATIENT'S FAILURE TO MAKE PAYMENT ARRANGEMENTS THROUGH VARIOUS AVAILABLE PAYMENT OPTIONS OR FAILURE TO APPLY FOR AND RECEIVE APPROVAL UNDER THE FINANCIAL ASSISTANCE POLICY MAY RESULT IN THE ACCOUNT BEING REFERRED TO A COLLECTION AGENCY DUE TO NON-PAYMENT. THE COLLECTION AGENCY MAY REPORT THE ACCOUNT TO ONE OR ALL THREE CREDIT REPORTING AGENCIES, WHICH MAY ADVERSELY AFFECT THE PATIENT'S CREDIT SCORE.A PATIENT MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE APPLICATION PERIOD, EVEN IF THE ACCOUNT HAS BEEN PLACED WITH A COLLECTION AGENCY. IF AN INDIVIDUAL SUBMITS A COMPLETE FINANCIAL ASSISTANCE APPLICATION DURING THE APPLICATION PERIOD, AND PARKVIEW HEALTH DETERMINES THE INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THEN PARKVIEW HEALTH WILL TAKE ALL REASONABLE AVAILABLE MEASURES TO REVERSE ANY EXTRAORDINARY COLLECTION ACTION (EXCEPT FOR A SALE OF DEBT) TAKEN AGAINST THE INDIVIDUAL TO OBTAIN PAYMENT FOR THE CARE. ALSO, IF AN INDIVIDUAL SUBMITS AN INCOMPLETE FINANCIAL ASSISTANCE APPLICATION DURING THE APPLICATION PERIOD, PARKVIEW WILL SUSPEND ANY EXTRAORDINARY COLLECTION ACTIONS AGAINST THE INDIVIDUAL (WITH RESPECT TO CHARGES TO WHICH THE FINANCIAL ASSISTANCE APPLICATION UNDER REVIEW RELATES) UNTIL THE FINANCIAL ASSISTANCE APPLICATION HAS BEEN PROCESSED AND AN ELIGIBILITY DECISION RENDERED. PART VI, LINE 2: DESCRIBE HOW THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES, IN ADDITION TO ANY CHNAS REPORTED IN PART V, SECTION B.IN ADDITION TO COMPLETING A COMMUNITY HEALTH NEEDS ASSESSMENT ON A TRIENNIAL BASIS, DEKALB MEMORIAL HOSPITAL, INC. ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY IT SERVES THROUGH PRIMARY AND SECONDARY DATA ANALYSIS, WORKING WITH THE ORGANIZATION'S COMMUNITY PARTNERS, AND FRONTLINE STAFF. DEKALB MEMORIAL HOSPITAL, INC. IDENTIFIES AND VERIFIES COMMUNITY HEALTH NEEDS THROUGH THE FOLLOWING:1. HEALTHY COMMUNITIES INSTITUTE (HCI) SECONDARY DATA ANALYSIS2. OBSERVATIONS AND DATA COLLECTED FROM FRONTLINE STAFF WORKING WITH VULNERABLE POPULATIONS (I.E., COMMUNITY NURSES AND COMMUNITY HEALTH WORKERS)3. REVIEW OF COMMUNITY NEEDS ASSESSMENTS CONDUCTED BY LOCAL ORGANIZATIONS (I.E., UNITED WAY, BRIGHTPOINT, ETC.) 4. PARKVIEW LEADERS SERVING ON HEALTH-RELATED AND SOCIAL SERVICE BOARDS OF DIRECTORS IN THE COMMUNITY5. OTHER PUBLIC HEALTH DATABASES (E.G. COMMUNITY COMMONS, COUNTY HEALTH RANKINGS) KEY HOSPITAL REPRESENTATIVES MAINTAIN ON-GOING RELATIONSHIPS THROUGHOUT THE COMMUNITY AND MEET REGULARLY WITH ORGANIZATIONS THAT SHARE THE MISSION OF IMPROVING THE HEALTH AND INSPIRING THE WELL-BEING OF THE COMMUNITY WE SERVE. PART VI, LINE 3: DESCRIBE HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.SIGNAGE AND BROCHURES ARE POSTED AND AVAILABLE AT ALL HOSPITAL POINTS OF REGISTRATION AND IN THE EMERGENCY DEPARTMENT. PATIENTS ARE OFFERED PLAIN LANGUAGE SUMMARIES OF THE FINANCIAL ASSISTANCE POLICY DURING THE REGISTRATION PROCESS AND IN EACH FOLLOW UP STATEMENT SENT TO THE PATIENT. PATIENT STATEMENTS WILL INDICATE HOW A PATIENT CAN OBTAIN FINANCIAL ASSISTANCE APPLICATIONS AND WHO THEY CAN CONTACT FOR ASSISTANCE. PART VI, LINE 4: DESCRIBE THE COMMUNITY THE ORGANIZATION SERVES, TAKING INTO ACCOUNT THE GEOGRAPHIC AREA AND DEMOGRAPHIC CONSTITUENTS IT SERVES.DEKALB MEMORIAL HOSPITAL, INC., IS LOCATED IN DEKALB COUNTY AND IS THE SOLE LICENSED HOSPITAL IN THE COUNTY. DEKALB MEMORIAL HOSPITAL INC. SERVES DEKALB, PORTIONS OF STEUBEN, LAGRANGE, NOBLE, AND ALLEN COUNTIES IN ADDITION TO SEVERAL BORDER TOWNS OF HICKSVILLE AND EDGERTON IN NORTHWEST OHIO. ACCORDING TO CONDUENT HEALTHY COMMUNITIES INSTITUTE (HCI), DEKALB COUNTY IS A RURAL AREA WITHIN THE HEALTH SYSTEM'S SERVICE AREA WITH A POPULATION OF 43,333 (2021). IN ADDITION, HCI REPORTS THE MEDIAN HOUSEHOLD INCOME OF DEKALB COUNTY RESIDENTS IS APPROXIMATELY $60,757 WITH 10.4% LIVING BELOW THE FEDERAL POVERTY LEVEL (2017-2021). APPROXIMATELY 92% OF DEKALB COUNTY RESIDENTS HAVE HEALTH INSURANCE (2020). ACCORDING TO THE INDIANA HOSPITAL ASSOCIATION DIMENSIONS DATABASE (2022), DEKALB MEMORIAL HOSPITAL, INC. HAD 20.4% OF INPATIENT DISCHARGES THAT WERE MEDICAID PATIENTS AND 1.8% WERE SELF-PAY. FOR OUTPATIENT PROCEDURES, 19.9% WERE MEDICAID PATIENTS, AND 2.95% PERCENT WERE SELF-PAY. HEALTH RESOURCES & SERVICES ADMINISTRATION (HRSA), AN AGENCY OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, DEVELOPS SHORTAGE DESIGNATION CRITERIA INTENDED TO IDENTIFY A GEOGRAPHIC AREA, POPULATION GROUP OR FACILITY AS A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) OR A MEDICALLY UNDERSERVED AREA OR POPULATION (MUA/P). HEALTH RESOURCES & SERVICES ADMINISTRATION (HRSA) HAS DESIGNATED/IDENTIFIED THE FOLLOWING MEDICALLY UNDERSERVED AREAS/POPULATIONS AND HEALTH PROFESSIONAL SHORTAGE AREAS:1) DISCIPLINE: PRIMARY CAREHSPA ID: 1186905830HPSA NAME: MHCA 20 - DEKALB COUNTYDESIGNATION TYPE: GEOGRAPHIC HPSACOUNTY NAME: DEKALB COUNTYHPSA SCORE:8 STATUS: DESIGNATEDRURAL STATUS: RURAL2) DISCIPLINE: MENTAL HEALTHHSPA ID: 7186175063HPSA NAME: NORTHEASTERN CATCHMENT AREA 18DESIGNATION TYPE: GEOGRAPHIC HPSACOUNTY NAME: DEKALB, LAGRANGE, NOBLE, AND STEUBEN COUNTIESHPSA SCORE:17 STATUS: DESIGNATEDRURAL STATUS: RURALALSO, LOCATED IN DEKALB COUNTY, A FREE MEDICAL, DENTAL AND VISION CLINIC, ST. MARTINS HEALTHCARE, INC., SERVES UNINSURED, LOW-INCOME INDIVIDUALS IN DEKALB AND NOBLE COUNTY. PART VI, LINE 5: PROVIDE ANY OTHER INFORMATION IMPORTANT TO DESCRIBING HOW THE ORGANIZATION'S HOSPITAL FACILITIES OR OTHER HEALTH CARE FACILITIES FURTHER ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY (E.G. OPEN MEDICAL STAFF, COMMUNITY BOARD, USE OF SURPLUS FUNDS, ETC.).THE MAJORITY OF THE DEKALB MEMORIAL HOSPITAL, INC. BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY MEMBERS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. DEKALB MEMORIAL HOSPITAL, INC. ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.PEOPLE THROUGHOUT THE COMMUNITY CAN COUNT ON DEKALB MEMORIAL HOSPITAL, INC. TO BE STANDING BY WITH EMERGENCY CARE 24 HOURS A DAY, 365 DAYS A YEAR. THE EMERGENCY DEPARTMENT IS STAFFED WITH BOARD-CERTIFIED EMERGENCY CARE PHYSICIANS AND A NURSING STAFF THAT IS TRAINED AND EXPERIENCED IN EMERGENCY CARE. IN ADDITION, LOCAL PHYSICIANS STAFF AN AFTER-HOURS CLINIC AFTER THEIR REGULAR BUSINESS HOURS AND ON THE WEEKENDS. FURTHERMORE, NO PATIENT IS EVER DENIED TREATMENT, REGARDLESS OF THEIR ABILITY TO PAY, AND DEKALB MEMORIAL HOSPITAL, INC. AND ITS AFFILIATES CONTINUE TO ADAPT TO MEET THE NEEDS OF THE COMMUNITY.ADDITIONALLY, DEKALB MEMORIAL HOSPITAL, INC. ANNUALLY FUNDS COMMUNITY HEALTH IMPROVEMENT INITIATIVES AND PARTNERS WITH COMMUNITY ORGANIZATIONS TO ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF NORTHEAST INDIANA. KEY PROJECTS AND AREAS OF FOCUS FUNDED THROUGH THE COMMUNITY HEALTH IMPROVEMENT INITIATIVE AND OTHER HOSPITAL FUNDS INCLUDE:-EDUCATION: DEKALB MEMORIAL HOSPITAL, INC. IS TAKING THE LEAD IN PARTNERING WITH SCHOOLS FOR HEALTH OCCUPATION EDUCATION PROGRAMS, AND CAREER PATHWAYS PROGRAMS. -COMMUNITY PARTNERSHIPS: DEKALB MEMORIAL HOSPITAL, INC. INVESTS IN KEY ORGANIZATIONS (HEALTH PARTNERS) THAT ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF DEKALB COUNTY AND NORTHEAST INDIANA. WE PARTNER WITH JUDY A. MORRILL RECREATION CENTER TO ENCOURAGE HEALTHIER LIFESTYLES. TO ASSIST THOSE LESS FORTUNATE, WE SUPPORT ST. MARTIN'S HEALTHCARE AND THE UNITED WAY OF DEKALB COUNTY. TO ENCOURAGE HIGHER PAYING JOBS AND ECONOMIC IMPROVEMENT, WE PARTNER WITH THE DEKALB COUNTY ECONOMIC DEVELOPMENT CORPORATION. DEKALB MEMORIAL HOSPITAL, INC. ALSO PARTNERS WITH INSPIRATION MINISTRIES, A STATE LEADER IN RECOVERY, RE-ENTRY AND RESTORATIVE SERVICES. -MEDICATION ASSISTANCE PROGRAM (MAP): DEKALB MEMORIAL HOSPITAL, INC. MAINTAINS A MEDICATION ASSISTANCE PROGRAM FOR DEKALB COUNTY RESIDENTS. MAP PARTNERS WITH PATIENTS, PHYSICIANS, PHARMACEUTICAL COMPANIES AND DONORS TO PROVIDE MEDICATION ASSISTANCE AT LITTLE OR NO COST FOR QUALIFIED INDIVIDUALS. FOR ACUTE MEDICATION NEEDS, MEDICATIONS ARE PROVIDED BY PARKVIEW PHARMACY AT NO COST TO THE PATIENT. LONG-TERM MEDICATION HELP IS PROVIDED THROUGH CONNECTING CLIENTS WITH PHARMACEUTICAL ASSISTANCE PROGRAMS (PAP) AND COPAY ASSISTANCE PROGRAMS.-HEALTH SCREENINGS & SUPPORT: DEKALB MEMORIAL HOSPITAL, INC. IN PARTNERSHIP WITH PARKVIEW CENTER FOR HEALTHY LIVING, PUTS ON NUMEROUS HEALTH SCREENINGS THROUGHOUT THE YEAR THAT ARE DESIGNED TO PROVIDE HEALTH SCREENINGS FOR DISEASE PREVENTION AT A REDUCED COST AND THE PROMOTION OF HEALTHY LIFESTYLES. -PHARMACARE: DEKALB MEMORIAL HOSPITAL, INC.'S PHARMACARE PROGRAM IS A FULL-SERVICE RETAIL PHARMACY FEATURING OVER THE COUNTER ITEMS, VITAMINS AND NATURAL SUPPLEMENTS, ORTHOPEDIC SUPPORTS AND BREASTFEEDING SUPPLIES. PRESCRIPTION COMPOUNDING AND CUSTOMIZED MEDICATIONS ARE ALSO AVAILABLE. THE PHARMACARE PROGRAM ALSO OFFERS MEDICATION PACKAGING TO HELP PATIENTS ADHERE TO THEIR DOSAGE SCHEDULE AND PROVIDE PEACE OF MIND THAT THE RIGHT DOSAGE IS BEING ADMINISTERED AT THE RIGHT TIME. MEDICATION DELIVERY IS ALSO AVAILABLE TO RELIEVE THE TRANSPORTATION BARRIER FOR THOSE WITHOUT ACCESS, THE ELDERLY AND OTHERS WHO MAY NEED MEDICATIONS DELIVERED.IN ADDITION, MANY OF DEKALB MEMORIAL HOSPITAL, INC.'S MANAGERS AND STAFF DONATE THEIR TIME TO SUPPORT ST. MARTIN'S HEALTHCARE (FOR UNINSURED). CO-WORKERS ALSO SERVE ON THE BOARD OF THE UNITED WAY, COMMUNITY FOUNDATION OF DEKALB COUNTY, ST. MARTIN'S HEALTHCARE AND SERVE AS A LUNCH BUDDY AT A LOCAL ELEMENTARY SCHOOL THROUGH BIG BROTHERS BIG SISTERS OF NORTHEAST INDIANA. PART VI, LINE 6: IF THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM, DESCRIBE THE RESPECTIVE ROLES OF THE ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED.PARKVIEW HEALTH SYSTEM, INC. (PARKVIEW), A HEALTHCARE SYSTEM SERVING NORTHEAST INDIANA AND NORTHWEST OHIO THROUGH OUR HOSPITALS AND PHYSICIAN CLINICS, INCLUDES THE NOT-FOR-PROFIT HOSPITALS OF PARKVIEW HOSPITAL, INC.; COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.; COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.; DEKALB MEMORIAL HOSPITAL, INC.; HUNTINGTON MEMORIAL HOSPITAL, INC.; PARK CENTER, INC.; PARKVIEW WABASH HOSPITAL, INC.; WHITLEY MEMORIAL HOSPITAL, INC.; AS WELL AS 60 PERCENT OWNERSHIP IN THE JOINT VENTURE OF ORTHOPEDIC HOSPITAL AT PARKVIEW NORTH, LLC.EACH HOSPITAL ENTITY ENGAGES IN COMMUNITY OUTREACH ACTIVITIES CUSTOMIZED TO MEET THE UNIQUE HEALTH NEEDS OF THEIR RESPECTIVE COMMUNITIES. AFFILIATE HOSPITALS ALSO WORK TOGETHER AND SHARE PROGRAMMING AND MESSAGING WHERE COMMON COMMUNITY HEALTH ISSUES ARE IDENTIFIED. FROM THE LIST OF HEALTH ISSUES IDENTIFIED IN NORTHEAST INDIANA AS PART OF THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT, THE HEALTH PRIORITY OF MENTAL HEALTH WAS SELECTED BY ALL AFFILIATE HOSPITALS.AFFILIATE HOSPITALS EACH HAVE A LOCAL BOARD OF DIRECTORS. PARKVIEW HEALTH SYSTEM, INC. ALSO ENGAGES WITH A BOARD OF DIRECTORS THAT CONSISTS OF REPRESENTATION FROM EACH OF THE AFFILIATE HOSPITAL BOARDS AND UP TO 15 AT-LARGE PHYSICIANS OR COMMUNITY LEADERS. MOST OF THE BOARD OF DIRECTORS SHALL ALWAYS BE INDEPENDENT AS DEFINED BY THE INTERNAL REVENUE SERVICE (IRS). PARKVIEW CONTRIBUTES TO THE OVERALL SUCCESS OF THE REGION THROUGH SIGNIFICANT INVOLVEMENT IN THE COMMUNITIES WE SERVE. BY DEVELOPING VARIOUS PARTNERSHIPS AND ALIGNMENTS WITH DIFFERENT SECTORS AND ORGANIZATIONS, PARKVIEW HELPS TO BENEFIT THE ECONOMY, QUALITY OF LIFE, AND HEALTH AND WELL-BEING ACROSS THE REGION. WITH A CONSISTENT FOCUS ON OUR MISSION AND VISION, WE WORK TO PROVIDE EXCELLENT CARE TO EVERY PERSON, EVERY DAY WITHIN OUR FACILITIES WHILE SERVING AS GOOD STEWARDS OF SURPLUS FUNDS TO POSITIVELY IMPACT COMMUNITY HEALTH STATUS. PART VI, LINE 7, REPORTS FILED WITH STATES IN PART VI, LINE 7 CONT'D: A COPY OF FORM 990, SCHEDULE H IS FILED WITH THE INDIANA STATE DEPARTMENT OF HEALTH. 