2014-11-13T15:26:27-06:00 2013-12-31 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 2000 INDIANAPOLIS IN 462045108 990 2013-01-01 341880767 PROMEDICA PHYSICIANS AND CONTINUUM SERVICES PROM 4198247200 5855 MONROE ST SYLVANIA OH 43560 LEE W HAMMERLING PRESIDENT 4194693842 2014-11-13 1 SAMANTHA BOKORI P01057347 3174648600 2014-10-27 2013 2015-11-30 17:44:51Z LEE W HAMMERLING 1801 RICHARDS RD TOLEDO OH 43607 35689887 0 X WWW.PROMEDICA.ORG X 1998 OH PROMEDICA PHYSICIANS AND CONTINUUM SERVICES IS A MEDICAL SERVICE ORGANIZATION THAT WAS CREATED TO MANAGE THE PHYSICIAN SERVICES COMPONENT OF PROMEDICA HEALTH SYSTEM, INC.'S INTEGRATED DELIVERY NETWORK. 19 12 205 13 0 0 17580373 13104803 20534168 22523779 21722 29743 1245 31562 38137508 35689887 1700450 1454900 0 0 16982353 19599011 0 0 0 17419639 23052936 36102442 44106847 2035066 -8416960 29374048 76118344 16910751 72072007 12463297 4046337 X PROMEDICA PHYSICIANS AND CONTINUUM SERVICES IS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC. WE WILL BE THE PREMIER COMMUNITY-BASED MANAGED SERVICES ORGANIZATION AND PROVIDER OF RELATED HEALTHCARE SERVICES TO NORTHWEST OHIO / SOUTHEAST MICHIGAN, OFFERING QUALITY, COST-EFFECTIVE, EFFICIENT, AND VALUE-ADDED SERVICES TO ACHIEVE SUPERIOR PATIENT SATISFACTION AND A FINANCIALLY VIABLE NETWORK OF PHYSICIANS SUPPORTING THE MEDICAL NEEDS OF THE COMMUNITY. 0 0 32259554 1452000 19844806 PROMEDICA PHYSICIANS AND CONTINUUM SERVICES PROVIDES MANAGERIAL AND ADMINISTRATIVE SERVICES TO THE TAX-EXEMPT PHYSICIANS' SERVICES COMPONENT OF PROMEDICA PHYSICIAN GROUP. THESE SERVICES ENABLE PHYSICIANS TO DEVOTE MORE TIME AND RESOURCES TO PROVIDING THE HIGHEST QUALITY CARE TO THEIR PATIENTS INSTEAD OF DIRECTLY MANAGING THEIR OWN OFFICE PRACTICES. - SEE SCHEDULE O. 4627318 2900 2710535 PROMEDICA PHYSICIANS AND CONTINUUM SERVICES PROVIDES HOSPICE (HOMECARE) THAT FOCUSES ON THE QUALITY OF AN INDIVIDUAL'S LIFE. THE GOAL IS TO IMPROVE THE PATIENT'S QUALITY OF LIFE THROUGH PAIN AND SYMPTOM MANAGEMENT, IMPROVE THE FUNCTIONAL CAPACITY FOR PATIENTS WITH SERIOUS CHRONIC AND TERMINAL ILLNESSES AND MEET THE NEEDS OF PATIENT'S FAMILY MEMBERS. - SEE SCHEDULE O. 36886872 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 181 0 1 205 1 0 0 0 0 0 0 0 0 0 0 X 19 12 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 0 OH X RICH POTTER 4198918506 5901 MONCLOVA RD MAUMEE OH 43537 STEPHEN P BAZELEY MD TRUSTEE 1.00 46.00 X 0 95209 11868 JAMES H BRENNAN JR TRUSTEE 1.00 6.00 X 0 0 0 GREGORY B DENNY TRUSTEE 1.00 6.00 X 0 0 0 BRIAN A DOLSEY MD TRUSTEE 1.00 45.00 X 0 697377 43049 PATRICK D FARVER TRUSTEE 1.00 8.00 X 0 0 0 LYNN L FRUTH TRUSTEE 1.00 6.00 X 0 315 0 THEODORE T HAHN TRUSTEE 1.00 6.00 X 0 0 0 JONATHAN K HARDING TRUSTEE 1.00 6.00 X 0 0 0 JILL K KEGLER TRUSTEE 1.00 6.00 X 0 0 0 JOSEPH D NAPOLI TRUSTEE 1.00 7.00 X 0 0 0 EMILY A OSTROWSKI MD TRUSTEE 1.00 45.00 X 0 63304 2000 KEVIN T RAHE TRUSTEE 1.00 6.00 X 0 0 0 ALLAN M RUBIN MD TRUSTEE 1.00 45.00 X 0 460171 39259 DEBRA G SCHAEFER TRUSTEE 1.00 6.00 X 0 0 0 C MICHAEL SMITH TRUSTEE 1.00 7.00 X 0 0 0 RONALD J WAINZ MD TRUSTEE 1.00 45.00 X 0 487543 40369 RANDALL OOSTRA EX OFFICIO 1.00 54.50 X 0 1364902 272358 STEPHEN H STAELIN EX OFFICIO 1.00 10.00 X 0 479 0 LEE W HAMMERLING MD PRESIDENT, EX OFFICIO 1.00 48.00 X X 0 760695 77446 ROBERT J CHIRDON CHAIRPERSON 1.00 7.00 X X 0 0 0 JEFFREY C KUHN SECRETARY 0.50 51.00 X 0 521270 73952 KATHLEEN S HANLEY TREASURER 0.50 51.50 X 0 700133 104802 DEE ANN BIALECKI-HAASE VP MEDICAL OPS, PPG 0.50 40.00 X 0 218196 24755 MATT BODENSTEDT VP, PPCS & GENERAL MGR., TPC 40.00 0.50 X 0 177482 26011 ANNEMARIE HAINEN VP OPS, PPG 0.50 40.00 X 0 174731 35322 LORI JOHNSTON PRESIDENT AND CAO, PPG 0.50 42.50 X 0 332483 55470 KIM MCCLURE VP FINANCE, PPCS 0.50 43.00 X 0 197902 34329 WILLIAM MUELLER COO, PPG 0.50 40.50 X 0 336231 40793 JULIE TOME VP MEDICAL OPS, PPCS 0.50 40.00 X 0 326468 214658 DAVID BREWER AVP, BUS STRAT DEVELOP 40.00 0.00 X 116646 0 34085 MICHAEL MCKELVEY DIRECTOR, OPERATIONS 40.00 0.00 X 126843 0 28718 RITA ROTH DIRECTOR, PATIENT ACCOUNTS 40.00 0.00 X 113757 0 20413 GREGORY STANG DIRECTOR, OPERATIONS 40.00 0.00 X 119590 0 44831 RITA WESTPHAL ADMIN. DIRECTOR, PPCS FINANCE 40.00 0.00 X 124920 0 10133 GARY AKENBERGER FORMER KEY EMPLOYEE 0.00 44.50 X 0 336133 72295 DAWN BUSKEY FORMER KEY EMPLOYEE 0.00 40.00 X 0 296424 50903 MARTIN DANSACK FORMER KEY EMPLOYEE 0.00 41.50 X 0 191469 35079 DAVID DEWEY FORMER KEY EMPLOYEE 0.00 40.00 X 0 184987 238228 ROBERT FREDRICK FORMER KEY EMPLOYEE 0.00 40.50 X 0 406784 70378 A DAVID JAMES FORMER KEY EMPLOYEE 0.00 40.00 X 0 332964 18037 KHURRAM KAMRAN FORMER KEY EMPLOYEE 0.00 41.00 X 0 473290 41049 601756 9136942 1760590 8 1 1 0 ATHENA HEALTH INC 311 ARSENAL ST WATERTOWN MA 02472 BILLING SERVICES 5412807 KOBOR MED SEARCH LLC PO BOX 1931 DAWSONVILLE GA 30534 PHYSICIAN COVERAGE 1133291 TOLEDO VASCULAR INSTITUTE 2109 HUGHES DR STE 450 TOLEDO OH 43606 PHYSICIAN COVERAGE 738809 MEDICAL MARKETING MANAGEMENT 21415 CIVIC CENTER DR STE 211 SOUTHFIELD MI 48076 PHYSICIAN COVERAGE 649675 PRO-NURSE LLC 3722 ATLANTA HIGHWAY STE 1 ATHENS GA 30606 STAFFING SERVICES 484519 18 12962303 142500 13104803 SUPPORT FEES 621111 19813244 19813244 NET PATIENT SERVICES 621610 2710535 2710535 22523779 29743 29743 MEDICAL RECORDS 900099 31562 31562 31562 35689887 22555341 0 29743 1454900 1454900 15559422 12574053 2985369 428645 346875 81770 2467892 1986636 481256 1143052 951159 191893 356251 356251 129483 129483 863 863 1293492 1184168 109324 1419117 1322111 97006 612156 584342 27814 8193096 6531045 1662051 103297 42852 60445 479443 377127 102316 1949209 1949209 5522269 5235853 286416 EQUIPMENT RENTAL 563511 550236 13275 DRUGS 481133 481133 CONTINGENT LIAB. ADJ. 478170 478170 INTERCOMPANY SERVICES 387913 3625 384288 1083533 833378 250155 44106847 36886872 7219975 0 1909723 1956986 2269554 30412 41960 12489575 9184045 2435137 3305530 6272585 5809385 18678928 62782192 29374048 76118344 4741340 3973424 12169411 68098583 16910751 72072007 X 12383212 3824636 80085 221701 0 12463297 4046337 29374048 76118344 -8416960 0 X 0 1 X 1 0 X X X 0 0 0 PROMEDICA PHYSICIAN GROUP 341899439 9 1 1 1 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 863 863 0 PART II-B, LINE 1: PROMEDICA PHYSICIANS AND CONTINUUM SERVICES PAYS DUES TO THE NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION AND THE MIDWEST CARE ALLIANCE - A PORTION OF WHICH IS ALLOCABLE TO LOBBYING BY THE ORGANIZATIONS. 66120 66120 84495 84495 781577 608648 172929 11553701 8575397 2978304 3682 3682 3305530 DUE FROM AFFILIATES 62130706 OTHER RECEIVABLES 659614 CERTIFICATE OF DEPOSIT 42117 INVESTMENT IN AFFILIATES -50245 62782192 DUE TO AFFILIATES 64485996 CONTINGENT LIABILITIES 3612587 68098583 X PART X, LINE 2: PROMEDICA PHYSICIANS AND CONTINUUM SERVICES IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES (PHS). THE FOLLOWING REFLECTS PHS'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740. EXCEPT AS NOTED BELOW, PHS DID NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2013 AND 2012. FOR THE YEARS ENDED DECEMBER 31, 2013 AND 2012, A TAXABLE SUBSIDIARY OF PHS RECOGNIZED A LIABILITY FOR UNCERTAIN TAX POSITIONS OF $1,059,000 AND $1,552,000, RESPECTIVELY. THE SUBSIDIARY RECOGNIZED A CREDIT FOR INTEREST AND PENALTIES WITHIN THE INCOME TAX EXPENSE LINE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS RELATED TO UNRECOGNIZED TAX BENEFITS OF $20,000 AND $117,000 AS OF DECEMBER 31, 2013 AND 2012, RESPECTIVELY. PROMEDICA PHYSICIANS AND CONTINUUM SERVICES DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2013 AND 2012. 1 PROMEDICA CENTRAL CORPORATION OF MICHIGAN 5855 MONROE ST SYLVANIA OH 43560 383322278 1452000 OPERATING GRANT 0 1 PART I, LINE 2: AS AN AFFILIATE OF PROMEDICA HEALTH SYSTEM, INC. (PHS), CORPORATE TREASURY, WITH THE APPROVAL AND OVERSIGHT OF THE FINANCE COMMITTEE, ENSURES THAT FUNDS ARE DISTRIBUTED APPROPRIATELY ACCORDING TO PHS'S STRATEGIC BUSINESS PLAN AND CONSISTENT WITH CORPORATE TREASURY POLICIES AND PROCEDURES. 1 1 0 0 0 0 1 0 0 BRIAN A DOLSEY MD TRUSTEE 0 531508 0 149173 0 16696 0 17000 0 26049 0 740426 0 0 ALLAN M RUBIN MD TRUSTEE 0 442151 0 0 0 18020 0 17000 0 22259 0 499430 0 0 RONALD J WAINZ MD TRUSTEE 0 469098 0 0 0 18445 0 17000 0 23369 0 527912 0 0 RANDALL OOSTRA EX OFFICIO 0 909149 0 397620 0 58133 0 258503 0 13855 0 1637260 0 0 LEE W HAMMERLING MD PRESIDENT, EX OFFICIO 0 497534 0 217001 0 46160 0 62534 0 14912 0 838141 0 0 JEFFREY C KUHN SECRETARY 0 355991 0 144956 0 20323 0 52946 0 21006 0 595222 0 0 KATHLEEN S HANLEY TREASURER 0 460254 0 196212 0 43667 0 89856 0 14946 0 804935 0 0 DEE ANN BIALECKI-HAASE VP MEDICAL OPS, PPG 0 216362 0 0 0 1834 0 21293 0 3462 0 242951 0 0 MATT BODENSTEDT VP, PPCS & GENERAL MGR., TPC 0 150529 0 19110 0 7843 0 9652 0 16359 0 203493 0 0 ANNEMARIE HAINEN VP OPS, PPG 0 137978 0 31398 0 5355 0 26182 0 9140 0 210053 0 0 LORI JOHNSTON PRESIDENT AND CAO, PPG 0 243222 0 74193 0 15068 0 36630 0 18840 0 387953 0 0 KIM MCCLURE VP FINANCE, PPCS 0 136478 0 35357 0 26067 0 32877 0 1452 0 232231 0 0 WILLIAM MUELLER COO, PPG 0 241031 0 78820 0 16380 0 26692 0 14101 0 377024 0 3890 JULIE TOME VP MEDICAL OPS, PPCS 0 205361 0 57802 0 63305 0 210990 0 3668 0 541126 0 0 DAVID BREWER AVP, BUS STRAT DEVELOP 113424 0 500 0 2722 0 12297 0 21788 0 150731 0 0 0 MICHAEL MCKELVEY DIRECTOR, OPERATIONS 125029 0 500 0 1314 0 14430 0 14288 0 155561 0 0 0 GREGORY STANG DIRECTOR, OPERATIONS 113405 0 500 0 5685 0 20693 0 24138 0 164421 0 0 0 GARY AKENBERGER FORMER KEY EMPLOYEE 0 224600 0 79130 0 32403 0 49671 0 22624 0 408428 0 0 DAWN BUSKEY FORMER KEY EMPLOYEE 0 215582 0 71538 0 9304 0 39864 0 11039 0 347327 0 0 MARTIN DANSACK FORMER KEY EMPLOYEE 0 148893 0 33835 0 8741 0 21888 0 13191 0 226548 0 0 DAVID DEWEY FORMER KEY EMPLOYEE 0 150819 0 32327 0 1841 0 226057 0 12171 0 423215 0 0 ROBERT FREDRICK FORMER KEY EMPLOYEE 0 306560 0 78328 0 21896 0 62676 0 7702 0 477162 0 0 A DAVID JAMES FORMER KEY EMPLOYEE 0 192600 0 116705 0 23659 0 17470 0 567 0 351001 0 0 KHURRAM KAMRAN FORMER KEY EMPLOYEE 0 414963 0 55845 0 2482 0 16554 0 24495 0 514339 0 0 PART I, LINE 3 PROMEDICA HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION OF PROMEDICA PHYSICIANS AND CONTINUUM SERVICES, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4A: AS PER OUR EMPLOYMENT AGREEMENT, UPON A QUALIFYING TERMINATION DEFINED AS AN INVOLUNTARY SEPARATION FROM SERVICE OTHER THAN FOR CAUSE, THE EMPLOYEE IS ENTITLED TO SEVERANCE PAY BASED UPON YEARS OF SERVICE. THE TERMS AND CONDITIONS TO RECEIVE SEVERANCE PAYMENTS REQUIRE THE EMPLOYEE TO SIGN A RELEASE OF CLAIMS FORM THAT COVERS ALL SITUATIONS SURROUNDING THE EMPLOYEE'S EMPLOYMENT AND SEPARATION FROM PROMEDICA. JULIE TOME $58,246 PART I, LINE 4B: ALL EMPLOYEES AND AMOUNTS LISTED ARE VOLUNTARY DEFERRALS OR COMPANY CONTRIBUTIONS TO VARIOUS NON-QUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. WILLIAM MUELLER $3,901 PART I, LINE 6B: CERTAIN LISTED PERSONS RECEIVE INCENTIVES BASED ON INDIVIDUAL PRODUCTIVITY NET EARNINGS. FORM 990, PART VI, SECTION A, LINE 6 AS AN OHIO NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A PROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE PARENT CORPORATION AND SOLE MEMBER OF PROMEDICA PHYSICIANS AND CONTINUUM SERVICES. AS THE MEMBER, PHS HAS THE RIGHT TO (A) ELECT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF PROMEDICA PHYSICIANS AND CONTINUUM SERVICES, AND (B) FILL ANY VACANCY ON THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B WHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER AND (VI) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION. FORM 990, PART VI, SECTION B, LINE 11 UNDER THE GUIDANCE OF PROMEDICA HEALTH SYSTEM, INC.'S (PHS) TAX CONSULTANTS, FORM 990S ARE PREPARED BY THE RESPECTIVE ACCOUNTING DEPARTMENT OF EACH AFFILIATE AND REVIEWED BY THE AFFILIATE'S FINANCE LEADERSHIP. AFTER AFFILIATE'S FINANCE LEADERSHIP APPROVAL, COPIES OF THE FORM 990 FOR PHS AND THEIR SUBSIDIARIES ARE PROVIDED TO THE RESPECTIVE COMPANY'S BOARD OF TRUSTEES AND ARE REVIEWED AND SIGNED BY THE RESPECTIVE COMPANY'S PRESIDENT PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C PROMEDICA HEALTH SYSTEM, INC. AND AFFILIATES (PHS) HAVE STANDARDS OF CONDUCT THAT APPLY TO ALL PHS BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER CERTIFICATION STATEMENT WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER CERTIFICATION STATEMENTS ARE COMPILED AND REVIEWED BY THE V.P., AUDIT & COMPLIANCE/CHIEF COMPLIANCE OFFICER (CCO). SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, GENERAL COUNSEL, BUSINESS UNIT PRESIDENTS AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (PRESIDENT/CEO), BASED UPON THEIR RESPECTIVE KNOWLEDGE OF THE BOARD MEMBERS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO ALLOW THEM TO IDENTIFY TO THE V.P., AUDIT & COMPLIANCE, ANY POTENTIAL UNDISCLOSED CONFLICTS. THE AUDIT & COMPLIANCE DEPARTMENT THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER CERTIFICATION STATEMENTS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. THE RESULTS OF THE AUDIT ARE REPORTED DIRECTLY TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE WITH A COPY TO THE PRESIDENT/CEO. THE REPORT INCLUDES A SUMMARY OF THE AUDIT PROCEDURES PERFORMED, ANY SIGNIFICANT CONCERNS IDENTIFIED AND THEIR RESOLUTION. ANY UNRESOLVED CONFLICTS ARE ADDRESSED BY THE AUDIT COMMITTEE WITH RECOMMENDATIONS TO THE FULL BOARD AS NEEDED. FAILURE TO FILE THE CERTIFICATION STATEMENT, OR THE FILING OF A FALSE OR INCOMPLETE CERTIFICATION STATEMENT, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBER'S CERTIFICATION STATEMENT OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL SALARIED EMPLOYEES ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC EMPLOYEE CERTIFICATION QUESTIONNAIRE WITHIN 30 DAYS OF NOTIFICATION. THE HUMAN RESOURCES DEPARTMENT ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND PROVIDES NOTIFICATION TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL EMPLOYEE CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED, COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT, AND A LIST OF ALL NEW EMPLOYEES HIRED DURING THE PREVIOUS 12 MONTHS. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE V.P., AUDIT & COMPLIANCE AND IF NECESSARY DISCUSSED WITH THE BUSINESS UNIT PRESIDENT IN WHICH THE EMPLOYEE WORKS, AND GENERAL COUNSEL. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL OF THE PHS PRESIDENT/CEO. RESULTS OF THE EMPLOYEE PROCESS AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. FAILURE TO COMPLETE THE CERTIFICATION QUESTIONNAIRE, OR THE COMPLETION OF A FALSE OR INCOMPLETE CERTIFICATION QUESTIONNAIRE, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE EMPLOYEE'S CERTIFICATION QUESTIONNAIRE OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. FORM 990, PART VI, SECTION B, LINE 15 PROMEDICA PHYSICIANS AND CONTINUUM SERVICES' TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF PROMEDICA PHYSICIANS AND CONTINUUM SERVICES' TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR. FORM 990, PART VI, SECTION C, LINE 19 PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST. FORM 990, PART III, LINE 4: PROMEDICA HEALTH SYSTEM, INC. - PROGRAM SERVICE ACCOMPLISHMENTS ESTABLISHED IN 1986, PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A MISSION-BASED, LOCALLY OWNED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN AND IS ONE OF THE REGION'S LEADING HEALTHCARE PROVIDERS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN CUTTING-EDGE TECHNOLOGY, INNOVATIVE PROGRAMS AND FAMILY-CENTERED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF A PATIENT'S ABILITY TO PAY. BASED ON NEEDS THAT WE HAVE ASSESSED WITHIN THE COMMUNITIES WE SERVE, PROMEDICA LAUNCHED NEW SERVICES AND PROGRAMS IN 2013 TO HELP MEET THE GROWING DEMANDS OF LOCAL CONSUMERS ACROSS ALL SPECTRUMS OF LIFE, INCLUDING THOSE INDIVIDUALS WHO ARE OFTEN THE MOST VULNERABLE WHEN IT COMES TO HEALTH CARE: THE ELDERLY, POOR AND UNDERSERVED. PROMEDICA'S MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THOSE WE SERVE. THIS IS REFLECTED IN OUR FOUR CORE VALUES, INCLUDING: COMPASSION - WE TREAT OUR PATIENTS AND EACH OTHER WITH RESPECT, INTEGRITY AND DIGNITY; INNOVATION - WE CONTINUALLY SEARCH TO FIND A BETTER WAY FORWARD; TEAMWORK - WE PARTNER WITH OTHERS BECAUSE WE ARE BETTER TOGETHER THAN APART; AND EXCELLENCE - WE STRIVE TO BE THE BEST IN ALL WE DO. PROMEDICA AND ITS AFFILIATES COMPRISE 320 SITES, MORE THAN 1,800 PHYSICIANS AND APPROXIMATELY 15,000 EMPLOYEES AND VOLUNTEERS. DURING 2013, PROMEDICA DISCHARGED 69,357 INPATIENTS AND SERVED MORE THAN 1,394,807 OUTPATIENTS, WHILE HANDLING 269,606 EMERGENCY VISITS SYSTEM-WIDE. AMONG THE REGION'S LARGEST EMPLOYERS, PROMEDICA PLAYS A SIGNIFICANT ROLE IN ECONOMIC DEVELOPMENT AND STABILITY IN OUR REGION. DURING 2013, FOR EVERY ONE DOLLAR OF REVENUE, ANOTHER 33 CENTS WAS CREATED IN OUR SERVICE-AREA ECONOMY, WITH A TOTAL ECONOMIC OUTPUT OF $3.01 BILLION. WE ALSO CREATE A DIRECT ECONOMIC IMPACT WITH OUR REVENUE, PAYROLL AND EMPLOYMENT. ADDITIONALLY, SPENDING ON SERVICES AND MATERIALS WITH VENDORS IN OUR REGION CREATES AN INDIRECT ECONOMIC BENEFIT. ADDITIONALLY, OUR PHYSICIANS, LEADERSHIP TEAM MEMBERS AND EMPLOYEES INDIVIDUALLY CONTRIBUTE PERSONAL RESOURCES TO THE COMMUNITY IN NUMEROUS WAYS - SUCH AS THROUGH TUTORING ELEMENTARY STUDENTS IN READING, PROVIDING MONTHLY HEALTH LECTURES AT LOCAL SENIOR CENTERS, GENEROUSLY CONTRIBUTING TO COMMUNITY FUNDRAISING CAMPAIGNS SUCH AS UNITED WAY, PARTICIPATING IN MEDICAL MISSIONS, SERVING ON LOCAL NOT-FOR-PROFIT BOARDS, AND DONATING NONPERISHABLE GOODS TO NUMEROUS LOCAL FOOD PANTRIES AND CHURCHES - UNDERSCORING A KEY BENEFIT OF PROMEDICA BEING LOCALLY OWNED AND OPERATED. PROMEDICA'S MEMBER AND AFFILIATE HOSPITALS INCLUDE: THE TOLEDO HOSPITAL; TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF THE TOLEDO HOSPITAL); FLOWER HOSPITAL; FOSTORIA HOSPITAL ASSOCIATION; DEFIANCE HOSPITAL, INC.; BAY PARK COMMUNITY HOSPITAL; HERRICK MEMORIAL HOSPITAL, INC.; EMMA L. BIXBY MEDICAL CENTER; PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL (A DIVISION OF THE TOLEDO HOSPITAL); AND ST. LUKE'S HOSPITAL. IN 2013, PROMEDICA ALSO PROVIDED INTEGRATED SERVICES, COMPRISED OF: - PROMEDICA CONTINUING CARE SERVICES CORPORATION, PROVIDING REHABILITATION, HOSPICE, HOME CARE, AMBULATORY AND SENIOR SERVICES, COMMUNITY HEALTH, MEDICAL TRANSPORTATION SERVICES, AND CARE COORDINATION. - PROMEDICA PHYSICIAN GROUP (PROMEDICA PHYSICIANS), WITH MORE THAN 550 HEALTHCARE PROVIDERS, INCLUDING PRIMARY CARE, OBSTETRICS AND SPECIALTY PHYSICIANS, AS WELL AS ADVANCED PRACTICE PROVIDERS; THEY HELP PROMEDICA TO BROADEN THE CARE WE OFFER AREA RESIDENTS, INCLUDING IN SMALLER, OUTLYING COMMUNITIES. - PROMEDICA INSURANCE CORPORATION, THE LARGEST HEALTH MAINTENANCE ORGANIZATION PHYSICALLY LOCATED IN NORTHWEST OHIO. IN 2013, PARAMOUNT ADVANTAGE BEGAN PROVIDING MEDICAID COVERAGE IN ALL OF OHIO'S 88 COUNTIES. TO SUPPORT THESE EFFORTS PARAMOUNT OPENED FIELD OFFICES IN CLEVELAND, COLUMBUS AND THE CINCINNATI/DAYTON AREA. - ACADEMIC HEALTH CENTER CORPORATION, AN ACADEMIC RELATIONSHIP BETWEEN PROMEDICA AND THE UNIVERSITY OF TOLEDO, CONTINUED TO PROMOTE RESEARCH AND EDUCATION THROUGHOUT THE REGION. PROMEDICA HAS ADDITIONAL ACADEMIC RELATIONSHIPS WITH NUMEROUS OTHER INSTITUTIONS INCLUDING THE UNIVERSITY OF MICHIGAN, MICHIGAN STATE UNIVERSITY, AND THE WEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE. - PROMEDICA INDEMNITY CORPORATION, PROVIDING MEDICAL PROFESSIONAL AND COMPREHENSIVE GENERAL LIABILITY COVERAGE FOR PROMEDICA, INCLUDING IN OUTLYING AREAS WHERE PRIMARY-CARE PHYSICIAN RECRUITMENT IS DIFFICULT. - TWELVE CONTROLLED FOUNDATIONS THAT SERVE AS FUNDRAISING ENTITIES FOR THEIR RESPECTIVE HOSPITALS/BUSINESS UNITS AND FACILITIES, SUCH AS THE EBEID HOSPICE RESIDENCE ON THE FLOWER HOSPITAL CAMPUS. PROMEDICA'S SPECIALIZED CARE INCLUDES ONCOLOGY, ORTHOPAEDICS, HEART AND VASCULAR, NEUROLOGY, REHABILITATIVE, AND BEHAVIORAL MEDICINE, AS WELL AS WOMEN'S AND PEDIATRIC CARE. A FUNDAMENTAL PART OF OUR MISSION IS THAT OUR SERVICES ARE TAILORED TO THE NEEDS OF OUR COMMUNITIES AND THEY ARE AVAILABLE TO EVERYONE IN OUR COMMUNITY, REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION TO BEING A STRONG ADVOCATE FOR THE HEALTH AND WELL-BEING OF OTHERS, PROMEDICA PROVIDES AND PROMOTES COMMUNITY WELLNESS, COLLABORATING WITH MORE THAN 300 LOCAL NONPROFIT AGENCIES AND ORGANIZATIONS IN 2013 THAT HAD VALUES AND MISSIONS SIMILAR TO OUR OWN. PROMEDICA IS CONTINUALLY IMPROVING ITS SERVICES, FACILITIES, TECHNOLOGIES, AND OUTREACH EFFORTS TO MEET THE EVER-CHANGING NEEDS OF ITS DIVERSE POPULATIONS. IN DIRECT RESPONSE TO COMMUNITY NEEDS, A FEW EXAMPLES FROM 2013 INCLUDE THE FOLLOWING: - PROMEDICA SPONSORED A SCHOOL-BASED FOOD DRIVE CHALLENGE AS PART OF ITS COME TO THE TABLE INITIATIVE. SCHOOLS RAISED MORE THAN 17,000 POUNDS OF NON-PERISHABLE FOOD ITEMS FOR COMMUNITY FOOD PROGRAMS ACROSS PROMEDICA'S SERVICE AREA. - PROMEDICA'S SUMMER YOUTH EMPLOYMENT PROGRAM PARTNERED 70 CENTRAL-CITY TEENS AGES 16 19 WITH MENTORS IN DEPARTMENTS SUCH AS HUMAN RESOURCES, RADIOLOGY, DIETARY, AND INFORMATION TECHNOLOGY TO LEARN SKILLS INCLUDING CUSTOMER SERVICE, PUNCTUALITY AND BEING ACCOUNTABLE TO OTHERS. - PROMEDICA SYSTEM GRANTS SUBMITTED AN APPLICATION FOR $24 MILLION OVER THREE YEARS TO THE CMS HEALTH CARE INNOVATION AWARDS, ROUND 2. THE PROPOSED POPULATION HEALTH MODEL INTEGRATES EVIDENCE-BASED CLINICAL PROGRAMS AND COMMUNITY SERVICES INCLUDING EDUCATION AND OUTREACH, WELLNESS AND PREVENTION, SOCIAL SUPPORT SERVICES, CASE AND DISEASE MANAGEMENT, HOME CARE COORDINATION AND TELEMEDICINE, CLINICAL PHARMACY - MEDICATION ADHERENCE, AND CARE NAVIGATION AS MEANS FOR IMPROVING COMMUNITY HEALTH AND WELL-BEING. - PROMEDICA FURTHER ENHANCED ITS RELATIONSHIP WITH CLEVELAND CLINIC IN 2013, SIGNING A MEMORANDUM OF UNDERSTANDING TO DEVELOP A HEALTH SYSTEM AFFILIATION THAT WILL ALLOW THE TWO ORGANIZATIONS TO CREATE A CLINICALLY ALIGNED NETWORK FOCUSED ON PROVIDING HIGH-QUALITY, COST-EFFECTIVE AND TECHNOLOGICALLY ADVANCED CLINICAL SERVICES. - PROMEDICA CONTINUED ITS INITIATIVE TO FIGHT OBESITY BY INTRODUCING A PILOT PROGRAM FOR CHILDREN AND ADOLESCENTS WITH A BODY MASS INDEX (BMI) THAT CLASSIFIES THEM AS OBESE. FAMILIES MEET QUARTERLY OVER A 12-MONTH PERIOD WITH A DIETITIAN IN A PHYSICIAN'S OFFICE OR OUTPATIENT CLINIC TO RECEIVE NUTRITION COUNSELING AND ASK QUESTIONS. EACH CHILD'S BMI AND RESPONSES TO A HEALTH QUESTIONNAIRE WILL BE COMPARED BEFORE, DURING AND AFTER THE 12-MONTH PERIOD TO DETERMINE THE PROGRAM'S EFFECTIVENESS. - COORDINATED THROUGH OUR ADVOCACY DEPARTMENT, PROMEDICA CONTINUED TO PROVIDE HEALTH AND NUTRITION EDUCATION TO ELEMENTARY SCHOOL CHILDREN IN GRADES 1 - 6. THE HEALTHY KIDS CONVERSATION MAP(R) PROGRAM IS DESIGNED TO EMPOWER STUDENTS AND THEIR PARENTS/GUARDIANS TO MAKE HEALTHY CHOICES ABOUT FOOD AND EXERCISE. - PROMEDICA PHYSICIANS EXPANDED CARE TO BETTER COVER LOCAL AND RURAL COMMUNITIES, ADDING 88 NEW PRIMARY