2024-11-14T09:04:36-06:00 2023-12-31 990 2023-01-01 311122883 PREMIER COMMUNITY HEALTH PREM 9374999942 110 N MAIN ST 200 DAYTON OH 45402 J MICHAEL SIMS SYSTEM VP & CORP. CONTROLLER 9374999942 2024-11-14 1 2023 2024-10-15 13:58:12Z J NICK LAIR 3170 KETTERING BLVD MORAINE OH 45439 1298169 0 X WWW.PREMIERHEALTH.COM X 1984 OH SEE PART III, LINE 1 3 0 17 0 0 0 482870 645608 5331675 0 265703 -36936 4 0 6080252 608672 0 0 0 0 4749974 273263 0 0 0 2555441 137534 7305415 410797 -1225163 197875 3268556 1887006 6288218 4850892 -3019662 -2963886 X WE CARE. WE TEACH. WE INNOVATE. WE SERVE. 0 1 244405 0 0 PREMIER COMMUNITY HEALTH (PCH) OFFERS THE LARGEST PROGRAM WITH FREE BREAST AND CERVICAL CANCER SCREENINGS FOR LOW-INCOME, UNINSURED AND UNDERINSURED WOMEN IN THE GREATER DAYTON REGION. FUNDING COMES FROM THE CENTERS FOR DISEASE CONTROL THROUGH THE OHIO DEPARTMENT OF HEALTH BREAST AND CERVICAL CANCER PROJECT (BCCP), FOUNDATION GRANTS AND DONATIONS. IN 2023, THE PROGRAM COMPLETED 1080 BREAST SERVICES AND PROVIDED CASE MANAGEMENT SERVICES FOR 195 WOMEN WHO NEEDED FURTHER DIAGNOSTIC TESTING. 30 OF THESE WOMEN WERE DIAGNOSED WITH BREAST CANCER, AND WE ASSISTED WITH LINKING THESE WOMEN TO ADDITIONAL RESOURCES FOR TREATMENT. IN ADDITION, 297 WOMEN RECEIVED CERVICAL SERVICES DURING CALENDAR YEAR 2023 WITH 31 ABNORMAL FINDINGS FOR WHICH ADDITIONAL DIAGNOSTIC TESTING AND TREATMENT WAS PROVIDED AS NEEDED. 127200 0 0 PREMIER COMMUNITY HEALTH SERVES THE COMMUNITY BY PARTNERING WITH LOCAL ORGANIZATIONS SUCH AS CHURCHES, COMMUNITY CENTERS, SENIOR CENTERS, MUNICIPALITIES AND MORE. PCH OFFERS A VARIETY OF SERVICES THAT INCLUDE BIOMETRIC SCREENINGS, FLU VACCINATIONS, WELLBEING WORKSHOPS AND CHALLENGES, LIFESTYLE COACHING AND LIFESTYLE MANAGEMENT PROGRAMS SUCH AS: NICOTINE CESSATION, EMPOWER YOUR LIFESTYLE, SUSTAINABLE WELLNESS AND CHECK-CONTROL-CONNECT. ADDITIONAL PREVENTATIVE OFFERINGS INCLUDE SKIN SCREENINGS AND PROSTATE SPECIFIC ANTIGEN (PSA) SCREENINGS. THE BIOMETRIC SCREENINGS ENCOMPASS MEASURES OF TOTAL CHOLESTEROL, HIGH-DENSITY OR LOW-DENSITY LIPOPROTEIN (HDL OR LDL CHOLESTEROL), BLOOD GLUCOSE, HEMOGLOBIN A1C, BLOOD PRESSURE AND BODY COMPOSITION MEASUREMENTS. ADDITIONAL SCREENINGS MAY INCLUDE: COTININE LEVELS AND/OR HEARING AND VISION SCREENINGS. EVENTS ARE HELD AT COMMUNITY PARTNER SITES OR USING OUR MOBILE CLINIC. IN 2023, PCH STAFF SCREENED 3,169 INDIVIDUALS. TOTAL SCREENING NUMBERS INCLUDED 1,628 CHOLESTEROL/BLOOD PRESSURE SCREENINGS, 748 BLOOD PRESSURE ONLY SCREENINGS, 567 BLOOD GLUCOSE SCREENINGS, 1,582 A1C SCREENINGS, 210 BODY COMPOSITION MEASUREMENTS, 40 HEARING SCREENINGS, 8 VISION SCREENINGS, 39 PSA SCREENINGS, 599 FLU SHOTS AND 0 COVID VACCINATIONS. THE FOLLOWING PARTICIPANTS WERE POSITIVELY IMPACTED THROUGH HEALTH EDUCATION INITIATIVES AND PROGRAMMING: 301 COACHING SESSIONS WERE LOGGED, 302 ATTENDED A WORKSHOP (VIRTUAL AND IN-PERSON), 24 PARTICIPATED IN A CHALLENGE AND 7 PARTICIPATED IN A LIFESTYLE MANAGEMENT PROGRAM. CH ATTENDED MANY HEALTH FAIR EVENTS IN 2023 AND ENGAGED A TOTAL OF 1,821 IN HEALTH EDUCATION THROUGH LOOK-N-LEARN BOOTHS. DUE TO UNFORSEEN CIRCUMSTANCES, PCH DID NOT OFFER ANY FREE SKIN SCREENINGS TO COMMUNITY MEMBERS IN THE 2023 CALENDAR YEAR. THE SKIN SCREENING SCHEDULE WILL RESUME IN THE 2024 CALENDAR YEAR. PCH PILOTED A NEW SERVICE AND OFFERED SPORTS PHYSICALS. THE SPORTS PHYSICALS WERE OFFERED TO STUDENT ATHLETES 12 YEARS AND OLDER. A TOTAL OF 79 SPORTS PHYSICALS WERE CONDUCTED. 371605 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 17 1 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X RENEE MOCK 9375453516 3170 KETTERING BLVD MORAINE OH 45439 JENNIFER J HAULER DO TRUSTEE (TO APR) 0.50 39.50 X 0 957363 303885 J NICK LAIR PRESIDENT & CEO (FROM JUN) 2.00 38.00 X X 0 449652 57305 JOSEPH P ALLEN MD BOARD CHAIR 0.50 39.50 X X 0 449578 25838 PAULA J THOMPSON PRESIDENT & CEO (TO JUN) 16.00 24.00 X X 0 404773 50445 RENEE L MOCK BOARD TREASURER 0.50 39.50 X X 0 342601 32295 BENJAMIN A WATSON EQQ BOARD SECRETARY (TO OCT) 0.50 39.50 X 0 166904 14504 ELIZABETH D WILFONG EQQ BOARD SECRETARY (FROM OCT) 0.50 39.50 X 0 93483 361 0 2864354 484633 0 0 1 0 0 349183 261375 35050 645608 18161 18161 634400 689497 -55097 -55097 -55097 608672 0 0 -36936 249348 226533 22815 5953 5408 545 17962 16319 1643 1765 1765 10400 9448 952 674 612 62 7287 6620 667 6217 5648 569 72024 65434 6590 OPERATING SUPPLIES 29837 27107 2730 PATIENT RELATIONS 7197 6538 659 FLEET EXPENSE 2133 1938 195 410797 371605 39192 0 762 100 716845 359457 995330 203589 382340 162116 330735 220224 846274 801340 378610 302296 3268556 1887006 210291 164885 6077927 4686007 6288218 4850892 X -3019662 -2963886 -3019662 -2963886 3268556 1887006 X 197875 38701 -180800 X 0 1 X 1 0 X 289992 281899 349555 482870 645608 2049924 5443601 4868726 5676989 5331679 21320995 5733593 5150625 6026544 5814549 645608 23370919 0 427752 174991 271682 448252 323842 1646519 427752 174991 271682 448252 323842 1646519 21724400 14852 18161 33013 14852 18161 33013 5733593 5150625 6026544 5829401 663769 23403932 0.92820 0.93540 0.00140 0.00050 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 253601 29634 480 282755 287643 -33543 499 253601 257769 30432 558 287643 229814 28536 584 257769 196536 33682 404 229814 0.00000 0.00000 1.00000 1 0 366185 162116 204069 16155 16155 220224 ALTERNATIVE INVESTMENTS 302296 F 302296 AFFILIATES PAYABLE 4387925 ACCRUED LIABILITIES 298082 4686007 X PART V, LINE 4: THE ENDOWMENT FUNDS ARE USED TO SUPPORT THE MISSION BY OFFERING HEALTH SCREENINGS, HEALTH EDUCATION, AND OTHER SERVICES TO THE RESIDENTS OF THE GREATER DAYTON, OHIO AREA. THIS INCLUDES CARDIOVASCULAR RISK SCREENINGS AND EDUCATION, DIABETES HEMOGLOBIN A1C, LUNG EDUCATION FOR THOSE WHO HAVE ADULT ASTHMA OR COPD, AND SERVICES FOR THE PREVENTION AND EARLY DETECTION OF BREAST CANCER, SKIN CANCER, AND LUNG CANCER. PART X, LINE 2: THE FOLLOWING FOOTNOTE IS FROM THE 2023 CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR PREMIER HEALTH (PHP) AND AFFILIATES. PHP IS THE SOLE MEMBER OF FIDELITY HEALTH CARE, INC., WHICH IS THE SOLE MEMBER OF PREMIER COMMUNITY HEALTH (PCH). PHP HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE A TAX-EXEMPT NON-PROFIT CORPORATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS A TAX-EXEMPT ORGANIZATION, ITS INCOME IS EXEMPT FROM FEDERAL INCOME TAX EXCEPT TO THE EXTENT OF ANY UNRELATED BUSINESS ACTIVITIES. PHP CONSOLIDATES CERTAIN SUBSIDIARIES WHICH ARE FOR-PROFIT CORPORATIONS SUBJECT TO FEDERAL INCOME TAXES. THESE ARE: * PREMIER HEALTH HOLDING COMPANY (PHHC) (WHOLLY OWNED SUBSIDIARY OF PHP) * MVHE, INC., (AND ITS WHOLLY OWNED SUBSIDARY EXTENDED CARE), SAMARITAN FAMILY CARE, INC., PREMIER HEALTH SPECIALISTS, INC. AND PREMIER HEALTH URGENT CARE, INC. (WHOLLY OWNED SUBSIDIARIES OF PHHC) MANAGEMENT ANNUALLY REVIEWS THE TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS. 1 1 0 0 0 0 0 0 0 JENNIFER J HAULER DO TRUSTEE (TO APR) 0 219289 0 102218 0 635856 0 302929 0 956 0 1261248 0 216934 J NICK LAIR PRESIDENT & CEO (FROM JUN) 0 319674 0 62349 0 67629 0 21695 0 35610 0 506957 0 0 JOSEPH P ALLEN MD BOARD CHAIR 0 348101 0 81774 0 19703 0 11229 0 14609 0 475416 0 0 PAULA J THOMPSON PRESIDENT & CEO (TO JUN) 0 168944 0 51247 0 184582 0 21510 0 28935 0 455218 0 0 RENEE L MOCK BOARD TREASURER 0 297481 0 42860 0 2260 0 16281 0 16014 0 374896 0 0 BENJAMIN A WATSON EQQ BOARD SECRETARY (TO OCT) 0 145490 0 21105 0 309 0 6147 0 8357 0 181408 0 0 PART I, LINE 3C: COMPENSATION FOR PREMIER COMMUNITY HEALTH'S (PCH) CEO IS REVIEWED AND APPROVED BY PREMIER HEALTH, WITH WHICH PCH IS AN AFFILIATE. SEE EXPLANATION ON SCHEDULE O FOR FORM 990, PART VI, SECTION B, LINE 15. PART I, LINE 4A: THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE: JENNIFER HAULER, D.O. $344,571 IN 2023, AND WILL RECEIVE $233,419 IN 2024; PAULA THOMPSON $171,306 IN 2023. PART I LINE 4B: DUE TO RESTRICTIONS IMPOSED BY THE INTERNAL REVENUE CODE, CERTAIN PERSONS ARE LIMITED IN THE AMOUNT OF BENEFIT THAT CAN BE EARNED UNDER A QUALIFIED RETIREMENT PLAN. LIKE MANY EMPLOYERS, PREMIER COMMUNITY HEALTH (PCH) AND ITS AFFILIATED ORGANIZATIONS COMPENSATE FOR THIS LIMITATION AND SUPPLEMENT THE AFFECTED EXECUTIVES' QUALIFIED PENSION THROUGH CERTAIN NONQUALIFIED PLANS. PCH SUPPLEMENTS THE AFFECTED EXECUTIVES THROUGH A PENSION RESTORATION PLAN AND A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE BENEFITS UNDER THESE SUPPLEMENTAL NONQUALIFIED PLANS ARE SUBJECT TO MULTI-YEAR VESTING AND A PARTICIPANT CAN FORFEIT BENEFITS EARNED IF VESTING REQUIREMENTS ARE NOT SATISFIED. UNDER THE TERMS OF THE SUPPLEMENTAL PLANS, AND BECAUSE OF TAX RULES PERTAINING TO TAXATION OF THE EARNED BENEFITS UPON VESTING, CERTAIN INDIVIDUALS RECEIVED A PAYOUT OF THE CUMULATIVE VESTED BENEFITS UNDER THEIR SUPPLEMENTAL PLAN DURING 2023. THE INDIVIDUAL LISTED BELOW HAS MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE PENSION RESTORATION PLAN RECEIVED THE ASSOCIATED PAYMENT IN 2023: J. NICK LAIR $43,310. THE INDIVIDUALS LISTED BELOW HAVE MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE SERP AND RECEIVED THE ASSOCIATED PLAN PAYMENT 2023: JENNIFER HAULER, D.O. $275,693; PAULA THOMPSON $6,923. 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: JENNIFER HAULER, D.O. $58,759; RENEE MOCK $2,489. 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. FORM 990, PART III, LINE 3 PREMIER COMMUNITY HEALTH (PCH) TRANSFERRED PROGRAM SERVICES FOR OCCUPATIONAL HEALTH, WORKPLACE WELLNESS, COMMUNITY WELLNESS, EMPLOYEE CARE, AND CPR TRAINING TO FIDELITY HEALTH CARE (FHC). FHC IS THE SOLE CORPORATE MEMBER OF PCH. FORM 990, PART V, LINE 2A: PCH DOES NOT HAVE EMPLOYEES, BUT INSTEAD SHARES EMPLOYEES WITH FIDELITY HEALTH CARE (FHC). THESE EMPLOYEES RECEIVE THEIR W-2 FROM FHC (EIN 31-1075381). FORM 990, PART VI, SECTION A, LINE 3 PREMIER HEALTH (PREMIER), AS THE OPERATOR OF BOTH PREMIER COMMUNITY HEALTH (PCH) AND ITS CORPORATE MEMBER, FIDELITY HEALTH CARE, DEVELOPS AND OVERSEES THE IMPLEMENTATION OF THE STRATEGIC PLAN FOR PCH, WHICH INCLUDES (BUT IS NOT LIMITED TO) SUCH MATTERS AS LOCATION OF CLINICAL AND ADMINISTRATIVE EXPENSES AND THE CONSOLIDATION OF SUCH SERVICES. PCH SHALL COMPLY WITH AND IMPLEMENT THIS PLAN AND SHALL NOT TAKE ANY ACTION THAT MATERIALLY DEPARTS FROM THIS PLAN WITHOUT PREMIER'S APPROVAL. PCH SHALL IMPLEMENT ANY CAPITAL AND OPERATING BUDGET SO APPROVED AND/OR REVISED FOR IT BY PREMIER. PCH SHALL IMPLEMENT THE BUSINESS PLAN APPROVED BY PREMIER. PREMIER IS THE SOLE AGENT TO NEGOTIATE ALL RELATIONSHIPS WITH PAYORS ON BEHALF OF PCH WITH ALL THIRD-PARTY PAYORS AND ALTERNATIVE DELIVERY SYSTEMS INCLUDING, BUT NOT LIMITED TO, INSURERS. PCH MUST HAVE APPROVAL FROM PREMIER TO BORROW IN ANY FISCAL YEAR, GUARANTEE IN ANY YEAR, OR INCUR ANY LIEN OR OTHER ENCUMBRANCE ON ANY PROPERTY IN AN AMOUNT EQUAL TO OR GREATER THAN $1,000,000. PCH MUST SEEK PREMIER'S APPROVAL FOR ANY ACQUISITIONS, SALE OR TRANSFER OF ANY MATERIAL ASSET USED IN PCH'S ACTIVITIES. FORM 990, PART VI, SECTION A, LINE 6 PREMIER COMMUNITY HEALTH HAS ONE CORPORATE MEMBER; FIDELITY HEALTH CARE, AN OHIO NON-PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A FIDELITY HEALTH CARE (FHC) HAS THE SOLE AUTHORITY TO ELECT THE BOARD OF TRUSTEES FOR PREMIER COMMUNITY HEALTH. FOR ADDITIONAL INFORMATION, SEE THE RESPONSE ABOVE FOR FORM 990, PART VI, SECTION A, LINE 3. FORM 990, PART VI, SECTION A, LINE 7B SEE EXPLANATION FOR LINE 7A ABOVE. FORM 990, PART VI, SECTION B, LINE 11B THIS 990 FILING AND ATTACHED SCHEDULES (THE RETURN) ARE PREPARED BY A STAFF MEMBER IN THE TAX DEPARTMENT OF PREMIER, OF WHICH PREMIER COMMUNITY HEALTH IS AN AFFILIATE. THE RETURN IS REVIEWED BY THE MANAGER AND DIRECTOR OF TAX COMPLIANCE OF PREMIER. AFTER ALL CHANGES FROM THE ABOVE PERSONS ARE MADE, THE RETURN IS REVIEWED BY THE VICE PRESIDENT/CONTROLLER OF PREMIER. A FINAL VERSION OF THE RETURN IS THEN PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW. AT A BOARD OF TRUSTEES MEETING, THE VICE PRESIDENT/CONTROLLER OF PREMIER (OR DESIGNEE) SHARES DETAILED INFORMATION ON COMPENSATION AND OTHER KEY AREAS, AS WELL AS ADDRESSES ANY OTHER QUESTIONS FROM THE BOARD OF TRUSTEES, PENDING THEIR REVIEW. THE 990 FILING IS ALSO SHARED WITH THE AUDIT COMMITTEE OF PREMIER. FORM 990, PART VI, SECTION B, LINE 12C PREMIER REQUIRES ALL BOARD MEMBERS, BOARD COMMITTEE MEMBERS, MEDICAL DIRECTORS, SUPPLY CHAIN DIVISION MEMBERS, AUTHORIZED SIGNERS, DIRECTORS, EXECUTIVES, MEDICAL EXECUTIVE COMMITTEE MEMBERS, MEDICAL DEPARTMENT AND SECTION CHAIRS, PHYSICIAN PARTNERSHIP COMMITTEE MEMBERS, PHYSICIAN GUIDANCE GROUP MEMBERS, AND ALL EMPLOYED PHYSICIANS TO ANNUALLY REVIEW THE PREMIER COMPREHENSIVE CONFLICT OF INTEREST STATEMENT, AN EXPLANATORY MEMORANDUM, THE ANTITRUST COMPLIANCE POLICY, AND COMPLETE AN INDIVIDUAL QUESTIONNAIRE DISCLOSING ANY POTENTIAL CONFLICTS AS DEFINED IN THE CONFLICT OF INTEREST POLICY. THIS IS ACCOMPLISHED EITHER BY WAY OF AN ELECTRONIC COMMUNICATION SENT OUT DIRECTLY BY THE CORPORATE COMPLIANCE DEPARTMENT OR BY WAY OF A MEMO SENT OUT FROM THE CHAIRMAN OF THE BOARD AND CHIEF EXECUTIVE OFFICER OF PREMIER. IT ALSO INCLUDES AN EXPLANATORY MEMORANDUM OF SPECIFIC ACTIVITIES THAT MIGHT GIVE CAUSE TO A CONFLICT AND AN INDIVIDUAL QUESTIONNAIRE TO DISCLOSE ALL SUCH ACTIVITIES. THIS QUESTIONNAIRE MUST BE COMPLETED AND SIGNED BY THE INDIVIDUAL. THIS CORRESPONDENCE INCLUDES A COPY OF THE ANTITRUST COMPLIANCE POLICY THAT MUST BE SIGNED BY THE INDIVIDUAL. ALL OF THESE DOCUMENTS ARE SENT TO THE CORPORATE COMPLIANCE DEPARTMENT. THE CORPORATE COMPLIANCE DEPARTMENT ENSURES ALL FORMS ARE RETURNED AND RETAINS THE DOCUMENTS FOR FIVE YEARS. IN ADDITION, AT EACH MEETING OF THE BOARD OR ANY BOARD COMMITTEE, FOLLOWING APPROVAL OF THE PREVIOUS MEETING'S MINUTES, THE BOARD OR COMMITTEE CHAIR SHALL REQUEST ANY BOARD MEMBER WHO PERCEIVES A POTENTIAL CONFLICT OF INTEREST ON ANY OF THE MEETING'S AGENDA ITEMS TO DISCLOSE THE POTENTIAL CONFLICT. ADDITIONALLY, AT ANY BOARD OR BOARD COMMITTEE MEETING WHERE THE SUBJECT OF CONFLICT OF INTEREST IS DISCUSSED, THE MINUTES SHALL CONTAIN THE NAME OF THE PARTY DISCUSSING A POTENTIAL CONFLICT OF INTEREST, THE NATURE OF THE POTENTIAL CONFLICT OF INTEREST AND WHETHER A CONFLICT OF INTEREST WAS FOUND TO EXIST. IF A CONFLICT OF INTEREST IS DETERMINED BY THE BOARD TO EXIST, THE MEMBER WILL BE EXCUSED FROM PARTICIPATING IN ANY DISCUSSION OR VOTING ON THE PARTICULAR AGENDA ITEM. THE CHIEF COMPLIANCE AND ENTERPRISE RISK OFFICER REPORTS THE RESULTS OF THE PREMIER CONFLICT OF INTEREST QUESTIONNAIRES NO LESS THAN ANNUALLY TO THE BOARD OF TRUSTEES BY WAY OF THE COMPLIANCE AND AUDIT COMMITTEE. THIS REVIEW IS DOCUMENTED IN THE MINUTES OF THE MEETING. PERIODICALLY, THE INTERNAL AUDIT DEPARTMENT WILL REVIEW A SAMPLE OF COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES AND REPORT THE RESULTS TO THE COMPLIANCE AND AUDIT COMMITTEE. THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES ARE INDIVIDUALLY SUMMARIZED IN A DOCUMENT AND SENT ELECTRONICALLY TO THE FINANCE DEPARTMENT FOR ANY NECESSARY DISCLOSURES REQUIRED ON THE 990 FILING. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR PREMIER COMMUNITY HEALTH'S (PCH) CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH PCH IS AN AFFILIATE, ON AN ANNUAL BASIS. THE REVIEW PROCESS PERFORMED BY PREMIER FOLLOWS A MARKET BASED COMPENSATION PHILOSOPHY DESIGNED TO ATTRACT AND RETAIN THE EXECUTIVE TALENT REQUIRED TO MEET THE HIGH-PERFORMANCE STANDARDS OF OUR BOARD AND OUR COMMUNITY. PREMIER ANNUALLY REVIEWS EXECUTIVE COMPENSATION SURVEY DATA FOR A REGIONAL AND NATIONAL PEER GROUP OF SYSTEMS AND HOSPITALS THAT ARE SIMILAR IN SIZE AND COMPLEXITY TO PREMIER AND ITS AFFILIATES. THE DATA FOR THE SURVEY IS PROVIDED BY A THIRD-PARTY CONSULTANT GROUP THAT IS INDEPENDENT OF PREMIER. THIS REPORT INCLUDES COMPARABILITY DATA FOR KEY EXECUTIVES, VICE PRESIDENTS, AND DIRECTOR LEVEL POSITIONS. THE INDEPENDENT COMPARABILITY DATA IS REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE ON AN ANNUAL BASIS. THIS COMMITTEE CONTAINS THREE MEMBERS, ALL OF WHOM ARE INDEPENDENT. THIS COMMITTEE REVIEWS IN DETAIL THE COMPENSATION FOR THE PREMIER CEO, COO, CFO, CCO AND OTHER TOP EXECUTIVES. OTHER POSITIONS ARE REVIEWED AT A HIGH LEVEL FOR REASONABLENESS. ALL THE MEETING MINUTES ARE DOCUMENTED AND KEPT ON FILE ALONG WITH ANY COMPARABILITY DATA AND THE CONSULTANT REPORT. AFTER THE COMPENSATION COMMITTEE REVIEWS AND APPROVES THE COMPENSATION ACTIONS, THE PROCESS IS AUDITED BY THE INTERNAL AUDIT DEPARTMENT. THE EXECUTIVE COMPENSATION COMMITTEE PRESENTS THE COMPENSATION ACTIONS TO THE PREMIER BOARD ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC WHEN REQUIRED BY LAW OR FOR ACCREDITATION PURPOSES. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFER FROM AFFILIATES -255,800. WALLACE FUND -200,000. CAPITAL DONATIONS 275,000. PREMIER HEALTH 110 MAIN ST 200 DAYTON OH 45402 311446699 PARENT OH 501 (C) (3) 12B N/A 0 MEDAMERICA HEALTH SYSTEMS CO 110 N MAIN ST 200 DAYTON OH 45402 311040228 SUPPORT ORG OH 501 (C) (3) 12B N/A 0 MIAMI VALLEY HOSPITAL 110 N MAIN ST 200 DAYTON OH 45402 310537504 HOSPITAL OH 501 (C) (3) 3 PREMIER HEALTH 0 MIAMI VALLEY HOSPITAL FOUNDATION 110 N MAIN ST 200 DAYTON OH 45402 311040231 FOUNDATION OH 501 (C) (3) 7 PREMIER HEALTH 0 FIDELITY HEALTH CARE INC 110 N MAIN ST 200 DAYTON OH 45402 311075381 HOME HEALTH OH 501 (C) (3) 10 PREMIER HEALTH 0 GOOD SAMARITAN FOUNDATION - DAYTON 110 N MAIN ST 200 DAYTON OH 45402 237296923 FOUNDATION OH 501 (C) (3) 7 PREMIER HEALTH 0 ATRIUM HEALTH SYSTEM 110 N MAIN ST 200 DAYTON OH 45402 310537492 SUPPORT ORG OH 501 (C) (3) 12B N/A 0 ATRIUM MEDICAL CENTER 110 N MAIN ST 200 DAYTON OH 45402 311079309 HOSPITAL OH 501 (C) (3) 3 PREMIER HEALTH 0 UVMC 110 N MAIN ST 200 DAYTON OH 45402 341850683 SUPPORT ORG OH 501 (C) (3) 12B N/A 0 UPPER VALLEY MEDICAL CENTER 110 N MAIN ST 200 DAYTON OH 45402 310537095 HOSPITAL OH 501 (C) (3) 3 PREMIER HEALTH 0 UPPER VALLEY PROFESSIONAL CORP 110 N MAIN ST 200 DAYTON OH 45402 311400963 HEALTH CARE OH 501 (C) (3) 10 PREMIER HEALTH HOLDING CO 0 UVPC SPECIALISTS 110 N MAIN ST 200 DAYTON OH 45402 203687536 HEALTH CARE OH 501 (C) (3) 10 PREMIER HEALTH HOLDING CO 0 UVMC NURSING CARE INC 110 N MAIN ST 200 DAYTON OH 45402 311224064 NURSING HOME OH 501 (C) (3) 10 PREMIER HEALTH 0 COMPUNET CLINICAL LABORATORIES LLC 110 N MAIN ST 200 DAYTON OH 45402 311258010 LAB OH 501 (C) (3) 12B PREMIER HEALTH 0 SAMARITAN BEHAVIORAL HEALTH INC 110 N MAIN ST 200 DAYTON OH 45402 020633634 BEHAVIORAL HEALTH OH 501 (C) (3) 7 PREMIER HEALTH 0 SWEITZER STREET LLC 110 N MAIN ST 200 DAYTON OH 45402 454700417 REAL ESTATE OH MVHE INC EXCLUDED 0 0 SWEITZER MOB LLC 110 N MAIN ST 200 DAYTON OH 45402 474554657 REAL ESTATE OH MVHE INC EXCLUDED 0 0 MVHE INC 110 N MAIN ST 200 DAYTON OH 45402 311185270 PHYSICIAN SVCS OH PREMIER HEALTH HOLDING CO C 0 PREMIER HEALTH SPECIALISTS 110 N MAIN ST 200 DAYTON OH 45402 061744704 PHYSICIAN SVCS OH PREMIER HEALTH HOLDING CO C 0 SAMARITAN FAMILY CARE 110 N MAIN ST 200 DAYTON OH 45402 311299450 PHYSICIAN SVCS OH PREMIER HEALTH HOLDING CO C 0 AFTER HOURS FAMILY CARE 110 N MAIN ST 200 DAYTON OH 45402 311269483 HEALTH CARE OH UPPER VALLEY PROFESSIONAL CORP C 0 UVMC MANAGEMENT CORP 110 N MAIN ST 200 DAYTON OH 45402 311360489 MANAGEMENT COMPANY OH PREMIER HEALTH C 0 PREMIER HEALTH URGENT CARE INC 110 N MAIN ST 200 DAYTON OH 45402 822079409 URGENT CARE OH PREMIER HEALTH HOLDING CO C 0 PREMIER HEALTH PLAN INC 110 N MAIN ST 200 DAYTON OH 45402 463024049 HEALTH INSURANCE OH PREMIER HEALTH INSURING CO C 0 GOOD SAMARITAN HOSPITAL 110 N MAIN ST 200 DAYTON OH 45402 310536981 HOSPITAL OH PREMIER HEALTH C 0 PREMIER HEALTH INT'L INSURANCE BUTTERFIELD BANK BLDG 6TH FLR 65 HAMILTON BD HM12 980548485 INSURANCE BD PREMIER HEALTH C 0 PREMIER HEALTH ACO OF OHIO 110 N MAIN ST 200 DAYTON OH 45402 474049773 MEDICARE ACO OH PREMIER HEALTH C 0 PREMIER HEALTH HOLDING CO 110 N MAIN ST 200 DAYTON OH 45402 812419110 HOLDING CO OH PREMIER HEALTH C 0 PREMIER HEALTH INSURING CO 110 N MAIN ST 200 DAYTON OH 45402 464766841 HEALTH INSURANCE OH PREMIER HEALTH C 0 0 0 1 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1