Schedule L
(Form 990)
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, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
DEACONESS HOSPITAL INC
 
Employer identification number

35-0593390
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) 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) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by 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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting 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 assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990) 2021
Page 2
Schedule L (Form 990) 2021
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) ABBY PAPARIELLA SEE PART V 132,144 COMP.   No
(2) JESSICA COX SEE PART V 308,530 COMP.   No
(3) JOAN MCCOY SEE PART V 57,608 COMP.   No
(4) LAUREN WATHEN SEE PART V 92,841 COMP.   No
(5) OLD NATIONAL BANK
  		SEE PART V 355,756 INVESTMENT MANAGEMENT FEES   No
(6) SHERRI MCCOY SEE PART V 23,976 COMP.   No
(7) SOUTH WESTERN COMMUNICATIONS
  		SEE PART V 352,521 TELECOMMUNICATION SERVICES   No
(8) LARRY KILINSKI
  		SEE PART V 76,594 ANESTHESIA SERVICES   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
SCH L, PART IV, ABBREVIATION: BD MBR = BOARD MEMBERCOMP. = REPORTABLE COMPENSATIONSRVS. = SERVICES
SCH L, PART V, RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: INTERESTED PERSON: ABBY PAPARIELLARELATIONSHIP: DAUGHTER OF DAVE PAPARIELLAINTERESTED PERSON: SOUTH WESTERN COMMUNICATIONSRELATIONSHIP: BOARD MEMBER KEVIN KOCH IS THE CHAIRMAN OF SOUTH WESTERN COMMUNICATIONS. SOUTH WESTERN COMMUNICATIONS PROVIDES TELECOMMUNICATION SERVICES.INTERESTED PERSON: JESSICA COXRELATIONSHIP: DAUGHTER TO LYNN LINGAFELTERINTERESTED PERSON: JOAN MCCOYRELATIONSHIP: WIFE OF SHAWN MCCOYINTERESTED PERSON: OLD NATIONAL BANKRELATIONSHIP: BOARD MEMBER JAMES RYAN IS THE CEO OF OLD NATIONAL BANK. OLD NATIONAL BANK PROVIDES INVESTMENT MANAGEMENT SERVICES.INTERESTED PERSON: SHERRI MCCOYRELATIONSHIP: SISTER OF SHAWN MCCOYINTERESTED PERSON: LAUREN WATHERNRELATIONSHIP: DAUGHTER TO CHERYL WATHENINTEREST PERSON: LARRY KILINSKIRELATIONSHIP: LARRY KILINSKI, BOARD MEMBER OF THE HOSPITAL, PROVIDES ANESTHESIA SERVICES TO THE HOSPITAL.
Schedule L (Form 990) 2021


Additional Data


Software ID:  
Software Version: