2013-11-11T09:08:41-06:00 2012-12-31 350921680 CROWE HORWATH LLP 330 E JEFFERSON BLVD PO BOX 7 SOUTH BEND IN 466240007 990 2012-01-01 350868085 PARKVIEW HOSPITAL INC PARK 2603738407 11109 PARKVIEW PLAZA DRIVE FORT WAYNE IN 468451701 MICHAEL P BROWNING 2603738407 2013-11-11 1 KENNETH J KEBER P00240883 5742323992 2012 2016-03-07 17:11:31Z MICHAEL PACKNETT 10501 CORPORATE DRIVE FORT WAYNE IN 46845 778130773 0 X WWW.PARKVIEW.COM X 1941 IN PARKVIEW HOSPITAL, INC. WORKS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND PROVIDES QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US. 16 11 4321 838 1902692 153553 815172 1142115 613854672 737317882 913553 1135655 9689582 9995581 625272979 749591233 1409188 1292622 0 0 196956562 231713753 0 0 0 358457657 433591855 556823407 666598230 68449572 82993003 357672470 834136664 42676375 517663176 314996095 316473488 X PARKVIEW HOSPITAL, INC. WORKS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND PROVIDES QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US. 0 0 560837208 1292622 739802786 PARKVIEW HOSPITAL, INC. IS A 410-BED REGIONAL TERTIARY REFERRAL CENTER, AS WELL AS A 154 BED COMMUNITY HOSPITAL AND AN 85 BED BEHAVIORAL HEALTH HOSPITAL, LOCATED IN FORT WAYNE, INDIANA. IT IS THE LARGEST HEALTHCARE EMPLOYER IN THE REGION AND IS HOME TO NORTHEAST INDIANA'S FIRST VERIFIED LEVEL II ADULT AND PEDIATRIC TRAUMA CENTER. ADDITIONAL SERVICES INCLUDE THE SAMARITAN FLIGHT PROGRAM, PARKVIEW HEART INSTITUTE, A CERTIFIED STROKE CENTER, WOMEN'S & CHILDREN'S HOSPITAL, OUTPATIENT SERVICES CENTER AND COMPREHENSIVE CANCER CENTER. AS A NOT-FOR-PROFIT HOSPITAL, WE TAKE OUR MISSION TO HEART. PARKVIEW HOSPITAL, INC. EXISTS FOR ONE PURPOSE - TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. PARKVIEW HOSPITAL, INC. GIVES BACK TO THE COMMUNITY IN THE FORM OF IMPROVED FACILITIES, EDUCATION AND OUTREACH PROGRAMS, FREE AND DISCOUNTED CARE, VOLUNTEERISM, AND SO MUCH MORE. IN MARCH 2012, THE NEWLY CONSTRUCTED PARKVIEW REGIONAL MEDICAL CENTER OPENED AND REPRESENTS AN INVESTMENT OF $536 MILLION TO PROVIDE STATE-OF-THE-ART CARE AND EXCEPTIONAL SERVICE FOR THOSE THAT ENTRUST THEIR CARE TO US. THROUGH THE PARKVIEW HOSPITAL, INC. COMMUNITY BENEFIT FUND, THE HOSPITAL WORKS WITH COMMUNITY PARTNERS IN TAKING A PROACTIVE APPROACH TO IMPROVING SPECIFIC HEALTH-RELATED OUTCOMES. AREAS OF FOCUS INCLUDE PROVIDING INCREASED ACCESS TO HEALTHCARE, HEALTH SCREENINGS AND PREVENTION PROGRAMS, DISEASE MANAGEMENT, HEALTH AND HEALTHCARE INNOVATION, AND RESEARCH AND DEVELOPMENT. PARKVIEW HOSPITAL, INC., IN CONJUNCTION WITH PARKVIEW HEALTH SYSTEM, INC., HAS PARTICIPATED IN PAST COMMUNITY HEALTH ASSESSMENTS. HEALTH INITIATIVES AT PARKVIEW HOSPITAL, INC., IDENTIFIED FROM THE COMMUNITY HEALTH ASSESSMENTS, HAVE INCLUDED A PNEUMONIA VACCINATION PROGRAM AND COLORECTAL AND MAMMOGRAPHY SCREENINGS. CHILDREN'S HEALTH AND WELLNESS HAS ALSO BEEN A HEALTH PRIORITY. TO BETTER UNDERSTAND SPECIFIC HEALTH NEEDS OF ALLEN COUNTY LOW INCOME FAMILIES, A LOW INCOME HEALTH ASSESSMENT WAS CONDUCTED IN COLLABORATION WITH OTHER COMMUNITY ORGANIZATIONS THAT SHARE THE COMMON GOAL OF IMPROVING THE HEALTH OF THE UNDERSERVED. PARKVIEW HOSPITAL, INC. IS CURRENTLY CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT WITH THE HELP OF THE SOCIAL RESEARCH DEPARTMENT, INDIANA UNIVERSITY/PURDUE UNIVERSITY FORT WAYNE. IN ADDITION, THE HOSPITAL IS WORKING WITH PURDUE UNIVERSITY'S HEALTHCARE ADVISORS IN REGARD TO THE PUBLIC HEALTH AND HEALTHCARE PROFESSIONALS' SURVEY. DEVELOPMENT OF AN IMPLEMENTATION STRATEGY TO ADDRESS IDENTIFIED HEALTH PRIORITIES IS UNDERWAY. THE FOLLOWING ARE SOME OF THE WAYS PARKVIEW HOSPITAL, INC. IS REACHING OUT TO MAKE OUR NEIGHBORHOODS AND COMMUNITIES HEALTHIER:FINANCIAL ASSISTANCE:PARKVIEW HOSPITAL, INC.'S MISSION INCLUDES CARING FOR PATIENTS WHO DO NOT HAVE THE MEANS TO MEET THEIR FINANCIAL OBLIGATIONS. THE HOSPITAL PLACES ITS PRIORITY ON PROVIDING THE NECESSARY CARE, NOT ON THE PATIENT'S FINANCIAL ABILITY TO PAY FOR THEIR MEDICAL EXPENSES.COMMUNITY HEALTH IMPROVEMENT INITIATIVES:THE PURPOSE OF PARKVIEW HOSPITAL, INC.'S COMMUNITY HEALTH IMPROVEMENT PROGRAM IS TO FUND COMMUNITY HEALTH IMPROVEMENT EFFORTS WITHIN THE SERVICE AREA OF PARKVIEW HOSPITAL, INC. THE HOSPITAL ANNUALLY FUNDS COMMUNITY HEALTH INITIATIVES AND PARTNERS WITH COMMUNITY ORGANIZATIONS TO ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF NORTHEAST INDIANA. SEVERAL INITIATIVES AND PROGRAMS ARE HIGHLIGHTED BELOW. COMMUNITY NURSING INITIATIVE: BELIEVING THAT THE KNOWLEDGE AND SKILL OF DEDICATED NURSES HAS GREAT BENEFIT OUTSIDE THE HOSPITAL WALLS, PARKVIEW HOSPITAL, INC. HAS, SINCE 1998, FUNDED A PROGRAM THAT PLACES PARKVIEW NURSES IN STRATEGIC POSITIONS THROUGHOUT THE COMMUNITY. FUNDING SUPPORTS NURSES IN PUBLIC SCHOOLS DEMONSTRATING THE GREATEST HEALTH NEEDS. PARKVIEW NURSES ALSO PROVIDE HEALTHCARE MANAGEMENT EXPERTISE AT CANI HEADSTART AND MARTIN LUTHER KING MONTESSORI PRESCHOOLS, SCAN, INC. (STOP CHILD ABUSE AND NEGLECT), AND THE FORT WAYNE WOMEN'S BUREAU TRANSITIONS PROGRAM FOR WOMEN RECOVERING FROM DRUG ABUSE. IN ADDITION, PARKVIEW HOSPITAL, INC. PROVIDES TWO DIABETES SPECIALTY NURSES, AN ASTHMA SPECIALTY NURSE, AND A RESPIRATORY THERAPIST TO IMPROVE THE HEALTH OF CHILDREN IN FORT WAYNE COMMUNITY SCHOOLS, EAST ALLEN COUNTY SCHOOLS, AND NORTHWEST ALLEN COUNTY SCHOOLS.CHILDREN'S HEALTH AND WELLNESS:THROUGH VARIOUS PROGRAMS PROVIDED BY COMMUNITY NURSES, REGISTERED DIETITIANS AND OTHER STAFF, PARKVIEW HOSPITAL, INC. DEMONSTRATES ITS COMMITMENT