COMMUNITY HOSPITAL OF NOBLE COUNTY INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HOSPITAL OF NOBLE COUNTY INC (EIN 35-2087092)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-07
- IRS object ID
- 202123119349300552
- Schema version
- 2020v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-07T10:46:53-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 330 E JEFFERSON BLVD P O BOX 7 | AddressLine1Txt |
| City | SOUTH BEND | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 466240007 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352087092 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL OF NOBLE COUNTY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 2603738429 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 SAWYER ROAD | AddressLine1Txt |
| City | KENDALLVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46755 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEANNE' WICKENS | PersonNm |
| Person Title | PH CFO | PersonTitleTxt |
| Phone | 2602669313 | PhoneNum |
| Signature | 2021-11-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JEANNE | PersonFirstNm |
| Person Last | WICKENS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BRITTNEY KOCAJ | PreparerPersonNm |
| PTIN | P01320603 | PTIN |
| Phone | 5742323992 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PARKVIEW NOBLE HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL J PACKNETT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1450 PRODUCTION RD | AddressLine1Txt |
| City | FORT WAYNE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46808 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $68,287,819 | 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 | 1999 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. WORKS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND PROVIDES QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 315 | TotalEmployeeCnt |
| Total Volunteers | 45 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $220,123 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,699,734 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $71,483,329 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $62,467,796 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$30,383 | PYInvestmentIncomeAmt |
| CY Investment Income | -$5,652 | CYInvestmentIncomeAmt |
| PY Other Revenue | $172,894 | PYOtherRevenueAmt |
| CY Other Revenue | $72,981 | CYOtherRevenueAmt |
| PY Total Revenue | $71,845,963 | PYTotalRevenueAmt |
| CY Total Revenue | $68,234,859 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $195,461 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $109,589 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $19,720,783 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $19,601,545 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $156,203 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $44,574,141 | PYOtherExpensesAmt |
| CY Other Expenses | $38,895,388 | CYOtherExpensesAmt |
| PY Total Expenses | $64,490,385 | PYTotalExpensesAmt |
| CY Total Expenses | $58,606,522 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,355,578 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $9,628,337 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $24,073,117 | TotalAssetsBOYAmt |
| Total Assets EOY | $39,986,763 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,340,409 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,799,109 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $20,732,708 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $29,187,654 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | COMMUNITY HOSPITAL OF NOBLE COUNTY, 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 | $46,348,924 | ExpenseAmt |
| Grant | $109,589 | GrantAmt |
| Revenue | $62,467,796 | RevenueAmt |
| Desc | COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. COMMUNITY HEALTH IMPROVEMENT:AS A NOT-FOR-PROFIT HOSPITAL, WE FOCUS ON OUR MISSION TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE AND TO PROVIDE A PERSONALIZED WELLNESS JOURNEY. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. EXISTS FOR ONE PURPOSE - TO IMPROVE THE HEALTH OF OUR COMMUNITIES. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. GIVES BACK TO THE COMMUNITY IN THE FORM OF IMPROVED FACILITIES, EDUCATION AND OUTREACH PROGRAMS, FREE AND DISCOUNTED CARE, VOLUNTEERISM AND MUCH MORE. PARKVIEW CONDUCTS A COMMUNITY HEALTH ASSESSMENT ON A REGULAR BASIS TO IDENTIFY HEALTH NEEDS(SEE SCHEDULE O FOR CONTINUATION)WITHIN NORTHEAST INDIANA, PARTICULARLY, IN THE FIVE COUNTIES IN WHICH OUR HOSPITALS EXIST. THE FOLLOWING ARE SOME OF THE WAYS COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. IS REACHING OUT TO MAKE OUR NEIGHBORHOODS AND COMMUNITIES HEALTHIER:-FINANCIAL ASSISTANCE-COMMUNITY HEALTH IMPROVEMENT INITIATIVES-PRIMARY HEALTH CARE /ACCESS-HEALTH SCREENINGS AND PREVENTION-DISEASE MANAGEMENT-HEALTH EDUCATIONFINANCIAL ASSISTANCE:COMMUNITY HOSPITAL OF NOBLE COUNTY, 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 COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.'S COMMUNITY HEALTH IMPROVEMENT PROGRAM IS TO FUND COMMUNITY HEALTH IMPROVEMENT EFFORTS WITHIN THE SERVICE AREA OF COMMUNITY HOSPITAL OF NOBLE COUNTY, 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.CENTER FOR HEALTHY LIVING SUPPORTED BY THE CENTER FOR HEALTHY LIVING SUPERVISOR: COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. OFFERS A WELLNESS FACILITY WHERE THE COMMUNITY CAN ACCESS FITNESS CLASSES, COOKING DEMONSTRATIONS, DIABETES EDUCATION, HEALTH BEHAVIOR CHANGE PROGRAMS, REDUCED COST BLOOD DRAWS, HEALING ARTS AND PROFESSIONAL LECTURES ON HEALTH/WELLNESS. THE CENTER FOR HEALTHY LIVING'S SUPERVISOR IS INSTRUMENTAL IN THE IMPLEMENTATION OF KEY STRATEGIES AS IDENTIFIED BY OUR COMMUNITY HEALTH NEEDS ASSESSMENT - OBESITY, TOBACCO CESSATION, AND DRUG ABUSE AT THE CENTER FOR HEALTHY LIVING - PARKVIEW NOBLE. ALL PROGRAMS AND SERVICES ARE OFFERED FREE, AT LOWER COST, OR SCHOLARSHIPS ARE PROVIDED; AS NO ONE IS TURNED AWAY FOR INABILITY TO PAY. A SENIOR CLUB IS ALSO OFFERED TARGETING THE ELDERLY POPULATION FOR SOCIAL INTERACTION, EDUCATIONAL OPPORTUNITIES VITAL TO MAINTAINING AN ACTIVE LIFESTYLE THROUGH HEALTHY AGING. MANY OF THE PROGRAMS TARGETED OBESITY AND OVERALL WELLNESS. THE SUPERVISOR CONTINUES TO PROMOTE AND MANAGE THE MY BEST HEALTH PROGRAM TO SUPPORT THE OBESITY INITIATIVE TO IMPROVE BMI, WEIGHT, AND RISK FOR CHRONIC DISEASE FOR THOSE IN NOBLE COUNTY. THE CENTER FOR HEALTHY LIVING ADAPTED AND IMPLEMENTED NEW PROGRAMS IN MARCH-DECEMBER 2020 TO CONTINUE TO SERVE THE NEEDS OF THE NOBLE COUNTY COMMUNITY THROUGHOUT THE COVID-19 PANDEMIC. FITNESS CLASSES, COOKING DEMOS, SUPPORT GROUPS, AND "MEMBER MEET UPS" WERE OFFERED VIRTUALLY JUNE-DECEMBER 2020. CENTER FOR HEALTHY LIVING SUPERVISOR: COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.'S CENTER FOR HEALTHY LIVING SUPERVISOR WORKS WITH THE COUNTY SCHOOL DISTRICTS, PAROCHIAL AND PRIVATE SCHOOLS, THE NOBLE COUNTY HEALTH DEPARTMENT AS WELL AS WITH THE COMMUNITY AT LARGE TO PROVIDE HEALTH EDUCATION AND SCREENING PROGRAMS. THE GOAL IS TO IMPROVE HEALTH ACCESS, RESOURCES AND EDUCATION TO THE CITIZENS OF COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.'S COMMUNITY. THIS INCLUDES WORKING WITH THE COUNTY HEALTH DEPARTMENT TO PROVIDE VISION SCREENINGS TO HELP ASSURE THAT STUDENTS ARE ABLE TO PERFORM AT THEIR BEST AT SCHOOL. MULTIPLE EDUCATION PROGRAMS ARE PRESENTED, FROM TOBACCO EDUCATION, NUTRITION AND OTHER HEALTH RELATED TOPICS FOR SCHOOL AGE CHILDREN. THE SUPERVISOR IS ALSO INSTRUMENTAL IN IMPLEMENTATION OF TEENAGE PREGNANCY PROGRAMS, TOBACCO CESSATION, AND DRUG ABUSE EDUCATION PROGRAMS IN NOBLE COUNTY. DURING 2020, THE CENTER FOR HEALTHY LIVING SUPERVISOR WORKED DILIGENTLY & COLLABORATIVELY WITH VARIOUS COMMUNITY ORGANIZATIONS TO ENSURE THE NOBLE COUNTY COMMUNITY COULD STILL ACCESS RESOURCES AND EDUCATION THROUGH THE COVID-19 PANDEMIC. COMMUNITY PARTNERSHIPS: COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. INVESTS IN KEY ORGANIZATIONS (HEALTH PARTNERS) THAT ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF NOBLE COUNTY AND NORTHEAST INDIANA. WE PARTNER WITH THE COLE FAMILY CENTER YMCA ON MULTIPLE PROJECTS TO ENCOURAGE HEALTHIER LIFESTYLES AND NOBLE TRAILS TO FUND WALKING AND BIKING TRAIL DEVELOPMENT. TO ASSIST THOSE LESS FORTUNATE, WE SUPPORT COMMON GRACE, NOBLE HOUSE AND LOCAL FOOD PANTRIES. WE ALSO PARTNER WITH THE NOBLE COUNTY HEALTH DEPARTMENT TO PROVIDE IMMUNIZATIONS TO CHILDREN WHO OTHERWISE COULD NOT ACCESS THEM. TO ENCOURAGE HIGHER PAYING JOBS AND ECONOMIC IMPROVEMENT, WE PARTNER WITH THE NOBLE COUNTY ECONOMIC DEVELOPMENT CORPORATION. FUNDS ARE PROVIDED FOR LIFE AND FAMILY SERVICES' BABE PROGRAM, PEERS PROGRAM & MOM TO BE SUPPORT GROUP ENCOURAGE PRE-NATAL VISITS, WELL BABY VISITS AND EDUCATION FOR PARENTS. TO ASSIST IN HEALTH EDUCATION IN OUR SCHOOL DISTRICTS, FUNDS ARE PROVIDED TO MCMILLEN HEALTH TO PROVIDE EVIDENCE-BASED EDUCATION OVER OBESITY, TOBACCO USE, DRUG USE, AND PREGNANCY TO AREA SCHOOLS. OTHER PARTNERS ACTIVE IN ADDRESSING MEDICAL ISSUES INCLUDE DRUG FREE NOBLE COUNTY AND ACTIVATE NOBLE COUNTY. DURING THE COVID-19 PANDEMIC, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.'S HEALTH PARTNERS ADAPTED PROGRAMS TO BE OFFERED VIRTUALLY OR THROUGH E-LEARNING. ACTIVATE NOBLE COUNTY: THIS ORGANIZATION IS A TRUE COMMUNITY PARTNERSHIP WITH MANY ORGANIZATIONS INCLUDING COMMUNITY HOSPITAL OF NOBLE COUNTY, INC., THE COLE FAMILY CENTER YMCA, EAST NOBLE SCHOOL CORPORATION, PARKS AND RECREATION AND LOCAL GOVERNMENT. THE MISSION IS "TO IMPROVE THE HEALTH AND WELLNESS OF NOBLE COUNTY BY INCREASING OPPORTUNITIES FOR HEALTHY EATING AND ACTIVE LIVING." THE GROUP HAS BEEN THE CENTRAL PARTNERSHIP TO ESTABLISH COMMUNITY GOALS AROUND THE COMMUNITY HEALTH NEEDS ESTABLISHED FROM OUR ASSESSMENT: MENTAL HEALTH/DRUG ABUSE AND OBESITY. THE GROUP MEETS MONTHLY WORKING COLLABORATIVELY TO ESTABLISH PROGRAMS, GUIDELINES AND TO MAKE IMPROVEMENTS TO KEY METRICS FROM THE ASSESSMENT PLAN AND HAS ESTABLISHED SOCIAL MEDIA PLATFORMS TO INCREASE ENGAGEMENT AND ACTION AMONG THE COMMUNITY. THE GROUP CONTINUED TO MEET VIRTUALLY THROUGH THE COVID-19 PANDEMIC. ACTIVATE NOBLE COUNTY ALSO IS AN INSTRUMENTAL PART IN POLICY CHANGE IN NOBLE COUNTY. THE GROUP HAS STARTED CONVERSATION AND GAINED MOMENTUM AROUND WALKABILITY AND BIKE ABILITY IN NOBLE COUNTY. THE GROUP LED THE EFFORT FOR BOTH PARKLETS AND WAYFINDING SIGNS TO BE INSTALLED IN ONE OF NOBLE COUNTY'S DOWNTOWNS TO PROVIDE A DESTINATION THAT ENCOURAGES WALKING. THE GROUP ALSO GROWS AND MAINTAINS A COMMUNITY GARDEN TO HELP INCREASE ACCESS TO FRESH, AFFORDABLE PRODUCE. THROUGH THE COVID-19 PANDEMIC, THE GROUP CONTINUED TO MAINTAIN A COMMUNITY GARDEN FOR COMMUNITY MEMBERS TO ACCESS FRESH, AFFORDABLE PRODUCE. PRIMARY HEALTH CARE/ACCESS:MEDICATION ASSISTANCE PROGRAM (MAP): COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. MAINTAINS A MEDICATION ASSISTANCE PROGRAM FOR NOBLE COUNTY RESIDENTS. MAP PARTNERS WITH PATIENTS, PHYSICIANS, PHARMACEUTICAL COMPANIES, LOCAL PHARMACIES, AND DONORS TO PROVIDE MEDICATION ASSISTANCE AT LITTLE OR NO COST FOR QUALIFIED INDIVIDUALS. EMERGENCY VOUCHERS FOR ACUTE MEDICATION NEEDS ARE REDEEMED AT LOCAL PHARMACIES. LONG-TERM MEDICATION HELP IS PROVIDED THROUGH CONNECTING CLIENTS WITH PHARMACEUTICAL ASSISTANCE PROGRAMS (PAP).HEALTH SCREENING AND DISEASE PREVENTION AND MANAGEMENT:HEALTH FAIRS AND SCREENINGS: COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. PARTICIPATES IN NUMEROUS HEALTH FAIRS AND ACTIVITIES THROUGHOUT THE YEAR DESIGNED TO PROVIDE HEALTH EDUCATION, HEALTH SCREENINGS FOR DISEASE PREVENTION, AND TO PROMOTE HEALTHY LIFESTYLES. THE HOSPITAL ALSO PROVIDES SUPPORT GROUPS TO ASSIST PATIENTS AND FAMILIES IN MANAGING DISEASE. THESE HEALTH FAIRS WERE PAUSED IN MARCH 2020 BUT RESUMED IN JUNE 2020 IN A MODIFIED FORMAT TO OFFER HEALTH SCREENINGS TO THE COMMUNITY. | Desc |
| Total Program Service Expenses | $46,348,924 | 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 |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| 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 | 42 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 315 | 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 |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEANNE' WICKENS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2602669313 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1450 PRODUCTION RD | AddressLine1Txt |
| City | FORT WAYNE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46808 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 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 |
|---|---|---|---|---|---|---|---|---|---|
| MICHAEL PACKNETT | |||||||||
| DIRECTOR/PH PRESIDENT & CEO | 0.00 | 40.00 | Yes (X) | Yes (X) | $0 | $2,048,421 | $1,656,853 | ||
| CHRISTOPHER FRAZIER | |||||||||
| DIRECTOR/PH PHYSICIAN | 0.00 | 40.00 | Yes (X) | $3,502 | $482,888 | $67,555 | |||
| LISA LANE | |||||||||
| DIRECTOR/PH PHYSICIAN | 0.00 | 40.00 | Yes (X) | $16,648 | $372,844 | $63,847 | |||
| GARY ADKINS | |||||||||
| DIRECTOR/NBHOS PRESIDENT | 40.00 | 0.00 | Yes (X) | Yes (X) | $271,218 | $0 | $90,348 | ||
| DOUGLAS SCOTT | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $13,000 | $0 | $0 | |||
| THOMAS LEEDY | |||||||||
| DIRECTOR/CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $6,000 | $1,750 | $0 | ||
| GEORGE BENNETT | |||||||||
| DIRECTOR/TREASURER | 1.00 | 0.00 | Yes (X) | Yes (X) | $4,500 | $0 | $0 | ||
| ROBERT KIRSCH | |||||||||
| DIRECTOR/VICE CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $4,500 | $0 | $0 | ||
| BETH MUNK | |||||||||
| DIRECTOR/SECRETARY | 1.00 | 0.00 | Yes (X) | Yes (X) | $4,500 | $0 | $0 | ||
| JARROD RAMER | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $4,250 | $0 | $0 | |||
| GARY GATMAN | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $3,000 | $0 | $0 | |||
| KARA WARRENER | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $2,000 | $0 | $0 | |||
| JEANNE' WICKENS | |||||||||
| PH CHIEF FINANCIAL OFFICER | 0.00 | 40.00 | Yes (X) | $0 | $1,084,552 | $339,895 | |||
| ERIN GOLDSBERRY | |||||||||
| NBHOS VP PATIENT CARE | 40.00 | 0.00 | $169,715 | $13,643 | $42,325 | Yes (X) | |||
| KELLY BALYEAT | |||||||||
| NBHOS MGR PHARMACY | 40.00 | 0.00 | $177,071 | $0 | $40,325 | Yes (X) | |||
| RICHARD LARIMORE | |||||||||
| NBHOS MGR SUPPORT SVCS | 40.00 | 0.00 | $133,186 | $0 | $20,455 | Yes (X) | |||
| JULIE DESPER | |||||||||
| NBHOS MGR REHAB | 22.00 | 18.00 | $77,933 | $50,196 | $46,939 | Yes (X) | |||
| HEATHER ANTAL | |||||||||
| NBHOS MGR NURSING SVCS | 40.00 | 0.00 | $123,067 | $0 | $45,040 | Yes (X) | |||
| GARY HEIMAN | |||||||||
| NBHOS PARAMEDIC | 40.00 | 0.00 | $103,568 | $11,016 | $21,519 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,117,658 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,065,310 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,435,101 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 11 | 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 |
|---|---|---|---|---|---|
| PARKVIEW HOSPITAL INC | |||||
| 11109 PARKVIEW PLAZA DRIVE | FORT WAYNE | IN | 46845 | LABORATORY SERVICES | $2,348,940 |
| CLINICAL COLLEAGUES INC | |||||
| PO BOX 824246 | PHILADELPHIA | PA | 19182 | ANESTHESIOLOGISTS | $1,140,476 |
| NORTHEAST INTERNAL MEDICINE ASSOC INC | |||||
| 2500 N DETROIT ST | LAGRANGE | IN | 46761 | HOSPITALISTS | $439,998 |
| HEALOGICS WOUND CARE & HYPERBARIC SERVIC | |||||
| PO BOX 551187 | JACKSONVILLE | FL | 32255 | MEDICAL SERVICES | $370,336 |
| AVERA HEALTH | |||||
| 3900 WEST AVERA DRIVE | SIOUX FALLS | SD | 57108 | NURSES | $328,992 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $65,223 | RelatedOrganizationsAmt |
| Government Grants | $5,634,511 | GovernmentGrantsAmt |
| Noncash Contributions | $780 | NoncashContributionsAmt |
| Total Contributions | $5,699,734 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE | 622000 | $62,001,167 | $62,001,167 |
| EMS SUBSIDY | 621910 | $278,628 | $278,628 |
| INTERUNIT RENT | 531120 | $116,285 | $116,285 |
| PHARMACY | 446110 | $32,972 | $32,972 |
| HEALTH FAIR | 621990 | $32,460 | $32,460 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,284 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,284 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $62,467,796 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $79 | TotalRevenueColumnAmt |
| Exclusion | $79 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $25,306 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $47,229 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$21,923 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$21,923 | TotalRevenueColumnAmt |
| Exclusion | -$21,923 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,731 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$5,731 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$5,731 | TotalRevenueColumnAmt |
| Exclusion | -$5,731 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA SALES | 722210 | $88,009 | $88,009 |
| GIFT SHOP | 453220 | $6,895 | $6,895 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $94,904 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $68,234,859 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $62,467,796 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $67,329 | 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 | $109,589 | TotalAmt |
| Program Services | $109,589 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $635,573 | TotalAmt |
| Management And General | $635,573 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,144,744 | TotalAmt |
| Program Services | $14,144,744 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,821,228 | TotalAmt |
| Program Services | $4,821,228 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,589,607 | TotalAmt |
| Program Services | $5,718,750 | ProgramServicesAmt |
| Management And General | $870,857 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $762 | TotalAmt |
| Program Services | $264 | ProgramServicesAmt |
| Management And General | $498 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,076,531 | TotalAmt |
| Program Services | $952,764 | ProgramServicesAmt |
| Management And General | $123,767 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,659 | TotalAmt |
| Program Services | $1,659 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,353,470 | TotalAmt |
| Program Services | $2,352,132 | ProgramServicesAmt |
| Management And General | $1,338 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,295 | TotalAmt |
| Program Services | $6,885 | ProgramServicesAmt |
| Management And General | $1,410 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,981 | TotalAmt |
| Program Services | $6,981 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,547 | TotalAmt |
| Program Services | $4,547 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,088,945 | TotalAmt |
| Program Services | $1,079,509 | ProgramServicesAmt |
| Management And General | $9,436 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,344 | TotalAmt |
| Program Services | $88,344 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| FEDERAL & STATE INCOME | $694 | $694 | |
| CORP SERVICE ALLOCATION | $10,359,940 | $10,359,940 | |
| PH CLINICAL SUPPORT | $8,315,902 | $8,315,902 | |
| MEDICAL SUPPLIES | $5,238,510 | $5,238,510 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,761,201 | TotalAmt |
| Program Services | $3,507,116 | ProgramServicesAmt |
| Management And General | $97,882 | ManagementAndGeneralAmt |
| Fundraising | $156,203 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,606,522 | TotalAmt |
| Program Services | $46,348,924 | ProgramServicesAmt |
| Management And General | $12,101,395 | ManagementAndGeneralAmt |
| Fundraising | $156,203 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,952 | BOYAmt |
| EOY | $10,440 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,856,536 | BOYAmt |
| EOY | $9,535,105 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $430,222 | BOYAmt |
| EOY | $425,412 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,806 | BOYAmt |
| EOY | $15,850 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $18,052,185 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $12,384,051 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,033,486 | BOYAmt |
| EOY | $5,668,134 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,000 | BOYAmt |
| EOY | $5,000 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $840,505 | BOYAmt |
| EOY | $840,505 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,858,610 | BOYAmt |
| EOY | $23,486,317 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,073,117 | BOYAmt |
| EOY | $39,986,763 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,583,182 | BOYAmt |
| EOY | $2,598,085 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $4,841,386 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $757,227 | BOYAmt |
| EOY | $3,359,638 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,340,409 | BOYAmt |
| EOY | $10,799,109 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,732,708 | BOYAmt |
| EOY | $29,187,654 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,732,708 | BOYAmt |
| EOY | $29,187,654 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,073,117 | BOYAmt |
| EOY | $39,986,763 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $9,628,337 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$1,173,391 | 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 | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 | $4,717 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,717 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | REPRESENTS THE PORTION OF THE DUES PAID TO INDIANA HOSPITAL AND HEALTH ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION AND VARIOUS PROFESSIONAL ASSOCIATIONS USED FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $130,151 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $5,785 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $135,936 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $126,071 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $4,080 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $130,151 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $122,487 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $3,584 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $126,071 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $113,496 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $8,991 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $122,487 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $97,757 | BeginningYearBalanceAmt |
| Contributions | $11,500 | ContributionsAmt |
| Investment Earnings Or Losses | $4,239 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $113,496 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 1.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,922,018 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,035,258 | DepreciationAmt |
| Book Value | $1,886,760 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $63,781 | OtherCostOrOtherBasisAmt |
| Depreciation | $34,962 | DepreciationAmt |
| Book Value | $28,819 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,934,276 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,740,876 | DepreciationAmt |
| Book Value | $3,193,400 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,132,110 | OtherCostOrOtherBasisAmt |
| Depreciation | $572,955 | DepreciationAmt |
| Book Value | $559,155 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,668,134 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE TO/FROM INTERUNIT | $22,960,075 |
| RIGHT OF USE ASSETS | $526,242 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $23,486,317 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| EST 3RD PARTY SETTLEMENTS | $970,736 |
| EST MEDICARE/MEDICAID SETTLEMENTS | $1,851,008 |
| LEASE LIABILITY | $537,894 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,359,638 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | TO SUPPORT HOSPITAL BUILDING NEEDS FOR COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. |
| 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, 2020 AND 2019, 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 2016 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 | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| 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 | $1,238,234 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,238,234 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02460 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,011,636 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,545,043 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,466,593 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04900 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,244,600 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,103,559 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,141,041 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04260 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,494,470 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,648,602 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,845,868 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11620 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $92,411 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,514 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $89,897 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $100,387 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $100,387 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $192,798 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,514 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $190,284 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00380 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,687,268 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,651,116 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,036,152 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12000 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $25,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $30,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $30,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $0 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $54,713 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $10,697,005 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,876,334 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $2,820,671 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL OF NOBLE COUNTY INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 SAWYER RD | AddressLine1Txt |
| City | KENDALLVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46755 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PARKVIEW.COM | WebsiteAddressTxt |
| State License | 14-002434-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL OF NOBLE COUNTY 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 | 19 | 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 | HTTPS://WWW.PARKVIEW.COM/LOCALHEALTHNEEDS | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://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 |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.PARKVIEW.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.PARKVIEW.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.PARKVIEW.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| COMMUNITY HOSPITAL OF NOBLE COUNTY, 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 2019 CHNA, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. AND THE INDIANA PARTNERSHIP FOR HEALTHY COMMUNITIES (IN-PHC) RESEARCH TEAM WERE DILIGENT IN ENSURING THE INPUT FROM PERSONS REPRESENTING THE BROADER INTERESTS OF THE COMMUNITY'S VULNERABLE POPULATIONS WERE CONSIDERED.IN GATHERING QUALITATIVE COMMUNITY INPUT, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. AND ITS RESEARCH PARTNERS OBTAINED THE FOLLOWING: 1) PRIMARY DATA COLLECTED VIA AN ONLINE SURVEY OF PARKVIEW HEALTH SYSTEM, INC. HEALTHCARE PROVIDERS (E.G., PHYSICIANS, NURSES, SOCIAL WORKERS, ETC.). ADDITIONALLY, THE HEALTH SYSTEMS CHNA RESEARCH PARTNERS CONDUCTED A SURVEY OF THE COMMUNITY RESIDENTS IN EACH PARKVIEW HEALTH COUNTY. 2) SECONDARY DATA WAS GATHERED FROM CONDUENT'S HEALTHY COMMUNITIES INSTITUTE (HCI) DATABASE AND OTHER LOCAL AND NATIONAL AGENCIES.IN ADDITION TO DATA COLLECTION, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. TURNED TO THE COMMUNITY AND PARTNERING ORGANIZATIONS WHEN SELECTING AND PRIORITIZING NOBLE COUNTY'S HEALTH NEEDS. IN DOING SO, A MODIFIED HANLON METHOD PRIORITIZED 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.). ALTHOUGH COMPLEX TO IMPLEMENT, IT IS 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.THE INDIANA PARTNERSHIP FOR HEALTHY COMMUNITIES PRESENTED AN OVERVIEW OF THE REGIONAL CHNA FINDINGS ON JULY 16, 2019, TO ATTENDEES REPRESENTING THE PARKVIEW HEALTH SYSTEM. IN TOTAL OVER 60 INDIVIDUALS PARTICIPATED IN THE PRIORITIZATION PROCESS, INCLUDING REPRESENTATIVES FROM HOSPITAL SERVICE LINES, COMMUNITY HOSPITALS, HEALTHCARE PROVIDERS/PHYSICIANS, EXECUTIVE LEADERSHIP TEAM, COMMUNITY HEALTH AND HOSPITAL BOARD OF DIRECTORS. AFTER A THOROUGH REVIEW OF THE DATA AND CONSIDERABLE DISCUSSION, THE GROUP USED AN ELECTRONIC VOTING SYSTEM TO RANK THE VARIOUS HEALTH NEEDS IDENTIFIED IN THE CHNA. ULTIMATELY, THE GROUP VOTED ON SUBSTANCE USE DISORDER/MENTAL HEALTH, AS THE SHARED HEALTH PRIORITY ACROSS THE HEALTH SYSTEM.AS A CONTINUATION OF THE PRIORITIZATION PROCESS, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC FORMED AN INTERNAL, MULTI-DISCIPLINARY ADVISORY COUNCIL TO SELECT ADDITIONAL HEALTH PRIORITIES FOR COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. THIS GROUP OF STAKEHOLDERS MET AND DISCUSSED THE RESULTS OF THE CHNA. AFTER A THOUGHTFUL REVIEW OF THE DATA AND EXTENSIVE DISCUSSION, THE ADVISORY COMMITTEE SELECTED OBESITY AS OUR SECOND PRIORITY.COMMUNITY HOSPITAL OF NOBLE COUNTY ALSO HELD A COMMUNITY SESSION TO SHARE THE NOBLE COUNTY CHNA RESULTS AND TO GATHER FEEDBACK FROM LOCAL NON-PROFIT AND PUBLIC HEALTH ORGANIZATIONS. ADDITIONALLY, THE TOP TWO HEALTH PRIORITIES WERE PRESENTED TO AND ADOPTED BY COMMUNITY HOSPITAL OF NOBLE COUNTY, INC'S HOSPITAL BOARD OF DIRECTORS. |
| COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. | PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY'S CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES:PARKVIEW HOSPITAL, INC. (EIN 35-0868085); COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. (EIN 20-2401676); HUNTINGTON MEMORIAL HOSPITAL, INC. (EIN 35-1970706); WHITLEY MEMORIAL HOSPITAL, INC. (EIN 35-1967665); PARKVIEW WABASH HOSPITAL, INC. (EIN 47-1753440) AND ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH, LLC (EIN 26-0143823). |
| COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. | PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY'S CHNA WAS ALSO CONDUCTED WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES:PARKVIEW HEALTH, INC. (EIN 35-1972384); INDIANA PARTNERSHIP FOR HEALTHY COMMUNITIES (A PARTNERSHIP BETWEEN THE INDIANA UNIVERSITY RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH AND THE POLIS CENTER AT IUPUI) AND CONDUENT HEALTHY COMMUNITIES INSTITUTE. |
| COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. | PART V, SECTION B, LINE 11: DESCRIBE HOW THE HOSPITAL FACILITY IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA AND ANY SUCH NEEDS THAT ARE NOT BEING ADDRESSED TOGETHER WITH THE REASONS WHY SUCH NEEDS ARE NOT BEING ADDRESSED:SIGNIFICANT HEALTH NEEDS BEING ADDRESSED:OBESITY:COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. IS BOLSTERING ITS EFFORTS IN AREAS DEEMED TO BE THE HIGHEST IMPACT FOR OBESITY PREVENTION. THESE INCLUDE THE FOLLOWING: 1) WORKING TO INCREASE ACCESS TO FRESH, AFFORDABLE AND LOCALLY GROWN (WHEN POSSIBLE) FOOD; 2) INCREASING CONSUMPTION OF FRESH PRODUCE; 3) OFFERING CURRICULUM TO ELEMENTARY SCHOOLS FOR PHYSICAL ACTIVITY AND NUTRITION; 4) PREVENTIVE HEALTH AND SKILL-BUILDING CLASSES FOR FAMILIES AND INDIVIDUALS AND 5) PROVIDER DIRECTED WELLNESS RESOURCES INCLUDING REFERRALS TO MY BEST HEALTH, HEALTH BEHAVIOR CHANGE PROGRAM. ACTIONS TO ADDRESS THE ISSUE OF OBESITY CENTER AROUND AND INCLUDE THE FOLLOWING PROGRAMS: 1) MY BEST HEALTH, HEALTH BEHAVIOR CHANGE PROGRAMA. JANUARY-MARCH 2020 THE MY BEST HEALTH PROGRAM WAS RUN AS NORMAL.B. MID MARCH-OCTOBER 2020 THE MY BEST HEALTH PROGRAM WAS RUN VIRTUALLY FOR PARTICIPANTS DUE TO COVID-19 SAFETY RESTRICTIONS. PROFESSIONALS MET WITH PARTICIPANTS VIRTUALLY THROUGH A ZOOM OR TEAMS PLATFORM TO CONTINUE TO WORK TOWARDS LIFESTYLE, HEALTH BEHAVIOR CHANGE. 2) CENTER FOR HEALTHY LIVING PHYSICAL FITNESS CLASSESA. JANUARY-EARLY MARCH 2020-FITNESS CLASSES WERE OFFERED IN PERSON TO COMMUNITY MEMBERS.B. MID MARCH-MAY 2020-NO FITNESS CLASSES WERE OFFERED TO COMMUNITY MEMBERS DUE TO THE COVID-19 PANDEMIC AND SAFETY PRECAUTIONS. C. JUNE-DECEMBER 2020 THE CENTER FOR HEALTHY LIVING OFFERED FITNESS CLASSES VIA ZOOM FOR COMMUNITY MEMBERS. 3) ACTIVATE NOBLE COUNTY FARM STANDSA. ACTIVATE NOBLE COUNTY MAINTAINED A GARDEN IN THE SUMMER GROWING MONTHS AND ALLOWED COMMUNITY MEMBERS TO ACCESS FRESH, AFFORDABLE PRODUCE DURING THE SUMMER MONTHS WHILE PRACTICING OUTDOOR SOCIAL DISTANCING. 4) DIABETES WORKSHOPS AND SUPPORT GROUPSA. DIABETES SUPPORT GROUPS AND WORKSHOPS WERE RUN FREE OF CHARGE TO THE COMMUNITY JANUARY AND FEBRUARY 2020 BUT WERE PAUSED MARCH-DECEMBER DUE TO COVID-19.5) COOKING DEMONSTRATIONS A. JUNE-DECEMBER 2020 COOKING DEMOS WERE OFFERED TO THE COMMUNITY BY THE COMMUNITY OUTREACH RDN VIA ZOOM. 6) EMERGENCY FOOD BAGMENTAL HEALTH & DRUG ABUSE: COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. IS BOLSTERING IT'S EFFORTS IN AREAS DEEMED TO BE HIGHEST IMPACT FOR MENTAL HEALTH & DRUG ABUSE IN THE FOLLOWING WAYS: TOBACCO USE: 1) PROVIDE EDUCATION IN THE SCHOOL SYSTEMS FOR PREVENTION OF TOBACCO USE. A. JANUARY-FEBRUARY 2020 EDUCATION WAS PROVIDED IN PERSON IN NOBLE COUNTY SCHOOLS.B. MARCH-DECEMBER 2020 EDUCATION WAS ADAPTED TO BE OFFERED VIRTUALLY OR THROUGH E-LEARNING DUE TO COVID-19 PRECAUTIONS. 2) OFFER FREEDOM FROM SMOKING (TOBACCO CESSATION PROGRAM) FOR FREE TO ALL PARTICIPANTS. A. FREEDOM FROM SMOKING WAS OFFERED IN PERSON FEBRUARY 2020 BUT WAS TRANSITIONED TO A VIRTUAL SETTING IN MARCH TO FINISH THE PROGRAM. DRUG USE: COMMUNITY HOSPITAL OF NOBLE COUNTY PARTNERS WITH VARIOUS COMMUNITY PARTNERS TO PROVIDE EDUCATION IN OUR SCHOOL SYSTEMS. JANUARY-FEBRUARY 2020 EDUCATION WAS PROVIDED IN PERSON IN NOBLE COUNTY SCHOOLS MARCH-DECEMBER 2020 EDUCATION WAS ADAPTED TO BE OFFERED VIRTUALLY OR THROUGH E-LEARNING DUE TO COVID-19 PRECAUTIONS. MENTAL HEALTH: 1) THE CENTER FOR HEALTHY LIVING OFFERS CLASSES FOR STRESS REDUCTION AS WELL AS A HEALING ARTS SERIES. A. JANUARY AND FEBRUARY 2020 STRESS REDUCTION CLASSES/HEALING ARTS WERE OFFERED AT THE CENTER FOR HEALTHY LIVING.2) PARKVIEW BEHAVIORAL HEALTH IS INVOLVED IN THE NOBLE COUNTY COMMUNITY TO BRIEFLY PROVIDE THERAPY AND RESOURCES FOR THOSE WITH IMMEDIATE MENTAL HEALTH NEEDS. 3) SUPPORTING LOCAL PARTNERS SUCH AS NOBLE HOUSE MINISTRIES.OTHER HEALTH NEEDS NOT BEING ADDRESSED:-DIABETES - COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. CURRENTLY ALREADY HAS A DIABETES EDUCATOR ON STAFF AND FREE WORKSHOPS AND SUPPORT GROUPS OFFERED TO THE COMMUNITY. REGISTERED DIETICIANS ARE ON STAFF TO PROVIDE CONSULTATIONS FOR THOSE DIAGNOSED WITH DIABETES. SUPPORT GROUPS AND WORKSHOPS WERE AFFECTED BY THE COVID-19 PANDEMIC BUT EDUCATION WAS STILL PROVIDED TO PATIENTS THROUGH THE DIABETES EDUCATOR (RN) AND RDN VIRTUALLY. -MATERNAL/INFANT/CHILD HEALTH - A BIRTH PLANNER ON STAFF TEACHES SAFE SLEEP CLASSES FOR EXPECTING PARENTS AND LIFE AND FAMILY SERVICES & HEALTHIER MOMS AND BABIES ALREADY OFFER WORKSHOPS AND EDUCATION FOR THE UNDERSERVED POPULATIONS. THE BIRTH PLANNER, OB SUPERVISORS, AND LIFE AND FAMILY SERVICES ALSO PARTNER TO OFFER A MOM TO BE SUPPORT GROUP TO INSPIRE AND ENCOURAGE ALL MOMS ESPECIALLY YOUNG MOMS ACROSS THE COUNTY. THESE PROGRAMS WERE ADAPTED THROUGH THE COVID-19 PANDEMIC TO BE ABLE TO BE OFFERED VIRTUALLY. -CARDIOVASCULAR DISEASE - THE SIZE OF THE HEALTH PROBLEM WAS LOWER IN RANKING THAN THE THREE HEALTH NEEDS IDENTIFIED. -CANCER - THE SIZE OF THE HEALTH PROBLEM WAS LOWER IN RANKING THAN THE THREE HEALTH NEEDS IDENTIFIED. -HEALTH CARE ACCESS - COST AND QUALITY - COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. CURRENTLY OFFERS MEDICATION ASSISTANCE, CHARITY CARE, FINANCIAL ASSISTANCE WITH HOSPITAL BILLS, AND TRANSPORTATION FOR THE UNDERSERVED POPULATION TO ACCESS HEALTH CARE. -ASTHMA - THIS NEED RANKED TOO LOW OVERALL ON THE HANLON SCORES BY INDICATOR AND WAS NOT CHOSEN. -AGING - THIS NEED RANKED TOO LOW OVERALL ON THE HANLON SCORES BY INDICATOR AND WAS NOT CHOSEN. |
| 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. |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | EQUITY IN A HOME OTHER THAN THE PATIENT OR GUARANTOR'S PRIMARY RESIDENCE. |
| PART I, LINE 6A: | THE RELATED ENTITIES OF PARKVIEW HEALTH SYSTEM, INC. (EIN 35-1972384); PARKVIEW HOSPITAL, INC. (EIN 35-0868085); COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. (EIN 20-2401676); COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. (EIN 35-2087092); HUNTINGTON MEMORIAL HOSPITAL, INC. (EIN 35-1970706); WHITLEY MEMORIAL HOSPITAL, INC. (EIN 35-1967665) AND PARKVIEW WABASH HOSPITAL, INC. (EIN 47-1753440) PREPARED A COMBINED REPORT TO THE COMMUNITY DETAILING COMMUNITY BENEFIT PROGRAMS AND SERVICES. |
| PART I, LINE 7: | PART I, LINE 7ATHE FINANCIAL ASSISTANCE COST REPORTED ON LINE 7A IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE FINANCIAL ASSISTANCE CHARGES FOREGONE ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF SERVICES RENDERED.PART I, LINE 7BCOMMUNITY HOSPITAL OF NOBLE COUNTY, 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 7CCOMMUNITY HOSPITAL OF NOBLE COUNTY, 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, COMMUNITY HOSPITAL OF NOBLE COUNTY, 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 EXPENSECOMMUNITY HOSPITAL OF NOBLE COUNTY, INC. EXCLUDED $8,315,902 OF PH CLINICAL SUPPORT EXPENSE. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | DESCRIBE HOW THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES, AS REPORTED, PROMOTE THE HEALTH OF THE COMMUNITIES THE ORGANIZATION SERVES.HEALTH RESOURCES & SERVICES ADMINISTRATION (HRSA), IS AN AGENCY OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. HRSA DEVELOPS SHORTAGE DESIGNATION CRITERIA AND USES THEM TO DECIDE WHETHER OR NOT A GEOGRAPHIC AREA, POPULATION GROUP OR FACILITY IS A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) OR A MEDICALLY UNDERSERVED AREA OR POPULATION (MUA/P). HRSA HAS DESIGNATED NOBLE COUNTY AS A GEOGRAPHIC HPSA IN PRIMARY CARE, AND THE NORTHEASTERN CATCHMENT AREA 18 IN NOBLE COUNTY AS A GEOGRAPHIC HPSA IN MENTAL HEALTH. AS SUCH, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. PROVIDES SUPPORT FOR LOCAL ECONOMIC DEVELOPMENT PROGRAMS. THESE EFFORTS ARE ALIGNED WITH OF THE HEALTH SYSTEM'S STRATEGIC INVOLVEMENT IN THE NORTHEAST INDIANA REGIONAL PARTNERSHIP'S VISION 2020, A REGIONAL INITIATIVE DESIGNED TO TRANSFORM NORTHEAST INDIANA INTO A TOP GLOBAL COMPETITOR BY FOCUSING ON A COMMON MISSION TO DEVELOP, ATTRACT AND RETAIN TALENT. VISION 2020'S REGIONAL PRIORITIES ARE TIED TO EDUCATION/WORKFORCE, BUSINESS CLIMATE, ENTREPRENEURSHIP, INFRASTRUCTURE AND QUALITY OF LIFE FOR THE ELEVEN-COUNTY REGION IN NORTHEAST INDIANA. PROMOTION OF ECONOMIC DEVELOPMENT IN NOBLE COUNTY IS A PART OF A COLLECTIVE PLAN TO IMPROVE THE QUALITY OF LIFE AND ULTIMATELY THE OVERALL HEALTH AND WELL-BEING OF THE COMMUNITY. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. HAS A STRONG COMMITMENT TO SUPPORTING AND ENHANCING THE VITALITY OF OUR COMMUNITY. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. INVESTS IN PROJECTS THAT HELP TO IMPROVE THE HEALTH AND INSPIRE THE WELL-BEING OF THE COMMUNITY. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. PARTNERS WITH NOBLE COUNTY ECONOMIC DEVELOPMENT TO CONTINUE TO SUPPORT NOBLE COUNTY AS A TOP PLACE TO LIVE, WORK AND PLAY. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. ALSO SUPPORTS PHYSICIAN RECRUITMENT ACTIVITIES TO ASSIST IN TIMELY RESPONSE TO PATIENT CARE NEEDS IN THE COMMUNITY. THESE RECRUITMENT ACTIVITIES ARE BASED ON RESULTS OF A PERIODIC PHYSICIAN NEEDS ASSESSMENT. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. DEVELOPED A PHYSICIAN RECRUITMENT PLAN TO ADDRESS POTENTIAL GAPS IN PATIENT COVERAGE. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. STRIVES TO BRING THE BEST INTEGRATED, QUALITY, COST EFFECTIVE CARE AND INNOVATIVE TECHNOLOGY TO OUR COMMUNITIES. IN DOING SO, WE FOCUS OUR EFFORTS ON RECRUITING AND AN EXCEPTIONAL TEAM OF PHYSICIANS. PARKVIEW NOBLE CENTER FOR HEALTHY LIVING IS FULLY IMPLEMENTED WITH AN EMPHASIS ON HEALTH NEEDS SUCH AS REDUCTION IN THE OBESITY RATE, SMOKING CESSATION CLASSES AND DRUG ABUSE REDUCTION IN NOBLE COUNTY. EXERCISE CLASSES, NUTRITIONAL TALKS AND SUPPORT GROUPS HELP AREA RESIDENTS IMPROVE THEIR HEALTH AND SENSE OF WELL-BEING. IN ADDITION, FREE AND REDUCED - COST SCREENINGS ARE OFFERED ON A REGULAR BASIS. THE CENTER FOR HEALTHY LIVING ADAPTED IT'S PROGRAMING IN JUNE OF 2020 AFTER BEING CLOSED MARCH-MAY 2020 DUE TO THE COVID-19 PANDEMIC TO OFFER PROGRAMING VIRTUALLY.EVERY MEMBER OF COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.'S HEALTHCARE TEAM IS RESPONSIBLE FOR NURTURING AN ENVIRONMENT OF EXCELLENCE AS THE BEST PLACE FOR CO-WORKERS TO WORK, PHYSICIANS TO PRACTICE MEDICINE, AND PATIENTS TO RECEIVE CARE. WE ARE COMMITTED TO PROVIDING EXCELLENT CUSTOMER SERVICE TO ALL PEOPLE. WE KNOW HOW IMPORTANT CLINICAL, SERVICE AND OPERATIONAL EXCELLENCE IS TO THE SUCCESS OF COMMUNITY HOSPITAL OF NOBLE COUNTY, INC., AND WE RECOGNIZE HOW IMPORTANT OUR SUCCESS IS TO THE COMMUNITY. |
| 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. THE AMOUNT REPORTED ON PART III, LINE 3 IS THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER PARKVIEW HEALTH SYSTEM'S FINANCIAL ASSISTANCE POLICY ON A GROSS BASIS. |
| PART III, LINE 3: | COSTING METHODOLOGY USED:UNCOLLECTIBLE PATIENT ACCOUNTS ARE CHARGED AGAINST THE PROVISION FOR BAD DEBT IN ACCORDANCE WITH THE POLICIES OF COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. HOWEVER, DURING THE COLLECTION PROCESS THERE IS A CONTINUOUS EFFORT TO DETERMINE IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. THEREFORE, ONCE AN UNCOLLECTIBLE ACCOUNT HAS BEEN CHARGED OFF AND IT IS DETERMINED THROUGH THE COLLECTION PROCESS THAT THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THE UNCOLLECTIBLE ACCOUNT IS RECLASSIFIED TO CHARITY CARE AND ALL COLLECTION EFFORTS CEASE. PATIENTS ARE ELIGIBLE TO APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE APPLICATION PERIOD, INCLUDING PATIENTS WHOSE ACCOUNTS HAVE BEEN PLACED WITH A COLLECTION AGENCY. THE AMOUNT REFLECTED ON LINE 3 WAS CALCULATED BY TOTALING THE ACCOUNTS PREVIOUSLY WRITTEN OFF TO BAD DEBT AND PLACED WITH A COLLECTION AGENCY, BUT SUBSEQUENTLY RECLASSIFIED AS CHARITY CARE DURING THE TAX YEAR. THE ACCOUNTS WERE RECLASSIFIED AS CHARITY CARE DUE TO THE FACT THAT PATIENTS APPLIED FOR, AND WERE APPROVED FOR, FINANCIAL ASSISTANCE AFTER THE ACCOUNTS WERE PLACED WITH A BAD DEBT AGENCY. |
| PART III, LINE 4: | BAD DEBT EXPENSE - PARKVIEW HEALTH SYSTEM, INC. AND SUBSIDIARIES - NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTSTEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE OR THE PAGE NUMBER ON WHICH THIS FOOTNOTE IS CONTAINED IN THE ATTACHED FINANCIAL STATEMENTS:PAGES 13 AND 24 - 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. COMMUNITY HOSPITAL OF NOBLE COUNTY, 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, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. HAS TAKEN THE POSITION NOT TO INCLUDE THE MEDICARE SHORTFALLS OR SURPLUSES AS PART OF COMMUNITY BENEFIT. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. RECOGNIZES THAT THE SHORTFALL OR SURPLUS FROM MEDICARE DOES NOT INCLUDE THE COSTS AND REVENUES ASSOCIATED WITH MEDICARE ADVANTAGE PATIENTS. AS SUCH, THE TOTAL SHORTFALL OR SURPLUS OF MEDICARE IS UNDERSTATED DUE TO THE COSTS AND REVENUES ASSOCIATED WITH MEDICARE ADVANTAGE PATIENTS NOT BEING INCLUDED IN THE COMMUNITY BENEFIT DETERMINATION. |
| PART III, LINE 9B: | IF THE PATIENT CANNOT PAY IN FULL, THE OPTION OF A LOW INTEREST LOAN IS AVAILABLE WITH THE SAME DISCOUNT OFFERED FOR CASH PAYMENTS AS LONG AS THE LOAN IS ARRANGED WITHIN 30 DAYS OF THE FIRST GUARANTOR STATEMENT. IF THE PATIENT DEFAULTS ON THE LOAN, THE DISCOUNT WILL BE REVERSED AND THE PATIENT'S ACCOUNT WILL BE PLACED IN A COLLECTION AGENCY.INTEREST-FREE PAYMENTS WITH PAY-OUT NOT TO EXCEED THIRTY-SIX (36) MONTHS ARE AVAILABLE. THE MINIMUM MONTHLY PAYMENT IS $25.FINANCIAL ASSISTANCE MAY BE AVAILABLE FOR THOSE PATIENTS WHO CANNOT PAY THEIR BILL. THOSE OPTIONS ARE GOVERNMENTAL ASSISTANCE OR FREE CARE THROUGH THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM. THE HEALTH SYSTEM FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON PARKVIEW.COM OR BY VISITING ANY HOSPITAL CASHIER OFFICE OR BY CALLING PATIENT ACCOUNTING AT 260.266.6700 OR TOLL FREE 855.814.0012. A PATIENT MAY APPLY FOR FINANCIAL ASSISTANCE ANYTIME DURING THE APPLICATION PERIOD. FAILURE TO MAKE ARRANGEMENTS AS LISTED ABOVE OR FAILURE TO APPLY FOR AND RECEIVE APPROVAL UNDER THE FINANCIAL ASSISTANCE POLICY MAY RESULT IN THE ACCOUNT BEING PLACED IN A COLLECTION AGENCY DUE TO NON-PAYMENT. THE COLLECTION AGENCY MAY REPORT THE ACCOUNT TO ONE OR ALL THREE CREDIT REPORTING AGENCIES WHICH MAY ULTIMATELY ADVERSELY AFFECT THE PATIENT'S CREDIT SCORE. ADDITIONALLY, THE COLLECTION AGENCY MAY SUE AND OBTAIN A JUDGMENT AGAINST THE PATIENT FOR NON-PAYMENT. THESE ACTIONS WILL NOT OCCUR UNTIL 120 DAYS AFTER THE PATIENT IS SENT THEIR FIRST FOLLOW-UP STATEMENT INDICATING THE AMOUNT THEY OWE.A PATIENT MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE APPLICATION PERIOD, EVEN THOUGH THEY HAVE BEEN PLACED WITH A COLLECTION AGENCY. IF THE PATIENT WAS SENT THEIR FIRST NOTICE ON THE ACCOUNT FOR WHICH THEY ARE APPLYING FOR FREE CARE BETWEEN 120 DAYS AND THE END OF THE APPLICATION PERIOD, THE ACTIONS ABOVE WILL BE SUSPENDED UNTIL THE FREE CARE APPLICATION ELIGIBILITY IS DETERMINED. |
| PART VI, LINE 2: | DESCRIBE HOW THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES, IN ADDITION TO ANY CHNAS REPORTED IN PART V, SECTION B.IN ADDITION TO COMPLETING A COMMUNITY HEALTH NEEDS ASSESSMENT ON A TRIENNIAL BASIS, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES THROUGH PRIMARY AND SECONDARY DATA ANALYSIS, WORKING WITH THE ORGANIZATION'S COMMUNITY PARTNERS, AND ITS FRONTLINE STAFF. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. IDENTIFIES AND VERIFIES COMMUNITY HEALTH NEEDS THROUGH THE FOLLOWING:- HEALTHY COMMUNITIES INSTITUTE (HCI) SECONDARY DATA ANALYSIS- OBSERVATIONS FROM FRONTLINE STAFF WORKING WITH VULNERABLE POPULATIONS (I.E., COMMUNITY NURSES AND COMMUNITY HEALTH WORKER'S- REVIEW OF COMMUNITY NEEDS ASSESSMENTS CONDUCTED BY LOCAL ORGANIZATIONS (I.E., UNITED WAY, BRIGHTPOINT, ETC.)- PARKVIEW LEADERSHIP'S SERVICE ON HEALTH-RELATED AND SOCIAL SERVICE COMMUNITY BOARDSKEY 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.COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. PRIMARILY SERVES THE NOBLE COUNTY COMMUNITIES OF KENDALLVILLE, LIGONIER, AVILLA, ALBION, ROME CITY, CROMWELL, AND WOLCOTTVILLE. AS THE ONLY HOSPITAL IN THIS COUNTY, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. ALSO SERVES, TO A LIMITED EXTENT, OTHER SURROUNDING COMMUNITIES. ACCORDING TO THE U.S. CENSUS BUREAU, NOBLE COUNTY HAS APPROXIMATELY 47,744 RESIDENTS, PRIMARILY CAUCASIAN. HISPANICS OR LATINOS MAKE UP APPROXIMATELY 10.5% OF NOBLE COUNTY RESIDENTS. ACCORDING TO PARKVIEW'S 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, THE MEDIAN INCOME IN NOBLE COUNTY IS $52,393 AND HAS A POVERTY RATE OF 9.3%. THE MAKE-UP OF EMPLOYMENT IS HEAVILY MANUFACTURING, FOLLOWED BY HEALTH CARE AND SOCIAL ASSISTANCE JOBS. ACCORDING TO COUNTY HEALTH RANKINGS, NOBLE COUNTY'S UNINSURED RATE IS 11% AND THE UNEMPLOYMENT RATE IS 3.1%. |
| 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 COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY MEMBERS WHO RESIDE IN HOSPITAL'S PRIMARY SERVICE AREA. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. PEOPLE THROUGHOUT THE COMMUNITY CAN COUNT ON COMMUNITY HOSPITAL OF NOBLE COUNTY, 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, AN AFTER-HOURS CLINIC IS STAFFED BY LOCAL PHYSICIANS AFTER HOURS AND ON THE WEEKENDS. DURING THE HEIGHT OF THE COVID-19 PANDEMIC, THIS CLINIC WAS TRANSITIONED INTO A RESPIRATORY CLINIC. DURING THIS TIME, ALL PATIENTS WITH ANY TYPE OF ACUTE ILLNESS THAT COULD BE COVID RELATED WERE DIVERTED TO THE AFTER-HOURS CLINIC. ACUTE INJURIES OR NON-COVID CONDITIONS WERE SENT TO OUR LOCAL PARKVIEW PHYSICIAN'S GROUP FAMILY MEDICINE OFFICE TO BE SEEN. FURTHERMORE, NO PATIENT IS EVER DENIED TREATMENT, REGARDLESS OF THEIR ABILITY TO PAY, AND COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. AND IT'S AFFILIATES CONTINUE TO ADAPT TO MEET THE NEEDS OF THE COMMUNITY. ADDITIONALLY, COMMUNITY HOSPITAL OF NOBLE COUNTY, 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: COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. IS TAKING THE LEAD IN PARTNERING WITH SCHOOLS FOR HEALTH OCCUPATION EDUCATION PROGRAMS, CAREER PATHWAYS PROGRAMS, AND SCREENINGS FOR STUDENTS. -COMMUNITY PARTNERSHIPS: COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. INVESTS IN KEY ORGANIZATIONS (HEALTH PARTNERS) THAT ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF NOBLE COUNTY AND NORTHEAST INDIANA. WE PARTNER WITH THE COLE FAMILY CENTER YMCA ON MULTIPLE PROJECTS TO ENCOURAGE HEALTHIER LIFESTYLES AND NOBLE TRAILS TO FUND WALKING AND BIKING TRAIL DEVELOPMENT. TO ASSIST THOSE LESS FORTUNATE, WE SUPPORT COMMON GRACE, NOBLE HOUSE AND LOCAL FOOD PANTRIES. TO ENCOURAGE HIGHER PAYING JOBS AND ECONOMIC IMPROVEMENT, WE PARTNER WITH THE NOBLE COUNTY ECONOMIC DEVELOPMENT CORPORATION. WE PARTNER WITH THE NOBLE COUNTY HEALTH DEPARTMENT TO PROVIDE IMMUNIZATIONS TO CHILDREN WHO COULD OTHERWISE NOT ACCESS THEM. FUNDS ARE PROVIDED FOR LIFE AND FAMILY SERVICES' BABE PROGRAM, PEERS PROGRAM & MOM TO BE SUPPORT GROUPS. OTHER PARTNERS ACTIVE IN ADDRESSING MEDICAL ISSUES INCLUDE DRUG FREE NOBLE COUNTY, ACTIVATE NOBLE COUNTY, AND MCMILLEN HEALTH. -ACTIVATE NOBLE COUNTY: A TRUE COMMUNITY PARTNERSHIP BETWEEN COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. AND MANY AREA ORGANIZATIONS, INCLUDING THE LOCAL YMCA. THE MISSION IS "TO IMPROVE THE HEALTH AND WELLNESS OF NOBLE COUNTY BY INCREASING OPPORTUNITIES FOR HEALTHY EATING AND ACTIVE LIVING." THE GROUP HAS BEEN THE CENTRAL PARTNERSHIP TO ESTABLISH COMMUNITY GOALS AROUND THE COMMUNITY HEALTH NEEDS ESTABLISHED FROM OUR ASSESSMENT: OBESITY, SMOKING CESSATION AND TEEN-AGE PREGNANCY. THE GROUP MEETS MONTHLY WORKING COLLABORATIVELY TO ESTABLISH PROGRAMS, GUIDELINES AND MAKE IMPROVEMENTS TO KEY METRICS FROM THE ASSESSMENT PLAN. THROUGH COVID-19, THE GROUP CONTINUED TO MEET VIRTUALLY AND OFFER A COMMUNITY GARDEN TO THOSE IN NEED IN THE COMMUNITY. -MEDICATION ASSISTANCE PROGRAM (MAP): COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. IMPLEMENTED A MEDICATION ASSISTANCE PROGRAM FOR NOBLE COUNTY RESIDENTS IN 2006 AND HAS EXPERIENCED STEADY GROWTH SINCE ITS INCEPTION. MAP PARTNERS ALONG WITH PATIENTS, PHYSICIANS, PHARMACEUTICAL COMPANIES, LOCAL PHARMACIES, AND DONORS PROVIDE MEDICATION ASSISTANCE AT LITTLE OR NO COST FOR QUALIFIED INDIVIDUALS. EMERGENCY VOUCHERS FOR ACUTE MEDICATION NEEDS ARE REDEEMED AT LOCAL PHARMACIES. LONG-TERM MEDICATION HELP IS PROVIDED BY CONNECTING PATIENTS WITH PHARMACEUTICAL ASSISTANCE PROGRAMS (PAP). THE MAP WAS OFFERED THROUGH COVID-19 VIRTUALLY. -HEALTH FAIRS AND SCREENINGS: COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. PARTICIPATES IN NUMEROUS HEALTH FAIRS AND ACTIVITIES THROUGHOUT THE YEAR THAT ARE DESIGNED TO PROVIDE HEALTH EDUCATION, HEALTH SCREENINGS FOR DISEASE PREVENTION, AND THE PROMOTION OF HEALTHY LIFESTYLES. THE HOSPITAL ALSO PROVIDES SUPPORT GROUPS TO ASSIST PATIENTS AND FAMILIES IN MANAGING DISEASE. IN MARCH OF 2020, THESE HEALTH FAIRS PAUSED FOR A FEW MONTHS BUT RESUMED IN JUNE ON A MODIFIED LEVEL TO SERVE OUR COMMUNITY. |
| PART VI, LINE 6: | IF THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM, DESCRIBE THE RESPECTIVE ROLES OF THE ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED.PARKVIEW HEALTH SYSTEM, INC. (PARKVIEW), A HEALTHCARE SYSTEM SERVING NORTHEAST INDIANA AND NORTHWEST OHIO THROUGH OUR HOSPITALS AND PHYSICIAN CLINICS, INCLUDES THE NOT-FOR-PROFIT HOSPITALS OF PARKVIEW HOSPITAL, INC.: COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.; COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.; PARKVIEW WABASH HOSPITAL, INC.; WHITLEY MEMORIAL HOSPITAL, INC.; HUNTINGTON MEMORIAL HOSPITAL, INC.; DEKALB MEMORIAL HOSPITAL, INC.; AS WELL AS 60 PERCENT OWNERSHIP IN THE JOINT VENTURE OF ORTHOPEDIC HOSPITAL AT PARKVIEW NORTH, LLC.THE CORPORATE 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.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 THE SEVEN-COUNTY AREA, THE HEALTH PRIORITY OF SUBSTANCE USE DISORDER/MENTAL HEALTH PROMOTION 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.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/WELL-BEING ACROSS THE REGION. WITH A CONSISTENT FOCUS ON OUR MISSION AND VISION, WE WORK TO PROVIDE THE BEST CARE TO EVERY PERSON, EVERY DAY WITHIN OUR FACILITIES WHILE SERVING AS GOOD STEWARDS OF SURPLUS FUNDS IN OUR EFFORTS TO POSITIVELY IMPACT COMMUNITY HEALTH STATUS. |
| 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 (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| COLE CENTER FAMILY YMCA - KENDALLVILLE | |||||||
| P O BOX 233 | KENDALLVILLE | IN | 46755 | 237077600 | 501(C)(3) | $28,000 | HEALTH AND WELLNESS PROGRAMS |
| LIFE AND FAMILY SERVICES INC | |||||||
| 201 SOUTH PARK AVE | KENDALLVILLE | IN | 46755 | 311164090 | 501(C)(3) | $19,500 | BABE PROGRAM |
| THE COMMUNITY LEARNING CENTER INC | |||||||
| P O BOX 98 401 E DIAMOND ST | KENDALLVILLE | IN | 46755 | 834223782 | 501(C)(3) | $10,000 | PROGRAMS TO FOSTER AND ENHANCE ECONOMIC AND COMMUNITY DEVELOPMENT |
| NOBLE HOUSE INC | |||||||
| 205 EAST HIGHLAND | ALBION | IN | 46701 | 351883761 | 501(C)(3) | $10,000 | EMERGENCY ASSISTANCE AND REFERRALS TO FAMILIES |
| DRUG FREE NOBLE COUNTY INC | |||||||
| 2090 S SR 9 SUITE E | ALBION | IN | 46701 | 352135869 | 501(C)(3) | $10,000 | PROGRAMS TO REDUCE THE USE AND ABUSE OF ALCOHOL, TOBACCO AND OTHER DRUGS |
| NOBLE TRAILS INC | |||||||
| P O BOX 654 | ROME CITY | IN | 46784 | 800856444 | 501(C)(3) | $7,500 | PROGRAMS TO PROMOTE PHYSICAL ACTIVITY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 6 | 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) |
|---|---|---|
| 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 (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL PACKNETT | ||||||||||||||
| DIRECTOR/PH PRESIDENT & CEO | $0 | $1,193,402 | $0 | $487,482 | $0 | $367,537 | $0 | $1,624,548 | $0 | $32,305 | $0 | $3,705,274 | $0 | $319,527 |
| JEANNE' WICKENS | ||||||||||||||
| PH CHIEF FINANCIAL OFFICER | $0 | $750,792 | $0 | $262,181 | $0 | $71,579 | $0 | $309,952 | $0 | $29,943 | $0 | $1,424,447 | $0 | $49,457 |
| CHRISTOPHER FRAZIER | ||||||||||||||
| DIRECTOR/PH PHYSICIAN | $3,502 | $395,935 | $0 | $62,849 | $0 | $24,104 | $226 | $31,124 | $261 | $35,944 | $3,989 | $549,956 | $0 | $0 |
| LISA LANE | ||||||||||||||
| DIRECTOR/PH PHYSICIAN | $16,648 | $279,815 | $0 | $68,488 | $0 | $24,541 | $1,340 | $30,010 | $1,389 | $31,108 | $19,377 | $433,962 | $0 | $0 |
| GARY ADKINS | ||||||||||||||
| DIRECTOR/NBHOS PRESIDENT | $214,704 | $0 | $54,845 | $0 | $1,669 | $0 | $55,546 | $0 | $34,802 | $0 | $361,566 | $0 | $0 | $0 |
| ERIN GOLDSBERRY | ||||||||||||||
| NBHOS VP PATIENT CARE | $137,538 | $13,602 | $31,767 | $0 | $410 | $41 | $10,416 | $837 | $28,760 | $2,312 | $208,891 | $16,792 | $0 | $0 |
| KELLY BALYEAT | ||||||||||||||
| NBHOS MGR PHARMACY | $157,784 | $0 | $19,017 | $0 | $270 | $0 | $12,955 | $0 | $27,370 | $0 | $217,396 | $0 | $0 | $0 |
| JULIE DESPER | ||||||||||||||
| NBHOS MGR REHAB | $64,071 | $50,045 | $13,669 | $0 | $193 | $151 | $9,776 | $6,297 | $18,774 | $12,092 | $106,483 | $68,585 | $0 | $0 |
| HEATHER ANTAL | ||||||||||||||
| NBHOS MGR NURSING SVCS | $108,884 | $0 | $13,546 | $0 | $637 | $0 | $13,608 | $0 | $31,432 | $0 | $168,107 | $0 | $0 | $0 |
| RICHARD LARIMORE | ||||||||||||||
| NBHOS MGR SUPPORT SVCS | $118,268 | $0 | $13,944 | $0 | $974 | $0 | $9,328 | $0 | $11,127 | $0 | $153,641 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF COMMUNITY HOSPITAL OF NOBLE COUNTY, 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): MICHAEL PACKNETT $319,527; JEANNE' WICKENS $49,457 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 $319,527 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: GARY ADKINS $36,163; MICHAEL PACKNETT $1,598,898; JEANNE' WICKENS $290,002 |
| PART I, LINE 7 | MANAGEMENT INCENTIVE COMPENSATION PLAN (MICP) AND PHYSICIAN AND PROVIDER INCENTIVE COMPENSATION PLAN (PICP) ARE ANNUAL INCENTIVE PROGRAMS. SYSTEM GOALS ARE APPROVED BY THE BOARD. AT CONCLUSION OF THE PLAN YEAR, RESULTS ARE SHARED WITH THE BOARD AND THE EXECUTIVE COMMITTEE OF THE BOARD APPROVES FINAL PAYMENT. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (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, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC., EIN 35-2087092. 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, 2020 WAS 738. THE TOTAL NUMBER OF EMPLOYEES REPORTED ON FORM W-3 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2020 WAS 15,150. FOR PURPOSES OF COMPLETING FORM 990, PART V, LINE 1A AND 2A, THE NUMBER REPORTED FOR THE COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. WAS 42 AND 315 RESPECTIVELY. |
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE OFFICERS OF THE BOARD, THE PRESIDENT OF THE CORPORATION, THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATE MEMBER OR HIS/HER DESIGNEE, THE CURRENT PRESIDENT OF THE MEDICAL STAFF AND SUCH OTHER PERSONS AS IDENTIFIED BY THE CHAIR OF THE BOARD, EACH OF WHOM SHALL BE ENTITLED TO VOTE. IN NO EVENT SHALL THE MEMBERS OF THE EXECUTIVE COMMITTEE EXCEED EIGHT (8) PEOPLE. THE EXECUTIVE COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION IN ANY MATTER WHEN THE BOARD IS NOT IN SESSION, REPORTING TO THE BOARD FOR ITS RATIFICATION OF ITS ACTION. THE CHAIR OF THE BOARD SHALL SERVE AS CHAIR OF THE EXECUTIVE COMMITTEE. MEETINGS OF THE EXECUTIVE COMMITTEE MAY BE CALLED BY THE CHAIR OR BY THREE (3) MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 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 COMMUNITY HOSPITAL OF NOBLE COUNTY, 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. COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. IS A SUBSIDIARY CORPORATION OF PARKVIEW HEALTH SYSTEM, INC. AN ELECTRONIC COPY OF THE ORGANIZATION'S FINAL FORM 990 (INCLUDING REQUIRED SCHEDULES) WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY, PRIOR TO FILING WITH THE IRS. ON OCTOBER 27, 2021, THE SYSTEM AUDIT COMMITTEE REVIEWED THE FORM 990 AS ULTIMATELY FILED WITH THE IRS. THIS REVIEW INCLUDED A PRESENTATION BY THE ORGANIZATION'S TAX PREPARER TO HIGHLIGHT THE SIGNIFICANT AREAS ON THE FORM 990 AND SUPPLEMENTAL SCHEDULES. |
| FORM 990, PART VI, SECTION B, LINE 12C | AS DESCRIBED IN ARTICLE IX SECTION 6, OF THE PARKVIEW HEALTH SYSTEM, INC. (PH) BYLAWS, PH ADOPTED PH'S COMPLIANCE POLICY FOR THE ORGANIZATION AND ITS NOT-FOR-PROFIT RELATED ORGANIZATIONS (AND AS LIKEWISE NOTED IN THEIR BYLAWS) WHEN ADDRESSING CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. THIS COMPLIANCE POLICY (COMPLIANCE POLICY #14) REQUIRES THAT EACH BOARD MEMBER, BOARD COMMITTEE MEMBER, AND KEY MANAGEMENT PERSONNEL MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST FORM. THIS INFORMATION IS PROVIDED TO THE CHAIRMAN OF THE BOARD (FOR BOARD AND BOARD COMMITTEE MEMBERS) AND TO SENIOR MANAGEMENT (FOR KEY MANAGEMENT PERSONNEL). IN ADDITION, AS TO THE CONDUCT OF BOARD MEETINGS, THE FOLLOWING PROCESS IS FOLLOWED: "WHENEVER A PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE IS CONSIDERING A TRANSACTION OR ARRANGEMENT WITH AN ORGANIZATION, ENTITY OR INDIVIDUAL IN WHICH A PERSON COVERED BY THIS POLICY HAS A FINANCIAL OR CONFLICTING INTEREST, THE FOLLOWING SHALL OCCUR: 1. THE INTERESTED PERSON MUST DISCLOSE THE FINANCIAL OR CONFLICTING INTEREST AND ALL MATERIAL FACTS TO THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE; 2. THE INTERESTED PERSON WITH THAT FINANCIAL OR CONFLICTING INTEREST MAY MAKE A PRESENTATION AT THE BOARD OR BOARD COMMITTEE MEETING REGARDING THE TRANSACTION OR ARRANGEMENT HOWEVER, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE FINANCIAL OR CONFLICTING INTEREST; AND 3. THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE MUST APPROVE THE TRANSACTION OR ARRANGEMENT BY A MAJORITY VOTE OF THE BOARD MEMBERS PRESENT AT A MEETING THAT HAS A QUORUM, NOT INCLUDING THE VOTE OF THE INTERESTED PERSON. THE INTERESTED PERSON MAY NOT VOTE ON THE MATTER. A. UPON THE REQUEST OF PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE, THE MATTER MAY BE DELEGATED TO THE PH COMPLIANCE COMMITTEE FOR EVALUATION, RECOMMENDATION AND/OR DETERMINATION. 4. WHENEVER A FINANCIAL OR CONFLICTING INTEREST IS ADDRESSED BY A PH OR PH AFFILIATE BOARD, NOTICE SHALL BE GIVEN TO THE PH COMPLIANCE OFFICER / GENERAL COUNSEL." |
| FORM 990, PART VI, SECTION B, LINE 15 | LINES 15A AND 15B ARE ANSWERED NO IN ACCORDANCE WITH THE IRS INSTRUCTIONS. TO THE EXTENT THAT THE ORGANIZATION HAS VICE PRESIDENT OR ABOVE, THE COMPENSATION COMMITTEE OF RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., DETERMINES THE COMPENSATION OF THE CEO, OFFICERS, AND KEY EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER: PROGRAM SERVICE EXPENSES 1,946,990. MANAGEMENT AND GENERAL EXPENSES 72,754. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,019,744. MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,140,476. MANAGEMENT AND GENERAL EXPENSES 404,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,544,476. COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 394,103. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 394,103. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 2,348,940. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,348,940. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 282,344. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 282,344. |
| 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 -1,173,391. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (18 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 | |||||||||||
| 1450 PRODUCTION RD | FORT WAYNE | IN | 46808 | 351972384 | HEALTH CARE | IN | 501(C)(3) | LINE 12C, III-FI | N/A | 0 | |
| COMMUNITY HOSPITAL OF NOBLE COUNTY FOUNDATION INC | |||||||||||
| 401 SAWYER ROAD | KENDALLVILLE | IN | 46755 | 352089183 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | Yes (1) | COMMUNITY HOSPITAL OF NOBLE COUNTY 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 | |
| DEKALB MEMORIAL HOSPITAL INC | |||||||||||
| 1316 EAST SEVENTH STREET | AUBURN | IN | 46706 | 351064295 | 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 | |
| MIDWEST COMMUNITY HEALTH ASSOCIATES INC | |||||||||||
| 442 W HIGH STREET | BRYAN | OH | 43506 | 341045870 | PHYSICIANS | OH | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| PARK CENTER HOLDINGS INC | |||||||||||
| 909 EAST STATE BLVD | FORT WAYNE | IN | 46805 | 843684074 | TO SUPPORT PARK CENTER, INC. | IN | 501(C)(3) | LINE 12D, III-O | 0 | PARKVIEW HEALTH SYSTEM INC | |
| PARK CENTER INC | |||||||||||
| 909 EAST STATE BLVD | FORT WAYNE | IN | 46805 | 351135451 | COMPREHENSIVE MENTAL HEALTH CENTER | IN | 501(C)(3) | LINE 10 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| PARKVIEW DEKALB HOSPITAL FOUNDATION INC | |||||||||||
| 1316 EAST SEVENTH STREET | AUBURN | IN | 46706 | 356047817 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | DEKALB MEMORIAL HOSPITAL INC | |
| PARKVIEW FOUNDATION INC | |||||||||||
| 3844 NEW VISION DR | FORT WAYNE | IN | 46845 | 237220589 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | PARKVIEW HOSPITAL 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 | |
| PARKVIEW HUNTINGTON HOSPITAL FOUNDATION INC | |||||||||||
| 2001 STULTS ROAD | HUNTINGTON | IN | 46750 | 320012095 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | HUNTINGTON MEMORIAL HOSPITAL INC | |
| PARKVIEW LAGRANGE HOSPITAL FOUNDATION INC | |||||||||||
| 207 N TOWNLINE ROAD | LAGRANGE | IN | 46761 | 833347115 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC | |
| PARKVIEW OCCUPATIONAL HEALTH CENTERS INC | |||||||||||
| 1450 PRODUCTION RD | FORT WAYNE | IN | 46808 | 352064353 | OCCUPATIONAL HEALTH | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| PARKVIEW WABASH HOSPITAL FOUNDATION INC | |||||||||||
| 10 JOHN KISSINGER DRIVE | WABASH | IN | 46992 | 351921445 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | PARKVIEW WABASH HOSPITAL INC | |
| PARKVIEW WABASH HOSPITAL INC | |||||||||||
| 10 JOHN KISSINGER DRIVE | WABASH | IN | 46992 | 471753440 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| WHITLEY MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 1260 E STATE ROAD 205 | COLUMBIA CITY | IN | 46725 | 311190239 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | 0 | WHITLEY MEMORIAL HOSPITAL 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 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH LLC | ||||||||||
| 1450 PRODUCTION RD | FORT WAYNE | IN | 46808 | 260143823 | ORTHO HOSPITAL | IN | N/A | N/A | 0 | 0 |
| MANAGED CARE SERVICES LLC | ||||||||||
| 1450 PRODUCTION RD | FORT WAYNE | IN | 46808 | 351996535 | HEALTH PLAN ADMIN | IN | N/A | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| PARKVIEW PROFESSIONAL PROGRAMS INC | |||||||||
| 1450 PRODUCTION RD | FORT WAYNE | IN | 46808 | 351668888 | REFERENCE LAB | IN | N/A | C | 0 |
| MIDWEST COMMUNITY HEALTH ASSOCIATES INC | |||||||||
| 442 W HIGH STREET | BRYAN | OH | 43506 | 341045870 | PHYSICIANS | OH | N/A | C | 0 |
| WOODLAND PLAZA MEDICAL PARK CONDO ASSOC INC | |||||||||
| 202 W BERRY ST SUITE 800 | FORT WAYNE | IN | 46802 | 352058340 | CONDO MANAGEMENT | IN | N/A | C | 0 |
| 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL OF NOBLE COUNTY FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | M | TransactionTypeTxt |
| Involved | $156,203 | InvolvedAmt |
| Method Of Amount Determination | PART VII SUPPLEMENTAL INFORMATION | MethodOfAmountDeterminationTxt |
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 |