HUNTINGTON MEMORIAL HOSPITAL INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- HUNTINGTON MEMORIAL HOSPITAL INC (EIN 35-1970706)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-12
- IRS object ID
- 201733169349300618
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-12T15:17:44-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE HORWATH LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 330 EAST 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 | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351970706 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HUNTINGTON MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HUNT | BusinessNameControlTxt |
| Phone | 2603738429 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2001 STULTS ROAD | AddressLine1Txt |
| City | HUNTINGTON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46750 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEANNE' WICKENS | PersonNm |
| Person Title | PH CFO | PersonTitleTxt |
| Phone | 2603738407 | PhoneNum |
| Signature | 2017-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KENNETH J KEBER | PreparerPersonNm |
| PTIN | P00240883 | PTIN |
| Phone | 5742323992 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 204.58.171.16 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-12 | IPDt |
| IP Tm | 15:33:55 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | BD78C0151F32BCCEC501E79B474C54CD1328F117 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | BD78C0151F32BCCEC501E79B474C54CD1328F117 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL J PACKNETT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10501 CORPORATE DRIVE | AddressLine1Txt |
| City | FORT WAYNE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46845 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $72,570,518 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PARKVIEW.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1995 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | HUNTINGTON MEMORIAL HOSPITAL, INC. WORKS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND PROVIDES QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 348 | TotalEmployeeCnt |
| Total Volunteers | 103 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $38,365 | PYContributionsGrantsAmt |
| CY Contributions Grants | $187,661 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $62,738,751 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $63,849,952 | CYProgramServiceRevenueAmt |
| PY Investment Income | $688,184 | PYInvestmentIncomeAmt |
| CY Investment Income | $977,302 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,595 | PYOtherRevenueAmt |
| CY Other Revenue | $34,599 | CYOtherRevenueAmt |
| PY Total Revenue | $63,467,895 | PYTotalRevenueAmt |
| CY Total Revenue | $65,049,514 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $467,350 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $458,013 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,340,457 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $18,602,873 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $31,342,308 | PYOtherExpensesAmt |
| CY Other Expenses | $31,751,010 | CYOtherExpensesAmt |
| PY Total Expenses | $49,150,115 | PYTotalExpensesAmt |
| CY Total Expenses | $50,811,896 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $14,317,780 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $14,237,618 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $42,445,212 | TotalAssetsBOYAmt |
| Total Assets EOY | $45,974,498 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,795,618 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,269,328 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $40,649,594 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $40,705,170 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | HUNTINGTON MEMORIAL HOSPITAL, INC. WORKS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND PROVIDES QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $42,281,738 | ExpenseAmt |
| Grant | $458,013 | GrantAmt |
| Revenue | $63,849,952 | RevenueAmt |
| Desc | THE STAFF OF HUNTINGTON MEMORIAL HOSPITAL, INC., STRIVES TO PROVIDE EXCELLENT CARE TO EVERY PERSON EVERY DAY, AS EVIDENCED BY THE HOSPITAL'S RECOGNITION AS A 100 TOP HOSPITALS FACILITY BY TRUVEN HEALTH ANALYTICS FOR THE FOURTH TIME IN 2016. SERVICES INCLUDE A FULL-SERVICE, 24-HOUR EMERGENCY DEPARTMENT WITH EIGHT TREATMENT ROOMS AND ONE TRAUMA BAY, TWO SURGICAL SUITES, A FAMILY BIRTHING CENTER WITH SIX PRIVATE LABOR-DELIVERY-RECOVERY-POSTPARTUM ROOMS, REHABILITATION SERVICES INCLUDING PHYSICAL AND OCCUPATIONAL THERAPY, SPEECH THERAPY, CARDIAC AND PULMONARY REHAB, AND DIAGNOSTIC IMAGING, MAMMOGRAPHY, ULTRASOUND, CT SCAN, MRI, AND NUCLEAR MEDICINE.COMMUNITY-FOCUSED: (SEE SCHEDULE O FOR CONTINUATION)AS A NOT-FOR-PROFIT HOSPITAL, OUR MISSION IS CENTRAL TO HOW WE DELIVER CARE. HUNTINGTON MEMORIAL HOSPITAL, INC., EXISTS FOR ONE PURPOSE -- TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITIES. HUNTINGTON MEMORIAL HOSPITAL, INC. SUPPORTS THE NEEDS OF PEOPLE IN HUNTINGTON COUNTY WITH CERTIFIED NURSING STAFF, HEALTH EDUCATION AND OUTREACH PROGRAMS, AND FREE AND DISCOUNTED MEDICAL CARE. THE FIVE PROGRAMS LISTED HERE DEMONSTRATE SOME OF THE WAYS IN WHICH HUNTINGTON MEMORIAL HOSPITAL, INC., REACHES OUT TO OUR NEIGHBORHOODS AND HELPS AREA RESIDENTS CREATE HEALTHIER LIVES.FINANCIAL ASSISTANCE:HUNTINGTON MEMORIAL HOSPITAL, INC. IS COMMITTED TO MAKING MEDICALLY NECESSARY HEALTHCARE ACCESSIBLE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. PATIENTS WHOSE FAMILY INCOME DOES NOT EXCEED TWICE THE FEDERAL POVERTY GUIDELINES MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE PATIENT ACCESS TEAM INFORMS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY AS PART OF THE REGISTRATION PROCESS. THE HOSPITAL COMMITS TO PROVIDING THE BEST CARE, REGARDLESS OF ANY PERSON'S ABILITY TO PAY.COMMUNITY HEALTH IMPROVEMENT INITIATIVES:THE PURPOSE OF HUNTINGTON MEMORIAL HOSPITAL, INC.'S COMMUNITY HEALTH IMPROVEMENT PROGRAM IS TO FUND COMMUNITY HEALTH IMPROVEMENT EFFORTS WITHIN THE HOSPITAL'S SERVICE AREA. THE HOSPITAL SETS ASIDE UP TO 10 PERCENT OF ITS NET INCOME ANNUALLY TO FUND COMMUNITY HEALTH INITIATIVES AND PROGRAMS OF COMMUNITY HEALTH PARTNERS. WITH OUR COMMUNITY HEALTH PARTNERS PROGRAM, HUNTINGTON MEMORIAL HOSPITAL, INC. INVESTS IN KEY ORGANIZATIONS THAT PROMOTE THE HEALTHY LIFESTYLE CHOICES AND WELL-BEING OF INDIVIDUALS, CHILDREN, AND FAMILIES OF HUNTINGTON COUNTY. IN THE CALENDAR YEAR 2016, THE HOSPITAL SELECTED 11 COMMUNITY AGENCIES OR ORGANIZATIONS TO SUPPORT AND COLLABORATE IN ADDRESSING OUR FOCUS AREAS OF SMOKING CESSATION, PRENATAL CARE AND OBESITY.THE HOSPITAL IS A CONTRIBUTING MEMBER OF THE HEALTH AND WELLNESS COALITION OF HUNTINGTON COUNTY. THIS COLLABORATION OF NOT-FOR-PROFIT ORGANIZATIONS SUCH AS THE UNITED WAY, YMCA, AND AREA SCHOOLS MEETS REGULARLY TO DISCUSS AND PLAN ACTIVITIES THROUGH WHICH YOUTH AND ADULTS CAN PRACTICE GOOD NUTRITION HABITS AND PURSUE A MORE ACTIVE LIFESTYLE. PRIMARY HEALTH CARE/ACCESS:HUNTINGTON MEMORIAL HOSPITAL, INC. PROVIDES SUPPORT TO THE HUNTINGTON COUNTY FREE CLINIC AS A COMMUNITY HEALTH PARTNER. THE FREE CLINIC PROVIDES CARE FOR UNINSURED AND UNDERINSURED HUNTINGTON COUNTY RESIDENTS AND ITS 90-DAY WELLNESS PROGRAM PROVIDES INDIVIDUALIZED WEIGHT MANAGEMENT COACHING.IN ADDITION, THE HOSPITAL PROVIDES SUPPORT FOR THE HUNTINGTON MEDICAL ASSISTANCE PROGRAM WHICH ASSISTS THOSE WHO QUALIFY IN OBTAINING MEDICAL SUPPLIES AND PRESCRIPTION MEDICATIONS AT NO COST. THE PROGRAM ALSO HELPS PATIENTS ENROLL IN PHARMACEUTICAL ASSISTANCE PROGRAMS (PAP).LAUNCHED LAST YEAR, THE PATIENT AND FAMILY ENGAGEMENT ADVISORY COUNCIL BEGAN WORK THIS YEAR TO REVISE THE PATIENT AND FAMILY GUIDE. THIS GROUP OF COMMUNITY LEADERS AND REPRESENTATIVES OFFERED THEIR FEEDBACK AND GUIDANCE TOWARD MAKING THIS PUBLICATION A VALUABLE TOOL FOR PATIENTS, FAMILY MEMBERS AND GUESTS. HEALTH SCREENING AND PREVENTION:HUNTINGTON MEMORIAL HOSPITAL, INC. PARTICIPATES IN NUMEROUS HEALTH FAIRS AND ACTIVITIES THROUGHOUT THE YEAR TO PROVIDE HEALTH EDUCATION AND HEALTH SCREENINGS FOR DISEASE PREVENTION, AND TO PROMOTE HEALTHY LIFESTYLES. AT THE PARKVIEW HUNTINGTON YMCA HEALTHY KIDS DAY, FOR EXAMPLE, HOSPITAL EXPERTS ENCOURAGE AREA YOUTH TO COMMIT TO INCREASING THEIR DAILY PHYSICAL ACTIVITY AND CONSUMPTION OF FRUITS AND VEGETABLES.HUNTINGTON MEMORIAL HOSPITAL INC. SPONSORS HEALTHY STEPS, A POPULAR, SEMI-ANNUAL HEALTH AND WELLNESS EVENT FOR HUNTINGTON COUNTY RESIDENTS. AT EACH OF THE SPRING AND FALL EVENTS, MORE THAN 350 INDIVIDUALS VISIT THE HOSPITAL FOR BLOOD/LAB WORK, PHYSICIAN CONSULTATIONS, IMAGING FOR BREAST AND HEART HEALTH, AND TO TAKE ADVANTAGE OF EDUCATIONAL BOOTHS OFFERING A VARIETY OF SCREENINGS FOR BONE DENSITY, STRENGTH AND BALANCE, PULMONARY (SLEEP LAB), SKIN CANCER, AND DENTAL, VISION AND HEARING ISSUES.HUNTINGTON MEMORIAL HOSPITAL, INC. ENGAGES IN OUTREACH AND ASSISTANCE TO PATIENTS AND FAMILIES THROUGH VARIOUS SUPPORT GROUPS FOR CONDITIONS INCLUDING DIABETES, CHRONIC PAIN, AND ALZHEIMER'S DISEASE.COMMUNITY NURSING:HUNTINGTON MEMORIAL HOSPITAL, INC. PROVIDES FUNDING TO KIDS KAMPUS TO PROVIDE SICK-CARE TO THE DAY CARE CENTER, AFFILIATED WITH PATHFINDERS SERVICES. THIS CARE PROVIDED ON SITE ENSURES PARENTS A QUALITY, CONVENIENT PLACE WHERE THEIR SICK CHILD CAN RECEIVE INDIVIDUALIZED CARE.HUNTINGTON MEMORIAL HOSPITAL, INC. PROVIDES A LACTATION CONSULTANT TO HELP PATIENTS AND COMMUNITY MEMBERS LEARN AND PRACTICE EFFECTIVE BREAST FEEDING TECHNIQUES. A CERTIFIED OB NURSE PROVIDES PRENATAL CARE EDUCATIONAL SESSIONS TO HUNTINGTON COUNTY RESIDENTS AND FACILITATES A SUPPORT GROUP FOR NEW MOTHERS.HUNTINGTON MEMORIAL HOSPITAL, INC. STRIVES TO BE A RESPONSIBLE CORPORATE CITIZEN AND TO CONTRIBUTE IN MEANINGFUL WAYS TO THE HEALTH AND WELL-BEING OF INDIVIDUALS AND ALL OF HUNTINGTON COUNTY. | Desc |
