COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC (EIN 20-2401676)
Tax period: 2010-01-01 to 2010-12-31
Filed: 2011-11-08
IRS object ID: 201143129349301854
Schema version: 2010v3.4
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-11-08T12:26:11-06:00	Timestamp
Tax Period End Date	2010-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CROWE HORWATH LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	330 E JEFFERSON BLVD P O BOX 7	AddressLine1
City	SOUTH BEND	City
State	IN	State
ZIP Code	466240007	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2010-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	202401676	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	COMM	NameControl
Phone	2603738407	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	207 N TOWNLINE RD	AddressLine1
City	LAGRANGE	City
State	IN	State
ZIP Code	46761	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	MICHAEL P BROWNING	Name
Title	PH SVP & CFO	Title
Phone	2603738407	Phone
Date Signed	2011-11-08	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	KENNETH J KEBER	Name
Phone	5742323992	Phone

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	MICHAEL PACKNETT	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	10501 CORPORATE DRIVE	AddressLine1
City	FORT WAYNE	City
State	IN	State
ZIP Code	46845	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	27551928	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.PARKVIEW.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	2005	YearFormation
State Legal Domicile	IN	StateLegalDomicile
Activity Or Mission Description	COMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	11	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	7	NbrIndependentVotingMembers
Total Nbr Employees	236	TotalNbrEmployees
Total Nbr Volunteers	54	TotalNbrVolunteers
Total Gross UBI	-2078	TotalGrossUBI
Net Unrelated Business Txbl Income	-2078	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	74614	ContributionsGrantsPriorYear
Contributions Grants Current Year	107637	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	27152074	ProgramServiceRevenuePriorYear
Program Service Revenue CY	27252786	ProgramServiceRevenueCY
Investment Income Prior Year	11231	InvestmentIncomePriorYear
Investment Income Current Year	-43854	InvestmentIncomeCurrentYear
Other Revenue Prior Year	147805	OtherRevenuePriorYear
Other Revenue Current Year	170448	OtherRevenueCurrentYear
Total Revenue Prior Year	27385724	TotalRevenuePriorYear
Total Revenue Current Year	27487017	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	33882	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	37716	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	12742142	SalariesEtcPriorYear
Salaries Etc Current Year	10295293	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	19923	TotalFundrsngExpCurrentYear
Other Expense Prior Year	14765253	OtherExpensePriorYear
Other Expenses Current Year	17452693	OtherExpensesCurrentYear
Total Expenses Prior Year	27541277	TotalExpensesPriorYear
Total Expenses Current Year	27785702	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-155553	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-298685	RevenuesLessExpensesCY
Total Assets BOY	36622844	TotalAssetsBOY
Total Assets EOY	33293052	TotalAssetsEOY
Total Liabilities BOY	37847536	TotalLiabilitiesBOY
Total Liabilities EOY	35526008	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	-1224692	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	-2232956	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	COMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	22384405	Expense
Grants	37716	Grants
Revenue	27265998	Revenue
Description	COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IMPROVED AND EXPANDED FACILITIES:COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. OPENED ITS ALL-NEW $25 MILLION REPLACEMENT FACILITY IN JULY OF 2008. THE 25-BED CRITICAL ACCESS FACILITY FEATURES ALL PRIVATE ROOMS AND BLENDS THE LATEST IN HEALTHCARE TECHNOLOGY WITH AMENITIES THAT INCORPORATE THE UNIQUE FLAVOR OF LAGRANGE COUNTY. THE EMERGENCY DEPARTMENT IN THE NEW HOSPITAL IS THREE TIMES AS LARGE AS THAT OF THE OLD FACILITY. WITH FOUR PRIVATE EXAM ROOMS, TWO TRAUMA ROOMS AND THREE OBSERVATION ROOMS, EMERGENCY SERVICES ARE GREATLY ENHANCED AS ARE PATIENTS' COMFORT AND PRIVACY. TWO STATE-OF-THE-ART SURGICAL SUITES AND AN ADDITIONAL MINOR PROCEDURE ROOM PROVIDE THE RESOURCES TO EXPAND SURGICAL SERVICES TO INCLUDE ORTHOPAEDIC, GYNECOLOGIC AND OTHER PROCEDURES TO COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. THAT WERE PREVIOUSLY UNAVAILABLE.NEW EQUIPMENT IN THE CRITICAL CARE UNIT INCORPORATES THE ELECTRONIC INTENSIVE CARE UNIT (EICU) SYSTEM WITH AN EICU ROBOT. THIS TECHNOLOGY BRINGS A HIGHER LEVEL OF CARE TO CRITICALLY ILL PATIENTS AND A GREATER PEACE OF MIND TO THEIR FAMILIES. MONITORING SYSTEMS BUILT INTO TWO OF THE HOSPITAL'S EICU ROOMS TRANSMIT PATIENT DATA TO THE LOCAL NURSING STATION DOWN THE HALL AND TO BOARD-CERTIFIED INTENSIVISTS OR CRITICAL CARE SPECIALISTS AT AN OFF-SITE LOCATION. THE EICU SYSTEM PROVIDES AN ADDITIONAL LEVEL OF SERVICE THAT MAKES IT POSSIBLE FOR MORE PATIENTS TO RECEIVE CARE LOCALLY.TECHNOLOGY IS ONLY A PIECE OF THE PICTURE. LOCAL AMISH WOODWORKERS WERE CONTRACTED TO CREATE HANDCRAFTED FURNISHINGS FOR THE MAIN LOBBY AND SECOND FLOOR WAITING AREA. FRAMED, LOCALLY MADE QUILTS AND ICONIC IMAGES OF LAGRANGE COUNTY PHOTOGRAPHED BY A LOCAL PHOTOGRAPHER SERVE AS ARTWORK THROUGHOUT THE FACILITY. FOR VISITORS FROM OUTSIDE THE COUNTY, THE AMBIENCE CREATED IS WARM AND WELCOMING; FOR PATIENTS AND VISITORS FROM LAGRANGE, THE FURNITURE AND ARTWORK OFFER SOMETHING FAMILIAR AND COMFORTING, A REMINDER OF HOME.COMMUNITY HEALTH IMPROVEMENT:AS A NOT-FOR-PROFIT HOSPITAL, WE TAKE OUR MISSION TO HEART. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. EXISTS FOR ONE PURPOSE - TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. GIVES BACK TO THE COMMUNITY IN THE FORM OF IMPROVED FACILITIES, EDUCATION AND OUTREACH PROGRAMS, FREE AND DISCOUNTED CARE, VOLUNTEERISM AND MUCH MORE. THE FOLLOWING ARE SOME OF THE WAYS COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IS REACHING OUT TO MAKE OUR NEIGHBORHOODS AND COMMUNITIES HEALTHIER:-CHARITY CARE -COMMUNITY HEALTH IMPROVEMENT INITIATIVES-PRIMARY HEALTH CARE/ACCESS -HEALTH SCREENING AND PREVENTION -DISEASE MANAGEMENTCHARITY CARE:COMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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:COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. BECAME PART OF THE PARKVIEW FAMILY DURING 2005. THE PURPOSE OF COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.'S COMMUNITY HEALTH IMPROVEMENT PROGRAM IS TO FUND COMMUNITY HEALTH IMPROVEMENT EFFORTS WITHIN THE SERVICE AREA OF COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. THE HOSPITAL SETS ASIDE UP TO 10 PERCENT OF ITS NET INCOME ANNUALLY TO FUND COMMUNITY HEALTH INITIATIVES, AND PARTNERS WITH COMMUNITY ORGANIZATIONS TO ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF LAGRANGE COUNTY.KEY INITIATIVES INCLUDE:PLAIN CHURCH SERVICES:AMISH AND PLAIN CHURCH RESIDENTS MAKE UP NEARLY 40% OF THE POPULATION IN LAGRANGE COUNTY. FOR THE MEMBERS OF THESE FAITH-BASED COMMUNITIES - PARTICULARLY THE AMISH - EVERYDAY TRAVEL IS BY HORSE AND BUGGY OR BICYCLE; COMMUNICATIONS ARE FACE-TO-FACE OR THROUGH THE USE OF A COMMUNITY-OWNED, CENTRALLY LOCATED PHONE. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. PARTNERS WITH "HIRED DRIVERS" WHO SERVE THE AMISH POPULATION AS A COMMON FORM OF TRANSPORTATION TO AND FROM APPOINTMENTS AT THE HOSPITAL. RECOGNIZING THE DIVERSE CIRCUMSTANCES OF THESE COMMUNITIES, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. REPRESENTATIVES AND THE PLAIN CHURCH COORDINATOR HAVE BEEN WORKING CLOSELY WITH MEMBERS OF THE PLAIN CHURCH COMMUNITY FOR SEVERAL YEARS, HELPING TO IDENTIFY SPECIFIC HEALTH NEEDS AND DEVELOP SYSTEMS TO ADDRESS THEM. THE PLAIN CHURCH COORDINATOR SERVES AS A SINGLE POINT OF ACCESS FOR AMISH, MENNONITE AND OTHER PLAIN CHURCH MEMBERS WHO HAVE QUESTIONS ABOUT THE HEALTHCARE SERVICES AVAILABLE WITHIN THE PARKVIEW HEALTH SYSTEM. WHETHER THE QUESTION CONCERNS THE APPROXIMATE COST OF A PROCEDURE, THE SCHEDULING OF A DIAGNOSTIC TEST, OR A BILLING QUESTION, THE PLAIN CHURCH COORDINATOR WILL ASSIST INDIVIDUALS AND FAMILIES BY OBTAINING AN ANSWER.HEALTH EDUCATION AND INFORMATION:"HEALTHY VIEW" COMMUNITY NEWSLETTER IS MAILED QUARTERLY TO ALL HOUSEHOLDS IN LAGRANGE COUNTY AND TARGETED HOUSEHOLDS IN MIDDLEBURY AND STURGIS (MI). THE PUBLICATION OFFERS HEALTH INFORMATION ON LEADING TOPICS OF INTEREST INCLUDING CANCER, HEART DISEASE, DIABETES, AND MORE, AND MAKES READERS AWARE OF NEW SERVICES AT COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. THE PUBLICATION IS OF PARTICULAR VALUE TO THE PLAIN CHURCH COMMUNITIES WHO DO NOT RECEIVE INFORMATION THROUGH TELEVISION, RADIO OR OTHER ELECTRONIC MEANS.PRIMARY HEALTH CARE ACCESS:COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. PARTNERED WITH THE LAGRANGE COUNTY COUNCIL ON AGING TO ASSIST WITH OPERATIONAL SUPPORT FOR THE COA'S SERVICES TO SENIORS. THE COA PROVIDES A TRANSPORTATION PROGRAM, HOMEMAKER SERVICES, A FOOD PANTRY AND MUCH MORE IN THEIR EFFORTS TO HELP SENIORS IN LAGRANGE COUNTY REMAIN INDEPENDENT IN THE HOMES OF THEIR CHOICE FOR AS LONG AS POSSIBLE. NEARLY HALF OF THE TRIPS THE COA OFFERS TO SENIORS ARE TO THEIR PHYSICIAN FOR A CHECK-UP OR TO THE HOSPITAL FOR A TEST OR TREATMENT. HOMEMAKER SERVICES HELP WITH DAY-TO-DAY TASKS THAT, IN MANY CASES, COULD PUT THE SENIOR AT RISK OF A FALL OR OTHER INJURY.HEALTH SCREENING AND PREVENTION AND DISEASE MANAGEMENT:COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. PARTICIPATES IN NUMEROUS HEALTH FAIRS AND ACTIVITIES THROUGHOUT THE YEAR OFFERING FREE AND LOW COST HEALTH SCREENINGS AND INFORMATION TO DIVERSE POPULATIONS IN OUR SERVICE AREA, INCLUDING THE PLAIN CHURCH AND HISPANIC RESIDENTS AND SENIORS WHO RESIDE IN THE COUNTY. THESE EVENTS PROVIDE HEALTH EDUCATION, HEALTH SCREENINGS FOR DISEASE PREVENTION, AND PROMOTE HEALTHY LIFESTYLES. THE HOSPITAL ALSO PROVIDES SUPPORT GROUPS TO ASSIST PATIENTS AND FAMILIES IN MANAGING DISEASE.	Description
Total Program Service Expense	22384405	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	0	ReportOtherLiabilities
Report Fin48 Footnote	0	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	1	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	1	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Info In Schedule O Part V	X	InfoInScheduleOPartV
Number Forms Transmitted With1096	28	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	236	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	1	QuidProQuoContributions
Quid Pro Quo Disclosure	1	QuidProQuoDisclosure
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	11	NbrVotingGoverningBodyMembers
Number Independent Voting Members	7	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	1	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	IN	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	MICHAEL P BROWNING	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	2603738407	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	10501 CORPORATE DRIVE	AddressLine1
City	FORT WAYNE	City
State	IN	State
ZIP Code	46845	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
ROBERT MYERS
DIRECTOR/LGHOS SVP & COO	40.00	X	X	212093	0	47252
MICHAEL PACKNETT
DIRECTOR/PH CEO	1.00	X	X	0	912103	158919
LISA BOOTH
DIRECTOR/PH PHYSICIAN	1.00	X		18010	72293	4157
MIROSLAW FOLTYNIAK
DIRECTOR/PH PHYSICIAN	1.00	X		12087	374488	45172
STEPHANIE GOUGH
DIRECTOR/TREASURER	1.00	X		5500	750	0
KEVIN LAMBRIGHT
DIRECTOR	1.00	X		4000	0	0
DENNIS LEHMAN
DIRECTOR	1.00	X		5250	0	0
THOMAS MILLER
DIRECTOR/SECRETARY	1.00	X		5500	0	0
GENE MORY
DIRECTOR	1.00	X		5750	0	0
JOE PIERCE
DIRECTOR/VICE CHAIR	1.00	X		6250	2250	0
JOHN PRICE
DIRECTOR/CHAIR	1.00	X		7250	3000	0
MICHAEL BROWNING
CURRENT PH SVP & CFO	1.00		X	0	80871	5343
JEFFREY FRANCIS
PH SVP & CFO	1.00		X	0	206802	15269
STANTON RISSER
INTERIM PH CFO	1.00		X	0	138872	24814
MARGARET MCKEE
LGHOS VP	40.00			143002	0	34450	X
BRENDA ARMENTROUT
LGHOS MGR PHARMACY	40.00			134269	0	14770	X
CHITTARANJAN PATEL
LGHOS PHARMACIST	40.00			103828	0	9974	X
CHARLES MASON
PH PRESIDENT EMERITUS	0.00			0	448413	0		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	662789	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	2239842	TotalReportableCompFrmRltdOrgs
Total Other Compensation	360120	TotalOtherCompensation
Number Individuals GT100 K	4	NumberIndividualsGT100K
Formers Listed	1	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	GREAT LAKES ANESTHESIA PC	BusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	500 N NAPPANEE ST STE 11-B	AddressLine1
City	ELKHART	City
State	IN	State
ZIP Code	46514	ZIPCode

Field	Value	IRS element (for citing)
Description Of Services	ANESTHESIOLOGISTS	DescriptionOfServices
Compensation	136205	Compensation

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	1	NumberOfContractorsGT100K
Federated Campaigns	1505	FederatedCampaigns
Fundraising Events	20556	FundraisingEvents
Related Organizations	460	RelatedOrganizations
Government Grants	30734	GovernmentGrants
All Other Contributions	54382	AllOtherContributions
Noncash Contributions	5119	NoncashContributions
Total Contributions	107637	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE	622000	26774825	26774825
EMS SUBSIDY	900099	219600	219600
PHARMACY	446110	201808	201808
RENTAL INCOME FROM AFF	531120	38714	38714
SPEECH THERAPY	621300	12412	12412

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	5427	TotalRevenueColumn
Related Or Exempt Function Income	5427	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	27252786	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	2581	TotalRevenueColumn
Exclusion	$2,581	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	3133	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	5211	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	-2078	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	-2078	TotalRevenueColumn
Unrelated Business Revenue	-2078	UnrelatedBusinessRevenue

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	4380	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	50815	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Other	-46435	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-46435	TotalRevenueColumn
Exclusion	-$46,435	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	5139	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	20556	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	8885	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	-3746	TotalRevenueColumn
Exclusion	-$3,746	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
CAFETERIA REVENUE	722210	143740	$143,740
GIFT SHOP REVENUE	453220	13070	$13,070
MEDICAL STAFF CREDENTI	561499	6250	$6,250

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	13212	TotalRevenueColumn
Related Or Exempt Function Income	13212	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	176272	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	27487017	TotalRevenueColumn
Related Or Exempt Function Income	27265998	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	-2078	UnrelatedBusinessRevenue
Exclusion	$115,460	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	25142	Total
Program Services	25142	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	12574	Total
Program Services	12574	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	331184	Total
Management And General	331184	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	7577521	Total
Program Services	7512059	ProgramServices
Management And General	51488	ManagementAndGeneral
Fundraising	13974	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	2386588	Total
Program Services	2326769	ProgramServices
Management And General	55452	ManagementAndGeneral
Fundraising	4367	Fundraising

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	2987916	Total
Program Services	2729441	ProgramServices
Management And General	258475	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	7145	Total
Program Services	6838	ProgramServices
Management And General	25	ManagementAndGeneral
Fundraising	282	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	3072644	Total
Program Services	3047459	ProgramServices
Management And General	24749	ManagementAndGeneral
Fundraising	436	Fundraising

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	487150	Total
Program Services	479469	ProgramServices
Management And General	7681	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	30091	Total
Program Services	22534	ProgramServices
Management And General	6693	ManagementAndGeneral
Fundraising	864	Fundraising

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	29836	Total
Program Services	17586	ProgramServices
Management And General	12250	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	844863	Total
Program Services	844863	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	2090746	Total
Program Services	2081923	ProgramServices
Management And General	8823	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Management And GeneralManagementAndGeneral	Program ServicesProgramServices
CORP SERVICE ALLOCATION	4581948	4581948
BAD DEBT	2326699		2326699
PH SUBSIDY	824451		824451
PHYSICIAN RECRUITMENT	88981		88981
DUES & SUBSCRIPTIONS	45277	35219	10058

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	34946	Total
Program Services	27559	ProgramServices
Management And General	7387	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	27785702	Total
Program Services	22384405	ProgramServices
Management And General	5381374	ManagementAndGeneral
Fundraising	19923	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	1250	BOY
EOY	1250	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	665	BOY
EOY	10519	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	14913	BOY
EOY	10708	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	3291937	BOY
EOY	2930266	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	222811	BOY
EOY	179720	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	8920	BOY
EOY	46357	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	30343292	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	6299264	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	26125708	BOY
EOY	24044028	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	267	BOY
EOY	1246	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	5011241	BOY
EOY	5011241	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	1945132	BOY
EOY	1057717	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	36622844	BOY
EOY	33293052	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	667498	BOY
EOY	761858	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	23704662	BOY
EOY	23088658	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	2796120	BOY
EOY	1079251	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	10596241	BOY
EOY	10596241	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	83015	BOY
EOY	0	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	37847536	BOY
EOY	35526008	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	-1224692	BOY
EOY	-2232956	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	-1224692	BOY
EOY	-2232956	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	36622844	BOY
EOY	33293052	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	-298685	ReconcilationRevenueExpenses
Reconcilation Other Changes	-709579	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	1	FederalGrantAuditRequired
Federal Grant Audit Performed	1	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$2,984	OtherActivitiesAmount
Total Lobbying Expenditures IIB	2984	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF OTHER LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1I:	ReturnReference
Explanation	A PORTION OF THE DUES PAID TO INDIANA HOSPITAL AND HEALTH ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION WERE USED FOR LOBBYING ACTIVITIES.	Explanation

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	265000	OtherCostOrOtherBasis
Book Value	265000	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	13230046	OtherCostOrOtherBasis
Depreciation	945981	Depreciation
Book Value	12284065	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	29098	OtherCostOrOtherBasis
Depreciation	16970	Depreciation
Book Value	12128	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	14928007	OtherCostOrOtherBasis
Depreciation	4893720	Depreciation
Book Value	10034287	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1891141	OtherCostOrOtherBasis
Depreciation	442593	Depreciation
Book Value	1448548	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	24044028	TotalOfBookValueLandBuildings

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	LAGRANGE PADDLE	NameOfEvent1
Gross Receipts Event1	15542	GrossReceiptsEvent1
Charitable Contributions Event1	12227	CharitableContributionsEvent1
Gross Revenue Event1	3315	GrossRevenueEvent1
Non Cash Prizes Event1	778	NonCashPrizesEvent1
Rent Facility Costs Event1	1569	RentFacilityCostsEvent1
Food And Beverage Event1	1144	FoodAndBeverageEvent1
Other Direct Expenses Event1	1127	OtherDirectExpensesEvent1
Name Of Event2	FESTIVAL OF TREES	NameOfEvent2
Gross Receipts Event2	10153	GrossReceiptsEvent2
Charitable Contributions Event2	8329	CharitableContributionsEvent2
Gross Revenue Event2	1824	GrossRevenueEvent2
Cash Prizes Event2	64	CashPrizesEvent2
Non Cash Prizes Event2	1368	NonCashPrizesEvent2
Rent Facility Costs Event2	136	RentFacilityCostsEvent2
Food And Beverage Event2	1833	FoodAndBeverageEvent2
Entertainment Event2	112	EntertainmentEvent2
Other Direct Expenses Event2	754	OtherDirectExpensesEvent2
Gross Receipts Total	25695	GrossReceiptsTotal
Charitable Contributions Total	20556	CharitableContributionsTotal
Gross Revenue Total Events	5139	GrossRevenueTotalEvents
Cash Prizes Total Events	64	CashPrizesTotalEvents
Non Cash Prizes Total Events	2146	NonCashPrizesTotalEvents
Rent Facility Costs Total Events	1705	RentFacilityCostsTotalEvents
Food And Beverage Total Events	2977	FoodAndBeverageTotalEvents
Entertainment Total Events	112	EntertainmentTotalEvents
Other Direct Expenses Total Events	1881	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	8885	DirectExpenseSummaryEvents
Net Income Summary	-3746	NetIncomeSummary

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	0	FPGReferenceDiscountedCare
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	825761	TotalCommunityBenefitExpense
Net Community Benefit Expense	825761	NetCommunityBenefitExpense
Percent Of Total Expense	0.03240	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2488095	TotalCommunityBenefitExpense
Direct Offsetting Revenue	696740	DirectOffsettingRevenue
Net Community Benefit Expense	1791355	NetCommunityBenefitExpense
Percent Of Total Expense	0.07040	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	305756	TotalCommunityBenefitExpense
Direct Offsetting Revenue	288434	DirectOffsettingRevenue
Net Community Benefit Expense	17322	NetCommunityBenefitExpense
Percent Of Total Expense	0.00070	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3619612	TotalCommunityBenefitExpense
Direct Offsetting Revenue	985174	DirectOffsettingRevenue
Net Community Benefit Expense	2634438	NetCommunityBenefitExpense
Percent Of Total Expense	0.10350	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	237397	TotalCommunityBenefitExpense
Direct Offsetting Revenue	179099	DirectOffsettingRevenue
Net Community Benefit Expense	58298	NetCommunityBenefitExpense
Percent Of Total Expense	0.00230	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2860	TotalCommunityBenefitExpense
Net Community Benefit Expense	2860	NetCommunityBenefitExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1099732	TotalCommunityBenefitExpense
Net Community Benefit Expense	1099732	NetCommunityBenefitExpense
Percent Of Total Expense	0.04320	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	71359	TotalCommunityBenefitExpense
Net Community Benefit Expense	71359	NetCommunityBenefitExpense
Percent Of Total Expense	0.00280	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1411348	TotalCommunityBenefitExpense
Direct Offsetting Revenue	179099	DirectOffsettingRevenue
Net Community Benefit Expense	1232249	NetCommunityBenefitExpense
Percent Of Total Expense	0.04840	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	5030960	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1164273	DirectOffsettingRevenue
Net Community Benefit Expense	3866687	NetCommunityBenefitExpense
Percent Of Total Expense	0.15190	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	110972	TotalCommunityBuildingExpense
Net Community Building Expense	110972	NetCommunityBuildingExpense
Percent Of Total Expense	0.00440	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	110972	TotalCommunityBuildingExpense
Net Community Building Expense	110972	NetCommunityBuildingExpense
Percent Of Total Expense	0.00440	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$890,853	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	6136566	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	6078846	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	57720	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY HOSPITAL OF LAGRANGE COUNTY	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	207 N TOWNLINE RD	AddressLine1
City	LAGRANGE	City
State	IN	State
ZIP Code	46761	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Critical Access Hospital	X	CriticalAccessHospital
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	NOT REQUIRED	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	1	NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	PARKVIEW LAGRANGE RADIOLOGY	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	8175 WEST US 20	AddressLine1
City	SHIPSHEWANA	City
State	IN	State
ZIP Code	46565	ZIPCode

Field	Value	IRS element (for citing)
Facility Type	DIAGNOSTIC RADIOLOGY SERVICES	FacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 3C: ELIGIBILITY CRITERIA FOR FREE OR DISCOUNTED CARECOMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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 7ACOMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IS COMMITTED TO PROVIDING CHARITY CARE TO PATIENTS UNABLE TO MEET THEIR FINANCIAL OBLIGATIONS. IT IS FURTHERMORE THE POLICY OF COMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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 7BCOMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. ACCEPTS ALL MEDICAID, MEDICAID MANAGED CARE, AND OUT-OF-STATE MEDICAID PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEDICAID PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING MEDICAID, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE UNREIMBURSED MEDICAID COST REPORTED ON LINE 7B IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE MEDICAID CHARGES ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF MEDICAID SERVICES RENDERED. THEN, THE COST OF MEDICAID SERVICES RENDERED IS DEDUCTED FROM THE REIMBURSEMENT RECEIVED FOR MEDICAID PATIENTS TO ARRIVE AT A GAIN/(LOSS) RELATIVE TO THESE PATIENTS.PART I, LINE 7CCOMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. ACCEPTS ALL MEANS-TESTED PATIENTS FROM THE HEALTHY INDIANA PLAN (HIP) WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEANS-TESTED PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING HIP, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE UNREIMBURSED HIP COST REPORTED ON LINE 7C IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE HIP CHARGES ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF HIP SERVICES RENDERED. THEN, THE COST OF HIP SERVICES RENDERED IS DEDUCTED FROM THE REIMBURSEMENT RECEIVED FOR HIP PATIENTS TO ARRIVE AT A GAIN/(LOSS) RELATIVE TO THESE PATIENTS.PART I, LINE 7EAMOUNTS PRESENTED ARE BASED ON ACTUAL SPEND FOR THOSE SERVICES AND BENEFITS PROVIDED DEEMED TO IMPROVE THE HEALTH OF THE COMMUNITIES IN WHICH WE SERVE AND CONFORM WITH THE MISSION OF OUR EXEMPT PURPOSE.PART I, LINE 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 7IIN KEEPING WITH OUR MISSION AND COMMITMENT TO THE COMMUNITIES IN WHICH WE SERVE, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. CONTINUES ITS TRADITION OF CONTRIBUTING TO NUMEROUS ORGANIZATIONS ON BOTH AN AS-NEEDED BASIS AND NEGOTIATED BASIS. AMOUNTS PRESENTED REPRESENT ACTUAL SPEND TO ORGANIZATIONS THROUGHOUT OUR COMMUNITIES.
PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. INCLUDED $774,447 IN COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC AS SUBSIDIZED HEALTH SERVICES.
PART I, L7 COL(F): PERCENT OF TOTAL EXPENSESCOMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. EXCLUDED $2,326,699 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.COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. SUPPORTS PHYSICIAN RECRUITMENT ACTIVITIES TO ASSIST IN TIMELY RESPONSE TO PATIENT CARE NEEDS IN THE COMMUNITY. THESE RECRUITMENT ACTIVITIES ARE BASED ON RESULTS OF A PERIODIC PHYSICIAN NEEDS ASSESSMENT. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. DEVELOPS A PHYSICIAN RECRUITMENT PLAN TO ADDRESS POTENTIAL GAPS IN PATIENT COVERAGE. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. STRIVES TO BRING THE BEST INTEGRATED, QUALITY, AND COST EFFECTIVE CARE AND INNOVATIVE TECHNOLOGY TO OUR COMMUNITIES. IN DOING SO, WE HAVE SPENT TIME AND ENERGY ON RECRUITING THE BEST TEAM OF PHYSICIANS. EVERY MEMBER OF COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.'S HEALTHCARE TEAM IS RESPONSIBLE FOR NURTURING AN ENVIRONMENT OF EXCELLENCE AS THE BEST PLACE FOR CO-WORKERS TO WORK, PHYSICIANS TO PRACTICE MEDICINE, AND PATIENTS TO RECEIVE CARE. WE ARE COMMITTED TO PROVIDING EXCELLENT, HIGH-QUALITY CUSTOMER SERVICE TO ALL PEOPLE. WE KNOW HOW IMPORTANT CLINICAL, SERVICE AND OPERATIONAL EXCELLENCE IS TO THE SUCCESS OF PARKVIEW HEALTH, AND WE RECOGNIZE HOW IMPORTANT COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.'S SUCCESS IS TO THE COMMUNITY.
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 COMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. ACCEPTS ALL MEDICARE PATIENTS, AS REFLECTED ON THE YEAR-END MEDICARE COST REPORT, WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS OR LONGFALLS. 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 OR LONGFALL. AS A RESULT, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. HAS TAKEN THE POSITION NOT TO INCLUDE THE MEDICARE SHORTFALLS OR LONGFALLS AS PART OF THE COMMUNITY BENEFIT REPORT THAT IS SUBMITTED TO THE STATE OF INDIANA. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. RECOGNIZES THAT THE SHORTFALL OR LONGFALL FROM MEDICARE DOES NOT INCLUDE THE COSTS AND REVENUES ASSOCIATED WITH MEDICARE ADVANTAGE PATIENTS. AS SUCH, THE TOTAL SHORTFALL OR LONGFALL 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.IN CONJUNCTION WITH PARKVIEW HEALTH SYSTEM, INC., COMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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 OF 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 THIS SURVEY HAS BEEN 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. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. REPRESENTATIVES HAVE RELATIONSHIPS THROUGHOUT THE COMMUNITY AND MEET REGULARLY WITH VARIOUS ORGANIZATIONS THAT SHARE COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.'S MISSION OF IMPROVING THE HEALTH OF THE COMMUNITIES.ADDITIONALLY, PARKVIEW HEALTH SYSTEM, INC. PLANS TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT BEGINNING IN 2012.
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 FOR THE APPLICABILITY OF GOVERNMENT ASSISTANCE AND OFFER FREE CARE APPLICATIONS TO PATIENTS WHO CANNOT AFFORD TO PAY THEIR BILLS.-THE ONLINE ACCOUNT MANAGER OF COMMUNITY HOSPITAL OF LAGRANGE COUNTY, 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 THE APPLICABILITY OF GOVERNMENT ASSISTANCE, AS WELL AS OFFERING FREE CARE APPLICATIONS TO PATIENTS WHO CANNOT AFFORD TO PAY THEIR BILLS.-OUTBOUND PHONE CALLS ARE MADE TO PATIENTS TO SET UP PAYMENT ARRANGEMENTS. IF A PATIENT CANNOT MAKE PAYMENT ON THEIR ACCOUNT, THEY WILL BE SCREENED FOR THE APPLICABILITY OF GOVERNMENT ASSISTANCE. ADDITIONALLY, FREE CARE APPLICATIONS WILL BE OFFERED TO PATIENTS WHO CANNOT AFFORD TO PAY THEIR BILLS.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.COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. PRIMARILY SERVES THE LAGRANGE COUNTY COMMUNITY WHICH INCLUDES LAGRANGE, SHIPSHEWANA, TOPEKA, AND WOLCOTTVILLE. AS THE ONLY HOSPITAL IN THIS COUNTY, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. ALSO SERVES, TO A LIMITED EXTENT, SURROUNDING COMMUNITIES. LAGRANGE COUNTY HAS APPROXIMATELY 37,128 RESIDENTS, PRIMARILY CAUCASIAN. THE COUNTY'S UNEMPLOYMENT RATE IS 12.9%. THE MEDIAN SALARY IN LAGRANGE COUNTY IS $45,578. AMISH AND PLAIN CHURCH RESIDENTS MAKE UP NEARLY 40% OF THE POPULATION IN LAGRANGE COUNTY. FOR THE MEMBERS OF THESE FAITH-BASED COMMUNITIES, PARTICULARLY THE AMISH, EVERYDAY TRAVEL IS BY HORSE AND BUGGY OR BICYCLE; COMMUNICATIONS ARE FACE-TO-FACE OR THROUGH THE USE OF A COMMUNITY-OWNED, CENTRALLY LOCATED PHONE. LAGRANGE ALSO SERVICES A LARGE NUMBER OF HISPANIC RESIDENTS.
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.).COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.'S BOARD OF DIRECTORS IS COMPOSED OF MEMBERS, OF WHICH SUBSTANTIALLY ALL ARE INDEPENDENT COMMUNITY MEMBERS. A MAJORITY OF THE BOARD RESIDES IN COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.'S PRIMARY SERVICE AREA. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. PEOPLE THROUGHOUT THE COMMUNITY CAN COUNT ON COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. TO BE STANDING BY WITH EMERGENCY CARE 24 HOURS A DAY, 365 DAYS A YEAR. THE EMERGENCY DEPARTMENT IS STAFFED WITH BOARD-CERTIFIED EMERGENCY CARE PHYSICIANS AND A NURSING STAFF THAT IS TRAINED AND EXPERIENCED IN EMERGENCY CARE. FURTHERMORE, NO PATIENT IS EVER DENIED TREATMENT, REGARDLESS OF THEIR ABILITY TO PAY.ADDITIONALLY, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. OPENED ITS ALL-NEW $25 MILLION REPLACEMENT FACILITY IN JULY OF 2008. THE 25-BED CRITICAL ACCESS FACILITY FEATURES ALL PRIVATE ROOMS AND BLENDS THE LATEST IN HEALTHCARE TECHNOLOGY WITH AMENITIES THAT INCORPORATE THE UNIQUE FLAVOR OF LAGRANGE COUNTY. LOCAL AMISH WOODWORKERS WERE CONTRACTED TO CREATE HANDCRAFTED FURNISHINGS FOR THE MAIN LOBBY AND SECOND FLOOR WAITING AREA. FRAMED, LOCALLY MADE QUILTS AND ICONIC IMAGES OF LAGRANGE COUNTY PHOTOGRAPHED BY A LOCAL PHOTOGRAPHER SERVE AS ARTWORK THROUGHOUT THE FACILITY. FOR VISITORS FROM OUTSIDE THE COUNTY, THE AMBIENCE CREATED IS WARM AND WELCOMING; FOR PATIENTS AND VISITORS FROM LAGRANGE, THE FURNITURE AND ARTWORK OFFERS SOMETHING FAMILIAR AND COMFORTING, A REMINDER OF HOME.COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. GIVES BACK TO THE COMMUNITY IN THE FORM OF IMPROVED FACILITIES, EDUCATION AND OUTREACH PROGRAMS, FREE AND DISCOUNTED CARE, VOLUNTEERISM AND MUCH MORE. THE FOLLOWING ARE SOME OF THE WAYS COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IS REACHING OUT TO MAKE OUR NEIGHBORHOODS AND COMMUNITIES HEALTHIER:-COMMUNITY HEALTH IMPROVEMENT INITIATIVES: COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. BECAME PART OF THE PARKVIEW HEALTH SYSTEM, INC. FAMILY DURING 2005. THE PURPOSE OF COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.'S COMMUNITY HEALTH IMPROVEMENT PROGRAM IS TO FUND COMMUNITY HEALTH IMPROVEMENT EFFORTS WITHIN THE SERVICE AREA OF COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. THE HOSPITAL ANNUALLY FUNDS COMMUNITY HEALTH INITIATIVES, AND PARTNERS WITH COMMUNITY ORGANIZATIONS TO ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF LAGRANGE COUNTY.-PLAIN CHURCH SERVICES: AMISH AND PLAIN CHURCH RESIDENTS MAKE UP A LARGE PART OF THE POPULATION IN LAGRANGE COUNTY. RECOGNIZING THE DIVERSE CIRCUMSTANCES OF THESE COMMUNITIES, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. REPRESENTATIVES HAVE BEEN WORKING CLOSELY WITH MEMBERS OF THE PLAIN CHURCH COMMUNITY FOR SEVERAL YEARS, HELPING TO IDENTIFY SPECIFIC NEEDS AND DEVELOP SYSTEMS TO ADDRESS THEM. THE MOST RECENT INITIATIVE IS THE ADDITION OF A PLAIN CHURCH COORDINATOR POSITION AT COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. THE PLAIN CHURCH COORDINATOR SERVES AS A SINGLE POINT OF ACCESS FOR AMISH, MENNONITE AND OTHER PLAIN CHURCH MEMBERS WHO HAVE QUESTIONS ABOUT THE AVAILABILITY OF HEALTHCARE SERVICES. WHETHER THE QUESTION CONCERNS THE APPROXIMATE COST OF A PROCEDURE, THE SCHEDULING OF A DIAGNOSTIC TEST, OR A BILLING QUESTION, THE PLAIN CHURCH COORDINATOR WILL ASSIST THE CALLER IN OBTAINING AN ANSWER.-HEALTH EDUCATION AND INFORMATION:"HEALTHY VIEW" COMMUNITY NEWSLETTER IS MAILED QUARTERLY TO ALL HOUSEHOLDS IN LAGRANGE COUNTY AND TARGETED HOUSEHOLDS IN MIDDLEBURY AND STURGIS (MI). THE PUBLICATION OFFERS HEALTH INFORMATION ON LEADING TOPICS OF INTEREST INCLUDING CANCER, HEART DISEASE, DIABETES, AND MORE, AND MAKES READERS AWARE OF NEW SERVICES AT PARKVIEW LAGRANGE HOSPITAL. THE PUBLICATION IS OF PARTICULAR VALUE TO THE PLAIN CHURCH COMMUNITIES WHO DO NOT RECEIVE INFORMATION THROUGH TELEVISION, RADIO OR OTHER TECHNICAL MEANS.-PRIMARY HEALTH CARE ACCESS: COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. PARTNERED WITH THE LAGRANGE COUNTY COUNCIL ON AGING (COA) TO ASSIST WITH OPERATIONAL SUPPORT FOR THE COA'S SERVICES TO SENIORS. THE COA PROVIDES A TRANSPORTATION PROGRAM, HOMEMAKER SERVICES, A FOOD PANTRY AND MUCH MORE IN THEIR EFFORTS TO HELP SENIORS IN LAGRANGE COUNTY REMAIN INDEPENDENT IN THE HOMES OF THEIR CHOICE FOR AS LONG AS POSSIBLE. NEARLY HALF OF THE TRIPS THE COA OFFERS TO SENIORS ARE TO THEIR PHYSICIANS FOR CHECK-UPS OR TO THE HOSPITAL FOR TESTS OR TREATMENTS. HOMEMAKER SERVICES HELP WITH DAY-TO-DAY TASKS THAT, IN MANY CASES, COULD PUT THE SENIOR AT RISK OF A FALL OR OTHER INJURY. -HEALTH SCREENING AND PREVENTION AND DISEASE MANAGEMENT: COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. PARTICIPATES IN NUMEROUS HEALTH FAIRS AND ACTIVITIES THROUGHOUT THE YEAR OFFERING FREE AND LOW COST HEALTH SCREENINGS AND INFORMATION TO DIVERSE POPULATIONS IN OUR SERVICE AREA, INCLUDING THE PLAIN CHURCH AND HISPANIC RESIDENTS AND SENIORS WHO RESIDE IN THE COUNTY. THESE EVENTS PROVIDE HEALTH EDUCATION, HEALTH SCREENINGS FOR DISEASE PREVENTION, AND PROMOTE HEALTHY LIFESTYLES. THE HOSPITAL ALSO PROVIDES SUPPORT GROUPS TO ASSIST PATIENTS AND FAMILIES IN MANAGING DISEASE.
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 IS GUIDED BY A MISSION TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES. PARKVIEW CONTRIBUTES TO THE SUCCESS OF NORTHEAST INDIANA BY EFFICIENTLY OPERATING ITS FACILITIES, DELIVERING HIGH QUALITY HEALTHCARE SERVICES TO ITS PATIENTS, AND PROVIDING SUPPORT TO 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 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.
IN	REPORTS FILED WITH STATES	PART VI, LINE 7

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
LAGRANGE COUNTY COMMUNITY FOUNDATION
109 E CENTRAL AVENUE	LAGRANGE	IN	46761	351834679	501 ( C ) 3	10500	LCEDC PROGRAM
LAGRANGE COUNTY COUNCIL ON AGING
125 FENN ST SUITE 4	LAGRANGE	IN	46761	237455893	501 ( C ) 3	10000	MEDICAL TRANSPORTATION

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	2	TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part III Form990ScheduleIPartIII (3 entries)

Type Of GrantTypeOfGrant	Number Of RecipientsNumberOfRecipients	Amount Of Cash GrantAmountOfCashGrant
MEDICATION ASSISTANCE	74	8188
EMPLOYEE ASSISTANCE FUND	13	4136
TRANSPORTATION	1	250

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	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.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Personal Services	X	PersonalServices
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Form990 Of Other Organizations	X	Form990OfOtherOrganizations
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	1	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ROBERT MYERS
157559	0	45854	0	8680	0	29958	0	17294	0	259345	0	0	0
MICHAEL PACKNETT
0	638622	0	270643	0	2838	0	145546	0	13373	0	1071022	0	0
MIROSLAW FOLTYNIAK
11396	332351	0	21862	691	20275	843	26107	570	17652	13500	418247	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
MARGARET MCKEE
111270	0	29442	0	2290	0	20637	0	13813	0	177452	0	0	0
CHARLES MASON
0	0	0	0	0	448413	0	0	0	0	0	448413	0	448413

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReference	ExplanationExplanation
PART I, LINE 1A	PERSONAL SERVICES TAXABLE ALLOWANCE FOR FINANCIAL PLANNING PAID TO: MARGARET MCKEE $750
PART I, LINE 4B	SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS TAXABLE - JEFFREY FRANCIS $8,835; CHARLES MASON $448,413 PARTICIPANTS DEFERRED - MICHAEL BROWNING $3,835; MARGARET MCKEE $13,385; ROBERT MYERS $19,295; 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.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	INDIANA HEALTH AND EDUCATIONAL FACILITY FINANCING AUTHORITY	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	351611409	IssuerEIN
CUSIP Number	45479RCF2	CUSIPNumber
Date Issued	2007-03-15	DateIssued
Issue Price	24930000	IssuePrice
Description Of Purpose	SEE PART V	DescriptionOfPurpose
Defeased	0	Defeased
On Behalf Of Issuer	0	OnBehalfOfIssuer
Pool Financing	0	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Amount Retired	1785000	AmountRetired
Total Proceeds	25942463	TotalProceeds
Capitalized Interest	1074019	CapitalizedInterest
Issuance Costs From Proceeds	208535	IssuanceCostsFromProceeds
Credit Enhancement	154519	CreditEnhancement
Capital Expenditures	24505390	CapitalExpenditures
Year Of Subst Completion	2008	YearOfSubstCompletion
Current Refunding	0	CurrentRefunding
Advance Refunding	0	AdvanceRefunding
Final Allocation Made	1	FinalAllocationMade
Adequate Books And Recds Maintaind	1	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Owning Bond Financed Property	0	OwningBondFinancedProperty
Any Lease Arrangements	1	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	1	MngmentCntrctBondFinancdPrprty
Any Research Agreements	0	AnyResearchAgreements
Bond Counsel Routinely Engaged	1	BondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others	0.00000	PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI	0.00000	PercentageOfPrvtBusinessReUBI
Total Private Business Use	0.00000	TotalPrivateBusinessUse
Post Issuance Compliance Procdrs	1	PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Form8038 T Filed	0	Form8038TFiled
Variable Rate Issue	1	VariableRateIssue
Hedge Identified In Books And Recds	0	HedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1

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Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

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Business Name Line1	NA	BusinessNameLine1

Field	Value	IRS element (for citing)
Gross Proceeds Invested	0	GrossProceedsInvested
Exception To Rebate	1	ExceptionToRebate

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SCHEDULE K, PART 1,A,F	DESCRIPTION OF PURPOSE	CONSTRUCTION OF NEW HOSPITAL FACILITY FOR COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IN LAGRANGE INDIANA
SCHEDULE K, PART III, LINES 4-6	PRIVATE BENEFIT USE	COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. CLOSELY MONITORS THE LEVEL OF PRIVATE USE AT OUR BOND FINANCED FACILITIES. THE LEVEL OF EQUITY PROVIDED BY COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. FOR THIS FACILITY IS MORE THAN SUFFICIENT TO COVER THE LOW LEVEL OF PRIVATE USE OCCURRING WITHIN THE FACILITY CONSTRUCTED IN PART WITH BOND FINANCING.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (16 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 2	DIRECTORS THOMAS MILLER AND JOE PIERCE HAVE A BUSINESS RELATIONSHIP AS DIRECTORS ON THE BOARD OF AN UNRELATED ENTITY.
FORM 990, PART VI, SECTION A, LINE 4	DURING 2010, SEVERAL CHANGES WERE MADE TO THE BYLAWS OF COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. AND ARE AS FOLLOWS: THE CHANGED PORTION AS NOW FINALIZED, OF ARTICLE IV, SECTION 1 IS AS FOLLOWS: THE CORPORATE MEMBER SHALL ACT BY EXECUTING AND DELIVERING TO THE CHAIR OF THE BOARD OR PRESIDENT OR THE CHIEF OPERATING OFFICER OF THE CORPORATION A WRITTEN INSTRUMENT WHICH SETS FORTH THE ACTION TAKEN AND THE APPLICABLE CORPORATE AUTHORIZATIONS OR DIRECTIVE FROM THE BOARD OF DIRECTORS OF THE CORPORATE MEMBER. THE ACTION OF THE CORPORATE MEMBER SHALL BE DEEMED TO HAVE BEEN TAKEN ON THE DATES THE WRITTEN INSTRUMENTS ARE SO DELIVERED UNLESS THE WRITTEN INSTRUMENTS PROVIDE OTHERWISE. ARTICLE V, SECTION 2 IS AS FOLLOWS: THE BOARD SHALL BE COMPOSED OF NO MORE THAN TWELVE (12) DIRECTORS, INCLUDING THE CHIEF OPERATING OFFICER OF THE CORPORATION OR HIS/HER DESIGNEE; THE PRESIDENT/CEO OF THE CORPORATE MEMBER OR HIS/HER DESIGNEE, AND THE PRESIDENT AND VICE PRESIDENT OF THE MEDICAL STAFF (UNLESS UNABLE TO SERVE, IN WHICH CASE, SUCH PHYSICIAN AS DESIGNATED BY THE MEDICAL STAFF BYLAWS), WHO SHALL SERVE AS DIRECTORS BY VIRTUE OF THEIR OFFICES, AND UP TO EIGHT (8) COMMUNITY LEADERS WHO SHALL BE SELECTED FROM THE SERVICE AREA OF THE CORPORATION. ALL DIRECTORS SHALL BE SELECTED FROM THOSE PERSONS WHO HAVE DEMONSTRATED AN ABILITY AND WILLINGNESS TO SERVE EFFECTIVELY IN THE DISCHARGE OF CORPORATE RESPONSIBILITIES AND WHO ARE ABLE AND WILLING TO SERVE AND WHO SATISFY THE CRITERIA FOR BOARD PARTICIPATION. CONSIDERATION SHOULD BE GIVEN TO PROMOTE DIVERSITY ON THE BOARD OF DIRECTORS. A MAJORITY OF THE BOARD OF DIRECTORS SHALL, AT ALL TIMES, BE CONSIDERED TO BE INDEPENDENT AS DEFINED BY THE INTERNAL REVENUE SERVICE. THE BOARD SHALL CONDUCT AN ORIENTATION SESSION FOR ALL NEW DIRECTORS AND CONTINUING EDUCATION SESSIONS REGARDING CURRENT TOPICS IN HEALTH CARE (INCLUDING MECHANISMS FOR DESIGNING, MEASURING, ASSESSING AND IMPROVING HOSPITAL PERFORMANCE) TO ASSIST ALL DIRECTORS IN THE DISCHARGE OF THEIR DUTIES. IT SHALL BE THE DUTY OF DIRECTORS TO ATTEND REGULAR, SPECIAL AND ANNUAL MEETINGS OF THE BOARD. WHEN VACANCIES ON THE BOARD OCCUR BY REASON OF DEATH, RESIGNATION, OR OTHERWISE, THE NUMBER OF DIRECTORS SHALL BE REDUCED BY SUCH VACANCIES UNTIL QUALIFIED REPLACEMENTS ARE ELECTED, AS SET FORTH IN ARTICLE V, SECTION 4. THE CHANGED PORTION AS NOW FINALIZED, OF ARTICLE V, SECTION 3 IS AS FOLLOWS: THOSE DIRECTORS WHO ARE COMMUNITY REPRESENTATIVES SHALL BE APPOINTED FOR A TERM OF THREE (3) YEARS AND UNTIL A SUCCESSOR HAS BEEN DULY APPOINTED AND QUALIFIED. THE INITIAL BOARD SHALL BE CLASSIFIED IN APPROXIMATELY EQUAL CLASSES OF CLASS 1, CLASS 2 AND CLASS 3. CLASS 1 DIRECTORS SHALL SERVE AN INITIAL TERM OF ONE (1) YEAR AND SHALL THEREAFTER BE APPOINTED FOR AN ADDITIONAL THREE (3) YEAR TERM. CLASS 2 DIRECTORS SHALL SERVE AN INITIAL TERM OF TWO (2) YEARS. CLASS 3 DIRECTORS SHALL SERVE AN INITIAL TERM OF THREE (3) YEARS. EXCEPT AS PROVIDED IN THIS ARTICLE, NO PERSON SHALL BE ELIGIBLE FOR ELECTION TO MORE THAN THREE (3) CONSECUTIVE THREE (3) YEAR TERMS, EXCEPT THAT CLASS 1 AND CLASS 2 DIRECTORS WHO SERVE LESS THAN AN INITIAL THREE (3) YEAR TERM MAY SERVE FOR NO MORE THAN A TOTAL OF ELEVEN (11) CONSECUTIVE YEARS. 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 THAT A VACANCY OCCURS IN THE BOARD FOR A REPRESENTATIVE FROM THE COMMUNITY, THE NOMINATING COMMITTEE SHALL NOMINATE A CANDIDATE FROM THE SERVICE AREA OF THE CORPORATION AND PRESENT THE NAME TO THE BOARD. THE BOARD SHALL SUBSEQUENTLY RECOMMEND TO THE CORPORATE MEMBER AN INDIVIDUAL FOR THE CONSIDERATION OF 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 THAT FILLED AN UNEXPIRED TERM OF THEIR PREDECESSOR PRIOR TO JANUARY 1, 2010, SHALL BE "GRANDFATHERED". ARTICLE V, SECTION 10 IS AS FOLLOWS: THE BOARD SHALL DEVELOP AND ADOPT AN OUTLINE OF CRITERIA TO BE USED BY THE NOMINATING COMMITTEE TO EVALUATE CANDIDATES AS COMMUNITY REPRESENTATIVES FOR APPOINTED BOARD MEMBERSHIP, WHICH SHALL BE PERIODICALLY REVIEWED AND REVISED TO ENSURE TIMELINESS. SAID CRITERIA SHALL REFLECT THE CORPORATION'S NEED TO HAVE REPRESENTED ON ITS BOARD CIVIC AND COMMUNITY LEADERS AND HEALTH CARE PROFESSIONALS FROM THE CORPORATION'S SERVICE AREA, WHO HAVE AN INTEREST IN THE DELIVERY OF HEALTH CARE AND ARE ATTUNED TO THE NEEDS OF THE GEOGRAPHIC REGIONS SERVED BY THE CORPORATION. COLLECTIVELY, THE BOARD SHOULD REPRESENT A DIVERSITY OF INTERESTS, HAVE SOME PRIOR BOARD OR DIRECTORSHIP EXPERIENCE AND BE INDIVIDUALS WHO ARE AVAILABLE AND WILLING TO SERVE. THE CHANGED PORTION AS NOW FINALIZED, OF ARTICLE VII, SECTION 2 IS AS FOLLOWS: THE CHAIR SHALL APPOINT MEMBERS AND CHAIRS OF ALL STANDING COMMITTEES AND SUCH SPECIAL COMMITTEES AS MAY BE CONSTITUTED. THE CHAIR MAY, AT HIS/HER DISCRETION, ATTEND AND VOTE AS AN EX OFFICIO MEMBER AT ALL COMMITTEE MEETINGS. 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 LAGRANGE 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 A MEMBER 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 COMPOSED OF THE OFFICERS OF THE BOARD, THE CHIEF OPERATING OFFICER OF THE CORPORATION OR HIS/HER DESIGNEE, THE PRESIDENT/CEO OF THE CORPORATE MEMBER OR HIS/HER DESIGNEE, THE CURRENT PRESIDENT OF THE MEDICAL STAFF AND SUCH OTHER PERSONS AS IDENTIFIED BY THE CHAIR OF THE BOARD, EACH OF WHOM SHALL BE ENTITLED TO VOTE. THE EXECUTIVE COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION IN ANY MATTER WHEN THE BOARD IS NOT IN SESSION, REPORTING TO THE BOARD FOR ITS RATIFICATION OF ITS ACTION. THE CHAIR OF THE BOARD SHALL SERVE AS CHAIR OF THE EXECUTIVE COMMITTEE. ARTICLE VIII, SECTION 5 IS AS FOLLOWS: THE NOMINATING COMMITTEE SHALL CONSIST OF AT LEAST FIVE (5) MEMBERS, THE MAJORITY OF WHOM SHALL BE DISINTERESTED. THE CHAIR OF THE BOARD SHALL SERVE BY VIRTUE OF HIS/HER OFFICE, AND THE OTHER MEMBERS OF THE COMMITTEE SHALL BE APPOINTED BY THE CHAIR OF THE BOARD. THE NOMINATING COMMITTEE SHALL NOMINATE INDIVIDUALS TO SERVE AS OFFICERS OF THE CORPORATION. THE NOMINATING COMMITTEE SHALL ALSO NOMINATE COMMUNITY REPRESENTATIVES TO SERVE AS DIRECTORS OF THE CORPORATION. IN MAKING NOMINATIONS, THE NOMINATING COMMITTEE SHALL COMPLY WITH CRITERIA ESTABLISHED BY THE BOARD. ARTICLE VIII, SECTION 6 IS AS FOLLOWS: THE QUALITY COMMITTEE SHALL CONSIST OF AT LEAST FIVE (5) MEMBERS, AND SHALL INCLUDE THE MEDICAL DIRECTOR, THE PRESIDENT OF THE MEDICAL STAFF, THE CHIEF OPERATING OFFICER 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 4	CONTINUED: THE CHANGED PORTION AS NOW FINALIZED, OF ARTICLE VIII, SECTION 7 IS AS FOLLOWS: TO EXPEDITE APPOINTMENT, REAPPOINTMENT, RENEWAL OR MODIFICATION OF CLINICAL PRIVILEGES, THE BOARD MAY DELEGATE THE AUTHORITY TO RENDER THESE DECISIONS TO A COMMITTEE, APPOINTED BY THE BOARD. THIS COMMITTEE SHALL BE COMPOSED OF THE PRESIDENT OF THE HOSPITAL, THE PRESIDENT/CEO OF THE CORPORATE MEMBER, THE BOARD CHAIR, THE PRESIDENT AND VICE PRESIDENT OF THE MEDICAL STAFF, OR THEIR DESIGNEES, AND SUCH OTHER BOARD MEMBERS AS THE CHAIR DETERMINES ARE APPROPRIATE. THIS COMMITTEE SHALL MEET AS OFTEN AS NECESSARY, AS DETERMINED BY THE BOARD CHAIR. A POSITIVE DECISION BY THIS COMMITTEE RESULTS IN THE STATUS AND/OR PRIVILEGES REQUESTED.
FORM 990, PART VI, SECTION A, LINE 6	THE ORGANIZATION IS ORGANIZED AS A NOT-FOR-PROFIT CORPORATION. PURSUANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, PARKVIEW HEALTH SYSTEM, INC. EIN 35-1972384 IS THE SOLE MEMBER OF COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. WITH CERTAIN RESERVED POWERS.
FORM 990, PART VI, SECTION A, LINE 7A	THE CORPORATE MEMBER, PARKVIEW HEALTH SYSTEM, INC. EIN 35-1972384, SHALL HAVE THE FOLLOWING RESERVED POWERS AS DEFINED IN THE NETWORK AGREEMENT: (A) APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, MEMBERS OF THE BOARD SUBJECT TO THE COMPOSITION REQUIREMENTS REGARDING COMMUNITY AND PHYSICIAN REPRESENTATION SET FORTH IN ARTICLE V, SECTION 2; (B) APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE CHAIR AND VICE CHAIR OF THE BOARD AND THE CHIEF OPERATING OFFICER OF THE CORPORATION; (C) APPROVE AND/OR REQUIRE THE ADOPTION OF AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (D) APPROVE AND/OR REQUIRE THE ESTABLISHMENT, ACQUISITION, DIVESTITURE, DISSOLUTION, CLOSURE, MERGER, CONSOLIDATION, CHANGE IN CORPORATE MEMBERSHIP, AFFILIATION OR CORPORATE REORGANIZATION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (E) APPROVE AND ADOPT THE STRATEGIC PLAN AND ANY AMENDMENTS THERETO FOR THE CORPORATION AND ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (F) APPROVE AND/OR REQUIRE THE INCURRENCE OF ANY DEBT, INCLUDING THE ISSUANCE OF ANY BONDS, PROPOSED BY THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION IN EXCESS OF LIMITS SPECIFIED IN THE POLICY OF THE CORPORATE MEMBER; (G) APPROVE AND/OR REQUIRE THE APPROVAL OF CONTRACTS OR LOANS OBLIGATING THE CORPORATION TO EXPEND OR REPAY AN AMOUNT IN EXCESS OF LIMITS SPECIFIED IN THE POLICY OF THE CORPORATE MEMBER; (H) APPROVE AND/OR REQUIRE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE, TRANSFER, ENCUMBRANCE OR OTHER DISPOSITION OF PROPERTY AND ASSETS OF THE CORPORATION IN EXCESS OF LIMITS SPECIFIED IN THE POLICY OF THE CORPORATE MEMBER; (I) APPROVE AND ADOPT THE CAPITAL BUDGET, OPERATING BUDGET, FINANCIAL PLANS AND ANY AMENDMENTS THERETO FOR THE CORPORATION AND ANY SUBSIDIARY OR AFFILIATE TO THE CORPORATION; (J) APPROVE AND/OR REQUIRE THE ADOPTION OF A MANAGED CARE POLICY FOR THE CORPORATION AND ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION, INCLUDING NETWORK PARTICIPATION, PARTICIPATION IN ANY MANAGED CARE AGREEMENT AND PARTICIPATION IN ANY OTHER HEALTH CARE SERVICE ARRANGEMENTS; (K) APPOINT AND REMOVE AUDITORS, ATTORNEYS AND OTHER PROFESSIONAL ADVISORS FOR THE CORPORATION AND ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (L) DEVELOP, APPROVE AND/OR REQUIRE THE ADOPTION OF MEDICAL STAFF QUALITY ASSURANCE STANDARDS, UTILIZATION REVIEW STANDARDS, CRITERIA, POLICIES AND PROCEDURES FOR THE CORPORATION AND ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (M) APPROVE AND/OR REQUIRE THE ADOPTION OF ANY ACTION TO CHANGE THE CORPORATION FROM A GENERAL, ACUTE CARE COMMUNITY HOSPITAL OR TO CLOSE THE CORPORATION'S CURRENT LOCATION; (N) APPROVE EACH ANNUAL LIST OF PROPOSED DONEES AND AMOUNTS OF DONATIONS OR GRANTS NOT INCLUDED IN THE ANNUAL BUDGET, AND MAKE PROPOSALS TO DEVIATE THEREFROM THROUGHOUT EACH YEAR IN EXCESS OF LIMITS SPECIFIED IN THE POLICY OF THE CORPORATE MEMBER; AND (O) APPROVE AND/OR REQUIRE THE ADOPTION OF ANY ACTION THAT IS INCONSISTENT WITH THE POLICY OF THE CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7B	SEE SCHEDULE O EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A
FORM 990, PART VI, SECTION B, LINE 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. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IS A SUBSIDIARY CORPORATION OF PARKVIEW HEALTH SYSTEM, INC. AN ELECTRONIC COPY OF THE ORGANIZATION'S FINAL FORM 990 (INCLUDING REQUIRED SCHEDULES) WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY, PRIOR TO FILING WITH THE IRS. ON OCTOBER 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.
	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 12C
	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 B, LINE 15
	COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.	FORM 990, PART VI, SECTION C, LINE 19
COMMON PAYING AGENT FOR FILING ORGANIZATION	PARKVIEW HEALTH SYSTEM, INC. (PH), EIN 35-1972384, IS THE COMMON PAYING AGENT FOR THE FILING ORGANIZATION, COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC., EIN 20-2401676. 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 COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. WAS 28 AND 236 RESPECTIVELY. AS REFLECTED IN PART VII, SECTION B, APPROXIMATELY 1 INDEPENDENT CONTRACTOR RECEIVED MORE THAN $100,000 IN COMPENSATION FOR SERVICES FROM COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.	FORM 990, PART V, LINE 1A, 2A AND PART VII, SECTION B, LINE 2:
AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS	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) PARKVIEW OCCUPATIONAL HEALTH CENTERS, INC. (POHCI) HUNTINGTON MEMORIAL HOSPITAL, INC. (HMHOS) COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. (LGHOS)- FILING ORGANIZATION 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) LISA BOOTH (DIRECTOR/PH PHYSICIAN) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO LGHOS, AND 40 HOURS PER WEEK TO PH. MIROSLAW FOLTYNIAK (DIRECTOR/PH PHYSICIAN) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO LGHOS, AND 40 HOURS PER WEEK TO PH. STEPHANIE GOUGH (DIRECTOR/TREASURER) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO LGHOS, AND ONE HOUR PER WEEK TO PH. JOE PIERCE (DIRECTOR/VICE CHAIR) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO LGHOS, AND ONE HOUR PER WEEK TO PH. JOHN PRICE (DIRECTOR/CHAIR) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO LGHOS, AND ONE HOUR PER WEEK TO PH.	FORM 990, PART VII, SECTION A, COLUMN B:
SALARIES AND WAGES, OTHER EMPLOYEE BENEFITS AND PAYROLL TAXES	PARKVIEW HEALTH SYSTEM, INC., EIN 35-1972384, SERVES AS THE COMMON PAYING AGENT FOR ALL TAX-EXEMPT ORGANIZATIONS OF THE SYSTEM. SALARIES AND WAGES OF EMPLOYEES WORKING FOR THESE ORGANIZATIONS ARE CHARGED DIRECTLY TO THE ORGANIZATIONS IN WHICH THEY WORK. THE ACTUAL EXPENSES FOR PAYROLL TAXES, EMPLOYEE BENEFITS, AND PENSION PLAN CONTRIBUTIONS ARE REFLECTED ON THE BOOKS OF PARKVIEW HEALTH SYSTEM, INC. FOR FINANCIAL REPORTING PURPOSES. TO ACCOUNT FOR BENEFIT COSTS ON THE BOOKS OF THE OTHER TAX EXEMPT ORGANIZATIONS, AN ALLOCATION METHODOLOGY IS UTILIZED TO CHARGE THESE ORGANIZATIONS WITH AN ESTIMATE OF THE OVERALL COSTS, REFERRED TO AS A "BENEFIT ALLOCATION" FROM PARKVIEW HEALTH SYSTEM, INC. THE ALLOCATION DOES NOT DISTINGUISH BETWEEN THE COSTS OF THE VARIOUS COMPONENTS (I.E. PAYROLL TAXES, EMPLOYEE BENEFITS, AND PENSION PLAN CONTRIBUTIONS). THEREFORE, FOR PURPOSES OF THE FORM 990, PART IX, THE TOTAL BENEFIT ALLOCATION FOR THE EMPLOYEES' SALARIES AND WAGES REPORTED ON LINE 7 IS REFLECTED ON LINE 9 AND NOT ALLOCATED BETWEEN LINES 8 OR 10. FOR PURPOSES OF THE FORM 990, PART IX, LINES 5 AND 6 REFLECT COMPENSATION AND BENEFIT AMOUNTS REPORTED IN PART VII.	FORM 990, PART IX, LINES 5-10:
CORPORATE SERVICE ALLOCATION	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.	FORM 990, PART IX, LINE 24A
CHANGES IN NET ASSETS OR FUND BALANCES:	ASSET ADJUSTMENTS/TRANSFERS -709,579. TOTAL TO FORM 990, PART XI, LINE 5: -709,579.	FORM 990, PART XI, LINE 5:
REQUIREMENTS UNDER SINGLE AUDIT ACT AND OMB CIRCULAR A-133	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. COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC. IS A SUBSIDIARY CORPORATION OF PARKVIEW HEALTH SYSTEM, INC.	FORM 990, PART XII, LINE 3:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg	Business Name Line1DirectControllingEntityName/BusinessNameLine1
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
COMMUNITY HOSPITAL OF NOBLE COUNTY INC
401 SAWYER ROAD	KENDALLVILLE	IN	46755	352087092	HOSPITAL CARE	IN	501(C)(3)	LINE 3		0	PARKVIEW HEALTH SYSTEM INC
PARKVIEW OCCUPATIONAL HEALTH CENTERS INC
2200 RANDALLIA DRIVE	FORT WAYNE	IN	46805	352064353	OCCUP HEALTH	IN	501(C)(3)	LINE 3		0	PARKVIEW HEALTH SYSTEM INC
PARKVIEW HOSPITAL INC
2200 RANDALLIA DRIVE	FORT WAYNE	IN	46805	350868085	HOSPITAL CARE	IN	501(C)(3)	LINE 3		0	PARKVIEW HEALTH SYSTEM INC
WHITLEY MEMORIAL HOSPITAL INC
353 N OAK STREET	COLUMBIA CITY	IN	46725	351967665	HOSPITAL CARE	IN	501(C)(3)	LINE 3		0	PARKVIEW HEALTH SYSTEM INC
HUNTINGTON MEMORIAL HOSPITAL INC
2001 STULTS ROAD	HUNTINGTON	IN	46750	351970706	HOSPITAL CARE	IN	501(C)(3)	LINE 3		0	PARKVIEW HEALTH SYSTEM INC

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	1	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	1	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	0	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg