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Nonprofiteer
← DEKALB MEMORIAL HOSPITAL INC

Form 990 for tax year 2022

Filed by DEKALB MEMORIAL HOSPITAL INC.

Totals

Total revenue
$74,809,983
Total expenses
$77,572,413
Contributions and grants received
$258,327
Grants paid
$25,694
Program service revenue
$73,855,983
Investment income
$272,972
Other revenue
$422,701
Total assets, end of year
$61,926,781
Total liabilities, end of year
$3,822,960
Net assets or fund balances, end of year
$58,103,821
Program services expenses (Part IX)
$64,095,403
Management and general expenses
$13,470,686
Fundraising expenses
$6,324
Program service expenses (Part III)
$64,095,403

Program services were 82.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $5,556

  • 1e · Government grants (contributions)

    $252,771

  • 1g · Noncash contributions included above

    $230

  • 2a · Program service revenue: NET PATIENT SERVICE REVENUE

    total $65,856,354 · related or exempt $65,856,354

  • 2b · Program service revenue: PHARMACY

    total $6,525,137 · related or exempt $4,877,940 · unrelated business $1,647,197

  • 2c · Program service revenue: INTERUNIT RENT

    total $1,213,174 · related or exempt $1,213,174

  • 2d · Program service revenue: EMS SUBSIDY

    total $250,000 · related or exempt $250,000

  • 2e · Program service revenue: HEALTH/DISEASE EDUCATION CLASSES

    total $10,246 · related or exempt $10,246

  • 2f · All other program service revenue

    total $1,072 · related or exempt $1,072

  • 3 · Investment income

    total $278,546 · excluded $278,546

  • 6a · Gross rents

    real property $219,518

  • 6b · Less rental expenses

    real property $212,770

  • 6c · Rental income or loss

    real property $6,748

  • 6d · Net rental income or loss

    total $6,748 · excluded $6,748

  • 7a · Gross sales of assets other than inventory

    securities $49,502,065

  • 7b · Less cost or other basis and sales expenses

    securities $49,497,866 · other assets $9,773

  • 7c · Gain or loss

    securities $4,199 · other assets -$9,773

  • 7d · Net gain or loss

    total -$5,574 · excluded -$5,574

  • 11a · Other revenue: CAFETERIA REVENUE

    total $415,953 · excluded $415,953

  • 11e · Other revenue, total

    $415,953

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $25,694 · program services $25,694

  • 5 · Compensation of officers, directors and key employees

    total $815,033 · management and general $815,033

  • 7 · Other salaries and wages

    total $19,159,582 · program services $19,159,582

  • 9 · Other employee benefits

    total $6,548,225 · program services $6,548,225

  • 11f · Fees: investment management

    total $43,535 · management and general $43,535

  • 11g · Fees: other

    total $9,640,088 · program services $9,100,849 · management and general $539,239

  • 12 · Advertising and promotion

    total $1,114 · program services $1,114

  • 13 · Office expenses

    total $1,663,047 · program services $1,423,093 · management and general $239,954

  • 14 · Information technology

    total $8,495 · program services $8,495

  • 16 · Occupancy

    total $1,816,280 · program services $1,809,034 · management and general $7,246

  • 17 · Travel

    total $7,940 · program services $7,586 · management and general $354

  • 19 · Conferences, conventions and meetings

    total $8,021 · program services $5,565 · management and general $2,456

  • 20 · Interest

    total $14,649 · program services $14,649

  • 22 · Depreciation, depletion and amortization

    total $2,232,324 · program services $2,229,526 · management and general $2,798

  • 23 · Insurance

    total $197,906 · program services $174,455 · management and general $23,451

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $11,891,594 · program services $11,891,594

  • 24b · Other expenses: CORP SERVICE ALLOCATION

    total $11,749,363 · management and general $11,749,363

  • 24c · Other expenses: PH CLINICAL SUPPORT

    total $8,698,633 · program services $8,698,633

  • 24d · Other expenses: HOSPITAL ASSESSMENT FEE

    total $2,880,691 · program services $2,880,691

  • 24e · All other expenses

    total $170,199 · program services $116,618 · management and general $47,257 · fundraising $6,324

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $2,950 · end of year $2,950

  • 2 · Savings and temporary cash investments

    beginning of year $84,481 · end of year $143,440

  • 3 · Pledges and grants receivable

    beginning of year $252,916 · end of year $0

  • 4 · Accounts receivable

    beginning of year $11,397,992 · end of year $9,292,554

  • 8 · Inventories for sale or use

    beginning of year $880,016 · end of year $1,145,094

  • 9 · Prepaid expenses and deferred charges

    beginning of year $52,449 · end of year $31,711

  • 10a · Land, buildings and equipment: cost or other basis

    $38,634,609

  • 10b · Land, buildings and equipment: accumulated depreciation

    $7,106,993

  • 10c · Land, buildings and equipment, net

    beginning of year $27,617,427 · end of year $31,527,616

  • 11 · Investments: publicly traded securities

    beginning of year $25,045,603

  • 15 · Other assets

    beginning of year $6,516,269 · end of year $19,783,416

  • 17 · Accounts payable and accrued expenses

    beginning of year $3,826,250 · end of year $3,022,963

  • 19 · Deferred revenue

    beginning of year $2,867,511 · end of year $146

  • 25 · Other liabilities

    beginning of year $2,365,907 · end of year $799,851

  • 27 · Net assets without donor restrictions

    beginning of year $62,790,435 · end of year $58,103,821

Mission and programs · 2022

Mission

DEKALB MEMORIAL HOSPITAL, INC. WORKS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND PROVIDES QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US.

Activities or mission (Part I)

IMPROVE HEALTH & PROVIDE QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO US.

  • AS A NOT-FOR-PROFIT HOSPITAL, DEKALB MEMORIAL HOSPITAL, INC. FOCUSES ON OUR MISSION TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE AND PROVIDING A PERSONALIZED WELLNESS JOURNEY. DEKALB MEMORIAL HOSPITAL, INC. EXISTS FOR ONE PURPOSE - TO IMPROVE THE HEALTH OF OUR COMMUNITIES. DEKALB MEMORIAL HOSPITAL, INC. GIVES BACK TO THE COMMUNITY IN THE FORM OF IMPROVED FACILITIES, EDUCATION AND OUTREACH PROGRAMS, FREE AND DISCOUNTED CARE, VOLUNTEERISM AND MUCH MORE. THE FOLLOWING ARE SOME OF THE WAYS DEKALB MEMORIAL HOSPITAL, INC. IS REACHING OUT TO MAKE OUR NEIGHBORHOODS AND COMMUNITIES HEALTHIER:(SEE SCHEDULE O FOR CONTINUATION)-FINANCIAL ASSISTANCE-COMMUNITY HEALTH IMPROVEMENT INITIATIVES-PRIMARY HEALTHCARE /ACCESSFINANCIAL ASSISTANCE:DEKALB MEMORIAL HOSPITAL, INC.'S MISSION INCLUDES CARING FOR PEOPLE WHO DO NOT HAVE THE MEANS TO MEET THEIR FINANCIAL OBLIGATIONS. THE HOSPITAL PLACES ITS PRIORITY ON PROVIDING THE NECESSARY CARE, NOT ON THE PATIENT'S ABILITY TO PAY FOR THEIR MEDICAL EXPENSES.COMMUNITY HEALTH IMPROVEMENT INITIATIVES:THE PURPOSE OF DEKALB MEMORIAL HOSPITAL, INC.'S COMMUNITY HEALTH IMPROVEMENT PROGRAM IS TO FUND COMMUNITY HEALTH IMPROVEMENT EFFORTS WITHIN THE SERVICE AREA OF DEKALB MEMORIAL HOSPITAL, INC. THE HOSPITAL SETS ASIDE A PORTION OF ITS NET INCOME ANNUALLY TO FUND COMMUNITY HEALTH INITIATIVES AND PARTNERS WITH COMMUNITY ORGANIZATIONS TO ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF NORTHEAST INDIANA. SOME OF THESE INITIATIVES AND PROGRAMS ARE HIGHLIGHTED BELOW.COMMUNITY HEALTH IMPROVEMENT MANAGER: DEKALB MEMORIAL HOSPITAL, INC.'S COMMUNITY HEALTH IMPROVEMENT MANAGER PARTNERS WITH VARIOUS COMMUNITY ORGANIZATIONS AND NON-PROFITS TO BENEFIT THE OVERALL COMMUNITY. THE COMMUNITY HEALTH IMPROVEMENT MANAGER PARTICIPATES IN VARIOUS COALITIONS AND COMMUNITY PARTNERSHIPS INCLUDING LEADING THE DEKALB COUNTY MENTAL HEALTH COLLABORATIVE. THIS COLLABORATIVE IS WORKING TO SET BOTH LONG-TERM AND SHORT-TERM GOALS AROUND IMPROVING QUALITY OF LIFE AND REDUCING BARRIERS TO ACCESS CARE IN DEKALB COUNTY. THIS COLLABORATIVE IS ALSO EXPLORING THE OPPORTUNITY TO BECOME A CERTIFIED CRISIS INTERVENTION TEAM AND IDENTIFYING OPPORTUNITIES TO BETTER SERVE OUR COMMUNITY ACROSS MULTIPLE INTERCEPTS OF CRIMINAL JUSTICE SYSTEMS AND HEALTHCARE. THE COMMUNITY HEALTH IMPROVEMENT MANAGER IDENTIFIES, DEVELOPS, IMPLEMENTS AND EVALUATES ALL COMMUNITY PROGRAMS OFFERED THROUGH DEKALB MEMORIAL HOSPITAL, INC., INCLUDING NUTRITION EDUCATION, HEALTH SCREENINGS AND VARIOUS OTHER ACTIVITIES IN PARTNERSHIP WITH MULTIPLE COMMUNITY PARTNERS.COMMUNITY PARTNERSHIPS: DEKALB MEMORIAL HOSPITAL, INC. INVESTS IN KEY ORGANIZATIONS (HEALTH PARTNERS) THAT ENCOURAGE HEALTHIER LIFESTYLES AMONG THE CITIZENS OF DEKALB COUNTY AND NORTHEAST INDIANA. WE PARTNER WITH THE JUDY A. MORRILL RECREATION CENTER TO INCREASE ACCESS TO EXERCISE OPPORTUNITIES IN DEKALB COUNTY. TO ASSIST THOSE LESS FORTUNATE, WE SUPPORT ST. MARTIN'S HEALTHCARE AND THE UNITED WAY OF DEKALB COUNTY. TO ENCOURAGE HIGHER PAYING JOBS AND ECONOMIC IMPROVEMENT, WE PARTNER WITH THE DEKALB COUNTY ECONOMIC DEVELOPMENT CORPORATION. TO SUPPORT THOSE IN RECOVERY, RE-ENTRY AND OFFER RESTORATIVE SERVICES, WE PARTNER WITH INSPIRATION MINISTRIES. INSPIRATION MINISTRIES WORKS TO DEVELOP AND SUSTAIN SERVICES THAT REDUCE ADDICTION, RECIDIVISM AND POVERTY IN NORTHEAST INDIANA. PRIMARY HEALTHCARE/ACCESS: PHARMACARE: DEKALB MEMORIAL HOSPITAL, INC'S PHARMACARE PROGRAM IS A FULL-SERVICE RETAIL PHARMACY FEATURE OVER THE COUNTER ITEMS, VITAMINS AND NATURAL SUPPLEMENTS, ORTHOPEDIC SUPPORTS AND BREASTFEEDING SUPPLIES. PRESCRIPTION COMPOUNDING AND CUSTOMIZED MEDICATIONS ARE ALSO AVAILABLE. THE PHARMACARE PROGRAM ALSO OFFERS MEDICATION PACKAGING TO HELP PATIENTS ADHERE TO THEIR DOSAGE SCHEDULE AND PROVIDE PEACE OF MIND THAT THE RIGHT DOSAGE IS BEING ADMINISTERED AT THE RIGHT TIME. MEDICATION DELIVERY IS ALSO AVAILABLE TO RELIEVE THE TRANSPORTATION BARRIER FOR THOSE WITHOUT ACCESS, THE ELDERLY AND OTHERS WHO MAY NEED MEDICATIONS DELIVERED. MEDICATION ASSISTANCE PROGRAM (MAP): DEKALB MEMORIAL HOSPITAL, INC. MAINTAINS A MEDICATION ASSISTANCE PROGRAM FOR DEKALB COUNTY RESIDENTS. MAP PARTNERS WITH PATIENTS, PHYSICIANS, PHARMACEUTICAL COMPANIES AND DONORS TO PROVIDE MEDICATION ASSISTANCE AT LITTLE OR NO COST FOR QUALIFIED INDIVIDUALS. FOR ACUTE MEDICATION NEEDS, MEDICATIONS ARE PROVIDED BY PARKVIEW PHARMACY AT NO COST TO THE PATIENT. LONG-TERM MEDICATION HELP IS PROVIDED THROUGH CONNECTING CLIENTS WITH PHARMACEUTICAL ASSISTANCE PROGRAMS (PAP) AND COPAY ASSISTANCE PROGRAMS. HEALTH SCREENINGS AND SUPPORT GROUPS: DEKALB MEMORIAL HOSPITAL, INC. IN PARTNERSHIP WITH PARKVIEW CENTER FOR HEALTHY LIVING OFFERS NUMEROUS HEALTH SCREENINGS THROUGHOUT THE YEAR THAT ARE DESIGNED TO PROVIDE HEALTH SCREENINGS FOR DISEASE PREVENTION AT A REDUCED COST AND THE PROMOTION OF HEALTHY LIFESTYLES.

    Expenses $64,095,403 · Grants $25,694 · Revenue $72,208,786

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Michael Packnett

    DIRECTOR/PH PRESIDENT & CEO

    Total calculated
    $2,941,140
    From this org
    $0
    From related orgs
    $2,602,841
    Other
    $338,299
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,330,197 related
    Bonus
    $0 + $664,677 related
    Other
    $0 + $607,967 related
    Deferred
    $0 + $302,282 related
    Nontaxable benefits
    $0 + $36,017 related
    Filer's total
    $0 + $2,941,140 related

  • Thomas Mason

    DIRECTOR/PH PHYSICIAN

    Total calculated
    $472,445
    From this org
    $1,250
    From related orgs
    $399,919
    Other
    $71,276
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $1,250 + $338,867 related
    Bonus
    $0 + $37,296 related
    Other
    $0 + $23,756 related
    Deferred
    $0 + $33,550 related
    Nontaxable benefits
    $0 + $37,726 related
    Filer's total
    $1,250 + $471,195 related

  • Natasha Eicher

    DIRECTOR/DMHOS PRESIDENT

    Total calculated
    $443,306
    From this org
    $342,897
    From related orgs
    $0
    Other
    $100,409
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $222,868
    Bonus
    $92,054
    Other
    $27,975
    Deferred
    $62,741
    Nontaxable benefits
    $37,668
    Filer's total
    $443,306

  • Trina Chapman-Smith

    DIRECTOR-PARTIAL YR/PH PHYSICIAN

    Total calculated
    $213,829
    From this org
    $3,000
    From related orgs
    $197,824
    Other
    $13,005
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $3,000 + $173,445 related
    Bonus
    $0 + $20,750 related
    Other
    $0 + $3,629 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $13,005 related
    Filer's total
    $3,000 + $210,829 related

  • Douglas Morrow

    DIRECTOR/CHAIR

    Total calculated
    $7,500
    From this org
    $6,250
    From related orgs
    $1,250
    Other
    $0
    Hours/week
    1 + 1 related

  • Thomas Hartman

    DIRECTOR

    Total calculated
    $4,250
    From this org
    $4,250
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • Michael Tullis

    DIRECTOR

    Total calculated
    $4,500
    From this org
    $4,500
    From related orgs
    $0
    Other
    $0
    Hours/week
    1 + 1 related

  • Bryan Nugen

    DIRECTOR/SECRETARY/TREASURER

    Total calculated
    $4,250
    From this org
    $4,250
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • Trenton Stuckey

    DIRECTOR

    Total calculated
    $4,125
    From this org
    $4,125
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • Scott Pflughoeft

    DIRECTOR/VICE CHAIR

    Total calculated
    $4,500
    From this org
    $4,500
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • Tyler Johnson

    DIRECTOR

    Total calculated
    $13,600
    From this org
    $13,600
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • Claramary Winebrenner

    DIRECTOR

    Total calculated
    $4,250
    From this org
    $4,250
    From related orgs
    $0
    Other
    $0
    Hours/week
    1 + 1 related

  • Jeanne' Wickens

    PH CHIEF FINANCIAL OFFICER

    Total calculated
    $1,622,167
    From this org
    $0
    From related orgs
    $1,264,400
    Other
    $357,767
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $804,432 related
    Bonus
    $0 + $363,922 related
    Other
    $0 + $96,046 related
    Deferred
    $0 + $325,215 related
    Nontaxable benefits
    $0 + $32,552 related
    Filer's total
    $0 + $1,622,167 related

  • Karra Heggen

    DMHOS VP PATIENT CARE SVCS

    Total calculated
    $321,752
    From this org
    $285,591
    From related orgs
    $0
    Other
    $36,161
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $196,331
    Bonus
    $64,404
    Other
    $24,856
    Deferred
    $19,772
    Nontaxable benefits
    $16,389
    Filer's total
    $321,752

  • Lon Keyes

    DMHOS PHARMACY MGR

    Total calculated
    $211,299
    From this org
    $187,301
    From related orgs
    $0
    Other
    $23,998
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $160,696
    Bonus
    $24,625
    Other
    $1,980
    Deferred
    $11,208
    Nontaxable benefits
    $12,790
    Filer's total
    $211,299

  • Jacob Clendenen

    DMHOS PHARMACIST

    Total calculated
    $194,300
    From this org
    $152,996
    From related orgs
    $0
    Other
    $41,304
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $151,976
    Bonus
    $750
    Other
    $270
    Deferred
    $6,461
    Nontaxable benefits
    $34,843
    Filer's total
    $194,300

  • Anthony Stump

    DMHOS MGR REHAB

    Total calculated
    $195,643
    From this org
    $149,473
    From related orgs
    $0
    Other
    $46,170
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $127,598
    Bonus
    $20,200
    Other
    $1,675
    Deferred
    $13,738
    Nontaxable benefits
    $32,432
    Filer's total
    $195,643

  • Bethany Heileman

    DMHOS PHARMACIST

    Total calculated
    $184,859
    From this org
    $136,900
    From related orgs
    $0
    Other
    $47,959
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $135,989
    Bonus
    $750
    Other
    $161
    Deferred
    $15,575
    Nontaxable benefits
    $32,384
    Filer's total
    $184,859

  • Jeannette Sturges

    DMHOS NURSING SERVICES MGR

    Total calculated
    $171,100
    From this org
    $132,553
    From related orgs
    $0
    Other
    $38,547
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $113,855
    Bonus
    $18,187
    Other
    $511
    Deferred
    $14,906
    Nontaxable benefits
    $23,641
    Filer's total
    $171,100

  • Bret Claghorn

    FORMER OFFICER/CURRENT PH VP

    Total calculated
    $315,098
    From this org
    $0
    From related orgs
    $253,943
    Other
    $61,155
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $193,732 related
    Bonus
    $0 + $59,552 related
    Other
    $0 + $659 related
    Deferred
    $0 + $23,489 related
    Nontaxable benefits
    $0 + $37,666 related
    Filer's total
    $0 + $315,098 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 1a · Personal services (maid, chauffeur, chef)
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 1A
PERSONAL SERVICES - TAXABLE ALLOWANCE FOR FINANCIAL PLANNING PAID TO: TRENTON STUCKEY $125
PART I, LINE 3
RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF DEKALB MEMORIAL HOSPITAL, INC.'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. INDEPENDENT COMPENSATION CONSULTANT FORM 990 OF OTHER ORGANIZATIONS COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC.
PART I, LINE 4B
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS THE FOLLOWING INDIVIDUALS PARTICIPATE IN SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLANS. BENEFITS EARNED UNDER THE PLANS WILL FUND THE EMPLOYEES' EVENTUAL RETIREMENT BENEFIT. THESE BENEFITS ARE PROVIDED IN EXCHANGE FOR THE EMPLOYEES' YEARS OF SERVICE TO THE ORGANIZATION AND THE AMOUNT OF THE BENEFITS MAY VARY FROM YEAR TO YEAR. THE FOLLOWING INDIVIDUALS VESTED IN A PORTION OF THEIR DEFERRED COMPENSATION PLANS, WHICH IS TREATED AS TAXABLE INCOME TO THE INDIVIDUALS AT THE TIME OF VESTING. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III): NATASHA EICHER $6,634; MICHAEL PACKNETT $577,374; JEANNE' WICKENS $70,644 AMOUNTS LISTED ABOVE THAT HAVE BEEN REPORTED AS DEFERRED COMPENSATION ON PRIOR FORM 990 WILL ALSO BE REFLECTED IN SCHEDULE J, PART II, COLUMN (F). FOR EXAMPLE, THE AMOUNT OF $577,374 REPORTED AS REQUIRED FOR MR. PACKNETT WAS A RESULT OF THE VESTING OF SUCH AMOUNT UNDER THE TERMS OF THE RESPECTIVE PLANS. HOWEVER, THESE AMOUNTS WERE PREVIOUSLY REPORTED IN MR. PACKNETT'S DEFERRED COMPENSATION OVER MORE THAN 10 YEARS AS THE AMOUNTS WERE DEFERRED UNDER THE PLANS. AS SUCH, THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN (F) IS AN INDICATION OF AMOUNTS THAT HAVE BEEN REPORTED TWICE, ONCE AS A DEFERRAL AND ONCE AS VESTED. THE FOLLOWING INDIVIDUALS HAVE AN AMOUNT INCLUDED IN SCHEDULE J, PART II, COLUMN (C) FOR AN AMOUNT EARNED BUT NOT YET VESTED UNDER ONE OF PARKVIEW'S DEFERRED COMPENSATION PLANS. THE AMOUNTS ARE AT RISK AND WILL NOT BE PAID UNLESS AND UNTIL EACH EMPLOYEE HAS PROVIDED SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION. BENEFITS UNDER THE PLANS VEST AT THE TIME SET FORTH IN THE PLAN DOCUMENTS AND ARE FORFEITED IF THE EMPLOYEES TERMINATE EMPLOYMENT BEFORE SATISFYING THOSE PLAN CONDITIONS. DEFERRALS REPORTED IN SCHEDULE J, PART II, COLUMN (C) INCLUDE: NATASHA EICHER $41,391; MICHAEL PACKNETT $268,732; JEANNE' WICKENS $308,865
PART I, LINE 7
MANAGEMENT INCENTIVE COMPENSATION PLAN (MICP) AND PHYSICIAN AND PROVIDER INCENTIVE COMPENSATION PLAN (PICP) ARE ANNUAL INCENTIVE PROGRAMS. SYSTEM GOALS ARE APPROVED BY THE BOARD. AT CONCLUSION OF THE PLAN YEAR, RESULTS ARE SHARED WITH THE BOARD AND THE EXECUTIVE COMMITTEE OF THE BOARD APPROVES FINAL PAYMENT.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

  • GARRETT COMMUNITY CENTER INC

    $9,996

    PROGRAMS TO CELEBRATE AND STRENGTHEN THE VIBRANT COMMUNITY BY CONNECTING PEOPLE AND ORGANIZATIONS THROUGH ACTIVITIES THAT IMPROVE THE QUALITY OF LIFE FOR THE GREATER GARRETT INDIANA AREA.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

  • DEKALB MEMORIAL PHARMACARE LLC

    PHARMACY · IN · income $6,525,137 · assets $1,403,042

    Directly controlled by DEKALB MEMORIAL HOSPITAL INC

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH LLC

    N/A · ORTHOPAEDIC HOSPITAL · IN

  • MANAGED CARE SERVICES LLC

    N/A · HEALTH PLAN ADMINISTRATION · IN

  • FOUNDATION SURGERY AFFILIATE OF FORT WAYNE LLC

    N/A · SURGICAL SERVICES · IN

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • PARKVIEW PROFESSIONAL PROGRAMS INC

    C · REFERENCE LAB · IN

  • WOODLAND PLAZA MEDICAL PARK CONDO ASSOC INC

    C · PROPERTY OWNERS ASSOCIATION · IN

Provenance

Return type
form_990
Tax year
2022
Filed
9 November 2023
IRS schema version
2022v5.0
Source object
202323139349305267

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