PARKVIEW FOUNDATION INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- PARKVIEW FOUNDATION INC (EIN 23-7220589)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-11
- IRS object ID
- 201923159349303732
- Schema version
- 2018v3.1
- 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 G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-11-11T15:04:50-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | 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 PO 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 | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237220589 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PARKVIEW FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PARK | BusinessNameControlTxt |
| Phone | 2603738429 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10622 PARKVIEW PLAZA DRIVE | AddressLine1Txt |
| City | FORT WAYNE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46845 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEANNE' WICKENS | PersonNm |
| Person Title | PH CFO | PersonTitleTxt |
| Phone | 2602669313 | PhoneNum |
| Signature | 2019-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KENNETH J KEBER | PreparerPersonNm |
| PTIN | P00240883 | PTIN |
| Phone | 5742323992 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 204.58.171.16 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-11 | IPDt |
| IP Tm | 15:56:24 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | B38744F01C9F8B49338464F7361C640636AC5E7B | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B38744F01C9F8B49338464F7361C640636AC5E7B | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL J PACKNETT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10501 CORPORATE DRIVE | AddressLine1Txt |
| City | FORT WAYNE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46845 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $473,807,188 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PARKVIEWFOUNDATIONS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | TO SERVE AS THE PRIMARY FUNDRAISING ENTITY FOR PARKVIEW HOSPITAL, INC. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 17 | TotalEmployeeCnt |
| Total Volunteers | 115 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,582,690 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,162,723 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $673,779 | PYInvestmentIncomeAmt |
| CY Investment Income | $319,824 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$3,829 | PYOtherRevenueAmt |
| CY Other Revenue | -$24,712 | CYOtherRevenueAmt |
| PY Total Revenue | $4,252,640 | PYTotalRevenueAmt |
| CY Total Revenue | $5,457,835 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,573,700 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $905,984 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,059,441 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,295,393 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $167,975 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $308,670 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1,218,624 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $529,835 | PYOtherExpensesAmt |
| CY Other Expenses | $540,356 | CYOtherExpensesAmt |
| PY Total Expenses | $3,330,951 | PYTotalExpensesAmt |
| CY Total Expenses | $3,050,403 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $921,689 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,407,432 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,300,363 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,783,797 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $522,051 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $241,310 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,778,312 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $13,542,487 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO SERVE AS THE PRIMARY FUNDRAISING ENTITY FOR PARKVIEW HOSPITAL, INC. FUNDS ARE USED FOR THE CONTINUED IMPROVEMENT OF THE HOSPITAL'S FACILITIES, EQUIPMENT, PROGRAMS & SERVICES IN ACCORDANCE WITH THE NEEDS OF THE COMMUNITY WHERE THE HOSPITAL IS LOCATED. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,175,057 | ExpenseAmt |
| Grant | $905,984 | GrantAmt |
| Desc | AT PARKVIEW HEALTH SYSTEM, INC. WE MAINTAIN FOUNDATIONS FOR EACH OF OUR HOSPITALS. THESE NONPROFIT ORGANIZATIONS PROVIDE PHILANTHROPIC SUPPORT FOR OUR MISSION OF PROVIDING QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO PARKVIEW. WE ALSO STRIVE TO IMPROVE THE HEALTH OF THE COMMUNITIES THAT WE SERVE.THE STAFF AT PARKVIEW FOUNDATION, INC. BUILDS RELATIONSHIPS THAT FOSTER GIFT GIVING FOR THE BENEFIT OF OUR PATIENTS AND THEIR FAMILY MEMBERS, CAREGIVERS, HOSPITAL PROGRAMS AND SERVICES, AND FOR EQUIPMENT. THESE RELATIONSHIPS ARE MADE WITH PARKVIEW HOSPITAL, INC. CO-WORKERS, PHYSICIANS, VENDORS, PATIENT FAMILIES, AND THE COMMUNITY AT LARGE. IN (SEE SCHEDULE O FOR CONTINUATION)AN IMPORTANT WAY, THE PARKVIEW FOUNDATION, INC. IS COMPOSED OF A COLLECTION OF INDIVIDUAL DONORS WHO SEE PARKVIEW HOSPITAL, INC. AS AN AGENT FOR SAVING AND CHANGING LIVES. MOREOVER, THEY VIEW PARKVIEW FOUNDATION, INC. AS A VEHICLE FOR TRANSFORMING LIVES, CHANGING COMMUNITIES, AND PROVIDING HOPE.EACH GIFT RECEIVED BY PARKVIEW FOUNDATION, INC. IS EITHER IMMEDIATELY SPENT, OR SET ASIDE, FOR THE BENEFIT OF PARKVIEW HOSPITAL, INC. ALL GIFTS, FROM THOSE MADE BY EMPLOYEES, INDIVIDUALS, OR OUTSIDE ORGANIZATIONS ARE GREATLY APPRECIATED.IN 2018, THESE GIFTS WERE TRANSFORMED INTO MANY NEW IMPROVEMENTS FOR PATIENT CARE. THE FOLLOWING ARE A FEW EXAMPLES OF PARKVIEW FOUNDATION, INC. PROVIDING FUNDING TO PARKVIEW HOSPITAL, INC. FOR VARIOUS HOSPITAL PROGRAMS, SERVICES, EQUIPMENT AND IMPROVEMENTS:EMPLOYEE EMERGENCY ASSISTANCE PROGRAM:-GROCERY GIFT CARDS TO SUPPORT EMERGENCY EMPLOYEE ASSISTANCE NEEDSPARKVIEW CANCER INSTITUTE:-GENETIC RESEARCH COUNSELING FOR CANCER PATIENTS-CANCER PATIENT SUPPLIES, SUCH AS WIGS AND ACCESSORIES, NUTRITIONAL SUPPLIES, PATIENT EDUCATION BINDERS AND MATERIALPEDIATRICS UNIT:-FIVE DVD PLAYERS AND BRACKETS FOR PEDIATRIC ROOMSREHAB OUTPATIENT: -MINDCAP TRAINING COURSE - PEDS REHAB TEAMPARKVIEW BEHAVIORAL HEALTH:-CHRISTMAS ITEMS FOR PATIENTS-STAFF TRAINING TO HELP PATIENTS WHO STRUGGLE WITH GRIEF, PANIC, PHOBIA, SUBSTANCE ABUSETRAINING & EDUCATION:-TRAUMA SYMPOSIUM - FIVE EMPLOYEES-COMMUNICATIONS TRAINING COURSE - THREE EMPLOYEES-MIND CAP TRAINING COURSE - SPEECH PATHOLOGISTSUPPORTIVE CARE:-SAPPHIRE PUMPS FOR END-OF-LIFE HOSPICE CARE PATIENTSEQUIPMENT:-USCAN BLADDER SCANNER TABLET SYSTEM FOR POST-ACUTE CONTINUING CARE & INPATIENT REHABFRANCINE'S FRIENDS MOBILE MAMMOGRAPHY:-SCREENING MAMMOGRAMS-DIAGNOSTIC EXAMS AND SERVICESSPECIAL TOUCH FUND:-PRESCRIPTION ASSISTANCE-INFANT CAR SEAT PROGRAM-WHEELCHAIR RAMPNEW LIFE CENTER:-INFANT MEMORY BOXES FOR FAMILIES WITH PERINATAL LOSSPEDIATRIC PULMONARY FUND: -AIRWAY MANAGEMENT STAFF COMPLIANCE TRAINING FLIGHT PROGRAM:-STRYKER POWER LOAD COT SYSTEM FOR SAMARITAN FLIGHT SERVICES PARKVIEW HOSPICE PROGRAM:-TWO SMART TV FOR INFUSION AREA-PATIENT PILLBOXES MISSION & COMMUNITY OUTREACH:-PATIENT EDUCATION FOLDERS-I-SPEAK TRANSLATION BOOKLETS TO ASSIST WITH COMMUNICATION BETWEEN PATIENT AND STAFF-MAGNETS FOR PATIENTS REGARDING SEPSIS EDUCATIONPARKVIEW HEART INSTITUTE:-ZOLL LIFE VESTS WEARABLE DEFIBRILLATORS FOR FIRST MONTH OF WEAR-ECMO CONFERENCE - 6 PEOPLE ATTENDED. RECEIVED ELSO PATHWAYS TO EXCELLENCE AWARD AT CONFERENCE RESPIRATORY CARE EDUCATION:-AIM HIGH CONFERENCE SPEAKERMCHA COMMUNITIES - OHIO:-DIAGNOSTIC MAMMOGRAPHY SERVICES SIMULATION LAB:-TWO SIMULATION MANIKINS WITH WARRANTIESOTHER CAPITAL PURCHASES: -OUTDOOR SCULPTURE -GEO MACHINE | Desc |
| Total Program Service Expenses | $1,175,057 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (1) | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | 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 | 0 | RelatedOrganizationCtrlEntInd |
| 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 | 10 | IRPDocumentCnt |
| IRP Document W2 G | 1 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 17 | 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | 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 | 10501 CORPORATE DRIVE | AddressLine1Txt |
| City | FORT WAYNE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46845 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| TIMOTHY MCELWEE | ||||||||
| DIRECTOR/SEC/TREAS/SVP FOUNDATIONS | 40.00 | 5.00 | Yes (X) | $315,283 | $0 | $77,638 | ||
| BENJAMIN MILES | ||||||||
| DIRECTOR/PVHOS PRESIDENT | 1.00 | 40.00 | Yes (X) | $0 | $655,188 | $140,126 | ||
| JAMES DOZIER | ||||||||
| DIRECTOR/PH PHYSICIAN | 1.00 | 40.00 | Yes (X) | $0 | $1,256,882 | $24,503 | ||
| JAMES EDLUND | ||||||||
| DIRECTOR/CHAIR/PH PHYSICIAN | 1.00 | 40.00 | Yes (X) | $0 | $382,727 | $25,379 | ||
| ROBERT GODLEY | ||||||||
| DIRECTOR/PH PHYSICIAN | 1.00 | 40.00 | Yes (X) | $0 | $537,753 | $62,858 | ||
| MICHAEL GRABOWSKI | ||||||||
| DIRECTOR/PH PHYSICIAN | 1.00 | 42.00 | Yes (X) | $0 | $881,384 | $62,737 | ||
| MIKE ALTENDORF | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $1,000 | $0 | ||
| MADELEINE BAKER | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| IAN BOYCE | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $4,514 | $0 | ||
| DANIEL GARMAN | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $1,326 | $0 | ||
| TRACIE MARTIN | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BETH REGEDANZ | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRISTINE RUPP | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ALEX SMITH | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| W THOMAS SMITH | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SUSAN TRENT | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL PACKNETT | ||||||||
| PH PRESIDENT & CEO | 1.00 | 56.00 | $0 | $1,447,044 | $759,330 | Yes (X) | ||
| JEANNE' WICKENS | ||||||||
| PH CHIEF FINANCIAL OFFICER | 1.00 | 56.00 | $0 | $869,537 | $314,918 | Yes (X) | ||
| TRACY BOSTWICK | ||||||||
| WBFND COMM HOSP FND DIR | 0.00 | 40.00 | $28,558 | $88,500 | $35,687 | Yes (X) | ||
| LIZABETH STEIN | ||||||||
| PVFND DIR LEADERSHIP GIFTS | 40.00 | 40.00 | $54,639 | $53,881 | $26,417 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $398,480 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,179,736 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,529,593 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRENZEBACH GLIER & ASSOCIATES INC | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 S MICHIGAN AVENUE SUITE 2100 | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60604 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | PROFESSIONAL FUNDRAISING | ServicesDesc |
| Compensation | $193,458 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $358,248 | FundraisingAmt |
| Related Organizations | $2,295,152 | RelatedOrganizationsAmt |
| All Other Contributions | $2,509,323 | AllOtherContributionsAmt |
| Noncash Contributions | $50,674 | NoncashContributionsAmt |
| Total Contributions | $5,162,723 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $278,894 | TotalRevenueColumnAmt |
| Exclusion | $278,894 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $468,232,056 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $468,191,126 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $40,930 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $40,930 | TotalRevenueColumnAmt |
| Exclusion | $40,930 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $119,640 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $358,248 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $157,449 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$37,809 | TotalRevenueColumnAmt |
| Exclusion | -$37,809 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $13,875 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $778 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,097 | TotalRevenueColumnAmt |
| Exclusion | $13,097 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,457,835 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $295,112 | 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 | $802,729 | TotalAmt |
| Program Services | $802,729 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,255 | TotalAmt |
| Program Services | $103,255 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $392,921 | TotalAmt |
| Program Services | $58,938 | ProgramServicesAmt |
| Management And General | $137,522 | ManagementAndGeneralAmt |
| Fundraising | $196,461 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $661,467 | TotalAmt |
| Program Services | $99,222 | ProgramServicesAmt |
| Management And General | $231,512 | ManagementAndGeneralAmt |
| Fundraising | $330,733 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $241,005 | TotalAmt |
| Program Services | $36,150 | ProgramServicesAmt |
| Management And General | $84,352 | ManagementAndGeneralAmt |
| Fundraising | $120,503 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $308,670 | TotalAmt |
| Fundraising | $308,670 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,800 | TotalAmt |
| Management And General | $15,800 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,368 | TotalAmt |
| Program Services | $2,619 | ProgramServicesAmt |
| Management And General | $2,628 | ManagementAndGeneralAmt |
| Fundraising | $10,121 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,403 | TotalAmt |
| Program Services | $2,101 | ProgramServicesAmt |
| Management And General | $840 | ManagementAndGeneralAmt |
| Fundraising | $5,462 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,904 | TotalAmt |
| Program Services | $23,317 | ProgramServicesAmt |
| Management And General | $3,110 | ManagementAndGeneralAmt |
| Fundraising | $56,477 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,807 | TotalAmt |
| Program Services | $7,535 | ProgramServicesAmt |
| Management And General | $3,015 | ManagementAndGeneralAmt |
| Fundraising | $48,257 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,686 | TotalAmt |
| Program Services | $32,922 | ProgramServicesAmt |
| Management And General | $13,168 | ManagementAndGeneralAmt |
| Fundraising | $85,596 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,882 | TotalAmt |
| Program Services | $1,888 | ProgramServicesAmt |
| Management And General | $1,888 | ManagementAndGeneralAmt |
| Fundraising | $15,106 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,356 | TotalAmt |
| Program Services | $1,839 | ProgramServicesAmt |
| Management And General | $736 | ManagementAndGeneralAmt |
| Fundraising | $4,781 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,034 | TotalAmt |
| Fundraising | $1,034 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $280 | TotalAmt |
| Program Services | $70 | ProgramServicesAmt |
| Management And General | $28 | ManagementAndGeneralAmt |
| Fundraising | $182 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CORP SERVICE ALLOCATION | $162,000 | $162,000 | ||
| DUES & SUBSCRIPTIONS | $23,180 | $2,318 | $20,862 | |
| BANK CHARGES | $12,166 | $12,166 | ||
| MISCELLANEOUS | $2,490 | $123 | $154 | $2,213 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,050,403 | TotalAmt |
| Program Services | $1,175,057 | ProgramServicesAmt |
| Management And General | $656,722 | ManagementAndGeneralAmt |
| Fundraising | $1,218,624 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,275,892 | BOYAmt |
| EOY | $2,118,576 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $907,860 | BOYAmt |
| EOY | $856,078 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $183,958 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $183,077 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,161 | BOYAmt |
| EOY | $881 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,115,450 | BOYAmt |
| EOY | $10,808,262 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,300,363 | BOYAmt |
| EOY | $13,783,797 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,757 | BOYAmt |
| EOY | $3,013 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $494,294 | BOYAmt |
| EOY | $238,297 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $522,051 | BOYAmt |
| EOY | $241,310 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,486,505 | BOYAmt |
