UPPER VALLEY MEDICAL CENTER: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: UPPER VALLEY MEDICAL CENTER (EIN 31-0537095)
Tax period: 2019-01-01 to 2019-12-31
Filed: 2020-11-16
IRS object ID: 202043219349315419
Schema version: 2019v5.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule H
Schedule I
Schedule J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-11-16T14:40:52-06:00	ReturnTs
Tax Period End	2019-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	221 E 4TH STREET SUITE 2900	AddressLine1Txt
City	Cincinnati	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45202	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2019-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	310537095	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	UPPER VALLEY MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% J MICHAEL SIMS	InCareOfNm
Business Name Control	UPPE	BusinessNameControlTxt
Phone	9374999942	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	110 N MAIN ST 500	AddressLine1Txt
City	DAYTON	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45402	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	TIMOTHY D SNIDER	PersonNm
Person Title	VP-FINANCE & COO	PersonTitleTxt
Phone	9374999942	PhoneNum
Signature	2020-11-09	SignatureDt

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JULIE L SPARKS	PreparerPersonNm
PTIN	P01268401	PTIN
Phone	5136121400	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	108.206.163.59	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	31499120203215000005	FederalOriginalSubmissionId
Federal Original Submission Id	2020-11-16	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	A6E5CA7D42B22EAE9EAB39D40921AF7EA2C02C61	AtSubmissionCreationDeviceId
At Submission Filing Device Id	770194AAF055F9EA87E64CA02E08FE540289067F	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2019	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Kevin Harlan	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3130 N COUNTY RD 25 A	AddressLine1Txt
City	TROY	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45373	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$190,323,526	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.PREMIERHEALTH.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1926	FormationYr
Legal Domicile State	OH	LegalDomicileStateCd
Activity Or Mission	UPPER VALLEY MEDICAL CENTER WILL IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH OTHERS WHO SHARE OUR COMMITMENT TO PROVIDE HIGH-QUALITY, COST-COMPETITIVE HEALTH SERVICES.	ActivityOrMissionDesc
Voting Members Governing Body	7	VotingMembersGoverningBodyCnt
Voting Members Independent	1	VotingMembersIndependentCnt
Total Employee	1551	TotalEmployeeCnt
Total Volunteers	141	TotalVolunteersCnt
Total Gross UBI	$147,093	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$461,209	PYContributionsGrantsAmt
CY Contributions Grants	$122,348	CYContributionsGrantsAmt
PY Program Service Revenue	$148,660,764	PYProgramServiceRevenueAmt
CY Program Service Revenue	$157,511,735	CYProgramServiceRevenueAmt
PY Investment Income	$1,551,291	PYInvestmentIncomeAmt
CY Investment Income	$5,695,870	CYInvestmentIncomeAmt
PY Other Revenue	$1,599,454	PYOtherRevenueAmt
CY Other Revenue	$1,358,709	CYOtherRevenueAmt
PY Total Revenue	$152,272,718	PYTotalRevenueAmt
CY Total Revenue	$164,688,662	CYTotalRevenueAmt
PY Grants And Similar Paid	$5,082,206	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$2,386,261	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$72,514,959	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$66,189,175	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$69,201,999	PYOtherExpensesAmt
CY Other Expenses	$60,499,768	CYOtherExpensesAmt
PY Total Expenses	$146,799,164	PYTotalExpensesAmt
CY Total Expenses	$129,075,204	CYTotalExpensesAmt
PY Revenues Less Expenses	$5,473,554	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$35,613,458	CYRevenuesLessExpensesAmt
Total Assets BOY	$181,418,752	TotalAssetsBOYAmt
Total Assets EOY	$176,594,804	TotalAssetsEOYAmt
Total Liabilities BOY	$92,036,773	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$93,696,478	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$89,381,979	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$82,898,326	NetAssetsOrFundBalancesEOYAmt
Mission	UPPER VALLEY MEDICAL CENTER WILL IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH OTHERS WHO SHARE OUR COMMITMENT TO PROVIDE HIGH-QUALITY, COST-COMPETITIVE HEALTH SERVICES.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$124,449,999	ExpenseAmt
Grant	$2,386,261	GrantAmt
Revenue	$157,396,972	RevenueAmt
Desc	THE PRIMARY EXEMPT PURPOSE OF UPPER VALLEY MEDICAL CENTER IS TO PROVIDE COMPREHENSIVE INPATIENT, OUTPATIENT, AND EMERGENCY HEALTH CARE SERVICES TO THE RESIDENTS OF CHAMPAIGN, DARKE, MIAMI, AND SHELBY COUNTIES. THE HOSPITAL FURTHERS ITS TAX-EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY IN MANY WAYS. SEE SCHEDULE H FOR MORE INFORMATION.	Desc
Total Program Service Expenses	$124,449,999	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	false	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	Yes (true)	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	81	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1551	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	7	GoverningBodyVotingMembersCnt
Independent Voting Member	1	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (true)	DelegationOfMgmtDutiesInd
Change To Org Documents	Yes (true)	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	OH	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	J MICHAEL SIMS	PersonNm
Phone	9374999942	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	110 N MAIN ST SUITE 500	AddressLine1Txt
City	Dayton	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45402	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (34 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Key EmployeeKeyEmployeeInd	OfficerOfficerInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
MICHAEL J MAIBERGER
FORMER KEY EMPLOYEE	0.0	0.0	Yes (X)	$0	$2,292,818	$1,062,061
MARY H BOOSALIS
PREMIER PRESIDENT & CEO	0.5	39.5		$0	$1,820,985	$43,290	Yes (X)
SCOTT A SHELTON
FORMER KEY EMPLOYEE	0.0	40.0	Yes (X)	$0	$926,869	$31,126
JENNIFER J HAULER D
FORMER KEY EMPLOYEE	0.0	40.0	Yes (X)	$0	$893,785	$55,776
FAYEZ D ABBOUD MD
PRES MEDICAL STAFF (FROM SEP)	0.5	39.5		$0	$681,725	$37,792	Yes (X)
BARBARA A JOHNSON
EXEC VP & PREMIER COO	10.0	30.0		$0	$665,968	$38,127		Yes (X)
GEOFFREY P WALKER
FORMER OFFICER	0.0	40.0	Yes (X)	$0	$648,904	$50,342
THOMAS R PARKER
PRESIDENT & CEO	38.0	2.0		$619,173	$0	$79,761	Yes (X)		Yes (X)
DIANE L PLEIMAN
FORMER OFFICER	0.0	40.0	Yes (X)	$0	$647,081	$29,118
GARY G GINTER
VP &PREMIER CHIEF INFO OFFICER	10.0	30.0		$0	$553,521	$98,017		Yes (X)
CRAIG SELF
FORMER KEY EMPLOYEE	0.0	0.0	Yes (X)	$0	$523,869	$94,847
RENEE P GEORGE
FORMER KEY EMPLOYEE	0.0	40.0	Yes (X)	$0	$539,890	$63,443
MARGARET W MARK
VP NURSING SERVICE/PREMIER CNO	10.0	30.0		$0	$527,720	$51,383		Yes (X)
DALE E CREECH JR
FORMER OFFICER	0.0	0.0	Yes (X)	$0	$510,477	$29,497
RAFAY ATIQ MD
TRUSTEE	0.5	39.5		$0	$483,227	$41,964	Yes (X)
SCOTT B KANAGY DO
TRUSTEE & CMO	40.0	0.0		$474,231	$0	$42,523	Yes (X)
J MICHAEL SIMS
SYS VP-TREAS & CORP CONTROLLER	10.0	30.0		$0	$461,159	$53,405		Yes (X)
THOMAS R CURTIN
VP - REVENUE CYCLE	10.0	30.0		$0	$407,459	$60,214		Yes (X)
MARK W SHAW
FORMER KEY EMPLOYEE	0.0	0.0	Yes (X)	$0	$418,206	$22,568
TIMOTHY D SNIDER
BOARD TREASURER & COO	37.0	3.0		$355,991	$0	$51,164			Yes (X)
KIM K STRAHL
SYS VP & CPO	10.0	30.0		$0	$337,548	$33,785		Yes (X)
BILLIE L LUCENTE-BAKE
SYS VP - HR OPS (FROM AUG)	10.0	30.0		$0	$252,199	$34,146		Yes (X)
JENNA M DOWNEY ESQ
FORMER OFFICER	0.0	40.0	Yes (X)	$0	$223,359	$21,938
MELISSA M TALLMADGE
DIR NURSING - SURGERY/ED	40.0	0.0		$182,650	$0	$35,724				Yes (X)
KATHRYN M BOERGER
DIRECTOR HR	40.0	0.0		$185,595	$0	$15,390				Yes (X)
TERESA A GULKER
DIR NRS-MEDSURG/WMS SRVCS	40.0	0.0		$175,093	$0	$22,383				Yes (X)
REBECCA A RICE
FORMER TRUSTEE & OFFICER	0.0	0.0	Yes (X)	$178,181	$0	$17,806
RYAN E MCELDOWNEY
STAFF PHARMACIST	40.0	0.0		$151,872	$0	$38,039				Yes (X)
ELAINE M DEAN
SYSTEM VP-BUSINESS DEVELOPMENT	10.0	30.0		$0	$178,818	$8,144		Yes (X)
BENJAMIN A WATSON ES
BOARD SECRETARY	0.5	39.5		$0	$166,716	$16,245			Yes (X)
CHRISTOPHER J PATSIAV
STAFF PHARMACIST	40.0	0.0		$166,355	$0	$2,460				Yes (X)
MICHAEL S GELBART M
PRES MEDICAL STAFF (TO AUG)	0.5	0.5		$55,833	$0	$0	Yes (X)
SCOTT SWABB DO
TRUSTEE	0.5	0.0		$0	$34,493	$0	Yes (X)
ROWAN R NICKOL MD
BOARD CHAIR	0.5	2.0		$0	$0	$0	Yes (X)		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,817,640	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$13,816,769	TotReportableCompRltdOrgAmt
Total Other Compensation	$2,177,401	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	31	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
CATHOLIC HEALTH INITIATIVES
3900 OLYMPIC BLVD 400	ERLANGER	KY	41018	CLINICAL ENGINEERING	$1,633,042
DAWSON HEALTHCARE
1114 DUBLIN RD	COLUMBUS	OH	43215	MEDICAL SERVICES	$1,488,777
WENCO CONSTRUCTION CO LLC
1807 Dalton Dr	NEW CARLISLE	OH	45344	CONSTRUCTION	$1,319,241
PULMONARY CRITICAL CARE CONSULTANTS
1520 S Main St Suite 2	DAYTON	OH	45409	Medical Services	$1,288,378
HEALOGICS WOUND CARE HYPERBARIC S
28525 Network Place	CHICAGO	IL	60673	Medical Services	$1,005,578

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	25	CntrctRcvdGreaterThan100KCnt
Related Organizations	$122,348	RelatedOrganizationsAmt
Total Contributions	$122,348	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT CARE REVENUE	621110	$82,449,297	$82,309,763	$139,534
MEDICARE/MEDICAID	621110	$72,822,450	$72,822,450
HOSPITAL FRANCHISE TAX RECOVERIES	900099	$2,143,487	$2,143,487
ATHLETIC TRAINING	900099	$63,829	$63,829
MEDICAL RECORDS	900099	$32,672	$32,672

Field	Value	IRS element (for citing)
Total Program Service Revenue	$157,511,735	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,146,969	TotalRevenueColumnAmt
Exclusion	$1,146,969	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$3,191,962	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$3,050,871	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$141,091	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$141,091	TotalRevenueColumnAmt
Exclusion	$141,091	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$26,780,612	SecuritiesAmt
Other	$213,848	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$22,394,254	SecuritiesAmt
Other	$51,305	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$4,386,358	SecuritiesAmt
Other	$162,543	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,548,901	TotalRevenueColumnAmt
Exclusion	$4,548,901	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$244,143	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$138,434	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$105,709	TotalRevenueColumnAmt
Exclusion	$105,709	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CAFETERIA SALES	721210	$568,908	$568,908
PENSION COST (INCOME)	900099	$376,274	$376,274
PURCHASE DISCOUNTS	900099	$24,771		$24,771

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$141,956	TotalRevenueColumnAmt
Unrelated Business Revenue	$7,559	UnrelatedBusinessRevenueAmt
Exclusion	$134,397	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,111,909	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$164,688,662	TotalRevenueColumnAmt
Related Or Exempt Func Income	$157,396,972	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$147,093	UnrelatedBusinessRevenueAmt
Exclusion	$7,022,249	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$2,386,261	TotalAmt
Program Services	$2,386,261	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,622,843	TotalAmt
Program Services	$516,754	ProgramServicesAmt
Management And General	$1,106,089	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$52,380,099	TotalAmt
Program Services	$50,927,799	ProgramServicesAmt
Management And General	$1,452,300	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,861,257	TotalAmt
Program Services	$2,725,705	ProgramServicesAmt
Management And General	$135,552	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$5,514,182	TotalAmt
Program Services	$5,514,182	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,810,794	TotalAmt
Program Services	$3,613,397	ProgramServicesAmt
Management And General	$197,397	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$98,645	TotalAmt
Program Services	$98,645	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$23,258	TotalAmt
Management And General	$23,258	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$3,553	TotalAmt
Program Services	$3,553	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$126,066	TotalAmt
Management And General	$126,066	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$10,320,947	TotalAmt
Program Services	$10,291,350	ProgramServicesAmt
Management And General	$29,597	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$366,079	TotalAmt
Program Services	$366,079	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$735,573	TotalAmt
Program Services	$483,428	ProgramServicesAmt
Management And General	$252,145	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$709,280	TotalAmt
Program Services	$546,098	ProgramServicesAmt
Management And General	$163,182	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,026,429	TotalAmt
Program Services	$2,026,429	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$84,295	TotalAmt
Program Services	$69,563	ProgramServicesAmt
Management And General	$14,732	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,632,958	TotalAmt
Program Services	$1,632,958	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$9,254,848	TotalAmt
Program Services	$9,254,848	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
OPERATING SUPPLIES	$21,039,537	$21,039,537	$0
PURCHASED SERVICES	$10,017,059	$9,073,495	$943,564
HOSPITAL FRANCHISE TAX	$2,434,978	$2,434,978
REPAIRS AND MAINTENANCE	$887,933	$887,933

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$738,330	TotalAmt
Program Services	$557,007	ProgramServicesAmt
Management And General	$181,323	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$129,075,204	TotalAmt
Program Services	$124,449,999	ProgramServicesAmt
Management And General	$4,625,205	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$4,310	BOYAmt
EOY	$4,310	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$5,597,903	BOYAmt
EOY	$10,036,164	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$21,132,481	BOYAmt
EOY	$21,035,708	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$110,000	BOYAmt
EOY	$73,500	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,230,450	BOYAmt
EOY	$1,079,571	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,679,103	BOYAmt
EOY	$387,315	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$205,434,537	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$130,295,678	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$83,990,300	BOYAmt
EOY	$75,138,859	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$39,498,579	BOYAmt
EOY	$48,187,394	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$15,996,268	BOYAmt
EOY	$19,894,133	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$12,179,358	BOYAmt
EOY	$757,850	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$181,418,752	BOYAmt
EOY	$176,594,804	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$13,749,974	BOYAmt
EOY	$12,608,818	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$4,581,532	BOYAmt
EOY	$5,824,782	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$53,854	BOYAmt
EOY	$53,299	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$57,530,878	BOYAmt
EOY	$54,673,726	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$192,900	BOYAmt
EOY	$685,833	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$15,927,635	BOYAmt
EOY	$19,850,020	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$92,036,773	BOYAmt
EOY	$93,696,478	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$89,381,979	BOYAmt
EOY	$82,898,326	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$89,381,979	BOYAmt
EOY	$82,898,326	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$181,418,752	BOYAmt
EOY	$176,594,804	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$35,613,458	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$4,189,270	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$46,286,381	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (true)	GrantsOtherOrganizationsInd
Grants Other Organizations	$3,553	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$3,553	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind
Form4720 Filed4912 Tax	false	Form4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1F:	FormAndLineReferenceDesc
Explanation	PAYMENTS FOR LOBBYING ACTIVITIES INCLUDE DUES PAID TO GREATER DAYTON AREA HOSPITAL ASSOCIATION AND OHIO HOSPITAL ASSOCIATION.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,908,623	OtherCostOrOtherBasisAmt
Book Value	$1,908,623	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$134,121,447	OtherCostOrOtherBasisAmt
Depreciation	$76,587,767	DepreciationAmt
Book Value	$57,533,680	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$66,680,612	OtherCostOrOtherBasisAmt
Depreciation	$53,707,911	DepreciationAmt
Book Value	$12,972,701	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,723,855	OtherCostOrOtherBasisAmt
Book Value	$2,723,855	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$75,138,859	TotalBookValueLandBuildingsAmt
Financial Derivatives		FinancialDerivativesGrp
Closely Held Equity Interests		CloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	ALTERNATIVE INVESTMENTS	Desc
Book Value	$19,894,133	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$19,894,133	TotalBookValueSecuritiesAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDesc	AmtAmt
PENSION OBLIGATION	$11,630,375
DUE TO AFFILIATES	$3,148,034
MALPRACTICE INSURANCE	$2,494,511
WORKER'S COMP RESERVE	$978,253
SETTLEMENT - 3RD PARTY PAYOR	$733,754
DEFERRED COMPENSATION	$595,511
OTHER	$269,582

