Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2010 and ending 12-31-2010
BCheck if applicable:
CName of organization
PARKVIEW HEALTH SYSTEM INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
10501 CORPORATE DRIVE
 
Room/suite
City or town, state or country, and ZIP + 4
FORT WAYNE, IN46845
D Employer identification number

35-1972384
E Telephone number

G Gross receipts $ 2,077,003,398
F Name and address of principal officer:
MICHAEL PACKNETT
10501 CORPORATE DRIVE
FORT WAYNE,IN46845
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.PARKVIEW.COM
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1995
M State of legal domicile: IN
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: PARKVIEW HEALTH SYSTEM, 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.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 15
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 10
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 2,190
6 Total number of volunteers (estimate if necessary) .... 6 8
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 2,115,794
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 17,047
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 26,933 36,881
9 Program service revenue (Part VIII, line 2g) ......... 101,154,439 250,801,671
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... -4,780,948 16,042,418
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 888,526 -34,586
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 97,288,950 266,846,384
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,212,529 1,280,134
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 68,924,711 156,056,725
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 52,585,577 115,470,282
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 122,722,817 272,807,141
19 Revenue less expenses. Subtract line 18 from line 12...... -25,433,867 -5,960,757
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 1,077,596,927 1,163,484,562
21 Total liabilities (Part X, line 26)............ 751,696,963 792,370,514
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 325,899,964 371,114,048
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: PARKVIEW HEALTH SYSTEM, 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.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 261,767,319 including grants of $ 1,280,134 ) (Revenue $ 248,603,867 )
PARKVIEW HEALTH SYSTEM, INC. SUPPORTS THESE HOSPITALS: PARKVIEW HOSPITAL, INC.; HUNTINGTON MEMORIAL HOSPITAL, INC.; COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC.; COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.; AND WHITLEY MEMORIAL HOSPITAL, INC. IMPROVING THE HEALTH OF THE COMMUNITY IS A FUNDAMENTAL PART OF PARKVIEW HEALTH SYSTEM, INC.'S MISSION. AS A NOT-FOR-PROFIT, COMMUNITY-BASED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC. REINVESTS ITS FUNDS AND OTHER RESOURCES IN COMMUNITY SERVICES AND HOSPITAL PROGRAMS DESIGNED TO IMPROVE THE HEALTH AND WELL BEING OF RESIDENTS IN THE AREAS WHERE PARKVIEW HEALTH SYSTEM, INC. HOSPITALS ARE LOCATED.TO GUIDE US IN THIS ENDEAVOR, PARKVIEW HEALTH SYSTEM, INC. ROUTINELY SPONSORS A COMMUNITY HEALTH SURVEY. IN ADDITION, PARKVIEW HEALTH SYSTEM, INC. REVIEWS TREND AND TREATMENT ANALYSIS DATA ON AN ONGOING BASIS. DATA OBTAINED FROM THESE STUDIES IS USED IN PARKVIEW HEALTH SYSTEM, INC.'S STRATEGIC PLANNING PROCESS TO IDENTIFY AND SET PRIORITIES FOR CRITICAL HEALTH INITIATIVES IN THE COMMUNITIES PARKVIEW HEALTH SYSTEM, INC. SERVES.PARKVIEW HEALTH SYSTEM, INC. EMPLOYS 264 PRIMARY AND SPECIALTY CARE PHYSICIANS AS PART OF THE PARKVIEW PHYSICIANS' GROUP. THESE PHYSICIANS PROVIDE CARE TO RESIDENTS THROUGHOUT NORTHEAST INDIANA AND NORTHWEST OHIO REGARDLESS OF THEIR ABILITY TO PAY FOR THOSE SERVICES. PARKVIEW HEALTH EMPLOYS ONE FULL TIME PHYSICIAN RECRUITER WHOSE TIME IS DEVOTED TO RECRUITING PHYSICIANS. ALL PHYSICIAN RECRUITMENT ACTIVITY IS BASED ON A PHYSICIAN NEEDS ASSESSMENT AND THE OVERSIGHT OF THE COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS TO ENSURE THAT WE FOLLOW THE GUIDELINES SET FORTH BY THE FEDERAL GOVERNMENT. ON THE AVERAGE, 15-25 NEW PHYSICIANS ARE RECRUITED EACH YEAR.PARKVIEW HEALTH SYSTEM, INC. PROVIDES SIGNIFICANT FUNDING TO LOCAL UNIVERSITIES TO PROMOTE AND SUPPORT THE NURSING PROGRAMS IN ORDER TO DEVELOP, TEACH AND TRAIN TALENTED STUDENTS FOR THE NURSING PROFESSION. PARKVIEW HEALTH SYSTEM, INC. HAS PARTNERSHIPS WITH THE NURSING DEPARTMENTS AT INDIANA UNIVERSITY PURDUE UNIVERSITY AT FORT WAYNE, AND THE UNIVERSITY OF SAINT FRANCIS TO PROVIDE FINANCIAL ASSISTANCE FOR SCHOLARSHIPS, OPERATIONAL, CAPITAL, AND MARKETING SUPPORT. IN ADDITION, PARKVIEW HEALTH SYSTEM, INC. IS A SIGNIFICANT CONTRIBUTOR TO THE NORTHEAST INDIANA ECONOMIC DEVELOPMENT COUNCIL TO SUSTAIN THE ECONOMIC VITALITY OF THIS AREA. PARKVIEW HEALTH SYSTEM, INC. HAS PLAYED A KEY ROLE IN THE REGION'S VISION 20/20 INITIATIVE GEARED TOWARD THE DEVELOPMENT OF STRATEGIES IMPERATIVE TO THE REGION'S FUTURE GROWTH AND VITALITY.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 261,767,319
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II.. Click to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III.. Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
249
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
2,190
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletDA , IT , NO , SW , SZ
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
15
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
10
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
 
No
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
 
No
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IN
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
MICHAEL P BROWNING
10501 CORPORATE DRIVE
FORT WAYNE,IN46845
(260) 373-8407
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) MICHAEL PACKNETT
DIRECTOR/PH CEO
 40.00 X   X       912,103 0 158,919
(2) RAYMOND DUSMAN
DIRECTOR/VICE CHAIR/PH PHYSICIAN
 40.00 X           623,425 0 44,655
(3) DUANE HOUGENDOBLER
DIRECTOR/PH PHYSICIAN
 40.00 X           513,914 596 48,348
(4) MITCHELL STUCKY
DIRECTOR/PH PHYSICIAN
 40.00 X           164,738 118,166 38,381
(5) MICHAEL AXEL
DIRECTOR
 1.00 X           3,500 5,250 0
(6) RICHARD BAKER
DIRECTOR
 1.00 X           3,750 6,250 0
(7) THOMAS BEAVER
DIRECTOR
 1.00 X           3,000 6,500 0
(8) JANET CHRZAN
DIRECTOR/SECRETARY
 1.00 X           10,750 0 0
(9) DAVID HAIST
DIRECTOR
 1.00 X           3,500 4,750 0
(10) MICHAEL LEE
DIRECTOR
 1.00 X           6,750 0 0
(11) LAURA LEFEVER
DIRECTOR
 1.00 X           4,500 7,250 0
(12) JOHN PRICE
DIRECTOR
 1.00 X           3,000 7,250 0
(13) CHARLES SCHRIMPER
DIRECTOR/CHAIR
 1.00 X           11,500 0 0
(14) WIL SMITH
DIRECTOR/TREASURER
 1.00 X           4,500 4,500 0
(15) THOMAS WALSH
DIRECTOR
 1.00 X           11,000 0 0
(16) MICHAEL BROWNING
CURRENT PH SVP & CFO
 40.00     X       80,871 0 5,343
(17) JEFFREY FRANCIS
PH SVP & CFO
 40.00     X       206,802 0 15,269
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) STANTON RISSER
INTERIM PH CFO
 40.00     X       138,872 0 24,814
(19) MARK NAFZIGER
PH EVP & COO
 40.00     X       588,952 0 56,938
(20) ARTHUR DETORE
PH EVP
 40.00       X     449,416 0 79,719
(21) CATHERINE WILCOX
PH SVP
 40.00       X     348,390 0 60,925
(22) JEFFREY BROOKES
PH MEDICAL DIR - COMMUNITY HOSPITALS
 1.00       X     77,405 263,027 56,424
(23) JAMES STAPEL
PH MEDICAL DIR - PPG
 40.00       X     335,889 2,010 75,369
(24) RICK HENVEY
PH REGIONAL COO - COMMUNITY HOSPITALS
 40.00       X     301,648 0 53,626
(25) RONALD DOUBLE
PH CIO
 40.00       X     297,464 0 57,972
(26) DEBRA WILLIAMS
PH SVP
 40.00       X     287,353 0 42,705
(27) JAMES WITMER
PH SVP
 40.00       X     256,214 0 40,608
(28) JAMES HAUGUEL
PH SVP
 40.00       X     213,132 0 44,409
(29) SAILAJA BLACKMON
PH PHYSICIAN
 40.00         X   788,837 0 44,775
(30) DAVID SOWDEN
PH PHYSICIAN
 40.00         X   745,999 400 41,212
(31) DOUGLAS GRAY
PH PHYSICIAN
 40.00         X   717,431 0 43,613
(32) DAVID LLOYD
PH PHYSICIAN
 40.00         X   710,534 0 37,540
(33) SATISH VELAGAPUDI
PH PHYSICIAN
 40.00         X   652,492 0 34,775
(34) CHARLES MASON
PH PRESIDENT EMERITUS
 0.00           X 448,413 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 9,926,044 425,949 1,106,339
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet249
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
INDIANA MEDICAL ASSOCIATES LLC
7900 W JEFFERSON STE 201
FORT WAYNE,IN46804 		PHYSICIANS 798,730
NAVVIS CONSULTING LLC
15450 SOUTH OUTER FORTY DRIVE STE 2
CHESTERFIELD,MO63017 		CONSULTANTS 570,994
ERNST & YOUNG US LLP
P O BOX 96550
CHICAGO,IL60693 		CPA FIRM 344,654
BEERS MALLERS BACK & SALIN LLP
110 W BERRY STREET STE 1100
FORT WAYNE,IN46802 		ATTORNEYS 311,122
GALILEO MANAGEMENT SERVICES LLC
5025 LITCHFIELD ROAD
FORT WAYNE,IN46835 		CONSULTANTS 300,000
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet18
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 36,881
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 36,881
Program Service Revenue Business Code
2a CORP SER ALLOCATION 561,000 110,882,088 110,882,088    
b NET PATIENT SERVICE 621,110 100,375,806 100,375,806    
c PH SUBSIDY 561,499 15,958,555 15,958,555    
d ORTHOPAEDIC HOSPITAL 621,110 10,508,533 10,508,533    
e BILLING & MGMT FEES 561,000 4,591,083 2,673,710 1,917,373  
f All other program service revenue . 8,485,606 8,169,809 315,797  
g Total. Add lines 2a–2f........MediumBullet 250,801,671
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 11,730,889     11,730,889
4 Income from investment of tax-exempt bond proceeds..MediumBullet 194,645     194,645
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents 2,188,991  
b Less: rental expenses 2,864,228  
c Rental income or (loss) -675,237  
d Net rental income or (loss).......MediumBullet -675,237   -117,376 -557,861
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 1,811,336,398 73,272
b Less: cost or other basis and sales expenses 1,807,162,087 130,699
c Gain or (loss) 4,174,311 -57,427
d Net gain or (loss)..........MediumBullet 4,116,884     4,116,884
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a CAFETERIA REVENUE 722,100 605,285     605,285
b MISCELLANEOUS 900,099 35,366 35,366    
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 640,651
12 Total revenue. See Instructions....MediumBullet 266,846,384 248,603,867 2,115,794 16,089,842
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 1,280,134 1,280,134
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 6,706,630   6,706,630  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 121,160,215 121,160,215    
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....        
9 Other employee benefits ....... 6,608,814 6,608,814    
10 Payroll taxes ........... 21,581,066 21,581,066    
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 606,678 606,678    
c Accounting ........... 682,174 682,174    
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ...... 1,507,177 1,507,177    
g Other .......... 15,244,087 12,359,893 2,884,194  
12 Advertising and promotion .... 2,357,148 2,352,998 4,150  
13 Office expenses ....... 13,320,691 12,751,492 569,199  
14 Information technology ...... 20,339,932 20,339,932    
15 Royalties ..        
16 Occupancy ........... 7,343,606 7,307,729 35,877  
17 Travel ............ 714,749 554,103 160,646  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 1,702,344 1,622,376 79,968  
20 Interest ........... 21,282,189 21,282,189    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 18,359,946 18,345,657 14,289  
23 Insurance .............. 2,114,693 1,902,973 211,720  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a UBI TAXES & REFUNDS -59,538 -59,538    
b BAD DEBT 6,067,549 6,067,549    
c DUES & SUBSCRIPTIONS 863,780 550,175 313,605  
d PHYSICIAN RECRUITMENT 736,825 736,825    
e TUITION & CERTIFICATION 646,794 646,794    
f All other expenses 1,639,458 1,579,914 59,544  
25 Total functional expenses. Add lines 1 through 24f 272,807,141 261,767,319 11,039,822 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 17,495 1 21,381
2 Savings and temporary cash investments ....... 42,478,235 2 52,978,116
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 32,744,783 4 16,282,925
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net ............. 11,377,966 7 10,857,261
8 Inventories for sale or use .............. 321,199 8 306,862
9 Prepaid expenses and deferred charges ............ 9,911,986 9 10,086,500
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 669,096,958
b Less: accumulated depreciation. ..... 10b 157,497,185 257,109,405 10c 511,599,773
11 Investments—publicly traded securities .......... 628,459,235 11 438,922,625
12 Investments—other securities. See Part IV, line 11 ...... 84,209,612 12 110,263,867
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ......... 7,057,081 14 8,762,222
15 Other assets. See Part IV, line 11 ........... 3,909,930 15 3,403,030
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,077,596,927 16 1,163,484,562
Liabilities 17 Accounts payable and accrued expenses . 42,903,074 17 67,707,293
18 Grants payable ..........   18  
19 Deferred revenue .......... 192,943 19 173,103
20 Tax-exempt bond liabilities .......... 562,234,647 20 565,576,364
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 8,894,606 23 16,560,649
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 137,471,693 25 142,353,105
26 Total liabilities. Add lines 17 through 25..... 751,696,963 26 792,370,514
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 325,899,964 27 371,114,048
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 325,899,964 33 371,114,048
34 Total liabilities and net assets/fund balances ..... 1,077,596,927 34 1,163,484,562
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
266,846,384
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
272,807,141
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
-5,960,757
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
325,899,964
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
51,174,841
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
371,114,048
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
PARKVIEW HEALTH SYSTEM INC
 
