2023-11-14T16:14:36-06:00 2022-12-31 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2022-01-01 203376102 PARAMOUNT ADVANTAGE PARA 4192525772 300 MADISON AVE 270 TOLEDO OH 43604 TERRENCE METZGER CFO 4192525772 2023-11-10 1 TERRENCE METZGER 999009999 0 AMY CIMINELLO P00796388 3122071040 2023-11-10 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z X TERRENCE METZGER 300 MADISON AVE 270 TOLEDO OH 43604 500755380 0 X WWW.PARAMOUNTHEALTHCARE.COM X 2005 OH PARAMOUNT ADVANTAGE ADMINISTERS OHIO MEDICAID HEALTH CARE COVERAGE TO ELIGIBLE OHIO RESIDENTS. PARAMOUNT ADVANTAGE WORKS IN CLOSE COLLABORATION WITH PHYSICIANS AND OTHER PROVIDERS TO MONITOR AND IMPROVE PERFORMANCE IN CLINICAL OUTCOMES, MEDICAL AND BEHAVIORAL SERVICES, AND PATIENT SAFETY. TO SUPPORT THIS COMMITMENT, PARAMOUNT DEVOTED A RANGE OF RESOURCES TO CLINICAL QUALITY IMPROVEMENT, PARTICULARLY CASE MANAGEMENT. PARAMOUNT ADVANTAGE HAS ESTABLISHED THREE STRATEGIC FOCUS AREAS TO IDENTIFY HIGH RISK PATIENTS, IMPROVE CARE, AND IMPROVE QUALITY OF LIFE AND DEVOTES FURTHER RESOURCES TO IMPROVING CARE IN THE AREAS OF DIABETES CARE, MATERNAL & NEWBORN HEALTH, AND BEHAVIORAL HEALTH SERVICES. THE ADVANTAGE NETWORK IS A STATEWIDE, COMPREHENSIVE PANEL OF PROVIDERS THAT PROVIDES ACUTE, PREVENTATIVE, BEHAVIORAL HEALTH, PHARMACY, DENTAL AND VISION CARE THROUGHOUT THE STATE. OUR PANEL CURRENTLY EXCEEDS 48,000 PROVIDERS AND EXCEEDS STATE MINIMUM REQUIREMENTS FOR THE NUMBERS OF PCPS. 3 2 0 2 0 0 0 0 1568084578 212348020 3854756 47317022 0 0 1571939334 259665042 0 0 0 0 41916298 38217771 0 0 0 1452104636 130035829 1494020934 168253600 77918400 91411442 609960761 207974426 335870097 117224964 274090664 90749462 X THE MISSION OF PARAMOUNT ADVANTAGE IS TO FACILITATE THE PROVISION OF HEALTH CARE SERVICES FOR ELIGIBLE OHIO MEDICAID CONSUMERS THROUGH A COMPREHENSIVE NETWORK OF PHYSICIANS, HOSPITALS, AND OTHER PROVIDERS, AND TO ADVANCE THE BETTERMENT OF HEALTH CARE THROUGHOUT THE STATE OF OHIO. KEY ELEMENTS TO ENSURE THAT OUR MISSION IS ACCOMPLISHED INCLUDE: PROMOTING PREVENTATIVE HEALTH CARE PROGRAMS, COORDINATING SERVICES AMONG MEMBERS AND PROVIDERS, PARTICIPATING IN PROGRAMS OR ACTIVITIES THAT PROVIDE RELATED HEALTH CARE SERVICES, EDUCATION, COUNSELING, SOCIAL SERVICES ASSISTANCE, AND ADVOCACY ON BEHALF OF OUR OHIO MEDICAID MEMBERS AND THE COMMUNITY AT LARGE. 0 0 114818472 212348020 PARAMOUNT ADVANTAGE ADMINISTERS OHIO MEDICAID HEALTH CARE COVERAGE TO ELIGIBLE OHIO RESIDENTS. - SEE SCHEDULE O. 114818472 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 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 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 2 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X TERRENCE METZGER 4192525772 100 MADISON AVE TOLEDO OH 43604 X JAMES F WHITE JR CHAIRMAN 1.00 2.00 X X 0 0 0 LORI A JOHNSTON PRESIDENT 1.00 49.00 X X 0 966984 9450 ELAINE CANNING TRUSTEE 1.00 1.00 X 0 0 0 RANDALL OOSTRA PHS PRES. & CEO - PART YEAR 1.00 54.00 X 0 5476040 3579 STEPHEN M SADOWSKI CHIEF LEGAL OFFICER 1.00 54.00 X 0 683615 6102 JEFFREY C KUHN SECRETARY, CHIEF LEGAL OFFICER - PART YEAR 1.00 54.00 X 0 