Field	Value	IRS element (for citing)
Total Liability	$19,850,020	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	THE FOLLOWING FOOTNOTE IS FROM THE 2019 CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR PREMIER HEALTH (PHP) AND AFFILIATES. PHP IS THE SOLE MEMBER OF UPPER VALLEY MEDICAL CENTER. 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.	ExplanationTxt

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp (2 entries)

RegionRegionTxt	Type Of Activities ConductedTypeOfActivitiesConductedTxt	Region Total ExpendituresRegionTotalExpendituresAmt	Specific Services ProvidedSpecificServicesProvidedTxt
Central America and the Caribbean	Investments	$6,182,000
Central America and the Caribbean	Program Services	$25,000	Insurance

Field	Value	IRS element (for citing)
Subtotal Spent	$6,207,000	SubtotalSpentAmt
Total Spent	$6,207,000	TotalSpentAmt
Transfer To Foreign Corp	false	TransferToForeignCorpInd
Interest In Foreign Trust	false	InterestInForeignTrustInd
Foreign Corp Ownership	false	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	false	PassiveForeignInvestmestCoInd
Foreign Partnership	false	ForeignPartnershipInd
Boycott Countries	false	BoycottCountriesInd

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,348,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,464,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,884,000	NetCommunityBenefitExpnsAmt
Total Expense	0.02230	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$13,834,487	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,143,487	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$11,691,000	NetCommunityBenefitExpnsAmt
Total Expense	0.09060	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,091,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,912,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$179,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00140	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$20,273,487	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,519,487	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$14,754,000	NetCommunityBenefitExpnsAmt
Total Expense	0.11430	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$423,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$416,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00320	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,879,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,879,000	NetCommunityBenefitExpnsAmt
Total Expense	0.03780	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$688,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$688,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00530	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,990,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,983,000	NetCommunityBenefitExpnsAmt
Total Expense	0.04630	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,263,487	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,526,487	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$20,737,000	NetCommunityBenefitExpnsAmt
Total Expense	0.16060	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$105,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$105,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00080	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,440,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,440,000	NetCommunityBenefitExpnsAmt
Total Expense	0.01120	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,000	NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,546,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,546,000	NetCommunityBenefitExpnsAmt
Total Expense	0.01200	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$5,307,511	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$32,148,000	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$33,301,000	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$1,153,000	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost Accounting System	Yes (X)	CostAccountingSystemInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	UPPER VALLEY MEDICAL CENTER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3130 N COUNTY RD 25-A	AddressLine1Txt
City	TROY	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45373	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.PREMIERHEALTH.COM	WebsiteAddressTxt
State License	SEE PART V SEC C	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	UPPER VALLEY MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	19	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	See Part V, Section C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	20	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	See Part V, Section C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SEC C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SEC C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SEC C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp

Field	Value	IRS element (for citing)
Form And Line Reference	PART V, SECTION B, LINE 1:	FormAndLineReferenceDesc
Explanation	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. UPPER VALLEY MEDICAL CENTER'S (UPPER VALLEY) REGISTRATION NUMBER IS 1036. PART V, SECTION B, LINE 3E: UPPER VALLEY'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. THE CHNA TEAM INVOLVED FOUR ENTITIES WORKING CLOSELY TOGETHER: THE HEALTH COLLABORATIVE (LEAD AGENCY); THE GREATER DAYTON AREA HOSPITAL ASSOCIATION; GWEN FINEGAN (LEAD CONSULTANT AND PROJECT MANAGER); AND PUBLIC HEALTH - DAYTON & MONTGOMERY COUNTY (SECONDARY DATA COLLECTION FOR OHIO COUNTIES). THE HEALTH COLLABORATIVE (THC) CONTRACTED WITH MS. FINEGAN TO CONDUCT A COMPREHENSIVE AND COLLABORATIVE ASSESSMENT FOR THE HEALTHCARE SYSTEMS AND HOSPITALS. THE LEAD CONSULTANT ASSEMBLED A TEAM OF FOUR SUB-CONTRACTORS TO ASSIST HER. BOTH THC AND THE GREATER DAYTON AREA HOSPITAL ASSOCIATION (GDAHA) MANAGED THE RELATIONSHIPS AND SIGNED AGREEMENTS WITH THEIR RESPECTIVE MEMBER HOSPITALS. THE LEAD CONSULTANT INITIATED THE CONNECTION WITH THE SOUTHWEST DISTRICT OF THE ASSOCIATION OF OHIO HEALTH COMMISSIONERS (AOHC), AND BOTH SHE AND THC REPRESENTATIVES ATTENDED SIX AOHC MEETINGS. THE LEAD CONSULTANT WORKED CLOSELY WITH ERIK BALSTER, DIRECTOR FOR THE SW DISTRICT OF AOHC AND HEALTH COMMISSIONER OF PREBLE COUNTY TO INCORPORATE AOHC'S REQUESTS AND ENSURE SMOOTH COMMUNICATION. THE LEAD CONSULTANT ALSO WORKED CLOSELY WITH DAWN EBRON, COMMUNITY HEALTH IMPROVEMENT PLANNING AND EPIDEMIOLOGY SUPERVISOR, AND EPIDEMIOLOGISTS KYLE WALLACE, ASHLEY SEYBOLD, AND SUSAN HERZFELD AT PUBLIC HEALTH - DAYTON & MONTGOMERY COUNTY TO COORDINATE MEETINGS AND FOR SECONDARY DATA COLLECTION. INTERACT FOR HEALTH PROVIDED DATA FROM THEIR GREATER CINCINNATI HEALTH STATUS SURVEY AS DID PREVENTIONFIRST! FROM ITS PRIDE SURVEY. LOUISE KENT, PLANNING ADMINISTRATOR FOR THE NORTHERN KENTUCKY HEALTH DEPARTMENT, IDENTIFIED ADDITIONAL DATA SOURCES FOR THE COMMONWEALTH OF KENTUCKY AND THE THREE NORTHERN COUNTIES. THE CINCINNATI HEALTH DEPARTMENT GATHERED DATA FOR THE CITY OF CINCINNATI. PART V, SECTION B, LINES 6A & 6B: UPPER VALLEY 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 DIRECT 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: UPPER VALLEY MEDICAL CENTER 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 U	ExplanationTxt

Field	Value	IRS element (for citing)
Facility	5	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
HYATT CENTER
450 N HYATT ST	TIPP CITY	OH	45371	DIAGNOSTICS AND IMAGING, SPORTS MEDICINE, PEDIATRICS, OUTPATIENT SURGERY
OUTPATIENT CARE CENTER NORTH
280 LOONEY RD	PIQUA	OH	45356	DIAGNOSTICS AND IMAGING, REHABILITATIVE THERAPY, PEDIATRICS
OUTPATIENT CARE CENTER SOUTH
998 S DORSET RD	TROY	OH	45373	DIAGNOSTICS AND IMAGING, OCCUPATIONAL HEALTH, REHABILITATIVE THERAPY
STANFIELD PLACE
31 STANFIELD RD	TROY	OH	45373	IMAGING, ENT, LABORATORY RHEUMATOLOGY
UVMC SIDNEY CENTER
1529 FAIR RD	SIDNEY	OH	45365	PHYSICAL THERAPY, WOMEN'S SERVICES

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 6A:	FormAndLineReferenceDesc
Explanation	THE COMMUNITY BENEFIT REPORT FOR UPPER VALLEY 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: UPPER VALLEY 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 $4,836,000. PART II, LINE 2: UPPER VALLEY 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, UPPER VALLEY 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 UPPER VALLEY 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, $104,614 WAS CONTRIBUTED TO PHYSICAL IMPROVEMENTS, AND $1,439,500 WAS CONTRIBUTED TO COMMUNITY BUILDING ECONOMIC DEVELOPMENT. 2) $1,000 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 $23,921,000 AND INCURRED COST OF $35,817,000, FOR AN ADDITIONAL NET SHORTFALL OF $11,896,000 ASSOCIATED WITH THESE PROGRAMS. BELOW IS A RECONCILIATION OF THE AMOUNTS ASSOCIATED WITH MEDICARE PROGRAMS. ALLOWABLE MEDICARE REVENUE PER MEDICARE COST REPORT (PART III, SECTION B) $32,148,000 MEDICARE REVENUE NOT REPORTED IN PART III, SECTION B $23,921,000 TOTAL MEDICARE ASSOCIATED REVENUE $56,069,000 ALLOWABLE MEDICARE COST PER MEDICARE COST REPORT (PART III, SECTION B) $33,301,000 MEDICARE COST NOT REPORTED IN PART III, SECTION B $35,817,000 TOTAL MEDICARE ASSOCIATED COST $69,118,000 MEDICARE SHORTFALL PER PART III, SECTION B $ 1,153,000 ADDITIONAL SHORTFALL NOT INCLUDED IN PART III, SECTION B $11,896,000 TOTAL MEDICARE SHORTFALL $13,049,000 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 47.3% 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. A SUMMARY OF 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 ASSISTANCE. PART VI, LIN	ExplanationTxt