TO CHILDREN'S HEALTH ISSUES. IN 2011, THE HOSPITAL HOSTED A LOCAL CHILDREN'S HEALTH SUMMIT BRINGING NUMEROUS COMMUNITY ORGANIZATIONS TOGETHER TO DISCUSS CHILDREN'S HEALTH. AS A RESULT, THE HOSPITAL EMBARKED ON A PARTNERSHIP WITH BALL STATE UNIVERSITY THROUGH A STUDENT IMMERSIVE LEARNING PROJECT. THE PROJECT PRODUCED A THIRD- AND FOURTH-GRADE HEALTH AND WELLNESS CURRICULUM WITH INPUT FROM LOCAL TEACHERS, COORDINATED PILOTS OF THE CURRICULUM IN LOCAL SCHOOLS, INCORPORATED THE LOCAL MINOR LEAGUE BASEBALL TEAM MASCOT AS A KEY LEARNING TOOL, AND DEVELOPED SUPPORTING MATERIALS AND ACTIVITIES TO CREATE A TRUE LEARNING EXPERIENCE. IN 2012, THE HOSPITAL KICKED OFF THE LIVE PROGRAM PROMOTING THE 8 HEALTHY HABITS TO CHILDREN AND PARENTS. THIS PROGRAM IS A MEDIA CAMPAIGN AS WELL AS AN EDUCATIONAL PROGRAM THAT BRINGS THE MESSAGE OF THE IMPORTANCE OF HEALTHY EATING AND REGULAR PHYSICAL ACTIVITY TO THE EVERYDAY LIVES OF FAMILIES IN THE REGION. 560837208 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 0 1 X 137 0 1 4321 1 1 1 0 0 0 0 0 0 0 0 0 X 16 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 IN X MICHAEL P BROWNING 2603738407 10501 CORPORATE DRIVE FORT WAYNE IN 46845 X SUZANNE EHINGER 40.00 1.00 X X 539751 0 89074 MICHAEL PACKNETT 1.00 55.00 X X 0 1149762 166973 MICHAEL GRABOWSKI 5.00 2.00 X 76000 2500 0 JEFFREY NICKEL 7.00 0.00 X 114975 0 0 THOMAS BEAVER 1.00 1.00 X 2000 500 0 STEVE CORONA 1.00 0.00 X 4500 0 0 THOMAS KIMBROUGH 1.00 1.00 X 6000 1000 0 DAVID KOHLI 1.00 0.00 X 4500 0 0 DAVID MICHEL 1.00 0.00 X 4500 0 0 SHERRI MILLER 1.00 1.00 X 4750 0 0 MARILYN MORAN-TOWNSEND 1.00 0.00 X 4750 0 0 WENDY ROBINSON 1.00 0.00 X 4000 0 0 CHRISTINE RUPP 1.00 1.00 X 4750 0 0 DAN STARR 1.00 0.00 X 4750 0 0 IRENE WALTERS 1.00 0.00 X 3250 0 0 MICHAEL YURKANIN 4.00 1.00 X 50800 450 0 MICHAEL BROWNING 1.00 55.00 X 0 608926 75200 CHAD CARPENTER 40.00 0.00 X 219525 0 35750 JUDITH BOERGER 40.00 0.00 X 349636 0 51161 DANIEL GARMAN 40.00 0.00 X 286931 0 56282 CHARLES CLARK 40.00 0.00 X 220193 0 44152 THOMAS GUTWEIN 24.00 1.00 X 167700 800 0 TIMOTHY CMELIK 40.00 0.00 X 190274 0 36419 YUENIAN ZHANG 40.00 0.00 X 215076 0 11501 RAE GONTERMAN 40.00 0.00 X 201962 0 37259 MICHAEL GERUE 40.00 0.00 X 186024 0 56431 STANTON RISSER 0.00 40.00 X 0 132531 27053 2866597 1896469 687255 97 1 1 0 PREFERRED ANESTHESIA CONSULTANTS PC 1818 CAREW STREET STE 220 FORT WAYNE IN 46805 ANESTHESIOLOGISTS 5066464 INDIANA SURGICAL SPECIALISTS LLC 1818 CAREW STREET STE 160 FORT WAYNE IN 46805 PHYSICIANS 2358702 ORTHOPAEDICS NORTHEAST PC 5050 N CLINTON STREET FORT WAYNE IN 46825 PHYSICIANS 861605 ALLIED HOSPITAL PATHOLOGISTS PC 2458 LAKE AVENUE FORT WAYNE IN 46805 MEDICAL SERVICES 587748 GLOBAL WORKPLACE SOLUTIONS 9823 CINCINNATI DAYTON ROAD WEST CHESTER OH 45069 CONSULTANTS 442212 11 1051321 88625 2169 16299 1142115 NET PATIENT SERVICE 622000 698149779 698149779 LAB SERVICES 621500 18484630 18484630 PHARMACY 446110 15178264 15136936 41328 MEANINGFUL USE 900099 3744218 3744218 INTERUNIT RENT 900099 1008548 1008548 752443 258394 494049 737317882 427570 427570 3439440 1915542 1523898 1523898 8656 1515242 26897715 25982172 207458 915543 -207458 708085 708085 369561 434368 -64807 -64807 ORTHO BILLINGS 541900 3400716 2126851 1273865 CAFETERIA & MEALS 722210 3091597 3091597 ORTHO DEF REV/GN SALE 900099 1060508 1060508 983669 893430 84794 5445 8536490 749591233 739802786 1902692 6743640 X 1266658 1266658 25964 25964 2181980 2181980 171471830 169732282 1739548 58059943 57075154 984789 70042 70042 72161370 67356051 4805319 1146534 1135624 10910 24065269 21795440 2269829 2907 2907 12195466 11676421 519045 1070295 940032 130263 271972 128813 143159 291364 291364 40614660 40253300 361360 1732640 50274 1682366 CORP SERVICE ALLOCATION 90826092 90826092 MEDICAL SUPPLIES 79631217 79631217 BAD DEBT 68972873 68972873 PH SUBSIDY 36482991 36482991 4056163 4019843 36320 666598230 560837208 105761022 0 12852 14898 85878 0 76807665 102712927 562483 449983 9256896 11373072 1355192 1344096 999145139 312672925 158118255 686472214 16656287 18750691 6415221 6983764 1543174 1543174 86858567 4491845 357672470 834136664 22411602 29167034 11944150 10808047 2412421 8409004 5908202 469279091 42676375 517663176 X 314996095 316473488 314996095 316473488 357672470 834136664 X 82993003 828025 -82343635 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 24166 24166 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: A PORTION OF THE DUES PAID TO INDIANA HOSPITAL AND HEALTH ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION, INDIANA ASSOCIATION OF HOMES & SERVICES FOR THE AGING, INC. AND AMERICAN ASSOCIATION OF HOMES & SERVICES FOR THE AGING, INC. WERE USED FOR LOBBYING ACTIVITIES. 6760319 6760319 512320401 165152320 347168081 9522589 3448595 6073994 407552535 133650440 273902095 62989295 10421570 52567725 686472214 EST. MEDICARE/MEDICAID SETTLEMENTS 4646008 RESTRICTED FUNDS 467806 PROPERTY SECURITY DEPOSITS 2025 DUE TO/FROM INTERUNIT 464163252 469279091 1 1 X 1 X 0 1 1 0 0 16084453 16084453 0.02690 65633175 30672045 34961130 0.05850 3895316 2578842 1316474 0.00220 85612944 33250887 52362057 0.08760 4732442 351623 4380819 0.00730 4622094 1639277 2982817 0.00500 36481669 36481669 0.06100 1908309 239143 1669166 0.00280 1344918 217371 1127547 0.00190 49089432 2447414 46642018 0.07800 134702376 35698301 99004075 0.16560 8500 8500 0.00000 9500 9500 0.00000 50462 50462 0.00010 68462 68462 0.00010 1 68972873 3175347 114618135 131687420 -17069285 X 1 1 1 1 PARKVIEW HOSPITAL INC

11109 PARKVIEW PLAZA DRIVE FORT WAYNE IN 46845

X X X X X PARKVIEW HOSPITAL INC 1 1 1 200.000000000000 0 0 1 1 X X 1 0 1 X 0 0 23 PARKVIEW BEHAVIORAL HEALTH

1720 BEACON STREET FORT WAYNE IN 46805

IP & OP BEHAVIORAL PARKVIEW REGIONAL CANCER CENTER

11141 PARKVIEW PLAZA DR FORT WAYNE IN 46845

ONCOLOGY CENTER PVHOS FORT WAYNE CARDIOLOGY OP IMAGING

1819 CAREW STREET FORT WAYNE IN 46805

OUTPATIENT IMAGING OUPATIENT SERVICE CENTER OSC

11141 PARKVIEW PLAZA DR FORT WAYNE IN 46845

OP AMBULATORY PARKVIEW HOME HEALTHCARE

1900 CAREW STREET SUITE 6 FORT WAYNE IN 46805

HOME HEALTH & HOSPICE PARKVIEW CMP AMBULATORY SITE

1818 CAREW ST FORT WAYNE IN 46805

OP AMBULATORY EYE SURGERY INSTITUTE

1818 CAREW ST SUITE 020 FORT WAYNE IN 46805

AMBULATORY SURGERY CENTER PVHOS OP IMAGING - PARKVIEW FIRST CARE

3909 NEW VISION DRIVE FORT WAYNE IN 46845

OP AMBULATORY CAREW MRI

2110 CAREW STREET FORT WAYNE IN 46825

OP AMBULATORY PARKVIEW HOME INFUSION SERVICES

1900 CAREW STREET SUITE 4 FORT WAYNE IN 46805

OP INFUSION PARKVIEW REHAB OP CLINIC

2622 LAKE AVE FORT WAYNE IN 46805

OP REHAB SERVICES PARKVIEW CHILDRENS REHAB CLINIC

1900 CAREW STREET SUITE 2 FORT WAYNE IN 46805

OP REHAB SERVICES SOUTHWEST SLEEP CENTER

1625 MAGNAVOX WAY SUITE A FORT WAYNE IN 46804

OP SLEEP CENTER PARKVIEW YMCA

10001 DAWSONS CREEK BLVD FORT WAYNE IN 46845

OP REHAB SERVICES PARKVIEW NEW HAVEN AMBULATORY SITE

1331 MINNICH RD NEW HAVEN IN 46774

OP AMBULATORY PARKVIEW CYTOGENETICS

11141 PARKVIEW PLAZA DR FORT WAYNE IN 46845

REFERENCE LAB PARKVIEW RESEARCH CENTER

2426 EAST STATE BLVD FORT WAYNE IN 46825

CLINICAL RESEARCH PARKVIEW WOODLAND PLAZA AMBULATORY SITE

1234 DUPONT RD FORT WAYNE IN 46845

OP AMBULATORY PARKVIEW HEALTH & FITNESS

3000 E STATE BLVD FORT WAYNE IN 46805

HEALTH FITNESS PARKVIEW FAMILY MED SW - DIAG IMAGING

10515 ILLINOIS RD FORT WAYNE IN 46814

OP AMBULATORY WOMEN'S HEALTH CENTER

11123 PARKVIEW PLAZA DR FORT WAYNE IN 46845

WOMEN'S HEALTH ISSUES CMP - CHILDREN SPECIALTY CLINIC

1818 CAREW ST SUITE 120 FORT WAYNE IN 46805

OP SPECIALTY CLINIC INVERNESS IMAGING

8028 CARNEGIE BLVD SUITE 100 FORT WAYNE IN 46804

OUTPATIENT IMAGING PART I, LINE 3C: ELIGIBILITY CRITERIA FOR FREE OR DISCOUNTED CAREPARKVIEW HOSPITAL, INC. PROVIDES DISCOUNTED CARE TO UNINSURED PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IF THE PATIENT ULTIMATELY QUALIFIES FOR CHARITY CARE USING THE 200% FPG, THE REMAINING BALANCE AFTER THE DISCOUNT IS WRITTEN OFF TO CHARITY. PART I, LINE 7: PART I, LINE 7APARKVIEW HOSPITAL, INC. IS COMMITTED TO PROVIDING CHARITY CARE TO PATIENTS UNABLE TO MEET THEIR FINANCIAL OBLIGATIONS. IT IS FURTHERMORE THE POLICY OF PARKVIEW 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 CHARITY CARE COST REPORTED ON LINE 7A IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE CHARITY CARE CHARGES FOREGONE ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF SERVICES RENDERED.PART I, LINE 7BPARKVIEW HOSPITAL, INC. ACCEPTS ALL MEDICAID, MEDICAID MANAGED CARE, AND OUT-OF-STATE MEDICAID PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEDICAID PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING MEDICAID, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE UNREIMBURSED MEDICAID COST REPORTED ON LINE 7B IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE MEDICAID CHARGES ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF MEDICAID SERVICES RENDERED. THEN, THE COST OF MEDICAID SERVICES RENDERED IS DEDUCTED FROM THE REIMBURSEMENT RECEIVED FOR MEDICAID PATIENTS TO ARRIVE AT A GAIN/(LOSS) RELATIVE TO THESE PATIENTS.PART I, LINE 7CPARKVIEW HOSPITAL, INC. ACCEPTS ALL CERTAIN MEANS-TESTED PATIENTS FROM THE HEALTHY INDIANA PLAN (HIP) WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEANS-TESTED PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING HIP, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE UNREIMBURSED HIP COST REPORTED ON LINE 7C IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE HIP CHARGES ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF HIP SERVICES RENDERED. THEN, THE COST OF HIP SERVICES RENDERED IS DEDUCTED FROM THE REIMBURSEMENT RECEIVED FOR HIP PATIENTS TO ARRIVE AT A GAIN/(LOSS) RELATIVE TO THESE PATIENTS.PART I, LINE 7EAMOUNTS PRESENTED ARE BASED ON ACTUAL SPEND FOR THOSE SERVICES AND BENEFITS PROVIDED DEEMED TO IMPROVE THE HEALTH OF THE COMMUNITIES IN WHICH WE SERVE AND CONFORM WITH THE MISSION OF OUR EXEMPT PURPOSE.PART I, LINE 7FAMOUNTS PRESENTED ARE BASED UPON ACTUAL SPEND AND ARE IN CONFORMITY WITH AGREED UPON COMMITMENTS WITH THE VARIOUS EDUCATIONAL PROGRAMS.PART I, LINE 7HAMOUNTS PRESENTED REPRESENT ACTUAL SPEND TO SUPPORT THE RESEARCH CONDUCTED BY THE PARKVIEW RESEARCH CENTER. SPEND IS BASED ON THE OPERATING EXPENSES ASSOCIATED WITH RESEARCH ACTIVITIES OVER AND ABOVE GRANTS AND OTHER REVENUE RECEIVED BY THE CENTER. PART I, LINE 7IIN KEEPING WITH OUR MISSION AND COMMITMENT TO THE COMMUNITIES IN WHICH WE SERVE, PARKVIEW 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, LINE 7G: SUBSIDIZED HEALTH SERVICES PARKVIEW HOSPITAL, INC. INCLUDED $36,481,669 IN COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES. PART I, L7 COL(F): PERCENT OF TOTAL EXPENSESPARKVIEW HOSPITAL, INC. EXCLUDED $68,972,873 OF BAD DEBT EXPENSE. PART II: DESCRIBE HOW THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES, AS REPORTED, PROMOTES THE HEALTH OF THE COMMUNITIES THE ORGANIZATION SERVES.PARKVIEW HOSPITAL, INC. HAS A STRONG COMMITMENT TO THE VITALITY OF THE LOCAL COMMUNITY AND TO THE NORTHEAST INDIANA REGION AND INVESTS IN ENHANCING VARIOUS ASPECTS THAT HELP TO IMPROVE THE HEALTH OF THE COMMUNITY. WORKFORCE DEVELOPMENT:PARKVIEW HOSPITAL, INC. PROMOTES HEALTHCARE CAREERS THROUGH STUDENT JOB SHADOWING AND INTERNSHIP OPPORTUNITIES IN VARIOUS HEALTHCARE AREAS THROUGHOUT THE ORGANIZATION.LEADERSHIP DEVELOPMENT/TRAINING FOR COMMUNITY MEMBERS:ANOTHER WAY IN WHICH PARKVIEW HOSPITAL, INC. EXHIBITS ITS COMMITMENT TO THE BETTERMENT OF THE COMMUNITY IS THROUGH THE SUPPORT OF LOCAL LEADERSHIP DEVELOPMENT PROGRAMS. PART III, LINE 4: BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTETEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE:PAGE 15 OF AUDITED FINANCIAL STATEMENTS.COSTING METHODOLOGY USED:UNCOLLECTIBLE PATIENT ACCOUNTS ARE CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH THE POLICIES OF PARKVIEW HOSPITAL, INC. HOWEVER, DURING THE COLLECTION PROCESS THERE IS A CONTINUOUS EFFORT TO DETERMINE IF THE PATIENT QUALIFIES FOR CHARITY. THEREFORE, ONCE AN UNCOLLECTIBLE ACCOUNT HAS BEEN CHARGED OFF AND IT IS DETERMINED THROUGH THE COLLECTION PROCESS THAT THE PATIENT QUALIFIES FOR CHARITY CARE, THE UNCOLLECTIBLE ACCOUNT IS RECLASSIFIED TO CHARITY AND ALL COLLECTION EFFORTS CEASE. PATIENTS ARE ELIGIBLE TO APPLY FOR FREE CARE 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 FREE CARE DURING THE 2012 CALENDAR YEAR. THE ACCOUNTS WERE RECLASSIFIED AS FREE CARE DUE TO THE FACT THAT PATIENTS APPLIED FOR, AND WERE APPROVED FOR, FREE CARE AFTER THE ACCOUNTS WERE PLACED WITH A BAD DEBT AGENCY. PARKVIEW HOSPITAL, INC. PROVIDES HEALTH CARE SERVICES THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED, AMONG OTHER THINGS, TO ENHANCE THE HEALTH OF THE COMMUNITY AND IMPROVE THE HEALTH OF AT-RISK POPULATIONS. IN ADDITION, PARKVIEW HOSPITAL, INC. PROVIDES SERVICES INTENDED TO BENEFIT THE POOR AND UNDERSERVED, INCLUDING THOSE PERSONS WHO CANNOT AFFORD HEALTH INSURANCE DUE TO INADEQUATE RESOURCES OR WHO ARE UNINSURED OR UNDERINSURED. PART III, LINE 8: COMMUNITY BENEFIT & METHODOLOGY FOR DETERMINING MEDICARE COSTSSUBSTANTIAL SHORTFALLS TYPICALLY ARISE FROM PAYMENTS THAT ARE LESS THAN THE COST TO PROVIDE THE CARE OR SERVICES AND DO NOT INCLUDE ANY AMOUNTS RELATING TO INEFFICIENT OR POOR MANAGEMENT. PARKVIEW HOSPITAL, INC. ACCEPTS ALL MEDICARE PATIENTS, AS REFLECTED ON THE YEAR-END MEDICARE COST REPORT, WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. HOWEVER, MEDICARE PAYMENTS REPRESENT A PROXY OF COST CALLED THE "UPPER PAYMENT LIMIT." IT HAS HISTORICALLY BEEN ASSUMED THAT UPPER PAYMENT LIMIT PAYMENTS DO NOT GENERATE A SHORTFALL. AS A RESULT, PARKVIEW HOSPITAL, INC. HAS TAKEN THE POSITION NOT TO INCLUDE THE MEDICARE SHORTFALLS OR SURPLUSES AS PART OF COMMUNITY BENEFIT. PARKVIEW HOSPITAL, INC. RECOGNIZES THAT THE SHORTFALL OR SUPLUS 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: COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR CHARITY CARETHE LAST PARAGRAPH OF THE PAYMENT POLICY STATES:"FINANCIAL ASSISTANCE MAY BE AVAILABLE FOR THOSE PATIENTS WHO CANNOT PAY THEIR BILL. THOSE OPTIONS ARE WELFARE ASSISTANCE OR FREE CARE THROUGH THE HOSPITAL CHARITY PROGRAM. (SEE CHARITY CARE POLICY.) PATIENTS WILL BE INSTRUCTED TO CONTACT A COUNSELOR TO DISCUSS THE AVAILABLE OPTIONS."ADDITIONALLY, THERE IS AN ONGOING EFFORT THROUGHOUT THE COLLECTION PROCESS TO SCREEN FOR MEDICAID ELIGIBILITY AND THE NEED FOR PROVIDING CHARITY CARE APPLICATIONS TO PATIENTS. IF A PATIENT MAY BE ELIGIBLE FOR MEDICAID, THE HOSPITAL PROVIDES A SERVICE TO OUR PATIENTS THAT HELPS THEM APPLY FOR MEDICAID WITH THE STATE IN WHICH THEY RESIDE. IF A PATIENT IS APPROVED FOR CHARITY CARE, THEIR ACCOUNT IS WRITTEN OFF AND COLLECTION EFFORTS CEASE. PARKVIEW HOSPITAL, INC. PART V, SECTION B, LINE 11: ELIGIBILITY CRITERIA FOR FREE OR DISCOUNTED CAREPARKVIEW HOSPITAL, INC. PROVIDES DISCOUNTED CARE TO UNINSURED PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IF THE PATIENT ULTIMATELY QUALIFIES FOR CHARITY CARE USING THE 200% FPG, THE REMAINING BALANCE AFTER THE DISCOUNT IS WRITTEN OFF TO CHARITY. PARKVIEW HOSPITAL, INC. PART V, SECTION B, LINE 20D: FULL WRITEOFFS ARE PROVIDED TO PATIENTS WHOSE INCOME FALLS UNDER 200% OF THE FPG. ON CHARITY CARE PATIENTS WITH RESIDUAL SELF-PAY BALANCES AFTER INSURANCE PROCESSED AND PAID OR DENIED THEIR CLAIM, 100% OF THE REMAINING ACCOUNT BALANCE AFTER INSURANCE PAYMENTS AND CONTRACTUAL ADJUSTMENTS IS WRITTEN OFF TO CHARITY CARE. PART VI, LINE 2: DESCRIBE HOW THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES.IN 2006, PARKVIEW HOSPITAL, INC. COLLABORATED AS A FUNDING PARTNER WITH THE ST. JOSEPH COMMUNITY HEALTH FOUNDATION, THE LUTHERAN FOUNDATION, AND THE FORT WAYNE-ALLEN COUNTY DEPARTMENT OF HEALTH TO FACILITATE THE ALLEN COUNTY, INDIANA LOW-INCOME HEALTH SURVEY. PROFESSIONAL RESEARCH CONSULTANTS, INC., A NATIONAL HEALTHCARE RESEARCH FIRM, WAS ENGAGED TO CONDUCT THE STUDY. THIS LOW-INCOME COMMUNITY HEALTH ASSESSMENT WAS UNDERTAKEN TO BETTER UNDERSTAND THE HEALTH STATUS, RISKS, AND BEHAVIORS OF ALLEN COUNTY ADULTS AND FAMILIES WHO, BECAUSE OF LOWER SOCIO-ECONOMIC STATUS, MAY FACE GREATER BARRIERS TO ACCESSING HEALTH CARE SERVICES. THE STUDY FOCUSED ON THOSE WHOSE HOUSEHOLD INCOME WAS UP TO 200% OF THE FEDERAL POVERTY LEVEL. IN LATE 2007, PARKVIEW HEALTH SYSTEM, INC., INCLUDING PARKVIEW HOSPITAL, INC., AGAIN PARTICIPATED IN A COMMUNITY HEALTH ASSESSMENT. PROFESSIONAL RESEARCH CONSULTANTS, INC. WAS ENGAGED TO CONDUCT THE SURVEY AND TO PROVIDE AN EVALUATION OF THE STUDY. THE SURVEY INSTRUMENT USED FOR THIS STUDY WAS LARGELY BASED ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM AS WELL AS OTHER PUBLIC HEALTH SURVEYS. IT INCLUDED CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO NATIONAL HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. PARKVIEW HEALTH SYSTEM, INC., INCLUDING PARKVIEW HOSPITAL, INC., AND IN CONJUNCTION WITH THE ALLEN COUNTY - FORT WAYNE HEALTH DEPARTMENT, IS CURRENTLY CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE FIVE-COUNTY SERVICE AREA IN WHICH PARKVIEW HOSPITALS RESIDE. IN ADDITION, PARKVIEW HEALTH SYSTEM, INC. HAS PARTNERED WITH THE INDIANA UNIVERSITY/PURDUE UNIVERSITY OF FORT WAYNE'S (IPFW) SOCIAL RESEARCH DEPARTMENT AND PURDUE UNIVERSITY HEALTHCARE ADVISORS TO COMPLETE MUCH OF THE FIELD WORK. IPFW IS CONDUCTING THE RANDOM COMMUNITY MEMBER SURVEY TO OBTAIN PRIMARY DATA. PURDUE UNIVERSITY IS ASSISTING WITH SURVEYING PUBLIC HEALTH AND OTHER HEALTHCARE PROFESSIONALS, PROVIDING SECONDARY DATA RESEARCH AND DATA ANALYSIS. PARKVIEW HEALTH SYSTEM, INC. PLANS TO FINALIZE THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE IMPLEMENTATION STRATEGY TO ADDRESS IDENTIFIED HEALTH NEEDS DURING 2013. THE INFORMATION GATHERED FROM THIS SURVEY IS PROVING TO BE A VALUABLE TOOL AS WE SEEK AND PRIORITIZE OPPORTUNITIES TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE AND IDENTIFY OPPORTUNITIES FOR COLLABORATION AMONG COMMUNITY ORGANIZATIONS AND LEADERS. PARKVIEW HEALTH SYSTEM, INC. REPRESENTATIVES HAVE RELATIONSHIPS THROUGHOUT OUR COMMUNITIES AND MEET REGULARLY WITH VARIOUS ORGANIZATIONS THAT SHARE OUR MISSION OF IMPROVING THE HEALTH OF THESE COMMUNITIES. 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.-AT POINT OF REGISTRATION OR SCHEDULING, IF A PATIENT EXPRESSES THEIR INABILITY TO PAY, THE REGISTRAR OR SCHEDULER WILL REFER THE PATIENT TO A FINANCIAL COUNSELOR OR WILL PROVIDE FINANCIAL COUNSELING CONTACT INFORMATION IN THE FORM OF A BUSINESS CARD TO THE PATIENT OUTSIDE OF NORMAL BUSINESS HOURS.-SIGNAGE IN THE EMERGENCY DEPARTMENT AND CASHIER AREAS INFORMS THE PATIENT OF THEIR RIGHT TO RECEIVE CARE REGARDLESS OF THEIR ABILITY TO PAY AND TELLS THEM THEY MAY BE ELIGIBLE FOR GOVERNMENTAL ASSISTANCE.-THE PATIENT'S INITIAL STATEMENT INSTRUCTS THE PATIENT TO CALL THE PATIENT ACCOUNTING DEPARTMENT IF THEY CANNOT PAY IN FULL. THE PATIENT ACCOUNTING CALL CENTER COLLECTORS SCREEN AND OFFER FREE CARE APPLICATIONS TO PATIENTS WHO CANNOT AFFORD TO PAY THEIR BILLS.-THE ONLINE ACCOUNT MANAGER OF PARKVIEW HOSPITAL, INC.'S WEBSITE (WWW.PARKVIEW.COM) CONTAINS INFORMATION ON HOW TO CONTACT THE PATIENT ACCOUNTING DEPARTMENT FOR PAYMENT OPTIONS OR FREE CARE ELIGIBILITY.-ALL UNINSURED OR UNDERINSURED PATIENTS WHO ARE INPATIENT OR OBSERVATION STATUS ARE VISITED BY FINANCIAL COUNSELORS. THE FINANCIAL COUNSELORS PROVIDE PAYMENT OPTIONS INCLUDING SCREENING FOR FREE CARE AND PROVIDE THE PATIENT WITH FREE CARE APPLICATIONS.-OUTBOUND PHONE CALLS ARE MADE TO PATIENTS TO SET UP PAYMENT ARRANGEMENTS. IF A PATIENT CANNOT MAKE PAYMENT ON THEIR ACCOUNT, THE PATIENT WILL BE SCREENED FOR FREE CARE AND PROVIDED WITH AN APPLICATION TO APPLY FOR FREE CARE.-IF A PATIENT'S ACCOUNT IS PLACED WITH A COLLECTION AGENCY, THE AGENCY IS INSTRUCTED TO SCREEN FOR FREE CARE IF THE PATIENT EXPRESSES THEIR INABILITY TO PAY. PART VI, LINE 4: DESCRIBE THE COMMUNITY THE ORGANIZATION SERVES, TAKING INTO ACCOUNT THE GEOGRAPHIC AREA AND DEMOGRAPHIC CONSTITUENTS IT SERVES.THE FACILITIES OF PARKVIEW HOSPITAL, INC., CONSISTING OF THE PARKVIEW REGIONAL MEDICAL CENTER AND PARKVIEW HOSPITAL RANDALLIA, ARE LOCATED IN FORT WAYNE, THE PRIMARY URBAN AREA THAT RESIDES IN THE HEALTH SYSTEM'S SERVICE AREA. ACCORDING TO INFORMATION FROM WWW.STATS.INDIANA.EDU AND THE US CENSUS BUREAU, IN 2012, FORT WAYNE REPORTED A POPULATION OF 254,555 AND COMPRISES 70.6% OF THE TOTAL ALLEN COUNTY POPULATION. NEW HAVEN, THE LARGEST TOWN IN THE COUNTY, ACCOUNTS FOR 4.3% OF THE COUNTY POPULATION. PARKVIEW HOSPITAL INC. WAS THE REGION'S FIRST LEVEL II TRAUMA CENTER AND SERVES THE SURROUNDING COMMUNITIES TO A GREAT EXTENT. TOTAL POPULATION IN ALLEN COUNTY STOOD AT 360,412, A 1.4% INCREASE SINCE 2010. IN 2011, APPROXIMATELY 13.4% OF THE POPULATION WAS REPORTED BELOW THE FEDERAL POVERTY LEVEL, A DECREASE OF 3.6% SINCE 2010. THE PER CAPITA PERSONAL (ANNUAL) INCOME WAS $35,199 AND THE MEDIAN HOUSEHOLD INCOME WAS $47,411. AS OF APRIL 2013, UNEMPLOYMENT STOOD AT 7.6%. A SECTION OF THE SOUTH FORT WAYNE SERVICE AREA IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA (MUA) BY THE FEDERAL GOVERNMENT.IN 2012, 15% OF ALLEN COUNTY RESIDENTS WERE ENROLLED IN MEDICAID, A 4.5% DECREASE SINCE 2010. 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.).PARKVIEW HOSPITAL, INC.'S BOARD OF DIRECTORS IS COMPRISED OF MEMBERS OF WHOM SUBSTANTIALLY ALL ARE INDEPENDENT COMMUNITY MEMBERS. A MAJORITY OF THE BOARD RESIDES IN PARKVIEW HOSPITAL, INC.'S PRIMARY SERVICE AREA. PARKVIEW HOSPITAL, INC. ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. PARKVIEW HOSPITAL, INC. IS PROUD TO FEATURE THE OPENING OF THE NEW PARKVIEW REGIONAL MEDICAL CENTER ON OUR NORTH CAMPUS, WHICH OPENED IN MARCH 2012. THE NEW CENTER OFFERS THE LATEST IN CARE DESIGN AND STATE OF THE ART EQUIPMENT AND CLINICAL CAPABILITIES. PEOPLE THROUGHOUT THE COMMUNITY CAN COUNT ON PARKVIEW 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 EXCEPTIONALLY TRAINED AND EXPERIENCED IN EMERGENCY CARE. FURTHERMORE, NO PATIENT IS EVER DENIED TREATMENT, REGARDLESS OF THEIR ABILITY TO PAY.PARKVIEW HOSPITAL, INC.'S EMERGENCY DEPARTMENT ALSO CONNECTS CRITICALLY ILL OR INJURED PATIENTS WITH THE SPECIALIZED CARE THEY NEED - THROUGH ACCESS TO THE REGION'S FIRST VERIFIED LEVEL II ADULT AND PEDIATRIC TRAUMA CENTER, THE NEW PARKVIEW HEART INSTITUTE AND HOSPITAL, AND THE CERTIFIED PARKVIEW STANLEY WISSMAN STROKE CENTER. PATIENTS RECEIVING EMERGENCY CARE AT PARKVIEW HOSPITAL, INC. MAY ALSO SEE SPECIALISTS IN ORTHOPAEDICS, NEUROSURGERY, PLASTIC SURGERY AND MANY MORE.BECAUSE THE FIRST HOUR AFTER AN EMERGENCY IS THE MOST CRITICAL, PARKVIEW HOSPITAL, INC. ESTABLISHED THE SAMARITAN FLIGHT PROGRAM FOR RAPID AIR TRANSPORT. THE TWO SAMARITAN EMERGENCY RESPONSE HELICOPTERS ARE AVAILABLE FOR DISPATCH 24 HOURS A DAY, WITH A HIGHLY TRAINED CREW AND ADVANCED ON-BOARD TRAUMA TECHNOLOGY.ADDITIONALLY, DATA OBTAINED THROUGH PERIODIC COMMUNITY HEALTH ASSESSMENTS, PHYSICIAN SURVEYS, AND TREND AND TREATMENT ANALYSIS IS UTILIZED IN THE ORGANIZATION'S STRATEGIC PLANNING PROCESS IN IDENTIFYING COMMUNITY HEALTH NEEDS. AS A RESULT OF THIS STRATEGIC PLANNING PROCESS, PARKVIEW HOSPITAL, INC. HAS ESTABLISHED SEVERAL PRIORITY AREAS. THESE PRIORITY AREAS ARE ALIGNED WITH PARKVIEW HOSPITAL, INC.'S MISSION, VISION, AND GOALS AND HELP DIRECT THE TYPES OF HEALTH INITIATIVES THAT THE HOSPITAL UNDERTAKES. PRIORITY AREAS INCLUDE THE FOLLOWING:PRIMARY HEALTH CARE/ACCESS TO HEALTH CARE:-ADDITIONAL RECRUITMENT AND TRAINING OF PRIMARY CARE PHYSICIANS FOR THE COMMUNITY-EXPANSION OF PRIMARY CARE ACCESS AND NON-TRADITIONAL HOURS OF PRACTICE-CONTINUED SUPPORT OF PROGRAMS PROVIDING PRIMARY CARE TO THE UNINSURED-PROGRAMS TO INCREASE DISTRIBUTION OF FREE MEDICATIONS TO THE POOR-PROMOTION OF HEALTH CAREERS, PARTICULARLY THOSE IN WHICH THE COMMUNITY IS EXPERIENCING A CURRENT SHORTAGE OF HEALTH CARE PROFESSIONALS-SUPPORT FOR ACTIVITIES WHICH INCREASE THE AFFORDABILITY AND ACCESSIBILITY OF HEALTH INSURANCE TO THE UNINSUREDHEALTH SCREENING AND PREVENTION:-CANCER SCREENING PROGRAMS, PARTICULARLY MAMMOGRAM AND PROSTATE SCREENING-TOBACCO CESSATION PROGRAMS-INJURY PREVENTION FOR YOUNG PEOPLE-DIABETES EDUCATION AND SCREENING-CARDIOVASCULAR DISEASE EDUCATION AND SCREENING-PROGRAMS TO REDUCE DANGEROUS DRIVINGDISEASE MANAGEMENT:-CARDIOVASCULAR DISEASE -CANCER-MENTAL ILLNESSES-TRAUMA AND ORTHOPAEDIC AILMENTS-WOMEN'S AND CHILDREN'S MEDICINE WITH AN EMPHASIS ON CHILDREN'S ASTHMA-DIABETES AND OBESITY HEALTH INNOVATION, EDUCATION, AND RESEARCH AND DEVELOPMENT:-ENHANCING HEALTH CARE EDUCATION, MEDICAL RESEARCH, AND TECHNOLOGY-PROMOTING ECONOMIC AND OTHER DEVELOPMENT OF THE COMMUNITY PARKVIEW HOSPITAL, INC. ANNUALLY FUNDS COMMUNITY HEALTH IMPROVEMENT EFFORTS. THESE FUNDS ARE USED TO SUPPORT HEALTH-RELATED, COMMUNITY-BASED PROGRAMS, PROJECTS AND ORGANIZATIONS. THESE FUNDS ARE ALSO USED TO SUPPORT A PORTION OF PARKVIEW HOSPITAL, INC.'S COMMUNITY OUTREACH PROGRAMS AND HEALTH INITIATIVES. THE EMPHASIS WITH THESE PROJECTS CONTINUES TO BE ON IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE.(CONTINUED RESPONSE IS LOCATED IMMEDIATELY AFTER THE FOLLOWING SECTION OF PART VI, LINE 6): 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., WHITLEY MEMORIAL HOSPITAL, INC. AND HUNTINGTON MEMORIAL HOSPITAL, INC., AS WELL AS 60% OWNERSHIP IN THE JOINT VENTURE OF ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH, LLC. PARKVIEW CONTRIBUTES TO THE SUCCESS OF THE REGION BY 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 BENEFITS ITS PATIENTS, PHYSICIANS, CO-WORKERS AND COMMUNITIES.PARKVIEW PRIDES ITSELF IN NOT ONLY OFFERING THE HIGHEST LEVEL OF CARE TO ITS PATIENTS, BUT ALSO IN PROVIDING A WORKPLACE THAT IS SECOND TO NONE FOR ITS PHYSICIANS, NURSES AND STAFF. PARKVIEW'S MISSION IS TO PROVIDE QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US AND TO IMPROVE THE HEALTH OF OUR COMMUNITIES. 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. PROMOTION OF COMMUNITY HEALTH: PART VI, LINE 5 CONTINUED: CONTINUED RESPONSE TO THE FOLLOWING: 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.)PARKVIEW HOSPITAL, INC. PROVIDES A COMMUNITY-BASED NURSING PROGRAM THAT PROVIDES SUPPORT AND EDUCATION TO THOUSANDS OF CHILDREN AND THEIR FAMILIES EACH YEAR. OTHER PARKVIEW HOSPITAL, INC. OUTREACH PROGRAMS INCLUDE MEDICATION ASSISTANCE, MOBILE MAMMOGRAPHY, NUTRITION EDUCATION AND TRAUMA PREVENTION. SOME LOCAL HEALTH PARTNERS THAT ADDRESS ACCESS TO HEALTHCARE INCLUDE MATTHEW 25 HEALTH AND DENTAL CLINIC, NEIGHBORHOOD HEALTH CLINICS, SUPER SHOT IMMUNIZATION CLINIC, CANI COVERING KIDS AND FAMILIES, AND CANCER SERVICES OF NORTHEAST INDIANA. IN ADDITION, PARKVIEW HOSPITAL, INC. PROVIDES FUNDING TO COMMUNITY TRANSPORTATION NETWORK TO PROVIDE MEDICAL TRANSPORTATION THROUGHOUT THE COMMUNITY. A COMMITTEE OF COMMUNITY LEADERS, MADE UP OF MEMBERS OF THE PARKVIEW HOSPITAL, INC. BOARD, AS WELL AS REPRESENTATION FROM THE PARKVIEW HOSPITAL, INC. STAFF, MEETS REGULARLY TO ESTABLISH OR AFFIRM FUNDING PRIORITIES FOR PARKVIEW HOSPITAL, INC.'S COMMUNITY HEALTH IMPROVEMENT PROGRAM. PARKVIEW HOSPITAL, INC. PROACTIVELY SEEKS TO BUILD COMMUNITY