| Total Program Service Expenses | $42,281,738 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 27 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 348 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEANNE' WICKENS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2603738407 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10501 CORPORATE DRIVE | AddressLine1Txt |
| City | FORT WAYNE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46845 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 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 |
|---|---|---|---|---|---|---|---|---|---|
| JULI JOHNSON | |||||||||
| DIRECTOR/HMHOS PRESIDENT | 40.00 | 1.00 | Yes (X) | Yes (X) | $243,853 | $0 | $75,408 | ||
| MICHAEL PACKNETT | |||||||||
| DIRECTOR/PH PRESIDENT & CEO | 1.00 | 56.00 | Yes (X) | Yes (X) | $0 | $2,067,010 | $712,544 | ||
| TODD SIDER | |||||||||
| DIRECTOR/PH PHYSICIAN | 1.00 | 40.00 | Yes (X) | $4,889 | $628,050 | $55,709 | |||
| KEVIN STAMM | |||||||||
| DIRECTOR/PH PHYSICIAN | 1.00 | 40.00 | Yes (X) | $17,101 | $496,982 | $54,771 | |||
| JULIE UTENDORF | |||||||||
| DIRECTOR/PH PHYSICIAN | 1.00 | 40.00 | Yes (X) | $4,995 | $373,538 | $58,586 | |||
| MATT ECKERT | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JANICE MATTERN | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $4,750 | $0 | $0 | |||
| JOHN NELSON | |||||||||
| DIRECTOR/VICE CHAIR | 1.00 | 2.00 | Yes (X) | $4,750 | $1,250 | $0 | |||
| JENNIFER NEWTON | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $2,750 | $750 | $0 | |||
| DARLENE STANLEY | |||||||||
| DIRECTOR/SECRETARY | 1.00 | 0.00 | Yes (X) | $4,750 | $0 | $0 | |||
| CHRIS STORIE | |||||||||
| DIRECTOR/TREASURER | 1.00 | 0.00 | Yes (X) | $4,750 | $0 | $0 | |||
| RYAN WARNER | |||||||||
| DIRECTOR/CHAIR | 1.00 | 1.00 | Yes (X) | $6,250 | $2,250 | $0 | |||
| JEANNE' WICKENS | |||||||||
| PH CHIEF FINANCIAL OFFICER | 1.00 | 56.00 | Yes (X) | $0 | $372,369 | $79,329 | |||
| STANTON RISSER | |||||||||
| INTERIM PH CFO - PARTIAL YEAR/PH VP | 1.00 | 56.00 | Yes (X) | $0 | $318,160 | $67,612 | |||
| DOUGLAS SELIG | |||||||||
| HMHOS VP PATIENT CARE | 40.00 | 0.00 | $170,132 | $0 | $45,965 | Yes (X) | |||
| EDWARD STRUBEL III | |||||||||
| HMHOS MGR PHARMACY | 40.00 | 0.00 | $168,661 | $0 | $44,163 | Yes (X) | |||
| HOLLY SALE | |||||||||
| HMHOS DIR RHB-WELLNESS-PHY | 40.00 | 0.00 | $156,378 | $0 | $26,675 | Yes (X) | |||
| BRYAN HALL | |||||||||
| HMHOS PHARMACIST | 47.00 | 2.00 | $124,815 | $4,743 | $32,416 | Yes (X) | |||
| SCOTT AMBURGEY | |||||||||
| HMHOS DIR SUPPORT SERVICE | 40.00 | 0.00 | $119,389 | $0 | $36,738 | Yes (X) | |||
| ELIZABETH DONLEY | |||||||||
| HMHOS NURSE LEADER | 40.00 | 0.00 | $108,754 | $0 | $22,261 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,146,967 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,265,102 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,312,177 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | 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 | $2,038,082 |
| GREAT LAKES ANESTHESIA PC | |||||
| 500 N NAPPANEE ST STE 11-B | ELKHART | IN | 46514 | ANESTHESIOLOGISTS | $562,397 |
| NORTHEAST INTERNAL MEDICINE ASSOC INC | |||||
| 2500 N DETROIT ST | LAGRANGE | IN | 46761 | HOSPITALISTS | $330,688 |
| HOSPITAL LAUNDRY SERVICES INC | |||||
| 3322 CAVALIER DRIVE | FORT WAYNE | IN | 46808 | LAUNDRY SERVICES | $147,401 |
| OPTUM EXECUTIVE HEALTH RESOURCES INC | |||||
| 15 CAMPUS BLVD STE 200 | NEWTOWN SQUARE | PA | 19073 | CONSULTANTS | $103,245 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $169,594 | RelatedOrganizationsAmt |
| Government Grants | $17,392 | GovernmentGrantsAmt |
| All Other Contributions | $675 | AllOtherContributionsAmt |
| Noncash Contributions | $1,250 | NoncashContributionsAmt |
| Total Contributions | $187,661 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE | 622000 | $61,893,327 | $61,893,327 |
| PHARMACY | 446110 | $684,301 | $684,301 |
| EMS DISPATCH | 900099 | $633,084 | $633,084 |
| EMS SUBSIDY | 900099 | $352,080 | $352,080 |
| EMS SERVICES TO WABASH | 900099 | $140,208 | $140,208 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $146,952 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $146,952 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $63,849,952 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $688,002 | TotalRevenueColumnAmt |
| Exclusion | $688,002 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $120,354 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $235,757 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$115,403 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$115,403 | TotalRevenueColumnAmt |
| Exclusion | -$115,403 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,565,983 | SecuritiesAmt |
| Other | $8,564 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,285,247 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $280,736 | SecuritiesAmt |
| Other | $8,564 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $289,300 | TotalRevenueColumnAmt |
| Exclusion | $289,300 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA REVENUE | 722210 | $149,662 | $149,662 |
| FITNESS CENTER - EMPLOYEES | 713940 | $340 | $340 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $150,002 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $65,049,514 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $63,849,952 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,011,901 | 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 | $458,013 | TotalAmt |
| Program Services | $458,013 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $593,368 | TotalAmt |
| Management And General | $593,368 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,447 | TotalAmt |
| Program Services | $11,447 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,665,923 | TotalAmt |
| Program Services | $13,665,923 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,332,135 | TotalAmt |
| Program Services | $4,332,135 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,969 | TotalAmt |
| Management And General | $85,969 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,232,423 | TotalAmt |
| Program Services | $3,553,768 | ProgramServicesAmt |
| Management And General | $678,655 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,306 | TotalAmt |
| Program Services | $13,306 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,484,152 | TotalAmt |
| Program Services | $1,382,331 | ProgramServicesAmt |
| Management And General | $101,821 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,252,972 | TotalAmt |
| Program Services | $2,252,783 | ProgramServicesAmt |
| Management And General | $189 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,291 | TotalAmt |
| Program Services | $32,091 | ProgramServicesAmt |
| Management And General | $23,200 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,312 | TotalAmt |
| Program Services | $27,690 | ProgramServicesAmt |
| Management And General | $7,622 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,164 | TotalAmt |
| Program Services | $6,164 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $914,501 | TotalAmt |
| Program Services | $912,540 | ProgramServicesAmt |
| Management And General | $1,961 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,137 | TotalAmt |
| Program Services | $125,137 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| CORP SERVICE ALLOCATION | $6,981,000 | $6,981,000 | |
| BAD DEBT | $5,743,885 | $5,743,885 | |
| MEDICAL SUPPLIES | $5,584,088 | $5,584,088 | |
| PH SUBSIDY | $4,108,134 | $4,108,134 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $128,676 | TotalAmt |
| Program Services | $72,303 | ProgramServicesAmt |
| Management And General | $56,373 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,811,896 | TotalAmt |
| Program Services | $42,281,738 | ProgramServicesAmt |
| Management And General | $8,530,158 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,550 | BOYAmt |
| EOY | $2,580 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $444,502 | BOYAmt |
| EOY | $450,712 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,863,324 | BOYAmt |
| EOY | $6,591,951 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $208,223 | BOYAmt |
| EOY | $272,824 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,500 | BOYAmt |
| EOY | $21,901 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,736,272 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,862,159 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,317,386 | BOYAmt |
