2021-11-08T11:09:44-06:00 2020-12-31 346565596 ERNST & YOUNG US LLP 221 E 4TH ST 2900 CINCINNATI OH 45202 990 2020-01-01 311446699 PREMIER HEALTH PARTNERS PREM 9374999942 110 N MAIN ST 500 DAYTON OH 45402 J MICHAEL SIMS VP & CONTROLLER 9374999942 2021-11-08 1 J MICHAEL SIMS 999009999 JULIE L SPARKS P01268401 5136121400 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z PREMIER HEALTH MARY H BOOSALIS 110 N MAIN ST 500 DAYTON OH 45402 5801930 0 X WWW.PREMIERHEALTH.COM X 1995 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. 21 17 21 17 784187 0 177027 834002 1741781 4717029 -25000 25000 996272 225899 2890080 5801930 6471 500 0 0 118995855 116425048 0 0 0 105240664 108458964 224242990 224884512 -221352910 -219082582 61768462 62759053 13477492 34095759 48290970 28663294 X WE WILL IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH OTHERS WHO SHARE OUR COMMITMENT TO PROVIDE HIGH QUALITY, COST-COMPETITIVE HEALTH SERVICES. 1 0 189701020 500 1537238 THE PRIMARY EXEMPT PURPOSE OF PREMIER HEALTH (PREMIER) IS TO ESTABLISH, MAINTAIN, SUPPORT, AND STIMULATE THE DEVELOPMENT OF A HEALTHCARE SYSTEM INCLUDING WITHOUT LIMITATION, HOSPITALS, CLINICS, AND OTHER FACILITIES THAT PROVIDE INPATIENT OR OUTPATIENT CARE OR AMBULATORY SERVICES, ACCOMMODATIONS, DIAGNOSTICS, AND TREATMENTS TO PERSONS SUFFERING FROM ILLNESS.CONTINUED IN SCHEDULE O. 2792170 0 2395604 THE PROGRAM SERVICE ACTIVITIES OF COMPUNET CLINICAL LABORATORIES LLC (CCL) FROM FEBRUARY 25, 2020 TO MARCH 08, 2020 ARE INCLUDED IN THIS FILING AS CCL WAS A WHOLLY-OWNED LLC TREATED AS A DISREGARDED ENTITY FOR FILING PURPOSES. BEGINNING MARCH 09, 2020, CCL WILL BE INCLUDING ITS PROGRAM SERVICE ACTIVITIES ON ITS SEPARATELY FILED FORM 990. 2084368 0 0 PREMIER HEALTH GROUP (PHG) IS A NON-EQUITY MODEL PHYSICIAN HOSPITAL ORGANIZATION CREATED TO CLINICALLY INTEGRATE PHYSICIANS AND HOSPITALS IN THE COMMON INTEREST OF ACHIEVING THE TRIPLE AIM: IMPROVED CONSUMER EXPERIENCE WITH THE HEALTHCARE SYSTEM AND LOWERING TOTAL COST OF CARE, WHILE MAINTAINING OR IMPROVING QUALITY OUTCOMES. PHG SERVES AS THE PROVIDER NETWORK FOR AND PROVIDES CONTINUOUS QUALITY IMPROVEMENT FUNCTIONS FOR PREMIER HEALTH PLAN, PREMIER HEALTH INSURING CORPORATION AND PREMIER HEALTH ACO OF OHIO, ALL AFFILIATES OF PREMIER HEALTH.CONTINUED IN SCHEDULE O. 194577558 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 1 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 1 149 0 1 21 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 21 17 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X J MICHAEL SIMS 9374999942 110 N MAIN ST SUITE 500 DAYTON OH 45402 X MARY H BOOSALIS PRESIDENT & CEO 37.00 3.00 X X 2150189 0 41653 GEORGE T BRODERICK JR MD TRUSTEE 0.50 39.50 X 0 492987 22990 SUBODH K WADHWA MD TRUSTEE 0.50 39.50 X 0 266728 20097 DARIN J PANGALANGAN MD TRUSTEE 0.50 39.50 X 40050 142697 0 STEVE BEINLICH TRUSTEE 0.50 0.50 X 0 0 0 ANITA J MOORE BOARD CHAIR 0.50 0.50 X X 0 0 0 KATHLEEN A CARLSON TRUSTEE 0.50 0.50 X 0 0 0 MARVA COSBY TRUSTEE 0.50 0.00 X 0 0 0 GAIL P FOREST TRUSTEE 0.50 0.50 X 0 0 0 JOSEPH M GERAGHTY TRUSTEE 0.50 0.00 X 0 0 0 LARRY L HOLLINGSHEAD TRUSTEE 0.50 0.50 X 0 0 0 DANIEL L HOOD MD TRUSTEE 0.50 1.00 X 0 0 0 JOHN W JACK LOHBECK TRUSTEE 0.50 0.00 X 0 0 0 WILLIAM E LUKENS TRUSTEE 0.50 2.00 X 0 0 0 MITCH MELFI TRUSTEE 0.50 0.00 X 0 0 0 ROWAN R NICKOL MD TRUSTEE 0.50 2.50 X 0 0 0 EDGAR M PURVIS JR TRUSTEE 0.50 0.50 X 0 0 0 COLLEEN RYAN TRUSTEE 0.50 0.00 X 0 0 0 THOMAS G THORNTON MD TRUSTEE 0.50 0.50 X 0 0 0 JILL WILSON TRUSTEE 0.50 0.50 X 0 0 0 SUSIE WISE TRUSTEE 0.50 2.00 X 0 0 0 SCOTT A SHELTON BOARD TREAS & CFO 39.50 0.50 X 1342217 0 46962 BARBARA A JOHNSON EXECUTIVE VP & COO 39.00 1.00 X 968394 0 27115 GEOFFREY P WALKER BOARD SECRETARY & CLO 10.00 30.00 X 834993 0 50821 GARY G GINTER VP & PREMIER CHIEF INFO OFFICER 10.00 30.00 X 545293 0 90857 MARC R BELCASTRO DO VP MEDICAL AFFAIRS & PREMIER CMO 10.00 30.00 X 667457 0 39724 MARGARET W MARK VP NURSING/CNO/PATIENT EXP 10.00 30.00 X 530877 0 47367 THOMAS R CURTIN VP REVENUE CYCLE 9.00 31.00 X 494429 0 67304 J MICHAEL SIMS SYS VP TREAS & CORP CONTROLLER 9.00 31.00 X 505791 0 52141 ELAINE LAINIE M DEAN CHIEF OF STRATEGY & BUS DEV 10.00 30.00 X 457787 0 24516 KIM K STRAHL VICE PRESIDENT & CPO 10.00 30.00 X 363757 0 33262 BILLIE L LUCENTE-BAKER SYSTEM VP-HR OPERATIONS 10.00 30.00 X 283148 0 32159 DIANE L PLEIMAN PRESIDENT & CEO-PHYS COMPANIES 8.00 32.00 X 722830 0 32955 MATTHEW S REEVES VALUE BASE SV & PRES PHG (FROM SEP) 40.00 0.00 X 519224 0 61410 RENEE P GEORGE VALUE BASE SVS & PRES PHG (TO AUG) 40.00 0.00 X 326752 0 44244 DAVID J CARPENTER DIR-TECHNOL VALUE INTEGRATION 40.00 0.00 X 186025 0 19914 JASON M BAILEY DIRECTOR - ACO OPERATIONS 40.00 0.00 X 169461 0 30765 MICHAEL J MAIBERGER FORMER OFFICER 0.00 0.00 X 847352 522472 39080 JENNIFER J HAULER DO FORMER KEY EMPLOYEE 0.00 40.00 X 0 877119 85663 THOMAS R PARKER FORMER KEY EMPLOYEE 0.00 40.00 X 0 686531 57139 11956026 2988534 968138 18 1 1 0 CDW DIRECT 75 REMITTANCE DR 1150 CHICAGO IL 60675 PROFESSIONAL SERVICE 9593698 EPIC SYSTEMS CORPORATION 1979 MILKY WAY VERONA WI 53593 SOFTWARE MAINTENANCE 6414346 MICROSOFT LICENSING GP 1950 N STEMMONS FWY DALLAS TX 75207 SOFTWARE LICENSE 3385989 NUANCE COMMUNICATIONS INC 1 WAYSIDE ROAD BURLINGYON MA 01803 INTELLIGENCE NETWORK 3284939 PLATINUM MARKETING GROUP 1205 PENDLETON ST CINCINNATI OH 45202 PROFESSIONAL SERVICE 2639973 95 92643 718253 23106 834002 CLINICAL & ANATOMIC PATHOLOGY LAB 621500 3179791 2395604 784187 PATIENT INFORMATION PARTNERS 900099 1528383 1528383 HEALTH EDUCATION 900099 8855 8855 4717029 25000 0 25000 25000 25000 CAFETERIA SALES 900099 209304 209304 EMS EDUCATION 900099 9719 9719 CAREFINDERS 900099 875 875 6001 6001 225899 5801930 3932842 784187 250899 X 500 500 9738263 3726489 6011774 85993157 76282441 9710716 2895698 2568703 326995 10430251 9252422 1177829 7367679 6535689 831990 8071 7160 911 1196008 1060950 135058 1228950 1090172 138778 73031 64784 8247 4475 3970 505 30264661 26847046 3417615 6578362 5835505 742857 2783693 2469347 314346 37382500 33161108 4221392 2293798 2034773 259025 173876 154241 19635 11411 10122 1289 15885206 14091380 1793826 1206999 1070700 136299 OPERATING SUPPLIES 3300186 2927515 372671 TRAINING AND EDUCATION 2345395 2080543 264852 DUES & SUBSCRIPTIONS 980096 869419 110677 PATIENT RELATIONS 738589 655184 83405 2003657 1777395 226262 224884512 194577558 30306954 0 195953 5350177 137834 182386 12894327 16941584 184873345 145000179 48150606 39873166 389742 411740 61768462 62759053 12005585 33427256 35925 34706 1127577 78568 308405 555229 13477492 34095759 X 48290970 28663294 48290970 28663294 61768462 62759053 X -219082582 199454906 X 0 1 X 1 0 X X 11 ATRIUM MEDICAL CENTER 311079309 3 1 0 0 MIAMI VALLEY HOSPITAL 310537504 3 1 0 0 UPPER VALLEY MEDICAL CENTER 310537095 3 1 0 0 MIAMI VALLEY HOSPITAL FOUNDATION 311040231 7 1 0 0 FIDELITY HEALTH CARE INC 311075381 10 1 0 0 PREMIER COMMUNITY HEALTH 311122883 10 1 0 0 GOOD SAMARITAN FOUNDATION - DAYTON 237296923 7 1 0 0 SAMARITAN BEHAVIORAL HEALTH INC 020633634 7 1 0 0 UPPER VALLEY PROFESSIONAL CORPORATION 311400963 10 1 0 0 UVPC SPECIALISTS INC 203687536 10 1 0 0 UVMC NURSING CARE INC 311224064 10 1 0 0 11 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 PART IV, SECTION A, LINE 1: THE JANUARY 1, 2018 DEFINITIVE SYSTEM REORGANIZATION AGREEMENT DESIGNATED PREMIER HEALTH (PREMIER) AS THE SOLE CORPORATE MEMBER OF THE THREE SYSTEM HOSPITALS (FIVE LOCATIONS) AND ALL HOSPITAL SUBSIDIARIES AND AFFILIATES UNLESS SPECIFICALLY EXCLUDED. THE HOSPITAL SUBSIDIARIES ARE NOT CALLED OUT BY NAME. PART IV, SECTION A, LINE 5A: PREMIER HEALTH'S ORGANIZING DOCUMENTS STATE THE ORGANIZATION WILL SUPPORT ALL OF ITS AFFILIATES WHICH ARE EXEMPT FROM TAXATION UNDER SECTION 501(C)(3). HEART INSTITUTE OF DAYTON (EIN: 30-0502367) IS WAS DISSOLVED WITH THE STATE EFFECTIVE DEC 31, 2019. PART IV, SECTION C, LINE 1: THE JANUARY 1, 2018 DEFINITIVE SYSTEM AGREEMENT GRANTS PREMIER THE ABILITY TO APPOINT AND / OR REMOVE BOARD MEMBERS OF THE SUPPORTED ORGANIZATIONS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 51431 0 0 1 21600 73031 0 PART II-B, LINE 1F: PAYMENTS FOR LOBBYING ACTIVITIES INCLUDE DUES PAID TO AMERICAN HOSPITAL ASSOCIATION AND DAYTON DEVELOPMENT CORPORATION. PART II-B, LINE 1I: PREMIER CONTRACTS WITH A LOBBYIST FOR HEALTHCARE RELATED ISSUES. 7915718 3532235 4383483 9428 3824 5604 174015651 141464120 32551531 2932548 2932548 39873166 DEFERRED COMPENSATION 291740 OTHER 263489 555229 X PART X, LINE 2: THE FOLLOWING FOOTNOTE IS TAKEN FROM THE 2020 CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR PREMIER HEALTH (PHP) AND AFFILIATES. 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. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 92879000 0 0 0 0 0 0 92879000 0 92879000 1 0 0 1 1 0 PART III ACCOUNTING METHOD: PART I, LINE 3: THE INVESTMENTS LISTED IN SCHEDULE F ARE NOT REPORTED ON PREMIER'S 990, PART X, BUT ARE INSTEAD REPORTED ON THE THREE HOSPITALS WHERE PREMIER IS THE MEMBER. X X X X 1 1 0 0 0 0 0 0 0 MARY H BOOSALIS PRESIDENT & CEO 1521403 0 589975 0 38811 0 21458 0 20195 0 2191842 0 0 0 MICHAEL J MAIBERGER FORMER OFFICER 0 0 244961 0 602391 522472 17753 0 21327 0 886432 522472 610086 522472 SCOTT A SHELTON BOARD TREAS & CFO 539248 0 376065 0 426904 0 14812 0 32150 0 1389179 0 0 0 BARBARA A JOHNSON EXECUTIVE VP & COO 647940 0 252301 0 68153 0 15954 0 11161 0 995509 0 0 0 JENNIFER J HAULER DO FORMER KEY EMPLOYEE 0 539982 0 335280 0 1857 0 82899 0 2764 0 962782 0 0 GEOFFREY P WALKER BOARD SECRETARY & CLO 417391 0 188245 0 229357 0 23002 0 27819 0 885814 0 0 0 DIANE L PLEIMAN PRESIDENT & CEO-PHYS COMPANIES 405795 0 189426 0 127609 0 24480 0 8475 0 755785 0 0 0 THOMAS R PARKER FORMER KEY EMPLOYEE 0 244968 0 224567 0 216996 0 37630 0 19509 0 743670 0 35319 MARC R BELCASTRO DO VP MEDICAL AFFAIRS & PREMIER CMO 475256 0 137384 0 54817 0 13525 0 26199 0 707181 0 34681 0 GARY G GINTER VP & PREMIER CHIEF INFO OFFICER 396542 0 144812 0 3939 0 62814 0 28043 0 636150 0 0 0 MATTHEW S REEVES VALUE BASE SV & PRES PHG (FROM SEP) 362374 0 134203 0 22647 0 28957 0 32453 0 580634 0 0 0 MARGARET W MARK VP NURSING/CNO/PATIENT EXP 345989 0 147406 0 37482 0 19858 0 27509 0 578244 0 10459 0 THOMAS R CURTIN VP REVENUE CYCLE 326009 0 160675 0 7745 0 34119 0 33185 0 561733 0 0 0 J MICHAEL SIMS SYS VP TREAS & CORP CONTROLLER 311052 0 106785 0 87954 0 23220 0 28921 0 557932 0 0 0 GEORGE T BRODERICK JR MD TRUSTEE 0 395028 0 87045 0 10914 0 10717 0 12273 0 515977 0 0 ELAINE LAINIE M DEAN CHIEF OF STRATEGY & BUS DEV 315881 0 120665 0 21241 0 11103 0 13413 0 482303 0 0 0 KIM K STRAHL VICE PRESIDENT & CPO 240551 0 116520 0 6686 0 20938 0 12324 0 397019 0 0 0 RENEE P GEORGE VALUE BASE SVS & PRES PHG (TO AUG) 220820 0 93145 0 12787 0 34504 0 9740 0 370996 0 0 0 BILLIE L LUCENTE-BAKER SYSTEM VP-HR OPERATIONS 220143 0 61876 0 1129 0 18160 0 13999 0 315307 0 0 0 SUBODH K WADHWA MD TRUSTEE 0 262220 0 0 0 4508 0 9157 0 10940 0 286825 0 0 DAVID J CARPENTER DIR-TECHNOL VALUE INTEGRATION 156689 0 27124 0 2212 0 6926 0 12988 0 205939 0 0 0 JASON M BAILEY DIRECTOR - ACO OPERATIONS 145654 0 23328 0 479 0 5668 0 25097 0 200226 0 0 0 DARIN J PANGALANGAN MD TRUSTEE 40050 129595 0 0 0 13102 0 0 0 0 40050 142697 0 0 PART I, LINE 4A: THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT: THOMAS PARKER $163,848 IN 2020 AND WILL RECEIVE $49,154 IN 2021. THE FOLLOWING INDIVIDUAL WAS SELECTED TO PARTICIPATE IN A VOLUNTARY RETIREMENT PROGRAM AND RECEIVED THE FOLLOWING PAYMENTS: MICHAEL MAIBERGER $610,086. 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 HEALTH (PREMIER) AND ITS AFFILIATED ORGANIZATIONS COMPENSATE FOR THIS LIMITATION AND SUPPLEMENT THE AFFECTED EXECUTIVES' QUALIFIED PENSION THROUGH CERTAIN NONQUALIFIED PLANS. PREMIER 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 2020. THE INDIVIDUALS LISTED BELOW HAVE MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE PENSION RESTORATION PLAN AND RECEIVED THE ASSOCIATED PAYMENT IN 2020: DIANE PLEIMAN $124,338; SCOTT SHELTON $402,778; J. MICHAEL SIMS $83,220; GEOFFREY WALKER $222,983. THE INDIVIDUALS LISTED BELOW HAVE MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE SERP AND RECEIVED THE ASSOCIATED PAYMENT IN 2020: MARC BELCASTRO, M.D. $40,805; BARBARA JOHNSON $56,031; MARGARET MARK $10,459; THOMAS PARKER $35,319. 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 AND PAID TO THE SERP PARTICIPANTS: MARC BELCASTRO, M.D. $4,243; THOMAS CURTIN $13,484; RENEE GEORGE $22,648; GARY GINTER $39,595; JENNIFER HAULER $72,593; BARBARA JOHNSON $441; MICHAEL MAIBERGER $1,933; MARGARET MARK $9,647; THOMAS PARKER $15,609; MATTHEW REEVES $19,963. 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 I, LINE 7B: NET UNRELATED BUSINESS TAXABLE INCOME /(LOSS) COMPRISES AMOUNTS FROM PARTNERSHIP INVESTMENTS THAT ARE NOT RECOGNIZED FOR BOOK PURPOSES, THEREFORE NO UNRELATED BUSINESS INCOME/(LOSS) FROM PARTNERSHIP INVESTMENTS APPEARS ON PART VIII. FORM 990, PART III, LINE 2 SEE PART III, LINE 4B FORM 990, PART III, LINE 4A (CONTINUED): AS SUCH, PREMIER IS RESPONSIBLE FOR OVERSIGHT OF THE THREE HOSPITAL ENTITIES AS ITS CHARITABLE GOAL, AND THE INFORMATION BELOW IS CUMULATIVE OF THEIR SEPARATE REPORTS: QUANTITATIVE DESCRIPTION OF COMMUNITY BENEFIT COMMUNITY BENEFIT SUMMARY FROM RELATED HOSPITALS SCHEDULE H FOR THE YEAR ENDED DECEMBER 31, 2020. CHARITY AND MEANS-TESTED GOVERNMENT PROGRAMS AND CERTAIN OTHER COMMUNITY BENEFITS AT COST: $18,757,000 CHARITY CARE AT COST $123,582,000 UNREIMBURSED MEDICAID $7,332,000 UNREIMBURSED COSTS OF OTHER MEANS-TESTED GOVERNMENT PROGRAMS ------------- $149,671,000 TOTAL OTHER BENEFITS: $2,713,000 COMMUNITY HEALTH IMPROVEMENT SERVICES & COMMUNITY BENEFIT OPERATIONS $29,873,000 SUBSIDIZED HEALTH SERVICES $13,363,000 CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY GROUPS -------------- $45,949,000 TOTAL ------------- $195,620,000 GRAND TOTAL PROGRAM & OTHER COMMUNITY BENEFITS COMMUNITY BUILDING ACTIVITIES: $325,000 PHYSICAL IMPROVEMENTS --------- $325,000 TOTAL COMMUNITY BUILDING ACTIVITIES $26,492,000 UNPAID COST OF MEDICARE (ALLOWABLE COST AND REIMBURSEMENTS REPORTED ON MEDICARE COST REPORT) $133,302,000 OTHER UNPAID COST OF MEDICARE (COST AND REIMBURSEMENTS NOT REPORTED ON MEDICARE COST REPORT) ------------ $159,794,000 TOTAL UNPAID COST OF MEDICARE ------------ $355,739,000 TOTAL COMMUNITY BENEFIT INCLUDING THE UNPAID COSTS OF MEDICARE ========= FORM 990, PART III, LINE 4C (CONTINUED): THROUGH OUR PHYSICIAN-LED ORGANIZATION, WE DEPLOY VARIOUS POPULATION HEALTH MODELS TO OUR PROVIDERS TO HELP THEM BETTER COORDINATE CARE FOR THEIR PATIENTS IN OUR EFFORTS TO SERVE PREMIER HEALTH'S MISSION OF BUILDING HEALTHIER COMMUNITIES. FORM 990, PART VI, SECTION A, LINE 6 PREMIER HEALTH (PREMIER) HAS FOUR CORPORATE MEMBERS: MEDAMERICA HEALTH SYSTEMS, CATHOLIC HEALTH INITIATIVES, ATRIUM HEALTH SYSTEM, AND UVMC. FORM 990, PART VI, SECTION A, LINE 7A MEDAMERICA HEALTH SYSTEMS ELECTS 8 BOARD MEMBERS, CATHOLIC HEALTH INITIATIVES ELECTS 7 BOARD MEMBERS, ATRIUM HEALTH SYSTEM ELECTS 3 BOARD MEMBERS AND UVMC ELECTS 3 BOARD MEMBERS. THE MEMBERS MUST APPROVE ANY DISSOLUTION OF ASSETS AND ANY CHANGES IN THE CODE OF REGULATIONS OR ARTICLES OF INCORPORATION. THE MEMBERS DO NOT APPROVE ANY OPERATIONAL DECISIONS OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B SEE EXPLANATION FOR 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. THE RETURN IS REVIEWED BY THE TAX MANAGER AND DIRECTOR OF TAX COMPLIANCE OF PREMIER. THE RETURN IS CONCURRENTLY SENT TO ERNST & YOUNG U.S. LLP FOR THEIR REVIEW. 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 SENT TO ERNST & YOUNG U.S. LLP FOR A FINAL REVIEW AND 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 THE ANNUAL 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. FORM 990, PART VII, SECTION A, SYSTEM KEY EMPLOYEES: THE SYSTEM KEY EMPLOYEES' TOTAL COMPENSATION AMOUNT IS ACCURATELY REPORTED ON THE VARIOUS ENTITIES THEY SERVE. THE KEY EMPLOYEES' COMPENSATION IS BEING REPORTED AS PAID BY PREMIER AS THE PAYMASTER OF THEIR APPLICABLE AFFILIATED ORGANIZATION IN ORDER TO MORE CLEARLY REFLECT THEIR RESPONSIBILITIES ACROSS THE PREMIER SYSTEM. COMPENSATION AND RELATED PAYROLL REPORTING REQUIREMENTS FOR SYSTEM KEY EMPLOYEES ARE PROCESSED AND FILED BY AFFILIATES OF PREMIER. FORM 990, PART IX, LINE 11G CONSULTANT FEES: PROGRAM SERVICE EXPENSES 12,499,900. MANAGEMENT AND GENERAL EXPENSES 1,591,231. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,091,131. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 7,545,187. MANAGEMENT AND GENERAL EXPENSES 960,498. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,505,685. ACCRUED OTHER: PROGRAM SERVICE EXPENSES 2,117,608. MANAGEMENT AND GENERAL EXPENSES 269,570. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,387,178. CREDIT CARD FEES: PROGRAM SERVICE EXPENSES 1,142,311. MANAGEMENT AND GENERAL EXPENSES 145,416. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,287,727. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 866,588. MANAGEMENT AND GENERAL EXPENSES 110,316. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 976,904. PURCHASED LABOR: PROGRAM SERVICE EXPENSES 697,369. MANAGEMENT AND GENERAL EXPENSES 88,775. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 786,144. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 495,403. MANAGEMENT AND GENERAL EXPENSES 63,064. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 558,467. BANK FEES: PROGRAM SERVICE EXPENSES 426,781. MANAGEMENT AND GENERAL EXPENSES 54,329. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 481,110. COLLECTION COSTS: PROGRAM SERVICE EXPENSES 420,814. MANAGEMENT AND GENERAL EXPENSES 53,569. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 474,383. RECRUITMENT: PROGRAM SERVICE EXPENSES 200,560. MANAGEMENT AND GENERAL EXPENSES 25,531. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 226,091. ARCHIVES/REC RETENTION SVC: PROGRAM SERVICE EXPENSES 184,899. MANAGEMENT AND GENERAL EXPENSES 23,537. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 208,436. AMBULANCE & AMBULETTE: PROGRAM SERVICE EXPENSES 171,459. MANAGEMENT AND GENERAL EXPENSES 21,827. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 193,286. MATERIAL STERILIZATION: PROGRAM SERVICE EXPENSES 58,534. MANAGEMENT AND GENERAL EXPENSES 7,451. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 65,985. OTHER FEES: PROGRAM SERVICE EXPENSES 19,633. MANAGEMENT AND GENERAL EXPENSES 2,501. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,134. FORM 990, PART XI, LINE 9: EQUITY TRANSFER 199,454,906. 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