Skip to content
Nonprofiteer
← WHITLEY MEMORIAL HOSPITAL FOUNDATION INC

Form 990 for tax year 2023

Filed by WHITLEY MEMORIAL HOSPITAL FOUNDATION INC.

Totals

Total revenue
$49,242
Total expenses
$190,404
Contributions and grants received
$31,320
Grants paid
$179,761
Program service revenue
$5,375
Investment income
$12,547
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)
$179,761
Management and general expenses
$10,551
Fundraising expenses
$92
Program service expenses (Part III)
$179,761

Program services were 94.4% 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

    $4,342

  • 1f · All other contributions, gifts and grants

    $26,978

  • 2a · Program service revenue: FNDRSNG SER ALLOCATION

    total $5,375 · related or exempt $5,375

  • 3 · Investment income

    total $15,541 · excluded $15,541

  • 7a · Gross sales of assets other than inventory

    securities $279,843

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

    securities $282,837

  • 7c · Gain or loss

    securities -$2,994

  • 7d · Net gain or loss

    total -$2,994 · excluded -$2,994

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $177,761 · program services $177,761

  • 2 · Grants to domestic individuals

    total $2,000 · program services $2,000

  • 11f · Fees: investment management

    total $5,267 · management and general $5,267

  • 13 · Office expenses

    total $92 · fundraising $92

  • 24a · Other expenses: CORPORATE SERVICE ALLOC

    total $5,284 · management and general $5,284

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    end of year $0

  • 2 · Savings and temporary cash investments

    beginning of year $2,990 · 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

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

    $0

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

    $0

  • 10c · Land, buildings and equipment, net

    beginning of year $0 · end of year $0

  • 11 · Investments: publicly traded securities

    beginning of year $403,287 · 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 $423,210 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year $437,819 · end of year $0

  • 28 · Net assets with donor restrictions

    beginning of year $391,668 · end of year $0

Mission and programs · 2023

Mission

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

  • WHITLEY MEMORIAL HOSPITAL FOUNDATION, INC. - A FOUNDATION FOR GIVINGAT PARKVIEW HEALTH SYSTEM, INC., WE MAINTAIN FOUNDATIONS FOR EACH OF OUR HOSPITALS. THESE NONPROFIT ORGANIZATIONS PROVIDE PHILANTHROPIC SUPPORT FOR OUR MISSION OF PROVIDING QUALITY HEALTH SERVICES TO ALL WHO ENTRUST THEIR CARE TO PARKVIEW, AND FOR IMPROVING THE HEALTH OF THE COMMUNITY.WHITLEY MEMORIAL HOSPITAL FOUNDATION, INC. BUILDS RELATIONSHIPS THAT FOSTER GIFT-GIVING FOR THE BENEFIT OF PARKVIEW WHITLEY HOSPITAL PATIENTS AND THEIR FAMILY MEMBERS, CAREGIVERS, HOSPITAL PROGRAMS AND SERVICES, AND EQUIPMENT. (SEE SCHEDULE O FOR CONTINUATION)THESE RELATIONSHIPS ARE MADE WITH WHITLEY MEMORIAL HOSPITAL, INC. CO-WORKERS, PHYSICIANS, VENDORS, PATIENT FAMILIES, OR THE COMMUNITY AT LARGE. IN AN IMPORTANT WAY, WHITLEY MEMORIAL HOSPITAL FOUNDATION, INC. IS A COLLECTION OF INDIVIDUAL DONORS WHO SEE WHITLEY MEMORIAL HOSPITAL, INC. AS AN AGENT FOR SAVING AND CHANGING LIVES - A VEHICLE FOR CREATING HEALTHIER COMMUNITIES FOR GENERATIONS TO COME.EACH GIFT THE WHITLEY MEMORIAL HOSPITAL FOUNDATION, INC. RECEIVES - WHETHER FROM INDIVIDUALS, BUSINESSES, OR FOUNDATIONS - IS GREATLY APPRECIATED, AND IS A VITAL PART OF OUR MISSION TO IMPROVE THE HEALTH OF THE COMMUNITY. IN 2023, THESE GIFTS WERE TRANSFORMED INTO MANY NEW IMPROVEMENTS FOR PATIENT CARE. HERE ARE JUST A FEW EXAMPLES:MEDICATION ASSISTANCE PROGRAM (MAP):-PATIENTS WHO NEED MEDICATIONS FOR ACUTE ILLNESSES OR LONG-TERM ASSISTANCE AND CANNOT AFFORD IT NOW HAVE ACCESS TO HELP THROUGH THE MEDICATION ASSISTANCE PROGRAM (MAP). COMMUNITY BENEFIT FUNDS PROVIDE A COORDINATOR WHO CONNECTS PATIENTS WITH PHARMACEUTICAL ASSISTANCE PROGRAMS FOR LONG-TERM CARE.GREATEST NEED FUND:-THE GREATEST NEED FUND PROVIDED EQUIPMENT AND SERVICES TO PATIENTS AT PARKVIEW WHITLEY HOSPITAL INCLUDING CARDIAC MONITORS FOR THE EMERGENCY DEPARTMENT TO PROVIDE CONTINUOUS CARDIAC MONITORING, AND FUNDING FOR A CERTIFIED MASSAGE THERAPIST TO ROUND ON PATIENTS FOR HAND, FOOT, AND SHOULDER MASSAGES DURING THE PATIENT'S INPATIENT STAY. MASSAGE IS PROVEN TO HELP IN THE HEALING PROCESS.EMERGENCY MEDICAL SERVICES FUND:-THE EMERGENCY MEDICAL SERVICES FUND PROVIDED A NEW STRYKER POWERLOAD AMBULANCE STRETCHER TO THE EMERGENCY MEDICAL SERVICES TEAM AT PARKVIEW WHITLEY HOSPITAL. THE NEW STRETCHER SIGNIFICANTLY DECREASES THE RISK OF INJURY TO BOTH PATIENTS AND CO-WORKERS.FAMILY BIRTHING CENTER FUND:-THE FAMILY BIRTHING CENTER FUND PROVIDED BEREAVEMENT BOXES TO PARENTS WHO HAVE LOST A CHILD DURING CHILDBIRTH WHILE AT PARKVIEW WHITLEY HOSPITAL. WHITLEY HOSPICE FUND:-THE WHITLEY HOSPICE FUND PROVIDED MASSAGES AND MUSIC THERAPY FOR PATIENTS, BEREAVEMENT CARE THROUGH CHAPLAINCY VISITS, FAMILY SUPPORT GROUPS AND BEREAVEMENT MATERIALS FOR LOVED ONES FACING GRIEF AND LOSS.WHITLEY HOME HEALTH CARE FUND:-THE WHITLEY HOME HEALTH CARE FUND PROVIDED PILL BOXES TO PATIENTS WHO ARE BEING TREATED BY PARKVIEW HOME HEALTH CARE. SPECIAL TOUCH FUND:-THE SPECIAL TOUCH FUND, WHICH FOCUSES ON PATIENT ASSISTANCE, WAS ABLE TO PROVIDE CLOTHING FOR EMERGENCY ROOM PATIENTS' DAMAGED OR STAINED ITEMS. THIS ALLOWED PATIENTS TO WEAR CLEAN CLOTHES UPON HOSPITAL DISCHARGE. FUNDING WAS ALSO PROVIDED FOR THE AFTER-HOURS TRANSPORTATION PROGRAM TO PROVIDE QUALIFIED PATIENTS WITH TRANSPORTATION FROM THE HOSPITAL UPON DISCHARGE. THOSE DEMONSTRATING THE INABILITY TO ARRANGE AND PAY FOR THEIR TRANSPORTATION HOME ARE PROVIDED WITH A VOUCHER FOR THE WHITLEY COUNTY COUNCIL ON AGING'S TRANSIT SERVICES.TRAINING AND EDUCATION FUND:-THE FOUNDATION CONTINUED ITS COMMITMENT TO HELP MAINTAIN THE HIGHEST STANDARDS OF TRAINING AND CERTIFICATIONS OF HOSPITAL CO-WORKERS. THERE WERE MULTIPLE OPPORTUNITIES FOR CO-WORKERS IN 2023, INCLUDING SPEECH PATHOLOGY, CAR SEAT SAFETY TECHNICIAN COURSE, ASSOCIATION OF WOMEN'S HEALTH, OBSTETRIC AND NEONATAL NURSES CONFERENCE, OBSTETRICAL PATIENT SAFETY COURSE, LYMPHEDEMA COURSE AND INFUSION NURSING CONFERENCE. THOSE FRONTLINE CO-WORKERS FROM THE EMERGENCY DEPARTMENT WERE ABLE TO TAKE ADVANTAGE OF ADVANCED, SPECIALIZED INSTRUCTION AND SHARE BEST PRACTICES WITH THEIR SUPERVISORS AND CO-WORKERS. SCHOLARSHIPS: -SCHOLARSHIPS PROVIDED ACADEMIC ASSISTANCE FOR TWO STUDENTS ENROLLED IN POST-SECONDARY STUDIES IN HEALTHCARE-RELATED FIELDS.BLOOM HEALING GARDENS FUND:-THE BLOOM HEALING GARDENS FUND PROVIDED FUNDS FOR IMPROVEMENT AND UPKEEP OF LANDSCAPING ON THE PARKVIEW WHITLEY HOSPITAL GROUNDS. WHITLEY COUNTY COMMUNITY FOUNDATION FUND:-THE WHITLEY COUNTY COMMUNITY FOUNDATION FUND PROVIDED FUNDING TO RENOVATE THE LOBBY OF THE EMERGENCY DEPARTMENT AT PARKVIEW WHITLEY HOSPITAL. NEW FLOORING AND COUNTERTOPS WERE ADDED TO THE EMERGENCY DEPARTMENT TO IMPROVE THE SPACE FOR PATIENTS AND FAMILIES WAITING IN THE LOBBY.

    Expenses $179,761 · Grants $179,761 · Revenue $5,375

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

  • Lisa Hatcher

    DIRECTOR/PH PHYSICIAN

    Total calculated
    $19,922
    From this org
    $0
    From related orgs
    $19,491
    Other
    $431
    Hours/week
    1 + 1 related

  • Scott Gabriel

    DIRECTOR/MARKET PRESIDENT

    Total calculated
    $467,027
    From this org
    $0
    From related orgs
    $353,558
    Other
    $113,469
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $260,023 related
    Bonus
    $0 + $44,819 related
    Other
    $0 + $48,716 related
    Deferred
    $0 + $74,725 related
    Nontaxable benefits
    $0 + $38,744 related
    Filer's total
    $0 + $467,027 related

  • David Smith

    DIRECTOR

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

  • Lucas Konger

    DIRECTOR/CHAIR

    Total calculated
    $0
    Hours/week
    1

  • Cari Wells

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Jim Heuer

    DIRECTOR

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

  • Shawn Ellis

    DIRECTOR

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

  • Joseph Kessie

    DIRECTOR

    Total calculated
    $3,750
    From this org
    $0
    From related orgs
    $3,750
    Other
    $0
    Hours/week
    1 + 1 related

  • David Lieb

    DIRECTOR/WMHOS CONTRACTED PHYSICIAN

    Total calculated
    $18,000
    From this org
    $0
    From related orgs
    $18,000
    Other
    $0
    Hours/week
    1 + 1 related

  • Brad Voelz

    DIRECTOR

    Total calculated
    $8,500
    From this org
    $0
    From related orgs
    $8,500
    Other
    $0
    Hours/week
    1 + 2 related

  • Laura McDermott

    DIRECTOR

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

  • Jane Wear

    DIRECTOR

    Total calculated
    $4,750
    From this org
    $0
    From related orgs
    $4,750
    Other
    $0
    Hours/week
    1 + 1 related

  • Bridget Dolohanty-Johnson

    DIRECTOR

    Total calculated
    $4,500
    From this org
    $0
    From related orgs
    $4,500
    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 WHITLEY MEMORIAL 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): SCOTT GABRIEL $45,647; 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: SCOTT GABRIEL $46,487; 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

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
202443109349302119

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.