﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2024v5.2">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-11-05T15:07:31-06:00</ReturnTs>
    <TaxPeriodEndDt>2024-12-31</TaxPeriodEndDt>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2024-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>311079309</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>ATRIUM MEDICAL CENTER</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>ATRI</BusinessNameControlTxt>
      <PhoneNum>9374999942</PhoneNum>
      <USAddress>
        <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
        <CityNm>DAYTON</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>45402</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>J MICHAEL SIMS</PersonNm>
      <PersonTitleTxt>SYSTEM VP &amp; CORP. CONTROLLER</PersonTitleTxt>
      <PhoneNum>9374999942</PhoneNum>
      <SignatureDt>2025-11-05</SignatureDt>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>0</IRSResponsiblePrtyInfoCurrInd>
    <TaxYr>2024</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="13">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>KEVIN W HARLAN</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>1 MEDICAL CENTER DR</AddressLine1Txt>
        <CityNm>MIDDLETOWN</CityNm>
        <StateAbbreviationCd>OH</StateAbbreviationCd>
        <ZIPCd>45005</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>348280648</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.PREMIERHEALTH.COM</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1983</FormationYr>
      <LegalDomicileStateCd>OH</LegalDomicileStateCd>
      <ActivityOrMissionDesc>SEE PART III, LINE 1</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>10</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>2</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>1889</TotalEmployeeCnt>
      <TotalVolunteersCnt>179</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>498117</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>1015407</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>246733205</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>268370387</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>6348151</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>5769606</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>8419707</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>5193180</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>261999180</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>280348580</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>470602</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>258037</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>88376847</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>107556604</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>138993731</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>139054413</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>227841180</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>246869054</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>34158000</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>33479526</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>282456426</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>275128015</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>298119445</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>306603859</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>-15663019</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>-31475844</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>WE CARE. WE TEACH. WE INNOVATE. WE SERVE.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>239523847</ExpenseAmt>
      <GrantAmt>258037</GrantAmt>
      <RevenueAmt>268370387</RevenueAmt>
      <Desc>THE PRIMARY EXEMPT PURPOSE OF ATRIUM MEDICAL CENTER IS TO PROVIDE COMPREHENSIVE INPATIENT, OUTPATIENT, AND EMERGENCY HEALTH CARE SERVICES TO THE RESIDENTS OF BUTLER AND WARREN COUNTIES. THE HOSPITAL FURTHERS ITS TAX-EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY IN MANY WAYS. SEE SCHEDULE H FOR MORE INFORMATION.</Desc>
      <TotalProgramServiceExpensesAmt>239523847</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc1039700001">0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd referenceDocumentId="RetDoc1039700001">1</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc1039700001">0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">1</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd referenceDocumentId="RetDoc1040500001">1</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd referenceDocumentId="RetDoc1040500001">0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd referenceDocumentId="RetDoc1040500001">0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd referenceDocumentId="RetDoc1041500001">1</OperateHospitalInd>
      <AuditedFinancialStmtAttInd referenceDocumentId="RetDoc2317200001">1</AuditedFinancialStmtAttInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc1041900001">1</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc1041900001">0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd referenceDocumentId="RetDoc1053100001">1</TaxExemptBondsInd>
      <InvestTaxExemptBondsInd>0</InvestTaxExemptBondsInd>
      <EscrowAccountInd>0</EscrowAccountInd>
      <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd referenceDocumentId="RetDoc1042900001">1</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd referenceDocumentId="RetDoc1042900001">0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>0</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>1889</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>10</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>2</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>1</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>1</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>1</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>1</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>1</InvestmentInJointVentureInd>
      <WrittenPolicyOrProcedureInd>1</WrittenPolicyOrProcedureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>J MICHAEL SIMS</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>9374999942</PhoneNum>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL C RIORDAN</PersonNm>
        <TitleTxt>TRUSTEE / PREMIER CEO</TitleTxt>
        <AverageHoursPerWeekRt>10.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>30.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>1543400</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>36349</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KEVIN W HARLAN</PersonNm>
        <TitleTxt>PRESIDENT &amp; CEO</TitleTxt>
        <AverageHoursPerWeekRt>19.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>20.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>834770</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>20947</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOSHUA J ORDWAY MD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>39.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>697690</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>38265</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SCOTT B KANAGY DO</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>588150</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>56143</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KIMBERLY A HENSLEY</PersonNm>
        <TitleTxt>TRUSTEE &amp; COO &amp; CNO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>482765</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>28870</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JON D GIRARD MD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>39.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>466351</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>41168</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WILLIAM ANDREW MD</PersonNm>
        <TitleTxt>TRUSTEE &amp; CHIEF OF STAFF</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>247817</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JILL ASTON MD</PersonNm>
        <TitleTxt>TRUSTEE &amp; CHIEF OF STAFF ELECT</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>28300</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GREGORY W SIEWNY MD</PersonNm>
        <TitleTxt>BOARD CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANUJ GOYAL MD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TONYA Y CASEY</PersonNm>
        <TitleTxt>BOARD TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>39.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.50</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>218941</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15409</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHANDLER BRODERICK ESQ</PersonNm>
        <TitleTxt>BOARD SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>39.50</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>202069</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>27877</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KEITH D BRICKING MD</PersonNm>
        <TitleTxt>EVP &amp; CHIEF CLINICAL OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>10.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>30.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>1168492</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>67475</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARY M CLANCY</PersonNm>
        <TitleTxt>CHIEF DIGITAL &amp; INFORMATION OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>10.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>30.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>730195</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>58862</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>J MICHAEL SIMS</PersonNm>
        <TitleTxt>SYS VP &amp; CORPORATE CONTROLLER</TitleTxt>
        <AverageHoursPerWeekRt>10.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>30.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>635424</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>50996</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LISA M GOSSETT</PersonNm>
        <TitleTxt>VP NURSING/CNO/PATIENT EXP-PH</TitleTxt>
        <AverageHoursPerWeekRt>10.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>30.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>614633</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>36325</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CARA W POWERS</PersonNm>
        <TitleTxt>CHIEF LEGAL OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>10.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>30.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>588710</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>51822</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AMANDA K ADKINS-RICCI</PersonNm>
        <TitleTxt>SYSTEM VP REVENUE CYCLE</TitleTxt>
        <AverageHoursPerWeekRt>10.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>30.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>393531</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>25566</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MANDI L ARNETT</PersonNm>
        <TitleTxt>ASSOCIATE CNO - AMC</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>223290</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24882</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WENDY H PARKS</PersonNm>
        <TitleTxt>DIR - MARKETING</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>231129</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14877</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JACOB L FROEHLICH</PersonNm>
        <TitleTxt>DIRECTOR - SURGICAL SERVICES</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>212559</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>30744</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ALLISON E WENTLAND WEST</PersonNm>
        <TitleTxt>DIR-PAT EXP AMC &amp; SYS INF CTRL</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>204190</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>33764</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>INGRID E WAGGONER</PersonNm>
        <TitleTxt>DIRECTOR REHABILITATION-AMC</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>222590</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>13653</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARQUITA L TURNER</PersonNm>
        <TitleTxt>FORMER TRUSTEE &amp; OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>566782</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>41909</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LYNDSEY A PITTMAN</PersonNm>
        <TitleTxt>FORMER OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>213051</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10369</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GEOFFREY P WALKER</PersonNm>
        <TitleTxt>FORMER KEY EMPLOYEE</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>739507</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>34512</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ELAINE LAINIE M DEAN</PersonNm>
        <TitleTxt>FORMER KEY EMPLOYEE</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>658980</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43753</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BILLIE L LUCENTE-BAKER</PersonNm>
        <TitleTxt>FORMER KEY EMPLOYEE</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>370826</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>36241</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARC R BELCASTRO DO</PersonNm>
        <TitleTxt>FORMER KEY EMPLOYEE</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.50</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>361466</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>11044</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GARY G GINTER</PersonNm>
        <TitleTxt>FORMER KEY EMPLOYEE</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>232887</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10065</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>3218384</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>10460111</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>861887</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>167</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>1</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>103050</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>23970</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>888387</AllOtherContributionsAmt>
      <NoncashContributionsAmt>605912</NoncashContributionsAmt>
      <TotalContributionsAmt>1015407</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>141950852</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>141950852</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICARE/MEDICAID PAYMENTS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>126387242</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>126387242</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>ATHLETIC TRAINING</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>27260</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>27260</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>HOSPITAL FRANCHISE TAX RECOVERIES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>3133</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3133</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICAL RECORDS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>1900</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1900</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>268370387</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>2271503</TotalRevenueColumnAmt>
        <ExclusionAmt>2271503</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>3442397</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>2665933</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>776464</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>776464</TotalRevenueColumnAmt>
        <ExclusionAmt>776464</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>67696171</SecuritiesAmt>
        <OtherAmt>951450</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>63797132</SecuritiesAmt>
        <OtherAmt>1352386</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>3899039</SecuritiesAmt>
        <OtherAmt>-400936</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>3498103</TotalRevenueColumnAmt>
        <ExclusionAmt>3498103</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <GrossSalesOfInventoryAmt>202345</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>116617</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>85728</TotalRevenueColumnAmt>
        <ExclusionAmt>85728</ExclusionAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>GAIN ON INTEREST SWAP ADJ</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>4216466</TotalRevenueColumnAmt>
        <ExclusionAmt>4216466</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>SECURITY</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>27375</TotalRevenueColumnAmt>
        <ExclusionAmt>27375</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>CAFETERIA SALES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>18279</TotalRevenueColumnAmt>
        <ExclusionAmt>18279</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>68868</TotalRevenueColumnAmt>
        <ExclusionAmt>68868</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>4330988</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>280348580</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>268370387</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>10962786</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>258037</TotalAmt>
        <ProgramServicesAmt>258037</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>2245995</TotalAmt>
        <ProgramServicesAmt>1155928</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1090067</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>80310032</TotalAmt>
        <ProgramServicesAmt>77516784</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2793248</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>11368121</TotalAmt>
        <ProgramServicesAmt>10833381</ProgramServicesAmt>
        <ManagementAndGeneralAmt>534740</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>7700938</TotalAmt>
        <ProgramServicesAmt>7338697</ProgramServicesAmt>
        <ManagementAndGeneralAmt>362241</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>5931518</TotalAmt>
        <ProgramServicesAmt>5680685</ProgramServicesAmt>
        <ManagementAndGeneralAmt>250833</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>152629</TotalAmt>
        <ProgramServicesAmt>152629</ProgramServicesAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>3180</TotalAmt>
        <ManagementAndGeneralAmt>3180</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>318439</TotalAmt>
        <ManagementAndGeneralAmt>318439</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>50150243</TotalAmt>
        <ProgramServicesAmt>48917720</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1232523</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>170400</TotalAmt>
        <ProgramServicesAmt>170400</ProgramServicesAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>642090</TotalAmt>
        <ProgramServicesAmt>306286</ProgramServicesAmt>
        <ManagementAndGeneralAmt>335804</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>2116706</TotalAmt>
        <ProgramServicesAmt>1928046</ProgramServicesAmt>
        <ManagementAndGeneralAmt>188660</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>7601902</TotalAmt>
        <ProgramServicesAmt>7505693</ProgramServicesAmt>
        <ManagementAndGeneralAmt>96209</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>53196</TotalAmt>
        <ProgramServicesAmt>44473</ProgramServicesAmt>
        <ManagementAndGeneralAmt>8723</ManagementAndGeneralAmt>
      </TravelGrp>
      <InterestGrp>
        <TotalAmt>7975839</TotalAmt>
        <ProgramServicesAmt>7975839</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>15184711</TotalAmt>
        <ProgramServicesAmt>15184711</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>326627</TotalAmt>
        <ProgramServicesAmt>306952</ProgramServicesAmt>
        <ManagementAndGeneralAmt>19675</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>OPERATING SUPPLIES</Desc>
        <TotalAmt>45499011</TotalAmt>
        <ProgramServicesAmt>45499011</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>HOSPITAL FRANCHISE TAX</Desc>
        <TotalAmt>7521004</TotalAmt>
        <ProgramServicesAmt>7521004</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS AND MAINTENANCE</Desc>
        <TotalAmt>657075</TotalAmt>
        <ProgramServicesAmt>657075</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MINOR EQUIPMENT</Desc>
        <TotalAmt>228592</TotalAmt>
        <ProgramServicesAmt>225280</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3312</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>452769</TotalAmt>
        <ProgramServicesAmt>345216</ProgramServicesAmt>
        <ManagementAndGeneralAmt>107553</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>246869054</TotalAmt>
        <ProgramServicesAmt>239523847</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7345207</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>3220</BOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>1152615</BOYAmt>
        <EOYAmt>1247284</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>39871052</BOYAmt>
        <EOYAmt>33831356</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>9375</BOYAmt>
        <EOYAmt>481331</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>1701066</BOYAmt>
        <EOYAmt>1854742</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>3101078</BOYAmt>
        <EOYAmt>4641189</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>383544570</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>272056225</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>121893861</BOYAmt>
        <EOYAmt>111488345</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>75745870</BOYAmt>
        <EOYAmt>81182695</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>28999427</BOYAmt>
        <EOYAmt>30067893</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>9033830</BOYAmt>
        <EOYAmt>8991763</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>945032</BOYAmt>
        <EOYAmt>1341417</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>282456426</BOYAmt>
        <EOYAmt>275128015</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>19552385</BOYAmt>
        <EOYAmt>17355214</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <GrantsPayableGrp>
        <BOYAmt>423607</BOYAmt>
        <EOYAmt>232276</EOYAmt>
      </GrantsPayableGrp>
      <DeferredRevenueGrp>
        <BOYAmt>218798</BOYAmt>
        <EOYAmt>218798</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>181073110</BOYAmt>
        <EOYAmt>178369106</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>15802151</BOYAmt>
        <EOYAmt>15285292</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>81049394</BOYAmt>
        <EOYAmt>95143173</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>298119445</BOYAmt>
        <EOYAmt>306603859</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>-15663019</BOYAmt>
        <EOYAmt>-31475844</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>-15663019</BOYAmt>
        <EOYAmt>-31475844</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>282456426</BOYAmt>
        <EOYAmt>275128015</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>33479526</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>2295770</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>-51588121</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="RetDoc1039700001">
      <VolunteersInd>0</VolunteersInd>
      <PaidStaffOrManagementInd>0</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>0</MediaAdvertisementsInd>
      <MailingsMembersInd>0</MailingsMembersInd>
      <PublicationsOrBroadcastInd>0</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>1</GrantsOtherOrganizationsInd>
      <GrantsOtherOrganizationsAmt>3180</GrantsOtherOrganizationsAmt>
      <DirectContactLegislatorsInd>0</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>0</RalliesDemonstrationsInd>
      <OtherActivitiesInd>0</OtherActivitiesInd>
      <TotalLobbyingExpendituresAmt>3180</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>0</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II-B, LINE 1, LOBBYING ACTIVITIES:</FormAndLineReferenceDesc>
        <ExplanationTxt>PAYMENTS FOR LOBBYING ACTIVITIES INCLUDE DUES PAID TO GREATER DAYTON AREA HOSPITAL ASSOCIATION, AND OHIO HOSPITAL ASSOCIATION.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>22574747</OtherCostOrOtherBasisAmt>
        <BookValueAmt>22574747</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>239038854</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>173380736</DepreciationAmt>
        <BookValueAmt>65658118</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>482905</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>352566</DepreciationAmt>
        <BookValueAmt>130339</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>114925858</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>98322923</DepreciationAmt>
        <BookValueAmt>16602935</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>6522206</OtherCostOrOtherBasisAmt>
        <BookValueAmt>6522206</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>111488345</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>ALTERNATIVE INVESTMENTS</Desc>
        <BookValueAmt>30067893</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>30067893</TotalBookValueSecuritiesAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>INTERCOMPANY PAYABLE</Desc>
        <Amt>67811649</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>PENSION OBLIGATION &amp; DEFERRED COMP</Desc>
        <Amt>13280991</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>SELF INSURANCE RESERVE</Desc>
        <Amt>6132754</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>SWAP LIABILITY</Desc>
        <Amt>4787633</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>ACCRUED MANAGED CARE SETTLEMENT</Desc>
        <Amt>1615965</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>MEDICAL STAFF FEE ACCRUAL</Desc>
        <Amt>666804</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>LOAN GUAR &amp; OTHER LTL</Desc>
        <Amt>328092</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>OTHER LIABILITIES</Desc>
        <Amt>519285</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>95143173</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOLLOWING FOOTNOTE IS FROM THE 2024 CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR PREMIER HEALTH (PHP) AND AFFILIATES. PHP IS THE SOLE MEMBER OF ATRIUM MEDICAL CENTER (AMC). 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.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleF documentId="RetDoc1040500001">
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>CENTRAL AMERICA/CARIBBEAN</RegionTxt>
        <OfficesCnt>0</OfficesCnt>
        <EmployeeCnt>0</EmployeeCnt>
        <TypeOfActivitiesConductedTxt>PROGRAM SERVICES</TypeOfActivitiesConductedTxt>
        <SpecificServicesProvidedTxt>INSURANCE</SpecificServicesProvidedTxt>
        <RegionTotalExpendituresAmt>28000</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <SubtotalOfficesCnt>0</SubtotalOfficesCnt>
      <SubtotalEmployeesCnt>0</SubtotalEmployeesCnt>
      <ContinuationTotalOfficeCnt>0</ContinuationTotalOfficeCnt>
      <ContinuationTotalEmployeeCnt>0</ContinuationTotalEmployeeCnt>
      <TotalOfficeCnt>0</TotalOfficeCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <SubtotalSpentAmt>28000</SubtotalSpentAmt>
      <ContinuationSpentAmt>0</ContinuationSpentAmt>
      <TotalSpentAmt>28000</TotalSpentAmt>
      <TransferToForeignCorpInd>0</TransferToForeignCorpInd>
      <InterestInForeignTrustInd>0</InterestInForeignTrustInd>
      <ForeignCorpOwnershipInd>0</ForeignCorpOwnershipInd>
      <PassiveForeignInvestmestCoInd>0</PassiveForeignInvestmestCoInd>
      <ForeignPartnershipInd>0</ForeignPartnershipInd>
      <BoycottCountriesInd>0</BoycottCountriesInd>
    </IRS990ScheduleF>
    <IRS990ScheduleH documentId="RetDoc1041500001">
      <FinancialAssistancePolicyInd>1</FinancialAssistancePolicyInd>
      <WrittenPolicyInd>1</WrittenPolicyInd>
      <AllHospitalsPolicyInd>X</AllHospitalsPolicyInd>
      <FPGReferenceFreeCareInd>1</FPGReferenceFreeCareInd>
      <Percent200Ind>X</Percent200Ind>
      <FPGReferenceDiscountedCareInd>1</FPGReferenceDiscountedCareInd>
      <Percent300Ind>X</Percent300Ind>
      <FreeCareMedicallyIndigentInd>1</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>1</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>1</ExpensesExceedBudgetInd>
      <UnableToProvideCareInd>0</UnableToProvideCareInd>
      <AnnualCommunityBnftReportInd>1</AnnualCommunityBnftReportInd>
      <ReportPublicallyAvailableInd>1</ReportPublicallyAvailableInd>
      <FinancialAssistanceAtCostTyp>
        <TotalCommunityBenefitExpnsAmt>4798000</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>4798000</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.01940</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
        <TotalCommunityBenefitExpnsAmt>29773133</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>3133</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>29770000</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.12060</TotalExpensePct>
      </UnreimbursedMedicaidGrp>
      <UnreimbursedCostsGrp>
        <TotalCommunityBenefitExpnsAmt>1148000</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>1148000</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00470</TotalExpensePct>
      </UnreimbursedCostsGrp>
      <TotalFinancialAssistanceTyp>
        <TotalCommunityBenefitExpnsAmt>35719133</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>3133</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>35716000</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.14470</TotalExpensePct>
      </TotalFinancialAssistanceTyp>
      <CommunityHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>1262000</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>126000</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>1136000</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00460</TotalExpensePct>
      </CommunityHealthServicesGrp>
      <SubsidizedHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>12072000</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>12072000</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.04890</TotalExpensePct>
      </SubsidizedHealthServicesGrp>
      <CashAndInKindContributionsGrp>
        <TotalCommunityBenefitExpnsAmt>76000</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>76000</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00030</TotalExpensePct>
      </CashAndInKindContributionsGrp>
      <TotalOtherBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>13410000</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>126000</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>13284000</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.05380</TotalExpensePct>
      </TotalOtherBenefitsGrp>
      <TotalCommunityBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>49129133</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>129133</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>49000000</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.19850</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <BadDebtExpenseReportedInd>1</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>11530129</BadDebtExpenseAmt>
      <BadDebtExpenseAttributableAmt>0</BadDebtExpenseAttributableAmt>
      <ReimbursedByMedicareAmt>41642000</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>44461000</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>-2819000</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <CostAccountingSystemInd>X</CostAccountingSystemInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>1</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>1</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>1</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>ATRIUM MEDICAL CENTER</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>ONE MEDICAL CENTER DR</AddressLine1Txt>
          <CityNm>MIDDLETOWN</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45044</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>WWW.PREMIERHEALTH.COM</WebsiteAddressTxt>
        <StateLicenseNum>1116LH</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>ATRIUM MEDICAL CENTER</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FacilityNum>1</FacilityNum>
        <FirstLicensedCYOrPYInd>0</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>0</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>1</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <PriorCHNAImpactInd>X</PriorCHNAImpactInd>
        <CHNAConductedYr>24</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>1</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>1</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>1</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>1</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>SEE SCHEDULE H, PART V, SECTION C</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>1</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>23</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>1</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>SEE SCHEDULE H, PART V, SECTION C</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>0</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>1</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>200.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>300.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ExplainedBasisInd>1</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>1</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <IncludesPublicityMeasuresInd>1</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>SEE SCHEDULE H, PART V, SECTION C</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>SEE SCHEDULE H, PART V, SECTION C</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>PART V, SECTION C</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPTranslatedInd>X</FAPTranslatedInd>
        <OtherPublicityInd>X</OtherPublicityInd>
        <FAPActionsOnNonpaymentInd>1</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>0</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>1</NondisEmergencyCarePolicyInd>
        <LookBackMedicaidMedcrPrvtInd>X</LookBackMedicaidMedcrPrvtInd>
        <AmountsGenerallyBilledInd>0</AmountsGenerallyBilledInd>
        <GrossChargesInd>0</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, SECTION B, LINE 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>THIS COMMUNITY HEALTH NEEDS ASSESSMENT WAS CROSS-SECTIONAL IN NATURE AND INCLUDED AN ONLINE SURVEY OF ADULTS WITHIN THE GREATER DAYTON AREA. FROM THE BEGINNING, COMMUNITY LEADERS WERE ACTIVELY ENGAGED IN THE PLANNING PROCESS AND HELPED DEFINE THE CONTENT, SCOPE, AND SEQUENCE OF THE STUDY. ACTIVE ENGAGEMENT OF COMMUNITY MEMBERS THROUGHOUT THE PLANNING PROCESS IS REGARDED AS AN IMPORTANT STEP IN COMPLETING A VALID NEEDS ASSESSMENT. COMPARISONS TO LOCAL, STATE, AND NATIONAL DATA WERE MADE, ALONG WITH ALIGNMENT TO THE HEALTHY PEOPLE 2030 TARGET OBJECTIVES, WHEN APPLICABLE.SAMPLING:THE SAMPLING FRAME FOR THE ADULT SURVEY CONSISTED OF ADULTS AGES 18 AND OVER LIVING IN THE 10-COUNTY GREATER DAYTON AREA. THERE WERE 1,090,792 PERSONS AGES 18 AND OVER LIVING IN THE 10-COUNTY GREATER DAYTON AREA. THE INVESTIGATORS CONDUCTED A POWER ANALYSIS TO DETERMINE WHAT SAMPLE SIZE WAS NEEDED TO ENSURE A 95% CONFIDENCE LEVEL WITH A CORRESPONDING MARGIN OF ERROR OF 6% (I.E., WE CAN BE 95% SURE THAT THE "TRUE" POPULATION RESPONSES ARE WITHIN A 6% MARGIN OF ERROR OF THE SURVEY FINDINGS). A SAMPLE SIZE OF AT LEAST 267 ADULTS WAS NEEDED TO ENSURE THIS LEVEL OF CONFIDENCE FOR THE GENERAL POPULATION.PROCEDURE:THE PRIMARY DATA COLLECTION TOOL USED WAS AN ONLINE SURVEY VIA SURVEY MONKEY. THE ADVISORY COMMITTEE ALSO PROVIDED PAPER SURVEYS TO SELECT POPULATIONS. THE ADVISORY COMMITTEE ESTABLISHED A RAFFLE WITH A VARIETY OF GIFT CARDS TO ENCOURAGE PARTICIPATION IN THE SURVEY. DATA COLLECTION OCCURRED FROM APRIL-JULY 2024, SEGMENTED INTO TWO MAJOR SAMPLING METHODOLOGIES: CONVENIENCE SAMPLING AND PURPOSEFUL SAMPLING. THE COMBINATION OF SAMPLING METHODOLOGIES WAS UTILIZED TO YIELD VALUABLE INSIGHTS REFLECTIVE OF THE COUNTY'S UNIQUE CHARACTERISTICS.CONVENIENCE SAMPLING TOOK PLACE DURING THE FIRST THREE WEEKS OF DATA COLLECTION. THIS APPROACH ENABLED THE INCLUSION OF COMMUNITY MEMBERS WHO WERE EASILY ACCESSIBLE, SUCH AS RESIDENTS ATTENDING LOCAL EVENTS, USING PUBLIC SERVICES, OR INTERACTING WITH ONLINE PLATFORMS. THE PURPOSE OF THIS FIRST PHASE WAS TO ENABLE SWIFT DATA COLLECTION AND BROAD REPRESENTATION ACROSS VARIOUS SEGMENTS OF THE POPULATION.FOLLOWING CONVENIENCE SAMPLING, RESEARCHERS CONDUCTED A DEMOGRAPHIC ANALYSIS TO IDENTIFY UNDER-REPRESENTED POPULATIONS AMONG THE POOL OF RESPONDENTS. BY COMPARING THE DEMOGRAPHICS OF THE SURVEY RESPONDENTS TO U.S. CENSUS 2022 AMERICAN COMMUNITY SURVEY ESTIMATES, RESEARCHERS IDENTIFIED THE FOLLOWING UNDER-REPRESENTED POPULATIONS AMONG THE SURVEY RESPONDENTS: MALE RESPONDENTS, BLACK/AFRICAN AMERICAN AND HISPANIC RESPONDENTS, AND THOSE 60 AND OLDER LIVING IN DARKE, GREENE, MIAMI, MONTGOMERY, AND SHELBY COUNTIES.UTILIZING THE RESULTS OF THE DEMOGRAPHIC ANALYSIS, PURPOSEFUL SAMPLING TOOK PLACE OVER THE COURSE OF SIX WEEKS. THIS APPROACH TARGETED THE COLLECTION OF DATA FROM UNDER-REPRESENTED DEMOGRAPHIC GROUPS BY PROMOTING THE SURVEY IN AREAS THESE POPULATIONS FREQUENTED. EFFORTS INCLUDED IN-PERSON OUTREACH AT SPECIFIC LOCATIONS AND COLLABORATION WITH KEY COMMUNITY STAKEHOLDERS TO RAISE AWARENESS OF THE SURVEY.BY COMBINING THE APPROACHES OUTLINED ABOVE, RESEARCHERS AIMED TO CAPTURE A COMPREHENSIVE PICTURE OF THE 10-COUNTY GREATER DAYTON AREA POPULATION, ITS DYNAMICS, AND ITS VARIED PERSPECTIVES, CONTRIBUTING TO INFORMED DECISION-MAKING AND COMMUNITY-FOCUSED INITIATIVES WITHIN THE REGION. AFTER THOROUGHLY CLEANING THE ADULT DATA THAT WAS COLLECTED DURING THE THIRTEEN WEEKS, A TOTAL OF 2,175 RESPONSES WERE CONSIDERED VALID FOR ANALYSIS.THIS SAMPLE SIZE (N=2,175: CI= 2.10%) MEANS THAT THE RESPONSES IN THE ADULT HEALTH ASSESSMENT SHOULD BE REPRESENTATIVE OF THE ENTIRE REGION AND EACH UNDERLYING COUNTY.NOTE: "N" REFERS TO THE TOTAL SAMPLE SIZE, "CI" REFERS TO THE CONFIDENCE INTERVAL.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, SECTION B, LINES 6A &amp; 6B:</FormAndLineReferenceDesc>
        <ExplanationTxt>ATRIUM MEDICAL CENTER (AMC) COLLABORATED WITH THE OTHER MEMBER HOSPITALS OF GREATER DAYTON AREA HOSPITAL ASSOCIATION INCLUDING KETTERING MEDICAL CENTER, SYCAMORE MEDICAL CENTER, KETTERING BEHAVIORAL MEDICAL CENTER, GRANDVIEW MEDICAL CENTER, SOUTHVIEW MEDICAL CENTER, SOIN MEDICAL CENTER, GREENE MEMORIAL HOSPITAL, FORT HAMILTON HOSPITAL, MIAMI VALLEY HOSPITAL, ATRIUM MEDICAL CENTER, UPPER VALLEY MEDICAL CENTER, MIAMI VALLEY HOSPITAL SOUTH, MIAMI VALLEY HOSPITAL NORTH, WILSON MEMORIAL HEALTH, WAYNE HEALTHCARE, MERCY HEALTH SPRINGFIELD REGIONAL MEDICAL CENTER, AND MERCY HEALTH URBANA HOSPITAL. ADDITIONALLY, AMC COLLABORATED WITH OUR REGION'S PUBLIC HEALTH DEPARTMENTS, INCLUDING AUGLAIZE COUNTY HEALTH DEPARTMENT, CHAMPAIGN HEALTH DISTRICT, CLARK COUNTY COMBINED HEALTH DISTRICT, DARKE COUNTY GENERAL HEALTH DISTRICT, GREENE COUNTY HEALTH DEPARTMENT, MIAMI COUNTY PUBLIC HEALTH, PREBLE COUNTY HEALTH DEPARTMENT, PUBLIC HEALTH DAYTON &amp; MONTGOMERY COUNTY, AND SIDNEY-SHELBY COUNTY HEALTH DEPARTMENT.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, SECTION B, LINES 7A &amp; 10A:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE WEBSITE ADDRESS WHERE THE CHNA AND THE RELATED IMPLEMENTATION STRATEGY CAN BE ACCESSED IS:HTTPS://WWW.PREMIERHEALTH.COM/ABOUT-PREMIER/COMMUNITY-INVOLVEMENT/COMMUNITY-HEALTH-IMPROVEMENT</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, SECTION B, LINE 11:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMMUNITY HEALTH IMPROVEMENT PLAN WORKGROUP IDENTIFIED THREE OVERARCHING PRIORITY AREAS SPANNING THE FULL CONTINUUM OF CARE:BARRIERS TO ACCESSING CARE: ADDRESSING SYSTEMIC AND LOGISTICAL OBSTACLES THAT PREVENT INDIVIDUALS FROM RECEIVING TIMELY AND APPROPRIATE HEALTHCARE. ELEVATING DELIVERY OF HEALTHCARE SERVICES: ENHANCING THE EFFICIENCY, COORDINATION, AND QUALITY OF HEALTHCARE SERVICES ACROSS THE REGION. WELLBEING AND QUALITY OF LIFE: ADDRESSING FACTORS THAT CONTRIBUTE TO LONG-TERM PHYSICAL, MENTAL, AND SOCIAL WELLBEING. FOR EACH PRIORITY AREA, TARGETED STRATEGIES WERE DEVELOPED TO DRIVE MEANINGFUL IMPROVEMENTS. WHILE MANY STRATEGIES ARE SPECIFIC TO EACH FOCUS AREA, TWO CROSS-CUTTING THEMES EMERGED AS CRITICAL ACROSS ALL PRIORITIES: ADVOCACY AND SOCIAL DETERMINANTS OF HEALTH (SDOH).SDOH: SUCH AS ECONOMIC STABILITY, EDUCATION, AND ACCESS TO NUTRITIOUS FOOD PROFOUNDLY INFLUENCE PATIENT OUTCOMES AND HEALTHCARE COSTS. HOSPITALS PLAY A VITAL ROLE IN CONNECTING PATIENTS TO COMMUNITY-BASED ORGANIZATIONS AND NONPROFIT RESOURCES THAT CAN MEET THESE NEEDS. ADDRESSING SDOH IS ESSENTIAL FOR REDUCING HEALTH DISPARITIES, IMPROVING PREVENTIVE CARE, AND FOSTERING A HEALTHIER, MORE EQUITABLE DAYTON REGION.ADVOCACY: BY CHAMPIONING POLICIES THAT SUPPORT EQUITABLE HEALTHCARE ACCESS, FUNDING FOR PUBLIC HEALTH INITIATIVES, AND STRONGER COMMUNITY PARTNERSHIPS, HOSPITALS AND STAKEHOLDERS CAN HELP SHAPE A HEALTHCARE ENVIRONMENT THAT BETTER SERVES THE NEEDS OF ALL DAYTON RESIDENTS. COLLABORATIVE ADVOCACY EFFORTS WILL BE ESSENTIAL IN DRIVING POLICY CHANGES THAT SUPPORT THE LONG-TERM SUCCESS OF THE CHIP.REGIONAL PRIORITY #1:BARRIERS TO ACCESSING CARE (1A):EDUCATE &amp; INFORM PATIENTS ON THEIR HEALTH CARE BENEFITS AND OPTIONSTHIS STRATEGY FOCUSES ON EQUIPPING PATIENTS WITH THE KNOWLEDGE THEY NEED TO MAKE INFORMED DECISIONS REGARDING THEIR HEALTHCARE PLANS, SERVICES, AND COVERAGE. BY ENHANCING PATIENT UNDERSTANDING, WE AIM TO REDUCE CONFUSION, IMPROVE ACCESS TO CARE, AND INCREASE OVERALL SATISFACTION WITH HEALTHCARE SERVICES.THE HOSPITALS OF THE DAYTON REGION PLAN TO WORK COLLABORATIVELY TO INCREASE THE DAYTON REGION'S HEALTH LITERACY AND THE NUMBER OF INDIVIDUALS REACHED THROUGH HEALTH LITERACY PROGRAMMING (WITH AN EMPHASIS ON UNDERINSURED AND UNINSURED POPULATIONS).OUR ACTION ITEMS WILL BE TO STANDARDIZE HOW HEALTH LITERACY IS MEASURED AND TRACKED, AND TO HAVE A REGIONAL CAMPAIGN TO EDUCATE/INFORM (RE: HEALTHCARE OPTIONS, INSURANCE BENEFITS, COVERAGE TRANSITIONS, ETC.). PARTNER WITH CHAMBER AND BUSINESS COMMUNITY TO EDUCATE ON INSURANCE TRANSITIONS.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, SECTION B, LINE 11 (CONTINUED):</FormAndLineReferenceDesc>
        <ExplanationTxt>BARRIERS TO ACCESSING CARE (1B):INCREASE ACCESS &amp; AVAILABILITY OF CARE OPTIONS, WITH FOCUS ON UNINSURED AND UNDERINSURED INDIVIDUALSTHIS STRATEGY AIMS TO REDUCE HEALTH CARE DISPARITIES BY EXPANDING ACCESS TO CARE OPTIONS AND ENSURING THAT THESE INDIVIDUALS CAN OBTAIN THE SERVICES THEY NEED, REGARDLESS OF THEIR INSURANCE STATUS. BY FOCUSING ON THE NEEDS OF THE UNDERSERVED POPULATIONS, WE WILL ENHANCE THE AVAILABILITY OF ESSENTIAL HEALTH CARE SERVICES AND SUPPORT SYSTEMS THAT FACILITATE IMPROVED HEALTH OUTCOMES.THE HOSPITALS OF THE DAYTON REGION PLAN TO WORK COLLABORATIVELY TO INCREASE HEALTH SCREENINGS IN UNDERSERVED ZIP CODES.OUR ACTION ITEMS WILL BE TO REVIEW AND ANALYZE POPULATION AND VISIT DATA TO AID IN IDENTIFICATION OF AREAS WITH HIGHEST NEED FOR SCREENING, DEVELOP ALTERNATIVE MODELS OF CARE (I.E., MOBILE CLINICS), AND FOCUS ON AVAILABILITY (I.E., WAIT TIMES), AND CONSIDER FLEXIBLE OPTIONS FOR CARE (I.E., URGENT, WALK-IN, ETC.) MEDICAL, DENTAL, MENTAL HEALTH.STRATEGIC INITIATIVES:PROGRAM: COMMUNITY HEALTH VOUCHERSDESCRIPTION: PROVIDES FINANCIAL AID FOR BREAST AND CERVICAL CANCER SCREENINGS.ELIGIBILITY: UNINSURED/UNDERINSURED WITH INCOME 400% FPL.COVERED SERVICES: MAMMOGRAMS, BIOPSIES, PAP TESTS, ULTRASOUNDS, AND MORE.GOAL: EARLY CANCER DETECTION FOR SUCCESSFUL TREATMENT.OUTCOMES:3-YEAR PROJECTION: 150 WOMEN SYSTEM-WIDE SERVED. EXPANSION EFFORTS: PREMIER HEALTH WORKING TO INCREASE PROVIDER CONTRACTS FOR CERVICAL SERVICES. ENROLLMENT TREND: CLIENT NUMBERS STEADY DESPITE THE HEALTH CARE MARKETPLACE CHANGES.PARTNERS &amp; RESOURCES:ATRIUM MEDICAL CENTER FOUNDATION, GOOD SAMARITAN FOUNDATION-DAYTON, UVMC FOUNDATION, MIAMI VALLEY HOSPITAL FOUNDATION (HELP HER FIGHT), BREAST CANCER FOUNDATION, KUHNS BROTHERS AND FIVE RIVERS HEALTH CENTERS PROGRAM SITES: MAGNOLIA WOMEN'S HEALTH, FIVE RIVERS HEALTH CENTER, ATRIUM MEDICAL CENTER, UPPER VALLEY MEDICAL CENTER, MIAMI VALLEY HOSPITAL, MIAMI VALLEY NORTH, MIAMI VALLEY SOUTH</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, SECTION B, LINE 11 (CONTINUED):</FormAndLineReferenceDesc>
        <ExplanationTxt>PROGRAM: BCCP GRANT PROGRAMTHE BREAST AND CERVICAL CANCER PROJECT'S PATIENT NAVIGATION PROGRAM HELPS WOMEN ACCESS CANCER SCREENINGS, PROVIDERS, AND RESOURCES.ASSISTS TO ANSWER QUESTIONS ABOUT APPOINTMENTS, INSURANCE, AND MORE.IMPROVE ACCESS FOR EARLY DETECTION OF BREAST AND CERVICAL CANCERS IMPROVES TREATMENT SUCCESS.OUTCOMES: INCREASE ACCESS UN-INSURED AND UNDERINSURED COMMUNITY MEMBERS WHO FALL WITHIN THE ELIGIBILITY GUIDELINES. (PREMIER HEALTH PROVIDES IN-KIND SUPPORT FOR OFFICE SPACE AND ADMINISTRATIVE SUPPORT.)PARTNERS &amp; RESOURCES:ATRIUM MEDICAL CENTER FOUNDATION, GOOD SAMARITAN FOUNDATION-DAYTON, UVMC FOUNDATION, MIAMI VALLEY HOSPITAL FOUNDATION (HELP HER FIGHT), BREAST CANCER FOUNDATION, KUHNS BROTHERS AND FIVE RIVERS HEALTH CENTERS PROGRAM SITES: MAGNOLIA WOMEN'S HEALTH, FIVE RIVERS HEALTH CENTER, ATRIUM MEDICAL CENTER, UPPER VALLEY MEDICAL CENTER, MIAMI VALLEY HOSPITAL, MIAMI VALLEY NORTH, MIAMI VALLEY SOUTHPROGRAM: VACCINES FOR CHILDRENTHE PREMIER COMMUNITY HEALTH VACCINES FOR CHILDREN (VFC) MOBILE PROGRAM PROVIDES ROUTINE CHILDHOOD IMMUNIZATIONS TO UNINSURED, UNDERINSURED, AND MEDICAID-ELIGIBLE CHILDREN IN UNDERSERVED COMMUNITIES THROUGH MOBILE CLINICS AT SCHOOLS AND COMMUNITY CENTERS. THE VFC PROGRAM TARGETS CHILDREN (0-18) IN UNDERSERVED AREAS, ADDRESSING ACCESS BARRIERS LIKE TRANSPORTATION AND COST. PROVIDES EDUCATION ON VACCINE SAFETY AND IMMUNIZATION SCHEDULES AND CONNECTS FAMILIES TO ONGOING HEALTH CARE AND FOLLOW-UP SUPPORT.OUTCOMES: NUMBER OF CHILDREN VACCINATED THROUGH THE MOBILE PROGRAM INCREASE IN IMMUNIZATION RATES IN TARGET COMMUNITIES NUMBER OF VACCINE OUTREACH AND EDUCATION SESSIONS PROVIDED REDUCTION IN SCHOOL-ENTRY VACCINE NON-COMPLIANCE RATES NUMBER OF FAMILIES CONNECTED TO PRIMARY CARE PROVIDERS FOR ONGOING PREVENTIVE CAREPARTNERS &amp; RESOURCES:AREA SCHOOLS, EARLY LEARNING CENTERS, FAITH-BASED ORGANIZATIONS, AND PUBLIC HOUSING SITESREGIONAL PRIORITY #2ELEVATING DELIVERY OF HEALTH CARE SERVICESEDUCATE &amp; INFORM PATIENTS ON THEIR HEALTH CARE BENEFITS AND OPTIONSOUR GREATER DAYTON HOSPITALS PLAY A VITAL ROLE IN ADDRESSING CHRONIC DISEASE, MATERNAL AND INFANT HEALTH, AND BEHAVIORAL HEALTH. THIS PRIORITY AREA WILL ADVANCE THE GREATER DAYTON REGION'S COMMUNITY HEALTH THROUGH ENHANCED HEALTH CARE SERVICES. IT WILL HELP PATIENTS NAVIGATE LONG-TERM CONDITIONS, REDUCE PREVENTABLE COMPLICATIONS, ENSURE HEALTHIER PREGNANCIES AND BIRTHS, AND ADDRESS THE GROWING NEED FOR COMPREHENSIVE BEHAVIORAL HEALTH SERVICES.ELEVATING DELIVERY OF HEALTH CARE SERVICES (2A):THIS STRATEGY SUPPORTS CHRONIC DISEASE MANAGEMENT THROUGH A COMPREHENSIVE APPROACH DESIGNED TO ENHANCE PATIENT OUTCOMES AND ENCOURAGE SELF-MANAGEMENT.OUTCOMES:REDUCE ACUTE CARE DAYS FOR CHRONIC DISEASE CARE (BASED ON MOST PREVALENT CHRONIC DISEASE IN COUNTY) REDUCE ED ADMISSIONS RELATIVE TO CHRONIC DISEASE DIAGNOSESFOCUS ON SCHOOL EDUCATION AND PREVENTATIVE SCREENINGSACTION ITEMS:SHARE CHRONIC DISEASE MANAGEMENT PROGRAM/SERVICE INFORMATION MORE BROADLY ACROSS HOSPITALS, PUBLIC HEALTH DEPARTMENTS LEVERAGE ACCESS TO REGIONAL HEALTH CARE DATA TO INFORM COMMUNITIES OR POPULATIONS OF HIGHEST NEED TO INFORM OPPORTUNITIES FOR PROGRAM DEVELOPMENT OR PARTNERSHIPCONSIDER REMOTE MONITORING OR TELEHEALTH EXPLORE HOW PUBLIC HEALTH DEPARTMENT PROGRAMMING COULD SUPPORT CHRONIC DISEASE PATIENTS WITH ONGOING MANAGEMENT AND PREVENTION</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, SECTION B, LINE 11 (CONTINUED):</FormAndLineReferenceDesc>
        <ExplanationTxt>STRATEGIC INITIATIVES:PROGRAM: COMMUNITY HEALTH AND MOBILE CLINIC PROGRAMMINGPREMIER HEALTH'S COMMUNITY HEALTH PROGRAMMING AIMS TO IMPROVE CARDIOVASCULAR AND DIABETES PREVENTION THROUGH SCREENINGS, EDUCATION, AND RESOURCE NAVIGATION FOR AT-RISK POPULATIONS. THE PROGRAM PROVIDES BOTH IN-PERSON AND VIRTUAL EVENTS TO PROMOTE EARLY DETECTION, LIFESTYLE CHANGES, AND CHRONIC DISEASE MANAGEMENT IN UNDERSERVED COMMUNITIES.PROGRAM COMPONENTS: PREVENTIVE SCREENINGS (BLOOD PRESSURE, BMI, CHOLESTEROL, ETC.) AT COMMUNITY EVENTS AND VIA MOBILE CLINICONE-ON-ONE HEALTH COACHING AND GROUP EDUCATION ON CHRONIC DISEASE MANAGEMENT.COMMUNITY RESOURCE NAVIGATION FOR SDOH NEEDS VIRTUAL "TUESDAY TALKS" HEALTH FOCUSED WEBINARS ON HEALTHOUTCOMES:NUMBER OF COMMUNITY MEMBERS SCREENED FOR CARDIOVASCULAR AND DIABETES RISK FACTORS PERCENTAGE OF HIGH-RISK INDIVIDUALS REFERRED TO PROVIDERSENGAGEMENT LEVELS IN "TUESDAY TALKS" VIRTUAL EDUCATION SERIESINCREASED HEALTHCARE ACCESS FOR PROGRAM PARTICIPANTSPARTNERS &amp; RESOURCES:LOCAL COMMUNITY ORGANIZATIONS, CHURCHES, SENIOR CENTERS, MIDDLETOWN CONNECT WALK WITH A DOC, COMMUNITY HEALTH WELLNESS PROGRAM, CITY OF STARS BARBERSHOP, DEEEZ CUTTZ BARBERSHOP, MAN UP BARBERSHOP, HEADLINERS BARBERSHOP, NAKEDA 7 SPA, R. ANTHONY HAIR SALON, RON WEST BARBERING SCHOOL, SERENITY SALON, STYLZES BARBERSHOP, X-QUISITE BARBERSHOP &amp; BARBERING SCHOOLPROGRAM: BARBERSHOP HEALTH INITIATIVETHE PREMIER COMMUNITY HEALTH BARBERSHOP INITIATIVE PROVIDES PREVENTIVE SCREENINGS, EDUCATION, AND RESOURCE NAVIGATION AT BARBERSHOPS TO ADDRESS HEALTH DISPARITIES, PARTICULARLY FOR AFRICAN AMERICAN MEN AT RISK FOR CHRONIC CONDITIONS. PROGRAM COMPONENTS:ON-SITE HEALTH SCREENINGS AND COACHINGBARBER TRAINING FOR HEALTH ADVOCACYCULTURALLY TAILORED EDUCATION ON DISEASE PREVENTIONOUTCOMES:NUMBER OF BARBERSHOPS PARTICIPATING IN THE INITIATIVE NUMBER OF INDIVIDUALS SCREENED AND REFERRED TO FOLLOW-UP CAREINCREASE ENGAGEMENT IN PREVENTIVE HEALTHCARE AND PRIMARY CARE IMPROVE BARBERS' ENGAGEMENT AND IMPACT AS PEER HEALTH ADVOCATESPARTNERS &amp; RESOURCES:CITY OF STARS BARBERSHOP, DEEEZ CUTTZ BARBERSHOP, MAN UP BARBERSHOP, HEADLINERS BARBERSHOP, NAKEDA 7 SPA, R. ANTHONY HAIR SALON, RON WEST BARBERING SCHOOL, SERENITY SALON, STYLZES BARBERSHOP, X-QUISITE BARBERSHOP &amp; BARBERING SCHOOL</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, SECTION B, LINE 11: (CONTINUED)</FormAndLineReferenceDesc>
        <ExplanationTxt>PROGRAM: TELEHEALTH PROGRAM - REMOTE PATIENT MONITORINGTHE REMOTE PATIENT MONITORING (RPM) PROGRAM IMPROVES HEALTH OUTCOMES FOR PATIENTS IN RURAL AND LOW-INCOME URBAN AREAS BY OFFERING CONTINUOUS MONITORING FOR CHRONIC CONDITIONS, REDUCING HOSPITAL READMISSIONS AND HEALTH CARE DISPARITIES.PROGRAM COMPONENTS: HOME MONITORING DEVICES, TELEHEALTH CHECK-INS, 24/7 MONITORING, NURSE-LED COACHING, AND SUPPORT FOR MEDICATION ADHERENCE. COLLABORATION WITH COMMUNITY ORGANIZATIONS TO REACH VULNERABLE POPULATIONS.HEALTH EQUITY: FREE EQUIPMENT, MULTI-LINGUAL SUPPORT, AND DIGITAL LITERACY.OUTCOMES:REDUCTION IN HOSPITAL READMISSIONS AND EMERGENCY DEPARTMENT VISITSIMPROVEMENTS INPATIENT ADHERENCE TO MEDICATION AND CARE PLANS PATIENT-REPORTED IMPROVEMENTS IN HEALTH STATUS AND QUALITY OF LIFEPARTNERS &amp; RESOURCES:AREA HOSPITALS, PHYSICIANS, COMMUNITY ORGANIZATIONSELEVATING DELIVERY OF HEALTH CARE (2B):ENHANCE THE QUALITY AND ACCESSIBILITY OF PRENATAL CARE TO EXPECTANT MOTHERS AND EDUCATE ON ITS' IMPORTANCEENHANCING THE QUALITY AND ACCESSIBILITY OF PRENATAL CARE IS CRITICAL FOR ENSURING THE HEALTH AND WELL-BEING OF BOTH EXPECTANT MOTHERS AND THEIR BABIES. A WELL-ROUNDED STRATEGY TO IMPROVE PRENATAL CARE FOCUSES ON PROVIDING COMPREHENSIVE, PERSONALIZED CARE, REMOVING BARRIERS TO ACCESS, AND EDUCATING MOTHERS ABOUT THE IMPORTANCE OF PRENATAL CARE THROUGHOUT THEIR PREGNANCY.OUTCOMES:DECREASE PRE-TERM BIRTHSDECREASE LOW WEIGHT BIRTHSIMPROVED BIRTH OUTCOMESINCREASE # OF MOTHERS RECEIVING PRENATAL CARE IN FIRST TRIMESTERACTION ITEMS:DEVELOP REGIONAL RESOURCES AND BEST PRACTICES TO HELP PATIENTS UNDERSTAND IMPORTANCE OF MATERNAL AND INFANT HEALTH CONTINUE TO STRENGTHEN REGIONAL AND LOCAL PARTNERSHIPS WITH ALL LEVELS OF CARE AND SUPPORT FOR PREGNANT INDIVIDUALS (I.E. DOULAS, COMMUNITY ORGANIZATIONS, HEALTHCARE PROVIDERS)EARLY SCREENING FOR HIGH-RISK PREGNANCIESNUTRITIONAL COUNSELINGMATERNAL EDUCATIONSTRATEGIC INITIATIVES:PROGRAM: HELP ME GROW, BRIGHTER FUTURESHELP ME GROW BRIGHTER FUTURES (HMGBF) HOME VISITING IS A VOLUNTARY, HOME-BASED SERVICE THAT PROVIDES SOCIAL, EMOTIONAL, HEALTH-RELATED AND PARENTING SUPPORT AND INFORMATION TO FAMILIES AND LINKS THEM TO APPROPRIATE RESOURCES. OUR PROGRAMS SERVE FAMILIES WITH CHILDREN UP TO AGE THREE.HMGBF IS AN OPERATING ENTITY OF GDAHA. PREMIER HEALTH SUPPORTS THIS PROGRAM BY PROVIDING RESOURCES FOR SALARY AND BENEFITS AS A PART OF A COMMUNITY COLLABORATION.OUTCOMES:CASELOAD GOAL: SERVE 1,770 FAMILIES IN 2025.INFANT MORTALITY: REDUCE RACIAL DISPARITIES IN INFANT MORTALITY, ESPECIALLY AMONG AFRICAN AMERICAN INFANTS.PARTNERS &amp; RESOURCES:GREATER DAYTON AREA HOSPITAL ASSOCIATION, KETTERING HEALTH NETWORK, LIFE STAGES CENTERING, FIVE RIVERS HEALTH CENTERS, SOUTHVIEW WOMEN'S CENTER, GRANDVIEW WOMEN'S CENTER, PUBLIC HEALTH, PHYSICIAN OFFICES, AND A VARIETY OF COMMUNITY PROGRAM SUCH AS THE WESLEY CENTER, ELIZABETH NEW LIFE, MIAMI VALLEY CHILD DEVELOPMENT CENTER, PROMISE TO HOPE, LIFE RESOURCE CENTER, AND FAMILY SERVICE AGENCY</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, SECTION B, LINE 11: (CONTINUED)</FormAndLineReferenceDesc>
        <ExplanationTxt>PROGRAM: PROMISE TO HOPETHE PROGRAM PROVIDES MULTIDISCIPLINARY CARE FOR PREGNANT WOMEN WITH SUBSTANCE USE OR OPIATE USE DISORDERS TO IMPROVE MATERNAL AND INFANT HEALTH. GOALS INCLUDE REDUCING OVERDOSE DEATHS, SUPPORTING SUCCESSFUL PARENTING, AND INCREASING BREASTFEEDING RATES FOR MOTHERS IN RECOVERY. PROVIDING MEDICATION ASSISTED TREATMENT (MAT), PERSONALIZED CARE, RECOVERY SUPPORT, AND PRENATAL/POST-PARTUM SERVICES THROUGH PROMISE TO HOPE. TO ENSURE HEALTHY OUTCOMES, PREGNANT WOMEN WITH SUBSTANCE USE DISORDER OR OPIATE USE DISORDER REQUIRE A MULTIDISCIPLINARY APPROACH WITH CONNECTION TO COMMUNITY RESOURCES.OUTCOMES:MEASURE THE TOTAL CLIENTS SERVED PER YEARREDUCE OVERDOSE DEATHS IMPROVE INFANT HEALTH INCREASE BREASTFEEDING RATES FOR MOTHERS IN RECOVERYPARTNERS &amp; RESOURCES:ADAMHS BOARD OF MONTGOMERY COUNTY, JOSHUA RECOVERY MINISTRIES, BRIGID'S PATH, NOVA BEHAVIORAL HEALTH, BERRY HEALTH CENTER, FAMILY TREATMENT COURT, CARESOURCE, AND FRESH STARTPROGRAM: ATRIUM PREGNANCY CENTERINGATRIUM MEDICAL CENTER'S CENTERING PREGNANCY(R) PROGRAM PROVIDES GROUP-BASED PRENATAL CARE FOR HIGH-RISK PREGNANT WOMEN IN THE MIDDLETOWN COMMUNITY. LAUNCHED IN 2017, THE PROGRAM AIMS TO IMPROVE MATERNAL AND INFANT HEALTH OUTCOMES BY OFFERING INTERACTIVE, COMMUNITY-BASED SESSIONS INSTEAD OF TRADITIONAL ONE-ON-ONE VISITS. THE PROGRAM FOCUSES ON REDUCING INFANT MORTALITY, PREMATURE BIRTHS, AND LOW BIRTHWEIGHTS, ESPECIALLY AMONG AFRICAN AMERICAN AND LOW-INCOME WOMEN.OUTCOMES:REDUCE BARRIERS TO CARE LIKE TRANSPORTATION, CHILDCARE, MEDICAID NAVIGATIONINCREASE HEALTH LITERACY FOR PREGNANT MOTHERSPARTNERS &amp; RESOURCES:COMMUNITY BASED ORGANIZATIONS, MENTAL HEALTH PROVIDERS, JOB AND FAMILY SERVICESELEVATING DELIVERY OF HEALTH CARE (2C):SUPPORT MENTAL HEALTH &amp; SUBSTANCE USE DISORDER INTERVENTIONSSUPPORTING MENTAL HEALTH AND SUBSTANCE USE DISORDER (SUD) INTERVENTIONS REQUIRES A COMPREHENSIVE, MULTI-TIERED STRATEGY THAT ADDRESSES BOTH THE IMMEDIATE AND LONG-TERM NEEDS OF INDIVIDUALS AFFECTED BY THESE ISSUES. THE GOAL IS TO CREATE AN INTEGRATED SYSTEM OF CARE THAT NOT ONLY PROVIDES TREATMENT FOR MENTAL HEALTH AND SUD BUT ALSO PROMOTES PREVENTION, EARLY INTERVENTION, AND ONGOING SUPPORT.OUTCOMES:INCREASE MEDICAL PROVIDER BEHAVIORAL HEALTH LITERACYINCREASE NUMBER OF PCPS SCREENING FOR BEHAVIORAL HEALTH NEEDSACTION ITEMS:STANDARDIZE SCREENING AND DATA COLLECTION/TRACKING MECHANISM FOR MENTAL HEALTH ACROSS HEALTHCAREWORK WITH PCPS/MEDICAL CARE PROVIDERS TO INTEGRATE BEHAVIORAL HEALTH SERVICESCREATE REGIONAL BEST PRACTICE FOR ADDRESSING BEHAVIORAL HEALTH ALONGSIDE MEDICAL CARE CONSIDER TRAUMA INFORMED CARE TRAINING FOR HEALTH CARE PROVIDERSINTEGRATE BEHAVIORAL HEALTH SERVICES</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, SECTION B, LINE 11: (CONTINUED)</FormAndLineReferenceDesc>
        <ExplanationTxt>STRATEGIC INITIATIVES:PROGRAM: SMOKING CESSATION PROGRAM (LIVING SMOKE FREE)THE SMOKING CESSATION PROGRAM PROVIDES SUPPORT ON TOBACCO-RELATED HEALTH ISSUES, TRIGGERS, AND WELL-BEING. IT MEETS WEEKLY FOR FIVE WEEKS IN A GROUP SETTING PROVIDING COUNSELING AND SUPPORT TO PATIENTS, TO HELP THEM QUIT SMOKING.OUTCOMES:INCREASE NUMBER OF PARTICIPANTS REPORTING REDUCTION IN NICOTINE USEPARTNERS &amp; RESOURCES:PREMIER HEALTH PHYSICIAN NETWORK, COMMUNITY HEALTH CENTERS, COMMUNITY BASED ORGANIZATIONSPROGRAM: SUBSTANCE USE NAVIGATORSPREMIER HEALTH'S SUBSTANCE USE NAVIGATOR (SUN) PROGRAM ASSISTS EMERGENCY DEPARTMENT PATIENTS WITH SUBSTANCE USE ASSESSMENTS AND CONNECTS THEM TO TREATMENT AND SUPPORT SERVICES BY USING NAVIGATORS EXPERIENCED IN SUBSTANCE USE DISORDER, NURSING, OR SOCIAL WORK.OUTCOMES:INCREASE NUMBER OF PATIENTS SERVEDIMPROVED CONNECTIONS TO ONGOING TREATMENTPARTNERS &amp; RESOURCES:AREA TREATMENT PROGRAMS, SBHI, TRI COUNTY MENTAL HEALTH BOARD, COUNTY PUBLIC HEALTHREGIONAL PRIORITY #3WELL-BEING AND QUALITY OF LIFE ENCOURAGE HEALTHY BEHAVIORS &amp; EDUCATE ON A HEALTHY LIFESTYLETHERE IS AN OPPORTUNITY TO PROACTIVELY SUPPORT AND ENCOURAGE THE WELLBEING OF THOSE WHO LIVE IN THE GREATER DAYTON AREA. WELLBEING (OR LACK THEREOF) IS VIEWED AS AN UNDERLYING DRIVER OF HEALTH CHOICES AND OUTCOMES. A SHARED FOCUS ON THIS PRIORITY AREA CAN ENCOURAGE INDIVIDUALS TO ADOPT HEALTHIER LIFESTYLES, LEADING TO LONG-TERM IMPROVEMENTS IN PHYSICAL AND MENTAL WELL-BEING.WELL-BEING AND QUALITY OF LIFE (3A):ENCOURAGE HEALTHY BEHAVIORS &amp; EDUCATE ON A HEALTHY LIFESTYLEENCOURAGING HEALTHY BEHAVIORS AND EDUCATING INDIVIDUALS ABOUT A HEALTHY LIFESTYLE IS KEY TO IMPROVING OVERALL PUBLIC HEALTH, PREVENTING CHRONIC DISEASES AND PROMOTING LONG-TERM WELL-BEING. THE STRATEGY INVOLVES A MULTI-PRONGED APPROACH THAT NOT ONLY PROVIDES INFORMATION BUT ALSO CREATES ENVIRONMENTS AND SYSTEMS THAT SUPPORT HEALTHY CHOICES.OUTCOMES:INCREASING HEALTH LITERACY IN RELATION TO HEALTHY BEHAVIORS / MAKING INFORMED DECISIONS ABOUT LIFESTYLE CHOICESIMPROVE A1CS AND METABOLIC PANEL VALUES DECREASE BMI OVER ALL PATIENTSACTION ITEMS:FOCUS ON YOUTH EDUCATION ON HEALTHY BEHAVIORS AND LIFESTYLES PROMOTE EXERCISE, FOOD CHOICES, SELF-CARE, MINDFULNESS, YOUTH ACTIVITIES/SPORTS, ETC. CONSIDER SCHOOL-BASED PARTNERSHIPS TO EDUCATE YOUTHSTRATEGIC INITIATIVES:PROGRAM: COMMUNITY BENEFITS GRANT PROGRAMPREMIER HEALTH'S GRANT PROGRAM SUPPORTS COMMUNITY HEALTH IMPROVEMENT AND SAFETY BY ADDRESSING ACCESS TO HEALTH SERVICES, SOCIAL DETERMINANTS, AND HEALTH DISPARITIES. GRANTS RANGE FROM $500 TO $8,000 AND PRIORITIZE PROJECTS THAT ALIGN WITH PREMIER HEALTH'S GOALS AND INVOLVE COMMUNITY ENGAGEMENT.GRANTS RANGE FROM $500 TO $8,000.FOCUS AREAS INCLUDE BEHAVIORAL HEALTH, CHRONIC DISEASE, AND HEALTH EQUITY. EMPHASIZES COMMUNITY INVOLVEMENT AND DATA-DRIVEN, EVIDENCE-BASED SOLUTIONS.OUTCOMES:IMPROVE HEALTH SERVICES, PUBLIC HEALTH, AND KNOWLEDGE.ADDRESS ROOT CAUSES LIKE POVERTY AND HOMELESSNESSPARTNERS &amp; RESOURCES:AREA NONPROFIT COMMUNITY-BASED ORGANIZATIONS</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, SECTION B, LINES 16 A, B, AND C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE DIRECT WEBSITE ADDRESS WHERE A COPY OF THE FINANCIAL ASSISTANCE POLICY, THE APPLICATION, AND A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY CAN BE ACCESSED IS:HTTPS://WWW.PREMIERHEALTH.COM/PATIENT-AND-VISITOR-GUIDE/PATIENT-GUIDE/COSTS-AND-INSURANCE/BILLING/FINANCIAL-ASSISTANCE</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, SECTION B, LINE 16J:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HOSPITAL WIDELY DISTRIBUTES INFORMATION ABOUT ITS FINANCIAL ASSISTANCE POLICY WITHIN THE AREA THAT IT SERVES. THIS INFORMATION INCLUDES THE METHOD OF APPLYING FOR AND ACCESSING FINANCIAL ASSISTANCE. NOTICES ARE PUBLICIZED IN PATIENTS' BILLS AND ARE POSTED IN THE EMERGENCY ROOM, ADMITTING AND REGISTRATION AREAS, AS WELL AS OTHER PUBLIC AREAS. THE FINANCIAL ASSISTANCE POLICY IS PUBLISHED ON THE HOSPITAL'S WEBSITE. FINANCIAL COUNSELORS, PATIENT ADVOCATES, AND CUSTOMER SERVICE REPRESENTATIVES DISCUSS THE FINANCIAL ASSISTANCE POLICY WITH ALL UNINSURED PATIENTS, AND ANY PATIENT WHO EXPRESSES FINANCIAL HARDSHIP WITH PAYING THEIR BILL. APPLICATIONS FOR FINANCIAL ASSISTANCE POLICY ARE AVAILABLE IN BOTH ENGLISH AND SPANISH.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>10</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>1 - ATRIUM HEALTH CENTER TRENTON</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>3590 BUSENBARK RD</AddressLine1Txt>
            <CityNm>TRENTON</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45067</ZIPCd>
          </USAddress>
          <FacilityTxt>CARIDIOLOGY, VASCULAR, SPORTS MED &amp; PHYSICAL THERAPY, DIAGNOSTICS &amp; IMAGING</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>2 - MEDICAL IMAGING IN MIDDLETOWN</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4214 GRAND AVE</AddressLine1Txt>
            <CityNm>MIDDLETOWN</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45044</ZIPCd>
          </USAddress>
          <FacilityTxt>IMAGING AND RADIOLOGY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>3 - RALPH J STOLLE COUNTRYSIDE YMCA</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1697 DEERFIELD RD</AddressLine1Txt>
            <CityNm>LEBANON</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45036</ZIPCd>
          </USAddress>
          <FacilityTxt>SPORTS MEDICINE &amp; PHYSICAL THERAPY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>4 - SPORTS MEDICINE AND PHYSICAL THERAPY IN</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4859 NIXON PARK DR SUITE B</AddressLine1Txt>
            <CityNm>MASON</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45040</ZIPCd>
          </USAddress>
          <FacilityTxt>SPORTS MEDICINE &amp; PHYSICAL THERAPY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>5 - ATRIUM FAMILY YMCA</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>5750 INNOVATION DR</AddressLine1Txt>
            <CityNm>MIDDLETOWN</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45005</ZIPCd>
          </USAddress>
          <FacilityTxt>SPORTS MEDICINE &amp; PHYSICAL THERAPY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>6 - SPORTS MEDICINE AND PHYSICAL THERAPY IN</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>909 E SECOND ST</AddressLine1Txt>
            <CityNm>FRANKLIN</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45005</ZIPCd>
          </USAddress>
          <FacilityTxt>SPORTS MEDICINE &amp; PHYSICAL THERAPY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>7 - PHYSICAL THERAPY IN MIDDLETOWN</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>275 N BREIEL BLVD</AddressLine1Txt>
            <CityNm>MIDDLETOWN</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45042</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICAL THERAPY &amp; SPORTS MEDICINE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>8 - SOUTHWEST OHIO SURGERY CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>295 N BREIEL BLVD</AddressLine1Txt>
            <CityNm>MIDDLETOWN</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45042</ZIPCd>
          </USAddress>
          <FacilityTxt>GENERAL SURGERY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>9 - UNION VILLAGE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>580 N ST ROUTE 741</AddressLine1Txt>
            <CityNm>LEBANON</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45036</ZIPCd>
          </USAddress>
          <FacilityTxt>DIAGNOSTICS, IMAGING, HEALTH CENTER, AND OCCUPATIONAL HEALTH</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>10 - SLEEP SERVICES IN CENTERVILLE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>7056 CORPORATE WAY</AddressLine1Txt>
            <CityNm>CENTERVILLE</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45459</ZIPCd>
          </USAddress>
          <FacilityTxt>SLEEP SERVICES</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3C:</FormAndLineReferenceDesc>
        <ExplanationTxt>FINANCIAL ASSISTANCE IS ONLY PROVIDED FOR CARE THAT IS DEEMED EMERGENCY CARE OR MEDICALLY NECESSARY CARE AND AFTER PATIENTS HAVE BEEN FOUND TO MEET ESTABLISHED FINANCIAL CRITERIA OUTLINED IN THE FINANCIAL ASSISTANCE POLICY. PREMIER HEALTH HOSPITALS OFFER BOTH FREE CARE AND DISCOUNTED CARE, DEPENDING ON AN INDIVIDUAL'S FAMILY SIZE AND INCOME AS A PERCENT OF THE FEDERAL POVERTY GUIDELINES. ADDITIONALLY, PREMIER HEALTH HOSPITALS MAY USE A FAMILY'S ASSETS TO DETERMINE WHETHER A PATIENT MEETS THE ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE. PATIENTS RECEIVING A DISCOUNT ARE EXPECTED TO PAY THEIR REMAINING BALANCE, AND MAY WORK WITH PREMIER HEALTH HOSPITALS' FINANCIAL COUNSELORS TO SET UP A PAYMENT PLAN BASED ON THEIR FINANCIAL SITUATION.IN ADDITION TO COMPLETING THE APPLICATION, INDIVIDUALS SHOULD BE PREPARED TO SUPPLY THE FOLLOWING DOCUMENTATION:A) PROOF OF INCOME FOR APPLICANT (AND SPOUSE IF APPLICABLE) SUCH AS A PAY STUB, UNEMPLOYMENT INSURANCE PAYMENT STUBS, OR SUFFICIENT INFORMATION ON HOW PATIENTS ARE CURRENTLY FINANCIALLY SUPPORTING THEMSELVES.B) BANK STATEMENTC) SOCIAL SECURITY STATEMENTD) TAX RETURN - SCHEDULE C FOR SELF-EMPLOYMENT INCOMEE) DOCUMENTATION OF THE FAMILY'S ASSETS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 6A:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMMUNITY BENEFIT REPORT FOR ATRIUM MEDICAL CENTER IS PART OF THE PREMIER HEALTH (PREMIER) REPORT (EIN# 31-1446699).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>A COST TO CHARGE RATIO WAS USED TO CALCULATE THIS FINANCIAL ASSISTANCE AT COST. THIS CALCULATION TAKES TOTAL OPERATING EXPENSES LESS OTHER OPERATING REVENUES DIVIDED BY TOTAL GROSS REVENUES. UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENTAL PROGRAMS WERE CALCULATED USING A COST ACCOUNTING SYSTEM. THIS SYSTEM ADDRESSES ALL PATIENT SEGMENTS AND INCLUDES FULLY LOADED COSTS. FOR THE REMAINING ITEMS, THE ORGANIZATION USED SPECIFIC NUMBERS FOR EXPENSE PAID DIRECTLY FOR THESE SERVICES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7G:</FormAndLineReferenceDesc>
        <ExplanationTxt>ATRIUM MEDICAL CENTER (AMC) PROVIDES SUBSIDIZED EMERGENCY SERVICES BY OPERATING A 24-HOUR EMERGENCY ROOM 365 DAYS PER YEAR. THIS EMERGENCY ROOM IS OPEN TO ALL INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL INCURS EXPENSES RELATED TO ON CALL TIME AND PHYSICIAN SUBSIDIES DUE TO THE LARGE NUMBER OF INDIGENT PATIENTS COMING THROUGH THE EMERGENCY ROOM. FOR 2024, THE AMOUNT PAID FOR ON CALL AND SUBSIDIES WAS $12,072,000.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINES 2 &amp; 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT EXPENSE IS INCURRED WHEN AN ACCOUNT IS TAKEN OUT OF ACCOUNTS RECEIVABLE AND TURNED OVER TO A COLLECTION AGENCY. THIS ACTION MAY OCCUR IF A PATIENT REFUSES PAYMENT ARRANGEMENTS, REFUSES TO APPLY FOR FINANCIAL ASSISTANCE, AND THERE IS NOT AN INSURANCE BALANCE BEING CONTENDED. AN ACCOUNT IS WRITTEN OFF TO BAD DEBT AFTER 130 DAYS IF AN ATTEMPT TO COLLECT FROM THE PATIENT IS MADE WITHIN OUR COLLECTION POLICY. THE COLLECTION AGENCY ATTEMPTS TO COLLECT THE ACCOUNT IN ACCORDANCE WITH ESTABLISHED GUIDELINES. COLLECTION ATTEMPTS ARE CEASED AND THE ACCOUNT RETURNED TO THE ORGANIZATION IF THE PATIENT APPLIES FOR FINANCIAL ASSISTANCE. ANY AMOUNTS COLLECTED FROM THESE ACCOUNTS ARE CREDITED BACK AGAINST BAD DEBT EXPENSE. THE ORGANIZATION RECOGNIZES THERE ARE ACCOUNTS WRITTEN OFF TO BAD DEBT THAT MAY HAVE QUALIFIED FOR CHARITY CARE IF THE PATIENT HAD PROVIDED THE NECESSARY FINANCIAL INFORMATION. TO RESOLVE THIS, THE ORGANIZATION HAS ENGAGED A THIRD-PARTY VENDOR TO ANALYZE DATA BASED ON CREDIT SCORES TO REALLOCATE SOME OF THIS EXPENSE TO CHARITY CARE. A REPRESENTATIVE SAMPLE OF THESE ACCOUNTS IS THEN SENT TO OUR THIRD-PARTY VENDOR WHO GATHERS EXTERNAL CREDIT DATA THAT PRESENTS THE ACCOUNT AS LESS THAN 100% FEDERAL POVERTY LEVEL OR NOT ENOUGH INFORMATION (TYPICALLY INDICATIVE OF INDIGENT). THESE ACCOUNTS ARE RECLASSED FROM BAD DEBT EXPENSE TO CHARITY EXPENSE ON OUR INCOME STATEMENT. ANY CREDIT SCORE THAT PRESENTS THE ACCOUNTS AS GREATER THAN 100% FEDERAL POVERTY LEVEL REMAINS IN BAD DEBT EXPENSE. DUE TO THIS PROCESS, THE ORGANIZATION HAS USED BEST EFFORTS TO NOT REPORT BAD DEBT EXPENSE FOR PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION DOES NOT HAVE A FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS WHICH DISCUSSES THIS CALCULATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, SECTION B, LINES 5, 6, AND 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AMOUNTS REPORTED ON LINES 5, 6, AND 7 DO NOT INCLUDE CERTAIN MEDICARE PROGRAM REVENUES AND COSTS, AND THUS DO NOT REFLECT ALL OF THE ORGANIZATION'S REVENUES AND COSTS ASSOCIATED WITH ITS PARTICIPATION IN MEDICARE PROGRAMS. IN ADDITION TO THE AMOUNTS REPORTED ON LINE 5, 6, AND 7, THE ORGANIZATION RECEIVED REVENUE OF $68,877,000 AND INCURRED COST OF $88,473,000 FOR AN ADDITIONAL NET SHORTFALL OF $19,596,000 ASSOCIATED WITH THESE PROGRAMS. BELOW IS A RECONCILIATION OF THE AMOUNTS ASSOCIATED WITH MEDICARE PROGRAMS.ALLOWABLE MEDICARE REVENUE PER MEDICARE COST REPORT IN PART III, SECTION B $41,642,000MEDICARE REVENUE NOT REPORTED IN PART III, SECTION B $68,877,000TOTAL MEDICARE ASSOCIATED REVENUE $110,519,000ALLOWABLE MEDICARE COST PER MEDICARE COST REPORT IN PART III, SECTION B $44,461,000MEDICARE COST NOT REPORTED IN PART III, SECTION B $88,473,000TOTAL MEDICARE ASSOCIATED COST $132,934,000ALLOWABLE MEDICARE SHORTFALL IN PART III, SECTION B $2,819,000ADDITIONAL SHORTFALL NOT INCLUDED IN PART III, SECTION B $19,596,000TOTAL MEDICARE SHORTFALL $22,415,000</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S SHORTFALL SHOULD BE CONSIDERED CHARITY CARE BECAUSE IT IS PROVIDING HIGH-QUALITY CARE, IN EXCESS OF COST, TO OUR COMMUNITY RESIDENTS THAT NEED CARE. THE MEDICARE POPULATION AT THE ORGANIZATION IS IN EXCESS OF 53% OF NET PATIENT REVENUE. THE ORGANIZATION USED A COST ACCOUNTING SYSTEM TO CALCULATE THE MEDICARE ALLOWABLE COSTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 9B:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES REASONABLE EFFORTS TO DETERMINE WHETHER OR NOT AN INDIVIDUAL IS ELIGIBLE FOR ASSISTANCE UNDER THE STATE OR HOSPITAL FINANCIAL ASSISTANCE POLICY BEFORE ENGAGING IN EXTRAORDINARY COLLECTIVE ACTIONS AGAINST THAT INDIVIDUAL. PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ARE OFFERED REASONABLE PAYMENT PLAN ARRANGEMENTS FOR ANY REMAINING BALANCES. ANY THIRD-PARTY COLLECTING SELF-PAY RECEIVABLES ON OUR BEHALF IS REQUIRED TO MAKE REASONABLE EFFORTS TO DETERMINE IF THE INDIVIDUAL MEETS THE QUALIFICATIONS OF THE STATE OR OF OUR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS.REASONABLE EFFORTS INCLUDE:A. VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENT HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL.B. DOCUMENTING THAT THE ORGANIZATION HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE UNDER ITS FINANCIALASSISTANCE POLICY.C. DOCUMENT THAT THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE.D. DOCUMENT THAT THE PATIENT HAS BEEN OFFERED AND ACCEPTED TERMS FOR A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN.THE FINANCIAL COUNSELORS MEET WITH INPATIENT, OUTPATIENT, SELF-PAY, AND OTHER PATIENTS UPON REQUEST WHO MAY NEED FINANCIAL ASSISTANCE. IN ADDITION TO ASSISTING PATIENTS WHO WANT TO APPLY FOR ASSISTANCE THROUGH THE MEDICAID PROGRAM, THE FINANCIAL COUNSELOR WILL PROVIDE THE PATIENT WITH A FINANCIAL ASSISTANCE APPLICATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION WORKS WITH THE COMMUNITY ON PROGRAMS THAT ADDRESS THE UNDERLYING CAUSES OF PERSISTENT HEALTH PROBLEMS AS PART OF A COMPREHENSIVE STRATEGY TO IMPROVE THE HEALTH STATUS AND QUALITY OF LIFE FOR IDENTIFIED MEMBERS OF THE COMMUNITY WHO ARE ECONOMICALLY DISADVANTAGED, DISENFRANCHISED AND/OR WHO HAVE DISPROPORTIONATE UNMET HEALTH NEEDS. THE ORGANIZATION STRIVES TO WORK WITH PREMIER, THE HOSPITAL BOARD OF TRUSTEES, EXECUTIVE MANAGEMENT, MANAGERS, STAFF MEMBERS, COMMUNITY GROUPS, AND INDIVIDUALS TO PROVIDE A COLLABORATIVE APPROACH TO THE GOVERNANCE AND MANAGEMENT OF COMMUNITY BENEFIT ACTIVITIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE ARE SEVERAL WAYS IN WHICH OUR ORGANIZATION INFORMS AND EDUCATES PATIENTS WHO MAY BE BILLED FOR SERVICES ABOUT ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS, OR UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. FIRST, NOTIFICATION OF SUCH AVAILABLE ASSISTANCE IS CLEARLY POSTED IN REGISTRATION AREAS, AS WELL AS MATERNITY AND EMERGENCY DEPARTMENTS. NEXT, PATIENT ADVOCATES, PATIENT ACCESS STAFF MEMBERS, AND FINANCIAL COUNSELORS IN THE INPATIENT AND EMERGENCY DEPARTMENTS MEET WITH UNINSURED AND UNDERINSURED PATIENTS, AND THOSE WITH ONLY MEDICARE COVERAGE TO DISCUSS ELIGIBILITY FOR ASSISTANCE. FINANCIAL COUNSELORS ALSO DISCUSS OPTIONS TO RESOLVE UNPAID ACCOUNT BALANCES WITH UNINSURED AND UNDERINSURED PATIENTS. THE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE HOSPITAL'S WEBSITE, ALONG WITH INFORMATION ON HOW TO OBTAIN AN APPLICATION. WHEN A PATIENT RECEIVES A BILL, THE REVERSE SIDE OF THE BILL CONTAINS INFORMATION ABOUT THE STATE OF OHIO FREE CARE PROGRAM (CARE ASSURANCE) AND A FINANCIAL ASSISTANCE APPLICATION. THE BILLING STATEMENTS OFFER THE FINANCIAL ASSISTANCE OPTIONS AVAILABLE, AND THE CONTACT INFORMATION FOR ASSISTANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>ATRIUM MEDICAL CENTER IS LOCATED IN MIDDLETOWN OHIO, SERVICING BUTLER AND WARREN COUNTIES. THE POPULATION OF ATRIUM MEDICAL CENTER'S SERVICE AREA IS APPROXIMATELY 656,000 PEOPLE. THE MEDIAN HOUSEHOLD INCOME OF WARREN COUNTY IS $107,843 PER YEAR, WITH APPROXIMATELY 5.9% OF ITS CITIZENS LIVING BELOW THE FEDERAL POVERTY LEVEL. THE MEDIAN HOUSEHOLD INCOME OF BUTLER COUNTY IS $81,194 PER YEAR, WITH APPROXIMATELY 11.9% OF ITS CITIZENS LIVING BELOW THE FEDERAL POVERTY LEVEL. FOR 2024, MEDICARE PATIENTS REPRESENTED 53.2% OF GROSS PATIENT REVENUE AND MEDICAID REPRESENTED 16.3% OF GROSS PATIENT REVENUE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>ATRIUM MEDICAL CENTER'S (AMC) MOST VISIBLE CONTRIBUTION TO THE COMMUNITY IS IN THE FORM OF PROVIDING HIGH-QUALITY INPATIENT AND OUTPATIENT CARE TO OUR PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. OUR MISSION INCLUDES CONTINUALLY STRIVING TO ENRICH THE COMMUNITY BY TRAINING AND EDUCATING FUTURE HEALTHCARE WORKERS, OFFERING HEALTH AWARENESS AND EDUCATION TO THE COMMUNITY, SUCH AS PROMOTION OF BREAST CANCER SCREENINGS, WOMEN AND INFANT HEALTH, DIABETIC WELLNESS AND DRIVER SAFETY AWARENESS FOR HIGH-SCHOOL STUDENTS. AMC PARTNERS WITH THE LOCAL YMCA TO CO-HOST A FREE, PUBLIC ANNUAL DIABETES WELLNESS FAIR. ORGANIZATIONS SPECIALIZING IN DIABETIC CARE AND HOSPITAL REPRESENTATIVES ARE ON HAND TO OFFER HEALTH SCREENINGS AND DISCUSS AVAILABLE SERVICES. FREE DIAPERS, BOTTLES, WIPES AND OTHER ESSENTIAL SUPPLIES ARE PROVIDED TO LOCAL PARENTS IN NEED THROUGH A COLLABORATION WITH ANOTHER LOCAL NON-PROFIT ORGANIZATION. THE HOSPITAL ALSO PROVIDES RELEVANT EDUCATION FOR EMS AND PRE-HOSPITAL CARE PROVIDERS THROUGHOUT THE REGION. THE TRAINING INCLUDES LOCAL CASE REVIEWS, LECTURES, HANDS-ON SIMULATION AND PANEL DISCUSSIONS PERTAINING TO THE EDUCATION ON USE OF TOOLS, PRIORITIES OF PATIENT CARE AND OTHER CRITICAL INFORMATION. AMC PARTNERS WITH MANY OF THE LOCAL SCHOOLS TO PROVIDE CERTIFIED AND LICENSED ATHLETIC TRAINERS AT THEIR CAMPUSES TO AID IN INJURY PREVENTION, RECOGNITION AND TREATMENT OF SPORTS-RELATED INJURIES. THE HOSPITAL ALSO SUPPORTS THE COMMUNITY THROUGH SPONSORSHIPS AND PARTICIPATION IN LOCAL FUNDRAISING EVENTS THAT PROMOTE HEALTHY LIFESTYLE CHOICES, PREVENTATIVE CARE, CHRONIC DISEASE MANAGEMENT AND GENERAL HEALTH EDUCATION. WITHIN THE HOSPITAL, INTERPRETERS ARE OFFERED TO PATIENTS AT NO COST AS A RESULT OF INCREASED VOLUMES OF NON-ENGLISH-SPEAKING PATIENTS. AMC PROVIDES DIRECT PASTORAL SUPPORT AND COUNSELING SERVICES TO PATIENTS AND FAMILY MEMBERS BY 4 TRAINED PROFESSIONALS, IN-HOUSE 13 HOURS A DAY MONDAY THROUGH FRIDAY, AND ON CALL OUTSIDE THOSE HOURS.THE HOSPITAL HAS AN OPEN MEDICAL STAFF, PARTICIPATES IN MEDICAID AND MEDICARE, AND HAS AN ACTIVE CHARITY CARE PROGRAM. AMC'S MISSION REFLECTS A COMMITMENT TO PROVIDE HIGH-QUALITY COST-EFFECTIVE HEALTH SERVICES TO THE DIVERSE COMMUNITIES THAT IT SERVES. AT THE CORE OF THE COMMITMENT IS THE BELIEF THAT IN ORDER TO MEET OUR PATIENTS' EXPECTATIONS AND TO IMPROVE TREATMENT OUTCOMES, IT IS NECESSARY FOR US TO UNDERSTAND THE PATIENT'S FRAME OF REFERENCE. A DIVERSE WORKFORCE ALLOWS US TO DRAW UPON THE RICHNESS OF OUR HUMAN RESOURCES, CREATE A POSITIVE WORK ENVIRONMENT, AND MEET THE EXPECTATIONS OF THOSE WE SERVE. AMC'S COMMITMENT TO DIVERSITY IS ACCOMPLISHED BY:* TAKING A LEADERSHIP ROLE IN CREATING AND SUSTAINING AN ORGANIZATIONAL ENVIRONMENT THAT ACTIVELY SUPPORTS DIVERSITY,* POSITIONING DIVERSITY AS A LONG-TERM COMPREHENSIVE ORGANIZATIONAL STRATEGY,* ESTABLISHING AND SUPPORTING RELATIONSHIPS WITH MINORITY AND DIVERSITY FOCUSED ORGANIZATIONS AND* PROVIDING EMPLOYMENT AND EDUCATION OPPORTUNITIES FOR INDIVIDUALS WITH SIGNIFICANT DISABILITIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>PREMIER HEALTH (PREMIER) IS THE SOLE MEMBER OF ATRIUM MEDICAL CENTER, TWO OTHER HOSPITAL ENTITIES (FIVE TOTAL LOCATIONS), AND SEVERAL OTHER HEALTH CARE SERVICE SUBSIDIARIES. PREMIER HAS THE AUTHORITY TO OPERATE EACH HOSPITAL WITH RESPECT TO MATTERS SUCH AS BUDGETING, STRATEGIC PLANNING, MANAGED CARE CONTRACTING, EMPLOYEE COMPENSATION, TRANSFER/SALE OF MATERIAL ASSETS, ETC. AS AN INTEGRATED HEALTHCARE SYSTEM, PREMIER PROVIDES A CONTINUUM OF CARE FOR THE RESIDENTS OF SOUTHWEST OHIO. AS A SYSTEM, PREMIER IS A COMMUNITY LEADER IN SUPPORTING VARIOUS COMMUNITY BENEFIT PROGRAMS THAT ALIGN WITH ITS CURRENT CHNA. RESOURCES ARE LEVERAGED IN EACH ENTITY WITHIN THE PREMIER SYSTEM TO SUPPORT THESE PROGRAMS IDENTIFIED AT THE PREMIER SYSTEM LEVEL. THE POLICIES FOR BAD DEBT AND CHARITY COLLECTIONS ARE ESTABLISHED BY PREMIER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>OHIO</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MIAMI VALLEY HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <RecipientEIN>310537504</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>112964</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>PREMIER COMMUNITY HEALTH</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <RecipientEIN>311122883</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>58711</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>REACH OUT MONTGOMERY COUNTY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>25 E FORAKER ST</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45409</ZIPCd>
        </USAddress>
        <RecipientEIN>311434282</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>18375</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MIAMI VALLEY HOSPITAL FOUNDATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <RecipientEIN>311040231</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>8995</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UVMC FOUNDATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <RecipientEIN>311581859</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>5810</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>5</Total501c3OrgCnt>
      <TotalOtherOrgCnt>0</TotalOtherOrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>1) DISBURSEMENTS ARE ANALYZED MONTHLY THROUGH VARIOUS REPORTS AND COMMITTEE MEETINGS. 2) INVOICES ARE RECEIVED IN ACCOUNTS PAYABLE AND APPROVED AND DISBURSED PER ORGANIZATIONAL POLICY. 3) GRANT SPENDING IS MONITORED AGAINST BUDGETED AMOUNTS ON AN ONGOING BASIS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <SeverancePaymentInd>1</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHAEL C RIORDAN</PersonNm>
        <TitleTxt>TRUSTEE / PREMIER CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>1375311</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>25000</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>143089</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>10954</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>25395</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1579749</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KEITH D BRICKING MD</PersonNm>
        <TitleTxt>EVP &amp; CHIEF CLINICAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>705465</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>437442</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>25585</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>32340</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>35135</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1235967</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KEVIN W HARLAN</PersonNm>
        <TitleTxt>PRESIDENT &amp; CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>514770</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>240926</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>79074</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>11274</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>9673</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>855717</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARY M CLANCY</PersonNm>
        <TitleTxt>CHIEF DIGITAL &amp; INFORMATION OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>488227</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>228389</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>13579</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>24309</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>34553</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>789057</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GEOFFREY P WALKER</PersonNm>
        <TitleTxt>FORMER KEY EMPLOYEE</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>301836</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>233995</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>203676</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>20971</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>13541</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>774019</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOSHUA J ORDWAY MD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>530661</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>165473</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>1556</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>13668</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>24597</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>735955</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ELAINE LAINIE M DEAN</PersonNm>
        <TitleTxt>FORMER KEY EMPLOYEE</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>299150</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>206389</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>153441</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>31363</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>12390</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>702733</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>J MICHAEL SIMS</PersonNm>
        <TitleTxt>SYS VP &amp; CORPORATE CONTROLLER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>407084</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>165482</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>62858</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>23409</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>27587</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>686420</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LISA M GOSSETT</PersonNm>
        <TitleTxt>VP NURSING/CNO/PATIENT EXP-PH</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>417540</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>192965</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>4128</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>20707</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>15618</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>650958</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SCOTT B KANAGY DO</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <BaseCompensationFilingOrgAmt>419532</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>166402</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>2216</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>32389</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>23754</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>644293</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CARA W POWERS</PersonNm>
        <TitleTxt>CHIEF LEGAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>447726</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>138596</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>2388</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>24120</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>27702</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>640532</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARQUITA L TURNER</PersonNm>
        <TitleTxt>FORMER TRUSTEE &amp; OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>413523</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>149219</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>4040</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>29142</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>12767</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>608691</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KIMBERLY A HENSLEY</PersonNm>
        <TitleTxt>TRUSTEE &amp; COO &amp; CNO</TitleTxt>
        <BaseCompensationFilingOrgAmt>322717</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>128167</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>31881</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>19434</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>9436</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>511635</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JON D GIRARD MD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>348983</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>116182</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>1186</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>17002</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>24166</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>507519</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>AMANDA K ADKINS-RICCI</PersonNm>
        <TitleTxt>SYSTEM VP REVENUE CYCLE</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>281216</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>111699</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>616</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>16317</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>9249</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>419097</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BILLIE L LUCENTE-BAKER</PersonNm>
        <TitleTxt>FORMER KEY EMPLOYEE</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>256251</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>113026</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>1549</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>22822</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>13419</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>407067</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARC R BELCASTRO DO</PersonNm>
        <TitleTxt>FORMER KEY EMPLOYEE</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>361466</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>11044</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>372510</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MANDI L ARNETT</PersonNm>
        <TitleTxt>ASSOCIATE CNO - AMC</TitleTxt>
        <BaseCompensationFilingOrgAmt>172476</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>50195</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>619</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6110</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18772</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>248172</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>WILLIAM ANDREW MD</PersonNm>
        <TitleTxt>TRUSTEE &amp; CHIEF OF STAFF</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>247817</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>247817</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>WENDY H PARKS</PersonNm>
        <TitleTxt>DIR - MARKETING</TitleTxt>
        <BaseCompensationFilingOrgAmt>177664</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>52625</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>840</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12700</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>2177</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>246006</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JACOB L FROEHLICH</PersonNm>
        <TitleTxt>DIRECTOR - SURGICAL SERVICES</TitleTxt>
        <BaseCompensationFilingOrgAmt>161915</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>50195</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>449</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7586</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>23158</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>243303</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GARY G GINTER</PersonNm>
        <TitleTxt>FORMER KEY EMPLOYEE</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>232887</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>10065</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>242952</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ALLISON E WENTLAND WEST</PersonNm>
        <TitleTxt>DIR-PAT EXP AMC &amp; SYS INF CTRL</TitleTxt>
        <BaseCompensationFilingOrgAmt>155279</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>48063</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>848</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10220</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>23544</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>237954</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>INGRID E WAGGONER</PersonNm>
        <TitleTxt>DIRECTOR REHABILITATION-AMC</TitleTxt>
        <BaseCompensationFilingOrgAmt>170114</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>50195</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>2281</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12776</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>877</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>236243</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TONYA Y CASEY</PersonNm>
        <TitleTxt>BOARD TREASURER</TitleTxt>
        <BaseCompensationFilingOrgAmt>171375</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>44572</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>2994</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6830</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>8579</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>234350</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHANDLER BRODERICK ESQ</PersonNm>
        <TitleTxt>BOARD SECRETARY</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>156506</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>45293</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>270</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>5909</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>21968</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>229946</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LYNDSEY A PITTMAN</PersonNm>
        <TitleTxt>FORMER OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>164299</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>47978</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>774</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>7421</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>2948</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>223420</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION FOR ATRIUM MEDICAL CENTER'S (AMC) CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH AMC IS AN AFFILIATE. SEE EXPLANATION ON SCHEDULE O FOR FORM 990, PART VI, SECTION B, LINE 15.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4A:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE: MARC BELCASTRO, D.O. $324,324; ELAINE DEAN $131,034; GARY GINTER $219,618.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4B:</FormAndLineReferenceDesc>
        <ExplanationTxt>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, ATRIUM MEDICAL CENTER (AMC) AND ITS AFFILIATED ORGANIZATIONS COMPENSATE FOR THIS LIMITATION AND SUPPLEMENT THE AFFECTED EXECUTIVES' QUALIFIED PENSION THROUGH CERTAIN NONQUALIFIED PLANS. AMC SUPPLEMENTS THE AFFECTED EXECUTIVES THROUGH A PENSION RESTORATION PLAN OR 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 HAVE MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE PENSION RESTORATION PLAN RECEIVED THE ASSOCIATED PAYMENT IN 2024: MARY CLANCY $8,646; J. MICHAEL SIMS $56,017; GEOFFREY WALKER $194,485. THE INDIVIDUALS LISTED BELOW HAVE MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE SERP AND RECEIVED THE ASSOCIATED PLAN PAYMENT 2024: MARC BELCASTRO, M.D. $41,167; GARY GINTER $15,527; KEVIN HARLAN $47,900; KIMBERLY HENSLEY $27,156; MICHAEL RIORDAN $93,572. 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: KEITH BRICKING, M.D. $21,279; ELAINE DEAN $18,136; LISA GOSSETT $9,078; SCOTT KANAGY, M.D. $19,629; BILLIE LUCENTE-BAKER $711; CARA POWERS $7,753; MARQUITA TURNER $11,222. 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.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>COUNTY OF MONTGOMERY OHIO</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>316000172</BondIssuerEIN>
        <CUSIPNum>613520LO6</CUSIPNum>
        <BondIssuedDt>2019-09-24</BondIssuedDt>
        <IssuePriceAmt>83203105</IssuePriceAmt>
        <PurposeDesc>REFUND SERIES 2008 A &amp; B</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>CITY OF MIDDLETOWN OHIO</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>316000139</BondIssuerEIN>
        <CUSIPNum>597146AQ2</CUSIPNum>
        <BondIssuedDt>2025-05-15</BondIssuedDt>
        <IssuePriceAmt>79515000</IssuePriceAmt>
        <PurposeDesc>REFUND SERIES 2016A</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>1706770</RetiredAmt>
        <TotalProceedsAmt>83203105</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>766203</IssuanceCostsFromProceedsAmt>
        <OtherSpentProceedsAmt>82436902</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2019</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>1</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <TotalProceedsAmt>79515000</TotalProceedsAmt>
        <OtherSpentProceedsAmt>79515000</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2024</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>1</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>1</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>1</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>1</HedgeIdentifiedInBksAndRecInd>
        <HedgeProviderName>
          <BusinessNameLine1Txt>BARCLAYS PNC BANK</BusinessNameLine1Txt>
        </HedgeProviderName>
        <TermOfHedgePct>20.800000000000</TermOfHedgePct>
        <SuperintegratedHedgeInd>0</SuperintegratedHedgeInd>
        <HedgeTerminatedInd>0</HedgeTerminatedInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>NOTE A, PART I, LINE A, COLUMN E:</FormAndLineReferenceDesc>
        <ExplanationTxt>ISSUE PRICE IS NOT IDENTICAL TO THE ISSUE PRICE LISTED ON FORM 8038 DUE TO THE SERIES 2019 BONDS' PROCEEDS BEING SPLIT BETWEEN ATRIUM MEDICAL CENTER, MIAMI VALLEY HOSPITAL AND UPPER VALLEY MEDICAL CENTER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>NOTE A, PART I, LINE A, COLUMN F:</FormAndLineReferenceDesc>
        <ExplanationTxt>REFUNDED THE FOLLOWING SERIES BONDS: SERIES 2008A BONDS - ISSUE DATE 11/21/2008 SERIES 2008B BONDS - ISSUE DATE 11/21/2008</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>NOTE A PART IV, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPUTATION DATE IS 10/15/2024</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleM documentId="RetDoc1042900001">
      <ClothingAndHouseholdGoodsGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <NoncashContributionsRptF990Amt>5122</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
      </ClothingAndHouseholdGoodsGrp>
      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>MEDICAL EQUIP</Desc>
        <ContributionCnt>26</ContributionCnt>
        <NoncashContributionsRptF990Amt>515851</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>EMPLOYEE FOOD</Desc>
        <ContributionCnt>20</ContributionCnt>
        <NoncashContributionsRptF990Amt>84939</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
      <Form8283ReceivedCnt>0</Form8283ReceivedCnt>
      <AnyPropertyThatMustBeHeldInd>0</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>0</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>0</ThirdPartiesUsedInd>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>PREMIER HEALTH (PREMIER) AS THE OPERATOR OF ATRIUM MEDICAL CENTER (AMC) DEVELOPS AND OVERSEES THE IMPLEMENTATION OF THE STRATEGIC PLAN FOR AMC, WHICH INCLUDES (BUT IS NOT LIMITED TO) SUCH MATTERS AS LOCATION OF CLINICAL AND ADMINISTRATIVE EXPENSES AND THE CONSOLIDATION OF SUCH SERVICES. AMC SHALL COMPLY WITH AND IMPLEMENT THIS PLAN AND SHALL NOT TAKE ANY ACTION THAT MATERIALLY DEPARTS FROM THIS PLAN WITHOUT PREMIER'S APPROVAL. AMC SHALL IMPLEMENT ANY CAPITAL AND OPERATING BUDGET SO APPROVED AND/OR REVISED FOR IT BY PREMIER. AMC SHALL IMPLEMENT THE BUSINESS PLAN APPROVED BY PREMIER. PREMIER IS THE SOLE AGENT TO NEGOTIATE ALL RELATIONSHIPS WITH PAYORS ON BEHALF OF AMC WITH ALL THIRD-PARTY PAYORS AND ALTERNATIVE DELIVERY SYSTEMS INCLUDING, BUT NOT LIMITED TO, INSURERS. AMC 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. AMC MUST SEEK PREMIER'S APPROVAL FOR ANY ACQUISITIONS, SALE OR TRANSFER OF ANY MATERIAL ASSET USED IN AMC'S ACTIVITIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>ATRIUM MEDICAL CENTER HAS ONE CORPORATE MEMBER: PREMIER, AN OHIO NON-PROFIT CORPORATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>PREMIER HAS THE SOLE AUTHORITY TO ELECT THE BOARD OF TRUSTEES FOR ATRIUM MEDICAL CENTER (AMC). PREMIER HAS THE AUTHORITY TO REMOVE SUCH TRUSTEES AT ANY REGULAR OR SPECIAL MEETING OR BY WRITTEN CONSENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE EXPLANATION FOR LINE 7A.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THIS 990 FILING AND ATTACHED SCHEDULES (THE RETURN) ARE PREPARED BY A STAFF MEMBER IN THE TAX DEPARTMENT OF PREMIER, OF WHICH ATRIUM MEDICAL CENTER 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 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 QUESTIONS FROM THE BOARD OF TRUSTEES, PENDING THEIR REVIEW. THE 990 FILING IS ALSO SHARED WITH THE AUDIT COMMITTEE OF PREMIER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>PREMIER, WITH WHICH ATRIUM MEDICAL CENTER 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION FOR ATRIUM MEDICAL CENTER'S (AMC) CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH AMC 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 19,795,472. MANAGEMENT AND GENERAL EXPENSES 674,220. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,469,692. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 14,202,184. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,202,184. PURCHASED LABOR: PROGRAM SERVICE EXPENSES 10,191,259. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,191,259. CHI C/E DIRECT CHARGE: PROGRAM SERVICE EXPENSES 2,668,502. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,668,502. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 968,057. MANAGEMENT AND GENERAL EXPENSES 89,741. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,057,798. COLLECTION COSTS: PROGRAM SERVICE EXPENSES 871,778. MANAGEMENT AND GENERAL EXPENSES 42,074. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 913,852. PERSONNEL PHYSICALS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 169,598. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 169,598. COURIER SERVICE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 148,301. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 148,301. RESIDENTS: PROGRAM SERVICE EXPENSES 147,388. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 147,388. MEDICAL STAFF SUPPORT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 83,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 83,000. ADMINISTRATIVE EXPENSES: PROGRAM SERVICE EXPENSES 61,589. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 61,589. RECRUIT-PHYSICIAN: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 25,544. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 25,544. OTHER FEES: PROGRAM SERVICE EXPENSES 11,491. MANAGEMENT AND GENERAL EXPENSES 45. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,536.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>EQUITY TRANSFERS -61,125,375. FUNDING FROM AFFILIATES -475,586. PENSION ADJUSTMENT 10,012,840.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>311446699</EIN>
        <PrimaryActivitiesTxt>PARENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12B</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MEDAMERICA HEALTH SYSTEMS CO</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>311040228</EIN>
        <PrimaryActivitiesTxt>SUPPORT ORG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12B</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MIAMI VALLEY HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>310537504</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MIAMI VALLEY HOSPITAL FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>311040231</EIN>
        <PrimaryActivitiesTxt>FOUNDATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>FIDELITY HEALTH CARE INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>311075381</EIN>
        <PrimaryActivitiesTxt>HOME HEALTH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PREMIER COMMUNITY HEALTH</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>311122883</EIN>
        <PrimaryActivitiesTxt>HEALTH EDUCATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>FIDELITY HEALTH CARE</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>GOOD SAMARITAN FOUNDATION - DAYTON</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>237296923</EIN>
        <PrimaryActivitiesTxt>FOUNDATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ATRIUM HEALTH SYSTEM</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>310537492</EIN>
        <PrimaryActivitiesTxt>SUPPORT ORG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12B</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UVMC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>341850683</EIN>
        <PrimaryActivitiesTxt>SUPPORT ORG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12B</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UPPER VALLEY MEDICAL CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>310537095</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UPPER VALLEY PROFESSIONAL CORP</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>311400963</EIN>
        <PrimaryActivitiesTxt>HEALTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH HOLDING CO</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UVPC SPECIALISTS</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>203687536</EIN>
        <PrimaryActivitiesTxt>HEALTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH HOLDING CO</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UVMC NURSING CARE INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>311224064</EIN>
        <PrimaryActivitiesTxt>NURSING HOME</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COMPUNET CLINICAL LABORATORIES LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>311258010</EIN>
        <PrimaryActivitiesTxt>LAB</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12B</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SAMARITAN BEHAVIORAL HEALTH INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>020633634</EIN>
        <PrimaryActivitiesTxt>BEHAVIORAL HEALTH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SWEITZER STREET LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>454700417</EIN>
        <PrimaryActivitiesTxt>REAL ESTATE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MVHE INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>EXCLUDED</PredominantIncomeTypeTxt>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SWEITZER MOB LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>474554657</EIN>
        <PrimaryActivitiesTxt>REAL ESTATE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MVHE INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>EXCLUDED</PredominantIncomeTypeTxt>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MVHE INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>110 MAIN STREET SUITE 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>311185270</EIN>
        <PrimaryActivitiesTxt>PHYSICIAN SVCS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH HOLDING CO</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PREMIER HEALTH SPECIALISTS</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>061744704</EIN>
        <PrimaryActivitiesTxt>PHYSICIAN SVCS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH HOLDING CO</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SAMARITAN FAMILY CARE</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>311299450</EIN>
        <PrimaryActivitiesTxt>PHYSICIAN SVCS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH HOLDING CO</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>AFTER HOURS FAMILY CARE</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>311269483</EIN>
        <PrimaryActivitiesTxt>HEALTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>UPPER VALLEY PROFESSIONAL CORP</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>UVMC MANAGEMENT CORP</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>311360489</EIN>
        <PrimaryActivitiesTxt>MANAGEMENT COMPANY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PREMIER HEALTH URGENT CARE INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>822079409</EIN>
        <PrimaryActivitiesTxt>URGENT CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH HOLDING CO</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PREMIER HEALTH PLAN INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>463024049</EIN>
        <PrimaryActivitiesTxt>HEALTH INSURANCE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH INSURING CO</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>GOOD SAMARITAN HOSPITAL</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>310536981</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PREMIER HEALTH INT'L INSURANCE</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>BUTTERFIELD BANK BLDG 6TH FLR 65</AddressLine1Txt>
          <CityNm>HAMILTON</CityNm>
          <CountryCd>BD</CountryCd>
          <ForeignPostalCd>HM12</ForeignPostalCd>
        </ForeignAddress>
        <EIN>980548485</EIN>
        <PrimaryActivitiesTxt>INSURANCE</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>BD</LegalDomicileForeignCountryCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PREMIER HEALTH ACO OF OHIO</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>474049773</EIN>
        <PrimaryActivitiesTxt>MEDICARE ACO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PREMIER HEALTH HOLDING CO</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>812419110</EIN>
        <PrimaryActivitiesTxt>HOLDING CO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PREMIER HEALTH INSURING CO</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>110 N MAIN ST 200</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <EIN>464766841</EIN>
        <PrimaryActivitiesTxt>HEALTH INSURANCE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PREMIER HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>1</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>1</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>1</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>1</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>