CARE PHYSICIANS AND SPECIALISTS IN 2013. - PROMEDICA PARTICIPATED IN DOZENS OF COMMUNITY HEALTH FAIRS THAT INCLUDED APPROXIMATELY 8,000 FREE PUBLIC SCREENINGS FOR HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, BODY MASS INDEX AND BONE DENSITY. - AS PART OF ITS HUNGER-FREE INITIATIVE, PROMEDICA ESTABLISHED A FOOD RECLAMATION PROGRAM IN PARTNERSHIP WITH HOLLYWOOD CASINO (ROSSFORD, OHIO), AS WELL AS THE TOLEDO AND FLOWER HOSPITALS, PROVIDING MORE THAN 70,000 POUNDS OF REPACKAGED, UN-SERVED FOOD TO COMMUNITY FEEDING SITES. - PROMEDICA CANCER INSTITUTE'S COMMUNITY OUTREACH INCLUDED SCREENINGS FOR SKIN AND PROSTATE CANCERS, THE FOURTH ANNUAL SURVIVOR CELEBRATION FOR CANCER SURVIVORS, FRIENDS AND CAREGIVERS, AND SPONSORSHIP OF THE ANNUAL SUSAN G. KOMEN RACE(R) FOR THE CURE IN SUPPORT OF BREAST CANCER RESEARCH. - THROUGH ITS ADVOCACY FUND, PROMEDICA CONTINUED TO SUPPORT LOCAL COMMUNITY ORGANIZATIONS THAT PROVIDE ASSISTANCE TO THOSE IN NEED WITH BASIC NECESSITIES THAT DIRECTLY IMPACT INDIVIDUALS' HEALTH AND WELL-BEING. THIS SUPPORT AMOUNTED TO GRANTS TOTALING NEARLY $400,000 IN 2013. - PROMEDICA BEGAN CONSTRUCTION OF THE 55,000 SQUARE FOOT MARY ELLEN FALZONE DIABETES CENTER. OPENING IN 2014, THE FACILITY IS NAMED FOR A YOUNG GIRL WHO DIED FROM JUVENILE DIABETES BEFORE HER FAMILY EVEN KNEW SHE HAD THE DISEASE. LOCATED ON THE CAMPUS OF THE TOLEDO HOSPITAL, IT WILL BRING DIABETES PROGRAMS, SERVICES AND PHYSICIANS TOGETHER IN ONE CONVENIENT LOCATION TO SERVE ALL COMMUNITY MEMBERS WORKING TO MANAGE THEIR DIABETES. - FLOWER HOSPITAL BEGAN RENOVATIONS TO ADD PRIVATE PATIENT ROOMS FOR INPATIENTS AND EXPAND ITS PSYCHIATRIC CARE UNIT. - PROMEDICA CONTINUING CARE SERVICES CORPORATION, IN PARTNERSHIP WITH PARAMOUNT INSURANCE, BEGAN OFFERING TELEHEALTH MONITORING SERVICES TO ELIGIBLE HOME-CARE PATIENTS TO REDUCE HOSPITAL READMISSIONS BY CAREFUL DAILY MONITORING OF VITAL STATISTICS, NUTRITION AND MEDICATION ADHERENCE. - WITH OTHER COMMUNITY PARTNERS, PROMEDICA INTRODUCED THE WITNESS TO HUNGER PHOTO EXHIBIT AT THE TOLEDO MUSEUM OF ART. PHOTOS WERE TAKEN BY INDIVIDUALS FACING HUNGER IN THEIR DAILY LIVES TO DEMONSTRATE ITS IMPACT ON FAMILIES, CHILDREN AND OLDER ADULTS IN OUR COMMUNITY. - BAY PARK COMMUNITY HOSPITAL, EMMA L. BIXBY MEDICAL CENTER, FLOWER HOSPITAL, ST. LUKE'S HOSPITAL, THE TOLEDO HOSPITAL, TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF THE TOLEDO HOSPITAL), AND WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL (A DIVISION OF THE TOLEDO HOSPITAL) SUCCESSFULLY COMPLETED THE 90-DAY REPORTING PERIOD TO VERIFY ADOPTION OF ELECTRONIC HEALTH RECORDS (EHRS). BESIDES IMPROVING BOTH CARE AND CARE COORDINATION, EHRS ARE EXPECTED TO ENSURE ADEQUATE PRIVACY AND SECURITY FOR PERSONAL HEALTH INFORMATION. THEY ALSO AIM TO REDUCE HEALTH DISPARITIES AND IMPROVE POPULATION AND PUBLIC HEALTH. - PROMEDICA PHYSICIANS INTRODUCED ITS NEW PROMEDICA PATIENT PORTAL AT ALL PRIMARY CARE AND SPECIALIST PRACTICES. THE PATIENT PORTAL IS A FREE AND SECURE PLATFORM FOR PATIENTS TO SCHEDULE APPOINTMENTS, MONITOR HEALTH RECORDS, AND OBTAIN CERTAIN LAB TEST RESULTS FROM THE CONVENIENCE OF THEIR OWN HOME COMPUTER. - PROMEDICA PHYSICIANS OPENED PROMEDICA AFTERHOURS IN PERRYSBURG, PROVIDING RESIDENTS WITH DIAGNOSIS AND TREATMENT FOR NON-EMERGENCY MEDICAL ISSUES AS WELL AS PRESCRIPTION SERVICES. PROVIDING NEW OPTIONS FOR MEDICAL CARE WHEN PHYSICIAN OFFICES NORMALLY ARE CLOSED, AFTERHOURS IS STAFFED BY PROMEDICA PHYSICIANS CERTIFIED NURSE PRACTITIONERS AND IS OPEN NIGHTS, WEEKENDS AND HOLIDAYS 365 DAYS A YEAR. - PROMEDICA EMPLOYEES PLEDGED MORE THAN $500,000 TO THE UNITED WAY CAMPAIGN IN 2013, SUPPORTING NUMEROUS COMMUNITY PROGRAMS AND SERVICES ACROSS NORTHWEST OHIO AND SOUTHEAST MICHIGAN. - PROMEDICA COLLABORATED WITH TOLEDO PUBLIC SCHOOLS' TOLEDO EARLY COLLEGE HIGH SCHOOL (TECHS) TO DEVELOP CURRICULUM FOR STUDENTS INTERESTED IN HEALTHCARE CAREERS AS PART OF THE STEMM (SCIENCE, TECHNOLOGY, ENGINEERING, MATHEMATICS, AND MEDICINE) PROGRAM. IN 2013, PROMEDICA CONTRIBUTED $129,920,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE. THESE NUMBERS NOT ONLY INDICATE PROMEDICA'S LONG-STANDING COMMITMENT TO THE COMMUNITY, BUT ALSO FULFILL OUR NOT-FOR-PROFIT STATUS BY IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS IN THE COMMUNITIES WE SERVE. SPECIFICALLY, THROUGH COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, CASH AND IN-KIND CONTRIBUTIONS, COMMUNITY BUILDING ACTIVITIES, AND OTHER COMMUNITY BENEFIT OPERATIONS, PROMEDICA CONTRIBUTED $45,598,000 IN 2013. THESE PROGRAMS INCLUDED FREE COMMUNITY HEALTH SCREENINGS, SUCH AS DIABETES TESTING, BLOOD PRESSURE, BONE DENSITY, BODY MASS, AND CANCER CHECKUPS; MAMMOGRAM SCREENINGS FOR LOW-INCOME AND UNINSURED WOMEN; CHILDHOOD IMMUNIZATIONS; REDUCED-COST SCHOOL-ATHLETIC PHYSICALS; FIRST-AID COVERAGE AT COMMUNITY EVENTS; VOLUNTEER ELEMENTARY SCHOOL MENTORS; PUBLIC HEALTH EDUCATION LECTURES AND SEMINARS; A CHILDHOOD OBESITY PROGRAM; COLLEGE SCHOLARSHIPS FOR STUDENTS ENTERING HEALTHCARE CAREERS; AND MANY OTHER COMMUNITY-BASED INITIATIVES. PROMEDICA ALSO CONTRIBUTED $30,212,000 IN FINANCIAL ASSISTANCE FOR PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. THIS AMOUNT REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS THAT ARE WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. IN ADDITION, PROMEDICA'S COST OF BAD DEBT FOR 2013 WAS $27,571,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $129,920,000 NOTED ABOVE. FURTHER, PROMEDICA CONTINUES TO BE A LEADING PARTICIPANT IN THE LUCAS COUNTY CARENET INITIATIVE - A COLLABORATIVE EFFORT AMONG PROMEDICA, MERCY HEALTH PARTNERS, THE UNIVERSITY OF TOLEDO MEDICAL CENTER, THE CITY OF TOLEDO, AND OTHERS. CARENET WAS CREATED TO PROVIDE FREE OR LOWER-COST HEALTH CARE FOR LOW-INCOME LUCAS COUNTY RESIDENTS. ESTABLISHED IN 2003, CARENET BRIDGES THE GAP BETWEEN ADULTS WITHOUT HEALTH INSURANCE AND NEEDED HEALTHCARE SERVICES. WHILE SOME INDIVIDUALS MAY QUALIFY FOR GOVERNMENTAL INSURANCE PROGRAMS SUCH AS MEDICAID, OTHERS DO NOT; IT IS FOR THESE INDIVIDUALS THAT CARENET WAS ESTABLISHED. ADDITIONALLY DURING 2013, PROMEDICA PROVIDED $54,110,000 OF COMMUNITY BENEFIT THROUGH THE COST - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID PATIENTS. PROMEDICA'S TOTAL COST - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS DURING 2013 WAS $93,196,000 AND IS NOT REFLECTED IN THE COMMUNITY BENEFIT AMOUNT OF $129,920,000 NOTED ABOVE. INDEED, PROMEDICA GOES BEYOND INDUSTRY STANDARDS IN MEETING THE GOAL OF PROVIDING CARE TO EVERYONE, REGARDLESS OF THEIR ABILITY TO PAY. WE PROVIDE HOSPITAL CARE FREE-OF-CHARGE TO ALL FAMILIES WITHOUT INSURANCE WITH INCOMES AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL. IN ADDITION TO FREE CARE FOR THOSE FAMILIES UNDER THIS FEDERAL POVERTY LEVEL, PROMEDICA HOSPITALS PROVIDE SIGNIFICANT DISCOUNTS TO FAMILIES WITH INCOMES OF UP TO 400% OF THE FEDERAL POVERTY LEVEL. IN MANY SITUATIONS, OTHER FUNDING SOURCES ARE SECURED AND ACCOMMODATIONS MADE. PROMEDICA'S POLICIES ARE POSTED AND AVAILABLE IN WRITING IN ALL PROMEDICA FACILITIES. ALSO, FINANCIAL ADVOCATES ARE AVAILABLE TO HELP PATIENTS BY EXPLAINING OUR FREE CARE AND DISCOUNT PROGRAMS, AND TO ASSIST WITH THE PAPERWORK NECESSARY TO QUALIFY FOR GOVERNMENT FUNDING. PATIENT BILLS PROVIDE CLEAR EXPLANATIONS, QUALIFICATIONS AND REMINDERS OF THESE PROGRAMS. IN SUMMARY, PROMEDICA DEMONSTRATES ITS MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES; RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE. PROMEDICA PHYSICIANS AND CONTINUUM SERVICES - PROGRAM SERVICE ACCOMPLISHMENTS PROMEDICA PHYSICIANS AND CONTINUUM SERVICES (PPCS) HAS OVERSIGHT OF ADMINISTRATIVE, ANCILLARY AND PRACTICE MANAGEMENT SERVICES FOR THE TAX-EXEMPT PHYSICIANS' SERVICES COMPONENT OF PROMEDICA PHYSICIAN GROUP, PART OF PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA). PROMEDICA IS A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN, AND IS ONE OF THE REGION'S LEADING HEALTHCARE PROVIDERS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN CUTTING-EDGE TECHNOLOGY, INNOVATIVE PROGRAMS AND FAMILY-CENTERED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF A PATIENT'S ABILITY TO PAY. IN 2013, PPCS, THROUGH PROMEDICA PHYSICIAN GROUP, TREATED MORE THAN 1.4 MILLION PATIENTS IN MORE THAN 130 PROVIDER OFFICES. PPCS CONTRACTED WITH VARIOUS BUSINESSES AND INSURERS. THESE SERVICES ENABLE PHYSICIANS TO DEVOTE MORE RESOURCES TO PROVIDING HIGH-QUALITY CARE TO THEIR PATIENTS VERSUS SPENDING TIME MANAGING THEIR OWN PRACTICE OPERATIONS. PPCS AND ITS EMPLOYEES SUPPORTED THE COMMUNITIES IN WHICH THEY WORK THROUGH THEIR INVOLVEMENT IN NUMEROUS ACTIVITIES THROUGHOUT 2013, INCLUDING THE SUSAN G. KOMEN(R) RACE FOR THE CURE AND THE AMERICAN CANCER SOCIETY'S RELAY FOR LIFE; SERVING ON LOCAL NOT-FOR-PROFIT BOARDS; DONATING THEIR TIME AND EXPERTISE FOR MEDICAL MISSIONS; AND CONTRIBUTING TO MYRIAD FUNDRAISING ACTIVITIES IN SUPPORT OF FINANCIAL ASSISTANCE, BUILDING RENOVATIONS, AND PATIENT AND FAMILY SERVICES WITHIN PROMEDICA HOSPITALS. ADDITIONALLY, OUR PHYSICIANS TRAINED MEDICAL RESIDENTS, AS WELL AS MENTORED LOCAL HIGH SCHOOL AND UNIVERSITY STUDENTS INTERESTED IN HEALTHCARE CAREERS. PPCS PROVIDED 176 JOBS THROUGH DIRECT EMPLOYMENT, THEREBY CONTRIBUTING TO THE ECONOMIC STABILITY OF NORTHWEST OHIO. A TOTAL OF $6,166,000 IN NET PAYROLL WAS EXPENDED IN THE NORTHWEST OHIO REGION IN 2013. A TOTAL OF $379,000 WAS WITHHELD FROM EMPLOYEES IN STATE AND LOCAL TAXES. IN SUMMARY, PPCS DEMONSTRATES PROMEDICA'S MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, PROMEDICA PROVIDES THESE HEALTHCARE SERVICES; RECRUITS AND TRAINS HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDES APPROPRIATE FINANCIAL ASSISTANCE; OFFERS SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENTS FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE. COMMUNITY BENEFIT DEFINITIONS PROMEDICA HEALTH SYSTEM, INC. AND ITS SUBSIDIARIES (THE SYSTEM) PREPARES ITS COMMUNITY BENEFIT REPORTS USING REPORTING GUIDELINES PUBLISHED BY THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES AND CONSISTENT WITH FORM 990, SCHEDULE H, HOSPITALS, REPORTING. COMMUNITY BENEFITS ARE PROGRAMS AND ACTIVITIES THAT PROVIDE TREATMENT AND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. COMMUNITY BENEFITS REPORTED BY THE SYSTEM RESPOND TO AN IDENTIFIED COMMUNITY NEED AND MEET AT LEAST ONE OF THE FOLLOWING CRITERIA: - IMPROVE ACCESS TO HEALTHCARE SERVICE. - ENHANCE THE HEALTH OF THE COMMUNITY. - ADVANCE MEDICAL OR HEALTHCARE KNOWLEDGE. - RELIEVE OR REDUCE THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS. FINANCIAL ASSISTANCE CONSISTENT WITH ITS MISSION, THE SYSTEM PROVIDES A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO PATIENTS WITH LIMITED OR NO ABILITY TO PAY THEIR BILL. PROMEDICA HOSPITALS PROVIDE FREE CARE TO THOSE UNINSURED PATIENTS WITH INCOMES UP TO 200% OF THE FEDERAL POVERTY LEVEL. SIGNIFICANT DISCOUNTS ARE ALSO PROVIDED ON A SLIDING SCALE TO UNINSURED PATIENTS UP TO 400% OF THE FEDERAL POVERTY LEVEL. FINANCIAL ASSISTANCE IS REPORTED IN THE FORM OF COST TO PROVIDE SERVICES AND HAS BEEN REDUCED TO REFLECT REIMBURSEMENT RECEIVED FROM STATE PROGRAMS DESIGNED TO RELIEVE THE BURDEN OF PROVIDING FINANCIAL ASSISTANCE. THE COST OF FINANCIAL ASSISTANCE DOES NOT INCLUDE THE COSTS FOR ACCOUNTS THAT ARE WRITTEN OFF TO BAD DEBT FOR PATIENTS THAT DO NOT PAY THEIR BILL. GOVERNMENT-SPONSORED HEALTH CARE GOVERNMENT-SPONSORED HEALTH CARE INCLUDE SERVICES THAT ARE REIMBURSED OR PARTIALLY REIMBURSED THROUGH FEDERAL, STATE AND LOCAL MEANS-TESTED PROGRAMS SUCH AS MEDICAID. THE SYSTEM INCLUDES THE UNPAID COSTS OF THESE PUBLIC PROGRAMS TO THE EXTENT THAT PAYMENTS RECEIVED ARE LESS THAN THE COSTS OF PROVIDING SERVICES. THE UNPAID COSTS OF TREATING MEDICARE PATIENTS IS REPORTED SEPARATELY AND IS NOT INCLUDED IN THE SYSTEM'S COMMUNITY BENEFIT REPORT. ADDITIONALLY, THE COST OF FINANCIAL ASSISTANCE HAS BEEN ELIMINATED FROM ANY AMOUNTS REPORTED IN THIS CATEGORY. COMMUNITY HEALTH IMPROVEMENT SERVICES & COMMUNITY BENEFIT OPERATIONS COMMUNITY HEALTH IMPROVEMENT SERVICES INCLUDE ACTIVITIES CARRIED OUT FOR THE EXPRESS PURPOSE OF IMPROVING COMMUNITY HEALTH. THESE ACTIVITIES DO NOT GENERATE INPATIENT OR OUTPATIENT BILLS AS THEY EXTEND BEYOND PATIENT CARE ACTIVITIES AND ARE SUBSIDIZED BY THE SYSTEM. COMMUNITY BENEFIT OPERATIONS INCLUDE COSTS ASSOCIATED WITH DEDICATED STAFF, COMMUNITY HEALTH NEED AND/OR ASSESSMENT, AND OTHER COSTS ASSOCIATED WITH COMMUNITY BENEFIT PLANNING AND ADMINISTRATION. HEALTH PROFESSIONS EDUCATION HEALTH PROFESSIONS EDUCATION INCLUDE COSTS FOR INTERNSHIPS AND RESIDENCY EDUCATION, THE PROVISION OF A CLINICAL SETTING FOR UNDERGRADUATE/VOCATIONAL TRAINING FOR STUDENTS OUTSIDE THE ORGANIZATION, AND FUNDING FOR EDUCATION THAT IS LINKED TO COMMUNITY SERVICES AND HEALTH IMPROVEMENT. SUBSIDIZED HEALTH SERVICES SUBSIDIZED HEALTH SERVICES ARE SERVICES PROVIDED TO THE COMMUNITY DESPITE A FINANCIAL LOSS. THESE SERVICES GENERATE A BILL FOR REIMBURSEMENT, AND INCLUDE CLINICAL PATIENT CARE SERVICES THAT ARE PROVIDED BECAUSE THEY ARE NEEDED IN THE COMMUNITY AND OTHER PROVIDERS ARE UNWILLING, OR UNABLE, TO PROVIDE THE SERVICES, OR THE SERVICES OTHERWISE WOULD NOT BE AVAILABLE TO MEET PATIENT DEMAND. RESEARCH RESEARCH ACTIVITIES INCLUDE CLINICAL AND COMMUNITY HEALTH RESEARCH, AS WELL AS STUDIES ON HEALTHCARE DELIVERY. THE AMOUNT REPORTED FOR THE SYSTEM IS REDUCED BY ANY EXTERNAL SUBSIDIES, SUCH AS GRANTS. CASH AND IN-KIND CONTRIBUTIONS CASH AND IN-KIND CONTRIBUTIONS INCLUDE FUNDS AND IN-KIND SERVICES DONATED TO COMMUNITY ORGANIZATIONS AND/OR THE COMMUNITY AT LARGE. IN-KIND SERVICES INCLUDE HOURS DONATED BY STAFF TO THE COMMUNITY WHILE ON WORK TIME; AS WELL AS DONATION OF FOOD, EQUIPMENT AND SUPPLIES. 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