1 GARRETT COMMUNITY CENTER INC 1200 E HOUSTON STREET GARRETT IN 46738 352010882 501(C)(3) 9996 0 PROGRAMS TO CELEBRATE AND STRENGTHEN THE VIBRANT COMMUNITY BY CONNECTING PEOPLE AND ORGANIZATIONS THROUGH ACTIVITIES THAT IMPROVE THE QUALITY OF LIFE FOR THE GREATER GARRETT INDIANA AREA. 1 0 PART I, LINE 2: COMMUNITY HEALTH IMPROVEMENT FUNDING PARTNER ORGANIZATIONS ARE REQUIRED TO SUBMIT AN ANNUAL PROGRESS REPORT RELATED TO PROGRAM FUNDING. PARTNER ORGANIZATIONS ARE REQUIRED TO RE-APPLY FOR FUNDING ON AN ANNUAL BASIS. X 1 1 0 1 0 0 0 0 0 1 0 MICHAEL PACKNETT DIRECTOR/PH PRESIDENT & CEO 0 1330197 0 664677 0 607967 0 302282 0 36017 0 2941140 0 577374 JEANNE' WICKENS PH CHIEF FINANCIAL OFFICER 0 804432 0 363922 0 96046 0 325215 0 32552 0 1622167 0 70644 THOMAS MASON DIRECTOR/PH PHYSICIAN 1250 338867 0 37296 0 23756 0 33550 0 37726 1250 471195 0 0 NATASHA EICHER DIRECTOR/DMHOS PRESIDENT 222868 0 92054 0 27975 0 62741 0 37668 0 443306 0 6634 0 KARRA HEGGEN DMHOS VP PATIENT CARE SVCS 196331 0 64404 0 24856 0 19772 0 16389 0 321752 0 0 0 BRET CLAGHORN FORMER OFFICER/CURRENT PH VP 0 193732 0 59552 0 659 0 23489 0 37666 0 315098 0 0 TRINA CHAPMAN-SMITH DIRECTOR-PARTIAL YR/PH PHYSICIAN 3000 173445 0 20750 0 3629 0 0 0 13005 3000 210829 0 0 LON KEYES DMHOS PHARMACY MGR 160696 0 24625 0 1980 0 11208 0 12790 0 211299 0 0 0 ANTHONY STUMP DMHOS MGR REHAB 127598 0 20200 0 1675 0 13738 0 32432 0 195643 0 0 0 JACOB CLENDENEN DMHOS PHARMACIST 151976 0 750 0 270 0 6461 0 34843 0 194300 0 0 0 BETHANY HEILEMAN DMHOS PHARMACIST 135989 0 750 0 161 0 15575 0 32384 0 184859 0 0 0 JEANNETTE STURGES DMHOS NURSING SERVICES MGR 113855 0 18187 0 511 0 14906 0 23641 0 171100 0 0 0 PART I, LINE 1A PERSONAL SERVICES - TAXABLE ALLOWANCE FOR FINANCIAL PLANNING PAID TO: TRENTON STUCKEY $125 PART I, LINE 3 RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF DEKALB MEMORIAL HOSPITAL, INC.'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. INDEPENDENT COMPENSATION CONSULTANT FORM 990 OF OTHER ORGANIZATIONS COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS THE FOLLOWING INDIVIDUALS PARTICIPATE IN SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLANS. BENEFITS EARNED UNDER THE PLANS WILL FUND THE EMPLOYEES' EVENTUAL RETIREMENT BENEFIT. THESE BENEFITS ARE PROVIDED IN EXCHANGE FOR THE EMPLOYEES' YEARS OF SERVICE TO THE ORGANIZATION AND THE AMOUNT OF THE BENEFITS MAY VARY FROM YEAR TO YEAR. THE FOLLOWING INDIVIDUALS VESTED IN A PORTION OF THEIR DEFERRED COMPENSATION PLANS, WHICH IS TREATED AS TAXABLE INCOME TO THE INDIVIDUALS AT THE TIME OF VESTING. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III): NATASHA EICHER $6,634; MICHAEL PACKNETT $577,374; JEANNE' WICKENS $70,644 AMOUNTS LISTED ABOVE THAT HAVE BEEN REPORTED AS DEFERRED COMPENSATION ON PRIOR FORM 990 WILL ALSO BE REFLECTED IN SCHEDULE J, PART II, COLUMN (F). FOR EXAMPLE, THE AMOUNT OF $577,374 REPORTED AS REQUIRED FOR MR. PACKNETT WAS A RESULT OF THE VESTING OF SUCH AMOUNT UNDER THE TERMS OF THE RESPECTIVE PLANS. HOWEVER, THESE AMOUNTS WERE PREVIOUSLY REPORTED IN MR. PACKNETT'S DEFERRED COMPENSATION OVER MORE THAN 10 YEARS AS THE AMOUNTS WERE DEFERRED UNDER THE PLANS. AS SUCH, THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN (F) IS AN INDICATION OF AMOUNTS THAT HAVE BEEN REPORTED TWICE, ONCE AS A DEFERRAL AND ONCE AS VESTED. THE FOLLOWING INDIVIDUALS HAVE AN AMOUNT INCLUDED IN SCHEDULE J, PART II, COLUMN (C) FOR AN AMOUNT EARNED BUT NOT YET VESTED UNDER ONE OF PARKVIEW'S DEFERRED COMPENSATION PLANS. THE AMOUNTS ARE AT RISK AND WILL NOT BE PAID UNLESS AND UNTIL EACH EMPLOYEE HAS PROVIDED SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION. BENEFITS UNDER THE PLANS VEST AT THE TIME SET FORTH IN THE PLAN DOCUMENTS AND ARE FORFEITED IF THE EMPLOYEES TERMINATE EMPLOYMENT BEFORE SATISFYING THOSE PLAN CONDITIONS. DEFERRALS REPORTED IN SCHEDULE J, PART II, COLUMN (C) INCLUDE: NATASHA EICHER $41,391; MICHAEL PACKNETT $268,732; JEANNE' WICKENS $308,865 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. 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, DEKALB MEMORIAL HOSPITAL, INC., EIN 35-1064295. 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, 2022 WAS 627. THE TOTAL NUMBER OF EMPLOYEES REPORTED ON FORM W-3 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2022 WAS 17,284. FOR PURPOSES OF COMPLETING FORM 990, PART V, LINE 1A AND 2A, THE NUMBER REPORTED FOR THE DEKALB MEMORIAL HOSPITAL, INC. WAS 33 AND 413 RESPECTIVELY. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE OFFICERS OF THE BOARD, THE PRESIDENT OF THE CORPORATION, THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATE MEMBER OR HIS/HER DESIGNEE, THE CURRENT CHIEF OF THE MEDICAL STAFF, AND SUCH OTHER PERSONS AS IDENTIFIED BY THE CHAIR OF THE BOARD, EACH OF WHOM SHALL BE ENTITLED TO VOTE. IN NO EVENT SHALL THE MEMBERS OF THE EXECUTIVE COMMITTEE EXCEED EIGHT (8) PEOPLE. THE EXECUTIVE COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION AS THE PLANNING COMMITTEE AND IN ANY OTHER MATTER WHEN THE BOARD IS NOT IN SESSION, REPORTING TO THE BOARD FOR ITS RATIFICATION OF ITS ACTION. THE CHAIR OF THE BOARD SHALL SERVE AS CHAIR OF THE EXECUTIVE COMMITTEE. MEETINGS OF THE EXECUTIVE COMMITTEE MAY BE CALLED BY THE CHAIR OR BY THREE (3) MEMBERS. FORM 990, PART VI, SECTION A, LINE 2 DIRECTOR/OFFICER MICHAEL PACKNETT AND OFFICER JEANNE' WICKENS HAVE BUSINESS RELATIONSHIPS AS OFFICERS OF RELATED ENTITIES. 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 DEKALB MEMORIAL HOSPITAL, INC. WITH CERTAIN RESERVED POWERS. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE MEMBER, PARKVIEW HEALTH SYSTEM, INC. EIN 35-1972384, SHALL HAVE THE FOLLOWING RESERVED POWERS AS DEFINED IN THE NETWORK AGREEMENT: (I) APPOINT (INCLUDING TO FILL A VACANCY) 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 (INCLUDING TO FILL A VACANCY) 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, JOINT VENTURE, PARTNERSHIP, 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, INCLUDING ANY INDIVIDUAL INITIATIVES OR ARRANGEMENTS, SUCH AS A NEW SERVICE OR CONTRACTUAL ARRANGEMENT DEEMED BY THE CORPORATE MEMBER TO BE OF STRATEGIC IMPORTANCE FOR THE CORPORATION AND ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION, 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. DEKALB MEMORIAL HOSPITAL, INC. IS A SUBSIDIARY CORPORATION OF PARKVIEW HEALTH SYSTEM, INC. AN ELECTRONIC COPY OF THE ORGANIZATION'S FINAL FORM 990 (INCLUDING REQUIRED SCHEDULES) WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY AND THE SYSTEM AUDIT COMMITTEE, PRIOR TO FILING WITH THE IRS. ON OCTOBER 24, 2023, THE SYSTEM AUDIT COMMITTEE REVIEWED THE FORM 990 AS ULTIMATELY FILED WITH THE IRS. THIS REVIEW INCLUDED A PRESENTATION BY THE ORGANIZATION'S TAX PREPARER TO HIGHLIGHT THE SIGNIFICANT AREAS ON THE FORM 990 AND SUPPLEMENTAL SCHEDULES. FORM 990, PART VI, SECTION B, LINE 12C AS DESCRIBED IN ARTICLE IX SECTION 6, OF THE PARKVIEW HEALTH SYSTEM, INC. (PH) BYLAWS, PH ADOPTED PH'S COMPLIANCE POLICY FOR THE ORGANIZATION AND ITS NOT-FOR-PROFIT RELATED ORGANIZATIONS (AND AS LIKEWISE NOTED IN THEIR BYLAWS) WHEN ADDRESSING CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. THIS COMPLIANCE POLICY (COMPLIANCE POLICY #14) REQUIRES THAT EACH BOARD MEMBER, BOARD COMMITTEE MEMBER, AND KEY MANAGEMENT PERSONNEL MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST FORM. THIS INFORMATION IS PROVIDED TO THE CHAIRMAN OF THE BOARD (FOR BOARD AND BOARD COMMITTEE MEMBERS) AND TO SENIOR MANAGEMENT (FOR KEY MANAGEMENT PERSONNEL). IN ADDITION, AS TO THE CONDUCT OF BOARD MEETINGS, THE FOLLOWING PROCESS IS FOLLOWED: "WHENEVER A PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE IS CONSIDERING A TRANSACTION OR ARRANGEMENT WITH AN ORGANIZATION, ENTITY OR INDIVIDUAL IN WHICH A PERSON COVERED BY THIS POLICY HAS A FINANCIAL OR CONFLICTING INTEREST, THE FOLLOWING SHALL OCCUR: 1. THE INTERESTED PERSON MUST DISCLOSE THE FINANCIAL OR CONFLICTING INTEREST AND ALL MATERIAL FACTS TO THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE; 2. THE INTERESTED PERSON WITH THAT FINANCIAL OR CONFLICTING INTEREST MAY MAKE A PRESENTATION AT THE BOARD OR BOARD COMMITTEE MEETING REGARDING THE TRANSACTION OR ARRANGEMENT HOWEVER, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE FINANCIAL OR CONFLICTING INTEREST; AND 3. THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE MUST APPROVE THE TRANSACTION OR ARRANGEMENT BY A MAJORITY VOTE OF THE BOARD MEMBERS PRESENT AT A MEETING THAT HAS A QUORUM, NOT INCLUDING THE VOTE OF THE INTERESTED PERSON. THE INTERESTED PERSON MAY NOT VOTE ON THE MATTER. A. UPON THE REQUEST OF PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE, THE MATTER MAY BE DELEGATED TO THE PH COMPLIANCE COMMITTEE FOR EVALUATION, RECOMMENDATION AND/OR DETERMINATION. 