Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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. | ||||||
Calendar year
(or fiscal year beginning in)
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(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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.) | ||||||
Calendar year
(or fiscal year beginning in)
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(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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 on 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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2024 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2024 |
(iii) Distributable Amount for 2024 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2024 from Section C, line 6 | ||||
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2
Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2024: | ||||
| a From 2019....... | ||||
| b From 2020....... | ||||
| c From 2021....... | ||||
| d From 2022....... | ||||
| e From 2023....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2024 distributable amount | ||||
|
i
Carryover from 2019 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2024 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2024 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2024, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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6
Remaining underdistributions for 2024. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2025. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2020..... | ||||
| b Excess from 2021..... | ||||
| c Excess from 2022..... | ||||
| d Excess from 2023..... | ||||
| e Excess from 2024..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
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| FORM 99, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS: | SERVICES OFFERED: THE HOSPITAL IN WHITLEY COUNTY FEATURES 30 PRIVATE ROOMS, INCLUDING 4 CONSTANT CARE BEDS, IN A 96,000 SQUARE FOOT FACILITY LOCATED ON 42 ACRES. A 60,000 SQUARE FOOT MEDICAL PLAZA IS CONNECTED, WHICH INCLUDES HOD DEPARTMENTS AS WELL AS PRIMARY CARE AND SPECIALTY PROVIDER CLINICS. IN ADDITION TO THE SERVICES BELOW, THERE IS A CHAPEL, A FULL-SERVICE CAFETERIA, A GIFT SHOP, AND A PUBLIC WALKING PATH AROUND THE CAMPUS. IN JANUARY 2024, THE OUTPATIENT FACILITY IN WARSAW (PARKVIEW WARSAW) EXPANDED TO A FULL-SERVICE HOSPITAL AND WAS RENAMED PARKVIEW KOSCIUSKO HOSPITAL. THE INPATIENT MEDICAL/SURGICAL UNIT HAS 24 PRIVATE ROOMS, INCLUDING 4 CONSTANT CARE BEDS. A 7-BED OBSTETRICS UNIT WAS ALSO OPENED IN SEPTEMBER 2024. THE KOSCIUSKO FACILITY IS NOW 175,000 SQUARE FEET SITUATED ON 11 ACRES. EMERGENCY MEDICAL CARE IS PROVIDED 24 HOURS A DAY, 365 DAYS A YEAR WITH BOARD-CERTIFIED EMERGENCY CARE PHYSICIANS AND NURSING STAFF THAT ARE TRAINED AND EXPERIENCED IN EMERGENCY CARE. THERE ARE 8 TREATMENT ROOMS, 1 TRIAGE ROOM, AND 2 THAT ARE EQUIPPED FOR TRAUMA PATIENTS AT WHITLEY MEMORIAL HOSPITAL, INC. PARKVIEW KOSCIUSKO HAS 10 TREATMENT ROOMS AND 2 TRAUMA BEDS. THERE WERE 14,671 PATIENTS TREATED IN THE WHITLEY EMERGENCY ROOM IN 2024 AND 17,409 AT KOSCIUSKO. NO PATIENT IS EVER DENIED TREATMENT, REGARDLESS OF THEIR ABILITY TO PAY. EMS: WHITLEY MEMORIAL HOSPITAL, INC. PROVIDES EMERGENCY MEDICAL SERVICES IN WHITLEY COUNTY, AS WELL AS PROVIDES COVERAGE AS NEEDED FOR THE SURROUNDING COUNTIES WITH PARKVIEW HEALTH EMS SERVICES. TRANSFERS FROM WHITLEY MEMORIAL HOSPITAL, INC. ENTITIES TO OTHER HOSPITALS ARE ALSO COVERED BY THE DEPARTMENT. THERE WERE 5,210 AMBULANCE RUNS AND 4,252 PATIENT TRANSPORTS IN 2024. WHITLEY MEMORIAL HOSPITAL, INC. CONTRACTED WITH FULTON COUNTY TO MANAGE THEIR EMS SERVICES STARTING IN JULY 2024. THREE NEW AMBULANCES AND A SQUAD SUV WERE PURCHASED, AS WELL AS STATE-OF-THE-ART EQUIPMENT TO OUTFIT THE TRUCKS. THERE WERE 1,317 RUNS COMPLETED JULY THROUGH DECEMBER FOR THE COMMUNITIES IN THAT COUNTY. MEDICAL/SURGICAL ROOMS: THERE ARE 21 PRIVATE MED/SURG ROOMS AND 4 CCU ROOMS AT WHITLEY MEMORIAL HOSPITAL, INC., WITH A TOTAL OF 1,293 PATIENT DISCHARGES FOR 2024. IN JANUARY 2024, PARKVIEW KOSCIUSKO HOSPITAL ADDED 20 PRIVATE INPATIENT BEDS TO MEET THE NEEDS OF THE COMMUNITY. THEY ALSO ADDED 4 CCU ROOMS FOR THOSE IN NEED OF A HIGHER LEVEL OF CARE. THAT LOCATION CARED FOR 922 PATIENTS DURING THE YEAR. OBSTETRICS: THERE WERE FIVE PRIVATE LABOR/DELIVERY/RECOVERY AND POSTPARTUM (LDRP) ROOMS AT WHITLEY MEMORIAL HOSPITAL, INC., UNTIL SEPTEMBER 2024, WHICH PRODUCED 275 BIRTHS. DURING THAT MONTH, THE UNIT AT WHITLEY WAS CLOSED AND REOPENED AT PARKVIEW KOSCIUSKO TO BETTER SERVE THE REGION WITH A MORE CENTRAL LOCATION OF SERVICES. PARKVIEW KOSCIUSKO HOSPITAL'S FAMILY BIRTHING CENTER HAS A DEDICATED SURGERY SUITE IN THE OB UNIT FOR C-SECTIONS. THERE WERE 64 BIRTHS AT KOSCIUSKO FROM SEPTEMBER THROUGH DECEMBER. SURGERY: THE WHITLEY LOCATION OF WHITLEY MEMORIAL HOSPITAL, INC. HAS 3 LARGE SURGICAL SUITES WITH STATE-OF-THE-ART EQUIPMENT, INCLUDING DA VINCI MINIMALLY INVASIVE ROBOTIC TECHNOLOGY, AND TWO PROCEDURE ROOMS. THERE WERE 1271 SURGICAL CASES AND 855 ENDOSCOPY PROCEDURES AT THAT LOCATION IN 2024, OF WHICH 391 CASES USED ROBOTICS FOR GENERAL AND GYNECOLOGICAL SURGERIES. IN JANUARY 2024, PARKVIEW KOSCIUSKO ADDED 2 FULLY EQUIPPED SURGICAL SUITES AND 2 PROCEDURE ROOMS WITH SHELL SPACE FOR FUTURE EXPANSION. DA VINCI ROBOTIC TECHNOLOGY IS OFFERED AT THAT FACILITY AS WELL. THERE WERE 531 SURGERIES PERFORMED, INCLUDING 73 ROBOTIC CASES, PLUS 507 ENDOSCOPY PROCEDURES, IN 2024. SURGICAL SERVICES INCLUDED GENERAL, ORTHOPEDIC, GYNECOLOGICAL, PAIN MANAGEMENT, AND PODIATRY. DIAGNOSTIC IMAGING: ROUTINE DIAGNOSTIC, MRI, CT, ULTRASOUND, FLUOROSCOPY, ECHOCARDIOGRAPHY, AND DIGITAL 3D MAMMOGRAPHY ARE AVAILABLE AT BOTH WHITLEY MEMORIAL HOSPITAL, INC. LOCATIONS. NUCLEAR MEDICINE AND BONE DENSITY TESTING ARE SERVICES OFFERED AT WHITLEY ONLY. WHITLEY AND KOSCIUSKO PERFORMED 38,047 AND 32,657 PROCEDURES, RESPECTIVELY, IN 2024. SLEEP DISORDERS LAB: FOR THE DIAGNOSIS AND TREATMENT OF SLEEP-RELATED DISORDERS, THERE WERE 179 SLEEP STUDIES PERFORMED IN THE SLEEP LAB AT WHITLEY MEMORIAL HOSPITAL, INC., AND 521 HOME STUDIES ADMINISTERED IN 2024. OUTPATIENT LAB SERVICES: WHITLEY MEMORIAL HOSPITAL, INC. OFFERS IN-HOUSE TESTING OF COAGULATION, URINALYSIS, HEMATOLOGY, BLOOD GAS, AND CHEMISTRY TESTS. THERE ARE CERTIFIED CLINICAL LABORATORY SCIENTISTS ON STAFF 24 HOURS A DAY AT BOTH LOCATIONS, WHERE A TOTAL OF 393,349 LAB TESTS WERE PERFORMED DURING 2024 FOR BOTH LOCATIONS COMBINED. REHABILITATION SERVICES: PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY ARE OFFERED AT BOTH LOCATIONS AS WELL AS CARDIAC-PULMONARY REHAB. A TOTAL OF 28,087 VISITS WERE EXPERIENCED IN 2024. THE PARKVIEW PACKNETT FAMILY CANCER INSTITUTE EXTENSION AT PARKVIEW KOSCIUSKO HOSPITAL OPENED IN 2024. THIS SPACE INCLUDES SEVEN EXAM ROOMS AND NINE INFUSION BAYS. WITH A FOCUS ON A HEALING ENVIRONMENT FOR PATIENTS, SEVEN OF THE INFUSION BAYS ARE SITUATED ALONG WINDOWS WITH PRIVACY GLASS, ALLOWING PATIENTS TO VIEW OUR COURTYARD, KNOWN AS THE HEALING GARDEN, DURING TREATMENT. THERE WERE 1546 PATIENT ENCOUNTERS IN THIS SPACE IN 2024. OTHER: CARDIO-PULMONARY SERVICES, DIABETES EDUCATION, OUTPATIENT INFUSION, DIETITIAN APPOINTMENTS, AND ANTICOAGULATION CLINIC ARE ALSO OFFERED. THERE IS DEDICATED SPACE FOR PROVIDERS AT BOTH LOCATIONS TO PROVIDE CONVENIENT, EASY ACCESS FOR PATIENTS TO RECEIVE CARE FROM FAMILY AND AN ARRAY OF SPECIALTY PHYSICIANS. TWO IMPORTANT IMAGING TESTS ARE OFFERED TO THE PUBLIC FOR A REASONABLE OUT-OF-POCKET COST AT BOTH LOCATIONS. THE HEARTSMART CT SCAN IS A SIMPLE, NON-INVASIVE TEST THAT CAN DETECT CORONARY ARTERY DISEASE IN ITS EARLY STAGES. THERE WERE 1146 SCANS PERFORMED IN 2024. LUNG SCANS ARE AVAILABLE AT BOTH LOCATIONS FOR THOSE INDIVIDUALS CONSIDERED TO BE "AT-RISK". A TOTAL OF 598 INDIVIDUALS UTILIZED THIS SERVICE. THE TEST INVOLVES A LOW-DOSE CT TO ASSIST IN DIAGNOSING EARLY-STAGE LUNG CANCER. FINANCIAL POLICY: WHITLEY MEMORIAL HOSPITAL, INC. IS COMMITTED TO MAKING HEALTHCARE ACCESSIBLE TO THOSE WHO NEED IT, REGARDLESS OF THEIR HEALTH STATUS OR ABILITY TO PAY. WITH FINANCIAL ASSISTANCE, PATIENTS CAN RECEIVE THE PARKVIEW CARE THEY EXPECT - NO MATTER WHAT FINANCIAL OBSTACLES THEY MIGHT FACE. FINANCIAL ASSISTANCE SERVICES INCLUDE USING FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES, INCLUDING CHARITABLE CARE AND FINANCIAL ASSISTANCE POLICIES AND A STANDARD APPLICATION PROCESS; AND PROVIDING EMERGENCY CARE, REGARDLESS OF ABILITY TO PAY. ANY PATIENT EXPERIENCING FINANCIAL HARDSHIP CAN REACH THE SINGLE BILLING OFFICE TO DISCUSS OPTIONS. COMMUNITY BENEFIT: WHITLEY MEMORIAL HOSPITAL, INC. COMMUNITY HEALTH IMPROVEMENT PROGRAM WAS ESTABLISHED TO HELP FUND COMMUNITY HEALTH IMPROVEMENT EFFORTS WITHIN WHITLEY MEMORIAL HOSPITAL, INC.'S SERVICE AREA. WHITLEY MEMORIAL HOSPITAL, INC. INVESTS IN KEY ORGANIZATIONS THAT PROMOTE THE HEALTH AND WELL-BEING OF FAMILIES, CHILDREN, AND INDIVIDUALS OF THE COMMUNITIES THAT IT SERVES. COMMITMENT TO IMPROVING HEALTH AND INSPIRING WELL-BEING EXTENDS BEYOND THE HOSPITAL WALLS AND THROUGHOUT OUR COMMUNITY. THROUGH PARKVIEW'S COMMUNITY HEALTH IMPROVEMENT (CHI) PROGRAM, WHITLEY MEMORIAL HOSPITAL, INC. COLLABORATES WITH OTHERS INSIDE AND OUTSIDE THE HEALTH SYSTEM WHO SHARE PARKVIEW'S MISSION AND VALUES. FUNDED BY A PERCENTAGE OF WHITLEY MEMORIAL HOSPITAL, INC.'S NET OPERATING SURPLUS, CHI STRATEGICALLY REINVESTS DOLLARS INTO COMMUNITY ORGANIZATIONS AND INITIATIVES THAT ADDRESS THE GREATEST HEALTH NEEDS OUTLINED BY THE HOSPITAL'S MOST RECENT TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). BASED ON THE 2022 CHNA RESULTS, THREE HEALTH CONCERNS FOR WHITLEY MEMORIAL HOSPITAL, INC. ARE BEING ADDRESSED. MENTAL HEALTH, SUBSTANCE ABUSE, AND OBESITY (FOOD INSECURITY) HAVE BEEN THE FOCUS IN 2024. DESIGNATIONS/ACHIEVEMENTS: WHITLEY MEMORIAL HOSPITAL, INC. WAS AWARDED A TOP PERFORMER BIRNBAUM QUALITY AND ACCOUNTABILITY AWARD, WHICH RECOGNIZES PARTICIPATING HEALTHCARE ORGANIZATIONS THROUGH THE VIZIENT QUALITY AND ACCOUNTABILITY STUDY THAT MEASURES QUALITY OF PATIENT CARE IN SAFETY, MORTALITY, EFFECTIVENESS, EFFICIENCY, PATIENT CENTEREDNESS, AND EQUITY. PARKVIEW KOSCIUSKO HOSPITAL WAS NAMED THE CHAMBER OF COMMERCE BUSINESS OF THE YEAR AWARD FOR 2024. WHITLEY MEMORIAL HOSPITAL, INC. RECEIVED A GRADE OF "A" IN BOTH SPRING AND FALL OF 2024. THE HOSPITAL SAFETY GRADE IS A PUBLIC SERVICE PROVIDED BY THE LEAPFROG GROUP, AN INDEPENDENT NONPROFIT ORGANIZATION COMMITTED TO DRIVING QUALITY, SAFETY, AND TRANSPARENCY IN HEALTHCARE. |
| FORM 990, PART V, LINES 1A AND 2A: | PARKVIEW HEALTH SYSTEM, INC. (PH), EIN 35-1972384, IS THE COMMON PAYING AGENT FOR THE FILING ORGANIZATION, WHITLEY MEMORIAL HOSPITAL, INC., EIN 35-1967665. THEREFORE, PH REPORTS AND FILES ALL APPLICABLE IRS TAX FILINGS, INCLUDING FORMS 1099, 1096, W-2, AND W-3. THE TOTAL NUMBER REPORTED IN BOX 3 OF FORM 1096 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2024, WAS 703. THE TOTAL NUMBER OF EMPLOYEES REPORTED ON FORM W-3 AND FILED BY THE COMMON PAYING AGENT, PH, FOR THE YEAR ENDED DECEMBER 31, 2024, WAS 18,730. FOR PURPOSES OF COMPLETING FORM 990, PART V, LINE 1A AND 2A, THE NUMBERS REPORTED FOR THE WHITLEY MEMORIAL HOSPITAL, INC. WERE 35 AND 604, RESPECTIVELY. |
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE OFFICERS OF THE BOARD, THE PRESIDENT OF THE CORPORATION, THE PRESIDENT/CEO OF THE CORPORATE MEMBER OR HIS/HER DESIGNEE, THE CURRENT PRESIDENT OF THE MEDICAL STAFF AND SUCH OTHER PERSONS AS IDENTIFIED BY THE CHAIR OF THE BOARD, EACH OF WHOM SHALL BE ENTITLED TO VOTE. THE EXECUTIVE COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION IN ANY MATTER WHEN THE BOARD IS NOT IN SESSION, REPORTING TO THE BOARD FOR RATIFICATION OF ITS ACTION. THE CHAIR OF THE BOARD SHALL SERVE AS CHAIR OF THE EXECUTIVE COMMITTEE. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION IS ORGANIZED AS A NOT-FOR-PROFIT CORPORATION. PURSUANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, PARKVIEW HEALTH SYSTEM, INC. EIN 35-1972384 IS THE SOLE MEMBER OF WHITLEY MEMORIAL HOSPITAL, INC. WITH CERTAIN RESERVED POWERS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE CORPORATE MEMBER, PARKVIEW HEALTH SYSTEM, INC. EIN 35-1972384, SHALL HAVE THE FOLLOWING RESERVED POWERS: (A) APPOINT DIRECTORS (INCLUDING APPOINTMENTS TO FILL A VACANCY) AND INITIATE THE REMOVAL AND REMOVE ANY DIRECTOR OF THE CORPORATION, WITH CAUSE, PROVIDED CONSIDERATION IS GIVEN TO RECOMMENDATIONS OF THE BOARD REGARDING SUCH APPOINTMENT OR REMOVAL, IF ANY ARE SO MADE; (B) APPOINT (INCLUDING APPOINTMENTS TO FILL A VACANCY) AND INITIATE THE REMOVAL AND REMOVE THE PRESIDENT OF THE CORPORATION, WITH OR WITHOUT CAUSE, PROVIDED CONSIDERATION IS GIVEN TO RECOMMENDATIONS OF THE BOARD REGARDING SUCH APPOINTMENT OR REMOVAL, IF ANY ARE SO MADE; (C) APPROVE AND ADOPT THE STRATEGIC PLAN FOR THE CORPORATION AND ITS AFFILIATES, INCLUDING ANY INDIVIDUAL INITIATIVES OR ARRANGEMENTS, SUCH AS A NEW SERVICE OR CONTRACTUAL ARRANGEMENT, DEEMED BY THE CORPORATE MEMBER TO BE OF STRATEGIC IMPORTANCE TO THE CORPORATION OR ITS AFFILIATES AND DIRECT AND MONITOR COMPLIANCE WITH SUCH PLANS, INITIATIVES AND ARRANGEMENTS; (D) APPROVE AND ADOPT THE CAPITAL AND OPERATING BUDGETS OF THE CORPORATION AND ITS AFFILIATES; (E) APPROVE THE INCURRENCE OF ANY DEBT PROPOSED BY THE CORPORATION, INCLUDING THE ISSUANCE OF BONDS, BY THE CORPORATION AND ITS AFFILIATES AND REQUIRE THE INCURRENCE OF DEBT BY THE CORPORATION AND ITS AFFILIATES; (F) APPROVE THE TRANSFER OF ASSETS BY THE CORPORATION AND ITS AFFILIATES, INCLUDING TRANSFERS OF REAL PROPERTY, PERSONAL PROPERTY, CASH, STOCK OR OTHER TANGIBLE OR INTANGIBLE ASSETS, UNLESS OTHERWISE IDENTIFIED IN PREVIOUSLY APPROVED STRATEGIC PLANS, INITIATIVES, ARRANGEMENTS OR BUDGETS. (G) REQUIRE AND DIRECT THE TRANSFER OF ASSETS BY THE CORPORATION OR ITS AFFILIATES, PROVIDED THAT APPROVAL OF THE BOARD IS ALSO REQUIRED IF THE TRANSFER INVOLVES A TRANSFER OR SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR WOULD PREVENT THE CORPORATION FROM OPERATING AN ACUTE CARE HOSPITAL IN THE COMMUNITY. FOR PURPOSES OF THIS SECTION, BOARD APPROVAL SHALL NOT BE REQUIRED FOR PARTICIPATION IN A MASTER TRUST INDENTURE, POOLED FINANCING OR ANY OTHER KIND OF DEBT INSTRUMENT, BORROWING OR GUARANTY OBLIGATING CORPORATION ASSETS; (H) APPROVE PARTICIPATION (INCLUDING THE EXERCISE OF RENEWAL OPTIONS) BY THE CORPORATION AND ITS AFFILIATES IN NETWORKS, AFFILIATIONS, JOINT VENTURES, PARTNERSHIPS, MERGERS OR ACQUISITIONS AND REQUIRE PARTICIPATION BY THE CORPORATION AND ITS AFFILIATES IN SUCH ARRANGEMENTS; (I) APPROVE DECISIONS OF THE CORPORATION AND ITS AFFILIATES TO PARTICIPATE (INCLUDING THE EXERCISE OF RENEWAL OPTIONS) IN MANAGED CARE OR OTHER HEALTH CARE SERVICE PURCHASING ARRANGEMENTS AND REQUIRE PARTICIPATION BY THE CORPORATION AND ITS AFFILIATES IN SUCH HEALTH CARE SERVICE PURCHASING ARRANGEMENTS; (J) DEVELOP AND REQUIRE ADOPTION OF MINIMUM MEDICAL STAFF QUALITY ASSURANCE AND UTILIZATION REVIEW STANDARDS, CRITERIA AND PROCEDURES FOR THE CORPORATION AND ITS AFFILIATES IN CONSULTATION WITH THE CORPORATION; (K) APPROVE ANY ACTION OF THE CORPORATION OR AN AFFILIATE TO CHANGE THE HOSPITAL FROM A GENERAL, ACUTE CARE COMMUNITY HOSPITAL OR TO CLOSE THE HOSPITAL; AND (L) APPROVE ANY AMENDMENT TO THE BYLAWS OR THE ARTICLES OF INCORPORATION OF THE CORPORATION, AND THE ARTICLES AND BYLAWS OF ANY NEWLY CREATED AFFILIATE AND REQUIRE AMENDMENT OF THESE GOVERNING DOCUMENTS AS NECESSARY OR ADVISABLE TO RESOLVE SIGNIFICANT ETHICAL ISSUES; TO MAINTAIN JOINT COMMISSION ACCREDITATION, TAX-EXEMPT STATUS, PARTICIPATION IN MEDICARE/MEDICAID OR TO PREVENT SIGNIFICANT ADVERSE LEGAL OR FINANCIAL EFFECTS TO THE CORPORATION OR SYSTEM, EXCEPT THAT THERE CAN BE NO AMENDMENT TO THE RESERVED POWERS LISTED IN SECTIONS (G) AND (K) OF THIS EXHIBIT A OR THE REQUIREMENT THAT ELECTED DIRECTORS BE REPRESENTATIVES OF WHITLEY COUNTY, AS DESCRIBED IN ARTICLE V, SECTIONS 2 AND 10 OF THESE BYLAWS WITHOUT THE CONSENT OF THE CORPORATION. THE CORPORATE MEMBER SHALL DEVELOP POLICIES FOR THE IMPLEMENTATION OF THE RESERVED POWERS, INCLUDING MATERIALITY POLICIES REGARDING MATTERS SUBJECT TO REVIEW. |
| FORM 990, PART VI, SECTION A, LINE 7B | SEE SCHEDULE O EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A |
| FORM 990, PART VI, SECTION B, LINE 11B | PURSUANT TO PARKVIEW HEALTH SYSTEM INC.'S BYLAWS, THE SYSTEM COMPLIANCE AND AUDIT COMMITTEE MAY ACT ON BEHALF OF THE CORPORATION TO PROVIDE REVIEW OF THE CORPORATION AND ITS SUBSIDIARY CORPORATIONS' FORM 990 FILINGS. WHITLEY MEMORIAL HOSPITAL, INC. IS A SUBSIDIARY CORPORATION OF PARKVIEW HEALTH SYSTEM, INC. AN ELECTRONIC COPY OF THE ORGANIZATION'S FINAL FORM 990 (INCLUDING SUPPLEMENTAL SCHEDULES) WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY AND THE SYSTEM COMPLIANCE AND AUDIT COMMITTEE, PRIOR TO FILING WITH THE IRS. ON OCTOBER 23, 2025, THE SYSTEM COMPLIANCE AND AUDIT COMMITTEE REVIEWED THE FORM 990 AS ULTIMATELY FILED WITH THE IRS. THIS REVIEW INCLUDED A PRESENTATION BY THE ORGANIZATION'S TAX PREPARER TO HIGHLIGHT THE SIGNIFICANT AREAS ON THE FORM 990 AND SUPPLEMENTAL SCHEDULES. |
| FORM 990, PART VI, SECTION B, LINE 12C | AS DESCRIBED IN ARTICLE IX SECTION 6, OF THE PARKVIEW HEALTH SYSTEM, INC. (PH) BYLAWS, PH ADOPTED PH'S COMPLIANCE POLICY FOR THE ORGANIZATION AND ITS NOT-FOR-PROFIT RELATED ORGANIZATIONS (AND AS LIKEWISE NOTED IN THEIR BYLAWS) WHEN ADDRESSING CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. THIS COMPLIANCE POLICY (COMPLIANCE POLICY #14) REQUIRES THAT EACH BOARD MEMBER, BOARD COMMITTEE MEMBER, AND KEY MANAGEMENT PERSONNEL MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST FORM. THIS INFORMATION IS PROVIDED TO THE CHAIRMAN OF THE BOARD (FOR BOARD AND BOARD COMMITTEE MEMBERS) AND TO SENIOR MANAGEMENT (FOR KEY MANAGEMENT PERSONNEL). IN ADDITION, AS TO THE CONDUCT OF BOARD MEETINGS, THE FOLLOWING PROCESS IS FOLLOWED: "WHENEVER A PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE IS CONSIDERING A TRANSACTION OR ARRANGEMENT WITH AN ORGANIZATION, ENTITY OR INDIVIDUAL IN WHICH A PERSON COVERED BY THIS POLICY HAS A FINANCIAL OR CONFLICTING INTEREST, THE FOLLOWING SHALL OCCUR: 1. THE INTERESTED PERSON MUST DISCLOSE THE FINANCIAL OR CONFLICTING INTEREST AND ALL MATERIAL FACTS TO THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE; 2. THE INTERESTED PERSON WITH THAT FINANCIAL OR CONFLICTING INTEREST MAY MAKE A PRESENTATION AT THE BOARD OR BOARD COMMITTEE MEETING REGARDING THE TRANSACTION OR ARRANGEMENT HOWEVER, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE FINANCIAL OR CONFLICTING INTEREST; AND 3. THE PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE MUST APPROVE THE TRANSACTION OR ARRANGEMENT BY A MAJORITY VOTE OF THE BOARD MEMBERS PRESENT AT A MEETING THAT HAS A QUORUM, NOT INCLUDING THE VOTE OF THE INTERESTED PERSON. THE INTERESTED PERSON MAY NOT VOTE ON THE MATTER. A. UPON THE REQUEST OF PH OR PH AFFILIATE BOARD OR BOARD COMMITTEE, THE MATTER MAY BE DELEGATED TO THE PH COMPLIANCE AND AUDIT COMMITTEE FOR EVALUATION, RECOMMENDATION AND/OR DETERMINATION. 4. WHENEVER A FINANCIAL OR CONFLICTING INTEREST IS ADDRESSED BY A PH OR PH AFFILIATE BOARD, NOTICE SHALL BE GIVEN TO THE PH COMPLIANCE OFFICER / GENERAL COUNSEL." |
| FORM 990, PART VI, SECTION B, LINE 15 | LINES 15A AND 15B ARE ANSWERED NO IN ACCORDANCE WITH THE IRS INSTRUCTIONS. RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., HAS A PROCESS IN PLACE FOR REVIEWING AND APPROVING COMPENSATION OF THE CEO & EVP LEVEL EXECUTIVES. THE PROCESS INCLUDES CONSULTATIONS WITH AN INDEPENDENT COMPENSATION ADVISOR AND THE REVIEW OF APPROPRIATE COMPARABILITY DATA; REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE OF THE GOVERNING BODY CONSISTING OF MEMBERS WHO DO NOT HAVE A CONFLICT OF INTEREST CONCERNING THE COMPENSATION; AND CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. IN 2024, THE COMPENSATION COMMITTEE OF PARKVIEW HEALTH SYSTEM, INC. REVIEWED AND APPROVED ALL CEO & EVP LEVEL COMPENSATION, BENEFITS, AND PERQUISITES FOR THE 2024 COMPENSATION PACKAGE, PURSUANT TO THE PARKVIEW HEALTH BYLAWS. IN ADDITION, AGGREGATE INFORMATION ON ALL OTHER EXECUTIVE ROLES (OUTSIDE OF THE CEO & EVPS) IS SHARED. THE COMPENSATION PACKAGE OF THE CEO AND EVPS WAS APPROVED BY A MAJORITY OF THE INDEPENDENT COMPENSATION COMMITTEE MEMBERS. ADDITIONALLY, THE COMPENSATION COMMITTEE REVIEWS AND APPROVES THE PLAN DOCUMENTS FOR THE MANAGEMENT INCENTIVE COMPENSATION PLAN (MICP) AND THE PHYSICIAN AND PROVIDER INCENTIVE COMPENSATION PLAN (PICP). THE BOARD OF PARKVIEW HEALTH SYSTEM, INC. APPROVES ANY CHANGES IN COMPENSATION FOR THE CEO. PARKVIEW'S INDEPENDENT CONSULTANT PREPARES A SUMMARY OF THE EXECUTIVE COMPENSATION PROCESS 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 AND EVP LEVEL EXECUTIVES. |
| FORM 990, PART VI, SECTION C, LINE 19 | COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER: PROGRAM SERVICE EXPENSES 153,393. MANAGEMENT AND GENERAL EXPENSES 1,540,809. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,694,202. MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 6,183,870. MANAGEMENT AND GENERAL EXPENSES 65,286. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,249,156. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 4,942,840. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,942,840. COLLECTION EXPENSE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 172,271. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 172,271. |
| FORM 990, PART IX, LINES 5-10: | PARKVIEW HEALTH SYSTEM, INC., EIN 35-1972384, SERVES AS THE COMMON PAYING AGENT FOR ALL TAX-EXEMPT ORGANIZATIONS OF THE SYSTEM. SALARIES AND WAGES OF EMPLOYEES WORKING FOR THESE ORGANIZATIONS ARE CHARGED DIRECTLY TO THE ORGANIZATIONS IN WHICH THEY WORK. THE ACTUAL EXPENSES FOR PAYROLL TAXES, EMPLOYEE BENEFITS, AND PENSION PLAN CONTRIBUTIONS ARE REFLECTED ON THE BOOKS OF PARKVIEW HEALTH SYSTEM, INC. FOR FINANCIAL REPORTING PURPOSES. TO ACCOUNT FOR BENEFIT COSTS ON THE BOOKS OF THE OTHER TAX EXEMPT ORGANIZATIONS, AN ALLOCATION METHODOLOGY IS UTILIZED TO CHARGE THESE ORGANIZATIONS WITH AN ESTIMATE OF THE OVERALL COSTS, REFERRED TO AS A "BENEFIT ALLOCATION" FROM PARKVIEW HEALTH SYSTEM, INC. THE ALLOCATION DOES NOT DISTINGUISH BETWEEN THE COSTS OF THE VARIOUS COMPONENTS (I.E. PAYROLL TAXES, EMPLOYEE BENEFITS, AND PENSION PLAN CONTRIBUTIONS). THEREFORE, FOR PURPOSES OF THE FORM 990, PART IX, THE TOTAL BENEFIT ALLOCATION FOR THE EMPLOYEES' SALARIES AND WAGES REPORTED ON LINE 7 IS REFLECTED ON LINE 9 AND NOT ALLOCATED BETWEEN LINES 8 OR 10. FOR PURPOSES OF THE FORM 990, PART IX, LINES 5 AND 6 REFLECT COMPENSATION AND BENEFIT AMOUNTS REPORTED IN PART VII. |
| FORM 990, PART XI, LINE 9: | ASSET TRANSFERS/ADJUSTMENTS 80,184. |
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