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (21 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
CITYWIDE DEVELOPMENT CORP
8 N MAIN ST	DAYTON	OH	45402	310821189	501(C)(4)	$1,529,114	COMMUNITY DEVELOPMENT
ONEFIFTEEN RECOVERY
6636 LONGSHORE ST 200	DUBLIN	OH	43017	833504845	501(C)(3)	$250,000	SUPPORT
MIAMI COUNTY DENTAL CLINIC
70 TROY TOWN DR	TROY	OH	45373	204901192	501(C)(3)	$110,150	SUPPORT
MIAMI COUNTY RECOVERY COUNCIL
1059 N MARKET ST	TROY	OH	45373	310917327	501(C)(3)	$109,000	SUPPORT
HEALTH PARTNERS FREE CLINIC
1300 N CO RD 25A	TROY	OH	45373	311596731	501(C)(3)	$95,400	SUPPORT
SAMARITAN BEHAVIORAL HEALTH
110 N MAIN ST SUITE 500	DAYTON	OH	45402	020633634	501(C)(3)	$93,250	SUPPORT
MIAMI VALLEY HOSPITAL
110 N MAIN ST 500	DAYTON	OH	45402	310537504	501(C)(3)	$74,190	support
JOHNSTON FARM & INDIAN AGENCY
9845 N HARDIN RD	OH	OH	45356	270191878	501(C)(3)	$25,050	SUPPORT
EDISON FOUNDATION
1973 EDISON DR	PIQUA	OH	45356	311379781	501(C)(3)	$25,000	SUPPORT
REACH OUT MONTGOMERY COUNTY
25 E FORAKER ST	DAYTON	OH	45409	311434282	501(C)(3)	$18,729	RX ASSISTANCE
TROY COMMUNITY DEVELOPMENT
405 SW PUBLIC SQ 330	TROY	OH	45373	311736034	501(C)(3)	$15,000	SUPPORT
LINCOLN COMMUNITY CENTER
110 ASH ST	TROY	OH	45373	310584315	501(C)(3)	$10,516	SUPPORT
HOMEFULL
33 W FIRST ST 100	DAYTON	OH	45402	311236989	501(C)(3)	$10,100	SUPPORT
GALA OF HOPE FOUNDATION
3500 PENTAGON BLVD	BEAVERCREEK	OH	45431	464277044	501(C)(3)	$10,000	SUPPORT
MIAMI VALLEY HOSPITAL FOUNDATION
110 N MAIN ST 500	DAYTON	OH	45402	311040231	501(C)(3)	$7,850	SUPPORT
DAYTON FOUNDATION
40 N MAIN ST 500	BEAVERCREEK	OH	45423	316027287	501(C)(3)	$7,500	SUPPORT
MIDAMCO
3333 RICHMOND DR	BEACHWOOD	OH	44122	346627493	NONE	$7,500	SUPPORT
CITY OF PIQUA OHIO
201 W WATER STREET	PIQUA	OH	45356	316000136	GOVT	$6,750	SUPPORT
DAYTON ART INSTITUTE
456 BELMONTE PARK	DAYTON	OH	45405	310537480	501(C)(3)	$6,500	SUPPORT
PIQUA ARTS COUNCIL
427 N MAIN ST	PIQUA	OH	45356	311505713	501(C)(3)	$5,500	SUPPORT
TROY AREA CHAMBER OF COMMERCE
405 SW PUBLIC SQ	TROY	OH	45373	310529268	GOVT	$5,150	SUPPORT

Field	Value	IRS element (for citing)
Total501c3 Org	19	Total501c3OrgCnt
Total Other Org	2	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (31 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MICHAEL J MAIBERGER
FORMER KEY EMPLOYEE	$0	$564,689	$0	$520,375	$0	$1,207,754	$0	$1,031,331	$0	$30,730	$0	$3,354,879	$0	$831,140
MARY H BOOSALIS
PREMIER PRESIDENT & CEO	$0	$1,152,156	$0	$616,657	$0	$52,172	$0	$22,778	$0	$20,512	$0	$1,864,275	$0	$0
SCOTT A SHELTON
FORMER KEY EMPLOYEE	$0	$505,156	$0	$269,139	$0	$152,574	$0	$13,302	$0	$17,824	$0	$957,995	$0	$0
JENNIFER J HAULER DO
FORMER KEY EMPLOYEE	$0	$519,043	$0	$372,959	$0	$1,783	$0	$52,997	$0	$2,779	$0	$949,561	$0	$0
FAYEZ D ABBOUD MD
PRES MEDICAL STAFF (FROM SEP)	$0	$618,585	$0	$36,800	$0	$26,340	$0	$9,558	$0	$28,234	$0	$719,517	$0	$0
BARBARA A JOHNSON
EXEC VP & PREMIER COO	$0	$476,627	$0	$149,539	$0	$39,802	$0	$27,000	$0	$11,127	$0	$704,095	$0	$0
GEOFFREY P WALKER
FORMER OFFICER	$0	$411,905	$0	$140,011	$0	$96,988	$0	$23,811	$0	$26,531	$0	$699,246	$0	$0
THOMAS R PARKER
PRESIDENT & CEO	$399,599	$0	$168,998	$0	$50,576	$0	$66,901	$0	$12,860	$0	$698,934	$0	$0	$0
DIANE L PLEIMAN
FORMER OFFICER	$0	$415,889	$0	$178,508	$0	$52,684	$0	$21,465	$0	$7,653	$0	$676,199	$0	$0
GARY G GINTER
VP &PREMIER CHIEF INFO OFFICER	$0	$408,643	$0	$140,815	$0	$4,063	$0	$69,684	$0	$28,333	$0	$651,538	$0	$0
CRAIG SELF
FORMER KEY EMPLOYEE	$0	$0	$0	$148,256	$0	$375,613	$0	$74,192	$0	$20,655	$0	$618,716	$0	$300,262
RENEE P GEORGE
FORMER KEY EMPLOYEE	$0	$387,083	$0	$151,484	$0	$1,323	$0	$50,260	$0	$13,183	$0	$603,333	$0	$0
MARGARET W MARK
VP NURSING SERVICE/PREMIER CNO	$0	$376,334	$0	$137,400	$0	$13,986	$0	$23,441	$0	$27,942	$0	$579,103	$0	$0
DALE E CREECH JR
FORMER OFFICER	$0	$0	$0	$82,482	$0	$427,995	$0	$17,945	$0	$11,552	$0	$539,974	$0	$151,924
RAFAY ATIQ MD
TRUSTEE	$0	$398,631	$0	$81,430	$0	$3,166	$0	$10,166	$0	$31,798	$0	$525,191	$0	$0
SCOTT B KANAGY DO
TRUSTEE & CMO	$334,777	$0	$138,312	$0	$1,142	$0	$16,373	$0	$26,150	$0	$516,754	$0	$0	$0
J MICHAEL SIMS
SYS VP-TREAS & CORP CONTROLLER	$0	$303,223	$0	$68,302	$0	$89,634	$0	$24,054	$0	$29,351	$0	$514,564	$0	$0
THOMAS R CURTIN
VP - REVENUE CYCLE	$0	$318,812	$0	$80,976	$0	$7,671	$0	$26,866	$0	$33,348	$0	$467,673	$0	$0
MARK W SHAW
FORMER KEY EMPLOYEE	$0	$0	$0	$30,246	$0	$387,960	$0	$16,713	$0	$5,855	$0	$440,774	$0	$38,000
TIMOTHY D SNIDER
BOARD TREASURER & COO	$255,385	$0	$98,141	$0	$2,465	$0	$25,016	$0	$26,148	$0	$407,155	$0	$0	$0
KIM K STRAHL
SYS VP & CPO	$0	$233,940	$0	$100,231	$0	$3,377	$0	$21,635	$0	$12,150	$0	$371,333	$0	$0
BILLIE L LUCENTE-BAKER
SYS VP - HR OPS (FROM AUG)	$0	$215,099	$0	$35,605	$0	$1,495	$0	$20,083	$0	$14,063	$0	$286,345	$0	$0
JENNA M DOWNEY ESQ
FORMER OFFICER	$0	$190,262	$0	$32,305	$0	$792	$0	$8,381	$0	$13,557	$0	$245,297	$0	$0
MELISSA M TALLMADGE
DIR NURSING - SURGERY/ED	$157,116	$0	$24,448	$0	$1,086	$0	$17,378	$0	$18,346	$0	$218,374	$0	$0	$0
KATHRYN M BOERGER
DIRECTOR HR	$139,037	$0	$27,195	$0	$19,363	$0	$14,659	$0	$731	$0	$200,985	$0	$0	$0
TERESA A GULKER
DIR NRS-MEDSURG/WMS SRVCS	$149,514	$0	$24,273	$0	$1,306	$0	$13,272	$0	$9,111	$0	$197,476	$0	$0	$0
REBECCA A RICE
FORMER TRUSTEE & OFFICER	$0	$0	$36,605	$0	$141,576	$0	$17,678	$0	$128	$0	$195,987	$0	$40,307	$0
RYAN E MCELDOWNEY
STAFF PHARMACIST	$150,216	$0	$777	$0	$879	$0	$11,651	$0	$26,388	$0	$189,911	$0	$0	$0
ELAINE M DEAN
SYSTEM VP-BUSINESS DEVELOPMENT	$0	$178,094	$0		$0	$724	$0	$2,692	$0	$5,452	$0	$186,962	$0	$0
BENJAMIN A WATSON ESQ
BOARD SECRETARY	$0	$144,706	$0	$21,428	$0	$582	$0	$6,180	$0	$10,065	$0	$182,961	$0	$0
CHRISTOPHER J PATSIAVOS
STAFF PHARMACIST	$165,330		$778		$247		$1,252		$1,208		$168,815		$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 4A:	FormAndLineReferenceDesc
Explanation	THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT IN 2019: CRAIG SELF $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; MICHAEL MAIBERGER $221,850; REBECCA RICE $111,075; MARK SHAW $103,000. 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, UPPER VALLEY AND ITS AFFILIATED ORGANIZATIONS COMPENSATE FOR THIS LIMITATION AND SUPPLEMENT THE AFFECTED EXECUTIVES' QUALIFIED PENSION THROUGH CERTAIN NONQUALIFIED PLANS. UPPER VALLEY 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 AND RECEIVED THE ASSOCIATED PAYMENT IN 2019: DALE CREECH JR $196,960; BARBARA JOHNSON $25,958; MICHAEL MAIBERGER $18,567; MARGARET MARK $5,206; THOMAS PARKER $22,946; DIANE PLEIMAN $49,329; REBECCA RICE $30,579; MARK SHAW $286,638; SCOTT A SHELTON $144,980; J. MICHAEL SIMS $65,725; GEOFFREY P. WALKER $90,728. 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. 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: THOMAS CURTIN $7,888; RENEE GEORGE $38,933; GARY GINTER $47,436; JENNIFER HAULER, D.O. $43,676; BARBARA JOHNSON $11,541; SCOTT KANAGY $8,069; MICHAEL MAIBERGER $83,348; MARGARET MARK $13,181; THOMAS PARKER $43,947; CRAIG SELF $65,158; TIMOTHY SNIDER $3,843. 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.	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	County of Montgomery Ohio	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	316000172	BondIssuerEIN
CUSIP	613520LO6	CUSIPNum
Bond Issued	2019-09-24	BondIssuedDt
Issue Price	$24,859,875	IssuePriceAmt
Purpose	REFUNDED SERIES 2016B BONDS	PurposeDesc
Defeased	false	DefeasedInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Pool Financing	false	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$0	RetiredAmt
Bond Defeased	$0	BondDefeasedAmt
Total Proceeds	$24,859,875	TotalProceedsAmt
In Reserve Fund	$0	InReserveFundAmt
Capitalized Interest	$0	CapitalizedInterestAmt
Refunding Escrow	$0	RefundingEscrowAmt
Issuance Costs From Proceeds	$228,930	IssuanceCostsFromProceedsAmt
Credit Enhancement	$0	CreditEnhancementAmt
Working Capital Expenditures	$0	WorkingCapitalExpendituresAmt
Capital Expenditures	$0	CapitalExpendituresAmt
Other Spent Proceeds	$24,630,944	OtherSpentProceedsAmt
Unspent	$0	UnspentAmt
Refunding Tax Exempt Bonds	Yes (true)	RefundingTaxExemptBondsInd
Refunding Taxable Bonds	false	RefundingTaxableBondsInd
Final Allocation Made	Yes (true)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (true)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedPropertyInd
Any Lease Arrangements	Yes (true)	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	false	MgmtContractBondFincdPropInd
Any Research Agreements	false	AnyResearchAgreementsInd
Private Bus Use By Others	0.00050	PrivateBusUseByOthersPct
Private Bus Concerning UBI	0.00240	PrivateBusConcerningUBIPct
Total Private Business Use	0.00290	TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test	false	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	false	ChangeInUseBondFinancedPropInd
Remedial Action Taken	false	RemedialActionTakenInd
Procs Nonqualified Bond Remdtd	Yes (true)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiledInd
Rebate Not Due Yet	Yes (true)	RebateNotDueYetInd
Exception To Rebate	false	ExceptionToRebateInd
No Rebate Due	false	NoRebateDueInd
Variable Rate Issue	false	VariableRateIssueInd
Hedge Identified In Bks And Rec	false	HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Gross Proceeds Invested	false	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (true)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (true)	ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	NOTE A PART I, LINE A, COLUMN E:	FormAndLineReferenceDesc
Explanation	ISSUE PRICE IS NOT IDENTICAL TO THE ISSUE PRICE LISTED ON FORM 8038 DUE TO THE SERIES 2019A BONDS' PROCEEDS BEING SPLIT BETWEEN UPPER VALLEY MEDICAL CENTER, ATRIUM MEDICAL CENTER AND MIAMI VALLEY HOSPITAL. NOTE A PART I, LINE A, COLUMN F: REFUNDED THE FOLLOWING SERIES BONDS: SERIES 2016B BONDS - ISSUE DATE 8/31/2016	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	FORM 990, PART VI, SECTION A, LINE 3:	FormAndLineReferenceDesc
Explanation	PREMIER HEALTH (PREMIER) AS THE OPERATOR OF UPPER VALLEY MEDICAL CENTER (UPPER VALLEY), DEVELOPS AND OVERSEES THE IMPLEMENTATION OF THE STRATEGIC PLAN FOR UPPER VALLEY, WHICH INCLUDES (BUT IS NOT LIMITED TO) SUCH MATTERS AS LOCATION OF CLINICAL AND ADMINISTRATIVE EXPENSES AND THE CONSOLIDATION OF SUCH SERVICES. UPPER VALLEY SHALL COMPLY WITH AND IMPLEMENT THIS PLAN AND SHALL NOT TAKE ANY ACTION THAT MATERIALLY DEPARTS FROM THIS PLAN WITHOUT PREMIER'S APPROVAL. UPPER VALLEY SHALL IMPLEMENT ANY CAPITAL AND OPERATING BUDGET SO APPROVED AND/OR REVISED FOR IT BY PREMIER. UPPER VALLEY SHALL IMPLEMENT THE BUSINESS PLAN APPROVED BY PREMIER. PREMIER IS THE SOLE AGENT TO NEGOTIATE ALL RELATIONSHIPS WITH PAYORS ON BEHALF OF UPPER VALLEY WITH ALL THIRD-PARTY PAYORS AND ALTERNATIVE DELIVERY SYSTEMS INCLUDING, BUT NOT LIMITED TO INSURERS. UPPER VALLEY 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. UPPER VALLEY MUST SEEK PREMIER'S APPROVAL FOR ANY ACQUISITIONS, SALE OR TRANSFER OF ANY MATERIAL ASSET USED IN UPPER VALLEY'S ACTIVITIES. FORM 990, PART VI, SECTION A, LINE 6: UPPER VALLEY 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 UPPER VALLEY. 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 RETURN AND ATTACHED SCHEDULES (THE RETURN) ARE PREPARED BY A STAFF MEMBER IN THE PREMIER TAX DEPARTMENT, OF WHICH UPPER VALLEY 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 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 UPPER VALLEY 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 & 15B: COMPENSATION FOR UPPER VALLEY'S CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH UPPER VALLEY 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 19A: 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 B: THE AMOUNT REPORTED ON 1099 FOR WENCO CONSTRUCTION, LLC. INCLUDES MATERIAL/REIMBURSEMENT EXPENSES. THE BILLING STATEMENTS DO NOT SEGREGATE THE SERVICES AND THE MATERIAL COST BUT PROVIDE A LUMPSUM AMOUNT UNDER THE JOB DESCRIPTION AS "PROVIDED LABOR AND MATERIALS". DUE TO THIS REASON, THE AMOUNT OF MATERIAL REIMBURSEMENT IS DIFFICULT TO SEGREGATE FROM THE AMOUNT OF SERVICE PAID. FORM 990, PART XI, LINE 9: TRANSFER FROM AFFILIATES (47,890,973) FOUNDATION ADJUSTMENT (122,348) PENSION ADJUSTMENT (1,269,717) CAPITAL DONATIONS 2,996,657 ----------- TOTAL (46,286,381)	ExplanationTxt

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
Premier Health Partners (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
Atrium Medical Center
110 N MAIN ST 500	DAYTON	OH	45402	311079309	Hospital	OH	501(c)(3)	3	PREMIER	false
MedAmerica Health Systems Co (MAHS)
110 N Main St 500	DAYTON	OH	45402	311040228	Support Org	OH	501(C)(3)	12B		false	N/A
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	FCH	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	BEHAVIORAL 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 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

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	UBI Code VUBICodeVAmt	General Or Managing PartnerGeneralOrManagingPartnerInd
Premier Plaza LLC
110 N Main St 500	DAYTON	OH	45402	800708185	Holding Compa	OH	MAHS	EXCLUDED	$0	$0	false	$0	false
Compunet Clinical Laboratories LLC
2308 Sandridge Dr	Moraine	OH	45439	311258010	Medical Labs	OH	MVHE Inc	RELATED	$0	$0	false	$0	false
Sweitzer Street LLC
110 N MAIN ST 500	DAYTON	OH	45402	454700417	Real Estate	OH	MVHE Inc	EXCLUDED	$0	$0	false	$0	false
Sweitzer MOB LLC
110 N MAIN ST 500	DAYTON	OH	45402	474554657	Real Estate	OH	MVHE Inc	EXCLUDED	$0	$0	false	$0	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Controlled OrganizationControlledOrganizationInd
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

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	Yes (true)	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd