2020-11-16T14:09:47-06:00 2019-12-31 ERNST & YOUNG US LLP 221 E 4TH STREET SUITE 2900 CINCINNATI OH 45202 990 2019-01-01 311079309 ATRIUM MEDICAL CENTER % J MICHAEL SIMS ATRI 9374999942 110 N MAIN ST 500 DAYTON OH 45402 J MICHAEL SIMS VP & CONTROLLER 9374999942 2020-11-03 true JULIE L SPARKS P01268401 5136121400 108.206.163.59 31499120203215000004 2020-11-16 P A6E5CA7D42B22EAE9EAB39D40921AF7EA2C02C61 770194AAF055F9EA87E64CA02E08FE540289067F 2019 2021-01-29 14:40:06Z KEITH D BRICKING MD 1 MEDICAL CENTER DR MIDDLETOWN OH 45005 267432362 false 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 HEALTHCARE SERVICES. 11 2 2172 295 144235 0 589494 395641 223424893 224878626 3275698 7511891 6174302 883453 233464387 233669611 449165 2535349 0 0 101729336 90438402 0 0 0 126617928 118208883 228796429 211182634 4667958 22486977 363615202 350047962 253985972 282210489 109629230 67837473 ATRIUM MEDICAL CENTER WILL IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH OTHERS WHO SHARE OUR COMMITMENT TO PROVIDE HIGH-QUALITY, COST-COMPETITIVE HEALTHCARE SERVICES. false false 205238015 2535349 224735350 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. 205238015 true true false true false false false false false true true true false false true true false true false false true false false false false false true true true false true true false false false false false false false false false false false false false false false true false false false true 109 0 true 2172 true true true false false false false false false false false false false false X 11 2 false true true false true true true true true false false true true true true true true true true true true OH X J MICHAEL SIMS 9374999942 110 N MAIN ST SUITE 500 DAYTON OH 45402 X MICHAEL J MAIBERGER FORMER KEY EMPLOYEE 0.0 0.0 X 0 2292818 1062061 MARY H BOOSALIS TRUSTEE AND PREMIER CEO 0.5 39.5 X 0 1820985 43290 SCOTT A SHELTON FORMER OFFICER 0.0 40.0 X 0 926869 31126 JENNIFER J HAULER D FORMER KEY EMPLOYEE 0.0 40.0 X 0 893785 55776 MICHAEL R UHL FORMER TRUSTEE AND OFFICER 0.0 40.0 X 0 710746 83340 JOHN M MILLER MD TRUSTEE 0.5 39.5 X 10637 710652 40339 BARBARA A JOHNSON EXECUTIVE VP & PREMIER COO 10.0 30.0 X 0 665968 38127 GEOFFREY P WALKER SYSTEM VP-CHIEF LEGAL OFFICER 10.0 30.0 X 0 648904 50342 THOMAS R PARKER FORMER KEY EMPLOYEE 0.0 40.0 X 0 619173 79761 MATTHEW S REEVES DO TRUSTEE (TO MAY) 40.0 0.0 X 597153 0 56942 GARY G GINTER VP &PREMIER CHIEF INFO OFFICER 10.0 30.0 X 0 553521 98017 CRAIG SELF FORMER KEY EMPLOYEE 0.0 0.0 X 0 523869 94857 RENEE P GEORGE FORMER KEY EMPLOYEE 0.0 40.0 X 0 539890 63443 MARGARET W MARK VP NURSING SERVICE/PREMIER CNO 10.0 30.0 X 0 527720 51383 DONNA L BANKS SYS VP-OPERATIONS INNOVATION 40.0 0.0 X 325238 0 225061 DALE E CREECH JR FORMER KEY EMPLOYEE 0.0 0.0 X 0 510477 29497 J MICHAEL SIMS SYS VP-TREAS & CORP CONTROLLER 10.0 30.0 X 0 461159 53405 KEITH D BRICKING MD PRESIDENT & CEO 39.5 0.5 X X 477608 6250 30647 JOSHUA A ORDWAY MD TRUSTEE (FROM JUL) 0.5 39.5 X 0 448044 38715 THOMAS R CURTIN VP REVENUE CYCLE 10.0 30.0 X 0 407459 60214 MARK W SHAW FORMER KEY EMPLOYEE 0.0 0.0 X 0 418206 22568 MARQUITA L TURNER TRUSTEE & COO 40.0 0.0 X X 377057 0 23181 KIM K STRAHL SYS VP & CPO 10.0 30.0 X 0 337548 33785 TAMARA L LAINE VP-BUSINESS DEV-DAYTON REGION 40.0 0.0 X 281004 0 48975 JOANNE R MORGAN SYSTEM VP - PHARMACY OPS 40.0 0.0 X 261855 0 27055 BILLIE L LUCENTE-BAKE SYS VP - HR OPERATIONS 10.0 30.0 X 0 252199 34146 RHONA L SEIDENSCHMIDT TRUSTEE 40.0 0.0 X 230504 0 32619 ROBYN S MYERS DIRECTOR-PATIENT SAFETY & PI 40.0 0.0 X 189574 0 30159 MONICA H BORCHERS DIR-FINANCIAL ACCOUNTING 40.0 0.0 X 178327 0 21408 ELAINE M DEAN SYSTEM VP-BUSINESS DEVELOPMENT 10.0 30.0 X 0 178818 8144 BENJAMIN A WATSON ES BOARD SECRETARY (FROM NOV) 0.5 39.5 X 0 166716 16245 DALE J BOLCK MD TRUSTEE (TO APR) 0.5 39.5 X 0 156181 26026 ANDRE T HARRIS MD TRUSTEE (FROM MAY) 39.5 0.5 X 149958 0 14088 JEFFREY S ZOLLETT M FORMER TRUSTEE & OFFICER 0.0 40.0 X 0 126751 7610 LYNDSEY A PITTMAN BOARD TREAS & FINANCE DIRECTOR 39.5 0.5 X 124124 0 6494 WILLIAM ANDREW MD TRUSTEE / CHIEF OF STAFF 0.5 0.0 X 50000 450 0 PERCY DAVID MITCHELL TRUSTEE 0.5 0.0 X 30400 450 0 BARRY ROBERTSON MD BOARD CHAIR 0.5 0.0 X X 0 0 0 BARBARA L STEEL MD BOARD VICE-CHAIR 0.5 0.0 X 0 0 0 2330552 14024043 2441907 64 true true false DAWSON HEALTHCARE 1114 DUBLIN RD COLUMBUS OH 43215 MEDICAL SERVICES 3211121 EMERGENCY ACUTE CARE MED CO NE IN 440 STEVENS AVE 150 SOLANA BEACH CA 92075 MEDICAL SERVICES 1786634 WEATHERBY LOCUMS INC 6451 N FEDERAL HWY 700 FORT LAUDERDALE FL 33308 MEDICAL SERVICES 1666513 CATHOLIC HEALTH INITIATIVES 3900 OLYMPIC BLVD 400 ERLANGER KS 41018 CLINICAL ENGINEERING 1183708 HILLTOP OB GYN INC 200 MEDICAL CENTER DR 160 FRANKLIN OH 45005 MEDICAL SERVICES 1100000 33 395641 395641 NET PATIENT SERVICE REVENUE 900099 117598595 117455319 143276 MEDICARE/MEDICAID PAYMENTS 900099 103867686 103867686 HOSPITAL FRANCHISE TAX RECOVERIES 900099 3359469 3359469 MEDICAL RECORDS 900099 30347 30347 MISCELLANEOUS 900099 22529 22529 224878626 1700970 1700970 0 0 2807160 3303928 -496768 0 -496768 -496768 35756410 484518 29899919 530088 5856491 -45570 5810921 5810921 0 0 0 0 0 0 91225 28816 62409 62409 PENSION INCOME 900099 311371 311371 CAFETERIA SALES 900099 888005 959 887046 ALL OTHER REVENUE 900099 118436 118436 1317812 233669611 224735350 144235 8394385 2535349 2535349 0 0 0 2211412 410875 1800537 0 0 72053936 71066429 987507 2598276 2500732 97544 8269749 7959289 310460 5305029 5083852 221177 101836 101836 18131 18131 0 6864 6864 0 186274 186274 15520152 15430461 89691 310379 310379 938766 609833 328933 2597645 2475053 122592 0 3355513 3244838 110675 94495 72189 22306 0 0 14732288 14732288 0 17929361 17929361 1283244 1260734 22510 OPERATING SUPPLIES 44032071 44032071 PURCHASED SERVICES 10770363 9414363 1356000 HOSPITAL FRANCHISE TAX 4286659 4286659 ASSET IMPAIRMENT 548471 548471 1496371 1232953 263418 211182634 205238015 5944619 0 10320 9920 1529211 10330846 0 0 31448952 32222043 0 0 0 0 63748 958327 2227768 2722622 3153177 1636336 412527099 232979723 195300728 179547376 72310599 81320935 27124227 31462317 0 0 8874147 8657463 21572325 1179777 363615202 350047962 19182131 17173278 326400 2138508 235093 223617 188255359 188090250 0 0 0 0 16909516 21028775 0 0 29077473 53556061 253985972 282210489 X 109497890 67706133 131340 131340 109629230 67837473 363615202 350047962 X 22486977 6824536 -138833 -70964437 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X false false false false false true 6864 false false false 6864 false false PART II-B, LINE 1F: PAYMENTS FOR LOBBYING ACTIVITIES INCLUDE DUES PAID TO GREATER DAYTON AREA HOSPITAL ASSOCIATION, DAYTON DEVELOPMENT COALITION, AND OHIO HOSPITAL ASSOCIATION. 131340 131340 131340 131340 131340 131340 133659 328 2647 131340 132575 3734 2650 133659 0.00000 0.00000 1.00000 false false 25307441 25307441 256433053 130361208 126071845 949067 678544 270523 121389371 101939971 19449400 8448167 8448167 179547376 ALTERNATIVE INVESTMENTS 31462317 F 31462317 0 SWAP LIABILITY 23592538 PENSION OBLIGATION & DEFERRED COMP 15953825 SELF INSURANCE RESERVE 5824944 DUE TO AFFILIATES 3815916 LEASE LIABILITIES 1730461 ACCRUED MANAGEMENT CARE SETTLEMENT 1292839 MEDICAL STAFF FEES 273449 WORKERS COMP RESERVE & OTHER 1072089 53556061 X PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS ARE DESIGNATED TO SUPPORT SPECIFIC HEALTHCARE SERVICES OR CAPITAL NEEDS. SCHEDULE D, PART X, LINE 2: THE FOLLOWING FOOTNOTE IS FROM THE 2019 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 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), * UVMC MANAGEMENT CORPORATION AND AFTER HOURS FAMILY CARE, INC. (SUBSIDIARIES OF PHP) THE TAX CUTS AND JOBS ACT (THE ACT) WAS ENACTED ON DECEMBER 22, 2017. FOR TAX-EXEMPT ENTITIES, THE ACT REQUIRES ORGANIZATIONS TO PAY AN EXCISE TAX ON REMUNERATION TO EXECUTIVES ABOVE CERTAIN THRESHOLDS AND REPORT INCOME OR LOSS FROM UNRELATED BUSINESS ACTIVITIES ON AN ACTIVITY-BY-ACTIVITY BASIS, AMONG OTHER PROVISIONS. PHP HAS RECORDED ESTIMATED LIABILITIES AND RELATED EXPENSES FOR ALL EXCISE AND UNRELATED BUSINESS INCOME TAXES IDENTIFIED AT DECEMBER 31, 2019. MANAGEMENT ANNUALLY REVIEWS THE TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS. Central America and the Caribbean Investments 10241000 Central America and the Caribbean Program Services Insurance 25000 10266000 10266000 false false false false false false true true X true X true X true true true false true true 5822000 2775000 3047000 0.01440 24253469 3359469 20894000 0.09890 3482000 2641000 841000 0.00400 33557469 8775469 24782000 0.11730 428000 54000 374000 0.00180 8748000 8748000 0.04140 523000 523000 0.00250 9699000 54000 9645000 0.04570 43256469 8829469 34427000 0.16300 126000 126000 0.00060 1709000 1709000 0.00810 1000 1000 1836000 1836000 0.00870 true 6088642 0 51551000 57185000 -5634000 X true true 1 1 ATRIUM MEDICAL CENTER ONE MEDICAL CENTER DRIVE MIDDLETOWN OH 45044 WWW.PREMIERHEALTH.COM SEE PART V SEC C X X X A ATRIUM MEDICAL CENTER 1 false false true X X X X X X X X X 19 true true true true X SEE SCHED H, PART V, SECTION C X true 20 true SEE SCHED H, PART V, SECTION C false true X 200. 300. X X true true X X X true X SEE SCHED H, PART V, SECT C X SEE SCHED H, PART V, SECT C X SEE SCHED H, PART V, SECT C X X X X X X X true X false X X X X true X false false PART V, SECTION A, LINE 1: THE STATE OF OHIO DOES NOT LICENSE HOSPITALS, BUT THE OHIO DEPARTMENT OF HEALTH DOES REGISTER HOSPITALS. AS PART OF THIS REGISTRATION PROCESS, HOSPITALS IN THE STATE OF OHIO ARE REQUIRED TO COMPLETE AND SUBMIT THE ANNUAL HOSPITAL REGISTRATION AND PLANNING REPORT (AHR) EACH CALENDAR YEAR. ATRIUM MEDICAL CENTER'S REGISTRATION NUMBER IS 1116. PART V, SECTION B, LINE 3E: ATRIUM MEDICAL CENTER'S SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND WERE IDENTIFIED THROUGH THE CHNA. PART V, SECTION B, LINE 5: THE CHNA TEAM COLLECTED 140 MEASURES FROM PUBLICLY AVAILABLE SOURCES, STARTING WITH THE COUNTY HEALTH RANKINGS. CRITERIA FOR INCLUSION INCLUDED AVAILABILITY OF TREND DATA AT THE COUNTY LEVEL AND EASE OF COMPARISON AND UPDATING. THE COLLABORATIVE CHNA FOR 2019 SHARES DATA FOR THE WHOLE REGION AS WELL AS DETAILED COUNTY-LEVEL DATA. SERVICE AREAS OF HOSPITALS VARY, AND THIS APPROACH PROVIDES THE MOST THOROUGH PICTURE OF HEALTH NEEDS LOCALLY AND REGIONALLY. AN ADDED BONUS THIS CYCLE IS THE ACTIVE PARTICIPATION OF THE SOUTHWEST OHIO MEMBERS OF THE ASSOCIATION OF OHIO HEALTH COMMISSIONERS. THE CHNA TEAM REACHED OUT TO THEM IN SPRING 2017 TO TAKE THE FIRST STEPS TOWARDS THE STATE OF OHIO'S REQUIREMENT THAT HEALTH DEPARTMENTS AND HOSPITALS ALIGN THEIR ASSESSMENTS STARTING IN 2020. AS A RESULT, THE CHNA TEAM HAS RESEARCHED MORE SECONDARY DATA MEASURES, INCLUDED HOSPITAL UTILIZATION DATA, OVERSAMPLED VULNERABLE POPULATIONS, AND ENGAGED MORE PARTICIPANTS. A TOTAL OF 1,416 PEOPLE OR ORGANIZATIONS COMPLETED A SURVEY OR ATTENDED A MEETING. A SIGNIFICANT PART OF THE INCREASE WAS DUE TO LOCAL HEALTH DEPARTMENTS HELPING TO PROMOTE AND CONDUCT MEETINGS. THE PRIMARY DATA COLLECTION AND ANALYSIS USED THE NARRATIVE METHOD AND SPECIFICALLY THE TECHNIQUE OF DISCOURSE ANALYSIS. THE FOCUS WAS ON COLLECTING DATA FROM INDIVIDUALS BASED ON THEIR EXPERIENCE. THERE WERE SEVERAL IMPORTANT STEPS TO ENSURE A CONSISTENT PROCESS: 1) VERBATIM ENTRY OF COMMENTS - THIS HAPPENS AUTOMATICALLY WITH THE ONLINE SURVEY PROCESS AND SCRIBES WERE TRAINED TO DO THIS AT THE COMMUNITY MEETINGS 2) CREATING CUSTOM TAGS TO SUMMARIZE EACH RESPONSE, E.G., CANCER, DIABETES, HEART DISEASE 3) CREATING THEMES THAT CONNECT SOME OF THE TAGS, E.G., CHRONIC DISEASE 4) PROOFREADING EACH OTHER'S TAGS AND ANALYSIS, WITH REVIEW BY AT LEAST 3 DIFFERENT PEOPLE TO ENSURE OVERALL CONSISTENCY 5) USE OF SURVEYMONKEY'S 'GOLD' LEVEL ENABLED THE CREATION OF CUSTOM TAGS AND INITIAL SORTING. IT ALSO PROVIDED A CONSISTENT WAY TO COMPARE SURVEY RESULTS WITH MEETING RESPONSES. IT WORKED FOR FACE-TO-FACE VERBAL ENCOUNTERS, SUCH AS IN MEETINGS, AS WELL AS WRITTEN RESPONSES. COMMENTS MADE IN PERSON WERE ENTERED INTO SURVEYMONKEY, TAGGED, AND THEMES IDENTIFIED. THE LEAD CONSULTANT CUSTOMIZED THE TAGGING IN SURVEYMONKEY BECAUSE SHE FOUND THAT ITS AUTOMATIC GROUPING OF IDEAS WAS NOT PRECISE ENOUGH AND COULD NOT ACCOUNT FOR CONTEXT OR ADAPT WHEN RESPONSES USED DIFFERENT WORDS FOR SIMILAR CONCEPTS. 6) REVIEWING TAGS AT THE COUNTY-LEVEL, URBAN LEVEL, AND REGIONAL LEVEL WAS DONE TO ENSURE THAT THE TAGS AND THEMES MADE SENSE AND WERE APPLICABLE AT ALL LEVELS. FOR EXAMPLE, THE CONSULTANTS CREATED TAGS FOR 'ADDICTION,' 'HEROIN,' 'METH' AS SUBSETS OF THE 'SUBSTANCE ABUSE' THEME, BECAUSE OF THEIR APPARENT FREQUENCY AT THE BEGINNING OF THE TAGGING PROCESS. THEY COUNTED EACH TAG AND SAVED THE COUNT, BUT NONE OF THESE TAGS REACHED HIGH ENOUGH NUMBERS (MORE THAN 5% OF MENTIONS) TO WARRANT ITS OWN CATEGORY IN THE FINAL ANALYSIS. SEE APPENDIX K FOR GUIDELINES USED TO ASSIGN CATEGORIES AND FOR SORTING AND TABULATING RESPONSES. 7) SURVEYMONKEY'S FILTER OPTIONS FACILITATED THE PROCESS OF SORTING AND ANALYZING BY COUNTY, BY GROUPS OF COUNTIES, BY TYPE OF SURVEY, AND/OR BY SUB-POPULATION. THIS IS A USEFUL OPTION TO CONSIDER CONTEXT OR CULTURE, SUCH AS URBAN RESPONDENTS OR LATINO RESPONDENTS. PART V, SECTION B, LINES 6A & 6B: ATRIUM MEDICAL CENTER PARTNERED WITH MEMBER HOSPITALS OF THE GREATER DAYTON AREA HOSPITAL ASSOCIATION, PUBLIC HEALTH DEPARTMENTS, THE HEALTH COLLABORATIVE IN CINCINNATI, OHIO, ADAMS COUNTY HEALTH DEPARTMENT, BROWN COUNTY HEALTH DEPARTMENT, BUTLER COUNTY HEALTH DEPARTMENT, CHAMPAIGN-URBANA COUNTY DEPARTMENT, CINCINNATI HEALTH DEPARTMENT, CITY OF HAMILTON HEALTH DEPARTMENT, CLARK COUNTY COMBINED HEALTH DISTRICT, CLERMONT COUNTY PUBLIC HEALTH, CLINTON COUNTY HEALTH DEPARTMENT, DARKE COUNTY GENERAL HEALTH DISTRICT, FAYETTE COUNTY PUBLIC HEALTH, GREENE COUNTY PUBLIC HEALTH, HAMILTON COUNTY PUBLIC HEALTH, HIGHLAND COUNTY HEALTH DEPARTMENT, MIAMI COUNTY PUBLIC HEALTH, MIDDLETOWN CITY HEALTH DISTRICT, NORWOOD HEALTH DEPARTMENT, PIQUA CITY HEALTH DEPARTMENT, PREBLE COUNTY PUBLIC HEALTH, PUBLIC HEALTH - DAYTON & MONTGOMERY COUNTY, SIDNEY SHELBY COUNTY HEALTH DEPARTMENT, SPRINGDALE HEALTH DEPARTMENT & WARREN COUNTY COMBINED HEALTH DISTRICT. PART V, SECTION B, LINES 7A & 10A: THE WEBSITE ADDRESS WHERE THE 2019 CHNA AND THE 2020 COMMUNITY HEALTH IMPLEMENTATION PLAN CAN BE ACCESSED IS: HTTPS://WWW.PREMIERHEALTH.COM/ABOUT-PREMIER/COMMUNITY-INVOLVEMENT/ COMMUNITY-HEALTH-IMPROVEMENT PART V, SECTION B, LINE 11: ATRIUM MEDICAL CENTER (AMC) ADOPTED AN IMPLEMENTATION STRATEGY TO ADDRESS THE FOLLOWING PRIORITIZED NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA): * ACCESS TO CARE AND/OR SERVICES * CHRONIC DISEASE * HEALTHY BEHAVIORS * SUBSTANCE ABUSE AND MENTAL HEALTH ACCESS TO CARE/SERVICES ER VIRTUAL CARE --------------------------------------- METRICS: NUMBER OF NEW SITES, NUMBER OF RESIDENTS SERVED, REASON FOR CONSULTATIONS, EMERGENCY DEPARTMENT TRANSFERS/HOSPITALIZATION RATES, AND PATIENT AND CLINICIAN SATISFACTION. HEALTH ISSUE: AS NURSING FACILITIES ARE CALLED UPON TO CARE FOR HIGHER-ACUITY PATIENTS AND DRIVE BETTER OUTCOMES AT A FRACTION OF THE COST OF A HOSPITALIZATION, SYSTEMS ARE REQUIRED THAT DELIVER QUALITY PHYSICIANS TO THE BEDSIDE AT TIMES OF CHANGE OF CONDITION. INTERVENTION'S GOAL: THE GOAL OF THE PROGRAM IS TO FACILITATE EARLY TREATMENT OF CONDITIONS, REDUCE EMERGENCY ROOM TRANSFERS AND HOSPITALIZATIONS, AND REDUCE CARE COSTS FOR RESIDENTS. THE LONG-TERM PLAN IS TO EXPAND ER VIRTUAL CARE TO NURSING FACILITIES ACROSS OUR MARKET AND EXPAND SERVICE OFFERINGS TO INCLUDE SPECIALTIES SUCH AS NEUROLOGY, WOUND CARE, AND BEHAVIORAL HEALTH. DESCRIPTION: VIDEO CONSULTATION WITH A DOCTOR CAN EXPEDITE EVALUATION OR TREATMENT FOR PATIENTS AT NURSING FACILITIES OR AT HOME. ER VIRTUAL CARE USES REAL-TIME VIDEO AND AUDIO FOR AN EMERGENCY MEDICINE PHYSICIAN TO TREAT A PATIENT REMOTELY. BY REMOVING GEOGRAPHICAL BOUNDARIES, THE HOSPITAL CAN LEVERAGE AVAILABLE PROVIDERS FROM A DISTANCE TO PROVIDE SUPPORT AND TREAT PATIENTS. THIS TELEMEDICINE SOLUTION CAN HELP ADDRESS UNNECESSARY TRANSFER OF NURSING HOME AND ASSISTED LIVING RESIDENTS TO HOSPITALS BY ALLOWING ACCESS TO EMERGENCY MEDICINE SPECIALISTS FOR AFTER HOUR AND WEEKEND COVERAGE. BACKGROUND: THE CLOSURE OF GOOD SAMARITAN HOSPITAL LED TO AN INCREASED DEMAND IN SERVICES AT MVH-NORTH. CLINICAL AND OPERATIONAL LEADERSHIP IDENTIFIED AN OPPORTUNITY TO LEVERAGE TELEMEDICINE AND HELP TREAT PATIENTS THAT PRESENT WITH LOW ACUITY SYMPTOMS TO EXPEDITE TREATMENT AND REDUCE WAIT TIMES. INITIAL RESULTS ON UTILIZATION AND PATIENT SATISFACTION WERE POSITIVE AND EXPANDED PREMIER HEALTH'S SCOPE FOR INCLUSION OF COMMUNITY PARTNER FACILITIES. NURSING FACILITIES ARE CHALLENGED WITH CARING FOR HIGHER ACUITY PATIENTS. THE SERVICE PROMOTES PREMIER HEALTH'S MISSION IN PROVIDING HIGHEST QUALITY OF CARE AT THE RIGHT TIME AND RIGHT PLACE. PARTNERS: MIAMI VALLEY EMERGENCY SPECIALISTS, SPRINGMEADE HEALTH CENTER, AND KOESTER PAVILION ACCESS TO CARE/SERVICES COMMUNITY HEALTH MOBILE CLINIC --------------------------------------- METRICS: NUMBER OF PEOPLE SERVED. NUMBER OF PEOPLE CONNECTED TO RESOURCES. PERCENT OF PEOPLE IDENTIFIED AS 'AT RISKRECEIVING FOLLOW-UP. HEALTH ISSUE: BOTH URBAN AND RURAL RESIDENTS CAN EXPERIENCE OBSTACLES TO RECEIVING MEDICAL CARE. A MOBILE CLINIC CAN TRAVEL TO LOCATIONS CONVENIENT FOR RESIDENTS IN UNDERSERVED AREAS. INTERVENTION'S GOAL: THE GOAL IS TO BRING HEALTHCARE PROVIDERS AND SERVICES ON A ROUTINE BASIS TO UNDERSERVED COMMUNITIES THROUGH THE PREMIER COMMUNITY HEALTH MOBILE CLINIC PROGRAM. THE GOAL IS TO MAKE QUALITY HEALTHCARE ACCESSIBLE TO SUCH LOCATIONS AS PREBLE COUNTY AND WEST DAYTON BY UTILIZING SITES AT NONPROFIT ORGANIZATIONS, PARTICIPATING CVS PHARMACIES, AND LOCAL SCHOOLS. DESCRIPTION: THE PROGRAM UTILIZES MEDICAL PROVIDERS WHO OFFER PATIENTS ASSESSMENTS, COUNSELING, FOLLOW-UP CARE, AND REFERRALS THROUGH THE PREMIER HEALTH ONLINE SCHEDULING PORTAL. THE PATIENTS ARE PROVIDED BLOOD PRESSURE, CHOLESTEROL, BLOOD GLUCOSE, A1C SCREENINGS, (ALL WITH IMMEDIATE RESULTS) AS WELL AS FLU SHOTS ADMINISTERED BY PREMIER COMMUNITY HEALTH NURSES. THE CARE WILL BE DOCUMENTED IN EPIC ALLOWING TRACKING OF PROGRESS AND PROVIDING ACCESS OF THEIR MOBILE CLINIC'S VISITS TO OTHER PROVIDERS AS NEEDED. ALONG WITH THE HEALTH SCREE 2 SOUTHWEST OHIO AMBULATORY SURGERY CENTER 295 N BREIEL BLVD MIDDLETOWN OH 45042 General Medical & Surgical Outpatient Facility ATRIUM HEALTH CENTER TRENTON 3590 BUSENBARK ROAD TRENTON OH 45067 HEALTH CENTER PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT FOR ATRIUM MEDICAL CENTER IS PART OF THE PREMIER HEALTH (PREMIER) REPORT (EIN# 31-1446699). PART I, LINE 7: 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. PART I, LINE 7G: 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 CALL TIME AND PHYSICIAN SUBSIDIES DUE TO THE LARGE NUMBER OF INDIGENT PATIENTS COMING THROUGH THE EMERGENCY ROOM. FOR 2019, THE AMOUNT PAID FOR CALL AND SUBSIDIES WAS $8,748,000. PART II: -------- ATRIUM MEDICAL CENTER (AMC) IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH A VARIETY OF PREVENTION, HEALTH IMPROVEMENT AND ENGAGEMENT PROGRAMS. AS PART OF ITS OVERALL COMMITMENT TO THE COMMUNITY, AMC FOCUSES ON FOUR AREAS OF SERVICE: --INVESTING IN THE COMMUNITY --PREVENTION AND WELLNESS --COMMITMENT TO THE UNDER-SERVED --COMMUNITY ENGAGEMENT SOME OF THE PROGRAMS SUPPORTED BY AMC DURING 2019 INCLUDE: 1) PROJECTS, PROGRAMS, AND POLICIES WILL BE DEVELOPED TO ADVANCE THE DESIRED OUTCOMES FOR THE PHOENIX PROJECT AREA (AS DEFINED BELOW). THE PRIORITY OUTCOMES ARE TO DRIVE ECONOMIC VITALITY, CREATE JOBS, ENHANCE THE IMAGE OF THE AREA, LEVERAGE INVESTMENT, AND PROMOTE HEALTHY LIVING. OTHER DESIRABLE OUTCOMES ARE TO IMPROVE LIVABILITY, PROVIDE AMENITIES, DRAW PEOPLE FROM OUTSIDE THE AREA, EXCITE THE COMMUNITY, IMPROVE SAFETY, ADVANCE EDUCATIONAL SUCCESS, SUPPORT THE WELL-BEING OF YOUTH, SERVE THE DIVERSE DEMOGRAPHICS OF THE NEIGHBORHOODS, PROVIDE AN ATTRACTIVE ENVIRONMENT, ATTRACT, AND SUSTAIN NEW/YOUNG PEOPLE AND PROMOTE ENVIRONMENTAL SUSTAINABILITY. IN ORDER TO MEET THESE GOALS, $125,536 WAS CONTRIBUTED TO PHYSICAL IMPROVEMENTS AND $1,709,400 WAS CONTRIBUTED TO COMMUNITY BUILDING ECONOMIC DEVELOPMENT. 2) $1,200 WAS DONATED TO ASSIST IN RECOVERY FROM NATURAL DISASTERS PART III, LINES 2 & 3: 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. PART III, LINE 4: THE ORGANIZATION DOES NOT HAVE A FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS WHICH DISCUSSES THIS CALCULATION. PART III, SECTION B, LINES 5, 6, AND 7: 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 $43,176,000 AND INCURRED COST OF $59,158,000 FOR AN ADDITIONAL NET SHORTFALL OF $15,982,000 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 $51,551,000 MEDICARE REVENUE NOT REPORTED IN PART III, SECTION B $43,176,000 TOTAL MEDICARE ASSOCIATED REVENUE $94,727,000 ALLOWABLE MEDICARE COST (PER MEDICARE COST REPORT) REPORT IN PART III, SECTION B $57,185,000 MEDICARE COST NOT REPORTED IN PART III, SECTION B $59,158,000 TOTAL MEDICARE ASSOCIATED COST $116,343,000 ALLOWABLE MEDICARE SHORTFALL IN PART III, SECTION B $5,634,000 ADDITIONAL SHORTFALL NOT INCLUDED IN PART III, SECTION B $15,982,000 TOTAL MEDICARE SHORTFALL $21,616,000 PART III, LINE 8: THE ORGANIZATION'S SHORTFALL SHOULD BE CONSIDERED CHARITY CARE BECAUSE IT IS PROVIDING HIGH-QUALITY CARE IN EXCESS OF THE COST TO OUR COMMUNITY RESIDENTS THAT NEED CARE. THE MEDICARE POPULATION AT THE ORGANIZATION IS IN EXCESS OF 52% OF NET PATIENT REVENUE. THE ORGANIZATION USED A COST ACCOUNTING SYSTEM TO CALCULATE THE MEDICARE ALLOWABLE COSTS. PART III, LINE 9B: 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 FINANCIAL ASSISTANCE 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. PART VI, LINE 2: 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. PART VI, LINE 3: 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 true CITYWIDE DEVELOPMENT CORP 8 N MAIN ST DAYTON OH 45402 310821189 501(C)(4) 1834936 COMMUNITY DEVELOPMENT ONEFIFTEEN RECOVERY 6636 LONGSHORE ST 200 DUBLIN OH 43017 833504845 501(C)(3) 300000 SUPPORT MIAMI VALLEY HOSPITAL 110 N MAIN ST 500 DAYTON OH 43017 310537504 501(C)(3) 93784 SUPPORT MIDDLETOWN TRANSIT SYSTEM 3045 MOSER CT HAMILTON OH 45011 316000139 GOVERNMENT 75000 SUPPORT REACH OUT MONTGOMERY COUNTY 25 E FORAKER ST DAYTON OH 45409 311434282 501(C)(3) 23114 RX ASSISTANCE HOMEFULL 33 W FIRST ST 100 DAYTON OH 45402 311236989 501(C)(3) 12120 SUPPORT GALA OF HOPE FOUNDATION 3500 PENTAGON BLVD 500 BEAVERCREEK OH 45431 464277044 501(C)(3) 12000 SUPPORT MIAMI VALLEY HOSPITAL FOUNDATION 110 N MAIN ST 500 DAYTON OH 45402 311040231 501(C)(3) 9420 SUPPORT DAYTON FOUNDATION 40 N MAIN ST 500 DAYTON OH 45423 316027287 501(C)(3) 9000 SUPPORT DAYTON ART INSTITUTE 456 BELMONTE PARK N DAYTON OH 45405 310537480 501(C)(3) 8900 SUPPORT GEM CITY MARKET 33 W 1ST ST 100 DAYTON OH 45402 821168121 7060 SUPPORT ATRIUM MEDICAL CENTER FOUNDATION 110 N MAIN ST 500 DAYTON OH 45402 311079213 501(C)(3) 5136 SUPPORT 10 2 SCHEDULE I, PART I, LINE 2: 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. X X X X true true false false false false false false false MICHAEL J MAIBERGER FORMER KEY EMPLOYEE 0 564689 0 520375 0 1207754 0 1031331 0 30730 0 3354879 0 831140 MARY H BOOSALIS TRUSTEE AND PREMIER CEO 0 1152156 0 616657 0 52172 0 22778 0 20512 0 1864275 0 0 SCOTT A SHELTON FORMER OFFICER 0 505156 0 269139 0 152574 0 13302 0 17824 0 957995 0 0 JENNIFER J HAULER DO FORMER KEY EMPLOYEE 0 519043 0 372959 0 1783 0 52997 0 2779 0 949561 0 0 MICHAEL R UHL FORMER TRUSTEE AND OFFICER 0 513722 0 176180 0 20844 0 53774 0 29566 0 794086 0 0 JOHN M MILLER MD TRUSTEE 10637 684277 0 1481 0 24894 0 11205 0 29134 10637 750991 0 0 BARBARA A JOHNSON EXECUTIVE VP & PREMIER COO 0 476627 0 149539 0 39802 0 27000 0 11127 0 704095 0 0 GEOFFREY P WALKER SYSTEM VP-CHIEF LEGAL OFFICER 0 411905 0 140011 0 96988 0 23811 0 26531 0 699246 0 0 THOMAS R PARKER FORMER KEY EMPLOYEE 0 399599 0 168998 0 50576 0 66901 0 12860 0 698934 0 0 MATTHEW S REEVES DO TRUSTEE (TO MAY) 362249 0 212770 0 22134 0 25117 0 31825 0 654095 0 0 0 GARY G GINTER VP &PREMIER CHIEF INFO OFFICER 0 408643 0 140815 0 4063 0 69684 0 28333 0 651538 0 0 CRAIG SELF FORMER KEY EMPLOYEE 0 0 148256 0 375613 0 74192 0 20665 0 618726 0 300262 RENEE P GEORGE FORMER KEY EMPLOYEE 0 387083 0 151484 0 1323 0 50260 0 13183 0 603333 0 0 MARGARET W MARK VP NURSING SERVICE/PREMIER CNO 0 376334 0 137400 0 13986 0 23441 0 27942 0 579103 0 0 DONNA L BANKS SYS VP-OPERATIONS INNOVATION 233477 81869 0 9892 0 208482 0 16579 0 550299 0 0 0 DALE E CREECH JR FORMER KEY EMPLOYEE 0 0 0 82482 0 427995 0 17945 0 11552 0 539974 0 151924 J MICHAEL SIMS SYS VP-TREAS & CORP CONTROLLER 0 303223 0 68302 0 89634 0 24054 0 29351 0 514564 0 0 KEITH D BRICKING MD PRESIDENT & CEO 474971 6250 0 0 2637 0 0 0 30647 0 508255 6250 0 0 JOSHUA A ORDWAY MD TRUSTEE (FROM JUL) 0 411245 0 36000 0 799 0 11199 0 27516 0 486759 0 0 THOMAS R CURTIN VP REVENUE CYCLE 0 318812 0 80976 0 7671 0 26866 0 33348 0 467673 0 0 MARK W SHAW FORMER KEY EMPLOYEE 0 0 0 30246 0 387960 0 16713 0 5855 0 440774 0 38000 MARQUITA L TURNER TRUSTEE & COO 287718 0 87874 0 1465 0 18792 0 4389 0 400238 0 0 0 KIM K STRAHL SYS VP & CPO 0 233940 0 100231 0 3377 0 21635 0 12150 0 371333 0 0 TAMARA L LAINE VP-BUSINESS DEV-DAYTON REGION 60972 0 48830 0 171202 0 25467 0 23508 0 329979 0 3374 0 JOANNE R MORGAN SYSTEM VP - PHARMACY OPS 220721 0 34340 0 6794 0 12786 0 14269 0 288910 0 0 0 BILLIE L LUCENTE-BAKER SYS VP - HR OPERATIONS 0 215099 0 35605 0 1495 0 20083 0 14063 0 286345 0 0 RHONA L SEIDENSCHMIDT TRUSTEE 178364 0 50888 0 1252 0 6585 0 26034 0 263123 0 0 0 ROBYN S MYERS DIRECTOR-PATIENT SAFETY & PI 158150 0 25215 0 6209 0 7744 0 22415 0 219733 0 0 0 MONICA H BORCHERS DIR-FINANCIAL ACCOUNTING 150412 0 26562 0 1353 0 8301 0 13107 0 199735 0 0 0 ELAINE M DEAN SYSTEM VP-BUSINESS DEVELOPMENT 0 178094 0 0 0 724 0 2692 0 5452 0 186962 0 0 BENJAMIN A WATSON ESQ BOARD SECRETARY (FROM NOV) 0 144706 0 21428 0 582 0 6180 0 10065 0 182961 0 0 DALE J BOLCK MD TRUSTEE (TO APR) 0 120348 0 33835 0 1998 0 9283 0 16743 0 182207 0 0 ANDRE T HARRIS MD TRUSTEE (FROM MAY) 149245 0 0 0 713 0 0 0 14088 0 164046 0 0 0 JEFFREY S ZOLLETT MD FORMER TRUSTEE & OFFICER 0 125347 0 0 0 1404 0 5059 0 2551 0 134361 0 0 PART I, LINE 4A: THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT IN 2019: CRAIG SELF RECEIVED $ 381,414. THE FOLLOWING INDIVIDUALS WERE SELECTED TO PARTICIPATE IN A VOLUNTARY RETIREMENT PROGRAM AND RECEIVED THE FOLLOWING PAYMENTS IN 2019: DALE CREECH JR $234,232; MARK SHAW $103,000; MICHAEL MAIBERGER $221,850. 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, 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 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 2019. THE INDIVIDUALS LISTED BELOW HAVE MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE PENSION RESTORATION PLAN RECEIVED THE ASSOCIATED PAYMENT IN 2019: DALE CREECH, JR $196,960; BARBARA JOHNSON $25,958; MARGARET MARK $5,206 AND MICHAEL MAIBERGER $18,567. THE INDIVIDUALS LISTED BELOW HAVE MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE SERP AND RECEIVED THE ASSOCIATED PLAN PAYMENT 2019: MICHAEL MAIBERER $111,125; THOMAS PARKER $22,946; MARK SHAW $286,638; SCOTT A SHELTON $144,980, MICHAEL J. SIMS $65,725; GEOFFREY P. WALKER $90,728. 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: MICHAEL MAIBERGER $ 83,348; THOMAS CURTIN $7,888; RENEE GEORGE $38,933; GARY GINTER $47,436; JENNIFER HAULER, D.O. $43,676; BARBARA JOHNSON $11,541; MARGARET MARK $13,181; THOMAS PARKER $43,947; MATTHEW REEVES $18,453; CRAIG SELF $65,158; MARQUITA TURNER 6,182, MICHAEL UHL $43,890. 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. A CITY OF MIDDLETOWN OH 316000139 597146AP4 2016-08-31 86392792 REFUND SERIES 2010 false false false B CITY OF MONTGOMERY OH 316000172 613520LO6 2019-09-24 83203105 REFUND SERIES 2008 A & B false false false A 3452792 0 86392792 0 0 0 400067 0 0 0 85992725 0 2019 true false true true B 0 0 83203105 0 0 0 766203 0 0 0 82436902 0 2019 true false true true A false false false true true 0.00000 0.00100 0.00100 false false false true B false false false true true 0.00000 0.00100 0.00100 false false false true A false true false false false true BARCLAYSPNC BANK 15.4 false false false 0 false true B false true false false true false 0 false 0 false true A true B true PART I, LINE B, COLUMN E: NOTE B: ISSUE PRICE IS NOT IDENTICAL TO THE ISSUE PRICE LISTED ON FORM 8038 DUE TO THE SERIES 2019A BONDS' PROCEEDS BEING SPLIT BETWEEN: ATRIUM MEDICAL CENTER, MIAMI VALLEY HOSPITAL, AND UPPER VALLEY MEDICAL CENTER. PART I, LINE B, COLUMN F: NOTE B: REFUNDED THE FOLLOWING SERIES BONDS: SERIES 2008A BONDS - ISSUE DATE 11/21/2008 SERIES 2008B BONDS - ISSUE DATE 11/21/2008 FORM 990, PART VI, SECTION A, LINE 3: 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 PREMIER'S ACTIVITIES. FORM 990, PART VI, SECTION A, LINE 6: ATRIUM MEDICAL CENTER HAS ONE CORPORATE MEMBER; PREMIER, AN OHIO NON-PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINES 7A & 7B: 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. 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 ATRIUM MEDICAL CENTER IS AN AFFILIATE. 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, 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. FORM 990, PART VI, SECTION B, LINES 15A AND 15B: 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 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 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 IS COMPRISED OF 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 XI, LINE 9: EQUITY TRANSFERS TO AFFILIATES (69,831,387) PENSION ADJUSTMENT (1,050,704) FUNDING FROM FOUNDATION (395,641) CAPITAL DONATION 313,293 ------------ TOTAL (70,964,437) PREMIER HEALTH (PREMIER) 110 N MAIN ST 500 DAYTON OH 45402 311446699 PARENT OH 501(C)(3) 12B NA false ATRIUM HEALTH SYSTEM (AHS) 110 N MAIN ST 500 DAYTON OH 45402 310537492 SUPPORT ORG OH 501(C)(3) 12B NA false MedAmerica Health Systems Co (MAHS) 110 N MAIN ST 500 DAYTON OH 45402 311040228 SUPPORT ORG OH 501(C)(3) 12B NA false MIAMI VALLEY HOSPITAL 110 N MAIN ST 500 DAYTON OH 45402 310537504 HOSPITAL OH 501(C)(3) 3 PREMIER false Miami Valley Hospital Foundation 110 N Main St 500 DAYTON OH 45402 311040231 FOUNDATION OH 501(C)(3) 7 PREMIER false Fidelity Health Care Inc (FHC) 110 N MAIN ST 500 DAYTON OH 45402 311075381 HOME HEALTH OH 501(C)(3) 10 PREMIER false Premier Community Health 110 N MAIN ST 500 DAYTON OH 45402 311122883 HEALTH EDUCAT OH 501(C)(3) 10 FHC false Samaritan Health Partners (SHP) 110 N Main St 500 DAYTON OH 45402 311107411 SUPPORT ORG OH 501(C)(3) 12B PREMIER false Good Samaritan Foundation - Dayton 110 N Main St 500 DAYTON OH 45402 237296923 FOUNDATION OH 501(C)(3) 7 PREMIER false Heart Institute of Dayton 110 N Main St 500 DAYTON OH 45402 300502367 EDUCATION OH 501(C)(3) 10 PREMIER false Samaritan Behavioral Health Inc 110 N Main St 500 DAYTON OH 45402 020633634 BEHAVORIAL HE OH 501(C)(3) 7 PREMIER false UVMC 110 N Main St 500 DAYTON OH 45402 341850683 SUPPORT ORG OH 501(C)(3) 12B NA false Upper Valley Medical Center 110 N Main St 500 DAYTON OH 45402 310537095 HOSPITAL OH 501(C)(3) 3 PREMIER false Upper Valley Professional Corp (UVPC) 110 N Main St 500 DAYTON OH 45402 311400963 HEALTH CARE OH 501(C)(3) 10 PREMIER false UVPC Specialists Inc 110 N Main St 500 DAYTON OH 45402 203687536 HEALTH CARE OH 501(C)(3) 10 UVPC false UVMC Nursing Care Inc 110 N Main St 500 DAYTON OH 45402 311224064 NURSING HOME OH 501(C)(3) 10 PREMIER false Premier Plaza LLC 110 N Main St 500 DAYTON OH 45402 800708185 HOLDING CO OH MAHS false 0 Compunet Clinical Laboratories LLC 2308 Sandridge Dr MORAINE OH 45439 311258010 MEDICAL LABS OH MVHE INC false 0 Sweitzer Street LLC 110 N MAIN ST 500 DAYTON OH 45402 454700417 REAL ESTATE OH MVHE INC false 0 Sweitzer MOB LLC 110 N MAIN ST 500 DAYTON OH 45402 474554657 REAL ESTATE OH MVHE INC false 0 MVHE INC 110 N Main St 400 DAYTON OH 45402 311185270 PHYSICIAN SVC OH PREMIER HOLDING C CORP 0 0 false Premier Health Specialists 110 N Main St 400 DAYTON OH 45402 061744704 PHYSICIAN SVC OH PREMIER HOLDING C CORP 0 0 false Samaritan Family Care 110 N Main St 400 DAYTON OH 45402 311299450 PHYSICIAN SVC OH PREMIER HOLDING C CORP 0 0 false After Hours Family Care 110 N Main St 500 DAYTON OH 45402 311269483 HEALTH CARE OH UVPC C CORP 0 0 false UVMC Management Corp 110 N Main St 500 DAYTON OH 45402 311360489 MANAGEMENT CO OH PREMIER C CORP 0 0 false Premier Health Urgent Care Inc 110 N Main St 900 DAYTON OH 45402 822079409 URGENT CARE OH PREMIER HOLDING C CORP 0 0 false Premier Health Plan Inc 110 N Main St 500 DAYTON OH 45402 463024049 HEALTH INSURANCE OH PHIC C CORP 0 0 false Premier Health ACO of Ohio 110 N Main St 500 DAYTON OH 45402 474049773 MEDICARE ACO OH PREMIER C CORP 0 0 false Premier Health Holding (premier holding) 110 N Main St 400 DAYTON OH 45402 812419110 HOLDING CO OH PREMIER C CORP 0 0 false Premier Health Insuring Co (PHIC) 110 N Main St 500 DAYTON OH 45402 464766841 HEALTH INSURANCE OH PREMIER C CORP 0 0 false Good Samaritan Hospital (GSH) 110 N Main st 500 Dayton OH 45402 310536981 Hospital OH Premier C Corp 0 0 false false true true false false false false false false true false false false false false true true true true