2025-11-05T11:02:12-06:00 2024-12-31 990 2024-01-01 311075381 FIDELITY HEALTH CARE FIDE 9374999942 110 N MAIN ST 200 DAYTON OH 45402 J MICHAEL SIMS SYSTEM VP & CORP. CONTROLLER 9374999942 2025-11-05 0 2024 2025-03-06 01:10:19Z J NICK LAIR 3170 KETTERING BLVD MORAINE OH 45439 71674700 0 X WWW.PREMIERHEALTH.COM X 1983 OH SEE PART III, LINE 1 4 1 1069 0 148824 0 36431 53592 51780745 52606452 78752 28187 2866055 2058726 54761983 54746957 0 0 0 0 41946091 41861217 0 0 0 11809658 12168729 53755749 54029946 1006234 717011 33455769 24153609 2913634 2226390 30542135 21927219 X WE CARE. WE TEACH. WE INNOVATE. WE SERVE. 0 0 34212082 0 41647373 FIDELITY HEALTH CARE PERFORMED 262,512 VISITS. FIDELITY HEALTH CARE SERVED 654 INFUSION PATIENTS, 1,750 OXYGEN PATIENTS, AND PROVIDED $51,178 IN CHARITY CARE. 3798541 0 5026428 FIDELITY HEALTH CARE PROVIDED DURABLE MEDICAL EQUIPMENT (DME) TO THOSE SHOWING A PRESCRIPTION FROM A PHYSICIAN. DME INCLUDES THE SALE OF HOSPITAL BEDS, CANES, CRUTCHES, CPAP MACHINES (RESPIRATORY THERAPY), HEARING AIDS, OXYGEN, ECT. 3733381 0 3379880 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. 4784852 0 4485398 FIDELITY HEALTH CARE (FHC) OPERATED A RETAIL PHARMACY IN FIVE LOCATIONS WITHIN PREMIER HEALTH AFFILIATED HOSPITALS AND HEALTH CENTERS. THE PHARMACIES PRIMARILY SERVE PATIENTS RECEIVING HEALTH CARE SERVICES AT THESE LOCATIONS.THE COMMUNITY WELLNESS PROGRAM OFFERS COMPREHENSIVE NURSING SERVICES TO SCHOOLS BY OFFERING A FULL-TIME CLINIC WITH 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 HOUSE BILL THAT MANDATES ALL HIGH SCHOOL STUDENTS NEED TO BE TRAINED ON CPR.FHC SERVES EMPLOYER GROUPS SUCH AS SCHOOL DISTRICTS, MUNICIPALITIES, MANUFACTURING FACILITIES AND MORE. FHC 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. IN 2024, FHC STAFF IMPACTED 14,506 EMPLOYEES AND SPOUSES. TOTAL SCREENING NUMBERS INCLUDED 2,294 CHOLESTEROL/BLOOD PRESSURE SCREENINGS, 304 BLOOD PRESSURE ONLY SCREENINGS,1,053 LIPID SCREENINGS, 2,428 BLOOD GLUCOSE SCREENINGS, 3,124 A1C SCREENINGS, 222 COTININE SCREENINGS, 3,362 BODY COMPOSITION MEASUREMENTS, 480 WAIST CIRCUMFERENCE MEASURES, 53 HEARING SCREENINGS, 645 VISION SCREENINGS, 84 PSA SCREENINGS, AND 9,190 FLU SHOTS. THE FOLLOWING PARTICIPANTS WERE POSITIVELY IMPACTED THROUGH HEALTH EDUCATION INITIATIVES AND PROGRAMMING: 438 HEALTH RISK ASSESSMENTS WERE COMPLETED, 716 COACHING SESSIONS WERE LOGGED, 1,116 ATTENDED A WORKSHOP (VIRTUAL AND IN-PERSON), 184 PARTICIPATED IN A CHALLENGE AND 6 PARTICIPATED IN A LIFESTYLE MANAGEMENT PROGRAM. FHC ATTENDED MANY HEALTH FAIR EVENTS IN 2024 AND ENGAGED A TOTAL OF 765 IN HEALTH EDUCATION THROUGH LOOK-N-LEARN BOOTHS.MINI HEALTH CLINICS LOCATED AT THE UNIVERSITY OF DAYTON, WILBERFORCE COLLEGE, AND MASONIC HOME. PROVIDING STUDENTS AT THE COLLEGES AND RESIDENTS OF THE MASONIC HOME WITH CONVENIENT ACCESS TO CARE. EXPRESSIONS OF HOPE (EOH) IS A SERVICE FOR WOMEN OFFERED BY FIDELITY HEALTH CARE. EOH SERVICES ARE DESIGNED TO OFFER WOMEN A WIDE RANGE OF POST MASTECTOMY AND LUMPECTOMY PRODUCTS.FHC PROVIDES CPR TRAINING TO INTERNAL AND EXTERNAL CUSTOMERS. 4784852 0 4485398 46528856 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 0 0 1069 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 4 1 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X RENEE MOCK 9374999942 3170 KETTERING BLVD MORAINE OH 45439 J NICK LAIR PRESIDENT & CEO 28.00 12.00 X X 0 534087 57751 RENEE L MOCK BOARD TREASURER 0.50 39.50 X X 0 436511 40371 JOSEPH P ALLEN MD BOARD VICE-CHAIR 0.50 39.50 X X 0 444424 28000 THOMAS GREER MD BOARD CHAIR 0.50 0.50 X 0 0 0 ELIZABETH D WILFONG BOARD SECRETARY (TO OCT) 0.50 39.50 X 0 187502 1609 EMMA M WALTON BOARD SECRETARY (FROM OCT) 0.50 39.50 X 0 155205 835 DARIN S TAYLOR SR DIRECTOR CLINICAL SERVICES & ASSOCIATE CNO 40.00 0.00 X 280129 0 47818 ERIC D NAPIER DIRECTOR RETAIL PHARMACY 40.00 0.00 X 251919 0 11454 SANDRA R HAIG SR DIRECTOR OPERATIONS 40.00 0.00 X 230822 0 19556 JERRY J TASSET PHYSICIAN 40.00 0.00 X 217433 0 6420 ADENIYI P ADENOTE PHYSICAL THERAPIST 40.00 0.00 X 209503 0 4729 PAULA J THOMPSON FORMER OFFICER 0.00 0.00 X 251885 0 25253 1441691 1757729 243796 91 1 1 0 0 905 32489 20198 33300 53592 HOME HEALTHCARE 621610 41647373 41647373 DME 900099 5026428 4877604 148824 OCCUPATIONAL HEALTH 624100 3379880 3379880 COMMUNITY WELLNESS 624100 988181 988181 WORKPLACE WELLNESS 624100 626427 626427 938163 938163 52606452 173 173 470329 346427 123902 123902 123902 29649 1635 28014 28014 28014 18512308 16579681 1932627 1932627 MEDICAL RECORDS 900099 2197 2197 2197 54746957 54390255 148824 154286 35491899 30413068 5078831 488360 418477 69883 2953337 2530719 422618 2927621 2523959 403662 763 763 1828141 1263930 564211 114101 114101 711779 561625 150154 1015051 781689 233362 662705 456344 206361 1000501 983970 16531 2692 2438 254 579761 525032 54729 171148 13035 158113 OPERATING SUPPLIES 5515391 5515391 REPAIRS AND MAINTENANCE 167226 134519 32707 FLEET EXPENSE 148758 121739 27019 TRAINING AND EDUCATION 129178 115759 13419 121534 53061 68473 54029946 46528856 7501090 0 2764 2704 15185348 7229410 8649075 7861473 1315791 1487391 29450 46396 10789019 7384189 3741982 3404830 4531359 4121405 33455769 24153609 2428347 1984091 485287 242299 2913634 2226390 X 30542135 21927219 30542135 21927219 33455769 24153609 X 717011 -9331927 X 0 1 X 1 0 X 1269258 397860 51282 36432 57751 1812583 59693152 65289240 62365088 67944693 70972133 326264306 60962410 65687100 62416370 67981125 71029884 328076889 0 0 0 328076889 426415 432626 388456 453921 470502 2171920 426415 432626 388456 453921 470502 2171920 9782 446 10228 61388825 66129508 62804826 68435492 71500386 330259037 0.99340 0.99330 0.00660 0.00670 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 763 0 0 0 763 0 PART II-B, LINE 1, LOBBYING ACTIVITIES: PAYMENTS FOR LOBBYING ACTIVITIES INCLUDE A PORTION OF DUES PAID TO THE OHIO COUNCIL FOR HOME CARE & HOSPICE. 215926 215926 3430219 1401501 2028718 18104 18104 0 7089850 5964584 1125266 34920 34920 3404830 AFFILIATES RECEIVABLE 4121405 4121405 X PART X, LINE 2: THE FOLLOWING FOOTNOTE IS FROM THE 2024 CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR PREMIER HEALTH (PHP) AND AFFILIATES. PHP IS THE SOLE MEMBER OF FIDELITY HEALTH CARE, INC. 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 HOLDING COMPANY (PHHC) (WHOLLY OWNED SUBSIDIARY OF PHP) * MVHE, INC., (AND ITS WHOLLY OWNED SUBSIDARY EXTENDED CARE), SAMARITAN FAMILY CARE, INC., PREMIER HEALTH SPECIALISTS, INC. AND PREMIER HEALTH URGENT CARE, INC. (WHOLLY OWNED SUBSIDIARIES OF PHHC) MANAGEMENT ANNUALLY REVIEWS THE TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS. 1 1 0 0 0 0 0 0 0 J NICK LAIR PRESIDENT & CEO 0 338211 0 155353 0 40523 0 22303 0 35448 0 591838 0 0 RENEE L MOCK BOARD TREASURER 0 309405 0 125470 0 1636 0 16503 0 23868 0 476882 0 0 JOSEPH P ALLEN MD BOARD VICE-CHAIR 0 339428 0 103965 0 1031 0 11443 0 16557 0 472424 0 0 DARIN S TAYLOR SR DIRECTOR CLINICAL SERVICES & ASSO 202145 0 77835 0 149 0 6636 0 41182 0 327947 0 0 0 PAULA J THOMPSON FORMER OFFICER 0 0 0 0 251885 0 79 0 25174 0 277138 0 0 0 ERIC D NAPIER DIRECTOR RETAIL PHARMACY 192457 0 56291 0 3171 0 0 0 11454 0 263373 0 0 0 SANDRA R HAIG SR DIRECTOR OPERATIONS 178567 0 50902 0 1353 0 10357 0 9199 0 250378 0 0 0 JERRY J TASSET PHYSICIAN 214704 0 0 0 2729 0 5911 0 509 0 223853 0 0 0 ADENIYI P ADENOTE PHYSICAL THERAPIST 197995 0 11508 0 0 0 4292 0 437 0 214232 0 0 0 ELIZABETH D WILFONG BOARD SECRETARY (TO OCT) 0 174677 0 12500 0 325 0 707 0 902 0 189111 0 0 EMMA M WALTON BOARD SECRETARY (FROM OCT) 0 145135 0 10000 0 70 0 241 0 594 0 156040 0 0 PART I, LINE 3: COMPENSATION FOR FIDELITY HEALTH CARE'S (FHC) CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH FHC IS AN AFFILIATE. SEE EXPLANATION ON SCHEDULE O FOR FORM 990, PART VI. PART I, LINE 4A: THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE: PAULA THOMPSON $252,152. 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, FIDELITY HEALTH CARE (FHC) AND ITS AFFILIATED ORGANIZATIONS COMPENSATE FOR THIS LIMITATION AND SUPPLEMENT THE AFFECTED EXECUTIVES' QUALIFIED PENSION THROUGH CERTAIN NONQUALIFIED PLANS. FHC 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 2024. THE INDIVIDUALS LISTED BELOW HAS MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE PENSION RESTORATION PLAN RECEIVED THE ASSOCIATED PAYMENT IN 2024: J. NICK LAIR $13,917. THE INDIVIDUAL LISTED BELOW HAS MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE SERP AND RECEIVED THE ASSOCIATED PLAN PAYMENT 2024: PAULA THOMPSON $5,243. IN ADDITION, THE FOLLOWING SERP AMOUNTS WERE DEFERRED ON THE PARTICIPANTS' BEHALF DURING THE YEAR AND WILL BE HELD UNTIL THE INCREMENTAL AMOUNTS ARE VESTED: RENEE MOCK $1,605. 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 AMOUNTS ARE PROPERLY REPORTED AS COMPENSATION FOR FORM 990 PURPOSES NOT TREATED AS DEFERRED COMPENSATION FOR PURPOSES OF SCHEDULE J. SUCH WHEN INCLUDED IN THE PARTICIPANTS' FORM W-2 WAGES. X POPCORN 4 33300 FMV 0 0 1 0 FORM 990, PART VI, SECTION A, LINE 3 PREMIER HEALTH (PREMIER), AS THE OPERATOR OF FIDELITY HEALTH CARE (FHC) DEVELOPS AND OVERSEES THE IMPLEMENTATION OF THE STRATEGIC PLAN FOR FHC, WHICH INCLUDES (BUT IS NOT LIMITED TO) SUCH MATTERS AS LOCATION OF CLINICAL AND ADMINISTRATIVE EXPENSES AND THE CONSOLIDATION OF SUCH SERVICES. FHC SHALL COMPLY WITH AND IMPLEMENT THIS PLAN AND SHALL NOT TAKE ANY ACTION THAT MATERIALLY DEPARTS FROM THIS PLAN WITHOUT PREMIER'S APPROVAL. FHC SHALL IMPLEMENT ANY CAPITAL AND OPERATING BUDGET SO APPROVED AND/OR REVISED FOR IT BY PREMIER. FHC SHALL IMPLEMENT THE BUSINESS PLAN APPROVED BY PREMIER. PREMIER IS THE SOLE AGENT TO NEGOTIATE ALL RELATIONSHIPS WITH PAYORS ON BEHALF OF FHC WITH ALL THIRD-PARTY PAYORS AND ALTERNATIVE DELIVERY SYSTEMS INCLUDING, BUT NOT LIMITED TO INSURERS. FHC 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. FHC MUST SEEK PREMIER'S APPROVAL FOR ANY ACQUISITIONS, SALE OR TRANSFER OF ANY MATERIAL ASSET USED IN FHC'S ACTIVITIES. FORM 990, PART VI, SECTION A, LINE 6 FIDELITY HEALTH CARE HAS ONE CORPORATE MEMBER; PREMIER, AN OHIO NON-PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A PREMIER HAS THE SOLE AUTHORITY TO ELECT THE BOARD OF TRUSTEES FOR FHC. PREMIER HAS THE AUTHORITY TO REMOVE SUCH TRUSTEES AT ANY REGULAR OR SPECIAL MEETING OR BY WRITTEN CONSENT. FORM 990, PART VI, SECTION A, LINE 7B SEE EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A. 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 FIDELITY HEALTH CARE 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, WITH WHICH FHC IS AN AFFILIATE, 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 FIDELITY HEALTH CARE'S (FHC) CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH FHC 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 XI, LINE 9: AFFILIATES TRANSFER -9,331,927. FIDELITY NURSING SYSTEMS LLC 3832 KETTERING BLVD MORAINE OH 45439 311075381 PRIVATE PAY OH 9201204 2598578 FIDELITY HEALTH CARE PREMIER HEALTH 110 N MAIN STREET 200 DAYTON OH 45402 311446699 PARENT OH 501 (C) (3) 12B N/A 0 MEDAMERICA HEALTH SYSTEMS CO 110 N MAIN STREET 200 DAYTON OH 45402 311040228 SUPPORT ORG OH 501 (C) (3) 12B N/A 0 MIAMI VALLEY HOSPITAL 110 N MAIN STREET 200 DAYTON OH 45402 310537504 HOSPITAL OH 501 (C) (3) 3 PREMIER HEALTH 0 MIAMI VALLEY HOSPITAL FOUNDATION 110 N MAIN STREET 200 DAYTON OH 45402 311040231 FOUNDATION OH 501 (C) (3) 7 PREMIER HEALTH 0 PREMIER COMMUNITY HEALTH 110 N MAIN STREET 200 DAYTON OH 45402 311122883 HEALTH EDUCATION OH 501 (C) (3) 10 FIDELITY HEALTH CARE 0 GOOD SAMARITAN FOUNDATION - DAYTON 110 N MAIN STREET 200 DAYTON OH 45402 237296923 FOUNDATION OH 501 (C) (3) 7 PREMIER HEALTH 0 ATRIUM HEALTH SYSTEM 110 N MAIN STREET 200 DAYTON OH 45402 310537492 SUPPORT ORG OH 501 (C) (3) 12B N/A 0 ATRIUM MEDICAL CENTER 110 N MAIN STREET 200 DAYTON OH 45402 311079309 HOSPITAL OH 501 (C) (3) 3 PREMIER HEALTH 0 UVMC 110 N MAIN STREET 200 DAYTON OH 45402 341850683 SUPPORT ORG OH 501 (C) (3) 12B N/A 0 UPPER VALLEY MEDICAL CENTER 110 N MAIN STREET 200 DAYTON OH 45402 310537095 HOSPITAL OH 501 (C) (3) 3 PREMIER HEALTH 0 UPPER VALLEY PROFESSIONAL CORP 110 N MAIN STREET 200 DAYTON OH 45402 311400963 HEALTH CARE OH 501 (C) (3) 10 PREMIER HEALTH HOLDING CO 0 UVPC SPECIALISTS 110 N MAIN STREET 200 DAYTON OH 45402 203687536 HEALTH CARE OH 501 (C) (3) 10 PREMIER HEALTH HOLDING CO 0 UVMC NURSING CARE INC 110 N MAIN STREET 200 DAYTON OH 45402 311224064 NURSING HOME OH 501 (C) (3) 10 PREMIER HEALTH 0 COMPUNET CLINICAL LABORATORIES LLC 110 N MAIN STREET 200 DAYTON OH 45402 311258010 LAB OH 501 (C) (3) 12B PREMIER HEALTH 0 SAMARITAN BEHAVIORAL HEALTH INC 110 N MAIN STREET 200 DAYTON OH 45402 020633634 BEHAVIORAL HEALTH OH 501 (C) (3) 7 PREMIER HEALTH 0 SWEITZER STREET LLC 110 N MAIN STREET 200 DAYTON OH 45402 454700417 REAL ESTATE OH MVHE INC EXCLUDED 0 0 SWEITZER MOB LLC 110 N MAIN STREET 200 DAYTON OH 45402 474554657 REAL ESTATE OH MVHE INC EXCLUDED 0 0 MVHE INC 110 N MAIN STREET 200 DAYTON OH 45402 311185270 PHYSICIAN SVCS OH PREMIER HEALTH HOLDING CO C 0 PREMIER HEALTH SPECIALISTS 110 N MAIN STREET 200 DAYTON OH 45402 061744704 PHYSICIAN SVCS OH PREMIER HEALTH HOLDING CO C 0 SAMARITAN FAMILY CARE 110 N MAIN STREET 200 DAYTON OH 45402 311299450 PHYSICIAN SVCS OH PREMIER HEALTH HOLDING CO C 0 AFTER HOURS FAMILY CARE 110 N MAIN STREET 200 DAYTON OH 45402 311269483 HEALTH CARE OH UPPER VALLEY PROFESSIONAL CORP C 0 UVMC MANAGEMENT CORP 110 N MAIN STREET 200 DAYTON OH 45402 311360489 MANAGEMENT COMPANY OH PREMIER HEALTH C 0 PREMIER HEALTH URGENT CARE INC 110 N MAIN STREET 200 DAYTON OH 45402 822079409 URGENT CARE OH PREMIER HEALTH HOLDING CO C 0 PREMIER HEALTH PLAN INC 110 N MAIN STREET 200 DAYTON OH 45402 463024049 HEALTH INSURANCE OH PREMIER HEALTH INSURING CO C 0 GOOD SAMARITAN HOSPITAL 110 N MAIN STREET 200 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 N MAIN STREET 200 DAYTON OH 45402 474049773 MEDICARE ACO OH PREMIER HEALTH C 0 PREMIER HEALTH HOLDING CO 110 N MAIN STREET 200 DAYTON OH 45402 812419110 HOLDING CO OH PREMIER HEALTH C 0 PREMIER HEALTH INSURING CO 110 N MAIN STREET 200 DAYTON OH 45402 464766841 HEALTH INSURANCE OH PREMIER HEALTH C 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 1 1 1 1 1 PREMIER COMMUNITY HEALTH O 640058 FMV