2024-11-12T09:57:02-06:00 2023-12-31 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2023-01-01 208734161 PROMEDICA CHILDREN'S SPECIALISTS PROM 4192525772 100 MADISON AVE ATTN TAX DEPARTM TOLEDO OH 43604 TERRENCE METZGER CFO 4192525772 2024-11-07 1 1 AMY CIMINELLO P00796388 3122071040 2024-11-07 2023 2024-10-15 13:58:12Z TERRENCE METZGER 100 MADISON AVE ATTN TAX DEPARTMENT TOLEDO OH 43604 8225593 0 X WWW.PROMEDICA.ORG X 2020 MI PROMEDICA CHILDREN'S SPECIALISTS IS PART OF THE PHYSICIAN SERVICES COMPONENT OF PROMEDICA HEALTH SYSTEM, INC.'S INTEGRATED DELIVERY SYSTEM AND PROVIDES SERVICES TO IMPROVE THE HEALTH CARE OF THE COMMUNITY IN AN EFFICIENT AND COST-EFFECTIVE MANNER. 27 19 0 19 0 0 0 580 6949510 8225013 0 0 0 0 6949510 8225593 0 0 0 0 13188135 13724540 0 0 0 2592871 4317842 15781006 18042382 -8831496 -9816789 812451 1259697 3724592 13988677 -2912141 -12728980 X AS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC., WE WILL BE THE PREMIER COMMUNITY-BASED MANAGEMENT SERVICES ORGANIZATION AND PROVIDER OF RELATED HEALTHCARE SERVICES FOR NORTHWEST OHIO/SOUTHEAST MICHIGAN, OFFERING QUALITY, COST-EFFECTIVE, EFFICIENT, AND VALUE-ADDED SERVICES TO ACHIEVE SUPERIOR PATIENT SATISFACTION AND A FINANCIALLY VIABLE NETWORK OF PHYSICIANS SUPPORTING THE MEDICAL NEEDS OF THE COMMUNITY. 0 0 18042382 0 8225013 SERVING INDIVIDUALS AND FAMILIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN, PROMEDICA CHILDREN'S SPECIALISTS, A SUBSIDIARY OF PROMEDICA PHYSICIAN GROUP (PPG), OFFERS A LARGE SELECTION OF PHYSICIANS AND ADVANCED PRACTICE PROVIDERS WHO PROVIDE MEDICAL CARE AND OTHER HEALTHCARE SERVICES VIA AN INTEGRATED APPROACH THROUGH WHICH THEY COLLABORATE WITH OTHER PROVIDERS. THIS INTEGRATED DELIVERY IS MORE COST-EFFECTIVE THAN TRADITIONAL DELIVERY SYSTEMS AND HELPS TO ENSURE PATIENTS HAVE BETTER ACCESS TO CARE IN THE MOST APPROPRIATE SETTING. PPG AND ITS SUBSIDIARIES ARE PART OF PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 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. PPG'S WELL-EQUIPPED PHYSICIAN FACILITIES ARE LOCATED IN APPROXIMATELY 200 LOCATIONS, AND ITS NETWORK IS COMPRISED OF MORE THAN 1,200 HEALTHCARE PROVIDERS CERTIFIED IN MORE THAN 50 SPECIALTIES, INCLUDING ANESTHESIOLOGY, BARIATRICS, CARDIOLOGY, CRITICAL CARE, ENT, FAMILY MEDICINE, GASTROENTEROLOGY, GENERAL SURGERY, HEMATOLOGY-ONCOLOGY, HOSPITALISTS, INTERNAL MEDICINE, NEUROLOGY AND NEUROSURGERY, OBSTETRICS/GYNECOLOGY, OCCUPATIONAL MEDICINE, OPHTHALMOLOGY, ORTHOPEDIC SURGERY, PEDIATRIC CARDIOLOGY, PEDIATRIC CRITICAL CARE MEDICINE, PEDIATRICS, PSYCHIATRY, SPORTS CARE, SURGICAL ONCOLOGY, UROLOGY, AND VASCULAR MEDICINE. PPG CONDUCTED APPROXIMATELY 2 MILLION PATIENT ENCOUNTERS IN 2023. ADDITIONALLY, PPG PRIMARY CARE PRACTICES NOW SCREEN FOR 5 DIFFERENT SOCIAL DETERMINANTS SCREENS FOR AREAS SUCH AS FOOD INSECURITY, FINANCIAL, TRANSPORTATION, AND UTILITIES. PATIENTS SCREENING POSITIVE ARE CONNECTED TO COMMUNITY RESOURCES TO IMPROVE HEALTH AND WELL-BEING. PROMEDICA CHILDREN'S SPECIALISTS ALSO PROVIDED A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO THE COMMUNITY DURING 2023, OF WHICH $75,531 REPRESENTED UNCOMPENSATED AMOUNTS FOR TREATMENT OF PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. FINANCIAL ASSISTANCE REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. ITS COST OF BAD DEBT FOR 2023 TOTALED $452,423.IN SUMMARY, PPG AND ITS SUBSIDIARIES DEMONSTRATE THEIR MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, PROMEDICA PROVIDES THESE HEALTHCARE SERVICES; RECRUITS AND TRAINS HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDES APPROPRIATE FINANCIAL ASSISTANCE; OFFERS SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENTS FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE. 18042382 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 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 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 27 19 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 0 X TERRENCE METZGER 4192525772 100 MADISON AVE TOLEDO OH 43604 X ARTURO POLIZZI TRUSTEE/CEO 1.00 54.00 X X 0 2121593 5857 LOUIS ROBICHAUX TREASURER - PART YEAR 1.00 54.00 X X 0 0 0 TERRENCE METZGER TRUSTEE/TREASURER 1.00 54.00 X X 0 1055090 4079 STEVE SADOWSKI TRUSTEE/SECRETARY 1.00 54.00 X X 0 1407180 6028 LISA HAWKER TRUSTEE 1.00 14.00 X 0 40000 0 BILL MCDONNELL TRUSTEE 1.00 15.00 X 0 0 0 NANCY KABAT TRUSTEE 1.00 15.00 X 0 0 0 MARCY BROWN TRUSTEE 1.00 14.00 X 0 0 0 LISA MILLER TRUSTEE/DIRECTOR 1.00 14.00 X 0 90513 4657 KATHLEEN MERRILL TRUSTEE 1.00 14.00 X 0 0 0 LAURA KLINE TRUSTEE 1.00 14.00 X 0 0 0 AMANDA KISSNER TRUSTEE 1.00 14.00 X 0 0 0 LINDA THIEL TRUSTEE 1.00 14.00 X 0 0 0 BARRY LUSE TRUSTEE 1.00 14.00 X 0 0 0 SUE VANISACKER TRUSTEE 1.00 14.00 X 0 0 0 KRISTINE BRENNER TRUSTEE 1.00 14.00 X 0 0 0 JIM BRENNAN TRUSTEE 1.00 15.00 X 0 0 0 VICTOR CHERFAN TRUSTEE/PHYSICIAN 1.00 44.00 X 0 659149 0 DONALD CRESCENZO TRUSTEE/PHYSICIAN 1.00 44.00 X 0 918456 0 TIM BUBLICK TRUSTEE 1.00 13.00 X 0 0 0 EVON EBEID TRUSTEE 1.00 13.00 X 0 0 0 ALEX GERKEN TRUSTEE 1.00 13.00 X 0 0 0 KEVIN PIROZEK TRUSTEE 1.00 13.00 X 0 0 0 DAVE SNAVELY TRUSTEE 1.00 13.00 X 0 0 0 DAWN BUSKEY TRUSTEE/PRESIDENT 1.00 54.00 X 0 1412400 5337 KENT BISHOP TRUSTEE/PRESIDENT 1.00 54.00 X 0 1437763 4120 ROBERT LACLAIR TRUSTEE 1.00 23.00 X 0 30000 0 SANJOY BANERJEE PHYSICIAN 45.00 0.00 X 629847 0 6972 AARON BUERK PHYSICIAN 43.00 2.00 X 834658 0 6895 ADRIAN LEWIS PHYSICIAN 45.00 0.00 X 769457 0 6128 ALICE BONNELL PHYSICIAN 45.00 0.00 X 635000 0 7267 SUSAN TOURNER PHYSICIAN 45.00 0.00 X 552088 0 1811 STEVEN M CAVANAUGH TREASURER, CFO - FORMER 0.00 0.00 X 0 1335180 5657 JEFFREY C KUHN SECRETARY, CHIEF LEGAL OFFICER - FORMER 0.00 0.00 X 0 748426 30922 GARY AKENBERGER SR VP FINANCE - FORMER 0.00 0.00 X 0 528647 43532 3421050 11784397 139262 35 1 1 0 0 580 580 NET PATIENT SERVICES 621110 8120653 8120653 PHYSICIANS SERVICES 621110 104360 104360 8225013 8225593 8225013 0 0 12112156 12112156 277082 277082 764483 764483 570819 570819 1689792 1689792 95 95 80711 80711 507 507 4088 4088 9141 9141 2060 2060 381790 381790 INTERCOMPANY SERVICES 1627969 1627969 PROVISION FOR BAD DEBTS 452423 452423 MEDICAL SUPPLIES 56251 56251 MINOR EQUIPMENT 6756 6756 6259 6259 18042382 18042382 0 0 50 0 752616 1123361 50000 128611 393813 386088 9785 7725 812451 1259697 691756 1134243 3032836 12854434 3724592 13988677 X -2912141 -12728980 -2912141 -12728980 812451 1259697 X -9816789 -50 X X 0 1 X 1 1 1 X 580 580 2420771 6433232 6949510 8225013 24028526 2420771 6433232 6949510 8225593 24029106 0 0 0 24029106 20833 20833 2420771 6454065 6949510 8225593 24049939 0.99910 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2021 AMOUNT: $ 20,833. PART III, SHORT YEAR EXPLANATION: PROMEDICA CHILDREN'S SPECIALISTS CONVERTED TO A NON-PROFIT CORPORATION ON JULY 14, 2020. AS A RESULT, TAX YEAR 2020 WAS A SHORT YEAR COVERING THE PERIOD FROM JULY 14, 2020 THROUGH DECEMBER 31, 2020. 393813 386088 7725 7725 DUE TO AFFILIATES 12854434 12854434 1 1 0 0 0 0 0 0 0 ARTURO POLIZZI TRUSTEE/CEO 0 1315647 0 789979 0 15967 0 0 0 5857 0 2127450 0 0 KENT BISHOP TRUSTEE/PRESIDENT 0 679900 0 752663 0 5200 0 0 0 4120 0 1441883 0 0 DAWN BUSKEY TRUSTEE/PRESIDENT 0 658750 0 751150 0 2500 0 0 0 5337 0 1417737 0 0 STEVE SADOWSKI TRUSTEE/SECRETARY 0 625095 0 774925 0 7160 0 0 0 6028 0 1413208 0 0 STEVEN M CAVANAUGH TREASURER, CFO - FORMER 0 0 0 0 0 1335180 0 0 0 5657 0 1340837 0 0 TERRENCE METZGER TRUSTEE/TREASURER 0 480090 0 575000 0 0 0 0 0 4079 0 1059169 0 0 DONALD CRESCENZO TRUSTEE/PHYSICIAN 0 887550 0 25800 0 5106 0 9766 0 0 0 928222 0 0 AARON BUERK PHYSICIAN 812858 0 21500 0 300 0 0 0 6895 0 841553 0 0 0 JEFFREY C KUHN SECRETARY, CHIEF LEGAL OFFICER - FOR 0 26526 0 0 0 721900 0 26526 0 4396 0 779348 0 0 ADRIAN LEWIS PHYSICIAN 753950 0 15058 0 449 0 0 0 6128 0 775585 0 0 0 VICTOR CHERFAN TRUSTEE/PHYSICIAN 0 383348 0 274961 0 840 0 5857 0 3307 0 668313 0 0 ALICE BONNELL PHYSICIAN 635000 0 0 0 0 0 0 0 7267 0 642267 0 0 0 SANJOY BANERJEE PHYSICIAN 488092 0 141037 0 718 0 0 0 6972 0 636819 0 0 0 GARY AKENBERGER SR VP FINANCE - FORMER 0 246095 0 83570 0 198982 0 36639 0 6893 0 572179 0 0 SUSAN TOURNER PHYSICIAN 543000 0 9000 0 88 0 0 0 1811 0 553899 0 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. NO SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO ANY LISTED PERSONS IN PART VII. STEVEN CAVANAUGH RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION, PROMEDICA HEALTH SYSTEM, IN THE AMOUNT OF $1,335,180 DURING 2023. JEFFERY KUHN RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION, PROMEDICA HEALTH SYSTEM, IN THE AMOUNT OF $721,900 DURING 2023. MATTHEW KANG RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION, PROMEDICA HEALTH SYSTEM, IN THE AMOUNT OF $583,664 DURING 2023. GARY AKENBERGER RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION, THE TOLEDO HOSPITAL, IN THE AMOUNT OF $195,150 DURING 2023. FORM 990, PART III, LINE 4: PROMEDICA CHILDREN'S SPECIALISTS PROGRAM SERVICE ACCOMPLISHMENTS SERVING INDIVIDUALS AND FAMILIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN, PROMEDICA CHILDREN'S SPECIALISTS, A SUBSIDIARY OF PROMEDICA PHYSICIAN GROUP (PPG), OFFERS A LARGE SELECTION OF PHYSICIANS AND ADVANCED PRACTICE PROVIDERS WHO PROVIDE MEDICAL CARE AND OTHER HEALTHCARE SERVICES VIA AN INTEGRATED APPROACH THROUGH WHICH THEY COLLABORATE WITH OTHER PROVIDERS. THIS INTEGRATED DELIVERY IS MORE COST-EFFECTIVE THAN TRADITIONAL DELIVERY SYSTEMS AND HELPS TO ENSURE PATIENTS HAVE BETTER ACCESS TO CARE IN THE MOST APPROPRIATE SETTING. PPG AND ITS SUBSIDIARIES ARE PART OF PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 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. PPG'S WELL-EQUIPPED PHYSICIAN FACILITIES ARE LOCATED IN APPROXIMATELY 200 OFFICES, AND ITS NETWORK IS COMPRISED OF MORE THAN 1,200 HEALTHCARE PROVIDERS CERTIFIED IN MORE THAN 50 SPECIALTIES, INCLUDING ANESTHESIOLOGY, BARIATRICS, CARDIOLOGY, CRITICAL CARE, ENT, FAMILY MEDICINE, GASTROENTEROLOGY, GENERAL SURGERY, HEMATOLOGY-ONCOLOGY, HOSPITALISTS, INTERNAL MEDICINE, NEUROLOGY AND NEUROSURGERY, OBSTETRICS/GYNECOLOGY, OCCUPATIONAL MEDICINE, OPHTHALMOLOGY, ORTHOPAEDIC SURGERY, PEDIATRIC CARDIOLOGY, PEDIATRIC CRITICAL CARE MEDICINE, PEDIATRICS, PSYCHIATRY, SPORTS CARE, SURGICAL ONCOLOGY, UROLOGY, AND VASCULAR MEDICINE. PPG CONDUCTED APPROXIMATELY XXX MILLION PATIENT ENCOUNTERS IN 2023. ADDITIONALLY, PPG PRIMARY CARE PRACTICES NOW SCREEN FOR 10 DIFFERENT SOCIAL DETERMINANTS SCREENS FOR AREAS SUCH AS FOOD INSECURITY, FINANCIAL WELLNESS, DOMESTIC VIOLENCE, HOUSING, AND MORE. PATIENTS SCREENING POSITIVE IN THREE OR MORE DOMAINS ARE CONNECTED TO COMMUNITY RESOURCES TO IMPROVE HEALTH AND WELL-BEING. PROMEDICA CHILDREN'S SPECIALISTS PROVIDED A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO THE COMMUNITY DURING 2023, OF WHICH $75,531 REPRESENTED UNCOMPENSATED AMOUNTS FOR TREATMENT OF PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. FINANCIAL ASSISTANCE REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. ITS COST OF BAD DEBT FOR 2023 TOTALED $452,423. FURTHER, PROMEDICA CHILDREN'S SPECIALISTS PROVIDED $XXX OF COMMUNITY BENEFIT THROUGH COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID PATIENTS. ALSO IN 2023, THE TOTAL COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS WAS $XXX. IN SUMMARY, PPG AND ITS SUBSIDIARIES DEMONSTRATE THEIR MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, PROMEDICA PROVIDES THESE HEALTHCARE SERVICES; RECRUITS AND TRAINS HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDES APPROPRIATE FINANCIAL ASSISTANCE; OFFERS SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENTS FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE. 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 A MICHIGAN NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A PROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE SOLE MEMBER OF PROMEDICA PHYSICIAN GROUP, INC. WHICH IS THE SOLE MEMBER OF PROMEDICA CHILDREN'S SPECIALIST. PHS HAS THE RIGHT TO (A) ELECT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF PROMEDICA CHILDREN'S SPECIALIST, AND (B) FILL ANY VACANCY. 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 PROMEDICA CHILDREN'S SPECIALISTS' TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF PROMEDICA CHILDREN'S SPECIALISTS' 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 XI, LINE 9: TRANSFERS BETWEEN AFFILIATES -50. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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