2023-11-08T16:02:20-06:00 2022-12-31 350921680 CROWE LLP 401 E LAS OLAS BLVD SUITE 1100 FORT LAUDERDALE FL 33301 990 2022-01-01 352089183 COMMUNITY HOSPITAL OF NOBLE COUNTY FOUNDATION INC COMM 2603738429 401 N SAWYER RD KENDALLVILLE IN 467552568 JEANNE' WICKENS PH CFO 2602669313 2023-11-08 1 JEANNE WICKENS 999009999 1 BRITTNEY KOCAJ P01320603 9542028600 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z RICK HENVEY 1450 PRODUCTION RD FORT WAYNE IN 468081167 6891467 0 X WWW.PARKVIEWFOUNDATIONS.ORG X 1999 IN TO SERVE AS THE PRIMARY FUNDRAISING ENTITY FOR COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. 11 8 1 8 0 0 68054 66267 68371 73050 138149 37345 0 0 274574 176662 134709 89833 0 0 51856 2226 0 0 645 19823 70175 206388 162234 68186 14428 2564289 2296900 72 1000 2564217 2295900 X TO SERVE AS THE PRIMARY FUNDRAISING ENTITY FOR COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. FUNDS ARE USED FOR THE CONTINUED IMPROVEMENT OF THE HOSPITAL'S FACILITIES, EQUIPMENT, PROGRAMS & SERVICES IN ACCORDANCE WITH THE NEEDS OF THE COMMUNITY WHERE THE HOSPITAL IS LOCATED. 0 0 90934 89833 73050 THE MISSION OF THE PARKVIEW FOUNDATIONS IS TO INSPIRE THE GENEROUS SPIRIT OF OUR COMMUNITY THAT BRINGS GIFTS OF HEALING AND COMFORT TO EVERYONE PARKVIEW SERVES.THE COMMUNITY HOSPITAL OF NOBLE COUNTY FOUNDATION, INC., D.B.A. PARKVIEW NOBLE FOUNDATION, ADHERES TO THIS MISSION. THE FOUNDATION RAISES FUNDS TO SUPPORT NEW PROGRAMS AND SERVICES, EDUCATIONAL NEEDS, AND INNOVATIVE TECHNOLOGY FOR THE COMMUNITY HOSPITAL OF NOBLE COUNTY, INC., D.B.A. PARKVIEW NOBLE HOSPITAL, WITH THE ULTIMATE GOAL OF ENABLING THIS COMMUNITY HOSPITAL TO PROVIDE THE "ABOVE AND BEYOND" CARE AND SERVICES THAT WOULD NOT BE POSSIBLE WITHOUT THE SUPPORT OF PARKVIEW NOBLE FOUNDATION DONORS. (SEE SCHEDULE O FOR CONTINUATION)THE GIFTS RECEIVED IN 2022 BY PARKVIEW NOBLE FOUNDATION WERE DESIGNATED TO TEMPORARILY RESTRICTED OR UNRESTRICTED FUNDS, ACCORDING TO DONOR WISHES, AND WERE USED FOR A NUMBER OF MISSION-DRIVEN PURPOSES THAT TOUCHED THE LIVES OF PARKVIEW NOBLE HOSPITAL PATIENTS AND THEIR FAMILIES IN NUMEROUS WAYS. THE FOLLOWING ARE EXAMPLES OF PARKVIEW NOBLE FOUNDATION PROVIDING FUNDING TO PARKVIEW NOBLE HOSPITAL FOR VARIOUS HOSPITAL PROGRAMS, SERVICES, EQUIPMENT, AND IMPROVEMENTS:-THE SPECIAL TOUCH FUND PROVIDED A TENS/NMES UNIT FOR A PATIENT WHO SUFFERED CVA. THIS DEVICE IS BASICALLY AN E-STIM UNIT THAT WILL HELP RETRAIN MUSCLES IN THE ARM AND HAND OUTSIDE OF THERAPY. THIS EQUIPMENT WAS NOT COVERED UNDER THE PATIENT'S INSURANCE AND WAS NEEDED TO HELP WITH RECOVERY. THE SPECIAL TOUCH FUND ALSO PROVIDED A SPECIAL CHAIR FOR A PATIENT WITH COPD AND CHF. THIS CHAIR WILL ALLOW THE PATIENT TO BREATHE EASIER.-THE CO-WORKER EMERGENCY FUND ASSISTED CO-WORKERS FACING EMERGENCIES SUCH AS A HEALTH EMERGENCY, DOMESTIC VIOLENCE OR OTHER LIFE CRISIS. THIS FUND PROVIDED PAYMENTS FOR RENT, UTILITIES AND ADDRESSED FOOD INSECURITY.-THE NURSING EDUCATION FUND PROVIDED CERTIFICATION TRAINING FOR THREE NURSES PURSUING ADVANCED TRAINING AND EDUCATION IN SPECIALTY AREAS.-SCHOLARSHIP FUNDS PROVIDED TEAM MEMBERS FINANCIAL ASSISTANCE AS THEY PURSUED THEIR NURSING/MEDICAL CAREER.-MEDICATION ASSISTANCE PROGRAM PROVIDED PATIENTS WITH HELP PAYING FOR PRESCRIPTIONS NECESSARY FOR DISCHARGE.-DIABETES EDUCATION SUPPLIES FOR PATIENTS.-THE FAMILY BIRTHING CENTER WAS PROVIDED NEW LABOR GUIDES AND BIRTHING POSTERS FOR PATIENT EDUCATION. THEY WERE ALSO PROVIDED WITH PACK N PLAY FITTED CRIBS FOR PATIENT USE.-THE FOUNDATION FUNDED SERVICES PROVIDED BY PARKVIEW HOME HEALTH AND HOSPICE TO NOBLE COUNTY RESIDENTS. THESE SERVICES INCLUDED MASSAGES FOR PATIENTS, EDUCATIONAL MATERIALS AND BEREAVEMENT GROUPS ASSISTED FAMILIES FACING GRIEF AND LOSS.-THE GREATEST NEED FUND PROVIDED EQUIPMENT AND EDUCATION FOR PATIENTS IN 2022. SOME ITEMS THAT WERE PROVIDED INCLUDE SHOWER CHAIRS FOR THE MEDICAL/SURGICAL UNIT, BLANKET WARMER FOR THE WOUND CLINIC, FURNITURE FOR THE ATU CLINIC, REMOTE CONTROLS FOR VISUALLY IMPAIRED PATIENTS, KNEE ROLLERS FOR WOUND CLINIC, AND A DRY NEEDLING TRAINING COURSE. 90934 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 8 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 IN X JEANNE' WICKENS 2602669313 1450 PRODUCTION RD FORT WAYNE IN 468081167 DENA JACQUAY DIRECTOR/PH CHIEF ADMIN OFFICER 0.00 40.00 X X 0 908033 284995 GARY ADKINS DIRECTOR/NBHOS PRESIDENT 0.00 40.00 X 0 376298 89224 ERIN GOLDSBERRY DIRECTOR-PARTIAL YR/PVHOS VP PAT SVR 0.00 40.00 X 0 232503 44250 BECKY DRERUP DIRECTOR/PH NURSE PRACTITIONER 0.00 5.00 X 0 20979 0 DENISE LEMMON DIRECTOR/CHAIR 1.00 1.00 X X 0 250 0 LORI BLACKBURN DIRECTOR 1.00 0.00 X 0 0 0 JASON BLUME DIRECTOR 1.00 0.00 X 0 0 0 DEBRA HOCKLEY DIRECTOR 1.00 0.00 X 0 0 0 VICKIE IRWIN DIRECTOR 1.00 0.00 X 0 0 0 AMY LEEDY DIRECTOR/SECRETARY/TREASURER 1.00 0.00 X X 0 0 0 JEAN NESS DIRECTOR/VICE CHAIR 1.00 0.00 X X 0 0 0 GABRIELA RUVALCABA DIRECTOR 1.00 0.00 X 0 0 0 MICHAEL PACKNETT PH PRESIDENT & CEO 0.00 40.00 X 0 2602841 338299 JEANNE' WICKENS PH CHIEF FINANCIAL OFFICER 0.00 40.00 X 0 1264400 357767 BENJAMIN MILES FORMER OFFICER/CURRENT HPS PRESIDENT 0.00 40.00 X 0 582664 6193 0 5987968 1120728 0 1 1 0 0 1811 50 64406 290 66267 FNDRSNG SER ALLOCATION 561499 73050 73050 73050 31315 31315 6720835 6714805 6030 6030 6030 176662 73050 0 37345 X 87833 87833 2000 2000 1648 741 577 330 578 260 202 116 4894 4894 520 81 281 158 48 12 29 7 75 7 34 34 CORPORATE SERVICE ALLOC 64638 64638 162234 90934 70655 645 42083 14235 11042 4900 17277 17165 187 112 2022593 1696146 488384 581507 2564289 2296900 72 1000 72 1000 X 1694027 1487372 870190 808528 2564217 2295900 2564289 2296900 X 14428 -277204 -5541 X 0 1 X 1 0 X X 1 COMMUNITY HOSPITAL OF NOBLE COUNTY INC 352087092 3 1 27543 290 1 27543 290 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART I, LINE 11G, COLUMN VI T-SHIRTS AND LEGGINGS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 17277 17165 112 112 DUE TO/FROM INTERUNIT 581507 581507 X PART X, LINE 2: PARKVIEW HEALTH SYSTEM, INC. AND SUBSIDIARIES - NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES THE LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): INCOME TAXES: THE INTERNAL REVENUE SERVICE HAS DETERMINED THAT THE CORPORATION AND CERTAIN AFFILIATED ENTITIES ARE TAX-EXEMPT ORGANIZATIONS AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CERTAIN SUBSIDIARIES OF THE CORPORATION ARE TAXABLE ENTITIES, THE TAX EXPENSE AND LIABILITIES OF WHICH ARE NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION AND ITS TAX-EXEMPT AFFILIATED ENTITIES EACH FILE A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THESE RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH SYSTEMS INCLUDE SUCH MATTERS AS THE TAX-EXEMPT STATUS OF EACH ENTITY, THE CONTINUED TAX-EXEMPT STATUS OF BONDS, THE NATURE, CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME, AND VARIOUS POSITIONS RELATING TO POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (REPORTED ON FORM 990T). AS OF DECEMBER 31, 2022 AND 2021, THERE ARE NO UNRECOGNIZED TAX BENEFITS RESULTING FROM UNCERTAIN TAX POSITIONS. FORMS 990 AND 990T FILED BY THE CORPORATION AND ITS TAX-EXEMPT AFFILIATED ENTITIES ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. FORMS 990 AND 990T FILED BY THE CORPORATION AND ITS TAX-EXEMPT AFFILIATED ENTITIES ARE GENERALLY NO LONGER SUBJECT TO EXAMINATION FOR THE YEAR 2018 AND PRIOR. 1 PARKVIEW HOSPITAL INC 11109 PARKVIEW PLAZA DR FORT WAYNE IN 468451701 350868085 501(C)(3) 60000 0 HOME HEALTH AND HOSPICE PROGRAM FOR SERVICE AREA OF COMMUNITY HOSPITAL OF NOBLE COUNTY INC COMMUNITY HOSPITAL OF NOBLE COUNTY INC 401 SAWYER RD KENDALLVILLE IN 467552568 352087092 501(C)(3) 27543 290 OTHER T-SHIRTS AND LEGGINGS HOSPITAL PROGRAMS 2 0 PART I, LINE 2: HOSPITAL FUNDING: HOSPITAL DEPARTMENTS COMPLETE FUNDING REQUEST FORMS THAT ARE RETURNED TO THE FOUNDATION. UPON COMPLETION OF THE PROJECT, THE DEPARTMENT SUBMITS A REIMBURSEMENT REQUEST ALONG WITH AN ATTACHED PURCHASE ORDER OR RECEIPT FOR SUPPLIES. BASED UPON THE ORGANIZATION'S AUTHORITY TO ACT POLICY, APPROVALS ARE MADE BY THE FOUNDATION DIRECTOR AND FOUNDATION BOARD. 1 1 0 0 0 0 0 0 0 MICHAEL PACKNETT PH PRESIDENT & CEO 0 1330197 0 664677 0 607967 0 302282 0 36017 0 2941140 0 577374 JEANNE' WICKENS PH CHIEF FINANCIAL OFFICER 0 804432 0 363922 0 96046 0 325215 0 32552 0 1622167 0 70644 DENA JACQUAY DIRECTOR/PH CHIEF ADMIN OFFICER 0 648964 0 217050 0 42019 0 239919 0 45076 0 1193028 0 39944 BENJAMIN MILES FORMER OFFICER/CURRENT HPS PRESIDENT 0 64367 0 0 0 518297 0 1948 0 4245 0 588857 0 242356 GARY ADKINS DIRECTOR/NBHOS PRESIDENT 0 225609 0 87378 0 63311 0 59715 0 29509 0 465522 0 59976 ERIN GOLDSBERRY DIRECTOR-PARTIAL YR/PVHOS VP PAT SVR 0 167088 0 64856 0 559 0 12781 0 31469 0 276753 0 0 PART I, LINE 3 RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF COMMUNITY HOSPITAL OF NOBLE COUNTY FOUNDATION, INC.'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. INDEPENDENT COMPENSATION CONSULTANT FORM 990 OF OTHER ORGANIZATIONS COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. PART I, LINES 4A-B SEVERANCE PAYMENT BENJAMIN MILES $275,656 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS THE FOLLOWING INDIVIDUALS PARTICIPATE IN SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLANS. BENEFITS EARNED UNDER THE PLANS WILL FUND THE EMPLOYEES' EVENTUAL RETIREMENT BENEFIT. THESE BENEFITS ARE PROVIDED IN EXCHANGE FOR THE EMPLOYEES' YEARS OF SERVICE TO THE ORGANIZATION AND THE AMOUNT OF THE BENEFITS MAY VARY FROM YEAR TO YEAR. THE FOLLOWING INDIVIDUALS VESTED IN A PORTION OF THEIR DEFERRED COMPENSATION PLANS, WHICH IS TREATED AS TAXABLE INCOME TO THE INDIVIDUALS AT THE TIME OF VESTING. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III): GARY ADKINS $59,976; DENA JACQUAY $39,944; BENJAMIN MILES $242,356; MICHAEL PACKNETT $577,374; JEANNE' WICKENS $70,644 AMOUNTS LISTED ABOVE THAT HAVE BEEN REPORTED AS DEFERRED COMPENSATION ON PRIOR FORM 990 WILL ALSO BE REFLECTED IN SCHEDULE J, PART II, COLUMN (F). FOR EXAMPLE, THE AMOUNT OF $577,374 REPORTED AS REQUIRED FOR MR. PACKNETT WAS A RESULT OF THE VESTING OF SUCH AMOUNT UNDER THE TERMS OF THE RESPECTIVE PLANS. HOWEVER, THESE AMOUNTS WERE PREVIOUSLY REPORTED IN MR. PACKNETT'S DEFERRED COMPENSATION OVER MORE THAN 10 YEARS AS THE AMOUNTS WERE DEFERRED UNDER THE PLANS. AS SUCH, THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN (F) IS AN INDICATION OF AMOUNTS THAT HAVE BEEN REPORTED TWICE, ONCE AS A DEFERRAL AND ONCE AS VESTED. THE FOLLOWING INDIVIDUALS HAVE AN AMOUNT INCLUDED IN SCHEDULE J, PART II, COLUMN (C) FOR AN AMOUNT EARNED BUT NOT YET VESTED UNDER ONE OF PARKVIEW'S DEFERRED COMPENSATION PLANS. THE AMOUNTS ARE AT RISK AND WILL NOT BE PAID UNLESS AND UNTIL EACH EMPLOYEE HAS PROVIDED SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION. BENEFITS UNDER THE PLANS VEST AT THE TIME SET FORTH IN THE PLAN DOCUMENTS AND ARE FORFEITED IF THE EMPLOYEES TERMINATE EMPLOYMENT BEFORE SATISFYING THOSE PLAN CONDITIONS. DEFERRALS REPORTED IN SCHEDULE J, PART II, COLUMN (C) INCLUDE: GARY ADKINS $38,365; DENA JACQUAY $203,319; MICHAEL PACKNETT $268,732; JEANNE' WICKENS $303,865 FORM 990, PART V, LINES 1A AND 2A: PARKVIEW HEALTH SYSTEM, INC. (PH), EIN 35-1972384, IS THE COMMON PAYING AGENT FOR THE FILING ORGANIZATION, COMMUNITY HOSPITAL OF NOBLE COUNTY FOUNDATION, INC., EIN 35-2089183. 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, 2022 WAS 627. THE TOTAL NUMBER OF EMPLOYEES REPORTED ON FORM W-3 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2022 WAS 17,284. FOR PURPOSES OF COMPLETING FORM 990, PART V, LINE 1A AND 2A, THE NUMBER REPORTED FOR THE COMMUNITY HOSPITAL OF NOBLE COUNTY FOUNDATION, INC. WAS 0 AND 1 RESPECTIVELY. FORM 990, PART VI, SECTION A, LINE 2 OFFICERS MICHAEL PACKNETT AND JEANNE' WICKENS HAVE BUSINESS RELATIONSHIPS AS OFFICERS OF RELATED ENTITIES. 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, COMMUNITY HOSPITAL OF NOBLE COUNTY, INC. EIN 35-2087092 IS THE SOLE MEMBER OF COMMUNITY HOSPITAL OF NOBLE COUNTY FOUNDATION, INC. WITH CERTAIN RESERVED POWERS. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE MEMBER SHALL HAVE THE FOLLOWING RESERVED POWERS: (A) APPOINT DIRECTORS (INCLUDING APPOINTMENTS TO FILL A VACANCY) AND INITIATE THE REMOVAL AND REMOVE ANY DIRECTOR OF THE CORPORATION, WITH CAUSE, PROVIDED CONSIDERATION IS GIVEN TO RECOMMENDATIONS OF THE BOARD REGARDING SUCH APPOINTMENT OR REMOVAL, IF ANY ARE SO MADE; (B) APPOINT (INCLUDING APPOINTMENTS TO FILL A VACANCY) AND INITIATE THE REMOVAL AND REMOVE THE CHIEF ADMINISTRATIVE OFFICER OF THE CORPORATION, WITH OR WITHOUT CAUSE, PROVIDED CONSIDERATION IS GIVEN TO RECOMMENDATIONS OF THE BOARD REGARDING SUCH APPOINTMENT OR REMOVAL, IF ANY ARE SO MADE; (C) APPROVE AND ADOPT THE STRATEGIC PLAN FOR THE CORPORATION, INCLUDING ANY INDIVIDUAL INITIATIVES OR ARRANGEMENTS, SUCH AS A NEW SERVICE OR CONTRACTUAL ARRANGEMENT, DEEMED BY THE CORPORATE MEMBER TO BE OF STRATEGIC IMPORTANCE TO THE CORPORATION AND DIRECT AND MONITOR COMPLIANCE WITH SUCH PLANS, INITIATIVES AND ARRANGEMENTS; (D) APPROVE AND ADOPT THE CAPITAL AND OPERATING BUDGETS OF THE CORPORATION; (E) APPROVE THE INCURRENCE OF ANY DEBT PROPOSED BY THE CORPORATION, AND REQUIRE THE INCURRENCE OF DEBT BY THE CORPORATION, WHERE APPROPRIATE; (F) APPROVE THOSE TRANSFERS OF ASSETS BY THE CORPORATION, WHETHER BY SALE OR GIFT, WHERE THE ASSET BEING TRANSFERRED IS AN INTEREST IN REAL PROPERTY OR IS AN OPERATING ASSET OF THE CORPORATION, UNLESS OTHERWISE IDENTIFIED IN PREVIOUSLY APPROVED STRATEGIC PLANS, INITIATIVES, ARRANGEMENTS OR BUDGETS; (G) APPROVE PARTICIPATION (INCLUDING THE EXERCISE OF RENEWAL OPTIONS) BY THE CORPORATION IN NETWORKS, AFFILIATIONS, JOINT VENTURES, PARTNERSHIPS, AND REQUIRE PARTICIPATION BY THE CORPORATION IN SUCH ARRANGEMENTS; (H) APPROVE ANY AMENDMENT TO THE BYLAWS OR THE ARTICLES OF INCORPORATION OF THE CORPORATION, AND REQUIRE AMENDMENT OF THESE GOVERNING DOCUMENTS AS NECESSARY OR ADVISABLE TO RESOLVE SIGNIFICANT ETHICAL ISSUES, TO MAINTAIN TAX-EXEMPT STATUS, OR TO PREVENT SIGNIFICANT, ADVERSE LEGAL OR FINANCIAL EFFECTS TO THE CORPORATION OR THE CORPORATE MEMBER. THE CORPORATE MEMBER SHALL FROM TIME TO TIME DEVELOP POLICIES FOR THE IMPLEMENTATION OF THE RESERVED POWERS. FORM 990, PART VI, SECTION A, LINE 7B SEE SCHEDULE O EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A FORM 990, PART VI, SECTION A, LINE 8B AT THE CURRENT TIME NO EXECUTIVE COMMITTEE EXISTS. THE BYLAWS ALLOW FOR SUCH COMMITTEE IN THE FOLLOWING PASSAGE: THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE OFFICERS OF THE BOARD, THE DIRECTOR OF THE CORPORATION, THE CHIEF ADMINISTRATIVE OFFICER OF PARKVIEW FOUNDATION, INC., THE CHIEF OPERATING OFFICER OF THE CORPORATE MEMBER, AND SUCH OTHER PERSONS AS IDENTIFIED BY THE CHAIR, EACH OF WHOM SHALL BE ENTITLED TO VOTE. IN NO EVENT SHALL THE MEMBERS OF THE EXECUTIVE COMMITTEE EXCEED EIGHT (8) PEOPLE. THE EXECUTIVE COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION IN ANY MATTER WHEN THE BOARD IS NOT IN SESSION, REPORTING TO THE BOARD FOR ITS RATIFICATION OF ITS ACTION. THE CHAIR OF THE BOARD SHALL SERVE AS CHAIR OF THE EXECUTIVE COMMITTEE. MEETINGS OF THE EXECUTIVE COMMITTEE MAY BE CALLED BY THE CHAIR OR BY THREE (3) MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B PURSUANT TO PARKVIEW HEALTH SYSTEM INC.'S BYLAWS, THE SYSTEM AUDIT COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION TO PROVIDE REVIEW OF THE CORPORATION AND ITS SUBSIDIARY CORPORATIONS' FORM 990 FILINGS. COMMUNITY HOSPITAL OF NOBLE COUNTY FOUNDATION, INC. IS A SUBSIDIARY CORPORATION OF PARKVIEW HEALTH SYSTEM, INC. AN ELECTRONIC COPY OF THE ORGANIZATION'S FINAL FORM 990 (INCLUDING REQUIRED SCHEDULES) WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY, PRIOR TO FILING WITH THE IRS. ON OCTOBER 24, 2023, THE SYSTEM AUDIT COMMITTEE REVIEWED THE FORM 990 AS ULTIMATELY FILED WITH THE IRS. THIS REVIEW INCLUDED A PRESENTATION BY THE ORGANIZATION'S TAX PREPARER TO HIGHLIGHT THE SIGNIFICANT AREAS ON THE FORM 990 AND SUPPLEMENTAL SCHEDULES. FORM 990, PART VI, SECTION B, LINE 12C AS DESCRIBED IN ARTICLE IX SECTION 6, OF THE PARKVIEW HEALTH SYSTEM, INC. (PH) BYLAWS, PH ADOPTED PH'S COMPLIANCE POLICY FOR THE ORGANIZATION AND ITS NOT-FOR-PROFIT RELATED ORGANIZATIONS (AND AS LIKEWISE NOTED IN THEIR BYLAWS) WHEN ADDRESSING CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. THIS COMPLIANCE POLICY (COMPLIANCE POLICY #14) REQUIRES THAT EACH BOARD MEMBER, BOARD COMMITTEE MEMBER, AND KEY MANAGEMENT PERSONNEL MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST FORM. THIS INFORMATION IS PROVIDED TO THE CHAIRMAN OF THE BOARD (FOR BOARD AND BOARD COMMITTEE MEMBERS) AND TO SENIOR MANAGEMENT (FOR KEY MANAGEMENT PERSONNEL). IN ADDITION, AS TO THE CONDUCT OF BOARD MEETINGS, THE FOLLOWING PROCESS IS FOLLOWED: "WHENEVER A PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE IS CONSIDERING A TRANSACTION OR ARRANGEMENT WITH AN ORGANIZATION, ENTITY OR INDIVIDUAL IN WHICH A PERSON COVERED BY THIS POLICY HAS A FINANCIAL OR CONFLICTING INTEREST, THE FOLLOWING SHALL OCCUR: 1. THE INTERESTED PERSON MUST DISCLOSE THE FINANCIAL OR CONFLICTING INTEREST AND ALL MATERIAL FACTS TO THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE; 2. THE INTERESTED PERSON WITH THAT FINANCIAL OR CONFLICTING INTEREST MAY MAKE A PRESENTATION AT THE BOARD OR BOARD COMMITTEE MEETING REGARDING THE TRANSACTION OR ARRANGEMENT HOWEVER, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE FINANCIAL OR CONFLICTING INTEREST; AND 3. THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE MUST APPROVE THE TRANSACTION OR ARRANGEMENT BY A MAJORITY VOTE OF THE BOARD MEMBERS PRESENT AT A MEETING THAT HAS A QUORUM, NOT INCLUDING THE VOTE OF THE INTERESTED PERSON. THE INTERESTED PERSON MAY NOT VOTE ON THE MATTER. A. UPON THE REQUEST OF PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE, THE MATTER MAY BE DELEGATED TO THE PH COMPLIANCE COMMITTEE FOR EVALUATION, RECOMMENDATION AND/OR DETERMINATION. 4. WHENEVER A FINANCIAL OR CONFLICTING INTEREST IS ADDRESSED BY A PH OR PH AFFILIATE BOARD, NOTICE SHALL BE GIVEN TO THE PH COMPLIANCE OFFICER / GENERAL COUNSEL." FORM 990, PART VI, SECTION B, LINE 15 LINES 15A AND 15B ARE ANSWERED NO IN ACCORDANCE WITH THE IRS INSTRUCTIONS. TO THE EXTENT THAT THE ORGANIZATION HAS A VICE PRESIDENT OR ABOVE, THE RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., HAS A PROCESS IN PLACE FOR DETERMINING COMPENSATION OF THE CEO, OFFICERS, AND KEY EMPLOYEES. THE PROCESS INCLUDES CONSULTATIONS WITH AN INDEPENDENT COMPENSATION ADVISOR AND THE REVIEW OF APPROPRIATE COMPARABILITY DATA; REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE OF THE GOVERNING BODY CONSISTING OF MEMBERS WHO DO NOT HAVE A CONFLICT OF INTEREST CONCERNING THE COMPENSATION; AND CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. IN 2022, THE COMPENSATION COMMITTEE OF PARKVIEW HEALTH SYSTEM, INC. REVIEWED AND APPROVED ALL EXECUTIVE COMPENSATION, BENEFITS, AND PERQUISITES FOR THE 2022 COMPENSATION PACKAGE, PURSUANT TO THE PARKVIEW HEALTH BYLAWS. THE COMPENSATION PACKAGE WAS APPROVED BY A MAJORITY OF INDEPENDENT COMPENSATION 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. THE BOARD APPROVES ANY CHANGES IN COMPENSATION FOR THE CEO AND THEIR DIRECT REPORTS. APPROVAL IS ALSO PROVIDED FOR THE SALARY BUDGET FOR THE ENTIRE ORGANIZATION. THE BOARD REVIEWS AND APPROVES THE PLAN DOCUMENTS FOR THE MANAGEMENT INCENTIVE COMPENSATION PLAN (MICP) AND THE PHYSICIAN AND PROVIDER INCENTIVE COMPENSATION PLAN (PICP). FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINES 5-10: PARKVIEW HEALTH SYSTEM, INC., EIN 35-1972384, SERVES AS THE COMMON PAYING AGENT FOR ALL TAX-EXEMPT ORGANIZATIONS OF THE SYSTEM. SALARIES AND WAGES OF EMPLOYEES WORKING FOR THESE ORGANIZATIONS ARE CHARGED DIRECTLY TO THE ORGANIZATIONS IN WHICH THEY WORK. THE ACTUAL EXPENSES FOR PAYROLL TAXES, EMPLOYEE BENEFITS, AND PENSION PLAN CONTRIBUTIONS ARE REFLECTED ON THE BOOKS OF PARKVIEW HEALTH SYSTEM, INC. FOR FINANCIAL REPORTING PURPOSES. TO ACCOUNT FOR BENEFIT COSTS ON THE BOOKS OF THE OTHER TAX EXEMPT ORGANIZATIONS, AN ALLOCATION METHODOLOGY IS UTILIZED TO CHARGE THESE ORGANIZATIONS WITH AN ESTIMATE OF THE OVERALL COSTS, REFERRED TO AS A "BENEFIT ALLOCATION" FROM PARKVIEW HEALTH SYSTEM, INC. THE ALLOCATION DOES NOT DISTINGUISH BETWEEN THE COSTS OF THE VARIOUS COMPONENTS (I.E. PAYROLL TAXES, EMPLOYEE BENEFITS, AND PENSION PLAN CONTRIBUTIONS). THEREFORE, FOR PURPOSES OF THE FORM 990, PART IX, THE TOTAL BENEFIT ALLOCATION FOR THE EMPLOYEES' SALARIES AND WAGES REPORTED ON LINE 7 IS REFLECTED ON LINE 9 AND NOT ALLOCATED BETWEEN LINES 8 OR 10. FOR PURPOSES OF THE FORM 990, PART IX, LINES 5 AND 6 REFLECT COMPENSATION AND BENEFIT AMOUNTS REPORTED IN PART VII. FORM 990, PART XI, LINE 9: DOUBTFUL PLEDGE EXPENSE -5,541. 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