927467 44223 LOUIS ROBICHAUX TREASURER 1.00 54.00 X 0 0 0 STEVEN M CAVANAUGH TREASURER, CFO - PART YEAR 1.00 54.00 X 0 2435815 41525 ARTURO POLIZZI PRESIDENT AND CEO 1.00 54.00 X 0 1605830 12750 ALAN M SATTLER FORMER TREASURER, VP BUSINESS DEV. 0.00 40.00 X 0 252074 7396 GARY W AKENBERGER FORMER TREASURER, COO, METRO REGION 0.00 40.00 X 0 466247 33651 JOHN C RANDOLPH FORMER PRESIDENT, COO PPG 0.00 0.00 X 0 236928 0 0 13051000 158676 0 1 1 0 0 NET PATIENT SERVICES 524114 212348020 212348020 212348020 4417124 4417124 233990236 50000000 241090338 0 -7100102 50000000 42899898 42899898 259665042 212348020 0 47317022 X 37260237 27740565 9519672 905867 40655 865212 51667 20731 30936 357625 357625 392370 392370 52316079 29349133 22966946 30343 30343 120571 120571 15030 15030 4356793 4356793 MEDICAL EXPENSE 46084929 46084929 INTERCOMPANY SERVICES 12576586 12576586 TAXES 11328641 11328641 SUPPLIES 199008 199008 2257854 54810 2203044 168253600 114818472 53435128 0 317763109 127094087 221622992 64686254 66990690 12796587 14497 0 169673 0 3399800 3397498 609960761 207974426 163710261 20009126 172159836 97215838 335870097 117224964 X 274090664 90749462 274090664 90749462 609960761 207974426 X 91411442 -5696764 -1555880 -267500000 X X 0 1 X 1 1 1 X 1341108165 1493079936 1534627805 1568084578 212348020 6149248504 1341108165 1493079936 1534627805 1568084578 212348020 6149248504 0 0 0 6149248504 5491139 4351146 5673300 4437144 4417124 24369853 5491139 4351146 5673300 4437144 4417124 24369853 1346599304 1497431082 1540301105 1572521722 216765144 6173618357 0.99610 0.99650 0.00390 0.00350 X 0 ACCRUED CLAIMS 16840575 DUE TO AFFILIATES 63813960 AGGREGATE HEALTH POLICY RESERVES 6775905 OTHER LIABILITIES 9785398 97215838 259044292 0 259044292 620750 620750 259665042 167632850 0 167632850 620750 620750 168253600 1 1 0 0 0 0 0 0 0 RANDALL OOSTRA PHS PRES. & CEO - PART YEAR 0 1664907 0 2628840 0 1182293 0 0 0 3579 0 5479619 0 0 STEVEN M CAVANAUGH TREASURER, CFO - PART YEAR 0 604206 0 1107251 0 724358 0 28986 0 12539 0 2477340 0 0 ARTURO POLIZZI PRESIDENT AND CEO 0 1003178 0 597348 0 5304 0 0 0 12750 0 1618580 0 0 LORI A JOHNSTON PRESIDENT 0 708408 0 255489 0 3087 0 0 0 9450 0 976434 0 0 JEFFREY C KUHN SECRETARY, CHIEF LEGAL OFFICER - PAR 0 390988 0 196494 0 339985 0 23904 0 20319 0 971690 0 0 STEPHEN M SADOWSKI CHIEF LEGAL OFFICER 0 596289 0 86275 0 1051 0 0 0 6102 0 689717 0 0 GARY W AKENBERGER FORMER TREASURER, COO, METRO REGION 0 391743 0 68216 0 6288 0 9317 0 24334 0 499898 0 0 ALAN M SATTLER FORMER TREASURER, VP BUSINESS DEV. 0 220780 0 27308 0 3986 0 0 0 7396 0 259470 0 0 JOHN C RANDOLPH FORMER PRESIDENT, COO PPG 0 0 0 0 0 236928 0 0 0 0 0 236928 0 0 PART I, LINE 3 A RELATED ORGANIZATION, PROMEDICA HEALTH SYSTEM, INC., USES AN INDEPENDENT CONSULTANT, COMPENSATION COMMITTEE, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S EXECUTIVES. PART I, LINES 4A-B ELIGIBLE EMPLOYEES PARTICIPATE IN VARIOUS NONQUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EMPLOYEE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO THE FOLLOWING LISTED PERSONS IN PART VII: STEVEN CAVANAUGH RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION, PROMEDICA HEALTH SYSTEM, IN THE AMOUNT OF $688,132 DURING 2022. JEFFERY KUHN RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION, PROMEDICA HEALTH SYSTEM, IN THE AMOUNT OF $333,184 DURING 2022. SCHEDULE J, SUPPLEMENTAL INFORMATION: IN ADDITION, HCR MANORCARE, INC. A RELATED ORGANIZATION PROVIDES A SPLIT-DOLLAR LIFE INSURANCE PLAN TO ITS CHIEF EXECUTIVE OFFICER FROM WHICH NO CASH PAYMENTS WERE MADE DURING THE YEAR. FORM 990, PART III, LINE 4: PARAMOUNT ADVANTAGE - PROGRAM SERVICE ACCOMPLISHMENTS PARAMOUNT ADVANTAGE IS A MEMBER OF PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA OFFERS COMPREHENSIVE HEALTH SERVICES INCLUDING MEDICAL, SURGICAL, PSYCHIATRIC, REHABILITATIVE, SKILLED NURSING, HOME HEALTH, AND HOSPICE SERVICES IN 28 STATES ACROSS THE COUNTRY AND IS ONE OF THE NATION'S LEADING HEALTH SYSTEMS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN PATIENT-CENTERED CARE, ADVANCED TECHNOLOGY, INNOVATIVE PROGRAMS, AND FAMILY-ORIENTED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF PATIENTS' ABILITY TO PAY. PARAMOUNT ADVANTAGE AND PROMEDICA HAVE ESTABLISHED AND PROMOTED THE FOLLOWING KEY VALUES THROUGHOUT THE ORGANIZATIONS: - COMPASSION WE TREAT PEOPLE WITH DIGNITY AND RESPECT; - INNOVATION WE CONTINUALLY SEARCH TO FIND A BETTER WAY FORWARD; - TEAMWORK WE PARTNER WITH OTHERS BECAUSE WE ARE BETTER TOGETHER THAN APART; - EXCELLENCE WE STRIVE TO BE THE BEST IN ALL WE DO; - LEARNING WE USE THE LESSONS WE LEARN TO IMPROVE OUR MEMBERS' LIVES PARAMOUNT ADVANTAGE IS A MEDICAID MANAGED CARE PLAN (MCP) CONTRACTED THROUGH THE OHIO DEPARTMENT OF MEDICAID (ODM) THAT PROVIDES HEALTH CARE SERVICES TO MORE THAN 255,000 OHIO RESIDENTS IN 54 COUNTIES ELIGIBLE FOR AGED, BLIND OR DISABLED, COVERED FAMILIES AND CHILDREN, OR ADULT EXTENSION MEDICAID BENEFITS VIA A STATEWIDE HEALTH MAINTENANCE ORGANIZATION (HMO) PLATFORM. TO THIS END, ALL MEMBERS SELECT A PRIMARY CARE PHYSICIAN (PCP) AT THE TIME OF ENROLLMENT AND ARE ENCOURAGED TO ESTABLISH A RELATIONSHIP WITH THE PHYSICIAN AS SOON AS POSSIBLE. IF MEMBERS DO NOT CHOOSE A PCP, THEN THEY ARE ASSIGNED ONE. THE MEMBER IS INSTRUCTED TO CONTACT HIS/HER PCP WHENEVER MEDICAL OR BEHAVIORAL HEALTH CARE IS NEEDED. THUS, THE PCP IS INFORMED ABOUT HIS/HER PATIENT'S NEEDS AND CAN MAKE INFORMED, APPROPRIATE DECISIONS REGARDING TREATMENT. CARE MANAGEMENT PROGRAMS SUCH AS DISEASE MANAGEMENT, UTILIZATION MANAGEMENT AND CASE MANAGEMENT PROVIDE MEMBERS EDUCATION ABOUT THEIR CONDITION, ENSURE THEY HAVE ACCESS TO APPROPRIATE CARE, AND ASSIST IN HELPING HIGH RISK MEMBERS MANAGE AND NAVIGATE THEIR CARE IN A SUPPORTIVE, COST EFFECTIVE ENVIRONMENT. ADDITIONALLY, PARAMOUNT ADVANTAGE MEDICAID EARNED A 4 OUT OF 5 RATING IN THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE'S (NCQA) MEDICAID HEALTH INSURANCE PLAN RATINGS FOR 2019-2020. THIS WAS THE HIGHEST OF ALL FIVE MEDICAID MANAGED CARE PLANS IN OHIO. NCQA ACCREDITS AND CERTIFIED A WIDE RANGE OF HEALTHCARE ORGANIZATIONS AND MANAGES THE EVOLUTION OF HEDIS, THE PERFORMANCE MEASUREMENT TOOL USED BY MORE THAN 90% OF THE NATION'S HEALTH PLANS. IT RATES EACH HEALTH PLAN ON DOZENS OF QUALITY MEASURES RELATED TO CONSUMER SATISFACTION, PREVENTION AND TREATMENT. PARAMOUNT ADVANTAGE MEMBERS HAVE ACCESS TO A MOBILE APPLICATION, MEMBER NEWSLETTERS, SOCIAL SERVICES REFERRALS, AND THE ABILITY TO SPEAK WITH THE SAME CUSTOMER SERVICE REPRESENTATIVE WHEN CALLING IN FOR SERVICES. MEMBER MATERIALS ARE PROVIDED IN FOUR LANGUAGES AND TRANSLATION SERVICES ARE PROVIDED IN VIRTUALLY ANY LANGUAGE. FOR MEMBERS AND NON-MEMBERS, AN ON-LINE COMMUNITY RESOURCE GUIDE IS AVAILABLE TO INFORM ABOUT HEALTH AND WELL-BEING SERVICES OFFERED IN THEIR COMMUNITIES. THESE SERVICES ARE ALL DESIGNED TO ENSURE OHIO'S MOST VULNERABLE RESIDENTS RECEIVE APPROPRIATE, COORDINATED CARE. PARAMOUNT ADVANTAGE MEMBER WELLNESS PROGRAMS INCLUDE INCENTIVES DESIGNED TO ENSURE SAFER PREGNANCIES AND DELIVERIES FOR MOTHERS AS WELL AS SCREENING, DIAGNOSIS AND TREATMENT SERVICES FOR ADULTS AND CHILDREN. HEALTHCHECK, AN EARLY AND PERIODIC SCREENING, DIAGNOSTIC AND TREATMENT BENEFIT FOR CHILDREN, ALONG WITH A 24-HOUR NURSING HOTLINE, PROVIDE A BROAD RANGE OF NO-COST PREVENTIVE CARE SERVICES. AS PART OF PROMEDICA, PARAMOUNT ADVANTAGE DEMONSTRATES ITS MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. OUR MISSION IS TO IMPROVE YOUR HEALTH AND WELL-BEING. PART V, LINE 1A THE PROMEDICA HEALTH SYSTEM PROCESSES ALL ACCOUNTS PAYABLE THROUGH ONE PAY COMPANY. ALL 1099 FORMS FOR PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES ARE FILED UNDER PROMEDICA HEALTH SYSTEM, INC. FEIN 34-1517671. FORM 990, PART VI, SECTION A, LINE 6 AS AN OHIO NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A PROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE PARENT CORPORATION AND SOLE MEMBER OF PROMEDICA INSURANCE CORPORATION, WHICH IS THE SOLE MEMBER OF PARAMOUNT ADVANTAGE. PHS HAS THE RIGHT TO (A) ELECT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF PARAMOUNT ADVANTAGE, AND (B) FILL ANY VACANCY OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B WHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER AND (VI) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN IS REVIEWED BY MANAGEMENT BEFORE BEING PROVIDED TO THE BOARD OF TRUSTEES PRIOR TO FILING. ANY COMMENTS OR QUESTIONS FROM THE BOARD ARE REVIEWED AND INCORPORATED INTO THE RETURN IF APPROPRIATE. FINAL RETURNS ARE PROVIDED TO A PRINCIPAL OFFICER FOR SIGNATURE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C PROMEDICA HEALTH SYSTEM, INC. AND AFFILIATES (PHS) HAVE STANDARDS OF CONDUCT THAT APPLY TO ALL PHS BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER SOC SURVEY WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER SOC SURVEYS ARE REVIEWED BY THE V.P., AUDIT & COMPLIANCE/CHIEF COMPLIANCE OFFICER (CCO). SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, GENERAL COUNSEL, BUSINESS UNIT PRESIDENTS AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (PRESIDENT/CEO), BASED UPON THEIR RESPECTIVE KNOWLEDGE OF THE BOARD MEMBERS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO ALLOW THEM TO IDENTIFY TO THE V.P., AUDIT & COMPLIANCE, ANY POTENTIAL UNDISCLOSED CONFLICTS. THE AUDIT & COMPLIANCE DEPARTMENT THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER SOC SURVEYS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. THE RESULTS OF THE AUDIT ARE REPORTED DIRECTLY TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE WITH A COPY TO THE PRESIDENT/CEO. THE REPORT INCLUDES A SUMMARY OF THE AUDIT PROCEDURES PERFORMED, ANY SIGNIFICANT CONCERNS IDENTIFIED, AND THEIR RESOLUTION. ANY UNRESOLVED CONFLICTS ARE ADDRESSED BY THE AUDIT COMMITTEE WITH RECOMMENDATIONS TO THE FULL BOARD AS NEEDED. FAILURE TO COMPLETE THE SURVEY OR THE SUBMISSION OF A FALSE OR INCOMPLETE SURVEY, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBER'S SURVEY RESULTS OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES, EXCLUDING EMPLOYED PROVIDERS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL BONUS-ELIGIBLE SENIOR LEADERSHIP AND SPECIFICALLY IDENTIFIED ADDITIONAL EMPLOYEES, ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC EMPLOYEE CERTIFICATION QUESTIONNAIRE BY AN ESTABLISHED DEADLINE THAT IS COMMUNICATED TO THE EMPLOYEE. THE HUMAN RESOURCES DEPARTMENT ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND PROVIDES NOTIFICATION TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL EMPLOYEE CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT. ALL NEW EMPLOYEES, EXCLUDING EMPLOYED PROVIDERS, ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYEE STANDARD OF CONDUCT AND THE EMPLOYEE CERTIFICATION STATEMENT WHICH THE NEW EMPLOYEE IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. THE AUDIT & COMPLIANCE DEPARTMENT HAS ACCESS TO A REPORT THAT IDENTIFIES ALL NEW HIRES. A SAMPLE OF EMPLOYEES IS IDENTIFIED AND AN AUDIT IS CONDUCTED TO ENSURE THAT REQUIRED DOCUMENTATION IS ON FILE. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE V.P., AUDIT & COMPLIANCE AND IF NECESSARY DISCUSSED WITH THE BUSINESS UNIT PRESIDENT IN WHICH THE EMPLOYEE WORKS, THE CHIEF HUMAN RESOURCE OFFICER, AND GENERAL COUNSEL. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL OF THE PHS PRESIDENT/CEO. RESULTS OF THE EMPLOYEE PROCESS AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. FAILURE TO COMPLETE THE CERTIFICATION QUESTIONNAIRE, OR THE COMPLETION OF A FALSE OR INCOMPLETE CERTIFICATION QUESTIONNAIRE, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE EMPLOYEE'S CERTIFICATION QUESTIONNAIRE OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. ADDITIONALLY, AS PART OF THE ANNUAL MANDATORY COMPLIANCE TRAINING ASSIGNED TO ALL PROMEDICA EMPLOYEES, EACH EMPLOYEE IS REQUIRED TO ELECTRONICALLY ACKNOWLEDGE THAT THEY HAVE RECEIVED A COPY OF THE PROMEDICA STANDARDS OF CONDUCT, THAT THEY UNDERSTAND HOW THE STANDARDS APPLY TO THEM, ACKNOWLEDGE THEIR OBLIGATION TO FOLLOW THEM, THEIR OBLIGATION TO REPORT VIOLATIONS OF THE STANDARDS OR REQUESTS THAT WOULD RESULT IN VIOLATIONS OF THE STANDARDS TO APPROPRIATE COMPANY OFFICERS AND THAT THEY HAVE REPORTED ALL VIOLATIONS KNOWN TO THEM AS REQUIRED BY THE STANDARDS. IN ADDITION THE ATTESTATION STATES ANY CONFLICTS OF INTEREST OR OTHER MATTERS FOR WHICH THE STANDARDS REQUIRE WRITTEN DISCLOSURE TO THE COMPANY HAVE BEEN SO DISCLOSED BY THE EMPLOYEE AND THEY UNDERSTAND AND ACKNOWLEDGE THAT TO THE EXTENT THEY ARE AN AT-WILL EMPLOYEE, THE STANDARDS DO NOT AFFECT THE AT-WILL NATURE OF MY EMPLOYMENT RELATIONSHIP WITH THE COMPANY. EMPLOYED PROVIDERS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL EMPLOYED PROVIDERS ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC PROVIDER CERTIFICATION QUESTIONNAIRE BY THE ESTABLISHED AND COMMUNICATED DEADLINE. THE OFFICE OF THE PRESIDENT/CHIEF MEDICAL OFFICER FOR PROMEDICA PHYSICIAN GROUP, INC. (PPG) ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND REVIEWED AND ENSURES NOTIFICATION IS PROVIDED TO THE OFFICE OF THE PROMEDICA HEALTH SYSTEM, INC. ("PHS") V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL PROVIDER CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND ALSO ENSURES COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE PHS AUDIT & COMPLIANCE DEPARTMENT ARE FORWARDED ACCORDINGLY. ALL NEW EMPLOYED PROVIDERS ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYED PROVIDER STANDARD OF CONDUCT AND THE PROVIDER CERTIFICATION STATEMENT WHICH THE NEW PROVIDER IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, OR DESIGNEE, AND IF APPROPRIATE, ARE SUBSEQUENTLY REPORTED TO THE OFFICE OF THE PHS V.P., AUDIT & COMPLIANCE. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL BY THE PHS PRESIDENT/CHIEF EXECUTIVE OFFICER. RESULTS OF THE EMPLOYED PROVIDER AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. ANY ITEMS THAT MEET CRITERIA FOR PUBLIC DISCLOSURE WILL BE COMMUNICATED TO THE IDENTIFIED PROVIDER BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, OR DESIGNEE, IN ADVANCE OF THE POSTING. THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, OR DESIGNEE, WILL PROVIDE THE PROVIDER-INDUSTRY RELATIONSHIP DISCLOSURES TO THE APPLICABLE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. THE PUBLIC DISCLOSURE WILL BE POSTED ON THE PHS WEBSITE (HTTPS://WWW.PROMEDICA.ORG/PAGES/ABOUT-US/INDUSTRY-RELATIONSHIPS.ASPX) DATABASE BY THE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. FORM 990, PART VI, SECTION B, LINE 15 PARAMOUNT ADVANTAGE'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF PROMEDICA FOUNDATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR. FORM 990, PART VI, SECTION C, LINE 19 PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST. PART VII, SECTION B PROMEDICA HEALTH SYSTEM PROCESSES ALL ACCOUNTS PAYABLE THROUGH ONE PAY COMPANY, PROMEDICA HEALTH SYSTEM, INC. THE INDEPENDENT CONTRACTORS OVER $100,000 WILL BE LISTED ON THE 990 FILED FOR PROMEDICA HEALTH SYSTEM, INC. FEIN 34-1517671. FORM 990, PART VII, SECTION A LOUIS ROBICHAUX IS EMPLOYED BY A MANAGEMENT AGENCY THAT IS UNDER A CONTRACT TO PROVIDE MANAGEMENT SERVICES TO PROMEDICA HEALTH SERVICES. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 29,349,133. MANAGEMENT AND GENERAL EXPENSES 22,966,946. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 52,316,079. FORM 990, PART XI, LINE 9: TRANSFER TO AFFILIATES -267,500,000. FORM 990, PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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