Employer identification number

35-1972384
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
No
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
No
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
No
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
(1) PARKVIEW HOSPITAL INC
  		350868085 3 Yes   Yes   Yes   85,228,452
(2) HUNTINGTON MEMORIAL HOSPITAL INC
  		351970706 3 Yes   Yes   Yes   7,193,616
(3) WHITLEY MEMORIAL HOSPITAL INC
  		351967665 3 Yes   Yes   Yes   6,362,832
(4) COMMUNITY HOSPITAL OF NOBLE COUNTY INC
  		352089183 3 Yes   Yes   Yes   7,096,224
(5) COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC
  		202401676 3 Yes   Yes   Yes   4,581,948
Total                 110,463,072

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
PARKVIEW HEALTH SYSTEM INC
 
Employer identification number

35-1972384
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
PARKVIEW HEALTH SYSTEM INC
  		Employer identification number

35-1972384
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
PARKVIEW HEALTH SYSTEM INC
  		Employer identification number

35-1972384
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
PARKVIEW HEALTH SYSTEM INC
  		Employer identification number

35-1972384
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
PARKVIEW HEALTH SYSTEM INC
 
Employer identification number

35-1972384
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
55,674
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
 
No
 
j
Total. lines 1c through 1i ...................................
55,674
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
PARKVIEW HEALTH SYSTEM INC
 
Employer identification number

35-1972384
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land ................. 23,655,281 23,770,866 47,426,147
b Buildings ................   118,572,367 36,020,112 82,552,255
c Leasehold improvements ............   3,106,604 880,684 2,225,920
d Equipment ................   169,760,584 116,109,110 53,651,474
e Other .................   330,231,256 4,487,279 325,743,977
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 511,599,773
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives 110,263,867 F
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 110,263,867
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
DUE TO/FROM INTERUNIT 113,526,348
ACC RETIREMENTS COST 20,203,270
RESERVE FOR SIGNATURE CARE 4,748,908
RESERVE FOR MALPRACTICE 3,270,204
RESERVE FOR IBNR 600,000
PROPERTY SECURITY DEPOSITS 4,375



Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 142,353,105
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE F
(Form 990)

Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,
Part IV, line 14b, 15, or 16.
Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
PARKVIEW HEALTH SYSTEM INC
 
Employer identification number

35-1972384
Part I
General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of the grants or
assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award
the grants or assistance? ...................................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside the
United States.
3
Activites per Region. (Use Part V if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees or agents in region or independent contractors (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total
expenditures for region/investments
in region
EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 INVESTMENTS   2,404,178
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....   0 2,404,178
b Total from continuation sheets to Part I ...   0 0
c Totals (add lines 3a and 3b)   0 2,404,178
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990,
Part IV, line 15, for any recipient who received more than $5,000. Check this box if no one recipient received more than $5,000 ........ MediumBullet
Use Part V if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2
Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .....MediumBullet
 
3
Enter total number of other organizations or entities ........................MediumBullet
 
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Use Part V if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926 (see instructions for Form 926).................
2 Did the organization have an interest in a foreign trust during the tax year? If " Yes," the organization may be required to file Form 3520 and/or Form 3520-A. (see instructions for Forms 3520 and 3520-A)..........
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with respect to Certain Foreign Corporations. (see instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with respect to Certain Foreign Partnerships. (see instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see instructions for Form 5713)................................................
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 5
Part V
Supplemental Information
Complete this part to provide the information (see instructions) required in Part I, line 2, and any additional information.
Identifier ReturnReference Explanation
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2010
Additional Data


Software ID:  
Software Version:  



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
PARKVIEW HEALTH SYSTEM INC
 
Employer identification number

35-1972384
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
 
No
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		    154,011   154,011 0.060 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    1,463,547 732,476 731,071 0.270 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....     563,789 363,276 200,513 0.070 %
dTotal Charity Care and
Means-Tested Government Programs ..... 		    2,181,347 1,095,752 1,085,595 0.400 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    246,087   246,087 0.090 %
f Health professions education
(from Worksheet 5) .. 		    946,650   946,650 0.350 %
g Subsidized health services
(from Worksheet 6) .. 		    831,036 457,228 373,808 0.140 %
h Research (from Worksheet 7)            
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		    458,035   458,035 0.170 %
jTotal Other Benefits ...     2,481,808 457,228 2,024,580 0.750 %
kTotal. Add lines 7d and 7j. ..     4,663,155 1,552,980 3,110,175 1.150 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     299,747   299,747 0.110 %
2 Economic development     365,000   365,000 0.140 %
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members     5,000   5,000 0 %
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development     880,571   880,571 0.330 %
9 Other            
10 Total     1,550,318   1,550,318 0.580 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
3,059,386
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
0
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
5,468,277
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
7,390,121
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-1,921,844
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
11 IMAGING SERVICES HOLDING COMPANY LLC
  		HOLDING COMPANY 50.000 %   50.000 %
22 ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH LLC
  		ORTHOPAEDIC HOSPITAL 60.000 %   40.000 %
33 PREMIER SURGERY CENTER LLC
  		SURGERY CENTER 50.000 %   50.000 %
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH
11119 PARKVIEW PLAZA DRIVE
FORT WAYNE,IN46845 		X X   X          
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:NOT REQUIRED
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?74
Name and address Type of Facility (Describe)
1 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
2 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
3 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
4 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
5 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
6 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
7 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
8 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
9 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
10 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
11 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
12 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
13 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
14 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
15 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
16 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
17 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
18 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
19 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
20 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
21 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
22 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
23 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
24 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
25 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
26 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
27 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
28 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
29 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
30 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
31 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
32 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
33 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
34 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
35 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
36 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
37 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
38 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
39 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
40 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
41 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
42 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
43 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
44 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
45 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
46 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
47 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
48 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
49 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
50 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
51 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
52 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
53 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
54 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
55 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
56 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
57 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
58 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
59 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
60 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
61 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
62 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
63 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
64 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
65 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
66 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
67 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
68 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
69 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
70 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
71 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
72 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
73 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
74 PARKVIEW PHYSICIANS' GROUP
1819 CAREW STREET
FORT WAYNE,IN46805 		PHYSICIAN OFFICE
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. 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.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. 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.).
6 Affiliated health care system. 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.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    PART I, LINE 3C: ELIGIBILITY CRITERIA FOR FREE OR DISCOUNTED CAREPARKVIEW HEALTH SYSTEM, 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 6A: PARKVIEW HOSPITAL, INC.
    PART I, LINE 7: COSTING METHODOLOGY USED TO CALCULATE CHARITY CAREPART I, LINE 7APARKVIEW HEALTH SYSTEM, INC. IS COMMITTED TO PROVIDING CHARITY CARE TO PATIENTS UNABLE TO MEET THEIR FINANCIAL OBLIGATIONS. IT IS FURTHERMORE THE POLICY OF PARKVIEW HEALTH SYSTEM, INC. NOT TO WITHHOLD OR DENY ANY REQUIRED MEDICAL CARE AS A RESULT OF A PATIENT'S FINANCIAL INABILITY TO PAY HIS/HER MEDICAL EXPENSES.THE CHARITY CARE COST REPORTED ON LINE 7A IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. UNDER THIS METHOD, THE CHARITY CARE CHARGES FOREGONE ARE MULTIPLIED BY THE RATIO OF COST TO CHARGES TO DETERMINE THE COST OF SERVICES RENDERED.PART I, LINE 7BPARKVIEW HEALTH SYSTEM, 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 7FAMOUNTS PRESENTED ARE BASED UPON ACTUAL SPEND AND ARE IN CONFORMITY WITH AGREED UPON COMMITMENTS WITH THE VARIOUS EDUCATIONAL PROGRAMS.PART I, LINE 7GAMOUNTS PRESENTED REPRESENT ACTUAL SPEND RELATIVE TO CLINICAL OPERATIONS AND SERVICES. PART I, LINE 7IIN KEEPING WITH OUR MISSION AND COMMITMENT TO THE COMMUNITIES IN WHICH WE SERVE, PARKVIEW HEALTH SYSTEM, INC. CONTINUES ITS TRADITION OF CONTRIBUTING TO NUMEROUS ORGANIZATIONS ON BOTH AN AS-NEEDED BASIS AND NEGOTIATED BASIS. AMOUNTS PRESENTED REPRESENT ACTUAL SPEND TO ORGANIZATIONS THROUGHOUT OUR COMMUNITIES.
    PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES PARKVIEW HEALTH SYSTEM, INC. INCLUDED NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC AS SUBSIDIZED HEALTH SERVICES.
    PART I, L7 COL(F): PERCENT OF TOTAL EXPENSESPARKVIEW HEALTH SYSTEM, INC. EXCLUDED $6,067,549 OF BAD DEBT EXPENSE.
    PART II: DESCRIBE HOW THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES, AS REPORTED, PROMOTE THE HEALTH OF THE COMMUNITIES THE ORGANIZATION SERVES.PARKVIEW HEALTH SYSTEM, INC. HAS A STRONG COMMITMENT TO THE VITALITY OF THE LOCAL COMMUNITY AND TO THE NORTHEAST INDIANA REGION AND INVESTS IN ENHANCING VARIOUS ASPECTS OF THE COMMUNITY THAT CONTRIBUTE TO IMPROVED HEALTH OF THE COMMUNITY. PHYSICAL IMPROVEMENTS:PARKVIEW NORTH FAMILY PARK IS A RECREATIONAL PARK AREA OPEN TO THE PUBLIC LOCATED ON THE NORTH CAMPUS, FUTURE HOME OF PARKVIEW REGIONAL MEDICAL CENTER. PARKVIEW HEALTH SYSTEM, INC. MAKES THE PARK AVAILABLE AND MAINTAINS THE PROPERTY TO ENHANCE THE COMMUNITY AND PROMOTE PHYSICAL ACTIVITY. ECONOMIC DEVELOPMENT:PARKVIEW HEALTH SYSTEM, INC. FOSTERS ECONOMIC DEVELOPMENT IN SEVERAL WAYS. PARKVIEW HEALTH SYSTEM, INC. HAS PLAYED A KEY ROLE IN THE NORTHEAST INDIANA REGIONAL MARKETING PARTNERSHIP'S NEI=ROI CAMPAIGN TO MARKET NORTHEAST INDIANA ON A GLOBAL BASIS. PARKVIEW HEALTH SYSTEM, INC. MADE A MULTI-YEAR PLEDGE TO THE CAMPAIGN AND ISSUED AN ANNUAL CHALLENGE FOR MATCHING FUNDS FROM AREA BUSINESSES. THE VISION 20/20 INITIATIVE (DISCUSSED IN LINE 4) DESIGNED TO ENGAGE ALL CITIZENS IN THE DEVELOPMENT OF THE REGION IS AN EXTENSION OF THE NORTHEAST INDIANA REGIONAL MARKETING PARTNERSHIP EFFORTS. PARKVIEW HEALTH SYSTEM, INC. ALSO SUPPORTS THE REGIONAL CHAMBER OF NORTHEAST INDIANA. SUPPORT PROVIDED TO THE CITY OF FORT WAYNE FOR A NEWLY BUILT BASEBALL STADIUM LOCATED IN DOWNTOWN FORT WAYNE IS AN EFFORT TO BRING RENEWED ECONOMIC VITALITY TO THE DOWNTOWN AREA ENHANCING THE COMMUNITY AS A WHOLE. THE BASEBALL FIELD IS THE CENTERPIECE OF OTHER SIGNIFICANT PROJECTS TOWARD THE GOAL OF DOWNTOWN REVITALIZATION. RELATED TO ECONOMIC DEVELOPMENT AND COMMUNITY OUTREACH, PARKVIEW HEALTH SYSTEM, INC. PARTNERED WITH THE FORT WAYNE CIVIC THEATRE TO PROVIDE SCHOLARSHIPS FOR TICKETS TO ATTEND PERFORMANCES FOR THOSE THAT MAY NOT OTHERWISE HAVE THE OPPORTUNITY TO ATTEND. LEADERSHIP DEV/TRAINING FOR COMMUNITY MEMBERS:IN CONJUNCTION WITH THE BETTER BUSINESS BUREAU, PARKVIEW HEALTH SYSTEM, INC. PROVIDED SUPPORT FOR A LOCAL EDUCATIONAL PROGRAM DESIGNED FOR AREA COMMUNITY AND BUSINESS LEADERS.WORKFORCE DEVELOPMENT:PARKVIEW HEALTH SYSTEM, 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. PARKVIEW HEALTH SYSTEM, INC. DEVELOPS A PHYSICIAN RECRUITMENT PLAN TO ADDRESS POTENTIAL GAPS IN PATIENT COVERAGE.IN ADDITION, PARKVIEW HEALTH SYSTEM, INC. PROMOTES HEALTH CARE CAREERS THROUGH STUDENT JOB SHADOWING AND INTERNSHIP PROGRAMS IN VARIOUS HEALTH CARE AREAS THROUGHOUT THE ORGANIZATION.
    PART III, LINE 4: BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTETEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE:THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR BAD DEBTS BASED UPON THESE INDICATORS AND ACCOUNTS RECEIVABLE PAYOR COMPOSITION AND AGING AND CONSIDERING HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY AND AGING. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBT AND TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR BAD DEBTS. IN ADDITION, PH FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES.COSTING METHODOLOGY USED:UNCOLLECTIBLE PATIENT ACCOUNTS ARE CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH THE POLICIES OF PARKVIEW HEALTH SYSTEM, INC. THE BAD DEBT EXPENSE REPORTED ON LINE 2 IS CALCULATED UNDER THE COST TO CHARGE RATIO METHODOLOGY. HOWEVER, DURING THE COLLECTION PROCESS THERE IS A CONTINUOUS EFFORT TO DETERMINE IF THE PATIENT QUALIFIES FOR CHARITY. THEREFORE, ONCE AN UNCOLLECTIBLE ACCOUNT HAS BEEN CHARGED OFF AND IT IS DETERMINED THROUGH THE COLLECTION PROCESS THAT THE PATIENT QUALIFIES FOR CHARITY CARE, THE UNCOLLECTIBLE ACCOUNT IS RECLASSIFIED TO CHARITY AND ALL COLLECTION EFFORTS CEASE. PARKVIEW HEALTH SYSTEM, INC. PROVIDES HEALTH CARE SERVICES THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED, AMONG OTHER THINGS, TO ENHANCE THE HEALTH OF THE COMMUNITY AND IMPROVE THE HEALTH OF AT-RISK POPULATIONS. IN ADDITION, PARKVIEW HEALTH SYSTEM, INC. PROVIDES SERVICES INTENDED TO BENEFIT THE POOR AND UNDERSERVED, INCLUDING THOSE PERSONS WHO CANNOT AFFORD HEALTH INSURANCE DUE TO INADEQUATE RESOURCES OR WHO ARE UNINSURED OR UNDERINSURED.
    PART III, LINE 8: COMMUNITY BENEFIT & METHODOLOGY FOR DETERMINING MEDICARE COSTSSUBSTANTIAL SHORTFALLS ARISE FROM PAYMENTS THAT ARE LESS THAN THE COST TO PROVIDE THE CARE OR SERVICES AND DO NOT INCLUDE ANY AMOUNTS RELATING TO INEFFICIENT OR POOR MANAGEMENT. PARKVIEW HEALTH SYSTEM, INC. ACCEPTS ALL MEDICARE AND MEDICARE ADVANTAGE PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS. INTERNAL REVENUE SERVICE (IRS) REVENUE RULING 69-545 IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. HOWEVER, MEDICARE AND MEDICARE ADVANTAGE PAYMENTS REPRESENT A PROXY OF COST CALLED THE "UPPER PAYMENT LIMIT." IT HAS HISTORICALLY BEEN ASSUMED THAT UPPER PAYMENT LIMIT PAYMENTS DO NOT GENERATE A SHORTFALL. AS A RESULT, PARKVIEW HEALTH SYSTEM, INC. HAS TAKEN THE POSITION NOT TO INCLUDE THE MEDICARE AND MEDICARE ADVANTAGE SHORTFALLS AS PART OF THE COMMUNITY BENEFIT REPORT THAT IS SUBMITTED TO THE STATE OF INDIANA.
    PART III, LINE 9B: COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR CHARITY CARETHE LAST PARAGRAPH OF THE PAYMENT POLICY STATES:"FINANCIAL ASSISTANCE MAY BE AVAILABLE FOR THOSE PATIENTS WHO CANNOT PAY THEIR BILL. THOSE OPTIONS ARE WELFARE ASSISTANCE OR FREE CARE THROUGH THE HOSPITAL CHARITY PROGRAM. (SEE CHARITY CARE POLICY.) PATIENTS WILL BE INSTRUCTED TO CONTACT A COUNSELOR TO DISCUSS THE AVAILABLE OPTIONS."ADDITIONALLY, THERE IS AN ONGOING EFFORT THROUGHOUT THE COLLECTION PROCESS TO SCREEN FOR MEDICAID ELIGIBILITY AND THE NEED FOR PROVIDING CHARITY CARE APPLICATIONS TO PATIENTS. IF A PATIENT MAY BE ELIGIBLE FOR MEDICAID, THE HOSPITAL PROVIDES A SERVICE TO OUR PATIENTS THAT HELPS THEM APPLY FOR MEDICAID WITH THE STATE IN WHICH THEY RESIDE. IF A PATIENT IS APPROVED FOR CHARITY CARE, THEIR ACCOUNT IS WRITTEN OFF AND COLLECTION EFFORTS CEASE.
    PART VI, LINE 2: DESCRIBE HOW THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES.PARKVIEW HEALTH SYSTEM, INC. CONDUCTED A COMMUNITY HEALTH ASSESSMENT IN LATE 2007 AS A JOINT PROJECT OF PARKVIEW HOSPITAL, INC., WHITLEY MEMORIAL HOSPITAL, INC., COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC., COMMUNITY HOSPITAL OF NOBLE COUNTY, INC., AND HUNTINGTON MEMORIAL HOSPITAL, INC. PROFESSIONAL RESEARCH CONSULTANTS, INC. OF OMAHA, NEBRASKA, WAS ENGAGED TO CONDUCT THE SURVEY AND TO PROVIDE AN EVALUATION OF THE STUDY. THE SURVEY SAMPLE INCLUDED 1,400 RESIDENTS AGE 18 AND OLDER OF ALLEN, HUNTINGTON, LAGRANGE, NOBLE, AND WHITLEY COUNTIES. A TELEPHONE INTERVIEW METHODOLOGY WAS EMPLOYED. THE SURVEY INSTRUMENT USED FOR THIS STUDY WAS LARGELY BASED ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM AS WELL AS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO NATIONAL HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND RECOGNIZED HEALTH ISSUES. THE INFORMATION FROM 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. PARKVIEW HEALTH SYSTEM, INC. REPRESENTATIVES HAVE RELATIONSHIPS THROUGH OUT THE COMMUNITY AND MEET REGULARLY WITH VARIOUS ORGANIZATIONS THAT SHARE PARKVIEW HEALTH SYSTEM, INC.'S MISSION OF IMPROVING THE HEALTH OF THE COMMUNITIES THAT WE SERVE.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 PARKVIEW HEALTH SYSTEM, 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.PARKVIEW HEALTH SYSTEM, INC. SERVES THE NORTHEAST INDIANA REGION AND OPERATES FACILITIES AND MEDICAL PRACTICES IN ALLEN, HUNTINGTON, LAGRANGE, NOBLE, AND WHITLEY COUNTIES. ALLEN COUNTY IS CONSIDERED THE URBAN AREA AMONGST THE OTHER FOUR RURAL COUNTIES. SINCE 1995, NORTHEAST INDIANA HAS EXPERIENCED A 15 PERCENT DECREASE IN PER CAPITA INCOME COMPARED TO THE NATION OVERALL. ACCORDING TO THE LATEST STATISTICS, NORTHEAST INDIANA WORKERS ARE EARNING NEARLY 20 PERCENT LESS THAN THE NATIONAL AVERAGE. IN LIGHT OF THIS FACT AND OTHER ECONOMIC INDICATORS, MICHAEL PACKNETT, PRESIDENT AND CEO OF PARKVIEW HEALTH, SERVES AS CO-CHAIR OF THE VISION 20/20 INITIATIVE, LEADING A GROUP OF COMMUNITY REPRESENTATIVES FROM ACROSS BUSINESS, EDUCATION, GOVERNMENT AND FOUNDATION SECTORS TO DEVELOP A COMPELLING AND ACTIONABLE VISION FOR THE TEN-COUNTY NORTHEAST INDIANA REGION. COMPLETION OF THE FIRST PHASE OF VISION 20/20 WILL REVEAL A CLEAR, UNIFYING VISION FOR THE FUTURE, SHARED REGIONAL PRIORITIES AND ACCOUNTABILITY, PLANS WITH SPECIFIC STRATEGIES AND TACTICS, AND AN ATTITUDE OF PASSION AND URGENCY TO SEE THE VISION TO ACTION. HEALTH IS AN IMPORTANT COMPONENT OF THE VISION.
    PART VI, LINE 6: PROVIDE ANY OTHER INFORMATION IMPORTANT TO DESCRIBING HOW THE ORGANIZATION'S HOSPITAL FACILITIES OR OTHER HEALTH CARE FACILITIES FURTHER ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY (E.G. OPEN MEDICAL STAFF, COMMUNITY BOARD, USE OF SURPLUS FUNDS, ETC.).PARKVIEW HEALTH SYSTEM, INC.'S BOARD OF DIRECTORS IS COMPOSED OF MEMBERS, OF WHICH SUBSTANTIALLY ALL ARE INDEPENDENT COMMUNITY MEMBERS. A MAJORITY OF THE BOARD RESIDES IN PARKVIEW HEALTH SYSTEM, INC.'S PRIMARY SERVICE AREA. PARKVIEW HEALTH SYSTEM, INC. AS PARENT OF THE SYSTEM'S VARIOUS HOSPITALS AND PHYSICIAN PRACTICES, SERVES IN AN OVERSIGHT CAPACITY TO FORM AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. IN DOING SO, THE HOSPITALS ARE PROVIDED WITH CENTRALIZED, COST-EFFECTIVE ADMINISTRATIVE SUPPORT AND GUIDANCE TO FORM A COMPLETE AND COMPREHENSIVE CARE DELIVERY SYSTEM FOR THE REGION. BY ITSELF AND THROUGH ITS MEMBER HOSPITALS AND ORGANIZATIONS, PARKVIEW HEALTH SYSTEM, INC. SERVES TO MEET ITS MISSION TO ITS COMMUNITIES BY PERIODICALLY ASSESSING THE NEEDS OF THE REGION AND OFFERING THE SERVICES NECESSARY FOR A SAFER AND HEALTHIER POPULATION. DATA OBTAINED THROUGH PERIODIC COMMUNITY HEALTH ASSESSMENTS, PHYSICIAN SURVEYS, AND TREND AND TREATMENT ANALYSIS IS UTILIZED IN PARKVIEW HEALTH SYSTEM, INC.'S STRATEGIC PLANNING PROCESS IN IDENTIFYING COMMUNITY HEALTH NEEDS. AS A RESULT OF THIS STRATEGIC PLANNING PROCESS, PARKVIEW HEALTH SYSTEM, INC. HAS ESTABLISHED SEVERAL PRIORITY AREAS. THESE PRIORITY AREAS ARE ALIGNED WITH PARKVIEW HEALTH SYSTEM, INC.'S MISSION, VISION, AND GOALS, AND HELP DIRECT THE TYPES OF HEALTH INITIATIVES THAT THE HOSPITAL AND THE HEALTH SYSTEM UNDERTAKE. PRIORITY AREAS INCLUDE THE FOLLOWING:PRIMARY HEALTH CARE/ACCESS TO HEALTH CARE:-ADDITIONAL RECRUITMENT AND TRAINING OF PRIMARY CARE PHYSICIANS FOR THE COMMUNITY-EXPANSION OF PRIMARY CARE ACCESS AND NON-TRADITIONAL HOURS OF PRACTICE-CONTINUED SUPPORT OF PROGRAMS PROVIDING PRIMARY CARE TO THE UNINSURED-PROGRAMS TO INCREASE DISTRIBUTION OF FREE MEDICATIONS TO THE POOR-PROMOTION OF HEALTH CAREERS, PARTICULARLY THOSE IN WHICH THE COMMUNITY IS EXPERIENCING A CURRENT SHORTAGE OF HEALTH CARE PROFESSIONALS-SUPPORT FOR ACTIVITIES WHICH INCREASE THE AFFORDABILITY AND ACCESSIBILITY OF HEALTH INSURANCE TO THE UNINSUREDHEALTH SCREENING AND PREVENTION:-CANCER SCREENING PROGRAMS PARTICULARLY MAMMOGRAM, COLORECTAL, AND PROSTATE SCREENING-TOBACCO CESSATION PROGRAMS-INJURY PREVENTION FOR YOUNG PEOPLE-EDUCATION, SCREENING AND PREVENTION OF SEXUALLY TRANSMITTED DISEASES-DIABETES EDUCATION AND SCREENING-CARDIOVASCULAR DISEASE EDUCATION AND SCREENING-PNEUMONIA VACCINATIONS FOR INDIVIDUALS AGE 65 AND OLDER-PROGRAMS TO REDUCE DANGEROUS DRIVINGDISEASE MANAGEMENT:-CARDIOVASCULAR DISEASE -CANCER-MENTAL ILLNESSES-TRAUMA AND ORTHOPAEDIC AILMENTS-WOMEN AND CHILDREN'S MEDICINE WITH AN EMPHASIS ON CHILDREN'S ASTHMA-DIABETES AND OBESITY HEALTH INNOVATION, EDUCATION, AND RESEARCH AND DEVELOPMENT:THIS AREA CONCENTRATES ON OPPORTUNITIES FOR: -ENHANCING HEALTH CARE EDUCATION, MEDICAL RESEARCH, AND TECHNOLOGY-PROMOTING ECONOMIC AND OTHER DEVELOPMENT OF THE COMMUNITY PARKVIEW HEALTH SYSTEM, INC., AS THE PARENT ORGANIZATION AND THROUGH ITS MEMBER HOSPITALS, ANNUALLY FUNDS LOCAL COMMUNITY HEALTH IMPROVEMENT EFFORTS. THESE FUNDS ARE USED TO SUPPORT HEALTH-RELATED, COMMUNITY-BASED PROGRAMS, PROJECTS AND ORGANIZATIONS. FUNDS ARE ALSO USED TO SUPPORT COMMUNITY OUTREACH PROGRAMS AND HEALTH INITIATIVES. THE EMPHASIS WITH THESE PROJECTS CONTINUES TO BE ON IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. PARKVIEW HEALTH SYSTEM, INC., THROUGH ITS FLAGSHIP HOSPITAL PARKVIEW HOSPITAL, INC., PROVIDES A COMMUNITY-BASED NURSING PROGRAM THAT PROVIDES SUPPORT AND EDUCATION TO THOUSANDS OF CHILDREN AND THEIR FAMILIES EACH YEAR IN SCHOOL SYSTEMS THROUGHOUT THE REGION. OTHER PARKVIEW HOSPITAL, INC. OUTREACH PROGRAMS INCLUDE MEDICATION ASSISTANCE, MOBILE MAMMOGRAPHY, NUTRITION EDUCATION AND TRAUMA INJURY PREVENTION EDUCATION. CURRENTLY UNDER CONSTRUCTION, THE PARKVIEW REGIONAL MEDICAL CENTER ON THE PARKVIEW HOSPITAL, INC. NORTH CAMPUS AND SLATED FOR A MARCH 2012 OPENING REPRESENTS A SIGNIFICANT INVESTMENT IN THE LOCAL COMMUNITY AND THE NORTHEAST INDIANA REGION. THE CENTER WILL BLEND THE LATEST MEDICAL TECHNOLOGY WITH THE BEST POSSIBLE PATIENT-CENTERED CARE AND PROVIDE GREATER ACCESS TO HEALTH CARE FOR THE ENTIRE REGION. THE PARKVIEW HOSPITAL, INC. CAMPUS LOCATED IN NORTH CENTRAL FORT WAYNE WILL RECEIVE A FACELIFT AND REMAIN A VITAL PART OF THE LOCAL NEIGHBORHOOD. IN ADDITION, PARKVIEW HOSPITAL, INC. WILL BE PARTNERING WITH THE LIFE SCIENCE AND RESEARCH CONSORTIUM OF NORTHEAST INDIANA TO CREATE A CAMPUS FOR ACADEMIC PROGRAMS AND RESEARCH TIED TO BEHAVIORAL HEALTH, REHABILITATION, AND SENIOR CARE.
    PART VI, LINE 7: IF THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM, DESCRIBE THE RESPECTIVE ROLES OF THE ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED.PARKVIEW HEALTH SYSTEM, INC. (PARKVIEW), A HEALTH CARE SYSTEM SERVING NORTHEAST INDIANA, INCLUDES THE NOT-FOR-PROFIT HOSPITALS OF PARKVIEW HOSPITAL, INC., COMMUNITY HOSPITAL OF LAGRANGE COUNTY, INC., COMMUNITY HOSPITAL OF NOBLE COUNTY, INC., WHITLEY MEMORIAL HOSPITAL, INC. AND HUNTINGTON MEMORIAL HOSPITAL, INC. AS WELL AS 60% OWNERSHIP IN THE JOINT VENTURE OF ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH, LLC. PARKVIEW 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.
REPORTS FILED WITH STATES PART VI, LINE 7 IN
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
PARKVIEW HEALTH SYSTEM INC
 
Employer identification number
35-1972384
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) IPFW2101 EAST COLISEUM BLVD
FORT WAYNE,IN46805 		35-6033698 501 ( C ) 3 560,546       SUPPORT FOR SCHOOL
(2) UNIVERSITY OF SAINT FRANCIS2701 SPRING STREET
FORT WAYNE,IN46806 		35-0886846 501 ( C ) 3 300,000       SUPPORT FOR SCHOOL
(3) CITY OF FORT WAYNE REDEVELOPMENT COMMISSIONONE EAST MAIN STREET
FORT WAYNE,IN46802 		GOVT ORG 150,000       CAPITAL MAINTENANCE & IMPROVEMENT FUND - PARKVIEW FIELD
(4) FRIENDS OF LINCOLN COLLECTION OF INDIANA INCPO BOX 11083
FORT WAYNE,IN46855 		35-2101024 501 ( C ) 3 83,333       OPERATING FUNDS
(5) FORT 4 FITNESSPO BOX 9007
FORT WAYNE,IN46899 		26-1936423 501 ( C ) 3 25,000       SPONSORSHIP
(6) RONALD MCDONALD HOUSE CHARITIES OF NORTHEAST INDIANA2200 RANDALLIA DRIVE
FORT WAYNE,IN46805 		35-1950376 501 ( C ) 3 25,000       PROGRAMS & OPERATING FUNDS
(7) AMERICAN HEART ASSOCIATION6100 WEST 96TH STREET
INDIANAPOLIS,IN46278 		13-5613797 501 ( C ) 3 17,760       PROGRAMS & OPERATING FUNDS
(8) UNITY PERFORMING ARTS FOUNDATIONPO BOX 10394
FORT WAYNE,IN46825 		35-2110907 501 ( C ) 3 12,491       PROGRAMS & OPERATING FUNDS
(9) FORT WAYNE URBAN LEAGUE2135 SOUTH HANNA STREET
FORT WAYNE,IN46803 		35-0869052 501 ( C ) 3 12,000       PROGRAMS & OPERATING FUNDS
(10) AMERICAN RED CROSS2025 E STREET NW
WASHINGTON,DC20006 		53-0196605 501 ( C ) 3 10,000       PROGRAMS & OPERATING FUNDS
(11) ERINS HOUSE3811 ILLINOIS ROAD SUITE 205
FORT WAYNE,IN46804 		35-1884264 501 ( C ) 3 8,100       PROGRAMS & OPERATING FUNDS
(12) VERA BRADLEY FOUNDATION FOR BREAST CANCERP O BOX 80201
FORT WAYNE,IN46898 		35-2058177 501 ( C ) 3 7,500       SUPPORT FOR RESEARCH
2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
12
3
Enter total number of other organizations ................................ . Bullet Image
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: COMMUNITY HEALTH IMPROVEMENT FUNDING PARTNER ORGANIZATIONS ARE REQUIRED TO SUBMIT AN ANNUAL PROGRESS REPORT RELATED TO PROGRAM FUNDING. PARTNER ORGANIZATIONS ARE REQUIRED TO RE-APPLY FOR FUNDING ON AN ANNUAL BASIS.
Schedule I (Form 990) 2010


Additional Data


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Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
PARKVIEW HEALTH SYSTEM INC
 
Employer identification number

35-1972384
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) MICHAEL PACKNETT (i)
(ii)		 638,622
0 		270,643
0 		2,838
0 		145,546
0 		13,373
0 		1,071,022
0 		0
0
(2) RAYMOND DUSMAN (i)
(ii)		 604,787
0 		0
0 		18,638
0 		26,950
0 		17,705
0 		668,080
0 		0
0
(3) DUANE HOUGENDOBLER (i)
(ii)		 442,820
592 		67,760
0 		3,334
4 		26,919
31 		21,373
25 		562,206
652 		0
0
(4) MITCHELL STUCKY (i)
(ii)		 150,034
116,923 		13,109
0 		1,595
1,243 		15,693
11,257 		6,656
4,775 		187,087
134,198 		0
0
(5) JEFFREY FRANCIS (i)
(ii)		 103,936
0 		56,980
0 		45,886
0 		5,960
0 		9,309
0 		222,071
0 		8,835
0
(6) STANTON RISSER (i)
(ii)		 106,781
0 		31,911
0 		180
0 		7,098
0 		17,716
0 		163,686
0 		0
0
(7) MARK NAFZIGER (i)
(ii)		 407,974
0 		162,245
0 		18,733
0 		54,054
0 		2,884
0 		645,890
0 		0
0
(8) ARTHUR DETORE (i)
(ii)		 335,903
0 		75,118
0 		38,395
0 		66,540
0 		13,179
0 		529,135
0 		19,057
0
(9) CATHERINE WILCOX (i)
(ii)		 261,323
0 		68,254
0 		18,813
0 		48,154
0 		12,771
0 		409,315
0 		0
0
(10) JEFFREY BROOKES (i)
(ii)		 10,110
260,295 		67,189
0 		106
2,732 		10,318
35,061 		2,511
8,534 		90,234
306,622 		0
0
(11) JAMES STAPEL (i)
(ii)		 250,722
1,857 		64,104
0 		21,063
153 		59,943
359 		14,977
90 		410,809
2,459 		0
0
(12) RICK HENVEY (i)
(ii)		 237,847
0 		52,777
0 		11,024
0 		32,842
0 		20,784
0 		355,274
0 		10,364
0
(13) RONALD DOUBLE (i)
(ii)		 243,971
0 		51,753
0 		1,740
0 		51,005
0 		6,967
0 		355,436
0 		0
0
(14) DEBRA WILLIAMS (i)
(ii)		 229,857
0 		56,396
0 		1,100
0 		33,672
0 		9,033
0 		330,058
0 		0
0
(15) JAMES WITMER (i)
(ii)		 192,937
0 		49,956
0 		13,321
0 		35,904
0 		4,704
0 		296,822
0 		10,432
0
(16) JAMES HAUGUEL (i)
(ii)		 180,055
0 		33,008
0 		69
0 		36,376
0 		8,033
0 		257,541
0 		0
0
(17) SAILAJA BLACKMON (i)
(ii)		 711,376
0 		75,971
0 		1,490
0 		17,150
0 		27,625
0 		833,612
0 		0
0
(18) DAVID SOWDEN (i)
(ii)		 641,369
387 		83,787
0 		20,843
13 		26,936
14 		14,254
8 		787,189
422 		0
0
(19) DOUGLAS GRAY (i)
(ii)		 606,315
0 		93,131
0 		17,985
0 		22,050
0 		21,563
0 		761,044
0 		0
0
(20) DAVID LLOYD (i)
(ii)		 605,879
0 		83,799
0 		20,856
0 		17,150
0 		20,390
0 		748,074
0 		0
0
(21) SATISH VELAGAPUDI (i)
(ii)		 634,354
0 		0
0 		18,138
0 		17,150
0 		17,625
0 		687,267
0 		0
0
(22) CHARLES MASON (i)
(ii)		 0
0 		0
0 		448,413
0 		0
0 		0
0 		448,413
0 		448,413
0
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
  PART I, LINE 1A PERSONAL SERVICES TAXABLE ALLOWANCE FOR FINANCIAL PLANNING PAID TO: SAILAJA BLACKMON $500; RONALD DOUBLE $750; RAYMOND DUSMAN $500; DOUGLAS GRAY $385; DUANE HOUGENDOBLER $500; JAMES STAPEL $300; CATHERINE WILCOX $675
  PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS TAXABLE - ARTHUR DETORE $19,057; JEFFREY FRANCIS $8,835; RICK HENVEY $10,364; CHARLES MASON $448,413; JAMES WITMER $10,432 PARTICIPANTS DEFERRED - JEFFREY BROOKES $30,137; MICHAEL BROWNING $3,835; ARTHUR DETORE $40,815; RONALD DOUBLE $25,280; JAMES HAUGUEL $21,240; RICK HENVEY $27,942; MARK NAFZIGER $46,704; MICHAEL PACKNETT $133,296; JAMES STAPEL $30,902; CATHERINE WILCOX $32,336; DEBRA WILLIAMS $27,547; JAMES WITMER $22,640
  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 J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
PARKVIEW HEALTH SYSTEM INC
 
Employer identification number
35-1972384
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A INDIANA FINANCE AUTHORITY
  		35-1602316 45471ABQ4 08-27-2009 264,703,254 SEE PART V   X   X   X
B INDIANA FINANCE AUTHORITY
  		35-1602316 45471AAS1 08-27-2009 223,665,000 SEE PART V   X   X   X
C INDIANA FINANCE AUTHORITY
  		35-1602316 NONEAVAIL 05-04-2010 30,000,000 SEE PART V   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . . 7,910,000      
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 264,704,689 223,909,069 30,000,000  
4 Gross proceeds in reserve funds . .        
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . .        
7 Issuance costs from proceeds . . . 3,451,766 1,367,866 155,500  
8 Credit enhancement from proceeds. 193,601 193,601    
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . . 140,225,815 140,225,815 12,900,000  
11 Other spent proceeds . . 261,252,923 73,266,604    
12 Other unspent proceeds. . . 8,855,183 8,855,183 16,944,500  
13 Year of substantial completion . . . 2009 2011 2011
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? X   X   X      
15 Were the bonds issued as part of an advance refunding issue?   X   X   X    
16 Has the final allocation of proceeds been made? . . X     X   X    
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X   X      
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . X   X   X      
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use? X   X   X      
b Are there any research agreements that may result in private business use of bond-financed property? . . X   X   X      
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X   X   X      
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0 % 0 % 0 %  
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 % 0 % 0 %  
6 Total of lines 4 and 5 . . .. . . . . . 0 % 0 % 0 %  
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X      
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X    
2 Is the bond issue a variable rate issue?   X X   X      
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X X     X    
b Name of provider . NA
  		CITIGROUP
  		NA
  		 
 
c Term of hedge . . 20.000000000000 20.000000000000    
d Was the hedge superintegrated? .   X   X        
e Was a hedge terminated? .   X   X        
4a Were gross proceeds invested in a GIC? .   X   X   X    
b Name of provider . NA
  		NA
  		NA
  		 
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .   X   X   X    
6 Did the bond issue qualify for an exception to rebate? . . . X   X   X      
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
SCHEDULE K, PART 1,A,F DESCRIPTION OF PURPOSE SERIES 2009A - 1) PARTIALLY REFUNDED OUTSTANDING 2005 SERIES BOND ISSUE 2) PARTIALLY REFUNDED OUTSTANDING BONDS FOR 2001 SERIES BOND ISSUE
SCHEDULE K, PART 1,B,F DESCRIPTION OF PURPOSE SERIES 2009BCD - 1) NEW MONEY FOR CONSTRUCTION OF NEW HOSPITAL IN FORT WAYNE, IN 2) FULLY REFUNDED BALANCE OF OUTSTANDING 2005 SERIES BONDS
SCHEDULE K, PART 1,C,F DESCRIPTION OF PURPOSE SERIES 2010 - NEW MONEY FOR CONSTRUCTION OF NEW PARKVIEW WHITLEY HOSPITAL FACILITY IN COLUMBIA CITY, IN
SCHEDULE K, PART II, 3, C TOTAL PROCEEDS ON ISSUE THIS IS A CONSTRUCTION DRAW BOND AND THEREFORE NO INTEREST WILL BE EARNED ON ANY PROJECT FUNDS.
SCHEDULE K, PART III, LINES 4-6 PRIVATE BENEFIT USE PARKVIEW HEALTH SYSTEM, INC. CLOSELY MONITORS THE LEVEL OF PRIVATE USE AT OUR BOND FINANCED FACILITIES. THE LEVEL OF EQUITY PROVIDED BY PARKVIEW HEALTH SYSTEM, INC. FOR THIS FACILITY IS MORE THAN SUFFICIENT TO COVER THE LOW LEVEL OF PRIVATE USE OCCURING WITHIN THE FACILITY CONSTRUCTED IN PART WITH BOND FINANCING.
Schedule K (Form 990) 2010

Additional Data


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Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
PARKVIEW HEALTH SYSTEM INC
 
Employer identification number

35-1972384
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) FCFP LLC
  		ENTITY OF WHICH DIRECTOR MITCHELL STUCKY OWNED A GREATER THAN 5% INTEREST 789,632 RENTAL OF PROPERTY TO PARKVIEW HEALTH SYSTEM, INC. - TRANSACTIONS WERE ENTERED INTO AT ARM'S LENGTH. ADDITIONALLY, DIRECTOR MITCHELL STUCKY DOES NOT PARTICIPATE IN THE DISCUSSIONS/DECISION TO LEASE PROPERTY OR THE LEASE TERMS AND PAYMENTS.   No
(2) NORTHEAST ORTHOPAEDIC HOSPITAL INVESTORS LLC
  		ENTITY OF WHICH DIRECTOR MICHAEL LEE OWNED A GREATER THAN 5% INTEREST 21,198,333 PARKVIEW HEALTH SYSTEM, INC. AND NORTHEAST ORTHOPAEDIC HOSPITAL INVESTORS, LLC ARE BOTH MEMBERS IN THE JOINT VENTURE OF ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH, LLC. THE TOTAL AMOUNT INVESTED BY PARKVIEW HEALTH SYSTEM, INC. IN THE JOINT VENTURE AS OF 12/31/2010 IS $21,198,333.   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
PARKVIEW HEALTH SYSTEM INC
 
Employer identification number

35-1972384
Identifier Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 2   KEY EMPLOYEE JAMES WITMER AND DIRECTORS THOMAS BEAVER AND CHARLES SCHRIMPER 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 PARKVIEW HEALTH SYSTEM, INC. AND ARE AS FOLLOWS: THE CHANGED PORTION AS NOW FINALIZED, OF ARTICLE IV, SECTION 2 IS AS FOLLOWS: 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 IV, SECTION 4. ARTICLE IV, SECTION 3 IS AS FOLLOWS: ELECTED DIRECTORS SHALL SERVE FOR A TERM OF THREE (3) YEARS AND UNTIL A SUCCESSOR HAS BEEN DULY ELECTED AND QUALIFIED. NO ELECTED DIRECTOR SHALL BE ELIGIBLE FOR ELECTION TO MORE THAN THREE (3) CONSECUTIVE THREE (3) YEAR TERMS. AFTER AN ABSENCE OF ONE (1) YEAR, A PERSON SHALL BECOME ELIGIBLE FOR RE-ELECTION 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 IV, SECTION 4 IS AS FOLLOWS: IN THE EVENT THAT A VACANCY OF A DIRECTOR WHO IS NOT SERVING IN AN EX OFFICIO CAPACITY OCCURS IN THE BOARD, THE EXECUTIVE COMMITTEE SHALL NOMINATE A CANDIDATE AND PRESENT THE NAME TO THE BOARD. 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 IV, SECTION 9 IS AS FOLLOWS: THE CHAIR, REGARDLESS OF TENURE OF BOARD MEMBERSHIP AND THE RESTRICTIONS OF ELIGIBILITY SET FORTH IN THIS ARTICLE, MAY BE SUCCESSIVELY ELECTED FOR NO MORE THAN FIVE (5) ONE-YEAR TERMS, WHERE CONSECUTIVE SERVICE AS THE CHAIR IS DETERMINED TO BE APPROPRIATE FOR ORGANIZATIONAL EFFECTIVENESS. AFTER SERVICE AS CHAIR, THE CHAIR SHALL NOT BE ELIGIBLE FOR RE-ELECTION TO THE SAME POSITION UNTIL EXPIRATION OF THREE (3) INTERVENING YEARS. IF A CHAIR'S NORMAL TERM AS A DIRECTOR EXPIRES WHILE SERVING AS THE CHAIR, AND IF HE/SHE IS NOMINATED FOR RE-ELECTION AS CHAIR, IN ORDER TO SERVE AS CHAIR, HE/SHE WILL BE RE-ELECTED TO THE BOARD FOR AN ADDITIONAL YEAR BEYOND THEIR TERM AS CHAIR, SECTION 3 OF THIS ARTICLE NOTWITHSTANDING. THE CHANGED PORTION AS NOW FINALIZED, OF ARTICLE V, 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 VI, 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 FIVE (5) MEMBERS. MEMBERSHIP ON THE PARKVIEW HEALTH BOARD, OR A PARKVIEW HEALTH SUBSIDIARY OR AFFILIATE 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. NOTWITHSTANDING ANY SPECIAL DESIGNATION WITHIN THESE BYLAWS AS TO THE COMPOSITION OF A PARTICULAR COMMITTEE, THE CHAIR MAY DESIGNATE OTHER COMMITTEE MEMBERS AS DEEMED NECESSARY. EXCEPT AS TO THE AUDIT COMMITTEE, THE PRESIDENT AND CHIEF EXECUTIVE 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 MINUTES OF THEIR MEETINGS AND SUBMIT THE MINUTES TO THE BOARD. ARTICLE VI, SECTION 4(A)IS AS FOLLOWS: THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE CHAIR OF THE BOARD, VICE CHAIR OF THE BOARD, THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, TREASURER AND SECRETARY OF THE CORPORATION AND AT LEAST ONE DIRECTOR WHO IS AN EX-OFFICIO VOTING MEMBER OF THE BOARD AND SUCH OTHER DIRECTORS AS ARE DESIGNATED BY THE CHAIR OF THE BOARD. THE EXECUTIVE COMMITTEE MAY ACT AS THE EXECUTIVE COMPENSATION COMMITTEE FOR THE CORPORATION. OTHER THAN THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (WHO SHALL NOT PARTICIPATE WITH THE EXECUTIVE COMMITTEE WHEN IT ACTS AS THE EXECUTIVE COMPENSATION COMMITTEE), ALL VOTING MEMBERS OF THE EXECUTIVE COMMITTEE SHALL BE INDEPENDENT, AS DEFINED BY THE INTERNAL REVENUE SERVICE. AT THE DISCRETION OF THE CHAIR, OTHERS MAY BE INVITED TO PARTICIPATE IN EXECUTIVE COMMITTEE MEETINGS WITHOUT VOTE. THE CHAIR OF THE BOARD SHALL SERVE AS CHAIR OF THE EXECUTIVE COMMITTEE. THE CHANGED PORTION AS NOW FINALIZED, OF ARTICLE VI, SECTION 4(B) IS AS FOLLOWS: THE EXECUTIVE COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION IN ANY MATTER WHEN THE BOARD IS NOT IN SESSION. IN ADDITION, THE COMMITTEE SHALL PERFORM ALL RESPONSIBILITIES DELEGATED TO IT BY THE BOARD. THE EXECUTIVE COMMITTEE MAY SERVE AS THE EXECUTIVE COMPENSATION COMMITTEE FOR THE CORPORATION AND ALL OF ITS ENTITIES, AS DETERMINED BY THE CHAIR OF THE BOARD, AT WHICH TIME, THE EXECUTIVE COMPENSATION COMMITTEE SHALL ESTABLISH THE COMPENSATION FOR ALL KEY MANAGEMENT PERSONNEL, PURSUANT TO THE STANDARDS OF CONDUCT RELATING TO EXECUTIVE COMPENSATION. NO OTHER BOARD OR COMMITTEE CAN APPROVE EXECUTIVE COMPENSATION ARRANGEMENTS. THE CHANGED PORTION AS NOW FINALIZED, OF ARTICLE VI, SECTION 5(B) IS AS FOLLOWS: THE SYSTEM FINANCE COMMITTEE SHALL CONSIST OF AT LEAST FIVE (5) MEMBERS, THE MAJORITY OF WHOM SHALL BE DISINTERESTED, AND SHALL INCLUDE THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, THE CHIEF FINANCIAL OFFICER AND INCLUDE PARKVIEW HEALTH SERVICE AREA REPRESENTATION, AS DESIGNATED BY THE CHAIR OF THE BOARD. THE CHANGED PORTION AS NOW FINALIZED, OF ARTICLE VI, SECTION 5(C) IS AS FOLLOWS: THE SYSTEM CORPORATE COMPLIANCE COMMITTEE SHALL CONSIST OF AT LEAST FIVE (5) MEMBERS, THE MAJORITY OF WHOM SHALL BE DISINTERESTED, AND SHALL INCLUDE THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, THE CORPORATE COMPLIANCE OFFICER, AND INCLUDE PARKVIEW HEALTH SERVICE AREA REPRESENTATION, AS DESIGNATED BY THE CHAIR OF THE BOARD. THE CHANGED PORTION AS NOW FINALIZED, OF ARTICLE VI, SECTION 5(D) IS AS FOLLOWS: THE QUALITY COMMITTEE SHALL CONSIST OF AT LEAST FIVE (5) MEMBERS, AND SHALL INCLUDE THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, THE ADMINISTRATIVE CORPORATE OFFICER RESPONSIBLE FOR THE SYSTEM'S QUALITY INITIATIVES, AND INCLUDE PARKVIEW HEALTH SERVICE AREA REPRESENTATION, AS DESIGNATED BY THE CHAIR OF THE BOARD. THE CHANGED PORTION AS NOW FINALIZED, OF ARTICLE VI, SECTION 5(E) IS AS FOLLOWS: THE SYSTEM AUDIT COMMITTEE SHALL CONSIST OF AT LEAST FIVE (5) MEMBERS, THE MAJORITY OF WHOM SHALL BE DISINTERESTED, AND SHALL INCLUDE THE CHAIR OF THE AUDIT COMMITTEE, WHO SHALL BE DISINTERESTED, AND INCLUDE PARKVIEW HEALTH SERVICE AREA REPRESENTATION, AS DESIGNATED BY THE CHAIR OF THE BOARD. THE AUDIT COMMITTEE SHALL BE CONDUCTED CONSISTENT WITH THE TERMS OF THE AUDIT COMMITTEE CHARTER. THE SYSTEM AUDIT COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION TO PROVIDE REVIEW OF THE CORPORATION AND ITS AFFILIATE AND SUBSIDIARY CORPORATIONS' FORM 990 FILINGS. THE CHANGED PORTION AS NOW FINALIZED, OF ARTICLE VI, SECTION 5(F) IS AS FOLLOWS: THE SYSTEM INFORMATION TECHNOLOGY GOVERNANCE COMMITTEE SHALL CONSIST OF AT LEAST FIVE (5) MEMBERS, THE MAJORITY OF WHOM SHALL BE DISINTERESTED, AND SHALL INCLUDE THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, THE CHIEF INFORMATION OFFICER, AND INCLUDE PARKVIEW HEALTH SERVICE AREA REPRESENTATION, AS DESIGNATED BY THE CHAIR OF THE BOARD.
FORM 990, PART VI, SECTION B, LINE 11   AN ELECTRONIC COPY OF THE ORGANIZATION'S FINAL FORM 990 (INCLUDING REQUIRED SCHEDULES) WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY AND THE SYSTEM AUDIT COMMITTEE, PRIOR TO FILING WITH THE IRS. ON OCTOBER 12, 2011, THE SYSTEM AUDIT COMMITTEE REVIEWED THE FORM 990 AS ULTIMATELY FILED WITH THE IRS. THIS REVIEW INCLUDED A PRESENTATION BY THE ORGANIZATION'S TAX PREPARER TO HIGHLIGHT THE SIGNIFICANT AREAS ON THE REDESIGNED FORM 990 AND SUPPLEMENTAL SCHEDULES.
  FORM 990, PART VI, SECTION B, LINE 12C AS DESCRIBED IN ARTICLE IX SECTION 6, OF THE PARKVIEW HEALTH SYSTEM, INC. (PH) BYLAWS, PH ADOPTED PH'S COMPLIANCE POLICY FOR THE ORGANIZATION AND ITS NOT-FOR-PROFIT RELATED ORGANIZATIONS (AND AS LIKEWISE NOTED IN THEIR BYLAWS) WHEN ADDRESSING CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. THIS COMPLIANCE POLICY (COMPLIANCE POLICY #14) REQUIRES THAT EACH BOARD MEMBER, BOARD COMMITTEE MEMBER, AND KEY MANAGEMENT PERSONNEL MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST FORM. THIS INFORMATION IS PROVIDED TO THE CHAIRMAN OF THE BOARD (FOR BOARD AND BOARD COMMITTEE MEMBERS) AND TO SENIOR MANAGEMENT (FOR KEY MANAGEMENT PERSONNEL). IN ADDITION, AS TO THE CONDUCT OF BOARD MEETINGS, THE FOLLOWING PROCESS IS FOLLOWED: WHENEVER A PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE IS CONSIDERING A TRANSACTION OR ARRANGEMENT WITH AN ORGANIZATION, ENTITY OR INDIVIDUAL IN WHICH A PERSON COVERED BY THIS POLICY HAS A FINANCIAL OR CONFLICTING INTEREST, THE FOLLOWING SHALL OCCUR: 1. THE INTERESTED PERSON MUST DISCLOSE THE FINANCIAL OR CONFLICTING INTEREST AND ALL MATERIAL FACTS TO THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE; 2. THE INTERESTED PERSON WITH THAT FINANCIAL OR CONFLICTING INTEREST MAY MAKE A PRESENTATION AT THE BOARD OR BOARD COMMITTEE MEETING REGARDING THE TRANSACTION OR ARRANGEMENT. HOWEVER, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE FINANCIAL OR CONFLICTING INTEREST; AND 3. THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE MUST APPROVE THE TRANSACTION OR ARRANGEMENT BY A MAJORITY VOTE OF THE BOARD MEMBERS PRESENT AT A MEETING THAT HAS A QUORUM, NOT INCLUDING THE VOTE OF THE INTERESTED PERSON. IN ADDITION, THE FOLLOWING CONSIDERATIONS SHOULD BE MADE: 4. IF APPROPRIATE, THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT; AND 5. IN ORDER TO APPROVE THE TRANSACTION, THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE MUST FIRST FIND, BY A MAJORITY VOTE OF THE DISINTERESTED BOARD MEMBERS, THAT THE PROPOSED TRANSACTION OR ARRANGEMENT IS IN THE BEST INTERESTS OF AND FOR THE BENEFIT OF PH AND/OR PH AFFILIATES AND THE PROPOSED TRANSACTION IS FAIR AND REASONABLE TO PH AND/OR PH AFFILIATES AND, AFTER REASONABLE INVESTIGATION, THAT THE PH AND/OR PH AFFILIATES CANNOT OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES."
  FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USED A PROCESS FOR DETERMINING COMPENSATION OF THE CEO, OFFICERS, AND KEY EMPLOYEES. THE PROCESS INCLUDES CONSULTATIONS WITH AN INDEPENDENT COMPENSATION ADVISOR; REVIEW, AND APPROVAL BY THE GOVERNING BODY; AND CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. THE BOARD EXECUTIVE COMMITTEE OF PARKVIEW HEALTH SYSTEM, INC. SERVED AS THE EXECUTIVE COMPENSATION COMMITTEE IN 2010, PURSUANT TO THE ORGANIZATION'S BYLAWS, FOR PURPOSES OF REVIEWING AND APPROVING ALL EXECUTIVE COMPENSATION, BENEFITS AND PERQUISITES FOR THE 2010 COMPENSATION PACKAGE. THE COMPENSATION PACKAGE WAS APPROVED BY A MAJORITY OF INDEPENDENT BOARD EXECUTIVE COMMITTEE MEMBERS. PARKVIEW'S INDEPENDENT CONSULTANT PREPARES A COMPETITIVE COMPENSATION ANALYSIS USING DATA FROM MULTIPLE PUBLISHED SURVEYS PREPARED BY INDEPENDENT FIRMS FOR POSITIONS THAT ARE FUNCTIONALLY COMPARABLE IN SIMILAR-SIZED HEALTH SYSTEMS AND HOSPITAL ORGANIZATIONS ON BOTH A REGIONAL AND NATIONAL BASIS. THE INDEPENDENT CONSULTANT PROVIDES A STATEMENT OF REASONABLENESS OF THE COMPENSATION PROVIDED TO THE CEO AS WELL AS ALL EXECUTIVES AT THE VICE PRESIDENT LEVEL AND ABOVE. ALL DATA IS SHARED WITH THE BOARD OF DIRECTORS EXECUTIVE COMMITTEE. THE BOARD APPROVES ANY CHANGES IN COMPENSATION FOR THE CEO AND HIS DIRECT REPORTS. APPROVAL IS ALSO PROVIDED FOR THE MERIT BUDGET FOR THE ENTIRE ORGANIZATION. THE BOARD REVIEWS AND APPROVES THE MANAGEMENT INCENTIVE COMPENSATION PLAN (MICP). OFFICES OR POSITIONS REVIEWED AT THE 2010 MEETING: PRESIDENT AND CEO PH EXECUTIVE VICE PRESIDENT STRATEGIC DIRECTION AND BUSINESS DEVELOPMENT EXECUTIVE VICE PRESIDENT PARKVIEW HEALTH/COO PARKVIEW HOSPITAL EXECUTIVE VICE PRESIDENT AND COO PARKVIEW HEALTH MEDICAL DIRECTOR COMMUNITY HOSPITALS SENIOR VICE PRESIDENT OPERATIONS / SERVICE EXCELLENCE SENIOR VICE PRESIDENT HUMAN RESOURCES SENIOR VICE PRESIDENT AND GENERAL COUNSEL SENIOR VICE PRESIDENT HEALTH PLAN SERVICES SENIOR VICE PRESIDENT PATIENT CARE SENIOR VICE PRESIDENT AND CHIEF QUALITY OFFICER / PATIENT SAFETY OFFICER SENIOR VICE PRESIDENT OPERATIONS SENIOR VICE PRESIDENT AND CHIEF INFORMATION OFFICER SENIOR VICE PRESIDENT/COO ORTHOPEDIC HOSPITAL SENIOR VICE PRESIDENT/COO COMMUNITY HOSPITALS - HUNTINGTON SENIOR VICE PRESIDENT/COO COMMUNITY HOSPITALS - NOBLE SENIOR VICE PRESIDENT/COO COMMUNITY HOSPITALS - WHITLEY SENIOR VICE PRESIDENT/COO COMMUNITY HOSPITALS - LAGRANGE SENIOR VICE PRESIDENT/COO PHYSICIAN PRACTICES SENIOR VICE PRESIDENT AND CHIEF FINANCIAL OFFICER SENIOR VICE PRESIDENT REVENUE CYCLE MANAGEMENT MEDICAL DIRECTOR PARKVIEW PHYSICIAN GROUP SENIOR VICE PRESIDENT FACILITY DESIGN AND OVERSIGHT EXECUTIVE DIRECTOR WOMEN AND CHILDREN'S SERVICES VICE PRESIDENT - PATIENT CARE - NOBLE VICE PRESIDENT - PATIENT CARE - WHITLEY VICE PRESIDENT - PATIENT CARE - LAGRANGE CORPORATE DIRECTOR MARKETING, COMMUNICATIONS, COMMUNITY RELATIONS VICE PRESIDENT/ADMINISTRATOR PRIMARY CARE PRACTICE GROUP EXECUTIVE DIRECTOR CANCER SERVICES VICE PRESIDENT CHANGING SPACES CONSTRUCTION/PROJECT MANAGEMENT MEDICAL DIRECTOR HEALTH PLAN SERVICES CORPORATE DIRECTOR DIETETICS/FOOD SERVICES VICE PRESIDENT PLANNING AND DECISION SUPPORT VICE PRESIDENT STRATEGIC AND BUSINESS PLANNING VICE PRESIDENT HEALTH INFORMATION MANAGEMENT EXECUTIVE DIRECTOR PKV OUTPATIENT ENTERPRISE VICE PRESIDENT/ADMINISTRATOR SPECIALTY PRACTICE GROUP VP SPECIAL PROJECTS VP PPG FINANCE VP SUPPLY CHAIN COO PARKVIEW HEART INSTITUTE
  FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
COMMON PAYING AGENT FOR FILING ORGANIZATION FORM 990, PART V, LINE 1A, 2A AND PART VII, SECTION B, LINE 2: PARKVIEW HEALTH SYSTEM, INC. (PH), EIN 35-1972384, IS THE COMMON PAYING AGENT FOR THE FILING ORGANIZATION AS WELL AS RELATED ENTITIES. 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 PARKVIEW HEALTH SYSTEM, INC. WAS 249 AND 2,190 RESPECTIVELY. AS REFLECTED IN PART VII, SECTION B, APPROXIMATELY 18 INDEPENDENT CONTRACTORS RECEIVED MORE THAN $100,000 IN COMPENSATION FOR SERVICES FROM PARKVIEW HEALTH SYSTEM, INC.
AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII, SECTION A, COLUMN B: MICHAEL PACKNETT (DIRECTOR/PH CEO), MICHAEL BROWNING (CURRENT PH SVP & CFO), JEFFREY FRANCIS (PH SVP & CFO), STANTON RISSER (INTERIM PH CFO), MARK NAFZIGER (PH EVP & COO), CATHERINE WILCOX (PH SVP), RONALD DOUBLE (PH CIO), AND DEBRA WILLIAMS (PH SVP) 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) 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) DUANE HOUGENDOBLER (DIRECTOR/PH PHYSICIAN) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO HMHOS AND 40 HOURS PER WEEK TO PH. MITCHELL STUCKY (DIRECTOR/PH PHYSICIAN) DEVOTED APPROXIMATELY 20 HOURS PER WEEK TO PVHOS AND 20 HOURS PER WEEK TO PH. MICHAEL AXEL (DIRECTOR) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO NBHOS AND ONE HOUR PER WEEK TO PH. RICHARD BAKER (DIRECTOR) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO HMHOS AND ONE HOUR PER WEEK TO PH. THOMAS BEAVER (DIRECTOR) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO PVHOS AND ONE HOUR PER WEEK TO PH. DAVID HAIST (DIRECTOR) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO PVHOS AND ONE HOUR PER WEEK TO PH. LAURA LEFEVER (DIRECTOR) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO WMFND, ONE HOUR PER WEEK TO PH AND ONE HOUR PER WEEK TO WMHOS. JOHN PRICE (DIRECTOR) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO LGHOS, AND ONE HOUR PER WEEK TO PH. WIL SMITH (DIRECTOR/TREASURER) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO PVHOS AND ONE HOUR PER WEEK TO PH. JEFFREY BROOKES (PH MEDICAL DIR - COMMUNITY HOSPITALS) DEVOTED APPROXIMATELY 10 HOURS PER WEEK TO HMHOS, 10 HOURS PER WEEK TO LGHOS, 10 HOURS PER WEEK TO NBHOS, 10 HOURS PER WEEK TO WMHOS AND ONE HOUR PER WEEK TO PH. JAMES STAPEL (PH MEDICAL DIR - PPG) DEVOTED APPROXIMATELY 40 HOURS PER WEEK TO PH AND AS-NEEDED HOURS TO HMHOS, LGHOS, NBHOS, AND WMHOS. RICK HENVEY (PH COO-COMMUNITY HOSPITALS) DEVOTED APPROXIMATELY ONE HOUR PER WEEK TO WMFND FOR PARTIAL YEAR WHILE WMHOS INTERIM COO, 40 HOURS PER WEEK TO WMHOS FOR PARTIAL YEAR WHILE WMHOS INTERIM COO, 40 HOURS PER WEEK TO PH FOR PARTIAL YEAR DURING HIS REGULAR POSITION OF PH COO-COMMUNITY HOSPITALS AND ONE HOUR PER WEEK TO PVHOS, POHCI, HMHOS, LGHOS, AND NBHOS.
SALES OF SECURITIES FORM 990 PART VIII, LINES 7A, B & C, COLUMN I: LINE 7A GROSS AMOUNT FROM SALES OF ASSETS OTHER THAN INVENTORY $1,811,336,398. LINE 7B LESS: COST OR OTHER BASIS AND SALES EXPENSES $1,807,162,087. LINE 7C GAIN OR (LOSS) $4,174,310.
SALARIES AND WAGES, OTHER EMPLOYEE BENEFITS AND PAYROLL TAXES FORM 990, PART IX, LINES 5-10: PARKVIEW HEALTH SYSTEM, INC., EIN 35-1972384, SERVES AS THE COMMON PAYING AGENT FOR ALL TAX-EXEMPT ORGANIZATIONS OF THE SYSTEM. SALARIES AND WAGES OF EMPLOYEES WORKING FOR THESE ORGANIZATIONS ARE CHARGED DIRECTLY TO THE ORGANIZATIONS IN WHICH THEY WORK. THE ACTUAL EXPENSES FOR PAYROLL TAXES, EMPLOYEE BENEFITS, AND PENSION PLAN CONTRIBUTIONS ARE REFLECTED ON THE BOOKS OF PARKVIEW HEALTH SYSTEM, INC. FOR FINANCIAL REPORTING PURPOSES. TO ACCOUNT FOR BENEFIT COSTS ON THE BOOKS OF THE OTHER TAX EXEMPT ORGANIZATIONS, AN ALLOCATION METHODOLOGY IS UTILIZED TO CHARGE THESE ORGANIZATIONS WITH AN ESTIMATE OF THE OVERALL COSTS, REFERRED TO AS A "BENEFIT ALLOCATION" FROM PARKVIEW HEALTH SYSTEM, INC. THE ALLOCATION DOES NOT DISTINGUISH BETWEEN THE COSTS OF THE VARIOUS COMPONENTS (I.E. PAYROLL TAXES, EMPLOYEE BENEFITS, AND PENSION PLAN CONTRIBUTIONS). THEREFORE, FOR PURPOSES OF THE FORM 990, PART IX, THE TOTAL BENEFIT ALLOCATION FOR THE EMPLOYEES' SALARIES AND WAGES REPORTED ON LINE 7 IS REFLECTED ON LINE 9 AND NOT ALLOCATED BETWEEN LINES 8 OR 10. FOR PURPOSES OF THE FORM 990, PART IX, LINES 5 AND 6 REFLECT COMPENSATION AND BENEFIT AMOUNTS REPORTED IN PART VII.
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 4,966,345. ASSET ADJUSTMENT TRANSFERS 733,097. BOOK/TAX DIFF FROM K-1'S 1,409,219. CURRENT YEAR EARNINGS TRANSFERRED FROM 501( C )3'S 40,714,705. AMORTIZE BOND SWAP OCI 42,600. ADJUST OCI FOR PENSION 3,308,875. TOTAL TO FORM 990, PART XI, LINE 5: 51,174,841.
REQUIREMENTS UNDER SINGLE AUDIT ACT AND OMB CIRCULAR A-133 FORM 990, PART XII, LINE 3: AS REQUIRED BY THE U.S. OFFICE OF MANAGEMENT AND BUDGET CIRCULAR A-133, AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS, IN 2010 PARKVIEW HEALTH SYSTEM, INC. AND SUBSIDIARIES RECEIVED AN AUDIT FOR THE 2009 CONSOLIDATED FINANCIAL STATEMENTS IN ACCORDANCE WITH THE SINGLE AUDIT ACT.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
PARKVIEW HEALTH SYSTEM INC
 
Employer identification number

35-1972384
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity







(1) NORTHEAST OBSTETRICS & GYNECOLOGY INC
10501 CORPORATE DRIVE
FORT WAYNE,IN46845
32-0118260 		PHYSICIANS IN     N/A
(2) NEW VISION PROFESSIONAL PARK LLC
10501 CORPORATE DRIVE
FORT WAYNE,IN46845
35-1972384 		REAL ESTATE IN 1,052,802 15,783,401 N/A
(3) TRI-STATE MEDICAL IMAGING LLC
3250 INTERTECH DR SUITE D
ANGOLA,IN46703
20-4212330 		RADIOLOGY IN 211,222 1,578,000 COMMUNITY HOSPITAL OF NOBLE COUNTY INC
 
(4) FORT WAYNE ENDOSCOPY CENTER LLC
10501 CORPORATE DRIVE
FORT WAYNE,IN46845
43-1957176 		ENDOSCOPY IN 420,850 1,843,340 N/A




Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) PARKVIEW HOSPITAL INC

2200 RANDALLIA DRIVE

FORT WAYNE,IN46805
35-0868085 		HOSPITAL CARE IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC
 
Yes
 
(2) PARKVIEW FOUNDATION INC

2200 RANDALLIA DRIVE

FORT WAYNE,IN46805
23-7220589 		FUND MGMT IN 501(C)(3) LINE 11A, I PARKVIEW HOSPITAL INC
 
Yes
 
(3) PARKVIEW OCCUPATIONAL HEALTH CENTERS INC

2200 RANDALLIA DRIVE

FORT WAYNE,IN46805
35-2064353 		OCCUP HEALTH IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC
 
Yes
 
(4) COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC

207 N TOWNLINE ROAD

LAGRANGE,IN46761
20-2401676 		HOSPITAL CARE IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC
 
Yes
 
(5) COMMUNITY HOSPITAL OF NOBLE COUNTY INC

401 SAWYER ROAD

KENDALLVILLE,IN46755
35-2087092 		HOSPITAL CARE IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC
 
Yes
 
(6) COMMUNITY HOSPITAL OF NOBLE COUNTY FOUNDATION INC

401 SAWYER ROAD

KENDALLVILLE,IN46755
35-2089183 		FUND MGMT IN 501(C)(3) LINE 11A, I COMMUNITY HOSPITAL OF NOBLE COUNTY INC
 
Yes
 
(7) WHITLEY MEMORIAL HOSPITAL INC

353 N OAK STREET

COLUMBIA CITY,IN46725
35-1967665 		HOSPITAL CARE IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC
 
Yes
 
(8) WHITLEY MEMORIAL HOSPITAL FOUNDATION INC

353 N OAK STREET

COLUMBIA CITY,IN46725
31-1190239 		FUND MGMT IN 501(C)(3) LINE 11A, I WHITLEY MEMORIAL HOSPITAL INC
 
Yes
 
(9) HUNTINGTON MEMORIAL HOSPITAL INC

2001 STULTS ROAD

HUNTINGTON,IN46750
35-1970706 		HOSPITAL CARE IN 501(C)(3) LINE 3 PARKVIEW HEALTH SYSTEM INC
 
Yes
 
(10) PARKVIEW HUNTINGTON HOSPITAL FOUNDATION INC

2001 STULTS ROAD

HUNTINGTON,IN46750
32-0012095 		FUND MGMT IN 501(C)(3) LINE 11A, I HUNTINGTON MEMORIAL HOSPITAL INC
 
Yes
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH LLC

10501 CORPORATE DRIVE
FORT WAYNE,IN46845
26-0143823 		ORTHO HOSPITAL IN  
RELATED 10,508,713 23,711,805   No   Yes   60.000 %
(2) FOUNDATION SURGERY AFFILIATE OF FORT WAYNE LLC

8004 CARNEGIE BLVD
FORT WAYNE,IN46804
20-1394120 		SURGICAL SERVICES IN  
RELATED 743,187 657,362   No   Yes   51.000 %
(3) MANAGED CARE SERVICES LLC

2200 RANDALLIA DRIVE
FORT WAYNE,IN46805
35-1996535 		HEALTH PLAN ADMIN IN  
RELATED 225,388 1,758,204   No   Yes   90.000 %
(4) PARKVIEW IMAGING HUNTINGTON LLC

10501 CORPORATE DRIVE
FORT WAYNE,IN46845
20-8651460 		EQUIPMENT LEASING IN HUNTINGTON MEMORIAL HOSPITAL INC
  		RELATED       No     No  






Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) PARKVIEW PROFESSIONAL PROGRAMS INC
2200 RANDALLIA DRIVE
FORT WAYNE,IN46805
35-1668888 		REFERENCE LAB IN PARKVIEW HOSPITAL INC
  		C 14,822,049 2,308,214  
(2) PARKVIEW PROFESSIONAL BILLINGS INC
2200 RANDALLIA DRIVE
FORT WAYNE,IN46805
35-1950305 		BILLING IN PARKVIEW HOSPITAL INC
  		C 1,680    
(3) FIRST CARE FAMILY PHYSICIANS PC
10501 CORPORATE DRIVE
FORT WAYNE,IN46845
35-1714247 		PHYSICIANS IN N/A
 C 206,520   100.000 %
(4) FORT WAYNE CARDIOVASCULAR SURGEONS PC
10501 CORPORATE DRIVE
FORT WAYNE,IN46845
35-1150847 		PHYSICIANS IN N/A
 C 26,374 35,580 100.000 %
(5) NORTHEAST INDIANA COLON AND RECTAL SURGEONS PC
10501 CORPORATE DRIVE
FORT WAYNE,IN46845
35-2032295 		PHYSICIANS IN N/A
 C 68,897   100.000 %
(6) FORT WAYNE CARDIOLOGY CORPORATION
10501 CORPORATE DRIVE
FORT WAYNE,IN46845
61-1419843 		PHYSICIANS IN N/A
 C 2,715,382 817,659 100.000 %
(7) GI CONSULTANTS INC
10501 CORPORATE DRIVE
FORT WAYNE,IN46845
35-1460624 		PHYSICIANS IN N/A
 C 225,254   100.000 %
(8) MIDWEST COMMUNITY HEALTH ASSOCIATES INC
442 W HIGH STREET
BRYAN,OH43506
34-1045870 		PHYSICIANS OH N/A
 C   13,477,487 100.000 %
(9) SIGNATURE CARE INC
2200 RANDALLIA DRIVE
FORT WAYNE,IN46805
38-3069801 		INVESTMENT IN N/A
 C -509   100.000 %
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) HUNTINGTON MEMORIAL HOSPITAL INC

 A 1,925,802 PART VII SUPPLEMENTAL INFORMATION
(2) COMMUNITY HOSPITAL OF NOBLE COUNTY INC

 A 11,846 PART VII SUPPLEMENTAL INFORMATION
(3) PARKVIEW OCCUPATIONAL HEALTH CENTERS INC

 A 59,275 PART VII SUPPLEMENTAL INFORMATION
(4) PARKVIEW HOSPITAL INC

 A 854,933 PART VII SUPPLEMENTAL INFORMATION
(5) WHITLEY MEMORIAL HOSPITAL INC

 A 481,981 PART VII SUPPLEMENTAL INFORMATION
(6) COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC

 A 4,914 PART VII SUPPLEMENTAL INFORMATION
(7) COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC

 D 10,596,241 PART VII SUPPLEMENTAL INFORMATION
(8) HUNTINGTON MEMORIAL HOSPITAL INC

 I 1,925,802 PART VII SUPPLEMENTAL INFORMATION
(9) PARKVIEW OCCUPATIONAL HEALTH CENTERS INC

 I 59,275 PART VII SUPPLEMENTAL INFORMATION
(10) PARKVIEW HOSPITAL INC

 I 854,933 PART VII SUPPLEMENTAL INFORMATION
(11) WHITLEY MEMORIAL HOSPITAL INC

 I 481,981 PART VII SUPPLEMENTAL INFORMATION
(12) COMMUNITY HOSPITAL OF NOBLE COUNTY INC

 J 50,895 PART VII SUPPLEMENTAL INFORMATION
(13) WHITLEY MEMORIAL HOSPITAL INC

 J 202,467 PART VII SUPPLEMENTAL INFORMATION
(14) FIRST CARE FAMILY PHYSICIANS PC

 J 190,000 PART VII SUPPLEMENTAL INFORMATION
(15) NORTHEAST INDIANA COLON AND RECTAL SURGEONS PC

 J 64,440 PART VII SUPPLEMENTAL INFORMATION
(16) ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH LLC

 K 3,738,356 PART VII SUPPLEMENTAL INFORMATION
(17) FOUNDATION SURGERY AFFILIATE OF FORT WAYNE LLC

 K 581,799 PART VII SUPPLEMENTAL INFORMATION
(18) FORT WAYNE ENDOSCOPY CENTER LLC

 K 285,103 PART VII SUPPLEMENTAL INFORMATION
(19) FIRST CARE FAMILY PHYSICIANS PC

 K 143,009 PART VII SUPPLEMENTAL INFORMATION
(20) FORT WAYNE CARDIOVASCULAR SURGEONS PC

 K 124,376 PART VII SUPPLEMENTAL INFORMATION
(21) NORTHEAST INDIANA COLON AND RECTAL SURGEONS PC

 K 69,285 PART VII SUPPLEMENTAL INFORMATION
(22) FORT WAYNE CARDIOLOGY CORPORATION

 K 671,309 PART VII SUPPLEMENTAL INFORMATION
(23) PARKVIEW HOSPITAL INC

 P 96,304,042 PART VII SUPPLEMENTAL INFORMATION
(24) HUNTINGTON MEMORIAL HOSPITAL INC

 P 8,030,744 PART VII SUPPLEMENTAL INFORMATION
(25) COMMUNITY HOSPITAL OF NOBLE COUNTY INC

 P 8,395,452 PART VII SUPPLEMENTAL INFORMATION
(26) WHITLEY MEMORIAL HOSPITAL INC

 P 8,334,993 PART VII SUPPLEMENTAL INFORMATION
(27) COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC

 P 5,356,395 PART VII SUPPLEMENTAL INFORMATION
(28) MANAGED CARE SERVICES LLC

 P 363,120 PART VII SUPPLEMENTAL INFORMATION
(29) COMMUNITY HOSPITAL OF LAGRANGE COUNTY INC

 Q 628,563 PART VII SUPPLEMENTAL INFORMATION
(30) PARKVIEW HOSPITAL INC

 R 25,106,710 PART VII SUPPLEMENTAL INFORMATION
(31) HUNTINGTON MEMORIAL HOSPITAL INC

 R 8,056,933 PART VII SUPPLEMENTAL INFORMATION
(32) WHITLEY MEMORIAL HOSPITAL INC

 R 3,787,540 PART VII SUPPLEMENTAL INFORMATION
(33) COMMUNITY HOSPITAL OF NOBLE COUNTY INC

 R 3,763,522 PART VII SUPPLEMENTAL INFORMATION
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
METHOD USED TO DETERMINE VALUE SCHEDULE R, PART V, LINE 2, COLUMN (C): THE AMOUNTS REPORTED AS TRANSACTIONS WITH RELATED ORGANIZATIONS ARE CONSISTENT WITH THE AMOUNTS REPORTED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS UNDER THE GENERALLY ACCEPTED ACCOUNTING STANDARDS DEPENDING ON THE TYPE OF TRANSACTION INVOLVED.
Additional Data


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