| EOY | $4,874,113 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,976,732 | BOYAmt |
| EOY | $33,242,054 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $246,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,596,995 | BOYAmt |
| EOY | $272,363 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,445,212 | BOYAmt |
| EOY | $45,974,498 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,503,567 | BOYAmt |
| EOY | $2,107,969 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $106,003 | BOYAmt |
| EOY | $194,712 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $186,048 | BOYAmt |
| EOY | $2,966,647 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,795,618 | BOYAmt |
| EOY | $5,269,328 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,649,594 | BOYAmt |
| EOY | $40,705,170 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,649,594 | BOYAmt |
| EOY | $40,705,170 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,445,212 | BOYAmt |
| EOY | $45,974,498 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $14,237,618 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,387,174 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$15,569,216 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,690 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,690 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | REPRESENTS THE PORTION OF THE DUES PAID TO INDIANA HOSPITAL AND HEALTH ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION USED FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,316,724 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,112,475 | DepreciationAmt |
| Book Value | $1,204,249 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $32,500 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,062 | DepreciationAmt |
| Book Value | $2,438 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,855,406 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,440,023 | DepreciationAmt |
| Book Value | $3,415,383 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $531,642 | OtherCostOrOtherBasisAmt |
| Depreciation | $279,599 | DepreciationAmt |
| Book Value | $252,043 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,874,113 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO/FROM INTERUNIT | $2,924,380 |
| RESTRICTED FUNDS | $42,267 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,966,647 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | PARKVIEW HEALTH SYSTEM, INC. AND SUBSIDIARIES - NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES THE LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): PAGE 16 OF ATTACHED FINANCIAL STATEMENTS. INCOME TAXES: THE INTERNAL REVENUE SERVICE HAS DETERMINED THAT THE CORPORATION AND CERTAIN AFFILIATED ENTITIES ARE TAX-EXEMPT ORGANIZATIONS AS DEFINED IN SECTION 501(C)3 OF THE INTERNAL REVENUE CODE. CERTAIN SUBSIDIARIES OF THE CORPORATION ARE TAXABLE ENTITIES, THE TAX EXPENSE AND LIABILITIES OF WHICH ARE NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION AND ITS TAX-EXEMPT AFFILIATED ENTITIES EACH FILE A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THESE RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH SYSTEMS INCLUDE SUCH MATTERS AS THE TAX-EXEMPT STATUS OF EACH ENTITY, THE CONTINUED TAX-EXEMPT STATUS OF BONDS, THE NATURE, CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME, AND VARIOUS POSITIONS RELATING TO POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (REPORTED ON FORM 990T). AS OF DECEMBER 31, 2016 AND 2015, THERE ARE NO UNRECOGNIZED TAX BENEFITS RESULTING FROM UNCERTAIN TAX POSITIONS. FORMS 990 AND 990T FILED BY THE CORPORATION AND ITS TAX-EXEMPT AFFILIATED ENTITIES ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. FORMS 990 AND 990T FILED BY THE CORPORATION AND ITS TAX-EXEMPT AFFILIATED ENTITIES ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEAR 2012 AND PRIOR. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 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 | $602,913 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $602,913 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01340 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,399,781 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,865,066 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,534,715 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05620 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,197,458 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,026,735 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,170,723 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04820 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,200,152 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,891,801 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,308,351 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11780 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $187,267 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $43,391 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $143,876 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00320 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $350,864 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $350,864 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00780 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $538,131 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $43,391 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $494,740 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01100 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,738,283 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,935,192 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,803,091 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12880 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,525 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,525 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,849 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,849 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,374 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $29,374 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,743,885 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $154,557 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,623,238 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,491,763 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,868,525 | 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 | HUNTINGTON MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2001 STULTS ROAD | AddressLine1Txt |
| City | HUNTINGTON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46750 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PARKVIEW.COM | WebsiteAddressTxt |
| State License | 14-005081-1 | 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 | HUNTINGTON MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.PARKVIEW.COM/LOCALHEALTHNEEDS | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.PARKVIEW.COM/LOCALHEALTHNEEDS | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.PARKVIEW.COM | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.PARKVIEW.COM | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.PARKVIEW.COM | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| HUNTINGTON MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 5: THE RESEARCH TEAM WORKED TO ENSURE THAT THE NEEDS OF THE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS WERE TAKEN INTO ACCOUNT DURING THE COURSE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE SURVEY SAMPLE WAS STRATIFIED TO ENSURE THAT POPULATION SUBSETS WERE REPRESENTED ACCURATELY. SURVEYING OF PUBLIC HEALTH OFFICIALS, OTHER HEALTHCARE PROFESSIONALS AND VARIOUS SOCIAL SERVICE ORGANIZATIONS THAT SPECIALIZE IN AIDING VULNERABLE POPULATIONS IN THE SEVEN-COUNTY AREA WAS ALSO CONDUCTED. ADDITIONALLY, THE ASSESSMENT TEAM CONDUCTED TARGETED FOCUS GROUPS WITH POTENTIALLY VULNERABLE POPULATIONS, INCLUDING THE HISPANIC/LATINO AND AFRICAN AMERICAN POPULATIONS. THE AMISH POPULATION WAS RANDOMLY SURVEYED THROUGH A WRITTEN SURVEY. INFORMATION GAINED THROUGH FOCUS GROUPS AND WRITTEN SURVEYS HELPED TO GAIN INSIGHT INTO THE HEALTH NEEDS AND PERCEPTIONS OF THESE SUB-POPULATION GROUPS TO BETTER UNDERSTAND KEY PUBLIC HEALTH AND HEALTHCARE ISSUES. |
| HUNTINGTON MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 6A: PARKVIEW HOSPITAL, INC. (EIN 35-0868085); COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. (EIN 20-2401676); COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. (EIN 35-2087092); WHITLEY MEMORIAL HOSPITAL, INC. (EIN 35-1967665); PARKVIEW WABASH HOSPITAL, INC. (EIN 47-1753440) AND ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH, LLC (EIN 26-0143823). |
| HUNTINGTON MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 6B: PARKVIEW HEALTH SYSTEM, 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. |
| HUNTINGTON MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 11: SIGNIFICANT HEALTH NEEDS BEING ADDRESSED:OBESITY: OBESITY (HAVING A BODY MASS INDEX GREATER THAN 30.0) AFFECTS ALL AGE GROUPS AND DISPROPORTIONATELY AFFECTS PEOPLE OF DIFFERENT SOCIOECONOMIC STATUSES AND RACIAL/ETHNIC GROUPS. THERE ARE OFTEN MANY COMPLICATIONS THAT CAN OCCUR AS A DIRECT OR INDIRECT RESULT OF OBESITY. OBESITY RATES IN INDIANA ARE HIGHER THAN THE NATIONAL AVERAGE, WITH RATES IN MOST OF NORTHEAST INDIANA ABOVE THE STATE AVERAGE. IN INDIANA, CHILDHOOD OBESITY HAS BEEN IDENTIFIED AS A "STAGGERING" PROBLEM WITH 30 PERCENT OF CHILDREN AGES 10 TO 17 YEARS OF AGE OVERWEIGHT. IN COLLABORATION WITH OTHER COMMUNITY LEADERS, HUNTINGTON MEMORIAL HOSPITAL, INC. ACTIONS ARE TO SUPPORT THE FURTHER DEVELOPMENT OF HEALTHY LIFESTYLE CHOICES AMONG RESIDENTS OF HUNTINGTON COUNTY. THE STRATEGIC GOAL OF THIS INITIATIVE IS TO INCREASE OVERALL AWARENESS OF HEALTHY LIFESTYLE CHOICES, INCREASE THE NUMBER OF ADULTS WHO REPORT CONSUMING FRUITS AND VEGETABLES ON A DAILY BASIS, AND INCREASE THE NUMBER OF NUTRITIONAL AND ACTIVITY BASED PROGRAMS OFFERED FOR FAMILIES IN OUR COMMUNITY. THE ANTICIPATED IMPACT IS REDUCTION OF THE OBESITY RATE AND IN TURN THE CHRONIC DISEASES THAT GO HAND IN HAND WITH OBESITY. ALCOHOL AND SUBSTANCE ABUSE/ADDICTION: IN COLLABORATION WITH OTHER COMMUNITY LEADERS, HUNTINGTON MEMORIAL HOSPITAL, INC. ACTIONS ARE TO SUPPORT THE PREVENTION AND TREATMENT OF ALCOHOL AND SUBSTANCE ABUSE/ADDICTION AMONG RESIDENTS OF HUNTINGTON COUNTY. THE STRATEGIC GOAL OF THIS INITIATIVE IS TO INCREASE OVERALL AWARENESS OF THIS MAJOR ISSUE, DECREASE THE NUMBER OF ADULTS WHO REPORT THINKING OF OR USING ALCOHOL AND DRUGS, AND INCREASE THE NUMBER OF PREVENTION AND TREATMENT BASED PROGRAMS OFFERED IN OUR COMMUNITY. THE ANTICIPATED IMPACT IS IMPROVED PHYSICAL, MENTAL AND FINANCIAL WELL-BEING OF OUR COMMUNITY. OTHER HEALTH NEEDS NOT BEING ADDRESSED:-DIABETES, CARDIOVASCULAR DISEASE AND CANCER - WHILE HUNTINGTON MEMORIAL HOSPITAL, INC. DID NOT SELECT THESE CHRONIC DISEASES AS TOP HEALTH PRIORITIES, OUR INTENT IS TO HELP TO PREVENT AND REDUCE THE PRESENCE OF CHRONIC CONDITIONS LIKE THE AFOREMENTIONED DISEASES BY ADDRESSING OBESITY THROUGH NUTRITION EDUCATION, INCREASED ACCESS TO HEALTHY FOODS, ACTIVE LIVING PROGRAMS AND EDUCATION ON OTHER HEALTHY LIFESTYLE HABITS. -MATERNAL/INFANT/CHILD HEALTH PRENATAL CARE IS OFFERED FROM HUNTINGTON MEMORIAL HOSPITAL, INC. VIA THE BIRTH PLANNING PROGRAM. WIC, KIDS KAMPUS ALSO PROVIDE SERVICES. -HEALTHCARE ACCESS-COST AND QUALITY - WE COLLABORATE WITH PARKVIEW PHYSICIANS GROUP TO PROVIDE THE MEDICAL COVERAGE THAT IS NEEDED FOR OUR COMMUNITY. IF AN INDIVIDUAL DOES NOT HAVE A LOCAL PHYSICIAN, WE PROVIDE THEM WITH A LIST OF THE LOCAL PHYSICIANS AND THEIR CONTACT NUMBERS. AS APPROPRIATE, WE REFER THE PATIENT TO THE HUNTINGTON COUNTY FREE CLINIC FOR CARE. -MENTAL HEALTH - HUNTINGTON MEMORIAL HOSPITAL, INC. HAS REPRESENTATION AT MONTHLY SYSTEM OF CARE MEETINGS, AND PARTNERS WITH THE BOWEN CENTER THROUGH THE COALITION. HUNTINGTON UNIVERSITY ALSO HAS THEIR LIFESPRING COUNSELING PROGRAM. -CHRONIC KIDNEY DISEASE - MAJOR RISK FACTORS RELATED TO CHRONIC KIDNEY DISEASE ARE DIABETES, HIGH BLOOD PRESSURE AND AGE OF 60 AND OLDER WHICH AGAIN WE ARE WORKING TO IMPROVE BY DECREASING OBESITY. -ASTHMA-PATHFINDER'S KIDS KAMPUS, A HUNTINGTON MEMORIAL HOSPITAL, INC. FUNDED PARTNER, PROVIDES KIDS KLINIC THAT ADDRESSES THE NEEDS OF THOSE WITH ASTHMA. -HUNTINGTON MEMORIAL HOSPITAL, INC. PROVIDES SENIORS IN OUR COMMUNITY WITH DISCOUNTS (SUCH AS IN OUR FITNESS CENTER) AND OTHER OPPORTUNITIES THROUGH OUR PARKVIEW SENIOR CLUB. THE HUNTINGTON COUNTY COUNCIL ON AGING IS ONE OF OUR FUNDED PARTNERS AND IS INVOLVED WITH THE HEALTH & WELLNESS COALITION. THE HOSPITAL TEAM MEMBERS REGULARLY PRESENT PRIOR TO MONTHLY SENIOR MEETINGS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - JOHN B KAY MEDICAL BUILDING | ||||
| 2003 STULTS ROAD | HUNTINGTON | IN | 46750 | LAB DRAW SITE |
| 2 - PARKVIEW HUNTINGTON YMCA | ||||
| 1160 W 500 NORTH | HUNTINGTON | IN | 46750 | PHYSICAL THERAPY |
| 3 - PARKVIEW MEDICAL PLAZA | ||||
| 2708 GUILFORD STREET | HUNTINGTON | IN | 46750 | LAB DRAW SITE |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | EQUITY IN A HOME OTHER THAN THE PATIENT OR GUARANTOR'S PRIMARY RESIDENCE. |
| PART I, LINE 7: | PART I, LINE 7AHUNTINGTON MEMORIAL HOSPITAL, INC. IS COMMITTED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS UNABLE TO MEET THEIR FINANCIAL OBLIGATIONS. IT IS FURTHERMORE THE POLICY OF HUNTINGTON MEMORIAL HOSPITAL, INC. NOT TO WITHHOLD OR DENY ANY REQUIRED MEDICAL CARE AS A RESULT OF A PATIENT'S FINANCIAL INABILITY TO PAY HIS/HER MEDICAL EXPENSES.THE FINANCIAL ASSISTANCE COST REPORTED ON LINE 7A IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE FINANCIAL ASSISTANCE CHARGES FOREGONE ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF SERVICES RENDERED.PART I, LINE 7BHUNTINGTON MEMORIAL HOSPITAL, INC. ACCEPTS ALL MEDICAID, MEDICAID MANAGED CARE, AND OUT-OF-STATE MEDICAID PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEDICAID PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING MEDICAID, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE UNREIMBURSED MEDICAID COST REPORTED ON LINE 7B IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE MEDICAID CHARGES ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF MEDICAID SERVICES RENDERED. THEN, THE COST OF MEDICAID SERVICES RENDERED IS DEDUCTED FROM THE REIMBURSEMENT RECEIVED FOR MEDICAID PATIENTS TO ARRIVE AT A GAIN/(LOSS) RELATIVE TO THESE PATIENTS.PART I, LINE 7CHUNTINGTON MEMORIAL HOSPITAL, INC. ACCEPTS ALL MEANS-TESTED PATIENTS FROM THE HEALTHY INDIANA PLAN (HIP) WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEANS-TESTED PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING HIP, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE UNREIMBURSED HIP COST REPORTED ON LINE 7C IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE HIP CHARGES ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF HIP SERVICES RENDERED. THEN, THE COST OF HIP SERVICES RENDERED IS DEDUCTED FROM THE REIMBURSEMENT RECEIVED FOR HIP PATIENTS TO ARRIVE AT A GAIN/(LOSS) RELATIVE TO THESE PATIENTS.PART I, LINE 7EAMOUNTS PRESENTED ARE BASED ON ACTUAL SPEND FOR THOSE SERVICES AND BENEFITS PROVIDED DEEMED TO IMPROVE THE HEALTH OF THE COMMUNITIES IN WHICH WE SERVE AND CONFORM WITH THE MISSION OF OUR EXEMPT PURPOSE.PART I, LINE 7IIN KEEPING WITH OUR MISSION AND COMMITMENT TO THE COMMUNITIES IN WHICH WE SERVE, HUNTINGTON MEMORIAL HOSPITAL, INC. CONTINUES ITS TRADITION OF CONTRIBUTING TO NUMEROUS ORGANIZATIONS ON BOTH AN AS-NEEDED BASIS AND NEGOTIATED BASIS. AMOUNTS PRESENTED REPRESENT ACTUAL SPEND TO ORGANIZATIONS THROUGHOUT OUR COMMUNITIES. |
| PART I, LN 7 COL(F): | PERCENT OF TOTAL EXPENSEHUNTINGTON MEMORIAL HOSPITAL, INC. EXCLUDED $5,743,885 OF BAD DEBT 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 HUNTINGTON COUNTY AS A HSPA IN PRIMARY CARE AND MENTAL HEALTH.AS SUCH, HUNTINGTON MEMORIAL HOSPITAL, 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 HUNTINGTON 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.HUNTINGTON MEMORIAL HOSPITAL, 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. HUNTINGTON MEMORIAL HOSPITAL, INC. DEVELOPED A PHYSICIAN RECRUITMENT PLAN TO ADDRESS POTENTIAL GAPS IN PATIENT COVERAGE. HUNTINGTON MEMORIAL HOSPITAL, INC. STRIVES TO BRING THE BEST INTEGRATED, QUALITY, AND COST EFFECTIVE CARE AND INNOVATIVE TECHNOLOGY TO OUR COMMUNITIES. IN DOING SO, WE FOCUS OUR EFFORTS ON RECRUITING AN EXCEPTIONAL TEAM OF PHYSICIANS. EVERY MEMBER OF HUNTINGTON MEMORIAL HOSPITAL, INC.'S HEALTHCARE TEAM IS RESPONSIBLE FOR NURTURING AN ENVIRONMENT OF EXCELLENCE AS THE BEST PLACE FOR CO-WORKERS TO WORK, PHYSICIANS TO PRACTICE MEDICINE, AND PATIENTS TO RECEIVE CARE. WE ARE COMMITTED TO PROVIDING EXCEPTIONAL CUSTOMER SERVICE TO ALL PEOPLE. WE KNOW HOW IMPORTANT CLINICAL, SERVICE AND OPERATIONAL EXCELLENCE IS TO THE SUCCESS OF HUNTINGTON MEMORIAL HOSPITAL, INC., AND WE RECOGNIZE HOW IMPORTANT OUR SUCCESS IS TO THE COMMUNITY. |
| PART III, LINE 2: | THE AMOUNT REPORTED IS CONSISTENT WITH THE AMOUNT REPORTED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS UNDER THE GENERALLY ACCEPTED ACCOUNTING STANDARDS.DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS (BAD DEBT RECOVERIES) ARE FACTORED INTO THE ALLOWANCE FOR BAD DEBT ESTIMATION PROCESS. |
| PART III, LINE 3: | COSTING METHODOLOGY USED:UNCOLLECTIBLE PATIENT ACCOUNTS ARE CHARGED AGAINST THE PROVISION FOR BAD DEBT IN ACCORDANCE WITH THE POLICIES OF HUNTINGTON MEMORIAL HOSPITAL, INC. HOWEVER, DURING THE COLLECTION PROCESS THERE IS A CONTINUOUS EFFORT TO DETERMINE IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. THEREFORE, ONCE AN UNCOLLECTIBLE ACCOUNT HAS BEEN CHARGED OFF AND IT IS DETERMINED THROUGH THE COLLECTION PROCESS THAT THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THE UNCOLLECTIBLE ACCOUNT IS RECLASSIFIED TO CHARITY CARE AND ALL COLLECTION EFFORTS CEASE.PATIENTS ARE ELIGIBLE TO APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME, INCLUDING PATIENTS WHOSE ACCOUNTS HAVE BEEN PLACED IN A BAD DEBT AGENCY. THE AMOUNT REFLECTED ON LINE 3 WAS CALCULATED BY TOTALING THE ACCOUNTS PREVIOUSLY WRITTEN OFF TO BAD DEBT AND PLACED WITH A COLLECTION AGENCY, BUT SUBSEQUENTLY RECLASSIFIED AS CHARITY CARE DURING THE TAX YEAR. THE ACCOUNTS WERE RECLASSIFIED AS CHARITY CARE DUE TO THE FACT THAT PATIENTS APPLIED FOR, AND WERE APPROVED FOR, FINANCIAL ASSISTANCE AFTER THE ACCOUNTS WERE PLACED WITH A BAD DEBT AGENCY. |
| PART III, LINE 4: | BAD DEBT EXPENSE - PARKVIEW HEALTH SYSTEM, INC. AND SUBSIDIARIES - NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTSTEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE OR THE PAGE NUMBER ON WHICH THIS FOOTNOTE IS CONTAINED IN THE ATTACHED FINANCIAL STATEMENTS:PAGE 14 OF ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | COMMUNITY BENEFIT & METHODOLOGY FOR DETERMINING MEDICARE COSTSSUBSTANTIAL SHORTFALLS TYPICALLY ARISE FROM PAYMENTS THAT ARE LESS THAN THE COST TO PROVIDE THE CARE OR SERVICES AND DO NOT INCLUDE ANY AMOUNTS RELATING TO INEFFICIENT OR POOR MANAGEMENT. HUNTINGTON MEMORIAL HOSPITAL, INC. ACCEPTS ALL MEDICARE PATIENTS, AS REFLECTED ON THE YEAR-END MEDICARE COST REPORT, WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. HOWEVER, MEDICARE PAYMENTS REPRESENT A PROXY OF COST CALLED THE "UPPER PAYMENT LIMIT." IT HAS HISTORICALLY BEEN ASSUMED THAT UPPER PAYMENT LIMIT PAYMENTS DO NOT GENERATE A SHORTFALL. AS A RESULT, HUNTINGTON MEMORIAL HOSPITAL, INC. HAS TAKEN THE POSITION NOT TO INCLUDE THE MEDICARE SHORTFALLS OR SURPLUSES AS PART OF COMMUNITY BENEFIT. HUNTINGTON MEMORIAL HOSPITAL, INC. RECOGNIZES THAT THE SHORTFALL OR SURPLUS FROM MEDICARE DOES NOT INCLUDE THE COSTS AND REVENUES ASSOCIATED WITH MEDICARE ADVANTAGE PATIENTS. AS SUCH, THE TOTAL SHORTFALL OR SURPLUS OF MEDICARE IS UNDERSTATED DUE TO THE COSTS AND REVENUES ASSOCIATED WITH MEDICARE ADVANTAGE PATIENTS NOT BEING INCLUDED IN THE COMMUNITY BENEFIT DETERMINATION. |
| PART III, LINE 9B: | IF THE PATIENT CANNOT PAY IN FULL, THE OPTION OF A LOW INTEREST LOAN IS AVAILABLE WITH THE SAME DISCOUNT OFFERED FOR CASH PAYMENTS AS LONG AS THE LOAN IS ARRANGED WITHIN 30 DAYS OF THE FIRST GUARANTOR STATEMENT. IF THE PATIENT DEFAULTS ON THE LOAN, THE DISCOUNT WILL BE REVERSED AND THE PATIENT'S ACCOUNT WILL BE PLACED IN A COLLECTION AGENCY.INTEREST-FREE PAYMENTS WITH PAY-OUT NOT TO EXCEED TWELVE (12) MONTHS ARE AVAILABLE. THE MINIMUM MONTHLY PAYMENT IS $25.FINANCIAL ASSISTANCE MAY BE AVAILABLE FOR THOSE PATIENTS WHO CANNOT PAY THEIR BILL. THOSE OPTIONS ARE GOVERNMENTAL ASSISTANCE OR FREE CARE THROUGH THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM. THE HEALTH SYSTEM FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON PARKVIEW.COM OR BY VISITING ANY HOSPITAL CASHIER OFFICE OR BY CALLING PATIENT ACCOUNTING AT 260.373.7770 OR TOLL FREE 855.814.0012. A PATIENT MAY APPLY FOR FINANCIAL ASSISTANCE ANYTIME DURING THE APPLICATION PERIOD. FAILURE TO MAKE ARRANGEMENTS AS LISTED ABOVE OR FAILURE TO APPLY FOR AND RECEIVE APPROVAL UNDER THE FINANCIAL ASSISTANCE POLICY MAY RESULT IN THE ACCOUNT BEING PLACED IN A COLLECTION AGENCY DUE TO NON-PAYMENT. THE COLLECTION AGENCY MAY REPORT THE ACCOUNT TO ONE OR ALL THREE CREDIT REPORTING AGENCIES WHICH MAY ULTIMATELY ADVERSELY AFFECT THE PATIENT'S CREDIT SCORE. ADDITIONALLY, THE COLLECTION AGENCY MAY SUE AND OBTAIN A JUDGMENT AGAINST THE PATIENT FOR NON-PAYMENT. THESE ACTIONS WILL NOT OCCUR UNTIL 120 DAYS AFTER THE PATIENT IS SENT THEIR FIRST FOLLOW-UP STATEMENT INDICATING THE AMOUNT THEY OWE.A PATIENT MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE APPLICATION PERIOD, EVEN THOUGH THEY HAVE BEEN PLACED IN A COLLECTION AGENCY. IF THE PATIENT WAS SENT THEIR FIRST NOTICE ON THE ACCOUNT FOR WHICH THEY ARE APPLYING FOR FREE CARE BETWEEN 120 DAYS AND THE END OF THE APPLICATION PERIOD, THE ACTIONS ABOVE WILL BE SUSPENDED UNTIL THE FREE CARE APPLICATION ELIGIBILITY IS DETERMINED. |
| PART VI, LINE 2: | DESCRIBE HOW THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES.PARKVIEW HEALTH SYSTEM, INC. INCLUDING HUNTINGTON MEMORIAL HOSPITAL, INC. CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE SEVEN COUNTIES (ALLEN, HUNTINGTON, KOSCIUSKO, LAGRANGE, NOBLE, WABASH AND WHITLEY) WHERE PARKVIEW HAS HOSPITALS. ADDITIONALLY, PARKVIEW HEALTH SYSTEM, INC. PARTNERED WITH THE INDIANA PARTNERSHIP FOR HEALTHY COMMUNITIES (IPHC) TO COMPLETE MUCH OF THE FIELD WORK. IPHC CONDUCTED THE RANDOMLY SELECTED COMMUNITY MEMBER SURVEY TO OBTAIN PRIMARY DATA. THE SURVEY INSTRUMENT USED FOR THIS STUDY WAS LARGELY BASED ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM. OUR SURVEY INCLUDED CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO NATIONAL HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. IPHC ASSISTED WITH SURVEYING PUBLIC HEALTH, OTHER HEALTHCARE PROFESSIONALS, SOCIAL SERVICE AGENCIES AND OTHER COMMUNITY GROUP REPRESENTATIVES. THEY ALSO CONDUCTED SECONDARY DATA RESEARCH, DATA ANALYSIS AND FACILITATED PRIORITIZATION OF IDENTIFIED HEALTH ISSUES. A COLLECTIVE SECONDARY DATA BASE PROVIDED BY CONDUENT HEALTHY COMMUNITIES INSTITUTE WAS ALSO USED TO DETERMINE HEALTH ISSUES FOR EACH COUNTY IN THE SEVEN-COUNTY AREA. OTHER STATE AND NATIONAL SECONDARY SOURCES INCLUDED CENTERS FOR DISEASE CONTROL AND PREVENTION, COUNTY HEALTH RANKINGS, HEALTH INDICATORS WAREHOUSE, INDIANA STATE DEPARTMENT OF HEALTH, INDIANA UNIVERSITY CENTER FOR HEALTH POLICY AND THE US CENSUS BUREAU. CHNA REPORTS WERE PRESENTED TO AND ADOPTED BY THEIR RESPECTIVE HOSPITAL BOARD OF DIRECTORS IN 2016. HUNTINGTON MEMORIAL HOSPITAL, INC. REPRESENTATIVES MAINTAIN ON-GOING RELATIONSHIPS THROUGHOUT OUR COMMUNITIES AND MEET REGULARLY WITH ORGANIZATIONS THAT SHARE THE MISSION OF IMPROVING THE HEALTH AND INSPIRING THE WELL-BEING OF OUR COMMUNITIES. HEALTH ISSUES IDENTIFIED IN THE SURVEY INCLUDED: OBESITY, TOBACCO USE, CANCER, MATERNAL/CHILD HEALTH, DIABETES, CARDIOVASCULAR DISEASE, DRUG/ALCOHOL USE, HEALTHCARE ACCESS, MENTAL HEALTH, ASTHMA, AGING AND CHRONIC KIDNEY DISEASE.THE PRIORITIZATION OF HEALTH ISSUES WAS CONDUCTED USING A MODIFIED HANLON METHOD WHICH TAKES INTO ACCOUNT THE SIZE OF THE HEALTH PROBLEM, SERIOUSNESS OF THE HEALTH PROBLEM AND THE EFFECTIVENESS OF INTERVENTIONS. THIS METHOD, CALLED THE BASIC PRIORITY RATING SYSTEM (BPRS) IS RECOMMENDED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO) FOR THE PURPOSE OF PRIORITIZING COMMUNITY HEALTH NEEDS. FROM THE LIST OF HEALTH ISSUES IDENTIFIED, THREE TOP HEALTH PRIORITIES WERE SELECTED THROUGH APPLYING THE PEARL TEST WHICH IS DESIGNED TO SCREEN OUT IMPRACTICAL OR IMPRACTICABLE INTERVENTIONS BASE ON KEY FEASIBILITY FACTORS. THESE PRIORITIES ARE: 1) OBESITY/HEALTHY LIFESTYLES; 2) DRUG AND ALCOHOL USE. OTHER WAYS THAT HUNTINGTON MEMORIAL HOSPITAL, INC. IDENTIFIES OR VERIFIES COMMUNITY HEALTH NEEDS: -OTHER COMMUNITY NEEDS ASSESSMENTS CONDUCTED BY LOCAL ORGANIZATIONS -OBSERVATIONS BY HEALTHCARE PROFESSIONALS WHO WORK WITH VULNERABLE POPULATIONS-SPECIFIC REQUESTS PROMPTED BY OBSERVATION BY OTHER PROFESSIONALS IN THE COMMUNITY |
| PART VI, LINE 3: | DESCRIBE HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.SIGNAGE AND BROCHURES ARE POSTED AND AVAILABLE AT ALL HOSPITAL POINTS OF REGISTRATION AND IN THE EMERGENCY DEPARTMENT. PATIENTS ARE OFFERED PLAIN LANGUAGE SUMMARIES OF THE FINANCIAL ASSISTANCE POLICY DURING THE REGISTRATION PROCESS AND IN EACH FOLLOW UP STATEMENT SENT TO THE PATIENT. PATIENT STATEMENTS WILL INDICATE HOW A PATIENT CAN OBTAIN FINANCIAL ASSISTANCE APPLICATIONS AND WHO THEY CAN CONTACT FOR ASSISTANCE. |
| PART VI, LINE 4: | DESCRIBE THE COMMUNITY THE ORGANIZATION SERVES, TAKING INTO ACCOUNT THE GEOGRAPHIC AREA AND DEMOGRAPHIC CONSTITUENTS IT SERVES.HUNTINGTON MEMORIAL HOSPITAL, INC. PRIMARILY SERVES THE HUNTINGTON COUNTY COMMUNITIES OF HUNTINGTON, ANDREWS, MARKLE, MT. ETNA, ROANOKE AND WARREN. HUNTINGTON COUNTY HAS APPROXIMATELY 36,400 RESIDENTS, PRIMARILY CAUCASIAN (97.1%) FOLLOWED BY HISPANIC (2.2%) AND AFRICAN AMERICAN (.6%). THE COUNTY'S ANNUAL UNEMPLOYMENT RATE IS 4.6%. THE MEDIAN INCOME IN HUNTINGTON COUNTY IS $46,832. THE EMPLOYMENT AND EARNINGS BY INDUSTRY IS HEAVILY MANUFACTURING (31.3%) FOLLOWED BY HEALTHCARE/SOCIAL SERVICES (8.7%) AND CONSTRUCTION JOBS (4.7%). THE POVERTY RATE IN HUNTINGTON COUNTY STANDS AT 10.9%. |
| 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.).HUNTINGTON MEMORIAL HOSPITAL, INC.'S BOARD OF DIRECTORS IS COMPRISED OF MEMBERS, OF WHICH SUBSTANTIALLY ALL ARE INDEPENDENT COMMUNITY MEMBERS. A MAJORITY OF THE BOARD RESIDES IN HUNTINGTON MEMORIAL HOSPITAL, INC.'S PRIMARY SERVICE AREA. HUNTINGTON MEMORIAL HOSPITAL, INC. ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. PEOPLE THROUGHOUT THE COMMUNITY CAN COUNT ON HUNTINGTON MEMORIAL HOSPITAL, INC. TO BE STANDING BY WITH EMERGENCY CARE 24 HOURS A DAY, 365 DAYS A YEAR. THE EMERGENCY DEPARTMENT IS STAFFED WITH BOARD-CERTIFIED EMERGENCY CARE PHYSICIANS AND A NURSING STAFF THAT IS TRAINED AND EXPERIENCED IN EMERGENCY CARE. FURTHERMORE, NO PATIENT IS EVER DENIED TREATMENT, REGARDLESS OF THEIR ABILITY TO PAY. ADDITIONALLY, HUNTINGTON MEMORIAL HOSPITAL, INC. 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 INITIATIVES AND OTHER HOSPITAL FUNDS INCLUDE:-INVESTMENT IN KEY ORGANIZATIONS (HEALTH PARTNERS) THAT ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF HUNTINGTON COUNTY AND NORTHEAST INDIANA.-HEALTH AND WELLNESS COMMITTEE: THE HOSPITAL IS PART OF A GROUP OF NOT-FOR-PROFIT ORGANIZATIONS, INCLUDING THE UNITED WAY AND THE YMCA THAT MEET REGULARLY TO DISCUSS AND ACT ON THE HEALTH AND WELLNESS ISSUES OF HUNTINGTON COUNTY. -COMMUNITY NURSING INITIATIVE: HUNTINGTON MEMORIAL HOSPITAL, INC. PROVIDES SUPPORT TO HAVE LICENSED PRACTICAL NURSE AT PATHFINDER, INC.'S "KIDS KAMPUS". THE NURSE WORKS IN THE SICK CARE UNIT OF THIS CHILD-CARE CENTER TO ENABLE PARENTS TO HAVE A PLACE WHERE THEIR SICK CHILDREN CAN RECEIVE EXCELLENT CARE. -HUNTINGTON MEMORIAL HOSPITAL, INC. PROVIDES OPERATING SUPPORT TO THE HUNTINGTON COUNTY FREE CLINIC TO CARE FOR UNINSURED AND UNDERINSURED HUNTINGTON COUNTY RESIDENTS. IN ADDITION, THE HOSPITAL PROVIDES SUPPORT FOR THE HUNTINGTON MEDICAL ASSISTANCE PROGRAM THAT ASSISTS THOSE WHO QUALIFY IN OBTAINING MEDICAL SUPPLIES AND PRESCRIPTION MEDICATIONS AT LITTLE OR NO COST. THE PROGRAM ALSO ASSISTS PATIENTS TO ENROLL IN THE PHARMACEUTICAL ASSISTANCE PROGRAM (PAP). |
| PART VI, LINE 6: | IF THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM, DESCRIBE THE RESPECTIVE ROLES OF THE ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED.PARKVIEW HEALTH SYSTEM, INC. (PARKVIEW), A HEALTHCARE SYSTEM SERVING NORTHEAST INDIANA AND NORTHWEST OHIO THROUGH OUR HOSPITALS AND PHYSICIAN CLINICS, INCLUDES THE NOT-FOR-PROFIT HOSPITALS OF PARKVIEW HOSPITAL, INC.; COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.; COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.; PARKVIEW WABASH HOSPITAL, INC.; WHITLEY MEMORIAL HOSPITAL, INC.; HUNTINGTON MEMORIAL HOSPITAL, INC.; AS WELL AS 60 PERCENT OWNERSHIP IN THE JOINT VENTURE OF ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH, LLC. PARKVIEW CONTRIBUTES TO THE SUCCESS OF THE REGION BY EFFECTIVELY MANAGING ITS FACILITIES, EFFICIENTLY PROVIDING AND DELIVERING ITS SERVICES, AND SUPPORTING LOCAL BUSINESSES AND ACTIVITIES. PARKVIEW SEEKS TO CREATE ALIGNMENT OPPORTUNITIES TO DELIVER COMPREHENSIVE HIGH-QUALITY CARE THAT BENEFIT PATIENTS, PHYSICIANS, CO-WORKERS AND COMMUNITIES. EACH HOSPITAL ENTITY ENGAGES IN COMMUNITY OUTREACH CUSTOMIZED TO MEET THE UNIQUE NEEDS OF THEIR RESPECTIVE COMMUNITIES. AFFILIATE HOSPITALS WORK TOGETHER AND SHARE PROGRAMMING AND MESSAGING WHERE COMMON COMMUNITY HEALTH ISSUES ARE IDENTIFIED. FROM THE LIST OF HEALTH ISSUES IN THE SEVEN-COUNTY AREA, THE HEALTH PRIORITY OF OBESITY/HEALTHY LIFESTYLE PROMOTION AND EDUCATION INCLUDING GOOD NUTRITION, ACCESS TO AND CONSUMPTION OF HEALTHY FOODS AND AN ACTIVE LIFESTYLE WAS SELECTED BY ALL AFFILIATE HOSPITALS. PARKVIEW PRIDES ITSELF IN NOT ONLY OFFERING THE HIGHEST LEVEL OF CARE TO ITS PATIENTS, BUT ALSO IN PROVIDING AN EXCELLENT WORKPLACE FOR ITS PHYSICIANS, NURSES AND STAFF. PARKVIEW'S MISSION AND VISION IS AS FOLLOWS: AS A COMMUNITY OWNED, NOT-FOR-PROFIT ORGANIZATION, PARKVIEW HEALTH IS DEDICATED TO IMPROVING YOUR HEALTH AND INSPIRING YOUR WELL-BEING BY: 1) TAILORING A PERSONALIZED HEALTH JOURNEY TO ACHIEVE YOUR UNIQUE GOALS, 2) DEMONSTRATING WORLD-CLASS TEAMWORK AS WE PARTNER WITH YOU ALONG THAT JOURNEY 3) PROVIDING THE EXCELLENCE, INNOVATION AND VALUE YOU SEEK IN TERMS OF CONVENIENCE, COMPASSION, SERVICE, COST AND QUALITY. PARKVIEW BELIEVES THAT THE COMMUNITIES IT SERVES SHOULD ALL HAVE THE PEACE OF MIND THAT COMES WITH ACCESS TO COMPASSIONATE, HIGH-QUALITY HEALTHCARE, REGARDLESS OF WHETHER THE CARE IS DELIVERED IN A RURAL OR URBAN SETTING. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IN |
| PART VI, LINE 7: | A COPY OF FORM 990, SCHEDULE H IS FILED WITH THE INDIANA STATE DEPARTMENT OF HEALTH. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| BOYS AND GIRLS CLUB OF HUNTINGTON COUNTY | |||||||
| 608 EAST STATE STREET | HUNTINGTON | IN | 46750 | 352094506 | 501 ( C ) 3 | $104,214 | LIFE SKILLS PROGRAMS FOR ALL YOUNG PEOPLE |
| PARKVIEW HUNTINGTON HOSPTIAL FOUNDATION INC | |||||||
| 2001 STULTS ROAD | HUNTINGTON | IN | 46750 | 320012095 | 501 ( C ) 3 | $80,000 | OPERATIONS |
| COMMUNITY AND FAMILY SERVICES HUNTINGTON | |||||||
| 521 SOUTH WAYNE STREET | PORTLAND | IN | 47371 | 356059208 | 501 ( C ) 3 | $55,000 | PROVIDE ASSISTANCE AND ADVOCACY FOR LOW-INCOME RESIDENTS |
| PARKVIEW HUNTINGTON FAMILY YMCA | |||||||
| 1160 WEST 500 NORTH | HUNTINGTON | IN | 46750 | 350905959 | 501 ( C ) 3 | $40,500 | PROGRAMS THAT BUILD HEALTHY SPIRIT, MIND AND BODY FOR ALL |
| PATHFINDER SERVICES INC | |||||||
| 2824 THEATER AVE | HUNTINGTON | IN | 46750 | 351122311 | 501 ( C ) 3 | $40,000 | LOCAL SICK-CARE DAYCARE FOR CHILDREN |
| UNITED WAY OF HUNTINGTON | |||||||
| PO BOX 347 | HUNTINGTON | IN | 46750 | 351134872 | 501 ( C ) 3 | $32,500 | PROGRAMS & RESOURCES TO ENHANCE THE QUALITY OF LIFE FOR THE CITIZENS OF HUNTINGTON COUNTY |
| HUNTINGTON COUNTY COUNCIL ON AGING | |||||||
| 354 NORTH JEFFERSON STREET | HUNTINGTON | IN | 46750 | 351323270 | 501 ( C ) 3 | $30,000 | HUNTINGTON AREA TRANSPORTION AND PROGRAMMING |
| LOVE INC | |||||||
| 715 BRYON STRET | HUNTINGTON | IN | 46750 | 311144508 | 501 ( C ) 3 | $15,000 | ASSISTANCE PROGRAM FOR THOSE IN NEED |
| HUNTINGTON COUNTY SHERIFF'S DEPARTMENT | |||||||
| 332 EAST STATE STREET | HUNTINGTON | IN | 46750 | 320289878 | GOVT ORG | $10,000 | AED DEFIBRILLATORS |
| CANCER SERVICES OF NORTHEAST IN | |||||||
| 6316 MUTUAL DRIVE | FORT WAYNE | IN | 46825 | 350965609 | 501 ( C ) 3 | $10,000 | PATIENT ADVOCACY |
| CANCER SERVICES OF HUNTINGTON COUNTY | |||||||
| PO BOX 51 | HUNTINGTON | IN | 46750 | 351579660 | 501 ( C ) 3 | $10,000 | FINANCIAL ASSISTANCE FOR INDIVIDUALS WITH A CANCER DIAGNOSIS |
| HUNTINGTON UNIVERSITY | |||||||
| 2303 COLLEGE AVENUE | HUNTINGTON | IN | 46750 | 350868101 | 501 ( C ) 3 | $8,500 | NURSING CAREER ACADEMY |
| YOUTH SERVICES BUREAU OF HUNTINGTON COUNTY INC | |||||||
| 1344 MAPLE DRIVE | HUNTINGTON | IN | 46750 | 311207251 | 501 ( C ) 3 | $8,000 | ON YOUR WAY UP & SUICIDE PREVENTION PROGRAMS |
| CITY OF HUNTINGTON | |||||||
| 300 CHERRY STREET | HUNTINGTON | IN | 46750 | 356001061 | GOVT ORG | $7,787 | AEDS FOR THE CITY FIRE DEPT. TRUCKS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 14 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | COMMUNITY HEALTH IMPROVEMENT FUNDING PARTNER ORGANIZATIONS ARE REQUIRED TO SUBMIT AN ANNUAL PROGRESS REPORT RELATED TO PROGRAM FUNDING. PARTNER ORGANIZATIONS ARE REQUIRED TO RE-APPLY FOR FUNDING ON AN ANNUAL BASIS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JULI JOHNSON | ||||||||||||||
| DIRECTOR/HMHOS PRESIDENT | $180,459 | $0 | $62,150 | $0 | $1,244 | $0 | $52,333 | $0 | $23,075 | $0 | $319,261 | $0 | $0 | $0 |
| MICHAEL PACKNETT | ||||||||||||||
| DIRECTOR/PH PRESIDENT & CEO | $0 | $999,068 | $0 | $525,000 | $0 | $542,942 | $0 | $669,350 | $0 | $43,194 | $0 | $2,779,554 | $0 | $419,516 |
| TODD SIDER | ||||||||||||||
| DIRECTOR/PH PHYSICIAN | $4,889 | $496,500 | $0 | $109,177 | $0 | $22,373 | $184 | $23,666 | $246 | $31,613 | $5,319 | $683,329 | $0 | $0 |
| KEVIN STAMM | ||||||||||||||
| DIRECTOR/PH PHYSICIAN | $17,101 | $412,996 | $0 | $63,817 | $0 | $20,169 | $793 | $23,057 | $1,029 | $29,892 | $18,923 | $549,931 | $0 | $0 |
| JULIE UTENDORF | ||||||||||||||
| DIRECTOR/PH PHYSICIAN | $4,995 | $320,577 | $0 | $50,879 | $0 | $2,082 | $385 | $28,765 | $388 | $29,048 | $5,768 | $431,351 | $0 | $0 |
| JEANNE' WICKENS | ||||||||||||||
| PH CHIEF FINANCIAL OFFICER | $0 | $329,339 | $0 | $15,000 | $0 | $28,030 | $0 | $60,171 | $0 | $19,158 | $0 | $451,698 | $0 | $0 |
| STANTON RISSER | ||||||||||||||
| INTERIM PH CFO - PARTIAL YEAR/PH VP | $0 | $193,037 | $0 | $116,196 | $0 | $8,927 | $0 | $40,555 | $0 | $27,057 | $0 | $385,772 | $0 | $6,041 |
| DOUGLAS SELIG | ||||||||||||||
| HMHOS VP PATIENT CARE | $136,248 | $0 | $33,273 | $0 | $611 | $0 | $25,989 | $0 | $19,976 | $0 | $216,097 | $0 | $0 | $0 |
| EDWARD STRUBEL III | ||||||||||||||
| HMHOS MGR PHARMACY | $148,000 | $0 | $20,247 | $0 | $414 | $0 | $20,644 | $0 | $23,519 | $0 | $212,824 | $0 | $0 | $0 |
| HOLLY SALE | ||||||||||||||
| HMHOS DIR RHB-WELLNESS-PHY | $128,846 | $0 | $26,319 | $0 | $1,213 | $0 | $9,472 | $0 | $17,203 | $0 | $183,053 | $0 | $0 | $0 |
| BRYAN HALL | ||||||||||||||
| HMHOS PHARMACIST | $123,223 | $4,739 | $1,500 | $0 | $92 | $4 | $8,993 | $342 | $22,236 | $845 | $156,044 | $5,930 | $0 | $0 |
| SCOTT AMBURGEY | ||||||||||||||
| HMHOS DIR SUPPORT SERVICE | $98,234 | $0 | $20,885 | $0 | $270 | $0 | $11,824 | $0 | $24,914 | $0 | $156,127 | $0 | $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: JULI JOHNSON $335; DOUGLAS SELIG $169; |
| PART I, LINE 3 | RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF HUNTINGTON MEMORIAL HOSPITAL, INC.'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKIEW HEALTH SYSTEM, INC. INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. |
| PART I, LINE 4B | SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS TAXABLE - MICHAEL PACKNETT $419,516; STANTON RISSER $6,041 PARTICIPANTS DEFERRED - THE FOLLOWING INDIVIDUALS HAVE AN AMOUNT INCLUDED IN SCHEDULE J, PART II, COLUMN (C) FOR AN AMOUNT EARNED BUT NOT YET VESTED UNDER ONE OF PARKVIEW'S DEFERRED COMPENSATION PLANS. BENEFITS EARNED UNDER THE PLANS WILL FUND THE EMPLOYEES' EVENTUAL RETIREMENT BENEFIT. THESE BENEFITS ARE PROVIDED IN EXCHANGE FOR ALL OF THE EMPLOYEES' YEARS OF SERVICE TO THE ORGANIZATION, AND THE COST OF THE BENEFITS MAY VARY FROM YEAR TO YEAR. THE AMOUNTS ARE AT RISK AND WILL NOT BE PAID UNLESS AND UNTIL EACH EMPLOYEE HAS PROVIDED SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION. BENEFITS UNDER THE PLANS VEST AT THE TIME SET FORTH IN THE PLAN DOCUMENTS AND ARE FORFEITED IF THE EMPLOYEES TERMINATE EMPLOYMENT BEFORE SATISFYING THOSE PLAN CONDITIONS. JULI JOHNSON $30,736; MICHAEL PACKNETT $645,500; STANTON RISSER $22,005; DOUGLAS SELIG $14,278; JEANNE' WICKENS $57,021 |
| 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 L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | HEATHER ECKERT | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FAMILY MEMBER OF DIRECTOR MATT ECKERT | RelationshipDescriptionTxt |
| Transaction | $11,447 | TransactionAmt |
| Transaction | EMPLOYEE HEATHER ECKERT RECEIVED COMPENSATION FROM HUNTINGTON MEMORIAL HOSPITAL, INC. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
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, HUNTINGTON MEMORIAL HOSPITAL, INC., EIN 35-1970706. THEREFORE, ALL APPLICABLE IRS TAX FILINGS, INCLUDING FORMS 1099, 1096, W-2 AND W-3 ARE REPORTED AND FILED BY PH. THE TOTAL NUMBER REPORTED IN BOX 3 OF FORM 1096 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2016 WAS 573. THE TOTAL NUMBER OF EMPLOYEES REPORTED ON FORM W-3 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2016 WAS 12,046. FOR PURPOSES OF COMPLETING FORM 990, PART V, LINE 1A AND 2A, THE NUMBER REPORTED FOR THE HUNTINGTON MEMORIAL HOSPITAL, INC. WAS 27 AND 348 RESPECTIVELY. |
| FORM 990, PART VI, SECTION A, LINE 2 | DIRECTORS JULI JOHNSON AND RYAN WARNER HAVE A BUSINESS RELATIONSHIP AS DIRECTORS ON THE BOARD OF AN UNRELATED ENTITY. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION IS ORGANIZED AS A NOT-FOR-PROFIT CORPORATION. PURSUANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, PARKVIEW HEALTH SYSTEM, INC. EIN 35-1972384 IS THE SOLE MEMBER OF HUNTINGTON MEMORIAL HOSPITAL, INC. WITH CERTAIN RESERVED POWERS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE CORPORATE MEMBER, PARKVIEW HEALTH SYSTEM, INC. EIN 35-1972384, SHALL HAVE THE FOLLOWING RESERVED POWERS AS DEFINED IN THE NETWORK AGREEMENT: (A) APPOINT DIRECTORS (INCLUDING APPOINTMENTS TO FILL A VACANCY) AND INITIATE THE REMOVAL AND REMOVE ANY DIRECTOR OF THE CORPORATION, WITH CAUSE, PROVIDED CONSIDERATION IS GIVEN TO RECOMMENDATIONS OF THE BOARD REGARDING SUCH APPOINTMENT OR REMOVAL, IF ANY ARE SO MADE; (B) APPOINT (INCLUDING APPOINTMENTS TO FILL A VACANCY) AND INITIATE THE REMOVAL AND REMOVE THE PRESIDENT OF THE CORPORATION, WITH OR WITHOUT CAUSE, PROVIDED CONSIDERATION IS GIVEN TO RECOMMENDATIONS OF THE BOARD REGARDING SUCH APPOINTMENT OR REMOVAL, IF ANY ARE SO MADE; (C) APPROVE AND ADOPT THE STRATEGIC PLAN FOR THE CORPORATION AND ITS AFFILIATES, INCLUDING ANY INDIVIDUAL INITIATIVES OR ARRANGEMENTS, SUCH AS A NEW SERVICE OR CONTRACTUAL ARRANGEMENT, DEEMED BY THE CORPORATE MEMBER TO BE OF STRATEGIC IMPORTANCE TO THE CORPORATION OR ITS AFFILIATES AND DIRECT AND MONITOR COMPLIANCE WITH SUCH PLANS, INITIATIVES, AND ARRANGEMENTS; (D) APPROVE AND ADOPT THE CAPITAL AND OPERATING BUDGETS OF THE CORPORATION AND ITS AFFILIATES; (E) APPROVE THE INCURRENCE OF ANY DEBT PROPOSED BY THE CORPORATION, INCLUDING THE ISSUANCE OF BONDS, BY THE CORPORATION AND ITS AFFILIATES AND REQUIRE THE INCURRENCE OF DEBT BY THE CORPORATION AND ITS AFFILIATES; (F) APPROVE THE TRANSFER OF ASSETS BY THE CORPORATION AND ITS AFFILIATES, INCLUDING TRANSFERS OF REAL PROPERTY, PERSONAL PROPERTY, CASH, STOCK OR OTHER TANGIBLE OR INTANGIBLE ASSETS, UNLESS OTHERWISE IDENTIFIED IN PREVIOUSLY APPROVED STRATEGIC PLANS, INITIATIVES, ARRANGEMENTS OR BUDGETS; (G) REQUIRE AND DIRECT THE TRANSFER OF ASSETS BY THE CORPORATION OR ITS AFFILIATES, PROVIDED THAT APPROVAL OF THE BOARD IS ALSO REQUIRED IF THE TRANSFER INVOLVES A TRANSFER OR SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR WOULD PREVENT THE CORPORATION FROM OPERATING AN ACUTE CARE HOSPITAL IN THE COMMUNITY. FOR PURPOSES OF THIS SECTION, BOARD APPROVAL SHALL NOT BE REQUIRED FOR PARTICIPATION IN A MASTER TRUST INDENTURE, POOLED FINANCING OR ANY OTHER KIND OF DEBT INSTRUMENT, BORROWING OR GUARANTY OBLIGATING CORPORATION'S ASSETS; (H) APPROVE PARTICIPATION (INCLUDING THE EXERCISE OF RENEWAL OPTIONS) BY THE CORPORATION AND ITS AFFILIATES IN NETWORKS, AFFILIATIONS, JOINT VENTURES, PARTNERSHIPS, MERGERS OR ACQUISITIONS AND REQUIRE PARTICIPATION BY THE CORPORATION AND ITS AFFILIATES IN SUCH ARRANGEMENTS; (I) APPROVE DECISIONS OF THE CORPORATION AND ITS AFFILIATES TO PARTICIPATE (INCLUDING THE EXERCISE OF RENEWAL OPTIONS) IN MANAGED CARE OR OTHER HEALTH CARE SERVICE PURCHASING ARRANGEMENTS AND REQUIRE PARTICIPATION BY THE CORPORATION AND ITS AFFILIATES IN SUCH HEALTH CARE SERVICE PURCHASING ARRANGEMENTS; (J) DEVELOP AND REQUIRE ADOPTION OF MINIMUM MEDICAL STAFF QUALITY ASSURANCE AND UTILIZATION REVIEW STANDARDS, CRITERIA AND PROCEDURES FOR THE CORPORATION AND ITS AFFILIATES IN CONSULTATION WITH THE CORPORATION; (K) APPROVE ANY ACTION OF THE CORPORATION OR AN AFFILIATE TO CHANGE THE HOSPITAL FROM A GENERAL, ACUTE CARE COMMUNITY HOSPITAL OR TO CLOSE THE HOSPITAL; AND (L) APPROVE ANY AMENDMENT TO THE BYLAWS OR THE ARTICLES OF INCORPORATION OF THE CORPORATION, AND THE ARTICLES AND BYLAWS OF ANY NEWLY CREATED AFFILIATE AND REQUIRE AMENDMENT OF THESE GOVERNING DOCUMENTS AS NECESSARY OR ADVISABLE TO RESOLVE SIGNIFICANT ETHICAL ISSUES; TO MAINTAIN JCAHO ACCREDITATION, TAX-EXEMPT STATUS, PARTICIPATION IN MEDICARE/MEDICAID OR TO PREVENT SIGNIFICANT ADVERSE LEGAL OR FINANCIAL EFFECTS TO THE CORPORATION OR SYSTEM, EXCEPT THAT THERE CAN BE NO AMENDMENT TO THE RESERVED POWERS LISTED IN SECTIONS (G) AND (K) OF THIS LIST OR THE REQUIREMENT THAT APPOINTED DIRECTORS CAN BE REPRESENTATIVES OF HUNTINGTON COUNTY, AS DESCRIBED IN ARTICLE V, SECTIONS 2 AND 10 OF BYLAWS WITHOUT THE CONSENT OF THE CORPORATION. THE CORPORATE MEMBER SHALL DEVELOP POLICIES FOR THE IMPLEMENTATION OF THE RESERVED POWERS, INCLUDING MATERIALITY POLICIES REGARDING MATTERS SUBJECT TO REVIEW. |
| FORM 990, PART VI, SECTION A, LINE 7B | SEE SCHEDULE O EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A |
| FORM 990, PART VI, SECTION B, LINE 11B | PURSUANT TO PARKVIEW HEALTH SYSTEM INC.'S BYLAWS, THE SYSTEM AUDIT COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION TO PROVIDE REVIEW OF THE CORPORATION AND ITS SUBSIDIARY CORPORATIONS' FORM 990 FILINGS. HUNTINGTON MEMORIAL HOSPITAL, INC. IS A SUBSIDIARY CORPORATION OF PARKVIEW HEALTH SYSTEM, INC. AN ELECTRONIC COPY OF THE ORGANIZATION'S FINAL FORM 990 (INCLUDING REQUIRED SCHEDULES) WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY AND THE SYSTEM AUDIT COMMITTEE, PRIOR TO FILING WITH THE IRS. ON OCTOBER 25, 2017, THE SYSTEM AUDIT COMMITTEE REVIEWED THE FORM 990 AS ULTIMATELY FILED WITH THE IRS. THIS REVIEW INCLUDED A PRESENTATION BY THE ORGANIZATION'S TAX PREPARER TO HIGHLIGHT THE SIGNIFICANT AREAS ON THE FORM 990 AND SUPPLEMENTAL SCHEDULES. |
| FORM 990, PART VI, SECTION B, LINE 12C | AS DESCRIBED IN ARTICLE IX SECTION 6, OF THE PARKVIEW HEALTH SYSTEM, INC. (PH) BYLAWS, PH ADOPTED PH'S COMPLIANCE POLICY FOR THE ORGANIZATION AND ITS NOT-FOR-PROFIT RELATED ORGANIZATIONS (AND AS LIKEWISE NOTED IN THEIR BYLAWS) WHEN ADDRESSING CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. THIS COMPLIANCE POLICY (COMPLIANCE POLICY #14) REQUIRES THAT EACH BOARD MEMBER, BOARD COMMITTEE MEMBER, AND KEY MANAGEMENT PERSONNEL MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST FORM. THIS INFORMATION IS PROVIDED TO THE CHAIRMAN OF THE BOARD (FOR BOARD AND BOARD COMMITTEE MEMBERS) AND TO SENIOR MANAGEMENT (FOR KEY MANAGEMENT PERSONNEL). IN ADDITION, AS TO THE CONDUCT OF BOARD MEETINGS, THE FOLLOWING PROCESS IS FOLLOWED: "WHENEVER A PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE IS CONSIDERING A TRANSACTION OR ARRANGEMENT WITH AN ORGANIZATION, ENTITY OR INDIVIDUAL IN WHICH A PERSON COVERED BY THIS POLICY HAS A FINANCIAL OR CONFLICTING INTEREST, THE FOLLOWING SHALL OCCUR: 1. THE INTERESTED PERSON MUST DISCLOSE THE FINANCIAL OR CONFLICTING INTEREST AND ALL MATERIAL FACTS TO THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE; 2. THE INTERESTED PERSON WITH THAT FINANCIAL OR CONFLICTING INTEREST MAY MAKE A PRESENTATION AT THE BOARD OR BOARD COMMITTEE MEETING REGARDING THE TRANSACTION OR ARRANGEMENT HOWEVER, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE FINANCIAL OR CONFLICTING INTEREST; AND 3. THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE MUST APPROVE THE TRANSACTION OR ARRANGEMENT BY A MAJORITY VOTE OF THE BOARD MEMBERS PRESENT AT A MEETING THAT HAS A QUORUM, NOT INCLUDING THE VOTE OF THE INTERESTED PERSON. THE INTERESTED PERSON MAY NOT VOTE ON THE MATTER. A. UPON THE REQUEST OF PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE, THE MATTER MAY BE DELEGATED TO THE PH COMPLIANCE COMMITTEE FOR EVALUATION, RECOMMENDATION AND/OR DETERMINATION. 4. WHENEVER A FINANCIAL OR CONFLICTING INTEREST IS ADDRESSED BY A PH OR PH AFFILIATE BOARD, NOTICE SHALL BE GIVEN TO THE PH COMPLIANCE OFFICER / GENERAL COUNSEL." |
| FORM 990, PART VI, SECTION B, LINE 15 | REGARDING LINES 15A AND 15B, TO THE EXTENT THAT THE ORGANIZATION HAS VICE PRESIDENT OR ABOVE, THE ORGANIZATION USED A PROCESS FOR DETERMINING COMPENSATION OF THE CEO, OFFICERS, AND KEY EMPLOYEES. THE PROCESS INCLUDES CONSULTATIONS WITH AN INDEPENDENT COMPENSATION ADVISOR AND THE REVIEW OF APPROPRIATE COMPARABILITY DATA; REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE OF THE GOVERNING BODY CONSISTING OF MEMBERS WHO DO NOT HAVE A CONFLICT OF INTEREST CONCERNING THE COMPENSATION; AND CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. IN 2016, THE BOARD OF PARKVIEW HEALTH SYSTEM, INC. REVIEWED AND APPROVED ALL EXECUTIVE COMPENSATION, BENEFITS AND PERQUISITES FOR THE 2016 COMPENSATION PACKAGE, PURSUANT TO THE PARKVIEW HEALTH BYLAWS. THE COMPENSATION PACKAGE WAS APPROVED BY A MAJORITY OF INDEPENDENT BOARD MEMBERS. PARKVIEW'S INDEPENDENT CONSULTANT PREPARES A COMPETITIVE COMPENSATION ANALYSIS USING DATA FROM MULTIPLE PUBLISHED SURVEYS PREPARED BY INDEPENDENT FIRMS FOR POSITIONS THAT ARE FUNCTIONALLY COMPARABLE IN SIMILAR-SIZED HEALTH SYSTEMS AND HOSPITAL ORGANIZATIONS ON BOTH A REGIONAL AND NATIONAL BASIS. THE INDEPENDENT CONSULTANT PROVIDES A STATEMENT OF REASONABLENESS OF THE COMPENSATION PROVIDED TO THE CEO AS WELL AS ALL EXECUTIVES AT THE VICE PRESIDENT LEVEL AND ABOVE. ALL DATA IS SHARED WITH THE BOARD OF DIRECTORS. THE BOARD APPROVES ANY CHANGES IN COMPENSATION FOR THE CEO AND HIS DIRECT REPORTS. APPROVAL IS ALSO PROVIDED FOR THE SALARY BUDGET FOR THE ENTIRE ORGANIZATION. THE BOARD REVIEWS AND APPROVES THE PLAN DOCUMENTS FOR THE MANAGEMENT INCENTIVE COMPENSATION PLAN (MICP) AND THE PHYSICIAN AND PROVIDER INCENTIVE COMPENSATION PLAN (PICP). OFFICES OR POSITIONS REVIEWED AT THE 2016 MEETING: PRESIDENT AND CHIEF EXECUTIVE OFFICER PARKVIEW HEALTH EXECUTIVE VICE PRESIDENT CHIEF PHYSICIAN EXECUTIVE CHIEF OPERATING OFFICER PARKVIEW HEALTH CHIEF EXPERIENCE OFFICER PHYSICIAN EXECUTIVE OFFICER PARKVIEW PHYSICIANS GROUP PRESIDENT PARKVIEW REGIONAL MEDICAL CENTER AND AFFILIATES CHIEF CLINICAL INTEGRATION OFFICER CHIEF FINANCIAL OFFICER CHIEF INFORMATION OFFICER SENIOR VICE PRESIDENT GENERAL COUNSEL SENIOR VICE PRESIDENT CHIEF OPERATING OFFICER PARKVIEW PHYSICIANS GROUP CHIEF QUALITY AND SAFETY OFFICER SENIOR VICE PRESIDENT REVENUE CYCLE AND PAYOR STRATEGIES CHIEF HUMAN RESOURCES OFFICER CHIEF NURSING EXECUTIVE SENIOR VICE PRESIDENT STRATEGIC INITIATIVES CHIEF ACADEMIC AND RESEARCH OFFICER CHIEF MEDICAL INFORMATICS OFFICER CHIEF MEDICAL OFFICER PARKVIEW PHYSICIANS GROUP MEDICAL DIRECTOR COMMUNITY HOSPITALS MEDICAL DIRECTOR INTEGRATION AND DEVELOPMENT CHIEF OPERATING OFFICER - RANDALLIA CHIEF NURSING OFFICER - PARKVIEW REGIONAL MEDICAL CENTER AND AFFILIATES PRESIDENT - PARKVIEW CANCER CENTER SENIOR VICE PRESIDENT CHIEF OPERATING OFFICER SERVICE LINE LEADER BEHAVIORAL HEALTH SENIOR VICE PRESIDENT CHIEF OPERATING OFFICER SERVICE LINE LEADER ORTHO SENIOR VICE PRESIDENT CHIEF OPERATING OFFICER SERVICE LINE LEADER HEART INSTITUTE SENIOR VICE PRESIDENT CHIEF OPERATING OFFICER SERVICE LINE LEADER CANCER INSTITUTE SENIOR VICE PRESIDENT SERVICE LINE LEADER SENIOR VICE PRESIDENT DELIVERY SYSTEM INTEGRATION SENIOR VICE PRESIDENT FACILITY DESIGN AND OVERSIGHT SENIOR VICE PRESIDENT HEALTH AND WELL-BEING SENIOR VICE PRESIDENT PARKVIEW PHYSICIANS GROUP OPERATIONS DEPLOYMENT SENIOR VICE PRESIDENT SUPPLY AND SUPPORT SERVICES PRESIDENT COMMUNITY HOSPITALS VICE PRESIDENT CLINICAL INTEGRATION VICE PRESIDENT CONSTRUCTION VICE PRESIDENT EMPLOYEE STRATEGIES VICE PRESIDENT FINANCE VICE PRESIDENT MARKETING/COMMUNICATIONS/COMMUNITY RELATIONS VICE PRESIDENT NURSING RANDALLIA VICE PRESIDENT OPERATIONS - CANCER INSTITUTE VICE PRESIDENT PATIENT CARE SERVICES COMMUNITY HOSPITALS VICE PRESIDENT PARKVIEW PHYSICIANS GROUP FINANCE VICE PRESIDENT PARKVIEW PHYSICIANS GROUP PHYSICIAN PRACTICES VICE PRESIDENT STRATEGY AND BUSINESS DEVELOPMENT VICE PRESIDENT SURGICAL SERVICES PARKVIEW REGIONAL MEDICAL CENTER AND AFFILIATES VICE PRESIDENT CLINICAL OPERATIONS - PARKVIEW PHYSICIANS GROUP VICE PRESIDENT INFORMATION SECURITY VICE PRESIDENT INTERNAL AUDIT VICE PRESIDENT TECHNOLOGY VICE PRESIDENT PATIENT CARE SERVICES - COMMUNITY HOSPITALS |
| FORM 990, PART VI, SECTION C, LINE 19 | COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINES 5-10: | PARKVIEW HEALTH SYSTEM, INC., EIN 35-1972384, SERVES AS THE COMMON PAYING AGENT FOR ALL TAX-EXEMPT ORGANIZATIONS OF THE SYSTEM. SALARIES AND WAGES OF EMPLOYEES WORKING FOR THESE ORGANIZATIONS ARE CHARGED DIRECTLY TO THE ORGANIZATIONS IN WHICH THEY WORK. THE ACTUAL EXPENSES FOR PAYROLL TAXES, EMPLOYEE BENEFITS, AND PENSION PLAN CONTRIBUTIONS ARE REFLECTED ON THE BOOKS OF PARKVIEW HEALTH SYSTEM, INC. FOR FINANCIAL REPORTING PURPOSES. TO ACCOUNT FOR BENEFIT COSTS ON THE BOOKS OF THE OTHER TAX EXEMPT ORGANIZATIONS, AN ALLOCATION METHODOLOGY IS UTILIZED TO CHARGE THESE ORGANIZATIONS WITH AN ESTIMATE OF THE OVERALL COSTS, REFERRED TO AS A "BENEFIT ALLOCATION" FROM PARKVIEW HEALTH SYSTEM, INC. THE ALLOCATION DOES NOT DISTINGUISH BETWEEN THE COSTS OF THE VARIOUS COMPONENTS (I.E. PAYROLL TAXES, EMPLOYEE BENEFITS, AND PENSION PLAN CONTRIBUTIONS). THEREFORE, FOR PURPOSES OF THE FORM 990, PART IX, THE TOTAL BENEFIT ALLOCATION FOR THE EMPLOYEES' SALARIES AND WAGES REPORTED ON LINE 7 IS REFLECTED ON LINE 9 AND NOT ALLOCATED BETWEEN LINES 8 OR 10. FOR PURPOSES OF THE FORM 990, PART IX, LINES 5 AND 6 REFLECT COMPENSATION AND BENEFIT AMOUNTS REPORTED IN PART VII. |
| FORM 990, PART XI, LINE 9: | CURRENT YEAR EARNINGS TRANSFERRED TO PARENT -15,569,259. CLEAR DUE TO/FROM PARKVIEW WHITLEY LONG TERM CARE 43. |
| FORM 990, PART XII, LINE 9 | EFFECTIVE DECEMBER 1, 2014, PARKVIEW WHITLEY HOSPITAL DIVESTED THE PARKVIEW WHITLEY LONG TERM CARE OPERATIONS TO AN INDEPENDENT THIRD PARTY. AS PART OF THE DIVESTITURE AGREEMENTS, PARKVIEW WHITLEY LONG TERM CARE MAINTAINED RESPONSIBILITY FOR THE COLLECTION AND PAYMENT OF CERTAIN RECEIVABLES AND LIABILITIES. AS OF MARCH 31, 2016, PARKVIEW WHITLEY HOSPITAL MANAGEMENT DETERMINED THESE ACTIVITIES WERE COMPLETE AND THE DECISION WAS MADE TO CLOSE OUT ACCOUNTS ON THE PARKVIEW WHITLEY LONG TERM CARE BALANCE SHEET. AT THE TIME OF THIS DECISION, THE PARKVIEW WHITLEY LONG TERM CARE BALANCE SHEET WAS COMPRISED OF INTERNAL RECEIVABLES AND LIABILITIES ASSOCIATED WITH OTHER PARKVIEW HEALTH RELATED ENTITIES. THE BALANCE SHEET WAS CLOSED OUT THROUGH THE TRANSFERRING OF NET ASSETS TO AND FROM RELATED PARKVIEW ENTITIES IN SETTLEMENT OF THESE INTERNAL RECEIVABLES AND LIABILITIES. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| PARKVIEW HEALTH SYSTEM INC | |||||||||||
| 10501 CORPORATE DRIVE | FORT WAYNE | IN | 46845 | 351972384 | HEALTH CARE | IN | 501(C)(3) | LINE 12C, III-FI | N/A | 0 | |
| PARKVIEW HUNTINGTON HOSPITAL FOUNDATION INC | |||||||||||
| 2001 STULTS ROAD | HUNTINGTON | IN | 46750 | 320012095 | FUND MGMT | IN | 501(C)(3) | LINE 12A, I | Yes (1) | HUNTINGTON MEMORIAL HOSPITAL INC | |
| PARKVIEW OCCUPATIONAL HEALTH CENTERS INC | |||||||||||
| 10501 CORPORATE DRIVE | FORT WAYNE | IN | 46845 | 352064353 | OCCUP HEALTH | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| PARKVIEW HOSPITAL INC | |||||||||||
| 11109 PARKVIEW PLAZA DRIVE | FORT WAYNE | IN | 46845 | 350868085 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC | |||||||||||
| 207 N TOWNLINE ROAD | LAGRANGE | IN | 46761 | 202401676 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| WHITLEY MEMORIAL HOSPITAL INC | |||||||||||
| 1260 E STATE ROAD 205 | COLUMBIA CITY | IN | 46725 | 351967665 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| COMMUNITY HOSPITAL OF NOBLE COUNTY INC | |||||||||||
| 401 SAWYER ROAD | KENDALLVILLE | IN | 46755 | 352087092 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
| PARKVIEW WABASH HOSPITAL INC | |||||||||||
| 710 N EAST ST | WABASH | IN | 46992 | 471753440 | HOSPITAL CARE | IN | 501(C)(3) | LINE 3 | 0 | PARKVIEW HEALTH SYSTEM INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH LLC | ||||||||||
| 10501 CORPORATE DRIVE | FORT WAYNE | IN | 46845 | 260143823 | ORTHO HOSPITAL | IN | N/A | N/A | 0 | 0 |
| FOUNDATION SURGERY AFFILIATE OF FORT WAYNE LLC | ||||||||||
| 8004 CARNEGIE BLVD | FORT WAYNE | IN | 46804 | 201394120 | SURGICAL SERVICES | IN | N/A | N/A | 0 | 0 |
| MANAGED CARE SERVICES LLC | ||||||||||
| 10501 CORPORATE DRIVE | FORT WAYNE | IN | 46845 | 351996535 | HEALTH PLAN ADMIN | IN | N/A | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| MIDWEST COMMUNITY HEALTH ASSOCIATES INC | |||||||||
| 442 W HIGH STREET | BRYAN | OH | 43506 | 341045870 | PHYSICIANS | OH | N/A | C | 0 |
| WOODLAND PLAZA MEDICAL PARK CONDO ASSOC INC | |||||||||
| 202 W BERRY ST SUITE 800 | FORT WAYNE | IN | 46802 | 352058340 | CONDO MANAGEMENT | IN | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 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 | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PARKVIEW HUNTINGTON HOSPITAL FOUNDATION INC | ||
| B | $80,000 | PART VII SUPPLEMENTAL INFORMATION |
| PARKVIEW HUNTINGTON HOSPITAL FOUNDATION INC | ||
| C | $169,594 | PART VII SUPPLEMENTAL INFORMATION |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART V, LINE 2, COLUMN (C): | FormAndLineReferenceDesc |
| Explanation | THE AMOUNTS REPORTED AS TRANSACTIONS WITH RELATED ORGANIZATIONS ARE CONSISTENT WITH THE AMOUNTS REPORTED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS UNDER THE GENERALLY ACCEPTED ACCOUNTING STANDARDS DEPENDING ON THE TYPE OF TRANSACTION INVOLVED. | ExplanationTxt |
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