2021-11-08T09:57:09-06:00 2020-12-31 990 2020-01-01 311075381 FIDELITY HEALTH CARE FIDE 9374999942 110 N MAIN ST 500 DAYTON OH 45402 PAULA J THOMPSON PRESIDENT & CEO 9374999942 2021-11-08 PAULA THOMPSON 999009999 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z PAULA J THOMPSON 3170 KETTERING BLVD MORAINE OH 45439 61635715 0 X WWW.PREMIERHEALTH.COM X 1983 OH WE WILL IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH OTHERS WHO SHARE OUR COMMITMENT TO PROVIDE HIGH-QUALITY, COST-COMPETITIVE HEALTH SERVICES. 5 0 874 3 246890 -3503 114 1269258 56992956 43057675 1451 492 393073 4021040 57387594 48348465 7000 0 0 0 34843431 35391563 0 0 0 21911894 10705745 56762325 46097308 625269 2251157 24112804 32167086 3406818 9209943 20705986 22957143 WE WILL IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH OTHERS WHO SHARE OUR COMMITMENT TO PROVIDE HIGH-QUALITY, COST-COMPETITIVE HEALTH SERVICES. 0 0 35547637 0 43628483 FIDELITY HEALTH CARE PERFORMED 270,207 VISITS AND 32,061 HOURS OFSERVICE. FIDELITY HEALTH CARE SERVED 1,000 INFUSION PATIENTS AND PROVIDED $ 221,791 IN CHARITY CARE. 2005898 0 2752356 FIDELITY HEALTH CARE OPERATED A RETAIL PHARMACY IN FIVE LOCATIONSWITHIN PREMIER HEALTH AFFILIATED HOSPITALS AND HEALTH CENTERS. THEPHARMACIES PRIMARILY SERVE PATIENTS RECEIVING HEALTH CARE SERVICESAT THESE LOCATIONS. 242093 0 152077 EXPRESSIONS OF HOPE (EOH) IS A SERVICE FOR WOMEN OFFERED BYFIDELITY HEALTH CARE. EOH BOUTIQUE SERVICES ARE DESIGNED TO OFFERWOMEN A WIDE RANGE OF POST MASTECTOMY AND LUMPECTOMY PRODUCTS. 37795628 1 1 0 1 0 0 0 0 0 0 1 0 0 1 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 1 1 1 1 0 0 1 26 0 1 874 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 5 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 0.50 39.50 X 0 877119 85663 MICHAEL R UHL TRUSTEE 0.50 39.50 X 0 977711 103696 THOMAS R CURTIN TRUSTEE 0.50 39.50 X 0 494429 67304 PAULA J THOMPSON PRESIDENT & CEO 24.00 16.00 X X 379376 0 59171 MARK E WILLIAMS MD TRUSTEE 0.50 39.50 X 0 366488 46153 RENEE L MOCK BOARD TREASURER & CFO 36.00 4.00 X 223233 0 23538 BENJAMIN A WATSON ESQ BOARD SECRETARY 0.50 39.50 X 0 187718 15994 ERIC D NAPIER DIRECTOR RETAIL PHARMACY 40.00 X 189628 0 23911 MARY K WALTERS VP CHIEF NURSING OFFICER 40.00 X 194600 0 17036 SHELIA M GRUBB MANAGER, CLINICAL OPERATIONS 40.00 X 155652 0 23849 SANDRA HAIG DIRECTOR IT MED EQUIP. & REV CYCLE 40.00 0.00 X 160480 0 24831 MERLIN E COLLINS PHARMACY SUPERVISOR - RETAIL 40.00 X 143695 0 23422 1446664 2903465 514568 40 0 1 0 PREMIER HEALTH CARE SERVICES 811 TIMBERLODGE TRAIL C DAYTON OH 45458 MEDICAL SERVICES 804348 NETSMART TECHNOLOGIES INC 11100 NALL AVE OVERLAND PARK KS 66211 SOFTWARE MAINTENANCE 341368 BRIGHTREE LLC 1735 N BROWN RD NW 500 LAWRENCEVILLE GA 30043 CONSULTING 158037 3 1268258 1000 1269258 NET PATIENT REVENUE 900099 43057675 42810785 246890 43057675 492 492 425923 127014 298909 298909 298909 16471632 13160236 3311396 3311396 MEDICAL ANSWERING SERVICE 900099 395916 395916 PURCHASE DISCOUNTS 900099 10693 10693 MEDICAL RECORDS 900099 4126 4126 410735 48348465 46532916 246890 299401 696645 449874 246771 28813663 23652591 5161072 324025 324025 3148480 2555787 592693 2408750 1974668 434082 1040 1040 4346 4346 740905 222137 518768 102582 60282 42300 874450 759976 114474 762182 448573 313609 562817 499275 63542 1057796 971331 86465 10703 10703 765853 765853 167729 167729 OPERATING SUPPLIES 5046256 5046256 REPAIRS AND MAINTENANCE 147673 61943 85730 ASSET IMPAIRMENT 106293 106293 MINOR EQUIPMENT 98963 2286 96677 256157 207800 48357 46097308 37795628 8301680 0 2171 2171 9139295 18044455 7411485 6365666 1335401 1352928 389611 284555 9314874 5519178 3818133 3795696 103999 1912709 2321615 24112804 32167086 3342343 4921937 64475 144387 0 4143619 3406818 9209943 X 20705986 22957143 20705986 22957143 24112804 32167086 2251157 0 X 0 1 X 1 0 X 526957 177065 235 114 1269258 1973629 61884232 60698839 58070457 57136430 46779806 284569764 335126 413428 419629 425923 1594106 62411189 61211030 58484120 57556173 48474987 288137499 0 0 0 288137499 430 575 465 1451 492 3413 430 575 465 1451 492 3413 7465 7465 62419084 61211605 58484585 57557624 48475479 288148377 1.00000 0.99990 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 1040 0 0 0 1040 0 PART II-B, LINE 1: PAYMENTS FOR LOBBYING ACTIVITIES INCLUDE A PORTION OF DUES PAID TO THE OHIO COUNCIL FOR HOME CARE & HOSPICE. 215926 215926 2864317 709517 2154800 18104 12975 5129 6148115 4796686 1351429 68412 68412 3795696 AFFILIATES RECEIVABLE 2321615 2321615 ACCRUED MEDICARE ADVANCED PAYMENT 3394289 LTL DEFERRED EMPLOYER FICA 749330 4143619 X PART X, LINE 2: THE FOLLOWING FOOTNOTE IS FROM THE 2020 CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR PREMIER HEALTH (PHP) AND AFFILIATES. PHP IS THE SOLE MEMBER OF FIDELITY HEALTH CARE, INC. PHP HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE A TAX-EXEMPT NON-PROFIT CORPORATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS A TAX-EXEMPT ORGANIZATION, ITS INCOME IS EXEMPT FROM FEDERAL INCOME TAX EXCEPT TO THE EXTENT OF ANY UNRELATED BUSINESS ACTIVITIES. PHP CONSOLIDATES CERTAIN SUBSIDIARIES, WHICH ARE FOR-PROFIT CORPORATIONS SUBJECT TO FEDERAL INCOME TAXES. THESE ARE: * PREMIER HEALTH INSURING CO. (PHIC), AND PHHC (WHOLLY OWNED SUBSIDIARIES OF PHP), * PREMIER HEALTH PLAN (PHPLAN) (A WHOLLY OWNED SUBSIDIARY OF PHIC), * MVHE, INC., SAMARITAN FAMILY CARE, INC., PREMIER HEALTH SPECIALISTS, INC. AND PREMIER HEALTH URGENT CARE, INC. (SUBSIDIARIES OF PHHC), *GOOD SAMARITAN HOSPITAL, UVMC MANAGEMENT CORPORATION (SUBSIDIARIES OF PHP) AND AFTER-HOURS FAMILY CARE, INC. (SUBSIDIARY OF UVPC). MANAGEMENT ANNUALLY REVIEWS THE TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS. 0 1 0 0 0 0 0 0 0 MICHAEL R UHL TRUSTEE 0 576119 0 379106 0 22486 0 73678 0 30018 0 1081407 0 0 JENNIFER J HAULER DO TRUSTEE 0 539982 0 335280 0 1857 0 82899 0 2764 0 962782 0 0 THOMAS R CURTIN TRUSTEE 0 326009 0 160675 0 7745 0 34119 0 33185 0 561733 0 0 PAULA J THOMPSON PRESIDENT & CEO 259909 0 109931 0 9536 0 28344 0 30827 0 438547 0 3183 0 MARK E WILLIAMS MD TRUSTEE 0 339024 0 25675 0 1789 0 19057 0 27096 0 412641 0 0 RENEE L MOCK BOARD TREASURER & CFO 174795 0 46919 0 1519 0 12103 0 11435 0 246771 0 0 0 ERIC D NAPIER DIRECTOR RETAIL PHARMACY 163824 0 24995 0 809 0 7232 0 16679 0 213539 0 0 0 MARY K WALTERS VP CHIEF NURSING OFFICER 166210 0 27501 0 889 0 6916 0 10120 0 211636 0 0 0 BENJAMIN A WATSON ESQ BOARD SECRETARY 0 160670 0 26383 0 665 0 6182 0 9812 0 203712 0 0 SANDRA HAIG DIRECTOR IT MED EQUIP. & REV CYCLE 135678 0 24528 0 274 0 13541 0 11290 0 185311 0 0 0 SHELIA M GRUBB MANAGER, CLINICAL OPERATIONS 153484 0 700 0 1468 0 8011 0 15838 0 179501 0 0 0 MERLIN E COLLINS PHARMACY SUPERVISOR - RETAIL 143195 0 500 0 0 0 5806 0 17616 0 167117 0 0 0 PART I, LINE 3 COMPENSATION FOR FHC'S CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH FHC IS AN AFFILIATE. SEE EXPLANATION ON SCHEDULE O FOR FORM 990, PART VI, SECTION B, LINE 15 PART I, LINE 4B DUE TO RESTRICTIONS IMPOSED BY THE INTERNAL REVENUE CODE, CERTAIN PERSONS ARE LIMITED IN THE AMOUNT OF BENEFIT THAT CAN BE EARNED UNDER A QUALIFIED RETIREMENT PLAN. LIKE MANY EMPLOYERS, FIDELITY HEALTH CARE (FHC) AND ITS AFFILIATED ORGANIZATIONS COMPENSATE FOR THIS LIMITATION AND SUPPLEMENT THE AFFECTED EXECUTIVES' QUALIFIED PENSION THROUGH CERTAIN NONQUALIFIED PLANS. FHC SUPPLEMENTS THE AFFECTED EXECUTIVES THROUGH A PENSION RESTORATION PLAN AND A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE BENEFITS UNDER THESE SUPPLEMENTAL NONQUALIFIED PLANS ARE SUBJECT TO MULTI-YEAR VESTING AND A PARTICIPANT CAN FORFEIT BENEFITS EARNED IF VESTING REQUIREMENTS ARE NOT SATISFIED. THE FOLLOWING SERP AMOUNTS WERE DEFERRED ON THE PARTICIPANTS' BEHALF DURING THE YEAR AND WILL BE HELD UNTIL THE INCREMENTAL AMOUNTS ARE VESTED AND PAID TO THE SERP PARTICIPANTS: THOMAS CURTIN $13,484; JENNIFER HAULER $72,593; PAULA THOMPSON $4,394; MICHAEL UHL $63,262; MARK WILLIAMS $7,333. 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 NOT TREATED AS DEFERRED COMPENSATION FOR PURPOSES OF SCHEDULE J. SUCH AMOUNTS ARE PROPERLY REPORTED AS COMPENSATION FOR FORM 990 PURPOSES WHEN INCLUDED IN THE PARTICIPANTS' FORM W-2 WAGES. ANY PAYMENTS MADE AFTER THE 2-1/2 MONTHS WERE PROPERLY REPORTED ON PRIOR YEARS' FILED IRS FORM 990 RETURNS, DISCLOSING COMPENSATION EARNED BY THESE INDIVIDUALS UNDER THE PLANS FOR EACH SUCH YEAR. FORM 990, PART VI, SECTION A, LINE 3 PREMIER HEALTH (PREMIER) AS THE OPERATOR OF FIDELITY HEALTH CARE (FHC) DEVELOPS AND OVERSEES THE IMPLEMENTATION OF THE STRATEGIC PLAN FOR FHC, WHICH INCLUDES (BUT IS NOT LIMITED TO) SUCH MATTERS AS LOCATION OF CLINICAL AND ADMINISTRATIVE EXPENSES AND THE CONSOLIDATION OF SUCH SERVICES. FHC SHALL COMPLY WITH AND IMPLEMENT THIS PLAN AND SHALL NOT TAKE ANY ACTION THAT MATERIALLY DEPARTS FROM THIS PLAN WITHOUT PREMIER'S APPROVAL. FHC SHALL IMPLEMENT ANY CAPITAL AND OPERATING BUDGET SO APPROVED AND/OR REVISED FOR IT BY PREMIER. FHC SHALL IMPLEMENT THE BUSINESS PLAN APPROVED BY PREMIER. PREMIER IS THE SOLE AGENT TO NEGOTIATE ALL RELATIONSHIPS WITH PAYORS ON BEHALF OF FHC WITH ALL THIRD-PARTY PAYORS AND ALTERNATIVE DELIVERY SYSTEMS INCLUDING, BUT NOT LIMITED TO INSURERS. FHC MUST HAVE APPROVAL FROM PREMIER TO BORROW IN ANY FISCAL YEAR, GUARANTEE IN ANY YEAR, OR INCUR ANY LIEN OR OTHER ENCUMBRANCE ON ANY PROPERTY IN AN AMOUNT EQUAL TO OR GREATER THAN $1,000,000. FHC MUST SEEK PREMIER'S APPROVAL FOR ANY ACQUISITIONS, SALE OR TRANSFER OF ANY MATERIAL ASSET USED IN FHC'S ACTIVITIES. FORM 990, PART VI, SECTION A, LINE 6 FHC HAS ONE CORPORATE MEMBER; PREMIER, AN OHIO NON-PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A PREMIER HAS THE SOLE AUTHORITY TO ELECT THE BOARD OF TRUSTEES FOR FHC. PREMIER HAS THE AUTHORITY TO REMOVE SUCH TRUSTEES AT ANY REGULAR OR SPECIAL MEETING OR BY WRITTEN CONSENT. FORM 990, PART VI, SECTION A, LINE 7B SEE EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A. FORM 990, PART VI, SECTION B, LINE 11B THIS 990 FILING AND ATTACHED SCHEDULES (THE RETURN) ARE PREPARED BY A STAFF MEMBER IN THE TAX DEPARTMENT OF PREMIER, OF WHICH FHC IS AN AFFILIATE. THE RETURN IS REVIEWED BY THE TAX MANAGER AND DIRECTOR OF TAX COMPLIANCE OF PREMIER. AFTER ALL CHANGES FROM THE ABOVE GROUPS ARE MADE, THE RETURN IS REVIEWED BY THE VICE PRESIDENT/CONTROLLER OF PREMIER AND THE CHIEF FINANCIAL OFFICER OF THIS ENTITY. A FINAL VERSION OF THE RETURN IS THEN PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW. AT A BOARD OF TRUSTEES MEETING, THE VICE PRESIDENT/CONTROLLER OF PREMIER (OR DESIGNEE) SHARES DETAILED INFORMATION ON COMPENSATION AND OTHER KEY AREAS, AS WELL AS ADDRESSES ANY OTHER QUESTIONS FROM THE BOARD OF TRUSTEES, PENDING THEIR REVIEW. THE 990 FILING IS ALSO SHARED WITH THE AUDIT COMMITTEE OF PREMIER. FORM 990, PART VI, SECTION B, LINE 12C PREMIER, WITH WHICH FHC IS AN AFFILIATE, REQUIRES ALL BOARD MEMBERS, BOARD COMMITTEE MEMBERS, MEDICAL DIRECTORS, SUPPLY CHAIN DIVISION MEMBERS, AUTHORIZED SIGNERS, DIRECTORS, EXECUTIVES, MEDICAL EXECUTIVE COMMITTEE MEMBERS, MEDICAL DEPARTMENT AND SECTION CHAIRS, PHYSICIAN PARTNERSHIP COMMITTEE MEMBERS, PHYSICIAN GUIDANCE GROUP MEMBERS, AND ALL EMPLOYED PHYSICIANS TO ANNUALLY REVIEW THE PREMIER COMPREHENSIVE CONFLICT OF INTEREST STATEMENT, AN EXPLANATORY MEMORANDUM, THE ANTITRUST COMPLIANCE POLICY, AND COMPLETE AN INDIVIDUAL QUESTIONNAIRE DISCLOSING ANY POTENTIAL CONFLICTS AS DEFINED IN THE CONFLICT OF INTEREST POLICY. THIS IS ACCOMPLISHED EITHER BY WAY OF AN ELECTRONIC COMMUNICATION SENT OUT DIRECTLY BY THE CORPORATE COMPLIANCE DEPARTMENT OR BY WAY OF A MEMO SENT OUT FROM THE CHAIRMAN OF THE BOARD AND CHIEF EXECUTIVE OFFICER OF PREMIER. IT ALSO INCLUDES AN EXPLANATORY MEMORANDUM OF SPECIFIC ACTIVITIES THAT MIGHT GIVE CAUSE TO A CONFLICT AND AN INDIVIDUAL QUESTIONNAIRE TO DISCLOSE ALL SUCH ACTIVITIES. THIS QUESTIONNAIRE MUST BE COMPLETED AND SIGNED BY THE INDIVIDUAL. THIS CORRESPONDENCE INCLUDES A COPY OF THE ANTITRUST COMPLIANCE POLICY THAT MUST BE SIGNED BY THE INDIVIDUAL. ALL OF THESE DOCUMENTS ARE SENT TO THE CORPORATE COMPLIANCE DEPARTMENT. THE CORPORATE COMPLIANCE DEPARTMENT ENSURES ALL FORMS ARE RETURNED AND RETAINS THE DOCUMENTS FOR FIVE YEARS. IN ADDITION, AT EACH MEETING OF THE BOARD OR ANY BOARD COMMITTEE, FOLLOWING APPROVAL OF THE PREVIOUS MEETING'S MINUTES, THE BOARD OR COMMITTEE CHAIR SHALL REQUEST ANY BOARD MEMBER WHO PERCEIVES A POTENTIAL CONFLICT OF INTEREST ON ANY OF THE MEETING'S AGENDA ITEMS TO DISCLOSE THE POTENTIAL CONFLICT. ADDITIONALLY, AT ANY BOARD OR BOARD COMMITTEE MEETING WHERE THE SUBJECT OF CONFLICT OF INTEREST IS DISCUSSED, THE MINUTES SHALL CONTAIN THE NAME OF THE PARTY DISCUSSING A POTENTIAL CONFLICT OF INTEREST, THE NATURE OF THE POTENTIAL CONFLICT OF INTEREST AND WHETHER A CONFLICT OF INTEREST WAS FOUND TO EXIST. IF A CONFLICT OF INTEREST IS DETERMINED BY THE BOARD TO EXIST, THE MEMBER WILL BE EXCUSED FROM PARTICIPATING IN ANY DISCUSSION OR VOTING ON THE PARTICULAR AGENDA ITEM. THE CHIEF COMPLIANCE AND ENTERPRISE RISK OFFICER REPORTS THE RESULTS OF THE PREMIER CONFLICT OF INTEREST QUESTIONNAIRES NO LESS THAN ANNUALLY TO THE BOARD OF TRUSTEES BY WAY OF THE COMPLIANCE AND AUDIT COMMITTEE. THIS REVIEW IS DOCUMENTED IN THE MINUTES OF THE MEETING. PERIODICALLY, THE INTERNAL AUDIT DEPARTMENT WILL REVIEW A SAMPLE OF COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES AND REPORT THE RESULTS TO THE COMPLIANCE AND AUDIT COMMITTEE. THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES ARE INDIVIDUALLY SUMMARIZED IN A DOCUMENT AND SENT ELECTRONICALLY TO THE FINANCE DEPARTMENT FOR ANY NECESSARY DISCLOSURES REQUIRED ON THE 990 FILING. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR FHC'S CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH FHC IS AN AFFILIATE, ON AN ANNUAL BASIS. THE REVIEW PROCESS PERFORMED BY PREMIER FOLLOWS A MARKET BASED COMPENSATION PHILOSOPHY DESIGNED TO ATTRACT AND RETAIN THE EXECUTIVE TALENT REQUIRED TO MEET THE HIGH-PERFORMANCE STANDARDS OF OUR BOARD AND OUR COMMUNITY. PREMIER ANNUALLY REVIEWS EXECUTIVE COMPENSATION SURVEY DATA FOR A REGIONAL 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, CHIEF INTEGRATION OFFICER, CHIEF STRATEGY OFFICER, AND THE HOSPITAL CEOS. 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. FIDELITY NURSING SYSTEMS LLC 3832 KETTERING BLVD MORAINE OH 45439 311075381 PRIVATE PAY OH 3430917 1193016 FHC PREMIER HEALTH 110 MAIN STREET SUITE 500 DAYTON OH 45402 311446699 PARENT OH 501 (C) (3) 12B N/A 0 MEDAMERICA HEALTH SYSTEMS CO 110 MAIN STREET SUITE 500 DAYTON OH 45402 311040228 SUPPORT ORG OH 501 (C) (3) 12B N/A 0 MIAMI VALLEY HOSPITAL 110 MAIN STREET SUITE 500 DAYTON OH 45402 310537504 HOSPITAL OH 501 (C) (3) 3 PREMIER HEALTH 0 MIAMI VALLEY HOSPITAL FOUNDATION 110 MAIN STREET SUITE 500 DAYTON OH 45402 311040231 FOUNDATION OH 501 (C) (3) 7 PREMIER HEALTH 0 PREMIER COMMUNITY HEALTH 110 MAIN STREET SUITE 500 DAYTON OH 45402 311122883 HEALTH EDUCATION OH 501 (C) (3) 10 FIDELITY HEALTH CARE 0 SAMARITAN HEALTH PARTNERS 110 MAIN STREET SUITE 500 DAYTON OH 45402 311107411 SUPPORT ORG OH 501 (C) (3) 12B PREMIER HEALTH 0 GOOD SAMARITAN FOUNDATION - DAYTON 110 MAIN STREET SUITE 500 DAYTON OH 45402 237296923 FOUNDATION OH 501 (C) (3) 7 PREMIER HEALTH 0 ATRIUM HEALTH SYSTEM 110 MAIN STREET SUITE 500 DAYTON OH 45402 310537492 SUPPORT ORG OH 501 (C) (3) 12B N/A 0 ATRIUM MEDICAL CENTER 110 MAIN STREET SUITE 500 DAYTON OH 45402 311079309 HOSPITAL OH 501 (C) (3) 3 PREMIER HEALTH 0 UVMC 110 MAIN STREET SUITE 500 DAYTON OH 45402 341850683 SUPPORT ORG OH 501 (C) (3) 12B N/A 0 UPPER VALLEY MEDICAL CENTER 110 MAIN STREET SUITE 500 DAYTON OH 45402 310537095 HOSPITAL OH 501 (C) (3) 3 PREMIER HEALTH 0 UPPER VALLEY PROFESSIONAL CORP 110 MAIN STREET SUITE 500 DAYTON OH 45402 311400963 HEALTH CARE OH 501 (C) (3) 10 PREMIER HEALTH 0 UVPC SPECIALISTS 110 MAIN STREET SUITE 500 DAYTON OH 45402 203687536 HEALTH CARE OH 501 (C) (3) 10 UPPER VALLEY PROFESSIONAL CORP 0 UVMC NURSING CARE INC 110 MAIN STREET SUITE 500 DAYTON OH 45402 311224064 NURSING HOME OH 501 (C) (3) 10 PREMIER HEALTH 0 COMPUNET CLINICAL LABORATORIES LLC 110 MAIN STREET SUITE 500 DAYTON OH 45402 311258010 LAB OH 501 (C) (3) 12B PREMIER HEALTH 0 SAMARITAN BEHAVIORAL HEALTH INC 110 MAIN STREET SUITE 500 DAYTON OH 45402 020633634 BEHAVIORAL HEALTH OH 501 (C) (3) 7 PREMIER HEALTH 0 SWEITZER STREET LLC 110 N MAIN STREET SUITE 500 DAYTON OH 45402 454700417 REAL ESTATE OH MVHE INC EXCLUDED 0 0 SWEITZER MOB LLC 110 N MAIN STREET SUITE 500 DAYTON OH 45402 474554657 REAL ESTATE OH MVHE INC EXCLUDED 0 0 MVHE INC 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 311185270 PHYSICIAN SVCS OH PREMIER HEALTH HOLDING C 0 PREMIER HEALTH SPECIALISTS 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 061744704 PHYSICIAN SVCS OH PREMIER HEALTH HOLDING C 0 SAMARITAN FAMILY CARE 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 311299450 PHYSICIAN SVCS OH PREMIER HEALTH HOLDING C 0 AFTER HOURS FAMILY CARE 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 311269483 HEALTH CARE OH UPPER VALLEY PROFESSIONAL CORP C 0 UVMC MANAGEMENT CORP 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 311360489 MANAGEMENT COMPANY OH PREMIER HEALTH C 0 PREMIER HEALTH URGENT CARE INC 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 822079409 URGENT CARE OH PREMIER HEALTH HOLDING C 0 PREMIER HEALTH PLAN INC 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 463024049 HEALTH INSURANCE OH PREMIER HEALTH INSURING CO C 0 GOOD SAMARITAN HOSPITAL 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 310536981 HOSPITAL OH PREMIER HEALTH C 0 PREMIER HEALTH ACO OF OHIO 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 474049773 MEDICARE ACO OH PREMIER HEALTH C 0 PREMIER HEALTH HOLDING 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 812419110 HOLDING CO OH PREMIER HEALTH C 0 PREMIER HEALTH INSURING CO 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 464766841 HEALTH INSURANCE OH PREMIER HEALTH C 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 1 1 1 0 1 PREMIER COMMUNITY HEALTH O 3046141 FMV