2023-11-14T16:22:53-06:00 2022-12-31 990 2022-01-01 311122883 PREMIER COMMUNITY HEALTH PREM 9374999942 110 N MAIN ST 500 DAYTON OH 45402 J MICHAEL SIMS SYSTEM VP & CORP. CONTROLLER 9374999942 2023-11-14 J MICHAEL SIMS 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z J NICK LAIR 3170 KETTERING BLVD MORAINE OH 45439 52320301 0 X WWW.PREMIERHEALTH.COM X 1984 OH SEE PART III, LINE 1 3 0 103 0 0 0 349555 482870 5676989 5331675 115604 265703 0 4 6142148 6080252 0 0 0 0 4874100 4749974 0 0 0 2642774 2555441 7516874 7305415 -1374726 -1225163 3886537 3268556 5514524 6288218 -1627987 -3019662 X WE WILL IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH OTHERS WHO SHARE OUR COMMITMENT TO PROVIDE HIGH-QUALITY, COST-COMPETITIVE HEALTH SERVICES. 0 0 3708723 0 3423769 OCCUPATIONAL HEALTH OFFERS COMPREHENSIVE SERVICES FOR EMPLOYERS FOCUSED ON KEEPING EMPLOYEES HEALTHY AND INJURY-FREE. OUR SERVICES AND PROGRAMS INCLUDE INJURY CARE, DRUG AND ALCOHOL SCREENINGS, WORKPLACE SCREENINGS, VACCINATION PROGRAMS, MEDICAL PROGRAMS, POST-EMPLOYMENT SERVICES, HEALTH AND WELLNESS PROGRAMS AND MANY OTHER WORKSITE SERVICES. 1822052 0 1003853 PREMIER COMMUNITY HEALTH SERVES EMPLOYER GROUPS AND THE COMMUNITY BY PARTNERING WITH EMPLOYER GROUPS AND LOCAL ORGANIZATIONS SUCH AS CHURCHES, COMMUNITY CENTERS, SENIOR CENTERS, MUNICIPALITIES AND MORE. PREMIER COMMUNITY HEALTH OFFERS A VARIETY OF SERVICES THAT INCLUDE BIOMETRIC SCREENINGS, FLU VACCINATIONS, WELLBEING WORKSHOPS AND CHALLENGES, LIFESTYLE COACHING AND LIFESTYLE MANAGEMENT PROGRAMS SUCH AS: NICOTINE CESSATION, EMPOWER YOUR LIFESTYLE, SUSTAINABLE WELLNESS AND CHECK-CONTROL-CONNECT. ADDITIONAL PREVENTATIVE OFFERINGS INCLUDE SKIN SCREENINGS AND PROSTATE SPECIFIC ANTIGEN (PSA) SCREENINGS. THE BIOMETRIC SCREENINGS ENCOMPASS MEASURES OF TOTAL CHOLESTEROL, HIGH-DENSITY OR LOW-DENSITY LIPOPROTEIN (HDL OR LDL CHOLESTEROL), BLOOD GLUCOSE, HEMOGLOBIN A1C, BLOOD PRESSURE AND BODY COMPOSITION MEASUREMENTS. ADDITIONAL SCREENINGS MAY INCLUDE: COTININE LEVELS AND/OR HEARING AND VISION SCREENINGS. EVENTS ARE HELD AT EMPLOYER GROUPS, COMMUNITY PARTNER SITES OR USING OUR MOBILE CLINIC. IN 2022, PCH STAFF SCREENED 16,831 INDIVIDUALS. TOTAL SCREENING NUMBERS INCLUDED 1,390 CHOLESTEROL/BLOOD PRESSURE SCREENINGS, 333 BLOOD PRESSURE ONLY SCREENINGS, 3,129 LIPID SCREENINGS, 4,322 A1C SCREENINGS, 295 COTININE SCREENINGS, 3,608 BODY COMPOSITION MEASUREMENTS, 654 WAIST CIRCUMFERENCE MEASURES, 30 HEARING SCREENINGS, 617 VISION SCREENINGS, 48 PSA SCREENINGS, 10,055 FLU SHOTS AND 676 COVID VACCINATIONS. THE FOLLOWING PARTICIPANTS WERE POSITIVELY IMPACTED THROUGH HEALTH EDUCATION INITIATIVES AND PROGRAMMING: 959 HEALTH RISK ASSESSMENTS WERE COMPLETED, 1,378 COACHING SESSIONS WERE LOGGED, 532 ATTENDED A WORKSHOP (VIRTUAL AND IN-PERSON), 282 PARTICIPATED IN A CHALLENGE AND 82 PARTICIPATED IN A LIFESTYLE MANAGEMENT PROGRAM. PREMIER COMMUNITY HEALTH ATTENDED MANY HEALTH FAIR EVENTS IN 2022 AND ENGAGED A TOTAL OF 648 IN HEALTH EDUCATION THROUGH LOOK-N-LEARN BOOTHS.EACH MAY, PREMIER COMMUNITY HEALTH HIGHLIGHTS SKIN CANCER AWARENESS MONTH BY OFFERING FREE SKIN SCREENINGS TO COMMUNITY MEMBERS IN THE GREATER DAYTON REGION. THE PURPOSE OF THE SKIN SCREENINGS IS TO EDUCATE AND ENCOURAGE THE COMMUNITY TO LEARN PREVENTATIVE SKIN MEASURES. AS A RESULT OF THE PANDEMIC, A LIGHT SCHEDULE WAS ESTABLISHED IN 2022 AND ONLY TWO SMALL SKIN SCREENING EVENTS WERE CONDUCTED IN SEPTEMBER - 45 SKIN SCREENINGS WERE CONDUCTED IN TOTAL. 857034 0 904057 THE SCHOOL NURSE PROGRAM OFFERS COMPREHENSIVE NURSING SERVICES TO SCHOOLS BY OFFERING FULL-TIME CLINIC, ONE-ON-ONE NURSING AND SUBSTITUTE NURSE STAFFING SERVICES. THE SCHOOL NURSE PROGRAM IS STAFFED BY 2 LICENSED SCHOOL NURSES (LSN), A SUPERVISOR, AND A MEDICAL DIRECTOR THAT OVERSEES OUR PROTOCOLS AND CLINICAL GUIDELINES. THE NURSES PROVIDE FULL NURSING SERVICES WITHIN THE EMBEDDED SCHOOLS DEPENDING ON THE NEEDS OF THE STUDENTS WHICH INCLUDE MEDICATION MANAGEMENT, MONITORING IMMUNIZATION TIMING AND COMPLETION OF ALL SERIES, INJURY CARE AND REFERRALS. FURTHERMORE, THE SCHOOL NURSES AND ATHLETIC TRAINERS PROVIDE CPR TRAINING TO MEET THE NEW HOUSE BILL THAT MANDATES ALL HIGH SCHOOL STUDENTS NEED TO BE TRAINED ON CPR. 239997 0 0 PREMIER COMMUNITY HEALTH OFFERS THE LARGEST PROGRAM WITH FREE BREAST AND CERVICAL CANCER SCREENINGS FOR LOW-INCOME, UNINSURED AND UNDERINSURED WOMEN IN THE GREATER DAYTON REGION. FUNDING COMES FROM THE CENTERS FOR DISEASE CONTROL THROUGH THE OHIO DEPARTMENT OF HEALTH BREAST AND CERVICAL CANCER PROJECT (BCCP), FOUNDATION GRANTS AND DONATIONS. IN 2022, THE PROGRAM COMPLETED 818 BREAST SERVICES AND PROVIDED CASE MANAGEMENT SERVICES FOR 129 WOMEN WHO NEEDED FURTHER DIAGNOSTIC TESTING. THIRTY TWO OF THESE WOMEN WERE DIAGNOSED WITH BREAST CANCER, AND WE ASSISTED WITH LINKING THESE WOMEN TO ADDITIONAL RESOURCES FOR TREATMENT. IN ADDITION, 191 WOMEN RECEIVED CERVICAL SERVICES DURING CALENDAR YEAR 2022 WITH 17 ABNORMAL FINDINGS FOR WHICH ADDITIONAL DIAGNOSTIC TESTING AND TREATMENT WAS PROVIDED AS NEEDED. 239997 0 0 6627806 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 103 1 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X RENEE MOCK 9375453516 3170 KETTERING BLVD MORAINE OH 45439 JENNIFER J HAULER DO TRUSTEE 0.50 39.50 X 0 765079 19428 MICHAEL R UHL TRUSTEE (TO JUN) 0.50 39.50 X 0 629989 33939 JOSEPH P ALLEN MD BOARD CHAIR 0.50 39.50 X X 0 471583 25527 PAULA J THOMPSON PRESIDENT & CEO 16.00 24.00 X X 0 403600 50654 RENEE L MOCK BOARD TREASURER 0.50 39.50 X 0 332383 26302 BENJAMIN A WATSON ESQ BOARD SECRETARY 0.50 39.50 X 0 212206 16090 JERRY J TASSET PHYSICIAN 40.00 0.00 X 265540 0 2699 PAMELA M LYONS DIRECTOR URGENT CARE 40.00 0.00 X 137403 0 28864 JENNIFER J BROWN REMOTE PATIENT MONITORING CLINICAL COORDINATOR 40.00 0.00 X 116483 0 23536 SANDY M NICKLEY EMPLOYER HEALTH CONSULTANT 40.00 0.00 X 110688 0 13932 