PARTNERSHIPS AND COLLABORATIONS IN DEVELOPING AND IMPLEMENTING HEALTH INITIATIVES. PARKVIEW HOSPITAL, INC. IS DEDICATED TO THE INVESTMENT OF TIME AND RESOURCES IN THE PROCESS AND CHALLENGES OF IMPROVING THE HEALTH OF THE COMMUNITY. OUR GOAL IS TO UTILIZE BEST PRACTICES AND INNOVATIVE METHODS TO IMPROVE THE HEALTH OF THE COMMUNITY, PARTICULARLY FOR THE UNDERSERVED.PARKVIEW RESEARCH CENTER PROVIDES CLINICAL RESEARCH SERVICES TO PARKVIEW HEALTH SYSTEM, INC. PHYSICIANS AND HAS DEVELOPED AREAS OF SPECIALIZATION IN CARDIOLOGY, NEUROLOGY, RADIATION ONCOLOGY, EMERGENCY MEDICINE AND CRITICAL CARE. IN AN EFFORT TO BEST MEET PATIENT NEEDS, ALL AREA QUALIFIED PHYSICIANS MAY APPLY FOR PRIVILEGES AT PARKVIEW HOSPITAL, INC. PARKVIEW HOSPITAL, INC. IS PROUD TO FEATURE THE NEW PARKVIEW REGIONAL MEDICAL CENTER ON THE PARKVIEW HOSPITAL, INC. NORTH CAMPUS, WHICH OPENED IN MARCH 2012, REPRESENTING A SIGNIFICANT INVESTMENT IN THE LOCAL COMMUNITY AND THE NORTHEAST INDIANA REGION. THE CENTER BLENDS THE LATEST MEDICAL TECHNOLOGY WITH THE BEST POSSIBLE PATIENT-CENTERED CARE AND PROVIDES GREATER ACCESS TO HEALTHCARE FOR THE ENTIRE REGION. ALSO PART OF PARKVIEW HOSPITAL, INC., THE HOSPITAL FACILITY AND CAMPUS LOCATED IN NORTH CENTRAL FORT WAYNE (PARKVIEW HOSPITAL RANDALLIA) WILL RECEIVE AN UPGRADE AND REMAIN A VITAL PART OF THE LOCAL NEIGHBORHOOD. IN ADDITION, PARKVIEW HOSPITAL, INC. IS PARTNERING WITH THE LIFE SCIENCE AND RESEARCH CONSORTIUM OF NORTHEAST INDIANA TO CREATE A CAMPUS FOR ACADEMIC PROGRAMS AND RESEARCH TIED TO BEHAVIORAL HEALTH, REHABILITATION, AND SENIOR CARE. 1 MATTHEW 25 HEALTH CLINIC 413 E JEFFERSON BLVD FORT WAYNE IN 46802 351484951 501 ( C ) 3 332267 PROGRAMS & OPERATIONS FUNDING EARLY CHILDHOOD ALLIANCE INC 3320 FAIRFIELD FORT WAYNE IN 46807 350953465 501 ( C ) 3 318016 OPERATIONS FUNDING IPFW 2101 E COLISEUM BLVD FORT WAYNE IN 46805 356002041 501 ( C ) 3 273798 OPERATIONS & TAPESTRY FUNDING NEIGHBORHOOD HEALTH CLINICS INC 1717 SOUTH CALHOUN STREET FORT WAYNE IN 46802 351922483 501 ( C ) 3 100000 OPERATIONS FUNDING MIDWEST ALLIANCE FOR HEALTH EDUCATION 1819 CAREW FORT WAYNE IN 46805 351637515 501 ( C ) 3 30000 RESEARCH PROJECTS & INTERNSHIPS CANCER SERVICES OF NORTHEAST INDIANA 6316 MUTUAL DRIVE FORT WAYNE IN 46825 350965609 501 ( C ) 3 25000 OPERATIONS FUNDING & PATIENT ADVOCACY PROGRAMS AMERICAN HEART ASSOCIATION 4040 VINELAND DRIVE FORT WAYNE IN 46815 135613797 501 ( C ) 3 25000 PROGRAMS & OPERATIONS FUNDING UNITY PERFORMING ARTS FOUNDATION INC P O BOX 10394 FORT WAYNE IN 46852 352110907 501 ( C ) 3 25000 SPONSORSHIP OF WORLD CHOIR GAMES FORT WAYNE MUSEUM OF ART 311 EAST MAIN STREET FORT WAYNE IN 46802 350953440 501 ( C ) 3 15000 ART PROGRAMS & OPERATIONS FUNDING IVY TECH COMMUNITY COLLEGE 3800 N ANTHONY BLVD FORT WAYNE IN 46805 237073977 501 ( C ) 3 12500 OPERATIONS FUNDING COMMUNITY TRANSPORTATION NETWORK 2701 S COLISEUM BLVD SUITE 1315 FORT WAYNE IN 46803 352109955 501 ( C ) 3 11500 MEDICAL TRANSPORTATION TURNSTONE CENTER FOR DISABLED CHILDREN AND ADULTS 3320 N CLINTON FORT WAYNE IN 46805 350913541 501 ( C ) 3 11250 FITNESS AND WELLNESS PROGRAMS VERA BRADLEY FOUNDATION FOR BREAST CANCER PO BOX 80201 FORT WAYNE IN 46898 352058177 501 ( C ) 3 10000 SPONSORSHIP OF RESEARCH EVENT HEALTH AND HOSP CORP OF MARION COUNTY 3835 NORTH RURAL ST INDIANAPOLIS IN 46205 356005697 501 ( C ) 3 10000 OPERATIONS & ADVOCATE PROGRAMS STEUBEN CO COMMUNITY FOUNDATION 5009 E US HIGHWAY 20 ANGOLA IN 46703 351857065 501 ( C ) 3 10000 OPERATIONS FUNDING AFRICAN AMERICAN HEALTHCARE ALLIANCE OF FORT WAYNE INC 815 CROWDER COURT FORT WAYNE IN 46825 352134195 501 ( C ) 3 10000 STUDENT SCHOLARSHIPS FOR HEALTHCARE EDUCATION VERA BRADLEY FOUNDATION FOR BREAST CANCER PO BOX 80201 FORT WAYNE IN 46898 352058177 501 ( C ) 3 10000 SPONSORSHIP OF RESEARCH EVENT NAACP FORT WAYNE CHAPTER 1521 EAST PONTIAC STREET FORT WAYNE IN 46803 800592313 501 ( C ) 3 10000 PROGRAMS & OPERATIONS FUNDING THREE RIVERS FESTIVAL EXECUTIVE BOARD INC 102 THREE RIVERS NORTH FORT WAYNE IN 46802 351338028 501 ( C ) 3 7500 OPERATIONS FUNDING 19 0 FAMILY & CHILDREN ASSISTANCE 1238 5175 FMV TOYS, BABY ITEMS, ETC. CAR SEAT DISTRIBUTION PROGRAM 403 20789 CAR SEATS PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: COMMUNITY HEALTH IMPROVEMENT FUNDING PARTNER ORGANIZATIONS ARE REQUIRED TO SUBMIT AN ANNUAL PROGRESS REPORT RELATED TO PROGRAM FUNDING. PARTNER ORGANIZATIONS ARE REQUIRED TO RE-APPLY FOR FUNDING ON AN ANNUAL BASIS. 0 1 0 0 0 0 0 1 0 SUZANNE EHINGER 360733 0 159130 0 19888 0 69059 0 20015 0 628825 0 0 0 MICHAEL PACKNETT 0 740193 0 389731 0 19838 0 154794 0 12179 0 1316735 0 0 MICHAEL BROWNING 0 409616 0 181320 0 17990 0 51645 0 23555 0 684126 0 0 CHAD CARPENTER 168594 0 48555 0 2376 0 24139 0 11611 0 255275 0 0 0 JUDITH BOERGER 254533 0 77294 0 17809 0 37983 0 13178 0 400797 0 13403 0 DANIEL GARMAN 205756 0 67650 0 13525 0 37875 0 18407 0 343213 0 10687 0 CHARLES CLARK 165491 0 0 0 54702 0 32561 0 11591 0 264345 0 0 0 THOMAS GUTWEIN 167700 800 0 0 0 0 0 0 0 0 167700 800 0 0 TIMOTHY CMELIK 158909 0 30541 0 824 0 13785 0 22634 0 226693 0 0 0 YUENIAN ZHANG 214612 0 0 0 464 0 0 0 11501 0 226577 0 0 0 RAE GONTERMAN 150930 0 48928 0 2104 0 25762 0 11497 0 239221 0 0 0 MICHAEL GERUE 143330 0 42174 0 520 0 37000 0 19431 0 242455 0 0 0 STANTON RISSER 0 109732 0 22335 0 464 0 9419 0 17634 0 159584 0 0 PART I, LINE 3 RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF PARKVIEW HOSPITAL, INC.'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE (BOARD OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC.) INDEPENDENT COMPENSATION CONSULTANT FORM 990 OF OTHER ORGANIZATIONS COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE (BOARD OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC.) PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS TAXABLE - JUDITH BOERGER $13,403; DANIEL GARMAN $10,687 PARTICIPANTS DEFERRED - JUDITH BOERGER $27,983; MICHAEL BROWNING $46,020; CHAD CARPENTER $19,768; CHARLES CLARK $19,407; SUZANNE EHINGER $39,059; DANIEL GARMAN $22,875; MICHAEL PACKNETT $137,294 PART I, LINE 7 MANAGEMENT INCENTIVE COMPENSATION PLAN (MICP) IS AN ANNUAL INCENTIVE PROGRAM. SYSTEM GOALS ARE APPROVED BY THE BOARD IN ADVANCE OF THE PLAN YEAR. AT CONCLUSION OF THE PLAN YEAR, RESULTS ARE SHARED WITH THE BOARD AND THE BOARD APPROVES FINAL PAYMENT. INDIANA SURGICAL SPECIALISTS LLC ENTITY OF WHICH DIRECTOR MICHAEL GRABOWSKI WAS SERVING AS AN OFFICER 2358702 COMMON PAYMASTER, PARKVIEW HEALTH SYSTEM, INC. EIN 35-1972384, PAID INDIANA SURGICAL SPECIALISTS, LLC FOR CONTRACTED SERVICES. TRANSACTIONS WERE ENTERED INTO AT ARM'S-LENGTH. THE CONTRACTED SERVICES INCLUDE: CALL COVERAGE 24/7, MEDICAL DIRECTOR COVERAGE, AND PROFESSIONAL TRAUMA SERVICES PROVIDED TO PARKVIEW HOSPITAL, INC. PATIENTS. INDIANA SURGICAL SPECIALISTS, LLC ASSIGN THEIR BILLINGS AND RECEIPTS TO THE HOSPITAL. COLLECTED AMOUNT OF $556,134 IS NOT REFLECTED ON SCHEDULE L. 0 TRAVIS CARPENTER TRAVIS CARPENTER IS A FAMILY MEMBER OF OFFICER CHAD CARPENTER 11968 TRAVIS CARPENTER RECEIVED COMPENSATION FROM PARKVIEW HOSPITAL, INC. 0 PROGRAM SERVICE ACCOMPLISHMENTS CONTINUED: FORM 990, PART III, LINES 4A: FRANCINE'S FRIENDS MOBILE MAMMOGRAPHY PROGRAM: IN PARTNERSHIP WITH FRANCINE'S FRIENDS AND THE BREAST DIAGNOSTIC CENTER, PARKVIEW'S COMPREHENSIVE CANCER CENTER ADMINISTERS A MOBILE MAMMOGRAPHY PROGRAM IN ALLEN COUNTY AND THE SURROUNDING AREA. THIS INITIATIVE BEGAN IN DECEMBER OF 2005 AND IS TARGETED TO INCREASE THE NUMBER OF MAMMOGRAMS GIVEN TO WOMEN AGE 40 AND OVER. IN ADDITION, THE PROGRAM PROVIDES FINANCIAL ASSISTANCE TO THOSE WHO DO NOT HAVE THE MEANS TO PAY FOR A MAMMOGRAM. COMMUNITY HEALTH ASSESSMENTS SUBSEQUENT TO THE CREATION OF THIS PROGRAM REVEALED A SIGNIFICANT INCREASE IN SCREENINGS FOR ALLEN COUNTY. MEDICATION ASSISTANCE PROGRAM: PARKVIEW HOSPITAL, INC.'S MEDICATION ASSISTANCE PROGRAM HELPS LOW-INCOME PATIENTS OBTAIN PRESCRIPTION MEDICATIONS UPON DISCHARGE AT REDUCED RATES, AND COMPLIMENTS OTHER LONG-TERM PHARMACEUTICAL ASSISTANCE PROGRAMS TO MEET PATIENTS' HEALTH MAINTENANCE NEEDS. RECENTLY, THE PROGRAM EXPANDED ITS SCOPE AND SERVES PATIENTS REFERRED BY PHYSICIAN OFFICES BY PROVIDING ASSISTANCE WITH ENROLLING IN PHARMACEUTICAL ASSISTANCE PROGRAMS. PRIMARY HEALTH CARE ACCESS: IN ADDITION TO PROVIDING A FINANCIAL ASSISTANCE PROGRAM TO THOSE THAT QUALIFY, PARKVIEW HOSPITAL, INC. REACHES OUT TO THE UNDERINSURED, UNINSURED, AND SPECIAL AT-RISK POPULATIONS BY PROVIDING FUNDING FOR LOCAL CLINICS AND SUPPORTING MEDICAL TRANSPORTATION PROGRAMS AS FOLLOWS: MATTHEW 25 HEALTH & DENTAL CLINIC AND NEIGHBORHOOD HEALTH CLINICS: PARKVIEW HOSPITAL, INC. PROVIDES OPERATIONAL SUPPORT FOR MATTHEW 25 HEALTH AND DENTAL CLINIC AND PROVIDES FUNDING FOR LABORATORY SERVICES FOR THEIR PATIENTS. THE HOSPITAL ALSO PROVIDES SUPPORT FOR SERVICES TO THE UNINSURED AND UNDERINSURED AT NEIGHBORHOOD HEALTH CLINICS, INCLUDING THE CLINIC'S DIABETES MANAGEMENT PROGRAM AND IN-KIND STAFF FOR RADIOGRAPHIC IMAGING SERVICES. IN ADDITION, THE HOSPITAL PROVIDES FUNDING FOR MEDICATION ASSISTANCE PROGRAMS AT EACH OF THE AFOREMENTIONED CLINICS. PARKVIEW SUPER SHOT CLINIC: IN ADDITION TO CASH DONATIONS FOR OPERATIONAL SUPPORT, PARKVIEW HOSPITAL, INC. PROVIDES SPACE, UTILITIES, AND BUILDING MAINTENANCE FOR THE PARKVIEW SUPER SHOT CLINIC (CHILDREN'S IMMUNIZATION CLINIC) LOCATED AT PARKVIEW CHILDREN'S SPECIALTY CLINICS IN THE NEW REGIONAL MEDICAL CENTER. COMMUNITY TRANSPORTATION NETWORK: THE HOSPITAL HAS A WORKING RELATIONSHIP WITH, AND PROVIDES FINANCIAL SUPPORT TO, THE COMMUNITY TRANSPORTATION NETWORK (CTN), A NOT-FOR-PROFIT ORGANIZATION THAT PROVIDES AND COORDINATES MEDICAL TRANSPORTATION FOR SENIORS, PERSONS WITH DISABILITIES, LOW-INCOME FAMILIES, YOUTH, AND CHILDREN. PASSENGER ASSISTANCE IS PROVIDED IN A "DOOR-THROUGH-DOOR, ARM-IN-ARM, AND HAND-TO-HAND" FASHION. CTN ADDRESSES TRANSPORTATION ISSUES AS THEY RELATE TO ACCESSING HEALTHCARE FOR OBTAINING AND MAINTAINING GOOD COMMUNITY HEALTH. HEALTH SCREENING AND PREVENTION: PARKVIEW HOSPITAL, INC. HAS A LONG-TERM COMMITMENT TO IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH DISEASE PREVENTION PROGRAMS AND HEALTH EDUCATION. PARKVIEW HOSPITAL, INC. OFFERS 24-HOUR TELEPHONE COUNSELING THROUGH PARKVIEW BEHAVIORAL HEALTH FOR PEOPLE WITH ALCOHOL AND DRUG PROBLEMS, DEPRESSION OR OTHER MENTAL HEALTH CRISES. IN ADDITION, THE HOSPITAL PARTICIPATES IN NUMEROUS HEALTH FAIRS THROUGHOUT THE YEAR TO PROVIDE HEALTH EDUCATION, HEALTH SCREENINGS FOR DISEASE PREVENTION, AND TO PROMOTE HEALTHY LIFESTYLES FOR THE UNDERSERVED POPULATION AND THE COMMUNITY AT LARGE. TRAUMA PREVENTION EDUCATION: PARKVIEW HOSPITAL, INC. IS A LEVEL II TRAUMA CENTER AS VERIFIED BY THE AMERICAN COLLEGE OF SURGEONS. IT IS NOT ONLY PARKVIEW HOSPITAL, INC.'S RESPONSIBILITY TO PROVIDE EMERGENCY CARE, BUT TO ALSO CONDUCT PUBLIC EDUCATION WITH THE GOAL OF REDUCING THE NUMBER OF PREVENTABLE INJURIES IN THE COMMUNITY. TO HELP ACCOMPLISH THIS, THE HOSPITAL SPONSORS A TRAUMA PREVENTION TASK FORCE THAT CONSISTS OF PARKVIEW EMERGENCY AND TRAUMA STAFF, OTHER EMPLOYEES, COMMUNITY-BASED EMERGENCY RESPONSE PROFESSIONALS, AND REPRESENTATIVES FROM THE COMMUNITY. SOME OF THE PROGRAMS INCLUDE: "DON'T DRINK AND DRIVE", "SHARE THE ROAD", TEEN DRIVER SAFETY, "DON'T TEXT AND DRIVE", AND INFANT CAR SEAT SAFETY PROGRAMS. "SHARE THE ROAD" IS A COMMUNITY AWARENESS CAMPAIGN AND EDUCATIONAL PROGRAM TO PROMOTE SAFE PRACTICES FOR MOTORISTS, CYCLISTS, MOTORCYCLISTS, AND HORSE-DRAWN BUGGIES WHILE TRAVELING ON AREA ROADWAYS. PROGRAM SERVICE ACCOMPLISHMENTS CONTINUED: FORM 990, PART III, LINES 4A: "DON'T DRINK & DRIVE" IS AN EDUCATIONAL PROGRAM GEARED TOWARD TEENS TO WARN THEM ABOUT THE DANGERS OF DRINKING AND DRIVING, MUCH AS "DON'T TEXT & DRIVE" INFORMS TEENS AND ADULTS ABOUT THE DANGERS OF TEXTING AND DRIVING. PARKVIEW HOSPITAL, INC. PARTNERS WITH THE ALLEN COUNTY SHERIFF RESERVES AND THE INDIANA STATE POLICE TO PROVIDE EDUCATION THROUGH COMMUNITY SPEAKING EVENTS, CLASSROOM PRESENTATIONS, AND BILLBOARD AND MEDIA COVERAGE. VIEWED AS A LEADING DISTRACTED DRIVING PREVENTION PROGRAM, STAFF WITH PARKVIEW'S "DON'T TEXT & DRIVE" PROGRAM WERE INVITED TO THE ANNUAL MEETING OF THE INTERNATIONAL TELECOMMUNICATION UNION, AN AGENCY OF THE UNITED NATIONS, IN GENEVA, SWITZERLAND. HEALTH INNOVATION AND RESEARCH: IN AN EFFORT TO PROVIDE THE NEWEST TECHNOLOGIES, PROCEDURES AND MEDICINES TO PATIENTS IN A SHORTER TIME SPAN, PARKVIEW RESEARCH CENTER, IN COOPERATION WITH PHYSICIANS AND HOSPITAL STAFF, OFFERS PATIENTS NEW THERAPIES NOT AVAILABLE OUTSIDE THE INVESTIGATIONAL SETTING. AS THE COMMUNITY LEADER IN MEDICAL RESEARCH FOR THE PAST DECADE, THE CENTER PROVIDES CLINICAL RESEARCH SERVICES TO MORE THAN 500 NORTHEAST INDIANA PHYSICIANS AFFILIATED WITH PARKVIEW. THE CENTER HAS DEVELOPED AREAS OF SPECIALIZATION IN CARDIOLOGY, NEUROLOGY, RADIATION ONCOLOGY, EMERGENCY MEDICINE AND CRITICAL CARE. HEALTH CAREERS AND CONTINUING EDUCATION: PARKVIEW HOSPITAL, INC. SUPPORTS MEDICAL AND HEALTH EDUCATION FOR PHYSICIANS, NURSES, PHARMACISTS, AND OTHER CLINICAL PROFESSIONALS THROUGH CONTINUING MEDICAL EDUCATION PROGRAMS. THE HOSPITAL ALSO SUPPORTS PROGRAMS THAT PROMOTE AND EDUCATE AREA YOUTH ABOUT POSSIBLE CAREERS IN HEALTHCARE AND HEALTH-RELATED FIELDS. COMFORT AND SUPPORT: WHILE MANY OF PARKVIEW HOSPITAL, INC.'S COMMUNITY PROGRAMS ARE AIMED AT THE GENERAL PUBLIC, THE HOSPITAL ALSO SPONSORS SUPPORT GROUPS FOR PEOPLE WITH SPECIAL NEEDS. THERE ARE MANY HOSPITAL SUPPORT GROUPS FOR THOSE SUFFERING FROM RESPIRATORY AILMENTS, DIABETES, CANCER, BEHAVIORAL HEALTH, STROKE, AND OTHER HEALTH CONDITIONS. IN ADDITION TO PROVIDING SUPPORT FOR PEOPLE WITH SPECIAL NEEDS, PARKVIEW HOSPITAL, INC. CARES FOR THE WHOLE PERSON, WHICH INCLUDES SPIRITUAL HEALING AS WELL AS PHYSICAL. FULL-TIME CHAPLAINS ARE ON STAFF TO MINISTER TO THE SPIRITUAL NEEDS OF OUR PATIENTS AND THEIR FAMILIES OF ALL FAITHS. WHETHER CELEBRATING THE MIRACLE OF LIFE OR MOURNING THE LOSS OF A LOVED ONE, PARKVIEW HOSPITAL, INC.'S CHAPLAINS ARE AVAILABLE 24 HOURS A DAY. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS ORGANIZED AS A NOT-FOR-PROFIT CORPORATION. PURSUANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, PARKVIEW HEALTH SYSTEM, INC. EIN 35-1972384 IS THE SOLE MEMBER OF PARKVIEW HOSPITAL, INC. WITH CERTAIN RESERVED POWERS. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE MEMBER 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) UPON RECOMMENDATIONS OF THE CORPORATION, THE CORPORATE MEMBER SHALL 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. ANY ASSET TRANSFER OR CAPITAL CONTRIBUTION FROM THE CORPORATION SHALL BE SUBJECT TO ANY AND ALL RESTRICTIONS SET FORTH IN EXHIBIT A-1 OF THE BYLAWS. (G) REQUIRE AND DIRECT 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. SUCH RIGHT BY THE CORPORATE MEMBER TO DIRECT THE TRANSFER OF ASSETS SHALL NOT INCLUDE ANY TRANSFER WHICH WOULD CAUSE THE CORPORATION TO BE PUT INTO A FINANCIALLY VULNERABLE POSITION AS AN ONGOING CONCERN, NOR SHALL ANY SUCH TRANSFER CAUSE THE CORPORATION TO VIOLATE THE TERMS AND CONDITIONS OF ANY GIFTS, BEQUESTS, BOND COVENANTS, OR RESTRICTIONS SET FORTH IN THIS LIST. FURTHER, 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 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 SERVICES 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 THE SYSTEM, EXCEPT THAT THERE CAN BE NO AMENDMENT TO THE RESERVED POWERS LISTED IN SECTIONS (G) AND (K) OF THIS LIST 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 11 PURSUANT TO PARKVIEW HEALTH SYSTEM INC.'S BYLAWS, THE SYSTEM AUDIT COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION TO PROVIDE REVIEW OF THE CORPORATION AND ITS SUBSIDIARY CORPORATIONS' FORM 990 FILINGS. PARKVIEW 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, PRIOR TO FILING WITH THE IRS. ON OCTOBER 9, 2013, 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. IN ADDITION, THE FOLLOWING CONSIDERATIONS SHOULD BE MADE: 4. IF APPROPRIATE, THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT; AND 5. IN ORDER TO APPROVE THE TRANSACTION, THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE MUST FIRST FIND, BY A MAJORITY VOTE OF THE DISINTERESTED BOARD MEMBERS, THAT THE PROPOSED TRANSACTION OR ARRANGEMENT IS IN THE BEST INTERESTS OF AND FOR THE BENEFIT OF PH AND/OR PH AFFILIATES AND THE PROPOSED TRANSACTION IS FAIR AND REASONABLE TO PH AND/OR PH AFFILIATES AND, AFTER REASONABLE INVESTIGATION, THAT THE PH AND/OR PH AFFILIATES CANNOT OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES." FORM 990, PART VI, SECTION B, LINE 15 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; REVIEW, AND APPROVAL BY THE GOVERNING BODY; AND CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. IN 2012, THE BOARD OF PARKVIEW HEALTH SYSTEM, INC. REVIEWED AND APPROVED ALL EXECUTIVE COMPENSATION, BENEFITS AND PERQUISITES FOR THE 2012 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 MERIT BUDGET FOR THE ENTIRE ORGANIZATION. THE BOARD REVIEWS AND APPROVES THE MANAGEMENT INCENTIVE COMPENSATION PLAN (MICP). OFFICES OR POSITIONS REVIEWED AT THE 2012 MEETING: PRESIDENT AND CHIEF EXECUTIVE OFFICER PRESIDENT PARKVIEW REGIONAL MEDICAL CENTER AND AFFILIATES PHYSICIAN EXECUTIVE OFFICER PARKVIEW PHYSICIANS GROUP SENIOR VICE PRESIDENT CHIEF FINANCIAL OFFICER SENIOR VICE PRESIDENT CHIEF INFORMATION OFFICER SENIOR VICE PRESIDENT COO COMMUNITY HOSPITAL SENIOR VICE PRESIDENT COO PARKVIEW PHYSICIANS GROUP SENIOR VICE PRESIDENT COO SERVICE LINE LEADER SENIOR VICE PRESIDENT DELIVERY SYSTEM INTEGRATION SENIOR VICE PRESIDENT FACILITY DESIGN AND OVERSIGHT SENIOR VICE PRESIDENT GENERAL COUNSEL SENIOR VICE PRESIDENT HUMAN RESOURCES SENIOR VICE PRESIDENT PATIENT CARE SENIOR VICE PRESIDENT SERVICE LINE LEADER SENIOR VICE PRESIDENT STRATEGIC INITIATIVES VICE PRESIDENT CHANGING SPACES CONSTRUCTION PROJECT MANAGEMENT VICE PRESIDENT PARKVIEW PHYSICIANS GROUP FINANCE VICE PRESIDENT PARKVIEW PHYSICIANS GROUP PHYSICIAN PRACTICES VICE PRESIDENT PATIENT CARE SERVICES COMMUNITY HOSPITAL VICE PRESIDENT PLANNING AND DECISION SUPPORT VICE PRESIDENT RANDALLIA OPERATIONS VICE PRESIDENT REVENUE CYCLE MANAGEMENT VICE PRESIDENT STRATEGY AND BUSINESS DEVELOPMENT VICE PRESIDENT SUPPLY CHAIN MEDICAL DIRECTOR COMMUNITY HOSPITAL MEDICAL DIRECTOR HEALTH PLAN SERVICES MEDICAL DIRECTOR PARKVIEW PHYSICIANS GROUP ASSOCIATE MEDICAL DIRECTOR EXECUTIVE DIRECTOR EMPLOYER STRATEGIES CHIEF ADMINISTRATIVE OFFICER CHIEF MEDICAL INFORMATICS OFFICER CORPORATE DIRECTOR MARKETING, COMMUNICATIONS, COMMUNITY RELATIONS 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. COMMON PAYING AGENT FOR FILING ORGANIZATION FORM 990, PART V, LINE 1A, 2A AND PART VII, SECTION B, LINE 2: PARKVIEW HEALTH SYSTEM, INC. (PH), EIN 35-1972384, IS THE COMMON PAYING AGENT FOR THE FILING ORGANIZATION, PARKVIEW HOSPITAL, INC., EIN 35-0868085. 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, 2012 WAS 475. THE TOTAL NUMBER OF EMPLOYEES REPORTED ON FORM W-3 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2012 WAS 9,435. FOR PURPOSES OF COMPLETING FORM 990, PART V, LINE 1A AND 2A, THE NUMBER REPORTED FOR THE PARKVIEW HOSPITAL, INC. WAS 137 AND 4,621 RESPECTIVELY. AS REFLECTED IN PART VII, SECTION B, 11 INDEPENDENT CONTRACTORS RECEIVED MORE THAN $100,000 IN COMPENSATION FOR SERVICES FROM PARKVIEW HOSPITAL, INC. OTHER FEES FORM 990, PART IX, LINE 11G CONTRACTED SERVICES MEDICAL: PROGRAM SERVICE EXPENSES 16,800,290. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,800,290. OTHER: PROGRAM SERVICE EXPENSES 50,555,761. MANAGEMENT AND GENERAL EXPENSES 4,805,319. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 55,361,080. SALARIES AND WAGES, OTHER EMPLOYEE BENEFITS AND PAYROLL TAXES 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: ASSET TRANSFERS/ADJUSTMENTS 1,705,618. CURRENT YEAR EARNINGS TRANSFERRED TO PARENT -84,524,451. INCOME (LOSS) FROM HOSPITAL LAUNDRY SERVICE, INC. -123,120. INCOME (LOSS) FROM PARKVIEW PROFESSIONAL PROGRAMS, INC. 691,663. BOOK/TAX DIFFERENCES K-1'S -93,345. PARKVIEW HEALTH SYSTEM INC 10501 CORPORATE DRIVE FORT WAYNE IN 46845 351972384 HEALTH CARE IN 501(C)(3) LINE 11C, III-FI N/A 0 PARKVIEW FOUNDATION INC 2200 RANDALLIA DRIVE FORT WAYNE IN 46805 237220589 FUND MGMT IN 501(C)(3) LINE 11A, I PARKVIEW HOSPITAL INC 1 PARKVIEW OCCUPATIONAL HEALTH CENTERS INC 10501 CORPORATE DRIVE FORT WAYNE IN 46845 352064353 OCCUP HEALTH IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC 0 COMMUNITY HOSPITAL OF NOBLE COUNTY INC 401 SAWYER ROAD KENDALLVILLE IN 46755 352087092 HOSPITAL CARE IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC 0 COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC 207 N TOWNLINE ROAD LAGRANGE IN 46761 202401676 HOSPITAL CARE IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC 0 WHITLEY MEMORIAL HOSPITAL INC 1260 E STATE ROAD 205 COLUMBIA CITY IN 46725 351967665 HOSPITAL CARE IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC 0 HUNTINGTON MEMORIAL HOSPITAL INC 2001 STULTS ROAD HUNTINGTON IN 46750 351970706 HOSPITAL CARE IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC 0 PARKVIEW PROFESSIONAL PROGRAMS INC 2200 RANDALLIA DRIVE FORT WAYNE IN 46805 351668888 REFERENCE LAB IN PARKVIEW HOSPITAL INC C 16366851 5570270 1.00000 0 1 1 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 0 PARKVIEW FOUNDATION INC A 25263 PART VII SUPPLEMENTAL INFORMATION PARKVIEW FOUNDATION INC C 1051321 PART VII SUPPLEMENTAL INFORMATION PARKVIEW PROFESSIONAL PROGRAMS INC Q 86217 PART VII SUPPLEMENTAL INFORMATION METHOD USED TO DETERMINE VALUE SCHEDULE R, PART V, LINE 2, COLUMN (C): 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.