4. WHENEVER A FINANCIAL OR CONFLICTING INTEREST IS ADDRESSED BY A PH OR PH AFFILIATE BOARD, NOTICE SHALL BE GIVEN TO THE PH COMPLIANCE OFFICER / GENERAL COUNSEL." FORM 990, PART VI, SECTION B, LINE 15 LINES 15A AND 15B ARE ANSWERED NO IN ACCORDANCE WITH THE IRS INSTRUCTIONS. TO THE EXTENT THAT THE ORGANIZATION HAS A VICE PRESIDENT OR ABOVE, THE RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., HAS A PROCESS IN PLACE 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 2022, THE COMPENSATION COMMITTEE OF PARKVIEW HEALTH SYSTEM, INC. REVIEWED AND APPROVED ALL EXECUTIVE COMPENSATION, BENEFITS, AND PERQUISITES FOR THE 2022 COMPENSATION PACKAGE, PURSUANT TO THE PARKVIEW HEALTH BYLAWS. THE COMPENSATION PACKAGE WAS APPROVED BY A MAJORITY OF INDEPENDENT COMPENSATION COMMITTEE 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 THEIR 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). 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 1,480,820. MANAGEMENT AND GENERAL EXPENSES 304,950. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,785,770. MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 4,314,242. MANAGEMENT AND GENERAL EXPENSES 5,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,319,242. LAB SERVICES: PROGRAM SERVICE EXPENSES 3,305,787. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,305,787. COLLECTION EXPENSE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 229,289. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 229,289. FORM 990, PART IX, LINES 5-10: PARKVIEW HEALTH SYSTEM, INC., EIN 35-1972384, SERVES AS THE COMMON PAYING AGENT FOR ALL TAX-EXEMPT ORGANIZATIONS OF THE SYSTEM. SALARIES AND WAGES OF EMPLOYEES WORKING FOR THESE ORGANIZATIONS ARE CHARGED DIRECTLY TO THE ORGANIZATIONS IN WHICH THEY WORK. THE ACTUAL EXPENSES FOR PAYROLL TAXES, EMPLOYEE BENEFITS, AND PENSION PLAN CONTRIBUTIONS ARE REFLECTED ON THE BOOKS OF PARKVIEW HEALTH SYSTEM, INC. FOR FINANCIAL REPORTING PURPOSES. TO ACCOUNT FOR BENEFIT COSTS ON THE BOOKS OF THE OTHER TAX EXEMPT ORGANIZATIONS, AN ALLOCATION METHODOLOGY IS UTILIZED TO CHARGE THESE ORGANIZATIONS WITH AN ESTIMATE OF THE OVERALL COSTS, REFERRED TO AS A "BENEFIT ALLOCATION" FROM PARKVIEW HEALTH SYSTEM, INC. THE ALLOCATION DOES NOT DISTINGUISH BETWEEN THE COSTS OF THE VARIOUS COMPONENTS (I.E. PAYROLL TAXES, EMPLOYEE BENEFITS, AND PENSION PLAN CONTRIBUTIONS). THEREFORE, FOR PURPOSES OF THE FORM 990, PART IX, THE TOTAL BENEFIT ALLOCATION FOR THE EMPLOYEES' SALARIES AND WAGES REPORTED ON LINE 7 IS REFLECTED ON LINE 9 AND NOT ALLOCATED BETWEEN LINES 8 OR 10. FOR PURPOSES OF THE FORM 990, PART IX, LINES 5 AND 6 REFLECT COMPENSATION AND BENEFIT AMOUNTS REPORTED IN PART VII. FORM 990, PART XI, LINE 9: ASSET TRANSFERS/ADJUSTMENTS 2,008,266. 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