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Nonprofiteer
← PARKVIEW DEKALB HOSPITAL FOUNDATION INC

Form 990 for tax year 2023

Filed by PARKVIEW DEKALB HOSPITAL FOUNDATION INC.

Totals

Total revenue
$42,933
Total expenses
$4,269
Contributions and grants received
$38,226
Grants paid
$171
Program service revenue
$3,913
Investment income
$794
Other revenue
$0
Total assets, end of year
$0
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$0
Program services expenses (Part IX)
$175
Management and general expenses
$2,239
Fundraising expenses
$1,855
Program service expenses (Part III)
$175

Program services were 4.1% 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.

  • 1a · Federated campaigns

    $134

  • 1d · Related organizations

    $600

  • 1f · All other contributions, gifts and grants

    $37,492

  • 2a · Program service revenue: FNDRSNG SER ALLOCATION

    total $3,913 · related or exempt $3,913

  • 3 · Investment income

    total $1,317 · excluded $1,317

  • 7a · Gross sales of assets other than inventory

    securities $45,254

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

    securities $45,777

  • 7c · Gain or loss

    securities -$523

  • 7d · Net gain or loss

    total -$523 · excluded -$523

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $171 · program services $171

  • 11f · Fees: investment management

    total $185 · management and general $185

  • 13 · Office expenses

    total $1,859 · program services $4 · fundraising $1,855

  • 24a · Other expenses: CORPORATE SERVICE ALLOC

    total $2,054 · management and general $2,054

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    end of year $0

  • 2 · Savings and temporary cash investments

    beginning of year $6,728 · end of year $0

  • 3 · Pledges and grants receivable

    end of year $0

  • 4 · Accounts receivable

    end of year $0

  • 5 · Loans and receivables from officers and key people

    end of year $0

  • 6 · Loans and receivables from disqualified persons

    end of year $0

  • 7 · Other notes and loans receivable

    end of year $0

  • 8 · Inventories for sale or use

    end of year $0

  • 9 · Prepaid expenses and deferred charges

    end of year $0

  • 10c · Land, buildings and equipment, net

    end of year $0

  • 11 · Investments: publicly traded securities

    beginning of year $48,980 · end of year $0

  • 12 · Investments: other securities

    end of year $0

  • 13 · Investments: program-related

    end of year $0

  • 14 · Intangible assets

    end of year $0

  • 15 · Other assets

    beginning of year $32,413 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year $69,559 · end of year $0

  • 28 · Net assets with donor restrictions

    beginning of year $18,562 · end of year $0

Mission and programs · 2023

Mission

TO SERVE AS THE PRIMARY FUNDRAISING ENTITY FOR DEKALB MEMORIAL HOSPITAL, INC. FUNDS ARE USED FOR THE CONTINUED IMPROVEMENT OF THE HOSPITAL'S FACILITIES, EQUIPMENT, PROGRAMS & SERVICES IN ACCORDANCE WITH THE NEEDS OF THE COMMUNITY WHERE THE HOSPITAL IS LOCATED.

Activities or mission (Part I)

TO SERVE AS THE PRIMARY FUNDRAISING ENTITY FOR DEKALB MEMORIAL HOSPITAL, INC.

  • THE MISSION OF THE PARKVIEW FOUNDATIONS IS TO INSPIRE THE GENEROUS SPIRIT OF OUR COMMUNITY THAT BRINGS GIFTS OF HEALING AND COMFORT TO EVERYONE PARKVIEW SERVES.PARKVIEW DEKALB HOSPITAL FOUNDATION, INC. ADHERES TO THIS MISSION. THE FOUNDATION RAISES FUNDS TO SUPPORT NEW PROGRAMS AND SERVICES, EDUCATIONAL NEEDS, AND INNOVATIVE TECHNOLOGY FOR THE DEKALB MEMORIAL HOSPITAL INC., D.B.A. PARKVIEW DEKALB HOSPITAL, WITH THE GOAL OF ENABLING THIS COMMUNITY HOSPITAL TO PROVIDE THE EXCELLENT CARE AND SERVICES THAT WOULD NOT BE POSSIBLE WITHOUT THE SUPPORT OF PARKVIEW DEKALB HOSPITAL FOUNDATION, INC. DONORS.(SEE SCHEDULE O FOR CONTINUATION)PARKVIEW HEALTH SYSTEM, INC. MAINTAINS FOUNDATIONS FOR EACH OF ITS HOSPITALS. THESE NONPROFIT ORGANIZATIONS PROVIDE PHILANTHROPIC SUPPORT FOR PARKVIEW'S MISSION OF PROVIDING QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO PARKVIEW AND IMPROVING THE HEALTH OF THE COMMUNITIES PARKVIEW SERVES.THE GIFTS RECEIVED BY PARKVIEW DEKALB HOSPITAL FOUNDATION, INC. WERE DESIGNATED TO TEMPORARILY RESTRICTED OR UNRESTRICTED FUNDS, ACCORDING TO DONOR WISHES, AND WERE USED FOR SEVERAL MISSION-DRIVEN PURPOSES THAT TOUCHED THE LIVES OF PARKVIEW DEKALB HOSPITAL PATIENTS AND THEIR FAMILIES IN NUMEROUS WAYS.THE FOLLOWING IS AN EXAMPLE OF PARKVIEW DEKALB HOSPITAL FOUNDATION, INC. PROVIDING FUNDING TO PARKVIEW DEKALB HOSPITAL FOR VARIOUS HOSPITAL PROGRAMS, SERVICES, EQUIPMENT, AND IMPROVEMENTS:MEDICATION ASSISTANCE PROGRAM:-PARKVIEW DEKALB HOSPITAL'S MEDICATION ASSISTANCE PROGRAM (MAP) SERVES QUALIFIED PATIENTS WHO NEED ASSISTANCE IN PROCURING MEDICATIONS NEEDED FOR ACUTE ILLNESSES, LONG-TERM ASSISTANCE OR TO BE RELEASED FROM THE HOSPITAL. THE PROGRAM PROVIDES EMERGENCY MEDICATIONS OR VOUCHERS TO QUALIFIED PATIENTS FOR ESSENTIAL, NON-OPIOID PRESCRIPTIONS. NOT ONLY DOES THIS ASSIST IN REDUCING RE-ADMISSION RATES AT THE HOSPITAL, BUT IT ALSO ADDRESSES A CRITICAL AREA OF PARKVIEW'S MISSION TO IMPROVE THE HEALTH OF OUR COMMUNITY.

    Expenses $175 · Grants $171 · Revenue $3,913

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Dena Jacquay

    DIRECTOR/PH CHIEF ADMIN OFFICER

    Total calculated
    $1,926,311
    From this org
    $0
    From related orgs
    $1,629,814
    Other
    $296,497
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $759,072 related
    Bonus
    $0 + $149,247 related
    Other
    $0 + $721,495 related
    Deferred
    $0 + $239,600 related
    Nontaxable benefits
    $0 + $56,897 related
    Filer's total
    $0 + $1,926,311 related

  • Natasha Eicher

    DIRECTOR/MARKET PRESIDENT

    Total calculated
    $467,832
    From this org
    $0
    From related orgs
    $363,341
    Other
    $104,491
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $253,450 related
    Bonus
    $0 + $47,021 related
    Other
    $0 + $62,870 related
    Deferred
    $0 + $71,793 related
    Nontaxable benefits
    $0 + $32,698 related
    Filer's total
    $0 + $467,832 related

  • Karra Heggen

    DIRECTOR/DMHOS VP PATIENT CARE SVCS

    Total calculated
    $297,703
    From this org
    $0
    From related orgs
    $263,484
    Other
    $34,219
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $202,846 related
    Bonus
    $0 + $32,782 related
    Other
    $0 + $27,856 related
    Deferred
    $0 + $18,228 related
    Nontaxable benefits
    $0 + $15,991 related
    Filer's total
    $0 + $297,703 related

  • Michael Tullis

    DIRECTOR

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

  • Kendra Klink

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Rebecca Schmidt

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Claramary Winebrenner

    DIRECTOR

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

  • Jeanne' Wickens

    PH CHIEF FINANCIAL OFFICER

    Total calculated
    $2,443,396
    From this org
    $0
    From related orgs
    $2,165,508
    Other
    $277,888
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $834,975 related
    Bonus
    $0 + $187,034 related
    Other
    $0 + $1,143,499 related
    Deferred
    $0 + $239,228 related
    Nontaxable benefits
    $0 + $38,660 related
    Filer's total
    $0 + $2,443,396 related

  • Michael Packnett

    FORMER OFFICER/RETIRED PH CEO

    Total calculated
    $5,063,462
    From this org
    $0
    From related orgs
    $5,034,209
    Other
    $29,253
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $66,747 related
    Bonus
    $0 + $351,881 related
    Other
    $0 + $4,615,581 related
    Deferred
    $0 + $26,400 related
    Nontaxable benefits
    $0 + $2,853 related
    Filer's total
    $0 + $5,063,462 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

  • 4b · Supplemental nonqualified retirement plan

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
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF PARKVIEW DEKALB HOSPITAL FOUNDATION, INC.'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. INDEPENDENT COMPENSATION CONSULTANT FORM 990 OF OTHER ORGANIZATIONS COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC.
PART I, 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 $38,673; DENA JACQUAY $685,401; MICHAEL PACKNETT $4,613,104; JEANNE' WICKENS $1,101,767 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 $4,613,104 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 $48,772; DENA JACQUAY $200,000; JEANNE' WICKENS $216,128

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

No itemized grants to organizations on this return.

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.

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

  • COMMUNITY HOSPITALS AND WELLNESS CENTERS PAIN MANAGEMENT LLC

    N/A · MEDICAL SERVICES · OH

  • EXCEL SPORTS GROUP LLC

    N/A · SPORTS CAMPS & LEAGUES · 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

  • PARKVIEW HEALTH SYSTEM INC 457(B) PLAN

    T · TRUST - 457(B) PLAN 003 · IN

  • PARKVIEW HEALTH SYSTEM SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN

    T · TRUST - SERP PLAN 004 · IN

  • PARKVIEW HEALTH SYSTEM INC 457(F) PLAN

    T · TRUST - 457(F) PLAN 005 · IN

  • PARKVIEW HEALTH SYSTEM SUPPLEMENTAL

    T · TRUST - SUPPLEMENTAL PLAN 008 · IN

  • PARKVIEW HEALTH SYSTEM EVPCEO

    T · TRUST - EVP/CEO PLAN 009 · IN

Assets distributed on this return

Schedule N, as filed: what the organization did with its assets when it liquidated or dissolved, or disposed of more than a quarter of them, and who received them. A recipient with an EIN is usually a successor organization; filers also list expenses such as legal fees here.

Provenance

Return type
form_990
Tax year
2023
Filed
5 November 2024
IRS schema version
2023v5.1
Source object
202423109349302352

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