2011-11-08T12:26:11-06:00 2010-12-31 CROWE HORWATH LLP 330 E JEFFERSON BLVD PO BOX 7 SOUTH BEND IN 466240007 990 2010-01-01 350868085 PARKVIEW HOSPITAL INC PARK 2603738407 2200 RANDALLIA DRIVE FORT WAYNE IN 46805 MICHAEL P BROWNING 2603738407 2011-11-08 1 KENNETH J KEBER 5742323992 2010 2016-02-24 21:20:13Z MICHAEL PACKNETT 10501 CORPORATE DRIVE FORT WAYNE IN 46845 563430042 0 X WWW.PARKVIEW.COM X 1941 IN PARKVIEW HOSPITAL, INC. WILL PROVIDE QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US AND WE WILL WORK TO IMPROVE THE HEALTH OF OUR COMMUNITIES. 18 13 3910 654 1883433 0 669527 650214 555896744 519727587 -859327 815760 9100484 9537551 564807428 530731112 1385467 1472467 0 0 237996507 196168267 0 0 0 281301512 319530434 520683486 517171168 44123942 13559944 370176008 356942675 49301802 44675536 320874206 312267139 X PARKVIEW HOSPITAL, INC. WILL PROVIDE QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US AND WE WILL WORK TO IMPROVE THE HEALTH OF OUR COMMUNITIES. 0 0 418911864 1472467 522280983 PARKVIEW HOSPITAL, INC. IS A 616 BED REGIONAL TERTIARY REFERRAL CENTER 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 MUCH MORE. CURRENTLY UNDER CONSTRUCTION AND SLATED TO OPEN IN MARCH 2012, THE PARKVIEW REGIONAL MEDICAL CENTER REPRESENTS AN INVESTMENT OF $536 MILLION IN THE REGION THAT WE SERVE. 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 HEALTH CARE, HEALTH SCREENINGS AND PREVENTION PROGRAMS, DISEASE MANAGEMENT, HEALTH INNOVATION PLUS RESEARCH AND DEVELOPMENT. IN CONJUNCTION WITH PARKVIEW HEALTH SYSTEM, INC., PARKVIEW HOSPITAL, INC. PARTICIPATED IN A COMMUNITY HEALTH ASSESSMENT IN LATE 2007. INITIATIVES AT PARKVIEW HOSPITAL, INC., DERIVED FROM THE COMMUNITY HEALTH ASSESSMENT, WERE PNEUMONIA VACCINATIONS AND COLORECTAL AND MAMMOGRAPHY SCREENINGS. CHILDREN'S HEALTH 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 2006 IN COLLABORATION WITH OTHER COMMUNITY ORGANIZATIONS THAT SHARE THE COMMON GOAL OF IMPROVING THE HEALTH OF THE UNDERSERVED. PARKVIEW HOSPITAL, INC. IS CURRENTLY PREPARING TO CONDUCT A COMMUNITY HEALTH ASSESSMENT AND DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN. THE FOLLOWING ARE SOME OF THE WAYS PARKVIEW HOSPITAL, INC. IS REACHING OUT TO MAKE OUR NEIGHBORHOODS AND COMMUNITIES HEALTHIER:-CHARITY CARE -COMMUNITY HEALTH IMPROVEMENT INITIATIVES AND PARTNERS THAT FOCUS ON: ACCESS TO HEALTH CARE HEALTH SCREENING AND PREVENTION DISEASE MANAGEMENT HEALTH INNOVATION, RESEARCH AND DEVELOPMENT -HEALTH CAREERS AND CONTINUING EDUCATION -COMFORT AND SUPPORT -INTERNATIONAL MEDICAL MISSION WORKCHARITY CARE:PARKVIEW HOSPITAL'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:THROUGH VARIOUS PROGRAMS PROVIDED BY THE COMMUNITY NURSING INITIATIVE, 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 WILL PRODUCE A THIRD AND FOURTH-GRADE HEALTH AND WELLNESS CURRICULUM WITH INPUT FROM LOCAL TEACHERS, COORDINATE PILOTS OF THE CURRICULUM IN LOCAL SCHOOLS, INCORPORATE THE LOCAL BASEBALL MASCOT AS A KEY LEARNING TOOL, AND DEVELOP SUPPORTING MATERIALS AND ACTIVITIES TO CREATE A TRUE LEARNING EXPERIENCE. FRANCINE'S FRIENDS MOBILE MAMMOGRAPHY PROGRAM:IN PARTNERSHIP WITH FRANCINE'S FRIENDS AND THE BREAST DIAGNOSTIC CENTER, PARKVIEW 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. THE 2007 COMMUNITY HEALTH ASSESSMENT REVEALED A 9% INCREASE IN SCREENINGS FOR ALLEN COUNTY. COLORECTAL CANCER SCREENINGS:PARKVIEW'S COMPREHENSIVE CANCER CENTER ORGANIZED A COMMUNITY TASK FORCE TO INCREASE AWARENESS OF COLORECTAL CANCER SCREENING. THIS CAMPAIGN INCLUDED DISTRIBUTION OF TAKE-HOME BLOOD STOOL TEST KITS AT HOSPITAL, PHYSICIAN OFFICE AND HEALTH FAIR LOCATIONS IN ADDITION TO BROAD-BASED PREVENTION EDUCATION. DURING THE THREE-YEAR PERIOD OF THIS INITIATIVE, SIGMOIDOSCOPY AND COLONOSCOPY SCREENINGS INCREASED 15 PERCENT FOR ADULTS AGE 50 AND OLDER IN ALLEN COUNTY. PARKVIEW HOSPITAL, INC. CONTINUES TO MAKE THE TEST KITS AVAILABLE TO THE COMMUNITY.MEDICATION ASSISTANCE PROGRAM:PARKVIEW HOSPITAL, INC.'S MEDICATION ASSISTANCE PROGRAM HELPS LOW-INCOME PATIENTS OBTAIN PRESCRIPTION MEDICATIONS AT DISCHARGE, AND AS A PART OF LONG-TERM PHARMACEUTICAL ASSISTANCE PROGRAMS TO MEET PATIENTS' HEALTH MAINTENANCE NEEDS. RECENTLY, THE PROGRAM BEGAN A PILOT TO EXPAND ITS SCOPE AND SERVE PATIENTS REFERRED BY PHYSICIAN OFFICES TO RECEIVE ASSISTANCE WITH ENROLLING IN PHARMACEUTICAL ASSISTANCE PROGRAMS. PRIMARY HEALTH CARE/ACCESS: IN ADDITION TO PROVIDING CHARITY CARE, 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 CLINIC: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 CLINIC, INCLUDING THE CLINIC'S DIABETES MANAGEMENT PROGRAM. IN ADDITION, THE HOSPITAL PROVIDES FUNDING FOR MEDICATION ASSISTANCE PROGRAMS AT EACH OF THE AFOREMENTIONED CLINICS. PARKVIEW HOSPITAL, INC. ALSO PROVIDES FUNDING FOR RADIOGRAPHIC IMAGING SERVICES FOR NEIGHBORHOOD HEALTH CLINIC.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 CAREW MEDICAL PARK. PARKVIEW HOSPITAL, INC. ALSO PROVIDES FUNDING FOR VACCINES AND NURSING SUPPORT FOR THE CLINIC WHEN NEEDED.(PLEASE NOTE - RETURN TO PAGE 2, PART III, LINE 4B FOR CONTINUATION OF PROGRAM SERVICE ACCOMPLISHMENTS BEFORE READING INFORMATION BELOW) CONTINUED FROM SCHEDULE O, PART III, LINE 4ACOMMUNITY TRANSPORTATION NETWORK:THE HOSPITAL HAS A WORKING RELATIONSHIP WITH AND PROVIDES FINANCIAL SUPPORT TO 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 WELLNESS AND 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 CRISIS. 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," BIKE HELMET SAFETY, TEEN DRIVER SAFETY, "DON'T TEXT AND DRIVE", AND INFANT CAR SEAT SAFETY PROGRAMS.THE BIKE HELMET SAFETY PROGRAM PROVIDES FREE AND LOW-COST HELMETS TO CHILDREN WHO DO NOT HAVE THE FINANCIAL RESOURCES TO AFFORD A HELMET. THE STAFF WORKS CLOSELY WITH COMMUNITY GROUPS TO DISTRIBUTE THE HELMETS AND CONDUCTS BICYCLE RODEOS DURING THE SUMMER TO EMPHASIZE OVERALL BIKE SAFETY AND HELMET USAGE. "DON'T DRINK & DRIVE" IS AN EDUCATIONAL PROGRAM GEARED TOWARDS TEENS THAT WARN THEM ABOUT THE DANGERS OF DRINKING AND DRIVING AS "DON'T TEXT & DRIVE" INFORMS TEENS ABOUT THE DANGER 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. 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 SERVICE 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 YOUTH ABOUT HEALTH CAREERS. 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. 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. 418911864 1 1 0 1 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 X 175 0 1 3910 1 1 1 0 0 0 0 0 0 0 0 0 X 18 13 0 0 1 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 X X 403795 0 81597 MICHAEL PACKNETT 1.00 X X 0 912103 158919 THOMAS BOND 1.00 X 43102 218022 38903 LARRY BAGWELL 1.00 X 1750 1500 0 THOMAS BEAVER 1.00 X 6500 3000 0 STEVE CORONA 1.00 X 4000 250 0 MICHAEL GRABOWSKI 1.00 X 75000 0 0 DAVID HAIST 1.00 X 4750 3500 0 HERB HERNANDEZ 1.00 X 4500 1750 0 THOMAS KIMBROUGH 1.00 X 4500 250 0 DAVID KOHLI 1.00 X 4500 0 0 DAVID MICHEL 1.00 X 3750 0 0 SHERRI MILLER 1.00 X 3250 250 0 MARILYN MORAN-TOWNSEND 1.00 X 4250 250 0 JEFFREY NICKEL 1.00 X 25000 0 0 WENDY ROBINSON 1.00 X 4000 0 0 CHRISTINE RUPP 1.00 X 3250 250 0 WIL SMITH 1.00 X 4500 4500 0 MICHAEL BROWNING 1.00 X 0 80871 5343 JEFFREY FRANCIS 1.00 X 0 206802 15269 STANTON RISSER 1.00 X 0 138872 24814 JUDITH BOERGER 40.00 X 300699 0 37295 DANIEL GARMAN 40.00 X 253100 0 56205 SUBHASH SHARMA 40.00 X 247577 0 35272 CHARLES CLARK 40.00 X 200176 0 42194 TIMOTHY CMELIK 40.00 X 187951 0 27917 THOMAS GUTWEIN 40.00 X 166771 600 0 CHAD CARPENTER 40.00 X 155226 0 26630 CHARLES MASON 0.00 X 0 448413 0 2111897 2021183 550358 98 1 1 0 PREFERRED ANESTHESIA CONSULTANTS PC 1818 CAREW STREET STE 220 FORT WAYNE IN 46805 ANESTHESIOLOGISTS 4751732 INDIANA SURGICAL SPECIALISTS LLC 1818 CAREW STREET STE 160 FORT WAYNE IN 46805 PHYSICIANS 2190939 ORTHOPAEDICS NORTHEAST PC 5050 N CLINTON STREET FORT WAYNE IN 46825 PHYSICIANS 662350 FORT WAYNE RADIOLOGY 3707 NEW VISION DRIVE FORT WAYNE IN 46845 MEDICAL SERVICES 542436 ALLIED HOSPITAL PATHOLOGISTS PC 2458 LAKE AVENUE FORT WAYNE IN 46805 MEDICAL SERVICES 464996 11 393029 257185 6988 650214 NET PATIENT SERVICE 622000 496003863 496003863 LAB SERVICES 621500 16337664 16337664 PHARMACY 446110 6786872 6786872 PATHOLOGY TESTS 621500 383365 383365 WOMEN'S HEALTH CENTER 812900 174286 42226 132060 41537 41537 519727587 368293 368293 3546186 1801202 1744984 1744984 -15501 1760485 30768632 97072 30404310 13927 364322 83145 447467 447467 518461 479491 38970 38970 ORTHO BILLINGS 541900 3314055 2104666 1209389 CAFETERIA & MEALS 722210 2118454 2118454 ORTHO DEF REV/GN SALE 900099 1060508 1060508 1260580 964155 174120 122305 7753597 530731112 522280983 1883433 5916482 1442012 1442012 30455 30455 1335715 1335715 148437687 146233125 2204562 46394865 45542000 852865 45201 45201 67689994 63745944 3944050 146454 121937 24517 85488287 83364287 2124000 9134925 8532372 602553 1023689 888914 134775 265676 101580 164096 299023 299023 21178814 21132924 45890 1333632 30463 1303169 UBI TAXES & REFUNDS 72800 72800 CORP SERVICE ALLOCATION 85228452 85228452 BAD DEBT 32031086 32031086 PH SUBSIDY 11104759 11104759 RESIDENCY SUPPORT 3388676 3388676 1098966 849507 249459 517171168 418911864 98259304 0 13390 12900 33475 918662 88167115 73714133 895849 724240 9125633 9193791 758976 1823075 441902537 274877182 169612768 167025355 15326893 16939817 3488152 5478968 1101984 1543174 81651773 79568560 370176008 356942675 24153966 22963653 14027942 12950646 5307448 3852825 5812446 4908412 49301802 44675536 X 320874206 312267139 0 0 320874206 312267139 370176008 356942675 X 13559944 -22167011 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 22967 22967 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: 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. 6627744 6627744 234777484 142231729 92545755 9708714 2777846 6930868 178371288 122204655 56166633 12417307 7662952 4754355 167025355 DUE TO/FROM INTERUNIT 78257102 EST. MEDICARE/MEDICAID SETTLEMENTS 1000001 RESTRICTED FUNDS 311457 79568560 EST. MEDICARE/MEDICAID SETTLEMENTS 4593810 RESTRICTED FUNDS 311457 PROPERTY SECURITY DEPOSITS 3145 4908412 1 1 X 1 X 0 1 1 1 0 1 1 17057335 17057335 0.03520 57110739 20295167 36815572 0.07590 3207671 2899213 308458 0.00060 77375745 23194380 54181365 0.11170 3807326 528479 3278847 0.00680 5010580 1473144 3537436 0.00730 11950548 122673 11827875 0.02440 1292767 285011 1007756 0.00210 1736179 131984 1604195 0.00330 23797400 2541291 21256109 0.04390 101173145 25735671 75437474 0.15560 257982 257982 0.00050 27560 27560 0.00010 1137 1137 0.00000 7844 7844 0.00000 72751 72751 0.00010 367274 367274 0.00070 1 9896074 0 97453765 110868446 -13414681 X 1 1 2 1 PARKVIEW RANDALLIA

2200 RANDALLIA DRIVE FORT WAYNE IN 46805

X X X X X 2 PARKVIEW NORTH

11115 PARKVIEW PLAZA DRIVE FORT WAYNE IN 46845

X X X X NOT REQUIRED 1 NOT REQUIRED 2 20 PARKVIEW BEHAVIORAL HEALTH

1720 BEACON STREET FORT WAYNE IN 46805

IP & OP BEHAVIORAL PARKVIEW RADIATION THERAPY & ONCOLOGY

11141 PARKVIEW PLAZA DR FORT WAYNE IN 46845

ONCOLOGY CENTER PARKVIEW HOME HEALTHCARE

1900 CAREW STREET SUITE 6 FORT WAYNE IN 46805

HOME HEALTH & HOSPICE OUPATIENT SERVICE CENTER OSC

11141 PARKVIEW PLAZA DR FORT WAYNE IN 46845

OP AMBULATORY 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 CAREW MRI

2110 CAREW STREET FORT WAYNE IN 46825

OP AMBULATORY 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 CHILDREN'S EDUCARE CENTER

2125 BEACON STREET FORT WAYNE IN 46805

CHILDCARE CENTER PARKVIEW HEALTH & FITNESS

3000 E STATE BLVD FORT WAYNE IN 46805

HEALTH FITNESS PARKVIEW SOUTHWEST AMBULATORY SITE

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 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: COSTING METHODOLOGY USED TO CALCULATE CHARITY CAREPART 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 7GAMOUNTS PRESENTED REPRESENT ACTUAL SPEND RELATIVE TO LOSSES SUSTAINED BY PHYSICIAN PRACTICES AND OTHER CLINICAL OPERATIONS AND SERVICES. SUBSIDIZED LOSSES EXCLUDE BAD DEBT AND REFLECT ASSISTANCE REQUIRED TO SUPPORT THE OPERATIONS OF THE VARIOUS OFFICES, CLINICS AND SERVICES, SUCH AS EMS/AMBULANCE SERVICES, BEYOND CASH COLLECTIONS AND OPERATING EXPENSES AND ARE PROVIDED TO SUSTAIN SERVICES IN THESE FACILITIES AND MEET THE NEEDS OF OUR MISSION TO OUR COMMUNITIES. 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 $11,075,590 IN COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC AS SUBSIDIZED HEALTH SERVICES. PART I, L7 COL(F): PERCENT OF TOTAL EXPENSESPARKVIEW HOSPITAL, INC. EXCLUDED $32,031,086 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 OF THE COMMUNITY THAT HELP TO IMPROVE THE HEALTH OF THE COMMUNITY. PHYSICAL IMPROVEMENTS AND HOUSING:PARKVIEW HOSPITAL, INC. REPORTED SEVERAL PHYSICAL IMPROVEMENTS THAT PROMOTE NEIGHBORHOOD REVITALIZATION, I.E., RENOVATIONS AT A NEARBY BRANCH OF THE ALLEN COUNTY PUBLIC LIBRARY, AND ENHANCE THE INFRASTRUCTURE FOR PHYSICAL ACTIVITY, I.E., THE SLEN TRAIL PROJECT. THE HOSPITAL ALSO HAS A LONG-TERM INVESTMENT IN AN ON-GOING SEWER IMPROVEMENT PROJECT. ECONOMIC DEVELOPMENT:THROUGH THE SUPPORT OF VARIOUS LOCAL ART PROGRAMS, PARKVIEW HOSPITAL, INC. IS FOCUSED ON IMPROVING LOCAL ECONOMIC VITALITY THAT ULTIMATELY AFFECTS THE HEALTH AND WELL BEING OF AREA RESIDENTS. COMMUNITY SUPPORT:PARKVIEW HOSPITAL, INC. PARTNERED WITH THE ALLEN COUNTY UNITED WAY TO PARTICIPATE IN THE ANNUAL DAY OF CARING AND DONATED NEW EDUCATIONAL EQUIPMENT AND SUPPLIES TO THE NEIGHBORHOOD EARLY CHILDHOOD ALLIANCE DAY CARE AND PRE-SCHOOL.COALITION BUILDING:PARKVIEW HOSPITAL, INC. HOSTED A CHILDREN'S HEALTH SUMMIT IN ORDER TO GAIN INSIGHT FROM LOCAL AGENCIES THAT SERVE CHILDREN, PROVIDE EDUCATION ON COLLABORATIVE COMMUNITY INITIATIVES AND PROVIDE A VENUE FOR NETWORKING WITH REPRESENTATIVES FROM LOCAL ORGANIZATIONS THAT SHARE THE SAME GOALS RELATED TO IMPROVING CHILDREN'S HEALTH.WORKFORCE DEVELOPMENT:PARKVIEW HOSPITAL, INC. PROMOTES HEALTH CARE CAREERS THROUGH STUDENT JOB SHADOWING AND INTERNSHIP PROGRAMS IN VARIOUS HEALTH CARE AREAS THROUGHOUT THE ORGANIZATION. PART III, LINE 4: BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTETEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE:THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR BAD DEBTS BASED UPON THESE INDICATORS AND ACCOUNTS RECEIVABLE PAYOR COMPOSITION AND AGING AND CONSIDERING HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY AND AGING. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBT AND TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR BAD DEBTS. IN ADDITION, PH FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES.COSTING METHODOLOGY USED:UNCOLLECTIBLE PATIENT ACCOUNTS ARE CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH THE POLICIES OF PARKVIEW HOSPITAL, INC. THE BAD DEBT EXPENSE REPORTED ON LINE 2 IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. 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. 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 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 AS PART OF THE COMMUNITY BENEFIT REPORT THAT IS SUBMITTED TO THE STATE OF INDIANA. PARKVIEW HOSPITAL, INC. RECOGNIZES THAT THE SHORTFALL FROM MEDICARE DOES NOT INCLUDE THE COSTS AND REVENUES ASSOCIATED WITH MEDICARE ADVANTAGE PATIENTS. AS SUCH, THE TOTAL SHORTFALL 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. PART VI, LINE 2: DESCRIBE HOW THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES.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 2006 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. THIS SURVEY WAS INITIATED AS A PROJECT OF THE HEALTHCARE ACCESS PROGRAM (HAP). THE MISSION OF HAP IS TO CONVENE LOCAL LOW-COST, NO-COST HEALTHCARE PROVIDERS TO SERVE AS A CENTER OF EXCELLENCE IN ORGANIZING AND ADMINISTERING PROGRAMS THAT INCREASE QUALITY AND EFFICIENCY, AND REDUCE THE COST OF HEALTHCARE FOR THE UNINSURED AND UNDERINSURED RESIDENTS OF ALLEN COUNTY, INDIANA. PARTICIPANTS OF HAP INCLUDE MATTHEW 25 HEALTH AND DENTAL CLINIC, NEIGHBORHOOD HEALTH CLINICS, FORT WAYNE MEDICAL EDUCATION PROGRAM, FORT WAYNE-ALLEN COUNTY DEPARTMENT OF HEALTH, PARKVIEW HEALTH, LUTHERAN HEALTH NETWORK, ST. JOSEPH COMMUNITY HEALTH FOUNDATION, AND THE FORT WAYNE MEDICAL SOCIETY. THIS PROJECT REPRESENTS A STEP IN THE LONG-TERM VISION OF IMPROVING THE HEALTH AND WELLNESS OF LOW-INCOME RESIDENTS IN ALLEN COUNTY. INTERVIEWS WERE RANDOMLY CONDUCTED WITH 454 LOW-INCOME RESIDENTS AGE 18 AND OVER IN THE FOLLOWING ZIP CODES IN ALLEN COUNTY, INDIANA: 46802, 46803, 46805, 46806, 46807, 46808, AND 46816. THE SURVEY RESULTS REPRESENT A MAXIMUM ERROR RATE OF PLUS OR MINUS 4.6% AT THE 95 PERCENT LEVEL OF CONFIDENCE. A MINIMUM OF 100 SURVEYS WERE COMPLETED FOR BOTH AFRICAN-AMERICAN AND FOR HISPANIC RESPONDENTS. A TELEPHONE INTERVIEW METHODOLOGY WAS EMPLOYED. 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 AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO NATIONAL HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND RECOGNIZED HEALTH ISSUES. THE RESULTS WERE ALSO DISSEMINATED TO THE PUBLIC DURING SEVERAL COMMUNITY HEALTH PRESENTATIONS CONDUCTED DURING THE SPRING OF 2007. THE PURPOSE OF THE PRESENTATIONS WAS TO CALL ATTENTION TO THIS COMMUNITY HEALTH STATUS RESEARCH AND TO GENERATE INTEREST AMONG COMMUNITY ORGANIZATIONS AND COMMUNITY LEADERS WHO PLAY A ROLE IN COMMUNITY HEALTH IMPROVEMENT.IN CONJUNCTION WITH PARKVIEW HEALTH SYSTEM, INC., PARKVIEW HOSPITAL, INC. PARTICIPATED IN A COMMUNITY HEALTH ASSESSMENT IN LATE 2007. PROFESSIONAL RESEARCH CONSULTANTS, INC. OF OMAHA, NEBRASKA, WAS ENGAGED TO CONDUCT THE SURVEY AND TO PROVIDE AN EVALUATION OF THE STUDY. THE SURVEY SAMPLE INCLUDED 1,400 RESIDENTS AGE 18 AND OLDER OF ALLEN, HUNTINGTON, LAGRANGE, NOBLE, AND WHITLEY COUNTIES. A TELEPHONE INTERVIEW METHODOLOGY WAS EMPLOYED. 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 AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO NATIONAL HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND RECOGNIZED HEALTH ISSUES. THE INFORMATION FROM BOTH OF THESE SURVEYS WILL BE A VALUABLE TOOL AS WE SEEK AND PRIORITIZE OPPORTUNITIES TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE AND AS WE IDENTIFY OPPORTUNITIES FOR COLLABORATION AMONG COMMUNITY ORGANIZATIONS AND LEADERS. PARKVIEW HOSPITAL, INC. REPRESENTATIVES HAVE RELATIONSHIPS THROUGHOUT THE COMMUNITY AND MEET REGULARLY WITH VARIOUS ORGANIZATIONS THAT SHARE PARKVIEW HOSPITAL, INC.'S MISSION OF IMPROVING THE HEALTH OF THE COMMUNITIES THAT WE SERVE INCLUDING THE ALLEN COUNTY BOARD OF HEALTH. 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.PARKVIEW HOSPITAL, INC. PRIMARILY SERVES THE ALLEN COUNTY COMMUNITY. AS A REGIONAL HOSPITAL AND A LEVEL II TRAUMA CENTER, PARKVIEW HOSPITAL, INC. ALSO SERVES SURROUNDING COMMUNITIES TO SOME EXTENT.ALLEN COUNTY IS THE URBAN AREA THAT RESIDES IN PARKVIEW HEALTH'S SERVICE AREA. BASED ON 2010 DATA, THE POPULATION OF THE COUNTY IS APPROXIMATELY 355,329, OF WHICH 71% OF THE POPULATION INHABITS THE CITY OF FORT WAYNE. NEW HAVEN IS THE LARGEST TOWN AND ACCOUNTS FOR 4.2% OF THE ALLEN COUNTY POPULATION. IN 2008, APPROXIMATELY 11.5% OF THE POPULATION WAS REPORTED BELOW THE FEDERAL POVERTY LEVEL. THE PER CAPITA PERSONAL (ANNUAL) INCOME WAS $34,652 AND THE MEDIAN HOUSEHOLD INCOME WAS $49,110. AS OF JUNE 2010, UNEMPLOYMENT STOOD AT 10.4%. ACCORDING TO THE JANUARY 2009 FEDERAL REPORT, THE SOUTH SIDE SERVICE AREA OF FORT WAYNE WAS DESIGNATED AS A MEDICALLY UNDERSERVED AREA (MUA).ACCORDING TO THE DECEMBER 2009 INDIANA HEALTH COVERAGE PROGRAM ENROLLMENT DATA, 15.7% OF ALLEN COUNTY RESIDENTS ARE ENROLLED IN MEDICAID. PART VI, LINE 6: 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 WHICH 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. 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 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, ACCREDITED CHEST PAIN CENTER 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 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 UNINSURED.HEALTH SCREENING AND PREVENTION-CANCER SCREENING PROGRAMS, PARTICULARLY MAMMOGRAM, COLORECTAL, AND PROSTATE SCREENING-TOBACCO CESSATION PROGRAMS-INJURY PREVENTION FOR YOUNG PEOPLE-EDUCATION, SCREENING AND PREVENTION OF SEXUALLY TRANSMITTED DISEASES-DIABETES EDUCATION AND SCREENING-CARDIOVASCULAR DISEASE EDUCATION AND SCREENING-PNEUMONIA VACCINATIONS FOR INDIVIDUALS AGE 65 AND OLDER-PROGRAMS TO REDUCE DANGEROUS DRIVINGDISEASE MANAGEMENT-CARDIOVASCULAR DISEASE -CANCER-MENTAL ILLNESSES-TRAUMA AND ORTHOPAEDIC AILMENTS-WOMEN AND CHILDREN'S MEDICINE WITH AN EMPHASIS ON CHILDREN'S ASTHMA-DIABETES AND OBESITY HEALTH INNOVATION, EDUCATION, AND RESEARCH AND DEVELOPMENTTHIS AREA CONCENTRATES ON OPPORTUNITIES FOR: -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.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 HEALTH CARE INCLUDE MATTHEW 25 HEALTH AND DENTAL CLINIC, NEIGHBORHOOD HEALTH CLINIC, SUPER SHOT, CANI COVERING KIDS AND FAMILIES, AND CANCER SERVICES OF NORTHEAST INDIANA. IN ADDITION, PARKVIEW HOSPITAL, INC. PROVIDES FUNDING TO THREE LOCAL ORGANIZATIONS THAT 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, MEET 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. CURRENTLY UNDER CONSTRUCTION AND SLATED TO OPEN MARCH 2012, THE PARKVIEW REGIONAL MEDICAL CENTER ON THE PARKVIEW HOSPITAL, INC. NORTH CAMPUS REPRESENTS A SIGNIFICANT INVESTMENT IN THE LOCAL COMMUNITY AND THE NORTHEAST INDIANA REGION. THE CENTER WILL BLEND THE LATEST MEDICAL TECHNOLOGY WITH THE BEST POSSIBLE PATIENT-CENTERED CARE AND PROVIDE GREATER ACCESS TO HEALTH CARE FOR THE ENTIRE REGION. THE PARKVIEW HOSPITAL, INC. CAMPUS LOCATED IN NORTH CENTRAL FORT WAYNE WILL RECEIVE A FACELIFT AND REMAIN A VITAL PART OF THE LOCAL NEIGHBORHOOD. IN ADDITION, PARKVIEW HOSPITAL, INC. WILL BE 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. PART VI, LINE 7: 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 HEALTH CARE SYSTEM SERVING NORTHEAST INDIANA, 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 NORTHEAST INDIANA BY MANAGING ITS FACILITIES, EFFICIENTLY PROVIDING AND DELIVERING ITS SERVICES, AND THROUGH SUPPORTING LOCAL BUSINESSES AND ACTIVITIES. PARKVIEW SEEKS TO CREATE ALIGNMENT OPPORTUNITIES TO DELIVER COMPREHENSIVE HIGH-QUALITY CARE THAT BENEFITS ITS PATIENTS, COMMUNITIES, PHYSICIANS, AND CO-WORKERS.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 WE WILL WORK 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 HEALTH CARE, REGARDLESS OF WHETHER THE CARE IS DELIVERED IN A RURAL OR URBAN SETTING. REPORTS FILED WITH STATES PART VI, LINE 7 IN 1 MATTHEW 25 HEALTH CLINIC 413 E JEFFERSON BLVD FORT WAYNE IN 46802 351484951 501 ( C ) 3 441704 PROGRAMS AND OPERATIONS FUNDING EARLY CHILDHOOD ALLIANCE INC 3320 FAIRFIELD FORT WAYNE IN 46807 350953465 501 ( C ) 3 203065 OPERATIONS FUNDING NEIGHBORHOOD HEALTH CLINICS INC 1717 SOUTH CALHOUN STREET FORT WAYNE IN 46802 351922483 501 ( C ) 3 140000 OPERATIONS FUNDING CANCER SERVICES OF NORTHEAST INDIANA 6316 MUTUAL DRIVE FORT WAYNE IN 46825 350965609 501 ( C ) 3 60000 OPERATIONS FUNDING AND PATIENT ADVOCACY PROGRAMS COMMUNITY TRANSPORTATION NETWORK 2701 S COLISEUM BLVD 1315 FORT WAYNE IN 46803 352109955 501 ( C ) 3 35000 MEDICAL TRANSPORTATION MIDWEST ALLIANCE FOR HEALTH EDUCATION 1819 CAREW FORT WAYNE IN 46805 351637515 501 ( C ) 3 35000 RESEARCH PROJECTS AND INTERNSHIPS TURNSTONE CENTER FOR DISABLED CHILDREN AND ADULTS 3320 N CLINTON FORT WAYNE IN 46805 350913541 501 ( C ) 3 30000 FITNESS AND WELLNESS PROGRAMS AIDS TASK FORCE 525 OXFORD STREET FORT WAYNE IN 46806 311191147 501 ( C ) 3 25000 OPERATIONS AND PREVENTION EDUCATION PROGRAMS IPFW 2101 E COLISEUM BLVD FORT WAYNE IN 46805 356002041 501 ( C ) 3 25000 SPONSORSHIP - TAPESTRY FRIENDS OF THE THIRD WORLD INC 611 WEST WAYNE STREET FORT WAYNE IN 46802 237183804 501 ( C ) 3 24445 HUNGER AND POVERTY ALLEVIATION PROGRAMS AFRICAN AMERICAN HEALTHCARE ALLIANCE OF FORT WAYNE INC 815 CROWDER COURT FORT WAYNE IN 46825 352134195 501 ( C ) 3 20000 STUDENT SCHOLARSHIPS FOR HEALTHCARE EDUCATION ALLEN COUNTY COUNCIL ON AGING 233 WEST MAIN STREET FORT WAYNE IN 46802 351270976 501 ( C ) 3 20000 MEDICAL TRANSPORTATION BOYS AND GIRLS CLUB OF FORT WAYNE 2609 FAIRFIELD AVENUE FORT WAYNE IN 46807 351778767 501 ( C ) 3 20000 NUTRITION AND FITNESS PROGRAMS ASH CENTRE 1701 FREEMAN STREET FORT WAYNE IN 46802 300202606 501 ( C ) 3 15000 OPERATIONS FUNDING SUPER SHOT INC 709 CLAY STREET SUITE 300 FORT WAYNE IN 46802 352122575 501 ( C ) 3 15000 CHILDREN'S IMMUNIZATION PROGRAMS ASSOCIATED CHURCHES OF FORT WAYNE AND ALLEN COUNTY 602 EAST WAYNE STREET FORT WAYNE IN 46802 350905944 501 ( C ) 3 13500 BABY'S CLOSET PROGRAM TTHE CARRIAGE HOUSE 3327 LAKE AVENUE FORT WAYNE IN 46805 352026647 501 ( C ) 3 13000 EVENT SPONSORSHIP AND OPERATIONS FUNDING YWCA NORTHEAST INDIANA INC 1610 SPY RUN AVENUE FORT WAYNE IN 46805 350868220 501 ( C ) 3 12500 EVENT SPONSORSHIP AND OPERATIONS FUNDING BALL STATE UNIVERSITY FOUNDATION 2800 WEST BETHEL AVENUE MUNCIE IN 47304 356024566 501 ( C ) 3 12000 EDUCATION PROGRAMS FORT WAYNE MUSEUM OF ART 311 EAST MAIN STREET FORT WAYNE IN 46802 350953440 501 ( C ) 3 12000 ART PROGRAMS AND OPERATIONS FUNDING SOUTHEAST YMCA - YMCA OF GREATER FORT WAYNE 347 WEST BERRY STREET SUITE 500 FORT WAYNE IN 46802 350886850 501 ( C ) 3 12000 OBESITY, FITNESS AND NUTRITION PROGRAMS VERA BRADLEY FOUNDATION FOR BREAST CANCER PO BOX 80201 FORT WAYNE IN 46898 352058177 501 ( C ) 3 11100 SPONSORSHIP OF RESEARCH EVENT ARTHRITIS FOUNDATION INC 615 NORTH ALABAMA STREET INDIANAPOLIS IN 46204 350854247 501 ( C ) 3 10000 EVENT SPONSORSHIP COMMUNITY HARVEST FOOD BANK OF NORTHEAST INDIANA INC P O BOX 10967 FORT WAYNE IN 46855 311100607 501 ( C ) 3 10000 OPERATIONS FUNDING FORT WAYNE PUBLIC TRANSPORTATION 801 LEESBURG ROAD FORT WAYNE IN 46808 351147407 GOVT ORG 10000 CITILINK ACCESS PROGRAM HEALTH AND HOSPITAL CORP 6900 SOUTH GRAY ROAD INDIANAPOLIS IN 46237 GOVT ORG 10000 EVENT SPONSORSHIP AND OPERATIONS FUNDING AMERICAN CANCER SOCIETY 111 EAST LUDWIG ROAD FORT WAYNE IN 46825 381387120 501 ( C ) 3 7000 OPERATIONS FUNDING FORT WAYNE HEALTHY CITIES 3400 EAST COLISEUM BLVD FORT WAYNE IN 46805 351839680 501 ( C ) 3 6543 OPERATIONS FUNDING BLESSINGS IN A BACKPACK 111 EAST WAYNE STREET FORT WAYNE IN 46802 262627847 501 ( C ) 3 6000 EVENT SPONSORSHIP SCAN 500 WEST MAIN STREET FORT WAYNE IN 46802 310899309 501 ( C ) 3 5907 EVENT SPONSORSHIP UNITED HISPANIC AMERICANS INC 2424 FAIRFIELD AVENUE FORT WAYNE IN 46807 237115725 501 ( C ) 3 5040 EVENT SPONSORSHIP 31 FAMILY & CHILDREN ASSISTANCE 1127 30455 FMV GAMES/TOYS/BABY ITEMS/CARSEATS 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. X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 SUZANNE EHINGER 309497 0 75530 0 18768 0 67321 0 14276 0 485392 0 0 0 MICHAEL PACKNETT 0 638622 0 270643 0 2838 0 145546 0 13373 0 1071022 0 0 THOMAS BOND 43010 179536 0 37983 92 503 3640 18410 2782 14071 49524 250503 0 0 JEFFREY FRANCIS 0 103936 0 56980 0 45886 0 5960 0 9309 0 222071 0 8835 STANTON RISSER 0 106781 0 31911 0 180 0 7098 0 17716 0 163686 0 0 JUDITH BOERGER 232551 0 63792 0 4356 0 32201 0 5094 0 337994 0 0 0 DANIEL GARMAN 199525 0 41124 0 12451 0 35956 0 20249 0 309305 0 9478 0 SUBHASH SHARMA 208595 0 20429 0 18553 0 29400 0 5872 0 282849 0 0 0 CHARLES CLARK 162389 0 36458 0 1329 0 31043 0 11151 0 242370 0 0 0 TIMOTHY CMELIK 157186 0 30139 0 626 0 7245 0 20672 0 215868 0 0 0 THOMAS GUTWEIN 166771 600 0 0 0 0 0 0 0 0 166771 600 0 0 CHAD CARPENTER 134253 0 7000 0 13973 0 15242 0 11388 0 181856 0 0 0 CHARLES MASON 0 0 0 0 0 448413 0 0 0 0 0 448413 0 448413 PART I, LINE 1A PERSONAL SERVICES TAXABLE ALLOWANCE FOR FINANCIAL PLANNING PAID TO: SUZANNE EHINGER $750; DANIEL GARMAN $135 PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS TAXABLE - JEFFREY FRANCIS $8,835; DANIEL GARMAN $9,478; CHARLES MASON $448,413 PARTICIPANTS DEFERRED - JUDITH BOERGER $27,301; MICHAEL BROWNING $3,835; CHAD CARPENTER $15,242; CHARLES CLARK $19,026; SUZANNE EHINGER $37,921; DANIEL GARMAN $22,448; MICHAEL PACKNETT $133,296 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 2190939 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 $491,181 IS NOT REFLECTED ON SCHEDULE L. 0 FORM 990, PART VI, SECTION A, LINE 4 DURING 2010, SEVERAL CHANGES WERE MADE TO THE BYLAWS OF PARKVIEW HOSPITAL, INC. AND ARE AS FOLLOWS: THE FOLLOWING WAS ADDED TO ARTICLE V, SECTION 2: A MAJORITY OF THE BOARD OF DIRECTORS SHALL, AT ALL TIMES, BE CONSIDERED TO BE INDEPENDENT AS DEFINED BY THE INTERNAL REVENUE SERVICE. THE CHANGED PORTION AS NOW FINALIZED, OF ARTICLE V, SECTION 3 IS AS FOLLOWS: AS TO THOSE DIRECTORS WHO ARE NOT SERVING IN AN EX OFFICIO CAPACITY, THESE DIRECTORS SHALL BE APPOINTED FOR A TERM OF THREE (3) YEARS AND UNTIL A SUCCESSOR HAS BEEN DULY APPOINTED AND QUALIFIED. THE BOARD OF DIRECTORS SHALL BE CLASSIFIED IN APPROXIMATELY EQUAL CLASSES OF CLASS 1, CLASS 2 AND CLASS 3. NO PERSON SHALL BE ELIGIBLE FOR APPOINTMENT TO MORE THAN THREE (3) CONSECUTIVE THREE (3) YEAR TERMS. AFTER AN ABSENCE OF ONE (1) YEAR, A PERSON SHALL BECOME ELIGIBLE FOR REAPPOINTMENT TO THE BOARD. TERMS SHALL COMMENCE ON JANUARY 1 OF EACH CALENDAR YEAR. IF A DIRECTOR BEGINS THEIR SERVICE MIDWAY THROUGH THE YEAR (JUNE 30TH) OR AFTER, THE DIRECTOR SHALL NOT BE DEEMED TO HAVE COMMENCED THE FIRST YEAR OF THEIR TERM UNTIL JANUARY 1 OF THE FOLLOWING YEAR. ARTICLE V, SECTION 4 IS AS FOLLOWS: IN THE EVENT OF A VACANCY OF A DIRECTOR WHO IS NOT SERVING IN AN EX OFFICIO CAPACITY, THE EXECUTIVE COMMITTEE SHALL NOMINATE A CANDIDATE AND PRESENT THE NAME TO THE BOARD. THE BOARD SHALL SUBSEQUENTLY RECOMMEND TO THE CORPORATE MEMBER AN INDIVIDUAL TO FILL THE VACANCY, WHICH INDIVIDUAL MAY BE SUBSEQUENTLY APPOINTED BY THE CORPORATE MEMBER. THE NEW DIRECTOR SHALL NOT SERVE FOR THE UNEXPIRED TERM OF THE DIRECTOR THAT IS REPLACED, BUT SHALL INSTEAD BEGIN THEIR OWN TERM ON THE BOARD. ANY CURRENT DIRECTOR WHO FILLED AN UNEXPIRED TERM OF THEIR PREDECESSOR PRIOR TO JANUARY 1, 2010, SHALL BE "GRANDFATHERED". ARTICLE VIII, SECTION 1 IS AS FOLLOWS: THE BOARD MAY ESTABLISH FROM TIME TO TIME SUCH STANDING AND SPECIAL COMMITTEES AS IT SHALL DEEM NECESSARY FOR THE CONDUCT OF THE CORPORATION'S AFFAIRS. UNLESS THE COMMITTEE MEMBERSHIP IS OTHERWISE SPECIFIED BY THESE BYLAWS, ALL STANDING COMMITTEES SHALL BE COMPOSED OF NOT LESS THAN TWO (2) BOARD MEMBERS. MEMBERSHIP ON THE PARKVIEW HOSPITAL BOARD SHALL NOT BE A REQUIREMENT FOR COMMITTEE MEMBERSHIP OR FOR SERVICE AS A COMMITTEE CHAIR. UNLESS OTHERWISE SPECIFIED IN THESE BYLAWS, THE CHAIR OF THE BOARD SHALL APPOINT THE COMMITTEE MEMBERS AND THE CHAIR OF EACH COMMITTEE AND DESIGNATE THE TERM OF OFFICE FOR EACH COMMITTEE MEMBER. UNLESS OTHERWISE SPECIFIED IN THESE BYLAWS, THE CHAIR OF THE BOARD AND THE CHIEF OPERATING OFFICER SHALL BE VOTING MEMBERS OF EACH COMMITTEE AND MAY DESIGNATE ANOTHER DIRECTOR OR OFFICER TO ATTEND COMMITTEE MEETINGS ON HIS/HER BEHALF. ALL COMMITTEES SHALL KEEP WRITTEN MINUTES OF THEIR MEETINGS AND SUBMIT THE MINUTES TO THE BOARD. ARTICLE VIII, SECTION 4 IS AS FOLLOWS: THE EXECUTIVE COMMITTEE SHALL BE COMPRISED OF THE OFFICERS OF THE BOARD, THE CHIEF OPERATING OFFICER OF THE CORPORATION, THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF PARKVIEW HEALTH SYSTEM, INC., THE IMMEDIATE PAST CHAIR OF THE BOARD, THE CURRENT PRESIDENT OF THE MEDICAL STAFF, AND SUCH OTHER PERSONS AS IDENTIFIED BY THE CHAIR OF THE BOARD. IN NO EVENT SHALL THE MEMBERS OF THE EXECUTIVE COMMITTEE EXCEED EIGHT (8) PEOPLE. THE EXECUTIVE COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION IN ANY MATTER WHEN THE BOARD IS NOT IN SESSION, REPORTING TO THE BOARD FOR RATIFICATION OF ITS ACTION. MEETINGS MAY BE CALLED BY THE CHAIR OR BY THREE (3) MEMBERS. ARTICLE VIII, SECTION 5 IS AS FOLLOWS: THE QUALITY COMMITTEE SHALL BE COMPRISED OF THE CHIEF MEDICAL OFFICER, THE PRESIDENT-ELECT OF THE MEDICAL STAFF, AND THE CHIEF OPERATING OFFICER OF THE CORPORATION, THE ADMINISTRATIVE CORPORATE OFFICER RESPONSIBLE FOR THE HOSPITAL'S QUALITY INITIATIVES, OR A DESIGNEE OF THESE INDIVIDUALS, AND AT LEAST TWO ADDITIONAL BOARD MEMBERS, AND ADDITIONAL MEMBERS AS DESIGNATED BY THE BOARD CHAIR. IT SHALL COORDINATE WITH THE SYSTEM QUALITY COMMITTEE AND BE RESPONSIBLE FOR IMPLEMENTING ALL STANDARDS, MEASUREMENTS AND QUALITY EFFORTS. IT SHALL FURTHER PROGRAMS AND PROCEDURES FOR ACCREDITATION, LICENSURE AND CERTIFICATION BY APPROPRIATE AGENCIES. IT SHALL BE RESPONSIBLE FOR MONITORING THE MAINTENANCE OF EFFECTIVE MEDICAL STAFF PERFORMANCE AND QUALITY IMPROVEMENT PROGRAMS. IT SHALL MAKE RECOMMENDATIONS TO THE BOARD FOR CHANGES TO THESE PROGRAMS. 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 12, 2011, 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 REDESIGNED 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 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. THE BOARD EXECUTIVE COMMITTEE OF PARKVIEW HEALTH SYSTEM, INC. SERVED AS THE EXECUTIVE COMPENSATION COMMITTEE IN 2010, PURSUANT TO THE ORGANIZATION'S BYLAWS, FOR PURPOSES OF REVIEWING AND APPROVING ALL EXECUTIVE COMPENSATION, BENEFITS AND PERQUISITES FOR THE 2010 COMPENSATION PACKAGE. THE COMPENSATION PACKAGE WAS APPROVED BY A MAJORITY OF INDEPENDENT BOARD EXECUTIVE COMMITTEE MEMBERS. PARKVIEW'S INDEPENDENT CONSULTANT PREPARES A COMPETITIVE COMPENSATION ANALYSIS USING DATA FROM MULTIPLE PUBLISHED SURVEYS PREPARED BY INDEPENDENT FIRMS FOR POSITIONS THAT ARE FUNCTIONALLY COMPARABLE IN SIMILAR-SIZED HEALTH SYSTEMS AND HOSPITAL ORGANIZATIONS ON BOTH A REGIONAL AND NATIONAL BASIS. THE INDEPENDENT CONSULTANT PROVIDES A STATEMENT OF REASONABLENESS OF THE COMPENSATION PROVIDED TO THE CEO AS WELL AS ALL EXECUTIVES AT THE VICE PRESIDENT LEVEL AND ABOVE. ALL DATA IS SHARED WITH THE BOARD OF DIRECTORS EXECUTIVE COMMITTEE. 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 2010 MEETING: PRESIDENT AND CEO PH EXECUTIVE VICE PRESIDENT STRATEGIC DIRECTION AND BUSINESS DEVELOPMENT EXECUTIVE VICE PRESIDENT PARKVIEW HEALTH/COO PARKVIEW HOSPITAL EXECUTIVE VICE PRESIDENT AND COO PARKVIEW HEALTH MEDICAL DIRECTOR COMMUNITY HOSPITALS SENIOR VICE PRESIDENT OPERATIONS / SERVICE EXCELLENCE SENIOR VICE PRESIDENT HUMAN RESOURCES SENIOR VICE PRESIDENT AND GENERAL COUNSEL SENIOR VICE PRESIDENT HEALTH PLAN SERVICES SENIOR VICE PRESIDENT PATIENT CARE SENIOR VICE PRESIDENT AND CHIEF QUALITY OFFICER / PATIENT SAFETY OFFICER SENIOR VICE PRESIDENT OPERATIONS SENIOR VICE PRESIDENT AND CHIEF INFORMATION OFFICER SENIOR VICE PRESIDENT/COO ORTHOPEDIC HOSPITAL SENIOR VICE PRESIDENT/COO COMMUNITY HOSPITALS - HUNTINGTON SENIOR VICE PRESIDENT/COO COMMUNITY HOSPITALS - NOBLE SENIOR VICE PRESIDENT/COO COMMUNITY HOSPITALS - WHITLEY SENIOR VICE PRESIDENT/COO COMMUNITY HOSPITALS - LAGRANGE SENIOR VICE PRESIDENT/COO PHYSICIAN PRACTICES SENIOR VICE PRESIDENT AND CHIEF FINANCIAL OFFICER SENIOR VICE PRESIDENT REVENUE CYCLE MANAGEMENT MEDICAL DIRECTOR PARKVIEW PHYSICIAN GROUP SENIOR VICE PRESIDENT FACILITY DESIGN AND OVERSIGHT EXECUTIVE DIRECTOR WOMEN AND CHILDREN'S SERVICES VICE PRESIDENT - PATIENT CARE - NOBLE VICE PRESIDENT - PATIENT CARE - WHITLEY VICE PRESIDENT - PATIENT CARE - LAGRANGE CORPORATE DIRECTOR MARKETING, COMMUNICATIONS, COMMUNITY RELATIONS VICE PRESIDENT/ADMINISTRATOR PRIMARY CARE PRACTICE GROUP EXECUTIVE DIRECTOR CANCER SERVICES VICE PRESIDENT CHANGING SPACES CONSTRUCTION/PROJECT MANAGEMENT MEDICAL DIRECTOR HEALTH PLAN SERVICES CORPORATE DIRECTOR DIETETICS/FOOD SERVICES VICE PRESIDENT PLANNING AND DECISION SUPPORT VICE PRESIDENT STRATEGIC AND BUSINESS PLANNING VICE PRESIDENT HEALTH INFORMATION MANAGEMENT EXECUTIVE DIRECTOR PKV OUTPATIENT ENTERPRISE VICE PRESIDENT/ADMINISTRATOR SPECIALTY PRACTICE GROUP VP SPECIAL PROJECTS VP PPG FINANCE VP SUPPLY CHAIN COO PARKVIEW HEART INSTITUTE 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, 2010 WAS 510. THE TOTAL NUMBER OF EMPLOYEES REPORTED ON FORM W-3 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2010 WAS 7,707. FOR PURPOSES OF COMPLETING FORM 990, PART V, LINE 1A AND 2A, THE NUMBER REPORTED FOR THE PARKVIEW HOSPITAL, INC. WAS 175 AND 3,910 RESPECTIVELY. AS REFLECTED IN PART VII, SECTION B, APPROXIMATELY 11 INDEPENDENT CONTRACTORS RECEIVED MORE THAN $100,000 IN COMPENSATION FOR SERVICES FROM PARKVIEW HOSPITAL, INC. AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII, SECTION A, COLUMN B: MICHAEL PACKNETT (DIRECTOR/PH CEO), MICHAEL BROWNING (CURRENT PH SVP & CFO), JEFFREY FRANCIS (PH SVP & CFO), AND STANTON RISSER (INTERIM PH CFO) DEVOTED APPROXIMATELY 40 HOURS PER WEEK TO PARKVIEW HEALTH SYSTEM, INC. (PH), AND ONE HOUR PER WEEK TO EACH OF THE FOLLOWING TAX-EXEMPT AND TAXABLE ORGANIZATIONS RELATED TO PH: PARKVIEW HOSPITAL, INC. (PVHOS) - FILING ORGANIZATION PARKVIEW OCCUPATIONAL HEALTH CENTERS, INC. (POHCI) HUNTINGTON MEMORIAL HOSPITAL, INC. (HMHOS) COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. (LGHOS) COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. (NBHOS) WHITLEY MEMORIAL HOSPITAL, INC. (WMHOS) PARKVIEW FOUNDATION, INC. (PVFND) PARKVIEW HUNTINGTON HOSPITAL FOUNDATION, INC. (HMFND) COMMUNITY HOSPITAL OF NOBLE COUNTY FOUNDATION, INC. (NBFND) WHITLEY MEMORIAL HOSPITAL FOUNDATION, INC. (WMFND) PARKVIEW PROFESSIONAL PROGRAMS, INC. (PPP) MIDWEST COMMUNITY HEALTH ASSOCIATES, INC. (MCHA) ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH, LLC (ORTHO) MANAGED CARE SERVICES, LLC (MCS) FOUNDATION SURGERY AFFILIATE OF FORT WAYNE, LLC (ISCLC) PARKVIEW IMAGING HUNTINGTON, LLC (PIHLC) THOMAS BOND (DIRECTOR/PH PHYSICIAN) DEVOTED APPROXIMATELY 1 HOUR PER WEEK TO PVHOS AND 40 HOURS PER WEEK TO PH. LARRY BAGWELL (DIRECTOR) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO PVHOS AND ONE HOUR PER WEEK TO PH. THOMAS BEAVER (DIRECTOR/CHAIR) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO PVHOS AND ONE HOUR PER WEEK TO PH. STEVE CORONA (DIRECTOR) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO PVHOS AND ONE HOUR PER WEEK TO PH. DAVID HAIST (DIRECTOR) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO PVHOS AND ONE HOUR PER WEEK TO PH. HERB HERNANDEZ (DIRECTOR) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO PVFND, ONE HOUR PER WEEK TO PH AND ONE PER WEEK TO PVHOS. THOMAS KIMBROUGH (DIRECTOR/VICE-CHAIR) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO PVHOS AND ONE HOUR PER WEEK TO PH. SHERRI MILLER (DIRECTOR) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO PVFND, ONE HOUR PER WEEK TO PH AND ONE PER WEEK TO PVHOS. MARILYN MORAN-TOWNSEND (DIRECTOR/SECRETARY) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO PVHOS AND ONE HOUR PER WEEK TO PH. CHRISTINE RUPP (DIRECTOR/TREASURER) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO PVFND, ONE HOUR PER WEEK TO PH AND ONE PER WEEK TO PVHOS. WIL SMITH (DIRECTOR) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO PVHOS AND ONE HOUR PER WEEK TO PH. THOMAS GUTWEIN (PVHOS MEDICAL DIR ECC) DEVOTED APPROXIMATELY 40 HOURS PER WEEK TO PVHOS AND ONE HOUR PER WEEK TO PVSYS. 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. CORPORATE SERVICE ALLOCATION FORM 990, PART IX, LINE 24A IN 2009, THE CORPORATE SERVICE ALLOCATION MADE A DISTINCTION BETWEEN SALARIES, BENEFITS, AND PURCHASED SERVICES. IN 2009, AMOUNTS DESIGNATED AS SALARIES AND BENEFITS WITHIN THE CORPORATE SERVICE ALLOCATION WERE RECLASSIFIED TO LINES 5-10 ACCORDINGLY. IN 2010, THE CORPORATE SERVICE ALLOCATION DOES NOT MAKE A DISTINCTION BETWEEN SALARIES, BENEFITS, AND PURCHASED SERVICES. DUE TO THIS CHANGE, IN 2010, SALARIES AND BENEFITS ARE NOT RECLASSIFIED TO LINES 5-10. WHEN COMPARING 2009 TO 2010 BALANCES, THE AMOUNTS REPORTED ON LINES 5-10 VERSUS LINE 24A INCREASE / DECREASE BY APPROXIMATELY THE SAME AMOUNT. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 938,801. ASSET TRANSFERS/ADJUSTMENTS 62,636. CURRENT YEAR EARNINGS TRANSFERRED TO PARENT -25,106,710. INCOME (LOSS) FROM HOSPITAL LAUNDRY SERVICE, INC. -34,732. INCOME (LOSS) FROM PARKVIEW PROFESSIONAL PROGRAMS, INC. 1,998,037. BOOK/TAX DIFFERENCES K-1'S -25,043. TOTAL TO FORM 990, PART XI, LINE 5: -22,167,011. REQUIREMENTS UNDER SINGLE AUDIT ACT AND OMB CIRCULAR A-133 FORM 990, PART XII, LINE 3: AS REQUIRED BY THE U.S. OFFICE OF MANAGEMENT AND BUDGET CIRCULAR A-133, AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS, IN 2010 PARKVIEW HEALTH SYSTEM, INC. AND SUBSIDIARIES RECEIVED AN AUDIT FOR THE 2009 CONSOLIDATED FINANCIAL STATEMENTS IN ACCORDANCE WITH THE SINGLE AUDIT ACT. PARKVIEW HOSPITAL, INC. IS A SUBSIDIARY CORPORATION OF PARKVIEW HEALTH SYSTEM, INC. 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 2200 RANDALLIA DRIVE FORT WAYNE IN 46805 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 353 N OAK STREET 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 C 14822049 2308214 1.00000 PARKVIEW PROFESSIONAL BILLINGS INC 2200 RANDALLIA DRIVE FORT WAYNE IN 46805 351950305 BILLING IN C 1680 1.00000 1 0 1 0 0 0 0 0 1 1 0 0 0 0 1 0 1 0 PARKVIEW FOUNDATION INC A 25263 PART VII SUPPLEMENTAL INFORMATION PARKVIEW FOUNDATION INC C 391856 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.