2025-08-11T11:36:24-05:00 2024-09-30 420714325 RSM US LLP 30 SOUTH WACKER DR SUITE 3300 CHICAGO IL 606063392 990 2023-10-01 331075317 NCHMD INC NCHM 2396246338 PO BOX 413029 NAPLES FL 341013029 NOBLE ARRINGTON CFO 2396244005 2025-08-08 1 1 REBEKUH ELEY P01247672 3126343400 2025-08-08 2023 2025-03-06 01:10:19Z NCH PHYSICIAN GROUP PAUL HILTZ PO BOX 413029 NAPLES FL 341013029 134719274 0 X WWW.NCHMD.ORG X 2003 FL HELPING EVERYONE LIVE A LONGER, HAPPIER, AND HEALTHIER LIFE.OUR VISION IS TO BE A WORLD-CLASS LEADER OF EXCELLENCE INHEALTHCARE AND TO PROVIDE EXCELLENCE IN EVERY PATIENT EXPERIENCE. 9 3 930 9 -908119 0 72741488 34524936 98178436 100286497 1162 -93054 -3228188 -112609 167692898 134605770 0 0 0 0 125832702 139666453 0 0 0 28761749 23492891 154594451 163159344 13098447 -28553574 94177869 131035825 29299382 23730310 64878487 107305515 X HELPING EVERYONE LIVE A LONGER, HAPPIER, AND HEALTHIER LIFE. 0 0 41403022 23526954 CARDIOLOGY IS THE LARGEST SERVICE LINE OF THE NCH PHYSICIANS GROUP FOR 2024. THIS PROGRAM OFFERS SPECIALIZED SERVICES THAT FOCUS ON THE STUDY AND TREATMENT OF DISORDERS OF THE CARDIOVASCULAR SYSTEM, WHICH INCLUDE THE HEART, ARTERIES, AND VIENS. THESE PHYSICIANS USE A VARIETY OF TREATMENTS INCLUDING SURGERY, MEDICATION, LIFESTYLE CHANGES, WEIGHT LOSS RECOMMENDATIONS, DIET MANAGEMENT, THERAPIES, AND OTHER METHODS TO HELP OUR PATIENTS LIVE A HAPPIER, HEALTHIER LIFE. WITHIN THIS SERVICE LINE, NCHMD EMPLOYED 40 LICENSED INDEPENDENT PRACTITIONERS AND 75 FULL-TIME EQUIVALENT EMPLOYEES WHO PERFORMED 386,146 RELATIVE VALUE UNITS AND PROVIDED $581,070 OF CHARITY CARE. 29950644 27326232 FAMILY PRACTICE IS THE SECOND LARGEST SERVICE LINE ACCOMPLISHMENT FOR NCH PHYSICIANS GROUP FOR 2024. THIS PROGRAM SERVICE OFFERS CARE TO THE WHOLE FAMILY, BY TREATING NOT ONLY ILLNESSES, BUT BY HELPING YOU FIND WAYS TO IMPROVE YOUR HEALTH AND PREVENT DISEASE. OUR FAMILY MEDICINE OFFICES PROVIDE COMPLETE CARE TO INFANTS, CHILDREN, ADOLESCENTS, ADULTS AND THE ELDERLY.WITHIN THIS SERVICE LINE, NCHMD EMPLOYED 36 LICENSED INDEPENDENT PRACTITIONERS AND 86 FULL-TIME EQUIVALENT EMPLOYEES WHO PERFORMED 170,213 RELATIVE VALUE UNITS AND PROVIDED $83,791 OF CHARITY CARE. 26158494 15347918 INTERNAL MEDICINE SERVICES WERE NCH PHYSICIAN GROUP'S THIRD LARGEST PROGRAM SERVICE IN 2024. THE NCH PHYSICIAN GROUP'S INTERNAL MEDICINE PHYSICIANS FOCUS ON ADULT MEDICINE BY EMPHASIZING PREVENTION AND TREATMENT OF ADULT DISEASES WITH STATE OF THE ART TECHNOLOGY IN A COMPASSIONATE ENVIRONMENT. THESE PHYSICIANS WORK CLOSELY WITH ALL OUR SPECIALISTS AS WELL AS OUR ANCILLARY TESTING DEPARTMENTS SUCH AS RADIOLOGY AND LABORATORY TO HELP SOLVE DIAGNOSTIC PROBLEMS.WITHIN THIS SERVICE LINE, NCHMD EMPLOYED 58 LICENSED INDEPENDENT PRACTITIONERS AND 29 FULL-TIME EQUIVALENT EMPLOYEES WHO PERFORMED 268,569 RELATIVE VALUE UNITS, PROVIDED $996,422 OF CHARITY CARE. 56429139 34125068 IN PROVIDING THE OTHER SERVICE PROGRAM SERVICE LINES, NCHMD EMPLOYED 71 LICENSED INDEPENDENT PRACTICIONERS AND 237 FTES WHO PERFORMED 454,095 RELATIVE VALUE UNITS AND PROVIDED $1,101,405 OF CHARITY CARE.SERVICE LINE EXPENSES REVENUE ORTHOPEDICS 15,070,621 9,993,250 PULMONARY 14,377,366 5,959,698 GASTROENTEROLOGY 10,172,164 5,079,902 GENERAL SURGERY 5,143,529 4,373,112 URGENT CARE 3,955,971 3,264,079 PEDIATRICS 1,897,517 1,419,027 PAIN MANAGEMENT 1,100,102 472,080 NEUROLOGY 1,019,264 711,663 GME 919,209 1,143,372 PSYCHIATRY 824,477 451,456 INFECTIOUS DISEASE 686,116 549,633 LAB AND RADIOLOGY 492,814 230,437 WOUND HEALING 392,113 536,690 PRO TIME 232,513 3,302 UROLOGY 54,158 2,212 RHEUMATOLOGY 43,891 -4,060 ENDOCRINOLOGY 26,902 3,504 POST ACUTE 10,999 722 NEUROSURGERY 8,793 -65,009 GERIATRICS 622 0 56429139 34125068 153941299 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 1 0 0 1 79 0 1 930 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 3 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 FL X NOBLE ARRINGTON CFO 2396246338 350 SEVENTH STREET NORTH NAPLES FL 34102 DINESH SHARMA MD PHYSICIAN 40.00 0.00 X 2084846 0 38968 PAUL HILTZ PRESIDENT/CEO/TRUSTEE 1.00 44.00 X X 0 2156805 36167 DAVID LINZ MD PHYSICIAN/TRUSTEE 40.00 0.00 X 1081735 0 40385 CARLO SANTOS-OCAMPO MD PHYSICIAN/OFFICER 40.00 0.00 X 1036481 0 35521 BRYAN C MURPHEY MD PHYSICIAN/CHAIRMAN 40.00 0.00 X X 991694 0 37866 KRISTIN MASCOTTI MD TERM 0224 TRUSTEE/CMO 1.00 44.00 X X 0 890788 31938 ROBERT GROSSMAN MD PHYSICIAN/TRUSTEE 40.00 0.00 X 747520 0 21156 EMILY ESSERT MD PHYSICIAN/TRUSTEE 40.00 0.00 X 370902 0 35749 REBECCA WITHERELL MD PHYSICIAN/TRUSTEE 40.00 0.00 X 377095 0 20803 KEVIN BEEBE TRUSTEE 0.50 2.00 X 0 0 0 SCOTT LUTGERT TRUSTEE 0.50 2.00 X 0 0 0 MICHAEL WYNN TRUSTEE 0.50 2.00 X 0 0 0 JONATHAN KLING RN CHIEF OPERATING OFFICER SYSTEM 1.00 44.00 X 0 693883 38478 CARLOS B QUINTERO MD CHIEF QUALITY OFFICER 41.00 4.00 X 636644 0 41361 JIM MAHON SENIOR VICE PRESIDENT 1.00 44.00 X 0 640135 13937 RENEE M THIGPEN TERM 0824 CHIEF HR OFFICER 1.00 44.00 X 0 538268 34354 NOBLE ARRINGTON CFO/ASSISTANT TREASURER 1.00 44.00 X 0 429341 60054 ANDREW COOPER CHIEF INFORMATION OFFICER 1.00 44.00 X 0 373336 52315 GINA TEEGARDEN RN CHIEF NURSING EXECUTIVE 1.00 44.00 X 0 375123 49047 MATTHEW STACELL CHIEF PERFORMANCE MANAGEMENT OFFICER 1.00 44.00 X 0 292790 50101 ERIN RANEY CHIEF ADMINISTRATIVE OFFICER 1.00 44.00 X 0 254142 46065 ILIA ECHEVARRIA RN CHIEF NURSING OFFICER NNH 1.00 44.00 X 0 266751 24079 MAGALI PALMA START 0224 CHIEF ASSISTANT OPERATIONS OFFICER 1.00 44.00 X 0 207581 29810 JENNIFER HART START 0624 CHIEF CULTURE OFFICER 1.00 44.00 X 0 151320 31791 MARA HAMMOND START 1023 CHIEF IMPACT OFFICER 1.00 44.00 X 0 102127 3464 HOWARD KAPP MD PHYSICIAN 40.00 0.00 X 2534713 0 29470 JON S DOUNCHIS MD PHYSICIAN 40.00 0.00 X 2009786 0 40202 DAVID R AXLINE MD PHYSICIAN 40.00 0.00 X 1341829 0 39178 EDISON VALLE GILER MD PHYSICIAN 40.00 0.00 X 1214266 0 31946 ROBERTO CUBEDDU MD PHYSCIAN 40.00 0.00 X 1938904 0 38284 RICK WYLES TERM 0523 FORMER CHIEF FINANCIAL OFFICER 0.00 0.00 X 0 793225 31990 MARGARET DIMOND TERM 0423 FORMER CHIEF ADMINISTRATIVE OFFICER 0.00 0.00 X 0 400663 16654 PHILLIP DUTCHER TERM 0721 FORMER CHIEF OPERATING OFFICER 0.00 0.00 X 0 344359 768 MICHAEL RILEY TERM 1120 FORMER CHIEF STRATEGY OFFICER 0.00 0.00 X 0 141564 0 16366415 9052201 1001901 219 1 1 0 ENVERA HEALTH INC 1001 HAXALL POINT 1B RICHMONT VA 23219 COLLECTION RESOURCE 2910664 SUNNY DAY MATERNAL FETAL MEDICINE 203 8TH AVE S NAPLES FL 34102 SUNNY DAY MFM IS NPG'S CONTRACTED SERVIC 1179300 D AND Y PO BOX 635715 CINCINNATI OH 45263 PHYSICIAN STAFFING SERVICES 956390 GULF TO BAY ANESTHESIOLOGY ASSOC PA PO BOX 639425 CINCINNATI OH 45263 PHYSICIAN STAFFING SERVICES 651796 VIRENCE HEALTH TECHNOLOGIES PO BOX 840952 DALLAS TX 752840952 SOFTWARE AND SUPPORT SERVICES 465557 24 34524936 680294 34524936 OFFICES OF PHYSICIANS 621110 100286497 100286497 100286497 298382 5450 292932 292932 292932 15000 108054 -93054 -93054 -93054 OUTSOURCING MILLENNIUM 561300 462903 462903 MEDICAL DIRECTORSHIP 900099 39675 39675 LOSS INVESTMNT PROSCAN 621500 -908119 -908119 -405541 134605770 100326172 -908119 662781 7767888 7424458 343430 30577 30577 121537187 115376962 6160225 2471261 2346957 124304 2259915 2149741 110174 5599625 5317964 281661 5000 5000 7454843 6268924 1185919 171449 171449 1116672 846741 269931 1129485 1072718 56767 3994555 3415435 579120 118016 116222 1794 1915195 1841160 74035 2359685 2359685 MEDICAL SUPPLIES 5158774 5159343 -569 OTHER MISC EXPENSE 42963 42963 BAD DEBT 26254 26254 163159344 153941299 9218045 0 3063676 54123618 88900613 6494879 7032247 1153260 1139099 2318487 2199474 39580985 22836964 16792764 16744021 4423289 3872461 1923865 1972872 6947707 6111362 94177869 131035825 18332097 13684292 2858796 3389170 8108489 6656848 29299382 23730310 X 12296420 19804233 52582067 87501282 64878487 107305515 94177869 131035825 X -28553574 618456 70362146 X 0 1 X 1 0 X 3354173 20261566 72741488 34524936 130882163 113273393 124724841 108052859 98178436 100286497 544516026 113273393 128079014 128314425 170919924 134811433 675398189 0 0 0 675398189 89775 359590 325314 292932 1067611 89775 359590 325314 292932 1067611 37500 36000 44517 38469 502578 659064 113310893 128204789 128718532 171283707 135606943 677124864 0.99740 0.99850 0.00160 0.00120 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISC ACCOUNTS REC RECEIPTS - 2022 AMOUNT: $ 2,469. 2023 AMOUNT: $ 462,903. EMPLOYEE SALES - 2021 AMOUNT: $ 2,402. MEDICAL DIRECTORSHIP - 2019 AMOUNT: $ 37,500. 2020 AMOUNT: $ 36,000. 2021 AMOUNT: $ 42,115. 2022 AMOUNT: $ 36,000. 2023 AMOUNT: $ 39,675. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2559424 2559424 14178215 5459862 8718352 8758742 6753232 2005510 13133526 10623870 2509657 951078 951078 16744021 ESTIMATED SELF INSURANCE CLAIMS 5257516 LIABILITY OF RESTRICTED FUNDS 1399332 6656848 X PART X, LINE 2: THE SYSTEM AND ALL OF ITS NOT-FOR-PROFIT SUBSIDIARIES ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE (THE CODE). THE SYSTEM AND ALL OF ITS NOT-FOR-PROFIT SUBSIDIARIES DO NOT HAVE SIGNIFICANT UNRELATED BUSINESS INCOME; HOWEVER, SUCH STATUS IS SUBJECT TO FINAL DETERMINATION UPON EXAMINATION OF THE RELATED INCOME TAX RETURNS BY THE APPROPRIATE TAXING AUTHORITIES. THE SYSTEM IS GENERALLY NO LONGER SUBJECT TO TAX EXAMINATIONS IN THE MAJOR U.S. TAXING JURISDICTIONS IN WHICH THEY OPERATE FOR TAX YEARS PRIOR TO 2020. X X X X 1 1 0 0 0 0 0 1 0 HOWARD KAPP MD PHYSICIAN 2216342 0 293585 0 24786 0 13200 0 16270 0 2564183 0 0 0 PAUL HILTZ PRESIDENT/CEO/TRUSTEE 0 1056981 0 911722 0 188102 0 13200 0 22967 0 2192972 0 158079 DINESH SHARMA MD PHYSICIAN 1683837 0 378329 0 22680 0 13200 0 25768 0 2123814 0 0 0 JON S DOUNCHIS MD PHYSICIAN 1760988 0 225538 0 23260 0 13200 0 27002 0 2049988 0 0 0 ROBERTO CUBEDDU MD PHYSCIAN 1615995 0 300000 0 22909 0 13200 0 25084 0 1977188 0 0 0 DAVID R AXLINE MD PHYSICIAN 1192181 0 125960 0 23688 0 13200 0 25978 0 1381007 0 0 0 EDISON VALLE GILER MD PHYSICIAN 871515 0 325513 0 17238 0 13200 0 18746 0 1246212 0 0 0 DAVID LINZ MD PHYSICIAN/TRUSTEE 899539 0 159534 0 22662 0 13200 0 27185 0 1122120 0 0 0 CARLO SANTOS-OCAMPO MD PHYSICIAN/OFFICER 884596 0 128197 0 23688 0 13200 0 22321 0 1072002 0 0 0 BRYAN C MURPHEY MD PHYSICIAN/CHAIRMAN 813182 0 151198 0 27314 0 13200 0 24666 0 1029560 0 0 0 KRISTIN MASCOTTI MD TERM 0224 TRUSTEE/CMO 0 717818 0 145655 0 27315 0 13200 0 18738 0 922726 0 0 RICK WYLES TERM 0523 FORMER CHIEF FINANCIAL OFFICER 0 236350 0 116346 0 440529 0 13842 0 18148 0 825215 0 86428 ROBERT GROSSMAN MD PHYSICIAN/TRUSTEE 537803 0 187055 0 22662 0 13200 0 7956 0 768676 0 0 0 JONATHAN KLING RN CHIEF OPERATING OFFICER SYSTEM 0 555617 0 113144 0 25122 0 13200 0 25278 0 732361 0 0 CARLOS B QUINTERO MD CHIEF QUALITY OFFICER 527573 0 84970 0 24101 0 13200 0 28161 0 678005 0 0 0 JIM MAHON SENIOR VICE PRESIDENT 0 445789 0 90090 0 104256 0 13200 0 737 0 654072 0 66924 RENEE M THIGPEN TERM 0824 CHIEF HR OFFICER 0 375297 0 77340 0 85631 0 13200 0 21154 0 572622 0 57452 NOBLE ARRINGTON CFO/ASSISTANT TREASURER 0 403050 0 0 0 26291 0 33472 0 26582 0 489395 0 0 ANDREW COOPER CHIEF INFORMATION OFFICER 0 330718 0 19443 0 23175 0 33420 0 18895 0 425651 0 0 GINA TEEGARDEN RN CHIEF NURSING EXECUTIVE 0 302459 0 48616 0 24048 0 38947 0 10100 0 424170 0 0 MARGARET DIMOND TERM 0423 FORMER CHIEF ADMINISTRATIVE OFFICER 0 184209 0 115713 0 100741 0 12286 0 4368 0 417317 0 90254 EMILY ESSERT MD PHYSICIAN/TRUSTEE 329716 0 18507 0 22679 0 11228 0 24521 0 406651 0 0 0 REBECCA WITHERELL MD PHYSICIAN/TRUSTEE 312686 0 41747 0 22662 0 13200 0 7603 0 397898 0 0 0 PHILLIP DUTCHER TERM 0721 FORMER CHIEF OPERATING OFFICER 0 7912 0 0 0 336447 0 0 0 768 0 345127 0 0 MATTHEW STACELL CHIEF PERFORMANCE MANAGEMENT OFFICER 0 254297 0 15145 0 23348 0 23822 0 26279 0 342891 0 0 ERIN RANEY CHIEF ADMINISTRATIVE OFFICER 0 231462 0 0 0 22680 0 20382 0 25683 0 300207 0 0 ILIA ECHEVARRIA RN CHIEF NURSING OFFICER NNH 0 242560 0 1421 0 22770 0 10756 0 13323 0 290830 0 0 MAGALI PALMA START 0224 CHIEF ASSISTANT OPERATIONS OFFICER 0 206690 0 711 0 180 0 4504 0 25306 0 237391 0 0 JENNIFER HART START 0624 CHIEF CULTURE OFFICER 0 151050 0 0 0 270 0 5899 0 25892 0 183111 0 0 MICHAEL RILEY TERM 1120 FORMER CHIEF STRATEGY OFFICER 0 141564 0 0 0 0 0 0 0 0 0 141564 0 0 PART I, LINES 4A-B PART I, LINE 4A: CHIEF FINANCIAL OFFICER RESIGNED 05/23 AND RECEIVED A SEVERANCE PAYMENT OF $330,890 FOR CALENDAR YEAR 2023. PART I, LINE 4B: THE FOLLOWING EXECUTIVES PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: PAUL HILTZ PRESIDENT AND CEO JONATHAN KLING CHIEF OPERATING OFFICER JENNIFER HART CHIEF CULTURE OFFICER CARLOS QUINTERO, M.D. CHIEF QUALITY OFFICER GINA TEEGARDEN, R.N. CHIEF NURSING EXECUTIVE ANDREW COOPER CHIEF INFORMATION OFFICER MATTHEW STACELL CHIEF PERFORMANCE MANAGEMENT OFFICER NOBLE ARRINGTON CHIEF FINANCIAL OFFICER ERIN RANEY CHIEF ADMINISTRATIVE OFFICER MAGALI PALMA CHIEF ASSISTANT OPERATIONS OFFICER DT MARA HAMMOND CHIEF IMPACT OFFICER ILIA ECHEVARRIA CHIEF NURSING OFFICER NNH KRISTIN MASCOTTI, M.D. FORMER CHIEF MEDICAL OFFICER RENEE M. THIGPEN FORMER CHIEF HUMAN RESOURCES OFFICER JIM MAHON SENIOR VICE PRESIDENT THE FOLLOWING EXECUTIVES RECEIVED A DISTRIBUTION FROM THE 457 (F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN IN CALENDAR YEAR 2023: PAUL HILTZ PRESIDENT AND CEO $ 158,079 RICK WYLES FORMER CHIEF FINANCIAL OFFICER $ 86,428 JIM MAHON SENIOR VICE PRESIDENT $ 66,924 RENEE M. THIGPEN CHIEF HR OFFICER $ 57,452 MARGARET DIMOND FORMER CHIEF ADMINISTRATIVE OFFICER $ 90,254 PART I, LINE 7 PROVISIONS OF NON-FIXED PAYMENTS THIS ORGANIZATION IS AN AFFILIATE OF NCH HEALTHCARE SYSTEM, INC. ("THE SYSTEM"). THE SYSTEM MAY PROVIDE DISCRETIONARY BONUS AND/OR INCENTIVE COMPENSATION PAYMENTS TO ELIGIBLE EMPLOYEES. COMPENSATION PAYMENTS FOR ALL EMPLOYEES EXCLUDING THE CEO AND SENIOR LEADERSHIP TEAM IS DETERMINED BY THE SYSTEM BOARD OF TRUSTEES HUMAN RESOURCES COMMITTEE AND/OR CEO. COMPENSATION PAYMENTS MADE TO ANY DISQUALIFIED PERSON IS APPROVED BY THE SYSTEM THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15. VLADIMIRA KLING FMLY MEMBER/OFFICER 30577 EMPLOYEE 0 FORM 990, SCHEDULE L, PART IV FORM 990, SCHEDULE L, PART IV VLADIMIRA KLING, ARNP. IS THE SPOUSE OF JONATHAN KLING, CHIEF OPERATING OFFICER. X 8 680294 FMV 0 0 1 0 FORM 990, PART VI, SECTION A, LINE 6 GOVERNING BODY AND MANAGEMENT NCH HEALTHCARE SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A GOVERNING BODY AND MANAGEMENT NCH HEALTHCARE SYSTEM, INC. SOLE MEMBER OF THIS ORGANIZATION, ELECTS THIS ORGANIZATION'S DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B GOVERNING BODY AND MANAGEMENT ALL OF THE GOVERNANCE DECISIONS FOR NCHMD, INC. ARE RESERVED TO THE GOVERNING BODY OF NCH HEALTHCARE SYSTEM, INC. FORM 990, PART VI, SECTION B, LINE 11B REVIEW PROCESS INFORMATION RELATED TO NCHMD, INC.'S ("NCHMD") FORM 990 FILING IS GATHERED BY FINANCE STAFF AND PROVIDED TO RSM US LLP FOR REVIEW. AFTER THE REVIEW BY RSM US LLP, THE FORM 990 IS REVIEWED BY THE NCH HEALTHCARE SYSTEM CHIEF FINANCIAL OFFICER. THE FORM 990 IS THEN REVIEWED BY OUTSIDE COUNSEL FOR THE BOARD. PRIOR TO BOARD APPROVAL, THE FORM 990 IS PROVIDED TO ALL OF THE FINANCE COMMITTEE BOARD OF TRUSTEES FOR THEIR REVIEW VIA THE BOARD PORTAL. AT THE CONCLUSION OF THIS REVIEW PROCESS THE FORM 990 IS APPROVED BY THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY ANNUALLY, ALL NCH HEALTHCARE SYSTEM, INC. OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE INTERESTS THAT COULD POTENTIALLY GIVE RISE TO CONFLICTS. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. MANAGEMENT SHALL DISCLOSE OTHER POTENTIAL CONFLICTS WITH THE COMPLIANCE OFFICER. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINED UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A GREATER THAN TWO-THIRDS VOTE OF THE DISINTERESTED TRUSTEES WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. THE COMPLIANCE OFFICER WILL DETERMINE IF A MANAGEMENT TEAM MEMBER OR EMPLOYEE SHOULD BE EXCUSED FROM A DISCUSSION OR PARTICIPATE IN A DECISION IN WHICH THERE MAY BE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PROCESS THIS ORGANIZATION IS AN AFFILIATE OF THE NCH HEALTHCARE SYSTEM, INC. ("THE SYSTEM"). COMPENSATION ARRANGEMENTS INVOLVING OUR CEO AND SENIOR LEADERSHIP TEAM ARE ESTABLISHED BY THE SYSTEM BOARD OF TRUSTEES COMPENSATION COMMITTEE PURSUANT TO A PROCESS THAT SATISFIES THE REBUTTABLE PRESUMPTION PROCEDURE AVAILABLE FOR SECTION 4958 EXCESS BENEFIT TRANSACTION TAX PURPOSES (WHICH REQUIRES A REVIEW OF COMPENSATION DETERMINATION BY DISINTERESTED PERSONS, USE OF APPROPRIATE COMPARABILITY DATA, AND CONTEMPORANEOUS DOCUMENTATION OF THE PROCESS). FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS AVAILABLE TO THE PUBLIC THE FORMS 1023 AND 990, GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY OF NHSI ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS ARE ALSO AVAILABLE VIA OUR WEBSITE: HTTP://WWW.NCHMD.ORG/ABOUT-US/ANNUAL-REPORTS. DOCUMENTS AVAILABLE FOR REQUEST ARE AVAILABLE PURSUANT TO THE PERIOD OF DISCLOSURE PROVIDED IN SECTION 6104(D). FORM 990, PART XI, LINE 9: TRANSFERS FROM AFFILIATES 69,347,855. PROSCAN NCH IMAGING, INC. INVESTMENT GAIN 1,014,291. NCH HEALTHCARE SYSTEM INC PO BOX 413029 NAPLES FL 34101 592314655 HOLDING CO FL 501(C) (3) LINE 12B, II N/A 0 NAPLES COMMUNITY HOSPITALINC PO BOX 413029 NAPLES FL 34101 590694358 HEALTHCARE FL 501(C) (3) LINE 3 NCH SYSTEM 1 MARCO ISLAND HOSPITAL INC 40 HEATHWOOD DRIVE MARCO ISLAND FL 34145 592315435 HEALTHCARE FL 501(C) (3) LINE 3 NCH SYSTEM 1 COLLIER HEALTH CARE INC PO BOX 413029 NAPLES FL 34101 650244276 HEALTHCARE FL 501(C) (3) LINE 3 NCH SYSTEM 1 PROSCAN NCH IMAGING LLC 350 7TH STREET NORTH NAPLES FL 34102 861212843 RADIOLOGY SERVICES DE NCHMD INC UNRELATED 94748 1098448 0 1 0.51000 NCH- VH JOINT VENTURE LLC 350 7TH STREET NORTH NAPLES FL 34102 874042152 SURGICAL SERVICES KS N/A 0 0 NCH NH BONITA JV LLC 350 7TH STREET NORTH NAPLES FL 34102 874042152 SURGICAL SERVICES FL N/A 0 0 NCH BONITA AMBULATORY SURGERY CENTER LLC 350 7TH STREET NORTH NAPLES FL 34102 873854125 SURGICAL SERVICES FL N/A 0 0 HEALTH RESOURCES CORPORATION 350 7TH STREET NORTH NAPLES FL 34102 592568003 HOLDING COMPANY FL NCH SYSTEM C 1 AMBULATORY SURGICAL CARE CENTER INC 350 7TH STREET NORTH NAPLES FL 34102 592568029 OUTPATIENT SURGERY FL HEALTH RESOURCES CORPORATION C 1 COMMUNITY HOME CARE INC 350 7TH STREET NORTH NAPLES FL 34102 592372966 HOME HEALTH FL HEALTH RESOURCES CORPORATION C 1 COMMUNITY IMAGING INC 350 7TH STREET NORTH NAPLES FL 34102 592446336 RADIOLOGY LAB FL HEALTH RESOURCES CORPORATION C 1 GREATER COLLIER INSURANCE LTD 350 7TH STREET NORTH NAPLES FL 34102 INSURANCE CJ N/A C 0 1 1 1 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 NAPLES COMMUNITY HOSPITAL INC Q 68157000 FMV NCH HEALTHCARE SYSTEM INC Q 1190604 FMV