630114 2814840 240971 4 0 1 0 0 113 182279 256828 43650 482870 OCCUPATIONAL HEALTH 624100 3423765 3423765 SCREENING & FLU SHOTS 624100 1003853 1003853 RN SCHOOL SERVICE 624100 904057 904057 5331675 14852 14852 46490900 46240049 250851 250851 250851 4 0 4 4 6080252 5331679 0 265703 X 3987829 3618955 368874 87802 79680 8122 432866 392826 40040 241477 219140 22337 2047 2047 1567673 1422663 145010 5817 5279 538 18286 16595 1691 23038 20907 2131 261887 237662 24225 61422 55740 5682 19560 17751 1809 10281 9330 951 OPERATING SUPPLIES 555192 503837 51355 TRAINING AND EDUCATION 11557 10488 1069 DUES AND SUBSCRIPTIONS 8342 7570 772 FLEET EXPENSE 5045 4578 467 5294 4805 489 7305415 6627806 677609 0 980 762 1116008 716845 1266862 995330 580253 249518 57241 330735 1445446 846274 378610 3886537 3268556 170822 210291 5343702 6077927 5514524 6288218 X -1627987 -3019662 -1627987 -3019662 3886537 3268556 -1225163 -166512 0 X 0 1 X 1 0 X 362598 289992 281899 349555 482870 1766914 4397421 5443601 4868726 5676989 5331679 25718416 4760019 5733593 5150625 6026544 5814549 27485330 0 440132 427752 174991 271682 448252 1762809 440132 427752 174991 271682 448252 1762809 25722521 14852 14852 14852 14852 4760019 5733593 5150625 6026544 5829401 27500182 0.93540 0.93620 0.00050 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 287643 -33543 499 253601 257769 30432 558 287643 229814 28536 584 257769 196536 33682 404 229814 205234 -8256 442 196536 0.00000 0.00000 1.00000 1 0 43790 36957 6833 520308 212561 307747 16155 16155 330735 ALTERNATIVE INVESTMENTS 378610 F 378610 AFFILIATES PAYABLE 5942491 ACCRUED LIABILITIES 135436 6077927 X PART V, LINE 4: THE ENDOWMENT FUNDS ARE USED TO SUPPORT THE MISSION BY OFFERING HEALTH SCREENINGS, HEALTH EDUCATION, AND OTHER SERVICES TO THE RESIDENTS OF THE GREATER DAYTON, OHIO AREA. THIS INCLUDES CARDIOVASCULAR RISK SCREENINGS AND EDUCATION, DIABETES HEMOGLOBIN A1C, LUNG EDUCATION FOR THOSE WHO HAVE ADULT ASTHMA OR COPD, AND SERVICES FOR THE PREVENTION AND EARLY DETECTION OF BREAST CANCER, SKIN CANCER, AND LUNG CANCER. PART X, LINE 2: THE FOLLOWING FOOTNOTE IS FROM THE 2022 CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR PREMIER HEALTH (PHP) AND AFFILIATES. PHP IS THE SOLE MEMBER OF FIDELITY HEALTH CARE, INC., WHICH IS THE SOLE MEMBER OF PREMIER COMMUNITY HEALTH (PCH). PHP HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE A TAX-EXEMPT NON-PROFIT CORPORATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS A TAX-EXEMPT ORGANIZATION, ITS INCOME IS EXEMPT FROM FEDERAL INCOME TAX EXCEPT TO THE EXTENT OF ANY UNRELATED BUSINESS ACTIVITIES. PHP CONSOLIDATES CERTAIN SUBSIDIARIES WHICH ARE FOR-PROFIT CORPORATIONS SUBJECT TO FEDERAL INCOME TAXES. THESE ARE: * PREMIER HEALTH INSURING CO. (PHIC), AND PREMIER HEALTH HOLDING COMPANY (PHHC) (WHOLLY OWNED SUBSIDIARIES OF PHP), * PREMIER HEALTH PLAN (PHPLAN) (A WHOLLY OWNED SUBSIDIARY OF PHIC), * MVHE, INC., SAMARITAN FAMILY CARE, INC., PREMIER HEALTH SPECIALISTS, INC. AND PREMIER HEALTH URGENT CARE, INC. (SUBSIDIARIES OF PHHC), * PREMIER HEALTH ACO OF OHIO AND UVMC MANAGEMENT CORPORATION - CLOSED JUNE 2022 (SUBSIDIARIES OF PHP) MANAGEMENT ANNUALLY REVIEWS THE TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS. 0 1 0 0 0 0 0 0 0 JENNIFER J HAULER DO TRUSTEE 0 557482 0 184044 0 23553 0 17044 0 2384 0 784507 0 0 MICHAEL R UHL TRUSTEE (TO JUN) 0 344188 0 274802 0 10999 0 19572 0 14367 0 663928 0 241187 JOSEPH P ALLEN MD BOARD CHAIR 0 345979 0 104887 0 20717 0 9774 0 15753 0 497110 0 0 PAULA J THOMPSON PRESIDENT & CEO 0 305139 0 84654 0 13807 0 19273 0 31381 0 454254 0 0 RENEE L MOCK BOARD TREASURER 0 261654 0 69911 0 818 0 11624 0 14678 0 358685 0 0 JERRY J TASSET PHYSICIAN 265540 0 0 0 0 0 2012 0 687 0 268239 0 0 0 BENJAMIN A WATSON ESQ BOARD SECRETARY 0 175577 0 36299 0 330 0 6107 0 9983 0 228296 0 228296 PAMELA M LYONS DIRECTOR URGENT CARE 113406 0 23997 0 0 0 4717 0 24147 0 166267 0 0 0 PART I, LINE 3: COMPENSATION FOR PCH'S CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH PCH IS AN AFFILIATE. SEE EXPLANATION ON SCHEDULE O FOR FORM 990, PART VI. PART I, LINE 4B: DUE TO RESTRICTIONS IMPOSED BY THE INTERNAL REVENUE CODE, CERTAIN PERSONS ARE LIMITED IN THE AMOUNT OF BENEFIT THAT CAN BE EARNED UNDER A QUALIFIED RETIREMENT PLAN. LIKE MANY EMPLOYERS, PREMIER COMMUNITY HEALTH (PCH) AND ITS AFFILIATED ORGANIZATIONS COMPENSATE FOR THIS LIMITATION AND SUPPLEMENT THE AFFECTED EXECUTIVES' QUALIFIED PENSION THROUGH CERTAIN NONQUALIFIED PLANS. PCH SUPPLEMENTS THE AFFECTED EXECUTIVES THROUGH A PENSION RESTORATION PLAN AND A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE BENEFITS UNDER THESE SUPPLEMENTAL NONQUALIFIED PLANS ARE SUBJECT TO MULTI-YEAR VESTING AND A PARTICIPANT CAN FORFEIT BENEFITS EARNED IF VESTING REQUIREMENTS ARE NOT SATISFIED. UNDER THE TERMS OF THE SUPPLEMENTAL PLANS, AND BECAUSE OF TAX RULES PERTAINING TO TAXATION OF THE EARNED BENEFITS UPON VESTING, CERTAIN INDIVIDUALS RECEIVED A PAYOUT OF THE CUMULATIVE VESTED BENEFITS UNDER THEIR SUPPLEMENTAL PLAN DURING 2022. THE INDIVIDUAL LISTED BELOW HAS MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE SERP AND RECEIVED THE ASSOCIATED PAYMENT IN 2022: PAULA THOMPSON $7,455. THE FOLLOWING SERP AMOUNTS WERE DEFERRED ON THE PARTICIPANTS' BEHALF DURING THE YEAR AND WILL BE HELD UNTIL THE INCREMENTAL AMOUNTS ARE VESTED: JENNIFER HAULER $7,358; MICHAEL UHL $8,385. BASED ON THE GUIDANCE PROVIDED IN THE INSTRUCTIONS TO THE FORM 990, ANY PAYMENTS TO THE PARTICIPANTS RELATED TO THESE PLANS THAT WERE MADE WITHIN 2-1/2 MONTHS AFTER THE END OF THE ORGANIZATION'S TAX YEAR ARE NOT TREATED AS DEFERRED COMPENSATION FOR PURPOSES OF SCHEDULE J. SUCH AMOUNTS ARE PROPERLY REPORTED AS COMPENSATION FOR FORM 990 PURPOSES WHEN INCLUDED IN THE PARTICIPANTS' FORM W-2 WAGES. FORM 990, PART V, LINE 2A: PCH DOES NOT HAVE EMPLOYEES, BUT INSTEAD SHARES EMPLOYEES WITH FIDELITY HEALTH CARE (FHC). THESE EMPLOYEES RECEIVE THEIR W-2 FROM FHC (EIN 31-1075381). FORM 990, PART VI, SECTION A, LINE 3 PREMIER HEALTH (PREMIER), AS THE OPERATOR OF BOTH PREMIER COMMUNITY HEALTH (PCH) AND ITS CORPORATE MEMBER, FIDELITY HEALTH CARE, DEVELOPS AND OVERSEES THE IMPLEMENTATION OF THE STRATEGIC PLAN FOR PCH, WHICH INCLUDES (BUT IS NOT LIMITED TO) SUCH MATTERS AS LOCATION OF CLINICAL AND ADMINISTRATIVE EXPENSES AND THE CONSOLIDATION OF SUCH SERVICES. PCH SHALL COMPLY WITH AND IMPLEMENT THIS PLAN AND SHALL NOT TAKE ANY ACTION THAT MATERIALLY DEPARTS FROM THIS PLAN WITHOUT PREMIER'S APPROVAL. PCH SHALL IMPLEMENT ANY CAPITAL AND OPERATING BUDGET SO APPROVED AND/OR REVISED FOR IT BY PREMIER. PCH SHALL IMPLEMENT THE BUSINESS PLAN APPROVED BY PREMIER. PREMIER IS THE SOLE AGENT TO NEGOTIATE ALL RELATIONSHIPS WITH PAYORS ON BEHALF OF PCH WITH ALL THIRD-PARTY PAYORS AND ALTERNATIVE DELIVERY SYSTEMS INCLUDING, BUT NOT LIMITED TO, INSURERS. PCH MUST HAVE APPROVAL FROM PREMIER TO BORROW IN ANY FISCAL YEAR, GUARANTEE IN ANY YEAR, OR INCUR ANY LIEN OR OTHER ENCUMBRANCE ON ANY PROPERTY IN AN AMOUNT EQUAL TO OR GREATER THAN $1,000,000. PCH MUST SEEK PREMIER'S APPROVAL FOR ANY ACQUISITIONS, SALE OR TRANSFER OF ANY MATERIAL ASSET USED IN PCH'S ACTIVITIES. FORM 990, PART VI, SECTION A, LINE 6 PREMIER COMMUNITY HEALTH HAS ONE CORPORATE MEMBER; FIDELITY HEALTH CARE, AN OHIO NON-PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A FIDELITY HEALTH CARE (FHC) HAS THE SOLE AUTHORITY TO ELECT THE BOARD OF TRUSTEES FOR PREMIER COMMUNITY HEALTH. FOR ADDITIONAL INFORMATION, SEE THE RESPONSE ABOVE FOR FORM 990, PART VI, SECTION A, LINE 3. FORM 990, PART VI, SECTION A, LINE 7B SEE EXPLANATION FOR LINE 7A ABOVE. FORM 990, PART VI, SECTION B, LINE 11B THIS 990 FILING AND ATTACHED SCHEDULES (THE RETURN) ARE PREPARED BY A STAFF MEMBER IN THE TAX DEPARTMENT OF PREMIER, OF WHICH PREMIER COMMUNITY HEALTH IS AN AFFILIATE. THE RETURN IS REVIEWED BY THE MANAGER AND DIRECTOR OF TAX COMPLIANCE OF PREMIER. AFTER ALL CHANGES FROM THE ABOVE PERSONS ARE MADE, THE RETURN IS REVIEWED BY THE VICE PRESIDENT/CONTROLLER OF PREMIER. A FINAL VERSION OF THE RETURN IS THEN PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW. AT A BOARD OF TRUSTEES MEETING, THE VICE PRESIDENT/CONTROLLER OF PREMIER (OR DESIGNEE) SHARES DETAILED INFORMATION ON COMPENSATION AND OTHER KEY AREAS, AS WELL AS ADDRESSES ANY OTHER QUESTIONS FROM THE BOARD OF TRUSTEES, PENDING THEIR REVIEW. THE 990 FILING IS ALSO SHARED WITH THE AUDIT COMMITTEE OF PREMIER. FORM 990, PART VI, SECTION B, LINE 12C PREMIER REQUIRES ALL BOARD MEMBERS, BOARD COMMITTEE MEMBERS, MEDICAL DIRECTORS, SUPPLY CHAIN DIVISION MEMBERS, AUTHORIZED SIGNERS, DIRECTORS, EXECUTIVES, MEDICAL EXECUTIVE COMMITTEE MEMBERS, MEDICAL DEPARTMENT AND SECTION CHAIRS, PHYSICIAN PARTNERSHIP COMMITTEE MEMBERS, PHYSICIAN GUIDANCE GROUP MEMBERS, AND ALL EMPLOYED PHYSICIANS TO ANNUALLY REVIEW THE PREMIER COMPREHENSIVE CONFLICT OF INTEREST STATEMENT, AN EXPLANATORY MEMORANDUM, THE ANTITRUST COMPLIANCE POLICY, AND COMPLETE AN INDIVIDUAL QUESTIONNAIRE DISCLOSING ANY POTENTIAL CONFLICTS AS DEFINED IN THE CONFLICT OF INTEREST POLICY. THIS IS ACCOMPLISHED EITHER BY WAY OF AN ELECTRONIC COMMUNICATION SENT OUT DIRECTLY BY THE CORPORATE COMPLIANCE DEPARTMENT OR BY WAY OF A MEMO SENT OUT FROM THE CHAIRMAN OF THE BOARD AND CHIEF EXECUTIVE OFFICER OF PREMIER. IT ALSO INCLUDES AN EXPLANATORY MEMORANDUM OF SPECIFIC ACTIVITIES THAT MIGHT GIVE CAUSE TO A CONFLICT AND AN INDIVIDUAL QUESTIONNAIRE TO DISCLOSE ALL SUCH ACTIVITIES. THIS QUESTIONNAIRE MUST BE COMPLETED AND SIGNED BY THE INDIVIDUAL. THIS CORRESPONDENCE INCLUDES A COPY OF THE ANTITRUST COMPLIANCE POLICY THAT MUST BE SIGNED BY THE INDIVIDUAL. ALL OF THESE DOCUMENTS ARE SENT TO THE CORPORATE COMPLIANCE DEPARTMENT. THE CORPORATE COMPLIANCE DEPARTMENT ENSURES ALL FORMS ARE RETURNED AND RETAINS THE DOCUMENTS FOR FIVE YEARS. IN ADDITION, AT EACH MEETING OF THE BOARD OR ANY BOARD COMMITTEE, FOLLOWING APPROVAL OF THE PREVIOUS MEETING'S MINUTES, THE BOARD OR COMMITTEE CHAIR SHALL REQUEST ANY BOARD MEMBER WHO PERCEIVES A POTENTIAL CONFLICT OF INTEREST ON ANY OF THE MEETING'S AGENDA ITEMS TO DISCLOSE THE POTENTIAL CONFLICT. ADDITIONALLY, AT ANY BOARD OR BOARD COMMITTEE MEETING WHERE THE SUBJECT OF CONFLICT OF INTEREST IS DISCUSSED, THE MINUTES SHALL CONTAIN THE NAME OF THE PARTY DISCUSSING A POTENTIAL CONFLICT OF INTEREST, THE NATURE OF THE POTENTIAL CONFLICT OF INTEREST AND WHETHER A CONFLICT OF INTEREST WAS FOUND TO EXIST. IF A CONFLICT OF INTEREST IS DETERMINED BY THE BOARD TO EXIST, THE MEMBER WILL BE EXCUSED FROM PARTICIPATING IN ANY DISCUSSION OR VOTING ON THE PARTICULAR AGENDA ITEM. THE CHIEF COMPLIANCE AND ENTERPRISE RISK OFFICER REPORTS THE RESULTS OF THE PREMIER CONFLICT OF INTEREST QUESTIONNAIRES NO LESS THAN ANNUALLY TO THE BOARD OF TRUSTEES BY WAY OF THE COMPLIANCE AND AUDIT COMMITTEE. THIS REVIEW IS DOCUMENTED IN THE MINUTES OF THE MEETING. PERIODICALLY, THE INTERNAL AUDIT DEPARTMENT WILL REVIEW A SAMPLE OF COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES AND REPORT THE RESULTS TO THE COMPLIANCE AND AUDIT COMMITTEE. THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES ARE INDIVIDUALLY SUMMARIZED IN A DOCUMENT AND SENT ELECTRONICALLY TO THE FINANCE DEPARTMENT FOR ANY NECESSARY DISCLOSURES REQUIRED ON THE 990 FILING. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR PREMIER COMMUNITY HEALTH'S (PCH) CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH PCH IS AN AFFILIATE, ON AN ANNUAL BASIS. THE REVIEW PROCESS PERFORMED BY PREMIER FOLLOWS A MARKET BASED COMPENSATION PHILOSOPHY DESIGNED TO ATTRACT AND RETAIN THE EXECUTIVE TALENT REQUIRED TO MEET THE HIGH-PERFORMANCE STANDARDS OF OUR BOARD AND OUR COMMUNITY. PREMIER ANNUALLY REVIEWS EXECUTIVE COMPENSATION SURVEY DATA FOR A REGIONAL AND NATIONAL PEER GROUP OF SYSTEMS AND HOSPITALS THAT ARE SIMILAR IN SIZE AND COMPLEXITY TO PREMIER AND ITS AFFILIATES. THE DATA FOR THE SURVEY IS PROVIDED BY A THIRD-PARTY CONSULTANT GROUP THAT IS INDEPENDENT OF PREMIER. THIS REPORT INCLUDES COMPARABILITY DATA FOR KEY EXECUTIVES, VICE PRESIDENTS, AND DIRECTOR LEVEL POSITIONS. THE INDEPENDENT COMPARABILITY DATA IS REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE ON AN ANNUAL BASIS. THIS COMMITTEE CONTAINS THREE MEMBERS, ALL OF WHOM ARE INDEPENDENT. THIS COMMITTEE REVIEWS IN DETAIL THE COMPENSATION FOR THE PREMIER CEO, COO, CFO, CCO AND OTHER TOP EXECUTIVES. OTHER POSITIONS ARE REVIEWED AT A HIGH LEVEL FOR REASONABLENESS. ALL THE MEETING MINUTES ARE DOCUMENTED AND KEPT ON FILE ALONG WITH ANY COMPARABILITY DATA AND THE CONSULTANT REPORT. AFTER THE COMPENSATION COMMITTEE REVIEWS AND APPROVES THE COMPENSATION ACTIONS, THE PROCESS IS AUDITED BY THE INTERNAL AUDIT DEPARTMENT. THE EXECUTIVE COMPENSATION COMMITTEE PRESENTS THE COMPENSATION ACTIONS TO THE PREMIER BOARD ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC WHEN REQUIRED BY LAW OR FOR ACCREDITATION PURPOSES. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 816,788. MANAGEMENT AND GENERAL EXPENSES 83,253. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 900,041. PROF/CONSULTING FEES: PROGRAM SERVICE EXPENSES 461,517. MANAGEMENT AND GENERAL EXPENSES 47,042. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 508,559. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 101,468. MANAGEMENT AND GENERAL EXPENSES 10,343. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 111,811. PURCHASED LABOR: PROGRAM SERVICE EXPENSES 38,148. MANAGEMENT AND GENERAL EXPENSES 3,888. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,036. MEALS & NUTRITION SERVICE: PROGRAM SERVICE EXPENSES 2,135. MANAGEMENT AND GENERAL EXPENSES 218. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,353. TAXES AND LICENSES: PROGRAM SERVICE EXPENSES 1,392. MANAGEMENT AND GENERAL EXPENSES 142. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,534. ADMINISTRATIVE EXPENSES: PROGRAM SERVICE EXPENSES 1,215. MANAGEMENT AND GENERAL EXPENSES 124. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,339. PREMIER HEALTH 110 MAIN STREET SUITE 500 DAYTON OH 45402 311446699 PARENT OH 501 (C) (3) 12B N/A 0 MEDAMERICA HEALTH SYSTEMS CO 110 MAIN STREET SUITE 500 DAYTON OH 45402 311040228 SUPPORT ORG OH 501 (C) (3) 12B N/A 0 MIAMI VALLEY HOSPITAL 110 MAIN STREET SUITE 500 DAYTON OH 45402 310537504 HOSPITAL OH 501 (C) (3) 3 PREMIER HEALTH 0 MIAMI VALLEY HOSPITAL FOUNDATION 110 MAIN STREET SUITE 500 DAYTON OH 45402 311040231 FOUNDATION OH 501 (C) (3) 7 PREMIER HEALTH 0 FIDELITY HEALTH CARE INC 110 MAIN STREET SUITE 500 DAYTON OH 45402 311075381 HOME HEALTH OH 501 (C) (3) 10 PREMIER HEALTH 0 GOOD SAMARITAN FOUNDATION - DAYTON 110 MAIN STREET SUITE 500 DAYTON OH 45402 237296923 FOUNDATION OH 501 (C) (3) 7 PREMIER HEALTH 0 ATRIUM HEALTH SYSTEM 110 MAIN STREET SUITE 500 DAYTON OH 45402 310537492 SUPPORT ORG OH 501 (C) (3) 12B N/A 0 ATRIUM MEDICAL CENTER 110 MAIN STREET SUITE 500 DAYTON OH 45402 311079309 HOSPITAL OH 501 (C) (3) 3 PREMIER HEALTH 0 UVMC 110 MAIN STREET SUITE 500 DAYTON OH 45402 341850683 SUPPORT ORG OH 501 (C) (3) 12B N/A 0 UPPER VALLEY MEDICAL CENTER 110 MAIN STREET SUITE 500 DAYTON OH 45402 310537095 HOSPITAL OH 501 (C) (3) 3 PREMIER HEALTH 0 UPPER VALLEY PROFESSIONAL CORP 110 MAIN STREET SUITE 500 DAYTON OH 45402 311400963 HEALTH CARE OH 501 (C) (3) 10 PREMIER HEALTH HOLDING CO 0 UVPC SPECIALISTS 110 MAIN STREET SUITE 500 DAYTON OH 45402 203687536 HEALTH CARE OH 501 (C) (3) 10 PREMIER HEALTH HOLDING CO 0 UVMC NURSING CARE INC 110 MAIN STREET SUITE 500 DAYTON OH 45402 311224064 NURSING HOME OH 501 (C) (3) 10 PREMIER HEALTH 0 COMPUNET CLINICAL LABORATORIES LLC 110 MAIN STREET SUITE 500 DAYTON OH 45402 311258010 LAB OH 501 (C) (3) 12B PREMIER HEALTH 0 SAMARITAN BEHAVIORAL HEALTH INC 110 MAIN STREET SUITE 500 DAYTON OH 45402 020633634 BEHAVIORAL HEALTH OH 501 (C) (3) 7 PREMIER HEALTH 0 SWEITZER STREET LLC 110 N MAIN STREET SUITE 500 DAYTON OH 45402 454700417 REAL ESTATE OH MVHE INC EXCLUDED 0 0 SWEITZER MOB LLC 110 N MAIN STREET SUITE 500 DAYTON OH 45402 474554657 REAL ESTATE OH MVHE INC EXCLUDED 0 0 MVHE INC 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 311185270 PHYSICIAN SVCS OH PREMIER HEALTH HOLDING CO C 0 PREMIER HEALTH SPECIALISTS 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 061744704 PHYSICIAN SVCS OH PREMIER HEALTH HOLDING CO C 0 SAMARITAN FAMILY CARE 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 311299450 PHYSICIAN SVCS OH PREMIER HEALTH HOLDING CO C 0 AFTER HOURS FAMILY CARE 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 311269483 HEALTH CARE OH UPPER VALLEY PROFESSIONAL CORP C 0 UVMC MANAGEMENT CORP 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 311360489 MANAGEMENT COMPANY OH PREMIER HEALTH C 0 PREMIER HEALTH URGENT CARE INC 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 822079409 URGENT CARE OH PREMIER HEALTH HOLDING CO C 0 PREMIER HEALTH PLAN INC 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 463024049 HEALTH INSURANCE OH PREMIER HEALTH INSURING CO C 0 GOOD SAMARITAN HOSPITAL 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 310536981 HOSPITAL OH PREMIER HEALTH C 0 PREMIER HEALTH INT'L INSURANCE BUTTERFIELD BANK BLDG 6TH FLR 65 HAMILTON BD HM12 980548485 INSURANCE BD PREMIER HEALTH C 0 PREMIER HEALTH ACO OF OHIO 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 474049773 MEDICARE ACO OH PREMIER HEALTH C 0 PREMIER HEALTH HOLDING CO 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 812419110 HOLDING CO OH PREMIER HEALTH C 0 PREMIER HEALTH INSURING CO 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 464766841 HEALTH INSURANCE OH PREMIER HEALTH C 0 0 0 1 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1