| EOY | $6,491,838 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,464,123 | BOYAmt |
| EOY | $6,196,950 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $827,684 | BOYAmt |
| EOY | $853,699 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,778,312 | BOYAmt |
| EOY | $13,542,487 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,300,363 | BOYAmt |
| EOY | $13,783,797 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,407,432 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$636,411 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$6,846 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PARKVIEW HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350868085 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $660,648 | SupportAmt |
| Other Support | $38,305 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $660,648 | SupportSumAmt |
| Other Support Sum | $38,305 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 11G, COLUMN VI | FormAndLineReferenceDesc |
| Explanation | TOYS, BOOKS, BLANKETS, BABY ITEMS, ETC. | ExplanationTxt |
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 | $219 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $219 | 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 | OTHER ACTIVITIES - REPRESENTS THE PORTION OF DUES PAID TO VARIOUS PROFESSIONAL ASSOCIATIONS USED FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,123,524 | BeginningYearBalanceAmt |
| Contributions | $47,384 | ContributionsAmt |
| Investment Earnings Or Losses | -$101,047 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $13,436 | GrantsOrScholarshipsAmt |
| End Year Balance | $6,056,425 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,059,545 | BeginningYearBalanceAmt |
| Contributions | $4,000 | ContributionsAmt |
| Investment Earnings Or Losses | $86,679 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $26,700 | GrantsOrScholarshipsAmt |
| End Year Balance | $6,123,524 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,008,489 | BeginningYearBalanceAmt |
| Contributions | $225 | ContributionsAmt |
| Investment Earnings Or Losses | $64,680 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $13,849 | GrantsOrScholarshipsAmt |
| End Year Balance | $6,059,545 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,975,804 | BeginningYearBalanceAmt |
| Contributions | $4,535 | ContributionsAmt |
| Investment Earnings Or Losses | $43,549 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $15,399 | GrantsOrScholarshipsAmt |
| End Year Balance | $6,008,489 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,977,296 | BeginningYearBalanceAmt |
| Contributions | $39 | ContributionsAmt |
| Investment Earnings Or Losses | $43,003 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $44,534 | GrantsOrScholarshipsAmt |
| End Year Balance | $5,975,804 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.82550 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.14100 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.03350 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $183,958 | OtherCostOrOtherBasisAmt |
| Depreciation | $183,077 | DepreciationAmt |
| Book Value | $881 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $881 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| PVFND-CHARITABLE GIFT ANNUITY | $4,853 |
| DUE TO/FROM INTERUNIT | $233,444 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $238,297 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | BOARD DESIGNATED ENDOWMENTS ARE USED TO COVER THE OPERATING EXPENSES OF THE FOUNDATION. PERMANENT ENDOWMENTS ARE USED FOR SCHOLARSHIPS AND CHAPLAINCY SERVICES. |
| 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, 2018 AND 2017, THERE ARE NO UNRECOGNIZED TAX BENEFITS RESULTING FROM UNCERTAIN TAX POSITIONS. FORMS 990 AND 990T FILED BY THE CORPORATION AND ITS TAX-EXEMPT AFFILIATED ENTITIES ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. FORMS 990 AND 990T FILED BY THE CORPORATION AND ITS TAX-EXEMPT AFFILIATED ENTITIES ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEAR 2014 AND PRIOR. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (1) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | ActivityActivityTxt | Fundraiser Control Of FundsFundraiserControlOfFundsInd | Gross ReceiptsGrossReceiptsAmt | Retained By ContractorRetainedByContractorAmt | Net To OrganizationNetToOrganizationAmt |
|---|---|---|---|---|---|---|---|---|
| GRENZEBACH GLIER & ASSOCIATES INC | ||||||||
| 200 S MICHIGAN AVENUE SUITE 2100 | CHICAGO | IL | 60604 | DEVELOPMENT & CONSULTATION SERVICES | 0 | $0 | $193,458 | -$193,458 |
| SNF WRITING SOLUTIONS LLC | ||||||||
| P O BOX 7652 | GREENWOOD | IN | 46142 | GRANT WRITING SERVICES | 0 | $0 | $65,337 | -$65,337 |
| CANDACE SCHULER | ||||||||
| 7022 PALLADIO SQUARE | FORT WAYNE | IN | 46804 | GRANT WRITING SERVICES | 0 | $0 | $36,300 | -$36,300 |
| BRAND INNOVATION GROUP LLC | ||||||||
| 8902 AIRPORT DRIVE SUITE A | FORT WAYNE | IN | 46809 | CONSULTATION & PREPARATION OF SOLICITATION MATERIAL | 0 | $0 | $13,575 | -$13,575 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Retained By Contractors | $308,670 | TotalRetainedByContractorsAmt |
| Total Net To Organization | -$308,670 | TotalNetToOrganizationAmt |
| Licensed States | AK | LicensedStatesCd |
| Licensed States | AL | LicensedStatesCd |
| Licensed States | AR | LicensedStatesCd |
| Licensed States | AZ | LicensedStatesCd |
| Licensed States | CA | LicensedStatesCd |
| Licensed States | CT | LicensedStatesCd |
| Licensed States | CO | LicensedStatesCd |
| Licensed States | FL | LicensedStatesCd |
| Licensed States | GA | LicensedStatesCd |
| Licensed States | HI | LicensedStatesCd |
| Licensed States | IL | LicensedStatesCd |
| Licensed States | IN | LicensedStatesCd |
| Licensed States | KS | LicensedStatesCd |
| Licensed States | KY | LicensedStatesCd |
| Licensed States | MA | LicensedStatesCd |
| Licensed States | MD | LicensedStatesCd |
| Licensed States | ME | LicensedStatesCd |
| Licensed States | MI | LicensedStatesCd |
| Licensed States | MN | LicensedStatesCd |
| Licensed States | MO | LicensedStatesCd |
| Licensed States | MS | LicensedStatesCd |
| Licensed States | NC | LicensedStatesCd |
| Licensed States | NH | LicensedStatesCd |
| Licensed States | NJ | LicensedStatesCd |
| Licensed States | NM | LicensedStatesCd |
| Licensed States | NY | LicensedStatesCd |
| Licensed States | OH | LicensedStatesCd |
| Licensed States | OK | LicensedStatesCd |
| Licensed States | OR | LicensedStatesCd |
| Licensed States | PA | LicensedStatesCd |
| Licensed States | RI | LicensedStatesCd |
| Licensed States | SC | LicensedStatesCd |
| Licensed States | TN | LicensedStatesCd |
| Licensed States | UT | LicensedStatesCd |
| Licensed States | VA | LicensedStatesCd |
| Licensed States | WA | LicensedStatesCd |
| Licensed States | WI | LicensedStatesCd |
| Licensed States | WV | LicensedStatesCd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | COOKIN' MEN EVENT | Event1Nm |
| Gross Receipts Event1 | $222,691 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $147,536 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $75,155 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $10,228 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $14,064 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $50,301 | OtherDirectExpensesEvent1Amt |
| Event2 | GOLF OUTING | Event2Nm |
| Gross Receipts Event2 | $188,203 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $148,038 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $40,165 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $2,289 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $30,720 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $11,883 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $25,744 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $66,994 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $62,674 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $4,320 | GrossRevenueOtherEventsAmt |
| Rent Fclty Costs Other Events | $2,000 | RentFcltyCostsOtherEventsAmt |
| Food And Beverage Other Events | $10,220 | FoodAndBeverageOtherEventsAmt |
| Gross Receipts Total | $477,888 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $358,248 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $119,640 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $2,289 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $42,948 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $36,167 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $76,045 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $157,449 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$37,809 | NetIncomeSummaryAmt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE G, PART I, LINE 2B, COLUMN (V) | THE TOTAL PAYMENT OF $193,458 TO PROFESSIONAL FUNDRAISER, GRENZEBACH GLIER & ASSOCIATES, INC., CONSISTED OF $181,763 FOR DEVELOPMENT AND CONSULTATION SERVICES, AND $11,695 FOR REIMBURSEMENT OF TRAVEL EXPENSES. THE TOTAL PAYMENT OF $65,337 TO PROFESSIONAL FUNDRAISER, SNF WRITING SOLUTIONS, LLC, CONSISTED OF $62,739 FOR GRANT WRITING AND COORDINATING SERVICES, AND $2,598 FOR REIMBURSEMENT OF TRAVEL EXPENSES. |
| SCHEDULE G, PART I, LINE 2B, COLUMN IV: | GROSS RECEIPTS FROM ACTIVITY: THE GROSS RECEIPTS ASSOCIATED WITH THE ACTIVITIES OF THE PROFESSIONAL FUNDRAISERS ARE NOT READILY ASCERTAINABLE AS THE GRANT WRITING, COORDINATING, DEVELOPMENT AND CONSULTATION SERVICES WERE RENDERED ON BEHALF OF MULTIPLE PARKVIEW ORGANIZATIONS AND WERE NOT DIRECTLY CONNECTED WITH SPECIFIC FUNDRAISING ACTIVITIES. AS SUCH, NO AMOUNTS HAVE BEEN DISCLOSED IN PART I, LINE 2B, COLUMN IV. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc | Purpose Of GrantPurposeOfGrantTxt | Non Cash AssistanceNonCashAssistanceAmt |
|---|---|---|---|---|---|---|---|---|---|---|
| PARKVIEW HEALTH SYSTEM INC | ||||||||||
| 10501 CORPORATE DRIVE | FORT WAYNE | IN | 46845 | 351972384 | 501(C)(3) | $85,157 | N/A | N/A | SYSTEM PROGRAMS | |
| PARKVIEW HOSPITAL INC | ||||||||||
| 11109 PARKVIEW PLAZA DRIVE | FORT WAYNE | IN | 46845 | 350868085 | 501(C)(3) | $660,648 | OTHER | TOYS, BOOKS, BLANKETS, BABY ITEMS, ETC. | HOSPITAL PROGRAMS | $38,305 |
| PARKVIEW OCCUPATIONAL HEALTH CENTERS INC | ||||||||||
| 10501 CORPORATE DRIVE | FORT WAYNE | IN | 46845 | 352064353 | 501(C)(3) | $18,500 | N/A | N/A | EMPLOYEE EMERGENCY ASSISTANCE PROGRAM CLASSES | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| EMPLOYEE EMERGENCY ASSISTANCE FUND | 114 | $76,255 |
| SCHOLARSHIPS | 26 | $27,000 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | HOSPITAL FUNDING: HOSPITAL DEPARTMENTS COMPLETE FUNDING REQUEST FORMS THAT ARE RETURNED TO THE FOUNDATION. UPON COMPLETION OF THE PROJECT, THE DEPARTMENT SUBMITS A REIMBURSEMENT REQUEST ALONG WITH AN ATTACHED PURCHASE ORDER OR RECEIPT FOR SUPPLIES. BASED UPON THE ORGANIZATION'S AUTHORITY TO ACT POLICY, APPROVALS ARE MADE BY THE FOUNDATION DIRECTOR AND FOUNDATION BOARD. EMPLOYEE EMERGENCY ASSISTANCE FUND (EEAF): THE EEAF PROVIDES LIMITED FINANCIAL ASSISTANCE FOR PARKVIEW EMPLOYEES FOR SHORT-TERM CRISIS SITUATIONS THAT ARE THE RESULT OF EMERGENCIES OR CATASTROPHIC EVENTS. THE FUNDS ARE USED AS A LAST RESORT FOR BASIC NEEDS SUCH AS FOOD, SHELTER, UTILITIES, ETC. TO BE ELIGIBLE AN EMPLOYEE MUST: -BE AN EMPLOYEE OF PARKVIEW FOR A MINIMUM OF 6 MONTHS -BE AT LEAST A .5 FTE STATUS -HAVE NOT RECEIVED MONEY FROM THE FUND IN THE LAST 24 MONTHS -COMPLETE AN APPLICATION FORM THE EEAF COMMITTEE SHALL: -REVIEW, CONSIDER AND MAKE DECISIONS RELATIVE TO THE EMPLOYEE'S APPLICATION FOR ASSISTANCE AND APPROVE A REQUEST BY A MAJORITY OF AFFIRMATIVE VOTES -CONSIST OF BETWEEN FIVE (5) AND ELEVEN (11) PARKVIEW EMPLOYEES REPRESENTING A CROSS SECTION OF THE EMPLOYEE COMMUNITY AND WILL INCLUDE BOTH MANAGEMENT AND NON-MANAGEMENT EMPLOYEES -BE APPOINTED BY THE FOUNDATION DIRECTOR -NOT BE AWARE OF THE IDENTITY OF THE EMPLOYEE MAKING THE REQUEST SCHOLARSHIPS: 1) ROLLAND SCHOLARSHIP -APPLICANTS MUST BE A HIGH SCHOOL SENIOR PREPARING TO ENTER THE SCHOOL OF NURSING AT THE UNIVERSITY OF SAINT FRANCIS OR INDIANA UNIVERSITY-PURDUE UNIVERSITY AT FORT WAYNE WITH THE INTENT OF COMPLETING AN R.N. PROGRAM OF STUDY. -APPLICANTS MUST RESIDE IN ALLEN, DEKALB, NOBLE, WHITLEY, HUNTINGTON, WELLS OR ADAMS COUNTY. -APPLICANTS MUST SHOW ACADEMIC ABILITY, AS EVIDENCED BY A "B" AVERAGE OR BETTER ON THE HIGH SCHOOL TRANSCRIPT AND EXHIBIT SOME FINANCIAL NEED, AS EVIDENCED BY THE STATEMENT OF FINANCIAL CHALLENGES. ONE SCHOLARSHIP WILL BE AWARDED ANNUALLY AND IS RENEWABLE FOR UP TO THREE ADDITIONAL YEARS, PROVIDED THE STUDENT MAINTAINS A "B" AVERAGE OR BETTER AND IS MAKING PROGRESS, AS DEFINED BY UNIVERSITY STANDARDS, TOWARD COMPLETION OF THE R.N. DEGREE. APPLICATIONS ARE AVAILABLE AT LOCAL HIGH SCHOOLS. THE EXECUTIVE DIRECTOR OF THE FOUNDATION MEETS WITH MEMBERS OF THE ROLLAND FAMILY TO REVIEW QUALIFIED APPLICANTS' INFORMATION. THE FAMILY MAKES THE FINAL DECISION. 2) SUE JOHNSON SCHOLARSHIP THE SCHOLARSHIP IS AVAILABLE TO ALL ELIGIBLE CANDIDATES SYSTEM-WIDE. CANDIDATES MUST MEET THE FOLLOWING CRITERIA IN ORDER TO BE CONSIDERED FOR THE SCHOLARSHIP: -BE ENROLLED IN A B.S. NURSING PROGRAM -HAVE AT LEAST TWO (2) YEARS OF SERVICE WITH PARKVIEW -HAVE A FTE STATUS OF .4 OR HIGHER -BE IN GOOD STANDING WITH NO DISCIPLINARY ACTIONS IN THE PREVIOUS TWO (2) YEARS -IF APPLYING FOR A SECOND YEAR OF FUNDING, CANDIDATES MUST PROVIDE PROOF THAT HE/SHE COMPLETED THE FIRST YEAR WITH AT LEAST A "B" AVERAGE OR EQUIVALENT. -MUST PROVIDE ONE (1) PROFESSIONAL RECOMMENDATION FROM A SUPERVISOR, COWORKER, OR EDUCATOR QUALIFIED APPLICANTS' INFORMATION IS REVIEWED BY A PANEL CONSISTING OF SVP PATIENT CARE, MANAGER CLINICAL STAFF DEVELOPMENT, AND A FOUNDATION STAFF MEMBER. 3) DARLENE TIELKER MEMORIAL SCHOLARSHIP AVAILABLE TO GRADUATING HIGH SCHOOL SENIORS THROUGHOUT NORTHEAST IN OR PARKVIEW COWORKERS SYSTEM WIDE. CRITERIA FOR HIGH SCHOOL STUDENTS: THE SCHOLARSHIP IS AVAILABLE TO ALL HIGH SCHOOL SENIORS OR PARKVIEW COWORKERS PURSUING AN ADVANCED DEGREE IN NURSING. CANDIDATES MUST MEET THE FOLLOWING CRITERIA IN ORDER TO BE CONSIDERED FOR THE SCHOLARSHIP: -MUST BE ACCEPTED TO AND PLANNING TO ATTEND INDIANA UNIVERSITY-PURDUE UNIVERSITY AT FORT WAYNE. -MUST BE ACCEPTED TO B.S. NURSING PROGRAM AT INDIANA-PURDUE UNIVERSITY AT FORT WAYNE. -CARRY A CUMULATIVE G.P.A. OF AT LEAST "B" (OR EQUIVALENT) -PROVIDE PROOF OF FINANCIAL NEED -PROVIDE TWO (2) RECOMMENDATIONS FROM A TEACHER, AN EMPLOYER, A CHURCH OR COMMUNITY LEADER, AN EXTRACURRICULAR COACH OR MENTOR CRITERIA FOR PARKVIEW COWORKERS: THE SCHOLARSHIP IS AVAILABLE TO ALL ELIGIBLE PARKVIEW COWORKERS SYSTEM-WIDE WHO ARE PURSUING A BACHELOR'S DEGREE IN NURSING AT INDIANA-PURDUE FORT WAYNE. CANDIDATES MUST MEET THE FOLLOWING CRITERIA IN ORDER TO BE CONSIDERED FOR THE SCHOLARSHIP: -BE ACCEPTED TO AND PLANNING TO ATTEND THE B.S. NURSING PROGRAM AT INDIANA-PURDUE UNIVERSITY AT FORT WAYNE. -HAVE AT LEAST 2 YEARS OF SERVICE WITH PARKVIEW -BE IN GOOD STANDING WITH NO DISCIPLINARY ACTIONS IN THE PREVIOUS TWO (2) YEARS -PROVIDE PROOF OF FINANCIAL NEED -MUST PROVIDE TWO (2) RECOMMENDATIONS, ONE OF WHICH MUST BE FROM A SUPERVISOR, COWORKER, OR EDUCATOR. QUALIFIED APPLICANTS' INFORMATION IS REVIEWED BY DR. TIELKER AND HIS CHILDREN, AND THEY CHOOSE THE RECIPIENT BASED ON WHOM THEY FEEL BEST EXEMPLIFIED DARLENE TIELKER'S TRAITS AS A PERSON AND A NURSE. 4) CATHY E. HARRIS GOOD SAMARITAN SCHOLARSHIP THE SCHOLARSHIP WILL PROVIDE A TOTAL OF $2,000 A YEAR AT THE BEGINNING OF THE SCHOOL YEAR, DISTRIBUTED AMONGST THE RECIPIENTS. THOSE PURSUING BASIC EMT WILL BE ELIGIBLE FOR $300, ADVANCED EMT $700, AND PARAMEDIC $1,000. THE SCHOLARSHIP DOLLARS, WHICH WILL BE DISTRIBUTED DIRECTLY TO THE SCHOOL OR PROGRAM, MAY BE USED TOWARD TUITION AND/OR BOOKS. THE SCHOLARSHIP IS AVAILABLE TO ALL ELIGIBLE CANDIDATES OF NORTHEAST INDIANA AND NORTHWEST OHIO. CANDIDATES MUST MEET THE FOLLOWING CRITERIA IN ORDER TO BE CONSIDERED FOR THE SCHOLARSHIP: -ACCEPTED INTO OR ENROLLED INTO A EMT, ADVANCED EMT, OR PARAMEDIC PROGRAM -HAVE AT LEAST ONE (1) YEAR OF SERVICE WITH PARKVIEW HEALTH -BE IN GOOD STANDING WITH NO DISCIPLINARY ACTIONS IN THE PREVIOUS YEAR -MUST PROVIDE ONE (1) PROFESSIONAL RECOMMENDATION FROM A SUPERVISOR, COWORKER, OR EDUCATOR QUALIFIED APPLICANTS' INFORMATION IS REVIEWED BY A PANEL CONSISTING OF PARKVIEW SENIOR STAFF. 5) DR. JAMES E. ALBRIGHT PARKVIEW SPORTS MEDICINE EXCELLENCE SCHOLARSHIP THE SCHOLARSHIP HONORS REMARKABLE SENIOR STUDENT ATHLETES. THESE ATHLETES ARE NOMINATED BY THEIR ATHLETIC TRAINERS - AND SELECTED BY THE SCHOLARSHIP REVIEW COMMITTEE - BASED ON THE FOLLOWING CRITERIA: -EXCEL ACADEMICALLY -MAKE A POSITIVE IMPACT ON THEIR COMMUNITY -DEMONSTRATE EXCEPTIONAL LEADERSHIP SKILLS -EXHIBIT OUTSTANDING ATHLETIC ABILITY THEY RECEIVE FUNDING FOR FOUR YEARS, BASED ON THE FOLLOWING SCHEDULE: YEAR 1: $1,000 YEAR 2: $750 YEAR 3: $500 YEAR 4: $250 6) DR. DARRYL R. SMITH MED-TECH SCHOLARSHIP TWO $1,000 SCHOLARSHIPS WILL BE AWARDED EACH YEAR. ONE TO THE PARKVIEW MED-TECH STUDENT WITH THE HIGHEST GRADE POINT AVERAGE AND THE OTHER TO THE PARKVIEW MED-TECH STUDENT WITH THE GREATEST FINANCIAL NEED. QUALIFIED APPLICANTS' INFORMATION IS REVIEWED BY A PANEL CONSISTING OF PARKVIEW MED-TECH SENIOR STAFF. THE PANEL WILL INFORM THE FOUNDATION OF THE SELECTED RECIPIENTS AND THE FOUNDATION WILL INFORM DR. AND MRS. SMITH OF THE SCHOLARSHIP RECIPIENTS, INCLUDING BIOGRAPHICAL INFORMATION ABOUT THE AWARDEES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Personal Services | Yes (X) | PersonalServicesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TIMOTHY MCELWEE | ||||||||||||||
| DIRECTOR/SEC/TREAS/SVP FOUNDATIONS | $232,938 | $0 | $57,807 | $0 | $24,538 | $0 | $49,375 | $0 | $28,263 | $0 | $392,921 | $0 | $0 | $0 |
| BENJAMIN MILES | ||||||||||||||
| DIRECTOR/PVHOS PRESIDENT | $0 | $507,288 | $0 | $111,879 | $0 | $36,021 | $0 | $104,242 | $0 | $35,884 | $0 | $795,314 | $0 | $31,782 |
| JAMES DOZIER | ||||||||||||||
| DIRECTOR/PH PHYSICIAN | $0 | $1,235,544 | $0 | $0 | $0 | $21,338 | $0 | $5,500 | $0 | $19,003 | $0 | $1,281,385 | $0 | $0 |
| JAMES EDLUND | ||||||||||||||
| DIRECTOR/CHAIR/PH PHYSICIAN | $0 | $299,735 | $0 | $69,396 | $0 | $13,596 | $0 | $8,250 | $0 | $17,129 | $0 | $408,106 | $0 | $0 |
| ROBERT GODLEY | ||||||||||||||
| DIRECTOR/PH PHYSICIAN | $0 | $453,826 | $0 | $49,099 | $0 | $34,828 | $0 | $30,250 | $0 | $32,608 | $0 | $600,611 | $0 | $0 |
| MICHAEL GRABOWSKI | ||||||||||||||
| DIRECTOR/PH PHYSICIAN | $0 | $715,192 | $0 | $128,267 | $0 | $37,925 | $0 | $30,250 | $0 | $32,487 | $0 | $944,121 | $0 | $17,796 |
| MICHAEL PACKNETT | ||||||||||||||
| PH PRESIDENT & CEO | $0 | $1,060,073 | $0 | $345,323 | $0 | $41,648 | $0 | $723,342 | $0 | $35,988 | $0 | $2,206,374 | $0 | $0 |
| JEANNE' WICKENS | ||||||||||||||
| PH CHIEF FINANCIAL OFFICER | $0 | $642,848 | $0 | $176,468 | $0 | $50,221 | $0 | $284,505 | $0 | $30,413 | $0 | $1,184,455 | $0 | $28,885 |
| TRACY BOSTWICK | ||||||||||||||
| WBFND COMM HOSP FND DIR | $28,434 | $75,860 | $0 | $12,308 | $124 | $332 | $3,228 | $10,004 | $5,478 | $16,977 | $37,264 | $115,481 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | TRAVEL FOR COMPANIONS - TAXABLE EXPENSE REIMBURSEMENT FOR FAMILY MEMBER PAID TO: TIMOTHY MCELWEE $357 NON-TAXABLE MANDATORY ANNUAL MEDICAL PHYSICAL PAID FOR: TIMOTHY MCELWEE $4,012 |
| PART I, LINE 3 | RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF PARKVIEW FOUNDATION, INC.'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. INDEPENDENT COMPENSATION CONSULTANT FORM 990 OF OTHER ORGANIZATIONS COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. |
| PART I, LINE 4B | SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS TAXABLE - MICHAEL GRABOWSKI $17,796; BENJAMIN MILES $31,782; JEANNE' WICKENS $28,885 PARTICIPANTS DEFERRED - THE FOLLOWING INDIVIDUALS HAVE AN AMOUNT INCLUDED IN SCHEDULE J, PART II, COLUMN (C) FOR AN AMOUNT EARNED BUT NOT YET VESTED UNDER ONE OF PARKVIEW'S DEFERRED COMPENSATION PLANS. BENEFITS EARNED UNDER THE PLANS WILL FUND THE EMPLOYEES' EVENTUAL RETIREMENT BENEFIT. THESE BENEFITS ARE PROVIDED IN EXCHANGE FOR ALL OF THE EMPLOYEES' YEARS OF SERVICE TO THE ORGANIZATION, AND THE COST OF THE BENEFITS MAY VARY FROM YEAR TO YEAR. THE AMOUNTS ARE AT RISK AND WILL NOT BE PAID UNLESS AND UNTIL EACH EMPLOYEE HAS PROVIDED SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION. BENEFITS UNDER THE PLANS VEST AT THE TIME SET FORTH IN THE PLAN DOCUMENTS AND ARE FORFEITED IF THE EMPLOYEES TERMINATE EMPLOYMENT BEFORE SATISFYING THOSE PLAN CONDITIONS. BENJAMIN MILES $84,992; TIMOTHY MCELWEE $42,500; MICHAEL PACKNETT $698,592; JEANNE' WICKENS $274,192 |
| 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 M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | TOYS, BOOKS, BLANKETS, BABY ITEMS, ETC. | 17 | $38,305 | ESTIMATED VALUE |
| Yes (X) | EVENT ITEMS | 35 | $12,369 | ESTIMATED VALUE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION USED NUMBER OF CONTRIBUTORS FOR LINES 25 & 26. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINES 1A, 1B AND 2A: | PARKVIEW HEALTH SYSTEM, INC. (PH), EIN 35-1972384 IS THE COMMON PAYING AGENT FOR THE FILING ORGANIZATION, PARKVIEW FOUNDATION, INC., EIN 23-7220589. 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, 2018 WAS 568. THE TOTAL NUMBER OF EMPLOYEES REPORTED ON FORM W-3 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2018 WAS 13,593. FOR PURPOSES OF COMPLETING FORM 990, PART V, LINE 1A, 1B, AND 2A, THE NUMBER REPORTED FOR THE PARKVIEW FOUNDATION, INC. WAS 10 AND 17 RESPECTIVELY. OF THE 10 REPORTED ON PART V, LINE 1A, PARKVIEW FOUNDATION, INC. DIRECTLY FILED 2 FORMS 1099-R TO REPORT ANNUITIES EARNED BY A PROGRAM OWNED AND FUNDS HELD BY PARKVIEW FOUNDATION, INC. |
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE OFFICERS OF THE BOARD, THE CHIEF ADMINISTRATIVE OFFICER OF THE CORPORATION, THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF PARKVIEW HEALTH OR HIS/HER DESIGNEE, AND THE PRESIDENT OR CHIEF OPERATING OFFICER OF THE CORPORATE MEMBER, AND SUCH OTHER PERSONS AS IDENTIFIED BY THE CHAIR, EACH OF WHOM SHALL BE ENTITLED TO VOTE. IN NO EVENT SHALL THE MEMBERS OF THE EXECUTIVE COMMITTEE EXCEED EIGHT (8) PEOPLE. THE EXECUTIVE COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION IN ANY MATTER WHEN THE BOARD IS NOT IN SESSION, REPORTING TO THE BOARD FOR ITS RATIFICATION OF ITS ACTION. THE CHAIR OF THE BOARD SHALL SERVE AS CHAIR OF THE EXECUTIVE COMMITTEE. MEETINGS OF THE EXECUTIVE COMMITTEE MAY BE CALLED BY THE CHAIR OR BY THREE (3) MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 2 | OFFICER JEANNE' WICKENS AND DIRECTORS MICHAEL GRABOWSKI AND BENJAMIN MILES HAVE A BUSINESS RELATIONSHIP AS DIRECTORS ON THE BOARD OF A RELATED ENTITY. |
| FORM 990, PART VI, SECTION A, LINE 4 | DURING 2018, THE FOLLOWING SIGNIFICANT CHANGE WAS MADE TO THE BYLAWS OF PARKVIEW FOUNDATION, INC.: ARTICLE IX - COMMITTEES OF THE BOARD OF DIRECTORS, SECTION 9 - VOLUNTEERS WAS ADDED TO ALLOW THE BOARD TO AUTHORIZE VOLUNTEERS AND OTHER COMMITTEE MEMBERS TO ASSIST IN FACILITATING GAMING ACTIVITES AND IS AS FOLLOWS: THE FOUNDATION BOARD MAY AUTHORIZE VOLUNTEERS AND OTHER COMMITTEE MEMBERS TO ASSIST IN FACILITATING GAMING ACTIVITIES, SUCH AS THE SALE OF RAFFLE TICKETS, ON BEHALF OF THE PARKVIEW HOSPITAL FOUNDATION. HOWEVER, SUCH VOLUNTEERS AND COMMITTEE MEMBERS SHALL HAVE NO VOTING RIGHTS AND ARE NOT PERMITTED TO PARTICIPATE IN PARKVIEW HOSPITAL FOUNDATION BOARD MEETINGS. |
| 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 HOSPITAL, INC. EIN 35-0868085 IS THE SOLE MEMBER OF PARKVIEW FOUNDATION, INC. WITH CERTAIN RESERVED POWERS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE CORPORATE MEMBER SHALL HAVE THE FOLLOWING RESERVED POWERS: (A) APPOINT DIRECTORS (INCLUDING APPOINTMENTS TO FILL A VACANCY) AND INITIATE THE REMOVAL AND REMOVE ANY DIRECTOR OF THE CORPORATION, WITH CAUSE, PROVIDED CONSIDERATION IS GIVEN TO RECOMMENDATIONS OF THE BOARD REGARDING SUCH APPOINTMENT OR REMOVAL, IF ANY ARE SO MADE; (B) APPOINT (INCLUDING APPOINTMENTS TO FILL A VACANCY) AND INITIATE THE REMOVAL AND REMOVE THE CHIEF ADMINISTRATIVE OFFICER OF THE CORPORATION, WITH OR WITHOUT CAUSE, PROVIDED CONSIDERATION IS GIVEN TO RECOMMENDATIONS OF THE BOARD REGARDING SUCH APPOINTMENT OR REMOVAL, IF ANY ARE SO MADE; (C) APPROVE AND ADOPT THE STRATEGIC PLAN FOR THE CORPORATION, INCLUDING ANY INDIVIDUAL INITIATIVES OR ARRANGEMENTS, SUCH AS A NEW SERVICE OR CONTRACTUAL ARRANGEMENT, DEEMED BY THE CORPORATE MEMBER TO BE OF STRATEGIC IMPORTANCE TO THE CORPORATION AND DIRECT AND MONITOR COMPLIANCE WITH SUCH PLANS, INITIATIVES AND ARRANGEMENTS; (D) APPROVE AND ADOPT THE CAPITAL AND OPERATING BUDGETS OF THE CORPORATION; (E) APPROVE THE INCURRENCE OF ANY DEBT PROPOSED BY THE CORPORATION, AND REQUIRE THE INCURRENCE OF DEBT BY THE CORPORATION, WHERE APPROPRIATE; (F) APPROVE THOSE TRANSFERS OF ASSETS BY THE CORPORATION, WHETHER BY SALE OR GIFT, WHERE THE ASSET BEING TRANSFERRED IS AN INTEREST IN REAL PROPERTY OR IS AN OPERATING ASSET OF THE CORPORATION, UNLESS OTHERWISE IDENTIFIED IN PREVIOUSLY APPROVED STRATEGIC PLANS, INITIATIVES, ARRANGEMENTS OR BUDGETS; (G) APPROVE PARTICIPATION (INCLUDING THE EXERCISE OF RENEWAL OPTIONS) BY THE CORPORATION IN NETWORKS, AFFILIATIONS, JOINT VENTURES, AND PARTNERSHIPS, AND REQUIRE PARTICIPATION BY THE CORPORATION IN SUCH ARRANGEMENTS; (H) APPROVE ANY AMENDMENT TO THE BYLAWS OR THE ARTICLES OF INCORPORATION OF THE CORPORATION, AND REQUIRE AMENDMENT OF THESE GOVERNING DOCUMENTS AS NECESSARY OR ADVISABLE TO RESOLVE SIGNIFICANT ETHICAL ISSUES, TO MAINTAIN TAX-EXEMPT STATUS, OR TO PREVENT SIGNIFICANT ADVERSE LEGAL OR FINANCIAL EFFECTS TO THE CORPORATION OR THE CORPORATE MEMBER. THE CORPORATE MEMBER SHALL FROM TIME TO TIME DEVELOP POLICIES FOR THE IMPLEMENTATION OF THE RESERVED POWERS. |
| FORM 990, PART VI, SECTION A, LINE 7B | SEE SCHEDULE O EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A |
| FORM 990, PART VI, SECTION B, LINE 11B | PURSUANT TO PARKVIEW HEALTH SYSTEM INC.'S BYLAWS, THE SYSTEM AUDIT COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION TO PROVIDE REVIEW OF THE CORPORATION AND ITS SUBSIDIARY CORPORATIONS' FORM 990 FILINGS. PARKVIEW FOUNDATION, 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 2, 2019, 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, 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: | DOUBTFUL PLEDGE EXPENSE -6,846. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| PARKVIEW HEALTH SYSTEM INC | |||||||||||
| 10501 CORPORATE DRIVE | FORT WAYNE | IN | 46845 | 351972384 | HEALTH CARE | IN | 501(C)(3) | LINE 12C, III-FI | N/A | 0 | |
| PARKVIEW HOSPITAL INC | |||||||||||
| 11109 PARKVIEW PLAZA DRIVE | FORT WAYNE | IN | 46845 | 350868086 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PARKVIEW PROFESSIONAL PROGRAMS INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10501 CORPORATE DRIVE | AddressLine1Txt |
| City | FORT WAYNE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46845 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351668888 | EIN |
| Primary Activities | REFERENCE LAB | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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